{"id":2348,"date":"2011-12-16T17:24:49","date_gmt":"2011-12-16T17:24:49","guid":{"rendered":"https:\/\/orangutan.com\/?p=2348"},"modified":"2011-12-16T17:27:28","modified_gmt":"2011-12-16T17:27:28","slug":"orangutan-conservancy-2011-orangutan-veterinary-advisory-group-workshop-report","status":"publish","type":"post","link":"https:\/\/orangutan.com\/orangutan-conservancy-2011-orangutan-veterinary-advisory-group-workshop-report\/","title":{"rendered":"Orangutan Conservancy 2011 Orangutan Veterinary Advisory Group Workshop Report"},"content":{"rendered":"

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ORANGUTAN CONSERVANCY 2011 ORANGUTAN VETERINARY ADVISORY GROUP WORKSHOP REPORT<\/strong><\/span><\/p>\n

\u00a0\"\"<\/a><\/p>\n

Photos provided by Raffaella Commitante, Steve Unwin and orangutan portraits by Wiwik Astutik (BOS Samboja Lestari)<\/p>\n

Orangutan Conservancy 2011 Veterinary Workshop logo courtesy Amy Burgess<\/p>\n

\u00a9 Copyright 2011 by Orangutan Conservancy Prepared with participants of the Orangutan Conservancy 2011, Orangutan Veterinary Advisory Group (OVAG) Workshop, Jogjakarta, Indonesia, 4-8 July 2011\u00a0 R. Commitante, S. Unwin (Editors). Orangutan Conservancy (OC). 2011.
\nOrangutan Conservancy 2011 Orangutan Veterinary Advisory Group Workshop Report.<\/p>\n

Additional copies of the Orangutan Conservancy 2011 Veterinary Advisory Group Workshop Report can be ordered through the Orangutan Conservancy, P.O. Box 513, 5001Wilshire Blvd., #112, Los Angeles, California, 90036, USA., or go to our website at orangutan.com<\/a>.<\/p>\n

Webpage Note:\u00a0 You are viewing a text-only copy of the 2011 Report.\u00a0 To view the Report in its entirety (photos, layout, charts, links, etc.) OC\u00a0recommends that you click on the pdf version here 2011 OC-OVAG Veterinary Workshop Report<\/a>.<\/strong><\/em><\/p>\n

Orangutan Conservancy 2011 Orangutan Veterinary Advisory Group (OVAG) Workshop<\/strong><\/p>\n

July 4 \u2013 8 2011<\/p>\n

LPP Convention Hotel, Jogjakarta, South Central java, Indonesia<\/p>\n

Participating Organizations:<\/p>\n

Orangutan Conservancy, United States
\nChester Zoo \/ NEZS, United Kingdom
\nLiverpool School of Tropical Medicine, United Kingdom
\nMurdoch University, Perth, Western Australia
\nSumatran Orangutan Conservation Programme (SOCP), Medan, Indonesia
\nBorneo Orangutan Survival Foundation, Nyaru Menteng, Palangkaraya, Kalimantan, Indonesia
\nBorneo Orangutan Survival Foundation, Samboja Lestari, Samboja, Kalimantan, Indonesia
\nOrangutan Foundation International (OFI), Kalimantan, Indonesia
\nOrangutan Foundation United Kingdom (OFUK), Kalimantan, Indonesia
\nSyah Kuala University, Aceh, Sumatra, Indonesia
\nGadjah Mada University, Jogyjakarta, Indonesia
\nInternational Wildlife Rescue, Indonesia (GPOCP)
\nABAXIS Europe, Germany
\nBogor Agricultural University\/Primate Center for Wildlife Studies (IPB\/PSSP) Java, Indonesia
\nPutra University, Kuala Lampur, Malaysia
\nFrankfurt Zoological Society\/Jambi SOCP Orangutan Release Site, Sumatra, Indonesia<\/p>\n

Supporting Organizations:
\nOrangutan Conservancy, United States
\nChester Zoo\/ NEZS, United Kingdom
\nAmerican Association of Zoo Keepers (Birmingham, AL), United States
\nABAXIS Europe, Germany
\nCleveland Metroparks Zoo \/ Cleveland Zoological Society, United States
\nMurdoch University, Australia
\nChembio Diagnostics, Inc., United States
\nLiverpool School of Tropical Medicine, United Kingdom<\/p>\n

Hosted by:
\nGadjah Mada University, Fakultas Kedokteraan Hewan, Jogyjakarta, Indonesia<\/p>\n

Orangutan Conservancy 2011 Orangutan Veterinary Advisory Group (OVAG) Workshop 2011 OVAG Report<\/strong><\/p>\n

TABLE OF CONTENTS<\/strong><\/p>\n

Section 1<\/strong>
\nExecutive Summary
\nBudget
\n<\/strong><\/p>\n

Section 2<\/strong>
\nLetter of Invitation
\nAgenda
\nParticipants Contact List
\n<\/strong><\/p>\n

Section 3<\/strong>
\nProceedings
\n<\/strong><\/p>\n

Section 4<\/strong>
\nMiscellaneous Notes
\n<\/strong><\/p>\n

Section 5<\/strong>
\nAttachments<\/p>\n

Orangutan Conservancy 2011 Orangutan Veterinary Advisory Group (OVAG) Workshop 2011 OVAG Report<\/strong>
\nJuly 4 – 8 , 2011<\/strong><\/p>\n

Section 1<\/strong><\/p>\n

Executive Summary<\/strong><\/p>\n

<\/strong>
\nCollectively, they care for the largest captive population of orangutans in the world. Yet the handful of veterinarians and healthcare staff who work at orangutan rehabilitation centers across Sumatra and Borneo face nearly impossible odds, and often find themselves short of medicine, equipment, money, space, support staff and time.<\/p>\n

But those same dedicated men and women do not lack for skill; or commitment. And that is why the Orangutan Conservancy was once again proud to be able to stage the Orangutan Conservancy (OC) 2011 Orangutan Veterinary Advisory Group (OC\/OVAG) Workshop, held July 4 – 8 in Jogjakarta, Indonesia. The workshop series, which was inaugurated in 2009 in Borneo, gathered together the veterinary teams that work at the frontlines of the orangutan conservation crisis, and gave them a rare opportunity to hone skills, discuss issues and ideas, and renew friendships that could someday mean the difference between life and death for endangered apes in Southeast Asia.<\/p>\n

Orangutans are in severe crisis. The largest of the great apes found in Asia, their natural range is limited to the islands of Borneo and Sumatra, and their rainforest homes are disappearing quickly. More than 80 percent of the orangutans\u2019 habitat has been destroyed over the last 20 years, and approximately only 60,000 orangutans are thought to exist. At the current rate of decline, experts believe that orangutans may become extinct in the wild within 25 years!<\/p>\n

The primary threats to orangutans are illegal logging and habitat destruction, human encroachment, the conversion of rainforests to oil palm plantations, and the pet trade. As a result of such intense pressures, an extremely large number of orphaned orangutans exist in rehabilitation centers across Borneo and Sumatra. These orangutans \u2013 which number approximately 1,600 \u2013 arrive bearing a host of physical and emotional wounds, and require intense veterinary care to recover.<\/p>\n

Now, more than ever, veterinarians in the field are under pressure due to the Indonesian government\u2019s mandate to release all captive orangutans within the next 5 to 7 years.<\/p>\n

The orangutans that are judged fit to return to the wild will be reintroduced after a long, complex process, but an overwhelming majority will continue to reside in the rehabilitation centers.<\/p>\n

The 2011 OC \/OVAG Workshop focused on the many aspects of captive orangutan care, with a special emphasis on the detection and treatment of tuberculosis (TB) and parasites. A joint program between OC and Chembio Diagnostics Systems Inc. begun in 2010 was nearing completion. This collaboration provided PrimaTB STAT-PAK test kits to several of the facilities as part of a large-scale tuberculosis study covering great ape populations in Southeast Asia and Africa (with Pan African Sanctuary Alliance (PASA)). The PrimaTB STAT-PAK testing kits are considered useful in the detection of tuberculosis in primates, a severe respiratory disease that can prove deadly. Though the PrimaTB State-Pak has proven successful with monkeys, this joint study has proved less so when used with orangutans. For now, the best testing methods appear to be PCR and culture for TB surveillance in orangutans.<\/p>\n

The OC \/OVAG Workshop was sponsored by the Birmingham (U.S.) chapter of the American Association of Zoo Keepers(AAZK), which once again directed the proceeds of its annual Zoo Run to support the workshop. Other sponsors included a Cleveland Metroparks Zoo \/ Cleveland Zoological Society Asian Seed Grant, the Chester Zoo, and the Orangutan Conservancy, in association with the Liverpool School of Tropical Medicine, Chembio Diagnostics Systems Inc., Murdoch University, Abaxis (Europe) and the veterinary faculty of Gajah Mada University, Jogjakarta.<\/p>\n

The OC 2011 Orangutan Veterinary Advisory Group Workshop included 36 participants from the orangutan rescue and rehabilitation centers in Indonesia and Malaysia, along with experts and facilitators from the United States, the United Kingdom, Malaysia, Australia, and Germany. The OC 2011 Orangutan Veterinary Advisory Group Workshop was designed and facilitated by Dr. Steve Unwin of the Chester Zoo, in partnership with Dr. Raffaella Commitante of OC, the same team that helped create the format from its inception in 2009.<\/p>\n

In addition to presentations, practical demonstrations and roundtable discussions, the delegates made site visits to the veterinary faculty at Gajah Mada University, as well as visiting several well-known local attractions such as the Prambanan Temple and Malioboro shopping district and the Jogjakarta Animal Care Center which will be building a new orangutan Dome at their facility designed by Dr. Willie Smits.<\/p>\n

The focus of the OC 2011 Veterinary Workshop, however, remained the practical sessions, presentations, roundtables, and break-out groups that make the workshop so valuable. There, veterinarians who often work alone under extreme duress got a chance to pose questions and tackle hypothetical scenarios that might otherwise get overlooked. They also established friendships and alliances that strengthened the orangutan conservation community as a whole. These friendships and alliances are carried over through the entire year. Participants stay in touch and contact each other frequently regarding issues they share as well as contacting outside experts who have now become their friends.<\/p>\n

As with the past three workshops, the OVAG continued to tackle tough issues, such as euthanasia, laboratory politics, the veterinary aspects of eco-tourism, field diagnostics, and fundamentals of environmental enrichment, disease case studies and tuberculosis testing. In this way, the OC Veterinary Workshops have helped build a community of veterinary healthcare experts that stands strongest when it stands together.<\/p>\n

Orangutan Conservancy 2011 Orangutan Veterinary Advisory Group (OVAG) Workshop 2011 OVAG Report July 4 – 8 , 2011
\n<\/p>\n

Workshop Budget<\/strong><\/span><\/p>\n

ITEM UNIT COST TOTAL
\nAirfare (International) $ 2,000 x 4 $8,000
\nAirfare (Domestic) $ 400 x 25 $10,000
\nAccommodation $ 60 x 27 x 6 nights $9,720
\nGround Transportation $ 500
\nPrinting $ 300
\nTOTAL $28,520<\/p>\n

Orangutan Conservancy 2011 Orangutan Veterinary Advisory Group (OVAG) Workshop 2011 OVAG Report July 4 – 8 , 2011<\/p>\n

Section 2<\/strong><\/p>\n

Official letter of Invitation<\/p>\n

Orangutan Conservancy 2011 Orangutan Veterinary Advisory Group (OVAG) Workshop 2011 OVAG Report July 4 – 8 , 2011<\/p>\n

AGENDA<\/strong><\/p>\n

<\/strong>
\nSunday, July 3
\nDelegate Arrival \/ Set Up of Sessions
\nMonday, July 4
\n08:00. Welcome to delegates (Pak Sumiarto, Steve Unwin and Raffaella Commitante)
\n09:00 Disease Risk Analysis for Primate Reintroduction Programmes, Part 2
\nContingency Planning for Disease Risk Outbreaks \/ Updates (Steve Unwin)
\n10:30 Coffee\/Tea
\n11:00 Ice Breaker Exercise (all delegates)
\nNyaru Menteng example of DRA and Risk Assessments (Steve and Siska)
\n13:00 Lunch
\n14:00 Disease Risk Assessment Exercise and Wrap Up (all delegates)
\n15:30 Coffee\/Tea
\n16:00 Clinical Practice\/Tuberculosis Update (Steve, Siska Agus)
\n17:00 Hepatitis B (Pak Joko)
\n19:00 Dinner\/Ice Breaker
\nTuesday, July 5
\n08:00 Group Photo
\n08:30 Nutrition Basics (Andrea Fidgett))
\n09:30 Open Discussion on Current Dietary Situations in Rehab Centers (all delegates)
\n10:30 Coffee\/Tea \u2013
\n11:00 Bus to UGM (Gadah Mada University)
\n11:30 Clinical Practice \u2013 Radiographic Imaging (Steve – all delegates)
\n13:00 Lunch
\n14:00 Practicals \/ Diagnostics \/ Parasitology (Wendi Bailey)
\n17:00 Bus back to Hotel
\n17:30 Coffee\/Tea
\n19:00 Dinner \u2013 Open Discussion (all delegates)
\nWednesday, July 6
\n08:00 Parasites! (Reuben)
\n09:00 Parasites (Wendi)
\n11:00 Bus to Jogja Orangutan Center\/Prambanan Temple and Malioboro (all delegates)
\n13:00 Lunch (at Jogja Orangutan Center)
\n19:00 Dinner
\nThursday, July 7
\n08:00 Malnutrition (Andrea)
\n10:30 Coffee break
\n11:00 Sample Collecting (Joost Phillipa and Steve)
\n13:00 Lunch
\n14:00 Bus to UGM
\nAnesthetics, Blow Piping and Darting (Steve, Ali and all delegates)
\nBlood Gas Demonstration (Barbel)
\nParasite Wrap-Up (Wendi)
\n15:00 Bus Back To Hotel
\n19:00 Dinner
\nFriday, July 8
\n08:00 Update: Where are We and Where do we need to be (Steve, all delegates)
\n09:00 Case Studies (Meriam fom NM and Yenny from SOCP)
\n10:00 Welfare Issues (Sumita)
\nOpen Forum (all delegates)
\n11:00 Friday Praying Time \/ Lunch
\n14:00 Reporting Back: DRA and Wrap-Up (all delegates)
\nEvaluation of Workshop\/Review
\n17:00 Overview of the past year\/Next Year
\n19:00 Closing Dinner \/ Presentation of Certificates<\/p>\n

