Worms and Germs Blog

Campylobacter upsaliensis: an overlooked problem?

jsweese@uoguelph.ca (Scott Weese) — Fri, 20 Nov 2009 08:12:55 -0500

Campylobacter bacteria are important causes of disease in people. A variety of Campylobacter species exist, and these different species are quite variable in their ability to cause disease in people and animals. Campylobacter jejuni is one of the most common causes of diarrhea in people worldwide and is most commonly foodborne, however a few different studies have reported that having pets (especially pets with diarrhea) is a risk factor for Campylobacter jejuni infection.

Another Campylobacter species that may be of concern is Campylobacter upsaliensis. This species is primarily associated with dogs and cats, and a large percentage of healthy dogs and cats may be shedding this bacterium in their stool at any time. It doesn't seem to be a cause of disease in dogs and cats, but it may be an important and overlooked cause of disease in people. One study from the US reported that C. upsaliensis was the 2nd most common Campylobacter strain found in people with diarrhea (after C. jejuni). However, the true role of this species is unclear, partly because of common laboratory testing methods. Culture is the main method to diagnose infection with Campylobacter, but this bacterium can be difficult to grow. Usually, culture media for Campylobacter contain antibiotics to inhibit other, better growing, bacteria. Unfortunately, C. upsaliensis is often inhibited by these antibiotics, so it's possible to miss it. Therefore, we might be underestimating the role of this Campylobacter species in diarrhea. This is important to figure out because C. upsaliensis is strongly associated with dogs and cats, and it's important to determine what role pets play in human disease.

Avoiding Campylobacter infection involves some basic steps: avoid contact with feces, take care when handling diarrhea from pets, wash your hands regularly after handling pets and always after any contact with feces. Make sure your physician knows you have pets. In particular, if you have a pet with diarrhea or have recently acquired a new pet (especially a puppy or kitten), make sure Campylobacter infection is considered. Most infections are mild and go away on their own but some require specific treatment.

More information about Campylobacter can be found in our Resources section.

Image credit: CDC/ Dr. Patricia Fields, Dr. Collette Fitzgerald

More H1N1 cat cases

jsweese@uoguelph.ca (Scott Weese) — Thu, 19 Nov 2009 15:34:25 -0500

Perhaps not too surprisingly, more cats have been diagnosed with H1N1. Following the first reported case in Iowa, two more cases have been reported; one in Utah and one is Oregon. The Utah case apparently had typical flu-like disease. The cat from Oregon died of severe respiratory disease.

This doesn't really change anything. We know cats are susceptible, although not highly so considering the small number of cases despite large numbers of cats being exposed by their owners. H1N1 in cat is a human-associated disease, with cats getting infected from infected people. We still have no evidence that pets are a source of human infection. Despite that good general hygiene practices should be used around infected pets and people to reduce the risk of transmission in both directions.

Antibiotic Awareness Day

mander01@uoguelph.ca (Maureen Anderson) — Wed, 18 Nov 2009 08:00:00 -0500

European Antibiotic Awareness Day is an initiative of the European Centre for Disease Prevention and Control. This year it falls on November 18. The aim of the Day is to provide an annual opportunity for raising awareness about the threat to public health of antibiotic resistance and how to use antibiotics responsibly.

Responsible use of antibiotics can help stop resistant bacteria from developing and help keep antibiotics effective for the use of future generations. Successful national public awareness campaigns are already resulting in more rational use of antibiotics and a reduction in levels of antibiotic resistance in Europe.

Responsible use of antibiotics includes use in people and in animals. Here are some of the things you can do to help with regard to antibiotic use in your pets:

Only give your pet antibiotics if directed to do so by your veterinarian.
Make sure your pet gets the full dose of medication at the correct time(s) of day. If you are having problems getting your pet to swallow pills or take medication, contact your veterinarian as soon as possible. Your veterinarian may be able to give you advice on some "tricks" for getting your pet to take the medication, or sometimes the medication can be provided in a different form (e.g. a liquid instead of a pill).
Always ensure your pet finishes the entire prescription. There should be no leftover pills or medication. Do not stop giving your pet the antibiotics just because it looks/acts like its feeling better. This is a common mistake that can have disasterous consequences! You should NEVER "save a few pills for the next time."
Never give your pet antibiotics that were prescribed for you or any other person, whether they are expired or not.

