Healthy animals, healthy people: zoonosis risk from animal contact in pet shops, a systematic review of the literature

[New awareness for zoonoses using the example of rat bite fever : Case report and literature review]

BACKGROUND

Rat bite fever is a rare but potentially fatal bacterial zoonosis. The symptoms can be unspecific, but severe sepsis can be associated with involvement of different organs.

CASE REPORT

A 27-year-old homeless man presented with fever, suspected meningitis, acute renal failure, unclear skin lesions as well as joint problems and muscular pain. Bite wounds were not detected. Meningitis could be excluded after lumbar puncture, and there was no evidence of endocarditis as the cause of the skin lesions. After 72 h, growth of Streptobacillus moniliformis in blood cultures was detected. Clinical symptoms were compatible with the diagnosis of rat bite fever. Calculated antibiosis with ampicillin sulbactam and doxycycline led to regression of the symptoms.

CONCLUSION

Rat bite fever poses a diagnostic challenge due unspecific symptoms, diverse differential diagnostic options, and challenging microbiological detection. Patient history is of the utmost importance. Due to the rarity of the disease, this case report is intended to raise awareness.

Zoonotic Pathogens Associated with Pet and Feeder Murid Rodent Species: A Global Systematic Review

Background: Pet and feeder rodents are one of the main sources of emerging infectious diseases. These rodents are purchased from pet shops, breeders, and online. Consequently, some of these rodents may subtly transmit diseases as they may be asymptomatic to certain pathogens. Materials and Methods: We systematically searched four academic databases viz. Google Scholar, PubMed, Web of Science, and Scopus to determine zoonotic pathogens associated with pet and feeder rodents globally. Our searches were performed in R statistical software using the packages "metagear" and "revtool". Results: We found 62 studies reporting on zoonotic pathogens between 1973 and 2022 from 16 countries representing 4 continents, namely Africa, Europe, Asia, and North America. The review identified 30 zoonotic pathogens isolated from pet and feeder rodents, including the African pygmy mouse (Mus minutoides), brown rat (Rattus norvegicus), and the house mouse (Mus musculus). The greatest number of pathogens was reported from the United States, followed by Togo and the United Kingdom. Bacterial pathogens were the most prevalent. However, the Seoul virus and rat bite fever (Streptobacillus moniliformis) were the most studied pathogens, found in more than one country, with reported outbreak cases. Most of the zoonotic pathogens were isolated from rodents acquired from pet shops. Conclusions: We recommend that pet and feeder rodents purchased from pet shops should be regularly screened for potential zoonotic pathogens as some of these animals may not show clinical signs of the illness. There is also a critical need to develop strict regulations and policies, especially in underdeveloped and developing regions for an effective surveillance process, which will include early detection, rapid response, and control of zoonotic diseases globally.

[Zoophilic dermatophytes during coronavirus pandemic in Germany]

During the coronavirus pandemic, significantly more pets were probably bought and kept. This study focuses on whether more zoophilic dermatophytes have subsequently been isolated and which species predominate. In the 1‑year period from March 2020 through February 2021, all zoophilic dermatophytes from all submissions to the Mölbis laboratory were recorded. Both the cultural and the molecular evidence of fungal detection from skin scrapings, hair roots, and, in single cases, from nails, were considered. For dermatophyte DNA (Deoxyribonucleic acid) detection, an in-house polymerase chain reaction (PCR) - enzyme-linked immunosorbent assay (ELISA) was used. In distinct cases, identification of dermatophytes was confirmed by sequencing of the internal transcribed spacer (ITS) region of the rDNA, and of the gene of the translation elongation factor (TEF)-1α. In 579 (2.56%) of 22,575 samples studied in the year 2020/2021, zoophilic dermatophytes were detectable with PCR-ELISA and/or by cultivation. In comparison, the proportion of zoophilic dermatophytes was 2.03% in the 1‑year period 2014/2015, and only 1.6% in 2018/2019. The 579 zoophilic dermatophytes were identified as follows: Trichophyton (T.) benhamiae 186 (32.1%), T. mentagrophytes 173 (29.9%), T. quinckeanum 110 (19.0%), Microsporum (M.) canis 78 (13.5%), T. verrucosum 22 (3.8%), Nannizzia (N.) persicolor 8 (1.4%), T. erinacei 1 (0.2%), and T. equinum 1 (0.2%). T. benhamiae had the highest prevalence from June to September 2020, then again in December. T. quinckeanum is associated with a sharp increase in the mice population in Germany in 2020; a significant increase was found in the months September 2020 to January 2021. T. mentagrophytes had a conspicuous peak in September. Compered with that M. canis in November. Up to 50% of the dermatophytoses caused by T. mentagrophytes, T. quinckeanum, and M. canis affected children and adolescents, while in the case of T. benhamiae it was as much as two thirds. Tinea corporis was the most common, followed by tinea faciei and tinea capitis. M. canis infections affected the capillitium more frequently than the face. Zoophilic dermatophytes were increasingly isolated during the coronavirus pandemic in Germany when compared to previous year periods. In first place, the dermatophyte T. benhamiae from guinea pigs was found in children and adolescents. A significant proportion of dermatophytoses concerned adults. T. quinckeanum is an emerging pathogen in Germany with unprecedented high infection rates in 2020.

