There's been a lot of press about strangles (Streptococcus equi) outbreaks in Ontario lately, including a biosecurity update from the Ontario Ministry of Agriculture and Food (OMAF). In some ways, it's surprising since this is an endemic disease and strangles is pretty much always causing trouble somewhere in the province. However, a little press is never a bad thing, if it can help get people to do what they need to do (but often don't do) to control this highly contagious equine disease.
A big problem with strangles control is the unwillingness of some people to admit they have cases and/or people knowingly taking exposed horses off the farm, thereby spreading the bacterium to other farms.
Along that line, here's our latest educational poster. As with all of our materials, feel free to print, copy, post or disseminate at will. A higher resolution version can be downloaded from the Worms & Germs Resources - Horses page.
There’s been some controversy in the past regarding allowing pets to sleep in or on the bed. I don’t get too worked up about it, since I think it’s very low-risk in terms of disease transmission for most pets and households, but a variety if reasons for prohibiting this practice have been given.
I haven’t previously heard the reason: “Don’t do it because you might think you’re petting your cat when you are actually mistakenly pissing off the rabid raccoon that’s dozing beside you.”
Maybe that should be added to at list.
A Massachusetts woman learned this one the hard way. The woman was asleep one night a few weeks ago and reached over to pet what she thought was her cat. Unbeknownst to her, the critter beside her was actually a rabid raccoon that had come into the house through a cat door. Unhappy at being disturbed (and with a less-than-functional brain from rabies), the raccoon attacked, jumping on the woman's face and biting her lip, refusing to let go. She managed to pry the creature off her face, whack it with her phone and call 911. Animal control caught the raccoon, which was subsequently euthanized and confirmed as rabid.
From a more serious standpoint, this case highlights one of the big drawbacks of having a cat door that allows entry and exit of any cat-sized animal. Keeping cats indoors is a good idea for the cat’s health, the family’s health and the wild bird population (and avoids the cat door issue entirely!).
I would have thought this would fall under the realm of common sense, but as the saying goes: Common sense is like deodorant, the people that need it the most don’t use it.
A recent report out of Scotland is warning people not to kiss their pet reptiles, in response to four people who were hospitalized with salmonellosis after kissing bearded dragons, and other reptiles.
Reptile-associated salmonellosis is a major concern, and while there are ways to make reptile ownership very safe for most people, some risk will always remain. Certain behaviours will increase that risk. A large percentage of healthy reptiles have Salmonella in their intestinal tracts, and anything that’s in the intestinal tract ends up in the animal’s habitat and on its skin. Kissing reptiles is an obvious way to be exposed to this bacterium, which can cause serious disease in some situations.
Among the report's recommendations are:
- Families that own a bearded dragon or similar reptiles are advised to consult their doctor if they become ill with symptoms of fever, vomiting, abdominal pain and/or diarrhoea.
- They should also inform their GP that they keep a reptile. Children are particularly at risk because they like to stroke and handle pets.
- NHS Forth Valley have also issued a guide for pet owners to reduce the risk of catching Salmonella from lizards, which includes supervising children to make sure they do not put the animal, or objects it has been in contact with, near their mouths.
- It also recommended washing hands with soap and water immediately after handling a reptile, its cage or any other equipment, keeping a reptile out of rooms where food it prepared or eaten, and disposing of droppings and waste water down a toilet, rather than in a sink or bath.
Just common sense.
More information about reptiles and Salmonella can be found on the Worms & Germs Resources - Pets page.
The University of Guelph’s Animal Health Laboratory recently published a summary of selected zoonotic disease diagnoses in its monthly newsletter. It’s an interesting summary of what’s gone through the lab in the last year. It also helps to remind us of the zoonotic potential of all of these pathogens, some of which are relatively common and can be found in a variety of species.
A couple months ago, I wrote about a family suing PetsMart over a case of rat bite fever in a child.
Now, a San Diego family is suing PetCo after their ten-year-old son died of the same infection. Rat bite fever is a bacterial infection caused by Streptobacillus moniliformis, and it is almost always associated with bites from rats.
The San Diego family’s situation is tragic. Fortunately fatal zoonotic diseases from pets are rare. But when they happen, who’s to blame?
Part of figuring that out is thinking about what has to happen for an infection to develop, and where that cascade can be interrupted.
What has to happen for rat bite fever to develop?
The rat has to be carrying the bacterium in its mouth.
- The bacterium is found in basically all rats, so you have to assume that every rat is infected. (So, it’s hard to blame the supplier.)
The bacterium has to get into the person's body, usually by a bite.
- Bite avoidance is therefore key, and involves proper handling of the rat and selecting a rat that has a good temperament.
When the bacterium gets into the body, it has to be able to cause disease.
