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EMERGING AND RE-EMERGING 
Prajwal S. 
14-M.V.M-49 
ZOONOSES
DEFINITION 
EMERGING ZOONOSES; 
A zoonosis that is newly recognized or newly evolved. 
Shows an increase in incidence. 
Expansion in geographical host or vector range.(W.H.O) 
RE EMERGING ZOONOSES 
Is considered an already known disease 
Shifts its geographical setting. 
Expands its host range. 
Significantly increases its prevalence. (O.I.E) 
2 11/20/14
CONTENTS 
Definition 
Etiology 
Epidemiology 
Symptoms 
Diagnosis 
Control and prevention 
3 11/20/14
BOVINE SPONGIFORM 
ENCEPHELOPATHY(B.S.E) 
Syn Mad Cow Disease 
Fatal neurodegenerative disease (encephalopathy) 
Spongy degeneration in the brain and spinal cord. 
BSE has a long incubation period, about 30 months to 8 
years, all breeds being equally susceptible. 
Etiology 
The Prion = Proteinaceous infectious particle 
Nature of the transmissible agent is not well 
understood. 
4 11/20/14
PRION 
Fibril model of prion propagation 
PrPC (for Common or Cellular) 
PrPSc for Scrapie 
5 11/20/14
By www.cdc.gov/ncidod/dvrd/bse/ 
6 11/20/14
7 11/20/14
SYMPTOMS 
Deteriorating behavioral 
and neurological signs. 
Increase in aggression. 
Slowly become ataxic. 
Systemic signs of disease, 
Drop in milk production. 
Anorexia and lethargy. 
8 11/20/14
DIAGNOSIS 
No ante mortem testing available 
Sample 
9 11/20/14
POST MORTEM DIAGNOSIS 
Histopathology of brain tissue 
Spongiform changes in 
gray matter 
Detection of abnormal prion protein 
Differentials 
Nervous ketosis, 
Hypomagnesaemia, Listeriosis, 
Polioencephalomalacia, Rabies, 
Brain tumor, Lead poisoning 
Spinal cord trauma. 
z 
Conti… 
10 11/20/14
DIAGNOSIS 
All are based on antibodies to detect prion protein in 
tissue 
Immunohistochemistry (IHC) is considered the gold 
standard 
Internationally recognized 
Expensive, labor intensive 
Rapid diagnostic tests 
Western blotting, ELISA 
11 11/20/14
CONTROL 
Feeding regulations and surveillance measures. A ban on 
feeding cattle meat and bone meal 
At the abattoir , the brain, spinal cord, trigeminal ganglia, 
intestines, eyes and tonsils from cattle are classified as 
specified risk materials, and must be disposed of 
appropriately. 
India has been recognized as the most secure status for 
the deadly mad cow disease.(78th W.H.O general session) 
12 11/20/14
AMERICAN TRYPANOSOMIOSIS 
syn; Chagas disease 
Is a potentially life-threatening illness 
Caused by the protozoan parasite, Trypanosoma cruzi (T. 
cruzi). 
It is found mainly in Latin America, where it is 
Mostly transmitted to humans by the faeces of triatomine 
bugs, known as kissing bugs 
Carlos Ribeiro Justiniano Chagas, a Brazilian doctor who 
discovered the disease in 1909. 
13 11/20/14
ETIOLOGY 
Is a hemoflagellate is 
found in mammalian 
blood and is 15 to 20 
microns in length. 
•VECTOR 
•TRITOMINE BUG (KISSING BUG) 
14 11/20/14
LIFE CYCLE
EPIDEMIOLOGY 
Chagas disease occurs 
mainly in Latin America. 
This is due mainly to 
population mobility 
between Latin America 
and the rest of the world. 
TRANSMISSION 
Blood transfusion 
Organ donation 
Congenital transmission 
(from infected mother to 
child) 
www.cdc.gov/chagas
SIGNS AND SYMPTOMS 
Acute phase ( 2 months after infection) 
Fever, headache, enlarged lymph glands, pallor, muscle 
pain, difficulty in breathing, swelling and abdominal or 
chest pain. 
Chronic phase 
Cardiac disorders 
Digestive disorders(typically enlargement of the 
esophagus or colon) 
17 11/20/14
DIAGNOSIS 
Microscopic examination of fresh anticoagulated blood, or 
its Buffy coat, for motile parasites; or by preparation of 
thin and thick blood smears stained with Giemsa, for direct 
visualization of parasites. 
