Download Occupational Health for Wildlife Handlers

Occupational Health for
Wildlife Handlers
M. A. Stevenson, DVM, PhD, DACVS
Director and Attending Veterinarian
The University of Montana-Missoula
Occupational Health

Why now?
– Mandatory for UM
to maintain animal
research program
accreditation

Why us?
– Everyone listed on
an AUP must and
any one else
interested may
participate
Staying Safe

Training

Knowledge

Awareness

Co-workers
Basic Safety Principles

Use appropriate PPE
– Gloves, coveralls, washable boots,
eye protection, mask or respirator
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Good hygiene  especially hands
Protect human food and water
Proper use of sharps containers
Communicate with your team
Please do not kiss the animals!
Early Reporting of Injury
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Absolutely imperative to inform
– Direct Supervisor
– Principal Investigator
– Co-workers when in remote field areas


Any unusual symptoms  seek
medical help immediately
Best defense is a good offense 
Provide a complete history to assist
physicians
Rabies
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Rhabdovirus
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Fatal if no treatment
or vaccine protection
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Infects all warmblooded mammals
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Sylvatic rabies 
wildlife in life cycle

Ole Yeller

Photo credits - CDC
“Mad” Rabies
Rabies
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“Dumb” rabies

Wildlife
– Lose fear of humans
– Unusually “friendly”
– Uncharacteristic
places
– Uncharacteristic
times of day
– Neurological signs
– Photo credits - CDC
Rabid fox
Rabies

Wildlife
reservoirs in US
in 2001
–
–
–
–
Raccoons (38%)
Skunks (30%)
Bats (17%)
Foxes (6%)
– Photo credits - CDC
Silver-haired bat
Rabies Incidence in U.S.
Rabies Transmission
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Animal bites (virus in saliva)
Contamination of broken skin
Aerosol in bat caves
Corneal, liver, kidney transplant
from infected donor
1-2 human cases/year in U.S.
most often bat-associated
Rabies
Clinical Signs

75% humans ill < 90 days
after bite wound

Nausea, vomiting,
headache

Tingling and pain on side of
body where bite located
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Furious and paralytic forms
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Cause of death usually
respiratory failure during
paralytic phase
CDC
Negri bodies – large pink
inclusions in cytoplasm of
brain cells – diagnose Rabies
Rabies Prevention

Avoid close contact with wild animals
exhibiting unusual behavior
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Consider pre-exposure immunization if
work is high-risk

Report animal bites immediately: post-
exposure treatment should start
within 24 hours
Hantavirus
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Hemorrhagic fever
with renal syndrome
(HFRS)
1993 - Hantavirus
pulmonary
syndrome (HPS)
Sin Nombre virus
Wildlife reservoir -
CDC
Peromyscus
maniculatus
CDC
Sin Nombre Incidence in U.S.
Sin Nombre Transmission
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Aerosol of deer mouse urine or
feces
Contaminated hands  mucous
membranes
Contaminated food
Bite transmission rare
30-35% fatality rate
Sin Nombre
Clinical Signs
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Incubation 9 to 33
days
High fever, malaise,
muscle or joint
aches, nausea,
vomiting, diarrhea,
headaches,
respiratory distress,
cough
CDC
Early stage of disease
CDC
Middle stage of disease
Sin Nombre Prevention
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Personal protective equipment
– Gloves, coveralls, boots
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Work upwind of animals
Work in the sun, if possible
Wear a respirator
– Fit-test through Environmental
Health & Risk Management
Plague
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Yersinia pestis
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Nonmotile, Gram –
rod
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“Black Death”
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3 forms (mortality):
– Bubonic
– Septicemic (5-50%)
– Pneumonic (20%)
CDC
Gangrene of fingers – a
complication of plague
Prairie Dog
Plague
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> 200 species rodent
reservoirs: prairie
dogs, rats, marmots,
hares, chipmunks,
ground squirrels
Xenopsylla cheopis
rat flea – regurgitates
up to 20,000 plague
bacteria from
“blocked” gut
CDC
CDC
Plague in Animals
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Pin-point
hemorrhage 
petechiae
Swollen lymph
nodes
Respiratory
disease
Photo credits - CDC
Plague Transmission
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Bites of infected rodent fleas
Entry into breaks in skin when
handling infected rodents or
rabbits; wild carnivores that eat
infected prey
Domestic cats highly susceptible
– aerosol or handling
Dogs and cats can carry rat fleas
Plague
Clinical Signs
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Illness 2-6 days
after infection
Swollen lymph
gland, fever, chills,
headache,
extreme
exhaustion
Photo credits - CDC
Plague Clinical Signs
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Cough, bloody
sputum,
increased
heart rate,
shock, DIC
Gangrene of
fingers and
toes
CDC
1 month after finger amputation
for gangrene
Plague Prevention
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Prevent flea infestation
Handle wild rodents with
appropriate PPE
Do not handle wild rodents with
petechial hemorrhages
Four Corners area of the US high
incidence
Tularemia
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Francisella
tularensis
Aerobic, gram coccobacillus
> 10 organisms
1.4% fatality rate
Arthropods in life
cycle
CDC
Rhipicephalus sanguineus
“Brown dog tick”
Tularemia Transmission

