Bacteria
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PATHOGENICITY:
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CONTAINMENT
REQUIREMENTS:
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MODE OF TRANSMISSION:
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Campylobacter
Jejuni
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Acute enteric disease of variable
severity; diarrhea, abdominal pain,
malaise, fever, nausea and vomiting;
prolonged illness in up to 20% of
patients; blood in association with
mucus and WCBs present in liquid of
foul smelling stools; typhoidal-like
syndrome, reactive arthritis may occur ;
rare cases of febrile convulsions,
Guillain-Barré syndrome and meningitis
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Biosafety level 2 practices,
containment equipment
and facilities for activities
with clinical materials
known or potentially
infected and cultures;
animals biosafety level 2
facilities and practices
Allow aerosols to settle
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By ingestion of organisms in
undercooked food or in
unpasteurized milk or water; from
contact with infected pets
(puppies and kittens), farm
animals or infected infants;
possibly from
cross-contamination from these
sources to foods eaten
uncooked or poorly refrigerated
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Escherichia
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Hemorrhagic colitis, intestinal disease
accompanied by cramps and abdominal
pain; initially watery, followed by bloody
diarrhea; low grade fever; last about 8
days; 5-10% of hemorrhagic colitis
victims may develop hemolytic uremic
syndrome (HUS); affects all ages,
higher death rates occur in elderly and
young; can cause thrombocytopenic
purpura (TTP) in elderly
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Biosafety level 2 practices,
containment equipment
and facilities for activities
involving cultures and
infected clinical materials
Allow aerosols to settle
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Ingestion of contaminated food
(undercooked hamburger meat,
unpasteurized milk); fecal-oral
transmission; person-to-person
transmission (extremely high)
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Salmonella
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Salmonellosis is an acute
gastroenteritis; acute infectious disease
with sudden onset of abdominal pain,
diarrhea, nausea and vomiting;
dehydration may be severe in infants
and elderly; deaths are uncommon
except in very young or very old or
debilitated/immunocompromised;
morbidity may be high; food borne
disease; may progress to more serious
septicemia, includes focal infections,
abscesses, endocarditis, pneumonia;
may also cause typhoid like enteric
fever; some cases develop reactive
arthritis (Reiter's syndrome) which may
become chronic
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Biosafety level 2 practices,
containment equipment
and facilities for activities
with clinical materials
known or potentially
infected and cultures
Allow aerosols to settle
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By ingestion of directly or
indirectly contaminated food,
from infected animals or food by
infected animal or person; from
animal feeds and fertilizers
prepared from contaminated
meat scraps; fecal-oral
transmission from person to
person; direct contact with pets
such as reptiles, birds, turtles,
tortoises
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Shigetla
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Acute disease of large and small
intestine; diarrhea, fever, nausea, and
sometimes toxemia, vomiting, cramps
and tenesmus; stools contain blood,
mucus and pus; alterations in
consciousness may occur; mild and
asymptomatic infections occur; severity
of illness depends on host, dose and
serotype - S. dysenteriae infections
have up to 20% case fatality rate in
hospitalized patients, while S. sonnei
infections have negligible fatality rate;
S.flexneri precipitate reactive arthritis
(Reiter's syndrome) in some patients
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Biosafety level 2 practices,
containment equipment,
and facilities for all
activities utilizing known or
potentially infectious
clinical materials or
cultures; animal biosafety
level 2 facilities and
practices for activities with
experimentally or naturally
infected animals
Allow aerosols to settle
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By direct or indirect fecal-oral
transmission from a patient or
carrier; poor hygiene practices
spread infection to others by
direct physical contact or
indirectly by contaminating food;
water, milk, cockroach, and
fly-borne transmission may occur
as the result of direct fecal
contamination; sexual
transmission in homosexual men
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Vibrio
Cholerae
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Symptoms range from asymptomatic to
cholera gravis. Acute bacterial enteric
disease with sudden onset, profuse
watery stools, occasional vomiting,
rapid dehydration, acidosis and
circulatory collapse; in severe
untreated cases, death may occur
within a few hours, case fatality rate
exceed 50%; with proper treatment rate
is below 1%; pathogenic non O1/O139
strains produce a self-limiting
gastroenteritis
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Biosafety level 2 practices,
containment equipment
and facilities for activities
with cultures or potentially
infectious clinical materials;
animal biosafety level 2
practices and facilities for
activities with infected
animals
Allow aerosols to settle
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Primarily through ingestion of
water contaminated with feces or
vomitus of patients; ingestion of
food which had been
contaminated by dirty water,
feces, soiled hands or flies
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Viruses
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Entroviruses
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Sudden onset of pain or the sensation
of a foreign body in the eye;
progresses rapidly; swollen eyelids,
phobophobia, hyperemia of the
conjunctivae, seromucous discharge,
subconjunctival haemorrhages; 60-90%
of cases have haemorrhages in both
eyes and vary in size, large
haemorrhages resolves in 7-12 days;
rarely systemic and upper respiratory
infection; fever and headache in 20% of
cases; course of inflammatory is 4-6
