Baylisascaris and dogs
Recently, I was speaking with a physician who mentioned that a colleague has recommended that people with raccoons in their yard get rid of their dogs because of the risk of Baylisascaris procyonis. This parasite, also known as the raccoon roundworm, can cause severe neurological disease in people that ingest infective parasite eggs from the environment.
The most severe type of disease caused by the migrating larvae of this roundworm (neural larval migrans) is very nasty, and usually causes death or serious, severe neurological deficits. However, the recommendation to get rid of dogs when there are raccoons around makes no sense. Here's why:
- The main host for Baylisascaris is the raccoon. A large percentage of healthy raccoons (over 90% in some areas) are infected and pass large numbers of parasite eggs in their stool. Exposure to eggs from raccoon feces is the main source of human infection.
- Human infections are very rare. They predominantly occur in people that are at increased risk of ingesting feces or dirt, based on their age or behaviour.
- Dogs can be infected with Baylisascaris, but this is rare.
- The small number of dogs that are shedding Baylisascaris in their feces do not pose an immediate risk to people. Eggs that are passed in feces are not immediately infective. Eggs must mature in the environment (which usually takes 2-4 weeks) before they are able to cause infections.
- There are no clearly documented cases of dogs being a source of human infection.
- The main risk from dogs is probably the potential for dogs to carry old (i.e. infectious) Baylisascaris eggs into houses on their haircoats, after roaming around raccoon infested areas.
How do you reduce the already very low risk associated with Baylisascaris and dogs?
- Discourage raccoons from living near your house. Raccoons defecate in certain areas or "latrines," where the soil becomes heavily contaminated with raccoon feces, and where tremendous numbers of infectious eggs can be present. If you make your yard uninviting to raccoons, then they won't establish a latrine near your house.
- Carefully clean any raccoon latrines that might be on your property.
- Don't let you dog have contact with raccoon latrines.
- If your dog has had contact with a raccoon latrine, give it a bath. Baylisascaris eggs are sticky and can stick to the dog's coat quite well, so a thorough bath is much better than a quick rinse or brush. Wear gloves and some form of protective outwear (e.g. a coat that you take off after and promptly launder) while bathing the dog. Wash your hands thoroughly when done.
- Closely supervise people at increased risk of ingesting feces or dirt (e.g. young children) when they're outside.
- A routine deworming program will eliminate Baylisascaris in the intestinal tract of a pet dog, in the unlikely event it's been infected.
- Prophylactic treatment of dogs that have eaten (or have a tendency to eat) raccoon feces could be considered, but the need and usefulness of this is not clear.
Bottom line: You don't need to get rid of your dog if there are raccoons in your yard. The risk of Baylisascaris infection from your dog is extremely low, and the steps above can help you decrease the risk even further. Getting rid of the raccoons (instead of the dog) will be much more effective.
More information about Baylisascaris and neural larval migrans is available in our archives.
Deworming dogs... How often?
Deworming has become a controversial subject. There are numerous opposing views, strong opinions and conflicts of interest that drive a lot of debate on the subject. There's no argument that parasites can be bad for pets and some can pose a risk to people. There's no argument that we want to reduce parasite burdens in pets to improve pet health and decrease human risks. It's the "how" that causes all of the problems. Developing deworming strategies requires consideration of a several different things, including:
- What parasites are in the area?
- Are the risks the same all year round or are they seasonal?
- What parasites pose a risk to an individual pet or what are the pet's chances of exposure? (e.g. Does the pet go outside? Is it exposed to many other animals? Are there multiple pets in the household?)
- Are there any people in the household at particular risk for parasitic infections? (e.g. young children, people with developmental disorders that might be more likely to be exposed to pet feces?)
Everyone agrees puppies and kittens need more aggressive deworming, but there are a few different approaches to managing deworming in adult animals.
The Companion Animal Parasite Council advocates monthly deworming for a few reasons. One is that, based on the duration of activity of the drugs used, monthly treatment prevents establishment of significant parasite populations in the animal (and therefore also in the animal's environment). It also keeps the treatment user-friendly - it makes it easier for people to remember to treat their pet. Some concerns with this approach include its "one plan fits all" mentality, despite the fact that there are great differences in the risks between different regions, and even between pets in the same area. There are also concerns about such heavy use contributing to the development of parasite drug resistance (which is a problem in some other species like horses and sheep), although this doesn't seem to be a major concern... at least not yet.
