The role of veterinarians in zoonosis prevention: Advising families of immunocompromised children with pets

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.

Feline Toxoplasmosis in Greece: A Countrywide Seroprevalence Study and Associated Risk Factors

Toxoplasma gondii is a ubiquitous zoonotic parasite, with felines being the only definitive hosts. Cats shed oocysts with their faeces, and seroprevalence studies can be used to indirectly assess the environmental contamination. The current study aimed to evaluate T. gondii seroprevalence in Greek cats and identify possible risk factors. In total, 1554 blood samples were analyzed from different cats across all nine geographic regions of Greece, and a short questionnaire was completed for each cat. A rapid immunochromatographic test was used to detect anti-T. gondii antibodies, IgG type, and 21.8% of cats were seropositive. Regarding risk factors, when chi-square tests were applied, seropositivity was significantly higher (p < 0.05) in rural cats, cats with outdoor access, and hunting cats. Gender, age, ownership, and raw feeding were not significant risk factors, although female, adult, stray, and raw-feeding cats had a higher seroprevalence than their counterparts. Binary logistic regression models were developed to adjust for the confounding effects of the initially recognized risk factors, and only hunting in urban areas remained a significant risk factor. Greek cats had lower seropositivity than the average European value, and the present research highlights the importance of updated seroprevalence and risk factor studies within the context of One-Health.

Prevalence of Toxoplasma gondii Measured by Western Blot, ELISA and DNA Analysis, by PCR, in Cats of Western Mexico

Toxoplasma gondii is the causative agent of toxoplasmosis in humans and animals. The sexual reproductive cycle of Toxoplasma takes place in the small intestine of felines, the definitive hosts. In the final part of the sexual cycle, T. gondii forms oocysts in infected cats. Oocysts transferred via the faeces to the environment are highly infectious to both animals and humans. This study aimed to determine the prevalence and risk factors associated with T. gondii infection in cats from the metropolitan region of Guadalajara in western Mexico. Western blotting and ELISA for anti-Toxoplasma IgG antibodies was performed, and Toxoplasma DNA was identified using polymerase chain reaction. Prevalence of anti-T. gondii antibodies was 14.8% (44/297), and only 2/297 cases were positive for PCR. Cats older than one year were at an increased risk of infection (OR = 3.9, 95% CI 1.844–8.362). Sex, raw meat feeding, hunting habits, vaccination status, and body condition were not associated with positivity. The prevalence of T. gondii infection determined with Western blot in cats in the metropolitan area of Guadalajara, Jalisco, Mexico, was lower than that reported in previous studies.

Endoparasite prevalence and infection risk factors among cats in an animal shelter in Estonia

Cats are important hosts for different zoonotic parasites that can be hazardous to human health. To date, few studies have attempted to identify the factors affecting parasitic infections in shelter animals. This study aims to analyse the presence of endoparasites in shelter cats in Tartu, Estonia, and identify factors affecting endoparasite prevalence and intensity. The risk factors considered were age, location (urban vs rural cats) and time spent in shelter. In total, 290 faecal samples were collected from cats at an animal shelter in 2015-2016 and investigated for endoparasites using the concentration flotation technique. In total, 138 shelter cats (47.6%) were infected with endoparasites and their overall prevalence was: Toxocara cati (36.6%), Cystoisospora spp. (12.4%), Taeniidae gen. sp. (4.1%), Toxoplasma gondii/Hammondia hammondi (3.4%), Eucoleus aerophilus (2.1%), Cryptosporidium spp. (2.1%), Ancylostoma sp. (0.7%) and Giardia sp. (0.7%). Coinfections occurred in 38 cats (13.1%) most frequently of T. cati and Cystoisospora spp. (4.5%), Cystoisospora spp. and T. gondii/H. hammondi (2.1%). Where species identification of cestode and nematode samples was not possible according to morphology, genetic analysis of the mitochondrial cox1 gene was carried out. DNA was successfully analysed for 6 out of 13 samples that required genetic identification, revealing Ancylostoma tubaeforme in one nematode sample and Hydatigera taeniaeformis in five cestode samples. Cats from rural areas had significantly higher endoparasite prevalence than cats from urban areas. Helminth prevalence decreased to some extent due to anthelmintic treatment in cats available for adoption (held ≥15 days in the shelter), whereas the prevalence of infection with protists increased significantly in these animals. It is important to note that the analysis revealed lower infection intensity for quarantine cats (held 1-14 days in the shelter) compared with cats available for adoption. The relatively high prevalence of endoparasites (including zoonotic) in shelter cats ready for adoption suggests that current anthelminthic procedures require improvements.

