Cutaneous Listeriosis in a Veterinarian with the Evidence of Zoonotic Transmission – A Case Report

A case of Listeria monocytogenes skin infection in a man is presented. A 54‐year‐old male veterinary practitioner developed pustular changes on the skin of arms and hands after assisting with the delivery of a stillborn calf. Listeria monocytogenes was isolated from the skin lesions on the arms and from the bovine placenta. Listeria monocytogenes isolates were serotyped and genotyped with pulsed‐field gel electrophoresis (PFGE) to confirm the suspected transmission of the pathogen from animal to human. All isolates were of serotype 4b with identical pulsotype. To the best of our knowledge, this is the first case of cutaneous listeriosis in which the evidence for zoonotic transmission of L. monocytogenes is supported by genotyping methods.     

Seroprevalence of Toxoplasma gondii in wild boar and deer in Brandenburg,Germany

Consumption of game in Germany has increased during the past 10 years. Wild boar (Sus scrofa), roe deer (Capreolus capreolus) and red deer (Cervus elaphus) are the most frequently hunted and consumed game animals in Germany, yet information on the occurrence of zoonotic pathogens in these animal species is scarce. To better estimate the public health risk emanating from handling and consumption of game, this study investigated seroprevalences of Toxoplasma gondii in game hunted in the German federal state of Brandenburg during two hunting seasons from 2017 to 2019. Toxoplasma gondii‐specific antibodies were detected in 24.4% (44/180, 95% CI: 18.4%–31.4%) of wild boar, 12.8% (16/125, 95% CI: 7.5%–20%) of roe deer and 6.4% (3/47, 95% CI: 1.3%–17.5%) of red deer using a commercial ELISA kit. Seroprevalences were similar in the two hunting seasons. Correlation between sex and seropositivity could not be observed. A rise in seroprevalence was seen with increasing age in all studied game species. Observed seroprevalences suggest that T. gondii is endemic in the sylvatic environment in the German federal state of Brandenburg and imply that game could represent a relevant source for human T. gondii infection.     

Capnocytophaga canimorsus Meningitis: Three Cases and a Review of the Literature

Bacterial meningitis is a disease with a high morbidity and mortality. It may be caused by the zoonotic pathogen Capnocytophaga canimorsus, which is part of the commensal oral flora in dogs and cats. We report three cases of C. canimorsus meningitis in a nationwide cohort study of bacterial meningitis patients and performed a review of the literature. Three episodes of C. canimorsus meningitis were identified in three patients included in a nationwide cohort study from 2006 through 2014. The calculated annual incidence was 0.03 per million adults. When combined with the literature, 33 patients were identified of which 28 were male (85%). The median age was 63 years, and 13 (42%) were immunocompromised, which consisted of alcoholism in 7 (21%). Animal contact could be established in 29 of 30 patients (93%) and consisted of dog bites in 22 of 29 (76%). One patient died (3%) and 8 had neurological sequelae upon discharge (25%), most often hearing loss (n = 6, 19%). Capnocytophaga canimorsus meningitis is associated with dog bites. Although mortality is relatively low, survivors often have neurological sequelae.     

Trichinellosis Outbreak Caused by Meat from a Wild Boar Hunted in an Italian Region Considered to be at Negligible Risk for Trichinella

The wild boar is an important source of trichinellosis for people in European countries as a large number of hunted animals escape veterinary control. In November 2012, uncooked sausages made with meat from wild boar were consumed by 38 persons in a village of the Lucca province (Tuscany region, Italy). Of them, 34 were serologically positive, 32 developed clinical signs and symptoms of trichinellosis, and two were asymptomatic. Trichinella britovi larvae were detected in vacuum‐packed sausages made with the same batch of sausages consumed raw which had been prepared with meat from wild boar hunted in the Lucca province. As no case of trichinellosis had been reported in this region during the last 20 years, the regional public health authority considered the risk for this zoonosis to be negligible and put in place a surveillance programme on Trichinella spp. in indicator animals (mainly foxes and including wild boar for private consumption), by testing only a percentage of heads. The experience from this outbreak shows that the definition of a region with a negligible risk for Trichinella infection is not applicable to wild boar and stresses the need to test all Trichinella‐susceptible wild animals intended for human consumption and to implement risk communication to consumers and hunters.     

