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Zoonotic Diseases: More Common than You Think. Jason Stull, VMD, MPVM Public Health Veterinarian, NH DHHS Assistant Clinical Professor, UNH. Zoonoses. From the Greek: Zoon: Animal Noson: Disease

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zoonotic diseases more common than you think

Zoonotic Diseases: More Common than You Think

Jason Stull, VMD, MPVM

Public Health Veterinarian, NH DHHS

Assistant Clinical Professor, UNH

NH Department of Health and Human Services

Division of Public Health Services

zoonoses
Zoonoses

From the Greek:

Zoon: Animal

Noson: Disease

Diseases and infections which are naturally transmitted between vertebrate animals and humans

- WHO 1959

NH Department of Health and Human Services

Division of Public Health Services

zoonoses animal species
Zoonoses: Animal Species
  • Dogs & Cats
    • Rabies
    • Roundworm
    • Ringworm
    • Cat Scratch Disease
  • Food Animals
    • Salmonella
    • E.coli
    • Brucellosis

NH Department of Health and Human Services

Division of Public Health Services

zoonoses animal species4
Zoonoses: Animal Species
  • Birds:
    • Psittacosis
    • West Nile virus
    • Eastern Equine Encephalitis
    • Avian Influenza
  • Reptiles, Fish, & Amphibians
    • Salmonella
    • Mycobacterium
  • Wild Animals
    • Hantavirus
    • Plague
    • Tularemia
    • Lyme Disease

NH Department of Health and Human Services

Division of Public Health Services

zoonoses5
Zoonoses
  • Common (of 1,407 human pathogens)
    • 58% are zoonotic
    • 70% of emerging diseases are zoonotic
  • Occur in numerous animal species
  • Very diverse
    • Severity
    • Transmission dynamics
  • Difficult to predict changes in incidence

NH Department of Health and Human Services

Division of Public Health Services

zoonoses6
Zoonoses
  • Risk factors should be considered in ill patients
    • Animal ownership and contact
    • Activities bringing humans into contact with animals
  • Discuss appropriate pet species for appropriate individuals
  • Animals as sentinels of disease

NH Department of Health and Human Services

Division of Public Health Services

common zoonotic disease question areas
Common Zoonotic Disease Question Areas
  • Rabies
  • Lyme Disease
  • Mosquito-borne Disease
  • Animals in Public Settings
  • Food-borne Disease
  • Avian Influenza

NH Department of Health and Human Services

Division of Public Health Services

common zoonotic disease question areas8
Common Zoonotic Disease Question Areas
  • Rabies
  • Lyme Disease
  • Mosquito-borne Disease
  • Animals in Public Settings
  • Food-borne Disease
  • Avian Influenza

NH Department of Health and Human Services

Division of Public Health Services

common zoonotic disease question areas9
Common Zoonotic Disease Question Areas
  • Rabies
  • Lyme Disease
  • Mosquito-borne Disease
  • Animals in Public Settings
  • Food-borne Disease
  • Avian Influenza

NH Department of Health and Human Services

Division of Public Health Services

common zoonotic disease question areas10
Common Zoonotic Disease Question Areas
  • Rabies
  • Lyme Disease
  • Mosquito-borne Disease
  • Animals in Public Settings
  • Food-borne Disease
  • Avian Influenza

NH Department of Health and Human Services

Division of Public Health Services

common zoonotic disease question areas11
Common Zoonotic Disease Question Areas
  • Rabies
  • Lyme Disease
  • Mosquito-borne Disease
  • Animals in Public Settings
  • Food-borne Disease
  • Avian Influenza

NH Department of Health and Human Services

Division of Public Health Services

common zoonotic disease question areas12
Common Zoonotic Disease Question Areas
  • Rabies
  • Lyme Disease
  • Mosquito-borne Disease
  • Animals in Public Settings
  • Food-borne Disease
  • Avian Influenza

NH Department of Health and Human Services

Division of Public Health Services

common zoonotic disease question areas13
Common Zoonotic Disease Question Areas
  • Rabies
  • Lyme Disease
  • Mosquito-borne Disease
  • Animals in Public Settings
  • Food-borne Disease
  • Avian Influenza

NH Department of Health and Human Services

Division of Public Health Services

psittacosis chlamydophila psittaci

Psittacosis(Chlamydophila psittaci)

NH Department of Health and Human Services

Division of Public Health Services

august 2006
August 2006
  • Family boarded birds at pet store in August 06
  • Birds became ill Aug 23 (~2 weeks after returned from pet store)
    • Lethargy, nasal d/c
  • Husband and wife ill Sept 6
    • Fever, cough, headache

NH Department of Health and Human Services

Division of Public Health Services

september 2006
September 2006
  • MD visit (Sept 8)
    • Dx pneumonia (chest radiographs)
    • Abx started; illness quickly resolved
    • Titers positive for psittacosis (Chlamydophila psittaci)

NH Department of Health and Human Services

Division of Public Health Services

november 2006
November 2006
  • Patient reported by veterinarian!
  • Investigation:
    • Child in household ill since Nov 1 with cough
    • Birds still in house…..

