Biosecurity in Small Animal Practice
World Small Animal Veterinary Association World Congress Proceedings, 2004
Nilüfer Aytug, Prof. Dr.
Uludag University, Veterinary Faculty, Dept. Of Internal Medicine
Bursa, Turkey

Biosecurity means many different things to different people depending on the situation, but should be looked at from a number of angles. The term biosecurity has been introduced, primarily as related to the security of the health of the human population. From Veterinarian's point, biosecurity is not only a matter of reducing the possibility of terrorist attacks, biosecurity is a word "implementing protocols that are designed to limit the animal's, staff's and owner's exposure to pathogens and disease."

Biosecurity for a small animal hospital/clinic has a different meaning than it has for a dairy farm, where the aim is to keep contagious diseases from entering and to practice effective immunization against pathogens. In a hospital or clinic, the goal of biosecurity is to prevent the spread of contagious diseases by controlling cross-contamination of body fluids between animals, and animals and people A nosocomial infection is one obtained from entering the hospital. A dog or cat may enter the hospital for vaccination, and end up in an infection. This does not mean the hospital is unclean, but the odds of infection are high since so many pets are in the waiting room, including owners and staff. Everyone who directly or indirectly deal with animals are responsible for biosecurity measures.

The two key strategies in developing a program for controlling nosocomial diseases are reducing the number of pathogenic organisms to which patients and owners are exposed, and maximizing patient resistance and avoiding further increasing patient susceptibility.

Handwashing is the most important procedure for reducing the number of pathogens since the hands are the principal vehicle for the transmission of infection. Handwashing with plain soaps or detergents suspends microorganisms and allows them to be rinsed off; handwashing with antimicrobial-containing products kills or inhibits the growth of microorganisms; this process is often referred to as chemical removal of microorganisms.

Disinfection of floors and surfaces, as well as of the instruments and materials used in daily clinical practice, are the basic in the reducing the load of pathogens in the environment, it will decrease the risk of disease.

 Before disinfection, contaminated surfaces in examination rooms should be cleaned.

 Contaminated surfaces, including the examination tables, floors, water taps, cage, walls, ceiling, and door should be wetted thoroughly with a disinfectant and then blotted with clean paper towels or mops. Surface should be in contact with the disinfectant for 10 minutes.

 High risk areas such as examination/operating tables, kennels, and equipment (e.g., stethoscopes, pen lights, thermometers, scissors...) can be a fomite and should be cleaned and disinfected for 10 minutes after each use.

 Low risk areas such as waiting rooms, corridors, desks and walls should be disinfected at least weekly.

Hospitalization. All cats and dogs with suspected infectious diseases should be hospitalized in an isolated area of the hospital. The number of staff members entering the isolation area should be kept to a minimum. Upon entry into the isolation area, outerwear should be removed and disposable shoe covers placed over the shoes or a footbath filled with disinfectant should be placed by the exit and used when leaving the area.

Vaccination. The other essential point is to maximize the resistance and avoid increasing the susceptibility. These are accomplished by passive immunity through vaccination. Vaccines are integral part of the veterinary practice. Core vaccines are those vaccines that every animal should receive, noncore vaccines are optional.

Canine core vaccines include canine adenovirus type 2 (CAV-2), canine distemper virus (CDV), canine parvovirus type 2 (CPV-2) and rabies virus. Optional vaccines for use in dogs with high risk for developing the disease include Bordetella bronchiseptica, Borrelia burgdorferi, Leptospira spp., Coronavirus and Giardia.

Core vaccines (canine distemper virus, adenovirus 2, parvovirus, rabies)

 Puppies born to vaccinated bitches and presented at 6-12 weeks of age should be vaccinated every 3-4 weeks until 14-16 weeks of age.

 When puppy is presented between 12-16 weeks of age, 3-4 weeks apart, 2 vaccines should be given.

 Puppies at 16 weeks or older require 1 modified vaccine or 2 killed vaccines, 3-4 weeks apart. Puppies between 6 and 8 weeks of age should receive a distemper-measles vaccine at that time, and then receive routine vaccines at 10, 13, and 16 weeks of age.

