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Shelter Outbreak Response for LVTs
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0:03
Good morning or actually good afternoon Some of us have still not eaten lunch yet, so we're still in mourning apparently So a shelter outbreak response for the LVT and the reason this is important for veterinary technicians is the same reason that? Dermatology is important for veterinary technicians if you were here for the first hour today It's because you guys are the frontline of disease management and prevention in the shelter so most of the time there isn't a veterinarian
0:28
That's just lurking around the intake desk waiting for an animal to come and look at it and then identify something that may be potentially contagious and
0:36
Potentially contagious not only to the animals of that species, but to other species including people but the LBT czar and the adoptions The intake staff are as well And so as intake staff and as veterinary technicians working in shelters you guys are the ones that are going to be
0:58
Saving everybody from a lot of hassle When you recognize that certain diseases are happening, and you take the right actions when you recognize that certain things are happening So thank you in advance for helping us not spread disease and throughout the shelter Yeah This is this is my present to you for today. No it's good. I'm not getting anybody kittens Um so what what is an outbreak one who we say that we're gonna control outbreaks, and we're gonna manage outbreaks
1:24
What are we talking about just shout out answers. This is a participatory lecture
1:30
Sure more than one animals affected yes that has to happen for an outbreak what else
1:37
Well that can contribute to an outbreak But what what is an outbreak if I see there's an outbreak of X disease in a shelter. What is happening in that shelter
1:45
Spreading around right so that's kind of the key point is that these diseases are diseases that are contagious from one animal to another You can have situations where multiple animals are affected that are not outbreaks for example if you use too much too concentrated Quaternary ammonium cleaners in your cat wards and everybody ends up with oral ulcers and sneezing that's not a disease outbreak That's a toxin exposure it can look like a disease outbreak
2:13
Similarly if you have panleukopenia running through a cat calling it may look like all the animals are being poisoned But actually it's an infectious disease, and so it can go both ways with those That's our most common differential when people say somebody poison my feral cat colony most of the time it's actually panleukopenia
2:30
So an outbreak has to have an increase in the number of animals that have a particular disease beyond the normal levels so if you normally have three cats that have upper respiratory disease at any given time in your shelter and Suddenly your isolation ward has 15 cats in it you may be experiencing an outbreak of upper respiratory infection
2:53
What types of diseases can have outbreaks
2:57
Rainwear that's a good one what else
3:00
Upper respiratory yep parvo kennel cough khaleesi virus yep HIV HIV, and I don't know about people s SIV, yes for sure we can that one is transmissible We don't tend to see outbreaks of that one in particular. There's it's kind of complicated, but that is a transmissible disease yes
3:24
C IV so influenza virus for dogs yes and also for cats now unfortunately
3:30
So how many cases is an increase?
3:35
Well more than normal exactly and so it depends on the disease so if I have Three cats that have upper respiratory disease and suddenly I have 15 I think I can make a pretty good argument that that's an increase what if I go from zero cases to one case? well if I have rabies Then that is actually maybe an outbreak of rabies because there are so many different things that happen with that one animal that is affected So that one animal is way more than normal, right?
4:04
What is the normal prevalence of a disease in your shelter population so what is the normal level of? Percentage of animals that are affected you may not know like in your head wooden um what number that is But you may if you work at a shelter long enough have a fairly good idea Just sort of whether something is more than normal or whether something is less than normal And if you get that gut feeling that something is maybe more than normal like really another one of those
4:34
Didn't we just have one of those that's when you should probably start investigating Right, okay, so oh? This is supposed to be in Succession as well, but how does an outbreak happen? Well, there's a couple different ways one Is that one animal comes into the shelter with an infectious disease and then all of a sudden everybody's affected? so Influenza is a really good example of this if you get one dog with influenza that comes into an animal shelter and that animal isn't
5:00
Isolated because you didn't know that they weren't coughing yet They were they were shedding, but they didn't have any clinical signs you may end up with a lot of kind of infectious influenza in your kennels or
5:12
You can have a few animals that come in so if you have a litter of kittens that come in and one of those litter Goes in this cage, and one of the litter goes in that cage And one of the litter goes in that cage and all of a sudden you have ringworm for example and all of your cages that's why it's because number of animals came in and they all had this disease and now they're All spreading it throughout the shelter and then the last one is that animals contract the disease in the shelter
5:34
We can't really do anything about those first two well We can do a little bit then maybe about that second one which is keeping animals that come in together together and away from other animals in the shelter, but when animals are contracting new diseases in the shelter That's when we really feel like this is our responsibility, and there's something that we did wrong if this is what's happening?
