Reverse Zoonosis: A new way of thinking about pathogen flow Nancy P. Lung, VMD, MS Director of Veterinary Services Fort Worth Zoo

The Science of Zoonosis Control One-directional thinking

Pathogen Flow is Dynamic

This dynamic flow can result in many fascinating situations! Reverse Zoonosis Pass-through Zoonosis

Examples from the literature and from my experience Animal Hospitals Agriculture Risks from Ecotourism Zoos

Animal Hospital Setting MRSA in Horses VMTH 11 Cases of post-procedure infection over a 13-month period Previously undiagnosed at this hospital 3/5 people associated with equine surgery and recovery were positive by nasal culture Likely that colonized staff transmitted the bacteria to the affected horses

Agriculture Herd of 122 dairy cattle Long standing TB negative status in herd 14 of 122 developed clinical M. bovis Source identified from the farmer Asymptomatic renal M. bovis Infected the cattle by urinating on the straw in the barn Risk to the swine industry from H1N1

Risks from Ecotourism Tourism is now the world’s largest industry---$476 billion! 698 million international travelers per year Ecotravel is rising by 30% per year and is growing fastest in developing countries.

Ecotourism Pathogen Flow Local People Domestic or Wild Animals Traveler Arthropod vectors

Endangered primate populations are particularly vulnerable.

Mountain Gorillas of the Virunga Mountains Dian Fossey’s first field work in mid 1970’s First tourists visited camp in 1979. First gorilla group was officially “visited” by a handful of tourists in 1981. 10,641 tourists visited in 2005!!

Pathogen Flow in the Zoo setting Interaction between animal care staff and the collection animals Interaction between the public and the collection animals

A fascinating pass-through, amplification situation 20/55 infected (36%) 13 elephant keepers 5 nursery staff 1 vet 1 nutritionist MRSA-colonized caretaker USA 300

Elephant calf MRSA Lesions

Elephant Keeper MRSA Lesion Here’s an example of a healing MRSA lesion in one of the elephant calf handlers. Notice how it looks like a spider bite, which it is often confused with, even by physicians.

Reducing Pathogen Flow Between the Public and Collection Animals Case Examples

“Jackie” the Lowland Gorilla 10yr old female Flu-like symptoms in family group Rapid decline in Jackie—recumbent within 48 hrs Confirmed Parainfluenza 3 Placed on life support for 7 days Eventually made a full recovery

“Ramses” 31 yr old gorilla “Kate” 39 yr old gorilla Pneumococcal pneumonia Maintained in oxygen cage Outcome--recovered Influenza A Secondary pericarditis Outcome--died

Chimpanzee Group Lincoln Park Zoo March, 2009 “Basan” 4yr old orangutan 7 animals in a single family group All 7 had cold/flu-like symptoms 9 yr old male—status declined rapidly Outcome—young male died, others recovered Confirmed human metapneumoniavirus Upper and lower respiratory infection Confirmed Haemophilus influenzae Outcome--recovered

Kimberly Clarke Chimpanzee Forest Dallas Zoo

FWZ Outdoor Chimpanzee and Bonobo exhibit

FWZ Bonobo Exhibit

How to protect the health of animals in captive settings Exhibit design in zoos Personnel health assessment protocols in captive animal settings Personal protective equipment during animal interactions Public Education

Zoonosis Control Pathogen Flow is Dynamic

Protection of People and Animals Goes Hand-in-Hand