1. Reverse Zoonosis: A new way of thinking about pathogen flow
Nancy P. Lung, VMD, MS
Director of Veterinary Services
Fort Worth Zoo

2. The Science of Zoonosis Control One-directional thinking

3. Pathogen Flow is Dynamic

4. This dynamic flow can result in many fascinating situations!
Reverse Zoonosis
Pass-through Zoonosis

5. Examples from the literature and from my experience
Animal Hospitals
Agriculture
Risks from Ecotourism
Zoos

6. Animal Hospital Setting MRSA in Horses
VMTH
11 Cases of post-procedure infection over a 13-month period
Previously undiagnosed at this hospital
3/5 people associated with equine surgery and recovery were positive by nasal culture
Likely that colonized staff transmitted the bacteria to the affected horses

7. Agriculture Herd of 122 dairy cattle
Long standing TB negative status in herd
14 of 122 developed clinical M. bovis
Source identified from the farmer
Asymptomatic renal M. bovis
Infected the cattle by urinating on the straw in the barn
Risk to the swine industry from H1N1

8. Risks from Ecotourism
Tourism is now the world’s largest industry---$476 billion!
698 million international travelers per year
Ecotravel is rising by 30% per year and is growing fastest in developing countries.

9. Ecotourism Pathogen Flow
Local People
Domestic or Wild Animals
Traveler
Arthropod vectors

10. Endangered primate populations are particularly vulnerable.

11. Mountain Gorillas of the Virunga Mountains
Dian Fossey’s first field work in mid 1970’s
First tourists visited camp in 1979.
First gorilla group was officially “visited” by a handful of tourists in 1981.
10,641 tourists visited in 2005!!

12. Pathogen Flow in the Zoo setting
Interaction between animal care staff and the collection animals
Interaction between the public and the collection animals

13. A fascinating pass-through, amplification situation
20/55 infected (36%)
13 elephant keepers
5 nursery staff
1 vet
1 nutritionist
MRSA-colonized caretaker
USA 300

15. Elephant calf MRSA Lesions

16. Elephant Keeper MRSA Lesion
Here’s an example of a healing MRSA lesion in one of the elephant calf handlers. Notice how it looks like a spider bite, which it is often confused with, even by physicians.

17. Reducing Pathogen Flow Between the Public and Collection Animals
Case Examples

18. “Jackie” the Lowland Gorilla
10yr old female
Flu-like symptoms in family group
Rapid decline in Jackie—recumbent within 48 hrs
Confirmed Parainfluenza 3
Placed on life support for 7 days
Eventually made a full recovery

20. “Ramses” 31 yr old gorilla
“Kate”
39 yr old gorilla
Pneumococcal pneumonia
Maintained in oxygen cage
Outcome--recovered
Influenza A
Secondary pericarditis
Outcome--died

21. Chimpanzee Group Lincoln Park Zoo March, 2009
“Basan”
4yr old orangutan
7 animals in a single family group
All 7 had cold/flu-like symptoms
9 yr old male—status declined rapidly
Outcome—young male died, others recovered
Confirmed human metapneumoniavirus
Upper and lower respiratory infection
Confirmed Haemophilus influenzae
Outcome--recovered

24. Kimberly Clarke Chimpanzee Forest
Dallas Zoo

25. FWZ Outdoor Chimpanzee and Bonobo exhibit

26. FWZ Bonobo Exhibit

27. How to protect the health of animals in captive settings
Exhibit design in zoos
Personnel health assessment protocols in captive animal settings
Personal protective equipment during animal interactions
Public Education

28. Zoonosis Control Pathogen Flow is Dynamic

29. Protection of People and Animals Goes Hand-in-Hand