What types of zoonoses do horses have
The Medical Advisory Board at the Federal Ministry for Health and Social Security, Section "Occupational Diseases", has approved the following new version of the leaflet on occupational disease No. 3102 of the annex to the Occupational Diseases Ordinance, which is hereby published.
I. Occurrence and sources of danger
Under the BK no. 3102 those infections and their clinical pictures are recorded which are transmitted from animals to humans. According to the WHO, over 200 diseases known as zoonoses are known. Some of this multitude of zoonoses can also occur in Germany. There may be a risk of infection in particular for people who are professionally involved in animal husbandry and care or who otherwise deal with animals, animal products or excretions. This includes handling objects that have come into contact with infected animals and their parts or excretions. An infection risk for zoonoses that is typical of the occupational group can therefore occur: with agricultural and veterinary staff, slaughterhouse staff, employees in animal laboratories, in hunting and forestry, in animal processing plants, zoological gardens, game enclosures and pet shops as well as with people who work with meat, fish and milk , Eggs, hides, skins, furs, animal bristles, hair, feathers and bones; also for people who come into contact with infectious material in sewage disposal. Most zoonoses occur in other countries and may need to be taken into account by business travelers, development workers, fitters, tour guides etc. after a stay abroad.
Zoonoses are caused by bacteria (including chlamydia and rickettsiae), viruses, fungi, parasites (protozoa, helminths or arthropods); It is currently under discussion whether they can also be caused by prions (abbreviation for Proteinaceous infectious particles - infectious protein). After handling infected animals, animal material or the like, pathogens can penetrate the human body via the skin or mucous membranes; This is also possible by inhaling air contaminated with pathogens or via the digestive system, e.g. via contaminated hands (dirt or smear infection). Mammals - horses, cattle, sheep, goats, pigs, dogs, cats, bats, hamsters, mice, rats, hedgehogs - and birds as well as fish come into consideration as pathogen reservoirs. Latently infected animals can also act as reservoirs for the maintenance of pathogens. The transmission of pathogens is often linked to arthropods (insects, ticks or arachnids) and rodents. Rodents, flies, cockroaches or pharaoh ants in particular can mechanically transmit germs that cause disease to susceptible hosts (humans or animals) and media. Known as vectors (carriers of pathogens or food spoilage pathogens) and reservoirs (intermediate hosts of parasites) are shield and leather ticks, flies, biting flies, cockroaches, horseflies, fleas, lice, rats and mice. In addition to living vectors, there are also inanimate vectors such as water, dust, air, animal waste, care items, etc. After an incubation period that is typical for every infection, during which the pathogens multiply, the symptoms of the disease generally begin (suddenly). The incubation time varies depending on the number and transmission route of the pathogens and the individual disposition of the infected person.
III. Diseases and diagnoses
With regard to the clinical pictures and their diagnoses, reference is made to the relevant textbooks. Sorted by pathogen groups, the following diseases can mainly occur in Germany:
1. Caused by bacteria (including chlamydia and rickettsiae)
2. Caused by viruses
3. Caused by mushrooms
4. Caused by parasites (protozoa and worms)
5. Caused by other pathogens
For example, mites as a pathogen causing scabies, mange, etc., can be transmitted when handling eggs, animal material, etc.
To illustrate the importance of the temporal relationship relevant to the occupational disease, the incubation period, reservoir, route of infection and typical clinical pictures are shown in alphabetical order in the appendix.
In most cases, the history and clinical symptoms only allow a suspected diagnosis. The diagnosis and its etiology are confirmed by direct pathogen detection and / or antibody detection (ideally two examinations at an interval of 10 to 14 days to check the titer dynamics; a single serological examination often does not allow a reliable diagnostic statement). In the case of viruses with existing subtypes, it is possible to reliably identify or exclude the source of infection using genomic analyzes of the viruses detected (via cell culture). This is also the case with some bacterial species, such as Campylobacter ssp., Salmonella ssp. by means of lysotype, plasmid fingerprinting or
Restriction enzyme analyzes possible. In individual cases, a proven (pathogen and / or antibody detection) or endemic occurrence of the infectious agent in the animal can also be regarded as a reliable source of infection.
IV. Further information
For the well-founded suspicion of the presence of an occupational disease, the occurrence of the respective pathogen at the workplace is just as important as a temporal connection to the exposure. The disease must develop within a time that is within the scope of the incubation period.
In the case of inapparent diseases, the development of the stage concerned and the possible subsequent condition of the infectious disease should be considered; Transmission path and infectivity of the pathogen must also be taken into account. Complications and permanent damage can occur in particular with brucellosis, enterohaemorrhagic E. coli infections, TBE, leptospirosis, Lyme borreliosis, Q fever tuberculosis and enteral yersiniosis.
