Transcript Occupational Health Program for Employees with Animal Exposures

DLAM ZOONOSES AND LAB
ANIMAL ALLERGY TRAINING
Purpose of Program
•This
training is intended for research animal handlers
and animal caretakers who are consistently in physical
contact with the animals in DLAM facilities.
•These employees are required to participate in an
annual occupational health surveillance program for
animal handlers.
•This training is required annually.
Possible Hazards in DLAM Facilities

Allergic responses

Animal bites, scratches, or other trauma

Zoonotic diseases
Animals and Health Risks
LABORATORY ANIMAL ALLERGIES
15% of the general population is allergic to
animals.
•30 – 50% of those without a previous allergy
history will develop an allergy to lab animals while
working in that environment.
•10 – 15% of these allergic workers will develop
asthma.
•
Risk Factors for Development of
Laboratory Animal Allergies

Exposure to allergens
 Duration
 Frequency
 Intensity

Previous allergic conditions
 Personal

history of allergies/atopy/eczema
Other predisposing conditions
 Illness
 Immunocompromised
 Pets
 Family
history
Common Lab Animal Allergy Sources
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Rats/ Mice--major allergens in urine/saliva
Cats--sebaceous glands, hair, saliva
Dogs--saliva, hair, skin
Rabbits--fur, saliva, urine
Birds--droppings
Bedding
Allergy Symptoms
•
•
•
•
•
Red, itchy, watery eyes, runny nose1
Sneezing, itchy, runny nose, congestion1
Red itching skin, welts, hives2
Asthma3 – cough (can be late-phase with symptoms starting
several hours after leaving the animal facility), wheezing,
chest tightness, shortness of breath
Anaphylaxis4 – itching, hives, throat tightness, fainting,
nausea, vomiting, diarrhea
1 = common, 2 = somewhat common, 3 = about 15 – 30%, 4 = rare
Prevention of Lab Animal
Associated Allergies
Biosafety cabinets
 Filter top cages
 Ventilated cage racks
 Biobubble
 Choice of bedding
 Reduce time with animals
 Wash hands frequently

Animal density
 Proper
housekeeping
practices
 Proper humidity
 Personal protective
equipment (masks,
respirator)

Treatment of Lab Animal
Associated Allergies
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Prevention is preferred
Education of employees
Proper use of personal protective equipment
Re-assign employees when needed
Medical treatment to reduce symptoms
If you develop allergy symptoms to lab animals,
contact University Employee Occupational Health
Clinic (UEOHC at 966-9119) for an appointment
for a medical evaluation
Knowledge Review
1.
Risk factors for developing laboratory animal allergies include:
a. Amount of time spent around laboratory animals
b. Family history of allergies
c. Whether or not you have pets
d. All of the above
e. None of the above
2.
Laboratory animal allergies can be prevented by using of which of the following?
a. Good hygiene practices
b. Biosafety Cabinets
c. Respirators
d. A & C
e. All of the above
Zoonoses
Research personnel who handle animals and/or animal
tissues are at risk for zoonotic disease transmission.
• Zoonotic agents are infectious agents capable of
being transmitted from animals to humans or from
humans to animals. (TB to monkeys, flu to people)
•
•Zoonoses
can cause minor or serious illness. In some cases,
zoonotically infected individuals do not become ill.
•On the other hand, some zoonoses can be extremely
dangerous to people, especially those with a weakened
immune system.
Zoonoses
Bacteria
 Exposure to feces/urine (e.g. Salmonella, Shigella, E. coli, Leptospira)
 Bites/scratches: Bartonella (cat scratch disease), Rat Bite Fever-Spirillum minor,
Streptobaccilis moniliformis, Leptospirosis
Viruses
 Herpes B virus from Macaques – potentially fatal to humans
 Rabies virus – potentially fatal to humans
 Lymphocytic Choriomeningitis Virus (LCMV)– rodents
Parasites
 Gastrointestinal – Giardiasis, cryptosporidium, tapeworms (in urine and feces)
 Systemic – Toxoplasma (fatal defects in the fetus may occur if pregnant women are
exposed to shedding cats)
 Dermatomycosis (ringworm) can be spread by contact with infected animal
Transmission of zoonotic diseases can be prevented by
prompt recognition and isolation of any ill animal
Cats
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Cat scratch disease--Bartonella henselae
Toxoplasmosis---Toxoplasma gondii
Prevention--good hygiene
Toxoplasmosis---Toxoplasma gondii
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Toxoplasmosis is caused by the protozoan parasite
Toxoplasma gondii.
Cats play an important role in the spread of toxoplasmosis.
They become infected by eating infected rodents, birds, or
other small animals. The parasite is then passed in the cat's
feces in an oocyst form, which is microscopic.
Kittens and cats can shed millions of oocysts in their feces
for as long as 3 weeks after infection.
A Toxoplasma-infected cat that is shedding the parasite in
its feces contaminates the litter box or if allowed outside,
can contaminate the soil or water in the environment as well.
Toxoplasmosis---Toxoplasma gondii


