zoonoses and you
DESCRIPTION
Zoonoses and You. Julia M. Murphy, DVM, MS, DACVPM Epidemiologist. Zoonosis. An infection or infestation shared in nature by humans and other animals Stedman’s Medical Dictionary, 27 th Edition. Zoonotic Skew. 1709 Human Pathogens 49% zoonotic 156 emerging human pathogens 73% zoonotic - PowerPoint PPT PresentationTRANSCRIPT
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Zoonoses and You
Julia M. Murphy, DVM, MS, DACVPM
Epidemiologist
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Zoonosis
An infection or infestation shared in nature by humans and other animalsStedman’s Medical Dictionary,
27th Edition
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Zoonotic Skew
1709 Human Pathogens 49% zoonotic
156 emerging human pathogens 73% zoonotic
Emerging pathogens 3 times more likely to be zoonotic. Taylor & Woodhouse, ICEID 2000
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Zoonotic Agents of Concern
CDC has categorized biological agents of concern
All but one Class A agent is zoonotic:Viral Hemorrhagic Fevers
Plague Tularemia AnthraxSmallpox Botulism
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Zoonotic transmission
Possible routes: Fecal Oral – bacterial, parasiticInhalationDirect ContactVector Borne – mosquitoes and ticksPenetrating Wounds
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Fecal-oral transmission
Salmonella Ancylostoma Campylobacter Toxoplasma E. coli O157:H7 Listeria Giardia Trichinella Cryptosporidia Toxocara
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Salmonella
Bacteria Frequently reported in Virginia
(>1000 cases/year) ~30,000 reported to CDC/year Over 1 million cases suspected ~2000 serotypes cause disease
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Salmonella
Commonly associated w/meat, poultry, and dairy
Wide reservoir in animals and environment
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Salmonella
Incubation 6-72 hours Vomiting, stomach cramps,
diarrhea 15-20 bacteria to infect Mostly self limiting
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Salmonella-Prevention
o Avoid temperature abuse and cross contamination
Avoid consumption of raw meats and raw dairy
Wash produce thoroughly Hand washing
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E. Coli O157:H7
Reportable in VA since 1999 ~70 cases reported/year in VA CDC estimates 73,000 cases/year
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E. Coli O157:H7
E. coli found in intestines of all animals and humans
O157:H7 found in cattle and maybe deer
produces a toxin
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E. Coli O157:H7
Thought that 10 bacteria can infect
Incubation 3-4 days Bloody diarrhea, stomach cramps Potential kidney failure
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E. Coli-Prevention
Avoid cross contamination Thoroughly cooking all foods Avoid consumption of raw meats
and raw dairy Wash produce thoroughly Hand washing
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Giardia
Protozoan parasite ~400 cases reported in VA/year ~20,000 cases reported in US/year most common intestinal parasite
IDed by PH labs in the US
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Giardia
Found in soil, food, water, or surfaces that have been contaminated with infected feces
1 organism can cause disease Can be found in a wide variety of
animals
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Giardia
7-10 day incubation Variety of symptoms or may be
asymptomaticFrequent episodes of diarrheaBloatingCramps
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Giardia-Prevention
Carefully dispose of sewage wastes so as not to contaminate surface or groundwater
Avoid drinking improperly treated water
Hand washing
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Cryptosporidium
Protozoan parasite ~40 cases reported in VA/year ~3000 cases reported in US/year
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Cryptosporidium
Young cattle, pigs, horses and sheep can manifest clinical signs
Immunosuppressed animals Hardy in the environment Not species specific
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Cryptosporidium
Incubation about 7 days Clinical symptoms:
DiarrheaAbdominal cramps
Asymptomatic carriers are common
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Cryptosporidium-Prevention
Persons with diarrhea should not use public swimming facilities
Avoid water or food that may be contaminated
Hand washing
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Inhalation Transmission
Psittacosis Histoplasmosis Hantavirus Coxiella burnetii (Q Fever) Tuberculosis
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Psittacosis
Caused by Chlamydophila psittaci
Rarely reported in VA
<50 cases reported/year in US
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Psittacosis
Birds shed intermittently in feces and respiratory secretions
Often no signs in infected birds Stress initiates shedding/illness
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Psittacosis
Inhaled from desiccated droppings/secretions, dust from feathers
Incubation 1-4 weeks Fever, headache, rash, chills Only rare instances of person to
person spread
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Psittacosis-Prevention
Diagnose and treat sick birds Clean bird cages regularly Use of protective clothing and
equipment when working with birds
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Hantavirus
A total of 396 cases of hantavirus pulmonary syndrome have been reported in the United States
Over 50% of cases from the Four Corners area
VA has reported 2 cases
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Hantavirus
