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Bacterial Zoonotic diseases of pets


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Bacterial Zoonotic diseases of pets

  1. 1. SUBMITTED TO: Dr. Ali Raza
  2. 2.  Those diseases and infections which are naturally transmitted between vertebrate animals and man. (Shakespeare, 2009) Zoonotic diseases are the diseases being common to, shared by or transmitted between human beings and other vertebrate animals. (Bjerkås, 2008)
  3. 3. Zoonoses Continue… A comprehensive literature review identifies 1415 species of infectious organism known to be pathogenic to humans. This include 217 viruses and prions, 538 bacteria and rickettsia, 307 fungi, 66 protozoa and 287 helminthes. Out of these, 868 (61%) are zoonotic, that is, they can be transmitted between humans and animals, and 175 pathogenic species are associated with diseases considered to be emerging. Out of the emerging pathogens, 132 (75%) are zoonotic. (Taylor et al., 2001)
  4. 4. Emerging Zoonoses A zoonosis that is newly recognized or newly evolved, or that has occurred previously but shows an increase in incidence or expansion in geographical, host or vector range". Emerging zoonotic diseases have potentially serious human health and economic impacts and their current upwards trends are likely to continue. (WHO, 2004)
  5. 5. The causative organisms responsible forzoonoses are very diverse andrepresentative of a wide range ofpathogens, or parasites.
  6. 6.  The range of symptoms and effects that this extensive range of causative organisms produce in both their animal hosts and humans is just as diverse, from the asymptomatic, through the slightly inconvenient, to some associated cases with fatalities in excess of 50% of infected individuals. (Shakespeare, 2009)
  7. 7. Routes of Transmission A potential zoonosis may not necessarily cause detectable symptomatic disease in the animal host, nor is transmission to humans certain from every exposure to the pathogen. As with any other infection, the size of inoculum necessary to initiate progress to clinical disease varies from causative organism to causative organism, and also depends on the route of transmission. The mode of transmission varies from zoonosis to zoonosis, and can also vary for the same causative organism from host species to host species. Transmission from animal to human can be not only by direct, but also by indirect contact. Indirect spread by physical contact with a previously infected object or surface is known as fomite spread. (Shakespeare, 2009)
  8. 8. Routes of Transmission Continue…The disease presentation and the clinical courseassociated with a particular pathogen may also varydepending on the route and mode of infection. (Shakespeare, 2009)
  9. 9. Risk Groups Most healthy adults with a competent immune system are unlikely to acquire a zoonotic infection even if an inoculum of potentially infective magnitude is present. This does not indicate that infection does not occur in this group only that it is less likely than in the groups shown in Table, who are identified by the WHO as primarily „at risk‟. (Shakespeare, 2009)
  10. 10. Animal Bites Diseases mainly transferred by saliva through bites and scratches. Many bite wounds caused by dogs or cats develop into infections. Cat bites are usually associated with a higher risk of wound infection than dog bites. Potential pathogen bacteria can be cultivated from about 90 % of bite wounds caused by a cat or a dog, and in most cases more than one agent is diagnosed. J. Grøndalen, B. Sævik, H. Sørum, 2008, EJCAP
  11. 11. Animal Bites Continued… The most common isolates include species of Pasteurella, Streptococcus, Staphylococcus, Neisseria and Moraxella. Pasteurella multocida is also part of the normal flora in most vertebrates, including the dog and cat. Pasterurella infections are especially seen after cat bites. Clinical signs may include cellulitis, lymphangitis and lymphadenopaty, in some cases in combination with arthritis
