Exam 1 Flashcards

(94 cards)

1
Q

Paratenic host

A
  • intermediate host required for completion of lifecycle

* no development of parasite occurs

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2
Q

Percutaneous

A

o Made, done, or effected through the skin

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3
Q

Sporotrichiosis Basics & effects on humans vs cats

A
o	Sporothrix schenkii
o	Dimorphic fungus
o	Soil saprophyte
o	Can be gotten from rose garden pokes
o	Reverts to yeast in tissue (37 degrees C)

Humans
• Nodular, ulcerative pyogranulomatous dermatitis.
• Nodules along lymph channels near surface of skin.
• Infrequently can affect lungs, joints, CNS

Cats
• Nodular, ulcerative pyogranulomatous dermatitis
• Adult cats are usually resistant

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4
Q

Sporotrichiosis Diagnosis, Treatment, Client Education

A

Diagnosis
• Cytology on exudates from lesion
• Looking for polymorphonuclear things

Treatment
• Itraconazole

Client Education
• potential for transmission from cat lesions.
• Wear gloves; wash hands

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5
Q

Classification of zoonoses based on hosts

A

Direct zoonoses
• One vertebrate host
• Transmission through contact, aerosol, vehicle, or mechanical vector

Cyclozoonoses
• 2 vertebrate hosts

Metazoonoses
• Biological vector

Saprozoonoses
• Has an environmental stage

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6
Q

Mycobacterium Species

A

M. tuberculosis:
• Human-to-human (elephants)

M. avium complex:
• disseminated disease in immunocompromised patients.

M. avium paratuberculosis:
• Johne’s disease, Crohn’s Disease?

Other “Atypical mycobacterial diseases”
• M. marinum (fish), M. chelonae (pedicures)

M. leprae:
• leprosy, human-to-human Armadillo-to-human

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7
Q

Reservoir & Hosts for M bovis

A

Reservoir for M bovis
• Cattle
• Does not multiply outside host

Hosts
•	Cattle, humans, swine, goats, dogs, rarely cats 
•	White-tail deer, elk, bison
•	Badgers in the UK
•	Brush-tailed possums in New Zealand
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8
Q

Transmission of M bovis

A

Infected bovine to non-infected
• Aerosol or milk

Infected bovine to humans
• Mostly milk worldwide but more aerosol in US

Infected bovine to other animals
• Raw milk or aerosol

Humans to non-infected bovine
• aerosol

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9
Q

Vaccine for M bovis

A
  • BCG vaccine
  • Attenuated strain of M bovis
  • Used for humans
  • Can stimulate immune system in cancer patients
  • Can cause infection in AIDS patients
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10
Q

Diagnosis of M bovis

A

• Histopathology of lesions using acid-fact stain will be (+)
for ALL Mycobacteria

Live animals
• Skin (antigen) testing

Postmortem
• Culture, PCR (NVSL)

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11
Q

Testing for M bovis in different species

A
  • Done by accredited vets or state/fed vets
  • Done for interstate or international shipment

Cattle bison goats
• Caudal tail fold test

Camelids
• Axillary skin region

Cervids
• Single cervical test

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12
Q

Performing a caudal fold test

A
  • Inject 0.1 purified protein derivative, tuberculin Ag ->
  • Return and read in 72 h +/- 6 h
  • Vet who made the injection must be vet who reads test result.
  • determine results by observation and palpation of site 

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13
Q

US State Accreditation for Dz’s

A
  • USDA-APHIS-VS regulate inter-state (between states) movement of livestock 

  • States regulate intra-state movement (state’srights) 

  • used for Bovine TB, Brucellosis, Equine Infectious Anemia 

  • Uniform rules are developed to control diseases
  • Status is given to areas (states) free of disease 

  • Movement between areas (states) is less restricted when status is “free” 

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14
Q

Basics of M avium & M tuberculosis

A

M avium
• No Federal control program
• environment is Reservoir

M tuberculosis
• Maintained in Humans & NH primates
• Some other animals are susceptible pigs, dogs

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15
Q

What does a (+) caudal fold test mean & what are the regulations?

