Worms & Germs Blog

Classroom Pets Going Home for the Holidays

Posted in Other animals, Pocket pets, Reptiles

My kids come home from school with lots of consent forms. Last week, one came home asking permission to enter Erin into the draw to see who gets to take home their Grade 3 class fish (Lord Bubbles). She didn’t win the draw, but it fit with a recent article in the Toronto Star entitled “Classroom pets head home for the holidays”.

Classroom pets are an area that has been minimally studied from animal welfare and zoonotic disease standpoints. Problems such as infectious diseases (mainly Salmonella from reptiles), bites and scratches definitely occur, but there can also be positive impacts, particularly when pets are brought into learning activities or when kids have no pet exposure at home. As with most things, it’s a balancing act, managing the risks and maximizing the benefits. How to actually do that (and whether any thought goes into it in most classrooms) isn’t clear.

Adopting out classroom pets is usually necessary. If the teacher won’t take the animal home, someone else has to. I suspect there’s often little prior communication with parents – “look what I brought home Dad!” is probably a common way this happens. Ideally, there’s some advanced planning and education of the prospective adopters before the animal goes home. The gecko shown in the picture with the Star article highlights a high-risk species (a reptile), so hopefully there was some consideration of whether the household to which it was going included any high-risk individual (e.g. pre-school age kids) and some information was provided about animal care, including zoonotic disease risks and how to mitigate them. Unfortunately, those thought processes aren’t particularly common. That’s one reason we have info sheets for various species on the Worms & Germs Resources – Pets page.

Most classroom pets are low-risk and adopting them can be beneficial all around. A little education and some common sense go a long way.

Photo: Jennifer Pyz, thestar.com

Clean Hands Save Lives: Horsey-Style

Posted in Horses

Infection control isn’t rocket science. Wash your hands, don’t eat that, keep your finger out of your nose… things you learned in kindergarten go a long way to preventing infections. The basic nature of the core infection control concepts is also a barrier – hand washing isn’t fancy, new or associated with some fancy machine. (There is actually “an app for that,” but it can’t get people to wash their hands, it’s only used for recording whether or not they do.)

Clean hands save lives” is more than a slogan, it’s a fact. Whether it’s a human, horse, dog or any other species, hands are important sources of bugs that cause infections. That’s why a lot of effort is put into getting people in human and veterinary hospitals to improve hand hygiene compliance; something we know (in large part from Maureen’ s work) isn’t great in veterinary medicine.

On the equine side, here are a couple of new hand hygiene posters – perfect for posting in equine clinics, but also excellent reminders in any barn, boarding facility or competition venue where horses are brought together.  More information and resources will be coming soon to the veterinary hand hygiene website.  Remember, “Clean hands – Safe Animals“.

Worms and Germs Map Update

Posted in Cats, Dogs, Horses, Parasites, Rabies

A few years ago, we launched WormsAndGermsMap to help track certain emerging and endemic diseases. Data are entered by participating veterinary clinics, surveillance programs and the WormsAndGerms team. While we certainly can’t capture every case, we do collect some interesting information about the presence of certain diseases.

Using the “Report Filter” bar on the left, you can filter by disease, animal species and date.

For those who haven’t visited the Map (yet!), here are some screen shots from a few selected diseases – check out the website for lots more!  Clinics interested in participating by submitting cases for the map can register using the link at the top of the page.

Rabies

Equine herpesvirus myeloencephalopthy (EHM)

Canine lungworm in Ontario

Equine influenza in the UK

Canine Importation Working Group Recommendations, and Rio2016 Adoptions

Posted in Cats, Dogs

Last year, a Working Group was established to review the issue of importation of dogs into Canada and to come up with options and recommendations to:

  • Mitigate the risks to animal health (domestic and wildlife) and public health posed by the current system through which dogs are imported from abroad.
  • Mitigate the same risks posed by unmonitored movement of animals within Canada (particularly from remote northern regions)
  • Address animal welfare issues with regard to transportation of companion animals exhibiting clinical signs of illness within and at Canadian borders.

Stray puppyThe report of the working group has now been released; to view it, click here.

The time might be right to be thinking about this topic again. We saw large numbers of “Sochi” dogs shipped out of Russia after the 2014 Sochi Olympics. Already, people are talking about “Rio 2016” dogs. The Rio 2016 Olympic Committee is actually running a program to adopt stray dogs from Olympic venues and find homes for them – in Brazil.  That’s great. “Rio 2016” becoming the next fad pet in other countries wouldn’t be so great.

