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Brucellosis, Tetanus & Plague By Dr. Riaz Ahmed. Brucellosis Also known as undulant fever / malta fever / mediterranean fever. Also known as undulant.

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Presentation on theme: "Brucellosis, Tetanus & Plague By Dr. Riaz Ahmed. Brucellosis Also known as undulant fever / malta fever / mediterranean fever. Also known as undulant."— Presentation transcript:

1 Brucellosis, Tetanus & Plague By Dr. Riaz Ahmed

2 Brucellosis Also known as undulant fever / malta fever / mediterranean fever. Also known as undulant fever / malta fever / mediterranean fever. Bacterial zoonosis which is transmitted to man by direct / indirect contact with animals. Bacterial zoonosis which is transmitted to man by direct / indirect contact with animals. Caused by different species of brucella- group of organisms and characterized by: Caused by different species of brucella- group of organisms and characterized by: Intermittent / irregular febrile attacks Intermittent / irregular febrile attacks Arthritis / enlarged spleen etc. Arthritis / enlarged spleen etc.

3 Epidemiology Agent factors: Agent factors: Brucella abortus – in bovine – abortus fever Brucella abortus – in bovine – abortus fever B.Suis – Pigs – Swine – F or Porcine B.Suis – Pigs – Swine – F or Porcine B.Canis – Canines – Canine fever B.Canis – Canines – Canine fever B.Melitensis – Goats – Caprine fever B.Melitensis – Goats – Caprine fever  Host factors: predominantly disease of males. Farmers Farmers Shepherds Shepherds Butchers Butchers Slaughter house men Slaughter house men Veterinarians Veterinarians Lab-workers – are at special risk because of occupational exposure. Lab-workers – are at special risk because of occupational exposure.

4 Environmental factors: Environmental factors: Most prevalent under conditions of advanced domestication in the absence of corresponding advanced S.O. Hygiene (+) where there is Overcrowding of herds Overcrowding of herds Increased rain fall Increased rain fall Lack of exposure to sunlight Lack of exposure to sunlight Unhygienic practice of milking/ heat production Unhygienic practice of milking/ heat production

5 M.O.T: M.O.T: Ingestion – milk / milk products Ingestion – milk / milk products - meat even of camel - meat even of camel Contact – absorption from skin Contact – absorption from skin Inhalation Inhalation Inoculation 02mm – throat or oral cavity Inoculation 02mm – throat or oral cavity  Source / Reservoir: S – milk, lochial secretions, placenta, urine, feces & meat. R – farm animals e.g., cattle, goats, swine etc.  I.P: highly variable usually 1-3 weeks.

6  Lab diagnosis: Bacteriological Bacteriological Serological / allergic test Serological / allergic test  Control:  in animals: Test / slaughter Test / slaughter Vacc – B.Abortus strain – 19 Vacc – B.Abortus strain – 19 Hygienic measures Hygienic measures  In humans: At individual level At individual level At community level At community level

7 Tetanus An acute disease caused by exotoxins of clostridium tetani clinically characterized by : An acute disease caused by exotoxins of clostridium tetani clinically characterized by : Muscular rigidity Muscular rigidity Painful paraoxysmal spasms of voluntary muscles esp. Painful paraoxysmal spasms of voluntary muscles esp.  Masseters ( trismus / lock-jaw )  Facial (risus sardonicus)  Back / neck (opisthotonus) And those of lower limbs and abdomen o Mortality : 40-80%

8 Agent factors: Agent factors: Clostridium tetani Clostridium tetani Reservoir of infection Reservoir of infection Source – soil / dust Source – soil / dust Exotoxin Exotoxin P.O.C – None P.O.C – None  Host factors: Age / sex Age / sex Occupation Occupation Rural / urban differences Rural / urban differences Immunity Immunity  Environmental factors: Tetanus is a positive environmental hazard. Tetanus is a positive environmental hazard.  M.O.T: contamination of wounds with tetanus spores.

9 I.P: 6 – 10 days I.P: 6 – 10 days Types: Types: Traumatic Traumatic Puerperal Puerperal Otogenic Otogenic Idopathic Idopathic Tetanus Neonatorum (8 th day syndrome) Tetanus Neonatorum (8 th day syndrome)  Prevention: Active immunization – DPT Active immunization – DPT Passive – ATS Passive – ATS Both Both Antibiotics Antibiotics Observe tetanus schedule for pregnant women Observe tetanus schedule for pregnant women

10 Plague (Black Death) Basically & primarily a zoonotic disease caused by Yersinia pestis involving rodents & fleas. Basically & primarily a zoonotic disease caused by Yersinia pestis involving rodents & fleas. It exists in natural foci & is transmitted by infected flea bites to humans living or intruding into the same ecological environment. It exists in natural foci & is transmitted by infected flea bites to humans living or intruding into the same ecological environment. Occurrence: many forms e.g., Occurrence: many forms e.g., Epizootic Epizootic Enzootic Enzootic Sporadic Sporadic And in epidemics of all forms including anthroporotic primarily pnemonic.

