Epidemiology of gonorhea

Gonorrhea is among the most prevalent sexually transmitted diseases from 19761980 more than 1million cases reported each year but since then the incidence has
declined progressively probably due to increase condom use for the fear of aids.
Factors that influence incidence of gonorrhea
1. Birth control pills: oral contraceptive without the use of a condom offer no
protection against sexually transmitted diseases and may increase
susceptibility to them. Use of oral contraceptive leads migration of gonorrhea
susceptible epithelial cells from the cervical lumen on to more exposed area
of the outer cervix, oral contraceptive also tend to increase both the ph and
moist content of the vagina favoring infection with gonococci and other agent
of sexually transmitted diseases. Besides being more vulnerable to gonorrhea
women taking oral contraceptives are also more likely to develop
complications from the disease
2. Carriers: carriers of gonococcal both male and female can unknowing
transmit this bacteria over months or even years.
3. Lack of immunity: there is little or no immunity following recovery from the
disease. Individuals can contract gonorrhea repeatedly.
PREVENTION
The risk of infection can be reduced significantly by

abstinence,
monogamous relationship,
barrier protection with a consistent use of condoms,
prompt identification and treatment of sexual contact.
Diagnosing and treating the asymptomatic patient.
Treating infected individuals quickly to prevent further spread also public
eduction on sexually transmitted disease.
No vaccines is available

READ UP SYPHILLIS
ZONOSIS
Zoonosis are infectious diseases of animals (usually vertebrate) that can
naturally be transmitted to humans. They are caused by a range of diseased
pathogens such as viruses, bacteria, fungi and parasite. 61% of pathogens
that infect human originated in animals{ salmonellosis is a zoonotic disease
it is found in chicken but it doesnt cause infection}. Zoonosis have different
modes of transmission:

1. Direct zoonosis: this is directly transmitted from animal to humans

through media such as air (influenza) or through bite and saliva(Rabies).
2. Transmission can also through intermediate sp (vector) which harbours
the pathogen without getting infected.
3. Humans can also infect animals in which case it is called reverse zoonosis
or anthroponosis (yellow fever)
Major factors that contribute to appearance of new zoonotic pathogen in
human population is increased contact between humans and wild life.
Infectious organisms in non human reservoir that may be transmitted to
humans
Disease

Aetiologic agent

Non-human host
or suspected host

Brucellosis AKA
undulant fever

Brucella
Brucella
Brucella
Brucella

Cattle, goat,
swine, sheep,
horses

Campylobacteriosis

Campylobacter
jejuni
Campylobacter
fetus
Listeria
monocytogen

Listeriosis

canis
melitensis
swiss
abortus

Plaque

Yersina pestis

Q fever

Coxiella burneti

Tuberculosis

Mycobacterium
bovis
m. africanum
m.avium complex
m.tuberculosis
Camticella
tularensis

Tularemia
AKA rabbit

Cattle, sheep,
poultry, swine

Sheep, cattle ,
goat, chickens,
birds and
crustaceans
Domestic rat and
many wild rodents
Sheep, cattle,
goat
Cattle, horses,

Wild rabbits, and

Usuall mode of
human infection
(transmission)
Egestion of
unpasteurized milk
and milk product
including meat. It
can also be by
direct contact with
infected animal.
Contaminated
water and food

Basically food
borne infection

Flea bite
Inhalation of
contaminated soil
and dust
From
unpasteurized milk
and also by direct
contact
Direct contact with
infected carcass
with infected
rabbit.
Tick bite

Leptospirosis

Leptospiral
interroeans

Mice, skunks,
raccoons,

Rabies

Rabies virus

Dogs, bats,

Giardia

Giardia intestinalis

Rodent, deer

Cryptosporidiosis

Cryptosporidium sp

Farm animals and

pets

Through skin,
drinking water or
food
Bites of rabid
animal
Contaminated
water
Contaminated
water

