VPH - Quiz 2-3

drraythe's version from 2016-03-22 22:07


Question Answer
What is Brucellosis czd by? Say a little about itCzd by different Brucella species. It is an intracellular pathogen. It is a BIOTERRORISM AGENT which puts it at a CDC category B
Is Brucella reportable? Why or why not?YES - it is zoonotic & has a bioterrorism CDC category of B. it is also ZOONOTIC so there are many eradication efforts
What are the 5 Brucella species we care about? Why do we care about them? (2 we dont care about)ZOONOTIC!!!!
Brucella melitensis
B. abortus
B. suis
B. canis
B. maris
(2 we don't care about arent zoonotic-B. ovis & B. netomae)
Brucella melitensis affects who? (Ie 1° reservoir)GOATS (humans) (& sheep)
B. abortus affects who? (ie 1° reservoir)Cattle mainly. (has a large host range so can affect cattle, dogs, horses, humans)
B. suis affects who? (ie 1° reservoir)Swine (humans)
B. canis affects who? (ie 1° reservoir)Dogs (humans)
B. maris affects who? (ie 1° reservoir)Marine mammals (humans)
(Which Brucella sp has worldwide distribution?)B. abortus
*Which Brucella sp has the highest pathogenicity to humans?Brucella melitensis (goat one)
What kinda zoonoses are Brucella sp?DIRECT
Most common routes of exposure to humans w/ B. abortus?Raw dairy foods
Animal husbandry
Laboratory work
Most common routes of exposure to humans w/ B. melitensis?Raw dairy foods
Animal husbandry
Laboratory work
Most common routes of exposure to humans w/ B. suis?Pork slaughter
Feral pig hunting
Laboratory work
Most common routes of exposure to humans w/ B. canis?Dog breeding & whelping operations
What are reservoir hosts for B. abortus? What are the main problems it czs?Cattle, bison, elk → abortion; orchitis
Why is eradication of B. abortus difficult?There is a wildlife reservoir (bison) around the greater Yellowstone area
In the US, what is the main way people are infected w/ B. abortus?Direct contact w/ infected animals. occupational risk: Abattoir workers, farmers, vets. (In individuals returning to the US from other countries-due to consumption of raw milk/milk products)
Is there a Vx for Brucella abortus?YES!! For CATTLE!! It is the RB51 vs, which is a modified live, Rifampin-Resistant mutant of the virulent B abortus strain 2308. ~65% effective in cattle under field conditions. Usually sufficient for herd immunity
(How does B. suis present in pigs?)Tends to localize in bones & joints... Unlike other spp of Brucella, B suis infects the non-pregnant uterus, czing endometritis & infertility (not abortion)
Which Brucella sp does NOT cz abortion?S. suis...czs endometritis & infertility (repro tract is not main target in swine Brucellosis, bones & joints are)
What part of the cow does B. abortus target?The PREGNANT uterus → abortion
What is 1 of the problems/difficulties w/ the swine Brucellosis control program?The control program targets the commercial swine industry, focuses on domestic swine, but FERAL SWINE are also carriers
What part of the body (of what animals) does B. melitensis target?Small rumis (Goats, sheep, camels: Can also infect cattle). Targets the REPRO TRACT (highly contagious to HOOMANS)
Is there a Vx for B. melitensis?YES, but only in countries where endemic in goats & sheep
Where in the body does B. canis target? What should you do?Targets repro tract (czs abortion & orchitis). Can be pathogenic to humans but low risks to owners from dogs. NEUTER if dog is positive bc repro tract is targeted
Which Brucella species can be primarily spread via AEROSOL? How/when is it aerosolized?B. abortus, B. melitensis primarily. It is shed in high #s - at parturition, at abortion (in Uterine fluids + placenta) & in urine, feces, semen, milk
What are the 4 main ways Brucella can be spread?Aerosol
In utero
What are the main ways that Brucella is spread orally? (2)(1) Infected placenta (cows lick placenta of other cows), fetal fluids
(2) Ingestion of milk
Can Brucella be spread in utero?Yes! Important in animal-to-animal spread. Major reason for abortions (not B. suis tho, no abortion in B. suis)
Which Brucella sp are likely to be spread venereally? Which are NOT likely to be spread venereally?VENEREAL: B suis & B canis. (Already know dogs is STD & of course a PIG would get a DIRTY STD) NOT LIKELY in B. abortus & B melitensis. (These stay way up in the uterus)
