%PDF-1.6
%
230 0 obj
<>
endobj
2 0 obj
<>
endobj
255 0 obj
<>stream
2009-03-20T11:20:40Z
OmniPage 11 http://www.scansoft.com
2009-03-20T11:26:41+13:00
2009-03-20T11:26:41+13:00
OmniPage 11 http://www.scansoft.com
application/pdf
uuid:854b4786-9fef-4d21-a076-56efd2fd5ee0
uuid:876e0b52-7e7a-4177-b116-5b13a3983d73
endstream
endobj
1 0 obj
<>
endobj
4 0 obj
<>
endobj
18 0 obj
<>
endobj
32 0 obj
<>
endobj
46 0 obj
<>/ProcSet[/PDF/Text]>>/Type/Page>>
endobj
58 0 obj
<>/ProcSet[/PDF/Text]>>/Type/Page>>
endobj
70 0 obj
<>
endobj
82 0 obj
<>
endobj
94 0 obj
<>/ProcSet[/PDF/Text]>>/Type/Page>>
endobj
106 0 obj
<>/ProcSet[/PDF/Text]>>/Type/Page>>
endobj
118 0 obj
<>
endobj
130 0 obj
<>/ProcSet[/PDF/Text]>>/Type/Page>>
endobj
143 0 obj
<>/ProcSet[/PDF/Text]>>/Type/Page>>
endobj
155 0 obj
<>
endobj
167 0 obj
<>
endobj
179 0 obj
<>
endobj
191 0 obj
<>
endobj
203 0 obj
<>
endobj
215 0 obj
<>
endobj
228 0 obj
[]
endobj
227 0 obj
[222 0 R 224 0 R]
endobj
216 0 obj
<>/Height 105/Type/XObject>>stream
Έahˢ>GEEDtGDtc.DDDDDDDDd)EDx^1фm #/F:#>GE!."""""""3HфqEDtg""hF"H23Ⱦ_#2>m!G4FE.eфG8#:6ˣ<EtGQR.R
hDto/ t1#>]taDtaDtsHe:">_.>GDtGDt]GG͢:#|ф#Pͣ0vGdx#AADFh":#mc#.":1FaG2>]RHZ.#:8菘!CB$t1"aqtGG:.""""""9#:1QDGE#2:.쏗
"1/d||DDDDDDHc%:#|"9DqC
endstream
endobj
226 0 obj
<>/Font<>/ProcSet 3 0 R>>
endobj
3 0 obj
[/PDF/Text/ImageB/ImageC/ImageI]
endobj
220 0 obj
<>
endobj
221 0 obj
<>
endobj
218 0 obj
<>/Height 370/Type/XObject>>stream
V1B{澃5[G֧ҧG
endstream
endobj
222 0 obj
<>stream
q
0 0 0 rg
1 0 0 1 70 70 cm
8 0 0 89 0 0 cm
/picture_0 Do
Q
endstream
endobj
224 0 obj
<>stream
BT
0 g
/OP11Font0 11 Tf
0 0 0 rg
109 Tz
1 0 0 1 68 754 Tm
(APPENDIX 3) Tj
110 Tz
1 0 0 1 68 712 Tm
(HANDLING HEALTHY ANIMALS) Tj
/OP11Font1 11 Tf
1 0 0 1 68 683 Tm
(Handling all seals is often difficult and potentially dangerous, particularly when dealing with) Tj
121 Tz
1 0 0 1 68 669 Tm
(the speedy and agile sea lions and fur seals.) Tj
118 Tz
1 0 0 1 314 668 Tm
(Ailing animals are usually lethargic and) Tj
110 Tz
1 0 0 1 68 655 Tm
(relatively docile, whereas healthy seals are resilient, active and will often take the aggressive) Tj
112 Tz
1 0 0 1 68 641 Tm
(initiative in any confrontation where their escape routes are restricted.) Tj
1 0 0 1 426 640 Tm
(When fur seals and) Tj
111 Tz
1 0 0 1 68 627 Tm
(sea lions attack, they will usually deliver a powerful bite, securing their prey firmly with the) Tj
109 Tz
1 0 0 1 68 613 Tm
(large canine and caniform incisor teeth, and then shake laterally, using their immensely strong) Tj
111 Tz
1 0 0 1 68 599 Tm
(necks, to cause severe tissue damage. Even small bites from pups are potentially dangerous.) Tj
117 Tz
1 0 0 1 68 570 Tm
(It is therefore imperative that you are able to control the head if you are going to safely) Tj
112 Tz
1 0 0 1 68 557 Tm
(manipulate and handle seals in any way.) Tj
1 0 0 1 68 529 Tm
(Heavy leather welder's gauntlets with long tops are effective protection for pup bites.) Tj
113 Tz
1 0 0 1 68 501 Tm
(When lifting healthy or moribund pups, pick the seal up by one scutter \(hind flipper\), slide) Tj
122 Tz
1 0 0 1 68 487 Tm
(the other hand beneath the seal and grasp the opposite fore-flipper close to the body) Tj
110 Tz
1 0 0 1 68 473 Tm
(supporting the seal's weight on your forearm. Seal pups are more comfortable and less likely) Tj
1 0 0 1 68 459 Tm
(to struggle when held supported in this way. If they begin to struggle, pull the scutter toward) Tj
111 Tz
1 0 0 1 68 445 Tm
(you while pushing the fore flipper away thus straightening the animal's body and preventing) Tj
110 Tz
1 0 0 1 68 432 Tm
(it from turning.) Tj
112 Tz
1 0 0 1 68 404 Tm
(When dealing with large juveniles and adults it is advisable to immobilise them, either with) Tj
118 Tz
1 0 0 1 68 390 Tm
(a net or by using a choker-pole. The latter is simple to make and use and is particularly) Tj
105 Tz
1 0 0 1 68 377 Tm
(effective.) Tj
115 Tz
1 0 0 1 122 376 Tm
(The poles should be of soft but resilient wood, such as Kahikitea \(white pine\),) Tj
118 Tz
1 0 0 1 68 362 Tm
(about 50mm diameter and 2-2.5m long. A piece of rope \(not less than 12mm diameter\)) Tj
111 Tz
1 0 0 1 68 348 Tm
(about 85cm long is threaded through two holes 30-35cm apart drilled through one end of the) Tj
101 Tz
1 0 0 1 68 335 Tm
(pole.) Tj
112 Tz
1 0 0 1 99 334 Tm
(A simple knot tied at each end of the rope prevents it from pulling through the holes.) Tj
114 Tz
1 0 0 1 67 307 Tm
(When using the pole drop the loop around the seal's neck so it lies behind the angle of the) Tj
113 Tz
1 0 0 1 66 293 Tm
(jaw. Turn the pole so the loop winds up on itself until it is firm, but not over-tight. The aim) Tj
1 0 0 1 67 279 Tm
(is to control the movement of the head, not throttle the seal.) Tj
115 Tz
1 0 0 1 67 251 Tm
(If the seal is large, two poles can be used from opposite sides to push the head toward the) Tj
112 Tz
1 0 0 1 67 236 Tm
(ground. The animal can then be moved about by pushing the poles forward or by lifting the) Tj
1 0 0 1 67 222 Tm
(scutters up so the seal must walk forward on its fore flippers. Alternatively, it can be netted) Tj
1 0 0 1 67 208 Tm
(or physically constrained by some other method for movement and manipulation.) Tj
109 Tz
1 0 0 1 66 181 Tm
(SAFETY WATCHPOINTS:) Tj
112 Tz
1 0 0 1 102 153 Tm
(Do not stand in front of the animal.) Tj
113 Tz
1 0 0 1 102 139 Tm
(Do not stand between a released seal and the sea.) Tj
112 Tz
1 0 0 1 102 125 Tm
(Do not handle the heads of seals which are unrestrained.) Tj
117 Tz
1 0 0 1 101 110 Tm
(Do not handle seals without some form of protection such as long topped leather) Tj
107 Tz
1 0 0 1 101 97 Tm
(gloves.) Tj
111 Tz
1 0 0 1 101 83 Tm
(Do not over-tighten choker-poles or obstruct airways.) Tj
112 Tz
1 0 0 1 101 69 Tm
(Keep handling episodes as brief as possible.) Tj
0 g
ET
endstream
endobj
214 0 obj
[]
endobj
213 0 obj
[208 0 R 210 0 R]
endobj
204 0 obj
<>/Height 105/Type/XObject>>stream
Ϊ>udt\ˣ2]DE#.莋|##!1gFh#8"9~#4F2j""##t]EDDFh"]DE(]FtaDG4FFhG!>]DFC\.:.:F/hԋ+t}G
#DDDDDFC#莈菑DtP莋"""""""}Jts0
endstream
endobj
212 0 obj
<>/Font<>/ProcSet 3 0 R>>
endobj
206 0 obj
<>
endobj
207 0 obj
<>
endobj
208 0 obj
<>stream
endstream
endobj
210 0 obj
<>stream
BT
0 g
/OP11Font0 11 Tf
0 0 0 rg
110 Tz
1 0 0 1 67 755 Tm
(APPENDIX 2) Tj
/OP11Font1 11 Tf
94 Tz
1 0 0 1 73 433 Tm
(13.) Tj
106 Tz
1 0 0 1 104 433 Tm
(Elastonet) Tj
/OP11Font0 11 Tf
111 Tz
1 0 0 1 115 712 Tm
(SUGGESTED FIRST AID KIT FOR MARINE MAMMALOGISTS) Tj
/OP11Font1 11 Tf
84 Tz
1 0 0 1 77 685 Tm
(1.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
109 Tz
1 0 0 1 104 684 Tm
(Antiseptic solution \(Dettol etc\)) Tj
96 Tz
1 0 0 1 76 664 Tm
(2.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
108 Tz
1 0 0 1 104 663 Tm
(Sterile Saline) Tj
111 Tz
1 0 0 1 173 663 Tm
(Washes \(wound flushing\)) Tj
96 Tz
1 0 0 1 76 643 Tm
(3.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
108 Tz
1 0 0 1 104 643 Tm
(Nail Brush) Tj
96 Tz
1 0 0 1 76 622 Tm
(4.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
110 Tz
1 0 0 1 104 621 Tm
(Antibiotic Solution \(Betadine surgical scrub\)) Tj
96 Tz
1 0 0 1 76 600 Tm
(5.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
112 Tz
1 0 0 1 104 600 Tm
(Topical Antibiotic \(Betadine dry powder spray - ointment\)) Tj
96 Tz
1 0 0 1 76 579 Tm
(6.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
110 Tz
1 0 0 1 104 578 Tm
(Wound Dressings \(Field pressure dressings\)) Tj
96 Tz
1 0 0 1 76 558 Tm
(7.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
109 Tz
1 0 0 1 104 558 Tm
(Leucopore Adhesive Tape) Tj
96 Tz
1 0 0 1 76 537 Tm
(8.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
110 Tz
1 0 0 1 104 537 Tm
(Telfa Pads \(non-adhesive dressing pads\)) Tj
96 Tz
1 0 0 1 76 517 Tm
(9.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
110 Tz
1 0 0 1 104 516 Tm
(Adhesive Butterfly Wound Sutures) Tj
94 Tz
1 0 0 1 73 496 Tm
(10.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
111 Tz
1 0 0 1 104 495 Tm
(Autraumatic Wound Sutures and Suturing Forceps) Tj
94 Tz
1 0 0 1 73 475 Tm
(11.) Tj
106 Tz
1 0 0 1 104 475 Tm
(Lignocaine) Tj
94 Tz
1 0 0 1 73 454 Tm
(12.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
108 Tz
1 0 0 1 104 453 Tm
(Crepe Bandage) Tj
94 Tz
1 0 0 1 73 413 Tm
(14.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
110 Tz
1 0 0 1 104 412 Tm
(Tube Gauze \(with applicator/s\)) Tj
94 Tz
1 0 0 1 73 392 Tm
(15.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
108 Tz
1 0 0 1 104 392 Tm
(Tetracycline \(capsule form\)) Tj
94 Tz
1 0 0 1 73 371 Tm
(16.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
110 Tz
1 0 0 1 103 371 Tm
(Erythromycin \(capsule form\)) Tj
94 Tz
1 0 0 1 73 350 Tm
(17.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
109 Tz
1 0 0 1 104 350 Tm
(Anti-inflammatory drug \(Voltarin etc\)) Tj
94 Tz
1 0 0 1 73 329 Tm
(18.) Tj
108 Tz
1 0 0 1 103 329 Tm
(Tourniquet) Tj
94 Tz
1 0 0 1 73 308 Tm
(19.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
109 Tz
1 0 0 1 103 308 Tm
(Thermometer \(clinical\)) Tj
94 Tz
1 0 0 1 72 288 Tm
(20.) Tj
107 Tz
1 0 0 1 103 288 Tm
(Scissors) Tj
101 Tz
1 0 0 1 71 267 Tm
(21.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
107 Tz
1 0 0 1 103 267 Tm
(Safety Pins) Tj
101 Tz
1 0 0 1 71 246 Tm
(22.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
110 Tz
1 0 0 1 103 246 Tm
(Pain Relief \(Temgesic etc\)) Tj
101 Tz
1 0 0 1 71 224 Tm
