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>> Good afternoon, everyone My name is Laura Morrell and I work in the National Center for Emerging and Zoonotic Infectious Diseases at the Centers for Disease Control and Prevention On behalf of the One Health Office, I’m pleased to welcome you to the monthly Zoonoses and One Health Updates Call on December 2, 2020 Although the content of this webinar is directed to veterinarians, physicians, epidemiologists, and related public health professionals and federal, state and local positions, the CDC has no control over who participates Therefore, please exercise discretion on sensitive content material as confidentiality cannot be guaranteed Today’s webinar is being recorded If you have any objections, you may disconnect now Today’s presentations will address one or more of the following five objectives Describe two key points from each presentation, describe how a multisectoral One Health approach can be applied to the presentation topics to identify an implication for animal and human health, identify a One Health approach strategy for prevention, detection, or response to public health threats, and identify two new resources from CDC partners In compliance with continuing education requirements, all presenters must disclose any financial or other associations with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters, as well as any use of unlabeled products or products under investigational use CDC, our planners, presenters, and their spouses and partners wish to disclose they have no financial interests or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters The Planning Committee reviewed content to ensure there is no bias The presentations will not include any discussion of the unlabeled use of a product or a product under investigational use CDC did not accept commercial support for this activity Instructions for receiving free continuing education are available at cdc.gov/onehealth/zohu/ continuingeducation The course access code is OneHealth2020 To receive free CE for today’s webcast complete, the evaluation at cdc.gov/TCE online, by January 11, 2021 A web-on-demand recording of today’s webinar will be posted online at cdc.gov/One Health/ ZOHU/2020/December.html by January 12, 2021 To receive free CE for the web-on-demand video today’s webinar, complete the evaluation at cdc.gov slash TCE online by January 12, 2023 Before we begin today’s presentations, Dr. Casey Barton Behravesh, Director of CDC’s One Health office, will share some news and updates You may begin >> Hi, everyone Thanks again for joining us on today’s ZOHU Call We appreciate your help in spreading the word about the ZOHU Call, and for you continuing to share our website link with your colleagues from human, animal, environment, and other relevant health sectors Before our presentations today, I want to share just a few highlights from today’s ZOHU call email newsletter If you haven’t yet subscribed, please use the link at the top of the main ZOHU call web page so you can stay informed CDC’s response to the COVID-19 outbreak continues to evolve Please check CDC’s website for the latest guidance and resources including information about pets and other animals The CDC One Health Federal Interagency COVID-19 Coordination Group or OHFICC continues to bring together representatives from 18 key federal agencies for regular meetings to share news updates, publications, and guidance on the One Health aspects of COVID-19 relevant to the health of people, the environment, and animals, including companion animals, livestock, and other production animals like mink, wildlife, and zoo animals We also have a state-federal One Health call every week to talk to public health veterinarians, wildlife officials, and state animal health officials as well to ensure we’re coordinating and exchanging information and responding to the One Health aspects of this pandemic The One Health Partners COVID-19 webinar is also something

available that takes place once a month to provide the latest information on the news and key updates as well as guidance and resources for a variety of One Health Partners This webinar also gives updates on domestic and global animal cases of SARS-CoV-2 infection in the US and around the world And talks about our One Health work in the US, and the next call is scheduled on December 15 At this time, CDC is aware of 138 confirmed cases of SARS-CoV-2 in a variety of animal species from 16 countries around the world There’s 75 cats, 52 dogs, three lions, seven tigers, and one puma at three different zoos or animal exhibits in three, in two countries Also in the United States, there 94 animals confirmed with SARS-CoV-2 infection, which makes up about 68% of the total animals confirmed globally We’re also aware of 391 mink farms with SARS-CoV-2 in animals from ten countries with an unknown number of affected animals There are 16 mink farms in four states in the United States, with mink and other animals that have tested positive for SARS-CoV-2 And we want to remind everyone that guidance for farmers and veterinarians as well as government partners is available on USDA’s website and more resources will be available as well At this time, there’s no evidence that animals play a significant role in spreading SARS-CoV-2 to people Based on the limited information available to date, the risk of animals spreading this virus to people is considered to be low We are still learning about this virus, but it appears that it does spread from person to animal in some situations So to help keep people and animals healthy, limit your contact with people and animals, whether pets or others, if you think you might have COVID-19 or if you tested positive for this virus Also treat pets like you would other human family members and don’t let them interact with people outside of your household There’s a lot of great work ongoing to learn more about this virus and the impact on people and animals in our environment And we’ll continue sharing timely updates as information evolves So the University of Minnesota has released a pocket guide to antimicrobial prescribing for common small-animal diseases And also the current Emerging Infectious Diseases or EIDJjournal has a new zoonotic disease theme this month, so be sure to check that out There’s a third new outbreak of E. coli infections of unknown sources that’s been posted on CDC’s website And the next ZOHU Call is going to take place on February 2 Please email topics or suggestions for future presentations and news from your