5:55
Upper respiratory gets a little tricky with this one because there's two ways that upper respiratory is That we see cats that have come up with upper respiratory in the shelter so the first one is that? The animal already is infected with herpes virus They come in they get stressed because hey guess what they're in a shelter And then they recruit desks with the symptoms of herpes virus that we all know so well so the gup-e eyes the runny nose sneezing
6:21
But not eating necessarily all of those things can happen The cat didn't catch that disease from other animals in the shelter But the cat is having that disease because of the way that it's kept in the shelter The other way that you can get upper respiratory disease in the shelter is by catching it from another cat that's sneezing although most of the time with cats the way that upper respiratory infections are spread is by fomites not by aerosolization so what I mean by that is I'm
6:48
Touching the cat's and then I'm touching the other cats and that's how I'm spreading the disease from one to another Cats when I sneeze they have teensy little noses And they can only get those aerosol droplets about three feet before they fall And then they're in the environment and we clean the environment and everything is fine, so it's not really the spread by the air With dogs it is So that's something that we have to be worried about if we have a huge kennel full of dogs
7:13
They can get their aerosol droplets about 20 feet big noses So these are all different things that you should consider when you're looking at what this uptick in disease is in your shelter What why it might be happening?
7:28
So outbreak characteristics What determines the seriousness of an outbreak how much should I care if I have a little bit of a diarrhea virus? That's going through the cats in my shelter and everybody is getting a little bit of diarrhea, and then two days later. They're fine
7:45
Do I really care that much? Well as long as that's the pattern that continues and everybody gets better and nobody needs any treatment I might be very vigilant and monitoring everybody, but I'm not really gonna do much beyond that if I start seeing animals dying if I start seeing Everybody being infected those are two things that I care very much about
8:06
so see I have a nice sight sorry Backing up the severity of the disease and who's affected the other part about that is is it just that species That's affected or em are the people at risk are the other species that are in the shelter at risk so those make the disease A little bit more concerning to me than the diseases that are very particular to one specific species So this is my illustration enough saying that this dog is having Neurological symptoms right so I'm going to go through this
8:37
Breakdown and what is going on with this dog, so I've got this dog. I've got neurological symptoms. He's got these tremors
8:43
Already looks kind of crazy so This is one of my differentials any time. I've seen your illogical disease in the shelter. How serious is this
8:52
It's pretty serious right it's pretty serious I now have to make sure that the dog is Safe not gonna bite anybody have to go back to her history figure out who he talked to who he touched who touch him Who brought him in who all was in that household all of those different things because rabies is fatal And it's a zoo a notic so the two worst things that you can get in a disease right well. What if it's December So right yeah, I care because I have a lot of other dogs
9:20
and I want to make sure that this dog is not going to pass his disease to anybody else in the shelter and so it's Serious he could die especially if he if he has neurological disease. That's part of his distemper complex syndrome
9:34
But I as a person. I'm not going to be affected so it's a little bit better. Maybe then rabies I Mean depends on your sort of skill what if he has a fungal encephalitis? But if he's from Arizona, and he's coccidia mycosis in his brain. It's infectious. He got it from the environment It's an infectious disease is he gonna give it to anybody else No, is he gonna. Give it to me is he gonna die
9:58
He could yeah, you could die yeah, so that I'm concerned about it for his sake as one animal but not necessarily as a population What about rat poison?
10:11
Not contagious he could die But it might be something that's in the environment that other animals may be also investigating maybe touching maybe eating and so I care about where he got it from Potentially, but he's the only one that's gonna be infected, and I'm probably if I can nurse him through his symptoms. He's gonna survive Unlike the dog with the fungal infection what about cerebellar hypoplasia? What if he is shaking because his cerebellum didn't develop properly?
