ZOONOSIS

Dr.rer.biol.hum. dr. Erma Sulistyaningsih, M.Si.

PS Pasca Sarjana Ilmu Kesehatan Masyarakat
2016

Topics
1.
2.
3.
4.
5.
6.

Definition
Type of zoonosis
Animals that transmitted zoonosis
Zoonosis in Indonesia
Prevention and Control of Zoonosis
Global Scale to control zoonotic diseases

1. DEFINITION

Zoonosis
WHO, 1959: Diseases and infections which are naturally

transmitted between vertebrate animals and humans.

Common (of 1,407 human pathogens)
58% are zoonotic
70% of emerging diseases are zoonotic: deforestation,
animals and food supplies, are constantly crossing
borders..SARS, Ebola, H1N1, Antraks.
Occur in numerous animal species
Very diverse
Severity
Avian influenza virus
Transmission dynamics
Difficult to predict changes in incidence
Antraks

Nature Study
EID events: 1940 - 2004

Nature Study
Regression analysis

adjusted for:

Human population

density and growth

Rainfall

Latitude

Wildlife host species
richness

Global Distribution of Relative Risk of an EID

Event

(a) zoonotic pathogens from wildlife, (b) zoonotic pathogens from nonwildlife, (c) drug-resistant pathogens, (d) vector borne pathogens

Human-Livestock-Wildlife Interface
Global Commerce in Livestock Products
Increased Demand for Animal Protein
Loss of Wildlife Habitat
Ecosystem Degradation
Cleared Land for Agricultural Use
Increased Opportunity for Human-Animal

Interaction

Human-Livestock-Wildlife Interface

Bush Meat Trade

N. Wolfe

Human-Livestock-Wildlife Interface

Logging, Agricultural Encroachment, and Wildlife Habitat Loss

NGS

Human-Livestock-Wildlife Interface

Wet Markets

2. TYPE OF ZOONOSIS

Berdasarkan transmisinya
Direct zoonosis: Zoonosis langsung
Zoonosis berlangsung dalam 1 jenis vertebrata dan agen infeksi
hanya sedikit berubah/tidak berubah. Contoh: rabies, brusellosis,
leptospirosis
Siklo-zoonosis
Siklus penularan memerlukan lebih dari 1 vertebrata, tanpa
melibatkan invertebrata untuk melengkapi siklus hidunya. Contoh:
taeniasis
Meta-zoonosis
Siklus penularan memerlukan vertebrata dan invertebrata. Contoh:
arthropode-borne diseases
Sapro-zoonosis
Siklus penularan tergantung pada benda (bunda hewan) seperti zat
organik. Contoh: histoplasmosis

Menurut reservoir utamanya

Antropozoonosis
Penyakit yang dapat bebas berkembang diantara hewan liar
maupun domestik. Manusia kadang terinfeksi, dan merupakan titik
akhir infeksi, tidak dapat menularkan ke manusia atau hewan lain
secara natural. Misalnya: rabies, leptosiprosis
Amphixenosis
Manusia dan hewan menjadi reservoir yang cocok untuk agen
infeksi. Contoh: Streptococosis
Zooanthroponosis
Penyakit berlangsung secara bebas pada manusia, hanya kadangkadang menyerang hewan, yang menjadi titik akhir infeksi.
Misalnya: tuberculosis humanus

Berdasarkan asal hewan penularnya

Wild life zoonosis
Berasal dari satwa liar
Domicilated animal zoonosis
Berasal dari hewan yang tinggal di sekitar pemukimam manusia.
Misalnya leptospirosis
Domesticated animals
Berasal dari hewan piaraan seperti anjing, kucing, sapi.

Menurut agen penyebabnya

Bacterial zoonosis:
Anthrax
Plague
Leptospirosis
Viral zoonosis
Rabies
Avian influenza
Crimean-Congo Hemorrhagic fever
Ebola
Rift Valley fever
Parasitic zoonosis
Taeniasis
Toxoplasmosis
Fungi zoonosis
Dermatophytoses
Sporotrichosis

3. ANIMALS THAT
TRANSMITTED
ZOONOSIS

Animal and the Zoonotic Disease

Dogs & Cats
Rabies
Roundworm
Ringworm
Cat Scratch Disease
Food Animals
Salmonella
E.coli
Brucellosis

Animal and the Zoonotic Disease

Birds:
Psittacosis
West Nile virus
Eastern Equine Encephalitis
Avian Influenza

Reptiles, Fish, & Amphibians

Salmonella
Mycobacterium

Wild Animals
Hantavirus
Plague
Tularemia
Lyme Disease

What kind of animals transmit zoonoses?

