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Brief Awareness on
Bird Droppings Cryptococcosis & Histoplasmosis
By
Mitul Desai (MCOH1)
Corporate Industrial Hygienist
Agenda
BIRD DROPPINGS
• Introduction
• Health Effects
• Diagnosis & Treatment
• Removal / Cleaning
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Bird DroppingsIntroduction
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Background
Bird droppings are noticeable in / around birds feeding, roosting (resting) &
shelter (nesting) spots. For example,
• building roof that allows birds ingress & / or nesting e.g. Maintenance Workshops
• roof area of abandon process equipment / machinery (e.g. gathering Station)
• in / around RO & STP plants or under large size tress
• balconies, ventilation systems
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Why are we discussing this topic?
Birds droppings introduce parasites & ticks into the
environment. This combined with the unpleasant
odours presents a risk to human health.
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Bird Droppings – Introduction
• Large populations of roosting / nesting birds may present the
risk of disease to people nearby.
• Serious health risks may arise from disease organisms that
can grow in the nutrient-rich accumulations of bird droppings,
feathers & debris under a roost — particularly if roosts have
been active for years.
• External parasites also may become a problem when
infested birds or bats leave roosts or nests. The parasites
then can invade buildings & bite people.
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Bird Droppings – Introduction
• Soil that contains large amounts of bird or bat droppings allow growing
of particular types of disease organisms (parasites - fungus, bacteria).
• The soil under a birds roost usually have to be enriched by droppings
for two years or more for the organisms to reach significant levels.
• Any activity that disturb the contaminated soil or bird droppings allows
these bacteria / fungus spores (microscopic size) to circulate in the air.
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• When people breathe in these spores, they
enter the lung. The person’s body temperature
allows the spores to transform into yeast.
• The yeast can then travel to lymph nodes & can
spread to other parts of the body through the
bloodstream.
Activities that may disturb soil with bird droppings
• Exploring caves with birds nesting;
• Cleaning / sweeping of area (having birds droppings);
• Cleaning, Painting or Demolition of roof, chimney, HVAC,
(abandoned) buildings & bridges with birds roosting / nesting;
• Farming / Gardening or Pest control;
• Microbiology laboratory work etc.
It is unlikely that healthy people will become infected even at
high levels of exposure. A major risk factor for infection is a
compromised immune system.
Bird Droppings – Exposure to Disease Organism
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Bird DroppingsHealth Effects
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Bird Droppings – Diseases
• Histoplasmosis is a disease caused by a fungus called
Histoplasma capsulatum, which grows in pigeon droppings. It
also grows in soils & can be found throughout the world.
• Cryptococcosis is a fungal disease caused by a fungus
called Cryptococcus, associated with droppings & also grows
in soils. It is very unlikely that healthy people will become
infected even at high levels of exposure.
• Psittacosis is an infection caused by Chlamydia psittaci, a
type of bacteria found in the droppings of birds such as
pigeons. When bird droppings dry & become airborne,
people may inhale them & get sick.
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Bird Droppings – Histoplasma
• The fungus histoplasma lives throughout the world - Most
common in North & Central America & lives in parts of
South America, Africa, Asia & Australia.
• Birds can get histoplasmosis & spread the fungus in their
droppings.
• Histoplasmosis can’t spread from the lungs between people
or between people & animals.
• However, in extremely rare cases, the infection can be
passed through an organ transplant with an infected organ.
Information for Supervisors11
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Biology of Histoplasmosis
Information for Supervisors
• Histoplasmosis symptoms appear about 10 days after initial
infection. Most cases of produce no symptoms or very mild ones.
• Other people may have flu-like symptoms that usually go away on
their own within a few weeks. Symptoms include: fever, cough,
extreme tiredness, chills, headache, chest pain & body aches
• However, if the infection becomes severe, the symptoms may last
longer than this. Severity of illness depends on immunity of the
person & the intensity of the exposure.
• The disease primarily affects the lungs. Occasionally, if other
organs are affected may cause death, if left untreated.
