Shared Flashcard Set

Details

Public Health Exam 1
N/A
234
Veterinary Medicine
Professional
11/05/2011

Additional Veterinary Medicine Flashcards

 


 

Cards

Term
About how many diseases and parasites of animals can be transmitted to humans through ingestion of contaminated meat or meat products?
Definition
About 90
Term
What are two goals of meat inspection?
Definition

1. Prevent diseased meat from reaching the consumer

2. Ensure sanitary conditions at processing facilities

Term
Is meat inspection required by law?
Definition
Yes
Term
When were the first meat inspection laws made?
Definition
End of the 19th century.
Term
What was the first U.S. inspection law?
Definition
It was related to exports of salted pork and bacon.
Term
What were the second and third US inspection laws?
Definition

2. Pre-slaughter inspection for interstate shipment or export

3. Condemnation of diseased animals for shipment

Term
What was the point of early meat inspection laws - protect the people, or protecting trade?
Definition
Protecting trade
Term
Who was the author, and what was the book that described the unsanitary conditions in the Chicago meat-packing industry at the turn of the century?
Definition
The Jungle by Upton Sinclair in 1906.
Term
What was the result of Upton Sinclair's book?
Definition
President Roosevelt called upon Congress to pass a law establishing the Food and Drug Administration, and for the first time, setting up federal inspection standards for meat.
Term
What were the two parts of the 1906 Pure Food and Drug Act?
Definition

1. For preventing the manufacture, sale, or transportation of adulterated or misbranded or poisonous or deleterious foods, drugs, medicines, and liquors, and for regulating traffic therein.

2. That the introduction into any State or Territory or the District of Columbia from any other state or Territory or the District of Columbia, or from any foreign country, or shipment to any foreign country any article of food or drugs which is adulterated or misbranded is hereby prohibited.

 

Term
What was the goverment concerned with during the Pure Food and Drug Act?
Definition
More concerned at this point in time with the additives to the food.
Term
What were the reasons for the 1906 Federal Meat Inspection Act?
Definition

1. To safeguard the public by eliminating diseased animals and unwholesome meat products.

2. Inspection of both products and facility sanitation

3. Provided safeguards against the use of harmful ingredients.

4. Mandated the United States Department of Agriculture (USDA) inspection of meat processing plants that conducted business across state lines.

Term
Was the Federal Meat Inspection Act driven for food safety or commerce?
Definition
It was commerce driven.
Term

During the end of what decade of the twentieth century did the Horse Meat Inspection Act come into existence?

 

Definition
1919.
Term
During the middle of what twentieth century decade was there voluntary poultry inspection?
Definition
During the 1920's (1924)
Term
What was unique/ironic about the voluntary poultry inspection?
Definition
It was funded by the companies.
Term
When was poultry inspection a federal requirement? (AKA when was the Poultry Inspection Act passed?)
Definition
Late 1950's. (1957)
Term
What decade of the twentieth century was the Humane Slaughter Act passed?
Definition
The sixties (1960)
Term
What was the requirement of the humane slaughter act?
Definition

Animals must be unconscious when exsanguinated (i.e. via captive bolt stunner; electric shock)

It was pushed for by animal rights activist groups

Term
What decade of the twentieth century was the Wholesome Meat Act passed?
Definition
The 1960's (1967)
Term
What was called for in the wholesome meat act?
Definition

1. Inspection for all products:  export, interstate, and intrastate

2. Cooperative state-federal program

3. Required that states have inspection programs "equal to" that of the federal government

 

Term
What decade of the twentieth century was the Wholesome Poultry Products Act passed?
Definition
1960's (1968).
Term
What decade was the Processed Products Inspection Improvement Act passed?
Definition
1980's (1986)
Term
What decade of the twentieth century was the mandatory adoption of SSOP and HACCP plans for all processing plants passed?
Definition
1990's (1996)
Term
What are the SSOP?
Definition
Sanitation Standard Operating Procedures
Term
What are the HACCP?
Definition
Hazard Analysis and Critical Control Points.
Term
What are the seven HACCP Principles?
Definition

1. Analyze Hazards

2. Identification of CCP's

3. CCP Prevention Measures

4. Monitoring of CCP Prevention Measures

5. CCP Not Met

6. HACCP & CCP Log

7. Establish procedures for verifying the HACCP system is working as intended

Term
What happens during the Analyze Hazards principle?
Definition
Potential hazards to the food safety are recognized, in addition measures to regulate and control the hazards are identified.
Term
What happens during the identification of CCP's principle?
Definition
Critical Control Points throughout the production process of the product are established.
Term
What happens during the CCP prevention measures principle?
Definition

A prevention measure is established at all CCP's

Example - a computer system would moniter and log the temperature.

 

Term
What happens during the CCP not met procedure?
Definition

Establish a precaution when the CCP hasn't been met.

