Download Bacteria, Fungi, and Viruses-OH MY!!

Bacteria, Fungi, and
Viruses-OH MY!!
RW Summit 2014
Kelly Harrison DVM, MS
Veterinary Program Manager
Objectives
• Refresher on cleaning and
disinfection
• Overview of common
infectious diseases
– Focus on canines
• Discussion on how to keep
calm and carry on!
Introduction
• Controlling infectious disease is
a CHALLENGE
– Inherent risk
– Exposure prior to entry
– Animals without clinical
signs
• Strain on shelter resources
– Time
– Money
– Morale
Introduction
• So many FACTORS
– Animals (host)
– Disease (pathogen)
– Environment
Overview
• STRATEGY
– Population
management
– Vaccination
– Cleaning and
disinfection
– Structured plan for sick
animals
Population Management
• Housing capacity
• Daily rounds
• Stress reduction
– Crowding
– Random co-mingling
• Segregated housing
– Dogs and cats
– Adults and juveniles
Vaccination
• Vaccination on intake
– DA2PP (dogs)
– FVRCP (cats)
– Schedule for puppies/kittens
o If < 20 weeks: every 2 weeks until
at least 20 weeks of age
o < 6 months : on intake, day 14
o > 6 months: on intake
• Bordetella: prevention versus mitigation
Cleaning and Disinfection
• Goal: reduce dose of infectious
agents in environment
• Staff training order is
important!
– Healthy kittens/puppies
– Healthy adults
– Stray/Quarantine
– Sick/Isolation
Cleaning and Disinfection
Proper cleaning and disinfection
techniques
Clean THEN Disinfect
• Step1 : Clean
– Remove organic material
– Detergent activity-soap it up!
– Elbow grease (mechanical
cleaning)
• Step 2: Disinfect
Cleaning and Disinfection
Don’t forget the…
• Transport carriers
• Transport vehicles
• Windows/walls
• Doors/doorknobs
• Play yards
• Exam tables
• Bedding
• Toys
•
•
•
•
•
•
•
Litter boxes
Bowls
Scoops, brushes
Clothing
Ventilation ducts
Phones/keyboards
HANDS!!!
Cleaning and Disinfection
• Selecting a disinfectant
– Risk assessment
– Efficacy
– Type of surface to be
cleaned
– Ease of
application/storage
– Stability/shelf-life
– Contact time
– Number of steps
involved
– Cost $$$
– Safety/toxicity
Cleaning and Disinfection
• Enveloped or not?
Enveloped Viruses
Non-Enveloped Viruses
Canine Distemper
Canine Parvovirus
Canine Parainfluenza
Canine Adenovirus
Canine Influenza
Feline Calicivirus
Feline Herpes
Feline Panleukopenia
Cleaning and Disinfection
• Make sure you are using a disinfectant that is
effective against non-enveloped viruses
– Bleach
o Sodium hypochlorite
o Wysiwash®
– Oxidizing Agents
o Trifectant ®, Virkon ®
– Accelerated Hydrogen Peroxides
o Accel ®, Oxivir ®
Cleaning and Disinfection
• Make sure you are using appropriate concentrations
– Ex: Bleach
o 1:32 for routine cleaning
–½ cup bleach with 1 gallon of water
o 1:10 for ring worm
–1.5 cups bleach with 1 gallon of water
• Know your contact times
• Inappropriate concentrations can be hazardous
– more is not better!
Cleaning and Disinfection
A word on quaternary ammonium compounds…
NOT reliably effective against non-enveloped viruses!
Cleaning and Disinfection
• Dog runs should be unoccupied for
cleaning
– “move down one”
– guillotine door method
– no mop buckets
• Different strategy for cats
– Spot-cleaning
Cleaning and Disinfection
• Separate cleaning supplies
for different areas
• Designated staff
– Quarantine
– Isolation
– No public
• Training is key!
Plan for Sick Animals
• Clinically affected dogs and cats should be
segregated
– Isolation
– Quarantine
• Diagnosis
• Response to therapy
Respiratory Disease
• “Max”
– 2 year old, intact male
– Nasal discharge
– Coughing
Photo courtesy of Dr. Amie Burling
Respiratory Disease
Respiratory Disease
• Canine Infectious Respiratory Disease (CIRD)
– “Kennel Cough”
o Bordetella bronchiseptica
o Parainfluenza virus
o Adenovirus type 2
o Influenza virus
o Respiratory coronavirus
o Distemper virus
Photo courtesy of Dr. Amie Burling
Respiratory Disease
• Canine Infectious Respiratory Disease (CIRD)
– Often viral
– Secondary bacterial infections
Respiratory Disease
• Canine Infectious Respiratory Disease (CIRD)
– Incubation period (varies)
o Days to weeks
– Shedding (varies)
o Weeks to months
– Transmission
o Direct contact with secretions
o Sneezing/Coughing/Staff
Respiratory Disease
• Canine Infectious Respiratory Disease (CIRD)
– Increased risk
o Puppies
o Unvaccinated adult dogs
o Debilitated animals
– Consider
o Crowding
o Co-mingling
o Stress
Respiratory Disease
• Canine Infectious
Respiratory Disease (CIRD)
– Diagnosis
o Cannot diagnose based
on clinical signs!
o Bacterial versus viral?
