Transcript Document

Iowa Animal Sheltering
Conference 2003
C. J. Baldwin, D.V.M.
Director Maddie’s Shelter Medicine Program
Iowa State University
November 2003
Sponsors
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The Miccio Foundation
Co-Sponsors
– ASPCA
– AVID/Microchip
– Schering-Plough Animal Health
– IFHS
– HSUS Midwest Regional Office
– City of Ames Animal Shelter
November 2003
Today’s Zoonotic Concerns
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Zoonoses: diseases that are transmitted to
man from infected animals
Agents include bacteria, viruses, fungi, and
parasites
Increased concern for those with increased
contact to animals
Interstate and global transport of animals
Global disharmony
November 2003
Zoonoses
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Why are shelters at increased risk?
How can we prevent or control this?
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Sanitation - disinfection
Parasite and pest control
Care and treatment of animals
Protection of staff, volunteers, foster and
adoptive families, and the immunocompromized
What diseases are we concerned with?
November 2003
Why Are Shelters At
Increased Risk?
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Shelters are unique because of the
numbers of animals that are admitted
With the high numbers of animals, the
potential for zoonotic diseases
increases
Stress, malnutrition, concurrent
disease allow increased shedding of
organisms into the environment
November 2003
Why Are Shelters At
Increased Risk?
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Isolation of incoming animals is tough
Shedding of infectious agent occurs before
illness is detected many times
Environmental factors may compromise
animals
Disinfection and pest/parasite control may
be difficult
Personnel handle frightened and aggressive
animals which put them at risk
November 2003
Sanitation - Disinfection
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Diseases can be spread directly, or indirectly
by fomites
Fomites are any inanimate object that can
spread disease
– Areas: rooms, cages, carriers
– Bowls, bedding, litter pans
– Hands, clothing
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Disinfectants: 1:32 dilution of bleach is gold
standard
November 2003
Care of Sick Animals
Infected animals may not be sick
 Sick animals should be isolated and
protective measures should be taken
 Veterinary care should be sought and
tests should be run
 Visual inspection prior to animal
handling should be a standard
 Post signs if there is concern
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November 2003
Parasite and Pest Control
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Treatment should be routine for
internal parasites
Treatment for external parasites may
be necessary
Rodent control is essential
November 2003
Human Protection
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Provide information about zoonotic disease
Provide methods to contain, including
protective clothing
Provide guidelines regarding reporting of
bites or suspected zoonotic diseases
– Include phone numbers of officials (public
health, human and veterinary health)
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Provide pre-exposure rabies vaccinations
November 2003
Human Protection
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Foster: can prevent transmission of disease
by education
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Fecal exams
Skin lesions
Ectoparasites
Abortion in pregnant animals
Adopters: agreements, and health checks
Immunocompromised
November 2003
What Diseases Are We
Concerned With?
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Bite, scratch, exudate exposure
Gastrointestinal diseases
Urinary and genital tract diseases
Exotic diseases
November 2003
Bite Exposure: Rabies
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Virus infecting warm blooded animals
may be infected
Skunks are the prominent type here
Vaccination is not 100% effective
Signs in animals occur within ~10 days
following a bite if animal is rabid
Definitive diagnosis requires brain
examination – remove and refrigerate
November 2003
Rabies
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Furious form: aggression, anxiety,
roaming
Dumb form: paralysis, first of the
throat
Transmission between animals
– Bite
– Ingestion
November 2003
Rabies Transmission to
Humans and Prevention
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Bite wounds, possibly scratches and
inhalation
After a bite, incubation may be 3 weeks to
years
Rabies is lethal once signs appear
Prevention
– Vaccination for Animal Control +/- staff
– Care of bite wounds, and reporting with 10 day
quarantine or brain examination of animal
– Post-exposure prophylaxis
November 2003
Bite – Scratch: Bartonella
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Bacteria which causes Cat
Scratch Fever and liver
disease in humans
Many cats are exposed, up
to 81%
Transmission between cats
is highest with flea
infestation
A scratch or bite may
transmit to humans
More significant in
immunocompromised
people
November 2003
Bartonella: Human Infection
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Incubation: 3 weeks
Fever, flu like symptoms (headache)
Joint pain
Enlarged lymph nodes
Skin lesions
Diagnosis: blood testing
November 2003
Cat Scratch – Bartonella
November 2003
Courtesy of R Davis, ISU
Bartonella
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Treatment:
– May not be necessary
– Antibiotics may be prescribed
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Prognosis:
– Good
– Guarded in immunocompromised
November 2003
Bite – Scratch: Tularemia
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Bacterial disease Francisella tularensis
Present through out the US
Several ticks are known vectors and
can also transmit disease
Since 2000, 3 human cases identified
in Iowa (NW, N Cental and Ankeny)
November 2003
Tularemia
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Recently a national
alert when Prairie
Dogs, originating
from Texas
distributors, were
shipped
Biological weapon
Human Cases 1990-2000
November 2003
Tularemia
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Several forms
recognized in man
and animal
Range from ulcers
to swollen lymph
nodes to septicemia
Septicemic form
reported in cats
November 2003
Courtesy of R Davis, ISU
Ulceroglandular disease
November 2003
www.cdc.gov/ncidod/eid/vol8no1/01-0131.htm)
Tularemia
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History is critical
– Rabbits
– Ticks
– Bites
– Sick domestic animals
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Diagnosis: antibody titers, culture
Treatment: antibiotics
Prognosis: varies
November 2003
Bites-Scratches: Plague
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Feline Plague :
bacteria (Yersini
