1

Zoonoses

Carol A Glaser, DVM, MPVM, MD

Division of Pediatric Infectious Diseases

University of California, San Francisco

&

Pediatric Infectious Diseases

Kaiser Permanente Oakland I HAVE NO DISCLOSURES

Outline

Overview of zoonotic diseases

“Fact or Fiction” dealing with common misperceptions or questions

Focus on zoonotic aspect of different disease (rather than Rx)

Common and not-so-common illnesses, range of animal hosts/types of zoonoses

Mostly practical information…but some esoteric…

Outline

Pet related zoonoses– Cats and dogs

Toxoplasmosis, Bartonella/CSD, DF-2, Pasteurella

Rabies

– Less traditional petsPocket pets-RBF

Wildlife issuesRabies

Baylisascaris

Fact or Fiction

2

Relative/hypothetical probability of contracting illness (not real)

What is a zoonosis?

Zoonosis refers to diseases that can be passed from animals, whether wild or domesticated, to humans

Tick

Deer

• Borreliosis• Trypanosomiasis

Direct contact

• Tularemia

Rat

Flea

• Leptospirosis• Rat-bite fever

• Plague• Haemorrhagic fever

Bat

• Rabies

Mosquito• West Nile virus• JEV• Chik• Dengue

DogCat

• Toxocariasis• Rabies• Leptospirosis

• Toxoplasmosis• Rabies• Bartonella hensleae

Sheep

Cattle

• Q feverFood chain

Direct contact

• Salmonella• E. coli• Campylobacter• Cryptosporidum• Mycobacterium• Brucellosis

Chicken & Eggs

• Salmonella• Campylobacter• Avian flu

Pigeon / Pet Bird• Psittacosis• Cryptococcus• M. avium-intracellulare

Companion Animals US households 2012

Dogs Cats Birds Horses

% households 37% 30% 3% 1.5%

Average/household

1.6 2.1 2.3 2.7

Total # 69,926,000 74,059,000 8,300,000 4,856,000

https://www.avma.org/KB/Resources/Statistics/Pages/Market-research-statistics-US-pet-ownership

3

Specialty and Exotic Animals 2012

https://www.avma.org/KB/Resources/Statistics/Pages/Market-research-statistics-US-pet-ownership.aspx#exotic

Lots of reptiles, mostly increasing since 2007

{

“Pocket pets”; ownership increasing

Zoonoses: General

Many are missed because of vague clinical presentation –’viral’

On the other hand, people often worry unnecessarily and/or erroneously ascribe illness to pets

Transmission complex and often ‘new twists’

For the unusual/orphan diseases, diagnosis problematic

A Partial List of Bacterial Zoonoses

Anthrax BrucellosisCampylobacteriosisCat Scratch DiseaseEhrlichiosisE. coli O157:57GlandersLeptospirosisListeriosisLyme DiseaseMelioidosisPlague

PsittacosisQ FeverRat-bite FeverRelapsing FeverRocky Mountain Spotted FeverSalmonellosisTularemiaTyphus YersiniosisZoonotic tuberculosis

A Partial List of Viral Zoonoses

Arenaviruses (LCMV, Lassa, S. American hemorrhagic fevers)Bat lyssavirusesColorado tick feverEbolaEquine encephalitides (WEE, EEE, VEE)Hantaviruses (Hantaan, Sin Nombre)Hendra

Herpesvirus BInfluenza (avian)Japanese encephalitisNipahRabiesRift Valley feverSARSVesicular stomatitisWest Nile Virus

4

A Partial List of Parasitic Zoonoses

Protozoa

BabesiosisCryptosporidiosis*Leishmaniasis*Giardiasis*Toxoplasmosis*Trypanosomiasis

Helminths:(roundworms, tapeworms, flukes)*

AnisakiasisCysticercosisHydatidosisMesocestoidiasisSchistosome dermatitis (Swimmer’s Itch)Trichinosis*Visceral Larval Migrans*Toxocariasis/Baylisascaris

Emerging Infectious Diseases

Estimated that 75% are zoonotic– Many viral—SARS, MERS

– Many vector borne (e.g., West Nile virus, Ebola, Zika )

-Chomel et al., Emerg Inf Dis 2006

FACT OR FICTION

Toxoplasmosis in humans is generally acquired from cats

Fact or Fiction?