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Recent European guidelines take a somewhat different approach and use a philosophy more geared towards individual risks for each animal. These guidelines recommend that if regular deworming is used, animals should be treated at least 4 times a year, with no more than 3 months between each treatment. This is based on some research indicating that dropping treatment to 3-4 times per year had no effect on parasite levels. This approach is therefore more conservative (in terms of the number of treatments) and probably has less of an impact on the development of resistance, but it requires more organization and thought. If used properly, it's probably a good approach.
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Yet another approach was recommended by a Canadian Parasite Expert Panel. With their approach, in low-risk households (both pets at low risk for parasite exposure and people at low risk of infection), treatment is based on fecal examination results or, if fecal testing is not performed, once or twice yearly treatment is recommended. In high risk households, fecal testing is recommended 3-4 times per year, with treatment based on results, or administration of routine preventive treatment at least 2, and preferably 3-4 times per year. The main criticism of this approach is that it's more complicated and perhaps prone to errors or missed treatments.
There's no clear answer, nor should there be. There really can't be a "one program fits all" approach that properly addresses the risks for all pets (and people) in all regions. Tailoring the deworming strategy to your pet, based on your pet's and your family's risk, is the logical approach. Regardless of the chosen approach, regular fecal testing is a good (and underused) way to assess what's going on with parasites in your pet, and to identify treatment failure or the emergence of drug resistance.
Monthly heartworm prevention has an impact on what you do as well, since typical heartworm preventives are also effective against roundworms and hookworms, the main parasites targeted by routine deworming. If you are in a region where heartworm is present, monthly treatment during the heartworm season is indicated, and the main decision that needs to be made is what to do the rest of the year (where heartworm isn't a risk year-round).
Heartworm in people
Heartworm is an important problem in dogs. It's a parasitic disease caused by Dirofilaria immitis and is spread by mosquitoes. It can cause serious, even fatal disease, and routine testing and preventive medication is an important thing for dogs in areas where D. immitis is present. Dogs (wild and domestic) are the natural host for this parasite, but other species can be accidentally infected, including people and cats. People become infected by being bitten by a mosquito that is carrying the parasite, having acquired it from an infected dog. Human infections seem to be quite uncommon and, interestingly, while this is a serious problem in dogs, it tends to be rather innocuous in people. In fact, the biggest problem with heartworm infection in people is the fact that it can be confused with other, more serious problems, leading to invasive testing.
After infecting someone, D. immitis works its way to the blood vessels in the lungs. This can result in a small area of inflamed tissue in the area. If a chest x-ray is taken, a "coin lesion" (a small, usually 1-3 cm spot) is often present. The parasite infection usually doesn't cause any problems in people, but lung cancer and tuberculosis can look the same on x-rays. Usually, open-chest surgery ends up being performed to get a biopsy of the area because of the concerns about cancer. In heartworm cases,the biopsy identifies the problem as D. immitis, which is much better than cancer, but the risks associated with having undergone such an invasive procedure are much greater than that of the parasitic infection itself.
Typically, treatment is not recommended in people because the infection rarely causes problems and people are "dead end" hosts, meaning they cannot pass on the infection. (Unlike in dogs, infected people don't have the parasite microfilaria in their blood, which is how the infection is passed on to mosquitoes and other animals).
Heartworm is a rare and rather innocuous problem in humans - it's nothing to lose sleep about.
Image: A diagram of a very severe case of heartworm in a dog, in which there are so many worms in the pulmonary arteries that there is "back-up" of the parasites into the right side of the heart, which is how the parasite got its common name.
More on Giardia in healthy dogs
New research provides more information on the debate about testing and treating of healthy dogs for Giardia. Two abstracts on the subject by researchers at Colorado State University were presented at the recent American College of Veterinary Internal Medicine conference.
In the first study (Clark et al), fecal samples were collected from 220 healthy dogs. Giardia was detected in 11.4% of samples, but no dogs carried assemblages (types) known to cause disease in people.
In the second study (Lappin et al), they evaluated whether treatment of healthy dogs that were shedding Giardia would eliminated the parasite. Sixteen infected dogs were treated with either fenbendazole or nitazoxanide. Eight (50%) of the dogs had to be removed from the study because of adverse effects from treatment! Of the dogs that completed the study, Giardia was still detected in 63% of dogs 34 days after treatment, indicating that the infection wasn't eliminated or that dogs were quickly re-infected.
