Zoonoses and Allergens: What Every Technician Should Know

Transcription

1 Zoonoses and Allergens: What Every Technician Should Know 2012 AALAS District 5 Meeting Sarah Allison, DVM, DACLAM University of Illinois at Urbana-Champaign

2 What is a Zoonosis? O A disease that can be transmitted from animals to humans

3 Prevention O Most effective approach O Education O Exposure O Types of exposure O Nature and significance of risks O Appropriate first aid and follow up for potential exposure O Reinforce information

4 Prevention O Veterinary Programs O Comprehensive and responsive O All workers share responsibility for protecting their own health O Personal Hygiene O Involvement of researchers O Personal Protective Equipment (PPE) O Use when handling animals and their housing and bedding materials

5 PPE O Lab coat or dedicated uniform O Disposable gown or Tyvek O Gloves

6 PPE O Face protection O Head cap or bonnet O Shoe covers or dedicated shoes

7 Animal Sources O Animals may be obtained from a variety of sources that vary in health status O Commercial vendors O Provide high-quality laboratory animals of defined health status O Eliminate all or most zoonotic agents

8 Animal Sources O Research may require wild-caught or animals from an undefined source O No documented history O May introduce unique population of endogenous and acquired pathogens into facility

9 Bacterial Diseases

10 Campylobacteriosis O Campylobacter coli, C. fetus, C. jejuni O Description: Gram-negative, rod-shaped bacteria, microaerophilic O Reservoir O Pigs, chickens, sheep, dogs, cats, ferrets, hamsters, NHP O Transmission O Fecal-oral

11 Campylobacteriosis O Clinical Signs O Animals O None O Watery diarrhea; abortion and stillbirths; fever, anorexia, vomiting O People O None O Abdominal pain, fever, vomiting, diarrhea

12 Campylobacteriosis O Diagnosis and Treatment O Fecal culture, microscopic exam; ELISA O Supportive care- fluids, electrolytes O Control and Prevention O Good hygiene and sanitation O Detection and treatment of infected animals

13 Rat-Bite Fever O Streptobacillus moniliformis, gram negative rod O Spirillum minus, gram negative spiral shaped bacteria O Reservoir O Wild or laboratory rats, mice O Transmission O Bites

14 Rat Bite Fever O Clinical Signs O Animal O None O People O Chills, fever, headache, muscle pain, weakness, swollen lymph nodes (S. moniliformis) O Red to purple rash (S. minus)

15 Rat Bite Fever O Diagnosis and Treatment O Culture and isolation O Wash bite wounds O Penicillin or tetracycline O Tetanus prophylaxis O Control and Prevention O PPE, gloves, proper restraint techniques

16 Leptospirosis O Leptospira canicola (dogs) O L. hardjo, L. pomona (pigs, sheep, goats, gerbils, hamster, rarely NHP) O L. icterohaemorrhagia (rats) O L. interrogans serovar ballum (mice) O L. sejroe (dogs); O Spirochete bacteria

17 Leptospirosis O Transmission O Exposure to contaminated urine, placenta, fetal tissues O Inhalation O Oral ingestion O Skin abrasions

18 O Clinical Signs O Animals O Mice none Leptospirosis O Dogs fever, blood in urine, liver and kidney disease O Sheep and goats reproductive failure O Squirrel monkeys- icterohemorrhagic disease, with abortion

19 Leptospirosis O Clinical signs: People O Mild flu with fever, headaches, rash, muscle pain O Severe infection with involvement of liver, kidney, heart, brain O Diagnosis and Treatment O Demonstration of rising antibody titers in serological tests O ELISA, IFA tests O Dark-field microscopy, PCR (urine) O Antibiotics, possibly IV

20 Leptospirosis O Control and Prevention O Sanitation, waste control O Vaccination programs O Antibiotics for infected animals O Isolation and quarantine O PPE O Good hygiene

