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.

II. Etiopathogenesis

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)

4.1. Protozoa

4.2. 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.

V. Literature

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

Serial No.Disease pathogenincubation periodReservoir (main ones are underlined)Routes of infectionClinical picture1Balantidiosis
(Balantidienruhr)
Balantidium coli Hours to dayspig, Rabbits, rats (large intestine commensals), rarely monkeys, cattle, sheep Oral (smear infection), flies as mechanical carriers Ulcerative colitis with tennesmas and slimy, bloody stools2Swine vesicle disease (SVD)
SVD virus (rhabdovirus) 2 to 9 days pig Close contact with infected pigs;
Brakes Make vesicles in contact, aphthae, clinically in-apparent infection3Brucellosis1-3 weeks  Smear infection (secretion, lochia), inhalation (dust, aerosol), oral (food: especially raw milk, sheep and goat cheese)Granulomas in the liver, spleen, bones (arthritis); Complication: endocarditis, osteomyelitis, meningoencephalitis Brucella abortus, Beef B. melitensissheep, goat, Beef B. suispig, Hare B. canisdog4Campylobacter infections
Campylobacter jejuni (11/2) 3-5 (-11) days  Oral (contaminated food, especially raw milk, drinking water); Smear infection of infected animals (faeces), also from person to person (faeces)Gastritis, colitis, proctitis, arthritis, meningitis, Guillain-Barré syndrome, peritonitis, urinary tract infection, abortion, sewis C. coli  pig, Cattle, sheep, zoo animals, cats, golden hamsters, guinea pigs, mice C. lari  Seagulls, Dog5Chlamydiosis
Chlamydophila psittaci, 7-21 days (up to 3 months)Birds, Domestic and wild animalsMainly inhalation (dust), also smear infection (faeces), direct contact (cat conjunctivitis), via conjunctiva; also from person to personMild "flu" to atypical "interstitial pneumonia, orchitis, endocarditis, glomerulonephritis, miscarriage Chl. pecorum  Beef, Sheep, wildlife Chl. felis  cat Chl. abortus  sheep6Echinococcosis Alveolar echinococcosis
Echinococcus multilocularis
(Fox tapeworm) <5 to 15 years Fox (50% infected), dog, cat (<5% infected), field mouse (<1% infected) in endemic areas (in Germany: low mountain regions) Orally through contaminated food (berries and mushrooms contaminated with fox droppings) Metastatic cysts in the liver, lungs and brain Cystic echinococcosis
E. granulosus (dog tapeworm)   Dog (<1% infected) Oral (dirt and smear infection) after contact with fecal excretions from dogs Expansive cysts (no metastases) in the liver, lungs, spleen, peritoneum, brain; anaphylactic reaction after rupture7Enterohemorrhagic Escherichia coli
(EHEC) infections