Stray cats and H1N1 influenza

jsweese@uoguelph.ca (Scott Weese) — Mon, 16 Nov 2009 17:18:48 -0500

The topic of the potential for feral (stray) animals, particularly cats, to be sources of human influenza infection came up today. For feral animals to be a public health problem, the following sequence has to happen:

Feral animals need to be exposed to H1N1

This is pretty unlikely. Influenza is spread through close contact, mainly through aerosols generated by an infectious person coughing, sneezing or breathing. Influenza only travels short distances in this manner. The likelihood of a feral animal being exposed to the H1N1 influenza virus is very low because it is rare for a feral animal to get that close to people. If there is close contact, it's probably very short term, and not high risk for exposure.

They need to become infected AND shed appreciable levels of virus

Considering the number of infected people, how common pet cats are, and the fact that only one cat has been diagnosed with H1N1, the risk of actually transmitting the virus to a cat is very low even with close contact with an infected person. If tens of thousands of household pet cats have had close and prolonged exposure and only one infection has been diagnosed, this virus is pretty poorly transmissible to cats.

They need to be exposed to susceptible people

As discussed above, there's not too much contact between stray cats and people. Close and prolonged contact is extremely rare. Influenza is only shed by infected individuals for a short period of time, unlike some other infections. So, the chance of an infected cat having close contact with a person during the relatively short infectious period is very low.

Each one of these events independently is very unlikely. When you combine them, it should be clear that the risks posed by feral cats are extremely low (probably about as close to zero as we get with infectious diseases).

A bigger concern might be someone infecting their indoor/outdoor cat, who would then infect a stray cat, which would then infect another indoor/outdoor cat, which could infect a family member. That's still a VERY unlikely situation - really it's nothing to worry about.

There are certainly public health issues with feral cats. H1N1 is not one of them.

How to remove a skunk from a pool

jsweese@uoguelph.ca (Scott Weese) — Sun, 15 Nov 2009 10:32:00 -0500

This morning, as my dog Meg and I went out to get the newspaper, she ran towards our pool fence, barking (pretty unusual for a dog that is afraid of chipmunks). I wondered what the issue was until I saw a black and white tail sticking out. The pool has been closed for the season and there was a skunk standing on the cover. The cover's about 1.5 feet below the deck and the skunk couldn't get out.

After going over various options, like putting things in for the skunk to climb out on (unsuccessful), getting a live trap (too lazy to go find one), scooping it up with the pool skimmer net (a matter of how badly I'd be sprayed, not whether I'd be sprayed), getting a wildlife removal person in (too cheap to get someone else to do it) or lacing food with a sedative, I came up with the following plan:

Find a large garbage pail with a handle. Tie a long rope to one handle.
Place the garbage pail on its side in the pool, with the handle tied to the rope on top.
Lure the skunk into the pail (e.g. with food) or, as I did, herd it in using a LONG pole.
When the skunk is inside, pull on the rope to tip the garbage pail back up.
Cover the garbage pail. A plastic kiddie pool works well.
Carefully but quickly lift the covered garbage pail out of the pool.
RUN... upwind.

It worked for me... no guarantees however.

Family Salmonella outbreak from school reptile

jsweese@uoguelph.ca (Scott Weese) — Wed, 11 Nov 2009 15:30:00 -0500

Three Louisville, Kentucky children and their father recently contracted Salmonella from two lizards (green anoles) that the kids brought home from school. Two weeks after the lizards were brought home, the youngest child got sick. Then the other kids and the father got sick.

This outbreak highlights numerous problems:

Schools are not pet stores: Why is an exotic (and difficult to care for) pet that is a known Salmonella vector being sent home with students? Apparently, the school sent home a standard letter they use when students take home pets. (I assume sending animals home must be a very common event if the school has a standard form for it.) The letter provides "caretaking tips" but apparently mentions nothing about Salmonella and reptiles. The school has now modified the letter to include a "reminder to parents that good hygiene is imperative when dealing with any kind of living organism as a pet, so they need to make sure their kids wash their hands well after handling them or cleaning them out." That's better, but if they are sending home reptiles, they need a clear statement about the risk of Salmonella exposure. They need to be direct and highlight the greater risk associated with reptiles.

