Health and Safety Information for Marine Mammal Workers (2004)

Information provided by the United States Marine Mammal Commission
National Marine Fisheries Service
Wildlife Health Center, UC Davis School of Veterinary Medicine
by T.D. Hunt, M.H. Ziccardi, F.M.D. Gulland, M.M. Manos, D.W. Hird, J.A.K. Mazet

Μπορείτε να κατεβάσετε ολόκληρο το βιβλίο εδώ.

Περιεχόμενα

Background
Is there a health risk for people who work with marine mammals?

Recent Findings Summary of results of a recent survey of marine mammal workers and detailed findings in downloadable format

Occupational Safety
Health and safety information and downloadable brochure

Documented Zoonotic Diseases
Table of documented zoonotic diseases and other potential pathogens and more detail on pathogens of specific concern

Helpful Zoonoses Links

References

Is there a risk for people who work with marine mammals?

Photo by Joseph Gaydos Necropsy of a beached fin whale

Many species of marine mammals can be infected with, or be healthy carriers of, bacterial, fungal and viral organisms which are known zoonotic pathogens. The risk of acquiring diseases from marine mammals differs as humans interact with marine mammals under different circumstances, such as commercial fishing, subsistence harvesting, scientific activities, wildlife rehabilitation, and animal training. Epidemics of food- borne illnesses such salmonellosis, trichinellosis and toxoplasmosis have been reported in native peoples of arctic and Australasian regions who harvest marine mammals as part of a traditional diet (Tryland 2000; Cawthorn 1997); however, the risk of acquiring diseases by scientists, wildlife rehabilitators, and animal trainers is not well understood. Zoonotic disease transmission as a result of occupational contact between marine mammals and humans has been infrequently reported in the scientific literature. The most commonly reported disease is "seal finger". Hundreds of cases of this ailment have been reported in the scientific literature from fishermen and whalers (Hartley and Pitcher 2002), but there are few case reports of the disease occurring in scientists and rehabilitators. This syndrome was once thought to be caused by the bacteria Erysipelothrix rhusiopathiae but is now thought to be caused by Mycoplasma spp. This bacteria-like organism is carried in the mouth and on the skin of marine mammals (primarily seals and sea lions) and can infect humans by entering the body through breaks in the skin. The resulting infection causes a painful dermal abscess. Other reports of marine mammal workers acquiring diseases from marine mammals include:     Calicivirus (San Miguel Seal Lion virus) from northern fur seals (Callorhinus ursinus). Reference: Smith, Berry et al. 1998 Blastomyces dermatitidis from a bottlenose dolphin (Tursiops truncatus). Reference: Cates, Kaufman et al. 1986 Erysipelothrix rhusiopathiae from a beached pilot whale (Globicephala melaena). Reference: Chastel, Masure et al. 1975 Influenza A virus from harbor seals (Phoca vitulina) Reference: Webster, Geraci et al. 1981 Leptospira spp. from California sea lion (Zalophus californianus) carcasses.  Reference: Smith, Vedros et al. 1978 Mycobacterium bovis from a New Zealand fur seal (Arctocephalus forsteri).  Reference: Thompson, Cousins et al. 1993  Mycobacterium marinum from a bottlenose dolphin (Tursiops truncatus). Reference: Flowers 1970 Sealpox virus from gray seals (Halichoerus grypus).  Reference: Hicks and Worthy 1987

Kάκη Πριμηκύρη: Aσθένειες που μεταδίδονται από τα κητώδη (2013)

Οι γιατροί των ανθρώπων θα πρέπει να είναι ενημερωμένοι σχετικά με τις ασθένειες από τις οποίες μπορεί να προσβληθούν άτομα που έρχονται σε επαφή με τα ζώα των δελφιναρίων, προκειμένου να διαχειριστούν σωστά τα περιστατικά.

Tα κυριότερα βακτηριακά νοσήματα που μπορούν να μεταδοθούν στον άνθρωπο από τα θαλάσσια θηλαστικά είναι η βρουκέλλωση, το ερυσιπελατοειδές, η λεπτοσπείρωση, η μυκοβακτηριδίαση και η μυκοπλάσμωση.

Στρεπτόκοκκοι, σταφυλόκοκκοι, ψευδομονάδες, πρωτέας, κλωστρίδια και μυκοβακτήρια. Αναπνευστικά νοσήματα και σηψαιμία, ερπητοϊοί. Ιογενείς γαστρεντερίτιδες σε παιδιά. Έλκος του στομάχου και ανοσοκαταστολή.