Mobile Zoos and Other Itinerant Animal Handling Events: Current Status and Recommendations for Future Policies

Mobile zoos are events in which non-domesticated (exotic) and domesticated species are transported to venues such as schools, hospitals, parties, and community centres, for the purposes of education, entertainment, or social and therapeutic assistance. We conducted literature searches and surveyed related government agencies regarding existing provisions within laws and policies, number of mobile zoos, and formal guidance issued concerning operation of such events in 74 countries or regions. We also examined governmental and non-governmental guidance standards for mobile zoos, as well as websites for mobile zoo operations, assessed promotional or educational materials for scientific accuracy, and recorded the diversity of species in use. We used the EMODE (Easy, Moderate, Difficult, or Extreme) algorithm, to evaluate identified species associated with mobile zoos for their suitability for keeping. We recorded 14 areas of concern regarding animal biology and public health and safety, and 8 areas of false and misleading content in promotional or educational materials. We identified at least 341 species used for mobile zoos. Mobile zoos are largely unregulated, unmonitored, and uncontrolled, and appear to be increasing. Issues regarding poor animal welfare, public health and safety, and education raise several serious concerns. Using the precautionary principle when empirical evidence was not available, we advise that exotic species should not be used for mobile zoos and similar itinerant events.

Fungal Flora in Asymptomatic Pet Guinea Pigs and Rabbits

Simple Summary

Small mammals hider a wide number of saprophytic fungi associated with dermatophytosis in young or immunocompromised humans. This raises the possibility of potential zoonotic transmission of dermatophytes in animals from pet shops. Therefore, it is recommended that routine fungal diagnostic testing in pet guinea pigs (Cavia porcellus) and rabbits (Oryctolagus cuniculus domesticus) be carried out, to detect potential zoonotic fungi. The almost complete lack of cutaneous lesions in many cases associated with the presence of such a dermatophyte on healthy mammals may increase the risk of zoonotic transmission. This study identifies the most common fungal species that occur on the skin in guinea pigs and rabbits and determines the rate of asymptomatic carriers in healthy pet animals.

Abstract

Fungal skin diseases are well-recognized diseases with public health implications. The study provides a comprehensive overview and aims to determine the rate of positive fungal cultures to identify the most common fungal species in guinea pigs and rabbits and to determine the rate of asymptomatic carriers in healthy pet animals. This knowledge is essential for understanding disease transmission dynamics and epidemiological situation problems. A total of 167 animals (64 rabbits and 103 guinea pigs) were investigated in this study. The fungi of the genus Penicillium, Rhizopus, Mucor, Cladosporium, and Aspergillus were the most common in the examined animals, and they were isolated from 162 (97%) of the animals enrolled. No fungal growth was observed in 5 animals. In 15 cases (8.98%), we found pathogenic zoonotic dermatophytes (Trichophyton mentagrophytes), which caused several health problems in two humans in contact with affected animals. This study presents the prevalence of fungal flora in pet guinea pigs and rabbits in Slovakia.

