Brucellosis in India: Comparing exposure amongst veterinarians, para-veterinarians and animal handlers

Abstract

The exposure to Brucella species is an occupational hazard for veterinary personnel in India. In our previous study, paraveterinarians and animal handlers were found to be at higher risk of being seropositive. In the present study, we further investigate comparative exposure risk to brucellosis amongst the veterinary professionals, identify risk factors, and evaluate the perceptions and practices towards using adequate personal protective equipment (PPE) while attending high risk veterinary interventions. A cross-sectional study was conducted amongst veterinary personnel in the Punjab state of India. Logistic and negative binomial regression models were constructed to interpret the influence of categorical and numerical variables on prevalence of brucellosis and the adequacy of PPE use, respectively. Compared to veterinarians, animal handlers were less likely to consider veterinary practice in sheep and goats (odds ratio [OR] 0.3; 95% confidence interval [CI]: 0.2–0.7) or assisting in obstetric interventions (OR 0.3, 95% CI 0.1–0.8) as potential exposures. They were less aware of the signs and symptoms of the disease in humans (OR 0.05, 95% CI 0.02–0.14) and of the availability of vaccines for cattle (OR 0.07, 95% CI 0.01–0.3) than the veterinarians, and were least likely of the three groups to recommend vaccination of cattle against brucellosis to animal owners (OR 0.1, 95% CI 0.02–0.3). Compared to veterinarians, they were also less likely to consider zoonotic risk (OR 0.4, 95% CI 0.2–0.8) or better efficiency (OR 0.1, 95% CI 0.05–0.4) as enablers of PPE use during veterinary procedures. Of the three occupational groups, animal handlers were also less likely to use adequate PPE during high-risk veterinary exposures, although they were found to have handled the highest number of cases of abortion. The average use of adequate PPE during high-risk interventions in one month preceding this study was lowest for animal handlers. Veterinary personnel with a higher rate of PPE use during high-risk veterinary interventions were likely to obtain information on brucellosis from government sources ( p = 0.06) and felt that PPE use enhanced their professional efficiency (Incidence rate ratio [IRR] 3.3, 95% CI 1.5–8.1) compared to those who were less likely to use adequate PPE. We recommend concerted efforts to increase awareness amongst veterinary personnel, particularly amongst animal handlers, regarding brucellosis and the importance of biosecurity measures in veterinary practice. Designing training courses on the importance of PPE use along with formulation of biosecurity guidelines at local levels could help reduce the prevalence of the disease in veterinary personnel.

Occupation-Related Biological Health Hazards and Infection Control Practices among Indian Veterinarians

“…The majority (59.8%) of the respondents did not undergo zoonotic disease screening in the past two years. Our findings are similar to those in a study conducted in the Northern part of the country (Punjab state) for brucellosis exposure among animal handlers, para veterinarians, and veterinarians, which reported that amongst the different tehsils (subdistricts), the veterinarians from Khanna were least likely to have been tested for brucellosis [ 34 ]. Screening of zoonotic diseases is very important for the health of the veterinarians; in a survey conducted among Australian veterinarians, wherein 44.9% ( n = 344) reported acquiring a zoonotic disease throughout their career [ 35 ], a higher percentage of positive for zoonoses reported among Australian veterinarians may be because of a higher percentage of screening of zoonotic diseases due to more awareness and availability of zoonotic diseases screening facility.…”

“…Veterinarians must also be aware of their responsibility to protect colleagues and associated staff, particularly nontechnical staff who may not know or be unaware of how to recognize and adequately protect themselves from zoonoses. A study conducted in Punjab state India has underscored that lack of awareness about zoonotic diseases among animal handlers compared to paraveterinarians and veterinarians places them at higher risk to contract Brucella organism [ 34 ]. In Australia, veterinarians are legally required to provide this information [ 24 ].…”

Occupational exposure to livestock and risk of tuberculosis and brucellosis: A systematic review and meta-analysis

“…In contrast, brucellosis is one of the seven most neglected diseases in the world, with an estimated 5,000,000 to 12,500,000 cases annually [ 10 , 11 ]. In addition, it is suspected to be a re-emerging disease that affects 500,000 new cases of human infection each year [ 12 ].…”

Brucella Seropositivity at a Tertiary Care Hospital in Chandigarh

“…The combination of doxycycline with rifampin or an aminoglycoside is effective in the treatment of brucellosis in humans. A retrospective study, such as this one, provides useful information regarding the trend of disease that can help formulate policies and strategies for the control and eradication of this occupationally hazardous disease, which is otherwise neglected [ 12 , 13 ].…”