Sanitation and Disease Control (Advanced)

This Chapter Covers: Introduction Disease Transmission Methods to Reduce Disease Transmission Animal Management for Disease Control Factors in the Cleaning Process Cleaning and Sanitation Terms Key Chemical Agents Used in Shelter Sanitation Cleaning and Disinfecting Processes Pest Control Introduction There are several important reasons for establishing and maintaining a proper disease control program: it reduces animal and human disease transmission, creates a healthier living environment for the animals, improves the shelter's image, and increases employee morale and pride in their shelter. Place primary focus on a disease control program. A quality program is not cheap, but it is essential in order to protect the health of employees and the animals in their care. Additionally, a successful adoption program and public support cannot exist without a good disease control program. Zoonosis Control Division 9/03 Sanitation and Disease Control - 1

Animal care includes two large areas: animal management and sanitation. The animal control staff must be educated regarding methods to reduce disease transmission, animal management for disease control, factors in the cleaning process, cleaning and sanitation terms, key chemical agents used in shelter sanitation, cleaning and disinfecting processes, and pest control. Disease Transmission Infectious microorganisms include bacteria, viruses, parasites and fungi. To properly control and prevent disease transmission, you must have a good understanding of the different methods of disease transmission: direct, indirect, fomites, mechanical and biological vectors, and airborne. Direct transmission - Direct skin-to-skin contact between animals allows for transmission of mites (scabies) and fungi (ringworm). Direct transmission also occurs through contact with body fluids. Indirect transmission - This route is through contact with surfaces contaminated with body fluids (discharge from eyes or nose, phlegm, saliva, urine, feces, and blood) of infected animals. Contaminated surfaces can include an object that harbors microorganisms (fomite) or a living entity (mechanical vector). Fomites - Objects that can become contaminated and spread organisms to other animals are called fomites. Examples of fomites are: shoes, clothes, food and water bowls, leashes, catch poles, litter pans, mops, shovels, brooms, and surfaces of kennels, cages, carriers, trucks, floors, walls, and counters. Sanitation and Disease Control - 2 Zoonosis Control Division 9/03

Mechanical vectors - Contaminated living entities are mechanical vectors that physically carry the organisms from one place to another. An example of a mechanical vector could be a rodent, an insect (roaches, flies, ants, etc.), your own hands, or any living entity (such as a person or a dog) that visits a dog with a disease (such as parvovirus) and then contacts the environment (such as a food bowl) of another dog. Biological vectors - These are living organisms that are necessary for the development and transmission of the infectious organism. Fleas (for tapeworms, plague, and murine typhus), ticks (for Rocky Mountain spotted fever, Lyme disease, and ehrlichiosis), and mosquitoes (for heartworms) are all examples of biological vectors. Airborne transmission - Upper respiratory diseases (parainfluenza, feline rhinotracheitis, and bordetella, which is known as kennel cough or canine cough) can be transmitted through the air. The sneezing and coughing of animals infected with the microorganisms allow the virus and bacteria particles to be circulated in the air for short distances. In the process of spraying runs during cleaning, urine and feces can be aerosolized and transmit disease. Methods to Reduce Disease Transmission Consider all methods for controlling environmental, animal to animal, animal to human, and human to animal disease transmission. You can avoid most problems through a properly managed and designed facility. Use construction materials that are nonporous and waterproof for any surfaces that the animals contact. Do not use wood because it cannot be properly sanitized. Seal cracks and crevices so dirt and microorganisms will not seep through them after every washing. Zoonosis Control Division 9/03 Sanitation and Disease Control - 3

Avoid direct transmission by isolation and separation of animals. Reduce indirect transmission by proper kennel design, sunlight and ultraviolet lighting, and a frequent and thorough sanitation program. Adequate ventilation (10 to 15 air exchanges per hour), distance isolation, and barriers prevent airborne transmission. An external parasite control program for the impounded animals and a pest control program for the shelter and the surrounding area help to eliminate biological vectors. Animal Management for Disease Control Every animal entering a facility is a potential disease carrier. Each animal has been in contact with an unknown number and variety of diseases. Whether infected, incubating, or just carrying disease organisms on its hair or pads, the healthiest looking animal must be considered a potential danger to other animals. Prevention of disease is based upon separation. Do not allow incoming animals to have direct or indirect contact with any other animal. Direct contact is prevented by providing a separate cage for each animal with dividers between enclosures. It also means preventing contact between animals during cleaning and exercise periods. Segregation is the separation of larger groups of animals from one another. Provide different holding areas for stray, adoptable, quarantined, and isolated animals. Within these areas, separate adults from juveniles. The adults have a greater chance of carrying disease, and the young are more susceptible to contracting disease. Minimize stress in the animals by keeping dogs and cats in different areas. Even with adequate sanitation, it is best to keep an animal in the same cage during the time it spends in a holding area. Sanitation is never 100% and switching cages increases indirect exposure. Sanitation and Disease Control - 4 Zoonosis Control Division 9/03

