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Zoonotic Diseases of Various Species


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Title: Zoonotic Diseases of Various Species

Zoonotic Diseases of Various Species
  • Part II

Note The images in this presentation are for
non-profit, educational use only.
Neil Grove University of North Carolina Chapel
Hill Division of Laboratory Animal Medicine
What We Will Cover
  • Baylisascaris
  • Rocky Mountain Spotted Fever
  • Lyme Disease
  • Avian Influenza
  • Mycobacterium marinum

For each disease we will answer these questions
  • What is it?
  • How do I get it?
  • What are the symptoms?
  • What preventive measure can be taken?

Baylisascaris Infection What is it?
  • Baylisascaris, an intestinal raccoon roundworm,
    can infect a variety of other animals, including
    humans. The worms develop to maturity in the
    raccoon intestine, where they produce millions of
    eggs that are passed in the feces. (1)

Baylisaccaris Infection What is it?
  • Released eggs take 2-4 weeks to become infective
    to other animals and humans.
  • The eggs are resistant to most environmental
    conditions and with adequate moisture, can
    survive for years.(1)

Baylisascaris Infection What is it?
  • Infected raccoons have been found throughout the
    United States, mainly in the Midwest, Northeast,
    middle Atlantic, and West coast.
  • Infection rarely causes symptoms in raccoons.
    Predator animals, including dogs, may also become
    infected by eating a smaller animal that has been
    infected with Baylisascaris. (1)

How Do I get It?
  • People become infected when they accidentally
    ingest infective eggs in soil, water, or on
    objects that have been contaminated with raccoon
  • When humans ingest these eggs, they hatch into
    larvae in the person's intestine and travel
    throughout the body, affecting the organs and

Heightened Risk
  • Anyone who is exposed to environments where
    raccoons live is potentially at risk.
  • Young children or developmentally disabled
    persons are at highest risk for infection when
    they spend time outdoors and may put contaminated
    fingers, soil, or objects into their mouths. (1)

Heightened Risk
  • Hunters, trappers, taxidermists, and wildlife
    handlers may also be at increased risk if they
    have contact with raccoons or raccoon

How Common is Human Infection?
  • Infection is rarely diagnosed. Fever than 25
    cases have been diagnosed and reported in the
    United States as of 2003.
  • It is believed that cases are mistakenly
    diagnosed as other infections or go undiagnosed.
  • Cases have been reported in Oregon, California,
    Minnesota, Illinois, Michigan, New York, and
  • Five of the infected persons died.(1)

  • Symptoms of infection depend on how many eggs are
    ingested and where in the body the larvae migrate
    (travel to).
  • Once inside the body, eggs hatch into larvae and
    cause disease when they travel through the liver,
    brain, spinal cord, or other organs.
  • Ingesting a few eggs may cause few or no
    symptoms, while ingesting large numbers of eggs
    may lead to serious symptoms. Symptoms of
    infection may take a week or so to develop.(1)

  • Symptoms include
  • Nausea
  • Tiredness
  • Liver enlargement
  • Loss of coordination
  • Lack of attention to people
  • and surroundings
  • Loss of muscle control
  • Coma
  • Blindness (1)

  • Avoid direct contact with raccoons especially
    their feces. Do not keep, feed, or adopt raccoons
    as pets! Raccoons are wild animals.
  • Discourage raccoons from living in and around
    your home or parks by
  • preventing access to food
  • closing off access to attics and basements
  • keeping sand boxes covered at all times, (becomes
    a latrine)
  • removing fish ponds they eat the fish and drink
    the water
  • eliminating all water sources
  • removing bird feeders
  • keeping trash containers tightly closed
  • clearing brush so raccoons are not likely to make
    a den on your property (1)

