title: Risk behaviors for disease transmission among petting zoo attendees.
abstract: OBJECTIVE
  To evaluate risk behaviors for transmission of zoonotic diseases at petting zoos during a period without a recognized disease outbreak.
  
  
  METHODS
  Observational survey with environmental microbiologic sampling.
  
  
  METHODS
  6 petting zoos in Tennessee.
  
  
  METHODS
  Attendees were observed for animal and environmental contact, eating or drinking, hand-to-face contact, and use of a hand sanitizer. Hands were examined via bacteriologic culture on some attendees. Environmental samples were collected at three petting zoos.
  
  
  RESULTS
  991 attendees were observed; of these, 74% had direct contact with animals, 87% had contact with potentially contaminated surfaces in animal contact areas, 49% had hand-to-face contact, and 22% ate or drank in animal contact areas. Thirty-eight percent used hand sanitizer; children had better compliance than adults. Results of bacteriologic cultures of hands were negative for Salmonella spp and Escherichia coli O157; Salmonella spp were isolated from 63% and E coli O157 from 6% of the environmental samples.
  
  
  CONCLUSIONS
  High risk behaviors were common among petting zoo visitors, and disease prevention guidelines were inconsistently followed. This is an example of the importance of one-medicine, one-health initiatives in protecting the public health. Veterinarians, venue operators, and public health authorities must work together on targeted education to improve implementation of existing disease prevention guidelines.
authors.affiliation: Tennessee Department of Health, Vanderbilt University School of Medicine, Nashville, TN 37212, USA.
authors.forename: Marcy
authors.initials: M
authors.lastname: McMillian
authors.forename: John R
authors.initials: JR
authors.lastname: Dunn
authors.forename: James E
authors.initials: JE
authors.lastname: Keen
authors.forename: Karen L
authors.initials: KL
authors.lastname: Brady
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Jones
mesh_terms: D000328:Adult; D000818:Animals; D000836:Animals, Zoo / Q000382:microbiology*; D002648:Child; D018562:Disease Transmission, Infectious / Q000662:veterinary; D004783:Environmental Microbiology; D019453:Escherichia coli O157 / Q000302:isolation & purification; D006801:Humans; D006920:Hygiene; D007899:Leisure Activities; D012309:Risk-Taking; D012475:Salmonella / Q000302:isolation & purification; D013714:Tennessee; D015047:Zoonoses / Q000382:microbiology / Q000635:transmission*