If diseases have not been transmitted from animals to humans but from human to human, BK No. 3101 may apply.
With regard to damage to a womb as a result of occupational infection of the pregnant woman with a zoonosis (e.g. in the case of chlamydiosis, leptospirosis, listeriosis, Lyme borreliosis, toxoplasmosis) during the respective pregnancy, compensation for the child in accordance with Section 12 of Book VII of the Social Code should be considered.
For the encephalomyelitis caused by Bornaviruses observed in horses in Germany, the zoonotic status has not yet been reliably clarified. The identity of the viruses isolated from horses and humans has not yet been proven.
So far, no human spongiform encephalopathies through transmission of BSE (bovine spongiform encephalopathy) pathogens have been identified as a disease with the characteristics of an occupational disease. This also applies to related TSE (transmissible spongiform encephalopathy) pathogens such as the scrapie agent, which only affects sheep and goats. Any suspected cases should be reported anyway.
Krauss, H, A Weber, B Enders, H G Schiefer, W Slenzka, H Zahner: Zoonoses. Infectious diseases that can be transmitted from animal to human. 3. Ed. - Cologne: Dt. Doctors-Verl. 2003 (in press)
Meslin F X: Global aspects of emerging and potential zoonoses: A WHO perspective. Emerg Infect Dis 3 (1997) 223-8
Neff J M: Introduction to Poxviridae [Chapter 1201, Vaccinia Virus (Cowpox) [Chapter121] - In: Mandell, Douglas, and Bennett's principles and practice of infections diseases / ed by Gerald L Mandell, John E Bennett, Raphael Dolin. 5th ed., Philadelphia, Pennsylvania, Churchill Livingstone 1552-3 (2000)
Palmer S R, L Soulsby, D I H Simpson: Zoonoses. Biology, Clinical Practice and Public Health Control Oxford, Oxford University Press 1998
Weinberg A N: Zoonoses [Chapter 314] - In: Mandell, Douglas, and Bennett's principles and practice of infections diseases / ed. By Gerald L Mandell, John E Bennett, Raphael Dolin. - 5th ed.,
Appendix: Brief description of the most important diseases that can be transmitted from animals to humans
SVD virus (rhabdovirus)
E. granulosus (dog tapeworm)
Escherichia coli (VTEC)
Particularly dangerous serovars O 157: H7 and O 157: H-
(HPS - Hantavirus Pulmonary Syndrome, NE-Nephropathia epidemica) Hantaviruses (Bunyaviridae)
The most commonly detected serovars are:
- Phase: high fever (39-40 ° C), chills, headache and muscle pain
- Phase: hepatitis, nephritis, meningitis, myocarditis, iridocyclitis, intrauterine fetal death, miscarriage or premature birth
Most important route of infection orally (raw milk, soft cheese, salads)
Systemic: septic typhoid monocyte angina, endocarditis, pleurisy, pneumonia, urethritis, liver abscess, meningitis, encephalitis, neonatal listeriosis
B. afzelii (syn. Group VS 461)
LCM virus (arenavirus)
Pulmonary anthrax: severe bronchopneumonia
Intestinal anthrax.: Carbuncle in the small intestine, with perforation peritonitis
Phlegmon, abscess, necrosis, periostitis, osteomyelitis
acute and subacute:
Bronchitis, pneumonia or asthma, conjunctivitis, stomatitis, enteritis, peritonitis, intra-abdominal abscess, urinary tract infection, myositis
P. canis or Mannheimia haemolytica (former name
Pneumocystis carinii (the assignment to fungi or parasites has not yet been finally clarified)
Initial focus: painless papule, fluctuating, ulcerated, serous or pustular; further nodules along the lymphatic system
nodular changes (nose, mouth, pharynx, larynx, trachea), regional lymph node swelling
Lungs, bones, joints, muscles, eyes, testicles, epididymis
Streptococcus equi subsp. zooepidernicus, Str. equi subsp. equi
Chronic: intermittent fever, arthralgia, psych. Alteration, organ manifestation in lymph nodes, liver, spleen, eye, CNS
with initial infection malformations and infection of the newborns
circinatus, folliculitis acuminata, tinea corporis
(T. mentagrophytes var. Quinckeanum
(T. mentagrophytes var.Erinacei)
(syn. Microsporum gallinae)
Mycobacterium tuberculosis, M. bovis,
Inner shape: Pleurisy, spleen swelling, diarrhea, intermittent fever, rash, anginal symptoms (as a result of endotoxin)
Also possible: Prinaud's conjunctivitis, liver cirrhosis, Far Eastern scarlet fever
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