Infect rodents worldwide Deer mouse is 1° reservoir in US Aerosol transmission from rodent
excreta Person to person
spread not beenseen in US
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Hantavirus
Early symptoms usually nonspecific:Fever, chills, muscle aches
Within 24 hours most cases develop hypotension and pulmonary edema
36% of reported cases have died
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Hantavirus-Prevention
Rodent control in and around the home remains the primary strategy
Cleaning using a bleach solution or household disinfectant when cleaning rodent infestations
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Direct Contact Transmission
Leptospirosis Tularemia Brucellosis Monkeypox
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Brucella
Bacteria that affects various species including sheep, goats, cattle, deer, elk, pigs, dogs
100-200 cases per year in US ~1 case/year in VA
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Brucella
Incubation variable (1-2 mo. common)
Irregular fever, headache, sweats, chills
No evidence of person to person spread
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Brucella
People become infected via direct contact with infected tissues, blood, urine, vaginal discharges, aborted material
Can cause infection if inhaled Can cause infection if consumed
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Brucella
Higher risk occupations for exposureVeterinariansAbattoir workersLaboratory workers
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Brucella-Prevention
Avoid raw dairy products, especially in foreign countries
Vaccinate livestock; test and slaughter
Use gloves and other personal protective equipment around afterbirth, aborted fetuses
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Monkeypox
Virus related to smallpox Mostly in west and central Africa Isolated from monkeys and other
species Introduced into US and eliminated
in 2003
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Monkeypox
Introduced into US by prairie dogs infected by imported African rodents, most likely African Gambian rats.
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Monkeypox
Transmitted by the bite of or contact with infected animal
Possible person to person transmission
Incubation period 7-14 days
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Monkeypox
Rash, fever, chills/sweats, headache, back ache, swollen lymph nodes, sore throat, cough, shortness of breath.
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Monkeypox
Importation rules and interstate transport and sale/trading of such animals not very stringent
79 humans in 6 states infected by prairie dogs
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Monkeypox-Prevention
In 6/2003, the CDC and FDA issued a legal order to stop the import of all rodents from Africa into the United States
In 10/2003, the order was replaced by an interim final rule which continues to enforce the order
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Vector Borne Transmission
Arboviral encephalitisExamples: West Nile virus
(WNV) Eastern equine encephalitis (EEE)
Rocky Mountain spotted fever Lyme disease Ehrlichiosis
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West Nile Virus
Mosquito borne 1999- First identified in US 2002- First identified in VA Number of cases in US have
ranged from 62-~3800/year Number of cases in VA have
ranged from 0-29
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West Nile Virus
West Nilevirus
West Nilevirus
Mosquito vectorIncidental infections
Bird reservoir hosts
Incidental infections
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West Nile Virus
Non-Neuroinvasive DiseaseMild, flu-like, self limitingResolves in ~1 week
Neuroinvasive Disease~1/150 peopleMeningitis, encephalitis
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West Nile Virus “Iceberg”
<1%CNSDisease
~20%“West Nile Fever”
~80%Asymptomatic
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WNV-Prevention
Long, loose, light clothing Repellants - DEET (<50% adults;
<30% children) Screens on windows Avoid environments/times of day
when mosquitoes biting
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WNV-Prevention
Mosquito ControlEliminate breeding sites
proper drainageremove or turn over water containerschange bird baths weekly
LarvicideAdulticide – aerial spraying after
Hurricane Isabel
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Lyme disease
First discovered in 1975Lyme, Connecticut
Tick borne disease ~20,000 cases/year in US ~200 cases/year in VA Dogs considered good sentinels
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Lyme disease
Erythema migrans (EM)3 to 32 days after tick exposure
Headache, fever, stiff neck Muscle aches and joint pain Swollen lymph nodes Chronic complications if not treated
early
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EM Lesion
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Adult female
Adult male Nymph Larvae
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Lyme disease-Prevention
Avoid tick-infested areas such as tall grass and dense vegetation.
Keep grass cut and underbrush thinned in yards.
Wear light-colored clothing. Tuck pant legs into socks and
boots. Wear long sleeved shirts buttoned at the wrist.
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Lyme disease-Prevention
Conduct tick checks on yourself, your children and your pets every four to six hours.
Apply tick repellent to areas of the body and clothing that may come in contact with grass and brush.
Tick control for pets.
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Wound Transmission
Tetanus
Cat Scratch disease
Rabies