  • Stay away from areas and materials that might be
    contaminated by raccoon feces.
  • Raccoons typically defecate at the base of or in
    raised forks of trees, or on raised horizontal
    surfaces such as fallen logs, stumps, or large
  • Raccoon feces also can be found on woodpiles,
    decks, rooftops, and in attics, garages, and
  • Feces usually are dark and tubular, have a
    pungent odor (usually worse than dog or cat
    feces), and often contain undigested seeds or
    other food items. (1)

  • To eliminate eggs, raccoon feces and material
    contaminated with raccoon feces should be removed
    carefully and burned, buried, or sent to a
  • Care should be taken to avoid contaminating hands
    and clothes.
  • Treat decks, patios, and other surfaces with
    boiling water or a propane flame-gun. (Exercise
    proper precautions!)(1)

  • Newly deposited eggs take at least 2-4 weeks to
    become infective. Prompt removal and destruction
    of raccoon feces will reduce risk for exposure
    and possible infection.
  • Contact your local animal control office for
    further assistance. (1)

Case Description
  • In January 2000, a boy aged 17 years with an
    8-year history of severe developmental
    disabilities was admitted to a Los Angeles
    hospital comatose and with generalized hypertonia
    and hyperreflexia. His mouth was tightly
    clenched, his eyes wandered rapidly, and he
    responded only to painful stimuli. Two days
    before admission, he had a low-grade fever,
    drowsiness, and problems with coordination. Tests
    on CSF and blood failed to identify an infectious
    agent. On examination by a pathologist, a brain
    biopsy revealed sections of a nematode consistent
    with Baylisascaris species. The patient's
    condition deteriorated and he had progressive,
    deep white matter abnormalities of the brain on
    MRI. After a 2-month hospitalization, he was
    transferred to a long-term--care facility where
    he remained comatose until he died a year later.

Case Description
  • The patient had resided in a group home for
    developmentally handicapped adolescents and
    adults in Los Angeles County. In February 2000, a
    field study conducted in the yard in which the
    patient regularly played revealed several sites
    containing raccoon feces a sample of sandbox
    soil was positive for BP eggs. Multiple sites in
    the adjoining yard, to which he also had access,
    contained raccoon feces with BP eggs. (2)

Review Questions
  • Released eggs take ________ to become infective
    to other animals and humans.

  • Released eggs take 2-4 weeks to become infective
    to other animals and humans.

Question True or False
  • Human Baylisascaris infection is quite common,
    with an average of one diagnosed case per week
    throughout the northeastern United States.

  • False - Infection is rarely diagnosed. Fewer than
    25 cases have been diagnosed and reported in the
    United States as of 2003.

Rocky Mountain Spotted Fever What is It?
  • Rocky Mountain spotted fever (RMSF) is the most
    severe tick-borne rickettsial illness in the
    United States. This disease is caused by
    infection with the bacterial organism Rickettsia

Gimenez stain of tick hemolymph cells infected
with R. rickettsii
Rocky Mountain Spotted Fever What is It?
  • Rocky Mountain spotted fever has been a
    reportable disease in the United States since the
  • In the last 50 years, approximately 250-1200
    cases of Rocky Mountain spotted fever have been
    reported annually, although it is likely that
    many more cases go unreported. (3)

Annual incidence per million population for Rocky
Mountain spotted fever by state in the United
States for 2002, as determined on the basis of
cases reported to the National Electronic
Telecommunications System for Surveillance.
Rocky Mountain Spotted Fever Where is It?
  • Over half of Rocky Mountain spotted fever
    infections are reported from the south-Atlantic
    region of the United States (Delaware, Maryland,
    Washington D.C., Virginia, West Virginia, North
    Carolina, South Carolina, Georgia, and Florida).
  • Infections also occur in The Pacific region
    (Washington, Oregon, and California) and west
    south-central (Arkansas, Louisiana, Oklahoma, and
    Texas) region. (3)