Orangutan Conservancy 2011 Orangutan Veterinary Advisory Group (OVAG) Workshop 2011 OVAG Report July 4 – 8 , 2011<\/p>\n

Participant List:<\/strong><\/p>\n

Name Affiliation Email
\n1 Dr. Raffaella Commitante Orangutan Conservancy rcommitante@gmail.com
\n2 Dr. Steve Unwin Chester Zoo s.unwin@chesterzoo.org
\n3 Dr. Wendi Bailey Liverpool School of Tropical Medicine jwbailey@liverpool.ac.uk
\n4 drh. Citra Kasih Nente Independent citrakasih@gmail.com
\n5 drh. Antasiswa W. Rosetiadewi Gadjah Mada University antarosetyadewi@yahoo.com
\n6 drh. Fransiska Sulistyo BOS-Nyaru Menteng fransiska_liz@yahoo.com
\n7 drh. Agus Irwanto BOS-Samboja gus_ndut@yahoo.com
\n8 drh. Yenny Saraswati Sumatran Orangutan Conservation Programme – Manager misoca2003@yahoo.com
\n9 drh Rachmad Wahyudi Sumatran Orangutan Conservation Programme wahyudirachmad@yahoo.com
\n10 drh. Erdiansyah Rahmi Syiah Kuala University erdia.ersan@gmail.com
\n11 drh. Ricko Jaya Sumatran Orangutan Conservation Programme rickojaya@gmail.com
\n12 drh. . Anita Herawati International Animal Rescue Indonesia\/ Yayasan IAR anitahmi@yahoo.com
\n13 drh. Adi Irawan International Animal Rescue Indonesia\/Yayasan IAR – Manager adi@internationalanimalrescue.org
\n14 drh. Popowati OFI iccaros@yahoo.com
\n15 drh. Winda Titi Pratiwi Independent wynd4_tp@yahoo.com
\n16 drh. Zulfiqri Fiqri OFUK fikri_boda@yahoo.co.id
\n17 Pak Tigor OFUK – Manager Tigor1999@yahoo.com
\n18 B\u00e4rbel K\u00f6hler ABAXIS baerbelkoehler@abaxis.de
\n19 Dr. drh. Hery Wijayanto Gadjah Mada University herykh@ugm.ac.id
\n20 Dr. drh. Joko Pamungkas IPB\/PSSP jpi-pssp@indo.net.id
\n21 Dr. Reuben Sharma Putra University, KL rsksharma@hotmail.com
\n22 Dr. Sumita Sugnaseelan Putra University, KL sseelan@yahoo.com
\n23 drh. Winny Pramesywari Frankfurt Zoo\/Jambi\/SOCP Release win.pramesywari@gmail.com
\n24 Annaleis Martin Frankfurt Zoo\/Jambi\/SOCP Release Annaleis.martin@gmail.com
\n25 Alison Kelsall Chester Zoo a.kelsall@chesterzoo.org
\n26 Andrea Fidgett Chester Zoo a.fidgett@chesterzoo.org
\n27 Anton Nurcahyo BOS, Nyaru Menteng – Manager Anton.mondro@gmail.com
\n28 Aschtanita BOS, Samboja Lestari – Manager aschta@oraguntan.or.id
\n29 Drh. Dian Tresno Wikanti Jogja Orangutan Center budhe_ppsj@yahoo.com
\n30 Joost Phillipa Volunteer- Nyaru Menteng joost.philippa@gmail.com
\n31 Dr Putri Astuti UGM Pastuti2001@yahoo.com
\n32 Dr drh Esti UGM estifleh@ugm.ac.id
\n33 Pak Togu Manurung BOS \u2013 Headquarters, CFO toguman@orangutan.or.id
\n34 Drh Heru Susilo Agricultural Minister veterinarian \u2013 Pangkalan Bun Pithix_dv@yahoo.com
\n35 Drh Meriam Sirupang BOS \u2013 Nyaru Menteng meriam@orangutan.or.id<\/p>\n

Orangutan Conservancy 2011 Orangutan Veterinary Advisory Group (OVAG) Workshop 2011 OVAG Report July 4 – 8 , 2011<\/p>\n

Section 3<\/strong><\/p>\n

Proceedings<\/strong>
\nIntroduction
\nThe OC\/OVAG 2011 Workshop was officially opened by Professor Dr. drh. Bambang Sumiarto, Dean of Fakultas Kedokteran Hewan, Universitas Gajah Mada, Yogyakarta. Welcome and introductory remarks by Steve Unwin and Raffaella Commitante.
\nIntroduction Overview:
\nTeam Building exercise \u2013 participants divided onto 4 groups for this cooperative exercise. These groups were kept for the veterinary technical exercises through the workshop.
\nParticipants introduced themselves to the group
\nRelevant documents and resources pertinent to what was being covered in the workshop were made available for participants to download on flash drives\/computers. Examples of there can be found at the end of this report.
\nVeterinary participants will receive a certificate of participation as well as a separate certificate for knowledge exhibited regarding review of various veterinary procedures reviewed during this workshop.
\nReview of week\u2019s schedule (Steve Unwin)
\nReview of last year (Steve Unwin)<\/p>\n

The Participants of OC\/OVAG agree to the following:<\/p>\n

\u2022 All ideas are valid
\n\u2022 Discussions are recorded visibly
\n\u2022 Everyone participates
\n\u2022 No-one dominates
\n\u2022 Participants listen to each other
\n\u2022 Participants treat each other with respect
\n\u2022 Differences are acknowledged not “worked”
\n\u2022 Time-frames are observed<\/p>\n

It is expected that all participants have a good understanding of:<\/p>\n

\u2022 Protocols that assist in managing a disease outbreak
\n\u2022 Assessing disease risk
\n\u2022 Basic nutritional principles
\n\u2022 Assessment and mitigation of malnutrition
\n\u2022 Radiographic safety
\n\u2022 Field anesthesia kits and their safety
\n\u2022 Primate parasitology
\n\u2022 New technologies available in diagnostics
\n\u2022 Welfare issues facing orangutans in their centers
\n\u2022 Where to locate papers\/ expert advice<\/p>\n

It is expected that all participants have basic training in and demonstrate skill in:<\/p>\n

\u2022 Darting , anesthesia and intubation technique
\n\u2022 Basic radiology skills \u2013 taking and interpreting radiographs
\n\u2022 Identifying parasitic pathogens
\n\u2022 Highlighting diseases of concern for reintroduction
\n\u2022 Provide management advice on pathogen control
\n\u2022 Create a contingency plan for a disease outbreak<\/p>\n

Everyone acknowledges that most centers are focusing on orangutan release plans. However, there will always be individuals that can never be released for a variety of reasons. Contingency planning and disease risk approaches must also be applied to un-releasable individuals as well.<\/p>\n

Review of the Pan African sanctuary Alliance (PASA) program for the use of reintroduction as a conservation tool (available from the PASA AC on request). This program is based on the IUCN Reintroduction Guidelines to provide evidence that reintroduction can help contribute to global CBD targets.<\/p>\n

Example:<\/p>\n

IUCN guidelines \u2013 Initial reintroduction activity area: Environmental scan + site assessment. This (for example) increases the understanding of landscape condition and threats, which will help improve Government, NGO and community land management practices. This allows policy development that will intend to protect and enhance biodiversity and in turn provide a measurable contribution to global and national biodiversity conservation targets.
\nSo even if you never release, by going through the IUCN reintroduction process, you are still making a contribution to conservation. Documenting the release process and protocols will allow for engagement in talks on many levels with many different people and organizations in any given area. This means that even if releases never happen, we are educating as we go through the process, as we have made a difference in our local communities which will help in the protection of wild life in that area \u2013 and so we have made a contribution to overall conservation.<\/p>\n

In the course of a day\u2019s work, it is easy to think the above has been addressed, but if we document, then we can prove that the above has been done. Documenting all efforts, whether positive or negative, also helps others in their release programs.<\/p>\n

Summary from presentation: Disease Risk Analysis, contingency planning and outbreak training \u2013 Steve Unwin<\/p>\n

Risk is the likelihood of the occurrence and the magnitude of the consequences (severity) of an adverse event \u2013 for this you need a vulnerable population and the possibility of exposure, to a particular hazard. That is, risk is a measure of the probability (likelihood) of harm and the severity of the impact of a hazard. In veterinary risk analyses, hazards are usually a pathogen (e.g virus) or a clinical sign (e.g pneumonia). Objective measurement and scientific repeatability are key features of risk evaluation.<\/p>\n

There is often a large degree of uncertainty in deciding what is going to be a problem disease for your animals, and what may not be. Often information on disease risk and population health is scanty. By working through a risk analysis process, the aim is not only to highlight what we do know, or strongly suspect, but also where we need to focus our research efforts, to find out what we don\u2019t know. Risk analysis is a formal procedure for estimating the likelihood and consequences of adverse effects occurring in a specific population, taking into consideration exposure to potential hazards and the nature of their effects. This includes the management (usually reduction) of the likelihood of exposure.<\/p>\n

As facilities are being asked to release orangutans into the wild you will need to give a scientifically based answer to support your decision as to which individuals are suitable for release \u2013 on both a physical and psychological basis.<\/p>\n

Thus, disease risk analysis is an animal management tool to assist projects preventing disease issues in the animals under their care, as well as dealing with disease issues more effectively when they do occur.<\/p>\n

CBSG\/IUCN will be providing an online open access resource on how to reintroduce by December 2011. ACTION: All OC participants will be told when this occurs (SU).
\nOC\/OVAG vets are part of this resource (PASA vets will also be contributing). Thank you to participants who responded to the request for information from this group. OC\/OVAG vets knowledge of orangutan reintroduction\/rehabilitation is unique and extensive, and were thus identified as world authorities to contribute to the toolkit in the area of great ape disease risk analysis.<\/p>\n

Review and improve on Defining Pathway Charts from last year (SU)<\/p>\n

Group Discussion:<\/strong><\/p>\n

Drh. Citra tracked the spread of TB through the population of Samboja from 1998 through to 2010. What should be done with ex Tb and TB orangutans? Once you treat Orangutans for TB they are considered unsuitable for release because of testing inaccuracies.<\/p>\n

Case study presentation (SU): Bovine Tuberculosis situation for lions in Kruger National Park.
\nLevel of Bovine TB contracted by wild lions: transmission from one animal to another. Lions, as predators, eat infected buffalo, other pride members may have been infected, other lions outside pride can be infected \u2013 high probability of TB transmission. Of these various populations, about 20% are latent \u2013 of that 20%, 100% die. Unfortunately, we are unlikely to obtain this sort of quantifiable data for orangutans, so we must adopt a more cautionary approach to any data interpretation. The questions we want to answer are:<\/p>\n

What is the probability that an infected animal will be released?
\nWhat would be the implications if even one orangutan is released with TB?
\nAspects of this process reviewed:<\/p>\n

\u2022 Review of Mapping the Pathway \u2013 where orangutans could potentially have contact with a disease. Examples were given from chimpanzee releases in Africa.
\n\u2022 Possibility and Probability Questions at each control point.
\n\u2022 Contingency planning \u2013 allows everyone to know what to do in the face of a disease outbreak \u2013 who to call and keep informed, where relevant information is kept, and how to manage disease spread. The contingency plan format used followed suggestions to break the chain of transmission in an outbreak.
\n\u2022 Disease Risk Assessment Tool kit will be downloaded to all participants \u2013 useful articles and resources dispensed electronically including the report from CBSG workshop in Auckland, New Zealand \u2013Risk Management and Reduction
\nLink: https:\/\/sites.google.com\/site\/cbsgdratoolkitreview\/
\n\u2022 An early draft risk assessment for tuberculosis from Nyaru Menteng using HACCP technique was presented by Drh. Siska Sulystio. Notes on this are presented below but the report was worked on during the workshop and in the weeks following. A final version is available from Nyaru Menteng Vet Team.<\/p>\n

TASK: Participants divide into Working Groups<\/p>\n

Each group must contain one manager or \u2018pretend manager\u2019 to work together on Draft Risk Assessment templates (DRA) and Contingency Plan Template: fill out the form from templates provided. (Notes were added for any changes or suggestions that could improve the usefulness of the template for each facility).<\/p>\n

Disease Risk Analysis 2011 Rosalie Dench and Fransiska Sulistyo \u2013 Fransiska Sulistyo presenter<\/p>\n

Nyaru Menteng (NM) was started in 1999, in Palangkaraya, KalTeng, Indonesia. Carrying capacity was 400 +\/- but their current population is 622 orangutans. There are 189 orangutans ready to be released and an additional 183 should be ready in 2 years.<\/p>\n

Defining the Problem:<\/p>\n

Overcrowding, poor cage facilities, poor nearby forest quality and poor welfare.
\nSeveral cases of TB \u2013 could potentially be a larger problem for the future?
\nWild primate populations travel through the area such as macaques, leaf monkeys, gibbon, and orangutan.
\nMalaria, TB, and typhoid are endemic to area. Disease of particular concern is TB.<\/p>\n

Mapping the pathway<\/p>\n

Listing of disease hazards<\/p>\n

Hazard analysis and Critical Control Point (HACCP) plan provides a framework to assessing risks.
\nHACCP was originally designed for meat hygiene \u2013 but allows for a logical framework which can be followed and can easily be adapted for purposes of reintroduction.
\nTarget: producing orangutans that are free from TB through the NM Pathway.
\nTB HACCP NM \u2013 several steps followed to assess the pathway of TB in NM<\/p>\n