Occupational transmission of an Orthopoxvirus infection during an outbreak in a colony of Macaca tonkeana in Lazio Region,Italy, 2015

Orthopoxviruses spill over from animal reservoirs to accidental hosts, sometimes causing human infections. We describe the surveillance and infection control measures undertaken during an outbreak due to an Orthopoxvirus occurred in January 2015 in a colony of Macaca tonkeana in the province of Rieti, Latio, Italy, which caused a human asymptomatic infection. According to the epidemiological investigation, the human transmission occurred after an unprotected exposure. The contacts among wild, captive and domestic animals and humans, together with decreased immunity against Orthopoxviruses in the community, may put animal handlers at risk of infection, especially after the cessation of smallpox vaccination. To reduce these threats, standard precautions including respiratory hygiene and transmission‐based precautions should be carefully applied also in veterinary medicine.     

Puumala Virus Outbreak in Western Thuringia,Germany, 2010: Epidemiology and Strain Identification

In 2010, the highest annual number of human Puumala virus (PUUV) infections was reported in Germany since hantavirus surveillance started in 2001. The increase in annual case numbers was especially marked in western Thuringia. We combined results of case‐based hantavirus surveillance in humans and serological and molecular investigations in the rodent reservoir to describe the epidemiological situation and to identify the putative outbreak strain. A 5‐fold increase in notified hantavirus cases compared to the previous annual maximum was observed in western Thuringia in 2010. Disease incidence varied tremendously within a small geographical area with case patients' places of residence clustering around beech‐dominated broad leaf forest patches. Investigations in the rodent reservoir revealed a novel Puumala virus (PUUV) subtype, which is clearly distinct from strains collected in other PUUV endemic regions of Germany. It can be assumed that in regions in western Thuringia where hantavirus cases occurred in 2010 or previous outbreak years, PUUV has been present in the environment for a long time. Further studies are needed to elucidate the population dynamics and hantavirus prevalence of the rodent reservoir and driving ecological factors.     

Staphylococcus sciuri peritonitis in a patient on peritoneal dialysis

Staphylococcus sciuri is an occasional cause of human infection that has been described in the flora of numerous animal species and in environmental specimens. Here, we report a rare case of S. sciuri peritonitis in a dialysis patient who had exposure to peridomestic animals.     

Brucellosis: A rapid risk assessment by a regional outbreak team and its coordinated response with the Directorate‐General for Food and Veterinary,North region of Portugal, 2019

We report a Brucella outbreak with seven cases in the Northern Region of Portugal in 2018–2019, associated with the consumption of fresh cheese. This outbreak has implications for risk assessment in Portuguese migrants related to this area, and it is an example of cooperation between public institutions, in a One Health based approach.     

A Multistate Investigation of Antibiotic‐Resistant Salmonella enterica Serotype I 4,[5],12:i:‐ Infections as Part of an International Outbreak Associated with Frozen Feeder Rodents

While most human Salmonella infections result from exposure to contaminated foods, an estimated 11% of all Salmonella infections are attributed to animal exposures, including both direct animal handling and indirect exposures such as cleaning cages and handling contaminated pet food. This report describes the epidemiologic, environmental and laboratory investigations conducted in the United States as part of the response to an international outbreak of tetracycline‐resistant Salmonella enterica serotype I 4,[5],12:i:‐ infections with over 500 illnesses occurring from 2008 to 2010. This investigation found that illness due to the outbreak strain was significantly associated with exposure to pet reptiles and frozen feeder rodents used as food for pet reptiles. Salmonella isolates indistinguishable from the outbreak strain were isolated from a frozen feeder mice‐fed reptile owned by a case patient, as well as from frozen feeder mice and environmental samples collected from a rodent producing facility (Company A). An international voluntary recall of all Company A produced frozen feeder animals sold between May 2009 and July 2010 occurred. Only 13% of cases in our investigation were aware of the association between Salmonella infection and mice or rats. Consumers, the pet industry, healthcare providers and veterinarians need to be aware of the potential health risk posed by feeder rodents, whether live or frozen. Frozen feeder rodent producers, suppliers and distributors should follow the animal food labelling requirements as described in 21 CFR §501.5, and all packages of frozen feeder rodents should include safe handling instructions. Persons should wash their hands thoroughly with soap and water after handling live or frozen feeder rodents, as well as reptiles or anything in the area where the animals live. Continued opportunities exist for public health officials, the pet industry, veterinarians and consumers to work together to prevent salmonellosis associated with pet food, pets and other animals.     

