Biosecurity in a Large Animal Hospital

The veterinary profession--like human medicine--is placing new emphasis on infectious disease prevention in patient facilities. Bradford P. Smith, DVM, Dipl. ACVIM, discussed this topic at the American College of Veterinary Medicine (ACVIM) conference in June on behalf of his co-author colleagues John K. House, BVSc, PhD, Dipl. ACVIM; K. Gary Magdesian, DVM, Dipl. ACVIM ,and John E. Madigan, DVM, MS, Dipl. ACVIM, from the School of Veterinary Medicine at University of California, Davis.

"The goal of biosecurity is to prevent the spread of contagious diseases between patients," Smith noted. Numerous large animal hospitals, both private and institutional, have experienced nosocomia or hospital-borne disease outbreaks, most commonly in horses. Equids are very susceptible to enteric pathogens such as Salmonella and Clostridium difficile when they don't consume a normal amount of feed, are receiving antibiotics, have had surgery involving the gastrointestinal tract, or are stressed by high environmental temperatures or concurrent illness.

"Similarities do exist between large animal and human hospitals," said Smith, "but in reality, it’s very different. Most notably, in large animal hospitals, fecal matter flows freely."

Cattle in a veterinary hospital often excrete Salmonella in feces, so cattle and horses should be housed separately and movement of people and equipment between them controlled. He said all hospitals should develop an Infectious Disease Control (IDC) program in order to reduce the number of pathogenic organisms to which patients are exposed, maximize patient resistance, and avoid increasing patient susceptibility.

Initial defenses include:

  • Preventing aerosol spread of pathogens such as equine influenza;
  • Instituting effective cleaning, disinfecting, and monitoring of enteric pathogens such as Salmonella;
  • Promoting appropriate personal habits of cleanliness (hand washing and clean boots);
  • Controlling flow patterns of human and animal traffic;
  • Separating equine housing; rapidly identifying patients with signs of a contagious disease or patients ill with a contagious pathogen and enforcing protocols for isolation; and
  • Controlling rodents, opossums, birds, and flies.

Cleaning crews must be educated and trained in procedures, Smith said.

He next stressed that hospitals should maximize resistance and avoid increasing the susceptibility of patients to contagious pathogens by controlling ambient temperature, minimizing the use of antimicrobial drugs, feeding to re-establish normal gut and rumen fauna, and increasing passive immunity through the administration of antisera.

The leader and person responsible for enforcing the program would be the IDC Officer who is, optimally, a respected clinician with the power to enforce protocols. "The IDC Officer should be given a stipend and appropriate recognition; in other words, underscore his or her critical role," suggested Smith. "An effective IDC program raises morale in the hospital and increases the confidence of clients and referring veterinarians, thus paying for itself in many ways."

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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