  12. 12. Cat Scratch Disease Casautive Agent:  Bartonella henselae  hemotropic gram – negative Most humans that develop “cat scratch disease” are children or young adults. It is estimated to affect 22,000 people in the United States every year the disease is considered to be the most common cause of chronic lymphadenopathy in this age group. Cats with chronic bacteremia are contagious through saliva. J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  13. 13. Cat Scratch Disease Continued… The most common clinical symptoms in humans are  non-pruritic swelling on the inoculation site  Lymphadenopathy  In some cases fever and general malaise occur  In rare cases, acute encephalopathy, liver- and spleen abscesses and pneumopathies may develop Dogs are believed also to develop and transfer disease caused by Bartonella spp. J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  14. 14. Cat Scratch Disease Continued… Diagnosis: 1. Culture of B. henselae from blood or infected tissues  Culture can be difficult, and B. henselae will not be recovered using routine blood culture methods because of the fastidious, slow growing nature of the organism. Ten to fi fty - six days may be required before visible colonies are identified. 2. Detection of Bartonella spp. DNA by PCR is standard for diagnosis. J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  15. 15. Cat Scratch Disease Continued… Prevention: a. The main preventive measures are proper training and handling of cats to avoid bites, scratches, licks and flea control. b. Any bites or scratches should be promptly and carefully cleaned. c. Extra care should be taken in households with immunocompromised individuals. d. Animals that are negative could be exposed any time thereafter, so a negative result cannot be taken as indication of an absence of the risk of B. henselae exposure. e. Screening of feline blood donors for B. henselae has been recommended because of the ability to transmit infection through contaminated blood. J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  16. 16. Cat Scratch Disease Continued… Treatment:  Patients with mild or moderate CSD, only conservative symptomatic treatment is recommended1) Administration of antipyretics and analgesics as needed2) Occasionally, lymph node aspiration is indicated for pain relief in patients3) Use of antibiotics is controversial and not indicated for typical CSD in immunocompetent patients Stephen J Nervi, New Jersey Medical School
  17. 17. Anthrax Causative Agent:  B. anthracis  Gram-positive  encapsulated, spore-forming bacterium  Exist in both vegetative and spore forms  Vegetative cells have a characteristic polypeptide capsule that is visible with methylene blue or Giemsa stains.  Spores are dormant forms that are highly resistant to environmental effects and disinfectants.  When culture form ‘medusa-head colonies’ J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  18. 18. Anthrax Continued… 4 forms of acute disease in humans:  Cutaneous (most frequent and least dangerous)  Gastrointestinal (rare)  Inhalational (rare and extremely dangerous)  Intravenous – injection drug users
  19. 19. Anthrax Continued…
  20. 20. Anthrax Continued… Clinical presentation: o Infection almost always originates from oral exposure o Fever o Anorexia o Inflammation of regional lymph nodes of the head, neck, and mediastinum o Severe lymph node enlargement can cause asphyxiation o Toxemia and shock are more common causes of death o Hemorrhagic gastroenteritis can develop, particularly in younger animals J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  21. 21. Anthrax Continued… Diagnosis:  A history of potential exposure greatly facilitates diagnosis, both in terms of making the correct diagnosis and safety of the diagnostician.  Aspirates of blood, lymph nodes, other affected tissues, or pharyngeal swabs can be collected for cytological examination and culture.  Methylene blue or Giemsa stains should be used on aspirates to look for the characteristic encapsulated organism.  Culture is the definitive diagnostic test but should only be attempted by facilities with proper containment.  Animals that have died of anthrax typically display little or no rigor mortis and often have dark blood oozing from various orifices.  ELISA  PCR J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  22. 22. Anthrax Continued… Prevention:  The risk of anthrax exposure from companion animals, either in households or in veterinary clinics, is very low in most areas.  Reducing roaming of dogs and cats should greatly reduce the risk of anthrax exposure and infection.  In veterinary clinics, care should be taken to reduce the risk of environmental contamination or personnel exposure.  Necropsy should not be performed because it will permit the formation of highly resistant B. anthracis spores J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  23. 