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Accidental self-inoculation with Mycobacterium paratuberculosis bacterin (Johne's bacterin) by veterinarians in
C J Patterson1, M LaVenture, S S Hurley
1Section of Acute and Communicable Disease Epidemiology, Wisconsin Division of Health, Madison 53701-0309.
Abstract:
We surveyed Wisconsin veterinarians to assess the frequency and severity of accidental self- and other human exposure to Mycobacterium paratuberculosis bacterin (Johne's bacterin). Of 199 veterinarians administering the bacterin to cattle, 22 reported one or more exposures, including 19 needle-stick exposures, 8 skin surface exposures, and 2 oral mucosa exposures. The mean incidence of needle sticks was 5.5/100 veterinarians/year of bacterin use or 1/1,000 doses administered. The mean total doses given in the needle-stick exposure group was 276 +/- 318 vs 80 +/- 268 in the group without needle-stick exposure, and the mean number of months administering the bacterin was 21.7 and 16.1, respectively; 63% of needle-stick exposures took place during the injection process. Five adverse reactions were reported, and each resulted from needle-stick exposure. The only systemic reaction followed an exposure to the original bacterin formulation of sonically ruptured M paratuberculosis in Freund incomplete adjuvant. The remaining reactions were to the current formulation of whole killed M paratuberculosis in mineral oil and ranged from a small nodule persisting for 4 to 6 months to painful inflammation of a finger persisting for 24 months. We anticipate an increase in incidence of these minimally debilitating injuries as the use and distribution of the bacterin expands. For hand wounds, we recommend conservative management. Surgical intervention should be considered if a granuloma persists and causes the patient functional difficulty.
Insights
Veterinarians reported accidental exposures to Mycobacterium paratuberculosis bacterin (Johne
Area of Science:
- Veterinary Medicine
- Microbiology
- Occupational Health
Background:
- Mycobacterium paratuberculosis bacterin (Johne's bacterin) is used in cattle.
- Accidental human exposure to this bacterin can occur during administration.
Purpose of the Study:
- To assess the frequency and severity of accidental self- and other human exposure to Mycobacterium paratuberculosis bacterin among veterinarians.
- To identify risk factors and adverse reactions associated with bacterin exposure.
Main Methods:
- A survey was conducted among Wisconsin veterinarians administering Mycobacterium paratuberculosis bacterin to cattle.
- Data collected included types of exposure, incidence rates, and reported adverse reactions.
Main Results:
- 22 out of 199 surveyed veterinarians reported exposures, with 19 needle-stick injuries.
- The incidence of needle sticks was 5.5 per 100 veterinarians per year or 1 per 1,000 doses.
- Five adverse reactions were reported, all from needle-stick exposures, ranging from nodules to painful inflammation.
Conclusions:
- Accidental exposures to Mycobacterium paratuberculosis bacterin, particularly needle-stick injuries, occur in veterinary practice.
- Adverse reactions can be localized and persistent, necessitating conservative management or surgical intervention for granulomas.
- Increased use of the bacterin may lead to more frequent injuries.