Ornithosis is one of the so-called zoonoses – disease transmission between animals and humans is possible. However, people rarely get sick.
What is ornithosis?
Ornithosis is an infectious disease that occurs very rarely in humans. In many cases, ornithosis is caused by the so-called bacterium Chlamydia psittaci. See usvsukenglish for What does the abbreviation TIHP stand for.
The disease also owes its alternative name ‘psittacosis’ to this type of bacteria. In addition, ornithosis is sometimes also referred to as bird breeder’s lung or parrot disease. As an animal disease, ornithosis is subject to reporting within Germany.
The pathogens responsible for the disease first settle in organs such as the spleen and liver. Occasionally, due to this fact, slight symptoms of jaundice can occur, but these usually go unnoticed by the patient.
The first noticeable symptoms of ornithosis then usually resemble the symptoms caused by flu ; these include, for example, headaches and sore throats, colds and/or fever. In addition, ornithosis often leads to symptoms typically associated with pneumonia ; like, above all, a dry cough.
Causes
Most often, birds are responsible for the transmission of the pathogen that leads to ornithosis. Therefore, people who are often in contact with birds (such as animal keepers or employees in the pet shop) are particularly at risk.
Infection with germs responsible for ornithosis is possible both via direct contact and via droplet transmission (e.g. when cleaning out bird cages). Infectious germs enter the body of an affected person via the respiratory tract. Once the germs have penetrated the patient’s body, they multiply in the patient’s cells.
The incubation period (the period between infection with germs and the outbreak of the disease) of ornithosis is approx. 10 – 20 days.
Symptoms, Ailments & Signs
Ornithosis caused by the pathogen Chlamydia psitacci usually shows a sudden onset with high fever, headache and body aches as well as chills. Muscle pain is also part of the flu-like symptom complex. In the majority of those infected, an uncharacteristic rash develops on the body in the first few days of the illness. Some of the patients recover after this flu-like illness episode.
If this is not the case, interstitial pneumonia forms. It is not the functional tissue of the lungs that is affected by the inflammation, but the tissue between the alveoli. This is also referred to as atypical pneumonia. Those affected suffer from a dry and persistent dry cough, which is occasionally accompanied by pain in the chest. In the further course, the pneumonia can lead to hemoptysis, in which the patients cough up blood-containing secretions.
Many patients also complain of severe headaches as an accompanying symptom. In more than half of all patients with ornithosis, the spleen is swollen (splenomegaly), liver swelling, on the other hand, only occurs in exceptional cases. Another sign of illness that points to ornithosis is MALT lymphoma in the area of the tear ducts. It is a malignant disease of the lymphatic system.
Diagnosis & History
If the symptoms are appropriate, the fact that an affected person has frequent contact with birds can already give the first indications of the presence of ornithosis. However, the disease can also occur in people in whom a corresponding connection cannot be drawn directly.
X-rays of a patient’s chest, for example, are used for further diagnostics if ornithosis is suspected; if there is ornithosis, this can be recognized by the structures of the lungs. Laboratory values that indicate ornithosis include, for example, a slight increase in white blood cells.
The course of the disease of ornithosis varies depending on the patient and depends, for example, on the age and intactness of the immune system of the person affected. On average, there is a gradual reduction in fever during the fourth week of illness. The period of time until final recovery is influenced, among other things, by the severity of the symptoms and the start of treatment. If left untreated, severe forms of ornithosis in particular can lead to the death of the affected person.
Complications
In the case of the so-called parrot disease, the course of the underlying disease is already very stressful for those affected and is regularly accompanied by severe flu symptoms. Sometimes there are also disturbances of consciousness and severe gastrointestinal complaints. It is not uncommon for patients to develop pneumonia.
In addition, however, further complications only occur in particularly severe cases. In these cases, the pathogens spread throughout the body and also infect other organs. Then there is a risk of myocarditis (inflammation of the heart muscle) and in particularly severe cases, if the pericardium is also inflamed, perimyocarditis.
With these diseases, the patient suffers from shortness of breath, pain and feelings of pressure in the chest, especially behind the breastbone, as well as heart palpitations and cardiac arrhythmias. Due to the lack of oxygen, the lips, and sometimes the entire skin of the face, turn bluish. The liver and spleen may also enlarge.
Another rare complication is endocarditis. In this disease, the inner lining of the heart becomes inflamed, usually together with the heart valves. Those affected develop a high fever, chills and joint pain. The doctor can also often detect changed heart sounds. In addition, there is often a disruption in kidney function.
Occasionally, the pathogens that cause ornithosis also affect the central nervous system and cause meningitis (inflammation of the meninges). As a rule, however, such serious complications can only be expected if the ornithosis is not treated in good time or if the patient suffers from a severely weakened immune system.
When should you go to the doctor?
If symptoms such as body aches, greenish diarrhea and fever occur, ornithosis may be the cause. A doctor should be consulted if the symptoms persist over a long period of time, get worse quickly or seriously affect the well-being of the patient.
