Monkey bites and rabies quarantine

"A monkey was placed under a six-month quarantine on Tuesday after it reportedly bit a woman at a Beaumont restaurant on Sunday..."

Oh, where to start...

  1. Why do people feel the need to have monkeys as pets? I realize that they’re fascinating critters, but is it in the best interests of the monkey and the public? (Generally no...)
  2. Why is a pet monkey in a restaurant? Actually, here, it was three monkeys. I have fewer issues with dogs in restaurants since a well trained dog would just sit quietly on the floor. I doubt that the average monkey is going to do the same. Add two more monkeys to the mix and there's not a chance. In this case, problems started when one of the monkeys took off and ran under a parked car.
  3. Why does a monkey that’s allowed out in public bite? I know that extreme circumstances occur and that you can’t 100% guarantee that bites won’t happen, but monkeys tend to bite more than the average pet. That’s just the way they are. As such, why are they out in public? In this case, after one of the monkeys took off, they were retrieved by another person, who was ultimately bitten when she returned to the runaway monkey to her owner.
  4. Why a six month quarantine? Someone definitely dropped the ball here. After an animal bites, there’s supposed to be a quarantine period to give the animal time to develop signs of rabies if it was indeed able to transmit rabies at the time of the bite. That takes a matter of days. A 10 day quarantine or observation period is the standard approach for dogs, cats and ferrets (since we know more about how rabies progresses in those species). For other species, where less is known, the default response on paper is often euthanasia and immediate testing for rabies, but in practice, a 10-30 day observation period is usually applied. California (where this incident occurred) guidelines are consistent with this and state “While isolation of biting animals other than dogs, cats, and ferrets is not recommended for the reasons given above, local health officers have the prerogative to forego euthanasia and testing in rare special circumstances. If the biting animal has a comprehensive and reliable history that precludes opportunity for exposure to rabies virus, and the risk of rabies in the biting animal is judged by the health officer to be acceptably low, the health officer may institute a prolonged (30-day) isolation of the biting animal."

Like many other aspects of this situation, a six month quarantine just doesn’t make sense.  In contrast, if the monkey had been bitten by a potentially rabid animal (for example, a bat), then it would require a six month quarantine to ensure it had not become infected by being bitten.  The difference between the two kinds of quarantine periods is frequently misunderstood.

Image: A 19th-century organ grinder and his capuchin monkey (click image for source)

Boo Boo gets pardoned, but so much for stress relief

Let’s put this one in the "smart people doing stupid things" file.

Some well-intentioned people at Washington University in St. Louis thought they'd help relieve stress during exam time by bringing in a petting zoo - that unfortunately included "Boo Boo" the biting bear. As you can likely guess, problems ensued.

18 students sustained skin-breaking bites from Boo Boo.

  • You’d think someone would clue into there being an issue after, say, a few bites. Once it hit a dozen, I would have thought anyone with common sense would get concerned. But 18??? Did they even pull Boo Boo out of the petting zoo by then, or did he just get tired of biting people? (Or did he simply run out of willing victims?)

Local public health officials originally mandated euthanasia and rabies testing.

  • Because Boo Boo is a wild animal species, there are no quarantine provisions after potential rabies exposure. Because of that, standard guidelines are to euthanize the animal for rabies testing. This didn’t go over well (not surprisingly), and they eventually relented. From a practical point, it’s reasonable since Boo Boo’s not likely rabid, he’s just not a good petting zoo critter. However, the decision was probably more PR than science and they’ve gone against standard rabies prevention practices. This is one reason why wild species aren’t supposed to be in petting zoos.

It was reported that "This year, without the university's prior knowledge, the petting zoo included in the experience a 2-month old bear cub,"

  • Easy way to deflect blame but no excuse. The University brought in the animals. They had a duty to know what was happening.

Petting zoos can be fun and entertaining. Bear bites and rabies scares aren’t. A little common sense goes a long way. Unfortunately, common sense isn’t always very common.

Dumb internet advice

No, not what I write (although I certainly get enough emails suggesting otherwise... and I'm sure another round of interesting emails is going to be coming at my way shortly).

In the past, and even sometimes still today, public health has had to deal with the phenomenon of having "chickenpox parties." These are events held by well-intentioned but grossly-uninformed parents who deliberately expose their kids to a child with chickenpox in order to "get it over with." Yes, the children will get chickenpox and yes, the children will become nicely immune to the disease thereafter. Most of the time, it’s not really a problem, but then there are the times when a child develops serious (and potentially fatal) complications from chickenpox. Or when one child picks up chickenpox and spreads it to a high-risk child who then develops complications. It went so far at one time that at least one person was selling lollipops laced with chickenpox over the internet (until it was pointed out that this was essentially a bioterrorism activity).

We now have the analogue being recommended in dogs. The basic idea is to take young puppies to an area where distemper virus or parvovirus is likely present, so the puppy will be exposed and vaccination won’t be required.

Sure, it might work.

  • The puppy might get exposed to enough virus to develop an immune response but not cause disease.
  • Or the puppy might get sick and require expensive veterinary care.
  • Or the puppy might get sick and die.
  • Or the puppy might do any one of the three above and also spread the virus to other susceptible dogs, whose owners didn’t make the conscious - and dumb - choice to purposefully expose their dogs to these potentially fatal viruses.

Do vaccine reactions occur?

  • Of course.

Are animals vaccinated more often than needed?

  • Probably. Vaccination intervals are increasing so progress is being made. However, confusing the debate about how long we can go between vaccines with whether dogs should be vaccinated at all is dangerous. There's no doubt that young animals need proper early-life vaccination to prevent these potentially fatal infections.

Does the benefit outweigh the costs?

  • Absolutely. Vaccination has controlled some incredibly important infectious diseases.
  • Choosing not to vaccinate in response to internet rumours isn’t logical and it puts lots of animals at risk.
  • Also, decreasing population vaccination rates increases the disease risk to the dog and cat population overall, since fewer protected animals means more chance of disease circulating from animal to animal to animal before it can be stopped. It’s like the “Wakefield effect”: the surge in some vaccine-preventable diseases attributed to the now-discredited (and former doctor) Andrew Wakefield, whose flawed and unethical research fed the anti-vaccine movement with since-retracted data.

Vaccination of young animals is critical for the control of certain infectious diseases. Recommending otherwise is illogical, and when it’s done by people who should know better, it’s unethical. Hopefully this doesn't get to the point where we need to start tracking the animal equivalent of the Jenny McCarthy Body Count.

Cat attack pins family in bedroom

Actually, the title of this post should be “Obese cat attacks family after being booted in the rear as a disciplinary measure. Family freaks out but wants to keep cat.”

Oh, where to start.

1) A 22 lb cat is obese and there are obviously animal care issues.

2) Kicking a cat in the rear after it objects to having its tail yanked by a baby is hardly an appropriate training measure

3) A cat that will attack with enough vehemence to make a group of adults barricade themselves and call 911 has other behaviour issues.

4) A family that thinks a cat that has a history of aggression and that made them barricade themselves in a room and call 911 is still an appropriate family pet for a household with a seven-month-old child is delusional.

While there may well be more to this story than has been reported, it seems like the baby pulled the cat’s tail, the cat objected and scratched the child, the owner kicked the cat, the cat responded, and the owners ended up locking themselves in a bedroom and calling 911 saying "I kicked the cat in the rear, and it has gone over the edge, He's trying to attack us -- he's very hostile. He's at our door; he's charging us" as the cat screeched in the background.

Yet, after all that they apparently want to keep the cat, though they "definitely want to keep [the cat] away from the baby and keep an eye on his behavior."

Does this cat pose a major risk?

It’s hard to say. Probably not in most circumstances, but it can certainly be sent over the edge and respond very aggressively, something that has apparently happened more than once.

Should this cat be in this household?

Probably not. It’s in a household with a high-risk individual (the baby). Kids sometimes inappropriately handle animals, and this cat clearly doesn’t respond well to provocation. The owners don’t seem equipped to handle this properly. The cat might be perfectly fine in a household where it’s not provoked, but it doesn’t seem like a good fit for this household.

Can anything be done to prevent further problems?

A few things need to be considered. The first is a veterinary exam to make sure there’s not a physical reason for the cat’s response (e.g. is there a problem that made a little tail pull cause severe pain?). A consultation with a veterinary behaviourist (a veterinarian that specializes in behaviour as a result of extensive specialty training - not a self-proclaimed, untrained "pet psychologist" that the owners mentioned) would then be indicated to try to identify why this happened, and how (or whether) it can be prevented in the future.

While rarely (if ever) is there a situation where there should be no pets in households, there are situations where a combination of a certain pet and certain people doesn't fit. This is probably one of those.

Things not to do with reptiles

I would have thought this would fall under the realm of common sense, but as the saying goes: Common sense is like deodorant, the people that need it the most don’t use it.

A recent report out of Scotland is warning people not to kiss their pet reptiles, in response to four people who were hospitalized with salmonellosis after kissing bearded dragons, and other reptiles.

Reptile-associated salmonellosis is a major concern, and while there are ways to make reptile ownership very safe for most people, some risk will always remain. Certain behaviours will increase that risk. A large percentage of healthy reptiles have Salmonella in their intestinal tracts, and anything that’s in the intestinal tract ends up in the animal’s habitat and on its skin. Kissing reptiles is an obvious way to be exposed to this bacterium, which can cause serious disease in some situations.

Among the report's recommendations are:

  • Families that own a bearded dragon or similar reptiles are advised to consult their doctor if they become ill with symptoms of fever, vomiting, abdominal pain and/or diarrhoea.
  • They should also inform their GP that they keep a reptile. Children are particularly at risk because they like to stroke and handle pets.
  • NHS Forth Valley have also issued a guide for pet owners to reduce the risk of catching Salmonella from lizards, which includes supervising children to make sure they do not put the animal, or objects it has been in contact with, near their mouths.
  • It also recommended washing hands with soap and water immediately after handling a reptile, its cage or any other equipment, keeping a reptile out of rooms where food it prepared or eaten, and disposing of droppings and waste water down a toilet, rather than in a sink or bath.

Just common sense.

More information about reptiles and Salmonella can be found on the Worms & Germs Resources - Pets page.

"Angels' eyes"...and this is a good idea because...?

Antibiotic resistance is a big deal. Lots of people and animals die because of it every year. It costs the healthcare systems (human and veterinary) tremendous amounts of money and it’s not getting better.

It’s been clear for years that we have to do a better job of using antibiotics responsibly, in both animals and humans. It’s a complex area, and people often spend too much time complaining about the "other" side (human vs veterinary) rather than trying to address their own problems. However, there are issues with certain practices that seem so straightforward I’m amazed they're allowed to continue and that they haven't already been addressed.

One such issue is the ability to buy certain antibiotics in large volumes over the counter at feed stores in some countries (like Canada), with no veterinary involvement.

Another is the plethora of fish antibiotics you can buy all too easily in pet stores (and which often end up being used on dogs and cats).

And today’s rant is about a group of products that's ongoing use boggles my mind: tear stain prevention products like Angels' Eyes. These are over-the-counter products marketed to reduce tear staining, mostly in small, white dogs. Yes, tear staining - an entirely cosmetic problem that has absolutely no impact on health. The scary part is that products like Angels' Eyes contain tylosin, an antibiotic of the macrolide family. (How much it contains is a bit of a mystery since that information isn't even included on the label.)

Does it make any sense to treat animals for a purely cosmetic problem for long periods of time (or lifelong) with a (presumably) low dose of any antibiotic, let alone one in a drug class that includes many antibiotics that are important for treating infections in people and animals?

In some countries, irrational antibiotic use like this is banned. More countries need to follow suit.

Projectile penguin poop

In my line of work, I deal with feces from a lot of different species. Never once, however, have I thought to model defecation pressure and distances.

Maybe I’m just strange.

A few years ago, German researchers felt the need to model the defecation habits of penguins. The title of the paper, published in Polar Biology, was “Pressures produced when penguins pooh - calculations on avian defaecation" (Meyer-Rochow et al 2003).

The authors considered the fact that penguins don’t leave their nests to defecate (probably preferring not to freeze every time they need to poop). Rather, they observed that penguins move to the edge, “stand up, turn their back nest-outward, bend forward, lift their tail, and shoot. The expelled material hits the ground maximally 40±12 cm away from the bird and then leaves behind a whitish or pinkish streak that can end a few centimetres from the nest’s periphery and may be up to 1 cm wide.

That observation lead (perhaps fostered by some alcohol?) to questions about the exit velocity of the feces.

Given their protected status, you can’t run around poking and prodding penguins, so much of the research is done from a distance. The researchers in this case used pictures to estimate the "aperture" and determined it to have a "maximal diameter of 8 mm at the moment of "firing"."

Using the size of the "exit" and an estimate of average penguin poop viscosity, along with the angle and distance of firing, they used mathematical models to determine the "penguin-generated pressures" associated with defecation.

I won’t get into all the of the calculations. Suffice it to say, the image at right will probably not been seen in too many other scientific papers.

They concluded that "fully grown chinstrap and Adelie penguins generate pressures between 10 kPa (77 mmHg) and 60 kPa (450 mmHg) during the evacuation of their faeces on land. The process of defaecation commences with the highest pressure initially and then rapidly drops to zero, hence the production of faecal streaks (and not ‘‘blobs’’). In water, different parameters would apply, although (as in air) the smaller the cloacal diameter, the higher the pressure."

And to wrap it up…

"All birds, penguins included, spend a considerable time preening and cleaning their feathers. It seems therefore that these birds propel their faeces as far away as possible (with a minimum amount of effort) lest they soil their plumage. Birds could theoretically increase their projectile defaecation range by squirting 45° up-wards. However, their upright posture and position of the vent prohibit this in penguins, but in eagles and other birds-of-prey the squirt is, indeed, directed upward by ca. 15–30° (unpublished observation). The forces involved apparently do not lead to an energetically wasteful turbulent flow. It is interesting to note that the streaks of the faecal material radiate from the edge of the nest into all directions (no preference is noticeable). Whether the bird deliberately chooses the direction into which it decides to expel its faeces or whether this depends on the direction from which the wind blows at the time of evacuation are questions that need to be addressed on another expedition to Antarctica."

Photo: Adelie penguins, Antarctica (credit: JHB Anderson)

More on fake service dogs

This one's not very surprising since it's the typical fake service dog scam, but it made me laugh. While on a completely unrelated website, I saw an ad on the page that said something like "Trouble walking on the beach with your service dog? Check us out." Unfortunately, I did.

