Disease | Causative Organism | Animals Involved | Known Distribution | Probable Means of Spread to People | Clinical Manifestations in People |
---|---|---|---|---|---|
Bacterial Diseases | |||||
Actinomycosis ( see Actinomycosis Actinomycosis ) | Actinomyces bovis and other species in animals may affect people, but most human infections are caused by commensals of people, especially Actinomyces israelii | Mammals | Worldwide; very rare in people | Probably contact; actinomycosis usually disseminates from endogenous human flora | Granulomas, abscesses, skin lesions; chronic bronchopneumonia; abdominal mass that may mimic a tumor; endocarditis; sepsis |
Bacillus anthracis | Mainly in cattle, sheep, goats, horses, wild herbivorous animals; virtually all mammals and some birds are susceptible to high dose | 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/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%–20% (cutaneous) to 100% (inhalation) | |
Arcobacter infections | Arcobacter butzleri, A cryaerophilus, A skirrowii, possibly others | Poultry, cattle, pigs, sheep, horses, shellfish; some studies detected these organisms in dogs and/or 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 Kennel Cough Kennel cough results from inflammation of the trachea. It is a mild, self-limiting disease but may progress to bronchopneumonia in puppies or to chronic bronchitis in debilitated adult or aged... read more ) | Bordetella bronchiseptica | Dogs, rabbits, cats, pigs, guinea pigs, other mammals | Worldwide; uncommon in people | Exposure to saliva or sputum, aerosols | Sinusitis, bronchitis, pertussis-like illness; pneumonia and disseminated disease (eg, endocarditis, peritonitis, meningitis), usually in immunocompromised; wound infection |
Borreliosis ( see Lyme Borreliosis Lyme Borreliosis ) | |||||
—Lyme disease | Borrelia burgdorferi sensu lato complex (B burgdorferi sensu stricto, B garinii, B afzelii, B spielmanii, B japonica) | Wild rodents, insectivores, hedgehogs, hares, other mammals; birds are reservoirs for agent; deer are hosts for tick vector only (blood meals) | 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 | Ixodes spp bites | Nonspecific febrile illness early; target skin lesions in many; may progress 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; recurring episodes, often milder, after a symptom-free period; death in 2%–5% |
—Southern tick-associated rash illness | Etiology uncertain; various Borrelia spp suggested | USA; most cases in southeast | Tick bite (Amblyomma americanum) | Resembles Lyme disease | |
Brucellosis ( see Brucellosis in Large Animals Brucellosis in Large Animals and see Brucellosis in Dogs Brucellosis in Dogs ) | Brucella abortus | Cattle, bison, water buffalo, African buffalo, elk, deer, sheep, goats, camels, South American camelids; other mammalian spillover hosts | Once worldwide, now eradicated from domestic animals in some countries or regions; reservoirs in wildlife in some disease-free areas | Ingestion (especially unpasteurized dairy products or undercooked meat), contact with mucous membranes and broken skin; strain 19 vaccine | Extremely variable, subacute and undulant to sepsis; often nonspecific febrile illness with drenching sweats early; arthritis, spondylitis, epididymo-orchitis, endocarditis, neurologic, other syndromes if chronic; case fatality 5% in untreated |
B melitensis | Goats, sheep, camels; other mammalian spillover hosts | Asia, Africa, Middle East, Mexico, Central and South America, some parts of Europe | Ingestion (including unpasteurized dairy products or undercooked meat), contact with mucous membranes and broken skin; Rev 1 vaccine | As above; this species highly pathogenic for people | |
B suis biovars 1–4; biovar 5 has not been reported in people | Swine and wild pigs (biovars 1, 2, 3), European hares (biovar 2), 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 | Ingestion, direct contact with mucous membranes and broken skin | As above | |
B canis | Dogs; evidence of infection in wild canids including coyotes, foxes | Worldwide; rare in people | Probably via ingestion or contact with mucous membranes, broken skin; close contact, especially with animals that recently aborted or gave birth | Probably as above | |
B pinnipedialis and B ceti | Marine mammals | Atlantic, Arctic, and Pacific oceans; Mediterranean sea | Laboratory exposure; sources of other infections unknown (possibly contact with animals or exposure to seawater); rare or underdiagnosed in people | Few cases known: mild to severe febrile illness, similar to that caused by other Brucella spp; neurobrucellosis with headache and chronic neurologic signs; spinal osteomyelitis | |
Campylobacter enteritis ( see Enteric Campylobacteriosis Enteric Campylobacteriosis ) | 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) | Gastroenteritis from mild cases to fulminating or relapsing colitis; occasional sequelae such as reactive arthritis; occasionally, other syndromes, including sepsis |
Campylobacter fetus infection | C fetus subsp fetus (most cases), C fetus subsp testudinum (proposed name); possibly C fetus subsp venerealis | C fetus subsp fetus and C subsp venerealis in cattle, sheep, goats; C fetus subsp testudinum 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 | 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 |
Chlamydiosis (see also Psittacosis below) | Chlamydia ( Chlamydophila) abortus, C felis | C abortus in sheep, goats, cattle, other mammals; C felis in cats | C felis worldwide; C abortus in most sheep-raising areas but not Australia or New Zealand | Contact with animals; C abortus probably contact with pregnant or aborting ruminants | C abortus: abortions, septicemia; C felis suspected agent of keratoconjunctivitis, also implicated in other conditions (controversial) |
Clostridial diseases ( see Clostridial Diseases Clostridial Diseases ) | Clostridium difficile; some ribotypes found in animals have been implicated as potential zoonoses | Ribotypes from some calves, pigs, dogs are identical to some ribotypes found in people | Worldwide | Possible zoonosis; from contact or ingestion in contaminated meat; also from environment and contact with infected people | Gastroenteritis, varying in severity from diarrhea to fulminant colitis, usually in conjunction with antibiotic use |
Clostridium perfringens, type A (most common), C, or D; environmental or endogenous source, with some potential for zoonotic transmission | Domestic and wild animals, people | 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 antibiotics; life-threatening necrotic enteritis, often in debilitated; gas gangrene, sepsis; necrotic enteritis, gas gangrene, sepsis are fatal if not treated | |
Corynebacterium ulcerans and C pseudotuberculosis infections | C ulcerans, C pseudotuberculosis | 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 | Probably worldwide; uncommon in people 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 possible; peritonitis; isolated skin infection; some cases serious or fatal |
Dermatophilosis ( see Dermatophilosis Dermatophilosis ) | Dermatophilus congolensis | Cattle, horses, deer, sheep, goats, other mammals | Worldwide, especially in warmer regions | Usually direct contact with lesions; mechanical transmission on arthropod vectors, fomites possible | Pustular desquamative dermatitis, other skin lesions |
Enterohemorrhagic Escherichia coli infectionsb | E coli O157:H7; also implicated are types O157:H, and members of serogroups O26, O103, O104, O111, O145, and others | Especially cattle, sheep; also goats, bison, deer, pigs, other species of mammals, birds | Worldwide | Ingestion of undercooked meat (especially ground beef), vegetables or water contaminated with feces; direct contact with feces or contaminated soil | Diarrhea or hemorrhagic colitis; up to 15% of patients with hemorrhagic colitis progress to hemolytic uremic syndrome (HUS); case fatality rate for HUS is 3%–5%, higher in some populations (eg, 5%–10% in children, up to 50% in elderly) |
Erysipeloid ( see Erysipelothrix rhusiopathiae Infection Erysipelothrix rhusiopathiae Infection ) | 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); 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; felids, many other domesticated and wild mammals also susceptible | 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 | |
Helicobacter infection | H pullorum, 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; bacteremia in immunosuppressed patients | |
Mycobacterium leprae | Armadillos; nonhuman primates (rare) | Armadillos in parts of southern USA, Mexico, South America; nonhuman primates in Africa, possibly other locations; only human reservoirs in other areas | Transmission of animal leprosy to people likely | Various skin lesions, sensory nerve lesions and deficits, nasal mucosal lesions; mild, self-limiting to progressive destruction | |
Leptospirosis ( see Leptospirosis Leptospirosis ) | 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) |
Listeriosis ( see Listeriosis Listeriosis ) | Listeria monocytogenes (types most often associated with disease are ½a, ½b, 4b), Listeria ivanovii (rare) | Numerous mammals, birds, fish, crustaceans | Worldwide | Foodborne, especially unpasteurized dairy products, raw meat and fish, vegetables, processed foods contaminated after processing; ingestion of contaminated water, soil; direct contact with infected animals; nosocomial in hospitals, institutions | 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; papular or pustular rash ± fever, chills in healthy adults after handling infected fetuses |
Melioidosis (Pseudoglanders, see Melioidosis Melioidosis ) | Burkholderia pseudomallei (other species of soil-associated Burkholderia, such as B oklahomensis sp nov in North America, rarely linked to human infections) | Sheep, goats, swine; occasional cases in many other terrestrial and aquatic mammals; also reptiles, some birds including parrots, tropical fish | Asia, Africa, Australia, South America, Middle East, Caribbean | Wound infection, inhalation, and ingestion; organisms live in soil and surface water; most cases are acquired from environment, but 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 gene; some strains maintained in animals (eg, livestock-associated CC398), other strains mainly in people but animals can become carriers | Pigs (major reservoirs for livestock-associated strain CC398, also carry ST9); cats, dogs mainly acquire strains from people; 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 asymptomatic 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 antibiotic |
Mycobacteriosis ( see Tuberculosis and other Mycobacterial Infections Tuberculosis and other Mycobacterial Infections ) | Mycobacterium avium complex | Many species of mammals, some birds | Worldwide | Environmental, mainly from water, and/or soil; infection common to people 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 |
M avium paratuberculosis | Cattle, sheep, goats, camelids, deer, other ruminants; rabbits and other nonruminants; corvids | Worldwide | Ingestion; accidental injection of vaccine | Postulated involvement in Crohn’s disease after ingestion (controversial); severe local reaction if vaccine accidentally injected | |
Mycobacteria other than tuberculosis (includes M simiae, M kansasii, M xenopi, M scrofulaceum, M szulgai, M chelonae, M marinum, M ulcerans, others) | Cattle, other ruminants; swine, cats, dogs, koalas, other mammals, amphibians, reptiles (uncommon), fish; predominant Mycobacterium spp vary with host | Worldwide; distribution varies with the organism | Environmental, from water and/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) | |
Mycoplasma infections | Mycoplasma spp | Livestock, nonhuman primates, marine mammals, cats, dogs, rodents, other mammals | Worldwide; zoonotic infections rare | Direct contact; bites; wound contamination, including accidental inoculation | Asymptomatic carriage; cellulitis; other syndromes, including respiratory disease, septic arthritis, septicemia have been reported, especially in immunocompromised |
Pasteurellosis ( see Pasteurellosis of Sheep and Goats Pasteurellosis of Sheep and Goats and see Pasteurellosis Pasteurellosis Pasteurellosis is common in domestic rabbits. The etiologic agent is Pasteurella multocida, a gram-negative, nonmotile coccobacillus. Rabbits will usually become infected with P multocida... read more | Pasteurella multocida and other species | Many species of domestic and wild animals, including dogs, cats, livestock, rabbits, birds | Worldwide | Wounds, scratches, bites, close contact with mucus membranes | Wound infections, cellulitis most common; other syndromes possible, including osteomyelitis, septic arthritis, sepsis, meningitis, respiratory disease; systemic conditions more common in immunocompromised |
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 or scratches, eating uncooked infected tissues | Febrile flu-like syndrome with swollen, very painful draining lymph node(s) (buboes); pneumonia; 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 | |
Psittacosis and ornithosis ( see Avian Chlamydiosis Avian Chlamydiosis ) | Chlamydia (Chlamydophila) psittaci | Psittacine birds (especially parakeets, cockatiels), pigeons, turkeys, ducks, geese, and other domestic or wild birds; mammalian strains of C psittaci also exist (zoonotic potential still undetermined) | Worldwide | Inhalation of respiratory secretions or dried guano | Influenza-like febrile illness with nonproductive cough that may progress to pneumonia; complications, including endocarditis, myocarditis, meningoencephalitis, hepatitis, glomerulonephritis, and other organ dysfunction; sepsis; some cases fatal if untreated, < 1% with treatment |
Rat bite fever | Streptobacillus moniliformis | Rodents; 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 | Fever, severe myalgia and joint pain, headache, rash, sometimes GI signs; complications, including polyarthritis (usually but not always sterile), hepatitis, endocarditis, focal abscesses, sepsis possible if untreated; overall case fatality rate 10%–13% if untreated |