Rocky Mountain Spotted Fever Where is It?
  • The states with the highest incidences of Rocky
    Mountain spotted fever are North Carolina and
    Oklahoma these two states combined accounted for
    35 of the total number of U.S. cases reported to
    CDC during 1993 through 1996.
  • Although Rocky Mountain spotted fever was first
    identified in the Rocky Mountain states, less
    than 3 of the U.S. cases were reported from that
    area during the same interval (1993-1996). (3)

How Do I Get It?
  • The organism that causes Rocky Mountain spotted
    fever is transmitted by the bite of an infected
    tick. Less commonly, infections may occur
    following exposure to crushed tick tissues,
    fluids, or tick feces.
  • In the case of Rocky Mountain spotted fever,
    ticks are the natural hosts, serving as both
    reservoirs and vectors of R. rickettsii. (3)

How Do I Get It?
  • Because ticks on dogs can be infected with R.
    rickettsii, dogs and people can get Rocky
    Mountain spotted fever from the same ticks. These
    ticks can also bite other animals and pass Rocky
    Mountain spotted fever to them. (3)

How Do I Get It?
  • The American dog tick (Dermacentor variabilis)
    and Rocky Mountain wood tick (Dermacentor
    andersoni) are the primary athropods (vectors)
    which transmit Rocky Mountain spotted fever
    bacteria in the United States. (3)

American Dog Tick
Rocky Mountain Wood Tick
How Do I Get It?
  • The brown dog tick Rhipicephalus sanguineus has
    also been implicated as a vector as well as the
    tick Amblyomma cajennense in countries south of
    the United States.(3)

How Do I Get It?
  • Over 90 of patients with Rocky Mountain spotted
    fever are infected during April through
    September.  This period is the season for
    increased numbers of adult and nymphal
    Dermacentor ticks.
  • A history of tick bite or exposure to
    tick-infested habitats is reported in
    approximately 60 of all cases of Rocky Mountain
    spotted fever.(3)

  • Initial symptoms may include fever, nausea,
    vomiting, severe headache, muscle pain, lack of
  • The rash first appears 2-5 days after the onset
    of fever and is often not present or may be very
    subtle when the patient is initially seen by a

  • Younger patients usually develop the rash earlier
    than older patients. Most often it begins as
    small, flat, pink, non-itchy spots (macules) on
    the wrists, forearms, and ankles. These spots
    turn pale when pressure is applied and eventually
    become raised on the skin.(3)

Early (macular) rash on sole of foot
  • Later signs and symptoms include rash, abdominal
    pain, joint pain, diarrhea.
  • The characteristic red, spotted (petechial) rash
    of Rocky Mountain spotted fever is usually not
    seen until the sixth day or later after onset of
    symptoms, and this type of rash occurs in only
    35 to 60 of patients with Rocky Mountain
    spotted fever. (3)

Late (petechial) rash on palm and forearm
  • The rash involves the palms or soles in as many
    as 50 to 80 of patients however, this
    distribution may not occur until later in the
    course of the disease. As many as 10 to 15 of
    patients may never develop a rash.(3)

Characteristic rash of late-stage Rocky Mountain
spotted fever on legs of a patient
RMSF - Hospitalization
  • Rocky Mountain spotted fever can be a very severe
    illness and patients often require
  • Because R. rickettsii infects the cells lining
    blood vessels throughout the body, severe
    manifestations of this disease may involve the
    respiratory system, central nervous system,
    gastrointestinal system, or renal system. (3)

RMSF - Hospitalization
  • Host factors associated with severe or fatal
    Rocky Mountain spotted fever include advanced
    age, male sex, African-American race, chronic
    alcohol abuse, and glucose-6-phosphate
    dehydrogenase (G6PD) deficiency. (3)

RMSF - Hospitalization
  • Deficiency of G6PD is a sex-linked genetic
    condition which occurs with highest frequencies
    in people of African, Middle Eastern, and
    Southeast Asian origin it affects approximately
    12 of the U.S. African-American male population
    deficiency of this enzyme is associated with a
    high proportion of severe cases of Rocky Mountain
    spotted fever.
  • This is a rare clinical course that is often
    fatal within 5 days of onset of illness. (3)

