VPH - Final 3

drraythe's version from 2016-04-25 13:33

Influenza cont..

Question Answer
HPAI → in chickens & turkeys when the virus is particularly lethal, signs may be minimal & birds are typicallyFound dead w/ little warning. If they survive, CNS signs & drop in egg production may occur in a laying flock. It is multisystemic & there will be pneumonia, widespread hemorrhage...
Why is Influenza A (H5N1) is of concern? (4)(1) Mutates rapidly: ↑ ability to reassort
(2) Deadly to domestic poultry... spread rapidly w’in flock
(3) Crossed spp. barrier to ppl
(4) Economic importance to the Poultry Industry-trade
HPAI is H__N__H5N1
Can HPAI H5N1 affect people?YES, can be deadly!! (50% mortality in humans!)
What is a ↑ risk for HPAI industry in Asia?LBMs = Live Bird Markets
So far, spread of H5N1 HPAI from birds to people has only occurred as a result of...Extensive direct contact w/ infected birds [home slaughter/defeathering]
Has there been human-to-human xmission of Avian Influenza A?No
*Explain the Pathogenesis of Human dz of HPAI flu A, H5N1. What is mortality like?“Cytokine Storm” = An Innate exaggerated immune response czd by rapidly proliferating & highly activated T-cells or natural killer (NK) cells, which leads to a Severe Flu-like + lower respiratory tract symptoms & Pneumonia ..Multi-organ failure. Mortality: ↑ among hospitalized PTx
*Is there a Vx for HPAI?Yes - for birds & 1 FOR HUMANS NOW ALSO AVAILABLE
Why is the Vx for HPAI controversial? (PROS & CONS)PROS: Reducing the CS, diminishing the duration/extent of shedding
CONS: Some healthy Vxd birds become infected, shed & then become a source of infxn for others! In all countries which have applied Vx to control H5N1, infxn has become endemic, might not protect against variants
**All H__ & H__ viruses are notifiable when in poultry!5 & 7
*If there is Avian Flu of H5 or H7 in the US, what must the USDA do?Report to OIE
Does poultry have to be Vx against AI?No Federal program mandating Vx of birds but AI testing/surveillance of birds by States/federal
What are 4 ways the USDA does surveillance of AI?(1) Survey live bird markets
(2) Commercial - preslaughter surveillance of broilers - test each flock on the farm before it is sent to slaughter
(3) Backyard flocks: encourage biosecurity practices
(4) Watch migratory bird populations (Additionally, birds that show signs of illness are tested)
USDA Import restrictions about AI?Quarantine & tests imported live birds for foreign animal dzs eg. HPAI H5N1
Trade restrictions on imports from countries that have endemic HPAI H5N1
Agricultural inspections for illegally smuggled poultry/ products conducted by Department of Homeland Security (DHS) -Customs & Border Protection
What other species can H5N1 affect & how?Cat, Domestic cats infected if fed uncooked meat from H5N1-infected chickens then spread infxn to other cats
Equine-Canine Influenza is H__N_H3N8 (I have 3 horses and 8 dogs)
Is there a Vx for H3N8?(Equine canine flu) Yes, for horses
What is H1N1?The predominant circulating Influenza virus worldwide. It is a mix of N. American Swine Influenza viruses, North American Avian Influenza viruses, Human Influenza viruses, [N] & matrix [M] genes from Eurasian [found in both Asia & Europe] Swine Influenza viruses
Can H1N1 go from human to human?YES!!
What kinda humans are most at risk for H1N1? How is it xmitted?Aerosol human-human. People <25yrs most at risk
Is there a Vx for H1N1?Yes - but both H1N1 Vx & seasonal flu Vx. Risk of flu by 70% to 90% in healthy adults... ALSO 1 for pigs
How did "Swine flu" (H1N1) start?In people! Altho swine CAN get infected, there is actually a Vx to protect them from people!
Is there a H1N1 Vx for pets?No
Swine Type A Influenza Viruses → Swine origin Influenza virus [S-OIV’s] → what should be noted about this?NOT the H1N1 of people!
When is it appropriate to say "Swine flu”?The term “Swine flu” should only be used to refer to dz due to Influenza viruses circulating in swine
Influenza viruses that circulate in pigs (Different from Influenza viruses in people) → what are the 4 main subtypes?H1N1
**H3N2 affects who & is aka?PIGs, aka [TRIG cassette] bc contain a combination of genes from avian, swine & human viruses known as the triple reassortant internal gene(t.r.i.g.)
Do Swine Origin Influenza Virus [S-OIV’s] infect humans?Do not normally infect humans! When human infxns w/ these viruses occur, these viruses are called “variant” viruses (denoted “v”)
Altho rare, if a S-OIV (Swine Origin Influenza Virus) infects a human, what's the xmission?MOST human cases are czd by close contact w/ infected pigs. S-OIV’s not xmitted to humans by food!!!
How are Swine Origin Influenza Virus [S-OIV’s] xmitted btwn pigs?Aerosol - Close contact btwn pigs, OR Contaminated objects like infected-uninfected pigs
What are the CS of swine flu in swine?Sudden onset:
Cough (bark)
Oculoresperatory signs
Are there Vx for H3N2 swine flu?Swine Influenza Virus (SIV) H3N2 Vx USDA approved
Is swine flu (H3N2) reportable?It is not a reportable dz in the US or globally unlike HPAI Avian Influenza
What’s H7N9?Novel reassortant avian-origin Influenza A (H7N9) virus
How do humans get H7N9?Birds
Are animals usually treated w/ antiviral drugs?Not usually, bc not approved & resistance concerns
If there is a flock w/ H5N1, what usually is done about it?Poultry flocks w/ HPAI viruses are depopulated, not Txd

