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Preventing Outbreaks of Illness linked to
Animal Contact: It is Possible!
Megin Nichols, DVM, MPH, DACVPM
Enteric Zoonoses Activity Lead
Outbreak Response and Prevention Branch
Agritourism: Protecting Public Health, Animal Health and your Farm
August 24, 2016
National Center for Emerging and Zoonotic Infectious Diseases
Division Name in this space
Prevention
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Eliminating all risk from animal contact might not be
achievable
Preventing and minimizing disease and injury is the goal
A One Health Approach to Prevention
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Focuses on the intersection of health of humans, animals,
and environments
Framework for the classification of drivers of human
exposure to animal pathogens (interspecies barrier)
Gortazar C, Reperant LA, Kuiken T, de la Fuente J, Boadella M, et al. (2014) Crossing the Interspecies Barrier: Opening the Door to Zoonotic
Pathogens. PLoS Pathog 10(6): e1004129. doi:10.1371/journal.ppat.1004129
http://127.0.0.1:8081/plospathogens/article?id=info:doi/10.1371/journal.ppat.1004129
Guidelines for Disease Prevention
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Recommendations for:
 Local, state and federal agencies
 Venue operators and staff
 Personnel involved in animal management/care
 School and childcare settings
 General public
Recommendations for Local, State and Federal Agencies
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Foundation of cooperation and communication
 Disseminate the compendium
 Provide educational and training material
 Oversight of animal contact venues
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Conduct outbreak investigations
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Survey affected individuals to determine source of infection
Collect samples and perform analysis
Work to implement control and prevention measures
Report outbreaks to state and local authorities
Regulation
Map of States with Hand Sanitation
Laws for Animal Contact Exhibits
http://www.cdc.gov/phlp/docs/menu-animalsanition.pdf
Recommendations for Venue Operators and Staff:
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Education
 Notify visitors of potential risks
 Verbal and written hygiene reminders
http://www.cdc.gov/features/animalexhibits/animalexhibitssafet
y2007.pdf
http://www.cdc.gov/Features/AnimalExhibits/
Recommendations for Venue Operators and Staff:
 Provide training and educational material for staff regarding the
risks associated with zoonotic agents and animal-related injuries
 Consult with veterinarians, state and local agencies to establish
guidelines for safe animal contact
• Age minimum for some exhibits
• Species of animals that should not be handled by the general public
• Eliminate animals as prizes
 Provide information for schools planning field trips, prior to arrival,
outlining safe animal contact practices
 Ensure public compliance with posted and verbal
recommendations
Recommendations for Venue Operators and Staff:
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Facility design
 Adequate hand-washing stations with
placards that outline proper protocols
for removing zoonotic pathogens
 Maintain hand-washing stations
(i.e. clean water supply; soap; paper
towels)
 Place staff near stations to encourage
compliance
http://avmajournals.avma.org/doi/pdf/10.2460/javma.243.9.1270
Recommendations for Venue Operators and Staff:
 Build exhibits to minimize cross-traffic
between animal, non-animal and food
service areas
 Provide hand-washing stations at exit
transitions
 Disinfect all surfaces to remove organic
matter (1:32 bleach dilution, quaternary
ammonium compound)
 Maintain proper waste management
and disposal of manure
http://avmajournals.avma.org/doi/pdf/10.2460/javma.243.9.1270
Recommendations for Venue Operators and Staff:
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Animal Areas
 Do not allow food, beverages, toys, pacifiers, strollers, baby bottles
or spill-proof cups in animal exhibit areas
 Advise staff and parents to watch children closely
 Animal contact/feeding should only be allowed with barriers in
place
 Provide proper ventilation in the exhibit area
 Remind visitors which individuals fall into high-risk populations
(i.e. young children, elderly, immuno-compromised, pregnant)
Curran et al. An Outbreak of Escherichia coli O157:H7 Infections following a Dairy Education School Field Trip in Washington State, 2015 .