Long-Term Health Problems
  • Long-term health problems following acute Rocky
    Mountain spotted fever infection include partial
    paralysis of the lower extremities, gangrene
    requiring amputation of fingers, toes, or arms or
    legs, hearing loss, loss of bowel or bladder
    control, movement disorders, and language
  • These complications are most frequent in persons
    recovering from severe, life-threatening disease,
    often following lengthy hospitalizations.(3)

  • Limiting exposure to ticks reduces the likelihood
    of infection with Rocky Mountain spotted fever.
  • In persons exposed to tick-infested habitats,
    prompt careful inspection and removal of crawling
    or attached ticks is an important method of
    preventing disease.
  • It may take extended attachment time before
    organisms are transmitted from the tick to the

  • Wear light-colored clothing which allows you to
    see ticks that are crawling on your clothing.
  • Tuck your pants legs into your socks so that
    ticks cannot crawl up the inside of your pants
  • Apply repellents to discourage tick attachment.
    Repellents containing permethrin can be sprayed
    on boots and clothing, and will last for several
    days. Repellents containing DEET can be applied
    to the skin, but will last only a few hours
    before reapplication is necessary. Use DEET with
    caution on children.  Application of large
    amounts of DEET on children has been associated
    with adverse reactions. (3)

  • Conduct a body check upon return from potentially
    tick-infested areas by searching your entire body
    for ticks. Use a hand-held or full-length mirror
    to view all parts of your body. Remove any tick
    you find on your body.
  • Parents should check their children for ticks,
    especially in the hair, when returning from
    potentially tick-infested areas.  Ticks may also
    be carried into the household on clothing and
    pets and attach later, so both should be examined
    carefully to exclude ticks. (3)

Review Questions
  • _________ and_______ these two states combined
    accounted for 35 of the total number of U.S.
    cases reported to CDC during 1993 through 1996.

  • North Carolina and Oklahoma

  • The __________ and Rocky Mountain wood tick are
    the primary athropods (vectors) which transmit
    Rocky Mountain spotted fever bacteria in the
    United States.

  • American Dog Tick

  • Over 90 of patients with Rocky Mountain spotted
    fever are infected between the months of _______
    and ________.

  • April and September

Lyme Disease What is it?
  • Lyme disease is caused by the bacterium Borrelia

Borrelia burgdorferi
How Do I Get It?
  • The Lyme disease bacterium, Borrelia burgdorferi,
    normally lives in mice, squirrels and other small
    animals. It is transmitted among these animals
    and to humans -- through the bites of certain
    species of ticks. (4)

  • Within 1 to 2 weeks of being infected, people may
    have a "bull's-eye" rash with fever, headache,
    and muscle or joint pain. Some people have Lyme
    disease and do not have any early symptoms. Other
    people have a fever and other "flu-like" symptoms
    without a rash. (4)

Bulls-eye Rash
  • After several days or weeks, the bacteria may
    spread throughout the body of an infected person.
    These people can get symptoms such as rashes in
    other parts of the body, pain that seems to move
    from joint to joint, and signs of inflammation of
    the heart or nerves. (4)

  • If the disease is not treated, a few patients can
    get additional symptoms, such as swelling and
    pain in major joints or mental changes, months
    after getting infected.(4)

  • Whenever possible, you should avoid entering
    areas that are likely to be infested with ticks,
    particularly in spring and summer when nymphal
    ticks feed.
  • If you are in an area with ticks, you should wear
    light-colored clothing so that ticks can be
    spotted more easily and removed before becoming
  • If you are in an area with ticks, wear
    long-sleeved shirts, and tuck your pants into
    socks. You may also want to wear high rubber
    boots (since ticks are usually located close to
    the ground). (4)

  • Application of insect repellents containing DEET
    (n,n-diethyl-m-toluamide) to clothes and exposed
    skin, and permethrin (which kills ticks on
    contact) to clothes, should also help reduce the
    risk of tick attachment. DEET can be used safely
    on children and adults but should be applied
    according to Environmental Protection Agency
    guidelines to reduce the possibility of toxicity.

