The latest edition of the journal Emerging Infectious Diseases contains an article about a South African vet student that acquired West Nile virus from a pony while performing a necropsy. Occupational exposure to infectious diseases is an inherent risk in veterinary medicine. Veterinarians know that they are at higher risk of encountering various infectious diseases and take (or should take) precautions to reduce those risks. Sometimes infections occur despite the best precautions. Sometimes infections occur because of bad practices. This report highlights the latter.
In this case, a 4-month-old pony began showing vague signs of illness, then developed neurological abnormalities and was euthanized. A necropsy (post-mortem exam) was then performed by a veterinary pathologist with the assistance of two veterinary students. As part of the necropsy, the student removed the brain and spinal cord for testing, but gloves were the only protective gear that were used. No face or eye protection was used, which is quite astounding.
The pony was eventually diagnosed with West Nile virus. Six days after performing the necropsy, the veterinary student developed a fever, malaise, sore muscles, stiff neck and severe headache. West Nile virus infection in the student was confirmed, and the viruses from the pony and person were the same type based on testing. Fortunately, the signs of infection in the student subsided after approximately ten days.
Horses are considered "dead-end" hosts for West Nile virus, meaning they cannot naturally transmit the virus. This is because horses (even severely affected ones) only have very low levels of virus in their blood, so a biting mosquito can’t pick up the virus and transmit it to other individuals. However, the brain and spinal cord, particularly in a clinically affected horse, may contain very large amounts of the virus. It’s astounding that a veterinary school would have a student removing the brain and spinal cord of an animal that died from a neurological condition, especially without proper protective gear, since the procedure carries a risk of splashing or aerosol exposure to the virus. Anyone performing necropsies needs to be aware of the potential risks and take appropriate precautions. The paper states that after the incident, biosafety practices were improved to include the wearing of masks and eye protection during necropsies. Well, I guess it’s better late than never…
This Worms & Germs entry was originally posted on our sister site, equIDblog, on 11-Mar-10.