Pathogen Set 3

(protozoa with flagella) (Trich) Symptoms- occurs in 50% of females and males (asymptomatic); vaginal itching, burning, white to green frothy discharge; chronic infection can lead to HIV and infertility; premature labor and low-birth-weight infants; superinfection; foul odor; men rarely have symtoms

(Chancroid) G- rod Symptoms- genital ulcerative disease; begins as soft papule at point of contact; develops into a "soft chancre"; very painful in men but unnoticed in women; inguinal lymph nodes can become very swollen and tender; 5,000 cases; week long incubation; discharge of pus-like substance; highly infectious; more frequent in men

(Gonorrhea) G- diplococci Symptoms- 4-10 day incubation; males: painful urination, yellow discharge; scar tissue in spermatic ducts during healing can lead to infertility; females: swelling and pain of labia; mucus and pus discharge, bloody vaginal discharge, painful urination; can lead to salpingitis, pelvic inflammatory disease ; blindness, joint pain; most common STD in AL. Infective source- Direct contact (STD), vertical Diagnosis- ELISA, culture on Thayer-Martin agar

(Syphilis) G- spirocci Symptoms- 2-3 week incubation; Primary: appearance of hard chancre at site of entry; painless; spirochetes. (male urethra, female cervix, wherever contact is made) Secondary: 3 to 6 months after chancre heals; fever, headache, sore throat, lymphadenopathy, red/brown rash, hair loss; rash on skin, mucus membrane, cervix; (highly contagious to dental workers) Tertiary: 2-3 years; not contagious during this stage; 30% of infections; cardiovascular complications, painful swollen tumors (gummas), neurological damage: headaches, blindness, dementia, convulsions. Infective source- Direct contact and vertical Diagnosis- serology, blood tests for antibodies, PCR Treatment- antibiotics (not effective during tertiary stage); Penicillin G Prevention- Antibiotic of all possible contacts, avoiding contact

(Genital herpes) Symptoms-20 million affected; 1 week incubation; asymptomatic or appearance of painful fluid filled vesicles on the genitalia, perineum, thigh, and buttocks; accompanied by malaise, anorexia, fever, and swelling; can cause meningitis; urination is painful; burning sensation; sores heal in two weeks; base of penis; 88% have reoccurrences (menstrual cycles, scratching); can cause miscarriage; can cause severe nerve damage in fetus; remain alive in hot tubs for many hours Infective source- Direct contact, vertical Diagnosis- Clinical presentation, PCR, Ab tests, viral culture Treatment- No cure; antivirals Prevention- Avoiding contact, antivirals can reduce reoccurrences

(retrovirus) (Human Immunodeficency Virus) Symptoms- 2 to 4 weeks after infected: flu-like symptoms (headache, sore throat, rash); (prevents T- cells from working); Years later: swollen lymph nodes, diarrhea, weight loss, shortness of breath (can last for several years). Progresses to AIDS if not treated: chills, blurred vision, fatigue, weight loss; originally associated male homosexuals; once in Stage 6 patient will die in 2 years; 10 years to develop into AIDS Infective source- Direct contact (sexual), blood-borne, vertical; body fluids Diagnosis- Screening for antibody followed by Western blot confirmation of antibody Treatment- AZT, HAART (reverse transcriptase inhibitors) Prevention- Avoid contact, contaminated blood, breast milk

(HPV) (Genital Warts) Symptoms- fastest growing STD; incubation of weeks to months; If present, manifest as warts on the tissue of the genitalia. Range from tiny flat bumps to cauliflowerlike masses (condyloma acuminata). Cause of cervical cancer or penile cancer Infective source- Direct contact (STD) Diagnosis- PCR tests for certain HPV types, clinical diagnosis of warts Treatment- Precancerous tissues/warts can be removed; virus not treatable Prevention- Vaccine available, avoid direct contact, cervical screening

(Vulvovaginal candidiasis) fungus; "thrush of mouth" Symptoms- Vaginal itching, burning, and vaginal discharge; males can get too Infective source- Opportunism; oral contraceptives Diagnosis- Wet prep or gram stain; observation Treatment- topical or oral antifungals Prevention- none

G- rod Symptoms- lower abdominal pain; urinary frequencies (bladder loses elasticity); painful urination, pus and blood in urine; can lead to kidney infection Infective source- feces, soil, sewage, sexually Diagnosis- Urinalysis test, culture from urine Treatment-Antibiotics Prevention- Good hygiene

Trachomisis (eye infection)) G-rod Symptoms- #1 STD in US; 2 to 4 week incubation; Males: inflammation of the urethra, discharge, and painful urination. Females: vaginal itching, cervicitis, a discharge, and salpingitis. Causes Pelvic Inflammatory Disease; can be passed to fetus and cause death Infective source- Direct contact (STD), vertical Diagnosis- PCR or ELISA, can be followed by cell culture, antibody test Treatment- Antibiotics (end up in ER) Prevention- Avoid contact; condoms

