>> Good afternoon, everyone. My name is Laura Morrell and
I work in the National Center for Emerging and Zoonotic
Infectious Diseases at the Centers for Disease
Control and Prevention. On behalf of the
One Health Office, I'm pleased to welcome you
to the monthly Zoonoses and One Health Updates
Call on December 2, 2020. Although the content of
this webinar is directed to veterinarians,
physicians, epidemiologists, and related public health
professionals and federal, state and local positions,
the CDC has no control over who participates.
Therefore, please
exercise discretion on sensitive content material as confidentiality
cannot be guaranteed. Today's webinar is
being recorded. If you have any objections,
you may disconnect now. Today's presentations
will address one or more of the following
five objectives. Describe two key points
from each presentation, describe how a multisectoral One
Health approach can be applied to the presentation topics
to identify an implication for animal and human health, identify a One Health approach
strategy for prevention, detection, or response
to public health threats, and identify two new
resources from CDC partners. In compliance with continuing
education requirements, all presenters must disclose any
financial or other associations with the manufacturers
of commercial products, suppliers of commercial
services, or commercial supporters,
as well as any use of unlabeled products
or products under investigational use. CDC, our planners,
presenters, and their spouses and partners wish to disclose
they have no financial interests or other relationships
with the manufacturers of commercial products, suppliers of commercial
services, or commercial supporters. The Planning Committee
reviewed content to ensure there is no bias. The presentations will
not include any discussion of the unlabeled use of
a product or a product under investigational use.
CDC did not accept commercial
support for this activity. Instructions for receiving
free continuing education are available at cdc.gov/onehealth/zohu/
continuingeducation. The course access
code is OneHealth2020. To receive free CE for today's
webcast complete, the evaluation at cdc.gov/TCE online,
by January 11, 2021. A web-on-demand recording of today's webinar
will be posted online at cdc.gov/One Health/
ZOHU/2020/December.html by January 12, 2021. To receive free CE for the
web-on-demand video today's webinar, complete the evaluation at cdc.gov slash TCE
online by January 12, 2023. Before we begin today's
presentations, Dr. Casey Barton Behravesh, Director of CDC's
One Health office, will share some news
and updates. You may begin. >> Hi, everyone.
Thanks again for joining
us on today's ZOHU Call. We appreciate your help
in spreading the word about the ZOHU Call,
and for you continuing to share our website link with
your colleagues from human, animal, environment, and
other relevant health sectors. Before our presentations today, I want to share just
a few highlights from today's ZOHU
call email newsletter. If you haven't yet subscribed,
please use the link at the top of the main ZOHU call web
page so you can stay informed. CDC's response to the COVID-19
outbreak continues to evolve. Please check CDC's website
for the latest guidance and resources including
information about pets and other animals. The CDC One Health Federal
Interagency COVID-19 Coordination Group
or OHFICC continues to bring together
representatives from 18 key federal
agencies for regular meetings to share news updates,
publications, and guidance on the One Health aspects of
COVID-19 relevant to the health of people, the environment,
and animals, including companion
animals, livestock, and other production
animals like mink, wildlife, and zoo animals.
We also have a state-federal One
Health call every week to talk to public health veterinarians,
wildlife officials, and state animal
health officials as well to ensure we're coordinating
and exchanging information and responding to the One
Health aspects of this pandemic. The One Health Partners COVID-19
webinar is also something available that takes
place once a month to provide the latest
information on the news and key updates as well
as guidance and resources for a variety of
One Health Partners. This webinar also gives
updates on domestic and global animal cases
of SARS-CoV-2 infection in the US and around the world. And talks about our One
Health work in the US, and the next call is
scheduled on December 15. At this time, CDC is aware
of 138 confirmed cases of SARS-CoV-2 in a
variety of animal species from 16 countries
around the world.
There's 75 cats, 52 dogs,
three lions, seven tigers, and one puma at three different
zoos or animal exhibits in three, in two countries. Also in the United States,
there 94 animals confirmed with SARS-CoV-2 infection,
which makes up about 68% of the total animals
confirmed globally. We're also aware of 391 mink
farms with SARS-CoV-2 in animals from ten countries
with an unknown number of affected animals. There are 16 mink farms in four
states in the United States, with mink and other animals that have tested
positive for SARS-CoV-2. And we want to remind everyone
that guidance for farmers and veterinarians as well as
government partners is available on USDA's website and more
resources will be available as well.
At this time, there's
no evidence that animals play
a significant role in spreading SARS-CoV-2
to people. Based on the limited
information available to date, the risk of animals
spreading this virus to people is considered
to be low. We are still learning about
this virus, but it appears that it does spread from person
to animal in some situations. So to help keep people
and animals healthy, limit your contact with people
and animals, whether pets or others, if you think
you might have COVID-19 or if you tested
positive for this virus. Also treat pets like you would
other human family members and don't let them interact with people outside
of your household. There's a lot of great
work ongoing to learn more about this virus and
the impact on people and animals in our environment. And we'll continue
sharing timely updates as information evolves. So the University of Minnesota
has released a pocket guide to antimicrobial prescribing for
common small-animal diseases.