Hazard identification<\/p>\n

CONFISCATION\/RESCUE
\n\u2022 Already infected with TB
\n\u2022 from forest
\n\u2022 from owner
\n\u2022 from other centre
\n\u2022 Infection from rescue staff<\/p>\n

QUARANTINE
\n\u2022 Failure to detect existing TB cases
\n\u2022 active TB
\n\u2022 latent TB
\n\u2022 TB in incubation period when OU enters quarantine
\n\u2022 Infection of new OU from:
\n\u2022 other OUs in quarantine
\n\u2022 NM OUs with latent TB
\n\u2022 wild monkeys
\n\u2022 Staff
\n\u2022 Spread of TB from new arrival to other OUs at NM<\/p>\n

TRANSPORT
\n\u2022 Infection from transport vehicle or transport cage<\/p>\n

REHABILITATION
\n\u2022 Failure to detect TB cases in population:
\n\u2022 latent cases
\n\u2022 active cases
\n\u2022 Infection from:
\n\u2022 NM OU with latent TB
\n\u2022 NM OU with active TB
\n\u2022 wild monkey
\n\u2022 staff<\/p>\n

ISLANDS
\n\u2022 Failure to detect TB cases in population:
\n\u2022 latent cases
\n\u2022 active cases
\n\u2022 Infection from:
\n\u2022 NM OU with latent TB
\n\u2022 NM OU with active TB
\n\u2022 wild monkey
\n\u2022 staff
\n\u2022 Human population e.g. In village<\/p>\n

PRE-RELEASE QUARANTINE
\n\u2022 Failure to detect existing TB cases
\n\u2022 active TB
\n\u2022 latent TB
\n\u2022 TB in incubation period when OU enters quarantine
\n\u2022 Infection of new OU from:
\n\u2022 other OUs in quarantine
\n\u2022 NM OUs with latent TB
\n\u2022 wild monkeys
\n\u2022 Staff<\/p>\n

RELEASE PROCESS
\n\u2022 Infection from transport vehicle and transport cage
\n\u2022 Infection from rescue staff<\/p>\n

\u2022 Incomplete: Other hazards will become apparent as the full details of these stages are finalized<\/p>\n

Qualitative Assessment Risk<\/p>\n

\u2022 Hazard-based risk assessment focuses on three factors:
\n\u2022 For TB, likelihood of transmission in different circumstances is difficult to assess…
\n\uf0d8 … So we have assumed this parameter to be equally high for all steps, and therefore have focused on the first two elements.
\n\u2022 For health screen elements, this doesn\u2019t apply; the risk of failing to detect TB is based on the sensitivity of the tests used.<\/p>\n

Critical control point determination:<\/p>\n

A point, step or procedure at which control can be applied so a pathogenic hazard can be prevented, eliminated or reduced to acceptable levels<\/p>\n

HACCP and CCP Plan
\n\u2022 Going through the HACCP process has highlighted areas where we need to act.
\n\u2013 SOP for accepting animals from other centres:
\n\u2022 Pre-arrival testing for TB would enable us to place the animal into the appropriate facility on arrival (i.e. directly into TB isolation if results positive)
\n\u2013 Set up new arrival quarantine facilities and biosecurity SOPs:
\n\uf0fc The current \u201cQuarantine Area\u201d set-up is not a quarantine, as the new arrivals are not isolated from the orangutans in the rehabilitation process.
\n\uf0fc We now have good quarantine facilities for infants that can be handled easily (up to 2 years old)
\n\u2013 Consider the best way of testing for TB in quarantine:
\n1. MOT + StatPak + IFN\u03b3 + x-ray
\n\u2013 If clinical signs, add tracheal wash for culture +PCR
\n2. If any result from these tests is positive, sedate again for tracheal wash for culture + PCR
\n3. If x-ray positive, treat with antibiotics to see if there is an improvement
\n4. After 8 weeks, repeat MOT + StatPak + IFN\u03b3
\n\u2013 And x-ray if it was positive before.
\n\u2013 Set up a protocol for dealing with clinical cases that could potentially be TB:
\n\u2022 Isolate all respiratory cases until we see whether they respond to antibiotics or not
\n\u2022 Test with StatPak , IFN\u03b3 and x-ray
\n\u2022 Consider how we would isolate several individuals at once if they were all coughing (limited by the facilities available)
\n\u2013 Set up a TB isolation facility and biosecurity SOPs
\n\u2022 TB isolation facilities and protocols have been developed and are now in use
\n\u2022 Space limitations mean there are still some suspect TB animals outside the isolation facilities.
\n\u2013 Consider the hazards that are not being formally addressed and ways we could reduce the risk
\n\u2022 SOPs for disinfection of transport cages and vehicles
\n\u2022 SOPs relating to daily health observations of the orangutans on the islands
\n\u2022 Wild monkeys
\n\u2013 Electric fence around our TB isolation block so monkeys not picking up TB from our animals and spreading elsewhere
\n\u2013 Consider testing local macaque population with StatPak?<\/p>\n

The next move?<\/p>\n

Once this process has been set up for one disease, it will make the process for other diseases of concern easier.<\/p>\n

Simian retrovirus serotype (SRV-2) \u2013 Pak Joko (Bogor Vet School) presenter<\/p>\n

There is a natural AIDS in macaque with seven serotypes which are not found in Africa or New World monkeys. It is also found in orangutan but with lower prevalence.
\nSimian T-lymphotropic virus (STLV) is found in orangutan with low viral loads. It follows a slow transmission process with close contact.
\nSimian Immune Deficiency virus (SIV) naturally affects African monkeys but in macaques it is fatal \u2013 the prevalence is unknown and there is no evidence for SIV in orangutan \u2013 although it has been tested using HIV kits which might not be adequate for orangutans.
\nHep B in non-human primates:
\nCross reactivity with human HBV: the first isolate was found in chimps. It is occurs naturally in chimpanzees, gibbons, orangutans, gorillas and woolly monkeys.
\nSamples for this study were obtained from Nyaru Menteng, Samboja Lestari and COP (Center for Orangutan Protection).
\n—————————————————————————————————————————<\/p>\n

TB Update \u2013 Steve, Siska and Agus presenters<\/p>\n

Review of Paper by Dr. Chris Waltzer and Dr. Alex Lecu for Samboja TB Risk Assessment \u2013 their recommendations mirror what OC\/OVAG participants have been discussing for the past 2 years (paper can be found in section 5).<\/p>\n

NO single test meets all the requirements for determining TB status.<\/p>\n

From Chembio StatPak makers: Rhesus macaques and green monkeys have the highest degree of testing accuracy combining skin test with the Stat Pak, but there was no evidence positive or negative for orangutans. This is what initiated the use of the Chembio Statpak in great apes to evaluate its effectiveness. Data analysis will begin now and continue to the next year. If it appears, after analysis of the data, that the StatPak is not useful for great apes, results will be published and Chembio will continue to support efforts to find an adequate testing method. Currently there is a lack of information on orangutan TB. (Papers were distributed to participants in the scientific resource section).<\/p>\n

Results from Pan African Sanctuary Alliance (PASA) (SU)<\/p>\n

Overall:
\n\u2022 Chimpanzees: N= 165
\n\u2022 Statpak positive \u2013 9.6%
\n\u2022 TST positive \u2013 4.8%
\n\u2022 TST + Statpak positive \u2013 2.4%
\n\u2022 Confirmed TB (culture) \u2013 1.8% = N=3. One positive to Mammalian Old Tuberculin, One positive to stat-pak, One positive to neither
\n\u2022 Bonobos: N= 40 \u2013 all negative to both TST and statpak<\/p>\n

Preliminary results suggest Chembio stat-pak has helped identify a confirmed case. BUT there is also a case which was negative to both tests.
\nSpecific examples from PASA presented: Sierra Leone, Cameroon, DR Congo.<\/p>\n

Actions:
\nResponse back to Chembio needs to be formulated by PASA and OVAG vets as statpak has not been as useful as was hoped. Urine based PCR does not historically work \u2013 but work continues on using urine PCR \u2013 but new methods and tests are coming out \u2013 at the moment PCR and culture are still the most reliable tests. Drh Citra is finishing up her master\u2019s thesis at Murdoch University on the use of the Chem Bio StatPak in 2 orangutan centers, one in Central Kalimantan and one in east Kalimantan. : SU to contact Chembio with collated information after the PASA vet meeting in November. This will allow OVAG delegates time to gather their data as well<\/p>\n

TB and Samboja case studies\u2026. Agus, presenter<\/p>\n

OVAG StatPak testing:
\nOrangutan N=387
\nStatPak SL=20.4% NM= 7.1%
\nTST SL 72.6% NM
\nConfirmed no single test can establish presence of TB<\/p>\n

TB and Nyaru menteng case studies\u2026. Siska, presenter<\/p>\n

NM: 305 orangutans tested \u2013
\n303 not yet tested \u2013 AFB and culture all came back negative though there was some mycobacterium shedding<\/p>\n

Questions generated by testing:
\nWhat is reliability of StatPak?
\nWhat test should be used to determine TB status of orangutan?<\/p>\n

TB Group Discussion:<\/p>\n

The situation is very confusing regarding testing.
\nStatPak worked successfully with other monkey species but not as well with Chimps and Orangutans.
\nExecutive summary to go to Chembio that StatPak is not effective for great apes.<\/p>\n

DISCUSSION – PCR and culture recommended for use:<\/p>\n

Reuben: PCRs should have positive and negative controls \u2013 mention was made of the temperature of the culture -20 degrees is too cold for culture of most bacteria to grow, optimum is 4 degrees for culture to grow. Freezing should only be an option if long term storage is necessary \u2013 but again not optimum\u2026Mycobacterium can last about 4 weeks frozen but culture success drops after about 2 weeks.<\/p>\n

Joost: Sample storage is key in order to get accurate results \u2013 Confirmed positive serum samples should be stored to be used as controls.<\/p>\n

Rachmad: During attendance, the TB symposium at the German Primates Center at Gottingen last December, many participants (from companies and primate experts) had many opinions according to their research. TB is a very difficult disease to diagnose even with the many diagnostic test kits available (primagram, statpack, MoT, Tb antibodies, X-ray, AFB, Culture). The golden standard test is said to be culture BUT culture is very, very difficult to grow the M.tuberculosis and needs long time. At that symposium no conclusion was made. Opinions varied depending on where each participant worked. Some agreed that if a culture is positive, the management of the facility should suggest the government authority to have the animal euthanatized.
\nEach individual orangutan has its own history, so we don\u2019t know exactly where it came from, who was the poacher, who was the owner, or if it could have gotten diseases from other animals. That is why testing with the above methods is sometimes difficult. Field and laboratory situations are also very different. In a laboratory setting to test and challenge a new test kit, a lab has access to specific pathogen free monkeys where they have controls for positive and negative.
\nAs field vets, it is complicated to test, wait and isolate then re-check in 2 months, medicate, and re-check again, etc. If you are fairly certain that an orangutan is positive and the culture is positive, it might be best to euthanize those individuals rather than risk spreading the disease throughout the sanctuary.<\/p>\n

Citra: Epidemiologists agree that which test is not crucial as long as you know sensitivity and specificity of the test \u2013 Tests must be run until we can minimize the risk \u2013 using predictive values for probability and follow up tests, culture and PCR, we must run tests as many times as needed to get best possible results to determine a negative and a positive population \u2013 you can never be 100% sure \u2013 all you can do is minimize the risk.<\/p>\n

Sumita: Collecting samples and handling needs to be improved upon especially in field situations. We need to be sure that the sample will not be spoiled before analysis.<\/p>\n

Joko: A culture is needed to cultivate viable bacteria \u2013 if you have a long term frozen sample there will be no viable culture \u2013 we should consider not using frozen samples for culture. PCR is still the most sensitive and specific if we have the correct conditions and include positive and negative controls.<\/p>\n

Siska: At the time of testing, it was decided that they send the culture sample even though it was frozen for a long time. It is difficult testing hundreds of orangutan and getting a lab to do the work. We use a human facility and they use standardized procedures for humans, therefore proper getting positive and negative controls is difficult.<\/p>\n

Reuben: Maybe a solution might be to add a freezing mix or glycerol for long term freezing of samples?<\/p>\n

Joko: If an animal is suspected of being TB positive, what is the bio security hazard for humans? Especially during a necropsy for positive TB animals (directed to Agus at SL) \u2013 you need correct equipment to do necropsy on high risk diseases!<\/p>\n

Steve: What bio security measures were taken? If you have confirmed TB animals \u2013 take and store as much whole blood as possible as it can be confirmed and is useful information to keep on hand for the future.<\/p>\n

Sumita: What is in place\/protocol to screen and increase safety of personnel?<\/p>\n

Yenny: Personnel are cleared before hiring and yearly tests are given \u2013 if there is any doubt, tests are given every 6 months. Visitors are also tested if they are staying long term, they need to submit a clear medical record. Visitors that are just daily visitors do not get close enough to be a problem<\/p>\n

Citra: Emaliodosis: drugs for this were non effective, but when individuals were treated with TB drugs, there was a much better response but we still need to test for this disease.<\/p>\n

Joost: Do centers make it allow staff to work when they are feeling ill? Are they taken away from areas or can they continue working while ill, unknown to managers?<\/p>\n

Anton: Staff can work as much as they want \u2013 it is up to them to decide if they are too ill to work.<\/p>\n

Nita: The managers know when personnel go to the doctor \u2013 so they monitor illness among employees that went to a doctor or a hospital.<\/p>\n

Steve: Example: conditions in the field for TB necropsy- sometimes the necropsy far outweighed the risk to humans especially if it can be done very fast.<\/p>\n

Joost: Collecting positive serum from positive animals is key for future testing.<\/p>\n

Steve: Does anyone have a serum bank? SL, SOCP, NM, and OFI, have a limited collection.<\/p>\n