Never overcrowd. The larger the population density, the greater the stress on the animals and the more difficult it becomes to sanitize properly and control disease. It is best to do a good job with the number of animals that can be provided with proper care rather than jeopardize the health of all. Filling a facility beyond its capacity only increases health problems and replaces euthanasia with death from disease. Wash hands (or rubber gloves if you are wearing them) between cleaning cages when the animals have to be handled during the cleaning process. You nullify good shelter cleaning and sanitation procedures if you allow unprotected contact between people and animals. Shelters also must be concerned with preventing the public from going cage to cage petting the animals for two reasons: it increases the chances of someone being bitten, and it is more likely to allow indirect transmission of diseases. Factors in the Cleaning Process Many substances will need to be removed in the cleaning process including grease and oils, which can be left on surfaces from an animal's fur, pads, and feces; proteins from blood and feces; and acid or alkaline material from dust and dirt. These substances may be fresh, ground-in, soft, or dried. The water used for cleaning purposes must be clean. Water that gets dirty during cleaning (mop water) can limit the effectiveness of the cleaning agent. Generally, the higher the water temperature in which the cleaning agent is dissolved, the faster the chemical reaction and the more effective the cleaning action. However, some disinfecting products are specifically made to work in cold water. Steam inactivates most bacteria and viruses on contact, but it also creates a humid environment that is conducive for the growth of any remaining bacteria. Zoonosis Control Division - 9/03 Sanitation and Disease Control - 5

Water physically dislodges and removes particles. The higher the water pressure used, the better it can dislodge particles from cracks. Water also decreases the number of disease agents through dilution. Application of water to clean is most efficient through a high pressure system. If this is not available, use a regular pressure hose with a spray nozzle on the end. This process can create aerosolized and airborne transmission of diseases; as a safety measure, wear a dust mask while you are cleaning. Cleaning and Sanitation Terms Sanitation involves achieving and maintaining a clean environment to reduce the possibility of disease transmission. A sanitary environment is the most important factor in the prevention of disease transmission. Appropriate disinfecting products, cleaning schedules, and sanitation procedures, along with the cooperation and commitment from all shelter staff, are essential elements in maintaining good sanitation in your facility. Cleaning and disinfecting are two different processes. They are not necessarily accomplished at the same time or with the same chemical. It is possible to have a cage that is clean but not disinfected. A variety of cleaning and disinfecting products are on the market. When considering which products to use in your shelter, you need to understand various terms, including: Antiseptic a chemical agent applied to living tissue to prevent growth and reproduction of microorganisms. Shelter personnel need to use an antiseptic to wash their hands. Sanitation and Disease Control - 6 Zoonosis Control Division - 9/03

Bactericide Bacteriostat Contact time Deodorant Detergent Disinfectant Fungicide Fungistat Germicide Sanitizing agent Soap Spore Sporocide Sterilization Virucide a chemical agent that kills bacteria. a chemical agent that inhibits growth and reproduction of bacteria. the amount of time that a cleaning agent must be left on the surface being cleaned to be effective. an agent that destroys or masks odors. Deodorizers have no place in an animal shelter. Odors are indications that there is a problem that needs to be corrected, not masked. a combination of compounds that act by emulsifying oils and suspending dirt particles. a chemical agent applied to inanimate objects or surfaces to kill pathogenic microorganisms (usually does not kill bacterial spores). a chemical agent that kills fungi. a chemical agent that inhibits growth and reproduction of fungi. a broad term applied to chemical agents that kill microorganisms. a chemical agent that reduces bacterial population on inanimate objects or surfaces. a cleansing agent composed of a combination of fats and alkalis. a body formed within bacteria or fungus and regarded as the resting stage during the life history of the cell. a chemical agent that kills spores. the process of complete destruction of all forms of microbial life. a chemical agent that kills viruses. Zoonosis Control Division - 9/03 Sanitation and Disease Control - 7

