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Infection > Zoonoses > Flashcards

Zoonoses Flashcards

1
Q

What are zoonoses?

A

Infections that can pass between living animals and humans

Source of disease is the animal

WHO; infections that are naturally transmitted between vertebrate animals and humans

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2
Q

What is not a zoonose?

A

Malaria
Schistosomiasis
Oncoceriasis
Elephantitis

Because even though transmitted from animals, they depend on human host for part of their life cycle

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3
Q

What is anthroponosis?

A

‘Reverse zoonoses’

Humans infecting animals e.g. influenza, strep throat, leishmaniasis

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4
Q

What can cause zoonoses?

A

Viruses, bacteria, parasites, fungi

Pathogens have developed strategies to ensure their own survival

  • causing a chronic infection to survive
  • or have a non-human reservoir
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5
Q

What are some bacterial zoonoses?

A
  • salmonella
  • campylobacter
  • shigella
  • anthrax
  • brucella
  • E coli
  • leptosporiasis
  • plague
  • psittacosis
  • Q fever
  • tularaemia
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6
Q

What are some viral zoonoses?

A
  • rabies
  • avian influenza
  • crimean-congo haemorrhagic fever
  • ebola virus disease
  • lassa fever
  • rift valley fever
  • west nile fever
  • yellow fever
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7
Q

What are some parasitic zoonoses?

A
  • cysticercosis
  • echinococcosis
  • toxoplasmosis
  • trichinellosis
  • visceral larva migrans
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8
Q

What are some fungal zoonoses?

A
  • dermatophytoses

- sporotrichosis

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9
Q

What are emerging zoonoses?

A

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

i.e. avian influenza

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10
Q

Describe rabies infection

A

Viral infection transmitted from bite of infected animal

Wide range of animal transmitters, most commonly dogs 97%

incubation period humans 2 weeks to several months

Travels to brain via peripheral nerves

Causes acute encephalitis

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11
Q

What are symptoms of rabies?

A

Malaise, headache, fever

Progressing to mania, lethargy and coma

Over production saliva and tears

Unable to swallow and hydrophobia

Death by respiratory failure

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12
Q

Describe rabies diagnosis

A

Difficult

  • PCR of saliva or CSF
  • Often confirmed post mortem on brain biopsy

Always fatal if untreated

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13
Q

Describe rabies management

A

Immediately after bite give post-exposure prophylaxis

  • human rabies Ig
  • infiltrated round bite if possible
  • +4 doses of rabies vaccine over 14 days
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14
Q

Describe brucellosis

A

Used to be occupational hazard of farmers, vets etc.

Organisms excreted in milk, placenta and aborted foetus

Humans are infected

a) during milking infected animals
b) during parturition
c) handling carcasses of infected animals
d) consumption unpasturised dairy products

NOW RARE IN UK

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15
Q

Describe brucella

A

Small, gram negative coccobacilli

3 species

  • melitensis
  • suis
  • abortus

Incubation period up 5-30days

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16
Q

Describe symptoms of brucellosis

A

Acute lasts 1-3 weeks

  • high ‘undulant’ fever
  • weakness, headaches
  • drenching sweats
  • splenomegaly

Subacute over 1 month
- fever and joint pains

Chronic for months or years

  • flu-like symptoms, malaise, depression, chronic arthritis
  • endocarditis, epididymo-orchitis, rarely meningism, eplnomegaly

Subclinical is most common form
- 50% of exposed have positive serology

17
Q

Management of brucellosis

A

Long acting doxycycline for 2-3 months + rifampicin or + intramuscular gentamicin for first week(s)

Relapses occur due to intracellular organism (5-10%)

Chronic form - difficult to free

Add cotrimoxazole for 2 weeks in CNS disease

18
Q

Describe leptospirosis illness

A

Was due to L.icterohaemorrhagica
Flu-like symptoms - then jaundice and renal failure

But now L.hardjo (cattle) is most common form; 11% dairy workers have positive serology and most have no history of illness

Fever, meningism - no jaundice

19
Q

Describe leptospirosis bacteria

A

Thin, highly mobile spirochaetes

One of the most widespread zoonosis

Many reservoir host

Survive in environment for weeks to months

Penetrate abraded skin or mucous membranes and cause systemic illness

20
Q

Describe symptoms of leptospirosis

A

Undifferented fever, myalgia, headaches and abdo pain

Severe disease in 5-15%

  • Weil’s disease (triad of jaundice, AKI, bleeding)
  • pulmonary haemorrhage (PH)
  • case fatality 5-40%, >50% in PH
21
Q

Describe diagnosis of leptospirosis

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

22
Q

Describe management of leptospirosis

A

Early treatment

  • lack of evidence that antibiotics are effective
  • doxycycline for mild disease, IV penicillin for severe
  • steroids do not help

Prompt dialysis

Mechanical ventilation

23
Q

Describe lyme borrelios

A

Spirochaete found in wild deer

Transmitted by tick (ixodes genus)

Commonest in summer months

24
Q

Describe erythema migrans (EM)

A

Occurs in 80-90% of cases of lyme borrelios

3-90 days after bite

Single or multiple lesions

25
Q

Describe acrodermatitis atroficans (ACA)

A

European, elderly people

Extensor surfaces of distal extremities

Bluish red discolouration; progresses over months to years to atrophic phase

Peripheral neuropathy common

26
Q

Describe lymphocytoma

A

Bluish solitary painless nodule

Earlobe or areola

Children>adults

27
Q

Describe neuroborreliosis (NB)

A

App 15% Lyme disease patients develop NB

Triad of facial nerve palsy, radicular pain an lymphocytic meningitis

  • radicular pain; migratory, worse at night
  • cranial neuropathy; facial palsy ~50%

Onset of symptoms 2-6 weeks after bite

Preceded by EM in 30-50%

28
Q

How do you diagnose lyme disease?

A

EM a clinical diagnosis; no lab needed

ACA and lymphocytoma clinical and high serology titres

Arthritis; high serology titres from synovial fluid, PCR

NB, clinical + lab;

  • neuro symptoms consistent with LNB and other causes excluded
  • CSF pleocytosis (WBC in CSF), often lymphocytotic
  • paired blood and CSF serology
29
Q

Treatment of lyme disease

A

Oral doxycycline or amoxicillin, or IV ceftriaxone

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

30
Q

What are some manifestations of lyme disease?

A
  • erythema migrans
  • acrodermatitis chronica atroficans (ACA)
  • lymphocytoma
  • neuroborreliosis (NB)
  • arthritis

Infection (15 decks)

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