Tough mudders beware: there is E. coli risk

In August 2018, Public Health England (PHE) was made aware of five probable cases of Shiga toxin‐producing Escherichia coli (STEC) O157:H7 among individuals reporting participation in a mud‐based obstacle race. An additional four cases, identified via routine whole‐genome sequencing, were subsequently linked to the same event. Two of the nine cases were due to secondary household transmission.

Despite an agreement between the event organizers and the local authority, to ensure that all livestock were removed from the site 28 days before the event, sheep were observed grazing on some of the routes taken by the runners 2 days prior to the race taking place. A retrospective review of incidents reported to PHE between 2015 and 2018 identified 41 cases of gastroenteritis associated with muddy assault course events. Of these, 25 cases were due to infection with STEC O157:H7, of which all but one were associated with outbreaks.

Due to the environment in which such events take place, it is impossible to entirely remove the risk of exposure to potentially pathogenic zoonoses. However, race organizers should ensure that livestock are removed from the course 28 days before the event. They should also ensure that participants are made aware of the risk of contracting gastrointestinal disease from the environment, and to stress the importance of hand hygiene post‐event and the risk of secondary transmission, particularly to children who are at risk of developing haemolytic uraemic syndrome.

An outbreak of shiga toxin-producing Escherichia coli O157:H7 linked to a mud-based obstacle course, England, August 2018

Zoonoses and Public Health

Alexander Sharp, Elizabeth Smout, Lisa Byrne, Rebecca Greenwood, Richard Abdoollah, Charlotte Hutchinson, Claire Jenkins, Nachi Arunachalam, Simon Padfield, Gareth Hughes, Mike Gent

https://doi.org/10.1111/zph.12744

https://onlinelibrary.wiley.com/doi/abs/10.1111/zph.12744

Is quarantine the right time to get a puppy?

Yes

We got George, to go with Ted,  a few weeks ago when he was 8 weeks old.

I’ve had turtles that small but never a dog

Ronda Kaysen of the New York Times asked the same question a week ago.

For Julie Taylor, a TV writer and producer in Glendale, Calif., the answer was two.

Stuck at home with her husband and two teenage children following coronavirus stay-at-home orders, she started to get the itch in mid-March for something furry, happy and oblivious to the stress going on around her.

“It hit me pretty much as soon as we locked down. I really wanted a dog,” said Ms. Taylor, 48. “I can turn on the news at night and three hours later I’m still watching. I get sucked in. I was hoping a dog could help me be more in the moment.”

So earlier this month, the family adopted an 8-month-old pug named Bentley from a friend of a friend, immediately transforming their home life from gloomy to giddy. For the teenagers, the puppy offered a reprieve from the disappointment of a stunted social life. Bentley “has been a fast distraction,” Ms. Taylor said. “He’s added a lot of life into the house.”

On Petfinder.com, adoption inquiries in the four weeks between March 15 and April 15 jumped 122 percent from the previous four weeks. Americans are fostering, too, as shelters look to empty their facilities during the pandemic. Since March 15, more than 1,500 people have completed online foster applications for the ASPCA’s New York City and Los Angeles foster programs, a 500 percent increase compared to typical application numbers usually seen in this period.

“Bringing a new life into a home is an act of optimism,” said Judith Harbour, a licensed clinical social worker for the Animal Medical Center on East 62nd Street in Manhattan, pointing out that many animals in shelters need homes now. “So there is an idea that some people might have: I can do this good thing right now.”

A pet is also a way to wrestle control back into a life that feels unmoored. Our routine may be thrown, but dogs still need to be walked, fed, cleaned and nurtured. A pet’s schedule gets us out of bed and maybe even out of our pajamas and onto the street for some fresh air.

Practical ways to help vets during COVID-19

Maureen Anderson writes in the Worms & Germs Blog, “the COVID-19 pandemic has put a lot of strain on a lot of people, and those in the veterinary profession are no exception.  Thank you, Captain Obvious. 

Self-care and mental health support at times like these are critical, but can be hard to come by for many still working on the front lines in clinics, both human and veterinary.  It’s important to recognize that everyone is stressed, even our clients, but giving others that extra little bit of leeway and understanding can be tough when you’re already at the end of your own rope. (Right, that’s Kate the Vet of Kansas State University and my research partner on a couple of handwashing projects and papers back in the day.)

