Difficulties experienced by veterinarians when communicating about emerging zoonotic risks with animal owners: the case of Hendra virus

Risk Communication on Zoonoses and Antimicrobial Resistance-How Do Exotic Pet Owners Perceive the Communication of Their Veterinarians?

Exotic animals traded and kept as pets can transmit a variety of diseases to humans and other animals, and vice versa. Therefore, it is essential for pet owners, particularly vulnerable groups, to be informed about associated risks. Veterinarians play a crucial role in informing pet owners about health risks associated with zoonotic pathogens and antimicrobial resistance (AMR) and should, therefore, have good communication skills to effectively transfer information to pet owners. Thus, exotic pet owners in Germany were surveyed on animal husbandry, veterinary consultation and risk communication. To evaluate the perception of communication, a self-developed questionnaire was used to derive a communication score. The perception of veterinarian communication received a high average score showing a high level of satisfaction. The duration of the veterinarian-client relationship was associated with better communication perception, and the frequency of communication on zoonoses and AMR was associated with the presence of a permanent veterinarian. However, the results indicated that the frequency of disseminated information on zoonoses and/or AMR from veterinarians was lower than desired by the pet owners. Therefore, more educational material on zoonoses and AMR should be made available, and the awareness concerning risk communication should be increased by further education and training at universities.

Perception and Knowledge of Portuguese Veterinarians about the Zoonotic Transmission of Helicobacter pylori and Helicobacter suis: The Need for One Health Intervention

Helicobacter species can colonize the gastrointestinal tract of both humans and animals, and are associated with gastrointestinal and extra-gastrointestinal diseases. Some studies indicate that animals, health professionals, and people in close contact with animals might be at higher risk for infection with gastric Helicobacter spp. Considering that veterinarians are professionals at risk for infection with zoonotic gastric Helicobacters and are also seen by many as health communicators concerning zoonoses, the aim of this study was to evaluate the Portuguese veterinarians' perception and knowledge of Helicobacter spp. infection and its zoonotic risk/potential. Therefore, a structured questionnaire composed of 34 dichotomic, multiple-choice, rating scale, matrix, drop-down, and open-ended questions was developed and given to Portuguese veterinarians via an online platform from May 2021 to July 2021, and statistical analysis was used to obtain results. There was a total of 149 respondents, most of them (73.8%) being females. Evidently, Portuguese veterinarians have a limited perception regarding Helicobacter spp. infections. Of the respondents that "have heard of Helicobacter", 17.6% do not know which animal species can be affected by it. Most of the companion animal veterinarians (76.2%) do not consider Helicobacter spp. infection a differential diagnosis when evaluating animals with gastritis. A significant percentage (37.2%) of the respondents that have "heard of H. suis" do not consider it a zoonotic bacterium. There is a need for education and sensitization of veterinarians regarding the potential zoonotic risk of Helicobacter spp. in order to elucidate these professionals to this One Health issue, as the number of reports of non-Helicobacter pylori Helicobacter in livestock, companion, and wild animals is increasing.

'It's our job': Constraints to investigation of atypical disease events-Opinions of Australian veterinarians

Frontline health practitioners need to be adequately prepared to recognize and respond to atypical disease presentations, some of which may have zoonotic potential. Data from previous research have suggested that veterinarians may face challenges in investigation of disease events due to time and money constraints. As part of an Australia-wide survey project, veterinarians were asked to answer an open-ended question regarding potential constraints in investigation of atypical disease events where there may be concern about a zoonosis or emerging infectious disease. Qualitative data were analysed using thematic content analysis with the consideration of the respondent's area of practice and level of experience. Five main themes were identified which encapsulated constraints to disease investigation described by participants, namely: (a) financing of disease investigations, including client willingness/ability to pay in absence of alternative government schemes; (b) client-related factors, including willingness to consent to investigation and comply with instructions; (c) professional preparedness to act, related to practitioner knowledge and technical competency; (d) workplace environment, impacted by physical, logistical and managerial aspects of workplaces; and (e) access to external technical support, primarily from government veterinary services. Successful investigation and management of atypical diseases, including potential zoonoses, requires preparedness of all veterinarians. Continuing professional education for veterinarians in infection prevention and control and biosecurity, alongside adequate government funding and support will help facilitate optimal health and biosecurity outcomes. Both state and federal governments need to review existing animal health structures to ensure cohesive responses for future disease events.

