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Y2 infection > zoonoses - optional > Flashcards

zoonoses - optional Flashcards

1
Q

define zoonoses

A

infections that can pass between living animals and humans

the source of disease is from the animal

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2
Q

4 examples of diseases that aren’t zoonoses and why

A

malaria
schistosomiasis
oncoceriasis
elephantiasis

even though they are transmitted from animals they depend on the human host for part of their life-cycle

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3
Q

define anthroponosis

A

reverse zoonoses

humans are infecting animals

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4
Q

4 examples of anthroponosis

A

influenza - virus; birds, pigs
strep throat - bacteria; dogs
leishmaniasis - parasite; dogs
chytridomycosis - fungus; amphibians

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5
Q

what organisms can cause zoonoses

A

virus
bacteria
parasites
fungi

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6
Q

strategies developed by pathogens to ensure their own survival

A

causing a chronic infection to survive

non-human reservoir

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7
Q

examples 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

examples of viral zoonoses

A 
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

examples of parasitic zoonoses

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

2 examples of fungal zoonoses

A

Dermatophytoses

Sporotrichosis

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11
Q

example of prion zoonoses

A

BSE/CJDV

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12
Q

what are the 6 commonest zoonoses in the UK

A 
salmonella 
campylobacter
toxoplasma 
psittacosis 
Q fever 
ringworm/dermatophytosis
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13
Q

5 uncommon zoonoses in the UK

A 
anthrax
rabies
bubonic plague 
tularaemia 
acute brucellosis
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14
Q

what is an emerging zoonoses

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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15
Q

5 examples of emerging zoonoses

A 
avian influenza
nipah virus 
rabies
brucellosis 
monkeypox
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16
Q

how is rabies transmitted

A

viral infection
bite of an infected animals
97% dogs, bats, monkeys, foxes, racoons, skunks, wolves, cats

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17
Q

mortality of rabies

A

~550 000 (mainly children) die p/a

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18
Q

incubation period of rabies in humans

A

2wks up to several mths

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19
Q

how does rabies get to the brain

A

travels via peripheral nerves

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20
Q

clinical features of rabies

A

causes an acute encephalitis

malaise, headache, fever 
progresses to mania, lethargy and coma 
over production of saliva and tears
unable to swallow and hydrophobia 
death by respiratory failure
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21
Q

diagnosis of rabies

A

difficult

PCR of saliva or CSF
often confirmed post-mortem on brain biopsy

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22
Q

prognosis of rabies

A

always fatal if untreated

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23
Q

treatment of rabies

A

post-exposure prophylaxis immediately after the bite

  • human rabies immunoglobulin (HRIG)
  • infiltrated around the bite if possible
    • 4 doses of rabies vaccine over 4 days
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24
Q

who was at main risk of brucellosis

A

used to be occupational hazard of farmers, vets, slaughterhouse workers etc

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25
Q

where are brucellosis organisms excreted

A

in milk, placenta and aborted foetus

26
Q

when are humans infected with brucellosis

A

during milking of infected animals
during parturition
handling carcasses of infected animals
consumption of unpasteurised dairy products

27
Q

what organism causes brucellosis

A

brucella

small, gram -ve coccobacilli

28
Q

3 species of brucella

A

melitensis
suis
abortus

29
Q

which species of brucella is most and least virulent

A

most - melitensis

least - abortus

30
Q

animal hosts of brucella species

A

melitensis - goats, sheep, camels

suis - pigs

abortus - cattle, buffalo

31
Q

geographic area of brucella species

A

melitensis - Mediterranean, S america, China, India, middle east

suis - N and S america, SE asia

abortus - worldwide

32
Q

incubation period of brucellosis

A

5-30 days

up to 6mths

33
Q

symptoms of brucellosis

A

acute - now very rare in scotland
subacute
chronic
subclinical - commonest

34
Q

acute presentation of brucellosis

A

lasts 1-3wks
high ‘undulant’ fever
weakness, headaches, drenching sweats
splenomegaly

35
Q

subacute presentation of brucellosis

A

lasts >1mth

fever and joint pains - knee, hip, back SI joints

36
Q

chronic presentation of brucellosis

A 
lasts for mths-yrs
flu-like symptoms
malaise
depression 
chronic arthritis 
endocarditis 
epididymo-orchitis
rarely meningism 
splenomegaly
37
Q

subclinical presentation of brucellosis

A

most common form

50% of exposed have +ve serology

38
Q

treatment of brucellosis

A

long acting doxycycline for 2-3mths
+ rifampicin
or + IM gentamycin for first wk

chronic form is difficult to treat

add co-trimoxazole for 2wks in CNS disease

39
Q

relapse in brucellosis

A

occurs due to intracellular organism (5-10%)

