ZOONOSES

Learning objectives 1.What are zoonoses and how are they transmitted? 2.What major factors need to be considered in order to control and prevent zoonoses? 3.Examples of zoonoses caused by bacteria, viruses and protozoa

What are zoonoses?

-diseases that affect both animals and humans -animals are the reservoirs of the pathogenshumans encounter the zoonotic pathogen when they cross into the animal cycle

Definitions
Zoonoses- transmission of the infectious agent to humans from an ongoing reservoir life cycle in animals, without the permanent establishment of a new life cycle in humans. A zoonosis is an animal disease transmissible to humans, generally by direct contact, aerosols, or bites. Diseases in animals may be enzootic, present endemically in certain populations or epizootic, With incidence reaching epidemic proportions Epizootic diseases occur on periodic, sometimes cyclic basis.

Over 200 zoonoses have been described and they have been known for many centuries. They are caused by all types of agents: bacteria, parasites, fungi, viruses and unconventional agents.

Modes of transmission

2 means transmission of pathogens from animals to humans

1.direct: from animal to human: eg rabies virus is transmitted from a diseased animal to a person through a bite or contact with the animals saliva 2. Indirect: Pathogen transmitted from animal to humans through vector

Elements that Contribute to the Emergence of a New Zoonoses

Microbial/viral (e.g. mutations and evolution) Individual host (e.g. acquired immunity (vaccination) and lack of immune surveillance (AIDS)

Population host (e.g. transportation and urban crowding) Environmental (e.g. ecological and climate influences)

Reasons for emergence of zoonoses

alteration of the environment affecting the size and distribution of certain animal species, vector and transmitters of infectious agents of humans

increasing human population favouring an increase level of contact between human and infected animals
industrialization of foods of animal origin changes in food processing and consumer nutritional habits life style of people Increasing movements of people as well as trade of animals and animals products and decreasing activities for the surveillance and control for major zoonoses

Increases in Zoonotic Pathogens

Global human and livestock populations continue to grow -this brings people and animals in closer contact Advanced transportation makes long distance travel possible in less than the incubation period of most infectious agents Massive ecological and environmental changes brought about by humans

Zoonotic agents may be the choice for many bioterrorist activities

Zoonotic Microbial Pathogens

Pathogen Animal Diseases

Bacteria

Bacillus anthracis Borrelia burgdorferi Camplylobacter Listeria monocytogens

Cattle Mice,deer tick Cattle , poulty

Anthrax Lyme disease

Salmonella spp
Yersinia pestis Leptospira Brucella
VIRUS
Dengue virus

Cattle, poultry
Rodents, fleas rat

Gastroenteritis
Plague Leptospirosis Brucellosis Dengue fever

Monkeys, mosquitoes

Hantavirus Rabies

Rodents Raccoons, skunks bats, foxes

Pneumonia Rabies

Other parasitic zoonoses are trematodosis, echinococcosis/hydatidosis, toxoplasmosis and trichinellosis

Yersinia pestis and Plague

Plague-an infection of rodents and small animals that may be transmitted to humans -caused by bacterium, Yersinia pestis.= G negative, facultative anaerobe, two forms of plague :bubonic plaque and pneumonic plaque clinical features: inflammation and swelling of lymph nodes (buboes), especially in the groin area Fever, chills, headache, general malaise, chest, muscle pain, nausea When the disease is limited primarily to involvement of lymph nodes, it is called bubonic plague Plague that invades the lungs and is transmitted by the airborne route through direct exposure to large respiratory droplets is called pneumonic plague. Cells of Y.pestis either inhaled directly or via the blood or lymphatic circulation. Symptoms usu. Absent until lst day or two of the disease bloody sputum Pneumonic plague-uncommon but it represents an especially serious public health problem. Highly contagious and can spread rapidly via person-to person respiratory route. Septicemic plaque is the rapid spread of Y.pestis throughout body via the bloodstream without the formation of buboes , usu cause death before diagnosi can be made.

Modes of transmission most cases of human plague are bubonic form in which Y. pestis is transmitted from animals to humans through bites of infected fleas fleas feeding on infected animals contract Y pestis which reproduces in the flea intestinal tract when the infected fleas feed on another animal or a person, they regurgitate Y pestis into the bite wound The natural reservoir for Y. pestis is wild rodents Other wild animals: rabbits, coyotes, wolves domestic cats, dogs-can harbour Y.pestis plague that circulates within a wild animal population the natural cycle of plague sylvatic plague

humans accidentally contract Y.pestis from the sylvatic plague cycle when people move into areas where sylvatic cycle is occurring or when infected animals or infected fleas move into areas where humans live. Bubonic plague circulate among urban rodents such as rats . this cycle is known a urban plague The rats acquire Y.pestis from wild rodents and then humans come into contact with infected rat fleas Urban plague is a much greater threat to humans than slyvatic plague. Greater contact with infected rat fleas in crowded cities