Example - if the temperature is too low, the computer will alarm the batch to be destroyed

Term
What happens during the HACCP & CCP Log principle?
Definition
Maintain a log system of all the CCP's, also, this would include records of CCP control methods and action taken to correct potential problems.
Term
When was the National Food Safety Initiative made?
Definition
In 1997; made by USDA, HHS, EPA
Term
What was the recent food safety act that was passed into law earlier this year?
Definition
The FDA Food Safety Modernization Act
Term
What does the FDA Food Safety Modernization Act do?
Definition
Gives the FDA the power to order food recalls on its own instead of relying on cooperation from industry.
Term
What federal groups are able to recall food?
Definition

USDA - meat and poultry

FDA - other foods (seafood, juice, eggs)

Term
What is a problem with current recall times?
Definition
By the time a recall is made (even with the new law) a lot of recalled food is already consumed.
Term
What two goverment agencies are in charge of performing meat and poultry inspection?
Definition
US Department of Agriculture (USDA) and Food Safety and Inspection Service (FSIS)
Term
What are the elements of inspection?
Definition

1. Sanitation

2. Antemortem inspection

3. Postmortem inspection

4. Condemnation

5. Product inspection

6. Laboratory inspection

7. Labeling

Term
What are the nine steps of the inspection process?
Definition

1. Examination of animals and their carcasses at slaughter

2. Inspection to assure sanitary handling and equipment at all stages of preparation

3. Destruction of condemned product

4. Examination of added ingredients

5. Application of identification standards

6. Enforcement of accurate labeling

7. Inspection of imported products

8. Administration of produce certification

9. Verification of adequacy and effectiveness of plant SSOPs

Term
How many inspectors are there?
Definition

Three

1. Food inspectors (laymen)

2. Veterinary medical officers (DVMs)

3. Laboratory inspectors (trained in food science)

Term
What are the three classifications of antemortem inspection?
Definition

1. Passed - acceptable for slaughter

2. Suspect - animal suspected of having a disease which may result in condemnation

3. Condemned - animal does not go to slaughter (5 Ds: dead, dying, diseased, disabled, or drugged)

Term
What are the five purposes of antemortem inspection?
Definition

1. Remove conditions undetectable on postmortem

2. Prelude to postmortem

3. Prevent contamination of personnel or equipment

4. Report reportable diseases including foreign animal diseases

5. Identify symptoms from drug misuse

Term
Do you want to observe an animal in an antemortem inspection only at rest or only in motion?
Definition
NEITHER!! Want to observe them in both states!
Term
What are the condemnation body temperatures for animals?
Definition

< 96 F in any species - b/c dying

> 105 F in cattle, sheep, goats, and horses

> 106 F in swine

Term
If you see an animal with epithelioma is that animal passed, suspect, or condemned?
Definition
Suspect
Term
If you see an animal with actinomycoses is that animal passed, suspect, or condemned?
Definition
Suspect
Term
If you see an animal with pneumonia is that animal passed, suspect, or condemned?
Definition
Suspect
Term
If an animal has CNS signs, is that animal passed, suspect, or condemned?
Definition
Condemned
Term
When can you slaughter a postpartum cow?
Definition
After the placenta has passed
Term
If you have downer cattle, are they passed, suspect, or condemned?
Definition
Condemned after a dairy cow was diagnosed w/BSE in December 2003.
Term
If an animal is a TB reactor are they passed, suspect, or condemned?
Definition
TB reactors are US suspect.  They have a 'T' brand on the left jaw and a reactor tag in the left ear.  They can be passed on postmortem inspection or passed for cooking at 170 F for 30 minutes.
Term

Are Brucellosis reactors passed, suspect, or condemned?

 

Definition
They are passed, but reactor bull testicles and cow udders are condemned.  They are branded with a B in the left jaw and a reactor tag is in their left ear.  They do not have any special postmortem examinations.
Term
What are the methods of humane stunning?
Definition

1. Captive bolt (penetrating and nonpenetrating)

2. Firearms (brain and head meat are non-edible then)

3. Electrical

4. Carbon dioxide (for smaller species)

 

Term
What are the five principles of postmortem inspection?
Definition

1. Generalized vs. localized conditions

2. Acute vs. chronic

3. Body functions are deranged

4. Injurious to consumer's health

5. Offensive or repugnant

Term
What are the differences between generalized vs localized infections?
Definition

Generalized - systemic spread of organism or condition, cannot remove affected tissue

Localized - body has isolated condition, affected tissue can be trimmed, remaining tissue is safe to use, no secondary carcass changes

Term
What are the differences between acute vs chronic infections?
Definition

Acute - causative agent still present and active, tend to be more generalized

Chronic - tend to be more localized

Term
What is looked at in the postmortem inspection?
Definition

Lymph nodes (incise superficial nodes)

Cheek muscles

Palpate tongue

Internal organs (palpate, incise thoracic and mesenteric nodes, open heart, open bile duct)

Internal body surfaces

Term
Is an animal with septicemia/toxemia passed, suspect, or condemned?
Definition
If there is degeneration of heart, liver, spleen and kidneys = condemn
Term
If an animal has icterus, xanthosis, emaciation is it passed, suspect, or condemned?
Definition
Condemned
Term
In postmortem conditions, how do you determine to pass or condemn pneumonia animals?
Definition
Depends on the severity, and if it is localized or generalized.  It is then either trimmed or condemned.
Term
How do you make a determination of passing or condemning an animal with epithelioma?
Definition