And also the current
Emerging Infectious Diseases or EIDJjournal has a new
zoonotic disease theme this month, so be sure
to check that out. There's a third new outbreak
of E. coli infections of unknown sources that's
been posted on CDC's website. And the next ZOHU Call is going
to take place on February 2. Please email topics
or suggestions for future presentations and
news from your organization to zohucall@cdc.gov and I'll
turn it back over to Laura. Thanks. >> Thank you. You may submit questions at any
time using Zoom's Q&A feature. Please include the topic
or presenter's name. The Q&A session will follow
the final presentation. Our first presentation,
SARS-CoV-2 Infection and Seropositivity
Among Pets of Persons with Laboratory-confirmed
SARS-CoC-2 2020 will be given by Grace Goryoka. Please begin when you're ready. >> Hey, everyone,
I'm Grace Goryoka, and I'm a Public Health Advisor
in CDC's One Health Office, and I'm also on the CDC
One Health Working Group of the COVID-19 Response.
I'm looking forward to
sharing with you all some work that the One Health
Working Group has done on SARS-CoV-2 infection and
seropositivity among pets of persons with laboratory
confirmed SARS-CoV-2. In the United States, approximately 85 million
households own at least one pet, with dogs and cats being the
most common, most popular. Human-animal interactions
are associated with improved mental, social. and physiologic health,
including decreased feelings of loneliness, as well as
decreased blood pressure, cholesterol, and
triglyceride levels.
Owning pets also creates
increased opportunities for exercise and outdoor
activities and socialization. Additionally, human-animal
interactions are critical for service and working dogs. Animals have an important
role in our lives, whether they are a part of our
families or we work with them. At the start of the pandemic,
the role of companion animals in COVID-19 transmission
was unknown. For some background,
I want to go back to what we knew in
March of 2020. We knew that all known human
coronaviruses had originated from a mammalian
host, which suggested that SARS-CoV-2 was a zoonotic
pathogen that had the potential to spill over to other
animals such as pets.
Previous studies on
SARS coronavirus, back in 2003 indicated that
cats were naturally infected with SARS coronavirus,
and that both ferrets and cats could be experimentally
infected and transmit to members of the same species. We also knew that research on
the receptor binding domain of SARS-CoV-2 suggested
that amino acid residues in mammalian h2 receptors are
biologically conserved in cats, ferrets, pigs and
non-human primates. This suggested that these
animals had cell types that were permissive
to viral entry. This information on species
susceptibility highlighted the gaps in knowledge about companion animals
and SARS-CoV-2. In addition, in late February,
global news of the late, of the first companion animal
testing positive for SARS-CoV-2 in Hong Kong was reported
after having contact with a confirmed
human COVID-19 case.
We also saw animal welfare
concerns as reports surfaced of pets being abandoned
or killed due to fears around COVID-19. There was a lack of information
about the role of pets in the pandemic,
their susceptibility and role as hosts or fomites. We are continuing to learn
more about the role of animals in the COVID-19 pandemic and are
updating the link at the bottom of this slide as we learn more. In response to these
concerns in March, we knew that an opportunity to conduct a One Health
epidemiologic investigation would allow us to
further investigate some unanswered questions.
So the One Health working group of the COVID-19 Response
collaborated across local, state, and federal human
and animal health agencies to conduct this One Health
household transmission investigation in
Utah and Wisconsin. Listed on this slide
are the many agencies that supported this One
Health investigation. CDC had already begun a human
COVID-19 household transmission investigation in households
with at least one person with laboratory-confirmed
COVID-19 infection, which is defined as a
human household member who was positive by PCR on
nasal pharyngeal or nasal swabs or had SARS-CoV-2
antibodies detected. Results from the human component of this household transmission
investigation can be found in the publication
linked on this slide. The primary purpose of
the One Health component of this household
transmission investigation was to assess SARS-CoV-2 infections
in mammalian pets residing in households with laboratory-confirmed
human COVID-19 cases.
The results from this
investigation would help inform guidance and decision-making
during this pandemic and for future preparedness
efforts. So, CDC's One Health
Working Group of the COVID-19 Response
deployed two veterinary field teams to join our
other CDC colleagues in Utah and Wisconsin. Any household from the ongoing
CDC household transmission investigation in Utah and
Wisconsin that had one or more mammalian pets living
in the household was included for recruitment into
this One Health component of this investigation.
In the human portion of the household
transmission investigation, individuals were asked about companion animals
residing in their home. And if their pets had developed
clinical signs consistent with SARS-CoV-2 infection
after the diagnosis of the COVID-19 human
index case. Eligible households were
then contacted over the phone to collect information
for pet enrollment. Pets were enrolled
into this investigation if the owner consented, a
questionnaire was completed by a household member, and at least one sample
was collected for each pet. Once a household
pet was enrolled, CDC field teams administered
a questionnaire to the household members for
each pet to capture information on the pet's [inaudible]
medical history and the household
members' knowledge of public health
recommendations.
We also asked about any clinical
signs in the pet since onset of illness of the first
human household case, and asked about the duration of
interaction the index case had with their pets and types
of interactions like petting and cuddling and what types of community interactions
their pets had. The questionnaire also
asked about the household and personal precautionary
measures taken since the human index
case's diagnosis. Our CDC field teams were also
prepared to answer questions that households may have had
about animals and SARS-CoV-2. Additionally, at the end
of each household visit, households were given an
educational information sheet on animals and SARS-CoV-2. This information sheet provided
answers to questions like, how long will it take
to get the results and how will I be notified? What do I do with my pet
test positive for the virus? Who should I contact
if I have any questions about my pet during the study? We also provided
additional information on how to stay healthy around
animals and links to our CDC webpages
for more information.
