Contributors: Sarah Binns, Scott Weese, Karen Coyne

 Species: Canine   |   Classification: Miscellaneous

Introduction

  • Biosecurity are measures put in place to reduce the likelihood of the introduction of a disease into a country, region, or specific location, such as veterinary premises, or animal facility.
  • Infection control measures are designed to reduce the transmission of disease within and between locations once a disease is already present.
  • Biosecurity measures are often not specific to a particular disease or infectious agent. They tend to be a collection of general measures that should be useful for prevention of most infectious agents of concern. Specific biosecurity measures for individual pathogens may be applied as needed.
  • Both dog and cat diseases are transmitted in various ways including direct and indirect contact, horizontal (direct or indirect transmission between animals of the same generation) and vertical transmission (transmission between dam and offspring either before or during birth).
  • Direct contact is of particular significance for fragile pathogens that are unable to survive for extended periods outside the host; examples include feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV).
  • Indirect contact between animals occurs if infection is acquired from contaminated environments or a vector.
  • Contaminated environments might include bedding, grooming kits, bowls, litter trays, medical equipment and contact with feces.
  • Vectors may be biological; these are organisms that may not cause disease in their own right but may convey infectious organisms from one host to another. A number of significant canine diseases are transmitted by biological vectors; examples include sandflies that transmit leishmaniosis Canine leishmaniosis , ticks that transmit Lyme disease Borreliosis , and mosquitoes that can carry Dirofilaria immitis(heartworm Canine cardiopulmonary dirofilariasis ). Feline diseases transmitted by biological vectors include feline infectious anemia (FIA), caused by Mycoplasma haemofelis, which is transmitted by fleas.
  • People may also act as vectors by transporting infection on their skin, clothing or shoes. Examples include canine parvovirus (CPV Canine parvovirus ), a virus which is highly persistent outside the host.

Biosecurity measures

  • The most common biosecurity measures include monitoring, surveillance, isolation, movement restrictions, eradication and prevention.
  • Both biosecurity and infection control measures are designed to reduce the risk of disease transmission between and within species, including humans.
  • Biosecurity measures are based on a thorough risk assessment (see below).
  • Biosecurity measures can be designed and implemented at the international, national, regional and premises (including veterinary practices) levels.
  • Veterinarians are often the primary source of information about biosecurity for their clients, and veterinarians have unique expertise that is vital for national biosecurity and biological risk assessment.
  • The major principles of biosecurity for small animal veterinary premises include:
    • Identification of all animals at risk.
    • Identify the main infectious disease risks.
    • Protect against infection.
    • Reduce exposure to predisposing factors.
    • Manage personnel and visitors.
    • Record all activities.
    • Reduce the risk of disease introduction by controlling insect or animal vectors of disease.
  • Vector control is vital, especially in regions where arthropod-borne diseases such as Lyme disease, leishmaniasis and heartworm are prevalent.
  • Maintain records of all animal health events, including prophylactic treatments and disease incidents.
  • For some dog and cat premises, such as breeding establishments, rescue shelters, and boarding premises the following biosecurity measures should be taken into account.

Introduction of new animals

  • Know as much as possible about the health status of incoming animals, eg any common diseases associated with the origin of the animal
  • Control all movements on to the premises as strictly as possible.
  • Vet any incoming animals, this is of particular significance in rescue shelters were the disease status of the majority of new animals is unknown. In some instances, infectious diseases may be latent (eg FHV) and only become apparent after admission.
  • The vaccination status of new animals should be checked and verified if possible.
  • Isolate newly introduced animals; this is of particular significance in breeding establishments.
  • Vaccinate and provide anthelmintic treatment for new arrivals as necessary, as well as keeping prophylactic measures up to date for resident animals.
  • Test new arrivals if appropriate, eg for FIV, FeLV (cats).

Segregation and isolation

  • Keep newly acquired animals away from resident animals until you are as sure as possible that they are free of infection. Between 2 and 3 weeks will often be sufficient for disease to become apparent for most infectious diseases. However, some infectious agents can be carried by apparently healthy animals for prolonged periods of time, eg FCV in cats.
  • Be especially vigilant if animals are brought onto the premises from rescue facilities, or where animals congregate under stressful conditions.
  • Isolation comprises, at a minimum, prevention of direct contact with other animals and avoid the use of shared feed, water and equipment.
  • Isolate sick animals at the first sign of illness and check all other individuals. Handle sick animals or those in isolation facilities last.
  • Maintain strict hygiene precautions, especially in breeding establishments and when sick animals are present. Wash hands after dealing with sick/isolated animals.
  • Use protective clothing/barrier nursing if necessary.

