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Garcia-Sanchez P, Romero-Trancón D, Sainz T, Calvo C, Iglesias I, Perez-Hernando B, Hurtado-Gallego J, Sánchez R, Alcolea S, Moya L, Mendez-Echevarria A. The role of veterinarians in zoonosis prevention: Advising families of immunocompromised children with pets. One Health 2024; 18:100662. [PMID: 38204817 PMCID: PMC10776649 DOI: 10.1016/j.onehlt.2023.100662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/07/2023] [Indexed: 01/12/2024] Open
Abstract
Background Pet ownership is widespread, offering numerous benefits to individuals and families. However, the risk of zoonotic diseases must be carefully considered, especially for immunosuppressed patients. Knowledge gaps in preventive measures for zoonoses have been identified, underscoring the vital role of veterinarians in addressing this issue. Objectives This study aimed to assess the knowledge and recommendations of veterinarians regarding pet ownership by immunocompromised individuals. Additionally, we compared these insights with responses from European healthcare professionals specializing in pediatric transplant recipients. Methods We conducted an observational, cross-sectional study involving small animal veterinarians in Spain. An online survey was administered to gather information on veterinarians' knowledge of zoonoses and their recommendations for immunocompromised pet owners. Results A survey of 514 individuals was collected from experienced veterinarians mainly working in primary care clinics. Surprisingly, 63% of respondents did not routinely inquire about the presence of immunocompromised individuals among pet owners, although 54% offered specific recommendations for this group. Most respondents adhered to deworming guidelines for pets owned by immunocompromised individuals and demonstrated sound practices in Leishmania and Leptospira prevention, as well as the avoidance of raw food. However, gaps were noted concerning Bordetella bronchiseptica vaccination. Notably, veterinarians outperformed medical professionals in their knowledge of zoonotic cases and identification of zoonotic microorganisms. The presence of specific recommendations in veterinary clinics was viewed positively by nearly all respondents. Conclusions Our findings indicate that veterinarians possess a superior understanding of zoonotic pathogens and exhibit greater proficiency in diagnosing zoonoses compared with physicians. They stay well-informed about recommendations outlined in established guidelines and are more likely to provide written recommendations in their clinics than physicians. Nevertheless, knowledge gaps among veterinarians emphasize the need for enhanced communication between medical and veterinary professionals. Reinforcing the "One Health" concept is imperative, with veterinarians playing a pivotal role in this collaborative effort.
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Affiliation(s)
- Paula Garcia-Sanchez
- Pediatric Emergency Department, La Paz University Hospital, Madrid, Spain
- La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Doctoral Program in Medicine and Surgery, Autonomous University of Madrid (UAM), Madrid, Spain
| | | | - Talía Sainz
- Pediatric Infectious and Tropical Diseases Department, La Paz University Hospital and La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Center for Biomedical Research in the Infectious Diseases Network (CIBERINFEC), Madrid, Spain
- Pediatric Department, Autonomous University of Madrid (UAM), Madrid, Spain
- Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | - Cristina Calvo
- Pediatric Infectious and Tropical Diseases Department, La Paz University Hospital and La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Center for Biomedical Research in the Infectious Diseases Network (CIBERINFEC), Madrid, Spain
- Pediatric Department, Autonomous University of Madrid (UAM), Madrid, Spain
- Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | - Irene Iglesias
- Center for Animal Health Research (CISA), INIA-CSIC, Madrid, Spain
| | - Belén Perez-Hernando
- Center for Biomedical Research in the Infectious Diseases Network (CIBERINFEC), Madrid, Spain
- Carlos III Health Institute, Spain
| | - Jara Hurtado-Gallego
- La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Center for Biomedical Research in the Infectious Diseases Network (CIBERINFEC), Madrid, Spain
| | - Rocío Sánchez
- La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Doctoral Program in Microbiology, Autonomous University of Madrid (UAM), Madrid, Spain
| | - Sonia Alcolea
- Pediatric Infectious and Tropical Diseases Department, La Paz University Hospital and La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Center for Biomedical Research in the Infectious Diseases Network (CIBERINFEC), Madrid, Spain
- Doctoral Program in Medicine and Surgery, Autonomous University of Madrid (UAM), Madrid, Spain
| | - Laura Moya
- IDEXX Laboratorios, S.L. Laboratory Key Account Manager, Spain
