Worms and Germs Blog : Animal Health & Diseases : University of Guelph : Ontario Veterinary College : Zoonotic Diseases : Guelph, Hamilton, Ontario

Peritoneal dialysis is used to treat some people with chronic kidney failure. Infection is a major concern, particularly peritonitis (infection of the lining of the abdomen) because peritoneal dialysis involves having an indwelling catheter that goes through the skin and body wall directly into the abdominal cavity.

Infections can occur from bacteria that inadvertently get flushed into the abdomen during dialysis treatment or potentially migrate along the side of the catheter. Accordingly, most infections associated with peritoneal dialysis are caused by bacteria that are found on peoples' skin, such as Staphylococcus aureus.

While the vast majority of peritoneal dialysis infections are human-associated, infections from pets have been reported. Multiple different pet species have been implicated, even hamsters - one case report described an infection in a child that was thought to be caused by a hamster that slept in the same bed as the child (Campos et al 2000).

A recent study in the journal Seminars in Dialysis (Broughton et al 2010) involved a review of the scientific literature for reports of pet-associated peritoneal dialysis infections, as well as a review of records from the authors' peritoneal dialysis unit.

In their review, they identified 124 reported infections caused by zoonotic microorganisms in the literature, involving 12 different microorganisms. The most common microorganisms were Campylobacter, Pasteurella, Zygomycetes, Neisseria, Rhodococcus, Listeria, Mycobacterium avium complex, Capnocytophaga spp, Salmonella, Brucella and Bordetella bronchiseptica. However, only a subset of these were probably associated with pet contact, and retrospectively determining the sources is quite difficult for some. For example, Campylobacter and Salmonella could as easily (or more easily) come from contact with raw meat as from pets. Infections were fatal in 13.5% of cases, demonstrating why this is an important issue.

The most common bacterium causing convincing pet-associated infections was Pasteurella, which can be found in the mouths (and other places) of healthy pets. It is a common cause of pet bite infections and it makes sense that Pasteurella could contaminate pet owners' hands or the dialysis catheter site. In the study of their own hospital's cases, the authors found similar findings, with a low rate of zoonotic infections and a predominance of Pasteurella among those.

Literature reviews aren't a great way of determining the true scope of a problem, because they require people to:

1. identify the infection
2. identify a pet as a possible source (often the weak link; furthermore, identifying an infection caused by a potentially zoonotic microorganism doesn't necessarily mean a pet was the source)
3. decide to write a case report
4. get that case report accepted by a journal

Studying medical records has limitations as well, since steps 1 and 2 still need to be performed (with the weak link again being thinking about a pet-association). So, care should be taken when interpreting the results of this study. However, while the results indicate that pet-associated peritoneal dialysis infections do occur, they are probably relatively uncommon.

While pet-associated infections are likely uncommon, any peritoneal infection can be a major problem, so common sense measures that would likely reduce the risk should be used:

• Avoid contact of pets with the dialysis catheter and catheter site
• Wash hands after having any contact with pets
• Don't let pets sleep in the bed
• Wash hands before touching the catheter

Additionally,

• Physicians should be aware of the potential for pet-associated infections, and pet contact by their patients
• If a pet (usually a cat) bites the tubing, this should be reported to a physician ASAP and preventative treatment for infection might be indicated
• Initial antibiotic therapy choices should cover common pet-associated pathogens if there is a history of contact of pets with the catheter or tubing.

People with peritoneal dialysis catheters shouldn't fear their pets, and there is no need for these people to get rid of pets (although they should avoid high-risk pets like reptiles). Pet owners are presumably at somewhat higher risk than non-pet-owners, but the risk appears to be fairly low. In most situations, the positive aspects of pet ownership probably outweigh the risks.

Image: Schematic diagram of peritoneal dialysis (click image for source)

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I heard this on the radio yesterday morning, I kid you not: Butterball has a "Turkey Talk" toll-free helpline, which naturally gets busy around turkey holidays like Thanksgiving and Christmas.  Like many helplines, they get stories of every kind, and this year apparently one person called in and asked if it was alright that she thawed her frozen turkey in the bathtub - while her kids were in it taking a bath!