Influenza numbers

Question Answer
H5N1 is?HPAI (Highly Pathogenic Avian Influenza)
H5 means...Bird
H7 means...Bird
H3N8 is?Equine-canine flu (I have 3 horses & 8 dogs. All the other H3s are pig viruses)
pH1N1 is?HUMAN H1N1 ( p for ppl)
H1N1 in who?PIGS. Not same as pH1N1
H3N2 in who?PIGS, [TRIG] cassette ( triple reassortment internal gene bc contain a combination of genes from avian, swine & human viruses )
H3N1 in who?Pig
H3N2v is what?Pig, it's the TRIG matrix + [m] gene from pH1N1
H7N9 is what?Bird, has killed ppl

Group Discussion Readings AVMA & the Law & Vet Std (kinda just read over, common sense)

Question Answer
Legal duties of vets are determined by who?State Veterinary Medical Boards
Legal duties → (3)Standard of care to avoid malpractice
State laws & regulation
Additionally all employers (vets/non-vets) obligation to employees to provide worker safety & public safety
What are some ethical duties of vets?Ethical duty to promote public health & to educate clients on risks associated w/ Zoonoses in their pets & minimizing the xmission of zoonotic dzs (as stated in the vet oath)
If a vet does not adhere to their ethical duties, what can happen?State Veterinary Medical Board can take action to suspend a vet’s license if ethical duties not adhered to
The following 4 elements must be present to sustain a claim of malpractice.... (4)Duty, a breach of the applicable professional standard of care, causation & damages
Malpractice → duty. Explain how duty must be present to sustain a claim of malpracticeEstablishment of a vet-client relationship establishes a duty for the vet to provide a standard of care, if there is no relationship, the vet owes no duty to the PTx. (So the vet must actually be the vet for the client)
Malpractice → standard of care. Explain how standard of care must be present to sustain a claim of malpracticeA breach of the applicable professional standard of care where the vet fails to Dx, recommend preventive measures for zoonoses, refer to a specialist for a spp/condition not w/in the treating vets’ expertise & advise clients on this & seeking MD care [INCLDS educating VETERINARY STAFF on risks also].
Malpractice → causation & damages. Explain how causation/damages must be present to sustain a claim of malpracticeDetermine if the vet’s conduct was negligent & czd the injury / dz in which case the owner can be awarded damages [financial compensation] (What the vet must remember is new & advanced diagnostics are available to confirm animals as the source of human infxns & these diagnostic tools must be utilized)
If employee contracts a zoonoses during employment, who might be held liable?The vet!
What's OSHA & what does it mean for the vet?Occupational Safety & Hazards Act - Vets’ responsibility to implement an infxn control plan to protect employees from exposure to zoonoses. Protect by implementing infxn control practices (PPE), handwashing, disinfxn of premises/…..
*To negate initial elements reqd for a negligence claim, Vets should...Record any advice they give to clients & keep accurate records
