Venkat Heather, Yaglom Hayley D, Adams Laura
Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA; Arizona Department of Health Services, 150 N 18th Ave Suite 140, Phoenix, AZ, 85007, USA; Career Epidemiology Field Officer, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA.
Arizona Department of Health Services, 150 N 18th Ave Suite 140, Phoenix, AZ, 85007, USA.
Prev Vet Med. 2019 Aug 1;169:104711. doi: 10.1016/j.prevetmed.2019.104711. Epub 2019 Jun 18.
Veterinarians play a crucial role in zoonotic disease detection in animals and prevention of disease transmission; reporting these zoonoses to public health officials is an important first step to protect human and animal health. Evidence suggests veterinarians and their staff are at higher risk for exposure to zoonoses because of possible interactions with infected animals. We examined the knowledge, attitudes, and practices of veterinarians regarding zoonotic disease reporting to public health agencies and associated infection prevention (IP) practices such as personal protective equipment (PPE) use, and the need for targeted education and outreach for veterinarians in Arizona. An online questionnaire was developed and distributed by email in September 2015 and was available through November 2015 to all 1,100 members of the Arizona Veterinary Medical Association. Chi-square and logistic regression analyses were performed. In total, 298 (27%) veterinarians from all 15 Arizona counties completed the survey; the majority (70%) were female, practiced small animal medicine (84%), and reported practicing veterinary medicine for ≥10 years (75%). Only 57% reported they knew when to report a suspected zoonotic disease and 60% reported they knew how to make that type of report. The majority said they would report rabies (97%), plague (96%), and highly pathogenic avian influenza (91%) to a state agency. Most respondents reported using PPE (e.g., masks, face shields, and gloves) when performing a surgical procedure (96%) or necropsy (94%), although fewer reported using PPE for handling clinically ill animals (37%) or healthy animals (17%). Approximately 70% reported always using PPE when in contact with animal birthing fluids, urine, or feces, and 47% for contact with animal blood, saliva, or other body fluids. Veterinarians who agreed that they knew the appropriate actions to protect themselves from zoonotic disease exposures were more likely to report always washing their hands before eating or drinking at work (OR = 3.81, 95% confidence interval (CI) [1.97-7.35], P < 0.01). Responses for when to make a report and how to report were not significantly different by gender, years of practice, or holding additional degrees, but did differ by practice type, age, and number of veterinarians in the practice. Small animal veterinarians were less likely to report knowing when to make a report compared to other veterinarians (P < 0.01). Respondents demonstrated suboptimal zoonotic disease reporting and IP practices, including PPE use. Public health agencies should improve outreach and education to veterinarians to facilitate better zoonotic disease prevention practices and reporting.
兽医在动物源性疾病的检测及疾病传播预防中发挥着关键作用；向公共卫生官员报告这些人畜共患病是保护人类和动物健康的重要第一步。有证据表明，由于可能与受感染动物接触，兽医及其工作人员感染人畜共患病的风险更高。我们调查了亚利桑那州兽医关于向公共卫生机构报告人畜共患病及相关感染预防（IP）措施（如使用个人防护装备（PPE））的知识、态度和做法，以及对兽医进行针对性教育和宣传的必要性。2015年9月通过电子邮件编制并分发了一份在线调查问卷，该问卷在2015年11月前对亚利桑那州兽医协会的1100名会员开放。进行了卡方检验和逻辑回归分析。总共有来自亚利桑那州15个县的298名（27%）兽医完成了调查；大多数（70%）为女性，从事小动物医学（84%），且报告从事兽医工作≥10年（75%）。只有57%的人报告他们知道何时报告疑似人畜共患病，60%的人报告他们知道如何进行此类报告。大多数人表示他们会向州机构报告狂犬病（97%）、鼠疫（96%）和高致病性禽流感（91%）。大多数受访者报告在进行外科手术（96%）或尸检（94%）时使用个人防护装备（如口罩、面罩和手套），不过较少有人报告在处理临床患病动物（37%）或健康动物（17%）时使用个人防护装备。约70%的人报告在接触动物分娩液体、尿液或粪便时总是使用个人防护装备，47%的人报告在接触动物血液、唾液或其他体液时使用。认为自己知道采取适当行动以保护自己免受人畜共患病感染的兽医更有可能报告在工作时饭前便后总是洗手（比值比（OR）=3.81，95%置信区间（CI）[1.97 - 7.35]，P<0.01）。关于何时报告以及如何报告的回答在性别、执业年限或拥有其他学位方面没有显著差异，但在执业类型、年龄和诊所兽医人数方面存在差异。与其他兽医相比，小动物兽医报告知道何时报告的可能性较小（P<0.01）。受访者在人畜共患病报告和感染预防措施（包括个人防护装备的使用）方面表现欠佳。公共卫生机构应加强对兽医的宣传和教育，以促进更好的人畜共患病预防措施和报告工作。