10:39
Because his mother got parvo virus when he was in his mother's womb
10:47
Not a contagious not gonna spread. He's only gonna get better so that's fine So this is why it matters to figure out why he's doing what he's doing because each one of these different diseases Has a different profile and has a different risk For you as a shelter and for him as an individual dog and for me as somebody who's touching him and working him up
11:08
So and How contagious the disease is so that's something else that we talked about a little bit here is the disease vaccine preventible? That's something. I really care about because if it is vaccine preventible my population should be protected as long as they're vaccinated Why wasn't he vaccinated well maybe he came in with it? That's not my fault. That's something I'm just gonna have to deal with what if he got it in my shelter
11:31
Now we have a problem, and I have to figure out where that problem is what if it's airborne
11:37
Now I have to worry about all the rest of my population versus if it's just fomites I might have protected him by wearing different gloves with different animals as I'm going through the shelter is it easy to disinfect So can I just use my regular? Busy wash or kennel Saul or whatever it is that I used to clean my shelter and be fairly confident that even if he has This disease I have already cleaned up after it
11:59
Or is it something gonna have to buy something special for or take special actions to disinfect and then biosecurity? wear gloves wash your hands that already Gets in the way of a lot of transmission of diseases from the animals to you
12:16
Hand sanitizer works pretty well Yep, gloves. Gloves are great for that sort of thing also What dr. Araceli said earlier today? Don't eat poop? That's the other one big three big three public health things
12:31
Right so when we talk about risk one of the ways that we talk about it is this How much of a hazard something is and that's the severity of the problem? Times the probability that that problem will actually occur so if you have rabies the severity of the problem is so big But it doesn't matter that it probability of occurring is actually fairly small we care a lot about rabies But if we have rat poison, it's not that common It is severe for that one dog
12:59
But it's not severe for the shelter population as a whole and it's not severe to me as a person and so maybe that Sort of the concern that I feel for an animal Individually is high, but the concern that I feel for the shelter as an outbreak management Situation is not as basically zero unless they picked up that rat poison in the shelter somewhere How do outbreaks happen and shelters just?
13:23
Show this is where you shout things out so not watching hands already for the one
13:28
Touching animals excellent Not cleaning kennels properly not cleaning anything properly what else?
13:37
Sorry not wearing PPE excellent what else
13:43
Excellent so not isolating sick animals great anything else Yeah, the environment you mean contaminate it excellent So I'm gonna that these are I can't control the order that these come in so these are things that I think of some mixing populations Allowing animals animal contact taking in sick animals having small cages having too many cats having not enough time not enough space
14:05
Overcrowding not recognizing sick animals not cleaning properly. Those are probably the biggest three things mixing sick and healthy animals and Lastly of course our favorite thing to talk about in the shelter is stress because stress Decreases the immunity of the particular animal so then they are more susceptible to disease
14:24
Have you guys seen this triangle before? Every time you get a lecture by somebody who's in public health or epidemiology. You get to see this triangle It's a very nice triangle. It's got three parts like every triangle
14:36
It's got the environment So if you're not cleaning properly if there's a lot of disease in the environment if there's too many animals that are shedding a lot of things into the environment That can play a large role in disease accumulation the agent so if I have a rabies virus what are the characteristics of that virus that make it so that it can get Into another animal or maybe not get into another animal right so those particular characteristics
14:59
and then there's the host which is the animal itself and that's where stress comes in and So some of these things in a shelter I can modify Some of them. I can't so I can't really do much about the agent. I can't really take that virus and then Mmm-maybe genetically modify it so it's not as contagious as it would be if I didn't mess with it I can't really do that but I can modify the environment By making it a clean environment by making it a less stressful environment by making it
15:29
May be a larger rooms for the cats So they don't get up a respiratory or maybe more enriched rooms for the dogs, so they don't get And I can modify the host so I can make sure he's vaccinated I can make sure he's dewormed I can set him up for having good immune responses to the things that he's going to encounter that I can't control so It's triangles important So prevention is also very um
15:54
Very dear to my heart. That's my preventive medicine degree that I have so what you want to do is minimize the probability of Acquiring disease and this is what we do On a daily basis at the shelter when animals are not sick We are trying to prevent them from getting sick And the goal is to get them through this Sheltering process in as short a time as possible and as healthy as possible the whole way through
16:17
So that they can get through and get out on the other side and be a successful dog or cat or whatever job They have in life for the people that adopt them and so boosting that individual resistance to disease and Minimizing the exposure to pathogens is really key And there's seven basic ways of doing that by vaccinating them on intake by separating them by species and by age group By isolating the animals that are ill By treating any pre-existing conditions that come in
16:48
by effective cleaning and sanitation by using appropriate housing for that species and that age group and by giving them enrichment so that they can have mental stimulation and sort of Calm and quiet when they need it they can hide if they need it they can control Have a sense of control over their environment, and this is how you avoid an outbreak
17:11
basically pure and simple But again there's that cat that walks through the door. That's shutting things that we don't know that they're shutting things Because they're doing it before they have any clinical signs and then sometimes we have to mop up
17:24
So here's a scenario
17:28
This is my excuse for finding all these pictures of sneezing cats. I love pictures of sneezing cats They're so like they managed to be Static and dynamic at the same time like you just can't look at that picture and think that it's just sitting still like everybody sees this cat Closing his mouth and likes not going everywhere It's fantastic so you've got five cats on your adoption floor that are suddenly sneezing rouse here was
17:48
First one to start having a runny nose, and they noticed this on Friday evening It's thirty minutes before the shelter opens on Monday morning now You've got five cats two adult cats and two kittens are having ocular and nasal discharge
18:01
So that's right now what you don't know is that in two more days three more cats are gonna get sick Is this an outbreak? Yeah, well so it depends. What is the normal level of cats sneezing on your adoption floor?
