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Systems: Infection AB > Zoonoses > Flashcards

Zoonoses Flashcards

1
Q

What is zoonoses?

A
  • Infections that can pass between living animals and humans
  • The source of the disease is from the animal
  • Infections that are naturally transmitted between vertebrae animals and humans
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2
Q

Why are malaria, snail fever, river blindness and lymphatic filariasis not considered zoonoses?

A

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

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3
Q

What is anthroponosis?

A

‘Reverse zoonoses’ in that humans are infecting animals

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4
Q

Give examples of anthoponosis.

A
  • Influenza (virus affecting birds, pigs)
  • ‘Strep throat’ (bacteria affecting dogs)
  • Leishmaniasis (parasite affecting dogs e.g.)
  • Chytridiomycosis (fungus affecting amphibians)
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5
Q

What can cause zoonoses?

A
  • Virus
  • Bacteria
  • Fungus
  • Parasites
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6
Q

What strategies have pathogens developed to ensure their own survival/propagation?

A
  • Causing a chronic infection to survive

- Have a non-human reservoir

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7
Q

Give examples of bacteria zoonoses.

A
  • Salmonella
  • Campylobacter
  • Shigella
  • Anthrax
  • Brucella
  • E-coli (verotoxigenic)
  • Leptospirosis
  • Plague
  • Psittacosis (Ornitosis)
  • Q fever
  • Tularaemia
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8
Q

Give examples of virus zoonoses.

A
  • Rabies
  • Avian influenza
  • Crimean-Congo haemorrhagic fever (CCHF)
  • Ebola virus disease
  • Lassa Fever
  • Rift Valley fever
  • West Nile Fever
  • Yellow Fever
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9
Q

Give examples of parasite zoonoses.

A
  • Cysticercosis
  • Echinococcosis
  • Toxoplasmosis
  • Trichinellosis
  • Visceral larva migrans (toxocara)
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10
Q

Give examples of fungi zoonoses.

A
  • Dermatophytoses

- Sporotrichosis

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11
Q

Give examples of prion zoonoses

A

BSE/CJDv

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12
Q

What are common zoonoses in the UK?

A
  • Salmonella
  • Campylobacter
  • Toxoplasma
  • (Psittacosis: Chlamydophila psittaci)
  • (Q-fever: Coxiella Burnetti)
  • Ringworm/dermatophytosis
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13
Q

What zoonoses are now rarely seen in the UK?

A
  • Anthrax
  • Rabies
  • Bubonic plague
  • Tularaemia
  • Acute brucellosis
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14
Q

What is an emerging zoonoses?

A

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

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15
Q

Give examples of emerging zoonoses.

A
  • Avian influenza
  • Nipah virus
  • Rabies
  • Brucellosis
  • Monkeypox
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16
Q

What is rabies

A

Viral Infection (lyssavirus) transmitted from the bite of an infected animal

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17
Q

What animal can transmit rabies?

A

Wide range of wild animal transmitters:

  • Dogs (97%), bats
  • Also monkeys, foxes, racoons, skunks, wolves, cats
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18
Q

How many people die from rabies per year?

A

App. 55000 people, mainly children, die each year

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19
Q

What is the incubation period for rabies?

A

2 weeks to several months

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20
Q

What happens once the rabies virus enters the body?

A

It travels to the brain via the peripheral nerves and causes an acute encephalitis

  • Malaise, headache & fever
  • Progressing to mania, lethargy & coma
  • Over production of saliva & tears
  • Unable to swallow & ‘hydrophobia’
  • Death by respiratory failure
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21
Q

How is rabies diagnosed?

A
  • Diagnosis is difficult
  • PCR of saliva or CSF
  • Often confirmed post mortem on brain biopsy
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22
Q

How should rabies be treated?

A

It is always fatal if left untreated so immediately after bite give post-exposure prophylaxis:

  • Human rabies immunoglobulin (HRIG)
  • Infiltrated round the bite (if possible)
  • +4 doses of rabies vaccine over 14 days
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23
Q

How is brucellosis transmitted?

A

Organisms are excreted in milk, placenta and aborted foetus

24
Q

How are humans infected with brucellosis?

A
  • During milking infected animals
  • During parturition
  • Handling carcasses of infected animals
  • Consumption of unpasteurized dairy products
25
Q

What organism is responsible for brucellosis?

A

Brucella, a small gram negative coccobacilli

26
Q

What are the 3 species of brucella?

A
  • Melitensis
  • Suis
  • Abortus
27
Q

What are the features of the melitensis species of brucella?

A
  • Most virulent in man
  • Goat, sheep and camel host
  • Found in the Mediterranean, S. America, China, India and the Middle East
28
Q

What are the features of the suis species of brucella?

A
  • Pig host

- Found in N. America, S. America and SE Asia

29
Q

What are the features of the abortus species of brucella?

A
  • Least virulent in man
  • Cattle and buffalo host
  • Found worldwide
30
Q

What is the incubation period for brucellosis?

A

5-30 days (up to 6 months)

31
Q

What is the acute presentation of brucellosis?

