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CATTLE MANAGEMENT IN DISASTER
DISPOSAL OF DEAD BODIES
(24TH & 25TH JANUARY 2008)
DR. S. J. GANDHIDEPUTY DIRECTOR
(EPIDEMIC BRANCH)COMMISSIONER OF HEALTH
MEDICAL SERVICES & MEDICAL EDUCATION
GANDHINAGAR
ANTHRAX
AFTER CONFIRMATION OF BEING A CASE OF ANTHRAX, A CARCASS SHOULD NOT BE OPENED AND SHOULD BE DISPOSED OF BY
INCINERATION OR
RENDERING
DEEP BURIAL AFTER DISINFECTION IS A LESS FAVORURED OPTION.
BLOOD FROM THE DEAD ANIMAL SHOULD BE COLLECTED BY FOLLOWING STRICT ASEPTIC PRECAUTIONS FOR CONFIRMATION OF DIAGNOSIS.
NECROPSY SHOULD NOT BE DONE, AS THIS HAS THE RISK OF SPREAD OF INFECTION.
EDUCATION
EDUCATE EMPLOYEES ABOUT MODES OF ANTHRAX TRANSMISSION.
CONTROL DUST AND PROPERLY VENTILATE ALL HAZARDOUS INDUSTRIES PARTICULARLY WHICH ARE HANDELING RAW ANIMAL MATERIALS
DO NOT USE /SELL HIDES OF ANIMALS EXPOSED TO ANTHRAX NOR USE THEIR CARACASSES AS FOOD OR FEED SUPPLEMENTS
TREAT PROPERLY THE EFFLUENTS FROM HAZARDOUS INDUSTRIES HANDELING ANIMALS,ETC.
MEASSURES IN OUTBREAKS
INVESTIGATE
CONFIRM WITH LABORATORY DIAGNOSIS
SEARCH FOR THE SOURCE
IN THE AFFACTED AREA: -
THE CARACASSES OF INFECTED CATTEL ARE TO BE EITHER BURNT AT THESITE OF DEATH
THE ASHES BURIED DEEPLY,OR WRAPPED IN DOUBLE THICKNESS PLASTICBAG TO PREVENT SPILLING OF BODY FLUIDS AND REMOVED TO A MORE SUITABLE SITE WHERE THEY ARE BURNT AND THE ASHES BURIED
THE SITE WHERE THE ANIMAL DIED IS TO BE DISINFECTED WITH 5% FORMALDEHYDE AFTERE DISPOSAL OF CARACASS
ALL OTHER ANIMALS IN THE AFFACTED AREA ARE TO BE VACCINATED
QUARNTINE & OTHER PRECAUTIONS
AFFACTED PREMISSES ARE TO BE QUARANTINED FOR AT LEAST 20 DAYS AFTER THE LAST CASE OR 6 WEEKS AFTER VACCINATION, WHICHEVER IS LATER
ANY MILK COLLECTED FROM A COW, BUFFALO OR GOAT SHOWING SIGNS OF ANTHRAX WITHIN 8 HOURS OF MILKING IS TO BE DESTROYED, ALONG WITH ANY OTHER MILK THAT MAY HAVE BEEN MIXED WITH SUSPECTED MILK
PEOPLE ENTERRING INFECTED PREMISES ARE REQUIRRED TO WEAR PROTECTIVE CLOTHING, WHICH ARE DISINFECTED BEFORE LEAVING THE PREMISES
ALL CATTLE ON NEIGHBOURING PREMISES SHOULD ALSO BE VACCINATED
QUARNTINE & OTHER PRECAUTIONSA BUFFER ZONE, 20-30 KM WIDE, IS TO BE ESTABLISHED AROUND THE INFECTED AREA, WITHIN WHICH ALL CATTLE AND EXPOSED SHEEP ARE VACCINATED AND QUARANNTIED
