Agent summary statement of Hantavirus and corynebacteria .pptx

Agent summary statement of Hantavirus and corynebacteria

1. Agent Summary Statements Sporothrix schenckii Hantavirus

2. Group Participation Data collection: Babar Ali and Nirma Asghar Sides Formation: Hafsa Amir and Afaf Presented by Sadia Jabeen , Ayesha kanwal and Iqra ismail

3. BACTERIA Family: corynebacteriaceae Genus: corynebacterium Gram positive, club shaped Small aerobic Pleomorphic (single, pair, V-shaped) Non-motile, non-spore forming Catalase positive. Responsible for disease called diphtheria. Belongs to risk group 2.

4. Diphtheria (leather in Greek) Upper throat disease characterized by fever, sore throat, or pseudo membrane formation at the back of an infected person throat. The WHO reported 7088 cases of diphtheria world wide in 2008 and 5000 estimated deaths in 2004 Exotoxin released by Corynebacterium diphtheria is called diphtheria toxin. Exotoxin is basically protein consist of 2 units A (for toxicity) and B (for attachment).

5. Mechanism of Disease Fig a: target cell and protein Fig b: Attachment Fig c: Entry Fig d: Release When A part releases it give damaging effect to the target cell by inhibiting protein synthesis. a b c d

6. Transmission, Host range, resorvior Route of transmission: is respiratory track. Diphtheria is spread (transmitted) from person to person, usually through respiratory droplets, like from coughing or sneezing. or by direct contact with patient or carrier. Host Range: They mainly infect humans, although rare strains are isolated from cow, cats, and horses RESERVOIR : Humans are thought to be a significant reservoir for  C. diphtheria. ZOONOSIS : None VECTORS : None

7. Epidemiology, Incubation period and Communicability Epidemiology : The WHO reported 7088 cases of diphtheria world wide in 2008 and 5000 estimated deaths in 2004.   Risk population: Children and adults who don't have up-to-date immunizations. People living in crowded or unsanitary conditions. Anyone who travels to an area where diphtheria is endemic. Infectious dose: Unknown Incubation period : 2-4 days Communicability : Variable period. In the absence of antibiotic therapy, disease is communicable for 2-4 weeks

8. Stability and Viability Drug Susceptibility : Susceptible to penicillin, erythromycin, tetracycline and certain cephalosporins . Some strains resistant to erythromycin have been reported. Drug Resistance: Erythromycin-resistant isolates have been reported Susceptibility to Disinfectants : C. diphtheriae  and related species can also be inhibited by chlorhexidine (MIC of 5mg/l). Most vegetative bacteria are also susceptible to 1% sodium hypochlorite, 70% ethanol, glutaraldehyde , formaldehyde, iodines , hydrogen peroxide, peracetic acid, and quaternary ammonium compounds. Physical Inactivation: vegetative bacteria can be inactivated by moist heat (121°C for 15 min- 30 min) and dry heat (160-170°C for 1-2 hours). Survival Outside Host : C. diphtheriae  can survive on dry inanimate surfaces from 7 days to 6 months

9. First aid / Medical and Control Surveillance : Monitor for symptoms. Diagnosis of diphtheria is done mainly through monitoring of clinical symptoms. Confirmation of  C.diphtheriae  infection can be done by culture of the bacteria on selective media such as 5% sheep blood agar,   followed by Gram staining, and differential biochemical tests. Administration of diphtheria antitoxin (DAT) is the most successful treatment for diphtheria  Antibiotics: penicillin, cephalosporin, erythromycin, and tetracycline are recommended. Immunization : 3 dose of Pentavalent vaccine( DTP+Hep B + Hib ) are given  for the control of diphtheria infection at the age of 6 weeks, 10 weeks, 14 weeks

10. Laboratory Hazards: Laboratory-Acquired Infections : Thirty-three cases of laboratory acquired diphtheria were reported as of 1976. Although localized skin and eye infections have occurred in an occupational setting, no pulmonary infections have been reported as a result from laboratory exposure. It should be noted that serious disseminated infections have been reported in immunocompromised persons. Source/Specimens : Exudates or secretions from nose, throat, nasopharynx , larynx, wounds, blood, skin. Primary Hazards : Inhalation, accidental parenteral inoculation, and ingestion . Special Hazards : None.

