Apr 28 2019

Zoonotic infections – know the signs

Zoonotic Infections are organisms that can pass naturally between different animals and humans. They range in severity from nuisance to life threatening.

 

There are a wide range of circumstances where Trust staff, volunteers and guests can be exposed to these risks – practical work on pasture occupied by livestock, working next to bodies of water, general woodland tasks, walking through dense undergrowth where ticks may be present and many more.

 

The transmission of zoonotic infections occurs both after direct contact with an animal – handling livestock or mammal surveying for example, or indirect contact – inadvertently touching animal waste, or contaminated ground whilst working, without realising it.

 

The following guidance is to raise awareness of the risk of Zoonotic infections on Trust sites, and give general precautions to help prevent them.

 

There are more than 40 Zoonotic organisms present in the UK – this guidance does not cover them all – it highlights the most serious and the most common. The main aim of this guidance is to promote two things:

 

  • The importance of good hygiene among outdoor workers
  • The importance of seeking medical help promptly if you fall ill following outdoor activities.

 

 

 

 

 

Infection type: Rabies * Lyssavirus, Rhabdoviridae

Risk Factors

Classical rabies is an acute viral encephalomyelitis caused by several members of the Rhabdoviridae family. It transmits through infected saliva, via bites or scratches from rabid animals (in particular dogs).

Because it is almost invariably fatal once symptoms develop, rabies still poses a significant public health problem in many countries in Asia and Africa where 95% of human rabies deaths occur.

Post-exposure treatment using rabies vaccine is highly effective in preventing disease if given correctly and promptly after exposure. Approximately 2000 people each year require post-exposure treatment in England, of which 12% were potentially exposed to bats in the UK and 88% exposed to an animal overseas.

The UK has been free of rabies in terrestrial animals since 1922.

However, a rabies-related virus – European Bat Lyssavirus-2 (EBLV-2) – has been regularly found in Daubenton’s (Myotis daubentonii) bats across the UK in recent years.

EBLV-2 is a virus related to the ‘classical’ (terrestrial) rabies virus that is prevalent in Africa and Asia and can lead to clinical rabies infection in humans.

In October 2018, the presence of a different type of bat rabies virus, European Bat Lyssavirus-1 (EBLV-1) – responsible for the majority of bat rabies cases.

Reported in Europe – was confirmed for the first time in the UK in a serotine bat (Eptesicus serotinus).

Although the risk is low, anyone who comes into contact with a bat and is scratched or bitten, could, theoretically be at risk.

 

Symptoms

Without treatment, the symptoms of rabies will usually develop after 3 to 12 weeks, although they can start sooner or much later than this.

 

The first symptoms can include:

  • A high temperature (fever) of 38C or above
  • A headache
  • Feeling anxious or generally unwell
  • In some cases, discomfort at the site of the bite or scratch

 

Other symptoms appear a few days later, such as:

  • Confusion or aggressive behaviour
  • Seeing or hearing things (hallucinations)
  • Producing lots of saliva or frothing at the mouth
  • Muscle spasms
  • Difficulty swallowing and breathing
  • Inability to move (paralysis)

 

Once symptoms appear, rabies is almost always fatal.

 

General precautions & Treatment

Woodland Trust Bat hibernaculums must be entered with care and only under the guidance of a suitably trained specialist – advice can be sought from the Bat Conservation Trust.

 

Dealing with bats:

 

  • Don’t touch a bat (alive or dead) with your bare hands
  • If you have to touch a bat, always wear thick gloves
  • If you need to contain a bat to move it, cover the bat with a small box, such as a plastic tub, with air holes and then slide a sheet of card under the box
  • If you find a bat in your home, don’t attempt to catch it while it is flying.
  • Open a window to the outside as wide as possible, dim the lights and close the door leaving the bat alone in the room. A bat will usually fly out on its own
  • If your pet catches a bat, handle the bat safely as explained above and then keep your pet under observation. Contact your vet immediately if your pet falls sick or starts behaving unusually