Spirillum minus | Rodents; might also be transmitted by carnivores, which are probably infected or transiently colonized from rodents | Organism is common only in Asia | Mainly bites and scratches | As above, but indurated, often ulcerated lesion at inoculation site; can relapse; some (minority) may have distinctive rash (large violaceous or reddish macules); polyarthritis is rare; overall case fatality rate 7%–10% if untreated | |
Salmonellosis ( see Salmonellosis Salmonellosis ) | 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 | 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, possibly others | S suis in swine; S equi zooepidemicus in horses; S canis in dogs, cats; S iniae in fish; each species can also be found in other animals | Worldwide | Ingestion, especially of unpasteurized dairy products, pork; direct contact often through broken skin; the human pathogen S pyogenes can also colonize bovine udder and be transmitted in milk | Skin and soft-tissue infections; pharyngitis; other conditions, including pneumonia, meningitis, arthritis, endocarditis, streptococcal toxic shock syndrome, sepsis |
Tuberculosis (see also mycobacteriosis, above, see Tuberculosis and other Mycobacterial Infections Tuberculosis and other Mycobacterial Infections , and see Tuberculosis Tuberculosis ) | Mycobacterium bovis | Cattle, bison, African buffalo, cervids, brushtail opossums, badgers, kudu can be reservoirs; swine and many other mammals can be spillover hosts | Once worldwide, now eradicated or rare in some countries | Ingestion (unpasteurized dairy products, undercooked meat including bushmeat), inhalation, contamination of breaks in the skin | Skin lesions, cervical lymphadenitis (scrofula), pulmonary disease; genitourinary disease; can affect bones and joints, meninges; gastroenteritis |
Mycobacterium caprae | Mainly goats, also infects other ruminants; can occur in other mammals, including pigs, horses, cervids, camels, carnivores | Reported mainly in Europe | Thought to be ingestion or direct contact with livestock, similarly to M bovis | Extrapulmonary conditions, including skin lesions, meningitis, lymphadenitis, pericarditis, urinary, dissemination; also pulmonary disease | |
Mycobacterium microti | Rodents thought to be reservoir; can occur in domestic animals, including cats, dogs, ferrets, livestock | Appears to be rare human zoonosis | Most reported cases have been pulmonary; can also cause extrapulmonary disease | ||
Francisella tularensis subsp tularensis more virulent, F tularensis subsp holarctica (F tularensis type B) less virulent, F tularensis subsp mediasiatica, F tularensis subsp novicida | Rabbits, rodents, cats, sheep, other mammals, birds, reptiles, fish; often in wild animals | F tularensis subsp tularensis almost exclusively in North America; F tularensis subsp holarctica in North America, Europe, Asia; F tularensis subsp mediasiatica in Central Asia; F tularensis subsp novicida reported in North America, Australia, Spain | 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) | |
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 (continued) | V cholerae O1/O139 (epidemic strains) | Oysters, crabs, shrimp, mussels; most cases acquired from people | Rare/absent to epidemic in different regions; one focus along USA Gulf Coast in shellfish | Ingestion | Mild to severe, voluminous diarrhea, vomiting, dehydration; severe cases fatal if untreated, but low mortality if treated |
V cholerae non-O1/O139 (nonepidemic strains) | Oysters, other seafood; 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 swine, dogs, cats, rodents, wild mammals, birds | Agent probably worldwide; prevalence may vary between regions | Ingestion of contaminated water, food (including meat [especially pork], 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 |
Y enterocolitica; not all serotypes are pathogenic | Many domestic and wild mammals, including rodents; some birds, reptiles, amphibians; zoonotic serotypes most common in pigs (major zoonotic source), pathogenic types also occur in dogs, cats | Worldwide; prevalence of human disease may vary between regions (commonly reported in Europe) | Ingestion | Gastroenteritis with watery diarrhea especially in young children, bloody feces uncommon; pseudoappendicitis; sequelae may include erythema nodosum, reactive arthritis; sepsis, other syndromes | |
Rickettsial Diseases | |||||
Human ewingii ehrlichiosis (formerly granulocytic ehrlichiosis) | Ehrlichia ewingii | Dogs, deer proposed | Southeastern and south central USA; has been detected in South America | Ticks, including Amblyomma americanum | Few cases described; fever, headache, malaise, myalgia, nausea, vomiting; many patients were immunosuppressed |
Human monocytic ehrlichiosis ( see Ehrlichiosis, Anaplasmosis, and Related Infections in Animals Ehrlichiosis, Anaplasmosis, and Related Infections in Animals Ehrlichiosis is a tick-transmitted disease that infects blood cells and can cause a variety of signs from none to fever and generalized achiness to possible fatality. Several species of bacteria... read more ) | Ehrlichia chaffeensis | Deer are probably major reservoir in North America, dogs and other canids, lemurs, other mammals can also be infected | North America; also reported in South America, Asia, and Africa | 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 2%–3% |
Human granulocytic anaplasmosis (formerly human granulocytic ehrlichiosis) | Anaplasma phagocytophilum (formerly Ehrlichia phagocytophilum and E equi) | Wild rodents, deer may be reservoirs in North America; livestock, wild ungulates, wild rodents may be reservoirs in Europe; many other animals (eg, equids, ruminants, dogs, cats, birds) can also be infected | Worldwide | Tick bites (Ixodes spp) | Resembles human monocytic ehrlichiosis; often asymptomatic to mild in immunocompetent; rash uncommon; estimated case fatality rate < 1% |
Infection by other Ehrlichia species | E canis, E muris–like organism implicated rarely in human illness | Dogs and other canids thought to be reservoirs for E canis, might also occur in felids; rodents may be reservoirs for E muris | E canis worldwide; E muris Eastern Europe to Asia; E muris–like organism in North America | Ticks (E canis transmitted by Rhipicephalus sanguineus, E muris by Haemaphysalis flava and Ixodes persulcatus complex) | Rare cases of febrile illness, in both healthy and immunosuppressed |
Q fever (Query fever, see Coxiellosis Coxiellosis ) | Coxiella burnetii | Sheep, cattle, goats, cats, dogs, rodents, other mammals, birds, ticks | Worldwide | Mainly airborne; exposure to placenta, birth tissues, animal excreta; occasionally ingestion (including unpasteurized milk); tickborne infections probably rare or nonexistent in people | Febrile influenza-like illness; atypical pneumonia, hepatitis, endocarditis in some; 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 | Thought to be ingestion of raw fish | Relatively mild, nonspecific, febrile illness, resembles infectious mononucleosis |
Spotted fever group of Rickettsia | |||||
—African tick bite fever | R africae | Ungulates | Sub-Saharan Africa, eastern Caribbean | Bite of infected tick (mainly Amblyomma hebraeum, A variegatum, also A lepidum, possibly Rhipicephalus decoloratus,Rhipicephalus appendiculatus) | Nonspecific febrile illness; painful regional lymphadenopathy in many; eschars often multiple; nuchal myalgia; sometimes sparse maculopapular and/or vesicular rash; deaths do not seem to occur |
—Mediterranean spotted fever; Boutonneuse fever; Tick bite fever; | R conorii subsp conorii | Dogs, rabbits implicated as reservoirs; other animals can be infected | Europe, especially Mediterranean; cases reported in sub-Saharan Africa | Bite of infected ticks (mainly Rhipicephalus sanguineus, also others), crushing tick | Nonspecific febrile illness; eschar (typically single) may or may not be present; rash, often maculopapular, in most; life-threatening disseminated disease or neurologic signs possible but uncommon; case fatality rate 1%–3% if untreated |
—Israeli spotted fever, Astrakhan spotted fever, Indian tick typhus | R conorii subsp israelensis (Israeli spotted fever), R conorii subsp caspia (Astrakhan spotted fever), R conorii subsp indica (Indian tick typhus) | Reservoir hosts uncertain | Israeli spotted fever in Middle East, reported in Europe; Astrakhan spotted fever in Russia, Kazakhstan; Indian tick typhus in Asia (Indian subcontinent) | Bite of infected ticks (mainly Rhipicephalus spp), crushing tick | Astrakhan spotted fever and Indian tick typhus resemble Mediterranean spotted fever, but Israeli spotted fever may be more severe |
—Fleaborne spotted fever; Cat flea typhus | R felis (synonym ELB agent) | Unknown; dogs have been suggested as possible amplifying hosts | North and South America, Europe, Asia, Africa, probably worldwide | Flea bites; mainly associated with Ctenocephalides felis (cat flea), also infects C canis and other fleas | Few clinical cases have been described but resembles other spotted fevers; febrile illness; rash in most; eschar may be uncommon; most cases seem to be mild but CNS involvement, pneumonia 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 disseminated disease, complications, death possible |
—Rickettsial pox | R akari | Mice; also rats, Korean voles | Organism may be cosmopolitan; human cases seem to be uncommon | 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 America, detected in parts of South America | Bite of infected ticks, Amblyomma maculatum; also found in other Amblyomma spp | Resembles Rocky Mountain spotted fever (RMSF) but seems to be milder in most cases; differs from RMSF in that eschars occur in most cases (may be multiple), petechial rash does not seem to be characteristic | |
—Rocky Mountain spotted fever ( see Rocky Mountain Spotted Fever in Dogs Rocky Mountain Spotted Fever in Dogs Spotted fevers are diseases caused by a set of related bacteria in the Rickettsia genus, of which Rocky Mountain spotted fever is the most severe. After transmission of the pathogen through... read more ) | R rickettsii | Rodents, rabbits, opossums, and other small mammals might amplify; dogs can be infected | Western hemisphere | Bite of infected ticks, especially Dermacentor variabilis, D andersoni (D variabilis in USA); Amblyomma cajennense, A aureolatum in South America; Rhipicephalus sanguineus in Arizona, Mexico, and South America; also 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 (up to 85%) if untreated, ~3% or less with treatment in North America but higher in parts of 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; R slovaca especially in Dermacentor marginatus, D reticulatus; R raoultii in Rhipicephalus pumilio, D nuttalli, other Dermacentor spp | 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 monacensi, R amblyommii, others | Various vertebrates | Worldwide; distribution varies by species | Bites of ixodid ticks; specific vector varies by species | Inoculation site eschar (most); febrile illness with headache, myalgia, sometimes other signs; rash; local lymphadenopathy (some species); major signs, risk of complications, severity vary with species of Rickettsia |
Typhus group of Rickettsia | |||||
—Murine typhus; Fleaborne typhus | R typhi (formerly R mooseri) | Rats are major reservoir; cats, opossums, possibly dogs, other species 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 signs, including arthralgia, cough, nausea/vomiting in some; mortality rate 4% 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 in “typhus islands” | Bite of infected larval trombiculid mites (chiggers) | Eschar in some; rash, headache, fever, painful lymphadenopathy, body aches, interstitial pneumonitis, GI signs; pneumonia, neurologic signs or cardiac complications in some; mild to severe; convalescence prolonged; case fatality rate up to 30%–50% if untreated |
—Typhus | R prowazekii | Flying squirrels | Eastern USA | Squirrel lice or fleas suspected | Nonspecific febrile illness, rash; GI signs in some; sepsis possible; appears to be somewhat milder than non-zoonotic typhus, which has a mortality rate of 20%–60% if untreated |
Fungal Diseases | |||||
Aspergillosis; Allergic bronchopulmonary aspergillosis ( see Aspergillosis Aspergillosis ) | Aspergillus spp | Birds and mammals | Worldwide | Environmental exposure (decaying vegetation or grains); infection common to people and animals, insignificant as zoonosis | Allergic respiratory signs, especially in people with certain respiratory conditions or immunodeficiencies; allergic sinusitis; pneumonia sometimes with dissemination in immunocompromised (can be fatal); chronic pulmonary disease ± aspergilloma (fungus ball); localized infections of other organs, tissues |
Blastomyces dermatitidis | Dogs, cats, horses, marine mammals, other mammals | Distribution in environment uncertain; clinical cases focal; locally acquired cases reported in parts of North America, Africa, Middle East, India | Environmental exposure, organism is most common in moist soil; infection common in people and animals; also reported rarely by animal exposure | Acute to chronic pulmonary disease; skin or bone lesions; meningitis, other syndromes, disseminated disease possible; course mild to severe, some cases fatal | |
Coccidioides immitis, C posadasii | Cattle, sheep, horses, llamas, dogs, many other mammals | Especially southwestern USA, Mexico, Central and South America; in arid or semiarid foci; some cases might be acquired outside usual foci | Principally environmental exposure (inhalation of arthrospores), including fungal cultures; infection common in people and animals, one unusual case reported after necropsy of horse with disseminated disease | Self-limited, febrile, flu-like illness, sometimes with cough, chest pain in healthy host; serious, possibly life-threatening pulmonary disease or disseminated infection with cutaneous/subcutaneous lesions, persistent meningitis or osteomyelitis, especially in immunocompromised | |
