Worms & Germs Blog

Promoting Safe Pet Ownership

Posted in Genki 2 second edition

  • The next day, he had some numbness, tingling and other progressive signs, so he went back to emergency, where he was diagnosed with a herniated disc and sent home with more drugs.
  • That night, his symptoms got worse. He became anxious and fearful, and started hallucinating, and was taken back to the hospital. There, he was diagnosed with a reaction to the drugs he was on.
  • The next day, he couldn’t swallow his medications, and he developed more signs of neurological disease. He ended up on a ventilator shortly thereafter because of respiratory failure.

  • Nine family members and friends, and seven healthcare personnel were identified as having high-risk exposure and received post-exposure prophylaxis for rabies.
  • The rabies virus strain that was isolated was a bat rabies strain found predominantly in the tricolored bat (Perimyotis subflavus). The man had apparently reported seeing a bat in his home a few weeks before he got sick. When the trailer was inspected, bats were not found but there were several places where a bat could get it. There was also the potential for exposure at work, since we worked in a warehouse where bats were occasionally seen.

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Here’s where a basic epidemiology term comes in: specificity.

  • Basically, the specificity of a test tells us how often we get false positive results (a positive result in an individual that does not have the disease). If the test is 95% specific, 1 in 20 positive tests will be a false positive (95% will be right, 5% will be wrong).

Another epidemiological term also comes into play: positive predictive value.

  • This is the likelihood that a positive test means that the individual really has the disease.

We need to consider a few things when it comes to screening:

  • How specific is the test?
  • How low would the positive predictive value be in a healthy animal?
  • What would the response be to a positive result?

So can testing this dog for blasto be justified?

If the result is negative…

  • That’s great. That’s the expected and hoped-for result. If the dog is healthy and the urine test is negative, it is very unlikely this dog has blastomycosis.

If the result is positive…

  • That’s not great. That doesn’t mean the dog has blasto, but it means that more work is needed. To me, that would involve a thorough physical examination and a chest radiograph to look for the characteristic lung lesions. If those were normal, odds are it is a false positive test but we still couldn’t rule out early disease. I’d probably recommend re-doing the urine test to see if the positive result was consistent and, perhaps more importantly, whether the value increased over time. If the latter, I’d be concerned that the dog was developing disease.
  • I would not take a positive urine test and embark directly on a prolonged and expensive course of treatment in a clinically normal animal.

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Can animals get infected with Zika virus?

  • It depends on what you include in “animals.” We could be technical and say that humans are animals.
  • Beyond that, non-human primates are susceptible. Zika was first identified in 1947 when yellow fever researchers working in the Zika forest in Uganda stumbled onto it. They had a macaque in a cage and it developed a febrile illness from something that was transmissible. The virus was described as Zika virus in 1952 and then found in people a couple of years later.

But can domestic animals get infected with Zika virus?

  • Again, we need to think about the question. Infected means they get exposed to the virus and it replicates in the body. That may occur, but we don’t have any evidence of it at this point.
  • The more relevant question is whether animals can get sick from Zika virus exposure, and there’s also no evidence of that to date.
  • A third aspect is whether infected (but potentially healthy) animals could be a reservoir for the virus, being able to pass it on to mosquitoes. There’s no evidence of that, either.

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To answer the question, we need to think about how diseases are diagnosed and reported.

Here’s what’s involved if I get Salmonella from my imaginary chickens.

  • I have to get sick (the easy part)
  • I have to be sick and/or motivated enough to go to a doctor.
  • The doctor has to ask for a fecal sample for testing.
  • I have to actually collect the sample and drop it off.
  • The lab has to grow Salmonella from the sample.
  • That gets reported to Public Health.
  • Public Health investigates and finds out I have chickens.

Probably not.

If there are 4 infections identified by a health unit in a summer, what does that mean?

  • If it’s 4 infections from 4000 houses with chickens, that’s different than if it’s 4 infections from 8 houses with chickens.
  • It’s also much different if it’s 4 chicken owners vs 4 neighbours of chicken owners (who didn’t choose to have chickens).

As is common, a lack of good data doesn’t help the decision-making process.