PERSONS WHO HAVE HANDELED INFECTED ANIMALS OR THEIR CARACASSES SHOULD BE VACCINATED AGAINST ANTHRAX, IF THEIR EXPOSURE IS FREQUENT & IF HUMAN VCCINE IS AVAILABLE
SUCH PERSONS SHOULD AVOID ANY CONTACT WITH OTHER PERSONS OR ANIMALS WITHOUT FIRST CHANGING CLOTHING, WASHING HANDS AND TAKING APPROPRIATE MEASSURES
WHERE THERE IS A RISK OF AEROSOLIZATION OF SPORES
CONSIDER DAMPING DOWN OF MATERIAL WITH 5% FORMALIN, WEARING OF FACE MASKS ETC
DISPOSAL OF DEAD BODIESPLAGUE
RISK SIGNALS TO START IMMEDIATE FIELD INVESTIGATIONS:
EVIDENCE OF RAT FALL
SUSPECTED HUMAN CASE
FLEA NUISANCE/ HIGH FLEA INDEX
POSITIVE PLAGUE SEROLOGY IN RODENTS / CANNINES
DURING AN OUTBREAK OF BUBONIC PLAGUE ,RODENT CONTROL MEASURES WOULD FURTHER AGGREVATE THE PLAGUE TRANSMISSION BECAUSE LARGE NUMBER OF FLEAS WOULD LEAVE THEIR DEAD RODENT HOST AND WOULD FEED ON MAN AND OTHER DOMESTIC AND PERIDOMESTIC RODENTS AND
MAINTAIN DISEASE TRANSMISSION
SAFE DISPOSAL OF THE BODIES OF PERSONS DYING DUE TO PLAGUE AND DEAD RODENTS DURING RAT FALL: -
IN FATAL CASES OCCURRING DUE TO SUSPECTED PLAGUE POST MORTEM SHOULD BE DISCOURAGED.
CREMATION OR BURIAL OF THE DEAD BODY AS PER THE LOCAL CUSTOMS SHOULD BE UNDERTAKEN.
FUNERAL CEREMONIES IN THE HOUSES OF PLAGUE VICTIMS WHICH MAY INVOLVE ASSEMBLY OF PEOPLE SHOULD BE DISCOURAGED.
THE DEAD BODIES OF PLAGUE VICTIMS SHOULD NOT BE HANDLED AND ENCOFFINED BY THE RELATIVES AND FRIENDS OF THE DECEASED.
THE BURIAL STAFF SHOULD USE MASKS, PROTECTIVE CLOTHINGS, BOOTS & THICK RUBBER GLOVES.
OTHER NECESSARY PRECAUTIONS
PROFESSIONALS HANDLING THE DEAD BODIES SHOULD RECIEVE CHEMOPROPHYLAXIS IN RECOMMENDED DOSAGE AS PER THE ADVICE OF THE DOCTOR.
A LAYER OF LIME AS AN ABSORBENT MATERIAL TO BE KEPT ON THE COFFINS BEFORE THE DEAD BODIES ARE PUT IN IT.
THE DEAD BODY SHOULD BE PACKED IN AN IMPERVIOUS BODY BAG FOR TRANSPORT FROM THE PLACE OF DEATH AND SHOULD NOT BE EXTRACTED FROM THE BAG, AND SHOULD NOT BE BATHED BEFORE CREMATION/ BURIAL.
OTHER NECESSARY PRECAUTIONS
THE BAGGED BODY SHOULD BE PLACED IN A HERMETICALLY SEALED COFFIN AND BURIED WITHOUT RE-OPENING.
DEAD BODY SHOULD BE BURIED IN SUFFICIENT DEEP GRAVES TO PREVENT ACCESS TO RODENTS AND OTHER ANIMALS.
THE GARMENTS AND OTHER BELONGINGS OF A PATIENT DYING DUE TO BUBONIC PLAGUE IN THE HOUSE MUST BE GOT RID OF THE RAT-FLEAS BY THE APPLICATION OF 10% DUST FORMULATION OF MALATHION.