Not understanding the advantages and limitations of the types of cleaning and sanitizing agents available can lead to disappointing results, high costs, corrosion, and hazardous conditions. Use products that have been tested on animal microorganisms, specifically parvovirus (canine parvovirus can survive for several weeks if not properly disinfected). Fact sheets accompanying the disinfectant usually list the microorganisms that it will effectively destroy. Key Chemical Agents Used in Shelter Sanitation Consider your shelter's cleaning goals and purchase products that meet your needs. What works well for one purpose may be totally ineffective for another purpose. Additionally, various cleaning agents may damage some surfaces. Select products that are stable, noncorrosive, nontoxic when applied as directed, and economical. You may pay more for some concentrated products, but you will save money by using less of the product over time. There are combination detergent/disinfectant products available, but you must never mix disinfectants with any other product. Mixing a disinfectant with another chemical, soap, or disinfectant may inactivate it or cause a safety hazard. Sanitation and Disease Control - 8 Zoonosis Control Division - 9/03

Detergents and Disinfectants Name Usage Characteristics Acid detergents Alkaline detergents Iodine Quaternary ammonium compounds (AQuats@) Remove dried urine particles on equipment and cages. Remove oils left on surfaces from food, fecal material, or animal skin and hair. Sanitizes equipment, utensils, and skin. Kill enveloped viruses (feline rhinotracheitis). Corrosive; potential health hazards; need to remove residual detergent by rinsing with water. Separate fat molecules so can remove by rinsing. Stable; irritates skin less and corrodes metals less than other products; bactericide; sporocide; may stain. Noncorrosive; nontoxic; can cause skin irritation; may leave a residual coating on hard surfaces that inhibits bacterial growth; can leave oily film. Phenols Kill enveloped viruses. Bactericidal; fungicidal; virucidal (enveloped viruses); toxic to cats; cause skin and mucous membrane irritation; leave residual activity; corrosive. Products containing chlorine (hypochlorites) Kill enteroviruses (parvovirus, coronavirus). Effective against many viruses, bacteria, and fungi; have deodorizer activity; inexpensive; may be corrosive; may irritate skin and respiratory tract; whiten materials. Cleaning and Disinfecting Processes It is essential that the animals be maintained in a clean, sanitary environment. All animal holding rooms, cages, runs, and equipment must be thoroughly cleaned and disinfected on a regular, routine, frequent basis with additional cleaning and disinfection as needed for special circumstances. Zoonosis Control Division - 9/03 Sanitation and Disease Control - 9

Remove animals from their pens or cages during the cleaning process. This will avoid getting the animals wet, exposing them to potentially harmful chemicals, and stressing them by the whole process. You will also be able to clean more thoroughly because you will not be distracted by the animal. The difficult part in removing animals during the cleaning process is that you need to have somewhere to put them. Do not allow an animal to roam in the aisle while its cage is being cleaned because it can directly and indirectly transmit disease. Inside-outside runs for dogs work great for shelters that have them. This allows the animal to stay in the same cage and reduces the possibility of disease transmission. When inside-outside runs are not available, a clean temporary cage is needed to house animals during the cleaning process. The temporary cage must be cleaned and disinfected after every animal. Remember: Animals that are in quarantine must be kept in isolation while their cages are being cleaned. Remove food and water bowls. Soak bowls in a detergent solution while kennels and cages are being cleaned. Then scrub them, rinse them, rinse again if necessary, and dry them. You can use a dishwasher if one is available. Remove any bedding or blankets. Seal disposable bedding in plastic garbage bags. A washer and dryer are essential if blankets are used. To complete the first step in cleaning cages or other equipment, remove all the visible organic (substances derived from living organisms) matter from the surface. Feces and spilled food cannot be disinfected. Organic matter also directly inactivates many disinfectants. After scooping organic matter from a kennel, you may need to spray the kennel with water to remove small particles. Sanitation and Disease Control - 10 Zoonosis Control Division - 9/03

If necessary, use a detergent in combination with some type of physical force to solubilize (loosen or dissolve) remaining material (you can remove 90% of the bacteria during this process). If this is done, rinse the object or surface with water to remove the detergent and organic matter. Apply a disinfectant according to the manufacturer's instructions for concentration and contact time. Rinse with water if the disinfectant requires it. Squeegee any standing water to a drain. Allow the cage or run to dry before returning the animal. Pest Control Pests or vermin are noxious (destructive to living beings) animals or insects that can transmit diseases as mechanical or biological vectors. Shelters that are not managed and maintained correctly can provide an excellent environment for vermin to live and reproduce. Once they become established in a shelter, they can be very difficult to eliminate. Therefore, preventing their entry into the facility is the key to controlling them. Treatment and Control of External Parasites External parasites (fleas, ticks, and mites) can serve as biological vectors of diseases to animals and humans. Heavy infestations can make animals miserable and directly affect an animal's health through loss of blood, bites and sores, allergic reactions, and intense itching. Controlling external parasites can be difficult in a shelter. Once they are introduced, they have a huge reservoir of potential breeding places in the environment and within the animal population. For effective control, treat both the environment and animals. Zoonosis Control Division - 9/03 Sanitation and Disease Control - 11

