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Vector-Borne Diseases in Pets: the Stealth Health Threat

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Vector-Borne Diseases in Pets: the Stealth Health Threat Parasites 101 Vector-Borne Diseases in Pets: The Stealth Health Threat Michael W. Dryden, DVM, MS, PhDa Kansas State University Elizabeth Hodgkins, DVM, JD Summit VetPharm Rutherford, New Jersey n 1975, in the small coastal town of Lyme, Connecticut, the bite of the deer tick (Ixodes scapularis) and was asso- a group of mothers brought a unique, remarkable clus- ciated with neurologic symptoms in some patients. Today, Itering of cases to the attention of local health authori- human Lyme borreliosis is the most commonly diagnosed ties: all had children with diagnosed rheumatoid arthritis. infectious VBD, with more than 20,000 cases reported each Unfortunately, this malady was not immediately recognized year in the United States alone.1 as a bacterial vector-borne disease (VBD). Not until 1985 The history of the recognition of the insidious and often was “Lyme arthritis” associated with infection by the spiro- debilitating signs of Lyme disease illustrates how easily infec- chete Borrelia burgdorferi, by Dr. Willy Burgdorfer. tious agents can enter the human population and, unsus- Throughout the 1980s, many skeptics denounced the pected and undetected, wreak medical havoc for decades existence of Lyme disease, as it came to be known, as a or longer. The prevalence of clinical and subclinical Lyme discrete infectious disease of humans or animals. The mat- borreliosis in pets is poorly understood at present, much as ter was not settled until the 1990s, when the genome of the the prevalence of its human counterpart was decades ago. causative agent was sequenced and the pathogenesis of the This issue is complicated by a lack of agreement about how human disease was fully understood. to detect infection with the causative agent and controversy In fact, the first recorded case of Lyme disease had about when and whether to immunize pets in endemic been described more than a century earlier by Dr. Alfred areas against B. burgdorferi.2–4 Buchwald, who noted a degenerative human skin condi- Recent studies suggest that the US prevalence of B. burg- tion known as acrodermatitis chronica atrophicans (ACA). dorferi infection in dogs may be highest (more than 6%) in In 1921, Dr. Arvid Afzelius published research about the the upper Midwest and northeastern areas of the country, expanding ring skin lesion (erythema migrans) that is now where prevalence of the infection in humans is also high- well associated with Lyme disease in people. Dr. Afzelius est.5 Studies of this infection in cats are sparse; however, it speculated that this skin condition was somehow caused by is clear that cats, while not clinically affected, do become infected.6 What is most clear is that scientific understanding aDr. Dryden discloses that he has received financial benefits from Bayer Animal Health, Elanco, Merial, Novartis Animal Health, Pfizer of the importance of this VBD is incomplete and awaits a Animal Health, and Summit VetPharm. great deal more research. As this research unfolds, we may Contributed by the Companion Animal Parasite Council The Companion Animal Parasite Council (CAPC) is an independent association of veterinarians and other animal health care professionals established to create guidelines for the optimal control of internal and external parasites that threaten the health of pets and people. It brings together broad expertise in parasitology, internal medicine, public health, veterinary law, private practice, and association leadership. Initially convened in 2002, the CAPC was formed with the expressed purpose of chang- ing the way veterinary professionals and pet owners approach parasite management. The CAPC advocates best practices for protecting pets from parasitic infections and reducing the risk for zoonotic parasite transmission. For more information, visit www.capcvet.org. Vetlearn.com | June 2010 | Compendium: Continuing Education for Veterinarians® E1 ©Copyright 2010 MediMedia Animal Health. This document is for internal purposes only. Reprinting or posting on an external website without written permission from MMAH is a violation of copyright laws. Parasites 101: Vector-Borne Diseases in Pets discover that we have seriously underestimated the impor- • I. scapularis and Ixodes pacificus (black-legged ticks), tance, prevalence, and severity of borreliosis in companion vector for B. burgdorferi in the eastern and western animals. United States, respectively, as well as for Anaplasma and Unfortunately, B. burgdorferi is only one of a myriad of Bartonella spp VBD agents known to infect and cause mild to severe clini- • Rhipicephalus sanguineus (the brown dog tick, which cal signs in pets. Most of these agents, including Ehrlichia, lives in homes