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Zoonotic Diseases of SouthWest Flashcards

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1
Q

presence of zoonotic diseases in AZ is exacerbated by

A
  • diversity in wildlife species
  • disparities across communities
  • extreme climates
  • varrying topography
  • close proximity to international border
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2
Q

in AZ, tularemia circulates naturally among _____ and ______ and is usally found in areas above _______feet

A

rabbits and rodents
3,000 feet

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3
Q

Cases of tularemia in AZ have been related to exposure to what

A

rabbit or rabbit carcass, dog that was exposed to rabbit carcass, skinning elk, potentially from insect bites

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4
Q

Tularemia Agent

A

Francisella tularensis a gram (-) bacteria

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5
Q

T/F: tularemia is considered a potential bioterrorism weapon

A

T

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6
Q

most reported worldwide zoonoses

A
  • Rabies 55,000+
  • Leishmaniasis >2 million
  • Cysticercosis ~50,000 deaths
  • Brucellosis ~500K
    * Leptospirosis ~10 million
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7
Q

common zoonoses of the Southwest (6)

A
  • Tularemia
  • Rocky Mountain spotted fever (vectored by brown dog tick)
  • Chagas
  • Onchocerca lupi
  • hantavirus
  • plague
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8
Q

what is the third most common reported laboratory-associated bacterial infection

A

tularemia

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9
Q

tularemia incubation period

A

3-5 on average
but can be 1-14

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10
Q

how is tuleremia transmitted

A

drainage from tulameria lesion
flies can remain infective for 2 weeks
ticks remain infective throughout their lifetime

not directly transmitted from person to person

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11
Q

clinical diagnosis of tularemia

A

evidence or history of a tick or deerfly bit, exposure to tissue of mammalian host or exposure to contaminated water

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12
Q

tularemia symptoms

A
  • sudden fever
  • chills
  • headache
  • D+
  • muscle aches/joint pain
  • dry cough

w/out txt, can result in respiratory failture, shock, death

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13
Q

differential diagnosis for tularemia is…

A

plague

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14
Q

most common form of tularemia

A

Ulceroglandular
- usually following tick or deer fly bite or handling infected animal
- cutaneous ulcer w/ regional lymphadenopathy

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15
Q

regional lymphadenopathy w/ no ulcer (tularemia)

A

Glandular

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16
Q

Oculoglandular tularemia

A
  • bacteria gets into eye during butchering or touching eye
  • conjunctivitis w/ preauricular lymphadenopathy
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17
Q

Tularemia from eating/drinking contaminated food/water. Characterized by stomatitis, pharyngitis, tonsilitis, cervical lymphadenopathy

A

Oropharyngeal

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18
Q

most serious form of tularemia, caused by breathing dust or aerosols containing the organism

A

penumonic
primary pleuropulmonary disease

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19
Q

febrile (fever) illness w/out early localizing signs/symptoms (tularemia)

A

Typhoidal

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20
Q

Type A tularemia infections may be acquired from _____or_____

A

rabbits, ticks

A.II strains localizeed to western US

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21
Q

type B tularemia infections are often associated w/ hosts such as….?

A

rodents and hares

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22
Q

Tularemia mode of transmission

A
  • bite from certain arthropods
  • inoculation of skin, conjunctival sac, oropharyngeal mucosa w/ contaminated water, blood, tissue while handling infected animals
  • handling/ingesting insufficiently cooked meat of infected host
  • inhalation of dust from contaminated soil/grain/hay
  • contaminated pelts and paws of animals
  • rarely from bites of animals that ate an infected animal
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23
Q

tularemia treatment

A
  • antibiotics
  • 14-21 days
  • symptoms may last for weeks but mosst patients completely recover
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24
Q

All confirmed, probable or suspect tularemia cases must be reported to ______ within 4 hours

