COMPENDIUM of MEASURES TO PREVENT DISEASE and INJURY associated with ANIMALS in PUBLIC SETTINGS

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Chick's hatching daily Baby duck sliding down
the famous duck slide Dairy Cows with Calves
Beef Cow Sow with piglets SheepGoats Rabbits
Turkeys
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COMPENDIUM of MEASURES TO PREVENT DISEASE and
INJURY associated with ANIMALS in PUBLIC SETTINGS
National Association of State Public Health
Veterinarians (NASPHS)
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Problem Increasing Numbers of Human Illness
from Animals in Public Settings

• 12 Published incidents, 1995 -- 2000
• 15 Unpublished incidents, 1990 -- 2000

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National Association of State Public Health
Veterinarians, Inc

• Decision to establish compendium
• Committee appointed
• Literature review
• Draft document, May 2003, Madison, Wisconsin
• Final document April, 2005, Atlanta, Georgia

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Compendium Goal

• Review scientific status of problems and
  policies/methods to address risks
• Develop workable guidelines to reduce or prevent
  disease transmission
• Secure endorsements of compendium
• Publish final version
• Update annually

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NASPHV COMMITTEE MEMBERS
Millicent Eidson, MA, DVM, DACVPM Jeffrey B.
Bender, DVM, MS, DACVPM Russell W. Currier, DVM,
MPH, DACVPM John Grendon, DVM, MPH Michele
Jay-Russell, DVM, MPVM, DACVPM
CONSULTANTS
Frederick J. Angulo, DVM, PhD, DACVPM
CDC John S. Marr, MD, MPH, FACP
CSTE James H. Wright, DVM, MPVM, DACVPM
AVMA
ENDORSED BY
American Veterinary Medical Association Council
of State and Territorial Epidemiologists
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ANIMALS IN PUBLIC SETTINGS
Wildlife Photo Ops
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ANIMALS IN PUBLIC SETTINGS
Wildlife Photo Ops Zoologic Institutions

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ANIMALS IN PUBLIC SETTINGS
Wildlife Photo Ops Zoologic Institutions Natur
e Parks
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ANIMALS IN PUBLIC SETTINGS
Wildlife Photo Ops Zoologic Institutions Natur
e Parks Circuses
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ANIMALS IN PUBLIC SETTINGS
Wildlife Photo Ops Zoologic Institutions Natu
re Parks Circuses Farm Tours
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ANIMALS IN PUBLIC SETTINGS
Wildlife Photo Ops Livestock Birthing
Exhibits Zoologic Institutions Nature
Parks Circuses Farm Tours
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ANIMALS IN PUBLIC SETTINGS
Wildlife Photo Ops Livestock Birthing
Exhibits Zoologic Institutions Petting
Zoos Nature Parks Circuses Farm Tours
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ANIMALS IN PUBLIC SETTINGS
Wildlife Photo Ops Livestock Birthing
Exhibits Zoologic Institutions Petting
Zoos Nature Parks Local Fairs Circuses Far
m Tours
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ANIMALS IN PUBLIC SETTINGS
Wildlife Photo Ops Livestock Birthing
Exhibits Zoologic Institutions Petting
Zoos Nature Parks Local Fair Circuses County
Fair Farm Tours
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ANIMALS IN PUBLIC SETTINGS
Wildlife Photo Ops Livestock Birthing
Exhibits Zoologic Institutions Petting
Zoos Nature Parks Livestock Birthing
Exhibits Circuses County Fairs Farm
Tours State Fairs
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PUBLIC HEALTH ANIMAL DISEASE INJURY RISKS
O Misc. Diseases
Tuberculosis Herpes B (monkeys) Q
fever Psittacosis Club lamb fungus/ ringworm
infections
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PUBLIC HEALTH ANIMAL DISEASE INJURY RISKS
O Misc. Diseases
Tuberculosis Herpes B (monkeys) Q
fever Psittacosis Club lamb fungus/ ringworm
infections Orf
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PUBLIC HEALTH ANIMAL DISEASE INJURY RISKS
O Misc. Diseases O Asthma/Allergy
Dander Scales Fur Feathers Saliva Body wastes
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PUBLIC HEALTH ANIMAL DISEASE INJURY RISKS
O Misc. Diseases O Asthma/Allergy O Rabies
exposure O Injuries Bites Scratches Kicks
Stings Crushing of hands or feet Pinned
between animal and fixed object
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PUBLIC HEALTH ANIMAL DISEASE INJURY RISKS
O Misc. Diseases O Asthma/Allergy O
Injuries and Rabies O Enteric
Diseases Escherichia coli O157 Campylobacter
spp. Salmonella Cryptosporidium parvum
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Outbreak of Escherichia coli O157H7 Infections
Among Visitors to a Dairy Farm

• Montgomery County, PA (Sept Oct, 2000)
• 51 human cases identified
• 16 patients were hospitalized 8 developed HUS
• 28 (13) cattle identified with O157
• DNA fingerprint confirmed link

N Engl J Med 2002347555-60
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Outbreak of Escherichia coli O157H7 Infections
Among Visitors to a Dairy Farm

• Activities associated with infection
• Hand to mouth contact (i.e. nail biting)
• Contact with cattle (especially calves) or manure
• Individuals who washed their hands after touching
  animals and before eating were less likely to
  become ill