A little bit of kindness can go a long way, and that’s as important now as it was a month ago when the world changed overnight, maybe even more so.  Dr. Christopher Byers, a fellow veterinary internist in the US, wrote a blog post about how pet owners can help veterinarians during this crisis, and it also speaks to how we can all help each other.  Our mental and physical health go hand-in-hand, and are also closely associated with the health and welfare and care we are able to provide our animals.  Consider it a non-infectious consequence of a highly infectious disease, so I thought it was appropriate to share here.

You can read Dr. Byers full post on CriticalCareDVM.com, but here are his three very simple and practical points for pet owners:

  1. Be flexible
  2. Be kind
  3. Stay home if your pet isn’t sick

Zoonoses in Minnesota

Prospective, population-based surveillance to systematically ascertain exposures to food production animals or their environments among Minnesota residents with sporadic, domestically acquired, laboratory-confirmed enteric zoonotic pathogen infections was conducted from 2012 through 2016.

Twenty-three percent (n = 1708) of the 7560 enteric disease cases in the study reported an animal agriculture exposure in their incubation period, including 60% (344/571) of Cryptosporidium parvum cases, 28% (934/3391) of Campylobacter cases, 22% (85/383) of Shiga toxin-producing Escherichia coli (STEC) O157 cases, 16% (83/521) of non-O157 STEC cases, 10% (253/2575) of non-typhoidal Salmonella enterica cases and 8% (9/119) of Yersinia enterocolitica cases. Living and/or working on a farm accounted for 61% of cases with an agricultural exposure, followed by visiting a private farm (29% of cases) and visiting a public animal agriculture venue (10% of cases). Cattle were the most common animal type in agricultural exposures, reported by 72% of cases.

The estimated cumulative incidence of zoonotic enteric infections for people who live and/or work on farms with food production animals in Minnesota during 2012–2016 was 147 per 10 000 population, vs. 18.5 per 10 000 for other Minnesotans. The burden of enteric zoonoses among people with animal agriculture exposures appears to be far greater than previously appreciated.

Animal agriculture exposures among Minnesota residents with zoonotic enteric infections, 2012-2016, 17 December 2019

Epidemiology and Infection

CA Klumb, JM Scheftel and KE Smith

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/2F76B12833C41C4F63153CC4315C22F0/S0950268819002309a.pdf/animal_agriculture_exposures_among_minnesota_residents_with_zoonotic_enteric_infections_20122016.pdf

The Tripartite Zoonotic Guide (TZG): Worst catchphrase ever, but important

Every day I see jobs being advertised for communications and marketing types that I know I am qualified for and it would be nice to have a paycheck, but then I look at what is produced and realize I would have to check my brain at the door.

Not my style.

Someone from the OIE writes, we hear about health challenges at the human-animal-environment interface. Zoonotic diseases such as avian influenza, rabies, Ebola, and Rift Valley fever continue to have major impacts on health, livelihoods, and economies. These health threats cannot be effectively addressed by one sector alone. Multidisciplinary and multisectoral collaboration is needed to tackle them and to reduce their impacts.

As a way to support countries in taking a One Health approach to address zoonotic diseases, the guide: “Taking a Multisectoral, One Health Approach: A Tripartite Guide to Addressing Zoonotic Diseases in Countries” has been jointly developed by the Tripartite organizations (FAO, OIE, and WHO). This Guide, referred to as the Tripartite Zoonotic Guide (TZG) is flexible enough to be used for other health threats at the human-animal-environment interface; for example, food safety and antimicrobial resistance (AMR).

I won’t go into anymore. If you’re interested, click on the url.

Here’s a tripartite (below).

Predicting zoonotic Salmonella from livestock

Increasingly, routine surveillance and monitoring of foodborne pathogens using whole-genome sequencing is creating opportunities to study foodborne illness epidemiology beyond routine outbreak investigations and case–control studies.

