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19 Cards in this Set
- Front
- Back
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Q Fever – Characteristics
Variable Pleuomorphic Gram-_____ coccobacillus _______ intracellular pathogen Biphasic life cycle Vector-borne Genetics of Coxiella _______ . Genome (Single Chromosome): 2.1Mb / 2194 genes 4 Plasmids: 32 – 54 Kb / 215 genes |
Q Fever – Characteristics
Variable Pleuomorphic Gram-negative coccobacillus Obligate intracellular pathogen Biphasic life cycle Vector-borne Genetics of Coxiella burneti Genome (Single Chromosome): 2.1Mb / 2194 genes 4 Plasmids: 32 – 54 Kb / 215 genes |
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Q Fever – Disease Presentation
Low ID50 – 1 __________ organism Clinical Onset ~ 20 days post-exposure Severe headache, fever, chills, fatigue, myalgia Pneumonia (30 – 50%) Endocarditis (chronic cases < 10 %) Hepatitis (< 10 %) Mortality: 1 – 2 % Disease severity: 0-15, 50+, immune compromised – severe Healthy Adults – asymptomatic to mild |
Q Fever – Disease Presentation
Low ID50 – 1 aerosolized organism Clinical Onset ~ 20 days post-exposure Severe headache, fever, chills, fatigue, myalgia Pneumonia (30 – 50%) Endocarditis (chronic cases < 10 %) Hepatitis (< 10 %) Mortality: 1 – 2 % Disease severity: 0-15, 50+, immune compromised – severe Healthy Adults – asymptomatic to mild |
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Q Fever – Epidemiology
Found in: Urine, feces, milk Environmentally hardy Resistant to some disinfectants, heat and drying. |
Q Fever – Epidemiology
Found in: Urine, feces, milk Environmentally hardy Resistant to some disinfectants, heat and drying. |
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Q Fever – Epidemiology
Reservoirs: Cattle, Sheep, Goats Occupational Exposure ______ most common route – Humans ONLY VECTOR-BORNE – Animals Surveillance: CDC NNDR (1999) CDC Food-borne disease surveillance network (Milk) US: 1978 – 1999 : 436 cases reported. Wyoming: ~ 1 case/year |
Q Fever – Epidemiology
Reservoirs: Cattle, Sheep, Goats Occupational Exposure Aerosol most common route – Humans ONLY VECTOR-BORNE – Animals Surveillance: CDC NNDR (1999) CDC Food-borne disease surveillance network (Milk) US: 1978 – 1999 : 436 cases reported. Wyoming: ~ 1 case/year |
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Q Fever – Diagnostics
IF (Indirect immunofluorescence) IgM (3 weeks post-infection to 1 year after) IgG (6 weeks post-infection to 12+ years after) Cross-reactivity with ________ / Tularemia PCR (Polymerase Chain Reaction) Low # of organisms in blood No test certified yet… |
Q Fever – Diagnostics
IF (Indirect immunofluorescence) IgM (3 weeks post-infection to 1 year after) IgG (6 weeks post-infection to 12+ years after) Cross-reactivity with Legionella / Tularemia PCR (Polymerase Chain Reaction) Low # of organisms in blood No test certified yet… |
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Q Fever – Treatment/Prevention
Acute __________ 100mg 15 to 21 Days Chronic (valvular endocarditis) Doxycycline and hydroxychloroquine 18 months Q-VAX (Made in Australia) Licensed in Australia / Not the US Approved for Human & Animal Use Formalin-inactivated Phase II organisms |
Q Fever – Treatment/Prevention
Acute Doxycycline 100mg 15 to 21 Days Chronic (valvular endocarditis) Doxycycline and hydroxychloroquine 18 months Q-VAX (Made in Australia) Licensed in Australia / Not the US Approved for Human & Animal Use Formalin-inactivated Phase II organisms |
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Tularemia also known as
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“Rabbit Fever”
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Tularemia - Characteristics
Plueomorphic, small, gram-____ coccobacillus Grows on GCBAP or BCYE Vector-borne (sometimes) Life cycle Genetics of Francisella tularensis Single Chromosome: ~ 1.9 Mb No ________ Typing (A or B) / (I-Schu4 or II-WY96) / F. novicida |
Tularemia - Characteristics
Plueomorphic, small, gram-negative coccobacillus Grows on GCBAP or BCYE Vector-borne (sometimes) Life cycle Genetics of Francisella tularensis Single Chromosome: ~ 1.9 Mb No plasmids Typing (A or B) / (I-Schu4 or II-WY96) / F. novicida |
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Tularemia – Disease Presentation
Ulceroglandular form Septicemic form (<2 % mortality) Fever, malaise, cough, anoxeria, vomiting Oculoglandular form Oropharyngeal form Pneumonic form (10% mortality) Purulent sputum, dyspnea, tachypnea, pleuritic pain Incubation: 3-5 days (up to 14) ID50 : ~ 10-50 organisms |
Tularemia – Disease Presentation
Ulceroglandular form Septicemic form (<2 % mortality) Fever, malaise, cough, anoxeria, vomiting Oculoglandular form Oropharyngeal form Pneumonic form (10% mortality) Purulent sputum, dyspnea, tachypnea, pleuritic pain Incubation: 3-5 days (up to 14) ID50 : ~ 10-50 organisms |
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Tularemia – Epidemiology
Zoonotic Disease Vector-borne (ticks, biting flies, deer fly) > 200 mammals, also birds and reptiles Transmission: Vector transmission handling infected animal tissues eating or drinking contaminated food or water Inhalation |
Tularemia – Epidemiology
Zoonotic Disease Vector-borne (ticks, biting flies, deer fly) > 200 mammals, also birds and reptiles Transmission: Vector transmission handling infected animal tissues eating or drinking contaminated food or water Inhalation |
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Tularemia – Life Cycle
Picture incomplete After replication in cytoplasm… Re-enter endocytic compartment Via autophagy pathway. Both Coxiella & Francisella appear to utilize the _______ pathway. |
Tularemia – Life Cycle
Picture incomplete After replication in cytoplasm… Re-enter endocytic compartment Via autophagy pathway. Both Coxiella & Francisella appear to utilize the autophagy pathway. |
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Tularemia uses this secretion system?
