Survey of rabies vaccination status of Queensland veterinarians and veterinary students.

BACKGROUND: To determine the rabies vaccination status of Queensland veterinarians and veterinary students and their perception of zoonotic risk from Australian bat lyssavirus (ABLV). DESIGN: Cross-sectional questionnaire surveys. METHODS: Questionnaires were sent by post in 2011 to veterinary surgeons registered in Queensland, to final-year veterinary students at James Cook University via SurveyMonkey® in 2013 and to final-year veterinary students at James Cook University and University of Queensland via SurveyMonkey® in 2014. RESULTS: The response rate for registered veterinarians was 33.5% and for veterinary students 33.3% and 30% in 2013 and 2014, respectively. Of the 466 registered veterinary surgeons, 147 (31.5%) had been vaccinated, with 72 (15.5%) currently vaccinated. For veterinary students the rabies vaccination rate was 20.0% (4/20) and 13.0% (6/46) in the 2013 and 2014 surveys, respectively. More than 95% of veterinary students had received the mandatory Q fever vaccine. Both veterinarians and students regarded bats and horses as high-risk species for zoonoses. CONCLUSIONS: Queensland veterinarians and veterinary students have low levels of protection against ABLV. Although incidents of ABLV spilling over from a bat to a domestic mammal are likely to remain rare, they pose a significant human health and occupational risk given the outcome of infection in humans is high consequence. Principals of veterinary practices and veterinary authorities in Australia should implement a policy of rabies vaccination for clinical staff and veterinary students.

More bark than bite: Comparative studies are needed to determine the importance of canine zoonoses in Aboriginal communities. A critical review of published research.

The objective of this review was to identify and critique over forty years of peer-reviewed literature concerned with the transmission of canine zoonoses to Aboriginal people and determine the zoonotic organisms documented in dogs in Australian Aboriginal communities. A systematic literature search of public health, medical and veterinary databases identified 19 articles suitable for critical appraisal. Thirteen articles documented the occurrence of recognized zoonotic organisms in dogs in Aboriginal communities, including Toxocara canis, Dirofilaria immitis, Streptococcus dysgalactiae, Rickettsia felis, Sarcoptes scabiei and Giardia. Currently, there is definitive evidence indicating that dogs act as a reservoir for human scabies in Aboriginal communities. However, there is a need for large-scale, high-quality, comparative studies of dogs and humans from the same household to assess the occurrence and importance of transmission of S. scabiei and other diseases between dogs and humans. These studies should use current genetic and molecular techniques along with traditional techniques to identify and type organisms in order to better understand their epidemiology. This review has revealed that there is a lack of high-quality comparative studies to determine whether dogs are contributing to human disease by transmitting zoonoses. Our recommendations differ significantly from current public health policy and may have substantial implications for human and dog health.

Adenomatous hyperplasia of the mucous glands in captive Archey's frogs (Leiopelma archeyi).

AIMS: To describe the gross and light microscopic characteristics of skin lesions observed on the ventral skin of captive Archey's frogs (Leiopelma archeyi) between 2000 and 2012, and to investigate their occurrence, possible aetiology and association with survival. METHODS: Postmortem skin samples were obtained for histological evaluation from 37 frogs, with and without skin lesions, that died while in captivity at Auckland Zoo between 2000 and 2012. Four frogs with skin lesions were biopsied under general anaesthesia and samples used for both light and transmission electron microscopy. The records of 94 frogs held at the University of Otago and Auckland Zoo between 2000-2012 were reviewed, which included some frogs recently collected from the wild. Information about the occurrence of skin lesions, and mortality associated with skin lesions was collated. RESULTS: Grossly the skin lesions varied in appearance; most were circular, pale grey papules, which measured from <0.5-1.5 mm in diameter with no umbilication. The overlying epidermis was not fragile and there was no associated inflammation. Contents often appeared clear or semi-transparent. Lesions were located predominantly on ventral surfaces including trunk, thighs, lower legs and forearms, and gular region, but not on digits. The number ranged from single to multiple, often confluent lesions covering the entire ventral surface of the frog. Histologically the lesions consisted of enlarged proliferating mucous glands that expanded the dermis and elevated the epidermis. They were semi-organised, solid or occasionally cavitated acinar structures with central lumina which sometimes contained mucus. Nuclei showed moderate anisokaryosis and mitotic figures were uncommon. Transmission electron microscopy did not show any infectious agents. Between 2000 and 2012, skin lesions were recorded in 35/94 (37%) frogs. The size and location of skin lesions varied over time, with some resolving and sometimes reappearing. Skin lesions were not associated with an increased risk of death. CONCLUSIONS: The skin lesions had the gross and microscopic characteristics of adenomatous hyperplasia of the dermal mucous glands. CLINICAL RELEVANCE: The aetiology of this adenomatous hyperplasia is unknown, but factors associated with the captive environment are the most likely cause. This is the first description of adenomatous hyperplasia of the cutaneous mucous glands in amphibians.

