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Infection > Zoonoses > Flashcards

Zoonoses Flashcards

1
Q

Define zoonoses

A

Diseases that pass between living animals and humans (where animals are the source of the disease)

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2
Q

What are anthroponoses?

A

Diseases spread from humans to animals

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3
Q

Give examples of anthroponoses

A

Influenza (virus infecting pigs, birds), strep throat (bacteria infecting dogs), leishmaniasis (parasite infecting dogs), chytridiomycosis (fungus affecting amphibians)

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4
Q

Toxoplasmosis only tends to infect humans when they are what?

A

Immunosupressed

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5
Q

What are the common zoonoses in the UK?

A 
Salmonella
Campylobacter
Toxoplasmosis
Psittacosis
Q-fever
Ringworm
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6
Q

What causes psittacosis?

A

Chlamydophilia psittaci

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7
Q

What causes Q-fever?

A

Coxiella burnetti

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8
Q

What causes ring worm?

A

Dermatophytes

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9
Q

What zoonoses are rarely seen in the UK now?

A

Anthrax
Rabies
Bubonic plague

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10
Q

What is anthrax?

A

Bacteria spread by contact with bacterial spores (often in infected animal products)
Can lead to skin/lung/GI disease

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11
Q

What is bubonic plague spread by?

A

Insects & small animals

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12
Q

What is tularaemia?

A

Bacterial infection transmitted by ticks, deer flies, infection animals
Presents with fever, skin ulcer, tenderness, regional lymphadenopathy

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13
Q

Define emerging zoonoses

A

Zoonosis that is newly recognised/evolved/that previously occurred but now shows an increase in incidence/expansion in geographical/host/vector range

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14
Q

Give examples of emerging zoonoses

A 
Avian influenza
Nipah virus (SE Asia --> severe encephalitis) 
Rabies
Brucellosis
Moneypox
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15
Q

What is monkey pox?

A

Similar to small pox

Flu like stage –> eruption of maculopapules which develop into vesicles –> pustules & crusts

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16
Q

What is rabies infection with?

A

Lyssavirus

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17
Q

How is rabies spread?

A

Transmission via saliva from bite by infected animal

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18
Q

What animals tend to be carriers for rabies?

A

Mostly dogs and bats

Also monkeys, foxes, racoons, skunks, wolves, cats

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19
Q

What is the incubation period for rabies?

A

2wks-several months

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20
Q

How does rabies virus spread in the body?

A

Travels to brain via peripheral nerves

Further the bite is away from brain, the longer it will take to travel

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21
Q

Once rabies reaches the CNS what is the prognosis?

A

100% fatal

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22
Q

What is the clinical presentation of rabies?

A

Acute encephalitis:
Malaise, headache, fever, mania, lethargy, coma
Unable to swallow
Hydrophobia (involuntary pharyngeal muscle contraction when try to drink - pathognomic)

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23
Q

How do most people die of rabies?

A

Respiratory failure

24
Q

How do you diagnose rabies?

A

PCR of saliva/CSF

Mostly confirmed on post-mortem brain biopsy

25
Q

How do you Rx rabies?

A

Immediately after bite give PEP:
Cleaning & debridement
Human rabies Ig (esp around wound if poss.)
4 doses of rabies vaccine over 14 days

26
Q

Who did brucellosis used to affect?

A

Farmers, vets, slaughterhouse workers

27
Q

Where are the brucellosis organisms excreted?

A

Milk, placenta, aborted foetus

28
Q

When are humans at risk of being infected with brucellosis?

A

Milking/birthing infected animals
Handling carcasses of infected animals
Drinking unpasteurized diary products

29
Q

When sending a suspected brucellosis sample to the lab what must you do?

A

Warn them as it may spread in lab

30
Q

How do you diagnose brucellosis?

A

Culture with prolonged intubation time & serology

31
Q

What kind of microorganism is brucellosis?

A

Small, gram -ve coccobacilli

32
Q

What are the three species of Brucella and where do they mostly come from?

A

Melitensis - goat, sheep, camel
Suis - pig
Abortus - buffalo, cattle

33
Q

What is the incubation period for Brucella?