(23.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
109 Tz
1 0 0 1 103 224 Tm
(Aspirin, Panadol) Tj
101 Tz
1 0 0 1 71 204 Tm
(24.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
111 Tz
1 0 0 1 103 203 Tm
(Cotton Buds, Forceps, Snips \(for cutting boots etc\)) Tj
94 Tz
1 0 0 1 71 183 Tm
(25.) Tj
2000 Tz
1 0 0 1 0 841 Tm
(\t) Tj
115 Tz
1 0 0 1 102 182 Tm
(A list of local emergency contact numbers and persons \(especially cell phone\) and) Tj
111 Tz
1 0 0 1 102 168 Tm
(radio frequencies for medical services. These should be plastic laminated and kept in) Tj
107 Tz
1 0 0 1 102 155 Tm
(the kit.) Tj
110 Tz
1 0 0 1 66 126 Tm
(Note: Before departing for the field ALWAYS check team members for tolerance to specific) Tj
111 Tz
1 0 0 1 102 112 Tm
(drugs, especially aspirin and penicillin.) Tj
0 g
ET
endstream
endobj
202 0 obj
[]
endobj
201 0 obj
[196 0 R 198 0 R]
endobj
192 0 obj
<>/Height 105/Type/XObject>>stream
'EG"G"菑њ(Q:g#Gˢ>_#DDDDDDFiDtGD|8>#DDDGG#t]#,(DE#:11GPhDDhTDDbHB'0#:.`˲:/B""1u":.Gˢ:/G|NDtqDts#ƥ:#2:>莈.">GDtGT":x#xF":>q#BGF:.eDDDr#3E.莈MtGBDDF"""""3D]:#:.G.:瑴GDt{8\D!Z@&ЈNba1qED
endstream
endobj
200 0 obj
<>/Font<>/ProcSet 3 0 R>>
endobj
194 0 obj
<>
endobj
195 0 obj
<>
endobj
196 0 obj
<>stream
endstream
endobj
198 0 obj
<>stream
BT
0 g
/OP11Font0 11 Tf
0 0 0 rg
107 Tz
1 0 0 1 70 641 Tm
(Case Study) Tj
109 Tz
1 0 0 1 132 641 Tm
(5) Tj
/OP11Font1 11 Tf
113 Tz
1 0 0 1 70 598 Tm
(On 30 January 1994 a member of the Department of Conservation staff was assisting with) Tj
111 Tz
1 0 0 1 70 584 Tm
(seal surveys on Open Bay Islands, Jacksons Bay. During this work he was bitten by a young) Tj
117 Tz
1 0 0 1 70 570 Tm
(seal on the third \(ring\) finger of the left hand, cutting the skin between the hand and the) Tj
111 Tz
1 0 0 1 69 557 Tm
(proximal joint.) Tj
118 Tz
1 0 0 1 154 556 Tm
(A few of days after returning home he noted there was a little swelling) Tj
112 Tz
1 0 0 1 70 542 Tm
(around the wound which had almost closed with just a little pus visible.) Tj
114 Tz
1 0 0 1 70 515 Tm
(On 2 February 1994, three days after the bite, the hand was swollen, tender and warm. He) Tj
115 Tz
1 0 0 1 69 501 Tm
(consulted his doctor who prescribed a course of Erythromycin and advised him to return) Tj
99 Tz
1 0 0 1 69 487 Tm
(i) Tj
116 Tz
1 0 0 1 73 487 Tm
(mmediately if the symptoms did not respond to the medication. In a few days, the hand) Tj
111 Tz
1 0 0 1 69 473 Tm
(became grossly swollen and the pain intense. An x-ray of the hand was made on 8 February) Tj
112 Tz
1 0 0 1 70 459 Tm
(\(9 days following the bite\) and revealed no bone or joint involvement.) Tj
1 0 0 1 69 431 Tm
(The hand continued to swell slowly, was intensely painful and there was some concomitant) Tj
111 Tz
1 0 0 1 70 418 Tm
(swelling of axillary lymph nodes.) Tj
1 0 0 1 244 416 Tm
(Augmentin and Noroxin were prescribed without effect.) Tj
1 0 0 1 69 403 Tm
(On 14 February \(+ 15 days\) the patient was admitted to hospital and placed on intra-venous) Tj
110 Tz
1 0 0 1 69 390 Tm
(Augmentin. This reduced the pain and swelling to the point where he was discharged on oral) Tj
111 Tz
1 0 0 1 69 376 Tm
(Erythromycin on 19 February 1994 \(+20 days\).) Tj
110 Tz
1 0 0 1 69 348 Tm
(Three days later \(+23 days\) on 22 February, the patient presented again with a very hot, very) Tj
1 0 0 1 69 334 Tm
(swollen and extremely painful hand. On the advice of the author, tetracycline was prescribed) Tj
115 Tz
1 0 0 1 69 320 Tm
(and the patient commented that the effect, following the initial double dose, "was almost) Tj
99 Tz
1 0 0 1 69 307 Tm
(i) Tj
113 Tz
1 0 0 1 72 306 Tm
(mmediate". The swelling and pain reduced very quickly. Tetracycline was continued for a) Tj
116 Tz
1 0 0 1 69 293 Tm
(full 10 days.) Tj
121 Tz
1 0 0 1 146 292 Tm
(By 4 March 1994 \(+33 days\) the wounds were well healed and he had) Tj
116 Tz
1 0 0 1 68 278 Tm
(recovered full power in his grip. By 31 March only a mild swelling of the dorsum of the) Tj
108 Tz
1 0 0 1 68 265 Tm
(hand remained.) Tj
0 g
ET
endstream
endobj
190 0 obj
[]
endobj
189 0 obj
[184 0 R 186 0 R]
endobj
180 0 obj
<>/Height 105/Type/XObject>>stream
'GʄGfl_0AiEItmF#
"""""""2B#:/̏фoEQ]BDfml&PY4G#h./Rt-#)AN!͡# 0to#t_.Du.:$d|aqf:/G./ք\P!DF""'##:#>GD|":0eґ
""""""""#5!#5DtBaJȎ.͢>G@e FtGE]:.">]DRDDD`GF":#A210t]DtmDx#"""""""2dt]/GGG8tc
endstream
endobj
188 0 obj
<>/Font<>/ProcSet 3 0 R>>
endobj
182 0 obj
<>
endobj
183 0 obj
<>
endobj
184 0 obj
<>stream
endstream
endobj
186 0 obj
<>stream
BT
0 g
/OP11Font0 11 Tf
0 0 0 rg
109 Tz
1 0 0 1 71 640 Tm
(Case Study) Tj
90 Tz
1 0 0 1 133 641 Tm
(4) Tj
/OP11Font1 11 Tf
108 Tz
1 0 0 1 71 598 Tm
(In November 1974 a scientist working at the seal rookery on Open Bay Islands, Jacksons Bay,) Tj
113 Tz
1 0 0 1 71 584 Tm
(was threading a wire through a skull collected from a dead fur seal. The following account) Tj
112 Tz
1 0 0 1 71 570 Tm
(is based on the scientist's recollections and diary notes.) Tj
1 0 0 1 72 542 Tm
("As I was threading the wire, it pierced my finger but the cut was not deep and, in itself, of) Tj
110 Tz
1 0 0 1 71 528 Tm
(no significance.) Tj
116 Tz
1 0 0 1 159 528 Tm
(After 2-3 days the finger swelled, looked pasty white and became very) Tj
105 Tz
1 0 0 1 71 514 Tm
(painful.) Tj
118 Tz
1 0 0 1 118 515 Tm
(The pain spread up my arm. I vividly remember searing pain in the elbow and) Tj
109 Tz
1 0 0 1 71 500 Tm
(subsequently the shoulder joint.) Tj
110 Tz
1 0 0 1 233 501 Tm
(Approximately four days following the injury, I returned to) Tj
112 Tz
1 0 0 1 71 487 Tm
(Christchurch and consulted a doctor who diagnosed "septicaemia". I was put on a course of) Tj
116 Tz
1 0 0 1 72 473 Tm
(antibiotics and the arm was partially immobilised in a sling. The antibiotics reduced the) Tj
108 Tz
1 0 0 1 72 458 Tm
(symptoms but over the next 12 months I had recurrent bouts of "septicaemia" almost any time) Tj
114 Tz
1 0 0 1 71 445 Tm
(the skin was broken. These were treated with a variety of penicillin based drugs and other) Tj
1 0 0 1 72 431 Tm
(antibiotics but none gave more than temporary relief.) Tj
115 Tz
1 0 0 1 353 431 Tm
(Long term relief came only when) Tj
111 Tz
1 0 0 1 71 417 Tm
(prescribed double doses of two different antibiotics simultaneously.) Tj
117 Tz
1 0 0 1 72 390 Tm
(Septicaemia recurred at gradually increasing intervals for several years with symptoms) Tj
113 Tz
1 0 0 1 72 376 Tm
(identical to those described above; after two days the area around the wound would swell,) Tj
112 Tz
1 0 0 1 71 362 Tm
(become puffy and white with increasingly severe pain and tenderness. After a short 2-3 day) Tj
111 Tz
1 0 0 1 72 348 Tm
(course of antibiotics the symptoms would reduce then disappear.) Tj
1 0 0 1 71 320 Tm
(The symptoms have not recurred for the last 10 years or so and I believe the problem is now) Tj
107 Tz
1 0 0 1 71 306 Tm
(resolved.") Tj
113 Tz
1 0 0 1 71 265 Tm
(Regrettably there are no records available which describe either the diagnoses made or the) Tj
111 Tz
1 0 0 1 71 250 Tm
(drugs prescribed in this case.) Tj
0 g
ET
endstream
endobj
178 0 obj
[]
endobj
177 0 obj
[172 0 R 174 0 R]
endobj
168 0 obj
<>/Height 105/Type/XObject>>stream
z9".GFEaDub.c#:#:.#aE02!DE(C AK:h0|0>(EфGEѴ}ь#u:":#ˣh.DDDDDDDFN":/ћ7Du#Ђ>]#GDu4FDq2>]#h8̎DDDDDDDFhD|#tc/qDDDDDDDG|.}t_#=Dt]DtGFGGG""))"3Dm:#y#T(.xGr|#t"#DKEьѴGFtb>"""""3H##tG(B)#h.#0DDDDDDda莌":#ld~)G˩]/DDG|#t^#<^/QG<בtGF#>Eх$!RF#:#to75Dty>mF#>]FDDDDDDDdG/DtG#h"∈DGE:#h0Eѵ#EѼq"""""#3E6:7EDtyw4DtGEtGF/taF
endstream
endobj
176 0 obj
<>/Font<>/ProcSet 3 0 R>>
endobj
170 0 obj
<>
endobj
171 0 obj
<>
endobj
172 0 obj
<>stream
endstream
endobj
174 0 obj
<>stream
BT
0 g
/OP11Font0 11 Tf
0 0 0 rg
109 Tz
1 0 0 1 69 740 Tm
(Case Study) Tj
1 0 0 1 131 740 Tm
(3) Tj
/OP11Font1 11 Tf
111 Tz
1 0 0 1 68 711 Tm
(In January 1972 scientists were conducting field research on the Snares Island about 200 km) Tj
1 0 0 1 69 697 Tm
(south-west of New Zealand. A male Hooker's sea lion hauled out by the accommodation but) Tj
113 Tz
1 0 0 1 68 683 Tm
(where the scientists were living some distance above the sea. The animal was obviously ill) Tj
112 Tz
1 0 0 1 69 669 Tm
(and became progressively thinner over the next two months until it died in March.) Tj
109 Tz
1 0 0 1 69 641 Tm
(One scientist pulled the animal down to the tide-wash where he dissected it. His investigation) Tj
112 Tz
1 0 0 1 68 627 Tm
(revealed only a few white mites in the oesophagus and the presence of many white spots on) Tj
1 0 0 1 68 613 Tm
(the surface of the lungs.) Tj
114 Tz
1 0 0 1 69 585 Tm
(During the dissection, the scientist cut himself at the base of the right thumb.) Tj
111 Tz
1 0 0 1 468 583 Tm
(He thought) Tj
117 Tz
1 0 0 1 69 570 Tm
(little of the incident at the time but the cut did not heal. By August he noted his "energy) Tj
111 Tz
1 0 0 1 69 556 Tm
(levels had dropped to near zero" and he required a lot of sleep. Recurrent spells of lassitude) Tj
113 Tz
1 0 0 1 69 542 Tm
(came in series - "very tired for a couple of weeks, then small sores would break out on my) Tj
112 Tz
1 0 0 1 69 529 Tm
(head, shoulders and back. These sores took months to heal." In October, seven months after) Tj
120 Tz
1 0 0 1 69 515 Tm
(cutting himself during the dissection of the sea lion, a large swelling developed in the) Tj
111 Tz
1 0 0 1 69 501 Tm
(scientist's right armpit.) Tj
113 Tz
1 0 0 1 68 473 Tm
