RISK ASSESSMENTS AND PRECAUTIONS OF DISEASES SHARED BY PEOPLE AND ANIMALS

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RISK ASSESSMENTS AND PRECAUTIONS OF
DISEASESSHARED BY PEOPLE AND ANIMALS

• James Wright, DVM, MPVM
• Zoonosis Control Division
• Texas Department of State Health Services
• Tyler, Texas
• Buddy Faries, DVM, MS
• Texas Cooperative Extension
• Texas AM University
• College Station, Texas

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• Buddy James, you are a public health
  veterinarian. What occupies most of your time?
• James Zoonotic diseases (rabies, WNV, anthrax,
  plague), also anmal control officer rtraining and
  consultation.

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• Buddy Do a lot of people get rabies?
• James No. Very few. However, because
  transmission is via animal bites, every bite must
  be followed up. In the mind of most physicians,
  every biting animal is rabid until proven
  otherwise.
• Buddy So how does someone prove an animal was
  not rabid when it inflicted a bite?

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How to prove an animal does NOT have rabies..

• Quarantine (dog, cat, or ferret)

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Transmission of the rabies virus is via the
saliva

• Important fact in dogs, cats, and ferrets
• Animal will not have virus in its salivary
  glands for more than 5-6 days before showing some
  other sign of being ill.

Thereforequarantine for 10 days
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• Buddy What is the other way to prove the animal
  was not rabid when it bit?

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How to prove an animal does NOT have rabies..

• Quarantine (dog, cat, or ferret)

Lab testing
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So when a mother whose child has been bitten by
an animal calls, what our audience tell her?
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Bite victim should

• Find the animal

Animal control can help
Do NOT shoot in the head
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• Buddy That makes sense. I am sure some of our
  audience might get confused on quarantine period
  vs incubation period. The incubation period for
  rabies is 2 weeks to several months. Therefore,
  the quarantine just looks at the very last part
  of the incubation period and the very earliest
  time of clinical signs. That is to evaluate
  whether a dog or cat might be shedding the virus
  in its saliva.

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Incubation Period

• Variable
• 2 weeks to several months
• Quarantine period (dog or cat)
• 10 days

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• Buddy Rabies is a universally fatal disease.
  There is no cure. If a person cannot quarantine
  or laboratory test an animal that inflicted a
  bite, what does a person do to prevent rabies?

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Treatment

• Wash wound immediately
• Consider post-exposure prophylaxis
• Not a foregone conclusion
• Rarely an emergency

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• James Determine the species of the biting
  animal.
• Buddy Yes certain species are considered to be
  very high risk of being a rabies reservoir. For
  example

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Post-exposure Prophylaxis Decision
Species of biting animal
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Skunk High Risk
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Coyote High Risk
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Fox High Risk
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Raccoon High Risk
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• James will talk about bats after Buddy mentions
  the species

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BAT High Risk
Since 1980 in the US, over 90 of the
domestically acquired human rabies cases were
from bats.
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• James We have talked about high risk animal
  species, would you list some low risk animals,
  too?

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Low Risk Animals

• opossums
• armadillos
• rabbits
• rats, mice, squirrels, beavers

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• Buddy Besides the availability for quarantine
  or testing and the animals species, what else
  helps a doctor in deciding whether to administer
  the rabies post-exposure treatment?

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Post-exposure Prophylaxis Decision

• Species of biting animal

Vaccination status of animal

• Provoked vs not provoked

• Prevalence of rabies in the area

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• Buddy There are thousands of animal bites every
  year in Texas. Why do you think there are so few
  cases of human rabies?

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Few Cases of Human Rabies in US

• Vaccination of pets
• Public health education
• Bite follow-up

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Local Rabies Control Authority (LRCA) Health
and Safety Code 826.017 -- Commissioners Court
of each county and local governing body of each
municipality shall designate...local rabies
control authority. Can be health officer, animal
control officer, peace officer, or any other
entity.
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• James What are protective measures that people
  can follow to protect themselves against exposure
  to rabies?

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CREATE RABIES IMMUNED BARRIERSBETWEEN PEOPLE AND
WILDLIFE
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• MAINTAIN IMMUNITY IN DOMESTIC ANIMALS
• CONFINED HORSES, SHOW LIVESTOCK
• DOGS, CATS

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• ADOPT VACCINATION PROGRAMS RECOMMENDED BY
  VETERINARIANS

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DISCOURAGE POTENTIAL RABIES RESERVOIRSFROM
INHABITING PREMISES AROUND HOME

• SKUNKS, BATS, RACCOONS, FOXES, COYOTES

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• ELIMINATE BRUSHY, GRASSY AREAS FOR WILDLIFE
  NESTING

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• PREVENT PET AND LIVESTOCK FOODS FOR WILDLIFE
  FEEDING
• ELIMINATE WILD PERSIMMON TREES AND BERRY VINES
  THAT ATTRACT WILDLIFE

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AVOID WILDLIFE PETS

• SKUNKS, RACCOONS

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Buddy Is there anywhere in Texas that rabies is
not something to be considered?
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• James Afraid not, Buddy. Lets look at the
  distribution of rabies in Texas.

