Disease quizzes

Swine/ Avian flu 1. Virus

*Swine flu* 1. Virus 2. Variant influenza virus (H1N1, H1N2, H3N2) 3. Coming into close proximity with an infected pig (spread through the air and landing on a mucous membrane) and that person can transmit it to another person who they come into close contact with (coughing or sneezing) (not that many cases of that). The infection can also be transmitted if the pork is undercooked. - it's a concern if people get swine flu because swine can also be carrying other flu viruses and they have the potential to mix their genes within the pig and create a new virus. (antigenic shift) 4. People have symptoms similar to the symptoms of regular human seasonal influenza. - Fever, lethargy, lack of appetite and coughing. - Some people also have a runny nose, sore throat, eye irritation, nausea, vomiting and diarrhea. 6. Respiratory specimen would generally need to be collected within the first 4 to 5 days of illness (when an infected person is most likely to be shedding virus). However, some people, especially children, may shed virus longer. 8. RNA, enveloped, 9. No "classic" signs 10. Antivirals against flu: oseltamivir, peramivir and zanamivir 11. NO VACCINE, although there is a flu vaccine for humans it does not work on swine flu viruses. 12. Be careful when coming into close proximity to pigs. Wash hands after being in their barn and do not put anything in your mouth if you're around them *Avian Flu* 1. Virus 2. Avian Influenza type A virus 3. Human infections with bird flu viruses happens when enough virus gets into a person's eyes, nose or mouth, or is inhaled. This happens when virus is in the air (in droplets or possibly dust) and a person breathes it in, or when a person touches something that has virus on it then touches their mouth, eyes or nose. There have been rare cases in which humans get the infection through direct contact with an infected bird or surfaces that have been contaminated with avian flu. There has not been a case in which an infected person has transmitted the disease to another person, but the virus does have the possibility of changing at any moment. 4. Symptoms range from mild to severe and include conjunctivitis, influenza-like illness (fever, cough, sore throat, muscle aches) sometimes accompanied by nausea, abdominal pain, diarrhea, and vomiting, severe respiratory illness (shortness of breath, difficulty breathing, pneumonia, acute respiratory distress, viral pneumonia, respiratory failure), neurologic changes (altered mental status, seizures), and the involvement of other organ systems. Asian bird influenza has the most serious symptoms and have the highest motality rates. 6. Diagnosis is done by collecting a swab from the upper respiratory tract (nose or throat) of the sick person. - Molecular testing, - trying to grow the virus. - Evidence of antibodies can also be done for those individuals who no longer have any symptoms. 8. RNA, Enveloped 9. No "classic" signs 10. Treatment with a neuraminidase inhibitor. Most are susceptible to oseltamivir, peramivir, and zanamivir. But some Asian avian viruses are becoming resistant to antivirals. 11. NO VACCINE 12. People should avoid wild birds and observe them only from a distance. avoid contact with domestic birds that appear ill or have died. Avoid contact with surfaces that appear to be contaminated with feces from wild or domestic birds

Lyme Disease

-Bacteria -- spirochette -Borrelia burgdorferi -transmission: bite from infected Mice at larval stage (fall winter) develops into nymphs(immature ticks)which is originally received from field mice Reproduce on deers as Adult Ticks; requires at least 24 hours of attachment to the host before transfer of bacteria and infection occur Nymph Stage usually during spring and summer; not spread person to person or through breast milk; lyme disease can live in blood however there are no cases linking lyme disease with blood transfusions -animal vector: yes -general signs and symp:3-30 days after bite: Fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes; 70-80% of patients get a Erythema migrans (EM) rash (bull's eye looking): begins at site of tick bite 3-30 days after bite, expands gradually over a period of time up to 12 inches or more, can be warm, painful and itchy-----later symptoms: days to months after bite: severe headache, stiff neck, additional EM rashes on the body, arthritis, facial palsy, heart palpitations, dizziness, shortness of breath, inflammation of brain or spinal cord, nerve pain, short term memory issues, JOINT PAIN ARTHRITIS -body systems: can cross placenta causing stillbirth -agent identification/confirmation: 2 tiered testing:First: Enzyme Immunoassay (EIA) or immunoflourescence assay (IFA) 2. if signs and symptoms are less than or equal to 30 days than the second test is IgM and IgG western blot; if the signs and symptoms are greater than 30 days the second test will be an IgG -western blot only! accurate blood test depends on the state of the disease; during the first few weeks the blood test is usually negative; difficult to interpret through serology -treatment/cure: use tweezers to pull tick out as close to skin as possible -special symptom: often found in groin, armpit and scalp -antibiotics: doxycycline, amoxicillin, or cefuroxime axetil; penicillin and ceftriaxone may be used if patient has neurological or cardiac forms of illness vaccine: not anymore (discontinued in 2002) -transmission prevention: wear repellant and avoid woody, brushy areas, bathe asap if some get on you -elevated levels: no

Tapeworm (Helminth)

-Causative agent: Taenia saginata -Transmission: swallowing larvae, eating raw or uncooked beef -Symptoms: mild symptoms, abdominal pain, loss of appetite, weight loss, and upset stomach, passing of tapeworm segments in feces, can cause seizures and muscle or eye damage -systems: digestive -Diagnosed: stool samples -Treatment: Praziquantel orNiclosamide -Prevention: cook meat thoroughly -No vaccine -elevated IgE and eosinophils

Ebola (Viral) RNA enveloped

-Causative agent: hemorrhagic fevers -Transmission: person-person, animal-person blood or body fluids, objects (needles), infected fruit bats or primates not spread through the air, by water, or in general, by food. can be spread quickly through hospitals -Symptoms: Fever, Severe headache, Muscle pain, Weakness, Fatigue, Diarrhea, Vomiting, stomach pain, hemorrhage ebola can remain in a man's semen for months -Diagnosed: samples, blood tests (only show results after symptoms), ELISA, PCR, virus isolation -Treatment: IV fluids, balancing electrolytes No vaccine -Prevention: hygeine, avoid contact w/ body fluids, avoid contact w/ bats and primates, Avoid contact with semen from a man who has had Ebola, avoid contact with those who have ebola -No vaccine

Legionnaire's Disease (Legionellosis)

-Legionella pneumophila -Bacterial -weak gram negative (stain with silver instead) -rod -endotoxin -transmission: water, airborne transmission, spa (can be resistant to chlorine), humidifiers, showers, decorative fountains, potting soil, can grow in water of the air-conditioning cooling towers, (not person to person) -animal vector: no -general signs and symp: similar to other lung infections--2-10 days after being exposed: high fever, cough, shortness of breath, muscle aches, headaches; sometimes diarrhea, nausea and confusion. Complications: lung failure, death (about 1 in 10) -body systems: can affect kidneys -agent identification/confirmation: culture on a selective charcoal-yeast extract medium, fluorescent-antibody methods, DNA probe test is available, chest x-ray, urine test, taking sputum from the lung -treatment/cure: -special symptom: Pontiac fever symptoms are primarily fever and muscle aches; it is a milder infection than Legionnaires' disease. Symptoms begin between a few hours to 3 days after being exposed to the bacteria and usually last less than a week. Pontiac fever is different from Legionnaires' disease because someone with Pontiac fever does not have pneumonia. -antibiotics: Erythromycin, azithromycin and other macrolide antibiotic (goes away without special treatment) -vaccine: no -transmission prevention: avoid hot tubs, water tanks and heaters, cooling towers, large plumbing systems, decorative fountains -elevated levels: no

Walking pneumonia

-Mycoplasma pneumoniae -Bacterial -mollicutes -Mycoplasma pneumoniae -Bacterial -mollicutes (no cell wall; attaches to respiratory epithelium) -transmission:when small droplets of water that contain the bacteria get into the air by coughing and sneezing while in close contact with others, who then breathe in the bacteria. M. pneumoniae infections often spread within households. -animal vector: no -general signs and symp: sore throat, fatigue, fever, cough that lasts weeks or months, headache; kids: could wheeze, vomit or have diarrhea; complications: encephallitis, hemolytic anemia, renal dysfunction, skin disorders(steven-johnson's syndrome) -body systems: inhibits movement of cilia; superantigen; damages lining of respiratory tract (throat, lungs, windpipe) -agent identification/confirmation: throat swabs and sputum grown on a horse serum and yeast extract medium; form distinctive "fried egg" appearance colonies under magnification; PCR and serological tests to detect IgM antibodies, Diagnose with ELISA or immunofluorescence -treatment/cure: -special symptom: steven-johnson's syndrome-severe skin reaction -antibiotics: tetracycline (gets rid of bacteria but doesn't eliminate)or erythromycin -vaccine: no -transmission prevention: cover nose and mouth when coughing or sneezing, wash hands, stay away from crowded areas -elevated levels: no

Gastroenteritis/cryptosporidiosis (cryptosporidium) protozoan

-Transmission: drinking contaminated water. This is the leading cause of waterborne diseases in the US. Most prevalent species affecting humans c. Parvum and c. Hominis. -Symptoms: watery diarrhea, cramps, dehydration, nausea, vomiting, fever, weight loss. Some have no symptoms. Symptoms can come and go for 30 days. Can lead to death in someone w/ weak immune system. -Body systems: small intestine. respiratory tract (if weak immune system) -Diagnosis and confirmation: stool samples over several days, then examined microscopically (acid-fast staining, direct fluorescent antibody , and/or enzyme immunoassays) and molecular (PCR), FA test for assay antibodies (gold standard). -Treatment: drinking fluids, Nitazoxanide, -Prevention: good hygiene, do not swim in public pool after having diarrhea, do not swallow recreational pool water, wear a condom during anal sex -No vaccine

RSV (Respiratory syncytial virus) Viral RNA enveloped

-Transmission: droplet particles contact their nose, mouth, or eye after infected person sneezes or coughs, kissing the face of a child with RSV, touching infected surfaces such as doorknobs RSV infection most commonly causes a cold-like illness. can also cause bronchitis, croup, and lower respiratory infections like bronchiolitis and pneumonia. -Symptoms: runny nose, decrease in appetite. Coughing, sneezing, fever typically develop 1 to 3 days later, wheezing. In very young infants, irritability, decreased activity, and breathing difficulties may be the only symptoms of infection. Most do not need to be hospitalized -Diagnosed: antigen test and culture (children), PCR (adults and older children) -Treatment: No specific treatment. infants may require supplemental oxygen, suctioning of mucus from the airways, or intubation -Prevention: wash hands, cover mouth when coughing, avoid sharing cups and utensils and kissing -No vaccines palivizumab (medicine) can be used as a preventative measure for young children

Listeriosis- Bacterial (Listeria monocytogenes)

-Transmission: eating contaminated food. Most likely to effect pregnant women & their newborns,age 65 and up, or someone with weakened immune system. common transmission is unpasteurized dairy products, deli meats, and hot dogs -Symptoms: fever, diarrhea Pregnant women: flu-like symptoms, fatigue and muscle aches. infections during pregnancy can lead to miscarriage, stillbirth, premature delivery. Non pregnant people: headache, stiff neck, confusion, loss of balance, and convulsions -Organs/Systems: Causes severe infections in the bloodstream (sepsis), brain (causes meningitis or encephalitis), bones, joints, chest, abdomen -rod shaped, Gm+ (produce endotoxins, no exotoxins, does not produce endospores -Diagnosed: checking to see if bacterial culture grows from a body tissue or fluid, such as blood, spinal fluid, or the placenta. -Treatment: Antibiotics- IV ampicillin and gentamicin -Prevention: Properly cook your food, avoid buying things that could have been contaminated during making -No vaccine

Plague (yersinia pestis) bacterial gram negative, Rod shaped coccobaccillus, endotoxins and possibly exotoxins, encapsulated