If it is extensive and involving the orbit - condemn

If it is small and not involving the orbit - pass w/o the head

Term
How do you make the determination on condemnation for bruises and injury?
Definition

If it is slight - trim it and pass

If it is extensive - condemn it

Term
How do you make the determination of condemnation in pericarditis?
Definition

If it's extensive - condemn

If it's slight - trim

Term
How do you make the determination of condemnation in cysterciosis?
Definition

If slight and localized - trim and pass, observe carefully

If generalized - condemn

Term
What is a USDA labeling requirement?
Definition
USDA requires that safe handling instructions be put on all raw and not fully cooked meat and poultry products
Term
Are condemned products supposed to be labeled as such and disposed of properly?
Definition
Yes
Term
What six things are supposed to be on product labels?
Definition

1. Product name

2. Ingredients

3. Name and address

4. Net weight

5. Inspection legend

6. Warning statement (if applicable)

Term
True/False:  meat and meat products after processing are sterile.
Definition
False - they are not sterile
Term
What is the 40-140 Rule of temperature ranges?
Definition

Meat should be stored below 40 F, cooked thoroughly above 140 F (preferably above 150 F).

Temperatures between these two constitute the "Danger Zone"

Term
A foodborne illness is...
Definition
any illness that results from ingestion of any food product
Term
A foodborne outbreak is defined as...
Definition
the occurrence of 2 or more cases resulting from a single food item
Term
True/False:  Foodborne illnesses are estimated to cause 48 million illnesses, 325,000 hospitalizations, and 3,000 deaths in the US each year.
Definition
True
Term
What is food irradiation or cold pasteurization?
Definition
Food safety technology designed to greatly reduce disease-causing germs from food.  It is the process of exposing food to high levels of radiant energy which penetrates into food, killing microorganisms w/o significant increases in the temperature of the food.
Term
True/False:  Food irradiation replaces proper food handling and storage.
Definition
False - it only compliments proper food handling and storage.
Term
Is there a specific symbol that is required on irradiated food?
Definition
Yes, the Radura Symbol must be displayed on irradiated foods sold for retail.
Term
What are the four qualifications for the AVMA supporting the use of an ionizing source for the pasteurization of meat and poultry to inactivate contaminating micro-organisms?
Definition

1. The animals are healthy and free of chemical residues

2. The animals have been slaughtered and processed under clean, sanitary conditions

3. Ionizing pasteurization is applied at licensed levels and following propers safeguards

4. The meat and poultry are protected from recontamination until consumed

Term
What are the sources of protein in pet foods?
Definition

1. Lungs, spleen, and tripe

2. Slunks (fetal animals)

3. Meat and meat products

4. Certain condemned carcasses

5. Horse meat and meat products

Term
Is federal inspection of pet foods required or voluntary?
Definition
Voluntary - done under certification service of federal meat inspection programs.
Term
Do certified pet foods require an inspection legend?
Definition
Yes
Term
True/False:  Sanitation requirements of pet food are not the same as for human meat processing establishments.
Definition
False - they are the same
Term
What are the two considerations with regard to milk and public health?
Definition

1. Potential for transmission of pathogens btwn humans and animals

2. Potential for consumption of milk adulterated with biologicals, pharmaceuticals, pesticides, or hormones

Term
What does the Pasteurized Milk Ordinance do?
Definition

The US Dept. of Health and Human Services establishs nationwide quality standards for milk from pre-harvest to finished product.

Individual states may have additional requirements.

Term
Who does the PMO regulate and who is it enforced by?
Definition

Regulates dairy producers, creameries, milk processors, and veterinarians.

Enforced by State Milk Inspectors by the State Dept. of Health.

Term
What does it mean when milk is Grade A?
Definition

1. It is fluid milk

2. Excess used for manufacturing

3. SCC limit 750,000

4. Bacteria count limit 100,000 (pre-pasteurization)

5. No inhibitors

Term
What does it mean when milk is Grade B?
Definition

1. It is manufacturer grade (for manufacture of milk products like cheeses, yogurt, cottage cheese, ice cream, milk powder)

2. SCC limit = 750,000

3. Bacteria count limit = 500,000

4. No inhibitors

Term
What is the definition of abnormal milk?
Definition
Milk that is visibly changed in color, odor, and/or texture
Term
What is the definition of undesirable milk?
Definition
Milk that, prior to the milking of the animal, is known to be unsuitable for sale, such as milk containing colustrum.
Term
What is the definition of contaminated milk?
Definition
Milk that is un-saleable or unfit for human consumption following treatment of the animal with veterinary products, i.e. antibiotics, which have withhold requirements, or treatment with medicines or insecticides not approved for use on dairy animals by FDA or the Environmental Protection Agency (EPA)
Term
What is mastitis?
Definition
Inflammation of the mammary gland usually caused by a intramammary infection
Term
What are some common mastitis pathogens?
Definition
Staphylococci, Streptococci, Enteric pathogens, Mycoplasma sp., Arcanobacter sp., Corynebacterium sp., etc.
Term
What are the three main ways of contamination with milk?
Definition