Cryptococcus neoformans var grubii, C neoformans var neoformans, C gattii | Birds including pigeons, psittacines (mainly grows in guano; temporary colonization of intestinal tract also possible); clinical cases in cats, other mammals | Worldwide | Principally environmental exposure, especially pigeon nests for C neoformans, trees for C gattii; via inhalation or through the skin; infection common in people and animals, insignificant as zoonosis | Respiratory signs, mild to severe, often self-limiting in healthy host but more likely to be severe in immunocompromised; dissemination with CNS disease, ocular signs, other syndromes, most often in immunocompromised; skin lesions, either localized from inoculation (uncommon) or from disseminated disease | |
Histoplasma capsulatum var capsulatum | Dogs, cats, bats, cattle, sheep, horses, many other domestic and wild mammals, birds | Worldwide; clinical cases often cluster in regional foci | Principally environmental exposure, avian or bat feces encourage growth of organism; infection common in people and animals; insignificant as zoonosis | Flu-like, febrile illness, usually self-limiting in healthy hosts; skin lesions; chronic pulmonary disease, usually with preexisting lung disease; dissemination in very young, elderly, immunocompromised | |
H capsulatum var duboisii | As above | Africa | As above | Usually skin and subcutaneous lesions, osteolytic bone lesions but can disseminate | |
Malassezia infection | Malassezia spp | Dogs, cats, other animals | Worldwide | Exposure to symptomatic animals; normal levels on skin not thought to be a significant risk | Dermatitis; zoonotic strains might be implicated in fungemia in preterm neonates, other immunocompromised |
Ringworm (Dermatophytosis, see Dermatophytosis Dermatophytosis ) | Microsporum and Trichophyton spp | Dogs, cats, hedgehogs, cattle, sheep, goats, horses, rodents, other mammals, birds, very rarely reptiles | Worldwide | Direct skin/hair contact with infected animals, fomites | Skin and hair lesions, usually pruritic; rare skin dissemination in immunocompromised |
Sporothrix schenckii | Cats, other mammals, birds | Worldwide; epizootics in cats in South America | Primarily environmental in vegetation, wood, soil; inoculation from environment in penetrating wounds (splinters, bites, pecks), skin contact with lesions, especially in cats; bites, scratches, other close contact implicated during feline epidemics; inhalation rare | Papules, pustules, nodules, ulcerative skin lesions, may follow course of draining lymphatics; mucosa can be affected; extracutaneous involvement, especially bones, joints; disseminated disease (including meningitis) can be seen in immunocompromised; acute or chronic pulmonary disease resembling tuberculosis after inhalation, especially with underlying lung disease (rare) | |
Parasitic Diseases—Protozoans | |||||
Babesia microti complex, B duncani (formerly WA-1), and other species | Rodents, insectivores, lagomorphs, some other mammals; reservoirs uncertain for some species | Babesia spp worldwide in wild animals, many agents not identified to species; human illness due to B microti complex reported in North America (most), Europe, Asia, Australia | Bite of infected Ixodes ticks for B microti | Many immunocompetent patients may have mild to moderate flu-like, febrile illness; mild to severe hemolytic anemia, especially severe in immunocompromised and elderly; respiratory, hepatic, renal, and other organ dysfunction; recurrent or chronic infection may develop; dual infection with B burgdorferi may worsen both diseases; death possible in severe cases | |
B divergens | Cattle; B divergens or closely related organism in farmed reindeer, wild cervids | Europe, possibly North Africa; similar organisms might be present in North America; reported in Asia (China) | Tick bites (Ixodes ricinus) | Usually in splenectomized; acute, severe hemolysis; persistent high fever, headache, myalgia, abdominal pain, sometimes GI signs; shock and renal failure; cases progress rapidly; usually fatal if untreated; milder flu-like cases have been reported in immunocompetent patients | |
B bovis; uncertain zoonosis; some historical cases were probably B divergens | Cattle, water buffalo, African buffalo, possibly other species | Africa, Asia, Central and South America, Mexico, Australia, parts of Europe | Tick bites (Rhipicephalus microplus and R annulatus) | ||
Balantidiasis | Balantidium coli and related species | Swine, rats, nonhuman primates, other animals | Worldwide | Ingestion, especially of water contaminated with feces | Asymptomatic to mucoid, bloody feces; intestinal hemorrhage and perforation possible; rare extraintestinal cases |
Trypanosoma cruzi | Opossums, lagomorphs, rodents, armadillos, dogs, cats, other wild and domestic mammals | Western hemisphere—southern USA, Mexico, Central and South America | Fecal material of reduviid bug in family Triatomidae contaminates bite wounds, abrasions, or mucous membranes; ingestion in contaminated food | Acute disease—erratic fever, adenopathy, headache, myalgia, hepatosplenomegaly, swelling at inoculation site and eyelid; myocarditis or encephalitis in some; worse in immunocompromised Chronic form (in 10%–30% of patients)—cardiomyopathy, megaesophagus, megacolon, other forms; reported annual mortality rate in chronic form 0.2%–19% (higher rates from studies that include only cardiac patients) | |
Cryptosporidiosis ( see Cryptosporidiosis Cryptosporidiosis ) | Cryptosporidium parvum, C canis, C felis, C meleagridis, C cuniculus, C viatorum, C muris, and other species (C hominis and likely some genotypes of C parvum are adapted mainly to people) | Cattle and other ruminants, dogs, cats, rabbits, other domestic and wild mammals, birds, reptiles, fish | Worldwide | Fecal-oral; ingestion of contaminated food and water; inhalation | Self-limiting gastroenteritis in healthy; can be cholera-like and persistent in immunocompromised, with weight loss, wasting; cholecystitis; respiratory signs, pancreatitis, other syndromes mainly in immunosuppressed |
Giardiasis ( see Giardiasis (Giardia) Giardiasis (Giardia) ) | Giardia intestinalis, also known as G duodenalis (formerly G lamblia); only some genotypes seem to have zoonotic potential | Many domestic and wild mammals, including dogs, cats, ruminants, aquatic mammals such as beavers | Worldwide | Ingestion of water and less often food; direct fecal-oral (hands or fomites) | Gastroenteritis, may be persistent |
Leishmaniosis —Visceral (Kalaazar; see Leishmaniosis Leishmaniosis ) | Leishmania infantum | Wild canids and dogs are primary reservoirs, also in other mammals | Asia, South America, Caribbean, Africa, the Middle East, Europe (Mediterranean spreading north), North America | Bite of sand flies Phlebotomus and Lutzomyia spp | Undulating fever, hepatosplenomegaly; some have cough, diarrhea, lymphadenopathy, weight loss, petechiae or hemorrhages on mucous membranes, nodular lesions or darkening of skin; pancytopenia; mild cases with only a few signs may resolve on their own, but most other cases fatal if untreated |
—Cutaneous and mucocutaneous | L tropica complex (except L tropica, which is maintained in people), L braziliensis complex, L mexicana complex, others | Dogs (L peruviana), rodents, various wild mammals act as reservoir hosts; other mammals can be infected | Mediterranean, Asia, Africa, Middle East, Mexico to South America, Caribbean; localized focus in USA (Texas and Oklahoma) | As above | Papules to ulcers or nodules on skin ± mucous membranes; single or multiple lesions; localized or disseminated; may persist or recur; atypical forms in immunosuppressed; cutaneous form rarely fatal, mucocutaneous form can be disfiguring and may be fatal if pharynx affected |
Malaria of nonhuman primates | Nonhuman primate–associated Plasmodium spp, P knowlesi, rarely P cynomolgi, others also potential zoonoses | Old and New World monkeys, apes | P knowlesi in Asia; other species exist in Central and South America, Asia, Africa | Bite of anopheline mosquitoes | Febrile episodes with chills; headache, myalgia, malaise, cough, nausea, vomiting, and other symptoms in some; cases range from mild, self-limiting to fatal (3% case fatality rate for P knowlesi) |
Microsporidiosis | Microsporidia of Enterocytozoon bieneusi, Encephalitozoon cuniculi, E intestinalis, E hellem, others; both zoonotic and anthropnotic transmission reported for some agents | Widespread in vertebrates, including primates, rabbits, rodents, dogs, cats, cattle, pigs, goats, birds, fish; also in invertebrates | Worldwide | Fecal-oral; direct contact; ingestion of contaminated food or water; aerosols; possibly vector-transmitted | Keratitis; acute diarrhea (traveler’s diarrhea); chronic diarrhea in immunocompromised; may disseminate to systemic disease with variable symptoms in immunocompromised |
Rhinosporidium seeberi; some strains may be host specific | Natural hosts thought to be fish and amphibians; also found in various mammals, including horses, cattle, mules, dogs, and cats; birds | Worldwide, especially in tropics; endemic in South America, Asia, and Africa | Environmental exposure, probably water | Nasal and other mucous membrane masses and polyps (mainly nose, nasopharynx, eye); may cause obstruction; rare disseminated disease with osteolytic lesions or affecting viscera; rare skin and subcutaneous lesions | |
Sarcocystosis (Sarcosporidiosis, see Sarcocystosis Sarcocystosis ) | Sarcocystis suihominis, also called S meischeriana | People, nonhuman primates are definitive hosts; swine are intermediate host | Worldwide | Ingestion of raw pork | Gastroenteritis, usually mild, or asymptomatic |
S hominis, also called S fusiformis | People, nonhuman primates are definitive hosts; cattle are intermediate host | Worldwide | Ingestion of raw beef | Gastroenteritis, usually mild or asymptomatic | |
Sarcocystis spp; S nesbitti may be one cause | People are intermediate host; species of Sarcocystis and definitive host(s) are often unknown; definitive host for S nesbitti thought to be snakes | Worldwide; symptomatic cases mainly in Asia, probably because of distribution of definitive host | Assumed to be ingestion of oocysts shed in feces of definitive host(s) or sporocysts | Main syndrome is myositis, acute and self-limited to chronic, moderately severe; also cough, arthralgia, transient pruritic rashes, headache, malaise, lymphadenopathy in some | |
Toxoplasmosis ( see Toxoplasmosis Toxoplasmosis ) | Toxoplasma gondii | Felidae, including domestic cats, are definitive hosts; essentially all other mammals (including livestock) and birds thought to be susceptible as intermediate hosts | Worldwide | Ingestion of oocysts shed in feces of infected cats (including contaminated soil, food, water) or ingestion of tissue cysts in undercooked meat or unpasteurized milk | Lymphadenopathy or mild, febrile, flu-like syndrome or uveitis in immunocompetent, nonpregnant host; often severe in immunocompromised, with neurologic disease, chorioretinitis, myocarditis, pneumonitis, or disseminated disease; infection of fetus may result in CNS damage or generalized infection; abortions and stillbirths |
Trypanosoma brucei; T brucei rhodesiense is zoonotic; T brucei gambiense is primarily a human pathogen, although some animals (eg, pigs) can be infected and might serve as minor reservoirs | T brucei rhodesiense reservoirs may include cattle, sheep, antelope, hyenas, lions, other wildlife, people; also isolated from other mammals | Africa; common below the Sahara desert | Bite of infected tsetse fly (Glossina spp) | Painful chancre at bite site in some patients; intermittent fever, headache, adenopathy, rash, arthralgia; neurologic signs such as somnolence, seizures; cardiac complications possible; gambiense disease may last years; rhodesiense disease acute, may last weeks to months; both usually fatal without treatment | |
Parasitic Diseases—Trematodes (Flukes) | |||||
Clonorchiasis | Clonorchis sinensis (Chinese liver fluke) | Dogs, cats, swine, rats, other mammals are definitive hosts; fish (and snails) are intermediate hosts | Asia | Ingestion of undercooked infected freshwater fish or shrimp containing encysted larvae | Cholecystitis symptoms, indigestion, diarrhea, mild fever; chronic infections associated with cirrhosis, pancreatitis, or cholangiocarcinoma |
Dicrocoeliasis | Dicrocoelium dendriticum, possibly D hospes (lancet flukes) | Ruminants, especially sheep, goats, cattle, occasionally other domestic and wild mammals are definitive hosts; land snails (first) and ants (second) are intermediate hosts | D dendriticum on all major continents (may be focal); D hospes in Africa south of Sahara desert | Ingestion of infected ants | Abdominal discomfort, flatulent indigestion; occasionally GI signs (diarrhea, constipation, vomiting, pain); weight loss, fatigue; biliary obstruction, cholangitis, hepatomegaly, or acute urticaria possible |
Echinostomiasis | Echinostoma revolutum, E ilocanum, E hortense, and other Echinostoma spp; Echinochasmus japonicus and other members of Echinostomatidae can also be zoonotic | Cats, dogs, rodents, pigs, other mammals; birds, including poultry, are definitive hosts; fish, shellfish, tadpoles, snails are intermediate hosts | Most human cases in Asia, Western Pacific; this group of parasites is widely distributed, including Europe, Americas, Middle East | Ingestion of undercooked fish, shellfish, snails, or amphibians (frogs) | Abdominal discomfort; diarrhea, especially in heavy infestation; malnutrition, anemia, edema may occur, especially in children; intestinal perforation has been reported |
Fascioliasis | Fasciola hepatica | Cattle, sheep, water buffalo, horses, rabbits, other herbivores are definitive hosts; snails are intermediate hosts | Worldwide or nearly worldwide; previously thought to be mainly in temperate areas but may be more widely distributed | Ingestion of contaminated greens, eg, watercress, or water that contains metacercariae | Gastroenteritis, hepatomegaly, fever, urticaria possible acutely; biliary colic and obstructive jaundice in chronic cases; aberrant migration with extrahepatic signs (eg, pulmonary infiltrates, neurologic signs, lymphadenopathy, skin lesions or subcutaneous swelling) in some |
F gigantica | Cattle, buffalo, goats, sheep, zebras, other mammals are definitive hosts; snails are intermediate hosts | Thought to occur mainly in tropical areas: Africa, Asia, Middle East, and western Pacific | As above | Signs resemble fascioliasis caused by F hepatica | |