The website sells the typical "service dog" paraphernalia - at a pretty high price. To start off, the site takes you through a series of questions.

1) Do you currently have a physical impairment?

  • No

2) Do you currently have a mental impairment?

  • No (although my kids might have a different opinion on that one).

3) Do you have a record of a physical impairment or mental illness in the past that substantially limits one or more of your major life activities?

  • No

4) Are you regarded as having a physical impairment of mental impairment in the past that substantially limits one or more of your major life activities?

  • No

Survey says...

  • "No, you probably do not quality"

So far, so good. That's the right answer.

But... (I love the rest...)

"However, this is a self-assessment and reasonable minds can come to different conclusions. You may wish to take our Disability Self-Assessment Test again. Alternatively, you may wish to visit our Products page and see whether it nonetheless may be helpful to you."

In other words, try again and make up a fake answer, or just go ahead and give us money for  something like the $200 "Deluxe [fake] Service Animal ID Kit".

Ugh!

More on fake service dogs

I've written (whined, lamented, and complained) about this before, but it's rearing its ugly head again: fake service dogs. Essentially, it comes down to self-centred people who think they should be able to do whatever they want, and the inevitable fallout that can occur for people that truly rely on service animals.

It goes like this:

  • I want to take my pet anywhere I go.
  • I am the Centre of the Universe, so what I want must be provided.
  • I pay some other selfish/greedy/unethical person to provide me with a badge, tag or other identifier that says my dog is a service dog.
  • I take my pet wherever I go and if anyone questions me, I say "SERVICE DOG" as my get-of-out-jail-free card.

It's been going on for a while.

It's stupid and selfish.

It compromises real service dogs.

How? Service dogs are very well-trained animals that do an important job. They should have widespread access to places where regular pets are banned. However, when any idiot with $50 can get some form of service dog ID, there are going to be problems with some of these animals (e.g. disruption, bites) and the public, business owners and legislators may not realize the difference between a real and a fake service dog. Accordingly, if there is enough disruption (or a high profile event), there's the potential for problems (e.g. banning) for service animals that are truly needed.

A recent New York Post article highlights the issues with fake service dogs and shows an astounding degree of selfish behaviour. I always assumed that people who got fake service dog IDs would be quiet about it, because deep-down they know it's wrong or to avoid facing any negative public opinion.

Not Brett David, who enlightens us with comments such as

"I was sick of tying up my dog outside."

"He's been to most movie theaters in the city, more nightclubs than most of my friends."

"I don't care who you are, a teacup Yorkie will trump a black [American Express] card when you're trying to pick up a girl."

Or Kate Vlasovskaya, who isn't worried about people checking up on her fake service dog ID because "With all of that effort [required to find out anything], they will probably just let you in."

I'll bite my tongue here because anything else I have to say won't be good.

Chicken diapers...even I couldn't make this one up

I have three kids that are all now (thankfully) past the diaper stage. I have no idea how many diapers I changed, but I don't have a huge desire to start doing it again, especially for chickens.

Yes, there are now diapers for chickens.

I understand the whole urban chicken concept. I don't actually have many issues with it if it's done right - but that's a big IF, unfortunately. Keep your chickens on your property, don't do it if you have young kids or other high risk individuals in the household, use good basic hygiene practices, feed them right, don't get roosters, and don't run screaming to the newspapers or local politicians if some get eaten by carnivorous urban wildlife. The nuisance and risk of backyard poultry can be limited.

Live chickens inside the house... that's another story.

Chickens aren't house pets in my world. I'm not sure if the chickens benefit at all from living in a house with people, and it's probably actually detrimental in many ways. I'm not sure what the benefit is to people either. Although I haven't seen any studies on this specific topic, it stands to reason that keeping a chicken indoors would be associated with a fairly high risk of widespread contamination of the household with bacteria like Salmonella and Campylobacter, two bugs that cause millions of infections in humans every year.

I'm all for risk mitigation, including using creative (and sometimes off-the-wall) measures - but diapers for chickens?  Not so much.

Yet, Pampered Poultry makes diapers for your indoor chickens, and not just run-of-the-mill diapers: they're (allegedly) both functional and fashionable. This isn't the only company that sells chicken diapers either, much to my surprise.

One website states "Our chicken diapers are not just for the fashion obsessed hen. They offer your and your home protection against the inevitable! Our diapers fit comfortably and allow you to enjoy your birds in the house or car [car?] without worry."

Does using chicken diapers make sense?

I have a hard time believing these diapers are very useful. They probably do reduce the burden of pathogens that are deposited in the environment, but they are presumably far from 100% effective at containing all of a bird's droppings. It's also likely that chickens are contaminated with these bacteria on other parts of their bodies. Thinking you've eliminated the risk of household contamination from your pet poultry by using diapers isn't logical. The diapers also need to be changed (risk of more contamination) and disposed (don't we have enough waste already?) or washed (risk of cross-contaminating other items).

If you want fashionable chickens, go ahead and dress them up in diapers. Nothing says haute couture like a chicken walking around the living room in pink floral undies. Just don't convince yourself that you're reducing the infectious disease risk for other animals and people in the house. Better yet, let the chickens be chickens and keep them in a proper coop outside. I've seen too many indoor goats, pigs, miniature horses and other species with profound health problems from owners thinking they're just like people.

Apart from diapers, the store also sells "saddles" for the chickens. I'm not even going to start on that one.

Show me the paper...oh wait...

“Show me the peer-reviewed publication.”

This is a common refrain used, particularly by the scientifically-minded, when talking to someone about the latest trendy diagnosis, treatment or other medical "discovery." It used to be relatively easy to use this method to assess the reliability of new information. If something was published in a peer-reviewed journal, it was probably at least reasonably sound (not always, but it did provide a greater level of assurance).

Now, it’s getting tougher.

One reason for this is the proliferation of online journals in particular. Some are legitimate journals that have been created by people that perceived a need in a specific area. Yes, with more research, more journals can be supported. Some good journals reject 50-90% of submissions, and many rejected papers are still valid and indeed important. Having a wide range of journal options is important because everything can’t be published in Science, Nature or the New England Journal of Medicine.

But, there’s a limit.

I review a lot of papers for journals every year. Sometimes, I end up reviewing the same study a few times for different journals, after I’ve recommended rejection previously. Some of these get accepted if they are a better fit for the journal (e.g. scope of the study, priority of the type of research for the journal) or they end up making substantial changes to improve the manuscript. However, I’ve also rejected some papers a few times and eventually seen them published in pretty crappy journals. The sad reality is that marginal research can usually be published somewhere if the authors are persistent. Most people in academia know the strengths of journals in their field and can approach a paper in a "bottom-feeder" journal with care, but the general public doesn’t know that, may not have access to the full paper, and probably wouldn’t be able to assess the quality of the study anyway. So, just knowing that something’s been published in a peer reviewed journal these days only tells you part of the story.

Even worse, thousands of new journals have been created by for-profit groups. That doesn’t inherently mean they are bad, but it’s getting clear that for some, the size of the cheque is probably more important than the quality of research. I get emails from them pretty much every day from one group advertising a new journal, asking for journal submissions or requesting that I serve on their editorial board (yet curiously, I’ve never been asked to peer-review a paper for one). Unsuspecting academics have signed onto editorial boards thinking they were legitimate and have had a hard time getting their names removed once they realize the problems.

Some of these journals use impressive sounding names or ones that are very close to highly respected journals, further confusing the reading public.

All these things make it hard for the average person who wants to explore something a bit further to know what information can be trusted. Not only do you need to think about whether a study is published, you need to figure out if the study is valid and published in a reputable journal where the research was actually scrutinized, not published just because the authors paid a few thousand dollars for the publication fee.

Some of these for-profit groups sponsor scientific conferences that have the same issues. Normally, conference presenters are invited by scientific committees made up of experts in the area and/or are chosen through submission of research abstracts that undergo review. The more dodgy conferences solicit abstracts (I probably get an email a day from these) and get people to attend conferences, but then send them a bill at the end. So, they sucker paying attendees by making the conference look real (sometimes by putting names of high profile people as organizers or presenters without their knowledge) and get more money by charging presenters (thereby getting money from people who will pay to get their research presented or others with good research that are unsuspecting). In the end, you might be left with good research or invalid research, and it’s hard for the average person to sort this out.

There’s a good article in Nature about this subject, as well as a related article recently published in the New York Times.

How do we get this get under control? I have no idea.

 

Dogs in the delivery room?

Don't get me wrong. I'm all for pet therapy and animal visitation in hospitals - when it's done logically. I've been involved in research in the area, helped develop international guidelines and am chair of the medical advisory board of one of the largest pet therapy groups in the US. Animals can do great things in hospitals and we need to support good visitation programs. But that doesn't mean I check my brain at the door and think that all animals in all hospital situations are a good idea.

A colleague sent me a link to a Medscape News article entitled Woof! Does Fido Belong in the Hospital Delivery Room? 

  • My first thought was... not a chance. (My second, third and fourth thoughts were no better.)

The situation in the article isn't that clear cut though, since the English woman who wanted her dog in the delivery room had a trained therapy dog that helped her with an anxiety disorder. So, if this was truly a trained therapy dog (some people unfortunately make that claim just as an excuse to take their dog everywhere, and compromise people that truly need these animals), it would be justifiable since this is a service dog, not a companion, and we need to support access of service dogs.

However, it raises questions about whether this will open the door to requests for pets to join in the birthing process, now that we've moved from the era when dad paced outside the room to a time when half the family may be present, live-streaming the event to the internet and posting on Twitter.

What are some issues here?

A delivery room is a busy environment. Things can be nice and happy and relaxed. There can also be yelling (personal experience there), lots of activity and other things that might scare or upset the dog. I'm not worried about the dog's feelings here, but what a startled or upset dog might do (e.g jump, bark, bite, pee, try to run away).

Not all deliveries are smooth and things can go from good to bad quickly. The last thing that's needed is another distraction (e.g. the aforementioned dog jumping, growling, barking, peeing, etc.) when medical personnel are dealing with a life-threatening delivery complication.

A newborn is a high risk person for infectious diseases. Every dog is shedding multiple microorganisms that can cause disease. Usually, the risk is low. However, when you have a highly susceptible person (or persons, including the mother here to a lesser degree since post-partum infections are a concern), we don't want them exposed to pathogenic bacteria if we can avoid it. Yes, it's an ever-present risk in a hospital, but why add to the potential risks? It would seem illogical to have delivery personnel in full protective gear (e.g. gowns and gloves) with a dog potentially aerosolizing bacteria nearby through breathing, coughing, barking, shaking, and tail-wagging. People would also likely contaminate their hands often by touching the dog. Yes, medical staff can be to told to avoid contact with the animal and wash their hands, but we know from previous research that hand hygiene by medical personnel after animal contact is very (very!) uncommon.

Also, we know that a baby's first bacterial encounters have a major impact on its developing bacterial microbiome (that is, the composition of normal bacterial populations at various body sites, something that's important for good health and development). Babies born by C-section have much different microbiomes for a long period of time compared to those born by vaginal delivery. Do we really want to confuse the picture more by having some of the first bacteria encountered being Fido's bacterial flora? It's not going to make the baby start barking, but I'd rather the baby not be exposed to various bacteria from a dog seconds after it's born.

In my opinion, visitation is more important the longer the person is in hospital, the more lonely they are and the more upsetting or depressing the situation is. Delivery is typically a short-term, happy hospital stay. What's the real benefit here for your average dog owner?

Personal pets in any hospital situation is a controversial area. Unlike dogs that are part of proper visitation programs, these dogs tend not to have any health screening, behaviour screening or other type of assessment. There's also no handler training. You might say "well, the dog's just visiting its owner so that's not a big deal." However, the dog has to go from the parking lot to the room and back again. What are the odds that the dog's not going to encounter lots of other people in the process, let alone potentially distracting or scary situations. Do you want your elderly immunocompromised relative to ride (or be stuck in!) a hospital elevator with an aggressive or otherwise high risk dog? Or to have you child that just had surgery step on a pile of dog poop? There are clear screening, training and supervision criteria for hospital visitation dogs, and they are there for a reason.

Back to the article.  Dr. Arthur Kaplan, the author, sums things up nicely:

"I think there are risks, and I think the risks are pretty significant. I am not sure that we should open the door to every barnyard creature we could think of to be present at birth, even when the mom-to-be says that she would like to have her pet there. But at the same time, I think there are arguments that, for some people, such as the woman in England who has a special relationship with her pet, or perhaps a woman who is blind, a case can be made."

Ferret legging...a sport?

With the lingering NHL strike, TV networks are looking for replacement sports. One of my PhD students (who claims he doesn't spend too much time playing around on the internet but keeps coming up with these gems) sent me information about one sport that's not coming to a network near you.

Yes, it's ferret legging. That doesn't really seem like a sport to me...more like a fetish or something someone might do when they're really (really!) drunk. Yet, it apparently exists, evolving from its origins amongst Yorkshire coal miners to a not-much-broader audience.

The rules are pretty simple:

  • Tie your pant legs securely around your ankles
  • Let someone toss two ferrets down your pants.
  • Secure your belt.
  • Stand there until you can't take it any more.

"Clean the abrasions thoroughly and hope they don't get infected" is the step no one describes. Wounds are, not surprisingly, common, and some people, like world record holder Reg Mellor, wear white pants to show off the blood strains. Mr. Mellor's world record? 5 hours and 26 minutes.

Interest in ferret legging is dwindling, which is probably a good thing for both ferrets and competitors. There's no mention about whether there are any ferret legging family dynasties, but I suspect that regularly shoving sharp-toothed ferrets down your pants severely limits one's chances of reproducing. That's also good for ferrets and humans alike.

An attempt to be inclusive and create a women's competition involving sticking ferrets up a blouse apparently failed - likely due to relative differences in common sense amongst the genders.

Dear vet clinic design 'experts': Pet owners aren't stupid

In the latest edition of the American Animal Hospital Association's Trends magazine, there's an article about veterinary clinic design. The section dealing with exam rooms says:

Discussion is ongoing about whether sinks are needed in the exam room now that hand sanitizers are available.

