A couple of months BC (before COVID-19), I was planning a live simulation exercise for our hospital. The goal was to see how well we could identify and handle a nasty, reportable zoonotic disease, and to look at our personal protective equipment training and needs (COVID-19 helped with that last one, at least).
Here’s the test scenario we were going to use: A cat is presented with fever, lethargy and cough, with rapid progression to severe pneumonia. If travel history was queried (another test for the staff, as this step is commonly missed), the “owners” would say they just moved with the cat from Colorado. From there, some good questions would hopefully raise concerns about plague, although it’d be easy to miss initially as plague is a disease we don’t see around here, and most veterinarians have never seen a case. The primary goal of the exercise was to be to look at when and how we identified the concern, and our response to it. Those aspects are themselves educational, but the big-picture goal was to see how we can improve our ability to identify, respond and communicate around such a case.
Once the COVID-19 pandemic hit, it didn’t seem like a good time to do an exercise like this, given the changes and stressors in the clinic. However, while unlikely, the scenario wasn’t unreasonable. Plague, caused by the bacterium Yersinia pestis, is still present in some regions of North America and other parts of the world. Pets can be infected and the can occasionally pass the infection on to their human contacts. Veterinarians are at particularly high-risk for this kind of transmission because of our close contact with infected animals during examination and treatment.
A recent case of plague in a cat in Colorado highlights the zoonotic risks. There’s not any detail in the report, beyond saying a person got plague from a cat, but cat-associated plague is well documented.
Plague is now rare (thank goodness), but it can still be found in certain wildlife. People can be exposed from contact with infected wildlife (or their fleas), or via contact with domestic animals that were exposed to infected wildlife (or their fleas). People living in or traveling to areas where plague is present need to be aware of the risk and take some basic precautions:
- Avoid contact with wildlife (especially species like prairie dogs, squirrels and other rodents) and places where they live.
- Keep pets away from wildlife and their burrows/nests. In particular, keep pets away from dead wildlife.
- Keep pets indoors or under control when outdoors.
- Keep pets on a good flea prevention program.
I frequently harp about the need to query travel history in pets, since a lot of animals move around and knowing an animal came from somewhere else can be a key part of making a diagnosis. Pet owners need to play a role in that too, by making sure they mention places their pet has visited, or if it came from another region. Also (another factor that is often overlooked), travel doesn’t just mean long distances. From a disease standpoint, it simply means going to a place that is somewhat different microbiologically. The classic example is a dog that lives in the city but visits a cottage that may only be a few hours away by car. Since we have some regional differences in certain diseases (e.g. blastomycosis) and vectors (e.g. ticks), you don’t always have to go far to be exposed to new risks.
A few basic questions, like “where did you get your pet” and “have you gone anywhere with your pet recently” are easy, free and can make a big difference.