Animal Health & Diseases : University of Guelph : Ontario Veterinary College : Zoonotic Diseases : Guelph, Hamilton, Ontario

As we encounter more infections caused by antibiotic-resistant bacteria (e.g. MRSA), we need to explore treatment options other than antibiotics. While we usually focus on "new" treatments, sometimes we can look back in time for ideas to treat infections. An old treatment method that is getting increasing attention these days is the use of honey. Honey may be a safe, effective and affordable treatment option in many cases. Click on the picture below to view a video by Dr. Karol Mathews, a critical care specialist at the Ontario Veterinary College.

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It's that time of year again - we're coming up on flu season, and the ads on the radio and the television are out, encouraging everyone to get their "flu shot," (aka influenza vaccination).  Influenza isn't just a problem in people - it is a very versatile group of viruses that can infect many different species of animals. 

Equine and swine influenza viruses cause serious problems in horses and pigs, respectively.  Last year there was a massive outbreak of equine influenza in Australia.  Because Australia was previous free of equine influenza, most of the horses there had never been vaccinated against the virus.  Therefore the entire population was very susceptible to the disease and it spread very quickly.  The outbreak has since been brought under control.  A previous Worms & Germs post talked about an outbreak of canine influenza in dogs in Chicago IL this past summer.

Equine and canine influenza (and usually swine influenza) cannot be transmitted to people.  However, there are some strains of influenza that can cross species.  The most well-recognized one is certainly avian influenza (bird flu), which caused outbreaks in a number of Asian countries in 2004.  Although people are much less susceptible to avian influenza than birds, the H5N1strain has caused significant illness and fatalities in people.

A lesser known fact about influenza is that pet ferrets are very susceptible to the virus, including human strains.  This is part of the reason ferrets are often used as animal models of the disease in research studies.  Signs of the flu in ferrets are similar to what you'd expect to see in people - fever, sneezing, runny nose and lethargy.  A pet ferret can both transmit to and catch the flu from a person.  Unfortunately for the ferrets, there is no available vaccine for the flu in these animals.

Lucky for us, people can be vaccinated against influenza.  Most people are still far more likely to get the flu from another person than from any kind of animal.  Getting your flu shot is the best way to help prevent yourself from getting the flu, and spreading it to others.  However, it's important to remember that no vaccine is 100% protective, so it's still important to take a few common-sense precautions, like washing your hands frequently, and sneezing/coughing into the crook of your arm, not into your hands.  (And watch out for sick ferrets!)

There is lots of information about influenza and flu vaccine available on the web, including some of the links in this post, and also on the CDC Influenza (Flu) website.

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As we see more and more infections caused by antibiotic-resistant bacteria, we have to re-think our approach towards antibiotic therapy. This often involves using new drugs, but sometimes it also involves considering the use of older drugs that we haven't used very much for a long time.

One such drug is chloramphenicol. Years ago, this antibiotic was widely used, and is still used in people and animals in some situations. In some respects, it is a very good antibiotic - it is often effect against many bacteria including those that are resistant to many other drugs, such as MRSA.  Chlormaphenicol can also be given orally, and it's relatively cheap. Unfortunately this drug can also be very toxic, both to the animals being treated with it and to people that come in contact with with it in the process. In some animals, chloramphenicol can cause suppression of the bone marrow, where red and white blood cells are produced. This is more of a concern with long term use, but if the bone marrow does become suppressed, stopping treatment with the chloramphenicol typically resolves the problem.  Unfortunately, this bone marrow suppression is much more of a concern in people - the supression is very severe, and can occur with exposure to even a very low dose (or probably single dose) of chloramphenicol.  This results in a condition known as aplastic anemia,  which it typically fatal.  Fortunately this reaction is very rare in people, but there is no way to predict who might develop this condition, and since it is usually fatal, we obviously need to be cautious about using this drug. In some countries, chloramphenicol use in banned in all animals. In many others, it cannot be used in food animals, but can be used in pets.

• Chloramphenicol should only be used as a drug of last resort. There are situations where it is useful and may be life-saving, but the human health risks cannot be overlooked.
• If chloramphenicol is being considered, it is critical that  people who would need to handle the drug understand the risk and how to safely handle the drug to avoid exposure.
• Chloramphenicol tablets should not be crushed or otherwise processed at home because of the potential for breathing in the drug when it is in powder form.

Direct contact with pills or liquids should be avoided by use of gloves or other safe handling practices.

