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Tetanus Tetanus Presentation Transcript

  • Brucellosis, Tetanus & Plague By Dr. Riaz Ahmed
  • Brucellosis Also known as undulant fever / malta fever / mediterranean fever. Bacterial zoonosis which is transmitted to man by direct / indirect contact with animals. Caused by different species of brucella- group of organisms and characterized by:• Intermittent / irregular febrile attacks• Arthritis / enlarged spleen etc.
  • Epidemiology Agent factors:• Brucella abortus – in bovine – abortus fever• B.Suis – Pigs – Swine – F or Porcine• B.Canis – Canines – Canine fever• B.Melitensis – Goats – Caprine fever Host factors: predominantly disease of males.• Farmers• Shepherds• Butchers• Slaughter house men• Veterinarians• Lab-workers – are at special risk because of occupational exposure.
  •  Environmental factors:Most prevalent under conditions of advanced domestication in the absence of corresponding advanced S.O. Hygiene (+) where there is• Overcrowding of herds• Increased rain fall• Lack of exposure to sunlight• Unhygienic practice of milking/ heat production
  •  M.O.T:• Ingestion – milk / milk products - meat even of camel• Contact – absorption from skin• Inhalation• Inoculation 02mm – throat or oral cavity Source / Reservoir:S – milk, lochial secretions, placenta, urine, feces & meat.R – farm animals e.g., cattle, goats, swine etc. I.P: highly variable usually 1-3 weeks.
  •  Lab diagnosis:• Bacteriological• Serological / allergic test Control: in animals:• Test / slaughter• Vacc – B.Abortus strain – 19• Hygienic measures In humans:• At individual level• At community level
  • Tetanus An acute disease caused by exotoxins of clostridium tetani clinically characterized by :• Muscular rigidity• Painful paraoxysmal spasms of voluntary muscles esp. Masseters ( trismus / lock-jaw ) Facial (risus sardonicus) Back / neck (opisthotonus)And those of lower limbs and abdomeno Mortality : 40-80%
  •  Agent factors:• Clostridium tetani• Reservoir of infection• Source – soil / dust• Exotoxin• P.O.C – None Host factors:• Age / sex• Occupation• Rural / urban differences• Immunity Environmental factors:• Tetanus is a positive environmental hazard. M.O.T: contamination of wounds with tetanus spores.
  •  I.P: 6 – 10 days Types:• Traumatic• Puerperal• Otogenic• Idopathic• Tetanus Neonatorum (8th day syndrome) Prevention:• Active immunization – DPT• Passive – ATS• Both• Antibiotics• Observe tetanus schedule for pregnant women
  • Plague (Black Death) Basically & primarily a zoonotic disease caused by Yersinia pestis involving rodents & fleas. It exists in natural foci & is transmitted by infected flea bites to humans living or intruding into the same ecological environment. Occurrence: many forms e.g.,• Epizootic• Enzootic• SporadicAnd in epidemics of all forms including anthroporotic primarily pnemonic.
  • History Epidemics of plague are mentioned in Bible Association of plague with rats is known to be ancient. 1st out-break – 1320 B.C. 1st Pandemic – 542 A.D. called Justinian plague, which lasted for 50 years & estimated mortality was 100 deaths. 2nd Pandemic – 1346 B.C. lasted for 30 years & claimed one forth world mortality. In 1840 B.C. – Pandemic of pneumonic type In 1930 – 6 million deaths in India. In 1994 - out-break in India, then subsided gradually.
  • Plague Def: Highly fatal disease characterized by high fever, progressive heart failure & nervous symptoms.o Conjunctiva is injected with reddish appearance.o Skin – hemorrhage & pustular eruptions. Clinical forms:• Bubonic• Pnemonic• Septicemic• sylvatic
  • Bubonic plague Onset sudden, most common type High temperature, prostration Painful buboos Vesicular / pustular skin lesions Complications: secondary terminal pneumonia
  • Pneumonic plague Primary P. Plague is rare. Generally follows as a complication of bubonic - septicemic plague. Incidence decreased 1% Highly infectious Symptoms – acute bacterial infection Sputum – hemorrhagic Most deadly form of plague
  •  Septicemic :• Rare• Buboes absent• Fever – low• Hemorrhages into skin Sylvatic :• Endemic in rodents in jungles• Man is affected accidentally while doing activities like hunting etc.
  •  Source of infection: In bubonic plague : by bite of inf. Rat – fleas Xenophsylla cheopis Xenophsylla actia Xenophsylla braziliensis In pneumonic plague: exhaled droplets of saliva sputum of patients Reservoir : rats & wild rodents, out of 1700 species 200 associated with plague.
  •  I.P:• Bubonic : 2-7 days• Septicemic : 2-7 days• Pneumonic : 1-3 days P.O.C: pneumonic is very communicable from person to person, bubonic if terminal inf. is there. M.O.T:• Bubonic plague – bite of infected rat flea• Pneumonic plague – droplets
  • Epidemiology Agent factors: yersinia pestis, occur in blood, buboes, spleen, liver, other viscera of infected persons. Host factors:• Age / sex – all ages & both sexes• Activities of man e.g., hunting, cultivation, grazing, harvesting, construction etc.• Movements – ship, land, cargo• Immunity – no natural immunity Environmental factors:• Season : september – May• Temp : 20-25 C• Humidity less than 60%, Rain fall• Rural / urban, Human dwellings
  •  Population at risk:• Geologists, Biologists• Anthropologists• Hunters, agriculturists etc. Vector of plague: Pulex irritants (human fleas) Blocked / Partially blocked flea Flea Indices:o Total flea indexo Specific index – if >1o Sp.% of fleaso Burrow index
  • Prevention & Control Control of cases:• Early diagnosis• Notification• Isolation• Treatment• Disinfection Control of fleas/ rodents:Application of insecticides, rodenticides and other preventive measures to be adopted. Vaccination: 0.5-1ml SC after 7-10 days.
  •  Chemoprophylaxis: Surveillance Health education