18:16
Should be none so if it's not if it's what it should be if it's none then yes This is an outbreak so what do you do?
18:25
Yeah, I mean, I'm hearing fantastic suggestions all over the place these are all the steps to responding to an outbreak and They can happen in pretty much any order so I'm not listing them by number I'm just going through them because I have to go through them one at a time because I can't talk about them all at once it gets very confusing but So yes to all of the different things that you suggested um Have you guys seen this kind of graph before if this is an epidemic?
18:53
Curve, so what this is saying I do think I have a pointer thing here. Oh
18:58
Look at that. Okay, so this is the number of new cases So if one case here this cat is sneezing he continues to sneeze if he continues this needs we don't count him anymore We just can't count the next cat that he starts to sneeze in the next cat that starts to sneeze and so this is The time that the index case so that's Ralph is here, and he is shedding into the environment But he doesn't have any symptoms yet And so you don't see that until here
19:26
And now he's got clinical signs, and then this guy's got clinical signs and this guy's got clinical signs This is how long it takes for somebody to get the disease if they are now exposed to it so this is your incubation period which is Important it will come up later and then this is time running this direction so Everybody gets sick and then people start, then animals stop getting sick at the same rate, so this is still new animals getting sick
19:51
But it's not as many new animals getting sick all at once as there are right here, so that kind of makes sense Okay So more sneezing cat so We're recognizing that there is an outbreak so you guys already did that? You did that because you said we know that there should not be any cat sneezing on the adoption floor And now we have five cats and then in three days We're gonna have seven cats sneezing on the adoption floor, so that's the recognition part is this an outbreak?
20:18
Or is this normal shelter cat upper respiratory for your shelter It's an outbreak so that's good because this is a real look sure and outbreaks, and if it's not an outbreak Then I need to talk about something else so next How many URI cases do you normally have on your adoption floor? What if this is in your isolation ward? How many upper respiratory cases do you normally have in your isolation ward?
20:43
Yeah depends on your shelter It depends on how many cats you taken in a year So these are all things that you will have to specifically define for yourself, and it's good to have sort of a running total So you can then look back and say oh well you know in December last year we had two cats in isolation December this year we have 12 cats in isolation that's different. That's more so we should be concerned
21:06
So then the next one is identify and define the cases So how can you tell if this cat is part of this outbreak or if he? Maybe he came into the shelter and he was already sick
21:18
So you have to come up with what we call a case definition? And so that is saying all of the cats that have these symptoms We're gonna say because we don't know any better, and we're concerned about it that they are part of this outbreak So we're going to sort the cats into you have upper respiratory You don't have upper respiratory, and we're gonna say that sneezing and maybe ocular discharge equals You are in this group of affected cats and we're gonna put you all together now
21:44
Maybe they have different upper respiratory infections, maybe they have different bugs Maybe one of them has Khaleesi and one of them has herpes virus We don't know that but that's okay for right now because right now. We're just trying to identify and define the cases
21:59
If you have five cats and kittens having ocular discharge and sneezing and runny nose So that means that we've got five cats that we're gonna say meet this case definition and now we're going to Treat them differently and the other cats in our shelter So the next step is confirming the diagnosis and again this can happen kind of at any time, but if you are making some drastic interventions like Maybe euthanizing animals that have particular conditions make sure you call a veterinarian you
22:27
Call a diagnostic lab you get a confirmation of the disease that you think your euthanizing for because there have been shelters That think they're having a distemper outbreak and euthanize a whole bunch of dogs And then realize that it was their cleaning product That the dogs were licking and they didn't need to euthanize the animals and I don't want that to happen to any of you guys if you need help Make sure you get an actual diagnosis before you do anything drastic
22:52
Now if we're just isolating animals and with upper respiratory infections And we're putting them in a room until they're better, and then we're taking them back out again That's not that bad right you can do that to a cat that doesn't have anything and yeah It's gonna be a little bit more stressful, and they're gonna take a longer time to get through the shelter and out to adoption But the consequences are a little bit less grave, right? So for right now. We're saying upper respiratory infection
23:15
How important is it for me to get a comp a confirmed diagnosis for upper respiratory disease in these cats?