Cocirculation of two SARS-CoV-2 variant strains within imported pet hamsters in Hong Kong

During the investigation of a pet shop outbreak of severe acute respiratory coronavirus 2 (SARS-CoV-2) with probable hamster-to-human transmission, the environmental and hamster samples in epidemiologically linked pet shops were found positive for SARS-CoV-2 Delta variant AY.127 strains which are phylogenetically closely related to patient and reported European strains. This interspecies spill-over has triggered transmission chains involving 58 patients epidemiologically linked to three pet shops. Incidentally, three dwarf hamsters imported from Netherlands and centralized in a warehouse distributing animals to pet shops were positive for SARS-CoV-2 spike variant phylogenetically related to European B.1.258 strains since March 2020. This B.1.258 strain has almost disappeared since July 2021. While no hamster-to-human transmission of B.1.258-like strain was found in this outbreak, molecular docking showed that its spike receptor binding domain (RBD) has similar binding energy to human ACE2 when compared with that of Delta variant AY.127. Therefore, the potential of this B.1.258-related spike variant for interspecies jumping cannot be ignored. The co-circulation of both B.1.258-related spike variants with Delta AY.127 which originated in Europe and was not previously found in Hong Kong suggested that hamsters in our wholesale warehouse and retail pet shops more likely have acquired these viruses in Netherlands or stopovers during delivery by aviation than locally. The risk of human-to-hamster reverse zoonosis by multiple SARS-CoV-2 variants leading to further adaptive spike mutations with subsequent transmission back to human cannot be underestimated as outbreak source of COVID-19. Testing of imported pet animals susceptible to SARS-CoV-2 is warranted to prevent future outbreaks.

Rat bite fever, a diagnostic challenge: case report and review of 29 cases

Rats can transmit Streptobacillus moniliformis, which may cause rat-bite fever (RBF), a rare and potentially lethal zoonosis. Fastidious in vitro growth and unspecific symptoms, including fever, arthralgia, and polymorphous skin lesions, complicate the diagnosis. Rat-bite fever follows exposure to contaminated bodily fluids of infected rodents; however, reports on Streptobacillus moniliformis-related infections are few so far. A female patient presented with painful hemorrhagic pustules and purpuric lesions on hands and feet. She developed fever and migratory polyarthralgia. Blood culture yielded growth with Streptobacillus moniliformis. The patient owned rats and handled contaminated rat feces and urine, making this the most likely etiology of infection. We report a case of RBF due to Streptobacillus moniliformis in a rat handling-patient. Difficulties in clinical and microbiological diagnosis highlight the need for a thorough and complete history-taking and a greater understanding of this rare infectious disease.

A comprehensive review on avian chlamydiosis: a neglected zoonotic disease

Avian chlamydiosis is one of the important neglected diseases with critical zoonotic potential. Chlamydia psittaci, the causative agent, affects most categories of birds, livestock, companion animals, and humans. It has many obscured characters and epidemiological dimensions, which makes it unique among other bacterial agents. Recent reports on transmission from equine to humans alarmed the public health authorities, and it necessitates the importance of routine screening of this infectious disease. High prevalence of spill-over infection in equines was associated with reproductive losses. Newer avian chlamydial species are being reported in the recent years. It is a potential biological warfare agent and the disease is an occupational hazard mainly to custom officers handling exotic birds. Prevalence of the disease in wild birds, pet birds, and poultry causes economic losses to the poultry industry and the pet bird trade. Interestingly, there are speculations on the ‘legal’ and ‘illegal’ bird trade that may be the global source of some of the most virulent strains of this pathogen. The mortality rate generally ranges from 5 to 40% in untreated cases, but it can sometimes be higher in co-infection. The intracellular lifestyle of this pathogen makes the diagnosis more complicated and there is also lack of accurate diagnostics. Resistance to antibiotics is reported only in some pathogens of the Chlamydiaceae family, but routine screening may assess the actual situation in all pathogens. Due to the diverse nature of the pathogen, the organism necessitates the One Health partnerships to have complete understanding. The present review focuses on the zoonotic aspects of avian chlamydiosis with its new insights into the pathogenesis, transmission, treatment, prevention, and control strategies. The review also briefs on the basic understandings and complex epidemiology of avian chlamydiosis, highlighting the need for research on emerging one health perspectives.

Cat scratch disease sepsis in an immunocompromised patient

As a greater number of households have pets, the likelihood of zoonotic infections can rise too. Although in most healthy individuals these infections are self-limiting, they are more serious and can lead to adverse outcomes in the immunocompromised. There is minimal information available for the immunocompromised patient who are pet owners or on pet handling. We report a case of cat scratch disease-related sepsis in an immunocompromised patient. This case illustrates the need for a detailed history, including a pet history, in immunocompromised patients presenting with fever of unknown origin and the need for UK-based information for the immunocompromised on pet care and risks associated with having a pet.

