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Diseases from Pets to People

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Diseases from Pets to People Zoonosis: Diseases from pets to people Ankhi Dutta, MD MPH Pediatric Infectious Diseases DEPARTMENT NAME NO DISCLOSURES GOALS AND OBJECTIVES: 1) Identify the major pathogens transmitted from different pets (domestic and wild) to human 2) Discuss the clinical features associated with diseases transmitted from pets 3) Formulate a diagnostic and treatment plan for diseases transmitted from pets 4) Describe prevention strategies in order to keep pets disease free and prevent transmission to human. PETS AND US PET STATISTICS § 68% of U.S. households own a pet, according to the 2017-2018 National Pet Owners survey (up from 56% in 1988) § TOTAL NUMBER OF PETS OWNED IN THE UNITED STATES, BY TYPE OF ANIMAL (millions) Pet Number Freshwater fish 139.3 Cat 94.2 Dog 89.7 Bird 20.3 Saltwater fish 18.8 Small animal 14.0 Reptile 9.4 Horse 7.6 Source: American Pet Products Association's 2017-2018 National Pet Owners Survey. TOTAL U.S. PET INDUSTRY EXPENDITURES, 2007-2017 (1) ($ billions) YeArly Expenditure 2007 41.2 2008 43.2 2009 45.5 2010 48.4 2011 51.0 2012 53.3 2013 55.7 2014 58.0 2015 60.3 2016 66.8 2017 69.4 (1) Includes food, supplies and over-the-counter medicine, veterinarian care, live animal purchases and grooming and boarding. (2) Estimate. 1 - $100 • 7 year old boy, enjoys playing outside. They don’t have pets but they have noticed stray dogs and cats in the neighborhood along with opossums and rats on the street in the evenings. He began complaining of myalgia, abdominal pain, nausea and vomiting and has recently developed fever and a rash that began on his trunk and is now spreading to his extremities. What disease do you suspect? • Murine typhus: causes by Rickettsia typhi • Infected flea feces are rubbed into cuts or scrapes in the skin • Human Ehrlichiosis: causes by tick bites (lone star tick) DEPARTMENT NAME 1 - $200 n 13 year old female, who has recently developed blisters around her mouth, fever, headache, diarrhea and joint pain. She loves for her dog to give her kisses on her face and mouth. Blood culture growing GNR. n Capnocytophaga canimorsus n Skin lesions to septic shock n Risk factors for severe disease: immunocompromised, asplenic, alcohol use DEPARTMENT NAME DEPARTMENT NAME 1 - $300 n 16 year old male who had been wading through flood waters volunteering with evacuation efforts during and after Hurricane Harvey. Approximately 2 weeks after his time spent volunteering he developed a fever, headache, conjunctival suffusion, severe myalgias of the calf/back, vomiting, diarrhea, skin rash. Now his eyes seem yellow. n Leptospirosis- Leptospira interrogans n urine-contaminated water and soil n rats, dogs, and livestock (cattle, pigs) DEPARTMENT NAME 1 - $400 n 5 year old female comes in to your office. Her best best friend is a miniature Yorkshire terrier “Sparky.” Her mother has noticed fleas on the dog in the past but has chosen not to treat the fleas. Kate recently became frightened when she noticed “rice” in her stool. n Dipylidium Caninum n Infected flea n Treat both the dog and the child with praziquantal DEPARTMENT NAME 3 - $100 n 18 month old female comes to your office with watery diarrhea, abdominal pain and fever for the past 3 days. Mom has been giving her probiotics. They 2 puppies at home. Chickens in their backyard and just got a new turkey! What is the most likely bacteria? n Campylobacter jejuni; C.coli n Salmonella species DEPARTMENT NAME 2 - $400 n 2 yr old presents to your office with high eosinophils and anemia on their routine CBC. Per mother, she has had intermittent abdominal pain and fevers for the past month. They recently rescued two puppies and two kittens. n Toxocara canis and Toxocara cati DEPARTMENT NAME 2 - $300 n 12 year old presents with non-bloody watery diarrhea. His brother 6 yr old also with similar symptoms. They recently visited a petting zoo. And chose not to wash his hands after contact with the animals as well as disregarded the signage encouraging visitors not to drink the tap water. They also went swimming in the water park. What is the most likely organism? n Cryptosporidia species DEPARTMENT NAME 1 - $500 n 8 year old boy who lives in a rural area with his family who raises livestock. He spends a great deal of time with his dog “Buster” and the livestock (cattle and sheep) as well as picking and eating berries while in the fields. He began having chest and abdominal pain, nausea and vomiting along with a cough. n Echinococcosis: Echinococcus granulosus n Dogs are definitive host, livestock, pigs are intermediate hosts DEPARTMENT NAME 2 - $100 n 16 year old female, who volunteers at an animal shelter with kittens develops an enlarged, tender, axillary lymph node with fever, headache, poor appetite and