Using a global phylogeny of Salmonella entericaserotype Typhimurium, we found that major livestock sources of the pathogen in the United States can be predicted through whole-genome sequencing data. Relatively steady rates of sequence divergence in livestock lineages enabled the inference of their recent origins. Elevated accumulation of lineage-specific pseudogenes after divergence from generalist populations and possible metabolic acclimation in a representative swine isolate indicates possible emergence of host adaptation.

We developed and retrospectively applied a machine learning Random Forest classifier for genomic source prediction of Salmonella Typhimurium that correctly attributed 7 of 8 major zoonotic outbreaks in the United States during 1998–2013. We further identified 50 key genetic features that were sufficient for robust livestock source prediction.

Zoonotic source attribution of Salmonella Enterica serotype typhimurium using genomic surveillance data, United States

January 2019

Emerging Infectious Diseases vol. 25 no. 1

Shaokang Zhang, Shaoting Li, Weidong Gu, Henk den Bakker, Dave Boxrud, Angie Taylor, Chandler Roe, Elizabeth Driebe, David M. Engelthaler, Marc Allard, Eric Brown, Patrick McDermott, Shaohua Zhao, Beau B. Bruce, Eija Trees, Patricia I. Fields, and Xiangyu Deng 

https://wwwnc.cdc.gov/eid/article/25/1/18-0835_article

 

How can you have your pudding if you don’t eat your meat? Pink Floyd figured out educating don’t mean much in 1979

Compelling stories are what get people to pay attention.

The U.S Centers for Disease Control in 2011, when an outbreak of variant virus infections* in people was linked to exposure to pigs at agricultural fairs, public health officials quickly recognized the need to support states in using a One Health approach to respond effectively to novel influenza A and other zoonotic disease outbreaks in rural areas. The approach would need to involve organizations focused in animal and human health, as well as members of the communities most at risk. In the United States, there are around 7.2 million youth actively involved in 4-H and FFA combined1. CDC and USDA saw that working with these youth groups could be an effective way to reach rural Americans with important influenza and zoonoses prevention education to protect the 150 million people who visit agricultural fairs each year, as well as the animals shown and exhibited in these venues

To improve influenza education and communication efforts around youth in agriculture, several government and non-governmental organizations partnered to launch a pilot program called Influenza Education among Youth in Agriculture. The program has since taken off, reaching hundreds of thousands of youth and their families across rural America and has expanded to include other zoonotic diseases caused by infections such as E. coli and Salmonella. The program is a joint effort of federal government (CDC and USDA), the Council for State and Territorial Epidemiologists (CSTE), several state health departments, land-grant universities and the 4-H programs run out of them, and state departments of agriculture. These One Health partners work together to develop hands-on activities for youth, zoonotic disease curricula and lesson plans, educational workshops, biosecurity and handwashing posters, and also hold meetings to foster relationships, build networks, and achieve project goals to protect human and animal health.</em

Wild boars and zoonoses

Maria Fredriksson-Ahomaa writes in Foodborne Pathogens and Disease that wild boar populations around the world have increased dramatically over past decades. Climate change, generating milder winters with less snow, may affect their spread into northern regions. Wild boars can serve as reservoirs for a number of bacteria, viruses, and parasites, which are transmissible to humans and domestic animals through direct interaction with wild boars, through contaminated food or indirectly through contaminated environment. Disease transmission between wild boars, domestic animals, and humans is an increasing threat to human and animal health, especially in areas with high wild boar densities.

This article reviews important foodborne zoonoses, including bacterial diseases (brucellosis, salmonellosis, tuberculosis, and yersiniosis), parasitic diseases (toxoplasmosis and trichinellosis), and the viral hepatitis E. The focus is on the prevalence of these diseases and the causative microbes in wild boars. The role of wild boars in transmitting these pathogens to humans and livestock is also briefly discussed.

barfblog and a song; 118 sick from campy in puppies

We have escaped to Coff’s Harbour, about five hours south of Brisbane, for our annual hockey tournament at the Big Banana, which has a small ice rink so we play 3-on-3, and where Russell Crowe apparently learned to skate for his role in the 1999 movie, Mystery, Alaska (a great hockey movie).

Amy is involved in all kinds of things, I coached for a few years and am now a happy spectator.

JFK of NSA Hockey, who played junior in Michigan, runs a day-long hockey camp for kids who are interested, so it’s a couple of days of writing and chilling for me and the Hubbell.

