Testing for ringworm with toothbrushes

If your veterinarian suspects your pet may have ringworm, there are several different ways he or she may test for the causative fungus (a dermatophyte) on your animal's fur and skin.  Some of these techniques are more useful than others in different situations.

  • Wood's lamp:  A Wood's lamp is simply a special ultraviolet light.  Approximately half of all Microsporum canis strains (the most common species of dermatophyte that causes ringworm in cats and dogs) will fluoresce blue-green under such a light. This type of testing is obviously very easy to perform.  However, other debris in an animal’s hair coat may fluoresce as well, and other species of fungus that cause ringworm do not fluoresce, so this test is not useful by itself in most cases.
  • Microscopy: Sometimes ringworm fungus can be seen on hair shafts from an infected pet when examined under a microscope.  However, it is easy to confuse other debris and structures for dermatophytes.  Also, not every hair on an infected animal will carry the fungus, so it's possible to miss the infected hairs altogether with this test.
  • Fungal culture: The best way to diagnose ringworm is to culture the fungus from the infected individual (person or animal). In animals, one of the best ways to collect a sample for culture is to comb over all the fur and skin with a new toothbrush, and then try to grow dermatophytes from the toothbrush. This allows the fur from all over the animal to tested, rather than just one little clump of fur plucked from one area.  It can also make it easier to get a sample from the face and paws of cats, which is where these animals often carry the fungus.  Although fungal culture is the best way to diagnose ringworm, remember that fungal culture takes much longer than bacterial culture – instead of days, it may take up to three weeks to grow some dermatophytes.

It's also important to remember that dogs, and more often cats, may carry dermatophytes on their fur even when they look healthy.  A positive fungal culture from an animal with skin disease, particularly a cat, does not necessarily rule out other diagnoses, so your veterinarian may still recommend other tests as well.  However, any animal with ringworm should be treated to prevent spreading the infection to other animals and people.

More information about ringworm is now available on the Worms&Germs Resources page, and in our archives.
 

Ringworm Part 2: Cleaning Up

For more information on ringworm, see the Worms & Germs post Ringworm: Skin fungus by any other name.  The photos here show ringworm lesions on a person's arm and on a cat's face, respectively.  (Photo credits: A. Yu, Ontario Veterinary College)

Over the past several years, studies have shown that many environmental disinfectants sold and labeled for use against the fungi that cause ringworm (which are called dermatophytes) in animals and people are, in fact, not effective when used in households and veterinary clinics.  The problem is the chemicals are typically tested against a suspension of the organisms in a test tube, but in the “real world” the fungi are usually found on small fragments of infected hairs.  Its possible that the hair shaft protects the fungus from the actions of some disinfectants.

There are a few disinfectants that have been shown to be effective against dermatophytes even when they are found on infected hairs and skin cells in the environment.  The most readily available one is household bleach, used at concentrations of 1:10 to 1:100.  Other effective products include Virkon-S® (a detergent-peroxide based product) and Peroxigard® (an accelerated hydrogen peroxide product) . An environmental spray containing enilconazole (an antifungal agent that is also found in the topical medication Imaverol®) was also found to be very effective. This product is not approved for household use, but it is approved for use in catteries. It is also licensed as a topical treatment for dogs and horses in most of Europe and Canada.

Eliminating ringworm from the household or clinic environment can be difficult, because the fungus can be found anywhere that an infected animal (or person) sheds hair or skin cells.  Here are some guidelines for environmental disinfection of dermatophytes:

  • All bedding, brushes, combs, rugs, cages, etc. should be vacuumed, scrubbed, and washed with hot water, detergent, and 1:100 chlorine laundry bleach, or another effective disinfectant (see above). It is best to throw out any items that cannot be thoroughly disinfected.
  • Walls, floors, lamps, etc. should be scrubbed and cleaned in a similar manner.
  • Carpeted areas may be impossible to effectively decontaminate. If possible, remove the carpet and either wash in hot water and bleach, or discard it. Otherwise, frequent vacuuming with immediate disposal of the collection bag is necessary.
  • Vehicle interiors should be decontaminated as much as possible in a similar manner.
  • Curtains can be “dry-cleaned” at a professional cleaner.
  • Clean heating vents (from the house furnace) as well as possible. If the house is heated by hot air, change the furnace filter once weekly throughout the decontamination process.
  • Cleaning and disinfection of the environment should be repeated at least once every 4-6 weeks (the more often, the better) until all affected animals and people have eliminated the fungal infection.

Obviously, environmental clean-up for ringworm is quite an undertaking.  If infection can be identified early, lesions can potentially be kept covered and movement of pets can be restricted to reduce the extent and amount of environmental contamination.

Special thanks to Dr. Anthony Yu (one of the veterinary dermatologists at the Ontario Veterinary College) for providing much of the information in this post, as well at the photos.

Ringworm: skin fungus by any other name

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.

Hazardous hedgehogs

While most people that want a pet stick to the tried-and-true species, there are a huge number of different animals available. Some make good pets, some are relatively harmless but not suitable for most households and some are potentially dangerous. Hedgehogs probably fit into the latter 2 categories.

No...hedgehogs aren't sneaking out of their cages and attacking people as they sleep. Rather, they can carry a variety of microorganisms that can be transmitted to people. There have been a few reports describing infections associated with hedgehogs, particularly Salmonella and ringworm. An excellent report in the journal Emerging Infectious Diseases  highlighted the diseases hedgehogs have been shown to, or could, transmit to people. Hedgehogs don't have to be sick to be a source of infection.

Hedgehogs have been available for years, but they may be a fad pet at the moment. One breeder is quoted as saying “They are going up these last two months we actually have a waiting list about twenty people,” said Sarah Roberts a breeder in Mansfield. “That's never happened in the year’s of breeding we've done.”

While any pet could transmit infections to people, certain pets are higher risk. Overall, species that are rare or 'fad' pets may be of greater concern because we simply don't know much about them (i.e. what diseases they can transmit, how to reduce risks...).

These small creatures can probably be safe pets in some households, but are they really better than other species? You probably should not have a hedgehog if you or someone else in the household has a compromised immune system or if you have small children. If you do have a hedgehog, don't let it roam freely in the house and wash you hands after handling it.

Information Sheets for Pet Owners

INFORMATION SHEETS specifically for KIDS, for VETERINARIANS, for PHYSICIANS and for PUBLIC HEALTH PERSONNEL 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 Petting Zoos
Pet Birds Cryptosporidium Needlestick Injuries
Reptiles MRSA  
  MRSP  
  Salmonella  
  Ringworm  
  Campylobacter  
  Bartonella henselae  
     
     

 
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.