zoonoses arbo 2004

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Information about zoonoses arbo 2004

Published on April 7, 2008

Author: Calogera

Source: authorstream.com

VIRAL ZOONOSES:  VIRAL ZOONOSES ZOONOTIC VIRUSES TRANSMISSIBLE FROM ANIMALS ARTHROPODS often via a blood sucking arthropod VERTEBRATES bites, body fluids, inhalation etc VIRAL ZOONOSES:  VIRAL ZOONOSES PART I ARTHROPOD BORNE transmission:  transmission arthropod vectors (blood sucking) Many arboviral diseases world wide (hundreds) VIGILANCE:  VIGILANCE Slide6:  ARBOVIRUSES ENCEPHALITIS FEBRILE DISEASES HEMORRHAGIC FEVERS ARBOVIRUSES:  ARBOVIRUSES FAMILY ENVELOPE yes yes no SYMMETRY icosahedral helical icosahedral GENOME ssRNA (+ve) ssRNA (-ve) segmented dsRNA, segmented Slide9:  ARTHROPOD Habitat Diurnal activity Preferred host Annual activity Overwintering ability Transovarial transmission VERTEBRATE Migratory activity Persistence of viremia Clinical consequences Reservoir ? Dead end host? Slide10:  ST LOUIS ENCEPHALITIS PREVENTION:  PREVENTION SURVEILLANCE VECTOR CONTROL REPELLENTS CLOTHING TIMING OF ACTIVITY (OR CANCELLATION) VACCINE SYLVATIC (JUNGLE) CYCLE:  SYLVATIC (JUNGLE) CYCLE arthropod arthropod vertebrate man vertebrate URBAN CYCLE:  URBAN CYCLE arthropod arthropod man man ARBOVIRAL DISEASE:  ARBOVIRAL DISEASE MANY DIFFERENT ARBOVIRUSES CAUSE DISEASE OFTEN SUB-CLINICAL INITIAL VIRAL REPLICATION ENDOTHELIAL CELLS MACROPHAGES/MONOCYTE LINEAGE INTERFERON (RNA VIRUSES) VIREMIA RECOVERY:  RECOVERY INTERFERON CELL-MEDIATED IMMUNITY ANTIBODY MAY PLAY A ROLE DURING VIREMIC PHASE DIAGNOSIS:  DIAGNOSIS SPECIALIZED LABS (Commercial labs now testing for WNV) Immunological techniques PCR RESISTANCE:  RESISTANCE IgG ARBOVIRUSES – ENCEPHALITIS:  ARBOVIRUSES – ENCEPHALITIS DISTRIBUTION East US, Canada West US, Canada, Mexico, Brazil Central and S America, Texas, Florida North America, parts of Europe, parts of Africa North America North America FAMILY TOGAVIRIDAE Eastern equine encephalitis Western equine encephalitis Venezuelan equine encephalitis FLAVIVIRIDAE West Nile virus encephalitis St Louis encephalitis BUNYAVIRIDAE California serogroup (La Crosse etc) ARBOVIRUS ENCEPHALITIS:  ARBOVIRUS ENCEPHALITIS SPORADIC LOW % INFECTIONS -> CLINICAL CASES NOT ALL CASES -> MAJOR DISEASE PROBABLY UNDERDIAGNOSED EASTERN EQUINE ENCEPALITIS:  EASTERN EQUINE ENCEPALITIS Reservoir: birds Vector: mosquito Sentinels horse,quail, turkey <15, >50yrs at higher risk CFR ~35% ~5 cases/year av. CDC togavirus EASTERN EQUINE ENCEPALITIS:  EASTERN EQUINE ENCEPALITIS CDC togavirus WESTERN EQUINE ENCEPALITIS:  WESTERN EQUINE ENCEPALITIS Reservoir: birds Vector: mosquito Sentinels horse,quail, turkey Children at higher risk CFR 3-5% No human cases recently togavirus VENEZUELAN EQUINE ENCEPALITIS:  VENEZUELAN EQUINE ENCEPALITIS Reservoir: horse, small mammals Vector: mosquito Mild disease in man togavirus WEST NILE VIRUS:  WEST NILE VIRUS flavivirus http://www.cdc.gov/ncidod/dvbid/westnile/cycle.htm Reservoir: birds Vector: mosquito WEST NILE VIRUS:  WEST NILE VIRUS flavivirus http://www.cdc.gov/ncidod/dvbid/westnile/cycle.htm Symptoms: Fever Meningitis Encephalitis More rarely: Acute flaccid paralysis poliomyelitis -inflammation spinal cord West Nile Virus:  West Nile Virus For every ~150 people infected ~30 mild symptoms mild fever headache, body ache, maybe rash may never see physician, even if do, may not be diagnosed ~1 severe illness e.g. encepalitis, meningitis, high