Preventative Medicine

Question 1

Newly imported primates must be quarantined where? For how long?

Answer 1

CDC-registered primate import facility. Minimum of 31 days.

Question 2

Following the required 31-day quarantine, how long should animals quarantine at the receiving faicility?

Answer 2

At least 30 days.

Question 3

If staff must move from quarantine to a clean area, what must occur?

Answer 3

Shower and don clean clothing

Question 4

How long should the initial acclimation period be? What occurs after the acclimation period? What should occur at this time?

Answer 4

72-hour acclimation followed by a veterinary entry exam. Entry exam should include blood collection for hematology and serology, body weight, anthelmintics, fecal parasitology exam, vaccinations, thoracic rads (when appropriate), and Mantoux tuberculin skin test (TST)

Question 5

Describe the TST during quarantine.

Answer 5

Intradermal with Mammalian Old Tuberculin repeated every 2 weeks in alternating eyelids for the duration of quarantine. TST should be evaluated at 24, 48, and 72h. As this test is an assessment of delayed hypersensitivity, special attention should be paid to 48 and 72h timepoints.

Question 6

What should occur if there is any suspicious reaction to a TST?

Answer 6

Animal should be anesthetized and palpebrum manually palpated as a more sensitive indication of induration. TST should be repeated using opposite eyelid or shave region of abdomen near umbilicus.

Question 7

What occurs if one animal in a group tests positive or reacts in the TST?

Answer 7

All animals must be considered positive and the testing and quarantine procedures should be extended.

Question 8

What are the grades and descriptors of the TST?

Answer 8

0 - Negative or no reaction observed
1 - Negative. Bruise; extravasation of blood in eyelid from injection
2 - Negative. Varying degrees of erythema of palpebrum without swelling.
3 - Indeterminant - Varying degrees of erythema of palpebrum with minimum swelling or slight swelling without erythema
4 - Positive - Obvious swelling of palpebrum with drooping of eyelid with varying degrees of erythema
5 - Positive - Swelling and/or necrosis with eyelid closed.

Question 9

How often should animals in quarantine be examined? What are key parameters? Who should do this observation?

Answer 9

Daily. Activity, appetite, and excreta. Same individual should perform these observations as frequently as possible.

Question 10

What occurs once quarantine has been completed?

Answer 10

Vet carries out an exit physical and releases animal from quarantine or requires an extension of quarantine.

Question 11

What vaccines may be indicated if animals are housed in large production colonies or outdoor facilities?

Answer 11

Tetanus, rabies, and measles

Question 12

What are the vaccination recommendations for chimps, macaques, baboons, and marmosets?

Answer 12

Chimps: Polio, rabies, MMR, and tetanus toxoid
Macaque: Rabies, MMR, and tetanus toxoid
Baboon: Rabies, tetanus toxoid
Marmosets: MMR

Question 13

The new generation of pneumococcal vaccines show promise for preventing against what in what species?

Answer 13

Pneumococcal meningitis in chimps.

Question 14

Efforts to create vaccines against what two viruses have been largely unsuccessful? As a result, clearance of these agents relies on what? How reliable is this strategy?

Answer 14

Herpesvirus and retroviruses. Test and cull strategies. Has reduced zoonotic risk of McHV-1, but cannot be relied upon for complete elimination of the virus.

Question 15

What is the ultimate goal of serodiagnostic testing in NHP?

Answer 15

Mitigate the risks of adventitious infectious agents on research and use the information generated to make management decisions regarding the infection status of the animals.

Question 16

Describe the first diagnostic assay used in a multi-tiered approach to diagnostic testing.

Answer 16

Automated high-throughput assay such as EIA or MFIA. Biased for high diagnostic sensitivity to detect early infections at the cost of specificity, resulting in false positives.

Question 17

Describe the secondary assay used in a multi-tiered approach to diagnostic testing.

Answer 17

High diagnostic specificity (good at sorting out true positive from false positives), such as WIB or IFA. Used to make final positive or negative classification of the sample.

Question 18

Can the number of true and false negatives and positives be calculated from the diagnostic sensitivity and specificity?

Answer 18

No, requires prevalence.

Question 19

What are the positive and negative predictive values? What information must be known to calculate them?

Answer 19

The confidence you can have in a positive or negative test. Requires diagnostic sensitivity, specificity, and prevalence in target population.

Question 20

If the DSn and DSp are above 50%, what occurs as the prevalence in the population falls to zero? As the prevalence in the population approaches 100%

Answer 20

Predictive values for an assay follow the same trend. As prevalence falls to zero, so does PPV, while NPV increases to 100%. Converse is true - as prevalence of agent approaches 100%, so does PPV, while NPV falls to zero.

Question 21

What are additional diagnostic tests that have a greater DSp, and thus lower fate of false positives?

Answer 21

IFA, WIB, hemagglutination inhibition, and PCR.

Question 22

How often should routine physical exams and supporting laboratory tests be performed? What serology tests should be performed?

Answer 22

Annually, or more frequently based on health status of colony. Serology of McHV-1 for macaques and retroviral surveillance for OWM.

Question 23

How much mammalian old tuberculin is injected using what gauge of needled?

Answer 23

0.1 mL of full strength, 25 to 27 gauge needed.

Question 24

Why are immunization techniques against TB (BCG vaccines) not widely used?

Answer 24

Not practical. Make it difficult to sort protection against from infection.

Question 25

What adjunctive tests for TB have been developed? What is the most effective in NHPs? Which is required for CDC mandated import quarantine?

Answer 25

Interferon-gamma releasing assays and antibody assays. TST. TST

Question 26

During CDC quarantine, what should occur with any positive or suspicious reactors?

Answer 26

Eliminated along with direct contact animals.

Question 27

What is the greatest risk to the control and detection of TB?

Answer 27

Mammalian old tuberculin. Specialized, limited demand and its rigid manufacturing specifications make it impractical to manufacture in a cost-effective way.