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Pathology eLearning - Y5 > Zoonoses > Flashcards

Zoonoses Flashcards

1
Q

What are zoonoses?

A

Diseases that pass between people and animals.

>70% of emerging human infectious diseases come from animals.

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2
Q

What are examples of new emerging infectious diseases?

A

VHF

Respiratory diseases: MERS

Novel influenza viruses: pH1N1

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3
Q

How are zoonotic diseases transmitted?

A

Every day contact with animals:

  • Scratches or bites

By-products (feces/urine):

  • Contaminated soil
  • Litter

Foodstuffs:

  • Carcass processing
  • Milk and milking
  • Raw/undercooked meats
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4
Q

Which zoonoses are UK farm/wild animal associated?

A

Campylobacter

Salmonella

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5
Q

Which zoonoses are tropical farm/wild animal associated?

A

Brucella

Coxiella

Rabies

VHF

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6
Q

Which zoonoses are UK companion animal based?

A

Bartonella

Toxoplasmosis

Ringworm

Psitticosis

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7
Q

Which zoonoses are tropical companion animal associated?

A

Rabies

Tick-borne diseases

Spirilum minus

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8
Q

What is the reservoir and transmission for Campylobacter?

A

Reservoir:

  • Poultry
  • Cattle

Transmission:

  • Contaminated food

80% of campylobacter food poisoning in the UK come from contaminated poultry, especially chicken. One of the main ways to get and spread campylobacter poisoning is through cross-contamination from raw chicken. Campylobacter is also found in red meat, unpasteurised milk and untreated water.

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9
Q

What is the clinical presentation of Campylobacter? What are investigations and management for Campylobacter?

A
  • Diarrhoea
  • Bloating
  • Cramps

Investigations: Stool culture

Management: Supportive

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10
Q

What is the reservoir and transmission for Salmonella?

A

Reservoir:

  • Poultry
  • Reptiles/amphibians

Transmission:

  • Contaminated food
  • Poor hand hygiene
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11
Q

What is the clinical presentation of Salmonella? What are investigations and management for Salmonella?

A

Clinical presentation:

  • Diarrhoea
  • Vomiting
  • Fever

Investigations: Stool culture

Management:

  • Supportive
  • Ciprofloxacin
  • Azithromycin
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12
Q

What is the reservoir and transmission of Bartonella henselae?

A

Reservoir: Kittens > cats

Transmission:

  • Scratches
  • Bites
  • Licks of open wounds
  • Fleas
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13
Q

Which two diseases can Bartonella henselae cause?

A

Cat Scratch Disease

Bacillary angiomatosis

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14
Q

Why do kittens cause Bartonella henselae more than adult cats?

A

Bartonella is a slightly curved Gram negative rod.

Kittens are more likely to infect people because they scratch more often and have a higher prevalence of Bartonella.

Prevalence in cats of all ages can be 30 to 50%.

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15
Q

What is the clinical presentation of cat scratch disease? What are investigations and management for cat scratch disease?

A

Clinical presentation:

14% of cases can progress to more severe symptoms which can include eye problems, encephalopathy, arthritis, osteolysis, vascular system lesions, hepatitis, or pneumonia.

  • Macule at site of innoculation
  • Becomes pustular
  • Regional adenopathy
  • Systemic symptoms

Investigations: Serology

Management: Erythromycin, Doxycycline

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16
Q

What is the clinical presentation of bacilliary angiomatosis?

A

Mostly in HIV - infected and other immuno-suppressed individuals. Much more severe disease than is CSD. Vascular lesions may involve many organs, with skin being the most common.

Clinical presentation:

  • Occurs in immunocompromised
  • Skin papules
  • Disseminated multi-organ and vasculature involvement
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17
Q

What are investigations and management for bacilliary angiomatosis?

A

Prevention: Wash hands after handling cats, use flea control, do not let cats lick areas of abraded skin or open wounds.