Lack of education before getting a pet: Too many pets die and too many people get sick because people don't take the responsible step of finding out about the animal before they adopt it as a pet. This is particularly true with exotic pets, and death of the pet is a common outcome. It doesn't take a lot of effort to find out basic information about reptile care, and information about the risk of salmonellosis should be easy to find.

Poor knowledge (or a poor attempt at damage control) by the school: The teacher "noted that other common pets, such as dogs, can also carry salmonella. Like lizards, they're perfectly safe as long as you practice proper handwashing when you handle them." Except for the fact that 0-1% of healthy dogs carry Salmonella while very high percentages of reptiles do, that tens of thousands of cases of reptile-associated salmonellosis occur every year, that contact with reptiles is a major risk factor for salmonellosis, and that the CDC (among other groups) recommends that children less than five years of age and other high-risk groups not have contact with reptiles. This type of statement is misleading. It's unfortunately either an indication of ignorance of the issues or an attempt to cover their butts and not take their share of the responsibility for what happened. Certain reptiles can be good pets in certain situations, but are clearly inappropriate in others.

The "it's never happened before so it must be safe" fallacy: The school's disappointing response was that they've been using lizards in classrooms for years and no one has gotten sick. Well, their luck just ran out. Just because I could drive around without a seatbelt and not get hurt doesn't mean not using a seatbelt is a perfectly safe plan. Risky behaviours tend to catch up with you eventually.

The "it didn't happen here so it's not our fault" excuse: School officials said teachers are well-trained on the proper way to prevent students from getting Salmonella, but that's pretty debatable since three kids got sick because of their actions (i.e. sending the reptiles to the children's home). The infections may not have originated in the school but the school was still the source of the problem.

Poor hygiene associated with reptile contact: The father admitted that they didn't wash their hands regularly after handling the lizards.

There's little excuse for sending reptiles home with kids. Reptiles require specialized care and commitment, and many (many!) die each year from inappropriate care. The last thing we need is to make it easier for people to obtain them without much forethought. Reptile-associated salmonellosis is a serious problem, especially in kids. Serious, including fatal, infections can occur. Schools need to realize the liability they might assume by sending these animals into households, especially with inadequate scrutiny and education. Reptiles should not be kept in households with kids less than five years of age, pregnant women, elderly individuals or immunocompromised individuals. I doubt they asked whether any such people lived in the household before sending the reptiles home.

H1N1, cats and the potential for mutation

jsweese@uoguelph.ca (Scott Weese) — Sun, 08 Nov 2009 14:57:00 -0500

I've spent a lot of time talking to the press this week about H1N1 and pets. One question that has come up repeatedly involves concern about the potential for this virus to mutate because of its presence in pets. This largely relates to the general knowledge that pigs are potentially important "mixing vessels" for influenza viruses.

H1N1 infection of cats carries almost no risk of a significant mutation. For this to happen, the animal must be infected with two different influenza viruses, and those viruses must recombine so that a new virus containing parts of each of the parent viruses is produced. This virus must then be able to infect a new host and be transmitted. Pigs are a concern because they can be infected by various influenza viruses (from humans and birds, as well as swine-origin viruses), and they tend to live with many other pigs so that the transmission cycle can be started. This isn't the case with cats.

Cats don't have their own influenza virus that is in circulation. Therefore, it's very unlikely that a cat exposed to H1N1 already has a different influenza virus in its system. Even if a cat was infected with a different flu virus (which is exceedingly unlikely) and this virus recombined with H1N1 (which is unlikely even if the two viruses were present), your average cat doesn't have much contact with different individuals, human or animal, and it's quite possible that the virus would just die-out in that animal.

While we don't want to ignore some of the issues regarding H1N1 in pets, such as the potential for pet illness and the unproven possibility that they could transmit H1N1 to other people, we need to keep the concerns in perspective. The risk that pets pose to people is much lower than the already very low risk that people pose to pets, in terms of H1N1 influenza.

Human vaccinia infection from rabies bait exposure

jsweese@uoguelph.ca (Scott Weese) — Thu, 05 Nov 2009 12:35:00 -0500

Rabies baiting is a highly effective way to reduce rabies in wildlife populations. As we've discussed before, in Ontario this involves air-dropping edible rabies vaccine. These baits are dropped in key rural areas, but there is the potential for curious people to come into contact with the vaccine if they handle baits that they come across. It is recommended that people avoid contact with the baits and wash their hands if they do come into contact with one, because the baits contain a live virus. They do NOT contain live rabies virus. Rather, they contain a vaccinia virus that has been manufactured to produce immunity to rabies virus. The risk of human infection is low, but as we constantly get reminded with infectious diseases, low doesn't mean zero.

