Staff and Students of Veterinary Public Health Division, IVRI

Zoonotic Diseases: Global and Indian Perspectives

SVS Malik1, H. Rahman2, VM Vaidya3, and Simranpreet Kaur4

Sr. Scientist1, Pr. Scientist and Head2, Ph.D Scholar3, M.V.Sc. Scholar4 Division of Vety. Public Health, I.V.R.I., Izatnagar

What are zoonoses?

Zoonosis (singular) /( zoonoses,plural) Zoon = animals Noses = diseases
Infections or agents that are naturally transmitted Animals Man

Disease of animals transmissible to humans, under natural circumstances

Zoonotic Diseases

Why important ? (64% (14/ 22) infectious agents identified between 1973 & 1994 are Zoonoses ( 75% of Human infections are shared by animals (Zoonoses) ( Over 300 in Nos.
4

(Chomel,1998)

Impact

(Affect the efficient production of food - animal protein ( Serious occupational hazards : Close association of farmers/animal handlers with livestock. ( Obstacles in international trade in animals and animal products ( High number of deaths ( Loss of work efficiency
Aim of Control

Protecting yourself and your family from animal diseases and infections 5

Increased chance of illness

Populations at higher risk
Infants Children <5 Pregnant women People undergoing chemotherapy People with organ transplants People with HIV/AIDS Elderly
6

Increased chance of disease

Riskier animals
Reptiles Chicks/ducklings Puppies, kittens < 6 months Animals with diarrhea Exotic and wild animals

What kind of animals transmit zoonoses?

Farm Animals Cattle Swine Goats Cats Dogs Camel Poultry Wild Animals Rats Mice/rodents Squirrels Raccoons Foxes Bats Migratory birds others Vectors Mosquitoes Ticks Lice Flea House Flies Insects
8

Farmers more susceptible to contracting zoonoses

1. More likely to share air and space with animals 2. More contact with domestic and wild animals
9

How are disease transmitted?

Every day contact with animals Scratches or bites Contaminated foods (milk, meat, water) Contaminated soils/environment Occupational exposure Transportation of carcasses
10

Important Zoonoses In India

11

Tuberculosis
Indian scenario
30% of the total global TB cases in India Leading cause of death in Indian women with a total of 4,21,000 deaths annually 1000 Indians die from TB per day i.e. one per min 95% of new TB cases every year
(WHO,1999) (Krishnaswami, 2000)

Socio - economic impact

Loss of an average of 83 workdays 11% children discontinue schooling & 85% take up employment to support family on account of TB of their parents  Financial losses 4 - 7% loss in GDP due to TB in Asian countries TB costs more than Rs 13,000 crores in India / year 67% rural & 75% urban patients in debts on account of treatment & loss of workdays
(ICMR Bulletin, 2002)

 Social trauma Rejection of 100,000 women patients by their families More than 3 lac children rejected by schools because their parents had TB 15% rural & 11% urban patients unaccepted and ill treated by family members
12 (Rajeshwari et al., 1999, Geetharamani et al., 2001)

Zoonotic Tuberculosis
(TB in Animals(M. Bovis) spreading to Humans) 1. More severe than the Human TB,which spreads mainly from Man-to-Man
Growth on T2CH

2. Can spread in all directions (Animal-Man, Man-man,Man-Animal and Animal-to-animal) 3. Isolation and identification of M. Bovis is very difficult as well as needs more time and special media to grow 4. Zoonotic TB is grossly under reported and undiagnosed
M. TB M. TB M. Bovis

Niacin Reaction

13 M. Bovis

Prevention & Control

In animals 1. Good hygiene and management - Sanitation at farms and Good Ventilation - Tail-to-tail arrangement of keeping animals - Proper & hygienic disposal of waste -Isolation of sick and weak animals showing marked weight loss, emaciation,, low grade fever,coughing and diarrhoea 2.Tuberculin Testing -Segregation of all tuberculin positive animals -Test and slaughter policy in tuberculin positive 14 animals other than cows

Prevention & Control

In man Personal hygiene and sanitation Keep the human houses away from animal sheds Montoux test, sputum testing and x-rays in suspected cases with low grade fever, persistent cough, weight loss & diarrhoea Complete and proper treatment of infected subjects Notify the case to medical/ veterinary authorities Health education In food products
Never drink raw/unpasteurized milk

Don,t eat meat from an infected animals

15

Brucellosis
    Occupational zoonosis for farmers, veterinarians & workers in meat industry. One of the leading cause of infectious abortions (OIE, 2002) Prevalence rate on organized dairy farms: 17% Brucellosis in India is common in areas with high rainfall and humidity

Indian scenario
Species Cattle Buffalo Sheep Goat Human Prevalence rate 1.9% 1.8% 3.6 % 0.6 % 0.45 41.25% Reference OIE, 2002 OIE, 2002 Singh et al., 1994 Singh et al., 1994 Barbuddhe, 1993
Animal to human transmission

Socio economic impact

In India, brucellosis as a whole shown to cost Rs. 350 million in the form of food (Schwabe, 1984) animals and mandays of labour Losses due to abortion in the affected animal population. Loss of progeny & reduced milk production Human brucellosis causing physical incapacity 16 (Patel et al., 1986). Loss of 3 million mandays of labour annually