The application of One Health concept to an outdoor problem-based learning activity for veterinary students.

BACKGROUND: The One Health (OH) approach, which seeks to bring together human and animal health, is particularly suited to the effective management of zoonotic diseases across both sectors. To overcome professional silos, OH needs to be taught at the undergraduate level. Here, we describe a problem-based learning activity using the OH approach that was conducted outdoors for 3rd-year veterinary students in Malaysia. MATERIALS AND METHODS: A total of 118 students, divided into two groups, completed the activity which spanned 1½ days at a deer park adjacent to a wilderness area. Students were asked to evaluate the activity using an online survey that had quantitative and qualitative components. RESULTS: Response rate was 69.5%. The activity was rated excellent by 69.5% and good by 30.4%. Levels of satisfaction were high on a range of criteria. 97.5% of students intended to take action in their studies as a result of what they had learned. CONCLUSIONS: Delivery of an outdoor problem-based learning activity using OH approach was very successful in terms of participation, knowledge delivery and understanding, and the willingness of students to integrate OH into their future practice. For the improvement of future programs, the involvement of other disciplines (such as Medical, Biology, Biotechnology, Biomedical, and Public Health) is being considered.

Transmission of Streptococcus dysgalactiae subsp. equisimilis between child and dog in an Aboriginal Australian community.

Streptococcus dysgalactiae subsp. equisimilis (SDSE), also known as group G and C streptococci, is becoming increasingly recognized as a pathogen in humans. We report here the finding of an identical strain of SDSE in the throat of a child and their dog in an Aboriginal Australian community. The strain was identified using the API 20Strep system, 16S rRNA gene sequencing, emm sequence typing (emmST) and multilocus sequence typing (MLST) as a group C SDSE, stC839.5 and ST-3. Carriage of this strain by a human and dog in the same household justifies detailed epidemiological studies using molecular typing to clarify the extent of cross-species transmission and sharing of SDSE and other group G and C streptococci, and its impact in these communities.

Testing for Hendra virus: difficulties experienced by veterinarians in Queensland prior to 2011.

OBJECTIVE: To identify the perceived barriers to Hendra virus (HeV) management by private equine veterinarians in Queensland. DESIGN: An exploratory qualitative study of private equine veterinarians registered and working in coastal Queensland. METHODS: A questionnaire that included eight open-ended questions about the management of HeV was used in face-to-face in-depth interviews with 21 veterinary personnel working in equine or mixed private practice between Far North and South-East Queensland in 2009-10. The qualitative data was entered and analysed thematically using QSR's International's Nvivo 9 qualitative data analysis software. RESULTS: This study revealed key issues associated with HeV testing: (1) inadequate knowledge of testing procedures and laboratory diagnostic pathways; (2) difficulty in accessing laboratory services; (3) responsibility for cost of collection and transport of specimen; and (4) the role of government. Participants perceived these issues as reducing potential HeV case management efficiency. CONCLUSION: Although HeV management plans have been modified in part since 2009-10, this study highlights the importance of considering the perspectives of private veterinary practitioners in any biosecurity protocols.