Today's MMWR reported a case of human vaccinia infection associated with a rabies bait. In August, a 35-year-old Pennsylvania woman was picking berries and her dog and found a rabies bait. The dog punctured the bait packaging and the woman subsequently handled the bait. It took around 30 minutes for the woman to reach somewhere she could wash her hands, which she then did. This person had a few factors that put her at higher risk of developing an infection, including some skin lesions on her hands from berry thorns, and she was on multiple immunosuppressive drugs.

The day after exposure, her doctor took blood samples for rabies and vaccinia virus antibodies and examined her hands. Skin lesions (papules, i.e. little bumps) developed three days later. These lesions were tested and vaccinia virus was found in them. The skin lesions progressed and she was hospitalized a couple of days later. She was treated with antibodies against vaccinia virus because of the progression of disease and her compromised immune system. She went on to develop muscle aches, headache and a swollen lymph node. She was treated with more antibodies and an experimental antiviral drug. She ultimately responded to treatment and was discharged from the hospital on day 19.

This is the second reported human infection associated with a rabies bait. Considering the millions of baits that have been dropped and the presumably relatively large number of people that have had some contact with the baits, the overall risk of disease is still very low. This person was at high risk because of her immunocompromised status, and it's likely that an otherwise healthy person would not have developed an infection like she did. The big problem here was her contact with the bait. She did everything right after that: washed her hands as soon as she could, called the Department of Health, went to her physician and ensured that testing was done, but she still got sick.

Avoid rabies baits. The risks are low but why take any risk? People that have compromised immune systems or skin diseases should take particular care. If you've been exposed to a rabies bait, wash your hands ASAP and contact the local health authorities to determine if anything else should be done.

Image from: http://www.mnr.gov.on.ca/en/Business/Rabies/2ColumnSubPage/275904.html

How to diagnosis influenza in pets

jsweese@uoguelph.ca (Scott Weese) — Wed, 04 Nov 2009 16:08:00 -0500

One of the common questions accompanying the onslaught of calls I've taken today is "How do you diagnose influenza in pets?"

Clinical signs, such as sneezing, coughing, fever and lethargy, are not useful for diagnosis. Influenza can produce highly variable disease, ranging from almost none to very severe - so you can't look at an animal and say it has influenza just based on the clinical signs. We don't know much about H1N1 influenza in different animal species (including pets), but this type of influenza can probably cause a wide range of disease in animals as well (at least in those it can infect).

The presence of someone in the household with influenza should get you thinking about flu in a sick pet, but it is far from diagnostic. Many, many people have influenza, but very few pets do. There are many other diseases that can produce signs similar to influenza in pets. The health of people in the household is an important thing to know, but we can't jump to conclusions based on the household history alone.

Laboratory testing is required for the diagnosis of influenza, and there are a few options:

PCR testing of nasopharyngeal (throat) or nasal swabs, or fluid collected from the trachea: This molecular test detects influenza virus RNA. This is the fastest test and it is most sensitive when samples are taken early in disease. This is the main option for diagnosis at this time.
Serology: This involves testing blood for antibodies against influenza. Two samples are taken 10-14 days apart. If the antibody level rises 4-fold or greater, that is indicative of influenza infection. This is considered the most reliable method of diagnosis of influenza in many species but takes time. It is not currently a viable option for pets because tests for pets are not available.
Virus isolation from nasopharyngeal or nasal swabs, or tracheal fluid: Samples are inoculated into eggs to try to grow the virus. This can take quite a while and isolation of the virus can be difficult. This is a method used by specialized labs with laboratory containment conditions appropriate for this virus and may not be readily available.

H1N1 in a cat

jsweese@uoguelph.ca (Scott Weese) — Wed, 04 Nov 2009 14:01:00 -0500

H1N1 influenza has been confirmed in a cat in Iowa. The cat had "influenza-like illness" and was tested, with H1N1 being confirmed today. Two of three people in the house were also sick, but they became ill before the cat, and were presumably the source of infection for the cat. There's no evidence that the cat has infected anyone.