Antibody kinetics and exposure to Toxoplasma gondii in cats: a seroepidemiological study

Domestic cats are the most important definitive hosts for Toxoplasma gondii, the agent of an important global zoonosis. Serial sera from cats orally inoculated either withT. gondii tissue cysts (n = 3) or sporulated oocysts (n = 3) and from 65 client-owned cats, plus sera from 1,757 client-owned cats presented to veterinarians in Switzerland were analysed for an antibody response to T. gondii by ELISA. Risk factors for seropositivity and prevalence were estimated with a generalised linear and beta regression model. The first model examined the association of an OD₄₀₅ value as the dependent variable, with gender, age, and outside access as possible independent variables. In the second model, we first analysed the data assuming a bimodal distribution representing two overlapping distributions of OD₄₀₅ values from positive and negative cats, enabling the assignment of a probability of true infection status to each cat. Mean probabilities of true infection status across groups represent an estimate of true prevalence. These probabilities were then regressed against age, gender and outside access. Antibody kinetics in cats orally inoculated with tissue cysts, shedding oocysts, did not differ significantly from those of cats inoculated with sporulated oocysts without detectable oocyst excretion, suggesting extraintestinal parasite invasion and exposure to tachyzoites in both situations at an early stage of infection. Analysis of serial serum samples suggested a persisting long-term humoral immune response. Of the client-owned cats, 42.4% (95% confidence interval (CI): 40.1-44.6) had a positive true infection status. This was higher (56.3% (95% CI: 53.2-59.6)) in cats with outside access than in those without (22.1% (95% CI: 18.9-25.4)). In the first model, the factors age (P < 0.0001), gender (male: P = 0.046), and outside access (P < 0.0001) were independently associated with significantly higher OD₄₀₅ values. In the second model, the probability of having a positive true infection status increased with age (P < 0.0001), was higher with outside access (P < 0.0001) and in outdoor male cats (P = 0.0006).

Parasites in the changing world - Ten timely examples from the Nordic-Baltic region

The world is changing, and parasites adapt. The Nordic-Baltic region in northern Europe - including the Nordic countries Denmark, Finland, Iceland, Norway and Sweden, and the Baltic States Estonia, Latvia and Lithuania - is facing new parasitological challenges due to changes in populations of parasites and their hosts and the spread of new parasites to the region due to climate change. Some changes can also be ascribed to increased awareness and detection. In this paper, we review and discuss a convenience selection of ten timely examples of recent observations that exemplify trends and challenges from different fields of parasitology, with particular focus on climate change and potential changes in epidemiology of pathogens in northern Europe. The examples illustrate how addressing parasitological challenges often requires both intersectoral and international collaboration, and how using both historical baseline data and modern methodologies are needed.

All about toxoplasmosis in cats: the last decade

Toxoplasma gondii infections are common in humans and animals worldwide. Toxoplasmosis continues to be of public health concern. Cats (domestic and wild felids) are the most important host in the epidemiology of toxoplasmosis because they are the only species that can excrete the environmentally resistant oocysts in feces. Cats can excrete millions of oocysts and a single cat can spread infection to many hosts. The present paper summarizes information on prevalence, persistence of infection, clinical signs, and diagnosis of T. gondii infections in domestic and wild cats for the past decade. Special emphasis is paid to genetic diversity of T. gondii isolates from cats. Review of literature indicates that a unique genotype (ToxoDB genotype #9 or Chinese 1) is widely prevalent in cats in China and it has been epidemiologically linked to outbreaks of clinical toxoplasmosis in pigs and deaths in humans in China; this genotype has rarely been detected in other countries. This review will be of interest to biologists, parasitologists, veterinarians, and public health workers.