Real-World Ethical Dilemmas in Laboratory Safety for Microbiology Under-Resourced and Outreach Teaching

With modernization of safety standards for microbiology outreach teaching laboratories, ethical challenges arise in teaching microbiology for the public good without short-changing students in under-resourced situations, or when institutional support is subpar. Still, educators want students to engage using applied skills for inquiry, research-based microbial learning activities – safely. Following several United States microbial outbreaks, federal investigation traced sources back to teaching laboratories. Policy discussions ensued. The American Society for Microbiology (ASM) Task Force provides recommended but not mandated guidelines; however, guidelines are not amenable by all. Here, a real-world, ethical scenario of a university-level outreach microbiology laboratory course hosted at several locations provides context for under-resourced challenges in safety compliance. In this example of biomedical and public health ethical considerations, upper administration puts the onus on instructors to assure safe labs for their students and the general public. Temporarily hired instructors without curriculum or sufficient institutional support are put in precarious positions with often egregious practices to get the job done. This scenario is examined with different public health ethical frameworks and principles: non-maleficence, beneficence, health maximization, efficiency of policy regulations, respect for institutional and instructor autonomy, justice, and proportionality balancing stakeholder concerns. Sample curricular strategies are employed to mitigate these challenges. Taking a utilitarianism framework of the greatest good for the most benefit, this paper advocates for social justice supporting access to education as a moral duty. Administrations should ensure instructors are supported sufficiently to provide safe, authentic learning experiences. Solutions for under-resourced outreach teaching are needed for public trust.

Genomic characterization of enteropathogenic Escherichia coli (EPEC) of avian origin and rabbit ileal loop response; a pet macaw (Ara chloropterus) as a possible zoonotic reservoir

Enteropathogenic Escherichia coli (EPEC) constitutes one of the main causes of mortality in children in low- to medium-income countries. Diverse animal species have been linked as reservoirs, including birds. The aim of this study was to describe the genomic and phylogenetic features of an EPEC recovered from a pet macaw and further characterizing the macro and microscopic lesion in a rabbit ileal loop experimental model. The isolate was whole-genome sequenced (WGS) obtaining its genotypic and phenotypic in silico characteristics and inoculated in a rabbit experimental model with subsequently evaluating the strain's pathogenicity by scanning electron microscopy (SEM) and histopathology. The isolate was characterized as O109:H21-B1-ST40 typical EPEC, harboring several virulence factors of diarrheagenic E. coli. The macaw EPEC genome was located in a monophyletic clade of human and animal ST40 EPEC sequences. In vivo inoculation demonstrated severe hemorrhage with SEM and histopathological analysis confirming these lesions to be associated with intra-epithelial lymphocytes. Therefore, the isolate not only shared several genotypic and phylogenetic similarities with EPEC that affects humans and animals, but was able to induce severe tissue injury in a mammal model. These findings highlight the underrated role of pet birds as zoonotic reservoirs and the diversity in virulence factors being unraveled by new WGS studies.

Zoonotic Diseases: Etiology, Impact, and Control

Most humans are in contact with animals in a way or another. A zoonotic disease is a disease or infection that can be transmitted naturally from vertebrate animals to humans or from humans to vertebrate animals. More than 60% of human pathogens are zoonotic in origin. This includes a wide variety of bacteria, viruses, fungi, protozoa, parasites, and other pathogens. Factors such as climate change, urbanization, animal migration and trade, travel and tourism, vector biology, anthropogenic factors, and natural factors have greatly influenced the emergence, re-emergence, distribution, and patterns of zoonoses. As time goes on, there are more emerging and re-emerging zoonotic diseases. In this review, we reviewed the etiology of major zoonotic diseases, their impact on human health, and control measures for better management. We also highlighted COVID-19, a newly emerging zoonotic disease of likely bat origin that has affected millions of humans along with devastating global consequences. The implementation of One Health measures is highly recommended for the effective prevention and control of possible zoonosis.