  • I'm not sure who's discussing this. Hand sanitizers are great and should be used as much as possible, but that doesn't mean handwashing is obsolete. Some pathogens we deal with are resistant to alcohol, such as parvovirus, Clostridium spores and ringworm. We need to wash hands when these bugs might be present. Hand sanitizers also don't help if you have chunks of pus, blood or feces on your hands. If there's no sink in the exam room, handwashing usually won't be done when it's supposed to be. If someone has to leave the room and walk to a sink, it just doesn't happen often, even if it's a short distance. A person also runs the risk of contaminating other surfaces along the way, between the exam room door and the sink.

Experts agree, however, that if you have a sink, your clients will expect you to use it to wash your hands.

  • I'm not sure who these experts are, or what they're experts in. Certainly not common sense or infection control. What they're implying here is that pet owners will think veterinarians aren't doing a good job if they see a sink and the vet doesn't use it, but that if no sink is present, no one will think twice about a vet failing to practice good hand hygiene. If an owner is going to clue in to the presence of the sink and failure to wash hands (something we should be encouraging), their common sense and observation skills won't evaporate if there's no sink.

This is similar to an interview with an architect on dvm360.com where the guy says "if I have a sink I better wash my hands or the client thinks my hands aren't clean. In many cases it's better off not to have a sink..." (note: the banging you hear is me hitting my head against a wall). The same architect cited in this article, so hopefully he's actually the only one pushing this approach.

Pet owners aren't dumb.

Infection control isn't rocket science.

Handwashing is important and under-used.

We need sinks in exam rooms.

Common sense needs to be more common.

It's difficult to put sinks in existing exam rooms - some clinics just can't do this easily. That's tolerable if they are diligent in their infection control practices, use hand sanitizers as appropriate and make sure they get to a sink (without contaminating things along the way) when they need to wash their hands.  Not putting sinks in a newly designed clinic is just dumb.

More dumb pet problems

No, I'm not referring to pets lacking in intelligence (my dog Meg leads that category). Rather, I'm talking about questionable decisions by pet owners. Here are a few bewildering stories:

  • The Indian River Reptile Zoo near Peterborough, Ontario, rushed some of their stock of snake anti-venom to Brantford General Hospital (about three hours away) to aid in the treatment of a woman who had been bitten by a Copperhead snake. Hospitals in Ontario don't tend to stock anti-venom for snakes that don't live anywhere near here, and it's fortunate for the woman that a couple of zoos in Canada stock anti-venom and are willing to share it (and that those zoos happen to be in Ontario and not the other side of the country). Circumstances of the bite aren't clear but the woman or someone she visited a) is obviously keeping a dangerous snake and b) obviously isn't handling it properly. Indian River Reptile Zoo president Bry Loyst sums up some of the problems with snake bites, saying "Hospitals are amazing but they don't have the expertise right there,” and “You'd be surprised at how many venomous snakes there are out there [in Ontario homes].”
  • JayJay, a pet macaque (a kind of monkey) from Okeechobee, FL, was shot after "flipping out" and attacking its owner, "ripping apart his hand." The primate, who wore diapers and played with kids, had lived with the family for nine years, having been acquired at three weeks of age. He got out of the house and his owner was trying to catch him with a net. Whether it was the net, the joy of freedom or some other reason, JayJay lost it and clamped down on his owner's buttocks, thigh and hand, respectively, refusing to let go. A friend had a gun handy (no comment) and shot the monkey at the owner’s behest. The bite on the hand (in particular) was severe and deep, damaging tendons and a nerve, requiring surgical repair. This is another example of the "loving" exotic family pet going berserk for some unknown reason. The macaque often played with kids and the owners took him out in public (e.g. dressing him up and taking him trick-or-treating at Halloween).  If we can say anything good about this, it’s good that it was the adult owner who was attacked and not a child. Fortunately, unlike a large percentage of captive macaques, JayJay wasn’t a carrier of herpes B virus, a virus that can rarely cause fatal infections in people.  A good closing statement was made by Lion Country Safari wildlife director "Anybody that keeps a monkey is going to get bit... I haven't heard of a monkey that wouldn't bite someone."
  • A zookeeper in Berlin, Germany, was killed by a Siberian tiger that had escaped its enclosure. While not a pet, it’s another example of a fatal attack by a captive large cat. As with venomous snakes, there is a remarkably large number of these animals that are privately owned, and attacks certainly happen. Usually, the lucky survivors say it was a "freak incident" and totally unexpected because the animal was like a pet cat. The unlucky ones can’t talk, but often the same story comes from friends and family… the animal was this apparently loving, docile large cat that for some reason attacked. You can never be confident that these animals are safe, because fatal injuries can occur not just with attacks, but with playful behaviour given their size and strength.
  • In a related theme, a cougar was shot and killed in Muskoka Lakes, Ontario, after attacking a pet dog. The fact that the cougar had been declawed was a pretty good indication that it was an escaped pet. The owner of Guha's Tiger and Lion Farm, an "exotic animal menagerie" located down the road from where the cougar was shot, says he is not missing any of his cougars, which would "never want to escape" (except, I guess, for the jaguar that was shot by police after escaping in 2008). Since there's no regulation of exotic animals in the province, no one will know for sure from where the cougar came, how many cougars are present in Ontario and how they are being managed. Hopefully Mr. Guha has a containment plan for his other cougars, lions and jaguar that goes beyond assuming they'd never want to leave. If I was a neighbour, I wouldn't be too confident, however, when he says things like "If I leave the gate open for some reason — like I unlock it, then the phone rings so I pick up the phone — if they do get out they’ll go sit by (my front door) and wait for me."

(click image for source)

Transfusion-associated equine infectious anemia

A few years ago, I looked out my kitchen window one holiday morning and saw a newborn foal running outside of a fence line. The foal had been born to my neighbours' mare, a maiden mare, and they were out of town. The mare had rejected the foal and wasn't interested in any of my attempts to get them back together. She also had little colostrum (the first, antibody-rich milk that foals need to drink early in life to survive). To make a long story short, I ended up doing a field transfusion, collecting blood from another horse on the farm to give to the foal, to provide it with those much-needed antibodies. The donor horse was healthy and I didn't know of any disease issues in the area, so I was pretty confident that there wasn't a significant risk of disease transmission, but you never know. Ideally, equine blood donors are screened for infectious diseases, particularly equine infectious anemia (EIA), since EIA is a rare but nasty disease that can be spread by blood.

When I started to read a report the other day about a transfusion-associated EIA infection in a German foal, my first thoughts were "that's bad," followed by my ever-optimistic side thinking "well, maybe it was an emergency transfusion and it was a bad but unavoidable consequence" or "maybe it the donor was properly screened but was infected with the EIA virus after it's last test" (the latter situation is an ever-present risk when you are screening donors in advance (days, weeks or months) of collecting the blood for transfusion, since test results only tell you what their status was at the time of testing).

Unfortunately, it didn't take long to see that this wasn't an unfortunate or relatively unavoidable infection. Rather, I can only interpret this as stunning negligence.

Here's the story

  • On August 2, EIA was confirmed in a 3-month-old foal in North Rhine Westphalia. When the foal was two days old, it had a septic joint (and probably an overall deficiency in antibodies) and was treated with a plasma transfusion, which is a pretty standard procedure in such a case.
  • EIA antibodies were then detected in the donor.
  • Since 2009, 20 other horses had received plasma from this horse. Four have been confirmed as infected, and horses that live with these infected animals have been quarantined until test results are back. Positive horses are typically euthanized because they pose a lifelong risk of transmission of the virus to other horses.  The four positive horses in this case have been euthanized (and presumably the foal as well).

So, this wasn't some random emergency field transfusion, or a donor that got infected after testing. It appears that this donor has been used for years with no testing, despite the fact that it's well known that EIA transmission is a risk from blood transfusions and the virus is present (albeit rare) in Germany. While there are no standards of care for equine blood transfusions (as opposed to dogs), EIA testing is a standard recommendation in anything I've seen written about equine blood donor programs (click here for one example). Sometimes you get put into situations where testing can't be done in time for logistical reasons, but I can't see how anyone would not test horses that are to be used for a formal donation program or repeated transfusions. Failure to do low cost and easy EIA screening of that donor horse has resulted in the deaths of multiple horses, with the potential for even broader secondary transmission of this virus to additional animals.

LDDD outbreak in Ontario

It's apparent that there's an ongoing outbreak of LDDD, a potentially fatal dog-associated problem in people in this area. It seems to be a seasonal disorder, with nice weather bringing out more cases. I've seen a couple nasty cases in the past 24 hours, including one tonight that could have resulted in the deaths of an entire family.

What is LDDD?

A new bacterial infection? No.

A new virus? Nope.

Contrary to the focus on this site, it's not even an infectious disease. It's lap dog/dumb driver syndrome

Tonight's case was fairly classic, involving the driver of an SUV and a small dog...on the driver's lap with its head out the window. The driver had one hand (and I'm not sure how many eyes) on the dog, and the SUV swerved off the road, but fortunately not all the way into the ditch (or a pedestrian, cyclist or other vehicle).

In Ontario, it's illegal to drive while using a cell phone. Restraining a small (or not so small) dog on your lap has to be at least as distracting and it's far from rare. A little common sense goes a long way, but common sense isn't always that common.

Canine flu in Ontario...not really

It's amazing how one little email comment can make a mess of my week.

Here's the story: I sent an email to a colleague that works for an agency in Ontario. At the bottom of the email, I gave an FYI about an Ontario dog that was found to have antibodies against canine flu, but that wasn't sick. At the time, I didn't realize that my colleague was no longer at the aforementioned agency.

  • Astoundingly, instead of cancelling my colleague's email account, the agency had left the account active - and the CEO of the agency reads her emails!
  • In this case, not only does the CEO read the email, she forwards it to other people in the agency.
  • Not only do the others read it, they create a release that they send out to associates of their agency throughout the province and some other groups... without contacting me to get details, understand the full story or get permission to use the information I provided. Not exactly a good communications strategy.

In an amazingly short period of time, I was contacted by two provincial Ministries about Ontario's canine flu status, since incomplete information was forwarded to them, and veterinary clinics in the province are now asking questions about our "canine flu case" or "canine flu outbreak."

So, to set the record straight (and decrease the number of phone calls I'm getting today):

  • We found a dog that had antibodies against canine influenza as part of an outbreak investigation. The outbreak was not caused by canine flu.
  • The dog had the same antibody level on two blood samples taken two weeks apart. This is not consistent with disease caused by flu. Rather, it indicates that the dog has been exposed to the virus.
  • The fact that the dog has been exposed to the virus is noteworthy. The only other seropositive (i.e. antibody positive) dog that we have seen in Ontario was a greyhound from Florida, and we assumed it was infected in Florida. That was a few years ago, and we haven't seen anything since. Initial information indicates that this dog has not left the province, but I'm working to confirm that before I can be confident that this is evidence that canine flu is present in Ontario.

This is an important topic because if/when canine flu hits a region, it certainly has the potential to cause big outbreaks. The outbreak at a Texas racing facility that I wrote about yesterday is a good example of the bad things that can happen when flu hits a susceptible population. Knowing if the virus is in the area is important for things like vaccination programs and making recommendations for management of respiratory disease cases in veterinary clinics and in the community.

We currently have no evidence of canine flu activity in Ontario, but we are actively looking because we assume that it will make it here sometime, if it's not here now. Identifying it early and communicating that properly are critical control measures for canine flu and other emerging infectious diseases, but there's nothing to worry about at the moment.

Pasteurella infection from a dog...not likely

A few months ago, I wrote about an article that appeared in the journal Orthopedics. It was a very bad article that blamed a person's infection on "excessive contact" with pets, with no evidence that the pets were involved (and no evidence that dogs have ever been found to carry the bacterium in question).

Here's the Letter to the Editor that was just published.

Dear Editor:

I was surprised to see the article “Pyogenic cervical spondylitis caused by Pasteurella haemolytica attributed to excessive contact with dogs” by Machino et al. 1 The authors stated that Pasteurella haemolytica (which was renamed Mannheimia haemolytica over a decade ago) is a common inhabitant of the oral cavities of dogs and cats, citing prevalence rates of 71% to 90% in cats and 21% to 60% in dogs. However, they provided no references for these prevalence data, and I am unaware of any studies that have found this bacterium in the oral cavities of dogs, let alone at such high rates. The authors cited 3 articles as supporting zoonotic infections with this organism, yet these 3 articles all involved other Pasteurella species. Pasteurella multocida, a completely different bacterium, is a common oral commensal in dogs and cats and has been reported frequently as a cause of pet-associated infection. The authors may have confused these markedly different organisms. The authors also stated that the recent increase in pet ownership has caused an increase in P haemolytica infections from bite wounds, with no evidence supporting an increase in infections caused by this bacterium or the role of pets in human P haemolytica infections. Although zoonotic infections are problematic and it is important to consider the potential role of household pets in human disease, this article is highly flawed, and retraction should be considered.

J. Scott Weese, DVM, DVSc, DipACVIM
Guelph, Ontario, Canada 

The authors either didn't get any of the points I made or didn't care and wrote a rather evasive response.

We thank Dr Weese for his letter. We reported a rare case of Pasteurella haemolytica as the pathogenic bacteria behind pyogenic cervical spondylitis. We searched the literature for reports on spondylitis caused by P haemolytica to the greatest extent possible, but it seems that the present case was the first.

In the present case, a needle aspiration biopsy was performed under diskographic guidance, and P haemolytica was detected on bacterial culture. We believed that this case was caused by P haemolytica. Because the patient owns 2 dogs and frequently kisses them on the mouth, this excessive contact was believed to be the cause of infection. No other causes were evident in this case. Although we cannot declare that it is the cause, no evidence was found that it was not the cause.

Our main point in the article was that osteomyelitis has been reported in the field of orthopedics, and, keeping in mind the fact that pyogenic spondylitis is also caused by rare bacterium, we believe it is important to engage in routine treatment regimens.

Masaaki Machino, MD

Anyway, the point wasn't to make the authors look bad. It was to remind people that we need to consider pets as sources of infection but do so in a logical manner, and simply blaming the pet when there's no evidence doesn't do anyone any good.

More snake smuggling

I avoided the "snakes on a plane" title, as ever since the (bad) Samuel L. Jackson movie came out, every reptile smuggling headline seems to use use it. Regardless, would you like to be on a long trans-Atlantic flight with 247 smuggled animals, including a collection of venomous vipers? Probably not.

