Ornithosis (psittacosis) in children: causes, symptoms, diagnosis, treatment

Ornithosis (psittacosis) is an infectious disease caused by chlamydia and transmitted to humans from birds. Psittacosis is accompanied by symptoms of intoxication and lung damage.

ICD-10 code

A70 Infection caused by Chlamydia psittaci.

Epidemiology of ornithosis (psittacosis)

The natural reservoir of the infection is wild and domestic birds, mainly ducks, pigeons, seagulls, sparrows, parrots, in which the infection usually occurs in a hidden latent form. Epizootics among birds are possible. Trans-ovarian transmission of the pathogen to the offspring of infected birds is not excluded. Birds excrete the pathogen with feces and respiratory secretions. The main route of transmission is airborne and airborne dust. Children become infected through contact with indoor (parrots, canaries, bullfinches, etc.) and domestic birds (ducks, chickens, turkeys, etc.). In large cities, pigeons are especially dangerous, as they pollute balconies, cornices, and window sills with feces.

Sporadic incidence is usually recorded among children, but epidemic outbreaks are also possible in organized children's groups if sick ornamental birds are kept in the premises.

Susceptibility to ornithosis is high, but the exact incidence has not been established due to the difficulty of diagnosis.

Classification

There are typical and atypical forms of ornithosis (psittacosis). Typical cases include cases with lung damage, atypical cases include latent (like ARVI), subclinical (without clinical manifestations) forms, as well as ornithosis meningoencephalitis.

Typical ornithosis can be mild, moderate or severe.

The course of ornithosis can be acute (up to 1-1.5 months), protracted (up to 3 months), chronic (more than 3 months).

Pathogenesis of ornithosis (psittacosis)

The infection penetrates through the respiratory tract. The pathogen reproduces in the cells of the alveolar epithelium, epithelial cells of the bronchioles, bronchi and trachea. The consequence may be the destruction of the affected cells, the release of the pathogen, its toxins and products of cellular decay, which, entering the blood, cause toxemia, viremia and sensitization. In severe cases, hematogenous introduction of the pathogen into the parenchymatous organs, the central nervous system, myocardium, etc. is possible. In patients with impaired reactivity, the elimination of the pathogen is often delayed. It remains for a long time in the cells of the reticuloendothelium, macrophages, epithelial cells of the respiratory tract. Under unfavorable conditions for microorganisms, the pathogen can enter the blood, which causes a relapse or exacerbation of the disease.

In the pathogenesis of ornithosis, secondary bacterial flora is important, so the process often occurs as a mixed viral-bacterial infection.

Symptoms of ornithosis (psittacosis)

The incubation period of ornithosis (psittacosis) is from 5 to 30 days, on average - about 7-14 days. Ornithosis (psittacosis) begins acutely, with an increase in body temperature to 38-39 ° C, less often - up to 40 ° C, headaches and muscle pain, often chills. Dry cough, sore throat, hyperemia of the mucous membranes, oropharynx, injection of the vessels of the sclera and conjunctiva, hyperemia of the face, general weakness, insomnia, nausea, sometimes vomiting are noted. Fever is remittent or constant. A maculopapular or roseolous allergic rash sometimes appears on the skin. Changes in the lungs progressively increase. Initially, signs of tracheobronchitis are detected. and from the 3rd to the 5th day, less often from the 7th day of illness, small focal, segmental or confluent pneumonia forms mainly in the lower parts of the lungs.

In the peripheral blood of uncomplicated ornithosis, leukopenia, aneosinophilia with lymphocytosis, and a moderate increase in ESR are noted.

X-ray examination reveals inflammatory foci in the root zone or central part of the lungs, on one or both sides.

Diagnosis of ornithosis (psittacosis)

Ornithosis can be suspected in a child if the disease developed after close contact with dead or sick birds and atypical pneumonia with a tendency to a prolonged sluggish course is detected.

For laboratory confirmation, the most important methods are PCR and ELISA.

Treatment of ornithosis (psittacosis)

For the treatment of ornithosis (psittacosis), macrolides are used in an age-appropriate dose for 5-10 days. In case of bacterial complications, cephalosporins and aminoglycosides are indicated. In severe cases of ornithosis, glucocorticoids are prescribed for a short course (up to 5-7 days). Symptomatic, stimulating treatment and probiotics (Acipol, etc.) are widely used.

Prevention of ornithosis (psittacosis)

It is aimed at identifying ornithosis in birds, especially those with which humans are in constant contact (economic and decorative). Quarantine measures are important in poultry farms affected by ornithosis, as well as veterinary supervision of imported poultry. In the system of preventive measures, it is crucial to educate children in sanitary and hygienic skills when caring for decorative birds (pigeons, parrots, canaries). A patient with ornithosis is subject to mandatory isolation until complete recovery. The patient's sputum and excrement are disinfected with a 5% solution of lysol or chloramine for 3 hours or boiled in a 2% solution of sodium bicarbonate for 30 minutes. Specific prophylaxis has not been developed.

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