occupational health for wildlife handlers
DESCRIPTION
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? - PowerPoint PPT PresentationTRANSCRIPT
Occupational Health Occupational Health for Wildlife Handlersfor Wildlife Handlers
M. A. Stevenson, DVM, PhD, M. A. Stevenson, DVM, PhD, DACVSDACVS
Director and Attending Director and Attending VeterinarianVeterinarian
The University of Montana-The University of Montana-MissoulaMissoula
Occupational HealthOccupational Health Why now?Why now?
– Mandatory for UM Mandatory for UM to maintain animal to maintain animal research program research program accreditationaccreditation
Why us?Why us?– Everyone listed on Everyone listed on
an AUP an AUP mustmust and and any one else any one else interested interested maymay participateparticipate
Staying SafeStaying Safe
TrainingTraining KnowledgeKnowledge AwarenessAwareness Co-workersCo-workers
Basic Safety PrinciplesBasic Safety Principles Use appropriate PPEUse appropriate PPE
– Gloves, coveralls, washable boots, Gloves, coveralls, washable boots, eye protection, mask or respiratoreye protection, mask or respirator
Good hygiene Good hygiene especially hands especially hands Protect human food and waterProtect human food and water Proper use of sharps containersProper use of sharps containers Communicate with your teamCommunicate with your team Please do not kiss the animals!Please do not kiss the animals!
Early Reporting of Early Reporting of InjuryInjury
Absolutely imperativeAbsolutely imperative to informto inform– Direct SupervisorDirect Supervisor– Principal InvestigatorPrincipal Investigator– Co-workers when in remote field areasCo-workers when in remote field areas
Any unusual symptoms Any unusual symptoms seek seek medical help immediately medical help immediately
Best defense is a good offense Best defense is a good offense Provide a Provide a completecomplete history to history to assist physiciansassist physicians
RabiesRabies
RhabdovirusRhabdovirus Fatal if no treatment Fatal if no treatment
or vaccine or vaccine protectionprotection
Infects all warm-Infects all warm-blooded mammalsblooded mammals
Sylvatic rabies Sylvatic rabies wildlife in life cyclewildlife in life cycle
Ole YellerOle Yeller Photo credits - CDCPhoto credits - CDC “Mad”
Rabies
RabiesRabies
““Dumb” rabiesDumb” rabies WildlifeWildlife
– Lose fear of humansLose fear of humans– Unusually “friendly” Unusually “friendly” – Uncharacteristic Uncharacteristic
places places – Uncharacteristic Uncharacteristic
times of daytimes of day– Neurological signsNeurological signs
– Photo credits - CDCPhoto credits - CDCRabid fox
RabiesRabies
Wildlife Wildlife reservoirs in reservoirs in US in 2001US in 2001
– Raccoons (38%)Raccoons (38%)– Skunks (30%)Skunks (30%)– Bats (17%)Bats (17%)– Foxes (6%)Foxes (6%)
– Photo credits - CDCPhoto credits - CDC
Silver-haired bat
Rabies Incidence in Rabies Incidence in U.S.U.S.
Rabies TransmissionRabies Transmission
Animal bites (virus in saliva)Animal bites (virus in saliva) Contamination of broken skinContamination of broken skin Aerosol in bat cavesAerosol in bat caves Corneal, liver, kidney Corneal, liver, kidney
transplant from infected donortransplant from infected donor 1-2 human cases/year in U.S. 1-2 human cases/year in U.S.
most often bat-associatedmost often bat-associated
Rabies Rabies Clinical Clinical SignsSigns
75% humans ill 75% humans ill << 90 days 90 days after bite woundafter bite wound
Nausea, vomiting, Nausea, vomiting, headacheheadache
Tingling and pain on side Tingling and pain on side of body where bite locatedof body where bite located
Furious and paralytic Furious and paralytic formsforms
Cause of death usually Cause of death usually respiratory failure during respiratory failure during paralytic phaseparalytic phase
CDC
Negri bodies – large pink inclusions in cytoplasm of
brain cells – diagnose Rabies
Rabies PreventionRabies Prevention
Avoid close contact with wild Avoid close contact with wild animals exhibiting unusual behavioranimals exhibiting unusual behavior
Consider pre-exposure Consider pre-exposure immunization if work is high-riskimmunization if work is high-risk
Report animal bites immediately: Report animal bites immediately: post-exposure treatment should post-exposure treatment should start within 24 hoursstart within 24 hours
HantavirusHantavirus Hemorrhagic Hemorrhagic
fever with renal fever with renal syndrome (HFRS)syndrome (HFRS)
1993 - Hantavirus 1993 - Hantavirus pulmonary pulmonary syndrome (HPS)syndrome (HPS)
Sin Nombre virusSin Nombre virus Wildlife reservoir Wildlife reservoir
- - Peromyscus Peromyscus maniculatusmaniculatus
CDC
CDC
Sin Nombre Incidence in Sin Nombre Incidence in U.S.U.S.