THE SOILED ARTICLES OF PNEUMONIC –PLAGUE VICTIMS SHOULD BE PACKED IN A BAG, INCINERATED, AUTOCLAVED OR FUMIGARED AND PROPERLY DISPOSED OF BY BURNING
GUIDELINES FOR DISPOSAL OF DEAD RODENTS DURING RAT FALL:-
USE DOUBLE FOLDED CLOTH TO COVER YOUR FACE
DEAD RATS SHOULD NOT BE TOUCHED WITH BARE HANDS
DISPSABLE HAND GLOVES OR POLYTHENE SHEET SHOULD BE WRAPED AROUND THE HAND TO HANDLE DEAD RATS
GUIDELINES TO DISPOSE OF DEAD RATS
SPRAY INSECTICIDE DUST OVER THE DEAD RAT AND SUBSEQUENTLY BURRY IT IN A DEEP PIT.
PICK UP THE DEAD RAT BY MEANS OF LONG FORCEPS, LONG TONG ETC. AND PUT IT IN A CONTAINER CONTAINING COTTON WOOL SOAKED IN INSECTICIDE FOR FINAL DISPOSAL
THE DISPOSABLE ITEMS SHOULD BE BURNT OR BURRIED AND OTHER ITEMS SHOULD BE DISINFECTED
RABIES
THE TREATMENT SHOULD BE STARTED IMMEDIATELY AFTER THE BITE.
THE TREATMENT MAY BE MODIFIED IF ANIMAL INVOLVED (DOG OR CAT) REMAINS HEALTHY THROUGHOUT THE OBSERVATION PERIOD OF 10 DAYS .
A HISTORY OF RABIES VACCINATION IN AN ANIMAL IS NOT ALWAYS A GUARANTEE THAT THE BITING ANIMAL IS NOT RABID.
ONE VACCINE DOSE IN THE ANIMAL DOES NOT ALWAYS PROVIDE LONG LASTING PROTECTION AGAINST INFECTION WITH RABIES.
THE NATURAL HISTORY OF RABIES IN MAMMALS OTHER THAN DOGS AND CATS IS NOT FULLY UNDERSTOOD AND THEREFORE THE 10 DAY OBSERVATION PERIOD MAY NOT BE APPLICABLE
GUIDELINES FOR TREATMENT
BITE BY ALL WILD ANIMALS: TREAT AS CATEGORY 3 EXPOSURE FOR RABIES
BITE BY RODENTS: BITES BY DOMESTIC RATS, MICE, SQUIRREL, HARE AND RABBITS SELDOM REQUIRE TREATMENT
BAT RABIES: BAT RABIES HAS NOT BEEN CONCLUSIVELY PROVED IN INDIA AND HENCE EXPOSURE TO BATS DOES NOT WARRANT TREATMENT
VACCINE SCHEDULES
(A) INTRA-MUSCULAR VACCINE SCHEDULE:
HUMAN DIPLOID CELL VACCINE
PURIFIED CHICK EMBRYO CELL VACCINE
PURIFIED VERO CELL RABIES VACCINE
PURIFIED DUCK EMBRYO VACCINE
SCHEDULE OF DOSAGE:
0, 3, 7, 14 & 28 DAYS
SIXTH (D90) INJECTION, OPTIONAL IN-IMMUNOLOGICALLY DEFICIENT, ARE AT THE EXTREMES OF AGE AND ON STEROID THERAPY.