| | - Ana Mendez-Echevarria
- Pediatric Infectious and Tropical Diseases Department, La Paz University Hospital and La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Center for Biomedical Research in the Infectious Diseases Network (CIBERINFEC), Madrid, Spain
- Pediatric Department, Autonomous University of Madrid (UAM), Madrid, Spain
- Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
- ERN TransplantChild, Spain
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García Sánchez P, Iglesias I, Falces-Romero I, Serrano-Villar M, Calvo C, Alcolea S, Sainz T, Mendez-Echevarría A. Balancing the Risks and Benefits of Pet Ownership in Pediatric Transplant Recipients. Transplantation 2022; 107:855-866. [PMID: 36539923 DOI: 10.1097/tp.0000000000004419] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In recent decades, the number of pediatric transplantations and their survival rates have increased. Psychological problems and poorer quality of life are notable among children undergoing transplantation and can have long-lasting consequences and affect immunosuppressive therapy adherence. Pet ownership and animal contact have been associated with physical, mental, and social health benefits. Despite these potential benefits, however, companion animals are known to be a source of infection, which is one of the main concerns for clinicians. Because of immunosuppression, these children are particularly vulnerable to infections. Zoonoses comprise a long list of infectious diseases and represent a major public health problem. Nevertheless, many families and most healthcare providers are unaware of these potential risks, and there is a worrisome lack of recommendations to manage the risk-benefit balance, which could pose a risk for acquiring a zoonosis. Furthermore, no data are available on the number of transplanted patients with pets, and this risk-benefit balance is difficult to adequately evaluate. In this document, we review the currently available evidence regarding the epidemiology of zoonotic infections in patients undergoing transplantation, focusing on pediatric patients from a risk-benefit perspective, to help inform decision-making for clinicians. Families and healthcare professionals should be aware of the risks, and clinicians should actively screen for pets and offer comprehensive information as part of routine clinical practice. A multidisciplinary approach will ensure proper care of patients and pets and will establish preventive measures to ensure patients are safe living with their pets.
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Platero L, Garcia-Sanchez P, Sainz T, Calvo C, Iglesias I, Esperon F, de la Fuente R, Frauca E, Perez-Martinez A, Mendez-Echevarria A. Pets for pediatric transplant recipients: To have or not to have. Front Vet Sci 2022; 9:974665. [PMID: 36157192 PMCID: PMC9493113 DOI: 10.3389/fvets.2022.974665] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
Pets have many health, emotional and social benefits for children, but the risk of zoonotic infections cannot be underestimated, especially for immunosuppressed patients. We report the recommendations given by health professionals working with pediatric transplant recipients to their families regarding pet ownership. An online survey addressing zoonosis knowledge and recommendations provided by health care practitioners regarding pets was distributed to clinicians treating pediatric transplant recipients. The European Society of Pediatric Infectious Disease (ESPID) and the European Reference Network ERN-TransplantChild, which works to improve the quality of life of transplanted children, allowed the online distribution of the survey. A total of 151 practitioners from 28 countries participated in the survey. Up to 29% of the respondents had treated at least one case of zoonosis. Overall, 58% of the respondents considered that the current available evidence regarding zoonotic risk for transplanted children of having a pet is too scarce. In addition, up to 23% of the surveyed professionals recognized to be unaware or outdated. Still, 27% of the respondents would advise against buying a pet. Practitioners already owning a pet less frequently advised patients against pet ownership, whereas non-pet-owners were more keen to advise against pet ownership (p = 0.058). 61% of the participants stated that there were no institutional recommendations regarding pets in their centers/units. However, 43% of them reported therapeutic initiatives that involved animals in their centers. Infectious disease specialists were more likely to identify zoonotic agents among a list of pathogens compared to other specialists (p < 0.05). We have observed a huge heterogeneity among the recommendations that health care providers offer to families in terms of risk related to pet ownership for transplant recipients. The lack of evidence regarding these recommendations results in practitioners' recommendations based on personal experience.