days; self-limiting and symptoms
resolve in 1-2 weeks; very rarely
polio-like paralysis
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Biosafety level 2 practices,
containment equipment
and facilities for activities
with infected materials and
cultures
Allow aerosols to settle
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By direct or indirect contact with
discharge from infected eyes;
person-to-person transmission
with high attack rates in families;
large epidemics associated with
overcrowding and low standards
of hygiene
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Poliovirus
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Coxsackievirus
es
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Both groups are associated with many
diseases; vesicular pharyngitis
characterized by an abrupt onset of
fever, sore throat, anorexia, disphagia,
vomiting and small, discrete vesicular
lesions in the oral regions, most
frequent in children and usually
self-limited; vesicular stomatitis differs
from vesicular pharyngitis by the more
diffuse lesions in the oral region; acute
lymphonodular pharyngitis is
characterized by firm, raised lesions,
surrounded by a zone of erythema;
Group A viruses are associated with
aseptic meningitis, colds, acute
hemorrhagic conjunctivitis and acute
myocardiopathies and group B are
associated with acute myocarditis and a
polio-like paralysis
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Biosafety level 2 practices,
containment equipment
and facilities for all
activities involving known
or potentially infectious
materials
Allow aerosols to settle
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Direct contact with nasal and
throat secretions from an
infected person, fecal-oral route,
inhalation of infected aerosols
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Echovirus
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Most infections are subclinical; clinical
manifestations vary from mild to lethal
and acute to chronic; associated with
aseptic meningitis (mostly serotypes
2,5,6,7 and 9), muscle weakness and
paralysis, exanthems and enanthems,
pericarditis, myocarditis, common cold,
conjunctivitis and infantile diarrhea,
acute febrile respiratory illnesses
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Biosafety level 2 practices
and containment facilities
for all activities involving
the virus or work with
infectious body fluids or
tissues
Allow aerosols to settle
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Fecal-oral route
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Hepatitis A
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Many infections are asymptomatic;
abrupt onset with fever, malaise,
anorexia, nausea and abdominal
discomfort, followed within a few days
by jaundice; mild illness (1-2 weeks) to
severely disabling (6-9 months period);
convalescence is prolonged; low case
fatality rate and rare deaths usually in
older patients; prolonged, relapsing
hepatitis for up to 1 year occurs in 15%
of cases; no chronic (long term)
infections
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Biosafety level 2 practices
and containment for
activities with infected
materials; Animal Biosafety
level 2 for activities using
naturally or experimentally
infected chimpanzees
Allow aerosols to settle
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Person-to-person by faecal-oral
route; ingestion of contaminated
food (i.e., shell fish) and water;
rare instances of transmission by
blood transfusion from a donor in
the incubation period; hands
may play an important role in the
direct as well as the indirect
spread of HAV
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Norwalk and
Norwalk like
viruses
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Abrupt onset of diarrhea, vomiting,
non-bloody diarrhea and abdominal
cramps; 25-50% of affected persons
report myalgias, malaise, headache,
nausea and low-grade fever; illness
usually resolves within 24-48 hours;
fatality is associated with electrolyte
imbalance; symptoms can persist for up
to several weeks; higher risk of
symptomatic infection in individuals with
preexisting levels of antigen-specific
antibodies have been documented
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Biosafety level 2 practices
and containment
equipment for all activities
involving the virus or any
infectious or potentially
infectious body fluids or
tissues
Allow aerosols to settle
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Principally by fecal-oral route;
other documented sources
include water, food (particularly
shellfish and salads), aerosol
and fomites
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Reovirus
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Rotavirus
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Infects the mature villous epithelium of
the small intestine; characterized by
fever and vomiting, followed by a watery
diarrhea; occasionally associated with
severe dehydration and death in
children; neurologic abnormalities
ranging from aseptic meningitis to
subdural haemorrhage related to
electrolyte loss; infections in adults are
subclinical; local and systemic immune
responses are evoked; repeated
infections tend to be less severe than
the original infection
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Biosafety level 2 practices
and containment facilities
for all activities involving
virus and infectious body
fluids and tissues
Allow aerosols to settle
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Fecal-oral route;
person-to-person; contact with
respiratory secretions,
contaminated water, food or
other surfaces; contact with
fomites
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Helminth
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Hookworms
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Nematode
worms
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Tapeworms
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Ascaris Ova
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Helminthic infection of small intestine;
pulmonary manifestations may occur;
serious complications, including bowel
obstruction or obstruction of bile duct,
pancreatic duct and appendix; may be
fatal
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Biosafety level 2 facilities
and operational practices
for activities involving
infective stages;
hypersensitive individuals