1. Equipment & utensils (fomites)

2. Poor handling techniques

3. Unclean cattle

Term
What are the seven potential zoonoses in milk?
Definition

1. Brucellosis

2. Tuberculosis

3. Q fever (Coxiella burnetti)

4. Listeria monocytogenes

5. Salmonella (DT 104)

6. Mycobacterium paratuberculosis? (Johnes)

7. Mastitis pathogens?

Term
How do adulterants enter milk?
Definition

Treatment of cattle - biologics, hormones, antibiotics, NSAIDs, pesticides

Contamination

Term
Do you want to have cross-contamination of lactating animals with abnormal milk and normal lactating animals?
Definition
NO, dispose of abnormal milk and milk animals with abnormal milk separately or last and clean the equipment.
Term
What are the prohibited list of drugs for dairy cows?
Definition
Chloramphenicol, Clenbuterol, Diethylstilbestrol (DES), Dimetridazole, Ipronidazole, other nitroimidazoles, Furazolidone, Nitrofurazone, other nitrofurans, Sulfonamide drugs in lactating dairy cattle (except approved use of sulfadimethoxine, sulfabromomethazine, and sulfaethoxypyridazine), Fluoroquinolones, Glycopeptides (ex. vancomycin), Phenylbutazone in female dairy cattle 20 months of age or older
Term
What are the milk storage requirements?
Definition

Milk must be chilled:

to 50F (10C) w/in 4 hours of initiating milking

to 45F (7C) by 2 hours post-milking

Must be stored at that temperature until pick up

There must be a chart recorder on the tank

Term
True/False:  Water can be added to milk.
Definition
False - Can't be added and is tested by checking the freezing point
Term
The processor of milk does what tests on the bulk tanks of milk?
Definition

Bacterial growth inhibitors

SCC

Pre-pasteurization Bacteria Count (by standard plate count and loop plate count)

Term
What is the definition of pasteurization?
Definition
The heating of every particle of milk or milk product to a specific temperature for a specified period of time w/o allowing recontamination of that milk or milk product during the heat treatment process.
Term
What are the two purposes of pasteurization?
Definition

1. Kill pathogens in milk including zoonotic pathogens (current recommendations are based on killing the thermoduric Coxiella burnetti)

2. Enhance shelf-life

Term
What are the three methods of pasteurization?
Definition

1. Batch or vat method (heat jacketed vat)

2. High-Temperature-Short-Time (HTST) (counter-current heat exchanger (continuous method))

3. Ultra-high Temperature (UHT) (shefl storage w/o refrigeration)

Term
How many illnesses, hospitalizations, and deaths occur in the US each year due to foodborne illness?
Definition

48 million illnesses

325,000 hospitalizations

3,000 deaths

Term
What are the estimated costs associated with foodborne illness each year?
Definition
$5 billion/year
Term
What does it mean when I say that it is a foodborne infection?
Definition
The pathogen was in the food, replicated in the GI tract, and symptoms started in 24-48 hours
Term
What does it mean when I say that there is a foodborne intoxication?
Definition
The bacterial toxin was formed in the food, there was a shorter time course to illness (minutes to a few hours)
Term
Is the general trend for incidence of bacterial foodborne illnesses increasing or decreasing?
Definition
Decreasing
Term
Is Escherichia coli a member of the GI normal flora of humans and a variety of animal species?
Definition
Yes
Term
Where do you find E. coli?
Definition
In the shit! (shed in feces)
Term
Name the five major virotypes of E. coli.
Definition

1. Enterotoxigenic (ETEC)

2. Enteroinvasive (EIEC)

3. Enteropathogenic (EPEC)

4. Enterhemmorhagic (EHEC)

5. Enteroaggrative (EAggEC)

Term
What are two other names for ETEC?
Definition

1.Scours

2.Tourista

Term
What are the virulence properties in ETEC?
Definition

They are plasmid encoded.

Heat labile enterotoxin (increases cAMP level in target cells)

Heat stabile enterotoxin (increased cGMP levels in target cells)

Term
What allows ETEC to colonize the small bowel?
Definition
The pili which allows for adhesion
Term
Is ETEC zoonotic?
Definition
NO!  Human disease comes from human shit and not from animals
Term
What is the result of ETEC? (i.e. what type of diarrhea)
Definition
Watery (cholera-like) diarrhea
Term
How does EPEC cause disease?
Definition
It is an attaching and effacing lesion which means a loss of microvilli.  There are no enterotoxins.  Instead there is a bundle forming pilus
Term
What age group is EPEC most deadly to?
Definition
Infants.  Major killer of infants in developing countries
Term
What are the mortality rates of EPEC?
Definition
25-50%
Term
Is EPEC zoonotic?
Definition
NO!  Once again coming from human shit
Term
What happens in an attaching and effacing lesion?
Definition
Cells bind to the receptor, that triggers actin cytoskeletal rearrangement forming a pedestal, and then you have intimate contact btwn bacterium and host cell.  Absorptive properties are affected
Term
What does EIEC have? (method of invasion)
Definition
Salmonella-like invasiveness which can result in septicemia
Term
Where is EIEC found (what animals)?
Definition
In humans and can be found in poultry.  Rarely found in other mammals
Term
Is EIEC zoonotic?
Definition
NO, more human shit is responsible!
Term
What are the virulence factors of EAggEC?
Definition

