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![Page 1: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/1.jpg)
Outbreak of Cryptosporidiosis Among Veterinary Students in a
Bovine Obstetrics Laboratory
Carrie Klumb1,2, Jeff Bender3,
Kirk Smith1, Elizabeth Cebelinski1, Joni Scheftel1
1Minnesota Department of Health 2CSTE/CDC Applied Epidemiology Fellowship
3University of Minnesota Veterinary Population Medicine
![Page 2: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/2.jpg)
Background - Cryptosporidiosis
• Acute gastrointestinal illness caused by the protozoan parasite Cryptosporidium
• Estimated 748,000 cases and 46 deaths per year in the United States
• Incubation period 1-12 days, mean 7 days
• Profuse watery diarrhea, and cramping over days to weeks. Fever and vomiting also may occur
![Page 3: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/3.jpg)
Background - Cryptosporidiosis (cont.)
• 19 species of Cryptosporidium
– C. hominis – human primary reservoir
– C. parvum – cattle primary reservoir
• Oocysts (infective stage) are shed in the feces of infected hosts
• In cattle, primarily disease of calves
– Shed up to 1010 oocysts per day in feces
• C. parvum is present on 90% of dairy farms in the United States
![Page 4: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/4.jpg)
Background - Cryptosporidiosis (cont.)
• Transmission occurs through water and food, from person-to-person and through direct animal contact
• 1983: Published report of cryptosporidiosis outbreak due to direct cattle contact among veterinary researchers
• Numerous outbreaks of cryptosporidiosis have been reported among veterinary students
![Page 5: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/5.jpg)
Outbreak Detection
• On April 22, 2010 gastrointestinal illness among second year veterinary students at a college of veterinary medicine (CVM) was reported to the Minnesota Department of Health (MDH)
• Students had participated in a 2-day bovine obstetrics (OB) laboratory prior to becoming ill
![Page 6: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/6.jpg)
Outbreak Detection (cont.)
• Four, 2-day OB laboratory sessions were scheduled at the CVM on:
Lab 1: April 1 and 2
Lab 2: April 8 and 9
Lab 3: April 15 and 16
Lab 4: April 29 and 30
• The first three sessions had already occurred
![Page 7: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/7.jpg)
Methods - Epidemiologic Investigation
• Obtained contact list of all students registered for any of four OB laboratory sessions
• Spoke to professor and employees about laboratory set-up and specific activities
• Developed a questionnaire regarding symptoms and risk factors both in and outside of the laboratory setting
• Interviewed students by phone or in person
![Page 8: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/8.jpg)
Methods - Epidemiologic Investigation (cont.)
• Risk factors assessed
– Tracking in small, mixed or large animal practice
– Dates of laboratory attendance
– Eating or drinking in the laboratory
– Use of personal protective equipment (PPE)
![Page 9: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/9.jpg)
Methods - Epidemiologic Investigation (cont.)
• Risk factors assessed
– Hand hygiene
– Being splashed in the face during the laboratory session
– Events or meals in common with other students
• Analyses were performed using Epi-Info software, version 6.04d and SAS, version 9.2
![Page 10: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/10.jpg)
Methods - Case Definition
A student who attended an OB laboratory session and subsequently had either:
a) A stool sample test positive for Cryptosporidium spp.
OR
b) 3 or more days of diarrhea (≥3 loose stools in 24 hours)
![Page 11: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/11.jpg)
Methods - Laboratory Investigation
• Testing was performed on stool samples
– Students and employees with symptoms
– Calves from Dairy Farm A, where animals for class were obtained
• Fecal samples from the calves actually used in the laboratories were unavailable
![Page 12: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/12.jpg)
Methods - Laboratory Investigation (cont.)
• The MDH Public Health Laboratory conducted routine testing for Salmonella, Shigella, Campylobacter, Yersinia and E. coli O157:H7
• PCR for Shiga toxin-producing E. coli virulence factor genes (stx1, stx2, eae and hlyA) performed
![Page 13: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/13.jpg)
Methods - Laboratory Investigation (cont.)