Verotoxin-producing
Escherichia coli (VTEC)
Particularly dangerous serovars O 157: H7 and O 157: H- 3-4 (1-8) daysBeef, Sheep, goat, raw or half-cooked animal foods (minced beef, unpasteurized milk, yogurt, cream cheese), unchlorinated water, potatoes, salad dressing, applesauce Smear infection (faeces), oral (food), also from person to person Diarrhea, fever, vomiting; Complications HUS hemolytic uremic syndrome (renal insufficiency) and TTP - thrombocytopenic purpura (clouding of consciousness, convulsions, central nervous focus signs, hemiplegia)8Early summer meningoencephalitis
(TBE)
Flaviviruses 1-2 (-4) weeksTicks, Hedgehog, shrew, mole, (endemic areas) Tick ​​bite (altitude limit: 600 m), contact infection, airborne, rarely oral (raw milk) Clinically inapperent to flu-like up to 40 ° C fever and meningitis to encephalomyelitis with paresis and paralysis9Giardiasis (Lambliasis)
Giardia lamblia 6-15 daysdog, cat, Cattle, sheep, rodent, (human) Oral (smear infection), drinking water and food (flies as mechanical carriers) Symptom-free or: foul-smelling diarrhea, nausea, anorexia, flatulence, headache, slight fever, loss of appetite; also chronically relapsing10Hantavirus diseases
(HPS - Hantavirus Pulmonary Syndrome, NE-Nephropathia epidemica) Hantaviruses (Bunyaviridae) 14-21 days Rodents (field vole, bank vole, rat) Smear infection via excretions (urine, faeces, saliva) of infected mice or rats, airborne (aerosol), contaminated food High fever, shortness of breath, arthralgia, back and retrosternal pain, generalized edema, protein-rich pulmonary edema11Cat scratch disease
Bartonella henselae,
B. clarridgeiae,
Afipia felis 1-2 weekscat, very rarely dog ​​or squirrel Scratch or bite, (cat flea bite) Papule at the portal of entry, regional lymphadenitis, occasional fever, anorexia, generalized rash, rarely severe complications, encephalopathy, blindness, etc.12Cryptosporidiosis
Cryptosporidium parvum,5-28 dayscalf, LambOral transmission of the oocysts (smear infection)Enterocolitis followed by desiccosis, predominantly opportunistic C. baileyi (very rare) Birds13Leptospiroses
Leptospira interrogans,
The most commonly detected serovars are:
L. icterohaemorrhagiae
L. grippotyphosa
L. pomona
L. tarassovi
L. hardjo (2) 5-14 (-20) daysrat, mouse, Pig, cattle, horse, dog, fox, rabbit, hedgehog Over injured skin and mucous membranes, e.g. after diving, falling into canal water
  1. Phase: high fever (39-40 ° C), chills, headache and muscle pain
  2. Phase: hepatitis, nephritis, meningitis, myocarditis, iridocyclitis, intrauterine fetal death, miscarriage or premature birth
14Listeriosis
Listeria monocytogenes 1-3 days to 4 weeksBeef, sheep, Goat, pig, chicken, dog, cat, deer, zoo, fur and laboratory animals, birds, cold-blooded animals, insects Smear infection (faeces), via conjunctiva, inhalation (dust), diaplazenrar
Most important route of infection orally (raw milk, soft cheese, salads)Local: Papules, pustules (hands, arms, chest, face)
Systemic: septic typhoid monocyte angina, endocarditis, pleurisy, pneumonia, urethritis, liver abscess, meningitis, encephalitis, neonatal listeriosis15Lyme disease
Borrelia burgdorferi
sensu stricto
B. garinii
B. afzelii (syn. Group VS 461) 4-7 (3-14) daysTicks, rodents living in the wild, hedgehogs, roe deer, red deer, birds Bite, mainly from ticks (altitude limit: 1000 m), transplacental; also described after being bitten by an infected horse Erythema migrans, wandering arthralgia, heart problems, gastrointestinal symptoms, lymphadenosis, arthritis, acrodermatitis chronica atrophicans, encephalomyelitis, Bannwarth syndrome (meningoradiculitis), transplacental infection16Lymphocytic choriomeningitis
LCM virus (arenavirus) 6-13 daysHouse mouse, Hamsters, laboratory animals Bite, smear infection; aerogenic in laboratory infections Photophobia, runny nose, bronchitis, meningitis, meningoencephalitis, encephalitis, prenatal infections, malformations in newborns17Foot and mouth disease FMD virus (Picornaviridae) 2-8 days Cloven-hoofed (Beef, Sheep) Smear infection via animate and inanimate vectors, airborne General symptoms of the disease, primary naphthean portal of entry, painful blisters in the mouth and throat, on the fingers and toes18Milk knot Milker's knot virus (Parapoxvirus) 5-7 daysBeef (Udder pox) Direct contact Pea-sized, hemispherical, blue-red knots on the hands19Microsporia