Who let the cats out? A global meta-analysis on risk of parasitic infection in indoor versus outdoor domestic cats ( Felis catus)

Parasitic infection risks in domestic animals may increase as a result of outdoor activities, often leading to transmission events to and from owners, other domestic animals and wildlife. Furthermore, outdoor access has not been quantified in domestic animals as a risk factor with respect to latitude or parasite transmission pathway. Cats are an ideal model to test parasitic infection risk in outdoor animals because there have been many studies analysing this risk factor in this species; and there is a useful dichotomy in cat ownership between indoor-only cats and those with outdoor access. Thus, we used meta-analysis to determine whether outdoor access is a significant risk factor for parasitic infection in domestic pet cats across 19 different pathogens including many relevant to human, domestic animal and wildlife health, such as Toxoplasma gondii and Toxocara cati. Cats with outdoor access were 2.77 times more likely to be infected with parasites than indoor-only cats. Furthermore, absolute latitude trended towards significance such that each degree increase in absolute latitude increased infection likelihood by 4%. Thus, restricting outdoor access can reduce the risk of parasitic infection in cats and reduce the risk of zoonotic parasite transmission, spillover to sympatric wildlife and negative impacts on feline health.

The Pine marten (Martes martes) and the Stone marten (Martes foina) as possible wild reservoirs of Toxoplasma gondii in the Baltic States

Toxoplasma gondii is an important zoonotic parasite that infects a wide spectrum of mammals. Moreover, its presence in wild carnivores is indicative of environmental contamination by the parasite. A total of 186 marten (152 pine marten; 34 stone marten) meat juice samples from Latvia and Lithuania were tested for T. gondii seroprevalence. Samples were tested for T. gondii specific antibodies by a commercial ELISA and antibodies were found in 121 (65.1%) samples. Higher prevalence (67.8%) occurred in pine martens compared to that of stone martens (52.9%). Adult pine martens had a 2.0 (95% CI 0.9-4.7) times higher odds ratio to test seropositive than juvenile Pine martens. In addition, a significant positive correlation (r=0.75; P=0.05) was observed between T. gondii seroprevalence in martens and the number of estimated Eurasian lynx as a possible definitive host within the game administrative unit. The present study suggests that the high seroprevalence of T. gondii in Pine and Stone martens could indicate a high incidence of the parasite in the intermediate and definitive host population and in the environment.

Seroprevalence of Toxoplasma gondii infection in feral cats in Qatar

BACKGROUND

Cats are essential in the life cycle of Toxoplasma gondii as they can shed the environmentally resistant oocysts after acquiring infection. Human populations living in cities with high densities of feral cats are therefore likely to be at risk of infection. The current study is the first to estimate the seroprevalence of T. gondii in the feral cat population in Qatar. We investigated the seroprevalence of T. gondii among 495 adult cats from urban and suburban districts in Qatar. Using results from the Modified Agglutination Test, we fitted statistical models with host sex, area and season as explanatory factors and seropositivity as the outcome.

RESULTS

The analysis revealed an overall seroprevalence of 82%. Seroprevalence was significantly higher in the summer season (P = 0.006). No significant difference was detected (P > 0.05) between seroprevalence in female and male cats and in cats from urban and suburban districts of Qatar.

CONCLUSIONS

Despite the seasonal difference, the observed seroprevalence of T. gondii suggests high environmental contamination throughout the year, with some female cats generating more intense responses compared to males. Both findings merit further investigations.

