Mendez Diana H, Kelly Jenny, Buttner Petra, Nowak Madeleine, Speare Rick
BMC Vet Res. 2014 Sep 17;10:215. doi: 10.1186/s12917-014-0215-6.
Veterinary infection control for the management of Hendra virus (HeV), an emerging zoonosis in Australia, remained suboptimal until 2010 despite 71.4% (5/7) of humans infected with HeV being veterinary personnel or assisting a veterinarian, three of whom died before 2009. The aim of this study was to identify the perceived barriers to veterinary infection control and HeV management in private veterinary practice in Queensland, where the majority of HeV outbreaks have occurred in Australia.
Most participants agreed that a number of key factors had contributed to the slow uptake of adequate infection control measures for the management of HeV amongst private veterinarians: a work culture characterised by suboptimal infection control standards and misconceptions about zoonotic risks; a lack of leadership and support from government authorities; the difficulties of managing biosecurity and public health issues from a private workforce perspective; and the slow pattern of emergence of HeV. By 2010, some infection control and HeV management changes had been implemented. Participants interviewed agreed that further improvements remained necessary; but also cautioned that this was a complex process which would require time.
Private veterinarians and government authorities prior to 2009 were unprepared to handle new slowly emerging zoonoses, which may explain their mismanagement of HeV. Slowly emerging zoonoses may be of low public health significance but of high significance for specialised groups such as veterinarians. Private veterinarians, who are expected to fulfil an active biosecurity and public health role in the frontline management of such emerging zoonoses, need government agencies to better recognise their contribution, to consult with the veterinary profession when devising guidelines for the management of zoonoses and to provide them with greater leadership and support. We propose that specific infection control guidelines for the management of slowly emerging zoonoses in private veterinary settings need to be developed.
亨德拉病毒(HeV)是澳大利亚出现的一种人畜共患病,直到2010年,澳大利亚兽医感染控制措施一直未达到最佳水平。尽管感染HeV的人类中有71.4%(5/7)是兽医人员或协助兽医工作的人员,其中三人在2009年前死亡。本研究的目的是确定昆士兰私人兽医诊所中兽医感染控制和HeV管理方面存在的明显障碍,澳大利亚大部分HeV疫情都发生在昆士兰。
大多数参与者一致认为,一些关键因素导致了私人兽医在HeV管理方面未能及时采取充分的感染控制措施:工作文化中感染控制标准欠佳,且对人畜共患病风险存在误解;政府当局缺乏领导力和支持;从私人劳动力角度来看,管理生物安全和公共卫生问题存在困难;以及HeV出现的速度较慢。到2010年,已经实施了一些感染控制和HeV管理方面的变革。接受采访的参与者一致认为仍有必要进一步改进;但也告诫说,这是一个复杂的过程,需要时间。
2009年前,私人兽医和政府当局没有准备好应对新出现的、出现速度较慢的人畜共患病,这可能解释了他们对HeV的管理不善。出现速度较慢的人畜共患病可能对公众健康影响较小,但对兽医等专业群体影响重大。私人兽医有望在这类新出现的人畜共患病的一线管理中发挥积极的生物安全和公共卫生作用,政府机构需要更好地认识到他们的贡献,在制定人畜共患病管理指南时与兽医行业进行协商,并为他们提供更强有力的领导和支持。我们建议制定针对私人兽医环境中出现速度较慢的人畜共患病管理的具体感染控制指南。