Epidemiology & prevention of

Zoonotic diseases

Dr. Nadia Aziz

C.A.B.C.M
Department of community medicine
 Objectives

1- Define the zoonotic diseases

2- Identify different causes of zoonotic diseases

3- Identify Brucellosis & its prevention

4- Identify rabies & its prevention

5- Identify Toxoplasmosis & its prevention

 Zoonoses
From the Greek:
Zoon: Animal
Noson: Disease

Diseases and infections which are naturally

transmitted between vertebrate animals and
humans
- WHO 1959
 Zoonoses: Animal Species
Dogs & Cats
Rabies
Roundworm
Ringworm
Cat Scratch Disease
Food Animals
Salmonella
E.coli
Brucellosis
 Zoonoses: Animal Species
Birds:
Psittacosis
West Nile virus
Eastern Equine Encephalitis
Avian Influenza
Reptiles, Fish, & Amphibians
Salmonella
Mycobacterium
Wild Animals
Hantavirus
Plague
Tularemia
Lyme Disease
 BRUCELLOSIS ICD-10 A23
Undulant fever, Malta fever, Mediterranean
fever
Brucellosis is predominantly an occupational
disease of those working with infected animals
or their tissues
more frequent among males.
Sporadic cases and outbreaks occur among
consumers of raw milk and milk products
(especially unpasteurized soft cheese) from
cows, sheep and goats
 Clinical features
A systemic bacterial disease
onset, acute or insidious (gradual)
fever continued, intermittent or irregular of
variable duration.
Headache, weakness, profuse sweating, chills,
arthralgia, depression, weight loss and
generalized aching.
Localized suppurative infections of
organs, including liver and spleen may occur
 Complications

1- Osteoarticular, sacroiliitis (most frequent

joint manifestation).

2- Genitourinary involvement

orchitis and epididymitis (common

manifestations)
 Laboratory diagnosis
1. Isolation of infectious agent from blood,
bone marrow , other tissues, or from
discharges.
2. Current serological tests allow a precise
diagnosis in over 95% of cases.
it is necessary to combine a test (Rose Bengal
and seroaglutination) detecting agglutinating
antibodies (IgM, IgG and IgA) with others non-
agglutinating antibodies (Coombs–IgG or ELISA-
IgG) developing in later stages.
 Infectious agents
Brucella abortus
B. melitensis
B. suis
B. canis
 4. Reservoir
Cattle, swine, goats and sheep
 5. Mode of transmission
1. Contact through breaks in the skin with
animal tissues, blood, urine, vaginal
discharges, aborted fetuses and especially
placentas
2. ingestion of raw milk and dairy products
(unpasteurized cheese) from infected
animals.
3. Airborne infection occurs in pens and
stables for animals, and for humans in
laboratories and abattoirs.
 Incubation period
Variable usually 5–60 days
 Methods of control
The control of human brucellosis rests on
the elimination of the disease among domestic
animals.
 A. Preventive measures

1) Educate the public (especially tourists)

2) Educate farmers and workers in
slaughterhouses, meat processing plants and
butcher shops
3) Educate hunters to use protective outfits
(gloves, clothing) in handling feral swine and to
bury the remains
 A. Preventive measures
4) Search for infection among livestock by
serological testing, eliminate infected animals
(segregation and/or slaughtering).

In high-prevalence areas, immunize young

goats and sheep with live attenuated vaccine

5) Pasteurize or Boil milk and dairy products

from cows, sheep and goats.
B. Control of patient, contacts and the
immediate environment:

1) Isolation: Draining and secretion precautions

if there are draining lesions; otherwise none.
2) Concurrent disinfection: Of purulent
discharges.
3) Investigation of contacts and source of
infection
 Specific treatment

1- A combination of rifampicin (600–900

mg daily) or streptomycin (1 gram daily), and
doxycycline (200 mg daily) for at least 6 weeks
is the treatment of choice.
2- Trimethoprim-sufamethoxazole is
effective, but relapses are common (30%).
 RABIES ICD-10 A82
(Hydrophobia, Lyssa)

Almost a fatal acute viral encephalomyelitis

onset started by a sense of apprehension,
headache, fever, malaise and indefinite sensory
changes referred to the site of animal bite.
Excitability and aerophobia are frequent
symptoms.
The disease progresses to paresis or paralysis,
spasms of swallowing muscles leads to fear of
water (hydrophobia), delirium and convulsions
follow.
 Infectious agent
Rabies virus, a rhabdovirus of the genus
Lyssavirus
 Mode of transmission
Virus-laden saliva of rabid animal introduced
though a bite or scratch (very rarely into a fresh
break in the skin or through intact mucous
membranes).
Dogs transmit urban (or canine) rabies,
whereas sylvatic rabies is a disease
of wild carnivores and bats was not or could
not be provided.
 Incubation period
Usually 3–8 weeks, rarely as short as 9 days or
as long as 7 years depends on
wound severity, wound site in relation to
nerve supply
 Period of communicability

Usually for 3–7 days

before onset of clinical signs (rarely over 4

days) and throughout the course of the disease.
 Diagnosis
Death is often due to respiratory paralysis.
Presumptive diagnosis by specific FA

staining of frozen skin sections taken from the

back of the neck at the hairline.
 Methods of control

A. Preventive measures:
Many preventive measures are possible

at the level of the main animal main host(s)

and transmitter(s) of rabies to humans.
 Preventive measures
1) Register, license and immunize all dogs in
enzootic countries, collect and sacrifice
ownerless animals and strays.
Immunize all cats.
2) Maintain active surveillance for rabies in
animals.
 Preventive measures