(Eleven months after the original infection the scientist, who was again in the field, slipped) Tj
111 Tz
1 0 0 1 69 459 Tm
(and fell, breaking the skin and rupturing the swollen gland in his armpit which discharged a) Tj
1 0 0 1 69 445 Tm
(substantial amount of pus.) Tj
114 Tz
1 0 0 1 208 445 Tm
(A doctor who was present cleaned and dressed the wound and) Tj
111 Tz
1 0 0 1 69 431 Tm
(gave the patient antibiotics \(unspecified\).) Tj
115 Tz
1 0 0 1 69 404 Tm
(On return to Christchurch in March, 12 months after the initial infection, the patient was) Tj
110 Tz
1 0 0 1 69 390 Tm
(given a Mantoux test to which he reacted "very positively". He was hospitalised, the infected) Tj
118 Tz
1 0 0 1 69 376 Tm
(lymph node in his armpit and a couple of the larger, slow to heal sores were surgically) Tj
109 Tz
1 0 0 1 68 362 Tm
(removed. An "atypical tuberculosis"* infection was diagnosed and he was prescribed a course) Tj
112 Tz
1 0 0 1 68 349 Tm
(of an anti-tuberculin drug, Isoniazid, for about six months.) Tj
110 Tz
1 0 0 1 68 320 Tm
(Gradually his energy levels picked up, the sores healed and it appeared that he was rid of the) Tj
106 Tz
1 0 0 1 68 307 Tm
(infection.) Tj
112 Tz
1 0 0 1 122 306 Tm
(Unfortunately this was not so. Symptoms identical to those initially experienced) Tj
114 Tz
1 0 0 1 68 292 Tm
(- a period of extreme tiredness followed by the eruption of sores which were very slow to) Tj
1 0 0 1 68 279 Tm
(heal - returned every six months or so.) Tj
117 Tz
1 0 0 1 67 251 Tm
(Eventually, these became so bad that in the late 1970s he was again prescribed a further) Tj
110 Tz
1 0 0 1 68 236 Tm
(course of Isoniazid, and then another in the early 1980s. Several more large unhealed lesions) Tj
109 Tz
1 0 0 1 67 223 Tm
(were excised.) Tj
110 Tz
1 0 0 1 67 194 Tm
(Twenty two years after cutting himself during the dissection on the Snares Islands he still has) Tj
117 Tz
1 0 0 1 67 181 Tm
(the infection and has only recently recovered from another outbreak.) Tj
120 Tz
1 0 0 1 436 180 Tm
(The onset of the) Tj
112 Tz
1 0 0 1 67 167 Tm
(complaint is predictably precipitated by stress or over-tiredness, the lesions are smaller and) Tj
1 0 0 1 67 152 Tm
(now take only 3-4 weeks to heal. The patient now feels that he has some element of control) Tj
1 0 0 1 67 139 Tm
(over the infection and can prevent a relapse by avoiding stress and fatigue where possible.) Tj
113 Tz
1 0 0 1 66 110 Tm
(It is noteworthy that various culture techniques used to isolate and specifically identify the) Tj
1 0 0 1 66 97 Tm
(organism responsible for this "atypical tuberculosis"* have, so far, been unsuccessful. The) Tj
1 0 0 1 66 83 Tm
(patient has no doubt that the infection was from the dead Hooker's sea lion he dissected.) Tj
110 Tz
1 0 0 1 66 42 Tm
(* A general term referring to tuberculosis caused by mycobacteria other than M.tuberculosis.) Tj
0 g
ET
endstream
endobj
166 0 obj
[]
endobj
165 0 obj
[160 0 R 162 0 R]
endobj
156 0 obj
<>/Height 105/Type/XObject>>stream
:qB6>GDt]|Ψ?Dv]G興8莈GF9FDEH"D]莈.фhxmQVu4GtG<^#њDDDDDFOh."#躈B"MNFh @ܧ)9-'d.#aYѾʸN莌">/Font<>/ProcSet 3 0 R>>
endobj
158 0 obj
<>
endobj
159 0 obj
<>
endobj
160 0 obj
<>stream
endstream
endobj
162 0 obj
<>stream
BT
0 g
/OP11Font0 11 Tf
0 0 0 rg
111 Tz
1 0 0 1 68 642 Tm
(Case Study 2) Tj
/OP11Font1 11 Tf
114 Tz
1 0 0 1 68 599 Tm
(In 1993 two of the curatorial staff at the Queen Victoria Museum, Launceston, Tasmania,) Tj
109 Tz
1 0 0 1 68 584 Tm
(collected two stranded cetaceans, which had been dead about 7 days, to retrieve the skeletons) Tj
114 Tz
1 0 0 1 68 570 Tm
(for display in the museum. During the recovery of the skeletons, both men were, at times,) Tj
112 Tz
1 0 0 1 68 556 Tm
(working up to their waists in sea water with viscera, tissues and body fluids floating around) Tj
110 Tz
1 0 0 1 68 542 Tm
(them - not an unusual occurrence for enthusiastic museum collectors. One of the men grazed) Tj
112 Tz
1 0 0 1 68 529 Tm
(his fingers slightly in the process.) Tj
1 0 0 1 68 501 Tm
(The bones were returned to the museum where the men began removal of the last remnants) Tj
116 Tz
1 0 0 1 68 487 Tm
(of tissue by scraping and then blasting the material from the bones using a high pressure) Tj
113 Tz
1 0 0 1 68 473 Tm
(steam cleaner. Both men were dressed in plastic coveralls.) Tj
112 Tz
1 0 0 1 68 445 Tm
(About seven days after this job, both men became lethargic. One developed swollen lymph) Tj
1 0 0 1 68 431 Tm
(nodes in the armpits and neck. The other, who had grazed his hand, developed very swollen) Tj
114 Tz
1 0 0 1 68 417 Tm
(fingers which were red and extremely sore. There was no pus present and pressure on the) Tj
113 Tz
1 0 0 1 68 404 Tm
(swelling could not produce any discharge. He also developed open sores over the skin.) Tj
111 Tz
1 0 0 1 68 376 Tm
(Both men suffered from painful conjunctivitis.) Tj
113 Tz
1 0 0 1 68 348 Tm
(The two men consulted general practitioners who were uncertain in their diagnoses. Blood) Tj
111 Tz
1 0 0 1 68 335 Tm
(tests for glandular fever proved negative.) Tj
110 Tz
1 0 0 1 280 334 Tm
(No drugs or anti-biotics were prescribed.) Tj
113 Tz
1 0 0 1 68 307 Tm
(One of the two patients is now apparently hypersensitive to whale material.) Tj
112 Tz
1 0 0 1 456 306 Tm
(Whenever he) Tj
110 Tz
1 0 0 1 67 293 Tm
(comes in contact with whale tissue or oily bones the same symptoms of lethargy and swollen) Tj
1 0 0 1 67 279 Tm
(lymph nodes recur.) Tj
112 Tz
1 0 0 1 170 278 Tm
(Whether these symptoms are the result of contact with infected tissues) Tj
110 Tz
1 0 0 1 67 265 Tm
(or inhaled infective agents in the aerosol from the steam cleaner is impossible to tell. It could) Tj
113 Tz
1 0 0 1 67 251 Tm
(be the result of either or a combination of both.) Tj
115 Tz
1 0 0 1 67 222 Tm
(The history of the patient who grazed his hand is similar to what is normally described as) Tj
107 Tz
1 0 0 1 67 209 Tm
("spekk finger".) Tj
0 g
ET
endstream
endobj
154 0 obj
[]
endobj
254 0 obj
<>stream
BT
0 0 0 rg
/T1_0 11 Tf
109 Tz 69 715 Td
(APPENDIX 1)Tj
111 Tz 1 -70 Td
(Case Study 1)Tj
/T1_1 11 Tf
116 Tz 0 -42 TD
(In July 1967 I was working as a Canadian Government biologist sampling c\
ommercially)Tj
111 Tz 0 -14 TD
(caught whales at a whaling station in Nova Scotia.)Tj
112 Tz 257 -1 Td
(Whaling had been brisk and six animals)Tj
114 Tz -257 -14 Td
(had been landed. The heads, the last part of the whales to be processed,\
had been pulled to)Tj
T*
(one side of the flensing deck pending processing. During the process of \
removing the wax)Tj
116 Tz T*
(ear plug \(used for ageing\) from the ear canal I cut the skin over the \
proximal joint of my)Tj
T*
(right index finger on a sharp sliver of bone. The wound was trivial, abo\
ut 6mm long and)Tj
81 Tz 2 -13 Td
(I)Tj
121 Tz 5 0 Td
(mm deep, lifting a small flap of skin. There was very little bleeding an\
d what blood)Tj
114 Tz -6 -14 Td
(appeared was diluted by the film of whale oil on my skin. Gloves were ra\
rely worn as the)Tj
T*
(whales landed were extremely fresh being destined for consumption.)Tj
113 Tz 360 0 Td
(On completing my)Tj
114 Tz -360 -14 Td
(sampling - about 20 minutes after cutting my hand - I cleaned and dresse\
d the wound.)Tj
-1 -28 Td
(Four days later, the area around the cut was markedly swollen, tight and\
puffy with only a)Tj
115 Tz 1 -14 Td
(little pus accumulated at the edges of the cut. The joint was extremely \
painful and stiff. I)Tj
119 Tz T*
(thought it possible that a small particle of dirt had remained in the wo\
und to cause the)Tj
0 -13 TD
(inflammation. I then soaked the finger in hot water, lanced the swelling\
and cleaned it)Tj
112 Tz 0 -14 TD
(thoroughly. Two days later the swelling had increased to involve my enti\
re hand. The index)Tj
111 Tz T*
(and second fingers were swollen to about twice normal size and immobile.\
Pain in the joints)Tj
112 Tz 0 -13 TD
(of the index finger was extreme and the whole hand throbbed heavily. Red\
stripes extended)Tj
0 -14 TD
(from the wrist halfway up my forearm.)Tj
/TT0 11 Tf
130 Tz 0 -28 TD
(I )Tj
/T1_1 11 Tf
(consulted )Tj
/TT0 11 Tf
( )Tj
/T1_1 11 Tf
(the local general practitioner and penicillin)Tj
/TT0 11 Tf
( )Tj
/T1_1 11 Tf
(as immediately given)Tj
106 Tz 0 -14 TD
(intramuscularly.)Tj
118 Tz 87 0 Td
(This was accompanied by a course of oral antibiotics for 10 days. The)Tj
115 Tz -88 -14 Td
(combination of drugs held the infection in check but neither reduced the\
swelling nor the)Tj
1 -13 Td
(stripes up my arm.)Tj
119 Tz 106 -1 Td
(Nine days after the initial cut the hand remained swollen, stiff and)Tj
112 Tz -107 -13 Td
(extremely painful.)Tj
108 Tz 106 -1 Td
(I)Tj
119 Tz 11 0 Td
(returned to the doctor who prescribed Achromycin \(tetracycline)Tj
109 Tz -117 -14 Td
(hydrochloride\) with the instruction to complete both courses of drugs. \
Two days after starting)Tj
111 Tz T*
(the second drug the swelling and reddening was reducing rapidly. Twenty \
one days after the)Tj
T*
(original wound the hand was near normal and the cut had healed. Full mob\
ility was regained)Tj
114 Tz 0 -15 TD
(after 21 days medication. There was no recurrence of any symptoms.)Tj
110 Tz 0 -28 TD
(The infection was described as "spekk finger" by Norwegian whalers who w\
ere familiar with)Tj
112 Tz -1 -13 Td
(the symptoms but, regrettably, not the cure.)Tj
100 Tz 232 607 Td
(9)Tj
ET
endstream
endobj
144 0 obj
<>/Height 105/Type/XObject>>stream
