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      Zoonoses in Veterinary Students: A Systematic Review of the Literature

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          Abstract

          Background

          Veterinary students face diverse potential sources of zoonotic pathogens since the first years of their academic degree. Such sources include different animal species and pathologic materials which are used at university facilities as well as commercial clinics, farms and other external facilities.

          Objectives

          The present study utilizes a systematic review of the literature to identify zoonoses described in veterinary students.

          Data sources

          Web of Science and PubMed.

          Results

          Of the 1,254 titles produced by the bibliographic search, 62 were included in this review. Whereas 28 of these articles (45.2%) described individual cases or outbreaks, the remaining 34 (54.8%) reported serological results. The zoonotic etiological agents described were bacteria, in 39 studies (62.9%), parasites, in 12 works (19.4%), virus, in 9 studies (14.5%) and fungi, in 2 (3.2%) of the selected articles. The selected literature included references from 24 different countries and covered the time period of the last 55 years.

          Limitations

          The fact that common cases of disease or cases of little clinical importance without collective repercussions are not usually published in peer-reviewed journals limits the possibility to reach conclusions from a quantitative point of view. Furthermore, most of the selected works (66.1%) refer to European or North American countries, and thus, the number of cases due to pathogens which could appear more frequently in non-occidental countries might be underestimated.

          Conclusions/implications

          The results of the present systematic review highlight the need of including training in zoonotic diseases since the first years of Veterinary Science degrees, especially focusing on biosecurity measures (hygienic measures and the utilization of the personal protective equipment), as a way of protecting students, and on monitoring programs, so as to adequately advise affected students or students suspicious of enduring zoonoses.

          Related collections

          Most cited references 56

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          Prevalence of antibodies to hepatitis E virus in veterinarians working with swine and in normal blood donors in the United States and other countries.

          Hepatitis E virus (HEV) is endemic in many developing and some industrialized countries. It has been hypothesized that animals may be the source of infection. The recent identification of swine HEV in U.S. pigs and the demonstration of its ability to infect across species have lent credence to this hypothesis. To assess the potential risk of zoonotic HEV infection, we tested a total of 468 veterinarians working with swine (including 389 U.S. swine veterinarians) and 400 normal U.S. blood donors for immunoglobulin G anti-HEV. Recombinant capsid antigens from a U.S. strain of swine HEV and from a human HEV strain (Sar-55) were each used in an enzyme-linked immunosorbent assay. The anti-HEV prevalence assayed with the swine HEV antigen showed 97% concordance with that obtained with the human HEV antigen (kappa = 92%). Among the 295 swine veterinarians tested from the eight U.S. states (Minnesota, Indiana, Nebraska, Iowa, Illinois, Missouri, North Carolina, and Alabama) from which normal blood donor samples were available, 26% were positive with Sar-55 antigen and 23% were positive with swine HEV antigen. In contrast, 18% of the blood donors from the same eight U.S. states were positive with Sar-55 antigen and 17% were positive with swine HEV antigen. Swine veterinarians in the eight states were 1.51 times more likely when tested with swine HEV antigen (95% confidence interval, 1.03 to 2.20) and 1.46 times more likely when tested with Sar-55 antigen (95% confidence interval, 0.99 to 2.17) to be anti-HEV positive than normal blood donors. We did not find a difference in anti-HEV prevalence between veterinarians who reported having had a needle stick or cut and those who had not or between those who spent more time (> or = 80% of the time) and those who spent less time (< or = 20% of the time) working with pigs. Similarly, we did not find a difference in anti-HEV prevalence according to four job categories (academic, practicing, student, and industry veterinarians). There was a difference in anti-HEV prevalence in both swine veterinarians and blood donors among the eight selected states, with subjects from Minnesota six times more likely to be anti-HEV positive than those from Alabama. Age was not a factor in the observed differences from state to state. Anti-HEV prevalence in swine veterinarians and normal blood donors was age specific and paralleled increasing age. The results suggest that swine veterinarians may be at somewhat higher risk of HEV infection than are normal blood donors.
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            Isolation and Characterization of Methicillin-Resistant Staphylococcus aureus from Pork Farms and Visiting Veterinary Students