Fortunately for passengers on a flight from Buenos Aires to Madrid in early December, security screeners took note of the "organic substances moving inside" Karel Abelovsky's baggage. Inside, they found over 200 reptiles and mollusks, including 15 venomous vipers. Among these were two yararas (Bothrops jararaca), a viper that can grow up to 160 cm (~5 ft) in length, and which is a common cause of snakebites in some regions. Two of the animals were dead by the time they were found. Probably many (or most) of the others would have died during transit.

Animal smuggling is a big problem for many reasons:

  • It's an major animal welfare issue, since it is reasonable to suspect that only a small minority of smuggled animals survive the process, and even fewer thrive in their new homes.
  • Smuggling of endangered species can threaten survival of some species in the wild.
  • Smuggling of venomous or otherwise dangerous species can put people at risk. This includes people that purposefully buy dangerous animals but can't handle them, people who buy them not knowing they are dangerous, people at various points of the smuggling process (e.g. security screeners) that might come across the animals, and the general public who can be exposed if the animal escapes.
  • Moving animals between regions always carries some risk of bringing along infectious diseases. The less control, the greater the risk.

Mr. Abelovsky has been changed with smuggling and faces up to 10 years in prison, but typically people get off with minimal punishment. Weak enforcement and the potentially lucrative nature of smuggling means that it's going to continue until the problem gets taken more seriously, both in terms of investigation and charging of other people in the process (e.g. where did he get the animals, who was he working with, where were they going to go?) and application of penalties that are severe enough to discourage people.

Unfortunately, while an incident like this gets a lot of attention, it just represents the miniscule minority of smugglers that actually get caught.

Dumb and dumber get campy

The focus of this blog is companion animals, but sometimes I just can't resist commenting on other areas, and this one's too good to pass up.

Today's Morbidity and Mortality Weekly Reports, published by the CDC, describes Campylobacter jejuni infection in two men. Campylobacter is a zoonotic bacterium that causes diarrhea (and sometime severe complications) in people after it's ingested. It's usually a foodborne disease, but any  method that leads to the bacterium reaching the mouth and being swallowed can result in to infection. This report describes a rather unusual method of infection.

This summer, the Wyoming Department of Health investigated two cases of C. jejuni infection. Both people worked on a local sheep ranch and got sick at the same time. Both had typical campylobacteriosis disease with diarrhea, cramps, fever, nausea and vomiting. One was hospitalized but both recovered. The interesting part is how they got infected. It turns out the men were involved in a multiday "event" to castrate and dock tails of 1600 lambs. Ten other people were also involved and they didn't get sick. The difference between these two and the other ten? The two infected men used their teeth to castrate some of the lambs. Animal welfare issues aside, this is just stupid. (I doubt anyone's looking at this but these idiots shouldn't be allowed to care for animals.) I don't see how anyone with an iota of common sense wouldn't think this is a bad idea in the current day and age.  A very long time ago, apparently the "bit and spit" technique of castrating lambs (see photo, click for source) was relatively common practice.  But like so many things that people used to do, there are much better (and safer, and infinitely more hygienic) ways of doing this nowadays.

Hopefully, they learned their lesson. Additionally, hopefully the farm owner takes some responsibility to make sure their personnel don't act like idiots and that someone investigates the animal cruelty aspect.

Photo: In "the old days" during castration of lambs, after opening the scrotal sac with a sharp blade, the testicles were often removed using the teeth, because it was faster than attempting to do so with an instrument.  This technique is (almost) no longer practiced (except for at least two men in Wyoming, apparently). Photo source: http://old-photos.blogspot.com (used with permission)

Cats as dinner guests

To each his own, I guess. Today's Toronto Star has an article on the front page of the Life section about the Shine family and their rather close dining relationship with their four cats.

Among some of the highlights:

One of the front page pictures shows one of the cats standing on the counter while food is being prepared.

  • Would you want your cat to sit on your food before you ate it? Probably not. Would you lick the cat's feet after it got out of the litter box? Doubt it. By letting the cat sit on the food preparation area, aren't they essentially doing the same thing?

The cats' food and water bowls are on the kitchen counter.

  • Feeding pets in the kitchen was a risk factor in a Salmonella outbreak linked to contaminated pet food (Behravesh et al. 2010). That's just feeding them in the kitchen, let alone on the counters.

The other front page picture shows a different cat licking dinner rolls before they are being served. "I'll eat that one" declares the husband, an anesthesiologist (to check out the photo gallery, click here)

  • This maybe has a greater "ick factor" for most people, but in reality is probably much lower risk than the first two issues.

Yet another picture (slow news day?) shows a cat stretched out on the dining room table while the rest of the family eats.

As I said above, to each their own. People can make their own decisions about how to interact with animals. It doesn't seem like there are any young children (who are subjected to their parents decisions) to worry about in the household. However, it's unclear whether there might be any other high risk persons in the household to be worried about. Mrs. Shine has diabetes, and that can be associated with effects on the immune system. Further, what about other people that visit the house (or come over for dinner)? Are any of them high-risk individuals, and do they know about the potential risks? Who knows? (The Shine's say they don't have people over for dinner often.)

What's the real risk? It's hard to say. It's probably low but we know:

  • people can get infections from cats
  • many of the infections that people get from cats are acquired by ingesting microorganisms from these animals
  • certain types of pet management (e.g. feeding them in the kitchen) have been associated with higher risk of infection

I'm all for close contact with pets and making them part of the family. If my cat jumps up on the dining room table during the day, I don't panic and try to sterilize it (the table, that is). However, I try to maintain a balance between having my pets as part of the family and not having their microorganisms as part of my family.

There are much worse things that you can do with your pets than are demonstrated here, but I can't believe that it doesn't increase the risk of disease. Maybe for this family, they are willing to accept an increased degree of risk for the benefits they perceive. Unfortunately, I doubt they have really thought about the potential infectious diseases issues or talked to someone about them, to let them make a truly informed decision. (Perhaps (hopefully) their other daughter, who is currently attending vet school overseas, will be able to provide them with some more information on this topic when she gets home!)

Never upset the local snake charmer

Maybe the Occupy movement should take some tips from an Indian man who expressed his frustration with government corruption by releasing venomous snakes into a government office. Upset by the slow pace of the bureaucracy and demands for bribes, the man (the local snake charmer) dumped 40 snakes, including 4 cobras, onto the floor of the local land registry office. The people in the office weren't impressed, and neither were the snakes by the look of the video.  Not a healthy idea for either species.

Toilet research

The scope of research that's being done these days is astounding. Somewhere, someone's working on a project that will lead to a Nobel Prize in medicine. Other research will gather less critical acclaim but still have a big impact on science. Some research is more basic but can result in important preliminary information. And some studies... well, they may have a serious side but they're not what people typically think about when envisioning medical research.

Here are a few highlights from the lesser-heralded group of people investigating bathroom behaviours:

  • A study of toilet reading habits in Israeli adults (Goldstein et al. Neurogastroenterol Motil 2009) concluded that toilet reading is a common and benign habit. (I hadn't really thought of it as a potentially poor lifestyle choice, but I guess this confirms it's fine). While it involves more time spent in the bathroom, "It seems to be more for fun and not necessarily to solve or due to medical problems." (Perhaps a more relevant area of study would be hand hygiene practices by toilet readers and the impact of toilet reading on fecal contamination of reading materials.)
  • A Korean group has established that frequent recreational cycling does not have a negative impact on urination or sexual function in men (Kim et al. Korean Journal of Urology 2011). Cycling enthusiasts around the world, including me, rejoice.
  • Horseback riders can be similarly relieved (pardon the pun) that recreational riding isn't associated with increased risk urinary or sexual dysfunction (Alanee et al. Urology 2009).
  • A study with the catchy title "Female bowel function: the real story" (Zutshi et al Dis Colon Rectum 2007) wasn't too thrilling but had tidbits such as older women and women with children report more flatulence.

What do these have to do with zoonotic or infectious diseases? Nothing, but a little potty humour lightens up the start of the work day. More "real" posts to follow.

(click image for source)

Exotic pet problems

I've written numerous times about risks (mainly infectious disease risks) associated with some types of exotic pets. I'm not against all exotic pets, but I am against keeping improper pets and doing so in improper situations. The latter largely involves keeping species at high risk for certain pathogens like Salmonella in households with high-risk people (e.g children under five years of age and people with compromised immune systems). The former involves keeping pets that are just not appropriate as pets because of they are large, hard to care for or venomous, or where keeping them in captivity is otherwise risky to either the owner or the pet.

Some good examples of these issues were reported this week:

  • English snake "expert" Luke Yeomans died after being bitten by one of his pet king cobras. He kept 24 snakes in a compound behind his home and was planning on opening the space up to the public. He had stated that the trust he had built up with the snakes by feeding and caring for them ensured they would not turn on him. Famous last words.
  • A South Dakota man was bitten by his (or a visiting relative's... there's some controversy) pet copperhead snake. Along with what was characterized as an "exceedingly painful bite" he could face criminal charges for owning a dangerous animal. Fortunately, copperhead bites are rarely fatal, but they are far from pleasant. One expert described it as "go ahead and light your hand on fire and put the fire out with a hammer for several weeks."
  • A Florida man (note a gender bias here?) was bitten by his African Puff Adder. Neighbours heard his screams of "Help, my fingers are turning black!" as the ambulance arrived. Fortunately, a local serpentarium met them at the hospital to provide anti-venom to counteract the venom from this somewhat small but bite-prone snake that accounts for more than 50% of snake bite deaths in Africa.
  • A Putnam Lake, New York woman was found dead in her bedroom, with the prime suspect being a pet Black Mamba, one of 75 snakes she and her boyfriend kept. Black Mambas are described as one of the fastest and most venomous snakes in the world, a great combination for a predatory snake, not a good combination for a pet.

Some people may argue that these incidents are Darwin-in-action. However, while people have some degree of right to be stupid, they don't have the right to put other people at risk. There are too many instances of dangerous exotic pets escaping, with potential risk of exposure of members of the general public. At the moment, Ipswich, UK police are on the search for a 7.5 foot boa constrictor that's on the loose. They've warned that children and pets should be kept indoors, particularly since the owner describes the snake as "unfriendly" at the best of times and, having last been fed 3 weeks ago, "is due a feed." The risks to the public are limited, but people have been killed by pet constrictors in the past, so erring on the side of caution and awareness is justified.

Yes, exotic pets can be interesting and unique. People are sometimes attracted to something new and different, but often it's the 'look at me!' aspect of having something completely different. However, novelty should not be a justification for keeping pets. Our ability to safety and humanely take care of them, and manage potential risks to the public have to be part of the equation.

Image: A Black Mamba (Dendroaspis polylepis) (source: http://en.wikipedia.org)

Illegal alligators attract women? Who knew?

I guess I'm lucky I'm married since I'm obviously out of touch with the best ways to attract women. Unlike Dewayne Yarborough of Ford Heights, Illinois, I didn't know that a 4-foot-long alligator is a "chick magnet."

His reason for keeping the reptile was that he claimed it attracted women (I kid you not).  While it may have attracted a few dates, it ended up costing Mr. Yarborough, as he was charged with possession of an illegal animal. Investigators found the alligator in a fish tank in the man's kitchen. Apparently, he was keeping it in a small tank and feeding it minimally (aka starving it) to keep it from growing too big. (Apparently, the degree of attraction of women is not directly proportional to the size of the alligator.)

Besides being illegal in many jurisdictions, keeping alligators is rarely a good idea. They can grow very large and can be very aggressive. They need lots of space, a proper environment and a proper diet. Like all other reptiles, they are a potential source of Salmonella (and some other microorganisms), so keeping them in the kitchen is an even worse idea.

I wonder what other animal-associated dating trends I've missed over the past few years...

Dumb Easter decisions

Easter is one of those holidays when there are concerns about dumb pet purchases. Spur-of-the-moment purchases of inappropriate pets can lead to animal suffering and death, and risk of human infection. Easter's problems: baby chicks and rabbits.

Rabbits can make great pets. They're a long-term commitment, but they’re relatively low maintenance, a lot is known about how to raise them and they are generally low risk for transmission of infections to people. Chicks are a different story. Chicks are notorious Salmonella vectors and have been linked to numerous outbreaks. They are easily injured and often improperly raised. They also grow up (well, some of them do, at least) to be full sized poultry, something that most people don't really want.

A story from Vidalia, Georgia highlights some of the issues with Easter pets. In it, Tracy Gunn describes his need to buy a chick for his daughter - and not just any old chick, but a dyed chick, something that’s illegal in 36 US states, but not Georgia.  Gunn states "I don't know what she's going to do with it." Sounds like a recipe for a few minutes of novelty, followed by a relatively short life for the chick. At least his daughter’s 17, and not in the high risk group for salmonellosis.

Alongside the cage full of multicoloured chicks was a collection of rabbits.

The bunnies sell real good for Easter.  We've been selling a lot of them about the last month. Can't keep enough of them.” said a store employee.

He followed that up with “They buy (rabbits) for their kids for Easter, then they take Easter pictures and stuff like that with them, I'm not sure about what happens to them afterward.”

That’s the problem. Kids get a few minutes of novelty enjoyment, but then a lot of those animals end up dead, released into the wild (not a good thing) or dropped off at an animal shelter, because people don't think about the "afterward" part before they buy.

Pet purchases need to be made with thought and foresight:

  • Do I really want this pet?
  • Am I committed to taking care of it for its entire life?
  • Can I take care of it properly with my current living situation?
  • Can I afford to take care of it properly?
  • How do I take care of it?
  • Are there any disease risks that I need to be concerned about?
  • Are there any people in the household who are at high risk for disease caused by this type of animal?

If you can't answer these questions, don't buy or adopt an animal - of any kind.

When not to bring your dog to work

In some situations, bringing a pet to work might be acceptable. In other situations, it's totally inappropriate. A UK dentist learned that the hard way.

Ian Hulme-Ribsy, a dentist, was found guilty of unprofessional and inappropriate conduct for several bad behaviours. One was that he brought his dog to his dental clinic and failed to clean his hands after handling it. That's a pretty blatant breach of basic infection control practices, in the sense of both having an animal in a patient care area (outside of a structured visitation program) and failure to use basic standards of hygiene to reduce the risk of disease transmission. (It's particularly troubling when you consider that as a dentist the man would be putting his unwashed fingers directly in patients' mouths.)  It's pretty remarkable considering how much attention is generally paid to infection control in the dental world.