Farm Animals

Wild Animals

Cattle

Ticks

Swine

Squirrels

Goats

Raccoons

Cats & dogs

Mice/rodents

Poultry

others

Farmers more susceptible to contracting

zoonoses
1.

More likely to share air and space with animals

2.

More contact with domestic and wild animals

How are the zoonosis can be transmitted

by animal?
Diseases that move through animal bites or scratches, such as

bacteria like Bartonella that cause cat scratch fever

viruses that cause rabies
diseases like ringworm that are caused by fungi
Vector-transmitted (e.g., fleas, ticks, flies, mosquitoes)

diseases for which cats and dogs may act as reservoirs for the
pathogen
Diseases transmitted from animal feces when parasite eggs

are inadvertently eaten by humans, such as

Roundworms, toxoplasmosis, salmonella
Diseases transmitted from animal urine, like leptospirosis

How are disease transmitted?

Every day contact with animals
Transporting carcasses
By-products (feces/urine)
Scratches or bites
From milk and milking
Contaminated soils
Contaminated meats

4. ZOONOSIS IN INDONESIA

Zoonosis in Indonesia
Rabies
2. Antraks
3. Avian influenza
4. Salmonellosis
5. Brusellosis
6. Schistosomiasis
7. Sistiserkosis dan Taeniasis
8. Leptospirosis
9. Tuberkulosis
10. Toksoplasmosis
11. Japanese Encephalitis
1.

Zoonosis yang
berkaitan dengan
keamanan pangan
(food borne disease):
1. Camphylobacteriosis
2. Salmonellosis
3. Shigella
4. Yersinia
5. VTEC
(Verocytotoxigenic E
coli)
6. Listeriosis

1. Rabies
142 cases rabies/year
In 24 provinces in Indonesia

Common Carriers
Cats
Dogs
Raccoons
Bats
Foxes

Transmission
Animal Bite
Contact with infected tissue,

fluids or feces

Rabies
Direct contact
Bite of infected animal or through broken skin
Symptoms
Fever, headache
Itching at bite site
Confusion, seizure, abnormal behavior
Difficulty swallowing, Excessive salivation
Death within 2-10 of days
Vaccination BEFORE signs develop is

highly effective

2. Antraks
Agent: Bacillus anthracis
Three forms of the disease
Skin (direct, vector)
Intestinal (oral)
Inhalation (aerosol)
Most skin lesions go

away on their own

People at risk:
Handle infected hides,

wool, and furs

3. Avian influenza
Agent: Avian influenza virus
Genus Influenzavirus A
Family Orthomyxoviridae

Reservoir: Waterfowl and shorebirds

Asia: H5N1 avian influenza virus
re-emerged in 2003-2004
Poultry

About 470 human cases

60% case fatality rate
Concern remains that a severe human pandemic

could occur

Avian Influenza
Morbidity and Mortality in humans
Asian lineage H5N1
High case fatality rate (60%)
Prevalence unknown

H7, H9 viruses
Human disease reported
Resembles human influenza
Antibodies to other H subtypes

who work with birds

found in people

Species Affected
Wild birds
Waterfowl
Shorebirds
Cage birds
Poultry
Mammals
Pigs, horses, mink, cats, dogs, ferrets, stone martens,
palm civets, and others

H5N1 Infections in Humans

Symptoms usually appear in 2-5 days.
Cause severe disease
High fever
Upper respiratory symptoms
Mucosal bleeding
Gastrointestinal symptoms
Patients may deteriorate rapidly
Late symptoms
Organ failure, DIC

Transmission
Poultry:
In an infected flock, virus can spread in multiple ways
Fecal-oral, Aerosol, Fomites, Mechanical vectors