Complement fixation 
Indirect hemagglutination 
Indirect fluorescence assays 
Radioimmunoassay, and ELISA 
Polymerase chain reaction 
18 11/20/14
CRYPTOSPORIDIOSIS 
Is a protozoan disease caused by Cryptosporidium. 
It affects the intestines and is typically an acute short-term 
infection. 
It is spread through the fecal-oral route, contaminated 
water . 
Symptom is self-limiting diarrhea in people with intact 
immune systems. In immunocompromised individuals, 
the symptoms are particularly severe and often fatal. 
19 11/20/14
ETIOLOGY 
Micrograph showing cryptosporidiosis. 
The cryptosporidium are the small, round bodies in 
apical vacuoles on the surface of the epithelium. 
H&E stain (Colonic biopsy) 
20 11/20/14
EPIDEMIOLOGY 
Transmission 
People who swim regularly in pools with insufficient 
sanitation 
Child care workers 
Parents of infected children 
People who take care of other people with 
cryptosporidiosis 
International travelers 
21 11/20/14
Conti…. 
People, including swimmers, who swallow water from 
contaminated sources 
People who handle infected cattle 
Backpackers, hikers, and campers who drink 
unfiltered, untreated water 
People exposed to human feces through sexual contact
LIFE CYCLE 
23 11/20/14
DIAGNOSIS 
Diagnosis of 
cryptosporidiosis is 
made by stool samples 
Acid-fast staining, 
Direct fluorescent 
antibody [DFA] 
Enzyme immunoassays 
for detection of 
Cryptosporidium sp. 
antigens Cryptosporidium oocysts in a modified acid-fast stain. 
(CDC Photo; DPDx) 
24 11/20/14
DIFFRENTIAL DIAGNOSIS 
Amebiasis 
Campylobacter Infections 
Cyclospora 
Cytomegalovirus Colitis 
Escherichia Coli Infections 
Gastroenteritis, Viral 
Giardiasis 
Isosporiasis 
Salmonellosis 
Shigellosis 
25 11/20/14
PREVENTION & CONTROL 
Practice Good Hygiene Everywhere 
At recreational water venues (pools, interactive 
fountains, lakes, ocean) 
Minimize contact with the feces of all animals 
Immunocompromised persons don’t handle suspected 
samples 
Avoid close contact with any person or animal that has 
cryptosporidiosis. 
26 11/20/14
EBOLA HEAMORREGIC FEVER 
Ebola hemorrhagic fever (Ebola virus disease) is a severe, 
often-fatal disease caused by infection with a species of 
Ebola virus. 
 The first Ebola virus species was discovered in 1976 in 
what is now the Democratic Republic of the Congo near the 
Ebola River. 
27 11/20/14
ETIOLOGY 
Ebola belongs to a 
family of viruses 
entitled Filoviridae, 
 and is commonly 
classified as a viral 
hemorrhagic fever 
(CDC, 2002). 
28 11/20/14
Filovirus virions are characterized by having one 
molecule of single stranded, negative-sense RNA, as 
well as their unique "U" shaped structures (CDC, 2002). 
RNA viruses, whose survival is dependent on an animal 
reservoir. 
Viral hemorrhagic fever commonly describes a multiple 
organ systems of the body are affected as well as 
extensive internal bleeding. 
29 11/20/14
EPIDEMIOLOGY 
Ebola Outbreaks 
1976-2014 
11/30 20/14
TRANSMISSION 
Ebola is spread through direct contact (through broken 
skin or mucous membranes in, for example, the eyes, 
nose, or mouth) 
Blood or body fluids (including but not limited to urine, 
saliva, sweat, feces, vomit, breast milk, and semen) of a 
person who is sick with Ebola 
Objects (like needles and syringes) that have been 
contaminated with the virus 
Infected fruit bats or primates (apes and monkeys) 
31 11/20/14
LIFE CYCLE 
32 11/20/14
SYMPTOMS 
Nausea and vomiting 
Diarrhea (may be bloody) 
Red eyes 
Raised rash 
Chest pain and cough 
Stomach pain 
Severe weight loss 
Bleeding, usually from the eyes, 
and bruising 
33 11/20/14
Total Cases CDC 
Updated: August 19, 2014 
Suspected and Confirmed Case Count: 2240 
Suspected Case Deaths: 1229 
Laboratory Confirmed Cases: 1383 
WHO 
18 Aug 2014 
Total confirmed, probable, and suspect cases and deaths 
from Ebola virus disease : 
Cases: 2473 
Deaths: 1350. 