These studies provide more support of the notion that there is no indication to test or treat healthy dogs for Giardia. Testing makes no sense when the parasite is so common but most infected dogs are healthy, and when strains carried by infected dogs are usually of no consequence to people. Giardia is essentially a normal part of the intestinal microflora in many healthy dogs. Treatment of healthy carriers isn't indicated because it can make dogs sick and because it doesn't work very well. Remember: above all do no harm.
The bottom line is don't bother testing healthy dogs for Giardia or treating healthy dogs in normal households.
Traveling parasite roadshow
There have been a few press articles lately about the Companion Animal Parasite Council (CAPC)'s traveling roadshow on parasitic zoonoses. Measures to increase awareness about zoonotic diseases and encourage appropriate preventive measures are needed, and traveling shows such as this have the potential to reach wide audiences. However, it's important for people to critically assess everything they are told and understand the sources. CAPC produces some excellent educational material but, to my knowledge, it is fully funded by the pharmaceutical industry. That doesn't necessarily mean that CAPC's educational efforts are suspect - people participating with their roadshow have solid credentials, but you do have to critique some of the things CAPC says.
One news article about CAPC's efforts states that "The CDC reports that about 14 percent of the total U.S. population is currently infected with Toxocara, or internal roundworms, contracted from dogs and cats." I don't think that's accurate information. I believe that this is based on seroprevalence data, meaning 14 percent of the population has antibodies against Toxocara. The presence of antibodies means that at some point in life the person's (or animal's) body was exposed to Toxocara and produced antibodies. It does not mean that these people were ever sick and it certainly does not mean that these people are currently infected. Toxocara can cause serious infections and is a concern in some regions (although it's extremely rare in Ontario), so it warrants some attention, but we need to take a balanced and evidence-based approach.
One common theme in all of the reports that I've read lately is the statement that "The CAPC recommends that pet owners use preventive medicine year-round to control internal and external parasites for the life of their cat or dog, no matter where they live." There's simply no evidence supporting this broad of a statement. Risks in warm southern climates are not the same as in northern areas with cold winters. Prevalence rates of different parasites vary greatly between regions. There is no evidence supporting year-round deworming of dogs and cats in all regions. Statements like this weaken the other good educational information CAPC has, particularly when you consider their funding source.
Don't disregard educational materials from CAPC or other industry-sponsored groups, just don't accept them as gospel. Critically assess the information, and don't be afraid to ask for facts, or to get information from other sources.
For more information about deworming recommendations for dogs and cats in Canada, see this previous Worms & Germs post.
Baylisascaris (raccoon roundworm) in cats
A reader posed this question, with respect to having raccoons living around the house:
"One thing that causes me concern with the raccoon roundworm is the possible danger of infection to my pets and myself through the feces left behind from the raccoons in the yard and possibly in my vegetable garden. Can I acquire the roundworm from working in the soil and/or from my root vegetables etc? My cats mingle near the raccoons, they don't bother each other, should I get my cats tested?"
Certainly, working outside (particularly in soil) leads to the potential for exposure to many disease-causing agents, including Baylisascaris, as well as dog and cat roundworms (Toxocara spp.). Eating unwashed/uncooked vegetables is also a risk. However, in the grand scheme of things, the risks to the average person (not very young or very old, functional imune system) are minimal, especially if basic hygiene measures are used, such as washing hands after working in the garden, and thoroughly washing vegetables. Raccoons tend to defecate in the same specific areas most of the time (raccoon latrines), so in general gardens probably aren't common sites for raccoon feces, although it certainly can occur. Cats are probably more likely to defecate in gardens. We shouldn't take concerns about Baylisascaris lightly, because even though disease (larval migrans) is very rare, it can be very severe.
Now, about testing cats for Baylisascaris - there's not much use, for several reasons:
1) The likelihood of a positive result is very low. The prevalence of Baylisascaris in dogs is very low. Little is known about the prevalence in cats specifically, but it is presumably very uncommon there as well.
2) It can be difficult to differentiate Baylisascaris from the feline roundworm, Toxocara cati. Unless the lab has experience with this, they may not be able to tell the difference. Therefore, you might get a misleading result.
3) What does a positive test tell you? It tells you that the cat is shedding this parasite or that is has ingested eggs that are just passing through the intestine. The risk to people is still minimal if litterboxes are cleaned regularly. Contaminated stool is not infective until it has sat around for days to weeks, so regularly cleaning the litterbox and good handwashing can control the risk.
