VPH Final - Quick & Dirty

drraythe's version from 2016-04-25 13:55

Check yo'self before you wreck yo'self - Including Muzzy's Review

Lyme & Ehrlichia

Question Answer
*What is the organism that czs Lyme Dz?Borrelia burgdorferi
*How do most dogs w/ Lyme present?90% of dogs exposed do not show CS (dz). There can be acute onset polyarthropathy & accompanying pyrexia, though.
MOST SERIOUS LONG-TERM DZS FROM LYME IS... Glomerular dz due to Ag/Ab complexes & cardiac & neurologic dz (rare)
****How do white-footed deer mice contribute to the maintenance cycle of Lyme in the East?CRUCIAL TO MAINTENANCE! Bc they remain spirochetemic but tolerant to infection (can pass to uninfected ticks)
**What is crucial for the xmission of the Lyme spirochete from the tick bite?Takes 24 hours to xmit!!! So IMPORTANT TO REMOVE TICK EARLY ON
*How does Lyme dz usually present in humans?Presentation highly variable. Usually flu-like dz - usually 3 BODY SYSTEMS AFFECTED:
Cutaneous (erythema migrans = bullseye lesion which is not always present)
Musculoskeletal (dz usually progresses in stages)
*How can you Dx dogs w/ Lyme?DIFFICULT! Hx of tick exposure helps, along w/ CS:
Swollen joints
- If Tx, there will be RAPID RESPONSE to antimicrobial therapy. Upon serology, a "significant" positive titer as evidence of exposure. Paired titres important for current infection. High antibody titers do occur in asymptomatic dogs!!!!! Important to know infected animal may initially test seronegative
**How do you know if a dog was exposed to Lyme? Infected?Exposure = Elevated Ab titer
Infected = PAIRED titers
**How do we try to prevent confusion btwn Abs from Vx & Abs from exposure?Traditional ELISA for antibody cannot distinguish: Vx - induced antibodies from antibodies due to natural exposure. B. burgdorferi expresses several [OspA –C] Proteins but only when in the tick gut. These proteins used as Vx antigens. However, another outer membrane protein, **C6 is only expressed ONLY by LIVING B.burgdorferi & is not used as a Vx antigen**. So use C6 as a way to tell if the dog was exposed/infected my the actual organism vs just Vxd

Immunocompromised ppl & their pets

Question Answer
**Clinical definition of AIDS?2 things reqd for this Dx:
(1) HIV
(2) Has 1 of the following AIDS-defining zoonoses:
Cerebral Toxoplasmosis
Chronic Cryptosporidiosis

(both parasites - they are toxic for the HIV PTxs crypts of the body)
**What are some BACTERIAL zoonoses which IS or IC people are esp. at risk to?Pasteurella multocida
Capnocytophaga canimorsus
Mycobacterium marinum
Salmonella spp
Campylobacter spp
Bordetella Bronchiseptica
Rhodococcus equi
Bartonella henselae

(Sal & Cap'n Bart Borded their dog & Camped on the Rhod Passed Myco's Marina)
**How does Mycobacteria marinum affect IC PTx?Develop cutaneous lesions → "swimming-pool granuloma" or "fishtank granuloma”. Can be disseminated infxns which may be unresponsive to Tx
**How does Rhodococcus equi affect IS PTxs?Develop pneumonia from inhaling in from the enviro (SOIL)
**How does Bacillary Angiomatosis present in IC people?(From Bartonella) Cutaneous (SKIN DZ) papules & nodules
*What is the 1° reservoir for Bartonella henselae? How can it be xmitted to people?Cats are thot to be 1° reservoirs. Xmission not known but positive association w/ cat bite or scratch, OR owning a kitten (<1 yr old) w/ fleas; DIRECT EXPOSURE
*What is the MAIN 1° mammalian reservoir & 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 infxn w/ Bartonella spp [B. vinsonii]
**How is Toxoplasma gondii xmitted to humans? (3)(1) Most common way is undercooked meat/wild game UNDERCOOKED PORK MEAT containing cysts are the most important animal source
(2) Less commonly thru cats. Direct contact w/ cats themselves not likely source. Xmission of oocysts from cat feces-humans are a greater source of human infxn
(3) Mother-child - transplacental
(gondii didnt eat raw meat & he didn't like to eat cat shit either)
**How does Toxo affect IC people?They develop the CEREBRAL FORM (immunoCOMPETENT people don't) which czs a fatal encephalitis
**Will preventing infxn of T. gondii in a pet cat prevent infxn in the human?Will NOT prevent human infxn … as most are infected by eating raw meat!!!
*#1 cz of diarrhea in people w/ AIDS?Giardia
*How are humans infected w/ Giardia/Cryptosporidia?Ingestion of food or water contaminated by direct contact w/ shedding animals/humans or insect carriers or swallowing contaminated water while swimming
**Who sheds the most oocytes of Giardia/Cryptosporidium?Immunosuppressed (IS) & young animals shed more oocysts
**How does Cryptosporidium affect immunocompromised people?Chronic Cryptosporidiosis → people who are HIV+ & then develop this now have AIDS. IT czs persistent diarrhea that can lead to DEATH & there is no Tx
*Cryptococcus neoformans usually comes from where?Pigeon droppings


