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Iowa Animal Sheltering Conference 2003 C. J. Baldwin, D.V.M. Director Maddie’s Shelter Medicine Program Iowa State University November 2003 Sponsors 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 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 Why are shelters at increased risk? How can we prevent or control this? – – – – 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? 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? 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 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 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 November 2003 Parasite and Pest Control Treatment should be routine for internal parasites Treatment for external parasites may be necessary Rodent control is essential November 2003 Human Protection 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) Provide pre-exposure rabies vaccinations November 2003 Human Protection Foster: can prevent transmission of disease by education – – – – Fecal exams Skin lesions Ectoparasites Abortion in pregnant animals Adopters: agreements, and health checks Immunocompromised November 2003 What Diseases Are We Concerned With? Bite, scratch, exudate exposure Gastrointestinal diseases Urinary and genital tract diseases Exotic diseases November 2003 Bite Exposure: Rabies 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 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 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 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 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 Treatment: – May not be necessary – Antibiotics may be prescribed Prognosis: – Good – Guarded in immunocompromised November 2003 Bite – Scratch: Tularemia 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 Recently a national alert when Prairie Dogs, originating from Texas distributors, were shipped Biological weapon Human Cases 1990-2000 November 2003 Tularemia 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 History is critical – Rabbits – Ticks – Bites – Sick domestic animals Diagnosis: antibody titers, culture Treatment: antibiotics Prognosis: varies November 2003 Bites-Scratches: Plague Feline Plague : bacteria (Yersini pestis) Most common in western states Rodents are natural hosts Cats become infected Humans most commonly infected by rodent fleas Also by infected cats and wild animals November 2003 Courtesy of R Davis, ISU Plague Bubonic, pneumonic and septicemic forms in humans Prognosis: varies Diagnosis: culture Treatment: antibiotics Courtesy R Davis ISU November 2003 Bite Wounds 30,000 Emergency Room visits/year 28-80% of cat bites become infected – Minor signs – Severe: inflamed brain, heart, joints, shock Wounds involve multiple bacteria Treatment with antibiotics Prognosis varies – Good with appropriate treatment – Guarded in immunocompromised humans November 2003 Bite-Scratch: Sporotrix 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 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 Lesions in humans are similar November 2003 Dermatophytosis November 2003 Courtesy of JO Noxon, ISU Environment Courtesy of JO Noxon, ISU November 2003 Dermatophytosis 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 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 Agents include – Bacteria and more “typical” parasites November 2003 Nematodes (Worms) 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) 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 Prevention in humans involves – Treatment of infected animals – Routine de-worming (CDC) – Cleaning the environment – Keeping pets from defecating in child play areas Treatment in humans November 2003 Other Enteric Pathogens 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 Giardia (protozoan) – – – – 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 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 Dogs may transmit Brucella canis through aborted materials to humans November 2003 Urogenital - Leptospirosis 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 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 Prevention of infection in dogs is possible with vaccination Other modes of transmission are possible – Coon hunters – Water activities 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 4 PDs lab + by PCR & IHC Test + by PCR and virus isolation – 1 Gambian rat – 3 dormice – 2 rope squirrels November 2003 Human Cases 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 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 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 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 Transmitted by mosquito Affects birds Infects horses Infects humans November 2003 Questions? November 2003 Maddie’s Fund Mark Your Calendars! Tentative date for Mr. Rich Avanzino to visit ISU is February 12 & 13, 2004 E-mail [email protected] November 2003