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Transcript
Home hygiene, pets and other domestic animals August 2008 This leaflet has been put together to provide background information and advice on what to do about the risk of spread of infection from pets and other domestic animals in the home. This briefing material has been produced for healthcare professionals, the media and others who are looking for background understanding about infection risks associated with domestic animals and/or are responsible for providing guidance to the public on this issue. What are the risks? Pets (including reptiles, birds, etc.) and other animals in the home can pose a risk of infection. Pets can carry pathogens such as Salmonella in their faeces, on their fur, paws and in their mouths. Disease-causing organisms carried by domestic animals include bacterial, viral, parasitic and fungal species, such as those listed in the table below. Domestic animals such as cats and dogs can also harbour moulds and yeasts on their coats. Puppies and kittens with diarrhoea can pass on infections such as Campylobacter. Exotic pets such as reptiles have also been known to pass on Salmonella infections. Organism Campylobacter Cryptosporidium Listeria Pasteurella Salmonella Toxocaria Toxoplasma Cat Dog Rabbit Mouse Rat Hamster Reptiles Food poisoning microbes such as Campylobacter, Salmonella and Cryptosporidium can be present in farm animals. Farm animals naturally carry a range of microbes and some, such as E. coli O157, can cause serious disease and can even be fatal. Potential hazards include animal faeces and secretions that can contaminate animal feedstuffs, raw milk and water. Infections can be passed from animals to humans in several ways. Some infections are carried on the fur of animals. Infections can be transferred by touching and stroking animals and not washing hands. Other pathogens are excreted in the faeces of animals and can remain in the environment, especially in moist areas. Survival and transfer via surfaces occurs in the same way as it does for human pathogens. For example, Cryptosporidium can remain viable in the environment for up to 12 months. Fungal skin infections such as ringworm can be transmitted to humans by direct contact with animals. Water-borne transmission from pets to humans has also been documented. Infections can be passed on from animals in the kitchen. It is thus important to keep separate equipment for pets and to clean surfaces where pets have touched. How big is the risk? More than 50% of homes in the English-speaking world have cats and dogs, with 60 million cats and dogs in the USA. Domestic cats and dogs can carry organisms such as Salmonella, Campylobacter, Staphylococcus aureus (including MRSA and PVLproducing strains) and Clostridium difficile. Exotic pets such as reptiles can also be a source of infection e.g. Salmonella: In the USA, up to 39% of dogs may carry Campylobacter, and 10–27% may carry Salmonella A London study isolated 19 species of Campylobacter spp. from 100 specimens of faeces obtained from a cattery, including Campylobacter upsaliensis and Campylobacter jejuni A Canadian study showed that C. difficile was the most frequently isolated pathogen from dogs. C. difficile was isolated from 58 (58%) of 102 faecal specimens, of which 41 isolates were disease-causing strains. Although there is little data indicating the extent of the infection risk from animals in the home (i.e. how often infections are acquired from animals in the home) a number of studies have demonstrated situations in which pets were identified as a risk factor for infection in the home: A study of 50 US homes in which children under 4 years were known to be infected with Salmonella spp. showed that, in 34% of homes, there was also illness in another family member. The data indicated that environmental sources, infected family members and also pets, are more significant risk factors for development of salmonellosis in these children than contaminated foods. In 3 studies, discharged MRSA-infected hospital patients and health care workers were successfully treated at home to eradicate the organism, but subsequently became re-colonised. In each of these cases the evidence suggested that the source of re-colonisation was a domestic dog. The UK HPA report data indicating that reptile pets may pose a Salmonella risk to infants in the home. Salmonella arizona is commonly found in the gut of reptiles, with snakes being the largest reservoir of infection. HPA reported a significant increase in reported infections with S. arizona that may be a reflection of the increased popularity of reptiles as pets. In England and Wales in 2007, 55 human cases of S. arizona were reported out of 11,943 non-typhoidal salmonellas (0.46%) compared with 30 cases out of 23,134 non-typhoidal salmonellas (0.13%) reported in 1998. Domestic animals and high risk groups in the home “At risk” groups are at particular risk of