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Infection > Zoonoses > Flashcards

Zoonoses Flashcards

1
Q

What is the WHO definition of zoonoses?

A

Infections that are naturally transmitted between vertebrate animals and humans

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2
Q

Malaria, Schistosomiasis, Oncoceriasis and elephantiasis are NOT zoonoses. Why do these not classify as zoonoses?

A

Even though they are transmitted from animals, they depend on human host as part of life cycle

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3
Q

What are examples of an anthroponosis (humans infecting animals. ‘Reverse zoonoses’?

A

> Influenza (virus infecting birds, pigs)
‘Strep throat’ (bacteria affecting dogs)
Leishmaniasis (parasite infecting dogs)
Chytridiomycosis (fungus affecting amphibians)

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4
Q

List some examples of bacterial zoonoses? [7]

A
  • Salmonella
  • Campylobacter
  • Shigella
  • E. coli
  • Leptospirosis
  • Plague
  • Psittacosis
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5
Q

List some examples of viral zoonoses? [4]

A
  • Rabies
  • Avian influenza
  • Ebola
  • West Nile fever
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6
Q

List some examples of parasite zoonoses? [4]

A
  • Toxoplasmosis
  • Cysticercosis
  • Echinococcosis
  • Visceral larva migrans
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7
Q

What are fungal 2 and prion 1 zoonoses?

A

Fungal

  • Dermatophytoses
  • Sporotrichosis

Prions
-CJD

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8
Q

What are examples of more common zoonoses in the UK? [5]

A
  • Salmonella
  • Campylobacter
  • Toxoplasma
  • Psittacosis: Chlamydophila psittaci
  • Q fever: Coxiella burnetti
  • Ringworm
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9
Q

What are examples of rarely seen zoonoses in the UK? [5]

A
  • Rabies
  • Bubonic plague
  • Tularaemia
  • Acute brucellosis
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10
Q

List some emerging zoonoses? (newly evolved/occurred previously but shows increase in incidence/expansion in geographical, host or vector range) [5]

A
  • Avian influenza
  • Nipah virus
  • Rabies
  • Brucellosis
  • Monkeypox
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11
Q

What is rabies and how is it transmitted?

What are 4 animals that are involved in its route of transmission

A

Viral infection (lyssavirus) transmitted via animal bite

Animals include dogs (97%), bats, monkeys, foxes, racoons

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12
Q

What is the incubation period of rabies?

A

Can be 2 weeks to several months

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13
Q

Rabies travels to brain via peripheral nerves. What does it then cause?
4 points
Death by…

A

Acute encephalitis

  • Malaise, headache and fever
  • Progress to mania, lethargy and coma
  • Overproduction of saliva and tears
  • Can’t swallow and hydrophobia
  • Death by resp failure
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14
Q

What is the diagnosis [2] and treatment [4] of Rabies?

Is diagnosis easy/difficult? When is a diagnoses most commonly made in reality?

A

Diagnosis

  • PCR of saliva/CSF
  • Difficult, often found on post mortem

Treatment

  • Wash wound and immediately give post exposure prophylaxis: even if already previous vaccinated
  • If previous immunization, 2 further doses of vaccine
  • No previous immunisation, give human rabies immunoglobulin and full course of vaccination, around wound

Full course - 4 doses of rabies vaccine over 14d

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15
Q

Brucellosis causing organisms are excreted in milk, placenta and aborted foetuses of livestock. When can humans become infected? [4]

A

> During milking infected animals
During parturition
Handling carcasses of infected animals
Consumption of unpasteurized dairy products

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16
Q

Describe the Brucella organisms microscopic appearance

A

Small, gram negative coccobacilli

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17
Q

Discuss the following about Brucella Melitensis (1st of 3 Brucella organisms)

  • Human virulence
  • Animal host
  • Geographic area
A
  • Most virulent in humans out of 3 organisms
  • Goats, sheep and camels are hosts
  • Mediterranean area
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18
Q

Discuss the following about Brucella Suis (2nd of 3 Brucella organisms)

  • Human virulence
  • Animal host
  • Geographic area
A
  • Relatively virulent in humans
  • Pigs are hosts
  • N/S America, SE Asia
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19
Q

Discuss the following about Brucella Abortus (3rd of 3 Brucella organisms)

  • Human virulence
  • Animal host
  • Geographic area
A
  • Least virulent in humans out of 3 organisms
  • Cattle, buffalo are hosts
  • Worldwide
20
Q

What is the incubation period of Brucellosis?

A

5-30 days (up to 6m)

21
Q

What do you see in an acute presentation of Brucellosis? (lasts 1-3 weeks) [4]

A
  • High ‘undulant’ fever
  • Weakness, headaches
  • Drenching sweats
  • Splenomegaly
22
Q

What do you see in a subacute presentation of Brucellosis? (>1m) [2]

A
  • Fever

- Joint pains (knee, hip, back)

23
Q

What do you see in a chronic presentation of Brucellosis? (months/years) [5]

A
  • Flu like symptoms, Malaise, Splenomegaly, Chronic arthritis
  • Endocarditis
  • Depression
  • Epididymo-orchitis
  • Rarely meningism
24
Q

In subclinical brucellosis, how many have positive serology?

