Nontraditional pets pose increased risk of serious infections

Pediatric News, June, 2008 by Doug Brunk

LA JOLLA, CALIF. -- Parrots, baby chicks, and turtles may be endearing to young children, but exposure to such exotic and nontraditional pets in the home and in public settings puts children at risk for serious infectious diseases.

"When a child visits your office and has [Escherichia] coli 0157 or campylobacter or salmonella, a thorough history should be performed to determine whether or not he or she has been exposed to an animal in a public setting or whether [there are] some of these pets at home," Dr. Larry K. Pickering said at a meeting sponsored by Rady Children's Hospital and the American Academy of Pediatrics.

In 2007, about 63% of households in the United States contained one or more pets. Of these, 3% contained exotic or nontraditional pets.

"In 2005, approximately 88,000 mammals were imported legally into the United States, including 29 species of rodents," added Dr. Pickering, executive secretary of the Advisory Committee on Immunization Practices at the Centers for Disease Control and Prevention, Atlanta. "The illegal importation of animals into the United States and worldwide is huge. It's second only to drug and arms trafficking."

Exposure to parrots, parakeets, and cockatiels can lead to Chlamydia psittaci, an intracellular bacterial pathogen that causes acute febrile respiratory tract illness. In the United States, there were 12-19 cases per year reported annually from 2002 to 2006, "but the number of cases is probably higher," Dr. Pickering said. If you see a child or an adult with atypical pneumonia, ask if there is a bird in the home. "All birds can spread this infection. Diagnosis is difficult, confirmed only by serology." Treatment involves tetracycline or macrolides.

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Contact with baby poultry such as chicks, duckling, goslings, and turkeys increases the risk of developing salmonellosis. Children, the elderly, and immuno-compromised people are especially vulnerable (MMWR 2007;56:273-6).

Salmonella can be found in chicken feces, feathers, or their environment. Each year, 1.4 million salmonella infections are reported "out we don't know what percent is due to contact with baby poultry;" Dr. Pickering said. "Fewer than 20 hatcheries in the United States provide the majority of baby poultry sold in agricultural feed stores. This is good and bad. It's good because surveillance can be set up easily. The bad part is, if you get salmonella in a flock, an outbreak can be fairly widespread."

He pointed out that that many parents who purchase baby poultry for their children "remain unaware that the bird puts them in contact with salmonellosis and that these little critters will eventually grow to be adults and not be desirable pets."

Certain salmonella serotypes are isolated from specific animals, so if a child presents with salmonellosis, the organism should be serotyped to determine if it is an unusual species. Salmonellosis from turtles, lizards, and other reptiles represents 6% of all salmonella infections in the United States and 11% of infections in people less than 21 years of age (Clin. Infect. Dis. 2004;38:5353-61). Reptiles excrete salmonella in feces while asymptomatic. Dr. Pickering said that reptile-associated salmonellosis "is more likely to be associated with invasive disease, to involve infants, and to lead to hospitalization."

He warned that ferrets, which belong to the weasel family, are unsuitable pets for children younger than 5 years of age. A report from the late 1980s described severe facial injuries to infants from unprovoked attacks by pet ferrets (JAMA 1988;259:2005-6). "Ferrets can be aggressive animals," he said.

The chances of a child acquiring salmonella, E. coli 0157 or some other infectious disease at a public zoo are "very low, because most zoos are well maintained," Dr. Picketing said. "Petting zoos can be a problem, as can animal swap meets where children can handle animals and there are no hand-washing facilities on site."

Diseases that have been reported associated with pet store animals include salmonella in hamsters, mice, and rats; rabies in kittens; tularemia and lymphocytic choriomeningitis in hamsters; and monkeypox in prairie dogs.

The American Academy of Pediatrics is developing guidelines for nontraditional pets in the home, Dr. Pickering said.

The CDC advises washing hands after contact with animals, animal products, or their environment, and supervising children younger than age 5 years while interacting with animals. For more information, see MMWR 2005;54[RR04]:1-12 and www.cdc.gov/healthypets.> BY DOUG BRUNK

San Diego Bureau

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