A

Positive response
• delayed hypersensitivity ->
• TH1/macrophage response (cell mediated) ->
• Swelling ->
• Means the animal has been exposed
• Responder: (+) response
• Reactor: reacts specifically to M. bovis

Regulations for positive reactions
•	Reactors sent to slaughter
•	Post mortem inspection
•	No lesions -> pass carcass for cooking
•	Lesions -> condemn carcass
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16
Q

Taenia saginata (Cysticercus bovis) & Taenia solium (Cysticercus cellulosae) life cycle, & hosts

A
Lifecycle in human
•	Tissue cyst in animal ->
•	human eats undercooked meat & ingests cysticerci ->
•	shed eggs in feces ->
•	animal picks up eggs

Definitive Hosts
• House adult tapeworms
• T. saginata - Humans
• T. solium- Humans

Intermediate Hosts
• House larvae
• T. saginata – cows
• T. solium – swine

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17
Q

T. saginata & T. solium Dz in humans & control

A
Disease in humans
•	Taeniasis
•	rarely clinical 
•	Human cysticercosis 
•	serious, CNS and ocular 
Control
•	Prevent infection in animals 
•	Prevent access to human feces 
•	Treat human cases 
•	Meat inspection 
•	“Measly beef”

•	Condemn carcass if severe

•	If can trim, require freezing or cooking before sale. 
•	Cook meat well done
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18
Q

Rickettsia rickettsii (Rocky Mountain Spotted Fever); basics, hosts, & transmission

A

o Prefer endothelial cells -> vasculitis & rash
o Comes from Dermacentor & Rhipicephalus ticks
o Transmitted transovarian or transstadial
o Ticks infected for life

Hosts
• Wild rodents, lagomorphs, dogs. Opposums, humans
• Humans & dogs are dead end

Transmission
• Tick bite

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19
Q

Rickettsia rickettsii Dz in humans Vs animals

A
Dz in humans
•	Incubation: 2-14 days 
•	Fever, chills, muscle 
•	joint pain (flu-like) 
•	Rash 
•	Vasculitis 
•	Tx greatly shortens clinical course 
•	15-20% fatal if not Txed 
•	Most frequently reported rickettsial dz in U.S. 

Dz in animals
• Inapparent in most wildlife
• Dogs: fever, abdominal pain, depression, lethargy, anorexia, neurological signs
• Thrombocytopenia

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20
Q

Rickettsia rickettsii Diagnosis, Treatment, Control

A

Diagnosis:
• Serology (paired sample)

• Isolation of organism from blood

• PCR


Reportable disease in humans in the U.S. G.

Treatment:
• Tetracycline, Doxycycline

Control
• Vector control
• Tick removal

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21
Q

Definitive Vs Intermediate Host

A

Definitive
o organism in which the parasite reaches the adult stage and reproduces sexually.

Intermediate
o organism which harbors the sexually immature parasite.

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22
Q

Management of Dogs, Cats, & Ferrets Exposed to Rabies

A

Unvaccinated
• Euthanize

OR
• Strict quarantine for 4 mo. (D + C) 6 mo. (F) ->
• vaccinate w/in 4 days or 1 month before release ->
• If unable to do at entry, extend isolation to 6 
mo.

Vaccinated
• revaccinate w/in 4 days ->
• keep under owner’s control and observe for 45 days 


Vaccinated, but not current
• case-by-case evaluation

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23
Q

Management of Livestock & Horses Exposed to Rabies

A

Previously vaccinated
• Revaccinate immediately ->
• Observe for 45 days

Unvaccinated
• Euthanize immediately
OR
• Close observation for 6 mo

Euthanized immediately after exposure
• Eat meat

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24
Q

Management of Animals that Bite Humans

A

Cat, dog, ferret
• 10 day observation
• do not vaccinate
• euthanize & test if develop rabies signs