Hery: There are many methods of detection of TB in orangutans, among the methods mentioned StatPak TST has low sensitivity. If it is said that the golden standard is culture and PCR, why do not just use these two as the others are certainly quite expensive.<\/p>\n

On another note, what is the level of HIV incidence in orangutan? Should there be concern for the staff and vets? Response: HIV in orangutans is very rare and may not even exist at all in orangutans.<\/p>\n

Actions:<\/p>\n

An executive summary of findings in the Chembio StatPak testing with request for suggestions to move forward: to be completed one month after this meeting.<\/p>\n

Workshop business review:<\/p>\n

All participants must fill out the evaluation sheet. It is best to fill it in as you go so you do not forget anything important!
\nAndrea asked the group from 1 to 10, how much they feel overwhelmed by the amount of information presented. The group response: 20
\nAndrea also reminded the group to fill out the form about orangutan feeding practices: what foods, what quantities, photos of food, etc.<\/p>\n

Dr Andrea Fidgett (European NAG chair) \u2013 Nutrition presentation<\/p>\n

People typically do not feel as if nutrition is a strong part of their studies until they are working and then they realize the import of proper nutrition in maintain animal health. The study of nutrition involves a lot of chemistry and most find it too difficult. Hopefully, this information will give some clarification on nutrition.<\/p>\n

Today\u2019s session \u2013 the basics
\nWhile we cannot solve all the problems of orangutan nutrition \u2013we can at least get a start on understanding it \u2013 the real knowledge of the orangutan lies within this group!
\nProper Nutrition affects sea horses, frogs, elephants, etc. as nutrition affects reproduction among other vital body functions and has wide reaching implications to conservation.
\nEx. What are the nutritional forces causeing elephants to crop-raid?
\nOverview of digestion and nutrients:
\nWhat do you do? Do you keep diet records?
\nNutrition is the process within organisms of taking in and absorbing nutrients. Diet is a regulation of foods (for medical or cosmetic purposes). Foods typically eaten are defined in these categories: carnivore, omnivore, herbivore, and frugivore.<\/p>\n

Nutritions affects:<\/p>\n

Health \u2013 reproduction \u2013 maintenance of normal behavior \u2013 welfare and success of recovery programs
\n(There is a free access website for nutrition information:
\nNational Research Council: http:\/\/www.nap.edu\/openbook.php?isbn=0309069890
\nFor any species, we must know the following:
\nWhat to feed \/ How much \/ Why \/ Diets must be nutritionally adequate \/ Diets must be cost effective
\nOur Aim: to make diets better
\nObjectives for orangutan health and nutrition are very similar
\nWhy make diets better?:
\nTo maintain and improve health and welfare<\/p>\n

To understand and enhance nutritional processes necessary for reproduction and longevity
\nTo make evidence based captive management decisions
\nUnless and until captive management facilities are able to replicate the exact seasonal, temporal spatial and nutritional complexity of diets encountered in the wild, animals will be faced with choices they have not evolved to make.
\nAnimals make the right choices when they have the right food available. We must provide the right foods!!!
\nEvolution of comparative nutrition:
\nHusbandry skill & stockmanship\u2026..applied nutritional science\u2026.multi-disciplinary approach
\nFor most species we are still relying on husbandry skills & stockmanship \u2013 carried out by day to day practitioners
\nWhat we need to know:
\nWhat nutrients do they require? \/ What nutrients do they receive?
\nIn the diet provided? \/ In the diet consumed? \/ In the diet assimilated?
\nComparative or Conservation Nutrition
\nAnatomical components: mouth, lips, dentition: for orangutans, prehensile
\nPhysiological components: metabolic rate, stage of life, enzyme systems\u2026
\nWe do not know about some species but we do have enough information on primates
\nBehavioral components:
\nMeal patterns \/ Palatability \/ Selectivity
\nThere are animals that may have a particular preference for some foods
\nNutrients:
\nFrom ingredients to nutrients
\nFood \/ Item
\nWe have an appetite for energy, salt but not for nutrients
\nEx. Eggs: 50 grams \/ Carrot: 70 grams \/ Banana: 115 grams
\nThe above get converted to nutrient composition in terms of protein\/fat\/fiber\/ash\/carbohydrates
\nAnd WATER! The most important nutrient!!!
\nSources: from foods they eat rather than drinking
\nHow much is water?
\nlettuce carrots potatoes tomato grape apple
\n96% 88% 79% 93% 83% 84%
\nFruits and vegetables are high in water content and sugar! The balance is dry matter which is not so much
\nDry matter:
\nDigestible \u2013 easy to digest carbs, fats and proteins
\nFermentable only \u2013 not digestible \u2013 must have some adaptation to enable them to digest.
\nIndigestible \u2013 organic compounds such as lignin, inorganic compounds such as minerals (but necessary) neither provides energy<\/p>\n

Vertebrate digestive Gut<\/p>\n

The simplest is a stomach and a tube. There are many digestive strategies for primates:
\nInsectviores \/Herbivroes\/folivores\/
\nEnergy:
\nBody\u2019s fuel, measured in calories
\nBasal metabolic rate (BMR): daily energy requirements for a body at rest
\nEnergy: maintenance, growth & reproduction which varies with individual animals \u2013 but the amount of food would vary dependent upon whether an animal is maintaining, growing (young), or reproducing
\nCarbs: 4 kal\/gram
\nSimple: sugars and starches \u2013 very digestible
\nComplex \u2013 hemicelluloses, cellulose, pectin, gums, and chitin \u2013 varied digestibility
\nProtiens: 4 to 5 kcal\/gram (carnivores)
\nNitrogenous compounds \u2013 amino acids \u2013 the actual nutrient
\nFeed: crude protein \/ microbial: does not apply to orangutan
\nBound protein:
\nbrowse \u2013 lignin, secondary compounds
\ninsects (with hard shells), chitin
\nVitamins \u2013 fat soluble: vitamins A, D, E and K (can become toxic if stored from overuse\/ water soluble: B and C \u2013 are not stored in body so difficult to be stored and can cause deficiency
\nMinerals: inorganic and essential, macrominerals Ca, P, Mg, K, Na, Cl,S \/ microminerals: Mn, Fe, Zn, Cu, Co, Mo, I, Se
\nFats: 9 kcal\/gram
\nHuman foods \u2013 adequate substituted for non-human primates?
\nPlant composition \/ Cell contents \/ Sugars, starches etc.,
\nOrangutan stomach has an adaptation for digesting fibers whereas they are mostly being fed sugar and starches!!!!
\nFigs: wild figs on 3 continents had 8 x calcium in the wild fruits versus domestic figs
\nFig trees in the forest are calcium stores
\nNutrient requirement models:
\nDiet Book for Non-human primates as a reference resource \u2013 will be provided as a PDF to all participants!!!
\nRequirement models have limitations \u2013 but there are recommendations that can be made<\/p>\n

Group discussion:<\/p>\n

In terms of a single orangutan:
\nWhat items do you feed?
\nWhat quantity is fed?
\nWhat is the feeding schedule?
\nIs information documented?
\nHow?
\nWhat is the single most diet concern?<\/p>\n

Availability of foods can be low because of climate change and food costs
\nWorking with local communities to supply the centers
\nHow many of you keep diet records?
\nWhite boards to keep diet information \u2013 useful especially if diets change
\nWeighing food is good so you have a good idea of exactly what is being fed out
\nThere is diet and nutrition Management software available
\nAnimal Feeding Programme broken down per species and age groups and sex<\/p>\n

Radiography (at UGM Animal Hospital) \u2013Steve Unwin and Ali Kelsall
\nIt is a good image?
\nDoes it help to tell a diagnostic story?
\nHas it been taken safely for animal and humans?
\nPractical discussion and radiograph viewing conducted at the university.<\/p>\n

Radiography Safety and Basics of imaging:
\nThere is natural radiation which is not hazardous that is absorbed by the body.
\nIn the clinical sense \u2013 radiation is used to form an image \u2013 rays travel in straight lines, have a short wavelength, high frequency, etc.
\nAs a result we are producing radiation at a higher dosage and there are dangers.
\nThere can be cellular damage (death of cells).
\nInverse square law \u2013 the further you go the safer you will be
\nBe behind lead, glass or concrete if you are within a 3 meter zone
\nWear aprons \u2013 be sure they are not damaged!
\nControl area \u2013 main beam zone and within 2 meters of primary beam \u2013 signs clearly posted
\nEach machine is different \u2013 so get to know your machine \u2013 make clear useful notes of each radiograph that will help you with the next one<\/p>\n

Parasites: Reuben Sharma
\nParasites that affect both wild and captive orangutans:
\n4 species of protozoa and many that remain unidentified
\nA survey done in Peninsula Malaysia (zoos) and East Malaysia (captive and wild) with samples collected from:
\nPrimary forest \/ degraded forest \/ semi captive and captive (sampling groups)
\nSample size was not large but enough to give a general overview of the parasites that might be found.
\nIn wild populations in primary forest \u2013 there is a low level of parasite load. In logged forest the numbers rise. In semi-captive and captive populations, the numbers rise again.
\nBalantidium appears to be found in all orangutans.
\nMolecular detection of Bastocytisis by amplication of the 18S small subunit rRNA gene using PCR
\nPCR samples:
\nCollect blood in EDTA tubes NOT Heparin
\nStore at -20C on filter paper (FTA) cards or in lysis buffer
\nDNA extraction mist be dome in a separate room from PCR using separate equipment
\nPCR master mix must be done with separate equipment\/separate room
\nPrimers must be tested with a known control template DNA
\nDo not rely on one PCR result \u2013 one test is unreliable \u2013 must be done in duplicate – if conflicting results must run PCR 5 times (serial tests are often needed to improve accuracy \u2013 this can be why results take a while)
\nWith Plastocystic \u2013 wild orangutans in primary and logged forest show low levels, but in captive and semi captive populations, the numbers increase very significantly.
\n***Call for collaboration from various wild and captive sites for parasite prevalence research
\nIf you can \u2013 screen macaques in center areas to check for plasmodium (human) as this can be deadly for primates.
\nP. knowlesi \u2013 an emerging disease \u2013 60% of cases of malaria caused by P. knowlesi \u2013 can be transferred to humans and orangutans \u2013 reservoir: macaques.
\nWould it be possible to share what parasites are found at the various centers? Harvest adults in ethanol
\nWendi is willing to supply plasmodium detection kits to centers to further test for parasite prevalence
\n(Participants to give Wendi an idea of the number of kits they might want, She can then shop the number around)
\nIn Steve\u2019s experience, most fatal diseases in great apes are those contracted from humans. There is however, very little information on disease transmission between humans and orangutans.<\/p>\n

Wendi Bailey \u2013 Parasite Imaging Presentation<\/p>\n

Things to look for:<\/p>\n

Histolytic
\nType of movement (spinning, slow, fast\u2026) and what is causing the movement
\nSize range
\nIngestion of red blood cells
\nExamine a \u2018hot\u2019 stool (within 30 minutes)
\nBalantidium coli
\nGiardia
\nTrichomonas trophozoites
\nWhen looking at images:
\nWhat size is the object? Use a reference point (your own blood cells?)
\nWhat is the magnification?
\nIs there movement? What kind?<\/p>\n

Steve: Film
\nPASA and OVAG work: because we are a family \u2013 and we share information and communicate \u2013no matter how difficult it sometimes can be to be honest<\/p>\n

Practical Nutrition Part 2 \u2013 Andrea<\/p>\n

Resources:
\nSSP guidelines are available online, a chapter on nutrition will be provided as download for participants
\nHelpful websites: www.eaza.net www.nagonline.net AZA advisory group
\nNRC Nutritional Requirements for non-human primates: pdf to participants
\nUSDA National Nutrient database \u2013 on line
\nParticipants Need to compile:
\nScientific name of foods\/common name (English and local). Whether used in Sumatra \/Borneo or both
\nNutrient composition data
\nTemplates for feeding records
\nBody condition scores???? Way to assess animals
\nDraft feeding guidelines\u2026.hopefully to be included in an overall manual
\nMalnutrition: the condition that results from taking an unbalanced diet in which certain nutrients are lacking in excess (too high an intake) or in the wrong proportions
\nA number of nutrition disorders may arise, depending on which nutrients are lacking
\nNutrients Deficiency Excess
\nEnergy starvation obesity, diabetes mellitus
\nSimple carbs none \u201c
\nComplex carbs none obesity
\nEarly indications:
\nWeight
\nBody condition
\nDemeanor (character\/behavior)
\nTry to develop a scale to note body condition
\nUse a body outline or silhouette from emaciated to obese \u2013 using several people to get agreement
\nPerhaps have an orangutan body outline to follow and use as a guide?
\nIs this too subjective? What of animals with gastro problems that could give the appearances of obesity but is not?
\nAlso do we judge based on wild orangutan body condition or separate for captive?
\nSometimes, fur can also get in the way
\nUse visuals as well as palpating
\nTaking visuals as well as behavioral \/activity information
\nSeasonality
\nHitting the same energy plane throughout the year regardless of what is fed out
\nEnrichment
\nFood Presentation
\nPlace\/location time\/frequency type of food Individual \/group
\nFactors affecting choice
\nPalatability
\nNovelty
\nEnclosure design
\nSocial structure
\nFeed presentation
\nWho buys the food?
\nSome vets make the list for others to buy
\nSome add provisioned food to forest food
\nSome use local food sources solely
\nSome have partnership with local people to supply center with food = some centers (SL) can plant their own food sources
\nSome food decisions are made by vet staff and animal care staff and even behavior information
\nSometimes there is a basic food list and vet staff can make suggestions for certain foods based on what they need
\nWhat orangutans need is a high fiber diet \u2013 more leaves less fruit \u2013 leaves might be able to be found for free around your areas
\nEx sugar content:
\nwatermelon pineapple papaya figs spinach wild fruit
\n92% 87% 89% 79% 92% 76%<\/p>\n

