NASAAEP Symposium2016

Biosecurity Considerations for Equine Emergency ShelteringRebecca S. McConnico, DVM, PhD

Diplomate ACVIM (LA)Professor of Equine MedicineSchool of Veterinary MedicineLouisiana State UniversityEquine Branch Director - Louisiana State Animal Response Team

Emergency ShelteringPerfect Storm for Disease Outbreak

• Comingling of horses of unknown health status

• Allowing for entry & movement of disease• Stabling in close proximity• Lack of Biosecurity

– Allowance of environmental spread of disease– No isolation area

• Stressed & susceptible horse population

Biosecurity

A set of preventative measures designed to reduce the risk of transmission of infectious diseases• Biosecurity Principles - same

– veterinary hospital– equine event– boarding stable– emergency sheltering

• Protecting the health of livestock & personnel by preventing the transmission of disease– through physical barriers and hygiene practices.

Slide courtesy of L. Pantaleon

Biosecurity

ANIMAL DISEASE

HUMAN DISEASE

ENVIRONMENT

ONE HEALTH

Slide courtesy of L. Pantaleon

ConsiderationsBuy-in = Teamwork

– Every staff member needs to take responsibility for protecting:

• Animal evacuees• All staff members (including self)

– Reducing the risk of zoonotic disease– Veterinarian + public health officials – work together

on the plan– Overall human safety issues associated with taking

care of animals• Consider having co-located shelters where owners care for

their own animals– Decreases injuries and work-load– Need to coordinate feeding & animal exercise

Standard Operating Procedure (SOP)• SOPs are required for sustainability• If 1 person is in charge, with little buy-in or

oversight of a program (biosecurity or other)– there will be little opportunity for carry-over

• Important for continuity of biosecurity

Zoonotic InfectionsInfection of animals communicable to humans

Deadly• Rabies• Hendravirus (AUS)

Potentially deadly• Salmonellosis• Cryptosporidiosis• Bacillus anthracis• C. difficile

Non-deadly• Ringworm -

Dermatophytosis• Methicillin-resistant

Staphylococcus aureus(MRSA)

• Brucellosis• Giardiasis• Leptospirosis

Rabies - VirusSigns

LamenessColicIncoordinationProgressive neurologic signsSeizuresComa Death

TransmittedSaliva or spinal fluid/neuro

tissue with human mucous membrane

PPE – gloves, booties, coveralls, face protection

Zoonotic

Hendra virus – AustraliaRespiratory & Neurologic signsFatal

Zoonotic

Enteric InfectionsCauses

SalmonellosisClostridium difficileCryptosporidiosisGiardiaEquine corona virus

Signs EnterocolitisDiarrheaDebilitation

Can be deadly inimmunocompromised

people

Zoonotic

~1% to 2% of healthy horses are shedding Salmonella organisms

Glanders• Burkholderia mallei• Can be transmitted to Humans• Susceptibility to glanders has also been

demonstrated in camels, felines living in the wild, bears, wolves and dogs

Zoonotic

Brucellosis - bacteria

Brucella abortus• Can cause fistulous

withers in horses• Causes infectious

lymphadenitis in people– Transmitted by contact– Can cause intermittent

fever, flu-like symptoms– Results in sterility in

males• Problem in laboratory

workers

Zoonotic

Anthrax• High fever• Agitation• Severe colic• Loss of appetite• Depression• Neurologic signs• Labored breathing/suffocation• Exercise intolerance• Muscle weakness• Bloody diarrhea may be observed• Swelling of head/neck• Chest and lower abdomen

swelling• Localized skin infection (human)• Rapid deterioration/death

Dermatophytosis – fungal organismRingworm

Zoonotic

MRSAMethicillin–resistant Staph. aureus

• Cellulitis• Pain• Heat • Swelling• Redness• Non-healing wound

Zoonotic

Horse case

Human case

Foreign animal diseases• Emerging disease or foreign animal disease

– Required to contact at least 1 of these:1. State Veterinarian2. APHIS-VS Area Veterinarian3. Foreign animal disease diagnostician (Plum Island training)