- Most often, the immune system takes care of it. However, the number of bacteria that get into the body, the weakness of the immune system, and the whims of biology all play roles. In an otherwise healthy child, bite first aid is critical to help remove as many bacteria as possible from the wound before they invade the rest of the body.
To me, it all boils down to education.
- Pet stores need to inform purchasers about infectious disease risks and preventive measures.
- People need to take responsibility to learn about any pets they may purchase (before they get them), and take measures to reduce the risk of zoonotic pathogen exposure.
- Physicians need to be more aware of zoonotic diseases and ask about pet ownership and animal contact.
Would any of these have made a difference here? It’s hard to say. However, these are all relatively easy things to do and could probably prevent a lot of infections.
More information about Rat Bite Fever can be found on the Worms & Germs Resources - Pets page.
A female Corgi was presented to a Parker County, Texas veterinary clinic and subsequently diagnosed with rabies. Presumably, the dog was exhibiting neurological signs, died or was euthanized, and the veterinarian made sure the dog was tested for rabies (something that could become more complicated in Canada now that the CFIA has inexplicably dumped rabies investigation from their mandate).
Presumably, the dog contracted rabies from a skunk, since it brought a skunk carcass home with it a few weeks earlier, and that timeframe that fits with rabies' incubation period.
The dog's vaccination status wasn't reported, but it was probably not vaccinated against rabies. Rabies vaccination is not a 100% guarantee against contracting the disease (no vaccine is), but it's a very good vaccine, and failure of the owners to get the dog vaccinated is the most common contributing factor to rabies in dogs and cats. It's interesting that there were two other dogs in the family that were up-to-date, so it would be nice to get clarification of this dog's vaccination status.
Unfortunately, the dog was nursing a litter of five-week-old puppies at the time, and the puppies were euthanized. It's hard to say how likely it is that they had contracted rabies, but regardless, a six-month strict quarantine and hand-raising a litter of puppies don't exactly go hand-in-hand.
The report also says that two adults and a child are "currently under medical supervision and treatment as a precautionary measure," meaning they are getting a course of post-exposure prophylaxis, which consists of a shot of anti-rabies antibody and a series of four shots of rabies vaccine.
There's no guarantee, but effective vaccination might have prevented the death of the dog, euthanasia of five puppies, hassles with (presumably) a 45 day observation of the vaccinated dogs, and the angst and expense of post-exposure prophylaxis for three people. Rabies vaccination is well worth the investment!
I’ve written before about concerns I have with international rescue programs. We’ve been seeing various "foreign" diseases in dogs that have been imported to Ontario, and some of these could pose a risk to the broader dog population. I also have a hard time justifying someone spending a few thousand dollars to import a dog when we have lots of dogs right here in local shelters looking for homes. Often, people just want to be able to say they have an “[insert exotic sounding country here] rescue dog.”
There’s been a lot of discussion about stray dogs in Sochi, Russia, where there is a large stray population and reports of culls being undertaken by Russian authorities. Not surprisingly, even such a concerted effort isn’t going to get rid of all strays. More than a few people at the Sochi Olympics have bonded with local strays and are looking into bringing home a canine souvenir.
To me, this is a different situation than the one above, since these people have bonded with a specific dog (or dogs) and I can more easily justify the effort and cost to bring those dogs home.
However, disease risks remain the same.
Unfortunately, rules for importing dogs are very limited for most countries and don’t do much to protect the local dog population or public health. Typically, the only government concern is rabies, and even for that disease the rules are pretty lax.
- If it’s been vaccinated against rabies at least 30 days prior to entry, that’s all that's needed.
- If it has not been vaccinated, it can still be imported if the importer agrees to vaccinate the dog within 4 days of arrival and keep the animal confined for at least 30 days after vaccination.
- If the dog is less than 3 months of age (too young for rabies vaccination), it must be kept confined until 3 months of age, at which point it needs to be vaccinated and confined for 30 more days.
(I doubt anyone actually follows up to see if vaccination or confinement are done.)
Importing a dog into Canada
- This one’s even easier. If the dog is less than 3 months of age, it’s "welcome to Canada," since “Dogs do not require rabies vaccination or certification if they are less than three months of age at the time they are imported into Canada.”
- There is no quarantine or follow up.
So if you’re coming back from Sochi with a puppy, you’re not going to get a lot (or any) guidance from federal authorities. What should you do to protect the puppy, other animals and yourself?
- Take the dog to a veterinarian ASAP to identify any problems, and have it dewormed and vaccinated. Make sure it gets treated right away with praziquantel to eliminate any Echinococcus multilocularis (a highly concerning tapeworm) that might be present. (I have no idea what the prevalence of this parasite is in the Sochi area, but I’d err on the side of caution and assume the dog’s infected, particularly since a single dose of this very safe and inexpensive drug will eliminate it.)
