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Zoonoses and You

Zoonoses and You. Julia M. Murphy, DVM, MS, DACVPM Office of Epidemiology. 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

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Zoonoses and You

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  1. Zoonoses and You Julia M. Murphy, DVM, MS, DACVPM Office of Epidemiology

  2. Zoonosis • An infection or infestation shared in nature by humans and other animals • Stedman’s Medical Dictionary, 27th Edition

  3. 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

  4. Zoonotic Agents of Concern • CDC has categorized biological agents of concern • All but one Class A agent is zoonotic: • Viral Hemorrhagic Fevers • Plague Tularemia Anthrax • Smallpox Botulism

  5. Zoonotic transmission • Possible routes: • Fecal Oral – bacterial, parasitic • Inhalation • Direct Contact • Vector Borne – mosquitoes and ticks • Penetrating Wounds

  6. Fecal-oral transmission • Salmonella Ancylostoma • Campylobacter Toxoplasma • E. coliO157:H7Listeria • Giardia Trichinella • Cryptosporidia Toxocara

  7. Salmonella • Bacteria • Frequently reported in Virginia (>1000 cases/year) • ~30,000 reported to CDC/year • Over 1 million cases suspected • ~2000 serotypes cause disease

  8. Salmonella • Commonly associated w/meat, poultry, and dairy • Wide reservoir in animals and environment

  9. Salmonella Outbreaks • 2000-04 in Virginia • Range 3-7/year • Some multistate • Common serotypes: enteritidis, typhimurium, newport • Foods: eggs, tomatoes, beef, mangoes, salad

  10. Salmonella • Incubation 6-72 hours • Vomiting, stomach cramps, diarrhea • 15-20 bacteria to infect • Mostly self limiting

  11. Salmonella-Prevention • Avoid temperature abuse and cross contamination • Avoid consumption of raw meats and raw dairy • Wash produce thoroughly • Hand washing

  12. E. Coli O157:H7 • Reportable in VA since 1999 • ~70 cases reported/year in VA • CDC estimates 73,000 cases/year

  13. E. Coli O157:H7 in the news • WASHINGTON (Reuters) - U.S. food safety inspectors said Tuesday they will expand tests and recall infected meat more rapidly to combat E. coli contamination of meat products after the largest American manufacturer of hamburger patties went out of business this month. The U.S. Agriculture Department's Food Safety and Inspection Service said in a briefing the number of E. coli recalls climbed to 15 so far in 2007 compared to the five cases reported in all of 2005.

  14. E. ColiOutbreaks in Virginia • 2001: O157:H7, hamburger suspected • 2003: ETEC, vehicle unknown

  15. 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

  16. E. Coli O157:H7 • Thought that 10 bacteria can infect • Incubation 3-4 days • Bloody diarrhea, stomach cramps • Potential kidney failure

  17. E.Coli-Prevention • Avoid cross contamination • Thoroughly cooking all foods • Avoid consumption of raw meats and raw dairy • Wash produce thoroughly • Hand washing

  18. 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

  19. 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

  20. Giardia • 7-10 day incubation • Variety of symptoms or may be asymptomatic • Frequent episodes of diarrhea • Bloating • Cramps

  21. Giardia Outbreaks in Virginia • 10/06 Giardia associated with a public pool • 9/06 Giardia associated with a daycare

  22. Giardia-Prevention • Carefully dispose of sewage wastes so as not to contaminate surface or groundwater • Avoid drinking improperly treated water • Hand washing

  23. Cryptosporidium • Protozoan parasite • ~40 cases reported in VA/year • ~3000 cases reported in US/year

  24. Cryptosporidium • Young cattle, pigs, horses and sheep can manifest clinical signs • Immunosuppressed animals • Hardy in the environment • Not species specific

  25. Cryptosporidium • Incubation about 7 days • Clinical symptoms: • Diarrhea • Abdominal cramps • Asymptomatic carriers are common

  26. Cryptosporidium-Prevention • Persons with diarrhea should not use public swimming facilities • Avoid water or food that may be contaminated • Hand washing

  27. Inhalation Transmission • Psittacosis • Histoplasmosis • Hantavirus • Coxiella burnetii (Q Fever) • Tuberculosis

  28. Psittacosis • Caused by Chlamydophila psittaci • Rarely reported in VA • <50 cases reported/year in US

  29. Psittacosis • Birds shed intermittently in feces and respiratory secretions • Often no signs in infected birds • Stress initiates shedding/illness

  30. 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

  31. Psittacosis Investigation • 7/06: Psittacosis in a hobby breeding operation in southwest Virginia

  32. Psittacosis-Prevention • Diagnose and treat sick birds • Clean bird cages regularly • Use of protective clothing and equipment when working with birds

  33. Histoplasmosis • Histoplasmosis is a fungal disease • This fungus grows in soil and material contaminated with bat or bird droppings • The fungal spores become airborne when the soil is disturbed • People breathe in the spores and become infected

  34. Histoplasmosis • Most people exposed to the fungus have no ill effects • The acute form of the disease is characterized by respiratory symptoms • The disseminated form can be fatal • Young children and older persons are at an increased risk for severe disease

  35. Histoplasmosis • Reduce exposure • Avoid areas with accumulations of bird or bat droppings • Wear personal protective equipment when necessary

  36. Direct Contact Transmission • Leptospirosis • Tularemia • Brucellosis • HP H5N1 avian influenza • Monkeypox

  37. 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

  38. Brucella • Incubation variable (1-2 mo. common) • Irregular fever, headache, sweats, chills • No evidence of person to person spread

  39. 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

  40. Brucella • Higher risk occupations for exposure • Veterinarians • Abattoir workers • Laboratory workers

  41. 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

  42. Avian Influenza-HP H5N1 • HPAI H5N1 emerged in Asia and has persisted since 1997 • H5N1 has probably circulated in domestic birds in Southeast Asia since 1997 • Westward spread

  43. H5N1 status as of October 2007

  44. H5N1 Status as of October 2007 Country Cases Deaths Azerbaijan 8 5 Cambodia 7 7 China 25 16 Djibouti 1 0 Egypt 38 15 Indonesia 109 88 Iraq 3 2 Lao 2 2 Nigeria 1 1 Thailand 25 17 Turkey 12 4 Viet Nam 100 46 Confirmed Human Cases of H5N1 Reported to WHO, 2003-07 (10/17/07)

  45. H5N1 Public Health Concerns • Direct contact with infected poultry is thought to be the greatest risk • Aerosol of the virus as a risk factor is thought to be negligible • Multiple potential routes for spread

  46. Vector Borne Transmission • Arboviral encephalitis • Examples: West Nile virus (WNV), Eastern equine encephalitis (EEE) • Rocky Mountain spotted fever • Lyme disease • Ehrlichiosis

  47. 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

  48. West Nile Virus Mosquito vector Incidental infections West Nile virus West Nile virus Incidental infections Bird reservoir hosts

  49. West Nile Virus • Non-Neuroinvasive Disease • Mild, flu-like, self limiting • Resolves in ~1 week • Neuroinvasive Disease • ~1/150 people • Meningitis, encephalitis

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