Fasciolopsiasis | Fasciolopsis buski | Swine, people are definitive hosts; snails are intermediate hosts | Asian pig-raising regions | Ingestion of aquatic vegetables or contaminated drinking water containing metacercariae | Often asymptomatic; gastroenteritis; intestinal bleeding, obstruction, or perforation possible; facial, abdominal, extremity edema may occur |
Gastrodiscoidiasis | Gastrodiscoides hominis; uncertain whether people and swine carry the same strains | Swine, people, nonhuman primates, rodents, other mammals are definitive hosts; snails are intermediate hosts | Asia (including the Philippines), also reported in Africa, Volga delta in Russia | Possibly ingestion of water or aquatic plants | Mild diarrhea if high parasite burden |
Heterophyiasis | Heterophyes spp, Haplorchis spp, other heterophids | Cats, dogs, foxes, wolves, cattle, other mammals, fish-eating birds are definitive hosts (host varies with species of parasite); fish (and snails) are intermediate hosts | Middle East (especially Nile delta), Turkey, Asia | Ingestion of undercooked fish containing encysted larvae | Diarrhea with mucus, colicky pain; heart or CNS involvement possible; severity of signs may vary with species |
Metagonimiasis | Metagonimus yokogawai, M miyatai, M takahashii, and other Metagonimus spp | Cats, dogs, rats, other fish-eating mammals, possibly birds are definitive hosts; fish (and snails) are intermediate hosts | Human illness mainly in Asia, also reported in Siberia; parasites have been found in Europe | Ingestion of undercooked freshwater fish containing encysted larvae | Diarrhea with mucus, anorexia, mild epigastric pain or abdominal cramps; malabsorption, weight loss if high parasite burden |
Metorchiasis | Metorchis conjunctus, Canadian liver fluke | Dogs, foxes and other canids, cats, raccoons, muskrats, mink, other fish-eating mammals are definitive hosts; fish (and snails) are intermediate hosts | North America; human infection rare | Ingestion of undercooked freshwater fish containing encysted larvae | Fever, abdominal pain (mainly epigastric), anorexia during acute stage; effects of chronic infection uncertain |
Nanophyetiasis | Troglotrema salmincola (also called Nanophyetus salmincola) | Raccoons, foxes, dogs, cats, skunks, and other fish-eating mammals and birds are definitive hosts; salmonid and some non-salmonid fish (and snails) are intermediate hosts | North America along Pacific coast, Russia | Ingestion of undercooked fish or roe | Mild gastroenteritis |
Opisthorchiasis | Opisthorchis felineus (cat liver fluke) | Cats, dogs, foxes, swine, seals, other fish-eating mammals are definitive hosts; fish (and snails) are intermediate hosts | Europe, Kazakhstan, Russia, Ukraine | Ingestion of undercooked freshwater fish containing encysted larvae | Acute febrile illness with arthralgia, lymphadenopathy, skin rash; suppurative cholangitis and liver abscess in subacute, chronic stages; possible increased risk of cholangiocarcinoma |
O viverrini (small liver fluke); zoonotic transmission can occur, but people are important hosts | People, dogs, cats, rats, pigs, fish-eating mammals are definitive hosts; fish and snails are intermediate hosts | Southeast Asia | Ingestion of undercooked freshwater fish containing encysted larvae | Upper abdominal pain, diarrhea, fever, jaundice possible acutely; chronic infections with cirrhosis, pancreatitis, high incidence of cholangiocarcinoma | |
Amphimerus pseudofelineus | Various mammals, birds, reptiles are definitive hosts; fish suspected as intermediate hosts | North and South America | Undetermined but probably ingestion of undercooked fish | ||
Paragonimiasis (Lung fluke disease) | Paragonimus westermani, P heterotremus, P africanus, P mexicanus, and other species | Dogs, cats, swine, wild carnivores, opossums, and other mammals are definitive hosts; snails and freshwater crustaceans are intermediate hosts; wild boars, sheep, goats, rabbits, birds, other animals are paratenic hosts | Flukes are worldwide (distribution varies with species); most human infections in Asia, Africa, tropical America | Ingestion of undercooked, infected freshwater crustaceans (crabs, crayfish); metacercariae on contaminated hands, fomites after preparing crustaceans, or undercooked meat from paratenic hosts such as wild boars | Chills, fever possible during migration to lungs; pulmonary disease resembling tuberculosis with cough, blood-tinged sputum; abdominal form with dull pain, tenderness, possibly diarrhea; less often, neurologic signs, migratory skin nodules, other organ-specific symptoms; predominant signs vary with species of fluke |
Schistosomiasis, intestinal and hepatic | Schistosoma japonicum | Many mammals, including cattle, water buffalo (important host in Asia), swine, dogs, cats, deer, horses, nonhuman primates, and rodents, are definitive hosts; snails are intermediate hosts | Asia | Penetration of unbroken skin by cercariae from infected snails in water | Acute disease can include urticarial rash, mild signs, isolated pulmonary signs, or Katayama syndrome (occurs especially after first infection; febrile illness, sometimes with cough, diarrhea, abdominal pain, hepatosplenomegaly, and/or rash/urticaria); apparent clinical recovery may be followed by chronic intestinal schistosomiasis with abdominal pain/discomfort, diarrhea ± blood; chronic hepatic schistosomiasis with hepatosplenomegaly followed by liver fibrosis, ascites, portal hypertension with hematemesis and/or melena, portocaval shunting with pulmonary signs; ectopic parasites can cause seizures, paralysis, meningoencephalitis; intestinal and hepatic lesions tend to progress rapidly; death can occur |
S mansoni | People, nonhuman primates are major reservoir (definitive) hosts; also in rodents, insectivores, cattle, dogs; snails are intermediate hosts | Africa, Middle East, South America, Caribbean | Penetration of unbroken skin by cercariae from infected snails in water | Acute disease in some; intestinal (most often) and/or hepatic schistosomiasis similar to S japonicum but not as rapidly progressive; glomerulonephritis a possible complication; ectopic CNS parasites tend to cause transverse myelitis; also causes genital schistosomiasis with reproductive problems; death can occur | |
S mattheei; S bovis and S margrebowiei might also be zoonotic | Definitive hosts are artiodactylid ruminants (cattle, sheep, goats, waterbuck, wildebeest, antelope, buffalo), also found in nonhuman primates; snails are intermediate hosts | Southern Africa; seems to be rare in people, and some infections may have been misidentified | Penetration of unbroken skin by cercariae from infected snails in water | Suggested agent in intestinal and hepatic schistosomiasis | |
S mekongi | People are reservoir (definitive) hosts; also found in dogs, pigs; snails are intermediate hosts | Southeast Asia | Penetration of unbroken skin by cercariae from infected snails in water | Acute disease absent or very rare; intestinal and hepatic schistosomiasis; death can occur | |
S intercalatum, S guineensis | Primarily people, rodents may also be definitive hosts; some other mammals, including nonhuman primates, susceptible to infection; snails are intermediate hosts | Africa | Penetration of unbroken skin by cercariae from infected snails in water | Intestinal schistosomiasis only, often mild or asymptomatic; occasionally bloody feces, diarrhea | |
Schistosomiasis, urinary | S haematobium | People are main reservoir (definitive host); occasionally infects nonhuman primates, pigs, buffalo, sheep, rodents, or other mammals; snails are intermediate hosts | Africa (including Madagascar, Mauritius), the Middle East | Penetration of unbroken skin by cercariae from infected snails in water | Acute disease in some; chronic disease—hematuria, dysuria, kidney failure; calcification of bladder wall, ureter, and bladder can lead to bladder cancer; ectopic CNS parasites tend to cause transverse myelitis; genital schistosomiasis; death can occur |
Swimmer’s itch (Cercarial dermatitis) | Schistosome cercariae from Schistosoma spp (mammals); Gigantobilharzia, Trichobilharzia, and Austrobilharzia spp (birds) | Birds, mammals are definitive hosts; snails are intermediate hosts | Worldwide | Penetration of unbroken skin by cercariae from infected snails in fresh- and saltwater | Self-limiting urticaria, pruritus, rash; fever, local lymph node swelling possible in some cases |
Parasitic Diseases—Cestodes (Tapeworms) | |||||
Bertielliasis | Bertiella studeri, B mucronata | Nonhuman primates are usual hosts; other mammals, including dogs, people can be infected | Asia, South America, Africa; can occur in imported primates in other areas | Ingestion of infected oribatid mites in food | Most cases asymptomatic; abdominal pain, vomiting, diarrhea, constipation, weight loss |
Coenuriasis (Coenurosis) | Taenia multiceps | Definitive hosts are canids; intermediate hosts are sheep, other herbivores | Worldwide in scattered foci; mainly reported from Europe, Asia | Ingestion of tapeworm eggs in canine feces, may be via water, vegetables, soil | Painless skin swelling; possible CNS involvement (signs of mass lesion in brain) or larva in eye |
T serialis | Definitive hosts are canids; intermediate hosts are lagomorphs, rodents, occasionally other mammals | Africa, Europe, North America, Australia; rare in people | As above | Painless skin swelling; also in muscles and retroperitoneally; CNS involvement possible | |
T brauni | Definitive hosts are canids; intermediate hosts are gerbils, wild rodents, also people | Africa | As above | Most often in subcutaneous tissues (skin swelling) or eye, also CNS | |
Cysticercosis | Taenia solium (see also Taeniasis) | People are definitive hosts; swine, other mammals are intermediate hosts (people can be both definitive and intermediate hosts) | Worldwide where swine are reared; most cases seen in Africa, Asia, Central and South America | Ingestion of eggs (including autoinfection from adult parasite in human intestine) | Inflammation in CNS caused by death of small larva or growth to large size (often years after infection); can cause seizures, other CNS signs; less often in eye or heart; massive numbers in muscles can also be symptomatic |
T crassiceps | Foxes, also other canids and carnivores, including dogs, are definitive hosts; rodents, insectivores, rabbits, occasionally other mammals are intermediate hosts | North America, Europe, Asia, and other areas where foxes are present | Ingestion of eggs | Tissue invasion (mainly subcutaneous, muscle), ocular; one paravertebral pseudohematoma with local bleeding, one CNS larva; many but not all cases in immunocompromised | |
Diphyllobothriasis (Fish tapeworm infection) | Diphyllobothrium latum (Dibothriocephalus latus), D nihonkaiense, D pacificum, D dendriticum, and other Diphyllobothrium spp | Dogs, bears, seals, sea lions, gulls, and other fish-eating mammals and birds are definitive hosts; freshwater or marine fish (and copepods) are intermediate hosts | Worldwide; distribution of species varies | Ingestion of undercooked infected fish | Usually asymptomatic; may cause mild abdominal distress, diarrhea (chronic relapsing diarrhea possible in some cases) |
Dipylidiasis (Dog tapeworm infection) | Dipylidium caninum | Dogs, cats, wild canids, some other wild carnivores are definitive hosts; fleas are intermediate hosts | Worldwide; uncommonly reported in people | Ingestion of dog or cat fleas | Usually in children; asymptomatic or mild abdominal distress, diarrhea; proglottids in feces resemble cucumber seeds |
Echinococcosis | Echinococcus granulosus sensu lato | Dogs, other canids, hyenas are definitive hosts; sheep, goats, cattle, water buffalo, swine, camels, cervids, rodents, other mammals, or marsupials are intermediate or aberrant hosts; strains of parasite can be adapted to different intermediate hosts | Worldwide, strains differ in distribution | Ingestion of tapeworm eggs in food or water, to mouth on hands; eggs stick to fur and hands | Cause space-occupying lesions of organs, especially lung, liver, also other organs, rarely CNS; cyst grows slowly, can cause death if untreated; rupture can cause allergic reactions, dissemination of cysts |
E multilocularis | Foxes and other wild canids and felids are usual definitive hosts, but parasite can also mature in dogs, cats; intermediate hosts are usually rodents, insectivores, some other mammals | North America (mainly Canada to north central USA), northern and central Eurasia | Ingestion of tapeworm eggs in food or water, to mouth on hands; eggs stick to fur and hands | Usually involves liver with mass lesions, occasionally lung or CNS; primary lesion can metastasize to many organs; without treatment, 70%–100% cases are fatal | |
E oligarthrus | Wild felids are definitive hosts, can mature in cats; agouti, pacas, spiny rats are intermediate hosts | Central and South America; rare in people | Ingestion of tapeworm eggs in food or water, to mouth on hands; eggs stick to fur and hands | Has been seen in a variety of internal organs, eyes | |
E vogeli | Bush dogs are usual definitive host, can mature in other canids, including dogs; pacas, agouti, nutria, nonhuman primates, and other mammals can be intermediate hosts | Central and South America | Ingestion of tapeworm eggs in food or water, to mouth on hands; eggs stick to fur and hands | Usually involves liver, may invade adjacent tissues; mortality high in advanced cases, even with treatment (22% in one study) | |
Hymenolepiasis | Hymenolepis nana (dwarf tapeworm); most human infections probably transmitted from people, but zoonoses possible | People, nonhuman primates, rodents are definitive hosts; insects, including fleas, flour beetles, cereal beetles are intermediate hosts | Worldwide | Accidental ingestion of tapeworm eggs or infected insects; autoinfection possible | Mainly in children; mild abdominal distress, decreased appetite, irritability are most common; weight loss, flatulence, diarrhea possible |