For this One Health
investigation, the samples to be collected from
pets were oropharyngeal, nasal, rectal, and fur swabs, and
fecal and blood samples. All samples were sent to the Wisconsin Veterinary
Diagnostic Laboratory, WVDL, and preliminary RNA extraction and real-time quantitative
PCR testing of animal specimens
occurred at WVDL. If a specimen was PCR positive
at WVDL, it was considered to be presumptive
positive and sent to USDA's National Veterinary
Services Laboratories, NVSL, which is the national
animal reference laboratory for confirmatory
testing of SARS-CoV-2.
NVSL would also attempt
sequencing and viral isolation. Blood samples were received
and processed at WVDL and the serum was sent
to NBSL for testing by a SARS-CoV-2 virus
neutralization assay. We based our initial sample
collection on guidance from the World Organization
for Animal Health. In addition, we collected fecal
samples from a subset of animals to assess the relative
sensitivities for rectal swabs
versus fecal samples. This is of interest to us for
animal welfare consideration since fecal sample
collection is not invasive, and less stressful
for the animal. Now I'll present some
information on our enrollment. Of the 62 households enrolled into CDC's household
transmission investigation, 41 of those households had pets. From these we were
able to enroll 56 pets which included 37 dogs and
19 cats from 34 households in Utah and Wisconsin. We collected oral and fur
swabs from each pet, and nasal and rectal swabs from
nearly all animals. We collected blood samples
from 47 of the 56 pets and fecal samples
from 14 animals. If the animal became
uncomfortable or fractious, sample collection was stopped.
Now I'll present
some of the findings from this One Health
investigation. All oral, nasal, rectal
swabs collected and a subset of fecal samples collected were
all negative for SARS-CoV-2. We were able to collect blood
samples from 47 of the 56 pets and of these 47 pets, eight
pets which were four dogs and four cats were seropositive. The neutralizing titers from
all for all dog samples were one to 32, while cat titers ranged
from one to 32, to one to 128. The median time from
symptom onset of the household's human
index case to first date of pet sampling was 27 days. We also found that
the median proportion of human household members with laboratory-confirmed
SARS-CoV-2 infection was 45%. We did find that the proportion
of human household members with laboratory-confirmed
SARS-CoV-2 was greater in households with a
seropositive pet compared to households with
no seropositive pet, which was statistically
significant.
There were generally a higher
percentage of positive people in households that as that
had a positive pet compared with households who
didn't have a positive pet. We also asked owners about
if their pets had any clinical signs. So clinical signs that
could be consistent with SARS-CoV-2 infection
were reported in 14 pets from our investigation, and
included respiratory signs like sneezing, coughing,
nasal discharge and difficulty breathing
or shortness of breath, as well as gastrointestinal
signs like vomiting and diarrhea, and
nonspecific signs like inappetence or lethargy. Clinical signs consistent
with SARS-CoV-2 in animals are generally
nonspecific and could potentially be
attributed to other factors. The most commonly
reported clinical signs from this investigation
were respiratory, which included reports
of sneezing, coughing, and nasal discharge.
Among the eight seropositive
pets, owners reported that two seropositive dogs had
mild clinical signs consistent with SARS-CoV-2. One dog had nasal discharge
and the other had inappetence. None of the seropositive
cats had clinical signs in this investigation. Among the 39 seronegative
pets, eight had clinical signs. The owners reported most
pets had mild clinical signs, but one pet was reported to
have difficulty breathing. And among the nine pets that
did not have blood samples collected, four pets had
mild clinical signs including sneezing, coughing,
and lethargy. While 25% of the pets in
this investigation reported to have clinical signs
consistent with SARS-CoV-2, no animals received
veterinary treatment for those clinical signs. Our findings in conjunction
with other research suggests that clinical signs in companion
animals are a poor indicator of serostatus for SARS-CoV-2.
We also collected fur
samples in duplicate from pets during
this investigation. If the household had
multiple repeat visits, all samples including fur
were attempted for collection. Fur samples were obtained from
all pets in our investigation. SARS-CoV-2 RNA detection from
fur samples was extremely rare. Fur samples from one of
56 pets tested positive at one time point. This dog had no evidence
of infection and remained asymptomatic.
All nasal, oral,
and rectal swabs and stool were also negative. And this dog was
also seronegative. Viral culture from the fur
sample was unsuccessful. Subsequent fur samples from
this dog we're also negative. Now I would like to
talk a little bit more about this specific
dog's household. The day the positive fur sample
was collected all six human household members reported
symptoms consistent with COVID-19. Nasal pharyngeal swabs collected
from four household members on the same day the fur swab
was collected tested positive by PCR. Swabs from the remaining
two people in the household tested
positive two days later. We worked with the Utah
Department of Health for the sequences from
these positive tests from the human household
members. Seven near-full genomes or full, or full genomes were
generated from this household. These sequences were from
four household members and the dog's fur sample. The high sequence similarity
suggests one introduction from the community and subsequent internal
household transmission. Our findings suggest
that viral RNA on the fur was environmental
contamination from the household members. We had also asked household
members about the interactions between the human index case
and pets in these households.