Hygiene precautions

  • Use only approved disinfectants, in accordance with the label instructions and regulations. Note that disinfectants are ineffective in the presence of dirt and other organic matter.
  • Keep bedding clean and fresh. Used bedding is a source of contamination and should be disposed of using the appropriate measures.
  • Regularly remove feces from kennels/cages and litter trays.
  • Train all personnel in the principles of hygiene and disease security.
  • Clean and, if necessary, disinfect footwear on entering and leaving the premises.
  • Wash hands after handling cats and dogs.
  • Keep all vehicles, used for transport of dogs and cats clean and disinfect them when necessary.
  • Clean and disinfect all shared and hired equipment before and after use.
  • Used equipment should be disposed of safely.

Cat/Dog shows and other gatherings

  • Of most concern are diseases that are transmitted by vectors, aerosols or casual contact.
  • Pre-event veterinary inspections may be used.
  • If possible, isolate cats and dogs on return to the premises.
  • Minimize stress as far as possible during transportation and during shows.

Biosecurity for veterinary practices

  • By their nature, veterinary hospitals regularly admit dogs and cats with infectious diseases. Therefore, biosecurity is not relevant and the focus is on infection control to reduce the risk of further transmission of diseases to other animals or humans.
  • Development of a formal biosecurity program, based on a risk assessment for the particular practice (see below), is recommended.
  • Strict hand washing protocols should be adhered to; contaminated hands are probably the most important route of transmission of hospital associated infections.
  • Strict cleansing and disinfecting protocols should be used; disinfectants are inactive in the presence of organic matter, so surfaces should always be cleaned first.
  • Care should be taken not to contaminate vehicle surfaces. Items should be cleaned and hands washed before touching surfaces within the vehicle.
  • Additional precautions depend on the infectious diseases that are or may be present.
  • Handle infected and infectious animals last; use barrier nursing techniques where appropriate. Protective outerwear should be changed after handling a potentially infectious animal. This involves either a complete change of standard outerwear or using an extra layer of outerwear, ie lab coat, overalls, protective gown, over normal outerwear, which is changed or discarded after each use.
  • All items in contact with potentially infectious animals must be disinfected or disposed of after use. An adequate supply of equipment is required to facilitate this.
  • Effective communication is required to ensure that staff understands the reasons for the biosecurity measures and to achieve good compliance.

National biosecurity

  • National biosecurity is involved with maintaining the freedom of a nation or region from foreign diseases (exotic diseases) that are not currently present, and protecting the entire population of a nation from disease risks of all types, including bioterrorism.
  • Such diseases are often notifiable diseases, the occurrence of which must be reported by member countries to the World Organization for Animal Health (OIE).
  • The OIE publishes the Terrestrial Animal Health Code and the Manual of Diagnostic Tests and Vaccines for Terrestrial Animals (and equivalents for aquatic animals), which provide internationally recognized standards for animal health and biosecurity.
  • Surveillance and monitoring of endemic and exotic diseases is vital for national biosecurity, as is information transfer between different regions. This is usually carried out by the government veterinary services of a given country.
  • Disease introduction to a country can occur deliberately or accidentally, and a series of risk mitigation measures and regulations are generally implemented to prevent disease incursions through importation, smuggling or trans-shipment (movement across one country en route to another) of animals and animal products
  • Animal disease agents could theoretically be carried by human travellers or items in their baggage, and airport controls are designed to reduce this risk.
  • On entry of an animal to a country, the veterinary services will often perform checks of documentation, review of identification, visual inspection, prophylactic treatments for specific disease agents and vectors, testing and perhaps quarantine.
  • Surveillance schemes present in the UK to identify exotic diseases in dogs and cats include the Dog and Cat Travel and Risk Information (DACTARI).
  • DACTARI is a voluntary reporting scheme launched by the department for Environment and Rural Affairs (DEFRA) in 2003. DACTARI intends to report any exotic diseases of dogs and cats, but currently the focus in on four main diseases, Leishmaniosis Canine leishmaniosis , Babesiosis Babesiosis , Ehrlichiosis Ehrlichiosis and Dirofilariasis Canine cardiopulmonary dirofilariasis.
  • The Pet Travel Scheme (PETS Pet Travel Scheme ) is a system in place that allows pet dogs, cats and ferrets from certain countries to enter the UK without quarantine, as long as they adhere to certain rules. Dogs, cats and ferrets resident in the UK can also travel to EU countries and return to the UK, without the need for quarantine.
    • The rules are to keep the UK free from rabies and certain other diseases.
    • Animals must have been vaccinated against rabies
    • Rabies Rabies disease is the only notifiable disease in dogs and cats.