Microsporum canis Several days to a few weekscat, Dog, very rarely horse, pig, sheep, goat, other animal species Frequent direct contact with sick or latently infected animals (even long-haired cats that appear healthy are latently infected with M. canis up to 90%) Dermatomycosis: Tinea capitis or Tinea corporis20anthrax (Anthrax)
Bacillus anthracis 2-5 days (occasionally after a few hours)Bovine, Sheep, goats, horses, buffalo, camels, reindeer, mink, very rarely pigs and carnivores About skin fissures and cracks after contact with animal feed, hides, hides, animal products, sewage from tanneries, wool factoriesSkin anthrax: necrotizing carbuncles with lymphadenosis, possibly sepsis, shock or meningitis
Pulmonary anthrax: severe bronchopneumonia
Intestinal anthrax.: Carbuncle in the small intestine, with perforation peritonitis21Newcastle disease Newcastle Disease Virus (NDV) 1-2 (4) dayschicken, Domestic fowl and wild birds Aerogenic or conjunctival after contact with infected poultry; Infection with vaccine (non-pathogenic for chickens) is also possible (e.g. spray vaccine) Follicular conjunctivitis, preauricular lymph node swelling22Pasteurellos
Pasteurella multocida2-14 days Latent in the nasopharynx of mammals (in 75-90% of cats and up to 55% of dogs) and birdsAbout bite or scratch injuries from infected animals, smear infection, airborne droplet infection, orally (very rarely)After bite:
Phlegmon, abscess, necrosis, periostitis, osteomyelitis
acute and subacute:
Bronchitis, pneumonia or asthma, conjunctivitis, stomatitis, enteritis, peritonitis, intra-abdominal abscess, urinary tract infection, myositis Occasionally too
P. dagmatis
P. canis or Mannheimia haemolytica (former name
P. haemolytica) Physiologically in the upper respiratory tract in mice, rats, dogs and cats23Pneumocystosis
Pneumocystis carinii (the assignment to fungi or parasites has not yet been finally clarified) 4-8 weeksmouse, rat (which usually do not get sick), domestic and zoo animals Aerogenic (contaminated droplets, dust), diaplacental Pneumonia, rarely: in lymph nodes, liver, spleen and bones24Q fever
Coxiella burnetii 2-4 weeksRodents, Ticks, sheep, Goat, cattle, wildlife Aerogenic with contaminated dust (infectious for months), direct contact with excretions, lochia of infected animals (especially sheep) High fever, retrobulbar headache, weight loss, atypical pneumonia, endocarditis, complication: granulomatous hepatitis25Rat bite disease
Spirillum minus 2-3 weeks to 4 monthsrat, Weasel, squirrel, ferret, mouse, pig, cat, dogBy biting an infected animalEdema, vesicles, ulceration, rash at the bite site, fever, accompanying symptoms fever, dark red moniliform rash, pharyngolaryngeal symptoms Streptobacillus moniliformis 3-5 days Rat (buccopharyngeal saprophytism), other rodents26Rotlauf (Eryspeloid)
Erysipelothrix
rhusiopathiae 2-5 dayspig, fish, Poultry, rarely other species of birds and mammals Observed through injuries (cuts, stab wounds, tears and bites), through contact with infectious material or contaminated instruments, even after a dog bite Peripheral reddening, wheals, itching, pain, lymphangitis, rarely arthritis, sepsis, endocarditis27Salmonellosis Various serovars, especially: STyphimurium S. Enteritidis 5-72 hours Animals for slaughter, poultry, wild birds (seagulls, pigeons), housebirds, pets, rodents, contaminated food Primarily orally (dirt and smear infection) through contaminated food (chicken eggs and products made from them: egg powder, confectionery, slaughter poultry, minced meat), occasionally also after direct contact with salmonella-excreting animals (ornamental birds, housebirds, dogs, cats, turtles) Sudden vomiting, nausea, watery putrid stools, fever; Complications: sepsis, osteomyelitis, peritonitis, urinary tract infection, aortic valve endocarditis28Sporotrichosis
Sporothrix schenkii 3-21 days (up to 3 months) Rotten wood, rotten plants, soil and infected animals, especially Cats, rarely dog, horse, mule or squirrel Scratches and bite wounds of infected animals, especially cats, also described squirrels and badgers, injuries from contaminated wood splinters, plant thorns, etc., insect bites (transmission from person to person is very rare)Cutaneous shape:
Initial focus: painless papule, fluctuating, ulcerated, serous or pustular; further nodules along the lymphatic system
Mucosal porotrichosis:
nodular changes (nose, mouth, pharynx, larynx, trachea), regional lymph node swelling
Organ sporotrichosis:
Lungs, bones, joints, muscles, eyes, testicles, epididymis29Streptococcus equi infections
Streptococcus equi subsp. zooepidernicus, Str. equi subsp. equi 2-3 Days Home and pets, especially horse, also latent carriers Direct intensive contact with infected animals and their excretions e.g. nasal and pus secretions, through bites (dog, cat) Wound infection, pharyngitis, lymphadenopathy, pneumonia, pleurisy, endocarditis, sepsis, meningitis, arthritis, glomerulonephritis30Streptococcus suis infections
Streptococcus suis A few hours to 2 dayspig, also wild boar Direct contact (smear infection) via conjunctiva or skin lesions from infected animals or contaminated instruments Meningitic symptoms, hearing loss, balance disorders, long-term damage, e.g. deafness31Animal pox
(Orthopox virus)7-14 daysDroplet and smear infection (infected objects)Smallpox-like, mostly benign local disease, papular stomatitis; secondary bacterial infection, possibly generalization Monkey pox Monkeys Elephant pox Elephants Camel poxcamel, Dromedary cow-poxBeef, Cat Parapox sheep, Beef, Goat32rabies
Rabies virus
(Rhabdoviridae) Days - 3 months (also possible up to 1 year depending on the point of entry of the pathogen) Fox, dog, cat rarely: marten, badger increasingly: bat Bite, over skin injuries and conjunctiva, also possible airborne Paresthesia in the area of ​​injury, restlessness, tremor, cramps, hypersalivation, hydrophobia, hypersensitive to air movement and noise, excitation, paralysis, death33Toxoplasmosis
Toxoplasma gondii Weeks to monthscat, Pig, sheep, goat Smear infection (faeces), oral (raw meat), diaplacentalAcute: asymptomatic to localized or generalized lymphadenopathy, flu-like to meningoencephalitis
Chronic: intermittent fever, arthralgia, psych. Alteration, organ manifestation in lymph nodes, liver, spleen, eye, CNS
In pregnancy:
with initial infection malformations and infection of the newborns34Trichopythia
Trichopython
mentagrophytes14 days to 4 weeks Mouse, golden hamster, Guinea pig, Chinchilla, rat, Rabbits, Dog, cat, zoo animals (especially monkeys),  depth Trichophytia: profound, abscessing nodular-tumorous inflammation, regional swelling of the lymph nodes Surface Trichophytia:
circinatus, folliculitis acuminata, tinea corporis T. verrucosumBeef, (Sheep, horse),Direct contact with infected animals, indirectly via contaminated objects (bridles and saddles, stable posts, brushes, splinters of wood, straw, litter), possibly via flies, mites, lice, fleas, spiders T. equinumhorse T. quinckeanum
(T. mentagrophytes var. Quinckeanum Mouse, Guinea pig, Rat, Rabbits. (Dog Cat) Foci of disease smell like mouse urine T. erinacei
(T. mentagrophytes var.Erinacei) Hedgehog Fulminant developing clinical picture T. gallinae
(syn. Microsporum gallinae)chicken  35tuberculosis
Mycobacterium tuberculosis, M. bovis,
M. africanum 4-6 weeksBeef, Goat, dog, cat, zoo animals (especially monkeys) Aerogenic (infectious for months in dust and dried sputum), smear infection (sputum, milk, urine and faeces of infected animals), oral, via wounds Primary tuberculosis (primary focus and associated lymph nodes) in the lungs; Exudative pleurisy; haematogenic spread: miliary tuberculosis, meningitis, peritonitis, bone, joint, skin and genital tuberculosis36Tularemia
Francisella tularensis 2-10 daysHare, Wild rabbits, less often farm animals and pets (especially cats) Contact with excretions, blood or organs of infected animals, via small wounds percutaneously and via conjunctiva, bites, scratches, stings from blood-sucking insects, inhalation, orallyExternal shape: Primary ulcer lesion, regional swelling of the lymph nodes, or Perinaud's conjunctivitis
Inner shape: Pleurisy, spleen swelling, diarrhea, intermittent fever, rash, anginal symptoms (as a result of endotoxin)37(Enteral) yersiniosis
Yersinia enterocolitica, 3-10 daysPigs (in the tonsils and in the intestinal contents), (in the faeces of) dogs and cats; also rodents (guinea pigs, rabbits) and birds; also in the soil (e.g. garden soil, contaminated by the faeces of infected animals)Oral (dirt and smear infection)Enteritis, enterocolitis; Complications: arthritis, erythema nodosum,
Also possible: Prinaud's conjunctivitis, liver cirrhosis, Far Eastern scarlet fever Y. pseudotuberculosis 7-21 days