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Home , Bassaricyon, Bassariscus, Kinkajou, Margay, Potto, Procyonidae

1 Running head: and exotic felids

2 Zoonoses of Procyonids and Non-Domestic Felids

3 Edward C. Ramsay, DVM, DACZM

4

5 KEYWORDS

6 procyonis, Non-domestic felid, Procyonid, Procyonis lotor, , Zoonosis

7

8

9 Department of Small Clinical Sciences, College of Veterinary Medicine, The University of

10 Tennessee, Knoxville, TN 37996, USA

11 E-mail address: [email protected]

12 [Introduction]

13 Relatively few in the , other than domestic , , and , are

14 kept as pets, but members of the Families and are the most likely non-

15 domestic carnivores to be kept by private owners. Additionally, many non-domestic felids and

16 procyonids are exhibited by zoos and native wildlife parks. In the wild, contact with non-

17 domestic felids is rare but wild raccoons are common throughout North American, and

18 frequently found near dwellings and parks.

19 Reports of zoonoses transmitted from procyonids and non-domestic felids are

20 uncommon, with a few notable exceptions. As with any zoonosis, immuno-compromised

21 individuals and children are at the greatest risk of acquiring zoonoses and particular care must

22 be made to avoid infections in these people. 23 PROCYONIDS

24 The Family Procyonidae contains small to medium-sized that live in the temperate

25 and tropical regions of the Western Hemisphere. The best-known member of this group is the

26 common raccoon, lotor, which lives throughout North America, and has feral

27 populations established in Japan and Europe. Other species of procyonids live in the West

28 Indies, and Central and . The coatimundi, nasua, is similar in size to the

29 raccoon and ranges from Arizona to . The , flavus, and the olingos,

30 spp., are smaller, mostly arboreal procyonids of Central and South America. This

31 family also includes the rarely seen ring-tailed cats, spp., from western North and

32 .

33 Raccoons are the most common privately-owned procyonid seen in our practice and

34 popular exhibit worldwide. Wild raccoons live in urban, suburban, and rural areas and

35 are well adapted to living in close proximity to people. Raccoons will feed on garbage, and also

36 use bird feeders and unattended pet food as food sources. Increased interactions with

37 raccoons are likely as human populations continue to expand.It is estimated that the raccoon

38 population of the US will double over the next 10 years.1 are prehensile-tailed

39 procyonids and occasionally kept as pets. Other procyonids are rarely kept in the US but may

40 be kept as pets within their range countries. The discussion of zoonoses in this section will

41 refer almost strictly to raccoons, alluding to kinkajous where data is available.

42 Raccoons are susceptible to most zoonotic diseases which infect domestic dogs.

43 Serological surveys have also identified wild raccoons infected with a number of less common

44 zoonotic agents, including Bartonella rochalimaea,2 Francisella tularensis,3 influenza virus,4 45 Trichenella spiralis,5 and Trypanosoma cruzi.6 Of minor zoonotic pathogens, Ehrlichia chaffeenis

46 is probably the only organism for which raccoons are a potential reservoir host.7

47 Remarkably, there are very few reports of acquiring infections from raccoons,

48 with the exceptions of two pathogens: rabies, and the ascarid, . Rabies is

49 endemic in raccoons in the eastern portion of the US and is discussed in another chapter in this

50 book.

51 Baylisascaris procyonis

52 Baylisascaris procyonis is an enteric nematode parasite of raccoons (Figure 1) and has recently

53 been found in a pet kinkajou (A. Greene, personal communication). Domestic dogs have also

54 been found to shed B. procyonis ova.8 B. procyonis ova are very hardy and can remain infective

55 in the environment for a long time; making exposure possible long after raccoons are gone.

56 Reported infection prevalence rates in raccoons range up to 85%, with the western, upper

57 Midwest and northeastern parts of the US having the greatest reported prevalences.9 B.

58 procyonis can have a direct life cycle, but raccoons are most likely to acquire this organism via

59 ingestion of an intermediate host, such as an infected rodent. Raccoon infections are typically

60 asymptomatic but younger animals have heavier parasite infections and may show clinical

61 signs. Infected raccoons may pass thousands of B. procyonis ova.10 Diagnosis of infection in

62 procyonids is by identification of characteristic ova on fecal flotation exam or by direct

63 observation of the adult worms at necropsy.

64 People acquire B. procyonis by ingestion of infective ova. Individuals with a propensity

65 to eating dirt or soil (geophagia), such as very young children or mentally handicapped

66 individuals are at greatest risk for infection. Most human infections appear to be 67 asymptomatic.11 Severe clinical presentations are the result of visceral, ocular, or neural larval

68 migrans. Visceral larval migration may affect the heart, lungs, intestines, or mesenteries.