organization to [email protected] and I’ll turn it back over to Laura Thanks >> Thank you You may submit questions at any time using Zoom’s Q&A feature Please include the topic or presenter’s name The Q&A session will follow the final presentation Our first presentation, SARS-CoV-2 Infection and Seropositivity Among Pets of Persons with Laboratory-confirmed SARS-CoC-2 2020 will be given by Grace Goryoka Please begin when you’re ready >> Hey, everyone, I’m Grace Goryoka, and I’m a Public Health Advisor in CDC’s One Health Office, and I’m also on the CDC One Health Working Group of the COVID-19 Response I’m looking forward to sharing with you all some work that the One Health Working Group has done on SARS-CoV-2 infection and seropositivity among pets of persons with laboratory confirmed SARS-CoV-2 In the United States, approximately 85 million households own at least one pet, with dogs and cats being the most common, most popular Human-animal interactions are associated with improved mental, social and physiologic health, including decreased feelings of loneliness, as well as decreased blood pressure, cholesterol, and triglyceride levels Owning pets also creates increased opportunities for exercise and outdoor activities and socialization Additionally, human-animal interactions are critical for service and working dogs Animals have an important role in our lives, whether they are a part of our families or we work with them At the start of the pandemic, the role of companion animals in COVID-19 transmission was unknown For some background, I want to go back to what we knew in March of 2020 We knew that all known human coronaviruses had originated

from a mammalian host, which suggested that SARS-CoV-2 was a zoonotic pathogen that had the potential to spill over to other animals such as pets Previous studies on SARS coronavirus, back in 2003 indicated that cats were naturally infected with SARS coronavirus, and that both ferrets and cats could be experimentally infected and transmit to members of the same species We also knew that research on the receptor binding domain of SARS-CoV-2 suggested that amino acid residues in mammalian h2 receptors are biologically conserved in cats, ferrets, pigs and non-human primates This suggested that these animals had cell types that were permissive to viral entry This information on species susceptibility highlighted the gaps in knowledge about companion animals and SARS-CoV-2 In addition, in late February, global news of the late, of the first companion animal testing positive for SARS-CoV-2 in Hong Kong was reported after having contact with a confirmed human COVID-19 case We also saw animal welfare concerns as reports surfaced of pets being abandoned or killed due to fears around COVID-19 There was a lack of information about the role of pets in the pandemic, their susceptibility and role as hosts or fomites We are continuing to learn more about the role of animals in the COVID-19 pandemic and are updating the link at the bottom of this slide as we learn more In response to these concerns in March, we knew that an opportunity to conduct a One Health epidemiologic investigation would allow us to further investigate some unanswered questions So the One Health working group of the COVID-19 Response collaborated across local, state, and federal human and animal health agencies to conduct this One Health household transmission investigation in Utah and Wisconsin Listed on this slide are the many agencies that supported this One Health investigation CDC had already begun a human COVID-19 household transmission investigation in households with at least one person with laboratory-confirmed COVID-19 infection, which is defined as a human household member who was positive by PCR on nasal pharyngeal or nasal swabs or had SARS-CoV-2 antibodies detected Results from the human component of this household transmission investigation can be found in the publication linked on this slide The primary purpose of the One Health component of this household transmission investigation was to assess SARS-CoV-2 infections in mammalian pets residing in households with laboratory-confirmed human COVID-19 cases The results from this investigation would help inform guidance and decision-making during this pandemic and for future preparedness efforts So, CDC’s One Health Working Group of the COVID-19 Response deployed two veterinary field teams to join our other CDC colleagues in Utah and Wisconsin Any household from the ongoing CDC household transmission investigation in Utah and Wisconsin that had one or more mammalian pets living in the household was included for recruitment into this One Health component of this investigation In the human portion of the household transmission investigation, individuals were asked about companion animals residing in their home And if their pets had developed clinical signs consistent with SARS-CoV-2 infection after the diagnosis of the COVID-19 human index case Eligible households were then contacted over the phone to collect information for pet enrollment Pets were enrolled into this investigation if the owner consented, a questionnaire was completed by a household member, and at least one sample was collected for each pet Once a household pet was enrolled, CDC field teams administered a questionnaire to the household members for each pet to capture information on the pet’s [inaudible] medical history and the household members’ knowledge of public health recommendations We also asked about any clinical signs in the pet since onset of illness of the first human household case, and asked about the duration of interaction the index case had with their pets and types of interactions like petting and cuddling and what types of community interactions their pets had The questionnaire also asked about the household and personal precautionary measures taken since the human index case’s diagnosis Our CDC field teams were also prepared to answer questions that households may have had about animals and SARS-CoV-2 Additionally, at the end of each household visit, households were given an educational information sheet on animals and SARS-CoV-2 This information sheet provided answers to questions like, how long will it take to get the results and how will I be notified? What do I do with my pet test positive for the virus? Who should I contact if I have any questions about my pet during the study? We also provided additional information on how to stay healthy around animals and links to our CDC webpages for more information For this One Health investigation,

