Beware the black spot BELINDA LIN ID/MICROBIOLOGY REGISTRAR BARWON HEALTH
|
|
- Jayson Fletcher
- 6 years ago
- Views:
Transcription
1 Beware the black spot BELINDA LIN ID/MICROBIOLOGY REGISTRAR BARWON HEALTH
2 Mr MG, 61 Presents unwell 1 week following trekking the Kokoda Headache, arthralgias High fevers to 40 C, drenching sweats Delirium Atovaquone/proguanil (malarone) for malaria prophylaxis
3 Past Medical History Dyslipidemia Gastroesophageal reflux disease Medications Pantoprazole NKDA
4 Examination Blanching rash on back Small lesion Eschar?
5 Bloods from GP Dengue serology and NS1 Ag Negative Malaria thick and thin film No parasites seen Malaria ICT Negative In Hospital WCC 8.8 Neut 3.0 Lymph 4.7x10 9 /L Na 131mmol/L ALT 65, ALP 199, GGT 389IU/L, bilirubin 8 umol/l, albumin 30g/L CRP 10.7mg/L
6 HIV serology Negative HBV serology Immune HCV serology Negative Leptospirosis serology sent Rickettsial serology sent
7 Rickettsial serology 29/5 Spotted fever group Rickettsia australis Negative (<128) Rickettsia honei Negative (<128) Rickettsia conorii Negative (<128) Rickettsia africae Negative (<128) Rickettsia rickettsii Negative (<128) Rickettsia felis Negative (<128) Typhus group Rickettsia prowazekii Negative (<128) Rickettsia typhi Negative (<128) Scrub typhus group R. (Orentia) tsutsugamushi Gilliam POSITIVE (8192) Karp POSITIVE (256) Kato POSITIVE (2048) Cowley Beach POSITIVE (256) Orentia chuto Negative (<128)
8 Rickettsial PCR on skin biopsy Spotted Fever/Typhus group Not detected Scrub Typhus DETECTED
9 Case 2 Ms LZ, 25 Visiting Great Ocean Rd from Melbourne Transferred from a peripheral hospital with Fevers, rigors, meningism & mixed blanching rash on both her legs Proximal DVT, rivaroxaban
10 History Day 1: fevers and sore throat Day 3: begins trip to Great Ocean Road, develops prominent headache, myalgias, rigors and mild photophobia/neck stiffness Day 2: visit GP in Melbourne, Rx roxithromycin Day 4: visit local hospital, rash noted on her leg and transferred to Geelong. Rx IV dexamethasone and ceftriaxone.
11 Past History Proximal DVT, IVC filter Single functioning kidney Asthma Medications Rivaroxaban Mirena Allergy: penicillin (rash), contrast (rash/itch)
12 Epidemiology Previous travel to Africa and South East Asia 2013 Took malaria prophylaxis Social History Home with parents Stable relationship Vaccination Childhood vaccinations Meningococcal C
13 Examination 38.1 C HR /70 98% on air Photophobia and neck stiffness Rash (see picture)
14 Investigations FBE: WCC 10.5-, Neut 9.4-, Lymph 0.7x10 9 /L UEC: Na 135-, bicarb 19-, urea 4.5mmol/L, Cr 117 umol/l, egfr 56mL/min LFT ALT 18-, ALP 76-, GGT 19U/L, bilirubin 12 umol/l albumin 37g/L CRP 185mg/L INR 1.9, Fibrinogen 5.7g/L B-HCG <1 IU/L CXR no infective changes seen
15 Cultures Urine culture 22/2 WCC <10 Blood culture 22/2 negative LP ideal but not done due to rivaroxaban NPS influenza A, B & RSV PCR negative HIV serology Not done N. meningitidis PCR on serum: negative
16 History Day 1: fevers and sore throat Day 3: begins trip to Great Ocean Road, develops prominent headache, myalgias, rigors and mild photophobia/neck stiffness Day 5: worsening symptoms of meningism Day 2: visit GP in Melbourne, Rx roxithromycin Day 4: visit local hospital, rash noted on her leg and transferred to Geelong. Rx IV dexamethasone and ceftriaxone.
