Global Zoonotic Diseases: Bacterial and Rickettsial Diseases
Global Zoonotic Diseases: Bacterial and Rickettsial Diseases
Disease in Humans | Causative Organism | Animals Involved | Geographic Distribution | Probable Means of Transmission to Humans | Clinical Manifestations in Humans |
|---|---|---|---|---|---|
Bacterial Diseases | |||||
Bacillus anthracis | Mainly noted in production animals (cattle, sheep, goats, horses, water buffalo, camelids) and wild herbivores; however, virtually all mammals are susceptible to high doses. A few cases have been noted in birds. | Worldwide but distribution is focal; common in Africa, Asia, South America, Middle East, parts of Europe | Occupational contact exposure (abraded skin, mechanical transmission by biting flies, other routes); ingestion or foodborne, rarely airborne | Early signs vary with route of inoculation; papule to ulcerative skin lesions; mild to severe gastroenteritis ± hematemesis, bloody diarrhea, ascites (abdominal GI form); sore throat, dysphagia, fever, neck swelling, mouth lesions (oropharyngeal GI form); pneumonia; all may progress to sepsis, meningitis; untreated cases fatal in 5%–30% (cutaneous) to 100% (inhalation) | |
Arcobacter infections | Arcobacter butzleri, A cryaerophilus, A skirrowii, possibly others | Poultry, cattle, pigs, sheep, horses, shellfish; some studies have detected these organisms in dogs and cats | Worldwide | Ingestion of contaminated water, undercooked meat (especially poultry) has been suggested | Gastroenteritis; bacteremia, mainly in patients with chronic illnesses; endocarditis, peritonitis; emerging and incompletely understood |
Bordetellosis ( see Respiratory Diseases of Pigs Respiratory Diseases of Pigs and see Bordetellosis in Poultry Bordetellosis in Poultry Avian bordetellosis is a highly infectious, acute disease of the upper respiratory tract of young turkeys. Bordetella avium was once the only known etiologic agent, but B hinzii... read more | Bordetella bronchiseptica, B hinzii | B bronchiseptica in dogs, rabbits, cats, pigs, guinea pigs, other mammals; B hinzii mainly in poultry, uncommonly mammals (eg, rabbits, rodents) | Worldwide; uncommon in humans | Exposure to saliva or sputum, aerosols | Sinusitis, bronchitis, pertussis-like illness; pneumonia and disseminated disease (eg, endocarditis, peritonitis, meningitis), usually in immunocompromised; biliary infections; wound infection; abscesses |
Lyme disease (Lyme borreliosis) | Borrelia burgdorferi sensu lato complex (B burgdorferi sensu stricto, B garinii, B afzelii, B spielmanii, possibly others) | Wild rodents, insectivores, hedgehogs, hares, other mammals; birds are reservoirs for some agents (eg, B garinii); possibly some lizards | Agents exist worldwide where Ixodes ticks are found; human cases have been reported in North America, Europe, Australia, parts of Asia, Amazon region of South America | Nonspecific febrile illness early; erythema migrans ("target-like") skin lesions in many; may progress in some humans to arthritis, neurologic, cardiac, and/ or skin signs (acrodermatitis chronica atrophicans); syndromes may vary with infecting agent | |
Tickborne relapsing fever | B recurrentis, B crocidurae, B turicatae, B hermsii, B persica, B hispanica, others; some species such as B duttoni are human pathogens and not zoonotic | Wild rodents, insectivores, possibly birds | Africa, Asia, Europe, Americas; species varies with region | Tick bites (mainly Ornithodoros spp) | High fever, malaise, headache, myalgia, chills; neurologic signs or abortion possible; jaundice, epistaxis, major organ dysfunction possible; recurring episodes, often milder, after a symptom-free period; death in 2%–5% |
Borrelia miyamotoi disease | Borrelia miyamotoi | Rodents, birds, possibly larger mammals | Asia, Europe, North America, probably other locations | Tick bites (Ixodes spp) | Fever, nonspecific flu-like signs including GI signs in some, rash, thrombocytopenia; meningoencephalitis in immunocompromised |
Brucellosis ( See also Brucellosis in Large Animals Brucellosis in Large Animals and See also Brucellosis in Dogs Brucellosis in Dogs ) | Brucella abortus | Cattle, water buffalo, American bison, African buffalo, elk are reservoir hosts; numerous mammalian spillover hosts (eg, deer, sheep, goats, camels, South American camelids, pigs, canids, felids, horses) | Once worldwide, now eradicated or uncommon in domestic animals in some countries or regions; reservoirs in wildlife in some disease-free areas including the US | Exposure to birth products from animals, ingestion (especially unpasteurized dairy products or undercooked meat), contact with mucous membranes and broken skin, accidental inoculation of strain 19 vaccine; rare instances of person-to-person transmission (eg, assisting at a birth from an infected woman, in a blood transfusion, or during sexual intercourse) | Extremely variable, subacute and undulant to sepsis; often nonspecific febrile illness with drenching sweats early; arthritis, spondylitis, epididymo-orchitis, endocarditis, neurologic and , various other syndromes if chronic; case fatality 1%–2% in untreated |