Response of Australian veterinarians to the announcement of a Hendra virus vaccine becoming available.

DESIGN: A cross-sectional study of private veterinarians providing equine services in Queensland. RESULTS: The study revealed that a majority of veterinarians would support the introduction of a Hendra virus (HeV) vaccine. Moreover, almost half of the respondents intended to make vaccination a prerequisite to horse patient presentation. However, participants also responded that a vaccine would not reduce the risk sufficiently to cease or downgrade their HeV management plan and infection control measures. CONCLUSION: When devising promoting and marketing campaigns, government agencies and manufacturers should consider private veterinarians' intentions as a significant driver for the uptake of the HeV vaccine.

TB questions, East Kwaio answers: community-based participatory research in a remote area of Solomon Islands.

INTRODUCTION: East Kwaio is a remote region on the island of Malaita, Solomon Islands. Atoifi Adventist Hospital (the Hospital) is the only hospital and tuberculosis (TB) services provider in the region. If people come to the Hospital with TB, they are usually admitted for the two-month intensive phase of treatment as there are no community-based TB services. Most people walk or travel by canoe to the Hospital as there are no roads. East Kwaio is known to have high rates of TB; however, it has a low case detection rate and low treatment completion. The aims of this study were to explore why people with TB, especially from the mountain areas, present to the Hospital so late in their illness or do not present at all. The study was part of a larger project to strengthen the research capacity of local health workers and community leaders, supported by visiting researchers from Australia. METHODS: Semi-structured interviews with TB patients, a focus group of key informants and direct interaction with a community with a history of TB were used to explore reasons why people present to the Hospital late in their TB illness. RESULTS: Four interviews and a focus group of 12 key informants were conducted and a mountain hamlet with a history of TB was visited. The results represent the data from the interviews and the focus group. The time delay in presenting to the Hospital from when participants first became unwell ranged between two and three years. In the mountain hamlet, two additional people with probable TB were seen who had not presented to the Hospital during illnesses of five and nine months. Reasons for delays included: seeking care from traditional healers; the challenge of accessing health services due to distance, cost and cultural issues different from the Hospital's worldview; social isolation when in hospital; and being old so not having long to live. Delays in diagnosis of people with TB will increase the risk of transmission to family and through hamlets and villages. This study has led to plans being developed to build a more culturally appropriate TB ward and community treatment program. CONCLUSIONS: The study has identified TB questions that need East Kwaio answers. It has shown that a small project can inform the development of important changes to TB services, such as the redevelopment and relocation of the TB ward. To enable TB control, the local health services need to develop an understanding of, and appropriately engage with, traditional beliefs that influence how people interact with Hospital TB treatment and management. This is the case even if the beliefs are based on a worldview different than that of the health service providers. Ongoing operational research is required into TB diagnosis and treatment services and the many factors that contribute to the high TB burden in this remote area.

Measuring the sustainability of a community safety promotion network: working from the inside out.

Mackay Whitsunday Safe Communities (MWSC) was developed using a capacity building model that consciously attempted to design sustainability into the network. Our aim was to quantify the flow of resources used by MWSC to implement and sustain its injury control activities. Resource exchange among network members was quantified and analysed using social network analysis. In 2004, MWSC accessed an estimated 6.5 full-time staff equivalents and $0.9 million. However, these resources were largely accessed externally. The linking relationships that connected MWSC to its external support network, more than half of which were maintained by six broker network facilitators, were the critical social asset used to access resources and sustain network productivity. The sustainability of this network and arguably similar safety promotion networks is vulnerable to the changing priorities of external sponsoring agents and highly dependent on its leaders who facilitated access to the resources it required to remain productive.

Blood, guts and knife cuts: reducing the risk of swine brucellosis in feral pig hunters in north-west New South Wales, Australia.

