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

There was another paper published in the August issue of the Canadian Veterinary Journal about Baylisascaris procyonis (roundworms) in raccoons, this time in Winnipeg, Manitoba (Sexsmith et al 2009). The study was actually undertaken after infection with B. procyonis larvae was identifed as the cause of death of several animals in the collection at the Assiniboine Park Zoo in Winnipeg.

The researchers collected feces from 52 active raccoon latrines around the city and from 114 "nuisance" raccoons that were caught, euthanised and submitted for necropsy to the local lab. Interestingly, the vast majority of latrines and nuissance raccoons were found close to the two major rivers that run through Winnipeg. Half (50%) of all the latrines were positive for roundworm eggs on at least one sample (out of a possible 3). Among the necropsied raccoons, 61/114 (53.5%) were positive for roundworms. Adult raccoons were almost four times as likely to carry roundworms than juveniles (which is in contrast to a previous study that found juveniles more likely to be infected), and bigger raccoons (over 2.75 kg) were more than seven times as likely to carry roundworms compared to smaller animals. Although there are regions where the prevalence of B. procyonis s reported to be very low, Winnipeg, like many other regions of North America, has joined the ranks of those where the prevalence is high and the public needs to be aware of the associated risks.

The most severe zoonotic disease caused by B. procyonis is called neural larval migrans (NLM), which results from migration of parasite larvae through the central nervous system (i.e. brain). Two of the reasons this is much more of a concern with raccoon roundworms (Baylisascaris) compared to dog and cat roundworms (Toxocara) are:

1) A massive number of parasite eggs are passed in the feces of infected raccoons (which typically have a very high burden of adult worms). Coupled with the fact that the eggs are further concentrated in areas where many raccoons defecate (latrines), this can lead to heavy exposure of people (or animals) who come in contact with the soil in these areas, which greatly increases the risk of infection.

2) The larvae of B. procyonis are very active migrators, and they get bigger as they migrate through tissues - much bigger than Toxocara larvae ever get, which means they also tend to cause a lot more damage before they're finally (if ever) trapped or killed by the body's immune response.

Natural infection of dogs living in the same areas as raccoons has been found - it's not common, but it appears to occur frequently enough to warrant noting. Dogs and cats can also be infected by their own species of roundworms, which will also result in parasite eggs being shed in the feces. It's important to have your veterinarian perform a fecal examination for your pet on a regular basis so any parasite infestations (roundworm or other) can be treated.

Dogs and cats may also be susceptible to larval migrans in the same manner as people (and the animals at the zoo in Winnipeg) if they are exposed to high numbers of infectious eggs. Remember that roundworm eggs must be swallowed in order for infection of any kind to occur, so good hand hygiene and avoiding soil contamination of food are key to preventing transmission. Also, do not allow your pet to dig or play in an area where raccoons defecate (preventing direct contact between your dog and raccoons should go without saying!).  And of course, feces of any kind (and from any species) should be treated as infectious material, and handled with appropriate precautions.

More information about Baylisascaris and raccoon latrines is available in our archives.

• Email This
• Print
• Comments
• Trackbacks

When we have a -30C windchill and snow on the ground, my first thoughts usually aren't about survival of bacteria in the outdoor environment. However, some microorganisms are well adapted for survival in various adverse conditions and we shouldn't assume that cold=dead for every bug of concern. Along that line, we received a question recently about survival of Leptospira and I passed it along to our lepto expert, Dr. John Prescott. Here's his guest post:

A reader in Ohio owns a dog that had leptospirosis, and had some questions about leptospirosis that may be of general interest.

Q1. Since the yard is likely contaminated with leptospires, she asked “How cold does the temperature have to get before the Lepto organisms are killed?”

A1. Once it’s frozen, as it is now in January, they’re dead. Leptospires are fragile bacteria that are killed by dry heat and by freezing. They survive well in moist or wet environments, with moderate temperatures. In some countries leptospirosis is called “mud fever” or “fall fever” since this description captures so well the environmental conditions under which they thrive.

Although leptospirosis in dogs can occur at any time in the year, it mainly causes disease in the fall, late September to December, peaking in November. The increasingly mild and prolonged falls that we have experienced in the last decade are thought to be an important reason that leptospirosis has resurged in dogs. Interestingly, there is often a “blip” of leptospirosis in dogs in March in Ontario (and likely Ohio), since this is when the snow melts and conditions are wet, even though we can still get freezing at that time. I suspect that this is also the time when the raccoons that are thought to be the main source of leptospirosis for dogs are again active after the winter, and are foraging for food for themselves and their babies.