23:23
Well right so you have to know how to treat them But what if what if it's exactly like all the other upper respiratory infections that I always see And I have a protocol for treating them Do I really need that die is anything bad gonna happen to them if I don't have a diagnosis in this particular case no no I could be missing something else There's always that chance if I start my treatment protocol and something funny happens and they're not responding the way that they should be I
23:50
Can always try to get a diagnosis done as well so this can happen at any point? But if you're gonna do something drastic make sure it happens before that drastic event moving animals isolation doesn't count Okay
24:07
Different Diagnostics that you could do if you wanted to do diagnosis for upper respiratory Clinical science my ear my diagnostic of choice for upper respiratory But you could also do a PCR it's expensive You can do virus isolation you can do bacterial culture if you're worried about mycoplasma that takes extra all culturing techniques So it's not without consequences to culture and diagnosed everybody right because you have to pay for it and your shelter
24:31
Maybe doesn't want to do that because you're now spending extra money on these cats because they have to stay longer
24:37
So it's how you'd have to stick up the swab up the nose and then send it off and
24:44
Then how long does your diagnostic technique take that's another thing to think about Because if you're kind of on the fence about whether you want to do this particular diagnostic or not, how is it? How is it going to affect the population? If you need to wait for those animals to stay that long to get that answer back And then how are you going to explain it to the adopters later on if you get a positive? When are you done? When are you done treating so these are all the things?
25:07
I think about when people ask me questions about outbreaks that they're having in their shelter
25:12
The next step or a another step is to separate the affected animals So this is where I try to explain to you the different Difference between an isolation and a quarantine you guys know what the differences. I just it's kind of written up there actually
25:30
So the the suggestion is quarantine you have to gown up I agree, but isolation you also have to gown up
25:36
so isolation means that the animal is sick and Is now being separated from the rest of the population so those five cats that we talked about are going to go into upper respiratory? isolation They are separated from the rest of the population. They are only house with animals that also have clinical signs for that same disease
25:57
Quarantine is For animals that are not sick yet But are exposed to the animals that are sick and may become sick in the future, and if one of those quarantine animals become sick Generally the rest of those quarantine animals are now exposed to that animal so then their quarantine time period starts over the clock goes back to zero and you have to keep waiting whatever period that is so Quarantine and this is one of the ways that I remember what it means
26:26
Is a term that dates back to the bubonic plague in Italy the quarantine stands for quadrant a journo? Which is the 40 days that people who are exposed to people who died of the plague? Had to wait before they were allowed out into society again So 40 days quotient age ordinal is quarantine isolation is just isolate so away separated away from other the rest of the population If that helps you're gonna need to know these terms later because we have a great exercise for you guys
26:55
So here's another kitten. That's trying to sneeze
26:59
If you don't separate the animals Into isolation then you're gonna expose a lot more animals and so then everybody ends up having to be in quarantine Depending on how that disease is spread If you have one animal that spreads disease by aerosol route you may end up having to quarantine that entire room Of animals so it's kind of how it works if you have upper respiratory disease And it's a cats and you don't have people touching each cat with the same gloves
27:26
Then you might be able to just pull that cat out and not quarantine the rest depending on your level of Suspicion of how much exposure the animals in that room have had to the animal that was sick
27:39
All sounds fairly familiar, okay good great
27:44
Yeah, and then the other thing about Isolation is that the isolation room now? Becomes a biosecurity issue for your shelter, and so you want to control the people that are going in and out of that room Quarantine a little bit less so but you need to be very vigilant and be monitoring those animals on a daily basis To see if they're developing the symptoms of the disease that you're concerned about
28:09
So isolation is sick you got five cat so we're gonna put in there We're gonna control the access we're gonna give them some supportive care. We're gonna Maybe give them some doxycycline and we're gonna monitor them closely for response to treatment and normal course of disease what we expect So that guy gets to go in there Doesn't get to be in that room anymore and then in quarantine
28:30
If you have a group room and the cats are rubbing against each other or if you have a lot of volunteers that don't wear gloves in between cats like we have then You would want to quarantine the cats that are exposed in adoptions and the quarantine can happen maybe in adoptions for example Maybe you don't add any new cats to that population until you've waited for that period to be up
28:51
That's one way to do it the other way is to remove all of those cats from the adoption floor and put them in somewhere Else if you have is somewhere else and wait for those that time period to be up For them to not have any disease, and then you can put them back on the adoption floor
29:05
the quarantine period that I keep talking about is one incubation period So remember on that graph when I said it takes this long for if you're exposed to when you develop the disease So we've been studying these diseases a lot in the literature We have a lot of estimates about what you should expect in terms of when you get a disease When you were exposed to it, so if I expose an animal to a parvo virus
29:30
I know I can expect that that next puppy that I expose is going to break with disease anywhere between Three and ten days that that Z's was exposed so three days later to ten days later now There are some dogs that don't break till 14 days later so my advice then because I'm very concerned about parvo virus because the risk there the hazard equals death I Want to make sure we're waiting that full 14 days before I let that second puppy out of quarantine Does that make sense?