 Modified-live products should not be administered to clinically ill, debilitated, or pregnant animals.

 All puppies and kittens will receive a rabies vaccination at 12 weeks of age Rabies vaccine is administered at 12 or 16 weeks of age depending on local ordinances. The rabies vaccine should be given 3-4 weeks apart from the CDV/CPV-2 vaccines.

 The duration of immunity for the "core" vaccines after the initial puppy series and first booster: Canine Distemper (CDV), Canine Parvovirus-2 (CPV-2) Canine Adenovirus-2 (CAV-2) are reported to be 7 years with >90% efficacy. The Rabies virus vaccine was reported to be 3 years of age with >85% efficacy.

Canine parvovirus-2 (CPV-2) vaccines are available as inactivated or MLV products. MLV products offer better protection against shedding of virulent virus following challenge than inactivated vaccines. In case of an outbreak, MLV vaccines should always be used.

Distemper. Modified live virus (MLV) vaccines have been most effective in protecting dogs against canine distemper.

Rabies. In areas in which rabies is endemic and exposure may occur before 16 weeks of age, vaccination at 8, 10, or 12 weeks of age may be indicated. Rabies vaccination should be repeated at 1 year of age. If a rabies product with known duration of immunity of 3 years is used, it should then be administered every 3 years.

Infectious Canine Hepatitis. Vaccination for canine adenovirus infection is usually done in combination with that for distemper and other diseases.

Corona virus. Clinical disease is usually mild and self-limiting The virus does not cause disease in dogs after 6 weeks of age and so is apparently not indicated in adult dogs. CCV can enhance the severity of disease caused by CPV-2. CCV vaccine alone provided no protection for dogs challenged with a combination of CCV and CPV-2. vaccination is considered optional for pet dogs.

Inactivated Leptospiral vaccines against 4 serovars (L. canicola. L. icterohaemorrhagiae, L. grippotyphosa, and L. pomona) are available for dogs. Leptospira vaccine is optional for dogs, if needed, should be given at 9 weeks of age or older. Require two doses, given at intervals of 2 to 4 weeks If pup is >12 weeks, a single dose of MLV vaccines can immunize.

No vaccine available for cats.

Canine Bordetella vaccines Although Bordetella vaccination is "optional", canine intranasal Bordetella vaccination is recommended for dogs housed in kennels or shelters and before boarding in kennels. Duration of immunity is believed to be approximately 10 months. Revaccination is recommended annually or more often in very high-risk animals not protected by annual booster. Intranasal products should be given 2 to 3 days before potential exposure and may be more effective than parenterally administered vaccines. A Feline Bordetella bronchiseptica vaccine that may help protect cats was recently introduced.

Giardiasis An inactivated adjuvanted vaccine is given to dogs > 8 wks of age, subcutaneously, twice, 2-4 weeks apart. Routine annual revaccination is not indicated with this product except in the unusual situation where recurrent exposure and infection are documented and cannot be controlled using conventional hygienic methods.

Lyme vaccine should be used only in areas where Lyme disease is known to occur, and where it may pose a serious threat to the health of the dog. Infection with Borrelia burgdorferi is often mild. Lyme disease vaccine, should be given to dogs are at very high risk of infection/disease. Dogs previously naturally infected with B. burgdorferi likely do not benefit from vaccination.

The feline core vaccines include feline parvovirus, feline calicivirus, feline viral rhinotracheitis and rabies virus. Optional vaccines for use in cats with high risk for developing the disease include Feline Leukemia, coronavirus, Chlamydia, Bordetella, Microsporum canis.

FVRCR Vaccination against FHV-1 and FCV is highly recommended for all cats. Kittens presented at less that 12 weeks of age should receive a modified live or killed FVRCR with boosters given every 3-4 weeks until 12 weeks of age. Kittens presented at > 12 weeks of age should receive 2 killed or 2 modified live FVRCP 3-4 weeks apart. Following the initial series of vaccinations and revaccination 1 year later, cats should be vaccinated once every 3 years.