34 11/20/14
DIAGNOSIS 
Timeline of Infection Diagnostic tests available 
Within a few days after symptoms 
begin · Antigen-capture enzyme-linked 
immunosorbent assay (ELISA) 
testing 
· IgM ELISA 
· Polymerase chain reaction 
(PCR) 
· Virus isolation 
35 11/20/14
PREVENTION 
Avoid contact with bats and 
nonhuman primates or 
blood, fluids, and raw meat 
prepared from these 
animals. 
Wear appropriate PPE. 
Isolate patients with Ebola 
from other patients. 
Avoid direct contact with 
the bodies of people who 
have died from Ebola. 
36 11/20/14
CYCLOSPORIOSIS 
Caused by protozoan 
Cyclospora cayetanensis 
Pathogen transmitted by feces 
and contaminated fruits and 
vegetables. 
It is not spread from person to 
person 
Hazard for travelers by being 
a cause of diarrhea. 
37 11/20/14
ETIOLOGY 
Is a coccidia parasite that 
emerged in the last decade 
as an important enteric 
pathogen 
Cyclospora cayetanensis oocysts 
38 11/20/14
39 11/20/14
EPIDEMIOLOGY 
Initially tropical and subtropical regions, occurrences 
of Cyclosporiasis are becoming more frequent in North 
America according to the (CDC). 
There were 11 documented cases U.S. government public 
health agency, of Cyclospora infection outbreaks in the 
U.S. and Canada since the 1990s. 
CDC recorded 1,110 laboratory-confirmed sporadic 
instances of Cyclosporiasis. As of August 2, 2013 
40 11/20/14
SYMPTOMS 
Watery diarrhea (most 
common) 
Loss of appetite 
Weight loss 
Cramping 
Bloating 
Increased gas 
Nausea 
Fatigue 
41 11/20/14
DIAGNOSIS 
Examining stool specimens. 
Acid-fast staining, are often used to 
make Cyclospora oocysts more visible under the 
microscope. 
UV fluorescence microscope shows stool containing the 
parasite the parasite appears blue or green against a black 
background. 
 Polymerase chain reaction (PCR). 
42 11/20/14
CONTROL 
Avoiding food or water that may have been 
contaminated with feces is the best way to prevent 
cyclosporiasis. 
Treatment with chlorine or iodine is unlikely to 
kill Cyclospora oocysts. 
 No vaccine for cyclosporiasis is available. 
43 11/20/14
HANTAVIRUS PULMONARY 
SYNDROME (HPS) 
Is a severe, sometimes fatal, respiratory disease in 
humans caused by infection with a hantavirus. 
Contact with rodents that carry hantavirus is at 
risk of HPS. 
Rodent infestation in and around the home 
remains the primary risk. 
Even healthy individuals are at risk for HPS 
infection if exposed to the virus. 
44 11/20/14
ETIOLOGY 
Transmission electron micrograph of the Sin Nombre Hantavirus 
Negative sense single stranded R.N.A virus 
45 11/20/14
EPIDEMIOLOGY 
TRANSMISSION; Aerosolized rodent excreta still remains 
the only known way the virus is transmitted to humans. 
The hispid cotton rat, 
46 11/20/14
Case report in U.S.A 
 December 31, 2013, a total of 637 have been reported in 
the United States. 
 Out of606 cases occurred from 1993-onward, 
Thirty-six percent of all reported cases have resulted in 
death. 
47 11/20/14
48 11/20/14
SYMPTOMS 
Fever 
Cough 
Myalgia 
Headache 
Lethargy 
Shortness-of-breath 
49 11/20/14
DIAGNOSIS 
Early diagnosis is difficult confused with influenza. 
History of potential rural rodent exposure, together with 
shortness of breath, would be strongly suggestive of HPS 
50 11/20/14
PREVENTION AND CONTROL 
Rodent control primary prevention strategy. 
Eliminating contact with rodents in the 
workplace. 
Closed storage sheds and cabins are often ideal 
sites for rodent infestations. 
Wear a mask while cleaning such areas to avoid 
inhalation of aerosolized rodent secretions. 
51 11/20/14
INFLUENZA 
syn ;flu 
Is an infectious disease of birds and mammals caused by 
R.N.A viruses of the family Orthomyxoviridae 
the influenza viruses. 
The most common symptoms are chills, fever, runny 
nose, sore throat, muscle pains, headache, coughing, 
weakness and general discomfort. 