H diminuta (mouse tapeworm, rat tapeworm) | Rats, mice are definitive hosts; insects, including fleas and cereal beetles are intermediate hosts | Worldwide | Ingestion of infected insects in food | Mild abdominal symptoms of short duration | |
Inermicapsifer infection | Inermicapsifer spp | Rodents, people are definitive hosts in Africa; people may be exclusive host outside Africa | Africa, southeast Asia, tropical America | Probably ingestion of infected arthropods | Mild abdominal symptoms, if any |
Raillietina infection | R celebensis, R demerariensis; most Raillietina spp have not been reported in people | Rodents, nonhuman primates are definitive hosts for R celebensis, R demerariensis; other species in birds, mammals; arthropods, including ants, are intermediate hosts | R demerariensis in tropical America (human cases mainly Ecuador, Cuba, Guyana, Honduras); R celebensis in Asia, Australia, Africa | Probably ingestion of infected arthropods in food | Vague discomfort, many cases asymptomatic; gastroenteritis, possibly other signs; mainly in children |
Sparganosis | Spirometra spp (pseudophyllidean tapeworms, second larval stage) | Dogs, cats, wild canids and felids are definitive hosts; copepods are first intermediate host; fish, frogs, reptiles are second intermediate hosts; primates, pigs, weasels, rodents, insectivores, other mammals, birds are paratenic hosts | Worldwide; human cases most common in Asia | Ingestion of infected cyclops (in water) or undercooked intermediate or paratenic host; application of contaminated tissues to skin (eg, as poultice) | Nodular, itchy skin lesions that can migrate; conjunctival and eyelid lesions; urticaria, painful edema; other organ involvement, including CNS, eye |
Taeniasis | |||||
—Asian taeniasis | Taenia asiatica (also called T taiwanensis, T saginata asiatica | Domestic and wild pigs, occasionally cattle, goats, monkeys are intermediate hosts; people are definitive hosts | Asia | Ingestion of undercooked animal products, usually visceral organs such as liver and lung | Vague abdominal complaints and proglottid passage; anal pruritus; possible that ingestion of eggs may be followed by larval migration and disseminated disease (uncertain/controversial) |
—Beef tapeworm disease | T saginata | Cattle, water buffalo, llamas, reindeer, camels, other domestic and wild ruminants are intermediate hosts; people are definitive host | Worldwide | Ingestion of undercooked meat containing larvae | Mild abdominal discomfort and proglottid passage; gravid proglottids may travel to ectopic sites and cause symptoms; eggs do not cause disseminated disease |
—Pork tapeworm disease; cysticercosis and neurocysticercosis | T solium | People are definitive host; swine, occasionally other mammals, including people, are intermediate hosts | Worldwide where swine are reared; most cases seen in Africa, Asia, Central and South America | Ingestion of undercooked pork containing larvae causes taeniasis; ingestion of eggs (including autoinfection from adult worm in intestine) causes cysticercosis | Adult stage in intestine (taeniasis) mild or asymptomatic; cysticercosis usually asymptomatic for years until cysticercus becomes large or death of small cysticerci result in inflammation in CNS (seizures, other CNS signs) or infrequently in eye or heart; massive numbers in muscles can also be symptomatic |
Parasitic Diseases—Nematodes (Roundworms) | |||||
Angiostrongyliasis | Angiostrongylus costaricensis, also called Parastrongylus costaricensis | Cotton rats and other rodents are definitive hosts; slugs are intermediate hosts | Mainly in Central and South America, Caribbean parasite has also been reported in North America | Accidental ingestion of slugs or possibly plants contaminated by their secretions | Acute abdominal angiostrongyliasis; severe pain resembles appendicitis, especially in children; rarely, more insidious disease with liver involvement; complications can include intestinal ischemia, perforation; fatalities possible |
Angiostrongylus cantonensis, also called Parastrongylus cantonensis | Rodents (rats, including Rattus and Bandicota spp) are definitive hosts; snails, slugs are intermediate hosts; land planarians, crustaceans (crabs, shrimp, prawns), amphibians, fish, reptiles are paratenic hosts | Originated in Asia, spread to many other regions, mainly tropics, including Americas, Caribbean, Middle East, Australia | Ingestion of raw/undercooked intermediate or paratenic host (or accidental ingestion on vegetables); possibly ingestion of plants contaminated by secretions of intermediate host | Eosinophilic meningitis or meningoencephalitis, spinal cord involvement; ocular involvement with decreased vision; transient abdominal pain, pruritus in some; most cases relatively mild and self-limiting, but some fatal | |
Anisakiasis | Anisakis, Pseudoterranova, and Contracaecum spp | Marine mammals (cetaceans and pinnipeds) and fish-eating birds are definitive hosts; fish, crustaceans, and cephalopod mollusks are intermediate or paratenic hosts | Worldwide but many cases in northern Asia and western Europe | Ingestion of undercooked marine fish, squid, octopus | Gastroenteritis with upper quadrant pain; parasite usually in stomach; small-intestinal infections unusual but can occur; colon, esophagus rarely involved; oropharyngeal worm can cause hematemesis, cough; urticaria and other allergic signs after ingestion of live or dead worms |
Ascariasis | Ascaris suum; potentially zoonotic (controversial) | Pigs, also reported occasionally in other mammals, including nonhuman primates, sheep, cattle | Worldwide, prevalence varies | Ingestion of eggs from environment (shed in feces) | Visceral larva migrans (respiratory signs, fever during larval migration); GI signs |
Capillariasis | |||||
—Hepatic capillariasis | Capillaria hepatica (also called Calodium hepaticum) | Rodents major host, also in many other wild and domestic mammals | Worldwide in scattered foci | Ingestion of embryonated eggs in soil | Acute or subacute hepatitis with marked eosinophilia; subclinical to fatal |
—Intestinal capillariasis | C philippinensis (also called Paracapillaria philippinensis) | Aquatic birds, people can be definitive hosts; freshwater fish are intermediate host | Philippines, Thailand, also reported occasionally in other parts of Asia, Middle East, Cuba | Ingestion of undercooked infected fish | Enteropathy with protein loss and malabsorption; diarrhea, abdominal pain; weight loss can be severe; death possible |
—Pulmonary capillariasis | C aerophila (also called Eucoleus aerophilus) | Dogs, cats, other carnivores | Worldwide; rare in people | Accidental ingestion of infective eggs in soil or contaminated food | Fever, cough, bronchospasm, bronchitis, dyspnea; can mimic bronchial carcinoma |
Dioctophymosis (Giant kidney worm infection) | Dioctophyma renale | Mink, dogs, and other carnivores are definitive hosts; annelids are intermediate hosts; frogs, fish are paratenic hosts | Worldwide; rare in people | Ingestion of infected fish, frog, or annelid | Renal colic, hematuria, pyuria, ureteral obstruction, various kidney complications can be fatal; subcutaneous nodule |
Dracunculiasis (Guinea worm infection) | Dracunculus medinensis; people are most important host but possible role for zoonotic transmission in some locations | People, nonhuman primates are definitive hosts; infections have also been reported in animals, but parasite identification sometimes uncertain; domestic animals not thought to maintain parasite but possible exceptions (eg, dogs in Chad); copepods are intermediate hosts | Asia (mainly Indian subcontinent) and Africa | Ingestion of infected cyclops in water | No symptoms until just before larviposition (~1 yr); papule to vesicular skin lesion to ulcer that opens in water to reveal worm; allergic reaction common at this time, and secondary infection may occur |
Filariasis | |||||
—Dirofilariasis | Dirofilaria immitis | Dogs, cats, other mammals especially carnivores, mustelids, primates are definitive hosts (mainly patent in dogs and wild canids); mosquitoes are intermediate hosts | Worldwide | Bite of infected mosquitoes | Fever, cough acutely, larvae result in infarct or coin lesion in the lungs; often asymptomatic; rarely involves eye or other body sites |
D tenuis, D repens, rarely other species | D tenuis in raccoons; D repens mainly patent in dogs and some wild canids (eg, foxes); also infects cats but not usually patent | D tenuis in North America; D repens in Asia, Europe, Africa | Bite of infected mosquitoes | Subcutaneous nodule or submucosal swelling, some migratory and/or painful; subconjunctival (rarely intraocular); internal location (mainly lung but also brain, other organs) possible | |
—Malayan filariasis | Brugia malayi; subperiodic form is of uncertain origin, thought to be zoonotic or maintained in both animals and people; periodic form is exclusive to people | Cats, wild felids, pangolins, other carnivores, nonhuman primates susceptible | Asia; subperiodic form limited to peninsular Malaysia, Thailand, and parts of Indonesia, Vietnam, and the Philippines in swamp-forest environments | Bite of infected mosquitoes, Mansonia spp mainly associated with subperiodic form | Lymphatic filariasis: recurrent painful lymphadenitis, lymphangitis, often preceded by prodromal illness with malaise or urticaria; may progress to elephantiasis, usually of legs; hypersensitivity syndrome with cough, chest pain, asthmatic attacks especially at night |
Filariasis caused by other Brugia species | Brugia spp other than B malayi, including B pahangi | Various domestic and wild mammals, including dogs and cats, are definitive hosts | Asia, Africa, Americas | Mosquitoes | Occasional zoonotic infections (eg, cutaneous nodules, granuloma in lymph nodes) |
Gnathostomiasis | Gnathostoma spinigerum, G binucleatum, and some other Gnathostoma spp | Dogs, cats, wild carnivores are definitive hosts (G doloresi and G hispidum in pigs and wild boars); copepods, freshwater fish, eels, frogs, snakes, chickens, snails, pigs are intermediate or paratenic hosts | Worldwide; most human cases from Asia; emerging along Pacific coast of Mexico, Ecuador, Peru, Argentina | Ingestion of undercooked fish, poultry, or other intermediate or paratenic host, drinking water contaminated with copepods containing larvae; handling meat that contains larvae | Fever, malaise, gastroenteritis, urticaria, soon after ingestion; migratory skin lesions (intermittent swelling, often painful or pruritic, or linear erythematous lesions) after weeks to years; may involve viscera, eye, or CNS; CNS involvement can be fatal or result in permanent damage with reported case fatality rates of 7%–25% |
Gongylonemiasis | Gongylonema pulchrum | Ruminants, domestic and wild swine, other mammals, birds are definitive hosts; coprophagous insects (eg, beetles, cockroaches) are intermediate hosts | Worldwide; rare in people | Ingestion of infected beetles, probably on vegetables; possible inhalation of small beetles | Movement of parasite in submucosa of mouth is sensed; local irritation; pharyngitis, stomatitis possible |
Larva migrans, cutaneous (see alsognathostomiasis, above) | Ancylostoma braziliense, A caninum, A ceylanicum, Uncinaria stenocephala | Cats, dogs, wild carnivores are definitive hosts | Worldwide; distribution varies with the species | Contact with infective larvae that penetrate skin, usually via soil | Itchy, serpiginous, migrating skin lesions; papules, nonspecific dermatitis, vesicles; wheezing, cough, and urticaria may occur; myositis or ocular lesions possible; eosinophilic enteritis after ingestion of A caninum; A ceylanicum can also become patent in intestine, causing GI signs, anemia |
Bunostomum phlebotomum | Cattle | Temperate regions | As above | As above | |
Strongyloides stercoralis and other Strongyloides spp found in animals | S stercoralis in dogs, cats, primates, including people; other species in swine, sheep, goats, cattle, horses, raccoons, and other domestic and wild mammals | Worldwide, more common in tropics and subtropics | Contact with infective larvae that penetrate skin, from soil or direct contact with feces; autoinfection possible with S stercoralis | Larva currens (linear, serpiginous urticarial inflammation, often rapidly progressive); S stercoralis may also mature in intestine, causing enteritis and other signs (see below) | |
Larva migrans, visceral (see alsoangiostrongyliasis and anisakiasis, above) | Toxocara canis, T cati, possibly others | Dogs and wild canids (T canis), cats and wild felids (T cati) are definitive hosts; many species can be paratenic hosts | Worldwide | Ingestion of embryonated eggs shed in feces of dogs and cats; via soil, water, food, fomites | Fever, wheezing cough, upper abdominal discomfort; other symptoms, including neurologic signs, skin rashes also possible; may wax and wane for months; eye involvement (ocular migrans) may resemble retinoblastoma |
Baylisascaris procyonis, possibly other species of Bayliscascaris | Raccoons, kinkajous are definitive hosts; dogs can be definitive or intermediate host; many mammals (including people), marsupials, and birds are intermediate or paratenic hosts | North America, Europe, Japan | Accidental ingestion of embryonated eggs in soil, water, or fecal-contaminated material | Nonspecific signs, including fever, lethargy; hepatomegaly, pneumonitis, parasitic meningoencephalitis (may be fatal in infants, young children), ocular disease; other syndromes, including cardiac disease | |
Oesophagostomiasis, Ternidensiasis | Oesophagostomum spp, Ternidens deminutus; zoonotic potential may vary with parasite species/strain and geographic area | Primates, including people | Parasites found in Africa, Asia, South America; human cases mainly reported in Africa | Ingestion of infective larvae in soil, often in food or water | Abdominal pain and one or more masses ± mild fever; intestinal obstruction or abscessation possible; multinodular form (less common) with abdominal pain, persistent diarrhea, weight loss; rarely ectopic in omentum, liver, or skin |
