UF veterinarians implement new biosecurity program as proactive measure to prevent introduction, spread of Salmonella in horses

With the prime season for Salmonella contamination in horses approaching, the University of Florida College of Veterinary Medicine is initiating a surveillance program at its large animal teaching hospital to reduce the possibility of the potentially devastating disease being introduced or spread.

“Our role is to be ready,” said Dr. Jorge Hernandez, a veterinary epidemiologist at UF who heads the college’s biosecurity committee that convinced college administrators such a program was worth the $70,000 cost to implement it. That sum includes the salary of a full-time veterinary infectious disease specialist, whose day-to-day job includes educating veterinary students, faculty and staff about new safety protocols, and how and why they are being used.

This means taking more time to survey and test certain horses deemed to be at high risk for having the disease at the time they are admitted to the teaching hospital. It means more steps for students, faculty and technicians to take when horses are found to be shedding Salmonella, even when an animal does not show clinical signs of having it. For clients visiting the hospital with their animals, it may mean seeing personnel wearing gloves or gowns, stepping in bootbaths, or possibly areas roped off and isolated – even when there may be no clinical signs of the disease in the facility.

It’s a program not everyone understands.

“It can be confusing to people,” Hernandez said. “We are obligated to protect our valuable patients. We are only being proactive, but we have to do a lot of explaining and even then, we have to deal with rumor control.”

Salmonella is a type of bacteria that can cause intestinal disease, such as diarrhea, in horses, as well as cattle, sheep, goats, dogs, cats, birds, other animals and humans. Humans can be infected from animals, though children and individuals who are immune-compromised are at greatest risk. Symptoms can include diarrhea, signs of gastrointestinal illness, straining to defecate and shock.

Even healthy animals may shed the bacteria in their manure, and in times of stress, particularly in the summer, these bacteria can multiply.

“In a hospital, we must assume that all patients shedding Salmonella pose a potential risk to other patients and to humans until proven otherwise,” said Dr. Eleanor Green, chair of the college’s large animal clinical sciences department and chief of staff of the large animal teaching hospital. “This program is one more example of our continual efforts to be better and better for our clients. We want our clients to feel secure, not concerned by our bold approach.”

The concept of biosecurity to contain Salmonella infection is not new among veterinary teaching hospitals and some privately owned equine hospitals as well. Infection control programs at human hospitals have been used as the role model for biosecurity efforts in many medical fields.

“However, we are the first veterinary teaching hospital in the United States to develop and implement such a program before a catastrophe happens,” Hernandez said. “Several teaching hospitals elsewhere in the country have shut down, resulting in a loss of income and a loss of student teaching opportunities. There are many ramifications in the event of a Salmonella outbreak.”

Green said she hopes UF’s approach to infection control will set an example not just for veterinary hospitals, but for farms, race tracks and show grounds as well.

“Quality infection control programs should exist in every veterinary hospital -- but not just in veterinary hospitals,” she said. “Farm, race track, and show managers are intimately aware of the risks of disease transmission, even outbreaks, when apparently healthy animals are commingled. Our program’s principles can be adapted to farms, race tracks and show grounds.”

The program’s goals are to prevent client animals from becoming exposed to the disease or disease suspects from spreading it; to teach veterinary students the importance of proper disease-prevention and containment techniques; and to protect the hospital’s bottom line, which could be catastrophically affected in the event of a shutdown caused by a Salmonella outbreak.

The college’s plan for implementing the new program includes an early warning detection system, whereby certain horses and cattle admitted to the hospital automatically are given a fecal examination and carefully observed for signs of disease onset as well as an intensified effort to educate college and hospital personnel, as well as students.

“Earlier, we were only sampling for cases with clinical signs of Salmonella,” Hernandez said. “Now we have a surveillance program that targets high-risk patients; we don’t wait for patients to develop clinical signs of the disease. We want to react faster. As soon as we detect a patient is shedding the bacteria, if there are no clinical signs, we put it into what we call ‘ward isolation,’ confining it to its stall and having everyone who has contact with the animal wear plastic booties and gloves. If the patient has the disease, it goes directly to our isolation barn.”

Dr. Nicolas Ernst, the infectious disease specialist who is serving as biosecurity control officer, attends student rounds every morning, and gives a short overview of the new protocols and isolation procedures.

“I give them information about what infectious diseases are, and how important it is to enhance things like hand-washing in their patient care,” Ernst said.

Senior veterinary student Megan Downey, who will graduate in May and hopes to be an ambulatory equine veterinarian, says she understands the reason for the new protocols.

“I just think it’s good to be ahead of the game and be proactive in prevention rather than waiting until the regulatory officials step in,” she said. “I think people need to understand that we are doing this in the best interest of their horses, and because we want to practice good medicine, and that their horses are actually safer now than ever before.”