Wisconsin Department of Agriculture, Trade & Consumer Protection Division of Animal Health

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1 Wisconsin Department of Agriculture, Trade & Consumer Protection Division of Animal Health Zoonotic Diseases Where Human and Veterinary Medicine Meet Darlene Konkle, DVM, MS, DACVIM Assistant State Veterinarian Zoonosis - Any infectious disease that can be transmitted (in some cases by a vector) from non-human animals to humans Vector A carrier that transfers a disease causing micro-organism from one animal to another Ticks Mosquitoes flies 1

years world population will increase to:

2 9/18/ s of diseases worldwide are zoonotic 60% o of known o human u a pat pathogens oge s 75% of emerging infectious diseases Over the next 40 years world population will increase to: 9 billion people Ease of travel, exposure to wildlife Environmental factors Increased animal agriculture Deforestation Climate change 2

3 ONE HEALTH Human Health Environmental Health Animal Health Direct contact Feces Urine Secretions Bites, scratches Vectors and fomites Contaminated equipment, utensils Biological vectors Foodborne Waterborne 3

4 Image credit: Nature Middle Eastern Respiratory Syndrome Coronavirus o Emerged in 2012 Saudi Arabia 20 countries with cases Mortality 30% 688 cases, 282 deaths No evidence of sustained transmission person to person- requires close contact Animal source Camels bats 4

5 Isolates from camels indistinguishable from human isolates Virus recovered from camel milk not detectable after pasteurization Serologic evidence of MERS CoV circulation in camels in a wide area of the Middle East and Africa More epidemiologic evidence needed Risk of contact with camels Risk of consuming milk or other camel products Human animal interface for emerging influenza viruses Influenza viruses mutate and re-assort naturally Most emerging strains have limited ability to move from person to person so far Unlike H1N Could we see a virus capable of: Moving from animals to people Able to spread rapidly person to person With high pathogenicity 5

6 H5N1 highly pathogenic avian influenza Emerged in 2003 southeast Asia 63 countries at peak (2006) To date 667 human cases, 393 deaths (WHO) 400 million poultry culled $20+ billion cost CLOSE contact between people and poultry Virtually no human human transmission H1N1 pandemic 2009 Mexico U.S worldwide Virus contains genetic material from humans, swine and birds. Swine flu a misnomer human to human transmission. Some pigs infected from human contact. Millions of $$ cost to swine industry 6

H3N2 normally circulates in swine Swine origin virus The variant designation given when it is found in humans A triple re-assortment virus has genes from

In 2011 new virus found - has the M protein gene from the 2009 H1N1 pandemic virus Human illnesses associated with swine contact at county fairs, 2012-2013

IT IS RECOMMENDED THAT PERSONS AT HIGH RISK* OF SERIOUS FLU COMPLICATIONS SHOULD NOT HAVE CONTACT WITH PIGS OR ENTER AREAS WITH PIGS.

7 H3N2 normally circulates in swine Swine origin virus The variant designation given when it is found in humans A triple re-assortment virus has genes from human, swine and avian influenza viruses. In 2011 new virus found - has the M protein gene from the 2009 H1N1 pandemic virus Human illnesses associated with swine contact at county fairs, A SPECIFIC H3N2 INFLUENZA VIRUS HAS BEEN FOUND IN BOTH PEOPLE & PIGS IN A NUMBER OF STATES, INCLUDING 15 HUMAN CASES IN WISCONSIN. IT IS RECOMMENDED THAT PERSONS AT HIGH RISK* OF SERIOUS FLU COMPLICATIONS SHOULD NOT HAVE CONTACT WITH PIGS OR ENTER AREAS WITH PIGS. IF FLU IS CONTRACTED BY PEOPLE AT HIGH RISK*, SERIOUS COMPLICATIONS ARE POSSIBLE. *Those at HIGH RISK include: young children, people 65 years and older, pregnant women, and people with certain chronic medical conditions (like asthma, diabetes, heart disease, weakened immune systems, and neurological conditions). 7