If there is already a concrete suspicion, for example if the symptoms occur after contact with a possibly infected animal, it is best to consult the general practitioner immediately. The symptoms may be due to an animal disease, which can be fatal if left untreated. Therefore, a doctor must diagnose ornithosis and, if necessary, refer the patient to a specialist.
The doctor will prescribe antibiotics for the patient, which should resolve the symptoms within two to three weeks. If the medication has no effect, it is advisable to visit the doctor again. A more in-depth investigation is necessary, especially if there are signs of hepatitis or cardiac arrhythmias. These symptoms indicate a severe course, which under certain circumstances can lead to cardiac arrest and thus death. Early treatment by the family doctor or a specialist in infectious diseases prevents a serious course. With children, the pediatrician should be consulted first.
Treatment & Therapy
The therapeutic treatment of ornithosis usually includes antibiotics as early as possible (antibiotics are used to specifically combat bacteria). Which type of antibiotic a treating doctor prescribes in individual cases against an existing ornithosis depends, among other things, on factors such as the constitution of the patient.
In the case of ornithosis, which is caused by the bacterium Chlamydia psittaci, doctors often advise taking antibiotics in the form of so-called macrolides or tetracyclines. These types of antibiotics tend to be particularly effective at fighting the bacterium responsible for ornithosis, which is characterized by growing and living inside a patient’s cells.
Macrolides and tetracyclines disrupt the protein balance of the bacterium Chlamydia psittaci, which subsequently cannot grow any further and dies. Depending on the symptoms, the administration of antibiotics can be supplemented in individual cases, for example by measures to alleviate acute symptoms (such as severe headaches).
Outlook & Forecast
With timely and also adapted therapy with the use of antibiotics, the prognosis of ornithosis is very good. Before the advent of antibiotic medication for this disease, the mortality rate was 15 to 20 percent. Since then, it has declined and is now less than one percent. Mild infections are often asymptomatic and heal well, but the disease can last for varying lengths of time due to the persistence of pathogens in certain retreats.
Severe infections, which also necessitate hospitalization, are usually fatal. It is important and necessary with ornithosis to carry out treatment with antibiotics to the end. Discontinuing therapy prematurely, which many patients tend to do when symptoms improve, can encourage a relapse. Treatment can only lead to a successful prognosis if it is carried out consistently. The medication is usually taken for a period of two to three weeks.
The possible symptoms associated with the disease, such as gastrointestinal complaints with abdominal cramps, diarrhea and vomiting or even atypical pneumonia, occur depending on the immune status and age of the patient and can also be easily controlled with appropriate medication. Here, too, the timely start of therapy is crucial for the prognosis.
Prevention
In particular, people who are frequently confronted with birds and/or bird droppings in their free time or at work recommend wearing respiratory protection in the case of animals that are known to be infected in order to prevent ornithosis. Despite respiratory protection, avoiding direct contact with the faeces of infected birds can also help to avoid ornithosis.
Aftercare
The aftercare aims, among other things, at everyday support and long-term treatment of the symptoms. However, both aspects have no relevance after a treated ornithosis. Those affected are completely healed. They return to their everyday lives. Statistically, less than one percent of those affected die from ornithosis in a short time.
Optionally, doctors close to the end of life can offer palliative aftercare. Within this period, those affected receive painkillers that allow them to have a symptom-free period. Elementary life questions can be discussed with a pastor or psychotherapist.
In addition, follow-up to prevent recurrence plays an important role. This is known, for example, from tumor diseases. Patients present at a certain rhythm that doctors use to look for new cancers. They expect the best possible options for action from a diagnosis in the early stages. Such a form of medical aftercare also plays no role in ornithosis.
Rather, those affected can avoid re-infection themselves. The doctor provides information about suitable preventive measures that the patient is responsible for implementing. Direct contact with bird faeces should be avoided. Careful personal hygiene is always recommended when dealing with birds.
You can do that yourself
The antibiotic treatment necessary for ornithosis can be supported by various measures, but cannot be replaced by them. The antibiotic should therefore be taken according to the instructions for successful treatment and should not be dosed or discontinued independently.
However, the symptoms of the respiratory disease that has developed can be counteracted with simple measures, just like with a cold or flu. These include, above all, regularly keeping the mucous membranes moist by inhaling salt water, warm foot baths to boost your own immune system, and cold calf wraps or compresses when you have a high fever. Likewise, it is necessary to drink enough and the dietparticularly rich in vitamins and low in calories and fat, especially in the severe phase of the disease. For example, hot ginger tea with honey, small fruit snacks and hot vegetable soups are ideal. The often-recommended chicken soup also makes sense, but there is still no reliable evidence of its immune-boosting effect.
The immune system can also be supported by sleep or rest. Prolonged movements as well as physical and psychological stress should be avoided. Short walks in the fresh air, on the other hand, are beneficial if you don’t have a fever. The sick room should also be ventilated regularly and, if necessary, the humidity should be increased with air humidifiers or water bowls.