Occupy San Francisco's canine parvo outbreak
A parvovirus outbreak has been identified at the Occupy San Francisco camp, with at least three dogs affected by the highly contagious and potentially very serious viral disease. The San Francisco SPCA has visited the camp and their temporary clinic was attended by "dozens" of dog owners (indicating lots of dogs at the camp). This is a nice proactive step to help contain the parvo outbreak and hopefully reduce the risk of transmission of various other infectious diseases amongst the animals. Some people appreciated the help. Others (probably the subset that complains about everything) accused the SPCA of spreading bad publicity to help shut down the camp. (I guess they'd rather have good press than healthy dogs.)
In many ways, it's not too surprising. "Occupy" camps are just asking for infectious disease outbreaks, more so in people, but the same risk factors are there for dogs. Whenever you mix together lots of different individuals from different sources, put them in close and prolonged contact and have hygiene challenges, you set the scene for infectious diseases. From a canine parvovirus aspect, heavy fecal contamination from dogs defecating in a small, concentrated area and unvaccinated dogs feed the fire even more. (I don't know for sure that the affected dogs were un- or incompletely-vaccinated, however given the excellent effectiveness of parvovirus vaccines, it's highly likely that sick dogs were not adequately vaccinated.)
Parvo isn't the only infectious disease problem at the camp. Kennel cough (now known as canine infectious respiratory disease complex, CIRDC) has also been identified. This syndrome, caused by a mix of bacteria, viruses and Mycoplasma, has greater potential to spread widely because some of these bugs are highly contagious and vaccination coverage in the population will be lower than for parvo. A large-scale kennel cough outbreak is quite likely if there is kennel cough activity at the camp.
What can you do to reduce the risk, whether it's while "occupying" or during your daily activities?
- Have your puppy vaccinated as per your veterinarian's recommendations.
- Don't take unvaccinated puppies to areas where there will be lots of other dogs. "Unvaccinated" includes puppies who have not had their full initial series of vaccines.
- If your dog is sick, don't take it out in the public, especially to places where other dogs will be present.
- If your dog gets sick during a public event, take it away promptly to reduce the risk of it infecting other dogs.
- Don't let healthy skepticism grow to paranoia, and don't let political squabbles interfere with proper healthcare... both human and veterinary.
New York hotel-cat restrictions
New York City's Algonquin Hotel has a feline tradition of sorts - namely having a resident cat to greet people in the lobby. Matlida III is the tenth in a line of hotel cats that dates back to 1932. She has her own page on the hotel's website, and her own email address. Yet the City's Department of Public Health has issues with the hotel having both Matilda and another tradition - food in the lobby - co-existing.
According to the hotel website, the cat normally has the run of the building except for the dinning room and kitchens. However, since the hotel also serves food in its lobby, it's running afoul of the health code, which prohibits pets in any area where food is served. (Interestingly, the news article says there's an exception for restaurants that serve seafood. I'm not sure why, but I guess we all know cat's would never go for seafood...). Therefore, Matilda is now being kept on a leash and restricted to the reception desk, main entrance and coat room.
So, does any of this make sense? There's no clear answer, and like a lot of other infectious disease issues, it comes down to cost/benefit. Every human/animal encounter comes with some risk of infectious disease transmission, as does every human/human encounter. Some things increase the risk, while others can decrease the risk.
Having food served around animals increases the risk of disease transmission, because many of the infections we're concerned about are transmitted by ingestion of bacteria and parasites from animals. Based on that, it seems like a reasonable rule, even though it's probably much more likely that someone would contract an infectious disease from a person in the lobby than from the cat. Ideally, they'd figure out a way to have the food in another area so the cat could still roam the lobby without having access to the food serving area itself, but that may not be an option for the hotel.
One thing that often gets overlooked in these discussions is allergies. In reality, allergies are probably the biggest human health issue with a situation like this. Some people are extremely allergic to cats and wouldn't expect to encounter a cat in a place like this. An unexpected cat encounter could cause significant discomfort for some allergic individuals. Letting the cat hang around the coat room raises similar concerns because of the potential for contamination of peoples' coats with fur and dander.
Issues like this tend to generate a polarized response, with some people outraged at the cat's restriction and others outraged at peoples' outrage, reasoning that a hotel lobby is no place for a cat.