Other animals
• Usually euthanize and test

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25
Pre & Post Exposure Rabies Prohylaxis Humans; vx options
Pre • People @ risk • 3 injections @ days 0, 7, 21e ``` Post determined by • Biting species 
 • Geographic location • Circumstances 
 • Type of exposure
 ``` Rabies Biologics • human diploid cell vaccine (HDCV), IM or ID (deltoid region) 
 • Purified Chick Embryo Cell Vaccine (PCEC) 
 • HRIg - neutralizing antibody 

26
Protocol for Humans Post Exposure to Rabies
If not previously Vxd • Wound cleaning
 • 4 IM vaccinations (0, 3, 7, 14) • HRIG on day 0 around and into the wounds. • Any remaining volume injected IM at site distant from vaccine site. If previously Vxd • Wound cleaning • 2 IM vx on day 0 & 3 • No HRIG If Pregenant • No indication of fetal harm due to Vx
27
Brucellosis abortus Basics Reservoir, other hosts, in humans, transmission
Reservoir • Cattle bison elk Other hosts • Humans, horses, dogs In humans • Undulant fever or Malta fever and arthritis 
 • Raw milk or direct contact with infected animals or their fluids.
28
Brucellosis abortus Vaccine
* RB-51 * Approved for cattle in 1996 * Live Culture 
 * Rifampin & Penicillin resistant 
strain of B. abortus 
 * replaced the Strain 19 vaccine in cattle 
 * Antibodies to RB-51 can be differentiated from “wild type” * Can cause abortion in bison
29
What to do if a human comes into contact with RB-51
* Prompt medical attention | * 3-week course of doxycycline
30
Disadvantages of Brucella Vx Strain 19 Still Used in Elk
Cattle o abortion and orchitis Humans o Milder disease than field strain 
 o Accidental (usually self) 
inoculation 
 o Human transmission not naturally transmitted 
 • Persistent titers 

31
Brucella Suis Basics & Effects on Humans
o Focal granulomatous lesions in bones and joints 
 o Can cause endometritis, infertility o USDA Eradication 
Program 
 o No quarantined swine (domestic) herds left in the U.S. Effect on Humans • Pathogenic • Direct contact w/ infected pigs • Cases in hunters of feral swine
32
Brucella Suis State/Federal Eradication
* All intact swine >6mo must test (-) for brucellosis or originate from brucellosis-free herds * All state currently brucellosis free * Feral swine surveillance program
33
Brucella melitensis
``` o Effects goats, sheep, camelids o Not in US o Most pathogenic for humans o B. abortus VX does not protect o No approved VX o Also established in cattle in some European & middle eastern countries ```
34
Brucella canis
o Effects dogs o Only ~30 cases ever reported o Risk to humans very low o Causes discospondylitis
35
Brucella Ovis
o Primarily causes epididymitis in rams o Not zoonotic o Shed in high numbers in uterine fluids -> abortion o Transmitted orally through milk or fluids
36
Brucella & Food Safety
o Unpasteurized milk main source of human infection worldwide 
 o Meat not known to be source of infection o Killed by cooking, acid pH, autolytic changes 