the samples to be collected from pets were oropharyngeal, nasal, rectal, and fur swabs, and fecal and blood samples All samples were sent to the Wisconsin Veterinary Diagnostic Laboratory, WVDL, and preliminary RNA extraction and real-time quantitative PCR testing of animal specimens occurred at WVDL If a specimen was PCR positive at WVDL, it was considered to be presumptive positive and sent to USDA’s National Veterinary Services Laboratories, NVSL, which is the national animal reference laboratory for confirmatory testing of SARS-CoV-2 NVSL would also attempt sequencing and viral isolation Blood samples were received and processed at WVDL and the serum was sent to NBSL for testing by a SARS-CoV-2 virus neutralization assay We based our initial sample collection on guidance from the World Organization for Animal Health In addition, we collected fecal samples from a subset of animals to assess the relative sensitivities for rectal swabs versus fecal samples This is of interest to us for animal welfare consideration since fecal sample collection is not invasive, and less stressful for the animal Now I’ll present some information on our enrollment Of the 62 households enrolled into CDC’s household transmission investigation, 41 of those households had pets From these we were able to enroll 56 pets which included 37 dogs and 19 cats from 34 households in Utah and Wisconsin We collected oral and fur swabs from each pet, and nasal and rectal swabs from nearly all animals We collected blood samples from 47 of the 56 pets and fecal samples from 14 animals If the animal became uncomfortable or fractious, sample collection was stopped Now I’ll present some of the findings from this One Health investigation All oral, nasal, rectal swabs collected and a subset of fecal samples collected were all negative for SARS-CoV-2 We were able to collect blood samples from 47 of the 56 pets and of these 47 pets, eight pets which were four dogs and four cats were seropositive The neutralizing titers from all for all dog samples were one to 32, while cat titers ranged from one to 32, to one to 128 The median time from symptom onset of the household’s human index case to first date of pet sampling was 27 days We also found that the median proportion of human household members with laboratory-confirmed SARS-CoV-2 infection was 45% We did find that the proportion of human household members with laboratory-confirmed SARS-CoV-2 was greater in households with a seropositive pet compared to households with no seropositive pet, which was statistically significant There were generally a higher percentage of positive people in households that as that had a positive pet compared with households who didn’t have a positive pet We also asked owners about if their pets had any clinical signs So clinical signs that could be consistent with SARS-CoV-2 infection were reported in 14 pets from our investigation, and included respiratory signs like sneezing, coughing, nasal discharge and difficulty breathing or shortness of breath, as well as gastrointestinal signs like vomiting and diarrhea, and nonspecific signs like inappetence or lethargy Clinical signs consistent with SARS-CoV-2 in animals are generally nonspecific and could potentially be attributed to other factors The most commonly reported clinical signs from this investigation were respiratory, which included reports of sneezing, coughing, and nasal discharge Among the eight seropositive pets, owners reported that two seropositive dogs had mild clinical signs consistent with SARS-CoV-2 One dog had nasal discharge and the other had inappetence None of the seropositive cats had clinical signs in this investigation Among the 39 seronegative pets, eight had clinical signs The owners reported most pets had mild clinical signs, but one pet was reported to have difficulty breathing And among the nine pets that did not have blood samples collected, four pets had mild clinical signs including sneezing, coughing, and lethargy While 25% of the pets in this investigation reported to have clinical signs consistent with SARS-CoV-2, no animals received veterinary treatment for those clinical signs Our findings in conjunction with other research suggests that clinical signs in companion animals are a poor indicator of serostatus for SARS-CoV-2 We also collected fur samples in duplicate from pets during this investigation If the household had multiple repeat visits, all samples including fur were attempted for collection Fur samples were obtained from all pets in our investigation SARS-CoV-2 RNA detection from fur samples was extremely rare Fur samples from one of 56 pets tested positive

at one time point This dog had no evidence of infection and remained asymptomatic All nasal, oral, and rectal swabs and stool were also negative And this dog was also seronegative Viral culture from the fur sample was unsuccessful Subsequent fur samples from this dog we’re also negative Now I would like to talk a little bit more about this specific dog’s household The day the positive fur sample was collected all six human household members reported symptoms consistent with COVID-19 Nasal pharyngeal swabs collected from four household members on the same day the fur swab was collected tested positive by PCR Swabs from the remaining two people in the household tested positive two days later We worked with the Utah Department of Health for the sequences from these positive tests from the human household members Seven near-full genomes or full, or full genomes were generated from this household These sequences were from four household members and the dog’s fur sample The high sequence similarity suggests one introduction from the community and subsequent internal household transmission Our findings suggest that viral RNA on the fur was environmental contamination from the household members We had also asked household members about the interactions between the human index case and pets in these households When looking at the duration of interaction, we found that 33 pets that had serologic testing performed had frequent daily contact with the human index case prior to diagnosis Of those 33 pets, 14 pets had decreased contact with a human index case after diagnosis, and none of these pets were seropositive Nineteen pets had stable or increased contact with the human index case after diagnosis, and four were sero-positive In addition to the duration of interaction collected, we also captured information on various types of interactions between the human index case and their pets in each household, before