This doesn't really change anything that we've been recommending regarding H1N1 and pets. H1N1 infection is pets is rare but has been diagnosed in ferrets, and now in a cat. Considering the large number of infected people and the presumably large number of exposed pets, the risk of transmission to pets appears to be extremely low. Low doesn't mean no, however, and taking basic precautions is still wise.

Basically, remember that your pets are part of the household - microbiologically as well as socially. If you are doing something to reduce the risk of transmission of infection to people in the household, act the same way around your pets. Reduce contact with pets if you are sick. Avoid being around them when you are coughing. Wash your hands frequently. Avoid contact with their faces. If your pet gets sick after you've had H1N1 (or any other infection) make sure your veterinarian is aware of it.

Image source: icanhascheezburger.com

'Registered' service dog scam

jsweese@uoguelph.ca (Scott Weese) — Mon, 02 Nov 2009 21:00:00 -0500

I've written a few times in the past about the need for better definitions and guidelines for service dogs. Service animals are incredibly beneficial for some people, but there is great potential for abuse of the "service animal" designation by people who don't really need a service animal and/or are using completely untrained and sometimes inappropriate animals.

An example of such unscrupulous behaviour is RegisteredServiceDogs.com. At this site, you can enter your pet's name and your information, and get a form for your physician to sign requesting the dog be authorized as a service animal - but there is no such process, and this company has absolutely no authorizing power! Additionally, there's a place for a vet to sign affirming that the dog being "registered" has had all shots required by the state and that, to the best of the vet's knowledge, it will not be a threat to the general public. There is no mention about whether the dog is healthy, is well-trained, is specially trained as a service animal, has undergone any real scrutiny to determine whether it could be a "threat to the general public", or anything else that should be a requirement for a true service animal. In other words, this company does absolutely nothing to ensure that the animal is an appropriate service animal. For their overwhelming effort of providing you with a form to fill out, they charge $49.95 to send you a worthless card saying your dog is a "registered service animal".

Anyone who has a real service animal has no use for a card such as this. If they run into someone who inappropriately tries to restrict their access, they're better off with information from the agency that trained the animal or, in the US, a copy of highlights of the ADA, since restriction of service animals is illegal.

If this company was really in it to help the cause of service dogs, it would have some standard criteria to ensure that the animals it certifies as service dogs are really service dogs. Otherwise, it's a money-grab to provide a useless card to people with true service animals, and a way to help people who just want to take their pets with them to places where they are banned. None of this helps the cause of true service dogs. It is a disgrace.

Anyone with a service dog that has questions or concerns about access should contact the agency that trained their dog or another reputable (non-profit) source of information such as Delta Society.

Image source: www.guidedogsofamerica.org

Another ferret flu case

jsweese@uoguelph.ca (Scott Weese) — Sun, 01 Nov 2009 21:32:00 -0500

A second ferret in the US has been diagnosed with H1N1 influenza. The latest case involves a fatal infection in a ferret from Nebraska that was presumably infected by its owner. Three other ferrets in the household were also sick, and it's fair to assume that they had H1N1as well.

It's important to keep things in perspective. We have two confirmed pet cases among thousands and thousands of human cases. Thousands of pets have presumably been exposed to owners infected with H1N1, with few apparent problems. (You can never rule out additional cases completely, because pets tend to get ignored in outbreak investigations, but there's no indication that this is a major problem.)

This is yet another good reminder of the potential for diseases to move between species in households. If you are sick with a potential infectious disease, you should restrict contact with household members - all household members: human and animal. Ferrets are likely the greatest risk when it comes to H1N1, followed by pigs and pet birds. Dogs and cats are presumably low risk, but we can't say there's absolutely no risk.

If you might have H1N1, reduce close contact with your pets. Don't hide from them, but avoid close face-to-face contact and coughing around them. Wash your hands regularly. More details about household infection control precautions are available from the CDC. Take the same precautions around pets as you would around people. If your pet subsequently gets sick, make sure your veterinarian knows about the possible H1N1 exposure.

Image source: www.ferretfriends.org

Group A strep and dogs

jsweese@uoguelph.ca (Scott Weese) — Sat, 31 Oct 2009 08:05:00 -0500

I was asked this the other day, in regards to a post about pets and recurrent strep infections in people: "You listed a few things to remember and one of them was how the pet might be an "innocent bystander infected by a family member." Is there any indication that a dog might get sick from licking a person infected with Group A Strep?"

