Worms and Germs Blog : Animal Health & Diseases : University of Guelph : Ontario Veterinary College : Zoonotic Diseases : Guelph, Hamilton, Ontario

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.

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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!)

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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)

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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...

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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."

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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.

(click image for source)

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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.

(click image for source)

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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.

(click image for source)

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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.

(click image for source)

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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.

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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)

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Pet bites are a big problem. 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 his 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.

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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!

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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.

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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.

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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

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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.

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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

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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.

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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.

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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.

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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!

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