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Public Health > Zoonotic Disease Of The Southwest > Flashcards

Zoonotic Disease Of The Southwest Flashcards

1
Q

Most common zoonotic disease investigated by AZ health departments

A

Rabies

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2
Q

Presence of zoonotic diseases in AZ exacerbated by (5)

A

-Diversity in wildlife species
- Disparities across communities
- Extreme climates
- Varying topography
- Close proximity to an international border

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3
Q

Where does tularemia occur (5)

A

North America
Europe
Former Soviet Union
China
Japan

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4
Q

What is the 3rd most common reported lab associated bacterial infection

A

Tularemia

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5
Q

Tularemia in AZ: location, reservoir/vector

A

Naturally in rabbits and rodents
Above 3,000 feet

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6
Q

Tularemia agent

A

Francisella tularensis = gram neg bacterium
Potential bioterrorism weapon

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7
Q

Tularemia epidemiology: incubation, period of communicability, susceptibility and resistance

A

1-14 days, average 3-5 days
NOT person to person —->flies can stay infective for 14 days, ticks stay infective throughout lifetime
All ages susceptible
Long term immunity following infection

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8
Q

Tularemia clinical diagnosis

A

Evidence/history of tick or deer fly bite, exposure to tissues of mammalian host infected
Fever, chills, headaches, diarrhea, muscles aches, joint pain, dry cough, progressive weakness

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9
Q

Without treatment, tularemia infection could progress to

A

Respiratory failure, shock, death

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10
Q

6 clinical forms of tularemia

A

Ulceroglandular
Glandular
Oculoglandular
Oropharyngeal
Pneumonic
Typhoidal

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11
Q

Most common clinical form of tularemia

A

Ulceroglandular

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12
Q

Ulceroglandular tularemia: cause, clinical signs

A

After tick or deer fly bite OR handling infected animal
Cutaneous ulcer with regional lymphadenopathy(swollen lymph nodes)

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13
Q

Glandular vs Ulceroglandular tularemia

A

Glandular = regional lymphadenopathy with NO ulcer
Ulceroglandular = with ulcer

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14
Q

Oculoglandular tularemia: cause, clinical sign

A

Bacteria enter eye when person is butchering infected animal and touches their eye
Conjunctivitis with preauricular lymphadenopathy

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15
Q

Oropharyngeal tularemia: cause, clinical signs

A
  • From eating or drinking contaminated food or water
  • Stomatitis, pharyngitis, tonsillitis and cervical lymphadenopathy
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16
Q

Most serious form of tularemia

A

Pneumonic

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17
Q

Pneumonic tularemia: cause, clinical signs

A
  • From breathing dust or aerosols containing the organism or when other forms are left untreated and have hematogenous spread
    -Primary pleuropulmonary disease
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18
Q

Typhoidal tularemia: clinical signs

A

Febrile illness without early localizing signs and symptoms

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19
Q

Type A vs Type B tularemia infections: difference in reservoirs

A

Type A = rabbits or ticks
Type B = hares and rodents

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20
Q

Where are type A tularemia strains localized

A

Western US

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21
Q

Tularemia mode of transmission (MANY)

A
  • Bite of certain arthropods
  • Inoculation of skin, conjunctival sac, or oropharyngeal mucosa with contaminated water, blood, or tissue while handling carcasses of infected animals
  • Handling or ingesting insufficiently cooked meat of infected animal hosts
    -Drinking contaminated water
  • Inhalation of dust from contaminated soil, grain, or hay
    -Contaminated pelts and paws of animals
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22
Q

Tularemia treatment

A

Antibiotics = streptomycin, doxycycline, gentamicin
10-21 days
Most patients don’t completely recover

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23
Q

Where must tularemia be reported to (and time frame)

A

AZDA
Within 4 hours

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24
Q

Clinical samples used to test for tularemia

A

Ulcer scraping/swab
Lymph node biopsy
Tissue biopsy
Pharyngeal washes

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25
Q

Tularemia prevention

A

Note any change in behavior of pets
Inspect heard
Use dust masks when mowing
Use insect repellant with DEET
Wear long clothing
Remove attached ticks

