Biological Agents

Zoonoses
 Zoonoses are animal infections which may be
transmitted to people in the course of their work.
Common examples include:
– Brucellosis
– Q Fever
– Orf
– Psittacosis
– Anthrax
– Glanders
 Brucellosis
 Caused by the bacterium Brucella abortus, which
may infect people handling cattle or pigs or their
carcasses in abattoirs
 Not very severe but involves loss of appetite,
headache, insomnia and slight fever
 In the UK a policy of eradication has been pursued
since the 60’s by destroying any infected cattle
 Q Fever
 Known to occur in farm workers, abattoir
workers and veterinary surgeons
 The causative agent, Coxiela burnetii, has
been found in cows and sheep
 Not as serious as Brucellosis and takes the
form of cold or `flu-like symptoms
 Orf
 A contagious pustular dermatitis of viral
origin, mainly affecting farm workers,
shepherds, sheep shearers, butchers and
abattoir workers
 Lesion enlarges and often becomes
ulcerated, exuding fluid and pus
 Complete recovery occurs in about 3
weeks
 Psittacosis
 A virus-like bacterium of poultry, game and
other birds
 Can be fatal to man if untreated
 Illness sets in suddenly after an incubation
period of 2 to 3 weeks with fever, headache
and lethargy
 Pulmonary symptoms follow in a few days and
mortality may be as high as 20%, particularly
in the elderly
 Anthrax
 An acute infectious disease of farm animals caused
by a bacterium
 Transmitted to man by contact with infected hair,
hides, excrement or products such as bonemeal
 Fatal without treatment
 Initial lesion rapidly becomes ulcerated
 Treatment is by penicillin
 Inhaling the pathogen causes pulmonary anthrax
which is usually fatal in 3 or 4 days
 Glanders
 An infectious disease of horses, donkeys and
mules caused by the pathogen Pseudomonas
mallei
 Transmitted to humans by nasal or mouth
secretions from the infected animal
 Abscesses appear on hands, arms or face
 Lasts up to 4 months but is treatable with
modern antibiotics
Zoonose Control Strategies
 Most common route of entry is via the skin,
by way of open cuts, sores or abrasions
which provide direct entry to bloodstream
 Other routes include inhalation of
contaminated dusts, contact with
conjunctiva of eyes, direct injection by cuts
from infected animals or animal bites, and
direct ingestion via hands
Zoonose Control Strategies
 First stage of control strategy is to
assess those people at risk
 Factors to consider include:
– work being carried out
– susceptibility to infection of the workers
– how infections might occur
– how likely exposure to infection is
 Zoonose Control Strategies
 First priority for preventing occupational exposure
to zoonoses is to eliminate the infections from the
animal stock, usually by protecting exposed
animals through immunisation and improvement
of their environment
 Workers should be protected by suitable
environmental hygiene controls and wearing
protective clothing including hand, arm, foot and
leg protection
 Zoonose Control Strategies
 Where animal products likely to emit infected dust
are handled (e.g. wool, skin, hides, pelts), LEV and
possibly RPE should be provided to prevent airborne
infection
 Specific immunisation of workers may be necessary
 Clean & hygienic animal living conditions and
disinfection of stalls will also ensure better hygiene
in factory premises and will reduce probability of
infection
Zoonose Control Strategies
 Automation to reduce human contact and
enclosure of aerosol-producing activities
will reduce exposure to infection
 Finally, medical checks, training and
information, procedures, instruction and
records will give added protection to
workers
 Legionnaires Disease
 Caused by the bacterium Legionella pneumophilia
 A type of pneumonia affecting the lungs and other
organs
 A number of conditions have been found to affect rate
of growth:
– Water temp. in the range of 24-45oC. It does not survive
about 60oC. Organisms may remain dormant in cool water
– Sediment, sludge, scale and organic material in water
systems can act as a source of nutrients, as can organisms
such as algae, amoebae and other bacteria
– Incorporation of Legionella in slime on surfaces can protect
the organisms from biocides
 Legionnaires Disease
 Infection caused by inhaling airborne droplets or
particles containing Legionella, which are small
enough to pass deep into the lungs and be
deposited in the alveoli
 People at greatest risk include smokers, alcoholics
and patients with cancer, chronic respiratory or
kidney disease
 Initial symptoms include high fever, chills, headache
and muscle pain. A dry cough soon develops and
most patients suffer difficulty with breathing
 Legionnaires Disease
 Water systems potentially at risk include:
– Cooling towers
– Evaporative condensers
– Hot/cold water services where occupants are
susceptible, I.e. health care premises
– Humidifiers and air washers creating a spray of
water droplets above 20oC
– Spa baths & pools
 Legionnaires Disease
 Employers should manage the risk of Legionella
by:
– Identifying and assessing sources of risk, taking into account
potential for drop formation, water temperature, exposure
probability and adequacy of control
– Implementing and managing precautions and keeping records
of the precautions
 Particular attention should be paid to populations which
contain a high proportion of susceptible people
(hospitals or nursing homes) and situations where there
is a large number of such people at risk
 Legionnaires Disease
 Main aim of control measures is to avoid conditions
where Legionella can proliferate and to avoid
creating sprays or aerosols
 Growth of Legionella can be inhibited by:
– Avoiding water temperatures between 20-45oC
– Avoiding water stagnation & slimes
– Avoiding use of materials which provide nutrient for the