When looking at the
duration of interaction, we found that 33 pets that had
serologic testing performed had frequent daily contact with
the human index case prior to diagnosis. Of those 33 pets, 14 pets
had decreased contact with a human index
case after diagnosis, and none of these pets
were seropositive. Nineteen pets had stable
or increased contact with the human index
case after diagnosis, and four were sero-positive. In addition to the duration
of interaction collected, we also captured information on
various types of interactions between the human index case and
their pets in each household, before and after the human
index case's diagnosis. Some of these interactions
included cuddling, feeding, sleeping in the same location
and taking their pets for walks. Overall, owners reported pets
had fewer types of interactions with the human index case
after their diagnosis. We also asked households about their pet's
community interactions.
From the time the human
index case began isolation, 29 pets spent time
free-roaming in the yard or in the neighborhood. Five of these pets were
seropositive; however, only one pet, an eight-year-old
cat spent greater than 50% of their time outdoors, and
this cat was seropositive. Five pets also attended
a social setting which included a dog park,
daytime boarding facility, or a veterinary clinic, and all
of these pets were seronegative. Household members
were also asked if the human index
case wore any type of personal protection equipment
after starting home isolation. Five of 34 households
representing ten pets reported that the human index
cases wore face masks within their household. Of these five households, two
also used gloves around pets. In households with
reported facemask use, one pet was seropositive
while in households with no reported facemask use, seven of 43 pets
were seropositive. Additionally, to
better understand if our public health
recommendations were reaching the public, we asked about
the households familiarity with CDC recommendations
for people with suspected or confirmed COVID-9
restricting contact with pets. Of 34 households, ten identified
a household member familiar with CDC's recommendations
for people with suspected or confirmed COVID-19
restricting contact with pets.
Of these ten households, seven
did not have seropositive pets. Of the households familiar with CDC's recommendations
human index cases in two households reduced
interactions with all pets after the person's diagnosis,
and human index cases in two households used masks and gloves while
interacting with pets. It is difficult to draw
conclusions from this based on the sample size, but we
think it's important to present to better understand if public
health recommendations are being implemented and to
inform future studies.
This One Health household
transmission investigation systematically evaluated
pets residing in households with laboratory- confirmed human
COVID-19 cases and suggests that human-to-animal
transmission in this setting occurred
more frequently than previously recognized. The results identified from
this investigation further shows that transmission of SARS-CoV-2
from people to pets may occur in households especially
after contact with people with COVID-19. Our findings taken
in conjunction with other publications suggest that human-to-animal
transmission is occurring in these settings.
CDC at the start of the pandemic
had made recommendations to avoid animals, including
pets when sick with COVID-19. These results from our
investigation continue to highlight the importance
of people with suspected or confirmed COVID-19
restricting contact with pets and other animals to prevent
person-to-animal transmission. For some future suggestions, future household transmission
investigations should work to sample pets across
the spectrum of exposure, including time points closer
to the start of the household in the households index
case's exposure window and at multiple subsequent
time points to learn more about viral shedding, symptomatology, and
risk factors. We also continue to encourage that a One Health approach
is used for these types of household transmission
investigations. Since this household
transmission investigation ended, our One Health Working
Group has also been collecting data on clinical signs
of companion animals with confirmed SARS-CoV-2
infection in the United States.
The data from the household
transmission investigation were also incorporated into
this larger database. Surveillance data
is really limited and because there have been
so few cases, we are working with our state partners
to gather more information about how these cases of
SARS-CoV-2 in animals present to better understand and
characterize clinical signs of companion animals with
SARS-CoV-2 infection. Out of 77 cases of companion
animals in the US positive for SARS-CoV-2 infection, 57%
of these pets were asymptomatic, 32% have been clinical, and
11% are unknown as reported by state partners
conducting investigations into positive animals. Respiratory signs have
included coughing, sneezing, nasal or ocular discharge,
and nonspecific signs of included fever,
lethargy, and inappetence. Gastrointestinal signs of
included vomiting and diarrhea. And just to wrap up with
some reminders on what to do if you're sick and have
animals until we know more about this virus, it is
recommended to treat pets like human family members.
Don't let pets interact with
people outside your household. Keep cats indoors, do not
allow them to roam freely. Walk dogs on a leash at
least six feet from others. Avoid public places where a
large number of people gather. And additionally, masks
should not be put on pets. And if you are sick with
COVID-19, restrict contact with people and animals. When possible, have
another member of your household
care for your pet. Avoid contact with pets
including petting, snuggling, being kissed or licked,
sharing food or sleeping in the same bed. And if you must care for
your pets, wear a mask and wash your hands before and
after you interact with them. If your pet gets sick and
you are sick with COVID-19, please contact your
veterinarian. I want to express my
sincerest thank you to all of our collaborators that are
listed here on this slide. And additionally, I want to thank all the participating
households in the Salt Lake City and Milwaukee metropolitan
areas for their interest in this investigation
and willingness to involve their pets.