Anyone who has read anything about food safety hopefully knows that raw meat can potentially be (and usually is) contaminated with many different pathogens - that's the biggest reason why observing proper cooking times and temperatures is so important.  Raw poultry in particular should basically be treated like it's contaminated with Salmonella and/or Campylobacter until proven otherwise.  You can just imagine the field day that these bacteria could have in a nice warm, wet bathtub - it's just the way they like it, and it's exactly what we try to avoid in the kitchen, where food is ideally kept either nice and cold or nice and hot in order to prevent (or at least minimize) bacterial growth.  Then of all things to put young children in this veritable cesspool of bacteria - turkey and all - it's just a gastrointestinal disaster waiting to happen.  You also needs to consider what the turkey could become contaminated with sitting in bathwater.  Even children who don't have diarrhea can be shedding intestinal pathogens - human pathogens which are obviously transmissible to other people.  If you really cooked that bird well (maybe deep-fried it) I suppose that should ultimatley eliminate any surface contamination anyway, but I don't think I'd be able to get past the "ick" factor.  Don't throw the baby out with the bathwater, but of there's a turkey in there (as far as I'm concerned) that can go.

I realize this is primarily a food safety issue, but it made me think about what else this person (or others) may put in a bathtub.  In previous posts in which we've talked about reptiles kept as pets (all of which should be treated as Salmonella carriers), we've mentioned that ideally (if they need a bath) they should be bathed in their own designated container (like a big rubbermaid) and not in the bathtub.  If there is no other option and the bathtub must be used, it should be thoroughly cleaned and properly disinfected (keeping contact-time with the disinfectant in mind) before it is used again by a person (especially children). 

Ideally the same precautions should be taken if you bathe a dog in the bathtub, but the risks are not as high as with reptiles (unless the dog is very dirty, has skin lesions, or has (or recently had) diarrhea).  We've talked about the limited risks of allowing dogs in backyard swimming pools (but of course there is even less chlorine in bath water).  I hope no one ever bathes their dog with their kids - we could debate the risks, which likely aren't high anyway, but in the end the risk is simply unnecessary.  The pool is one thing, but there's no reason for a dog to be in the tub at the same time as the kids (and really, how clean are the kids going to get with a dirty dog in the tub?).  If you're trying to save water you can always throw the dog in after the kids are out.

If you're attempting to bathe a cat in the tub... well, based on most feline behaviour I'd say your primary risks are bites and scratches more than enteric bacteria and parasites.  Proceed at your own risk!

A happy (and hopefully healthy) American Thanksgiving to all of our US readers!

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Just when all those turkeys that managed to survive Thanksgiving weekend thought their troubles were over, there's new issue: H1N1 influenza (formerly known as swine flu) has been found in an Ontario turkey flock.  The H1N1 virus was first reported in birds in Chile in late August.

This is not a reason to panic.  No one can get the flu from eating a properly-cooked Thanksgiving turkey (nor from any other type of properly-cooked turkey).  The producer has voluntarily (and very responsibly) quarantined the affected flock, and no birds or eggs have left the facility.  There is no risk to the food chain.

Pigs can be infected by human, pig and bird flu viruses, and multiple infections can result in viruses trading genes and producing new viruses that can infect more species.  So it's not too surprising that H1N1can infect people, pigs and now birds as well.  This incident serves as an important reminder that we need to remain diligent about infection control and hygiene, even around animals.  It's highly unlikely that these turkeys had contact with infected pigs - most likely the virus was spread to this flock by a person.  Poultry producers may therefore need to consider getting vaccinated for H1N1 flu not only to protect themselves, but also their flocks, and anyone who may have the flu should definitely stay off these farms.  Hopefully the virus does not become established in wild bird populations (like H5N1 has in some areas), as this would make it much harder to control.

Recommendations for avoiding the flu (H1N1 or other) remain the same:

• Wash your hands and/or use alcohol-based hand sanitizer
• Sneeze into your elbow
• Disinfect commonly touched surfaces
• Stay home if you are sick
• Get vaccinated!

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In the same edition of Emerging Infectious Diseases as a report on Campylobacter jejuni in macaroni penguins in Antarctica, there is a report about vancomycin-resistant enterococci (VRE) in glaucous gulls in Point Barrow, a remote area of Alaska.

Vancomycin-resistant enterococci are an important problem in human medicine, mainly in hospitals where they can cause sporadic infections and outbreaks of infection. These infections can be difficult to treat because VRE is resistant to many antibiotics, including vancomycin. VRE is not very common in animals in North America at this time, but there is concern that it could be an emerging problem, because as VRE rates in people increase the bacterium gets spread more commonly to animals. There have been many more reports of VRE in animals in Europe. This has been largely attributed to the widespread use of avoparcin (a drug related to vancomycin) as a growth promoter in food animals in Europe, a practice that was common until the mid 1990s, but is now banned in many countries.

