Practical ways to help vets during COVID-19

Maureen Anderson writes in the Worms & Germs Blog, “the COVID-19 pandemic has put a lot of strain on a lot of people, and those in the veterinary profession are no exception.  Thank you, Captain Obvious. 

Self-care and mental health support at times like these are critical, but can be hard to come by for many still working on the front lines in clinics, both human and veterinary.  It’s important to recognize that everyone is stressed, even our clients, but giving others that extra little bit of leeway and understanding can be tough when you’re already at the end of your own rope. (Right, that’s Kate the Vet of Kansas State University and my research partner on a couple of handwashing projects and papers back in the day.)

A little bit of kindness can go a long way, and that’s as important now as it was a month ago when the world changed overnight, maybe even more so.  Dr. Christopher Byers, a fellow veterinary internist in the US, wrote a blog post about how pet owners can help veterinarians during this crisis, and it also speaks to how we can all help each other.  Our mental and physical health go hand-in-hand, and are also closely associated with the health and welfare and care we are able to provide our animals.  Consider it a non-infectious consequence of a highly infectious disease, so I thought it was appropriate to share here.

You can read Dr. Byers full post on CriticalCareDVM.com, but here are his three very simple and practical points for pet owners:

  1. Be flexible
  2. Be kind
  3. Stay home if your pet isn’t sick

Health types say animals were likely source of E. coil outbreak that killed 2 kids in Utah

The investigation into an outbreak of E. coli in the border towns of Hildale, Utah and Colorado City, Arizona are drawing to a close and it is believed that infected animals were the source of the disease.

Two young children died and at least 11 people were sickened due to the outbreak, which Fox 13 News first reported July 2. 

Friday, The Southwest Utah Public Health Department issued an update and stated that “It has been determined that the likely source of the disease was infected animals, followed by person-to-person contact. Several livestock tested positive for the E. coli strain involved in this outbreak.”

The owners of affected livestock have been notified and given guidance about how to proceed. The health department says tests of water systems, nearby springs, ground beef, produce and dairy products in the area were all negative. There have been no new cases reported in connection with this outbreak since July 9.

The family of 6-year-old Gabriella Fullerton of Hildale confirmed their daughter died of kidney failure as a result of E. coli. Fullerton and another young boy who lives nearby died while several other people were sickened.

 

Bats in salad is yuck factor stuff; actual illnesses end up lost

I don’t know exactly when the barfblog risk factor vs. yuck factor thing was coined, but it’s been a running theme for over a decade. The concept is that stuff that grosses some people out (like this 3-year old’s poop party) garners more attention than the stuff that actually makes people sick.

There’s literature out that that shows that individuals are likely to perceive a situation or product as unsafe if it appears dirty, gross, or yucky, regardless of whether or not there is an actual food safety risk.

Many food safety regulatory systems, at national and local levels, employ a risk-based standard and inspection process grounded in both epidemiological and scientific evidence for monitoring and addressing food safety from farm-to-fork.

Risk and yuck get confusing.

Like bats and scorpions in bagged salad are a bigger deal for the mere mortals like the hockey parents I hang out with than actual outbreaks (like this one). Finding something that’s gross, and isn’t expected, garners a stronger media reaction than seven cases of E. coli O157.

Lots of folks I’ve talked to over the past couple of days want to know why there are suddenly more of these weird animals-in-food events (there aren’t) and how it happens.

We’ve seen stuff like this before:

Frog found in bag of Aussie salad

‘Why have I a soggy fishcake on my plate?’ Tesco customers’ horror as they find dead bird in salad during meal

And rats.

It’s possible that the mechanical harvesting could pick something like this up and it makes it through the quality control steps (see this video of what a salad mix mechanical harvester looks like beginning at 1:17)
.