17 Epidemiology Previous travel to Africa and South East Asia 2013 Contact with wallabies and kangaroos on Philip Island 4 days prior to disease onset
18 Differentials
19 Rickettsial Serology 23/2 Spotted fever group Rickettsia australis POSITIVE (512) Rickettsia honei POSITIVE (128) Rickettsia conorii POSITIVE (128) Rickettsia africae POSITIVE (256) Rickettsia rickettsii POSITIVE (256) Rickettsia felis Negative (<128) Typhus group Rickettsia prowazekii Negative (<128) Rickettsia typhi POSITIVE (128) Scrub typhus group R. (Orentia) tsutsugamushi Negative (<128) Orentia chuto Negative (<128)
20 Rickettsial Serology 1/5 23/2 Spotted fever group Rickettsia australis POSITIVE (256) (512) Rickettsia honei POSITIVE (256) (128) Rickettsia conorii POSITIVE (256) (128) Rickettsia africae POSITIVE (256) (256) Rickettsia rickettsii POSITIVE (256) (256) Rickettsia felis Negative (<128) (<128) Typhus group Rickettsia prowazekii Negative (<128) (<128) Rickettsia typhi POSITIVE (128) (128) Scrub typhus group Not tested R. (Orentia) tsutsugamushi Negative (<128) Orentia chuto Negative (<128)
21 Literature Review Epidemiology of Rickettsial disease and their vectors Diagnostic tools Serology PCR MALDI-TOF
22 Rickettsioses Obligate intracellular gram-negative bacteria that invade endothelial cells and induce the formation of vasculitis Triad symptoms: fevers, headache and rash 26 Species SFG Typhus Scrub typhus Parola et al. CMR 2013
23 Transmission Bite from a tick, flea, louse or helminth Salivary excretions Mite Faecal matter Laboratory based aerosol Transfusion and transplant Seasonal most cases diagnosed late spring and summer
24 Rickettsia in Australia Geographic distribution mainly determined by their vectors
25 Rickettsia Vector R. australis Tick - Ixodes holocyclus R. honei Tick - Bothriocroton hydrosauri R. tsutsugamushi Mites (chiggers) - Leptotrombidium deliense R. prowazekii Human body louse (Pediculus R. typhi humanus corporis), some ticks, fleas
26 Ixodes holocyclus R. australis (QLD tick typhus) 3 host tick Larva, nymph & adult Slow feeders Optimal host - bandicoots
27 Bothriocroton hydrosauri R. honei (Flinders Island SF) Southern reptile tick 3 host tick Primary host Tiliqua rugosa (sleepy lizard) Opportunistically feed on humans, cattle and horses
28 Leptotrombidium mites R. tsutsugamushi Only larval forms of Leptotrombidium mites transmit disease Feeds on liquified skin tissue
29 Map of the area where scrub typhus is endemic. Daryl J. Kelly et al. Clin Infect Dis. 2009;48:S203-S by the Infectious Diseases Society of America
30 Eschar Site of bacterial entry sometimes develops into a localised inflammatory and necrotic skin lesion with a black crust, termed an inoculation eschar
31 Eschar Location Kim et al. Am J Trop Med Hyg 2007
32 Diagnosis of Rickettsial infections
33 Weil-Felix 1916 Uses Proteus OX-19 & OX-2 agglutination Poor sensitivity and specificity
34 Cell culture Vero cells African green monkey kidney epithelial cells Picture: Giménez staining of R. rickettsii-infected Vero 76 cells. The black arrow points to an individual bacterium. Ammerman et al. Curr Protoc Microbiol. 2008
35 Immunofluorescence Assay (IFA) 1963 Reference method How does it work?
36 Bozeman and Elisberg. Proc Soc Exp Biol Med. 1963
37 Seroconversion usually 7-15d after onset of illness 25-28d for R. africae infection IgM and IgG titres 128 considered positive result How well does this correlate with infection?
38 ,603 febrile patients admitted to the district hospital in Peninsular Malaysia Group 1 diseased population defined by isolation of R. tsutsugamushi and no conflicting clinical or serological diagnosis Group 2 control population negative culture for R. tsutsugamushi and definite alternative diagnosis (S. typhi or paratyphi, malaria, leptospirosis or flavivirus) At a cut-off point of >=1:400, the IFA test was 0.96 specific Brown et al. Am J Trop Med Hyg. 1983
39 Rickettsial Serology Use in diagnosis of Rickettsial infection: 4-fold increase in the titer in paired serum samples OR a single sample titer when there is an adequate local evidence base Disadvantage Cross reactivity between assays for different species in Spotted Fever group, Legionella and Proteus species Seroconversion usually 7-15d after onset of illness Inter-observer variability Blacksell et a. Clin Infect Dis Brouqui et al. Clin. Microbiol. Infect Parola et al. Clin. Microbiol. Rev
40 IFA Inter- & intra-observer Variability IFA interpretation subjective Inter-observer agreement (K) K = 0.45 (moderate) Murine typhus (R. typhi) K = 0.32 (fair) Scrub typhus (R. tsutsugamushi) Microscopist inexperience plays a role Phetsouvanh et al. Am J Trop Med Hyg. 2013
41 PCR Specimen Eschar Whole blood Skin biopsy
42 PCR of Eschar vs Blood in Scrub Typhus Nested PCR Eschar more sensitive than blood Sensitivity 86% (95% CI: 78-92%) Remains positive after initiation of treatment Blood Buffy coat used Sensitivity 82% (95% CI: 74-88%) Specificity 100% (95% CI: %) Kim et al. CID 2006
43 Effect of Abx Whole blood specimen