Streptococcal infections in dogs are very rare. When they occur, they are typically caused by Streptococcus canis, a Group G strep. Group B strep infections have also been reported. I'm not aware of any reports of Group A (Streptococcus pyogenes) infections in dogs, despite the fact that exposure is probably very common.

Group A strep is a predominantly, if not exclusively, human pathogen. It can be found in healthy individuals (e.g. in the throats of 10-15% of healthy kids) and is the main cause of strep throat. Group A strep also causes invasive infections such as cellulitis, various soft tissue infections, and in rare circumstances, necrotizing fasciitis (flesh-eating disease). Considering how commonly healthy people carry this bacterium and how common strep throat is, you have to assume that dogs are frequently exposed to this bacterium from household contacts.

Licking a healthy human carrier would certainly create an opportunity for a dog to be exposed. Licking wounds of patients with strep infections would probably be worse. Since exposure is probably common and we don't really identify problems in dogs with this bacterium, the risk of infection in dogs is presumably very low. However, basic measures should always be used to reduce the risk of exposure to infectious agents. Even though we don't recognize Group A strep as a problem in dogs, you don't want your dog to be the first case. Dogs shouldn't be allowed to lick infected wounds for both the health of the dog and the person. Strict avoidance of people with strep throat doesn't make sense, but licking should perhaps be avoided since the sick person could also be at higher risk for a secondary infection from the multitude of bacteria present in the dog's mouth.

Bottom line... the risk of Group A strep infection in dogs is minimal, but basic hygiene practices can make the risks even lower.

Rabies death in Indiana

jsweese@uoguelph.ca (Scott Weese) — Tue, 27 Oct 2009 16:48:00 -0500

An Indiana woman has died of rabies. Little information is currently available. Reports state that bat rabies was involved but that the source of exposure was not known. Presumably, they have determined that she was infected by the bat rabies variant (strain), but she didn't report being bitten or otherwise exposed to a bat. Bat rabies is a serious concern because it is easy to get bitten by a bat and not know it. Most cases of rabies in Canada and the US are associated with bat exposure. This is a tragic reminder about why we pay a lot of attention to bats and rabies (and why my family received post-exposure treatment after having a bat in the house a few years ago).

More information about rabies can be found on the Worms & Germs Resources page.

No spleen + dog bite = beware

jsweese@uoguelph.ca (Scott Weese) — Mon, 26 Oct 2009 20:20:00 -0500

A report from Seattlepi.com is a textbook example of what can happen to certain people after dog bites. Mike Moore tried to break up a fight involving his two dogs and received a minor bite. It barely broke the skin. No big deal, eh? Well, perhaps for most people, but unfortunately not for Mr. Moore.

He cleaned the wound and didn't think much about it. Two days later, he thought he had the flu. The next day, he was worse and went to the hospital. By the time he arrived, "his face and body had a bluish tint" ...never a good sign. When he was being examined, he was asked about the scar on his abdomen and he told the hospital staff it was from his spleen having been removed. They then asked about the bandage on his hand and he mentioned the dog bite. (Insert big ringing bells here!) The article says that the medical staff couldn't pinpoint the problem right away, but hopefully Capnocytophaga was a leading thought. Mr. Moore was critically ill by this point with multiple failing organs. He was admitted to ICU, became septic (overwhelming infection in his bloodstream) and was put on a ventilator. His hand had to be amputated, as did both legs below the knee and three fingers on the remaining hand. But he survived. (Despite the obvious long-term problems, he's very lucky to be alive after such a severe infection).

People that have had their spleens removed or who have non-functional spleens are at much greater risk for various infections, such as Capnocytophaga infections. No one should be allowed to leave a hospital after having their spleen removed without a letter saying, among other things, if you are bitten by a dog, get thee to a physician (pronto)! If you don't have a functioning spleen, make sure you know the risks and how to protect your health.

More information about Capnocytophaga and bites can be found on the Worms & Germs Resources page and in our archives.