Q2. Do dogs still shed leptospires after they’ve been treated?

A2. No. Leptospires are quickly killed by the antibiotics used in treatment, amoxicillin or doxycycline. There is no danger that dogs treated for a week with these drugs are a risk to people or other animals. You may read in otherwise very reputable textbooks that these antibiotics “do not eliminate the carrier state” but I have no idea where this misunderstanding comes from.

Q3. Where can I find out more about leptospirosis in dogs?

A3. I like the web site http://www.leptoinfo.com, which is maintained by a vaccine company. I was surprised how many web sites devoted to leptospirosis that there are, but like much on the internet some contain highly misleading information. The “Worms & Germs” site has good past blogs about canine leptospirosis and is usually (just kidding, Scott) a reliable source of information.

One very common entrenched misconception, which is very hard to kill, is that vaccination does not stop animals shedding the organism. This is quite wrong. I suspect this misconception came from an experimental study half a century ago when dogs with pre-existing kidney infection with a leptospiral serovar called Canicola were vaccinated. It would not be expected by anyone that these animals would stop shedding since antibodies don’t penetrate into the place in the kidney where the leptospires live and from which they are shed in the urine. What vaccination does incredibly effectively is to prevent leptospires from actually reaching the kidney and setting up home there. The leptospires are removed by antibodies in the blood, so they never reach the kidney.

• Email This
• Print
• Comments
• Trackbacks

A large number of rabies cases in Santa Cruz County, Arizona has lead to the rare practice of implementing a county-wide rabies quarantine. Fifty-four cases of rabies have been diagnosed so far this year, mainly in skunks. That's about twice as many as normal.

Quarantine is probably not the best description of what they are doing, but they are taking measures to improve vaccination of pets, reduce roaming pets and discourage human-wildlife interaction.

For the next 60 days, the following rules are in place:

• Dogs and cats must be vaccinated against rabies.
• Dogs must be confined to the property or on a leash.
• People are not allowed to feed wild animals.
• Pet food must not be left outdoors after sundown.

Those are all pretty standard measures that should be used anytime. It sounds like these rules already exist in Santa Cruz County but their "quarantine" means that they will be aggressive in enforcing them. Increasing enforcement is a good idea, but ongoing efforts after this quarantine period are also needed because rabies will continue to be a risk in that area.

Image source: www.acmeanimalremoval.com

• Email This
• Print
• Comments
• Trackbacks

This morning, as my dog Meg and I went out to get the newspaper, she ran towards our pool fence, barking (pretty unusual for a dog that is afraid of chipmunks). I wondered what the issue was until I saw a black and white tail sticking out. The pool has been closed for the season and there was a skunk standing on the cover. The cover's about 1.5 feet below the deck and the skunk couldn't get out.

After going over various options, like putting things in for the skunk to climb out on (unsuccessful), getting a live trap (too lazy to go find one), scooping it up with the pool skimmer net (a matter of how badly I'd be sprayed, not whether I'd be sprayed), getting a wildlife removal person in (too cheap to get someone else to do it) or lacing food with a sedative, I came up with the following plan:

1. Find a large garbage pail with a handle. Tie a long rope to one handle.
2. Place the garbage pail on its side in the pool, with the handle tied to the rope on top.
3. Lure the skunk into the pail (e.g. with food) or, as I did, herd it in using a LONG pole.
4. When the skunk is inside, pull on the rope to tip the garbage pail back up.
5. Cover the garbage pail. A plastic kiddie pool works well.
6. Carefully but quickly lift the covered garbage pail out of the pool.
7. RUN... upwind.

It worked for me... no guarantees however.

• Email This
• Print
• Comments
• Trackbacks

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.

• Email This
• Print
• Comments
• Trackbacks

A Montreal man is undergoing rabies post-exposure treatment after being bitten by a bat in Lachine's Summerlea Park. He found the bat lying on the ground and when he picked it up to take a closer look (surprise, surprise) the bat bit him.

This incident shows yet again the need for better rabies education. While we don't want to create fear and loathing of bats, we should consider them rabies-positive until proven otherwise. That doesn't mean we want to eradicate them. It means we want to educate people to enjoy them from a distance and never have direct contact with them.

Never try to touch a bat. A bat lying on the ground in a park is not a healthy bat. It may be sick for various reasons, but rabies is certainly a possibility. If you come across a sick bat, call animal control. They can safely remove it so that no one has the chance of being bitten. If someone has had contact with the animal, the bat must be tested for rabies, as was done here. Rabies is preventable using proper post-exposure treatment, but it's very expensive, a hassle and a series of vaccine's isnt' exactly fun.