This study demonstrates that organisms like VRE can be spread to wildlife in one of the most remote regions of North America. As the authors state "This spread suggests that few (if any) places on earth may be protected against the spread of such resistance, and the dispersal mechanisms are far more efficient than previously thought."

These two reports show how well (and expectedly) infectious agents can travel. They are also good examples of why we need to be thinking globally, ecologically and truly in the mindset of “one medicine” if we really want to understand infectious diseases.

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Recently, I wrote a post about the need for vets and physicians to communicate more, and about concerns that zoonotic diseases get missed because vets deal with animals and physicians deal with people, but few people pay attention to the interface between them. A reader (my father, actually) wrote this comment.

“...is the opposite also true? If I take my sick cat to the local vet, will he advise me to see my physician if I begin to feel ill effects? Are vets trained to know that pets can transfer disease to their owners or in this an emerging part of vet. science?”

It’s a good question and one that doesn’t have a straightforward answer. Vets certainly do get educated regarding zoonoses.  From what I understand from talking to colleagues in the human medical field, there is much more emphasis on zoonoses in the veterinary medical curriculum compared to the human medical curriculum. However, a lot of the focus is on foodborne and waterborne zoonoses, with much less information about companion animal (e.g. dog, cat, horse) zoonoses. Different vets have quite variable knowledge in this area, ranging from excellent to poor. It’s a huge field (I’m still learning more about it all the time), and vets and physicians alike have busy schedules and many other areas where they need to stay current as well, so it’s not unfathomable that zoonoses could get neglected.

So, to answer the question, if you take your sick cat to the vet, it’s unlikely he/she will initially ask about your health. However, if the vet suspects a zoonotic disease, hopefully he/she would tell you what it is and possibly what signs for which to watch out. Providing additional information would also be useful, which is why we're developing the information sheets that are available on our Resources page). At that point, the vet would typically (and reasonably) leave it up to you to determine whether you should see your physician and what should happen from there. In the grand scheme of things, it would be very useful for vets and physicians to have some form of dialogue or at least an understanding of each other's roles and a willingness to call each other when appropriate.

Both human and veterinary medicine have a long way to go to get to the "one medicine" concept that people like to talk about. I think we’re slowly moving in the right direction, but vets and physicians need to talk more to properly cover this important area of overlap between their professions.

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As is common this time of year, outbreaks of Salmonella infection in wild birds have been widely reported in parts of the US. Salmonella circulates regularly at low levels in the wild bird population, and sporadic outbreaks involving large numbers of sick and dead birds are periodically encountered. These are often noticed in urban areas when dead birds are found around bird feeders.

Salmonella can infect a wide range of species other than birds, including cats (and people). Cats can be exposed to Salmonella during these outbreaks from catching and eating sick birds, or healthy birds that are carriers of the bacterium. In fact, one name for salmonellosis in cats is songbird fever, a testament to the role of birding in feline salmonellosis. An example of the potential effect of wild bird Salmonella outbreaks on cats is described in the The Daily Journal from International Falls, Minnesota. In this report, a local veterinarian explains that he has seen an increase in salmonellosis cases in pets at his practice, mainly in cats. In the past 2 weeks, he has diagnosed approximately 20 cases, which is a pretty impressive number. Most of the infected cats had known contact with wild birds or areas around bird feeders.

If your cat goes outside, it is at higher risk for Salmonella. If there is an outbreak of salmonellosis in wild birds in the area (or you're seeing dead birds around the feeder), then the risks are probably much higher. While Salmonella is usually associated with diarrhea, not all cats that are infected develop diarrhea. Some develop mild disease without diarrhea (e.g. fever, lethargy), some get serious systemic infections (septicemia), and some may show no signs of illness at all but still pass Salmonella in their stool. In any case, the bacterium can still be transmitted to and infect people.

Any outdoor cat that develops diarrhea should be considered a Salmonella suspect. Really, Salmonella should be considered in all outdoor cats with fever and signs of illness that are not specific for a particular disease. Stool culture can be used to diagnose Salmonella.

