Transcript Zoonotic Diseases

Zoonotic Diseases:
More Common than You Think
Jason Stull, VMD, MPVM
Public Health Veterinarian, NH DHHS
Assistant Clinical Professor, UNH
NH Department of Health and Human Services
Division of Public Health Services
Zoonoses
From the Greek:
Zoon:
Animal
Noson: Disease
Diseases and infections which are
naturally transmitted between
vertebrate animals and humans
- WHO 1959
NH Department of Health and Human Services
Division of Public Health Services
Zoonoses: Animal Species
• Dogs & Cats
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Rabies
Roundworm
Ringworm
Cat Scratch Disease
• Food Animals
– Salmonella
– E.coli
– Brucellosis
NH Department of Health and Human Services
Division of Public Health Services
Zoonoses: Animal Species
• Birds:
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Psittacosis
West Nile virus
Eastern Equine Encephalitis
Avian Influenza
• Reptiles, Fish, & Amphibians
– Salmonella
– Mycobacterium
• Wild Animals
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–
–
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Hantavirus
Plague
Tularemia
Lyme Disease
NH Department of Health and Human Services
Division of Public Health Services
Zoonoses
• Common (of 1,407 human pathogens)
– 58% are zoonotic
– 70% of emerging diseases are zoonotic
• Occur in numerous animal species
• Very diverse
– Severity
– Transmission dynamics
• Difficult to predict changes in incidence
NH Department of Health and Human Services
Division of Public Health Services
Zoonoses
• Risk factors should be considered in ill
patients
– Animal ownership and contact
– Activities bringing humans into contact with
animals
• Discuss appropriate pet species for
appropriate individuals
• Animals as sentinels of disease
NH Department of Health and Human Services
Division of Public Health Services
Common Zoonotic Disease
Question Areas
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Rabies
Lyme Disease
Mosquito-borne Disease
Animals in Public Settings
Food-borne Disease
Avian Influenza
NH Department of Health and Human Services
Division of Public Health Services
Common Zoonotic Disease
Question Areas
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Rabies
Lyme Disease
Mosquito-borne Disease
Animals in Public Settings
Food-borne Disease
Avian Influenza
NH Department of Health and Human Services
Division of Public Health Services
Common Zoonotic Disease
Question Areas
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Rabies
Lyme Disease
Mosquito-borne Disease
Animals in Public Settings
Food-borne Disease
Avian Influenza
NH Department of Health and Human Services
Division of Public Health Services
Common Zoonotic Disease
Question Areas
•
•
•
•
•
•
Rabies
Lyme Disease
Mosquito-borne Disease
Animals in Public Settings
Food-borne Disease
Avian Influenza
NH Department of Health and Human Services
Division of Public Health Services
Common Zoonotic Disease
Question Areas
•
•
•
•
•
•
Rabies
Lyme Disease
Mosquito-borne Disease
Animals in Public Settings
Food-borne Disease
Avian Influenza
NH Department of Health and Human Services
Division of Public Health Services
Common Zoonotic Disease
Question Areas
•
•
•
•
•
•
Rabies
Lyme Disease
Mosquito-borne Disease
Animals in Public Settings
Food-borne Disease
Avian Influenza
NH Department of Health and Human Services
Division of Public Health Services
Common Zoonotic Disease
Question Areas
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•
•
•
•
•
Rabies
Lyme Disease
Mosquito-borne Disease
Animals in Public Settings
Food-borne Disease
Avian Influenza
NH Department of Health and Human Services
Division of Public Health Services
Psittacosis
(Chlamydophila psittaci)
NH Department of Health and Human Services
Division of Public Health Services
August 2006
• Family boarded birds at pet
store in August 06
• Birds became ill Aug 23 (~2
weeks after returned from
pet store)
– Lethargy, nasal d/c
• Husband and wife ill Sept 6
– Fever, cough, headache
NH Department of Health and Human Services
Division of Public Health Services
September 2006
• MD visit (Sept 8)
– Dx pneumonia (chest radiographs)
– Abx started; illness quickly resolved
– Titers positive for psittacosis
(Chlamydophila psittaci)
NH Department of Health and Human Services
Division of Public Health Services
November 2006
• Patient reported by
veterinarian!