Also included in his list of bad behaviours was giving patients sedatives in liquid form without measuring. He'd just pour some into a plastic cup. Reckless disregard for dosing of sedatives is probably a bigger concern than the dog issue, but both show poor judgment.

Mr. Hulme-Ribsy didn't lose his license, but must practice with restrictions. "... Hulme-Rigby must work under supervision and take courses in record keeping, infection control and dental practice ethics. He must undergo annual infection control and record keeping audits, and is banned from administering benzodiazepine drugs, or any other sedatives. Hulme-Rigby’s case will then be reviewed to decide if he is fit to practise without restrictions."

Pet raccoon attackes baby, owners in denial

Raccoons are fascinating critters but they don't make good pets. Their curiosity makes them quite disruptive and damaging, and they have seriously injured people (particularly infants). They are also rabies vectors, and in many regions raccoon ownership (along with other wildlife species) is illegal (or only legal with a license). Despite all this, some people continue to keep raccoons as pets, and injuries continue to happen. Unfortunately, it's often not the owners that suffer the consequences, but children.

A one-week-old Griggville, Illinois baby is in hospital after being attacked by her grandparents' pet raccoon. The baby was in a room with the raccoon (not a good idea to start with), when the raccoon starting biting and scratching the baby's face and head. The raccoon's owner thinks the raccoon wasn't being vicious, just curious and trying to get a ribbon off of the baby.

"Rampy was trying to get the bow off the baby's head and it's got long claws and he was scratching up the head trying to get the bow off," said the owner.

Regardless, the fact that it caused severe injury indicates it's a hazard. (Wounds caused by accidents heal at the same rates as those caused my malice.)

Euthanasia of the raccoon was requested to test it for rabies. The owner countered that it had been vaccinated against rabies and dewormed (which raises the question of what veterinarian did this. I'd consider vaccinating and deworming an illegal pet unethical at best).  Further, rabies vaccination does not guarantee that the raccoon isn't rabid. A judge eventually ordered the raccoon to be euthanized.

You'd think the raccoon's owners would be aghast at the attack.  While I can see how they'd be attached to their pet, typically concern over a grandchild takes precedence. Not here, however, as the owners fought the euthanasia order and are railing against local authorities for having the raccoon euthanized after a potentially life-threatening attack. Even the infant's father is taken back by their attitude, stating "If it was somebody's dog that bit a kid, they'd be held accountable. These people should be held accountable for [the raccoon]."

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Cobras make bad pets...duh!

A New Jersey man managed to avoid being a good example of Darwin's "natural selection," thanks to the help of medical professionals and the Bronx Zoo.

Eric Bortz (who, I'm sad to say, works at a veterinary clinic), purchased three snakes - a copperhead (venomous), a timber rattlesnake (venomous) and a monocled cobra (venomous) - a couple of weekends ago. (Sadly, that's not hard to do if you have a few hundred dollars.) The snakes joined his collection of pets, including a tarantula, several scorpions, a king snake, a boa constrictor and a rabbit (no word whether the rabbit was a pet or a snake-snack).

Anyway, the following Monday, he was bitten by the newly-acquired cobra. He had apparently been told that the snake had undergone a procedure to render it non-venomous, but it became apparent that it either wasn't true or it wasn't done right, when Mr. Bortz went into respiratory distress and started seizuring.

Fortunately, he received prompt medical care and his proximity to the Bronx Zoo facilitated access to antivenin. Zoos are often called in to help out when people get bitten by their venomous snakes, since zoos typically keep a supply of antivenin in case their staff get bitten.

Keeping venomous snakes is just stupid - there's no reason to do it, and t puts people at risk.  The risk is not just to the owners who made the choice to keep the animals, it's also to other people that might be exposed if the snake gets out, including family members, friends and neighbours, who didn't make the choice... it's something that has happened in the past, and will no doubt happen again. Venomous snakes (and other dangerous animals) are also a potential problem for first-responders if there's been a fire or other incident in the house. There's absolutely no reason for these creatures to be kept as pets, and no reason that keeping and selling them shouldn't be met by large fines or other deterrents.

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Tigers in the bedroom

A recent article in Emerging Infectious Diseases discussed infectious disease risks associated with having pets in the bedroom. It raised awareness about pets and zoonotic diseases, although some of the coverage was a bit over the top. There are risks, but for most people and most pets, the risks are quite low. Some things do increase the risk quite substantially. One is sleeping with a large predatory carnivore.

Large exotic animals such as lions and tigers are surprisingly common in small zoos, animal parks, exhibitions and even private homes. Many people get away it, but all too often it's an accident waiting to happen, as for a 17-year-old Florida girl who sleeps with a tiger in her bed.

Felicia Frisco is part of a family of animal handlers. Her father runs an "institute" that provides animals for movies, TV shows, presentations and for the public to "cuddle." Felicia has been raising Will, a now six-month-old Bengal tiger. Part of Will's training involves sleeping in Felicia's bed every night.

Felicia said her friends "think it's really cool that I have a pet tiger because most of them only have a cat or dog." Other people (the one's with common sense) think it's an appalling example of poor animal handling and weak regulations (along with poor parenting).

Will may be very friendly now, but that doesn't mean he's safe. Many people have been killed by pet lions and tigers. Sometimes it's from attacks, but sometimes it's just the result of normal playful behaviour. A playful swat to the head or neck from a large cat can be fatal. Think how aggressively some cats play. Scale that up a few hundred pounds and you can see the potential for injury or death. As Will gets older, the risks will increase based on his increasing size and natural instincts. Also, there may be behavioural changes associated with sexual maturity that could increase the risks.

Felicia's father, the ringleader of the venture, seems to be in complete denial: "She may have that young cub in her room and be taking care of him and raising him, but her mother and father who are full time professional animal trainers also live there with her and have many other tigers right outside the door that are part of their living."

  • Having someone in the next room doesn't prevent an attack. They just get to see the damage first.
  • Having other tigers doesn't reduce the risk. It means there are more animals to cause problems and the potential for people to be injured getting into the middle of a cat-cat quarrel.
  • Being a trainer doesn't make you invulnerable to teeth and claws (remember Siegfried and Roy?)

He further distances himself from parent-of-the-year honours by saying "That Felicia is risk-free is by no means true but neither are most 17-year-olds behind the wheel of a car... they die like flies across the country. It's like having an extreme sport in your life. The potential for accident and injury is certainly there."

Jack Hanna, a famous animal trainer, summed it up nicely: "Every cat has a different killing ability, the tiger it makes no difference, it's like they can go and it's a bomb going off wherever it hits."

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'Dead' raccoon takes down wrestling team

You're driving down the road. You see a dead raccoon. Obviously, the first thing that comes to mind is "Let's pick up the carcass and take it on a road trip."

  • No? Maybe only if you're a high school wrestler from North Dakota.

On the way to the finals of a tournament, a busload of wrestlers came across a "dead" raccoon. For reasons that are unclear, they thought it would be a good idea to pick up the raccoon carcass and take it with them. They put it in the storage area of their bus and continued on their way.

Not only did that group of students display some questionable judgment by picking up the carcass, they also failed to notice that their "dead" raccoon was not actually dead. When they arrived at the tournament, the raccoon got up and ran away.

So, not particularly bright (or observant), but maybe not that big of a deal. Raccoons are important rabies vectors and a raccoon that allows itself to be loaded onto a bus by a bunch of high school students, and then later runs away, must be considered potentially rabid since you can't prove otherwise. However, you don't get exposed to rabies just by riding in the same bus as a napping raccoon. You have to have close contact with it (e.g. bite that breaks the skin, exposure of an open scratch/wound or mucous membrane (nose, mouth, eyes) to raccoon saliva).

In this case, however, the team was removed from the tournament when officials found out "they had been in contact with the wild animal and feared they may have contracted rabies."  This makes no sense.

  • If they were exposed, they'd pose no risk to anyone else at that point. You don't become immediately infectious after exposure. These students could not have transmitted the virus to other competitors.
  • There was no evidence that they were actually exposed. No one was bitten or scratched.

Carrington school superintendent Brian Duchscherer said: "Once we found out, we didn't know if there was a potential of spreading anything or if the raccoon had rabies or not but we decided to bring our kids home." I would hope that a quick call to public health would have put those concerns to rest. Either they didn't bother to try to get good information or they got bad advice.

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Rabies follies in Massachusetts

A recent news report from Berkshire, Massachusetts that was highlighted by ProMed is a strange and concerning story of rabies exposure.

The story involves two people that were stalked and attacked by an aggressive fox. One man was attacked in his driveway. He fought the fox off with a smoker lid, but several hours later it attacked and attached itself to a woman next door who was outside collecting her recycling bin. The fox bit her multiple times, and it took 20 minutes (with the aid of the same smoker lid - apparently a good fox extractor) to remove the fox from the woman’s leg. The man then killed the fox.

The woman’s sister called the police, who dispatched paramedics and suggested they call Animal Control to get the fox tested for rabies.

So far, so good. Unfortunate attack but managed as well as can be expected.

Anyway, when the paramedics arrived, they told the woman that she didn’t need to go to the hospital. A little more information in the article would have been nice here. Based on the severity of the injury, the response of the paramedics probably makes sense. The fox had bitten her, but the bites didn’t appear to be too serious from a trauma standpoint, and racing her off to the hospital in an ambulance was not required. However, rabies exposure is a major concern and this scenario raises a good question: What is the role of paramedics in thinking about and educating people about the risk of rabies exposure? Ideally, paramedics should know enough to tell people that they should seek medical care when there has been potential exposure to rabies. I don’t know whether this is the case, however. If someone isn’t injured enough to require emergency care, is that all that the paramedic needs to assess?

The woman then had a relative drive her to the emergency room. If this was because of concerns about the severity of bites, then that makes sense. If it’s from a rabies exposure standpoint, then it’s overkill. Assessment of rabies exposure and starting treatment is considered a medical "urgency," but not an "emergency." Basically, that means you don’t need to be treated immediately and you have time to go to a regular physician. In this case, going to her physician the next day would have made the most sense, since emergency rooms are not the ideal place for rabies assessment and exposure treatment.

The fox was rabid in the end, and the woman was started on rabies post-exposure treatment. Even if this was an inefficient way of getting care, the key point is that she was treated. Rabies is almost invariably fatal but is almost 100% preventable with proper post-bite care.

The description of her treatment is strange, however. “On Monday she began the lengthy series of anti-rabies vaccinations, which included injections into each bite mark. She returned to the hospital for another shot on Thursday and learned that she has 10 more vaccinations to endure this month, with each hospital visit at a USD 75 co-pay.” This makes no sense. Current-day rabies post-exposure treatment consists of a series of 4 doses, not 10 or more.

Another strange part of this story is the apparent difficulty the two victims had getting the animal tested. The people who were attacked claim “I called a rabies hotline and nobody picked up." As a result, the fox's body sat on the woman's property for three days until they took it to a local vet clinic, that shipped the fox’s body for testing. In another strange twist, it seems the woman had to pay for testing herself. That makes absolutely no sense. This is clearly an animal with a high likelihood of having rabies and a situation where there has been clear exposure of a person. The rabies status of the animal must be determined and requiring people to pay for that themselves makes no sense.

By the time I posted this story, the Berkshire newspaper had pulled the article from its website. I don’t know why. It could because the story was poorly written or the information was incorrect. Regardless, it raises some interesting issues.

Dog causes airplane diversion

Bomb threat? Yes.

Heart attacks? Sure.

Mechanical problems? Absolutely.

Aggressive passengers? Yes.

But a 12-pound dog? Apparently so.

"Mandy," a Manchester terrier, has joined the exclusive club of causes of airplane diversions.

Mandy and her owner were flying from Newark to Phoenix on a US Airways flight. The dog was sedated and in an airline-approved cage under the seat, as per airline policy. So far, so good.

Then the dog started to become agitated. One report suggests it was because the sedation was wearing off. Whatever the cause, the owner tried to take the agitated dog out of the protective confines of its cage, into a noisy, crowded and potentially frightening new environment. Not surprisingly, when you take a dog coming out of sedation (and perhaps not completely aware of what's going on) and put it in a unfamiliar and confusing environment, bad things can happen.

In this case, it resulted in the dog biting the passenger in the seat next to the owner (who was trying to help calm down the dog). The dog then got loose and ran up and down the aisle of the plane, barking. A flight attendant who tried to grab the dog was also bitten.

The bites were minor, but the pilot decided to divert the flight to Pittsburgh so the bite victims could be treated (and presumably to get the dog off the plane before it bit more people). The people who were bitten eventually got back on board and continued the flight. However, Mandy and her owner did not, as "separate transportation" was arranged for them.

There's no information in the reports I've seen about the dog's rabies vaccination status, something that was hopefully queried by medical personnel. There's also no information about whether any action will be taken against the dog's owner. If the airline (and/or passengers) wanted to, I imagine a lawsuit could easily follow (especially given the litigious nature of US society). They might win, too, since the dog's owner deliberately broke clear rules that say the dog must remain in the carrier at all times. As a result of her action:

  • Two people were injured.
  • Medical costs were incurred.
  • The plane had to be diverted, probably resulting in a large cost to the airline for additional landing fees, fuel, personnel time, and perhaps the need to move flight personnel or postpone flights because of the diversion. (I'd love to know an estimate of what such a diversion actually costs.)
  • 122 passengers were inconvenienced and might have incurred costs from the delay as well.

...all for something that could have been avoided by leaving the dog in its cage.

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Tiger smuggler thwarted

Security screeners at a Thai airport discovered an attempted tiger smuggling, presumably by realizing stuffed animals don't have a skeleton. A 31-year-old Thai national was trying to smuggle a sedated tiger cub in a carry-on bag. As it went through the X-ray machine, screeners noticed an item resembling a real cat. Closer inspection identified the actual item and the individual was arrested.

Unfortunately, this person is presumably among the very small minority of smugglers that actually get caught. Creative smugglers, established smuggling pathways, lucrative markets and extremely lenient penalties combine to make this a pathetic but unfortunately often profitable venture that results in the deaths of huge numbers of animals, and acts as a potential way to transmit various infectious diseases that could affect other animals or humans.

Image: Tiger cub at the Philadelphia Zoo (source: http://commons.wikimedia.org)

Dog as scalpel...maybe effective but not recommended

What happens when you combine a festering toe wound, a doctor-averse person, a dog and a lot of alcohol. Well, I guess you get Jerry Douthett and his dog Kiko, a Jack Russel who is being called a "lifesaver" for gnawing off Jerry's infected toe.

