Zoonoses

Question 1

What are zoonoses (3)

Answer 1

Complex group of diseases
Many pathogenic microorganisms that cause disease/colonise animals
Depends on vertebrate intermediate

INFECTIONS ACQUIRED FROM VERTEBRATE ANIMALS

Question 2

What is an examples of zoonoses

Answer 2

Babesiosis - animal-tick-human

Question 3

How are zoonoses transmitted (3)

Answer 3

By direct contact
Indirect contact by vector
Indirect contact through environmental contamination

Question 4

Give transmission routes for zoonoses (6)

Answer 4

Direct contact 
Ingestion
Inhalation 
Arthropod intermediates
Animal bites 
RARE - person-to-person via blood transfusion

Question 5

What are the animal contacts that can give us zoonoses (4)

Answer 5

Pets
Lab animals
Household animals
Wild animals

Question 6

What is a historic example of a zoonoses that had a huge impact on humans

Answer 6

Bubonic plague -Bacteria = yersinia pestis

Brucella (Pompei, Florence Nightingale)

Question 7

What are some zoonoses that are transmitted via mechanical transmission (3)

Answer 7

Dysentry
Cholera
Typhoid

Question 8

What are some arthropod-borne zoonoses (8)

Answer 8

Plague 
Rickettsia
Ehrlichia 
Anaplasma
Relapsing fever
Lyme borreliosis
Leishmania
Arboviruses

Question 9

What is necessary for vector-bore transmission (3)

Answer 9

Organism must be in the correct place - the blood.
Rapid adaptation from human to arthropod.
Dissemination of parasite

Question 10

What are some traveler associated zoonotic infection (9)

Answer 10

Malaria
Brucellosis 
Dengue 
Leishmaniasis 
Relapsing fever
Bubonic plague 
Rabies
Ebola....21 day rule 
Melioidosis

Question 11

What zoonotic infections are associated with household pets (10)

Answer 11

Psitticosis
Q fever
Brucellosis
Salmonellosis
Bartonella
Lyme borreliosis
Rickettsia
Leishmaniasis
Echinococcosis
Rabies

Question 12

What are some infections transmitted from cats (5)

Answer 12

Bartonellosis 
Leptospirosis 
Q fever
Toxoplasmosis 
Rabies

Question 13

What are some infections acquired from dogs (5)

Answer 13

Hydatid disease 
Leptospirosis
Brucellosis
Q fever
Rabies

Question 14

What are some infections acquired from birds (6)

Answer 14

Psitticosis 
Influenza
Cryptococcus 
Infleunza A 
Poultry-salmonella 
West Nile virus

Question 15

What are some infections associated with mice (4)

Answer 15

Hantan viruses
Lyme borreliosis
Ehrlichia
Bartonella

Question 16

What are some infections associated with rats (5)

Answer 16

Rabies
Leptospirosis
Lassa fever (VHF)
Hantan viruses 
Plague

Question 17

What are some infections acquired from small ruminants (4)

Answer 17

Anthrax
Brucellosis
Q fever
Listeria

Question 18

What are some infections acquired form cattle (7)

Answer 18

Anthrax
Leptospirosis 
Brucellosis
Bovine tuberculosis
Anaplasmosis 
Toxoplasmosis 
Ecoli 0157

Question 19

What are some infections acquired from swine (6)

Answer 19

Brucellosis 
Leptospirosis 
Trichinella 
Hepatitis E
Influenza A
Japanese encephalitis

Question 20

What proportion of new emerging diseases are zoonotic in origin

Answer 20

75%

Question 21

What percentage of all human infections are zoonoses

Answer 21

58%

Question 22

What increases risk of zoonotic infections

Answer 22

Crowded, hot, unhygenic conditions

Question 23

What allows pathogens to cross species barriers

Answer 23

Mixing of multiple hosts allows:
Adaptation of pathogen
Adaptation fo vector

Question 24

What are some travel related sources of zoonotic infections (3)

Answer 24

Tourism
Livestock/exotic species/pets
Food

Question 25

What are some contact related sources of zoonitic infections (3)

Answer 25

Food - BSE Physical contact - changed livestock husbandry, new sports - eco challenges Environmental - encroachment of natural habitats

Question 26

What zoonotic infections are associated with recreational activities (7)

