This study found significant gaps in adherence to CDC recommendations for the control of respiratory infections in ambulatory care clinical settings. Practical strategies are needed to identify and reduce barriers to implementation of recommended practices for control of respiratory infections.

A small animal veterinarian in Washington State developed leptospirosis after an occupational exposure. Approximately 10 days prior to the onset of illness, he examined a healthy appearing pet rat for fleas, which urinated on his un-gloved hands. Although the veterinarian washed his hands after the examination, his hands had abrasions from gardening. The veterinarian was hospitalized for 12 days and was able to return to work part-time 1 month following discharge. This illness may have been prevented if the veterinarian had been wearing gloves during the examination as recommended by the National Association of State Public Health Veterinarians (NASPHV), Veterinary Infection Control Committee, in its Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary Personnel (2008). This case alerts us to the need for small animal veterinarians to minimize their infection risk by practising recommended infection control procedures. Veterinarians should establish and follow a written infection control plan based on the standardized infection control approach adopted by the NASPHV to minimize their risk of occupational zoonotic infections.

We surveyed 940 Washington state waste industry workers to evaluate occupational exposure to potentially infectious materials (response rate 47 percent). Only 26 percent were trained specifically to deal with safety hazards associated with medical waste. For the year preceding the survey, 50 percent of respondents reported having received cuts and scratches on the job, 22 percent reported direct contact with waste blood on their clothing or shoes, 8 percent had blood exposure on their skin, 3 percent blood exposure on their face or eyes, and 6 percent occupational hypodermic needlestick injuries (10 percent among waste collectors.

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