Do you know where 'that doggy in the window' came from?

Nearly 700 dogs were seized in the largest puppy mill raid ever in Tennessee. Puppy mills are large scale breeding operations that produce large numbers of puppies under questionable to horrible conditions. They typically raise dogs under intensive conditions, such as in cages in barns. There may be little attention to the quality of parents, with the goal being production of a large number of puppies, not production of healthy, happy and safe household pets. These conditions lead to increased risk of health problems, carriage of infectious diseases that can be transmitted to people and behavioural issues related to lack of proper care, inbreeding, poor veterinary care, lack of socialization with people and little attention to breeding appropriate parents. The high rates of infectious diseases can lead to excessive and inappropriate use of drugs like antibiotics and antivirals. Some puppies receive multiple rounds of drugs while passing through puppy mills and pet stores. Overuse of antibiotics and important antiviral drugs like Tamiflu is a major concern.

Unfortunately, puppy mills  (and smaller poor-quality breeding operations) are widespread, especially in some US states. Puppies from these operations can be sent across North America and sold through newspaper ads, internet ads and pet stores.

Puppy mills exist because there is a market for the puppies. I've never understood why people often spend incredibly large amounts of money for dogs of questionable background, marginal health and potentially raised in inhumane conditions.  Why buy a puppy that might have originated from a puppy mill when you can get a puppy (probably healthier) from a humane society or reputable breeder? Great dogs are awaiting adoption at humane societies. Otherwise, get to know the breeder. Good breeders make sure that their dog is appropriate for you, and you are appropriate for the dog. Places offering multiple  breeds, that always have puppies available upon demand and don't ask a lot of questions about potential buyers are a concern and could indicate that the puppies are being raised in puppy mill-like conditions.

Dog bites cost millions

A recent report by the Insurance Information Institute stated that 1/3 of US homeowner insurance liability claims that were paid in 2007 were due to dog bites. This represented a cost of over $356 million! The average cost per claim was an astounding $24 511.

This is just one more piece of evidence indicating the importance of dog bite prevention. The $356 million cost is just insurance claims. Not all bites are associated with insurance claims but can still be associated with financial costs, in addition to the obvious pain and emotional costs. There were ~14 500 insurance claims in 2007,  but it is estimated that 4.7 million people are bitten by dogs in the US each year, with 800 000 people requiring medical care.

In the US, dog owners are liable for injuries caused by their pets in the following circumstances:
  • if the owner knew the dog had a tendency to bite
  • if a state statute makes the owner liable, whether or not the owner knew the dog had a tendency to bite
  • if the injury was caused by carelessness on the part of the owner
I don't know how or if similar regulations apply to other regions such as Canada, but it is logical to assume that these situations could be of concern for dog owners elsewhere.

It is important that everyone, pet owners and non-pet owners alike, know how to reduce the risk of being bitten by a dog. More information on bites can be found in the bites archives or in the dog information sheets in the Resources section.
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Cat bites - Why it's not "just a scratch"

Even the most well-natured, lovable cat has the potential to bite. Particularly if an animal is frightened or in pain, it may lash out with teeth and claws, even at its most trusted human companion. Many of us are used to sustaining small cuts and wounds in everyday life, and at times it hardly seems worthwhile to trouble a physician to look at a little cat bite. But 20-50% of cat bites become infected, compared to 4-20% of dog bites. The bacteria responsible are most often combinations of Pasteurella spp., Staphylococcus spp., Streptococcus spp. and others. In some cases, particularly when Pasteurella multocida is involved, the infection can develop very rapidly (within hours) and may become very serious, or even spread to the bloodstream. Cat scratch disease (Bartonella henselae infection), despite the name, can also be transmitted by cat bites. Cat bites can be very deep, even though they look very small at the level of the skin, which may lead to infection of things like joints and tendons under the skin, which are more serious.

You should see a doctor about any cat bite on a hand, over a joint, over a tendon sheath (such as the wrist or ankle), over a prosthesis or implant, in the genital area, or that causes a deep tear. You should also see a doctor for any bite if you happen to have a weakened immune system for any reason (e.g. HIV/AIDS, cancer or transplant patients).

