OHSWildlifeHandlersW EB

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: 

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: 

Staying Safe Training Knowledge Awareness Co-workers

Basic Safety Principles : 

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!

Early Reporting of Injury: 

Early Reporting of Injury 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: 

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

Rabies: 

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

Rabies: 

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 Incidence in U.S.

Rabies Transmission: 

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

Rabies Clinical Signs: 

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

Rabies Prevention: 

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

Hantavirus: 

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

Sin Nombre Incidence in U.S.: 

Sin Nombre Incidence in U.S.

Sin Nombre Transmission: 

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

Sin Nombre Clinical Signs: 

Incubation 9 to 33 days High fever, malaise, muscle or joint aches, nausea, vomiting, diarrhea, headaches, respiratory distress, cough Sin Nombre Clinical Signs Early stage of disease Middle stage of disease CDC CDC

Sin Nombre Prevention: 

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

Plague: 

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

Plague: 

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 Prairie Dog CDC CDC

Plague in Animals: 

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

Plague Transmission: 

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

Plague Clinical Signs: 

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

Plague Clinical Signs: 

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

Plague Prevention: 

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

Tularemia: 

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

Tularemia Transmission: 

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

Tularemia Clinical Signs: 

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

Tularemia Prevention: 

Tularemia Prevention Personal protective equipment when skinning hares or rodents Check for ticks daily & remove Use repellants if possible Wild hare – common culprit for disease transmission to hunters from bare-handed field skinning CDC

West Nile Virus: 

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

WNV Clinical Signs: 

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)

West Nile Virus in the U.S.: 

West Nile Virus in the U.S.

West Nile Virus Prevention: 

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

Q Fever: 

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

Q Fever Clinical Signs: 

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

LCM: 

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.

LCM Clinical Signs: 

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%

Slide37: 

The University of Montana-Missoula Occupational Health and Safety Program Participant Capture Employee/Animal User IACUC reviews AUP Visitor Annual Training Sessions “Right to Know” Risk Assessment by OH&S Physician (questionnaire review, facility assessment, novel project assessment, feedback to IACUC) RSC IACUC Coordinator IBC Medical surveillance warranted Procedures/policies to minimize risk Annual Policy Reminder to Dept. Chairs & PIs IACUC No medical surveillance warranted Annual Medical Surveillance