A couple of months ago a tearful client explained that she’d had to go into the hospital for a MRSA infection. And now that her physician had demanded she remove all pets from her household, her husband and teenaged son had refused to live in the same house until she complied with the order––which, of course, she didn’t do. (Would you?)
Because of the limited data available on MRSA transmission between humans and household animals (we definitely know it’s possible), it's been my experience that many physicians treating MRSA infection patients have taken to recommending the “no pets” thing.
Apparently, plenty of veternarians have been hearing the same thing. According to a study in the latest issue of JAVMA (Journal of the American Veterinary Medical Association),
“...the authors have dealt with many situations in which it has been recommended that pets be removed from the household or euthanatized, even without verification of concurrent colonization, let alone the identification of pets as the source of infection.”
Consequently, the veterinary community has taken on the task: Figure out who’s giving MRSA to whom and what the real risk of transmission might be. Because while it’s the physician’s role to be cautious and suspicious of pets, it’s veterinary medicine’s job to preserve the human-animal bond––not to mention the health of our patients––by sussing out the truth of the matter.
Not that physicians always listen to their veterinary counterparts. (Consider the case of toxoplasmosis, for which some OB/Gyns continue to urge prevention during pregnancy through household cat eradication.) But if we don’t arm ourselves with solid research on the subject, more pet owners may suffer the unnecessary loss of their pets.
Indeed, the veterinary community has begun to unravel the mystery with some initial forays into the assessment of transmissibility of MRSA between humans and animals.
The results?
In this current JAVMA study, the high prevalence of identical strains of MRSA among both humans and pets in MRSA-infected households indicated that transmission was likely occurring. But here’s an interesting catch:
“...it is likely that humans were the ultimate source of MRSA in most households because most pets have limited contact with other animals.”
Yes, humans appear more likely to be the initiators of transmission. Which only makes sense given our heavy interaction with a variety of humans and with places and situations that might easily prove infectious. Our pets? Not so much.
Sure, more study is needed. But it appears that most of it will be geared towards determining the direction of transmission and to figuring out what it is we need to do to protect our pets from the wrath of our own greeblies...and not the other way around.
***
In today's DailyVet over on PetMD: "Ectropion and entropion in dogs and its animal welfare issues."
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Add Comment45 Comments
Great article. I've been interested in possible MRSA transmission through raw food. Some raw food manufacturers are utilizing raw pork livers in their formulas and not testing for MRSA bacteria. I've yet to see a MRSA study involving the transmission of the bacteria through eating raw pork but I'm concerned about the pets and the pet owners handling the raw food. The FDA, predictably, has downplayed MRSA in our food supply but I'm not convinced. What is your feeling about that?
Deb September 8th, 2009 09:15:41 AM
No, I would not have given up my pets. My teenage son and husband? Maybe
Seriously, I have seen too many people jump on the panic bandwagon without knowing exactly what's going on. It sounds like that's happening right now with MRSA. Heck, my mother contracted MRSA in the ICU of a local hospital a couple of years ago.
I've also dealt with the effects of the pregnant woman/no cats attitudes. Unfortunately, it's often the animals who pay the ultimate price - with their lives.
Glad that the vet community is doing some serious research into this. It does make more sense that the humans are infecting the animals simply because of the level and range of interactions outside of the home.
dottie September 8th, 2009 09:24:16 AM
Deb: Salmonella yes, MRSA no. Not that it's not possible. Just that it's unlikely and that, ultimately...we don't know what that low level of risk might be.
Dr. Patty Khuly September 8th, 2009 09:34:54 AM
You can get MRSA almost any public place these days. That is what makes it ridiculous to say "Oh! You have pets! Kill them!" My friend get it at an airport. Any hospital is crawling with it. It is going around colleges and schools. It would be heartbreaking if this turned into a media-hyped scare-fest that resulted in the deaths of cats and dogs. The veterinary community MUST make itself heard on this.
Susan September 8th, 2009 09:49:10 AM
Jill Moss, in the UK, lost her dog Bella to MRSA that was contracted at the vets. She started the Bella Moss Foundation which supports education about MRSA among pet owners and veterinary professionals.
The Foundation website is an incredible source of information on MRSA infection in pets. It includes information on infection control for both pet owners and vets.
http://www.thebellamossfoundation.com/index.asp
Stefani September 8th, 2009 10:19:02 AM
I am SO tired of hearing how the pet should be given up. A few years ago I was privy to a conversation where the pediatrician was trying to convince the parent that their child got strept throat from the family dog.
that is worse than misleading. That is incompetant....and ignorant...and frightning that someone would believe it.
okay, this is a topic that just annoys me to no end, so I am going to end my comments here ... I have almost no respect for the meidcal community any longer.
LorriM1 September 8th, 2009 10:25:05 AM
The staggering amount of wrong information that human doctors have about animals and zoonoses also pisses me off. The stupidity from them makes me even more disinclined to listen to anything they say. And when they are proven wrong, they almost never own up to it. Add in the fearmongering and collusion with media sources, and I'm amazed more animals aren't killed.