Λύσσα που μεταδίδεται με δαγκώματα. Στην αιχμαλωσία αυξάνεται η επιθετικότητα (και τα δαγκώματα) λόγω του στρες.

Στις δεξαμενές των δελφιναρίων, το νερό έχει υψηλό μικροβιακό φορτίο που μπορεί να μεταδόσει ασθένειες στα άγρια δελφίνια, αν χυθεί στη θάλασσα.

Γρίππη με πνευμονία απειλητική για τη ζωή. Διάφορες δερματικές και συστηματικές μυκητιάσεις (όπως η ασπεργίλλωση), από τις οποίες οι δεύτερες μπορεί να αποβούν θανατηφόρες. Αναφέρεται μετάδοση βλαστομύκωσης σε κτηνίατρο από δελφίνι.

Οι διάφοροι μολυσματικοί παράγοντες που προκαλούν ζωοανθρωπονόσους μπορεί να μεταδοθούν επίσης εμμέσως στους ανθρώπους, από το νερό που έχει μολυνθεί με τα ούρα και τα κόπρανα των δελφινιών και από τα διάφορα αντικείμενα και σκεύη που έχουν έρθει σε επαφή με αυτό.
Filikaki Tataimou
κτηνίατρος

PUBLIC HEALTH SIGNIFICANCE OF MARINE MAMMAL DISEASES, BY C.D.BUCK & J.P.SCHRODER

TAKEN FROM THE CRC HANDBOOK OF MARINE MAMMAL MEDICINE; HEALTH, DISEASE, AND REHABILITATION.

The above publication lists numerous infections known to be transmittable to humans from cetaceans.




φωτο

To minimise the risk of acquiring serious infections and to facilitate the proper management of those which do occur, it is important that persons dealing with the animals, and their physicians, be aware of the microbiological hazards associated with handling marine mammals. Persons handling marine mammals are at risk from infection by the numerous microorganisms normally present in the aquarium or marine environment, by the microorganisms that constitute the normal flora of the animal, as well as by the pathogenic microorganisms that cause disease in various marine mammals.

Infectious zoonotic agents can also gain access to humans by indirect methods of transmission. Respiratory aerosols, water contaminated with urine and feces, and hardware such as feed containers can facilitate the entry of the micro-organism into a human host.


BACTERIAL INFECTIONS: Streptococci, staphylococci, pseudomonas, proteus, aeromonas, erysipelothrix, vibrio, clostridium and mycobacteria are all known to infect skin wounds of marine mammals. It also states some marine organisms require special diagnostic techniques. It also lists 15 Vibrio spp. isolated in Hawaiian captive dolphins.

In another instance, a bite from a dolphin resulted in a long term infection with the agent (mycobacterium marinum).

A more insidious pathogen is Pseudomonas pseudomallei. It is know to cause respiratory disease in man and marine mammals. The organism also causes serious wound infections which can result in fatal septicaemia. Antibody levels were highest in those animal handlers who had more intimate contact with dolphins and handled the front end of the animal.


VIRAL INFECTIONS.
Marine mammals are also subject to viral and presumed viral diseases. Many of these have the potential of infecting man. Although many of these viral agents have only recently been recognised, the diseases they cause are not new.

A pox like virus has been isolated in a dolphin kidney cell line.

Members of the herpes family have been isolated.

With some diseases, such as rabies, one might be tempted to dismiss the risk of contracting the disease from marine mammals as non existent; however, rabies has been documented in a wild seal. All marine mammals are capable of contracting rabies, and workers who deal with wild marine mammals must consider the risk when planning their vaccinations or seeking treatment for bite wounds.

A rotavirus-like agent has been isolated from sea lions. In humans, members of this group are responsible for viral gastro-enteritis, which may cause serious diarrhoea in young children.


FUNGAL DISEASES
Many microorganisms have been isolated from dolphins that would not ordinarily be expected to be found in the marine environment. Blastomycosis and other mycotic diseases of marine mammals pose a health risk for their handlers. Several cetaceans are known to have died from disseminated yeast infections, and the transmission of blastomycosis from dolphin to a veterinarian has been documented.

Several Candida species are commonly found in aquarium waters. Candida albicans can cause localised inflammations in humans.

Several cetacean deaths have been reported due to asperillosis. Infections of cetaceans as well as other species have been reported.


