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This information
is provided by the New York Veterinary Medical
Association
October 30, 2001
Dear Veterinarian,
The New York State Department of
Health (NYSDOH) is sending this letter to the
veterinary community to provide updated information regarding bio -terrorism
concerns. The Centers for Disease Control and Prevention (CDC)
has identified a long list of potential biological and
chemical agents that could be used as part of a
terrorist attack. In addition to information on
the state websites attached, general information on these
agents can be found on the CDC website ( www.bt.cdc.gov
) Information specifically to animals
can be found on websites of the United States Department of Agriculture
(www.aphis.usda.gov/vs), Cornell University (http://web.vet.cornell.edu/public/fhc/practpg.html)
and the American
Veterinary Medical Association www.avma.org
No confirmed cases of illness in or
exposure to animals have been identified in the
recent mailed anthrax incidents in several states. However,
anthrax and other disease agents of concern have
been documented in New York State in the past, and
there is potential that animals could be exposed through the
same or separate sources as humans. Animals may be the first to develop
clinical illness as a result of an intentional release of
a biological agent. The most likely animals
to be exposed during the current mail incidents
are service dogs, such as those that are involved in emergency response,
search and rescue for humans and cadavers, and bomb sniffing dogs.
Although dogs can theoretically develop the same forms of
anthrax as people (cutaneous, gastrointestinal,
and inhalation), dogs are thought to be more resistant
than humans to anthrax infection. Scientists in laboratory studies
in the 1960's were not able to establish inhalation anthrax in dogs
by inhalation exposure to anthrax spores. It is unknown whether
this finding would apply to the current type of
anthrax distributed in the mail.
The New York State Department of
Agriculture and Markets (NYSAM) has a legal requirement
for veterinarians to report any suspect cases of anthrax, plague,
tularemia, brucellosis, or any other zoonotic disease.
Particularly at this time of increased concern, it
is critical for veterinarians to report suspect
cases. A number of local or state agencies may be of assistance
to you in answering questions or taking reports, depending on the
nature of your inquiry. Cornell University's
Veterinary Diagnostic Laboratory (607-253-3900) is
serving as a regional testing laboratory for the
northeastern USA.
For concerns about wildlife,
contact the New York State Department of Environmental
Conservation's Wildlife Pathology Unit (518-478-3032).
Specific
details have not yet been determined about the availability of all the
types of evaluations and tests that would be required for these types of
agents in wildlife species.
Attached to this letter are agency
phone numbers and website addresses, information
about some of the key disease syndromes that should be reported, guidelines
for specimen submission, and precautions to take in handling the animals.
If you have any questions about this information, please feel free
to contact one of the agencies listed on the attached
information sheet.
Sincerely,
Millicent Eidson, MA, DVM
State Public Health Veterinarian and Director,
Zoonoses Program
Enclosures
Reporting Animals Exposed To Or Ill From Biological
Or Chemical Agents
In New York City (New York City Dept. of Health, NYCDOH: www.ci.nyc.ny.us
During normal business hours:
Communicable Disease Program
212-295-5673 (Dr. Cherry)
Veterinary Public Health Services
646-248-0411; 646-248-0405
New York State Dept. of Ag. and Markets 518-457-3502,
www.agmkt.state.ny.us
After 5 PM and during weekends:
NYC Poison Control Center
212-POISONS (ask to have Dr. Cherry or Mr.
Boyce paged)
NYCDOH automated information: 1-877-817-7621
In New York State:
To report ill or exposed livestock: New York State
Dept. of Agriculture and Markets, 518-457-3502,
additional information available at www.agmkt.state.ny.us
To report ill or exposed pets: New York State Dept. of
Health Zoonoses Program, 518-474-3186,
additional
information available at www.health.state.ny.us/nysdoh/zoonoses/zoonoses.htm
To consult about laboratory testing
of owned animals: Cornell University's Veterinary
Diagnostic Laboratory, 607-253-3900 .
To consult about ill or dead
wildlife: NYS Dept. of Environmental Conservation's
Wildlife Pathology Unit, 518-478-3032. Availability of
laboratory
testing for wildlife specimens has not yet been determined.
For local questions or
reports, contact your local health department (see listings
in front of phone under under 'Rabies Reporting').
Management of exposed animals
(animals in definite contact with a highly suspect
powder from an unknown, suspicious source or accompanied by an explicit
threat):
- Call your local emergency
response, for example, 9-1-1. In some areas, local
emergency response will take these types of calls. If not,
contact your local health department.
- Restrict movement of the animal,
contact with the animal, and access to the
area.
- Use soap and water to
immediately wash off any material on people.
- Local authorities will determine
the need for appropriate laboratory testing of
material of concern.