B melitensis | Goats, sheep are the primary hosts; can infect various mammalian spillover hosts (eg, cattle, water buffalo, camelids, dogs, pigs, wild ungulates) | Parts of Asia, Africa, Middle East, Europe and Latin America including Mexico | As for B abortus; accidental inoculation of Rev 1 vaccine | As above; this species is considered highly pathogenic for humans | |
B suis biovars 1–4; biovar 5 has not been reported in humans | Swine and wild pigs (biovars 1, 2, 3), European hares (biovar 2 in Europe, possibly biovar 1 in South America), reindeer and caribou (biovar 4); B suis also in some other mammals | Biovars 1 and 3 worldwide in swine-raising regions except eradicated or nearly eradicated from domestic pigs in some countries; biovar 2 in wild boar in Europe; biovar 4 in Arctic regions of North America and Eurasia | As for B abortus; food sources may include uncooked caribou bone marrow (biovar 4) | As above | |
B canis | Dogs; evidence of infection in wild canids including coyotes, foxes | Worldwide except in a few regions (Australia, New Zealand); not common in humans | Probably as for B abortus; close contact, especially with animals that recently aborted or gave birth | Probably as above | |
B ceti and ST27 genotype from marine mammals, possibly B pinnipedialis | Marine mammals (B ceti mainly in cetaceans, B pinnipedialis mainly in pinnipeds) | Probably occur in most or all marine environments | Laboratory exposure; sources of other infections unknown (possibly contact with animals or exposure to seawater, seafood); rare or underdiagnosed in humans | Few cases known: mild to severe febrile illness, similar to that due to other Brucella spp; neurological signs occurred in some patients | |
B neotomae, B inopinata; additional species of Brucella maintained in wild animals might also be human pathogens | B neotomae in desert wood rat (Neotoma lepida) and possibly other rodents. Host of B inopinata unknown. | Uncertain. Two human cases due to B neotomae were acquired in South America | Unknown | Probably similar to cases due to other species of Brucella. Two cases due to B neotomae had neurological signs as well as other brucellosis symptoms. B inopinata was isolated from 1) an infected breast implant, possibly after a systemic infection, and 2) the lungs in a case of chronic pneumonia. | |
C jejuni, C coli, occasionally other species; some strains of C jejuni seem to have broader host ranges than others | Poultry, cattle, swine, dogs, cats, rodents, other mammals, wild birds | Worldwide | Foodborne (especially poultry and other meats, unpasteurized dairy products); waterborne; contact with infected animals (fecal-oral route) | Gastroenteritis from mild cases to fulminating or relapsing colitis; occasional sequelae such as reactive arthritis; occasionally, other syndromes, including sepsis | |
Campylobacter fetus infection | C fetusfetus (most cases), C fetustestudinum; possibly C fetusvenerealis | C fetusfetus and Cvenerealis in cattle, sheep, goats (human-adapted lineages also seem to exist); C fetustestudinum in reptiles | Worldwide | Probably direct contact or ingestion; often unknown | Opportunist; sepsis, meningitis, endocarditis, abscesses, other systemic infections in elderly, immunocompromised, or infants; abortions, preterm births in pregnant women, neonatal sepsis; gastroenteritis not prominent in most cases |
Capnocytophaga infection | C canimorsus, C cynodegmi, C canis (rare), possibly others | Dogs, cats | Probably worldwide | Bites or scratches | Fever, localized infections to bacteremia or sepsis, endocarditis, meningitis; often in immunocompromised or elderly |
Cat scratch disease | Bartonella henselae; B clarridgeiae and other Bartonella species also implicated rarely in cat scratch disease or other conditions (eg, endocarditis) | Cats and other felids; other Bartonella spp in canids, rodents, rabbits, other animals | Worldwide | Often associated with scratches, bites, especially from cats; potential for other exposures to broken skin via saliva; exposure of conjunctiva | Lymphadenopathy (may be absent in elderly), fever, malaise, skin lesions at inoculation site in immunocompetent, usually self-limiting with complications (eg, endocarditis, neuroretinitis, neurologic disease) uncommon; inoculation into eye results in conjunctivitis ± ocular granuloma and local lymphadenopathy; risk of bacteremia, disseminated disease, bacillary angiomatosis in immunosuppressed |
