Removing the Source of Infection
Initial Training and Periodic Refresher Courses
First
Aid for Bites, Scratches, Needle Sticks and Eye Splashes
Removing the Source of Infection
Based on the Experience of One US Research Facility Housing Approximately 500 Macaques (90% Cynomolgus and 10% Rhesus)
- Newly acquired Cynomolgus monkeys obtained from the island of Mauritius have not been known to be infected.
- Monkeys are tested for seroconversion one month prior to shipping by the vendor and every six months in the animal laboratory.
Therefore, measures to remove the source and to reduce the possibility of exposure include the following:
1. Acquire macaque monkeys from colonies that are B-virus free.
2. Test the monkeys periodically for serological conversion.
3. File, blunt or surgically disarm the large canine teeth of older animals.
4. Remove the sharp corners from all cages.
Medical Surveillance for Macaque Monkey Handlers
A serum sample will be drawn at the time of the pre-placement exam, frozen and stored for at least the duration of the monkey handler's employment. This will be used only if the worker suffers a monkey injury and the lab has difficulty interpreting the worker's serology pattern or in the event that baseline serum is not available. (The CDC Guidelines warn that, "about half of the human population --with or without previous contact with monkeys--possess HSV-neutralizing antibodies that cross-react with B virus.")
The worker's immunization status will be reviewed with attention to tetanus, measles. hepatitis A and hepatitis B. A two step TB skin test will be done on all new employees who do not have documentation of a previously positive PPD. For monkey handlers, the TB skin test will be repeated every six months. (See the Table of Possible Infectious Agents and Their Control for more information about the immunizations and TB skin testing.)
At the time of the pre-placement exam, the worker's medical history will be reviewed. Any evidence of a chronic skin condition, especially of the hands, will be noted so that appropriate work restrictions can be assigned.
Initial Training and Periodic Refresher Courses
Most important is training employees about safe handling of sharps and monkeys.
Personal Protective Equipment
This will be covered in the training courses. The veterinarian and safety director should ensure that all workers understand the proper use of gloves, clothing and safety glasses. Arm-length reinforced leather gloves should be used if direct handling is required. Other essential equipment includes long-sleeved protective clothing, face shields (or surgical masks and goggles) and latex or vinyl gloves.
First Aid for Bites, Scratches, Needle Sticks and Eye Splashes
Taking the proper action within the first few minutes after exposure;
According to Dr. Julia Hilliard, director of B Virus Resource Laboratory, thorough cleansing of wounds or contaminated mucous membranes eliminates 99% of the risk for infection.
Needed are:
- Bite and scratch log
- Bite/wound kits
- Medical evaluation protocol
See the specimen collection forms available from the NIH B Virus Resouce Laboratory.
Post-Exposure Plans
1. Assess Adequacy of Wound Cleansing.
2. Collect Viral Culture from Wound.
3. Collect Initial and Two Week Post-Exposure Blood Specimens for Antibody Titers.
4. Counsel Patient on Symptoms to Watch for and Precautions to Take at Home while Awaiting Results of Cultures and Blood Tests.
5. Ensure Collection of Animal Specimens and Shipment of All Specimens to the NIH B Virus Resource Laboratory.