Toxoplasmosis is not passed from person-to-person,
except in instances of mother-to-child (congenital)
transmission and blood transfusion or organ
transplantation.
People can be infected by:
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
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Accidental ingestion of oocysts after cleaning a cat's litter box
when the cat has shed Toxoplasma in its feces
Accidental ingestion of oocysts after touching or ingesting
anything that has come into contact with a cat's feces that contain
Toxoplasma
Drinking water contaminated with the Toxoplasma parasite
Toxoplasmosis---Toxoplasma gondii
Pregnant Women

Mother-to-child (congenital) transmission

A woman who is newly infected with Toxoplasma during
pregnancy can pass the infection to her unborn child (congenital
infection). The woman may not have symptoms, but there can be
severe consequences for the unborn child, such as diseases of
the nervous system and eyes.
If you are pregnant or thinking about becoming pregnant and
you work with cats, please contact EHS for a risk assessment.
SheepQ Fever
•
•
Q fever is a zoonotic disease caused by the
organism Coxiella burnetii.
Individuals acquire this infection by inhaling aerosols
and contaminated dusts generated by animals or
animal products. Q fever can also be contracted
via:
•
•
Direct or indirect contact with infected animal
Contact with contaminated surfaces, clothing,
equipment, bedding, etc
Prior to working with or around sheep

PAPR respirators or N95 masks are required to enter the
animal housing area and laboratory that contain sheep.
 This
requires annual training (EHS) and medical clearance and fit
testing at UEOHC annually.

The following should contact UEOHC for a medical
screening and/or EHS for a risk assessment :
Immunocompromised individuals and those with pre-existing heart
valve conditions are at higher risk of infection and should be fully
informed of the increased risks.
 Pregnant women or women who are considering becoming pregnant
should also be fully informed of the increased risks.

Swine
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Infected swine can transmit diseases to humans via
the fecal-oral route, urine or contaminated water
splashes, or direct contact
Colibacteriosis (E. coli)
Salmonella (Non-typhoidal)
Leptospirosis
Ringworm
Rodents
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Rat Bite FeverSpirillum minor, Streptobaccilis moniliformis
Leptospirosis
Lymphocytic Choriomeningitis Virus (LCMV)
Parasites
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Yersinia pestis--fleas from cats/ rodents in southwest
Borrelia burgdorferi (Lyme Disease)- transmitted to
animals/humans by infected ticks
Non- Human Primates (NHP)
Zoonotic hazards
 Herpes
B virus (Macaques)
 Salmonella
 Tuberculosis
 Simian Immunodeficiency Syndrome (SIV), Simian T-Cell
Lymphotropic Virus (STLV)
 Endogenous retroviruses
 Hepatitis A
 Hepatitis B
 Shigella dysenteriae
Rabies Virus

Feral animals represent the greatest risk
 Acquire
animals that have been documented free of
disease
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Post bite evaluation for need for Rabies booster,
wound prophylaxis, tetanus
Herpes B Virus
(Cercopithecine Herpesvirus 1)
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Naturally occurring infection seen only in genus Macaca
(rhesus, cynomolgus, pig-tailed, others).
80-100% imported adult rhesus macaques are Herpes B
positive.
In facilities where macaque monkeys are present saliva,
genital secretions and conjunctival secretions are considered
the primary body fluids associated with transmission
Transmission has been documented through handling infected
CNS & kidney tissue
Feces, urine or other fluids may be contaminated
Human disease is rare and has been identified in about 50
cases and well-documented in 26 cases.
 ~70% case fatality rate in humans
Tuberculosis
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Transmitted to humans through exposure to infected
animal/animal tissue.
Also a reverse zoonosis, can be spread from humans
to primates
Screening is done by PPD in arm at UEOHC.
 Positive
 Chest
tests indicate previous infection.
x-rays are then required to rule out active disease.
Simian Immunodeficiency (SIV)
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
SIV is a lenti-virus that infects non-human primates in
nature. Monkey SIV strains can infect humans, but does
not lead to the development of AIDS.
Unlike HIV infections in humans, SIV infections in their
natural hosts are widely believed to be nonpathogenic. However, if SIV is used to infect an Asian
rhesus macaque, for example, the animal will develop
an AIDS-like illness similar to HIV infection in humans
Hepatitis Viruses

