NH Department of Health and Human Services

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Zoonotic Diseases More Common than You Think
Jason Stull, VMD, MPVM Public Health
Veterinarian, NH DHHS Assistant Clinical
Professor, UNH
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Zoonoses

• From the Greek
• Zoon Animal
• Noson Disease
• Diseases and infections which are naturally
  transmitted between vertebrate animals and humans
• - WHO 1959

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Zoonoses Animal Species

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

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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

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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

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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

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Common Zoonotic Disease Question Areas

• Rabies
• Lyme Disease
• Mosquito-borne Disease
• Animals in Public Settings
• Food-borne Disease
• Avian Influenza

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Common Zoonotic Disease Question Areas

• Rabies
• Lyme Disease
• Mosquito-borne Disease
• Animals in Public Settings
• Food-borne Disease
• Avian Influenza

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Common Zoonotic Disease Question Areas

• Rabies
• Lyme Disease
• Mosquito-borne Disease
• Animals in Public Settings
• Food-borne Disease
• Avian Influenza

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Common Zoonotic Disease Question Areas

• Rabies
• Lyme Disease
• Mosquito-borne Disease
• Animals in Public Settings
• Food-borne Disease
• Avian Influenza

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Common Zoonotic Disease Question Areas

• Rabies
• Lyme Disease
• Mosquito-borne Disease
• Animals in Public Settings
• Food-borne Disease
• Avian Influenza

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Common Zoonotic Disease Question Areas

• Rabies
• Lyme Disease
• Mosquito-borne Disease
• Animals in Public Settings
• Food-borne Disease
• Avian Influenza

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Common Zoonotic Disease Question Areas

• Rabies
• Lyme Disease
• Mosquito-borne Disease
• Animals in Public Settings
• Food-borne Disease
• Avian Influenza

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Psittacosis(Chlamydophila psittaci)
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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

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September 2006

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

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November 2006

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

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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

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Psittacosis - Background

• Chlamydophila psittaci
• Intracellular bacterium
• Survive outside the host for days to weeks
• Transmission inhalation, vertical (birds)
• Zoonotic
• Reportable

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C. psittaci - Animals

• Wide host spectrum among birds and mammals
• Pet psittacine birds are most often implicated in
  human infection

Macaw
Parakeet
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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

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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

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C. psittaci - Humans

• Routes of infection
• Inhalation (feather dust, resp. secretions, dried
  feces)
• Mouth-to-beak contact
• Handling of infected birds plumage and tissues
• Even brief exposures can lead to infection

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Psittacosis Humans

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

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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 lt1 if
  properly treated

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Psittacosis Public Health

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

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Psittacosis Public Health

• Occupational hazard to workers in bird industry
• Pet birds
• Turkey-processing plants
• Sporadic cases associated with pet bird ownership

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Psittacosis Controlling Infection

• Prevent generation of aerosols and dust during
  cleanup
• Practice good bird husbandry

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