How to protect patients, families from enteric zoonoses
- Copyright © 2013 by the American Academy of Pediatrics
Pediatricians can alert children and their families to emerging issues they may not be aware of that can help prevent illness. One such issue is an increased number of enteric illness outbreaks detected by public health surveillance that are linked to pet ownership and animal contact.
Roughly 74 million U.S. households have one or more pets, according to the American Veterinary Medical Association. Pet ownership and other types of animal contact provide many benefits to people. However, certain animals are not appropriate pets for high-risk groups, including children under 5 years of age, immunocompromised persons and adults over 65 years of age.
Enteric illnesses such as Salmonella, Escherichia coli O157:H7 and Campylobacter are most commonly transmitted through contaminated food. However, these bacteria are among the many zoonotic pathogens that pets and other animals can spread to people. Illnesses and outbreaks of enteric zoonotic diseases (i.e., zoonoses) have been linked to exposure to many different kinds of animals in public and private settings (MMWR Recomm Rep. 2011;60[RR-04]:1-24).
In addition to pet ownership, public venues such as animal exhibits, farms, stores, schools and child care facilities offer opportunities for children to contact animals. Petting zoos and backyard poultry flocks also are becoming increasingly popular.
Salmonella infections can occur in individuals who have contact with certain types of animals, such as turtles and other reptiles; aquatic frogs and other amphibians; live poultry; hedgehogs; and rodents such as mice, hamsters and guinea pigs.
Campylobacter infections also can be transmitted though contact with animals, particularly farm animals such as cattle and poultry, as well as cats and dogs, particularly puppies and kittens. Infected animals can appear clean and healthy while still shedding pathogens that can lead to human illness.
Handling these animals is not the only way people can become ill. The environments where animals live and roam, such as water from a frog or turtle tank, can be as contaminated as the animal itself. Touching contaminated barriers around animal exhibits also can result in illness.
People of any age can become ill with enteric zoonoses, but the pediatric population, especially children under 5 years of age, is at higher risk for serious illness. Young children are at risk for infection because their immune systems are still developing, they don’t always wash their hands after animal contact, and they are more likely than others to put their fingers or other items into their mouths.
Data from recent outbreak investigations suggest that public awareness of the risks of illness linked to animal contact remains low. In several recent outbreaks of human Salmonella infections linked to water frogs, turtles and chicks (www.cdc.gov/zoonotic/gi/outbreaks.html), many of the ill patients or their parents said they did not know that these animals could cause Salmonella infections.
Pediatricians can help prevent the spread of enteric zoonoses by doing the following:
Ask patients and parents about contact with pets and other animals, both in and away from the home, and especially in places such as child care facilities, schools and animal exhibits (such as petting zoos or stores).
Educate patients and their families about the risks for Salmonella and other zoonotic infections from animals.
Advise patients that certain animals are not appropriate pets for children younger than 5 years of age, adults over 65 years of age and people with weak immune systems. These animals include turtles and other reptiles, amphibians, poultry (such as chicks and ducklings), and rodents.
Share prevention recommendations such as washing hands with soap and water immediately after handling pets and other animals, their food, or anything in the area where animals live and roam. Adults should supervise hand-washing for young children. To prevent cross-contamination, when possible, pets should be kept out of kitchens and other areas where food and drink is prepared, served, stored or consumed.
Know the signs and symptoms of enteric infection and test patients when appropriate.
More information about preventing pet- and other animal-associated infections, including patient education materials, is available at www.cdc.gov/zoonotic/gi/index.html (Enteric Diseases from Animals) and www.cdc.gov/healthypets/ (Healthy Pets, Healthy People).
Another resource is the 2012 AAP Red Book: Appendix XI, “Diseases Transmitted by Animals (Zoonoses),” and Section 2, pp. 215-218, “Diseases Transmitted by Animals (Zoonoses): Household Pets, and Exposure to Animals in Public Settings.”
See related Parent Plus online only at http://aapnews.aappublications.org/content/34/7/16.2.full.
Dr. Neil is a member of the AAP Section on Infectious Diseases.