• Investigation:
– Child in household ill
since Nov 1 with cough
– Birds still in house…..
NH Department of Health and Human Services
Division of Public Health Services
NH DHHS and Dept Ag Actions
• Child
– Acute and convalescent samples to CDC for
testing - pending
– Abx; illness resolved immediately
– Education to family and possible contacts
– No additional suspect cases identified
• Birds
– Placed in isolation
– Testing for Chlamydophila psittaci
• PCR (cloacal and oral swaps): negative
– Abx
NH Department of Health and Human Services
Division of Public Health Services
Psittacosis - Background
• Chlamydophila psittaci
• Intracellular bacterium
• Survive outside the host for
days to weeks
• Transmission: inhalation,
vertical (birds)
• Zoonotic
• Reportable
NH Department of Health and Human Services
Division of Public Health Services
C. psittaci - Animals
• Wide host spectrum
among birds and
mammals
• Pet psittacine birds are
most often implicated in
human infection
Macaw
Parakeet
NH Department of Health and Human Services
Division of Public Health Services
C. psittaci - Birds
• Not an unusual disease
among pet birds
• Shed in feces and nasal &
ocular discharges
• Incubation 3 days to several
weeks
• Latent infections - disease
may appear years after
exposure
NH Department of Health and Human Services
Division of Public Health Services
C. psittaci - Birds
• Clinical signs variable
• Intermittent & asymptomatic shedding possible
• Shedding can be activated by stress - shipping,
crowding, cold, breeding.
• Birds with confirmed or probable psittacosis should
be isolated and treated under the care of a
veterinarian
• Important consideration in any lethargic bird with
nonspecific illness - especially in a recently
acquired bird
NH Department of Health and Human Services
Division of Public Health Services
C. psittaci - Humans
• Routes of infection
– Inhalation (feather dust, resp. secretions, dried
feces)
– Mouth-to-beak contact
– Handling of infected bird’s plumage and tissues
• Even brief exposures can lead to infection
NH Department of Health and Human Services
Division of Public Health Services
Psittacosis: Humans
• Incubation ~ 5-14 d
• Inapparent to systemic illness
(pneumonia)
• Acute fever, chills, headache,
nonproductive cough, dyspnea
• Can affect other organ systems
NH Department of Health and Human Services
Division of Public Health Services
Psittacosis –
Diagnosis & Treatment
• Diagnosis
– Antibodies: may cross-react, acute and convalescent
samples (at least 2 weeks apart)
– Culture - rarely performed (difficult/safety concerns)
– PCR
• Treatment
– Tetracyclines
– Symptoms improve in 48-72 hours, but relapse is common if
inadequately treated
– 15-20% fatality pre antibiotics, today <1% if properly treated
NH Department of Health and Human Services
Division of Public Health Services
Psittacosis: Public Health
Reportable disease:
– USA: 923 cases reported
to CDC (1988 to 2002)
– NH: 2 cases (1998, 2003)
– True incidence likely
much higher
NH Department of Health and Human Services
Division of Public Health Services
Psittacosis: Public Health
• Occupational hazard to
workers in bird industry
– Pet birds
– Turkey-processing
plants
• Sporadic cases
associated with pet bird
ownership
NH Department of Health and Human Services
Division of Public Health Services
Psittacosis: Controlling Infection
• Prevent
generation of
aerosols and dust
during cleanup
• Practice good bird
husbandry
NH Department of Health and Human Services
Division of Public Health Services
Resources
http://www.nasphv.org/Documents/Psittacosis.pdf
NH Department of Health and Human Services
Division of Public Health Services
NH Department of Health and Human Services
Division of Public Health Services