Chlamydia abortus; C felis, C suis, C pecorum involved or suspected in a few cases | C abortus reservoirs are sheep, goats; C pecorum found in ruminants, horses, pigs, others; C felis mainly in cats; C suis mainly in suids; Chlamydia spp also infect mammals other than their usual hosts, occasionally reptiles, amphibians, possibly birds | C felis, C suis, C pecorum are cosmopolitan; C abortus in most sheep-raising areas but not Australia or New Zealand | Contamination of mucous membranes, inhalation and possibly other routes after contact with animals; C abortus in high concentrations in birth products but chlamydiae also occur in other secretions and excretions | C abortus: mainly abortions, stillbirths, preterm births, often associated with illness including septicemia in mother; respiratory disease and possibly other conditions in nonpregnant (few cases); other chlamydiae suggested to be involved rarely in various illnesses including C felis in conjunctivitis suspected agent of keratoconjunctivitis, also implicated in other conditions (controversial) | |
Clostridium difficile; some genotypes in animals are shared with humans and implicated as potential zoonoses | Cattle, pigs, dogs, and other species | Worldwide | Possible zoonosis; from contact or ingestion in contaminated meat; also from environment and contact with infected humans | Gastroenteritis, varying in severity from diarrhea to fulminant colitis, usually in conjunction with antimicrobial use | |
Clostridium perfringens, type A (most common), C, or D; environmental or endogenous source, with some potential for zoonotic transmission | Domestic and wild animals, humans | Worldwide | Foodborne (usually type A); nonfood-associated intestinal infection; wound contaminant, usually environmental; may be endogenous in debilitated from GI or urogenital tract | Foodborne gastroenteritis, usually brief, self-limited except in debilitated; nonfood-related intestinal infection with prolonged diarrhea, sometimes bloody, mainly in elderly after antimicrobials; life-threatening necrotic enteritis, often in debilitated; gas gangrene, sepsis; necrotic enteritis, gas gangrene, sepsis are fatal if not treated | |
Corynebacterium ulcerans, C pseudotuberculosis, and C bovis infections | C ulcerans, C pseudotuberculosis, C bovis | C ulcerans in cattle, pigs, small ruminants, dogs, cats, ferrets, other domestic and wild animals; C pseudotuberculosis in sheep, goats, cattle, horses, camelids, other mammals; C bovis in cattle, colonies of immunocompromised laboratory rodents | Probably worldwide; uncommon in humans but may be increasing | Direct contact, consumption of unpasteurized milk products | Acute upper respiratory illness with sinusitis, sore throat, tonsillitis, or more severe pharyngitis resembling diphtheria (pseudomembranous pharyngitis); cardiorespiratory complications including pneumonia possible; peritonitis; isolated skin infection; ocular disease (C bovis) and other localized conditions; some cases serious or fatal |
Dermatophilus congolensis | Cattle, horses, deer, sheep, goats, other mammals | Worldwide, especially in warmer regions | Usually direct contact with lesions; mechanical transmission on fomites possible | Pustular desquamative dermatitis, other skin lesions | |
Enterohemorrhagic and enteroaggregative Escherichia coli infections | E coli O157:H7, O157:H-, members of O26, O55, O91, O103, O111, O121, O145 and other serogroups | Especially cattle, sheep; also found in goats, bison, camelids, cervids, pigs, lagomorphs, many other of mammals; sometimes shed by birds | Worldwide | Ingestion of undercooked meat (especially ground beef), unpasteurized milk products, vegetables, other food sources or water contaminated with feces; direct contact with feces, animals (especially ruminants) or contaminated fomites | Diarrhea or hemorrhagic colitis; a minority of patients with hemorrhagic colitis develop hemolytic uremic syndrome (HUS); case fatality rate for HUS is 3%–5%, higher in some populations (eg, 1%–10% in children, up to 50% in elderly) |
Erysipelothrix rhusiopathiae | Swine, sheep, cattle, rodents, marine mammals; many other domestic and wild mammals and marsupials, birds (including poultry), reptiles, fish, mollusks, crustaceans | Worldwide | Contact with animal products; via skin, usually after scratch or puncture wound; contaminated soil (survives for weeks to months) | Localized cellulitis, usually self-limiting, often on hands; generalized skin lesions (uncommon); septic arthritis, often in finger joints near skin lesion; endocarditis (with high mortality, 38%); generalization with sepsis, other syndromes uncommon and often in immunocompromised | |