69 Ocular larval migration may cause choroidioretinitis or optic neuritis and may result in visual

70 defects or even blindness.12,13 Fewer than 20 cases of neural larval migrans have been reported

71 in North American but most of those cases have resulted in death or persistent, severe

72 neurological deficits. All reports of neural larval migrans have been in males, and either were

73 children or mentally-challenged individuals. Treatment of exposed individuals before the onset

74 of clinical signs with albendazole may be useful.10

75 There are several strategies for preventing human infection with Baylisasarcis procyonis.

76 Avoiding raccoon latrines and contact with raccoon feces or contaminated areas are the most

77 straight forward methods to avoid infection Young children and others at increased risk of

78 ingesting ova should be supervised when outside in areas with high raccoon activity. People

79 should not intentionally feed wild raccoons and avoid practices which attract raccoons, such as

80 leaving human and pet food outdoors overnight. Garbage containers should have tight lids and

81 remain sealed overnight. Sealing off or raccoon-proofing areas, such as garages and

82 unattended barns, may prevent the development of raccoon latrines near homes. Removal of

83 raccoon latrines, and treatment of potential intermediate rodent hosts is another strategy for

84 reducing the risk of infection in people.14

85 NON-DOMESTIC FELIDS

86 The Family Felidae contains approximately three dozen species, which are native to all

87 continents except Australia. The contains the charismatic large cats: (P.

88 leo); (P. tigris); (P. pardus & P. uncia); and (P. onca). The 89 ( jubatus) is a distinctive felid and the only member of its genus. The of the

90 remainder of the felids is under seemingly continuous debate but some have included all these

91 smaller cats in a single genus, . All felids are strict carnivores.

92 Non-domestic felids are not recommended as pets, but several species can be legally

93 acquired and are occasionally kept by private individuals. Two small, attractive American felids,

94 the (Felis pardalis) and (F. wiedii), were once popular but are now seldom seen

95 as pets. (F. ), (F. ), and mountain lions (also known as the

96 or , F. concolor) are the most commonly seen privately-owned non-domestic felids in our

97 practice.

98 All non-domestic felids appear to be susceptible to diseases commonly infecting

99 domestic cats. As such, any zoonosis which might be acquired from domestic cats could

100 potentially be acquired from non-domestic felids. Very few zoonoses, however, have been

101 documented to be contracted from a non-domestic felid. Two groups of pathogens,

102 dermatophytes and enteric organisms, deserve mention as risks when working with exotic

103 felids. Of the latter, knowledge of the biology of Toxoplasma gondii is frequently required for

104 counseling owners of exotic felids and animal keepers.

105 DERMATOPHYTOSIS

106 Microsporum is a keratophilic fungus which causes superficial skin infections in domestic

107 cats and dogs and has been the dermatophyte most commonly associated with disease in

108 exotic felids. Dermatophytosis in exotic cats is similar to the disease in domestic cats, and

109 lesions can include papular and miliary dermatitis or areas of alopecia on the face, body, and 110 limbs.15 Inapparent carriers may also exist. Diagnosis is made by clinical signs and fungal

111 culture of lesions.

112 In most cases, infections appear to be self-limiting.Treatment may be attempted for

113 severe or complicated cases, however, in one study of topical treatments of tigers and their

114 outdoor exhibits, untreated (control group) animals resolved infections as fast as or faster than

115 any treated tigers.15 Focal lesions on kittens can be clipped, cleaned with a tamed iodine

116 solution, such as povidone iodine, and treated with topical antifungal agents, such as

117 miconazole or clotrimazole. Systemic treatment with oral itraconazole will speed resolution of

118 lesions in adult cats (E. Ramsay, personal experience). Griseofulvin toxicity causing bone

119 marrow depression and death has been reported in .16

120 Dermatophytosis in people is characterized as focal, circular skin lesions (Figure 2), but

121 lesions may also include alopecia. Inflammation may be minimal to intense, with vesicles

122 and/or scaling present. The lesions can be pruritic. Diagnosis is based on history of exposure to

123 infected animals, clinical signs, and fungal cultures. Physicians should be consulted regarding

124 treatment. Wearing protective clothing and gloves and otherwise avoiding direct contact with

125 infected cats is advised. Frequent handwashing following contact with infected felids also

126 appears to limit zoonotic infections.

