Zoonosis Client Education in Exotic Practice
American Association of Zoo Veterinarians Conference 2010
Hayley Weston Murphy, DVM
Zoo Atlanta, Atlanta, GA, USA

Introduction

Keeping animals as pets has been well recognized as benefitting human emotional and physical well being. However, there is also some potential zoonotic disease risks associated with keeping animals, including exotic and non-traditional animals, as pets. These risks can be minimized by providing good client / owner education, following regulations and guidelines, and providing guidance on appropriate pet selections. It is important to remember that cases of zoonotic disease transmissions are still relatively rare. However, with the increases in exotic pet ownership and animal importations, the risks cannot be ignored.

Discussion

Since 1992, the number of exotic animals available in the United States has increased 75%. In 2005, 87, 991 mammals (including 29 species of rodents), 1.3 million reptiles, and 203 million fish were imported legally into the United States.2 The U.S. Fish and Wildlife Service estimates that in 2002, 365,000 birds were imported legally.2 Reptiles are now in 4.4 million homes. In addition, there is a worldwide illegal trade of exotic animals, estimated at $6 to $10 billion dollars annually, only exceeded by the trafficking of arms and drugs.2 With this increase in the number of exotic animal pets, more and more veterinarians are called upon to give advice on specialized husbandry needs, dietary requirements, and disease risks.

Regulations on exotic pet ownership vary from state to state and there are some national restrictions on owning and selling certain exotic pets. It is important to be aware of regulations and what is in effect where you practice. A well known example of pet legislation is the ban on selling turtles that are less than four inches long. This law was created in the 1975 (Title 21 CFR 1240.62 under the Public Health Services Act by the Food and Drug Administration) to address the problem of Salmonella infections in children.3 Many of the diseases that affect exotic pets and people also may be reportable diseases. National and state reportable disease lists change with emerging disease outbreaks and should be monitored periodically as disease priorities change.

Client Education

There are several important points that should be discussed with clients when they are deciding to obtain, or have already obtained, an exotic pet. Discussions on type of pets, appropriateness for the family (i.e., animals that may become aggressive with maturity, complex husbandry needs etc.), zoonosis risk and legality of owning that certain pet, are all critical points for discussion. Do not assume pet owners know the risks associated with these animals or have thought of the long term care some of these pets may need. Some key questions to ask are: "1. How old are the children with access to the pet? 2. Is anyone pregnant in the house? 3. Are there immunocompromised individuals in the family? 4. Are there young children in the family and/or home? 5. Do the owners routinely visit the veterinarian when animals are sick? 6. Do the clients properly care for the animals they have in their home and do they visit their own primary care physicians on a regular basis?" Encourage the owners to discuss their pets with their primary care physicians and to tell their doctors about any illnesses that may be similar between the pets and themselves. In particular, stress communications with immunocompromised clients and the importance of understanding potential zoonoses from their pets.1 Only 5% of pediatricians queried reported that they regularly educated patients or families about pet-associated salmonellosis or toxoplasmosis.2

It is also important if you are going to see exotic pets to be familiar with local breeders and distributors of these animals. Site visits to animal distribution and breeding centers will tell you if the animals are kept in clean environments with proper infection control. Questioning how frequently animals are imported into the distributor and mixed with existing populations may also help in determining if the facility is at high risk for disease outbreaks. One more thing to consider is if the animals are being indiscriminately treated with broad spectrum antibiotics when brought into the facility. The ever increasing amount of antibiotic resistant strains of bacteria associated with disease outbreaks in people and animals is very concerning.

Discussing zoonotic diseases specific to each type of pet (see Table 1) and also how diseases can be transmitted is important. Education about potential aerosol transmissions, fomites, vectors and good sanitation with clients may help prevent zoonoses.

Table 1: Zoonoses Associated with Nontraditional Pets

Avian pets

Chlamydia psittaci, Newcastle disease, Mycobacterium sp., influenza, GI pathogens (Salmonella sp., Campylobacter), Listeria, Giardia, cryptosporidia

Chinchillas

Listeria sp., dermatomycosis, lymphocytic choriomeningitis virus (LCM)

Ferrets

Influenza, dermatomycosis, GI pathogens, rabies, Giardia, Listeria, intestinal parasites

Guinea pigs

Dermatomycosis, Salmonella sp., Yersinia pseudotuberculosis

Hedgehogs

Sarcoptic mange, dermatomycosis, Salmonella, Mycobacterium sp., rabies, Yersinia sp.