The best way to prevent infection is to prevent the cat from biting you in the first place!
  • Use common sense – know how to handle a cat properly so that it is not frightened or uncomfortable. If a cat growls at you or tries to get away, let it go!
  • Don’t let cats play with your hands, feet or hair. Use a nice cat toy instead.
  • Don’t approach strange cats, especially strays. If you are bitten by a cat that may not have been vaccinated for rabies, it is very important to report the incident to you local public health department and your doctor, as you may need to receive rabies post-exposure prophylaxis (PEP).
More information on cat bites, what to do if you are bitten and ways to prevent cat bites can be found on the Worms & Germs Resources page.

Rabies awareness month

June has been declared Rabies Awareness Month in New York State. The focus of the occasion is on education, particularly with respect to bats.  Since 1990, 38 of 41 human rabies cases in the US  involved bats. Approximately one-third of bats tested in New York are positive for rabies. In 2007, 559 animals were confirmed as infected with rabies in New York, and  more than 3000 people were treated for rabies exposure. Further, more than 1400 New Yorkers undergo treatment each year following exposure to bats that were not caught and tested. State health personnel are emphasizing the need to catch and test bats if people have had contact with them, or when a bat has been present in a house with a sleeping person. They have produced a video on how to safely catch a bat in the house.

Important points to remember about rabies and bats are:
  • Never touch a bat.
  • Consider every bat to have rabies until proven otherwise.
  • If you have slept in a house overnight with a bat, you are considered exposed. Unless the bat is caught and tested (and shown to be negative) you should undergo post-exposure treatment.
  • If you or your pet may have been in contact with a bat, try to catch it (safely) so that it can be tested for rabies.
  • Vaccinate your pets against rabies, even if they never leave the house.
More information on rabies and rabies prevention can be found on the Worms & Germs Resources page.

Photo: Little brown bat (M.B. Fenton)

EU Antibiotic Awareness Day

The European Union has announced that November 18 will be the EU's Antibiotic Awareness Day. Antibiotics are incredibly important drugs and save countless lives (human and animal) on a daily basis. Resistance to antibiotics is a major threat to human and veterinary medicine. While antibiotic resistance is a complex issue, overuse and improper use (in animals and people) undoubtedly contribute to the emergence and spread of resistant bacteria like MRSA. Awareness of these concerns is important for healthcare professionals (both human physicians and vets) and the general public. Here are some general points to remember with respect to pets and antibiotics:
  • Do not encourage your vet to prescribe antibiotics when they are not necessary. Vets (and physicians) often feel pressure to prescribe 'something', even though they have no clear evidence of a bacterial infection. Antibiotics do not work for viral infections.
  • Never give antibiotics to your pet without the direction of your vet.
  • Always give the full antibiotic course, as prescribed. Do not stop early. Your pet may look better but the infection could still be there.
  • Never save antibiotics for 'future use'. If your pet develops another infection, you need to have your pet evaluated by a vet to determine if antibiotics are needed, and what antibiotic would be best.

FDA Requests Seizure of Animal Food Products at PETCO Distribution Center

The US Food and Drug Agency (FDA) has issued a warning about pet food produced by PETCO in the US and sold at PETCO stores in Alabama, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Minnesota, Missouri, Nebraska, Ohio, Oklahoma, Tennessee, Texas, and Wisconsin. The food production facility was inspected in April and had a serious bird and rodent infestation. The problems had not been corrected by the next visit so the FDA seized the food. They are concerned that the poor hygienic conditions in the facility could put pets at risk from eating the food, or people at risk from handling the products. No illnesses in people or pets have been reported, but authorities are urging people to report any possible cases. They are also recommending that people wash their hands thoroughly if they have had contact with these products (including packaging), and that they wash any surfaces that have come into contact with these products (including packaging). Presumably, people should contact the store about a refund (I'm not sure I'd want a replacement from a plant that was shut down for repeated serious hygienic breaches).

Any potential illnesses associated with these products should be reported promptly to the FDA's consumer complaints coordinators.

There is no indication any of these products were sold in Canada.
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Pet store sued over bird owner death

Once again, a pet store is being sued following a death related to a pet sold at the store. Earlier, we reported a pet store being sued by a woman whose husband died of lymphocytic choriomeningitis virus. Now, a pet store is being sued after a man died of psittacosis. This disease is caused by Chlamydophila psittaci, a bacterium that is most commonly found in psittacine birds (parrot family). It can cause disease in birds but can also be carried by healthy birds. The family had purchased a cockatiel prior to the man's illness, although details about the timing of disease, the bird's health and whether the bird was identified as carrying Chlamydophila psittaci aren't clear.

