Cases reported "Zoonoses"

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11/41. bordetella bronchiseptica infection in pediatric lung transplant recipients.

    bordetella bronchiseptica are small, pleomorphic Gram-negative coccobacilli which are commensal organisms in the upper respiratory tract of many wild and domestic animals ('kennel cough' in dogs). While it is common for health care providers to ask about exposure to ill family/friends, most do not routinely inquire about the health or immunization status of household pets. We report two cases of B. bronchiseptica pneumonia in lung transplant recipients [cystic fibrosis (CF); ages 10 and 15 yr; one male] who contracted B. bronchiseptica from pet dogs. We compared their course and outcome to four children (two CF, one congenital heart disease and one Duchenne's muscular dystrophy; four males, age range 6 months to 14 yr) with B. bronchiseptica cultured from the respiratory tract. Two of the four patients also acquired their illnesses from pet dogs and two from unknown sources. One lung transplant recipient expired from progressive respiratory failure. We conclude that B. bronchiseptica can cause serious infections in both immunosuppressed and immunocompetent children. We speculate that a detailed history of exposure to ill pets (particularly dogs), and the immunization status of all pets should be included in the routine evaluation of all pediatric transplant recipients.
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12/41. monkeypox in the united states: an occupational health look at the first cases.

    Between May 15 and June 20, 2003, 71 suspected cases of monkeypox were investigated and 37 individuals in the united states developed laboratory confirmed monkeypox. These were the first cases of human monkeypox ever documented in the united states or in the Western Hemisphere. The disease was transmitted from small animals imported from africa to other animals, including prairie dogs sold as pets throughout the U.S. Midwest. Direct contact with the infected animals was the method of infection, and although human to human transmission was thought to have occurred, this was not confirmed by follow up testing. Because of the link with contact with a prairie dog, initial evaluation of the disease was focused toward diseases commonly associated with this animal (e.g., tularemia, plague). Laboratory findings at the Marshfield Clinic in Marshfield, wisconsin pointed to the presence of an orthopox. The CDC confirmed monkeypox was the infecting orthopox agent. occupational health nurses from the Marshfield Clinic had direct involvement in the identification and follow up of employees who had direct contact with the diagnosed patients. programs, such as a respiratory protection program initiated and carried out by Clinic occupational health nurses, were used to prevent employee exposure for Clinic staff. One Clinic employee was thought to potentially have monkeypox because of her direct contact with one of the patients. Four Clinic employees were vaccinated with vaccinia vaccine as a result of their contact with patients or lab specimens. quarantine of the potentially infected employee and her boyfriend uncovered issues that must be addressed if other infectious diseases requiring quarantine or isolation of individuals emerge or re-emerge. These include a system to compensate individuals in quarantine or isolation who do not have any other source of income. The issue of whether workers' compensation should cover an employee who is quarantined or isolated for a potential work related exposure to an infectious disease if no disease is actually diagnosed also needs to be explored. A better system of getting state or CDC laboratory results back to the local level, including the occupational health area of the generating facility, must be developed. This will be very important if diseases such as severe acute respiratory syndrome (SARS) or smallpox should re-emerge in the united states. occupational health nurses are an integral part of any infectious disease process occurring in the united states. The identification of monkeypox in the united states shows that any planning to detect, prevent, and treat diseases with the potential to affect the employee population must include occupational health nurse involvement.
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13/41. pneumonia due to cryptococcus neoformans in a patient receiving infliximab: possible zoonotic transmission from a pet cockatiel.

    The use of humanized antibody against tumor necrosis factor alpha (TNF-alpha) may increase the risk of various opportunistic infections, including tuberculosis and fungal infections. We report a case of cryptococcal pneumonia in a patient who was taking infliximab for rheumatoid arthritis. A temporally related exposure history raised the possibility that our patient acquired the infection from his pet cockatiel. It seems prudent to advise patients receiving infliximab to avoid exposure to pet avian excreta.
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14/41. Naturally occurring tularemia in a dog.

    A 4-year-old spayed female Irish Setter was examined because of acute onset of lethargy, anorexia, and weakness. The dog had eaten an adult rabbit 36 hours earlier. tularemia was suspected because of the rabbit exposure; however, other common diseases characterized by fever, malaise, and lymphadenopathy of acute onset were also considered (ie, ehrlichiosis and rocky mountain spotted fever). The dog was treated with doxycycline (5 mg/kg [2.3 mg/lb], PO, q 24 h) for 14 days as well as supportive treatment with a balanced electrolyte solution (lactated Ringer's solution [200 mL, SC]). The diagnosis was first established by results of bacteriologic cultures of fine-needle aspirates obtained from lymph nodes and confirmed by results of ELISA and a polymerase chain reaction assay Successful and timely antemortem diagnosis of tularemia in dogs can be accomplished through lymph node aspiration and bacteriologic culture.
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15/41. Probable person-to-person transmission of avian influenza A (H5N1).