A

Lasts 1-3 weeks

  • High ‘undulant’ fever
  • Weakness, headaches
  • Drenching sweats
  • Splenomegaly
32
Q

What is the subacute presentation of brucellosis?

A

Lasts over 1 month

-Fever and joint pain (knee, hip, back SI joints)

33
Q

What is the chronic presentation of brucellosis?

A

Lasts for months or years

  • Flu-like symptoms
  • Malaise
  • Depression
  • Chronic arthritis
  • Endocarditis
  • Epidiymo-orchitis
  • Rarely meningism
  • Splenomegaly
34
Q

What is the subclinical presentation of brucellosis?

A

Most common form

-50% of exposed have positive serology

35
Q

What is the treatment for brucellosis?

A
  • Long acting Doxycycline for 2-3 months + Rifampicin, or + intramuscular gentamycin for first week(s)
  • Relapses occur due to intracellular organism (5-10%)
  • Chronic form – difficult to treat
  • Add Cotrimoxazole for 2 weeks in CNS disease
36
Q

What organism causes leptospirosis?

A
  • L. icterohaemorrhagica from rats

- L. hardjo from cattle

37
Q

What is another name for leptospirosis?

A

Rat fever

38
Q

How does L.hardjo infection present?

A
  • Fever
  • Meningism
  • NO JAUNDICE
39
Q

How does L. icterohaemorrhagica infection present?

A

Flu-like symptoms then jaundice and renal failure

40
Q

What are the featres of leptospira?

A 
Thin, highly mobile spirochaetes
-One of the most widespread
Zoonosis
-Many reservoir host
-Survive in the environment
for weeks to months
-Penetrate abraded skin or
mucous membranes and 
cause systemic illness-
41
Q

How is the epidemiology of leptospirosis changing?

A
  • Used to be an occupation disease

- Now outbreaks associated with recreational challenges. unexplained emergences and disaster associated outbreaks

42
Q

How do humans contact leptospirosis?

A
  • Humans are incidental hosts
  • Direct contact with the animal
  • Contact with environment (water) contaminated with their urine
43
Q

What is the incubation period for leptospirosis?

A

2-30 days (10-14)

44
Q

What are the symptoms of leptospirosis infection?

A
  • Undifferented fever
  • Myalgia
  • Headaches
  • Abdominal pain
45
Q

What symptoms can occur in severe leptospirosis?

A
  • Weil’s disease (Triad of jaundice, AKI, bleeding)
  • Pulmonary haemorrhage (PH)
  • Case fatality 5-40%, >50% in PH
46
Q

How is leptospirosis diagnosed?

A
  • Microscopic agglutination test (MAT) requires paired sera – not useful in clinical context
  • ELISA serology - suboptimal
  • PCR?
  • Culture – take at least one week on special media

-Think of the diagnosis in contect of the patient’s history

47
Q

What is the treatment for leptospirosis?

A

Early treatment

  • Doxycline for mild disease
  • IV penicillin for severe disease
  • Prompt dialysis
  • Mechanical ventilation
48
Q

How is Lyme borrelios transmitted?

A

Tick (Ixodes ricinus in Europe)

49
Q

When is Lyme disease most common?

A

Summer months ( ticks active >4C and in humid conditions)

50
Q

What organism is responsible for Lyme disease in Europe?

A

Borrelia burgdoferi

51
Q

What is erythema migrans?

A
  • A rash associated which can provide the clinical diagnosis of Lyme disease
  • Single or multiple lesions
  • Occur in 80-90% of cases
  • Appears 3-90 days after the bite (7-30)
52
Q

What is acrodermatitis chronic atroficans?

A
  • A late manifestation of Lyme disease
  • Occurs in elderly people
  • Bluish-red discolouration of the extensor surfaces of distal extremities which progresses over monthe to years to atrophic phase
  • Peripheral neuropathy is common
53
Q

What is lymphocytoma?

A
  • A bluish solitary painless nodule that usually occurs on the earlobes or areola
  • More common in children
  • Can occur in Lyme disease
54
Q

What is neuroborreliosis?

A
  • A triad of facial nerve palsy, radicular pain (migratory and worse at night) and lymphocytic meningitis
  • Onset 2-6 (1-2) weeks after tick bite (Lyme’s)
  • Often preceded by EM
55
Q

What symptoms of Lyme disease are more common in the USA?

A

Cardiac disorders

  • Carditis (peri-myocarditis)
  • Heart block

Arthritis
-Large joints, often knees

56
Q

How is Lyme disease diagnosed?

A
  • EM by clinical observation
  • ACA and lymphocytoma: high serology titres
  • Arthritis: very high serology titres of synovial fluid and PCR
  • Neuro symptoms consistent with LNB & other causes excluded
  • CSF pleocytosis (WBC in CSF), often lymphocytic
  • Paired blood and CSF serolgoy
57
Q

What is the treatment for Lyme disease?

A
  • Oral Doxycycline or Amoxicillin, or IV Ceftriaxone

- Most manifestations treat for 21 days (28 in arthritis or ACA)

Systems: Infection AB (12 decks)

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