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INTRODUCTION

GUIDING QUESTIONS

  1. Why have zoonotic infections increased in frequency?

  2. How is Lyme disease contracted and what animal is responsible for spreading this infection?

  3. What is the significance of erythema migrans and does this skin lesion require treatment?

  4. Should patients with a positive Lyme disease antibody titer and chronic fatigue be treated with antibiotics?

  5. What activities are associated with the highest risk of leptospirosis and why?

  6. Why is coinfection with Borrelia burgdorferi and Babesia common?

  7. How is Rocky Mountain spotted fever treated and how quickly should therapy be instituted?

  8. What are morulae and in what disease are they most frequently seen?

  9. What organism causes cat scratch fever and how should this infection be treated?

  10. Skinning of what animal carries a high risk of developing Brucellosis?

Virtually, all emerging infections are zoonotic. As a consequence of increased outdoor activities, increasing populations of deer in close proximity to urban areas, and the spread of housing to more rural settings, humans are increasingly coming in contact with animals and with disease-spreading insect vectors. In addition, worldwide travel now exposes tourists to native people who live in close proximity to domestic animals that have the potential to carry transmittable diseases. As a consequence of these conditions, the natural spread of infection from lower mammals to humans, termed “zoonotic infection,” has greatly increased since the mid-1970s.

Zoonotic infections represent one of the most important classes of emerging infectious diseases. By combining new understandings of the genomic structures of pathogens with highly sensitive and specific polymerase chain reaction (PCR) detection methods, a number of newly discovered zoonotic diseases have been identified—for example, Bartonella and Ehrlichia.

Several zoonotic pathogens have been engineered for use as bioterrorist weapons: Bacillus anthracis, Yersinia pestis, and Francisella tularensis. These pathogens possess unique characteristics that make them particularly well suited for biological warfare.

SPIROCHETES

POTENTIAL SEVERITY

Can present acutely or result in a chronic disease that is occasionally life-threatening.

LYME DISEASE

Epidemiology

Lyme disease is the most common insect-borne infection in the United States. The incidence of the disease in the United States as well as Europe has been steadily increasing. In 2001, 17,029 cases were reported in the United States, and by 2010 the number of reported cases had increased 77% to 30,158 (13.4 cases per 100,000). Between 2007 and 2016, 262,481 confirmed cases of Lyme disease were reported. Lyme disease is now the sixth most commonly reported disease in the United States. The majority of cases are reported between the months of May and September. Cases are concentrated in two areas of the country: the Northeast and mid-Atlantic region (Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, Pennsylvania, Maryland, Delaware, and Virginia) and the Midwest (primarily Minnesota and Wisconsin) and less commonly in the Far West (Washington and California). ...

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