21 Salmonellosis O Salmonella enterica serovar Enteriditis O Salmonella enterica serovar Typhimurium O Facultative anaerobic gram-negative rod O Reservoir O Guinea pigs, mice, rats, chickens, pigs, sheep cats, rabbits, reptiles, NHP O Transmission O Fecal-oral

22 Salmonellosis O Clinical Signs O Animals O O None O Septicemia, diarrhea, gastroenteritis O Sheep abortion People O Gastroenteritis with diarrhea O Diagnosis and Treatment O Stool culture O Supportive care, fluids and electrolytes O Antibiotics controversial

23 Salmonellosis O Control and Prevention O Sanitation in animal housing O Animal waste disposal O Purchase of Salmonella free animals O PPE, gloves

24 Tuberculosis O Mycobacterium avium complex, M. bovis, M. tuberculosis O Acid-fast rod-shaped bacteria O Reservoir O NHP O M. tuberculosis, M. bovis dogs, cats, pigs O M. bovis sheep, goats O M. avium pigs, chickens, pigeons O Transmission O Fecal-oral O Inhalation of aerosols O Fomites

25 O Clinical Signs O Animals Tuberculosis O Asymptomatic to sudden death; pulmonary disease, anorexia, chronic weight loss, swollen lymph nodes (+/- draining tracts); abscesses O People O Chronic cough, blood-tinged sputum, fatigue, fever, weight loss

26 Tuberculosis O Diagnosis and Treatment O Intradermal skin test, PCR, chest x-rays, acidfast stain of sputum O Antimicrobials O Drug-resistant strains

27 Tuberculosis O Control and Prevention O Quarantine O Testing and elimination of infected animals O Continuous surveillance O NHP O Tuberculin testing for personnel O Good sanitation O Good hygiene O PPE, including respiratory tract protection

28 Viral Diseases

29 B-virus infection O Cercopithecine herpesvirus 1 O aka: Herpes B, alphaherpes virus O O Reservoir O Macaque monkeys Transmission O O O O O O Contaminated bites and scratches Splashes to mucous membranes Needle stick injuries Contamination of broken skin with body fluids of macaques Cuts from contaminated equipment Contact with unfixed tissues or primary cell culture material from macaques

30 B-virus infection O Clinical Signs O Macaque O Usually asymptomatic O Lesions in oral cavity and genitalia, conjunctivitis O People O Early stage: flu-like illness (fever, chills, nausea, vomiting, dizziness), headaches, sinusitis O Vesicles may form near skin wounds O Life-threatening progression altered vision, seizures, respiratory failure, death

31 B-virus infection O Diagnosis and Treatment O Serology, virus isolation, PCR O Prompt and sufficient disinfection of injury sites O Follow-up care with knowledgeable medical professional O Antiviral therapy O Control and Prevention O PPE O Protect eyes and mucous membranes from macaque secretions O Safe handling and restraint procedures

32 Hantavirus infection O Hantaan virus; Seoul virus O Bunyavirus O Reservoir: Rats and mice; other wild rodents O Transmission O Virus shed in urine, feces, saliva of persistently infected rodents for months O Inhalation of infective aerosols from rodent droppings O Wound contamination O Conjunctival exposure O Ingestion O Rat cell lines

33 Hantavirus Infection O Clinical Signs O Rodents O None O People O Signs related to strain of virus O Hemorrhagic Fever and Renal Syndrome (HFRS)-- Acute onset of fever, lower back pain, possible hemorrhage and kidney failure. O Hantavirus pulmonary syndrome (Sin Nombre Virus)--fever, muscle pain, gastrointestinal dysfunction, respiratory distress, death

34 Hantavirus Infection O Diagnosis and Treatment O ELISA, IFA, RT-PCR O IV fluids, bed rest, +/- IV antiviral medication O Control and Prevention O Good hygiene O Disinfection of contaminated waste and work surfaces O Respiratory tract protection O Exclude wild rodents from laboratory facilities O Screen rodents and rodent-derived cell lines

