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21_Bordetella, Francisella & Brucella

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Bordetella, Francisella & Brucella

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Слайд 1

Слайд 2
Bordetella, Francisella & Brucella

Bordetella, Francisella & Brucella

Слайд 3General Overview of Bordetella,

Francisella & Brucella
Extremely small
Aerobic nonfermenters
Gram-negative coccobacilli
True pathogens: isolation always

associated with disease; i.e., always clinically significant
NOTE: Previously studied nonfermenters were all opportunistic pathogens
General Overview of Bordetella, Francisella & BrucellaExtremely small Aerobic nonfermentersGram-negative coccobacilliTrue

Слайд 4Human Disease & Associated Pathogens

Human Disease & Associated Pathogens

Слайд 6Bordetella pertussis

Bordetella pertussis

Слайд 7Man is only natural host; obligate parasites of man
Disease is

highly communicable (highly infectious)
Person-to-person spread via inhalation of infectious aerosols
Incidence

in U.S.A. significantly reduced with required DPT vaccine; Incidence increasing as some local school boards stop requirement
Children under one year at highest risk, but prevalence increasing in older children and adults

Epidemiology of Bordetella pertussis Infection

Man is only natural host; obligate parasites of manDisease is highly communicable (highly infectious)Person-to-person spread via inhalation

Слайд 8Incidence & Severity of Pertussis Cases in USA

Incidence & Severity of Pertussis Cases in USA

Слайд 9Incidence of Pertussis in USA

Incidence of Pertussis in USA

Слайд 10Age Distribution & Severity of Pertussis Cases

Age Distribution & Severity of Pertussis Cases

Слайд 11Changes in Age Distribution for Pertussis Cases
Blue = 1988
Orange =

1998

Changes in Age Distribution for Pertussis CasesBlue = 1988Orange = 1998

Слайд 12Clinical Progression of Pertussis
Most infectious, but generally not yet diagnosed
Inflammation

of respiratory mucosal memb.
,
or death

Clinical Progression of PertussisMost infectious, but generally not yet diagnosedInflammation of respiratory mucosal memb.,or death

Слайд 13Fimbriae not primarily involved in adherence; Exotoxin & hemagglutinin mediate

attachment specifically to ciliated epithelium of bronchial tree
Cells multiply among

cilia of epithelial cells and produce filamentous hemaglutinin and classic A-B exotoxin and other toxins leading to localized tissue damage and systemic toxicity
Pertussis toxin, adenylate cyclase toxin, tracheal cytotoxin, dermonecrotic toxin, filamentous hemagglutinin, LPS (lipid A & lipid X)
Classical A-B exotoxin has three distinct activities
Histamine sensitizing factor
Lymphocytosis promoting factor
Islet activating protein

Virulence Factors Associated with Bordetella pertussis

Fimbriae not primarily involved in adherence; Exotoxin & hemagglutinin mediate attachment specifically to ciliated epithelium of bronchial

Слайд 14Virulence Factors Associated with Bordetella pertussis

Virulence Factors Associated with Bordetella pertussis

Слайд 15Laboratory Culture, Prevention & Treatment of Bordetella
Inactivated whole bacterial cells

and toxoid are prepared in formalin for inclusion in DPT

vaccine
Subunit (acellular) vaccine also available
Treatment with erythromycin, suction, oxygen
Treatment does not eliminate symptoms

Nonmotile
Fastidious and slow-growing
Requires nicotinamide and charcoal, starch, blood, or albumin to absorb toxic substances
Requires prolonged growth
Isolated on modified Bordet-Gengou agar

Laboratory Culture, Prevention & Treatment of BordetellaInactivated whole bacterial cells and toxoid are prepared in formalin for

Слайд 16Differential Characteristics of Bordetella Species

Differential Characteristics of Bordetella Species

Слайд 18Francisella tularensis

Francisella tularensis

Слайд 19Francisella tularensis Infections

Francisella tularensis Infections

Слайд 20Francisella tularensis Infections (cont.)

Francisella tularensis Infections (cont.)

