Ornithosis

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Description

Ornithosis (meaning "bird disase", from Greek ornithos "bird") also called Psittacosis, Parrot Disease or Parrot Fever, is a serious human disease with mortality ranging from 1% when treated with antibiotics, to 20% when untreated. The bacteria (Chlamydia psittaci) invade people by breathing-in an invisible dust from infected birds. Most of the infected birds carry the disease without becoming sick and without any visible symptoms, a few die within three weeks. [1]

Causes

Although all birds can be carriers of this disease, parrots, parakeets, macaws, cockatiels, pigeons (widespread), turkeys, ducks, chicken, finches and canary birds have been most frequently involved in transmission to people, with parrots on top of this list, and canary birds at the bottom. Related diseases happen also among sheep and tortoises. Several cases of human-to-human infection have also been reported. The very same disease, when acquired from any kind of a parrots (order Psittaciformes) is called Psittacosis; when acquired from any other kind of bird, a generic name Ornithosis is used. [2] [3]

Symptoms

The symptoms start after 1-2 weeks of exposure, initially mildly, with subsequent aggravation. Initially symptoms may include: fever, shivering, sensitivity to light, muscle pains, bleeding from nose, abdominal pains, nausea or vomiting, restlessness. The second phase may include: endocarditis (inflammation of heart valves), hepatitis, painful coughing, severe pneumonia, acute respiratory distress syndrome (ARDS), and potentially deadly sepsis and septic shock (a whole-body inflammation). [4] [5]

Diagnosis

Diagnosis is possible (Levinthal-Cole-Lillie makrophages present) but in real life diagnosis is difficult, and likely to be mis-diagnosed as flu or pneumonia. According to CDC „since 1996, fewer than 50 confirmed cases were reported in the United States each year. Many more cases may occur that are not correctly diagnosed or reported.“ Larger outbreaks happen from time to time. Suspicion of psittacosis /ornithosis should be considered especially with the following symptoms on top of the forementioned: brachycardia (slow pulse) in spite of fever, enlargement of spleen. muscle aches with their tension, spots in the face skin. The increase in antibodies count, four-fold typically in psittacosis /ornithosis, may be misleadingly subdued by the use of antibiotics. [6] [7] [8]

Treatment

Treatment with antibiotics is almost always effective (with the exception of heart-valve inflammation, since heart valves themselves are not supplied with blood), unless treatment started too late. Doxycycline, Docycline hyclate administered intavenously in severe cases,Tetracycline hydrochloride, Chloramphenicol palmitate, have been successfully used. In very severe cases treatment should focus on supporting the vital functions. After recovering, the antibiotic treatment should continue for two weeks. [9] [10] [11]

Follow-up precautions

After returning home it is a good precaution to immediately and thoroughly wash (with bleach added to the water) the previously used bedding sheets and clothing. You can still have long-lasting effects on heart (myocarditis), joints (arthritis), brain (encephalitis, meningitis, paralysis) or eyes (keratoconjunctivitis). Those effects are rare, but this fact does not help those people who have them. Than think twice before approaching any bird, and especially before considering working in a pet store.

References

  1. http://www.cdph.ca.gov/healthinfo/discond/Pages/Psittacosis.aspx
  2. http://www.cdc.gov/osels/ph_surveillance/nndss/casedef/psittacosis_1996.htm Psittacosis (Chlamydia psittaci) (Ornithosis)
  3. http://www.cdph.ca.gov/healthinfo/discond/Pages/Psittacosis.aspx California Department of Health Psittacosis
  4. http://www.health.ny.gov/diseases/communicable/psittacosis/fact_sheet.htm Psittacosis (ornithosis, parrot fever, chlamydiosis)
  5. http://www.cdc.gov/osels/ph_surveillance/nndss/casedef/psittacosis_1996.htm Psittacosis (Chlamydia psittaci) (Ornithosis)
  6. http://www.health.ny.gov/diseases/communicable/psittacosis/fact_sheet.htm Psittacosis (ornithosis, parrot fever, chlamydiosis)
  7. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001152/ PubMed Health, Psittacosis, Ornithosis; Chlamydia psittaci
  8. http://www.patient.co.uk/doctor/Psittacosis.htm Patient.co.UK „Psittacosis“
  9. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001152/ PubMed Health, Psittacosis, Ornithosis; Chlamydia psittaci
  10. http://www.health.ny.gov/diseases/communicable/psittacosis/fact_sheet.htm Psittacosis (ornithosis, parrot fever, chlamydiosis)
  11. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001152/ PubMed Health, Psittacosis, Ornithosis; Chlamydia psittaci
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