陕西省某猪场一起猪腹泻病暴发的现场调查

2013年3月,陕西某县某猪场发生猪腹泻。为查明疫情波及范围、风险因素及提出有针对性的预防控制建议,主管部门对猪场的饲养管理、发病现状进行了现场询问并对发病猪进行临床及病理诊断。调查发现,此次暴发是由气温急剧变化引起,猪的转群导致疫病扩散,通过采取停止转群、加强猪舍出入消毒、在猪舍门口增加棉质的防风帘、火炉取暖等措施,使发病情况得到迅速控制。建议寒冷季节应加强猪舍的保温,加强消毒,一旦出现疫病,要严格控制发病猪的移动。     

Characterizing the Role of Animal Exposures in Cryptosporidiosis and Shiga Toxin‐producing Escherichia coli Infections: South Dakota, 2012

Cryptosporidium spp. and Shiga toxin‐producing Escherichia coli strains (STEC) are important causes of human illness. Incidence rates of these illnesses are high in South Dakota compared to the USA as a whole. Direct animal contact has been identified as a possible route of exposure for these illnesses. Ruminant animals may carry STEC subclinically, while young ruminants are common sources of zoonotic strains of Cryptosporidium. South Dakota patients with either STEC or cryptosporidiosis during 2012 were interviewed regarding seven categories of animal exposure: (i) petting zoo/fair attendance, (ii) animal event/rodeo attendance, (iii) feed/pet store visits, (iv) farm visits, (v) employment or residence at a farm, (vi) residence with pets and (vii) visiting other households with pets. Of the 50 STEC cases, 78.0% reported animal exposure prior to illness onset, with 23.3% having lived or worked on a farm. Farm visitors in particular had high degrees of animal contact and infrequently practiced personal protective measures. Of the 115 cryptosporidiosis cases, 87.8% reported animal exposures, with 45.6% having lived or worked on a farm and 29.0% having visited a farm prior to illness. Cases with farm exposures reported a high degree of direct animal contact and inconsistent use of personal protective measures. Cryptosporidiosis patients were significantly more likely than STEC patients to have lived or worked on a farm prior to their illness and were older on average. Patients with these illnesses had high rates of animal contact prior to illness. Animal contact on farms emerged as an important exposure route. Educational messages about personal protective measures should be directed at these individuals.     

Factors associated with Echinococcus multilocularis infection in coyotes in southern Ontario

Echinococcus multilocularis was recently reported in wild canids across southern Ontario, a newly recognized endemic area in Canada. In such areas, a comprehensive understanding of factors associated with infection in definitive hosts (wild canids) is critical for mitigating risk of transmission to humans. However, little is known about the transmission dynamics of the parasite in definitive hosts for this region. A study was therefore carried out to investigate the association of host‐level (sex, body condition), environmental (southern Ontario region, land cover), temporal (season, hunting season, calendar year) and extraneous factors (submitter type) with E. multilocularis infection in coyotes in southern Ontario. Between November 2015 and March 2017, 416 coyotes were collected from across the region as part of a study that investigated the prevalence and distribution of the parasite in wild canids; approximately 24% of coyotes were positive for E. multilocularis. Associations between infection and factors of interest were assessed via a mixed‐effects logistic regression model with a random intercept for submitter to account for clustering. Coyotes with poor body condition were at greater odds of E. multilocularis infection than those in good condition (odds ratio [OR] 2.14; 95% CI: 1.08–4.26; p = .030). A negative association was observed between infection in coyotes and the proportion of natural land in a coyote's estimated home range (OR: 0.67; 95% CI: 0.52–0.85; p = .001). Coyotes from the western region of southern Ontario had lower odds of infection compared to coyotes from the central region (OR: 0.26; 95% CI: 0.12–0.55; p < .001). These results can be used to help guide future public health prevention strategies for human alveolar echinococcosis.     