Invertebrates

Salmonella sp., Klebsiella sp., - usually found in unhygienic food sources.

Prairie Dogs

Monkey Pox, Francisella tularensis type B, Yersinia sp., rabies, dermatomycosis, GI pathogens

Reptiles

Salmonella sp., Mycobacterium sp., GI pathogens, Coxiella burnetii (from reptile ticks), GI parasites

Rabbits

Cheyletiella, GI pathogens, dermatomycosis, tularemia

Rodents

Lymphocytic choriomeningitis virus, Yersinia sp., tularemia, Salmonella sp.

Non-human primates

GI pathogens, Mycobacterium sp., viral diseases such a Herpes B, Simian Immunodeficiency Virus, Simian T-Cell Leukemia Virus, Simian Foamy Virus, Hepatitis viruses, etc., Balantidium, Entamoeba, Giardia, dermatomycosis. ** NHP have the greatest potential for zoonotic disease transmission due to their close genetic relatedness to humans.

Fish

Mycobacterium sp., Aeromonas sp., Vibrio sp., Edwardsiella sp., Salmonella sp., Streptococcus iniae, Erysipelothrix rhusiopathiae

Prevention

Stopping disease transmission before it ever occurs is the key to healthy pets and families. Clients need to be educated about zoonotic disease prevention. Discussing clinical signs associated with diseases, asymptomatic carriers, and proper hygiene are all components of good client education. There are many resources available for client education (see Table 2). Things as simple as proper hand washing every time a pet or its caging is handled, and supervising children when they are handling pets should be discussed. Keeping pets away from human food sources, kitchen counters and sinks, as well as bath tubs is also an important reminder to give the clients. Cages and equipment should not be cleaned in the kitchen or near food preparation areas or dishes. Additionally, sinks or tubs used for cleaning pet cages and equipment should be disinfected with a 10% bleach solution afterwards.

Table 2: Resources For Information on Zoonoses

CDC – exotic pets and wildlife trade

http://www.cdc.gov/ncidod/EID/13/1/6.htm

CDC- National center for zoonotic, vector borne, and enteric diseases

http://www.cdc.gov/nczved/

AVMA client educational brochures- selecting exotic pets, disease information

http://www.avma.org/animal_health/brochures/default.asp

AAZV link to concurrent and emerging diseases

http://www.aazv.org/displaycommon.cfm?an=9

ARAV client and veterinary information- reptiles and amphibians

http://www.arav.org/ECOMARAV/timssnet/PDF/Salmonella_Bacteria_and_Reptiles_client_final_11apr08.pdf
Editor’s note: Two Salmonella publications (one for owners, the other for veterinarians) are available at: http://www.arav.org/Publication.htm

National Association of State Public Health Veterinarians- compendia on animal contact and hand washing brochures

http://nasphv.org/Documents/AnimalsInPublicSettings.pdf

Association of Avian Veterinarians

http://www.aav.org/publications/index.php?content=brochures

World Health Organization-zoonoses and veterinary public health

http://www.who.int/zoonoses/vph/en/

FDA on turtles and salmonella, food handling and pets

http://www.fda.gov/AnimalVeterinary/GuidanceComplianceEnforcement/ComplianceEnforcement/UCM090573 

Morbidity and Mortality Weekly- reportable diseases

http://www.cdc.gov/mmwr/

Summary

With the growing popularity of exotic pets, more and more veterinarians are being asked for their guidance when it comes to disease prevention. The veterinary office is the perfect place to educate pet owners about the potential risks associated with owning exotic and unusual pets. Veterinarians need to be prepared to educate their clients about responsible pet ownership and disease prevention. Communications between veterinarians, public health officials and physicians also need to stay open so each party can stay educated about the benefits, as well as the risks, of exotic pet ownership.

References

1.  Johnson-Delaney, C.A. (1997) Non-traditional animals for contact with immunosuppressed people: precautions against zoonotic disease transmission. Proc. Am. Assoc. Zoo Vet. Annual Meeting 100–106.

2.  Pickering, L.K., N. Marano, J.A. Bocchini, F.J. Angulo, and the Committee on Infectious Disease. (2008) Exposure to nontraditional pets at home and to animals in public settings: risks to children. Pediatrics 122: 876–886.

3.  U.S. Food and Drug Administration, Code of Federal Regulations, Title 21. Available at http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=1240.62

 

Speaker Information
(click the speaker's name to view other papers and abstracts submitted by this speaker)

Hayley W. Murphy, DVM, DVM
Zoo Atlanta
Atlanta, GA, USA


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