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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

  • 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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