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Histoplasmosis – Symptoms
Histoplasmosis - Symptoms
• In rare cases, chronic lung infection or sudden flu-like infection
• Those with compromised immune systems (e.g. people living with
HIV / AIDS or cancer patients):
– are more at risk of developing histoplasmosis
– can develop into a long-term lung infection that can spread
from the lungs to other parts of the body (e.g. the brain & spinal
cord) called disseminated histoplasmosis
– mortality is high who develop histoplasmosis.
• The histoplasma fungus may cause a potentially blinding eye
condition known as ocular histoplasmosis syndrome (OHS).
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• When the disease spreads throughout the body, it affects
many organ systems & the person may then develop:
Anemia, Meningitis, Mouth ulcers, Infection of heart valves,
Pneumonia, Enlarged liver & spleen, Swollen lymph nodes
• Persons with a history of pulmonary disease can develop
chronic pulmonary histoplasmosis causing pericarditis(inflammation of fibrous sac surrounding the heart – causing chest pain),
broncholithiasis, pulmonary nodules, mediastinal fibrosis
(fibrosis on lymph nodes - blocking major vessels & airways).
• In persons who develop progressive, chronic or disseminated
disease, symptoms may persist for months or longer.
Histoplasmosis – Chronic Health Effects
Information for Supervisors15
Cryptococcosis – Symptoms
Cryptococcosis (or cryptococcal) is a fungal disease associated
with bird droppings & also grows in soils. It is caused by one of
three species of Cryptococcus – neoformans or gattii or grubii.
Symptoms
• Blurred vision or double vision
• Bone pain or tenderness of the breastbone
• Chest pain, Confusion, Dry cough, Fatigue, Fever,
Headache, Nausea, Skin rash - pinpoint red spots, Sweating
• Swollen glands, Unintentional weight loss, Weakness
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Psittacosis – Symptoms
Psittacosis is an infection caused by Chlamydia psittaci (a type of
bacteria) found in the droppings of birds e.g. pigeons. Symptoms usually
develop within 10 days after exposure / infection:
• Pneumonia with flu-like symptoms. Fever, chills & tiredness
• Mild or overwhelming whole-body inflammation & respiratory failure
• Respiratory – cough, sore throat, breathing shortness, chest pain
• Neurological (common) – photophobia, anxiety or extreme uneasiness
• Gastrointestinal (rarely) – vomiting, abdominal pain, diarrhoea &
jaundice
• Dermatological – facial rash (horder spots)
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Bird DroppingsDiagnosis & Treatment
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Information for Supervisors
Testing Environment for Histoplasma
Testing the environment for detecting Histoplasma is not useful because:
• The fungus is thought to be common in the environment in certain areas.
• A soil sample that tests positive for Histoplasma does not necessarily mean
that it is a source of infection & a sample that tests negative does not
necessarily mean that the fungus is not there.
• It is currently only done for scientific research; there is no standard test
commercially available.
If there are bird or bat droppings in / around your home or work area,
clean-up, if possible. If it is not possible to clean-up, try not to disturb it.
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Information for Supervisors
Histoplasmosis - Diagnosis
• Healthcares rely on the following to diagnose histoplasmosis:
– medical & travel history, symptoms,
– physical exams,
– imaging tests (chest x-rays or CT scans of lungs)
– sample collection & laboratory test tests (blood & urine sample, fluid from
respiratory tract, a tissue biopsy or culture).
• For some people, the symptoms of histoplasmosis will go away without
treatment. However, prescription antifungal medication (e.g.
itraconazole) is needed to treat severe histoplasmosis in the lungs,
chronic histoplasmosis & infections that have spread from the lungs to
other parts of the body (disseminated histoplasmosis).
• Depending on the severity of the infection & the person’s immune status,
the course of treatment can range from 3 months to 1 year.
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Information for
Supervisors
Histoplasmosis & Cryptococcosis – Treatment
• Mild cases may not need treatment.
• Some infections may not need treatment but may require
regular check-ups to make sure the infection has not spread.
• More serious cases, with symptoms that include high fever,
trouble breathing, loss of appetite (hunger) & malaise
(uneasiness), lung lesions or the disease spreading are
treated with anti-fungal medications.
• Anti-fungal drugs may need to be taken for a long time.