Prevention & Control

In animals 1. Good hygiene and management - Sanitation at farms - Proper & hygienic disposal of waste /aborted material - Adequate treatment of excreta before disposal - Care in handling abortion (usually occurs in 6-9 months) 2. Vaccination - Calf hood vaccination in female calf with Strain 19* In man Personal hygiene and sanitation Care in handling abortion (usually occurs in 6-9 months ) Health education
In Food products


 

Never drink or eat raw milk/ milk products Cook thoroughly and Handle properly Avoid cross-contamination

17

Anthrax
      Economically important agricultural disease People at Risk: Agri. workers, butchers, tanners & woolsorters Endemic in Tamil Nadu, Karnataka & Andhra.Pradesh 205 documented human cases majority of cutaneous anthrax
(Rao et al., 2005)

Sporadic disease in cattle in endemic areas; 479 deaths in last 3 years

(Peoples daily online, 2001)

Cutaneous anthrax accounts for more than 95% of human cases (Ghaffar,2003) Disease forms 1. Cutaneous (low mortality) 2. Grastrointestinal (50% mortality) 3. Pulmonary (High mortality) Indian Scenario
State & Year Orissa (2005) Andhra P. (1990) Karnataka (1991) Kerala (1994-95) Human Cases 23 6 3 23 Remarks CFR: 25-60% Epidemic Emerging zoonoses Reference Peoples daily online, 2005 Bachhil & Malik, 2005
18

Bacillus anthracis
Disease known for thousands of years. Organism first described in mid-1800s Used as proof of Henles postulates by Koch. First vaccines developed by Greenfield and Toussaint; public demonstration by Pasteur in 1881. Livestock and human vaccines.
19

20

21

HYPOACUTE

22

Cutaneous anthrax
This is a pathognomic skin lesion with a raised vesiculated edge, inflamed, and with a black base to the ulcer, e.g., charbon, Siberian ulcer.
23

Cutaneous anthrax
This postman had borrowed his sons woolen scarf; the son worked in a bone meal plant. Without prompt treatment, it carries a 10% case fatality rate.
24

25

Cutaneous anthrax
Cutaneous lesions follow occupational exposure. Usually seen in men after butchering an affected cow; or from handling hides, especially sun-dried hides; or from carrying contaminated building insulation. Also following insect bites.
26

HYPOACUTE

27

28

(5)

GASTROENTERIC

Onset usually 2-5 days after eating contaminated food Nausea, fever, malaise, abdominal pain, bloody vomiting & diarrhea Often fatal even with treatment

HYPOACUTE

29

Gastroenteric anthrax
Seen only in poor, developing countries with food shortages or inadequate veterinary inspection recent cases in SubSahelian Africa, Central Asia, Russia, India & Thailand. Usually have concurrent cutaneous cases from butchering the affected animal or handling the infected meat. Probable frequency: one outbreak per 64 infected animals eaten.
30

Anthrax status, 1998

Not reported

Sporadic Endemic Hyperendemic

Possibly free Free (= > 8 years without cases) 31

ANTHRAX
Epidemiology 101

32

Concerns
Anthrax is an emerging zoonosis in southern India. Anthrax strains are showing increasing resistance to penicillin & other Antibiotics

33

Prevention and Control

Pathogen of highest risk category-take appropriate precautions Never open and flay (to remove skin) a dead animal oozing of dark unclotted blood from ear, nose, anus, mouth and ear Only Burn, but do not not bury the carcass as spore survive in soil over 120 years Never eat the meat from anthrax suspected carcass Avoid contamination of feed and fodder with discharges from anthrax carcass 34

Prevention and Control

Plug the orifices of dead animal with cotton soaked in carbolic acid or Lysol Disinfect the site of dead animal with lysol or formaldehyde Always use face mask, hand gloves and Air exhaust in leather industry and when shearing ( removing wool) sheep Vaccinate the animal with Anthrax spore vaccine in areas where disease is prevalent Education of villagers and forest workers Notify the case to the Medical or Veterinary Hospital
35

Leptospirosis
Disease contracted from infected rats urine/ contaminated watercourses Population at high risk - Rural farm workers, rice field workers, sugarcane cutters, cattle farmers, fishermen, slaughterhouse & sewer workers (CDC, 2002) incidence: TN, Kerala, Andaman over the last 2 decades due to farming & inadequate rodent control. Economic impact
 Cost for medical treatment  Decreased productivity  Impact on trade animals,  Semen losses by reproductive failures &  Reduced milk yield

Indian scenario
State Andaman Chennai Incidence/ 105 50.0 10.5 Mortality 21.0 Ref. Hartskeerl, 2004
36

Kerala

5.6

10.1

Prevention & Control

In animals 1. Good hygiene and management - Sanitation at animal farms, in sugarcane and rice fields - Control of rats by rodenticides (2% Zinc phosphide etc) - Proper & hygienic disposal of waste /aborted material 2. Vaccination - vaccination of animals in areas with high prevalence In man Personal hygiene and sanitation Care in handling abortion (usually occurs in 6-9 months ) Avoid working or walking bare foot in sewer or field waters for long periods Use Gum Boots when working in dirty/muddy water Protect food from urine of rats by keeping it covered Seek medical attention if have symptoms and Red Eye37 Health education