Pili - thin fibrillar structures, aggregative adherence fimbriae (AAF/I)

EAST (heat stable) enterotoxin

Term
What age group is most affected by EAggEC?
Definition
Children - get a persistent form of diarrhea (> 14 days)
Term
Is EAggEC zoonotic?
Definition
Ha, NO! Even more human shit causes this diarrhea!
Term
Is EHEC zoonotic?
Definition
YES!! It comes from cattle who are asymptomatic
Term
What is another name for EHEC?
Definition
E. coli O157:H7
Term
What is the virulence factor of EHEC and how does it work?
Definition
EHEC strains produce Shiga toxin which inhibits protein syntehesis by cleaving 18S rRNA and kills cells (it's encoded on a prophage)
Term
What are the sources of infection in E. coli O157:H7 outbreaks?
Definition

1. Undercooked ground beef and unpasteurized milk

2. Unpasteurized fruit juices

3. Drinking water and recreational water

4. Contaminated vegetables (alfalfa, sprouts, spinach)

Term
What are three ways to prevent E. coli O157:H7 outbreaks?
Definition

1. Adequate refrigeration for storage and proper cooking (internal temperature of 160F for 15 sec.)

2. Pasteurization of milk and fruit juices

3. Implementation of Hazard Analysis and Critical Control Points (HACCP) in Slaughtering and Meat Processing procedures

Term
What happens in EHEC infections?
Definition
Occur 4 days post exposure, and you get watery to dysentery-like diarrhea, intense abdominal pain, 6-7 days of bloody diarrhea, hemorrhage and edema in the lamina propria.  Resolution occurs in 3-10 days.
Term
What can patients with EHEC infections also develop?
Definition
Can also develop hemolytic uremic syndrom (HUS) - about 6%
Term
What happens in HUS?
Definition

Acute kidney failure, hemolytic anemia, and thrombocytopenia.

Mortality rate is 5-15%.

Treatment is transfusion and dialysis

Term
How many salmonella infections occur every year in the US?
Definition
40,000 cases of salmonellosis are reported, and estimated that approximately 400 people die each year from acute salmonellosis
Term
What are the three forms of Salmonellosis in humans and what organisms are associated with each?
Definition

1. Typhoid fever - S. tyhpi

2. Paratyphoid fever (enteric fever) - S. parathyphi A, S. schotmulleri, S. hirshfeldii

3. Gastroenteritis - S. enterica serovars

Term
What is the most common form of salmonellosis?
Definition
Gastroenteritis
Term
How do you get Typhoid fever and what are the symptoms?
Definition

Get it from ingestion of contaminated food or water.

Symptoms are fever, malaise, headache, and anorexia (no diarrhea).  When bacteria are released into the bloodstream it also results in high fever, delerium, abdominal tenderness, and maculopapular erythematous lesions on the abdomen (rose spots).

Term
How does typhoid fever spread?
Definition
Bacteria multiply in the small intestine, invade across the mucosa, and multiply in the lamina propria (facultative intracellular parasites in gut associated monocytes).  Dissemination occurs via the reticuloendothelial system (lungs, liver, spleen, and bone marrow).
Term
What is the hallmark of typhoid fever?
Definition
The elevated fever! Duh!
Term
What is the time line of typhoid fever?
Definition

At 2-3 weeks, diarrhea begins (reinfection of the intestine via an infected gall bladder)

Necrosis of the Peyer's Patches (antigen-antibody interaction mediated).  Can lead to peritonitis

Chronic infection

Septicemia can lead to abscess formation anywhere in the body.

Shedding of organisms can occur for weeks or can be chronic (extending beyond a year)

Term
True/False:  Humans are the only natural reservoir of typhoid fever.
Definition
True
Term
What are the presentations of Paratyphoid fever?
Definition
Similar to typhoid fever, just with different Salmonella species and it is usually a milder disease.
Term
Who was the person that was most identified with the 1906 and 1915 epidemics of Tyhpoid fever?
Definition
Typhoid Mary! (Mary Mallon)
Term
Is gastroenteritis salmonellosis a zoonotic disease?
Definition
Yes!  Often foodborne (meat, chicken, eggs, and milk)
Term
What age groups are most affected by gastroenteritis salmonellosis?
Definition
Children and the elderly (severe for them while usually mild)
Term
What are the symptoms of gastroenteritis salmonellosis?
Definition
Diarrhea, abdominal cramps, chills, fever, nausea, or vomting, headache, etc.
Term
Where are gastroenteritis salmonella species found?
Definition
Found in the gut.  Requires replication of the organism in the gut so it usually takes 24-48 hours before symptoms of diarrhea and abdominal pain occur
Term
What are the common serotypes of gastroenteritis and where is it found?
Definition