fever, stiff neck, stupor, disorientation, coma, tremors, convulsions, muscle weakness frequency of flaccid paralysis unknown, but less than frequency of encephalitis WEST NILE VIRUS:  WEST NILE VIRUS flavivirus Case fatality ratio: Higher in elderly Most fatalities over 50 yrs age Slide28:  Reported Human WNV Disease Cases, US Cases States 1999 62 1 2000 21 3 2001 6 10 2002 4156 39 & DC 2003 9862 44 & DC 2004 2151* 40 & DC *As of 0ct 19 2004: 2004 Case Fatality Rate = 68/2151 = 3.2% flavivirus ST. LOUIS ENCEPHALITIS:  ST. LOUIS ENCEPHALITIS Second commonest mosquito borne disease in US Reservoir: birds Man usually dead end host Vector: mosquito <1% infections clinical Elderly at higher risk CFR 3-25% ~200 cases/year av. flavivirus CALIFORNIA SEROGROUP ENCEPHALITIS (includes La Crosse virus):  CALIFORNIA SEROGROUP ENCEPHALITIS (includes La Crosse virus) Recently commoner in eastern US Reservoir: small mammals Vector: mosquitos Children at higher risk Low CFR ~70 cases/year av. bunyavirus Slide31:  La Crosse life cycle 2000 - 2 cases in SC, Charleston area ARBOVIRUSES – FEVER AND HEMORRHAGIC FEVER:  ARBOVIRUSES – FEVER AND HEMORRHAGIC FEVER FAMILY FLAVIVIRIDAE Dengue Yellow fever REOVIRIDAE Colorado tick fever DISTRIBUTION World wide, especially tropics Africa, S. and C. America North America MAIN DISEASES fever, hemorrhagic fever hemorrhagic fever fever COLORADO TICK FEVER :  COLORADO TICK FEVER Vector: tick Mild disease in man Fever, rash, arthralgia RMSF important consideration in differential diagnosis Probably common, rarely reported Reovirus family Slide34:  World Distribution of Dengue 1999 DENGUE FEVER:  DENGUE FEVER jungle cycle (monkeys-mosquitos) urban cycle (man-mosquitos) rapidly increasing disease in tropics approx. 100-200 cases/yr in US due to import occasional indigenous transmission 50-100 million cases per year worldwide Reported Cases of DHF in the Americas, 1970 - 1999:  Reported Cases of DHF in the Americas, 1970 - 1999 * Provisional data through 1999 2001 - 609000 dengue cases in Americas alone (15,000 DHF) Dengue virus:  Dengue virus Viremia 0 5 8 12 Human #1 Mosquito feeds / acquires virus ILLNESS CDC DENGUE FEVER:  DENGUE FEVER fever headache retro-orbital pain myalgia, arthralgia bone-ache ‘breakbone fever’ sometimes rash may look like flu, measles, rubella more rarely encephalitis DENGUE HEMORRHAGIC FEVER/DENGUE SHOCK SYNDROME :  DENGUE HEMORRHAGIC FEVER/DENGUE SHOCK SYNDROME hemorrhages plasma leakage hemoconcentration hypotension circulatory failure shock Slide40:  DHF - petechiae CDC Slide41:  Dengue hemorrhagic fever - pleural effusion CDC Vaughn DW et al. J Infect Dis 1997; 176:322-30. DENGUE HEMORRHAGIC FEVER:  DENGUE HEMORRHAGIC FEVER immunopathological 4 serotypes (1, 2, 3, 4) maternal antibody DENGUE HEMORRHAGIC FEVER:  DENGUE HEMORRHAGIC FEVER Immune enhancement hypothesis more mononuclear infected infected monocytes release vasoactive mediators increased vascular permeability hemorrhagic symptoms DENGUE HEMORRHAGIC FEVER:  DENGUE HEMORRHAGIC FEVER children more severe disease do not give aspirin CFR depends on rapid response can be as low as 1% YELLOW FEVER:  CDC YELLOW FEVER jungle and urban cycles hemorrhages degeneration liver, kidney, heart CFR 50% Vaccine important to consider in travel to areas with yellow fever WEST NILE VIRUS:  WEST NILE VIRUS flavivirus http://www.cdc.gov/ncidod/dvbid/westnile/clinicians/epi.htm

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