Sin Nombre Sin Nombre TransmissionTransmission Aerosol of deer mouse Aerosol of deer mouse urineurine
or fecesor feces Contaminated hands Contaminated hands
mucous membranesmucous membranes Contaminated foodContaminated food Bite transmission rareBite transmission rare 30-35% fatality rate30-35% fatality rate
Incubation 9 to 33 Incubation 9 to 33 daysdays
High fever, High fever, malaise, muscle or malaise, muscle or joint aches, joint aches, nausea, vomiting, nausea, vomiting, diarrhea, diarrhea, headaches, headaches, respiratory respiratory distress, coughdistress, cough
Sin Nombre Sin Nombre Clinical Clinical SignsSigns
Early stage of disease
Middle stage of disease
CDC
CDC
Sin Nombre PreventionSin Nombre Prevention
Personal protective equipmentPersonal protective equipment– Gloves, coveralls, bootsGloves, coveralls, boots
Work upwind of animalsWork upwind of animals Work in the sun, if possibleWork in the sun, if possible Wear a respiratorWear a respirator
– Fit-test through Environmental Fit-test through Environmental Health & Risk ManagementHealth & Risk Management
PlaguePlague
Yersinia pestisYersinia pestis Nonmotile, Gram – Nonmotile, Gram –
rodrod ““Black Death”Black Death” 3 forms 3 forms
(mortality):(mortality):– Bubonic Bubonic – Septicemic (5-50%)Septicemic (5-50%)– Pneumonic (20%)Pneumonic (20%) Gangrene of fingers – a
complication of plague
CDC
PlaguePlague > 200 species rodent > 200 species rodent
reservoirs: prairie reservoirs: prairie dogs, rats, marmots, dogs, rats, marmots, hares, chipmunks, hares, chipmunks, ground squirrelsground squirrels
Xenopsylla cheopis Xenopsylla cheopis rat flea – rat flea – regurgitates up to regurgitates up to 20,000 plague 20,000 plague bacteria from bacteria from “blocked” gut“blocked” gut
Prairie Dog
CDC
CDC
Plague in Plague in AnimalsAnimals Pin-point Pin-point
hemorrhage hemorrhage petechiae petechiae
Swollen Swollen lymph nodeslymph nodes
Respiratory Respiratory diseasedisease
Photo credits - CDCPhoto credits - CDC
Plague TransmissionPlague Transmission Bites of infected rodent fleasBites of infected rodent fleas Entry into breaks in skin when Entry into breaks in skin when
handling infected rodents or handling infected rodents or rabbits; wild carnivores that eat rabbits; wild carnivores that eat infected preyinfected prey
Domestic cats highly susceptible Domestic cats highly susceptible – aerosol or handling– aerosol or handling
Dogs and cats can carry rat fleasDogs and cats can carry rat fleas
Plague Plague Clinical Clinical SignsSigns
Illness 2-6 days Illness 2-6 days after infectionafter infection
Swollen lymph Swollen lymph gland, fever, gland, fever, chills, headache, chills, headache, extreme extreme exhaustionexhaustion
Photo credits - CDCPhoto credits - CDC
Plague Clinical SignsPlague Clinical Signs
Cough, bloody Cough, bloody sputum, sputum, increased increased heart rate, heart rate, shock, DICshock, DIC
Gangrene of Gangrene of fingers and fingers and toestoes
1 month after finger amputation for gangrene
CDC
Plague PreventionPlague Prevention
Prevent flea infestationPrevent flea infestation Handle wild rodents with Handle wild rodents with
appropriate PPEappropriate PPE Do not handle wild rodents Do not handle wild rodents
with petechial hemorrhageswith petechial hemorrhages Four Corners area of the US Four Corners area of the US
high incidencehigh incidence
TularemiaTularemia Francisella Francisella
tularensistularensis Aerobic, gram - Aerobic, gram -
coccobacilluscoccobacillus >> 10 organisms 10 organisms 1.4% fatality 1.4% fatality
raterate Arthropods in Arthropods in
life cyclelife cycle Rhipicephalus sanguineus
“Brown dog tick”
CDC
Tularemia Tularemia TransmissionTransmission Bites by infected arthropodsBites by infected arthropods
– TicksTicks Handling infectious tissuesHandling infectious tissues Contaminated food, water, soilContaminated food, water, soil Inhalation of infective aerosolsInhalation of infective aerosols No human to human No human to human
transmissiontransmission
Tularemia Clinical Tularemia Clinical SignsSigns Fever, headache, Fever, headache,
chills, body chills, body aches (low aches (low back), nasal back), nasal discharge, sore discharge, sore throatthroat