*If there is an owner who refuses recommended diagnostics & Tx, what should the vet do?Obtain disclaimers & seek advice from an attorney on how to best to design & implement these disclaimers
*When should you treat owners/people?NEVER
Infxn control planning inclds what 4 things?(1) Exposure avoidance (e.g., refusal to provide care for species for which a practice is not equipped)
(2) Engineering controls (e.g., convenient placement of sharps containers or providing an employee break room)
(3) Administrative controls (e.g., employee training))
(4) Educate owners & staff on risks
Zoonotic agent xmission involves what 3 factors?(1) Source of Infxn
(2) Host Susceptibility (Age, IS/IC people, preg)
(3) Route Of Xmission (contact, aerosol, vector-borne xmission)
What are 3 major Veterinary Standard precautions vet should be doing?(1) Personal protection & equipment
(2) Protective actions during procedures
(3) Environmental infxn control
**Examples of Personal protection action & equipment? (7)(1) Hand hygiene to decrease risk of dz xmission
(2) Gloves & sleeves to dec. risk of pathogen xmission (like from Necropsies, Handling feces, body fluids, Dental procedures, NOT a substitute for handwashing)
(3) Facial protection to prevent exposure of mucous membranes of eyes, mouth, nose to pathogens. Use of face shields, goggles (when lancing abscesses, Flushing wounds, suction, Dental & obstetrical procedures)
(4) Respiratory tract protection: NIOSH CERTIFIED N95 Respirators [filter 95% of airborne particles] & protect airways from inhalation of aerosols /infectious agents (when working w/ Ill psittacines, Q-Fever-abortion storms, Respiratory-M. bovis)
(5) Disposable Protective outerwear, footwear to prevent exposure to infectious material & prevent spread
(6) Head covers
(7) Bite-resistant equipment to protect animal handlers from injury
What are some examples of Protective Actions during procedures? (6)(1) Isolate animals w/ infectious dzs in a separate examination room
(2) Ensure room has a source of running water & vets & personnel wash hands btwn examinations of individual animals or litters; alcohol based hand rubs, properly cleaned & disinfected btwn batches
(3) Protective outerwear/gloves for vet +personnel, facial protection. If suspect zoonoses
(4) Engineering controls-provide appropriate sharp containers to avoid needle stick injuries & discourage removal of needle caps by mouth
(5) Use gloves for venipuncture if animal has infectious dz
(6) Appropriate use of outerwear & disposal of gloves, use of facial masks, respirators.. During dental, diagnostic specimen handling, wound care, handling lab specimens, obstetrical, necropsy procedures. Resuscitate using endotracheal tubes & a manual resuscitator or anesthetic machine not your mouth!
Implement Vx policy for staff, such asRabies
Educate staff & encourage compliance w/ policies & procedures
Keep records
What should you be ESPECIALLY stringent out w/ record keeping?Record keeping especially documentation of exposure incidents (autoinoculation w/ Vxs, bites, needle stick injuries [euthatal] , zoonotic pathogen exposures & reporting where appropriate to local or State health departments)