Answer 26

``` Leptospirosis Hepatitis A Giardia Toxoplasmosis Mycobacterium marinum/ulcerans Burkholderia pseudomallei Ecoli ```

Question 27

What are some important travel associated exotic infections (2)

Answer 27

Leishmaniasis | Burkholderia pseudomallei

Question 28

What are some common travel related infections (3)

Answer 28

West Nile Virus in America Food poisoning (travellers diarrhoea) Influenza A

Question 29

What clinical clues point towards zoonoses (8)

Answer 29

Consumption of unpasturised dairy produce Undercooked meat from infected animals Eating aborted foetuses (Ecuador) Crushing umbilical cord of newborn lambs/kids between teeth.... Contact - skin lesions, mucous membranes (slaughter house workers, hunters, vets) Travel Exposure - food/water/animals Bites - fleas/ticks/mosquito/fly - time of day important E.g. walking on the beach in Greece

Question 30

Where is Leishmaniasis found (2)

Answer 30

Europe | South America

Question 31

What is the family of the rabies virus

Answer 31

Rhabdoviruses

Question 32

What type of virus is rabies

Answer 32

It is a lyssavirus, from rhabdoviruses

Question 33

What type of virus is vesicular stomatis virus

Answer 33

A vesuculoviris from rhabdoviruses

Question 34

What do rabies and vesicular stomatis have in common

Answer 34

Both rhabdoviruses

Question 35

What are rhabdoviruses shaped like

Answer 35

Rod-shaped

Question 36

What does lyssaviruse describe

Answer 36

Frenzy, fluffy appearance of viruse

Question 37

What are the clinical features of rabies (4)

Answer 37

Contact with infected animal (dog, bat) - usually through being bitten. Variable incubation Slow migration to CNS Inevitable clinical outcome is death

Question 38

What is the life cycle of a rabies virus in a racoon (6)

Answer 38

Raccoon is bitten by a rabid animal Rabies virus enters the raccoon through infected saliva Rabies virus spreads through the nerves to the spinal cord and brain The virus incubates in raccoon's body for approximately 3-12 weeks. The raccoon has no signs of illness during this time. When it reaches the brain, the virus multiplies rapidly, passes to the salivary glands, and the raccoon begins to show signs of disease. The infected animal usually dies within 7 days of becoming sick

Question 39

How many people die from rabies/year worldwide

Answer 39

55,000 worldwide/year

Question 40

How is rabies diagnosed (5)

Answer 40

IFA for rabies antigen in brain tissue IFA serial frozen skin sections Isolation of virus - murine neuroblastoma cells or intracerebral mouse inoculation RT-PCR (>15% nucleotide difference between rabies variants - 8 genotypes) Serology - neutralisation tests/ELISA for specific IgM

Question 41

How is rabies prevented (2)

Answer 41

Rabies vaccine pre-travel/exposure | Rapid access to point exposure vaccine and IgG

Question 42

What is brucellae

Answer 42

Gram-negative facultative intracellular bacteria Nine species currently recognised Different species and biovars (differential host specificity and pathogenicity)

Question 43

How is brucellosis transmitted (6)

Answer 43

``` Contact with infected animal/environmental contamination Consumption of infected animal products Respiratory Gastro-intestinal Laboratory acquired infection Bioterrorism ```

Question 44

What are the clinical features of brucellosis (6)

Answer 44

Incubation 3-4 weeks (may be up to 7-10 months). Non-specific onset with complications of osteomyelitis (occasionally meningoencephalitis). Severely debilitating – often chronic Culture bone marrow (>90% positive). Blood cultures (70% positive) need extended incubation! Serological diagnostic tests.

Question 45

What is the treatment for brucellosis infection (3)

Answer 45

Prolonged therapy of 4-6 weeks with tetracycline or doxycycline combined with streptomycin. Oral therapy with doxycycline and rifampicin 8 weeks (WHO) Above supplemented with amikacin bid 7 days

Question 46

Where is plague currently a problem (2)

Answer 46

Madagascar | Emerging infection in Kazakhstan

Question 47

What are the potential vectors for plague (4)

Answer 47

``` Carried in fleas: Birds Cats Rats Camels ```

Question 48

What are the two main subsets of plague (2)

Answer 48

Bubonic plague | Pneumonic plague

Question 49

How is plague diagnosed (2)

Answer 49

``` Conventional microbiological methods Molecular methods (e.g. PCR) ```

Question 50

How is plague treated (4)

Answer 50

Streptomycin Doxycycline Gentamicin Chloramphenicol - meningitis

Question 51

What is the vector for relapsing fever

Answer 51

Human body louse

Question 52

Who are most at risk of louse borne relapsing fever

Answer 52

Young males

Question 53

What are the early clinical features of lyme borreliosis (2)

Answer 53

Erythema migrans | Non-specific flu-like illness

Question 54

What is the vector for lyme borreliosis

Answer 54

Ticks | In the UK/Eurpose - ixodes tick

Question 55

What are the clinical features of early disseminated lyme borreliosis (4)

Answer 55

Secondary erythema migrans Palsies Carditis Srthritis

Question 56

What are the late clinical features of lyme borreliosis (3)

Answer 56

Arthritis ACA (acrodermatitis chronicum atrophocans) Encephalopathy

Question 57

What is the treatment for lyme borreliosis

Answer 57

Doxyclycline

Question 58

What are the causes of emerging zoonotic diseases (6)

Answer 58

``` Global warming Vectors moving/animals migrating habitats changing Wars Population growth, failure of vector control/waste removal Global travel ```