Слайд 21Clinical Presentation of Tularemia
NOTE: Also Gastrointestinal & Pneumonic forms of

disease

Clinical Presentation of TularemiaNOTE: Also Gastrointestinal & Pneumonic forms of disease

Слайд 22Rabbits, ticks & muskrats are main reservoirs in US
Two biochemical

varieties
F. tularensis bv. tularensis (a.k.a., Jellison Type A)
F. tularensis

bv. palaearctica (a.k.a., Jellison Type A)

Jellison Type A strains are the major biovar associated with severe disease in North America
Most commonly, transmission by tick vectors from rabbit reservoirs or direct contact with rabbits

Epidemiology of F. tularensis Infection

Rabbits, ticks & muskrats are main reservoirs in USTwo biochemical varietiesF. tularensis bv. tularensis (a.k.a., Jellison Type

Слайд 23Biochemical Variants (Biovar) of Francisella tularensis

Biochemical Variants (Biovar) of Francisella tularensis

Слайд 24Antiphagocytic capsule
Thin lipid capsule present in pathogenic strains

Facultative intracellular

parasite that can survive in macrophages of the reticuloendothelial system
Virulence

Factors of Fransicella tularensis
Antiphagocytic capsule Thin lipid capsule present in pathogenic strainsFacultative intracellular parasite that can survive in macrophages of

Слайд 25Nonmotile
Fastidious and slow-growing
Requires cysteine-supplemented specialized media wi
Requires prolonged growth

Disease

prevention:
Avoidance of reservoirs and vectors
Protective clothing and gloves
Laboratory personnel should

be made aware of potential for Fransicella in clinical specimens

Laboratory Culture, Prevention & Treatment of F. tularensis

NonmotileFastidious and slow-growingRequires cysteine-supplemented specialized media wiRequires prolonged growth Disease prevention:Avoidance of reservoirs and vectorsProtective clothing and

Слайд 26Antibody Response to Francisella tularensis Infections

Antibody Response to Francisella tularensis Infections

Слайд 28Brucella spp.

Brucella spp.

Слайд 29Brucella Infections

Brucella Infections

Слайд 30Brucella Infections (cont.)

Brucella Infections (cont.)

Слайд 31Animals are natural reservoir
Cattle, goats, sheep, swine, bison, elk, dogs,

foxes, coyotes
500,000 human cases per year worldwide
Less than 100 annual

cases in the U.S. due to successful control of the disease in livestock and the animal reservoir
Transmission via i) ingestion of contaminated milk or cheese, or ii) direct contact with infected animals or animal products
Because it can be transmitted to humans, brucellosis is one of the most regulated diseases of cattle in the U.S.

Epidemiology of Brucellosis

Animals are natural reservoirCattle, goats, sheep, swine, bison, elk, dogs, foxes, coyotes500,000 human cases per year worldwideLess

Слайд 32Incidence of Brucellosis in USA

Incidence of Brucellosis in USA

Слайд 33Brucella infect organs rich in erythritol (a sugar metabolized in

preference to glucose) like breast, uterus, placenta and epididymis (tube

that connects a pair of ducts that conduct spermatozoa during ejaculation)
Asymptomatic carriage, sterility or abortions
Transmitted between animals in aborted tissues

Brucellosis in Animals

Brucella infect organs rich in erythritol (a sugar metabolized in preference to glucose) like breast, uterus, placenta

Слайд 34Human Brucellosis & Associated Species
Severe

Human Brucellosis & Associated SpeciesSevere

Слайд 35Brucellosis in Humans
Reportable disease
Human brucellosis = Bang's disease, named for

Bernhard Bang & Sir David Bruce who discovered Brucella
Facultative intracellular

pathogens of mononuclear-phagocyte system (formerly reticuloendothelial system which is involved in immune defense against microbial infection and removal of worn-out blood cells)
Bacteria are phagocytosed by macrophage or polymorphonuclear leukocyte
Survive intracellularly by inhibiting killing
Carried to spleen, liver, bone marrow, lymph nodes, kidneys
Form granulomas (mass of granulation tissue produced in response to chronic infections, inflammation, or foreign bodies) and cause destructive tissue damage
Brucellosis in HumansReportable diseaseHuman brucellosis = Bang's disease, named for Bernhard Bang & Sir David Bruce who

Слайд 36Consumption of contaminated unpasteurized milk or direct contact with infected

animal reservoir
Disease associated with contact with infected cattle, cattle products,

or dogs is a milder form
Disease associated with contact with goats and sheep is acute and severe with complications common
Disease associated with contact with swine is chronic & suppurative with destructive lesions and localization in cells of the reticuloendothelial system (RES)
Occupational hazard of laboratory personnel, veterinarians, farm workers, and meat handlers at risk through direct contact or inhalation
Protective clothing for abattoir workers, avoidance of unpasteurized dairy products
Highest numbers of cases reported in CA and TX

Brucellosis in Humans (cont.)