11. Exposure controls / Personal protection: Containment Requirements : Containment Level 2 facilities, equipment, and operational practices for work involving infected or potentially infected materials, animals, or cultures . Protective Clothing : Lab coat. Gloves , Eye protection. OTHER PRECAUTIONS : All procedures that may produce aerosols, or involve high concentrations or large volumes should be conducted in a biological safety cabinet (BSC). The use of needles, syringes, and other sharp objects should be strictly limited.

12. Handling, Storage and Transport: Spills : Allow aerosols to settle and, wearing protective clothing, gently cover spill with paper towels and apply an appropriate disinfectant, Allow sufficient contact time before clean up.   Disposal : Decontaminate all wastes that contain or have come in contact with the infectious organism by autoclave, chemical disinfection, gamma irradiation, or incineration before disposing . Storage and Transport : The infectious agent should be stored and transported in leak-proof containers that are appropriately labeled 

13. FUNGUS Family: ophistomatacea Genus: Sporoththrix Saprophytic,   Dimorphic fungus  found as hyphae (35 ̊C) or cigar-shaped yeast (37 ̊C)  grows readily on Sabouraud dextrose agar  initially they produce cream- coloured , smooth or verrucous , moist colonies later matures into a black leathery colony Responsible for Sporotrichosis (rose gardener's disease) Belongs to risk group 2. Sporothrix schenckii

14. Sporotrichosis (rose gardener's disease)   Disease caused by the infection of the fungus Sporothrix schenckii   Sporotrichosis is classified into 4 categories: 1.  lymphocutaneous 2  fixedcutaneous 3. multifocal or disseminated 4.extra-cutaneousform Infection take place by inoculation of organism into skin(hand, arm or foot). In all forms cutaneous lesions usually arise in the limbs.

15. Transmission and Host range Route of transmission: transmission occur by direct contact ulcerous lesions, by animal (dog, squirrel, cats, armadillo) bite Introduction of fungus through the skin occurs as a result of pricks from splinters, thorns. Host Range: Humans, cats, horses, dogs, rodents, cattle, swine, camels, birds (parrots), armadillos, and wild animals.

16. Epidemiology, Incubation period and Communicability Epidemiology : Reported worldwide.   Risk population: Sporotrichosis is rare, but people who handle plant matter such as rose bushes, or hay are more likely to get the infection. Infectious dose: Unknown. Incubation period : Three to 21 days, and occasionally up to 3 months. Communicability : Transmission from person to person is rare.

17. Dissemination Reservoir : Soil, surface water, decaying vegetation, wood, moss, hay, grain, and marine animals Zoonosis : Sporotrichosis is a disease common to man and animals; however, feline sporotrichosis is the most common zoonotic disease around the world. VECTORS : None.

18. Stability and Viability Drug Susceptibility : Sensitive to saturated solution of potassium iodide, itraconazole , amphotericin B, ketoconazole, fluconazole  , other triazoles ( saperconazole , voriconazole , ravuconazole , and posaconazole )  and terbinafine  ,Some isolates are found to be resistant to amphotericin B. Susceptibility to Disinfectants : Sensitive to 70% ethanol, sodium hypochlorite (500 to 1,000 ppm), accelerated hydrogen peroxide (6,000 ppm) a mixture of zinc sulphate and formaldehyde. Physical Inactivation : Sensitive to moist heat (121°C for 15 minutes)  Survival Outside Host : Ubiquitous environmental saprophytes that can survive in soil, surface water, and decaying vegetation

19. First aid / Medical Surveillance : Diagnosis is based on clinical signs, histology, and/or by culture of biopsy samples and identification. classic therapy for of sporotrichosis   is saturated solution of potassium iodide. Medication:   itraconazole has become the drug of choice. oral antimycotic drugs such as triazole and saperconazole may be effective. Disseminated sporotrichosis : Initial treatment is usually initiated with amphotericin B and after initial improvement, is usually changed to itraconazole which may be continued lifelong for patients who have both HIV infection and sporotrichosis . Immunization : None

