Canine Influenza Update: Ontario, Oct 20

By Scott Weese on October 20, 2018 Posted in Dogs

Unsurprisingly, more cases have been identified since the re-introduction of H3N2 canine influenza to central Ontario was identified late in the week. That’s expected since the start of outbreak investigation is dedicated to figuring out the extent of the problem. Cases identified in the first few days or week reflect things that happened before we knew anything was going on. It’s what happens after the first week or so that’s most important. Ideally, once we know something is happening and start to intervene, new cases decrease and those that are found are found because we’ve traced them from other infected dogs. When new cases occur out of nowhere, we get concerned that we don’t truly know the extent of the issue.

So, at this point, we’re in a holding pattern, waiting for more testing and watching for more cases.

A few key points:

If you live in the affected area, be on the lookout for respiratory disease (e.g. cough, runny nose, runny eye). If your dog develops signs that could be influenza, call your veterinarian. Don’t just show up at the clinic. If your dog needs to be examined, your vet will want to take precautions to make sure your dog doesn’t infect other dogs at the clinic.
Most dogs with flu develop fairly mild disease that resolves on its own. Some develop complications that require treatment such as antibiotics. Rarely, flu can be fatal. Regardless, it’s highly transmissible and can spread quickly in the dog population
If you have imported a dog from Asia (or have adopted a dog that was imported in the past month), keep it isolated from other dogs for at least 28 days after importation. If your dog has been in contact with an Asian import, keep it away from other dogs for 28 days

Return of canine influenza: Ontario, Canada

By Scott Weese on October 17, 2018 Posted in Dogs

Canine influenza virus (CIV) has been re-introduced to Ontario, again in the Muskoka region. Variant typing for the latest case should be available shortly, but in all likelihood this is once again H3N2 CIV.

More details will follow; however, dog owners and veterinarians in this region should be aware of the return of this highly contagious canine virus. Testing of sick dogs and their contacts, as well as quarantine of infected and exposed animals, is important to help contain the virus. The previous introduction in early 2018 was successfully contained through an aggressive response, and the goal is to do the same this time, to prevent establishment of the virus in the dog population.

Veterinarians can check out the Worms & Germs infosheet on H3N2 CIV for more information and tips on basic precautions to help control the spread of CIV at the clinic level.

PetsAndTicks.com: Our 400th tick of the year

By Scott Weese on October 17, 2018 Posted in Cats, Dogs, Horses, Parasites

Here’s a post by Dr. Katie Clow from our sister site, PetsAndTicks.com:

Today, we received our 400th tick submission (actually, 401 to be exact). Does that sound like a large or a small number?

Although there’s no real answer to that question, to me it seems like a pretty small number. At this time last year, when the Pet Tick Tracker ran through the Worms & Germs Blog, over 1400 submissions had been received.

So, what might be going on this year? Here are some thoughts…

1. We’re getting bored with ticks and no longer reporting
This is a common problem with passive surveillance in areas where tick populations are well-established and the burden is high. Citizens get so used to seeing ticks and tire of submitting the same findings (understandably!). Although this may be occurring in some areas, we are still in a time when tick populations are changing rapidly, with ongoing expansion, so I don’t think this is the primary explanation. (**But, I’m still going to use this as an opportunity to encourage ongoing submissions, and sharing of our webpage with friends, family and colleagues!**)

2. We’re getting really good at using tick preventatives
I hope this is the reason! This means that our furry friends are protected. However, the most common tick products on the market (isoxazoline class of parasiticides) do not prevent tick bites, but kill the tick as it begins to feed. Therefore, we may still see ticks on our pets, just not for very long.

3. 2018 is a “low” tick year
Yes, this can happen, and this could be happening this year. It’s too early to really know, but other methods of surveillance have been finding ticks in lower numbers, too. Unfortunately, this does not mean that risk is decreasing. We see inter-annual fluctuations in ticks populations due to a variety of ecological factors. One hypothesis is that because it was so dry in many areas of the country, the ticks (especially blacklegged ticks) were not as active. Blacklegged ticks are highly sensitive to low humidity, so if it’s too dry, they will not be as active.