Effect of ripening: Banana – production of ethylene \u2013 enzymes begin
\nAcid neutralized \u2013 starches are converted to sugar \u2013 chlorophyll is denatured and pigment changes \u2013 pectin decreases as fruit gets softer
\nAnimals get used to things that taste sweet \u2013 if you leave them hungry they will eat the other items<\/p>\n

Primate requirements: Research on Internet
\nNational Research Council, non human primates requirements (2003)
\nWebsite: http:\/\/www.nap.edu\/openbook.php?isbn=0309069890<\/p>\n

For chimps and humans:
\nNDF = Neutral Detergent Fiber (NDF) is the most common measure of fiber used for
\nanimal … NDF measures most of the structural components in plant cells
\nWild fruit and wild leaves are best sources of protein and fiber
\nPlantation fruits have very low fiber!!!!!
\nOrangutan guts are designed to digest fiber!!!!!!!!!!!!!!!!!!!!!
\nCalcium to phosphorous ratios are quite low
\nLeafy greens have really high calcium to phosphorus level
\nIf leafy diet is increased \u2013 the use of probiotics might be able to be decreased
\nMost human probiotic products are useless
\nPlant composition \u2013 many nutrients, but you need the bacteria to break it down
\nDiet based on body weight:
\nBased on knowledge that animals will consume 1-2% of body weight in dry matter
\nSuggest feeding half of this amount as a primate pellet
\nLeafy green and veggies and 10-20 fruit
\nObese orangutans?????
\nWild orangutan feeding patterns from Cheryl Knott?
\nFood intake calculator?
\nCompile a list of all orangutan food choices and then look for analysis of each item
\nVolunteers to work on a body condition score
\nCompiling a food list with nutrient values
\nIn time, this will enable us to produce our own feeding guidelines<\/p>\n

GROUP activity
\nReview of Chester Food list analysis \u2013 food values will be the same but quality?
\nAs foods age, starches turn into sugar \u2013 but minerals should stay the same<\/p>\n

Anesthetics \u2013 Steve Unwin<\/p>\n

Practicals of anesthesia:
\nHow many people intubate orangutans when they anesthetize? Some
\nImportance of balanced anesthesia \u2013 state of animals before during and after\/choice of drug\/length of procedure
\nWe recommend intubating every ape every time
\nConsistency is important!!!!
\nThere should be a meeting before and a debriefing after
\nIf the animal is highly excited, you might require more anesthetic
\nA squeeze cage reduces the amount of time the animal is stressed<\/p>\n

Practical session at UGM:
\nTarget practice with Steve and Ali (for certificate)
\nFecal check from sitting samples (from Tuesday) with Wendi
\nReview of diagnostic blood gas with Barbel
\nGroup activity continuing with Risk Assessment and Contingency Plan<\/p>\n

Diagnostic Techniques \u2013 Joost Phillipa<\/p>\n

Review of Acquired immunity for diagnostic testing
\nSample collection:
\nMust be collected and stored in the proper way
\nProper storage:
\nCooling slows down enzyme breakdown and slows down bacteria
\n\u2022 Cool
\n\u2013 Slow down enzymatic breakdown
\n\u2013 Slow down bacteria
\n\u2022 Freeze
\n\u2013 -20\/ -80\/-135 \u00b0C
\n\u2013 Liquid Nitrogen (-196 \u00b0C)
\n\u2022 Bacterial Transport medium
\n\u2013 Maintain viability
\n\u2013 Buffers and salt
\n\u2022 Viral Transport medium
\n\u2013 Preserve \/maintain viability – infectivity
\n\u2013 Protein for stabilisation
\n\u2013 Buffer to maintain pH
\n\u2013 Antibacteria
\n\u2013 Antifungal
\nStorage of samples can be problematic in Indonesia due to variable electrical supply
\nPathogen\/Antigen detection: know your microscopy and staining
\nCulturing bacteria
\nGold standard for TB diagnosis \u2013 is it really?
\nLimitations: slow growing bacteria (8 weeks)
\nFailure to culture \u2013 does not mean the animal is not infected (latent)
\nNeeds a high standard:
\nRT-PCR Reverse transcriptase polymerase Chain reaction
\nWhat is the difference between plasma and or serum
\nHow the StatPak works
\nWould it be useful to make an orangutan specific MAPIA
\nCellular response test (TST \u2013 tuberculin skin test) \u2013 not very useful in orangutans as many false positives
\nInterferon gamma release Assay (IGRA) \u2013 measures T cell response
\nHowever, no test is 100% accurate \u2013 think about how you are storing samples, the most suitable test(s) and know why you are testing
\nVariability of surgical masks \u2013 particle respirator might be better than traditional surgical mask<\/p>\n

Case Studies<\/p>\n

Malaria & Dengue Case at Nyaru Menteng during Jan-Apr 2011 \u2013 Meriam, presenter<\/p>\n

Malaria: plasmodium vivax, P. falciparium, P. cynomolgy, P. knowlesi
\nMosquito from genus Anopheles
\nDistribution: Asia, Africa and America
\nMalaria outbreak in NM 2008-2009
\nClinical signs: Fever (up to 38.5 C), Low activity levels, Abdominal pain, Jaundice, Anorexia, Diarrhea
\nDiagnostics: Full blood count (FBC), Blood smear (DDR), PCR (sent to Eichman lab in Jakarta)
\nTreatment: ACT (Artecef + Sulfadoxine-Pyrimethamine) continuous with Primaquine for 14 days, Supportive therapy (IVI, Antibiotic, antipretic, Hematopan, iron supplement, blood transfusion
\n20 cases of malaria and 21 cases of Dengue + Malaria (mixed infection)<\/p>\n

Dengue: Also a mosquito borne infection potentially lethal complication if dengue hemorrhagic fever (WHO)
\nRNA virus of genus Flavivirus (arbovirus group B) family Flaviviradae. No clinical signs or fever up to38.5C usually for 5-7 days. Sometimes followed by malaria. One case of a red spot on mucus membrane
\nDiagnostic: Blood check: hematology
\nOpen discussion about malaria\/dengue
\nClose or large contact with humans an issue<\/p>\n

Updated Case: Deknong \u2013 Yenny SOCP, presenter<\/p>\n

In first OVAG meeting, Yenny presented information about an individual \u2013 update on condition<\/p>\n

Welfare of orangutans in Captivity : Dr Sumita Sugnaseelan<\/p>\n

Captive conditions:
\n\u2022 Placing a wild animal in captivity represents a major change in the animal\u2019s environment
\n\u2022 Environmental pressures are controlled in captivity
\n\u2022 Availability of resources
\n\u2022 Predation
\n\u2022 Captive individuals experience little to no competition for food or predation risk
\n\u2022 Group size is often more flexible in captivity than in the wild
\n\u2022 The living conditions of captive orangutans vary from abusive to pampered, but most often they are kept in poor condition with inadequate care<\/p>\n

Most individuals that arrive at rescue or rehabilitation centers are
\n\u2022 physically and\/or psychologically disabled as a result of accidents, inadequate captive care, or abuse by \u2018owners\u2019
\n\u2022 in poor condition due to poor diet in captivity
\n\u2022 diseased infected with a pathological agent that may\/may not be zoonotic in nature
\n\u2022 Certain traits that are selected for in nature are no longer selected in captivity
\n\u2022 Other behavioural characteristics become more significant
\n\u2022 Animals in close confinement & concentrated population
\n\u2022 Affect physiological & behavioural adaptation
\n\u2022 Changed how diseases are transmitted
\nAreas of concern in captive orangutans
\n\u2022 Nutrition
\n\u2022 Malnutrition \/ obesity
\n\u2022 Disease & injury
\n\u2022 Abnormal behaviour \u2013discussed in details \u2013 stereotypies, self or environment directed, abnormal behaviour addressed to another individual, failure to function, anomalous reactivity
\nWelfare assessment involves:
\n\u2022 The extent of any failure to cope
\n\u2022 The extent of any difficulty in coping
\n\u2022 The extent of signs of good welfare
\nMeasures of welfare
\nPhysiological indicators
\nBehavioural indicators
\nHealth status
\n\u2022 Points of welfare concerns
\n\u2022 Taken from site of origin
\n\u2022 Change in environment
\n\u2022 Separation from human care-givers
\n\u2022 Transportation
\n\u2022 Handling
\n\u2022 Mode of transportation
\n\u2022 Quarantine
\n\u2022 New environment
\n\u2022 Unfamiliar conspecific and\/or care-givers
\nSolutions
\n\u2022 Dietary management
\n\u2022 Usable space
\n\u2022 Horizontal vs vertical space
\n\u2022 Time-out
\n\u2022 Hide
\n\u2022 Social groupings
\n\u2022 Should an individual be placed in isolation, what do you do?
\nVeterinary care
\n\u2022 What do you do at your facility to promote and increase welfare amongst your orangutans?<\/p>\n

Disease Contingency Plan and Risk Assessment (CON\u2019T) \u2013 see next section<\/p>\n

BOS NM: TB in clinic area
\nBOS SL: TB
\nIAR: Nonspecific infection
\nOFI: Infection at Health Center
\nSOCP: Strongyloides in quarantine and release site<\/p>\n

Examples of PBLs: Reporting back Contingency Planning and Risk Assessment<\/p>\n

SOCP
\nOutbreak Situation. Please consider, discuss and answer the questions in bold. Modify your area risk assessment and contingency plans as appropriate
\nSudden death in a 9 year old female in SOCP quarantine cage. Only signs were that she seemed a little slower for 48 hours prior to death.
\nYour manager asks to delay the necropsy, as he has seen something similar and thinks it may be a poisoning.
\nReferring to your risk assessment, try to convince him why this might be a bad idea?
\nYou take a faecal sample from the group and find high levels of strongyloides<\/p>\n

Delegates are then given access to page 2.<\/p>\n

SOCP page 2.
\nYou are eventually allowed to do the necropsy 48 hours after death. What is your opinion for taking diagnostic samples from this?<\/p>\n

Five days later, 2 more animals who recently moved to the Jambi from the release sight become anorexic and weak. Non responsive to supportive therapy, both die within 24 hours. You try to phone the project manager, who is away, without success.<\/p>\n

These animals are necropsied.
\nWhat diagnostic samples do you take?
\nReferring to biosecurity \u2013 what do you do? (Based on your risk assessment \u2013 added measures beyond the general?)
\n(e.g \u2013 post mortem. Interview locals, quarantine area etc.)
\nRefer to your contingency plan \u2013 does it work?
\nProject manager calls to say he has heard there are some deaths and why wasn\u2019t he informed. He has just fielded a call from an international news crew who happen to be in town and who want a quote (a staff member has let slip there is an issue)
\nRefer to your contingency plan \u2013 does it help with the above question?
\nCOMPLICATIONS +\/-
\nThere is no response from your international colleagues.
\nLocal people find out the situation and demand answers
\nInfection in all three cases is confirmed as strongyloides.
\nIndicate ways how this could have infected the animals and why it might not have been picked up
\nModify your risk assessment and contingency plan as appropriate to make it useful. What extra information should you include in your contingency plan?<\/p>\n

Nyaru Menteng. Page 1.
\nOutbreak Situation. Please consider, discuss and answer the questions in bold. Modify your area risk assessment and contingency plans as appropriate<\/p>\n

Clinic \u2013 7 animals age 2 to 4 years all arrived in poor condition and with varying severity of upper respiratory infections. All arrived within the last 6 weeks but have stayed at the clinic as very ill. 2 are StatPak positive.<\/p>\n

Sudden death in a 3 year old female \u2013 one of the StatPak positive ones
\nYour manager says there is no need to conduct the necropsy as it is obviously a TB case and not to contaminate the area.
\nReferring to your risk assessment strategy, try to convince him why this might be a bad idea?
\nHow might you do the necropsy to prevent contamination if it is TB?<\/p>\n

Delegates are then given access to page 2.<\/p>\n

Nyaru Menteng page 2.
\nYou are eventually allowed to do the necropsy 48 hours after death. What is your opinion for taking diagnostic samples from this?<\/p>\n

Five days later, 2 more animals die (both StatPak negative). You try to phone the project manager, who is away, without success.
\nThese animals are necropsied. Referring to diagnostic samples – What do you do?
\nReferring to biosecurity \u2013 what do you do? (Based on your risk assessment \u2013 added measures beyond the general?)
\n(e.g \u2013 post mortem. Interview locals, quarantine area etc.)
\nRefer to your contingency plan \u2013 does it work?<\/p>\n

Project manager calls to say he has heard there are some deaths and why wasn\u2019t he informed. He has just fielded a call from an international news crew who happen to be in town who want a quote (a staff member has let slip there is an issue)
\nRefer to your contingency plan \u2013 does this help with the above issue?<\/p>\n

COMPLICATIONS +\/-
\nThere is no response from your international colleagues.
\nLocal people find out the situation and demand answers
\nYou don\u2019t find any TB lesions at necropsy, but there is a severe pneumonia in both cases.
\nThe remaining surviving animals are beginning to improve. What antibiotics have you been using?<\/p>\n

ANSWER:
\nTurns out to be Bacterial pneumonia (not tuberculosis) Pseudomonas and Haemophilus, and a respiratory viral infection is suspected. What samples would be useful to confirm this, from the remaining animals? 2 of the animals also have a low level Strongyloides burden \u2013 now what?<\/p>\n

Modify your risk assessment and contingency plan as appropriate to make it useful. What extra information should you include in your contingency plan?<\/p>\n

Staff Health Programme \u2013 Managing Zoonotic Disease Risk<\/p>\n

STAGE 1. Risk Assessment<\/p>\n

Component By Whom?
\n1 For each taxonomic group identify main diseases of concern (hazard) and estimate likelihood of occurrence Vet. Reviewed by advisors
\n2 For key disease risks -fill in disease info template Vet. Reviewed by advisors<\/p>\n