The report doesn’t say importation shouldn’t be allowed. However, there’s a need to make sure it’s done better to minimize the risks to the imported dogs, to local dogs and to people.

Will anything come from this report? Only time will tell, but hopefully it will lead to more discussion and ideally some changes in regulations to reduce the inherent risks of importation.

Worms & Germs is now on Facebook too! Find us there @wormsandgermsblog.

Raccoon Road Trips and Raccoon Rabies

Posted in Rabies

When raccoon rabies re-emerged in Ontario last fall, one of the big questions was “where did it come from?” It had been eradicated from the province and control measures were in place at the borders to reduce the risk of re-introduction. It was assumed that a rabid raccoon hitched a ride across the border from northwestern New York state and made it into the Hamilton region (outside the border area where rabies prevention measures were greatest).

Further genetic analysis of the raccoon-variant rabies virus that was found in Hamilton has essentially confirmed that it did indeed come from New York state, but it doesn’t seem to be from the closest border area as expected. As reported by the Canadian Press, Susan Nadin-Davis, a researcher with the Canadian Food Inspection Agency, compared the genetic sequence of the Hamilton virus with strains from different parts of the northeastern US. Surprisingly, “the virus is closely related to a strain from southeastern New York state, and quite distinct from the strains found closer to the border.”

Rather than a (still impressive) hitch-hike of 100 km or so from northwestern New York, past the rabies control zone in the Niagara Region and into Hamilton (where it infected other raccoons and and then spread into the skunk population as well), the index animal’s road trip was likely more like 500 km.

That road trip has caused a big problem in Ontario, with ongoing transmission in the raccoon and skunk populations (128 cases detected at last report) and a widening control zone (that now includes where I live).

For more information on rabies in Ontario and a full series of maps showing to the progression of detected cases to date, visit the OMAFRA rabies website.

rabieszone24

Mapping Zoonotic Disease Emergence Risk

Posted in Birds, Cats, Dogs, Horses, Other animals, Other diseases, Pocket pets, Reptiles

Predicting the future is a dodgy proposition at the best of times. It’s particularly hard with infectious diseases, which tend not to behave as expected. Yet, it’s important to plan surveillance, education and response. One approach is to assess where certain types of problems are more likely to develop. That can help direct resources (time, effort, money) to higher-risk locations where they’ll potentially have the most impact.

A recent study in Trends in Parasitology (Han et al 2016) did just that. They looked at existing information about mammalian species that are hosts for various zoonotic pathogens and they looked at a variety of factors that can influence disease risk. The paper has a lot of comprehensive discussion of risks associated with different types of mammals (e.g. rodents vs bats vs ungulates) and different types of pathogens.

However, since we tend to like things distilled down into pretty pictures, their maps are getting the most attention. Their assessment of the number of zoonoses in different regions might surprise some.

For the full story, the open source paper can be accessed via the hyperlink above.

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Moving Dogs, Moving Bugs

Posted in Dogs, Rabies, Vaccination

husky-dogI’ve written a lot about the issues of dog importation and the diseases that can sometimes “come along for the ride”. However, high risk movement doesn’t need to be international. Any movement from a high risk area can be a concern. A recent article in Canadian Communicable Disease Report (Curry et al. 2016) addresses the issue of movement of dogs from Nunavut (a territory in northern Canada) to southern regions. The article focuses on a couple of rabies incidents that resulted from movement of infected puppies to Alberta and Saskatchewan.

Alberta

The first incident was in 2013, when a Calgary resident that had worked in Nunavut arranged to have a friend bring a puppy back for her. She had seen the puppies while in Nunavut but couldn’t take one at that point because of their age. A few weeks later, the friend brought one of the puppies back.

Upon arrival, the puppy looked okay, but a little over a month later, it started vomiting and had bitten the other dogs in the household and the owner’s roommate. It deteriorated neurologically pretty quickly, was euthanized and identified as being rabid. Subsequent testing identified (not surprisingly) the Arctic fox strain of rabies virus.

The outcome:

  • The other dog had been primarily vaccinated for rabies but had not yet received its one-year booster.  The owner chose euthanasia over vaccinating the dog immediately and placing it under observation for 45 days.
  • 18 people were identified as having had contact with the puppy and 9 received rabies post-exposure prophylaxis. This consisted of 4 household members, 4 friends of the owner and one veterinarian.

Interestingly, none of the other puppies or the mother were identified as being rabid. A rabid fox had been identified in the community that winter and Arctic fox rabies is endemic in the area, but it was surprising that none of the others had been exposed (and infected) as well.