4) What does a negative test tell you? It tells you that the parasite was not detected on this single sample. It could have been there but not been identified. It might not be there today but could be there tomorrow (though this is still unlikely). A single negative test today does not tell you too much.
5) What would you do with the results? Probably not much. In the very unlikely chance that results were positive, it would likely be recommended to repeat testing to see if eggs are just passing through or whether the animal truly is infected with the parasite. That would determine whether treatment is needed. Otherwise, recommendations would be pretty much the same in both cases (good regular deworming program as directed by your veterinarian, proper handling of cat feces...).
The best way to prevent exposure of your cat to Baylisascaris (as well as other pathogens, predatory wildlife, vehicles, etc.) is to keep it inside.
Parasite exposure from pets
A recent study from the Netherlands investigated the prevalence of zoonotic parasites in pet feces and on pets' haircoats. The authors sampled feces and fur from dogs and cats, and looked for Toxocara (roundworms), Toxoplasma, Giardia and Cryptosporidium. All these parasites are of concern from a public health standpoint because they can be found in healthy pets and can also infect people.
Toxocara eggs were found on the haircoats of 12% of dogs and 3.4% of cats. Levels were low, ranging from 1-31 eggs per sample. An important aspect of this study was that they also assessed viability of these eggs, and found that none were viable. Therefore, even though eggs were present, they were not relevant because they were dead. Exposure to UV light and lack of humiditiy were cited as possible reasons for the death of the eggs.
Toxocara were found in the feces of 4.4% of dogs and 4.6% of cats, which is consistent with other studies of healthy pets.
Toxoplasma was not found in the feces of any cat. (Cats are the hosts for this parasite so dogs weren't tested.)
Giardia was found in the feces of 15% of dogs and 13.6% of cats. However, when these strains were typed, the vast majority were species-specific types that do not cause disease in people. Only 2 of the 15 Giardia samples were assemblage A, a type that is transmissible from pets to people. This is very important to know because crude Giardia numbers don't tell you the whole story.
Cryptosporidium was found in feces of 8.7% of dogs and 4.6% of cats. However, they were not able to type these parasites to determine if they were species that typically cause infection in humans, or whether they were Cryptosporidium felis or C. canis, which rarely cause disease in people.
The discussion section of the paper contains an interesting and relevant point about exposure to Toxocara eggs on the haircoat of pets. The authors state "Even in the worst case scenario of highly contaminated fur, e.g. with the highest Toxocara [eggs per gram] of 300 and an embryonated rate of 4% from the study of Wolfe and Wright, it is necessary to ingest more than 4 grams of hair, with 12 embryonated eggs per gram, to ingest 50 infective eggs." Based on these data, exposure to parasites from the haircoat of pets is quite unlikely. It might be a greater concern with stray or debilitated animals, or with puppies/kittens, who could have much greater coat contamination.
The take home message: Normal contact with healthy pets likely poses minimal risk of transmission of zoonotic parasites. That being said, regularly washing your hands is still a good idea because of the potential for exposure to other types of microorganisms (e.g. bacteria), and in rare circumstances where there may be large parasite burdens on a pet. Good deworming practices, particularly for puppies and kittens, also need to be considered.
Reference: Overgaauw et al, Veterinary Parasitology, 2009.
Canadian parasite treatment guidelines for pets
Canadian Guidelines for the Treatment of Parasites in Dogs and Cats have recently been released. These guidelines were developed by an expert panel, consisting of six Canadian veterinary parasitologists and two private practitioners. They provide a good, balanced approach to the treatment of parasites, with an emphasis on the risks present in different regions and in different types of pets. There is very little objective information on which to base some of the recommendations, so many aspects are instead based on expert opinion, not necessarily hard facts, but when data are lacking, that's when opinions from independent experts are most needed. The guidelines provide an overview of recommended treatments along with an explanation of the reasoning. This document is a useful resource for pet owners and veterinarians alike. There is also discussion about why guidelines in Canada differ from those in the US. To download these guidelines click here.
Note: Development of the guidelines was supported by a pharmaceutical company, but the information they contain was developed by the independent experts mentioned above.
Dog park closed because of bleach contamination
A dog park was closed because of an attempt by a dog-owner to disinfect puddles. The woman was seen pouring a gallon of bleach into a mud puddle, sparking an investigation. The site was closed while city staff pumped out puddles. The woman told the person that witnessed and reported the incident that her dog had contracted the intestinal parasite Giardia in the park, and she was trying to sanitize the water. However, authorities believe it may in fact have been a malicious act (i.e. an attempt to poison the dogs using the park).
