Educating Clients About Zoonoses

How can I effectively and efficiently educate  my clients about zoonotic diseases?

Effective exchange of information with clients regarding zoonoses is founded upon 3 basic tenets:

1. The veterinarian must be well-informed about each zoonosis of concern.
2. The veterinarian should carefully gather information from the client and provide the client with written information for review at home. A free flow of information between client and veterinarian will help the veterinarian assess all potential risks and provide the client with proper recommendations. 
3. The physician must be appreciated as part of the preventive medicine team.

Small animal practitioners are an important first line of defense in protecting humans from potential zoonoses carried by their pets. Although routine veterinary practice incorporates many preventive measures that protect the public health (eg, administration of anthelmintics, vaccination against rabies), practitioners must continue to look for opportunities to increase their knowledge in order to accurately assess potential risks for the pet-owning public. As such, it is critical that veterinarians remain current in their understanding of both common and emerging zoonotic diseases.  Newly emergent zoonotic diseases have been popular topics in the scientific literature during recent years. However, continued study of more well-known zoonoses is still warranted because, with the advent of molecular diagnostic tools, our understanding of many common zoonotic diseases is changing. Such study includes, but is not limited to, changes in taxonomic classifications and renaming of organisms. A variety of scientific journals, textbooks, and Web-based educational tools are available to assist in this endeavor.

Related article: Limiting Legal Liability in Zoonotic Cases

During each visit by a pet owner, the veterinarian must gather information on probable zoonoses, assess potential risks for human transmission, and educate the client about prevention and control. It is important to provide an atmosphere that encourages clients to share medical information pertinent to preventive health care for all family members. As such, many clients may be reluctant to provide medical information while staff are present in the examination room. Also, it is imperative that all employees who have access to patient medical records understand that, by law, these records must be treated with strict confidentiality.

The constraint imposed by time-limited appointments is a significant impediment to the process of data-gathering and information delivery. It may be helpful to use some simple strategies to both gather data and maximize the client's awareness of potential zoonoses.

1. Videotapes and DVDs can be placed on continuous rotation on televisions or computer monitors in the waiting area and examination room. These resources can effectively begin the educational process.
2. Brochures that discuss zoonoses should be readily available in the waiting area and examination room.
3. Waiting room posters on zoonoses can also serve to prompt client questions.
4. A thorough client history form will expedite the process of data gathering. Such forms may dramatically increase the amount and quality of information obtained in a short period. Depending on how the form is to be used, the client may complete it or the veterinarian may pose individual questions during the visit. Some clients may be more forthcoming if they are allowed to complete a form at their leisure.
5. Provide clients with a written list of Web sites administered by public health or health care professionals that focus on pet-related zoonoses. 
6. Make a note in the pet's record about any information given to the client, and detail specific recommendations that are made.
7. Use the clinic Web site to provide clients with more information on zoonoses and to point them toward useful Web sites. 
8. Veterinarians should always verbally educate clients about the risk posed by each suspected zoonotic disease. It is strongly suggested that written material be given to the client for review at home.

As noted above, the limited time available during most appointments severely hampers the amount of material that can be discussed. Regardless, the veterinarian is still responsible for assessing zoonotic risks to clients and providing necessary preventive health care information. At times, a follow-up phone call or appointment may be indicated if there is cause for concern. Additionally, it is important to note in the record that follow-up has taken place and to detail the specific information that has been delivered to the client. Redundancy in communication with the client is recommended.

The veterinarian and physician are occasionally at apparent odds when zoonotic disease transmission is a concern. Physicians may sometimes exaggerate the zoonotic risk created by pet ownership or recommend euthanasia of healthy pets. Clearly, all parties are well intentioned, but we must remember that the owner may feel trapped between 2 opposing sets of recommendations. Given our litigation-conscious society, it is understandable that physicians may suggest what appears (to the veterinarian and client) to be an extreme preventive measure. This can usually be avoided through discussion with the client's physician and sharing of pertinent information. The veterinarian should keep current, evidence-based literature handy so that it can easily be shared with physicians by phone, fax, mail, or electronic transmission. Similarly, the veterinarian should thoughtfully consider recommendations made by physicians when zoonoses are a concern. Veterinarians should also make a point of making collegial contact with physicians in their area and get to know them, which will better aid information sharing and acceptance of one another's viewpoint.

Veterinarians play a critical role in protecting the health, safety, and well-being of pet owners -it is part of their oath. Through individual client interaction, veterinarians have the opportunity to obtain detailed information about zoonotic disease potential and individual risk to clients and their families. Veterinarians must also maintain a positive interprofessional relationship with community physicians. Together, a committed team of health care professionals can provide a safe and healthy environment for pets and humans.