Preventing the spread of infectious disease within veterinary hospitals is a fundamental component of patient safety, staff wellbeing, and public health protection. Veterinary clinics bring together vulnerable animals, high levels of contact, and shared environments, creating ideal conditions for pathogens to spread if effective controls are not in place.
Infections that are acquired within healthcare settings are referred to as nosocomial infections or hospital-acquired infections (HAIs). These terms are used interchangeably to describe diseases that are transmitted between patients, staff, or the environment during the course of care. HAIs are a major concern in veterinary medicine because many hospitalised animals are already compromised by illness, injury, surgery, or stress. Preventing additional infections is therefore a core responsibility of veterinary teams.
Evidence suggests that HAIs are common across veterinary settings. More than 82% of veterinary teaching hospitals have reported at least one HAI outbreak over a five-year period, with an increasing proportion linked to multi-drug resistant organisms. These events can result in significant animal morbidity and mortality, human illness, service disruption, reputational damage, and substantial financial costs. As with most infectious disease challenges, prevention is far more effective than responding to outbreaks after they occur.
Case example 1: Cryptosporidium outbreak associated with calf handling at a university teaching hospital (2013)
Cryptosporidium parvum is a protozoal parasite that causes watery diarrhoea and abdominal cramps in calves and humans, with clinical signs typically lasting one to two weeks. There are currently no specific treatments for cryptosporidiosis beyond supportive care.
This case illustrates the critical importance of strict hygiene practices when working with calves.
Effective hospital infection control relies on multiple layers of protection working together. No single intervention is sufficient on its own.
After you finish handling a patient, you should always take the time to thoroughly wash your hands for a minimum of 20 seconds. This is length of time is takes to sing the popular classic “Happy Birthday” if you are looking for an easy way of keeping track of time. Depending on your vocal skills, do not feel obliged to sing out loud or you might start getting some concerned looks from colleagues.
Every fashionable veterinarian should have an array of disposable gloves, gowns, shoe covers, and facemasks that they can wear for every infectious disease occasion to protect your hands and clothing from getting contaminated. The surgery and anaesthesia teams here also have dedicated footwear and scrubs for use in theatre.
For your convenience, many veterinary hospitals contain big yellow biohazardous waste bins for any rubbish that has come in contact with a patient. There are also yellow sharps bins scattered about to dispose of needles, scalpel blades, and glass items that have the potential to cause needle-stick injuries and cuts to people handling them.
We also shouldn’t forget to thoroughly wipe down any tables or equipment like our stethoscopes or thermometers after using them for a patient. There are many good cleaning products that can be used to safely sanitise these items while minimising long term damage from continual use.
Many big hospitals will have separate isolation wards to house patients that are known or highly suspected to have an infectious disease. These spaces should ideally be completely enclosed and have a separate ventilation system to prevent airborne spread. For hospitals that don’t have space for a completely separate isolation room, they will often use brightly coloured tape on the floor or bright signs on particular cages indicating the need for caution. If you have the luxury of choosing cage or stall designs for your hospital, try to select units that will not allow neighbouring animals to reach a paw through the cage bars or touch noses with their neighbours.
Case example 2: Salmonella outbreak in an equine hospital
Salmonella is a bacterial infection of the gastrointestinal tract that can cause severe diarrhoea and, in some cases, systemic illness and sepsis. Transmission occurs primarily via the faecal–oral route.
Following the outbreak, a comprehensive suite of infection control policies was developed and implemented.
There are two general ways that infection control plans tend to be developed for veterinary clinics: the reactive and uncoordinated approach which is responding to issues and outbreaks after they have already occurred and the structured and pre-planned approach that draws on research evidence to develop a logical and coordinated system for preventing problems from occurring. Obviously, the latter is preferable and so we will now take a few minutes to review the general steps involved.
1. Evaluation
This is probably the most time-consuming step and involves listing all the potential diseases that could be spread within your clinic and locations where transmission is likely to occur. Common ones include surgical site infections and transmission between patients that are being housed in the wards. It is also important to evaluate the current hygiene practices you have in places for preventing disease spread including:
The current rates of hand hygiene are shocking low in veterinary hospital despite it being the most important means of preventing disease spread. Only 28% of small animal vets and 16% of large animal vets practice proper hand hygeiene. As a profession, we seem to take particular delight and pride in swapping stories about how absolutely filthy we can get during the course of a day.
When you are going through the process of identifying problem areas, it is really to involve hospital staff in the process as they might be able to provide insights about why infection control measures aren’t currently being followed as well as ideas for how to improve the situation.
Case example 3: Improving hand hygiene compliance on hospital wards
Hand hygiene compliance can be challenging in busy hospital environments, particularly when staff are under time pressure and facilities are poorly positioned relative to patient care areas.
By removing practical barriers and making good practice easy, hand hygiene compliance improved substantially without additional training or enforcement.
2. Prioritisation
There are often a lot of different areas in a hospital’s existing infection control plan with room for improvement and although we might want to tackle them all at once, it’s better to start with a few key interventions that will either have the biggest impact on reducing HAIs or are the most feasible to implement with you current staff workflow, building design, and financial limitations.
3. Action
Once you have come up with a plan, you then need to put it into action which is sometimes much easier said than done. There is a whole field of social science dedicated towards understanding how to motivate people to change their behaviours, but very briefly, tricks like providing social incentives (making good behaviour visible to others), immediate rewards (acknowledging people for doing well), and progress monitoring (showing how people have improved over time) can significantly improve compliance. There is a great 15-min TedTalk called “How to motivate yourself to change your behaviour” by Tali Sharot that is worth watching if you have time.
4. Monitoring
Assessing the impacts of the recommended changes and implementation making sure that good practices are kept up over time. Many veterinary teaching hospitals will also conduct routine surveillance for nosocomial infections by collecting samples from high-risk areas like the surgical suite or door handles or collecting samples for high risk patients like post-operative equine colic surgery patients that are at risk of getting Salmonella. This can lead to further suggestions for items to prioritise and act on in your evolving hospital infection plan.
5. Communication
The key to implementation and sustainability of your plan is getting the entire team on board by allowing them to communicate their ideas and then communicating the changes that will be put in place. It is also important to provide them with adequate instruction and support so that they can actually implement your changes.
The principles of hospital infection control are well established, but their effectiveness depends entirely on consistent application in day-to-day practice.
*** The single most effective measure for reducing infection risk in veterinary hospitals remains adherence to effective hand hygiene. ***
Advancing Animal Care through Shared Learning