![]() ![]() Treatment with metronidazole is usually curative. Again a complete travel history coupled with the otherwise non-specific symptoms should prompt stool examination, which will confirm the diagnosis. Petersburg, Russia and one should never drink anything but bottled water or vodka in this city. As shown in Figure 2, Giardiasis is endemic in the water supply of St. Giardia takes up residence in the small bowel, which results in bloating, abdominal pain and chronic diarrhea. Giardia is resistant to chlorine, so boiling or filtering the water is the only way to get rid of it. 2, asymptomatically and defecate it into the streams where the unknowing camper ingests it with his or her drink of “clean mountain water”. These animals harbor the protozoan organism, Giardia lamblia, shown in the upper right hand corner of Fig. The problem results from the fact that upstream from where one is drinking, lives a colony of beavers. This infection is also indigenous to the western U.S., where, it is associated with hiking and camping with the common activity being drinking water from beautiful crystal clear flowing streams. The next zoonosis I would like to discuss, is giardiasis ( Figure 2). The appearance of these cases in NYC immediately raised the specter of bioterrorism, but an accurate travel history quickly dispelled those fears. The woman made a rapid and uneventful recovery, but the man went on to develop DIC and lost parts of both upper and lower extremities. The diagnosis was made rapidly and antibiotic treatment instituted within hours. A married couple had traveled to New York for a vacation and within hours of arriving, the woman developed lymphatic swelling in the groin and the man developed pneumonia. Two such cases were seen at my former hospital in New York City. Counterclockwise from top left: Prairie dogs () Yersinia pestis () flea vector (mod.uk) axillary bubo () chest radiograph of plague pneumonia (). Infectious cycle and clinical presentations of plague. The flea bite can result in either a local infection of lymph nodes (bubonic plague-shown in the axilla in Figure 1) or may result in bacteremia causing pneumonia (pneumonic plague), and associated disseminated intravascular coagulopathy (DIC) with attendant gangrene of the extremities. The offending organism is a Gram negative rod, Yersinia pestis, which is transmitted to humans through the bite of a flea that lives on the skin of the prairie dog. ![]() In the middle ages, the animal host for plague was the rat now in the Southwestern United States, it's the prairie dog. The first zoonosis I would like to discuss is one that is endemic to the geographic area near this meeting site: namely plague ( Figure 1). I will give examples of each of these categories. Zoonoses can be categorized by organism causing the disease, by animal reservoir and by the manner in which the disease is contracted insect bite, animal bite, direct contact or ingestion. The second reason relates to the fact that zoonotic infections (those that have an animal reservoir) can probably never be eradicated, while those for which humans are the only hosts, such as smallpox, measles and polio, can theoretically be eliminated from the face of the earth. The first is that most of the diseases that today would be classified as “emerging infectious diseases”-ones of which we are newly becoming aware-are, in fact, zoonoses. There are two primary reasons for being particularly interested in zoonoses. there is little or no human-to-human transmission). There are hundreds of zoonoses some of which can be propagated human-to-human, but I want to concentrate today on those for which humans represent a dead-end host (i.e. Zoonoses are infections transmitted from animal to humans either directly or via an insect vector.
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