Question Answer
**Which animal has both receptor types of birds & humans?Swine, meaning they can get infected by both Human & Avian Influenza viruses (acts as a mixing vessel)
*Any virus designated as ___ or ___ (which 2 antigenic proteins?) is of concern as these have the capability to convert from LPAI to HPAIH5 or H7
*If HPAI is detected in a country, who should be alerted?OIE alerted
*Explain the Pathogenesis of Human dz of HPAI flu A, H5N1. What is mortality like?“Cytokine Storm” = An Innate exaggerated immune response czd by rapidly proliferating & highly activated T-cells or natural killer (NK) cells, which leads to a Severe Flu-like + lower respiratory tract symptoms & Pneumonia ..Multi-organ failure. Mortality: ↑ among hospitalized PTx
**All H__ & H__ viruses are notifiable when in poultry!5 & 7
*If there is Avian Flu of H5 or H7 in the US, what must the USDA do?Report to OIE
**H3N2 affects who & is aka?PIGs, aka [TRIG cassette] bc contain a combination of genes from avian, swine & human viruses known as the triple reassortant internal gene(t.r.i.g.)
H5N1 is?HPAI (Highly Pathogenic Avian Influenza)
H5 means...Bird
H7 means...Bird
H3N8 is?Equine-canine flu (I have 3 horses & 8 dogs. All other H3s are pig viruses)
pH1N1 is?HUMAN H1N1 ( p for ppl)
H1N1 in who?PIGS. Not same as pH1N1
H3N2 in who?PIGS, [TRIG] cassette (triple reassortment internal gene bc contain a combination of genes from avian, swine & human viruses )
H3N1 in who?Pig
H3N2v is what?Pig, it's the TRIG matrix + [m] gene from pH1N1
H7N9 is what?Bird, has killed ppl

Zoonotic Arboviruses

Question Answer
*What does the E protein of WNV do?Mediates virus-host cell binding (E for ENTER)
**Which surface protein of WNV elicits most virus-neutralizing antibodies, which means it is useful for Vxs?E. It is the MAJOR antigenic protein!
(e for enter & e for EEEEK! Abs, attack!!)
*Is WNV reportable?No bc its endemic (she'll use this as an distraction)
**How do humans get WNV?Bite from mosquito 99% of exposures
(technically, can also get from transfusions, transplants, Mother-to-Child. During pregnancy & breastfeeding rarely, Laboratory-acquired human infxns)
But you can't get it from casual contact or just touching an infected person or horse
*What is WNV dz like in humans?Typically develop symptoms 3-14 days after they are bitten by the infected mosquito
Majority are asymptomatic
Some develop mild symptoms:
Some get severe dz like CNS signs inclding encephalitis
*Which is a risk factor for getting a severe WNV infxn?AGE, Elderly are more at risk
**Essential reservoir host for VEE?RODENTS, NOT BIRDS!! (Venezuela must be full of rats or something)
*How do the accidental/dead end hosts differ btwn EEE/WEE/VEE?In EEE/WEE, HORSES & PEOPLE are dead end hosts
However, in VEE, only people are dead end hosts & horses are AMPLIFIER hosts
*Which Arbovirus has horses as an amplifier host?VEE
*Which Arbovirus is reportable?VEE
*Most severe mosquito-xmitted dzs in the US?EEE

Bats: Henipaviruses

Question Answer
***Henipaviruses encompass what 2 viruses? What kinda viruses are they?Hendra & Nipah viruses. Zoonotic Paramyxoviruses (henipavirs & "O" in henipa is not orthmyxo!!)
**Hendra & Nipah viruses are harbored by what kinda bats?Fruit bats (Flying Foxes)
**What is the reservoir host in Hendra virus & how is the virus shed?Pteropid (FRUIT BAT/Flying Foxes) res. host → shed virus in saliva, urine, semen, feces
(specifically: Little Red Flying-Fox, Black Flying-Fox, Grey-Headed Flying-Fox, Spectacled Flying-Fox)
**What are some ways to prevent horse-to-human xmission of Hendra?Isolation of ill horses
Quarantine horses who were exposed to horses testing (+) for HeV
Australian government determines fate! Euthanize? VX HORSES!
**What’s the mortality rate of Hendra in humans?50% human mortality rate but dz rare
**Which Henipavirus has a CDC category for bioterrorism & what is it?Nipah, Category C (Nipah is as dangerous as C4)
**What BSL (biosafety level) are Hendra & Nipah?Level 4 (Highest category, super dangerous, Nipah is as dangerous as C4)
****Which Henipavirus has human-human spread?Nipah!
**Which Henipavirus has a Vx?HENDRA


