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Year 3 - Infection > Zoonoses > Flashcards

Zoonoses Flashcards

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
Q

How is brucellosis transmitted?

A

1) During milking of infected animals
2) During parturition
3) Handling carcasses of infected animals
4) Consumption of unpasteurised dairy products

26
Q

Microbiology od brucellosis?

A

Small, gram negative coccobacilli

27
Q

What are the there species of Brucella?

A

1) Melitensis = Goats, sheep and camals
2) Suis = Pigs
3) Abortus = Cattle and buffalo

28
Q

Which species of Brucella is most virulent in humans?

A

Brucella melitensis, found in goats, sheep and camels in the Mediterranean

29
Q

Which species of Brucella is least virulent in humans?

A

Brucella abortus, found in cattle and buffalo worldwide

30
Q

What is the incubation period of brucellosis?

A

5-30days (Up to 6 months)

31
Q

What are the symptoms of Brucellosis?

A

Acute (V rare in Scotland)
Subacute
Chronic
Subclincal (Most common)

32
Q

What are the acute symptoms of Brucellosis?

A

Acute - Last 1-3 weeks:

  • High undulant fever
  • Weakness, headaches
  • Drenching sweats
  • Splenomegaly
33
Q

What are the subacute symptoms of Brucellosis?

A

Subacute - Last over a month:

- Fever and joint pains (Knee, hip, back and SI joints)

34
Q

What are the chronic symptoms of Brucellosis?

A

Chronic - Lasts for months or years:

  • Flu-like symptoms
  • Endocarditis
  • Epididymo-orchitis
  • Rarely meningism
  • Splenomegaly
35
Q

What are the subclinical symptoms of Brucellosis?

A

Subclinical - Most common form:

- 50% of exposed have positive serology

36
Q

How do you treat Brucellosis?

A

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
Q

If there is CNS disease in Brucellosis what drug should be added to the treatment?

A

Cotrimoxazole for 2 weeks

38
Q

What caused leptospirosis in fisherman in NE Scotland?

A

L icterohaemorrhagica

39
Q

What are the symptoms of Leptospirosis (icterohaemorrhagica)?

A

1) Flu-like symptoms
2) Jaundice
3) Renal failure

40
Q

What are the symptoms of Leptospirosis (hardjo)?

A

1) Fever
2) Meningism, myalgia, headaches
3) Abdominal pain

No jaundice

41
Q

What is the most common from of leptospirosis in modern day?

A

L hardjo - Found in cattle

42
Q

What is leptospirosis?

A

A thin, highly mobile spirochaetes

43
Q

How long can leptospirosis survive in the environment?

A

Weeks to months

44
Q

How does leptospirosis enter a host?

A

Penetration of abraded skin or mucous membrane

Can either be from direct contact with the animal or contact with contaminated water (Urine)

45
Q

What has caused emerging leptospirosis in Bornea, 2000?

A

Recreational, Borneo Eco Challenge

46
Q

What has caused emerging leptospirosis in Thailand, 1990s?

A

Unexplained emergence

47
Q

What has caused emerging leptospirosis in Philippines, 2009?

A

Typhoons

48
Q

What has caused emerging leptospirosis in Costa Rica, 2017?

A

Hurricane

49
Q

What complication can occur in severe leptospirosis?

A

1) Weil’s disease (Triad of jaundice, AKI, bleeding)
2) Pulmonary haemorrhage
3) Fatality 5-40%, >50 in PH

50
Q

How can you diagnose Leptospirosis?

A

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
Q

How do you treat Leptospirosis?

A

1) Early treatment:
- Mild disease = Doxycycline
- Severe = IV Penicillin

2) Prompt dialysis
3) Mechanical ventilation

52
Q

What is Lyme borrelios transmitted from and by?

A

Spirochaete found in wild deer and transmitted by ticks (lodes ricinus)

53
Q

When is Lyme borrelios most commonly transmitted?

A

In the summer months

54
Q

What is the vector of Lyme Borrelios?

A

Lxoden genus (Ticks):

  • Europe = L. ricinus
  • USA = L. scapularis, L pacificus
  • Asia = L. persulcatus
55
Q

How does someone present with Lyme Borrelios?

A

With Erythema migrans:

  • 3-90 days after the bite
  • Single or multiple lesions
56
Q

Complications of Lyme Borrelios?

A

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
Q

What is Neuroborreliosis?

A

> 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
Q

A key Lyme pie to the FACE…

A 
FACE:
F - Facial nerve palsy
A - Arthritis
C - Cardiac Block 
E - Erythema migrans
59
Q

Stages of Lyme disease?

A

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
Q

What does erythema migrans look like?

A

Typical Bulls-eye configuration

61
Q

How can we diagnose Lyme disease?

A

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
Q

How is Lyme disease treated?

A

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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