5

Toxoplasma gondii

Obligate intracellular parasitic protozoan

Capable of infecting all warm-blooded animals

Cats definitive host (and other felines); only host where parasite undergoes sexual reproduction

Worldwide distribution– Seroprevalence in US-born persons (12–49 y) (NHANES)

1988-1994: 14%

1999–2004: 9%

Toxoplasmosis Life Cycle

• Cats (and other felines definitive host)• Naïve cats ingest bradyzoites• Cats generally either asymptomatic or

have self-limited illness • Other animals can become infected from

oocysts• Tissue cysts in meat, unwashed produce

or placental transmission

Humans and Toxoplasmosis

After infection– Humans often asymptomatic or

– Flu-like illness

– Like other animals, tissue cysts and long term humoral response

Two important groups: – Pregnant women with primary infection

– Immunocompromised – primary infection or reactivation

ToxoplasmosisInfection in Pregnancy

Asymptomatic (50-90%)

Fatigue, lymphadenopathy

Fever, H/A, pharyngitis, myalgia

Rarely enanthem (rash on mm mouth), retinal disease

6

Congenital Toxoplasmosis

Transmission can occur during all trimesters; least likely 1st trimester but most severe

Classic triad– Hydrocephalus

– Intracranial calcifications

– Chorioretinitis

But most cases not classic-more subtle with IUGR, microcephaly

High index of suspicion for diagnosis

Congenital ToxoplasmosisAdditional Signs/Symptoms

FeverH-S-megalyLymphadenopathyJaundiceVomiting, diarrheaRashHypothermia

Ocular abnormalities

Pneumonia

Seizures

Labs: Abnormal CSF, anemia, eosinophilia, and coagulopathy

ToxoplasmosisInfection in Pregnancy

Source of infection unknown in approx 50%Food: meat and fresh fruit, vegetables, raw eggs and rarely mussels, oysters, unpasteurized milk (and even water)GardeningRarely: blood transfusion, laboratory-acquired

Cats - how commonly is it transmitted from cats?

Cats and Toxoplasma

Cats are generally asymptomatic or mildly ill during acute infection

Shed oocysts for ~10 days but usually only during acute infection (i.e., only once/lifetime)

<1% of cats shed oocysts on any given day

Oocysts are quite resistant – oocysts survived outdoors in Texas (6°C–36°C) in native cat

feces, uncovered, for 46 days, for 334 days when covered, and outdoors in soil buried at the depth of 3–9 cm in Kansas for 18 months

– oocysts survived at −21°C for 28 days

7

Toxoplasma & Food animals United States

Jones JL, Clin Infect Dis, 2012Will free range/organic meat increase %?

Toxoplasmosis Summary

Although cats are the definitive host for Toxoplasmosis, pet owners rarely acquire the infection from their pet cat

The best way to prevent Toxoplasmosis is to eat meat well cooked, wash fruits and vegetables and wear gloves for soil contact

Pregnant women and Immunocompromised patients do not need to give up their cat (but should avoid cleaning litter box or wear gloves)

Toxoplasmosis in humans is generally acquired from cats

Fiction

Cat Scratch Disease (CSD) is generally transmitted by the scratch or bite of healthy cat/kitten

Fact or Fiction?

8

Bartonellosis (CSD)

Cat scratch disease caused by Bartonella species (type of proteobacterium)Cats are main reservoir–B. henselae, B. clarridgeiae, B. koehleraeOther animals can also serve as reservoirTypically from a scratch (sometimes bite)Cat fleas (Ctenoceph felis) involved in transmission of B. henselae among catsUnclear role of fleas in human transmission

Bartonellosis background

Cats –B. henselae is a nearly perfectly

adapted parasite—produces high-grade bacteremia without disease

–5-41% of cats positive blood culture– Intermediately positive

Bartonellosis: Clinical

Cat scratch disease (CSD);– Benign, self-limiting lymphadenopathy, low

grade fever– Often lesion at inoculation site– Serious conditions however are in the

differential;Lymphoma, carcinoma, MTB, neuroblastoma

Bartonellosis: Clinical

Atypical forms– Erythema nodosum– Perinauds oculoglandular syndrome– Hepatic granuloma– Osteomyelitis– Pulmonary disease– Optic neuritis– Encephalopathy

Immunosuppressed– Bacillary angiomatosis– Peliosis hepatitis

9

Bartonellosis

Prognosis: generally excellent

For normal hosts-once immune, always immune

Treatment: – For most forms-no RX

– Immunosuppressed or severe cases: azithromycin or doxycycline and rifampin

Bartonella testing in cats

Positive serology = Bartonella bacteremia

Bartonella bacteremia can be intermittent

Bacteremia can last months or even years in cats

Testing in cats is recommended by some veterinarians

?Utility of testing?– Treatment of cat not efficacious

– Positive results? Negative results?