Apparently Mr. Douthett had what he believed was a small sliver in his toe a few months earlier. He picked away at it for a while, later using a knife to trim away infected tissue. The toe became so inflamed that he couldn't wear shoes. Eventually, he decided to numb the pain and his fear of doctors with a large volume of alcohol. After having 4-5 beers at a local restaurant, he downed two giant margaritas, then passed out after his wife drove him home. His wife explained "Jerry had had all these Margaritas, so I just let him sleep, but then I heard these screams coming from the bedroom, and he was yelling, 'My toe's gone, my toe's gone!'" 

Indeed it was, or at least most of it. "The toe was gone," he said. "[Kiko] ate it. I mean, he must have eaten it, because we couldn't find it anywhere else in the house. I look down, there's blood all over, and my toe is gone."

After the Jack Russel relieved Jerry of most of his big toe, Jerry ended up finally going to the hospital. Doctors confirmed that the rest of the toe needed amputation and the infection (which had reached the bone) was probably the result Type II diabetes.They removed the rest of the toe and treated the infection.

Jerry's not upset with his dog. Rather, he's grateful that Kiko's snacking made him go the the doctor, which led to him finally being diagnosed with diabetes which can now be properly managed. The dog is under a 10-day quarantine for rabies observation, as would happen with any dog bite.

People with diabetes are at high risk for various types of infections. I've heard of diabetics with serious foot infections that developed because their pets were licking foot wounds or chewing on their toes. Diabetics can have decreased nerve sensation and sometimes don't notice when their pet is doing damage by licking or chewing.

Diabetes is not a reason to avoid pets, but the increased risk of infection means that extra care needs to be taken to reduce the risk of infections caused by pets, particularly from pets licking wounds directly and from people indirectly spreading bacteria from a pet to a wound. Simple, logical preventative measures around pets and good attention to hygiene are important.

Not drinking yourself into a stupor also helps.

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Occupational "oops"

A couple people have learned the hard way that mixing dogs and their jobs isn't necessarily a good idea.

1) A Peterborough (Ontario) Regional Health Centre employee has been disciplined for performing an ultrasound on a pregnant dog in the hospital's emergency department. This raised various concerns, including:

  • medical equipment being used while people were waiting in the ER (no one had any tests delayed because of this)
  • inappropriate use of hospital equipment
  • infection control concerns

No one mentioned the whole aspect of practicing veterinary medicine without a license. This is a pretty minor issue here with a non-invasive technique done by (presumably) the pet's owner and with no money changing hands. It's not like a human medical ultrasound technician performing and interpreting ultrasounds on pets and charging for the service, which would be illegal in the province of Ontario.

If you want an ultrasound done on your dog, go to a veterinarian. If you want to take a dog to a hospital, do so as part of an organized hospital visitation program.

2) I've heard a lot of stories about strange things done with pets, but this morning's Toronto Star had a new one for me. It was an article about a dog that received communion last week at St. Peter's Anglican Church in Toronto. It was apparently a spontaneous act meant to make a new member feel welcome, but giving communion to a dog isn't exactly following church rules, and at least one churchgoer was offended by what he considered an affront to this sacred ritual. (I also doubt the reverend washed her hands after feeding the dog the communion wafer.)

A complaint was filed by a man who has since left the church. However, the bishop of York-Scarborough took a rather balanced approach. “Unless there is any further evidence that she is giving communion to animals, the matter is closed... we are after all, in the forgiveness and repair business,” he said.

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Turtle on a plane...but not for long

It's not likely going to spark a Hollywood movie, but a turtle on a plane triggered a lot of angst and controversy in the US recently.

A 10-year-old girl was traveling with her pet turtle, Neytiri, on an AirTran flight from Atlanta to Milwaukee. The airline has a no-reptiles policy (actually, a no-pets-at-all-in-the-cabin policy) and when one crew member spotted the turtle in a cage under the girl's seat, she was told that she had to get off the plane.

This is where things start to fall apart a little. Apparently, the girl and her sister threw the turtle and its cage in the trash. They say that they were told to do so, although AirTran disputes this. Regardless, the turtle was tossed and the girls got back on the plane.

Banning turtles from plane cabins makes complete sense. I'm not sure why anyone would really need to travel with their pet turtle, particularly in the cabin. Turtles are notorious vectors of Salmonella and a huge number of Salmonella infections in people are attributed to contact with pet reptiles. People under the age of five, the elderly, pregnant women and people with compromised immune systems are at particular risk and should not have contact with reptiles. The problem with a plane is you can't be sure whether or not such high-risk individuals are on it (or will be on subsequent flights). A turtle in a cage is probably of fairly low risk. The problem would be the owner handling the turtle or its cage, then touching common hand-contact sites in the plane. Those sites could then be touched by someone else, creating a theoretical risk of transmission.

What's the real risk in this situation? Probably minimal. However, you have to think about whether risks, even minimal ones, are worth taking when they are completely avoidable by keeping turtles and other high-risk species out of cramped and hygiene-limited public spaces like airplane cabins - places they don't need to be.

Did the airline over-react? I don't think so (although recommending someone toss a live animal in the garbage, if it happened, is completely unethical). They have a policy. It's a reasonable policy. If you fly on an airline, you have to abide by their rules. If you are going to do something unusual like travel with a pet, it's your responsibility to determine what the rules are.

The story has a happy ending, fortunately. It seems that an airline employee recovered the turtle from the trash, and the girl was re-united with her pet a couple of days later, after flying home on an AirTran plane... in the cargo hold.

One other interesting note about this story - the turtle, Neytiri, was only two-inches long.  In the US, the sale of pet turtles with a carapace length of less than four-inches has been illegal since 1975, due to high rates of turtle-associated salmonellosis among children, who were more likely to extensively handle tiny turtles.

Photo (left): Carley Helm and her pet turtle Neytiri.

Service dog training silliness

I often write about service dogs, and I'm often fairly critical. It's not that I dislike them - on the contrary, they're incredibly important to people who need them. However, when people do stupid things with service dogs, it can ultimately hurt the people who actually depend on these animals.

I was at the grocery store today and the first thing I saw when I walked in was a woman walking around with a dog in her shopping cart (i.e. the place the next person's food is going to sit). The dog was a poodle puppy wearing the standard "guide dog in training" vest, and the woman thought nothing about walking through the store pushing this dog around. When I asked her about it she said that the dog was just a puppy and it wasn't good to have it walking around on the floor (with no explanation why). She did take the dog out of the cart, but then proceeded to walk around the store carrying the dog in her arms. The site of her holding the dog while pawing (pun intended) the fresh fruits and vegetables raised eyebrows among more than just myself. Eventually, she put the dog down, which mainly resulted in her dragging the dog around as it tried to lay down or walk the other way (which may explain why she wanted it in the cart).

Service dogs are allowed into stores. They have wide access and that's needed. Service animals in training, however, are not service animals and they do not have the same absolute right to access. Training needs to be logical and supervised. Getting these dogs out in different environments is very important. However, how does pushing a dog around a store in a shopping cart help train it to be a service dog? I'm pretty sure part of the dog's ultimate job description doesn't include this particular activity. Being carried around a store while shopping is also not likely to be part of this dog's job. If a dog is not adequately trained to walk around a store on a leash, it shouldn't be there. A little common sense would indicate that basic training in another environment should precede activities such as this. 

Fostering a guide dog is a good thing to do, but it comes with a lot of responsibility. I'm certain this person was well-intentioned, although I'd certainly consider her actions misguided. The "guide dog in training" vest should not be interpreted as a free pass to take the dog wherever you want without any thought. Training such a dog is an important job, and people need to think about what they are doing.

I'd be interested in hearing from anyone that is involved in these programs. I was unable to find any information about guidelines for people fostering service dog puppies, and would love to know what type of guidance people get, and what organizers of these programs think of this incident.

Stupid, drunk and owner of a venomous exotic pet... Bad combination

A UK man is recovering from a tarantula bite that occurred when he, apparently in a drunken stupor, encouraged the venomous critter to bite him. (I suspect the "victim" has a pretty high endogenous level of stupidity, because I don't think you could get me drunk enough to say "Hey, maybe I should let an enormous venomous spider bite me!")

The character in question, Peter Saunders, stated "It was completely my own fault. I provoked the spider into biting me on my index finger so I can't complain about the consequences at all." At least the statement demonstrates some degree of logical thought. He ended up getting more than he bargained for, since the bite was a lot more painful than he anticipated. The day after the bite (presumably along with a massive hangover), Mr. Saunders' arm went numb and he was given various antibiotics to help treat a suspected secondary infection.

Unfortunately, the moment of clarity represented by his understanding that it was all his fault passed quickly since "... this incident has not put him off keeping these pets and he is considering buying more exotic creatures in the future." Let's hope he doesn't decide to see what it feels like when an African lion chews on his throat.

Photo: Fort Hall Baboon Tarantula (source: www.lotsalegs.tenczar.net)

Indian man's approach to rabies prevention not recommended

A man from Jharkhand, India, was bitten by a dog and realized that there was the potential for rabies transmission. That's good, particularly given the huge problem with rabies in India. However, he didn't take the recommended approach of proper wound care and getting post-exposure vaccination. Rather, he killed the dog (getting bitten a few more times in the process), cut out its heart with a pair of scissors and ate it raw, exclaiming that now there would be no problem with rabies.

Not a good idea.

Rabies is widespread in India. Every year, 25 000-30 000 people die of this disease. A person in India is bitten every 2 seconds and someone dies of rabies every 30 minutes.

Every dog bite needs to be considered a possible rabies exposure. If a dog that bites someone is not available for quarantine or testing to determine whether it has rabies, post-exposure treatment is necessary. That involves an injection of anti-rabies antibodies and a series of 4 or 5 vaccines, not ingestion of the animal's heart.

Hopefully, the dog didn't have rabies and this will go down as a somewhat curious little story. Unfortunately, if the dog had rabies, there is a good chance that this person has been infected, and if infected, he will almost certainly die.

Eating an animal's heart to prevent rabies transmission may just be a bizarre belief of an unusual individual. This is something that needs to be investigated, however, because if the same belief is held by many other people in the area, they will all put themselves at risk if they are bitten by not seeking appropriate and effective treatment. Not only does killing the dog and eating its heart have no chance of preventing infection, it probably increases the risk of rabies by leading to more bites. More rabies education is often needed in problem areas, and this may be the case here.

Image: Canine heart (source: www.historyforkids.org)

Antagonzing piranha... Maybe not a good idea

Pet bites are a big pDavid Brownroblem. Dogs bites in particular are far too common and can result in serious injury or even death in a small percentage of cases. Bites from other pet species also happen, but the extent of the problem is not clear. A good general rule is if it has a mouth, it can bite.

Another good general rule is if it has numerous sharp teeth, is a carnivore and your as upsetting it, you should get your hand out of the way. Pet store owner Dave Brown found this out the hard way, although in this situation he has the dubious distinction of having been bitten by a fish.

It seems that Mr. Brown was trying to catch a piranha that he was selling. I would have thought the standard way of catching a fish, not to mention a six-inch-long carnivorous fish, would be to use a net. Apparently not. Mr. Brown used piranhahis bare hands, and after a couple unsuccessful attempts to catch the fish, the piranha fought back, sinking his teeth into the store owner's thumb. The bite was severe enough that stitches were needed. According to Mr. Brown "There was blood everywhere. Every time I had him in a plastic bag the fish would bite through it. He was quite a feisty one." Personally, I think if a carnivorous fish was repeatedly trying to attack me through the bag, I'd probably change my approach to catching it.

According to a local fish expert, "[Mr. Brown] was very unlucky as these fish normally just attack when they're hungry. It may have been a bit peckish."

Fortunately, apart from a sore thumb, it sounds like the biggest problem Mr. Brown will face is the harassment that I assume he's going to take from friends after being bitten by a fish.

Snakes and cakes

My oldest daughter's latest favourite TV show is Cake Boss, a TLC show about life in a bakery (don't ask why... I guess it's better than John and Kate Plus 8). On a recent episode, they were making a cake for a circus sideshow and one of the performers appeared in the bakery's kitchen with a large albino snake. It makes for good entertainment but it's a break with common sense and presumably health codes.

Reptiles should never be allowed in a kitchen, let alone a commercial kitchen (especially one that presumably prepares items often eaten by children). Contact with reptiles is a significant risk factor for salmonellosis, and cross contamination is a concern in kitchens. All pets should be kept out of food preparation areas, but particular care should be taken around high risk species like reptiles, and every reptile should be assumed to be carrying Salmonella.

Things not to do for Thanksgiving

I heard this on the radio yesterday morning, I kid you not: Butterball has a "Turkey Talk" toll-free helpline, which naturally gets busy around turkey holidays like Thanksgiving and Christmas.  Like many helplines, they get stories of every kind, and this year apparently one person called in and asked if it was alright that she thawed her frozen turkey in the bathtub - while her kids were in it taking a bath!

Anyone who has read anything about food safety hopefully knows that raw meat can potentially be (and usually is) contaminated with many different pathogens - that's the biggest reason why observing proper cooking times and temperatures is so important.  Raw poultry in particular should basically be treated like it's contaminated with Salmonella and/or Campylobacter until proven otherwise.  You can just imagine the field day that these bacteria could have in a nice warm, wet bathtub - it's just the way they like it, and it's exactly what we try to avoid in the kitchen, where food is ideally kept either nice and cold or nice and hot in order to prevent (or at least minimize) bacterial growth.  Then of all things to put young children in this veritable cesspool of bacteria - turkey and all - it's just a gastrointestinal disaster waiting to happen.  You also needs to consider what the turkey could become contaminated with sitting in bathwater.  Even children who don't have diarrhea can be shedding intestinal pathogens - human pathogens which are obviously transmissible to other people.  If you really cooked that bird well (maybe deep-fried it) I suppose that should ultimatley eliminate any surface contamination anyway, but I don't think I'd be able to get past the "ick" factor.  Don't throw the baby out with the bathwater, but of there's a turkey in there (as far as I'm concerned) that can go.

I realize this is primarily a food safety issue, but it made me think about what else this person (or others) may put in a bathtub.  In previous posts in which we've talked about reptiles kept as pets (all of which should be treated as Salmonella carriers), we've mentioned that ideally (if they need a bath) they should be bathed in their own designated container (like a big rubbermaid) and not in the bathtub.  If there is no other option and the bathtub must be used, it should be thoroughly cleaned and properly disinfected (keeping contact-time with the disinfectant in mind) before it is used again by a person (especially children). 

