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Standard Operating Procedures Tier 1 Veterinary Medical Center Infectious Disease

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Standard Operating Procedures Tier 1 Veterinary Medical Center Infectious Disease Standard Operating Procedures Tier 1 Veterinary Medical Center Infectious Disease Section Hospital Protocol Date of Issue 12/14/2018 Part Infectious Zoonotic Disease Issued by Administration Pages 17 Revision Date 04/19/2021 Introduction: It is the standard operating procedure to maintain and control communicable diseases in the hospital. Kennel-sol solution is used at Tier 1 VMC for disinfection purposes and is effective as: Bactericidal: Proteus vulgaris, Bordetella bronchiseptica, Serratia marcescens, Escherichia coli, Staphylococcus aureus (antibiotic resistant), Fusobacterium necrophorum, Klebsiella pneumoniae (antibiotic resistant), Streptococcus pyogenes, Proteus mirabilis, Salmonella enterica, Salmonella typhimurium, Escherichia coli (antibiotic resistance), Shigella sonnei, Staphylococcus epidermidis (antibiotic resistant), Enterobacter cloacae, Pasteurella multocida, Staphylococcus aureus, Salmonella typhi, Chlamydia psittaci, Shigella flexneri, Enterobacter aerogenes, Streptococcus faecalis (antibiotic resistant), Klebsiella pneumoniae, Streptococcus faecalis Fungicidal: Trichophyton mentagrophytes, Candida albicans Virucidal: Canine parvovirus, Canine distemper, Feline leukemia, Feline panleukopenia, Feline picornavirus, Influenza A/Hong Kong, Herpes simplex virus type 1, Herpes simplex virus type 2, Vaccinia, Rubella, Adenovirus type 4, Rabies, Porcine parvovirus, Pseudorabies, Infectious bovine rhinotracheitis, Infectious bronchitis (Avian IBV), Avian Influenza A (H3N2 & H5N1) Dilution requirements for Tier 1 VMC are 8oz/gallon (240 mls/gallon). Bleach (Sodium hypochlorite) is used in special instances for disinfection where Kennel- sol is ineffective. Bleach is used to launder all laundry items associated with an infectious disease. Dilution requirement for Tier 1 VMC are 2oz/gallon (60mL/gallon) Standard Operating Procedures Tier 1 Veterinary Medical Center Infectious Disease Follow all SDS recommendations for handling disinfectants/dips/topical medications. The procedures for infectious disease control is as follows: General Requirements: Isolate and prevent spread of communicable diseases. Infectious diseases seen in the veterinary clinic that pose nosocomial risk: ● Dog: Parvo virus, distemper virus, bordetella bronchiseptica(kennel cough), Methicillin resistant infections ( MRSA, MRSP), rabies virus, leptospirosis bacteria, mange mites, and fleas. lice, coccidia, giardia (reportable in AK), intestinal parasites, campylobacter, tularemia, Brucellosis, o Rare/not common to Alaska but to be aware of: Plague, Leishmaniasis ● Cat: Feline immunodeficiency virus, feline calicivirus, feline leukemia virus, rabies virus, ringworm fungus, mange mites, fleas, toxoplasmosis, worms, panleukopenia, Bartonella henselae (Cat-Scratch Disease), tularemia ● Birds: psittacosis ● Reptile: Salmonella ● Small Mammals: o Rabbits: Pastuerella Zoonotic disease: Infectious diseases seen in the veterinary clinic that pose a zoonotic risk (transmissible to humans): 1. MRSA/MRSP 2. Rabies Virus 3. Leptospirosis 4. Mange 5. Giardia 6. Intestinal parasites/Worms (various) 7. Campylobacter 8. Tularemia 9. Brucellosis 10. Plague 11. Leishmaniasis 12. Ringworm Fungus 13. Toxoplasmosis 14. Cat Scratch Fever Standard Operating Procedures Tier 1 Veterinary Medical Center Infectious Disease 15. Psittacosis 16. Salmonella Reportable disease in the state of Alaska Must be reported to State of Alaska Department of Health and Social Services Division of Public Health if you (the human) become infected 1. MRSA/MRSP 2. Rabies Virus 3. Leptospirosis 4. Giardiasis 5. Campylobacteriosis 6. Tularemia 7. Brucellosis 8. Plague 9. Psittacosis 10. Salmonella Methicillin resistant bacteria o Methicillin resistant infections are diagnosed by the culture of infected skin. o Definition: ▪ Bacterium that is methicillin resistant “after exposure to multiple or sub therapeutic doses of antibiotics, the bacteria can become resistant to multiple antibiotics” http://dermvettacoma.com/mrsa/ ▪ MR infections are a general threat to those individuals whom are immunosuppressed, elderly, and babies. ▪ MRSA ● Staphylococcal aureus is the natural floral bacterium of humans and can live in low numbers in dog carriers. MRSA develops when the human form of SA becomes drug resistant on the human host. When cultured from the dog, this is generally indicative that a human host is infected or is a carrier of MRSA. ▪ MRSP Standard Operating Procedures Tier 1 Veterinary Medical Center Infectious Disease ● Staphylococcal pseudo-intermedius is the natural floral bacterium of dogs. MRSP can develop when the dog form of SP becomes drug resistant. ● Not generally contagious