VPH- final 3

untimely's version from 2015-04-27 04:26

Immunocompromised ppl and their pets CONTINUED

Question Answer
Bartonella henselae--> what dz does this cause in NORMAL people, what dz does this cause in IC people?normal people: Cat Scratch Disease. IC people: bacillary angiomatosis
what causes bacillary angiomatosis, and who gets it?IC people get it, it's caused by bartonella henselae (they get BA not cat scratch)
what is Bacillary peliosis?this is when bacillary angiomatosis in IC people moves on to vascular prolif in INTERNAL ORGANS
how does bacillary angiomatosis present in IC people?(from bartonella) Cutaneous papules and nodules
what is the primary reservoir for bartonella henselae? how can it be transmitted to people?cats are thought to be reservoirs. transmission not totally known but positive association with cat bite or scratch, OR owning a kitten (< 1 yr old) with fleas
best advice to avoid bartonellosis is...(2)(1) Flea control for the cat (2) Avoid cat bites and scratches (esp from very young cats-Advise against immunosuppressed keeping young cats)
why is it so hard to get rid of bartonella from a cat? (2)They have both (1) intraendothelial (2) and intraerythrocytic phases of infection:found inside cat rbc’s
what is the MAIN primary mammalian reservoir and vector for zoonotic B. henselae? who else might be able to carry it?CATS, however Increasingly evident that dogs can be a source Of human infection with Bartonella spp [B. vinsonii]
how does bartonella get spread among cats?FLEAS (Ctenocephalides felis, aka cat flea) primarily (bart simpson has fleas)
what is bartonella like in cats?theyre usually asymptomatic
most common type of cat inciminated for infecting human with bartonella are...usually immature [< 1 yr old] and asymptomatic
how does cat scratch dz present in humans?lymphadenopathy. The classic lesion is a PAINFUL granulomatous inflammation of regional lymph nodes. Fever and malaise develops in some cases and headache, anorexia, splenomegaly may also develop. (rollie scratched my lymphnodes and now they hurt and are grainy from his gross paws)
how would you go about treating a cat for bartonella?Treatment of symptomatic cats is focused upon symptomatic and supportive care. If antimicrobial treatment is warranted, the drug of choice is azithromycin Rigorous flea control essential for preventing reinfection!!
what are the 2 best things you can do to prevent barontella?(1) Vector control= Flea control. Keep cats indoors to minimize exposure to fleas. (2) Hygienic practices= Avoid cat scratch/ bites, particularly from young cats. Wash/disinfect scratch/bites. Wash hands after handling cats.
what are three things that The United States Public Health Service/Infectious Diseases Society of America (USPHS/IDSA) reccs for ppl with HIV to avoid cat dz is...(1) adopt a cat > 1 year of age that is in good health (2) avoid rough play with cats, maintain flea control (3) wash any cat-associated wounds promptly, and do not allow a cat to lick wounds or cuts
no evidence of benefit to cats or owners from doing what in regards to bartonella?no evidence of benefit to cats or owners from culture or serologic testing of cats for Bartonella infections.
Most common Zoonotic virus with pet related infections is?lymphocytic choriomenigitis virus (LCM)
main source of lymphocytic choriomenigitis virus (LCM) infection humans is?rodent bites, excretions or secretions
how does lymphocytic choriomenigitis virus (LCM)present in normal people? IC people?normal: asymptomatic to flu-like. IC people: Teratogenic effects
how is toxoplasma gondii transmitted to humans? (3)(1) most common way is is undercooked meat/wild game UNDERCOOKED PORK MEAT containing cysts are the most important animal source (2) Less commonly through cats. Direct contact with cats themselves not likely source. Transmission of oocysts from cat faeces -humans > source of human infection (3) Mother-child (ghandi didnt eat raw meat because of ghondi. And he didn't like to eat cat shit either)
they say people should be careful cleaning cat litter pans...why, and what details are there concerning this?People can get infected with oocysts through feco-oral transmission. NOTE: Oocysts need > 24 hrs in the environment after being shed in cat faeces to be infectious
how does toxo affect normal people?Healthy persons can also acquire Toxoplasmosis but infection becomes reactivated more commonly in the immunocompromised. Congenital toxoplasmosis may cause abortion, neonatal death or foetal abnormalities
how does toxo affect IC people?they develop the CEREBRAL FORM (normal people don't)which causes a fatal encephalitis