  • Since transmission of B. burgdorferi from an
    infected tick is unlikely to occur before 36
    hours of tick attachment, check for ticks daily
    and remove them promptly. Embedded ticks should
    be removed by using fine-tipped tweezers. Cleanse
    the area with an antiseptic.
  • You can reduce the number of ticks around your
    home by removing leaf litter, and brush- and
    wood-piles around your house and at the edge of
    your yard. By clearing trees and brush in your
    yard, you can reduce the likelihood that deer,
    rodents, and ticks will live there(4)

  • Being bitten by a _____ is the most common cause
    of Lyme disease.

  • tick

  • To repel ticks, insect repellents should contain

  • Deet

Avian Influenza What is it?
  • Avian influenza, or bird flu, is a contagious
    disease of animals caused by viruses that
    normally infect only birds and, less commonly,
  • Avian influenza viruses are highly
    species-specific, but have, on rare occasions,
    crossed the species barrier to infect humans.(7)

Avian Influenza What is it?
  • Influenza A (H5N1) is an influenza A virus
    subtype that occurs mainly in birds, is highly
    contagious among birds, and can be deadly to
    them. Outbreaks of H5N1 among poultry are ongoing
    in a number of countries. (6)
  • H5N1 is associated with human illness.

Avian Influenza What is it?
  • Influenza viruses are grouped into three types,
    designated A, B, and C. Influenza A and B viruses
    are of concern for human health. Only influenza A
    viruses can cause pandemics (worldwide
    outbreaks).(7)While H5N1 does not usually
    infect people, human cases of H5N1 infection
    associated with these outbreaks have been

Avian Influenza What is it?
  • Wild waterfowl are considered the natural
    reservoir of all influenza A viruses.
  • Considerable circumstantial evidence suggests
    that migratory birds can introduce low pathogenic
    H5 and H7 viruses to poultry flocks, which then
    mutate to the highly pathogenic form.(7)

Avian Influenza What is it?
  • Of the few avian influenza viruses that have
    crossed the species barrier to infect humans,
    H5N1 has caused the largest number of cases of
    severe disease and death in humans.
  • Unlike normal seasonal influenza, where infection
    causes only mild respiratory symptoms in most
    people, the disease caused by H5N1 follows an
    unusually aggressive clinical course, with rapid
    deterioration and high fatality.
  • Primary viral pneumonia and multi-organ failure
    are common. In the present outbreak, more than
    half of those infected with the virus have died.
    Most cases have occurred in previously healthy
    children and young adults.(7)

Avian Influenza What is it?
  • A second risk, of even greater concern, is that
    the virus if given enough opportunities will
    change into a form that is highly infectious for
    humans and spreads easily from person to person.
    Such a change could mark the start of a global
    outbreak (a pandemic).(7)

How do I get it?
  • Direct contact with infected poultry, or surfaces
    and objects contaminated by their feces, is
    presently considered the main route of human
  • To date, most human cases have occurred in rural
    or periurban areas where many households keep
    small poultry flocks, which often roam freely,
    sometimes entering homes or sharing outdoor areas
    where children play. (7)

How do I get it?
  • As infected birds shed large quantities of virus
    in their feces, opportunities for exposure to
    infected droppings or to environments
    contaminated by the virus are abundant under such
    conditions. (7)

How do I get it?
  • Because many households in Asia depend on poultry
    for income and food, many families sell or
    slaughter and consume birds when signs of illness
    appear in a flock, and this practice has proved
    difficult to change.
  • Exposure is considered most likely during
    slaughter, defeathering, butchering, and
    preparation of poultry for cooking.(7)