According to Dr. Sweeney, the situation in captivity creates an alteration in the normal social structure found in the wild, where males intermittently join and withdraw from the female centered groups, to captivity where adult males permanently interact within the social group. The frequent result, establishment of male dominance (especially related to juveniles), is often the source of many social and behavioural problems. Hierarchies where dominance plays a part, are known to exist in wild dolphin groups. However, as Dr. Sweeney explains, behaviours which are perhaps normal for aquatic mammals in the wild can become excessive or exaggerated under conditions of captivity. In situations where the social and behavioural environment is less than ideal, animals may respond by exhibiting excessive manifestions of behaviour. One such category of exaggerated behaviour is aggression, appearing most commonly in the form of intimidation, with infliction of rake-bite lacerations. Dr. Sweeney notes that at times the rake lacerations can be quite severe and not only represent cutaneous pathology, but also signal the presence of probable psychological intimidation in the secondary animal. Such aggression has also been aimed at swimmers and staff at captive facilities.

It is already known that the exaggerated aggression found in some captive dolphins can have dire consequences for the dolphins being intimidated. It is this intimidation which is the likely cause of the onset of many medical problems including gastric ulcerations, loss of immunity, and consequently, an increased incidence of incidental and potentially life-threatening infections. (Sweeney, 1990).

Disease transmission wild dolphin to captive dolphin & captive to wild.
Hundreds of striped dolphins died along the Spanish Mediterranean coasts from a morbillivirus, a highly infectious virus. Any cetaceans held in sea-pens, having access to open water or water drawn from the sea, must be a major cause of concern for disease transmission. Waste water from closed dolphinariums located on the coast also pose a potential threat of contamination to wild populations. The virus causes flu/pneumonia symptoms at death. (More details can be obtained from the Department of Pathology, Faculty of Veterinary Science, University of Barcelona, title; PATHOLOGIC AND IMMUNOCYTOCHEMICAL STUDIES OF MORBILLIVIRUS INFECTION IN STRIPED DOLPHINS, BY M. DOMINGO, J. VISA).


For those who are also concerned over the captivity industries latest way of exploiting both dolphins and humans with Dolphin Assisted Therapy, I would suggest you obtain a paper by Dr Lori Marino & Scott O.Lilienfeld, Department of Psychology, Emory University, USA. Entitled, Dolphin-Assisted Therapy: Flawed data, flawed conclusions.

Some quotes from this very enlightening paper:

1. Furthermore, despite their claim that attention deficits underline both their subjects disabilities and effectiveness of DAT, Nathenson et al. (1997) never assessed attention in their subjects either before of after DAT.

2. Nathenson et al. (1997) and Nathenson (1998) violated several important criteria for validity.

3. The source of most of the major flaws in Nathenson et al. (1997) is the absence of experimental control, making it impossible to determine whether their results were due to the specific effects of DAT or to a host of potentially confounding factors.

4. When comparing subjects responses with dolphins versus favourite toys the two conditions took place at entirely different facilities, viz, The Dolphin Research Centre versus a local motel, resulting in a complete confounding of treatment condition with setting.

5. Remarkably, behaviours that might have worsened were never systematically assessed or analysed.

6. Of 137 questionnaires sent out to parents only 52% were returned. This relatively low rate of return raises the possibility that parents who responded were unrepresentative of the entire sample of parents whose children were given DAT.

7. In summary, a plethora of serious threats to validity and flawed data analytic procedures render the findings of Nathenson and colleagues uninterpetable and their conclusions unwarranted and premature.

8. Both practitioners of DAT and parents considering DAT for their children should be made aware that this treatment has yet to be subjected to an adequate empirical test, and Nathenson and colleagues attention deficit hypothesis remains an explanation in search of a phenomenon. (Dr L. Marino, Neurosciences and Behavioural Biology Program, Department of Psychology, Emory University, Atlanta, Georgia 30322, USA).

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Πηγή

Hunt, Ziccardi, Gulland, Manos, Hird, Mazet: Health and Safety Information for Marine Mammal Workers (US Marine Mammal Commission, National Marine Fisheries Service, Wild Life Health Center, UC Davis School of Veterinary Medicine 2004)

Tα κυριότερα βακτηριακά νοσήματα που μπορούν να μεταδοθούν στον άνθρωπο από τα θαλάσσια θηλαστικά είναι η βρουκέλλωση, το ερυσιπελατοειδές, η λεπτοσπείρωση, η μυκοβακτηριδίαση και η μυκοπλάσμωση.