23. Salmonellosis Human salmonellosis is most commonly associated with foodborne infection, but transmission of Salmonella from pets can occur. The risk is greatest with reptiles. Salmonellae are gram negative enteric bacteria that are normally found in a wide range of mammals, reptiles, amphibians, birds, and insects. Transmission of Salmonella from dogs and cats to people can occur in households, shelters, and veterinary clinics. J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  24. 24. Salmonellosis Continued… Clinical presentation:  In dogs, salmonellosis can range from mild self limited diarrhea to severe hemorrhagic gastroenteritis and septicemia  Fever  Vomiting  Abdominal pain  Dehydration  Diarrhea may be mucoid, watery, or hemorrhagic  Animals recovering from infection may shed bacteria up till six weeks post infection. J. Grøndalen, B. Sævik, H. Sørum, 2008, EJCAP
  25. 25. Salmonellosis Continued…Turtles are asymptomatic carriers of salmonella. Ithas been reported that reptiles can have a carrierfrequency of more than 90%. All reptiles must beconsidered potential carriers. J. Grøndalen, B. Sævik, H. Sørum, 2008, EJCAP
  26. 26. Salmonellosis Continued… Diagnosis:  Treatment:  Isolation of Salmonella from feces is the  Replacement of fluids standard for the diagnosis  Anti-diarrheals  Isolation of the bacterium from blood or other sterile body sites is diagnostic for  Antibiotics invasive infections.  PCR J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  27. 27. Brucellosis Causative Agent:  Brucella spp.  non spore forming  gram negative coccobacilli The most clinically relevant Brucellae are Brucella abortus (primarily from cattle), Brucella melitensis (primarily from goats and sheep), and Brucella suis (swine). B. canis is associated with dogs and is a zoonotic pathogen, but is the least common cause of human brucellosis. The risk of infection is low in people that do not have contact with breeding dogs, but is relatively high in people who handle breeding dogs and who are exposed to reproductive tissues and fluids from infected dogs. J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  28. 28. Brucellosis Continued… Clinical presentation:  Subclinical infections are common  Late - term abortion is common  Decreased fertility with early embryonic death, stillbirths, and birth of weak puppies can also occur  Lymphadenopathy may be present Male dogs can develop  Orchitis  Epididymitis  Testicular enlargement in acute infection & atrophy with chronic disease Mortality is low but morbidity can be high J. Grøndalen, B. Sævik, H. Sørum, 2008, EJCAP
  29. 29. Brucellosis Continued… Clinical presentation: (Humans) Undulent fever  Granulomatous hepatitis It usually starts as  Gastroenteritis  Acute febrile illness  Hepatosplenomegaly  Headache  Endocarditis  Weakness  Myalgia  Back pain J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  30. 30. Brucellosis Continued… Diagnosis:  Isolation of B. canis is the gold standard for diagnosis  Blood culture is most often successful in the first 8 weeks after infection  Rapid slide agglutination test (RSAT)  Agar gel immunodiffusion (AGID)  Indirect fluorescent antibody (IFA)  ELISA  Urine culture J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  31. 31. Brucellosis Continued… Prevention & Treatment:  Isolation of Infected animals  The use of gloves and protective outerwear when handling the dog or potential infected fluids, or having contact with a contaminated environment.  Positive dogs should not be bred and should be neutered.  Infected dogs should not have any direct or indirect contact with uninfected dogs.  Stable plurilamellar vesicles (SPLVs) entrapping aminoglycosides are used.  Antibiotics Journal of Infectious Diseases, 1985 Sep;152(3):529-35
  32. 32. Campylobacteriosis Campylobacter spp. Diarrheic disease is most common C. upsaliensis is the most common species found in dogs C. upsaliensis , C. helveticus , and C. jejuni are found in cats Shedding ranged from 44 days to more than 6 months. J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  33. 33. Campylobacteriosis Continued… Clinical presentation:  Most infected animals have no signs of disease.  Diarrhea is the predominant clinical sign.  Anorexia  Vomiting  Abdominal pain  Dehydration J. Grøndalen, B. Sævik, H. Sørum, 2008, EJCAP