Q fever
( Notable zoonoses (occupational/foodborne)
(Marrie, 1990)

( High Mortality (1-11%) in chronic cases ( Endemic in many countries including India (> 51)
(Raoult, 1990)

Great Economic & Public health importance

- Close animal contact (Prasad et al., 1986) - Common housing - High morbidity & mortality in pregnancy - Abortions, Unpredictable infection (Marrie, 1990) - Sporadic & Unexpected outbreaks

Major states affected

Punjab, Haryana, Rajasthan, UP, M.P. & Karnataka
(Malik & Yadav, 2002)

Seroprevalence of Q fever in India

Humans Sheep Goats Swine Poultry (2.7-26%) (6.2-14.41%) (14.26-17.5%) (14.67%) (11.87%) Cattle (14.98%) Buffaloes (14.5-15.22%) Equines (20.1%) Dog (16%)
(Malik et al., 2000)

38

Q fever

Host Range
Domestic animals
Cat Dog Cattle Sheep Goat Horse Poultry

Wild animals
Arthropods Birds Rodents Primates Carnivores Poikilotherms

39

(Yadav & Sethi, 1980)

Prevention and Control

Pathogen of highest risk category-take appropriate precautions Never drink raw milk as pathogen is excreted in the milk of animals Handle abortion case with great care (Use hand gloves and mask on face Pregnant lady and children should avoid contact of with pregnant animals giving birth as disease spreads through air Avoid contamination of feed and fodder with foetal discharges,placenta & faeces of aborting animals Control Tick population and protect from tick-bite
40

Encephalitis
Common carriers Pigs Birds Horses Rodents
41

Encephalitis
Transmission
Mosquito bites Tick bites

Clinical presentation
Lethargy Fever Headache Disorientation

42

Rabies
( More than 99 % of all human rabies deaths occur in developing world ( Human mortality from endemic area estimated to be 30,000- 55, 000 deaths/ year ( Half of the global human population lives in canine rabies endemic areas
(WHO, 2005)

Economic impact
96% of cases due to bite of dogs (18 billion) 3 - 3.5 million take post-exposure vaccines Economic cost due to rabies in Asia US $ 563 million Livestock losses: rabies incidence rate / lac cattle = 5 Costs / head of cattle US $ 500; Costs / dog killed US $ 5 Annual no. of cattle deaths = 21,150
Human mortality Total population (millions) Population at risk (millions) No. of bites from suspected rabid dogs (1000) No. of rabies deaths No. of deaths/ 1 lac people Urban 284.7 284.7 409.4 1058 0.37 Rural 732.2 710.4 893.4 18201 2.49
43

(WHO Bull., 2005)

Rabies

Transmission
Animal Bite Contact with infected tissue, fluids or feces

Clinical presentation
Fever Furious/paralytic look Headache Agitation Confusion Seizures Excessive salivation 44

Rabies
Common Carriers
Cats Dogs Raccoons Skunks Bats Foxes
45

Prevention and Control

Handle rabies case with great care (Use hand gloves, mask on face, and goggles) Thoroughly wash the wound of bite with carbolic soap and plenty of water Try to avoid suturing of the wound All persons coming in direct or indirect contact of rabid animal must take post-exposure vaccine on days 0,3,7,14 and 28 Dont drink raw milk from infected animal as pathogen is excreted in the milk of animals Notify the case to the Medical or Veterinary Hospital
46

Japanese Encephalitis
    A disease of rural areas & people of lower socio-economic group. Leading cause of viral encephalitis & approx. 30,000 to 50,000 cases & 15000 deaths annually, India: 24 states/ UTs JE reported (PN Rao, 2000) 378 Million population is living at the risk

Recent Outbreaks in India

U P: July 29- Oct.3 2005 - Suspected cases 4679, 1016 deaths & CFR: 22% Bihar: 352 cases
(WHO, 2005)

Incidence of JE in India Year 2000 2001 2002 2003 2004 Cases 2593 2061 1765 2241 67 Deaths 556 479 460 670 0

Socio-economic impact
 Pigs: High mortality in piglets; Great economic impact in swine market  Equines: Morbidity: 2% during outbreak Mortality : upto 5%  Humans: Mortality: 5-35% Severe neurological sequelae: 33-50%  Economic costs: Approx. US $ 1 million/Yr
(CDC fact sheet)

47 (Govt. of India, annual report, 20032003-2004)

Transmission

48

Signs and symptoms:

HORSES : initial signs - fever, impaired locomotion, stupor , and grinding of teeth. Blindness, coma, and death. In apparent infections common. Post mortem lesions- non-specific, similar to EEE and WEE. Histologically, nonsuppurative meningoencephalitis
49

50

Swine
 Expulsion- litters( stillborn or mummified fetuses)  Piglets die - after birth  Tremor and convulsions before expiring.  Boars- sperm count & motility of sperm.  Transmitted to gilts by way of infected semen.  Fetuses are mummified and dark Post mortem lesions - .  Hydrocephalus, cerebellar hypoplasia and spinal hypomyelinogeneisis may be seen.