Condolences can be sent to Matilda via her personal email address: matildaalgonquincat@algonquinhotel.com
MRSA control in animals..Finnish style
As MRSA in animals gets more attention, there have been increasing efforts to develop guidelines to reduce the incidence and impact of this important zoonotic pathogen. Among these are a set of recommendations developed in Finland for the prevention and control of MRSA infections in animals (or metisilliiniresistentti Staphylococcus aureus, as they would say in Finnish). Apart from the abstract which is translated into English, the document is entirely in Finnish, but it might be of interest to any of our readers that are proficient in that language (presumably a pretty small subset). This is clearly a worldwide issue, and it's important that it is addressed on a worldwide basis.
More canine flu in New York and New Jersey
Canine influenza continues its rather puzzling spread through the US. After emerging years ago, it has spread sporadically, causing some large regional outbreaks but sparing many areas, and it has moved about in a pattern that's pretty unusual for a highly contagious virus.
There have been various reports of canine influenza activity in the New York and New Jersey areas over the past few months, and an outbreak has now been reported in a PetSmart doggie daycare in Farmingdale (NY) . Eight dogs have been diagnosed with canine flu (though not sure how or whether it's a lab-confirmed diagnosis) and the PetSmart doggie daycare has been closed since November 14. It was supposed to have re-opened on the 22nd, but dogs that had been there won't be allowed back until two week after their last visit, due to the potential that they were infected at the facility and are still infectious.
Like human influenza in people, canine flu is a viral infection that's readily transmissible between dogs. It typically causes mild disease, with coughing as the main sign, but can cause serious (and sometime fatal) pneumonia in some cases. A vaccine is available but it's not considered a "core" vaccine and is largely reserved for dogs in areas where the virus is active and/or in dogs whose lifestyle makes them more susceptible to exposure (e.g. contact with doggie daycare or boarding facilities, contact with many other dogs, travel to areas where the virus may be active).
Interestingly, PetSmart is paying for treatment of the infected dogs. That's pretty surprising, and may set a precedent they might want to avoid. Infectious diseases are a fact of life. We can do things to reduce the risk of exposure, but we can never completely eliminate the risk that our pets (or ourselves) will get an infection. Usually, infectious diseases that happen in facilities are considered an unfortunate fact of life (especially when it's a vaccine-preventable disease) and facilities rarely cover any costs associated with such outbreaks. In reality, this would be a reasonable approach assuming the facility used standard and reasonable practices to reduce the risk of disease.
If a facility has an infection control plan and adheres to it, whether it's a boarding facility or a veterinary hospital, it's hard to expect them to cover the costs of infections, since not all infections are preventable. In contrast, if there is no infection control program or if things aren't done right, it's easier to assign blame and expect some financial support. Sometimes, costs are covered purely on a public relations basis, which is perfectly reasonable as well. There's no indication why costs are being covered here, but it raises some interesting, broader questions about infection control in facilities like this and their role in covering any costs that are incurred from any type of infectious disease exposure.
Toilet research
The scope of research that's being done these days is astounding. Somewhere, someone's working on a project that will lead to a Nobel Prize in medicine. Other research will gather less critical acclaim but still have a big impact on science. Some research is more basic but can result in important preliminary information. And some studies... well, they may have a serious side but they're not what people typically think about when envisioning medical research.
Here are a few highlights from the lesser-heralded group of people investigating bathroom behaviours:
- A study of toilet reading habits in Israeli adults (Goldstein et al. Neurogastroenterol Motil 2009) concluded that toilet reading is a common and benign habit. (I hadn't really thought of it as a potentially poor lifestyle choice, but I guess this confirms it's fine). While it involves more time spent in the bathroom, "It seems to be more for fun and not necessarily to solve or due to medical problems." (Perhaps a more relevant area of study would be hand hygiene practices by toilet readers and the impact of toilet reading on fecal contamination of reading materials.)
- A Korean group has established that frequent recreational cycling does not have a negative impact on urination or sexual function in men (Kim et al. Korean Journal of Urology 2011). Cycling enthusiasts around the world, including me, rejoice.
- Horseback riders can be similarly relieved (pardon the pun) that recreational riding isn't associated with increased risk urinary or sexual dysfunction (Alanee et al. Urology 2009).
- A study with the catchy title "Female bowel function: the real story" (Zutshi et al Dis Colon Rectum 2007) wasn't too thrilling but had tidbits such as older women and women with children report more flatulence.
What do these have to do with zoonotic or infectious diseases? Nothing, but a little potty humour lightens up the start of the work day. More "real" posts to follow.
When does research become bioterrorism?