11 History Epidemics of plague are mentioned in Bible Epidemics of plague are mentioned in Bible Association of plague with rats is known to be ancient. Association of plague with rats is known to be ancient. 1 st out-break – 1320 B.C. 1 st out-break – 1320 B.C. 1 st Pandemic – 542 A.D. called Justinian plague, which lasted for 50 years & estimated mortality was 100 deaths. 1 st Pandemic – 542 A.D. called Justinian plague, which lasted for 50 years & estimated mortality was 100 deaths. 2 nd Pandemic – 1346 B.C. lasted for 30 years & claimed one forth world mortality. 2 nd Pandemic – 1346 B.C. lasted for 30 years & claimed one forth world mortality. In 1840 B.C. – Pandemic of pneumonic type In 1840 B.C. – Pandemic of pneumonic type In 1930 – 6 million deaths in India. In 1930 – 6 million deaths in India. In out-break in India, then subsided gradually. In out-break in India, then subsided gradually.

12 Plague Def: Highly fatal disease characterized by high fever, progressive heart failure & nervous symptoms. Def: Highly fatal disease characterized by high fever, progressive heart failure & nervous symptoms. o Conjunctiva is injected with reddish appearance. o Skin – hemorrhage & pustular eruptions.  Clinical forms: Bubonic Bubonic Pnemonic Pnemonic Septicemic Septicemic sylvatic sylvatic

13 Bubonic plague Onset sudden, most common type Onset sudden, most common type High temperature, prostration High temperature, prostration Painful buboos Painful buboos Vesicular / pustular skin lesions Vesicular / pustular skin lesions  Complications: secondary terminal pneumonia secondary terminal pneumonia

14 Pneumonic plague Primary P. Plague is rare. Generally follows as a complication of bubonic - septicemic plague. Primary P. Plague is rare. Generally follows as a complication of bubonic - septicemic plague. Incidence decreased 1% Incidence decreased 1% Highly infectious Highly infectious Symptoms – acute bacterial infection Symptoms – acute bacterial infection Sputum – hemorrhagic Sputum – hemorrhagic Most deadly form of plague Most deadly form of plague

15  Septicemic : Rare Rare Buboes absent Buboes absent Fever – low Fever – low Hemorrhages into skin Hemorrhages into skin  Sylvatic : Endemic in rodents in jungles Endemic in rodents in jungles Man is affected accidentally while doing activities like hunting etc. Man is affected accidentally while doing activities like hunting etc.

16 Source of infection: Source of infection:  In bubonic plague : by bite of inf. Rat – fleas Xenophsylla cheopis Xenophsylla cheopis Xenophsylla actia Xenophsylla actia Xenophsylla braziliensis Xenophsylla braziliensis  In pneumonic plague: exhaled droplets of saliva exhaled droplets of saliva sputum of patients sputum of patients  Reservoir : rats & wild rodents, out of 1700 species 200 associated with plague.

17 I.P: I.P: Bubonic : 2-7 days Bubonic : 2-7 days Septicemic : 2-7 days Septicemic : 2-7 days Pneumonic : 1-3 days Pneumonic : 1-3 days  P.O.C: pneumonic is very communicable from person to person, bubonic if terminal inf. is there.  M.O.T: Bubonic plague – bite of infected rat flea Bubonic plague – bite of infected rat flea Pneumonic plague – droplets Pneumonic plague – droplets

18 Epidemiology Agent factors: yersinia pestis, occur in blood, buboes, spleen, liver, other viscera of infected persons. Agent factors: yersinia pestis, occur in blood, buboes, spleen, liver, other viscera of infected persons. Host factors: Host factors: Age / sex – all ages & both sexes Age / sex – all ages & both sexes Activities of man e.g., hunting, cultivation, grazing, harvesting, construction etc. Activities of man e.g., hunting, cultivation, grazing, harvesting, construction etc. Movements – ship, land, cargo Movements – ship, land, cargo Immunity – no natural immunity Immunity – no natural immunity  Environmental factors: Season : september – May Season : september – May Temp : C Temp : C Humidity less than 60%, Rain fall Humidity less than 60%, Rain fall Rural / urban, Human dwellings Rural / urban, Human dwellings

19 Population at risk: Population at risk: Geologists, Biologists Geologists, Biologists Anthropologists Anthropologists Hunters, agriculturists etc. Hunters, agriculturists etc.  Vector of plague: Pulex irritants (human fleas)  Blocked / Partially blocked flea  Flea Indices: o Total flea index o Specific index – if >1 o Sp.% of fleas o Burrow index

20 Prevention & Control Control of cases: Control of cases: Early diagnosis Early diagnosis Notification Notification Isolation Isolation Treatment Treatment Disinfection Disinfection  Control of fleas/ rodents: Application of insecticides, rodenticides and other preventive measures to be adopted.  Vaccination: 0.5-1ml SC after 7-10 days.

21 Chemoprophylaxis: Chemoprophylaxis: Surveillance Surveillance Health education Health education

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