26
Q

Most severe disease caused by tick in US

A

Rocky Mountain spotted fever

27
Q

What percent of RMSF cases are fatal

A

5-10

28
Q

Is RMSF notifiable to CDC

A

YES

29
Q

What state the most cases of RMSF

A

Arizona

30
Q

RMFS: causative agent, mode of transmission (incubation period), how it causes disease

A

Rickettsia rickettsi = gran neg obligate intracellular parasite
Bite of infected tick
Usually 4-5 days
Invades endothelial cells of venules and capillaries —> replicates —> causes vasculitis

31
Q

RMSF clinical signs

A

Fever (102 - 105)
Severe lethargy
Rash (but not in AZ)

32
Q

In general what percent of RMSF cases develop rash

A

60

33
Q

RMSF clinical signs in the LATE stage

A

Necrosis
Abdominal pain, vomiting
Signs of depression
Vestibular defects
Dyspnea
Myalgia

34
Q

Most likely abnormal clinical finding for RMSF (3)

A

Hypoalbuminemia
Moderate leukocytosis
Thrombocytopenia

35
Q

Clinical RMSF resembles infection with what

A

Eherlichia canis

36
Q

Gold standard serologic test for RMSF

A

Indirect immunofluorescence assay with Ag

37
Q

Other test for RMSF

A

PCR

38
Q

Best antibiotic for RMSF treatment

A

Doxycycline

39
Q

RMSF prevention in dogs

A
  • Prevent tick attachment or promptly remove ticks
  • Topical or systemic tick-control treatment such as permethrin, fipronil
  • Seasonal tick and flea dips
  • Impregnated collars containing amitraz or propoxur
40
Q

Primary domestic reservoir for chagas

A

Dogs

41
Q

How many people in Mexico, Central America and South America have chagas

A

8 million

42
Q

Chagas: causative organism, mode of transmission, where only found

A

Trypanosoma cruzi = Protozoan parasite
To animals and people by insect vectors
Americas

43
Q

Chagas aka

A

American trypanosomiasis

44
Q

What insects in Arizona likely have chagas parasite

A

Kissing bugs

45
Q

Chagas transmission to humans (5)

A

Vector borne
Congenital
Blood
Organ transplantation
Oral ingestion of contaminated foods

46
Q

2 phases of chagas infection

A

Acute
Chronic

47
Q

Acute chagas: timeline, clinical signs

A

First few weeks or months
Fever, fatigue, body aches, rash
Ramanas sign = swelling of eyelids

48
Q

Chronic chagas: timeline, clinical signs

A

Decades to lifetime
Cardiac or GI complications

49
Q

What percent of chronic chagas cases develop cardiac or GI complications

A

20-30

50
Q

3 ways to diagnose chagas: acute vs chronic

A

PCR
Chronic = Serologic testing
Acute = find trypomastigotes in blood or CSF

51
Q

Chagas treatment

A

Antiparasitic to kill parasite = benznidazole
Manage symptoms
Monitor heart

52
Q

What is the only way to get drugs for chagas treatment in the United States and why

A

Through CDC
Not approved by FDA

53
Q

Chagas in dogs: presentation

A

arrythmias
myocardial dysfunction
congestive hear failure

54
Q

Risk factors for chagas in dogs

A

Living in or traveling to area with infected insect vectors
Dog kennels
High density areas attract kissing bugs

55
Q

Chagas prevention

A

Vector control
Turn off outdoor lights
Clean up brush
House dogs inside
Use insecticides

56
Q

Do traditional tick and flea repellants work on chagas

A

No

57
Q

onchocerca lupi: causative organism, epidemiology

A

filarial nematode
adults embedded in ocular nodules and granulomatus masses of infected dogs
females release microfilaria found in skin of ears, nose, umbilical rregions
suspected vector = black fly

58
Q

definitive host for onchocerca lupi

A

DOG

59
Q

onchocerca lupi: clinical diagnosis

A

detectable via ophthalmic evaluation
detection of ocular nodules in sclera
histopath id of adult worms

60
Q

onchocerca lupi treatment

A

surgical removal of worms
no evidence for treatment

Public Health (11 decks)

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