An integrated review of the role of communication in veterinary clinical practice

BACKGROUND

There is a growing interest in exploring the nature of communication in veterinary medicine and understanding how veterinary practitioners communicate with their clients and other professionals. This is the first integrative review of literature on veterinary communication. Applying the PRISMA model, the PubMed, PsychInfo and ERIC databases were searched using keywords such as 'veterinary', 'vet', 'communication' and 'interaction' for related articles published between 1 January 2000 and 31 December 2018.

RESULTS

Keyword searching through the databases yielded 1572 related studies. Only 48 of these studies were included in our analysis after an in-depth review by two independent reviewers using the critical appraisal skills Programme frameworks with high inter-rater reliability (Cohen's kappa coefficient κ > 0.8). The existing body of research on veterinary communication can be classified into three major areas: (a) client-veterinarian communication, (b) cross-disciplinary communication in a professional veterinarian team and (c) training of veterinary communication skills. This review details the complexity and heterogeneity of agenda in the field of veterinary communication. The included studies indicate that veterinary practitioners are not equipped with specific communication skills to address different agendas in veterinary communication. The veterinary curriculum should include a component on communication training that can help veterinary students acquire necessary communication skills that allow them to effectively communicate with clients and other professionals CONCLUSION: This review detailed the complexity of agendas in the field of veterinary communication. The results indicate that veterinary practitioners can further benefit from training on specific communication skills that address the agendas found in veterinary communication research. Furthermore, the veterinary curriculum should include a component on communication training that equips veterinary students with the necessary communication skills that allow them to effectively communicate with different stakeholders such as clients and colleagues with and across the field of veterinary science.

"Prevention is the biggest success": Barriers and enablers to personal biosecurity in the thoroughbred breeding industry

Employees in the equine industry are at occupational risk of zoonoses such as Hendra virus and equine chlamydiosis through exposure to infected materials. This study aimed to gain a deeper understanding of the views and experiences of employees, and the key drivers of infection control and personal biosecurity (PB) practices in the Thoroughbred breeding industry. Methods: An exploratory qualitative study was conducted in 2018 in New South Wales, Australia using interviews (9) and small group discussions (7). The 29 participants included veterinarians, veterinary nurses, foaling staff, stud managers and laboratory personnel working in a range of equine medicine settings. Interviews and focus groups were recorded, transcribed and analysed manually by at least two members of the research team. An iterative approach was used to derive themes. Results: Five main themes emerged: (i) greater awareness of current and emerging infectious risks promotes use of Personal Protective Equipment (PPE); (ii) currently available PPE is not comfortable, practical or well-suited to equine reproductive work in Australia's hot climate; (iii) creating supportive environments for PB reduces risk of exposure to infectious materials; (iv) strong leadership is required to implement sustainable change in workplace culture and practices; and (v) policy and economic factors play an important role in adopting biosecurity (BS) and PB measures in the workplace. Personnel working in the Australian Thoroughbred breeding industry face unique zoonotic risks in a challenging physical environment. A qualitative approach provided rich insights into social and physical factors motivating BS and PB in this occupational group. There is an opportunity for collaboration between Public Health services and industry partners to develop and implement strategies most likely to be effective in ensuring consistent uptake of PB measures in the workplace.

