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.
Healthmap
If you are looking for an interesting website to play around with, you should try HealthMap. This is a website created by the Harvard-MIT Division of Health Sciences and Technology that maps infectious disease reports from various sources. You can search by region and see what disease problems have been reported recently, or select specific diseases and find out where they've been reported. Some examples are shown below. The top image shows all disease reports worldwide (in the last 30 days), while the bottom image shows reports of Salmonella in North America during the same time period. The site relies on reports of diseases (many cases of various diseases occur but are never reported), so it focuses mainly on outbreaks or high profile cases , but it is still quite interesting.
Above: All reported disease outbreaks/cases worldwide in the last 30 days.
Below: Reported outbreaks/cases of Salmonella in North America in the last 30 days.
See the HealthMap site for more details.
"Clostridium" in dogs and cats: what's in a name?
People often ask me questions about "Clostridium" in dogs and cats, with the impression that "Clostridium" is a specific disease. Actually, Clostridium is a large bacterial genus (a group of related bacteria), which includes species that range from harmless to deadly. Some of the more important species are described below:
Clostridium perfringens: This is a common bacterium that can be found in the stool of a large percentage of healthy animals and people. It is a common cause of "food poisoning" in people, and is probably an important cause of diarrhea in dogs and cats. Our understanding of the role of this bacterium in disease in dogs and cats is limited by the fact that it is found in so many healthy animals, so simply growing it from the stool of a diarrheic dog or cat does not prove that it is causing the animal's illness.
Clostridium difficile: This bacterium is a very important cause of diarrhea (and more severe intestinal disease) in people, and is possibly an important cause of diarrhea in dogs and cats. It is rarely found in healthy adult pets, but is relatively common in puppies and kittens.
Clostridium botulinum: This bacterium produces the toxin that causes botulism, a potentially devastating disease that is very rare in dogs and cats. Botulism usually occurs following ingestion of food that has been improperly stored, in which C. botulinum has grown and produced its potent toxins.
Clostridium tetani: This bacterium produces the toxin that causes tetanus, which can occur in dogs and cats, however these species are relatively resistant to this disease. Tetanus usually occurs when a wound becomes contaminated with C. tetani from the soil, followed by growth of the bacterium and production of potent toxins.
Other clostridia: A large number of different species exist, and it is likely that many more clostridia are around but have not been identified and named. Many clostridia are part of the normal bacterial population in the intestinal tract. Some of these can probably also cause disease.
As you can see, "Clostridium" is more than a single bacterium or disease. An understanding of this concept, and the different disease-causing clostridia, is important. More information on Clostridium difficile can be found on the Worms & Germs Resources page.
Image: Photomicrograph of C. botulinum stained with Gentian violet. From CDC's Public Health Image Library (PHIL), ID number #1979.
Can dogs and cats get Clostridium difficile?
.jpg)
I've had this question a few times recently. There isn't really a straightforward answer, and it depends what people mean when they say 'get'. I've broken the question into a few components.
Can C. difficile be found in dogs and cats?
Yes. A small percentage (1-5%) of healthy dogs and cats carry C. difficile in their intestinal tract, and pass it in their stool. Higher carriage rates are found in certain groups, such as young animals, animals in veterinary hospitals and animals that visit human hospitals as part of therapy programs. Most animals that are carrying C. difficile do not get sick.
Does C. difficile cause disease in dogs and cats? (i.e. do they get sick?)
The answer to this one is 'probably'. I don't think we can say for sure, but C. difficile appears to be a cause of disease in dogs and cats, ranging from mild diarrhea to fatal severe colitis. There is evidence indicating that C. difficile might be one of the more common causes of diarrhea in dogs. In people, C. difficile infection is most common in hospitalized individuals and those being treated with antibiotics. The situation is different in dogs and cats, where disease seems to be most common in households (not veterinary hospitals), and in animals not being treated with antibiotics.
Information sheets on Clostridium difficile can be found on our Resources page.
Should I have my pet tested for Clostridium difficile?
I often get asked about testing of healthy pets for Clostridium difficile. This bacterium is an important cause of disease in people. While most common in people in hospitals, cases of C. difficile infection are occurring more in people in the general population. Also, C. difficile can be found in various animals, including dogs and cats. This has led to concerns about the role of pets in C. difficile infection in people. The role of animals in human infections has not been determined, but it is plausible that C. difficile could be transmitted between people and pets, in both directions.
I have been diagnosed with C. difficile. Should my pet be tested?
No. There is no evidence that it is useful. Even if C. difficile is isolated from your pet, it would not tell you if the pet was the source. Your pet could be carrying a completely different strain of C. difficile. Molecular typing of the recovered bacteria (from both you and your pet) would be needed to determine if they are the same strain, and this type of testing is not readily available. Even if you both had the same strain, your pet could have picked it up from you. So, testing of your pet really wouldn't tell you anything.
I'm worried that I may have acquired C. difficile from my pet. Can I just have my pet treated at the same time I'm being treated?
No. Treatment of healthy pets to eliminate C. difficile is not recommended. There is no evidence that we can eliminate C. difficile from a healthy pet with antibiotics.
More information on Clostridium difficile can be found in our Resources page.
Clostridium difficile in dogs
Clostridium difficile is a bacterium that is an important cause of disease in people and has been getting a lot of press lately in this area. Associated with that has been a lot of questions about C. difficile in dogs. Here are some facts to ponder:
- C. difficile is thought to be a cause of diarrhea in dogs in the general population, although its true role in disease is still unclear. C. difficile infection in dogs may cause mild to moderate diarrhea that is treatable.
- Some (<5%) healthy dogs can carry C. difficile in their intestinal tract. They may never have a problem with it.
- Dogs that visit human hospitals have much higher rates of C. difficile carriage, but we currently don't have any evidence that they are at higher risk for disease. They probably ingest the bacterium from the hospital environment and patients' hands.
- We are highly suspicious that C. difficile can be transmitted between people and pets (in both directions), but pets are probably not a major source of infection for people.
Certain risk factors for C. difficile carriage or infection are known, including antibiotic use (people and pets), advancing age (people) and admission to a hospital (people and pets). Some of these are not avoidable. General considerations for C. difficile prevention include:
- Don't use antibiotics unless they are actually required. This goes for people and pets.
- Wash your hands regularly.
- Avoid contact with dog stool, especially diarrhea.
- Enjoy your pet. There is always a risk of disease transmission but the risk of getting C. difficile from your pet is not something to stay up worrying about.
Information Sheets for Pet Owners
INFORMATION SHEETS specifically for KIDS, for VETERINARIANS and for PHYSICIANS 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. 
| Animals | Diseases | Other |
| Dogs | Rabies | Litter Boxes |
| Cats | Giardia | Sandboxes |
| Turtles | Toxoplasma | Cat Bites |
| Hamsters | Leptospira | Raw Meat |
| Rabbits | Clostridium difficile | |
| Birds | Cryptosporidium | |
| MRSA | ||
| Salmonella | ||
| Campylobacter | ||
| Ringworm |
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.
