Outbreak Management Flashcards

Question

Answer 1

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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

Answer 2

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Epidemiologic Triangle
- Pathogen
- Environment
- Host

Answer 3

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

Answer 4

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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

Answer 5

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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

Answer 6

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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

Answer 7

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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

Answer 8

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Block by increasing the animal’s ability to fight of disease
- Vaccination
- ID and treat
- Nutrition

Answer 9

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Boost immunity through comfort
- Primary enclosures
- Maintain capacity
- Plan animal/people traffic flow

Answer 10

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Decrease the chance of encountering a pathogen
- Disease transmission
- Sanitation
- Design

Answer 11

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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

Answer 12

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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.

Answer 13

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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

Answer 14

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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

Answer 15

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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

Answer 16

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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

Answer 17

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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)

Answer 18

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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

Answer 19

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“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

Answer 20

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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

Answer 21

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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

Answer 22

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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

Answer 23

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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

Answer 24

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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