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.
Baby chicks in preschools
Just last week I blogged about concerns regarding young children handling baby chicks in classrooms. Baby chicks are high-risk animals because of the potential for transmission of Salmonella. The Centers for Disease Control and Prevention (CDC) recommends that children less than 5 years of age not have contact with baby chicks for this reason. Unfortunately, few people seem to know this (or at least pay attention to it). If I have a problem with baby chicks in kindergarten classrooms, you can imagine the conniption I have about chicks in preschools. These pictures illustrate my concerns in phenomenal fashion.
If you look closely at this first picture (right), you can see the plop of "chick poop" on this child's sweater (which he seems all too happy about). The picture is from a blog written by the child's mother - she gives absolutely no recognition that this is an infectious disease concern.
The second picture (left) is from a news article about a preschool. The preschool obviously has no clue about infectious disease risks because they allowed this c to put the chick on his head and were apparently proud enough of it to have the reporter take a picture.
And last but certainly not least, we have a great picture (below) of a child either kissing a chick or eating very undercooked poultry. Either way, it's a bad idea. This picture is from another parent's blog, who apparently thought it was cute.
Baby chicks should not be in preschools - ever. The novelty factor of having chicks in the facility does not supercede the infectious disease risks and recommendations from public health agencies.
Chicks in classrooms: Salmonella shouldn't be a sign of spring
.jpg)
An annual "ritual" in some schools is hatching chicken eggs in the classroom. This can be a great educational experience for children as they learn about eggs and incubation, watch them hatch and see the baby chicks. It can also be a great source of infection for children if certain precautions are neglected. The picture on the right, from an article in the Ilkley Gazette, shows a good example of a bad idea. This four-year-old boy has a newly hatched chick on his shoulder. Why does this bother me?
- Chicks are a great source of potentially harmful bacteria, particularly Salmonella.
- You can't litter train a day-old chick. I wouldn't be surprised if it left a little biohazardous "present" on the child's shoulder.
- Outbreaks of salmonellosis in people associated with baby chicks have been reported.
- The Centers for Disease Control and Prevention (CDC) recommends children under five years of age should not have contact with chicks.
If there are going to be chicks in a classroom:
- They should only be in classrooms with older students.
- Contact with chicks should be restricted and always supervised.
- Careful attention must be paid to handwashing. Everyone who handles chicks or comes in contact with their environment (e.g. box, cage, incubator) should immediately and thoroughly wash their hands.
- Chicks should never be allowed to roam free in the classroom.
- Chicks should never be handled during lunch or snack time.
- Immunocompromised children should not be present in the class.
It's common sense, but it's amazing how uncommon "common sense" seems to be sometimes.
Hatching chicks in classrooms
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.