Feline leukemia virus vaccine is indicated in cats allowed to go outdoors or that have other exposure to cats of unknown FeLV status. Vaccination should be based on the cat's age and its risk of exposure. Vaccination is not recommended for cats with minimal to no risk of exposure, especially those > 4 months of age. Vaccinated cats should receive 2 vaccinations initially. Duration of immunity is unknown, so annual boosters are currently recommended. FeLV testing should be performed prior to vaccination because the retrovirus serologic status of all cats should be known so appropriate husbandry can be maintained.

The feline chlamydia vaccine Chlamydophyla felis infection in cats generally only results in mild conjunctivitis, and so whether vaccination is ever required is controversial. The use of this vaccine should be reserved for cats with a high risk of exposure to other cats and in catteries with endemic disease. Duration of immunity for Chlamydophyla vaccines may be short-lived, so high-risk cats should be immunized prior to a potential exposure.

The feline infectious peritonitis (FIP) vaccine. The vaccine is indicated for seronegative cats entering a known feline infectious peritonitis-infected household or cattery. The efficacy of this vaccine has not been proven in cats with positive coronavirus serology. Many cats that are to be exposed to coronaviruses have done so by 16 weeks of age and so if used, the vaccine may be more effective at 8 and 12 weeks of age.

Feline Immunodeficiency Virus (FIV). FIV is a species-specific, life-long, slowly progressive disease. FIV is non-transmissible from cats to people. The disease is present in blood, saliva and cerebrospinal fluid of infected cats. Transmission primarily occurs through a bite wound.

Feline Panleukopenia Vaccination against FPV is highly recommended for all cats. Maternal antibody titers generally wane sufficiently to allow immunization by 12 weeks of age. Most vaccinated animals are completely protected from infection and clinical disease. Both serologic and challenge exposure data indicate that a parenteral FPV vaccine induces immunity that is sustained for at least 7 years. Following the initial series of vaccinations and revaccination 1 year later, cats should be vaccinated no more frequently than once every 3 years.

Fungal Vaccine. The killed M. canis vaccine is marketed for treatment and prevention in cats. When used pre-exposure, it has been shown to lessen the severity, not reduce the incidence of disease in kittens subsequently exposed to virulent M. canis.

Each specific disease can be evaluated as it relates to the potential of other patients, owners and staff, so biosecurity control points should be assessed for specific diseases.

References

1.  American Association of Feline Practitioners: 2000 Feline Vaccination Guidelines. http://www.aafponline.org/pdf/guidelines_vaccine.pdf

2.  1998 Report of the American Association of Feline Practitioners and Academy of Feline Medicine Advisory Panel on Feline Vaccines. J AM Vet Med Assoc 1998; 212:227-241.

3.  Carmichael, L.E., Schultz, R.D., (May 5, 2000) Considerations in Designing Effective and Safe Vaccination Programs for Dogs. International Veterinary Information Service, Recent Advances in Canine Infectious Diseases. Location: http://www.ivis.org/advances/lnfect_Dis_Carmichael/schultz/chapter_frm.asp

4.  Ford RB and Vaden SL: Canine infectious tracheobronchitis. In CE Greene (ed): Infectious Diseases of the Dog and Cat. 2nd edition, pp. 33-38. Philadelphia, WB Saunders Co, 1998

5.  Lappin MR, Polysystemic Bacterial Diseases. (eds): Nelson RW, Couto CG In Small Animal Internal Medicine, 3rd ed. Mosby Publishing, St. Louis, 2003, pp 1259-1264.

6.  Schultz, Ronald D. (2000), "Considerations in Designing Effective and Safe Vaccination Programs for Dogs", in Recent Advances in Canine Infectious Diseases, Leland E. Carmichael, ed., IVIS, pp. 1-13.

7.  Schultz, Ronald D. (1998), "Current and Future Canine and Feline Vaccination Programs", Vet. Med. 93(3):pp. 233-254.

8.  Van Kampen, K. Recombinant vaccine technology in veterinary medicine. Vet Clinics of N Am: Sm Anim Pract. 2001; 31:535-8.

Speaker Information
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Nil├╝fer Aytug, Prof. Dr.
Uludag University, Veterinary Faculty
Dept. Of. Internal Medicine
Bursa, Turkey


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