Cayo Santiago

Animal Bites, Scratches and Injuries

(Excerpts from CDC Guidelines)

1. The most critical period for the prevention of B virus infection is during the first (5) minutes after an exposure occurs.
   
   
2. To ensure the safety of the Staff and Investigators of Cayo Santiago, Herpes B kits are located in:

1. The workshop on Cayo Santiago
   
   
2. Each of the huts (casitas) by each of the feeding corrals (N=3)
   
   
3. The Animal Processing area (Feeder 2)
   
   
4. Old lab in Upper Corral
   
   
5. Laboratory near shop
   
   
6. Water collection roof in Small Cay

If a person has been bit, scratched, or exposed to any potential bio-matter from a rhesus macaque, the instructions below must be followed:

Management of B virus exposure

1. Wash and scrub skin thoroughly with the provided BD E-Z Scrub (Povidone-Iodine impregnated scrub brush) for 15 minutes. This solution destroys the virus lipid envelope and inactivates the virus on the skin.
   
   
2. Wounds may be gently massaged to increase their contact with the cleansing solution.
   
   
3. After the wound has been properly disinfected return to the shop area and rinse well with water to clean the affected area.
   
   
4. Obtain one Viral Transport Medium located in a cooler box in the shop area for each area affected.
   
   
5. Place the cotton tipped portion of the applicator into the wound and while applying pressure, twirl the applicator in the wound. If the wound is covered with a flap of skin and / or crust the covering must be lifted or removed before the culture with the cotton swab is taken.
   
   
6. Insert the applicator halfway into the culture vial. Holding the vial and applicator at arm's length, bend the plastic toward you until it snaps. The cotton tipped portion of the applicator should remain in the vial.
   
   
7. Seal the vial securely and label it with the following information:
   
   

1. First and last name.
   
   
2. Place where the swab have been taken (e.g. arm, leg, back, finger, etc.)
   
   
3. Date, time, and type of exposure (i.e bite, scratch, eye exposure).
   
   

9. 9. Refrigerate the culture swab inside the cooler until shipment to Sabana Seca, do not freeze them. The culture should be maintained in the refrigerator in the shop area in Punta Santiago. Inform James Ayala, Colony Manager or Janet Rivera, Secretary so arrangements can be made to ship the sample to the Center for Disease Control.
   
   
10. If you do not have transportation, a member of the CPRC staff will take you to Ryder Hospital, the nearest emergency room, for a physical examination. Once your exam is complete you can call the staff member or if after hours, you can contact James Ayala. This staff member will drop you off with instructions for the Attending Physician. You should bring the "Letter for the Attending Physician", your health insurance card, reading material, a meal and a sweater. At the hospital, an evaluation of the exposure site and of the general health of the patient shall be performed. A prescription for post exposure antiviral prophylaxis is required for all exposed persons and a tetanus toxoid booster is strongly recommended.
    
    
11. Antiviral medication must be taken soon after potential exposure to the B virus (preferably within the first few hours following exposure). The National B Virus Resource Center (of the National Institutes of Health) recommends 1 g of valacyclovir, 3 X a day, for a 14-day course of treatment (http://www.cdc.gov/ncidod/diseases/bvirus.pdf).
    
    
12. Collect and obtain two whole blood samples with red top tubes (5 ml red top tube should be used to draw blood. The sample should be spun, and the collected serum should be frozen). Place sample in a bag with ice pad and take with you to our freezer located in the shop from the hospital or from a certified laboratory. If collected at the hospital, ask Physician to store blood sample in Hospital freezer. A Driver from the Caribbean Primate Research Center (CPRC) will pick this sample up the following day from the hospital. Alternatively, you can store sample in our freezer located in the shop and a driver from the CPRC will transport this sample to our headquarters where we shall send this sample to the National B Virus Resource Center. A follow-up blood sampling two weeks after the incident should be arranged (This follow-up blood sample should be collected following step # 12 however all second blood tests must be stored in the CPRC -85 c ultra-low freezer not a standard freezer).
    
    
13. Fill out an Animal Incident report

1. Eye or mouth exposures to B virus should be irrigated or flushed immediately with sterile saline solution or water for 15 minutes using the provided sterile eye wash and sterile eye wash cup.
2. Repeat procedures: 5-13 as described above.