Risk assessment and other epidemiologic techniques

  • Risk assessment should be performed to allow adaptation of generic biosecurity procedures, as listed above, to the individual circumstances of a premises, region or nation.
  • Risk assessment (or hazard analysis) is the estimation of the severity and likelihood of harm or damage resulting from exposure to hazardous agents or situations (Codex Alimentarius, 1995).
  • Risk assessment may be qualitative, ordinal or quantitative.
  • Risk assessment is usually carried out in stages, including:
    • Hazard identification, eg what are the disease problems of concern?
    • Exposure assessment, eg how likely are the problems to occur?
    • Risk characterization, eg what is the magnitude of the problem?
  • Risk assessment is then followed by risk management (implementation of methods of prevention) and risk communication, to personnel, visitors, etc.
  • Hazard identification is used to focus on and prioritize the microbial and chemical agents that present the greatest risks, based on the severity of associated diseases and their prevalence in the population at large.
  • Exposure assessment may be based on the analysis of risk factors for the introduction of a given disease or agent. An assessment should be made of the likelihood of the disease occurring on the premises.
  • Risk assessment is being used in the development of hazard analysis and critical control point (HACCP) plans in international trade of animals and animal products.
  • HACCP principles can also be used in designing biosecurity programs for individual premises. Critical control points to break the transmission of infective agents are identified, and corrective actions implemented, eg quarantine.
  • The study of risk factors also allows the design of appropriate preventive measures.
  • Quantitative models may be developed to represent the transmission of disease agents and, when properly validated, can be used in risk assessment and to guide disease control policy. Models can be used to evaluate and compare various biosecurity measures, including the use of diagnostic tests.

Infection control

  • Infection control measures are designed to reduce the transmission of disease within and between locations once a disease is already present.
  • As with biosecurity, infection control measures can be based at the premises (dog/cat or veterinary establishment), regional, national or international levels. All facilities should have a formal infection control program, then intensity of which varies greatly.
  • The goal is to prevent transmission of the infection to other premises, other animals or individuals of other species, including humans.
  • Programs at all levels should be based on a risk analysis approach, as described for biosecurity (see above).
  • Epidemiological studies designed to identify risk, or predisposing, factors for a particular disease can lead to the development of appropriate control measures.
  • All infection control is based on the implementation of effective surveillance and monitoring systems to detect the presence of infection and estimate its prevalence (see below).
  • Vaccination as a form of infection control is covered elsewhere Vaccination strategies - the future.

Surveillance, monitoring and outbreak detection

  • Surveillance is typically used to cover any activity evaluating infectious diseases, including endemic diseases.
  • Many countries have national schemes for surveillance and monitoring of infectious diseases in horses and farmed livestock. In contrast national schemes for surveillance and monitoring of infectious diseases in dogs and cats are limited. Surveillance schemes present in the UK to identify exotic diseases in dogs and cats include the Dog and Cat Travel and Risk Information (DACTARI).
    • DACTARI is a voluntary reporting scheme launched by the department for Environment and Rural Affairs (DEFRA) in 2003. DACTARI intends to report any exotic diseases of dogs and cats, but currently the focus in on four main disease, Leishmaniasis, Babesiosis, Ehrlichiosis and Dirofilariasis.
  • The Pet Travel Scheme (PETS) is a system in place that allows pet dogs, cats and ferrets from certain countries to enter the UK without quarantine, as long as they adhere to certain rules. Dogs, cats and ferrets resident in the UK can also travel to EU countries and return to the UK, without the need for quarantine.
  • Other surveillance schemes in small animals in the UK include:
    • CICADA, a computer based investigation of companion animal disease awareness
    • Acarus, the University of Bristols dedicated laboratory for the PCR detection of arthropod-borne infectious diseases in companion animals.
    • SAVSNET, a national program to investigate disease in the small animal population.
  • Surveillance schemes in small animals elsewhere are limited.
  • In a large facility, one member of staff should be designated to compile and monitor the results of laboratory testing, and to instigate any action if required. Thresholds for implementation of control procedures can be established if the baseline incidence is known.
  • The sensitivity and speed of surveillance and monitoring for pathogens has been greatly increased by the use of improved culture techniques, polymerase chain reaction (PCR Polymerase chain reaction ) testing, and serological assays.
  • Year-to-year comparison of the incidence of nosocomial infections Hospital-associated infections can be used to evaluate hospital-acquired control programs.
  • It is important to distinguish between hospital-acquired and community-acquired infections.