I once had the pleasure of laughing loudly and contemptuously at a pediatrician who told a friend that she needed to get rid of the cat because of pinworms - which don't come from cats, but do come from other children, which the pediatrician really, really should have known. I wished he'd said it in the waiting room, so other parents could have found out he was an idiot.
KateH September 8th, 2009 11:14:27 AM
Not on topic of the post, but of the replies. I had allergies that were year round, but tapered off to seasonal allergies. I asked my doctor at the time for some help, and he asked me if I had pets. I said yes, I had cats, and he told me to get rid of them. I said I would consider getting rid of them if he could explain to me why I only suffer from allergies twice a year and my cats live with me year round. He didn't have an answer, and I now have a new doctor.
Connie September 8th, 2009 11:48:08 AM
As most know, I have 5 dogs of my own, about 48 parrots and anywhere from 2 to 12 foster dogs at any given time... thank goodness when I got MRSA my doctor never said a peep about animals!
Turns out mine was caught at the bowling alley... and I managed to give it to one dog before being diagnosed.
My work however went ballistic and banned me from the premises for week. :(
Why is fear from headlines such a driver of company policy??
Beth P September 8th, 2009 11:48:22 AM
What about the new doctor show on USA called Royal Pains? They had an episode where the little cavalier had some kind of lung infection that the doctor claimed to be MRSA (by using a home made microscope, no stain, no culture and no sensitivty - and in less than 5 minutes of course!) and that the dog (that didn't have an open abscess from its lung) was giving the MRSA to all the house guests? I think that certainly contributes to the problem in the media of giving people the wrong idea - everyone seems to be really into the medical dramas these days and when they have erroneous information (even House called toxo a fungus once) people seem to get stuck on those ideas and don't believe the "animal" doctor. It's going to be very important in the near future for vets to get the word out not only to clients but the public in general, especially because there is a complete dearth of education in this arena to the average person!
anecdote September 8th, 2009 12:32:24 PM
When I had a MRSA infection, I asked about getting it from the dogs (not like it mattered cause I was not going to get rid of them anyway) and all of my doctors said no that it was probably not from the dogs. I blamed it on my husband. He was working in Gulfport, MS after Hurricane Katrina. I bet there was a lot of nasty stuff around after that.
Jen September 8th, 2009 01:54:51 PM
The whole handling of MRSA drives me up a wall.I work in an operating room where we have to take precautions(gowns and gloves,putting the chart in a plastic bag,etc)whenever we take care of an infected patient.However,their family does not have to follow these guidelines and the patients are in grocery stores,on public transportation and anywhere else they please as soon as they are discharged.I am sure most of us that work in healthcare have it in our nares,but because we are generally healthy we are okay.Put my dogs down?I'd sooner amputate a limb.
Susan H September 8th, 2009 05:36:49 PM
"I am sure most of us that work in healthcare have it in our nares" Um, and you're "in grocery stores, on public transportation and anywhere else" you please? Yeah, you guys have great immune systems but what's that doing for the rest of us when you're walking MRSA Marys? Sorry, don't get why it bugs you the patients and families are doing the same thing you are. And they're probably doing those things for the same reason as you; because they have to. One family member with MRSA, probably losing wages, definitely wracking up medical expenses. Could you afford a maid to run errands too? If you normally use public transport and suddenly have these circumstances, could you afford to buy a car or increase your transportation costs?
PJBoosinger September 8th, 2009 05:54:20 PM
While I don't think that getting rid of the dogs would be appropriate in the case you mentioned in this post, I think it is worth pointing out the possiblity of cross-infection. If dogs really can catch MRSA from people, then there's a chance that it can go the other way as well, and when the human patient is cured s/he could become reinfected from an infected dog. If it is recommended to quarantine a human with MRSA from other humans until cured, then it only makes sense to similarly quarantine a pet with MRSA until cured - from both humans and other animals.
zandperl September 8th, 2009 08:40:51 PM
The clinic I worked for euthanized a perfectly wonderful dog for this very reason, after attempting to reason with the owner and various physicians. In the end, if we didn't do it, the owners would just have taken him to another vet. We fed him forbidden chocolate cupcakes and gave him lots and lots of love on his last day. It still makes me cry to think about it. How can human physicians be so naive? And, in this case, their "authority" on the subject trumped that of the vet's.
LL September 8th, 2009 09:54:18 PM
<How can human physicians be so naive?>
problem is it is NOT naivete it is either complete disregard, or worse yet, complete stupidity and lack of any actually knowledge about the topic. That is irresponsible at best.
LorriM September 8th, 2009 10:38:47 PM
The list of zoonotic and "reverse" zoonotic diseases is growing and will probably grow exponentially in the future. While a virus, bacteria, whatever, may cause a different "disease" in different species, I think it's becoming obvious that the old thought that few things are zoonotic is simply wrong. I'm just thrilled some vet schools and human docs are FINALLY doing some science on it and talking about it like this.