Burkholderia mallei | Equids are reservoirs; many other domesticated and wild mammals also susceptible to infection, clinical cases reported occasionally, especially in felids | Middle East, Asia, Africa and South America | Contact with infected animals, tissues through broken skin, mucous membrane, ingestion, inhalation | Mucous membrane or skin lesions; pneumonia and pulmonary abscess; sepsis; chronic abscesses, nodules, ulcers in many organs, weight loss, lymphadenopathy; case fatality rate varies with form, but > 95% in untreated septicemia and 90%–95% in untreated pulmonary disease | |
Helicobacter infection | H pullorum, H canis,H suis, other species suspected as zoonoses | Poultry (H pullorum), rodents (H pullorum and other species), pigs (H suis), dogs (H canis), many other mammals | Uncertain; possibly ingestion of undercooked meat or direct contact | Gastroenteritis or diarrhea, liver disease; cellulitis; bacteremia in immunosuppressed patients | |
Mycobacterium leprae | Armadillos; nonhuman primates (rare) | Armadillos in parts of southern US, Mexico, South America; nonhuman primates in Africa, possibly other locations; only human reservoirs in other areas | Transmission of animal leprosy to humans likely | Various skin lesions, sensory nerve lesions and deficits, nasal mucosal lesions; mild, self-limiting to progressive destruction | |
Leptospira spp | Domestic and wild animals; reservoir hosts include rodents, dogs, cattle, pigs, farmed red deer, others | Worldwide | Occupational and recreational exposure, or exposure to rodent-contaminated material in urban locations; especially skin, mucous membrane contact with contaminated urine, infected fetuses, or reproductive fluids; water- and foodborne | Asymptomatic to severe, sometimes biphasic; nonspecific febrile illness followed by aseptic meningitis or icteric form (especially liver, kidney, CNS involvement, hemorrhages possible); pulmonary hemorrhage and edema, other syndromes; uveitis can be sequela; case fatality rate varies with syndrome (uncommon in aseptic meningitis, 5%–15% in icteric form, 30%–60% in severe pulmonary form) | |
Listeria monocytogenes, rarely Listeria ivanovii or other species of Listeria | Numerous mammals including marsupials, some birds and reptiles; subclinical fecal shedding has been reported in fish and amphibians; crustaceans can be contaminated | Worldwide | Most often foodborne, especially unpasteurized dairy products and various ready-to-eat refrigerated foods (eg, patés, deli meats); however, also many other sources including raw meat and fish, vegetables and fruits, foods contaminated after processing; ingestion of contaminated water, soil; direct contact with infected animals (via mucous membranes, broken skin as well as ingestion); transmission can occur between newborns in hospitals but person-to-person transmission otherwise absent or negligible | Acute, self-limited febrile gastroenteritis or mild, flu-like illness; ocular disease, conjunctivitis; abortion, premature or septicemic newborn if infected during pregnancy; meningitis, meningoencephalitis, septicemia in elderly, immunosuppressed, and infants; bone and joint infections in humans with implants; papular or pustular rash ± fever, chills in healthy adults after handling infected fetuses or other heavily contaminated source; occasionally other syndromes | |
Melioidosis Melioidosis (pseudoglanders) | Burkholderia pseudomallei (other species of soil-associated Burkholderia, (eg, B oklahomensis sp nov in North America, rarely linked to similar human diseases) | Sheep, goats, swine; occasional cases in many other terrestrial and aquatic mammals; also reptiles; some birds including psittacines, ratites, chickens; tropical fish | Mainly reported in parts of Asia and northern Australia; however, organisms or cases also documented in Africa, South America, Middle East, Caribbean; B pseudomallei is not known to exist in North America but a few cases that appeared to be indigenous were documented, source of organism uncertain | Via broken skin, inhalation, and ingestion; organisms live in soil and surface water; most cases are acquired from environment; direct transmission from animals is possible | Mimics many other diseases; acute localized infections, including skin lesions, cellulitis, abscesses, corneal ulcers; pulmonary disease, septicemia, internal organ abscesses; often occurs in immunocompromised; case fatality rate varies with form, > 90% in untreated septicemia |
Methicillin-resistant Staphylococcus aureus (MRSA) infections | S aureus that carry mecA or mecC gene; some strains maintained in animals (eg, production animals-associated CC398), other strains mainly in humans but animals can become carriers | Pigs (major reservoirs for production animals-associated strain CC398); cats, dogs mainly acquire strains from humans; MRSA also reported in other mammals, including horses, cattle; birds, including poultry, psittacines; turtles | Worldwide; can be reverse zoonosis or zoonosis; major strains in animals can vary with region | Usually by direct contact (typically with subclinically affected carrier animals); other routes also described; can be nosocomial in hospitals | Opportunist; localized skin and soft-tissue infections, invasive disease including septicemia, toxic shock syndrome; mortality varies with syndrome and success in finding antimicrobial |