Thank you very much. >> Thank you. Our final presentation. One Health Investigation
of SARS-CoV-2 on Multiple Mink
Farms in Utah is by Dr. Caitlin Cossaboom
and Dr. Dean Taylor. Take a moment to get
back to the slides and then you can begin
when you're ready. You can begin when you're ready. >> Okay, hi, everyone. My name is Caitlin Cossaboom. I'm a veterinary epidemiologist
currently supporting CDC's COVID-19 One Health
Working Group. It's my pleasure to co-present
today with Dr. Dean Taylor, Utah State Veterinarian on
the One Health investigation of SARS-CoV-2 on multiple
mink farms in Utah. As of December 1,
mink on 391 farms in ten countries
have been confirmed to have SARS-CoV-2 infection. The Netherlands, shown in
navy blue on the graph, identified the first affected
mink farm in the world and has since identified 70
total affected farms across the country. Denmark, shown in red and recently became the
leading country in the world with 289 affected mink farms,
with a doubling in the number of affected farms through
active surveillance and testing.
Just to note that the
most recent countries, Lithuania was just reported to
OIE today, and is not listed on the graph and Poland has
not yet been reported to OIE. On August 17, 2020,
the US Department of Agriculture's National
Veterinary Services Laboratories confirmed that mink
from two farms in Utah were infected
with SARS-CoV-2. The United States has
since identified a total of 16 affected farms with 12
in Utah, two in Wisconsin, one in Michigan and
one in Oregon. CDC has been working with One
Health collaborators including local and state health
departments, state Departments of Agriculture and
Natural Resources, USDA, and the National
Wildlife Health Center to investigate these
outbreaks on multiple farms in the United States, to help
figure out how the virus gets on the farm, how it's
transmitted between species on the farm by collecting
samples from mink, people, wildlife and other animals like
dogs and cats from the farms.
We're doing this to learn how
to prevent future outbreaks and to get more information
to help figure out what to do when this happens. CDC is aware that Denmark
has reported a new strain of SARS-CoV-2 virus in
minks that's also present in the local human population. This new strain or variant
referred to as cluster five, is defined by five mutations in
the region of the genome coding for the spike protein. based on the current
available data, these mutations do not appear to affect how quickly
the virus can spread, or the severity of infection. But more research is ongoing
to continue investigating if there are any implications
that these mutations may have. In response to this news, One Health Partners are
investigating scientific findings of Denmark's reports by conducting on-farm
investigations to address SARS-CoV-2 in people
and multiple animal species on mink farms in the United
States, including collaboration between CDC and USDA on sequence
analysis from positive mink, other animals, and
people associated with affected mink farms,
and generating guidance and recommendations for
states and mink farmers in collaboration with partners
in the US and globally.
Now, I will turn it over to my
co-presenter, Dr. Dean Taylor, the State Veterinarian of Utah, to give some background
information on the Utah mink
farm investigation. >> Good afternoon. I'm Dean Taylor, the
Utah State Veterinarian. It's my pleasure to share with
you our response to the outbreak of SARS-CoV-2 in mink in Utah. On August 10, the first
mink were presented to the Utah Veterinary
Diagnostic Lab from two farms who were experiencing higher
than normal death losses.
On August 13, we had
three farms affected. And by the 14th, When we
sent our veterinarians down to place quarantines
and collect additional mink from the additional farms,
we were up to four farms in two neighboring
counties there. This was because
one of the farmers in the initial county also
owned a separate facility in a neighboring county and shared his workers
between those two. On August 17, we got confirmation
confirming SARS-CoV-2 in the mink in the
United States. And on August 19, a One
Health response began. To give a history, all of
these farms have histories of workers falling ill with a
confirmation of COVID-19 prior to the onset of death
losses in the farms. There was an approximate
five-day lapse between when those
workers were sick and when they saw the death
losses start to increase.
And they reached numbers
of upwards of 500 per day. This number is somewhat
variable depending on the farm that we spoke to, and
it would average out to about five days per
for the interval. The first couple of days when these mink farmers saw
these increased death losses, they were attributing these
to other well-known diseases such as Pseudomonas,
Andalusian's disease. It was on the referral of
the attending veterinarian that dead mink were sent to you
Utah Veterinary Diagnostic Lab for sampling and necropsy. This immediately, as soon as Utah Veterinary
Diagnostic Lab suspected that we had SARS-CoV-2
in these mink, and then sent those samples to
the Washington diagnostic lab, we immediately started
getting calls and support from other agencies
around the country. And cooperative responses
formed between Utah's Department of Agriculture or Health
Department and other players such as the CDC, the USDA, both
Wildlife Services in One Health as well as labs involved. So the plan was for the CDC and
the Utah Department of Health to begin doing some
testing on these farms.
They looked at several different
types of sampling there. First, they would take the
fresh dead mink each day and test them. They also did some
mortality studies where they would sacrifice
animals who randomly on the farm as well as those with any
kind of clinical signs. And then they also took some
live samples from a number of mink on these farms. As CDC was doing
this, the Department of Health was also testing the
humans on these farms to look to see if they had
COVID-19 and to retest those who had previously
tested negative. In addition to these
two agencies, Wildlife Services
also stepped in and began testing
around the farms. They were testing all
types of wildlife, and also the feral mink who
had escaped from these farms.
So after this initial
round of testing was done, and we got some numbers there,
the team was going to return to Utah, and begin testing on
October 1, to see what kind of prevalence of the virus
these was on those farms at that point in time. Right prior to their
arrival on October 1, the second outbreak occurred in
a distant county in our state. Initially, in this
second outbreak, there was no history
of human COVID-19. And so our suspect
fell to the feral cats that were surrounding
all of these farms, as there's an abundance of them. Additionally, they
were right on a river where the feral mink would
set up housekeeping and live.