Δείτε αναλυτικά εδώ:

Marine Mammal Zoonotic Bacteria
Brucella Erysipelothrix Leptospira Mycobacterium Mycoplasma
Brucella
	In 1999, a researcher suffered headaches, lassitude and a severe sinusitis after exposure to marine mammal strains of Brucella with which the worker was in contact. The symptoms resolved in one week after treatment with doxycycline and rifampin. The researcher had a positive titer for Brucella, and the organism was cultured from blood samples. PCR-RFLP was used to positively identify the isolates as being comparable to marine mammal Brucella (Brew and Staunton 1999). Organisms Brucella ssp. are gram-negative intracellular bacteria and are a major source of zoonoses worldwide. B. melitensus, B. abortus, and B. suis are some species commonly recognized to play a role in human and animal health. Nomenclature for marine mammal strains of Brucella has not yet been fully developed, but B. maris and B. pinnipedia have so far been named. Transmission occurs primarily through contact with aborted fetal material, and consumption of contaminated milk. Clinical disease in marine mammals The bacteria have been isolated from multiple species of marine mammals, including pinnipeds, cetaceans and otters. Abortion and meningoencephalitis have been reported in dolphins from which the bacteria was isolated, but in the majority of cases, the animals did not demonstrate clinical disease (Godfroid 2002). Clinical disease in humansSymptoms can vary depending on the chronicity of the infection, ranging from acute "flu-like" symptoms (headaches, fever, myalgia, and malaise) to more chronic symptoms (arthritis, orchiepididymitis, and fatigue). Neurological symptoms are rare, being seen in less than 5% of cases. Serologic tests for Brucella are available, but culture is the most definitive test for diagnosis (Centers for Disease Control 2001). TreatmentDoxycycline and rifampin are the recommended therapies.  Other treatment has been associated with recurrence.	Back to Top
Erysipelothrix
	In 1975, four students from the Laboratoire de l'Institut Scientifique et Technique des Pêches Maritimes (Scientific and Technical Institute of Maritime Fishing) acquired a cutaneous Erysipelothrix rhusiopathiae infection from a beached pilot whale (Globicephala melaena). The organism was isolated from both the whale and the affected students (Chastel, Measure et al. 1975). Organism Erysipelothrix rhusiopathiae is a gram-positive, facultative anaerobic rod, and is recognized as the causative agent of swine erysipelas. Clinical disease in marine mammals Cetacea appear to be more susceptible than pinnipeds and can develop septicemia, endocarditis, and chronic skin abscessation (Couch, Fournie et al. 1993; Kinsel, Boehm et al. 1997). The characteristic rhomboid cutaneous lesions, which are caused by thrombosis of peripheral arteries and local tissue infarction, can also be seen (Sweeney and Ridgway 1975). Clinical disease in humans Infection in humans is usually associated with occupational and recreational exposure. The bacteria enter through breaks in the skin and infection can present in three clinical forms: 1. Erysipeloid form: localized, self-limiting cellulitis that develops around site of inoculation. 2. Cutaneous form: a more severe and diffuse infection. 3. Septicemic form: most severe and rare form with or without cutaneous lesions. Associated with arthritis and/or endocarditis with valvular destruction (Artz, Szabo et al. 2001). Treatment Erysipelothrix is susceptible to penicillins and cephalosporins.	Back to Top
Leptospira
	During the course of a 5 year study (1972-1977), three researchers became ill after exposure to California sea lions (Zalophus californianus) that were infected with Leptospira. The two workers with more severe illness became infected after necropsying a sea lion. All three developed serum agglutinating antibody titers to Leptospira interrogans serovar  pomona (Smith, Vedros et al. 1978). Organism Leptospira interrogans serovar pomona, is one of 200 serovars within this species of spirochete bacteria. For this and other potentially zoonotic serovars, transmission occurs directly between mammalian hosts and indirectly through exposure to contaminated water and soil. Clinical disease in marine mammals Renal disease has been observed in harbor seals (Phoca vitulina), and more commonly in California sea lions (Zalophus californianus) and fur seals (Arctocephalus spp.) (Gulland, Koski et al. 1996; Stamper, Gulland et al. 1998). The disease causes tubular necrosis consistent with interstitial nephritis. Clinical signs include anorexia, dehydration and polydipsia. Cytology and serum chemistry reveals a leukocytosis and high serum phosphorus, urea nitrogen and creatinine levels. Clinical disease in humans In the largest outbreak of environmentally-acquired leptospirosis, the most common symptoms reported were chills, headache, myalgia, eye pain, reddened eyes and diarrhea. Clinical signs included those consistent with acute hepatitis and renal failure. Diagnostics revealed elevated liver enzymes, bilirubinemia, thrombocytopenia, proteinuria, hematuria, and elevated creatinine (Morgan, Bornstein et al. 2002). Treatment Leptospira are susceptible to penicillins.	Back to Top