STAGE 2. Risk Management<\/p>\n

Component By Whom?
\n1 Hygiene: Vets to work with Curators and their teams to ensure daily biosecurity and hygienic measures are appropriate to degree of risk Vet. Reviewed by advisors
\n2 Disease Screening \u2013 Animal Collection: Vets to manage preimport, quarantine and opportunistic disease screening as laid out in CZ protocols Vet. Reviewed by advisors
\n3 Disease Screening Staff: For each taxonomic grouping, advisors to advise on what screening would be recommended for
\na. New staff
\nb. Current staff
\nc. At times of increased risk (e.g field work, in face of outbreak etc.)
\nAdvisors to advise on whether this should take the form of
\na. Declaration of particular symptoms
\nb. Active sampling
\nAdvisors to suggest process by which this might be managed. Health advisors
\n4 Prophylaxsis animal collection: Vets to manage any suitable prophylaxis of the animal collection in line with CZ protocols (i.e worming regimes, vaccinations etc.) Vet
\n5 Prophylaxis Staff: For each taxonomic grouping advisors to advise on appropriate prophylaxis
\na. Routine \u2013 regime
\nb. At times of increased risk \u2013 e.g fieldwork or in face of an outbreak Health advisors<\/p>\n

Stage 3. Management in the face of an outbreak<\/p>\n

Scenario 1. Zoonotic disease suspected in animal collection
\n1 Vets suspect or confirm a zoonotic disease in the animal collection
\n2 Vets refer to disease fact sheet or pull one together if not already done so
\n3 Hygienic measures (barrier nursing etc.) put in place to minimise risk of further transmission
\n4 Staff in contact with this species (including those working in the enclosure) given a verbal briefing and if one has already been produced and audited by health advisors, a fact sheet about the disease in question, what to look out for and what additional hygiene measures they should take.
\n5 Health advisors informed and provide advice on any additional info to be given to staff\/ their own general practitioners and whether any screening or prophylactic treatment is recommended.
\nHealth advisors to assist with fact sheet production if not already prepared.<\/p>\n

Scenario 2. Zoonotic disease suspected in staff member.
\n1 Staff member to report a disease that could be transmitted to\/ caught from the animal collection to vet\/ management\/ health advisor
\n2 Vets refer to disease fact sheet or pull one together if not already done so
\n3 Hygienic measures (sending staff member home\/ use of PPE etc.) put in place to minimise risk of further transmission
\n4 Animals with which the staff member was in contact are screened as appropriate. If they are found to be infected, measures taken as in scenario 1.
\n5 Staff in contact with the affected staff member are given a verbal briefing and if one has already been produced and audited by Health advisors, a fact sheet about the disease in question, what to look out for and what additional hygienic measures they should take.
\n6 Health advisors informed and provide advice on any additional info to be given to staff\/ their own general practitioners and whether any screening or prophylactic treatment is recommended.
\nHealth advisors to assist in fact sheet production if not already prepared.<\/p>\n

SOCP \u2013 Example of Answers
\nJika ada hewan yang mati di Center dan drh sedang tidak ada di tempat yang akan dilakukan adalah:
\n1. Hubungi drh tentang kondisi yang terjadi dan informasikan ke manajer
\na. Jika dokter hewan dapat segera kembali \uf0e0 lakukan nekropsi
\nb. Jika dokter hewan dapat segera kembali \uf0e0 pindahkan satwa mati ke temapt penyimpanan mayat\/freezer
\nIsolasi sisa populasi jika satwa berasal dr kandang populasi
\n2. Mengenai kandang
\na. Jika kandang individu \uf0e0 desinfeksi dan dikosongkan sementara
\nb. Jika kandang sosialisasi \uf0e0 sisa populasi tidak boleh dipindahkan sebelum hasil nekropsi keluar
\n3. Jika dokter hewan sudah datang \uf0e0 segera lakukan nekropsi sesuai dengan SOP nekropsi
\na. Hasil nekropsi :
\nJIka zoonotic\/penyakit menular:
\n\u2022 Terhadap kandang : desinfeksi
\n\u2022 Terhadap sisa populasi : lakukan general health check (faeces, urine, darah, etc)
\nJika ada yang positif \uf0e0 isolasi dan pengobatan
\nJika negatif \uf0e0 lanjutkan observasi
\n\u2022 Staff in contact : general check up
\nJika positif : diistirahatkan setelah dilakukan sosialisasi mengenai kondisi kesehatan
\nDiberikan pengobatan
\nJika negatif : boleh kembali bekerja
\n\u2022 Terhadap lingkungan :
\nInformasikan ke dinas terkait (kehutanan, karantina) dan dilakukan penutupan areal center tersebut untuk umum (\uf0e0restricted area)<\/p>\n

English Translations (Italic):<\/p>\n

If there are dead animals at the Center and vets were not present:
\n1. Contact vets about what happened and inform the manager
\na. Determine if the vet can do a necropsy
\nb. If the vet can, then move the dead animal into storage \/ freezer and
\nisolate remaining populations if the animal came from a stable population
\n2. About the cage:
\na. Disinfect cage
\nb. The rest of the population in socialization cages should not be moved until necropsy results are known
\n3. Upon arrival of vet, necropsy done in accordance with SOP necropsy protocol
\na. Necropsy results:
\nIf zoonotic \/ infectious disease:
\n\u2022 For the cage: disinfection
\n\u2022 For the rest of the population: do general health check (feces, urine, blood, etc.)
\nIf there is a positive result, isolation and treatment
\nIf negative result, continue observation
\n\u2022 If Staff had contact: general check-up
\nIf Positive: give treatment
\nIf negative: may return to work
\n\u2022 About the environment:
\nInform all relevant agencies (forestry, quarantine) which might enforce closing the center or creating a restricted area<\/p>\n

Outbreak situation.<\/p>\n

Please consider, discuss and answer the questions in bold. Modify your area risk assessment and contingency plans appropriate
\nClinic \u2013 7 animals age 2 to 4 years all arrived in poor condition and with varying severity upper respiratory infections. All arrived within the last 6 weeks but have stayed at the clinic as very ill. 2 are statpak positive
\nSudden death in a 3 year old female \u2013 one of the statpak positive ones
\nYour manager says there is no need to conduct the necropsy as it obliviously a TB case and not to contaminate the area.
\nReferring to your risk assesment strategy, try to convince him why this might be a bad idea?
\n\u2022 Statpak positif, belum berarti bahwa ou tersebut mengidap TB, tidak tertutup kemungkinan penyakit itu disebabkan oleh agen penyakit yang lain selain TB
\n\u2022 Nekropsi merupakan salah satu alat untuk mengetahui penyebab penyakit yang sebenarnya, sehingga bisa dilakukan penanganan yang benar<\/p>\n

\u2022 If the StatPak is positive, it does not mean that orangutans are suffering from TB, it is likely the disease was caused by agents other than TB disease
\n\u2022 Necropsy is one tool to determine the actual cause of the disease, so that proper treatment can be done
\nHow might you do the necropsy to prevent contamination if it is TB?
\n\u2022 Personal protection equipment level 3 (double mask, double gloves, overall, goggles, boots)
\n\u2022 Dilakukan di tempat tertutup,
\n\u2022 Dilakukan secepat mungkin, pembukaan karkas dilakukan seminimal mungkin dan dilakukan pengambilan sampel.
\n\u2022 Desinfektan setelah melakukan nekropsi (bleach)
\n\u2022 Alat-alat yang dipakai selama nekropsi disteril kembali, karkas dibakar di incinerator
\n\u2022 Alat yang \u2018single-use\u2019 spt masker, gloves, dll juga dibakar di incinerator
\n\u2022 Dokumentasi (PM sheet, foto)<\/p>\n

\u2022 Especially in enclosed places
\n\u2022 Do as soon as possible, keep to a minimum the opening of the carcass and take samples quickly
\n\u2022 Disinfectant after performing necropsy (bleach)
\n\u2022 The tools used during necropsy must be sterilzed, carcass burned in incinerators
\n\u2022 Tools that are ‘single-use’ such as masks, gloves, etc. are also burned in incinerator
\n\u2022 Documentation (notes, photos)<\/p>\n

You are eventually allowed to do the necropsy 48 hours after death.
\nWhat is your opinion for taking diagnostic samples from this? Nekropsi dan pengambilan sampel masih perlu untuk dilakukan, selama penyimpanan karkas sesuai dengan prosedur (eg: harus ditaruh di tempat yang dingin sehingga mencegah terjadinya pembusukan)
\nSamples need to be taken, storage of carcasses in accordance with the procedures (eg: should be placed in a cool place as to prevent spoilage) to take samples from<\/p>\n

Another 2 animals died, were StatPak negative. Referring the diagnostic samples, lakukan prosedur yang sama dengan kasus satwa yang mati (nekropsi, dll) sesuai dengan bio-security (karantina lokasi)
\nFollow a similar procedure to the case of dead animals (necropsy, etc.) in accordance with bio-security (quarantine location)<\/p>\n

Refer to your contingency plan \u2013 does it work? Ya, tetapi masih banyak hal yang belum termasuk dalam contingency plan yang dibuat sebelumnya (tidak punya SOP untuk nekropsi TB, tidak punya SOP untuk penanganan outbreak)
\nYes, but there are still many things that have not been included in the contingency plan made in advance (do not have a SOP for TB necropsy, no SOP for handling outbreaks)<\/p>\n

Manager called from abroad, because the staff let slip an issue to an international news crew, does this help with the above issue? Memberikan pemahaman mengenai kejadian outbreak yang terjadi di center, sehingga terjadi satu persepsi yang sama mengenai outbreak tsb. Usahakan untuk menunjuk satu pembicara saja untuk menghadapi newscrew
\nThis provides an understanding of the events that occurred in the center during the outbreak. Have only one speaker address the news crew.
\nWhat antibiotic is used: Amoxycillin clavulanate, Ciprofloxacin, Cefotaxime
\nSampel : dr tracheal wash
\n2 stronglyloides burden: beri anthelmintic (ivermectin)
\nNote :
\ntidak punya SOP untuk nekropsi TB
\ntidak punya SOP untuk penanganan outbreak
\ngive Anthelmintic (ivermectin)
\nNote:
\nnecropsy had no SOP for TB
\ndid not have SOPs for handling outbreaks<\/p>\n

Orangutan Conservancy 2011 Orangutan Veterinary Advisory Group (OVAG) Workshop
\n2011 OVAG Report
\nJuly 4 – 8 , 2011<\/p>\n

Section 4
\nFuture topics:
\nMeliodosis Records and scientific writing Positive Reinforcement techniques More case studies Nutrition Diagnostics \/ parasites Effect of Mental health on physical health Orangutans in the field
\nNext year (2012) possible locations are the Primate Center and Veterinary School in Bogor or even possibly Kuala Lampur in Malaysia. Steve will make a trip to Malaysian Borneo to try to get Malaysian vets involved with OC\/OVAG.
\nEvaluation Review for start of workshop<\/p>\n

1. The most sensitive method for diagnosing Strongyloides infection is:
\n\u2022 A Antibody detection test
\n\u2022 B Formol ether concentration
\n\u2022 C Faecal culture
\n\u2022 D Saline preparation for motile larvae.
\n2. The stage in the life-cycle of the malaria parasite most commonly seen in a stained blood film is the:
\n\u2022 A Merozoite.
\n\u2022 B Sporozoite.
\n\u2022 C Trophozoite.
\n\u2022 D Gametocyte.
\n3. Finding an amoebic cyst of 18\uf06dm in diameter with 8 nuclei in a stool may:
\n\u2022 A Indicate the animal has amoebiasis.
\n\u2022 B Indicate the animal has a non-pathogenic infection.
\n\u2022 C Indicate the animal could also have anaemia.
\n\u2022 D Be the cause of diarrhoea.
\n4. Give a 1 sentence definition of \u2018biosecurity\u2019
\n5. List the following types of investigative studies in order of result reliability, with the most reliable first
\nA. Cohort Studies
\nB. Expert Opinions, textbooks, personal experience and the internet
\nC. Systematic review
\nD. Randomised control trial
\nE. Meta-analysis
\nF. Single Case report
\nG. Case series
\n6. Which of the following are components of a disease or pathogen contingency plan?
\nA. A list of people and organisations to contact in a disease outbreak, and why they must be contacted.
\nB. Biosecurity protocols
\nC. Methods of disease transmission and management strategies to reduce transmission
\nD. A map of your facility
\nE. background information on the disease of concern
\n7. In 1 sentence, define disease risk
\n8. In 1 sentence, define malnutrition
\n9. Briefly describe the dietary components necessary for a juvenile orang-utan
\n10. After anaesthetising an animal with Ketamine and Medetomidine, how long should you ideally wait before approaching the animal to begin a procedure?
\nA. 1 minute
\nB. 5 minutes
\nC. 10 minutes
\nD. 15 minutes
\nE. 20 minutes
\n11. In radiograpy \u2013 the Higher the kV
\nA. The faster the electrons are at hitting the plate
\nB. The more electrons are at hitting the plate
\nC. The greater the tissue penetration
\nD. The more X-rays produced
\n12. In 1 sentence, why do we collimate radiographs?
\n13. For each of the following diagnostics, state whether the test is looking for the Mycobacteria itself, or for the body reaction to it
\nA: TST
\nB: 454 Sequencing
\nC: StatPak
\nD: Paralens
\nE. MAPIA
\nF. Culture
\n14. In 1 sentence, describe latent tuberculosis
\nANSWERS
\n1. C
\n2. C
\n3. B
\n4. Similar to: Protocols designed to reduce the risk of pathogen transmission
\n5. C, E, D, A, G, F, B.
\n6. They all are
\n7. Similar to: Disease Risk is the likelihood of the occurrence and the magnitude of the consequences (severity) of a pathogen entering a population \u2013 for this you need a vulnerable population and the possibility of exposure, to a particular pathogen
\n8. Similar to: Malnutrition occurs when the body does not get the right amount of vitamins, minerals, and other nutrients it needs to maintain healthy tissues and organ function and can occur when an animal is either undernourished or overnourished.
\n9. This will vary \u2013 but should include reference to wild diet, sanctuary diet, water access, and potentially energy, macro and micro nutrients etc,
\n10. D
\n11. A and C
\n12. Similar to: To control the size of the primary beam and improve image clarity and to reduce scatter.
\n13. A. body reaction. B. Organism C. Body reaction D. Organism E. Organism F. Organism
\n14. Similar to: Infection with M tuberculosis that has been contained by the host’s immune system and thus does not infect others<\/p>\n