After they came and
started doing testing, they found that there were
human COVID-19 cases on all of the affected farms in
the second outbreak as well. We then had a third round of
testing that will be coming on December 4, started
just a couple days ago. And we're going to be
looking at the animals who tested positive both
in August and in October, and help to determine if they're
persistently carrying this virus or not or whether
it's just circulating. Our concern from
the October testing, which was nearly ten weeks after
the first round of testing was that we still had an
actual increased percentage that were PCR positive,
with fairly low CT values.
So one of the things that
I thought I would bring up to the group is that there
have been some obstacles to our response. And this industry is one that
has innately has a little bit of mistrust, because of the fact
that they are targets oftentimes and so they are very, very closed to having
any outside people come onto their farms and
see their operations. The other problem we had was
that they were, we had to come up with some compensation
for mortality studies. Here in Utah, our
losses approached 50% on the breeding populations
of these farms. So to come in and
do mortality studies for research purposes
wasn't going to sit very well
with these producers.
So we had to find
some compensation for those mortality studies
before we could even begin. And then they were also holding out for compensation
for their losses. They fell into a
unique situation where they don't qualify
for indemnity through USDA, similar to some of
our other animals such as the beef
and food animals. And so they were fairly
resistant to having anybody come on to their facilities. The other thing that
was expressed by some of these farmers that
slowed the process down initially was worker fear, when they saw people
in full PPE. We worked through
all of these issues. And as we gained their
trust with privacy concerns, they were able to allow us to
come on and do that research.
But current management concerns
here in Utah are currently, our state is almost through
with their pelting process. But our current concerns
are how to do that safely, and
keep people safe. And one of the issues
that the producers have is that we continue to tell them
that our research indicates that this virus has gone
from people to mink. And at the same time we turn
around and tell them you need to use this PPE at
the highest level. And we're trying to get them
to understand that we're still in the process of
understanding this virus. And so we're going to take as
many precautions as possible. So most of these have been
pelted at this point in time. We're also approaching
the processing plants with the same advice
here in Utah.
Excuse me, the next thing that
we have that we're worrying about is how do we dispose
of things like waste and the water contamination
run off into the water tables. Many of these farms are right
next to rivers or they're out in areas where we have
high water tables here in Utah. Because some of these producers
have not done composting accurately, we have asked them
to dispose of all carcasses through sanitary landfill
that we've contracted with. >> So, this is Caitlin again. So we know that among
susceptible animal species, mink are particularly highly
susceptible to SARS-CoV-2.
This could be due to a
combination of genetic and environmental factors. For example, farmed
mink are often housed in relatively high densities,
where they're in close contact with one another, which
favors spread of the virus. Additionally, farmed mink do
not exhibit a large amount of genetic diversity, which
can favor infectious disease transmission and susceptibility. Like humans, mink have
exhibited symptoms that range from being asymptomatic or
having mild clinical signs like being off feed,
and having respiratory or gastrointestinal signs, to
rapid death in a high percentage of animals on a given farm. Because of this,
it's very important that extra precautions
are taken to protect mink and humans while
working on mink farms. CDC's COVID-19 One Health
Working Group has deployed field teams to support
on-farm investigations in the three states that have
had farms with mink confirmed to be infected with SARS-CoV-2. From the farms that have
been affected so far, many farmers have noticed that the animals went off feed
first before they showed any clinical signs of illness. In most cases, this was
followed by coughing, sneezing, severe nose and eye
discharge and crustiness and profound lethargy.
In the Netherlands, they also
saw animals with diarrhea. The signs progress to labored
breathing and death in most of the farms in the US. The disease moved rapidly
through the facilities both within and between barn. Farms in the US typically have
seen about seven to 10 days of high mortality, followed by
a period of residual sickness. This slide shows what we know
to date about the transmission of the virus on mink farms. We know that SARS-CoV-2
infection spreads most commonly from person to person. Infected people, either with
symptoms or without symptoms, initially introduced
the virus to the mink. Once it's initially
introduced to mink in the herd, the mink spreads the
virus to other mink. It spreads very quickly
on the farm, and we've seen losses
ranging from 20 to 50% on some affected farms. While we're still learning
about how long mink are infected with the virus and how it
can spread to other animals on the farm like dogs,
cats and wildlife, including feral mink
and other animals.
At this time, there's not
currently evidence suggesting to human transmission
has occurred on us farms. However, the investigations
are ongoing. We know that mink-to-human
transmission is suspected to have occurred on farms in
the Netherlands and Denmark, we're still learning about
the potential risk of mink and their pelts to transmit
virus back to people. And there's currently
work ongoing to investigate these questions. CDC's COVID-19 One Health
Working Group is continuing to work with state
and federal partners to continue investigating
and monitoring transmission of SARS-CoV-2 on mink
farms in the United States. We also wanted to make
you all aware of a webinar that we recently organized – a
national mink farmer training on steps to prevent
SARS-CoV-2 on mink farms. The purpose of this webinar
was to share information with mink producers and
farm workers on what we know about the virus that causes
COVID-19 in mink and people. Topics included how
to protect mink and workers from this virus.