Mycobacterium
	There is one reported case of an animal handler acquiring skin lesions similar to the cutaneous mycobacterosis lesions seen on a manatee which the handler was working (Howard 1983). In 1968, a dolphin trainer working with a bottle-nosed dolphin (Tursiops truncatus) was bitten and subsequently developed dermal abscesses. Mycobacterium marinum was cultured from aspirates taken from the lesions on the trainer's hands (Flowers 1970). In 1988, a seal trainer from western Australia was diagnosed with Mycobacterium bovis tuberculosis.  Diagnosis was made after the trainer developed a dry productive cough, exercise intolerance, and weight loss. Bacterial isolates from the trainer and the seals with which he worked were identical based on gel electrophoresis  (Thompson, Cousins et al. 1993). Organism Mycobacterium spp. are gram-positive acid-fast rods. Mycobacterium marinum is more commonly regarded as a salt- and fresh-water fish pathogen, while M. bovis primarily affects cattle and is an important zoonotic agent worldwide.Mycobacterium marinum Clinical disease in marine mammalsThe organism causes dermal abscesses when infection is local, and pulmonary tuberculosis or generalized abscessation with spreading infection (Tryland 2000). Clinical disease in humans This disease may also be called fish handler's disease or swimming pool granuloma in humans. The organism usually enters through breaks in the skin after host contact with contaminated water. Local infection results in a nodular lymphangitis with or without lymphadenitis. Skin lesions can ulcerate, and spreading infection can cause tenosynovitis, arthritis, and osteitis (Ryncarz 1999). Mycobacterium bovis Clinical disease in marine mammalsPathological findings in pinnipeds include pulmonary granulomas, lesions in the liver , draining lymph nodes, and tuberculous meningitis (Forshaw and Phelps 1991). Animals may also have subclinical infections. Clinical disease in humans Humans are usually infected with M. bovis from drinking contaminated cows milk. Infection can causes pulmonary tuberculosis, cervical lymphandenopathy, and Lupus vulgaris (chronic skin tuberculosis). Urogenital infections have also been reported (Cosivi, Grange et al. 1998). Treatment Common treatment for mycobacteriosis is long-term streptomycin and rifampin.	Back to Top
Mycoplasma (Seal Finger)
	While studying seal behavior at the New England Aquarium in 1979, a psychologist was bitten by a harbor seal (Phoca vitulina). Treatment with penicillin and oxacillin resulted in the resolution of symptoms, but the infection reappeared weeks later. The patient was then successfully treated with a 3 week course of tetracycline (Markham and Polk 1979). In 1980, a graduate student was stabbed with a necropsy knife while working on a sea lion carcass. Clinical symptoms worsened after treatment with dicloxacillin. Radiographs showed periosteal reaction indicative of an osteitis underlying the cutaneous infection. Finally, treatment with tetracycline resolved the infection (Sargent 1980). In 1990, a wildlife ranger was bitten while returning a seal to the ocean; he subsequently developed an skin infection. A two-week course of treatment with amoxicillin led to a persistent infection, and symptoms continued to persist after a change in antibiotics to flucloxacillin. Radiographs taken of the affected digit showed demineralization of phalanx 2 of the thumb suggestive of an osteitis. Finally a four-week course of treatment with tetracycline cured the infection (Eadie, Lee et al. 1990). In 1998, a trainer working at the New England Aquarium was bitten by a harbor seal. Treatment was with tetracycline. Cultures taken from the trainers infected digit and the oral cavity of the seal isolated the same strain of Mycoplasma (Baker, Ruoff et al. 1998). Organism Mycoplasmas are gram-negative coccobacilli that lack a cell wall. Clinical disease in marine mammals M. phocacerebrale, M. phocidae, and M. phocarhinis were isolated from harbor seals (Phoca vitulina) during an epidemic in New England (1980) and in the Baltic Sea (1989) (Baker, Ruoff et al. 1998). Mass mortality due to mycoplasmal pneumonia has been documented; however, pinnipeds likely carry these organisms as part of their normal flora. Clinical disease in humans The local infection in humans with M. phocacerebrale (possibly other Mycoplasma species as well) isolated from marine mammals is commonly referred to as "seal finger". The organism enters through breaks in the skin, and infection can occur after contact with pinniped skin and commonly after a bite from seals and sea lions. Infection causes local erythema and nodules at the site of inoculation, with progressive swelling that can be severely painful. If left untreated (or treated with inappropriate antibiotics), the infection can progress to cellulitis, tenosynovitis, and/or arthritis (Hartley, Pitcher 2002). Treatment Mycoplasma are susceptible to tetracyclines and are resistant to penicillins and erythromycins.  Treatment of severe cases may include arthrodesis or amputation.  Πηγή