• Email This
• Print
• Comments
• Trackbacks

We've written various posts about raccoons, raccoon latrines and concerns about the raccoon roundworm (Baylisascaris procyonis). I received a question today about how to keep raccoons from coming back after a latrine has been identified and cleaned. It's a good question, and one without a simple answer.  I've looked through various sources and have found a wide range of recommendations. (Whenever I see such a wide-ranging list of recommendations, I wonder whether anything actually works.)

Home remedies include:

• Sprinkling pure soap flakes on the lawn and watering thoroughly
• Mixing bone meal in garden soil
• Sprinkling diluted tabasco sauce over fruits and vegetables (wash before eating, as you should anyway!)
• Lighting up the area where raccoons are a problem

Various commercial deterrent compounds are available, such as one that apparently has the scent of a coyote, or one that's a combination of vinegar, pepper and sulfur.

Another approach is motion-sensitive deterrents. Motion-sensor-based lights can be useful since raccoons often come rooting around in the evening or overnight, and lights that turn on when they approach could be effective. These would require a power source, which could be limiting in some places like sheds. Similarly, motion-sensor based systems that spray water or citronella (sometimes used to keep cats out of certain areas or off countertops) could be useful. Battery-operated units could be used anywhere. (Here's a link to one. I've never used it but it shows you what I'm talking about). There are also motion sensors that hook up to hoses.

One problem with deterring raccoons is their intelligence. They can often find ways around deterrents, or adapt to them. Along with any attempts to actively deter the raccoons, it is also important to try to reduce the desire of the raccoon to come to the location. If there is a good food source or other desirable attraction, the raccoon will probably try harder to stay around. Tightly covering garbage cans and removing other possible food sources (e.g. food for outdoor cats) are important steps. Making sure neighbours (or other family members) aren't feeding the raccoons is also important, because food is a great motivator.

• Email This
• Print
• Comments
• Trackbacks

A reader posed this question, with respect to having raccoons living around the house:

"One thing that causes me concern with the raccoon roundworm is the possible danger of infection to my pets and myself through the feces left behind from the raccoons in the yard and possibly in my vegetable garden. Can I acquire the roundworm from working in the soil and/or from my root vegetables etc? My cats mingle near the raccoons, they don't bother each other, should I get my cats tested?"

Certainly, working outside (particularly in soil) leads to the potential for exposure to many disease-causing agents, including Baylisascaris, as well as dog and cat roundworms (Toxocara spp.). Eating unwashed/uncooked vegetables is also a risk. However, in the grand scheme of things, the risks to the average person (not very young or very old, functional imune system) are minimal, especially if basic hygiene measures are used, such as washing hands after working in the garden, and thoroughly washing vegetables. Raccoons tend to defecate in the same specific areas most of the time (raccoon latrines), so in general gardens probably aren't common sites for raccoon feces, although it certainly can occur. Cats are probably more likely to defecate in gardens. We shouldn't take concerns about Baylisascaris lightly, because even though disease (larval migrans) is very rare, it can be very severe.

Now, about testing cats for Baylisascaris - there's not much use, for several reasons:

1) The likelihood of a positive result is very low. The prevalence of Baylisascaris in dogs is very low. Little is known about the prevalence in cats specifically, but it is presumably very uncommon there as well.

2) It can be difficult to differentiate Baylisascaris from the feline roundworm, Toxocara cati. Unless the lab has experience with this, they may not be able to tell the difference. Therefore, you might get a misleading result.

3) What does a positive test tell you? It tells you that the cat is shedding this parasite or that is has ingested eggs that are just passing through the intestine.  The risk to people is still minimal if litterboxes are cleaned regularly. Contaminated stool is not infective until it has sat around for days to weeks, so regularly cleaning the litterbox and good handwashing can control the risk.

4) What does a negative test tell you? It tells you that the parasite was not detected on this single sample. It could have been there but not been identified. It might not be there today but could be there tomorrow (though this is still unlikely). A single negative test today does not tell you too much.

5) What would you do with the results? Probably not much. In the very unlikely chance that results were positive, it would likely be recommended to repeat testing to see if eggs are just passing through or whether the animal truly is infected with the parasite. That would determine whether treatment is needed. Otherwise, recommendations would be pretty much the same in both cases (good regular deworming program as directed by your veterinarian, proper handling of cat feces...).