Steps to prevent virus
introduction on the farm. Included recommended biosecurity and personal protective
equipment, practices, and available guidance
documents and resources to protect human
and animal health. Bio security refers to
management practices that reduce the risk of disease
and contamination on farms. These are some of the components of a comprehensive
biosecurity plan. The fur comission has a
biosecurity guidance document that goes into much more
detail than we can cover today. The link is shown at the
bottom of this slide. The highlighted recommendations
for the development of the mink farm biosecurity
plan should restrict access to the premises and
building where mink are kept, minimize visitors and
other animals, rodents, birds and wildlife on the
premises, require all employees to stay home if they're sick, maintain at least
six feet distance between all people working on
the farm, and use face masks and personal protective
equipment or PPE, such as dedicated footwear that
can be cleaned and disinfected, dedicated farm clothing
such as coveralls, gloves and eye protection such
as face shields or goggles.
It's important that people
on the farm wear PPE, including face masks, even
if they don't feel sick. We also recommend to disinfect
frequently touched surfaces, for example, door handles,
counters, control panels, feed bins, and practice
strict hygiene in areas where animal feed is
prepared and clean and disinfect feeding
equipment daily using an EPA-approved disinfectant. Finally, we recommend
to use caution when introducing new
mink to the herd, including quarantining before
bringing the mink into the herd. To prevent the introduction
of COVID-19 into the farm, it's critical to
make sure no one who is sick works
with the animals. One way to do this is to
conduct daily health checks, including symptom and/or
temperature screening of anyone including
family members, friends or employees before
they enter the farm. People who have symptoms
upon arrival at work or who become sick
during the day so they immediately be sent home
and should not return to work until the criteria to discontinue home
isolation are met.
It's possible that the virus
can be found on surfaces and equipment like tools, cages,
other items in the animal area, but fortunately,
there's a lot of cleaners that can kill the virus. The EPA has a list of
disinfectants that are effective against Coronavirus at the link
that's shown on this slide. And if you're at
the store looking into buying disinfectants you
can check the label to see if it's effective against the
Coronavirus or has the EPA seal. The contact time or time
the cleaner needs to be on the surface to disinfect does
depend on the cleaning product, so be sure to check the label. Additionally, any equipment used
on one farm should not be used on another farm including
protective clothing like coveralls and
leather gloves. Now we're going to talk about what personal
protective equipment or PPE should be
used on the farm. But before I do, I wanted to mention a couple
important things to remember. COVID-19 cases are
increasing everywhere, including among people
who work on mink farms.
People infected with a
virus may not show symptoms or symptoms may be mild, but they can still transmit the
virus to other people or mink through breathing or talking. People are the main source
of infection to each other and introduce the
virus to the mink farm. This virus causes high
morbidity and mortality in mink, and we need to protect
them and ourselves with PPE to prevent introduction
of the virus to the farm, stop spread to other farms,
and minimize animal losses. This is the basic
everyday PPE to use even with no known exposure to
COVID-19 or any symptoms given that we know people with
COVID-19 can be asymptomatic. This includes a facemask and if available a fit-tested
respirator such as N95, eye protection, dedicated
outerwear such as coveralls, and disposable gloves, or gloves that can be disinfected
between use.
If mink are sick or test
positive for SARS-CoV-2, to limit virus spread
between barns it's important to keep the number of
people working with mink who are positive to a minimum. This can be done by assigning
certain people to work only in certain barns, caring for
healthy animals before caring for sick animals, not sharing
equipment or feed between barns, disposing of leftover
feed and not sharing with other animals on the farm.
It's also recommended to not
have staff who are higher risk for severe illness for COVID-19
work with animals suspected or confirmed to be
infected with SARS-CoV-2. Additionally, anyone
who has contact with or works near sick animals
should wear respiratory protection, for example, an N95 respirator
instead of a face mask. In conclusion, we know that
mink are very susceptible to SARS-CoV-2. Anyone who is experiencing
COVID-19 symptoms or may have been exposed
to COVID-19 or diagnosed with COVID-19 should not
work with the mink in order to prevent introduction
of the virus to the herd and to protect the mink
from getting sick and dying.
Finally, we wanted to make
sure you all are aware of guidance documents that
were developed in collaboration between CDC, USDA, and state
animal health officials in the One Health Federal
Interagency Livestock subgroup. These guidance documents
can be found online at the link shown here on
the screen and were developed to provide recommendations
related to PPE, biosecurity, and steps to take if
infection is suspected or confirmed on the mink farm. This concludes our
presentation for today. We want to thank everyone
listed on this slide for making these
investigations possible, including the mink producers
that have been willing to work with us, all of our
state partners in Utah and federal partners with CDC's
COVID-19 One Health Working Group, USDA, and the National
Wildlife Health Center.
Thank you all very much for your
attention, and we would be happy to take any questions. >> Thank you. And thanks to all
today's speakers for their informative
presentations. We do have time for
some questions. Please use the Q&A feature in
Zoom to send your questions and include the presenter's
name or topic. I'll start with some questions that we've already
gotten for Grace. Can you elaborate
on what it means to use a One Health approach
in this specific example of infection investigations? >> Yes, thanks. So One Health approach for
this investigation was used by not only looking
at transmission of SARS-CoV-2 among people, and like a human household
transmission investigation, but also for pets in
this investigation. So by incorporating this, we're
looking at not only humans, but also pets or
animals in the household.