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Histoplasmosis & Cryptococcosis are diseases caused by fungus called Histoplasma
capsulatum & Cryptococcus fungal respectively.
It is unlikely that healthy people will become infected even at high levels of exposure.
Information for Supervisors
• Psittacosis is treated with Antibiotics.
• Patients normally show a response within 24-72 hours.
• Treatment is normally given for 2-3 weeks to lower the risk of
relapse (recurrence of a past medical condition).
• Patients who have severe disease are managed in intensive
care units & given intravenous fluids, using respiratory &
cardiovascular support.
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Psittacosis – Treatment
Psittacosis is an infection caused bacteria found in the droppings of birds e.g. pigeons.
Information for Supervisors
Bird DroppingsRemoval & Cleaning
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Bird Droppings – Removal / Cleaning
Safe removal / cleaning-up of bird droppings &
wastes is vital:
• to improve the aesthetic appearance of the
building or surface it is present on &
• to eliminate human health issues / hazards.
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• Ensure only authorized personnel are involved & present
during the removal of bird droppings.
• Ensure all the workers follow the necessary HSE
requirements to minimize risk from organisms in the
droppings.
• Remove small / negligible amount of droppings with soap
water or dispose in a dustbin.
• For removing large amounts of droppings, involve
professional hazardous waste operators.
• Remove large amounts of droppings by putting them into
sealed plastic garbage bags.
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Bird Droppings – Removing / Cleaning
• Rinse-off the outside of these bags before storing/sending
them for their safe disposal. While still wearing the respirator,
remove protective clothing & place it in a plastic bag.
• After complete removal of droppings, clean the area with hot
soapy water. Cleaning of large quantity of droppings may
involve sanitizing the area using adequate disinfectants to
kill any bacteria & organisms that may be present.
• Advise the workers to take shower.
• Take measures to prevent birds from reestablishing roost or
nest in the area of concern.
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Bird Droppings – Removing / Cleaning
Precautions - Prior to start Removal of bird droppings
• Confirm if there is intrusion & birds resting or nesting in roof /
roof cavities, they can be repelled by using ultrasonic repellant
equipment or repelling gels.
• Take care of eggs, baby or dependant birds - if there are baby
birds in nests present, wait until the birds have left the nest.
• Once birds are removed from roof cavities, permanently close
off all entry / ingress points in the area of concern.
• Clean-up any affected areas, after removing old nests, dead
birds, if any.
Bird Droppings – Removal / Cleaning
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Bird Droppings – Removal / Cleaning
Health & Safety Precautions - Prior to Removal of droppings
• Perform HSE Risk assessment for the cleaning task
• Ensure the removal work is done only by healthy individuals
• Ensure availability of necessary tools & PPE:
– water spray, hand brush or shovel (for large-scale
droppings)
– disposable suit, nitrile rubber gloves, safety goggles, shoe
covers,
– dust mask / half mask (that can filter 0.3 microns particles)
or full face mask if dealing with large quantity.
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Bird Droppings – Removal / Cleaning
Health & Safety Precautions - Prior to Removal of droppings
• Perform tool box talks to inform workers about the health
hazards & the method to be followed. Advise them to follow
good personal hygiene practices.
• Spray a fine jet of water over bird droppings to minimize
creation of dust & the spores to become airborne, when it is
disturbed.
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Bird Droppings – Ticks, Mites & other Parasites
• Bird roosts / nests harbor parasites (species that benefits at the expense
of the other species, the host) for example – bugs, ticks, lice, fly etc.
• Although, these parasites can bite & irritate, they are unlikely to transmit
diseases to humans.
• Droppings, feathers & dead birds in roosting/nesting area breed flies &
insects that may become problems in the immediate area. These pests
may fly through open windows or crawl through cracks to enter bldgs.
• Most parasites associated with bird roosts die quickly after the birds
leave, some may live for several weeks.
• Discourage birds from roosting around bldgs. Alternatively, treat the
affected area with appropriate insecticides for control of fleas, ticks,
mites & similar pests.
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If you understand the causes, then you can do
something about them,
otherwise you are left just to deal with the effects.
Thank You All
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