20. Laboratory Hazards: Laboratory-Acquired Infections : Several cases of sporotrichosis have described among laboratory workers who handled infected animals or cultures.direct contact with lesion, accidental inoculation has been suggested as the main causes of infection.  Another possibility of transmission is attributed to the scratch or bite of cats or laboratory animals. Source/Specimens :  Major environmental sources are contaminated soil, water and vegetation. Other sources include ulcerated lesions and infected animals. Primary Hazards : Direct contact with broken skin and mucus membranes, needlestick and aerosol, SPECIAL HAZARDS : None.

21. Exposure controls / Personal protection: Containment Requirements : Containment Level 2 facilities, equipment, and operational practices for work involving infectious or potentially infectious materials, animals, or cultures. Protective Clothing : Lab coat. Gloves , Eye protection. Other Precautions : All procedures that may produce aerosols, or involve high concentrations or large volumes should be conducted in a biological safety cabinet (BSC). The use of needles, syringes, and other sharp objects should be strictly limited.

22. Handling, Storage and Transport: Spills : Allow aerosols to settle and, wearing protective clothing, gently cover spill with paper towels and apply an appropriate disinfectant, Allow sufficient contact time before clean up.   Disposal : Decontaminate all wastes that contain or have come in contact with the infectious organism by autoclave, chemical disinfection, gamma irradiation, or incineration before disposing . Storage and Transport : The infectious agent should be stored and transported in leak-proof containers that are appropriately labeled 

23. VIRUS Family: Bunyaviridae Genus: Hantavirus Enveloped viruses about 100 nm in diameter single-stranded negative sense RNA genome enclosed within a spherical capsid responsible for hemorrhagic fever with renal syndrome (HFRS) and Hantavirus pulmonary syndrome (HPS ) Belongs to risk group 3 Hantavirus

24. Hemorrhagic fever with renal syndrome (HFRS) HFRS can manifest as mild, moderate or severe disease, depending upon the causative virus Clinical course can be divided into five phases: (a) Prodrome (lasts 3 to 7 days): initial symptoms. (b) Hypotensive (lasts several hours to many days): low B.P (c) Oliguric (lasts 3 to 7 days): low output of urine (d) Diuretic (Spontaneous diuresis indicates the beginning of recovery) (e) Convalescent (a person who is recovering after an illness or medical treatment).   The case fatality rate is 5 to 15%.

25. Hantavirus pulmonary syndrome (HPS) Clinical course can be divided into five phases: (a) Prodrome (b) Cardiopulmonary (c) Diuresis (d) Convalescence (a person who is recovering after an illness or medical treatment).   The case fatality is around 30%.

26. Transmission and Host range Route of transmission: Transmission occurs mainly by inhalation of aerosolized droplets of urine, saliva, or respiratory secretions from infected rodents or of aerosolized particles of feces, dust, or other organic matter carrying the infectious virus. They may also be transmitted by rodent bites, or ingestion of contaminated food or water, and direct contact of cutaneous injuries or mucous membranes with the infectious virus. Host Range:   Humans, and several species of rodents (voles, mice, rats).

27. Epidemiology, Incubation period and Communicability Epidemiology : Hantaviruses occur worldwide.   Risk population: Anyone who comes into contact with rodents that carry  hantavirus  is at  risk  of HPS. Even healthy individuals are at  risk  for HPS infection if exposed to the virus Infectious dose: Unknown. Incubation period : 2 to 4 weeks (range from few days to 2 months) for HFRS; and 14-17 days for HPS. Communicability : Person-to-person transmission is very rare.