-Transmission: insect vector flea bite (most common) travels from rat to rats rat fleas (Xenopsylla Cheopis) , contact with infected animal, skinning infected animals; scratches bites and licks by domestic cats, infectious droplets Prairie dog and squirrel can carry disease (rodents) -Symptoms: The plague "as the Black Death" in middle ages d/t dark blue skin from hemorrhages. 1. Bubonic plague: fever, headache, chills, weakness swollen and painful lymph nodes in groin and armpits. Multiples in lymph and if untreated can spread to other parts of the body. From bite of infected flea. Death after 1 week when symptoms occur 2. Septicemic: bacteria reaches blood stream; septic shock, fever, chills, extreme weakness, abdominal pain, shock, bleeding into the skin and other organs. Skin and other tissues may turn black and die. Bites from infected flea Pneumonic: bacteria spreads to lungs fever, headache, weakness, and a rapidly developing pneumonia with shortness of breath, chest pain, cough, and sometimes bloody or watery mucous. Most dangerous. Caused from infectious droplets -Diagnosis and confirmation: blood, sputum, lymph node tests, blood cultures for capsular antigen for y. pestis -Treatment: antibiotics and hospitalization. streptomycin, Tetracycline -Prevention: reduce rodent habitat around home, wear gloves if handling or skinning animals, bug repellent, keep fleas off pets -vaccine available

Tuberculosis- Bacterial (Mycobacterium tuberculosis)

-Transmission: person-person through the air. Someone coughing or speaking then another breathing in the bacteria not spread through: kissing, touching hands, sharing food, sharing toothbrushes -Symptoms: latent- no symptoms, cant spread bacteria to others. Infectious- cough that lasts weeks, chest pain, coughing up blood, weakness, weight loss, no appetite, chills, fever, night sweats -Body systems/organs: lungs, throats. bacteria in other parts of the body (kidney or spine) are not infectious -Acid fast, obligate, non endospore former -Diagnosed: skin test, blood test. does not tell if a person is latent or infected with disease. requires further testing needed if results are positive. -Treatment: Drugs for 6-9 months- soniazid, rifampin, ethambutol, pyrazinamide -Prevention: medicine, screenings, avoid infected people -Vaccine (Intradermal injection)

Chagas' Disease/American Trypanosomiasis (trypanasoma cruzi) protozoan

-Transmission: rodents possums armadillos are reservoirs/ insect vector "kissing bug" reduviid bug bites humans defecate parasite on skin and parasite get in through open wounds and bites or rub into eyes. Parasite grows inside insects. Blood transfusion, transplant and congenital -Symptoms: acute symptoms- mild, fever, swelling on site of inoculation, swollen glands Chronic- asymptomatic, many people do not know they are infected. Complication from chronic (very rare) can be dilated heart, esophagus or colon, heart rhythm abnormalities Megaesophagus and megacolon d/t damage peristaltic contractions over a long period of time. -Special symptoms: Romana's sign (swelling of child's eye) -Body systems: parasite is found in the circulating blood. Can affect cardiac system and gastrointestinal system -Diagnosis and confirmation: Acute- blood smears then microscope examination. It will not detect during chronic stage of infection Chronic- serological tests 2-3 sampling's required. -Treatment: systematic treatment. Specialists: cardiologist, gastroenterologist, or infectious disease specialist depending on symtoms. RX: Benznidazole, nifurtimox effective for acute stage. -Prevention: bed nets, bug spray, screening blood donations Regional: 40% insect in Az extend to northern illinois -No vaccines

Whooping cough/pertussis (bordetella pertussis) Obligated Aerobic Gram Negative bacterial gm-, encapsulated, coccobaccillus, nonspore, endotoxins and exotoxins

-Transmission: through the air by infectious droplets. Very contagious -Symptoms: 1st stage - Catarrhal stage- 1-2 weeks. Runny nose, fever, cough, sneezing resembles common cold 2nd Stage - Paroxysmal stage- rapid coughs, children may turn blue and vomit. to much mucus build up d/t ciliary action is compromise in trachea , constant cough with gasp of air ( whooping Cough) last 1-6 weeks. 3rd Stage - Convalescent stage- cough, still contagious last for months may cause braing damage to infant d/t hypoxia -Body systems: respiratory -Diagnosis and confirmation: characteristic history and physical examination.Lab culture of of cough throat swab or nasal swab. A lab tests that involves taking a specimen from the back of a person's throat, culture, PCR requre in infants, serological -Treatment: erythromycin or other macrolides not effected after onset of paroxysmal stage. -Prevention: get vaccinated -Vaccine

Rocky Mountain spotted fever (rickettsia rickettsi) bacterial gm-, endotoxins, coccobaccillus, intracellular, nonmotile nonspore, (only the typhus subdivision of rickettsia is encapsulated, not spotted fever)

-Transmission: tick bite (insect vector) bite humans. Pass on from tick to tick via eggs called transovarian passage -Regional - West the wood tick Dermacentor andersoni and the east dog tick Dermacentor variabilis 1/1000 ticks are infected Southern states and Appalachia -Symptoms: fever, *spotted macular rash, often on hands and palms*, headache Can be fatal in first 8 days if left untreated, even in healthy people -Special symptoms: the rash- flat, pink, non-itchy spots (2-5 days after fever) --> red to purple, spotted rash (6th day) -Body systems: skin Possible Long term health issues: infected endothelial cells that line blood vessels "vasculitis", bleeding or clotting in brain/vital organs, loss of circulation (can result in amputation), neurological issues -Diagnosis and confirmation: no test available at this time that can provide a conclusive result in time to make important decisions about treatment. Very challenging to treat since it resembles other common diseases. Doctors must treat at their discretion, may look at blood tests to check for low platelet count. To confirm: if they have a rash, PCR or immunohistochemical (IHC) staining can be performed on a skin biopsy, indirect immunofluorescence assay -Treatment: Tetracycline, chloramphenicol only in effective in early cases. Carries risks -Prevention: where long clothing, bug spray, remove ticks from pets -No vaccines

Salmonella (Salmonella enterica) Bacterial gm-, endotoxins only, rod shaped, non spore, encapsulated

-transmission: Food, reptiles -symptoms: diarrhea, fever, and abdominal cramps, possible death -GI tract -diagnosis: stool and blood sample, serotyping, DNA fingerprinting, Vi antigen can be detected with Widal test -treatment: amoxicilin, ampicilin, fluoroquinolones, ceftriaxone, cefotaxime, chloramphenicol, trimethoprim-sulfamethoxazole, ciprofloxacin -no vaccine -prevention: cook food thouroughly, wash hands and work surfaces

HIV (AIDS) (Lentivirus) retrovirus Viral-RNA enveloped Two identical rna strands enzyme reverstranscriptase and enveloped phospholipid and glycoprotein spikes gp120

-transmission: anal or vaginal sex, breast milk, transplacental infection of a fetus, blood contaminated needles, organ transplants, artificial insemination and blood transfusions; direct contact with infected body fluids, breast milk -animal vector: no -general signs and symp: stages: 1-acute HIV infection-flu like symptoms, swollen lymph nodes or none at all; 2-clinical latency (HIV inactive or dormant)-decline in immune system, possible fever and diarrhea; 3-AIDS-final; infection in lungs, eye infections, toxoplasmosis of the brain CD4 T cells below 200cells/ul -agent identification/confirmation: antibody tests through blood (most effective) or oral fluid, a combination or fourth generation test, or a nucleic acid test -DX - ELisa test first confirmed by western blot after need to wait 3 months for the virus level to accumulate(seroconversion), Plasma viral load -treatment/cure: highly active antiretroviral therapy (HAART) to control it Fusion inhibitors - enfuvirtide Protease inhibitors - atazanavir, indinavir, squinavir Intergrase inhibitors - Raltegravir special symptom: can get "superinfected" by another type of HIV virus; exposure to air will kill virus outside body; has a "window" period usually 3-12 weeks; -vaccine: no -prevention: abstinence, safe sex, limit partners, no needle sharing, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP)-within 72 hours after. -elevated levels: no

Cryptpcoccosis (Cryptococcus neoformans Meningitis) fungal

-transmission: breathing in the microscopic fungus or dried contaminated droppings from birds expecially pigeon droppings. Can contaminate nearby soil dormant in dead hollow trees spread through wood products. -symptoms: in the lungs: Cough, shortness of breath, chest pain, fever -resembles yeast reproduce by budding in the brain: Spreads to CNS cause meningitis. Headache, fever, neck pain, nausea and vomiting, sensitivity to light, confusion or changes in behavior -diagnosis and confirmation: LATEX AGGLUTINATION test for antigens in blood or Cerebospinal fluid. Opportunistic in AIDs patients. medical history, symptoms, physical examinations, and laboratory tests: sample of tissue or body fluid studied microscopically with antigen test, or cultured. Chest xray, CT scan -treatment: Amphotericin B in combination with flucytosine -no vaccine -elevated Ige and eosinophils -prevention: Difficult to avoid, very common in the environment, however most people who are generally healthy do not get sick

Leprosy aka Hansen's Disease (Mycobacterium leprae) Bacterial gm+, encapsulated, non spore, +acid fast

-transmission: coughs and sneezed from person over long periods of time -animal vector: armadillo -general signs and symp: SKIN: Discolored patches, usually flat, that may be numb and look faded (lighter than the skin around), Growths (nodules) on the skin, Thick, stiff or dry skin, Painless ulcers on the soles of feet, Painless swelling or lumps on the face or earlobes, Loss of eyebrows or eyelashes; NERVOUS SYSTEM: Numbness of affected areas of the skin, Muscle weakness or paralysis (especially in the hands and feet), Enlarged nerves (especially those around the elbow and knee and in the sides of the neck), Eye problems that may lead to blindness (when facial nerves are affected); MUCOUS MEMBRANE: stuffy nose, nose bleeds; if left untreated claw shaped hand; necrosis of tissue -body systems: grows in the PNS and invade myelin sheaths; -agent identification/confirmation: skin biopsy sample from active lesion, tissue damage and identifying acid-fast bacilli within nerves; punch biopsy, blood test detect the infection as early as 9-12 months; loss of feeling on patches of skin -treatment/cure: combination of dapsone, rifampin and clofazimine and a fat-soluble dye; chemotherapy; -special symptom: tuberculoid-neural form; lepromatous-progressive form -vaccine: no; although according to the book (page 618) Bacillus Calmette-Guerin (BCG) vaccine for tuburculosis has been found to be somewhat protective against leprosy -transmission prevention: get treated early -elevated levels: no -misc info: found in Mexico, Caribbean, Brazil, Asia, Africa; found in armadillos in Texas

Sporotrichosis (Sporothrix schenckii) Fungal

-transmission: fungus enters the skin through a small cut or scrape, cuts from animals. found in soil and on plant matter such as sphagnum moss, rose bushes, and hay -animal vector: scratches from animals, ex. cat -symptoms: small painless bump on skin where fungus has entered the skin, eventually looks like an open sore. If in the lungs: cough, shorthess of breath, chest pain, and fever. Other parts of the body: joint pain, difficulty thinking, headache, and seizures (CNS) -diagnosis and confirmation: cigar-shaped budding yeast visible in pus, biopsy of infected area with fungal culture, blood test (not common for skin infection) -treatment: itraconazole, Supersaturated potassium iodide, amphotericin B -no vaccine -elevated Ige and eosinophils -prevention: wear gloves and long sleeves when handling plant matter

Diptheria (Corynebacterium diptheriae) Bacterial gm+(have short mycolic acid chain in cell wall), exotoxin, rod shaped, non spore forming, no capsule

-transmission: person->person through respiratory droplets, coming in contact w/ an object contaminated -symptoms: weakness, sore throat, fever, swollen glands in neck -special symptoms: pseudomembrane= thick gray coating that covers tissues in the nose, tonsils, voice box, and throat -systems and organs: respiratory, if poison enters blood stream: kidneys, heart and nerves Cutaneous diptheria - local skin infection dt wounds or lesion, slow healing wound with gray membrane cover. -diagnosis and confirmation: swab from the back of the throat, sample from skin lesion, Elek test detects toxin production, stain with analine dyes -treatment: Using diphtheria antitoxin in conjunction with erythromycin, penicillin -vaccination- DTAP for children in the US -prevention: vaccination

