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Year 3 - Infection > Zoonoses > Flashcards

Zoonoses Flashcards

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1
Q

What are zoonoses?

A

Infection that can pass from living animal and humans

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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

Why are the like of Malaria, Schistosmoiasis, Onceriasis, Elephantiasis not consider zoonoses?

A

They depend on the human host for part of their life-cycle

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4
Q

What are anthropnosis?

A

“Reverse zoonoses” in which humans are infecting animals

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5
Q

What are examples of anthropnosis?

A

Influenza = Virus affecting birds and pigs

Strep throat = Dogs

Leishmaniasis = Parasite affecting dogs

Chytridiomycosis = Fungus affecting amphibians

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6
Q

Of the 1415 pathogens currently known to affect humans how many are zoonotic?

A

61%

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7
Q

List of bacterial zoonoses.

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

List of viral 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

List of parasitic zoonoses.

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

List of fungal zoonoses.

A

Dermatophytoses

Sporotrichosis

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11
Q

List of prion zoonoses.

A

BSE/CJDV

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12
Q

Common zoonoses in the UK?

A

Bacterial:

  • Salmonella
  • Campylobacter
  • Q-fever - Coxiella Burnetti
  • Psittacosis – Chlamydophila psittaci

Parasitic:
- Toxoplasma

Fungal:
- Ringworm/dermatophytosis

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13
Q

Uncommon zoonoses in the UK?

A 
Anthrax
Rabies
Bubonic plague
Tularaemia
Acute brucellosis
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14
Q

Examples of emerging zoonoses?

A 
Avian influenza
Nipah virus
Rabies
Brucellosis
Monkeypox
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15
Q

What are 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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16
Q

What is the virus that causes rabies?

A

Lyssavirus

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17
Q

How is rabies transmitted?

A

Through the bite of an infected animal

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18
Q

How many people each year die from rabies?

A

55,000 mainly children

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19
Q

What is the incubation period of rabies in humans?

A

2 weeks to several months

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20
Q

How does the rabies virus reach the brain?

A

Via peripheral nerves

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21
Q

What is the main complication of rabies?

A

Acute encephalitis

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22
Q

How is rabies diagnosed?

A

Difficult:

  • PCR of saliva or CSF
  • Often confirmed post mortem
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23
Q

What is the mortality rate of rabies if left untreated?

A

100%

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24
Q

If exposed to the rabies virus what needs to be done?

A

Pose-exposure prophylaxis:

