LAMS503 SA Biosecurity Lecture PDF

BIOSECURITY AND BIOSAFETY SMALL ANIMAL LAMS 503 Inga Karasek, DVM, MSc. CVA Talia Guttin, M.Ed, VMD, DACVIM Lecture Learning Outcomes Understand the basic principles of biosafety/biosecurity within small animal practice Recognize the need for appropriate biosecurity protocols in veterinary pract...

BIOSECURITY AND BIOSAFETY SMALL ANIMAL LAMS 503 Inga Karasek, DVM, MSc. CVA Talia Guttin, M.Ed, VMD, DACVIM Lecture Learning Outcomes Understand the basic principles of biosafety/biosecurity within small animal practice Recognize the need for appropriate biosecurity protocols in veterinary practices Know the 5 main routes of pathogen transmission Understand the veterinarian's role in a pandemic Definitions Biosecurity- the methods that are used to stop a disease or infection from spreading from one person, animal, or place to others – More to do with clinical practice situations Biosafety- methods that are used to stop a biohazard (= something such as a disease or chemical that may harm people, animals, or the environment) from spreading out of a place or from causing harm – More to do with laboratory situations – In hospital– needle/syringe/blood/tissue handling, disposal of sharps, biohazardous materials 2018 AAHA Infection Control, Prevention, and Biosecurity Guidelines A veterinary team’s best effort can be undone by a breach in infection control, prevention and biosecurity (ICPB). Breaches of ICPB- Medical impacts Social impacts Financial impacts Who is affected? Patients, clients, staff, hospital/clinic’s reputation…….anyone else? Definitions: Matching Game An infectious disease that Infectious is transmissible between X humans and animals. Clinical disease of a Contagious human or animal due to Invasion by a microorganism A microorganism that causes infection that can Zoonotic spread from one organism to another via direct or indirect contact. What infections can animals get from people? What are some zoonotic pathogens we should be aware of as veterinarians? ZOONOTIC INFECTIONS As veterinarians we need to be very concerned with the spread of zoonotic pathogens Examples are: Rabies Microsporum canis Leptospira Campylobacter Bartonella  Pathogens of Greatest Infection Control Concern in a SA Hospital Adenovirus (canine) Parainfluenza virus (canine) Bordetella bronchiseptica Parvoviruses (canine, feline) Calicivirus (feline) Respiratory coronavirus (canine) Chlamydophila (feline) Salmonella spp. Distemper virus (canine) Multidrug-resistant organisms: Herpesvirus (feline) Acinetobacter spp., Influenza viruses (canine, Escherichia coli, novel) Enterococcus spp., Staphylococcus spp., Leptospira interrogans Pseudomonas spp. Microsporum canis  Review of pathogen spread: 5 main routes Direct contact & _ with tissues/fluids of infected individual, bites, scratches e.g., rabies, Microsporum caninum, Leptospira spp Fomite transmission inanimate objects contaminated- tables, kennels, bowls then leading to infection in an animal e.g., canine parvovirus Aerosol via very small particles or droplet nuclei inhaled/on mucous membranes e.g., Bordetella bronchiseptica, canine influenza, and canine distemper virus Oral contaminated food or water, licking/chewing on contaminated objects or surfaces e.g., feline panleukopenia, Campylobacter, Salmonella, E. coli, and Leptospira Vector-borne living organisms that can transfer pathogenic microorganisms to other animals or places e.g., heartworm disease, Bartonella infection, Borrellia burgdorferi infection How do we deal with the 5 main routes of pathogen spread? Elimination Early identification of infectious cases to prevent exposures within the main hospital areas (PHONE TRIAGE) Extermination services/pest management regularly Design practices to allow for separate entrance for infectious patients Engineering Install hand hygiene stations in key locations Use of nonporous work surfaces Negative pressure ventilation especially in isolation/infectious areas How do we deal with the 5 main routes of pathogen spread? Develop and implement infection control, cleaning, and disinfection policies and procedures (SOPs) Administration Train the staff and clients Prevent nonessential staff entering infectious areas Remove vectors from patients Vaccinate staff (rabies, tetanus toxoid +/- influenza, Covid-19) Proper use of level of PPE in relation to the risk PPE e.g., gloves, masks, eye protection for dentistry, necropsies (risk of splash/aerosolization) Gloves for removal of vectors (ticks)  Select Select an Infection Control Practitioner Develop evidence based standard operating procedures (SOPs) related to Develop tasks performed frequently by the veterinary team (e.g., hand hygiene, phone triage) Assess the strengths and weaknesses of the current plan for the Assess clinic/hospital Recommendations for veterinary practices Educate and Educate and train the staff train Create Create client education material on biosecurity Implement Implement a surveillance program Infection Control Practitioner (ICP) This person has 2 main goals: Takes responsibility for the Limit pathogen introduction, exposure, practice's infection transmission, and control/biosecurity infection within the measures and ensures hospital population staff compliance/training Evaluate the effectiveness of the infection control practices at controlling disease STANDARD OPERATING PROTOCOLS (SOPS) Hand Washing (Soap & Water) Hand Rub (AHS) Turn on water - Wet Hands - Dispense product directly into hands (1-2 pumps) Dispense product directly into hands (1-2 pumps) Apply product to all surfaces of hands; min. 15 s Apply product to all surfaces of hands; min. 15 s contact time contact time Palms Palms Back of hands Back of hands Between fingers Between fingers Fingertips Fingertips Thumb and thumb web Thumb and thumb web +/- Wrists +/- Wrists Rinse all surfaces of hands with water - Dry hands thoroughly with single use paper towel Rub hands until dry Turn water off, using drying towel to avoid direct - contact with faucet handles (unless automatic faucet present) Discard towel - How to properly wash your hands!  