h:."?U4DtmGm菑>"""BXVke9)莋t$tB( 2Ds&T*
(r":6h#?TD B(8#!#>GVS9r>rDDDDDd_#莋h{1DDDDDDd#3.0tGEDA(Dt]tc<>]Dt]tGDt]^#1^XB"ȌDDFh菑фo.04GDt_0"""""""3DGEGEEѴGD|QP!zt"#4DtGIѴ]D|:0:#t]Q:/tGFDDDs:"mDDK#hGft_#ADDDDDDDd莋6"#<0莈"""""""#$":0莈菗ˢtb#|#A!HZ#.>GE|##tyFtGD|.莈hDDDDDDDy#Dt]aF(ЈǒtaGa.躈t]#:0""""#
endstream
endobj
232 0 obj
<>
endobj
146 0 obj
<>
endobj
147 0 obj
<>
endobj
233 0 obj
<>
endobj
142 0 obj
[]
endobj
241 0 obj
<>stream
BT
0 0 0 rg
/T1_0 11 Tf
108 Tz 71 731 Td
(REFERENCES)Tj
/T1_1 11 Tf
110 Tz 0 -28 TD
(Beck, B., Smith, T.G. 1976)Tj
/T1_2 11 Tf
113 Tz 138 -1 Td
(Seal Finger: an unsolved medical problem in Canada)Tj
/T1_1 11 Tf
108 Tz 270 0 Td
(Can Med.)Tj
109 Tz -408 -14 Td
(Assoc.J. 115:105)Tj
T*
(Candolin, Y. 1953)Tj
/T1_2 11 Tf
111 Tz 93 -1 Td
(Seal Finger \(Spekkfinger\) and its occurrence in the gulfs of the Balti\
c Sea)Tj
/T1_1 11 Tf
109 Tz -93 -13 Td
(Acta.Chir.Scand.\(Suppl.\) 177.62)Tj
112 Tz 1 -28 Td
(Cousins, D.V.,)Tj
118 Tz 80 0 Td
(Williams, S.N., Reuter, R., Foreshaw, D., Chadwick, B., Coughran, D.,)Tj
112 Tz -80 -14 Td
(Collins, P., and Gales, N. 1993)Tj
/T1_2 11 Tf
115 Tz 160 -1 Td
(Tuberculosis in wild seals and characterisation of the seal)Tj
107 Tz -160 -13 Td
(bacillus)Tj
/T1_1 11 Tf
46 -1 Td
(Aus.Vet.J.70\(3\):92-97)Tj
111 Tz -47 -28 Td
(England, G.A. 1924)Tj
/T1_2 11 Tf
108 Tz 104 0 Td
(Vikings of the Ice)Tj
/T1_1 11 Tf
112 Tz 91 0 Td
(Doubleday, New York. p.39)Tj
-194 -28 Td
(Fishman, A.P. 1988)Tj
/T1_2 11 Tf
117 Tz 105 0 Td
(Pulmonary Diseases and Disorders)Tj
/T1_1 11 Tf
116 Tz 187 0 Td
(Vol.3 \(2nd Edit.\) McGraw Hill,)Tj
107 Tz -292 -13 Td
(Auckland)Tj
115 Tz T*
(Geraci, J.R. and Valeria J. Lounsbury 1993)Tj
/T1_2 11 Tf
226 -1 Td
(Marine Mammals Ashore: A Field Guide for)Tj
110 Tz -226 -13 Td
(Strandings)Tj
/T1_1 11 Tf
111 Tz 60 -1 Td
(Texas A&M University Sea Grant College Program Publication TAMU-SG-93-)Tj
105 Tz -60 -13 Td
(601 ISBN 1-883550-01-7)Tj
T*
(Lavaag, K. 1940)Tj
/T1_2 11 Tf
90 Tz 82 0 Td
(To)Tj
107 Tz 15 -1 Td
(tilfelle av 'Spekkfinger' Tisskrift fur Den Norske Tegeforening)Tj
/T1_1 11 Tf
302 0 Td
(60:173-178)Tj
108 Tz -399 -27 Td
(Markham, R.B. and B. Frank Polk 1979)Tj
/T1_2 11 Tf
114 Tz 195 0 Td
(Seal Finger)Tj
/T1_1 11 Tf
107 Tz 60 0 Td
(Reviews of Infectious Diseases Vol. 1\(3\):)Tj
106 Tz -255 -13 Td
(567-569)Tj
110 Tz T*
(Panagis, K., Apps P., and Knight, M.H. 1982)Tj
/T1_2 11 Tf
112 Tz 227 -1 Td
(Seal Finger: occurrence in Antarctica)Tj
/T1_1 11 Tf
105 Tz 191 0 Td
(S.Afr.J.)Tj
108 Tz -418 -13 Td
(Antarct.Res.,Vol.12, 1982)Tj
107 Tz T*
(Rodahl, K. 1943)Tj
/T1_2 11 Tf
110 Tz 81 -1 Td
(Notes on the prevention and treatment of 'Spekkfinger')Tj
/T1_1 11 Tf
109 Tz 270 0 Td
(Polar Reocrd 4:17-18)Tj
127 Tz -351 -27 Td
(Suer, I.D. and Neylan A Vedros 1988)Tj
/T1_2 11 Tf
120 Tz 222 -1 Td
(Erysipelothirx rhusiopathiae.I. Isolation and)Tj
113 Tz -223 -13 Td
(characterization from pinnipeds and bite/abrasion wounds in humans)Tj
/T1_1 11 Tf
109 Tz 350 -1 Td
(Dis.aquat.Org.5: 1-5)Tj
108 Tz -350 -28 Td
(Thompson, P.J., Cousins, D.V., Gow, B.L., Collins, D.M., Williamson, B.H\
., and Dagnis, H.T.)Tj
100 Tz 1 -13 Td
(1993)Tj
/T1_2 11 Tf
112 Tz 27 -1 Td
(Seals, Seal Trainers, and Mycobacterial Infection)Tj
/T1_1 11 Tf
110 Tz 251 0 Td
(Am.Rev.Respir.Dis.147: 164-167)Tj
/T1_0 11 Tf
108 Tz -279 -28 Td
(Acknowledgements)Tj
/TT0 11 Tf
113 Tz T*
(I )Tj
/T1_1 11 Tf
(would like to thank the following for their interest and support:)Tj
112 Tz 0 -14 TD
(Steve Attwood, Marthan Bester, Fred Bruemmer, Debby Cousins, Anna Dyzel,\
Nick Gales,)Tj
108 Tz -1 -13 Td
(Joe Geraci,)Tj
109 Tz 61 -1 Td
(Mike Hine, Don Horning, Gerald McCormack, Simon Mitchell, Chris Robertso\
n,)Tj
111 Tz -61 -14 Td
(Peter Shaughnessy, Tom Smith and Kerry-Jane Wilson.)Tj
100 Tz 233 637 Td
(8)Tj
ET
endstream
endobj
131 0 obj
<>/Height 105/Type/XObject>>stream
B.DraaEDDFP#2<]Fh]EѴGZDDDDb"""#фf!FqeYXPYCSrH#h$DGG0H/E:#>mDDDDDG4Ef/GQQ"莈#B.GD?FOф]t]3DtqDDDDDDFt9Ⱥ#GQ2md~""""""2GfGEFqхQNфGDtaE|.""""""3LGF/EGDtf"-1!fA3Tr
endstream
endobj
133 0 obj
<>
endobj
134 0 obj
<>
endobj
135 0 obj
<>
endobj
129 0 obj
[]
endobj
128 0 obj
[123 0 R 125 0 R]
endobj
119 0 obj
<>/Height 105/Type/XObject>>stream
8DvmDtGE莈莋tb/DDDDDDDeZ69E6:#GE6""B""""0:0tGQф_4Eta#""""""#:":0tGD|7F"9:7Fa:#"""""9:&J#|莍t]NDDDDb<#DtGD|7&SR.쎈#]EԈ]"#وtfDvGQ:/E菘QѴGDtD:#FkEIFt_.#~""""""#:eG
endstream
endobj
127 0 obj
<>/Font<>/ProcSet 3 0 R>>
endobj
121 0 obj
<>
endobj
122 0 obj
<>
endobj
123 0 obj
<>stream
endstream
endobj
125 0 obj
<>stream
BT
0 g
/OP11Font0 11 Tf
0 0 0 rg
108 Tz
1 0 0 1 70 719 Tm
(RECOMMENDATIONS) Tj
/OP11Font1 11 Tf
84 Tz
1 0 0 1 79 677 Tm
(1.) Tj
96 Tz
1 0 0 1 78 635 Tm
(2.) Tj
1 0 0 1 79 593 Tm
(3.) Tj
109 Tz
1 0 0 1 78 537 Tm
(4.) Tj
96 Tz
1 0 0 1 79 509 Tm
(5.) Tj
109 Tz
1 0 0 1 78 467 Tm
(6.) Tj
1 0 0 1 78 426 Tm
(7.) Tj
96 Tz
1 0 0 1 79 384 Tm
(8.) Tj
109 Tz
1 0 0 1 78 343 Tm
(9.) Tj
90 Tz
1 0 0 1 300 777 Tm
(7) Tj
124 Tz
1 0 0 1 107 676 Tm
(All people working with whales or seals should be advised of the nature and) Tj
111 Tz
1 0 0 1 107 662 Tm
(symptoms of seal/spekk finger and mycobacterial infections.) Tj
112 Tz
1 0 0 1 107 634 Tm
(They must be aware of the need for prompt attention to any wounds, however trivial) Tj
1 0 0 1 107 620 Tm
(they may seem, and the need for good personal hygiene.) Tj
1 0 0 1 107 592 Tm
(Marine mammal workers who are handling animals must have the appropriate drugs) Tj
125 Tz
1 0 0 1 107 578 Tm
(in their medical kits which should always be close to hand.) Tj
120 Tz
1 0 0 1 448 577 Tm
(Kits should be) Tj
109 Tz
1 0 0 1 107 564 Tm
(comprehensive and practical.) Tj
112 Tz
1 0 0 1 107 536 Tm
(Wear good \(untorn\) gloves when handling animals, carcasses or tissues.) Tj
113 Tz
1 0 0 1 107 508 Tm
(Wear waterproof clothing to prevent clothing being contaminated by fluids such as) Tj
108 Tz
1 0 0 1 107 495 Tm
(blood.) Tj
113 Tz
1 0 0 1 107 466 Tm
(After completing necropsies, all clothing and reusable equipment must be scrubbed) Tj
107 Tz
1 0 0 1 107 453 Tm
(clean.) Tj
112 Tz
1 0 0 1 144 452 Tm
(Hands must be washed clean, then scrubbed with antiseptic.) Tj
122 Tz
1 0 0 1 107 425 Tm
(Medical staff nearest the work sites should be informed of the symptoms and) Tj
109 Tz
1 0 0 1 107 411 Tm
(treatment of these infections.) Tj
110 Tz
1 0 0 1 107 384 Tm
(Any bites, grazes or cuts resulting from handling marine mammals should be reported) Tj
104 Tz
1 0 0 1 107 371 Tm
(to) Tj
112 Tz
1 0 0 1 120 370 Tm
(medical staff with remarks as to the source of the injury.) Tj
116 Tz
1 0 0 1 107 342 Tm
(A comprehensive investigative programme should be put in place to ascertain the) Tj
111 Tz
1 0 0 1 107 328 Tm
(possible sources and extent of these infective agents in seals and whales around New) Tj
104 Tz
1 0 0 1 107 315 Tm
(Zealand.) Tj
0 g
ET
endstream
endobj
117 0 obj
[]
endobj
237 0 obj
<>stream
BT
0 0 0 rg
/T1_0 11 Tf
108 Tz 73 720 Td
(CONCLUSIONS)Tj
/T1_1 11 Tf
116 Tz 0 -29 TD
(It is now clear that some southern hemisphere seals carry both the bacte\
rial agent which)Tj
112 Tz 0 -14 TD
(causes "seal finger" and also mycobacteria, especially variants of M.bov\
is, which is readily)Tj
114 Tz T*
(transmitted to humans either through aerosols from sneezes, coughs and b\
arks, or directly)Tj
T*
(through broken skin. The spores of mycobacteria, which have a waxy coat,\
are resistant to)Tj
T*
(environmental degradation and can remain viable in sediments and soil fo\
r many years. In)Tj
115 Tz T*
(New Zealand, M.bovis has been a problem in domestic cattle, wild possums\
\(brush tailed)Tj
116 Tz T*
(phalangers\) and deer for many years. The disease may have been contract\
ed by seals via)Tj
112 Tz T*
(carcasses of these carriers which have been washed down rivers to the se\
a in the vicinity of)Tj
T*
(seal haulouts or rookeries or from the body wastes of feral deer.)Tj
111 Tz 0 -29 TD
(There is an obvious need for a comprehensive study to clarify the range,\
taxonomic position)Tj
112 Tz 0 -14 TD
(and origin of the mycobacteria involved in infections from seals.)Tj
0 -27 TD
(The agent causing seal finger is probably endemic in seals world-wide. I\
nfections have now)Tj
110 Tz 0 -14 TD
(been recorded not only from the northern hemisphere, but also from New Z\
ealand, Australia,)Tj
0 -13 TD
(South Africa and Antarctica.)Tj
112 Tz 0 -29 TD
(The risk of infection is low in healthy people who take normal precautio\
ns, are free of other)Tj
116 Tz 0 -14 TD
(infections and are not taking any immunosuppressant drugs. If infection \
does occur, it is)Tj
99 Tz 0 -13 TD
(i)Tj
112 Tz 4 0 Td
(mportant to recognise whether it is seal finger or a mycoplasma since th\
e treatment for one)Tj
111 Tz -4 -14 Td
(is quite ineffective against the other.)Tj
114 Tz 0 -27 TD
(Seal finger infection follows a regular course which is specific to this\
disease. It normally)Tj
0 -14 TD
(responds positively to tetracycline.)Tj
119 Tz 189 0 Td
(If left untreated, the chronic infection can result in)Tj
108 Tz -189 -14 Td
(permanent disability.)Tj
112 Tz 111 0 Td
(Mycobacterial infections similarly follow a prescribed course typical)Tj
110 Tz -111 -14 Td
(of non-tubercular infections. These usually respond to Streptomycin, Iso\
niazid Rifampin and)Tj
108 Tz 0 -13 TD
(similar drugs.)Tj
100 Tz 230 447 Td
(6)Tj
ET
endstream
endobj
107 0 obj
<>/Height 105/Type/XObject>>stream
=y=tG/фGB<@B#dvx2]E7ˠ@GG(#>h菘FD|6eքL!DF"""&4#;#yDt1>"ьEDDDDDd<莈.