One of the big doomsday scenarios of the past couple of decades has been an H5N1 avian influenza pandemic. Human infections with this virus have occurred in various parts of the world (mainly southeast Asia) and death rates are quite scarey (50% or higher). Fortunately, the virus does not transmit efficiently between people, so human cases are linked to contact with infected birds or very close contact with infected people, and the current form of the virus is unlikely to have a wide impact on people. The concern is that if this virus changes to become readily transmissible between people, like common human influenza viruses, then a pandemic similar to the devastating Spanish flu outbreak of 1918 could occur (see image).
This raises the question: Should researchers be tinkering with H5N1 to see what mutations make it more transmissible? Those in favour want to understand more about the virus and what has to happen for it to become more infectious, but obviously there are considerable risks involved and others think this is playing with fire. This debate has reached full swing following a report by a Dutch researcher at the 2011 ESWI Influenza conference describing lab-induced mutation of avian influenza virus to make it highly contagious between ferrets. Ferrets respond similarly to influenza viruses compared to people, so something that spreads quickly between ferrets probably also spreads quickly between people. Therefore, the researchers may have (rather easily, it turns out) already created the ultimate "superbug."
So, is this good or bad?
The good
- This type of research provides more insight into avian influenza and gives us more of an idea of what has to happen for the virus to become more transmissible. This may help determine whether there's a realistic concern of this happening in nature, and also provide more general information about influenza viruses.
The bad
- Is it responsible to create something like this that could kill millions if it gets out of the lab, either accidentally or maliciously? We have enough serious infectious disease threats already - do we need to be making more?
- Is publishing information like this just providing a recipe for bioterrorists? Manipulation of microorganisms can be done quite easily by people with some training and equipment. Materials are a lot easier to access than for other potential weapons of mass destruction. Do we want to make it easier by publishing step-by-step instructions?
The research findings haven't been published, and they are being scrutinized by an independent committee (set up by the US government) that provides advice about situations like this where legitimate research might be used for nefarious purposes. The committee makes non-binding recommendations, but presumably those recommendations would carry a lot of weight if publication is being considered.
This is a complex area. Academic freedom to pursue scientific investigations is very important and has helped modern science advance as quickly as it has. However, it's hard to determine where the benefits of individual academic freedom are outweighed by the risk to society from information developed in those academic pursuits.
Image: Historical photo of the 1918 Spanish influenza ward at Camp Funston, Kansas (where the pandemic began), showing the many patients ill with the flu. (US Army Photographer, 1918)
Raw diets...again
CTV has a consumer reports segment and a recent topic involved feeding pets "natural" diets (although no one ever defined what that really means). In the report on the CTV Consumer Alert website (it's currently about the third story into the video if you just press play, or you can shortcut to it using the link below the main video window), a 26 year old cat is held up as a poster child for the health benefits of raw food. Making it to 26 is a noteworthy accomplishment for a cat, but it's far from rare, and you can't know whether the cat survived because of its diet or despite its diet. At the end of the clip, they mention he cat has kidney disease, not an uncommon problem in older cats but one that is often blamed by raw proponents on commercial foods. It's also not a condition that I'd want to see someone try to manage with a raw diet.
Anyway, the story has the typical statements (including one from a veterinarian) about how raw and "natural" diets produce a healthier animal, stronger immune system and shinier haircoat, but without citing any proof (because there is none) and with no discussion whatsoever about the potential animal and public health impacts of raw meat feeding.
Good investigations are good. Quick reports put together with little thought or consideration of the issues are just time filler. The host, Pat Foran, said in his conclusion that "natural" pet foods have less filler so there's less to come out the back end of the dog. Well, news reports comprised of filler produce the same kind of by-product.
If you are going to feed raw, at least take the time to research how to do it safely, both for your pet and your household. Raw feeding can be done in a nutritionally sound manner, but it takes time, effort and money. Some people are willing and able to do that, but if you're not, don't feed raw. Raw feeding also carries some risk of gastrointestinal disease like salmonellosis in the animal as well as exposure of people in the household to those same bugs. Certain households, particularly those with high risk individuals (e.g. elderly, infants, pregnant women, immunocompromised persons) should avoid raw feeding or only use products that have been high pressure pasteurized. There are a few commercial raw diets that are treated in this manner and these are preferable as the process should kill most relevant bacteria, reducing or eliminating the infectious disease risks to pets and people.
Like many other things in life, the key is being informed so you understand the risks and benefits, and whether recommendations made by people have any substance behind them. Too often, people make a major change like feeding raw based on a comment on a website or from another dog owner, with no clue about the issues and no effort to figure out how to do it right. That's just asking for problems.