44 Rickettsemia 3 healthy volunteers infected with R. tsutsugamushi via laboratory-reared chiggers Clinical disease 8-10 days post chigger attachments all had eschars All subjects improved dramatically <24h following Abx therapy Rickettsemias detected in all 3, beginning on d7 PCA (bloods taken every 3d) Seroconversion (IFA) on d13-19 Shirai et al. Japan J Med Sci Biol 1982
45 Identification of Ticks Traditionally - morphology MALDI-TOF technology (research only) Specimen Tick legs Hemolymph protein mixture from tick legs Advantages: Requires no expertise in tick ID Inexpensive, rapid & accurate Dual identification of tick species and associated pathogens Can identify damaged ticks Need tick MS library Yssouf et al. J Clin Micro 2013 Yssouf et al. Ticks Tick Borne Dis 2015
46 Consistent and reproducible MS profiles were obtained from analysis of the legs of six tick vectors: Amblyomma variegatum, Rhipicephalus sanguineus, Hyalomma marginatum rufipes, Ixodes ricinus, Dermacentor marginatus, and Dermacentor reticulatus (French ticks) Yssouf et al. J Clin Micro 2013
47 Fig. 1. Photograph of a tick hemolymph drop collected by severing one leg from an adult specimen for the protein extraction used in the MALDI-TOF MS analysis. The hemolymph drop is indicated by the arrow. Yssouf et al. Ticks Tick Borne Dis. 2015
48 Proof of Concept: identification of tick species and presence of Borreliae in a single assay 88.9% sensitivity and a 93.75% specificity for the detection of B. crocidurae in 50 O. sonrai ticks Fotso Fotso et al. PLoS Negl Trop Dis 2014
49 R. conorii conorii or R. slovaca in Rhipicephalus sanguineus and Dermacentor marginatus ticks Using protein extracts prepared from tick legs Yssouf et al. PLoS Negl Trop Dis 2015
50 SUMMARY Consider Rickettsial disease in patients with fevers, headache and rash Eschar important in diagnosis Immunofluorescence current gold standard and readily available in Victoria Rapid diagnostic tests available PCR on blood, eschar and skin biopsy specimen
51 Acknowledgement ID unit, Barwon Health A/Prof Eugene Athan Dr Raquel Cowan Dr Eleanor MacMorran Australian Rickettsial Reference Laboratory A/Prof Jon Stenos Ms Chelsea Nguyen
Three patients with fever and rash after a stay in Morocco: infection with Rickettsia conorii
Three patients with fever and rash after a stay in Morocco: infection with Rickettsia conorii Stylemans D 1, Mertens R 1, Seyler L 1, Piérard D 2, Lacor P 1 1. Department of Internal Medicine, UZ Brussel
More informationLABORATORY ASSAYS FOR THE DIAGNOSIS OF TICK-TRANSMITTED HUMAN INFECTIONS
LABORATORY ASSAYS FOR THE DIAGNOSIS OF TICK-TRANSMITTED HUMAN INFECTIONS Stephen R. Graves, Gemma Vincent, Chelsea Nguyen, Haz Hussain-Yusuf, Aminul Islam & John Stenos. Australian Rickettsial Reference
More informationIntroduction- Rickettsia felis
Cat flea-borne spotted fever in humans is the dog to blame? Rebecca J Traub Assoc. Prof. in Parasitology Faculty of Veterinary and Agricultural Sciences Introduction- Rickettsia felis Emerging zoonoses
More informationWes Watson and Charles Apperson
Wes Watson and Charles Apperson Ticks are not insects! Class Acarina Order Parasitiformes Family Argasidae soft ticks (5 genera) Family Ixodidae hard ticks (7 genera) Genus Dermacentor 30 species Amblyomma
More informationWelcome to Pathogen Group 9
Welcome to Pathogen Group 9 Yersinia pestis Francisella tularensis Borrelia burgdorferi Rickettsia rickettsii Rickettsia prowazekii Acinetobacter baumannii Yersinia pestis: Plague gram negative oval bacillus,
More informationRickettsioses as Paradigms of New or Emerging Infectious Diseases
CLINICAL MICROBIOLOGY REVIEWS, Oct. 1997, p. 694 719 Vol. 10, No. 4 0893-8512/97/$04.00 0 Copyright 1997, American Society for Microbiology Rickettsioses as Paradigms of New or Emerging Infectious Diseases
More informationUpdate on Lyme disease and other tick-borne disease in North Central US and Canada
Update on Lyme disease and other tick-borne disease in North Central US and Canada Megan Porter, DVM Michigan State University 2018 CIF-SAF Joint Conference Tick season is here! Today s objectives: To
More informationThe Essentials of Ticks and Tick-borne Diseases
The Essentials of Ticks and Tick-borne Diseases Presenter: Bobbi S. Pritt, M.D., M.Sc. Director, Clinical Parasitology Laboratory Co-Director, Vector-borne Diseases Laboratory Services Vice Chair of Education
More informationFever in returning travellers: clinical cases
Fever in returning travellers: clinical cases Nick Beeching Senior Lecturer in Infectious Diseases Tropical & Infectious Disease Unit Royal Liverpool University Hospital Liverpool School of Tropical Medicine
More informationTopics. Ticks on dogs in North America. Ticks and tick-borne diseases: emerging problems? Andrew S. Peregrine
Ticks and tick-borne diseases: emerging problems? Andrew S. Peregrine E-mail: aperegri@ovc.uoguelph.ca Topics Ticks on dogs in Ontario and the pathogens they transmit? Should dogs be routinely screened
More informationBlood protozoan: Plasmodium
Blood protozoan: Plasmodium Dr. Hala Al Daghistani The causative agent of including Plasmodium vivax P. falciparum P. malariae P. ovale. malaria in humans: four species are associated The Plasmodium spp.
More informationRickettsial Diseases and friends.