  34. 34. Campylobacteriosis Continued… Diagnosis:  Diagnosis of Campylobacteriosis is challenging, largely because of the high prevalence of colonization in healthy animals.  Fecal culture is currently the standard for diagnosis, although interpretation can be difficult because of the presence of Campylobacter in a large percentage of healthy animals.  PCR J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  35. 35. Escherichia coli E. coli is a gram negative The main zoonotic disease concern involves verotoxigenic E. coli (VTEC), particularly E. coli O157:H7 These strains produce verotoxins (also known as Shiga toxins) The organism can be commonly found in the intestinal tracts of healthy cattle, sheep, goats, pets and wild birds The main source of human infections is contaminated food. The overall risk of E. coli O157 from pets is quite low. J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  36. 36. Escherichia coli Continued… Clinical presentation:  Mild self limited diarrhea to bloody diarrhea  Hemorrhagic colitis  Hemolytic uremic syndrome J. Grøndalen, B. Sævik, H. Sørum, 2008, EJCAP
  37. 37. Leptospirosis Leptospira spp. Long, thin, spiral shaped gram negative bacteria J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  38. 38. Leptospirosis Continued… Clinical presentation:  Subclinical infections appear to be the most  Severe weakness common form.  Depression  Clinical disease is rarely reported in cats, even  icterus when leptospiremia and histological renal and hepatic damage are present.  Fever  Vomiting  Abdominal pain  Diarrhea J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  39. 39. Leptospirosis Continued… Diagnosis:  Microscopic agglutination test (MAT)  ELISA  Macroscopic slide agglutination test (MSAT)  indirect hemagglutination assay (IHA)  PCR J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  40. 40. Leptospirosis Continued… Prevention:  Reducing exposure of animals Wet areas with drainage from potentially infected cattle, deer, or wildlife are of higher risk, particularly with slow moving, warm, and alkaline water.  Vaccination  Isolation of infected animals  Prophylactic treatment of exposed persons J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  41. 41. Leptospirosis Continued… Treatment:  High doses of antibiotics. Antibiotic treatment (doxycycline, Vibramycin, Oracea, Adoxa, Atridox, penicillin)  Fluid replacement  Antipyretic  Antiemetic William C. Shiel Jr., MD, FACP, FACR on 12/20/2010
  42. 42. Q-Fever Coxiella burnetii Obligate intracellular gram – negative bacterium Cats are the most important reservoir in urban areas Numerous outbreaks of Q-fever have been reported from contact with periparturient cats. Close contact with periparturient cats is not required for transmission, and simply being in the same house or room may be adequate. Dog - associated Q fever is uncommonly reported and is likely very rare, but can occur. J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  43. 43. Q-Fever Continued… Clinical presentation:  In Humans:  infections in companion animals are typically subclinical.  Flu like illness  Fever, anorexia, and lethargy can develop in  Fever cats after experimental infection.  headache,  Splenomegaly in dogs reported.  Sweats  Abortion, stillbirth, and birth of weak  Cough puppies and kittens can occur  Concurrent pneumonia or hepatitis is common. J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  44. 44. Q-Fever Continued… Prevention:  The greatest risk of pet associated Q fever comes from periparturient animals, particularly cats, so efforts should be focused on that group.  Immunocompromised individuals and pregnant women should avoid contact with periparturient and newborn animals.  Good hygiene practices should be used when handling dogs.  Household pets should not have direct contact with periparturient ruminants.  An inactivated whole cell unlicensed vaccine is effective in for protection against exposure, but severe local reactions to this vaccine may be seen in those who already possess immunity. Therefore, an intradermal skin test is recommended to detect pre-sensitized or immune individuals. J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  45. 45. Yersiniosis Yersinia enterocolitica is a bacterium that can replicate at refrigerator temperatures and exists as a number of different subgroups called serotypes. Serotype 3 and 9 cause most of the disease in humans and are zoonotic agents that are common in dogs, cats and pigs. Transmission to humans occurs through contact with a household pet that is shedding the bacterium in their faeces, by similar direct contact with pigs or by consumption of undercooked pork. Several other Yersinia spp. are zoonotic agents including Yersinia pseudotuberculosis, which causes gastrointestinal disease in humans and systemic granulomatous disease in cats.