Consumption of contaminated unpasteurized milk or direct contact with infected animal reservoirDisease associated with contact with infected

Слайд 37Acute disease often develops with initial nonspecific symptoms of malaise,

chills, fatigue, weakness, myalgias (muscles), weight loss, arthralgias (joint), and

nonproductive cough
Mild disease with rare suppurative complications
Chronic disease and recurrence are common because it can survive in phagocytic cells and multiply to high concentrations
May also take the form of destructive lesions

Clinical Presentation of Human Brucellosis

Acute disease often develops with initial nonspecific symptoms of malaise, chills, fatigue, weakness, myalgias (muscles), weight loss,

Слайд 38Plate agglutination test (a.k.a., Brucella ring test) diagnosing Brucella
Drop

of serum mixed with drop of Brucella antigen
Clumping indicates infection
If

the mixture remains clear, the result is negative.
Treated with combination of tetracycline and doxycycline
For infants, tetracycline is toxic, so children are treated with trimethoprim-sulfamethoxazole.

Diagnosis & Treatment of Human Brucellosis

Plate agglutination test (a.k.a., Brucella ring test) diagnosing Brucella Drop of serum mixed with drop of Brucella

Слайд 39In 1934, the U.S. Department of Agriculture (USDA) established the

National Brucellosis Eradication Effort which is managed by Animal, Plant,

and Health Inspection Service (APHIS)
APHIS certifies states as brucellosis-free, classes A, B, or C of which all states are currently classified A
Serology & confirmatory bacterial culture to identify infected animals
Positive animals/herds are destroyed
Vaccination is available but is not a 100% effective and is costly to cattle ranchers

Control & Prevention of Brucellosis

In 1934, the U.S. Department of Agriculture (USDA) established the National Brucellosis Eradication Effort which is managed

Слайд 41REVIEW
Bordetella, Francisella & Brucella

REVIEWBordetella, Francisella & Brucella

Слайд 42General Overview of Bordetella,

Francisella & Brucella
Extremely small
Aerobic nonfermenters
Gram-negative coccobacilli
True pathogens: isolation always

associated with disease; i.e., always clinically significant
NOTE: Previously studied nonfermenters were all opportunistic pathogens

REVIEW

General Overview of Bordetella, Francisella & BrucellaExtremely small Aerobic nonfermentersGram-negative coccobacilliTrue

Слайд 43Human Disease & Associated Pathogens
REVIEW

Human Disease & Associated PathogensREVIEW

Слайд 44Review of Bordetella pertussis

Review of Bordetella pertussis

Слайд 45Bordetella pertussis Infections
REVIEW

Bordetella pertussis InfectionsREVIEW

Слайд 46Bordetella pertussis Infections (cont.)
REVIEW

Bordetella pertussis Infections (cont.)REVIEW

Слайд 47Man is only natural host; obligate parasites of man
Disease is

highly communicable (highly infectious)
Person-to-person spread via inhalation of infectious aerosols
Incidence

in U.S.A. significantly reduced with required DPT vaccine; Incidence increasing as some local school boards stop requirement
Children under one year at highest risk, but prevalence increasing in older children and adults

Epidemiology of Bordetella pertussis Infection

REVIEW

Man is only natural host; obligate parasites of manDisease is highly communicable (highly infectious)Person-to-person spread via inhalation

Слайд 48Changes in Age Distribution for Pertussis Cases
Blue = 1988
Orange =

1998
REVIEW

Changes in Age Distribution for Pertussis CasesBlue = 1988Orange = 1998REVIEW

Слайд 49Clinical Progression of Pertussis
Most infectious, but generally not yet diagnosed
Inflammation

of respiratory mucosal memb.
,
or death
REVIEW

Clinical Progression of PertussisMost infectious, but generally not yet diagnosedInflammation of respiratory mucosal memb.,or deathREVIEW