52 11/20/14
ETIOLOGY 
53 11/20/14
Classification influenza viruses are 
Influenza virus A 
Influenza virus B 
Influenza virus C 
The serotypes that have been confirmed in humans, 
ordered by the number of known human pandemic 
deaths, are: 
•H1N1, which caused Spanish Flu in 1918, 
and Swine Flu in 2009 
Conti.. 
54 11/20/14
•H7N7, H2N2, which caused Asian Flu in 1957 
•H3N2, which caused Hong Kong Flu in 1968 
•H5N1, which caused Bird Flu in 2004 
•H1N7which has unusual zoonotic potential 
•H1N2 endemic in humans, pigs and birds 
•H9N2 
•H7N2 
•H7N3 
•H10N7 
•H7N9 
55 11/20/14
ANTIGENIC SHIFT AND DRIFT 
•Antigenic shift subtype having a mixture of the 
surface antigens of the two or more original strains. 
56 11/20/14
Antigenic drift viruses that involves the accumulation of 
mutations within the genes that code for antibody-binding 
sites. 
New strain of virus particles which cannot be inhibited as 
effectively by the antibodies 
Easier for the virus to spread throughout a partially 
immune population. 
Antigenic drift occurs in both influenza A and influenza 
B viruses. 
57 11/20/14
EPIDEMIOLOGY 
Transmission 
Infected person coughs, infected droplets get into the air. 
Hands contaminated with influenza viruses. 
Seasonal epidemics and disease burden 
In temperate climates, seasonal epidemics occur mainly 
during winter while in tropical regions, influenza may 
occur throughout the year, causing outbreaks more 
irregularly. 
58 11/20/14
http://www.who.int/entity/influenza/surveillance_monitoring/updates/2014_10_20_influenza_59 11/20/14
SYMPTOMS 
Fever and extreme coldness 
Cough 
Nasal congestion 
Runny nose 
Sneezing 
Body aches, especially joints and throat 
Fatigue 
Headache 
Irritated, watering eyes 
Reddened eyes, skin (especially face), mouth, throat and nose 
Petechial rash 
60 11/20/14
DIAGNOSIS 
Samples for influenza testing include nasopharyngeal or 
nasal swab, and nasal wash or aspirate 
Viral culture 
Serology 
Rapid antigen testing 
Polymerase chain reaction (PCR) 
Immunofluorescence assays 
Rapid molecular assays 
61 11/20/14
PREVENTION 
The most effective way to prevent the disease and/or severe 
outcomes from the illness is vaccination. Safe and effective 
vaccines are available and have been used for more than 60 
years. Among healthy adults, influenza vaccine can provide 
reasonable protection. However among the elderly, 
influenza vaccine may be less effective in preventing illness 
but may reduce severity of disease and incidence of 
complications and deaths. 
BY W.H.O. 
62 11/20/14
Vaccination is especially important for people at higher 
risk of serious influenza complications, and for people 
who live with or care for high risk individuals. 
Three types of inactivated vaccines, the 
Whole virus vaccines, 
Split virus vaccines, 
Subunit vaccines 
63 11/20/14
METHICILLIN-RESISTANT 
Staphylococcus aureus 
Methicillin-resistant Staphylococcus aureus (MRSA) is 
a bacteria that is resistant to many antibiotics. 
In the community, most MRSA infections are skin 
infections. 
In medical facilities, MRSA causes life-threatening 
bloodstream infections, pneumonia and surgical site 
infections. 
64 11/20/14
ETIOLOGY 
It is a Bacteria 
Family: 
Staphylococcaceae 
Genus: 
Staphylococcus 
Species: S. aureus 
Staphylococcus aureus 
65 11/20/14
EPIDEMIOLOGY 
Some risk factors include: 
Recurrent skin diseases or open wounds 
Long-term illness or long-term dialysis patient 
Surgery 
Contact with other persons with MRSA infection 
Recent antibiotic use 
Live in crowded settings 
66 11/20/14
LESION 
cutaneous abscess on the foot 
post packing 
cutaneous abscess on the hand, 
67 11/20/14
DIAGNOSIS 
Samples from blood, 
urine, sputum or other body-fluid 
samples 
Quantitative PCR :procedures 
which are employed in clinical 
laboratories for quickly 
detecting and identifying 
MRSA strains Mueller Hinton agar showing MRSA 
resistant to oxacillin disk 
68 11/20/14
Conti… 
Rapid latex agglutination test detects the PBP2a 
protein. PBP2a is a variant penicillin-binding 
protein that imparts the ability of S. aureus to be 
resistant to oxacillin. 