CSD summary

Utility of testing cats is very questionable!If human illness occurs, not a reason to get rid of cat!Since fleas are considered ‘essential’ to maintenance of infection in cats good flea control;– “vigilant elimination of fleas from pets...”

Also for prevention avoid unnecessary “trauma” cats people

Cat Scratch Disease (CSD) is generally transmitted by the scratch or bite of healthy cat/kitten

Fact

10

A child was bitten by squirrel in the park 2 days ago…animal can’t be

found…patient should undergo rabies PEP

FACT or FICTION

A child picked up bat during camping trip and the bat later flew

away, no bite wound -this child needs PEP

Fact or Fiction?

Patient bitten by neighbor’s dog-unprovoked bite and dog is not current on rabies

vaccine--

Rabies PEP should be given ASAP

Fact or Fiction

Rabies is treatable

Fact or Fiction

11

Rabies shots are painful and are given in the abdomen

Fact or Fiction

• Causes a severe acute progressive

encephalitis

• One of the ‘oldest’ infectious disease

known to man

• The world’s “most deadly virus”

• Latin for: to “be mad”/”madness”

Background

RabiesThe “quintessential” zoonosis

Etiology

• Family: Rhabdoviridae Negative-stranded RNA genome

• Genus: Lyssavirus• Envelope virus, bullet-shaped

12

Epidemiology

• Only 1-2 recognized cases/year in the United States…so why is it so important? “Uniformly fatal” without vaccine (until recently)

Tremendous ‘angst’: ~40,000 persons receive post-exposure prophylaxis (PEP) in the US

Many encephalitis cases are ‘rule out’ rabies …on the other hand, cases are missed

World: 50,000-100,000 cases/year• Most cases of rabies in India, China, SE Asia, Iran, Africa

and South America• Most are canine rabies• Estimated 50,000 cases/year

Rabies Reservoirs

• All mammals are susceptible

• However some species much more important > others, e.g., canine rabies, raccoon rabies, bat rabies, skunk, etc.

• Humans generally “dead-end” hosts

About rodents

There have been no documented cases if rabies in humans associated with exposure to rabid rodents in the US

Caveat; if rodent extreme bizarre behavior, then consider testing and/or PEP

13

Bats (non-terrestrial)and Rabies

• Most common source of human infection in US

• Since 1990, > 90% of endemically acquired rabies in the US

• Exposure to bat not always recognized, especially bites

Bites from bats may be overlooked

-Jackson A, Lancet, 2001

Clinical

• Incubation period ranges from few days to >1 year Most cases present between 2 and 16 weeks

• Pleomorphic manifestations, often mistaken for other CNS diseases (e.g., case 2)

• Initial symptoms are nonspecific: Fever, malaise, fatigue, anxiety, headache Half of patients have pain, itching or

paresthesias at site of the bite Lasts 2-10 days

Clinical

After prodrome:• Furious form (aka “mad dog”) Increasing agitation, hyperactivity, seizures,

hallucinations, aggressive behavior, hydrophobia(spasm of respiratory muscles when attempting to drink)

Coma develops, then death

• Paralytic form (aka dumb rabies) Progressive lethargy, incoordination and ascending

paralysis

Respiratory muscle paralysis may occur

Coma, then death

14

Diagnosis of Rabies

• Always consider in case of acute onset, rapidly progressive encephalitis

• Diagnosis before death is ‘tricky’ but do-able

• Testing after death includes: Testing for viral antigen by DFA in brain tissue

Prevention and Treatment IssuesThese issues often confused…note the differences

• Rabies pre-exposure prophylaxis Given to ‘high risk’ individuals such as veterinarians, animal

control workers, spleunkers before exposure

3 doses vaccine

• Rabies post-exposure prophylaxis (PEP) Given following a bite from rabid (or suspected rabid) animal Rabies Immune globulin (RIG) (infiltrated wound) and 4 doses vaccine

(day 0,3,7,14) IM injection deltoid /AL thigh (no longer in abdomen)

Highly effective for prevention

Vaccines not given in abdomen

• Rabies “Treatment” No known effective Rx; once symptoms develop, vaccine and RIG

of no benefit

Experimental treatment

PEP - Yes or No?

