Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Fort Collins, Colorado, USA.
Wyoming Department of Public Health, Cheyenne, Wyoming, USA.
Clin Infect Dis. 2024 Jan 31;78(Suppl 1):S71-S75. doi: 10.1093/cid/ciad687.
Tularemia is a disease caused by Francisella tularensis, a highly infectious bacteria that can be transmitted to humans by direct contact with infected animals. Because of the potential for zoonotic transmission of F. tularensis, veterinary occupational risk is a concern. Here, we report on a human case of tularemia in a veterinarian after an accidental needlestick injury during abscess drainage in a sick dog. The veterinarian developed ulceroglandular tularemia requiring hospitalization but fully recovered after abscess drainage and a course of effective antibiotics. To systematically assess veterinary occupational transmission risk of F. tularensis, we conducted a survey of veterinary clinical staff after occupational exposure to animals with confirmed tularemia. We defined a high-risk exposure as direct contact to the infected animal's body fluids or potential aerosol inhalation without use of standard personal protective equipment (PPE). Survey data included information on 20 veterinary occupational exposures to animals with F. tularensis in 4 states. Veterinarians were the clinical staff most often exposed (40%), followed by veterinarian technicians and assistants (30% and 20%, respectively). Exposures to infected cats were most common (80%). Standard PPE was not used during 80% of exposures; a total of 7 exposures were categorized as high risk. Transmission of F. tularensis in the veterinary clinical setting is possible but overall risk is likely low. Veterinary clinical staff should use standard PPE and employ environmental precautions when handling sick animals to minimize risk of tularemia and other zoonotic infections; postexposure prophylaxis should be considered after high-risk exposures to animals with suspected or confirmed F. tularensis infection to prevent tularemia.
兔热病是由弗朗西斯菌引起的疾病，这种高度传染性的细菌可以通过直接接触感染动物传播给人类。由于弗朗西斯菌有潜在的动物传染病传播风险，兽医职业风险是一个关注点。在这里，我们报告了一名兽医在为一只患病狗进行脓肿引流时意外被针刺伤后感染兔热病的病例。该兽医出现溃疡腺型兔热病，需要住院治疗，但在脓肿引流和使用有效抗生素治疗后完全康复。为了系统评估兽医在接触确诊感染了兔热病的动物时感染弗朗西斯菌的职业传播风险，我们对接触过此类动物的兽医临床工作人员进行了职业暴露后调查。我们将高风险暴露定义为直接接触感染动物的体液或潜在的气溶胶吸入，而没有使用标准个人防护设备（PPE）。调查数据包括来自 4 个州的 20 名兽医职业接触感染了弗朗西斯菌的动物的信息。兽医是最常接触的临床工作人员（40%），其次是兽医技术员和助理（分别为 30%和 20%）。接触感染猫的情况最常见（80%）。在 80%的暴露中未使用标准 PPE；共有 7 次暴露被归类为高风险。在兽医临床环境中传播弗朗西斯菌是可能的，但总体风险可能较低。兽医临床工作人员在处理患病动物时应使用标准 PPE 并采取环境预防措施，以最大程度地降低感染兔热病和其他人畜共患病的风险；对于疑似或确诊感染了弗朗西斯菌的动物的高风险暴露，应考虑进行接触后预防，以预防兔热病。