Rickettsial Diseases and friends. MAJ Jason M. Blaylock, MD 21 Nov 2014 *Acknowledgements: LTC Paige Waterman, MD, MAJ Leyi Lin, MD Objectives Familiarization with: Classification Geographic distribution
More informationCoccidioidomycosis Nothing to disclose
Coccidioidomycosis Nothing to disclose Disclosure Greg Melcher, M.D. Professor of Clinical Medicine Division of HIV, ID and Global Medicine Zuckerman San Francisco General Hospital University of California,
More informationVector Borne and Animal Associated Infections. Kimberly Martin, DO, MPH Assistant Professor of Pediatrics Pediatric Infectious Diseases
Vector Borne and Animal Associated Infections Kimberly Martin, DO, MPH Assistant Professor of Pediatrics Pediatric Infectious Diseases 1 Conflict of Interest I have no relevant financial relationships
More informationMedical and Veterinary Entomology
Medical and Veterinary Entomology An eastern treehole mosquito, Aedes triseriatus, takes a blood meal. Urbana, Illinois, USA Alexander Wild Photography Problems associated with arthropods 1) Psychological
More informationBrucellosis in Kyrgyzstan
Centers for Disease Control and Prevention Case Studies in Applied Epidemiology No. 053-D11 Brucellosis in Kyrgyzstan Participant's Guide Learning Objectives After completing this case study, the participant
More informationTick-borne Diseases, an Emerging Health Threat to US Forces Korea
Tick-borne Diseases, an Emerging Health Threat to US Forces Korea Terry A. Klein, COL (Ret), PhD Vector-borne Disease Program Manager FHP&PM, AGENDA Objectives, Concept, Organization Mite-, Tick, and Flea-borne
More informationClinical Manifestations and Treatment of Plague Dr. Jacky Chan. Associate Consultant Infectious Disease Centre, PMH
Clinical Manifestations and Treatment of Plague Dr. Jacky Chan Associate Consultant Infectious Disease Centre, PMH Update of plague outbreak situation in Madagascar A large outbreak since 1 Aug 2017 As
More informationLearning objectives. Case: tick-borne disease. Case: tick-borne disease. Ticks. Tick life cycle 9/25/2017
Learning objectives Medically Significant Arthropods: Identification of Hard-Bodied Ticks ASCLS Region V October 6, 2017 1. Describe the tick life cycle and its significance 2. Compare anatomical features
More informationBlood protozoan: Plasmodium
Blood protozoan: Plasmodium The causative agent of including Plasmodium vivax P. falciparum P. malariae P. ovale. malaria in humans:four species are associated The Plasmodium spp. life cycle can be divided
More informationTop End Souvenirs: Infectious Diseases. Dr Anna Ralph
Top End Souvenirs: Infectious Diseases Dr Anna Ralph Infectious Diseases Staff Specialist, Royal Darwin Hospital Clinical Researcher, Menzies School of Health Research Souvenir 1 Triage note says: 32 year
More informationAustralian and New Zealand College of Veterinary Scientists. Membership Examination. Medicine of Horses Paper 1
Australian and New Zealand College of Veterinary Scientists Membership Examination June 2015 Medicine of Horses Paper 1 Perusal time: Fifteen (15) minutes Time allowed: Two (2) hours after perusal Answer
More informationOutlines. Introduction Prevalence Resistance Clinical presentation Diagnosis Management Prevention Case presentation Achievements
Amal Meas Al-Anizi, PharmD Candidate KSU, Infectious Disease Rotation 2014 Outlines Introduction Prevalence Resistance Clinical presentation Diagnosis Management Prevention Case presentation Achievements
More informationUNDERSTANDING THE TRANSMISSION OF TICK-BORNE PATHOGENS WITH PUBLIC HEALTH IMPLICATIONS
UNDERSTANDING THE TRANSMISSION OF TICK-BORNE PATHOGENS WITH PUBLIC HEALTH IMPLICATIONS A. Rick Alleman, DVM, PhD, DABVP, DACVP Lighthouse Veterinary Consultants, LLC Gainesville, FL Tick-transmitted pathogens
More informationA concise overview on tick-borne human infections in Europe: a focus on Lyme borreliosis and tick-borne Rickettsia spp.
A concise overview on tick-borne human infections in Europe: a focus on Lyme borreliosis and tick-borne Rickettsia spp. Rita Abou Abdallah A, Didier Raoult B and Pierre-Edouard Fournier A,C A UMR VITROME,
More informationColorado s Tickled Pink Campaign
Colorado s Tickled Pink Campaign Leah Colton, PhD Medical Entomology & Zoonoses Epidemiologist Instituting a Statewide Passive Surveillance Program for Ticks Colorado s medically important ticks Tick-borne
More informationRickettsioses and the International Traveler
INVITED ARTICLE TRAVEL MEDICINE Charles D. Ericsson, Section Editor Rickettsioses and the International Traveler Mogens Jensenius, 1 Pierre-Edouard Fournier, 2 and Didier Raoult 2 1 Department of Internal
More informationTick-borne Disease Testing in Shelters What Does that Blue Dot Really Mean?
