View
1.113
Download
5
Category
Preview:
DESCRIPTION
Citation preview
DEEPA BABIN 1
Borrelia ARTROPOD DISEASE
LYMES DISEASESRELAPSING FEVERVINCENTS ANGINA
DEEPA BABIN 2
Species
• B.recurrentis –Relapsing fever• B.vincentii –Vincents angina• B.burgdorferi-Lyme disease
DEEPA BABIN 3
Epidemiology of Borrelia Infections
Borrelia recurrentis
Borrelia spp.
Borrelia burgdorferi
Ixodes spp.
Ornithodoros spp.
Pediculus humanus
DEEPA BABIN 4
Borrelia is a Spirochete
• Larger, Irregular, wide and open coils
• Motile• GRAM NEGATIVE• Some commensals-
Buccal /genital mucosa
DEEPA BABIN 5
Borrelia burgdorferi• Cause –LYME DISEASE• Spirochete: slender helical
shaped bacteria• Gram negative• Motile • Extracellular pathogen• Aerobic or microaerophilic
DEEPA BABIN 6
What is Lyme Disease?
• Lyme disease is caused by Borrelia burgdorferi and is transmitted to humans by the bite of infected Ixoid
ticks. • *Normally lives in mice, squirrels and
other small animals • Blacklegged (deer) ticks• Lone star ticks• American dog ticks
DEEPA BABIN 7
EPIDEMIOLOGY• Transmitted by Ixodes ticks• Nymph-stage ticks feed on humans-
transmit spirochete• Endemic areas–Northeastern coastal states–Wisconsin & Minnesota–Coast of Oregon & northern California
DEEPA BABIN 8
Methods of Transmission• Vector-borne disease• Vector is deer or black-legged tick (Ixodes
scapularis) or by the western black-legged tick (Ixodes pacificus) on the Pacific Coast.
• Transmits B. burgdorferi while feeding on an uninfected host– the spirochetes are present in the midgut and
migrate during blood feeding to the salivary glands, from which they are transmitted to the host via saliva.
DEEPA BABIN 9
Larva, nymph, and adult female and male Ixodes dammini ticksThey are smaller than we think
DEEPA BABIN 10
Symptoms• The early symptoms are
mild.IP- 3-30 DAYS• The first symptom is usually
an expanding rash.• Called Erythema Migrans.• a central spot surrounded
by clear skin that in ringed by an expanding red rash looks like bull’s eye.
DEEPA BABIN 11
Common presenting symptoms in lyme disease
• Symptoms of early localized Lyme disease (Stage 1) begin days or weeks after infection. They are similar to the flu and may include:
• Body-wide itching• Chills• Fever• General ill-feeling• Headache• Light-headedness or fainting• Muscle pain• Stiff neck
• There may be a "bull's eye" rash, a flat or slightly raised red spot at the site of the tick bite. Often there is a clear area in the center. It can be quite large and expanding in size.
DEEPA BABIN 12
Classic Bull’s Eye Rash
DEEPA BABIN 13
Arthritis
DEEPA BABIN 14
Disseminated and Persistant
• Paralysis or weakness in the muscles of the face• Muscle pain and pain or swelling in the knees and other
large joints• Heart problems, such as skipped heartbeats
(palpitations)• Symptoms of late disseminated Lyme disease (Stage 3)
can occur months or years after the initial infection. The most common symptoms are muscle and joint pain.
• Persistant- months or years later with chronic arthritis,polyneuropathy,encephalopathy
•
DEEPA BABIN 15
Prevention of lyme disease• Take precautions to avoid direct contact with ticks.
Be extra careful during warmer months. Whenever possible:
• Avoid wooded or bushy areas, or areas with high grasses and leaf litter..
• Ticks that carry Lyme disease are so small that they are very hard to see. After returning home, remove your clothes and thoroughly inspect all skin surface areas, including your scalp. Shower soon after coming indoors to wash off any unseen ticks.
DEEPA BABIN 16
Borrelia recurrentis- Relapsing fever• Relapsing fever borreliosis often occurs
with severe bacteraemia.• Borrelia recurrentis is transmitted by the
human body louse; no other animal reservoir
• Lice that feed on infected humans acquire the Borrelia organisms then multiply in the gut of the louse.
DEEPA BABIN 17
DEEPA BABIN 18
TWO TYPES OF RELAPSING FEVER
• LOUSE BORNE AND TICK BORN
• 1.EPIDEMIC LOUSE BORNE• 2.ENDEMIC TICK BORNE
DEEPA BABIN 19
Tick-borne = Endemic Relapsing Fever
Sporadic casesTransmitted by soft body ticks
(vectors) from small mammal reservoir
Ticks can multiply and infect new human hosts
DEEPA BABIN 20
Louse-borne = Epidemic Relapsing Fever
Transmitted person-to-person by human body lice (vectors) from infected human reservoir
Infect host only when louse is injured, e.g during scratching
Therefore, a single louse can only infect a single person
Lice leave host that develops a fever and seek normal temperature host
DEEPA BABIN 21
Relapse Of Fever
DEEPA BABIN 22
Morphology /Diagnosis• Gram Negative Irregular Spirals With Pointed Ends• 0.2 to 0.5 microns in width and 5 to 20 microns in
length. visible with light microscopy and have the cork-screw shape
• Culture-Noguchi s MEDIUM, CAM• Vector-Pediculus Humanus Corporis• Ip-2-10 Days• Febrile Onset Of Sudden Onset, fever Subsides After
3-5 Days And It Lasts For 4-10 Days
• Then Another Bout Of Fever Starts…relapse (3-10 Times) For Months Or Years
DEEPA BABIN 23
B.VINCENTII
• Mouth commensel• Associated with fusiform bacilli• Malnourished or viral infection it cause
ulcers - Gingivostomatitis
DEEPA BABIN 24
Diagnosis
• There are number of blood test available • Antibody test :ELISA and western blot
tests.Although there is false positive and negative
results• Antigen detection tests• Polymerase chain reaction: this test
multiplies the of Bb DNA to detectable measurable level
DEEPA BABIN 25
Diagnosis• Serologic data by IFA, ELISA and
imunoblotting techniques.– Detect presence of IgM or IgG antibodies in
patient’s serum against Borrelia burgdorferi – Tests are insensitive the first several weeks of
infection
–Western blot is more accurate and is used 6-12 weeks after infection to confirm results
• Direct Isolation– Biopsies of the skin lesions may yield the
organism in 50% or more of cases
DEEPA BABIN 26
DEEPA BABIN 27
Treatment• Antibiotic therapy• Doxycycline and amoxicillin are used for two to
four weeks in early cases• Doxycycline is also effective • Cefuroxime axetil or erythromycin can be used for
patients who are allergic to penicillin or who cannot take tetracycline's.
• More developed cases, may require treatment with intravenous ceftriaxone or penicillin for 4 weeks or more
DEEPA BABIN 28
Prevention
• Avoid tick habitats• Wear appropriate barrier clothing that follow
personal protection procedures• Apply insect repellent containing DEET to
skin• Apply permethrin to clothes• Perform regular body checks for ticks• Remove ticks promptly with tweezers and
clean area with antiseptic• Education of the general public
DEEPA BABIN 29
How to remove ticks
DEEPA BABIN 30
Control• Habitat modification for ticks
-Clear trees and brush• Chemical control of tick populations
-Apply pesticides to residential properties
• Habitat modification for deer and rodents-Keep rodents and deer away from houses and gardens
• Host management-Deer feeding stations equipped with pesticide
applicators-Baited devices to kill ticks on rodents
Recommended