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Healthy fairs

Healthy fairs. Gail R. Hansen, DVM, MPH Kansas Department of Health and Environment Ghansen@kdhe.state.ks.us. Short version (If you have to leave now). Website: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5404a1.htm. Zoonoses and fairs. Historical perspective

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Healthy fairs

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  1. Healthy fairs Gail R. Hansen, DVM, MPHKansas Department of Health and Environment Ghansen@kdhe.state.ks.us

  2. Short version(If you have to leave now) • Website: • http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5404a1.htm

  3. Zoonoses and fairs • Historical perspective • Why you are glad you aren’t in FL,NC, AZ • Compendium • Prevent disease from animals in public settings • Specific diseases • What does this mean for you • Practical tips • Q&A and Discussion

  4. Definition Zoonosis • Disease of animals transmissible to humans

  5. Basic tenet • Animals at fairs are a GOOD idea • Entertainment • Education

  6. When bad things happen to good exhibits

  7. 25+ outbreaks from 1990-2000 • E. coli 2000 • PA • 51 ill • WA • 5 ill • Salmonella 1996 • Denver zoo “Dragon days” • >75 ill • Many never touched the reptile directly

  8. E. coli, NC • Oct. 2004 • State fair • 108 ill • 13 hospitalized • E. coli found months later • Parent awareness of potential more likely to help than using a hand sanitizer

  9. Credit: John R. Dunn, DVM, PhD

  10. E. coli O157 positive E. coli O157 negative Systematic sample of Petting Zoo B • Soil / shavings sampled 16 days after fair • Results: sheep / goat area uniformly contaminated with E. coli O157 Sheep and goats Credit: John R. Dunn, DVM, PhD

  11. E. coli O157 positive E. coli O157 negative Systematically re-sampled Petting Zoo B: 100 days after fair • Results: • Sheep and goat area remained uniformly contaminated Sheep and goats Credit: John R. Dunn, DVM, PhD

  12. E. coli, FL • Local fairs, petting zoos • 26 confirmed, 68 total • 22 hospitalized

  13. E. coli, AZ • July 2005 • Petting zoo (in a zoo) • 2 children hospitalized • Only 1 with direct contact • E. coli found in petting zoo area and play area downhill from petting zoo • Petting zoo and play area closed

  14. 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

  15. Increased chance of disease • Riskier animals • Reptiles • Chicks/ducklings • Puppies, kittens < 6 months • Animals with diarrhea • Exotic and wild animals

  16. Compendium • Measures to Prevent Disease Associated with Animals in Public Settings 2005 • Not eliminate • Minimize risks • NASPHV/CDC • Document on CD-ROM

  17. Specific diseases • Enteric diseases • Salmonella • E. coli O157:H7 • Campylobacter • Rabies • Other pathogens • Bites/injuries

  18. Salmonella • Bacteria • Contamination of bedding, fur, skin, saliva • Fecal/oral transmission • Diarrhea/vomiting • May be bloody diarrhea • Illness 6-72 hours after exposure

  19. Salmonella • All are animal origin • Reptiles • Intermittent shedding • No treatment • Poultry • Eggs • Chicks, ducklings • Swine, cattle, sheep, goats

  20. E. coli O157:H7 • Bacteria • Diarrhea/vomiting • Bloody diarrhea • Kidney failure (HUS) • Illness 3-8 days after exposure • Unpasteurized juice, undercooked hamburger

  21. E. coli O157:H7 • Animals • Cattle • Deer • Infected animals rarely look ill • Shed when stressed • Summer and fall • Peak shedding

  22. Campylobacter • Bacteria • Diarrhea/vomiting • GBS can occur later • Illness 1-10 days after exposure

  23. Campylobacter • Raw milk • 2 outbreaks in KS in past 3 years • Kittens, puppies • Usually with diarrhea • Poultry • Horses

  24. Rabies • Virus • Fatal • All mammals potential • Carnivores most likely • Calf at local KS fair • Discovered before fair opened • “ADR”, sent home

  25. Parasites and more • Ringworm • GA, show lambs • Cryptosporidiosis • Orf • Leptospirosis

  26. Bites/injuries Dis-ease Avoidable • Bites, scratches • Kicks • Falls from animals, crushing

  27. Laws and Regulations • Regulations in KS • KAHD regs on inspection • No federal laws • Guidelines • Federal • State • This meeting

  28. Recommendations • Education • Handwashing • Food away from animals • Signs • Cleaning/disinfection • Environment

  29. Education • Operator • Staff • Able to explain to visitors • Authority to enforce • Encourage animal/human interaction • Available fo injury/bite reports

  30. Education • Exhibitor • Specifics on their animal(s) • Instructions if animal gets sick • Visitor • Field trips/group trips • Individuals/families

  31. Handwashing • THE most effective prevention • Most zoonoses transmitted fecal-oral • Thorough and often • Plain soap and water best • Waterless gels ok • Stations available

  32. Handwashing • Have stations available outside animal areas • Keep clean and supplied • Shoe scrapers?

  33. Food away from animals No food or beverages allowed in animal areas • Discourage: • Smoking • Pacifiers • Bottles/”sippy cups” • Carrying toys

  34. More on Food • If visitors allowed to feed animals • Only “approved” foods • Not in containers that can be eaten by people (e.g., ice cream cones)

  35. Signs • Different formats • Know your audience • Literacy • Poster contests? • Post at entrance and exits • Handwashing signs near food concession areas • Included in CD-ROM

  36. Wash Hands After Leaving Animal Exhibit Area

  37. Please supervise children in animal areas

  38. Please leave toys and pacifiers outside

  39. This way to Handwashing area

  40. No Food or Drink in Animal Exhibit Area

  41. Available in English and Spanish www.kdhe.state.ks.us/fofs/handouts/did_you_wash_em_color_sign.pdf

  42. Cleaning • Manure and soiled bedding removed as needed • Scheduled • “Unscheduled” • Avoid trucking through food areas • At least avoid spillage

  43. Cleaning • Disinfect after after removing bedding, other organic matter • 1-5% Bleach solution works well • Make fresh daily • Other disinfectants—see CD-ROM

  44. Environment • Flow through • Animal and non-animal areas • Food prepared/served in non-animal areas only • Restrict uncontrolled access to animals • Barriers

  45. Environment • Drinking water separate from waste water • Don’t duct tape together • If both leak…. • Back flow prevention devices • “Not for human consumption” on hoses

  46. Keep fairs fun for everyone No unwelcome souvenirs!

  47. Questions? Insert picture here KDHE hotline: 877-427-7317 www.kdhe.state.ks.us

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