Typically, psittacosis causes flu-like disease and is easily treated, if diagnosed properly, however more severe disease can develop. Infected birds can shed the bacterium through feces and nasal secretions. People usually become infected by inhaling aerosolized bacteria from dried feces or nasal secretion.

Psittacosis is an uncommon disease. Only 125 human cases were reported to the CDC in the US between 2000 and 2006, however many more cases probably occurred. The risk of acquiring psittacosis from a pet bird is very low.

  • Bird owners should make sure that their physician is aware that they have contact with birds. Psittacosis should be considered in people with flu-like disease that have bird contact.
  • Do not buy birds that look unhealthy (lethargy, nasal or eye discharge, ruffled feathers...).
  • If you have other birds, isolate new birds for 30 days before allowing them to have contact with existing birds.
  • Reduce aerosolization of materials when cleaning cages. Lightly wetting cage paper will reduce the risk of aerosolization.
  • Wash your hands after handling birds or cleaning their cage.
More information on psittacosis is available in the National Association of State Public Health Veterinarians' Psittacosis Compendium.

Tularemia Trouble

A case of pneumonic tularemia was recently reported in New York City.

Tularemia is a disease caused by the bacterium Francisella tularensis.  It causes different signs of illness depending on how the bacteria enter the body.  If the bacteria are inhaled, it tends to cause pneumonia (pneumonic tularemia).  If the bacteria get in through a break in the skin, infection may cause the local lymph nodes (glands) to become very swollen, and in some cases the skin itself may become infected resulting in the formation of large sores (ulcers).  Infection can also cause sores in the mouth and diarrhea.  The earliest, most common signs are things like fever, headache, chills, sore muscles, and sore throat which often come on very abruptly.  The infection can be treated with antibiotics, but it is important to see a doctor and start treatment as soon as possible.

Tularemia is also sometimes called "rabbit fever," because the bacteria are often carried by animals such as rabbits and hares.  Rodents (including beavers, rats, mice, squirrels etc.) can also carry F. tularensis, and occasionally so can cats and dogs.  Some biting insects like deerflies and certain species of ticks can carry the bacteria and transmit it when they bite.  Francisella tularensis can also survive in water and soil for a long time.  People can become infected by being bitten by an infected insect, handling an infected animal (dead or alive), or coming into contact with feces from an infected animal.  Occasionally a person may inhale the bacteria if it is in the air, as may happen with disturbed, dusty, contaminated soil.

More information on tularemia can be found on the CDC's tularemia website.

Things you can do to avoid tularemia:
Avoid touching or handling wildlife (dead or alive), especially rabbits and rodents.
Don't let your pet touch or eat dead animals.
Always wash your hands if you have been working outside in the dirt/soil.
Wear insect repellent containing DEET (visit the Health Canada website for more safety tips) 
Make sure you only wash food with and drink water that has been properly treated.

One of the reasons tularemia is such a big deal is it is very infectious - as few a ten bacteria can be enough to make even a healthy person sick!  But it is still quite uncommon in North America - about 100-200 cases are reported in people in the USA every year.  Between 2002-2004 there were 34 cases reported in Canada, most of which occurred in Quebec and in adults.  However, infection can be fatal in a very small number of cases, especially if proper treatment is not given as soon as possible.

Dog flu in Chicago

The Chicago Tribune is reporting canine influenza in dogs in the Chicago area.  These are the first reported cases oin Illinois. Canine influenza has now been reported in 27 American states. It has also been previously identified in the UK.

Here are some canine flu facts:
  • Canine influenza originated from an equine influenza virus.
  • Canine influenza can cause a wide range of clinical signs, ranging from mild illness (cough, fever, decreased appetite and activity) to very severe (and potentially fatal) pneumonia.
  • Dogs that have frequent contact with other dogs (e.g. in kennels or parks) or dogs in shelters are at higher risk of catching the virus.
  • About 80% of dogs that are exposed to this virus will get sick.
  • Most affected dogs recover fully.
  • Canine influenza cannot be diagnosed just by looking at the dog. Various other bacteria and viruses can cause similar disease.
  • Because the disease is caused by a virus, it can NOT be treated directly with antibiotics (just like influenza in people!)
  • There is no vaccine for canine influenza.
  • Canine influenza is not transmissible to people.
  • Try to keep your dog away from any dogs that looks ill, particularly those that are coughing.
  • If your dog starts coughing or looks otherwise sick, you should take your dog to the vet, especially if your dog has been in a kennel, shelter or in contact with another sick dog.