• Type of exposure (bite, non-bite) If bite: provoked vs. unprovoked Assess other circumstances of exposure,

e.g., behavior of animal• Severity of wound• Animal species involved• Animal health and vaccination history• Local animal rabies epidemiology• Animal available for observation / testing• Urgent but not “emergency”, consult local public health

About domestic dogs/catsin U.S.

Very few dogs and cats in US positive in last few decades in US

If dog/cat located, put in ‘quarantine’ x 10 days

If animal can’t be located-that is problematic

If dog/cat rabid, they have very strange behavior

Typically have a few days to decide

15

“Treatment”Human Rabies Survivors -Prior Experiences in US

• Recovery without rabies PEP 15 year old female, Wisconsin, 2004Milwaukee protocol

17 year old female, Texas, 2009 (“Abortive Case”)

8 year old female, California, 2011

• Meet case definition for human rabies based on clinical manifestations and rabies virus specific antibodies in serum and CSF

• Rabies virus, antigen, nucleic acid not detected from these patients

• Antibody identified “early”

• Most recently Peru experience

-Willoughby et al., New Eng J Med, 2005-CDC, MMWR, 2010CDC MMWR 2011

however

Several other investigators have attempted the Milwaukee protocol for ‘treatment’ of rabies and failed

Aramruro A, Clin Infect Dis, Sept 2011

A child was bitten by squirrel in the park 2 days ago…animal can’t be

found…patient should undergo rabies PEP

FICTION

A child picked up bat during camping trip and the bat later flew

away, no bite wound -this child needs PEP

Fact

16

Patient bitten by neighbor’s dog-unprovoked bite and dog is not current on rabies

vaccine--

Rabies PEP should be given ASAP

Fiction

Rabies is treatable

(mostly) Fiction

Rabies shots are painful and are given in the abdomen

Fiction

Rabies Summary

Rodents low risk for rabies and most bites don’t require PEP – always best to discuss with public health department

Bat bites are often not noticeable and any child with bat contact (if unobserved) need to assume bite occurred and rabies PEP should be considered (test bat is possible)

For most domestic dog or cat bites, don’t need PEP, but need 10 day ”quarantine” period

Rabies is preventable

Whether rabies is ‘treatable’ is questionable

17

Human wounds can heal faster when licked by dogs

Fact or Fiction?

Human wounds & Dog licks

“Human wounds can heal faster when licked by dogs dates all the way back to ancient Egypt, when dogs were used in healing practices. The Egyptians believed that being licked by a dog, especially on an open wound, would aid in recovery or even cure the disease causing the illness. Today, it isn’t unusual to hear a dog lover make a similar claim”

However…………….don’t encourage this…-HellaWella website, 4/27/2014

Dog & CatsBites*, Scratches & Licks

Capnocytophaga speciesPasteurella speciesStaphylococcus aureusStreptococciAnaerobesMoraxella spCornyebacterium speciesNeisseria sp

*-1% of ER visits & 10,000 inpatient hosp/year

CapnocytophagaLick of Death………

18

About Capnocytophaga

Fastidious Gram-negative bacillus (rod shaped)

Previously known as DF-2 (dysgonic fermenter type 2, ‘carbon loving’)

9 species-C ochracea, C gingivalis, C sputignea, C leadbetteri

C canimorsus, C cynodegmi (dog and cats)

C canimorsus-oral cavity

-67-86% dogs, 55-86% cats– After bite/scratch or lick clinical presentation

1-30 days (ave 5-6 day)

-Brenner DJ, J Clin Microbiol, 1989-Kullberg BJ, Medicine, 1991-Martino R, Clin Infect Dis, 2001

Capnocytophaga

Capnocytophaga canimorsus and Capnocytophaga cyndegmi

Often follow dog or cat bite/scratch, also lick

Capnocytophaga canimorsus– Fulminant sepsis, mortality 30-36%

– Meningitis, mortality 5%

Capnocytophaga cyndegmi– Less severe, usually restricted to skin and soft

tissue (although one case report/fatality

Capnocytophaga/risk gropus

Most common in immunocompromised

– Asplenic

– Cirrhosis or heavy ETOH use

– Steroid use

– Other; neutropenia, AML, ALL, solid tumors, SLE, multiple myeloma, CLL, s/p BMT

– + normal hosts (up to 40% cases w/o risk factors)