Firstly, there's no way the woman could know that the park (let alone a specific puddle) was the source of her dog's infection. Giardia can be found in the environment and in the stool of a small percentage of healthy dogs (~7% in many studies).- Secondly, pouring a toxic substance into the puddles in the park is obviously not an appropriate response. Bleach is a good disinfectant when it's used right, but disinfecting outdoor surfaces like this is essentially impossible. Organic debris (e.g. mud) will readily inactivate bleach, but the bleach could still make an animal sick if too much (too high a concentration) is swallowed, because it's very caustic.
- Thirdly, for this woman to take matters into her own hands like this without consulting someone who knows something about infectious diseases, and potentially exposing a lot of animals to high levels of bleach is irresponsible. If there was concern about the park as a source of infection, the appropriate response would have been to talk to city staff.
In reality, the risk to other dogs was probably pretty low. It’s pretty obvious when there's a lot of bleach somewhere (even just based on the smell), and in general dogs would probably be very reluctant to drink bleach-contaminated water.
One officer stated that he suspects the Giardia story was an excuse contrived by the woman when confronted by the passer-by who witnessed the bleaching incident. That’s certainly possible, but I’m surprised someone would come up with a specific excuse like Giardia. If the woman is found, that should be easy to figure out - the diagnosis would have to be in her dog's medical record. Police stated that the woman, if identified by the authorities, could potentially face animal cruelty charges. I think that’s pretty unlikely, considering what usually has to happen for someone to actually be charged and convicted of animal cruelty. I suspect this really was an overzealous response by someone who lacks common sense. There was no comment about whether the woman would be billed for the city staff time required to deal with the clean up - that might be a more effective deterrent to similar incidents in the future!
Parks are inherently a high-risk environment for exposure to infectious diseases. Whenever you mix large numbers of animals, especially in an area where they often pass stool, there is an increased risk of disease transmission. You have to accept that when going to a park. People should also ensure that they never take a sick animal to a park, promptly clean up stool, and may sure that their pet is on an appropriate vaccination and deworming program. Disinfection of a park will never be part of the infection control program.
More information about Giardia can be found on the Worms&Germs Resources page.
Lungworms in dogs: Parasite risk or marketing ploy?
I read a press release today entitled "New Parasite Infection Killing Pet Dogs in Southern England". It's about the lungworm Angiostrongylus vasorum. The main reservoir for this parasite in England is the common red fox. Slugs and snails are involved in transmission of the worm as well. Infection of dogs most likely occurs through ingestion of the parasite from contaminated water or other environmental sources. The press release mentions a study that was released last year which reported an increase in the parasite in wild foxes. It mentions (without providing any data) that infections are occurring regularly dogs in some regions. This may well be true but brings to mind an important point I mentioned the other day (among others): know the source of information you are reading. I know I'm being a bit cynical, and it's possible that they have the well being of pets in mind, but the press release is from an online veterinary pharmacy, a company that obviously benefits from increased treatment of pets with dewormers.
This is made clear by their statement "Luckily there are a number of medicines available that can provide real and lasting protection from this nasty parasite. At www.vetscriptions.co.uk we recommend that all dog owners make it their business to find out about this disease and make sure that their dogs are fully protected."
Is lungworm a real and increasing threat in the UK? It's certainly possible. I don't dismiss the possibility at all.
Would I get concerned about it at this point? No. I'd look for objective information and ask my vet if there are any concerns in my particular area. Like the press release says, people should "make it their business to find out about this disease."
So what does this tell me? It reminds me that there are a lot of potential infectious disease threats out there that I need to pay attention to, but there are also a lot of people trying to make money at the same time. It could be that this company is being benevolent and honestly trying to make sure that pet owners are aware of the risks of lungworm. It's also possible they are taking advantage of a marginally relevant problem. Information like this is good for raising some questions, but getting advice from a non-biased source is critical.