Evaluation Review for end of workshop<\/p>\n

1. After anaesthetizing an animal with Ketamine and Medetomidine, how long should you ideally wait before approaching the animal to begin a procedure?
\nA. 1 minute
\nB. 5 minutes
\nC. 10 minutes
\nD. 15 minutes
\nE. 20 minutes
\n2. In radiography \u2013 the Higher the mA
\nA. The faster the electrons are at hitting the plate
\nB. The more electrons are at hitting the plate
\nC. The greater the tissue penetration
\nD. The more X-rays produced
\n3. In 1 sentence, why do we collimate radiographs.
\n4. Which of the following are components of a disease or pathogen contingency plan?
\nA. A list of people and organizations to contact in a disease outbreak, and why they must be contacted.
\nB. Biosecurity protocols
\nC. Methods of disease transmission and management strategies to reduce transmission
\nD. A map of your facility
\nE. background information on the disease of concern
\n5. What can be used to preserve a bacterial sample at room temperature?
\n6. What can be used to preserve a virological sample at room temperature?
\n7. What tools are useful to help intubate an orangutan?
\n8. What is the MAIN reason to intubate an animal under anesthetic?
\nA. To obtain sterile lung wash samples
\nB. To maintain a patent airway
\nC. To help provide a stable anesthetic
\nD. Because Steve said we should
\n9. What tools which of the following (including all necessary consumables) would be of most use diagnostically in a field situation?
\nA. A microscope and a centrifuge?
\nB. A field PCR kit and a microscope?
\nC. An ultrasound and a pulse oxcimeter?
\nD. An X-ray and a field PCR kit?
\nE. A microscope and a field PCR kit?
\n10. You are faced with a disease outbreak in your center. Describe in 3-4 sentences how you would deal with this. Consider clinical and managerial aspects.
\nANSWERS
\n1. C
\n2. B and D
\n3. Reduce scatter, improve image
\n4. All
\n5. 10% glycerol
\n6. RNA later
\n7. Laryngoscope, swab, light source, a second person\u2026
\n8. B
\n9. A
\n10. Must mention diagnostics, biosecurity and communication<\/p>\n

Test 1 pre workshop – based on last year\u2019s material and topics being covered this year
\nQuestion Number Correct 1\/2 mark Incorrect Did not answer Comments
\n1 15 0 12 0
\n2 14 0 11 1
\n3 14 1 11 1
\n4 18 7 3 0
\n5 0 7 17 3 Accuracy of study
\n6 6 8 10 3
\n7 3 11 11 2
\n8 7 16 4 0
\n9 8 4 3 4 Increased protein prominent
\n10 5 0 20 1
\n11 0 19 6 2
\n12 2 13 9 3
\n13 6 16 2 3 Paralens\/ MAPIA unsure
\n14 20 3 1 3<\/p>\n

Test 2 – end of workshop, on topics covered this year
\nQuestion Number Correct 1\/2 mark Incorrect Did not answer
\n1 22 0 0 0
\n2 20 1 1 0
\n3 20 1 0 1
\n4 22 0 0 0
\n5 16 2 2 1
\n6 16 1 1 3
\n7 16 5 0 0
\n8 20 2 0 0
\n9 12 9 0 0
\n10 18 0 1 2<\/p>\n

A lot Some A little None
\nEnjoyment 20 2 0 0<\/p>\n

Comments:
\nVery important to meet colleagues from other centres andf reely share information and build friendships.
\nAs a manager, I do realise this sort of workshop is really important. But it will be very useful if the topics related to management were put in the beginning. Practical things are good to know, but if management material was in the first 3 days, managers would be more able to take back to their centres
\nYes – for the ideas, information and situation
\nI think the workshop is a fantastic forum for vets to share their knowledge and support\/ assist one another in overcoming the daily challenges they face in their roles
\nFor the information
\nIn the next maybe will be better if we follow the schedule, so we are not wasting time
\nMore motivational games!
\nMake final decision about TB and best policy that can apply generally
\nThe atmosphere of the whole event is really fun and warm
\nYes, because I can meet many colleagues<\/p>\n

A lot Some A little None
\nNew Knowledge and ideas 19 3 0 0<\/p>\n

Comments:
\nMainly the practical (parasitology) details were useful for me, but the nutrition bit has been essential as well
\nI have thought of several studies that have to be done in our centre and also we have to publish our field findings
\nYes – especially for TB test, parasitology, nutrition and behavioural enrichments
\nOften there was conflicting information presented which can be confusing and frustrating. Case studies were great. Practical aspects were fantastic
\nEspecially for new issue for TB test and the suggested\/ recommendation treat for a difficult care in Quarantine
\nI get many ideas to make disease risk analysis and I hope we can apply this idea
\nMore field technology
\nArrange better schedule so the presentations not ‘accumulate on last few days
\nThis time OVAG is less dense, compared to last year regarding the new knowledge I get. The 2011 is more like evaluating\/ doing practise from last year’s material. Still it is great. There is a continuation from year to year materials
\nYes – a lot of the things that was mentioned on the workshop is quite new for me, such as how to deal with TB, how to do good enrichment etc.<\/p>\n

A lot Some A little None
\nApplying the learning 15 7 0 0<\/p>\n

Comments:
\nI hope and will try to implement the ideas, and think that the ideas of having contingency plans and SOP\u2019s have woken people up. Just need to keep reminding people now.
\nSince I am not involved directly in any rehab centres, I can contribute by helping them in making planning and strategies based on what I learn from this meeting.
\nYes – I will. There some good and excellent ideas to shown the others, and I think I must do to impart this knowledge
\nI would like to see topics such as positive reinforcement techniques and recording (documentation) protocols and procedures covered – how are things documented, who has access to that info, how\/ where stored, what info is stored\/ documented and how we could improve. Mental health as an important component of physical health
\nYes I will. I will try but the impact\/ effect still needs a time to make them follow what I want and Quarantine needs.
\nWill use contingency planning for outbreak
\nLearn many things to make involvement at Bukit Tigapuluh Release Site – THANK YOU!!
\nSure, it’s just that this year\u2019s material is less ‘clinical’ so it is a bit difficult to share with the team.
\nYes, I will try and use the information and ideas. And yes, I have been shown how to impart this knowledge to others, but certainly that it will need time to make a difference<\/p>\n

A lot Some A little None
\nEffect on results 12 10 0 0<\/p>\n

Comments:
\nI think that in Nyaru Menteng the ideas and information will be implemented, but am not sure about the other centres
\nWe have a lot of constraints to implementing our ideas. Mostly lots of the ideas end up in the laptop because of the obstacles
\nYes, of course. Especially how to manage the spread of disease and how to manage the animal health management of the area.
\nYes I do. Because from here I got a lot of information and of course with the contact with others to improve the animals health in quarantine
\nI get more information about medication for orangutan, the diagnosis and methods etc. I think it will help us in centre to taking care of and giving treatment to orangutans
\nGive opportunity for representative to describe their centre, so everybody knowing well of each other
\nAbsolutely. These meetings make me more confident in doing my job, in providing me with back-ups as well
\nHopefully yes, with the new information and the ideas that have been shared – will help me see animal health problems with a new perspective<\/p>\n

Other Comments:
\nImproving communication (between vets in different centres, and between vets and managers) is very important. I think important first steps were made to improve this communication
\nMore participants with more different background studies.
\nThank you for inviting me in this new family
\nGreat improvement in terms of delegate\u2019s participation – fantastic!! Keep it up.
\nThere are so many ideas and information that I got. But most Indonesian people like us, 50% English words lost by not knowing or too fast speaking – please for note, because we all know how important the knowledge that the workshop does.
\nI think cebter manager involvement is important to encourage support of the vets in a united front\/ collaboration\/ co-operation. Thank you for allowing me to attend this workshop.
\nPlease give some idea to night activity so we can be more closer to each other and it would make it feel more comfortable with each other.
\nMaybe in the future (in the next course) we can discuss about orangutans in the release site, not just in the rehab centre.
\nCan provide primatologist for the behavioural aspect? Vets can cope at least a little\u2026
\nSweet! Well Done \ud83d\ude42
\nLanguage is still a problem I think. Don’t know how to solve that\u2026
\nMore little group activities, so that people will know each other better and make them more comfortable with each other
\nMay we do more practice and perhaps sometime we can do activities outdoor (under shade of trees or open field) like video on PASA workshop<\/p>\n

Orangutan Conservancy 2011 Orangutan Veterinary Advisory Group (OVAG) Workshop
\n2011 OVAG Report
\nJuly 4 – 8 , 2011<\/p>\n

Section 5<\/p>\n

Attachments made available for participants:<\/p>\n

1. Recommendations for Tuberculosis Risk Management in Samboja Lestari, East Kalimantan by Chris Walzer and Alex Lecu \u2013 reviewed and accepted by OVAG delegates
\n2. DRAFT RISK ASSESSMENT for Keeping staff working with Great Apes
\n3. Zoonosis\/ risk assessed disease
\n4. Contingency Plan template
\n5. PASA VETERINARY MINIMUM STANDARDS
\n6. Library of primate medicine resources<\/p>\n

1.<\/p>\n

Vienna and Paris 30.06.2011
\nResearch Institute of Wildlife Ecology
\nRecommendations for Tuberculosis Risk Management in Samboja Lestari,
\nEast Kalimantan
\nby Chris Walzer* and Alex Lecu#<\/p>\n

Goal: While aware that MTB most probably exists in the environment in Eastern Borneo,
\nminimize the risk of introducing MTB into the wild with rehabilitated orangutans. Exposure
\nof Orangutans to mycobacterium is usually limited because of their arboreal lifestyle.
\nHence, their journey into a rehabilitation center markedly increases the contamination
\nrisk due to human contact, greater time spent on ground and interactions with animals
\nof unknown status.<\/p>\n

Method: In order to move forward with this issue the initial diagnostic workup has been
\ngreatly simplified by taking into account the realities of the site. An acceptable risk must
\nbe defined \u2013 a zero risk approach will guarantee a standstill because of our current incapacity
\nto detect animals in the TB latent form.<\/p>\n

1. Robust clinical exam of each individual animal including x-ray etc.
\n2. Employ only Culture and PCR from tracheal washes as diagnostic tools
\n3. For first-stage screening use only two categories: a) TB-negative and b) all others
\nincl. the ex-TB
\n4. Define \u201cTB-negative\u201d as negative on BOTH culture and MTB complex specific-
\nPCR and negative on clinical exam, x-ray, use no other tests to make this classification.<\/p>\n

Notes:
\n– the validity of this assessment is entirely dependent on: i) the quality of the veterinarian\u02bcs diagnostic workup, ii) thorough knowledge in reading x-rays, iii) adequate
\nsampling techniques, iv) correct sample storage and transport, and v)
\nrobust lab procedures and protocols (according to WHO standards).
\n– the TST is clearly not valid for orangutans (Kilbourne et al. 2001); and has severe
\ngeneral limitations (see e.g. Rangel-Fausto et al., 2001 and Good et al.
\n2011)
\n– Tracheal wash should be run with a standard amount : 1ml\/kg BW of sterile saline
\nflushed into trachea and immediately collected back (usually 30 to 50% of
\ninitial volume) and then equally divided into tubes for PCR, cytology and stain
\n(EDTA) and culture.
\n– The PrimaTBStatPak\u00ae is not validated for species other than Macaca sp. and
\ntherefore cannot be used for initial screening. However, serum of all animals
\nshould be stored (-25\u00b0C) for further serological evaluation.<\/p>\n

5. isolate the TB-negative OU from all others immediately (healthy quarantine1), and
\nre-test them in 3 months (or more, see below)<\/p>\n

Note:
\n– this TB-negative group could contain \u201cfalse\u201d negative, i.e. latent TB cases. That
\nis why they cannot be released directly.
\n– 3 months is the recommended period for humans (of the tested species the ou\u02bcs
\nclosest relative).
\n– Protocols should me implemented in order to isolate Healthy Quarantine from
\nthe remaining animals, i.e separated tools, different staff, sequential work, physical
\nbuffering space \u2026<\/p>\n

6. All dead OU must undergo a full necropsy workup including culture and PCR of
\nthe following organs : lung (apical), liver, spleen and the following lymph nodes :
\nmediastinal, tracheobronchic, cervical, mesenteric..<\/p>\n

7. All other OU will require an individual workup to determine their status
\n1 In the \u201chealthy quarantine\u201d the negative animals must be spatially separated from the
\ngroup of other OU. Keeper staff should not move between the two groups. Keepers
\nshould have tested negative for TB. Fomite transmission must be prevented by employing
\nseparate tools and utensils. Feeding material of the two groups must not mix. If possible
\nanimals should be housed individually. However, behavioural wellbeing must be considered.<\/p>\n

If one individual in a group becomes positive during the three months all animals in
\nthat group should be considered positive.<\/p>\n

References<\/p>\n

Good, M., Clegg, T. A., Murphy, F., More, S. J. (2007): The comparative performance of the
\nsingle intradermal comparative tuberculin test in Irish cattle, using tuberculin PPD combinations
\nfrom different manufacturers. Vet Microbiol 151 : 77-84
\nKilbourn, A.M., Godfrey, H.P., Cook, R.A., Calle, P.P., Bosi, E.J., Bentley-Hibbert, S.I.,
\nHuygen, K., Andau, M., Ziccardi, M. & Karesh, W.B. (2001) Serum antigen 85 levels in adjunct
\ntesting for active mycobacterial infections in orangutans. Journal of Wildlife Diseases 37(1): 65-
\n71.
\nRangel-Frausto, M. S., Ponce-de-Le\u00f3n-Rosales, S., Martinez-Abarora, C. & Hasl\u00f8v, K. (2001):
\nTuberculosis and tuberculin quality: best intentions, misleading results. Infection Control and
\nHospital Epidemiology 22: 481\u2013484.<\/p>\n