More information about control of canine influenza can be found on the American Veterinary Medical Association Public Health Information website.

To our knowledge, there are still no reported cases of canine influenza in Canada. However, it seems inevitable that the virus will eventually make its way north of the US border, considering the number of US states that are now affected.

Dogs and dead birds

As the owner of a dog that loves to roll in (and eat) anything she finds, I certainly understand the questions that I get about risks to dogs from dead birds. Eating a dead bird is certainly not an appealing thought to us, but overall, the risks to a dog are pretty low. The greatest potential problem is likely gastroenteritis, often referred to as ‘garbage-gut’, which typically causes diarrhea (with or without vomiting) after "dietary indiscretion" (i.e. a dog eating things it shouldn't have). Another concern is Salmonella. Some birds carry Salmonella in their intestinal tracts and dogs could become infected from eating them. This is a bigger problem in cats that hunt birds - salmonellosis in outdoor cats is also referred to as songbird fever. West Nile virus can cause death in birds, especially species such as bluejays and crows, which may then be found by your dog. The risk of transmission of West Nile virus to dogs from eating dead birds is presumably very low. Further, this disease is very rare in dogs and they appear to be quite resistant to the virus.

  • Try to prevent your pet from eating/touching dead birds.
  • If your pet develops diarrhea after eating a dead bird, it is probably not a health concern for anyone else but Salmonella infection is possible, so consider taking your dog to the veterinarian. This is especially important if the dog appears sick (i.e. besides vomiting and diarrhea, the dog also is not acting like itself) or if there are people in the household that are at higher risk for getting sick from bugs like Salmonella (i.e. infants, people with weakened immune systems). All diarrhea should be considered potentially infectious to other animals and people.  Extra care should be taken around affected pets and their stool, including extra attention to hand washing, and disinfecting the site of any "accidents" that occur in the house.
  • In some areas where bird testing is performed for West Nile virus or avian influenza surveillance, public health personnel will collect dead birds. Contact your public health department if you are unsure what is done in your region.
If you must move or remove a dead bird, precautions should be taken. These include:
  • Do not touch dead birds with bare hands.
  • Use heavy-duty, leak-proof gloves to place the bird in a leak-proof plastic bag. Alternatively, fold two bags over your hand and use the bag to cover your hand when picking up the bird (like people do when poop-scooping), or use a shovel to place the bird in a bag.
  • Double bag the bird.
  • If the bird is not being collected for testing, contact your local waste management agency regarding disposal instructions.
  • Always wash your hands with soap and water as soon as you're done.

Molly the peeing lab

Molly is a 1-year-old Labrador Retriever (not mine!) that has a peeing problem. She often urinates in the house when she's excited, which raises the question about how to clean up such accidents.

In general, urine is sterile and is not a risk for disease transmission. Simply removing urine from the area should therefore be adequate. However, urinary tract infections can happen, and some of the bacteria that cause these infections could be transmitted to people, although the risk is likely extremely low. The risk is probably greatest in pets that develop repeated urinary tract infections because of underlying diseases such as diabetes. Another concern is leptospirosis, a bacterial infection that can cause kidney failure and that can be transmitted to people.  More information on leptospirosis is available on the Worms & Germs Resources page.

In most situations, indoor urination is more of an annoyance than a real health risk. If a pet suddenly starts urinating in the house, it should be examined by a vet to look for any of the many health or behavioural problems that can cause this. This includes testing for a urinary tract infection. If an infection is present, or a pet has suddenly started urinating in the house for an unknown reason, it is prudent to be more careful about cleaning it up than one might be when dealing with housetraining accidents in puppies, or with dogs with certain chronic urination problems not related to infection.