""""9:#tGD|tFDDDDg\qለD|DtG̺#toGDDraFh##G.""""""3DG_.d|(Eto. GG!.|]tqDtaQDtGEGE.莋y|")DD54B#:6:.e莏Dt]х
endstream
endobj
109 0 obj
<>
endobj
110 0 obj
<>
endobj
105 0 obj
[]
endobj
236 0 obj
<>stream
BT
0 0 0 rg
/T1_0 11 Tf
118 Tz 63 730 Td
(M.bovis, the species most often implicated in infections contracted from\
seals.)Tj
110 Tz 426 0 Td
(These)Tj
111 Tz -426 -14 Td
(organisms are responsible for more than 95% of the pulmonary bacterioses\
in the world, are)Tj
112 Tz 0 -14 TD
(environmentally resistant and are regarded as contagious from person to \
person.)Tj
111 Tz -1 -30 Td
(Mycobacterial disease is spread either through inhalation of aerosol bor\
ne bacilli or through)Tj
113 Tz 0 -15 TD
(direct transfer through broken skin.)Tj
115 Tz 190 1 Td
(The distribution of extrapulmonary infections are as)Tj
109 Tz -190 -14 Td
(follows: lymphatic 27.5%, pleural 23.4%, genitourinary 12.7%, other 36.4\
% \(Fishman 1988\).)Tj
/T1_1 11 Tf
0 -29 TD
(Symptoms)Tj
/T1_0 11 Tf
1 -27 Td
(The usual nondescript systemic symptoms of mycobacterial disease include\
slow, progressive)Tj
114 Tz 0 -15 TD
(fatigue, anorexia, weight loss, irregular menses, and low grade fevers o\
ver many weeks to)Tj
107 Tz 0 -14 TD
(months.)Tj
115 Tz 49 1 Td
(The standard tuberculin skin test utilises the intracutaneous \(Mantoux\)\
method,)Tj
113 Tz -49 -14 Td
(where the testing agent is injected into the skin of the dorsal area of \
the forearm.)Tj
/T1_1 11 Tf
109 Tz 0 -29 TD
(Treatment)Tj
/T1_0 11 Tf
112 Tz 0 -27 TD
(The approach to treatment varies with the species. Certain antibiotics t\
hat are of little use in)Tj
110 Tz 1 -14 Td
(the treatment of M.tuberculosis sometimes give good results in treating \
diseases produced by)Tj
106 Tz 0 -14 TD
(other mycobacteria.)Tj
110 Tz 103 1 Td
(Unfortunately, standardised treatment regimens for mycobacteriosis are)Tj
111 Tz -103 -14 Td
(not available because the diseases the mycobacteria cause are relatively\
uncommon.)Tj
115 Tz 0 -28 TD
(Commonly used drugs in the treatment of mycobacterial disease are Isonia\
zid, Rifampin,)Tj
111 Tz 0 -14 TD
(Streptomycin, Pyrazinamide and Ethambutol \(Fishman 1988\).)Tj
/T1_1 11 Tf
0 -41 TD
(SPEKK FINGER AND INFECTIONS FROM WHALES)Tj
/T1_0 11 Tf
112 Tz 0 -28 TD
(Contamination of humans from cetaceans is relatively unusual compared to\
the incidence of)Tj
110 Tz 0 -15 TD
(infections from seals.)Tj
114 Tz 115 1 Td
(The risks of disease are low if those involved take normal, sensible)Tj
110 Tz -115 -14 Td
(precautions, wear appropriate clothing and keep clean. In my experience,\
bacterial infections)Tj
119 Tz 1 -14 Td
(of injuries are few among flensers, lemmers, biologists and others worki\
ng at whaling)Tj
103 Tz 0 -14 TD
(stations.)Tj
114 Tz 48 0 Td
(The main reason for this is probably the freshness of the meat and blubb\
er being)Tj
110 Tz -49 -14 Td
(handled, as most of the product, in recent time, was destined for either\
human or high quality)Tj
111 Tz T*
(animal food.)Tj
119 Tz 0 -28 TD
(My own case of "spekk finger", detailed in Case Study 1, was a result of\
working with)Tj
112 Tz 1 -14 Td
(material which, although fresh when landed, had been sitting in the warm\
sun for a number)Tj
113 Tz -1 -14 Td
(of hours. Infection was assisted by tardy treatment of an apparently ins\
ignificant wound.)Tj
110 Tz T*
(Case Study 2, demonstrated the ease by which probable mycobacteria from \
long dead whales)Tj
117 Tz 0 -14 TD
(can infect workers, either through wounds or by inhalation of aerosols, \
in this case from)Tj
110 Tz T*
(steam cleaning of skeletal material.)Tj
112 Tz 182 0 Td
(Neither patient received the appropriate treatment. The)Tj
117 Tz -182 -14 Td
(subsequent hypersensitivity of one patient in Case Study 2 to handling w\
hale material is)Tj
107 Tz T*
(unexplained.)Tj
/T1_1 11 Tf
109 Tz 0 -28 TD
(Treatment)Tj
/T1_0 11 Tf
119 Tz 1 -22 Td
(The bacteria Erysipelothrix sp. has been isolated from a number of tooth\
ed whales and)Tj
112 Tz 0 -14 TD
(generally responds to penicillin.)Tj
100 Tz 237 729 Td
(5)Tj
ET
endstream
endobj
95 0 obj
<>/Height 105/Type/XObject>>stream
E~fOE:#Ȏ6""""""莍:1"]Ke%##ȎEф]
""""""#$">^/F`ͣhP4GDtGt^.'DDDDDDr|94SD]ts0fs#:.iDbhhRt$tm:. >GQ._.#4aD|∈j<.":..ѴGDtaFE!hR""#4JD|GDs.ez""""#4D|#FѴGF2.""""""9'EZ#Ld|GF2!F2#?.0>Gˢ:/DDDDE)4D|F""GGDGEtGE:#6GEtmfDDDDDDDfh"1#h1DtGDu.#G#."tGD~" %t!"3D]DtG@Db""""kˢ:#Ȓ(B""1Ѵ_#tmta:.#DDDDDFfDbT">
endobj
98 0 obj
<>
endobj
93 0 obj
[]
endobj
92 0 obj
[87 0 R 89 0 R]
endobj
83 0 obj
<>/Height 105/Type/XObject>>stream
E5#4EDfhѼfȺ/Dt]DDDDDDDF7#fD:#:#9$DDDDDDeGGф]0"""""34GD|G͢>^7фGQаB" DFh#yt_#_/DtGDu/taDtG_#>]ʊ 쏗2]DDDDDDDG>=(AYtGDr#]GDDF"""%:ѴmFyqDtaDDDDFg>GDxd|ѴGGEDDDYBB<G#|#h"!GD||DDDDDDFf##:#:#.tGqGFxG8mGQ]o<C#DDr_8vf菙tc
endstream
endobj
91 0 obj
<>/Font<>/ProcSet 3 0 R>>
endobj
85 0 obj
<>
endobj
86 0 obj
<>
endobj
87 0 obj
<>stream
endstream
endobj
89 0 obj
<>stream
BT
0 g
/OP11Font0 11 Tf
0 0 0 rg
112 Tz
1 0 0 1 56 654 Tm
(It is important to realise that the primary focus of mycobacterial infection is not necessarily) Tj
114 Tz
1 0 0 1 55 640 Tm
(the respiratory system.) Tj
119 Tz
1 0 0 1 183 640 Tm
(The infection can readily be sited in complex tissues and their) Tj
110 Tz
1 0 0 1 56 626 Tm
(accompanying lymph nodes.) Tj
1 0 0 1 56 598 Tm
(In 1972 a scientist working at the Snares Islands conducted a necropsy on a New Zealand sea) Tj
108 Tz
1 0 0 1 56 584 Tm
(lion \(Phocarctos hookeri\).) Tj
110 Tz
1 0 0 1 188 583 Tm
(During the course of the necropsy he noted that "the lung's linings) Tj
117 Tz
1 0 0 1 56 569 Tm
(had many white spots on them". The scientist accidentally cut the skin at the base of his) Tj
110 Tz
1 0 0 1 56 555 Tm
(right thumb. The wound would not heal properly and five months later his "energy levels had) Tj
113 Tz
1 0 0 1 56 541 Tm
(dropped to near zero". He would become very tired for a couple of weeks, then small sores) Tj
112 Tz
1 0 0 1 56 527 Tm
(would break out over his head, shoulders and back. These sores would take months to heal.) Tj
114 Tz
1 0 0 1 56 514 Tm
(Seven months after the accident a large lymph node swelled up in his right armpit. During) Tj
110 Tz
1 0 0 1 56 500 Tm
(field work the node ruptured and discharged. The wound was cleaned and treated by a doctor) Tj
111 Tz
1 0 0 1 56 486 Tm
(who put the patient on a course of antibiotics. One year after the original accident, a number) Tj
113 Tz
1 0 0 1 56 472 Tm
(of affected lymph nodes were excised along with some of the slow to heal sores nearby.) Tj
111 Tz
1 0 0 1 56 444 Tm
(The patient responded positively to a Mantoux test \(a specific test for tuberculosis infection\)) Tj
117 Tz
1 0 0 1 56 430 Tm
(and was put on a course of Isoniazid to combat what had been diagnosed as an atypical) Tj
108 Tz
1 0 0 1 56 417 Tm
(tuberculosis infection.) Tj
112 Tz
1 0 0 1 172 416 Tm
(The patient is still affected by the disease which will manifest itself) Tj
1 0 0 1 56 403 Tm
(following periods of stress or fatigue.) Tj
114 Tz
1 0 0 1 252 402 Tm
(All attempts to isolate and identify the causal agent) Tj
113 Tz
1 0 0 1 55 389 Tm
(of the patient's infection have, so far, been unsuccessful \(Case Study 3\).) Tj
110 Tz
1 0 0 1 55 361 Tm
(Between 1980 and 1985, during field work on sea lions at the Auckland Islands south of New) Tj
114 Tz
1 0 0 1 55 347 Tm
(Zealand, my assistant and I routinely necropsied dead animals to try to ascertain causes of) Tj
104 Tz
1 0 0 1 55 334 Tm
(death.) Tj
115 Tz
1 0 0 1 55 305 Tm
(Three mature female sea lions were noted to have creamy white caseous nodules over the) Tj
118 Tz
1 0 0 1 55 292 Tm
(surface of the lungs and pleura.) Tj
120 Tz
1 0 0 1 232 291 Tm
(Examination of a dead male fur seal with worn teeth) Tj
113 Tz
1 0 0 1 55 278 Tm
(revealed masses of white modules over the lungs and pleura. The thoracic cavity contained) Tj
114 Tz
1 0 0 1 55 264 Tm
(a considerable quantity of thick, whitish fluid.) Tj
115 Tz
1 0 0 1 299 263 Tm
(The assessment of a veterinarian was that) Tj
1 0 0 1 54 250 Tm
(these animals had probably all succumbed to "verminous pneumonia".) Tj
116 Tz
1 0 0 1 426 249 Tm
(This is normally) Tj
115 Tz
1 0 0 1 54 235 Tm
(caused by invasion of lung tissue by nematodes which can lead to bacterial infection. Sea) Tj
121 Tz
1 0 0 1 54 221 Tm
(lions are commonly parasitised although, to date, lung worms have not been found in) Tj
112 Tz
1 0 0 1 54 207 Tm
(Hooker's sea lion \(Phocarctos hookeri\). Bacterial pneumonia is a common cause of death in) Tj
110 Tz
1 0 0 1 54 193 Tm
(older sea lions. Clearly, from evidence such as that presented in Case Study 3, mycobacterial) Tj
111 Tz
1 0 0 1 54 180 Tm
(infections are also a factor.) Tj
113 Tz
1 0 0 1 53 151 Tm
(The pathogenesis of pulmonary tuberculosis has been well described. The tissue necrosis is) Tj
114 Tz
1 0 0 1 53 137 Tm
(described as "caseous", because it resembles cheese, being homogenous, yellow-white and) Tj
113 Tz
1 0 0 1 53 123 Tm
(rich in lipids and proteins derived from tubercle bacilli and dead cells.) Tj
109 Tz
1 0 0 1 53 95 Tm
(Non-tuberculous mycobacteria \(NTM\) are now a well-recognised cause of pulmonary disease.) Tj
113 Tz
1 0 0 1 52 81 Tm
(NTM are ubiquitous inhabitants of the natural environment and exist in a variety of animal) Tj
112 Tz
1 0 0 1 52 68 Tm
(hosts and non-biologic reservoirs, including the soil and water.) Tj
1 0 0 1 52 40 Tm
(The major members of the M.tuberculosis complex of mycobacteria are M.tuberculosis, and) Tj
109 Tz
1 0 0 1 280 762 Tm
(4) Tj
0 g
ET
endstream
endobj
81 0 obj
[]
endobj
80 0 obj
[75 0 R 77 0 R]
endobj
71 0 obj
<>/Height 105/Type/XObject>>stream
3GFtb1DtGˢ:0qHDF""#'BH@ .*DDDDYH#:1c#:#DDDDDDDf.F:6>aR|1hDDFB3DGD|#9E.#ф]DDDDDDDDFh>G莌":0GGEQ'7DDrt{5(F2GD|躚fDGaEt]莋>aMHDDR#AB#Sȿ'Gto#;#t]B1':3F1фGFtDDDDDDb$tGEE:#:4Rx"""""1e(G#>m=tc##"""#">/Font<>/ProcSet 3 0 R>>
