I’ve written a lot about raw pet food in the past. Initially, the concerns were about Salmonella, since raw-fed dogs and cats have high rates of shedding Salmonella, and both pets and owners can get sick from it (owners can be infected directly by the pet or from handling or cross-contamination from the pet food… it’s always hard to sort that out).
More recently, I’ve been concerned about multidrug-resistant E. coli and related bacteria in raw pet diets. I think this may now be a much bigger but insidious risk. Eating a raw diet has been shown in a few studies to be a major risk factor for fecal shedding of highly antibiotic-resistant bacteria in pets, particularly extended spectrum beta-lactamase (ESBL) producing bugs.
There are other facets to this problem as well. A recent paper in the journal Epidemiology and Infection (Kaindama et al, 2021) describes a cluster of human E. coli O157 infections in the UK that were linked to raw pet food. This strain of E. coli can cause serious illness in people, including hemolytic uremic syndrome, which can be fatal. The bacterium can be found in the intestines of food animals (mainly cattle) and can therefore sometimes contaminate meat, or vegetables fertilized with manure.
In this cluster, 4 people infected by a similar strain of E. coli O157 were identified.
- All 4 patients got sick within a one-month period in 2017.
- I’m guessing three were 6-year-old children, based on the median and age range provided in the paper. The burden of zoonotic diseases often falls disproportionately on kids.
- Three of the patients were hospitalized, and one died.
During the investigation, no typical sources of E. coli O157 exposure were identified. The only commonalities between cases were all had contact with dogs, and a history of consuming raw carrots. Three of the patients had been exposed to dogs fed a raw meat diet, two of which had received tripe from the same supplier. The other person’s dog was not fed a raw meat diet but had contact with another dog that was fed raw meat.
E. coli O157 was subsequently found in raw pet food samples from the affected households, but they were different strains. That’s not too surprising, since contamination of the pet food would be variable, and testing would have occurred well after the food that likely caused the infection was fed. One batch might be contaminated, the next not and the next contaminated with a different strain. Finding different strains doesn’t round out the story as nicely, but it highlights other concerns. This wasn’t a one-time point exposure cause by some unusual event. Contamination of raw pet food with this concerning bacterium might be more common than has been previously recognized.
Whether these are rare cases or a small subset of actual cases is unclear. This cluster was identified because:
- The infections occurred close together in time (within 1 month)
- Public Health England does detailed whole genome sequence testing of E. coli O157 isolates
- They have detailed case questionnaires
- They looked for and found a link
Large outbreaks of disease in people involving the same E. coli O157 strain wouldn’t be expected from exposure to dogs fed diets where there’s probably a lot of small batches of the pet food produced and batch-to-batch variation with regard to contamination. Patterns need to be apparent to flag a potential problem, and sporadic cases aren’t as amenable to that. So, we don’t know if this was an exceptional event (i.e. infections are rare) or whether this was a matter of the right circumstances allowing for rare diagnosis of a more common problem.
My personal opinion here is based on seeing enough sick pets and sick people from raw diets. For that reason, I don’t like to see these diets fed. That’s particularly true in households with people or animals that are at higher risk of severe disease (i.e. young, old, pregnant, immunocompromised). If someone is going to feed a raw diet anyway, there are ways to reduce the risk to people and animals, both in terms of products that are purchased (e.g. high pressure pasteurization likely reduces the risk a lot, even though it doesn’t eliminate it) and how raw diets are handled in the home. More information about feeding raw diets and reducing the risk is available on the Worms & Germs Resources – Pets page.