Rhinovirus (common cold) Viral-RNA non-enveloped

-transmission: through air and close contact with sick people; can get through respiratory secretions or poop -animal vector: no -general signs and symp: sore throat, runny nose, coughing, sneezing, headaches, body aches body systems: -agent identification/confirmation: symtoms -treatment/cure: over-the-counter meds to manage symptoms -special symptom: no -antibiotics: no -vaccine: no -prevention: wash hands, avoid touching face, stay away from sick people -elevated levels: no

Rubella (German Measles) rubivirus Viral-RNA enveloped

-transmission: when infected person coughs or sneezes; if pregnant can pass to fetus 1st trimester (3months) need vaccination prior or after 1st or 3rd month. (congenital rubella syndrome) -animal vector: no -general signs and symp: First sign(children): red rash first on face then spread to body; lasts about 3 days; other symptoms that may occur before rash: a low-grade fever, headache, mild pink eye (redness or swelling of the white of the eye), general discomfort, swollen and enlarged lymph nodes, cough, runny nose; adults:Most adults who get rubella usually have a mild illness, with low-grade fever, sore throat, and a rash that starts on the face and spreads to the rest of the body; Some adults may also have a headache, pink eye, and general discomfort before the rash appears; sometimes no symptoms at all and sometime no rash at all; Women: can experience arthritis, fetus: serious birth defects, heart defects loss of hearing and eye sight, liver or spleen damage or intellectual disability -agent identification/confirmation: -treatment/cure: serology; collect throat (best source), nasal, or urine specimens for viral detection by polymerase chain reaction (PCR) testing and molecular typing, and blood for serologic testing; no specific antiviral therapy -antibiotics: no -vaccine: yes (last 15 years) -transmission prevention: get vaccinated -elevated levels: no

Mumps Viral-RNA enveloped paramyxovirus

-transmission:coughing, sneezing, or talking, sharing items, such as cups or eating utensils, with others, and touching objects or surfaces with unwashed hands that are then touched by others -animal vector: no -general signs and symp: puffy face, swollen jaw, Fever, Headache, Muscle aches, Tiredness, Loss of appetite, Swollen and tender salivary glands under the ears on one or both sides (parotitis); sometimes no symptoms; complications: inflammation of testicles; Symptoms typically appear 16-18 days after infection, but this period can range from 12-25 days after infection -agent identification/confirmation: buccal or oral swab and a serology (serum) specimen; sometimes based on symptoms; can be isolated by empryonated egg or cell culture techniques and ELISA tests -antibiotics: no -vaccine: MMR vaccine -prevention: vaccine, don't share -cups/eating utensils, cover mouth when sneezing or coughing -elevated levels: no

Cody--Brucellosis

1 -Bacteria, 2 -Four species of brucella can cause human disease: B. melitensis, B. abortus, B. suis, and B. canis. 3-The most common way to be infected is by eating or drinking unpasteurized/raw dairy products. When sheep, goats, cows, or camels are infected, their milk becomes contaminated with the bacteria.Can also be infected by inhaling bacteria - mostly for people in labs or working in slaughter houses.Bacteria can also enter wounds in the skin/mucous membranes through contact with infected animals. YES ANIMAL VECTOR. 4- *Initial symptoms: fever sweats malaise anorexia headache pain in muscles, joint, and/or back fatigue *Long term symptoms recurrent fevers arthritis swelling of the testicle and scrotum area swelling of the heart (endocarditis) neurologic symptoms (in up to 5% of all cases) chronic fatigue depression swelling of the liver and/or spleen 5. - Gram Negative - All gram negatives have endotoxins 6.- bacteria in samples of blood, bone marrow, or other body fluids. In addition, a blood test can be performed to detect antibodies against the bacteria. 7. - Gram Negative Rod, Non-capsule, Non-motile 9.- Special symptoms - swelling of heart, testicles, scrotum, liver or spleen. 10. -the antibiotics Doxycycline and Rifampin are recommended in combination for a minimum of 6-8 weeks. 11.- No vaccine available for humans, Brucellosis vaccine can be given to animals. 12. -The best way to prevent brucellosis infection is to be sure you do not consume: undercooked meat unpasteurized dairy products, including: milk cheese ice cream Pasteurization is when raw milk is heated to a high temperature for a short period of time. This heating process destroys harmful bacteria that may make the milk unsafe to consume. If you are not sure that the dairy product is pasteurized, do not eat it. People who handle animal tissues (such as hunters and animal herdsman) should protect themselves by using: rubber gloves goggles gowns or aprons This will help ensure that bacteria from potentially infected animals do not get into eyes or inside a cut or abrasion on the skin.

Typhoid Fever Salmonella Typhi GM- RODS Endotoxin

1) Bacteria 2) Most virulent serotype Salmonella Typhi 3) Close contact to bacterium, contaminated food/water spread. Only in feces of humans TYPHOID MARY cook in NY. NO ANIMAL VECTOR. Typhoid multiples inside phagocytes and lysis them disseminates into spleen and liver (longer incubation 2-3 weeks). 4) High fever, continual headache, belly pain, and constipation or diarrhea appears in 2-3 weeks. Severe cases- ulceration and perforation of intestinal wall 5) Endotoxin 6) Diagnose- Isolation of bacteria on selective media, serotyping, ELISA-urine test looking for bacteria. 7) Gram Negative rod shape 9) Bacteria multiply in phagocytic cells and when lysed attack organs especially spleen and liver 10)Treatment- Quinolones & cephalosporins 11) Vaccine yes - Only for millitary or high risk lab personnel Varies 3-7 year protection. Recovery from typhoid will have lifelong immunity 12) prevention- Sanitation of water and food EX. sewage system 13) NO elevated IgE

Tetanus (lock jaw)

1) Bacteria 2) Clostridium Tetani 3) Transmission- Puncture wound 4) Symptoms- lockjaw, muscle spasms 5) Exotoxin- Neurotoxin- tetanospasmin 6) diagnose- Physical exam, medical and immunization history, signs, symptoms, muscle spasms, stiffness & pain (Lab test aren't generally helpul ) 7) Gram positive rod shape endospore former 9) Lockjaw- muscle spasms 10) treatment- tetanus immune globulin (TIG) & antibiotic 11) prevention- Vaccine yes- toxoid vaccine, DTaP, Td vaccine 13) NO elevated IgE

Cody 7--West Nile Arbovirus for arthropod borne virus Single Strand RNA enveloped

1. - Viral 2. - Causative Agent - West Nile Virus (arbovirus) 3. - Transmission - Most commonly transmitted to humans by mosquitos. A small number of cases have been reported by: Blood transfusions, organ transplant, exposure in a lab or from mother to baby during pregnancy, delivering or breastfeeding. NOT PASSED FROM PERSON TO PERSON. Yes insect vector - Mosquito 4. - 70-80% of those infected do not present with any symptoms. -1 in 5 infected will develop headache, body aches, joint pain vomiting, diarrhea or rash. Most people will make a complete recovery - fatigue and weakness may last from weeks up to a few months. -Less than 1% develop serious neurological illness such as encephalitis or meningitis ( of the brain or surrounding tissues.) The symptoms of neurologic illness can include headache, high fever, neck stiffness, disorientation, coma, tremors, seizures, or paralysis.Serious illness can occur in people of any age. However, people over 60 years of age are at the greatest risk for severe disease. People with certain medical conditions, such as cancer, diabetes, hypertension, kidney disease, and people who have received organ transplants, are also at greater risk for serious illness. ***About 10% of people who develop neurological illness due to West Nile Virus will die*** 6. -Laboratory diagnosis is generally accomplished by testing of serum or cerebrospinal fluid (CSF) to detect WNV-specific IgM antibodies. Immunoassays for WNV-specific IgM are available commercially and through state public health laboratories.Viral cultures and tests to detect viral RNA can be performed on serum and CSF. Abnormalities may be seen in the brain stem, ganglia and thalamus if a brain MRI is performed. 8. - Single stranded RNA virus, Enveloped 9. - No special signs or symptoms that I could find. 10. - No vaccine or specific antiviral treatments for West Nile virus infection are available. Over-the-counter pain relievers can be used to reduce fever and relieve some symptoms In severe cases, patients often need to be hospitalized to receive supportive treatment, such as intravenous fluids, pain medication, and nursing care. 11.- No vaccine is available for WNV. 12. - Transmission can be prevented by wearing insect repelent when outdoors. Wear long sleeves, pants and socks when outdoors. Report dead birds to local authorities as this can sometimes be an indication that WNV is circulating between birds and mosquitos in your area.

Epstein Barr - Mononucleosis -Herpesvirus 4

1. - Virus 2. - Epstein Barr Virus 3. - Transmission - EBV spreads most commonly through bodily fluids, especially saliva. However, EBV can also spread through blood and semen during sexual contact, blood transfusions, and organ transplantations. -The first time you get infected with EBV (primary EBV infection) you can spread the virus for weeks and even before you have symptoms. Once the virus is in your body, it stays there in a latent (inactive) state. If the virus reactivates, you can potentially spread EBV to others no matter how much time has passed since the initial infection. - Can be spread by using a toothbrush or a drinking glass that an infected person recently used. - No animal vector 4- Symptoms of EBV infection can include Sick child in bed fatigue fever inflamed throat swollen lymph nodes in the neck enlarged spleen swollen liver rash 6.- Diagnosis: Diagnosing EBV infection can be challenging since symptoms are similar to other illnesses. EBV infection can be confirmed with a blood test that detects antibodies. About nine out of ten of adults have antibodies that show that they have a current or past EBV infection. 8. - Double Helix DNA Virus, Enveloped 9. - No special signs/ symptoms 10/12 - There is no vaccine to protect against EBV infection. 11. -There is no specific treatment for EBV. However, some things can be done to help relieve symptoms, including: drinking fluids to stay hydrated getting plenty of rest taking over-the-counter medications for pain and fever 12. - You can help protect yourself by not kissing or sharing drinks, food, or personal items, like toothbrushes, with people who have EBV infection.