37
Transmission & Entry for Brucella SPecies
Inhalation (respiratory) • Organism aerosolized when shed in high numbers in uterine fluids and urine. • Most common route for humans Conjunctiva Percutaneous Venereal • Important rote for suis & canis In utero • Causes abortion
38
Three Types of Human Brucella Infection
Acute • Flu like symptoms Chronic • Localized in bones, joints, endocardium Abortion • Occasionally causes abortion
39
Brucella Diagnosis & Treatment
Diagnosis o Serology on live animals (exposure) o Culture/PCR of fetal tissues on abortions o Culture/PCR on blood of other suspect antemortem cases. o Warn the lab if suspect Brucella Treatment o No treatment for livestock o Antibiotics for humans
40
Brucellosis Control Program
``` o Uniform rules o VX o Animal ID (right ear) o Testing protocol o Regulatory agency to enforce ```
41
Vaccinating Cows for Brucellosis
o Vaccinate females at 4-12mo o Must clear vx before pregnancy o Do not vx bulls o If bull is vx’d on accident -> castrate or cull o If neither option above -> give prophylactic antibiotics
42
Testing, Slaughter & Quarantine for Brucella
o Test (+)
-> sent to slaughter if healthy 
 o Animals exposed to 
(+) animals -> quarantine -> o test
quarantined -> o Usually, entire herd must test negative on 2 sequential tests 
-> o If high rate of infection in the herd, may depopulate 

43
Species of Chlamydia & Dz caused
Chlamydophila felis • Rhinitis & conjunctivitis in cats Chlamydophila abortus • Abortion/weak neonates in sheep, goats, cattle Chlamydopjila psittaci • Conjunctivitis, respiratory, GI in birds
44
Terminology for Chlamydophila psittaci
o Psittacosis: disease in humans 
 o Ornithosis: disease in humans from non-psittacine birds 
 o Avian Chlamydiosis: disease in birds
45
2 Types of Chlamydiosis in Humans
Chlamydia trachomatis • most common STD in developed countries • Leading cause of preventable blindness worldwide Chlamydia pneumoniae: • asymptomatic to severe upper and lower respiratory disease • Clinically, very similar to psittacosis
46
Chlamydiosis in birds; Basics & Transmission
o Most or all birds susceptible 
 o Most common in psittacines and pigeons 
 o May be asymptomatic carriers or mild to severe illness 
 o May cause significant death loss in turkeys and ducks 
 Transmission • aerosol (feather dust, aerosolized feces) • ingestion, • fomites (feed and water) 
 • Some birds shed intermittently (when stressed) 
 • Incubation period of 3 days to weeks
47
Chlamydiosis in birds; Clinical Signs & Diagnosis
``` Clinical signs • ruffled feathers, • off feed, • ocular and nasal discharge, • respiratory signs, • conjunctivitis, • green droppings, • neurologic signs 
 ``` ``` Diagnosis • Mostly PCR • Culture • Direct smear & stain • Immunohistochemical stain ```
48
Chlamydiosis in birds; Treatment/Control & Necropsy Findings
``` Treatment & Control • No vaccine 
 • Tetracycline or doxycycline 
 • Quarantine and medicated feed • Wild birds and rodents excluded 
 • Clean and disinfect ``` Necropsy Findings • Air sacs cloudy and thick 
 • Liver enlarged, scattered white foci (necrosis) 
 • Spleen enlarged 

