VPH- Zoonoses Quiz Review 4

kelseyfmeyer's version from 2015-11-03 11:12

Q fever

Question Answer
agent that causes Q fever?coxiella burnetti (avenue Q is all about cox)
why is Q fever of public health importance?Highly pathogenic to humans =Bioterrorism agent (category B), Risk to vets/students; pregnant women; Lab staff
why is coxiella burnetti a bioterrorism agent?Low infectious dose reqd to cause infection in humans, Easily acquired by humans, Environmentally resistant, easily aerosolized
Human epidemics of Q-fever often associated with.....abortions in goat/sheep
if there is an outbreak, what are some immediate control measures? (4)(1) Vaccination of sheep and goats (2) Culling of ALL pregnant animals on infected farms (3) Restricting animal movements (4) Prevent visitors to infected farms –zoonotic risk
where does q-fever usually occur?rural settings
If there is animal involvement in a case of coxiella burnetti, who do you inform?Federal:Area Veterinarian in Charge (AVIC), and state vet
If there is human involvement in a case of coxiella burnetti, who do you inform?state health dept and CDC
what IS coxiella burnetti?Intracellular Proteobacteria.
why is cixiella burnetti so enviro resistant? what CAN kill it?Forms spore-like structures> resistant to environmental conditions and many disinfectants....But can be Destroyed by pasteurisation
what is the main reservoir for coxiella burnetti?Ruminants main reservoirs (but diverse reservoirs of human infection…wild mammals, birds , arthropods)
most human causes are linked to what?occupational hazards-- Abattoir workers, farmers, veterinarians
is there a control program for Q-fever?no, only by state
what are the Two cycles of infection of coxiella burnetti that exist independently in nature?(1) Direct Zoonoses: domestic animal reservoir (usually sm rumi). (2) Sylvatic cycle: between wild animals (mainly marsupials, rodents, lagomorphs) and their ectoparasites, especially ticks [Metazoonoses] (Q does 2)
When is infection of q fever at highest risk?AT PARTURITION
what is coxiella burnetti excreted in?feces, urine, milk of infected animals. In infected animals the organism is also shed notably in the placenta, amniotic fluid and fetal membranes.
what happens if an animal is latently infected with coxiella burnetti?*first off, subclinical infections can still shed organism. Latent infections in animals activated late in pregnancy, localize in the uterus, and be shed in high numbers at parturition.
what are 5 ways that coxiella burnetti can be transmitted?AEROSOL, oral, intrauterine, arthropods, human-human(RARE!!!)
**what is the MAIN route of infection for Q fever? for who?AEROSOL!! for both animal to animal AND animal to human (domestic animals). (Q for QUICK, DON'T BREATHE- you don't want to breathe cox) Most commonly via inhalation of aerosols from placental material and amniotic fluid.....aerosol can also come from When infected animals are processed as meat, during necropsies or assisting deliveries, Due to environmental persistence of the agent, dried infective material carried considerable distances by wind, and Fomites (wool, bedding, clothing)
how can q fever be orally transmitted?Young ruminants from milk of infected dams...since in milk, NEED TO PASTURiZE MILK
who does Q-fever cause abortion in and why does it cause abortion?abortion bc intrauterine infection! abortion in sheep, goats, cattle, recently cats.
can Q-fever cause abortion in huMANS?Humans are dead-end hosts but some evidence intrauterine transmission may occur though rare. Some congenital infections have been reported. Though not a common cause of human abortion it is still recommended that pregnant women avoid contact with sheep and goats that are parturient.
how can arthropods be a source of infection for Q fever? who is suseptible to this?Humans & domestic animals can acquire infection by entering a sylvatic (usually rodents/lagomorphs) focus > bites from infected ticks. Rare
how do animals usually present when infected with Q fever?USUALLY Asymptomatic /subclinically infected. In SHEEP/GOATS will often see abortion. Sometimes cats will have abortion. Often human cases are diagnosed first and then traced back to a subclinical animal reservoir
how do humans usually present when infected with Q fever? (IN GENERAL)Humans are considered to be dead end hosts and Most cases asymptomatic. However, humans are the only species known to develop illness regularly from infection.
what are the three manifestations of dz in humans?(1) Acute (less than 6 months duration) (2) Chronic (greater than 6 months duration) (3) Risk to foetus in pregnant women
describe the ACUTE manifestation of Q fever in humansSudden onset, Self-limiting flu-like (50%)--> Fever, myalgia, headache, fatigue, Non-productive cough, Chills, severe sweats, Pneumonia, An often prominent sign is severe retro-ocular pain (Q stuck his cox right behind my eye)