infection from domestic animals in the home who may be infected or carrying pathogenic spp. Demographic changes and changes in health service structure mean that the number of people in the home needing special care, because they are at increased risk of infection, is increasing. The largest of these “at risk” groups are the elderly who have reduced immunity to infection which is often exacerbated by other illnesses such as diabetes, etc. It also Page 2/4 includes the very young, patients discharged from hospital, taking immunosuppressive drugs or using invasive systems, etc. It also includes the estimated 40 million people in the global community who are infected with HIV/AIDS. In particular: Pregnant women should not handle litter trays as pathogens excreted in animal faeces, e.g. Toxoplasma gondii, can affect the developing foetus. Listeria is also a particular risk for pregnant women. Pregnant women should avoid eating cheeses made from unpasterised milk. If there is a baby in the house, ideally, reptiles should not be kept. Hygiene measures The principles of preventing the spread of pathogens from animals are the same as those for humans. Good handwashing practice is the single most important infection control measure. Hands should be thoroughly washed with soap and running water after handling domestic animals. Pets and illness Ensure all animals are regularly groomed and checked for signs of infection. If a pet becomes ill, seek advice from a vet. Ensure all animals receive up-to-date immunisations and other important treatments such as worming and flea treatments. Pets and food Keep pet food separate from human food. Always wash hands after touching animals or their food, toys, litter trays, etc., especially before preparing food for human consumption. Ensure pet feeding areas are clean and animals have their own dishes and utensils. Dishes, utensils and tin openers used for pet food, should be cleaned and stored separately. Keep pets off kitchen surfaces or areas where food is prepared. Pets and cleaning Clean all cages and bedding regularly. Ensure litter trays are cleaned regularly (at least daily). Use gloves and paper towels to clean up animal faeces. Animal faeces can be flushed down the toilet. However, faeces in plastic bags and soiled cat litter should go into the waste bin. Hygienically clean floor surfaces used by pets and pet feeding areas regularly by cleaning followed by disinfection, or using a disinfectant/cleaner. Keep sandpits covered to avoid soiling by animals. Pregnant women should avoid cleaning cat litter trays . Page 3/4 Farm animals On farm visits, ensure that the farm has washing facilities with running water, soap and disposable towels. Wash hands thoroughly after touching animals and before eating food. Further reading 1. 2. 3. 4. The changing hygiene climate: a review of infectious disease in the home and community. International Scientific Forum on Home Hygiene 2008. www.ifhhomehygiene.org/IntegratedCRD.nsf/111e68ea0824afe1802575070003f039/29858aa 006faaa22802572970064b6e8?OpenDocument Kuma G.S. and Smith H. (2000) Pets, poop and parasites. Microbiology Today 27;84-86. Goldstein E.J.C. (1991) Household pets and human infections. Infectious Disease Clinics of North America 5;117-130. Health and Safety Executive (1998) AIS23 Avoiding ill health at open farms. IFH Home Hygiene Guidelines and Training resources 1. Guidelines for prevention of infection and cross infection the domestic environment. International Scientific Forum on Home Hygiene. Available from: http://www.ifhhomehygiene.org/IntegratedCRD.nsf/70f1953cec47d5458025750700035d86/92111ae389 86bfbb802574dd003fc2c1?OpenDocument 2. Recommendations for selection of suitable hygiene procedures for use in the domestic environment. International Scientific Forum on Home Hygiene. Available from: http://www.ifhhomehygiene.org/IntegratedCRD.nsf/70f1953cec47d5458025750700035d86/24401f935 e57e79e802574e200391c43?OpenDocument . 3. Guidelines for prevention of infection and cross infection the domestic environment: focus on issues in developing countries. International Scientific Forum on Home Hygiene. Available from: http://www.ifhhomehygiene.org/IntegratedCRD.nsf/70f1953cec47d5458025750700035d86/24eb0634 5354d067802574e1005a075d?OpenDocument 4. Home Hygiene - prevention of infection at home: a training resource for carers and their trainers. International Scientific Forum on Home Hygiene. Available from: http://www.ifhhomehygiene.org/IntegratedCRD.nsf/571fd4bd2ff8f2118025750700031676/9aaaeb306bb 3c50c80257522004b4fdc?OpenDocument 5. Home Hygiene in Developing Countries: Prevention of Infection in the Home and Peridomestic Setting. A training resource for teachers and community health professionals in developing countries. International Scientific Forum on Home Hygiene. Available from: http://www.ifhhomehygiene.org/IntegratedCRD.nsf/571fd4bd2ff8f2118025750700031676/19155ab46 073e67f8025752200546d83?OpenDocument Page 4/4