Animal Health
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Check with state and local animal health authorities
 Vaccination
 Health certificates
 Animal movement
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Animals carrying the most common zoonotic agents often show no
clinical signs
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Animals shed organisms intermittently making detection difficult
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Treatment of animals does not eliminate pathogens, can prolong
shedding, and can result in antimicrobial resistance
Recommendations for Animal Care and
Management Personnel
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Monitor animals daily for signs of illness; isolate affected animals
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Ensure up-to-date inspection by accredited veterinarian
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Minimize contact between domestic and wild animals
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Prohibit contact between the public and dangerous animal species (i.e.
venomous snakes, nonhuman primates, lions, wolves, bears, tigers, bats,
raccoons, foxes etc.)
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Ensure the public has no contact with live animal births or newborn
animals
Recommendations for School and Childcare Settings
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Make sure teachers and staff are familiar with animal
species that are inappropriate or present high zoonotic risk
 Animals NOT recommended
• Nonhuman primates
• Dangerous and/or unpredictable animals (i.e. lions, bears, wild or
aggressive domestic animals)
• Mammals at high risk for transmitting rabies (i.e. bats, raccoons,
skunks, foxes, coyotes)
• Venomous or toxin-producing spiders, insects, reptiles or amphibians
Recommendations for School and Childcare Settings
 Animals that present a high risk for zoonotic disease transmission
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Reptiles or amphibians (i.e. turtles, snakes, lizards)
Live poultry
Ferrets
Farm animals (i.e. sheep, calves, goats)
Psittacine birds
 Other animals that can transmit zoonotic diseases:
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Rodents (i.e. mice, rats, guinea pigs, hamsters, gerbils)
Cats
Dogs
Rabbits
Nonpsittacine birds
http://www.cdc.gov/Features/HealthyPets/
Recommendations for School and Childcare Settings
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Farm animals, turtles and ferrets are not recommended in
facilities with children <5 years old
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Close supervision and meticulous attention to hygiene must be
observed when children >5 years of age engage in animal contact
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Wear gloves when cleaning aquariums and do not keep fish near
food preparation areas
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Assume owl pellets and frozen rodents used to feed reptiles are
contaminated with Salmonella organisms
Recommendations for School and Childcare Settings
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Ensure everyone washes their hands thoroughly after direct and
indirect animal contact
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Supervise all human-animal contact
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Do not allow animals to roam the classroom
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Do not clean cages in sinks used to prepare, serve or consume
food
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Obtain a health certificate or proof of rabies vaccination for all
animals being exhibited
http://www.cdc.gov/Features/HealthyPets/
Human Behavior
• 991 attendees observed at 6
petting zoos in Tennessee
• 74% direct animal contact
• 87% contacted contaminated
surfaces
• 49% hand-to-face contact
• 22% ate/drank in animal areas
Recommendations for the General Public
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High-risk individuals should take heightened precautions or
avoid animal exhibits (i.e. children < 5yr, elderly, pregnant women,
persons with HIV/AIDS or those receiving immunosuppressive treatments,
those who are ill at the time of the exhibit/fair)
 Wear protective equipment
 Wash hands thoroughly and often
 Avoid direct contact with animals
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Avoid sitting on the ground, handling animal bedding and
eating or drinking near animal exhibits
http://www.cdc.gov/Features/AnimalExhibits/
Recommendations for the General Public
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Reduce potential transmission by decreasing exposure time
(i.e. do not board with animals at agriculture fairs)
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Ensure all animals transported for exhibition have been
examined by an accredited veterinarian
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Abide by all written and verbal recommendations
made by staff and personnel
http://www.cdc.gov/flu/pdf/swineflu/fair_exhi
bitor_factsheet.pdf
Thank you
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
Visit: www.cdc.gov | Contact CDC at: 1-800-CDC-INFO or www.cdc.gov/info
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the
Centers for Disease Control and Prevention.
National Center for Emerging and Zoonotic Infectious Diseases
Division Name in this space