endobj
73 0 obj
<>
endobj
74 0 obj
<>
endobj
75 0 obj
<>stream
endstream
endobj
77 0 obj
<>stream
BT
0 g
/OP11Font0 11 Tf
0 0 0 rg
114 Tz
1 0 0 1 67 691 Tm
(Typically the infection is through an insignificant wound, such as a small bite, cut, scratch) Tj
119 Tz
1 0 0 1 67 676 Tm
(or graze. In three to seven days a small swelling may be noted at the site of the wound) Tj
116 Tz
1 0 0 1 67 663 Tm
(which may otherwise appear normal.) Tj
119 Tz
1 0 0 1 271 662 Tm
(The nearest joint usually becomes stiff, hot and) Tj
110 Tz
1 0 0 1 67 649 Tm
(exceptionally painful.) Tj
114 Tz
1 0 0 1 184 648 Tm
(Throbbing pain, exacerbated by sudden movement, can become so) Tj
110 Tz
1 0 0 1 67 634 Tm
(severe that the patients are prevented from sleeping. Swelling varies, but can cause the finger) Tj
113 Tz
1 0 0 1 67 620 Tm
(to enlarge to three times normal size and may spread to involve the entire hand, which can) Tj
111 Tz
1 0 0 1 67 607 Tm
(eventually look like an over-inflated rubber glove.) Tj
113 Tz
1 0 0 1 323 606 Tm
(Abscesses do not form, although a thick) Tj
112 Tz
1 0 0 1 67 592 Tm
(plasma-like fluid may exude from the skin. Red lines may appear on the skin, running from) Tj
114 Tz
1 0 0 1 67 578 Tm
(the site of infection along the lymph vessels to the nearby lymph nodes, eg in the axilla or) Tj
107 Tz
1 0 0 1 67 565 Tm
(groin.) Tj
/OP11Font1 11 Tf
112 Tz
1 0 0 1 67 537 Tm
(Treatment of Seal Finger) Tj
/OP11Font0 11 Tf
114 Tz
1 0 0 1 67 508 Tm
(Untreated, seal finger infections will take from three to six months to resolve, especially if) Tj
112 Tz
1 0 0 1 67 495 Tm
(there is any joint involvement.) Tj
110 Tz
1 0 0 1 67 467 Tm
(Early treatments used by sealers, other than amputation, usually involved poultices. The most) Tj
119 Tz
1 0 0 1 67 453 Tm
(extreme of these treatments is described by Rodahl \(1943\). "A thick layer of soft soap) Tj
111 Tz
1 0 0 1 67 439 Tm
(\(sometimes mixed with ordinary washing soda\) is spread on the infected hand. The covering) Tj
113 Tz
1 0 0 1 67 425 Tm
(bandage is from time to time placed in boiling water. Naturally, this treatment is extremely) Tj
1 0 0 1 67 411 Tm
(painful, but the prognosis is said to be good." Other treatments said to be less radical - and) Tj
110 Tz
1 0 0 1 67 398 Tm
(less effective - were poultices of camphor oil, and flour and alcohol pastes. These treatments) Tj
111 Tz
1 0 0 1 67 384 Tm
(were less a reflection of contemporary medical knowledge than the hopeful use of materials) Tj
113 Tz
1 0 0 1 67 371 Tm
(available in ships' medicine chests at the time.) Tj
112 Tz
1 0 0 1 67 343 Tm
(The bacterial etiology of seal finger remains obscure.) Tj
114 Tz
1 0 0 1 342 342 Tm
(All that can be said definitely about) Tj
1 0 0 1 67 328 Tm
(the agent of seal finger is that it appears to be resistant in vivo to penicillin, sulfonamides,) Tj
111 Tz
1 0 0 1 67 314 Tm
(and erythromycin, and is sensitive to tetracycline \(Markham and Polk 1979\).) Tj
116 Tz
1 0 0 1 66 287 Tm
(Broad spectrum tetracycline based drugs which have been successfully used to treat seal) Tj
110 Tz
1 0 0 1 66 273 Tm
(finger are Achromycin \(Beck and Smith 1976\), Vibramycin \(Shaughnessy pers comm. 1994,) Tj
113 Tz
1 0 0 1 66 259 Tm
(Panagis et al 1982\), Tetracycline \(Markham and Polk 1979\), Aureomycin and Ledermycin) Tj
111 Tz
1 0 0 1 66 246 Tm
(\(Panagis et al 1982\).) Tj
/OP11Font1 11 Tf
1 0 0 1 66 203 Tm
(MYCOBACTERIAL INFECTIONS FROM SEALS) Tj
/OP11Font0 11 Tf
121 Tz
1 0 0 1 65 174 Tm
(The stranding and death of seals and sea lions, particularly old animals, is frequently) Tj
114 Tz
1 0 0 1 65 160 Tm
(associated with bacterial pneumonia which is one of the most common diseases of marine) Tj
110 Tz
1 0 0 1 65 146 Tm
(mammals. The bacteria most commonly isolated from stranded pinnipeds are similar to those) Tj
122 Tz
1 0 0 1 65 132 Tm
(reported in cetaceans and include Pseudomonas, Staphylococcus, Streptococcus and) Tj
111 Tz
1 0 0 1 65 118 Tm
(Salmonella \(Cousins et al 1993\). Recently, for the first time a form of Mycobacterium bovis) Tj
113 Tz
1 0 0 1 64 104 Tm
(has been isolated from tissues of Australian sea lions \(Neophoca cinerea\) and New Zealand) Tj
119 Tz
1 0 0 1 64 91 Tm
(fur seals \(Arctocephalus forsteri\) in) Tj
113 Tz
1 0 0 1 260 90 Tm
(Western Australia.) Tj
119 Tz
1 0 0 1 368 90 Tm
(This infection received some) Tj
113 Tz
1 0 0 1 64 77 Tm
(prominence when it was revealed that in 1988 a seal trainer who was employed at a marine) Tj
111 Tz
1 0 0 1 64 63 Tm
(park in Western Australia developed pulmonary tuberculosis; the most likely cause being via) Tj
114 Tz
1 0 0 1 64 50 Tm
(aerosol transmission of the infective agent through close contact with barking or sneezing) Tj
106 Tz
1 0 0 1 62 39 Tm
(seals) Tj
/OP11Font1 11 Tf
72 Tz
1 0 0 1 86 39 Tm
(.) Tj
/OP11Font0 11 Tf
90 Tz
1 0 0 1 300 778 Tm
(3) Tj
0 g
ET
endstream
endobj
69 0 obj
[]
endobj
235 0 obj
<>stream
0 0 0 RG
q 1 0 0 1 338 550 cm
0 0 m
116 0 l
S
Q
q 1 0 0 1 234 509 cm
0 0 m
141 0 l
S
Q
BT
0 0 0 rg
/T1_0 11 Tf
112 Tz 68 705 Td
(infection to be established \(Rodahl, 1943; Markham and Polk, 1979\) and\
, as Rodahl \(1943\))Tj
0 -14 TD
(observed, "spekk finger occurs most frequently among people who take lit\
tle personal care,)Tj
114 Tz T*
(and who seldom clean their hands properly with hot water and soap". \(Ca\
se studies 1, 4 &)Tj
100 Tz T*
(5.\))Tj
115 Tz 22 0 Td
(Rodahl also noted, "It is a striking fact that Greenland Eskimos appear \
to be immune)Tj
110 Tz -22 -14 Td
[(from spekk finger, while it is quite common among European hunters.")-651(Whether this alleged)]TJ
/TT0 11 Tf
113 Tz T*
(i)Tj
/T1_0 11 Tf
(mmunity is a result of personal hygiene, more skilful technique or an hi\
storic immunity is)Tj
110 Tz T*
(unknown. Among the Aleuts who skinned fur seals on St Paul Island, Alask\
a, seal finger was)Tj
113 Tz T*
(a common problem infecting many of the men working there during the seal\
ing season. \(F.)Tj
109 Tz 0 -13 TD
(Bruemmer pers.comm.\))Tj
113 Tz 0 -29 TD
(People who developed infections after working with whales have often ass\
umed they have)Tj
109 Tz 1 -14 Td
("seal finger" as the symptoms can be almost identical.)Tj
110 Tz 269 -1 Td
(Erysipelothrix insidiosa)Tj
72 Tz 116 0 Td
(,)Tj
109 Tz 6 0 Td
(the causative)Tj
-392 -13 Td
(agent of erysipeloid, has been isolated from the following dolphin speci\
es, Tursiops truncatus,)Tj
112 Tz 0 -14 TD
(T.aduncus, Stenella plagiodon, Grampus griseus, and Lagenorynchus obliqu\
idens \(Suer and)Tj
110 Tz 1 -13 Td
(Vedros 1988\).)Tj
116 Tz 84 -1 Td
(The bacterium)Tj
112 Tz 81 0 Td
(Erysipelothrix rhusiopathiae)Tj
121 Tz 148 0 Td
(has been isolated from the)Tj
117 Tz -314 -14 Td
(teeth/gum margin area of 2-year old northern fur seals, northern elephan\
t seals, Atlantic)Tj
112 Tz 1 -14 Td
(herring fish meal and bite wounds in marine mammal handlers \(Suer and V\
edros 1988\).)Tj
/T1_1 11 Tf
111 Tz -1 -27 Td
(Symptoms of Seal Finger)Tj
/T1_0 11 Tf
124 Tz 1 -28 Td
(In his classic 1924 description of the commercial seal hunt on the ice n\
orth-east of)Tj
111 Tz -1 -14 Td
(Newfoundland, George Allen England sparingly stated, "Some of the wounds\
on account \(it)Tj
115 Tz 1 -13 Td
(is said\) of the seal fat, develop terrific infections.)Tj
261 -1 Td
(Seal fingers are such infections of the)Tj
103 Tz -261 -13 Td
(hands.")Tj
113 Tz -1 -28 Td
(Rodahl's \(1943\) description of the symptoms is somewhat fuller. "When \
infected, a sudden)Tj
T*
(painful swelling of the finger occurs; the skin takes a reddish colour, \
with a somewhat taut)Tj
T*
(and shiny appearance. The affected area is soft and swollen, due to a th\
ick colourless fluid;)Tj
105 Tz 0 -13 TD
(in)Tj
117 Tz 14 -1 Td
(most cases there is no pus. The patient complains of severe local pain a\
nd stiff joints.)Tj
116 Tz -14 -14 Td
(Throbbing is very marked. In many cases the whole arm becomes swollen, b\
ut the site of)Tj
115 Tz 0 -14 TD
(the infection in all cases I have examined has been the fingers. The axi\
llary lymph glands)Tj
111 Tz 0 -13 TD
(may also be swollen.")Tj
0 -29 TD
(Although seal finger is relatively common in the northern hemisphere, on\
ly three cases have)Tj
109 Tz 0 -14 TD
(been reported from Antarctica \(Lavaag 1940, Panagis et al 1982\). In th\
e most recent incident,)Tj
117 Tz T*
(four South African researchers were collecting data and information from\
21 Ross seals)Tj
114 Tz T*
(\(Ommatophoca rossi\) in the Antarctic pack-ice. The work involved disse\
ction and contact)Tj
117 Tz T*
(with most tissue types from the seals.)Tj
119 Tz 207 -1 Td
(Two members of the team working on one seal)Tj
112 Tz -208 -13 Td
(developed the symptoms of an infection resembling "seal finger".)Tj
113 Tz 0 -28 TD
(The first case was noticed some seven days after the last seal was proce\
ssed. The proximal)Tj
114 Tz -1 -14 Td
(joint of the index finger became swollen, pink and painful. This conditi\
on persisted for 28)Tj
116 Tz 1 -14 Td
(days until treated with Vibramycin which cleared the infection after 11 \
days. The second)Tj
112 Tz 0 -14 TD
(case appeared 41 days after the last seal was processed. The infection a\
ppeared in the distal)Tj
114 Tz -2 -14 Td
(joint of the forefinger and after three days the swelling was marked. At\
tempts to straighten)Tj
112 Tz 1 -14 Td
(the finger were painful. This case was treated with intravenous injectio\
n of Aureomycin and)Tj
117 Tz 0 -13 TD
(Ledermycin capsules were taken orally for seven days, after which the in\
fection cleared)Tj
111 Tz T*
(\(Panagis et al 1982\).)Tj
109 Tz 234 729 Td
(2)Tj
ET
endstream
endobj
59 0 obj
<>/Height 105/Type/XObject>>stream