Pets and H1N1 revisited

jsweese@uoguelph.ca (Scott Weese) — Fri, 23 Oct 2009 08:57:00 -0500

The recent discovery of H1N1 influenza in a pet ferret has led to another round of concern about the potential impact of H1N1 on pets and pets as a source of human infection. Finding H1N1 in a ferret is not particularly surprising, considering ferrets are susceptible to various (including human) influenza viruses. We shouldn't dismiss the potential that certain pets could become infected by this virus or transmit, it but the overall risks are presumed to be very low. There have obviously been many, many cases of H1N1 influenza in pet owners, yet there is just this one report in a pet (although it's certainly possible that other pets have been infected but not diagnosed). Ferrets may be the biggest concern. Pet birds and pot-bellied pigs may also be at higher risk considering this virus can clearly infect pigs and birds. Cats are probably a bigger concern than dogs because of what we know about cats' susceptibility to (and ability to shed) H5N1 (avian) influenza.

The risks are low to pets and pet owners, but there's rarely a no-risk situation with infectious diseases. A few basic measures should be taken to reduce the risks associated with this pandemic virus:

If you have (or think you may have) influenza, treat you pet like other people in your family. Avoid contact with them, especially their faces, and pay close attention to hygiene (especially handwashing). This should help reduce the risk of exposing your pet to H1N1.
If you have influenza, or your pet has been exposed to anyone with influenza, and your pet becomes ill (e.g. respiratory disease, fever, lethargy), contact your veterinarian. Avoid close contact with your sick pet (especially the face) and wash your hands after you handle it.
Relax and enjoy the company of your pet. The risks of influenza are low.

Swine flu has gone to the birds

mander01@uoguelph.ca (Maureen Anderson) — Thu, 22 Oct 2009 13:00:00 -0500

Just when all those turkeys that managed to survive Thanksgiving weekend thought their troubles were over, there's new issue: H1N1 influenza (formerly known as swine flu) has been found in an Ontario turkey flock. The H1N1 virus was first reported in birds in Chile in late August.

This is not a reason to panic. No one can get the flu from eating a properly-cooked Thanksgiving turkey (nor from any other type of properly-cooked turkey). The producer has voluntarily (and very responsibly) quarantined the affected flock, and no birds or eggs have left the facility. There is no risk to the food chain.

Pigs can be infected by human, pig and bird flu viruses, and multiple infections can result in viruses trading genes and producing new viruses that can infect more species. So it's not too surprising that H1N1can infect people, pigs and now birds as well. This incident serves as an important reminder that we need to remain diligent about infection control and hygiene, even around animals. It's highly unlikely that these turkeys had contact with infected pigs - most likely the virus was spread to this flock by a person. Poultry producers may therefore need to consider getting vaccinated for H1N1 flu not only to protect themselves, but also their flocks, and anyone who may have the flu should definitely stay off these farms. Hopefully the virus does not become established in wild bird populations (like H5N1 has in some areas), as this would make it much harder to control.

Recommendations for avoiding the flu (H1N1 or other) remain the same:

Wash your hands and/or use alcohol-based hand sanitizer
Sneeze into your elbow
Disinfect commonly touched surfaces
Stay home if you are sick
Get vaccinated!

Horse Strep in a person via a dog

jsweese@uoguelph.ca (Scott Weese) — Wed, 21 Oct 2009 15:02:00 -0500

Streptococcus equi subspecies zooepidemicus (usually just called Strep zooepidemicus) is a common cause of infection in horses. It is an "opportunist" that is often found in healthy horses, but which can cause disease in certain situations. While horses are the natural host of this bacterium, sporadic infections and outbreaks are occasionally reported in dogs at cats, particularly in shelters or other crowded situations. Severe (including fatal) pneumonia can occur, as was reported in a recent outbreak in a humane society in Ottawa. Rarely, S. zooepidemicus can also cause infections in people.

A report in the Journal of Medical Microbiology (Abbott et al) describes a serious S. zooepidemicus infection in a person, that was traced back to a dog. The dog lived on a farm that also had horses. It developed pneumonia and S. zooepidemicus was isolated from its respiratory tract. The dog was treated and recovered. However, the dog owner also became ill with fever, headache, a stiff neck and general malaise. Penicillin was prescribed, but the person's condition did not improve and he/she ended up in the hospital. Streptococcus zooepidemicus was also isolated from this person's nose and throat. When the dog and human strains were compared using molecular tests, they were related. An investigation of the farm was performed, and while all the horses present at the time were negative for S. zooepidemicus, the bacterium was isolated from a healthy dog.