Mycobacterium avium complex | Many species of mammals, some birds | Worldwide | Environmental, mainly from water, or soil; infection common to humans and animals | Soft-tissue and bone infections; cervical lymphadenitis; pulmonary disease, often in immunocompromised or those with preexisting lung conditions; disseminated in immunocompromised, especially AIDS patients with uncontrolled disease | |
Mycobacteria other than tuberculosis (eg, M simiae, M kansasii, , M genavense, M chelonae, M marinum, M ulcerans, others) | Ruminants; swine, cats, dogs, other mammals, amphibians, reptiles (uncommon), fish; species of Mycobacterium spp varies with host | Worldwide; distribution varies with the organism | Environmental, from water or soil | Same syndromes as M avium complex; some organisms tend to be associated with certain syndromes (eg, M marinum, M ulcerans, with ulcerative or nodular dermatitis) | |
Yersinia pestis | Rodents (eg, squirrels, prairie dogs, rats) and lagomorphs (pikas in Asia) are main reservoir; many mammals can be incidental hosts; cats and wild felids especially susceptible | Foci in North and South America, Asia, Middle East, and Africa | Flea bites, aerosols, handling infected animals or tissues (contact with broken skin or mucous membranes), bites, eating uncooked infected tissues | Febrile flu-like syndrome with swollen, very painful draining lymph node(s) (bubos); pneumonia; GI signs associated with foodborne outbreak; sepsis can occur in either bubonic or pneumonic form; case fatality rate in untreated 40%–70% (bubonic) to 100% (pneumonic); < 5% mortality if bubonic form treated early | |
Chlamydia psittaci, possibly other avian chlamydiae (eg, C gallinacea, C avium) | C psittaci in psittacines, pigeons, poultry, game birds, ratites and other domestic or wild birds; occasionally in mammals, possibly reptiles; C gallinacea in various poultry; C avium in pigeons, other birds | Worldwide | Direct contact with birds, inhalation of contaminated dust, feathers or aerosolized secretions or excretions from environment | Influenza-like febrile illness, with or without respiratory signs, that may progress to pneumonia; reproductive losses (abortion, premature birth); keratoconjunctivitis; endocarditis, myocarditis, meningoencephalitis, hepatitis, renal disease and other organ dysfunction, sepsis possible in severe cases; sometimes fatal if untreated, < 1% mortality with treatment | |
Rat bite fever | Streptobacillus moniliformis | Rodents, especially rats; might also be transmitted by carnivores (eg, dogs, cats, ferrets), which are probably infected or transiently colonized from rodents | Probably worldwide | Bites and scratches; handling or kissing a rodent, exposure to rodent urine; can be waterborne or foodborne | Febrile illness, often with rash; GI signs possible and especially common when foodborne polyarthritis/ polyarthralgia (usually but not always sterile) common, can persist for several months or more; other complications including hepatitis, endocarditis, focal abscesses, sepsis possible if untreated; overall case fatality rate 7%–13% if untreated |
Spirillum minus | as above | Seems to be common only in Asia but cases have been attributed to this organism on other continents | Mainly bites and scratches | As above; however, indurated, often ulcerated lesion at inoculation site; can relapse; some (minority) may have distinctive rash (large violaceous or reddish macules); polyarthritis is uncommon; overall case fatality rate 7%–10% if untreated | |
Salmonella enterica and S bongori (> 2,500 serovars) | Widespread in mammals, birds, reptiles, amphibians, including domestic species; also in crustaceans; higher-risk pets for human exposure may include reptiles, amphibians, young poultry, some exotic mammals, including hedgehogs | Worldwide | Foodborne infection or fecal-oral; some cases of occupational and recreational exposure | Gastroenteritis to sepsis; focal infections possible; especially severe in the elderly, young children, or immunocompromised | |
Streptococcal infections | Streptococcus spp, including S suis, S equi zooepidemicus, S canis, S iniae, S halichoeri, probably others | S suis in swine and wild boar; S equi zooepidemicus in horses; S canis in dogs, cats; S iniae and S halichoeri in fish (S halichoeri has affected various marine and terrestrial mammals including dogs, mink, farmed foxes, wild badger); each species can also be found in other animals | Streptococcus spp worldwide, but some organisms documented in limited locations (eg, S halichoeri in Europe) | Ingestion, especially of unpasteurized dairy products, undercooked animal tissues; direct contact, often through broken skin | Skin and soft-tissue infections; pharyngitis; other conditions, including pneumonia, meningitis, arthritis, endocarditis, streptococcal toxic shock syndrome, sepsis |
