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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?

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Occupational Health for Wildlife Handlers

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  1. Occupational Health for Wildlife Handlers M. A. Stevenson, DVM, PhD, DACVS Director and Attending Veterinarian The University of Montana-Missoula

  2. 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

  3. Staying Safe • Training • Knowledge • Awareness • Co-workers

  4. Basic Safety Principles • Use appropriate PPE • Gloves, coveralls, washable boots, eye protection, mask or respirator • Good hygiene  especially hands • Protect human food and water • Proper use of sharps containers • Communicate with your team • Please do not kiss the animals!

  5. Early Reporting of Injury • Absolutely imperativeto 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

  6. Rabies • Rhabdovirus • Fatal if no treatment or vaccine protection • Infects all warm-blooded mammals • Sylvatic rabies  wildlife in life cycle • Ole Yeller • Photo credits - CDC “Mad” Rabies

  7. Rabies • “Dumb” rabies • Wildlife • Lose fear of humans • Unusually “friendly” • Uncharacteristic places • Uncharacteristic times of day • Neurological signs • Photo credits - CDC Rabid fox

  8. Rabies • Wildlife reservoirs in US in 2001 • Raccoons (38%) • Skunks (30%) • Bats (17%) • Foxes (6%) • Photo credits - CDC Silver-haired bat

  9. Rabies Incidence in U.S.

  10. Rabies Transmission • 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

  11. Rabies Clinical Signs • 75% humans ill < 90 days after bite wound • Nausea, vomiting, headache • Tingling and pain on side of body where bite located • Furious and paralytic forms • Cause of death usually respiratory failure during paralytic phase CDC Negri bodies – large pink inclusions in cytoplasm of brain cells – diagnose Rabies

  12. Rabies Prevention • Avoid close contact with wild animals exhibiting unusual behavior • Consider pre-exposure immunization if work is high-risk • Report animal bites immediately: post-exposure treatment should start within 24 hours

  13. Hantavirus • Hemorrhagic fever with renal syndrome (HFRS) • 1993 - Hantavirus pulmonary syndrome (HPS) • Sin Nombre virus • Wildlife reservoir - Peromyscus maniculatus CDC CDC

  14. Sin Nombre Incidence in U.S.

  15. Sin Nombre Transmission • Aerosol of deer mouse urine or feces • Contaminated hands  mucous membranes • Contaminated food • Bite transmission rare • 30-35% fatality rate

  16. Sin Nombre Clinical Signs • 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

  17. Sin Nombre Prevention • Personal protective equipment • Gloves, coveralls, boots • Work upwind of animals • Work in the sun, if possible • Wear a respirator • Fit-test through Environmental Health & Risk Management

  18. Plague • Yersinia pestis • Nonmotile, Gram – rod • “Black Death” • 3 forms (mortality): • Bubonic • Septicemic (5-50%) • Pneumonic (20%) CDC Gangrene of fingers – a complication of plague

  19. Prairie Dog Plague • > 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

  20. Plague in Animals • Pin-point hemorrhage  petechiae • Swollen lymph nodes • Respiratory disease • Photo credits - CDC

  21. Plague Transmission • 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

  22. Plague Clinical Signs • Illness 2-6 days after infection • Swollen lymph gland, fever, chills, headache, extreme exhaustion • Photo credits - CDC

  23. Plague Clinical Signs • Cough, bloody sputum, increased heart rate, shock, DIC • Gangrene of fingers and toes CDC 1 month after finger amputation for gangrene

  24. Plague Prevention • 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

  25. Tularemia • Francisella tularensis • Aerobic, gram - coccobacillus • > 10 organisms • 1.4% fatality rate • Arthropods in life cycle CDC Rhipicephalus sanguineus “Brown dog tick”

  26. Tularemia Transmission • Bites by infected arthropods • Ticks • Handling infectious tissues • Contaminated food, water, soil • Inhalation of infective aerosols • No human to human transmission

  27. Tularemia Clinical Signs • Fever, headache, chills, body aches (low back), nasal discharge, sore throat • Substernal pain, cough, anorexia, weight loss, weakness CDC CDC

  28. Tularemia Prevention • 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

  29. West Nile Virus • Flavivirus • 1999 - in US • Horses & humans  encephalitis • Bird reservoirs: corvids • Spread by mosquitoes CDC CDC Ochlerotatus japonicus

  30. WNV Clinical Signs • 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)

  31. West Nile Virus in the U.S.

  32. West Nile Virus Prevention • 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/recout.html

  33. Q Fever • Coxiella burnetti • Sheep, goats, cattle • 1 organism can cause disease • Placental tissues • Spread by • Aerosol • Hands CDC CDC

  34. Q Fever Clinical Signs • 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

  35. LCM • 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.

  36. LCM Clinical Signs • 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%

  37. IACUC OH&S Physician Capture Mechanisms Flow of participants Administrative flow The University of Montana-Missoula Occupational Health and Safety Program Participant Capture Annual Policy Reminder to Dept. Chairs & PIs Visitor Employee/Animal User IBC RSC “Right to Know” IACUC reviews AUP IACUC Coordinator Annual Training Sessions 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 Annual Medical Surveillance

  38. 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) OH&S Physician Further Evaluation Cleared without Restrictions (E-mail notification) Annual Medical Surveillance Serious health problem or direct threat (Letter notification) Cleared with Restrictions (Letter notification) IACUC Coordinator IACUC Respirator necessary OH&S Physician HR Director consultation if employment impacted UM Administration Flow of participants Fit-test UM EH&RM Dept. Administrative flow

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