Saskatchewan

A construction camp worker in Nunavut became fond of a local puppy and decided to bring it back to Saskatchewan. The puppy became sick en route and had behavioural abnormalities by the time it arrived. It bit a family member and had many neurological abnormalities when it was examined by their vet. Rabies was suspected, the puppy was euthanized, and the test was positive.

The outcome:

  • The puppy had travelled to Saskatchewan from Nuvanut via Yellowknife (Northwest Territories) and Edmonton (Alberta), requiring multi-province/territory coordination.
  • Two co-workers in Nunavut were exposed. They had returned home to Nova Scotia, adding another province to the list.
  • The family member that was bitten received post-exposure prophylaxis. Because of pre-existing travel plans, the last dose was administered in Ireland, adding another country to the response.
  • The veterinary technician that was collecting samples for testing cut herself in the process. She received post-exposure prophylaxis.
  • Workers in multiple airports were investigated to ensure no one had contact with the puppy. Fortunately, no contacts were identified.
  • The other dog in the household was behind on its rabies vaccinations but was boostered immediately and quarantined for 45 days as per the Saskatchewan Ministry of Agriculture.

As expected, this puppy was infected with the Arctic fox strain. Littermates were not traced (in part because there is no veterinary or agricultural regulatory body in Nunavut). However, around the same time, another rabid dog was identified in the same community. Both it and a fox in the area were infected with rabies virus.

There’s a Test For That! But, Is There a Need?

Posted in Dogs

Long grassSome diagnostic tests that are available are more of a situation of a test looking for a market rather than filling a clinical need for additional information. That complicates matters since providing new information isn’t necessarily useful if we don’t know what to do with it. In some situations, it can even lead to bad decisions.

Increased awareness of tick-borne diseases is spawning a market for tick testing. If people finds ticks on themselves or their pets, they can submit the ticks for testing. In some regions, public health agencies do (and pay for) the testing. In others, it’s user-pay.

The question is “what does the test result tell us, and what do we do based on the results?” That’s the key. If testing leads to useful information or appropriate action, it’s good. If it confuses the situation, leads to no action or leads to inappropriate action, it’s bad. Tick testing can cover all of those, depending on how it’s applied.

Some government agencies test ticks to better understand what tick borne infections may be in the area, and to determine how commonly ticks are infected. That does not impact the management of the person or pet from which the tick came. Rather, it’s used at the population level to get more information and guide various programs and response. That’s useful, as long as people realize what the testing is for and the individual results aren’t going to change what happens to them.

Sometimes, tick testing results are taken as an indication that infection is present or likely, and that treatment is required. That’s not useful, and if anything is probably harmful. For example, for Lyme disease to develop, the following has to happen (also check out the latest OAHN infographic on Lyme Disease in dogs in Ontario):

  • a tick has to attach
  • it has to be the right type of tick
  • that tick has to be infected with Borrelia burgdorferi (the bacterium that causes Lyme disease
  • it has to feed for at least 24-48h to transmit the bacterium
  • the bacterium has to enter the body
  • the bacterium has to evade the immune system
  • disease has to develop

Testing the tick can answer points 1-3, but not the rest.

This leads me back to testing.  An over-the-counter test is now available in Canada for testing ticks for the presence of B. burgdorferi. If the test is accurate (a big if, since I’m not aware of any published data), the usefulness is as discussed above, i.e. potentially useful to understand the population and if an individual has been potentially exposed (but not necessarily infected). However, it’s bound to be misused.

As reported by the CBC, “The Public Health Agency of Canada does not recommend testing of ticks for infection to decide whether to treat someone for Lyme disease, but said the test may have a role to play in disease prevention if it prompts people to seek medical attention.” The question is, does this test actually change much?

If the tick is positive, what does that mean?

  • It means there was the potential for exposure, if the tick was attached for long enough. That doesn’t mean disease will occur. It means that if the individual develops signs consistent with Lyme disease, they should go to a physician (or bring their dog to a vet), and mention the Lyme test result. However, the same should apply to anyone who has (or has a pet with) signs consistent with Lyme disease if they have recently had a tick exposure, even without knowing the tick’s Borrelia status.

If the tick was negative…

  • That means the individual is at low risk of Lyme disease from that tick. It doesn’t mean no risk, unless the test is 100% accurate, which is unlikely, nor does it rule out potential exposure via other ticks that weren’t found and tested (particularly on a furry dog which makes them tough to find).

If I had the test available, would I test a tick I found on myself or my dog? Probably, out of interest and to get a better understanding of Borrelia in the area. The problem is, not everyone will approach the test that way. Unfortunately, it’s bound to lead to an “OMG THE TICK WAS POSITIVE. GIVE ME DRUGS… NOW!!!”

