Preventing infectious disease spread in your veterinary hospital: Five rules to follow

Canine influenza outbreaks across the country have shown us how rapidly a respiratory disease can spread when community immunity is low.  Dog parks, boarding facilities and dog shows have been common locations for outbreaks to start.  Veterinary hospitals also have congregating dogs so preventing infectious disease spread is crucial. None of us want patients that visit us for one reason to go home with a second disease.  However, I worry that many veterinary hospitals don’t have strict enough protocols to really keep  patients safe from contagion.

The holes in the overall healthcare response to infectious disease became national news when a case of Ebola was treated in a Texas hospital.  Two nurses contracted the disease from a patient due to inadequate infectious disease protection.  According to the nurses, they did not have enough training or available written protocols to really protect themselves.

We are very lucky that the vast majority of dog and cat diseases are not transmissible to people. However, ringworm, leptospirosis, plague and rabies are some notable exceptions.  In addition, we can act as fomites, passing disease from one pet to another with our hands, our clothes, and with our tools, such as stethoscopes.

These are five rules can make patients (and humans) safer in our veterinary hospitals.

1) Educate EVERYONE in your hospital about infectious disease risks.

Most veterinarians and many veterinary technicians have good knowledge around infectious disease spread.  However, most kennel and client care staff have not had prior education on what is an infectious disease and how they are transmitted.  Your kennel and janitorial staff will do a better job with cleaning if they understand the important role they play in disease prevention.  Your client care staff can alert you to potentially infectious patients that are on their way if they are trained on what clues to listen for.  Does your client care staff know that if they hear a dog coughing in your lobby that it should be isolated in an exam room quickly?  Do you have a way to identify patients that might have an infectious disease before they arrive so they are roomed immediately?

2) Wash your hands.

This is the easiest and most effective way to protect yourself and other pets. Sadly, almost no one washes their hands correctly every time they should.  A study published in JAVMA in 2012 revealed that only 20% of interactions between clinicians and patients had proper hand hygiene.  The good news is that an educational campaign improved this to 40%, which is still sadly less than HALF THE TIME.  However, if we can double hand washing with a simple intervention, it is worth doing.  A simple step is to show this great video  to your staff at your next staff meeting and talk about the importance of hand hygiene in preventing the spread of diseases such as canine influenza and kennel cough.

3) Have alcohol-based gels readily available in your hospital.

Alcohol based gels are as effective as hand washing in removing bacteria and viruses in many cases.  These gels do not remove physical matter, do not kill clostridium, and do not kill parvovirus, but they are effective in most other cases.  In cold winter months when hands get dry, people are more likely to gel consistently than to wash. Thus, it is important to have these available in convenient locations AND to make sure the dispensers stay filled.  Here is another fun video.

4) Clean exam tables and wet table tops between EVERY patient. 

If a pet sneezes on the table and has kennel cough, if they have a skin infection and shed hair on the table, or if they have an infectious cause of diarrhea and get a small amount of fecal material on the table, the disease can easily pass to the next pet who is placed there.  Cleaning tables between pets seems like an easy common sense move but it is done INFREQUENTLY in many hospitals I have visited.  Does cleaning exam surfaces between pets happen in your hospital?  Spend an hour on a busy Saturday morning and watch pets brought to the treatment area and tally how many times this simple step is missed – you’ll be surprised.

5) Contact time of your cleaning products matters.

Each antiseptic product has a different amount of contact time needed to be fully effective.  If you are not adhering to these recommendations, you are not killing the bacteria or viruses you think you are. If you are using a quaternary ammonium product, you may need up to 10 minutes of contact time to kill bacteria such as enterococcus.  Alcohol, quaternary ammonium products, accelerated hydrogen peroxide products and bleach all kill influenza virus but the contact time and dilutions needed vary.  Make sure you have appropriate written cleaning protocols in your hospital for different equipment and surfaces.

Interested in receiving a sample contagious canine respiratory disease hospital protocol?  Email me at bdavidow@vetidealist.com.

For more information on canine influenza, click here