69 11/20/14
PREVENTION 
Screening programs 
Surface sanitizing 
Hand washing 
Proper disposal of hospital gowns 
Used paper hospital gowns are associated with MRSA 
hospital infections, which could be avoided by proper 
disposal 
Isolation 
70 11/20/14
 Restricting antibiotic use 
Glycopeptides, cephalosporins and in 
particular quinolones are associated with an increased 
risk of colonization of MRSA. 
Reducing use of antibiotic classes that promote MRSA 
colonization, especially fluoroquinolones, is 
recommended in current guideline. 
71 11/20/14
REFRENCES 
Sherikar A.T.,Bachhil V.N.& Thapliyal D.S. 
(Eds.),for ICARGovt. Of India Textbook of 
Elements of Veterinary Public Health 
www.who.org 
www.cdc.gov 
www.oie.org 
72 11/20/14
73 11/20/14

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Emerging and Re-Emerging Zoonoses: Diseases at the Human-Animal Interface

  • 1. EMERGING AND RE-EMERGING Prajwal S. 14-M.V.M-49 ZOONOSES
  • 2. DEFINITION EMERGING ZOONOSES; A zoonosis that is newly recognized or newly evolved. Shows an increase in incidence. Expansion in geographical host or vector range.(W.H.O) RE EMERGING ZOONOSES Is considered an already known disease Shifts its geographical setting. Expands its host range. Significantly increases its prevalence. (O.I.E) 2 11/20/14
  • 3. CONTENTS Definition Etiology Epidemiology Symptoms Diagnosis Control and prevention 3 11/20/14
  • 4. BOVINE SPONGIFORM ENCEPHELOPATHY(B.S.E) Syn Mad Cow Disease Fatal neurodegenerative disease (encephalopathy) Spongy degeneration in the brain and spinal cord. BSE has a long incubation period, about 30 months to 8 years, all breeds being equally susceptible. Etiology The Prion = Proteinaceous infectious particle Nature of the transmissible agent is not well understood. 4 11/20/14
  • 5. PRION Fibril model of prion propagation PrPC (for Common or Cellular) PrPSc for Scrapie 5 11/20/14
  • 8. SYMPTOMS Deteriorating behavioral and neurological signs. Increase in aggression. Slowly become ataxic. Systemic signs of disease, Drop in milk production. Anorexia and lethargy. 8 11/20/14
  • 9. DIAGNOSIS No ante mortem testing available Sample 9 11/20/14
  • 10. POST MORTEM DIAGNOSIS Histopathology of brain tissue Spongiform changes in gray matter Detection of abnormal prion protein Differentials Nervous ketosis, Hypomagnesaemia, Listeriosis, Polioencephalomalacia, Rabies, Brain tumor, Lead poisoning Spinal cord trauma. z Conti… 10 11/20/14
  • 11. DIAGNOSIS All are based on antibodies to detect prion protein in tissue Immunohistochemistry (IHC) is considered the gold standard Internationally recognized Expensive, labor intensive Rapid diagnostic tests Western blotting, ELISA 11 11/20/14
  • 12. CONTROL Feeding regulations and surveillance measures. A ban on feeding cattle meat and bone meal At the abattoir , the brain, spinal cord, trigeminal ganglia, intestines, eyes and tonsils from cattle are classified as specified risk materials, and must be disposed of appropriately. India has been recognized as the most secure status for the deadly mad cow disease.(78th W.H.O general session) 12 11/20/14
  • 13. AMERICAN TRYPANOSOMIOSIS syn; Chagas disease Is a potentially life-threatening illness Caused by the protozoan parasite, Trypanosoma cruzi (T. cruzi). It is found mainly in Latin America, where it is Mostly transmitted to humans by the faeces of triatomine bugs, known as kissing bugs Carlos Ribeiro Justiniano Chagas, a Brazilian doctor who discovered the disease in 1909. 13 11/20/14
  • 14. ETIOLOGY Is a hemoflagellate is found in mammalian blood and is 15 to 20 microns in length. •VECTOR •TRITOMINE BUG (KISSING BUG) 14 11/20/14
  • 16. EPIDEMIOLOGY Chagas disease occurs mainly in Latin America. This is due mainly to population mobility between Latin America and the rest of the world. TRANSMISSION Blood transfusion Organ donation Congenital transmission (from infected mother to child) www.cdc.gov/chagas
  • 17. SIGNS AND SYMPTOMS Acute phase ( 2 months after infection) Fever, headache, enlarged lymph glands, pallor, muscle pain, difficulty in breathing, swelling and abdominal or chest pain. Chronic phase Cardiac disorders Digestive disorders(typically enlargement of the esophagus or colon) 17 11/20/14