Tick-borne Disease Testing in Shelters What Does that Blue Dot Really Mean? 2017 ASPCA. All Rights Reserved. Your Presenter Stephanie Janeczko, DVM, MS, DABVP, CAWA Senior Director of Shelter Medical Programs
More informationEXHIBIT E. Minimizing tick bite exposure: tick biology, management and personal protection
EXHIBIT E Minimizing tick bite exposure: tick biology, management and personal protection Arkansas Ticks Hard Ticks (Ixodidae) Lone star tick - Amblyomma americanum Gulf Coast tick - Amblyomma maculatum
More informationBorreliae. Today s topics. Overview of Important Tick-Borne Diseases in California. Surveillance for Lyme and Other Tickborne
Surveillance for Lyme and Other Tickborne Diseases in California with emphasis on Laboratory role Anne Kjemtrup, D.V.M., M.P.V.M., Ph.D. Vector-Borne Disease Section California Department of Public Health
More informationEmerging Tick-borne Diseases in California
Emerging Tick-borne Diseases in California Moral of my story today is Good taxonomy is good public health practice Kerry Padgett, Ph.D. and Anne Kjemtrup, DVM, MPVM, Ph.D. Vector-Borne Disease Section,
More informationAbout Ticks and Lyme Disease
About Ticks and Lyme Disease Ticks are small crawling bugs in the spider family. They are arachnids, not insects. There are hundreds of different kinds of ticks in the world. Many of them carry bacteria,
More informationGuidelines for the Initiation of Empirical Antibiotic therapy in Respiratory Disease (Adults)
Guidelines for the Initiation of Empirical Antibiotic therapy in Respiratory Disease (Adults) Community Acquired Pneumonia Community Acquired Pneumonia 1) Is it pneumonia? ie new symptoms and signs of
More informationPage 1 of 5 Medical Summary OTHER TICK-BORNE DISEASES This article covers babesiosis, anaplasmosis, and ehrlichiosis. See Rickettsial Infections (tick-borne rickettsia), Lyme Disease, and Tick-Borne Encephalitis
More information4/24/2013. Chapter 23 Microbial Diseases of the Cardiovascular and Lymphatic Systems Cardiovascular & Lymphatic Systems
1 2 Chapter 23 Microbial Diseases of the Cardiovascular and Lymphatic Systems Cardiovascular & Lymphatic Systems 3 4 5 Cardiovascular & Lymphatic Systems Plasma leaves blood to become interstitial fluid
More informationLyme Disease (Borrelia burgdorferi)
Lyme Disease (Borrelia burgdorferi) Rancho Murieta Association Board Meeting August 19, 2014 Kent Fowler, D.V.M. Chief, Animal Health Branch California Department of Food and Agriculture Panel Members
More informationZoonoses in West Texas. Ken Waldrup, DVM, PhD Texas Department of State Health Services
Zoonoses in West Texas Ken Waldrup, DVM, PhD Texas Department of State Health Services Notifiable Zoonotic Diseases Arboviruses* Anthrax Brucellosis Bovine Tuberculosis Creutzfeldt-Jacob disease (variant)
More informationTick-Borne Disease. Connecting animals,people and their environment, through education. What is a zoonotic disease?
Tick-Borne Disease Connecting animals,people and their environment, through education What is a zoonotic disease? an animal disease that can be transmitted to humans (syn: zoonosis) dictionary.reference.com/browse/zoonotic+disea
More informationIntroduction. Ticks and Tick-Borne Diseases. Emerging diseases. Tick Biology and Tick-borne Diseases: Overview and Trends
Introduction Tick Biology and Tick-borne Diseases: Overview and Trends William L. Nicholson, PhD Pathogen Biology and Disease Ecology Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention
More informationAdvance Publication by J-STAGE
Advance Publication by J-STAGE Japanese Journal of Infectious Diseases A case of human infection by Rickettsia slovaca in Greece Vasiliki Kostopoulou, Dimosthenis Chochlakis, Chrysoula Kanta, Andromachi
More informationBox 4. Mediterranean Spotted Fever (* controversial result due to the possibility of cross-reaction with other Rickettsia species).
Mediterranean spotted fever Mediterranean spotted fever (MSF) (or Boutonneuse fever, or Marseilles fever) is a Mediterranean endemic tick-borne disease belonging to the rickettsiosis group (Box 4), the
More informationEcology of RMSF on Arizona Tribal Lands
Ecology of RMSF on Arizona Tribal Lands Tribal Vector Borne Disease Meeting M. L. Levin Ph.D. Medical Entomology Laboratory Centers for Disease Control mlevin@cdc.gov Rocky Mountain Spotted Fever Disease
More informationInsect vectors. Dr. Carmen E. Rexach Micro 1 Mt SAC Biology Department Internet version
Insect vectors Dr. Carmen E. Rexach Micro 1 Mt SAC Biology Department Internet version Biological vs mechanical transmission Mechanical Pathogen is picked up from a source and deposited on another location
More informationSuggested vector-borne disease screening guidelines
Suggested vector-borne disease screening guidelines SNAP Dx Test Screen your dog every year with the SNAP Dx Test to detect exposure to pathogens that cause heartworm disease, ehrlichiosis, Lyme disease
More informationLyme Disease. Lyme disease is a bacterial infection spread by tick bites from infected blacklegged
Lyme Disease Lyme disease is a bacterial infection spread by tick bites from infected blacklegged ticks. The bacteria that causes the disease is Borrelia burgdorferi, a spirochete. The earliest symptoms
More informationCentral Nervous System Infections
Central Nervous System Infections Meningitis Treatment Bacterial meningitis is a MEDICAL EMERGENCY. ANTIBIOTICS SHOULD BE STARTED AS SOON AS THE POSSIBILITY OF BACTERIAL MENINGITIS BECOMES EVIDENT, IDEALLY
More informationVector-Borne Disease Status and Trends
Vector-Borne Disease Status and Trends Vector-borne Diseases in NY 2 Tick-borne Diseases: Lyme disease Babesiosis Ehrlichiosis/Anaplasmosis Rocky Mountain Spotted Fever Powassan Encephalitis STARI Bourbon
More informationSara Coleman Kansas Department of Health & Environment Bureau of Epidemiology and Public Health Informatics MPH Field Experience
The Identification of the Range of Ixodidae Ticks in Kansas and the Epidemiological Evaluation of Lyme Disease and Spotted Fever Rickettsiosis in Kansas from 2008 to 2012 Sara Coleman Kansas Department
More informationRhipicephalus sanguineus: Vector of a New Spotted Fever
INFECTION AND IMMUNITY, July 1975, p. 205-210 Copyright 0 1975 American Society for Microbiology Vol. 12, No. 1 Printed in U.S.A. Rhipicephalus sanguineus: Vector of a New Spotted Fever Group Rickettsia
More informationDetection and Identification of Rickettsia helvetica and Rickettsia sp. IRS3/IRS4 in Ixodes ricinus Ticks found on humans in Spain.