Ideally the same precautions should be taken if you bathe a dog in the bathtub, but the risks are not as high as with reptiles (unless the dog is very dirty, has skin lesions, or has (or recently had) diarrhea).  We've talked about the limited risks of allowing dogs in backyard swimming pools (but of course there is even less chlorine in bath water).  I hope no one ever bathes their dog with their kids - we could debate the risks, which likely aren't high anyway, but in the end the risk is simply unnecessary.  The pool is one thing, but there's no reason for a dog to be in the tub at the same time as the kids (and really, how clean are the kids going to get with a dirty dog in the tub?).  If you're trying to save water you can always throw the dog in after the kids are out.

If you're attempting to bathe a cat in the tub... well, based on most feline behaviour I'd say your primary risks are bites and scratches more than enteric bacteria and parasites.  Proceed at your own risk!

A happy (and hopefully healthy) American Thanksgiving to all of our US readers!

Family Salmonella outbreak from school reptile

Three Louisville, Kentucky children and their father recently contracted Salmonella from two lizards (green anoles) that the kids brought home from school. Two weeks after the lizards were brought home, the youngest child got sick. Then the other kids and the father got sick.

This outbreak highlights numerous problems:

Schools are not pet stores: Why is an exotic (and difficult to care for) pet that is a known Salmonella vector being sent home with students? Apparently, the school sent home a standard letter they use when students take home pets. (I assume sending animals home must be a very common event if the school has a standard form for it.) The letter provides "caretaking tips" but apparently mentions nothing about Salmonella and reptiles. The school has now modified the letter to include a "reminder to parents that good hygiene is imperative when dealing with any kind of living organism as a pet, so they need to make sure their kids wash their hands well after handling them or cleaning them out." That's better, but if they are sending home reptiles, they need a clear statement about the risk of Salmonella exposure. They need to be direct and highlight the greater risk associated with reptiles.

Lack of education before getting a pet: Too many pets die and too many people get sick because people don't take the responsible step of finding out about the animal before they adopt it as a pet. This is particularly true with exotic pets, and death of the pet is a common outcome. It doesn't take a lot of effort to find out basic information about reptile care, and information about the risk of salmonellosis should be easy to find.

Poor knowledge (or a poor attempt at damage control) by the school: The teacher "noted that other common pets, such as dogs, can also carry salmonella. Like lizards, they're perfectly safe as long as you practice proper handwashing when you handle them." Except for the fact that 0-1% of healthy dogs carry Salmonella while very high percentages of reptiles do, that tens of thousands of cases of reptile-associated salmonellosis occur every year, that contact with reptiles is a major risk factor for salmonellosis, and that the CDC (among other groups) recommends that children less than five years of age and other high-risk groups not have contact with reptiles.  This type of statement is misleading. It's unfortunately either an indication of ignorance of the issues or an attempt to cover their butts and not take their share of the responsibility for what happened.  Certain reptiles can be good pets in certain situations, but are clearly inappropriate in others.

The "it's never happened before so it must be safe" fallacy: The school's disappointing response was that they've been using lizards in classrooms for years and no one has gotten sick. Well, their luck just ran out. Just because I could drive around without a seatbelt and not get hurt doesn't mean not using a seatbelt is a perfectly safe plan. Risky behaviours tend to catch up with you eventually.

The "it didn't happen here so it's not our fault" excuse: School officials said teachers are well-trained on the proper way to prevent students from getting Salmonella, but that's pretty debatable since three kids got sick because of their actions (i.e. sending the reptiles to the children's home). The infections may not have originated in the school but the school was still the source of the problem.

Poor hygiene associated with reptile contact: The father admitted that they didn't wash their hands regularly after handling the lizards.

There's little excuse for sending reptiles home with kids. Reptiles require specialized care and commitment, and many (many!) die each year from inappropriate care. The last thing we need is to make it easier for people to obtain them without much forethought. Reptile-associated salmonellosis is a serious problem, especially in kids. Serious, including fatal, infections can occur. Schools need to realize the liability they might assume by sending these animals into households, especially with inadequate scrutiny and education. Reptiles should not be kept in  households with kids less than five years of age, pregnant women, elderly individuals or immunocompromised individuals. I doubt they asked whether any such people lived in the household before sending the reptiles home.

News flash: You can't sue a dog

A lawsuit against various parties, including a dog, has been tossed out by a Michigan judge. Inez Starks sued the city of Warren, several police officers and Liberty, a police dog, after being bitten during some sort of confrontation in 2007. I don't have any details about the bite, but "unprovoked attack" and "police dog" don't tend to go together. Police dogs can and will bite in certain situations, but these are extremely well-trained and well-handled dogs.  Most people that are bitten by a police dog probably have themselves to blame more than anyone else. Inadvertent bites could potentially result from being an innocent party in the middle of a confrontation, I guess, but there is no indication this person was merely an innocent bystander.

Anyway, the suit was tossed out by the judge. As a good example of sanity in the legal system, the judge fined Starks' lawyer for naming the dog in the suit.

Dog bites are a big deal and the cause of many lawsuits. Dog owners need to take their responsibilities seriously to reduce the risk of bites (and consequently being sued). At the same time, people need to take responsibility for themselves to reduce the likelihood of being bitten when confronted by a dog. Usually, that's focused on "be a tree" training in kids, but not upsetting police dogs is probably another good rule of thumb.

Pet bear kills woman

In yet another tragic example of why large wild species should not be kept as pets, a 37-year-old Pennsylvania woman was killed by her pet black bear. She entered the 350 pound bear's cage, a 15 by 15 foot steel and concrete enclosure (hardly a good environment for a bear) and was mauled. A neighbour then shot and killed the bear. A Bengal tiger and African lion were also present on the property. No indication was given about what might have triggered the attack.

Large carnivorous mammals don't make good pets. It's also questionable whether people can adequately and humanely care for such animals. I have a hard time believing the bear had a good quality of life living in a small steel and concrete pen. The picture above is not from this case but from another bear enclosure elsewhere  in Pennsylvania (see link here).

Every year, there are reports of these types of "pets" severely injuring or killing their owners, yet there is little effort in many regions to control the ownership of these animals. Local officials knew about these animals and the woman had permits for them. Why (and how) someone could actually get a permit to keep these species is beyond me.

Pets are great, but pet ownership has to be logical and safe, and there have to be benefits for both the human and animal. Keeping dangerous animals locked up for curiosity's sake is no longer (or at least should no longer be) socially acceptable. These animals should be in the wild or in a properly managed zoo or wildlife rehabilitation sanctuary.

Antibiotic loopholes and lunacy

People are justifiably concerned about overuse of antibiotics, in both veterinary and human medicine. There's ample talk about restrictions on use of antibiotics in animals (especially livestock), which is an area that needs good, objective research and discussion. Some politicians have made grand statements about restricting antibiotic use and have proposed strict legislation. (In North America, there's a lot more talk than action). However, I continue to be amazed that amongst all the hand-wringing about antibiotic use in animals, governments haven't taken the very simple initial step of making all antibiotics only available by a veterinarian's prescription. This seems to be a very logical first step, but it's one that almost never gets discussed.

A good example of why this type of regulation is needed comes from a website about Terriers, which says:

"Almost all human antibiotics can be used on dogs and almost everyone either has old antibiotics in their medicine cabinet or knows people that do. Look around, and you will probably find what you need."

  • What??!! Just what we need... recommendations that people sift through old drug supplies for a dose or two of who-knows-what, which may or may not be expired and may or may not be potentially useful for whatever problem is present, and may even be harmful. Determining whether or not an antibiotic should be used, and determining the drug and dose is not something that should be up to a pet owner. It should be up to a veterinarian.

"Drugs past the expiration date are going to be fine as long as they are no older than a year or so past the expiration date (even then they may be fine)."

  • Dumb. Drugs don't instantly go bad at their expiration date, but you don't know what you have left at that point. If you actually need an antibiotic, you need one that works like it's supposed to.

"If you prefer to order your medications outright, you can order cephelaxin (Fish-Flex) from most dog catalogues and it will cure 99% of your flesh wounds as well as most urinary tract and ear infections. Cephalexin or cefalexin is sold as a fish antibiotic in dog catalogues with full-knowledge it is being used for off-label treatment in dogs. It should cost about $30 for 100 250 mg. capsules, which is a perfect dose for a terrier."

  • Ugh!!  A good example of why loopholes like easy access to antibiotics for fish use need to be closed. Many dog internet sites sell fish drugs. I wonder what percentage of "fish" drugs actually make it into fish?

"You probably have some old amoxicillin around the house from the last time you got sick. This is fine to use even if "expired" more than a year ago. Expiration dates on non-liquid antibiotics are a marketing tool (i.e. they encourage people to throw good drugs down the drain) and have no scientific basis -- a fact demonstrated by the U.S. military."

  • Can't say I've seen that study. Expiry dates aren't a marketing ploy. You should use all the antibiotics prescribed, and if for some reason you have any left, you should throw the rest out. It has to do with health and proper use of antibiotics, not marketing.

Take home messages:

  • It's time for politicians to actually do something about antibiotic use and ban all over-the-counter access.
  • Beware of internet advice. Scrutinize sources of information carefully.

Dropping rabies requirement for licensing: Greedy and dumb

Clallam County (Washington) is considering dropping the requirement that pets be vaccinated against rabies in order to get a license. It's pretty clear that this is only based on a desire to get more people to pay for licenses. Sheriff Bill Benedict is quoted as saying "My view on this is, we're leaving money on the table by not finding a way to get more people buying licenses."

This money-driven mindset makes no sense, and raises the question "what is the purpose of licensing pet?" Is it only to provide a source of government income (in other words, a tax on pet ownership), or is it for greater purposes such as helping protect the pet and human population?

Another quote from Benedict: "You would still be required to have your pet vaccinated, but that would be more of an issue between the pet owner and the veterinarian." This isn't an issue solely between the pet owner and the veterinarian. Rabies vaccination is still required by law. Veterinarians do not have a mandate or power to require vaccination and enforce the law. With this "You still need have your pet vaccinated (wink, wink, nod, nod)" approach, the municipal government is essentially saying, "We really just want you to pay us for a license. We don't really care whether your pet is vaccinated against rabies or not as long as you give us money."

A local veterinarian wrote to the commission that "Licensing pets is sometimes the only reason an owner will get rabies vaccines... Rabies vaccinance is the law of the state, the law of the county. Licensing, in my view, is less important than vaccinating for rabies and may facilitate even more rabies cases."

Well said. The county may get more money because more people will get licenses, but it's certainly possible that fewer pets will get vaccinated. Just one rabies exposure could negate the increased revenue from more licenses based on the high costs of rabies post-exposure treatment (let alone the risk of disease, stress of exposure, costs required for investigating cases...). Since all those costs would come from other peoples' budgets, however, I doubt they're too concerned.

Benedict also stated "Most pet owners -- in fact the vast majority -- if they're responsible enough to get a license, they're responsible enough to get a pet vaccinated."

Good thing he's not a lawyer. It seems to me that he just shot his argument down. If the majority of pet owners that are responsible enough to get a license are also responsible enough to get a pet vaccinated, then why is this change required?  An attempt to increase cashflow is not a good reason to change rules that are designed to protect the public and pets from a fatal disease.

Zebra sidelines football player

No, I'm not talking about a referee, I'm talking about a real zebra. Pittsburgh State football player Joe Windscheffel will miss the entire upcoming season after being attacked by a zebra on a farm in Kansas. In a related story, Kansas State University Professor Gary West remarked about various problems associated with people owning exotic pets. Some are pretty clear, such as the risks posed by 500 lbs tigers or 20 ft pythons (or unruley zebras). Others are more insidious, such as the risks of transmitting various zoonotic diseases.

Exotic pets are an important source of zoonotic diseases. Some of these diseases, like Salmonella, are very common and well-understood. Others come out of nowhere and can cause major problems, such as the monkeypox outbreak in the US a few years ago that was caused by prairie dogs and African rodents. One problem with exotic pets is that we know little about the disease risks associated with them, and therefore we don't know what precautions should be taken or how to test them for the most important pathogens. While exotic pets can be interesting, they certainly pose an increased risk of disease compared to dogs, cats and other domestic animals for which we have a good idea of the risks involved and how to manage them. That's not to say that all exotic pets will cause disease and no dogs will - that's definitely not true. However, people having contact with exotic pets must accept an increased risk of disease exposure.

The CDC recommends that children under five years of age, elderly individuals, people with compromised immune systems and pregnant women not have contact with exotic pets. While these are the high risk groups, infections can occur in anyone. If you really want an exotic pet:

  • Stop, think, and read as much as you can before making the decision. Find out about the animal, how to care for it and what risks might be involved.
  • Make sure you can provide appropriate care. Many exotic pets die because of poor management because they're owners can't or don't know how to care for them properly.
  • Find a captive bred animal, as these animals likely pose less risk of harbouring exotic diseases.  It's also a much more humane way to get a pet than to buy a wild caught animal (especially when you consider that many animals die during capture and transit).
  • Make sure there are no high-risk people living in or visiting the household. Saying they will be in the house but won't have contact with the pet is not adequate, because infections from indirect contact can occur.
  • Remember that if you do things right, your pet should live for a while (e.g. years). If you think you might want to have kids in a couple of years, do you really want to get an exotic pet that will need to be re-homed at that time?
  • Make sure your physician knows you have an exotic pet. Various diseases that would not be an issue for the general population might need to be considered if you get sick.

Image source: University of Bergamo

Stupid things done with bats, part II

Last fall, I wrote about rabies exposure in a Montana school. The full story has just been published in CDC's Morbidity and Mortality Weekly Reports. The brief version of the story is:

  • Parent finds a dead bat carried in by the family cat and, for reasons known only to him/her, puts it in a jar.
  • The next day, the parent takes the bat to a school, takes it out of the jar, and presents it to 8 classrooms full of children. Many students, teachers and staff touch the bat.
  • The school nurse finds out later that day (I assume this finding is accompanied by a large spike in the nurse's blood pressure), and advises the parent to submit the bat for rabies testing.
  • The bat tests positive and an investigation is started.
  • 107 students and staff are interviewed and all are identified as requiring rabies post-exposure treatment. One student reported that their finger may have been pricked while sticking it in the bat's mouth, which would be a high risk exposure.
  • 74 people ended up being treated. There's no word as to why some declined.