Mycobacterium bovis | Cattle, bison, African buffalo, some cervids (elk, white-tailed deer), brushtail opossums, European badgers, wild boar, Kafua lechwe can be reservoirs; many other mammals can be spillover hosts, rare reports in birds | Once worldwide, now eradicated or rare in some countries | Ingestion (unpasteurized dairy products, undercooked meat), inhalation, contamination of breaks in the skin | Skin lesions, cervical lymphadenitis pulmonary disease; can also affect genitourinary tract, bones, joints, CNS, intestinal tract and other sites; disseminated disease possible, especially in immunocompromised or young children; slow progression in most healthy humans and low mortality if treated, but CNS disease, disseminated disease, and immunocompromised patients have higher fatality rates | |
Mycobacterium caprae | Goats are main reservoir; cattle, wild red deer may also maintain organism; also infects other mammals (eg, sheep, pigs, wild boar, horses, cervids, camels, foxes, zoo animals) | Reported mainly in Europe; also found in China, North Africa and may occur in other countries | Probably similar to M bovis | Similar to M bovis | |
Mycobacterium microti | Rodents, insectivores are reservoir; can occur in many other wild or domestic animals including cats, dogs, ferrets, production animals | Widely distributed | Probably similar to M bovis | Probably similar to M bovis | |
Mycobacterium orygis | Oryx, African buffalo, waterbuck, rhinoceros, nonhuman primates and other species | Africa, southern Asia, Middle East | Probably similar to M bovis | Probably similar to M bovis | |
Mycobacterium pinnipedii | Seals and sea lions are usual hosts; also reported in cetaceans and various terrestrial mammals (eg, cattle, camelids, nonhuman primates) | Coasts of Europe, South America, New Zealand, Australia, probably other locations | Probably similar to M bovis | Probably similar to M bovis | |
Francisella tularensis (some subspecies of this organism seem to be more virulent than others); other species of Francisella (eg, F hispaniensis, F philomiragia) can also cause illness but might mainly affect the immunocompromised | Lagomorphs, rodents, cats, sheep, many other mammals, birds, reptiles, fish; often in wild animals | F tularensistularensis almost exclusively in North America; F tularensisholarctica in Northern Hemisphere and Australia; F tularensismediasiatica in Central Asia; F tularensisnovicida reported in North America, Thailand; F hispaniensis in Europe (Spain) and Australia | Contact with mucous membranes, broken skin; insect bites (tabanids, mosquitoes, hard ticks); fomites; ingestion in food or water; inhalation | Nonspecific febrile illness, lymphadenitis; ulcerative skin lesions, exudative pharyngitis and stomatitis, conjunctivitis, gastroenteritis, respiratory signs or pneumonia, sepsis; case fatality rate 5% (localized disease, untreated) to > 50% (untreated typhoidal form or severe respiratory disease); 1%-–3% case fatality overall when treated | |
Vibriosis | Vibrio parahaemolyticus | Marine and estuarine shellfish, fish; also environmental in aquatic environments | Worldwide | Ingestion, wound infections | Gastroenteritis; dysentery (especially in some geographic regions); wound infections (mild to severe, including necrotizing fasciitis); sepsis; severe wound infections and sepsis usually in immunocompromised or those with liver disease (case fatality rate for sepsis 29%) |
V vulnificus | Marine shellfish, crustaceans (eg, shrimp), fish; also environmental in aquatic environments | Worldwide; human cases have been reported in North America, Europe, Asia | Ingestion (often raw oysters), wound infection from water or handling hosts | Wound infections from mild, self-limited lesions, bullae to cellulitis, myositis; necrotizing fasciitis; gastroenteritis; sepsis, usually in immunocompromised or those with liver disease, other debilitating illnesses; case fatality rate for sepsis > 50%, and up to 25% for wound infections | |
Vibriosis | V cholerae O1/O139 (epidemic strains) | Oysters, crabs, shrimp, mussels can act as a reservoir for organisms although most cases are acquired from humans | Rare or absent to epidemic in different regions; one focus along US Gulf Coast in shellfish | Ingestion | Mild to severe, voluminous diarrhea, vomiting, dehydration; severe cases fatal if untreated; however, low mortality if treated |