How do I get it?
  • Because all influenza viruses have the ability to
    change, scientists are concerned that H5N1 virus
    one day could be able to infect humans and spread
    easily from one person to another. (6)

How do I get it?
  • Because these viruses do not commonly infect
    humans, there is little or no immune protection
    against them in the human population.
  • If these H5N1 viruses gain the ability for
    efficient and sustained transmission among
    humans, an influenza pandemic (world wide) could
    result, with potentially high rates of illness
    and death. (6)

How do I get it?
  • It is likely that H5N1 infection among birds has
    become endemic in certain areas and that human
    infections resulting from direct contact with
    infected poultry will continue to occur. (6)

Does the virus spread easily from birds to
  • No. Though more than 100 human cases have
    occurred in the current outbreak, this is a small
    number compared with the huge number of birds
    affected and the numerous associated
    opportunities for human exposure, especially in
    areas where backyard flocks are common.
  • It is not presently understood why some people,
    and not others, become infected following similar

Since January, 2004 WHO has reported human cases
of avian influenza A (H5N1) in the following
  • East Asia and the Pacific
  • Cambodia
  • China
  • Indonesia
  • Thailand
  • Vietnam
  • Europe Eurasia
  • Azerbaijan
  • Turkey
  • Near East
  • Egypt
  • Iraq

(No Transcript)
  • The reported symptoms of avian influenza in
    humans have ranged from typical influenza-like
    symptoms (e.g., fever, cough, sore throat, and
    muscle aches) to eye infections (conjunctivitis),
    pneumonia, acute respiratory distress, viral
    pneumonia, and other severe and life-threatening
    complications. (6)

  • The majority of known human H5N1 cases have begun
    with respiratory symptoms. However, one atypical
    fatal case of encephalitis in a child in southern
    Vietnam in 2004 was identified retrospectively as
    H5N1 influenza through testing of cerebrospinal
    fluid, fecal matter, and throat and serum
    samples. (6)

What precautions can be taken to reduce the risk
for infection from wild birds in the United
  • As a general rule, the public should observe
    wildlife, including wild birds, from a distance.
    This protects you from possible exposure to
    pathogens and minimizes disturbance to the
  • Avoid touching wildlife. If there is contact with
    wildlife do not rub eyes, eat, drink, or smoke
    before washing hands with soap and water.
  • Do not pick up diseased or dead wildlife. Contact
    your state, tribal, or federal natural resource
    agency if a sick or dead animal is found.(6)

What precautions can hunters take to reduce the
risk for infection when hunting birds in the
United States?
  • Hunters should follow routine precautions when
    handling game, including wild birds. The National
    Wildlife Health Center recommends that hunters
  • Do not handle or eat sick game.
  • Wear rubber or disposable latex gloves while
    handling and cleaning game, wash hands with soap
    and water (or with alcohol-based hand products if
    the hands are not visibly soiled), and thoroughly
    clean knives, equipment and surfaces that come in
    contact with game.
  • Do not eat, drink, or smoke while handling
  • Cook all game thoroughly. (6)

  • There is currently a ban on the importation of
    birds and bird products from H5N1-affected
    countries. The regulation states that no person
    may import or attempt to import any birds whether
    dead or alive, or any products derived from
    birds. (6)

Question 1
  • ____ and ____ influenza viruses are of concern
    for human disease.

  • A and B

Question 2
  • What does pandemic outbreak mean?

  • global

Question 3
  • True or False The H5N1 virus spreads easily
    from birds to humans.