VACCINE SCHEDULES
(B) INTRA –DERMAL REGIMENS:
IN THIS METHOD SMALL AMOUNT OF RABIES
VACCINE/ANTIGEN IS DEPOSITED IN THE LAYERS OF
THE SKIN AT MULTIPLE SITES
THIS RESULTS IN A STRONGER IMMUNE RESPONSE
RABIES IN DOGS
CLINICAL PICTURE:
FURIOUS RABIES: CHANGE IN BEHAVIOUR, RUNNING AMUCK, CHANGE IN VOICE, EXCESSIVE SALIVATION, PARALYTIC STAGE
DUMB RABIES
LABORATORY DIAGNOSIS:
HEAD OF THE ANIMAL IS CUT OFF
DULY PACKED IN ICE IN AIR TIGHT CONTAINER
OR
BRAIN MAY BE REMOVED WITH ANTI-SEPTIC PRECAUTIONS
SENT IN 50% GLYCEROL –SALINE FOR EXAMINATION
JAPANESE ENCEPHALITIS
JAPANESE ENCEPHALITIS IS A MOSQUITO BORNE ZOONOTIC VIRAL DISEASE. PIGS AND BIRDS (CATTLE EGRETS, POND HERONS) ARE THE NATURAL HOSTS AND MAN AND HORSE ARE “ DEAD END” HOSTS.
AFFECTED STATES IN INDIA ARE ANDHRA PRADESH, BIHAR, KARNATAKA, TAMILNADU, UTTAR PRADESH AND WEST BENGAL.
JE OUTBREAKS USUALLY COINCIDE WITH MONSOON & POST MONSOON PERIOD, WHEN THE VECTOR DENSITY IS HIGH.
CASE FATALITY IN NEWLY AFFECTED AREAS IS TO THE EXTENT OF 30-40%
CHILDREN BELOW 15 YEARS OF AGE ARE ESPECIALLY HIGH RISK GROUP.
CAUSATIVE AGENT & TRANSMISSION
JAPANESE ENCEPHALITIS VIRUS WHICH IS ANTIGENICALLY RELATED TO OTHER FLAVIVIRUSES LIKE DENGUE, WEST NILE AND YELLOW FEVER.
TRANSMISSION BY:
MOSQUITO-BORN -CULEX TRITANEORHYNCHUS GROUP
THE VIRUS DOES NOT CAUSE ANY DISEASE AMONG IT’S NATURAL HOSTS AND THE TRANSMISSION GOES UN-NOTICED THROUGH MOSQUITOES PRIMARILY BELONGING TO THE GENUS CULEX.
THERE IS NO SPECIFIC TREATMENT.
CLINICAL PICTURE
ACUTE ENCEPHALITIS WHICH CAN PROGRESS TO
PARALYSIS
SEIZURES
COMA AND DEATH
MAJORITY OF CASES ARE SUB-CLINICAL.
SERIOUS NEUROLOGICAL SEQUELAE LIKE MENTAL IMPAIRMENT, SEVERE NEUROLOGICAL INSTABILITY, PERSONALITY CHANGE AND PARALYSIS MAY OCCUR IN AROUND 10-30% OF CASES.
Avian Influenza
Chingmeirong , Imphal
Control Room
The Nerve Centre
Quarantine: restrict access to infected premises; village; station and bus-stand
Physical survey of the area of operation
To determine nature and scope of operations.
Physical survey of the area of operation
Physical survey of the area of operation
Physical Survey To Know :
Cleaning of the farms Hygienic conditions on farmsQuantities of solid, semi-solid, liquid fecal material, feathers and other waste material lying unattendedFarmers participation in CullingNumber of birds on the Farm
Demarcation of Surveillance & Infected areas
Demarcation of Surveillance & Infected areas
5 km radius
Stamping Out
5 km radius Compulsory Vaccination / Surveillance (High risk poultry areas)
3 km Culling area
Demarcation of Surveillance & Infected areas
Culling: use of sedatives mixed in water to reduce activity level in birds.
SodiumFenoBarbital,
Culling : Dislocation & Decapitation
Culling: culled birds on farms were packed in bags for disposal, which were carried to disposal sites
Culling:public announcement not to release birds in morning; Panchayat involved; common disposal ground identified in villages; birds collected by veterinarians in morning; cash for bird; tremendous response
Different StrategyForBackyardpoultry
Backyard poultry: sites for disposal identified by Panchayat
Disposal
Two methods: bury or burn
Burning: bury ash, remains etc.; burn well; material requirements higher; incinerators
Burying: dig deep; dumped material be kept below ground level; lime/earth layers; no scavenging. Rodent problem
Dispose: birds, eggs/trays, sacks, feathers, feed/feed ingredients, fecal material, manure etc.