30:00
Yeah, okay great so and then if you're in quarantine and there's one animal in there that becomes sick you start that clock over again So if you have a litter of puppies and one of them becomes sick you take that puppy out you put that puppy in isolation the rest of those quarantine puppies now wait for another 14 days that
30:17
Kind of sucks when that happens so and then those those everybody the isolated animals and the quarantine on wheels all get very closely monitored So the next step here is the disinfect the mitigate the redirect step, so this is when you do your great shuffle and you move animals around the shelter and you maybe create a different pathway for animals coming into your shelter, so they're not exposed and
30:41
Making sure that you are doing the right type of cleaning for the right type of pathogen that you suspect So if you've got parvo virus you're not using parvis all to kill it because it doesn't even though the name is the same And so this is where you want to do some research This is where you talk to the veterinarian. This is where you look in the textbooks This is where you figure out if this disease. What do I need to use to kill it? How long does it take to incubate?
31:07
What what is the transmission like how did the animals become exposed and how can I avoid that with the animals that are coming into? The shelter do I need to stop animals from coming into the shelter or can I? Recommend that they go to a different shelter down the road, and if I have animals in my adoption area What do I have to do about those can I get them out and then maybe? Close adoptions until everybody else is healthy enough to be adopted, so these are all
31:29
This is the stuff where you do all that kind of analysis And it really really depends on what the disease is that you're dealing with so if it's upper respiratory What are some cleaning compounds that I can use to kill upper respiratory viruses?
31:44
Bleach sure yes, Excel. Yeah, well rescue. That's Excel. Yep
31:51
Yeah, anything else. What did it surpise virus?
31:55
Trifecta in mercs what else Anything really anything? This is not a hard virus to kill any like any sort of Disinfectant you have even the kennel saw even the parvis all all of your quaternary ammonium products all of those guys are gonna kill Her Peas if it's khaleesi virus, then we have to stick with the rescues and the trifecta and the bleaches, but if it's herpes It's very easy to kill And then One of the things that can happen if you don't use the right disinfectant not only do you not?
32:25
Clean up the disease from the area where it's most concentrated But you can end up spreading it to other parts of the shelter on your rags that you're using in those affected rooms So know what your disinfectant skill no when you have to pull out something special
32:40
There's a lot of resources out there for you to find that information out so The answer to what cleaning compound kills of a respiratory viruses herpes is most things Khaleesi is bleach trifecta and excel flash rescue. They keep changing the name What about bacteria the answer is most things? I'm gonna say most things. I mean you don't have to really worry about it. Whatever You're using probably is fine And then how is upper respiratory spread we talked about this a little bit so fomites
33:06
So bowls litter pans hands stethoscopes Swabs thermometers anything that you touch an animal with Ken then spread the disease to the next animal if you don't clean it in between But it's easy to kill. It's easy to clean so that shouldn't be too much of a problem
33:24
Yes okay so
33:29
In this step also this is where we might want to create a clean break in the shelter Do you guys know what I mean by clean break? So you have a population of animals in your shelter the way that animals come into your shelter usually? Depending on your shelter is one at a time they come in and then Eventually they get mixed in with the rest of the population Whether that's in a solo cage by themselves or maybe they'll be there for a little while and they'll be get put into a group
33:54
Room but you have all this huge population And then the way the animals leave is one at a time kind of in a random order Pending on how cute and fuzzy they are and how many problems they have and whether they're old they will leave One at a time out the front door in large animal operations most of the time It's called an all in all out situation where you have a bunch of animals come in all at once
34:15
They're only ever exposed to those animals in their particular group, and then they all leave at the same time Usually to slaughter maybe a feedlot or something like that We don't do that in shelters, so we have a lot of mixing in our population But with a with a clean break what we're trying to do is make the animals that are currently in the shelter a cohort of sick animals or or isolated animals or quarantine animals and then we're going to make a
34:42