8 H7N9 influenza China: Severe respiratory illness in people, 30% mortality Classified low path in poultry Infection requires close contact with poultry Poultry farm depopulations No evidence of sustained human-human transmission 8

9 Hendra Virus Australia 1994 New genus of virus Henipavirus Cross reacts with Nipah Multiple outbreaks horses died horses, 1 dog horses 4 human deaths Vaccine now available Plus: zoonotic diseases that just won t go away 9

10 Mycobacterium bovis: Bovine TB Nearly eradicated from US Transmitted in unpasteurized milk and by contact Leading cause of death early 1900s Bovine human transmission Human infections M. tuberculosis Human human Human-Bovine? Mycobacterium bovis Cattle Bison cervids 10

2010-2011 16 herds in 9 states (KY, NY, CO, IN, MI, MS, OH, NE & SD) herds have

replacements, rodeo stock (bucking bulls and roping steers) and cervids Numerous

Mexican Cattle Infected Large Dairies Infected Dairy heifer-raising facilities

11 herds in 9 states (KY, NY, CO, IN, MI, MS, OH, NE & SD) herds have consisted of beef, adult cull cow feed lots, adult dairy, dairy heifer replacements, rodeo stock (bucking bulls and roping steers) and cervids Numerous trace-out cases through interstate shipments Animal Health: Importation of Mexican Cattle Infected Large Dairies Infected Dairy heifer-raising facilities Persistent Wildlife Reservoirs Human Health Contact with infected animals Animal products- raw milk 11

12 Persistent wildlife reservoirs England and Ireland European badger New Zealand Bushytailed possum United States To date, no country with documented wildlife reservoirs has succeeded in eliminating the disease from wildlife or livestock. Dairy industry employs many workers from Mexico and other countries Many travel from farm to farm Many live in close contact with families and other workers If infected with TB, many do not seek medical treatment, or they stop treatment. 12

13 Reverse zoonosis Dairy herd infected by human worker Strain cultured from infected animals was identical to the strain from the worker Matched a strain found in a Mexican state not commonly found in U.S. What does this mean for animal and public health? 13

14 Estimated 50,000 human deaths occur annually from rabies worldwide Most due to dog strain Wisconsin wildlife species Skunk Bat Wisconsin Statute Chapter 95, Animal Health, Section Rabies Control Reportable, interaction with public and animal health 14

15 All warm-blooded animals are vulnerable to rabies infection The degree of species susceptibility varies greatly Incubation periods vary widely Abnormal, often aggressive behavior Sudden change in personality Wild animals may appear tame or friendly Nocturnal animals may be active during daylight Friendly animals may appear vicious Vicious animals may appear friendly or playful 15

Vaccines are currently approved for use in: Dogs Cats

well controlled in most developed countries Brucella

melitensis, abortus, suis, canis Gram negative,

16 Vaccines are currently approved for use in: Dogs Cats Ferrets Cattle Horses Sheep Distribution Worldwide but well controlled in most developed countries Brucella sp. vary by geographic distribution B. melitensis, abortus, suis, canis Gram negative, coccobacilli bacteria Strong host preference Control programs for livestock 16

Ingestion of infected tissues, body fluids Contact with

Fomites AI, contaminated syringes Venereal Estrus,

100 150 cases/ /year US Pens, stables, slaughter houses

Veterinarians Abattoir workers Meat inspectors Lab workers

17 Ingestion of infected tissues, body fluids Contact with infected tissues, body fluids Mucous membranes, injections Fomites AI, contaminated syringes Venereal Estrus, breeding, abortion Inhalation of infectious aerosols Humans cases/ /year US Pens, stables, slaughter houses Occupational Disease Cattle ranchers/ dairy farmers Veterinarians Abattoir workers Meat inspectors Lab workers Kennel operators Hunters Travelers e Consumers of unpasteurized dairy products 17