The best way to prevent exposure of your cat to Baylisascaris (as well as other pathogens, predatory wildlife, vehicles, etc.) is to keep it inside.

• Email This
• Print
• Comments
• Trackbacks

...Macaroni penguins, that is. There is a report in a recent edition of Emerging Infectious Diseases about isolation of Campylobacter jejuni from Macaroni penguins in Antarctica. Campylobacter is a bacterium that can cause diarrhea in people and animals, and which can also be found in the intestinal tracts of a wide variety of animal species, even when they’re healthy. Researchers typed the Campylobacter isolates from a group of penguins in Antarctica and found that many were a strain that commonly affects people. They had a few different ideas about how the penguins became infected. One possibility is contamination from toilet wastes that a nearby research station dumped into the surrounding water. They thought that ships discharging sewage into the ocean near the penguins' feeding grounds could also be a source of the bacteria, as could migratory birds like albatrosses that spend part of the year closer to people. Whatever way it got there, a penguin colony provides an exceptional opportunity for Campylobacter to spread, since huge numbers of penguins live in very close proximity to each other. Fortunately, Campylobacter rarely causes disease in birds, and we hope that's true with this strain in penguins as well.

This report shows how closely linked humans and animals can be, even when we usually live far apart. It also shows why we keep saying that a global ecological approach to infectious diseases is needed - we need to look at the big picture.

More information about Campylobacter can be found on the Worms & Germs Resources page.

• Email This
• Print
• Comments
• Trackbacks

Spring appears to have finally sprung in earnest in Southern Ontario (although we may still get one more frost on the weekend, so I hear) and people are getting back out into the garden.  An increasingly  popular trend in recent years, particularly this year now that the Obama's are doing it too, is vegetable gardening.  Lots of people like the idea of growing their own veggies in their own backyard, or perhaps in a community garden plot for city dwellers who still want to get their hands dirty - it's economical, good for the environment, and the plants can be grown "organically" without the use of chemicals or pesticides.  However, pesticides and garden bugs aren't always the only things to worry about having on your fresh veggies.  We received the following comment from a Worms&Germs reader:

"...What if veggies get infected with raccoon stool[?] Can eggs be killed after [the] veggie is grown and ready to eat?"

Great question.  The concern in the case of raccoon stool is the eggs of the roundworm Baylisascaris procyonis, which can be passed in huge numbers by a relatively high percentage of raccoons in many regions.  If swallowed, the eggs release larvae which can migrate through the tissues of the body, rarely causing visceral, ocular or neural larval migrans.

The good news:

• Raccoons like to defecate in the same areas most of the time, usually on a relatively flat, elevated surface (e.g. woodpile).  These areas become raccoon "latrines", and the soil in the area can become very heavily contaminated with roundworm eggs.  The good part is that most raccoons therefore not defecate in your garden.
• Vegetables cannot become "infected" by the parasite - the eggs cannot be absorbed or otherwise get inside a vegetable, they can only contaminate the parts of the plant that are directly in contact with soil.

The bad news:

• Even though raccoons may not poop in your garden, they can still track roundworm eggs into the soil on their fur or paws when they come by to explore your crop, so you should always consider soil outside as potentially contaminated.
• Baylisascaris eggs are highly resistant to disinfectants and chemicals, so they can't be killed this way.
• Raccoon roundworms aren't the only parasites that may be found in garden soil.  Dogs and cats can carry other roundworms (Toxocara spp.) which are also capable of causing larval migrans if swallowed (although infection with these worms in dogs and cats is not nearly as common as infection with Baylisascaris in raccoons).  Cats in particular, unfortunately, do sometimes like digging in gardens and may sometimes use a garden as a litterbox.
• Soil, particularly if it's contaminated by the stool of any animal, can also contain many different kinds of bacteria such as Salmonella.  Even if you can somehow protect your garden plot from animals, purchased garden soil and fertilizers may contain or may have come in contact with animal stool somewhere along the way.

So how do you make your garden veggies safe to eat?

• Wash wash wash: Because Baylisascaris eggs are so difficult to kill, the best thing to do is physically remove them from all surfaces of your vegetables by washing thoroughly to remove all visible dirt before doing anything else.  If you cut into a vegetable before washing it, the soil on the outside can contaminate the inside.
• Peel peel: Peeling vegetables ensures that all dirt (including any dirt stuck in tiny crevices on the vegetable's surface, or dirt you may not be able to see with the naked eye) is removed prior to consumption, but it's still crucial to wash the veggie first (and your hands) before peeling.
• Cook: From an infection control perspective, it's best to cook vegetables before eating them.  This actually won't do anything to Baylisascaris eggs - these have to be removed by washing and peeling - but it does help kill bacteria that either contaminated the veggies out in the garden or that contaminated the veggies during their preparation in the kitchen.  For those of us who like our nice crunchy vegetables, obviously cooking them won't do, therefore washing and peeling become that much more important.