If a HIV+ person tells you thye have a cat and they have T. gondii Abs, what should you know?No correlation between cat ownership + sero-conversion for T. gondii antibodies in HIV-infected people
Owner of cat wants the cat “tested” to be sure the cat isn’t a risk for (owner) getting infected with T. gondii. Would some kind of testing of the cat be beneficial?If tested for antibodies (serology)... If do a fecal to test for shedding: Inconclusive if negative
will Preventing infection of T. gondii in a pet cat prevent infection in the human?will NOT prevent human infection … as most are infected by eating raw meat!!!
what are some ways to prevent feline infection of T. gondii?Prevent feline infection (no hunting, no raw meat), Clean litter box daily or have someone else do it (oocysts must be in environment for >24hr > infective)
MOST IMPORTANT way to avoid infection of T. gondii?Cook meat well done. Wash hands after contact with soil or raw meat.
which giardia is most important spp with respect to human infection?Giardia lamblia (smiling lamb faces)
which spp of cryptosporidia is most important in human infection?C. parvum in mammals, mainly calves
how are humans infected with giardia/cryptoporidia?ingestion of food or water contaminated by direct contact with shedding animals/humans or insect carriers Or swallowing contaminated water while swimming
are giardia/cyrptosporidium zoonotic?Usually no zoonotic component...There is no real need for a vertebrate reservoir host
** who sheds the most oocytes of giardia/cryptosporidium?I/suppressed & young animals shed more oocysts
how does giardia affect immunoCOMPENTANT people?acute, self-limiting diarrhea, chronic diarrhea or as asymptomatic cyst shedding.
who are the 2 Types of individuals who are susceptible to infection with giardiasis?young children and AIDS patients
how dos cryptosporidium affect immunocompromised people?Chronic Cryptosporidiosis---> people who are HIV+ and then develop this now have AIDS. IT causes Persistent diarrhoea that can lead to death, and there is no tx
what are the risk factors on getting giardia/cryptosporidia (related to animals, and otherwise?) (and preventative measures you can take?)There is risk associated with DIRECT CONTACT with animals, so practice Good hygiene around infected animals and avoid direct contact with faeces that may contain oocysts. AVOID animals with diarrhea, Avoid very young or immunosuppressed animals. OTHER RISKS include Contaminated water(containing oocysts)
which dermatophyte most commonly affects IC people?Microsporum canis
Cryptococcus neoformans usually comes from where?bird droppings
what should you know about Cryptococcus neoformans and IC people?primarily a pathogen of the IC patient and has qualified as an AIDS defining infection
which cryptococcus affects normal ppl and which infects IC people?IC= C. neoformans (the one we usually learn is the one that's the prob for IC people which is prolly why we've heard ot it). normal= C. gattii
sporothrix schenkii is usually from where? how does it often infect humans?RESERVOIR IS THE ENVIRONMENT. however, a major source of infection is cats
what are two vx which might run a risk to IC people?Occasionally seen with I/C person’s contact with pet B. bronchiseptica vaccine, and also Potential with RB51 and contact with other Vet vaccines or in vaccinated animals shedding the agent
what are 4 major guidelines for existing pets for IC owners?(1) Animals should not be fed raw meat or be allowed to drink from the toilets (2) Recommend regular vet visits for early detection of infections (3) Let someone else handle animal waste disposal (4) Wash hands frequently and refrain from face and mouth contact with the animal
guidelines for new pets--> which age animals are preferred for IC owners?Older animals preferred. Young pups/kittens more prone to be carriers/infected with zoonotic agents
guidelines for new pets--> where should the IC person NOT get their pet from?Advise against pets from shelter environments
guidelines for new pets--> if they get their animal from a dealership, what should they avoid?Avoid Animal dealerships that mix animals from different sources. > Reported Transmission of zoonoses via contact with imported animals here.
guidelines for new pets--> before the new pet is introduced to the household, what should the IC person do?Animals should be examined by a vet pre-introduction to the patient’s household
what are some GENERAL reccomendations for IC people regarding pets? (3)(1) do Good hygiene around pets (2) Keep pets healthy (3) Avoid very young, I/compromised or sick animals…and reptiles, amphibians