("SSSS," Ritter's Disease, TSS, Impetigo) G+ cocci in clusters Symptoms- Skin flakes or peels off; itchiness; highly contagious; affects primarily children. Lesions are found around mouth, face, and extremities; abscesses (carbunkle, boils); nausea, vomiting, diarrhea due toxins but disappear within 24 hours; more likely form of Staph (can be found anywhere) Infective source- normal skin inhabitant; 20% or people are carriers; Direct contact, indirect contact Diagnosis- Clinical presentation, culture and Gram stain, PCR Treatment- Topical and oral antibiotics (Penicillin resistant) Prevention- Hygiene practices

(Rabdi bullet shaped RNA virus) Symptoms- 1 to 2 months incubation period; fever, nausea, vomiting, headache, fatigue, muscle ache, tingling at site of entry; later symptoms of neurological impairment for furious type: disorientation, seizures, twitching; dumb type: paralysis, disorientation, and stupor. Both phases result in coma and death; 50% develop hydrophobia Infective source- Parenteral (bite trauma), droplet contact (aerosols of wildlife urine) Diagnosis- smears; brain biopsy Treatment- Postexposure passive and active immunization; clean wound thoroughly Prevention- HDCV- inactivated vaccine, vaccination of animals

G+ cocci Symptoms- nosocomial disease in immune deficient persons; infection of biomaterials such as catheters; coagulase negative; bacteria causes biofilm to grow; fever, fatigue, pain or tenderness at the site of an implant, rapid breathing, rapid heart beat and sweating; endocarditis (inflammation of heart); Less likely form of Staph (only found in skin) Infective source- common inhabitant of skin; Direct and indirect contact Diagnosis- Isolation of organism, culture, Treatment- Antibiotics Prevention- Sterilizing medical equipment; hygiene

(Ring worm of head, foot, beard) Symptoms- Itchy red rash usually in the pattern of a ring; can affect the beard area, body, groin, feet, and hands; thin fluid discharge; blisters dry and leave behind scaly ring Infective source- Direct and indirect contact; vehicle (soil), towels, floors Diagnosis- Microscopic examination, KOH staining, culture, observation of spores Treatment- Antifungal topicals, oral treatment Prevention- Avoid contact; proper hygiene

produces endospores, G+ rod Symptoms- neurotoxin tetanospasmin that binds to target sites of the nervous system; blocks inhibition of muscle contraction; spastic paralysis; clenching of the jaw, extreme arching of the back, flexion of the arms, and extension of the legs; death usually occurs Infective source- Parenteral, indirect contact, infective wounds, soil contact Diagnosis- Symptomatic, clinical Treatment- Antitoxins, supportive, hard to treat Prevention- Tetanus toxoid immunization, DPT vaccine

G- rod Symptoms- Nosomical infection; urinary, respiratory, blood pathogen; UTI infections, common with ventilator equipment, symptoms similar to burn victims; swimmer's ear/itch, Infective source- Soil contamination, water, spas, normal flora of skin and digestive tract Diagnosis- isolation, culture Treatment- Antibiotics Prevention- Aseptic

(Anthrax) G+ rod Symptoms- Cutaneous: lesions in skin, invade lymph node, death in five days Infective source- Vehicle (soil, air), indirect contact (animal hides), vehicle (food), cattle, horses, sheep Diagnosis- Culture, direct fluorescent antibody tests, capsule test Treatment- Antibiotics (broad spectrum), anti0anthrax serum Prevention- Vaccine for high risk population, testing and elimination of animals Respiratory: permanent damge to lungs; 80% fatality rate

(Gangrene), G+ rod Symptoms- infection after injury, pain, tenderness, rotting, odor from gas production Infective source- contamination of wound through soil, Diagnosis- Clinical, serological Treatment- Antibiotics Prevention- Proper wound cleaning

(Ratbite Fever) Symptoms- fever rash, 4-28 days lesions at entry, swollen lymph nodes Infective source- Rodent bites Diagnosis- examination of blood or tissue Treatment- antibiotics Prevention- rodent control

Symptoms- anemia, lethargy, Infective source- Vehicle (soil), fomite, barefoot, skin contact Diagnosis- Blood count, serology, egg or worm detection, fecal smear Treatment- antiworm medications Prevention- Sanitation, proper innnoculation of dogs, wear shoes

(Afipia felis) G- curved rod Symptoms- 7 to 12 days: small red bumps; 1 to 4 wks: lymph nodes swell and pus filled; months later: symptoms disappear Infective source- Vehicle (meat), fecal-oral, scratches from infected cat Diagnosis- Serological detection of IgM, culture, histology, interdermal skin test Treatment- antibiotics Prevention- avoid cats

(Crabs, Scabies, Jock Itch) arthropod (mite) Symptoms- rash, itchy, red lesions; hairless Infective source- mite, direct contact Diagnosis- microscopic examination Treatment- Benzalidane Prevention- Good hygiene