  46. 46. Psittacosis Psittacosis is a disease caused by a bacterium Chlamydophila psittaci It is transmitted to humans from birds. 161 cases were diagnosed in Australia in 2005, of which 34 cases originated in Victoria. This disease is usually contracted by inhalation of dust containing faecal matter from infected birds. Clinical signs are most severe in immunosuppressed individuals. J. Grøndalen, B. Sævik, H. Sørum, 2008, EJCAP
  47. 47.  Disease is typically nonspecific and difficult to differentiate clinically from various other illnesses. Lethargy Anorexia Ruffled feathers Mucopurulent nasal & ocular discharge Diarrhea Excretion of green to yellow green urates J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  48. 48.  Chronic conjunctivitis, Enteritis Air sacculitis Pneumonitis Hepatosplenomegaly Pericarditis, Nasal adenitis Peritonitis Sudden death. J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  49. 49. Psittacosis Continued… Birds carrying this disease range from being clinically normal, to very ill. All ill birds should be handled carefully, and never allow any bird to place their head near your mouth. Good personal hygiene, such as washing hands with soap after handling your bird and dampening down the floor of your birds cage before cleaning to prevent aerosolisation of dusty faecal matter, will help prevent transmission of this disease to humans. J. Grøndalen, B. Sævik, H. Sørum, 2008, EJCAP
  50. 50. Tuberculosis M. tuberculosis, M. avium, Mycobacterium battey, “M. genavense”  Aerobic  Non spore forming  Slow growing organism (in vitro & in vivo) J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  51. 51. Tuberculosis Continued… Clinical presentation:  In Humans:  Fever  Fever  Weight loss  Weight loss  Anorexia  Chills  Nonproductive cough  Productive cough Gastrointestinal TB is more common in cats  Night Sweats  Vomiting  Extrapulmonary manifestations include  Weight loss  Meningitis  Anorexia,  Lymphadenitis  Anemia  Septic arthritis  Diarrhea  Osteomyelitis J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  52. 52. Tuberculosis Continued… Diagnosis:  Isolation of M. tuberculosis is the gold standard  Molecular testing of tissues and exudates can provide a rapid and specific diagnosis of M. tuberculosis .  Tuberculin testing is inconsistent and unreliable in dogs and cats.  PCR can be performed on tissues or fluid samples. J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  53. 53. Tuberculosis Continued…
  54. 54. Tuberculosis Continued… Prevention:  In households with infected pets, contact with the infected site should be avoided as much as possible.  Hand hygiene should be performed after contact. J. Scott Weese and Martha B. Fulford, 2011, Companion Animal Zoonoses
  55. 55. Summary Companion animals live in close contact with the human population The risk of transmitting zoonotic diseases to humans is significant if the animal itself has been infected. Increased travel activity increases the possibility of transfer of infection between animal populations, and increased risk for contact with new infectious agents. An increasing number of people suffer from immunodeficiencies. Environmental- and climatic conditions cause a change in distribution of vectors in need of special climatic conditions to establish. NVJ, 11/2004.
  56. 56. Summary Continued… Exotic species are also to an increasing extent introduced as family pets, which may contribute to a wider panorama of infections. However, the traditional zoonotic diseases are still the most important. Vaccination, proper hygiene measurements and knowledge on preventive measures restrict the risk of transmittance of infections from companion animals. The most significant risk of companion animals in Norway are mostly related to dog and cat bites or other physical injuries. NVJ, 11/2004.
  57. 57.  European Academies Science Advisory Council (EASAC). Combating the Threat of Zoonotic Infections. London: Royal Society, 2008. Taylor et al. 2001 Risk factors for human disease emergence Philosophical Transactions of the Royal Society B 356(1411):983-9. Stevenson, WJ. & Hughes, KL. (1988) Synopsis of Zoonoses in Australia, 2nd edition, Canberra: Australian Government Publishing Service. WHO/FAO/OIE joint consultation on emerging zoonotic diseases, Geneva, 3-5 May 2004.
  58. 58. Any Questions ??