51

Human beings
flu-like illness - headache, fever,nuchal rigidity and often G.I symptoms majority a symptomatic or nonspecific Children and the elderly -common Encephalitis- 1 : 300 patients (Tsai T,
1993)

I.P 6-16 days 25-30% recovered patientparalysis, ataxia and speech difficulties.

52

Prevention, Control & Treatment

JE-Prevention
standard of living  reduction in farming,  centralized pig production  immunization of humans and pigs

Vector Control
 In India, JEV isolated from 16 species of mosquitoes; the majority from Cx. vishnui complex in rice ecosystem. (Philip Samuel P, 2000)  JE mosquito vectors are zoophilic; consequently, cows &other animals may human risk by diverting vector mosquitoes (zoo prophylaxis).

53

Reduction in Man-vector Contact

Commercial mosquito repellants (coil, cream, mats). Pyrethroid - impregnated bed nets and curtains. (Theodore F, et. al. 1990).
 Limitation: repeated impregnation once in 6 to 9 months and periodical assessment for insecticide resistance

In general, during epidemics use space sprays (adult mosquitoes instantaneous)

54

Immunization against JE
JE vaccines in worldwide use
1990): (Theodore F, et. al.

1.Inactivated Mouse Brain-Derived, 2.Inactivated Primary Hamster Kidney Cell-Derived. 3.Live Attenuated.

Indian JE vaccine : Formalin inactivated brain of suckling mice inoculated with the Nakayama JE strain, (CRI, Kasauli,H.P). (Rao PN, 2001)
55

Immunization against JE
Table . Japanese encephalitis vaccine
Doses Subcutaneous route 12 years of age Primary series1,2, and3 Booster 0.5 mL 3 or more years of age 1.0 mL Days0,7, and 30 1 dose at 24 months or later Comments

0.5 mL

1.0 mL

56

Kyasanur Forest Disease (KFD)

Kyasanur forest disease Viral haemorrhagic disease transmitted through bite of infected ticks. Discovered in March 1957- Kyasanur forest area of Shimoga district of Karnataka. Large scale mortality among monkeys followed by acute prostrating febrile illness among villagers.
(Banergee, 1981)

466 human cases followed by 181 the year after.

(PAHO, 2003)

Disease confirmed in 1959 by isolation of virus and serological testing.

(Bhat, 1983)
57

58

An emerging zoonosis
Increased demands of human and animal population. Altered the ecosystem where virus previously circulated between wild animal and their vectors. Initially virus activity in few sq. miles of Sagar Sorab taluks within few months it spread in >2000 sq. miles. Earlier Serological surveys showed antibodies to KFD virus or a related virus in Kutch and Saurashtra, other parts of country. (Banergee, 1996) Recently in Andaman & Nicobar Islands, showed highest (22.4% ) positivity in human population (Padbidri et al., 2004)
59

Reported cases of KFD in India

YEAR HUMAN CASES DEATHS

1982 1983 1984 1985 1986 1987 1999 2001 2002 2003 2004-05

6 1161 605 48 22 5 10 77 98 253 720

NIL 114 137 4 NIL NIL 6 10 6

60

Source of infection

Primates are the primary host. Maximum mortality among two spp. Of monkeysThe grey langur Presbytis entellus, and The bonnet macaque Macaca radiata.

Virus isolated in large numbers from these two species. (WHO, 1985) Monkeys are amplifiers of the virus

61

Reservoirs
Small forest mammals, rodents become infected but do not die Virus isolated from several species of rodents and presence of neutralizing antibodies confirmed. Main reservoirs: Indian crested porcupine Hystrix indica
(Bhat, 1976)

Common giant flying squirrel Petaurista petaurista philippensis (Bhat, 1979)

62

Transmission
Human infection by bite of infected tick. Fifteen species of Ixodid spp. found to be infected naturally. - ten spp. belong to genus Haemaphysalis Important species H. spinigera, H. kyasanurensis, H. turturis, H. wellingtoni, Ixodes petauristae.
(Boshell et al., 1968; Bhat et al., 1975)

Mode of transmission: trans stadial. Trans ovarian transmission: only in Ixodes petauristae.

63

Natural cycle of KFD

64

Disease in monkeys: Epidemics are usually preceded by epizootics in monkeys a warning sign. Diseases in humans: Incubation period 3 to 8 days. Sudden onset of high fever(40 C), headache, myalgia, haemorrhagic manifestations epistaxis and hematuria. febrile period 6 to 11 days. Haemorrhages
65

Treatment

No specific anti viral drug, only supportive treatment.

Analgesics and antipyretics to reduce the temperature. Paracetamol preferred than aspirin due to bleeding tendency. (Gupta and Yashpal, 1975) Supportive treatment intravenous fluids to combat dehydration, if needed blood transfusion. Prevention and control Protective measures individual human protection from ticks. Insecticidal sprays Lindane highly effective in killing 66 ticks.