NH Department of Health and Human Services

Division of Public Health Services

nh dhhs and dept ag actions
NH DHHS and Dept Ag Actions
  • Child
    • Acute and convalescent samples to CDC for testing - pending
    • Abx; illness resolved immediately
    • Education to family and possible contacts
    • No additional suspect cases identified
  • Birds
    • Placed in isolation
    • Testing for Chlamydophila psittaci
      • PCR (cloacal and oral swaps): negative
    • Abx

NH Department of Health and Human Services

Division of Public Health Services

psittacosis background
Psittacosis - Background
  • Chlamydophila psittaci
  • Intracellular bacterium
  • Survive outside the host for days to weeks
  • Transmission: inhalation, vertical (birds)
  • Zoonotic
  • Reportable

NH Department of Health and Human Services

Division of Public Health Services

c psittaci animals
C. psittaci - Animals
  • Wide host spectrum among birds and mammals
  • Pet psittacine birds are most often implicated in human infection

Macaw

Parakeet

NH Department of Health and Human Services

Division of Public Health Services

c psittaci birds
C. psittaci - Birds
  • Not an unusual disease among pet birds
  • Shed in feces and nasal & ocular discharges
  • Incubation 3 days to several weeks
  • Latent infections - disease may appear years after exposure

NH Department of Health and Human Services

Division of Public Health Services

c psittaci birds22
C. psittaci - Birds
  • Clinical signs variable
  • Intermittent & asymptomatic shedding possible
  • Shedding can be activated by stress - shipping, crowding, cold, breeding.
  • Birds with confirmed or probable psittacosis should be isolated and treated under the care of a veterinarian
  • Important consideration in any lethargic bird with nonspecific illness - especially in a recently acquired bird

NH Department of Health and Human Services

Division of Public Health Services

c psittaci humans
C. psittaci - Humans
  • Routes of infection
    • Inhalation (feather dust, resp. secretions, dried feces)
    • Mouth-to-beak contact
    • Handling of infected bird’s plumage and tissues
  • Even brief exposures can lead to infection

NH Department of Health and Human Services

Division of Public Health Services

psittacosis humans
Psittacosis: Humans
  • Incubation ~ 5-14 d
  • Inapparent to systemic illness (pneumonia)
  • Acute fever, chills, headache, nonproductive cough, dyspnea
  • Can affect other organ systems

NH Department of Health and Human Services

Division of Public Health Services

psittacosis diagnosis treatment
Psittacosis – Diagnosis & Treatment
  • Diagnosis
    • Antibodies: may cross-react, acute and convalescent samples (at least 2 weeks apart)
    • Culture - rarely performed (difficult/safety concerns)
    • PCR
  • Treatment
    • Tetracyclines
    • Symptoms improve in 48-72 hours, but relapse is common if inadequately treated
    • 15-20% fatality pre antibiotics, today <1% if properly treated

NH Department of Health and Human Services

Division of Public Health Services

psittacosis public health
Psittacosis: Public Health

Reportable disease:

  • USA: 923 cases reported to CDC (1988 to 2002)
  • NH: 2 cases (1998, 2003)
  • True incidence likely much higher

NH Department of Health and Human Services

Division of Public Health Services

psittacosis public health27
Psittacosis: Public Health
  • Occupational hazard to workers in bird industry
    • Pet birds
    • Turkey-processing plants
  • Sporadic cases associated with pet bird ownership

NH Department of Health and Human Services

Division of Public Health Services

psittacosis controlling infection
Psittacosis: Controlling Infection
  • Prevent generation of aerosols and dust during cleanup
  • Practice good bird husbandry

NH Department of Health and Human Services

Division of Public Health Services

resources
Resources

http://www.nasphv.org/Documents/Psittacosis.pdf

NH Department of Health and Human Services

Division of Public Health Services

slide30
NH Department of Health and Human Services

Division of Public Health Services