If you are finding ticks, it’s so important that you continue to submit. The more information we have, the more we can learn about tick populations in our country.

P.S. Our maps have been updated again.

Pet therapy dogs and MRSA

By Scott Weese on October 6, 2018 Posted in Dogs, MRSA/MRSP

My email and phone have been lighting up over the past few days about news reports describing a study presented at a recent scientific meeting in San Francisco. I wasn’t there and the results aren’t published, so I don’t have a lot to go on, but here are some highlights from the news article on Time.com:

The study was an assessment of the dynamics of transfer between people and visitation dogs in hospitals of a particular antibiotic resistant “superbug” called methicillin-resistant Staphylococcus aureus (MRSA).

Researchers looked at 45 kids who interacted with 4 visitation dogs – a relatively small sample size but an interesting study nonetheless.
About 10% of kids who didn’t have MRSA at first were carrying it after visits with the dogs. Whether that means they really became MRSA carriers or just had the bug transiently on their hands isn’t clear to me.
More time with dogs was associated with a greater risk of finding MRSA on the kids.
Kids were supposed to use hand sanitizers when interacting with dogs, but that wasn’t strictly enforced (so it probably wasn’t commonly done).

Is this surprising?

Yes and no.
We showed quite a few years ago that dogs that participate in hospital visitation programs are at increased risk of carrying MRSA, and that petting a dog that has been visiting people in hospital can transfer MRSA to someone’s hands (even when the dog’s not an MRSA carrier, i.e. the dog is simply mechanically transferring the bug from person to person on its body). This is a nice extension of that work, looking more at the dynamics of MRSA transfer.

Here are my take home messages:

Pet therapy programs have clear benefits, but they’re not zero risk (like most things in life). The cost-benefit needs to be considered in each case, but there are some basic precautions we can use to minimize the “cost” (risk) component.
MRSA is a human-associated bacterium, in the dog-human context. MRSA in dogs is typically acquired from people. Dogs can be a vehicle for MRSA transfer since they get touched frequently by multiple people. The more human contacts, the greater the chance that someone will deposit something on the dog’s haircoat.
Ultimately, it doesn’t matter if the dog is an MRSA carrier or if the person is an MRSA carrier, as long as basic hygiene practices are used. Most importantly, if the person washes their hands or uses a hand sanitizer before and after animal contact, the risk of transmission in both directions can be minimized.

The Society for Healthcare Epidemiology of America (SHEA) guidelines for programs involving animals in healthcare settings were published in Infection Control and Hospital Epidemiology in 2015.

Campylobacter outbreak from pet store puppies (and an antibiotic rant)

By Scott Weese on September 20, 2018 Posted in Dogs

This week’s edition of the CDC’s Morbidity and Mortality Weekly Report has a summary of the 2016-2018 campylobacterosis outbreak linked to pet store puppies. Nothing is particularly surprising, but that doesn’t mean it’s not disappointing (or depressing).

Click here for the complete article. Here’s a (relatively) brief summary:

It all started when sequencing of Campylobacter jejuni isolates identified the same Campylobacter strain from puppies from a commercial pet store chain in Florida and a person that bought a puppy from that chain in Ohio.
Over the course of the investigation, 118 illnesses in people were identified, including 29 pet store employees. This is presumably only a minority of the actual infections that occurred, since most infections over the course of an outbreak go undiagnosed.
Sick people were found in 18 states over slightly more than 2 years.
No one died, but 24% of confirmed cases were hospitalized.

A particular concern was that the Campylobacter isolates were resistant to all commonly used antibiotics. This obviously complicates treatment because it means that initial treatments would likely fail, prolonging the course (and potentially severity) of disease.

The antibiotic resistance aspect is particularly frustrating. Investigators in 4 states visited pet stores and collected antibiotic use information. They obtained records for 149 puppies, and 142 of those had received one or more courses of antibiotics before arrival or at the store.