Clostridium difficile

1. Bacteria 2. Clostridium difficile 3. Healthcare associated infection. Health workers spread to patients. A person becomes infected when they touch something (toilet, bath tubs, rectal thermometers) contaminated with the bacteria (found in poop) then touch their mucous membranes. Elderly and those requiring long term antibiotics greater at risk. 4. Inflammation of colon, watery diarrhea, loss of appetite, nausea, abdominal pain 5. Exotoxins 6. Stool sample, molecular tests, antigen tests, antigen detection, toxin testing. False negatives can occur bc the toxin degrades at room temp & can be undetectable after 2 hours 7. Gm+, spore forming, 9. Watery diarrhea 10. metronidazole, vancomycin (administered orally), or recently approved fidaxomicin 11. No vaccines 12. Prevention: isolation rooms, hand hygiene, cleaning medical tools, disinfect in hospital

Anthrax

1. Bacterial 2. Bacillus anthracis 3. When in contact with infected animals or animal products. When spores get into the body (eating, through a cut). Bacteria multiply and spread out in body then produce toxins, cause severe illness. Uncommon in the US 4. Itchy blisters, swelling around sore, painless ulcer, sores on hands neck arms. Inhalation symp: fever, chest discomfort, chills, cough, confusion, nausea, headache, sweats, tiredness, body aches GI symp: fever, chills, swelling of neck, sore throat, painful swallowing, hoarseness, nausea, diarrhea (bloody), headache, flushing, stomach pain, fainting, abdominal swelling Effect: skin, intestine, 5. Produce exotoxins 6. Diagnosed through lab tests, PCR, Immunofluorescence microscopy 7. Gm +, rod shaped, capsulated, spore forming 9. Special symtom is skin lesion, dark centered painless ulcer after sore 10. Antibiotics for 60 days: ciprofloxacin, doxycycline, fluid drainage (severe cases) 11. vaccine: yes 12. Antibiotics

Campylobacteriosis Campylobacter Jejuni GM- Microaerophiles sprilly curved Endotoxin non Endospore, Capsule (food poisoning) Campylobacter Gastroenteritis

1. Bacterial 2. Camplyobacter/Campylobacter jejuni, 3. transmission: eating raw or undercooked poultry meat, unpasteurized dairy products, contaminated water, contact with the stool of an ill dog or cat (fecal->oral) Very little quantities cause infection (ex. cutting raw chicken on a cutting board then cutting other food and cross contaminating) 4. symptoms: diarrhea (sometimes bloody), cramping, abdominal pain, fever. In people with compromised immune systems it can enter the bloodstream and be life threatening 5. Endotoxin 6. Agent identification/diagnosis: Stool sample culture 7. Gm-, Spiral shaped, nonspore, capsule, non AF 8. Complication lead to neurological disease Guillian Barre Syndrome (progressive paralysis). Bacteria resembles lipid component of nerve tissue provokes an autoimmune attack. 9. N/A 10. Treatment: Almost everyone recovers without specific treatment. Drink plenty fluids. Azithromycin and fluoroquinolones can be used but often times there is resistance to fluoroquinolones. 11. No vaccine 12. Food safety

Pseudomonas Aeruginosa Aerobic GM - RODS Capsule non Endospore Exotoxin=pathogencity Endotoxin=Biofilm

1. Bacterial 2. Causative agent: Pseudomonas aeruginosa 3. transmission: IN SOIL AND WATER. Pseudomonas Dermatitis = Swimming pools saunas and tubs dilated hair follicle entry portal. Most common/most serious is spread through hospitals by hands of healthcare workers and equipment that is not properly cleaned d/t Endotoxin creates BIOFILM Exotoxin creates pathogencity. Mild infections can develop after exposure to water such as hot tubs or pools, eye infections in people who wear contact lenses. Swimmers Ears - otitis externa. Model opportunistic pathogen specially in lung cystic fribrosis and burn patients causes blue green pus (pyocyanin = bacterial pigment) 4.symptoms: -when infection is in the blood: fever, chills, fatigue, muscle and joint pain, very low BP -in the lungs: chills, fever, cough, difficulty breathing -in the skin (called folliculitis): redness, abscess formation, draining wounds -in the ear (swimmer's ear): swelling, ear pain, itching, discharge, difficulty hearing -in the eye: swelling, inflammation, pus, pain, redness, impaired vision also can cause UTI's 5. exotoxin A AND endotoxin 6. Agent identification/diagnosis: pus, blood, or tissue samples, complete blood count, brain scan if in the CNS 7. Gm- bacilli, non endospore, non AF, YES capsule 8. N/A 9. N/A 10. Treatment: Commonly antibiotic resistant. medicines: Quinolones, antipseudomonal b lactam number one choice. SIlver sulfadiazine for burn patients. aminoglycosides, cephalosporins, ceftazidime, ciprofloxacin, levofloxacin, gentamicin, cefepime, aztreonam, carbapenems, ticarcillin, ureidopenicillins 11. No vaccine 12. Prevention: proper cleaning of hands and medical equipment, avoid hot tubs and pools not properly cleaned 13. No elevated IgE levels

Gonorrhea

1. Bacterial 2. Neisseria gonorrhoeae 3. All forms of sex, mother-baby, can cause infection in rectum, genitals, throat 4. Some ppl show no symptoms Men: burning while peeing, discharge from penis, painful testicles Women: often mistaken for bladder i infection. Burning while peeing, discharge, bleeding b/w periods Rectal infection: discahrge, anal itching, soreness, bleeding, painful bowel movement 5. Endotoxins 6. Urine sample, rectal/throat swabs, uretha and cervix swabs 7. Gm-, diplococci, noncapsulated 10. Dual medication of intramuscular ceftriaxone and oral azithromycinf 11. No vaccine 12. Not have vaginal oral or anal sex, be in a monogamous relationship, get STD tested, condoms

Shigellosis

1. Bacterial infection 2. Shigella dysenteriae 3. When people put something in their mouth that has come in contact w/ stool of infected person. Very small amnts can cause infection. Comtaminating hands while changing diaper, touching bathrolm fixtures, eating infected food (flies breed in infected poop then land on food), swallowing pool water, sexual contact 4. Diarrheal disease. Symptoms start 1-2 days afyer exposure. Diarrhea (sometimes bloody), fever, abdominal pain, tenesmus (feeling the urge to poop but having empty bowels) 5. Have endotoxins 6. Diagnosed w/ stool sample 7. Gm-, nonspore forming, non acid fast, non capsulated, short rods 9. Special symptom could be the diarrhea 10. Usually resolves without antibiotics after 5-7 days. Mild fluids and rest and peptobismol are all effective. Shigella is resistance to most antibiotics so doctor has to run tests to see what will work. 11. No vaccine 12. Prevention: wash hands, discard diapers, avoid swallowing lake and pond water, avoid sex with someone recently recovered from diarrhea

San joaquin valley fever

1. Fungal infection 2. Coccidioides immitis 3. People can get it by breathing in the spores from the air. It is not comtagious. 4. Most people do not get sick, but those who do experience: Cough, fever, rash, fatigue, shortness of breath, headache, night sweats, muscle/joint pain Extreme symptoms: skin infection effected: lungs 1%:CNS, bones, joints 6. Diagnosed through blood sample, chest x ray, CT scan of lugs, tissue biopsy, culture 10. Most symptoms go away on their own. Or antifungal meds are used for 3-6 months: fluconazole. SQVF can turn into meningitis which has no cure & requires lifelong treatment 11. No vaccine 12. Prevention: avoid dusty areas, wear face mask, clean skin i juries, preventative antifungal meds 13. Elevated levels of IgE and eosinophilia Areas found: NM, AZ, CA, nevada, TX, utah, mexico, central america

Hantavirus

1. Hantavirus (can turn into Hantavirus pulmonary syndrome or Hemorrhagic Fever with Renal Syndrome) 2. Viral 3. transmission: Infected rodents or their urine and droppings not person to person, not from blood transfusion 4. symptoms: HPS: fatigue, fever and muscle ache, coughing and shortness of breath, can be fatal. HFRS: intense headaches, back and abdominal pain, fever, chills, nausea, and blurred vision. may have flushing of the face, inflammation or redness of the eyes, or a rash. Later symptoms can include low blood pressure, acute shock, vascular leakage, and acute kidney failure, which can cause severe fluid overload. 5. N/A 6. Diagnosis: HPS: symptoms and if person was around a rodent recently HFRS: serology tests, immunohistochemical staining and microscope examination for antigen, evidence in blood or tissue 7. N/A 8. single stranded, RNA, enveloped 10. treatment: HPS: no specific treatment, usually just oxygen therapy and intubated to get through respiratory distress HFRS: careful management of the patient's fluid, maintenance of correct oxygen and blood pressure levels, possible dialysis, Intravenous ribavirin early on 11. No vaccine 12. Rodent control

Yellow Fever

1. Yellow Fever 2. Viral 3. transmission: bite of an infected mosquito, blood transfusion or needlestick (human-to-vector-to-human) 4. symptoms: Mild cases cause fever, headache, nausea, and vomiting. Serious cases may cause fatal heart, liver, and kidney conditions. 5. N/A 6. Diagnosis: patient's clinical features, places and dates of travel, and activities. Lab diagnosis: Virus isolation or nucleic acid amplification tests performed early on, Serologic assays to detect virus-specific IgM and IgG 7. N/A 8. single stranded, RNA, enveloped 10. No specific treatment, rest, fluid, avoid medications, such as aspirin or nonsteroidal anti-inflammatory drugs, which may increase the risk for bleeding 11. Yes vaccine 12. avoid mosquitos, use repellent

Aspergillosis (Aspergillus) Fungal

1. transmission: breathe in Aspergillus spores that are very common indoors and outdoors and rarely infect healthy people. leads to allergies, lung infections, infections in other organs. There is a cutaneous type that enters through broken skin 2. Animal vector: No 3. Symptoms: symptoms of allergic bronchopulmonary aspergillosis -does not cause infection -Wheezing -Shortness of breath -Cough -Fever symptoms of allergic Aspergillus sinusitis -doesnt cause infection -Stuffiness -Runny nose -Headache -Reduced ability to smell symptoms of aspergilloma ("fungus ball") -in lungs or sinuses exclusively -Cough -Coughing up blood -Shortness of breath symptoms of chronic pulmonary aspergillosis -Weight loss -Cough -Coughing up blood -Fatigue -Shortness of breath Invasive aspergillosis (people who are sick with other infections) -very serious -Fever -Chest pain -Cough -Coughing up blood -Shortness of breath 4. Diagnosis: medical history, risk factors, symptoms, physical examinations, chest xray, CT scan of lungs or other organs where infection may be, fluid sample from resp. system if infection in lungs, tissue biopsy, blood test 5. treatment/cure: allergic forms -itraconazole -corticosteroids, invasive -voriconazole -lipid amphotericin formulations -posaconazole -isavuconazole -itraconazole -caspofungin -micafungin 6. vaccine: no 7 prevention: Try to avoid areas with a lot of dust, avoid activites with close contact to soil like gardening, clean injuries well, antifungal meds very difficult to prevent since it is so common in the environment 8. elevated levels: yes

Histoplsmosis- Fungal (Histoplasma capsulatum) Ohio Valley Fever

1. transmission: breathing in fungal spores through the air; bird and bat droppings 2. animal vector: 3. general signs and symp: sometimes none; fever, cough, fatigue, chills, headache, chest pain, body aches 4. body systems: brain and spine; lung, lymph, blood 5. agent identification/confirmation: travel history, blood and urine samples, chest xray, ct of lungs; fluid from respiratory tract, tissue biopsy 6. treatment/cure: yes; sometimes heal on its own 7. special symptom: can develop into a long term lung infection and spread to the central nervous system 7. antibiotics: Itraconazole (antifungal) if turns chronic 8. vaccine: no 9. transmission prevention: don't disturn soil where bird and bat droppings are; avoid cleaning chicken coops, exploring caves and cleaning, remodeling or tearing down old buildings 10. elevated levels: yes

Hookworm -- Helminth (soil transmitted)--Necator americanus /Ancylostoma duodenale

1. transmission: defecation in soil from an infected person and then eggs are deposited into soil; walking barefoot on contaminated soil; the larvae will penetrate the skin (itching or rash here); also ingestion of larvae 2. animal vector: 3. general signs and symptoms: most have none; serious effects abdominal pain, diarrhea, loss of appetite, weight loss, fatigue, anemia and protein deficiency; can affect physical and cognitive growth in kids 4. body systems: small intestine (larvae and adult worms live); GI 5. agent identification/confirmation: stool sample to look for eggs 6. treatment/cure: medications available 7. special symptom: 8. antibiotics: albendazole and mebendazole 9. vaccine: 10. transmission prevention: don't walk barefoot where hookworms are common or there may be fecal in the soil; effective sewage disposal 11. elevated levels: yes

Toxoplasmosis- Protozoan (Toxoplasma gondii)

1. transmission: eating undercooked meat (pork, lamb, venison), drinking contaminated H2O, swallowing parasite after cleaning cat litter, even the dust from the litter, contaminated soil, mom>child, organ transplant (rare) 3. general signs and symp: mostly none, flu-like symptoms, swollen lymph nodes, muscle aches; can go from acute to severe: damage brain, eyes or other organs; infected in womb babies might not get symptoms til later in life 4. body systems: brain, eyes or other organs 5. agent identification/confirmation: serologic testing, stained tissue sections, cerebrospinal fluid (CSF), or other biopsy material, molecular techniques to detect DNA in amniotic fluid 6. treatment/cure: medication available; lesions in eye if ocular disease is diagnosed 7. special symptom: 8. antibiotics: Pyrimethamine (Daraprim), Sulfadiazine 9. vaccine: no 10. transmission prevention: cook food thoroughly, wash and peel fruits and veggies, no undercooked shellfish or unpastuerized goats milk, wash hands and wear gloves while gardening 11. elevated levels: no