A

50%

25
Q

What is the treatment for Brucellosis? [3]

What would you give in CNS disease?

A

> Long acting Doxycycline 2-3 months
Rifampicin
IM gentamycin for first weeks

Add cotrimoxazole for 2 weeks in CNS disease

26
Q

Regarding leptospirosis, what organisms cause it and how is it transmitted? [3]
2 Types

A

> Leptospira icterohaemorrhagica (fish)
Leptospira hardjo (cattle) is commonest form now

Cattle, fish, rats

27
Q

What are the leptospirosis symptoms when infected with L. icterohaemorrhagica? [3]

A
  • Flu symptoms
  • Jaundice
  • Renal failure
28
Q

What are the leptospirosis symptoms when infected with L. hardjo? [3]

A
  • Fever
  • Meningism
  • No jaundice
29
Q

Leptospirosis organisms (spirochaetes) exist in contaminated water, mud and soil. What activities associated with these pose as risk factors? [7]

A
  • Planting
  • Hunting
  • Gutting
  • Canoeing
  • Weeding
  • Fishing
  • Swimming
30
Q

What contact is needed for humans to be infected? [3]

What is the incubation period?

A

> direct contact with animal (cattle/fish/rats)
Contact with environment
contaminated with urine

Incubation period 2-30 days (usually 10-14d)

31
Q

What are the symptoms of Leptospirosis? [4]

A
  • Undifferentiated fever
  • Myalgia
  • Headaches
  • Abd pain
32
Q

What is the treatment for Leptospirosis? [3]

A
  • Doxycycline for mild disesase, IV penicillin for severe
  • Prompt dialysis
  • Mechanical ventilation
33
Q

Lyme disease - most common pathogen in Europe

What is the causative organism?

A

By tick:
-Ixodes ricinus (Europe)

Causative organism:
Borrelia burgdorferi

34
Q

Erythema Migrans presents in 80-90% of Lyme cases. When does it present after bite?
Describe erythema migrans visible appearance

A

7-30 days after bite

Redness spreads and clears in middle forming a ring

35
Q 
Acrodermatitis Chronica Atroficans presents in the late stage of Lyme disease. How does it present?
Visible appearance
Duration, progression
Associated sx [1]
Sites
A

> Bluish-red discolouration: progresses over months to years to atrophic phase
Peripheral neuropathy common
Extensor surfaces of distal extremities

36
Q

Lymphocytoma is more common in children than adults in Lyme sufferers. How does it present?

A

Bluish solitary painless nodule on earlobe or areola

37
Q

Neuroborreliosis presents in around 15% Lyme sufferers. How does it present? [3]
When does it present

A

> 2-6 weeks after bite
Facial nerve palsy
Radicular pain
Lymphocytic meningitis

38
Q

In America, what symptoms present more often in Lyme borreliosis?

A

Cardiac disorders (8-10%): Carditis, heart block

Arthritis (large joints, often knees)

39
Q

How do you diagnose Lyme disease? [3]

A

> Erythema Migrans a clinical diagnosis
ACA plus lymphocytoma clinical and high serology titres
Arthritis v high serology titres from synovial fluid. PCR

40
Q

What is the treatment of Lyme disease?

EM - 2 options, duration of course
ACA - 3 options, dose and timing
LNB - Lyme Neuroborrealiosis

Disseminated infection

A

EM
>Oral doxycycline/Amoxicillin 2 weeks

ACA
> PcV 2g TDS or amoxicillin
> or Doxy 200mg OD 3/52

LNB
> Doxy 200 mg OD 10-14 days
> OR IV Ceftriaxone

Disseminated infection: ceftriaxone

41
Q 
Toxoplasmosis
Pathogen
What type of organism is it?
Source
How is it acquired by humans - 2 ways
A

Toxoplasma gondii
Protozoan parasite
Cats are the main source
Humans acquire infection from oocysts in cat feces or from trophozoites in undercooked meat e.g. cattle, pigs, horses

42
Q

Clinical features of toxoplasmosis
3 features of acute form
What is one feature of the acute form which necessitates prompt treatment in pregnant women?
3 clinical signs of chronic form
1 feature in both chronic and acute form [2]

A

Clinical features:

  • Acute form - pneumonia, fever, cough, rash
  • Acute infection during pregnancy can be transmitted to baby > congenital malformation
  • Chronic form - occipital lymphadenopathy, lymphocytosis, atypical mononuclear cells on blood film
  • chorioretinitis, uveitis
43
Q

Describe congenital form of toxoplasmosis [5]

A 
Hydrocephalus
Microphtalmos
Microcephaly
Convulsions
Calcification in brain on x-ray
44
Q

Toxoplasmosis Ix [2]
What is a positive result and what does it indicate
Which test indicates acute infection

A
  • Sabin Feldman dye test
    If positive within 1 month of infection, positive for life
  • IgM Abs indicate acute infection
45
Q

Toxoplasmosis
Treatment (although most don’t require treatment)
2 mainstays
2 modes of tx depending on case

A

sulfonamide + pyrimethamine

folate antagonist

Infection (20 decks)

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