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Shelter Medicine > Outbreak Management > Flashcards

Outbreak Management Flashcards

1
Q

Disease Outbreak

A
  • Increase to the total number or frequency of cases than would be expected at any given time and location
  • Significant increase in severity or duration of clinical signs for any given disease
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2
Q

Risk Factor Investigation

A
  • Epidemiologic Triangle
    • Pathogen
    • Environment
    • Host
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3
Q

Pathogen

A
  • Sucess of the pathogen will depend on several things
    • Infectivity
    • Suscepibility to treatments (Resiliency)
    • Ability to survive outside the host
    • Shedding
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4
Q

Infectivity

A
  • Amount of pathogen required to cause disease in a host
  • Specific to each pathogen
  • The lower infectivity, the lower the needed dose
  • Can help judge an animal’s exposure risk
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5
Q

Method of transmission

A
  • Can help us determine exposure risk
  • A pathogen that is spred through direct contact will generally expose a lower number of individuals
  • Aerosol transmission will generally expose a higher number of individuals
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6
Q

Host

A
  • Several things contribute to the susceptibility of a host:
    • Immunity (prior exposure)
    • Response of the immune system
    • Age
    • Co-morbidities
  • Vaccines can be protectve for the individual
  • Animals with compromised immune system will be at higher risk
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7
Q

Environment

A
  • A Secure environment may depend on:
    • Climate
    • Physical barriers
    • Population density
    • Social structures
    • Kennel Design (Substrates)
  • For disease mitigation, a shelter will generally include a variety of small rooms to hold specific populations
  • Kennel design- materials can contribute to disease prevention
    • Ex: wood is porous and is considered an unacceptable substrate, since it has a high chance of holding pathogens
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8
Q

Pathogen - Host Pathway

A
  • Block by increasing the animal’s ability to fight of disease
    • Vaccination
    • ID and treat
    • Nutrition
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9
Q

Host - Environment Pathway

A
  • Boost immunity through comfort
    • Primary enclosures
    • Maintain capacity
    • Plan animal/people traffic flow
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10
Q

Environment - Pathogen Pathway

A
  • Decrease the chance of encountering a pathogen
    • Disease transmission
    • Sanitation
    • Design
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11
Q

Management Strategies

A
  • Shelters will never be able to eliminate all diseases entering, but can limit the disease impact
  • Management Strategies include:
    • Prevention- Shelter rounds, vaccination, capacity maintenance, cleaning
    • Diagnosis- ELISA, PCR
    • Isolation
    • Quarentined
    • Decontamination
    • Clean break
  • Shelters are always implementing at least 1, but may do several during an outbreak
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12
Q

Prevention:

A
  • Shelter Rounds: one of the most important
    • Observe each animal every day, checking for medical or behavioral changes in the individuals and trends in the population
    • Monitor that recommended protocols are being implemented
      • if protocols are successful at breaking one side of the epidemiologic triangle, disease will not occur.
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13
Q

Protocols:

A
  • May include:
    • vaccination at time of intake
    • limiting crowding to improve animals well-being within the environement
    • Giving broad-spectrum cleaning and disinfection
  • Protocols for specific diseases may not be used daily, should be easily accessible for outbreaks
  • Diseases should have protocols addressing:
    • clinical signs
    • severity of illness
    • affected species ans zoonotic potential
    • mode and ease of transmission
    • incubation period
    • shedding interval (pre- and post-infection)
    • carrier state
    • pathogen longevity in environment
    • effective disinfection strategies
    • reliability of screening and Dx tests
    • preventation tools (vaccination)
    • identigy at-risks groups,
    • recovery time
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14
Q

Data collection

A
  • Imperative prior to and throughout an outbreak
  • Should anser the questions:
    • Who is affected - signalment
    • What control measures have been implemented
    • When did clinical signs start
    • Where did affected animals com from and where are they in the shelter
    • Why is this happening - diagnosis
    • How many affected
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15
Q

Diagnosis

A
  • Diagnosis of the pathogen causing the outbreak is a necessary component of outbreak management
    • Even is the diagnosis is obvious, verification is imperative
  • Identification of pathogen, reveals important characteristics and can be used to end the outbreak
    • Shedding
    • Incubation
    • Transmission
    • Longevity in environment
    • Effectiveness of disinfectants
    • Effectiveness of vaccination
  • Tests with rapid results are preferred
    • ELISA vs. PCR
  • Test all necessary animals
    • symptomatic
    • highlyy suspicious exposure history
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16
Q

ELISA (Enzyme-linked immunosorbent assay) tests

A
  • Point-of-care, rapid, easy-to-use tools that can test for proteins assoiated with specific pathogens
  • Commonly utilized in a shelter setting to evaluate for diseases such as:
    • Parvo
    • Feline Immunodeficiency virus (FIV)
    • Feline Leukemia Virus (FeLV)
    • Heartworm
  • Considered less sensitive than PCR test
17
Q