Separate group of animals that are coming in now That are not going to be exposed in any way to the animals. We already have in the shelter Does that make sense so? instead of maybe Coming in and getting put into the cat room with all the other cats there Can't they come in and they get put in the mobile unit without any other cats so they're not exposed to whatever the cats have
35:03
Or maybe instead of getting coming in and going into the exam room like they would normally come in to get their vaccines Maybe they come around back they get vaccinated in the parking lot and then they get into the foster Homes car and then they leave the shelter so they never get exposed to whatever is in the exam room or In the kennels or anywhere else for example if you're having a distemper or parvo outbreak
35:23
So there are certain diseases where this makes a lot of sense and there are certain diseases where this doesn't make a lot, so Creating a clean break with upper respiratory infection in the shelter since all of the cats that are coming in 75 to 80% of them already have herpes in them There really isn't much point in doing that right
35:40
There's a lot of point in making sure that they aren't stressed in the shelter's so they don't then recruit us But if you have parvo outbreak and you can redirect all of the dogs away from the dogs that you currently have until that quarantine period is up you're going to prevent any of those incoming animals from getting whatever the current animals have and Then when that quarantine period is up then you maybe can go back to normal operations although
36:03
I would say there's probably a lot that you want to be changing about your intake protocol if you ended up with an outbreak in the first place right So incoming em animals have no access to sick animals sick animals are kept very separate until they're adopted out and Outgoing animals continue to leave as fast as possible in whatever way that whether that's sending them out on transport to other shelters Whether that's adoption events whatever it is that you guys want to do to get them out?
36:32
the next step in the disinfect mitigate redirect
36:36
process is figuring out what the source of the infection was and What that prevention gap was because if you're having transmission within the shelter? We messed up somewhere and so trying to track that down is very important with certain diseases Vaccinations on intake is the problem. It's not happening correctly Whether it's you're not vaccinating animals that have like a little bit of a cold when they come in because you're worried that they're sick or Whether it's not vaccinating
37:06
puppies and kittens because you're worried that they are too small or Maybe it's mixing up your vaccines and leaving them on the counter for a day before you use them or maybe it's when the shipment Of vaccines comes in you don't put it in the refrigerator you leave it out All right, so all these different things can happen and it can lead to infectious disease outbreaks By diseases that are preventable by vaccines
37:29
so exci
37:32
and then Increasing outgoing numbers helps quite a lot in an outbreak situation if you can tell which animals are healthy in which animals are sick so if you can get the healthy ones out that gives your staff more time to deal with the sick ones and If you can reduce the number of animals you have in your in your population Any sort of way that's great that gives you the time and the bandwidth to actually deal with this problem
37:57
So and finally communication communication is really really really important This is a great picture hello picture um so communication happens at Every one of these other steps so when you're trying to figure out if an outbreak is happening you're communicating with everybody in your shelter Whether it's with signs. Whether it's a whiteboard whether it's Texting people that something is happening
38:20
Especially the manager is especially your director especially your veterinarian all need to know that something is happening and that you think you might be Worried that something else something might be going on when you're identifying and defining the cases This is a group effort Amongst everybody who's working in your shelter to pick out the cats that seem to be having the symptoms that you're looking for
38:38
When you're trying to confirm your diagnosis everybody needs to be on the same page with this so when you get that PCR back, and it says herpes virus then you can tell everybody oh This is herpes virus so that everybody knows what type of biosecurity to use what type of cleaner to use Whether you should be worried about cats that are getting newly infected or recrudescence of things Communication is part of the separating the animals
38:59
Because everybody needs to know that this room is different now this room is now for the quarantine and this room is different this room Is now for the isolation or maybe it's always isolation, but now you just happen to have a lot more animals in there and then Communication is really important in a disinfection and the mitigation in the redirection because how are you supposed to figure out?