49
Avian Chlamydiosis in Humans; Basics & Symptoms
``` o Reportable in humans o Can spread person to person o fever, chills, headache 
 o Sometimes respiratory distress and pneumonia 
 o Severe cases: heart, liver, CNS signs ```
50
Avian Chlamydiosis Treatment & Control
* Antibiotic treatment 
 * PPE * Respirator (N95) 
 * Dampen bird carcasses 
 * Dampen pigeon feces 
 * Do not allow children to touch dead birds
51
Chlamydophila felis
o Common cause of conjunctivitis in cats 
 o Vaccines can reduce clinical signs but do not prevent shedding 
 o May occasionally cause keratoconjunctivitis in humans
52
Chlamydophila abortus; basics, symptoms in humans, treatment
o Common cause of abortion in sheep and goats o Transmitted to humans oral or aerosol 
 o Organisms shed at lambing 
 o Can cause abortion in humans o Vaccine may reduce abortions 
 o Tetracycline or doxycyline 

53
Q Fever Basics
* Coxiella burnetii, * obligate intracellular Gram(-) * resistant to environmental stress 
 * remain viable for weeks to months in environment 
 * Worldwide distribution 
 * Started in Australia
54
How is Coxiella burnetti different form Ricketssia
o Resistant to elevated temps, UV light, chemicals 
 o Does not tend to cause rashes in humans 
 o Does not REQUIRE vector transmission, but can be vector- borne
55
Hosts & Transmission of Q Fever
Hosts o most have asymptomatic 
infections 
 o sheep, goats, cattle, cats, dogs, wildlife, ticks 
 o In ruminants, abortions or stillbirths, up to 50% of flock can be affected in sheep o Large number organisms shed at parturition 
 Transmission o Shed in feces, milk, urine, o persist in environment & spread by wind 
 o Arthropods (ticks): bite by an infected tick is rare o human to human: rare
56
Q fever in Ruminants
o Bacteria localizes in MG, LN, 
placenta, uterus 
 o May be shed in subsequent births and lactations 
 o Infection may be subclinical or cause anorexia, late abortion 

57
Diagnosis of Q Fever
Post Mortem Pathology o Infection involves mostly the 
placenta 
 o Grey-brown placental exudate 
 o Necrotizing vasculitis 
 Other Ways to Diagnose o impression smear of cotyledons stained by acid- fast stain (Geimsa) 
 o Serology: ELISA, CF, Immunohistochemistry, IFA 
(rising titer) o PCR placenta (this is how it is diagnosed mostly now) 
 o Culture rarely attempted 

58
Treatment & Prevention of Q Fever in Ruminants
o Efficacy of antibiotic treatment questionable (oral tetracycline) o Minimize contact with wildlife, minimize new animals into flock o Isolate pregnant animals in an outbreak o Bury or burn placentas, aborted fetuses o Clean and disinfect (10% bleach) birthing areas o Consider PPE/ respirator when cleaning birthing area o Rodent control (good practice for many diseases)
 o Do not allow dogs and cats to contact birth material o Do not move heavily pregnant or new dams off farm o Biosecurity (limit access)
59
Q Fever in Cats; basics, diagnosis, treatment
o Cats have caused infections in 
humans 
 o Cats exposed via aerosol, tick bites, or ingestion of aborted ruminant placenta/fetus 
 o high numbers in placenta of cats and may persist in uterus for weeks after birth o Cats often subclinical, but may abort 
 Diagnosis • serology (increased 
titer) may be performed 
 Treatment • Tetracycline and chloramphenicol may be used to treat
60
Basics of Q Fever in Humans
o Primarily affects those that work with animals, hides and wool 
 o Higher seroprevalence in > 40 years old 
 o Males> females 
 o Age 60+: highest risk for Q fever 
in U.S. 
 o More common in immunosuppressed people 
 o reportable
61
Symptoms of Q Fever in Humans
Symptoms • acute or chronic • Incubation period several days to several months or even years • Most cases are asymptomatic 
 • Flu-like symptoms, severe headache, chills, fever, sore throat, chest pain (and, thus, may be under-reported) 
 • Usually self-limiting, • severe pneumonia may occur in elderly, immunosuppressed patients 

62
Treatment for Q Fever in Humans
* Early antibiotic treatment may shorten illness and decrease complications (doxycycline) 
 * Long term treatment (years) for chronic endocarditis 
 * 4A vaccine is available in Australia for those in high risk occupations 

63
Chronic Q Fever in Humans
* rare 
 * Months to years after acute infection 
 * Endocarditis, encephalitis, pneumonia, hepatitis, osteomyelitis * Usually in people with heart conditions 

64
Triad of Infectious Dz
o Presence of a disease-causing agent is rarely sufficient to cause disease o Genetic predisposition usually requires environmental factors too 
 o Incidence of infection depends on the 
interrelationship of the host, the pathogen, and the environment 
 o vector plays an important role in disease transmission
65
Basics of Lyme Dz
o Most common tick borne dz o Emerging dz o reportable in humans & animals o spirochete Borrelia burgdorferi or rarely B. mayonii o Infected tick bites, stays on host 48 hours o Incidence higher in children than adolescents, young adults
66
Lyme Dz Symptoms in Humans
* Most cases: bulls-eye rash (erythema migrans), flu-like symptoms. * Can be cutaneous, arthritic, neurologic, cardiac symptoms 
 * 60% cases: Lyme arthritis of knees * Days to weeks following infection or months to years!
67
Lyme Dz Symptoms in Dogs
• Most do not get disease 
 Acute • intermittent, recurring lameness, fever, anorexia, lymphadenopathy, swollen joints 
 Renal failure • Bernese Mountain Dogs & Labs have high Ab levels and immune complex in kidney cause severe inflammation
68
Lyme Dz; Diagnosis in Dogs
* Over diagnosed 
 * History, clinical signs, R/O other diseases, lab tests, 
epidemiology, response to tx 