Deworming kittens and puppies
Deworming adult cats and dogs is a rather controversial area at the moment. Balancing concerns about animal health, zoonotic disease transmission, drug resistance, compliance and cost is difficult. Risks vary between different regions/climates and there are no clear answers. One area that is much less controversial is deworming of kittens and puppies (less than 6 months of age), as there is general consensus that aggressive deworming is needed in these animals.This is because young animals are much more likely to harbour parasites. They are also more likely to contaminate the household environment during the litter/house training process and tend to have very close contact with people. The greatest concern tends to be about roundworms, since they are very common in dogs and cats (especially young ones) and zoonotic infections can occur (i.e. visceral and ocular larval migrans, similar to that caused by the raccoon roundworm, Baylisascaris procyonis).
Standard deworming guidelines are:
- Puppies should be dewormed at 2, 4, 6 and 8 weeks of age, then monthly until 6 months.
- Kittens should be dewormed at 3, 5, 7 and 9 weeks of age, then monthly until 6 months.
Further treatments depend on various factors, including the animal's lifestyle (risk of exposure), how common different parasites are in the region and perhaps whether there are high-risk people in the household. Your veterinarian can provide the best advice for your individual pet.
Another thing to remember is that not all parasites are killed by all dewormers. Specific deworming programs need to be set up to address different parasite risks.
More information about roundworms (and other parasites) in dogs and cats can be found on the website of the Companion Animal Parasite Council, an industry-funded organization.
Photo: A large mass of roundworms from the intestine of a heavily infected animal.
More about Echinococcus tapeworms in dogs
Echinococcus granulosus is a tapeworm of dogs that causes a condition known as hydatid disease or hydatidosis in humans. The parasite is found in many parts of the world, and is very common in some regions of southern South America, the Mediterranean, the Middle East, southwestern Asia, northern Africa and Australia. To the best of our knowledge, E. granulosus does not occur in southern Ontario, but it is present in other parts of Canada including the western provinces and northern Ontario. A related, but much nastier, tapeworm called Echinococcus multilocularis is much less commonly found in North America.
A previous Worms & Germs post described what is known as the sylvatic cycle of Echinococcus granulosus, which is thought to be a common route of infection for dogs in Canada. In the sylvatic cycle, dogs become infected with Echinococcus by eating the internal organs (usually lungs and liver) of wild game such as moose and caribou. The dogs then pass tapeworm eggs in their stool, which can cause infection in other wild animals (thus continuing the cycle) or in people who accidentally swallow the eggs. In humans, Echinococcus forms slow-growing cysts (called hydatid cysts) in different organs of the body which can be very difficult to remove or treat in some cases.
Echinococcus also has a pastoral or domestic cycle. In this cycle, dogs acquire the parasite by eating the internal organs of infected sheep, and sometimes other livestock such as cattle and swine. This cycle is potentially very important in areas where there is a lot of sheep farming. In some areas of Latin America, 20-95% of sheep at slaughter may have evidence of hydatid cysts in their organs.
It is much more difficult to tell when a dog is infected with Echinococcus compared to other tapeworms such as Taenia or Dipylidium. An adult Echinococcus is tiny - only a few milimetres long (see picture right), very unlike the long, stringy white tapeworms that most people picture. Dogs can carry hundreds, even thousands of these tiny tapeworms without showing any signs of illness at all. The eggs can sometimes be difficult to detect on fecal examinations, and when they are seen they cannot be differentiated from Taenia eggs. Nonetheless, this is still the best way to detect infection, so fecal examinations should be performed regularly.
Remember:
- In areas where Echinococcus is known to exist, it's important to have your veterinarian perform fecal examinations on your dog's stool more frequently than the usual once-a-year, because of the serious zoonotic potential of this parasite.
- Always wash your hands well after handling dog stools.
- Do not let your dog eat uncooked meat, or the organs from farm animals or wild game.
For more information on Echinococcus, see Worms & Germs post entitled Echinococcus and hydatid disease - not your average tapeworm. There is also information available on the Michigan State Department of Natural Resources site.
Lower photo credit: Ontario Veterinary College
Updated: Raccoon Roundworms - Baylisascaris procyonis
This post has been updated with new information as of October 2, 2008.
Raccoons, just like dogs and cats, can have roundworms in their intestine. Dogs are typically infected by the species Toxocara canis, and cats are infected by Toxocara cati. Raccoons are infected by a type of roundworm from a different genus, called Baylisascaris procyonis. There is one thing that all three of the parasites have in common – the larvae of these worms can infect humans, causing a condition called visceral larval migrans.