INTRODUCTION: Humans who have close contact with livestock, wild or feral animals can risk acquiring zoonotic infections such as brucellosis, Q fever, and leptospirosis. Human infection with Brucella suis (swine brucellosis) usually follows occupational or recreational exposure to infected animals. Worldwide, many cases of human infection follow contact with infected feral pigs. In Australia there is a growing market for the export of 'wild boar' and a considerable number of people are involved in feral pig hunting. However, feral pig hunters are often hard to reach with health strategies. According to Australian authorities the most important means of preventing disease in humans includes covering cuts; wearing gloves; washing hands; and avoiding blood when coming into contact with feral pigs. There has not been an evaluation of the acceptability of these recommended risk-reduction strategies in the settings where feral pig hunting and evisceration occurs. METHODS: Semi-structured interviews and small focus groups were conducted with feral pig hunters in north-west New South Wales (NSW), Australia, to explore their hunting experiences and views on the brucellosis prevention strategies. Interview and focus group notes were thematically analysed. RESULTS: There was a range of experiences of feral pig hunting, from a very professional approach to a purely recreational approach. The main domains that emerged from participants' experiences during their most recent feral pig hunting activity and their reflections on current swine brucellosis risk reduction strategies were: 'you've gotta be tough to be a feral pig hunter'; 'most of the suggested strategies won't work as they are'; 'reducing risk in the scrub'; and 'how to let pig hunters know'. The recreational nature and prevailing macho perspective of participants demand a pragmatic approach to risk reduction if it is going to prove acceptable to feral pig hunters. The 'you've gotta be tough to be a feral pig hunter' context of the activity and the reality that many feral pig hunters participate with little preparation and a 'just keep going' approach, may counteract currently recommended risk-reduction strategies. The alternate strategies that emerged from the interviews need to be tested in the real activity, especially evisceration 'in the scrub' (at the site of slaughter). But the following ideas were grounded in the participants' experiences: take more time and watch your hands when making cuts; have good lighting; take care when cutting near a sow's uterus; use latex gloves to cover cuts on hands. CONCLUSIONS: Swine brucellosis is a zoonosis of concern for feral pig hunters in many parts of Australia, including north-west NSW. Many of the current strategies to reduce the risk of brucellosis did not appear appropriate or acceptable to the feral pig hunters interviewed. More acceptable strategies when eviscerating, such as taking more time, watching hands when cutting, ensuring good lighting, being careful in the vicinity of the uterus and using a latex glove to cover cuts and abrasions on hands need to be field tested. Further development of the food safety regulations is required to also support zoonosis risk reduction strategies.

The latest endangered species in Australia: a tobacco-smoking veterinarian.

The results of a tobacco smoking survey conducted among veterinarians in Queensland, Australia, during 2007 are presented. Of the 567 participants only 3% reported being current smokers, 24% were ex-smokers and 73% had never smoked. The prevalence of smoking was similar among males and females, and the highest smoking rate was reported among veterinarians aged 31-40 years. However, the rate of never-smokers was strongly and negatively correlated with age, and the proportion of ex-smokers increased with age. Encouragingly, the results from this study suggest that tobacco use has all but disappeared from the Australian veterinary profession in recent years.

Pathology of cutaneous trombidiosis caused by larval trombiculid mites in a wild Lesueur's tree frog (Litoria wilcoxii).

Cutaneous trombidiosis caused by larvae of trombiculid mites (Vercammenia gloriosa and V. zweifelorum) in the skin of a wild tree frog, Litoria wilcoxii, in northern Queensland, Australia manifested as small, domed vesicular lesions on the dorsal and lateral surfaces posterior to the eyes. The lesions contained small, orange trombiculid mites, with a surrounding minimal inflammatory reaction. The general health and behaviour of the frog appeared unaffected. Provisional diagnosis of cutaneous trombidiosis can be made from its distinctive clinical appearance and confirmed by biopsy with direct microscopic examination of mites. This case report represents a new host record.

Minimising exposure of amphibians to pathogens during field studies.