The washing, sorting line is a place for quality control to happen (and here’s another video about that process), but it doesn’t surprise me that small animals make it through (and these events seem really rare)

As for risk, animals can carry human pathogens. As with any fresh produce item, there’s not a cook step (usually), so the potential for these extra critters (and their feces or body parts) to carry something like Salmonella is there. But the exposure chance is pretty low. Once discovered, I don’t know if many folks will eat around the animals once discovered.

Folks might benefit from targeted information about yuck versus epidemiologically-driven food safety risks. Not just the home chefs, but the industry and government risk managers that have to explain where their food safety priorities lie – and how stuff – like bats – slip through the cracks.

We’re all hosts on a viral planet: New virus breaks the rules of infection

Michaeleen Doucleff of North Carolina Public Radio writes that human viruses are like a fine chocolate truffle: It takes only one to get the full experience.

283615-virusAt least, that’s what scientists thought a few days ago. Now a new study published Thursday is making researchers rethink how some viruses could infect animals.

A team at the U.S. Army Medical Research Institute of Infectious Diseases has found a mosquito virus that’s broken up into pieces. And the mosquito needs to catch several of the pieces to get an infection.

“It’s the most bizarre thing,” says Edward Holmes, a virologist at the University of Sydney, who wasn’t involved in the study. It’s like the virus is dismembered, he says.

“If you compare it to the human body, it’s like a person would have their legs, trunk and arms all in different places,” Holmes says. “Then all the pieces come together in some way to work as one single virus. I don’t think anything else in nature moves this way.”

Most viruses have simple architecture. They have a few genes — say about a half-dozen or so — that are packaged up into a little ball, 1/500th the width of a human hair.

“You can think of it like a teeny-weeny tennis ball with spikes,” Holmes says.

When the virus infects a cell, the ball latches onto the cell’s surface, opens up and pops its genes into the cell.

Poof! The cell is infected. That’s all it takes. One ball, sticking to one cell.

But that’s not the case for the Guaico Culex virus. It has five genes. And each one gets stuffed into a separate ball. Imagine five tennis balls, each with a different color: a red tennis ball, a blue one, a green one, a yellow one and an orange one.

Then to get infected with the virus, a mosquito needs to catch at least four different colored balls, researchers write in the journal Cell Host & Microbe. Otherwise the infection fails.

“The fifth ball seems to be optional,” says Jason Ladner, a genomicist at USAMRIID, who helped discover the virus. Getting the fifth one could control how dangerous the virus is, he says.

Ladner and his team found the virus inside a Culex mosquito found in Guaico, Trinidad — hence the name of the virus, Guaico Culex. Culex mosquitoes are common across the U.S. and spread West Nile Virus.

The study is part of a larger project aimed at figuring out what viruses, in addition to Zika and yellow fever, could be lurking inside mosquitoes and possibly waiting to spill over into people.

Indeed, each year, scientists are finding thousands of new viruses, says Vincent Racaniello, at Columbia University. “It’s hard to put a number on it. But it’s huge.”

“We finally have the tools to find them,” he says.

But that doesn’t mean we can immediately understand what they do, or even whom they infect.

“There’s so much we don’t know about viruses,” Racaniello adds. And with viruses, really anything is possible. “We should always expect the unexpected,” he says.

 

Ron Doering: reducing antibiotics in meat

Ron Doering, the first and only president of the Canadian Food Inspection Agency anyone can remember, and current counsel in the Ottawa offices of Gowlings (Ronald.doering@gowlings.com), writes in his monthly Food Law column that:

Health Canada (HC) and the Canadian Animal Health In­stitute (CAHI), the trade asso­ciation representing Canadian veterinary drug manufacturers, are to be com­mended for their decision on April 10 to follow the American initiative to address the growing concern over antimicrobial resistance in humans by introducing measures to promote the more prudent use of antimicrobials in animal produc­tion. HC announced its intention (1) “to work towards the removal of growth promotion and/or production claims of medically important antimicrobial drugs” and (2) “to develop options to strengthen the veterinary oversight of antimicrobial use in food animals.”

ab.res.prudent.may.14Contrary to many mainstream media reports, this does not mean that Canada is phasing out antibiotic use in meat production. Moreover, both initiatives face several difficult barriers to implementa­tion. This month we look at the difficulties associated with the first proposal, leaving next month for an analysis of why the oversight role by veterinarians must be strengthened if we are ever going to make real progress on what may be the most serious public health problem of our time.

