Protecting veterinary staff

Veterinary staff are often called to treat cases of leptospirosis, either confirmed or suspected, and their handling of both the animal and the samples taken for testing obviously place them at a higher risk of infection than the general public. Their risk events are also part of their occupation and so there are legal requirements in terms of employee protection and safety policy to satisfy.

Where staff are likely to come into contact with leptospira, either in direct care of animals or in a laboratory setting, it can be advantageous to take a blood sample and determine baseline titers for the commonly-expected serogroups, so that if a human infection is suspected the delay in performing a differential test can be removed. This is not generally worthwhile for every employee, but in some geographical regions and where the employee has a specific exposure bias (such as a research student working on the bacteria) it can be an important factor in processing acute infection cases with maximum efficiency. The same baseline system is used widely for other infectious agents and hazards, such as eye tests for workers using high-power lasers.

Human vaccination is not a possibility at this time, except in one or two countries, and the long-term use of prophylaxis is also not viable – therefore the best practice for protection is hygiene and barrier controls, plus a detailed awareness of the symptoms of infection. Should an employee believe they have suffered a risk event (an accident where the bacteria may have been able to cause an infection) then they should immediately be prescribed a single precautionary doxycycline dose (1x200mg oral) and arrange a blood test. In many cases the suspect serogroup will be known from the animal or lab sample being worked on, and so this will often make the human serology far simpler – a single serovar MAT is far faster than an entire panel – however a baseline test on file can also remove the need to run paired titers.

In terms of personal barrier protection, gloves should be used whenever handling infected samples or animals. broken skin should be covered with waterproof dressings, and staff must be careful not to transfer fluids to their eyes or mouth (either by hand or from animal licking, etc.). Masks and eye protection are not required for general care as the bacteria are not airborne, but are advised during surgical or post-mortem procedures where fluid aerosols may be generated.

Hand-washing between patients, before contact with other humans and certainly before any food or drink is of course the most important precaution, both for leptospirosis and many other infections. Soap, alcohol-based gels and antibacterial wipes are all effective. In particular, veterinary staff must be aware of the risks of cross-infecting animals, where a serovar is species-adapted it will cause more severe illness in other species, this being a concern for example with the serovars specific to cattle and pigs.

Handling dry material (equipment, toys, bedding, etc.) is of no significant risk, but any item contaminated with blood or urine and still moist should be disposed as clinical waste, or washed and dried.