Typhimurium: Chicken meat - most prevalent

Enteritidis:  Eggs and chicken - most prevalent

Heidelberg:  Chicken meat - most prevalent

Hadar:  Cattle

Newport:  Cattle

Dublin:  Cattle

Term
When was salmonella used as a bioterrorism agent?
Definition
1984 in the Delles, Oregon.  Trying to influence local elections. Followers of Bhagwan Shree Rajneesh.
Term
What is a common source of zoonotic transmission of salmonellosis?
Definition
REPTILES!
Term
What are the two Multi-Drug Resistant (MDR) Salmonella?
Definition

DT104

Newport

Term
What drugs is S. tyhpimurium DT104 resistant to and what is the mortality rate?
Definition

Drugs - ampicillin, chloramphenicol, streptomycin, sulfas, tetracylcine; some to quinolones

Mortality is 40% in infected cattle (zoonotic agent)

Term
What drugs is S. newport resistant to?
Definition

Drugs - most beta-lactam antibiotics, chloramphenicol, streptomycin, and tetracycline.

Resistance is mediated by a plasmid

Most outbreaks associated with exposure to dairy farms.

Term
What is cholera?
Definition
A disease characterized by production of large volumes of watery diarrhea (up to 20 liters/day).  It is a significant cause of morbidity and mortality of impoverished people throughout history
Term
What is the source of infection for cholera?
Definition
Fecally contaminated food or water
Term
How does the Cholera toxin work?
Definition

Cholera A-B type toxin binds to epithelial cells in the small intestine and the A subunit enters cells and ADP-ribosylates the G protein regulator of adenylate cyclase, activating the enzyme.  The resulting elevated cAMP leads to an outpouring of fluid and electrolytes into the lumen of the gut.

 

Toxin is very similar to the labile toxin of ETEC strains.

Term
How do you treat cholera?
Definition
Treat with orally administered fluids because absorptive properties of the gut are normal
Term
What is the problem associated with Vibrio parahaemolyticus?
Definition
Gastroenteritis.  Associated with the consumption of raw, improperly cooked, or cooked, recontaminated fish and shellfish.
Term
What symptoms are shown in gastroenteritis associated with Vibrio parahaemolyticus?
Definition
Diarrhea, abdominal cramps, nausea, vomiting, headache, fever, and chills
Term
V. vulnificus can cause disease people who do what?
Definition
Eat contaminated seafood or have an open wound that is exposed to seawater
Term
What are the symptoms of Vibrio vulnificus?
Definition
Vomiting, diarrhea, and abdominal pain.
Term
What can happen to immunocompromised people, especially those with chronic liver disease, infected with V. vulnificus?
Definition
It can infect the bloodstream, causing a severe and life-threatening illness characterized by fever and chills, decreased blood pressure (septic shock), and blistering skin lesions.  Bloodstream infections are fatal about 50% of the time.
Term
What is the leading cause of bacterial diarrheal illness in U.S.?
Definition
Camplylobacter infections
Term
True/False:  Camplylobacter infections occur as part of large outbreaks?
Definition
FALSE:  isolated, sporadic events
Term
What age group is more frequently affected by Camplyobacter infections?
Definition
Children under five years and young adults (15-29)
Term
What is the species that is the main cause of Campylobacter food poisoning?
Definition
Campylobacter jejuni
Term
How is Campylobacter transmitted?
Definition

1. Contaminated food (particularly poultry)

2. Un-treated water

3. Raw milk

4. Contact with infected animals (particularly cats and puppies)

5. Can be spread from person to person by the fecal-oral route

Term
What percentage of poultry for human consumption is contaminated with Campylobacter?
Definition
80%
Term
When do symptoms of campylobacteriosis usually occur?
Definition
Usually occur within 2 to 10 days
Term
What are the symptoms of campylobacteriosis?
Definition

1. Diarrhea (may contain blood or mucus)

2. Fever

3. Nausea

4. Vomiting

5. Abdominal pain

Term
What is the treatment of campylobacteriosis?
Definition
Most people will recover without specific treatment, but in severe cases antibiotics can be used.
Term
What are some complications of campylobacteriosis?
Definition

1. Meningitis

2. Urinary tract infections

3. Septicemia

4. Reactive arthritis (rare and almost always short-term)

5. Guillain-Barre syndrome, an unusual type of paralysis (rare)

Term
Is Campylobacteriosis zoonotic?
Definition
Yes? - see case report on slide 34 of this powerpoint.
Term
What are the symptoms of Yersinia enterocolitica?
Definition
Common symptoms in children are fever, abdominal pain, and diarrhea which is often bloody.  In older children and adults, right-sided abdominal pain and fever may be the predominant symptoms and may be confused w/appendicitis.
Term
What age group is most often affected by Yersinia enterocolitica?
Definition
Young children
Term
How do you get get a yersiniosis infection?
Definition
Most often acquired by eating contaminated food, especially raw or undercooked pork products.  Drinking contaminated unpasteurized milk or untreated water can also transmit.  Occasionally occurs after contact with infected animals.
Term
What are the skin infections seen with Staphylococcus aureus?
Definition