- Keep the dog away from other dogs for at least a few weeks. That means staying away from parks and other areas where it may encounter local dogs. This helps to protect the other dogs AND the new arrival, since it takes time for vaccines to work and there may be some impact on the immune system from the stress of travel and adjusting to a new home.
- If the dog gets sick, get it to a veterinarian. Don't mess around.
- If the dog develops neurological disease, make sure rabies is considered. The incubation period can be months, and while we need to think about rabies in all neurological cases, it’s of particular concern in dogs imported from some other areas of the world.
If someone bonds with a dog while and Sochi and wants to bring it home, good for them. However, they should take some measures to reduce the health risks to their new furry friend, other animals and themselves.
It's a scary sounding headline: “Cat Bites Pose Risk Of Infection As 1 In 3 Patients Bitten Hospitalized; Teeth Inject Bacteria Into Joints, Tissue” and it cites a research article from the Mayo Clinic in the Journal of Hand Surgery (Babovic et al 2014).
Cat bites are nasty. The mouth of any cat harbours thousands of different bacteria and their needle-like teeth can inoculate bacteria deep into tissues. A variety of complications can occur after cat bites, and they are not something to dismiss as innocuous.
But hospitalization of 1/3 of people that are bitten? Not a chance.
Let’s see what the paper actually said:
The paper is entitled “Cat bite infections of the hand: assessment of morbidity and predictors of severe infection.” It was a review of 193 patients that were presented to one hospital with cat bite injuries to the hand.
- Point 1: The study population is people who went to the hospital for a cat bite, not all people who were bitten.
- Point 2: The study only looked at people bitten on the hand(s). That’s a common site to be bitten by a cat, but it’s also a high-risk site for complications because hands have lots of sensitive and fairly superficial structures (e.g. bones, joints, tendon sheaths, nerves) that are more likely to cause problems if they get infected.
So, it’s pretty clear that 1/3 of all bites don’t result in hospitalization. In reality it's a much smaller percentage, but you really don’t want to be part of that small group, so bite avoidance and proper post-bite first aid are still very important.
Some other highlights from the paper:
- Nineteen percent (19%) of patients were admitted to the hospital at presentation (i.e. they had to stay at least one night). A further 11% failed initial outpatient antibiotic treatment and were subsequently hospitalized.
- Sixty-nine percent (69%) of patients were women (not sure why - could be that more women own cats, more women get bitten by their cats, or more women are likely to seek medical care if they're bitten by a cat, or a number of other reasons).
- Risk factors for hospitalization (compared to people that presented to the hospital for a bite but did not require hospitalization) included smoking, having a compromised immune system and a bit over a tendon sheath or joint. Those are not surprising at all.
- Signs of inflammation (e.g. redness, swelling at the site of the bite) were associated with increased risk of hospitalization. Not too surprising either.
- The average time from bite to presentation was 27 hours. Interestingly, time from the bite to presentation was not a risk factor for complications, as this has been reported as a risk factor previously (and it makes sense that it would be). However, don’t take that as an indication that you can wait a long time to seek medical care after a high-risk bite.
- Complications were those that are typically encountered with cat bites (and good reasons to avoid them): abscesses, tendon infection and nerve involvement.
- Seven percent (7%) of all patients (not just the hospitalized ones) had loss of joint mobility after resolution of infection. Remember that cat bites can have long-term consequences.
- Cultures were only available for some patients, but Pasteurella multocida was the most commonly isolated bacterium. This bacterium is a notorious bite-associated bacterium and is commonly (if not always) found in the mouths of cats.
Crappy headline but an important topic.
Cat bites are bad, and it doesn’t matter if the hospitalization rate is 30% or 0.3%, they can still result in serious problems. They can also be largely avoided through proper cat handling, understanding some basic cat behaviour and proper first aid - things every cat owner should know.
More information about cats and about cat bites can be found on the Worms & Germs Resources - Pets page.
Photo credit: Moyogo (click image for source)
Antibiotic resistance is a big deal. Lots of people and animals die because of it every year. It costs the healthcare systems (human and veterinary) tremendous amounts of money and it’s not getting better.
It’s been clear for years that we have to do a better job of using antibiotics responsibly, in both animals and humans. It’s a complex area, and people often spend too much time complaining about the "other" side (human vs veterinary) rather than trying to address their own problems. However, there are issues with certain practices that seem so straightforward I’m amazed they're allowed to continue and that they haven't already been addressed.
One such issue is the ability to buy certain antibiotics in large volumes over the counter at feed stores in some countries (like Canada), with no veterinary involvement.
Another is the plethora of fish antibiotics you can buy all too easily in pet stores (and which often end up being used on dogs and cats).