Transmission routes

  • Infectious agents can be secreted by a variety of routes. These routes of transmission can be taken into account when designing appropriate infection control methods.
  • Routes of transmission common in canine and feline diseases include:

General principles of infection control

  • Identify the diseases of significance and research their epidemiology.
  • For diseases spread by aerosols:
    • Maintain adequate distances between infected and unexposed animals.
    • Consider use of barriers.
    • Hygiene education of personnel (hand washing, protective clothing, etc).
    • Environmental cleansing and disinfection.
  • diseases spread by the feco-oral route require:
    • Disposal of feces and soiled bedding.
    • Prevent contamination of stored feed and water.
    • Hygiene education of personnel (hand washing, protective clothing, etc).
    • Environmental cleansing and disinfection.
  • Vector-borne diseases require control of insects and other vectors and reservoir hosts.
  • Avoid sharing of equipment and ensure adequate cleansing and disinfection of potential fomites.
  • Group animals according to their infection status.
  • Screening may be required to determine the presence of carriers.
  • Keep infected (and, particularly, infectious) dogs and cats in isolation and use barrier precautions.
  • Control movement of personnel between animals of different infection status.
  • Have protocols in place to rapidly identify potentially infectious animals.
  • Protocols for isolation defined for human hospitals and relevant to dog and cat facilities include:
    • Strict isolation.
    • Respiratory isolation.
    • Contact isolation.
    • Enteric precautions.
    • Drainage/secretion isolation protocols.
  • Important features of isolation areas include:
    • Physically separated from the rest of the facility.
    • A system of signage, eg color-coding on records, that alerts staff to the infection status of each animal.
    • Units should be designed so that animals rarely, if ever, have to leave the unit during their stay.
    • There should be minimal movement of personnel and items between the isolation unit and the rest of the establishment.
    • Showers and changing rooms should be available.
    • Kennel/Cattery facilities should be designed for ease of entry, and removal of waste. Surfaces must be amenable to disinfection.
    • Provision should be made for storage of equipment and consumables within the unit.
    • Closed-circuit or web-based cameras can be used for observation of patients.
  • Monitor for the occurrence of new cases of infectious disease through clinical examination and screening, and isolate and treat affected animals. The method of communication of the results of monitoring to all staff must be considered.
  • Implement basic hygiene procedures, eg hand hygiene and barrier precautions, which are appropriate to the likely routes of disease spread.
  • Hand hygiene is the most important infection control measure, but antibacterial rather than plain soaps must be used. Effective soaps may contain chlorhexidine, povidone-iodine, hexachlorophene or triclosan. Alcohol-based hand sanitizers may be used where there is minimal gross contamination. Nails should be short and jewellery should not be worn when in contact with patients.
  • Disinfection procedures should be appropriate for the pathogens encountered; therefore an accurate diagnosis of the cause of an outbreak is desirable:
    • Most bacteria and enveloped viruses are susceptible to chemical disinfectants if organic material has been removed by through prior cleaning to remove organic matter and biofilms.
    • Non-enveloped viruses are more resistant to disinfection, and therefore may remain persistent in the environment for prolonged periods of time, eg CPV.
    • Fungal spores, eg Microsporum canis Microsporum canis (Ringworm), are highly resistant to disinfection.
  • Barrier precautions are used to prevent contamination of personnel, other patients, and the environment. They are adapted to the route of transmission of the particular infectious agent, and include:
    • Provision of personal protective clothing to avoid contamination of the persons normal clothes, skin, eyes and mucous membranes. All protective clothing should be laundered or destroyed on site.
    • Use of gloves is particularly important, especially where transmission of zoonotic pathogens such as MRSA MRSA infection is a risk or where contact with feces, wound drainage, abscesses or nasal secretions may occur.
  • Strict hand hygiene is vital, even when gloves are used. Hands must be washed immediately after gloves are removed. Care should be taken not to contaminate surfaces by touching them with contaminated gloves.
  • Overboots or dedicated footwear should be provided.
  • Avoidance of blood contamination.
  • The economic cost of barrier precautions is a consideration, as are potential negative effects on patient care.
  • Protocols should be in place for control of various infectious agents if they are detected, or if the incidence of an endemic infection increases beyond a predetermined level. A vaccination program may be necessary, and vaccination of dogs/cats before admission may be advised.
  • Monitor compliance of personnel with infection control and biosecurity procedures.
  • Optimize resistance to disease by using vaccination, reducing stress, improving nutrition and minimizing the use of treatments, such as antibiotics, that may increase susceptibility to infection or encourage the development of resistant bacterial strains.