35 Lymphocytic Choriomeningitis Virus Infection (LCMV) O Arenavirus O Reservoir O Mice (Athymic and SCID), rats, hamsters, guinea pigs, NHP O Transmission O Parenteral inoculation, ingestion, inhalation, splash contamination of mucous membranes with infective secretions (urine, feces, saliva) O Contact with contaminated bedding O Immortalized hamster cell lines

36 Lymphocytic Choriomeningitis O Clinical Signs O Animals Virus Infection O Depends upon age, strain and dose of virus, route of inoculation O People O None O Flu-like illness with fever, headache, muscle pain; can progress to meningitis O Hazard for pregnant women

37 Lymphocytic Choriomeningitis Virus Infection O Diagnosis and Treatment O Serology O Supportive care O Control and Prevention O Exclude wild rodents from facilities O Screen rodents O Test rodent-derived cell lines O PPE, gloves for handling rodents and their tissues

38 Rabies O Rhabdovirus O Reservoir O Dogs, cats, ferrets, livestock, NHP O Transmission O Bite of rabid animal O Inoculation of infective saliva into fresh wounds or mucous membranes

39 Rabies O Clinical Signs O Animals O Furious to paralytic depending on area(s) of CNS affected O People O Hydrophobia, agitation, confusion, ataxia, paralysis O Headache, fever, malaise, encephalomyelitis, and death due to respiratory paralysis

40 Rabies O Diagnosis and Treatment O Rabies observation of animals O Detection of viral antigen in brain by use of the direct fluorescent antibody test O Supportive care; no specific treatment guidelines.

41 Rabies O Control and Prevention O Vaccination of dogs, cats and ferrets O Quarantine, euthanasia, and diagnostic testing of animals with clinical signs O Consider pre-exposure immunization O Immediate and thorough post exposure wound disinfection O Post exposure prophylaxis and concurrent administration of rabies vaccine

42 Protozoal Diseases

43 Cryptosporidiosis O Cryptosporidium parvum, C. canis, C. felis O Coccidian protozoan O Reservoir O Cats, dogs, NHP, sheep, pigs, ferrets, chickens, frogs O Transmission O Fecal-oral, possibly airborne

44 Cryptosporidiosis O Clinical Signs O Animals O None O Intractable diarrhea O O People O None Severe in immunocompromised animals O Profuse, watery diarrhea O Protracted illness in immunocompromised persons

45 Cryptosporidiosis O Diagnosis and Treatment O Microscopic detection; intestinal biopsy; increase in serum antibody titers O Supportive care O Control and Prevention O PPE, sanitation, good hygiene

46 Toxoplasmosis O Toxoplasma gondii O Intracellular coccidian protozoa O Reservoir O Cats (definitive host); mice, rats, dogs, sheep, goats, pigs, chickens (intermediate hosts) O Transmission O Fecal-oral, ingestion of infective oocysts from sources contaminated with cat feces

47 Toxoplasmosis O Clinical Signs O Animals O O O People O O None in adult cats (usually) Abortions and stillbirths in sheep, goats, and pigs Asymptomatic to mild flu-like illness O Can progress to more serious signs including fever, pneumonia, lymphadenopathy, chorioretinitis Severe illness in immunosuppressed and pregnant women

48 Toxoplasmosis O Diagnosis and Treatment O Clinical signs of disease, detection of increased titers, isolation of T. gondii from blood or bodily fluids O No treatment recommended, unless immunosuppressed with symptoms

49 Toxoplasmosis O Control and Prevention O Feed cats commercial cat food O Dispose of cat feces daily O House cats indoor and away from other species O PPE, gloves, good hygiene

50 Fungal Disease

51 Dermatomyphtosis O Saprophytic fungi O Trichophyton mentagrophytes guinea pigs, rabbits O T. verrucosum sheep and goats O Microsporum canis guinea pigs, rabbits, cats, dogs, NHP O Transmission O Direct contact with skin lesions O Spores persist in environment

52 Dermatophytosis O Clinical Signs O Animals O None O Lesions may be on or about the head, patchy areas of hair loss, redness, crust possible, itchy

