Boli transmise prin vectori
-
Upload
maravet-sa -
Category
Documents
-
view
214 -
download
0
description
Transcript of Boli transmise prin vectori
STEPs—Simple Tools for Effective Protocols
Suggested vector-borne disease screening guidelines
SNAP® 4Dx® Test
Screen your dog every year with the SNAP 4Dx Test to detect exposure to pathogens that cause heartworm disease, ehrlichiosis, Lyme disease and anaplasmosis.
If necessary
Retest in 1 year
Discuss disease prevention strategies
Depending on the results of your pet’s wellness screening, additional testing or therapies may be required.
Your pet’s screening result and what it means
•Reviewbenefits of prevention – preventives – vaccination
•Retestin1year
Negative result Exposure unlikely
Positive result The dog has been exposed and may be infected
Runadditionalteststoconfirminfection
Self-limiting infection Dogs that have likely resolved their infection
Subclinical infection Infected dogs without any apparent signs of illness
Clinical disease Infected dogs with clinical signs that are recognizable
Clinicalsignsand/orlaboratoryfindingsindicateeither
Monitor
Prevent
Treat
Diagnose
What to do next?
?
1
2
3
4
Protocol ImplementationVeCTor-borNe DiSeASe SCreeNiNg
STEPs—Simple Tools for Effective Protocols
page 2
Medical background
Primary vectorIxodes spp. (deer tick or black-legged tick)
Transmission24–48 hours of tick attachment
PathogenBorrelia burgdorferi spirochete, which localizes in tissues of infected dogs
Clinical presentationLyme is a chronic infection with clinical signs that may present acutely:• Fever,anorexia,lethargy• Jointswelling• Polyarthritis• Shiftingleglameness• Rapidlyprogressiverenalfailure• Neurologicsyndromes
Laboratory abnormalities• Elevated(≥30 U/mL) C6
antibody level• Proteinuria
Suggested Lyme Disease Screening Guidelines
Reviewbenefits of tick prevention
Doxycycline/tetracycline
Monitor for clinical signs
Retest C6 antibody level with or without UPC in 6monthstoconfirmtreatment success
Monitor
Prevent Discuss disease prevention strategies
Not generally recommendedTreat
Clinical signs and/or laboratoryfindingsDO NOT
support Lyme disease (C6 antibody level <30 U/mL)
Clinical signs and/or laboratoryfindingsDO
support Lyme disease (C6 antibody level ≥30 U/mL)
Diagnose*
Determine antibody level with the Lyme Quant C6 Test and evaluate for proteinuria (UPC)
What to do next?
What to do with your result
Negative result Infection is unlikely
Positive result Infection is likely
Transmitted by the deer tick or black-legged tick, Lyme disease is caused by the bacterium Borrelia burgdorferi. Clinical signs may not appear until several months after infection. Lyme disease has been found throughout North America with cases ranging from mild to severe.
Did you know?
The C6 peptide used in the IDEXX SNAP® 3Dx®, SNAP® 4Dx®/and Lyme Quant C6
® tests do not cross-react with antibody response to commercially available Lyme vaccines.1
Ixodes ticks are known to be vectors for both Lyme disease and anaplasmosis.
Dogs with seroreactivity to both B. burgdorferi and Anaplasma phagocytophilum may have two times the risk of developing clinical illness than singularly infected dogs.2
?
1
2
3
4
* Serology is typically used to diagnose Lyme disease. B. burgdorferi localizes to the tissues and is therefore rarely detectable in the blood by PCR.3
1.O’ConnorTP,EstyKJ,HanscomJL,ShieldsP,PhilippMT.Dogsvaccinated with common Lyme disease vaccines do not respond to IR6, the conserved immunodominant region of the VlsE surface protein of Borrelia burgdorferi. Clin Diagn Lab Immunol. 2004;11(3):458–462.
2.BeallMJ,ChandrashekarR,EbertsMD,etal.Serologicalandmolecularprevalence of Borrelia burgdorferi, Anaplasma phagocytophilum, and Ehrlichia species in dogs from Minnesota. Vector-Borne Zoonotic Dis. 2008;8(4):455–464.