pestis)
Most common in
western states
Rodents are natural
hosts
Cats become
infected
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Humans most
commonly infected
by rodent fleas
Also by infected
cats and wild
animals
November 2003
Courtesy of R Davis, ISU
Plague
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Bubonic,
pneumonic and
septicemic forms in
humans
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Prognosis: varies
Diagnosis: culture
Treatment:
antibiotics
Courtesy R Davis ISU
November 2003
Bite Wounds
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30,000 Emergency Room visits/year
28-80% of cat bites become infected
– Minor signs
– Severe: inflamed brain, heart, joints, shock
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Wounds involve multiple bacteria
Treatment with antibiotics
Prognosis varies
– Good with appropriate treatment
– Guarded in immunocompromised humans
November 2003
Bite-Scratch: Sporotrix
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Soil fungus
Infected animals with
exudative wounds can
be a reservoir
Chronic draining tracts
Diagnosis:
demonstration of the
organism
Treatment: anti-fungals
November 2003
Dermatophytosis
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Superficial fungal infection
Common to cats, may be seen in dogs
Lesions in animals may appear as:
– Broken hairs
– Patchy or generalized hair loss
– Redness and scales
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Lesions in humans are similar
November 2003
Dermatophytosis
November 2003
Courtesy of JO Noxon, ISU
Environment
Courtesy of JO Noxon, ISU
November 2003
Dermatophytosis
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Easily transmitted through contact
Difficult to eradicate from the
environment because of aerosol
transmission
Treatment involves
– Topical
– Systemic anti-fungals
– Environmental treatment
November 2003
Gastrointestinal Diseases
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Multitude of agents are zoonotic
Prevalence of any zoonotic agent
– 13-14% prevalence in adult cats and
dogs
– 40% in cats < 1 year of age
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Agents include
– Bacteria and more “typical” parasites
November 2003
Nematodes (Worms)
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Roundworms (Toxocara
and Bayliscaris) can
produce visceral larval
migrans
– Eggs/larva persist in
environment for months
– Humans ingest eggs
– Parasites migrate
through tissues
November 2003
Nematodes (Worms)
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Hookworms
(Ancyclostoma and
Uncinaria) can produce
cutaneous larval
migrans
– Eggs are passed
– Larva develop and
penetrate human skin
– Ingestion causes
intestinal problems
November 2003
Nematodes
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Prevention in humans involves
– Treatment of infected animals
– Routine de-worming (CDC)
– Cleaning the environment
– Keeping pets from defecating in child play
areas
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Treatment in humans
November 2003
Other Enteric Pathogens
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Toxoplasmosis
– Generally not a great concern if litter boxes are
cleaned daily
– Could be dangerous in pregnant women
– Raw meat is a bigger cause of infection
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Giardia (protozoan)
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Major cause of infectious diarrhea in people
Animals may not have signs of disease
Organisms not found on routine fecal exam
This organism was prevalent in Maddie’s
Summer Scholar 2003 Project
November 2003
Urinary and Genital Tract
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Cats have been incriminated in
transmission of Coxiella burnetti
(rickettsia) to humans, via aborted
material
– This organism may be found in up to
20% of normal cats
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Dogs may transmit Brucella canis
through aborted materials to humans
November 2003
Urogenital - Leptospirosis
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Caused by a bacterium
Infects many species including the dog
Many natural and reservoir hosts
Illness in the dog may involve the
kidneys, liver, or both organs
Transmission can occur through the
urine
November 2003
Leptospirosis
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Infected animals may be clinically normal or
have signs of kidney or liver disease
Prevalence of antibodies in the blood,
suggestive of exposure and subclinical
disease is 12.5% in Iowa
Organisms can be shed in canine urine for
up to 6 months following infection
Isolation of suspects is suggested
November 2003
Leptospirosis
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Prevention of infection in dogs is possible
with vaccination
Other modes of transmission are possible
– Coon hunters
– Water activities
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Disease in humans may present as brain
inflammation or kidney and liver disease
Treatment: antibiotics
Prognosis: variable
November 2003
The U.S. Outbreak
November 2003
Animal Investigation
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4 PDs lab + by PCR
& IHC
Test + by PCR and
virus isolation
– 1 Gambian rat
– 3 dormice
– 2 rope squirrels
November 2003
Human Cases
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Of 35 confirmed cases, all assoc. with
PD obtained from IL-1 distr. or distr.
who purchased from IL-1 distr.
At least 18 hospitalized
– Some as precaution only
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No person-to-person in this outbreak
Median incubation was 12 days
November 2003
Child: Secondary lesions 5/27/03,
adjacent to primary inoculation site on left
hand.
November 2003
Monkey Pox
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Disease was confined
Disease is not thought to have spread
to wildlife in the US
Reminder to us of our vulnerability to
zoonotic diseases
November 2003
SARS – Coronavirus
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Coronavirus determined to be the cause of the
SARS outbreak
Domestic cats and other wildlife were found to be
positive by blood tests
Investigation conducted to determine if the virus
infected tissues in the cat and ferret
Study indicated that the virus was infective to both
species
Ferrets became ill; cats did not
Infected cats and ferrets were able to transmit the
virus to uninfected subjects housed with them
November 2003
Nature 2003
West Nile Virus
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Transmitted by mosquito
Affects birds
Infects horses
Infects humans
November 2003
Questions?
November 2003
Maddie’s Fund
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Mark Your Calendars!
Tentative date for Mr. Rich Avanzino to
visit ISU is February 12 & 13, 2004
E-mail [email protected]
November 2003