Healthy fairs

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Healthy fairs

• Gail R. Hansen, DVM, MPHKansas Department of
  Health and Environment
• Ghansen_at_kdhe.state.ks.us

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Short version(If you have to leave now)

• Website
• http//www.cdc.gov/mmwr/preview/mmwrhtml/rr5404a1.
  htm

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Zoonoses and fairs

• Historical perspective
• Why you are glad you arent in FL,NC, AZ
• Compendium
• Prevent disease from animals in public settings
• Specific diseases
• What does this mean for you
• Practical tips
• QA and Discussion

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Definition

• Zoonosis
• Disease of animals transmissible to humans

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Basic tenet

• Animals at fairs are a GOOD idea
• Entertainment
• Education

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When bad things happen to good exhibits
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• 25 outbreaks from 1990-2000
• E. coli 2000
• PA
• 51 ill
• WA
• 5 ill
• Salmonella 1996
• Denver zoo Dragon days
• gt75 ill
• Many never touched the reptile
• directly

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• E. coli, NC
• Oct. 2004
• State fair
• 108 ill
• 13 hospitalized
• E. coli found months later
• Parent awareness of potential more likely to help
  than using a hand sanitizer

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Credit John R. Dunn, DVM, PhD
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Systematic sample of Petting Zoo B

• Soil / shavings sampled 16 days after fair
• Results sheep / goat area uniformly contaminated
  with E. coli O157

Sheep and goats
Credit John R. Dunn, DVM, PhD
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Systematically re-sampled Petting Zoo B 100 days
after fair

• Results
• Sheep and goat area remained uniformly
  contaminated

Sheep and goats
Credit John R. Dunn, DVM, PhD
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• E. coli, FL
• Local fairs, petting zoos
• 26 confirmed, 68 total
• 22 hospitalized

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• E. coli, AZ
• July 2005
• Petting zoo (in a zoo)
• 2 children hospitalized
• Only 1 with direct contact
• E. coli found in petting zoo area and play area
  downhill from petting zoo
• Petting zoo and play area closed

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Increased chance of illness

• Populations at higher risk
• Infants
• Children lt5
• Pregnant women
• People undergoing chemotherapy
• People with organ transplants
• People with HIV/AIDS
• Elderly

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Increased chance of disease

• Riskier animals
• Reptiles
• Chicks/ducklings
• Puppies, kittens lt 6 months
• Animals with diarrhea
• Exotic and wild animals

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Compendium

• Measures to Prevent Disease Associated with
  Animals in Public Settings 2005
• Not eliminate
• Minimize risks
• NASPHV/CDC
• Document on CD-ROM

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Specific diseases

• Enteric diseases
• Salmonella
• E. coli O157H7
• Campylobacter
• Rabies
• Other pathogens
• Bites/injuries

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Salmonella

• Bacteria
• Contamination of bedding, fur, skin, saliva
• Fecal/oral transmission
• Diarrhea/vomiting
• May be bloody diarrhea
• Illness 6-72 hours after exposure

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Salmonella

• All are animal origin
• Reptiles
• Intermittent shedding
• No treatment
• Poultry
• Eggs
• Chicks, ducklings
• Swine, cattle, sheep, goats

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E. coli O157H7

• Bacteria
• Diarrhea/vomiting
• Bloody diarrhea
• Kidney failure (HUS)
• Illness 3-8 days after exposure
• Unpasteurized juice, undercooked hamburger

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E. coli O157H7

• Animals
• Cattle
• Deer
• Infected animals rarely look ill
• Shed when stressed
• Summer and fall
• Peak shedding

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Campylobacter

• Bacteria
• Diarrhea/vomiting
• GBS can occur later
• Illness 1-10 days after exposure

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Campylobacter

• Raw milk
• 2 outbreaks in KS in past 3 years
• Kittens, puppies
• Usually with diarrhea
• Poultry
• Horses

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Rabies

• Virus
• Fatal
• All mammals potential
• Carnivores most likely
• Calf at local KS fair
• Discovered before fair opened
• ADR, sent home

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Parasites and more

• Ringworm
• GA, show lambs
• Cryptosporidiosis
• Orf
• Leptospirosis

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Bites/injuries

• Dis-ease
• Avoidable
• Bites, scratches
• Kicks
• Falls from animals, crushing

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Laws and Regulations

• Regulations in KS
• KAHD regs on inspection
• No federal laws
• Guidelines
• Federal
• State
• This meeting

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Recommendations

• Education
• Handwashing
• Food away from animals
• Signs
• Cleaning/disinfection
• Environment

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Education

• Operator
• Staff
• Able to explain to visitors
• Authority to enforce
• Encourage animal/human interaction
• Available fo injury/bite reports

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Education

• Exhibitor
• Specifics on their animal(s)
• Instructions if animal gets sick
• Visitor
• Field trips/group trips
• Individuals/families

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Handwashing

• THE most effective prevention
• Most zoonoses transmitted fecal-oral
• Thorough and often
• Plain soap and water best
• Waterless gels ok
• Stations available

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Handwashing

• Have stations available outside animal areas
• Keep clean and supplied
• Shoe scrapers?

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Food away from animals

• No food or beverages allowed in animal areas
• Discourage
• Smoking
• Pacifiers
• Bottles/sippy cups
• Carrying toys

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More on Food

• If visitors allowed to feed animals
• Only approved foods
• Not in containers that can be eaten by people
  (e.g., ice cream cones)

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Signs

• Different formats
• Know your audience
• Literacy
• Poster contests?
• Post at entrance and exits
• Handwashing signs near food concession areas
• Included in CD-ROM

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Wash Hands
After Leaving
Animal
Exhibit Area
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Please supervise children in animal areas
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Please leave toys and pacifiers outside
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This way
to
Handwashing area
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No Food or Drink in Animal Exhibit Area
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Available in English and Spanish
www.kdhe.state.ks.us/fofs/handouts/did_you_wash_em
_color_sign.pdf
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Cleaning

• Manure and soiled bedding removed as needed
• Scheduled
• Unscheduled
• Avoid trucking through food areas
• At least avoid spillage

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Cleaning

• Disinfect after after removing bedding, other
  organic matter
• 1-5 Bleach solution works well
• Make fresh daily
• Other disinfectantssee CD-ROM

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Environment

• Flow through
• Animal and non-animal areas
• Food prepared/served in non-animal areas only
• Restrict uncontrolled access to animals
• Barriers

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Environment

• Drinking water separate from waste water
• Dont duct tape together
• If both leak.
• Back flow prevention devices
• Not for human consumption on hoses

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Keep fairs fun for everyone

• No unwelcome souvenirs!

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Questions?
Insert picture here
KDHE hotline [phone]
www.kdhe.state.ks.us