1 Title Detection and Identification of Rickettsia helvetica and Rickettsia sp. IRS3/IRS4 in Ixodes ricinus Ticks found on humans in Spain. Authors P. Fernández-Soto, R. Pérez-Sánchez, A. Encinas-Grandes,
More informationGuidelines for the Initiation of Empirical Antibiotic therapy in Respiratory Disease (Adults)
Guidelines for the Initiation of Empirical Antibiotic therapy in Respiratory Disease (Adults) Community Acquired Community Acquired 1) Is it pneumonia? ie new symptoms and signs of a lower respiratory
More informationBiology and Control of Insects and Rodents Workshop Vector Borne Diseases of Public Health Importance
Vector-Borne Diseases of Public Health Importance Rudy Bueno, Jr., Ph.D. Director Components in the Disease Transmission Cycle Pathogen Agent that is responsible for disease Vector An arthropod that transmits
More informationOn People. On Pets In the Yard
*This information is provided by the Center for Disease Control as part of the public domain. Avoiding Ticks Reducing exposure to ticks is the best defense against Lyme disease, Rocky Mountain spotted
More informationTicks and tick-borne pathogens Jordi Tarrés-Call, Scientific Officer of the AHAW unit
Ticks and tick-borne pathogens Jordi Tarrés-Call, Scientific Officer of the AHAW unit Antwerp, June 2 nd 2010 1 The role of EFSA! To assess and communicate all risks associated with the food chain! We
More informationUpdate on diagnosis of feline infectious peritonitis (FIP)
Update on diagnosis of feline infectious peritonitis (FIP) Séverine Tasker RCVS Specialist in Feline Medicine The Feline Centre Langford Veterinary Services University of Bristol http://www.felinecentre.co.uk/
More informationWhat are Ticks? 4/22/15. Typical Hard Tick Life Cycle. Ticks of the Southeast The Big Five and Their Management
Ticks of the Southeast The Big Five and Their Management LT Jeff Hertz, MSC, USN PhD Student, Entomology and Nematology Dept., University of Florida What are Ticks? Ticks are MITES.really, really ig mites.
More informationAUSTRALIAN AND NEW ZEALAND COLLEGE OF VETERINARY SCIENTISTS. Sample Exam Questions. Veterinary Practice (Small Animal)
AUSTRALIAN AND NEW ZEALAND COLLEGE OF VETERINARY SCIENTISTS Sample Exam Questions Veterinary Practice (Small Animal) Written Examination (Component 1) Written Paper 1 (two hours): Principles of Veterinary
More informationCLINICAL PROTOCOL FOR COMMUNITY ACQUIRED PNEUMONIA. SCOPE: Western Australia. CORB score equal or above 1. All criteria must be met:
CLINICAL PROTOCOL F COMMUNITY ACQUIRED PNEUMONIA SCOPE: Western Australia All criteria must be met: Inclusion Criteria Exclusion Criteria CB score equal or above 1. Mild/moderate pneumonia confirmed by
More informationPETCARE IMMUNIZATION SUPPORT GUARANTEE
PETCARE IMMUNIZATION SUPPORT GUARANTEE 1 Zoetis will cover reasonable diagnostic and treatment costs up to $5,000 if a pet vaccinated with one of the Zoetis antigens listed below contracts the corresponding
More informationAustralian and New Zealand College of Veterinary Scientists. Membership Examination. Medicine of Cats Paper 1
Australian and New Zealand College of Veterinary Scientists Membership Examination June 2016 Medicine of Cats Paper 1 Perusal time: Fifteen (15) minutes Time allowed: Two (2) hours after perusal Answer
More informationDiscuss the reservoirs and vectors of the causative organisms of Lyme disease and other tick-borne
Brian S. Murphy, MD, MPH November 5, 2008 40th Annual Family Medicine Review Discuss the reservoirs and vectors of the causative organisms of Lyme disease and other tick-borne diseases Discuss the distribution
More informationRickettsial Pathogens and their Arthropod Vectors
Rickettsial Pathogens and their Arthropod Vectors Abdu F. Azad* and Charles B. Beard *University of Maryland School of Medicine, Baltimore, Maryland, USA; and Centers for Disease Control and Prevention,
More informationEnvironmental associations of ticks and disease. Lucy Gilbert
Environmental associations of ticks and disease Lucy Gilbert Ticks in Europe 1. Ixodes arboricola 2. Ixodes caledonicus 3. Ixodes frontalis 4. Ixodes lividus 5. Ixodes rothschildi 6. Ixodes unicavatus
More informationTick-borne Diseases 2018 Update. Thomas A. Moore, MD, FACP, FIDSA Clinical Professor of Medicine U of Kansas School of Medicine-Wichita Campus
Tick-borne Diseases 2018 Update Thomas A. Moore, MD, FACP, FIDSA Clinical Professor of Medicine U of Kansas School of Medicine-Wichita Campus Tick overview Common themes Tick-borne Diseases Cases (well-recognized
More informationSymptoms of cellulitis (n=396) %
Cellulitis and lymphoedema Vaughan Keeley May 2012 What is cellulitis? - also called erysipelas, acute inflammatory episodes etc. - bacterial infection of skin + subcutaneous tissues - more common in people
More informationTick-Borne Rickettsioses around the World: Emerging Diseases Challenging Old Concepts
CLINICAL MICROBIOLOGY REVIEWS, Oct. 2005, p. 719 756 Vol. 18, No. 4 0893-8512/05/$08.00 0 doi:10.1128/cmr.18.4.719 756.2005 Copyright 2005, American Society for Microbiology. All Rights Reserved. Tick-Borne
More informationTicks and tick-borne diseases
Occupational Diseases Ticks and tick-borne diseases Ticks Ticks are small, blood sucking arthropods related to spiders, mites and scorpions. Ticks are only about one to two millimetres long before they
More informationTicks 101. Tick-Borne Illness 10/18/2018. Tick-Borne Illnesses in North America