How do humans relate to the maintenance cycle of Brucella?They dont - Humans are accidental dead-end hosts
What is the most common route of exposure of humans to Brucella worldwide?ORALLY! Ingestion of unpasteurized milk & milk products (meat not a known source of infxn)
What are the 5 routes of exposure of humans to Brucella?ORAL
Aerosol (Inhalation)
(in utero/venereal → very little evidence.....person to person very rare but usually in blood transfusions, bone marrow transplants)
Explain how humans might be infected w/ Brucella via skin?Autoinoculation w/ Vx strains
Explain how humans might be infected w/ Brucella via conjunctiva?Vxs /infected tissue splash into the eye
Humans usually infected w/ Brucella via inhalation when...It is an occupational risk
What’s Bangs dz?Cow dz - Czd by contagious abortion in cows (B. abortus). (BANG! dead cow fetus)
What’s a weird, oral way that there is xmission of Brucella from cow to cow?Cows licking other cow’s placentas (Bruce is gross & is into placenta-licking porn)
Is there human to human xmission of Brucella? (If so, how)NO, doesnt transmit from ppl to ppl bc ppl dont shed it
What is "undulant fever" & what should you know about it?DZ IN HUMANS czd by Brucella. Severity depends on Brucella sp.
Top 3 Brucella sp which cz dz in humans (undulant fever) in order from most severe to least severe(MOST) B. meletensis > B. Suis > B. abortus (LEAST)
How does undulant fever/Brucellosis present like in humans?Acute: Flu-like. Undulating Fever, joint pain …In males, orchitis & epididymitis +/-high fever
There can be a persistent infxn in come people (chronic)
Does Brucella cz abortion in humans?No (Bruce the bison is only into young cows, not humans)
What do you do if a vet accidentally self-inoculates w/ RB51?Tx w/ ABX - The Vx is RIFAMPIN RESISTANT so you MUST treat w/ ****Doxycycline**** for 3 weeks (3 weeks - 3 looks like a B)
Is there a Brucellosis Vx for humans?No
Can you confirm Brucella on abortion? Can you confirm Brucella on serology?CAN'T w/ just abortion (lots of things cz abortion) & also, Positive serology must always be confirmed by culture (bc serology only confirms exposure not infxn)
What does serology test for? What else do you do? (Where do you take samples?)Serology detects Abs = EXPOSURE. You must CULTURE.... organism can be recovered from stomach/lungs of fetus, other uterine discharges & milk of affected animals. If fetus unavailable, placenta can have bacteria in it
Which Brucellas are REPORTABLE?B. abortus
B. suis
B. melitenses
(CANIS NOT REPORTABLE - not common to be a zoonosis but can be)
Do you report if the animal gets the dz? Humans?Report if EITHER/BOTH gets it
Do you treat if Brucellosis is discovered?NO Tx if in cattle or small rumis or any food animal. Can treat if dog/horse
What ABx do you use to Tx?Rifampin & Doxycycline (you treat BR w/ DR)
What are the 2 wild populations which perpetuate Brucella in the US & make eradication difficult?Western U.S.(greater Yellowstone area) - Elk & bison (B. abortus)
South eastern U.S.- Feral swine (B. suis)
Are there any states that are not "class free"? What must a state do to remain class free? (3)ALL states are "class free". They can retain their "class free" status if:
(1) Affected herds are maintained under quarantine
(2) An individual herd plan, including a test & remove schedule, is developed & implemented for each affected herd to prevent the spread of Brucellosis
(3) Appropriate surveillance is conducted to detect Brucellosis in other herds or species
Who formed the management plan & what is the management plan for preventing Brucellosis in wild herds in the greater Yellowstone area from infecting domestic herds?APHIS & state agencies. Mainly the method is to KEEP GYA ELK & BISON SEPARATE FROM DOMESTIC CATTLE! They uses fences & hazing when Brucella xmission risk is the highest (Jan-June) & vaccinate elk & bison. Also allow Native Americans to shoot migrating bison (native rights)
What is the Vx for GYA Elk? Bison?ELK = Strain 19
***Note: This is abortogenic is adults
CONTROL: What are the components of the cooperative state & federal Brucellosis eradication program for domestic cattle & bison? (3 things-what isn't part of the program?)TX IS NOT PART OF THE PROGRAM!!