EtGG{#:#tmDDDDDDDFiѴ_0#c#tgH 0XPT# RR:##F3a:0Dth:6фaDvmQB)(De#:0>s..""""""3D]DuΈ.h>DDDgTGͳ(G4GaDt(re]tG#tGEь#taRDXB"",/2:#ф_.GD|/""""""#4EvGDt_#1du
_#^7Ѵ_#|/FD|":6"""""""3F_#莈#/,(DP!莏v]Eˢ"""""""2FGDuD##uDt]"莋]DaE:#hV#m4#BЈDdtGEѴ]ѴG]DDDDDDsDtQH#tGF:!Aha:#GE|aE.h#:#QnGeAd|#||]"""1E3DtGED|ta$]Q:0"#
endstream
endobj
61 0 obj
<>
endobj
62 0 obj
<>
endobj
57 0 obj
[]
endobj
231 0 obj
<>stream
BT
0 0 0 rg
/T1_0 11 Tf
109 Tz 67 719 Td
(INTRODUCTION)Tj
/T1_1 11 Tf
110 Tz 0 -43 TD
(All whales and seals harbour a variety of parasites, bacteria, viruses a\
nd fungi. Some of these)Tj
114 Tz 0 -14 TD
(are pathogenic in humans and can cause chronic painful conditions which \
are reluctant to)Tj
116 Tz T*
(respond to many commonly used drugs. Some of the pathogens have only rec\
ently been)Tj
111 Tz T*
(identified and if infected humans are left untreated, are potentially fa\
tal. Geraci \(1993\) cites)Tj
118 Tz T*
(some examples noting: "Several investigators working on an outbreak of s\
eal influenza)Tj
110 Tz 0 -13 TD
(developed painful conjunctivitis caused by the same virus. At least one \
pox virus in seals can)Tj
111 Tz 0 -15 TD
(cause irritating skin lesions that take several months to heal. The bact\
eria Erysipelothrix sp.,)Tj
117 Tz 0 -14 TD
(Leptospira sp. and Loboa loboi have also been transmitted to people from\
contaminated)Tj
108 Tz 0 -13 TD
(animals.")Tj
110 Tz 0 -29 TD
(This paper is intended to bring to the attention of people working with \
marine mammals, and)Tj
116 Tz 0 -14 TD
(members of the medical profession, the symptoms and possible treatments \
of the serious)Tj
T*
(infections which can be passed from seals and whales to humans. Five cas\
e histories are)Tj
106 Tz 0 -13 TD
(appended.)Tj
114 Tz 1 -28 Td
(Of all the conditions resulting from contact with marine mammals, "seal \
finger' or "spekk)Tj
111 Tz 0 -14 TD
(finger" \(literally blubber finger as it is known to the Norwegians\) is\
the most notorious. The)Tj
113 Tz T*
(infection is described as a sub-acute, severely painful infection of the\
fingers which, if left)Tj
T*
(untreated, can result in permanent disability. In fact, the pain involve\
d in this infection can)Tj
111 Tz -1 -14 Td
(be so severe that there are reports of sealers resorting to amputation o\
f infected fingers in an)Tj
110 Tz 0 -13 TD
(attempt to cure themselves.)Tj
112 Tz 0 -28 TD
(With the development of marine oceanaria and similar facilities where wi\
ld or captive bred)Tj
117 Tz 0 -14 TD
(marine mammals are held in captivity and closely attended by trainers an\
d handlers, the)Tj
121 Tz 0 -13 TD
(chances of transmission of infectious diseases from animals to humans ha\
s increased)Tj
108 Tz 0 -14 TD
(significantly.)Tj
114 Tz 72 -1 Td
(Therefore it could be assumed that the chances to study these diseases h\
ave)Tj
108 Tz -72 -13 Td
(increased proportionally.)Tj
111 Tz 129 -1 Td
(Yet surprisingly little is known of the infective agents responsible)Tj
113 Tz -129 -14 Td
(for the various conditions often collectively referred to by the generic\
term "seal finger". It)Tj
109 Tz 0 -13 TD
(is)Tj
117 Tz 14 0 Td
(not surprising therefore that most general practitioners, when confronte\
d by a patient)Tj
112 Tz -14 -14 Td
(complaining of a "seal finger", are unsure of the appropriate treatment.\
)Tj
/T1_0 11 Tf
111 Tz -1 -42 Td
(SEAL FINGER)Tj
/T1_1 11 Tf
113 Tz 0 -29 TD
(Seal finger has been described in the medical literature since 1907 \(Ca\
ndolin, 1953\). Cases)Tj
110 Tz 0 -14 TD
(have now been recorded from people working with harp seals \(England, 19\
24\), ring seals and)Tj
109 Tz T*
(polar bears \(Beck and Smith, 1976\), South African fur seals \(Shaughne\
ssy, pers comm. 1994\),)Tj
113 Tz T*
(New Zealand fur seals \(Wilson, pers comm. 1994\) and Ross seals in the \
Antarctic \(Panagis)Tj
115 Tz T*
(et al, 1982\). In a pioneering work on the topic, Candolin \(1953\) inve\
stigated 224 cases of)Tj
114 Tz 0 -13 TD
(seal finger and most of his comm)Tj
113 Tz 169 0 Td
(ents are still valid.)Tj
112 Tz 101 -1 Td
(Although some microorganisms have)Tj
110 Tz -270 -14 Td
(been implicated as causative agents, none have yet been formally identif\
ied as the sole cause)Tj
111 Tz T*
(of seal finger.)Tj
112 Tz 0 -28 TD
(Seal finger is acquired most frequently by those people involved not onl\
y in sealing but also)Tj
0 -14 TD
(in the handling of seal meat and blubber. It appears that a break in the\
skin is necessary for)Tj
100 Tz 236 717 Td
(1)Tj
ET
endstream
endobj
47 0 obj
<>/Height 105/Type/XObject>>stream
">CGR( t]>GDtGDD4"#:Dt]6DDDDDf]#hGDt]фq␈ēF:/c<BDF""3D]DtyD|/˨6e1t]":0"""""">kdtaFFQGG.0"7DDPB!F"&tmM!(E:#DaDtaEh8B,
A x|#G8ˢ]ф#:8躈#^/F38B"""""1晄]F:#htgѴaDXB#H@RJ,ADtGf$|UAH:#EtGDta:#:9興8dtc0y0.""B""!1:t].#.6"""""""34GE:1G4""""#6#>_$"菘Dt]:."DDDEGH#tGEa$>nфq:?<"\E!tG":3DxGDtGDtG""""""#'j#3DtGϢ>GFѴaF
endstream
endobj
49 0 obj
<>
endobj
50 0 obj
<>
endobj
45 0 obj
[]
endobj
44 0 obj
[39 0 R 41 0 R]
endobj
33 0 obj
<>/Height 105/Type/XObject>>stream
4Q莋OEΊ?#8Ft#B#tGg3Q4{=ϨD#&2>hΑ4D|0""3G8
endstream
endobj
43 0 obj
<>/Font<>/ProcSet 3 0 R>>
endobj
37 0 obj
<>
endobj
38 0 obj
<>
endobj
35 0 obj
<>/Height 1985/Type/XObject>>stream
pσ
2!|l`2S}SKǪj t9BLKੵ"@_
?=tNaHTa6(!%2UupCXﭝ
>hh?܊n+x$BLs"""
4MSNUz~iivM2MfUMqIDDDZijMU4SLdXh4a4NӵڦM5M;_ߧq ijk8A0M4OMWAik1V8!de
,nF]o%)߅P!z#@!B=N?|{ ~?Wo¯ZN$AZ_a]}l.vt@5O^B ʶIN$N)2axa&TAiaTV8Ʌئ
84ii4;MtAʳ*'I0&R1ih zkiMUMlLD^4}[iڦiidI&Re&L."""""F.i_ONL&aTV6I$IN&2atDZiM=nSiji2ʶIN)"N)2a|8a4jw_^4M4""",& zvU[OB""&M5T5w""!a4 i~h4L&ikji"""#(`E|93]htv,=_bp)fAF^a B
0A!S¤,&A,&ݨ䭡|2./!]MOoJpad^ozoI}uv}ow_l8w_̄N
c[۷_w__w__ͧ_K;_MZiiSa0x
`
&DQAzFA:_z8a,GCaON_[{^^&hH}4&`DD?>"D Jd:g0C `-z[iL'DӆK3L2(n"Y tzzڿtk __A_zuw__ Z cima¦MZM?"B
L&I`ADDDDDD0 gkQGu{L*dhr,)3ge.
4;*ߧB!ޞ$N:a0Ojx'_=+EI5M"]~-a_~;k
}W IC#+_Op)G!TCЊ친24rBi{AńAd\PDdMC|/B2lj*MPFA
3A
/d3f`gmH}7i6dj[6iTBaXN@D+[x'nJV#%ny
a4OZVGǿdK.d#%n(vw^}
o}E$dK!"ܼMSuom~_ij?GW_}~nK྾!mu'B8/KL?۶ x"1%_xbktE ]o aT>^/{a?dq%l -J^EamZOkod4ii^K[I^p~)++'0_ PQ0X)}U]7A1LSH4شm_%zVV8LUa 5AAWh4AbXi&$X M42lH aa4զMMqAbh4MjݦiVʶUVʶIĜRd K""" g4NA zM0Я_m4OM4 LeYldRDRE'DDDDDDHxh
Hm{ꝦjiM2ʶUN)4""""#?S2B{ONӴ!iM4ӵza0ivv~TDDXL&M4M4SNWiM5N[B"""L&M0Q@8CDqbʖn[nC~8Gȇ4y5Xv& ! l@D*`цh!`oNCDorv =а.i,}V(O7mv}_}{wvnn7?ooZU?kmZ^a_Ii]{a4A*bAN%_M-exXB#!a=5
#"""4Iaz_#2#ڂ[v*W[u^'qAD"B^
8TA
D:gBO--?iX%wldG2${]? IOHnUu@5Ph'~#Kr_q [_6M45Ȑ40A
80M0OT(N #Y%8PDNAA>?r9|WUr@FaJ0) kiZkkiaUq'
lRwjVʶIII aᄛ"M&A0Sva4Ale[$)_*DAe uOOzzvi@2ld$)2c&WQaiӵ[M4M4L 2fUN)"+)a0h44]uگziii*
UXa4M4ӻ[OO_iݦDDDC M4;O}iDDDCAL&pOM5DDDE
4a4a;A!DDDDDEPiQeAjig+ P0T0׆"i7o_S#?O2)$z "JO)!#P!@
r&)9IU]A,&`0L&A?u šiaByB!
dR}QDwiS'i:MD! !A) /Z; 'a6Iȷ]+UzkQ{_Z_ۥօokC~M??[aWOᆗE>v>}lῶڿkwjoa~ᾛ
%tA"N)2Jt
muXy{n4VʶI$pbh4AiJTM44e[*V8HiM4-0 4=pZwiiʶUMq'0h0A
S0VM8SSM4AldI$IĜRd"""" QAN a}5~iM42le[$I1'ii_TM4 h2l6I&DDXL&M5NOO_iii iz~=oiT;Ok
0a4ӴSM{ODDDE N]|DDDDX&a4DDDGg<p&"ۧ6vRU_ΆuG2H?0D% 31IPA0, ?IdpM;DcD&QWGPWEIqIIXovұWL~i4V8dRi<m&զVia2le\Re&L-AM6+=SM4a4d$MqI
l+
4M42l8WЃj@pAL&i=4;N0*VʶI$RdRdL/jiMU;M4L&A2le[$I a4M5iڪiid*DDDZa4iv}}VNN-0ikUm(M4M4N[U_߶ M4i4
PQ`亦euz[ƹ` :z,ydFz$;`'`"P(c:) XA,) MSPnhmy;h9ynG'Iפ6zzzn+W?_1L@$?7k/wHݮoLa醗VV+=VIN$'I=4ᄬ+lC;TM42lL
AEUUkviʶU)2)2a%^L A
+[;_UL L ʶIN$)2ebIa5+5[izii* ʶUN$)2a%1DDDA\NikkNL&2ld$'0/M4iSS]5M5M0Ld$)2&DDDEikkjTM*_
0ivU;5M4 M4;M}}{zK""-4M4ӴM5xAwa4aijL&aSMAU1(A߈ȳ2잩2ml)\)Ʉ/&fEil=
RZ_TDUނ'
N6}''w
}_t[Pg!̧dtC2K_Ja !0C3#}Մ,!&ZR~ip!0zDr-CāHbցd$Y
KF;T4>4aҶ} ܼ*ӵMNUw/<=`WIzu}
/_Xz*41mo!acaF_
&q("<_}?$Љ[]xocAoMvwZM!{K~_Oq>d=Z}uk}0ubm?W_k8a+JXI5_յ+}aqQM]魦 1kv턗*
`
4EL:!kucI`~S!qVKCA"BipiN%AR 8M2+&b+X Q05)_TMzbelѕTWKuOL3;Q쨉wj&K
R/UL/vԼ4Z]qH>#:'HVUT䄐oUBTJ٦¢e&B}x5(f<ZZK-
few@KB'iL͚4"p3<ίOxDq'XLª(!Y0
C"1qN!mlޒ*r
H5PpMHCCh!. Eb]m;Mt]}'Da3MBCBukUF2(CN"pi$;*
Bt/z^>I:''W۪ޓ X*tIȑWv_jtOa7^IOtKo}?Kzᯭ~?_|{/ݽucAװoa_>߇mo!RD;;o~k[]~[䧿nK
^ҿV_aaҾ&]I_&_K_Zm
+[L'!o\7N*i1J0`fO[oL ⢪;[[1z+[T_i L& M;ow馛/uD
ȮowM;JcNҋD*qd䠡
pAh~
oi06 4! 48NָC0% TȮ j)
q]DDDDE
¦h:C)84k0LTF(i`
ZN#2*|L&W<v;33J(*{uE_xcFj"6F3$_ 0M0_KM0B
wK(f~HEDu4NݢWW!L`!T"8dHӇxICUB
[N&{DCM&"}i~կpMH֗2=}&!m+ޮ]w]IG?}oXm*ZNߤߪWW}{҃rMWmbJՏ؇kzPN8mRZ_m~AA8Qk ׆D0@ӋU[!#& 2A B#ƉtMY&A """ \&MZiDDDADDE
J[@⯰-C[X
endstream
endobj
39 0 obj
<>stream
q
0 0 0 rg
1 0 0 1 72 187 cm
458 0 0 477 0 0 cm
/picture_0 Do
Q
endstream
endobj
41 0 obj
<>stream
BT
0 g
/OP11Font0 12 Tf
0 0 0 rg
120 Tz
1 0 0 1 262 725 Tm
(CONTENTS) Tj
0 g
ET
endstream
endobj
31 0 obj
[]
endobj
30 0 obj
[25 0 R 27 0 R]
endobj
19 0 obj
<>/Height 105/Type/XObject>>stream
Du#'FtGDtn5EmDDRFGE:.tGDtGE}KE"""#"#aDtP#"""""2tGDtGDuX莈#DDDDFCFu
endstream
endobj
29 0 obj
<>/Font<>/ProcSet 3 0 R>>
endobj
23 0 obj
<>
endobj
24 0 obj
<>
endobj
21 0 obj
<>/Height 52/Type/XObject>>stream
D1XA@ #q vwvo<_m$+)[4b0G
endstream
endobj
25 0 obj
<>stream
q
0 0 0 rg
1 0 0 1 79 567 cm
10 0 0 12 0 0 cm
/picture_0 Do
Q
endstream
endobj
27 0 obj
<>stream
BT
0 g
/OP11Font0 11 Tf
0 0 0 rg
119 Tz
1 0 0 1 78 652 Tm
(ISSN 1171-9834) Tj
120 Tz
1 0 0 1 79 501 Tm
(Reference to material in this report should be cited thus:) Tj
114 Tz
1 0 0 1 79 473 Tm
(Cawthorn, M.W., 1994.) Tj
118 Tz
1 0 0 1 79 459 Tm
(Seal finger and mycobacterial infections of man from marine mammals) Tj
1 0 0 1 80 445 Tm
(occurrence, infection and treatment.) Tj
/OP11Font1 11 Tf
111 Tz
1 0 0 1 80 431 Tm
(Conservation Advisory Science Notes No. 102,) Tj
/OP11Font0 11 Tf
119 Tz
1 0 0 1 318 431 Tm
(Department of Conservation,) Tj
114 Tz
1 0 0 1 79 417 Tm
(Wellington. 15p.) Tj
116 Tz
1 0 0 1 80 96 Tm
(Commissioned by: Science & Research Division.) Tj
117 Tz
1 0 0 1 79 81 Tm
(Location: NZMS) Tj
118 Tz
1 0 0 1 93 570 Tm
(1994 Department of Conservation) Tj
0 g
ET
endstream
endobj
17 0 obj
[]
endobj
16 0 obj
[11 0 R 13 0 R]
endobj
5 0 obj
<>/Height 105/Type/XObject>>stream
MF; ".GDtmx?H"""#bDtGVPq3Dt]DDDGkFD|#ѴGE:duDqD|sH-&P(F">GD|>GEѴG菑F"L .Ac ys#u$u2O$f,3F"hDF"?
