Transcript Presentation

Zoonosis Prevention and
Infection Control in Zoos
Donald L. Janssen, DVM, Dip. ACZM
Corporate Director, Animal Health
San Diego Zoo and
San Diego Zoo’s Wild Animal Park
Topics for Today
1. General Biosecurity in Zoos
2. Handling Zoonotic Disease Cases
3. Zoonosis Training for Zoo staff
1. General Biosecurity
Guidelines
Organization-wide approach to
infection control
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BIOSECURITY
- DEFINITION
• Those precautions taken to minimize
the risk of introducing an infectious
disease into an animal population.
• All programs of infection control within
our facilities
GENERAL BIOSECURITY
HIGHLIGHTS
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Facilities
Animal Care Staff
Collection Animals
Animal Feed
Wild and Feral Animals
Surveillance
Education and Communications
Occupational Health Care
Enhanced Biosecurity Measures
BIOSECURITY
SPECIFIC POLICIES AND
PROCEDURES
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Primate Safety Policy
Reptile Handling Guidelines
Bat Handling Guidelines
Placenta and Newborn Animal
Handling Guidelines
• Highy-Pathogenic Avian Influenza
• Exotic Newcastle Disease
FACILITY BIOSECURITY
• Design and manage with biosecurity in
mind
• Facility “control points”
– Back of house
– Entrance and exit procedures
ANIMAL CARE STAFF
BIOSECURITY
• Includes employees, volunteers,
contractors, etc.
• Hand hygiene
• Uniforms and outerwear, footwear
• Animal products from outside
COLLECTION ANIMALS
BIOSECURITY
• Quarantine incoming animals
• Cleaning and disinfection of transport
carriers, nets, gloves,
ANIMAL FEEDS BIOSECURITY
• All food will be procured through the
Nutritional Services department
• Do not feed uncooked poultry products
• General food safety principles will be
followed in food storage and preparation
areas.
Feeder crickets
WILD AND FERAL ANIMALS
BIOSECURITY
• Minimize access by wildlife around animal
enclosures
• Follow protocols for handling sick and
injured native wildlife
• Prevent standing water accumulation in
accordance with West Nile virus
prevention program.
SURVEILLANCE
• Passive Surveillance
– Post-mortem Examinations
– Morbidity and Mortality Investigations
• Active Surveillance
– Preventive Medicine Examinations
COMMUNICATION AND EDUCATI
BIOSECURITY HIGHLIGHTS
• Public Communications
• Regulatory Communications
• Employee and Volunteer Training
OCCUPATIONAL HEALTH
• Occupation Safety and Health
Administration
• Employee occupational medicine provider
ENHANCED BIOSECURITY
• Foreign Animal Diseases
• Exotic Newcastle Disease
• Highly Pathogenic Avian Influenza (e.g.
H5N1)
• Foot and Mouth Disease
DISINFECTION GUIDELINES
DISINFECTION - PRINICIPLES
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Clean before disinfection
Contact time
Proper dilution – label directions
Frequency
Disinfectant classes and spectrum of
action
DISINFECTANTS - SPECIFIC USE
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Foot baths
Hand washing
Non-porous surfaces
Porous surfaces
Animal handling equipment
Footwear
DISINFECTANT APPROVAL
PROCESS
Approved Disinfectants for Use in Animal Areas
4/28/2010
Alcohol
Biguanide
Halogens
Oxidizing Agents
Phenols
Quaternary Ammonia
Quaternary Ammonia
Quaternary Ammonia
Quaternary Ammonia
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pr
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Ap
Brand name
Hand Sanitizer
Nolvasan®
Bleach 6.15%
Virkon S®
One-Stroke Environ®
Mint Quat®
Quat-Stat®
Roccal D® Plus
CaviCide®
M
Date
2/22/10
2/19/10
12/22/09
12/22/09
12/22/09
12/22/09
2/19/10
12/22/09
2/19/10
Disinfectant
Category
SD
S
W
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San Diego Zoo and Wild Animal Park
DJ
DJ
DJ
DJ
DJ
DJ
DJ
DJ
DJ
Precautions
Purell well-known brand; generic equivalents have 62% ethanol
see "bleach dilutions" tab
preferred for foot baths - see tab
may be toxic to some species, e.g. felids, suids
2. Managing Cases
Diagnosed With a
Zoonotic Disease Agent
What should we do when we
diagnose a zoonotic disease in
our zoo?
Definition: Zoonotic Disease
Any infectious disease that
can be readily transmitted
between animals and humans
Zoonotic Disease Occurrence
Questions to Ask Ourselves
What do we do?
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Who is in charge and making decisions?
Who should we notify and what do we say?
What do the caretakers need to know?
Do we need to isolate the animal? How?
How do we handle animal waste?
Do we need to report to government regulators?
How do we manage the medical care of the
infected animal?
Zoonotic Disease Occurrence
Consequences
What are the consequences of
mishandling this?
