Notes Unit 19 Soilborne Diseases Important Diseases 1. Anthrax Causative Organism: Type of Organism: Pathogenicity: Symptoms: Bacillus anthracis Bacteria; Gram positive bacillus with endospore Has endospores, which allow it to live for long periods of time. The symptoms (warning signs) of anthrax are different depending on the type of the disease. There are three types: Cutaneous: The first symptom is a small sore that develops into a blister. The blister then develops into a skin ulcer with a black area in the center. The sore, blister and ulcer do not hurt. Gastrointestinal: The first symptoms are nausea, loss of appetite, bloody diarrhea, and fever, followed by bad stomach pain. Inhalation: The first symptoms of inhalation anthrax are like cold or flu symptoms and can include a sore throat, mild fever and muscle aches. Later symptoms include cough, chest discomfort, shortness of breath, tiredness and muscle aches. Hallmark: Varies depending on type. Transmission: From Animals: Humans can become infected with anthrax by handling products from infected animals or by breathing in anthrax spores from infected animal products (like wool, for example). People can also become infected with gastrointestinal anthrax by eating undercooked meat from infected animals. As A Weapon: Anthrax also can be used as a weapon. This happened in the United States in 2001. Anthrax was deliberately spread through the postal system by sending letters with powder containing anthrax. This caused 22 cases of anthrax infection. Antibiotics and a vaccine available. Treatment: 2. Tetanus Causative Organism: Type of Organism: Pathogenicity: Hallmark: Transmission: Treatment: Clostridium tetani Bacteria: Gram positive bacillus with an endospore Produces a neurotoxin, tetanospasmin, that is released upon death of the bacteria. It enters the CNS through peripheral nerves and blood. Causes muscle spasms. Symptoms: Early symptoms: lockjaw, stiffness in the neck and abdomen, and difficulty swallowing. Later symptoms: severe muscle spasms, generalized seizure-like activity, severe nervous system disorders. Obtained through dirty puncture wound. Also called “Lockjaw.” Contaminated soil, especially in soils contaminated with animal feces. Enters the body through a break in the skin Tetanus antitoxin; best to prevent with vaccination 1 3. Leptospirosis (Swamp Fever) Causative Organism: Type of Organism: Pathogenicity: Symptoms: Transmission: Treatment: Leptospira interrogans Bacteria, spirochete Frequently confused with other diseases Wide range of symptoms, and some infected persons may have no symptoms at all. Symptoms include high fever, severe headache, chills, muscle aches, and vomiting, and may include jaundice (yellow skin and eyes), red eyes, abdominal pain, diarrhea, or a rash. If the disease is not treated, the patient could develop kidney damage, meningitis (inflammation of the membrane around the brain and spinal cord), liver failure, and respiratory distress. In rare cases death occurs. Usually caused by exposure to water contaminated with the urine of infected animals. Many different kinds of animals carry the bacterium; they may become sick but sometimes have no symptoms. Leptospira organisms have been found in cattle, pigs, horses, dogs, rodents, and wild animals. Humans become infected through contact with water, food, or soil containing urine from these infected animals. This may happen by swallowing contaminated food or water or through skin contact, especially with mucosal surfaces, such as the eyes or nose, or with broken skin. The disease is not known to be spread from person to person. Antibiotics 4. Psittacosis Causative Organism: Type of Organism: Pathogenicity: Symptoms: Hallmark: Transmission: Treatment: Chlamydia psittaci Bacteria; Gram negative, intracellular bacteria Tiny, elementary bodies are part of life cycle which are resistant to environmental stress Form of pneumonia where you have fever, headache, muscle aches, chills, and a dry cough. Heart, liver, and neurological damage may also occur. Pneumonia from infected bird droppings. Infection is acquired by inhaling dried secretions from infected birds. 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. Antibiotics. 5. Histoplasmosis Causative Organism: Type of Organism: Pathogenicity: Symptoms: Hallmark: Transmission: Histoplasma capsulatum Fungus Affects mainly people that live in states adjoining the Mississippi and Ohio Rivers Most infected persons have no apparent ill effects. The acute respiratory disease is characterized by respiratory symptoms, a general ill feeling, fever, chest pains, and a dry or nonproductive cough. Distinct patterns may be seen on a chest x-ray. Get from bats and birds, causes pneumonia-like symptoms. Grows in soil and material contaminated with bat or bird droppings. Spores become airborne when contaminated soil is disturbed. Breathing the spores causes infection. The disease is not transmitted from an infected person to someone else. The fungus has been found in poultry house litter, caves, areas harboring bats, and in bird roosts. 