Rotovirus (Reovirus) non-enveloped RNA Reoviridae

1. transmission: fecal-oral 2. animal vector: no 3. general signs and symp: watery diarrhea, vomiting, stomach pain, fever, loss of appetite, dehydration, decrease urination, dry mouth, dizzy 4. body systems: GI 5. agent identification/confirmation: symptoms 6. treatment/cure: medications to treat symptoms 7. special symptom: no 8. antibiotics: no 9. vaccine: yes (oral) 10. transmission prevention: good hygiene, hand washing 11. elevated levels: no

Hepatitis B enveloped DNA virus Orthohepadnavirus (HBV)

1. transmission: infected blood, semen or other body fluid enters another body; sexual contact, sharing needles or syringes, or mother to baby at birth;Toxins, certain drugs, some diseases, heavy alcohol use, and bacterial and viral infections; can be acute or chronic; start as acute (same with Hep C) 2. animal vector: no 3. general signs and symp: sometimes none; fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowels, joint pain, jaundice 4. body systems: liver 5. agent identification/confirmation: symptoms and blood sample 6. treatment/cure: no special treatments; will usually heal on its own; but if turns chronic there are a few medications 7. special symptom: no 8. antibiotics: no heal on its own 9. vaccine: yes (IM) 10. transmission prevention: vaccination 11. elevated levels: no

Whipworm Helminth (soil transmitted) CA: Trichuris trichiura

1. transmission: ingesting the whip worm eggs; also commonly found in soil 2. animal vector: 3. general signs and symp: sometimes no symptoms; w/ heavy infection: frequent, painful passage of diarrhea that contains a mixture of mucus, water, and blood; acrid (bitter) smell; severe cases: growth retardation; rectal prolapse, cognitive development in kids 4. body systems: worms live large intestine 5. agent identification/confirmation: eggs in stool sample 6. treatment/cure: treatment available 7. special symptom: no 8. antibiotics: no 9. vaccine: no 10. transmission prevention: cook, wash, and peel veggies/fruit; avoid contact with contaminated soil especially human feces soil; good hand washing; 11. elevated levels: yes

Dermatophyte Infections- Fungal Tinea infections (ringworm, athlete's foot)

1. transmission: person to person through clothes, towels and combs; animals to humans (cats, dogs, goats....); from the environment 2. animal vector: 3. general signs and symp: itchy; ring-shaped rash; red, scaly, cracked skin, hair loss 4. body systems: skin everywhere on body, fingernails and toenails; feet (tinea pedis or "athlete's foot", scalp (tinea capitis), groin (tinea cruris or jock itch), beard (tinea barbae) 5. agent identification/confirmation: looking at skin, skin scrapping under microscope or sent to lab for fungal culture, UV light (rare) 6. treatment/cure: yes; anti fungal over the counter meds usually good for ringworm on skin; ringworm on the scalp usually needs prescription strength anti fungal meds: Griseofulvin (Grifulvin V, Gris-PEG), Terbinafine, Itraconazole (Onmel, Sporanox), Fluconazole (Diflucan) antibiotics: antifungal considered antibiotic?? 7. vaccine: no 8. transmission prevention: don't walk barefoot in damp areas (ie...locker rooms), keep skin clean and dry, keep fingernails/toenails short and clean, changes socks and underwear at least once a day, don't share personal items (clothes, towels, combs), wash after handling pets, athlete's shower immediately after practice 9. elevated levels: yes

Pneumococcal pneumonia- Bacteria gm+ cocci (Streptococcus pneumonia)

1. transmission: respiratory secretions: saliva or mucus; 2. animal vector: no 3. general signs and symp: fever and chills, cough (sometimes bloody), rapid or difficult breathing, chest pain 4. body systems: lung (lung infection); bronchi and aveoli 5. agent identification/confirmation: samples of CSF, blood, sputum or throat, bile solubility test, urine test; if there is bacteria its grown in lab to identify type of bacteria 6. treatment/cure: antibiotics 7. special symptom: complicatons: Bacteremia (blood infection), meningitis (infection of the covering around the brain and spinal cord), death; interferes with oxygen up take; lungs fill with fluid 8. antibiotics: Fluoroquinolones, ciprofloxacin, gemifloxacin, levofloxacin, moxifloxicin, norfloxacin, ofloxacin 9. vaccine: yes 10.transmission prevention: get vaccinated, wash hands often 11. elevated levels: no 12. capsule: yes (makes extremely virulent)

Trichomoniasis- Protozoan (Trichomonas vaginalis)

1. transmission: sex 2. general signs and symp: none usually; can be mild irritation to severe inflammation, itching or irritation inside penis, burning after urinating or ejaculating, discharge from penis, change in vaginal discharge; can last month to years if not treated 3. body systems: vulva, vagina, cervix, urethra, inside penis (urethra), 4. agent identification/confirmation: lab test; can't use symptoms alone 5. treatment/cure: yes antibiotics: metronidazole or tinidazole 6. vaccine: no 7. transmission prevention: abstinence from vaginal, anal or oral sex, monogamy, use condoms (not the best protection) elevated levels: no

Hepatitis C enveloped RNA virus Hepatovirus A (HCV)

1. transmission: sharing infected needles; infected mother to child; less common: sex and sharing personal items; blood borne virus; starts acute and could turn chronic 2. animal vector: no 3. general signs and symp: sometimes none; fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowels, joint pain, jaundice 4. body systems: liver 5. agent identification/confirmation: symptoms and blood sample 6. treatment/cure: acute can sometimes heal on its own; if not there is medication 7. special symptom: no 8. antibiotics: no 9. vaccine: no 10. transmission prevention: 11. elevated levels: no

Hepatitis A non-enveloped RNA Viral

1.transmission: usually spread when a person ingests the virus from contact with objects, food, or drinks contaminated by feces or stool from an infected person, sexual contact (contagious) 2. animal vector: no 3. general signs and symp:fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowels, joint pain, jaundice 4. body systems: liver 5. agent identification/confirmation: symptoms and blood sample 6. treatment/cure: no special treatments; will usually heal on its own 7. special symptom: no 8. antibiotics: no heal on its own 9. vaccine: yes (IM) 10. transmission prevention: vaccination and frequent hand-washing 11. elevated levels: no

Roundworm- 1. Helminth

2. Ascaris lumbricoides 3. eggs are shed in feces of an infected person and under poor sanitary conditions ingested by another person 4. often show no symptoms, can be light symptoms, including abdominal discomfort. Heavy infections cause intestinal blockage and impair growth of children. If there is a cough it is due the migration of worms through body (throat). Worms have been known to leave through navel of children and through the nose. 6. microscopic exam of feces, adult worm will also merge through the anus, mouth, and nose. 9. no "classic signs" 10. mebendazole or albendazole 11. NO VACCINE 12. avoid ingesting contaminated soil, and fertilizer composed of human feces, wash hands, peel, or cook all raw veggies an fruits beore eating. - Life cycle: ingested and go through the upper intestine, eggs hatch into worm-like larvae that go into blood steam the lungs into the throat to then be swallowed and develop into egg laying adults in the intestines.

Gas Gangrene 1. Bacteria

2. Clostridium Perfringens 3. - Ischemia --> necrosis --> gangrene --> gas gangrene - gas gangrene is developed from already dead soft tissue that was either damaged as a wound or from poor circulation(from conditions such as diabetes). Clostridium bacteria thrive in anaerobic conditions from such tissue. so they ferment carbs in these tissues and produce gas (Co2 and hydrogen) that swell the tissue. - also caused by improper abortions *(found in soil and the intestinal tract of humans and domestic animals. Also found in meats, gravies, and pre cooked foods.) -in cases of food poisoning its caused when large quantities of food are prepared and kept warm for a long time before serving (such as cafeterias) 4. black necrotic tissue, systemic illness, swollen tissues, and even death 5. toxins hat move along muscle bundles, killing cells, and producing necrotic tissue for more favorable anaerobic conditions 6. Skin culture, physical exam, blood tests for white blood cell count, and a fecal sample for spores. 7. Gram + Rod (bacilli), SPORE forming, anaerobe, no cap, non AF 9. black necrotic tissue (pg. 646) 10. surgical removal of necrotic tissue, and amputation, hyperbaric chamber (pressurized oxygen-such atmosphere) for patients with gas gangrene in abdominal cavity or reproductive tract. - for food poisoning- oral rehydration, IV fluids, and electrolyte replacement. 11. NO VACCINE 12. prompt cleaning of serious wounds and precaution treatment with penicillin, no antibiotics are recommended.

SARS 1. Virus

2. Corona Virus 3. transmitted through close person-person contact with an infected person (droplet spread), by fomite, and is also airborne. 4. high fever, headache, discomfort, body aches, and mild respiratory symptoms. 10-20% of people had diarrhea, dry cough and pneumonia like symptoms. 6. If a person has traveled to an area where SARS is prevalent and have SARS like (or pneumonia like) symptoms then they should assume SARS. - isolate culture - reverse transcription polymerase chain reaction test can detect SARS-CoV in blood, stool, and nasal secretions. -Serologic testing also can be performed to detect SARS-CoV antibodies produced after infection. 8. RNA, single stranded, enveloped 9. no "classic" signs 10. SARS patients should get the same treatment that would be used for a patient with any serious community-acquired atypical pneumonia. SARS-CoV is being tested against various antiviral drugs to see if an effective treatment can be found. - no drug treatment so far and some patients will require oxygen 11. NO VACCINE 12. isolating infected person and infected person should stay away from people. - wash hands with soap and water or use of an alcohol-based hand rub. - avoid touching eyes, nose, and mouth with unclean hands - cover nose and mouth with a tissue when coughing or sneezing.

CMV- 1. Virus DNA Enveloped (human Herpesvirus 5)

2. Cytomegalovirus 3. Transmission: through body fluids (saliva, semen, blood, urine, tears, breast milk), kissing, sexually, congenitally, transfused blood, and tissue transplant. 4. no symptoms in healthy adults or may resemble a mild case of mononucleosis It will show more symptoms in those who are immune compromised (fever, sore throat, fatigue, swollen glands).They can slo get symptoms in eyes, lungs, liver, esophagus, stomach, and intestines. They may form rash, but accompanied by another child-hood disease. It's a frequent cause of life-threatening pneumonia in those whose immune system is compromised, and AIDS patients exhibit CMV eye infections (CMV retinitis) -Babies born with CMV or CID (cytomegalic inclusion disease) can have brain, liver, spleen, lung and growth problems. Along with hearing loss, small heads, seizures, retardation, and lack of coordination. in some cases CMV can cause miscarriages.mother that has cmv during conception less likely to pass it on. Mother thats pregnant and gets cmv then will highly pass it to child. 6. CMV infects cells and cause a formation of distinctive inclusion bodies (owl's eyes) when bodies are in pairs and are identifiable under microscope. Blood test, serological test (for blood donations) 8. DNA, enveloped 9. no "classic" sign 10. glanciclovir, if resistant strain then foscarnet -healthy people do not require treatment 11. NO VACCINE 12. when donating blood test it with serological test and remove white blood cells from blood. When donating tissue, test it by immunoglobulin preparation containing a standardized amount of antibody and there are now products that contain antibodies to neutralize CMV in donated tissue, wash hands especially after changing diapers