  • 18. DIAGNOSIS Microscopic examination of fresh anticoagulated blood, or its Buffy coat, for motile parasites; or by preparation of thin and thick blood smears stained with Giemsa, for direct visualization of parasites. Complement fixation Indirect hemagglutination Indirect fluorescence assays Radioimmunoassay, and ELISA Polymerase chain reaction 18 11/20/14
  • 19. CRYPTOSPORIDIOSIS Is a protozoan disease caused by Cryptosporidium. It affects the intestines and is typically an acute short-term infection. It is spread through the fecal-oral route, contaminated water . Symptom is self-limiting diarrhea in people with intact immune systems. In immunocompromised individuals, the symptoms are particularly severe and often fatal. 19 11/20/14
  • 20. ETIOLOGY Micrograph showing cryptosporidiosis. The cryptosporidium are the small, round bodies in apical vacuoles on the surface of the epithelium. H&E stain (Colonic biopsy) 20 11/20/14
  • 21. EPIDEMIOLOGY Transmission People who swim regularly in pools with insufficient sanitation Child care workers Parents of infected children People who take care of other people with cryptosporidiosis International travelers 21 11/20/14
  • 22. Conti…. People, including swimmers, who swallow water from contaminated sources People who handle infected cattle Backpackers, hikers, and campers who drink unfiltered, untreated water People exposed to human feces through sexual contact
  • 23. LIFE CYCLE 23 11/20/14
  • 24. DIAGNOSIS Diagnosis of cryptosporidiosis is made by stool samples Acid-fast staining, Direct fluorescent antibody [DFA] Enzyme immunoassays for detection of Cryptosporidium sp. antigens Cryptosporidium oocysts in a modified acid-fast stain. (CDC Photo; DPDx) 24 11/20/14
  • 25. DIFFRENTIAL DIAGNOSIS Amebiasis Campylobacter Infections Cyclospora Cytomegalovirus Colitis Escherichia Coli Infections Gastroenteritis, Viral Giardiasis Isosporiasis Salmonellosis Shigellosis 25 11/20/14
  • 26. PREVENTION & CONTROL Practice Good Hygiene Everywhere At recreational water venues (pools, interactive fountains, lakes, ocean) Minimize contact with the feces of all animals Immunocompromised persons don’t handle suspected samples Avoid close contact with any person or animal that has cryptosporidiosis. 26 11/20/14
  • 27. EBOLA HEAMORREGIC FEVER Ebola hemorrhagic fever (Ebola virus disease) is a severe, often-fatal disease caused by infection with a species of Ebola virus.  The first Ebola virus species was discovered in 1976 in what is now the Democratic Republic of the Congo near the Ebola River. 27 11/20/14
  • 28. ETIOLOGY Ebola belongs to a family of viruses entitled Filoviridae,  and is commonly classified as a viral hemorrhagic fever (CDC, 2002). 28 11/20/14
  • 29. Filovirus virions are characterized by having one molecule of single stranded, negative-sense RNA, as well as their unique "U" shaped structures (CDC, 2002). RNA viruses, whose survival is dependent on an animal reservoir. Viral hemorrhagic fever commonly describes a multiple organ systems of the body are affected as well as extensive internal bleeding. 29 11/20/14
  • 30. EPIDEMIOLOGY Ebola Outbreaks 1976-2014 11/30 20/14
  • 31. TRANSMISSION Ebola is spread through direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) Blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola Objects (like needles and syringes) that have been contaminated with the virus Infected fruit bats or primates (apes and monkeys) 31 11/20/14
  • 32. LIFE CYCLE 32 11/20/14
  • 33. SYMPTOMS Nausea and vomiting Diarrhea (may be bloody) Red eyes Raised rash Chest pain and cough Stomach pain Severe weight loss Bleeding, usually from the eyes, and bruising 33 11/20/14
  • 34. Total Cases CDC Updated: August 19, 2014 Suspected and Confirmed Case Count: 2240 Suspected Case Deaths: 1229 Laboratory Confirmed Cases: 1383 WHO 18 Aug 2014 Total confirmed, probable, and suspect cases and deaths from Ebola virus disease : Cases: 2473 Deaths: 1350. 34 11/20/14
  • 35. DIAGNOSIS Timeline of Infection Diagnostic tests available Within a few days after symptoms begin · Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing · IgM ELISA · Polymerase chain reaction (PCR) · Virus isolation 35 11/20/14