Urine should be removed with disposable paper towels, which are promptly discarded. The area should also be disinfected, if possible. Smooth surfaces (e.g. linoleum, tile, hardwood) can be wiped with any appropriate household disinfectant. Carpets are harder (if not impossible) to disinfect. Always wash your hands after cleaning up any accidents.
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Toxoplasmosis - Why Your Cat Shouldn't Get the Blame or the Boot

Toxoplasma gondii is one of the most widespread zoonotic pathogens in the world. Toxoplasma is a protozoal parasite that can infect almost any warm-blooded animal, including humans. In most people and animals, infection doesn’t cause any illness at all, and after the initial infection, the body usually produces strong immunity which protects it from subsequent Toxoplasma infection. Problems arise when infection occurs in a person with a weakened immune system. For example, toxoplasmosis (i.e. illness due to Toxoplasma) has been a major problem in HIV/AIDS patients, although better HIV treatments have decrased the incidence of the disease in this group in recent years. Toxoplasma can also cause problems when a woman is infected for the first time, before her body has developed immunity to the parasite, while she is pregnant. In these cases, the parasite can infect the fetus. This may result in birth defects or loss of the pregnancy altogether.

Our friendly feline companions have the unfortunate distinction of being what is called the “definitive host” of Toxoplasma. This means that even though the parasite can infect many species of animals, cats are the only species that shed the parasite “eggs” (which are called oocysts in this case) in their stool after they’re infected. But what most people don’t realize is that the number of cats that are shedding oocysts at any one time is very small – usually less than 1 in 100. And after the first time a cat is infected, it usually doesn’t shed oocysts again, and if it does it sheds them in very low numbers.

Depending on individual lifestyle and eating habits, a person is just as likely or more likely to be exposed to Toxoplasma from working in the garden or eating undercooked meat (particularly free-range pork or wild game). People who are pregnant or who have a weakened immune system do NOT need to get rid of their cats because of Toxoplasma, but they DO need to take steps to avoid exposure to Toxoplasma from all sources.  This includes avoiding contact with cat stool and kitty litter by asking someone else to clean their cat’s litter box for them if possible, or wearing rubber gloves and being very careful to wash their hand very well afterwards if they need to clean the box themselves. Here are a few more tips that can help reduce their risk of exposure to Toxoplasma:
  • Clean your cat’s litter box every day. The oocysts usually take about 24 hours to become infective once they’ve been passed in your cat’s stool, so daily cleaning helps remove them before they reach this stage.
  • Always wash your hands with soap and water after cleaning your cat’s litter box, after working in the garden or in any soil, and after handling raw meat.
  • Cook all meat, especially pork, lamb, mutton and wild game, to an internal temperature of 67ºC/153ºF or higher.
  • Keep sandboxes covered so outdoor cats don’t contaminate them with stool.
  • Keep your cat indoors. Outdoor cats are more likely to be exposed to Toxoplasma and shed oocysts in their stool.
You can find more information about Toxoplasma on the Worms & Germs Resources page.

Removing ticks

As we (finally) get nice weather here, a rash of questions about ticks usually follows.  Ticks are very common in some areas, and a short walk in the woods can result in exposure. Ticks themselves aren't the concern. The problem is infectious diseases that ticks can transmit, including Lyme disease. The risk and types of diseases of concern vary geographically. (In Ontario, exposure to ticks that can transmit Lyme disease is most common in Point Pelee, Rondeau, Long Point, Turkey Point and the Thousand Islands area). There are a number of ticks that may feed on people and pets, but only a few that transmit infections. Your veterinarian, physician and/or public health departments should be able to tell you what diseases are of concern in your area.

Regardless of where you live, if you and your pet might encounter ticks, you should know how to remove them. Prompt removal is the key. Most tickborne diseases aren't transmitted immediately. Rather, the tick must be attached for a period of time for infection to occur. Therefore, close inspection of your pet (and yourself) for ticks after spending time outside, is important.

The following tick removal tips come from the Centers for Disease Control and Prevention (CDC).
  • Remove a tick as soon as you see it.
  • Use fine-tipped tweezers to firmly grasp the tick very close to your skin. With a steady motion, pull the tick away from your skin. Then clean your skin with soap and warm water.
  • Avoid crushing the tick’s body.
  • Do not be alarmed if the tick’s mouthparts remain in the skin. Once the mouthparts are removed from the rest of the tick, it can no longer transmit Lyme disease bacteria.
  • If you accidentally crush the tick, clean your skin with soap and warm water or alcohol.
Tick removal devices are also available and can be used in place of tweezers. If you use one, make sure the device does not squeeze the tick's body as you remove it.