• If a liquid form is used and is squirted onto food, the food bowl should be handled as if it is contaminated.
• If pills are being used, the animal should be observed to ensure that the pill is ingested and not spit up and left on the floor.
• Contact with the mouth and face and animals that are being treated with chloramphenicol should be avoided in case drug residues are present.

If people are unable or unwilling to follow safe handling recommendations, they should not use this drug.

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Ringworm infection is not caused by a worm at all - it's actually a skin infection caused by certain kinds of fungus called dermatophytes. The scientific name for ringworm is dermatophytosis, or dermatomycosis. Some of the more common zoonotic species of dermatophytes found in animals include Microsporum canis, Trichophyton verrucosum, T. equinum, and T. mentagrophytes. There are also some dermatophytes that are primarily transmitted from person to person that are not carried by animals. These include the fungi that cause athlete's foot and jock itch.

Like many fungi, dermatophytes grow best in warm, moist environments, but they can grow almost anywhere on the body. They tend to grow around hairs and in the superficial layers of the skin, and the infection can be quite itchy. A ringworm skin lesion tends to spread out from one point on the skin, causing hairloss as it progresses, resulting in a bald patch (see picture right). The outside (most active) edge of the infection often appears as a red ring, from which "ringworm" gets its name.  The centre of the lesion may begin to heal, and the hair may start to grow back, even as the bald patch gets bigger.  It may take anywhere from a few days to a few weeks for visible lesions to develop after a person or animal has been infected. (Photo credit: A. Yu, Ontario Veterinary College)

Ringworm is quite contagious. The fungi are present in the large numbers on hair and skin cells that are shed by infected individuals. People or animals can be infected through contact with these infected hairs and skin cells, either directly on the affected person or animal (i.e. direct contact), or on things like clothing, blankets, hairbrushes etc. that have touched the affected skin (i.e. indirect contact).

Ringworm occurs all over the world, but no one knows exactly how common it is because there are so many different kinds of fungus that cause it, it's not reportable, and many cases probably go undiagnosed. Signs of ringworm in animals are often the same as in people, however not every animal that is infected with ringworm develops signs of infection. It has been estimated that ~90% of cats that are carrying dermatophytes do not show any signs of infection, but they can still transmit the fungus to other animals and people. (NB: this does NOT mean that ~90% of cats carry dermatophytes!)  Almost any animal can be infected by at least one dermatophyte or another - cats, dogs, rabbits, rodents... even horses and cattle!

• Early identification of ringworm is important to reduce the risk of transmission to people and other animals. If your pet develops bald patches, particularly if they're itchy, it should be examined by your veterinarian to determine if a fungal infection may be present.
• If you or anyone in your household develops an area of skin that appears infected (especially if it appears as a red "ring"), keep it covered with a piece of clothing or a bandage and see your doctor.
• Most cases of ringworm can be treated with either topical (e.g. ointments) or oral anti-fungal medication.
• Clean your pet's grooming supplies (e.g. brushes, combs) regularly.
• Always wash your hands after handling your pet.

Watch for another Worms & Germs blog post about ringworm and how to clean up if you or your pet is infected, coming soon!  More information about ringworm and dermatophytes can be found on the CDC's Dermatophytes website.

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A horse in Ontario was recently diagnosed with Eastern Equine Encephalitis (EEE), a serious neurological disease caused by a virus of the same name, which is transmitted by mosquitoes.  The horse was from the North Durham region.  The last reported cases of EEE in Ontario were in 2004.  A few weeks ago, the Worms & Germs Blog talked about a large number of cases of EEE that have been reported in Florida this year.

Here are some of the key points to remember about EEE:

• Like West Nile, EEE is a seasonal disease.  It is more common in warmer areas, especially some regions of the southeastern US.  It is rare in cooler climates, but occasionally EEE is found in horses in Ontario.
• EEE is usually fatal in horses, and there is no effective treatment.
• EEE can also occur in people, and can be fatal in some cases.
• Infected horses cannot transmit the EEE virus to people, but if a horse gets EEE from the mosquitoes in the area, then people could also potentially be exposed to the virus by mosquitoes.
• A vaccine for EEE is available for horses, but most horses in Ontario are not vaccinated for EEE because it is so rare.  Nonetheless, vaccination can be considered because the disease is so devastating when it occurs.
• As for West Nile virus, avoiding mosquitoes - for both horses and people - is an important preventative measure for EEE.

