PETS AND IMMUNOCOMPROMISED INDIVIDUALS
Dr Amit Kumar
1- Veterinary Officer, Government Veterinary Hospital, Mohanchatti-249304 Pauri Uttarakhand (India)
Now a day it has become very common to raise pets in our society. Dogs and Cats are most frequently owned Pets but some family are raise other species. But disease risks associated with pet’s ownership are not clearly defined. There are many zoonotic pathogens that, according to some species, are dangerous to all of us. Young children, pregnant women, as well as those whose immunity is weak, are at higher risk. Apart from this, the risk also increases in peoples who raise different animals. As we are moving forward with modernity and technology, the immunity of peoples is decreasing in the same way. And there are many reasons for this like HIV, Chemotherapy, Surgery, Co-morbidities, old age, Computer, mobile game etc. Immunocompromised can be found in one or more family members living with the pets. And peoples with weaken immunity are at higher risk of specifically pet-associated Zoonotic diseases. Along with this, people living with pets feel happier and lighter than those who live away from pets. This cannot be denied.
Human-Animal Bond
In todays run-of-the-mill life, many psychological changes like stress, social isolation, away from family etc. are taking a toll on the health of the peoples. Depression and anxiety are common. That may be due to sympatho-adrenal medulla system and hypothalamic-pituitary-adrenal axis that release corticosteroid and decrease myocardial perfusion. All these have a bad effect on the body.
Human animal bond has a huge capacity to overcome all this. This has led to psychological and physiological changes or Mental and physiological benefits. From pets animal to all age groups of peoples. There is also a lot of positivity like reduce anxiety, reduce stress and heart related diseases etc.
So now we can say that living with pets has both advantages and disadvantages. It is up to us what we think.
Pet-associated Zoonotic disease
Along with the benefits of pets ownership, companion animal are highly source of human disease. Immunocompromised person are often at an high risk of zoonotic disease and experience symptoms for a longer duration.
Table: Examples of pet-associated infections particularly relevant to immunocompromised individuals.
| Infectious agent | Frequency or risk in
immunocompromised individuals |
Common clinical
manifestations in general population (and immunocompromised) |
Other comments |
| Toxoplasma gondii | Moderate; incidence of
Toxoplasma encephalitis of 2.2% in HIV – infected individuals 76 |
Subclinical or self – limited
febrile illness (greater risk for in utero infection, encephalitis) |
Most cases among transplant
recipients caused by reactivation (3 – 26 weeks posttransplant); food and environment are main sources of human infection |
| Cryptosporidium spp. | Moderate; 3 – 6% of HIV –
infected individuals; risk increases with degree of immunosuppression and is largely limited to those with impaired T – cell function (e.g., acute leukemia and lymphoma) |
Subclinical or self – limiting
diarrhea (chronic intractable diarrhea, shortened survival; symptoms dependent on immune status and genotype/ species of infection) |
All species identified in
companion animals should be considered potentially zoonotic in immunocompromised individuals |
| Salmonella spp. | Low; incidence of bacteremia
20 – to 100 – fold higher among HIV – infected than among HIV – uninfected individuals |
Self – limiting diarrhea,
vomiting (higher rates of bacteremia, severe systemic and localized infections) |
Chemotherapy – triggered
reactivation of asymptomatic colonization occurs |
| Campylobacter
jejuni |
Low; greater rate in patients
with hematologic malignancy versus without malignancy |
Self – limiting diarrhea,
vomiting, fever (relapses of septicemia and diarrhea) |
|
| Bartonella
henselae |
Low, but perhaps
underdiagnosed |
Lymphadenopathy and fever
(bacteremia; proliferative lesions on the skin, liver, or spleen) |
Hospitalization rate for
general pediatric population under 5 years is 0.86 per 100,000 children |
| Giardia
intestinalis |
low | Subclinical or mild diarrhea
(chronic diarrhea, weight loss) |
|
| Bordetella
bronchiseptica |
rare | Generally none (respiratory
disease in children with lung transplants, those treated with immunosuppressive drugs, and HIV infected) |
|
| Capnocytophaga
canimorsus |
Rare | Generally none (sepsis,
disseminated intravascular coagulation, death especially among asplenic persons, those of advanced age, or alcoholics) |
Most relevant for
splenectomized or functionally asplenic individuals |
Knowledge of Zoonotic Disease, attitudes and practices of Immunocompromised individuals
To prevent any disease, the most important role is that we have to take such measures in time so that the spread and effect of zoonotic disease can be reduced. There have been many studies in this subject that pet ownership attitudes and disease prevention practices for general, medical professionals including veterinarians. Physicians generally keep information about their patients’ immune system but they forget to keep information about the important subject of pet ownership and contacts to pets. So not able to educate and inform the patient about prevention of zoonotic disease but Veterinary profession this can’t be happens.