If a large number ticks are present on your pet, you should contact your veterinarian for assistance. Typically, a product that kills ticks will be applied to your pet.

There are various anecdotal recommendations that should be avoided, including burning the tick off with a match and covering the tick with substances such as gasoline, petroleum jelly or nail polish.

Dog stool and garbage

I received the following question yesterday:

For approximately 20 years I have been involved in waste collection for the Parks Division.  A considerable amount of the waste which I collect on a daily basis is dog excrement.  This is usually, but not always contained in a plastic bag and thrown into a large garbage barrel which I man-handle and dump in a waste truck. Years ago I contacted the local Health Unit and asked if there was any special health risks associated with this job.  They advised me at that time the main danger to health would be with E.coli contamination.  I use neoprene gloves while carrying out my duties and of course try to ensure that I do not come in contact with any debris. This is not always possible.

There are 3 main risks with handling dog stool: exposure to bacteria that cause diarrhea, exposure to intestinal parasites  and infection of wounds.

Various bacteria that can cause diarrhea can be present in dog stool. These include Salmonella and Campylobacter. E. coli is not a major concern because strains found in dogs are not typically those that cause disease in people. A few intestinal parasites are also of concern, including Giardia and roundworms. The risk of exposure to these is hard to say because you don't know anything about the health status of the dogs, but it's wise to treat all stool as infectious. However, for these to cause disease, they must go from the garbage and into your mouth. The risk of this should be minimal with basic common-sense precautions.

A large number of bacteria present in stool can cause infections of wounds like cuts and scratches, or other skin lesions such as eczema. Direct contact of these lesions with stool would be required to cause infection. The risks of this can also be greatly reduced with basic preventative measures.

Some basic precautions (many of which you are doing) include:
  • Wear gloves when handling bags containing stool.
  • Change your gloves if they become contaminated with stool.
  • Have your gloves cleaned periodically, and whenever they become contaminated. Otherwise, use disposable gloves.
  • Promptly wash or disinfect your hands if they become contaminated. Carrying an alcohol-based hand sanitizer in your truck would be useful.
  • Wear coveralls or some other sort of outerwear that can be removed easily if contaminated. If your clothing becomes contaminated, change it (and wash your hands after).
  • Wash your hands after removing your gloves (and especially before eating).

Overall, the risks to you should be very low.

Methicillin-resistant staph: what's in a name?

There is a lot of concern and confusion about methicillin-resistant staphylococcal infections in pets. "Staphylococcus" is genus of bacteria which contains numerous different species. All these species can come in 'methicillin-resistant' forms that are resistant to many antibiotics, but some of these species are of greater concern than others. The main species of concern are discussed below.

Methicillin-resistant S. aureus (MRSA): This species is the big concern. MRSA is an important cause of disease in people and an increasing problem in pets. It can cause serious infections and be transmitted between animals and people (in both directions).

Methicillin-resistant S. intermedius (MRSI): Actually, what most laboratories still call S. intermedius appears to be a related species called S.  pseudintermedius. Regardless, MRSI (or MRSP) can cause a variety of infections in pets - usually skin and ear infections. While it can be spread from animals to people, this is likely rare and there is much less concern about MRSI compared to MRSA in terms of risk to humans from infected pets.

Methicillin-resistant S. schleiferi (MRSS): This species is closely related to (and often misidentified) as S. intermedius. It is most commonly found in skin and ear infections. There is no information about the risk of transmission to people from pets. It is probably possible but very unlikely.

Methicillin-resistant coagulase-negative staphylococci: This is a large group of staphylococcal species that are usually lumped together. They are commonly found in or on healthy dogs and cats as part of the body's normal bacterial population. They are less common causes of disease. There is currently minimal concern about transmission to humans.

MRSA is the main concern with regard to staph infections, and warrants particular attention when it causes infection in a pet. In these cases, important precautions to take include washing your hands frequently, avoiding contact with the infected part of the animal's body (plus the nose, where MRSA often hangs out), keeping the infected site(s) bandaged (if possible), keeping infected pets off the bed, and restricting contact with high risk people (e.g. young children, elderly, immunocompromised). For the other staph species, the risks to people are much lower, but it is still reasonable to implement these measures to further reduce the risks.
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