Occupational Risks and Exposures Among Wildlife Health Professionals

Mitigating Wildlife Spillover in the Clinical Setting: How Physicians and Veterinarians Can Help Prevent Future Disease Outbreaks

Introduction

The transmission of pathogens from wildlife to humans is a major global health threat that has been highlighted by the proposed origins of the COVID-19 pandemic. Numerous barriers impede pathogen spillover events from ensuing widespread human transmission, but human activity has accelerated the frequency of spillovers and subsequent disease outbreaks, in part through a booming wildlife trade whose impacts on health are not well understood.

Methods

A literature review was conducted to examine the risk that the wildlife trade poses to public health and the degree to which these risks are recognized and addressed in clinical practice and medical and veterinary education.

Results

The illicit aspects of the wildlife trade challenge efforts to understand its impacts on health. The U.S. and Europe play a leading role in the global wildlife trade that often goes unacknowledged. In particular, the consumption of wild meat and ownership of exotic pets poses public health risks. The potential role of clinicians is underutilized, both in the clinical setting and in clinical education.

Discussion

Physicians and veterinarians have the unique opportunity to utilize their clinical roles to address these knowledge gaps and mitigate future outbreaks. We outline a multifaceted approach that includes increasing clinical knowledge about the ecology of zoonotic diseases, leveraging opportunities for mitigation during patient/client-clinician interactions, and incorporating One Health core competencies into medical and veterinary school curricula.

First morphological and molecular isolation of Talaromyces marneffei in beech marten (Martes foina) in Portugal

Talaromyces marneffei is a zoonotic fungus that mostly infects immunocompromised individuals. For the first time, this fungus was isolated in an adult beech marten (Martes foina) hit by a car, found dead in Penamacor, Portugal. During the necropsy, different samples (skin, fur, lymph nodes, lung, spleen, kidneys, and brain) were collected and processed for microbiology (including mycology) and molecular biology. T. marneffei was identified through its mycological characteristics and confirmed by PCR in hair samples. No other lesions or alterations were reported, except a concomitant presence of M. avium subsp. paratuberculosis in lung, kidney and brain samples. To the authors' knowledge, this is the first description of this fungus beech marten, as well as the first case of co-infection with M. avium subsp. paratuberculosis in wildlife fauna. These results suggest a sylvatic life-cycle of T. marneffei, involving beech martens, in Portugal.

A Cross Sectional Study of Respiratory and Allergy Status in Dairy Workers

INTRODUCTION

Workers on dairy farms face exposures to organic dusts and endotoxin. At the same time, a number of studies of farmers have reported a lower prevalence of asthma in farmworkers compared to persons without farm contact. The "hygiene hypothesis" suggests that early life exposures on farms could be protective against allergic disease and asthma. Such protective relationships are less well studied in adult farm workers.

METHODS

A cross-sectional analysis of respiratory function and allergy status was performed in a sample of dairy farm workers (n = 42) and community controls (n = 40). Measures of respiratory status (spirometry, exhaled nitric oxide FeNO, self-reported symptoms) and levels of total and bovine-specific IgE were compared between the groups.

RESULTS

Prevalence of self-reported asthma and most respiratory symptoms was similar in the two groups, with the exception of increased report of dyspnea among dairy workers. In the dairy workers, level of lung function was not reduced and FeNO was not increased. In unadjusted and adjusted models, dairy work was not associated with reduced lung function or increased airway inflammation. Mean IgE levels did not differ significantly between workers and controls, but elevated bovine-specific IgE was detected only among dairy workers, with an apparent association between elevated bovine IgE and increased FeNO.

CONCLUSION

While dairy workers did not demonstrate increased asthma prevalence compared to controls, sensitization to bovine antigen in several workers appeared to be associated with airway inflammation. Occupational health programs for dairy workers should consider the risk of animal allergy as part of respiratory health protection efforts.

Bat E-Commerce: Insights Into the Extent and Potential Implications of This Dark Trade

Little is known about the global bat souvenir trade despite previous research efforts into bat harvest for bushmeat. We screened eBay listings of bats in Australia, Canada, Italy, Switzerland, United Kingdom and USA to assess the nature and extent of the online offers. A total of 237 listings were retrieved in between the 11th and 25th of May 2020 with a median price per item of US$38.50 (range: US$8.50–2,500.00). Items on offer were mostly taxidermy (61.2%) or skull (21.1%) specimens. Overall, 32 different species of bat were advertised, most of which (n = 28) are listed as “Least Concern” on the International Union for Conservation of Nature (IUCN) Red List. One species (Nycteris javanica) is classified as “Vulnerable” and one (Eidolon helvum) as “Near Threatened.” Pteropus spp. specimens were the most expensive specimens on offer and the conservations status of these species may range from “Critically Endangered” to “Data Deficient” by IUCN and the entire genus is listed in the Appendix II by the Convention on the International Trade in Endangered Species of Wild Fauna and Flora (CITES). However, the exact species concerned, and their respective conservation status, could not be confirmed based on the listings' photos. The sourcing of bat was restricted to mostly South-East Asian countries (a third of items sourced from Indonesia) and to two African countries. Our survey revealed that the online offer of bat products is diverse, abundant, and facilitated by worldwide sellers although most offered bats species are from South-East Asia. With a few exceptions, the species on offer were of little present conservation concern, however, many unknowns remain on the potential animal welfare, biosecurity, legal implications, and most importantly public health risks associated with this dark trade.