High Prevalence and Diversity of Cephalosporin-Resistant Enterobacteriaceae Including Extraintestinal Pathogenic E. coli CC648 Lineage in Rural and Urban Dogs in Northwest Spain

The aim of this work was to assess the prevalence of extended spectrum-β-lactamase (ESBL)- and carbapenemase-producing Enterobacteriaceae in fecal samples recovered from rural and urban healthy dogs in Northwest Spain (Galicia) to identify potential high-risk clones and to molecularly characterize positive isolates regarding the genes coding for ESBL/pAmpC resistance and virulence. Thirty-five (19.6%) out of 179 dogs were positive for cephalosporin-resistant Enterobacteriaceae, including Escherichiacoli and Klebsiella pneumoniae (39 and three isolates, respectively). All the isolates were multidrug resistant, with high rates of resistance to different drugs, including ciprofloxacin (71.4%). A wide diversity of ESBL/pAmpC enzymes, as well as E. coli phylogroups (A, B1, C, D, E, F and clade I) were found. The eight isolates (20.5%) found to conform to the ExPEC status, belonged to clones O1:H45-clade I-ST770 (CH11-552), O18:H11-A-ST93-CC168 (CH11-neg), O23:H16-B1-ST453-CC86 (CH6-31), and O83:H42-F-ST1485-CC648 (CH231-58), with the latter also complying the uropathogenic (UPEC) status. The three K. pneumoniae recovered produced CTX-M-15 and belonged to the ST307, a clone previously reported in human clinical isolates. Our study highlights the potential role of both rural and urban dogs as a reservoir of high-risk Enterobacteriaceae clones, such as the CC648 of E. coli and antimicrobial resistance traits. Within a One-Health approach, their surveillance should be a priority in the fight against antimicrobial resistance.

Major environmental and socioeconomic determinants of cutaneous leishmaniasis in Brazil - a systematic literature review

Cutaneous leishmaniasis (CL) is a zoonotic disease with complex transmission cycle. Some environmental and socioeconomic factors are known to be the major determinants of the transmission process, which are involved in configuring the spatiotemporal patterns and thus can be delimiting. However, the relevance of these socioeconomic and environmental determinants is still not well understood. In this study, we aimed to identify the major environmental and socioeconomic determinants of CL in Brazil by articulating a systematic literature review of studies that are based on this subject. The methodology included a search for studies according to a structured protocol using the scientific platforms, such as Scielo and PubMed. The references of each identified article were who referred to CL determinants were further screened, and so on. We extracted information from 41 articles and the determinants were grouped accordingly. Two measures were evaluated as follows: a) the frequency of citations of the determinants; and b) the proportion of determinants identified as having "significant association in analytical studies" with respect to the total number of determinants analyzed in other analytical studies using the same concept. The analyzed articles covered most of the regions of Brazil and 7 other countries bordering Brazil. We found 43 concepts of determinants. However, the final selection resulted in the identification of 14 major determinants. These results therefore contribute in the identification of major CL determinants and this information can be used to establish strategies for identifying risk prone areas for disease surveillance.

Leptospirosis meningitis transmission from a pet mouse: a case report

Background

Leptospirosis is a reemerging zoonosis with a worldwide distribution and a wide range of clinical manifestations. We report a case of leptospirosis meningitis in a previously healthy woman infected by her pet mouse.

Case presentation

A 27-year-old Caucasian woman with pet mice presented to our institute with a 1 week history of fever, headache, myalgia, vomiting, diarrhea, and dark urine. Her admission examination revealed neck stiffness, conjunctivitis, and icteric sclera. Her liver enzymes, bilirubin, white blood cell count, and C-reactive protein were elevated. Her cerebrospinal fluid showed an elevated white blood cell count. Polymerase chain reactions using her cerebrospinal fluid, blood, and urine showed negative results for leptospirosis, but the result of her microagglutination test was positive for Leptospira interrogans serovar sejroe with a more than threefold increase in paired sera. The patient was treated with ceftriaxone for 1 week, and her condition steadily improved.

Conclusions

This case report raises awareness of pet rodents as sources of leptospirosis. Leptospirosis meningitis should be considered in patients with meningeal symptoms and pet rodents.

2019 AAFP Feline Zoonoses Guidelines

AIM

The overarching purpose of the 2019 AAFP Feline Zoonoses Guidelines (hereafter referred to as the 'Guidelines') is to provide accurate information about feline zoonotic diseases to owners, physicians and veterinarians to allow logical decisions to be made concerning cat ownership.