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• Texas rabies map

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• Buddy - We have covered rabies. Now lets move
  on and talk about some disease vectors common all
  over the state.
• James You must mean ticks.
• Buddy Yes. Ticks are an irritant themselves,
  but they can carry some diseases also. Since
  most of our audience are not physicians or direct
  patient care providers, lets take only a brief
  look at the clinical symptoms of these illnesses.
  We can then discuss what our public health
  staffs can tell folks to help them keep from
  acquiring the illnesses. James, give us a brief
  overview of the tickborne diseases.

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Ticks and Disease
Rocky Mountain Spotted Fever Erhlichia Lyme
Disease STARI

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Rocky Mountain Spotted Fever

• Transmit
• Infected tick bite
• Contamination of broken skin or mucous membranes
  with infected tick feces.
• Symptoms are severe
• Treat -- antibiotics

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Erhlichia

• Symptoms
• Fever, headache, muscle aches, vomiting, nausea
• Mild to fatal
• Treat -- antibiotics

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Lyme Disease

• Flu-like symptoms (fever, malaise, fatigue,
  muscle aches)
• Erythema Migrans (60)
• Chronic
• Neurological abnormalities
• Cardiac abnormalities
• Arthritis (swelling pain)
• Treat antibiotics

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• James That is a quick look at the illnesses
  transmitted by ticks. Buddy, how about
  discussing ways a person avoids getting these
  diseases?
• Buddy There are a few strategies for avoiding
  disease transmission from ticks. First, dont
  get bit by ticks. That is, of course, easier
  said than done.

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Preventing Tick-borne Disease

• Clothes to exclude or see the ticks

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Preventing Tick-borne Disease
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Preventing Tick-borne Disease

• Clothes to exclude or see the ticks
• Repellants
• DEET is the gold standard

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• James Even if a tick attaches to a person, that
  doesnt mean disease transmission is for sure.

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Preventing Tick-borne Disease

• Clothes to exclude or see the ticks
• Repellants
• Tick Checks
• Ticks must be attached several hours before
  transmit the organism

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Preventing Tick-borne Disease

• Clothes to exclude or see the ticks
• Repellants
• Tick Checks
• Ticks must be attached several hours before
  transmit the organism
• Proper tick removal

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Not Recommended
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Tick Removal
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Preventing Tick-borne Disease

• Clothes to exclude or see the ticks
• Repellants
• Tick checks
• Proper tick removal
• Dont crush ticks

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• James Buddy, how can people control ticks in
  their environment? That would go a long way in
  helping them avoid a tick bite.
• (Buddy, talk as much as you want to on keeping
  ticks off pets and livestock and controlling them
  in the yard

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Preventing Tick-borne Disease

• Clothes to exclude or see the ticks
• Repellants
• Tick checks
• Proper tick removal
• Dont crush ticks
• Keep pets and yard free of ticks

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• APPLY CHEMICALS ON ANIMALS
• SPRAYS, DIPS, COLLARS, SPOT-ONS, BACKRUBBERS

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• BURN NON-FLAMMABLE HOUSING AREAS

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• SURVEY OUTDOOR AREAS
• DRAG WHITE FLANNEL SHEET

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• APPLY ENVIRONMENTAL CHEMICALS ON PREMISES
• SPRAYS, BAITS

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• DISCOURAGE ENVIRONMENTAL HOSTS ON PREMISES
• DEER, RABBITS, RODENTS, FERAL SWINE

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• CONTROL BRUSH AND WEEDS
• CHEMICAL APPLICATION
• MECHANICAL REMOVAL
• BURN PASTURE

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• James The zoonotic diseases, that we have
  discussed this afternoon, are transmitted by
  animal bites or tick bites. A food-borne,
  zoonotic disease, that is not known to be in the
  US, is BSE. What is BSE? What are the
  safeguards or firewalls enforced by USDA to
  prevent this disease from entering the US and
  from being transmitted to cattle and people?

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BOVINE SPONGIFORM ENCEPHALOPATHY (BSE)

• MAD COW DISEASE

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SPECIFIED RISK MATERIALS (SRMs)

• BRAIN, SPINAL CORD, SKULL, VERTEBRAE, ILEUM OF
  CATTLE

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TRANSMISSION

• CATTLE
• EAT CONTAMINATED MEAT, BONE, BLOOD MEALS
• PEOPLE
• EAT CONTAMINATED GROUND MEAT

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SAFEGUARDS FIREWALLS

• USDA IMPORT BANS
• RUMINANTS AND RUMINANT PRODUCTS
• COUNTRIES KNOWN TO HAVE BSE

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• USDA CATTLE FEED BANS
• RUMINANT MEAT, BONE AND BLOOD MEALS
• POULTRY LITTER

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• USDA CATTLE SLAUGHTER BANS
• DOWNERS
• BRAIN, SPINAL CORD
• SMALL INTESTINE
• SKULL, VERTEBRAE gt30 MOS AGE

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• James Enforcement of the safeguards by USDA, as
  you have discussed the slaughter surveillance in
  testing of cattle brains by USDA and no evidence
  of BSE in the US, reduce consumers concern of
  exposure to BSE by consumption of beef in the US.

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• Buddy Closing remarks
• James Closing remarks

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