And, of course, always wash your hands thoroughly with soap and water after you've been working in the garden, even if you wear gloves.

In a lot of urban areas, it's hard to prevent raccoons and other animals from getting into yards and gardens.  There are things you can do to discourage raccoons from hanging around your house, and if raccoons establish a latrine on your property it must be very carefully cleaned up.  For more information on Baylisacsaris, raccoons and cleaning up raccoon latrines, please see our archives.

• Email This
• Print
• Comments
• Trackbacks

Quarantining animals that have potentially been exposed to rabies is a standard practice, but quarantining a whole town is new to me. Because of a large increase in rabies cases in the Flagstaff, Arizona area, a rabies quarantine was established on April 8th by the Coconino County Board of Supervisors. The quarantine requires all dogs and cats to be enclosed or secured on their owner's property. When off the property, animals must be on a leash that is no longer than six feet in length. All dogs and cats must be vaccinated, and low-cost rabies vaccine clinics have been held to help increase compliance with this requirement. Vaccination of wildlife using baits containing an oral form of rabies vaccine will also be performed. The quarantine also restricts feeding and interacting with wildlife. Also, people cannot leave pet food outside after sunset and all compost piles must be completely enclosed.

This is an aggressive approach to rabies control in an area experiencing a wildlife outbreak of the disease. They've implemented comprehensive but still quite practical measures that should help reduce the risk of exposure of domestic animals (and people) without a significant negative impact on pet owners. I've mentioned my concerns about rabies vaccine clinics in the past, but this is a situation where I think it's a good idea.

It's always hard to evaluate the effectiveness of outbreak measures, because you never know what would have happened if nothing had been done. Regardless, it will be interesting to see how well this quarantine works, both in terms of the number of new rabies cases they see and the response of citizens to these restrictions. It would be very useful if Coconino County personnel provide information about how things went when the quarantine is over - the information might be useful for management of future rabies outbreaks.

• Email This
• Print
• Comments
• Trackbacks

A recent edition of the Veterinary Record contains a case report of Weil's disease in a person that adopted a feral (wild) rat (Strugnell et al, 2009). Weil's disease is a severe disease of the kidneys, liver and other body systems that can develop after acute leptospirosis (infection by Leptospira bacteria). This group of bacteria can infect a wide range of animals and is typically shed in the urine. The person that was affected adopted the rat after it was caught by her neighbour's cat. The paper says that the rat was "urinary incontinent" - not something we usually notice about rats since they are not typically litter or house trained. I presume this means the rat was urinating frequently when out of its cage, including when it was being handled. Because of this, the owner reported that she "aimed" to wash her hands after every time she touched the rat.

A couple of weeks after adopting the rat, the woman was admitted to hospital because of lethargy, muscle aches, mild abdominal pain, cough and a bloody nose. Blood tests showed that she had decreased levels of white and red blood cells, as well as liver and kidney disease. After further testing she was diagnosed with leptospirosis. She had to be treated in the ICU, but eventually made a complete recovery. The adopted rat and the other rat that she owned were euthanized by the owner's partner shortly after she was admitted to hospital. Testing of the adopted rat identified Leptospira in the kidneys.

This is another example of why wild animals should be left in the wild, and another case highlighting the need for veterinarians, physicians and public health personnel to work together.

More information on Leptospira and leptospirosis can be found on the Worms & Germs Resources page and in our archives.

• Email This
• Print
• Comments (3)
• Trackbacks

ProMed mail has a report about 2 cases of Baylisascaris procyonis infection in people in Brooklyn, New York.  Baylisascaris is the raccoon roundworm and is very commonly found in the intestinal tract of healthy raccoons. Raccoons shed this parasite in their stool, and after a short period of time, the parasite larvae become infective to other animals and people. Infective larvae can survive for a long time in the environment. People become infected by swallowing the larvae that can be found in dirt or on any object contaminated by raccoon stool. Disease in humans due to this parasite is rare but can be extremely severe.