and after the human index case’s diagnosis Some of these interactions included cuddling, feeding, sleeping in the same location and taking their pets for walks Overall, owners reported pets had fewer types of interactions with the human index case after their diagnosis We also asked households about their pet’s community interactions From the time the human index case began isolation, 29 pets spent time free-roaming in the yard or in the neighborhood Five of these pets were seropositive; however, only one pet, an eight-year-old cat spent greater than 50% of their time outdoors, and this cat was seropositive Five pets also attended a social setting which included a dog park, daytime boarding facility, or a veterinary clinic, and all of these pets were seronegative Household members were also asked if the human index case wore any type of personal protection equipment after starting home isolation Five of 34 households representing ten pets reported that the human index cases wore face masks within their household Of these five households, two also used gloves around pets In households with reported facemask use, one pet was seropositive while in households with no reported facemask use, seven of 43 pets were seropositive Additionally, to better understand if our public health recommendations were reaching the public, we asked about the households familiarity with CDC recommendations for people with suspected or confirmed COVID-9 restricting contact with pets Of 34 households, ten identified a household member familiar with CDC’s recommendations for people with suspected or confirmed COVID-19 restricting contact with pets Of these ten households, seven did not have seropositive pets Of the households familiar with CDC’s recommendations human index cases in two households reduced interactions with all pets after the person’s diagnosis, and human index cases in two households used masks and gloves while interacting with pets It is difficult to draw conclusions from this based on the sample size, but we think it’s important to present to better understand if public health recommendations are being implemented and to inform future studies This One Health household transmission investigation systematically evaluated pets residing in households with laboratory- confirmed human COVID-19 cases and suggests that human-to-animal transmission in this setting occurred more frequently than previously recognized The results identified from this investigation further shows that transmission of SARS-CoV-2 from people to pets may occur in households especially after contact with people with COVID-19 Our findings taken in conjunction with other publications suggest that human-to-animal transmission is occurring in these settings CDC at the start of the pandemic had made recommendations to avoid animals, including pets when sick with COVID-19

These results from our investigation continue to highlight the importance of people with suspected or confirmed COVID-19 restricting contact with pets and other animals to prevent person-to-animal transmission For some future suggestions, future household transmission investigations should work to sample pets across the spectrum of exposure, including time points closer to the start of the household in the households index case’s exposure window and at multiple subsequent time points to learn more about viral shedding, symptomatology, and risk factors We also continue to encourage that a One Health approach is used for these types of household transmission investigations Since this household transmission investigation ended, our One Health Working Group has also been collecting data on clinical signs of companion animals with confirmed SARS-CoV-2 infection in the United States The data from the household transmission investigation were also incorporated into this larger database Surveillance data is really limited and because there have been so few cases, we are working with our state partners to gather more information about how these cases of SARS-CoV-2 in animals present to better understand and characterize clinical signs of companion animals with SARS-CoV-2 infection Out of 77 cases of companion animals in the US positive for SARS-CoV-2 infection, 57% of these pets were asymptomatic, 32% have been clinical, and 11% are unknown as reported by state partners conducting investigations into positive animals Respiratory signs have included coughing, sneezing, nasal or ocular discharge, and nonspecific signs of included fever, lethargy, and inappetence Gastrointestinal signs of included vomiting and diarrhea And just to wrap up with some reminders on what to do if you’re sick and have animals until we know more about this virus, it is recommended to treat pets like human family members Don’t let pets interact with people outside your household Keep cats indoors, do not allow them to roam freely Walk dogs on a leash at least six feet from others Avoid public places where a large number of people gather And additionally, masks should not be put on pets And if you are sick with COVID-19, restrict contact with people and animals When possible, have another member of your household care for your pet Avoid contact with pets including petting, snuggling, being kissed or licked, sharing food or sleeping in the same bed And if you must care for your pets, wear a mask and wash your hands before and after you interact with them If your pet gets sick and you are sick with COVID-19, please contact your veterinarian I want to express my sincerest thank you to all of our collaborators that are listed here on this slide And additionally, I want to thank all the participating households in the Salt Lake City and Milwaukee metropolitan areas for their interest in this investigation and willingness to involve their pets Thank you very much >> Thank you Our final presentation One Health Investigation of SARS-CoV-2 on Multiple Mink Farms in Utah is by Dr. Caitlin Cossaboom and Dr. Dean Taylor Take a moment to get back to the slides and then you can begin when you’re ready You can begin when you’re ready >> Okay, hi, everyone My name is Caitlin Cossaboom I’m a veterinary epidemiologist currently supporting CDC’s COVID-19 One Health Working Group It’s my pleasure to co-present today with Dr. Dean Taylor, Utah State Veterinarian on the One Health investigation of SARS-CoV-2 on multiple mink farms in Utah As of December 1, mink on 391 farms in ten countries have been confirmed to have SARS-CoV-2 infection The Netherlands, shown in navy blue on the graph, identified the first affected mink farm in the world and has since identified 70 total affected farms across the country Denmark, shown in red and recently became the leading country in the world with 289 affected mink farms, with a doubling in the number of affected farms through active surveillance and testing Just to note that the most recent countries, Lithuania was just reported to OIE today, and is not listed on the graph and Poland has not yet been reported to OIE On August 17, 2020, the US Department of Agriculture’s National Veterinary Services Laboratories confirmed that mink from two farms in Utah were infected with SARS-CoV-2 The United States has since identified a total of 16 affected farms with 12 in Utah, two in Wisconsin,

