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Infection > Zoonoses > Flashcards

Zoonoses Flashcards

1
Q

What are zoonoses?

A

Infections that can pass between living animals and humans

Source of the disease is from the animal

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2
Q

What is the WHO definition of zoonoses?

A

Infections that are naturally transmitted between vertebrate animals and humans

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3
Q

Give examples of infections transmitted by animals but which are not zoonoses, why are these not zoonoses?

A

Malaria
Schistosomiasis
Oncoceriasis
Elephantitis

Even though these are transmitted from animals, they depend on the human host for part of their life cycle

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4
Q

What is anthroponosis?

A

‘reverse zoonosis’ - infections in humans that can infect animals

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5
Q

Give examples of anthoponoses

A

Influenza
Strep throat
Leishmaniasis
Chytridiomycosis

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6
Q

What percentage of the 1415 pathogens currently known to affect humans are zoonotic?

A

61%

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7
Q

Pathogen types which can cause zoonoses

A

Viruses
Bacteria
Parasites
Fungi

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8
Q

Examples of bacterial zoonoses

A 
Salmonella 
Campylobacter 
Shigella 
Anthrax 
Brucella 
E. coli 
Leptospirosis 
Plague 
Psittacosis 
Q fever 
Tularaemia
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9
Q

Examples of viral zoonoses

A 
Rabies 
Avian influenza 
Crimean-Congo Haemorrhagic fever 
Ebola virus disease 
Lassa fever 
Rift valley fever 
West Nile fever 
Yellow fever
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10
Q

Examples of parasitic zoonoses

A 
Cysticercosis 
Echinococcosis 
Toxoplasmosis 
Trichinellosis 
Visceral larva migrans
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11
Q

Examples of fungal zoonoses

A

Dermatophytoses

Sporotrichosis

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12
Q

Examples of prion zoonoses

A

BSE

CJD V

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13
Q

Common zoonoses in the UK

A 
Salmonella 
Campylobacter 
Toxoplasma 
Psittacosis 
Q fever 
Ringworm
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14
Q

Uncommon zoonoses in the UK

A 
Anthrax 
Rabies 
Bubonic plague 
Tularaemia 
Acute brucellosis
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15
Q

What is an emerging zoonosis?

A

A zoonosis that is newly recognised or newly evolved, or one that had occurred previously but shows an increase in incidence or expansion in geographical, host or vector range

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16
Q

Examples of emerging zoonoses

A 
Avian influenza 
Nipah virus 
Rabies 
Brucellosis 
Monkeypox
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17
Q

How is rabies transmitted?

A

Lyssavirus transmitted from the bite of an infected animal, most commonly dogs (97%) and bats, although there is a wide range of animal transmitters

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18
Q

Deaths caused per year by rabies

A

Approximately 55,000

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19
Q

Incubation period of rabies in humans

A

Ranges from 2 weeks to several months

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20
Q

How does the rabies virus work?

A

Travels to the brain via peripheral nerves and causes acute encephalitis

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21
Q

Clinical features of rabies

A 
Malaise, headache, fever 
Progression to mania, lethargy and coma 
Over-production of saliva and tears 
Inability to swallow 
Hydrophobia 
Death due to respiratory failure
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22
Q

What post-exposure prophylaxis should be given immediately after a bite from an animal with rabies?

A

Human rabies immunoglobulin
Infiltrated around the bite if possible
4 doses of rabies vaccine over 14 days

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23
Q

How are humans infected by brucellosis?

A

During milking infected animals
During parturition
Handling carcasses of infected animals
Consumption of unpasteurised dairy products

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24
Q

What species of brucella is the most virulent in humans?

A

Melitensis

25
Q

Clinical features of brucellosis

A

Incubation period of 5-30 days

Can be acute, subacute, chronic or subclinical

26
Q

Acute presentation of brucellosis

A 
Lasts 1-3 weeks 
High undulant fever 
Weakness
Headaches 
Drenching sweats 
Splenomegaly
27
Q

Subacute presentation of brucellosis

A

Lasts over 1 month
Fever
Joint pains

28
Q

Chronic presentation of brucellosis

A 
Lasts months or years 
Flu-like symptoms 
Malaise 
Depression 
Chronic arthritis 
Endocarditis 
Epididymo-orchitis 
Meningism, splenomegaly rarely
29
Q

Subclinical presentation of brucellosis

A

Most common form

50% of exposed will have positive serology

30
Q

Treatment of brucellosis

A

Long acting doxycycline for 2-3 months
Rifampicin or IM gentamicin for the first week

Add co-trimoxazole for 2 weeks in CNS disease

31
Q

Causative organism of leptospirosis

A 
L. Icterohaemorrhagica (rats)
L. Hardjo (cattle) 
L. Canicola (dogs) 
L. Pomona (pigs) 
L. Australis (hedgehogs) 
L. Grippotyphosa (voles)
32
Q

Presentation of leptospirosis

A

Flu like symptoms followed by jaundice and renal failure

33
Q

What is the commonest causative organism of leptospirosis?