SCOPE AND ACCESSIBILITY

The Panelists are physicians and veterinarians who worked closely together in an attempt to make these Guidelines a document that can be used to support the International One Health movement. This version of the Guidelines builds upon the first feline zoonosis panel report, published in 2003 ( catvets.com/guidelines ), and provides an updated reference list and recommendations. Each of the recommendations received full support from every Panelist. Primary recommendations are highlighted in a series of 'Panelists' advice' boxes.

Rat bite fever caused by Streptobacillus moniliformis infection in a Chinese patient

BACKGROUND

Rat bite fever (RBF), a severe infectious disease, can result from transmission of the pathogen Streptobacillus moniliformis (S. moniliformis) by rat bite. RBF diagnosis can be overlooked.

CASE PRESENTATION

We present a case of RBF in a Chinese patient who was infected with S. moniliformis in mainland China. Meta-next generation sequencing (mNGS) was used to identify potential pathogens and detected S. moniliformis genome sequences in the pustular sample in less than 72 h. Then the diagnosis was validated by polymerase chain reaction analysis. Despite having severe RBF with complications, this 54-year-old male patient was successfully cured with penicillin as a result of timely pathogen-based diagnosis.

CONCLUSIONS

Physicians should inquire about recent rat exposure and consider the possibility of RBF when a patient develops unexplained fever and rashes. mNGS is a new diagnostic technology and may identify RBF pathogens even when blood culture results are negative.

Would you like to purchase a rodent with dermatophytes?

The zoophilic dermatophyte Trichophyton benhamiae has received attention due to increasing infections in human in recent years. Trichophyton benhamiae has been found on asymptomatic rodents from pet shops in several countries posing a potential risk for transmission to humans. The aim of this study was to determine the prevalence of positive dermatophyte cultures from rodents in Danish pet shops in order to clarify the magnitude of potential sources of zoophilic infections and to prevent further spread. Specimen sampling was performed in 17 Danish pet shops using the brush technique (MacKenzie technique). After incubation, cultures were sent to ITS DNA sequencing for molecular species identification. Pet shop employees were asked to fulfil a five-question survey regarding purchase and procedures of diseased animals. A total of 98 animals were sampled (N = 32 rabbits, N = 32 guinea pigs and N = 34 hamsters). Trichophyton benhamiae was found in 14/98 samples (14%); 12/32 guinea pigs (38%) were positive with T benhamiae, 2/34 (6%) hamsters and 0/32 rabbits (0%). We found that hamsters and particularly guinea pigs from Danish pet shops are common asymptomatic carriers of the dermatophyte T benhamiae. Although a larger study is warranted to test this postulate, and it raises the question if infection control measures should be implemented in pet shops.

The Threat and Response to Infectious Diseases (Revised)

The threat from microorganisms is complex, and the approaches for reducing the challenges the world is facing are also multifaceted, but a combination approach including several simple steps can make a difference and reduce morbidity and mortality and the economic cost of fighting infectious diseases. This paper discusses the continually evolving infectious disease landscape, contributing factors in the rise of the threat, reasons for optimism, and the policies, technologies, actions, and institutions that might be harnessed to further reduce the dangers introduced by pathogens. It builds upon and updates the work of other authors that have recognized the dangers of emerging and re-emerging pathogens and have explored and documented potential solutions.

Pet rodents as possible risk for leptospirosis, Belgium and France, 2009 to 2016

Leptospirosis is an under-reported and emerging zoonotic disease which is potentially fatal in humans. Rodents are the main reservoirs for pathogenic Leptospira spp., but diagnosis in these animals is difficult, and their infection, which does not induce symptoms, usually goes unoticed. Although the exposures of most human cases of leptospirosis are poorly documented, we were able to identify six human cases of leptospirosis which were associated with direct contact with pet rodents (mice or rats) in Belgium and France between 2009 and 2016. All cases had severe disease and for all, the presence of Leptospira spp. DNA in the kidneys of their pet animals was confirmed, strongly suggesting that excretion of leptospires in urine was the way of transmission. Half of the cases shared the serogroup Icterohaemorrhagiae, which is usually associated with severe disease, with the pet rats which they were in contact with. With the popularity of rats and mice as pets, this study should contribute to raising awareness on asymptomatic pet rodents as a source of Leptospira infections.