Tick-Borne Illness Paul Carson, MD, FACP Tick-Borne Illnesses in North America Lyme Disease Anaplasmosis Ehrlichiosis Babesiosis Rocky Mountain Spotted Fever Tularemia Powassan Virus Relapsing Fever STARI
More informationPrevalence of pathogens in ticks feeding on humans. Tinne Lernout
Prevalence of pathogens in ticks feeding on humans Tinne Lernout Contexte Available data for Belgium: localized geographically questing ticks or feeding ticks on animals collection at one moment in time
More informationTicks and Tick-borne Diseases: More than just Lyme
Ticks and Tick-borne Diseases: More than just Lyme http://www.scalibor-usa.com/tick-identifier/ Katherine Sayler and A. Rick Alleman Important Emerging Pathogens Increase in disease prevalence in pets
More information29 JANUARY 2014 CHAPTER 129 CHAPTER 132 RABIES TICK-BORNE ILLNESSES
29 JANUARY 2014 CHAPTER 129 CHAPTER 132 RABIES TICK-BORNE ILLNESSES 1. Which of the following is true? A. Worldwide, dogs are the most commonly rabiesinfected animals. B. Despite similarities to dogs,
More informationTICK-BORNE DISEASES IN NORTH CAROLINA: SEROEPIDEMIOLOGY OF SPOTTED FEVER GROUP RICKETTSIAE AND PREVENTION OF TICK BITES AMONG OUTDOOR WORKERS
TICK-BORNE DISEASES IN NORTH CAROLINA: SEROEPIDEMIOLOGY OF SPOTTED FEVER GROUP RICKETTSIAE AND PREVENTION OF TICK BITES AMONG OUTDOOR WORKERS Meagan F. Vaughn A dissertation submitted to the faculty of
More informationClinical manifestations of brucellosis and leptospirosis
Clinical manifestations of brucellosis and leptospirosis Department of Internal Medicine Division of Infectious Diseases Medical University of Vienna Fever after sexual intercourse admissional status 25-year
More informationPLASMODIUM MODULE 39.1 INTRODUCTION OBJECTIVES 39.2 MALARIAL PARASITE. Notes
Plasmodium MODULE 39 PLASMODIUM 39.1 INTRODUCTION Malaria is characterized by intermittent fever associated with chills and rigors in the patient. There may be enlargement of the liver and spleen in the
More informationGeneral Practice Service Willows Information Sheets. Ectoparasites (fleas and other skin parasites) in cats
General Practice Service Willows Information Sheets Ectoparasites (fleas and other skin parasites) in cats Flea Tick Mite Louse Ectoparasites (fleas and other skin parasites) in cats What types of skin
More informationMidsouth Entomologist 2: ISSN:
Midsouth Entomologist 2: 47 52 ISSN: 1936-6019 www.midsouthentomologist.org.msstate.edu Report The Discovery and Pursuit of American Boutonneuse Fever: A New Spotted Fever Group Rickettsiosis J. Goddard
More informationMurine Typhus & Dipylidiasis
Murine Typhus & Dipylidiasis Sara Rechsteiner May 28, 2009 Outline I. Murine Typhus 1. What is Murine Typhus? general informafon including symptoms, history, and distribufon 2. The parasite 3. Vectors
More informationBRUCELLOSIS. Morning report 7/11/05 Andy Bomback
BRUCELLOSIS Morning report 7/11/05 Andy Bomback Also called undulant, Mediterranean, or Mata fever, brucellosis is an acute and chronic infection of the reticuloendothelial system gram negative facultative
More informationEvaluating the Role of MRSA Nasal Swabs
Evaluating the Role of MRSA Nasal Swabs Josh Arnold, PharmD PGY1 Pharmacy Resident Pharmacy Grand Rounds February 28, 2017 2016 MFMER slide-1 Objectives Identify the pathophysiology of MRSA nasal colonization
More informationDuke University Hospital Guideline for Empiric Inpatient Treatment of Cancer- Related Neutropenic Fever in Adult Patients
Duke University Hospital Guideline for Empiric Inpatient Treatment of Cancer- Related Neutropenic Fever in Adult Patients PURPOSE Fever among neutropenic patients is common and a significant cause of morbidity
More informationsoft ticks hard ticks
Ticks Family Argasidae soft ticks Only 4 genera of Argasidae Argas, Ornithodoros, Otobius (not covered) and Carios (not covered) Family Ixodidae hard ticks Only 4 genera of Ixodidae covered because of
More informationOrdering Arbovirus Serology and Other Zoonotic Tests Complementary Notes
Supplementary information is provided in the table that follows to assist with the ordering of tests on the new ProvLab Zoonotic Requisition. Many of these tests are sent to the National Microbiology Laboratory,
More informationCanine Anaplasmosis Anaplasma phagocytophilum Anaplasma platys
Canine Anaplasmosis Anaplasma phagocytophilum Anaplasma platys It takes just hours for an infected tick to transmit Anaplasma organisms to a dog. What is canine anaplasmosis? Canine anaplasmosis is a disease
More informationGUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS
Version 3.1 GUIDELINES FOR THE MANAGEMENT OF COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS Date ratified June 2008 Updated March 2009 Review date June 2010 Ratified by Authors Consultation Evidence base Changes
More informationDependable excellence in vector-borne diagnostics. Product Catalog
Dependable excellence in vector-borne diagnostics Product Catalog Fuller Laboratories opened in the city of Fullerton, in southern California, in 1990. Our focus has always been on providing superior technology
More informationBACTERIOLOGY. Microscopic agglutination test (MAT) for one sample 5 (for a maximum of 5 antigens)
BACTERIOLOGY 1 Bacterial isolation and identification 33.00 2 Special culture and identification : Anaerobes 55.00 Leptospira 138.00 Brucella 83.00 3 Fungal culture and identification 11.00 4 Antibiotic
More informationHow does tick ecology determine risk?