This is a rare situation and one that shouldn't result in too much concern. It does highlight a couple points that are good to remember:

Getting cultures is very important for obtaining a diagnosis.
Animal contact and pet health should be considered whenever someone is sick with a potential infectious disease. Physicians need to know whether their patients have contact with animals. They need to be told if a sick animal is present so they can consider whether the pet and human illness might be related. Knowing to what someone may have been exposed might speed up diagnosis and appropriate treatment.
Rare things are rare, but they happen. We shouldn't focus on rare events but we have to keep our minds open and recognize that strange things happen with infectious diseases.

Deja vu all over again: Turtles and Salmonella

jsweese@uoguelph.ca (Scott Weese) — Tue, 20 Oct 2009 18:26:00 -0500

You'd think, after countless outbreak of salmonellosis associated with pet turtles, that people would learn and things would start to improve. I guess not. A paper published this week in Pediatrics (Harris et al) described a large outbreak of Salmonella Java associated with pet turtles. Between May 2007 and January 2008, 107 infections were identified. The median age (the age in the middle of the range of affected people) was seven years old. Sixty percent of infected people reported exposure to turtles during the week before they got sick; 87% were small (<4 inch) turtles, and 34% were purchased at a retail store (despite the fact that the sale of turtles less than 4 inches long is banned in the US). Five infected people, all less than 10 years of age, reported kissing the turtle or putting it in their mouths.

When they compared people with Salmonella Java infection to people without the infection, 72% of people with Salmonella reported contact with turtles versus only 4% of controls.

Salmonella is far from rare but it's nothing to ignore. Thirty-three percent of infected people were hospitalized. Fortunately, no one died.

The link between turtles and Salmonella has been known for a long time. Healthy turtles can carry the Salmonella bacterium and be a source of infection, particularly for children. The sale of small turtles is banned in the US to reduce the likelihood of close contact between turtles and kids, but this law is widely flouted. An understanding of the link between turtles and Salmonella is surprisingly uncommon - only 32% of Salmonella patients in this study (and 28% of controls) reporting knowledge of this link. Clearly, there are a lot of areas which could be improved.

If banning the sale of small turtles is truly an effective measure, then it should be enforced. "Black market' turtles are far too easy to find.
More public education is needed, among the general population and particularly people buying turtles. You shouldn't be able to take a turtle home from a store without an information sheet about the risk of Salmonella and how to avoid it.
People with turtles (or any reptile) need to recognize the risk and act appropriately. Good general infection control and hygiene measures are needed to reduce the risk of Salmonella exposure.
Households with children under five years of age, or with immunocompromised individuals should not have pet turtles.
Antibiotics are not the solution. Attempts to create Salmonella-free turtles with drugs have just led to the production of turtles carrying antibiotic-resistant Salmonella.
Common sense needs to be a little more common. The picture above (from http://www.familylovezone.com/js_DeepAndWide.htm) was proudly posted by a parent.

More information about infectious disease risks associated with turtles can be found on the Worms & Germs Resources page.

News flash: You can't sue a dog

jsweese@uoguelph.ca (Scott Weese) — Mon, 19 Oct 2009 20:29:00 -0500

A lawsuit against various parties, including a dog, has been tossed out by a Michigan judge. Inez Starks sued the city of Warren, several police officers and Liberty, a police dog, after being bitten during some sort of confrontation in 2007. I don't have any details about the bite, but "unprovoked attack" and "police dog" don't tend to go together. Police dogs can and will bite in certain situations, but these are extremely well-trained and well-handled dogs. Most people that are bitten by a police dog probably have themselves to blame more than anyone else. Inadvertent bites could potentially result from being an innocent party in the middle of a confrontation, I guess, but there is no indication this person was merely an innocent bystander.

Anyway, the suit was tossed out by the judge. As a good example of sanity in the legal system, the judge fined Starks' lawyer for naming the dog in the suit.

Dog bites are a big deal and the cause of many lawsuits. Dog owners need to take their responsibilities seriously to reduce the risk of bites (and consequently being sued). At the same time, people need to take responsibility for themselves to reduce the likelihood of being bitten when confronted by a dog. Usually, that's focused on "be a tree" training in kids, but not upsetting police dogs is probably another good rule of thumb.