3.StraubingerRK.PCR-basedquantificationofBorreliaburgdorferiorganismsincaninetissuesovera500-daypostinfectionperiod.JClinMicrobiol. 2000;38(6):2191–2199.
Protocol ImplementationVeCTor-borNe DiSeASe SCreeNiNg
STEPs—Simple Tools for Effective Protocols
page 3
Monitor
Prevent
Treat
Diagnose*
What to do next?
?
1
2
3
4
Canine granulocytic anaplasmosis is caused by the bacterium Anaplasma phagocytophilum and is transmitted by the deer tick or black-legged tick. A. phagocytophilum is an obligate intracellular pathogen of neutrophils. Many mammalian species, including humans, are susceptible to infection.
Did you know?
Coinfection of Anaplasma species with other vector-transmitted pathogens may lead to more complex disease presentations and a slower response to therapy
Anaplasma platys is the cause of infectious cyclic thrombocytopenia in dogs, and antibodies to this pathogen cross-react with the A. phagocytophilum spot on the SNAP 4Dx Test
A. platys infects canine platelets and is frequently seen as a coinfection with Ehrlichia canis
Medical background
Primary vectorIxodes spp. (deer tick or black-legged tick)
Transmission<24 hours of tick attachment
PathogenAnaplasma phagocytophilum infects canine neutrophils
Clinical presentationCan present acutely:• Fever,anorexia, lethargy• Jointpainandswelling• Lameness• Neurologicsigns
Laboratory abnormalities• Thrombocytopenia• Lymphopenia• Increasedliverenzymes
Note Not known to be chronic, but experimental studies have shown persistent infection.4
Suggested Canine Anaplasmosis Screening Guidelines
Reviewbenefits of tick prevention
Checkforhematologicabnormalities(CBCand/orbloodfilm)
Positive result The dog has been exposed and may be infected
Negative result Exposure is unlikely
What to do with your result
Discuss disease prevention strategies
Evaluate platelet count in 1 week; if no improvement, pursue
other diagnoses
Recheck CBC at wellness exams
Not generally recommendedDoxycycline/tetracycline
Clinical signs and/orlaboratoryfindingsDO NOT support
anaplasmosis
Clinical signs and/orlaboratoryfindings
DO support anaplasmosis
* Additional diagnostics may include PCR or Anaplasma IFAtiter.SeetheDiagnosticsfor Sick Patients section of this guide for more information on serological and PCR testing.
4. Egenvall A, Lilliehöök I, Bjöersdorff A, Engvall EO, Karlstam E,ArturssonK,HeldtanderM,GunnarssonA.Detectionofgranulocytic Ehrlichia species DNA by PCR in persistently infected dogs. Vet Rec. 2000;146(7):186–190.
Protocol ImplementationVeCTor-borNe DiSeASe SCreeNiNg
STEPs—Simple Tools for Effective Protocols
page 4
Monitor
Prevent
Treat
Diagnose*
What to do next?
?
1
2
3
4
Medical background
Primary vectorRhipicephalus sanguineus (brown dog tick)
TransmissionTime needed for transmission is unknown
PathogenEhrlichia canis infects canine monocytes
Clinical presentationCan present acutely:• Fever• Anorexia• Lethargy• Uveitis• Lymphadenomegaly• Bleedingdisorders• CNSsigns
Hasachronicnature:• Weightloss• Bleedingdisorders• Polyarthritis• Seizures• Multisystemicsigns
Laboratory abnormalities• Anemia• Thrombocytopenia• Hyperglobulinemia• Hypoalbuminemia• Pancytopenia• Proteinuria
Suggested Canine Ehrlichiosis Screening Guidelines
Reviewbenefits of tick prevention
Check for hematologic abnormalities (CBC and/or bloodfilm)andchangesinserumproteins
Positive result The dog has been exposed and may be infected
Negative result Exposure is unlikely
What to do with your result
Canine ehrlichiosis is caused by the bacterium Ehrlichia canis and is transmitted by the brown dog tick. The infection may progress to a subclinical phase, which can last days, months or years. Chronic infections, if left untreated, can lead to bone marrow dysfunction or renal disease.