exhaustion about 2-3 weeks after she began volunteering. She has been on Augmentin for the past week without improvement in symptoms. n Bartonella henselae: Cat Scratch disease DEPARTMENT NAME 2 - $200 n 12 year old, has 3 cats at home and is responsible for cleaning the litter box. He has noticed enlarged cervical lymph nodes, fever, fatigue and cough. Also seeing “floaters” with slightly blurry vision. n Toxoplasmosis: Toxoplasma gondii n Cats, unpasteurized goat milk, undercooked meat DEPARTMENT NAME 2 - $500 n A cat bit 4 yr old child on the right arm while visiting his grandmother recently. Over the past few days his father noticed the bite becoming red, painful, swollen and has also noticed enlarged lymph nodes in his right axilla. What organisms should you cover for empirically? n Pasteurella multocida n 70-90% cats and 25-50% dogs are colonizes in their upper respiratory tract DEPARTMENT NAME 3 - $200 n A drum-maker from New York City got sick while on tour with a dance troupe in Pennsylvania. He had just returned from Africa with four goat skins that he planned to use to make drums. He said that when he processed the goat skins to remove the hair, he did not use chemicals on the skins to kill germs or wear protection while handing the skins. He also reported that while he processed the skins, hair and dust particles floated into the air. Four days after he last had contact with the goat skins, he Began having Breathing proBlems and was hospitalized. In ancient times– this was called the “fifth plague” n Anthrax: Bacillus anthracis n carcasses, hides, hair, wool, meat, and Bone meal DEPARTMENT NAME 3 - $300 n A 4 yr old boy is admitted to the hospital with fever for the past 12 days, headaches, bodyaches. PE reveal cervical LN+, hepatosplenomegaly. He recently visited his grandmother who lives on a farm and drank “fresh” milk from the cow . Blood culture + for gram negative coccobacilli. n Brucellosis: Caused by Brucella abortus, B.melitensis DEPARTMENT NAME 3 - $400 n 16 yr old male who has been working in the farm during spring break presents to the ER with fever, chills, dry cough, fatigue for the past 6 days. He looks ill, tachycardic and tachypneic. He has assisted with birthing of a calf and has been handling sheep as well. n Q fever: Coxiella burnetii DEPARTMENT NAME 3 - $500 n 10 yr old male with dry hacking cough for the past 3 weeks. Fatigued, low grade fevers. You get a CXR and see a BL lower lobe interstitial pneumonia. You ask about pets and dad says they did buy new pets recently about a week prior to his symptoms. What pets do you think he bought? n Birds: any birds, most commonly parakeets, macaws, parrots, cockatoo n Chlamydia psittaci n DEPARTMENTExposure NAME to bird /bat guano: Histoplasmosis DEPARTMENT NAME 5 - $100 n A 4 year old boy gets admitted to the hospital with fever and left leg pain. Found to have blood culture positive for a gram negative bacteria and MRI showing left tibial osteomyelitis. He is otherwise healthy and has not travelled anywhere else. They just got a new pet! n Reptiles and amphibians! pet turtles, iguanas, geckos, bearded dragons, lizards, snakes, frogs, toads, newts, salamanders n Non-typhoidal Salmonella DEPARTMENT NAME DEPARTMENT NAME 5 - $200 n A 10 yr old girl received a fish tank for her birthday! She has been diligently cleaning the tank as instructed and developed this lesion on her hand. n Mycobacterium marinum: swimming pool granuloma, fish tank granuloma DEPARTMENT NAME 5 - $300 n A 18 month old got bit by a pet rat 2-3 days ago and now presents with fever to 103 with chills, myalgias, maculopapular rash diffusely including palms and soles. The area of the bite looks ulcerated. What would treat this child with? n Penicillin- G n Rat bite fever causes by Streptobacillus moniliformis or Spirillum minus DEPARTMENT NAME 5 - $400 n 10 yr boy recently returned from a trip to Colorado and developed fever, shortness of breath, left sided lymph node swelling which is very painful. He also has some ulcerative skin lesions. In Colorado, he has been handling rabbits in the farm and helped his GF mow the farm. n Tularemia: Francisella tularensis DEPARTMENT NAME 5 - $500 n Which famous celebrity has this animal as pet? n What disease can this pet cause? Racoon roundworm:Baylisascaris procyonis Rabies: Rabies virus (Lyssa virus) Bats, raccoons, skunks, foxes, coyotes, bobcats, and mongoose DEPARTMENT NAME RABIES § The virus is present in saliva and is transmitted by bites or, rarely, by contamination of mucosa or skin lesions by saliva § Worldwide, most rabies cases in humans result from dog bites § Any warm blooded animal can be infected with rabies virus DEPARTMENT NAME FINAL JEOPARDY n This disease spread in the 1330s along the great trade routes to Constantinople and then to Europe, where it claimed an estimated
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