That’s ridiculous.

What’s even more ridiculous is the fact that 55% of treated puppies received drugs when they were not sick – the drugs were being used for “prevention.” Another 38% received antibiotics for both prevention and treatment. Only 1% of treated puppies were treated solely because they were actually sick.

If you need that much antibiotic treatment to truly prevent disease, you’re doing something very wrong. If you’re using that much antibiotic without any idea whether it’s needed or not, you’re also doing something wrong.

To me, that indicates:

This approach to puppy breeding and selling is inappropriate on many levels.
Antibiotic use practices for pet stores need to be developed (and followed).
Veterinarians that dispense large volumes of drugs to pet stores need to be accountable for their use.

Hopefully this outbreak has been contained, but it’s far from certain. As the report says “Although the investigation is completed, the risk for multidrug-resistant Campylobacter transmission to employees and consumers continues.”

The article concludes with “Finally, antibiotics should only be administered under veterinary supervision with a valid veterinary-client-patient relationship, consistent with existing stewardship principles.” That’s very true, and while the majority of antibiotic use in companion animals is reasonable and the majority of vets care about antibiotic resistance and how they use antibiotics, there’s still a lot of room for improvement.

A new Staph on the block

By Scott Weese on September 14, 2018 Posted in Dogs, Other diseases

It’s probably not actually a “new” bacterium but rather recognition of a species that we’ve been mixing up with something else, but regardless, a paper in the International Journal of Systematic and Evolutionary Microbiology (yes, that’s an actual journal) describes a new Staphylococcus species, Staphylococcus cornubiensis (Murray et al. 2018).

Here’s what we know:

The bacterium was isolated from a 64-year-old man with a soft tissue infection. Only a single bacterial colony was present on the wound culture. To me, that raises questions about whether it was clinically relevant or just a contaminant or part of the normal skin microbiota.
It’s a coagulase-positive staph. Staph can be coagulase-positive or coagulase-negative. Coagulase testing is a method that’s used to group staph, and the staph that cause the most disease (e.g. S. aureus, S. pseudintermedius) are coagulase-positive.
Genetically, it’s a member of the Staph. intermedius group (SIG). This includes S. pseudintermedius (the species that’s the main cause of staphylococcal disease in dogs), S. intermedius (mainly found in pigeons) and S. delphini (found mainly in dolphins and mink). It’s very closely related to these species but is different enough that it might be a different species.
It was also found during a study that went back and looked at historical SIG isolates from people.
It’s very closely related to a Staph isolated isolated from a dog in Norway in 2008.
Cornubiensis comes from the Latin name for Cornwall, the UK city where the infected person resided.

The close similarity to an isolate from a dog (and S. pseudintermedius) has led to a suggestion that it might have originated from a dog. Nothing is known about the patient’s dog ownership or dog contact, so it’s speculative. It’s not an unreasonable idea, but a lot more investigation needs to be done to support some of the headlines that have already sprouted as a result of this finding.

Most likely, this is a new Staph species that’s rare and of limited consequence to people or animals, and is simply one of the thousands of different bacteria that live in or on us, and our animals, all the time. I wouldn’t be surprised if it has a canine origin, but I doubt that this report means there are any new risks or new things to worry about.

Pets as a cause of death in natural disasters

By Scott Weese on September 13, 2018 Posted in Cats, Dogs

No, it’s not pets freaking out and killing people. It’s people staying in harm’s way during natural disasters because they can’t take their pets with them.

I saw some data about this from Hurricane Katrina years ago, and while I can’t remember the exact number, an astounding number of deaths were associated with people who didn’t evacuate because they couldn’t take their pets with them. It’s not just a natural disaster issue. Uncounted homeless people get sick and die each year because their pets can’t come with them to shelters, hospitals or doctor’s appointments, and there are few alternatives.