  • Human rabies immunoglobulin (HRIG)
  • +4 doses of rabies vaccine over 14 days
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25
How is brucellosis transmitted?
1) During milking of infected animals 2) During parturition 3) Handling carcasses of infected animals 4) Consumption of unpasteurised dairy products
26
Microbiology od brucellosis?
Small, gram negative coccobacilli
27
What are the there species of Brucella?
1) Melitensis = Goats, sheep and camals 2) Suis = Pigs 3) Abortus = Cattle and buffalo
28
Which species of Brucella is most virulent in humans?
Brucella melitensis, found in goats, sheep and camels in the Mediterranean
29
Which species of Brucella is least virulent in humans?
Brucella abortus, found in cattle and buffalo worldwide
30
What is the incubation period of brucellosis?
5-30days (Up to 6 months)
31
What are the symptoms of Brucellosis?
Acute (V rare in Scotland) Subacute Chronic Subclincal (Most common)
32
What are the acute symptoms of Brucellosis?
Acute - Last 1-3 weeks: - High undulant fever - Weakness, headaches - Drenching sweats - Splenomegaly
33
What are the subacute symptoms of Brucellosis?
Subacute - Last over a month: | - Fever and joint pains (Knee, hip, back and SI joints)
34
What are the chronic symptoms of Brucellosis?
Chronic - Lasts for months or years: - Flu-like symptoms - Endocarditis - Epididymo-orchitis - Rarely meningism - Splenomegaly
35
What are the subclinical symptoms of Brucellosis?
Subclinical - Most common form: | - 50% of exposed have positive serology
36
How do you treat Brucellosis?
1) Long acting Doxyclycline for 2-3 months; + 2) Rifampicin for the first week; or 3) Intramuscular gentamicin for the first week 4) For CNS disease add Cotrimoxazole for 2 weeks
37
If there is CNS disease in Brucellosis what drug should be added to the treatment?
Cotrimoxazole for 2 weeks
38
What caused leptospirosis in fisherman in NE Scotland?
L icterohaemorrhagica
39
What are the symptoms of Leptospirosis (icterohaemorrhagica)?
1) Flu-like symptoms 2) Jaundice 3) Renal failure
40
What are the symptoms of Leptospirosis (hardjo)?
1) Fever 2) Meningism, myalgia, headaches 3) Abdominal pain No jaundice
41
What is the most common from of leptospirosis in modern day?
L hardjo - Found in cattle
42
What is leptospirosis?
A thin, highly mobile spirochaetes
43
How long can leptospirosis survive in the environment?
Weeks to months
44
How does leptospirosis enter a host?
Penetration of abraded skin or mucous membrane Can either be from direct contact with the animal or contact with contaminated water (Urine)
45
What has caused emerging leptospirosis in Bornea, 2000?
Recreational, Borneo Eco Challenge
46
What has caused emerging leptospirosis in Thailand, 1990s?
Unexplained emergence
47
What has caused emerging leptospirosis in Philippines, 2009?
Typhoons
48
What has caused emerging leptospirosis in Costa Rica, 2017?
Hurricane
49
What complication can occur in severe leptospirosis?
1) Weil's disease (Triad of jaundice, AKI, bleeding) 2) Pulmonary haemorrhage 3) Fatality 5-40%, >50 in PH
50
How can you diagnose Leptospirosis?
1) History - Fever in cattle farmers; exposure to water or rats etc 2) MAT, Microscopic agglutination test 3) ELISA 4) PCR 5) Culture - take at least one week on special media
51
How do you treat Leptospirosis?
1) Early treatment: - Mild disease = Doxycycline - Severe = IV Penicillin 2) Prompt dialysis 3) Mechanical ventilation
52
What is Lyme borrelios transmitted from and by?
Spirochaete found in wild deer and transmitted by ticks (lodes ricinus)
53
When is Lyme borrelios most commonly transmitted?
In the summer months
54
What is the vector of Lyme Borrelios?
Lxoden genus (Ticks): - Europe = L. ricinus - USA = L. scapularis, L pacificus - Asia = L. persulcatus
55
How does someone present with Lyme Borrelios?
With Erythema migrans: - 3-90 days after the bite - Single or multiple lesions
56
Complications of Lyme Borrelios?
1) Acrodermatitis chronica atroficans (ACA): - Elderly patient - Extensor surfaces - Bluish-red discolouration - Peripheral neuropathy 2) Lymphocytoma: - Bluish solitary painless nodule - Earlobe or areola - Children > Adults 3) Neuroborreliosis 4) Carditis 5) Chronic arthritis 6) Encephalopathies
57
What is Neuroborreliosis?
> About 15% of people with Lyme Borrelios develop NB > Triad of facial palsy, radicular pain and lymphocytic meningitis: - Radicular Pain (70-85%), migratory, worse at night - Cranial neuropathy (50%) - -> Facial palsy > Onset of symptoms 2-6 weeks after bite
58
A key Lyme pie to the FACE...
``` FACE: F - Facial nerve palsy A - Arthritis C - Cardiac Block E - Erythema migrans ```
59
Stages of Lyme disease?
Stage 1 - Early localised: - Erythema migrans (Typical bulls-eye configuration) - Flu-like symptoms Stage 2- Early disseminated: - Secondary lesions - Carditis - AV heart block - Facial palsy - Myalgias - Transient arthritis Stage 3 - Late disseminated: - Encephalopathies - Chronic arthritis
60
What does erythema migrans look like?
Typical Bulls-eye configuration
61
How can we diagnose Lyme disease?
1) Erythema migrans - No lab needed 2) No Erythema migrans - ELISA --> Immunoblot test 3) Arthritis - Very high serology from synovial fluid, PCR 4) Clinical + Labs (CSF and bloods)
62
How is Lyme disease treated?
1st line = Oral doxycycline 2nd line = Oral amoxicillin or IV Ceftriaxone Children + pregnant women = Cefuroxime Treat for 21 days (28 for arthritis or ACA)

Year 3 - Infection (16 decks)

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