(call early to discuss rather than waiting until it’s too late)

Eg.Oral lesionsCoronary band lesionsNeuro-invasive diseasesDiagnostic test results

Most Common and Important Infectious Diseases of Horses

Bacterial or Viral origin• Clinical signs

– Bacterial and viral diseases• Vague• Mimic signs of other conditions• Common signs

– Weakness, ataxia, vague neurologic deficits, fever, diarrhea, nasal discharge, enlarged lymph nodes, and coughing, with laboratory findings including anemia and leukopenia or leukocytosis

• Exceptions• Ringworm infection – fungal• Endoparasites and ectoparasites can be problematic in certain

circumstances

WEEStrep equi equi

The OIE Top 6 for HHP horsesHHP - High Health High Performance

OIE – World Organization for Animal health1. African Horse Sickness – Not in US2. Venezuelan Equine Encephalitis – Not in

the US - (can be Zoonotic)3. Piroplasmosis4. EIA (Coggins disease)

• Equine Infectious AnemiaEradicated from many parts of US

5. Glanders – Not in US (Zoonotic)6. Equine Influenza

Pathogens aren’t picky

Vectors!

• Insect Management– Fans/ventilation– Insect repellants– Manure management– Overall shelter hygiene

Culicoides ‘no see-ums’African Horse Sickness

TabanidsEIA

Ticks Piroplasmosis

MosquitoesVEE

Who is the official in charge of equine sheltering in a local community during disasters?

• State veterinarian or designee• Coordination of local, regional, state, &

national plan – ICS– Establishing a network of trained/credentialed

personnel– Emergency managers

Emergency Sheltering Issues -Lessons learned – H. Katrina

• Must use ICS system– 12 hr. shifts– Span of control for

leadership– Mostly husbandry – Veterinary input for triage,

biosecurity, health maintenance

– Safety & security issues– Communication

Biosecurity Plan for an Equine Response Shelter

• Resource Management– Personnel– Facility Layout– Animal entry/exit– Stabling– Stall and environmental sanitation plan– Manure/bedding disposal– Water source & disposal– Feed/Hay storage– Horse to horse contact– Traffic – Record keeping

What needs to be considered for determining an appropriate equine shelter for emergency response? • Overall Goal

– Keep/move animals out of harm’s way without adding to the risk– i.e. gridlock traffic in summer heat– Shelter-in-place option

• Requires– Appropriate pre-storm or pre-event planning – Early evacuation

• Consider typical emergencies for different areas of the country

– Shelters to be far enough from harm if there is an impending disaster but in close enough proximity for practical purposes.

What needs to be considered for determining an appropriate equine shelter for emergency response?

Identify potential facilitiesInvolve these groups in planning & mitigation

1. State equine councils 2. Other state, regional, and local

community equine stakeholders 3. Shelter resource options

• Compiled by state animal response teams • Communicated with state veterinarian’s

office • Should be updated yearly

Shelter Considerations• Size of facility

– Large enough to provide for a separate area for sick animals

• Isolation– Maintain sick animals at 35

feet from presumed healthy animals (ie. EHM, Strangles)

• Memoranda of understanding/agreement with facility owner

• Examples – University livestock

exhibit/handling facilities– Stockyards– Sale barns– Feedlots– Private/public-owned

livestock arenas/expo centers– Fairgrounds– Horse activity centers– Exhibition facilities– Race tracks– Private horse farm

SheltersSafe animal handling/holding areas• Stalls, gates, and fences

– good working condition

• Water & other utilities –available

• Safe & secure • Enough space to separate

groups– isolation area– stallion area

Equine Shelter Facilities Need to be cleanable

• Cleanable surfaces– Cinderblock walls are used in construction

• Require painting with epoxy-type paints to maximize cleanability

• Most horse facilities – Wood– Concrete blocks– Asphalt– Metal– Rubber mats – Commercial flooring materials– Floors made of sand, dirt, compacted clay or other

organic materials cannot be adequately disinfected.

Animal Holding Areas• Unfamiliar horses

grouped together in paddocks or round pens– 6-8 animals per 50 ft.

round pen – allow enough space so

that pecking order activities can safely occur

• Individual stalls • Portable stalls• Round pens/panels • Rolled plastic

webbing/fencing to segregate– 2 layers of fencing

separated– Limits nose-to-nose

contact

Veterinarian’s Role• Biosecurity planning• Work with public health

veterinarian• ICS/ESF structure

• Credentialed?• Licensed?• Accredited?

What should be done to ensure that shelter horses’ medical needs and health maintenance are managed

appropriately?

Veterinarian’s responsibility– Overall health management of an equine

evacuation and/or response shelter– Daily nutritional management– Physical condition– Medical care of all sheltered horses– Shelter biosecurity– Work with public health officials regarding the

overall human safety issues associated with taking care of shelter horse

• protects the volunteers as well as well-intentioned but curious by-standers and others

Biosecurity/Isolation• If isolation procedures cannot be

followed for animals entering a shelter– Increase surveillance and health checks

at entry• Use Separate Equipment

– Grooms/care takers can sometimes be restricted to working only in specific barn and barns

• equine population at an event can be partitioned

Veterinarian’s Role with Emergency Sheltering

• All horses should be examined by a veterinarian as soon as possible upon admission– Within at least within 12 hours

• Sick horses need to be separated as soon as possible

– Fever– Nasal discharge– Lethargy– Diarrhea– Maintain in individual stalls in a remote area (at least 35

feet) from the rest of the sheltered animals– Handled by separate, dedicated, trained shelter personnel

wearing appropriate barrier precautions (PPE)

Which patients need to be isolated?

Require only mild barrier precautions & stall signage

• Minor barrier precautions -gloves or disposable boots– Brucellosis– Ringworm infection– Leptospirosis– Infection with methicillin-

resistant Staphylococcus aureus

– Staphylococcosis

Which patients need to be isolated?Higher Level

• Understanding a suspected disease is critical to ensuring effective control

• Understanding the route of transmission is important for determining the risk factor

• Route of transmission may not require patient isolation– Venereal diseases (e.g., equine

metritis) – Some blood-contaminating and

insect-borne diseases (e.g., equine piroplasmosis)

• Public perceptions– EIA?

• Patients with GI diseases with zoonotic potential– Clostridium spp, – Escherichia coli– Equine corona virus– Salmonella spp.

• Common diseases that require isolation – Salmonellosis– Strangles– Influenza– Rotavirus infection– Equine corona virus– Herpesvirus– EIA– Rabies

Managing Disease Outbreak• Have a biosecurity &

response plan• Maintain a log &

detailed medical record:– Case identification—

which horse(s) got sick, where, & when

– Control measures implemented

– Horse movement—within facility, entering and exiting facility

– Record diagnostic testing results

• Delegate tasks that do not require execution by a licensed veterinarian– Utilize licensed

veterinary technicians• Sample collection• Physical inspections,

temperature recording

Stopping movement…

• Biosecurity kit– Disinfectants, gloves, foot baths, signs

• Can be obtained quickly • Can be improvised

• Protocols – Hardest to control– Improvised – necessary

• Required to control spread and introduction of infection– Veterinarian actions– Authorization for movement of animals– Stall and other environmental cleaning

» specific and generic protocols

Horse Management• Notify veterinarians

– responsibility to report• Health requirements for access to shelter and

make necessary notifications:– Health Certificate +/- disease specific disclaimer– Coggins Test

• Vaccinations (requirements vs. recommendations)

• Horse tracking system:– Origin and date/time of arrival– Location of horse while present at shelter– Contact info for individual responsible for horse– Contact info for attending veterinarian– Destination and date/time of departure– Mode of transport

