FARMING ACTIVITIES AND WORK OUTDOORS

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FARMING ACTIVITIES AND WORK OUTDOORS

• Tartu
• 10.3.-11.3.2004

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FARMINIG ACTIVITIES

• includes
• contact with breeding animals
• EHEC (entero hemorrhagic E.coli)
• contact with wild animals
• directly by bites (tularemia)
• via vector (tularemia)
• work in farming facilities, where wild animals
  have been (tularemia by inhalation)
• work outdoors

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MICROBES MOVE FROM BREEDING ANIMALS - 1

• serologic evidence of Brucella, Q-fever,
  Leptospira, Toxoplasma, Salmonella and Yersinia
  (at least)
• similarities of drug resistance of coliforms of
  abattoir workers and slaughtered swine

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RISK OF MICROBIAL INFECTIONS FROM BREEDING
ANIMALS IN FINLAND

• some diseases have not been found for years
  (brucellosis)
• some are rare (tbc, salmonella)
• potentially dangerous (EHEC)
• serologic evidence exists, but what is the real
  risk (yersinia)
• risk unknown in farming (Toxoplasma, Listeria)

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CONTACT WITH WILD ANIMALS

• wild animals may be found in farming facilities
  or in the forest etc.
• what is farming work and what is free time
  activities
• two examples tularemia and Lyme disease

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TULAREMIA - 1

• rabbit fever
• bacterium Francisella tularensis
• commonly in rodents, rabbits and hares
• infection routes
• bites by infected insects
• handling of sick or dead animals
• eating or drinking contaminated food or water
• inhaling airborne bacteria

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TULAREMIA - 2

• less than 100 cases/year normally, but epidemic
  occur
• 2002 one case reported occupational
• exposure usually through skin (lymphadenitis),
  rarely by inhalation
• vaccination available, but not in use in Finland
  (pulmonary tularemia rare)

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EPIDEMIC NEPHRITIS

• Puumala-virus
• mole is the host
• virus secreted into urine
• infection through inhalation of dust or contact
  contaminated hands
• nephritis, encephalitis, carditis, hepatitis and
  pulmonary symptoms
• sometimes (0,2) fatal

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EPIDEMIC NEPHRITIS IN FINLAND

• about 1000 cases a year
• 91 occupational EN cases in 2002, almost all of
  them among farmers
• more moles - more infections
• about 5 of the population has antibodies
  against the virus -gt about 4000 infections/year

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LYME DISEASE - 1

• vector borne disease
• bacterium Borellia burgdorferi
• transmitted by ticks (of the Ixodes ricinus
  complex)
• deer, birds, rodents etc.
• in highly endemic areas every third tick has
  Borrelia

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LYME DISEASE - 2

• primary infection from the bite (erythema
  migrans), about 4 weeks
• secondary infection in 2-4 months
• late phase (third phase) 6 months - two years
• neurological
• dermal
• arthritis

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OCCUPATIONAL LYME DISEASE

• Serologic evidence from endemic areas
• no studies showing increased risk of clinical
  disease
• problematic selection of the control group
  (should have similar outdoor activities)

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RISK OF LYME DISEASES DEPENDS

• prevalence of Borrelia in the ticks (in southern
  Finland about 5)
• infective potential of a bite (every tenth bite
  of an infected tick leads to skin infection)
• number of bites
• from data above one bite out of 200 leads to
  infection

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VACCINATION

• available today
• because of occupation - not, because the risk of
  clinical disease is not shown
• because of residence on high risk area - maybe,
  but the risk must be high

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HOW TO AVOID TICKS 1

• Tuck your pant legs into your socks and your
  shirt into your pants.
• Wear light colored clothing. Dark ticks are more
  easily spotted against a light background.
• Inspect clothes often for ticks. Have a companion
  inspect your back.
• Apply repellents according to label instructions.
  Applying directly to clothing appears to be most
  effective.

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HOW TO AVOID TICKS 2

• Upon returning to the home remove clothing and
  wash or put it in the dryer for 30 minutes to
  kill any ticks.
• When you get in from the field shower and inspect
  your body thoroughly. Especially check groin,
  navel, armpits, head and behind knees and ears.
  Have a companion check your back, or use a
  mirror.

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HOW TO AVOID TICKS 3

• Inspect children at least once daily for ticks.
  When in heavily infested areas inspect children
  every three to four hours.
• When hiking stay in the middle of trails. Do not
  bushwhack.
• Clear brush from around your premises and keep
  grassy areas mown.

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HOW TO AVOID TICKS 4

• Avoid plantings that especially attract deer and
  other animals.
• Limit watering of lawns.
• Judicious use of environmental insecticides to
  kill ticks may be necessary in some areas.