Antimicrobial Resistance of Faecal Escherichia coli Isolates from Pig Farms with Different Durations of In‐feed Antimicrobial Use

Antimicrobial use and resistance in animal and food production are of concern to public health. The primary aims of this study were to determine the frequency of resistance to 12 antimicrobials in Escherichia coli isolates from 39 pig farms and to identify patterns of antimicrobial use on these farms. Further aims were to determine whether a categorization of farms based on the duration of in‐feed antimicrobial use (long‐term versus short‐term) could predict the occurrence of resistance on these farms and to identify the usage of specific antimicrobial drugs associated with the occurrence of resistance. Escherichia coli were isolated from all production stages on these farms; susceptibility testing was carried out against a panel of antimicrobials. Antimicrobial prescribing data were collected, and farms were categorized as long term or short term based on these. Resistance frequencies and antimicrobial use were tabulated. Logistic regression models of resistance to each antimicrobial were constructed with stage of production, duration of antimicrobial use and the use of 5 antimicrobial classes included as explanatory variables in each model. The greatest frequencies of resistance were observed to tetracycline, trimethoprim/sulphamethoxazole and streptomycin with the highest levels of resistance observed in isolates from first‐stage weaned pigs. Differences in the types of antimicrobial drugs used were noted between long‐term and short‐term use farms. Categorization of farms as long‐ or short‐term use was sufficient to predict the likely occurrence of resistance to 3 antimicrobial classes and could provide an aid in the control of resistance in the food chain. Stage of production was a significant predictor variable in all models of resistance constructed and did not solely reflect antimicrobial use at each stage. Cross‐selection and co‐selection for resistance was evident in the models constructed, and the use of trimethoprim/sulphonamide drugs in particular was associated with the occurrence of resistance to other antimicrobials.     

Giardia duodenalis in primates: Classification and host specificity based on phylogenetic analysis of sequence data

Giardia duodenalis colonizes the gastrointestinal tract of a wide range of hosts, including humans and other primates. It is grouped into eight different Assemblages and, beyond that, into a number of sub‐Assemblages, defined ad hoc on the basis of genetic differences; these various groups are often considered to be associated with a specific restricted host range. The aim of this study was to use publicly available genotyping data to investigate the relatedness of human and non‐human primate (NHP) Giardia isolates in order to evaluate the usefulness of current taxonomic classification and to assess whether there is potential for zoonotic transmission between humans and NHP. Our final data set consisted of sequence data from 165 isolates, 111 from NHP and 54 from humans. Assemblages were well defined, but sub‐Assemblages across Assemblage B were not resolved. Although sub‐Assemblages AI and AII were resolved, the terms were not found to capture any useful molecular or host/deme properties. In the phylogenetic tree, NHP isolates were scattered among human isolates across Assemblages A and B, and were even found in Assemblage E. We conclude that there does not appear to be significant molecular distinction between human and NHP Giardia isolates across these four molecular markers. Thus, on the basis of these markers, we cannot exclude a risk for zoonotic and anthropozoonotic transmission of Assemblages A and B isolates, irrespective of sub‐Assemblage classification. We further evaluated the relative merit of the four genes used in genotyping studies. The tpi, gdh and bg genes gave relatively congruent tree topologies, but the SSU gene did not resolve Assemblages according to the current classification. Future genotyping efforts should aim for multilocus or whole‐genome approaches and, in particular, use of the SSU gene as the sole marker should be avoided when possible.     