Avoiding wild-bird associated salmonellosis in cats is pretty easy - keep your cat indoors. A cat that can't catch birds or hang around contaminated areas surrounding bird feeders won't be exposed to Salmonella from wild birds. At a minimum, cats should be kept inside if there is an outbreak of Salmonella in wild birds in the area, or if dead birds are found around your bird feeder. Ideally, they should be kept inside all of the time, for many reasons.

More information about Salmonella in pets can be found on the Worms & Germs Resources page.

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Over 50% of households in Canada and the US have pets, and the numbers are probably similar in many other countries. Pets are often considered part of the family socially but we need to consider them part of the family biologically as well. It's clear that diseases that be transmitted between people and pets - in both directions. Unfortunately, it's also clear that physicians and vets don't do a very good job talking to each other.

Pet contact (and animal contact, in general) should be part of the standard history obtained by any physician.  In my perfect world, every medical record would include a permanent record of contact with pets or other animals. This information is potentially useful because certain diseases that are not a big issue for non-pet owners may need to be considered (or may be higher on the list of possibilities) in pet owners. Knowing about pet contacts up front could help speed up diagnosis and proper treatment.

For example:

I have a flock of rare breed sheep. The other day, I had to assist with a lambing. Contact with newborn lambs and fetal fluids is the main source of the organism Coxiella burnetti, which causes Q-fever. If I became infected, the illness would start off with vague signs like fever and malaise. If I went to a physician at that point, I'd probably be told to go home, rest and take anti-inflammatories as needed (the old "take two aspirin and call me in the morning" type thing). If the physician knew I had sheep, he/she might ask about the risk of exposure for Q-fever. Upon hearing that I had a high risk exposure a few days earlier, Q-fever would be considered right away and appropriate measures could be taken.

Also, as strange as it sounds, in my utopian world physicians would ask about pet health. Yes, it may seem strange if your doctor were to ask "So how are you doing today? And how's your dog been feeling lately?" - but it might be important. Illness in your pet may be associated with illness in you or other members of your household. Knowing that a pet is sick might give some indication of that (a) certain disease(s) are more likely in a person. Also, if the sick pet has been to a veterinarian for testing, those results might be useful to the physician. There's no guarantee that a pet and owner that are sick have the same thing, but a general principle of medicine is that a single cause is more likely than co-incidental independent problems.

For example:

Similar to the case of psittacosis in a pet store employee that I reported about recently, let's say that you own a bird and it's been sick for a week or so. It's weak and not eating well. You then come down with a fever and cough - something that's not uncommon. However, when your astute physician asks about the health of your pets, he/she gets concerned about the fact that your bird is sick. Your doctor contacts your bird's veterinarian, and it becomes clear that the bird could be infected with Chlamydophila psittaci, the cause of psittacosis in people. Your doctor therefore puts psittacosis on top of the list of potential problems, and instead of telling you to go home and rest, he/she takes some blood samples to try to diagnose it the infection and may even start treatment right away. Because your physician identified a higher risk situation with your sick bird, you get prompt treatment, you start to feel better in 24 hours and it's unlikely you'll have any major problems. (The mortality rate from psittacosis is < 1% in people that are treated properly. If the diagnosis is missed, the mortality rate increases to 20%, and you also run the risk of complications such as heart valve damage.)

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People that work with animals are at increased risk for certain infectious diseases. That's pretty clear. Pet shop employees fit into this group as well, and they may be at particular risk for specific diseases because of their close contact with young animals, birds, rodents and reptiles. A suspected case of psittacosis in a Toronto pet shop worker is an example of this.

A bird in the pet store where this person worked supposedly died of avian chlamydiosis in mid-March (although the initial test results have been called into question). Avian chlamydiosis is caused by the bacterium Chlamydophila psittaci. This organism is relatively common in psttacine birds (parrot family), especially in breeding colonies, but can also be found in other types of birds. It can cause serious disease in birds, but it is also commonly carried by healthy birds. People can become infected from breathing in the bacterium, often from aersolized dust containing dried bird droppings. The disease in people is called psittacosis. The pet store worker developed signs that could be consistent with psittacosis: cough, lethargy and difficulty breathing.  However, these signs are still fairly non-specific and could also be caused by numerous other respiratory pathogens.  Test results are still pending.