Mammals:
Close contact with dead or sick birds
Indirect exposure
Contact with feces
Swimming in contaminated water

Ingestion
Other routes (experimental): Respiratory, oral, intraocular,

Transplacental
Human:
Rare cases of person-to-person transmission
NO cases of sustained transmission
Fecal shedding and transplacental transmission may occur

Prevention in Humans
People working with infected poultry
Follow good hygiene practices
Wear protective clothing (gloves, masks)
Consider antiviral prophylaxis
Be vaccinated against human influenza
Do not have contact with sick birds if experiencing symptoms
of influenza
If Asian lineage H5N1 is present, avoid contact with:
Domesticated poultry
Poultry farms
Live bird markets
Prepare food properly
Practice good hygiene
Cook chicken and eggs thoroughly

4. Salmonellosis
Common carriers
Cattle

Cats
Dogs
Horses
Poultry
Transmission

Direct contact with animal or feces

Contaminated food

Salmonellosis
Ingestion (oral)
Direct contact
Symptoms
12 - 72 hours after infection
Nausea, vomiting, diarrhea
Cramping, abdominal pain
Headache, fever, chills
Severe in children, elderly and those with a weak immune

system

5. Brucellosis
Agent: Brucella abortus
Transmission:
Ingestion (oral)
Inhalation (aerosol)
Direct contact
Symptoms:
Variable (undulant) fever
Headache, weakness, joint
pain, depression, weight loss, fatigue, liver problems

Brucellosis
Human cases:
Incubation period- usually 30 days but can be up to

5 months
Symptoms - non-specific. Fever, chills, headache,
myalgia, arthralgia, anorexia, fatigue,
lymphadenopathy and splenomagaly. The ratio to
subclinical to clinical cases is 1:1 to 12:1.
Occupational exposures are common. Occupational
exposure is seen among packing plant workers,
veterinarians, livestock producers, and laboratory
workers.
Exposures occur through breaks in the skin,
inhalation and conjunctival contact.

6. Schistosomiasis
Epidemiologi: Danau Lindu dan Lembah Napu, Sulawesi

Tengah.
Agen: Schistosoma japonicum
Vector: Oncomelania hupensis lindoensis

Life Cycle

7. Sistiserkosis dan Taeniasis

Agen: Taenia solium
Epidemiologi di Indonesia: Bali, Sumatra utara, Papua.
Gejala: gangguan CNS, kejang

Siklus Cysticercosis dan Taeniasis

8. Leptospirosis
2012: 828 cases of leptosirosis in

Indonesia, 78 die.
Agent: Leptospira
Ingestion (oral)
Inhalation (aerosol)
Direct contact
Symptoms

Flu-like signs: Fever, body

aches, headache
Weakness, vomiting, mental confusion
Jaundice, stiff neck
Liver, kidney or central nervous
system damage

9. Tuberculosis
Agent: Mycobacterium bovis
Ingestion (oral)
Inhalation (aerosol)
Direct contact
Symptoms
May not be sick
Disease of the lungs: Fever,
cough, chest pain
Disease can spread: Kidney,
spine and brain

10. Toxoplasmosis
Common carriers
Cats
Sheep

Transmission
Ingestion of infected

meats
Fecal contaminated
soil

Clinical Presentation
Fever
Swollen nodes
Abortion
Still-birth
Mental retardation

11. Japanese Encephalitis

Epid: Jawa, Bali. Lombok,
Sumatra, Kalimantan,
Sulawesi, NTT, Maluku,
Papua.
Common carriers
Horses
Pig
Rodents

Transmission
Mosquito bites
Tick bites

Clinical presentation
Lethargy
Fever
Headache
Disorientation

Campylobacteriosis
Common Carriers
Cattle
Sheep
Pigs
Dogs
Rodents
Poultry

Transmission
Contaminated food or
animals

Clinical presentation
Stomach ache
Nausea
Headache
Diarrhea

Cat-Scratch Disease
Common carriers
Cats
Dogs

Transmission
Scratches and

puncture wounds
from infected animals

Clinical presentation
Fever
Skin papule
Swollen lymph nodes

Ringworm
Common Carriers
Cattle
Cats

Transmission

Direct contact with

infected animal

Clinical presentation
Skin lesions

5. PREVENTION AND CONTROL OF

ZOONOSIS

a. Assure an uncontaminated water

supply

Properly construct wells

Add chlorination to water
Connect to water supply
Appropriate disposal of wastes

b. Prevent food contamination

1.
2.
3.
4.
5.
6.