Can affect any organ or organ system All patients ts have a cyclical ca

depression, weight loss, fatigue, liver dysfunction, dermatitis, night

Hunters - feral swine Brucella suis s Clinical signs Fever Malaise Joint

18 Can affect any organ or organ system All patients ts have a cyclical ca fever e Variability in clinical signs Headache, weakness, arthralgia, depression, weight loss, fatigue, liver dysfunction, dermatitis, night sweats Not believed to cause abortion Endocarditis rare causes most deaths Hunters - feral swine Brucella suis s Clinical signs Fever Malaise Joint pain Patients with joint replacements Field dressing knife cut injuries On farm slaughter 18

Public health impact less clear Primarily reproductive e

will routinely notify Public Health of a positive B.

canis is reportable to WI State Veterinarian Regulatory

19 Public health impact less clear Primarily reproductive e problems in dogs Diagnosis in people is challenging DATCP will routinely notify Public Health of a positive B. canis finding in dogs B. canis is reportable to WI State Veterinarian Regulatory actions quarantine, test and removal of infected animals Risk to kennel workers, family members? 19

Alkaline soil, warm temps and periodic flooding NW Minnesota, Dakotas, NV & TX Spores can survive for years Last case in WI - 1956

20 Bacillus anthracis Basis s for Koch s postulates, one of the first diseases linked to a causal organism 1876 Cutaneous, gastrointestinal and inhalational forms Naturally occurring in parts of the U.S. Alkaline soil, warm temps and periodic flooding NW Minnesota, Dakotas, NV & TX Spores can survive for years Last case in WI Parasite Cryptosporidium parvum Frequent waterborne e disease Milwaukee cases reported in Iowa 2013 Millions of infective oocytes shed in feces Oocytes resistant to environment, disinfectants, etc. 20

21 Causes: Direct contact with animals Contact with contaminated water, food, fomites. For most, self limiting infection Immunocompromised individuals, increased risk of severe disease Case study UW School of Veterinary Medicine Bacteria Salmonella Many serotypes: typhimurium, enteriditis, agona 40,000 cases/ year in the U.S. Intestinal tract of humans and animals Usually a food borne illness 21

22 Reptiles and amphibians Domestic livestock Birds - poultry Multistate Outbreak of Human Salmonella Typhimurium Infections Linked to Live Poultry in Backyard Flocks 356 cases 39 states 62 hospitalizations 22

23 Increased contact humans and wildlife Shrinking habitats Wildlife trade Exotic farms, preserves Clay Coppage Keep wild animals out Restrict traffic Disinfect Wash hands footbaths Isolate sick animals Personal Protective Equip. Proper handling 23

Local and State volunteer organizations Local emergency

Emerging and Zoonotic Infectious Diseases http://www.cdc.

Global animal disease information system http://empres-i.

24 Local and State volunteer organizations Local emergency e services Community planning CDC- National Center for Emerging and Zoonotic Infectious Diseases OIE World Organization for Animal Health FAO- Food and Agriculture Organization EMPRES Global animal disease information system ifaoorg AVMA American Veterinary Medical Association 24

Veterinarian of a cluster of H3 influenza cases

The people were in contact with pigs from ABC farm.

severe headache, fever, aching joints and a rash.

25 Practice, practice, practice! Fictional Scenario: WI Public Health notifies State Veterinarian of a cluster of H3 influenza cases associated with a county fair. The people were in contact with pigs from ABC farm. A 60 year old woman was admitted to the hospital with severe headache, fever, aching joints and a rash. She did not go to the fair, tested negative for influenza, and further tests are pending. She bought a pig from ABC farm for home slaughter. 25

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27 Responder safety is one of the most important aspects of an animal disease investigation Good biosecurity is crucial, and we have to practice Humane handling techniques are essential, and we need training Collection of proper samples, packaging, decontamination, and shipping 27

28 Questions? 28

Indiana State Board of Animal Health

Indiana State Board of Animal Health Office of the State Veterinarian Marianne Ash, DVM, MVPH, DACVPM Animal Health Division Director BOAH s Charge the prevention, detection, control and eradication of