Some important recommendations for reducing the transmission from pets to Immunocompromised individuals
Many suggestions have been made by National and International Organizations to reduce the spread of zoonotic transmission and also issue new guidelines from time to time.
General recommendations for reducing zoonotic pathogen transmission from pets to Immunocompromised individuals.
Personal hygiene
- Wash hands thoroughly after handling animals or their environment and also follow for rule for children under 5 years.
- Avoid contact with pets’ feces and urine, if encounter so wash properly with soap.
- Avoid contact with animal – derived pet treats with naked hand.
- Thoroughly wash bites and scratches from animals.
- Do not allow pets to lick open wounds or cuts.
- Wear shoes, socks, long pants and long-sleeved shirts when farming or working in gardens.
- Wear gloves to clean aquariums; do not dispose of aquarium water in bathroom or kitchen sinks.
- Ensure playground sandboxes are kept covered when not in use.
Types and ages of animals
- Avoid as much as contact with dogs and cats less than 6 months of age or strays (avoid acquiring a cat less than 1 year of age)
- Avoid as much as contact with animals with diarrhea and vomiting.
- Avoid as much as contact with young farm animals (e.g., petting zoos, calf, foal, kid)
- Avoid as much as contact with reptiles, amphibians, rodents, ferrets, baby poultry (chicks and ducklings), and anything that has been in contact with these animals; preferably, these animals should be kept out of the households of Immunocompromised individuals.
- Reptiles, amphibians, rodents, and baby poultry should not be permitted to roam freely through a home or living area and should be kept out of kitchens and food preparation areas.
- Exercise caution when playing with cats to limit scratches; keep cats ’ nails short.
- When acquiring a new pet, seek larger, mature animals from established vendors as these pose a lower risk than other types of animals.
- Avoid as much as contact with exotic pets.
- When visiting other households with pets, take the same precautions with those pets.
- Consider limiting contact with pets an animals in medical settings. (e.g., therapy and visitation animals)
Pet health and husbandry
- Spay/neuter to reduce the likelihood of infectious pathogen transmission through reproductive tract secretions and copulation.
- Keep cats indoors; change litter boxes daily and keep cats away from kitchens or other areas where food preparation and eating occur.
- Keep dogs confined when possible; walk on leash to prevent hunting, coprophagia, and garbage eating.
- Feed only canned or dried commercial food or well – cooked home – prepared food; any dairy products should be pasteurized.
- Prohibit access to nonpotable water, such as surface water or toilet bowls.
- Follow routine preventative care for pets as well as own, including steps to control and prevent ecto and endoparasites as indicated by the area.
- Clean bird cage linings daily with disinfectant; wear disposable gloves, surgical mask, when handling.
- Clean small rodent cages regularly disinfectant and fresh water.
- Weekly launder pet bedding.
- Seek veterinary care at first sign of illness in animals.
- Regularly contact with near Veterinary Doctors.
Conclusions
Pets play a key role in maintain healthy and disease of Immunocompromised individuals. There are many pathogens that spread from pets to individuals and number of benefits occurs on pets ownership. So we have to walk with a balance in both. If we follow the given instructions then the risk of zoonotic disease will be less. From time to time, a healthy discussion for pets ownership must be organize and veterinarians an Physicians should work together. Thinking all this WHO and OIE start a One Health Program.
References
Hung C , Hung M , Hsueh P , et al. Risk of recurrent nontyphoid Salmonella bacteremia in HIV – infected immunocompatients in the era of highly active antiretroviral therapy and an increasing trend of fluoroquinolone resistance . Clin Infect Dis 2007 ; 45 ( 5 ): e60 – e67.
https://www.pashudhanpraharee.com/pet-borne-zoonotic-infection-its-prevention/
Gradel KO , Norgaard M , Dethlefsen C , et al. Increased risk of zoonotic Salmonella and Campylobacter gastroenteritis in patients with haematological malignancies: a population – based study . Ann Hematol 2009 ; 88 ( 8 ): 761 – 767 .
Trevejo RT , Barr MC , Robinson RA . Important emerging bacterial zoonotic infections affecting the immunocompromised . Vet Res 2005 ; 36 ( 3 ): 493 – 506 .
Centers for Disease Control and Prevention,Infectious Disease Society of America, American
Society of Blood and Marrow Transplantation .Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients .MMWR Recomm Rep 2000 ; 49 ( RR – 10 ): 1 – 125 , CE1 – 7.
Mofenson LM , Brady MT , Danner SP , et al. Guidelines for the prevention and treatment of opportunistic infections among HIV – exposed and HIV – infected children: recommendations from CDC, the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics . MMWR Recomm Rep 2009 ; 58 ( RR – 11 ): 1 – 166 .