 

Anyone bitten or scratched by a bat may need specialist medical treatment. Contact you GP for advice immediately or visit A&E

 

Post-exposure treatment involves:

 

  • Cleaning and disinfecting the wound
  • A course of the rabies vaccine – you’ll need to have 4 doses over a month if you have not been vaccinated against rabies before, or 2 doses a few days apart if you have
  • In some cases, a medicine called immunoglobulin is given into and around the wound – this provides immediate but short-term protection if there’s a significant chance you’ve been infected

 

Treatment should be started promptly – ideally within a few hours of being bitten or scratched – but it’s often safe to delay treatment until the next day if the vaccine or immunoglobulin need to be specially ordered in by your doctor.

 

 

 

 

 

Infection type: Botulism * Clostridium botulinum

Risk Factors

Botulism is a very rare but life-threatening condition caused by toxins produced by Clostridium botulinum bacteria.

These toxins are some of the most powerful known to science. They attack the nervous system (nerves, brain and spinal cord) and cause paralysis (muscle weakness).

Most people will make a full recovery with treatment, but the paralysis can spread to the muscles that control breathing if it isn’t treated quickly.

This is fatal in around 5 to 10% of cases.

Clostridium botulinum bacteria are found in soil, dust and river or sea sediments.

The bacteria themselves aren’t harmful, but they can produce highly poisonous toxins when deprived of oxygen, such as in closed cans or bottles, stagnant soil or mud, or occasionally, the human body.

Woodland Trust workers may come across botulism during almost any outdoor work activity.

 

Symptoms

The time it takes to develop symptoms can vary from a few hours to several days after exposure to the Clostridium botulinum bacteria or their toxins.

Depending on the exact type of botulism, some people initially have symptoms such as feeling sick, being sick (vomiting), stomach cramps, diarrhoea or constipation.

Without treatment, botulism eventually causes paralysis that spreads down the body from the head to the legs.

 

Symptoms can include:

•drooping eyelids

•blurred or double vision

•facial muscle weakness

•difficulty swallowing

•slurred speech

•breathing difficulties

 

Affected babies may also have a weak cry, find it difficult to feed, and have a floppy head, neck and limbs.

 

General precautions & Treatment

Botulism is common throughout the environment but does require special conditions to take hold.

Always wash hands before eating, drinking or smoking. Cover cuts with a waterproof plaster.

Never handle dead animals, particularly wild fowl with bare hands – always wear waterproof gloves.

Go to your nearest A&E department or immediately dial 999 if you or someone you know has symptoms of botulism.

Treatment is more effective the earlier it’s started.

 

 

 

 

 

 

Infection type: Chlamydia abortus

* Chlamydia abortus (formerly called Chlamydia psittaci) is a cause of abortion and foetal loss in sheep. Enzootic abortion in sheep is also known as ovine enzootic abortion (OEA) or enzootic abortion of ewes (EAE).

 

Risk Factors

Working with ewes during lambing season or in pasture occupied by them.

Infected animals excrete the organism in large amounts in diseased placenta, uterine discharges and faeces.

Human infections follow inhalation of infected aerosol material from livestock, or physical contact with contaminated material.

 

Symptoms

Chlamydia Abortus infections in humans are rare, however they have serious repercussions and the risks must be taken seriously.

Human symptoms include:

flu-like’ illness – headache, chills, fever, joint pains and non-productive cough. Photophobia, vomiting, sore throat and myocarditis may also occur.

In pregnancy, a more severe form of the disease is possible, the majority of reported cases occurring between 24 and 36 weeks.

Characteristic symptoms in pregnancy include:

  • Systemic illness & haemorrhaging
  • Renal complications
  • Hepatic complications

The main effects of chlamydiosis in pregnancy are severe, sometimes life-threatening, disease in the mother, and stillbirth or miscarriage.

 

General precautions & Treatment

Anyone who is pregnant or think they may be must avoid close contact with sheep during the lambing season, which runs from January to April.