  • 36. PREVENTION Avoid contact with bats and nonhuman primates or blood, fluids, and raw meat prepared from these animals. Wear appropriate PPE. Isolate patients with Ebola from other patients. Avoid direct contact with the bodies of people who have died from Ebola. 36 11/20/14
  • 37. CYCLOSPORIOSIS Caused by protozoan Cyclospora cayetanensis Pathogen transmitted by feces and contaminated fruits and vegetables. It is not spread from person to person Hazard for travelers by being a cause of diarrhea. 37 11/20/14
  • 38. ETIOLOGY Is a coccidia parasite that emerged in the last decade as an important enteric pathogen Cyclospora cayetanensis oocysts 38 11/20/14
  • 40. EPIDEMIOLOGY Initially tropical and subtropical regions, occurrences of Cyclosporiasis are becoming more frequent in North America according to the (CDC). There were 11 documented cases U.S. government public health agency, of Cyclospora infection outbreaks in the U.S. and Canada since the 1990s. CDC recorded 1,110 laboratory-confirmed sporadic instances of Cyclosporiasis. As of August 2, 2013 40 11/20/14
  • 41. SYMPTOMS Watery diarrhea (most common) Loss of appetite Weight loss Cramping Bloating Increased gas Nausea Fatigue 41 11/20/14
  • 42. DIAGNOSIS Examining stool specimens. Acid-fast staining, are often used to make Cyclospora oocysts more visible under the microscope. UV fluorescence microscope shows stool containing the parasite the parasite appears blue or green against a black background.  Polymerase chain reaction (PCR). 42 11/20/14
  • 43. CONTROL Avoiding food or water that may have been contaminated with feces is the best way to prevent cyclosporiasis. Treatment with chlorine or iodine is unlikely to kill Cyclospora oocysts.  No vaccine for cyclosporiasis is available. 43 11/20/14
  • 44. HANTAVIRUS PULMONARY SYNDROME (HPS) Is a severe, sometimes fatal, respiratory disease in humans caused by infection with a hantavirus. Contact with rodents that carry hantavirus is at risk of HPS. Rodent infestation in and around the home remains the primary risk. Even healthy individuals are at risk for HPS infection if exposed to the virus. 44 11/20/14
  • 45. ETIOLOGY Transmission electron micrograph of the Sin Nombre Hantavirus Negative sense single stranded R.N.A virus 45 11/20/14
  • 46. EPIDEMIOLOGY TRANSMISSION; Aerosolized rodent excreta still remains the only known way the virus is transmitted to humans. The hispid cotton rat, 46 11/20/14
  • 47. Case report in U.S.A  December 31, 2013, a total of 637 have been reported in the United States.  Out of606 cases occurred from 1993-onward, Thirty-six percent of all reported cases have resulted in death. 47 11/20/14
  • 49. SYMPTOMS Fever Cough Myalgia Headache Lethargy Shortness-of-breath 49 11/20/14
  • 50. DIAGNOSIS Early diagnosis is difficult confused with influenza. History of potential rural rodent exposure, together with shortness of breath, would be strongly suggestive of HPS 50 11/20/14
  • 51. PREVENTION AND CONTROL Rodent control primary prevention strategy. Eliminating contact with rodents in the workplace. Closed storage sheds and cabins are often ideal sites for rodent infestations. Wear a mask while cleaning such areas to avoid inhalation of aerosolized rodent secretions. 51 11/20/14
  • 52. INFLUENZA syn ;flu Is an infectious disease of birds and mammals caused by R.N.A viruses of the family Orthomyxoviridae the influenza viruses. The most common symptoms are chills, fever, runny nose, sore throat, muscle pains, headache, coughing, weakness and general discomfort. 52 11/20/14
  • 54. Classification influenza viruses are Influenza virus A Influenza virus B Influenza virus C The serotypes that have been confirmed in humans, ordered by the number of known human pandemic deaths, are: •H1N1, which caused Spanish Flu in 1918, and Swine Flu in 2009 Conti.. 54 11/20/14
  • 55. •H7N7, H2N2, which caused Asian Flu in 1957 •H3N2, which caused Hong Kong Flu in 1968 •H5N1, which caused Bird Flu in 2004 •H1N7which has unusual zoonotic potential •H1N2 endemic in humans, pigs and birds •H9N2 •H7N2 •H7N3 •H10N7 •H7N9 55 11/20/14