Dogs and cats are usually dewormed as puppies and kittens, and often as adults as well, which dramatically decreases the number of pets that are infected with roundworms. Raccoons are not so lucky – in the northern and northeastern parts of North America, over 70% of raccoons may be infected with Baylisascaris. In Ontario, it has been estimated that only about 20-30% of raccoons are infected, but usually with high numbers of worms. In either case, younger raccoons are even more likely to be infected. Infected animals may shed millions of parasite eggs in their stool, and the eggs can survive in the soil for months or even years.
After a few weeks, the eggs in the raccoon stool become infective. If a person swallows the eggs, they hatch in the small intestine and release larvae. These larvae can then burrow through the wall of the intestine and migrate through tissues all over the body, causing tissue damage and inflammation. The signs of illness are often not very specific, and may include things like fever, fatigue and nausea. If the larvae migrate through the brain or spinal cord, a person may develop neurological signs like loss of coordination and muscle control. This is called neural larval migrans, which is the most serious type of disease caused by these larvae. If the larvae migrate through the eye, they can cause blindness. This condition is known as ocular larval migrans.
There have been less than 25 cases of confirmed visceral larval migrans due to Baylisascaris in the USA as of 2003, but the condition is very hard to diagnose with certainty, and it is possible that many cases are mistaken for other illnesses. The disease is also very difficult to treat, and neurological damage from neural larval migrans is usually permanent, so the best thing to do is prevent infection in the first place. Here are some tips on avoiding Baylisascaris:
- Avoid contact with raccoons. Many people think raccoons are cute, but they are wild animals. Raccoons are also a risk for transmission of rabies if a person is scratched or bitten. NEVER keep a raccoon as a pet.
- Discourage raccoons from hanging around your house. Clear brush and seal access to basements and attics where raccoons may try to nest or form latrines. Keep garbage in tightly-closed garbage cans. Eliminate outdoor water sources.
- Always wash your hands well with soap and water after working with soil (e.g. in the garden).
- Clean up raccoon latrines. This must be done very carefully - avoid getting any raccoon stool on your hands or clothes. The stool should be burned, buried or sent to a landfill. Clean the area where the stool was found with boiling water. Wash your hands very carefully when you’re done. Follow this link for more detailed information on how to identify and clean up raccoon latrines.
Baylisascaris procyonis less commonly infects animal species other than raccoons, including skunks, and it has even been found in dogs. It's important to have your dog's stool examined for parasite eggs on a regular basis (typically once or twice a year) and to follow your veterinarian's recommendations for deworming your dog.
More information about Baylisascaris is available on the CDC’s Baylisascaris Infection website.
Echinococcus and hydatid disease - not your average tapeworm
A previous Worms & Germs post talked about the (very low) zoonotic risk of the tapeworm most commonly found in dogs and cats, Dipylidium caninum. Dogs can also carry other species of tapeworm, such as Taenia pisiformis, which cannot be naturally transmitted to people. But dogs can also carry tapeworms from the genus Echinococcus, the most common of which is E. granulosus. Echinococcus multilocularis is much less common in North America, and can also be carried by cats.
In Canada, dogs tend to be exposed to E. granulosus when they eat certain animals, particularly wild herbivores like moose and caribou. In other parts of the world, eating sheep organs is the most common way dogs are exposed. The immature form of the worm is found in the animal’s lungs, liver and other tissues. After being eaten by the dog, the worm matures in the intestine, and tapeworm eggs can soon be found in the dog’s stool. Tapeworm segments, as seen with Dipylidium infection, are usually not seen in the stool with Echinococcus. Under a microscope, it is possible to tell Dipylidium eggs from Echinococcus eggs, but it is not possible to tell Echinococcus eggs from Taenia eggs.
If a moose, caribou, sheep or another suitable “intermediate host” swallows the eggs from the dog stool, the parasite migrates through the animal’s body and forms cysts in various tissues which contain the immature form of the worm. If the animal dies or is killed, and a dog (or a wolf or coyote or related species) eats the cysts, the cycle begins again.
Unfortunately, humans can also be an “intermediate host” for these tapeworms. If a person ingests Echinococcus eggs from dog stool, the parasite can form cysts (called hydatid cysts) in many tissues and organs, including the liver, lungs, brain and heart. If the cysts are small and there are only a few, they may not cause any problems for years, and the person may never know they’re there. But as the cysts grow, they can get very large and start to interfere with the function of organs, or their size alone may be a problem, depending on where they are located. Treatment can be difficult – drugs are frequently not effective, and large problematic cysts may need to be surgically removed, if the surgery can be done safely. If a cyst bursts it can cause anaphylactic shock, which is very dangerous.