Partners of pregnant women working with lambing ewes must ensure that they don’t carry contaminated material into their homes – this includes clothing.

Any one in contact with livestock must always wash their hands before eating drinking or smoking and keep any cuts covered with a waterproof plaster.

Anyone suffering with flu-like symptoms after working around sheep should contact their GP immediately.

 

 

 

 

 

Infection type: E.Coli 0157 * Escherichia coli O157  

Risk Factors

E.coli O157 is found in the gut and faeces of many animals, particularly cattle. It is an uncommon cause of gastroenteritis but can be caught by:

  • Eating contaminated food.
  • Touching infected animals or accidentally coming into contact with their faeces.
  • Contact with people who have the illness.
  • Drinking contaminated water.
  • Swimming or playing in contaminated water, such as ponds or streams.

 

Symptoms

Symptoms include diarrhoea, stomach cramps and occasionally fever. People usually notice symptoms three to four days after they have been infected, but symptoms can start any time between one and 14 days afterwards. These symptoms can last up to two weeks. A small number of people with E. coli O157 infection go on to develop a serious condition called haemolytic uraemic syndrome (HUS). This can sometimes lead to kidney failure and death, although this is rare. The risk of HUS is highest in children aged less than five years.

General precautions & Treatment

Any one in contact with livestock must always wash their hands before eating drinking or smoking and keep any cuts covered with a waterproof plaster. There is no specific treatment for E. coli O157 infection. People who are infected can usually be cared for at home and most will get better without medical treatment.

It is important to drink plenty of fluids, as diarrhoea can lead to dehydration.

Anti-diarrhoea drugs such as loperamide (Imodium) are also not recommended as they may prolong your exposure to the toxin

Anyone who has had an E. coli O157 infection should stay away from work or school until they have been completely free of symptoms for 48 hours.

 

 

 

 

 

 

Infection Type: Lyme’s Disease

*Caused by a bacterium named Borrelia spread by ticks

 

Risk Factors

Any activity on sites inhabited by mammals between May and November. Lyme’s is passed on by Tick bites, so great care must be taken to try and prevent them and where they do occur medical help must be sought immediately if any symptoms occur.

 

Symptoms

Many people with early symptoms of Lyme disease develop a circular red skin rash around a tick bite. The rash can appear up to 3 months after being bitten by a tick and usually lasts for several weeks. Most rashes appear within the first 4 weeks. Not everyone with Lyme disease gets the rash. Some people also have flu-like symptoms in the early stages, such as:

  • A high temperature, or feeling hot and shivery
  • Headaches
  • Muscle and joint pain
  • Tiredness and loss of energy

 

General precautions & Treatment

Keep to footpaths where possible.

Wear appropriate clothing in areas likely to contain ticks (grassland or other undergrowth inhabited by mammals) a long-sleeved shirt and trousers tucked into your socks is advised.

Inspect skin for ticks at the end of the day, including your head, neck and skin folds (armpits, groin, and waistband) – remove any ticks promptly.

If taken, check that pets do not bring ticks home in their fur.

If symptoms of illness occur after insect bites – “Bullseye” rashes, excessive swelling or aches and pains for example contact a GP immediately.

Where ticks are found, the Trust recommends that they are removed using a tick removal tool specifically designed for that purpose – preferably a “Tick Lasso” as they are the easiest to use. Tick Lasso’s” are available from facilities@woodlandtrust.org.uk .

Where a tick removal tool is not available, sharp point tweezers may be used (not blunt nose, eyebrow type, as these are likely to crush the tick).