Question Answer
*How does SARS exemplify species jumping?SARS isolated in civets, bats, then sustained human-human via aerosol (Sars, species jumping, sustained)
**Main Reservoir Hosts of SARS CoV?Microbats, predominately horseshoe bats
*How is SARS xmitted from human to human?Aerosol: Readily xmitted human-human via close contact
**What are the symptoms of SARS (in ppl)↑ fever
Body aches
Some people get mild respiratory symptoms
Most PTx develop pneumonia


Question Answer
*Earliest they can be Vx for Rabies?3 mo
*How soon after 1st Vx is the animal considered protected?28d
*How do Vxd domestic animals protect us beyond just from bites from domestic animals?Vxd domestic animals are an effective barrier btwn wildlife reservoirs & human exposure
*↑ in Rabies cases in wildlife reservoirs can be associated w/ ↑ in...Domestic Animal Rabies cases
**What is the Flagstaff Rabies virus variant in Arizona & what does it show us?It is a newly recognized bat associated Rabies variant now circulating in skunk & fox in Arizona. Indicates cross‐species xmission of unprecedented magnitude! *Cross species & not just a bat infecting a fox/raccoon, bc they are xmitting fox-fox & coon-coon INDEPENDENT of bats, even tho it is a bat variant!!
1st time bat Rabies virus variant established in a terrestrial animal species
*What is spillover?Infxn from the reservoir species to another animal species. Sporadic, rarely initiates sustained intraspecific xmission in the new host species
**Rabies cases in domestic & terrestrial wild animals are associated w/ the viral variant specific to the particular.....?Terrestrial wild animal cycle in the area
*How common are spillover infxns linked to 2° xmission of Rabies to other animals/humans?UNCOMMONLY, but Rabies Control operates on the premise that 2° xmission can occur
*Reported cases of Rabies reflect what kind of surveillance?Reflect Passive surveillance (they are not going out & getting random samples)
**What is the avg time from onset of signs to death?3 days!!! (Rabies is a RAPIDLY PROGRESSING neuro dz!)
***WHEN do you do the 4 month isolation period on animals exposed to known or suspected rabid animal?4mo isolation (6mo for ferrets) is when the animal is UNVX & ALSO NO HUMAN EXPOSURE INVOLVED
**If a healthy, UNVXD domestic cat/dog is bit by a suspected or known rabid animal, what is the protocol? (NO HUMAN EXPOSURE)2 options
(1) Euthanize
(2) Strict isolation for 4 months & Vx UPON ENTRY or 1 MONTH BEFORE RELEASE
**If a healthy, VXD domestic cat/dog is bit by a suspected or known rabid animal, what is the protocol? (NO HUMAN EXPOSURE)Revaccinate immediately, kept under owner’s control & observe for 45 days
*If during the 4-6 month quarantine the animal begins to show signs compatible w/ Rabies, what do you do?Euthanize & check the brain for Rabies - anyone who was exposed needs to know
**What test on the brain to check for Rabies?Direct FA test
*Federal meat inspectors must do what about exposed animals?Federal meat inspectors must reject any animal known to be exposed to Rabies w/in last 8 months.
**Preexposure Rabies Vx in humans... how many & when?Series of 3 Vx injxns Days 0, 7, 21 (or 28)
**Should you do post-exposure prophylaxis? (Human) → If a dog/cat/ferret bit you, what are the options?If the animal is healthy & available for 10-day observation… observe. If tests (+) for Rabies or Rabies suspected… start Post-Exposure Protocol (PEP). If the animal was unknown/escaped, MD consults PH officials (which should incld a PH vet)
**Pre exposure shots vs post exposure shots (non Vx & Vx)PRE = 3 Vx Days 0, 7, 21 (or 28)
POST not Vxd
= RIG 4 IM Vxs Days 0, 3, 7, 14
= 2 IM Vxs Days 0 & 3
***If mom cat 2.5 yr old which was Vx at 8 mo. & 1.5 yr w/ a triennial Rabies Vx, was exposed to Rabies kitten.... do what?She’s up to date! She was exposed to Rabies tho. Not concerned about animal biting human so no 10 days thing. Re-Vx, confine & observed for 45 days (insurance, not strict isolation)
***If you accidentally inoculate yourself w/ 1 of the Canary Pox Rabies viruses... do what?Draw up another dose of Vx & properly Vx the animal
***What is the RFFIT? What is it good for?Measures ability of Rabies specific Abs to neutralize the virus. (Rabies Focused Fluorescent Inhibition Test) not viable test for Rabies. (If test was positive, cant conclude it has rabies...bc might be cross rxn, or something weird...also Ab could be a maternal Ab or previous unreported Vx, or exposure. if RFFIT neg, cant r/o Rabies, as Abs can show up late in course of dz)
***Is maternal Ab protective against Rabies?Not reliably