- To avoid overwhelming the
response system, use reasonable judgment in interpreting
the situation. Exposures do not include animals covered with
dust after rolling in the dirt, animals sniffing
boxes, or animals contacting packing dust in
mail from a known source.
- For high risk exposures, for
example to service dogs, a nasal and oropharyngeal
swab should be submitted to Cornell University in Amies
transport medium with charcoal, along with a nasal or
throat swab for gram staining or methylene
blue staining. If the animal is exhibiting clinical signs
of facial/head/neck edema or swelling, dyspnea, and fever, a blood
sample placed in a blood culture bottle, and if
feasible, edema fluid aspirated and placed
into Amies transport medium, should also be submitted.
- Routine nasal swabs of animals
and prophylactic antibiotics for animals are
not recommended in the absence of a confirmed or highly suspect
anthrax exposure.
- Testing is not available to
certify that a healthy, unexposed animal is disease-free.
- For service dogs with highly
suspect exposures, the U. S. Military recommends
providing enrofloxacin (Baytril) at a dose of 15-20 mg/kg administered
orally as a single dose or divided into two doses given at
12 hour intervals. Duration 60 days if
exposure confirmed; discontinued if substance
confirmed not to be anthrax. Do not use in immature animals.
Adverse effects may include vomiting and loss of
appetite. Alternative antibiotics:
penicillin, amoxicillin, tetracycline, doxycycline,
ciprofloxacin.
Epidemiological clues to unusual
disease presentation in animals:
- Suspected or confirmed zoonotic
diseases that are not endemic to New York,
especially in the absence of recent travel history (e.g.,
plague), or that have an unusual presentation.
- A sudden increase in illness in
previously healthy animals
- Simultaneous disease outbreaks in
human and animal populations
- Any unusual temporal and/or
geographic clustering of illness (e.g., pets from
a given area, or that recently visited a particular park)
New York State Dept.of Health,
October, 2001 Possible Disease Agents for
Bioterrorism Exposures to Animals
Anthrax:
,
Fever,
depression, splenomegaly, sepsis
Carnivores
may develop upper GI necrosis, mesenteric lymphadenopathy
Diagnosis: Large,
gram positive non-motile rods may be observed on blood smear
Sera,
blood for culture
Precautions: Standard
precautions of gloves and gowns should be used for handling animal
or clinical specimens. Necropsies of highly suspect
or confirmed positive animals should not be
done except by federally-approved officials as exposure
to air may allow for spore formation and dissemination. For
routine necropsies of other animals that die of
unknown causes in a geographic area
experiencing anthrax bio-terrorism exposures, use gloves, mask,
sterile technique, and look for gastrointestinal necrosis and
lymphadenopathy. Impression smears of involved
lymph nodes, spleen, and liver should be done
to look for bacilli. Isolate the carcass and notify appropriate
agencies immediately if anything suspicious is seen on these smears.
Tularemia
- Clinical syndrome:
- Weakness, abscess at
inoculation site, lymphadenopathy
- Rodents and lagomorphs most
susceptible
- Sheep may show respiratory
distress, fever, rigid gait
- Carnivores usually less
susceptible
- Diagnosis: Sera, blood
for culture, taps of abscesses or enlarged lymph nodes
- Precautions:
Veterinarians, staff, and owners are at risk of
infection particularly if animal is pneumonic
Use normal precautions when handling infected tissues
(gown, gloves, mask)
Keep animal in separate area, with respiratory
isolation, if showing indications of pneumonia
Plague
- Clinical syndrome: May
have only non-specific signs of fever, lethargy. Enlarged lymph
nodes in many cases, particularly in submandibular area Abscesses
possible, particularly on tongue, back, legs Some animals may develop
pneumonia with rapid decline and high case-fatality rate Most likely
to develop clinical illness--cats and prairie dogs
- Diagnosis: Tap
of enlarged lymph node or abscessed material will provide most rapid
diagnosis with fluorescent antibody (FA)
Blood for culture; sera
- Precautions:
High risk of human pneumonic infection and death if
animal has pneumonia.
Use normal precautions when handling infected tissues
(gown, gloves, mask)
Keep animal in separate area, with respiratory
isolation, if showing indications of pneumonia
Brucellosis
- Clinical syndrome:
Usually associated with abortion in mature female
animals, infection of reproductive organs in
males (orchitis, prostatitis, epididymitis)
// Neurological disease in
domestic pets //
Fistulous withers in horses
- Diagnosis: Sera
- Precautions: Avoid
contact with fetal fluids, placenta, or aborted fetus
New York State Dept.
of Health, October, 2001
Dr Bob Johnson
Vermont Dept of Health
rhj6@cornell.edu
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