That’s bad.

New superbug in dogs and cats: mcr-1

Posted in Cats, Dogs

MDR Ecoli PHIL 16802A few years ago, the New Delhi metallobetalactamase-1 (NDM-1) antibiotic resistance gene attracted a lot of attention. This resistance gene can be found in (and passed between) a variety of bacteria, and bacteria possessing this gene are resistant to a wide range of drugs. A drug of last resort for those infections is colistin (a pretty toxic drug but the only option in some cases). Last November, a new resistance gene, mcr-1 was identified in E. coli from food, food animals and people. It’s now been found in numerous countries, and it’s gotten even more press over the past week since being found in the US as well. The mcr-1 gene confers resistance to colistin.

The emergence of mcr-1 is a big issue, because if you’re infected by a bacterium that is resistant to most antibiotics, and mcr-1 adds resistance to what might be the drug of last resort, that leaves you with zero treatment options. It’s been stated that mcr-1 heralds the emergence of the first truly pan-resistant bacterial infections – infections that can’t be treated with any antibiotics at all. It’s probably a fair statement.

A report in an upcoming edition of Emerging Infectious Diseases (Zhang et al 2016) describes 3 people from China infected with mcr-1 harbouring E. coli. One of the individuals worked in a pet shop, so they tested 53 dogs and cats from the store. Pretty concerningly, mcr-1 was found in 4 dogs and 2 cats. That’s bad. What makes it worse is that a few different strains of E. coli in these animals carried mcr-1, indicating they had either been infected by multiple (unidentified) sources, or mcr-1 had be passed around between bacteria in the animals’ guts. Four isolates from the dogs and the isolate from the person were the same, supporting transmission between them. Whether that means it went from dog-to-person (along with dog-to-dog) or person-to-dog can’t be discerned. It also cannot be ruled out that the animals and person were infected by some other unidentified source. Either way, this highlights the potential for interspecies transmission of mcr-1 and potentially for the spread of mcr-1 within dog and cat populations, as well as transmission of the gene between bacteria within an individual. None of those are good news, but none are really that surprising.

What is the animal health risk?

Pretty minimal, most likely. Resistance to colistin isn’t too much of a concern since it’s a drug we’re very unlikely to use in animals. Lower profile but more common antibiotic resistant bacteria that we encounter on a regular basis are going to continue to have a greater impact.

What is the public health risk of mcr-1 in companion animals?

That’s a tougher question to answer. It’s probably very low but it’s pretty early to say much with confidence. The odds of any given household pet shedding a bacterium that has mcr-1 are probably very low. Further, if the pet has it, where did it get it? In a lot of situations, it would be from its closest contacts (i.e. people) who probably pose a greater risk of passing it on to other household contacts.

The scenario is probably going to be similar to what we see with MRSA in pets, albeit on a hopefully much smaller scale. MRSA infections in dogs and cats are typically human-associated. They get infected with common human strains and people are probably the ultimate sources of infection. That being said, if an animal is shedding MRSA, it poses some risk of passing it back to the human population. The same would likely apply to some bacteria carrying mcr-1.

What does this mean to veterinarians and animal owners?

It’s just one more reason to use antibiotics right. We need to use them, so we need to make sure that we use them well.

There’s a lot more to the story of mcr-1 and companion animals that needs to be discerned. As the report authors wrote “companion animals can serve as a reservoir of colistin-resistant E. coli, adding another layer of complexity to the rapidly evolving epidemiology of plasmid-mediated colistin resistance in the community.”

Image: The bacterial isolate on the left plate is susceptible to the antimicrobials in all of the different discs on the plate, which prevents it from growing near the discs.  The isolate on the right plate is resistant to all the antimicrobials and can therefore grow near the discs.  (CDC Public Health Image Library 16802)

Lyme Disease and Dogs Infographic

Posted in Dogs

OAHN Infographic - Ticks & Lyme - GF2 20160512The Ontario Animal Health Network – Companion Animal has released a new infographic on Ticks and Lyme Disease in Ontario: What’s The Real Risk?  It’s obviously Ontario-centric but some of the messages apply more broadly. It’s important to consider what the real risk of exposure is, and that involves thinking about things like how common Borrelia burgdorferi (the cause of Lyme disease) is in ticks in the region, the type of tick that was attached and how long it might have been attached, along with (importantly) whether any signs of disease are present. This varies regionally, and knowing what’s going on in your area is important for understanding the risk.

Click the image to download a pdf copy of the inforgraphic (8.5″x 14″).