Toxic Shock Syndrome 1. Bacterial

2. Staphylococcus Aureus and Streptococcus Pyogenes 3. *Staph - endogenous infection (from normal flora) - either from broken skin or invaded by medical procedures such as catheter being inserted or removed from veins, and bacteria entering through hair follicles. 3. *Strep - skin abrasions, and coming in direct contact with an infected person 4. *Staph - inflammatory response, pus, crusted over pustules, peeling skin, Scalded skin syndrome that later becomes Toxic Shock Syndrome. (TSS) -TSS- fever, vomiting, sunburn-like rash followed by shock, and organ failure especially in the kidneys. (pg. 583) - TSS has been linked to super absorbent tampons being left in too long, but is now uncommon. Nasal surgery absorbent packing is also the same idea. 4. *Strep - No rash, but there is tissue destruction (necrotizing fasciitis) , and organ damage, and an 80% death rate (higher than with staph TSS). (pg. 585) 5. *Staph toxins *coagulase positive * secrete proteins that block chemotaxis of neutrophils to infection site, and also produce toxins that kill phagocytic cells *can survive on a phagosome * respond to the immune system as a super antigen, but is able to evade the adaptive immune system entirely * TSS toxin 1 formed at the growth site and circulates in the bloodstream 5. *Strep toxins - hemolysins- lyse RBC's - streptolysins- lyse RBC and toxic to neutrophils - M protein- external to cell wall on fibrils: they prevent activation of complement an allow microbe to evade phagocytosis and kill neutrophils. they also adhere to mucous membrane. - streptokinase: dissolve blood clots -hyaluronic acid: dissolves hyaluronic acid connective tissue that cements cells together - deoxyribonucleases: degrade DNA 6. *Staph and Step (no info about this in the book) - both are diagnosed by culturing media - 7. *Staph: Gram +, cocci shaped (clustering sphere) non- spore, non-AF, no cap 7. *Strep: Gram +, cocci shaped (chain sphere), non-spore, no cap, non-AF 9. *Staph: lesions of scalded skin syndrome (early signs pg. 583) 9. *Strep: none 10. *Staph: IV fluids and electrolyte replacement, cleaning and treating of wounds, antibiotics through veins (intravenous) nafcillin or oxacillin with clindamycin 10. * Strep: cephalosporin, surgical removal or reconstruction, and amputation 11. *Staph and Strep: NO VACCINE 12. *Staph - wounds should always be cleaned and so should catheters - women should avoid super absorbent tampons 12. *Strep- no direct contact with infected person

Influenza Viral Eight Seperated RNA segments enclosed by inner layer of protein, enveloped Orthmyxovirus --There are 4 types of influenza viruses: A, B, C and D

A and B: seasonal epidemics almost every winter in the U.S. C: generally cause a mild respiratory illness and are not thought to cause epidemics D: primarily affect cattle and are not known to infect or cause illness in people. transmission: droplets made when people with flu cough, sneeze or talk animal vector: no; birds can carry the virus avian and mammalia, swine can be a warm freezer for virus. Hemoglutinin spikes and Neuramindase spikes differentiate virus H vs N ex H1N1 general signs and symp: chills, fever, headache, and muscular aches body systems: agent identification/confirmation: can't use symptoms alone; nasal washes or swabs in Drs office treatment/cure: antiviral drug amantadine and rimantadine reduce the symptoms of influenza A; zanamivir (relenza) inhaled and oseltamivir (Tamiflu) taken orally special symptom: Fever* or feeling feverish/chills, Cough, Sore throat, Runny or stuffy nose, Muscle or body aches, Headaches, Fatigue (tiredness), Some people may have vomiting and diarrhea, though this is more common in children than adults *don't always have fever antibiotics: no vaccine: yes inhaled transmission prevention: wash hands, stay away from sickos, stay home if sick, avoid touch face, get vaccinated elevated levels: no

Syphillis GM - spirochete Very complex primary stage (very infectious on site of infection) secondary stage (very infectious on lesions throughout body) latent stage (mother to fetus very infectious) (not normally infectious) only to fetus tertiary stage (not very infectious) Sexual contact 1st and 2nd stage dentist and health care workers can get non sexual exposure through lesions and chancre fluids from minute breaks in the skin and introducing the spirochete.

Bacteria Treponema Palladium NO animal vector Transmitted: Sexual contact of all kinds via syphilitic infections of the genitals or other body parts. Primary Stage -small hard chancre (sore) appears at site of infection. avg. 3wks exposure -Chancre is painless and an exudate of serum forms in center(FLUID IS HIGHLY INFECTIOUS) -Lesion disappears in couple of wks. -Many women are unaware because chancre often appears in cervix and urethra in males (which is not visible) -Bacteria then enters the blood and lymph system- distributes widely in body. Secondary Stage -Characterized mainly by skin rashes of varying appearance -widely distributed on skin and mucous membranes (especially visible on palms and soles ) -Loss of patches of hair, malaise, mild fever, few exhibit neurological symptoms -Lesions contain lots of spirochetes (highly infectious) -subtle disease- half the patients recall lesions at all Latent Period -Secondary syphilis subside after a few weeks and enter the latent period -NO SYMPTOMS 2-4 years latency -Not normally infectious only transmission from mother to fetus -Majority cases dont progress past latent stage even w/o treatment. Tertiary Stage -gummatous syphillis- characterized by gummas, form of progressive inflammation that appear as rubbery masses of tissue in various organs (most common skin, mucous membranes, and bones) after about 15 YEARS!! -Local destruction of tissue- no death or incapacitation Cardiovascular Syphilis - results in weakening of the aorta Neurosyphylis - CNS affected Personality changes, dementia, seizures, loss of coordinated voluntary movement, partial paralysis, loss of ability to use or comprehend speech, loss of sight hearing, loss bowel and bladder control -few pathogens to none in tertiary stage - not very infectious Congenital syphilis -most dangerous -transmitted across the placenta to fetus -damage to mental development -most common when pregnancy happens in latent stage -pregnancy in 1st and 2nd stage likely produce stillbirth -treatment antibiotics first six months of pregnancy Diagnosis- complex because each stage has unique requirements -3 general group test -preliminary test - microscopic &nontreponemal confirm test- treponemal serological test Primary stage- microscopic detect spirochetes in lesions and direct flourescent antibody test secondary stage -nontreponemal serological test detect a reagin type Antibody. Antigen is used from a extract of beef heart (cardiolipin) -70-80% primary syphilis cases but 99% 2nd stage syphylis -EX. slide agglutination VDRL test (veneral disease research labarotary) -ELISA test uses a VDRL antigen -rapid plasma reagin Treponemal stage (confirm test) -enzyme immuno Assay (EIA) -rapid diagnostic test (RDT's) -finger prick for blood treatment test used to confirm -Fluorescent treponemal antibody absorption test (FTA -ABS) indirect flourescent antibody test Treatment- Benzathine penicillin penicillin sensitive people- azithromycin, doxycycline, tetracycline GRAM Negative spirochete -no obvious virulence factors such as toxins -produces several lipoproteins that induce inflammatory immune response which cause tissue destruction. NO VACCINE prevention- safe sex and protective equipment when handling patients with sores and lesions.

Cholera

Bacteria (gm-) curviformvibrios Vibrio cholerae have endotoxins transmission: through drinking water or contaminated food feces usually contaminates the water/food insect vector: no symptoms: watery diarrhea "rice-water stools), vomiting and leg cramps; dehydration and shock; death body systems involved: toxins/factors that increase virulence: how agent is identified: how confirmed: stool sample/rectal swab under microscope special symptoms: Treatment: rehydration therapy, antibiotic treatment and zinc treatment common antibiotics: Doxycycline is recommended as first-line treatment for adults, while azithromycin is recommended as first-line treatment for children and pregnant women; tetracycline vaccine: yes two oral vaccines are available transmission prevention: drink/eat safe food; wash your hands with soap and safe water; use latrines and don't poop in the water; cook food well

Chlamydial infections

Bacteria (gm-) Chlamydia trachomatis (STD, eye infections) transmission: vaginal, anal and oral sex animal vector: no general symptoms: abnormal vaginal/penal discharge; burning urination; pain or swelling in testicles; conjunctival irritation; sometimes no symptoms body systems involved: urogenital and eyes Virulence factors: cell wall of chlamydia inhibit phagolysosome fusion enabling to survive and multiply. Elementary bodies encased in impervious envelope that ensures survival outside of host cell how is agent identified: urine sample or cotton swab confirmation of agent: special symptoms: sometimes non at all treatment: yes common antibiotic: azithromycin, doxycycline transmission prevention: abstinence, condoms and monogomy

Strep Throat

Bacterial Streptococcus Pyogenes -Most commonly transmitted by respiratory secretions - epidemics of strep pharyngitis used to spread frequently through unpasteurized milk (maybe animal vector because cow milk.) symptoms- Inflamed mucous membranes of the throat. -characterized by local inflammation and fever. -frequent tonsillitis- lymph nodes in neck swell and become tender and enlarge. -Otitis media complication as well. Infection is caused by group A streptococci (GAS)- resistance to phagocytosis. (Increase pathogenicity.) -Produce special enzymes called streptokinases which lyse fibrin clots & streptolysins which are cytotoxic to tissue cells, RBC's, and protective leukocytes WBC's Diagnose -Culturing bacteria from throat swabs -Rapid antigen detection of GAS directly on throat swab, use latex indirect agglutination methods. -replaced by immunoassay test (EIA)- more sensitive and easier to read. gram positive cocci non-spore typically have a capsule-composed of hyaluronic acid and are beta hemolytic negative acid fast NO VACCINE Treatment PENICILLIN (some resistance to erythromycin has appeared) -prevention (sanitation methods) washing hands, avoid touching nasal portal entry's. Extra information- Majority of patients seen for sore throats don't have strep infection. Many are virus infections so antibiotics are useless. Areas where acute rheumatic fever occurs, recommendation is use both bacterial culture and rapid tests.

E coli

Diarrheal and hemorrhagic 1. Bacterial 2. Escherichia coli 3. transmitted through contaminated water or food, or through contact with animals or persons 4. severe stomach cramps, diarrhea (often bloody), and vomiting. If there is fever, it usually is not very high. Systems and organs: respiratory, urinary (UTI), intestines 5. Endotoxins 6. Stool samples 7. Gram-negative, rod-shaped 10. Hydration, no antibiotics (can make it worse) 11. No vaccine 12. Wash hands, cook meat thoroughly, prevent food cross contamination, avoid swallowing recreational water, avoid raw milk and unpasteurized dairy

Candidiasis (yeast and thrust inf.)