REPORT

In 1981- a middle aged woman in California died of bubonic plague Pet cat-killed an infected chipmunk. 5 days later, cat died with difficult breathing and bloody nasal discharge. 3 days later, the woman developed fatal disease Cat exhumed and an autopsyrevealed both the lungs and lymph nodes were infected with Y.pestis

Prevention

reduce risk of people being bitten by fleas infected with Y. pestis rat control program critical: periodic surveillance and testing, proper garbage and refuse disposal public should be alerted of possible risk area. Eg campers, hunters pneumonic plague; strict precautions must be taken to interrupt airborne transmission

Discussion on local example:

Nipah virus outbreak in Malaysia Leptospirosis in Malaysia

Etiologic agent Epidemiology Steps taken by public health authorities in control of disease spread

BACKGROUND
Nipah virus is a newly recognised zoonotic virus.

Nipah virus caused disease in animals and in humans

through contact with infectious animal.

First was discovered in 1999. Named after the location where it was first detected in

Malaysia.
Member of the virus family Paramyxoviridae. This virus infect a wide range of host and produce disease causing

causing significant mortality in human.

ECONOMIC IMPORTANCE OF THE DISEASE

From September 1998 April 1999, there was large outbreak of encephalitis caused by Nipah virus in Malaysia. A total of 265 people were infected, and 105 died. About 99% of cases had occupational exposure to pigs. 1.1 million of pigs were culled. The outbreak in Perak result in the huge planning, logistics and cost. Various agencies were involved in to control the disease outbreak such as DBI (Ipoh City Hall), JKR (Public Works Dept), RELA, Drainage and irrigation Dept, Agriculture Dept and etc. Pig industry; a multi million dollar industry collapsed Disallowed to export pig anymore

AGENT OF THE DISEASE

The virus that cause this disease is the Nipah Virus.

The are believed that certain species of fruit bats are the natural host of the virus (Pteropid fruit bats including Pteropus vampyrus (Malayan flying fox) and Pteropus hypomelanus (Island flying fox). These bats are susceptible to the infection with this virus but they do not get ill Transmission of Nipah virus from flying foxes to pigs is thought to be due to an increasing overlap between bat habitats and piggeries in peninsular Malaysia.

MODE OF TRANSMISSION

Animal to animal - scientist speculate that bats waste/ fruit

contaminated by bat saliva fell into pig pens and were consumed by the pigs.

Animal to human - require close contact with contaminated tissue or

body fluids from infected animals.

Human to human (has not been reported)

Laboratory trials suggest the following variations in presentation of illness in pigs by different routes of transmission.
Clinical Presentation of Nipah Virus by Route of Exposure
Route of exposure Oral inoculation Parenteral inoculation Characteristics Incubation period 14-16 days Mild clinical signs and gross pathology Narrow study of two pigs revealed a more severe disease, closer resembling natural exposure Incubation period about 7-10 days

In-contact pigs Rapid infection Neutralizing antibodies detected at day 14

Adapted from Nor 1999 (see References).

THE RESERVOIRS

Natural reservoir
-Certain sp of fruit bats (referred to as flying fox).

Animal Reservoirs

- Bats: serves as a carrier - Pigs: source of infection among most human cases in Malaysia outbreak of Nipah (through close contact).

Other potential seropositive animals

- Dogs, rat, goats, horses and cats

PREVENTION

Reduce transmission of Nipah virus to pigs by removing the fruit source on a farm. Import / export precaution and biosecurity should be increased. Increased hygiene and updated protocols on pig operations are necessary. National surveillance to detect any additional infected herds. Personal protection equipment (PPE) among people exposed to pigs Studies of the virus should be managed in a high-level of biosecurity laboratory (BSL-4) as respiratory secretions contain the virus.

Control of zoonoses: factors to consider:

multiple targets to consider: humans, animals and vectors multiple targets can provide opportunities for control from a single human target animals: a diversified threat: direct contact or indirect contact ;urine, saliva, feces are infective animal reservoirs vectors: not only they transmit pathogens but also act as reservoirs resistance factors control measures themselves may represent problems: eg use of pesticides and antimicrobial agents may be harmful to humans

The control of neglected zoonotic diseases

At least 61% of all human pathogens are zoonotic, and have represented 75% of all emerging pathogens during the past decade. Except for the newly emerging zoonoses such as SARS and highly pathogenic avian influenza H5N1, the vast majority are not prioritized by health systems at national and international levels and are therefore labeled as neglected.

Many zoonotic diseases impact significantly on human health as well as livestock productivity, thus undermining livelihoods both by causing illness in the household and threatening its livestock and their output.

Prevention

increase surveillance Adequate government inspection and control of meat, herd and milk production control and elimination of animal reservoir Food processing : pasteurization of milk Proper cooking Introduction of vaccine Strict quarantine Notification of diseases Sanitation control of farms