* Univ. Prof. Dr. med. vet. Chris Walzer Dip. ECZM (Wildlife Pop. Health)
\nResearch Institute of Wildlife Ecology
\nUniversity of Veterinary Medicine
\nSavoyenstrasse 1, A-1160 Vienna, Austria,
\nchris.walzer@fiwi.at
\n# Dr. Alex L\u00e9cu, DVM,
\nParis Zoo, France
\nChair of the EAZWV Tuberculosis Working Group,
\nalecu@vetosphere.com<\/p>\n

2.
\nDRAFT RISK ASSESSMENT for Keeping staff working with Great Apes (Insert Centre) \u2013 guidance notes on filling in the form are in italics.
\nNote areas in blue can be filled in by center manager\/health and safety officer. Areas in yellow are likely to require input from the center veterinary surgeon. Areas in red should be agreed and discussed between them both.<\/p>\n

Name of Organisation<\/p>\n

Activity to be assessed Type of enclosure (including type of access)
\nLocation
\nPeople at risk
\nAnimals involved (taxonomic groups)
\nOther animal risks<\/p>\n

Sources of infection Transmission route Likelihood
\nEG:
\n\u2022 Body fluids (Blood, placenta, body parts)
\n\u2022 Waste (faeces, urine, vomit)
\n\u2022 Direct skin contact
\n\u2022 Aerosol route e.g. inhalation, ingestion etc Would need to give guidance on terminology (i.e. what does low or moderate or high mean). This section should also give a brief justification for the score given<\/p>\n

Control Measures to minimise transmission risk Safe working practices that managers should be able to come up with as a result of knowing the animals, their enclosure and assessing potential sources of infection and transmission routes alone<\/p>\n

Biological agents of primary concern Source (s) of infection Harm to humans Likelihood of occurrence at centre<\/p>\n

should tally with the ones in the blue section Consider severity of disease caused in humans, whether it can be easily treated and whether it can spread easily from person to person Vet should base this decision on factors such as the previous history of disease in population, whether disease could be introduced into animals<\/p>\n

Control measures to minimize contamination risk Measures directed at reducing the likelihood of the animals contracting the organisms listed and to controlling spread \/ contamination of the enclosure if these agents are suspected\/ confirmed. This should be within the capability of the collection\u2019s vet who could fill this in without knowing the details of how the enclosure is managed. The manager would not be able to fill in the yellow section as it requires specialist knowledge both microbiological and the disease history of the collection\/animals concerned.<\/p>\n

Further information\/ notes Any further notes (e.g. justification why things added or not included)
\nFurther information\/ notes Any further notes (e.g. justification why things added or not included)
\nAssessor (facility manager) Two assessors required as in most centres, no one person will have sufficient knowledge to complete both parts. Assessor Two assessors required as in most projects, no one person will have sufficient knowledge to complete both parts.
\nDate Date<\/p>\n

3.
\nZoonosis\/ risk assessed disease
\nSpecies:
\nNon-human apes Human Action
\nPositive ID at Centre or in wild ?
\nSource<\/p>\n

Transmission<\/p>\n

Clinical Signs<\/p>\n

Most at risk – (exposed\/ biological)<\/p>\n

Implications of infection<\/p>\n

Control of infection<\/p>\n

Management recommendations
\nReferences<\/p>\n

Disease of Concern:
\nContact details: Relevant diagnostic laboratories
\nContact details: Government officials
\nContact details: Management
\nContact details: Animal Health network
\nContact details: Trusted media<\/p>\n

4.
\nMain Routes of transmission Contingencies to reduce risk of transmission to\/from Sanctuary animals.
\nWildlife and Domestic animals Aim: reduce contact between wild animals and sanctuary animals:<\/p>\n

Preventative measures:<\/p>\n

New Arrivals Aim: Prevent introduction of infected animals.
\nControl measures:<\/p>\n

Food Aim: Prevent entry of the disease in infected food products.<\/p>\n

Control measures:<\/p>\n

Fomites (vehicles, equipment, crates, clothing and shoes etc.) Aim: Prevent disease being transferred to animals, their food or anything they may come in direct contact with.<\/p>\n

Control measures should disease be widespread (outbreak):<\/p>\n

Faeces \/ waste food\/ soiled bedding etc. Control measures in the event of outbreak:<\/p>\n

Infected Humans Prevention of transfer of a disease strain that can infect both humans and animals.<\/p>\n

Recommendations
\nVisitors:<\/p>\n

Staff:<\/p>\n

Additional points:
\n\u2022 These contingency measures are liable to revision as the threat changes and our knowledge of the disease and its control develops. They will be reviewed on a regular basis (minimum monthly).
\n\u2022 The contingency of how we would operate and provide care for our animals in the event of a human pandemic is also not covered within this document.
\nSummary:
\nMeasures in place (DATE):<\/p>\n

Measures to be put into effect ASAP:<\/p>\n

Timing to be supplied as soon as they are known.<\/p>\n

Measures to be put in place if outbreak:<\/p>\n

5.
\nPASA VETERINARY MINIMUM STANDARDS \u2013 available freely online at www.pasaprimtes.org<\/p>\n

Sections of PASA veterinary manual shared with delegates are freely available on the PASA website and include:
\nCreation of a preventative health programme
\nDisease contingency planning
\nBasic Nutrition
\nManagement of the malnourished primate
\nDiagnostic Sampling Procedures
\nAfrican primate handling and anaesthesia
\nTuberculosis and its control
\nRisk assessment \u2013 HBV in gibbons in a zoo setting \u2013 available from s.unwin@chesterzoo.org<\/p>\n

6.
\nTable 1. Typical serological patterns of acute and chronic HBV infection (adapted from Dienstag and Isselbacher, 2001 and Hollinger and Liang, 2001).<\/p>\n

Classification HBsAg (what we test for at CZ) Anti-HBs Anti-HBc HBeAg Anti-HBe
\nNever Exposed – – – – –
\nHigh infectivity chronic carrier + – + + –
\nLow infectivity chronic carrier + – + – +
\nCurrent acute infection + – + +\/- +\/-
\nVaccine Immunity – + – – –
\nPast exposure (exposure immunity) – + + – +\/-<\/p>\n

Appendix – List of 25 diseases of immediate concern
\nEach participant researched and investigated a disease from the list which will produce a rough assessment. 2 examples below
\nRough Assessment: Disease example: EMCV \u2013 Encephalomyocaditis virus. Family Picornaviridae, Genus Cardiovirus. Species: Orang-utans
\nLikelihood of susceptibility: 4. Susceptibility varies between species. Peracute mortality has occured in orangutans.
\nLikelihood of Exposure: 4. Currently unknown due to lack of data, but with suspected prevalence being high in wildlife, take precautionary approach due to vermin issues in most sanctuaries. Biosecurity measures will mitigate this somewhat (vermin control and potential vaccination \u2013 this second IF have confirmed cases. Note however, severe local reaction to vaccination seen in bonobos).
\nLikelihood of Becoming Infected: 3. Depends on local biosecurity \u2013 is spread in urine and faeces from rodents. Also species dependant. Ro\/ ID50 unknown, but highly virulent in African elephants, while Asian elephants appear to seroconvert. Sudden death has been seen in orangutans.
\nLikelihood of Transmitting it to others: 3. Depends on biosecurity as for above question.
\nSeverity for the individual: 4. Species dependant \u2013 subclinical to per acute death
\nSeverity for the Population: 4. Outbreaks confirmed in chimpanzees, bonobos and Bornean orangutans. Potentially disastrous, with mortality up to 10%.
\nZoonotic potential (extra question)? 2 (over 4 categories). This is LOW directly from apes due to transmission method BUT, humans are susceptible to infection in the same way apes are. Infection is possible in humans, but disease is rare.
\nEstimated Significance to the Programme?: 23\/35 = HIGH Requires risk assessment and management.
\nReferences Used: PASA vet healthcare manual Chapter 5.9 (and peer reviewed references contained therein); Vogelnest et al JZWM; Mclelland D Doctoral thesis, University of Sydney; see further reference listed within this thesis, personal experience
\nRough Risk Assessment: Pasteurella sp.
\nAccording to Kawashima et al. (2010) and Asheley et al. (2003) Pasteurella is found in the nasopharinx and gastrointestinal track of domestic animals. It produces a secondary infection in humans with low pathogenicity in healthy individuals. Contact with domestic animals increase the likelihood of infection. Very occasionally produces infectious disease in humans. As reported by Ashley et al. (2004) most of the human Pasteurella infections usually manifest as local skin or soft tissue infection following an animal bite or scratch. Systemic infections are less common and are limited to patients at the extremes of age or those who have serious underlying disorders.
\nEscande and Lion (1993) found in a retrospective study of infections due to Pasteurella that among the 958 cases recorded, wound infections (bites, scratches and punctures) were the common forms of pasteurellosis (66%) caused by P. multocida (48%), P. canis (11%), P. dagmatis (5%), P. stomatis (4%). In human infections unrelated to animal wounds, respiratory tract diseases and bacteremia-septicemia were the predominant infections with respectively 19 and 11%, and caused by P. multocida. Next in importance were urogenital (2.5%), abdominal (1%) and central nervous system (< 1%) infections.
\nIn a case study by Ashley et al. (2004) it is reported a fatal case of peritonitis and septicaemia caused by Pasteurella dagmatis in a patient with cirrhosis. The infection followed a scratch inflicted by a pet dog. Spontaneous bacterial peritonitis caused by P. dagmatis had not been reported previously. According to Ashley et al. (2004) Pasteurella dagmatis is a relatively recently described species, which is rarely reported as a human pathogen. This species may be misidentified unless commercial identification systems are supplemented by additional biochemical tests.
\nTable by Kawashima et al. 2010:<\/p>\n

Case\/author Age\/sex Animal Contact Risk factor Antibiotic Neurological complication Outcome
\nPer et al. 15\/M Rabbit None Cefazolin, penicillin, chloramfenicol Epidural epyema recovery
\nO\u2019Neill et al. 72\/F Dog None Penicilline Meningoencephalitis Recovery
\nPrulx et al. 33\/F Dog None Penicillin G ADEM Recovery
\nTjen et al 72\/F NR None Penicilline, cefotaxime ND Recovery
\nTattevin el at 66\/M Dog Alcoholism Cefotaxime ND Recovery
\nJordan et al 60\/F Cat None Aztreonam, Levofloxacine None Recovery
\nKawashima et al 44\/F Cat None Meropenem None Recovery<\/p>\n

Likelihood of susceptibility: 1. Susceptibility is low in humans. No data found in orang-utans.
\nLikelihood of Exposure: 3. Although currently in orang-utans is unknown due to lack of data, In humans it is mostly related to close contact (bite, scratches…) with domestic animals (dogs, cats…) , therefore the possibilities of exposure in orang-utans is considered very low as the access to domestic animals in rehabilitation centres is quite limited. However, contact with dogs, cats and other domestic animals is possible while the orangutan in captivity. Biosecurity measures to avoiding the contact of orang-utans with cats and dogs would potentially reduced the risk to almost 0, unless this bacteria is also found as normal flora in orang-utans for what data has not been found in all searched literature.
\nLikelihood of Becoming Infected: 1. In humans the main via of transmission is through close contact (kissing, bite, scratch) with domestic animals. The likelihood of this happening in orangutans is very low.
\nLikelihood of Transmitting it to others: 0. No data has been found about direct transmission amongst humans therefore it is considered that likelihood of transmission amongst the orang-utans is 0.
\nSeverity for the individual: 3. In humans only one fatal case has been found in the literature (Ashley et al. 2004). It is normally a treatable infection with the adequate antibiotherapy. Only concomitant diseases or association with underlying disorders and some cases of neurogical complications have been found.
\nSeverity for the Population: 0. Transmission amongst people has not been found in the literature. The probabilities of an outbreak are quite remote and mortality rate is very low.
\nZoonotic potential (extra question)? 1 (over 4 categories). Potential zoonosis in humans from domestic animals. Zoonotic potential from orang-utans to humans is very unlikely.
\nEstimated Significance to the Programme?: 9\/35 = very LOW risk. Does NOT Require risk management although more data specific for orangutans is needed. No data has been found for other species of Pasteurella (like P.haemolytica or P.pestis) in humans or other great apes.
\nReferences Used: Ashley et al. 2004; Escande and Lion 1993; Kawashima et al. 2010.<\/p>\n

To view photos from this year’s Vet Workshop click here:\u00a0 https:\/\/orangutan.com\/projects\/oc-veterinary-workshop\/2011-ocovag-veterinary-workshop-images\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

ORANGUTAN CONSERVANCY 2011 ORANGUTAN VETERINARY ADVISORY GROUP WORKSHOP REPORT \u00a0 Photos provided by Raffaella Commitante, Steve Unwin and orangutan portraits by Wiwik Astutik (BOS Samboja Lestari) Orangutan Conservancy 2011 Veterinary Workshop logo courtesy Amy Burgess \u00a9 Copyright 2011 by Orangutan Conservancy Prepared with participants of the Orangutan Conservancy 2011, Orangutan Veterinary Advisory Group (OVAG) Workshop, […]<\/p>\n","protected":false},"author":11,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2348","post","type-post","status-publish","format-standard","hentry","category-news-center"],"acf":[],"yoast_head":"\nOrangutan Conservancy 2011 Orangutan Veterinary Advisory Group Workshop Report - Orangutan Conservancy<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/orangutan.com\/orangutan-conservancy-2011-orangutan-veterinary-advisory-group-workshop-report\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Orangutan Conservancy 2011 Orangutan Veterinary Advisory Group Workshop Report - 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