1. Folliculitis

2. Boils

3. Pyogenic infections

4. Impetigo

5. Scalded Skin Syndrome

Term
What is a serious toxin produced by certain strains of S. aureus?
Definition
Toxic Shock Syndrome toxin
Term
What are the symptoms of toxic shock syndrome?
Definition
Sudden onset of fever, chills, vomiting, diarrhea, muscle aches and rash.  Can rapidly progress to severe ad intractable hypotension and multiorgan system dysfunction.  Desquamation, particularly on the palms and soles can occur 1-2 weeks after onset of illness.  5% of all cases are fatal.
Term
What is the usual source of food poisoning?
Definition
Source is food handler, not animal isolates usually
Term
True/False - food poisoning is intoxication with a relatively heat stable protein enterotoxin.
Definition
TRUE
Term
Is food poisoning rapid or slow onset?
Definition
Rapid onset
Term

What are the main clinical signs with Staphylococcal enterotoxins?

 

Definition
Vomiting and Diarrhea! (two buckets)
Term
What is unique about Staphylococcal enterotoxins?
Definition
Use superantigens
Term
What does a superantigen do?
Definition
Allows the non-specific binding of MHC II with CD4+ T cells, resulting in polyclonal T cell activation
Term
What are the three types of MRSA?
Definition

1. Hospital-associated strains

2. Community-associated strains

3. Veterinary clinical strains

Term
What is Listeria monocytogenes?
Definition
Gram-positive rod bacteria
Term
What is unique about Listeria monocytogenes?
Definition
Will grow at refrigerator temperatures! (not very quickly, but will increase in numbers)
Term
Where is Listeria monocytogenes found?
Definition

1. In soil and the intestinal tract of many species of animals

2. In feces and fecally contaminated materials

3. In milk

Term
What age group(s) are most severely affected by listeriosis?
Definition
Infants, elderly, and immunocompromised
Term
What is the correlation btwn pregnancy and listeriosis?
Definition
Pregnant women are about 20 times more likely than other healthy adults to get listeriosis.  Listeria infections have been linked to late-term miscarriages in pregnant women.
Term
What symptoms are seen in adult disease listeriosis?
Definition
Meningitis, septicemia, and endocarditis
Term
How does listeria get to the CNS or fetus?
Definition
After ingestion of contaminated food, the bacteria breach the intestinal barrier, travel via the bloodstream, and cross the blood-brain barrier to infect the CNS and also the placenta of pregnant women to infect the fetus.  Does this by the actin tails and a double layer of protection around the bacteria.  The double layer allows it to move from cell to cell w/o being exposed to the outside.
Term
What problems are seen with neonatal infections (granulomatosis infantiseptica) of listeriosis?
Definition

In utero infections - abortion

At birth - sepsis, pneumonia, fetal distress, seizures, rash, abscesses and granulomas

Exposure during vaginal delivery - septicemia, meningitis, meningoencephalitis

High mortality rate

Mother is usually asymptomatic

Term
What is the treatment for listeriosis?
Definition
It is sensitive to antibiotics.  Treatment of encephalitis success depends on the stage of the disease
Term
What is the advice for pregnant women and at-risk consumers to avoid listeriosis?
Definition

1. Do not eat hot dogs, luncheon meats, or deli meats unless they are reheated until steaming hot

2. Do not eat soft cheeses (hard cheeses, semi-soft cheese, pasteurized processed cheeses, cream cheese, and cottage cheese are safe)

3. Do not eat refrigerated pate or meat spreads

4. Do not eat refrigerated smoked seafood unless it is an ingredient in a cooked dish such as a casserole

5. Do not drink raw (unpasteurized) milk or eat food that contain unpasteurized milk

Term
What is Clostridium botulinum?
Definition

Botulism is a gram positive, endospore-forming, anaerobic bacterium.

Spores are heat resistant.

Found in soil

Disease is an intoxication

Term
How much botulism toxin does it take to cause disease and what type of disease does it cause?
Definition

Only a few nanograms causes illness.

All 7 neurotoxin serotypes cause flaccid paralysis by binding the neuromuscular junctions.

Term
Is the toxin of botulism destroyed by heat?
Definition
Yes the TOXIN is heat sensitive - destroyed by boiling
Term
Are the 7 neurotoxin serotypes of botulism host specific?
Definition
NO, there is some host bias but there is a lot of overlap as well
Term
What are the three forms of botulism and are they fatal?
Definition

1. Foodborne

2. Wound

3. Infant

All are fatal (100% if untreated)

Incubation period:  12-36 hours

Term
What causes foodborne botulism?
Definition
Preformed toxin ingested from contaminated food - most common source is from home-canned foods
Term
What symptoms are seen in human adult disease of foodborne botulism?
Definition
Nausea, vomiting, diarrhea, double vision (very important symptom), difficulty speaking or swallowing, descending weakness or paralysis, symmetrical flaccid paralysis, respiratory muscle paralysis
Term
What is the most common form of botulism in the US?
Definition
Infant botulism
Term
How do people get infant botulism?
Definition
Ingest spores (from honey, food, etc.) which germinate and produce toxin in the GIT
Term
What is the pathophysiology of infant botulism?
Definition