Fungal Candida albicans how transmitted: how does person get infected: enters through bloodstream and spreads throughout the body animal vector: no symptoms: white patches on the tongue and mouth, redness/soreness, difficult swallowing cracking at corners of mouth body systems involved: how agent is identified: symptoms and scraping the area to examine under microscope, positive culture test (not a confirmed diagnosis by itself) how confirmed: special symptoms: white patches in mouth treatment: yes common antibiotics used: clotrimazole troches and nystatin vaccine: no transmission prevention: good oral hygiene

Peptic Ulcers, Stomach ulcers GM- spirilla

Helicobacter pylori spiral gram negative endotoxins and exotoxins Etiology - Stomach produce proteolytic enzyme and hydrochloric acids h. pylori survive by making area of infection basic using UREASE to neutralize environment, stomach acid causes ulcers -transmission: unknown; most likely person to person fecal to oral or oral to oral; possibly contaminated water; latrogenic spread through contaminated endoscopes has been documented but can be prevented by proper cleaning of equipment; CDC still studying this -animal vector: no -general signs and symp: gnawing or burning pain in the abdomen between breast bone and belly button; usually occurs when stomach is empty; less common: vomiting (maybe bloody), nausea and loss of appetite -body systems: stomach and duodenum -agent identification/confirmation: blood test, urea breath test or endoscopy and perform biopsy and culture of tissue -treatment/cure: treatment options: see antibiotics -special symptom: could develop into gastric cancer -antibiotics: Omeprazole + clarithromycin x 2 wks, then omeprazole x 2 wks -OR- Ranitidine bismuth citrate (RBC) + clarithromycin x 2 wks, then RBC x 2 wks OR- Bismuth subsalicylate (Pepto Bismol®) + metronidazole + tetracycline x 2 wks + H2 receptor antagonist therapy as directed x 4 wks -OR- Lansoprazole + amoxicillin + clarithromycin x 10 days -OR-Lansoprazole + amoxicillin x 2 wks -OR- Rantidine bismuth citrate + clarithromycin x 2 wks, then RBC x 2 wks -OR- Omeprazole + clarithromycin + amoxicillin x 10 days -OR-Lansoprazole + clarithromycin + amoxicillin x 10 day -vaccine: no -transmission prevention: wash hand throughly -elevated levels: no

Schistosomiasis

Helminth Worm Schistosoma haematobium S. Mansoni S. japonicum transmission: animal vector: snail's carry general symptoms: rash, itchy skin, fever, chills, cough and muscle aches body systems involved: intestine, liver, lungs and bladder how is agent identified: stool or urine samples to see if you have the parasite. A blood sample can also be tested for evidence of infection. For accurate results, you must wait 6-8 weeks after your last exposure to contaminated water before the blood sample is taken agent confirmation: rise of chronic organ enlargement treatment: yes antibiotics: Praziquantel vaccine: no transmission prevention: avoid swimming in freshwater in other countries, drink safe water, heat water by boiling at least a min

Meningitis (N. meningitis, H. influenzae)

Meningococcal meningitis 1) Bacterial 3) Transmision: H. Influenza- endogenous infection normal flora found in our throat can occasionally enter blood stream and cause disease. Aerosols (however less common strain becasuse of vaccination) N. meningitis - normal flora nose and throat- direct contact with secretions and droplet aerosols (dangerous strain of meningitis) 4) symptoms- head ache, neck stiffness, and nausea rash that doesn't fade when pressed ( indication of meningitis (classic sign as well) 5) endotoxin 6) diagnose- spinal tap ,lumbar puncture of cerebral spinal fluid (CSF) gram stain on CSF ID's pathogen culture bacteria as well from CSF and latex agglutinations test are done (however negative test does not eliminate possibility of less common bacterial pathogen or non bacterial cause) it could be viral, fungi, or protozoan meningitis) 7) N. meningitis - gram negative diplococci, capsule h. influenza gram negative coccobacilli, capsule 10) treatment- cephalosporins (both) 11) vaccine for both capsule vaccine for n. meningitis (no vaccine for strain B only for strains A,C, W-135, X, and Y strain B is similar to fetal tissues so chances are it could damage host and produce antibody against host hib vaccine for h.influenza 12) prevention- vaccination leads to herd immunity- less chance of encounter with pathogen) 13) NO elevated IgE

Amebic dysentery

Protozoan Entamoeba histolytica transmission: fecal in mouth; food and water contamination; swallows mature cysts; some forms of sexual contact animal vector: no symptoms: loose feces, stomach pain, bloody stools and fever; weightloss body systems involved: Caecum, appendix, colon, rectum / GI, liver agent identification: fecal and blood samples special symptoms: stomach pain treatment: yes antibiotic: Iodoquinol, metronidazole (flagyl), tinidazole, paromomycin. vaccine: no transmission prevention: Control centers on adequate disinfection of water. Boiling or idodine tx due to cysts resistance of chlorine elevated levels:

Giardiasis

Protozoan Giardia lamblia transmission: swallowing picked up from surfaces, drinking water from untreated source, eating undercooked food, being in contact with someone with giardiasis, traveling where giardiasis is common; anything that comes in contact with poop (no blood transmission) animal insect vector: no symptoms: diarrhea, gas, greasy, floating stools, stomach cramps, nausea, dehydration agent identification: stool sample special symptoms: no treatment: yes antibiotics: Metronidazole vaccine: no transmission prevention: wash hands, avoid contaminated water and food, avoid contact with poop during sex

Malaria

Protozoan Plasmodium vivax, P. falciparum mosquito bite, transmitted by unsterilized syringes, blood transfusions yes there is an insect vector (mosquito) chills, fever, vomiting, headache affects the liver, circulatory, immune system and RBC's examining under the microscope a drop of the patient's blood, rapid diagnostic tests, Parasite nucleic acids are detected using polymerase chain reaction, Serology no special symptoms (most mimic colds and flu) treatment is available doxycycline, quinine no vaccines available prevent transmission by using prescription drugs, wearing long clothing and using insect repellant elevated levels of IgE

African Sleeping Sickness

Protozoan Trypanosoma brucei transmitted to humans from the bites of tsetse fly vectors (who received from an infected human or another animals that have human pathogenic parasites) yes there is a insect vector (tsetse fly) first stage: fever, headache, joint pain, itching; second stage: changes of behavior, confusion, poor coordination, disturbance in sleep cycles central nervous system is involved identified by serological tests and checking for clinical signs, especially swollen cervical lymph nodes; is it present in the body fluids, examining the cerebrospinal fluid special symptom: disturbance in sleep treatments: yes antibiotics: Pentamidine (1st stage); melarsoprol (2nd stage) vaccine: no transmission prevention: wear long, neutral colored clothing, inspect vehicles before entering, avoid bushes and use insect repellant elevated levels: no

Dengue Fever (Flavivirus) *aka "break bone fever"

RNA Virus--enveloped *single positive stranded -transmission: In order for transmission to occur the mosquito must feed on a person during a 5- day period when large amounts of virus are in the blood; this period usually begins a little before the person become symptomatic; although rare it can also be transmitted in organ transplants or blood transfusions and can pass from mother to fetus -animal vector: mosquito -general signs and symp: asymptomatic to flu-like symptoms usually develop 4-7 days after mosquito bite and last 3-10 days; can develop into lethal complications called severe dengue; painful back, muscle, joint pain, bone pain, severe headache, fever, rash, pain behind the eyes, severe bleeding and organ impairment. -body systems: -agent identification/confirmation: serology -treatment/cure: not really but possible can be treated with fluid replacement therapy if early diagnosed; can try and control with effective vector control measures -special symptom: -antibiotics: no -vaccine: no -transmission prevention: eliminate standing water around home, use insect repellent, wear long sleeves and pants -elevated levels: no -misc info: endemic in Caribbean, south america and other tropical environments; leading cause of death among southeast Asian children; becoming more prevalent in the U.S.; urban and semi-urban areas; there are four virus types, is a patients effectively fights off one but is reinfected with another dengue hemorrhagic shock can occur

Poliomyelitis (enterovirus) (picornavirus)

RNA Virus--non-enveloped *single stranded -transmission: ingestion of water contaminated with feces containing the virus (fecal-oral route) -animal vector: -general signs and symp: can be asymptomatic; headache, sore throat, fever, nausea, stiff neck, painful limbs -body systems: agent identification/confirmation: isolating the virus from feces and throat secretions; cell cultures can be inoculated and cytopathic effects on cells can be observed; serology -treatment/cure: no -special symptom: can cause paralysis, but pretty rare -antibiotics: no -vaccine: yes -transmission prevention: get vaccinated -elevated levels: no -misc info: found in areas with poor sanitation; multiplies in the throat and small intestines (initial sore throat and nausea); then virus invades the tonsils and lymph nodes of the neck and ileum (terminal end of small intestine); then enters blood resulting in viremia; might eventually at this point penetrate the capillary walls and enter the CNS where the virus displays a high affinity for nerve cells, particularly motor nerve cells in the upper spinal cord; it doesn't infect the PNS or the muscles; as virus multiplies, cells die and paralysis results; death can result from respiratory failure; middle aged adults that had polio as a kid may now show muscle weakness called postpolio syndrome; usually only affects kids under

other staph and strep infections

Staphylococcus Infections gram positive cocci that grown in grape clusters Impetigo- contagious skin infection transmitted by direct contact can also be caused by s. pyogenes more common is non bullous impetigo- enters through breaks in skin treated with topical antibiotic- lesions can heal without antibiotic and no scarring bullous impetigo- staphlycoccal toxin- produces scalded skin syndrome 2 serotypes Toxin A- localized causes bullous impetigo Toxin B- circulates - causes scalded skin syndrome toxin causes exofoliation separation of skin layers problem in nurseries pemphigus neonatorum or impetigo of the newborn Food Poisoining Staphylococal inf. ingested enterotoxin produced by staph aureus (serological type A most common) enzyme coagulates blood plasma (coagulase positive) -growth of microbe is facillatated by cooking heat kills other microbes (competition) because s. aureus has high heat resistance -survives high osmotic pressure -custards, hams, cream pies high risk foods -toxin survives 30 min of boiling -once ingested toxin triggers vomit reflex , abdominal pain -almost zero mortality in healthy people -diagnose by symptoms- culture bacteria if food not heated . isolate bacteria and phagetype. Strep Infections Streptococci skin infections- gram positive spherical bacteria that grow in chains -secrete toxins and enzymes toxins- hemolysins alpha, beta , gamma beta associated with human disease GAS group a streptcocci -m protein found in some strains- prevents complement activation avoids phagocytosis -capsule hyaluronic acid- resembles human connective tissue streptokinases- enzymes that dissolve blood clots hyaluronidase- enzyme dissolves hyaluronic acid in connective tissue deoxyribonucleases-enzyme degrades DNA streptolysins- lyse RBC's toxic to neutrophils Necrotizing fascitis - Group A strept flesh eating bacteria- may destroy tissue as rapid as surgeon can remove streptococcal m protein types produce exotoxin A - acts as a superantigen because it causes Immune system to be part of the damage Treatment- broad spectrum antiobiotic surgical removal of tissue Scarlet fever s. pyogenes produca and erythrogenic (reddening) toxin causes pinkish red skin rash and high fever rheumatic fever s. pyogenes short period of arthritis and fever expression Inflamation of the heart that damages valves because immune system misdirects attack at heart. 2nd attack can be lethal to the heart and lead to failure and death. s. pneumonia pnuemoccal meningitis gram positive diploccocci , capsule meningitis leading cause responsible for otitis media vaccine available Hib vaccine deadly for children and older people

Herpes Simplex 1,2

Virus (enveloped DNA virus) (HSV-1, HSV-2) HSV-1=Herpes labialis, ocular herpes/herpetic keratitis, gingivostomatitis, pharyngitis; HSV-2=Herpes genitalis transmission: direct exposure to secretions or lesions with virus, multiply in basal and epithelial cells general symptoms: inflammation, edema, cell lysis, urethritis, painful urination, cervicitis, itching--HSV-1: fever blisters/cold sores break out after tingling/itching, pain in area and lesion crust; HSV-2: malaise, anorexia, fever, bilateral swelling, then sensitive vesicles break out in cluster on genitalia, perineum, buttocks virulence: HSV-1= Latency occurs in trigeminal ganglion/ fifth cranial nerve that extends to oral region. HSV-2=Latency occurs in lumbosacral spinal nerve trunk. Triggers of recurrent infection= fever, UV radiation, stress, mechanical injury body system involved: nervous system, mucous membrane. HSV-1= facial herpes (Oral, Optic, Pharyngeal). HSV-2= genital herpes how agent identified: small, painful vesicles on mucous membrane of mouth/genitals, lymphadenopathy, exudates. Stained scrapings from base of lesion, growth in tissue culture, antibody tests (fluorescent/DNA probes), PCR. Presence of multinucleate, giant cells, inclusion bodies inside nucleus. A specimen of tissue/fluid is introduced to primary cell line such as monkey kidney or human embryonic kidney, then observed for cytopathic effects within 24-48 hours. special symptoms: treatment: yes cure: no antibiotics: Acyclovir (Zovirax); Famciclovir and valacyclovir vaccine: no transmission prevention: condoms, sexual contact (for those who have an active infection), extreme care w/ child for mothers w/ cold sores; no kisses on mouth, medical & dental personnel should wear gloves

Genital Warts (HPV)

