Posted By Steve Sedgwick
Bill
Its quite a few years since I studied this but I do believe a certain workers e.g. in sewers can be inoculated against this.

Obtain advise from your Occ Health Physician or even a GP.

There is an HSE leaflet, which should be given to those at risk (have a look on the HSE web site)

I also believe that another form of Leptospirosis can be contracted from cattle urine. From memory this is Leptospirosis "Harjo".

I am sure some of our other colleagues will have a better working knowledge of this and other zoonoses.

Check the leaflet out on the HSE web site.
Regards
Steve

Posted By Ken Taylor
The HSE leaflet is available at http://www.hse.gov.uk/pubns/indg84.htm . I believe that the reported incidences of Leptospiroses are fairly low but you should take into account that their are other diseases that can be transmitted to humans from rodents, cattle and soil and consider the need for information and training, personal protection and good hygiene before eating, drinking, touching mouths and noses, etc. Perhaps EMAS and the HSE's Agriculture and Forestry Advisory Group can help further?

Posted By Willian Holbrook
Many thanks for the replies on my query regarding weils disease. I have obtained the HSE literature on the subject as suggested. However the problem as I see it would be that the drivers are supplied with good quality waterproof PPEs including thick arm length gloves. When the driver picks up and disconnects the hose both gloves (and to a lesser degree) other clothing become contaminated. The dilemma arises when the driver re-enters the cab of the vehicle removes the gloves and starts to drive. If he touches any part of his clothing that is contaminated with his hands or any of the clothing should touch his face, then infection could arise. The vehicles including the cabs are thoroughly cleaned at the end of each shift and fresh PPEs are worn every day I do not feel that a change of clothing after each collection would be a practical solution. Any suggestions?

Bill Holbrook

Posted By Linda Crossland-Clarke
looks like a SSoW needs developing. As everyone has mentioned, ensure all cuts are covered with waterproof plasters, ensure no eating/smoking in the cab until personal hygiene has been attended to and then look into some sort of spray to put on surfaces at the end of the journey. Then do the training and provision on info bit to the staff. Awareness cards can be issued so drivers can present them to their GP if they display the "flu-like" symptoms.
I've seen what this can do to people and its not nice, blood transfusion was even offered to my freind in the sewerage industry.
Linda

Posted By Jack
Don't forget there are many types of Leptospirosis and your slurry could be contaminated with at least 2: Leptospira hardjo which is found in cattle and Leptospira icterohaemorrhagiae which is associated with rats.

There is no vaccine available in this country for humans (Cattle can be immunised and that reduces risk for humans).

Precautions as in previous responses: good hygiene, covering cuts with waterproof plasters, ppe and information for those likely to be exposed usually by issue of card (it's important that staff know that should they exhibit (flu like) symptoms after exposure that they go to their GP and show her/him the card. Treatment with antibiotics in early stages is usually effective.

Posted By Bill Elliott
You could do a lot worse than talk to your local Consultant in Communicable Disease Control (CCDC) contactable through the local Health Authority. Or alternatively an Infection control specialist also via local Health Trust. They will be able to advise you concerning the viability of survival of the pathogens to enable you to put in place control meaures.

Posted By Adrian Watson
Dear William

Leptospirosis is caused by pathogenic serovars of the genus Leptospira. A notifiable disease in humans throughout the United Kingdom, it is reportable under the Reporting of Injuries, Diseases, and Dangerous Occurrences Regulations 1985 (RIDDOR) to the Health and Safety Executive (HSE) and is a Prescribed Industrial Disease.

Leptospires persist in the kidneys and genital tracts of carrier animals and are shed in the urine and genital fluids. Humans may be infected through direct contact with animal urine or by environmental contact in areas contaminated by animal urine. Leptospires can invade the mucous membranes or abraded and water-softened skin leading to bacteraemic infection. Environmental conditions are important for the survival of leptospires outwith the host, the optimum being warm, moist conditions with a pH close to neutral. Man is always an accidental host.

Human disease and its severity varies according to the infecting serovar although all forms of the disease start in a similar way. The serovars encountered most frequently in the United Kingdom are Leptospira hardjo and Leptospira icterohaemorrhagiae. Weil’s disease is a clinical syndrome associated with Leptospira icterohaemorrhagiae. Infection, maintained by the brown rat, may be severe requiring careful management of the patient and presents a risk to those engaged in water associated leisure activities and occupations in contact with inland waters. Human infection with Leptospira serovar hardjo, a milder form usually acquired through urinary tract shedding by cattle, the maintenance host, is frequently an occupational disease of agricultural workers, especially those involved in cattle and dairy farming.

In England and Wales there were between 13 and 32 reported cases and between 21 and 54 cases of laboratory confirmed cases of Leptosptospirosis in the years between 1990 and 2000. The majority of cases are generally Leptospira icterohaemorrhagiae, followed by Leptospira hardjo. Approximately a quarter to a third of cases are acquired overseas. As you can see this is a faily rare condition.

I would suggest that the risk to hgv drivers collecting milk from farms would be extremely low even though the tankers collection hoses would become contaminated by coming into contact with the ground. Furthermore the most likely serovar likely to cause infection would be Leptospira hardjo.

My general recommendation would be to ensure that the drivers' are aware of the risk; they inform their doctor if they have any febrile condition; they cover cuts with waterproof plasters; they wear rubber gloves when handling dirty hoses; they keep connectors clean and exercise good personal hygiene, i.e. wash their hands before connecting up. This will minimise the risk from leprospirosis and other bovine zoonosis, as well as ensuring that the prouct is not contaminated at source.

Regards Adrian Watson