Capnocytophaga / Clinical

Most with Sepsis and/or meningitisOr FUO

-Janda MJ Emerg Infect Dis, 2006

Necrotizing eschar at site of bite

19

Severe complication--Purpura fulminas

Acute, often fatal, thrombotic disorder manifests as bruising and discoloration skin result of coagulation blood vessel in skin and leads to skin necrosis and DIC

aka Purpura gangrenosa

Diagnosis &Treatment Capnocytophaga

Can be difficult to isolate, often takes a few weeks for specific identification

Some isolates with beta-lactamase

Rx; Beta-lactam-beta-lactamase combination, 3rd

or 4th gen ceph, or carbapenem

Don’t use 1st gen ceph, anti-Staph PCN, macrolides and clindamycin for this infection

Another infection from bite/scratch/lick

Pastuerella spp.,

Oral cavity of dogs and cats

Gram negative coccobacilli

Mostly Pastuerella multocida, but other sp

Most frequent isolates from both cat and dog bites

rate from penetrating dog bites/cat bites– 2-10%/CG find this

Can also occur scratches and licks-Chang K, Scand J infect Dis 2003-Chun ML, Am J Obstet Gynecol 2003-Talan D, New Eng J Med, 1999

20

Pastuerella---Clinical

Soft tissue swelling– Very rapid development

– Intense inflammatory response

– Most within 24 hours, as early as 3 hours (cat)

– Necrotizing fasciitis can occur

Complications of SSTI:– Bone and joint

– Sepsis and PNA

– Meningitis

– Endocarditis

Treatment

Amoxicillin/Clavunate (oral)

Ampicillin/sulbactam (IV)

More severe infections

-Piperacillin/Tazo

-Carbapenem

-3rd generation + Metronidazole

• Also ensure UTD Tetanus vaccine

Human wounds can heal faster when licked by dogs

Fiction

Rat bite fever is almost always associated with a bite from rat…

FACT OR FICTION

21

Rat Bite Fever: Microbiology

Two distinct disease syndromes– Streptobacillus moniliformis: most cases in US

Incidence unknown since not a reportable diseaseProbably rare but likely underdiagnosedRelatively difficult to isolate

– Spirillum minor: not generally found in USMostly in AsiaDifferent syndromeSodoku or relapsing fever

About Rodents

Approximately 3% of US households have pet rodent (gerbil, hamster, mouse or rat)

Mostly rats, however other rodents can transmit

Doesn‘t have to be pet rat, can be acquired from wild rodent (including dead rodent)

Cats that hunt rodents can harbor organism in their mouth (transiently)

Rat Bite FeverStreptobacillus moniliformis: Epidemiology

Often transmitted by bite or scratch of rats, mice, squirrels, carnivores that prey on rodentsCan be acquired through handling of dead rats50-100% wild and lab rodents harbor organismFood/water contaminated with infected rat excreta (cases called Haverhill)40% of cases have no history of bite29% of US households experience rodent problem

Rat Bite Fever: Clinical

Incubation: ~7 days (range 1-10 days)Abrupt onset fever (irregular relapsing fever)Chills, headacheMigratory arthralgias, myalgias

Clinical features similar to other diseasesDiagnosis usually requires high index of suspicion (blood culture/add +)

22

Rat Bite Fever

Complications– Endocarditis, myocarditis, pericarditis– Meningitis – Pneumonia– Abscesses in “virtually every organ”

Treatment– Penicillin or Doxycycline– Untreated: 7-13% mortality

Elliot et al., Clin Microbiol Rev, 2007Dijkmans et al., Infection, 1984Pins et al., Clin Inf Dis, 1996

Summary RBF

Transmitted by rats and other rodents

Also can be transmitted by cats

In addition to bites, can be transmitted by scratches and contact with oral secretions of rodent and ingestion

Diagnosis requires high index suspicion

Very treatable but can be deadly if not recognized and treated promptly

Rat bite fever is almost always associated with a bite from rat…

FICTION

LIGHTENING ROUND

23

Reptiles are known to carry Salmonella but recent data show that treatment can eliminate 

Salmonella

Fact or Fiction?

Fiction

Reptiles / amphibians often carry Salmonella. Salmonella can get on cages, aquariums, terrariums, and other containers that house them

Shouldn’t be allowed to roam freely throughout the house or in areas where food or drink is prepared, served, or stored, such as kitchens, pantries, or outdoor patios

Reptiles can’t be ‘cleared’ of Salmonella

Caution for children < 5 years of age, older adults, or immunocompromised individuals

Since 1975, turtles < 4 inchesIllegal to sell………….

Raccoons can make good pets, especially if acquired when they

are young

Fact or Fiction?