Слайд 50Virulence Factors Associated with Bordetella pertussis
REVIEW

Virulence Factors Associated with Bordetella pertussisREVIEW

Слайд 51Review of Francisella tularensis

Review of Francisella tularensis

Слайд 52Francisella tularensis Infections
REVIEW

Francisella tularensis InfectionsREVIEW

Слайд 53Francisella tularensis Infections (cont.)
REVIEW

Francisella tularensis Infections (cont.)REVIEW

Слайд 54Clinical Presentation of Tularemia
NOTE: Also Gastrointestinal & Pneumonic forms of

disease
REVIEW

Clinical Presentation of TularemiaNOTE: Also Gastrointestinal & Pneumonic forms of diseaseREVIEW

Слайд 55Rabbits, ticks & muskrats are main reservoirs in US
Two biochemical

varieties
F. tularensis bv. tularensis (a.k.a., Jellison Type A)
F. tularensis

bv. palaearctica (a.k.a., Jellison Type A)

Jellison Type A strains are the major biovar associated with severe disease in North America
Most commonly, transmission by tick vectors from rabbit reservoirs or direct contact with rabbits

Epidemiology of F. tularensis Infection

REVIEW

Rabbits, ticks & muskrats are main reservoirs in USTwo biochemical varietiesF. tularensis bv. tularensis (a.k.a., Jellison Type

Слайд 56Biochemical Variants (Biovar) of Francisella tularensis
REVIEW

Biochemical Variants (Biovar) of Francisella tularensis REVIEW

Слайд 57Review of Brucella spp.

Review of Brucella spp.

Слайд 58Brucella Infections
REVIEW

Brucella InfectionsREVIEW

Слайд 59Brucella Infections (cont.)
REVIEW

Brucella Infections (cont.)REVIEW

Слайд 60Animals are natural reservoir
Cattle, goats, sheep, swine, bison, elk, dogs,

foxes, coyotes
500,000 human cases per year worldwide
Less than 100 annual

cases in the U.S. due to successful control of the disease in livestock and the animal reservoir
Transmission via i) ingestion of contaminated milk or cheese, or ii) direct contact with infected animals or animal products
Because it can be transmitted to humans, brucellosis is one of the most regulated diseases of cattle in the U.S.

Epidemiology of Brucellosis

REVIEW

Animals are natural reservoirCattle, goats, sheep, swine, bison, elk, dogs, foxes, coyotes500,000 human cases per year worldwideLess

Слайд 61Brucella infect organs rich in erythritol (a sugar metabolized in

preference to glucose) like breast, uterus, placenta and epididymis (tube

that connects a pair of ducts that conduct spermatozoa during ejaculation)
Asymptomatic carriage, sterility or abortions
Transmitted between animals in aborted tissues

Brucellosis in Animals

REVIEW

Brucella infect organs rich in erythritol (a sugar metabolized in preference to glucose) like breast, uterus, placenta

Слайд 62Human Brucellosis & Associated Species
Severe
REVIEW

Human Brucellosis & Associated SpeciesSevereREVIEW

Слайд 63Brucellosis in Humans
Reportable disease
Human brucellosis = Bang's disease, named for

Bernhard Bang & Sir David Bruce who discovered Brucella
Facultative intracellular

pathogens of mononuclear-phagocyte system (formerly reticuloendothelial system which is involved in immune defense against microbial infection and removal of worn-out blood cells)
Bacteria are phagocytosed by macrophage or polymorphonuclear leukocyte
Survive intracellularly by inhibiting killing
Carried to spleen, liver, bone marrow, lymph nodes, kidneys
Form granulomas (mass of granulation tissue produced in response to chronic infections, inflammation, or foreign bodies) and cause destructive tissue damage

REVIEW

Brucellosis in HumansReportable diseaseHuman brucellosis = Bang's disease, named for Bernhard Bang & Sir David Bruce who

Слайд 64Consumption of contaminated unpasteurized milk or direct contact with infected

animal reservoir
Disease associated with contact with infected cattle, cattle products,

or dogs is a milder form
Disease associated with contact with goats and sheep is acute and severe with complications common
Disease associated with contact with swine is chronic & suppurative with destructive lesions and localization in cells of the reticuloendothelial system (RES)
Occupational hazard of laboratory personnel, veterinarians, farm workers, and meat handlers at risk through direct contact or inhalation
Protective clothing for abattoir workers, avoidance of unpasteurized dairy products
Highest numbers of cases reported in CA and TX

Brucellosis in Humans (cont.)

REVIEW

Consumption of contaminated unpasteurized milk or direct contact with infected animal reservoirDisease associated with contact with infected

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