Onchocercosis | Onchocerca gutturosa, O cervicalis, O jakutensis, O dewittei japonica, O reticulata, O lupi, others | Definitive hosts include cattle, horses, cervids, wild boars, dogs and other canids, camels, other species | Distribution varies with species | Probably transmitted by black flies (Diptera: Simuliidae), possibly other vectors | Ocular disease, subcutaneous nodules |
Strongyloidiasis | Strongyloides stercoralis; most human infections thought to be from strains adapted to people; frequency of maturation of canine S stercoralis in people undetermined, thought to be rare | S stercoralis in dogs, cats, foxes, primates, including people | S stercoralis worldwide; more common in tropical and subtropical climates | Contact with infective larvae that penetrate skin, in soil or direct contact with feces; autoinfection possible | Frequently asymptomatic in healthy; possible larva currens (seelarva migrans, above); respiratory signs in some (cough to bronchopneumonia), especially in elderly, immunocompromised; abdominal pain, diarrhea, sometimes with periodic urticarial or maculopapular rash; disseminated strongyloidiasis, neurologic complications, septicemia, and death may occur in immunocompromised |
S fuelleborni | Primates, including people | Africa, Asia, and in captive primates in other areas | As above | Associated with abdominal pain, occasional diarrhea, not well studied | |
Thelaziasis (Eyeworms) | Thelazia callipaedia, T californiensis, possibly T rhodesii | Definitive hosts are dogs and other canids, cats (T callipaedia); dogs, wild mammals, occasionally cats (T californiensis); flies are intermediate hosts | T callipaedia in Asia, Europe; T californiensis in North America (western USA); rarely in people | Flies release parasite larvae on conjunctiva | Conjunctivitis; corneal scarring, opacity in chronic cases |
Trichinosis (Trichinellosis) | Trichinella spiralis and subspecies, T nativa, T britovi, T nelsoni, T pseudospiralis, possibly others | Main reservoir may be wild carnivores (foxes, badgers, wolves, lynx), omnivores (bears, boars); also in any mammal that eats (or is fed) meat, including domestic swine, rodents, cats, dogs, horses, marine mammals; also birds (T pseudospiralis); T zimbabwensis (zoonotic potential unknown) can infect reptiles | Worldwide, especially in temperate regions; some species are limited in their distribution | Ingestion of undercooked pork, horse meat, game, and other tissues containing viable cysts | Gastroenteritis in some; followed by fever, headache, severe myalgia, facial swelling (especially eyelids); ocular pain, rashes, or pruritus possible; pneumonitis, CNS, or myocardial involvement can occur; inapparent to fatal |
Trichostrongyliasis | Trichostrongylus spp | Cattle, sheep, other domestic and wild ruminants, sometimes other mammals | Worldwide | Ingestion of infective larvae on vegetables or in contaminated water, soil | Asymptomatic or mild gastroenteritis |
Trichuriasis (Whipworm infection) | Trichuris suis, possibly T vulpis and other species; main species in people is T trichiura, but zoonotic infections are unusual | T vulpis in canids; T suis in domestic and wild swine | Worldwide, especially warm, humid climates | Ingestion of embryonated eggs on plant foods, water, or in soil | T suis can colonize people, who develop GI signs; rare larva migrans or intestinal infections suggested from T vulpis (controversial identification) |
Parasitic Diseases—Acanthocephalans | |||||
Acanthocephaliasis, Macracanthorhynchosis | Macracanthorhynchus hirudinaceus and other species | Hosts vary with parasite species; definitive hosts include domestic and wild pigs, rodents, muskrats, arctic foxes, dogs, sea otters, other terrestrial and marine mammals; intermediate hosts are beetles, cockroaches, crustaceans; fish are paratenic hosts | Worldwide | Ingestion of infected beetles, other intermediate hosts, or fish | Gastroenteritis, may lead to gut perforation or intestinal obstruction; some cases asymptomatic |
Parasitic Diseases—Annelids (Leeches) | |||||
Hirudiniasis (internal) | Limnatis nilotica and other aquatic leeches | Cattle, buffalo, other domestic and wild mammals, probably frogs | Africa, Asia, southern Europe, Middle East | Drinking unfiltered water (leech enters nares or mouth), wading in deep water (enters genitourinary tract) | Attaches to nasopharynx, pharynx, esophagus, occasionally deeper in respiratory tract, or in genitourinary tract; pressure and/or pain at attachment site; bleeding (eg, hemoptysis, hematemesis, epistaxis, vaginal bleeding), anemia (can be severe); other signs depend on location |
Arthropod Diseases | |||||
Acariasis (Mange) | Mites of Sarcoptes, Cheyletiella, Dermanyssus, and Ornithonyssus spp, Notoedres cati, Trixacarus caviae, Liponyssoides sanguineus; possibly others (uncommon) | Mammals and birds | Worldwide | Contact with infected animals, fomites | Itchy skin lesions |
Myiasis | Cochliomyia hominivorax and Chrysomya bezziana (screwworms) | Mammals; rare in birds | C hominivorax in South America, Caribbean; C bezziana in Asia, Africa, Middle East | Flies lay eggs on host, larvae enter wounds (as small as a tick bite), mucous membranes | Painful, pruritic, foul-smelling, enlarging dermal and subdermal wounds or nodules, often with serosanguineous discharge; some infestations in cavities, including nasal cavity; larvae can invade living tissue, locally destructive (including bone, eye, sinuses, or cranial cavity); can be fatal if untreated |
Cordylobia anthropophaga, rarely C rodhaini (Tumbu flies) | Mammals, often found in dogs, rodents | Africa, Middle East; also reported in Mediterranean region of Europe | Larvae from environment invade unbroken skin | Furuncular swelling at site of invasion, often feet; fever, malaise, focal lymphadenopathy possible | |
Cuterebra spp | Rodents, lagomorphs, occasionally other mammals | North America | Larvae from vegetation enter host in natural cavities or invade intact skin | Subcutaneous furunculoid nodule(s); creeping skin eruption (uncommon); ocular lesions; rarely larvae might be found in upper respiratory tract | |
Dermatobia hominis(human botfly) | Mammals, some birds | South and Central America, Mexico | Eggs carried by other insects (eg, mosquitoes); larvae hatch and penetrate skin of mammalian host when insect lands | Nonmigratory larvae in furuncles; episodes of pain, intense pruritus, sometimes with lymphangitis or lymphadenitis; can invade eyelids, eye sockets, mouth, especially in children | |
Gasterophilus spp (equine botfly) | Equids, occasionally other mammals | Worldwide | Accidental exposure to larvae | Serpiginous, pruritic red stripes on skin resembling cutaneous larva migrans; very rarely might reach stomach (nausea, vomiting) | |
Hypoderma lineatum, H bovis (warbles), and other Hypoderma spp | H bovis and H lineatum in cattle, sometimes other mammals; other species primarily parasites of deer, caribou, or yaks | North America, Europe, Asia; species distribution varies | Eggs laid on host, larvae invade skin | Usually subcutaneous (slowly moving furuncles that can appear and disappear) or similar to cutaneous larva migrans; endophthalmia uncommon; H lineatum may also cause an eosinophilic syndrome with fever, muscle pain, sometimes respiratory, cardiac, or neurologic signs | |
Oestrus ovis, Rhinoestrus purpureus | O ovis mainly in sheep, goats, also other mammals; R purpureus mainly in equids | O ovis worldwide, usually in warmer climates; R purpureus in Asia, Africa, Europe | Larvae are deposited in nares, conjunctiva, occasionally lips/mouth by adult fly | Conjunctival form, with lacrimation and sensation of irritating foreign body in eye, ocular destruction rare; nasal form with localized pain or pruritus, congestion, headache; also reported in pharynx (inflammation, vomiting, dysphagia), rarely ear; usually self-limiting (except inside eye), because larvae cannot develop beyond first stage in people | |
Wohlfahrtia spp, Wohlfahrtia vigil, W magnifica | W vigil in rabbits, rodents, mink, foxes, dogs, and other carnivores, other mammals; W magnifica in sheep, cattle, dogs, other mammals, some birds, especially geese | W vigil in North America; W magnifica in Europe (mainly Mediterranean), north Africa, Asia | Larvae deposited on host or nearby, penetrate lesions (both agents) or intact skin (W vigil) and natural orifices | W vigil causes subcutaneous abscesses, furuncles; W magnifica has been reported from skin, eye, vulva, ear, orotracheal region | |
Pentastomid infections | Armillifer spp (tongue worms) | Definitive hosts are snakes; intermediate hosts are rodents and other wild animals | Africa, Asia | Ingestion, via water or vegetables contaminated with eggs (from feces or saliva of snakes); undercooked snake meat; contaminated hands, fomites after handling snake meat | Usually asymptomatic; large numbers of parasites can cause multifocal abscesses, masses, or obstruction of ducts in internal organs; symptoms vary with location; death rare |
Linguatula serrata | Definitive hosts are dogs and other canids, felids; intermediate hosts are herbivores (especially sheep, goats, lagomorphs) and people | Worldwide | Ingestion of water or vegetables contaminated with eggs (from feces, saliva, or nasal discharge of definitive host); ingestion of larvae in undercooked liver or lymph nodes from intermediate hosts | Ingestion of eggs—usually asymptomatic; ocular or pulmonary signs, abdominal pain, icterus, and other symptoms possible from invasion of internal organs Ingestion of larvae—throat irritation, pain; edema, congestion of nasopharynx may cause dyspnea, difficulty swallowing; most severe cases are probably in people who have been sensitized | |
Tick paralysis ( see Tick Paralysis Tick Paralysis ) | More than 40 species of ticks are capable of causing this disease; Dermacentor andersoni, D variabilis most common in North America | Various animals carry ticks | Worldwide | Tick attachment | Ascending flaccid paralysis, may be preceded by prodromal flu-like illness (malaise, weakness); can cause respiratory paralysis, also paresthesia; ends when tick is removed |
Tunga infections | Tunga penetrans(sand fleas, jiggers) | People, dogs, pigs, other mammals | Africa, Central and South America, Caribbean, south Asia | Skin contact with contaminated soil | Penetration of skin and burrowing result in pain and itching around discrete sores, often on feet; may be secondarily infected |
Viral Diseases | |||||
Alkhurma virus infection | Alkhurma virus (family Flaviviirdae, genus Flavivirus); may be a variant or strain of Kyasanur Forest virus | Sheep, goats, camels | Middle East, mainly reported in Saudi Arabia, also Egypt | Ticks (Ornithodoros and Hyalomma spp); direct contact with animal meat via broken skin or ingestion of unpasteurized camel milk linked to some cases | Febrile illness, often with GI signs (eg, vomiting, abdominal pain); encephalitic/neurologic and hemorrhagic signs in some; case fatality up to 25% in early reports, recently < 1% |
Barmah Forest virus infection; epidemic polyarthritis | Barmah Forest virus (family Togaviridae, genus Alphavirus) | Natural hosts unknown; horses, brushtail possums may be hosts | Australia | Mosquito bites; Culex annulirostris and Aedes spp implicated | Resembles disease caused by Ross River virus (see entry later in this table) but seems to persist longterm in fewer patients, rash more common |
Buffalopox virus infection | Vaccinia virus, Buffalopox virus strain (family Poxviridae, genus Orthopoxvirus) | Water buffalo, cattle | Indian subcontinent (south Asia), Egypt, Indonesia | Skin contact with infected animals, often when milking | Pox skin lesions mainly on hands, face, legs, buttocks; occasionally lymphadenopathy, fever, malaise |
California encephalitis virus serogroup (California serogroup) infections | California encephalitis virus serogroup (family Bunyaviridae, genus Orthobunyavirus); includes California, La Crosse, Tahyna, Inkoo, Jamestown Canyon, Morro Bay, Snowshoe hare, Guaroa, Lumbo, Chatanga, and other viruses | Many wild and domestic mammals | North and South America, Europe, Africa, Asia; possibly worldwide; distribution of each virus varies | Mosquito bites | Syndromes, severity vary with the virus; flu-like illness, meningitis, or encephalitis common with North American viruses |
—La Crosse encephalitis | La Crosse virus (California encephalitis virus serogroup) | Chipmunks, squirrels are major amplifying hosts; rabbits, foxes, and other mammals can be infected | North America | Mosquito bites | Many cases mild and flu-like; meningitis or encephalitis with seizures, paralysis, and focal neurologic signs possible; most cases in children; estimated case fatality rate < 1% in cases with encephalitis |
—Tahyna fever | Tahyna virus (California encephalitis virus serogroup) | Hares, rabbits, rodents, hedgehogs, and other mammals | Europe, Asia, Africa | Mosquito bites (culicine and anopheles) | Influenza-like illness, sometimes including GI signs; arthritis or respiratory signs, including bronchopneumonia in some; meningitis possible; most often in children; does not appear to cause fatal disease |
Camelpox | Camelpox virus | Old World camelids, possibly other species | Middle East, Asia, Africa, possibly other areas; human cases recently described in India in camel handlers, rare unconfirmed cases suggested in other locations | Direct contact | Skin lesions similar to cowpox, variola virus infections |
Chikungunya virus infection | Chikungunya virus (family Togaviridae, genus Alphavirus) | Sylvatic cycle in nonhuman primates, possibly rodents in Africa; virus thought to be maintained in people in Asia, but sylvatic cycle may also exist | Asia, Africa | Mosquito bites (especially Aedes spp) | Febrile illness, may have rash and/or GI signs; arthralgia, especially in small joints, and myalgia prominent, may persist for months; myocarditis, neurologic signs, hemorrhages reported in a few cases |
Colorado tick fever | Colorado tick fever virus (family Reoviridae, genus Coltivurus; Salmon River virus and California hare coltivirus may be variants | Rodents; also found in porcupines, lagomorphs, deer, elk, and other mammals | Rocky Mountain region of North America | Tick bites (primary vector is Dermacentor andersoni) | Nonspecific febrile illness; pharyngitis, rash, or GI signs possible; biphasic or triphasic in some; complications (eg, neurologic signs, hemorrhages, pericarditis, myocarditis, orchitis) uncommon but can occur in severe cases; deaths rare |