For more information, see the Worms & Germs Blog post "Eastern Equine Encephalitis – Not Just For Horses", or the CDC's website on arboviral encephalitides.

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Over 50 horses have died from Eastern Equine Encephalitis in Florida this year. The disease, caused by a virus of the same name, affects the brain, resulting in a broad range of clinical signs from behaviour changes to blindness to irregular gait. The disease is also sometimes called “sleeping sickness” because some horses may become severely depressed, with low head carriage and droopy eyes, ears and lips. Almost all horses that develop neurological signs from this infection die. Only 35 cases were reported in Florida in 2006 and 2007 combined.

There are actually three related equine encephalitis viruses – Eastern, Western and Venezuelan – which are called EEE, WEE and VEE for short. VEE is found in South and Central America and Mexico, and occasionally in the southern United States, but has never been reported as far north as Canada (VEE is a reportable disease in Canada). It is unique among the three diseases as the only one in which an infected horse will carry enough virus in its bloodstream to infect a mosquito, which could then pass the virus on to another animal. The EEE and WEE viruses, just like the West Nile virus, do not reach high enough levels in the bloodstream of horses to do this. The mosquitoes usually pick up the viruses from passerine birds, which do not become ill from the viruses (unlike West Nile virus in birds from the family Corvidae).

People can also be infected by EEE, WEE and VEE. About 10 fatal cases of EEE in people are reported in the United States every year. But horses cannot transmit EEE or WEE to humans, even if they’re bitten by the same mosquito. A higher number of cases in horses, however, may mean a higher number of mosquitoes that are carrying the virus. There is no vaccine for these viruses for humans, but there are vaccines available for EEE, WEE and VEE for horses.

In the end, EEE is just one more good reason to make sure you wear mosquito repellent when you’re enjoying the great outdoors during the summer. Visit the Health Canada website for safety tips on using personal insect repellents. EEE is very uncommon in Ontario, but horses that live in or travel to the southern United States should be vaccinated. Talk to your veterinarian about whether or not your horse should be vaccinated. Remember that fly control is also important for our equine companions (and also helps protect them against West Nile!).

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Many people in the horse world have heard the hype about methicillin-resistant Staphylococcus aureus (MRSA) in horses. MRSA can cause infection in horses, just like it can in people, dogs, cats and many other animals. It’s usually what we call an “opportunistic” pathogen, meaning it usually takes advantage of a person or an animal that is already sick or injured, like someone who’s in the hospital and has just had surgery. And because MRSA is resistant to many different antibiotics, the infection can be difficult to treat. The big concern with MRSA in recent years is that infections are now sometimes occurring in people who aren’t sick, and who don’t have wounds or incisions, which is where MRSA usually likes to move in. It’s very important to find out from the start if an infection is being caused by MRSA, so that it can be prevented from spreading to other people and animals, and so that it can (if necessary) be treated with the right kind of antibiotic.

Horses are a bit of a special case when it comes to animals and MRSA. When researchers look at the DNA of MRSA from a dog or a cat, it usually turns out to be one of the common human MRSA strains (usually called a “clone”) from the same area. This means that the dog or cat probably picked up the MRSA from a person somewhere.  When researchers look at the DNA of MRSA from horses, however, they often find a different clone, which seems to be more common in horses and people who work with horses than in people in general. A very similar situation has also been discovered in pigs. The worry is that this “horse MRSA clone” can survive in and be transmitted between horses better than the human MRSA clones. That means that in order to control MRSA, just controlling it in the people won't do the trick - we need to take steps to stop the spread of MRSA in horses specifically as well.

Here are some key points to help reduce the risk of your horse (and you!) getting MRSA:

• Always wash your hands with soap and water (or use an alcohol-based hand sanitizer) after handling a horse, and before handling another horse.
  • This is especially important if you have touched a horse’s nose, or any cuts or wounds that the horse may have.
  • Don’t go down the row of stalls in the barn and pet every horse on the nose! They love the attention, but this is a great way to spread MRSA if it’s there!
• New horses coming into the barn, or animals coming back from a hospital, should be kept separate from all the other animals and only dealt with after all the other horses, for 3-4 weeks.
  • This is an important measure for controlling many infectious diseases, not just MRSA.
• If your horse has a cut that looks infected, cover it with a bandage of some kind and contact your veterinarian. Your veterinarian can culture the wound to determine if it is an MRSA infection.

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