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Zoonotic Disease Considerations for Murine Typhus
Principal Animal Hosts: Rats, cats, opossums
Clinical Disease in Animals: Asymptomatic
Probable Mode of Transmission: Infected rodent fleas; possibly cat fleas
Known Distribution: Worldwide
Rickettsialpox
Treatment: Tetracycline 15mg/kg/day in four divided doses x 3-5 days duration
Zoonotic Disease Considerations for Rickettsialpox
Principal Animal Hosts: Mice
Clinical Disease in Animals: Asymptomatic
Probable Mode of Transmission: Bite of infected rodent mites, Liponyssoides spp
Known Distribution: Eastern USA, Africa, and Russia; rare
Patient Education
Medications: Avoid taking doxycycline with iron, milk or milk products, multivitamins or antacids, and avoid
the sun. Tetracyclines are often associated with mild gastritis and gastrointestinal upset. Take with food to
help with this symptom. Avoid sulfa medications during this illness as they can make symptoms worse.
Prevention and Hygiene: Avoid ticks and control fleas, lice and rats (see Preventive Medicine chapter).
Follow-up Actions
Evacuation/Consultation criteria: Evacuate unstable patients and those unable to complete the mission,
including those with RMSF. Consult infectious disease or primary care physician for RMSF cases and as
needed.
ID: Q fever
COL Naomi Aronson, MC, USAIntroduction: Q fever is caused by Coxiella burnetii, a rickettsia that infects sheep, cattle, goats, and
occasionally cats. Humans are infected by ingesting infected raw milk or by inhaling droplets or contaminated
dust. Tick bite and blood transfusion are rare methods of infection. The incubation period is 9-28 days.
Chronic infections cause hepatitis and sometimes jaundice.
Subjective: Symptoms
Constitutional Acute (1-7 days): Sweats, chills, fever (abrupt onset), severe retro-orbital headache,
myalgias, malaise Chronic (> 3 weeks): Fever continues if endocarditis develops
Specific Sub-acute (8-20 days): Non-productive cough; 1% have neurologic symptoms-weakness,
meningitis, sensory loss, paresthesias
Focused History: In the past month have you had exposure to a pregnant animal that gave birth? Been
working closely with ill animals? Have you ingested unpasteurized milk? Have you recently had a tick bite?
(all affirmative suggests exposure)
Objective: Signs
Using Basic Tools:
Inspection Acute(< 1 week): Fever to 104°F Chronic (>3 weeks): If fever persists 3 weeks, r/o endocarditis
(rare): check for embolic events (splinter hemorrhages, Roth spots [advanced tools], Osler nodes), clubbed
fingers
Auscultation Acute(< 1 week): Inspiratory crackles Chronic (>3 weeks): Diastolic murmur of aortic