Zoonotic Sporotrichosis: Biosafety Procedures

Background: Sporotrichosis is a fungal infection caused by Sporothrix schenckii species complex, which is distributed worldwide, especially in regions of tropical and subtropical climates. It can affect both humans and a great variety of animals, among which, the domestic dog and cat. Today is considered the subcutaneous mycosis more frequent in Brazil, due to the progressive increase of zoonotic transmission of the disease in the metropolitan region of Rio de Janeiro. Review: In the endemic region of zoonotic sporotrichosis in Rio de Janeiro, veterinarians, their assistants and owners of cats with sporotrichosis are considered risk groups for acquiring the infection. Of the human cases of sporotrichosis in this endemic region that were accompanied by the Clinical Research Institute Evandro Chagas (IPEC / Fiocruz) in the period from 1998 to 2001, 5% of the patients diagnosed for the disease were veterinarians, demonstrating the occurrence of the infection in this occupational group. Biosafety is defined as a condition of security achieved by a set of measures aimed at the prevention, control, reduction or elimination of risks involved in activities that could endanger the health of humans, animals, plants and the environment. However, small animal veterinary pratictioners from the endemic region of Rio de Janeiro usually do not follow biosafety measures, which increases the risk of acquisition of sporotrichosis. In most cases, the infection results from traumatic inoculation of the fungus in skin and in humans, clinical forms may be: fixed or localized cutaneous, lymphatic-cutaneous, spread-cutaneous, mucosal and extra-cutaneous or systemic. In the endemic form of this disease that occurs in Rio de Janeiro, the cat is seen as a source of infection, The zoonotic potential of the cat is characterized by the abundance of yeasts found in their skin lesions and proximity with humans. Cats acquire the disease after fights with other infected cats and the skin lesions more frequently found are nodules and ulcers, covered or not by crusts, which can progress to necrosis with exposure of bones and muscles. The presence of respiratory signs, especially sneezing, with or without lesions in the mucosal and in the nasal region is common. The azole itraconazole is considered the drug of choice for humans and cats. However, unlike humans, the treatment is considered difficult in cats. The definitive diagnosis of sporotrichosis is obtained by isolation of Sporothrix in culture. Nonetheless, in cats, due to the great quantity of yeasts in their lesions, cytopathological test is strongly indicated in the presumptive diagnosis because of the speed in processing, low cost and no requirement of sophisticated technical training or complex laboratory structure. Discussion: A zoonotic form of sporotrichosis has become endemic in the metropolitan region of Rio de Janeiro and the veterinarians are a high risk group for acquiring the disease as well as have a very important role in the application of measures for the prevention and control of sporotrichosis. Therefore, in this review, specific biosafety procedures to reduce risks during the handling of cats with suspected sporotrichosis by veterinarians, technicians, caretakers and owners of cats were described. The topics aproached were: clinical care of the cat (where were appointed the recommended personal protective equipment, animal restraint and good practices), decontamination of the environment, equipment and items used in the cat care and management of waste. Aspects related to the fungus and the disease itself were also discussed.