53 Dermatophytosis O Clinical Signs O People O Flat, spreading, ring-shaped lesions O Margin is reddish, vesicular, or pustular and may be dry and scaly with crusts

54 Dermatophytosis O Diagnosis O Appearance of characteristic lesions O Fluourescence under UV light (M. canis only) O Skin scrapings mounted in 10% KOH O Culture on fungal media

55 Dermatophytosis O Treatment O Thorough bathing with soap and water O Daily topical application of fungicide O +/- systemic fungicides O Control and Prevention O PPE, gloves, sanitation

56 O Know your risks Summary O Consult health care provider and occupational health service with any concerns O Report exposures O Follow up O PPE O Hygiene O Sanitation

57 Laboratory Animal Allergy

58 Laboratory Animal Allergy (LAA) O Significant, occupational disease O May affect up to one-third of personnel exposed to laboratory animals O 10% eventually develop occupation-related asthma O Higher risk O Up to 73% with pre-existing allergies develop LAA

59 Who is at risk? O Technicians O Researchers O Veterinarians O Others with prolonged, close association with animals or their secretions O Those who handle bedding/food

60 LAA O Classic IgE mediated reaction O Exposure to allergen O Allergen processed by immune cells O Sensitization O Allergen binds to IgE molecules O Release of histamine and other chemical mediators O Mediators causes symptoms

61 LAA: Symptoms O Nasal O Itchy eyes O Rashes O Occupation-related asthma O Cough O Wheezing O Shortness of breath O Chronic symptoms

62 LAA: Symptoms O Hives O Allergen(s) in direct contact onto skin O Scratches by dogs and cats O Latex gloves O Anaphylaxis O Itching, hives, swelling of face, lips, tongue, difficulty breathing O Rarely, sensitized to animal s saliva, develop anaphylaxis when bitten

63 How much exposure causes LAA? O LAA allergens are potent O Low levels of inhaled allergen, perhaps a few micrograms per year, may cause allergies O Nanogram amounts may cause symptoms in sensitized persons O Symptoms usually occur within minutes

64 Sources of allergens Rats urine and saliva Mice urine Guinea pig saliva, dander, urine, and fur

65 Sources of allergens Rabbit fur, minor components in urine and saliva Cat saliva, sebaceous glands of the skin Dog saliva, hair, skin Pig nitrogenous wastes

66 Exposure control O Prevent or minimize occupational exposure to laboratory animal allergens O Factors in allergic disease O Intensity or concentration of allergen exposure O Frequency O Duration O Routes of entry

67 Exposure control of occupational hazards O Engineering controls O Proper facility design O Ventilation O Administrative controls O Work practices O Training O PPE

68 Engineering controls O Material change or substitution O Animals, bedding O Process change or substitution O Automation (ie. robotics) O Cleaning methods O Avoid dry sweeping O Vacuum with HEPA

69 Engineering Controls O Isolation or enclosure O Filter tops O IVC O Use animal transfer or cage change stations O Cubicles or modules

70 Bedding Disposal O Transport dirty cages in closed system O Filter tops or enclosed cart O Drape with cover cloth or plastic sheet O Decontaminate before and after use O Keep activity in room to minimum O Avoid rapid arm movements O Keep doors shut O Leave on for 5 minutes after use

71 Administrative Controls O Facility zoning O Animal Density O Job rotation O Proper use and maintenance of equipment O Good housekeeping O Personal hygiene O Proper handling of waste and contaminated clothing O Training and education

72 PPE O Goal is to limit exposure to you and those around you O Gown, lab coat, or uniform O Hair bonnets O Gloves O Shoe covers O Remove PPE in the animal room or facility

73 PPE O Respiratory Protection O Dust/mist masks O Full face mask with HEPA filter O PAPR

74 PPE O Work Practices O Avoid wearing street clothes while working with animals O Leave work clothes at the workplace to avoid potential exposure problems for family members O Proper personal hygiene (hand washing, showering) after exposure

75 Summary O Know the potential risks O Follow recommendations for work practices and PPE O Know the symptoms O Contact OHS and health care provider for evaluation