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Affiliation(s)
- Lucía Platero
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
| | - Paula Garcia-Sanchez
- Pediatric Emergency Department, La Paz University Hospital, Madrid, Spain
- University Hospital La Paz Research Institute (IdiPAZ), Madrid, Spain
| | - Talía Sainz
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- University Hospital La Paz Research Institute (IdiPAZ), Madrid, Spain
- Centro de Investigación en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Pediatric Infectious Disease Department, La Paz University Hospital, Madrid, Spain
- ERN Transplant Child, Madrid, Spain
| | - Cristina Calvo
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- University Hospital La Paz Research Institute (IdiPAZ), Madrid, Spain
- Centro de Investigación en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Pediatric Infectious Disease Department, La Paz University Hospital, Madrid, Spain
- ERN Transplant Child, Madrid, Spain
| | | | - Fernando Esperon
- Veterinary Faculty, European University of Madrid, Madrid, Spain
| | - Ricardo de la Fuente
- Department of Animal Health, Veterinary Faculty, Complutense University, Madrid, Spain
| | - Esteban Frauca
- ERN Transplant Child, Madrid, Spain
- Pediatric Hepatology Department, La Paz University Hospital, Madrid, Spain
| | - Antonio Perez-Martinez
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- University Hospital La Paz Research Institute (IdiPAZ), Madrid, Spain
- ERN Transplant Child, Madrid, Spain
- Pediatric Hemato-Oncology Department, La Paz University Hospital, Madrid, Spain
| | - Ana Mendez-Echevarria
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- University Hospital La Paz Research Institute (IdiPAZ), Madrid, Spain
- Centro de Investigación en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Pediatric Infectious Disease Department, La Paz University Hospital, Madrid, Spain
- ERN Transplant Child, Madrid, Spain
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Nemec K, Prest M. Food Safety After Kidney Transplant. J Ren Nutr 2022; 32:e1-e2. [PMID: 35753584 DOI: 10.1053/j.jrn.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/16/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Kelly Nemec
- Transplant Dietitian at the University of Chicago Medicine The University of Chicago Medicine, 5841 S. Maryland Avenue Chicago, IL 60637.
| | - Melissa Prest
- Foundation Dietitian National Kidney Foundation of Illinois, 215 W Illinois Street, Suite 1C, Chicago, IL 60654.
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Abstract
Working After Lung Transplantation Abstract. Whether patients return to work after a successful lung transplant depends on various factors. The best predictive factor for employment after transplantation is the employment status before transplantation. Currently, there is no internationally standardized procedure regarding the questions of when and according to what criteria patients should be reintegrated into the working environment after lung transplantation. The risk of infection at the workplace/during the work activity should definitely be assessed before resuming work: a detailed work history is mandatory, an additional workplace inspection a further option. Advice should be based on the medical literature and general recommendations, and psychosocial factors must also be taken into account. In case of ambiguities, an interdisciplinary discussion is recommended.
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Affiliation(s)
- Reka Maria Blazsik
- Abteilung Arbeits- und Umweltmedizin, Institut für Epidemiologie, Biostatistik und Prävention und Poliklinik für Innere Medizin, Universität Zürich und Universitätsspital Zürich
| | | | - Holger Dressel
- Abteilung Arbeits- und Umweltmedizin, Institut für Epidemiologie, Biostatistik und Prävention und Poliklinik für Innere Medizin, Universität Zürich und Universitätsspital Zürich
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Seckin ZI, Brumble LM, Libertin CR. Serologic screening and infectious disease consultation (IDC): Indicated in heart, lung, liver (HLL) solid organ transplants (SOT) for measles, mumps, rubella, and varicella. Transpl Infect Dis 2019; 22:e13202. [PMID: 31647159 DOI: 10.1111/tid.13202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/18/2019] [Accepted: 10/13/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Solid organ transplant (SOT) recipients are a special group of patients who require comprehensive evaluation for preventable infectious diseases before transplantation. The main aim of our study was to investigate the number of heart, lung, and liver (HLL) transplant recipients who were evaluated for their immune status against measles, mumps, rubella (MMR), and varicella (VZV). As a secondary aim, we investigated whether pre-transplant infectious disease consultation (IDC) improves vaccination rates. METHODS This study was an institution-based retrospective analysis of HLL transplant recipients born in or after 1957 and evaluated at Mayo Clinic, FL Transplant Center between January 1st, 2016 and December 31st, 2017. Data collection was obtained from electronic medical records. The vaccination rates were compared by univariate analysis based on IDC and no ID consultation (NIDC). RESULTS One hundred and eighty-seven (77%) of a total 242 patients received an IDC pre-transplantation. Varicella IgG levels were screened in all 187 IDC candidates. Among the 187 IDC patients, mumps, measles, and rubella IgG serologies were performed in 9 (5%), 21 (11%), and 51 (27%), respectively. Among all 242 patients, vaccines given included 2 (0.8%) MMR, 10 (4.1%) varicella and 85 (35.12%) Zostavax. Univariate analysis revealed that Zostavax was given to 76 (40.6%) pre-transplant IDC patients and only in 9 (16.7%) NIDC patients (P < .001). CONCLUSIONS Despite the relatively high IDC rate, patients' screened numbers for MMR IgG levels were low. Results pointed out the need for MMR protocol-driven serologic screening as well as for VZV and IDC prior to transplantation to increase vaccination rates.
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Affiliation(s)
- Zeynep Idil Seckin
- Department of Neurodegenerative Research, Mayo Clinic, Rochester, MN, USA
| | - Lisa M Brumble
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Claudia R Libertin
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, USA
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