  1. Grasp the tick as close to the skin as possible and pull upwards with steady, even pressure.
  2. Do not twist or jerk the tick as this may leave its mouth parts embedded, or cause it to regurgitate infected fluids. If any mouth parts do break off, they may be removed with a sterilised needle or tweezer points.
  3. Do not squeeze or crush the body of the tick, because its fluids (saliva and gut contents) may contain infections and leak into the host’s bloodstream or into the skin.
  4. Do not handle the tick with bare hands, because certain disease-causing organisms may enter through breaks in the skin or through mucous membranes (if you touch eyes, nostrils or mouth).
  5. After removing the tick, disinfect the bite site with an antiseptic wipe or wound wash and wash your hands with soap and water

 

 

 

 

 

 

 

Infection Type: Leptospirosis

*Leptospira Icterohaemorragiae & Leptospira Hardjo (Weil’s Disease)

Risk Factors

Leptospirosis is spread in the urine of infected animals – most commonly rats, mice, cows, pigs and dogs.

You can catch it if soil or freshwater (such as from a river, canal or lake) containing infected urine gets in your mouth, eyes or a cut.

It’s very rare to get leptospirosis from pets, other people or bites.

Symptoms

If, after working with soil or water where rats may be present, you develop any of the following symptoms, contact your GP immediately and explain your concerns:

  • A high temperature, or feel hot and shivery
  • A headache
  • Feeling and being sick
  • Aching muscles and joints
  • Red eyes
  • Loss of appetite

If you develop any of the following symptoms, seek urgent medical help or attend A&E

  • Yellow skin and eyes (jaundice)
  • Swollen ankles, feet or hands
  • Chest pain
  • Shortness of breath
  • Coughing up blood

 

General precautions & Treatment

  • Wash hands whenever hygiene facilities become available.
  • Cover cuts with a waterproof dressing
  • If eating outdoors ensure hands can be washed/sanitized (sanitizing gel is fine if other hygiene facilities are unavailable).
  • Avoid getting river, canal, pond or stream water in mouth or cuts – if accidental contact occurs clean and rinse as soon as possible.
  • Shower as soon as possible if you’ve been in potentially infected water.
  • Do not touch dead animals with your bare hands.

*Check your dog is vaccinated against leptospirosis (there isn’t a vaccine for people)*

 

 

 

 

 

 

Infection Type: Cryptosporidiosis

* Cryptosporidium is a protozoan (single celled) parasite which, if ingested, can cause an illness called cryptosporidiosis.

Risk Factors

Infection occurs when Cryptosporidium oocysts (the hardy cyst stage of the parasite’s lifecycle) are taken in by mouth. The oocysts can survive in the environment and in water for long periods of time.

Human infection may be acquired by four main routes:

  • From other people
  • From animals and their faeces, From untreated drinking water contaminated by either agricultural or human sewage sources
  • Swimming in contaminated water.

Those working around livestock or near possibly contaminated water are the most at risk.

Symptoms

The main symptom in humans is diarrhoea, which can range from mild to severe. It is often accompanied by stomach pain, nausea or vomiting, fever and sometimes dehydration and weight loss. It is a leading cause of human gastrointestinal infection in the UK. A number of different Cryptosporidium species infect animals. In humans, illness is mainly caused by Cryptosporidium parvum and Cryptosporidium hominis.

 

 

General precautions & Treatment

Anyone working on a Woodland Trust site – particularly those occupied by livestock – should wash their hands before eating drinking or smoking. Avoid contact with possibly contaminated water, and rinse mouth our thoroughly if water accidently gets splashed in your face. There is no specific treatment for cryptosporidiosis, and most patients will recover within a month. The advice of a health professional should be sought in all cases of severe diarrhoea (especially in babies, children and the elderly). It is import to drink plenty of fluids in frequent small sips to avoid dehydration, which may be treated with oral rehydration therapy.

 

 

 

 

 

 

Infection Type: Giardiasis* Giardia lambli

 

Risk Factors

Giardiasis is caused by the parasite Giardia lambli.

This parasite exists in two forms – an active form called a trophozoite, and an inactive form called a cyst.

The active trophozoite attaches to the lining of the small intestine with a “sucker” and is responsible for causing the symptoms of the illness.

The Cyst is capable of surviving for long times outside the body and is how the parasite spreads.