Vaccination
Formalin inactivated chicken embryo cell culture KFD virus vaccine developed by Haffkine institute, Bombay.
(Manasharamani et al., 1967)

Good immune response in monkeys but during field trial 59.32% seroconversion in humans. Two doses of vaccine, 1 ml each at an interval of four weeks. Vaccine efficacy six months to one year. Children half the dose given to adults (Dandawate et al.,1980) Mouse brain vaccine of RSSE virus also used but not effective
(Aniker et al., Shah et al., Pavri et al., 1962)

Attenuated Langet virus vaccine 70% to100% protection against KFD virus in mice, experimentally used in human volunteers without any adverse reaction
(Thind et al., 1981)

67

Prevention and Control

Take appropriate precautions- Pathogen of highest risk category Control Tick population Wear White cloths in Jungle to spot ticks & avoid their bite Stop deforestation. Education of villagers and forest workers. Urgent need to develop new vaccine to deal with disease effectively.
68

Cat-Scratch Disease
Common carriers
Cats Dogs

69

Cat-Scratch Disease
Transmission
Scratches and puncture wounds from infected animals

Clinical presentation
Fever Skin papule Swollen lymph nodes

70

Prevention and Control

Avoid children playing and teasing cats, especially kittens Keep the cats clean and free from fleas, ticks, lice Immediately treat the scratch/ wound with antiseptics Take personal hygienic measures Start medication (antibiotics) if a rash develops at the site of scratch or bite with in 21 days
71

Salmonellosis
Foods : Raw poultry, eggs Illness: Illness Fever, cramps, diarrhea sometimes vomiting Onset: Onset 7 hrs to 3 days after eating

Duration: Duration 2-3 days

72

Salmonellosis
Common carriers
Cattle Cats Dogs Horses Poultry
73

Salmonellosis
Transmission
Direct contact with animal or feces Contaminated food

Clinical Presentation
Chills Fever Headache Diarrhea Vomiting

74

Prevention & Control

In poultry products

Avoid cross-contamination of ready-to-eat foods Thoroughly cook meat, especially poultry

Cook eggs thoroughly Never eat runny yolks or raw eggs Always refrigerate processed meat products
75

Campylobacter
Common Carriers:
Poultry (main) Cattle Sheep Pigs Dogs Rodents
76

Campylobacter
Transmission Contaminated food or animals Clinical presentation Stomach ache Nausea Headache Diarrhea
77

Campylobacteriosis
Foods Associated : Raw chicken eggs, poultry, raw beef,

cake icing, water and raw milk

Characteristics of Illness:

Diarrhea, often associated with fever, Abdominal pain, nausea, headache and muscle pain. Illness can appear very similar to Salmonellosis
Onset: 2-5 days after eating contaminated food. Duration: Illness may last 7-10 days.
78

Prevention & Control

In birds & animals 1. Good hygiene and management - Sanitation at farms, lairage and hatchery - Proper & hygienic waste /discharges disposal - Care in handling abortion (usually occurs in 3-6 months ) - Adequate treatment of excreta before disposal 2. Vaccination - Live attenuated or subunit vaccines - Oral killed whole-cell vaccine for animal use*
79

Prevention & Control

In man Personal hygiene and sanitation Health education Vaccination: *currently being tested in humans during phase I In Food products
o o o

Handle foods properly & Cook thoroughly Avoid cross-contamination Use sodium hypochlorite (Domex)solution in water(1:100) for disinfection of utensils & hands
80

LISTERIOSIS
Foods: Raw poultry meat, luncheon meats, hot dogs, refrigerated ready-to-eat foods soft cheese, ice-cream, salad-type products Illness: In healthy Flu-like illness Diarrhea, vomiting and nausea

In immuno-compromised- e.g. pregnant women Septicemia, meningitis, encephalitis Spontaneous abortion or stillbirth Onset: Duration: 12 hrs to a few weeks after consumption 24 to 48 hrs
81

The Disease
Emerging foodborne bacterial zoonosis Nagging Public health hazard (25-30% CFR)
Deaths caused(28%) ranks next to salmonellosis (36%)

Approx.1200 cases/year reported in USA Economic losses in USA : $ 480 m/ year

82

Prevention and Control

Human listeriosis
Properly store and cook foods Care in handling abortion cases (in 5-8 months) Avoid cross-contamination of foods by keeping the
raw and cooked foods separate

Avoid consumption of contaminated food stuff particularly soft cheese. Special care for pregnant women and alike
83

Prevention and Control

Human listeriosis
Limit the growth of pathogen (refrigeration, bacteriocins/GRAS chemicals, irradiations ) Avoid cross infections in hospital & food industry Public education Withdrawal of suspected product Surveillance programme is needed
84

Prevention and Control

Animal listeriosis
Care in silage preparation and use Handle abortion case (usually in 5-8 months) with care Sanitation on animal farm Clean production of milk and meat Culling of infected animals
85

Colibacillosis
Foods : Raw poultry meat, undercooked hamburgers Illness: Bloody diarrhea Hemolytic uremic syndrome (HUS) kidney failure thrombotic throbocytopenic purpura (TTP) Onset: 12 - 72 hrs after consumption
86

