CDC study: DVMs fail lepto safety practices

ATLANTA — It contaminates practices, brings about lawsuits and causes illness, even death. Yet veterinarians enforce shoddy safety measures when it comes to leptospirosis and exposure to bacteria contamination.

That finding comes from a soon-to-be released survey of 3,000 practitioners by the Centers of Disease Control and Prevention (CDC) and American Veterinary Medical Association (AVMA). According to preliminary results, a large proportion of DVMs reported "very poor practices when handling urine," CDC officials say. That includes failing to wear gloves and other safety gear despite expressing concern about zoonotic disease transmission.

CDC's message: Veterinarians need to up the ante on leptospirosis vigilance. To gauge occupational hazards tied to leptospirosis exposure, AVMA's Group Health and Life Insurance Trust recently garnered 600 DVM blood samples that are being studied by Emory University's Rollins School of Public Health. The National Association of State Public Health Veterinarians also weighs in with its recently released "Compendium of Veterinary Standard Precautions: Zoonotic Disease Prevention in Veterinary Personnel" that highlights leptospirosis transmission and prevention.

The spotlight on leptospirosis is overdue considering more virulent zoonotic bugs such as avian influenza and West Nile virus overshadow the disease, experts say. CDC's interest sparked during the 2003 monkeypox outbreak when DVMs made up 25 percent of the people infected, epidemiologist Dr. Jennifer McQuiston explains.

"It just highlighted that there are inadequacies in the current profession," says McQuiston, a CDC scientist evaluating the lepto survey. "What we've found is veterinarians worry about disease transmission among animals, but they don't necessarily take those precautions for themselves or their staff. I think that spells out a considerable human health threat."

Courtroom cases

While first-hand accounts of staff infection are hard to come by, court cases are readily available. Purdue University expert and researcher Dr. Larry Glickman says he's aware of a half a dozen incidents where family members and hospital staff have tested positive via hospital infection. In the 1980s, he testified during a jury trial that pitted a 17-year-old kennel worker's family against a New Jersey veterinary practice. The teenager died due to infection complications, and the case settled out of court.

Even educational institutions aren't immune. In February, judges dismissed a University of California appeal of a technician's discrimination judgment won after he was fired when he sought disability and a transfer upon contracting leptospirosis, court records show.

Glickman estimates there are up to 200 such infections each year. "The in-hospital transmission is a real threat and seems to be growing," he says. "Kennel workers are most at risk; they have the greatest contact with urine and the least knowledge. Veterinary technicians are the second major risk group. And for veterinarians, who are probably the least at risk, this is a real problem."

Such lawsuits will rise if veterinarians fail to protect staff as well as owners, predicts, James Wilson, DVM, JD.

"Write in records that you've told the owner to contact a physician and teach your staff precautionary measures," says Wilson, owner of Priority Veterinary Management Consultants. "The education goes a long way."

In the field

Internal medicine specialist Dr. Robin Pullen works in a Delaware specialty practice and considers pregnancy an added risk factor. For expectant staff, extra caution is necessary, yet the practice's environment bolsters leptospirosis incidence.

"Workers in practices that spray kennels are breathing in the bacteria," she says. "As a precaution, our kennels have running water and flush like a toilet. We try to keep our staff well-trained."

That's pertinent for any practice, considering the number of dogs testing positive for leptospirosis have "increased remarkably," rising to 13 percent of all submitted test samples, up from 8 percent in 2002, Glickman claims. Whether the spike stems from increased awareness or a rise in infection rates remains unclear. What's certain is that veterinarians need to ramp up on staff protection and awareness, he says.

"This is not some theoretical issue," Glickman warns. "Infection happens, and it happens in your neighborhood. It will happen in your practice."