1. Toxin is from infection in the GIT vs. ingestion of toxin in adult disease

2. Lack of competitive intestinal flora

3. Neuroparalytic disease caused by heat-labile toxin

4. Irreversibly binds to presynaptic nerve endings of cranial and peripheral cholinergic nerves

5. Blocks calcium dependent exocytosis of acetylcholine vesicles

Term
What are the risk factors with infant botulism?
Definition

1. Transition in feedings

2. Spore density

3. Local construction or family member working with soil

4. Honey or corn syrup consumption (4-25%)

Term
What is the Clinical presentation of infant botulism?
Definition

95% of cases occur in the first 6 months of life

Think there is a SIDS association

Descending neuromuscular blockade - cranial nerves, trunk, extremities, diaphragm

Term
What are the symptoms and signs of Infant Botulism?
Definition

Symptoms - constipation (most common), lack of expression, weak suck and prolonged feeding time, drooling, floppiness

Signs - poor head control, loss of gag/suck, sluggish or nonreactive pupils, hypotonia/hyporeflexia, diminished range of eye movements

Term
How does Wound botulism infect people/animals?
Definition
The organism goes into the wound and develops under anaerobic conditions.  From ground-in dirt or gravel.  Organism does not penetrate intact skin
Term
What is the treatment for botulism?
Definition

Supportive - ventilator (may take months)

Antitoxin - inactivates circulating toxin but does not neutralize bound toxin (only at CDC)

Long term (months) - problem if there is a large number of cases

Recovered patients are not immune

Term
Can/has botulism be used as a bioweapon?
Definition
Yes to both.  It is the most poisonous substance known
Term
What is Clostridium perfringens?
Definition

Anaerobic, gram-positive, spore-forming rod.

Commonly found in the GI tract of humans and animals

Term
What does C. perfringens illness look like?
Definition

Intense abdominal crampls and diarrhea

Starts 8-22 hours after consumption

Usually over w/in 24 hours

Term
How do you get disease from C. perfringens?
Definition

From ingesting the organisms, followed by sporulation in the gut and then toxin release.

Results from temperature abuse of food

Term
What is enteritis necroticans (pigbel)?
Definition

An often fatal illness characterized by hemorrhagic, inflammatory, or ischemic necrosis of the jejunum caused by Clostridium perfringens type C.

Bacteria multiply in the gut and produce beta toxin.

Death occurs by infection and necrosis of intestines and from the resulting septicemia.

Term
What type of virus is Hepatitis A?
Definition
Picornavirus
Term
What is Hepatitis A?
Definition
Usually a mild illness characterized by sudden onset of fever, malaise, nausea, anorexia, and abdominal discomfort, followed in several days by jaundice
Term
How is Hepatitis A spread?
Definition
Excreted in feces of infected people and can produce clinical disease when susceptible individuals consume contaminated water or foods (water, shellfish, and salads are the most frequent sources)
Term
When are you in most danger of spreading Hepatitis A?
Definition
During the middle of the incubation period, well before the first presentation of symptoms
Term
What age group is hepatitis A more common in?
Definition
Disease is more common in adults than in children
Term
Is disease mild or severe in Hepatitis A?
Definition
Usually mild and recovery is complete in 1-2 weeks.  Occasionally severe and recovery can take several months.
Term
What is the only common vaccine-preventable food-borne disease in the US?
Definition
Hepatitis A!
Term
What type of virus is Hepatitis E?
Definition
A non-enveloped RNA virus
Term
What is the case fatality rate of Hepatitis E?
Definition

Overall - 1-3%

Pregnant women - 15-25% (esp. 3rd trimester)

Term
Does illness severity increase or decrease with age in Hepatitis E disease?
Definition
Increased with age
Term
What are most outbreak of Hepatitis E associated with?
Definition
Fecally contaminated drinking water (also uncooked shellfish, uncooked fruit/vegetables not peeled or prepared by the traveler)
Term
What virus is most commonly associated with cruise ships?
Definition
Norovirus
Term
What type of virus is norovirus?
Definition
Caliciviridae
Term
Is norovirus contagious, and stable?
Definition
Yes to both!  Highly contagious and able to survive freezing and high temperatures
Term
How is norovirus transmitted?
Definition

1. Fecal-oral route

2. Indirect contact w/the virus on contaminated surfaces

3. Via contaminated food and water

4. Shellfish from sewage contaminated water

Term
What are the symptoms of norovirus and when do they start?
Definition

Start w/in 24-48 hours after exposure

Symptoms - vomiting, watery diarrhea, stomach cramping, low grade fever occurs in half of cases

Term
What is the treatment for norovirus?
Definition

No specific treatment!

If have diarrhea and/or vomiting drink plenty of fluids to prevent dehydration

Medications (i.e. antibiotics which don't work on viruses) should be avoided

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