Treat incoming animals to remove external parasites. There are many different options for treatment. The most labor intensive method is to bathe every animal with a flea and tick shampoo. Dips are very effective for fleas and ticks, but they cannot be used on all animals. Powders and sprays are easy and safe, but they kill only a percentage of the pests. Read labels and follow the manufacturer=s instructions on all products. Determine if the product is safe to use on young animals, debilitated (weak) animals, and cats before applying it to these animals. Treatment and Control of Mechanical Vector Insects Cockroaches can be the most annoying insects to manage in a shelter. Control is made more difficult by their resistance to chemicals. Cockroaches can live 60 days to 2 years, and a female roach can produce millions of offspring. Cockroaches frequently prefer moist places. They can be detected by directly observing them or their small, black, almost spherical droppings. They also can generate an oily odor that may be detectable by shelter staff. To control cockroach infestations, eliminate their food sources. For difficult roach problems, do not leave food in bowls continually. Reduce their hiding places by plugging holes in buildings and repairing all floor and wall cracks. Store food supplies and bedding so they are not touching the floors and walls. Remove trash frequently and provide good ventilation to reduce the moisture level. Do not bring roaches into the shelter with food supplies or donated newspapers. Flies transmit disease because they feed on human and animal waste. Bacteria stick to their mouths, footpads, and hairs and may be deposited wherever they land or eat. Keep shelter areas clean to reduce the fly's food supply. Positive airflow from the shelter interior to the outside will make it harder for flies to enter the building. Sanitation and Disease Control - 12 Zoonosis Control Division - 9/03

Insect pests (roaches, flies, ants, crickets, etc.) that serve as mechanical vectors can often be prevented by maintaining a clean environment. Routinely treat the grounds and facility with an insecticide. These products can be dangerous if used improperly, so you may want to have a professional exterminator or a trained individual select and apply the product. Before treating kennels and cages, remove all animals. Remember that the products used will be removed during the first cleaning. Treatment and Control of Rodents Rodents (rats and mice) have accompanied humans to most areas of the world. Historically, they have been responsible for more human illnesses and deaths than any other group of mammals. Indifference and carelessness in handling food and refuse have helped support populations of rats and mice. Rodents live and raise their families at the expense of humans and have become a prominent economic factor and health hazard. Rats gnaw in search of food and to wear down their constantly growing upper and lower incisors. Their gnawing on insulation around electrical wiring can cause fires. Rodent bites, their infected fleas and mites, and their habit of defecating and urinating on food and utensils spread disease. One fecal dropping may contain several million bacteria. Mice can enter buildings through dime size holes. Rats can enter through a hole the size of a quarter. These rodents can climb brick walls and jump 3 feet vertically and 4 feet horizontally. Rats and mice are strong swimmers and can enter through drains and toilet bowl traps. A single pair of rats can produce 50 offspring during their 1-year life span. Zoonosis Control Division - 9/03 Sanitation and Disease Control - 13

Rodents urinate and defecate frequently as they travel. You have a rodent problem if you notice droppings, rub marks (oily residue from their hair and pads), gnawing, or tracks in dust. Keep rodents from entering a building by covering drains, weather stripping, and sealing holes and doorways. Destroy their hiding places and eliminate clutter in rooms. Place sacks of food on racks so they do not touch the floors or walls. Exterminate rats and mice by using traps, glue boards, and poisons. Place poisons where the animals in your care cannot contact them. Some helpful conversion factors include: 1 milliliter (ml) = 1 cubic centimeter (cc) 1 teaspoon = 5 ml = 5 cc 2 ounce = 1 tablespoon = 15 ml = 15 cc = 1/16 cup 1 ounce = 2 tablespoons = 30 ml = 30 cc = 1/8 cup 2 cup = 8 tablespoons = 24 teaspoons 2 pint = 8 fluid ounces = 1 measuring cup. 240 ml 1 pint = 16 fluid ounces = 2 measuring cups. 480 ml 2 pints = 1 quart = 32 ounces 2 quarts = 2 gallon = 64 ounces 4 quarts = 1 gallon = 128 ounces 1 gallon = 4 quarts = 8 pints = 128 ounces References: O. Peter Snyder, Jr., The Federal Veterinarian, AControl of Surface Microorganisms and Biofilms,@ October 1992. Retail Food Division of the Texas Department of Health, AThe Basics of Food Safety,@ June 1995. Voglewede, Paula, Topics in Veterinary Medicine, Tech Talk, AIs Your Practice a Source of Infection? How to Maintain Good Clinic Hygiene,@ Autumn 1992. Sanitation and Disease Control - 14 Zoonosis Control Division - 9/03