Substernal pain, Substernal pain, cough, anorexia, cough, anorexia, weight loss, weight loss, weaknessweakness
CDC
CDC
Tularemia PreventionTularemia Prevention Personal Personal
protective protective equipment when equipment when skinning hares skinning hares or rodentsor rodents
Check for ticks Check for ticks daily & removedaily & remove
Use repellants if Use repellants if possiblepossible
Wild hare – common culprit for disease transmission to hunters from bare-handed field skinning
CDC
West Nile VirusWest Nile Virus Flavivirus Flavivirus 1999 - in US1999 - in US Horses & Horses &
humans humans encephalitisencephalitis
Bird Bird reservoirs: reservoirs: corvidscorvids
Spread by Spread by mosquitoesmosquitoes
Ochlerotatus japonicusCDC
CDC
WNV Clinical SignsWNV Clinical Signs Incubation 3-14 days Incubation 3-14 days 80% infected humans show no 80% infected humans show no
symptomssymptoms 20% mild symptoms: fever, 20% mild symptoms: fever,
headache, body aches, headache, body aches, nausea, rashnausea, rash
1 in 150 infected 1 in 150 infected severe severe disease (e.g., stupor, coma, disease (e.g., stupor, coma, convulsions, paralysis)convulsions, paralysis)
West Nile Virus in the West Nile Virus in the U.S.U.S.
West Nile Virus West Nile Virus PreventionPrevention Long-sleeved shirts and long Long-sleeved shirts and long
pants, when possiblepants, when possible Bug TamerBug Tamer™™ apparel (Shannon apparel (Shannon
Outdoors, Inc)Outdoors, Inc) Mosquito repellant – DEET for skinMosquito repellant – DEET for skin Avoid dusk to dawn hours outsideAvoid dusk to dawn hours outside Avoid areas of standing waterAvoid areas of standing water http://www.cdc.gov/niosh/topics/westnihttp://www.cdc.gov/niosh/topics/westni
le/recout.html le/recout.html
Q FeverQ Fever Coxiella burnettiCoxiella burnetti Sheep, goats, Sheep, goats,
cattlecattle 1 organism can 1 organism can
cause diseasecause disease Placental Placental
tissuestissues Spread by Spread by
– AerosolAerosol– HandsHands
CDC
CDC
Q Fever Clinical SignsQ Fever Clinical Signs 50% infected get ill in 2-3 weeks50% infected get ill in 2-3 weeks 30-50% infected get pneumonia30-50% infected get pneumonia Headache, malaise, muscle Headache, malaise, muscle
aches, confusion, GI signs, aches, confusion, GI signs, weight loss, hepatitisweight loss, hepatitis
1-2% fatality rate1-2% fatality rate Chronic infection Chronic infection endocarditis endocarditis 65% chronic cases end in death65% chronic cases end in death
LCMLCM Lymphocytic Lymphocytic
choriomeningitis choriomeningitis virusvirus
5% 5% Mus musculusMus musculus in in US; wild mice; pet US; wild mice; pet hamstershamsters
Saliva, urine, feces of Saliva, urine, feces of infected rodentsinfected rodents
Mucous membranes, Mucous membranes, broken skin, bitesbroken skin, bites
Hamster
Peromyscus sp.
LCM Clinical SignsLCM Clinical Signs Humans showing illness Humans showing illness signs 8-13 signs 8-13
days post-infectiondays post-infection Early: biphasic fever, malaise, muscle Early: biphasic fever, malaise, muscle
aches, headache, nausea, vomitingaches, headache, nausea, vomiting Later: headache, stiff neck, Later: headache, stiff neck,
confusion, neurological signsconfusion, neurological signs Early pregnancy: abortion or fetal Early pregnancy: abortion or fetal
birth defectsbirth defects Fatality rate < 1%Fatality rate < 1%
The University of Montana-MissoulaOccupational 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
IACUCNo medical surveillance warranted
Annual Medical Surveillance
IACUCOH&S PhysicianCapture Mechanisms
Flow of participants
Administrative flow
IACUCOH&S PhysicianUM Administration
Flow of participants
Administrative flow
Individual risk assessment reviewed by OH&S Physician
IACUC Coordinator
Medical surveillance not warranted
(E-mail notification)
Medical surveillance warranted
OH&S Physician Further Evaluation
Cleared without Restrictions (E-mail notification)
Annual Medical Surveillance
Serious health problem or direct threat
(Letter notification)
HR Director consultation if employment impacted
Respirator necessary
Fit-test UM EH&RM Dept.
Cleared with Restrictions
(Letter notification)
Occupational Health and Safety Program Participant Medical Review