In Canada, Echinococcus infection and hydatid disease are most common in the western provinces. Nonetheless, everyone can take a few simple steps to help prevent exposure of people to Echinococcus:
- Always wash your hands after handling dog stool, even if you use a plastic bag or a scoop to pick it up.
- Your dog should have a fecal examination for intestinal parasites at least once per year, or more frequently if your dog is at increased risk of exposure to Echinococcus. If tapeworm eggs are identified, your veterinarian can prescribe medication to treat the infection.
- Monthly heartworm preventatives that are effective against other intestinal worms are not effective against tapeworms!
- Do not let your dog eat uncooked meat, especially the organs of sheep or wild game such as moose and caribou.
More information on Echinococcus and hydatid disease is available on the CDC’s Echinococcosis webpage.
Tapeworms in dogs and cats
People typically realize their pet has tapeworms when they see small tapeworm segments in the animal's stool. These whitish, rice-sized pieces (called proglottids, see the picture on the right) are parts of the adult tapeworm, which break off and are passed in the stool.
Tapeworms are not usually harmful to dogs and cats, particularly if only one or a few worms are present. In some situations, weight loss can occur. Affected animals may 'scoot' (drag their rear end across the ground) because of irritation from tapeworm segments that are passed in the stool.
Diagnosis of a tapeworm infestation is easiest through identification of tapeworm segments in stool. Identification of tapeworm eggs in stool samples through routine testing used for other intestinal parasites is less useful, as the bare eggs are infrequently shed in stool. Therefore, a negative fecal egg examination does not rule out tapeworms.
Dipylidium infections are extremely rare in people. Children are at greatest risk. Disease in people, if present, is usually mild and easily treated. However, finding tapeworms in a person's stool can be distressing to the individual (and their family). Dipylidium cannot be transmitted directly from animals to people. People and pets get infected by ingesting a flea that is infected with tapeworm larvae. Therefore, flea control is the most important aspect of tapeworm prevention. People that find tapeworm segments in their stool should contact their physician to determine whether they are actually tapeworms (people often mistake other things for tapeworm segments) and to determine whether any treatment is needed.
There are specific dewormers that can be prescribed by your veterinarian to eliminate tapeworms in pets. It is also important to take measures to control fleas and prevent dogs and cats from catching and eating animals that might be carrying fleas.
Stray kittens
Various bacteria that can cause diarrhea in people can be carried by kittens, including Salmonella and Campylobacter. These are shed in the stool of infected animals, and people can become ill from handling the animal or stool-contaminated areas. Kittens may have higher rates of carriage of these bacteria than adult cats. Another bacterium that can be carried commonly by kittens is Bartonella henselae, the cause of cat scratch disease. This is transmitted by bites, scratches and fleas, and is just one reason for proper flea control. Stray kittens are also more likely to carry Toxoplasma, a parasite that is a concern in pregnant women and immunocompromised individuals. Other intestinal parasites such a roundworms are also a concern. Kittens are more likely to have these parasites than adult cats. Stool contamination of the haircoat is presumably more common in kittens as well because they are not as good about cleaning themselves as adult cats. So just handling a kitten, even if you avoid its stool, may result in exposure to some of these parasites and bacteria.
Rabies is always a concern, and widespread exposure of people to rabies has occurred from infected litters of kittens. While uncommon, rabies is a major concern because it is almost invariably fatal. Any stray (or recently rescued) animal that starts acting strangely should be considered a rabies-suspect and be taken to a vet immediately. [More information on rabies, and other topics, is available in our Resources page].
Stray kittens can also carry various infectious diseases that can be transmitted to other cats in the household, such as feline leukemia virus, panleukopenia, rhinotracheitis and calicivirus.
Overall, the risks from adopting stray kittens are low, but they are real. If you are going to adopt/rescue a stray kitten, keep these things in mind:
- Take the kitten to your vet as soon as possible to identify any health issues and determine the required vaccination, deworming and flea control program
- Wash your hands after handling the new kitten
- Keep the new kitten in a confined area while litterbox training is underway to reduce accidents throughout the house
- If you have another cat, make sure it is up-to-date on vaccinations before the kitten comes into the house.
- If the kitten gets sick, make sure it is taken to a vet. If it dies suddenly, make sure you take it to your vet to determine whether testing for rabies is required.
- Pregnant women and households with immunocompromised individuals should not adopt stray kittens.