  • 56. ANTIGENIC SHIFT AND DRIFT •Antigenic shift subtype having a mixture of the surface antigens of the two or more original strains. 56 11/20/14
  • 57. Antigenic drift viruses that involves the accumulation of mutations within the genes that code for antibody-binding sites. New strain of virus particles which cannot be inhibited as effectively by the antibodies Easier for the virus to spread throughout a partially immune population. Antigenic drift occurs in both influenza A and influenza B viruses. 57 11/20/14
  • 58. EPIDEMIOLOGY Transmission Infected person coughs, infected droplets get into the air. Hands contaminated with influenza viruses. Seasonal epidemics and disease burden In temperate climates, seasonal epidemics occur mainly during winter while in tropical regions, influenza may occur throughout the year, causing outbreaks more irregularly. 58 11/20/14
  • 60. SYMPTOMS Fever and extreme coldness Cough Nasal congestion Runny nose Sneezing Body aches, especially joints and throat Fatigue Headache Irritated, watering eyes Reddened eyes, skin (especially face), mouth, throat and nose Petechial rash 60 11/20/14
  • 61. DIAGNOSIS Samples for influenza testing include nasopharyngeal or nasal swab, and nasal wash or aspirate Viral culture Serology Rapid antigen testing Polymerase chain reaction (PCR) Immunofluorescence assays Rapid molecular assays 61 11/20/14
  • 62. PREVENTION The most effective way to prevent the disease and/or severe outcomes from the illness is vaccination. Safe and effective vaccines are available and have been used for more than 60 years. Among healthy adults, influenza vaccine can provide reasonable protection. However among the elderly, influenza vaccine may be less effective in preventing illness but may reduce severity of disease and incidence of complications and deaths. BY W.H.O. 62 11/20/14
  • 63. Vaccination is especially important for people at higher risk of serious influenza complications, and for people who live with or care for high risk individuals. Three types of inactivated vaccines, the Whole virus vaccines, Split virus vaccines, Subunit vaccines 63 11/20/14
  • 64. METHICILLIN-RESISTANT Staphylococcus aureus Methicillin-resistant Staphylococcus aureus (MRSA) is a bacteria that is resistant to many antibiotics. In the community, most MRSA infections are skin infections. In medical facilities, MRSA causes life-threatening bloodstream infections, pneumonia and surgical site infections. 64 11/20/14
  • 65. ETIOLOGY It is a Bacteria Family: Staphylococcaceae Genus: Staphylococcus Species: S. aureus Staphylococcus aureus 65 11/20/14
  • 66. EPIDEMIOLOGY Some risk factors include: Recurrent skin diseases or open wounds Long-term illness or long-term dialysis patient Surgery Contact with other persons with MRSA infection Recent antibiotic use Live in crowded settings 66 11/20/14
  • 67. LESION cutaneous abscess on the foot post packing cutaneous abscess on the hand, 67 11/20/14
  • 68. DIAGNOSIS Samples from blood, urine, sputum or other body-fluid samples Quantitative PCR :procedures which are employed in clinical laboratories for quickly detecting and identifying MRSA strains Mueller Hinton agar showing MRSA resistant to oxacillin disk 68 11/20/14
  • 69. Conti… Rapid latex agglutination test detects the PBP2a protein. PBP2a is a variant penicillin-binding protein that imparts the ability of S. aureus to be resistant to oxacillin. 69 11/20/14
  • 70. PREVENTION Screening programs Surface sanitizing Hand washing Proper disposal of hospital gowns Used paper hospital gowns are associated with MRSA hospital infections, which could be avoided by proper disposal Isolation 70 11/20/14
  • 71.  Restricting antibiotic use Glycopeptides, cephalosporins and in particular quinolones are associated with an increased risk of colonization of MRSA. Reducing use of antibiotic classes that promote MRSA colonization, especially fluoroquinolones, is recommended in current guideline. 71 11/20/14
  • 72. REFRENCES Sherikar A.T.,Bachhil V.N.& Thapliyal D.S. (Eds.),for ICARGovt. Of India Textbook of Elements of Veterinary Public Health www.who.org www.cdc.gov www.oie.org 72 11/20/14