Did you know?
Dogs coinfected with E. canis and A. platys were found to have more severe anemia and thrombocytopenia than dogs with either single infection.5
E. canis, and likely A. platys, are transmitted by the same vector, the brown dog tick.
In a study of healthy dogs with antibodies to E. canis, 39% were thrombocytopenic.6
Recheck CBC at wellness exams
Not generally recommendedDoxycycline/tetracycline
Clinical signs and/or laboratoryfindingsDO NOT support
ehrlichiosis
Clinical signs and/orlaboratoryfindings
DO support ehrlichiosis
Discuss disease prevention strategies
* Additional diagnostics may include PCR or EhrlichiaIFAtiter. See the Diagnostics for Sick Patients section of this guide for more information on serological and PCR testing.
Evaluate platelet count in 1 week; if no improvement, pursue
other diagnoses
5.GauntSD,RamaswamyC,BeallM,CaterinaK,BreitschwerdtE.PotentiationofthrombocytopeniaandanemiaindogsexperimentallycoinfectedwithAnaplasmaplatysandEhrlichiacanis.JVIM.2007;21(3):576.
6.HegartyBC,DinizPPVP,BradleyJM,LorentzenL,BreitschwerdtEB.Clinicalrelevanceofannualscreeningusingacommercialenzyme-linkedimmunosorbentassay(SNAP3Dx)forcanineehrlichiosis.JAAHA.2009;45(3):118–124.
Protocol ImplementationVeCTor-borNe DiSeASe SCreeNiNg
STEPs—Simple Tools for Effective Protocols
page 5
Treatment/Follow-upDependent upon supplementary test results
Treatment/Follow-up•TreataccordingtotheAmerican
HeartwormSocietyguidelines•Retest6–12monthsassessingfor:
- Conversion to Ag negative status - Improvement of cardiopulmonary
disease
Follow-upRefer to the American HeartwormSociety(AHS)/CompanionAnimal Parasite Council (CAPC) guidelines on chemoprophylaxis
* Less than 1% of infections willhavemicrofilariaebutnotbe antigenemic (American HeartwormSociety)
•ModifiedKnott’stesting formicrofilariae*
•Radiographs•CBC,chemistryand/or
other appropriate tests•Considerother
differential diagnosesIfnodefinitivediagnosis,repeat in 1–3 months
No action required
HWAgNegATiVe
•Confirmwithretest•Radiographs(assess
cardiopulmonary disease)•CBC,chemistryand/orother
appropriate tests
HWAgPoSiTiVe HWAgNegATiVe
No clinical signs Clinical signs
Canine heartworm testing
Medical background
Primary vector Mosquitoes
TransmissionPrepatent period approximately 6 months
PathogenDirofilaria immitis
Clinical presentationAsymptomaticatfirst,laterdeveloping:• Mild,persistentcough• Lethargy• Exerciseintolerance• Reducedappetite• Weightloss
Suggested Heartworm Screening Guidelines
What to do with your result
Dirofilaria immitis, the causative agent of heartworm disease, is transmitted by infected mosquitoes when D. immitis larvae are transferred to a healthy dog. Heartwormhasnoobviousclinicalsignsintheearlystages,makingpreventativemeasures so much more important—especially as advanced infection may result in death.
Did you know?
Despite availability of monthly preventatives, prevalence rates of canine heartworm has remained consistent nationwide.7
Theearliestheartwormantigenandmicrofilariaecanbedetectedpostinfectionis 5 months and 6.5 months, respectively.
Formoreinformationandcurrentrecommendationsontreatingcanine heartworm disease, go to heartwormsociety.org or capcvet.org.
©2011IDEXXLaboratories,Inc.Allrightsreserved.•09-71486-00•All®/TMmarksareownedbyIDEXXLaboratories,Inc.oritsaffiliatesintheUnitedStatesand/or other countries. The IDEXX Privacy Policy is available at idexx.com.
7.VerdonDR.Heartworminfectioncontinuesitsclimb,surveyreports.DVMNewsmagazine.February1,2006.
Protocol ImplementationVeCTor-borNe DiSeASe SCreeNiNg