V cholerae non-O1/O139 (nonepidemic strains) | Oysters, other seafood, fish; also environmental in aquatic environments | Worldwide | Ingestion, wound infection | Gastroenteritis, usually mild and self-limited; wound infections; septicemia, usually in immunosuppressed or those with liver disease (case fatality rate for sepsis 47%–60% or higher) | |
Yersiniosis | Yersinia pseudotuberculosis | Many species of mammals, including production animals, dogs, cats, lagomorphs, rodents, wild and zoo mammals, birds, possibly reptiles | Agent probably worldwide; prevalence may vary between regions | Ingestion of contaminated water, food (including meat, vegetables); fecal-oral (animal contact); dog bite (rare) | Gastroenteritis (enterocolitis); pseudoappendicitis (with mesenteric lymphadenitis, terminal ileitis, fever, abdominal pain); severe GI bleeding possible in some cases of colitis; pharyngitis; sequelae may include erythema nodosum, reactive arthritis; sepsis, especially in elderly or immunocompromised; occasionally other syndromes, eg, septic arthritis, Far Eastern scarlet-like fever |
Y enterocolitica; not all serotypes are pathogenic | Many domestic and wild mammals, including rodents; some birds, reptiles, amphibians; pigs are a major source of zoonotic organisms, pathogenic types also occur in dogs, cats | Worldwide; prevalence of human disease may vary between regions | Ingestion, as for Y pseudotuberculosis (pork is a common source), animal contact | Gastroenteritis sometimes bloody; pseudoappendicitis; sequelae may include erythema nodosum, reactive arthritis; myocarditis, other syndromes; sepsis possible | |
Rickettsial Diseases | |||||
Human ewingii ehrlichiosis (formerly granulocytic ehrlichiosis) | Ehrlichia ewingii | Dogs, deer proposed | Parts of North and South America, Africa; closely related organism in Asia | Ticks, including Amblyomma americanum | Few cases described; fever, headache, malaise, myalgia, nausea, vomiting (rash seems to be uncommon); probably mild in most healthy people; many patients were immunosuppressed |
Ehrlichia chaffeensis | Cervids, other domestic and wild mammals | North and South America, Asia, Africa; evidence for E chaffeensis or related organism in Europe | Ticks, including Amblyomma americanum | Asymptomatic to nonspecific febrile illness; rash in many pediatric cases, some adults; may progress to prolonged fever, renal failure, respiratory distress, hemorrhages, cardiomyopathy, neurologic signs, multiorgan failure; more severe in immunosuppressed, elderly; estimated case fatality rate 1% | |
Human granulocytic anaplasmosis (formerly human granulocytic ehrlichiosis) | Anaplasma phagocytophilum (formerly Ehrlichia phagocytophilum and E equi) | Wild rodents, deer and other wild ungulates; production animals may be reservoirs; many other animals can also be infected | Worldwide | Tick bites (Ixodes spp), possibly exposure to blood or tissues from infected animals | Resembles human monocytic ehrlichiosis; often asymptomatic to mild in immunocompetent; rash uncommon; estimated case fatality rate < 1% |
Infection by other Ehrlichia species | E canis, other organisms (eg, Emuris-like organism, possibly E ruminantium) implicated rarely in human illness | Dogs and other canids thought to be reservoirs; for E canis also reported in other animals including felids, camels, cattle, racoons, | E canis worldwide | Ticks | Rare cases of febrile illness, in both healthy and immunosuppressed |
Q fever Coxiellosis (Query fever) | Coxiella burnetii | Sheep, cattle, goats, cats, dogs, deer, rodents, small mammals, other domestic and wild mammals, birds | Cosmopolitan | Mainly airborne; exposure to placenta, birth tissues, animal excreta; occasionally ingestion (including unpasteurized milk); possibly tickborne infections | Febrile influenza-like illness; atypical pneumonia, hepatitis, occasionally other syndromes; persistent, localized infection of blood vessels, heart valve or other tissues, usually in those with pre-existing damage; possible pregnancy complications; overall case fatality rate 1%–2% if untreated |
Sennetsu fever | Neorickettsia sennetsu | Uncertain, possibly fish | Japan, Malaysia, Laos, possibly other Asian countries | Possibly ingestion of raw fish | Relatively mild, nonspecific, febrile illness, resembles infectious mononucleosis |
Spotted fever group of Rickettsia | |||||
—African tick bite fever | R africae | Cattle, other domestic and wild ungulates | Sub-Saharan Africa, eastern Caribbean | Bite of infected tick (mainly Amblyomma spp, possibly some Rhipicephalus spp | Nonspecific febrile illness; painful regional lymphadenopathy, stiffness and pain of neck muscles common; eschars often multiple; sometimes sparse maculopapular or vesicular rash; complications rare and deaths apparently absent or very rare |
