Update on Outbreak of Campylobacter Infections in People Linked to Puppies
The Centers for Disease Control and Prevention (CDC), several states, and the United States Department of Agriculture Animal and Plant Health Inspection Service (USDA-APHIS) have completed an investigation of a multistate outbreak of human Campylobacter infections.
According to the CDC, the outbreak included 113 people with laboratory-confirmed infections or symptoms consistent with Campylobacter infection from 17 states (Connecticut, Florida, Georgia, Illinois, Kansas, Massachusetts, Maryland, Missouri, New Hampshire, New York, Ohio, Oklahoma, Pennsylvania, Tennessee, Utah, Wisconsin, and Wyoming) and were exposed to puppies sold through retail stores. Epidemiologic and laboratory evidence indicated that contact with puppies sold through these stores was a likely source of this outbreak.
Campylobacter bacteria isolated from clinical samples from some of the people sickened in this outbreak were found to be resistant to first-line antibiotics. This means it would be difficult to treat these infections with the antibiotics that are most commonly prescribed for Campylobacter infections. The Pet Industry Joint Advisory Council (PIJAC) Zoonosis Committee has initiated discussions on developing best management practices to prevent antibiotic resistance.
Because nearly every living creature, humans included, can be a carrier of germs that may be transmitted to the people and animals around them, following good pet hygiene is important. PIJAC recently added a Campylobacter flyer as part of its Zoonotic Disease Prevention Series for Retailers. For more information, please visit: http://pijac.org/sites/default/files/pdfs/FLYERCampylobacter013118.pdf
Though the investigation is over, illnesses could continue to occur since people may be unaware of the risk of Campylobacter infections from puppies or dogs. It is important to know that a wide range of Campylobacter species can be carried by young dogs irrespective of source. Dogs may acquire Campylobacter jejuni through raw meat or unpasteurized milk in their diet. The infection can spread to humans through contact with dog feces or through consumption of undercooked poultry or unpasteurized milk. It usually does not spread from one person to another.
While some apparently healthy dogs are asymptomatic carriers of Campylobacter, symptomatic dogs may have diarrhea (which may be bloody, or occasionally bile-stained), reduced appetite and vomiting.
Symptoms in young dogs usually last from 3 to 7 days, returning intermittently for up to two weeks.
Most patients who develop Campylobacter infections will recover with supportive care (for example, rehydration and electrolyte replenishment) alone. For patients who may require antibiotics (those who are at high risk for serious illness, such as infants and young children, adults aged 65 years and older, pregnant women, and people with weakened immune systems), healthcare providers are encouraged to order stool culture with antimicrobial susceptibility testing and to choose an antibiotic based on the results of the patient’s stool cultures and antimicrobial susceptibility testing. Most people with a Campylobacter infection develop symptoms 2 to 5 days after being exposed to the bacteria. Symptoms usually last about a week. The following are typical human symptoms:
- Diarrhea (that is often bloody)
- Stomach cramps
By following these simple steps, you can keep your family healthy and enjoy having dogs in your life while preventing illness spreading between people and puppies and dogs:
- Wash your hands thoroughly with running water and soap for at least 20 seconds every time you touch dogs, their food, or clean up after them. Adults should supervise handwashing for young children.
- If soap and water are not readily available, use hand sanitizer until you are able to wash your hands with soap and water.
- Pick up and dispose of dog feces, especially in areas where children might play. Use disposable gloves and wash your hands thoroughly afterwards.
- Clean up any urine, feces, or vomit in the house immediately, and disinfect the area. Use disposable gloves to handle anything that has touched the waste, and wash your hands thoroughly afterwards.
- Don’t feed raw or undercooked meat or unpasteurized milk to pets. Keep pets out of kitchen and food preparation areas.
- Take your dog to the veterinarian regularly to keep it healthy and to help prevent the spread of disease.
- Antibiotic treatment for your pet should be under the direction of a veterinarian. Don’t let pets lick your mouth and face.
- Don’t let pets lick an open wound or areas with broken skin.
Pet Store Guidance
Campylobacter is one of several diseases that may be transmitted from puppies and dogs to retail staff who handle animals and their in-store habitats. Precautionary practices are recommended to prevent Campylobacter infection along with other bacterial illnesses. These recommendations apply to store personnel and customers.
Wash your hands.
Wash your hands thoroughly with running water and soap for at least 20 seconds during these times:
- Before and after eating
- After using the toilet
- After touching pets and other animals
- After touching uneaten pet food and treats, or food and water containers
- After cleaning up urine, feces, or vomit
- After touching raw food of animal origin
- Dry hands using a clean paper towel or air-dry them. Do not dry hands on clothing.
Eat and store your food safely.
- Always eat and drink in designated break areas away from places where animals move around, such as enclosures and exercise areas.
- Keep uneaten food for people away from areas where pet food and treats are stored, and where pets move around, pet enclosures, and exercise areas.
Play it safe with animals and their food.
- Wash your hands thoroughly with soap and water right after handling any pet food, including live or frozen rodents, wet or dry food, after touching feed and water containers, and after cooking/handling raw meat.
- Don’t let pets lick around your mouth and face.
- Don’t let pets lick any of your open wounds or areas with broken skin.
Clean up messes safely.
- Clean up any feces in stores immediately, and disinfect the area well.
- Clean and disinfect bedding regularly.
- Use disposable gloves for clean-ups, and wash your hands thoroughly afterwards.
- Wash work shoes or boots, gloves, clothes, and equipment regularly.
Follow store protocols for identifying and reporting sick or injured animals.
- Updates on this outbreak and other zoonotic issues can be found on the PIJAC website at http://www.pijac.org/animal-welfare-and-programs/zoonotic-disease-prevention
- CDC’s outbreak posting is available at https://www.cdc.gov/campylobacter/outbreaks/puppies-9-17/index.html
- CDC advice on keeping people and puppies healthy can be found at https://www.cdc.gov/healthypets/pets/dogs.html
- More information on Campylobacter is available at https://www.cdc.gov/campylobacter/index.html
- Retail Store’s three most recent announcements: