Control of Infectious Diseases in Vet Hospitals

Infectious disease outbreaks that occur in veterinary hospitals (nosocomial outbreaks) can present an overwhelming challenge to veterinary personnel, and they are often events that incite a greater awareness and concern for routine infection control efforts. Josie Traub-Dargatz, DVM, MS, Dipl. ACVIM, professor of equine medicine at Colorado State University's College of Veterinary Medicine and Biomedical Sciences, Animal Population Health Institute, addressed the nuances of these issues in her presentation at the American College of Veterinary Internal Medicine's convention earlier this year.

She directed most of her comments to veterinarians providing care for patients in a teaching hospital or large practice. Yet, she admits, "The best facility can't achieve zero infection occurrence. Our goal is to keep it to a minimum. One objective of infection control plans is to avoid outbreaks of nosocomial infections. However, if an outbreak occurs, it does not mean that the hospital was not up to standard."

Many lessons can be learned from methods used to control infections in human care facilities. However, "there are distinct differences between human and animal patients regarding the cause and methods necessary to control infectious disease spread among patients," said Traub-Dargatz.

"Animals in the hospital population are inherently high-risk for certain infections because of the sheer fact part of the population is sick animals," says Traub-Dargatz. "Yes, it's important to recognize that our hospital patients are at risk for spread of infectious disease, but being aware of this risk, we can take precautions."

The following factors put horses at increased risk for infections: Animals might have an alteration in diet, were transported, or be on medications that altered intestinal flora. A simple change in environment can increase stress.

"Protocols should be tailored to individual facilities and type of patient load," adds Traub-Dargatz. Animals that pose highly contagious infectious disease risk should be housed in an isolation facility. For example, additional precautions are taken at her hospital for animals posing high risk of shedding Salmonella spp. (a bacteria that causes diarrheal illness).

When unexpected illness develops within the patient population, aggressive action is warranted. "When fever isn't expected as part of the original complaint, we immediately try to determine what caused it, especially if it occurs in multiple patients over a short time period. If, for example, it's influenza, we isolate those affected by it and instruct new clients to be sure their horses are immunized against flu prior to coming in." Prompt and thorough evaluation of apparently related events is critical as is implementation of appropriate diagnostics.

"Many lessons learned at our hospital have helped us help owners at the farm level," says Traub-Dargatz. "Our monitoring and control methods may be more than would be indicated at a farm but the lessons learned are still valuable."

In summation, each facility needs its own plan based on population, hospital design, and problems that arise. "For some diseases we have absolutely zero tolerance, while others, based upon the population, occasionally will occur and must be detected as quickly as possible and dealt with appropriately."

About the Author

Stephanie Stephens

Stephanie Stephens is a USEF Media Award winner and American Horse Publications award winner whose work appears in major consumer magazines worldwide. She lives in Southern Calif., but she splits her time between New Zealand and the United States.

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