127 ENTERIC PATHOGENS

128 Toxocara cati and hookworms, Ancyclostoma spp., are common zoonotic parasites of domestic

129 cats and have been found in several species of non-domestic felids.17 T. cati infections rarely

130 cause clinical signs in exotic felids but can be persistent, despite aggressive anthelminthic 131 treatment. Infectious ascarid ova can be sequestered in an exhibit’s crevices or substrate and

132 remain infective for months to years, even in the most diligently cleaned enclosures.

133 T. cati and hookworms can cause visceral and cutaneous larval migrans, respectively, in

134 people. Human infections with T. cati are acquired through ingestion of infective ova.

135 Hookworm infections most typically occur when free-living larvae penetrate the skin. Both

136 infections are more common in individuals who might consume contaminated soil or have

137 considerable exposure to contaminated earth, such as children. A number of common

138 anthelminthics are used to treat human infections.

139 Non-domestic cats fed raw meat diets can commonly be asymptomatic carriers of

140 Salmonella spp.18 Diets are presumed to be the source of the bacteria, but cultures of food

141 items do not always reveal the same organisms cultured from feces. Salmonellosis may occur

142 in felids, but more frequently they shed Salmonella spp. without showing clinical signs.

143 Providing diets with low bacterial contamination, such as by acquiring meat from processors

144 with human food quality hygiene practices, will limit shedding of Salmonella spp. in non-

145 domestic felids.19

146 Gastrointestinal signs, such as vomiting and diarrhea, are the most common clinical

147 presentations associated with salmonella infections in people. Systemic signs are seen in

148 severe infections. No reports could be found of human salmonellosis acquired from an exotic

149 felid

150 Serologic surveys of our collections have shown non-domestic felids to be commonly

151 infected with Toxoplasma gondii. Domestic cats are known to be the definitive host for this

152 organism, and it is assumed that all felids may act as definitive hosts. While no records of 153 transmission of T. gondii from exotic felids to humans could be found, veterinarians are

154 frequently called upon to council private owners, animal caretakers, and zoological collection

155 managers about the risks of people becoming infected, especially when owners or keepers are

156 pregnant.

157 Cats recently infected with Toxoplasma gondii shed the organism in feces for two to

158 three weeks. Oocysts require at least 24 hours outside the body to sporulate and become

159 infective. Transmission to people occurs following consumption of infective oocysts. The vast

160 majority of human toxoplasmosis infections cause few signs or only mild flu-like disease, and

161 are not diagnosed. In immunocompromised individuals, severe clinical disease including

162 encephalitis may occur. Infection during pregnancy may result in fetal infection and cause fetal

163 death or miscarriage. In utero toxoplasmosis can cause fetal chorioretinitis and result in

164 blindness of the neonate.

165 Avoiding contact with feces is the primary method to avoid infection with all enteric

166 pathogens. Frequent hand washing and not eating, drinking, or smoking while feeding felids or

167 cleaning enclosures will limit an individual’s exposure to these pathogens. Wearing gloves

168 when cleaning cat boxes or enclosures, and digging in soils contaminated with cat feces is also

169 recommended. Hookworm infections can be avoided by wearing shoes in areas contaminated

170 with cat feces. Animal keepers feeding felids raw meat should wear gloves when handling

171 diets.

172 BITES

173 As with any wild animal, care must be taken when dealing with procyonids and non-domestic

174 felids to avoid injury to the owner, technicians, and the veterinarian. Heavy leather gloves can 175 be used to restrain smaller procyonids but many can still bite through gloves. Even those

176 animals most accustomed to captivity should be anesthetized or chemically restrained for

177 physical examination and collection of biological samples. Procyonids and small felids can be

178 netted and hand-injected with anesthetic agents. Alternately, we frequently leave the animal

179 in its transport container and place the entire container in a plastic bag, creating a of

180 anesthetic chamber. The bag is filled with inhalation anesthetic gases, such as isoflurane in

181 oxygen, and the animal induced without needing to be handled. Larger felids typically require

182 darting.

183 CONCLUSIONS

184 There are very few reports of zoonotic diseases having been acquired from procyonids and non-

185 domestic felids. Baylisascaris procyonis is the most commonly documented zoonotic agent in

186 these taxa. Routine personal protective strategies, such as wearing gloves and avoiding contact

187 with contaminated environments, remain the best strategies for preventing zoonotic infections

188 from procyonids and non-domestic felids.

189 190 REFERENCES

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237

238 239 Figure legends

240 Figure 1. Ova (inset) and adult Baylisascaris procyonis from a raccoon. Courtesy of The

241 University of Tennessee, College of Veterinary Medicine’s Parasitology Laboratory.

242 243

244 245 Figure 2. The arm of a veterinarian infected with Microsporum canis, acquired from a

246 (Panthera tigris). Courtesy of Dr. Edward Ramsay.

247

248