to humans however humans can become carriers or a reservoir for MRSP bacterium and can inadvertently spread the bacterium. ● Prevention Measures/PPE required: ○ Wear gloves ○ Wash hands ○ Wear a gown or have a spare pair of scrubs to change into after handling patient ○ Disinfect area with Kennel-Sol. Make sure there is 10 minutes contact time and wipe clean with non-reusable paper towels ○ Limit number of personnel handling case ○ Isolate patient while in hospital ● Hospitalization Measures: ○ Pens/pencils, stethoscopes, thermometers and other equipment should be kept for use with the affected patient only and disposed of or disinfected after use ○ Bedding should be disposed of. If re-use is essential it should be laundered at 60oC. Great care should be exercised to avoid contaminating other bedding during cleaning, but separate laundering isn’t necessary. ○ Owners should not be discouraged from visiting hospitalised patients. However, they should be informed of the potential risks, wear protective clothing and thoroughly wash their hands as outlined above. Contact should be restricted to their animal. ○ If an MRSA positive animal dies, all lesions and body orifices should be covered. The body should be placed in a sealed, impervious bag as soon as possible and be disposed of by cremation. Rabies virus o Overview: ▪ Rabies virus is transmitted through direct contact (such as through broken skin or mucous membranes in the eyes, nose, or Standard Operating Procedures Tier 1 Veterinary Medical Center Infectious Disease mouth) with saliva or brain/nervous system tissue from an infected animal. ▪ Usually transmitted by the bite of a rabid animal. It is also possible, but rare, for people to get rabies from non-bite exposures, which can include scratches, abrasions, or open wounds that are exposed to saliva or other potentially infectious material from a rabid animal. ▪ Other types of contact, such as petting a rabid animal or contact with the blood, urine or feces of a rabid animal, are not associated with risk for infection and are not considered to be exposures of concern for rabies. ▪ Only mammals can be affected by the rabies virus ▪ 90% of reported cases of rabies in animals occur in wildlife (racoons, skunks, bats, foxes) ▪ Most pets get rabies from having contact with wildlife ▪ Foxes, especially in the North Slope and Southwest regions, are the most common transmitters of rabies in Alaska. Rabies can cause death within days of symptoms, so be sure to seek medical attention as soon as possible if you suspect exposure. ▪ Alaska has enzootic regions of the state for rabies (meaning rabies is always present) ● Recognition ○ Vaccination status of animal should be determined upon arrival at Tier 1 VMC ○ General sickness of patient ○ Problems swallowing ○ Hypersalivation ○ Biting at everything (air/randomly etc.) ○ Trouble moving or paralysis ○ Travel history ● Prevention Measures/PPE required: ○ Utilize the rabies-pole to move patient within hospital ○ Fluid-proof barrier gloves ○ Wash hands after handling ○ Safety glasses ○ Gown ○ Disinfect area with Kennel-Sol. Make sure there is 10 minutes contact time and wipe clean with non-reusable paper towels Standard Operating Procedures Tier 1 Veterinary Medical Center Infectious Disease ○ Limit number of personnel handling case (ideally to those individuals who have received/are current on the Pre-Exposure Rabies Vaccination Series) ○ Isolate patient while in hospital ● If a rabies suspect animal dies or is euthanized: ○ Don gloves, mask, face-shield/safety glasses before assisting DVM with decapitation and packaging to send specimen to the State of Alaska Lab ■ Please contact the Section of Epidemiology for authorization prior to submitting specimens for rabies testing. Call (907) 269- 8000, or after hours call (800) 478-0084. ■ http://dhss.alaska.gov/dph/Labs/Pages/publications/default.aspx ● The body should be placed in a sealed, impervious bag as soon as possible and be disposed of by cremation. ● Disinfection protocol as indicated previously for all areas that came in contact with the patient. ● Resources: ○ https://www.cdc.gov/rabies/index.html ○ http://dhss.alaska.gov/dph/Epi/id/Pages/rabies/default.aspx ○ https://ehs.oregonstate.edu/sites/ehs.oregonstate.edu/files/pdf/rabies- prevention-program-12-14.pdf Leptospirosis bacterium o Overview: ▪ Caused by the bacterium of genus Leptospira. an aerobic gram- negative spirochete. ▪ Lepto is spread through the urine and rarely other bodily fluids of infected animals in water or soil of which can remain present for weeks to months. The bacterium can enter the body from open skin and mucous membranes. ▪ Animals may become infected by direct transmission of the spirochete (direct contact with infected urine, blood, ingestion of infected tissues, bite wound, and venereal or placental transfer) ▪ Indirect transmission includes
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