Psittacosis – The potential for occupational exposure

Investigation 2238 TGRInvestigation 2238 TGRSeptember 2009September 2009

0800 report 0800 report -- January 2010January 2010

Acknowledgements

• Hillery Harvey • John Potter• Cathy Harvey• Berend Westera• Gabrielle

Thompson• Doug Lush

• Simon Baker • Janine Manuel• Alistair Humphrey• James Corbett• Birandra Singh

Investigation plan

History - Tamaki• Birds:

– Start: Autumn 2009– Clinical signs– Progression

• Humans: – May 2009 (1st vet); Sept 2009 (2nd vet)– Timeline of events for 2nd vet:

• Dove post-mortems 25/27 September• Flu-like symptoms onset 5 October • Pneumonia – off work 12/13 October

Laboratory

• Doves

• Human: First serology test 16 OctoberSecond serology test 20 November

History - Christchurch

• Birds: – No disease in cockatiels

• Humans: – January 2010– Vet and vet nurse & Ix MOP:

contact with cockatiels in pet/vet clinic

– Debilitating disease in vet: 10 days in hospital, 4-5wks recovery

Follow up measures• Local MoH informed/engaged• Manakau Parks informed/engaged• Plan developed:

– Awareness (letter drop, NZVA)– Prohibit bird feeding– Clearing of dead birds– Reduce vegetation/tree cover

• Further awareness measures: – VetScript– Biosecurity Magazine– Kokako

Follow up work

• PCR work on wax blocks at IDC

• C. Pneumoniae or C. psittaci??• Family members (daughter and two

grandchildren)• Auckland Zoo sero-survey (2/47)

Outcomes:• Highlights the potential for

occupational exposure• Highlights the impacts esp. if

not caught early• Poor awareness amongst

medicos: ‘SilicosisSilicosis’• Are we doing enough?

– Should more routine screening of pets be carried out?– Rapid tests for humans – antigen ELISA as for birds?– Other awareness initiatives? – Should Psittacosis be Notifiable?

Awareness

Further advice/awareness

Psittacosis is an important zoonotic

concern as has the potential to cause severe human disease, even death

Staff awareness

is an important component of keeping safe:

■

Of potential exposure risks, including the low infectious dose

meaning infection can result from only brief proximity to a shedding bird

■

That infected birds can be asymptomatic ■

That infection may be acquired by inhalation, as well as exposure to

mucosal surfaces (eyes, nose, etc.) or cuts ■

That certain individuals (immunocompromised, pregnant) are more

susceptible ■

Of the symptoms of infection

■

That when consulting a doctor or other health care provider, prior potential exposure events should be bought to their attention