Infection control at premises level and veterinary practices

  • The objective of an infection control program at the premises level is to cure or prevent (further) clinical cases of the disease, to reduce the risk of introduction of infectious agents, and to prevent transmission of zoonoses to humans.
  • Recommendations for infection control on an infected premises are listed below.
  • If possible, avoid moving any animals on to or off the affected premises.
  • Segregate confirmed cases of disease, as well as dogs and/or cats with which they have had close contact, if possible to a dedicated isolation area.
  • Implement a monitoring program to allow for early detection of new cases.
  • Keep dogs/cats in quarantine following resolution of infection. The time required varies with the different infectious agent. In general, 34 weeks after signs of illness have passed is adequate, although some pathogens (FHV, FCV) can be carried for prolonged periods after resolution of clinical signs.
  • Put up signs to demarcate the isolation area and post a warning on the kennel/cattery doors of infected animals. Protective clothing (ideally disposable) and containers of disinfectant should be placed just outside the area.
  • If possible, different personnel should care for uninfected and infected animals. If this is not practicable, staff should work with healthy animals before those that are infected.
  • Keep equipment used for infected animals separate, including feed/water bowls, bedding, litter trays, containers, grooming and restraint equipment.
  • Personnel should ideally wear protective outer clothing and dispose after working with infected animals. Hands should be washed after working with infected animals.
  • Maintain daily records of health status and medicines administered to each animal.
  • After all animals have recovered and been returned to their normal accommodation, cleanse and disinfect the isolation area and all equipment.
  • Transfer of infectious diseases between dogs and cats should be considered when isolation sick animals, eg Bordetella bronchiseptica Bordetella bronchiseptica and CPV Canine parvovirus can be transmitted between species.

Infection control for veterinary practices

  • Hospital-based human epidemics of staphylococcal infections, including multi-resistant strains, have been reported since the 1950s and encouraged the development of hospital infection control policies.
  • The control of infectious diseases in small animal veterinary hospitals has been focused on zoonotic pathogens, respiratory disease in cats and contagious diarrheal diseases in dogs.
  • The objective of an infection control program in the veterinary practice reduces the risk of pathogen transmission to other hospitalized patients and personnel.
  • Further information about measures designed to prevent introduction of diseases into a practice can be found under Biosecurity. More information about nosocomial infections can be found under hospital-associated infections Hospital-associated infections.
  • The two major facets of any program to control hospital-based infections are:
    • Minimizing the number of pathogens to which patients are exposed.
    • Minimizing the impact of factors that render patients susceptible to infection, eg antimicrobials Therapeutics: antimicrobial drug , pain, high ambient temperature, pre-operative fasting (which alters the gastrointestinal flora).
  • A full hospital-associated infectious disease control program for a large facility will involve:
    • Surveillance and monitoring.
    • Investigation of outbreaks.
    • Education of personnel and visitors, particularly regarding hand hygiene.
    • Employee health.
    • Monitoring of antibiotic use and development of resistance.
    • Infection control protocols.
    • Monitoring of compliance.
  • It is important to involve staff in development of the infection control program and to encourage and monitor compliance with the measures.
  • Animals with contagious diseases must be isolated, as must those who are particularly susceptible to infection.
  • If there is no isolation unit in the hospital, animals isolated within the facility must be easily identified, moved as little as possible and strict hygiene measures must be followed. However, consideration must be given to whether it is appropriate to house potentially infectious dogs/cats in a facility without isolation capabilities. Care must be taken with barriers and waste disposal.
  • Programs are required to address infection control procedures for difference transmission pathways (see above for transmission routes).
  • Cleanse and disinfect contaminated equipment such as endoscopes, anesthesia equipment and surgical equipment.
  • Attention should be paid to the possibility of contamination of personal items, such as stethoscopes, mobile phones, pens and pagers. Stethoscopes should be cleaned with alcohol daily and after contact with a potentially infected patient.
  • Employ dedicated staff who is responsible for maintaining hygiene and cleanliness of the environment, independent of those who provide nursing care.