            In the last decade livestock-associated methicillin-resistant S. aureus (LA-MRSA) has become a public health concern in many parts of the world. Sequence type 398 (ST398) has been the most commonly reported type of LA-MRSA. While many studies have focused on long-term exposure experienced by swine workers, this study focuses on short-term exposures experienced by veterinary students conducting diagnostic investigations. The objectives were to assess the rate of MRSA acquisition and longevity of carriage in students exposed to pork farms and characterize the recovered MRSA isolates. Student nasal swabs were collected immediately before and after farm visits. Pig nasal swabs and environmental sponge samples were also collected. MRSA isolates were identified biochemically and molecularly including spa typing and antimicrobial susceptibility testing. Thirty (30) veterinary students were enrolled and 40 pork farms were visited. MRSA was detected in 30% of the pork farms and in 22% of the students following an exposure to a MRSA-positive pork farm. All students found to be MRSA-positive initially following farm visit were negative for MRSA within 24 hours post visit. Most common spa types recovered were t002 (79%), t034 (16%) and t548 (4%). Spa types found in pork farms closely matched those recovered from students with few exceptions. Resistance levels to antimicrobials varied, but resistance was most commonly seen for spectinomycin, tetracyclines and neomycin. Non-ST398 MRSA isolates were more likely to be resistant to florfenicol and neomycin as well as more likely to be multidrug resistant compared to ST398 MRSA isolates. These findings indicate that MRSA can be recovered from persons visiting contaminated farms. However, the duration of carriage was very brief and most likely represents contamination of nasal passages rather than biological colonization. The most common spa types found in this study were associated with ST5 and expands the range of livestock-associated MRSA types.
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              Australia's national Q fever vaccination program.

              A nationally funded Q fever vaccination program was introduced in Australia in 2002. The evaluation of this unique program included measures of program uptake, safety, and notification and hospitalisation rates for Q fever pre- and post-program implementation. Program uptake ranged from close to 100% amongst abattoir workers to 43% in farmers. The most commonly reported adverse event was injection site reaction. Q fever notification rates declined by over 50% between 2002 and 2006, particularly in young adult males, consistent with the profile of the abattoir workforce. Hospitalisation data showed similar trends. Available evidence suggests a significant impact of Australia's Q fever vaccination program; such a program merits consideration in other countries with a comparable Q fever disease burden.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                4 January 2017
                2017
                : 12
                : 1
                Affiliations
                Research Group of Ruminant Health, Animal Health Department, Veterinary School, Regional Campus of International Excellence ‘Campus Mare Nostrum’, Murcia University, Spain
                Institut National de la Recherche Agronomique, FRANCE
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                • Conceptualization: AS AC.

                • Formal analysis: AS MPvH JTD AP CdlF AGM JCC AC.

                • Investigation: AS MPvH JTD AP CdlF AGM JCC AC.

                • Supervision: AS.

                • Writing – original draft: AS MPvH.

                • Writing – review & editing: AS MPvH JTD AP CdlF AGM JCC AC.

                Article
                PONE-D-16-41688
                10.1371/journal.pone.0169534
                5215727
                28052113
                © 2017 Sánchez et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Page count
                Figures: 1, Tables: 1, Pages: 16
                Product
                Funding
                The authors have no support or funding to report.
                Categories
                Research Article
                Biology and Life Sciences
                Veterinary Science
                Veterinary Diseases
                Medicine and Health Sciences
                Infectious Diseases
                Zoonoses
                Medicine and Health Sciences
                Infectious Diseases
                Bacterial Diseases
                Brucellosis
                Medicine and Health Sciences
                Tropical Diseases
                Neglected Tropical Diseases
                Brucellosis
                Medicine and Health Sciences
                Infectious Diseases
                Zoonoses
                Brucellosis
                People and Places
                Population Groupings
                Professions
                Veterinarians
                Medicine and Health Sciences
                Infectious Diseases
                Bacterial Diseases
                Q Fever
                Medicine and Health Sciences
                Infectious Diseases
                Bacterial Diseases
                Enterococcus Infections
                Biology and Life Sciences
                Veterinary Science
                Veterinary Medicine
                Veterinary Hospitals
                Biology and Life Sciences
                Veterinary Science
                Veterinary Microbiology
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.

                Uncategorized

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