N Engl J Med 2002347555-60
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An Outbreak of Salmonellosis Among Children
Attending a Reptile Exhibit at a Zoo

• Public health officials observed an increase in
  Salmonella Enteritidis (SE) among children who
  attended a local zoo
• 65 patients were identified
• SE was isolated from patients, a Komodo dragon,
  and exhibit barriers

J Pediatr 1998132802-7
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An Outbreak of Salmonellosis Among Children
Attending a Reptile Exhibit at a Zoo

• Illness was associated with
• touching a wooden barrier around the Komodo
  dragon exhibit
• Not washing hands after visiting the exhibit

J Pediatr 1998132802-7
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CRYPTO
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Maurits Cornelis Escher
Theodor Escherich
1857-1911
1898-1972
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Escherichia coli 0157 (E. coli 0157)
O The most common shiga-toxin-producing E.
coli O Causes an estimated 60 deaths and
73,000 illnesses annually in the United
States O Healthy cattle are the main
recognized animal reservoirs O E coli enters
food chain directly in beef products or by
contamination of foods or water O Direct
transmission from live animals and their
environment to humans is increasingly recognized
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Existing Regulations

• No state laws as of 2000
• Recently MA, OH, WA developed guidelines
• PA regulated sanitation at animal exhibitions
• U.K. recommendations 1989, 1995, 2000
• Am. Zoo Aquarium Assoc. (AZA) guidelines to
  risk risks of public contact
• USDA Animal Care licenses animal exhibits for
  humane treatment of animals
• CDC, 2001, guidelines for reptiles, enteric
  infection

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RECOMMENDATIONS
O EDUCATION Provide Educational
Materials
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RECOMMENDATIONS
O EDUCATION Provide Educational
Materials Provide Educational Prior to
Contact
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MESSAGES AND SIGNAGE
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RECOMMENDATIONS
O EDUCATION Provide Educational
Materials Provide Educational Prior to
Contact Train Staff
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RECOMMENDATIONS
O CONTROLLING PUBLIC CONTACT WITH
ANIMALS Venue Design
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Recommended Human Flow through Exhibits
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RECOMMENDATIONS
O CONTROLLING PUBLIC CONTACT WITH
ANIMALS Venue Design Non-animals Areas
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RECOMMENDATIONS
O CONTROLLING PUBLIC CONTACT WITH
ANIMALS Venue Design Non-animals Areas Milk
Consumption
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RECOMMENDATIONS
O CONTROLLING PUBLIC CONTACT WITH
ANIMALS Venue Design Non-animals Areas Milk
Consumption Drinking Water
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RECOMMENDATIONS
O CONTROLLING PUBLIC CONTACT WITH
ANIMALS Venue Design Non-animals Areas Milk
Consumption Drinking Water Animal Births
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RECOMMENDATIONS
O CONTROLLING PUBLIC CONTACT WITH
ANIMALS Venue Design Non-animals Areas Milk
Consumption Drinking Water Animal Births
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RECOMMENDATIONS
O MANAGEMENT OF ACTIVITIES IN ANIMAL
AREAS Food and beverages
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RECOMMENDATIONS
O MANAGEMENT OF ACTIVITIES IN ANIMAL
AREAS Food and beverages Hand washing
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RECOMMENDATIONS
O MANAGEMENT OF ACTIVITIES IN ANIMAL
AREAS Food and beverages Hand
washing Cleaning and Disinfection
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RECOMMENDATIONS
O MANAGEMENT OF ACTIVITIES IN ANIMAL
AREAS Food and beverages Hand
washing Cleaning and Disinfection Venue
Staff
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RECOMMENDATIONS
O MANAGEMENT OF ACTIVITIES IN ANIMAL
AREAS Food and beverages Hand
washing Cleaning and Disinfection Venue
Staff Supervision of Children
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RECOMMENDATIONS
O MANAGEMENT OF ACTIVITIES IN ANIMAL
AREAS Food and beverages Hand
washing Cleaning and Disinfection Venue
Staff Supervision of Children Feeding Animals
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RECOMMENDATIONS
O MANAGEMENT OF ACTIVITIES IN ANIMAL
AREAS Food and beverages Hand
washing Cleaning and Disinfection Venue
Staff Supervision of Children Feeding
Animals Logs or Registers
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RECOMMENDATIONS
O MANAGEMENT OF ANIMALS IN ANIMAL
AREAS Animal care
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RECOMMENDATIONS
O MANAGEMENT OF ANIMALS IN ANIMAL
AREAS Animal care Veterinary care
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RECOMMENDATIONS
O MANAGEMENT OF ANIMALS IN ANIMAL
AREAS Animal care Veterinary care Rabies
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RECOMMENDATIONS
O MANAGEMENT OF ANIMALS IN ANIMAL
AREAS Animal care Veterinary
care Rabies Dangerous Animals
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RECOMMENDATIONS
O HIGH-RISK POPULATIONS PRECAUTIONS Children
Women Immunocompromised Immunosuppresed
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Reference
Compendium of Measures To Prevent Disease
Associated with Animals in
Public Settings, 2005 National Association of
State Public Health Veterinarians, Inc.
March 25, 2005 / 54(RR04)1-12
http//www.cdc.gov/mmwr/preview/mmwrhtml/rr5404a1.
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