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Animal well-being
Public health
Institutional reputation
Professional reputation
Unnecessary human and animal illness
Zoonotic Disease Occurrence
Solution
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Zoo clinicians are well-suited to handle this
Decide what to do before the occurrence
Develop a pre-determined process
Decide what will trigger the process
Zoonotic Disease Occurrence
Trigger
A zoonotic agent is
diagnosed or highly
suspected in an
animal or human
contact
Zoonotic Disease Occurrence
Suggested Steps
1. Notify
2. Infection Control
• Isolate
• Handle waste
3. Report
4. Treat/manage animal
#1 - Notify
Key Stakeholders
• Animal care supervisors
• Occupational health provider
• Provide disease fact sheet to
keepers
• Remind all to report signs and
symptoms of disease in
themselves
#2a - Isolate
Animal from others
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1st Infection Control step
Consider feasibility and risk
Required if guest contact
Reinforce personal hygiene
Institute PPEs as indicated
Footbath
Use of separate tools and equipment
#2b - Waste handling
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2nd Infection Control step
Use sewer disposal if possible
Contaminated bedding
Prevent spreading contamination
Disinfection
Follow local regulations for
biomedical wastes
#3 - Report
To authorities if required
• Know what diseases are
reportable (federal, state, county)
• Develop rapport with local health
departments
• Consider internal tracking
document
#4 – Medical Care
• Appropriate treatment, if indicated
• Follow up diagnostics as
appropriate
• Establish an end point for the
isolation and precautions
Resources Available
CDC Zoonotic Disease Fact Sheets
Resources Available
Reportable Diseases
Resources Available
EPA Waste Management
Case Examples
• Gorilla
– shigellosis
• Elephant
– MRSA
• Aviary
– Psittacosis
Gorilla - Shigellosis
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Trigger
Notify
Isolate
Waste Handling
Report
Medical Care
Elephant Calf - MRSA
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Trigger
Notify
Isolate
Waste Handling
Report
Medical Care
Aviary - Psittacosis
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Trigger
Notify
Isolate
Waste Handling
Report
Medical Care
Summary
1. The consequences of mishandling a
zoonotic disease occurrence are
enormous
2. A systematic process will help avoid
mistakes and failures to act
3. Set up a process ahead of time
3. Zoonosis Training
Program for Zoo Staff
Adapted from materials supplied by:
Carol Roach, RN, PHN
San Diego Health and Human Service
Agency
Community Epidemiology Branch
Course 1
Course 2
Basic infection
control principles
for all employees
Advanced training
for animal care
staff
Course 1
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Basic infection
control principles
for all employees
Choices and Responsibilities
Definitions
Factors for Disease Transmission
Transmission Pathways
Simple Rules of Infection Control
Hand washing 101
THREE DEFINITIONS YOU NEED TO KNOW
ZOONOSES
PATHOGEN
INFECTION
CONTROL
Infectious diseases that
move easily between animals
and humans
Any disease-producing
agent (especially a virus,
bacterium, fungi or parasite)
A system of preventive
measures to reduce the risk
of infectious disease
transmission
The How, When & Where of Disease Transmission
1. A Source of Pathogens
THERE ARE 3
FACTORS
NECESSARY
FOR DISEASE
TRANSMISSION
2. A Susceptible Host
3. A Means of Transmission
A Means of Transmission
3 Main Pathways:
Vector
Contact
Air-borne
Contact Transmission includes
food-borne and blood-borne disease
Remember:
The 3 Simple Rules of Infection Control
All the
preventive
THREE
measures
SIMPLE
mentioned in
RULES
OF
this training
INFECTION
are
based on
CONTROL
the
3 Simple
Rules
1. AVOID TRANSFER: Don’t
transfer pathogens from a
contaminated area or surface
to clean area or surface
2. DISINFECT: Kill or remove
as many pathogens as possible
by cleaning and disinfection
done the right way with the
right products
3. EQUIP: Give information
and tools to workers to protect
themselves, the environment,
and the public
HAND WASHING IN HISTORY
Ignaz Semmelweis
1818 – 1865
HANDWASHING
IS THE SINGLE
MOST
IMPORTANT
THING YOU
CAN DO
TO LOWER
YOUR RISK
FOR
TRANSMITTING
OR GETTING
AN INFECTIOUS
DISEASE
Hand Hygiene – When?
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Frequently!
Before and after animal contact
After using the restroom
Before hand-to-mouth activities
When going from dirty to clean activities
When changing activities
1. WET HANDS
& WRIST
2. APPLY & LATHER
SOAP
3. SCRUB PALM TO
PALM
Always use liquid soap
Wash for about 15-20 seconds -About as long as it takes to
sing Happy Birthday
4. SCRUB BACKS OF BOTH HANDS
5. INTERLACE FINGERS
AND SCRUB
Don’t forget
to wash your wrists
6. SCRUB BACKS OF FINGERS ON PALMS
7.
SCRUB
THUMBS
Use paper towels or a clean
unused towel to dry your
hands
Turn off the tap with the paper
towel you used to dry your
hands
Course 2
Advanced Zoonosis and
Biosecurity Training
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Advanced Training
For Animal Care
Staff
Review Course 1
General biosecurity guidelines
Disinfection guidelines
Personal Habits at Work
Personal Health
Personal Protective Equipment
Conclusions
Zoonosis Prevention
and Infection Control
in Zoos
1. Improving infection control in zoos –
biosecurity principles
2. Zoonotic disease occurrence - systematic
process for what to do
3. Zoonosis prevention - training for zoo
employees and volunteers