Zoonoses

Question 1

80% ofcampylobacterfood poisoning in theUKcome from ?

Answer 1

contaminated poultry, especially chicken

Question 2

apart from raw chicken how else can one get campylobacter infection?

Answer 2

red meat, unpasteurised milk and untreated water.

Question 3

presentation, investigation and management of Campylobacter infection?

Answer 3

• Clinical Presentation
		○ Diarrhoea 
		○ Bloating 
		○ Cramps 
	• Investigations
		○ Stool culture
	• Management
		○ Supportive

Question 4

reservoir for salmonella?

Answer 4

○ Poultry

○ Reptiles/amphibians

Question 5

there are 200 strains of salmonella and only 2 are human pathogens, the rest are zoonoses. which are the 2?

Answer 5

Salmonella Typhi and Salmonella Paratyphi A, which are adapted to humans and do not occur in other animals.

Question 6

clinical presentation of a patient with patient with salmonella?

Answer 6

• Clinical Presentation
○ Diarrhoea
○ Vomiting
○ Fever

Question 7

IVX and management of a patient with salmonella?

Answer 7

• Investigations
		○ Stool culture
	• Management
		○ SUPPORTIVE - self resolving
		○ Ciprofloxacin 
Azithromycin

Question 8

reservoir for Bartonella henselae ?

Answer 8

kittens/cats - mouths

Question 9

Bartonella henselae causes which 2 diseases?

Answer 9

Cat Scratch Disease

Bacillary angiomatosis

Question 10

what is the clinical presentation of cat scratch disease?

Answer 10

Macule at site of innoculation
Becomes pustular
Regional adenopathy
Systemic symptoms

Question 11

ivx and management of cat scratch disease?

Answer 11

Investigations
Serology

Management

Erythromycin
Doxycycline

Question 12

what is the clinical presentation of Bacillary angiomatosis?

Answer 12

Occurs in immunocompromised
Skin papules – distal to site of bite
Disseminated multi-organ and vasculature involvement

Question 13

ivx and management of Bacillary angiomatosis?

Answer 13

Investigations:
Histopathology!!* -liver/spleen
Serology

Management:
Erythromycin
Doxycycline
PLUS rifampicin

Question 14

Reservoir for toxoplasmosis?

route of transmission?

Answer 14

Cats
Sheep

Transmission:
Infected meat**
Faecal contamination*

Question 15

what is the clinical presentation of toxoplasmosis?

Answer 15

Immunosuppressed:

Fever
Adenopathy
Still-birth
Progressive visual, hearing, motor, & cognitive issues
Seizures
Neuropathies

Question 16

ivx and management of salmonella?

Answer 16

Investigations
Serology

Management

Spiramycin
Pyrimethamine plus sulfadiazine

Question 17

typhoid fever is caused by?

Answer 17

Salmonella Typhi, Paratyphi A, Paratyphi B, and Paratyphi C

Question 18

Reservoir for Brucellosis?

route of transmission?

Answer 18

Cattle
Goats

Transmission:
Unpasteurised milk
Undercooked meat
Mucosal splash
Aerosolisation/inhalation

Question 19

what is the clinical presentation of brucellosis?

Answer 19

Fever
Back pain
Orchitis
Focal abscesses (Psoas, liver etc)

Question 20

ivx and management of Brucellosis?

Answer 20

Investigations
1st line - Blood/pus culture
Serology - takes a while to get back

Management

Doxycycline PLUS
Gentamicin OR
Rifampicin

Question 21

which zoonotic disease has an Incubation period- usually 30 days but can be up to 5 months

Answer 21

coxiella burnetti

many are subclinical infections

Question 22

what is the clinical presentation of Coxiella burnetti?

Answer 22

Fever
‘Flu-like illness
Pneumonia
Hepatitis
Endocarditis
Focal abscesses (Para-vertebral/discitis etc)

Question 23

ivx and management of coxiella?

Answer 23

Investigations
Serology

Management

Doxycycline
(hydroxychloroquine

Question 24

Reservoir for Rabies?

Answer 24

Reservoir
Dogs
Cats
Bats

Question 25

Rabies is what type of virus?

Answer 25

Lyssa not lassa!

Question 26

Viruses in which family have a high fatality rate often near 100%

Answer 26

Rhabdoviruses e.g. rabies

Question 27

``` patient presents with Seizures Excessive salivation Agitation Confusion Fever Headache ``` this is what? how to investigate?

Answer 27

Rabies | Ivx: Serology Brain biopsy USA saliva PCR

Question 28

Management of rabies?

Answer 28

Management: Last stage = fatal Immunoglobulin - HRIG only given if direct exposure to saliva Vaccine

Question 29

Streptobacillus moniliformis or Spirillum minus are responsible for which condition?

Answer 29

rat bite fever

Question 30

patient is bitten by a rat and develops the following: Fevers Polyarthralgia Maculopapular progressing to purpuric rash Can progress to endocarditis most likely diagnosis? Ivx?

Answer 30

rat bite fever Investigations: Joint fluid microscopy & culture Blood culture

Question 31

how long after rat bite may one develop rat bite fever?

Answer 31

2-10 days

Question 32

management of rat bite fever?

Answer 32

Management: | Penicillins

Question 33

the following viruses cause which condition? Deer mouse; Sin Nombre virus White footed mouse; Sin Nombre virus Cotton rat; Black canal virus Rice rat; Bayou virus

Answer 33

Hantavirus Pulmonary Syndrome

Question 34

where is Hantavirus Pulmonary Syndrome popular?

Answer 34

Western & southern USA and most of central & South America

Question 35

homeless patient living in sewers in southern USA presents with: Fever Myalgia ‘Flulike illness Respiratory failure Bleeding Renal failure he is exposed to mice and rats which condition? Ivx?

Answer 35

Hantavirus Pulmonary Syndrome ivx: Serology PCR supportive management

Question 36

The following viruses cause which condition: Lassa, Marburg, Ebola, Congo-Crimean Hemorrhagic Fever

Answer 36

Viral Haemorrhagic Fever

Question 37

patient coming from Africa camping trip in safari presents with: Fever !! Myalgia ‘Flulike illness Bleeding – from all orifices diagnosis? ivx? management?

Answer 37

Viral Haemorrhagic Fever ivx: Serology PCR Mx: supportive

Question 38

3 important tests in patients with zoonoses?

Answer 38

Culture, serology, PCR

Question 39

why would a suspect case of Viral Haemorrhagic Fever | be isolated?

Answer 39

transmission is via Contact with fluids of infected