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PSITTACOSIS. Causative agent: Chlamydia psittaci Other names: parrot fever, ornithosis, Avian chlamydiosis Primarily a disease of birds. PSITTACOSIS. Background first identified in 1879, thought to be primarily in parrots (parrot fever)

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psittacosis
PSITTACOSIS
  • Causative agent: Chlamydia psittaci
  • Other names: parrot fever, ornithosis, Avian chlamydiosis
  • Primarily a disease of birds
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PSITTACOSIS
  • Background
    • first identified in 1879, thought to be primarily in parrots (parrot fever)
    • in 1929-1930, shipment of amazon parrots from Argentina caused world-wide epidemic
    • caused outbreaks in many non-psittacine birds
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PSITTACOSIS
  • Background
    • because of this pandemic, US (and many other countries) imposed a total ban on importation of birds
    • US finally lifted ban in 1973
    • changes in import regulations in 1993 has greatly reduced the number of imported birds
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PSITTACOSIS
  • Regulations for importation of birds
    • permit required in advance of shipping
    • health certificate from full-time government salaried veterinarian from exporting country
    • quarantine
      • minimum of 30 days
      • USDA approved facility at port of entry
      • psittacine birds receive medicated feed (1% tetracycline)
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PSITTACOSIS
  • Background
    • correctly called avian chlamydiosis
    • “ornithosis” is name given to disease when present in non-psittacine species
      • identified in over 140 avian species
    • “one-eyed roup” - conjunctivitis or pink-eye associated with infection
    • ban on importation of birds
    • US finally lifted ban in 1973
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PSITTACOSIS

Features of organism:

  • an obligate intracellular bacteria
  • non-motile coccoid bacteria entirely dependent on host cell for energy metabolism and biosynthesis
  • originally thought to be viruses, but have a cell wall and contain DNA, RNA and ribosomes, hence classified as bacteria
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PSITTACOSIS

Intracellular inclusion body of Chlamydia

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PSITTACOSIS

Features of organism:

  • distinguished from other bacteria, viruses, and rickettsia by unique reproduction, existing as two stages
    • elementary body - infectious form
    • reticulate body - intracytoplasmic, reproductive form
  • closely related to C. trachomatis, C. pneumoniae
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PSITTACOSIS

Infectious life cycle of Chlamydia

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PSITTACOSIS
  • Epidemiology
    • occurrence: worldwide
    • prevalence:
      • birds
        • occurs with high frequency among birds in crowded conditions (aviaries, zoos, pet shops
        • 20% of all pet birds tested at autopsy in study in Florida (1982)
        • incidence in wild parrots <5%, but may approach 100% after capture
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PSITTACOSIS
  • Epidemiology
    • prevalence:
      • humans
        • sporadic outbreaks
        • infrequent in humans, usually sporadic, many mild infections not reported
        • CDC (1982-1991) - 1,344 cases, 6 deaths (0.4% CFR)
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PSITTACOSIS
  • Epidemiology
    • reservoir: avian species, especially budgerigars and parrots
      • clinically inapparent (healthy) carriers
      • shed organisms during crowding, stress (shipping, quarantine, when newly introduced into aviary)
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PSITTACOSIS
  • Epidemiology
    • source of exposure:
      • most commonly imported birds
      • domestic poultry (turkey, duck) and squab farms
      • geese and pigeons
      • occasionally laboratory material
      • feline psittacosis if conjunctivitis
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PSITTACOSIS
  • Epidemiology
    • transmission:
      • inhalation of agent form desiccated droppings, excretions
      • laboratory exposure has occurred
      • person-person transmission can occur but considered rare
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PSITTACOSIS
  • Clinical features (human infection)
    • Incubation period: 5-14 days
    • Symptoms: asymptomatic to severe
      • flu-like symptoms with acute fever
      • rash
      • upper and lower respiratory signs generally mild although extensive pneumonia present
      • relapse may occur
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PSITTACOSIS
  • Clinical features (avian infection)
    • Incubation period: 7-28 days, but can be up to 96 days
    • Symptoms: asymptomatic to severe
      • asymptomatic infections
        • high number of infertile eggs
        • high mortality in nestlings
      • severe infections with death within 1 week not uncommon
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PSITTACOSIS
  • Clinical features (avian infection)
    • Symptoms:
      • strong affinity for mucous membranes:
        • conjunctivitis, sneezing, diarrhea, pneumonitis
      • anorexia, lethargy, ruffled feathers
      • if untreated, death due to malnutrition or pneumonia
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PSITTACOSIS
  • Clinical features (other animal infection)
    • Symptoms:
      • respiratory disease
        • feline pneumonitis (once common)
      • conjunctivitis “pink eye”
      • enteritis
      • abortion (sheep, cattle, goats)
      • polyarthritis (sheep, cattle, goats)
      • infertility/sterility
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PSITTACOSIS
  • Diagnosis
    • difficult due to ability to “hide” in host cells and because of variable clinical presentation
    • Human infection
      • history of exposure
      • culture of sputum or serum
      • ELISA but may yield false positive if post-infection
      • chest x-ray
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PSITTACOSIS
  • Diagnosis
    • Avian species
      • CF of paired sera commonly used in avian dx, most diagnostic
      • Antigen tests (ELISA, Indirect FA) may be helpful if shedding organism, but negative test with clinical signs cannot rule out infection without further testing
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PSITTACOSIS
  • Treatment
    • readily treated if initiated prior to extensive tissue and organ involvement
      • humans
        • tetracycline - 10-14 days after fever subsides, and after relapse if occurs
        • erythromycin if ttc contraindicated
      • psittacine birds
        • doxycycline for 30-45 days
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PSITTACOSIS
  • Prevention and control
    • difficult to kill, capable of lying dormant in environment for many months
    • disinfectants
      • quaternary ammonia compounds (Roccal-D® or Zepharin®) at 1:1000
      • bleach (Chlorox®) at 1:100
      • Lysol® at 1:100
    • education
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PSITTACOSIS
  • Prevention and control
    • reportable zoonotic disease
    • CDC case definition
      • confirmed
        • clinical specimens are culture positive

or

        • clinical signs with fourfold or greater rise in CF antibody titer in paired sera at least 2 weeks apart
      • probable
        • if signs with single titer of  32
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PSITTACOSIS
  • Prevention and control
    • regulation of importation
    • ban importation of wild psittacine birds
    • Compendium of Psittacosis (Chlamydiosis) Control, 1995 - adopted by the National Association of State Public Health Veterinarians
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