organisms
– Keeping the system clean and preventing a build-up of sediments
– Using appropriate water treatment chemicals
 Sick Building Syndrome
 Occupants suffer from measurably higher incidence
of illness than would be expected, for no readily
identifiable reason
 Symptoms may include ear, nose and throat
irritation; skin rashes; lethargy; headaches;
respiratory infections and nausea
 Occurs predominantly in air conditioned buildings
 Victims tend to be in low status repetitive jobs and
have little or no control over their working
environment
 Sick Building Syndrome
 Symptoms are more frequent in offices with large
numbers of employees, and are also reported with
greater frequency in the afternoons than in the
mornings
 Cause is likely to be due to a number of factors,
some of which may be biological, others not
 Airborne contaminants may cause SBS symptoms
through several mechanisms, including toxicity,
irritations, infection and allergy
 Sick Building Syndrome
 Other factors include inadequate ventilation and low
humidity
 Several “temporarily sick buildings” have been
“cured” by increasing ventilation, amongst other
measures
 Overall conclusion is that SBS is a complex
phenomenon with a number of causes, possibly
influenced by the victims reaction and attitude to the
working environment
 Leptospirosis - Weil’s Disease
 An infectious jaundice with symptoms of
fever, jaundice, liver enlargement,
haemorrhages and feverish relapses
 Causative organism is a spirochaete called
Leptospira icterohaemorrhagiae
 Rats are the primary cause of the disease
 Found in the kidneys of rats and is excreted
in urine
 Leptospirosis - Weil’s Disease
 There is evidence that the spirochaete can
pass through intact skin
 Persons at risk include:
– canal workers
– sewer workers
– agricultural workers
– rat catchers
– pig workers
– butchers
 Leptospirosis - Weil’s Disease
 Primary control is through systematic
destruction of rats in infested areas
 Prophylactic immunisation offers the best
solution in sewer workers
 All “at risk” workers should carry a card
warning of the dangers, stressing personal
cleanliness and hygiene, explaining the need
for protective clothing and alerting doctors to
the possibility of the disease
 Leptospirosis - Weil’s Disease
 It is essential that people subject to potential
risk are:
– aware of the causes and symptoms
– given instruction in suitable first-aid precautions
(e.g. covering existing skin wounds, cleaning and
disinfecting all fresh wounds), notifying a GP if
`flu-like symptoms occur and notifying public
authorities if rat infestation is noticed in a work
area
 Fungi
 Cause ill-health through inhalation of contaminated dust.
Examples include:
– Extrinsic Allergic Alveolitis is a type of pneumoconiosis of biological
origin caused by exposure to organic dusts of vegetable and
animal origin
– Bagassosis is a similar disease to farmer’s lung resulting from
exposure to spores present in the cellulose fibres of cane-sugar
after the sugar has been extracted
– Aspergillosis is an all-embracing term to describe the types of
extrinsic allergic Alveolitis (asthma) caused by the spores of the
Aspergillus fungus, found as a mould on cellulosic fibres such as
hay, straw, jute, flax, hemp, sugar-cane
 Fungi
 Farmer’s Lung is a specific disorder caused by
exposure to spores from mouldy hay.
– The disease is result of hypersensitivity due to an antigen
present in the dust.
– Symptoms are often mistaken for `flu, with extreme
shortness of breath on exertion
– Recovery is swift following removal of the individual from
the dust source
– However, with seasonal exposures the disease becomes
chronic, leading to pulmonary fibrosis, emphysema and
bronchiectasis, by which time it may be irreversible
 Hepatitis
 Those at risk include doctors, surgeons, nurses
and porters
 Infection amongst health workers is a result of
contact with blood or excreta of patients suffering
from viral hepatitis or in whom the disease is still
in its incubation stage
 Porters and refuse disposal are at risk from
carelessly discarded syringes and other sharps -
the problem is becoming worse with the increase
in drug addiction
 Hepatitis
 Course of disease is similar to Weil’s Disease, but is
usually much less severe and normally self-limiting
with recovery in about 6 weeks
 In about 5% of cases, chronic infectious hepatitis
follows, leading to cirrhosis and possibly death
 Persons exposed to risk can be protected with
injections of gammaglobulin
 In all cases, protective disposable gloves should be
worn and hands and arms washed regularly with
disinfectant
 AIDS
 Acquired Immune Deficiency Syndrome
 Caused by Human Immunodeficiency Virus
(HIV), which attacks the immune system
 Virus is found in most body fluids but is delicate
and relatively easy to kill with heat and
chemicals
 It has low infectivity and transmission is thought
to be more likely with repeated exposure to
infection rather than to a single contact
 AIDS
 Occupational risk comes from accidental
inoculation or contamination of a cut or
abrasion with blood or body fluids of an infected
person
 Doctors, nurses, dentists, laboratory and
hospital staff are at some risk, since they may
come into close contact with body fluids
 Other workers possibly at risk might include
community, welfare, custodial and emergency
service workers and first aiders
 AIDS
 Many of the precautions taken against other
infections, especially Hepatitis B, will be equally
effective against HIV. They include:
– Prevention of puncture wounds, cuts and abrasions
in the presence of blood and body fluids; and the
protection of existing wounds and skin lesions
– Control of surface contamination by containment
and disinfection
– Safe disposal of contaminated waste, especially
sharps