Your mother was right! Wash your hands

You may notice a recurring theme in many of our posts and on virtually all of the information sheets on the Worms & Germs Resources page: an emphasis on handwashing. There is increasing emphasis on hand hygiene (i.e. hand washing and use of alcohol hand sanitizers) education in hospitals because the hands of healthcare workers are a major (if not the most important) means of disease transmission between patients. Despite hand hygiene being easy, cheap and effective, people rarely wash their hands as often as they should, and they often don't do it properly.

Most of the research about hand hygiene that has been published has focused on its use and impact in human hospitals, but this area is now also being studied more with regard to animals and veterinary medicine. A study published earlier this year in Veterinary Microbiology provided more evidence that hand hygiene is a critical infection control measure when dealing with animals. The study, coordinated by Dr. Maureen Anderson (of Worms&Germs fame) looked at MRSA carriage rate in veterinarians who work with horses. In addition to finding a high rate of MRSA carriage among these veterinarians (which was consistent with other reports indicating that equine vets are at higher than average risk for exposure to MRSA), the study looked at factors associated with MRSA carriage. Vets that reported routinely washing their hands between farms and those that reported washing their hands after contact with potentially infectious cases had a significantly lower rate of MRSA carriage. That should come as absolutely no surprise, but it's one more piece of evidence that we need to pay more attention to this routine infection control measure, in human hospitals, in veterinary environments and in households.

Remember, the 10 most important sources of infection are the fingers on your hands!

Click here for instructions on how to wash your hands properly.

Exposure to animal blood

Periodically, pet owners may be exposed to blood from a pet. This can range from exposure to small amounts of blood through minor injuries like cut foot pads or broken toenails, to large amounts of blood following severe trauma.

In people, there are detailed protocols for avoiding blood exposure in healthcare situations, and protocols for managing people exposed to human blood in hospitals and in the community. This is mainly driven by concerns about HIV and hepatitis viruses that can be transmitted by contact with blood. But these viruses are not present in animals, and the risks of transmission of disease from pets to people through blood are very low. Even contact with blood from a rabid animal is not considered rabies exposure, because the virus is found in the saliva, not the blood. This has led to a rather cavalier approach towards blood exposure in veterinary medicine, which is understandable but not ideal.  New infectious diseases continue to emerge in animals and people, and eventually there is likely to be one that can be transmitted between species by blood. Therefore, it is prudent to try to reduce exposure to animal blood when possible, but without getting overly concerned (or paranoid).
  • Direct contact with animal blood should be avoided whenever possible.
    • In particular, avoid getting animal blood on any cuts, scrapes or other broken skin, and avoid getting the blood in your mouth, nose or eyes.
  • If you do get animal blood on your skin, wash it off as soon as possible.
  • While it is extremely unlikely for a person to get sick from touching animal blood, make sure you tell your physician about the incident if you do become ill.

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.

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.

Psittacosis

The National Association of State Public Health Veterinarians (NASPHV)  has recently released a comprehensive document about psittacosis. This is a disease of people caused by the bacterium Chlamydophila psittaci (formerly known as Chlamydia psittaci). Psittacosis usually causes flu-like disease but can cause severe pneumonia and other problems. Chlamydophila psittaci is most commonly carried by healthy psittacine birds (those in parrot family) but can also be carried by non-psittacine birds including pigeons and doves. It is an uncommon disease in people but sporadic cases and outbreaks do occur. While treatable, psittacosis is often overlooked in the early stages of illness if the physician does not know the patient has had contact with birds. People that own or have contact with birds should know about psittacosis, and the NASPHV document is an excellent resource.


This disease is another good example why people should make sure their physician knows what types of animals they own or have contact with.