This was clearly a completely avoidable situation that resulted in potential widespread exposure to rabies, a large investigation, stress for people and their families, as well as the expense and pain of multiple injections for many individuals - all because one well-meaning but poorly-informed parent brought a dead wild animal to school, and because none of the teachers or staff that witnessed this thought to act.

The school's insurance policy covered the $75 000 in vaccine costs (plus an additional $29 000 for vaccine that was ordered but not used by people who declined vaccination).

  • People need to be more informed about diseases such as rabies. This type of information is available on the Worms & Germs Resources page.
  • Schools need to develop and enforce policies regarding visitors and pets. Approximately 1/3 of large scale rabies exposures occur in schools.
  • Common sense needs to be a little more common.

Exotic animals in daycares... another bad idea

One more post about illogical and dangerous activities associated with animals and young children and I'll hopefully get off the subject for awhile. I came across this daycare's website today. Keep in mind (again) that the the Centers for Disease Control and Prevention (CDC) recommends that children less than 5 years of age not have contact with reptiles, and that the  Compendium of Measures to Prevent Disease Associated with Animals in Public Settings published by the National Association of State Public Health Veterinarians states that wild or exotic animals may not be appropriate in school settings. The photo gallery from this particular daycare included some great pictures of things that you should NOT do with young children. Some of the more striking example are below:

1) Letting a large snake wrap its body around the neck of a young child.

 

 2) Letting a young child kiss a snake.

 

3) Letting a child touch a turtle.

 

4) Letting a young child pet a pygmy hedgehog. (Like reptiles, hedgehogs very often carry infectious pathogens, including Salmonella.)

 

I wonder...

  • whether anyone made sure these children immediately washed their hands after they touched the animals.
  • how may kids but their hands in their mouths before they washed their hands. (Probably almost all of them, considering the "animal visit" probably went on for quite a while.)
  • whether this activity took place in the same area where the children later ate lunch or a snack.
  • whether the parents knew that this was going to happen.

I'm not against young children having contact with animals. I think pet contact can be very rewarding for young children. However, these individuals are at higher risk for infection and it is our responsibility to protect them. Putting them in high risk situations like these is inappropriate. Animal visitation in daycares is not necessarily a bad thing, if it involves animals that are a low risk species (e.g. dogs and cats), that are healthy, and that have been temperament tested (to show they are at low likelihood of biting).  It is also important that parents provide consent for their children to participate, that good hygiene practices are used (and enforced), and that the people bringing in the animals know what they are doing.

Baby chicks in preschools

Just last week I blogged about concerns regarding young children handling baby chicks in classroomsBaby 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.

Service monkeys and horses...where do we stop

I was at the annual conference of the Society for Healthcare Epidemiology of America on the weekend. This is a hospital infection control organization, and one of the talks I gave was about animals in healthcare facilities. One question that came up was about unusual service animal species like monkeys. Service animals are specially trained animals that help disabled individuals with specific tasks. The most common examples are seeing-eye dogs. In the US, the American Disabilities Act protects service animals and dictates that they must be allowed to go wherever the person goes. I don't think people have a problem with that in general. However, there are concerns with respect to non-traditional species being used in these roles, and the question at the meeting was about service monkeys. Monkeys can be incredibly strong physically, and they can carry some important infectious zoonotic diseases, so there are concerns about them being allowed in hospitals. Part of the issue is what really makes an animal a service animal.  Should all animals that help someone out (in any capacity) be considered service animals?

That same topic came up in a recent ABC News article that described a seeing-eye horse in Texas, including a video of the owner riding the horse while grocery shopping. 

I have no doubt that this horse helps out its owner and provides great joy, if not increased freedom. However, I'm not convinced that a horse is necessary to fulfill this person's need for a service animal. Why use a horse when a dog could do as good (or a better) job? How was the horse trained? Was it trained under a formal program so that it is truly helpful? What types of health and behaviour screening have been used? What are the additional risks associated with using such a large farm-animal species?

Horses, even based solely on their size, can easily cause injury to members of the public without meaning to, simply by stepping on a person's foot or bumping into them, for example.  Some people might be scared of horses, especially indoors. Horses aren't litter trained, and horse manure can carry potentially infectious agents. I have a big problem with the video of this horse in a grocery store.  At end of the day, is a horse really necessary for what this person needs, and has the horse been adequately evaluated to ensure that it is low risk to the public? I don't think the answer is yes to either question, let alone both.

We certainly must do all that we can to allow full access of appropriate service animals, but we also need ensure that novelty "service" animals don't cloud the picture and potentially have a negative impact on true service animals.  The article states "...the government has begun rethinking whether the regulations should be changed to exclude some animals." That sounds like a great idea to me. Careful review of this issue, including the benefits to people, risks to the public and the need for new species over traditional options all need to be considered. 

Image: captured from video at http://www.abcnews.go.com/GMA/story?id=7157206

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.

New York Times and Pet Health Advice: Bad Combination

I used the think the New York Times was a reputable newspaper and source of reasonable information. However, considering some of the articles I've seen, I no longer have a good opinion of this newspaper. One example from a few years ago came across my desk recently.  The article is basically an infomercial for an unqualified person that sells pet health products.  The person in question is an industrial designer by training - you'd think a reasonable news source would look for someone with training in veterinary medicine, nutrition or pharmacology when discussing pet health. (Given the level of expertise they require, I guess I'm qualified to comment in the New York Times about how to solve conflict in the Middle East or fix the economy). Among some of the gems in this article are:

  • People "have to include raw and whole foods in their pets' diets..." and "[Pets] don't get E. coli or Salmonella." Tell that to the dogs and cats that get sick and die from Salmonella. I can't believe people that sell raw foods continue to falsely claim that pets can't get Salmonella. Outbreaks of salmonellosis associated with raw foods have been reported. Dogs have even been sickened in the recent peanut butter Salmonella outbreak.
  • The big problem with the pet food industry is that people treat pets like televisions and get a new one if they're sick. Apart from the last part being ludicrous, what does that have to do with the pet food industry?
  • The alley dogs this guy grew up with in the Bronx lived a long time.  Now, a dog is considered old if it lives past 7 years. Show me any evidence that feral dogs live longer than household pets. Not a chance.
  • Pets are dying younger because of low grade nutrition and pharmaceuticals. Again, show me evidence that pets are living shorter lives. I'm certain it's the exact opposite.

People need to make sure that they critically assess things that they read about pet health and diseases. Just because something is written in a high profile newspaper doesn't mean it's necessarily correct. In the internet era, volume overload and differentiating good sources from bad sources can be difficult. Here are some tips:

  • Look for advice from qualified individuals. That's not a guarantee, but I'd rather have my car fixed by a mechanic than a gardener.
  • Beware of advice from people that are in a conflict of interest, such as people selling a product. For most reputable companies, representatives can be sources of good information, but unfortunately it's not always true.
  • Ask your veterinarian about questions relating to animal health and nutrition.
  • Use common sense. If something seems too good to be true, it probably isn't. Something that claims to cure all that ails you probably cures nothing.

A rebuttal to this article can be found here.

Why not to feed puppies human breast milk (in case you needed a reason)

I came across an interesting (and somewhat bizarre) paper in the journal The Lancet from 1988. It described a case of listeriosis in a baby. Listeriosis is caused by the bacterium Listeria monocytogenes. Human infections are usually acquired from eating contaminated food. I made some comments about the risk of listeriosis to household pets in an earlier post during the recent  foodborne outbreak of listeriosis in Canada that was associated with contaminated meat

The paper from 1988 puts a "new spin" on potential sources of infection for pets.

The baby described in the report was not breastfed for the first three days of life because her mother had some post-delivery complications. The surplus milk that was collected over those three days was reportedly fed to a litter of Doberman puppies. All three puppies in the litter became sick the day after the child began showing signs of illness. Listeriosis was diagnosed in both the baby and the puppies. Listeria monocytogenes was cultured from the mother's milk. Apparently the baby and the puppies were all infected by drinking the mother's milk. The baby, and two of the three puppies, survived.

Certainly, human-associated listeriosis in pets is extremely rare, and (presumably) so is feeding puppies human milk. This case just shows how infectious diseases can do strange things, and that diseases can move between people and animals in both directions. It also highlights that knowing the health status of both animals and people is important for physicians and veterinarians to make informed decisions about diagnosis and treatment of some diseases.

Stupid things done with snakes

A Las Vegas woman reportedly agreed to babysit a friend's pet python. She brought the 18-foot snake into her house, where her three-year-old son also lived. Bad move, for many reasons. At one point, the woman returned from the bathroom to find the snake wrapped around her son, who was turning blue. The mother stabbed the snake 17 times before it released the child.

Large snakes can be dangerous, particularly to young children. Without proper (escape proof) enclosures and people who know how to handle them (and some common sense), there is a real risk of injury or death, as was clearly demonstrated here. Also, reptiles of all kinds (including snakes) are prime sources of Salmonella infection. Allowing reptiles to roam the house and/or have direct or indirect contact with young children is an unnecessary risk. Various groups have stated that reptiles are not appropriate pets for children less than five years of age, nor for people with weakened immune systems, primarily because of the risks of Salmonella.

Hopefully the child in this terrifying case is alright, although he was also bitten, which can lead to complications of its own. The snake had to be euthanized because of the stab wounds. So, we have an injured child and a dead snake resulting from the stupidity of a couple of adults who didn't apparently see a problem with leaving a large predatory carnivore free in the same location as a prey-sized child. Authorities are still deciding whether to charge the mother with child endangerment.

Stupid things done with bats

I'm constantly amazed at what some people do with bats. Bats are a leading cause of human rabies exposure in North America.  Despite extensive efforts to educate people about the importance of avoiding contact with bats, some people still either don't know or don't take these warnings seriously.

The latest bizarre example of stupid things done with bats occurred in Montana, where a parent brought a dead bat to a school and let young children (kindergarten and grade 5 students) touch it. Touching a bat in itself is a bad idea, let alone touching one that has died of unknown causes and encouraging kids to touch it. The teachers apparently had no objections to this activity. The parent who brought the bat had the students use an alcohol hand sanitizer after touching the creature, but it is still very irresponsible for someone to encourage children to touch a high-risk animal, regardless of what is done after. I'm sure the parents of the children didn't know beforehand, and certainly some were no doubt very upset when they found out about the incident (or livid would be a better description, if it was my kids that were involved). School officials did not find out about the dead bat until after its little visit, at which time the local and state public health authorities were contacted. The bat was tested and was positive for rabies.

Overall, the risk of rabies transmission is probably low in this case, but not zero.  It has therefore been recommended that the 80 students that may have touched the bat be given post-exposure rabies shots, which may cost up to $800 per child!. Another ten children may have touched the bat at a soccer practice - for a dead bat, it sure covered a lot of ground!

  • Never touch a bat, dead or alive.  Obviously, if you shouldn't touch a bat, you shouldn't encourage kids to do so either!
  • Unstructured and unapproved contact with animals in classrooms should be prevented. Animals can be good educational tools, but only if student and animal health and welfare are properly addressed.

More information on Rabies is available on the Worms & Germs Resources page.

Petting zoos: What's wrong with this picture, Part II

Recently, my family went to an Ontario aviary/animal park. It was possible to touch many of the animals, and contact was encouraged because they sold food for the animals. The kids enjoyed having contact with animals, but this facility was an example of completely inadequate (or negligent) infection control practices. There's actually not much wrong with the picture in this post. The problem is that there was absolutely no means for people to wash or disinfect their hands after touching the animals. This is truly astounding in this day and age, with the increased awareness of the need for hand hygiene in these situations. Even at small, temporary animal exhibits and local fairs, handwashing facilities have become standard.  I can't fathom why a large, permanent animal park wouldn't be set up properly. (It was even possible for people to touch aquatic turtles, which are very high risk for Salmonella transmission, but that's another story.  More information on turtles can be found on the Resources page).

What do you do if you want to have contact with animals but don't know whether you'll be able to wash your hands? Bring your own alcohol-based hand sanitizer. They're cheap, easy to find and effective, and it never hurts to have them on hand (pardon the pun).

Discussion of other petting zoo issues and links to other resources can be found in our Petting Zoo archives.


"Pet" bat bites child

A woman from Kansas was cited for keeping exotic pets within city limits after her son was bitten by one of the family's pet bats. The bats were confiscated and will be tested for rabies.

Some animals make good pets, some are mediocre and some are completely inappropriate. Bats are in the last category. Bats are the main vector for rabies virus in North America and they do not have to look sick to be carrying rabies. Bats can bite when being handled and bites are often very small, so they are not always taken care of or even noticed. A person not reporting a seemingly harmless bat bite is a common history in human rabies cases.

Even if rabies didn't exist, keeping pet bats would still be a bad idea.  Bats are very difficult to care for  properly, and rarely survive for long in captivity, except in well-run zoos with excellent facilities and very knowledgeable caretakers. 

More information on rabies is available on our Resources page.

Horse visits hospital

Recently, a story about a man who brought a horse into a hospital to visit his father was widely reported. The horse apparently made it to the man’s room, which included a trip in an elevator. The son, who appeared intoxicated, was eventually asked to leave (and take the horse with him). Said a hospital spokesperson “We do have a pet visitation policy, but it does not include a horse”. Strangely, the horse that was brought to the hospital apparently wasn’t even the father’s horse (which supports suspicions of the son’s lack of sobriety).

There are guidelines about which animals are appropriate for hospital visits, although it shouldn’t take an expert to figure out that a horse is not an appropriate candidate. Kicks, bites, and trauma from being crushed or run over are among the most obvious concerns. Horses can also carry a variety of bacteria that are potentially dangerous, especially to people in hospitals. These include Salmonella and methicillin-resistant Staphylococcus aureus (MRSA). There also aren’t that many house-trained horses out there.

So, while I can easily see how someone in a hospital would like to see his or her horse, there’s no way this should even be considered.

Some closing thoughts
-    Would you like to ride in an elevator with a horse?
-    Would you like to be stuck in an elevator with a horse?
-    Do you think the horse was house trained?
-    Do you think any of the healthcare personnel washed their hands after touching the horse?


This isn't the first time a horse has been in hospital, and some even get invited. The picture is from a story in Veterinary Practice News that described a program where horses were brought into hospitals!