YARC       Comparative Medicine

Veterinary Clinical Services

Animal Associated Injuries

 

Nonhuman Primate Injuries     Dog Injuries     Cat Injuries

Procedure to Follow for Injuries Associated with the Care and Use of Non-human Primates (NHP’S)

  1. INTRODUCTION
    Non-human primates (NHP) can transmit infectious agents to humans. Notably, NHP bites have the risk of transmitting Herpes virus B infection. The following protocol must be followed if:
    1. a person is bitten by a NHP and the bite breaks the skin.
    2. any break in the skin occurs while handling NHP’s, NHP tissues or equipment contaminated with NHP secretions. This includes but is not limited to:
      1. bites
      2. scratches
      3. needle sticks
      4. cuts
    3. a person’s eyes are splashed by NHP blood, other body fluids or material contaminated with NHP secretions or excreta.
  2. PROCEDURE
    Note: Gloves must be worn when assisting with these procedures.
    1. THE INJURED PERSON SHOULD:
      1. use a bite/scratch kit located in NHP facility offices. Instructions and items needed for appropriate wound care are included in these kits.
        1. make the wound bleed.
        2. scrub the wound with a Betadine impregnated scrub brush under running water for at least 5 minutes.
        3. use pre-moistened sodium hypochlorite towelette to soak the wound for at least 5 minutes.
      2. if a bite/scratch kit is unavailable:
        1. scrub the wound with a solution of bleach and water (9 parts water to 1 part bleach) for at least 5 minutes.
        2. followed by hot soapy water for at least 5 minutes.
      3. irrigate splashes to eyes with 0.9% saline solution or, if unavailable, plain tap water for 15 minutes.
      4. inform an immediate supervisor or other staff member that an incident has occurred and convey the following information.
        1. animal number
        2. animal location
      5. Alternatively, call the Animal Resources Center office at 785-2526.
      6. fill out a " Health Service Appointment and Report" form obtained through the employee’s departmental business office. If after hours go to Urgent Visit at the Yale University Health Services (YUHS), 17 Hillhouse Avenue.
      7. notify the Department of Employee Health at 432-7978 or 432-0071 of the exposure and arrange for treatment. If the Employee Health Department is closed or unavailable the employee should go for treatment to Urgent Visit at the Yale University Health Services.
      8. bring a copy of this protocol to Urgent Visit (available in NHP offices). This protocol is on file in Urgent Visit, in the Employee Health protocol book .
      9. be alert for any signs or symptoms of zoonotic disease for the next four weeks and notify Employee Health about any suspected illness. See below section B.7.
    2. YUHS SHOULD:
      1. examine the wound, verify that appropriate cleansing was done and administer any treatment needed for the injury.
      2. swab the wound for viral culture using Bartels viral transport media and refrigerate. If the incident occurred while performing a TB test on the NHP, attempt to obtain a small piece of skin from the wound, place in Bartels viral transport media and refrigerate. Do not send out.
      3. administer a tetanus booster if indicated.
      4. draw one red top tube
        1. Label tube "post monkey bite sera". Use a miscellaneous lab slip; label, spin and hold at YUHS
        2. Store in refrigerator overnight.
      5. notify the Employee Health physician in the next business morning after the incident and relay the location of the cultures and sera. Employee Health will arrange for testing of samples.
      6. 6) inform the patient to schedule an appointment with Employee Health in two weeks (432-7978) for follow-up testing.
      7. counsel the patient regarding symptoms of potential Herpes B infection.
      8. These may include;
        1. vesicular eruptions at site of injury
        2. localized numbness, pain, itching
        3. flu-like illness with muscle aches
        4. fever and chills - especially any fever >101.3 for more than two days
        5. e) severe headaches lasting >24 hours
        6. loss of balance or muscle coordination
        7. g) shortness of breath
      9. inform employees who are immunosuppressed because of medication or underlying illness of the potential increased risk of infection following exposures.
    3. THE EMPLOYEE’S SUPERVISOR OR OTHER APPROPRIATE STAFF MEMBER SHOULD:
      1. identify the animal involved.
      2. arrange for "DO NOT FEED" sticker to be put on animals’ cage.
      3. confirm that Veterinary Clinical Services (VCS) was notified that an incident has occurred and which animal is involved.
      4. confirm that the employee has gone to Urgent Visit and that the Department of Employee Health (432-0071) was notified.
      5. fill out " Department Report of Injury Form" , sign and immediately fax to Workers Compensation (Fax number 432-6194).
      6. send " Department Report of Injury Form" to department head for signature. Note: Form requires animal number.
    4. VETERINARY CLINICAL SERVICES SHOULD:
      1. initiate bite/scratch record and maintain copies of paperwork submitted to and from virology and NIH B Virus Resource Laboratory until case is completed (kept in Primate Book).
      2. examine the animal for lesions indicative of zoonotic infection.
      3. obtain swabs for viral culture from the NHP’s mouth, conjunctiva and vagina at the time of the incident. Swabs for viral culture (Bartels Viral Transport) are available in the VCS pharmacy refrigerator and in the primate area refrigerators. Swabs must be kept cold during transport. Submit swabs with the initial blood sample.
      4. draw blood from the animal immediately and 2-3 weeks after the injury. Submit samples to be sent to NIH B Virus Resource Laboratory to the the Virology Unit of the Section of Comparative Medicine with appropriate paperwork.
      5. notify Associate Director for Animal Health Services.
      6. convey the results of serology when they become available, to the Chief, Department of Employee Health at UHS 432-007l.
      7. when the case is completed file in the Bite/Scratch book, and copy to the animals’ record.
    5. THE VIROLOGY UNIT OF CMED SHOULD:
      1. arrange for submission of the animals’ initial sera, swabs for culture and follow-up sera.

Date revised:10/19/98
By: Susan Morgenstern R.N., LATg, Manager of Non-Human Primate Health Services

Dog or Cat Bites

  1. Quarantine animal for 2 weeks.
  2. If animal is dead, refrigerated head should be taken to Hartford by Bio-safety or Investigator.
    • address is 10 Clinton Street, Hartford.
    • behind Bushnell Auditorium, phone 566-5723.
  3. Accompanying head, letter with following info:
    1. Name of person bitten
    2. Circumstances
    3. USDA and YARC # of animal.
    4. Animal's history
    5. Name of person submitting head (i.e., veterinarian).
  4. Bio-safety and Dr. Jacoby should be notified.

 

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Copyright © 1999 Yale Animal Resources Center, Yale University
Last modified: February 13, 2000