People that have close contact with pet birds, especially psittacines, need to know that they may be at increased risk of psittacosis. They also need to ensure that their physicians know about their increased risk. This is important because early signs of psittacosis are very vague, such as fever and cough. Psittacosis would presumably not be high on the doctor's list of possible diagnoses for the average person coming in with fever and a cough. If the doctor knows a person has contact with birds, hopefully psittacosis would be considered earlier so prompt diagnosis and appropriate treatment can be given. This disease is readily treatable if diagnosed early, so awareness of the possibility on the part of the patient and physician are important.

This report also demonstrates why determining a final diagnosis for sick or dead pets is critical. While the diagnosis may not help the animal (especially if it's already dead), it may play an important role in protecting the health of people or other animals. If the bird in this case was not tested, it's hard to say how long it would have taken for psittacoiss to be considered in the case of the pet store worker.

More information about psittacosis can be found in a document from the National Association of State Public Health Veterinarians. More information about good management practices to reduce the risk of disease transmission from birds can be found in the information sheets on pet birds on the Worms & Germs Resources page.

Image from: http://www.cbc.ca/health/story/2009/04/01/parrot-fever.html

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As you undoubtedly know, a large Salmonella outbreak has occurred in the US, associated with contaminated peanuts. The scope of this outbreak continues to expand in unexpected areas, including pets. The latest development is a voluntary recall of bird seed. The recall affects 20-pound packages of Wild Birds Unlimited Wildlife Blend bird food (produced by Kentucky-based Burkmann Feeds) with the manufacturing date code 81132200 2916 08124. 

The contaminated bird seed was linked to the deaths of several birds in North Carolina, and it was confirmed that the bird seed manufacturer received peanuts from the Georgia facility that was implicated in the Salmonella outbreak.

People that have used this bird seed should clear out their bird feeders, ideally while wearing gloves. The feeders should be thoroughly cleaned and then disinfected (although this may be easier said than done). Hands should be washed after handling the bird seed, potentially contaminated feeders or any other potentially contaminated items.

The risk to people is presumably quite low, but people handling the bird seed could potentially contaminate their hands with Salmonella and then inadvertently swallow some of the bacteria. Concerns are greatest in people with compromised immune systems, the very young, the elderly and people taking antibiotics, as they are more likely to get sick following exposure to small numbers of Salmonella.

More information about Salmonella can be found on the Worms & Germs Resources page.

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My oldest daughter is in Grade 2, and last year her class hatched chicken eggs in the classroom. As a parent, I was somewhat torn about the idea. My main concern was the risk of exposure to Salmonella. A recent article in Morbidity and Mortality Weekly Reports described outbreaks of salmonellosis associated with contact with live poultry.  Most cases were associated with handling baby chicks obtained from agricultural stores or by mail order. Infections from classroom and petting zoo-associated contacts were also reported.

Salmonella contamination of eggs and carriage by baby chicks is very common.  The CDC recommends that children less than five years old do not have any contact with baby chicks, and that older individuals pay close attention to hygiene in order to prevent transmission of Salmonella. Being six years old, my daughter was just over this age cutoff (although there's nothing magical about going from five to six years old, so I'd still consider her at somewhat higher risk). So, as long as good infection control practices were used (e.g. hand hygiene), the risk to the children was probably quite low. Were the benefits of hatching eggs in the classroom worth the risk? I don't know, but she enjoyed the experience and did learn a few things along the way. Concerns about infectious diseases are often dismissed, which is a problem, but sometimes excessive concern gets in the way of life. There's rarely a clear answer as to what is acceptable and what is too risky, given the potential benefits.

• Eggs and chicks should not be kept in classrooms where children under five years old will be present, or if there are immunocompromised children in the class. It's unclear whether all teachers would know if they had a high-risk child in the class. Parents of immunocompromised children should make sure teachers know about their child's increased risk.
• It is prudent for teachers to send home a note to inform parents if eggs/chicks will be in the classroom, or if similar activities involving animals are undertaken.
• Eggs and chicks should be kept in a complete enclosure, in an area that is always supervised when children are around.
• Chicks should always be kept in their enclosure. They should never be taken to areas (e.g. a student's desk) where food might be consumed.
• Direct contact with eggs and chicks (and their environment) should be kept to a minimum.
• Hands should be thoroughly washed or an alcohol hand sanitizer used immediately after contact with eggs, chicks or their environment.
• Appropriate thought should go into the use of eggs and chicks in classrooms. They should be there for more than the "novelty factor". There should be a clear teaching plan associated with them so they provide the maximum educational value possible.
• Testing eggs and chicks for Salmonella isn't practical. A negative result cannot guarantee that Salmonella is not there. As well, there are other infectious diseases that are of concern. Consider all eggs and chicks Salmonella-positive and handle them appropriately.