When my mother was diagnosed with AIDS, we tested the cats for toxoplasmosis. Isn't there a test for MRSA for animals? My Shiba currently has what appears to be a "hospital acquired" infection and now (not having y'all's great immune systems) I'm getting a sore throat. None of us getting put down but I'll sure treat everyone who appears ill so we can all get healthy again. I don't get the medical community (human and vet) obstinacy to change prior beliefs that aren't well founded in science, to truly consider the possibilities instead of mostly dismissing them out of hand because they don't fit accepted rhetoric. I gotta go with the informed common sense on this one; bacteria can well be harbored in various species and cross transmitted.
I mean, come on, my Shiba's face was swollen for a week and I'm shoving pills down her throat, literally. Even if I weren't, she's got such a swollen lip that she's drooling on herself, me, sister dog, the cats, all over the house so how difficult would it be for her to pass along a strep bacteria to us all. And me washing my hands really doesn't resolve all that!
PJBoosinger September 8th, 2009 10:41:02 PM
LorriM - You're probably right, and I also got a sense, in this situation, of "just an animal doctor" attempting to challenge the great wisdom of "real" medical doctors, made even worse by the fact that the vet was a woman and the human docs were men. *sigh*
LL September 8th, 2009 10:51:07 PM
When Louie started having ischemic dermatopathy at the rabies injection site, I thought for a time (due to the color of the crusting on the lesions) that he might have an MRSA infection. I thought at the time that he might have picked it up at the veterinary office, since we were spending so much time there and he'd had a few overnights. I think that's the only likely exposure for many pets. Thank goodness he didn't have it, as we had our hands full enough with everything that he did have!
Louie's Mom September 9th, 2009 01:34:51 AM
PJB: In the absence of wounds or other obvious sources of infection, nasal culture and sensitivity is the basic test for MRSA. The issue here is not that you can't get MRSA from your pets, just that it's no reason to euthanize an animal or even recommend a no-pet household––not in the absence of testing to confirm colonization. And, even then, it's important to recognize that the pet has probably been infected by the human, an important issue that veterinarians need to make MRSA patients aware of.
I would agree that if a pet or human tests positive, some sort of quarantine should ensue until they each test negative. And no, neither should be using public transportation or public lavatories.
And don't worry, strep throat has not been shown to be zoonotic.
Dr. Patty Khuly September 9th, 2009 07:33:49 AM
There was an interesting topic on the Dr. Oz radio show on XM this morning. He was talking about possible links between MRSA and the pork industry. <http://www.oprah.com/oradiohost/moz>
drbabe003 September 9th, 2009 11:25:34 AM
My German Shepherd contacted MRSA last year, She was one of the very few San Diego County has seen of the infection. She has allergies and begin to break out all over her belly with what was thought to be bacterial lesions caused from her allergies.
Finally, after may assorted antbiotics were found not to cure her problem and it got worse, the vet did a skin scraping test. Came back MRSA positive. By then , my poor Jilly was broken out all over her body. She had to be put on injections of the one antbiotic known to cure MRSA. Horribly frightening. And no, no one in the household got it. 6 wks later of shots 3 X weekly, she recovered. It is thought that MRSA in animals can be caused from too many antibiotcs. Can run the immune system down. An electric razor was also being used to shave around what were probably just bacterial lesion skin lesions fron her allergies in the beginning. MRSA can be on razors, vets offices anywhere. Thank god, she recovered. I never want to see MRSA again. I had one VERY sick dog.
Nancy Makowski
Temecula, California
Nancy Makowski September 9th, 2009 09:58:00 PM
This whole situation of applying the knee jerk solution of killing large numbers of animals to fix medical situations is practiced far and wide. Instead of spending time and money and some sweat figuring out what is happening, the economical response is used to kill the animal or animals. Eventually extremely ignorant people will start thinking that this would be a good economical solution when treating out of control epidemics. It would be best to stop the laziness now.
Robbie Robinson September 13th, 2009 10:21:27 PM
Please. We're seeing more and more community acquired MRSA from all kinds of sources. I'd never even heard of the pet one. Lately, I've been seeing cellulitis and abscesses from public bicycle stands, "gardening" wounds that later got infected, and of course schools-related fomites. I have never asked a MRSA patient about animal contact. It lives on mucous membranes - mostly the nose. Why on earth would it be more on a pet nose than any person's, their hands, or anything they touched?
Some people just really think keeping animals is dirty (I sort of am one of them, even, but I love them so I do it anyway) and use these kinds of tactics as an excuse to give advice not to keep pets. This is ridiculous...if a pediatrician really wants, so, fine, say that he thinks that a dog might be a bite risk or something. But to come up with this...really.
Your vaccination post also mirrors a huge problem in our community. Been interesting reading your blog and seeing how so much overlaps.
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