should conduct work in a
biological safety cabinet to
avoid exposure to
aerosolized antigens
Allow aerosols to settle
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By ingestion of infective eggs
from soil contaminated with
human faeces or from uncooked
food contaminated with soil
containing infective eggs;
transmission of infection by dust
is also possible; fresh faeces do
not contain infective eggs
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flatworms
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protozoans
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Balantidium,
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Infection of colon characterized by
diarrhea or dysentery; accompanied by
abdominal colic, tenesmus, nausea,
and vomiting with bloody and mucoid
stools
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Biosafety level 2 practices
are recommended for
activities involving
infectious stages of the
parasite
Allow aerosols to settle
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Fecal-oral route; fecally
contaminated water is a major
mechanism of transmission
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Crytosporidium
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Characterized by profuse, watery
diarrhea, cramping, abdominal pains,
weight loss, anorexia, flatulence and
malaise; nausea, vomiting, fever and
myalgias may also be present;
symptoms are self-limiting in healthy
individuals; immunocompromised
patients including AIDS patients may
experience prolonged symptoms with
increasing severity
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Biosafety level 2 practices,
containment equipment
and facilities for all
activities involving known
or potentially infectious
materials
Allow aerosols to settle
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Fecal-oral route
(person-to-person,
animal-to-person, food and
waterborne transmission
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Entamoeba
histolyca
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Approximately 90% of most infections
are asymptomatic, only evidence may
be seroconversion; debilitated,
pregnant or immunocompromised
individuals may develop an abrupt
onset of fever, severe abdominal
cramps, profuse bloody diarrhea and
tenesmus; complications include
massive hemorrhage, peritonitis,
amebomas and liver abscesses
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Biosafety level 2 practices
and containment facilities
for activities involving the
infectious stages of the
parasite and the
manipulation of known or
potentially infectious
tissues or body fluids
Allow aerosols to settle
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Ingestion of fecally contaminated
water and food (raw vegetables),
oral-anal sexual contact; by
fecally contaminated hands of
foodhandlers
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Giardia lambia
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Varies from asymptomatic in most
individuals to a sudden onset of
diarrhea with foul-smelling,
greasy-looking stool that lacks mucous
and blood; associated with abdominal
cramps, bloating, fatigue and weight
loss; restricted to upper small intestine
with no invasion; normally illness lasts 1
- 2 weeks; chronic infections can last
months to years
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Biosafety level 2 practices
and containment facilities
are recommended for
activities with infective
stages of mammalian
Giardia spp. and infectious
body fluids and tissues
Allow aerosols to settle
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Person-to-person, faecal-oral
route is most important (hand to
mouth transfer of cysts); infected
food handlers; one person can
pass 106 cysts each day;
ingestion of fecally-contaminated
water and food are also
mechanisms for transmission,
found in soil and on surfaces;
anal intercourse also facilitates
transmission
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Toxoplasma
gondii
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Most infections are asymptomatic; mild
cases with a localized lymphadenopathy
accompanied with fever, sore throat,
rash, mimicking infectious
mononucleosis in some individuals;
immunocompromised host suffers from
widespread dessimination of the
infection with pneumonitis, myocarditis,
and encephalitis; some
immunocompetent individuals develop
severe symptoms; congenital cases can
result in abortion and stillbirth, live
births may result in severe central
nervous system involvement along with
chorioretinitis; transplacental infection
is least likely during 1st trimester, but
these cases are the most severe;
responsible for 35% of chorioretinits
cases in US and Europe
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Biosafety level 2 practices
and containment facilities
for activities involving
infectious stages of the
parasite; work should be
conducted in a biosafety
cabinet
Allow aerosols to settle
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Consuming undercooked
infected meats (pork, mutton,
beef); ingestion of infective
oocysts in milk, food or water;
inhalation of oocysts;
transplacental; contact with soil
containing infected cat feces;
transmission through blood
transfusions or organ
transplantations is possible
although rare; may be
transmitted to food by flies or
cockroaches; at least one
outbreak attributed to
contaminated water supply
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Fungi
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Aspergillus
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Variety of forms of infection depending
on species involved, i.e. aspergilloma,
aspergillosis pneumonia; aspergillosis
is characterized by pulmonary
infiltrates, eosinophilia and a rise in
IgG; immunosuppressed individuals are
prone to develop an acute pneumonia
with multifocal infiltrates expanding to
consolidation; dissemination to other
organs (eg. cardiac valve) is common;
most common cause of otomycosis;
clinical manifestation and severity are
largely determined by the general
immunologic state of the patient
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Biosafety level 2 practices
and containment facilities
for activities involving the
fungus or infectious body
fluids and tissues
Allow aerosols to settle
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Inhalation of airborne conidia
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