Chlamydia psittaci (psittacosis) as a cause of community-acquired pneumonia: a systematic review and meta-analysis

Psittacosis is a zoonotic infectious disease caused by the transmission of the bacterium Chlamydia psittaci from birds to humans. Infections in humans mainly present as community-acquired pneumonia (CAP). However, most cases of CAP are treated without diagnostic testing, and the importance of C. psittaci infection as a cause of CAP is therefore unclear. In this meta-analysis of published CAP-aetiological studies, we estimate the proportion of CAP caused by C. psittaci infection. The databases MEDLINE and Embase were systematically searched for relevant studies published from 1986 onwards. Only studies that consisted of 100 patients or more were included. In total, 57 studies were selected for the meta-analysis. C. psittaci was the causative pathogen in 1·03% (95% CI 0·79-1·30) of all CAP cases from the included studies combined, with a range between studies from 0 to 6·7%. For burden of disease estimates, it is a reasonable assumption that 1% of incident cases of CAP are caused by psittacosis.

Prevalence and zoonotic risks of Trichophyton mentagrophytes and Cheyletiella spp. in guinea pigs and rabbits in Dutch pet shops

Young rabbits and guinea pigs are often purchased as pets for children and may be infected with zoonotic skin infections. To assess the risk of acquiring such an infection from rabbits or guinea pigs, this study investigated the prevalence of the fungus Trichophyton mentagrophytes and the fur mite Cheyletiella parasitovorax in asymptomatic rabbits and guinea pigs in Dutch pet shops. In 91 pet shops a total of 213 rabbits and 179 guinea pigs were sampled using the Mackenzie technique and cultured. Clean cultures were examined microscopically and a PCR was performed on at least one sample from each pet shop. All animals were investigated for fur mite using a flea comb, a magnifying glass and white paper. From the fur of 3.8% (8/213) of the rabbits and 16.8% (30/179) of the guinea pigs, T. mentagrophytes was isolated. From 1 guinea pig (0,6%) Chrysosporium keratinophilum was isolated. Dermatophyte-positive rabbits and guinea pigs originated from 5.6% (5/90) and 27.3% (24/88) of the investigated pet shops, respectively. Fur mites were not found. Pet shops can play an important role in preventing transmission of zoonotic ringworm infections (dermatophytosis) and educating their customers. Specific preventive measures such as routine screening examinations and (prophylactic) treatment of rabbits and guinea pigs are recommended next to regular hygiene when handling animals.

Streptobacillus moniliformis Bacteremia in a Pet Shop Employee: Case Report and Literature Review

A 39-year-old pet shop employee who sustained a bite from one of his store’s rats developed fever and arthritis. Streptobacillus moniliformis was cultured from the patient’s blood, confirming a diagnosis of rat-bite fever. Treatment with standard antibiotics was successful. Although rat-bite fever is commonly considered a zoonosis transmitted by wild or laboratory rats, our case emphasizes that it may be transmitted by pet animals as well.

Zoonotic disease risks for immunocompromised and other high-risk clients and staff: promoting safe pet ownership and contact

Pets can be a source of disease (zoonoses) for humans. The disease risks associated with pet contact are highest among young children, the elderly, pregnant women, and immunocompromised hosts. These individuals and household members display limited knowledge of pet-associated disease, rarely recall receipt of pet-associated disease information, and report pet ownership practices that are often at odds with established disease prevention recommendations. Veterinary staff are in a key position to promote safe pet ownership and contact practices. Encouraging and safeguarding client disclosure of immunocompromising health conditions and promoting veterinarian-physician communications are critical for effectively providing this service.

Zoonoses☆

Zoonoses are the ‘diseases and infections that are naturally transmitted between vertebrate animals and man,’ as defined in 1951 by the World Health Organization (WHO) Expert Committee on Zoonoses. The word zoonosis (plural zoonoses) is the combination of two Greek words (zoon, animals and noson, disease), and was coined at the end of the nineteenth century by Rudolph Virchow to designate human diseases caused by animals. Nevertheless, the term should also include vertebrate animal diseases caused by exposure to humans, such as measles in non-human primates, which is of major concern in any major primate center. The term ‘zoonosis’ is also considered to be shorter and more convenient than ‘anthropozoonosis’ (animals to humans) and ‘zooanthroponosis’ (humans to animals), which are based on the prevailing direction of transmission between humans and other vertebrates.