Avoid unpasturized milk

Wash hands
Disinfect kitchen surfaces
Wash raw fruits and vegetables
Dont defrost meats on the counter
Use separate utensils for raw/cooked meat

c. Fully cooked food

Cooking guidelines:
Cook eggs until firm
Avoid foods with partially cooked eggs
Cook meats until juices are clear
Poultry internal temp of 180 degrees
Beef internal temp of 160 degrees

Fish should be white and flaky

d. Storing leftovers
Store food in appropriate containers
Set refrigerator temp to 40 and freezer to 0
Refrigerate leftovers immediately
Never leave food out for more than 2 hours

e. Always drink pasteurized milk!

f. Avoid contact with diseased animals

Dispose of carcasses properly
Wear appropriate clothing and gloves
Spray dead animals before moving them
Dispose of animals according to law
Wash hands afterwards

g. Discourage animals from nesting in

your home
Keep a clean house
Seal small openings inside and out
Keep traps out of the reach
Store food in tight containers

h. Protect pets from

getting & transmitting diseases
Vaccinate cats and dogs against rabies
Do not keep wild animals as pets
Do not allow pest to drink from toilet
Clean pets living area 1x/week
Clean litter box daily

i. Additional safety precautions

Treat livestock that salivate as if they have rabies
Wash your hands after handling or cleaning up after

animals
Cover sandboxes when not in use

j. Prevent tick bites

Wear repellent
Wear appropriate clothing
Long-sleeved shirt
Tuck pant legs into socks
Check yourself and pets after being in a tick-infested area

k. Treat animal scratches and bites

seriously
Wash area with soap and water
Apply anti-bacterial medication
Bandage wound
Consider medical attention

What can pet owners do to protect themselves and

their pets from zoonotic diseases?
qVaccinate

pets, especially against rabies

qProvide

protection against external parasites like fleas

and ticks

qTest

and treat to control internal parasites

qPeriodic

physical examinations for pets to increase

likelihood that vaccinations and de-wormings are
appropriately done

qContact

a veterinarian for examination and treatment of a

newly adopted or rescued animals.

What can pet owners do to protect themselves and

their pets from zoonotic diseases? (cont.)
qOther

common-sense precautions for pet owners:

Removing feces from cat boxes daily

Washing hands after handling animals
Not handling animals that you are not familiar with
Avoiding animals if you are immunosuppressed
Not letting dogs drink from the toilet
Trying to avoid being licked by animals
Avoid feeding raw meat
Wearing gloves when gardening, and washing hands thoroughly when
finished gardening
Not sharing food utensils with pets
Clipping cat claws frequently to lessen the risk of scratches
Minimizing the interaction that your dogs or cats have with wildlife
e.g. should not leave pet food outdoors as that can attract wildlife, like
raccoons

6. Global Scale to control zoonotic

diseases

The strategic approach to addressing zoonotic diseases

Scaling up of Surveillance
Acceleration of IHR implementation
Emergency preparedness and response capabilities
Promote cross-sectoral collaboration and partnership
Enhance strategic communication
Advocacy for resource mobilization
Research

Scaling up of Surveillance systems

An Integrated Strategy for
surveillance adopted by all
Member States
Zoonotic diseases part of
the IDSR priority diseases
Event Based Surveillance
System in place

% score

Acceleration of IHR
implementation

Strengthening preparedness and response

capabilities

Epidemic
preparedness &
response plans

Management of
strategic stockpiles

Virtual Rapid
Response Teams
established
Documentation
and evaluation of
outbreaks

Cross-sectoral collaboration and

partnership

Enhanced Strategic Communication

Publication & dissemination of key information products for informed decision making and advocacy

Most Zoonoses are

preventable if
cautionary measures
are taken!!

THANK YOU