(Rye Syndrome) Protozoa Symptoms- mild inflammation, pain; can lead to blindness; requires cornea transplant or eye removal Infective source- water or soil contamination; eye discharge Diagnosis- Observation of cyst on cornea Treatment- Antiprotozoal medication Prevention- Sterile contact handling, water control

(Acne) G+ rod chains Symptoms- Follice associated lesions "pimple;" intense local inflammation Infective source- normal flora of skin; Endogenous Diagnosis- Clinical presentation Treatment- Antibiotics (drug resistant) Prevention- None

(African Sleeping sickness) (protozoan) Symptoms-fever, inflammation of lymph nodes, seizures, death Infective source- Vector, vertical, TseTse Fly, salivary glands Diagnosis- Microscopic examination of blood, CSF Treatment- Antiprotozoal medication Prevention- Vector control, avoiding fly infested area

(Malaria) protozoan Symptoms- sensation of intense cold, shivering, intense rise in temperature; headache, delirium; death due to cardiovascular problems; low death rate Infective source- Biological vector (Anopheles mosquito), vertical Diagnosis- Blood smear; serological methods Treatment- Antimalarial drugs (drug-resistance) Prevention- Mosquito control; use of bed nets; no vaccine

(Epidemic Typhus Fever) G- spirocci Symptoms- incubation: 1 to 3 wks; fever, chill, malaise; rash in armpits spread to everywhere but face and soles of feet; can lead body to functions to breakdown Infective source- Body or head lice Diagnosis- ELISA test Treatment- Antibiotics Prevention- Control lice

(Bubonic Plague) G-coccibacillus Symptoms- Chills, high fever, malaise; Bubo Stage: swollen lymph nodes (unless rupture not transmitted via person to person); highly infectious Infective source- Vector, bite from infective flea Diagnosis- Culture or Gram stain of blood or bubo aspirate Treatment- Antibiotics Prevention- Flea and animal control; vaccine for high-risk population; avoid rodents

(spirrocal single-stranded RNA isosohedral) Symptoms- usually in monkeys; 1 to 3 days; day 1: sudden fever, nausea, headache; day 3-4: symptoms subside; day 5: symptoms return with intensity; black vomit Infective source- Biological vector, mosquitoes Diagnosis- isolation of virus Treatment- Supportive, blood transfusions Prevention- Live attenuated vaccine, protection from mosquitoes

(caused by several viruses) Symptoms- Cerebral disfunction; immune infections; 5 to 10 days later: neuron damage (short circuits); blood-borne transmission enters nervous system Infective source- transferred by mosquito Diagnosis- Clinical presentation of meningitis, seizures Treatment- No treatment Prevention- Vaccination, avoiding mosquitoes

(Rabbit Fever) G- rod Symptoms- 3 week incubation: headache, backache, fever, chills, weakness, ulcerative region at entry; sore throat, diarrhea Infective source- bite or contact with rabbits or rodents Diagnosis- serology Treatment- Antibiotics Prevention- Vaccine for high-risk population; avoid contact

(Lyme Disease) G- spirocci Symptoms- Nonfatal disease; bull's eye rash around bite; arthritic symptoms and neurological symptoms; headache, fever, stiffness, dizziness Infective source- deer tick bite Diagnosis- ELISA for Ab, PCR Treatment- Antibiotics for 3 to 4 weeks Prevention- Tick avoidance

(Rocky Mountain Spotted Fever) Symptoms- fever, chills, muscular pain, lesions; gangrene can occur; cardiovascular damage; convulsions, tremors, death Infective source- tick bite Diagnosis- Fluorescent antibody, PCR Treatment- Antibiotics, Doxycycline Prevention- Avoid ticks

Symptoms- 14 days after infection: swelling and damage to brain, meninges, loss of memory, heart disorder, personality changes Infective source- mosquito bites Diagnosis- Patient history, serological tests Treatment- None; treat symptoms; supportive measures Prevention- Insect control, vaccines for WEE and EEE available

(River Blindness) worm Symptoms- nodules develop; inflammation of eye, permanent retinal damage Infective source- black fly Diagnosis- observation of worm in skin"Skin snips;" small pieces of skin in NaCl solution examines Treatment- Antibiotics Prevention- Avoiding black fly

(Break-Bone Fever) Symptoms- disrupts clotting; shock syndrome; toxins produce uncontrolled muscle contractions and can break long bones in body Infective source- mosquito Diagnosis- Rise in IgM titers Treatment- Supportive; some antitoxins Prevention- Vaccine being tested; avoiding mosquitoes

Symptoms- 20% are symptomatic; severe hemorrhagic syndrome (bleeding out); sore throat, back pain, deafness Infective source- Aerosolized rodent excretions Diagnosis- ELISA Treatment- RIbavirin Prevention- Avoiding rats; safe food storage

(4 tick borne diseases ,"Rocky Mountain Non-spotted Fever) Symptoms- headache, muscle pain, rigors Infective source-Tick bites Diagnosis- PCR, antibody Treatment- Doxycycline Prevention- Avoiding ticks