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Dr Ubaid N P Community Medicine Dept ACME, Pariyaram
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Page 1: Dr Ubaid N P Community Medicine Dept ACME, Pariyaram.

Dr Ubaid N PCommunity Medicine DeptACME, Pariyaram

Page 2: Dr Ubaid N P Community Medicine Dept ACME, Pariyaram.

Zoonoses Definition - “those diseases and infections which are

naturally transmitted between vertebrate animals and man”

a) Anthropo-zoonoses – infections transmitted to man from lower vertebrate animals

b) Zoo-anthroponoses - infections transmitted from man to lower vertebrate animals

c) Amphixenoses – infections maintained in both man and lower vertebrate animals that may be transmitted in either direction

Page 3: Dr Ubaid N P Community Medicine Dept ACME, Pariyaram.

Classification based on the type of life cycle of the infecting organism

1. Direct zoonoses: Transmitted from infected vertebrate host to a susceptible host by direct contact, fomites or by a mechanical vector. Undergoes little or no propogative or development changes during transmission. Eg – Rabies, trichinosis, Brucellosis

2. Cyclo zoonoses: Require more than one vertebrate host species to complete the developmental cycle; no invertebrate host. Eg – Echinococcosis, human taeniases

3. Meta zoonoses: Transmitted biologically by invertebrate vectors; multiplies or develops or do both in vectors. There is always an extrinsic incubation period before transmission to another vertebrate host. Eg – Arbovirus infection, Plague, Schistosomiasis

4. Sapro zoonoses: Have both a vertebrate host & a non animal developmental site or reservoir like, food, soil, plants. Eg – Larva migrants, some mycoses

Page 4: Dr Ubaid N P Community Medicine Dept ACME, Pariyaram.

Yellow Fever

Page 5: Dr Ubaid N P Community Medicine Dept ACME, Pariyaram.
Page 6: Dr Ubaid N P Community Medicine Dept ACME, Pariyaram.

Introduction• Zoonotic disease caused by an arbovirus

• Spectrum of disease varies from clinically indeterminate to severe cases

• Severe cases develop jaundice with hemorrhagic manifestations, albuminuria/ anuria, shock, stupor and coma

• Can have severe hepatic and renal involvement

• Death occurs between 5th and 10th day of illness

• Case fatality rate may reach 80% in severe cases

• 45 countries in Africa & Latin America has reported cases, with at risk population of 900 million

• No case has been reported in Asia, although the region is at risk as the conditions required for transmission are present there

Page 7: Dr Ubaid N P Community Medicine Dept ACME, Pariyaram.
Page 8: Dr Ubaid N P Community Medicine Dept ACME, Pariyaram.

Epidemiological determinantsAgent factors

a) Agent ▫ Flavivirus fibricus; group B arbovirus; Togavirus

family

b) Reservoir of infection ▫ In forest: monkeys & forest mosquitoes; ▫ In urban areas: Man & Aede aegypti mosquitoes

c) Period of communicability▫ Man: first 3 to4 days of illness; ▫ Mosquitoes: After an extrinsic incubation period of

8 to 12 days, mosquitoes becomes infective for life

Page 9: Dr Ubaid N P Community Medicine Dept ACME, Pariyaram.

Host factors

a) Age & sex – All ages and sexes

b) Occupation – person who has contact with forests (wood cutters, hunters)

c) Immunity – one attack gives life long immunity; Infants born to immune mothers have antibodies up to 6 months of life

Page 10: Dr Ubaid N P Community Medicine Dept ACME, Pariyaram.

Environmental factors

a) Climate – temp. of 24°C or over and relative humidity of over 60% is required for multiplication of virus and for the mosquitoes to live long respectively

b) Social factors – Urbanization, dense population, increases in number of people who travel from endemic to receptive areas

Page 11: Dr Ubaid N P Community Medicine Dept ACME, Pariyaram.

Modes of transmissionSylvatic(forest) YF - Intermediate YF -

Urban YF

Page 12: Dr Ubaid N P Community Medicine Dept ACME, Pariyaram.
Page 13: Dr Ubaid N P Community Medicine Dept ACME, Pariyaram.

Incubation period - 3 to 6 days

Treatment:•No specific treatment•Supportive care to treat dehydration and

fever•Antibiotics for secondary bacterial

infections

Page 14: Dr Ubaid N P Community Medicine Dept ACME, Pariyaram.

Control of YF•Jungle YF – continues to be uncontrollable

•Urban YF1) Vaccination

▫ 17D live attenuated▫ Sensitivity▫ Dose & Route of administration▫ Contra indications and ADRs▫ Vaccine interaction

2) Vector control3) Surveillance

▫ Aedes aegypti index <1%

Page 15: Dr Ubaid N P Community Medicine Dept ACME, Pariyaram.
Page 16: Dr Ubaid N P Community Medicine Dept ACME, Pariyaram.

International measures

•Missing link of YF in receptive countries•International Health Regulations(IHR) to

restrict the spread of YFi. Travellersii. Mosquitoes

•International certificate of vaccination•Reference centres

▫National Institute of Virology, Pune▫Central Research Institute, Kasauli

Page 17: Dr Ubaid N P Community Medicine Dept ACME, Pariyaram.

Thank You