A

L. Hardjo

34
Q

Treatment of leptospirosis

A

Penicillin as early as possible

35
Q

What leptospirosis infection is usually benign and self-limiting?

A

L. Hardjo

36
Q

Cause of toxoplasmosis

A

Intracellular protozoan parasite - toxoplasma gondii

37
Q

Main source of toxoplasmosis

A

Cats

30-80% of domestic adult cats show evidence of past exposure

38
Q

How do humans acquire toxoplasmosis infection?

A

From oocysts in cat faeces or from trophozoites in undercooked meats

39
Q

Clinical features of acute form of toxoplasmosis infection

A

Pneumonia
Fever
Cough
Rash

40
Q

Clinical features of chronic form of toxoplasmosis infection

A

Lymphadenopathy
Lymphocytosis
Atypical mononuclear cells on blood film
Chorio-retinitis and uveitis

41
Q

Clinical features of congenital form of toxoplasmosis infection

A 
Hydrocephalus
Micro-ophthalmos 
Microcephaly 
Convulsions 
Calcification in brain on x-ray 
Usually fatal
42
Q

Diagnosis of toxoplasmosis infection

A

Serological
Toxoplasma dye test, positive within 1 month of infection and remains positive for life
IgM antibodies - indicate acute infection

43
Q

Treatment of toxoplasmosis infection

A

Most will not require treatment
Sulphonamide and pyrimethamine
Folate antagonists
Occasionally tetracycline

44
Q

How is Lyme disease transmitted?

A

By ticks - ixodes recinus

45
Q

Species of ixodes genus responsible for Lyme disease

A

I. ricinus
I. scapularis/pacificus
I. persulcatus

46
Q

Pathogen responsible for Lyme disease

A

Borrelia Burgdorferi

47
Q

In what percentage of cases of Lyme disease doe erythema migrans occur?

A

80-90% of cases

7-30 days after the bite

48
Q

What patients are most affected by acrodermatitis chronica atroficans as a result of Lyme disease?

A

Elderly

49
Q

What patients are most affected by lymphocytoma as a result of Lyme disease?

A

Children

50
Q

How does acrodermatitis chronica atroficans present?

A

Bluish-red discolouration of the extensor surfaces of the distal extremities, progression over months to years
Peripheral neuropathy common

51
Q

How does lymphocytoma present?

A

Bluish, solitary, painless nodules on earlobe or areola

52
Q

What percentage of patients with Lyme disease will develop neuroborreliosis?

A

approximately 15%

53
Q

How does neuroborreliosis present?

A

Triad of facial nerve palsy, radicular pain and lymphocytic meningitis
Onset of symptoms 2-6 weeks (can range from 1-12 weeks) after the bite
Preceded by erythema migrans in 30-50%

54
Q

Conditions more common in individuals with Lyme Borreliosis

A

Cardiac disorders
Carditis
Heart block
Arthritis

55
Q

How are erythema migrans, acrodermatitis chronica atroficans, lymphocytoma and arthritis diagnosed?

A

EM - clinical, no labs
ACA and lymphocytoma - clinical and high serology titres
Arthritis - very high serology titres from synovial fluid

56
Q

Clinical and laboratory findings in Lyme disease

A

Neuro symptoms consistent with neuroborreliosis
CSF pleocytosis, often lymphocytic
Blood and intrathecal Bb-specific antibody production

57
Q

Management of erythema migrans

A

Doxycycline, amoxicillin or cefuroxime axetil recommended for two weeks

58
Q

Management of acrodermatitis chronica atroficans

A

PcV 2g TDS
or
doxycycline 200mg OD for 3 weeks

59
Q

Management of Lyme neuroborreliosis

A

Doxycycline 200mg OD-BD
10-14 days

or

Ceftriaxone 2g OD for 14 days

Infection (14 decks)

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