Coxiella burnetii seroprevalence and Q fever in Australian wildlife rehabilitators

Coxiella burnetii is the causative bacterium of the zoonotic disease Q fever, which is recognised as a public health concern globally. Macropods have been suggested as a potential source of C. burnetii infection for humans. The aim of this cross-sectional study was to determine the prevalence of C. burnetii exposure in a cohort of Australian wildlife rehabilitators (AWRs) and assess Q fever disease and vaccination status within this population. Blood samples were collected from adult participants attending the Australian Wildlife Rehabilitation Conference in Sydney in July 2018. Participants completed a questionnaire at the time of blood collection. Antibody titres (IgG, IgA and IgM) against phase I and phase II C. burnetii antigens as determined by immunofluorescence assay, revealed that of the unvaccinated participants, 6.1% (9/147) had evidence of exposure to C. burnetii. Of the total participants, 8.1% (13/160) had received Q fever vaccination, four of whom remained seropositive at the time of blood collection. Participants reporting occupational contact with ruminants, were eight times more likely to have been vaccinated against Q fever, than those reporting no occupational animal contact (OR 8.1; 95% CI 1.85-45.08). Three AWRs (2%) reported having had medically diagnosed Q fever, two of whom remained seropositive at the time of blood collection. Despite the lack of association between macropod contacts and C. burnetii seropositivity in this cohort, these findings suggest that AWRs are approximately twice as likely to be exposed to C. burnetii, compared with the general Australian population. This provides support for the recommendation of Q fever vaccination for this potentially 'at-risk' population. The role of macropods in human Q fever disease remains unclear, and further research into C. burnetii infection in macropods including: infection rate and transmission cycles between vectors, macropods as reservoirs, other animals and humans is required.

Zoonotic Disease Exposure Risk and Rabies Vaccination Among Wildlife Professionals

More than 70% of zoonotic diseases are wildlife associated putting wildlife professionals at increased risk of occupational exposure. In 2008 and 2018, the Arizona Department of Health Services surveyed Arizona wildlife professionals from multiple agencies to assess the risk of disease exposure, rabies pre-exposure prophylaxis (PrEP) history, personal protective equipment (PPE) use, and zoonoses knowledge. In 2008, a 12-question survey was distributed at a state wildlife professional meeting using an anonymous email link. In 2018, a 20-question survey was distributed using an anonymous email link to wildlife agency employees. We received 164 and 81 complete responses in the 2008 and 2018 surveys, respectively. Bites from rabies reservoir or spillover species were higher in 2008 (42%) than in 2018 (16%). More respondents received PrEP in 2018 (53%) than in 2008 (45%). Among 43 respondents who performed necropsies or collected animal samples within the past 5 years (2014-2018), only 60% always wore latex or nitrile gloves, and 79% never wore a facemask. Respondents indicated lower awareness of certain zoonoses, including brucellosis (72%) and leptospirosis (60%). Results on zoonoses awareness and reasons for non-use of PPE highlighted targets for education to improve practices, including facilitation of PPE training to prevent future disease transmission.

A review of roadkill rescue: who cares for the mental, physical and financial welfare of Australian wildlife carers?

The non-human animal deaths and injuries that result from collisions with motor vehicles are known colloquially as roadkill, and often lead to individuals from various taxa being orphaned. The complexities of multiple spatial and temporal variables in the available data on Australian roadkill and the scale of orphaning and injury make statistical analysis difficult. However, data that offer proxy measures of the roadkill problem suggest a conservative estimate of 4 million Australian mammalian roadkill per year. Also, Australian native mammals are mainly marsupial, so female casualties can have surviving young in their pouches, producing an estimated 560 000 orphans per year. A conservative estimate is that up to 50 000 of these are rescued, rehabilitated and released by volunteer wildlife carers. These roadkill-associated orphans are in addition to those produced by other anthropogenic and natural events and the injured adult animals in the care of volunteers. In accepting total responsibility for rescued animals, wildlife carers face many demands. Their knowledge base can require days of initial instruction with the need for continual updates, and their physical abilities and personal health can be tested by sleepless nights, demanding manual tasks and zoonoses. This review article explores the impact of this commitment and conservatively estimates carers’ financial input to raise one joey at approximately $2000 a year, and their time input at 1000 h, equating to $31 000 per year, applying a dollar value of $31 per hour. It categorises relevant types of grief associated with hand-rearing orphans and rehabilitating injured animals, and suggests that wildlife carers most likely experience many types of grief but are also susceptible to burn-out through compassion fatigue. A perceived lack of understanding, empathy and appreciation for their work by government can add to the stressors they face. Volunteering is declining in Australia at 1% per year, social capital is eroding and the human population is aging, while the number of injured and orphaned animals is increasing. Wildlife carers are a strategic national asset, and they need to be acknowledged and supported if their health and the public service they provide is not to be compromised.