Question Answer
what kinda viruses are flu viruses?RNA viruses in the Orthomyxoviridae family
what are the three genera of flu viruses (and who do they effect?)(1) influenza A. (humans, birds, horses, swine) (2) Influenza B (humans and seals) (3) Influenza C (humans, dogs and swine)
Birds are initial hosts to all Type _________ Influenza virusesA
how would you describe the structure of an influenza A virus? Enveloped virus & envelope contains 2 glycoproteins--> Hemagglutinin protein (H), Neuraminidase protein (N). RNA core has 8 segments
which type of flu has H and N proteins? why do we care about these?flu A. categorize subtypes based on these.
how do new subtypes of flu A viruses occur?due to REAsSORTMENT, which is when more than 1 subtype of Flu A viruses infects a cell simultaneously, and produce a new subtype
what are two different ways reassortment can occur?(1) between Human Type A viruses and Animal Type A viruses (2) RNA segments of each subtype reassort with each other producing a new subtype
New strains arise due to Antigenic ___drift (small, gradual, minor changes that occur through point mutations in genes producing H+ N proteins.)
Mechanism of Entry of Influenza virus into host cells is controlled by which antigen? how does it attach?H antigen, viral attachment to sialic acid receptors on host cells
where do human flu viruses tend to first attach?to receptors on human trachea
where do avian flu viruses tend to first attach?receptors on intestinal & respiratory tract of waterfowl.
which animal has both receptor types of birds and humans?swine, meaning they can get infected by both human & avian influenza viruses
which viral antigen elicits host's Ab response?H (Hey Abs! Here!)
release of virus from host cells is controlled by which viral antigen?N
H protein antigen does what?Mechanism of Entry of Influenza virus into host cells (HERRREEES VIREY!)
N protein antigen does what?involved in release of virus from host cells (NEW viruses made in your cells, out and about!)
what benefit does the host maing Abs to the N antigen have?limits spread of infections (bc N controls the release of it)
Who are the are the global, asymptomatic natural reservoir of influenzaA viruses from which novel viruses emerge to infect mammalian spp.?Wild Aquatic birds, notably waterfowl
Who is a "mixing vessel" for viral reassortment, and why?PIGS, bc express both human- & avian influenza virus receptors on epithelial cells in trachea
Avian Influenza--> Aquatic Avian reservoirs are wild birds of 2 Main Orders(1) Waterfowl of Order Anseriformes: ducks,geese,swan (2) Order Charadriiformes: gulls, terns, and shorebirds
what are the two subtypes of avian influenza, based on pathogenecity? explain their pathogenecity(1) Influenza A (LPAI) subtypes cause no clinical signs/low morbidity/mortality. Waterfowl & seabirds are the natural reservoir for all of these (2) Highly pathogenic AI (HPAI) are the ones of concern > significant morbidity & mortality within infected poultry
Any virus designated as ___ or ___ (which two antigenic proteins?) is of concern as these have the capability to convert from LPAI to HPAI H5 or H7
If if HPAI is detected in a country, who should be alerted?OIE alerted
how is avian flu transmitted/introduced into domestic poultry?wild birds shed virus along migratory pathways & introduce virus through contact with domestic poultry. Usually via aerosol (Shed in saliva, nasal d/c & commonly via feces between birds in close contact). Can also be via Fomite transmission between poultry facilities from the movement of infected birds/humans/equipment/eggs
describe LPAI dz in birdswidespread and cause mild respiratory disease in poultry. Problems in turkeys: Canada, US
descrine HPAI dz in birdssigns variable, depend on Genetics of the virus, Species of bird infected, Age of the bird.
HPAI--> In chickens and turkeys when the virus is particularly lethal, signs may be minimal and birds are typicallyfound dead with little warning. If they survive, CNS signs and drop in egg production may occur in a laying flock. It is multisystemic and there will be pneumonia, widespread haemorrhage...
Why is Influenza A (H5N1) is of concern? (4)(1) Mutates rapidly: High ability to reassort (2) Deadly to domestic poultry .. spread rapidly w’in flock (3) Crossed spp. barrier to ppl (4) Economic importance to the Poultry Industry- trade

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