Fiction

Besides being illegal, lots of other reasons not to own

Perhaps the most important is because of a type of worm they carry called – Baylisascaris procynosis

24

Baylisascaris procyonis

Intestinal nematodeNatural hosts– adult raccoons

Transmission– eggs shed in feces (millions of eggs shed)– require 3-4 weeks to become infectious– ova extremely resistant to

dessication/destruction; may remain viable in the environment for years Adult Baylisascaris procyonis

Female

Male

Baylisascaris NLM

Often devastating outcome with death or severe neurologic sequelae

However, a few ‘promising’ case reports– 14 month old boy with NLM from MA, some residual deficits and

moderate speech delay but overall good

– 4 year old boy from New Orleans, LA with NLM, “full recovery”

– Both Rxed with steroids and anti-helminthic

Peters et al., Pediatrics, 2012

Pai et al., Emerg Inf Dis, 2007

Baylisascaris procynosis

More severe than Toxocara– larger larvae (1-2 mm)– extensive migration (brain, eye, heart)

Clinical– eosinophilic meningoencephalitis– death or long-term DD in children

Pathology– deep cerebral white matter granulomas

25

Parvovirus in children is sometimes acquired from pet dogs

Fact or Fiction?

Fiction

canine parvovirus type 2b– Highly contagious viral illness that affects

dogs

– Two formsDiarrhea form

Cardiac from

Not the same as Human Parvovirus B19

Dogs can sometimes transmit Leptospirosis to people

Fact or Fiction?

Fact

Leptospirosis can be transmitted direct contact with urine, bite wounds, ingestion of infected tissue-penetrate skin or mucous membranes

Most human hosts associated with water contact ; however reports of acquiring lepto from infected dogs (particularly in vet hospitals)

Any dog with acute renal failure; treat as suspect lepto but dogs are often asymptomatic

26

Pets are a common source of ringworm and are almost always

symptomatic

Fact or Fiction?

Fiction

Some ringworm comes from pets but probably only minority of cases

Ringworm transmitted from pets is often more inflammatory > humans

Pets can harbor ‘ringworm’ and most of the time they are asymptomatic

Consider asking about pets if ringworm is refractory to Rx

MRSA in animals is a “humanosis”

Fact or Fiction?

Fact

MRSA is a reverse Zoonosis-MRSA has “jumped from humans to household pets”

Animals can carry the bacteria on their skin and may transmit it back to the pet owner or spread it to other animals

Just like people….

Asymptomatic carrier

Most common conditions – Skin infections and ear infections

– Post-op incisional infections or wounds

– Also: UTI, auditory canal, and joints

27

Pets are a relatively common source of Strep throat in pediatric

patients

Fact or Fiction?

Fiction

Earlier studies found that dogs were persistent reservoirs for GAS & anecdotal reports of treatment of dogs and cats as a means of controlling on-going transmission in householdsOne (older) study of the households of people with recurrent GAS pharyngitis found:– 42% dogs positive– 36% cats positive

Group A vs. non Group A strep; early studies used crude antimicrobial data on bacitracin susceptibilities rather than genetic subtypingLater when Lancefield typing done – True prevalence in household pets only 0-3% and not

correlated with the presence of infection in the owner

-Cooperman SM, NY State J Med, 1982-Kurek C, Epidem Reviews, 1971- Crowder HR, Int J Zoonoses, 1978

Fiction

GAS and dogs/cats - more recent studies

Longitudinal study – Households of children with acute pharyngitis

Throat cultures from children with acute pharyngitis

Concurrent samples from pets in household

– 230 pets sampled—No group A strep found in pets

Another study– Children with Group A Strep

Only 2 of 61 tested pets were positive

-Wilson KS, Ped ID J, 1995

-Falck G Scand J Infect Dis 1997

Ebola virus is considered a zoonotic infection

Fact or Fiction?

28

Fact Summary

Dogs and cats make great pets and are generally safe with a few important exception

Although cats are the definitive host for toxoplasmosis, people rarely acquire the infection from their pet cats

Important to avoid bites/scratches and licks from domestic animals

Bartonella transmitted by healthy cats/kittens generally benign but can have severe complications

Good flea control will help prevent diseases in pets and people

Summary

Rabies very uncommon in domestic dogs/cat

Rabies also rarely found in rodents

Bats are important source of rabies

Rodents can make great pets but need to remember RBF

Wild animals never make good pets

Relative/hypothetical probability of contracting illness (not real)

29

The End