(1) Vx w/ RB51
(2) Test & slaughter
(3) Hygiene & management practices
Why is RB51 Vx preferred over Strain 19 Vx?You can differentiate an animal which has been vxd from an animal which has been exposed if you use the RB51 strain - this is bc RB51 doesn't cz Abs to be formed, but an exposure WOULD produce Abs. ALSO, RB51 is less virulent & less abortiogenic & just as protective
**Aside from seek Tx, what must you do if you accidentally inoculate yourself or someone else w/ RB51?NOTIFY CDC if autoinoculate yourself or inoculate someone else as CDC keeps a registry of all human exposures & must be notified (CDC bc you are a people)
Why do we use strain 19 in elk?MORE EFFECTIVE than RB51 in ELK
WHO is vxd & what are the reasons why?FEMALE calves which are btwn 4-12 months old. Less than 4 months maternal Abs will be a problem. If greater than 1 year an intact female heifer can become preg. & abort & if theyre preg they can become permanently infected. (Gross, Bruce is only into super young females)
What are 2 problems w/ the Vx?(1) Vx can cz dz in humans & cattle/bison
(2) Vx is not 100% effective in preventing Brucellosis
(Control) Vx should be used in conjunction w/ what & why?W/ the SLAUGHTER POLICY, bc Vx can still cz dz & is not 100% effective
Who is TESTED for the eradication program? Who isnt?The organism targets the reproductive tract HENCE ONLY adult INTACT male & females that are at risk of exposure ARE TESTED being a threat to the eradication program. Young heifers are vxd but NOT TESTED
Slaughter surveillance will continue to be the main surveillance stream used in the new plan & consist of the collection of blood samples from ____ cattle / bison ___ (age) or older using approved diagnostic testsINTACT, 2 years of age
What are the 2 1° Surveillance procedures used to ID exposure?(1) Milk from dairy herds: tested for antibodies to Brucella. 2-4 times a year
(2) Serum: Market cattle testing (MCI) - cattle at market & at all state & federally inspected abattoirs of intact bulls & cows >2 years old
Once a heifer is Vx, what do you do?Orange R ear tag
What are reactors? What happens if the animal (cattle/goat) is a reactor?Reactor = Animals testing positive on USDA approved serologic tests. They are tagged; branded & sent to slaughter (IF HEALTHY) → they can only go directly to approved quarantine feedlots and/or directly to designated slaughter facilities. NOTE: Reactor goats cannot be slaughtered in the U.S. due to high human health risk w/ B. melitensis
If the reactors are sent to slaughter, what kinda precautions are taken?Designated slaughter facility, in bulls the testicles are condemned, udders of females condemned. NOTE: Unlike TB reactors, Brucellosis reactor cattle are not subjected to special postmortem exam at slaughter
What are "trace backs" & what happens?Trace back the origin of the reactor cow, to ID exposed herds, then herd can be quarantined & tested. Reactors sent to slaughter & herd retested until no reactors are identified. Quarantine is lifted after entire herd test negative on 2 tests 180 days apart
What is the # 1 CZ of loss of accreditation of U.S. vets??Not following the rules of the Brucellosis Eradication Program
Why don't we treat Brucella positive cows/goats?No role for Tx in an eradication program. There is a high failure rate w/ Tx & long term Tx reqd. Also concern w/ antibiotic residues in meat & milk
Bruce the Bison loves to visit...Yellowstone park (BRUCELLA=/=TB even tho both have cattle/bison reservoirs - TB is that there are TB hospitals in MEXICO where my DEER friend is, drinking dairy)

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