Safe Disposal: Deep trenches dug by JCB’s
Disposal:more than 40 JCB’s deployed in
Navapur & Jalgaon I; requisitioned from deptts
Burial of Birds
Disposal:material carried out manuallyfor disposal from farms/villages
Disposal: killed birds and infectedmaterial dumped into pits dug by JCB’s
Materialsshouldbe lowerthan groundlevel
Disposal:pits covered by earth and ‘limed’
Alternatelayers of earth and lime to pack it well
Disposal by Burning
PPE burnt on each farm on exit by each person from each farm
Disposal:eggs destroyed and buried with egg trays etc.
Disposal of feed and feed materials
Infected materialFeed manufacturing units within poultry farmGOI to share cost of compensation upto 50%
Disposal of feed and feed materials.
Disposal of feed and feed materials.
Disposal of feed and feed materials.
Major activity.Farms are largely two-tier structures.
Clean up:Commercial farms
Clean up:Commercial farms
Upper storey has bird cages and support systems
Lower storey is dump ground for fecal matter; ‘slurried’ due to water leakage from bird water systems
Clean up:Commercial farms
Clean up:Commercial farms
Clean up:Commercial farms
Physicallyimpossible to enter & clean up.Difficult to access lower storey due to low height
Clean up:Commercial farms
Jetting& suction machines
Liquid material pumped out
Clean up:Commercial farms
Discharged into pits which were covered withthick layer of lime and earth. Continuouswatch.
Clean up:Commercial farms
Clean up:Commercial farms
Covered with plastic sheets
Sheds cleaned manually thereafter
Clean up:Commercial farms
Clean up:Commercial farms : Use of labor
Specialized labor required. Availability an issue.
Farm owners: required to be involved; reluctant;
Reluctance to use PPE; Temiflu
Difficult work conditions
Feather disposal
laborious work; not possible manually
Feather disposal
Flame guns purchased and used; operated by LPG
Feather disposal
Cage systems are to be opened up, cleaned and disinfected; water systems to be handled similarly
Disinfecting & Spraying
Foggers provided by GOI. Sprayers to be providedby State Govt.
Disinfecting & Spraying
Disinfecting & Spraying
Disinfecting & Spraying
Disinfecting & Spraying: Commercial Poultry
Wash floors and walls with calcium hydroxide (3% solution)
Spray of bleaching powder & lime in floors of sheds and farm area
White-wash of concrete and bricked area with lime
Spray 4% formalin over area
Treat equipment with hypochlorite solution (2%) for 48 hours
KMnO4 mixed in water tanks etc
Close chamber fumigated with KMnO4 & formalin
Different strategyHeavily populated villages in JalgaonComplete culling in village before starting clean-upBurn baskets/egg trays/litter/feed and all the poultry in 10 km radiusBury the eggsRemove, burn all litter from permanent cages and clean the cagesBurn garbage around poultry keeping areaWhitewash the houses: 3km/10km
Disinfecting & Spraying :Backyard Poultry
Disinfecting & Spraying :Backyard Poultry
Spray all houses in 0-3 km Spray poultry rearing houses and yards in 3-10 km zoneSpray all damp areas/drains with 4% formalinFormalin not to be used in inhabited areas due to irritation to humans.Alternatives: Trilocid Concentrate, Virkon-S, Sodium hypochlorite. Sprinkle lime on topSprinkle lime on the roads, streets etc in all the villages under the operation
Sanitized farms
Sanitized farms
Sanitized farms
Sanitized farms
Sanitized farms
Sanitized farms
Sealing of farms
Sealing of farms
THANK YOU