    BACKGROUND: During 2004, a highly pathogenic avian influenza A (H5N1) virus caused poultry disease in eight Asian countries and infected at least 44 persons, killing 32; most of these persons had had close contact with poultry. No evidence of efficient person-to-person transmission has yet been reported. We investigated possible person-to-person transmission in a family cluster of the disease in thailand. methods: For each of the three involved patients, we reviewed the circumstances and timing of exposures to poultry and to other ill persons. Field teams isolated and treated the surviving patient, instituted active surveillance for disease and prophylaxis among exposed contacts, and culled the remaining poultry surrounding the affected village. Specimens from family members were tested by viral culture, microneutralization serologic analysis, immunohistochemical assay, reverse-transcriptase-polymerase-chain-reaction (RT-PCR) analysis, and genetic sequencing. RESULTS: The index patient became ill three to four days after her last exposure to dying household chickens. Her mother came from a distant city to care for her in the hospital, had no recognized exposure to poultry, and died from pneumonia after providing 16 to 18 hours of unprotected nursing care. The aunt also provided unprotected nursing care; she had fever five days after the mother first had fever, followed by pneumonia seven days later. autopsy tissue from the mother and nasopharyngeal and throat swabs from the aunt were positive for influenza A (H5N1) by RT-PCR. No additional chains of transmission were identified, and sequencing of the viral genes identified no change in the receptor-binding site of hemagglutinin or other key features of the virus. The sequences of all eight viral gene segments clustered closely with other H5N1 sequences from recent avian isolates in thailand. CONCLUSIONS: disease in the mother and aunt probably resulted from person-to-person transmission of this lethal avian influenzavirus during unprotected exposure to the critically ill index patient.
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16/41. Zoonotic transmission of cryptococcus neoformans from a magpie to an immunocompetent patient.

    We report a case of cryptococcal meningitis in an immunocompetent female patient with exposure to a pet magpie (pica pica). Genetically indistinguishable isolates were cultured from the cerebrospinal fluid of the patient and excreta of the bird. Our data strongly suggest zoonotic transmission of cryptococcus neoformans var. grubii from a magpie to this patient.
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17/41. Primary conjunctival sporotrichosis: two cases from a zoonotic epidemic in Rio de Janeiro, brazil.

    PURPOSE: To describe sporothrix schenckii conjunctivitis in 2 owners of cats with sporotrichosis. methods: Small case series and literature review. RESULTS: Two women had been caring for their pet cats with sporotrichosis for 2 months but did not recall any traumatic injury such as scratches or bites. Each presented a conjunctival granulomatous lesion measuring 4 to 5 mm accompanied by local hyperemia, secretion, and edema, in addition to painful facial subcutaneous nodes and regional lymph node enlargement. Pyogenic material was collected from the conjunctival sac and from cutaneous lesions on the cats. In both the patients and their respective cats, fungal colonies were isolated and identified as S. schenckii. Treatment with oral itraconazole 100 mg/d for 3 months resulted in complete healing of lesions in both patients. patients remained clinically cured 15 months after end of treatment. CONCLUSION: sporotrichosis is presently occurring as an emerging zoonosis in Rio de Janeiro, and some unusual clinical forms have been diagnosed in humans. The cases reported here suggest atraumatic exposure to cats infected by S. schenckii.
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18/41. rabies virus infection in a pet guinea pig and seven pet rabbits.

    Raccoon-variant rabies was confirmed in 7 pet rabbits and 1 pet guinea pig in new york State, and postexposure treatment was required in several adults and children. To prevent rabies virus infection, domestic rabbits and pet rodents should be protected from contact with wild animals, including double-cage housing when housed outside. Pet rabbits or rodents with any possible contact with a wild animal, particularly if the rabbit or rodent had wounds of unknown origin, should be quarantined for 6 months for observation, to prevent escape, and to avoid contact with humans, who will require treatment if the rabbit or rodent develops rabies. Bites and scratches to humans from rodents and lagomorphs should be evaluated for potential rabies exposure on an individual basis, with consideration of whether the animal was caged outside or permitted outdoors unsupervised.
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19/41. parapoxvirus infections acquired after exposure to wildlife.

    The histopathologic and electron microscopic findings in two patients with skin lesions that developed after exposure to deer and other wildlife were consistent with a parapoxviral infection. Human infections that were morphologically similar to parapoxvirus infection have been previously described concerning exposure to cervids (deer and related animals). Ours are the first reported cases in which viral particles were demonstrated by electron microscopy.
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20/41. leptospirosis. Epidemiological features of a sporadic case.

    leptospirosis occurred in a 45-year-old man with presumed infection from an exposure to contaminated water at his source of employment. An intensive epidemiological investigation, including serological examination of all family members and pets and cultures on the patient and his family pets (cats and dogs), proved that the leptospiral organism was acquired by the patient's exposure to his dogs. The risk of acquiring infection from dogs that are asymptomatic and vaccinated is emphasized by this report.
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