Brucella
Brucella spp.
• Gram negative, coccobacilli bacteria
• Facultative, intracellular organism
• Environmental persistence
– T...
Species Biovar/Ser
ovar
Natural Host Human
Pathogen
B. abortus 1-6, 9 cattle yes
B.melitensis 1-3 goats, sheep yes
B. suis...
The Many Names of Brucellosis
Human Disease
• Malta Fever
• Undulant Fever
• Mediterranean Fever
• Rock Fever of Gibraltar...
History of Malta Fever
• 450 BC: Described by Hippocrates
• 1905: Introduction into the U.S.
• 1914: B. suis Indiana, Unit...
History
• Alice Evans, American bacteriologist
– Credited with linking the organisms
– Similar morphology and pathology be...
Transmission to Humans
• Conjunctiva or broken skin contacting infected
tissues
– Blood, urine, vaginal discharges, aborte...
Who is at Risk?
• Occupational Disease
– Cattle ranchers/dairy farmers
– Veterinarians
– Abattoir workers
– Meat inspector...
B. melitensis
• Latin America, Middle East,
Mediterranean, eastern Europe, Asia,
and parts of Africa
• Accounts for most h...
B. abortus
• Worldwide
• Some countries have
eradicated it
• Notifiable disease
in many countries
– Poor surveillance and ...
Brucellosis in U.S.: 1975-2006
Human Disease
• Can affect any organ or organ system
• All patients have a cyclical fever
• Variability in clinical signs
...
Human Disease
• 20-60% of cases
– Osteoarticular complications
• Arthritis, spondylitis, osteomyelitis
• Hepatomegaly may ...
Human Disease
• Neurological
– Depression, mental fatigue
• Cardiovascular
– Endocarditis resulting in death
• Chronic bru...
Human Disease
• Congenitally infected infants
– Low birth weight
– Failure to thrive
– Jaundice
– Hepatomegaly
– Splenomeg...
Diagnosis in Humans
• Isolation of organism
– Blood, bone marrow, other tissues
• Serum agglutination test
– Four-fold or ...
Treatment of Choice
• Combination therapy has the best efficacy
– Doxycycline for six weeks in combination with
streptomyc...
Yersinia pestis
Yersinia pestis
• Yersinia originally classified in Pasteurellaceae
family
– Based on DNA similarities with E. coli, Y. pe...
Yersinia pestis
• Gram-negative bacteria
• Can grow with or without oxygen
• Most commonly found in rats but also found
in...
Types of Plague
• Bubonic Plague
– Most common
– Infection of the lymph system (attacks immune
system)
• Pneumonic Plague
...
• Symptoms
– Bubonic
• Fever, headache, chills,
weakness, swollen and
tender lymph glands
– Pneumonic
• Fever, headache, w...
http://rarediseases.about.com/od/infectiousdiseases/ig/Pictures-of-Bubonic-Plague/hand-gangrene.htm
Transmission
• Bubonic and Septicemic can not be transferred
human to human. They can only be contracted
if bitten by an i...
http://www.unbc.ca/nlui/wildlife_diseases
_bc/plague_cycles.gif
History
• There have been three major pandemics of the plague.
– Mid 6th
century, mid 14th
century, early 20th
century
• T...
http://neatorama.cachefly.net/images/2005-
12/sedlec-ossuary.jpg
Sedlec Ossuary in Kutna Hora
http://www.earth-photography...
Incidence
• Considered a re-emerging disease.
– Incidence is on the rise: 2,000 to 3,000 cases a
year worldwide.
http://ww...
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Brucellosis

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Brucellosis

  1. 1. Brucella
  2. 2. Brucella spp. • Gram negative, coccobacilli bacteria • Facultative, intracellular organism • Environmental persistence – Temperature, pH, humidity – Frozen and aborted materials • Multiple species
  3. 3. Species Biovar/Ser ovar Natural Host Human Pathogen B. abortus 1-6, 9 cattle yes B.melitensis 1-3 goats, sheep yes B. suis 1, 3 swine yes 2 hares yes 4 reindeer, caribou yes 5 rodents yes B. canis none dogs, other canids yes B. ovis none sheep no B. neotomae none Desert wood rat no B. maris (?) marine mammals ?