More information about raw diets can be found on the Worms & Germs Resources page.
equIDblog has moved to Worms & Germs!
Unfortunately, because of funding challenges (translation... there was no more money), we were no longer able to maintain our equine infectious disease blog (equIDblog) as a separate site. However, based on the positive feedback we had and the amount of traffic on the original site, we still think it serves a role and are dedicated to maintaining equIDblog in some form. So, we are going to merge equIDblog with the Worms & Germs Blog. We have already moved the equIDblog Resources page, which can be accessed through the link in the title bar. We will also gradually move all of the current archived blog posts from the site and place them under the equIDblog topic category which can be found in the left index bar. Here we will maintain all of the site's current content and continue to provide information and commentary on equine infectious disease issues. Thanks to all of our loyal equIDblog readers for making the blog such a success, and we hope you'll continue to follow us here on the Worms & Germs Blog!
Beat The Bugs: New Biosecurity Venture For Equine Guelph
Equine Guelph has received funding for Beat the Bugs, a new equine biosecurity venture. The program has been funded by the Agricultural Biosecurity Program, a Canadian federal-provincial-territorial initiative.
From ongoing cases of strangles to large outbreaks of EHV, it's abundantly clear that infection control is a critical area for the equine industry, and one that typically receives little attention in the absence of an outbreak. The new Beat the Bugs program will be launched in March 2012, and will facilitate development of farm-specific biosecurity programs through workshops and a two-week online program. The program is being developed by Equine Guelph with the cooperation of various academic and industry partners. More information can be found on the Equine Guelph website.
New guinea pig...new ringworm outbreak
A Kitchener, Ontario family is dealing with a household outbreak of ringworm, likely contracted from a new pet guinea pig. Ringworm is a fungal infection cause by a few different types of fungi. Some ringworm fungi are able to infect both people and animals, and those can be spread in households from direct contact with an infected person or pet. In this case, the Gross family purchased a new guinea pig from a local pet store, and unfortunately, ended up bringing ringworm home as a bonus.
As is common, the new pet was the centre of attention when it got home, and the Gross' three children, ages 8, 5, and 2, had very close and frequent contact with it. The next day, the family noticed an area of hair loss on the guinea pig, at which point they took it back to the store. Ringworm was subsequently diagnosed, though there's no mention of how this was done, nor is there any mention of what actually happened to the little critter afterward.
The big problems started a week later, when a red lesion was seen on their youngest child's back. This was also diagnosed as ringworm, though again there's no mention of how, or whether it was definitively confirmed as ringworm. The newspaper report goes on to say "More spots kept appearing on Matthew’s skin as Gross was given different steroid creams to try and contain the infection." You always need to take media descriptions of medical issues with a grain of salt. Hopefully, the child was treated with anti-fungal cream, not steroid cream, as the latter not only won't treat ringworm, they may make it worse if used alone. Steroid creams are often prescribed for non-specific skin issues (particularly if the skin is very itchy, which can certainly happen with ringworm), but in a case like this where there was known contact with an animal with ringworm, I have to hope that the physician was treating with an antifungal cream instead of, or in addition to, a steroid cream.
Anyway, whether despite or because of the treatment, more skin lesions kept appearing on the child. Then skin lesions were found on the family dog, and both the dog and cat ended up being treated for ringworm. The treatment for dogs and cats is relatively straightforward, but it's still a hassle and can be somewhat expensive, and often takes several weeks.
The family has contacted the pet store about paying for cleaning supplies, air purifiers and veterinary bills, but the company did not respond to the newspaper reporter's inquiries, citing an ongoing investigation. It's hard to say whether the company should be held responsible. It largely depends on the measures they take to reduce the risk that they are selling pets at increased risk of transmitting infectious diseases. There's always a chance of picking up something from a pet, so an infection does not necessarily indicate incompetence or liability. If a store had reasonable practices in place, it's probably the purchaser's responsibility to take proper precautions when they take the pet home, and it's an example of why prompt veterinary examination of new pets is always a good idea. It's rarely done, particularly for species that cost less than the price of a veterinary exam, and you never know whether it would have helped prevent anything in this case, but in many instances it can help identify potential issues and address them before problems occur.
Preventing outbreaks like this can be difficult. Ringworm can be found on animals in the absence of any skin disease, so you can't always tell an animal is infected by looking at it. (However, in this case if a large patch of hair loss was noticed by the owners the day after the guinea pig came home, it's likely that something was evident the day before). Ringworm is spread by direct contact, which is common between pets and kids, especially new pets that often get smothered with attention in the first few days. Good hygiene practices, particularly attention to handwashing, can certainly help, but some degree of risk will remain.