Hepatitis A:
 Enteric
(oral/fecal spread)
 Non chronic carrier state
Hepatitis Viruses

Hepatitis B
 Bloodborne
pathogen
 Low mortality (1 % case fatality rate)
 Up to 10% of those infected become chronic carriers
with high incidence of cirrhosis and liver cancer.
 Vaccine required (or declination)
Hepatitis Virus

Hepatitis C
 Bloodborne.
 Disease
is milder in comparison with Hepatitis B,
however there is a higher rate of chronic carriers.
 No vaccine, however, treatment within weeks of
infection can prevent chronic disease.
Routes of Exposure for
Zoonotic Diseases
Routes of Exposure
•
•
•
Bites and scratches from infected animals
Needlestick injuries with contaminated needles or
scalpels
Eye and mucous membrane exposure to body fluids or
particulates from infected animals
Percutaneous Exposure
Zoonotic diseases are commonly spread
percutaneously (bites, scratches, needlesticks):
 Some organisms are Staphlyloccus aureus, Bartonella
henselae
 Proper wound care/ tetanus immunization
 Appropriate antibiotic prophylaxis
Bacterial Infections from Bite Wounds

>200 species of bacteria in the mouths of many
animals, including humans.
 Streptococcal


species, staphylococcal species, tetanus.
Bite wounds should be thoroughly cleaned.
Prophylaxis for moderate to deep bites with
Amoxacillin/clavulinic acid (Augmentin).
Exposure Procedures

Immediate Response:
 Mucous
membrane: flush in an eye wash or potable
water for a minimum of 15 minutes.
 Non-intact skin exposures: Wash with soap and water
or antiseptic for 15 minutes.
REPORT ANY INJURIES AND ILLNESSES TO
PI/LAB SUPERVISOR AND IMMEDIATELY
REPORT TO UEOHC (962-9119)
Knowledge Review
3. Zoonotic agents are infectious agents capable of being transmitted from animals to
humans only?
a. True
b. False
4. A vaccine for _____________ is available for DLAM employees who work with/around
research animals.
a. Hepatitis B
b. Hepatitis C
c. Herpes B
d. All of the above
5. Zoonotic diseases cannot be spread by:
a. Needlesticks with contaminated needles
b. Contaminated materials being splashed into the eyes
c. Contaminated materials coming into contact with gloved hands
d. Being bitten by an infected animal
Access Control and Staff Training
Training (more extensive & periodic)
 Personnel must enroll in medical
surveillance program
 Restricted/controlled access
 Written emergency response plans

Hazardous Agents Used in
Research Animals
Animals exposed to biological, radiological, or chemical
hazards can create a risk of exposure to people.
When working with animals that have been exposed to
hazardous agents, precautionary measures (use of PPE,
engineering and administrative controls) should be taken.
Read the Use of Biological, Chemical, Radiation forms
posted on the animal room/cubicle doors
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Minimize Risk
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Wear proper PPE (respirators, gloves, Tyvek suit, gown,
shoe covers, etc.) as indicated by signage.
Use gloves when handling animals & change gloves
between animals.
Wash your hands as soon as possible after removing
gloves.
No eating, drinking, smoking, applying cosmetics or
handling contact lenses in any DLAM facility.
Minimize Risk
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Keep food intended for human consumption separate
from animal food.
Report any animals that appear to be ill.
Report any occupational illness or injury to your lab
manager and/or PI and immediately report to
UEOHC (919-966-9119, M-F 8:30-4:30)
Immunocompromised/Pregnant Individuals
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Immunocompromised individuals and pregnant women
should be aware of the potential zoonotic hazards that
may be present in the workplace.
If you are undergoing chemotherapy/radiation therapy,
being treated with steroids or other drugs that could
cause immunosuppression and/or you are pregnant or
plan on becoming pregnant, please notify EHS to
determine appropriate protective measures and
monitoring.