PHONE TRIAGE FOR INFECTIOUS PATIENTS What are some questions to ask before the patient even walks in the door that could help identify high-risk patients? Questions to ask an owner before an animal is admitted How old is the pet? What is the patient's vaccination history? Recent history: – Recent boarding kennel, dog park, day care facility, animal shelter, or other similar venue in the past month? – Traveled to another area or country? – Are other pets in the household ill? – Is the animal fed a raw food diet? Has the patient experienced any acute: – Vomiting? – Diarrhea (defined 3+ loose stools during the past 24 hr.) or bloody diarrhea? – Coughing? – Sneezing? – Respiratory/ocular discharge? Has the patient experienced a fever (if known)? Another important question……. Does this pet have a multi-drug resistant infection (MDR)? – Chronic infections (especially SKIN, ortho) Any animals exhibiting acute coughing, sneezing, vomiting, diarrhea, fever or having an MDR SHOULD NOT enter the reception area!! These animals need to go straight to a separate examination area either through a separate entrance or via carrier/on a gurney. This area must be cleaned and disinfected BEFORE another animal is placed in there. General cleaning and disinfection plan 1 Wear appropriate PPE 2 “Dry” clean surfaces (sweep, wipe with disposable micro-fiber cloth) 3 “Wet” clean surfaces (warm water & detergent, scrubbing/mopping) 4 Rinse with clean water  air dry 5 Disinfect using the appropriate concentration and contact time 6 Rinse with clean water  dry 7 +/- 2nd disinfection depending on area/suspected pathogen  1. Eyeballing disinfectant solution mixtures. 2. Failing to reach designated contact time. 3. Confusing sanitizing with disinfecting. Common 4. 5. Not knowing the shelf-life of the disinfectant being used. Topping off diluted disinfectant bottles, rather than disinfection 6. starting each time with a cleaned bottle and fresh batch. Mixing cleaning chemicals. mistakes! 7. 8. Spraying a surface and then wiping it with a dry cloth. Not giving or receiving product-specific training to veterinary team members. 9. Not getting buy-in from team members on a switch to a new product.  ISOLATION PROTOCOLS Small animal medicine specific Entering an isolation room: 1. Before entering the isolation area, remove practice outerwear (e.g., laboratory coat) and any equipment (e.g., stethoscope, scissors, thermometer, watch, cell phone) and leave outside the isolation unit/anteroom. 2. Gather any necessary supplies and medications before putting on PPE. 3. Wash or sanitize hands, then put on booties, gown, and gloves before entering the isolation room. 4. Attend to the patient in isolation as needed. DO NOT bring treatment sheets, pens, or electronic devices such as laptops, cell phones, or tablets into the isolation room. 5. Clean and disinfect any equipment used while caring for the patient. Exiting an isolation room: 1. Before leaving the isolation room, remove PPE (remove booties last as stepping out of the isolation room and avoid touching the outer surface of the boots). 2. Clean and disinfect non disposable PPE (e.g., eye protection). 3. Place used disposable PPE in the trash container lined with a biohazard bag in the isolation room. DO NOT SAVE DISPOSABLE PPE FOR REUSE. Avoid contact with external portions of the door when exiting the isolation room. 4. Wash hands with soap and water, and then disinfect any surfaces (e.g., doorknobs) that may have accidentally been contaminated when the room was exited. 5. Make any needed chart entries. 6. Wash hands again before leaving the anteroom (as applicable). Exiting an isolation room: https://www.youtube.com/watch?v=SQ4Z-8FEyFI Method 2: https://www.youtube.com/watch?v=wLuYDv65_to Disposing of urine/feces/fluids Whenever possible: disposable puppy pads – Weight= fluids lost – Very helpful for parvo puppies’/panleuk kittens’ fluid monitoring Large dogs: isolation dog runs – Clean-able disinfect-able ground material – Full sun is ideal – +/- urinary catheter Resource for SOPs safe disposal= CDC website – Example: Lepto https://www.cdc.gov/leptospirosis/pets/index.html#cdc_generi c_section_5-preventing-spread-from-animals-to-people Communication: Clients AND Staff Inform clients AND staff of zoonotic potential: – Pursue definitive diagnosis – People who are immunocompromised are especially at risk Who is immunocompromised? – People with a disease that lowers their immune function – People receiving immunosuppressive medication – Young people (