BRUCELLOSIS
AETIOLOGY
brucella are gram negative non motil coccobacilli strict aerobes and grow
well on blood agar. In the host they live as intracellular pathogens. Brucella
known to infect humans include B.swiis (swine) ,B.melitensis (goat and
cattle). Brucella abortus(cattle)
CLASSIFICATION AND ANTIGENIC TYPES
The three sp are differentiated by the production of urease and hydrogen
sulphide, dye sensitivity, cell wall antigen and bacteriophage sensitivity . the
various specie are divided into multiple biomass
Transmission
Direct contact with animals, ingested of contaminated product such as
unpasteurized milk, breathing in bacteria this may occur with contact with
infected animals. Entry through wounds or mucus membrane. Breast feeding,
person to person transmission is very rare but has been reported .
PATHOGENESIS
Portal of entery at the moth, conjunctiva, respiratory tract and abraded skin .
Organism spread in mononuclear phagocytes to reticuloendothelial sites. The
intracellular persistent of bacteria result in reticuloendothelial system organs
and tissues damage due to hypersensitity reaction. Note infective host
defense depends primarily on cell mediated immunity.
Symptoms
Brucella arbutus and B. canis may cause a mild superlative febrile infection
where as Bswis causes infection which cause lead to infection of the kidney.
Infection may either be acute or chronic. General sysmptoms include fever,
chills, swet fatigue.
Epidemiology

Exposure is frequently occupational, the disease is now uncommon in the

united states and britian. It is now common in the mediterean area, estern
euroupe, Africa, carribean and middle east, this area are regarded as higher
risk area.
DIAGNOSIS
Presumptive diagnosis: blood cultures are carried out on blood agar and
sometimes rosebenger test(rbt) also used for screening. Positive result can
be confirmed by carrying out confirmatory diagnosis.
Standard agglutination test: isolation of brucella species from blood or other
clinical specimen. antibody can be detected using elisa, PCR can also be
used in diagnosis
PREVENTION
It is prevented by pasteurizing milk eradication infection from herds and
using safety precautions( protected clothing and laboratory safety)
PLAQUE
aetiology
Plaque is caused by Yersinia pestis, Yersinia organism are small gram neg,
coccobacilli, showing bipolar stain, facultative aerobes, and also intracellular
parasite. 3 species are of medical important Yersinia pestis , Y.enterolytical
and Y. pseudotuberculosis
Transmission
Humans are usually infected by carrier rodent flea or rat flea. The flea
acquires the yersina organisms from infected rodent. Plaque can be also be
spread in aerosols in a cough or sneeze from an infected patient
Pathogenesis
In bubonic plaque, the bacilli spread from a local abscess to draining lymph
nodes. This is followed by septicemia and haemorhagic pneumonia.
Y.enterolytica enters via peyer;s patches and causes severe liver and splenic
abscesses y.pseudotuberclosis causes enlarge nodes in the payers patches
and mesenteric lymph nodes
Symptoms
Symptoms usually depend on the specie involved
bubonic plaque: this leads to swelling of the lymph nodes and can spread to
other parts of the body. The swelling of the lymph node is also refered to as

formation of bubones.
pneumonic plaque: this usually result inhalation of infected aerosol. it results
into spread of bacteria to the lung and most time resulting in
pneumonia(pneumonic plaque) chest pain , cough with sometimes watery or
bloody mucus and shortness of breathe
septicemic plaque: this is as result of flee bite or contact with infected
animals. Symptoms include bleedin the skin and organs. Skin particularly at
extremities become black and necrotic. Note bubonic plaque is also referred
to as black death.

Control
Control of rat and rat flee is central. Laboratory personel should be
vaccinated with killed Yersinia pestic vaccine. Y. enterolytica is controlled by
purifying water and pasteurizing milk
Tularemia
This is caused by franciscella tularensis. the organism are some nonmotile
gram neg cocco bacilli it is biochemically to brucellae but antigenically
distinct
Pathogenesis
The local abscess at the site of infection is followed by septicemia with rapid
spread to the liver and spleen 30% of untreated patient die. Tularemia is also
referred to as rabbit fever.
Symptoms
Tulareamia is characterized by the development of a skin ulceration and
enlargement regional lymphnode 2-5 days after a person is bitten by a tick or
insect or handles a wild animals. There are also symptoms like fever and
chills. When contracted by inhalation there is also a dry cough and pain
beneath the breast bone due to enlarged lymph nodes.symptoms usually
clear in 1-4 weeks but sometimes they last for months
Epidemiology
Franciscella is a primarily a pathogen of human and rabbits humans are
infected by bite by infected deer fly or tick or by handling or eating under
cooked infected rabbit meat
Diagnosis

Cultivation from blood or biopsy material is diffecult and slow. Blood smears
can be stained with specific fluorescent antibody. Appear heaglutinine
appears in ten to twelves days. A rising titre is often diagnosistic
Prevention and control
A live attenuated vaccine is available for laboratory personel. Goggles must
be worn in laboratory to prevent conjunctiva infection