Zoonotic Diseases from Horses: A Systematic Review

Background: Worldwide, horses play critical roles in recreation, food production, transportation, and as working animals. Horses' roles differ by geographical region and the socioeconomic status of the people, but despite modern advances in transportation, which have in some ways altered humans contact with horses, potential risks for equine zoonotic pathogen transmission to humans occur globally. While previous reports have focused upon individual or groups of equine pathogens, to our knowledge, a systematic review of equine zoonoses has never been performed. Methods: Using PRISMA's systematic review guidelines, we searched the English literature and identified 233 previous reports of potential equine zoonoses found in horses. We studied and summarized their findings with a goal of identifying risk factors that favor disease transmission from horses to humans. Results: These previous reports identified 56 zoonotic pathogens that have been found in horses. Of the 233 articles, 13 involved direct transmission to humans (5.6%).The main potential routes of transmission included oral, inhalation, and cutaneous exposures. Pathogens most often manifest in humans through systemic, gastrointestinal, and dermatological signs and symptoms. Furthermore, 16.1% were classified as emerging infectious diseases and thus may be less known to both the equine and human medical community. Sometimes, these infections were severe leading to human and equine death. Conclusions: While case reports of zoonotic infections directly from horses remain low, there is a high potential for underreporting due to lack of knowledge among health professionals. Awareness of these zoonotic pathogens, their disease presentation in horses and humans, and their associated risk factors for cross-species infection are important to public health officials, clinicians, and people with recreational or occupational equid exposure.

Information delivery and the veterinarian-horse owner relationship in the context of Hendra virus in Australia

Hendra virus (HeV) is an emerging bat-borne virus endemic in Australia that can be transmitted from horses to humans and has a high fatality rate for horses and people. Controversy surrounding HeV risk mitigation measures have strained the veterinarian-horse owner relationship. This study aimed to characterise the veterinarian-horse owner relationship in general and also in the context of HeV by analysing data derived from the 'Horse Owners and Hendra Virus: A Longitudinal Study to Evaluate Risk' (HHALTER) study. Australian horse owners were recruited via emails, social media and word-of-mouth for a series of five surveys that were administered online at six-monthly intervals over a two-year period to capture baseline knowledge, attitudes and practices of horse owners regarding HeV and any changes over time. In the current study, descriptive analyses of information sources were performed to understand the use of veterinarians as a HeV information source (Surveys 1 and 5; n = 1195 and n = 617). Ordinal logistic regression analyses were conducted to determine factors associated with the frequency of horse owner contact with a veterinarian (Survey 3; n = 636). This study found a relative increase over the study period in the proportion of horse owners who had used veterinarians as HeV information source in the last 12 months (from 51.9% to 88.3%). Owning more horses, being older, having a 'duty of care' for other people working with horses and deriving the main income from horse related business were factors associated with more frequent veterinary contact. Results suggest that traditional information sources such as workshops, information packs and risk training are likely to be used by horse owners. Smart phone applications should be considered for use in the future and require further investigation for horse health communication. The findings of this study may be helpful in optimising strategies for horse health information delivery.

Trajectories of public psycho-behavioural responses relating to influenza A(H7N9) over the winter of 2014-15 in Hong Kong

OBJECTIVE

To explore trajectories of public psycho-behavioural responses over one influenza A(H7N9) epidemic wave, and examine the interplays among social norm influence, disease worry and protective behaviours.

METHODS

Participants were 464 adults who completed the baseline and at least two follow-up assessments on their H7N9-related Perceived Susceptibility, Perceived Severity, Perceived Efficacy, Worry, Social Norms influence and Protective Behaviours in a five-phase longitudinal survey over one H7N9 epidemic wave. Latent growth modelling (LGM) identified trajectories of these psycho-behavioural responses while multi-process LGM examined the inter-relationships among trajectories of Social Norms influence, Worry and Protective Behaviours.

RESULTS

Trajectories of Perceived Susceptibility, Worry, Social Norms and Protective Behaviours increased initially but declined as the epidemic decayed, while Perceived Severity increased linearly and Perceived Efficacy remained stable across the epidemic. Change in Social Norms influence was significantly associated with change in Worry (β = 0.65) which was significantly associated with change in Protective Behaviours (β = 0.62).

CONCLUSION

The public's threat appraisal but not efficacy appraisal may have been well-informed by epidemic-related information. Social Norms may be important contributors of public emotional response to an epidemic. Communication via social networks during an epidemic could be important for regulating public emotional response and guiding their behavioural change.