The most common causes of Giardiasis are:

  • Water getting in your mouth while working or while swimming in places like lakes or rivers
  • Eating food with dirty hands

 

Symptoms

The main symptoms of giardiasis are:

  • Diarrhoea
  • Stomach pain or cramps
  • Excessive farting (flatulence)
  • Foul smelling burps – they may smell like eggs
  • Extensive bloating
  • Weight loss

Call your GP surgery or 111 if:

  • You’ve had diarrhoea for more than a week.
  • You have any symptoms of bleeding when you go to the toilet.

General precautions & Treatment

Avoid getting possibly contaminated water in your mouth while working, and swill your mouth out if contact does occur. Always wash hand before eating drinking or smoking.

Giardiasis is usually treated with antibiotics – after which symptoms should stop in about a week, but they can sometimes last longer.

Go back to your GP if you still have symptoms a week after starting treatment. They might give you more antibiotics or refer you to a specialist for treatment.

 

 

 

 

 

 

Infection Type: Yersiniosis

*Yersinia, (genus Yersinia), any of a group of ovoid- or rod-shaped bacteria of the family Enterobacteriaceae. This includes Y. Pestis the bacterium that causes plague

Risk Factors

Yersinia is widespread in domestic animals, including pigs and cattle, it’s also found in birds and aquatic species, such as frogs and oysters. It has been isolated from soil and from the surface layers of various bodies of water, including lakes and streams.

The organism is transmitted to humans as a foodborne or waterborne pathogen, and infection results in an acute gastrointestinal condition known as yersiniosis.

Anyone working in the countryside may be exposed to Yersinia Pathogens through contact with the soil, untreated water or animal waste.

Symptoms

Yersiniosis causes an acute gastrointestinal infection with symptoms that include:

  • Fever
  • Often-bloody diarrhoea and abdominal pain.
  • A temporary rash called erythema nodosum also may appear on the skin :
  • The disease can lead to a temporary arthritis of the knees, ankles, or wrists.

Frequently occurring in young children, the infection is more common during the winter months.

 

General precautions & Treatment

Yersiniosis is most commonly passed via the mouth – anyone engaged in practical work where they are handling soil or natural water sources must ensure they wash their hands thoroughly before eating drinking or smoking.

Most people who have healthy immune systems will recover without treatment. Treatment of yersiniosis usually involves treating the symptoms only. For example, persons with diarrhoea should generally drink lots of liquids to avoid dehydration. More severe or complicated cases may require antibiotics.

 

 

 

 

 

 

Infection Type: Ringworm* Trichophyton, Microsporum, Epidermophyton.

Risk Factors

Ringworm is caused by a type of fungi.

It’s possible that these fungi may live for an extended period as spores in soil. Humans and animals can contract ringworm after direct contact with this soil and each other.

It can be spread through close contact with:

  • An infected person or animal
  • Infected objects – such as bedsheets, combs or towels
  • Infected soil – although this is less common

Symptoms

The main symptom of ringworm is a red or silver rash. The rash may be scaly, dry, swollen or itchy. Ringworm can appear anywhere on the body, including the scalp (tinea capitis) and groin (jock itch). The rash is usually ring-shaped, unless it’s on your face, neck or scalp. Sometimes the rash grows, spreads or there’s more than one rash. Ringworm on the face or scalp may also cause patchy hair loss.

General precautions & Treatment

Livestock with ringworm will often be obviously affected with circular bald patches – this may, however, not always be the case. Anyone working with livestock must wash their hands/arms thoroughly as soon after they have finished the activity as possible. If, after working with livestock, you develop the symptoms of Ringworm, speak to a pharmacist first. They can look at your rash and recommend the best antifungal medicine. This might be a cream, gel or spray depending on where the rash is. You usually need to use antifungal medicine every day for 2 weeks. It’s important to finish the whole course, even if your symptoms go away. A pharmacist will tell you if they think you should see a GP.

It’s fine for your child to go to school or nursery once they have started treatment. Let your child’s teachers know they have it.

 

 

 

 

 

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