Prevention & Control

In Birds 1. Good management 2. Environmental sanitation 3. Immunization In Man 1. Strict hygienic measures 2. Proper cooking of foods 3. Health education
87

Clostridial Infections
Clostridium perfringens
Foods: Foods Meat and/or gravy contaminated with soil,

dishes (Meat, poultry, and other foods) held warm, but not hot, for serving

Illness: Illness Abdominal cramp and diarrhea, headache, chills,, Onset: 8 to 22 hrs after consumption
88

Prevention & Control

Keep hot foods hot (>60C) & serve immediately Else, cool foods rapidly after cooking Refrigerate foods (<5C) rapidly in shallow containers Adequate reheat before consumption
89

Psittacosis (Parrot Fever)

Common Carriers
Pigeons Parrots Turkeys Parakeets

90

Psittacosis
Transmission
Inhalation from infected birds Carcasses Secretions Contaminated facilities

Clinical presentation
Fever Headache Pneumonia

91

Prevention and Control

In Humans

Avoid air and touch contact with sick birds with ruffled
feathers, yellowish-green diarrhoea

Clean & disinfect the cages and droppings by wet mopping Observe hygienic practices & take antibiotics if sick
In Birds

Keep the sick and new birds in isolation for 15 days

Isolate the sick birds from healthy birds

Treat the sick birds with antibiotics and supplements

92

Influenza Viruses (Bird Flu)

Wild birds are natural reservoir for influenza viruses Avian influenza (AI) Type "A affects - food producing birds (chickens, turkeys, quails, guinea fowl, etc.) - pet birds - wild birds H5 and H7 subtypes are highly pathogenic Greatest number of deaths in birds
93

Lesions in Chickens
o Lesions may be absent in cases of sudden death o Nasal and oral cavity discharge o Severe congestion of the musculature o Subcutaneous oedema of the head and neck area o Severe congestion of conjunctivae, sometimes with petechiae o Excessive mucous exudate in the lumen of the trachea, or severe haemorrhagic tracheitis o Petechiae hemorrhages on the inside of the sternum, on the serosa and abdominal fat, serosal surfaces and in the body cavity o Severe kidney congestion, sometimes with urate deposits 94 in the tubules

HPAI - Edema of the wattles

95

HPAI - Congestion and petechiae in the skin on the hocks and shanks

96

Effect on Proventriculus

97

Control Measures
Effective disease surveillance for early detection & reporting of outbreak. Enhanced biosecurity of poultry farms. Control of movements of birds & products that may contain virus. Rapid humane destruction of poultry at high risk of infection. Disposal of carcasses & potentially infective material in a biosecure manner. Proper use of vaccination.

98

INFLUENZA Management (POULTRY)

 Primarily symptomatic, including hydration  Antivirals: Adamantanes Amantadine, Rimantidine decrease duration of symptoms by 50% if initiated within < 48 hours in trials Decrease in viral shedding Appearance and transmission of resistant virus  Broad spectrum Antibiotics to control secondary bacterial invaders and increasing house temperatures may help reduce mortality. 99

Vaccination (Poultry)
Nonviable oil-emulsion vaccine  To be effective, the vaccine must be produced using the autogenous virus. Recombinant vaccine  fowl pox virus or infectious laryngotracheitis as virus vector  A baculovirus-expression system has been used to produce recombinant H5 and H7 antigens for incorporation into vaccines. DNA encoding H5 haemagglutinin  Evaluated as a potential vaccine in poultry DIVA (Differentiation of Infected from Vaccinated Animals)  DIVA strategy to differentiatee infected from 100 vaccinated

DIVA AN INNOVATIVE VACCINATION STRATEGY

Differentiates infected from vaccinated animals Adopted in FAO Summit in Rome (Feb 2004) Adopted when stamping out damaged commercial viability of poultry industry Uses inactivated oil emulsion heterologous vaccine containing same HA subtype as field virus but a different NA Antibodies to the NA of the field virus are natural markers of field exposure Enable the differentiation of vaccinated/uninfected from vaccinated /infected birds Caused breakthrough in trade policy as commercial restriction on vaccinated poultry meat was lifted Financial compensation of farmers following stamping out of vaccinated/infected birds is part of strategy
101

Antiviral Prophylaxis
In Humans  Ion-channel blockers
eg., amantadine resistance develops quickly (eg H5N1)

 Neuraminidase inhibitors
- Oseltamivir : TAMIFLU 75 mg p.o.q.d prophylaxis. 75 mg p.o bid for 5 days as treatment. - Zanamivir : RELENZA 5 mg inhalation for 5 days as treatment
102

Influenza Prevention Immunoprophylaxis

In Humans:
   

INACTIVATED INFLUENZA VACCINE First developed in US by Armed Services 1940s Made of split viruses or viral subunits containing hemaglutinin and neuraminidase Contain 2 type A viruses and 1 type B virus Try to match what will most likely be in circulation each season
Age group 6-35m 3-8yrs. >9yrs. Dose 0.25ml 0.5ml 0.5ml No. of doses 1 or 2 1 or 2 1 Route IM
103