  • False

Mycobacterium marinum what is it?
  • Mycobacterium marinum (M. marinum) is a slowly
    growing bacteria that may cause disease in fish
    and people. The bacteria is normally found in
    bodies of fresh or salt water in many parts of
    the world.
  • Skin infection with Mycobacterium marinum is
    relatively rare and is usually acquired from
    swimming pools, aquariums, or fish-handling. This
    bacteria does not grow at normal body
    temperature. That is why it remains localized to
    the cooler skin surface. (8)

How do I get it?
  • Human infections with M. marinum under normal
    circumstances are rare. However, people who have
    breaks in the skin such as cuts and scrapes are
    at increased risk
  • When in contact with water from an aquarium or
    fish tank
  • When handling, cleaning, or processing fish, or
  • While swimming or working in fresh or salt water.
  • M. marinum infection is not spread from person to

What are the Symptoms?
  • When M. marinum infects the skin, it causes
    localized microscopic nodules to form. These
    nodules are called granulomas. They occur at
    sites of skin trauma where there are scratches,
    cuts, and the like.(8)

What are the Symptoms?
  • The most frequent sign is a slowly developing
    nodule (raised bump) at the site the bacteria
    entered the body. Frequently, the nodule is on
    the hand or upper arm.
  • Later the nodule can become an enlarging sore (an
    ulcer). Swelling of nearby lymph nodes occurs. (8)

What are the Symptoms?
  • Multiple granulomas may form in a line along the
    lymphatic vessel that drains the site.  These
    lesions will usually spontaneously heal in
    several months.
  • This infection can also involve the joints
    (septic arthritis) and bones.(8)

  • The granulomas usually appear within 2-3 weeks of
    exposure. Some reported cases have developed 2 to
    4 months or more after exposure to M. marinum
    because of the very slow-growing nature of this
  • A health care provider should be consulted if a
    skin nodule or reddened sore (ulcer) develops
    following direct skin contact with fresh or salt
    water or after handling or processing fish.(8)

Heightened Risk
  • For people with compromise of the immune system,
    M. marinum infection can be especially serious
    and involve disseminated (widespread) disease. If
    an infection is suspected under such
    circumstances, a health care provider should be
    promptly consulted.(8)

  • Avoid fresh or salt water activities if there are
    open cuts, scrapes, or sores on your skin,
    especially in bodies of water where this
    bacterium is known to exist.
  • If you have a weakened immune system, you can
    reduce the risk of infection by carefully
    covering cuts, scrapes, or sores during fresh or
    salt water activities and while cleaning fish
    tanks or handling, cleaning or processing fish.(8)

  • Wear heavy gloves (leather or heavy cotton) while
    cleaning or processing fish, especially fish with
    sharp spines that may cause cuts, scratches, or
    sores to the hands and skin. Wash hands
    thoroughly with soap and water after fish
    processing or use a waterless cleanser.
  • Wear waterproof gloves while cleaning home
    aquariums or fish tanks. Wash hands and forearms
    thoroughly with soap and running water after
    cleaning the tank, even if gloves were worn.
  • Ensure regular and adequate chlorination of
    swimming pools to kill any bacteria that may be
    present. (8)

  • 1. CDC. Baylisascaris Infection Fact Sheet.
  • 2. CDC. Morbidity and Mortality Monthly Report.
    Raccoon Roundworm Encephalitis --- Chicago,
    Illinois, and Los Angeles, California, 2000.
    January 4, 2002 / 50(51)1153-5
  • 3. CDC. Rocky Mountain Spotted Fever Home.
  • 4. CDC. Lyme Disease and Animals.
  • 5. CDC. Avian Influenza Infection in Humans.
  • 6. CDC. Key Facts About Avian Influenza (Bird
    Flu) and Avian Influenza A (H5N1) Virus
  • 7. WHO. Avian influenza frequently asked
    questions http//www.who.int/csr/disease/avian_inf
  • 8. MedicineNet.com. Mycobacterium marinum.

  • This presetation was created while I was an
    employee of Priority One Services (POS) at the
    National Institute of Environmental Health
    Sciences (NIEHS). Thus, both organizations
    deserve credit for supporting the work.
  • However, the opinions expressed in this
    presentation are mine and dont necessarily
    reflect those of POS, NIEHS, or UNC DLAM.
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