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Animal smuggling is a surprisingly big problem. A report in the Canberra Times quotes an Australian customs officer as saying animal smuggling is a $20 billion industry and the third largest criminal activity in the world (after drugs and weapons).

Animal smuggling can range from someone trying to sneak an exotic pet into the country, or large- scale smuggling by certain individuals (like the guy who tried to smuggle 300 poisonous frogs onto a plane). It can also consist of massive organized crime ventures.

There are many concerns associated with animal smuggling:

• Animal welfare: High death rates are not uncommon among animals during illicit transportation. Smuggled animals are often wild-caught, and even if they survive the stress of transportation, they may die soon after arrival. Particularly when you hear about animals being smuggled sewn up in giant teddy bears, or stuffed into pockets and pouches, it's a wonder as many of them survive as they do.  The customs office in the Canberra Times article sums it up nicely "'People who smuggle animals don't care about the animals ... They actually see dead animals as an overhead.'"
• Introduction of foreign diseases: Smuggled animals have been blamed for introduction of serious diseases like avian influenza into areas where these diseases don't normally exist. This can be a huge problem, as it creates the potential for large outbreaks amongst indigenous animals or people whose immune systems are completely naive to the diseases.
• Transmission of disease to new owners: Smuggled animals certainly have not undergone good health examinations and quarantines, and can carry a host of potentially harmful microorganisms. This can put buyers and their families at risk.

Despite being a huge industry, there are things that everyone can and should do to reduce animal smuggling:

• Don't buy animals that you know were or may have been illegally imported. Doing so  contributes to the death of countless other animals for every animal that survives.
• Don't buy wild-caught animals like birds and reptiles. Wild caught doesn't mean smuggled, but it may be hard to tell the two apart. Some of the disease risks, particularly to individual buyers, are the same with legally and illegally imported wild-caught animals. These days there are good, reputable and ethical breeders of many animal species around that can supply animals. If the species is so rare that there aren't any good breeders around, then don't buy it. It might be rare because the animals don't survive well in captivity, or are hard to find in the wild. You don't want to contribute to either of those situations. In some instances, you can find both wild-caught and captive-bred animals for sale. While the captive-bred version will almost certainly be more expensive, the extra cost is not so great when you consider the overall lifetime costs of the animal. And how much money do you really save if you end up with a sick or dead animal?
• If a deal sounds too good to be true, it probably is. That animal that you're getting for such a "great deal" might have been smuggled or be otherwise unhealthy.
• If, for some reason, you are determined to get a wild-caught animal, make sure that it comes from a reputable source who imported the animal legally. Ask how it was caught, stored and transported. A good supplier should be able to tell you everything that happened from the time of capture to its arrival, or at least be able to find that out. If they don't know or don't care, walk away.

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It's amazing where infectious disease discussions can develop (at least for strange people like me). I was having a conversation with Dr. Mike Taylor (an avian and exotics specialist at the Ontario Veterinary College) after hockey the other night, and we started talking about infectious diseases.

Mike has done a lot of work with proventricular dilatation disease (PDD), a serious disease of psittacine birds. Recently a virus (avian bornavirus) has been identified as the cause of the disease. One of Mike's observations during field investigations was that avian facilities that used a two-bowl cleaning system seemed to have a lower incidence of disease. In this type of system, the feed bowl in each bird enclosure is removed each day and replaced with a clean one. The dirty bowl is then cleaned, disinfected and allowed to dry until it is used again the next day. The system is quite easy to implement and allows for thorough disinfection of bowls. Cleaning and replacing the same bowl each day presumably results is a quicker and less thorough disinfection, and does not allow for a period of drying.  Bornavirus is fairly easily killed with proper cleaning, disinfection and drying, but can survive in a bowl that is not adequately cleaned. This two-bowl system may have helped kill more of the virus that was deposited in the bowls.

This simple management tool might be useful for controlling PDD (and other diseases) in birds, and perhaps could indirectly reduce the risk of transmission of certain pathogens from birds to people. Avian bornavirus itself does not infect people.