2 Treatment: Antifungal medication 6. Coccidioidomycosis (San Joaquin Fever) Causative Organism: Type of Organism: Pathogenicity: Symptoms: Hallmark: Transmission: Treatment: Coccidioides immitis Fungus Usually found in the dry, alkaline soils of South America and North Mexico. Also found in the San Joaquin valley in California. Symptomatic infection (40% of cases) usually presents as flu-like illness with fever, cough, headaches, rash, and muscle aches. Some patients fail to recover and develop chronic pulmonary infection or widespread disseminated infection (affecting meninges, soft tissues, joints, and bone). Severe pulmonary disease may develop in HIV-infected persons. Flu-like illness from breathing in dirty air in Southwest Inhalation of airborne spores after disturbance of contaminated soil by humans or natural disasters (e.g., dust storms and earthquakes). Antifungal medication 7. Ascariasis Causative Organism: Type of Organism: Pathogenicity: Symptoms: Hallmark: Transmission: Treatment: Ascaris lumbricoides parasitic helminth Can block intestines; deplete nutrients Most people have no symptoms that are noticeable, but infection may cause slower growth and slower weight gain. If you are heavily infected, you may have abdominal pain. Sometimes, while the immature worms migrate through the lungs, you may cough and have difficulty breathing. If you have a very heavy worm infection, your intestines may become blocked. Worm infection in the gut. You or your children can become infected after touching your mouth with your hands that have become contaminated with eggs from soil or other contaminated surfaces or by ingesting contaminated food. Ascaris eggs are found in human feces. After feces contaminate the soil, the eggs become infectious after a few weeks. Infection occurs when a person accidentally ingests (swallows) infectious Ascaris eggs. Once in the small intestines, immature worms hatch from the eggs. The larvae are carried through the lungs and then to the throat where they are swallowed. Once swallowed, they reach the intestines and develop into adult worms. Adult female worms lay eggs that are then passed in feces; this cycle will take between 2-3 months. Worms can get to be 1 foot long or longer! Anti-helminth medication. 8. Fungal Skin Infections Causative Organism: Type of Organism: Pathogenicity: Tinea sp. Fungus None. 3 Diseases Caused: Transmission: Treatment: Below are 4 of the most common diseases caused by fungi: a. Tinea capitis – Ringworm of the scalp – can lead to bald patches. b. Tinea cruris – “Jock Itch” – ringworm of the groin c. Tinea pedis – “Athlete’s Foot” – ringworm of the feet d. Tinea unguium – fungal finger and toe nail infection Person to person contact, or contact with fomites. Fungus prefers moist conditions. Fungus thrives in moist conditions and in soil. Antifungal medications. 9. Hookworm Causative Organism: Type of Organism: Pathogenicity: Symptoms: Transmission: Treatment: Ancylostoma duodenale (found in Europe, Africa, Asia, South America) Necator americanus (found is United States) Helminth (worm) Can cause anemia An itchy, slightly raised rash called "ground itch" may appear around the area where the larvae first bored through the skin. The skin in this area may become red and swollen. This lasts for several days and commonly occurs between the toes. The larvae are then pumped into the lungs. There, they bore into the tiny airsacs (alveoli) of the lungs. Their presence within the lungs usually causes enough irritation to produce coughing, fever, and wheezing. However, some people have none of these symptoms. The larvae are coughed up into the throat and mouth, and are then swallowed and passed into the small intestine. Within the intestine they develop into the adult worm. Hookworms cause trouble for their human host when they attach their mouths to the lining of the small intestine and suck the person's blood. Once established within the intestine, the adult worms can cause pain, decreased appetite, diarrhea, and weight loss. The worms suck between 0.03-0.2 ml of blood per day. When a worm moves from one area of the intestine to another, it detaches its mouth from the intestinal lining, leaving an irritated area that may continue to bleed for some time. This results in even further blood loss. A single adult worm can live for up to 14 years in a patient's intestine. Over time, the patient's blood loss may be significant. Anemia is the most serious complication of hookworm disease, progressing over months or years. Children are particularly harmed by such anemia and can suffer from heart problems, mental retardation, slowed growth, and delayed sexual development. In infants, hookworm disease can be deadly. Eggs are passed out of the host's body in feces. The eggs enter the soil, where they incubate. After about 48 hours, the immature larval form hatches out of the eggs. These larvae take about six weeks to develop into the mature larval form that is capable of causing human infection. If exposed to human skin at this point (usually bare feet walking in the dirt or bare hands digging in the dirt), the larvae will bore through the skin and ride through the lymph circulation to the right side of the heart. Anti-helminth medication. 4 10. Strongyloidiasis Causative Organism: Type of Organism: Pathogenicity: Symptoms: Transmission: Treatment: Strongyloides stercoralis (threadworm) Helminth (worm) None Frequently asymptomatic. Gastrointestinal symptoms include abdominal pain and diarrhea. Pulmonary symptoms (including Loeffler’s syndrome) can occur during pulmonary (lung) migration of the larvae. Skin problems include itchy rashes in the buttocks and waist areas. In immunocompromised people, can move throughout the whole body and can present with abdominal pain and swelling, shock, pulmonary and neurologic complications and infection of blood, and is potentially fatal. From contaminated soil, penetrate human skin and migrate to lungs, and then are coughed up and swallowed. Mostly in places with poor sanitation. Anti-helminth medication. 5