Respiratory Disease
• Canine Infectious Respiratory Disease (CIRD)
– Management
o Removal of clinically affected dogs
–Separate housing
–PPE for staff (personal protective equipment)
o Diagnosis directs treatment and isolation time
o Isolation/quarantine
–2 weeks
–ExceptionCDV
Respiratory Disease
• Canine Infectious Respiratory Disease (CIRD)
– Management
o Cleaning and disinfection
–SO IMPORTANT!
o Prevention
–Vaccination (prevention versus mitigation)
–Population management
–Stress reduction
Respiratory Disease
• In summary…
– Vaccination
– Recognition
– Quarantine/Isolation
– Testing
– Cleaning/Disinfection
Photo courtesy of Dr. Brian DiGangi
Respiratory Disease
• Vaccine available?
o Bordetella bronchiseptica
o Parainfluenza virus
o Adenovirus type 2
o Influenza virus
o Respiratory coronavirus
o Distemper virus
YES
YES
YES
YES
NO
YES
Respiratory Disease
• Mortality?
o Bordetella bronchiseptica
o Parainfluenza virus
o Adenovirus type 2
o Influenza virus
o Respiratory coronavirus
o Distemper virus
LOW
LOW
LOW
LOW
LOW
HIGH
Respiratory Disease
Photos courtesy of Dr. Natalie Isaza
Respiratory Disease
Photo courtesy of Dr. Natalie Isaza
Canine Distemper Virus
• Highly contagious viral
infection
• Infects multiple body
systems
• Mild/early cases can look
like “kennel cough”
• Transmission
– Direct contact with
secretions
– Sneezing/Coughing/Staff
Photo courtesy of Dr. Amie Burling
Canine Distemper Virus
• Clinical Signs
– Respiratory
o Nasal discharge/ocular
discharge
o Coughing
o Difficulty breathing
– Gastrointestinal
o Vomiting
o Diarrhea
o Decreased appetite
Photo courtesy of Dr. Amie Burling
Canine Distemper Virus
• Clinical Signs
– Neurologic
o Highly variable
o May occur with or
without other clinical
signs
o May occur early or
weeks to months later
– Changes in eyes and skin
Canine Distemper Virus
• Control
– Vaccination
– Recognition
– Quarantine/Isolation
– Testing
– Cleaning/Disinfection
Canine Parvovirus
• Highly contagious viral
infection
– Puppies (Panleukopenia
virus in kittens)
• Un-enveloped
Photos courtesy of Andrea Brower
Canine Parvovirus
• Clinical signs
– Fever
– Vomiting
– Diarrhea
– Dehydration
– Death
• Transmission
– Direct contact with animal or feces
– Fomites (toys, bowls, staff)
Photo courtesy of Dr. Amie Burling
Canine Parvovirus
• Diagnosis
– Cannot diagnose based on
clinical signs!
o Intestinal parasites, dietary
indiscretion, stress
– Commercial tests available
o IDEXX, Agen, Synbiotics
• Management
– Decide: to treat or not to treat
– Consider: available resources
Canine Parvovirus
• Management
– Removal of clinically
affected dogs
– Isolation/quarantine
– PPE for staff
Photo courtesy of Dr. Amie Burling
Canine Parvovirus
• Management
– Cleaning and disinfection
o SO IMPORTANT!
– Prevention
o Vaccination
–On intake
o Population management
o Stress reduction
Photos courtesy of Andrea Brower
Canine Parvovirus
• Control
– Vaccination
– Recognition
– Quarantine/Isolation
– Testing
– Cleaning/Disinfection
Diarrhea
• Oh the possibilities (its not always parvo!)
– Viral
– Bacterial
– Intestinal parasites
– Dietary indiscretion
– Stress
Photo courtesy of Dr. Brian DiGangi
Diarrhea
Prophylactic deworming
Cleaning and disinfection
Zoonotic transmission
Isolation
Diagnosis versus response to
therapy
• Supportive care
•
•
•
•
•
Photo courtesy of Dr. Brian DiGangi
Skin Disease: Ring Worm
• Dermatophytosis “Ring Worm”
– Fungal infection
– Highly contagious
– Zoonotic
– Transmission
o Direct contact
o Contaminated
environment
Photo courtesy of Dr. Amie Burling
Skin Disease: Ring Worm
• Clinical Signs
– Hair loss
– Scabbing/crusting
– Focal areas on face,
ears, feet, or tail
– Can look like anything!
– Itchiness +/• Diagnosis
– Fungal culture
Photos courtesy of Dr. Amie Burling
Skin Disease: Ring Worm
• Increased risk
– Age
– Species
– Immune status
– Pre-existing disease
Skin Disease: Ring Worm
• Prevention
– Careful inspection of all incoming
animals
– Segregate affected animals
– Good husbandry
• Management
– Very durable in the environment
– Cleaning and disinfection
o SO IMPORTANT!
Skin Disease: Ring Worm
• ISOLATE
• Environmental Decontamination:
The 5 D’s
– Diagnose
– Discard
– Debulk
– Disinfect
– Document
Skin Disease: Demodex
• Demodectic Mange “Demodex”
– Mite
– Immunocompromised
animals
– Generalized versus local
infection
– Secondary infections
Skin Disease: Demodex
Photo courtesy of Dr. Natalie Isaza
Skin Disease: Demodex
Photos courtesy of Dr. Natalie Isaza
Skin Disease: Demodex
• Demodectic Mange
“Demodex”
– Diagnosis: skin scrape
– Prolonged treatment for
generalized demodex
– Stress reduction for
localized infection
Skin Disease: Scabies
• Sarcoptic Mange “Scabies”
– Mite
– Very contagious
– Zoonotic!
– Transmission
o Direct contact
o Contaminated
environment
Skin Disease: Scabies
• Sarcoptic Mange “Scabies”
– Diagnosis: skin scrape
– Management
o Isolation
o Medical therapy
Skin Disease: Scabies
Photos courtesy of Dr. Natalie Isaza
Skin Disease
Skin Disease
Conclusion
• Prevention
– Vaccination
– Cleaning/Disinfection
• Recognition
– Quarantine/Isolation
– Testing
o So many things look alike!
• Manage
• Keep calm and RESCUE ON
THANK YOU!
QUESTIONS?