A

5-30d

34
Q

What are the symptoms of brucellosis?

A

Acute (1-3wk): high, undulant fever, weakness, headaches, drenching night sweats, splenomegaly

Subacute (>1m): fever & joint paints (knee, hip, SI joints)

Chronic (m-yrs): flu like symptoms, malaise, depression, chronic arthritis, endocarditis, epididymo-orchitis, rarely meningism, splenomegaly

Subclinical
(most common)

35
Q

What should make you think brucellosis?

A

Unspecific acute presentation, sweating, travel Hx, nonresponsive to antibx

36
Q

How do you Rx brucellosis?

A

Long acting doxycycline for 2-3m & rifampicin/IM gentamycin for first weeks
Add cotrimoxazole for 2 weeks if CNS dx

37
Q

What causes leptospirosis?

A

Spirochaete Leptospira interrogans

Mostly L. hardio from cattle

38
Q

What symptoms does L. hardio leptospirosis lead to?

A

Fever, meningism

39
Q

What are the life cycle of leptospira like?

A

Survive in environment for weeks/months

Direct transmission to humans via broken skin/mucous membrane & contact with infected animal urine

40
Q

Why is the incidence of leptospirosis increasing?

A

Recreational, e.g. increased white water rafting etc.
Unexplained emergence in Thailand
Climate change/disaster assoc, e.g. floods

41
Q

What is the incubation period of leptospirosis?

A

2-10d

42
Q

What are the symptoms of leptospirosis?

A

Undifferentiated fever, myalgia, headaches, abdominal pain

43
Q

How do you manage leptospirosis?

A

85% get better & don’t need Rx
10-15% get severe dx:
Weil’s disease/pulmonary haemorrhage

44
Q

What triad do you get in Weil’s disease?

A

Jaundice, AKI, bleeding

45
Q

When should you think about leptospirosis?

A

Fever in cattle farmer
Exposure to rats/water
Someone who works in an abattoir
Vets/sewage workers

46
Q

What tests should you do for leptospirosis?

A

Culture (blood/CSF), serology & PCR

47
Q

How do you Rx leptospirosis?

A

Doxycycline for mild dx
IV penicillin for severe
Haemodialysis
Mechanical ventilation

48
Q

What causes lyme disease?

A

Borrelia burgdirferi (spirochaete) found in wild deer

49
Q

What transmits lyme disease?

A

Tick (lxodes Ricinus) which active above 4C

Usually nymph that carries it

50
Q

What are the stages of lyme disease?

A 
Early, localised (3-30d): target board erythema migrans 
Early disseminated (wks-months): borrelial lymphocytoma (bluish/red plaque/nodule - check earlobes, nipples, genitalia), may also get neuroborreliosis or cardiac disorders (peri-myocarditis/heart block) & arthritis (more in USA)
Late disseminated (months-yrs): acrodermatitis chronica atroficans, lyme arthriris, peripheral neuropathy
51
Q

What is ACA?

A

Focal inflammation then atrophic skin

Caused by infection with B. afzelii

52
Q

What is lyme arthritis?

A

Bluish-red discolouration of extensor surfaces of extremities most commonly

53
Q

How do you diagnose lyme disease?

A

EM can be diagnosed clinically
ELISA - if +ve/equivocal –> immunoblot test to confirm
ELISA -ve - repeat in 4-6 weeks if still suspected
ACA/lymphocytoma - clinical and high serology titres
Arthritis - serology titres from synovial fluid/PCR

54
Q

How do you Rx lyme disease?

A

Oral doxycycline/amoxicillin
IV ceftriaxone if disseminated
Treat 21 days (28 for arthritis/ACA)

55
Q

How is leptospirosis ‘classically’ spread?

A

Infected rats urine

56
Q

What is leptospirosis aka?

A

Weil’s disease (although this term is sometimes reserved for the most severe cases associated with jaundice)

57
Q

What reaction is sometimes seen after initiating antibiotics to treat Lyme disease?

A

Jarisch-Herxheimer reaction

Infection (22 decks)

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