8 Lec Part 2 - Lab Animals and disease control in Healthcare Settings.pdf

Health-care workers with pets at home • An outbreak of infections caused by a yeast (Malassezia pachydermatis) among newborns was traced to transfer of the yeast from the hands of health-care workers with pet dogs at home. • In addition, an outbreak of ringworm in a NICU caused by Microsporum canis...

Health-care workers with pets at home • An outbreak of infections caused by a yeast (Malassezia pachydermatis) among newborns was traced to transfer of the yeast from the hands of health-care workers with pet dogs at home. • In addition, an outbreak of ringworm in a NICU caused by Microsporum canis was associated with a nurse and her cat, and an outbreak of Rhodococcus (Gordona) bronchialis sternal SSIs after coronary-artery bypass surgery was traced to a colonized nurse • In the latter outbreak, whether the dogs were the sole source of the organism and whether other environmental reservoirs contributed to the outbreak are unknown. • Nonetheless, limited data indicate that outbreaks of infectious disease have occurred as a result of contact with animals in areas housing immunocompetent patients. • However, the low frequency of outbreaks may result from the relatively limited presence of the animals in health-care facilities and the • Animal-Assisted Activities (AAA) are those programs that enhance the patients’ quality of life. These programs allow patients to visit animals in either a common, central location in the facility or in individual patient rooms. A group session with the animals enhances opportunities for ambulatory patients • Animal-Assisted Therapy (AAT) is a goaldirected intervention that incorporates an animal into the treatment process provided by a credentialed therapist. The concept for AAT arose from the observation that some patients with pets at home recover from surgical and medical procedures more rapidly than patients without pets. • Contact with animals is considered beneficial for enhancing wellness in certain patient populations (e.g., children, the elderly, and • Animals participating in either AAA or AAT sessions should be in good health and up-to-date with recommended immunizations and prophylactic medications (e.g., heartworm prevention) as determined by a licensed veterinarian based on local needs and recommendations. • Regular re-evaluation of the animal’s health and behavior status is essential. Animals should be routinely screened for enteric parasites and/or have evidence of a recently completed antihelminthic regimen. • They should also be free of ectoparasites (e.g., fleas and ticks) and should have no sutures, open wounds, or obvious dermatologic lesions that could be associated with bacterial, fungal, or viral infections or parasitic infestations. Incorporating young animals (i.e., those aged <1 year) into these programs is not encouraged because of issues regarding unpredictable behavior and elimination control. • Additionally, health of these animals at risk. Animals should be clean and well-groomed. The visits must be supervised by persons who know the animals and their behavior. • Animal handlers should be trained in these activities and receive site-specific orientation to ensure that they work efficiently with the staff in the specific health-care environment. Additionally, animal handlers should be in good health. • The most important infection-control measure to prevent potential disease transmission is strict enforcement of hand-hygiene measures (e.g., using either soap and water or an alcohol-based hand rub) for all patients, staff, and residents after handling the animals. • Care should also be taken to avoid direct contact with animal urine or feces. Clean-up of these substances from environmental surfaces requires gloves and the use of leak-resistant plastic bags to discard absorbent material used • The American Academy of Allergy, Asthma, and Immunology estimates that dog or cat allergies occur in approximately 15% of the population. Minimizing contact with animal saliva, dander, and/or urine helps to mitigate allergic responses. • Some facilities may not allow animal visitation for patients with underlying asthma, known allergies to cat or dog hair, respiratory allergies of unknown etiology, and immunosuppressive disorders. • As a general preventive measure, resident animal programs are advised to restrict animals from food preparation kitchens, laundries, central sterile supply and any storage areas for clean supplies, and medication preparation areas. • A service animal is any animal individually trained to do work or perform tasks for the benefit of a person with a disability. • A service animal is not considered a pet but rather an animal trained to provide assistance to a person because of a disability. • Although animals potentially carry zoonotic pathogens transmissible to man, the risk is minimal with a healthy, clean, vaccinated, well-behaved, and well-trained service animal, the most common of which are dogs and cats. • Occupational health programs for animal-care staff, researchers, and maintenance staff should take into consideration the animals’ natural pathogens and research pathogens. • Components of such programs include prophylactic vaccines, TB skin testing when primates are used, baseline serums, and hearing and respiratory testing. • The animal care and use program (the Program) means the policies, procedures, standards, organizational structure, staffing, facilities, and practices put into place by an institution to achieve the humane care and use of animals in the laboratory and throughout the institution. • Health monitoring can therefore be an essential prophylactic measure and helps to avoid animal losses or other complications. Some of the micro-organisms that may be present in laboratory animals (e.g. lymphocytic choriomeningitis virus, Streptobacillus moniliformis) can also infect humans (zoonoses). • Appropriate health monitoring is therefore an important prerequisite for the use of microbiologically-standardised animals in Working with simians • Some naturally occurring virus infections of simians are known to be especially pathogenic to man. B virus (Herpesvirus simiae), for example, has been responsible for a number of deaths in laboratory and animal workers. • Other viruses of concern are rabies and the filoviruses which cause viral haemorrhagic fevers. However, other agents are prudently assumed to be potentially harmful to humans, for example, the many herpes viruses found in vervets and baboons whose full range of pathogenicity is uncertain. • Haemorrhagic fever viruses and a number of different retroviruses have also been isolated from simians. Simian T-cell lymphotropic virus (STLV) and simian immunodeficiency virus (SIV), for example, bear a strong relationship to their human counterparts and laboratory workers have become infected, so far without evidence of disease occurring. • More familiar human pathogens may also be carried by simians eg, mycobacteria (TB or TB-like infections), Shigella spp, Salmonella spp, protozoa and helminths; some of which can be contracted by monkeys from human sources. Animal containment Level 1 • Security and access : Access to the room should be limited to authorised persons. • Disinfection and disposal procedures: (a) The animal room should be easy to clean. (b) Effective disinfectants should be available for immediate use. (c) Material for autoclaving and used animal cages should be transported without spillage and an autoclave for the sterilisation of contaminated waste materials should be accessible on site. (d) Used animal cages should be decontaminated after use. (e) • Air handling : The room should be adequately ventilated. Protective equipment and procedures. (a) All procedures should be performed so as to minimise the production of aerosols. (b) Suitable protective clothing and footwear should be worn in the animal room and cleansed, or removed, when leaving the animal room. (c) PPE including protective clothing, must be: (i) stored in a well-defined place; (ii) checked and cleaned at suitable intervals; (iii) when discovered to be defective, (d) PPE which may be contaminated by biological agents must be: (i) removed on leaving the working area; (ii) kept apart from uncontaminated clothing and equipment (iii) decontaminated and cleaned or, if necessary, destroyed. (e) Eating, chewing, drinking, smoking, taking medication, storing food for human consumption and applying cosmetics should be forbidden. (f) Mouth pipetting should be forbidden. (g) There should be a basin or sink that can be What is animal containment? • Generally this means that the enclosure you provide for your animals must stop them from escaping or protruding over, under, through the enclosure. • Enclosures should also meet the needs of your animals to ensure they are safe, comfortable and cared for.