Overall, guinea pigs are relatively low risk for zoonotic diseases, but this report shows that even "low risk" pets can be sources of infection. Fortunately, while controlling ringworm outbreaks can take time and be frustrating, it's not a serious disease and it is controllable.
More information about ringworm can be found on the Worms & Germs Resources page.
Ongoing canine flu problems in Texas
Canine influenza continues to be a problem in some areas of Texas, most notably in the Austin area. A recent news report indicates 30 confirmed cases and 70 suspected H3N8 canine influenza cases since September.
It's hard to say what the scope of the problem really is, but something's definitely happening. Getting good data about infectious diseases of companion animals is difficult because there is no central surveillance program and government animal health agencies tend to have little interest in non-food animals. Data tend to be assembled by word of mouth, which can lead to either over- or under-estimation of the problem. As highlighted by the number of "suspected" cases, lack of diagnostic testing is also an issue. Since dog owners have to pay for the testing themselves and since, for influenza, test results rarely change what's done for initial treatment of the dog, many people are reluctant to have the tests done. That leaves us with large numbers of unconfirmed cases, as is this situation. When there is documented flu activity in the area, a suspected case could quite likely be influenza. The bigger problem is in areas where flu is not common or hasn't been found, because canine flu looks no different than several other causes of respiratory disease, and knowing whether it's really flu is important for making vaccination decisions, as well as implementing certain infection control measures.
Avoiding exposure to canine flu is tough in areas where flu is active, just like it is for people when human flu is circulating. One of the big problems is that infected dogs start shedding the influenza virus from their respiratory tract before they get sick. Therefore, staying away from sick dogs and keeping your dog at home if it has signs of disease can't completely prevent exposure. However, these steps are still very important as they can help reduce the risk. Vaccination is another measure to reduce the risk. Vaccination is not 100% protective but it is an important part of influenza control in dogs that might be exposed to the virus.
No Answer In Aussie Horse Deaths
Despite relatively intensive efforts, no cause has been identified for the deaths of 22 horses ona Kooralbyn farm in Queensland, Australia. Readily identifiable causes have been ruled out, leaving two main theories:
As mentioned in an earlier post, one possibility is botulism It can be very hard to diagnose botulism in horses, and the disease is often presumptively diagnosed by ruling out all other reasonable options.
The other possibility is tick paralysis, which unfortunately is equally difficult to diagnose definitively. Certain types of ticks can cause progressive and severe paralysis which may look similar to botulism in some ways. Scrub ticks (the name typically used for Ixodes holocyclus) were noted on one of the first affected horses, but there's no information about whether all of the other horses had ticks too, and if so whether they were ticks that can cause paralysis. Kooralbyn is in a region where these paralysis ticks can be found and spring (e.g. now in Australia) tends to be the peak time for paralysis cases, so it's a reasonable consideration.
It's frustrating but far from unusual not to be able to make a solid diagnosis in outbreaks. Beyond the frustration factor, it's also a concern because it makes it hard to take precautions to prevent it from happening again.
Image: Two Ixodes holocyclus ticks, one before and one after feeding (photo credit: Bjørn Christian Tørrissen, click for source)
Spike in Michigan canine lepto cases
Veterinarians at Michigan State University's College of Veterinary Medicine are warning of an upswing in leptospirosis in dogs in the Detroit area. More than 20 cases of leptospirosis have been reported in dogs in the Detroit area, and it's likely that many more unreported cases have occurred. Leptospirosis, a bacterial infection, can cause very serious disease, including potentially fatal renal failure. It can be vague and hard to diagnosis if people aren't thinking about the disease. The most commonly identified problem is kidney disease, and early diagnosis and treatment is critical for successful treatment.
The Leptospira bacterium can survive well in the environment, particularly in moist conditions, and dogs are often exposed through wet environmental areas that have been contaminated with leptospires from the urine of infected wildlife. The strain that has predominated in the latest Michigan cases is Leptospira Icterohemorrhagiae, a type most often associated with rats.
Prevention of leptospirosis involves avoiding exposure to the bacterium as much as possible (largely through avoiding contact with wet areas where lepto cases have been identified) and vaccination. Vaccines are available for dogs and they can reduce the incidence and severity of disease caused by four different lepto types, including Icterohemorrhagiae. Vaccination should be considered in dogs in regions where lepto cases are identified and in dogs at increased risk of exposure based on lifestyle and travel.