Environmental Harboring of Organisms Organic Material

Environmental presence can render some disinfectants useless

ManureUrineBloodDischargesDirt

Disinfectants• Many bacteria can be killed using several

disinfectants– Enveloped viruses

• most easily killed• detergent breaks apart the envelope

• Rotavirus is non-enveloped – Can withstand freezing temperatures– Can remain alive for > 9 months at room

temperature– Even when dried on a surface, rotavirus

can be infective to foals for several hours– Disinfectants which can kill rotavirus can

kill the other known equine pathogens

Soap, Scrub, Rinse, Dry, Disinfect, Dry

• Organisms - organic Matter– Manure

• Rotavirus, Salmonella spp. and R. equi– Urine

• Leptospira spp. – Nasal secretions

• Streptococcus equi var equi• Influenza virus • Herpesvirus

• The importance of disinfectant efficacy in the presence of organic matter cannot be overemphasized

Disinfectants• Choice of disinfectants is critical, and many

factors must be considered– Ability of the chemical to be germicidal:

• on the surface • germicidal - relevant pathogens

– Efficacy in the presence • organic matter• hard water

– Cost?– Biodegradability?– Safety for animals and humans

Disinfectants

• Quaternary ammoniums – less expensive• Peroxygen disinfectants and accelerated

hydrogen peroxide• Bleach

– One of the most common household & workplace disinfectants

• Oxidizers– Quick kill & better than bleach in the presence

of organic debris• Phenolics• Biguanides

PPE – Personal Protective Equipment

• Barrier nursing precautions – Sick or high-risk animals

• Barriers– Disposable plastic gowns– Gloves– Plastic or rubber over boots– Footbaths for each patient

• Smocks• Laboratory coats or coveralls• Closed-toe footwear - easily cleanable such as

rubber over-boots

Decontamination

• Dawn dishwashing liquid• Thorough rinsing• Proper disposal of effluent • Barrier precautions for ‘bathers’

– Water repellent– Water resistant

• Requires medical monitoring of personnel for over-heating

Good Hygiene Is Critical• Between animals in a high risk situation

– wash hands or use an alcohol-based hand sanitizer• sanitizer works only if no gross debris or dirt is present

• Always wash your hands thoroughly with an antibacterial soap before eating or drinking

• Hand-washing stations – the more the better!• Many who work in equine health care have pets

or other animals to care for– Important to change clothing and shoes – If possible, shower after working with ill animals to

reduce the risk of disease spread.

Biosecurity Kit• AAEP.org – additional information• Part of shelter supply list

– Examination gloves (1 pr/horse)– Dedicated coveralls/animal examination (or group of

‘like’ animals)• Impervious to upper body toward secretions - nasal

discharge– Plastic shoe covers– Head covering (for isolation cases)– Spray container of disinfectant

• Soles of shoes or boots • Hand sanitizer• Hand soap with water source would be

HORSE(Colonize – Infected)

ENVIRONMENTPEOPLE(Hands – Feet)

horse-journal.com

thehorse.com

Slide courtesy of L. Pantaleon

Vaccinations• Manure, soil & dust harbor many organisms• Can’t disinfect everything• Appropriate vaccination and management can

be used to control many of these disease agents

Vaccinating During Disaster Response

• Risk assessment– Require tetanus toxoid booster – Vaccinating extremely stressed horses with

respiratory and encephalitis vaccines may not be necessary and may even contribute to adverse reactions

– If it is determined that the horses will remain in a shelter for a prolonged period of time, then mass vaccination for contagious equine respiratory viruses may be indicated (influenza & EHV 1 & 4).

Dealing with the MediaGulf Oil Spill 2010

What if something goes wrongAuthority – do you have it?

• What are your responsibilities?

• What are your options?

• Beware of being the default scapegoat if things go wrong A good scapegoat is just about as

good as a solution to the problem

What kinds of supplies are needed for stocking an equine shelter?