Seroprevalence of and Risk Factors for Toxoplasma gondii Infection in Cats in Estonia

In Estonia, northeastern Europe, Toxoplasma gondii seroprevalence in humans has not declined, in contrast to many other countries. The reasons for this are unknown. Domestic cats are important hosts in the epidemiology of the parasite, but information on local feline T. gondii infections has been lacking. An epidemiological cross-sectional study was conducted to estimate the seroprevalence of T. gondii and the risk factors associated with seropositivity in cats in Estonia. Surplus from blood samples that had been collected for unrelated diagnostic purposes from 306 pet cats and 184 shelter cats were analyzed for anti-T. gondii immunoglobulin G antibodies by using a direct agglutination test. Two questionnaires were designed to reveal relevant risk factors for seropositivity. The overall seroprevalence of T. gondii in cats in Estonia was 60.8%. Older age, outdoor access, hunting, living outside the city in the countryside, and not being a purebred cat were among the risk factors associated with seropositivity. T. gondii is highly prevalent in domestic cats in Estonia. This suggests that the environment has been contaminated with T. gondii. Seropositivity indicates previous oocyst shedding, and most of the cats had outdoor access. The increase in T. gondii seroprevalence with age indicates acquired infections, and most of the risk factors were lifestyle-related. Cat owners could diminish the risk of T. gondii infection and also limit the spread of the parasite by not allowing their cats to roam free.

Comparison of Toxoplasma gondii Seroprevalence in Shelter Cats and Dogs during 1999-2001 and 2009-2011 in Tokyo, Japan

Toxoplasma gondii is an important human health concern with respect to abortion, congenital hydrocephalus, and encephalitis in immunocompromised people. Cats and dogs both are potential sources of T. gondii because they have close contact with humans. However, no epidemiological surveys have been conducted in Tokyo over the past decade. Therefore, the present study investigated and compared the seroprevalence of T. gondii infection in shelter cats and dogs during 1999–2001 and 2009–2011 in Tokyo, Japan. Serum samples were collected from 337 shelter cats and 325 shelter dogs in urban and suburban areas of Tokyo, during 1999–2001 (233 cats and 219 dogs) and 2009–2011 (104 cats and 106 dogs). T. gondii antibodies were measured in the serum samples using a commercial latex agglutination test. Data were compared using the Fisher’s exact test, and significance was indicated at P < 0.05. The overall seroprevalence of T. gondii infection in cats was 5.6% (13 of 233) in 1999–2001 and 6.7% (7 of 104) in 2009–2011, and that in dogs was 1.8% (4 of 219) and 1.9% (2 of 106), respectively. Significantly higher seroprevalence was observed in cats from suburban areas compared with cats in urban areas during both periods (P < 0.05). These results reveal that there has been little change in the feline and canine seroprevalence over the past decade, indicating that the risk of T. gondii exposure for cats and dogs in Tokyo is considerably low as the seroprevalence has reached a steady state.

Toxoplasma gondii seroprevalence in pet cats in Norway and risk factors for seropositivity

OBJECTIVES

The aims of the study were to estimate Toxoplasma gondii seroprevalence in pet cats in Norway and to evaluate risk factors for seropositivity. Additionally, serum biochemistry and haematological variables for T gondii seropositive and seronegative cats were compared.

METHODS

A convenience sample of surplus sera submitted to the Central Laboratory, Norwegian University of Life Sciences, was collected. The samples were from healthy cats and cats with a variety of diseases. Analyses for IgG antibodies to T gondii were performed with a commercial direct agglutination test, with 1:40 as the threshold value. For risk factor analysis a logistic regression model of the relationship between predictors and the outcome was applied.

RESULTS

One hundred and ninety-six of 478 cats were seropositive for T gondii, and the estimated seroprevalence in the study sample was 41.0% (95% confidence interval 36.6-45.4). Compared with domestic cats, pedigree cats had reduced risk for Toxoplasma seropositivity (odds ratio [OR] 0.42). Males had increased risk (OR 1.63) compared with females. The effect of age was highly significant, and an increase in the cats' age across the interquartile range (IQR; 52-160 months/4-13 years of age) doubled the risk of Toxoplasma seropositivity (OR 2.11). The risk for Toxoplasma seropositivity among cats living in Oslo was significantly reduced (OR 0.51) when compared with the rest of Norway.

CONCLUSIONS AND RELEVANCE

Pet cats in Norway appear to be commonly exposed to T gondii. Signalment and geographical region influenced the odds of Toxoplasma seropositivity, whereas health status did not.