I’m going to catch up on some blog posts, fit each with one of my favorite songs, and then get on with that book.

I laid in bed and figured out the first half the other night.

We have Ted, the Wonder Dog, with us (he’s a wonder because how can such a little thing shit so much).

According to the U.S Centers for Disease Control, dogs, especially puppies, are a known source of sporadic Campylobacter infections in humans, but are uncommonly reported to cause outbreaks.

Investigation of a multistate, multidrug-resistant outbreak of Campylobacter jejuni infections implicated puppies from breeders and distributors sold through pet stores as the outbreak source. Outbreak strains were resistant to all antibiotics commonly used to treat Campylobacter infections.

Campylobacter causes an estimated 1.3 million diarrheal illnesses in the United States annually (1). In August 2017, the Florida Department of Health notified CDC of six Campylobacter jejuni infections linked to company A, a national pet store chain based in Ohio. CDC examined whole-genome sequencing (WGS) data and identified six isolates from company A puppies in Florida that were highly related to an isolate from a company A customer in Ohio. This information prompted a multistate investigation by local and state health and agriculture departments and CDC to identify the outbreak source and prevent additional illness. Health officials from six states visited pet stores to collect puppy fecal samples, antibiotic records, and traceback information.

Nationally, 118 persons, including 29 pet store employees, in 18 states were identified with illness onset during January 5, 2016–February 4, 2018. In total, six pet store companies were linked to the outbreak. Outbreak isolates were resistant by antibiotic susceptibility testing to all antibiotics commonly used to treat Campylobacter infections, including macrolides and quinolones. Store record reviews revealed that among 149 investigated puppies, 142 (95%) received one or more courses of antibiotics, raising concern that antibiotic use might have led to development of resistance. Public health authorities issued infection prevention recommendations to affected pet stores and recommendations for testing puppies to veterinarians. This outbreak demonstrates that puppies can be a source of multidrug-resistant Campylobacter infections in humans, warranting a closer look at antimicrobial use in the commercial dog industry.

If you’re a stray cat, Ted the Wonder Dog will make friends.

Multidrug-resistant campylobacter jejuni outbreak linked to puppy exposure- United States, 2016-2018

https://www.cdc.gov/mmwr/volumes/67/wr/mm6737a3.htm?s_cid=mm6737a3_e

‘You could make animals sick’

Gonzalo and Kate, after all those farm/petting zoo/animal experience visits, have you ever seen a sign like this:

It’s accurate, zoonoses go both or lots of other ways.

Many thanks to the barfblog.com subscriber who sent it along.

Going to a petting zoo? People need to be a lot more careful than they thought

 https://barfblog.com/2012/09/going-to-a-petting-zoo-people-need-to-be-a-lot-more-careful-than-they-thought/

The other parents hate me.

Even Amy changed her phone ring to the Debbie Downer noise from Saturday Night Live.

I’m Dougie Downer.

Every time there’s a sausage sizzle, I don’t complain, I cook for the kids and their families, and use a thermometer.

People think I’m weird.

The chicken coop at the daycare is still empty. And while no one will say it, I’m sure they blame me for depriving their little ones of chick interaction (and Salmonella).

This is nothing new; I’ve been causing angst or disgust for about 20 years, going with my kids on those field trips to the farm (the oldest of five daughters is 25; I’m ancient).

Besides, Gonzalo Erdozain did most of the work on this petting zoo paper, and he’s got a little one, so he can torment the parents of Roman’s future classmates.

Kansas State University came out with their version of our petting zoo paper and quoted me, as saying “People have to be careful — a lot more careful than they thought.”

Powell is co-author of the paper “Observation of Public Health Risk Behaviors, Risk Communication and Hand Hygiene at Kansas and Missouri Petting Zoos – 2010-2011″ that was published recently in the journal Zoonoses and Public Health.

courtlynn.petting.zooThe paper’s main author is Gonzalo Erdozain, a master of public health student at the Kansas State University who works with Powell. Erdozain, Manhattan, visited numerous petting zoos and fairs in Kansas and Missouri in 2010 and 2011 and found many sanitary problems at the facilities. Article co-authors include Katherine KuKanich, assistant professor of clinical sciences at Kansas State University, and Ben Chapman of North Carolina State University.