And today’s rant is about a group of products that's ongoing use boggles my mind: tear stain prevention products like Angels' Eyes. These are over-the-counter products marketed to reduce tear staining, mostly in small, white dogs. Yes, tear staining - an entirely cosmetic problem that has absolutely no impact on health. The scary part is that products like Angels' Eyes contain tylosin, an antibiotic of the macrolide family. (How much it contains is a bit of a mystery since that information isn't even included on the label.)
Does it make any sense to treat animals for a purely cosmetic problem for long periods of time (or lifelong) with a (presumably) low dose of any antibiotic, let alone one in a drug class that includes many antibiotics that are important for treating infections in people and animals?
In some countries, irrational antibiotic use like this is banned. More countries need to follow suit.
Sometimes, people send me links to articles because they think I’d be interested in them. Sometimes, they do it to see what kind of response they can evoke. I’m not sure which one this was:
I was directed by a couple of people to a recent post of PLOS’s blog about snakes in classrooms. (I don’t really know why a scientific journal organization has a blog to which people who aren’t experts in a given field can submit posts. I would have thought a PLOS blog would relate to PLOS papers, but what do I know.)
I’m sure many people would agree with the sentiments in this blog, but (surprise, surprise), I don’t. It’s not that I’m anti-reptile, anti-pet-in-classroom, or think that the writer is clueless. Rather, he seems to be a passionate and well-meaning educator who just doesn’t see the issues with reptiles in classrooms. I’ve seen the issues and have my take on some of his points (in italics) below.
In this post I hope to give other educators a good foundation for keeping snakes in their classroom. A classroom pet is always a good way to teach responsibility. Administrators love any outside-the-box methods of teaching. Let them know students will be using this animal not just to learn science, but to learn important life skills like responsibility and compassion.
- True, but it has to be logical and safe. It also has to be educational. Animals can be used in classrooms for educational purposes, but they can also be distracting. The practice can be questionable from an animal welfare standpoint (especially for nocturnal species). They can be associated with disease. Reptiles are the leaders in that class, and reptile-associated salmonellosis has occurred from classroom snakes and other reptiles. Widespread Salmonella contamination of feeder rodents adds an extra level of concern.
- I also doubt administrators like outside-the-box ideas that pose a health risk to students (and therefore liability).
Your administrator may bring up questions about health risks. Salmonella is often associated with pet reptiles. This can be a bit misleading. Most animals, including pets like hamsters and guinea pigs can carry salmonella, but because turtles are wild caught, and often live in terrariums there is a better chance of salmonella living on their shell.
- No…(multiple no’s actually). While most animals can carry Salmonella, the prevalence of Salmonella shedding by pet mammals is very low. The rate of Salmonella shedding by captive reptiles is, in contrast, very high. Studies looking at snakes over time have shown that virtually all captive snakes are shedding Salmonella.
- It’s not just wild caught turtles that are the issue. Captive turtles are also a big concern (the bigger concern, actually).
Most snakes are kept in the same cage setup as hamsters and have little risk of ever having salmonella on their skin.
- Not a chance. Most do. As mentioned above, studies have shown high (to ubiquitous) carriage of Salmonella by snakes.
I have been handling snakes for 25 years and admittedly have poor hand washing skills and have never had an issue.
- That’s similar to saying “Gee officer, I drive drunk all the time and I’ve never killed anyone, so you have to let me go.” Yeah, that’s an extreme analogy but you hopefully get the point. Reptile contact causes thousands of cases of salmonellosis in people every year. There might be no infections in this classroom over the next ten years - or a child could die next week. It’s more likely that the former will happen, the the latter is possible.
I do keep multiple bottles of hand sanitizer in the classroom and make sure the students properly sanitize after handling and/or cleaning.
- That’s great. It’s an important risk reduction tool, but it’s not perfect and doesn’t compensate for the risk.
I would wager students are more likely to salmonella in the lunch line than they are from snakes in a classroom.
- I doubt it. Even if it was true, eating is a required event. Having a snake in the classroom is not.
Once bitten, the students lose most of their fear and wear it as a badge of honor.
- Multiple issues with this one...
Some issues are often overlooked:
- Do teachers always know if they have any high-risk (immunocompromised) kids in the class?
- Do teachers always know if there will be any high-risk kids visiting the class?
- What if a student is very afraid of snakes? How is that managed? (Is it managed? Might a child be afraid to say anything and instead work in a very stressful situation in silence?)
- Are students eating in the same area as the snake (a high risk activity to be sure)?
Here's my standard disclaimer: I actually like reptiles. Now that our kids are beyond the high-risk ages, Heather would be the main barrier to a request from them for a reptile, not me. However, while I like reptiles, I don’t like them in all situations. When the Salmonella risk can’t be contained and assurances can’t be made that only low-risk people will be exposed, reptiles shouldn’t be kept around. A classroom is a perfect example of just such a situation.
More information about Salmonella and safe management of different pets can be found on the Worms & Germs Resources - Pets page.