one in Michigan and one in Oregon CDC has been working with One Health collaborators including local and state health departments, state Departments of Agriculture and Natural Resources, USDA, and the National Wildlife Health Center to investigate these outbreaks on multiple farms in the United States, to help figure out how the virus gets on the farm, how it’s transmitted between species on the farm by collecting samples from mink, people, wildlife and other animals like dogs and cats from the farms We’re doing this to learn how to prevent future outbreaks and to get more information to help figure out what to do when this happens CDC is aware that Denmark has reported a new strain of SARS-CoV-2 virus in minks that’s also present in the local human population This new strain or variant referred to as cluster five, is defined by five mutations in the region of the genome coding for the spike protein based on the current available data, these mutations do not appear to affect how quickly the virus can spread, or the severity of infection But more research is ongoing to continue investigating if there are any implications that these mutations may have In response to this news, One Health Partners are investigating scientific findings of Denmark’s reports by conducting on-farm investigations to address SARS-CoV-2 in people and multiple animal species on mink farms in the United States, including collaboration between CDC and USDA on sequence analysis from positive mink, other animals, and people associated with affected mink farms, and generating guidance and recommendations for states and mink farmers in collaboration with partners in the US and globally Now, I will turn it over to my co-presenter, Dr. Dean Taylor, the State Veterinarian of Utah, to give some background information on the Utah mink farm investigation >> Good afternoon I’m Dean Taylor, the Utah State Veterinarian It’s my pleasure to share with you our response to the outbreak of SARS-CoV-2 in mink in Utah On August 10, the first mink were presented to the Utah Veterinary Diagnostic Lab from two farms who were experiencing higher than normal death losses On August 13, we had three farms affected And by the 14th, When we sent our veterinarians down to place quarantines and collect additional mink from the additional farms, we were up to four farms in two neighboring counties there This was because one of the farmers in the initial county also owned a separate facility in a neighboring county and shared his workers between those two On August 17, we got confirmation confirming SARS-CoV-2 in the mink in the United States And on August 19, a One Health response began To give a history, all of these farms have histories of workers falling ill with a confirmation of COVID-19 prior to the onset of death losses in the farms There was an approximate five-day lapse between when those workers were sick and when they saw the death losses start to increase And they reached numbers of upwards of 500 per day This number is somewhat variable depending on the farm that we spoke to, and it would average out to about five days per for the interval The first couple of days when these mink farmers saw these increased death losses, they were attributing these to other well-known diseases such as Pseudomonas, Andalusian’s disease It was on the referral of the attending veterinarian that dead mink were sent to you Utah Veterinary Diagnostic Lab for sampling and necropsy This immediately, as soon as Utah Veterinary Diagnostic Lab suspected that we had SARS-CoV-2 in these mink, and then sent those samples to the Washington diagnostic lab, we immediately started getting calls and support from other agencies around the country And cooperative responses formed between Utah’s Department of Agriculture or Health Department and other players such as the CDC, the USDA, both Wildlife Services in One Health as well as labs involved So the plan was for the CDC and the Utah Department of Health to begin doing some testing on these farms They looked at several different types of sampling there

First, they would take the fresh dead mink each day and test them They also did some mortality studies where they would sacrifice animals who randomly on the farm as well as those with any kind of clinical signs And then they also took some live samples from a number of mink on these farms As CDC was doing this, the Department of Health was also testing the humans on these farms to look to see if they had COVID-19 and to retest those who had previously tested negative In addition to these two agencies, Wildlife Services also stepped in and began testing around the farms They were testing all types of wildlife, and also the feral mink who had escaped from these farms So after this initial round of testing was done, and we got some numbers there, the team was going to return to Utah, and begin testing on October 1, to see what kind of prevalence of the virus these was on those farms at that point in time Right prior to their arrival on October 1, the second outbreak occurred in a distant county in our state Initially, in this second outbreak, there was no history of human COVID-19 And so our suspect fell to the feral cats that were surrounding all of these farms, as there’s an abundance of them Additionally, they were right on a river where the feral mink would set up housekeeping and live After they came and started doing testing, they found that there were human COVID-19 cases on all of the affected farms in the second outbreak as well We then had a third round of testing that will be coming on December 4, started just a couple days ago And we’re going to be looking at the animals who tested positive both in August and in October, and help to determine if they’re persistently carrying this virus or not or whether it’s just circulating Our concern from the October