The first case in this report involved an infant with neural larval migrans, a condition caused by migration of the roundworm larvae through the brain. Despite treatment, the child now has permanent brain damage because of this disease. Unfortunately, this is not uncommon consequence, as the infection is not usually identified until severe and irreversible damage has already occurred. The child had a history of eating soil, and swallowing soil contaminated with raccoon feces is the most likely source of infection.

The second case involved a 17-year-old with ocular larval migrans, which is caused by migration of the parasite larvae through the eye. The parasite was killed using laser therapy, however the patient lost all vision in the affected eye before the infection was identified. There was no mention of where or how the teenager may have been exposed. Infection of someone of this age is very uncommon, as most 17-year-olds are much less likely in ingest (intentionally or accidentally) raccoon stool. It would be useful to know whether this patient had a developmental disability which results in an increased likelihood of swallowing dirt or feces, or whether there may have been some other type of exposure.

Baylisascaris infections in people are extremely rare, despite the fact that a large percentage of raccoons carry this roundworm. This report of two cases occuring in the same area within a few months of each other is surprising.  Hopefully it's just a bad coincidence, and not an indication of some change in the incidence of this disease. Avoiding Baylisascaris means avoiding ingestion of raccoon stool. Sounds simple enough, but this is of particular concern with young children and people with developmental delays who are more likely to swallow contaminated dirt or stool, or put dirty/contaminated hands or objects in their mouths.

More information about Baylisascaris and preventing transmission of the infection can be found in our archives, as well as information about cleaning up raccoon latrines.

• Email This
• Print
• Comments (2)
• Trackbacks (1)

As you undoubtedly know, a large Salmonella outbreak has occurred in the US, associated with contaminated peanuts. The scope of this outbreak continues to expand in unexpected areas, including pets. The latest development is a voluntary recall of bird seed. The recall affects 20-pound packages of Wild Birds Unlimited Wildlife Blend bird food (produced by Kentucky-based Burkmann Feeds) with the manufacturing date code 81132200 2916 08124. 

The contaminated bird seed was linked to the deaths of several birds in North Carolina, and it was confirmed that the bird seed manufacturer received peanuts from the Georgia facility that was implicated in the Salmonella outbreak.

People that have used this bird seed should clear out their bird feeders, ideally while wearing gloves. The feeders should be thoroughly cleaned and then disinfected (although this may be easier said than done). Hands should be washed after handling the bird seed, potentially contaminated feeders or any other potentially contaminated items.

The risk to people is presumably quite low, but people handling the bird seed could potentially contaminate their hands with Salmonella and then inadvertently swallow some of the bacteria. Concerns are greatest in people with compromised immune systems, the very young, the elderly and people taking antibiotics, as they are more likely to get sick following exposure to small numbers of Salmonella.

More information about Salmonella can be found on the Worms & Germs Resources page.

• Email This
• Print
• Comments
• Trackbacks

A 55-year-old man in Missouri recently died of rabies.  He was the first human rabies victim in that state in close to 50 years. He was apparently bitten by a bat in mid-October and started to show signs of rabies about six months later.

This tragic incident highlights a few important points. All bats should be considered rabid until proven otherwise. Any bite from a bat should be considered rabies exposure. If this person had received treatment for rabies exposure, he almost certainly would not have developed rabies. Post-exposure treatment consists of a dose of antibodies against the rabies virus as well as a series of 5 vaccinations over four weeks.  These are normal vaccines given in the arm - not like the old horror stories of reaction-prone vaccines given in the abdomen.

• Treat every bat as rabid. If you are bitten or may have been bitten (i.e. you were asleep in a room with a bat), you should consider yourself exposed unless the bat is tested and shown to be negative.
• If you are exposed to rabies, get proper treatment. It's not a big deal and it can save your life. See this post for my experience with bat rabies.
• Dogs and cats must be vaccinated against rabies. Even if they don't go outside they can still be exposed. It's also the law in most areas.
• Bat-proof your house.  Seal up holes and crevices where bats may hide or through which they may get into your home.
• If you wake up in a room and see a bat, don't let it out. It must be caught and tested for rabies, or you should receive post-exposure treatment. Bats can bite sleeping people without them noticing.
• Wildlife should want to stay away from people. Wild animals that are acting strangely or do not appear afraid of people could be rabid. Stay away from such animals and report them to your local animal-control official.

More information about rabies can be found on the Worms & Germs Resources page, and in our rabies archives.