Contagious ecthyma (Orf, see Contagious Ecthyma Contagious Ecthyma ) | Orf virus (family Poxviridae, genus Parapoxvirus) | Sheep, goats, camelids, reindeer, wild ungulates; rare cases in dogs | Worldwide | Occupational exposure via contact with broken skin (both live animals and meat processing) | Papule(s) that umbilicate and ulcerate, usually on hands; dissemination rare; large lesions refractory to treatment can be seen in immunosuppressed |
Cowpox ( see Pox Diseases Pox Diseases ) | Cowpox virus (family Poxviridae, genus Orthopoxvirus) | Rodents are usual reservoir host; also in domestic and wild cats, occasionally cattle, other mammals | Parts of Europe and Asia | Contact exposure via broken skin, bites, scratches | Papules, vesicles that become pustular, to ulcerative nodules, scars; single or multiple lesions, often on hands; regional adenopathy and malaise, flu-like symptoms in some; lesions remain localized in healthy people; more extensive or generalized disease may be seen in children, people with eczema,immunocompromised; severe cases can involve respiratory mucosa; rare fatal cases (eg, complications of encephalitis) |
Crimean-Congo hemorrhagic fever ( see Crimean-Congo Hemorrhagic Fever Crimean-Congo Hemorrhagic Fever ) | Crimean-Congo hemorrhagic fever virus (family Bunyaviridae, genus Nairovirus) | Cattle, rodents, sheep, goats, hares, other mammals, some birds | Africa, Middle East, central Asia, southeastern Europe; appears to be spreading | Tick bites, especially Hyalomma but also Rhipicephalus, Dermacentor, other species; skin contact with animal or human blood or tissues or crushed ticks; ingestion of unpasteurized milk | Fever, headache, pharyngitis, abdominal symptoms, petechial rash, hemorrhage, hepatitis, other organ involvement in some cases; very severe in pregnant women; case fatality rate 3%–50%, varies with region |
Eastern equine encephalomyelitis ( see Equine Arboviral Encephalomyelitis Equine Arboviral Encephalomyelitis ) | Eastern equine encephalomyelitis virus (family Togaviridae, genus Alphavirus); North American lineage 1 strains more virulent than South American lineages | Birds are principal reservoir hosts in North America, snakes might have role in overwintering virus; rodents, marsupials might be reservoir hosts in South America; clinical cases seen in equids and occasionally other mammals and birds; mammals are almost always dead-end hosts | Western hemisphere | Mosquito bites; Culiseta melanura important in maintenance cycle in birds in North America; various mosquito species (Aedes, Coquillettidia, Culex) can transmit to people | Nonspecific febrile illness may be followed by severe encephalitis, especially with North American lineage; neurologic sequelae common after encephalitis; case fatality rate 30%–70% with North American lineage; more severe in infants and elderly |
Ebola hemorrhagic fever | Zaire ebolavirus, Sudan ebolavirus, Ivory Coast ebolavirus, Bundibugyo ebolavirus (family Filoviridae, genus Ebolavirus); Reston ebolavirus does not seem to affect people | Bats are reservoir hosts for Zaire ebolavirus and suspected reservoir hosts for others; primates, duikers, possibly other mammals can be infected | Africa | Contact with infected tissues (especially nonhuman primates and duikers); probable transmission from bats in caves | Initially nonspecific febrile illness; maculopapular rash with desquamation; mild to severe bleeding tendency develops a few days after onset; mortality rate 36%–90%, varies with isolate |
Encephalomyocarditis | Encephalomyocarditis virus (family Picornaviridae, genus Cardiovirus); thought to be zoonotic | Rodents may be reservoir hosts; also in swine, nonhuman primates, elephants, other mammals, and wild birds | Worldwide in animals | Uncertain | Nonspecific febrile illness, sometimes with GI signs, and/or decreased reflexes have been reported in adults, with recovery within several days; CNS signs, including paralysis, have been reported in children |
Foot-and-mouth disease ( see Foot-and-Mouth Disease Foot-and-Mouth Disease ) | Foot-and-mouth disease virus (family Picornaviridae, genus Aphthovirus, types A, O, C, SAT 1, SAT 2, SAT 3, and Asia 1) | Cattle, swine, sheep, goats, other cloven-hoofed animals (Artiodactyla), a few mammals in other orders | Asia, Africa, Middle East, South America | Contact exposure, often in laboratories or other high concentrations of virus | People may become temporary nasal carriers of virus but do not usually become ill; mild influenza-like disease with vesicular lesions occurs very rarely |
Hantaviral diseases | |||||
—Hantaviral pulmonary syndrome | Sin Nombre, Black Creek Canal, Bayou, Andes, Bermejo, Choclo, Araraquara, Juquitiba, Laguna Negra, and Castelo dos Sonhosviruses, others (family Bunyaviridae, genus Hantavirus) | Rodents; each virus tends to be associated with a single reservoir host | North and South America | Aerosols from rodent excretions and secretions; contact with broken skin and mucous membranes; rodent bites | Prodromal stage with nonspecific febrile illness; followed by respiratory failure, cardiac abnormalities; hemorrhagic signs possible with South American viruses; significant kidney disease uncommon; mortality rate varies with the virus, but can reach 40%–60% |
—Hemorrhagic fever with renal syndrome | Hantaan virus, Dobrava virus, Puumala virus, Seoul virus, Saaremaa virus, others (family Bunyaviridae, genus Hantavirus) | Rodents; each virus tends to be associated with a single reservoir host, but Seoul virus is carried by both Rattus norvegicus and R rattus | Europe, Asia; Seoul virus is worldwide | Aerosols from rodent excretions and secretions; contact with broken skin and mucous membranes; rodent bites | Prodromal stage with abrupt onset of fever, headache, back pain, sometimes petechiae, GI signs (may be severe); followed by hypotension, renal signs to renal failure with oliguria; hemorrhage, other syndromes in some; mortality rate varies with the virus, from < 1% (Puumala virus) to 10%–15% (Hantaan virus) |
Hendra virus infection ( see Hendra Virus Infection Hendra Virus Infection ) | Hendra virus (family Paramyxoviridae, genus Henipavirus) | Fruit bats are normal reservoir host; horses can be infected | Australia | Direct contact with infected animals (all human cases have been linked with horses) or contaminated tissues | Respiratory infection, encephalitis (including recurrent encephalitis); few cases described but several were fatal |
Hepatitis E | Hepatitis E virus, mammalian isolates (family Hepeviridae, genus Hepevirus); genotypes 3 and 4 zoonotic; genotypes 1 and 2 maintained in people | People; animals, including swine, wild boar, deer, rabbits, ferrets, rats, mongoose, others; swine and probably other hosts are reservoirs for human infections | Worldwide; human and zoonotic genotypes may differ in prevalence between areas | Fecal-oral spread; consumption of raw or undercooked meat and liver; waterborne, contact with animal reservoirs | Mild, self-limiting hepatitis to liver failure, more severe in pregnancy and can result in abortion, death of newborn, premature birth; usually acute, but can be chronic in organ-transplant patients; case fatality rate < 1% to 4% in general population, up to 20% in pregnant |
Herpes B virus disease | Cercopithecine herpesvirus 1 (McHV, Herpesvirus simiae, B virus) (family Herpesviridae, genus Simplexvirus) | Carried in genus Macaca (Old World macaques), with lifelong latency and potential for periodic shedding after infection; other nonhuman primates susceptible; cell cultures | Worldwide, can be common, especially in closed groups of macaques; human cases rare | Monkey bites and scratches, contamination of mucous membranes with infected saliva, secretions | Influenza-like symptoms; vesicular skin lesions, pain, or itching around wound, followed by severe encephalitis with seizures, paralysis, coma; 85% mortality rate |
Influenza virus infections | |||||
—Avian influenza | Influenza A virus (family Orthomyxoviridae, genus Influenzavirus A); avian influenza viruses; many severe human cases linked to Asian lineage H5N1 highly pathogenic avian influenza (HPAI) viruses, but other viruses also cause illness | Avian influenza viruses in wild and domestic birds, especially poultry; uncommon in mammals | Worldwide, distribution of strains varies | Usually by contact with infected poultry; avian viruses may be shed in respiratory secretions and feces | Avian influenza viruses can cause conjunctivitis, human influenza-like illness, or severe disease with multiorgan dysfunction, death; severity of disease varies with influenza strain |
—Swine influenza | Influenza A virus (family Orthomyxoviridae, genus Influenzavirus A); swine influenza viruses | Usually in pigs; also turkeys; can infect mink, ferrets | Worldwide | Usually by contact with infected animals; swine influenza viruses occur in respiratory secretions | Seems to resemble human influenza; severity of disease varies; fatal cases have been reported uncommonly |
Japanese encephalitis (Japanese B encephalitis) | Japanese encephalitis virus (family Flaviviridae, genus Flavivirus) | Swine, wild birds are important maintenance hosts; horses ill but epidemiologically unimportant in amplification; other mammals, reptiles, amphibians may be infected, usually asymptomatically | Asia, Australia, Papua New Guinea, Pacific islands from Japan to the Philippines | Mosquito bites (Culex tritaeniorhynchus) important in maintenance cycle, other Culex and Aedes spp can transmit); also through broken skin or mucous membranes after direct contact with infected tissues | Fever, chills, myalgia, severe headache, GI symptoms; can progress to severe encephalitis; neurologic sequelae very common in survivors of encephalitis; case fatality rate 15%–30% |
Kyasanur Forest disease | Kyasanur Forest virus (family Flaviviridae, genus Flavivirus) | Rodents, shrews, other small mammals might be reservoirs (uncertain); affects monkeys; possible infections in other mammals, birds | India | Tick bites (especially Haemaphysalis spinigera, also others) | Nonspecific febrile illness; course may be biphasic; hemorrhagic signs (eg, ecchymoses, purpura, petechiae, GI bleeding, epistaxis) and/or neurologic signs possible in second stage; prolonged convalescence in many; case fatality rate ~3% |
Lassa fever | Lassa virus (family Arenaviridae, genus Arenavirus) | Wild rodents, usually multimammate mouse | West Africa | Contact with rodent excretions, secretions, or tissues; aerosols | Gradual onset of nonspecific febrile illness, may be followed by chest pain, cough, GI signs, hepatitis; severe swelling of head and neck, hypotension/shock can develop; pleural/pericardial effusions; hemorrhagic syndrome less common; overall mortality rate 1% in endemic areas; case fatality rate 20% among hospitalized patients |
Louping ill (Ovine encephalomyelitis, see Louping Ill Louping Ill ) | Louping ill virus (family Flaviviridae, genus Flavivirus) | Sheep, goats, also in llamas, cattle, horses, other domestic and wild mammals, grouse, ptarmigan | UK, Northern Ireland; also reported in Norway, Spain; uncommon in people | Tick bites (Ixodes ricinus); aerosol exposure in laboratory, contamination of skin wounds, contact with infected animals; possibly ingestion of milk | Biphasic influenza-like illness, sometimes followed by meningitis or meningoencephalitis, paralysis, joint pain in second phase; not usually fatal |
Lymphocytic choriomeningitis | Lymphocytic choriomeningitis virus (family Arenaviridae, genus Arenavirus) | Reservoir mainly house mouse; can be maintained in some other mice, hamster populations; also infects guinea pigs, chinchillas, rats, nonhuman primates, some other mammals | Worldwide | Contact with host excretions and secretions; bites; possibly ingestion | Ranges from mild flu-like illness to biphasic with meningitis in second phase; complications (eg, arthritis, parotitis, orchitis) possible; can cause congenital defects (CNS defects, chorioretinitis, and other ocular lesions) or abortion; rarely fatal in immunocompetent (overall case fatality rate < 1%) |
Marburg hemorrhagic fever | Marburg virus (family Filoviridae, genus Marburgvirus) | Bats are reservoir hosts; primates can be infected | Africa | Contact with infected tissues (especially nonhuman primates); probable transmission from bats in caves | Initially nonspecific febrile illness; maculopapular rash with desquamation; hepatitis; mild to severe bleeding tendency develops a few days after onset; mortality rate 20%–88%, varies with isolate |
Menangle virus infection | Menangle virus (family Paramyxoviridae) | Fruit bats are normal reservoir host; pigs can also be reservoir | Australia | Close direct contact with tissues, amniotic fluid or blood of pigs reported in human cases | Severe illness with fever, severe headache, myalgia, lymphadenopathy, drenching sweats, macular rash |
Middle East respiratory syndrome (MERS) | MERS coronavirus | Unknown reservoir host, possibly bats; source of infection for people uncertain, camels implicated | Middle East | Pneumonia, more likely in people with coexisting illness or immunosuppression but also in healthy; ~50% of known cases were fatal | |
Pseudocowpox virus (family Poxviridae, genus Parapoxvirus) | Cattle | Worldwide | Skin contact (especially broken skin) with lesions on cow’s udder or mouth of calf; also from fomites | Papular to nodular red skin lesions; self-limiting | |
Monkeypox | Monkeypox virus (family Poxviridae, genus Orthopoxvirus); Congo Basin clade causes more severe illness than West African clade | Nonhuman primates, some wild and pet rodents, including Gambian rats, dormice, prairie dogs, African squirrels, some other mammals such as opossums; full host range uncertain | West and central Africa | Contact with lesions, blood or body fluids, fomites; bites; aerosols during close contact | Smallpox-like disease; flu-like symptoms followed by maculopapular rash, which develops into vesicles, pustules, scabs; lymphadenopathy prominent; respiratory signs, encephalitis possible; case fatality rate varies with strain, < 1% to 10%–17% or higher; milder in those vaccinated for smallpox |