testing, which was nearly ten weeks after the first round of testing was that we still had an actual increased percentage that were PCR positive, with fairly low CT values So one of the things that I thought I would bring up to the group is that there have been some obstacles to our response And this industry is one that has innately has a little bit of mistrust, because of the fact that they are targets oftentimes and so they are very, very closed to having any outside people come onto their farms and see their operations The other problem we had was that they were, we had to come up with some compensation for mortality studies Here in Utah, our losses approached 50% on the breeding populations of these farms So to come in and do mortality studies for research purposes wasn’t going to sit very well with these producers So we had to find some compensation for those mortality studies before we could even begin And then they were also holding out for compensation for their losses They fell into a unique situation where they don’t qualify for indemnity through USDA, similar to some of our other animals such as the beef and food animals And so they were fairly resistant to having anybody come on to their facilities The other thing that was expressed by some of these farmers that slowed the process down initially was worker fear, when they saw people in full PPE We worked through all of these issues And as we gained their trust with privacy concerns, they were able to allow us to come on and do that research But current management concerns here in Utah are currently, our state is almost through with their pelting process But our current concerns are how to do that safely, and keep people safe And one of the issues that the producers have is that we continue to tell them that our research indicates that this virus has gone from people to mink And at the same time we turn around and tell them you need to use this PPE at the highest level And we’re trying to get them to understand that we’re still in the process of understanding this virus And so we’re going to take as many precautions as possible So most of these have been pelted at this point in time We’re also approaching the processing plants

with the same advice here in Utah Excuse me, the next thing that we have that we’re worrying about is how do we dispose of things like waste and the water contamination run off into the water tables Many of these farms are right next to rivers or they’re out in areas where we have high water tables here in Utah Because some of these producers have not done composting accurately, we have asked them to dispose of all carcasses through sanitary landfill that we’ve contracted with >> So, this is Caitlin again So we know that among susceptible animal species, mink are particularly highly susceptible to SARS-CoV-2 This could be due to a combination of genetic and environmental factors For example, farmed mink are often housed in relatively high densities, where they’re in close contact with one another, which favors spread of the virus Additionally, farmed mink do not exhibit a large amount of genetic diversity, which can favor infectious disease transmission and susceptibility Like humans, mink have exhibited symptoms that range from being asymptomatic or having mild clinical signs like being off feed, and having respiratory or gastrointestinal signs, to rapid death in a high percentage of animals on a given farm Because of this, it’s very important that extra precautions are taken to protect mink and humans while working on mink farms CDC’s COVID-19 One Health Working Group has deployed field teams to support on-farm investigations in the three states that have had farms with mink confirmed to be infected with SARS-CoV-2 From the farms that have been affected so far, many farmers have noticed that the animals went off feed first before they showed any clinical signs of illness In most cases, this was followed by coughing, sneezing, severe nose and eye discharge and crustiness and profound lethargy In the Netherlands, they also saw animals with diarrhea The signs progress to labored breathing and death in most of the farms in the US The disease moved rapidly through the facilities both within and between barn Farms in the US typically have seen about seven to 10 days of high mortality, followed by a period of residual sickness This slide shows what we know to date about the transmission of the virus on mink farms We know that SARS-CoV-2 infection spreads most commonly from person to person Infected people, either with symptoms or without symptoms, initially introduced the virus to the mink Once it’s initially introduced to mink in the herd, the mink spreads the virus to other mink It spreads very quickly on the farm, and we’ve seen losses ranging from 20 to 50% on some affected farms While we’re still learning about how long mink are infected with the virus and how it can spread to other animals on the farm like dogs, cats and wildlife, including feral mink and other animals At this time, there’s not currently evidence suggesting to human transmission has occurred on us farms However, the investigations are ongoing We know that mink-to-human transmission is suspected to have occurred on farms in the Netherlands and Denmark, we’re still learning about the potential risk of mink and their pelts to transmit virus back to people And there’s currently work ongoing to investigate these questions CDC’s COVID-19 One Health Working Group is continuing to work with state and federal partners to continue investigating and monitoring transmission of SARS-CoV-2 on mink farms in the United States We also wanted to make you all aware of a webinar that we recently organized – a national mink farmer training on steps to prevent SARS-CoV-2 on mink farms The purpose of this webinar was to share information with mink producers and farm workers on what we know about the virus that causes COVID-19 in mink and people Topics included how to protect mink and workers from this virus Steps to prevent virus introduction on the farm Included recommended biosecurity and personal protective equipment, practices, and available guidance documents and resources to protect human and animal health Bio security refers to management practices that reduce the risk of disease and contamination on farms These are some of the components of a comprehensive biosecurity plan The fur comission has a biosecurity guidance document that goes into much more detail than we can cover today The link is shown at the bottom of this slide The highlighted recommendations for the development of the mink farm biosecurity plan should restrict access to the premises and building where mink are kept, minimize visitors and other animals, rodents, birds and wildlife on the premises, require all employees to stay home if they’re sick, maintain at least six feet distance