3) Detain and clinically observe for 10 days any

healthy-appearing dog or cat known to have
bitten a person

dogs and cats showing suspicious signs of

rabies should be sacrificed and tested for
rabies.
 Preventive measures

4- In the case of bites by a normally behaving

valuable pet or zoo animal, it may be
appropriate to consider postexposure
prophylaxis for the human victim, and, instead
of sacrificing the animal, hold it in quarantine
for 3–12 weeks.
 Pre-exposure immunization
5- Individuals at high risk (e.g. veterinarians, personnel and
park rangers in enzootic or epizootic
areas, staff of quarantine kennels, laboratory and field
personnel working with rabies, long-term travellers to
rabies-endemic areas) should receive pre-exposure
immunization, using potent and safe cell-culture vaccines.
Vaccine can be given in 3 doses.
If risk of exposure continues, single booster doses are
Given every 2 years
 Post exposure prophylaxis
a) First aid: Clean and flush the wound
immediately with soap or detergent and water
(or water alone) then apply either 70% ethanol,
tincture of aqueous solution of iodine

or povidone iodine. The wound should not be

sutured unless unavoidable
 Post exposure prophylaxis
b) Specific treatment :
1- Specific immunological protection in
humans by administration of human (HRIG) or
equine (ERIG) rabies immune globulin at site of
bite as soon as possible after exposure
2- Giving vaccine at a different site to elicit
active immunity.
 Post exposure prophylaxis
Modern cell-culture vaccines
should be given in 5 IM doses in the deltoid
region, to start as soon as possible after exposure
and the last dose
within 28 days for IM (0, 3, 7, 14, 28) and 90 days
for ID (0, 3, 7, 28, 90) vaccination.
Pregnancy and infancy are not contraindications to
rabies vaccination.
 TOXOPLASMOSIS ICD-10 B58
A systemic coccidian protozoan disease
infections are frequently asymptomatic, or
as acute disease with lymphadenopathy only, or resemble
infectious mononucleosis, with fever, lymphadenopathy and
lymphocytosis persisting for days or weeks.
Development of an immune response decreases
parasitaemia, but Toxoplasma cysts remaining in the tissues
contain viable organisms.
TOXOPLASMOSIS with pregnancy
A primary infection during early pregnancy
may lead to fetal infection with death of the
fetus or manifestations such as chorioretinitis,
brain damage with intracerebral calcification,
hydrocephaly, microcephaly, fever, jaundice,
rash, hepatosplenomegaly, xanthochromic
CSF and convulsions evident at birth or
shortly thereafter.
 Diagnosis
1- Demonstration of the agent in body tissues or fluids
by biopsy or necropsy.
2- Rising antibody titres are corroborative of active
infection, (presence of specific IgM and/or rising IgG
titres in sequential sera ).
High IgG antibody levels may persist for years with no
relation to active disease.
 Infectious agent

Toxoplasma gondii, an intracellular

coccidian protozoan of cats
 Reservoir
The definitive hosts of T. gondii are cats and other
felines, which acquire infection mainly from eating infected
mammals (especially rodents) or birds, probably also from
oocysts acquired during natural licking/grooming.
Felines alone harbour parasites in the intestinal tract, where
the sexual stage of life cycle occurs, resulting in excretion of
oocysts in feces for 10–20 days, rarely longer.
 Reservoir
The intermediate hosts of T. gondii include sheep, goats,
rodents, swine, cattle, chickens and birds; all may carry an
infective stage of T. gondii encysted in tissue, especially
muscle and brain.
Tissue cysts remain viable for long periods, perhaps lifelong.
Cattle seem able to cope with natural Toxoplasma infection.
 Mode of transmission
1- Transplacental infection occurs in humans
when a pregnant woman has rapidly dividing cells
(tachyzoites) circulating in the bloodstream, usually
during primary infection.
2- Children may become infected by ingesting
infective oocysts from dirt in sandboxes, playgrounds
and yards in which cats have defecated.
 Mode of transmission
3- Infections arise from eating raw or undercooked
infected meat containing tissue cysts, or through
ingestion of infective oocysts in food or water
contaminated with feline feces.
4- Inhalation of sporulated oocysts (rare)
5- Infection may occur through blood transfusion or
organ transplantation from an infected donor.
 Period of communicability
No direct person-to-person transmission
except in utero. Oocysts shed by cats sporulate and
become infective 1–5 days later and may remain
infective in water or moist soil for over a year.
Cysts in the flesh of infected animals remain infective
as long as the meat is edible and uncooked
 Methods of control
A. Preventive measures:
1) Educate pregnant women about preventive
measures:
a) Use irradiated meats or cook them to 66°C
before eating. Freezing meat down to –20°C for
24 hours is a good alternative.
 Preventive measures
b) Unless they are known to have antibodies to T.
gondii,
pregnant women must avoid cleaning litter pans and
avoid contact with cats of unknown feeding history.
They must wear gloves during gardening .
 Preventive measures
3) Control stray cats and prevent their access to
sandboxes and sand piles used by children for play.
Keep sandboxes
covered when not in use.
4) Patients with AIDS must receive prophylactic
treatment throughout life with pyrimethamine,
sulfadiazine and folinic acid.
Thank you