Bites by infected arthropods
– Ticks

Handling infectious tissues
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Contaminated food, water, soil
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Inhalation of infective aerosols
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No human to human transmission
Tularemia Clinical Signs
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Fever, headache,
chills, body aches
(low back), nasal
discharge, sore
throat
Substernal pain,
cough, anorexia,
weight loss,
weakness
CDC
CDC
Tularemia Prevention
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Personal
protective
equipment when
skinning hares or
rodents
Check for ticks
daily & remove
Use repellants if
possible
CDC
Wild hare – common culprit for
disease transmission to hunters
from bare-handed field skinning
West Nile Virus
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Flavivirus
1999 - in US
Horses &
humans 
encephalitis
Bird reservoirs:
corvids
Spread by
mosquitoes
CDC
CDC
Ochlerotatus japonicus
WNV Clinical Signs
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Incubation 3-14 days
80% infected humans show no
symptoms
20% mild symptoms: fever,
headache, body aches, nausea,
rash
1 in 150 infected  severe
disease (e.g., stupor, coma,
convulsions, paralysis)
West Nile Virus in the U.S.
West Nile Virus Prevention
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Long-sleeved shirts and long pants,
when possible
Bug Tamer™ apparel (Shannon
Outdoors, Inc)
Mosquito repellant – DEET for skin
Avoid dusk to dawn hours outside
Avoid areas of standing water
http://www.cdc.gov/niosh/topics/westnile/re
cout.html
Q Fever
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Coxiella burnetti
Sheep, goats,
cattle
1 organism can
cause disease
Placental tissues
Spread by
CDC
– Aerosol
– Hands
CDC
Q Fever Clinical Signs
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50% infected get ill in 2-3 weeks
30-50% infected get pneumonia
Headache, malaise, muscle aches,
confusion, GI signs, weight loss,
hepatitis
1-2% fatality rate
Chronic infection  endocarditis
65% chronic cases end in death
LCM
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Lymphocytic
choriomeningitis virus
5% Mus musculus in
US; wild mice; pet
hamsters
Saliva, urine, feces of
infected rodents
Mucous membranes,
broken skin, bites
Hamster
Peromyscus sp.
LCM Clinical Signs
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Humans showing illness  signs 8-13
days post-infection
Early: biphasic fever, malaise, muscle
aches, headache, nausea, vomiting
Later: headache, stiff neck, confusion,
neurological signs
Early pregnancy: abortion or fetal birth
defects
Fatality rate < 1%
The University of Montana-Missoula
Occupational Health and Safety Program Participant Capture
Visitor
Annual Policy
Reminder to Dept.
Chairs & PIs
Employee/Animal User
IBC
“Right to Know”
Annual Training Sessions
RSC
IACUC reviews AUP
IACUC Coordinator
Risk Assessment by OH&S Physician (questionnaire review, facility
assessment, novel project assessment, feedback to IACUC)
IACUC
No medical surveillance warranted
Procedures/policies to minimize risk
Medical surveillance warranted
IACUC
OH&S Physician
Capture Mechanisms
Annual Medical Surveillance
Flow of participants
Administrative flow
Occupational Health and Safety Program Participant Medical Review
Individual risk assessment reviewed by OH&S Physician
Medical surveillance warranted
Medical surveillance
not warranted
(E-mail notification)
Cleared
without Restrictions
(E-mail notification)
Annual
Medical Surveillance
OH&S Physician
Further Evaluation
Serious health problem
or direct threat
(Letter notification)
Cleared
with Restrictions
(Letter notification)
IACUC Coordinator
Respirator necessary
IACUC
OH&S Physician
UM Administration
Flow of participants
Administrative flow
HR Director consultation if
employment impacted
Fit-test UM EH&RM Dept.