 Ab detection: • ELISA then positive samples tested by Western Blot (WB differentiates natural infection vs. vaccination) 
 C6 peptide assay: • specific for infection-induced Ab (may be false-negative shortly after infection) 
 Serology: • long incubation, persistence of Ab, disassociation of Ab response from clinical dz make dx by blood testing alone difficult 
 Bacterial isolation: • difficult, time-consuming (6 weeks) and often negative 
 PCR (joints, skin tissue etc.) • may be used, often negative 

69
Lyme Dz; Diagnosis in Humans
* Serology w/ western blot | * For IgM & IgG
70
Treatment & History of Lyme Dz
Treatment • Doxycycline or ampicillin History • Arthritis & rash in children in Lyme, CT -> • Suspected rickettsia -> • Found spirochete Borrelia burgdorferi
71
Lyme Dz Maintenance Cycle/Reservoir; ticks responsible
Tick vector • Nymph infects human • Adult infects dogs Ixodes scapularis o NE & Midwest o 25-50% infected Ixodes pacificus o West Coast o 1-5% infected Rodent reservoir • Mice have bacteria • Deer feed ticks • Animal to animal transmission not possible
72
Control & Vx Recommendations Lyme Dz
Control • Avoid ticks • Osp A Canine Recombinant Lyme vaccine Recommendations on Vx • Don’t Vx in non-endemic areas • Use tick prevention instead
73
Giardia Basics
* Many species * Protozoan * Humans: Giardia duodenalis (G. intestinalis, G. lamblia) * Dogs: Giardia canis * No environmental replication, cysts persist * Dogs & cats carry A & B that can infect humans
74
Giardia Transmission
o cysts shed in feces -> o Cysts can survive for months in cold water -> o Ingestion of cysts in contaminated water or food 
–> o Human-to-human transmission 
– Primary source of human infections 
 o Animal-to-human transmission 
– Only if assemblages A&B
75
Giardia in Humans; basics & acute/chronic symptoms
``` o Most common intestinal parasite in humans o 1-3wk incubation o late summer o Asymptomatic carriers o Re-infection common ``` Acute Symptoms • Cramps, nausea, V/D, gas, dehydration Chronic Symptoms • Weight loss & malnutrition
76
Giardia Diagnosis in Dogs & Cats
o Do 3 fecal samples due to intermittent shedding 
 o Direct fecal smear 
 o Zinc sulfate fecal 
floatation 
 o Fecal IFA & ELISA- SNAP test 
 o PCR- only method to determine Assemblage (Rarely done) 
 ELISA SNAP Giardia Test o Warm to room temp o Check results @ correct time
77
Giardia Treatment in Humans Vs Animals
Humans: • Metronidazole, • Tinidazole • nitazoxanide Animals: • Metronidazole, • fenbendazole, • albendazole
78
Giardia Prevention
``` o Good hygiene o Avoid potentially contaminated water o Prevent contact w/ feces o Diagnose & treat infections o Giardia vx for dogs/cats resists oocyte shedding (discontinued) ```
79
Leptospirosis Basics & Transmission
* Spirochete Leptospira * Gram (-) * Greater than 200 serovars * Does not replicate outside of the host * maintained in environmental water sources, mud, and wet soil for extended periods * Global distribution ``` Transmission o Urine, blood, tissue, contaminated soil/water into abraided skin or mucosal surface o In utero o Horizontally through semen o Lab transmission o Floods ```
80
Leptospirosis Clinical Signs
``` o Hepatic dz o Red water o Renal failure o Abortion o Mastitis o Uveitis in horses ```
81
Leptospirosis Diagnosis & Treatment
``` Diagnosis o Clin Path for renal and hepatic disease o Kidney biopsy o Serology
 o FA & IHC of abortions or necropsy o PCR 
of urine & water o Culture (very slow weeks) 
 ``` Treatment o doxycycline, o penicillin, o oxytetracycline
82
Leptospirosis Prevention
o Water sanitation o Hygiene: protective clothing, hand- washing Vaccination • Swine, Cattle, Dogs • Not cross protective • Controversial to recommend
83
Cattle Producer Leptospirosis Control Recommendations
o Vx for several serovars o Vx calves 3-6mo to avoid maternal Ab o Boost bi-annually
84
Basics of Tularemia
``` o Francisella tularensis
 o Gram negative, aerobic coccobacillus o Hardy, non-spore-forming o Category A bioterrorism agent o North Americ & Eurasia o Survives well in H2O, moist soil, decaying carcasses ```
85
2 Maintenance Cycles of Tularemia & Reservoir/Hosts
Maintenance Cycles o Rabbits/hares/ticks 
 OR o Voles, mice, squirrels, muskrat/direct contact or contaminated aquatic environment 
 o Reservoir Lagomorph, wild rodents, ticks (transovarian) o Hosts • MANY species
86
Transmission of Tularemia
o Biological vector: Dermacentor & Amblyomma ticks 
 o Mechanical vector: deer flies, mosquitoes 
 o Directcontact: bites, secretions 
 o Inhalation 
during lawn mewing, shearing rabbits o Ingestion of infected animals, contaminated food 
 o Lab BL3 to culture 
 o No person-to person transmission
87
Why is Tularemia Used as a Bioterrorism Weapon
``` o Easy to acquire 
 o Stable in the environment 
 o Intentional contamination of food and/or water 
 o Aerosolization 
 o Multiple species infected ```
88
4 Presentations of Tularemia in Humans
Ulceroglandular infection • An ulcerative skin lesion with lymphadenopathy Pharyngeal infection: • via ingestion • cervical, submandibular, mediastinal lymphadenitis; • exudative pharyngitis, oral ulcers Septicemia (typhoidal) • hepatomegaly, splenomegaly Pneumonic • via inhalation • Radiographic and clinical evidence of pneumonia, pleuritis, • 60% fatal if not treated
89
basics & 3 forms of Tularemia in Animals
o Fever, lethargy, anorexia, stiff gait, increased pulse and respiration, coughing, vomiting, diarrhea and pollakiuria 
 incubation: • 3-5 days, (1-14 days) 
 Ulceroglandular form: • cutaneous ulcers & regional lymphadenopathy 
 Septicemic form: • hepatomegaly, icterus, sheep 
 Pneumonic form: • rare 

