1. Spirochetes : Leptospira & Borrelia 2011274009 이인혜 PPT 제작, 자료조사 2011774030 김정근 QUIZ, 자료조사 2011274033 양가인 발표, 자 료조사 2011274055 이지원 PPT 제작, 자료조사

2. Classification Leptospira Borrlelia Spirochetes QUIZ

3. Spirochatales LeptospiraceaeLeptospira L.interrogansL.biflexa Spirochataeceae Treponema Borrelia B.hermsiiB.burgdorferiB.recurrentis

4.  나선균  Outer sheat  Axial filament

6. - Tight & Regular coil - bend or hook at one or both ends - Gram negative - Motility - Aerobic - Cannot dye with Anilin dyes - leptospirosis

7. Leptospira interrogans – cause leptospirosis in humans, animals – 200 serotypes – catalase (+) Leptospira biflexa – harmless – free-living saprobe

8. Zoonosis – Wild animals (rodents, skunks, raccouns, foxes) – Domestic animals ( horses, dogs, cattle, pigs) Shed in the urine of an infected animal

9. Contact of skin abrasions or mucus membrane Outdoor activity → high risk for infection (occupational disease) Mostly in the tropics Not usually transmitted from person to person

11. Principal targets

12. Leptospiremic phase : in the blood, cerebrospinal fluid : sudden high fever, chills, headache, vomiting, conjunctivitis, muscle ache Immune phase : Disappear the Blood infection → phagocyte, IgM

13. Weil’s syndrome - kidney invasion, hepatic disease, jaundice, anemia, neurological disturbances ⇒ death in elderly patients

14. a. History of environmental exposure, symtoms b. Dark-field microscopy c. Serological test d. MAT test

15. a. History of environmental exposure, symtoms → initial diagnosis b. Dark-field microscopy

16. c. Serological test : Leptospira infection → strong humoral response → patient’s serum for its antibody titer

17. d. Macroscopic slide agglutination test (MAT test) – serological test : live L.interrogans + patient’s serum → aggulatination with a dark-field microscope

18. Treatment - Penicillin G, tetracycline Prevent - doxycycline 200mg 1 회 /1 주 - No vaccine - wear protective foot wear and clothing - aviod swimming or wading in water

19. Two species : L. interrogans, L. biflexa Leptospirosis : zoonosis, contact with urine Two phase :Leptospiremic phase & immune phase Weil’s syndrome Dark field microscopy, MAT, Serologycal test

21.  comparatively lager  3 to 10 irregularly spaced and loose coil  Gram negative  Microaerophilic  Borreliosis : zoonotic disease  Arthropod vector : ticks or lice

22.  Reservoirs : squirrels, chipmunks, wild rodents, human-accidental host  Mature and persist in the salivary glands & intestines of the tick → bite and scratching → initiate infection

23.  Tick-borne relapsing fever (TBRF) : - in campers, backpackers - Borrelia hermsii - by soft tick  Louse-borne relapsing fever (LBRF) : - famine, war, natural disaster, poor hygiene - Borrelia recurrentis

24.  Symtoms - high fever, headache, fatigue, nausea, vomiting, muscle aches → disappear - if not treated → cycle may continue, damage to the liver, spleen, heart, kidneys, cranial nerves - Half of the patients hemorrhage into organs - some develop a rash on sholder and leg

25. Fluctuating course - Borrelia change surface Ag during growth → strategy for evading the immune system and avoiding destruction

26.  Diagnosis - A patient’s history,clinical symptoms - Borrelia in blood smears  Treatment - Tetracycline : except for pregnant and children under 7 years old - erythromycin, doxycyline and Chloramphenicol - easily treated with a 1~2 week course of antibiotics

27.  Borrelia burgdorferi  Reservoir : Hard tick, mouse, deer, bird  Most prominent borreliosis in the USA  High-risk groups : hikers, gardeners, campers

30. headache, stiff neck, fever, myalgia Neurologi cal symptoms, cardiac dysrhyth mias erythema migrans crippling polyarthr itis Erythema migrans → (EM; bull’s eye rash)

31. - ring-shaped lesions (EM) - isolation of spirochetes - serological test - Western blot - ELISA test

32.  Treatment : doxycycline, tetracycline, amoxicillin, ceftriaxone, penicillin  Prevention : protective clothing, boots, leggings, insect repellent(containing DEET)

33. CharacteristicTick-Borne RFLouse-Borne RFLyme Disease AgentSeveral speciesBorrelia Borrelia burgdorferi Vector Soft ticks (Ornithodoros spp.) Human body louse Hard ticks (Ixodes spp.) ReservoirRodentsHumansRodents EpidemiologyEndemicEpidemicEndemic DistributionTropical and temp.East Africa Temperate North America and Eurasia Serologic assay specificity Fair-poor Good-excellent ArthritisNo Common Antibiotic therapy Several dosesFew dosesSeveral doses

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