MEDI7305 Lecture Notes - Lecture 9: Swine Brucellosis, Hypotension, Erythema
M4a - Zoonoses & Tropical Diseases in Rural Setting
Learning objectives
Occupational & geographical risk groups for notable Australian zoonoses and tropical diseases transmitted by
animals, ticks and mosquitoes
Classification of AUS diseases
Types For each disease …
Animal zoonoses - Q fever,
Leptospirosis, Brucellosis
Tick-borne diseases - Aus
spotted fever/ QLD tick typhus, Flinders
island spotted fever, Scrub typhus
Mosquito-borne viruses -
Dengue fever, Ross River virus, Barmah
Forest virus
Other rural and tropical
diseases - Melioidosis, Hendra virus, Aus bat
lyssavirus, Hydatid disease, Strongyloides
Average cases/ yr in QLD
Cases as % Aus cases
Notifiable disease?
At risk groups - occupational, travel, contact
Geography of infection
Transmission - source, contact, vector
Clinical features - incubation, symptoms, signs,
investigations
Diagnostic tests
Management
Complications & case fatality
Prevention (including vaccines, insect
repellents, pasteurisation of milk)
Public health aspects
Safe initiation of oral doxycycline therapy
Optimal tick removal and bite site care
Overview
Key points Detailed occupational and travel history is vital for
diagnosis
Start empirical oral doxycycline
Symptoms/ signs look similar, hence look for specific
differences
Rash relatively uncommon in Q fever
Conjunctival suffusion in leptospirosis
Eschar in typhus
Early -ve serology requires repeating
Consider early PCR if available
Take paired sera for testing
Cases
Q fever 28yo cattle driver, QLD
1/52 fever, headache, general malaise, dry cough
No improvement with amoxicillin + clavulanic acid
O/E - sparse crackles in chest, systolic murmur, no rash
CXR - bilateral pneumonitis
Leptospirosis 45yo banana farm worker, Innisfail (Nth QLD)
Abrupt onset of high fever, prominent myalgia, conjunctivitis, extremity rash
Fever eventually abates but develops a headache, meningismus, jaundice and
hematuria
Brucellosis 36yo feral pig shooter
2/7 day hx of fever, headache, myalgias
Asymmetric polyarthritis and epididymo-orchitis
Physical examination is otherwise normal
Ticks 25yo F, bush block in Central QLD
Abrupt fever, myalgia, petechial rash, spots on palms and soles, lump on scalp
Non-stiff neck, feels unwell
Meningococcal cultures are -ve
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Document Summary
M4a - zoonoses & tropical diseases in rural setting. Occupational & geographical risk groups for notable australian zoonoses and tropical diseases transmitted by animals, ticks and mosquitoes. Tick-borne diseases - aus spotted fever/ qld tick typhus, flinders island spotted fever, scrub typhus. Other rural and tropical diseases - melioidosis, hendra virus, aus bat lyssavirus, hydatid disease, strongyloides. Optimal tick removal and bite site care repellents, pasteurisation of milk) Detailed occupational and travel history is vital for. Symptoms/ signs look similar, hence look for specific. O/e - sparse crackles in chest, systolic murmur, no rash. Abrupt onset of high fever, prominent myalgia, conjunctivitis, extremity rash. Fever eventually abates but develops a headache, meningismus, jaundice and. Abrupt fever, myalgia, petechial rash, spots on palms and soles, lump on scalp. Transient moderate fever, fine erythematous rash 1/52 after coastal fishing trip. Later on, she has pain with particular morning stiffness and swelling in multiple small/ medium joints + myalgia.
