RESUMO
Animal hoarding is an under-recognized problem that exists in most communities and adversely impacts the health, welfare, and safety of humans, animals, and the environment. These guidelines address public health and worker safety concerns in handling situations where animal hoarding or other dense concentrations of animals have caused unhealthy and unsafe conditions. Because animal hoarding situations are often complex, a full response is likely to be prolonged and require a cross-jurisdictional multiagency effort. Each animal hoarding case has unique circumstances related to the types and numbers of animals involved, the physical structure(s) where they are being kept, and the health status of the animals, among other factors that must be taken into account in planning a response. Some general public health considerations and associated recommendations for personal protective equipment use are presented that apply to all cases, however.
Assuntos
Poluição do Ar em Ambientes Fechados , Comportamento Compulsivo/epidemiologia , Exposição Ambiental/legislação & jurisprudência , Transtornos Mentais/epidemiologia , Saúde Pública/legislação & jurisprudência , Zoonoses/epidemiologia , Bem-Estar do Animal , Animais , Exposição Ambiental/efeitos adversos , Vínculo Humano-Animal , Humanos , Estados Unidos/epidemiologia , Zoonoses/transmissãoRESUMO
BACKGROUND: We present 2 case reports in the United States and investigations of diphtheria-like illness caused by toxigenic Corynebacterium ulcerans. A fatal case occurred in a 75-year-old male Washington resident who was treated with clindamycin but did not receive equine diphtheria antitoxin. A second, nonfatal case occurred in a 66-year-old female Tennessee resident who received erythromycin and diphtheria antitoxin. METHODS: Both case patients and close human and animal contacts were investigated by their respective state health departments. RESULTS: C. ulcerans isolated from the patient who died was resistant to erythromycin and clindamycin. For both isolates, conventional polymerase chain reaction results were positive for A and B subunits of diphtheria toxin gene tox, and modified Elek tests confirmed toxin production. The source of infection remained undetermined for both cases. Neither patient was up-to-date with diphtheria toxoid vaccination. CONCLUSION: These case reports highlight the importance of early treatment with diphtheria antitoxin, the selection of effective antimicrobial agents, and prevention through up-to-date vaccination.