Polymerase Chain Reaction (PCR) tests

A
  • Detect a specific sequence of DNA or RNA within a pathogen in order to identify the presence o a pathogen, making it extremely sensitive
  • Can be utilized in a comprehensive manner
  • Ex: Feline/Canine Respiratory PCR panel can test for all common pathogens that may be contributing to clinical signs of an upper respiratory infection
  • Advantage of being able to quantitate results
    • Ex: a dog that has been vaccinated for distemper virus may have a positive PCR test, but the amount of pathogen detected should be considerably less in a vaccinated dog versus a dog with an active infection
  • Drawback is that it can take several days for available results (critical time with an active oubreak)
18
Q

Testing

A
  • Testing every animal would be excessive, expensve, and unproductive
  • Target animals
    • who are symptomatic (ideally, 10-30%)
    • those that are considered high risk for exposure
19
Q

Isolation

A
  • “Separation for clinically ill animals with a communicable disease from the rest of the shelter
  • Isolating sick animals is the single most important step of outbreak management
    • achieves physical containment of the pathogen
    • reduces transmission of disease
    • decreases the infectious dose throughout the shelter
  • If fast/reliable diagnostic test is not available animals may need to be placed in isolation soley on suspicious clinial signs
  • On-site areas are physically separated from other animal housing
    • Alternative options can be explored
      • transfer to another clinic, vet facility, or foster
  • Animals will be isolated for the length of the contagious period
    • Results in longer length of stay
      • Will contribute to a significant drain on the shelters resources
  • Euthansia may be considerd of clinically sick animals during an outbreak
20
Q

Quarantined

A
  • Animals kept in a separate housing area to see if they become ill in order to limit exposure to the healthy population
    • There are several reasons an exposed animal may not be displaying clinical signs:
      • incubation period
      • subclinical infection
      • animmune
      • not exposed
  • Quarantine area should have designated PPE, cleaning supplies, and disinfection supplies
  • Animals can be individually assessed for risk through diagnostic testing.
    • Serologic testing can check for protective antibody titers.
      • Animals that show no clinical signs and is proven to have protective amounts of antibodies, is low risk and can be moved out of quarantine.
    • ELISA or PCR can be used to check for the pathogen within the animal
      • Positive tests will cause the animal to be moved to isolation
      • If testing can’t be performed animals will remain in quarantine for the length of the incubation period
  • When animals become clinically infected, individual animals should be immediately moved to isolation
    • At hat point, all animals in quarantine are considered newly exposed and the incubation is reset for the quarantine area
21
Q

Decontamination

A
  • All areas within the shelter, all sorces of environmental contamination should be investigated and decontaminated
  • Potential contanimates come from:
    • animal hair
    • equipment
    • crates/carriers
    • clothing
    • common/administration space
    • vehicles
    • toys
  • Effective agents will depend on the pathogen
  • Carpet and unsealed wood cannot be disinfected and should be disposed of
22
Q

Adoption

A
  • During outbreak conditions, it may be best to stop all intake and adoption activities until disease transmission has been resolved
  • Possible for some limited admission shelters, but open admission shelters cannot always stop intake
    • Especially if for strays in imminent danger, dangerous animals, and cruelty cases
  • Alternatives: Diverting intake to other shelters, using a temporary annex facility, or allowing adoptions straight from foster homes/off site events
  • Or implement a “clean break” strategy
23
Q

Clean Break

A
  • Strategy to protect the new population from being introduced
  • Animals are separated as far away as possible from those that are infected and exposed
  • The clean area should be treated as a “good isolation” area utiliting strict biosecurity protocols to include its own PPE, cleaning supplies, and disinfecting agents
    • signage may help define the clean area and decrease the chances of cross-contamination
  • Vaccination and prophylactic care should be provided to new animals
24
Q

Impact of Disease outbreak

A
  • Outbreak can have numerous consequences such as:
    • euthanasia of adoptable animals
    • Deceased adoptions
    • Financial burdens
    • resource allocation
    • low staff morale
    • tarnished repuation
    • vicious cycle of overcrowding
  • All leading to a general decrease in life saving capacity
  • Damages can be somewhat mitigated through examplary communication standards
    • Proactive communication averts spread of rumors and false information, improves the shelter’s image, and enlists public support and trust
    • Communication starts within the shelter staff, but should also include community stakeholders (volunteers, donors, adoptors, etc.)
    • Disseminating accurate information will noot be the sole responsibility of the veterinarian in charge, though the vet will play a crucial role
    • Communication is a group effort
25
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Shelter Medicine (13 decks)

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