between all people working on the farm, and use face masks and personal protective equipment or PPE, such as dedicated footwear that can be cleaned and disinfected, dedicated farm clothing such as coveralls, gloves and eye protection such as face shields or goggles It’s important that people on the farm wear PPE, including face masks, even if they don’t feel sick We also recommend to disinfect frequently touched surfaces, for example, door handles, counters, control panels, feed bins, and practice strict hygiene in areas where animal feed is prepared and clean and disinfect feeding equipment daily using an EPA-approved disinfectant Finally, we recommend to use caution when introducing new mink to the herd, including quarantining before bringing the mink into the herd To prevent the introduction of COVID-19 into the farm, it’s critical to make sure no one who is sick works with the animals One way to do this is to conduct daily health checks, including symptom and/or temperature screening of anyone including family members, friends or employees before they enter the farm People who have symptoms upon arrival at work or who become sick during the day so they immediately be sent home and should not return to work until the criteria to discontinue home isolation are met It’s possible that the virus can be found on surfaces and equipment like tools, cages, other items in the animal area, but fortunately, there’s a lot of cleaners that can kill the virus The EPA has a list of disinfectants that are effective against Coronavirus at the link that’s shown on this slide And if you’re at the store looking into buying disinfectants you can check the label to see if it’s effective against the Coronavirus or has the EPA seal The contact time or time the cleaner needs to be on the surface to disinfect does depend on the cleaning product, so be sure to check the label Additionally, any equipment used on one farm should not be used on another farm including protective clothing like coveralls and leather gloves Now we’re going to talk about what personal protective equipment or PPE should be used on the farm But before I do, I wanted to mention a couple important things to remember COVID-19 cases are increasing everywhere, including among people who work on mink farms People infected with a virus may not show symptoms or symptoms may be mild, but they can still transmit the virus to other people or mink through breathing or talking People are the main source of infection to each other and introduce the virus to the mink farm This virus causes high morbidity and mortality in mink, and we need to protect them and ourselves with PPE to prevent introduction of the virus to the farm, stop spread to other farms, and minimize animal losses This is the basic everyday PPE to use even with no known exposure to COVID-19 or any symptoms given that we know people with COVID-19 can be asymptomatic This includes a facemask and if available a fit-tested respirator such as N95, eye protection, dedicated outerwear such as coveralls, and disposable gloves, or gloves that can be disinfected between use If mink are sick or test positive for SARS-CoV-2, to limit virus spread between barns it’s important to keep the number of people working with mink who are positive to a minimum This can be done by assigning certain people to work only in certain barns, caring for healthy animals before caring for sick animals, not sharing equipment or feed between barns, disposing of leftover feed and not sharing with other animals on the farm It’s also recommended to not have staff who are higher risk for severe illness for COVID-19 work with animals suspected or confirmed to be infected with SARS-CoV-2 Additionally, anyone who has contact with or works near sick animals should wear respiratory protection, for example, an N95 respirator instead of a face mask In conclusion, we know that mink are very susceptible to SARS-CoV-2 Anyone who is experiencing COVID-19 symptoms or may have been exposed to COVID-19 or diagnosed with COVID-19 should not work with the mink in order to prevent introduction of the virus to the herd and to protect the mink from getting sick and dying Finally, we wanted to make sure you all are aware of guidance documents that were developed in collaboration between CDC, USDA, and state animal health officials in the One Health Federal Interagency Livestock subgroup These guidance documents can be found online at the link shown here on the screen and were developed to provide recommendations related to PPE, biosecurity, and steps to take if infection is suspected or confirmed on the mink farm This concludes our presentation for today We want to thank everyone listed on this slide for making these investigations possible, including the mink producers that have been willing to work with us, all of our state partners in Utah and federal partners with CDC’s COVID-19 One Health Working Group, USDA, and the National Wildlife Health Center

Thank you all very much for your attention, and we would be happy to take any questions >> Thank you And thanks to all today’s speakers for their informative presentations We do have time for some questions Please use the Q&A feature in Zoom to send your questions and include the presenter’s name or topic I’ll start with some questions that we’ve already gotten for Grace Can you elaborate on what it means to use a One Health approach in this specific example of infection investigations? >> Yes, thanks So One Health approach for this investigation was used by not only looking at transmission of SARS-CoV-2 among people, and like a human household transmission investigation, but also for pets in this investigation So by incorporating this, we’re looking at not only humans, but also pets or animals in the household And then additionally, when we conducted this investigation, we were not only working in the households for these, but we’re also working across many federal, state and local, human and animal health agencies and partners to be able to conduct this So making sure you’re collaborating and communicating and sharing information and results across all sectors is definitely something that goes into utilizing a One Health approach for these types of investigations >> Thank