A recent CNN article again raises the issue of rescuing pets during natural disasters, with regard to the impending Hurricane Florence. One family that’s trying to ride out the storm in North Carolina cites the challenges of taking in their pets with them as a deciding factor.

It’s not a zoonotic disease issue, but pets and animal care are an often-overlooked issue in emergency preparedness and interventions with the homeless.

Bad headlines

By Scott Weese on September 4, 2018 Posted in Dogs, Other animals, Rabies

I realize headline writers are trying to attract attention, and sometimes they don’t know much about the content. As a result, some headlines are quite over the top, and that can freak people out. Here are some examples from the past couple of days:

4 year old girl catches life-threatening infection by trying on shoes while barefoot

In this case, the girl got an abrasion on her foot. Any break in the skin can lead to an infection, although infections aren’t common and serious ones are rare. Unfortunately, she got a serious one and developed sepsis, which is an infection coursing through her bloodstream.

Any minor wound can potentially lead to a serious problem, but it’s rare so context is important. Parent’s shouldn’t be afraid to have their kids try on shoes. That’s a pretty low risk activity.

Wellington County, Ontario swimmers might have been exposed to rabies: health unit

No, rabies virus hasn’t suddenly become a waterborne pathogen that is exposing swimmers to a fatal disease while swimming anywhere in the county. Rather, the health unit was informing people that might have encountered a sick bat that was pulled from a local lake that they might have been exposed.

Swimming… no risk.

Touching a sick bat that happened to be in the water… risk.

There’s a difference.

Canadian woman contracts rabies from bat bite while she was sleeping

Media reports do not uncommonly mess up “getting exposed to a rabid animal” and “getting rabies.” Usually, the issue is getting exposed to a rabid animal, as was the case with this person. It’s actually a success story from a public health standpoint (not so much from the bat’s perspective, though).

The quick version:

Woman wakes up when bat bites her arm.
She realizes rabies is a concern.
She catches the bat… (something that was easier in this case than my own household encounter with a rabid bat, since this one wasn’t flying much)
The bat is submitted for testing and is determined to have rabies.
The woman undergoes post-exposure prophylaxis.
Life goes on.

That’s a textbook response and it all started with some basic rabies awareness on the part of the person who was bitten. Without that, we might have been talking about a rare human rabies case in Canada in the next couple months.

Image: Big brown bats are one of the most common species of bats found in Ontario. (Photo credit: USFWS/Ann Froschauer)

Human rabies death, Delaware, US

By Scott Weese on August 28, 2018 Posted in Cats, Dogs, Other animals, Rabies, Vaccination

Animal Bat Fly Halloween Silhouette Bat Ba Human deaths from rabies are common in some developing countries (where tens of thousands die from canine rabies every year) but rare in developed countries. It’s an almost invariably fatal disease, but at the same time it’s almost completely preventable because of the quality of vaccines and post-exposure prophylaxis available. Getting those treatments to the people who need them is the big barrier.

In developed countries, it’s not an issue of vaccine access, but usually a lack of awareness of the need for it.

Recently, a woman in Delaware died of rabies. This was only the 2nd rabies death in the state’s history, and the first since 1941. Little information has been released and there’s no indication of a likely source that I’ve seen. The woman owned a cat and it’s apparently being monitored, so there’s no chance that it could have been the source of infection given the timeline. Wildlife, such as bats and raccoons, are a more likely source. Bat bites are a concern in particular, since they are usually very minor and easy to dismiss (or miss altogether).

Whatever the case here, increased rabies awareness is still needed, even in North America. That includes the general public, physicians and veterinarians. More information about rabies can be found on the Worms & Germs Resources – Pets page, and in our archives.

Ticks know no borders

By Scott Weese on August 27, 2018 Posted in Cats, Dogs

While ticks don’t care about political boundaries, researchers often do (or practical aspects dictate that we must). That doesn’t mean we can’t work together, though. A recent post at our related site petsandticks.com talks about the differences between US and Canadian tick submissions, and how US residents can submit ticks to the Show Us Your Ticks program south at Oklahoma State University.