HIV/AIDS, kids and pets
The Centers for Disease Control and Prevention (CDC) has released updated Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV-exposed and HIV-infected Children. A small but still important part of this document involves recommendations for contact with animals. It's a nice, balanced document that acknowledges the risk but doesn't make unnecessarily restrictive recommendations.
Among the important recommendations regarding animals:
- When getting a new pet, avoid dogs and cats less than 6 months of age or strays: These animals are at higher risk for shedding various infectious diseases and are more likely to have problems with biting and scratching.
- Avoid contact with animals that have diarrhea.
- Wash hands after handling pets.
- Avoid contact with pet feces.
- Avoid contact with reptiles, chicks and ducklings: These are very high risk for Salmonella.
- Avoid contact with calves or lambs at farms or petting zoos: These animals are high risk for various infectious diseases such as Cryptosporidium and Salmonella.
These recommendations also largely apply to other high-risk groups, including people (of all ages) with compromised immune systems and young children (especially less than 5 years of age). A key point is normal contact with common household pest using basic hygiene practices is considered a low risk. Infection control isn't rocket science. It involves basic and practical measures that can reduce risks associated with animal contact.
Dietary indiscretion, HIV and dogs
A reader asked this question the other day:
"I was walking with my dog, when it got hold of a used condom. Is it possible that my dog got HIV or AIDS or something?"
The short answer is NO. Dogs cannot be infected by HIV, nor can dogs transmit the virus (although there is a theoretical concern that a dog could transmit HIV from one person to another if it bit someone with HIV, got blood from the person in its mouth, and then immediately bit someone else). The virus that causes HIV/AIDS does not survive long outside the human body and would quickly die in a dog's mouth. So HIV infection in a dog from chewing on or swallowing a used condom is not a concern.
Dogs are not susceptible to the other important sexually transmitted diseases in people either. The biggest potential problem in this situation (and a slim on at best) is if the dog swallowed the condom, it could cause a blockage in the dog's intestine. Most likely, though, the dog would pass the condom in its stool and nothing untoward would happen.
(The "ick" factor with dogs eating things like this furthers my objections to being licked in the face by any dog, however!)
Pets and immunocompromised people
There was an interesting article in USA Today about the increasing recognition of the positive role that pets can play in patients recovering from serious disease, and how contact with pets can sometimes conflict with disease transmission concerns in these same patients. The attitude towards pet ownership among physicians is highly variable - some recognize the strong human-animal bond and its positive effects, while others see pets as unnecessary infectious disease risks. The infectious disease concerns are heightened in patients with compromised immune systems, to the point that sometimes people are told to get rid of their pets if they are severely immunocompromised. However, more and more pet owners, veterinarians and physicians are beginning to question if this is truly the best approach.
The USA Today article describes the experiences of a cancer patient whose greyhounds were "banished to a caregiver on doctors’ orders". Considering she was at high risk for (potentially fatal) infectious disease because of chemotherapy, bone marrow transplant, stem cell transplant and immunosuppressive drugs, it’s not surprising that there was concern about the pets. After researching the risks, and measures she could take to reduce those risks, the patient convinced her doctors that the risks from her dogs were not as great as the benefits from having them around, and so the dogs returned home. While everyone’s relationship with their pets is different, the patient felt that the return of her dogs was an important step in her recovery, stating "There's no question that having (the dogs) with me these past few months made a huge difference in my recovery".
Infectious disease transmission from pets to people is certainly a real issue, and it is of particular concern in people with weakened immune systems. There is not, nor will there ever be, a "no-risk" pet. Every contact with a pet, just like every contact with another person, carries with it some degree of risk of disease transmission. What needs to be considered is the trade-off, the risks versus the benefits. In some people, the risks are greater than the benefits because of the severity of disease, type of pet, the person's ability (or more likely inability) to interact with the pet. In other people, especially those who have a very strong bond with the animal, the positive social and emotional benefits of pet ownership may greatly outweigh the associated disease risks. The article contains a great quote from Dr. Ray Pais, a pediatric hematology/oncology specialist, saying "Our young patients have already given up so much, I see no reason at that moment for them to also lose the dog."
People that have compromised immune systems need to have a serious discussion with their physician, veterinarian and family about the best thing to do with their pets while they are sick. While there is very little research in this area, taking a few common sense precautions should reduce the risks of disease transmission. These include:
- Avoiding contact with stool
- Frequent handwashing
- Preventing licking of the person by the pet
- Proper training to reduce the risk of bites and scratches
- Keeping cats indoors
- Following a good preventive medicine program for the pet
More information about Immunocompromised Pet Owners will be available soon on the Worms & Germs Resources page. The CDC also has useful information on its website about this topic.
Thanks to Dr. Doug Powell of Barfblog for forwarding this article.
Feline Immunodeficiency Virus - HIV/AIDS for Cats
Everyone is familiar with the human immunodeficiency virus (HIV) - the retrovirus that causes acquired immunodeficiency syndrome (AIDS) in people. Although HIV can only infect humans and some primates, cats can be infected by a very similar virus from the same genus (Lentivirus) with a similar name – feline immunodeficiency virus (FIV). The FIV virus is transmitted from cat to cat by contact with blood, usually through a cat bite. In Canada and the USA, up to 3% of healthy cats may be infected with FIV.
As with HIV in people, FIV attacks a cat’s immune system, which can leave the animal susceptible to many different infections that a healthy cat could normally fight off. Some of these infections, like toxoplasmosis, are similar to those that occur in AIDS patients. (More information on toxoplasmosis and Toxoplasma is available on the Worms & Germs Resources page). Depending on a number of factors, an FIV-positive cat may remain healthy for years, but once the animal begins to show signs of a weakened immune system, it will often develop chronic or recurrent health problems. The infection is life-long – there is no “cure” for FIV.
Some key points to remember:
- Cats cannot get HIV. People cannot get FIV. They are related but different viruses.
- Keeping your cat indoors will prevent fighting with other cats and decrease the risk of your cat contracting FIV.
- There is a vaccine available for FIV, but it remains uncertain if the vaccine can protect cats from all strains of the virus. The vaccine also interferes with tests for FIV infection. Therefore, preventing exposure to the virus is still the best way to prevent FIV infection.
- If your cat already has FIV, it is important to keep it indoors to decrease exposure to pathogens that could make your cat sick, and to prevent your cat from spreading the virus to other cats.
More information about FIV can be found on the Cornell Feline Health Center website.
HIV/AIDS and dogs
My dog licked someone with HIV/AIDS, and they had an open sore. Can my dog get HIV?
Can a dog that bites someone with HIV get infected?
If a dog bites someone with HIV then bites someone else right after, can it spread the virus?
The answers are no, no and it's very, very unlikely.
HIV (human immunodeficiency virus) does not infect dogs. Regardless of how a dog is exposed, it will not develop an infection. HIV is also a very fragile virus. It does not survive long in the environment and a dog's mouth is not a very hospitable location. It is theoretically possible that if a dog bit someone with HIV and then immediately bit someone else, it could transfer the virus, but this has not ever been identified and is very unlikely. In some countries, the source of all cases of HIV are investigated, and an animal bite has never been implicated as a potential cause.
Bottom line....don't worry about HIV and your pets.