First some law. The licensing and sale of antimicrobials fall under the jurisdic­tion of the federal government and its Food and Drugs Act, but the authority to manage their “use” lies with the provinces. The provinces also have the exclusive authority over the practice of veterinary medicine. What this means is that HC can require that a vet drug no longer have “growth promotion” as an indicated use on its label, but under the current regime it has limited power to actually determine how the drugs are used.

The issue of preventing growth promotion claims, and whether such a step will actually make a real difference, is a complex one. To begin with, most antibiotics are not actually used directly for growth promotion purposes but rather for disease prevention and control, what is often called disease prophylaxis. Removal of growth promotion claims will not prevent drugs to claim and be used for disease prevention. Farmers can continue to give their animals low doses of antibiotics to keep them from getting sick. The Public Health Agency of Canada, estimating that 90 per cent of the medication on farms is used for disease prevention, argues that antimicro­bials should not be used in this way and should be “limited to treating infection and not long-term mass medication for growth promotion or guarding against disease.” Others argue that there is insuf­ficient science to support the conclusion that low doses given to animals contrib­ute to antimicrobial resistance in humans and that outlawing the practice would result in more animal disease and the need for more drugs for disease treat­ment, possibly exacerbating the problem of antimicrobial resistance. When the science is uncertain, policy development is always difficult.

What is clear is that the proposal will not even apply to a large amount of anti­biotic use because of regulatory loopholes that result in part from our jurisdiction­ally fragmented regulatory framework. Our provinces still allow veterinarians to prescribe drugs for purposes not indicated on the product label (extra-label use). Unapproved drugs may be used on ani­mals because it is still legal for drugs to be imported for livestock production “own use” (OUI) if the drug is not offered for resale and it is not a prescrip­tion drug. As well, Active Pharmaceutical Ingredients (APIs) can still be imported by livestock producers to be mixed into feed on farm. None of these unregulated antibiotics are covered by the proposal. The latest Canadian Medical Association Journal contains a critical assessment of Canada’s performance in enhancing antimicrobial stewardship in agriculture and veterinary medicine, but it does state that HC has recently proposed measures to address OUI and API so, hopefully, reforms may be imminent.

As we shall see next month, none of the barriers described above can be adequately tackled without Canada’s veterinarians and their provincial regula­tory bodies taking a greater leadership role in combating the serious and growing problem of antimicrobial resistance in humans. Nowhere is the concept of One Health more compelling.

6 sick; how do kids get E. coli in a park? From the animals; and handwashing is never enough

Children have been given the all clear to return to a Birmingham, UK, park that was at the center of an E. coli outbreak.

The Health Protection Agency said there have been no new cases of the deadly bug in nearly six weeks at Sutton Park after steps were taken to reduce the risk of infection.

The Birmingham Mail reports parents of children under the age of 10 had been advised to keep them away from beauty spot in July, after two youngsters were rushed to hospital with the O157 strain of the bug. It was linked to the feces of animals that live in the park.

Four other children were also said to have had E.coli.

All six have now recovered.

Dr Roger Gajraj, a consultant with the Health Protection Unit (HPU) in Birmingham said, “the advice to wash hands before eating or drinking remains essential for visitors to the park and indeed for anyone visiting areas where contact with animals or animal feces is possible.”

New signage has been put up at the park, for visitors reminding them to wash their hands to avoid infection and showing them where facilities are available. Additional handwashing points have also been installed and areas such as the playgrounds and car parks have been cleaned.

The cattle that graze Sutton Park have now moved off site for the winter.