And then additionally, when we
conducted this investigation, we were not only working in
the households for these, but we're also working across
many federal, state and local, human and animal health
agencies and partners to be able to conduct this. So making sure you're
collaborating and communicating and sharing information
and results across all sectors is
definitely something that goes into utilizing a
One Health approach for these types of
investigations. >> Thank you. And another question was,
do you have any information for how long the virus
would remain on fur? >> Sure. So virus isolation
from the positive fur sample from this investigation
was unsuccessful, and subsequent fur swabs were
taken at various time points, and none of those were positive. And so based on the findings
from this investigation, fur is not considered
to be a fomite for SARS-CoV-2 transmission,
and just reiterating that virus isolation was
unsuccessful for this. >> Right, thank you. We'll move on to some questions
for the mink presenters. And how many mink were on the farms reporting the
mink mortalities is the first question.
>> So this is Dr.
Taylor, the number of mink on the farms ranged from 3000
to over 20,000 on some of them with everything in between. So there's a fairly high
range of the size of these, these different farms. >> Thank you. And let's see, there's one, can
you say more about how you went about communicating
with farms to get buy-in and to coordinate compensation? What challenges, successes, and
lessons learned were realized? >> Sure, we had to do
some creative financing through the state with, with
some of this CARES money that had already been
designated here in Utah.
It was, it was earmarked
for specific organizations and the amount that they could
get, and the mink producers in Utah had already received
that money when this happened. So it took us a few weeks,
but we were able to get, we had to have the
legislature meet and approve a change in that. And then we were able to get some compensation
for these losses. And that, quite honestly, is
what opened up the door for us to be able to get onto
these farms and continue to do the research there. They have wanted to help
that they've kind of felt like they were left out of
any kind of a helping hand.
So when our state came
through with that, it felt like the flavor of that
changed dramatically for us. And also I will say that the
professionalism of the CDC and the health department,
they developed friendships and gain trust with
the producers. And that allowed
us to get on there. Otherwise, we would have been
locked out of these facilities. >> Great, thank you. There's also a question.
Are mink really regulated
in Utah? Does it require a permit? And are they considered
farm animals? >> They're not highly
regulated here in Utah, but they are considered
livestock in Utah. And that goes back to the
same trouble that they had is that they're considered
livestock in Utah, but not federally. And that was one of our
obstacles that we had overcome. >> Thank you. And there's another question. Could you comment
on worker education and were workers
fit-tested N95 use? >> This is Caitlin I
can comment on that.
So we've been working very
closely with the Utah Department of Health to provide
education to all of the farmers on the affected mink farms
including providing personal protective equipment including
face masks and face shields and protective disposable
outerwear to the farmers, and provide training on
how to safely put those on and take those off. They are also looking
into opportunities to have the farmers pursue fit
testing, if that's something that they're interested in. >> Thank you. We have one more question
come in for Grace. Can you elaborate on SARS-CoV-2
and clinical signs in dogs? Is it still uncertain if a
dog can have clinical signs? Do you consider your study
helps to answer that question? >> Sure, so dogs can
have clinical signs and in our investigation
that dogs that did have clinical signs,
we're both mild clinical signs. So that is it is possible. But again, what we are
seeing is that they have from our investigation that
these were mild clinical signs. >> Thank you. Okay, and another
question for Dr. Taylor. I think he spoke a little
bit to this already.
But could you speak more
about how the concerns and fears the mink
farms had were overcome. And if there were any particular
communication strategies or techniques used for that? >> Initially, I had very few
contacts with this industry. And when I would try to
get contact with them, they would say just come
through the Fur Commission, and we'll pass it on, which
was not an effective way. The biggest thing that honestly
changed this was CNS put some effort into helping
them out financially. When they're losing that
volume of their business, in just literally one week's
time, and they've lost 50% of their breeders, and
several thousand mink, having someone come in
and just understand that, that that's life-shattering
for them, that was what opened up the door for communication.
And then I've tried to be completely
transparent with these people. As information comes,
Caitlyn with CDC has shared that information with
them, we haven't kept any of that back from them. We certainly wait
until it's confirmed and we know what
we're presenting. But I think that
open communication with them is what opened the
door and allowed us to get on and do some further studying
there, and is allowing us to do it currently
this week as well. >> Thank you. We've got a question about
access to the presentation. So the webinar will be
posted online after this. And then we will also
share as you can see on the screen the contact
information for the presenters if you'd like to reach out
directly with more questions. There was another question. Can you please elaborate on the carcass disposal
of the dead minks? >> Yeah, I can. Because we're still waiting
on information on how long that virus lasts, there's still
a lot of unknown answers as far as how much risk these
carcasses possess.
And because after we
went out onto these farms and saw what they're
composting, what they consider to be composting, which really
were just piled up mink, we made the decision
here in Utah to just have these
buried at landfills. So they are taking them in
lined dumpsters or trucks and the landfills, we've
contacted each landfill. So they understand that
as these mink come, they want to bury them
immediately, keep predators and scavengers off, and then
disinfecting these vehicles back and forth. So we just felt like right
now that was the quickest, easiest way to dispose of these
animals and the most safe. >> Thank you. We're at the top of the hour. If you have other questions
for today's presenters, like I mentioned, we've
included their email addresses on this slide. And they're also on
the ZOHU call web page for today's webinar, and in
today's email newsletter. So please join us for the next
ZOHU call on February 3, 2021. And thank you for
your participation. This ends today's webinar..