Virus Human Papilloma Virus non enveloped double-stranded DNA virus transmission: vaginal, anal or oral sex animal vector: no general symptoms: no or minimal symptoms body systems involved: vagina/penis, urethra, anal skin, skin of hands, feet and body how is agent identified: small bump or groups of bumps in the genital area; they can be small or large, raised or flat, or shaped like a cauliflower confirmation of agent: pap test special symptoms: treatment: no cure antibiotics: none vaccine: three HPV vaccines—Cervarix®, Gardasil®, and Gardasil® 9 transmission prevention: vaccine, safe sex, condoms, gloves

Cody--Prions

Virus, There are currently 5 prion diseases;Creutzfeldt-Jakob Disease (CJD),Variant Creutzfeldt-Jakob Disease (vCJD),Gerstmann-Straussler-Scheinker Syndrome, Fatal Familial Insomnia, Kuru Prion diseases or transmissible spongiform encephalopathies (TSEs) are a family of rare progressive neurodegenerative disorders that affect both humans and animals. They are distinguished by long incubation periods, characteristic spongiform changes associated with neuronal loss, and a failure to induce inflammatory response. The causative agents of TSEs are believed to be prions. The term "prions" refers to abnormal, pathogenic agents that are transmissible and are able to induce abnormal folding of specific normal cellular proteins called prion proteins that are found most abundantly in the brain. The functions of these normal prion proteins are still not completely understood. The abnormal folding of the prion proteins leads to brain damage and the characteristic signs and symptoms of the disease. Prion diseases are usually rapidly progressive and always fatal. Creutzfeldt-Jakob Disease (CJD) -The most common form of classic CJD is believed to occur sporadically, caused by the spontaneous transformation of normal prion proteins into abnormal prions -No specific therapy has been shown to stop progression of this disease. -Treatment:Diagnosed by standard neuropathological techniques; and/or immunocytochemically; and/or Western blot confirmed protease-resistant PrP; and /or presence of scrapie-associated fibrils. -CJD is not transmissible from person-to-person by normal contact or through environmental contamination.

Pneumocystis jiroveci (Fungal) causes Pneumocystis pneumonia, or PCP lung disease

the most common opportunistic infection in people with HIV 1. transmission: still remains unclear for humans, however DNA has been identified in ambient air, and airborne transmission between humans is likely. This is supported by reports among immunosuppressed patients, transmission of Pneumocystis DNA from PcP patients to healthcare workers, and transmission of Pneumocystis infection from a mother with PcP to her susceptible child. 2. Animal vector? No 3. symptoms:latent infection cough, fever, rapid breathing, shortness of breath, fatigue, night sweats. Can, cause lung infection in people with weakened immune system due to cancer, AIDS, Long-term use of corticosteroids, organ or bone marrow transplant. Can lead to complications such as pneumothorax, pleural effusion, or respiratory failure 4. diagnosis: tests include blood gases, bronchoscopy, lung biopsy, chest xray, sputum exam, CBC, ß-1,3 glucan level in the blood 5. treatment/cure: does not respond to antifungals. The treatment of choice= Trimethoprim-sulfamethoxazole (TMP-SMX), w/ second-line agents including pentamidine, Clindamycin, dapsone (often in combination with pyrimethamine), or atovaquone 6. vaccine: no 7. prevention: double-strength tablet of TMP-SMX 8. elevated levels: Yes

trichinosis (Trichinellosis) Helminth Trichinella spiralis

transmission: eating raw or undercooked Pork, or meat from animals infected with the microscopic parasite Trichinella cyst--typically bear, pork, wild feline (such as a cougar), fox, dog, wolf, horse, seal, or walrus, Ground meat by contaminated machinery. Human ingest cyst into intestine get unfolded developes into to adult and localize into muscles especially diaphragm and eye muscles. animal vector: general signs and symp: first symptoms: Nausea, diarrhea, vomiting, fatigue, fever, and abdominal discomfort; later symptoms: Headaches, fevers, chills, cough, swelling around eyes, small hemorrhaging under fingernails aching joints and muscle pains, itchy skin, diarrhea, or constipation; if patient is heavy may have breathing and heart probs and difficulty coordinating movements body systems: the stomach acid dissolves the hard covering of the cyst and releases the worms agent identification/confirmation: blood test ELISA or muscle biopsy treatment/cure: anti-parasitic drugs albendazole, mebendazole corticosteroids to reduce inflammation. special symptom: antibiotics: no vaccine: no transmission prevention: cook meat to safe temps, wash hands, clean meat grinders thoroughly elevated levels: yes

Pinworm Helminth Enterobius vermicularis

transmission: fecal-oral route, swallowing infective pinworm eggs that are on fingers, clothing, bedding or food, can be ingested through the air animal vector: general signs and symp: itching around the anus which can lead to difficulty sleeping and restlessness, sometimes mild and have no symptoms body systems: live in colon and rectum of humans agent identification/confirmation: itching the anus during the night, worms can sometimes be seen 2-3 hours after someone has gone to sleep, tape test in the anus for 3 consecutive mornings; rarely found in fecal samples treatment/cure: prescription or over-the-counter drugs--mebendazole, pyrantel pamoate, or albendazole special symptom: antibiotics: no vaccine: no transmission prevention: good hygiene, proper hand washing, keep fingernails short, don't nail bite or scratch your anus elevated levels: yes

Rabies Viral -Single Strand RNA enveloped Rhabdovirus Genus:Lyssavirus

transmission: saliva from bite from an infected animal; rarely may cross mucous membranes of the nose, mouth and eyes; sometimes from corneal transplants animal vector: silver haired bats, dogs, cats, skunk, bat, fox, coyote, bobcat or raccoon general signs and symp: fever, headache and general weakness or discomfort...when CNS becomes involved patients tent to alternate between agitation and calmness; spasms of muscles of the mouth and pharynx when patient feels air drafts or swallow liquids; even thinking of water can bring on spasms; final stages extensive nerve damage of the brain and spinal cord. As the disease progresses, more specific symptoms appear and may include insomnia, anxiety, confusion, slight or partial paralysis, excitation, hallucinations, agitation, hypersalivation (increase in saliva), difficulty swallowing, and hydrophobia (fear of water). Death usually occurs within days of the onset of these symptoms body systems: proliferates in PNS and moves to CNS, skeletal muscle and connective tissue agent identification/confirmation: viral antigen using the direct fluorescent-antibody (DFA) test using saliva, blood, CSF or skin; postmortem samples from brain; rapid immunohistochemical test (RIT) in less-developed parts of the world treatment/cure: once symptoms appear there is very little effective treatment; most survivors received PEP before the appearance of the symptoms; can induce an extended coma to minimize exictability while administering antiviral drugs (Milwaukee protocol) induce coma to slow CNS while administering antivirals special symptom: doesn't travel through the blood stream or lymph system only through connective tissues and muscles. antibiotics - no vaccine: yes --Human diploid cell vaccine (HDCV) or purified chick embryo cell vaccine (PCECV) Humans Rabies immune Globulin (RIG) transmission prevention: if animal is positive patient must undergo postexposure prophylaxis (PEP)-antirabies vaccinations and immune globulin injections, make sure pets shots are up to date

Chicken pox (Varicella) /shingles (Herpes Zoster) Viral enveloped DNA Herpesvirus Varicella Zoster

transmission: touching or breathing in virus particles that came from chicken pox blisters and possibly droplets in the air from infected person animal vector: no general signs and symp:Chicken Pox- itchy rash (can be all over body including in mouth, eyelids and genitals), fluid filled blisters that will scab, fever, tiredness, loss of appetite, headache Latent Varicella Zoster - Shingles the virus lay dormant in the dorsal ganglion near the spine stress immune compromise by aging no on under 20 usually older adults usually develops only once occurs around waist area can lead to nerve damage on one side. Burning Stinging sensation - Postherpedic neuralgia body systems: skin agent identification/confirmation: blood spot method, preparation of serum from whole blood, polyester swab method, glass slide method, collecting scabs, collecting CSF or biopsy tissue treatment/cure: Calamine lotion and colloidal oatmeal baths may help relieve some of the itching. Keeping fingernails trimmed short may help prevent skin infections caused by scratching blisters; acetaminophen for fever, Shingles RX- acyclovir, valacyclovir and Famciclovir special symptom: antibiotics: no vaccine: yes transmission prevention: get vaccinated can get it again breakthrough varicella would need booster vaccination also boost for 60 plus adults elevated levels: no

Botulism (Clostridium botulinum) Bacterial gm+, endotoxin, rodshaped, Endospore forming, produce the neurotoxin botulinum, encapsulated

types of botulism:foodborne, wound, infant, adult intenstinal toxemia, latrogenic Type A - most virulent death occurs lethal dose can be absorb thru skin. most heat resistant- proteolytic (breakdown protein) release foul odor. southwest regions Type B - european outbreak/ east of US proteolytic and non proteolytic Type E - marine and lake sediments less heat resistant non proteolytic, seafoof pacific north west. can live in o2 and fridge temp. -symptoms: double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, muscle weakness symptoms in infants: lethargic, feed poorly, constipated, weak cry, poor muscle tone if symptoms untreated, can lead to paralysis -diagnosis and confirmation: brain scan, spinal fluid examination, nerve conduction test (electromyography, or EMG), and a tensilon test for myasthenia gravis, test for botulinum toxin -treatment: antitoxin, induced vomiting and enemas to release food from gut if that was the mode of trans., antibiotics penicillin G or metronidazole -vaccine -prevention: appropriate canning methods in canning food at home, do not feed infants honey, vaccine

Smallpox (Variola virus or Orthopox Virus) Double strand DNA Enveloped

• Viral, • Variola Virus OR Orthopox Virus, • Contagious once first sores appear - Virus spread when patient coughs or sneezes and droplets land on others - Contagious until last smallpox scab falls off - scabs and fluid in sores contains virus, No animal or insect vector, • High Fever, Vomiting, Headaches, Rash starts as small red spots in mouth and on tongue - spreads to face, arms, hands, then legs and feet. Sores filled with opaque fluid with a dent in the center, Turns into Pustular rash ( round and firm touch - Feels like peas under the skin) form a crust then scab, 3 weeks after first sores appeared scabs will have fallen off. Person is contagious from the appearance of the first until the last scab has fallen off . • Usually diagnosed based on physical symptoms but can be confirmed with blood test if needed. • Double Stranded DNA Virus. Enveloped. • Classic symptom is the rash. • Prevention: Smallpox Vaccine if needed, we currently do not use smallpox vaccine because the virus has been eradicated in nature. Treatment: Tecovirimat has been shown in laboratory to be effective against smallpox, Cidofivir or Brincidofovir may also be prescribed. • Currently, the smallpox vaccine is not available to the general public because smallpox has been eradicated, and the virus no longer exists in nature. However, there is enough smallpox vaccine stockpiled to vaccinate every person in the United States if a smallpox outbreak were to occur.

Rubeola

• Virus, • Rubeola Virus - Measles • Spread through coughing and sneezing - Can live in the airspace for up to 2 hours where infected person has coughed or sneezed, Transmitted if you breath in infected air or touch contaminated surface then touch your eyes, nose or mouth. Measles is so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected. Contagious 4 days before and 4 days after rash appears. No insect or animal vector. • Symptoms appear 7-14 days after infection. Begins with high fever, cough, runny nose and red watery eyes. 2-3 days - tiny white spots may appear inside mouth. 3-5 days - Rash w/ flat red spots at hairline spreads down neck to feet. Rash may have small raised bumps. When rash is present sometimes fever spikes ( sometimes to 104 deg./f +) • Diagnosed based on physical appearance of rash or Koplik's spots ( white spots inside the mouth ) , can also be confirmed with a blood test. • Single Stranded Enveloped RNA Virus. • NO antibiotics given, Vitamin A given. Post exposure prophylaxis may be performed, or MMR vaccine may be given. • Prevention: MMR Vaccine