How does tick ecology determine risk? Sarah Randolph Department of Zoology, University of Oxford, UK LDA, Leicester, July.00 Tick species found in the UK Small rodents Water voles Birds (hole nesting)
More informationTick-Borne Disease Diagnosis: Moving from 3Dx to 4Dx AND it s MUCH more than Blue Dots! indications implications
Tick-Borne Disease Diagnosis: Moving from 3Dx to 4Dx Richard B. Ford, DVM, MS Professor of Medicine Diplomate ACVIM and (Hon) ACVPM North Carolina State University Raleigh, NC In just the past 3 to 5 years,
More informationEarly warning for Lyme disease: Lessons learned from Canada
Early warning for Lyme disease: Lessons learned from Canada Nick Hume Ogden, National Microbiology Laboratory @ Saint-Hyacinthe Talk outline The biology of Lyme disease emergence in the context of climate
More informationInfection Comments First Line Agents Penicillin Allergy History of multiresistant. line treatment: persist for >7 days they may be
Gastrointestinal Infections Infection Comments First Line Agents Penicillin Allergy History of multiresistant Campylobacter Antibiotics not recommended. Erythromycin 250mg PO 6 Alternative to first N/A
More informationDiagnosis and management of zoonoses a tool for general practice
clinical Praveena Gunaratnam Peter Massey Keith Eastwood David Durrhein Stephen Graves Diana Coote Louise Fisher Diagnosis and management of zoonoses a tool for general practice Background Zoonotic infections
More informationTicks, Tick-borne Diseases, and Their Control 1. Ticks, Tick-Borne Diseases and Their Control. Overview. Ticks and Tick Identification
Ticks, Tick-Borne Diseases and Their Control Jeff N. Borchert, MS ORISE Research Fellow Bacterial Diseases Branch Division of Vector-Borne Infectious Diseases Centers for Disease Control and Prevention
More informationCOMMITTEE FOR VETERINARY MEDICINAL PRODUCTS
The European Agency for the Evaluation of Medicinal Products Veterinary Medicines and Information Technology EMEA/CVMP/005/00-FINAL-Rev.1 COMMITTEE FOR VETERINARY MEDICINAL PRODUCTS GUIDELINE FOR THE TESTING
More informationTick-Borne Infections Council
Tick-Borne Infections Council of North Carolina, Inc. 919-215-5418 The Tick-Borne Infections Council of North Carolina, Inc. (TIC-NC), a 501(c)(3) non-profit organization, was formed in 2005 to help educate
More informationAntimicrobial Stewardship in the Long Term Care and Outpatient Settings. Carlos Reyes Sacin, MD, AAHIVS
Antimicrobial Stewardship in the Long Term Care and Outpatient Settings Carlos Reyes Sacin, MD, AAHIVS Disclosure Speaker and consultant in HIV medicine for Gilead and Jansen Pharmaceuticals Objectives
More informationDETECTION AND CHARACTERIZATION OF RICKETTSIAE IN WESTERN AUSTRALIA. Helen Clare OWEN, BVMS
DETECTION AND CHARACTERIZATION OF RICKETTSIAE IN WESTERN AUSTRALIA Helen Clare OWEN, BVMS This thesis is presented for the degree of Doctor of Philosophy of Murdoch University, 2007. I declare that this
More informationMinnesota Tick-Borne Diseases
Dr. Neitzel indicated no potential conflict of interest to this presentation. He does not intend to discuss any unapproved/investigative use of a commercial product/device. Minnesota Tick-Borne Diseases
More informationMalaria & Dengue Global Health Lecture Series
Malaria & Dengue Global Health Lecture Series Julie Gutman, MD MSc Pediatric Infectious Disease 5/13/2011 What would be the most appropriate treatment for a patient presenting with malaria acquired in
More informationTyphoid fever - priorities for research and development of new treatments
Typhoid fever - priorities for research and development of new treatments Isabela Ribeiro, Manica Balasegaram, Christopher Parry October 2017 Enteric infections Enteric infections vary in symptoms and
More informationApproach to pediatric Antibiotics
Approach to pediatric Antibiotics Gassem Gohal FAAP FRCPC Assistant professor of Pediatrics objectives To be familiar with common pediatric antibiotics o Classification o Action o Adverse effect To discus
More information