Giardia duodenalis in colony stray cats from Italy

Giardia duodenalis is the most common intestinal protozoan in humans and animals worldwide, including eight morphologically identical assemblages, infecting pets, livestock, wildlife and human beings. Assemblages A and B are those with the higher zoonotic potential, and they have been detected in several mammals other than humans; the others (C to H) show a higher host specificity. Cats can harbour both the specific Assemblage F and the zoonotic ones A and B. Several studies have been carried out on G. duodenalis genotypes in cats; however, the role of this species in the epidemiology of giardiasis is still poorly understood. In this scenario, the present study carried out the detection and genetic characterization at sub-assemblage level of G. duodenalis from colony stray cats in central Italy. In the period 2018–2019, 133 cat faecal samples were analysed for the presence of G. duodenalis cysts by a direct immunofluorescence assay. Positive samples were subsequently subjected to molecular analyses for assemblage/sub-assemblage identification. Forty-seven samples (35.3%) were positive for G. duodenalis cysts by immunofluorescence. G. duodenalis DNA was amplified at SSU-rDNA locus from 39 isolates: 37 were positive for zoonotic Assemblage A and 2 showed a mixed infection (A + B). Positive results for the β-giardin gene were achieved for 25 isolates. Sequence analysis revealed 16 isolates belonging to Sub-assemblage AII and 8 to Sub-assemblage AIII. One isolate resulted as ambiguous AI/AIII. Large sequence variability at the sub-assemblage level was detected, with several double peaks and mutations, making complex a proper isolate allocation. When compared with previous studies, the 35.3% prevalence of G. duodenalis in cats reported in the present article was surprisingly high. Moreover, all positive cats resulted to be infected with zoonotic assemblages/sub-assemblages, thus indicating stray cats as a possible source of human giardiasis and highlighting the sanitary relevance of cat colonies in the study area.     

Outbreak of human infections with uncommon Salmonella serotypes linked to pet bearded dragons, 2012–2014

Reptiles are one of the fastest growing sectors in the United States pet industry. Reptile‐associated salmonellosis (RAS) continues to be an important public health problem, especially among children. We investigated an outbreak of human Salmonella infections resulting from serotypes Cotham and Kisarawe, predominately occurring among children. An outbreak of illnesses was identified in persons with exposure to pet bearded dragon lizards. Human and animal health officials, in cooperation with the pet industry, conducted epidemiologic, traceback and laboratory investigations. Onsite sampling was conducted at two US breeding facilities, one foreign breeding facility, and a large pet retail chain. A total of 166 patients in 36 states were identified with illness onset dates from 02/2012–06/2014. The median patient age was 3 years (range, <1–79 years), 57% were aged ≤5 years, and 37% were aged ≤1 year. Forty‐four patients (37%) were hospitalized, predominantly children. Sampling at breeding facilities and a national pet store chain resulted in isolation of outbreak serotypes at each facility; isolation proportions ranged from 2%–24% of samples collected at each facility.Epidemiologic, microbiologic and traceback evidence linked an outbreak of uncommon Salmonella serotypes to contact with pet bearded dragons. The high proportion of infants involved in this outbreak highlights the need to educate owners about the risk of RAS in children and the potential for household contamination by pet reptiles or their habitats. Strategies should be developed to improve breeding practices, biosecurity and monitoring protocols to reduce Salmonella in the pet reptile trade.     

Human Brucella canis Infection and Subsequent Laboratory Exposures Associated with a Puppy,New York City, 2012

Human Brucella canis infection incidence is unknown. Most identified cases are associated with pet dogs. Laboratory‐acquired infections can occur following contact with Brucella spp. We identified a paediatric B. canis case, the source and other exposed persons. A 3‐year‐old New York City child with fever and dyspnoea was hospitalized for 48 h for bronchiolitis. After her admission, blood culture grew B. canis, she was prescribed anti‐microbials and recovered. B. canis was also isolated from blood of the child's pet dog; these isolates were genetically similar. The dog originated from an Iowa breeding facility which was quarantined after identification of the dog's infection. Additionally, 31 laboratory workers were exposed and subsequently monitored for symptoms; 15 completed post‐exposure prophylaxis. To our knowledge, this is the first report strongly suggesting B. canis zoonotic transmission to a child in the United States, and highlights the need for coordinated control policies to minimize human illness.