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Diseases explained...

Cryptococcosis:

Clinical Features Initial pulmonary infection is usually asymptomatic. Most patients present with disseminated infection, especially meningoencephalitis. In the United States, 85% of cases occur in HIV-infected persons.
Etiologic Agent Cryptococcus neoformans.
Reservoir C. neoformans var. neoformans has been isolated from the soil worldwide, usually in association with bird droppings. Less common etiologic agent, C. neoformans var. gattii has been isolated from eucalyptus trees in tropical and sub-tropical regions.
Incidence 0.4-1.3 cases per 100,000 in the general population. Among persons with AIDS, the annual incidence is 2-7 cases per 1,000.
Sequelae Meningitis may lead to permanent neurologic damage. Mortality rate is about 12%.
Transmission Inhalation of airborne yeast cells and/or basidiospores.
Risk Groups Immunocompromised persons, especially those with HIV infection.
Surveillance Active, population-based surveillance in selected U.S. sites. No national surveillance exists.
Challenges Developing a cost-effective prevention strategy (although fluconazole is effective chemoprophylaxis for persons with AIDS, it does not affect survival and is not considered cost-effective).

Histoplasmosis:

Clinical Features Symptomatic infection usually presents as a flu-like illness with fever, cough, headaches, and myalgias. Some patients fail to recover and develop chronic pulmonary infection or widespread disseminated infection (affecting mucosal surfaces, liver, spleen, adrenal gland and meninges). Acute septic presentation seen in some HIV-infected persons
Etiologic Agent Histoplasma capsulatum var. capsulatum. In Africa: H.capsulatum var. duboisii.
Reservoir Soil contaminated with bird or bat droppings. Endemic in parts of the central and eastern United States along Ohio and Mississippi river valleys. Microfoci in Central and South America, Africa, India, and Southeast Asia.
Incidence Approx. 80% of population living in areas with endemic disease is skin-test positive. Of HIV-infected persons in these areas, 10% - 25% develop disseminated histoplasmosis.
Sequelae Permanent lung damage with chronic disease. Mortality rate is about 10% in HIV-infected persons with disseminated disease.
Transmission Inhalation of airborne conidia (spores) after disturbance of contaminated soil.
Risk Groups Persons in areas with endemic disease with exposures to accumulations of bird or bat droppings (e.g., construction or agricultural workers, spelunkers). High risk groups are immunocompromised persons (e.g., persons with cancer, transplant recipients, persons with HIV infection).
Surveillance Reportable in some states in areas with endemic disease. No national surveillance exists.
Challenges Defining risk factors for disease in immunocompromised persons. Developing more sensitive and specific tests for diagnosis.

Psittacosis:

Clinical Features In humans, fever, chills, headache, muscle aches, and a dry cough. Pneumonia is often evident on chest x-ray.
Etiologic Agent Chlamydia psittaci, a bacterium
Incidence Since 1996, fewer than 50 confirmed cases were reported in the United States each year. Many more cases may occur that are not correctly diagnosed or reported.
Sequelae Endocarditis, hepatitis, and neurologic complications may occasionally occur. Severe pneumonia requiring intensive-care support may also occur. Fatal cases have been reported.
Transmission Infection is acquired by inhaling dried secretions from infected birds. The incubation period is 5 to 19 days. Although all birds are susceptible, pet birds (parrots, parakeets, macaws, and cockatiels) and poultry (turkeys and ducks) are most frequently involved in transmission to humans.
Risk Groups Bird owners, pet shop employees, and veterinarians. Outbreaks of psittacosis in poultry processing plants have been reported.
Surveillance Psittacosis is a reportable condition in most states.
Trends Annual incidence varies considerably because of periodic outbreaks. A decline in reported cases since 1988 may be the result of improved diagnostic tests that distinguish C.psittaci from more common C. pneumoniae infections.
Challenges Diagnosis of psittacosis can be difficult. Antibiotic treatment may prevent an antibody response, thus limiting diagnosis by serologic methods. Infected birds are often asymptomatic. Tracebacks of infected birds to distributors and breeders often is not possible because of limited regulation of the pet bird industry.
Opportunities Characterize new and rapid diagnostic tests for human and avian psittacosis, and determine value of screening flocks for avian psittacosis to prevent human infection.

Salmonellosis:

Clinical Features Fever, abdominal cramps, and diarrhea (sometimes bloody). Occasionally can establish localized infection (e.g., septic arthritis) or progress to sepsis.
Etiologic Agent Enterobacteriaceae of the genus Salmonella, a gram-negative rod-shaped bacilli. Approximately 2000 serotypes cause human disease.
Incidence An estimated 1.4 million cases occur annually in the United States; of these, approximately 30,000 are culture-confirmed cases reported to CDC.
Sequelae Estimated >500 fatal cases each year; 2% of cases are complicated by chronic arthritis.
Transmission Contaminated food, water, or contact with infected animals.
Risk Groups Affects all age groups. Groups at greatest risk for severe or complicated disease include infants, the elderly, and persons with compromised immune systems.
Surveillance National surveillance is conducted through the public health laboratories for culture-confirmed cases and through the National Notifiable Diseases Surveillance System (NNDSS). Active laboratory- and population-based surveillance is conducted in FoodNet sites.
Trends Half of salmonellosis cases are caused by 2 serotypes: S. Enteritidis (SE) and S. Typhimurium (ST). The proportion of salmonellosis caused by SE increased markedly from 1980 to 1995, but has decreased 22% since 1996. The incidence of ST decreased 24% since 1996, but an increasing proportion of isolates show resistance to multiple antimicrobial agents. S. Newport has increased 32% from 1996 to 2001 to become the third most frequent serotype, with many isolates resistant to >9 antimicrobial drugs.
Challenges Identifying unrecognized major sources of Salmonella infections. Assuring adequate supply of serotyping reagents; controlling SE infections through changes in the egg industry and education of food service workers and consumers; and developing effective education methods and materials to prevent reptile-associated salmonellosis.
Opportunities Improving detection of dispersed outbreaks through use of statistical outbreak detection algorithms and providing this capability to state health departments; training state health department personnel in Salmonella serotyping; and encouraging judicious use of antimicrobial agents in veterinary medicine.

 

(Information obtained from the Center for Diseases Control)

                   

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