Many of the recent global amphibian mass mortalities, declines and extinctions have been attributed to the emerging infectious disease chytridiomycosis. There have been mass mortalities due to ranaviral disease but no major declines or extinctions. Controlling the transmission and spread of disease is of utmost importance, especially where there is the potential for human involvement. We have reviewed current hygiene guidelines for working with wild frogs, identified potential flaws and recommended those most suitable and effective for the field environment. Our within-site hygiene measures aim to reduce the risk of transmission among individuals. These measures encompass the capture, handling and holding of amphibians, skin disinfection before and after invasive procedures, marking frogs, sealing open wounds and treatment of accessory equipment. Our between-site hygiene measures aim to mitigate the risk of pathogen spread among populations. We have designed a risk calculator to help simplify and standardise the decision-making process for determining the level of risk and appropriate risk mitigation strategies to reduce the risk of increasing pathogen spread above background levels. Calculation of an overall risk score for pathogen spread takes into account the prior activity of field workers, the proposed activity, remoteness of the site, presence of known pathogens and the consequences of increased pathogen spread for amphibians in a given area.

Musculoskeletal disorders and psychosocial risk factors among veterinarians in Queensland, Australia.

OBJECTIVE: Although musculoskeletal disorders (MSD) represent one of the most important occupational health issues in contemporary society, few studies have specifically investigated this problem among veterinarians. DESIGN: An anonymous questionnaire survey mailed to all veterinarians registered with the Veterinary Surgeons Board of Queensland during 2006. RESULTS: Almost two-thirds of respondents (63%) had experienced MSD of the lower back, 57% had experienced neck-related MSD, 52% had experienced shoulder-related MSD and 34% had experienced MSD of the upper back during the previous 12 months. MSD was statistically correlated with a range of psychosocial factors, including stress associated with career structure, time pressures, client's attitude, lack of recognition by the public, lack of recognition by colleagues, lack of understanding from family or partners and work stress because of insufficient holidays each year. CONCLUSION: Overall, this study has demonstrated significant correlations between MSD and psychosocial risk factors among a large cohort of veterinarians, apparently for the first time in the published literature. The results also suggest that personal and workplace issues may contribute more to the development of MSD among veterinarians than many of the previously recognised ergonomic risk factors.

In vitro efficacy of over-the-counter botanical pediculicides against the head louse Pediculus humanus var capitis based on a stringent standard for mortality assessment.

Infestation of the head louse Pediculus humanus var capitis DeGeer (Phthiraptera: Pediculidae) is an important public health problem in Australia, with up to a third of children infested in some primary schools. Insecticide resistance and inadequate attention to the application instructions of topical pediculicides are common reasons for treatment failure. This study evaluated six popular Australian over-the-counter products against head lice, primarily comprised of different botanical extracts, and compared them with permethrin 1% (Quellada) and a non-treatment control in order to assess their in vitro efficacy. We also assessed commonly used criteria for evaluating pediculicide efficacy in vitro. All tested products failed to demonstrate high levels of efficacy with the exception of Tea Tree Gel((R)), which outperformed 1% permethrin. Permethrin had a high level of efficacy, but using stringent criteria 18% of lice were not dead at 3 h, indicating some resistance to Quellada. Commonly used less stringent criteria were shown to overestimate mortality of head lice as a result of the protective phenomenon of stasis or sham death observed in exposed lice that may recover after some time. Using two different levels of stringency resulted in different rankings of efficacy for most products, with the exception of the first ranked product, Tea Tree Gel. Rankings of efficacy also varied over time, even within the different assessment criteria. Government regulatory agencies should require standard in vitro tests using stringent mortality criteria, with an observation period of >or= 6 h, to determine the efficacy of new pediculicides, and only products that cause a minimum mortality rate (e.g. 80%) in head lice collected from the target population should be licensed for sale.

High in vitro efficacy of Nyda L, a pediculicide containing dimeticone.