Infection control isn't rocket science. Simple, common-sense measures (like hand washing) are often the most important factors in the success or failure of disease prevention programs. Simple management tools such as this should be considered as part of routine activities to reduce the risk of various infectious diseases.

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A recent report in the Medical Journal of Australia described the case of a woman who was pecked in the leg by her daughter's pet magpie. The woman was otherwise healthy (i.e. she did not have a compromised immune system), but the wound became infected by the fungus Saksenaea vasiformis, which rarely causes disease in people or animals. The infection became so severe that the woman's leg had to be amputated.

Saksenaea vasiformis can be found in soil all over the world. There are a few possible routes by which the fungus may have infected the woman's leg in this case. The fungus could have been on the person's skin, and been carried into the deeper tissues by the pecking. It also could have been on the bird's beak. Alternatively, it could have contaminated the wound after the pecking, through contact with soil or dirty hands.

This is an example of an infection that would be difficult to anticipate, since it occurred in a healthy person as a result of contact with a healthy bird, and with minor trauma, but potentially could have been avoided. Although the bird may not have been the source of the fungus, the break in the protective barrier of the skin was the critical event. Basic wound care is always important, and any injury from an animal should be taken seriously and properly addressed. Wounds should be carefully cleaned and monitored for signs of infection.  A physician should be consulted as soon as possible if there are any concerns.  A physician should always be consulted for any wound that is:

• on the hands
• over a joint
• over a tendon (e.g. wrist, ankle)
• in the genital area
• over a prosthetic device
• sustained by a person with a compromised immune system (e.g. HIV/AIDS, transplant or cancer patient)

More information on bites can be found in the Cat Bites information sheet on the Worms & Germs Resources page).  It's unclear whether any of these precautions would have prevented the serious fungal infection that occured in this case, but these measures can reduce the risks of infection.

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A report about the health risks in children associated with nontraditional pets was recently published in Pediatrics, the official journal of the American Academy of Pediatrics. The report also discusses diseases associated with animals in public settings such as petting zoos and pet stores.  Although contact with pets and animals can be beneficial to growth and development in children, it is very important to be aware of the risks associated with certain kinds of animals.  Physicians, veterinarians and public health personnel can help parents select appropriate pets in order to maximize the benefits while minimizing the risks to children.

One of the most important pathogens discussed in the report is Salmonella. Although Salmonella can be transmitted by many animal species, including traditional pets like dogs and cats, it is a particularly high risk with certain other kinds of pets, including reptiles, amphibians and baby poultry (chicks and ducklings). It has been estimated that direct or indirect contact with reptiles or amphibians is responsible for 6% of all sporadic Salmonella infections in the US, and 11% of cases among people younger than 21 years. There is also a relatively high risk of Salmonella transmission associated with animal-derived pet treats, such as pig ears, and raw meat.

The report makes several recommendations about how to reduce the risk of infection, injury and allergies from nontraditional pets, many of which you may have seen before on the Worms & Germs website. Just a few of these are:

• Always wash your hands after contact with animals, animal products or their environment, and after contact with animal-derived pet treats.
• Supervise hand washing for children less than five years old

Children less than five years of age and individuals with weakened immune systems should avoid contact with reptiles, amphibians, rodents, ferrets and baby poultry. These animals:

• Should not be kept as pets in households where children less than five years of age or individuals with a weakened immune system live.
• Should not be brought to childcare centres.
• Should not be allowed to roam freely in ANY house or living area.
• Should not be permitted in kitchens or anywhere food is prepared.

More information about Salmonella in pets and the risks associated with feeding raw meat and animal-derived treats to pets can now be found on the Worms & Germs Resources page.

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• 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.

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• 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.

• 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.

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INFORMATION SHEETS specifically for KIDS, for VETERINARIANS, for PHYSICIANS and for PUBLIC HEALTH PERSONNEL are also available on the Worms & Germs RESOURCES page!

Click on the highlighted topics below for information sheets. Topics that are not highlighted are in development and coming soon. Sheets for other animal species and diseases are also under development and will be added when they are available.

 
Please Remember:

• Your veterinarian and physician are your ultimate resource for information about the health of your pets or your family.
• Information provided here is accurate to the best of our knowledge, but infectious diseases can be unpredictable and these sheets are for general information purposes only.
• There can be great variation in disease risks in different geographic areas. The information provided was developed for Ontario, Canada, but most of the information is relevant for other regions as well.

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