and kennels), vector for Babesia spp, Anaplasma, Rickettsia, Bartonella, Mycoplasma, Babesia, Ehrlichia canis, and the Rocky Mountain spotted fever and Cytauxzoon spp, are incompletely characterized. In pathogen, Rickettsia rickettsii 2008, Dr. Susan Little, of the University of Oklahoma, speak- • Dermacentor andersoni, vector for R. rickettsii and the ing at the North American Veterinary Conference, discussed tularemia pathogen, Francisella tularensis the disturbing findings that tick populations are expand- • Dermacentor variabilis, vector for Cytauxzoon felis, R. ing geographically and appear to be carrying an increasing rickettsii, and F. tularensis array of pathogenic organisms. Her data showed that at least • Amblyomma americanum, vector for Ehrlichia spp, C. one VBD agent exists in each of the 50 US states and that felis, and F. tularensis several disease agents are present in the tick populations of • Amblyomma maculatum, vector for Hepatozoon many states.7 americanum All of these pathogens have at least one thing in com- mon: they are transmitted to companion animals by arthro- Mosquitoes are also important disease vectors for pets, pod vectors worldwide. Only for Lyme disease does a notably as carriers of infective heartworm (Dirofilaria immi- preventive vaccine exist, and the widespread use of this tis) larvae. The mosquito species most commonly implicated vaccine is controversial among veterinary experts. However, in heartworm transmission to dogs and cats in the United there is hope for control of these vectors and the diseases States are Aedes (including the Asian tiger mosquito), Culex, they transmit to household pets. Regular, appropriate use of Anopheles, and Ochlerotatus. Mosquitoes also carry West arthropod-effective ectoparasiticides in the home environ- Nile virus, which can infect humans and many species of ment and, more importantly, on pets, is the most effective animals, but the importance of this disease in cats and dogs preventive measure available against VBD transmission in is thought to be small.10 companion animals. Although these products cannot guar- antee prevention of tick-transmitted diseases, regular and Can We Afford to Ignore Vector-Borne Diseases Any correct application can reduce the likelihood that pets will Longer? become infected. Public health authorities warn that VBDs are spreading from narrow historical ranges well into new areas of the United The Vectors and Their Diseasesb States. The vectors appear to be moving into new areas and Fleas, ticks, and mosquitoes are major arthropod carriers increasing in other areas due to the following factors11–13: of many potentially serious diseases of humans and pets in the United States. The cat flea, Ctenocephalides felis, is the • Natural climate fluctuations that favor the development most important flea species infesting dogs and cats in most of fleas, ticks, and mosquitoes areas of the world.8 In addition to causing serious skin irrita- • Mobility of people and pets and residential and recre- tion, flea bites can lead to the important clinical condition ational encroachment on highly populated wildlife areas flea allergy dermatitis, caused by injection of flea-specific • Population increases among critical reservoir wildlife spe- antigens.8,9 Occasionally, severe, even life-threatening, ane- cies, especially deer and wild turkeys, across the country mia can occur in young or debilitated pets with severe flea infestations. Adding to the complexity of VBD expansion is the under- Infectious agents transmitted by cat fleas include diagnosis of VBDs in pets and humans in regions where Bartonella henselae (the cause of cat-scratch disease in these diseases are already well established.7,14,15 The years humans), Rickettsia typhi (murine or endemic typhus), and ahead will almost certainly show physicians and veterinar- Rickettsia felis (murine typhus–like disease). Fleas are also ians that VBDs are far more important causes of serious the intermediate hosts for a clinically important tapeworm infectious disease in the United States than previously sus- of dogs and cats (Dipylidium caninum). pected. Improved understanding of the importance of VBDs Several tick species are responsible for transmitting dis- in humans may well come, in large part, from efforts to bet- eases of companion animals in North America. Some of the ter understand and diagnose these diseases in pets.16 most important are: Although veterinarians play an important role in the bFor more information on vector species and the infectious agents identification and prevention of zoonotic infections that they carry, visit www.capcvet.org. affect humans, the profession’s central focus is the success- E2 Compendium: Continuing Education for Veterinarians® | June 2010 | Vetlearn.com Parasites 101: Vector-Borne Diseases in Pets ful diagnosis, treatment,
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