Presentation on theme: "C. Psittaci & Psittacosis"— Presentation transcript:
1 C. Psittaci & Psittacosis Rhonda C. CampbellEast Tennessee Regional Health OfficeP.O. BoxKnoxville, TN(865)
2 East Tennessee Region– Pet cockatiel (Frankie) diagnosed with Chlamydophila psittaciWhat is C. psittaci and why do I need to do follow up on a bird?
3 Chlamydia or Chlamydophila Genus Birds“Avian chlamydiosis” best term to specify infection with C. psittaci in birdsHumans“Psittacosis” originating from parrots or psittacine birds (parrot fever)
4 What is Psittacosis?Psittacosis is an infectious disease transmitted to humans from birds in the parrot family, turkeys and pigeonsCaused by bacteria - Chlamydophila psittaci
5 Reservoir & Hosts130 species of birds worldwide and variety of mammals and humansMost common source of human infection: exposure to recently acquired parrot type birds (macaw, cockatoo, parakeet, cockatiel, lovebird)
6 Life Cycle Enters the host via inhalation or ingestion and replicates Released to the environment via feces, nasal secretions, sputum, blood or infected tissuesMay survive in soil 3 months or in bird droppings 1 monthHumans acquire by fecal/oral, mouth to beak contact, or handling plumage or tissuesInhalation of aerosolized organism
7 Clinical Signs and Symptoms – Human Incubation 5-14 daysAbrupt onset of fever, chills, headache, malaise, and myalgiaOccasional severe pneumonia and non respiratory health problems
8 Psittacosis Case Definition (CDC) Clinical descriptionIllness characterized by fever, chills, headache, photophobia, cough, and myalgiaLaboratoryIsolation of organism from respiratory secretions orFourfold or greater increase in antibody titer orHigh antibody titer by MIF (micro-immunofluorescence)
9 Opening ScenarioLocal veterinarian notified Tennessee Department of Health of positive c. psittaci for “Frankie” cockatielTime for us to go to work!!!Investigation begins….
10 National Association of State Public Health Veterinarians, Inc. Compendium of Measures to Control Chlamydophilia psittaci Infection Among Humans and Pet Birds, 2006National Association of State Public Health Veterinarians, Inc.
11 Psittacosis Compendium Prevention and controlTesting methodsTreatment optionsResponsibilities of owners, physicians, and veterinariansEpi investigationsBird quarantineBird importation
12 Psittacosis Compendium Prevention and controlTesting methodsTreatment optionsResponsibilities of owners, physicians, and veterinariansEpi investigationsBird quarantineBird importation
13 When to conduct an epidemiological investigation? Bird chlamydiosis (confirmed or probable) obtained from a pet store, breeder, or purchased w/in 60 days of onset of illnessPerson with confirmed or probable psittacosisSeveral avian chlamydiosis cases from same source
14 Diagnosis of C. Psittaci “Frankie” lab confirmed illnessPCR BloodPCR FecalIFA SerumFrankie was exposed to two recently purchased birds that diedVeterinarian noticed that Frankie's owner had “classical symptoms of psittacosis”
15 Investigation Bird owner – owned Frankie for several years Newly purchased cockatielsFirst one died two days after purchaseSecond bird was purchased then died 5 days laterFrom same pet store
16 Human Patient #1, Bird Owner Headache, fever, myalgia, cough for 3 weeksPCP confirmed:“Acute URI”Serology test for psittacosisRx: Doxycycline 100 mg bid x 10 days
17 Human Patient # 2, Store Owner Out of work ill; visiting doctorHeadache, cough, chills, fever 101.3, for 2-3 weeksCXR: “consistent with psittacosis”Serology for psittacosisRx: Doxycycline x 21 days
18 TreatmentHumanThese two were treated with Doxycycline. Other treatment choices include:Erythromycin orAzithromycin “Z-pack”BirdOral doxycycline is the treatment of choice
19 Human Case Confirmation Both patients improved with treatmentConvalescent serum collected after daysAcute and convalescent serum sent to state lab then CDC – results pending
20 Pet Store VisitQuestionnaire developed; employees and the distributor interviewed for illnessProvide: education and fact sheetOne employee reported “tiredness”Another employee reported headache, cough, tiredness; referred to physician but refused
21 Veterinary Visit to Store State Veterinarian notified (Dept. of Agriculture)Local Veterinarian visited Pet Store; 60 birds examined – no other illnesses Isolate and treat 3 birds caged with the 2 birds that diedStore employees educated on illness in birds, cleaning procedures, and preventive measures
22 Distributor Sick birds traced to an individual distributor Raised birds and had a few domestic breedersHoused at facility for short timeSales records and dates not keptLikely delivered the cockatiels one month prior
23 Results Illness in the 2 people resolved with treatment “Frankie” well and at homeNo other illnesses among staff or animals at store
24 Clinical Signs - BirdsRespiratory signs: nasal or ocular discharge, difficulty breathingSigns of liver disease: green urates in droppings, inappetanceCommon: spleen & liver enlargedPigeons & passerines exhibit little or no symptoms: “asymptomatic carriers”
25 Notifiable Disease? Human psittaci is a nationally notifiable disease Many states, not Tennessee, require avian chlamydiosis be reported to State VeterinarianImported birds not routinely tested for psittaci
26 Lessons LearnedFirst step: Consult the Psittacosis Compendium (NASPHV)Importance of Communication & TeamworkStore OwnerHealthcare ProvidersHealth Department (Local, Region, State, & State Lab)All of the Above
27 East Tennessee Regional Health Office QUESTIONS?QUESTIONS?Thank you!Rhonda C. CampbellEast Tennessee Regional Health OfficeP.O. Box 59019Knoxville, TN(865)
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