90
Tularemia Diagnosis, Treatment, Control
``` Diagnosis o Serology: 4-fold change 
 o Culture of blood, aspirate, exudate or 
biopsy 
 o Direct FA 
 o PCR 
 ``` Treatment o Doxycycline, tetracyclines, chloramphenica, ciprofloxacin o Resistant to Beta-lactams: Penicillin & cephalosporins ``` Control o Prevent pets from hunting rodents/rabbits o Tick control o PPE around infected animals o Food hygiene o No Vx ```
91
What is an Emerging Dz
``` o Appearance in new host o Changes in pathogen’s underlying epidemiology o Evolved strains o Recent & 1st entry into a host o Increased incidence ```
92
Factors of Pathogens Contributing to Emergence of Dz
Antimicrobial resistance • Transformation • Transduction • Conjugation ``` Genetic adaptation & change • Nucleotide substitution • Natural selection • Recombination • Reassortment ```
93
Factors of Humans Contributing to Emergence of Dz
``` Human demographic changes • Increased human contact • Increased contact with wildlife • Intensification of agriculture • Population displacement ``` Human behavior
 • Sexual practices, IV drug use: HIV • Intent to harm: Anthrax, Botulism • Domestication of animals: Toxoplasma Human susceptibility to infection • Immunocompromising conditions: HIV, cancer • Nosocomial infections: SARS, Ebola, MRSA, MERS-CoV • Transplants/infusions: HIV, Cryptococcus neoformans, Baboon cytomegalovirus • Implants/surgical instruments: vCJD, fungal meningitis in contaminated steroid injections
94
What does R sub 0 mean in Emerging Dz
o <1 = limited spread o 1 = endemic o >1 = epidemic