“One Health” gets talked about a lot these days, but is acted on much less often. Getting physicians and vets to talk is tough. Getting physicians to query animal contact is variably successful. Some get it and do it well, others don’t.
When I speak to human medical or public health groups about zoonotic diseases, I often talk about a particular paper on Rocky Mountain Spotted Fever (RMSF) in a person. This tick borne disease is pretty nasty, and can be fatal if not diagnosed and treated promptly.
The case described in the paper is of a woman who went to an ER with some vague clinical signs. She received an equally vague diagnosis and was sent home. She went to her own doctor a couple of days later with worse signs, and was hospitalized. She eventually was seen by an infectious disease physician who suspected she had RMSF. Treatment was started but, by then, she was seriously ill and died.
Where’s the animal side?
Her two dogs had died shortly before she got sick, and they had signs consistent with RMSF too. It isn’t spread from dogs to people, but dogs and people get infected the same way, from tick bites.
What I pose to the audience is whether the question “do you have pets?” would have saved her life. If she had said yes and mentioned that her dogs had recently died, would that have sped up consideration of RMSF? Maybe, and if so, maybe she’d still be alive.
A recent case of plague in Colorado has some similarities, in terms of the relevance of animal disease for aiding rapid identification of human disease. Information has been pretty sparse, but a person in Chaffee County Colorado was recently diagnosed with plague, treated with antibiotics and survived. The animal side is that the person’s dog became ill with signs consistent with plague a few days before the person got sick. I have no idea if they linked the two events and the dog’s illness actually triggered any thought of plague. However, it’s another example of the relevance of animal health to human health, the need for good communication between the veterinary and human medical worlds, and the need for physicians to query pet contact (and really, pet health).
If someone in an area where plague is present comes in with vague disease and says their dog got sick a few days earlier, knowing what that dog has (or might have) might be very important to the person getting proper testing and/or prompt treatment. Unfortunately, it’s a rare event for a physician to call a vet in a situation like that and, somewhat surprisingly, rare for a person to mention a pet’s illness to his or her doctor, even if the pet and person have the same signs.