BACKGROUND: The therapy of pediculosis remains a common problem in clinical practice. As resistance to commonly used chemical pediculicides is constantly increasing, there is a need for new effective compounds. STUDY DESIGN: The efficacy of Nyda L, a new pediculicide containing a high concentration of dimeticone, was assessed in an in vitro trial and compared with three reference products (Hedrin containing 4% dimeticone, Lyclear containing 1% permethrin, and Prioderm containing 1% malathion) and a negative control group. Head lice were collected from heavily infested patients in a resource-poor community in Northeast Brazil, where no resistance against pediculicides has been reported thus far. In each of the five groups, 50 adult fully vital lice were tested. We used a dip test (immersing head lice in the undiluted products for 3 min, washing off products after 20 min). Using predefined criteria for mortality, the lice were monitored at different points in time, for a period of 24 h. RESULTS: Nyda L and Prioderm killed all head lice already after 5 min. The efficacy of Nyda L was better than of Lyclear. Lice treated with Hedrin resurrected after several hours and did not show a significantly higher mortality compared with the control group after 24 h. CONCLUSION: Nyda L can be regarded as a very efficacious pediculicidal compound, killing all lice in vitro within 5 min.

What parents in Australia know and do about head lice.

INTRODUCTION: Although parents in developed market economies regard head lice infections (pediculosis) as a significant problem, health departments generally rate pediculosis as a low priority health issue, encouraging parents to manage and control it. But how well equipped and willing are parents to manage the infections? There do not appear to be any studies in the literature addressing these issues. This article presents the results of a survey conducted in Australia that aimed to answer these questions. METHODS: A cross-sectional survey of parents of primary school aged children in Victoria (Vic) and north Queensland (NQ) was conducted using a self-administered questionnaire. The study investigated the knowledge, attitudes and practices of parents regarding head lice infections. RESULTS: Only 7.1% of 1338 who completed the questionnaire answered all 10 knowledge questions correctly and more than one-third failed to answer half correctly. There was a weak negative correlation between parents' knowledge and the prevalence of active pediculosis in the school. Almost all parents wanted the responsibility for treating pediculosis and more than three-quarters saw it as a health concern. A higher proportion of parents in NQ used preventative strategies (67% vs 41%). Most parents spent less than AU$50 per year on treatments. Alarmingly, however, the proportion of children missing school as a result of pediculosis was 24.4% and 30.3% in Vic and NQ, respectively. In Vic there was a positive correlation (r = 0.39) between missing school in the previous 12 months and prevalence of pediculosis in the school. CONCLUSIONS: This appears to be the most comprehensive study of parental knowledge, beliefs, and practices regarding head lice infections. Although parents wanted responsibility for the management of pediculosis, deficiencies in their knowledge indicate they may be inadequately equipped to do so. Given the high proportion of children in both states who have missed school as a result of head lice, it is recommended that health departments in Australia should work to ensure that consistent and accurate messages about pediculosis are disseminated, and that relevant legislation is amended to prevent children being excluded from school.

Additional disinfectants effective against the amphibian chytrid fungus Batrachochytrium dendrobatidis.

Chytridiomycosis, a disease contributing to amphibian declines worldwide, is caused by the fungus Batrachochytrium dendrobatidis. Identifying efficient and practical disinfectants effective against B. dendrobatidis is important to reduce the spread of the disease both in the wild and captivity. Previous studies identified a range of suitable disinfectant strategies. We evaluated the suitability of 3 additional disinfectants: two of these (TriGene Virucidal Disinfectant Cleaner and F10 Super Concentrate Disinfectant) are mixtures of chemicals and one (Betadine Antiseptic Liquid) contains a single active ingredient, povidone iodine. The disinfectants were tested using a range of concentrations for 1,5 and 10 min to determine their ability to kill B. dendrobatidis in vitro. The measure of effectiveness was 100% kill of zoosporangia grown in multiwell plates. All disinfectants had a 100% efficacy at concentrations recommended by the manufacturers. The lowest concentrations capable of 100% kill after exposure for 1 min were 0.1 ml l(-1) for TriGene, 0.33 ml l(-1) for F10 and 100 ml l(-1) for Betadine. TriGene is the most effective disinfectant yet to be found, and both TriGene and F10 are more effective than various disinfectants tested in previous studies. TriGene and F10 are considered suitable for use in the field, as only small amounts of concentrate are needed.