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VI
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Tularemia – Treatment
Vaccine LVS - avirulent F. tularensis biovar palaearctica type B Desire for new recombinant subunit vaccine Treatment Preferred: _________, 1g IM twice daily Gentamicin, 5 mg/kg IM or IV once daily Alternate: Doxycycline, 100 mg IV twice daily Ciprofloxacin, 400 mg IV twice daily |
Tularemia – Treatment
Vaccine LVS - avirulent F. tularensis biovar palaearctica type B Desire for new recombinant subunit vaccine Treatment Preferred: Streptomycin, 1g IM twice daily Gentamicin, 5 mg/kg IM or IV once daily Alternate: Doxycycline, 100 mg IV twice daily Ciprofloxacin, 400 mg IV twice daily |
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Brucellosis
Small, Gram-______, ___-motile rods The Genus… 9 species now Four cause disease in humans (B. suis, abortus, melitensis, and canis) Genetics 2 chromosomes: ~ 4.0 Mb total No _______ Evolved from ____ pathogens… Last CA ~ 15,000 years ago |
Brucellosis
Small, Gram-negative, non-motile rods The Genus… 9 species now Four cause disease in humans (B. suis, abortus, melitensis, and canis) Genetics 2 chromosomes: ~ 4.0 Mb total No plasmids Evolved from plant pathogens… Last CA ~ 15,000 years ago |
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Brucellosis – Disease Presentation
Systemic ( < 1% mortality) Undulating fevers, anemia, depression, joint ill, orchitis Pulmonary ( < 10% mortality) Cough (mucopurulent), chest pain, fever, sore throat, pleural effusion Chronic Complications Endocarditis, osteoarthritis, spontaneous abortion, hepatitis, CNS involvement ID50 : ~ 10 – 50 organisms |
Brucellosis – Disease Presentation
Systemic ( < 1% mortality) Undulating fevers, anemia, depression, joint ill, orchitis Pulmonary ( < 10% mortality) Cough (mucopurulent), chest pain, fever, sore throat, pleural effusion Chronic Complications Endocarditis, osteoarthritis, spontaneous abortion, hepatitis, CNS involvement ID50 : ~ 10 – 50 organisms |
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Brucellosis – Epidemiology
Risk Groups Meat inspectors, animal handlers, veterinarians, and laboratorians. Transmission Infected Animals Milk Inhalation Surveillance CDC NNDR |
Brucellosis – Epidemiology
Risk Groups Meat inspectors, animal handlers, veterinarians, and laboratorians. Transmission Infected Animals Milk Inhalation Surveillance CDC NNDR |
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Brucellosis – Epidemiology
Most cases are caused by _______ CA, VI, FL, TX Average about 50 cases/yr in US Major problem for 3rd World Accidental Needle stick S19 & RB51 |
Brucellosis – Epidemiology
Most cases are caused by melitensis CA, VI, FL, TX Average about 50 cases/yr in US Major problem for 3rd World Accidental Needle stick S19 & RB51 |
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Brucellosis – Pathogenesis
________ Pathogen Tropism for Macrophages, Placental Trophoblasts |
Brucellosis – Pathogenesis
Intracellular Pathogen Tropism for Macrophages, Placental Trophoblasts |
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Brucellosis – Treatment
Vaccine No human vaccine exists Treatment Acute 6 weeks - doxycycline and rifampin/streptomycin Chronic (valvular endocarditis, etc.) 1 year - doxycycline and rifampin/streptomycin Fluoroquinolones may replace rifampin |
Brucellosis – Treatment
Vaccine No human vaccine exists Treatment Acute 6 weeks - doxycycline and rifampin/streptomycin Chronic (valvular endocarditis, etc.) 1 year - doxycycline and rifampin/streptomycin Fluoroquinolones may replace rifampin |
