Donald L. Janssen
Guidelines for the Management of Zoonotic Diseases
Most zoo clinicians have, at one time or another, encountered a case in which they diagnosed or suspected a zoonotic disease. For the purposes of this chapter, a zoonotic disease is defined as any infectious disease that may be readily transmitted between animals and humans. When a serious zoonotic disease is identified, often the demand for action is urgent, and little time is available to make systematic and intentional decisions. In contrast, when a subtle disease incident occurs, it may be completely overlooked and no specific action taken. In either case, we may fail to handle the situation in the best interests of the health and safety of the animals, staff, and guests.
To focus our efforts, it may be useful to ask several key questions, including the following:
◆ What circumstances should trigger a zoonotic disease investigation and response?
◆ Who is responsible for making decisions about public health implications?
◆ Who should be notified, and what do we say?
◆ Do we need to report to government regulators?
◆ What do the caretakers of the animal need to know?
◆ Do we need to isolate the animal, and if so, what procedures should we implement?
◆ How do we handle contaminated waste?
This chapter suggests a strategy to answer these questions using a systematic process when dealing with a zoonotic disease occurrence in a zoo setting.
Systematic Process
Having a systematic process for managing a zoonotic disease occurrence reduces the risk of mishandling them. The consequences of mishandling may be significant. The implications to the animal, its caretakers, the public, the institution, and our professional reputations may quickly become overwhelming. Failure to respond properly may lead to unnecessary human and animal illness or, in contrast, an overreaction to perceived risks. Other animals in contact with the infected animal may be put at risk. Public health may be compromised through unnecessary contact and exposure of disease agents to employees and guests. A zoonotic disease outbreak could affect the reputation of the institution, leading to public concern and adverse economic consequences. Media attention may become misdirected. Even our professional reputation could be damaged by improperly handling the many issues that come up when a zoonotic disease is identified.
The chances of avoiding these undesirable consequences are improved by setting up a systematic process ahead of time (Box 80-1). As a first step, it is important to identify triggers to initiate the process so that we do not overlook the occurrence of a zoonotic disease.
Identifying Triggers
The diagnosis or suspicion of a zoonotic disease in an animal or human contact should trigger the process to begin. Often, the trigger is a specific test result (e.g., a culture) reported from the laboratory. Another trigger may be the results of a postmortem examination that provide evidence of a zoonotic disease, either confirmed or suspected. A more unusual trigger could be an employee, volunteer, or guest who is diagnosed with an infectious disease that could have been acquired from contact with animals in the collection. A suspicion of a zoonotic disease may also act as a trigger (e.g., an outbreak of diarrheal disease in an animal contact area).
Once triggered, a systematic approach should be implemented. This could be approached in several ways. In our practice, a zoonotic disease occurrence triggers each of the following steps: (1) notifying stakeholders; (2) isolating the animal from others; (3) managing the contaminated waste from the animal; (4) reporting to authorities, if appropriate; and (5) treating the animal or otherwise managing the clinical illness, if present. All these steps are important, but key steps that need emphasis may be different in each case.
Notifying Stakeholders
Once the process is triggered, the most urgent step is to notify the appropriate internal stakeholders involved in the care of the animal and the occupational health care provider for the facility. It may seem desirable to keep the situation quiet and avoid overreaction and unnecessary attention to the situation. Approaching the problem in that way, however, often leads to greater problems. It is critical that employees be informed so that they may take proper precautions and report signs and symptoms of disease that they may be experiencing. It is useful to provide a written disease fact sheet to all stakeholders to remind them of the signs and symptoms. Well-written fact sheets on many zoonotic diseases are readily available in books, pamphlets, and from authoritative sources on the Internet.1,2
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