how does Q-fever affect age differently? what is the mortality?mortality low. Children <10 seem more resistant, people >40 MORE susceptible
describe the CHRONIC manifestation of Q fever in humans, and how it differs in WHO it affectsimmunocompromised at risk for chronic (otherwise rare). Primarily affects the CV system thus often get Endocarditis, can also get osteomyelitis, hepatitis or cirrhosis
humans with what problem should especially avoid coxiella burnetti?Individuals with valvular heart dz should not work with C. burnetii, because the chronic form can cause endocarditis
what are the best ways to diagnose q fever?Antigen detection(IHC, Direct FA), PCR /DNA (not always available), Serology (test for antibody)-ELISA(not super accurate or sensitive). (culture is high risk and requires a BSL-3 lab...not the best option)
how do you usually dx q fever in humans?Clinical signs, history, Serology, PCR, Blood culture
are animals treated for Q fever?questionable effectiveness, but Tetracycline has been given in water in the weeks preceding parturition in enzootic herds. This may help reduce shedding into birthing materials>less abortions?. so might not eradicate from carrier but might help reduce abortions
how are humans treated for Q fever?Self-limiting illness and most cases resolve within days to weeks, but for ACUTE: Is self-limiting, but treatment can decrease the duration of fever and other symptoms. Currently using tetracyclines or rifampin. If pneumonia develops, combinations of antibiotics are often used. For CHRONIC/ENDOCARDITIS: Long term combination antibiotics are used > 2 years. Surgical valve replacement.
Is q fever reportable? for who?depends on state. Yes in montana and washington (animals) (reportable in people to the state authority/vet/cdc)
is Q fever notifiable? for who?CDC has it notifiable as of 2013 for HUMANS
are there mandatory control programs for q fever?Mandatory control programs only for animals in research institutions
Is there a vx for q fever?FOR ANIMALS? NO...but Vaccination a future consideration-though does not prevent, may reduce shedding > environment & < human exposure risk. FOR HUMANS? Yes, but It is only given to people employed in high risk occupations and only after they test sero neg AND skin test neg
what are some methods for general control of Q fever in lifestock? (9 things... and two things to note)NOTE: Good general animal husbandry! also EDUCATION is importnt for prevention and control! (1) Cull / Depop. (2) Surveillance & replacement stock from flocks screened & free of C. burnetii-Antigen detection (3) Isolate new animals (4) Separate pregnant animals from others, especially at birthing (5) vx (but this isn't in the us!!!) (6) Personal protective equipment[PPE]-gloves, N95 masks (7) Placentas, aborted materials,fetal tissues properly disposed of. Incinerated, composting or burial in a designated landfill (8) Lambing areas treat with Lysol, bleach, hydrogen peroxide.Ensure equipment and environmental surfaces cleaned using a chemically approved disinfectant (9) Manure management: compost and rotate soil
what are two major reasons for why practical control in ALL LIVESTOCK is difficult?(1)Environmental stability (2)Many reservoirs- risk of infectivity for wild animals, arthropods, and humans. (Q is resistant and loves everyone- so getting rid of him is hard)
why would it be difficult to maintain a flock of sheep certified free of C. burnetti? (5)(1) Hard to identify infected sheep (usually subclinically infected) (2) Can be Seronegative with latent infection (why serology is not always the best testing method) (3) Can be Infected, shedding, but show no disease (4) No effective animal vaccine (5) Organism environmentally stable
If a vet finds Q fever, what should they do?Report /consult with State/Federal animal health /health agencies
whats up with vxs for Q fever?none for animals in USA. HIGH RISK VX in people, only if theyre sero/skin test negative and at high risk for the dz. (its a Killed vaccine)
what are the high-risk people and what should they not do?(pregnant women, immune compromised, prosthetic heart valves) should not have contact with sheep/goat herds or assist in any birthing processes.
you can use PPE if you are at an occupational risk. what are the occupational risks?vets, lab workers, sheep/goat farmers especially if breeding, abattoir workers
what is some PPE you can use to protect yourself with in case of Q fever being present?N-95 respirator + eye protection: face shield, goggles to prevent aerosol transmission, Disposeable shoe covers+ gloves +white coats
which animals would you prefer to use in research if you are worried about Q fever?male and non-preg animals

zoonotic chlamydial species (1)