endstream
endobj
15 0 obj
<>/Font<>/ProcSet 3 0 R>>
endobj
7 0 obj
<>
endobj
8 0 obj
<>
endobj
9 0 obj
<>
endobj
10 0 obj
<>
endobj
11 0 obj
<>stream
endstream
endobj
13 0 obj
<>stream
BT
0 g
/OP11Font0 14 Tf
0 0 0 rg
103 Tz
1 0 0 1 261 612 Tm
(REPORT TO) Tj
102 Tz
1 0 0 1 163 579 Tm
(THE DEPARTMENT OF CONSERVATION) Tj
104 Tz
1 0 0 1 175 546 Tm
(SCIENCE AND RESEARCH DIVISION) Tj
/OP11Font2 12 Tf
118 Tz
1 0 0 1 127 460 Tm
(SEAL FINGER AND MYCOBACTERIAL INFECTIONS) Tj
117 Tz
1 0 0 1 177 427 Tm
(OF MAN FROM MARINE MAMMALS:) Tj
1 0 0 1 146 395 Tm
(OCCURRENCE, INFECTION AND TREATMENT) Tj
/OP11Font0 11 Tf
95 Tz
1 0 0 1 241 101 Tm
(MARTIN W CAWTHORN) Tj
93 Tz
1 0 0 1 232 87 Tm
(CAWTHORN & ASSOCIATES) Tj
92 Tz
1 0 0 1 183 73 Tm
(MARINE MAMMALS-FISHERIES CONSULTANTS) Tj
94 Tz
1 0 0 1 208 59 Tm
(53 MOTUHARA ROAD, PLIMMERTON) Tj
110 Tz
1 0 0 1 259 46 Tm
(WELLINGTON) Tj
0 g
ET
endstream
endobj
229 0 obj
<>
endobj
xref
0 256
0000000006 65535 f
0000003581 00000 n
0000000095 00000 n
0000007527 00000 n
0000003762 00000 n
0000130171 00000 n
0000000012 00001 f
0000130753 00000 n
0000131920 00000 n
0000133083 00000 n
0000134256 00000 n
0000135421 00000 n
0000000014 00001 f
0000135470 00000 n
0000000020 00001 f
0000130598 00000 n
0000130139 00000 n
0000130120 00000 n
0000003886 00000 n
0000125991 00000 n
0000000022 00001 f
0000128826 00000 n
0000000026 00001 f
0000126497 00000 n
0000127661 00000 n
0000129131 00000 n
0000000028 00001 f
0000129249 00000 n
0000000034 00001 f
0000126355 00000 n
0000125959 00000 n
0000125940 00000 n
0000004012 00000 n
0000114366 00000 n
0000000036 00001 f
0000117202 00000 n
0000000040 00001 f
0000114870 00000 n
0000116038 00000 n
0000125681 00000 n
0000000042 00001 f
0000125801 00000 n
0000000048 00001 f
0000114728 00000 n
0000114334 00000 n
0000114315 00000 n
0000004138 00000 n
0000111112 00000 n
0000000051 00001 f
0000112013 00000 n
0000113166 00000 n
0000000052 00001 f
0000000053 00001 f
0000000054 00001 f
0000000055 00001 f
0000000056 00001 f
0000000060 00001 f
0000106924 00000 n
0000004314 00000 n
0000103611 00000 n
0000000063 00001 f
0000104622 00000 n
0000105771 00000 n
0000000064 00001 f
0000000065 00001 f
0000000066 00001 f
0000000067 00001 f
0000000068 00001 f
0000000072 00001 f
0000098856 00000 n
0000004502 00000 n
0000090407 00000 n
0000000076 00001 f
0000091547 00000 n
0000092711 00000 n
0000093879 00000 n
0000000078 00001 f
0000093928 00000 n
0000000084 00001 f
0000091422 00000 n
0000090375 00000 n
0000090356 00000 n
0000004628 00000 n
0000082142 00000 n
0000000088 00001 f
0000083205 00000 n
0000084369 00000 n
0000085537 00000 n
0000000090 00001 f
0000085586 00000 n
0000000096 00001 f
0000083080 00000 n
0000082110 00000 n
0000082091 00000 n
0000004754 00000 n
0000078910 00000 n
0000000099 00001 f
0000079789 00000 n
0000080938 00000 n
0000000100 00001 f
0000000101 00001 f
0000000102 00001 f
0000000103 00001 f
0000000104 00001 f
0000000108 00001 f
0000074953 00000 n
0000004931 00000 n
0000072002 00000 n
0000000111 00001 f
0000072649 00000 n
0000073803 00000 n
0000000112 00001 f
0000000113 00001 f
0000000114 00001 f
0000000115 00001 f
0000000116 00001 f
0000000120 00001 f
0000069481 00000 n
0000005112 00000 n
0000063949 00000 n
0000000124 00001 f
0000064666 00000 n
0000065835 00000 n
0000067000 00000 n
0000000126 00001 f
0000067050 00000 n
0000000132 00001 f
0000064537 00000 n
0000063914 00000 n
0000063894 00000 n
0000005243 00000 n
0000059765 00000 n
0000000136 00001 f
0000060439 00000 n
0000061593 00000 n
0000062743 00000 n
0000000137 00001 f
0000000138 00001 f
0000000139 00001 f
0000000140 00001 f
0000000141 00001 f
0000000145 00001 f
0000056309 00000 n
0000005449 00000 n
0000051710 00000 n
0000000148 00001 f
0000053765 00000 n
0000054919 00000 n
0000000149 00001 f
0000000150 00001 f
0000000151 00001 f
0000000152 00001 f
0000000153 00001 f
0000000157 00001 f
0000048248 00000 n
0000005642 00000 n
0000042220 00000 n
0000000161 00001 f
0000043037 00000 n
0000044206 00000 n
0000045371 00000 n
0000000163 00001 f
0000045421 00000 n
0000000169 00001 f
0000042907 00000 n
0000042185 00000 n
0000042165 00000 n
0000005773 00000 n
0000033889 00000 n
0000000173 00001 f
0000035007 00000 n
0000036176 00000 n
0000037341 00000 n
0000000175 00001 f
0000037391 00000 n
0000000181 00001 f
0000034877 00000 n
0000033854 00000 n
0000033834 00000 n
0000005904 00000 n
0000027994 00000 n
0000000185 00001 f
0000028772 00000 n
0000029941 00000 n
0000031106 00000 n
0000000187 00001 f
0000031156 00000 n
0000000193 00001 f
0000028642 00000 n
0000027959 00000 n
0000027939 00000 n
0000006035 00000 n
0000021864 00000 n
0000000197 00001 f
0000022678 00000 n
0000023847 00000 n
0000025012 00000 n
0000000199 00001 f
0000025062 00000 n
0000000205 00001 f
0000022548 00000 n
0000021829 00000 n
0000021809 00000 n
0000006166 00000 n
0000014760 00000 n
0000000209 00001 f
0000015455 00000 n
0000016624 00000 n
0000017789 00000 n
0000000211 00001 f
0000017839 00000 n
0000000217 00001 f
0000015325 00000 n
0000014725 00000 n
0000014705 00000 n
0000006297 00000 n
0000006483 00000 n
0000000219 00001 f
0000009909 00000 n
0000000223 00001 f
0000007575 00000 n
0000008744 00000 n
0000010204 00000 n
0000000225 00001 f
0000010321 00000 n
0000000234 00001 f
0000007379 00000 n
0000006448 00000 n
0000006428 00000 n
0000136254 00000 n
0000000016 00000 n
0000106943 00000 n
0000052585 00000 n
0000056069 00000 n
0000000238 00001 f
0000098875 00000 n
0000074973 00000 n
0000069501 00000 n
0000000239 00001 f
0000000240 00001 f
0000000242 00001 f
0000056329 00000 n
0000000243 00001 f
0000000244 00001 f
0000000245 00001 f
0000000246 00001 f
0000000247 00001 f
0000000248 00001 f
0000000249 00001 f
0000000250 00001 f
0000000251 00001 f
0000000252 00001 f
0000000253 00001 f
0000000000 00001 f
0000048268 00000 n
0000000129 00000 n
trailer
<]>>
startxref
136432
%%EOF
2 0 obj
<>
endobj
229 0 obj
<>
endobj
230 0 obj
<>
endobj
256 0 obj
<>
endobj
257 0 obj
<>
endobj
258 0 obj
<>
endobj
259 0 obj
<>
endobj
260 0 obj
<>
endobj
261 0 obj
<>
endobj
262 0 obj
<>
endobj
263 0 obj
<>
endobj
264 0 obj
<>
endobj
265 0 obj
<>
endobj
266 0 obj
<>
endobj
267 0 obj
<>
endobj
268 0 obj
<>
endobj
269 0 obj
<>
endobj
270 0 obj
<>
endobj
271 0 obj
<>
endobj
272 0 obj
<>
endobj
273 0 obj
<>
endobj
274 0 obj
<>
endobj
275 0 obj
<>
endobj
276 0 obj
<>
endobj
277 0 obj
<>
endobj
278 0 obj
<>
endobj
279 0 obj
<>
endobj
280 0 obj
<>
endobj
281 0 obj
<>
endobj
282 0 obj
<>
endobj
283 0 obj
<>
endobj
284 0 obj
<>
endobj
285 0 obj
<>
endobj
286 0 obj
<>
endobj
287 0 obj
<>
endobj
288 0 obj
<>
endobj
289 0 obj
<>
endobj
290 0 obj
<>
endobj
291 0 obj
<>
endobj
292 0 obj
<>
endobj
293 0 obj
<>
endobj
294 0 obj
<>
endobj
295 0 obj
<>
endobj
296 0 obj
<>
endobj
297 0 obj
<>
endobj
298 0 obj
<>
endobj
299 0 obj
<>
endobj
300 0 obj
<>stream
2009-03-20T11:20:40Z
OmniPage 11 http://www.scansoft.com
2009-03-20T11:33:19+13:00
2009-03-20T11:33:19+13:00
OmniPage 11 http://www.scansoft.com
application/pdf
uuid:854b4786-9fef-4d21-a076-56efd2fd5ee0
uuid:a56b4de9-168f-49d2-b9ae-213f73d12fa2
endstream
endobj
xref
0 1
0000000006 65535 f
2 1
0000141714 00000 n
229 2
0000141784 00000 n
0000141962 00000 n
256 45
0000142041 00000 n
0000142089 00000 n
0000142163 00000 n
0000142211 00000 n
0000142302 00000 n
0000142350 00000 n
0000142476 00000 n
0000142524 00000 n
0000142615 00000 n
0000142663 00000 n
0000142755 00000 n
0000142803 00000 n
0000142953 00000 n
0000143001 00000 n
0000143077 00000 n
0000143125 00000 n
0000143202 00000 n
0000143250 00000 n
0000143404 00000 n
0000143452 00000 n
0000143516 00000 n
0000143565 00000 n
0000143655 00000 n
0000143704 00000 n
0000143798 00000 n
0000143847 00000 n
0000143936 00000 n
0000143985 00000 n
0000144080 00000 n
0000144129 00000 n
0000144254 00000 n
0000144303 00000 n
0000144383 00000 n
0000144432 00000 n
0000144525 00000 n
0000144574 00000 n
0000144667 00000 n
0000144716 00000 n
0000144809 00000 n
0000144858 00000 n
0000144938 00000 n
0000144987 00000 n
0000145076 00000 n
0000145125 00000 n
0000145201 00000 n
trailer
<<781A356965607847A75B0DBC27341ED4>]/Prev 136432 >>
startxref
148653
%%EOF
230 0 obj
<>
endobj
301 0 obj
<>
endobj
302 0 obj
<>
endobj
303 0 obj
<>stream
2009-03-20T11:20:40Z
OmniPage 11 http://www.scansoft.com
2009-03-20T11:34:54+13:00
2009-03-20T11:34:54+13:00
OmniPage 11 http://www.scansoft.com
application/pdf
Seal finger and mycobacterial infections of man from marine mammals: occurence, infection and treatment
casn102
M.W. Cawthorn
uuid:854b4786-9fef-4d21-a076-56efd2fd5ee0
uuid:18811f7f-3b04-419a-a416-902d819a1a85
endstream
endobj
xref
0 1
0000000006 65535 f
230 1
0000149826 00000 n
301 3
0000149966 00000 n
0000150294 00000 n
0000150344 00000 n
trailer
<<5D90FA218C5DA5499E4564889EC32ABE>]/Prev 148653 >>
startxref
154334
%%EOF