Murray Valley encephalitis | Murray Valley encephalitis virus (family Flaviviridae, genus Flavivirus) | Wild water birds | Australia, New Guinea | Mosquito bites (Culex annulirostris) | Asymptomatic or mild nonspecific febrile illness in majority; encephalitis, often with neurologic sequelae, or poliomyelitis-like flaccid paralysis in small number of patients; case fatality rate 15%–30% in encephalitic form |
Newcastle disease | Newcastle disease virus/Avian paramyxovirus 1 (family Paramyxoviridae, genus Avulavirus) | Domestic and wild birds | Mildly virulent (lentogenic, mesogenic strains) are found worldwide; highly virulent (velogenic) strains found in Asia, the Middle East, Africa, Central and South America, parts of Mexico; also in cormorants in USA | Occupational exposure, usually after contact with large amounts of virus | Highly virulent (velogenic) strains can cause self-limiting conjunctivitis, possibly other syndromes |
New World hemorrhagic fever (Argentinean, Bolivian, Venezuelan and Brazilian hemorrhagic fevers [HF]) | Arenaviruses in Tacaribe complex (family Arenaviridae, genus Arenavirus): Juin virus (Argentine HF), Machupo virus (Bolivian HF), Guanarito virus (Venezuelan HF), Sabiá virus (Brazilian HF), Chapare virus; possibly others | Rodents | South America, related viruses might exist among rodents in Mexico | Viruses found in rodent excretions, secretions, tissues; inhalation of aerosolized virus or direct contact with mucous membranes or broken skin | Gradual onset of nonspecific signs, including myalgia, headache, and fever; may develop petechial or ecchymotic hemorrhages, bleeding, CNS signs, hypotension/shock; case fatality rate in untreated Bolivian hemorrhagic fever 5%–30%, untreated Argentine hemorrhagic fever 15%–30% |
Nipah virus infection ( see Nipah Virus Infection Nipah Virus Infection ) | Nipah virus (family Paramyxoviridae, genus Henipavirus) | Fruit bats are normal reservoir; swine can be reservoir; occasionally in other mammals (spillover hosts) | Malaysia, Bangladesh, and Northern India; virus is probably endemic in southeast Asia, but outbreaks seem to cluster in certain geographic areas | Direct contact with infected pigs or contaminated tissue; direct or indirect (eg, contaminated fruit juice) bat-to-human transmission | Initial signs flu-like with fever, headache, myalgia, sometimes vomiting; encephalitis and meningitis; respiratory disease, including acute respiratory distress syndromes in some; septicemia; other complications in severely ill; case fatality rate 33%–75% |
Omsk hemorrhagic fever | Omsk hemorrhagic fever virus (family Flaviviridae, genus Flavivirus) | Voles, muskrats; also found in other animals | Siberia | Tick bites (Dermacentor spp); direct contact with body fluids or carcasses of muskrats and possibly other animal hosts | Biphasic febrile illness with headache, GI signs, ± hemorrhages (nose, gums, lungs, uterus); CNS signs in minority of patients; mortality rate < 3% |
Powassan virus encephalitis | Powassan virus (family Flaviviridae, genus Flavivirus); two closely related lineages in different reservoirs | Rodents (groundhog, squirrels, mice) and other small mammals thought to be reservoirs | North America, eastern Russia | Ixodes spp ticks, also found in Dermacentor andersoni | Nonspecific febrile illness; may progress to neurologic signs, which may be severe; some cases fatal |
Lyssaviruses:rabies virus (family Rhabdoviridae, genus Lyssavirus) and the related lyssaviruses, Duvenhage virus, Mokola virus, Australian bat lyssavirus, European bat lyssaviruses 1 and 2, Irkut virus, possibly others | Wild and domestic canids, Mustelidae, Viverridae, Procyonidae, and order Chiroptera (bats) are important reservoir hosts; all mammals are susceptible; bats are reservoir hosts for Duvenhage virus, Australian bat lyssavirus, and European bat lyssaviruses; Mokola virus carried in rodents and shrews | Rabies is worldwide with some exceptions: completely absent from some islands; countries also considered rabies-free if no cases in people or domestic animals for 2 yr; rabies-related lyssaviruses found only in Eastern Hemisphere (distribution varies) | Bites of diseased animals; aerosols in closed environments | Paresthesias or pain at bite site; nonspecific prodromal signs such as fever, myalgia, malaise; mood changes progress to paresthesias, paresis, seizures, and many other neurologic signs; survival in clinical cases thought to be very rare | |
Rift Valley fever ( see Rift Valley Fever Rift Valley Fever ) | Rift Valley fever virus (family Bunyaviridae, genus Flavivirus) | Sheep, goats, cattle, buffalo, African buffalo, camels, nonhuman primates; squirrels and other rodents; puppies and kittens | Africa, foci on Arabian peninsula, Indian subcontinent | Mosquito bites (Aedes spp and Culex triteniorynchus); contact with tissues | Influenza-like febrile illness in most; complications, including hemorrhagic fever, meningoencephalitis in < 5%; ocular disease in 1%–10%; other syndromes include acute renal failure or thrombosis; death uncommon except with hemorrhagic syndrome |
Ross River virus infection, Ross River fever; epidemic polyarthritis | Ross River virus (family Togaviridae, genus Alphavirus) | Marsupials, including wallaby, brushtail possum, might be natural hosts; dusky rat also proposed; people, horses, ruminants, pigs, rabbits, other mammals (minor hosts) may also be a source of virus during epidemics | Australia, South Pacific Islands | Mosquito bites (especially Culex annulirostris and Aedes spp) | Mild fever, arthralgia ± arthritis, headache, rash; small joints most affected but large joints can also be involved; arthralgia, myalgia, lethargy may persist for months |
St. Louis encephalitis | St. Louis encephalitis virus (family Flaviviridae, genus Flavivirus) | Wild birds, domestic fowl; rodents, bats, other mammals might also maintain viruses in South America | Western hemisphere | Mosquito bites (Culex tarsalis, C pipiens-quinquefasciatus complex, C nigripalpus, also reported in other genera) | Flu-like illness sometimes followed by meningitis or encephalitis, focal neurologic signs, dysuria; more severe in elderly and those with debilitating diseases; case fatality rate of 5%–20% reported in epidemics |
Severe acute respiratory syndrome (SARS) | SARS coronavirus (family Coronaviridae, genus Coronavirus) | Bats are thought to be reservoir hosts; can also infect palm civets, raccoon dogs, cats, pigs, ferrets, rodents, nonhuman primates, other mammals | China, southeast Asia | Contamination of mucous membranes with respiratory droplets or virus on fomites; possibly aerosol transmission | Fever, myalgia, headache, diarrhea, cough; viral pneumonia with rapid deterioration; case fatality rate 15% |
Sindbis virus disease | Sindbis virus (family Togaviridae, genus Alphavirus) | Birds (passeriforms suspected as main reservoirs/amplifying hosts); occasionally found in other vertebrates | Virus widespread in Eastern hemisphere; human cases tend to occur in limited geographic regions | Mosquito bites; Culex and Culiseta, also others | Fever, arthritis, rash, prominent myalgia; nausea, vomiting, mild jaundice in some; joint pain can persist for months; seems to be mild or asymptomatic in most children; no fatal cases reported |
Tanapox | Tanapox virus (family Poxviridae, genus Yatapoxvirus); Yaba-like disease virus may be a variant of tanapox virus | Nonhuman primates | Asia, Africa, and in monkey colonies | Direct contact through broken skin; mosquitoes suspected to be vector in Africa | Nonspecific febrile illness and papulovesicular or nodular lesions (lesions may be pruritic or tender), often on extremities; more than one or two skin lesions uncommon |
Tickborne encephalitis (Far eastern tickborne encephalitis, Russian spring-summer encephalitis, Central European tickborne encephalitis) | Tickborne encephalitis virus (TBEV) (family Flaviviridae, genus Flavivirus); three subtypes: European (TBEV-Eu [least virulent]), Siberian (TBEV-Sib), Far Eastern (TBEV-FE) | Small mammals especially rodents; also in goats, sheep, dogs, and other mammals; birds | Eurasia; TBEV-Eu mainly Europe to former USSR; TBEV-FE mainly Asia to former USSR; TBEV-Sib mainly in Siberia | Tick bites (mainly Ixodes ricinus and I persculatus; also other species); may be ingested in milk | Often biphasic, with flu-like febrile illness in initial stage; neurologic signs from mild meningitis to severe encephalitis in some; myelitis or flaccid poliomyelitis-like paralysis (usually arms, shoulders, levator muscles of head); possibility of chronic and progressive forms, especially with TBEV-Sib; case fatality rate < 2% (TBEV-Eu), 2%–3% (TBEV-Sib); case fatality rate 20%–30% in TBEV-FE may be based on severe cases |
Usutu virus infections | Usutu virus (family Flaviviridae, genus Flavivirus) | Birds | Africa, Europe | Mosquito bites (Culex spp) | Very few cases identified: fever with rash, fever with jaundice, or meningoencephalitis |
Vaccinia-related poxviruses | Vaccinia or vaccinia-like viruses (family Poxviridae, genus Orthopoxvirus) of uncertain origin | Reservoir uncertain; found in wild rodents, cattle, horses, nonhuman primates | Appear to be endemic in Brazil | Direct contact | Pox skin lesions (papules, pustules, ulcerative nodules), may be accompanied by fever, lymphadenopathy |
Venezuelan equine encephalomyelitis | Venezuelan equine encephalitis virus (family Togaviridae, genus Alphavirus) | Enzootic subtypes maintained in rodents, other small mammals, bats; epizootic subtypes amplified in equids; occasionally in other mammals and birds | Western hemisphere; enzootic strains Florida to South America; epizootic strains emerge in South America, spread | Mosquito bites (Aedes, Culex, and Psorophora spp); exposure to aerosolized debris from infected laboratory rodents; laboratory accidents | Most have nonspecific febrile illness, can be followed by neurologic signs; < 5% children, < 1% adults progress to encephalitis with case fatality rate of 10%–35% (highest rates in children < 5 yr old) |
Vesicular stomatitis | Vesicular stomatitis Indiana virus, vesicular stomatitis New Jersey virus, vesicular stomatitis Alagoas virus, and Cocal virus (family Rhadboviridae, genus Vesiculovirus) | Swine, cattle, horses; occasionally in South American camelids, sheep, and goats; also rodents; serologic evidence of infection in many wild mammals, especially bats | North and South America; most likely not endemic north of Mexico but sporadic outbreaks | Contact with animals or in laboratory, probably also from insect bites, including mosquitoes and biting flies (Phlebotomus spp, Lutzomyia spp, and black flies) | Usually asymptomatic; may develop acute, febrile, flu-like illness; vesicles can be found in mouth, pharynx, or inoculation site (eg, hands); self-limiting |
Wesselsbron fever | Wesselsbron virus (family Flaviviridae, genus Flavivirus) | Ruminants, especially sheep, goats; also evidence of infection in other mammals, including lemurs; can infect birds | Southern Africa, southeast Asia | Mosquito bites (mainly Aedes spp, possibly others); also by contact with contaminated material | Nonspecific febrile illness ± maculopapular rash or ocular signs in some; few cases described but seems to be self-limiting |
West Nile fever and neuroinvasive disease ( see Equine Arboviral Encephalomyelitis Equine Arboviral Encephalomyelitis ) | West Nile virus (family Flaviviridae, genus Flavivirus); lineage 1 and lineage 2 viruses are both pathogenic | Birds are primary reservoir hosts; also affects horses, other mammals, alligators, possibly other reptiles and amphibians | Eastern and Western hemisphere | Mosquito bites (primarily Culex univittatus, Culex spp); also by handling infected birds or reptiles or their tissues | Nonspecific febrile illness, occasionally with rash; some cases progress to encephalitis, meningitis, and/or acute flaccid paralysis that resembles poliomyelitis; occasionally other syndromes; worse in elderly and immunocompromised; case fatality rate ~10% in all patients with neurologic disease, but higher in elderly |
Western equine encephalomyelitis ( see Equine Arboviral Encephalomyelitis Equine Arboviral Encephalomyelitis ) | Western equine encephalomyelitis virus (family Togaviridae, genus Alphavirus) | Birds are reservoir hosts, may also cycle in jackrabbits, rodents; equids, other mammals are incidental hosts; virus also found in reptiles, amphibians | Americas | Mosquito bites (Aedes, Culex, and Ochlerotatus spp); Culex tarsalis important in maintenance cycle in birds | Nonspecific febrile illness may be followed by encephalitis in infants and children, uncommonly in adults; case fatality rate 3%–4% |
Yellow fever | Yellow fever virus (family Flaviviridae, genus Flavivirus); only jungle cycle is zoonotic (people are reservoir for urban cycle) | Nonhuman primates | South America, Africa | Mosquito bites (Haemagogus spp and Sabethes spp in jungle cycles in South America, Aedes spp in jungle cycles in Africa) | Nonspecific, mild to severe febrile illness followed by liver and renal failure in some; hemorrhages (eg, epistaxis, hematemesis, melena, uterine hemorrhage) and often jaundice in severe cases; cases with hemorrhages often fatal |
Prion Disease | |||||
Variant Creutzfeldt-Jakob disease | Bovine spongiform encephalopathy prion | Cattle are most important host; also infects other ruminants, cats and other felids, lemurs | Most cases in the UK but also in many other countries | Ingestion of bovine products, especially those contaminated with CNS tissues | Neurodegenerative disorder similar to sporadic Creutzfeldt-Jakob disease but often in younger patients and progresses more rapidly; always fatal |
a Many proven zoonoses, including some relatively rare arthropodborne viral infections and helminth infections, have been omitted, as well as those diseases caused by fish and reptile toxins. | |||||
b Enterotoxigenic, enteroinvasive, enteropathogenic, and enteroaggressive strains are not considered zoonotic. |