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 CDC's Healthy Pets, Healthy People Teaching Kit Lesson 2: Pet-Related Zoonoses
Audience Health professionals and other community workers who serve immunocompromised patients or clients. Time Approximately 60 minutes Objectives By the end of lesson one, the participants will be able to:
Overview The purpose of this lesson is to briefly describe six pet-related zoonoses of concern to immunocompromised patients. It includes information on human and animal clinical signs, transmission, and treatment of campylobacteriosis, cat scratch disease, cryptosporididosis, E.coli O157 infections, salmonellosis, and toxplasmosis. Materials
Introduction (10 minutes) This portion of the lesson uses slides #1-x. Before class begins, have the slide profector or powerpoint equipment set up and ready to use. Also, before the students enter the room, tape the following posterboard stick-ups under their seats. Suggested Script Hello, team. I have been asked to debrief you on an outbreak that is happening at a zoo in Denver, Colorado. Last week, Colorado State's department of public health was alerted to an unusual cluster of diarrheal illness in Denver. Thus far, 26 cases have been associated with this outbreak. All of the cases submitted fecal samples and cultured positive for the pathogen Salmnella Serotype Infantis. Eighty-three percent of these cases are children. Upon interviewing the cases, the outbreak investigators discovered that every ill person had recently visited a special Komodo Dragon exhibit at the Denver Zoo one to three days before they became ill. A Komodo Dragon is the largest living reptile in the world, ranging from x to x feet long {Instructor: show slide #1}. None of the cases attending the exhibit came into direct contact with the reptile. Here is a picture of persons visiting the exhibit {Instructor: show slide #2}. Yesterday the same salmonella Serotype Infantis was isolated from the Komodo Dragon. What are your hypotheses on how these people became ill? Toss the ball to one of the class participants and ask them to either provide a hypothesis or to ask an additional question. After that participant has answered, have him/her toss the ball to another person in the classroom. Continue until adequate responses have been provided. Suggested Script This outbreak of salmonellosis did not occur last week, but in 1995. Take a look again at the picture of the persons visiting the exhibit. Many of the children visiting the exhibit placed their hands upon the wooden barrier. In this next picture, you can see the Komodo Dragon also placing its claws upon the same barrier {Instructor: show slide #3}. When the investigators tested the wooden barrier, they cultured Salmonella Serotype Infantis. Additionally, they also found that persons were statistically significantly less likely to become ill if they washed their hands after visiting the exhibit. This outbreak demonstrated the following three things: 1) people can acquire salmonellosis from reptiles, 2) salmonellosis from animals can be transmitted indirectly, and 3) washing hands is protective against illness. During the last lesson, we briefly discussed the risks of pet ownership for immunocompromised persons. We discussed diseases that may put persons at higher risk of acquiring diseases from pets. We defined the terms zoonoses, opportunistic infections, and immunocompromised. This lesson, we will take a closer look at specific pet-related zoonoses that are of special concern to immunocompromised patients. You will learn human and animal clinical signs, transmission, and general treatment for these zoonoses. As with the Komodo Dragon-related outbreak, we will emphasize that direct and indirect contact with animals needs to be addressed when providing recommendations to at-risk patients. Additionally, the importance of basic hygiene to prevent illness will be mentioned repeatedly over the next four sessions. Body (40 minutes) Paste up poster board signs as follows:
Using a board marker or chalk, fill in the clinical signs, pet(s) that can carry the disease, and transmission of each zoonotic disease.
Pet-related zoonotic disease: campylobacteriosis Primary clinical sign: diarrhea Pets that can carry disease: dogs, cats How disease is transmitted: fecal-oral
Pet-related zoonotic disease: cryptosporidiosis Primary clinical sign: diarrhea Pets that can carry disease: dogs, cats How disease is transmitted: fecal-oral
Pet-related zoonotic disease: salmonellosis Primary clinical sign: diarrhea Pets that can carry disease: dogs, cats, reptiles, birds, rodents How disease is transmitted: fecal-oral
Pet-related zoonotic disease: E. coli O157 infection Primary clinical sign: bloody diarrhea, kidney failure (HUS) Animals that can carry disease: cattle How disease is transmitted: fecal-oral
Pet-related zoonotic disease: cat scratch disease Primary clinical sign: swollen lymph nodes, fever Pets that can carry disease: cats How disease is transmitted: bite, scratch, potentially fleas
Pet-related zoonotic disease: toxoplasmosis Primary clinical sign: neurological dysfunction Pets that can carry disease: cats How disease is transmitted: fecal-oral After the table has been filled in, erase all the cells of the table. Ask participants to reach under their chairs for a label. Participants should then take their labels and place them in the appropriate places in the table. Review the table contents. Suggested Script You all did an excellent job. Today, we covered six pet-related zoonoeses of greatest concern to immunocompromised patients: camplylobacerios, cat scratch disease, cryptosporidiosis, E. coli O157 infection, salmonellosis, and toxoplasmosis. We discussed the primary clinical signs, animals that can carry each disease, and how each disease is transmitted. In the next lesson, we will cover which pets are relatively safe for immunocompromised patients and which are not recommended for at-risk patients.
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