When visiting petting zoos, Powell said parents need to be vigilant in watching their children and they need to put a health plan in effect for the visit. In Erdozain’s study, he observed children touching their faces after petting the animals, eating or drinking in the petting zoo, eating petting zoo food and sucking on a pacifier while at the zoo. Children were also seen picking up animal feces.

Another factor to watch for is the presence of high-risk animals — those most associated with zoonotic diseases, including chicks, young ruminants like goats, sheep and cattle.

Zoonotic diseases can be passed from animal to human, or vice versa.

Washing hands before and after encountering animals and the animal feed is one of the most recommended method to fight germs and bacteria from the animals and surrounding area of animal pens, Powell said.

“Hand-washing tool selection may also contribute to the success of hand hygiene as a preventive measure, as some outbreak investigations have reported alcohol-based hand sanitizer was not protective against illness, especially when hands are soiled,” Powell said.

Powell said Erdozain’s study found that visitors were five times as likely to wash their hands when a staff member was present. This observation, Powell said, is consistent with a study published last year that showed the importance of a little encouragement.

To help maintain a safe and healthy environment, Powell said petting zoos should constantly remind visitors to wash their hands when exiting the pens. Keeping clean and useful sinks near the exits of all facilities with a stand by attendant would help decrease the likeliness of a widespread illness due to forgetful hygiene, he said.

Strict governmental regulation and enforcement would be one way to ensure this happens but is an unlikely solution. Powell said that it is up to the zoos to help keep watch on what is happening within their pens and to make sure that the proper facilities are in place and are noticeable to visitors — children and adults alike.

“Providing hand hygiene stations, putting up some good signs, having staff supervise, avoiding high-risk animals and logical facility design are easy and inexpensive — and not doing so is inexcusable,” Powell said.

I’m fine with animal interactions; but people, and organizers, should be a lot more careful than they thought. That’s what I told my 3-year-old’s daycare as they prepared for a chicken coop. They hate me.

A table of petting zoo outbreaks is available at http://bites.ksu.edu/petting-zoos-outbreaks.

Erdozain G, Kukanich K, Chapman B, Powell D. 2012. Observation of public health risk behaviours, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011. Zoonoses Public Health. 2012 Jul 30. doi: 10.1111/j.1863-2378.2012.01531.x. [Epub ahead of print]

Abstract below:

Observation of public health risk behaviors, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011Outbreaks of human illness have been linked to visiting settings with animal contact throughout developed countries. This paper details an observational study of hand hygiene tool availability and recommendations; frequency of risky behavior; and, handwashing attempts by visitors in Kansas (9) and Missouri (4), U.S., petting zoos. Handwashing signs and hand hygiene stations were available at the exit of animal-contact areas in 10/13 and 8/13 petting zoos respectively. Risky behaviors were observed being performed at all petting zoos by at least one visitor. Frequently observed behaviors were: children (10/13 petting zoos) and adults (9/13 petting zoos) touching hands to face within animal-contact areas; animals licking children’s and adults’ hands (7/13 and 4/13 petting zoos, respectively); and children and adults drinking within animal-contact areas (5/13 petting zoos each). Of 574 visitors observed for hand hygiene when exiting animal-contact areas, 37% (n=214) of individuals attempted some type of hand hygiene, with male adults, female adults, and children attempting at similar rates (32%, 40%, and 37% respectively). Visitors were 4.8x more likely to wash their hands when a staff member was present within or at the exit to the animal-contact area (136/231, 59%) than when no staff member was present (78/343, 23%; p<0.001, OR=4.863, 95% C.I.=3.380-6.998). Visitors at zoos with a fence as a partial barrier to human-animal contact were 2.3x more likely to wash their hands (188/460, 40.9%) than visitors allowed to enter the animals’ yard for contact (26/114, 22.8%; p<0.001, OR= 2.339, 95% CI= 1.454-3.763). Inconsistencies existed in tool availability, signage, and supervision of animal-contact. Risk communication was poor, with few petting zoos outlining risks associated with animal-contact, or providing recommendations for precautions to be taken to reduce these risks.