Question Answer
Chlamydia vs Chlamydophila?these are two different genera within the order Chlamydiales. THE ONES WE CARE ABOUT ARE CHLAMYDOPHILA
what are the three zoonotic species of chlamyDOPHILA?C. felis, C. abortus, C. psittaci
chlamydophila psittaci affects who, and what is the primary dz in this host?BIRDS: conjunctivitis, respiratory systemic dz
chlamydophila abortus affects who, and what is the primary dz in this host?SHEEP/GOATS/CATTLE: abortion, weak neonates
chlamydophila felis affects who, and what is the primary dz in this host?CATS: rhinitis, conjunctavitis
which of the zoonotic chlamydophils is only a minor zoonosis?C. felis
Chlamydophila psittaci--> causes what dz in birds? humans?BIRDS get Avian chlamydiosis. HUMANS get Psittacosis (parrot fever)
who is at occupational risk for getting psittacosis?vets, poultry workers, lab workers, Pet store employees, bird owners
which chlamydophila species is a bioterrorism agent, and which class?C. psittaci, class B
what is the infection control plan for C. psittaci? (5)(1) Use of approved disinfectants for cages-Lysol, Roccal (2) Ventilation systems to dec aerosols in environment (3) screening birds (4) Isolation of new birds ; quarantine ill (5) Use of Personal protective equipment [PPE]
how does a bird with avian chlamydiosis present?Most infections in birds are latent and inapparent!!!! develop dz when stressed. lethargic, non-specific illness...primarily GI dz, diarrhea common-- GREEN TO YELLOWISH DROPPINGS!!! anorexia/emaciation, ruffled feathers, serous or mucopurulent oculonasal discharge, some respiratory signs, some CNS signs
is C. psittaci reportable? notifiable? If so, if WHO gets sick?NOTIFIABLE if in HUMANS (also reportable) (avian-- might be reportable, depends on state)
who regulates bird importation to prevent exotic diseases from going into the US?USDA-APHIS
C. psittaci--> Compendium--> what are 4 good preventative measure which vets are responsible to tell owners?(1) Isolate & quarantine NEW birds for 6 wk min. and refer to an avian vet for screening. (2) Reduce stress (3) Purchase from breeders who screen for the disease (4) Practise good husbandry: Hygienic practices
C. psittaci--> Compendium--> 3 major considerations for treating a bird with C. psittaci?(1) Isolate infected birds. Treat all birds in home to dec spread (2) Educate them on zoonotic risk prevention and tell them to go to the MD. Specifically risks to immunosuppressed owners and use of Personal Protective Equipment (PPE) (3) Advise client to follow treatment protocols for birds Remove Calcium supplements as < efficacy of meds
If treating birds for C. psittaci, what shouldn't you feed them?REMOVE CALCIUM SUPPLEMENTS! These dec efficacy of tx
where do the majority (>70%) of human exposures to C. psittaci come from?from CAGED PET BIRD exposures
what are the 2 main reservoirs for C. psittaci?(1) Psittaciformes (psittacine birds) (2) Columbiformes (pigeons, doves)
What are the three ways that a human can get C. psittaci from a bird? which is the MAIN way?(1) *most common* areosol/inhalation. (2) mouth-to-beak contact (3) In-utero transmission to fetus
explain how the trasmission of C. psittaci through aerosolization/inhalation occur?(1) Dried feces or respiratory secretions of infected birds. (2) From infected bird Carcasses/ feathers. **C. psittaci can be aerosolized on turkey, squab, and duck farms, and in poultry processing plants
what can precipitate shedding of C. psittaci from infected birds?STRESS
what are 4 ways that there is Bird-to-bird spread of C. psittaci?(1) AEROSOL from feces/nasal discharge of infected birds. (2) ingestion (coprophaga/cannabalism) (3) Fomites including contaminated feed or water. (4) vertical transmission has been occasionally reported
how does a human infected with C. psittaci usually present?(NOTE: Anyone who has been in contact with birds & develop symptoms consistent with psittacosis should go to the MD!) (1) Flu-like disease/atypical pneumonia: Many infections pass asymptomatically, while others vary in severity. (2) Pregnant women birth prematurely, +/- fetal death (3) Severe multisystemic signs in humans, can be fatal