• Testing for Giardia and Cryptosporidium spp. performed using acid fast staining, direct fluorescent antibody tests
• Positive Cryptosporidium specimens identified to species by PCR fragment length polymorphism (PCR-RFLP)
– Further identified to subtype by DNA sequence analysis of the 60-kDa glycoprotein (gp60) gene
![Page 14: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/14.jpg)
• Laboratory gives students hands-on experience assisting cows with difficult labors
• Course is highly physical and occurs in a small room
• Approximately 12 students working in pairs under the supervision of professor or lab technician
Results - OB Laboratory Description
![Page 15: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/15.jpg)
• Mock cows consisting of a wooden box, plastic bag, and cow pelvic bones
• Dead calves are placed inside mock cow
• Calves used are generally healthy, 48-hour old bull calves euthanized by captive bolt
Results - OB Laboratory Description
![Page 16: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/16.jpg)
Mock Cow
![Page 17: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/17.jpg)
Mock Cow
![Page 18: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/18.jpg)
Mock Cow
![Page 19: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/19.jpg)
Mock Cow
![Page 20: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/20.jpg)
• Day 1: practiced re-positioning abnormal fetal presentations and manual assistance of difficult births
Results - OB Laboratory Description
![Page 21: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/21.jpg)
• Day 2: Students practiced re-positioning abnormal presentations and performed a fetotomy
– Used when calf has died in utero and too large to be delivered naturally
– Calf is cut up in utero, removed in pieces
• Often results in laceration of the dead calf’s bowels
• Introduces fecal material into the classroom
Results - OB Laboratory Description
![Page 22: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/22.jpg)
• Clean-up procedures
– Students hosed down the inside of the boxes, the plastic linings, and the floor with a garden hose
– No facial protection used
Results - OB Laboratory Description
![Page 23: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/23.jpg)
OB Laboratory
![Page 24: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/24.jpg)
OB Laboratory
![Page 25: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/25.jpg)
Results - OB Laboratory Description
• Calves from Dairy Farm A used during outbreak were:
– Mix of male and female
– Several weeks old
– Some had died of diarrheal illness
• Calves stored together between day 1 and 2 and not labeled
– Could not tell who was exposed to which calves
![Page 26: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/26.jpg)
Results (cont.)
• 42 students had completed a lab at the time of the investigation
• 38 (91%) interviewed
• 8 (21%) met the case definition
• 22 (58%) reported no symptoms
• 8 (21%) reported gastrointestinal symptoms but did not meet case definition
![Page 27: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/27.jpg)
Results (cont.)
• 8 of 8 (100%) and 4 of 22 (18%) controls attended Lab 2 on April 8 and 9
– Fisher’s exact p < 0.001
• There were no cases among Lab 1 or Lab 3 attendees
![Page 28: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/28.jpg)
Case Symptoms (n = 8)
Symptom No. (%)
Diarrhea 8 (100)
Cramps 8 (100)
Gas 7 (88)
Weight Loss 4 (50)
Fever 3 (38)
Vomiting 1 (13)
Bloody Diarrhea 1 (13)
![Page 29: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/29.jpg)
Results (cont.)
• Median incubation period from Lab 2 was 7 days (range, 5 to 12 days)
• Median duration of illness for the 6 cases that had recovered at the time of the interview was 8.5 days (range, 7 to 14 days)
• 1 case was seen by their physician and 1 case was seen in an Emergency Department
![Page 30: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/30.jpg)
Results (cont.)
• A CVM employee also became ill with bloody diarrhea, gas and cramps with illness onset on April 23
• Employee still ill at time of interview
• Set up and cleaned up the OB laboratories on several different dates
• Incubation period calculated from the date of Lab 2 was 15 days
![Page 31: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/31.jpg)
• 4 of 8 human samples (3 student cases and CVM employee) positive for C. parvum of the same gp60 subtype (IIaA15G2R2)
• All human stool samples negative for Salmonella, Shigella, Campylobacter, Yersinia, E. coli O157:H7, Shiga toxin-producing E. coli virulence factors, and Giardia
Results - Human Testing
![Page 32: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/32.jpg)
No
. o
f C
ases
16 17 18 19 20 21 2212 13 14 153129 30
March
1
4
2
3
1 1110987
April
62 43
First Obstetrics Lab
5
Second Obstetrics Lab
Third Obstetrics Lab
23 24 25 2628
Second Obstetrics Lab Attendee
Laboratory-confirmed
Veterinary School Employee
Onset Date
Cryptosporidium parvum Cases Associated with a Veterinary School Bovine Obstetrics Laboratory by
Illness Onset Date, Minnesota, 2010
![Page 33: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/33.jpg)
Results (cont.)