Investigations:

  • Histopathology
  • Serology

Management:

  • Erythromycin
  • Doxycycline

PLUS rifampicin

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18
Q

What is the reservoir and transmission of Toxoplasmosis?

A

Reservoir:

  • Cats
  • Sheep

Transmission:

  • Infected meat
  • Faecal contamination
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19
Q

What is the clinical presentation of toxoplasmosis?

A

Fever

Adenopathy

Still-birth

Progressive visual, hearing, motor, & cognitive issues

Seizures

Neuropathies

20
Q

What are investigations and management of toxoplasmosis?

A

Investigations: Serology

Management:

  • Spiramycin
  • Pyrimethamine plus sulfadiazine
21
Q

What is the reservoir and transmission of Brucellosis?

A

Reservoir:

  • Cattle
  • Goats

Transmission:

  • Unpasteurised milk
  • Undercooked meat
  • Mucosal splash
  • Aerosolisation/inhalation
22
Q

What is the clinical presentation of Brucellosis?

A

Incubation period - usually 30 days but can be up to 5 months

Symptoms: Non-specific. Fever, chills, headache, myalgia, arthralgia, anorexia, fatigue, lymphadenopathy and splenomagaly.

The ratio to subclinical to clinical cases is 1:1 to 12:1.

  • Fever
  • Back pain
  • Orchitis
  • Focal abscesses (Psoas, liver etc)
23
Q

What are investigations and management for Brucellosis?

A

Investigations:

  • Blood/pus culture
  • Serology

Management:

Doxycycline PLUS Gentamicin OR Rifampicin

24
Q

What is the reservoir and transmission of Coxiella burnetii - Q fever?

A

Reservoir:

  • Goats
  • Sheep
  • Cattle

Transmission:

  • Aerosolisation/inhalation of secretions, waste, or milk of infected animals.
  • Unpasteurised milk
25
Q

What is the clinical presentation of Coxiella burnetti - Q fever?

A

Incubation period: Usually 30 days but can be up to 5 months.

Symptoms: Non-specific. Fever, chills, headache, myalgia, arthralgia, anorexia, fatigue, lymphadenopathy and splenomagaly.

The ratio to subclinical to clinical cases is 1:1 to 12:1.

  • Fever
  • ‘Flu-like illness
  • Pneumonia
  • Hepatitis
  • Endocarditis
  • Focal abscesses (Para-vertebral/discitis etc)
26
Q

What are investigations and management of Coxiella burnetti - Q fever?

A

Investigations: Serology

Management: Doxycycline (hydroxychloroquine)

27
Q

What is the reservoir and transmission of Rabies (Lyssa virus)?

A

Reservoir:

  • Dogs
  • Cats
  • Bats
  • Racoons

Approximately 120,000 animals or more are tested for rabies each year in the United States, and approximately 6% are found to be rabid.

Transmission:

  • Bites
  • Scratches
  • Contact with infected fluid
28
Q

What are similar viruses to Rabies (Lyssa virus)?

A

All of the newly identified australian bat viruses are Rhabdoviruses which are related to the viruses that cause rabies and Lyssa fever. Viruses in this family have a high fatality rate often near 100%.

Henda Virus (Equine Morbillivirus): Infects humans, horses, cats and Guinea pigs. Fruit bats are the natural reservoir.

Australian bat lyssa viruses (Ballina virus): This is a close relative of rabies.

Menangle virus: Carried by fruit bats and causes disease in pigs.

29
Q

What is the clinical presentation of Rabies?

A

Seizures

Excessive salivation

Agitation

Confusion

Fever

Headache

30
Q

What are investigations and management of Rabies (Lyssa virus)?

A

Investigations:

  • Serology
  • Brain biopsy
  • (USA saliva PCR)

Management:

  • Immunoglobulin
  • Vaccine

HRIG only given if direct exposure to saliva of likely infected animal and no pre-exposure vaccinations received by the patient.