39:18
What went wrong with your process if you don't talking to the people who are actually integral to that process? So and then communicating not only within the shelter maybe with adopters as well Maybe with newspapers as well like hey look We're having this huge problem at the shelter come and adopt the healthy animal so we can spend time with the sick ones That's fine Or maybe it's a public health announcement like we're having a ringworm problem and shelter
39:45
We understand that this is a problem if you would like to help us out We could really use your help right now Come and give us Bleach come and give us paper towels come and give us gloves all these things can be very helpful for you to manage this outbreak and Then back communication with people who dropped off the animals in case they didn't know that their animalistic is also really important
40:05
So you get a letter of ringworm kittens in the person who found those kittens didn't know that they have ringworm Maybe they were like going like this with the kittens It would probably be a good idea to give them a call and say hey, just so you know You might want to get yourself checked out So I can't say enough about communication lack of communication prevents outbreak response from actually being successful a lot of the time
40:28
so signing signage
40:32
Open communication all that stuff so also PPE and This is an example of a sign it says For your health and safety it is always wise to wash your hands with soap and water after touching animals or before eating please use the wash stations conveniently located in the children's zoo or the restrooms I When I read yours children's do I think of like all these kids? They're in cages that you get to go see like I was like what yeah, okay, so when is the outbreak over?
41:00
When are we done? This is really hard and it's stressful, and I want to be done with this well So there's a couple different ways that the outbreak is done So there's outbreak can be done for the individual animal and that's done when the animals no longer having clinical signs look I don't have any lesions anymore my hair's grown back. I'm good I don't need three more treatment any more um or maybe the animal no longer requires supportive care with parvo
41:22
They're still shedding the parvo. Maybe I still have some diarrhea cuz the parvo cut off all of my Villa I on my intestines, but I don't need fluids anymore. I'm eating fine on my own. I'm doing good so that animal is fine But they still in isolation because they're still infectious right when is isolation over Isolation is over when the animal is no longer shedding infectious organisms
41:43
or at least is shedding them at such a low level that it's not really a concern with the right environment and host and
41:50
other interventions, so if that puppy then the parvo puppy then tests negative on a snap test and a bath about a week after the last clinical signs that I saw I Feel pretty good that that puppy is no longer shedding and I can put that puppy out into the regular population get him spayed and neutered to get him or Him neutered and get him adopted out right when his quarantine over. We talked about this. What was it? What was the quarantine period
42:17
Well pricasso it's part of 14 days. Yeah 14 days for parvo It is the incubation period of your disease so however long it takes for that disease to pass from one animal to another That's how long quarantine is and there's a range of times always go with the longer range Because you never know that animal may be kind of healthy and it may take them longer to get that disease right And then there's the outbreak when is the outbreak over well
42:41
What we like to say in the industry is about two incubation periods so you can relax and say oh I think we're done with this if it's been now if it's parvo right 28 days since the last case that you saw
42:55
So that's the answer if it's upper respiratory If you don't have any clinical signs Now you're probably fine You might be shutting a little bit of virus, but it's probably not that significant and probably all the other cats are infected anyway So you can probably move out of isolation does that make sense so the same time the clinical signs are done? You can move out of isolation when is upper respiratory quarantine done. Do you guys know what the incubation period is for herpes virus
43:20
If you want to get a new infection of it It's about five to seven days So it's pretty short so quarantine then would be five to seven days seven days because I'm going with the outside one right So as soon as seven days are up, and no more cats and adoptions or sneezing I'm I'm good with the quarantine I can start adopting these animals out, and then my outbreak is over
43:41
14 day perfect nice good. Good math good job, so two incubation periods have passed no new cases So we're good now herpes of course being tricky because that healthy cat over there still has herpes He just hasn't broken with it yet because we didn't stress them out enough. It's a good thing
43:57
So if you need help, if you or think your experience an outbreak Don't feel like you're alone because you're not so these two these two textbooks both have very nice chapters about outbreaks this book here in every single Thing that you want to know about these particular diseases it has so it has the incubation periods it has what cleaners you need to use it has how its Transmitted how its shed when the animals are done shedding all of that information is in this book
44:26
We also do consultations here at Cornell Maddy's shelter medicine program So if you have concerns if you're having an outbreak Send us an email give us a call. We respond pretty quickly if somebody says outbreak You're like oh shoot better respond if you ask us about what should I use to bathe my dog in my take a few days? Or a week for us to get back to you, but the outbreak for you respond right away
44:47
Maddie's fund has a lot of educational resources on their website So please go there and take a look at it, and then the ASPCA Pro has a lot of resources on their website as well
44:57
Yes, okay cool excellent, thank you very much
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