• Email This
• Print
• Comments (3)
• Trackbacks

A recent report in the Journal of the American Veterinary Medical Association by Jesse Blanton and colleagues provided a detailed report of rabies infection in the US in 2007. Here are some of the more interesting points:

• Rabies was diagnosed in 7 258 animals and 1 person. That's a 4.6% increase in animals from 2006, but 2 fewer human cases.
• 93% of cases were wildlife: 37% raccoons, 27% bats, 20% skunks, 7% foxes.
• 0.8% of cases were in cattle and 0.6% were in horses.
• 4% of cases were cats, with the largest numbers of feline cases in Virginia, Florida, Pennsylvania, North Carolina, Maryland, New Jersey, New York, Georgia, Texas and Kansas.  Cat cases peaked in June and July.
• 1.3% of cases were dogs, with the largest number of canine cases in Texas, Georgia and North Dakota. Dog cases did not appear to have a seasonal pattern.
• Small numbers of a variety of other species were diagnosed, including pigs, wolves, opossums, bobcats, coyotes, otters, bears, deer, mongooses (in Puerto Rico), groundhogs and beavers.
• The largest number of rabies cases occurred in Texas (969).
• The infections that occurred were due to several rabies virus variants in circulation in North America, including raccoon rabies virus, skunk rabies virus, arctic fox rabies virus, bat rabies virus and Texas gray fox rabies virus.  In each region of the continent, one or more of these rabies virus variants may be more common.
• No infections with canine rabies virus were identified. Dogs and coyotes were infected by other variants of the rabies virus, but not with the dog variant.  It is believed that dog-to-dog transmission of canine rabies virus no longer occurs in the US.
• The one human rabies case in 2007 occurred in Minnesota, and was probably due to exposure to a rabid bat.

More information on rabies can be found on the  Worms & Germs Resources page, and in the rabies archives.

• Email This
• Print
• Comments
• Trackbacks

This post has been updated with new information as of October 2, 2008.

An article was published on Sunday in a local Guelph newspaper about a 14-month-old child who has been battling infection with Baylisascaris larvae in a Hamilton (Ontario) hospital for the last two weeks.  This comes on the heals of a very recent Worms & Germs post about Baylisascaris procyonis - the raccoon roundworm.

The disease caused by migration of Baylisascaris larvae through the body - visceral larval migrans - is uncommonly diagnosed in North America, although it may be more common than we think because it is difficult to diagnose with certainty, and the signs in mild cases may be very non-specific.  The most severe form of the disease is called neural larval migrans, which occurs when the larvae migrate through the brain or spinal cord, as in this most recent case.

The parents of the toddler in the article, a toddler who is still blind and cannot sit up on his own as a result of his infection, have a message for parents: keep raccoons out of your yard and away from your house.  The disease may be rare, but the effects can be devastating, and the risk can be significantly reduced by a few simple steps:

• Keep garbage in tightly-sealed containers.
• Clear brush and seal openings in buildings where raccoons may nest or form latrines.
• If you find raccoon stool or what appears to be a raccoon latrine on your property, clean it up very carefully.  Follow this link for more information on identifying and cleaning up raccoon latrines.
• Always wash your hands well after you've been working outside in soil, dirt or water which could be contaminated with raccoon feces.

For more information, see the last Worms & Germs post about Baylisascaris.

• Email This
• Print
• Comments
• Trackbacks

A previous Worms & Germs post talked about the (very low) zoonotic risk of the tapeworm most commonly found in dogs and cats, Dipylidium caninum. Dogs can also carry other species of tapeworm, such as Taenia pisiformis, which cannot be naturally transmitted to people. But dogs can also carry tapeworms from the genus Echinococcus, the most common of which is E. granulosus. Echinococcus multilocularis is much less common in North America, and can also be carried by cats.

In Canada, dogs tend to be exposed to E. granulosus when they eat certain animals, particularly wild herbivores like moose and caribou. In other parts of the world, eating sheep organs is the most common way dogs are exposed.  The immature form of the worm is found in the animal’s lungs, liver and other tissues. After being eaten by the dog, the worm matures in the intestine, and tapeworm eggs can soon be found in the dog’s stool. Tapeworm segments, as seen with Dipylidium infection, are usually not seen in the stool with Echinococcus. Under a microscope, it is possible to tell Dipylidium eggs from Echinococcus eggs, but it is not possible to tell Echinococcus eggs from Taenia eggs.

If a moose, caribou, sheep or another suitable “intermediate host” swallows the eggs from the dog stool, the parasite migrates through the animal’s body and forms cysts in various tissues which contain the immature form of the worm. If the animal dies or is killed, and a dog (or a wolf or coyote or related species) eats the cysts, the cycle begins again.