• Water buckets• Halters• Lead ropes• Louisiana State Animal

Response Team– Stockpiled

• 100 each water buckets, halters, lead ropes

Pre-planning Owners Responsibility

Medical Triage

Done rapidly and involves examining individual animals

– One approach is to use the following four physiological criteria (RPPN):

• Respiration/minute• Pulse rate/minute• Pulse pressure (although subjective, pulse pressure has a

linear relationship to stroke volume. Therefore, if the pulse pressure is decreased (as you might see in shock) the stroke volume is also likely decreased) – mucous membrane color and character; limb temperature

• Neurological status

Triage• Triage for suspected infectious disease• Animals requiring hospital level care in an equine

shelter should be transported to an equipped veterinary hospital

• MOU with local or regional veterinary hospitals

EIA – Coggins testing• Coggins test status

– should be determined prior to their admission• Don’t turn horses away without Coggins testing

– Plan to test– A specific animal identification team headed by a

veterinarian is helpful with organizing EIAV testing– Animal data sheets can be created for individual

horses• Information stored secure location• Animal release form may be used to document

owner retrieval of the horse from the shelter

Resource Management

• Personnel– Establish 'chain of command'– Verify contact information for:

• State Department of Agriculture Veterinarian• USDA Area-Veterinarian-In-Charge• Area practicing veterinarians• Assess personnel resources and skill level:

– Veterinarians– Veterinary technicians– Laypersons

– Assess communications needs and designate specific individuals for communications tasks

Shelter WorkersVolunteers or Owners or Both

• Owners– Horse owners (consider limiting

the number per family) • day-to-day care

– daily feeding– watering – hand walking for exercise

– Decreases risk of human injury associated with working with unfamiliar horses

– Limits the number of volunteers needed to run the shelter

Volunteers or Owners or Both• Volunteers

– Credentialed– ICS– Trained– Work within the system– MOU with NGO– Work with trained groups!

• NGO’s• Military• Local livestock groups

• Memoranda of Understanding (MOU or MOA)– Outline a specific understanding of parameters of

deployment, chain of command and the requests that will be made of the national organization

– As local capabilities mature, these MOA’s should evolve– Defining specific needs, eg ICS command team, shelter

management expertise, financial organization– Local planners need to be aware of all of the MOU’s in

place for each organization within their region

Utilizing these resources on a local level

• Highly trained Disaster Response Teams • ICS training and special skills • Global understanding of Disaster Response • Maintain expertise in communications, safety,

logistics, administration, finance, public relations• Rapid mobilization of volunteers with training

and experience • Expertise on management of emergent

volunteers• Shelter set-up and management expertise.

What the Big Humane Groups Can Do

• Search and Rescue expertise –required for coordination with human SAR.

• Training courses -- local and state-wide• Resource development and willingness to commit

financial resources; help with donations management• Some maintain distributed disaster response mobile

units, safety and support equipment• Working with FEMA/USDA and each other toward

national animal response plan. Formation of National Animal Rescue and Sheltering Coalition (NARSC)

• Working with governments and Red Cross to encourage set-up of Pet-Friendly Shelters

What the Big Humane Groups Can Do

Pet Identification

• Coggins database– Identification of all horses testing negative for

Equine Infectious Anemia (federally regulated disease)– Required in Louisiana

– Brand– Tattoo– Microchip

Animal Identification

Encourage owners to identify their petsPermanent

– Brand (large animal)– Microchip

• Microchips require a ‘chip’ reader

• Can’t see from a distance– Lip/ear tattoo

Temporary– Needs to have owner contact

info if possible– Luggage tag– Metal collar tag– Tab bands– Ear tags

• Pictures– Keep in folder with medical

records/papers– Face/front view– Side view

Resources• AAEP• AVMA• TAMU• LSART• ASPCA• IFAW• Code 3• TLAER• American

Humane• Red Rover• UC-Davis• NARSC

• HSUS• OSU• UF• USDA• NASAAEP• FEMA• State Depts. Of

Ag• Animal Health

Commissions• OIE• LDAF• SDMI

Equine TeamFormed sheltering teams for the northern and southern portions of the state

aka. – kicking team & receiving teamEquine Response Sheltering

- Leadership• North – LA Tech• Central & South – LSART Veterinarians/Vet Techs

– Shelter Volunteers • La Tech – Equine Science Program Student & staff • LSU SVM students & LSU Pre-vet students• LSART Volunteers

Building Community Resilience!

Director of LSART – Dr. Renee Poirrier