31
Q

What is the reservoir and transmission of rat bite fever?

A

Reservoir:

  • Rats: Nasopharyngeal carriage rates in healthy laboratory rats range from 10% to 100%; carriage rates in wild rats range from 50% to 100%.

Transmission:

  • Bites
  • Contact with infected urine or droppings

Transmission is usually through a rat bite. However, some cases have rat exposure but no reported bite.

32
Q

What are the responsible agents for rat bite fever?

A

Streptobacillus moniliformis

Spirillum minus

33
Q

What is the clinical presentation of rat bite fever?

A

2-10 days after rat bite:

  • Fevers
  • Polyarthralgia
  • Maculopapular progressing to purpuric rash
  • Can progress to endocarditis
34
Q

What are investigations and management for rat bite fever?

A

Investigations:

  • Joint fluid microscopy & culture
  • Blood culture

Management:

  • Penicillins
35
Q

What is the reservoir and transmission for Hantavirus Pulmonary Syndrome?

A

Reservoir:

  • Deer mouse: Sin Nombre virus
  • White footed mouse: Sin Nombre virus
  • Cotton rat: Black canal virus
  • Rice rat: Bayou virus

Transmission:

  • Contact with infected urine or droppings
  • Aerosolisation
36
Q

Where is Hantavirus pulmonary syndrome endemic and what is it associated with?

A

Western & southern USA and most of central & South America.

HPS has also been linked with hypertensive renal disease in the inner city.

37
Q

What is the clinical presentation for Hantavirus pulmonary syndrome?

A

Fever

Myalgia

Flulike illness

Respiratory failure

Bleeding

Renal failure

38
Q

What are investigations and management for Hantavirus pulmonary syndrome?

A

Investigations:

  • Serology
  • PCR

Management:

  • Supportive
39
Q

What is the reservoir and transmission of viral haemorrhagic fever?

A

Reservoir:

  • Ebola:?Bats
  • Marburg:?Bats
  • Lassa: Rats
  • CCHF: Ticks

Transmission:

Most are transmitted by direct contact of bodily fluids in the later stages of the disease. Vomiting, diarrhea, shock and hemorrhage.

Not transmissible via air.

Caregivers often infected.

40
Q

What are causative organisms of viral haemorrhagic fever?

A
  • Lassa
  • Marburg
  • Ebola
  • Congo-Crimean Hemorrhagic Fever

Ebola and Marburg are RNA viruses in the filovirus family.

41
Q

What is the clinical presentation of viral haemorrhagic fever?

A

Fever

Myalgia

Flulike illness

Bleeding

42
Q

What are investigations and management for viral haemorrhagic fever?

A

Investigations:

  • Serology
  • PCR

Management: Supportive

43
Q

A 35 year old patient presents with abdominal cramps and diarrhoea after a BBQ. What is the most likely source?

A. Beef

B. Pork

C. Chicken

D. Unpasteurised cheese

E. Playing with the tortoise

A

C. Chicken

44
Q

A 35 year old patient presents with fever after a bat bite.

What potential infection is most concerning?

A. Spirillum minus

B. Hanta virus

C. Lassa virus

D. Rabies virus

E. Streptobacillus moniliformis

A

D. Rabies virus

45
Q

A 35 year old patient is suspected of having a Brucella infection in their right psoas after drinking unpasteurised goats milk.

What is the first investigation to obtain?

A. Blood culture

B. Psoas pus culture

C. Serology

D. Whole blood PCR

E. Psoas muscle histopathology

A

A. Blood culture

46
Q

A 35 year old patient presents with fever of 38.8C after return from 3 months in Rwanda, when they co-habited in a hut with a family and their livestock.

How should this patient be managed?

A. Admit into a bay

B. Transfer to HCID unit at Royal Free

C. Admit into side room

D. Discharge

E. Discharge to return to infectious diseases clinic in 3 days

A

C. Admit into side room

Pathology eLearning - Y5 (17 decks)

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