—Mediterranean spotted fever; Boutonneuse fever; Israeli spotted fever, Astrakhan spotted fever, Indian tick typhus | R conorii | Rabbits, possibly rodents, dogs implicated as reservoirs for R conoriiconorii in Mediterranean; other animals can be infected | Europe, Africa, Asia | Bite of infected ticks (mainly Rhipicephalus spp), crushing tick | Nonspecific febrile illness; eschar (typically single) may or may not be present; rash, in most; complications including neurologic signs, cardiac involvement, multiorgan dysfunction, retinitis possible but uncommon; case fatality rate 1%–3% if untreated; R conorii subsp. israelensis might be more virulent |
—Fleaborne spotted fever; cat flea typhus | R felis (synonym ELB agent) | Dogs seem to be a reservoir host; evidence for organisms in cats and diverse other domestic and wild mammals | Cosmopolitan | Flea bites; mainly associated with Ctenocephalides felis (cat flea), also infects C canis and other fleas; possibly other arthropods | Febrile illness; rash in some; eschar may be uncommon; most cases seem to be mild but complications including CNS involvement, pneumonia; deaths possible |
—Queensland tick typhus | R australis | Bandicoots, rodents | Australia | Bite of infected Ixodes tick, especially I holocyclus, I tasmani | Febrile illness, eschar may be present, rash (either maculopapular or vesicular) in most; mild in most, but serious complications, death possible |
—Rickettsial pox | R akari | Mice; also rats, Korean voles | Organism may be cosmopolitan; human cases seem to be uncommon, mainly reported in a few locations in North America, Europe | Bite of infected rodent mites, Liponyssoides sanguineus | Eschar (single) in most; febrile illness; maculopapular rash progresses to vesicular, pustular, resembles chickenpox; self-limiting |
—Rickettsia parkeri rickettsiosis | R parkeri | North and South America | Bite of infected Amblyomma spp ticks | Resembles Rocky Mountain spotted fever (RMSF) but seems to be milder in most cases; and eschars common (may be multiple), petechial rash does not seem characteristic | |
R rickettsii | Rodents, rabbits, opossums, and other small mammals might amplify; dogs can be infected | North and South America | Bite of infected ticks; especially Dermacentor variabilis, D andersoni (in North America); Amblyomma spp, D nitens in South America; Rhipicephalus sanguineus also a vector in some areas; from crushing tick | Moderate to severe febrile illness; macular to generalized petechial rash; edema in some; usually no eschar; neurologic, pulmonary, hemorrhagic, and kidney signs in some; sepsis; gangrene; case fatality rate 15%–30% or higher if untreated, might be more severe in Brazil | |
—Tickborne lymphadenopathy; Dermacentor necrosis-erythema-lymphadenopathy | R slovaca, R raoultii | Uncertain; wild boar may be involved | Europe to Central Asia | Bites of infected ticks;Dermacentor marginatus, and other species | Eschar, local lymphadenopathy; localized alopecia at bite site; mild illness, fever and rash uncommon; no deaths reported |
—Other tickborne species in spotted fever group | R sibirica, R japonica, R helvetica, R honei, R heilongjiangensis, R aeschlimannii, R massiliae, R monacensis; others | Various vertebrates | Distribution varies by species | Bites of ixodid ticks; specific vector varies by species | Similar to other rickettsial diseases, with inoculation site eschar, rash, febrile illness, prevalence of major clinical signs, risk of complications, severity varies |
Typhus group of Rickettsia | |||||
—Murine typhus (fleaborne typhus, endemic typhus) | R typhi | Rats are major reservoir; opossums in some areas; cats, dogs, other species probably involved in peridomestic cycle | Worldwide, especially warmer regions | Infected rodent fleas, usually via flea feces; cat fleas seem to be involved in some cycles | Fever, severe headache, central rash (not always observed); other clinical signs, including arthralgia, cough, nausea/vomiting in some; complications possible in various organs; case fatality rate mortality rate < 1% without treatment |
—Scrub typhus; Chigger-borne rickettsiosis | Orientia tsutsugamushi and related species | Rodents, insectivores | Asia, Australia, islands of southwestern Pacific Ocean; cases are usually concentrated regionally; related organisms may exist in Africa, Middle East, South America | Bite of infected larval trombiculid mites (chiggers) | Nonspecific febrile illness with rash, painful lymphadenopathy, GI signs; eschar in some; complications can include pulmonary disease, neurologic signs, cardiac involvement, jaundice; mild to severe, with estimated case fatality rate from 6% to 30%–50% if untreated |
—Typhus, sylvatic (zoonotic cycle) | R prowazekii | Flying squirrels (Glaucomy s volans) | Eastern US (only human reservoirs known in other locations) | Squirrel lice or fleas suspected | Nonspecific febrile illness, rash; GI signs in some; sepsis possible; most cases seem to be milder than non-zoonotic typhus, which has a mortality rate of 10%–60% |
