Zoonoses Flashcards by Georgia Leggett

What are zoonoses?

Diseases that pass between people + animals.

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

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What are 3 examples of new emerging infectious diseases?

VHF

Resp diseases: MERS

Novel influenza viruses: pH1N1

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Give 3 modes of zoonotic diseases transmission

Everyday contact: Scratches or bites

By-products (feces/urine): Contaminated soil, Litter

Foodstuffs: Carcass processing, Milk/ milking, Raw/ undercooked meats

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Which zoonoses are UK farm/ wild animal associated?

Campylobacter

Salmonella

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Which zoonoses are tropical farm/ wild animal associated?

Brucella

Coxiella

Rabies

VHF

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Which zoonoses are UK companion animal based?

Bartonella

Toxoplasmosis

Ringworm

Psitticosis

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Which zoonoses are tropical companion animal associated?

Rabies

Tick-borne diseases

Spirilum minus

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What is the reservoir and transmission for Campylobacter?

Reservoir: POULTRY + Cattle

Transmission: Contaminated food

Often through cross-contamination from raw chicken.

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

Diarrhoea

Bloating

Cramps

Ix: Stool culture

Mx: Supportive

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What is the reservoir and transmission for Salmonella?

Reservoir: Poultry + Reptiles/ amphibians

Transmission: Contaminated food + Poor hand hygiene

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

Diarrhoea

Vomiting

Fever

Ix: Stool culture

Mx: Supportive

Ciprofloxacin/ Azithromycin in severe

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What is the reservoir and transmission of Bartonella henselae?

Reservoir: Kittens > cats

Transmission: Scratches, Bites, Licks of open wounds, Fleas

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Which two diseases can Bartonella henselae cause? Generally in which groups of patients?

Cat Scratch Disease: ImmunoCOMPETENT

Bacillary angiomatosis: ImmunoCOMPROMISED

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Why do kittens cause Bartonella henselae more than adult cats?

Slightly curved Gram -ve rod.

Kittens more likely to infect because they scratch more + have higher prevalence of Bartonella.

Prevalence in cats of all ages: 30-50%.

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

Macule at site of innoculation, becomes pustular

Regional adenopathy

Systemic sx (fever, night sweats, weight loss)

Ix: Serology

Mx: Erythromycin, Doxycycline

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What is the clinical presentation of bacilliary angiomatosis?

Mostly in HIV + immunosuppressed. Much more severe disease than CSD.

Skin papules (BIG)

Disseminated multi-organ + vasculature involvement

Liver: deranged LFTs, deranged clotting

Spleen: splenomegaly, thrombocytopenia, reticulocytosis, fragments on blood film

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What are investigations, management and prevention recommendations for bacilliary angiomatosis?

Ix: Histopathology, Serology

Mx: Erythromycin/ Doxycycline + Rifampicin

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

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What is the reservoir and transmission of Toxoplasmosis?

Reservoir: Cats > Sheep

Transmission: Infected meat, Faecal contamination

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What is the clinical presentation of toxoplasmosis?

Fever

Adenopathy

Still-birth

Progressive visual, hearing, motor, + cognitive issues

Seizures

Neuropathies

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What is the investigation for toxoplasmosis?

Serology

What is the reservoir and transmission of Brucellosis?

Reservoir: Cattle, Goats

Transmission: Unpasteurised milk/ cheese, Undercooked meat, Mucosal splash, Aerosolisation/ inhalation

What is the clinical presentation of Brucellosis?

Incubation 5d-7m

FLAWS

PUO

Back pain

Orchitis

Focal abscesses (Psoas, liver etc)

What are investigations and management for Brucellosis?

Ix: Blood/ pus culture in casteneda medium, Serology

Mx: Doxycycline + Gentamicin/ Rifampicin

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

Reservoir: Goats, Sheep (Cattle)

Transmission: Aerosolisation/ inhalation of secretions, waste, or milk of infected animals, Unpasteurised milk

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

Incubation period: 2-3w (1-6w) Fever ‘Flu-like' illness Pneumonia Hepatitis Endocarditis Focal abscesses (Para-vertebral/discitis etc)

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

**Ix**: Serology **Mx:** Doxycycline (+/-hydroxychloroquine)

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

**Reservoir:** Dogs, Cats, Bats **Transmission:** Bites, Scratches, Contact with infected fluid

What is the clinical presentation of Rabies?

Seizures Excessive salivation Agitation Confusion Fever Headache

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

**Ix:** Serology, Brain biopsy (USA saliva PCR) (mainly clinical dx) **Mx:** Immunoglobulin, Vaccine HRIG only given if direct exposure to saliva of likely infected animal + no pre-exposure vx

What is the reservoir and transmission of rat bite fever?

**Reservoir:** Rats **Transmission:** Bites, Contact with infected urine or droppings

What are the responsible agents for rat bite fever?

Streptobacillus moniliformis Spirillum minus

What is the clinical presentation of rat bite fever?

2-10d after bite: Fevers Polyarthralgia Maculopapular progressing to purpuric rash Can progress to endocarditis

What are investigations and management for rat bite fever?

**Ix:** Joint fluid microscopy + culture, BC **Mx:** Penicillins

What is the reservoir and transmission for Hantavirus Pulmonary Syndrome?

**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

What is the clinical presentation for Hantavirus pulmonary syndrome?

Fever Myalgia Flu-like illness Respiratory failure (USA) Bleeding (SE Asia) Renal failure (SE Asia)

What are investigations and management for Hantavirus pulmonary syndrome?

**Ix:** Serology, PCR **Mx:** Supportive

What is the reservoir and transmission of viral haemorrhagic fever?

**Reservoir:** Bats: Ebola + Marburg Rats: Lassa Ticks: CCHF **Transmission:** Contact of fluids of infected (saliva, urine, faeces, sweat, vomit)

What are causative organisms of viral haemorrhagic fever?

Lassa Marburg Ebola Congo-Crimean Hemorrhagic Fever Ebola + Marburg are RNA viruses in the filovirus family.

What is the clinical presentation of viral haemorrhagic fever?

Fever Myalgia Flu-like illness Bleeding

What are investigations and management for viral haemorrhagic fever?

**Ix:** Serology, PCR **Mx:** Supportive. No tx

**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

C. Chicken

**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

D. Rabies virus

**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. Blood culture

**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

C. Admit into side room

Name the 2 salmonella sub-species that are not zoonotic. What is their route of transmission?

Salmonella Typhi Salmonella paratyphi Human-Human: Faeco-oral

What % of Cat Scratch Disease patients progress? What symptoms may arise?

14% Eye problems Encephalopathy Arthritis Osteolysis Vascular system lesions Hepatitis Pneumonia.

Which disease should be considered in a young person with weight loss, night sweats and has had contact with companion animals? Why?

Bartonella Sometimes similar presentation to TB + Lymphoma Ask if they have had contact with a cat

What is the treatment for a Toxoplasmosis +ve mother and -ve baby on PCR?

Spiramycin 3w 2-3g/d

What is the treatment for a Toxoplasmosis +ve mother and +ve baby on PCR?

Pyrimethamine + Sulfadiazine Treat baby for up to 1y after delivery +/- Prednisolone in severe