you And another question was, do you have any information for how long the virus would remain on fur? >> Sure. So virus isolation from the positive fur sample from this investigation was unsuccessful, and subsequent fur swabs were taken at various time points, and none of those were positive And so based on the findings from this investigation, fur is not considered to be a fomite for SARS-CoV-2 transmission, and just reiterating that virus isolation was unsuccessful for this >> Right, thank you We’ll move on to some questions for the mink presenters And how many mink were on the farms reporting the mink mortalities is the first question >> So this is Dr Taylor, the number of mink on the farms ranged from 3000 to over 20,000 on some of them with everything in between So there’s a fairly high range of the size of these, these different farms >> Thank you And let’s see, there’s one, can you say more about how you went about communicating with farms to get buy-in and to coordinate compensation? What challenges, successes, and lessons learned were realized? >> Sure, we had to do some creative financing through the state with, with some of this CARES money that had already been designated here in Utah It was, it was earmarked for specific organizations and the amount that they could get, and the mink producers in Utah had already received that money when this happened So it took us a few weeks, but we were able to get, we had to have the legislature meet and approve a change in that And then we were able to get some compensation for these losses And that, quite honestly, is what opened up the door for us to be able to get onto these farms and continue to do the research there They have wanted to help that they’ve kind of felt like they were left out of any kind of a helping hand So when our state came through with that, it felt like the flavor of that changed dramatically for us And also I will say that the professionalism of the CDC and the health department, they developed friendships and gain trust with the producers And that allowed us to get on there Otherwise, we would have been locked out of these facilities >> Great, thank you There’s also a question Are mink really regulated in Utah? Does it require a permit? And are they considered farm animals? >> They’re not highly regulated here in Utah, but they are considered livestock in Utah And that goes back to the same trouble that they had is that they’re considered livestock in Utah, but not federally And that was one of our obstacles that we had overcome >> Thank you And there’s another question Could you comment on worker education and were workers fit-tested N95 use? >> This is Caitlin I can comment on that So we’ve been working very closely with the Utah Department of Health to provide education to all of the farmers on the affected mink farms including providing personal protective equipment including face masks and face shields and protective disposable outerwear to the farmers,

and provide training on how to safely put those on and take those off They are also looking into opportunities to have the farmers pursue fit testing, if that’s something that they’re interested in >> Thank you We have one more question come in for Grace Can you elaborate on SARS-CoV-2 and clinical signs in dogs? Is it still uncertain if a dog can have clinical signs? Do you consider your study helps to answer that question? >> Sure, so dogs can have clinical signs and in our investigation that dogs that did have clinical signs, we’re both mild clinical signs So that is it is possible But again, what we are seeing is that they have from our investigation that these were mild clinical signs >> Thank you Okay, and another question for Dr. Taylor I think he spoke a little bit to this already But could you speak more about how the concerns and fears the mink farms had were overcome And if there were any particular communication strategies or techniques used for that? >> Initially, I had very few contacts with this industry And when I would try to get contact with them, they would say just come through the Fur Commission, and we’ll pass it on, which was not an effective way The biggest thing that honestly changed this was CNS put some effort into helping them out financially When they’re losing that volume of their business, in just literally one week’s time, and they’ve lost 50% of their breeders, and several thousand mink, having someone come in and just understand that, that that’s life-shattering for them, that was what opened up the door for communication And then I’ve tried to be completely transparent with these people As information comes, Caitlyn with CDC has shared that information with them, we haven’t kept any of that back from them We certainly wait until it’s confirmed and we know what we’re presenting But I think that open communication with them is what opened the door and allowed us to get on and do some further studying there, and is allowing us to do it currently this week as well >> Thank you We’ve got a question about access to the presentation So the webinar will be posted online after this And then we will also share as you can see on the screen the contact information for the presenters if you’d like to reach out directly with more questions There was another question Can you please elaborate on the carcass disposal of the dead minks? >> Yeah, I can Because we’re still waiting on information on how long that virus lasts, there’s still a lot of unknown answers as far as how much risk these carcasses possess And because after we went out onto these farms and saw what they’re composting, what they consider to be composting, which really were just piled up mink, we made the decision here in Utah to just have these buried at landfills So they are taking them in lined dumpsters or trucks and the landfills, we’ve contacted each landfill So they understand that as these mink come, they want to bury them immediately, keep predators and scavengers off, and then disinfecting these vehicles back and forth So we just felt like right now that was the quickest, easiest way to dispose of these animals and the most safe >> Thank you We’re at the top of the hour If you have other questions for today’s presenters, like I mentioned, we’ve included their email addresses on this slide And they’re also on the ZOHU call web page for today’s webinar, and in today’s email newsletter So please join us for the next ZOHU call on February 3, 2021 And thank you for your participation This ends today’s webinar

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