Unfortunately, humans can also be an “intermediate host” for these tapeworms. If a person ingests Echinococcus eggs from dog stool, the parasite can form cysts (called hydatid cysts) in many tissues and organs, including the liver, lungs, brain and heart. If the cysts are small and there are only a few, they may not cause any problems for years, and the person may never know they’re there. But as the cysts grow, they can get very large and start to interfere with the function of organs, or their size alone may be a problem, depending on where they are located. Treatment can be difficult – drugs are frequently not effective, and large problematic cysts may need to be surgically removed, if the surgery can be done safely. If a cyst bursts it can cause anaphylactic shock, which is very dangerous.

In Canada, Echinococcus infection and hydatid disease are most common in the western provinces. Nonetheless, everyone can take a few simple steps to help prevent exposure of people to Echinococcus:

• Always wash your hands after handling dog stool, even if you use a plastic bag or a scoop to pick it up.
• Your dog should have a fecal examination for intestinal parasites at least once per year, or more frequently if your dog is at increased risk of exposure to Echinococcus. If tapeworm eggs are identified, your veterinarian can prescribe medication to treat the infection.
  • Monthly heartworm preventatives that are effective against other intestinal worms are not effective against tapeworms!
• Do not let your dog eat uncooked meat, especially the organs of sheep or wild game such as moose and caribou.

More information on Echinococcus and hydatid disease is available on the CDC’s Echinococcosis webpage.

• Email This
• Print
• Comments
• Trackbacks (1)

"Unintended consequences" are outcomes (usually negative) of a particular action that are unexpected. For example, in some areas, hospitals now receive decreased reimbursement for MRSA infections.  This policy was meant to help encourage hospitals to reduce MRSA infection rates. However, there are concerns are that this has actually lead to decreased MRSA testing (and potentially compromised patient care), because if the MRSA infection isn't documented, payment will not be withheld.

Unintended consequences can be found in many diverse areas. An interesting example was recently published in Ecological Economics and reported by the Toronto Star.  It described the unintended consequences that linked use of a cattle drug to rabies deaths in India. Here's here story:

• Didofenac is a drug that was routinely used in cattle in India
• The drug is apparently highly toxic to vultures
• Vultures fed on cattle that died of natural causes, but that had didofenac in their bodies
• Millions of vultures died, which led to a larger food supply for feral dogs
• It was estimated that this lead to 5.5 million more feral dogs in India from 1992 to 2006
• These additional dogs would have accounted for at least 38.5 million dog bites
• Rabies is a serious problem in feral dogs in India
• In India, 123 people die of rabies per 100 000 dog bites.

Putting these numbers together, the unintended consequences of didofenac use in cattle may have result in 47 000 human deaths from rabies and $34 billion in health care costs. There are a lot of assumptions in this report, but it is an interesting story and highlights the unpredictable nature of infectious diseases, and the varying effects that seemingly unrelated actions can have.

More information on rabies can be found on the Worms & Germs Resources page.

• Email This
• Print
• Comments
• Trackbacks

• Email This
• Print
• Comments
• Trackbacks

• Try to prevent your pet from eating/touching dead birds.
• If your pet develops diarrhea after eating a dead bird, it is probably not a health concern for anyone else but Salmonella infection is possible, so consider taking your dog to the veterinarian. This is especially important if the dog appears sick (i.e. besides vomiting and diarrhea, the dog also is not acting like itself) or if there are people in the household that are at higher risk for getting sick from bugs like Salmonella (i.e. infants, people with weakened immune systems). All diarrhea should be considered potentially infectious to other animals and people.  Extra care should be taken around affected pets and their stool, including extra attention to hand washing, and disinfecting the site of any "accidents" that occur in the house.
• In some areas where bird testing is performed for West Nile virus or avian influenza surveillance, public health personnel will collect dead birds. Contact your public health department if you are unsure what is done in your region.

• Do not touch dead birds with bare hands.
• Use heavy-duty, leak-proof gloves to place the bird in a leak-proof plastic bag. Alternatively, fold two bags over your hand and use the bag to cover your hand when picking up the bird (like people do when poop-scooping), or use a shovel to place the bird in a bag.
• Double bag the bird.
• If the bird is not being collected for testing, contact your local waste management agency regarding disposal instructions.
• Always wash your hands with soap and water as soon as you're done.

• Email This
• Print
• Comments
• Trackbacks

• Email This
• Print
• Comments
• Trackbacks