News

NEWS item submitted to One Health Initiative website August 6, 2013

 

Hospital personnel need greater awareness of animal-to-human disease threats

 

Clifford Warwick, PGDipMedSci, CBiol, CSci, EurProBiol, FOCAE, FSB

Consultant Biologist & Medical Scientist

Riverside House, River Lawn Road, Tonbridge, Kent TN9 1EP, UK

mail@emergentdisease.org

cliffordwarwick@yahoo.com

 

Susan Corning, BA, MSc, BVSc, MRCVS, FRSPH

Director, Collaborating for Global Health

Bologna, Italy

www.collab4globalhealth.com

dr.susan.corning@collab4globalhealth.com

 

 

The Royal Society of Medicine - Managing patients for zoonotic disease in hospitals, Warwick, C. & Corning, S. (2013).  J R Soc Med Sh Rep., 4: 1–9. DOI: 10.1177/2042533313490287

 

 

“Noscomial disease transmission is a true “One Health” issue, and there is an urgent need for the medical and veterinary professions to collaboratively plan to ensure that hospital staff can implement simple and effective measures to prevent and control this transmission.”

 

 

A new paper published this week in the Journal Royal Society of Medicine (Short Reports) warns that zoonotic diseases from pets, foreign travel, petting zoos and other sources warrant greater attention by hospital staff in order to minimise their spread within the hospital environment.  The paper entitled ‘Managing patients for zoonotic disease in the hospital environment’ identifies a need for greater awareness and better management of zoonoses in hospitals. 

 

Noting that zoonotic pandemics could pose a major global threat to human health, the paper states that: ‘Hospitals are often an early portal for infection cases and must be equipped to promptly and effectively diagnose and control the spread of zoonotic disease.’  Secondary care  staff who are not aware of, or have not implemented appropriate disease prevention and control measures may incidentally facilitate the spread of pathogens in hospitals, known as “noscomial disease transmission”. 

 

The paper cites an example of a hospital in Mauritania that in 2003 admitted a patient who had contracted Crimean-Congo hemorrhagic fever from a goat. This disease was transmitted within the hospital to 15 people and resulted in the infection and death of five hospital workers.  It was also noted that hospitals themselves may even unknowingly facilitate the transfer zoonotic pathogens to patients, as was evidenced during a donor transplantation in 2005.  Following organ transplants from a single donor to four patients in Massachusetts and Rhode Island, all four recipients were found to have been infected with lymphocytic choriomeningitis virus (LCMV). This rodent-borne arenavirus had apparently been contracted by the donor from an infected pet hamster.  The paper particularly warns against the ownership of exotic as pets such as amphibians, reptiles, birds, and primates which may pose involve special health risks to their keepers and others.

 

Under-ascertainment is believed to be common because numerous zoonoses superficially resemble common illnesses such as gastrointestinal, respiratory and dermal disease and thus may go undiagnosed.  Guidance for hospital staff is therefore critical, and the paper includes a protocol for managing patients, and also information leaflets that can be readily distributed to patients to help prevent animal-linked disease.

 

Noscomial disease transmission is a true “One Health” issue, and there is an urgent need for the medical and veterinary professions to collaboratively plan to ensure that hospital staff can implement simple and effective measures to prevent and control this transmission.

 

SEE: Full text HTML version: http://shr.sagepub.com/content/4/8/2042533313490287.full

PDF version: http://shr.sagepub.com/content/4/8/2042533313490287.full.pdf+html

[open access]

 

Clifford Warwick is a Consultant Biologist & Medical Scientist and Dr. Corning, a veterinarinan, is a One Health consultant for international organisations and global development projects, as well as corporate and non-for-profit business initiatives.

 

PRESS RELEASE (provided Thursday, 1 Aug 2013 15:18:49 +0100 by Clifford Warwick):

 

 New guidance to help hospitals fight exotic bugs

 

A new paper published today in the Journal of the Royal Society of Medicine (Short Reports) warns that animal-to-human (zoonotic) diseases from pets, foreign travel, petting zoos and other sources warrant greater attention by hospital staff.

 

The article entitled ‘Managing patients for zoonotic disease in the hospital environment’, says that animal-related pandemics have been identified as a major global threat to human health. People are exposed to disease risks through keeping exotic pets, foreign travel and visiting zoos among other things. The article states that: ‘Hospitals are often an early portal for infection cases and must be equipped to promptly and effectively diagnose and control the spread of zoonotic disease.’

 

The paper includes a protocol for managing patients, and also information leaflets that can be readily distributed to patients to help prevent animal-linked disease. ‘Under-ascertainment is believed to be common because numerous zoonoses superficially resemble common illnesses such as gastrointestinal, respiratory and dermal disease and thus may go undiagnosed’, the article says.

 

Exotic pets are highlighted as a particularly significant disease risk. The guidance provided emphasises the difficulty of guarding against exotic pet infections in the home and goes further to warn against keeping exotic pets at all:

 

‘Ownership of exotic pets such as fishes, amphibians, reptiles, birds, and mammals such as raccoons and primates involve special risks to the health of animal keepers and to the health of those around them. It is not advisable to keep exotic animals as pets. Many people, however, already have exotic pets, and this most likely causes thousands of cases of human illness annually and occasional deaths.’

 

Says lead author, Clifford Warwick, DipMedSci CBiol CSci EurProBiol FOCAE FSB Consultant Biologist & Medical Scientist, Emergent Disease Foundation

 

“Whether through keeping exotic pets in the home, visiting roadside zoos abroad or other issues, exposure to atypical bugs is a matter of increasing concern to both the medical profession and governments. Hospital personnel are frequently on the front line when dealing with these ‘zoonotic’ infections and infestations. This article sets out general protocols for healthcare workers when assessing possible zoonoses in patients, as well as equipping them with guidance to help patients avoid unnecessary animal-linked disease.”

 

Says co-author, Susan Corning, BA BVSc MSc MRCVS FRSPH Director, Collaborating for Global Health

 

“Given that many human diseases are of animal origin, our article highlights the importance of the early recognition of zoonoses by medical personnel in order to minimize their spread, including within the hospital environment. This is a true “One Health” issue, and there is an urgent need for the medical and veterinary professions to collaboratively plan to ensure that hospital staff can implement simple and effective measures to prevent and control zoonoses generally as well as nosocomial disease.”

 

The paper’s guidance also states:

 

‘Hygiene measures, such as hand-washing, where performed thoroughly and with correct chemicals, can significantly reduce the amount of germs on your hands but does not guarantee protection against becoming sick or remove the possibility of passing germs directly or indirectly to others.’

 

The guidance emphasises the difficulty of guarding against exotic pet infections in the home:

 

‘It is important to note that because exotic pets occupy the home, and that germs are easily spread around surfaces, walls, door-handles, clothes and other items, even thoroughly cleaned hands can quickly become contaminated again by simple contact with any of these items. Pet stores and the people who work there should also be regarded as sources of contamination. Thorough cleaning of exotic pet-related germs from the home may be practically impossible.’

 

And further the guidance concludes:

 

‘Local authorities, [physicians], [veterinarinans], and facility managers should advise their patients and customers of the health risks associated with having an exotic animal as a family pet and should provide appropriate health protection advice.’

 

The article is open access and available here:

http://shr.sagepub.com/content/4/8/2042533313490287.full.pdf+html

Issued: 1/8/13

Article: Managing patients for zoonotic disease in hospitals, Warwick, C. & Corning, S. (2013).  J R Soc Med Sh Rep., 4: 1–9. DOI: 10.1177/2042533313490287