40
Q

who gets leptospirosis

A

was common in NE scotland fish workers
Fife miners - rat bites
11% of dairy workers have +ve serology
most have no hx of illness

41
Q

leptospirosis causative organism

A

L. iceterohaemorrhagica

now L. hardjo (cattle) is commonest form

thin, highly mobile spirochaetes

42
Q

clinical presentation of leptospirosis

A

L. iceterohaemorrhagica: flu like symptoms
then jaundice and renal failure

L. hardjo:
fever, meningism, no jaundice

43
Q

leptospirosis reservoir

A

many reservoir hosts - mammals

survive in the environment for wks-mths

44
Q

how does leptospirosis enter the body

A

penetrate abraded skin or mucous membranes and cause systemic illness

45
Q

leptospirosis risk factors

A

planting, weeding, harvesting
hunting, gutting, skinning, butchering
canoeing, bathing, swimming
fishing, clamming

46
Q

changing epidemiology of leptospirosis

A

traditionally an occupational disease

emerging:
recreational - borneo eco challenge 2000
unexplained emergence in Thailand - late 1990s
climate change/disaster associated outbreaks - phillipines typhoon 2009, costa rican hurricane 2017

47
Q

human hosts and leptospirosis

A

humans are incidental hosts

  • direct contact w/ the animal
  • contact w/ environment (water) contaminated w/ their urine
  • incubation 2-30 days (10-14)
48
Q

symptoms of leptospirosis

A

undifferentiated fever, myalgia, headaches, abdo pain

49
Q

leptospirosis - severe disease

A

occurs in 5-15%
Weil’s disease: triad of jaundice, AKI, bleeding
pulmonary haemorrhage (PH)

case fatality 5-40%, >50% in PH

50
Q

diagnosis of leptospirosis

A

think is it likely?

  • fever in cattle farmer
  • exposure to water or rats
  • farmer w/ protracted flu-symptoms is more likely to have leptospirosis than brucellosis

microscopic anticoagulation test - not useful in clinical context
ELISA serology - suboptimal
PCR
culture - at least 1/wk on special media

51
Q

treatment of leptospirosis

A

early treatment
- abx are most effective during early phase of disease
doxycycline for mild disease, IV penicillin for severe
steroids don’t help
prompt dialysis
mechanical ventilation

52
Q

how is Lyme borrelios transmitted

A

spirochaete found in wild deer
transmitted by tick (Ixodes ricinus)
commonest in summer mths

53
Q

vector of Lyme borrelios

A

Ixodes genus ticks
I. ricinus - europe
I. scapularis/pacificus - N america
I. persulcatus - Asia

active >4C, humidity

54
Q

causative organism of Lyme borrelios

A

borrelia burgdorferi

55
Q

erythema migrans (EM) in Lyme borrelios

A

80-90% of cases
clinical diagnosis
3-90 days after the bite (7-30)
single or multiple lesions

56
Q

acrodermatitis chronica atroficans (ACA) in Lyme borrelios

A 
european (B. afzelii)
elderly people
extensor surfaces of distal extermities
bluish-red discolouration - progresses over mths-yrs to atrophic phase
peripheral neuropathy common
57
Q

lymphocytoma in Lyme borrelios

A

bluish solitary painless nodule
earlobe or areola
children > adults

58
Q

what 5 of Lyme borrelios pts develop neuroborreliosis (NB)

A

~15%

59
Q

symptoms of NB

A

triad of facial nerve palsy, radicular pain and lymphocytic meningitis

  • radicular pain (70-85%), migratory, worse at night
  • cranial neuropathy (~50%)

onset of symptoms 2-6 (1-12) wks after bite
preceded by EM in 30-50%

60
Q

lyme borreliosis - USA

A

cardiac disorders more common (8-10%)
- carditis (peri-myocarditis)
heart block

arthritis more common
- large joints, often knees

61
Q

diagnosis of Lyme borrelios

A

EM is a clinical diagnosis - no lab needed
ACA and lymphocytoma clinical and high serology titres
arthritis - very high serology titres from synovial fluid. PCR
- clinical + lab findings

  • neuro symptoms consistent w/ LNB and other causes excluded
  • CSF pleocytosis (WBC in CSF), often lymphocytic
  • paired blood + CSF serology
62
Q

Lyme treatment

A

oral doxycycline or amoxicillin or IV ceftriaxone

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

Y2 infection (15 decks)

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