A

AZDA

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25
Tularemia prevention
inspect yard before mowing to avoid sick / dead animals use dust masks use insect repellent w/ 20-30% DEET wear long pants, sleeves and sock to keep ticks and deer flies away remove ticks asap hunters wear gloves while skinning drink only treated water while camping
26
Rocky Mountain Spotted Fever (RMSF) is vectored by...
brown dog tick
27
most severe disease caused by tick in USA
RMSF Notifiable to CDC 5-10% of cases are fatal
28
state in US w/ most cases of RMSF
AZ, mostly in communities w/ lots of roaming dogs
29
what organism causes RMSF
Rickettsia rickettsii, gram (-) obligate intracellular parasite
30
how is R.rickettsii transmitted? what is the incubation period?
bite of an infected tick 4-5 days most common but can be 2-14 days
31
R. rickettsii invades ____Cells of the venules and capillaries, causing _______
endothelial cells, causing vasculitis
32
RMSF clinical signs
Fever, severe lethargy petechiae and ecchymoses on mucous membranes focal retinal hemorrhages edema of extremities about 60% of cases have rashes but rash is uncommon in AZ
33
late stage clinical signs of RMSF
necrosis, abdominal pain, V+, anorexia altered mental status myalgia or polyarthritis vestibular deficits dyspnea or cough
34
Abnormal clinical findings associated w/ RMSF
hypoalbuminemia moderate leukocytosis thrombocytopenia signs may resemble infection w/ Ehrlichia canis (which is also transmitted by brown dog tick)
35
gold standard for RMSF diagnosis
indirect immunofluorescence assay (IFA) w R. rickettsii antigen, performed on 2 paired serum samples to demonstrate 4 fold rise in antibody titers PCR testing
36
RMSF treatment
doxycycline mortality is related to incorrect txt or delayed diagnosis prompt use of antibiotics reduces severity of illness
37
RMSF prevention
prevent tick attachment, promptly remove if it occurs topical or systemic tick control prevention seasonal tick/flea dips collars w/ amitraz or propoxur txt of kennels/yards w/ acaricidal
38
Primary domestic reservoir of chagas
dogs
39
how many people in Mexico, central and south America are suspected to have Chagas
8 million if untreated, infection is lifelong and can be life threatening
40
chagas disease is caused by....
protozoan parasite: Trypanosoma cruzi, transmitted to animals and people by insect vectors
41
T/F: Chagas is only found in the Americas
T
42
Chagas transmission to humans
vector-borne infected triatomines (kissing bugs) - feces contains parasite, enters through bite or mucous membranes congenital transmission (mother to fetus) blood transfusion organ transplantation oral ingestion (Contaminated foods or acai, palm fruit, guava juice, sugarcane juice)
43
presence of Chagas in AZ
up to 1/2 of all kissing bugs have it but no confirmed cases from bug bites
44
Acute phase of Chagas (clinical signs)
acute phase = first few weeks-months of infection fever, fatigue, body ache, rash, D+/V+ some may have Romana's sign (swelling of eyelids near bite wound) young children or immunocompromised people may die from myocarditis or meningoencephalitis
45
Chronic phase of Chagas
lasts decades - lifetime 20-30% develop cardiac or GI complications
46
Chagas diagnosis
during acute phase, can look for trypomastigotes in blood of CSF (PCR) chronic phase - serologic testing
47
Chagas treatment
antiparasitic txt (benznidazole or nifurtimox) kills parasite symptomatic txt to manage symptoms monitor heart w/ heart tracing test
48
Chagas disease in dogs is a diagnostic differential in dogs w/....?
arrhythmias, myocardial dysfunction, congestive heart failure can present w/ findings like dilated cardiomyopathy, arrhythmogenic R ventricle cardiomyopathy, infectious myocarditis, congenital tricuspid valve dysplasia
49
Risk factors for Chagas in dogs
living or traveling in areas w/ infected insect vectors dogs that live outside or do outdoor work dog kennels high densities of dogs in confined areas w/ heat and CO2 (attract kissing bugs)
50
Chagas prevention
turn off outdoor lights clean up brush house dogs inside use insecticides
51
do traditional flea/tick repellants repel kissing bugs?
NO
52
Onchocera lupi was first described...?
wolf in Georgia, 1967 has been identified in US since 2013 (possibly came from dogs from Europe)
53
Onchocerca lupi most commonly infects...
dogs, cats, and humans in US (primarily southwestern states) considered an emerging zoonosis
54
organism that causes Onchocerca lupi
Filarial nematode adults embedded in ocular nodules and granulomatous masses of infected dogs
55
suspected arthropod vector of Onchocerca lupi
black fly or biting midge
56
this disease involves infection in the eyes, joints, limbs and upper cervical spine (masses) in humans
Onchocerca lupi
57
clinical symptoms of Onchocerca lupi in dogs
most are asymptomatic, esp if the worm is localized to the retrobulbar space of the eye (can't be detected during ophthalmic exam)
58
Clinical diagnosis of Onchocerca lupi
detection of ocular nodules in the sclera or conjunctiva subconjunctival threadlike parasites histopathological identification of adult worms microfilariae from skin snip biopsies in vivo confocal light microscopy
59
Onchocerca lupi treatment
currently no evidence-based protocols Drugs are administered based on treatments against other filarial parasites, mainly O. volvulus if possible, surgical excision of periocular nodules reoccurrences common
60
Hantavirus occurrence in AZ
sporadically in rural areas, usually in northern regions but infected rodents can be found statewide first discovered at 4 corners in 1993
61
when was plague first introduced to US
1900 by rat infected steamships coming from Asia epidemics occurred in port cities

PUBLIC HEALTH (18 decks)

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