IM IM

LIVE ATTENUATED INFLUENZA VACCINE FluMistR (Med Immune Inc),FluzoneR (Aventis pasteur Inc) & FluvirinR (Chiron) Produced by recombinant gene technology Viruses express contemporary influenza vaccine antigens Used only intra-nasally Dose is 0.5ml ; O.25ml to each nostril Sprayed when the recipient is in an upright position

104

Ringworm
Common Carriers Cattle Cats

105

Ringworm
Transmission
Direct contact with infected animal

Clinical presentation
Skin lesions

106

Ringworm
Transmission
Direct contact with infected animal

Clinical presentation
Skin lesions

107

Prevention & Control

Avoid direct contact with skin lesions of infected animal/man Send the skin scrapping to Lab. for examination Use antifungal ointment on lesions for at least 15 days Disinfect the hands and dip cloths in sodium hypochlorite solution for half an hour Observe hygienic measures

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Toxoplasmosis
Common carriers
Cats Sheep

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Toxoplasmosis
Transmission
Ingestion of infected meats Fecal contaminated soil

Clinical Presentation
Fever Swollen nodes Abortion Still-birth Mental retardation
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Clinical symptoms
In Humans :
Asymtomatic/flu-like symptoms CONGENITAL Abortion, foetal death, retinochoroiditis, hydrocephalus, convulsions, cerebral calcification, mental retardation Trimester Congenital infection 1st 2nd 3rd 13% 29% 50% Severity 80% 30% 70 to 90%

POSTNATAL

I. P. : 1-2 week Lymphadenitis, fever, malaise, fatigue, muscle pain, sore throat & headache Encephalitis in AIDS patients
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Clinical symptoms
Animals: Usually Sub clinical or Acute: Diarrhoea, lymphadenopathy, Hepatic lesions, encephalitis & ocular lesions Transplacental infection Early embryonic death Foetal death & mummification Abortion Still birth Birth of weak youngone

Swine: Pneumonia, encephalitis & abortion

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Prevention & Control

In Human Beings Meat should be cooked at 67 0 C & freeze at -13 0 C (> 3 days)) Hands should be washed with soap & water Vegetables should be washed thoroughly Gamma irradiation of foods (dose= 1.0 KGy) Gloves should be worn while gardening & cleaning cat litter trays Pregnant women should avoid contact with cat, soil & raw meat Periodic testing of pregnant women for Toxoplasma infection (Compulsory in France & Australia) Sanitary education In Animals Cat should not be fed uncooked animal tissue Eliminate cat & wild felines from stables & pastures in case of 113 sheep & swine

Scabies
Common Carriers Dogs Raccoons

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Scabies
Transmission
Direct contact with infected animals

Clinical presentation
Itching skin lesions

115

Prevention & Control

Avoid direct contact with skin lesions of infected animal/man Send the skin scrapping to Lab. for examination Use antifungal ointment on lesions for at least 15 days Disinfect the hands and dip cloths in sodium hypochlorite solution for half an hour Observe hygienic measures

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Milkers Nodules
Common carrier
Cow teats Ulcers from calves mouth

117

Milkers Nodules
Transmission
Milking or touching the teat of infected cow Contact with a mouth ulcer in a calve

Clinical presentation
5-14 day incubation period 2-5 small, red spots on hands
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Prevention and Control

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PERSONAL HYGIENE

121

Avoid Handling of Foods by

Persons with Illness Persons with Injuries on hands Persons recovering from illness Persons with bad personal Hygiene Persons with dirty hands,nails or cloths

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PERSONAL CLEANLINESS
 Personal effects  Hand washing  Use of antiseptic on hands

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Interventions at kitchen level

124

Food borne organisms associated with beef and goat meat

E. coli O157:H7 Salmonella spp. Staphylococcus aureus Listeria monocytogenes Campylobacter jejuni Yersinia enterocolitica BSE (Mad cow disease)
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Food borne organisms associated with pork

Trichinella spiralis Toxoplasma gondii Escherichia coli Salmonella Staphylococcus aureus Listeria monocytogenes.
126

Food borne organisms are associated with chicken

Salmonella spp. Staphylococcus aureus Campylobacter jejuni Listeria monocytogenes Organism in eggs -Salmonella Enteriditis

127

Foodborne organisms associated with Milk & Dairy products

Salmonella spp. Campylobacter jejuni Listeria monocytogenes Escherichia coli O157:H7 Staphylococcus spp. Streptococcus spp.
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Assure an uncontaminated water supply

Properly construct wells Add chlorination to water Connect to water supply Appropriate disposal of wastes

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Prevent food contamination

1. 2. 3. 4. 5. 6. 7. Avoid unpasturized milk Dont allow juices to drip on other foods Wash hands Disinfect kitchen surfaces Wash raw fruits and vegetables Dont defrost meats on the counter Use separate utensils for raw/cooked meat
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Cooking guidelines
Cook eggs until firm Avoid foods with partially cooked eggs Cook meats until juices are clear
Poultry internal temp of 180 degrees Beef internal temp of 160 degrees

Fish should be white and flaky

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Storing leftovers
Store food in appropriate containers Set refrigerator temp to 40C and freezer to 00C Refrigerate leftovers immediately Never leave food out for more than 2 hours

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Packaging
Packaging materials Protection of food Prevent recontamination

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Pest control
Entrance sites External and Internal inspection Assess the facilitys capacity for excluding pests.