• Among the Lab 2 attendees, the only risk factor that approached significance was being splashed in the face at any point during day 2 of the lab
– 7 of 7 cases vs. 1 of 3 controls*
– Fisher’s exact p = 0.07
*1 case and 1 control were not able to recall and could not answer the question
![Page 34: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/34.jpg)
Results (cont.)
• Students in Lab 2 were significantly more likely to have been splashed in the face at any point during the lab session than students in Labs 1 and 3
– Odds ratio, 13.0
– 95% confidence interval, 1.44 to 117.20
– p = 0.01
![Page 35: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/35.jpg)
Self-Reported Personal Protective Equipment (PPE) Use Among Students
PPE No. (%) PPE No. (%)
Day 1 Day 2
Sleeves 42 (100) Sleeves 42 (100)
Coveralls 28 ( 93) Coveralls 27 ( 96)
Boots 29 ( 97) Boots 29 (100)
Rubber Apron
0 ( 0)Rubber Apron
0 ( 0)
Mask/Face Shield
0 ( 0)Mask/Face Shield
0 ( 0)
![Page 36: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/36.jpg)
• 3 of 9 calf fecal samples collected at Dairy Farm A positive for C. parvum gp60 subtype (IIaA15G2R2)
– Matched C. parvum in human samples
– Subtype commonly found in Minnesota
• 3 fecal samples were positive for the E. coli virulence factor gene stx1
• Calf fecal samples negative for Salmonella, Shigella, Campylobacter, Yersinia, E. coli O157:H7 and Giardia
Results - Calf Testing
![Page 37: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/37.jpg)
Conclusion
• This was an outbreak of cryptosporidiosis among veterinary students in an OB laboratory
• Calves that had died of a diarrheal illness and then used in the laboratories were the source of infection
![Page 38: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/38.jpg)
Conclusion (cont.)
• Not surprising that stool samples from calves at Dairy Farm A tested positive for C. parvum
– C. parvum is present on 90% of dairy farms in the U.S.
– Higher prevalence in calves
• Highlights the zoonotic risk inherent in certain veterinary school activities
![Page 39: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/39.jpg)
Recommendations
MDH epidemiologists and infection control specialists from CVM made recommendations
• Have students read provided information about zoonoses and prevention measures
• Remind students about proper hand hygiene
• Restrict calves used to euthanized 48-hour old healthy bull calves
![Page 40: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/40.jpg)
Recommendations (cont.)
• Provide face shields/masks and rubber aprons to students
• Offer laundry service at school
• Use an EPA-approved disinfectant to clean laboratory
No illnesses were identified during the last laboratory on April 29 and 30
![Page 41: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/41.jpg)
Follow Up
• Visited laboratory on May 12, 2011 to observe
• Warning was added to this year’s syllabus
![Page 42: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/42.jpg)
Follow Up (cont.)
• Observations made
– All students wore boots, coveralls, sleeves
– No face shields/masks offered or worn by students
– Laundry service not being provided by the school
– Near-term fetuses were being obtained from slaughter facilities
![Page 43: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/43.jpg)
Follow Up (cont.)
![Page 44: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/44.jpg)
Conclusion
• Cryptosporidiosis is sometimes called a “rite of passage” in veterinary school
– Serious disease
– Infections should be avoided to the extent possible
![Page 45: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/45.jpg)
Conclusion• Prevention of future outbreaks
– Educating students about the risks
– Ensuring calves used in laboratories are healthy
– Providing face shields or a mask and goggles
• Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary Personnel offers infection control guidance
![Page 46: Outbreak of Cryptosporidiosis Among Veterinary Students in a Bovine Obstetrics Laboratory Carrie Klumb 1,2, Jeff Bender 3, Kirk Smith 1, Elizabeth Cebelinski.](https://reader035.fdocuments.us/reader035/viewer/2022062304/56649e9f5503460f94ba0df3/html5/thumbnails/46.jpg)
Acknowledgments
Minnesota Department of Health
Team Diarrhea
Foodborne, Vectorborne, and Zoonotic Disease Unit
University of Minnesota
Dr. Ricardo Chebel Amanda Doran
Dr. Tom Molitor Leslie Hiber