28. Dissemination Reservoir : Small rodents (mice, rats and voles) serve as the reservoirs of Hantaviruses Zoonosis : Yes, transmitted from rodents to humans .   Puumala virus – bank vole in northern and central Europe, Hantaan virus – striped field mouse in east Asia, Dobrava virus – yellow-necked mouse and striped field mouse in southern Europe, Seoul virus - Norway rat worldwide, Sin nombre virus – deer mouse in North America. VECTORS : None.

29. Stability and Viability Drug Susceptibility : Susceptible to latoferrin (in vitro) and ribavirin (in vitro and in vivo) in cases of HFRS; however, the efficacy of these drugs on cases of HPS have not been shown. Susceptibility to Disinfectants : Susceptible to 1% solution of sodium hypochlorite, 1-5% chlorine dioxide, 1-5% Dettol, 1-5% sodium-p-toluene- sulfonchloramide , 1-5% peracetic acid with a 10 minute contact time. Also susceptible to absolute methanol with a 10 minute contact time and 70% ethanol with a 30 minute contact time. Physical Inactivation: Inactivated by heat (15 min at 56ºC for viruses in cell culture medium, and 2 hours at 56 o C for dried viruses). Survival Outside Host : Ubiquitous environmental saprophytes that can survive in soil, surface water, and decaying vegetation

30. First aid / Medical Surveillance :   Monitor for symptoms. Diagnosis is based mainly on serological tests to detect Hantavirus specific IgM , IgG , and neutralizing antibodies against the N protein or glycoproteins. Treatment: with antiviral ribavirin improves the outcome of HFRS, but has not been investigated for HPS. Treatment is supportive. Furthermore, extracorporeal CO 2  elimination system should be considered for HPS patients to prevent life threatening pulmonary edema and cardiogenic shock. Immunization : None

31. Laboratory Hazards: Laboratory-Acquired Infections :   Yes, 226 cases (no deaths) have been reported for Hantaan virus. Source/Specimens :  Blood, urine, cerebrospinal fluid, and respiratory secretions, as well as rodent urine. Primary Hazards :   Ingestion, contact of mucous membranes or broken skin with infectious materials, inhalation, animal bites, and accidental parenteral inoculation. SPECIAL HAZARDS : Working with laboratory animals (exposure to animal excreta, fresh necroscropy material, and animal bedding)  

32. Exposure controls / Personal protection: Containment Requirements : Containment level 3 facilities, equipment and operational practices for all work involving infectious or potentially infectious materials, animals, or cultures. These containment requirements apply to the genus as a whole, and may not apply to each species within the genus. Protective Clothing : Personnel entering the laboratory should remove street clothing and jewellery , and change into dedicated laboratory clothing and shoes.   Additional protection(solid-front gowns with tight fitting wrists, gloves, and respiratory protection. Eye protection) Other Precautions : All activities with infectious material should be conducted in a biological safety cabinet (BSC) or other appropriate primary containment with PPE. Centrifugation of infected material must carried out in closed containers placed in sealed safety cups.

33. Handling, Storage and Transport: Spills : Allow aerosols to settle and, wearing protective clothing, gently cover spill with paper towels and apply an appropriate disinfectant, Allow sufficient contact time before clean up.   Disposal : Decontaminate all wastes that contain or have come in contact with the infectious organism by autoclave, chemical disinfection, gamma irradiation, or incineration before disposing . Storage and Transport : The infectious agent should be stored and transported in leak-proof containers that are appropriately labeled 

34. References: Ryan, K. J. (2004). Corynebacterium, Listeria, and Bacillus. In K. J. Ryan, & C. G. Ray (Eds.),  Sherris Medical Microbiology: An Introduction to Infectious Diseases  (4th ed., pp. 297-308). USA: McGraw Hill.  Acha , P. N., & Szyfres , B. (2003). Bacterioses and Mycoses  Zoonoses and Communicable Diseases Common to Man and Animals  (3rd ed., pp. pp. 352-356.). Washington, D.C.: Pan American Health Organization.  Fulhorst , C. F., & Bowen, M. D. (2007). Hantaviruses. In P. R. Murray (Ed.),  Manual of Clinical Microbiology  (9th ed., pp. 1501-1509). Washington D.C.: ASM Press.