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Always drink pasteurized milk!

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Care in Handling Animals

Dispose of carcasses properly

Avoid contact with diseased animals

Wear appropriate clothing and gloves Spray dead animals before moving them Dispose of animals according to law Wash hands afterwards

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Discourage animals from nesting in your home

Keep a clean house Seal small openings inside and out Keep traps out of the reach Store food in tight containers

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Food away from animals

No food or beverages allowed in animal areas
Discourage:
Smoking Pacifiers Bottles/sippy cups Carrying toys
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Protect pets from getting & transmitting diseases

Vaccinate cats and dogs against rabies Do not keep wild animals as pets Do not allow pest to drink from toilet Clean pets living area 1x/week Clean litter box daily
139

Pregnant women should not clean litter boxes

Additional safety precautions

Treat livestock that salivate as if they have rabies Wash your hands after handling or cleaning up after animals Cover sandboxes when not in use

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Prevent tick bites

Wear repellent Wear appropriate clothing
Long-sleeved shirt Tuck pant legs into socks

Check yourself and pets after being in a tick-infested area

142

Treat animal scratches and bites seriously

Wash area with soap and water Apply anti-bacterial medication Bandage wound Consider medical attention

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Most Zoonoses are preventable if cautionary measures are taken!!

Established in 1971 (IV Five Year Plan)

Aim
The contribution to complete physical, mental and social well being through an understanding and application of veterinary 145 medical sciences

Deployment of Scientific Staff

Dr. H. Rahman : Principal Scientist & Head I/C, Viral & Parasitic Zoonoses Labs.

Dr. S.V.S. Malik Dr. R.K. Agarwal Dr. D.K. Singh

: Sr.Sci. & I/C, Comp. Patho. Biomed. Lab. : Sr.Sci. & I/C, Salmonella Centre (B&M) : Sr.Sci. & I/C, Brucella Lab.

Dr. K.N. Bhilegaonkar : Sr.Sci. & I/C, Foodborne Infection Lab. Dr. R.S. Rathore Dr. S.C Das : Sr.Sci. & I/C, Bacterial Zoonoses Lab. & Animal Shed : Sr.Sci. , Calcutta Centre, IVRI
146

Distinctions conferred
FAO/WHO Collaborating Center
for Research and Training in Veterinary Public Health (Till 2000, fresh proposal submitted on new guidelines by WHO)

INFOTERA Registered Source till 1998

147

Awards and Recognition

 On Expert Panel of BIS -Food Hygiene (FAD-15, 16) Dr. R. K. Agarwal Dr. K.N. Bhilegaonkar  IVRI Merit Award for outstanding contribution in Vety. Sciences Dr. S.V.S. Malik National Brucellosis Reference Centre Dr. D.K. Singh  Associate NAAS Dr. K. N. Bhilegaonkar
148

Awards and Recognition

 Appreciation for Work

 WHO Expert Team from SEARO & Indian HQ  Director, Rajbhasha, ICAR

Appreciation for Expert invited assignments completed Dr. S.V.S. Malik

 Global Data sheets for CAB International for animal health and production compendium (AHPC) on  Listeriosis  Q- Fever  Rotavirus infections  Diploma Course on Meat Technology by IGNOU  Quality assurance  General methods and techniques in basic food microbiology
149

OBJECTIVES
Research on diagnosis, prevention & control of
Zoonoses Foodborne infections & intoxications Environmental pollution PG Education and Research

Strengthening of linkages with medical & other agencies

150

Diagnostic, Consultancy & public health services

Disease investigation Water/ Foodborne diseases Zoonoses Microbiological examination of referred clinical samples Culture/Serological Antibiogram Advice / Result reporting 151

Collaboration in Public Health activities

Revalidation of WHO Collaborating Center on Research and training in VPH:Updating and furnishing information Collaboration with WHO Networking of Public Health Laboratories under IDSP (Integrated Diseases Surveillance Project) Strengths, capabilities and role of IVRI in disease surveillance and outbreaks investigation
Rickettsial Diseases Biosafety & Biocontainment Production/ Supply of Standard Kits/Reagents Leptospirosis Anthrax Bird Flu
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Initiatives taken in Public Health activities

Visit of WHO Expert Team (Indian HQ and SEARO): 2005
 Model Network on Surveillance of Diseases of Livestock, Poultry, Wildlife and Fish having Public Health Significance National Network on important zoonotic diseases National Agricultural Innovation Project (NAIP) on important diseases of public health significance  Workshop on Strengthening Biosafety  Diploma in identification,prevention & control of Zoonotic Diseases for Medicos, Vets and Public 153 health workers

Initiatives taken in Public Health activities

Japanese Encephalitis
 Plan for Surveillance and sero-monitoring in animals and birds developed for U.P.  Diagnosis of Flaviviruses in humans by ELISA kit (NIV) undertaken

Place Bareilly Pilibhit Total

Sera tested for JE 32 20 52

+ ve 3 9 12

- ve 29 11 40
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