  4. 4. The Many Names of Brucellosis Human Disease • Malta Fever • Undulant Fever • Mediterranean Fever • Rock Fever of Gibraltar • Gastric Fever Animal Disease • Bang’s Disease • Enzootic Abortion • Epizootic Abortion • Slinking of Calves • Ram Epididymitis • Contagious Abortion
  5. 5. History of Malta Fever • 450 BC: Described by Hippocrates • 1905: Introduction into the U.S. • 1914: B. suis Indiana, United States • 1953: B. ovis New Zealand, Australia • 1966: B. canis in dogs, caribou, and reindeer
  6. 6. History • Alice Evans, American bacteriologist – Credited with linking the organisms – Similar morphology and pathology between: • Bang’s Bacterium abortus • Bruce’s Micrococcus melitensis • Nomenclature today credited to Sir David Bruce – Brucella abortus and Brucella melitensis
  7. 7. Transmission to Humans • Conjunctiva or broken skin contacting infected tissues – Blood, urine, vaginal discharges, aborted fetuses, placentas • Ingestion – Raw milk & unpasteurized dairy products – Rarely through undercooked meat • Incubation varies – 5-21 days to three months
  8. 8. Who is at Risk? • Occupational Disease – Cattle ranchers/dairy farmers – Veterinarians – Abattoir workers – Meat inspectors – Lab workers • Hunters • Travelers • Consumers of unpasteurized dairy products
  9. 9. B. melitensis • Latin America, Middle East, Mediterranean, eastern Europe, Asia, and parts of Africa • Accounts for most human cases – In the Mediterranean and Middle East • Up to 78 cases/100,000 people/year • Arabic Peninsula 20% seroprevalence • Recent emergence in cattle on Middle Eastern intensive dairy farms
  10. 10. B. abortus • Worldwide • Some countries have eradicated it • Notifiable disease in many countries – Poor surveillance and reporting due to lack of recognition – Fever of Unknown Origin (FUO)
  11. 11. Brucellosis in U.S.: 1975-2006
  12. 12. Human Disease • Can affect any organ or organ system • All patients have a cyclical fever • Variability in clinical signs – Headache, weakness, arthralgia, depression, weight loss, fatigue, liver dysfunction
  13. 13. Human Disease • 20-60% of cases – Osteoarticular complications • Arthritis, spondylitis, osteomyelitis • Hepatomegaly may occur • Gastrointestinal complications • 2-20% of cases – Genitourinary involvement • Orchitis and epididymitis most common
  14. 14. Human Disease • Neurological – Depression, mental fatigue • Cardiovascular – Endocarditis resulting in death • Chronic brucellosis is hard to define – Length, type and response to treatment variable – Localized infection • Blood donations of infected persons should not be accepted
  15. 15. Human Disease • Congenitally infected infants – Low birth weight – Failure to thrive – Jaundice – Hepatomegaly – Splenomegaly – Respiratory difficulty – General signs of sepsis (fever, vomiting) – Asymptomatic
  16. 16. Diagnosis in Humans • Isolation of organism – Blood, bone marrow, other tissues • Serum agglutination test – Four-fold or greater rise in titer – Samples 2 weeks apart • Immunofluorescence – Organism in clinical specimens • PCR
  17. 17. Treatment of Choice • Combination therapy has the best efficacy – Doxycycline for six weeks in combination with streptomycin for 2-3 weeks or rifampin for 6 weeks • CNS cases treat 6-9 months – Same for endocarditis cases plus surgical replacement of valves
  18. 18. Yersinia pestis
  19. 19. Yersinia pestis • Yersinia originally classified in Pasteurellaceae family – Based on DNA similarities with E. coli, Y. pestis is now part of Enterobacteriaceae family • 11 named species in genus  3 are human pathogens – Y. pestis, Y. pseudotuberculosis, Y. enterocolitica – Y. pestis and Y. pseudotuberculosis rarely infect humans – Y. enterocolitica is the cause of 1 – 3% of diarrhea cases caused by bacteria
  20. 20. Yersinia pestis • Gram-negative bacteria • Can grow with or without oxygen • Most commonly found in rats but also found in: – Mice, squirrels, fleas, cats, dogs, lice, prairie dogs, wood rats, chipmunks
  21. 21. Types of Plague • Bubonic Plague – Most common – Infection of the lymph system (attacks immune system) • Pneumonic Plague – Most serious type of plague – Infection of the lungs leading to pneumonia – Primary and Secondary • Septicemic Plague – Bacteria reproduces in the blood – Can be contracted like bubonic plague but is most often seen as a complication of untreated bubonic or pneumonic plague
  22. 22. • Symptoms – Bubonic • Fever, headache, chills, weakness, swollen and tender lymph glands – Pneumonic • Fever, headache, weakness, rapid onset of pneumonia (usually accompanied by: shortness of breath, chest pain, cough, bloody or watery sputum) – Septicemic • Fever, chills, weakness, abdominal pain, shock, bleeding underneath skin or other organs • Diagnosis and Treatment – Most cases of plague are diagnosed initially from presented symptoms, especially Bubonic plague. If plague is suspected, blood work is completed to determine how far the plague has progressed and to determine antibiotic resistances. – Since no major antibiotic resistances have developed, plague is usually treated with Streptomycin. Other antibiotics that can be used are: tetracyclines, fluoroquinolones and other aminoglycosides. – Antibiotics are administered to the patient as well as to those who are believed to have been exposed.
  23. 23. http://rarediseases.about.com/od/infectiousdiseases/ig/Pictures-of-Bubonic-Plague/hand-gangrene.htm
  24. 24. Transmission • Bubonic and Septicemic can not be transferred human to human. They can only be contracted if bitten by an infected rodent or flea. • Pneumonic can be transferred through exposure to infected particles. This usually occurs when in close contact with someone who is infected and is exposed to sputum that is coughed up.
  25. 25. http://www.unbc.ca/nlui/wildlife_diseases _bc/plague_cycles.gif
  26. 26. History • There have been three major pandemics of the plague. – Mid 6th century, mid 14th century, early 20th century • The most well known plague pandemic was in the mid 14th century in Europe known as the Black Death – The plague came from Asia and spread through Europe in two years. – In the two years, it killed more than half of the population. – People didn’t understand how the plague worked which allowed it to spread . – Benefits.
  27. 27. http://neatorama.cachefly.net/images/2005- 12/sedlec-ossuary.jpg Sedlec Ossuary in Kutna Hora http://www.earth-photography.com/photos/Countries/CzechRepublic/Czech_KutnaHora_Ossuary1.jpg http://z.about.com/d/goeaste urope/1/0/o/5/-/-/SedlicOssu ary11.JPG
  28. 28. Incidence • Considered a re-emerging disease. – Incidence is on the rise: 2,000 to 3,000 cases a year worldwide. http://www.cdc.gov/ncidod/dvbid/plague/world98.htm
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