Update on Outbreak of Multidrug-resistant Campylobacter Infections Linked to Contact with Pet Store Puppies
April 15, 2021 – The Centers for Disease Control and Prevention (CDC) and public health officials in several states have closed the investigation of a multistate outbreak of multidrug-resistant Campylobacter jejuni infections linked to puppies purchased from pet stores.
Fifty-six cases of human Campylobacter jejuni infections were reported in 17 states between January 9, 2019 through March 1, 2021. Of 41 people interviewed, 38 reported contact with a puppy before getting sick, and 21 of those 38 people reported contact with a puppy from a pet store. The ages of those infected range from less than two months to 84 years, with a median age of 40 years. There have been no deaths; nine people were hospitalized.
In this investigation, data analysis showed that bacteria from people infected in the outbreak were related genetically to bacteria from ill people in the 2016–2018 outbreak of multidrug-resistant Campylobacter infections linked to pet store puppies. A single, common supplier of puppies was not identified as the source of this outbreak.
Most people infected with Campylobacter develop diarrhea (often bloody), fever, and stomach cramps two to five days after being exposed to the bacteria. The illness usually lasts about a week and most people recover without antibiotic treatment. Antibiotics are needed only for patients who are very ill or at high risk for severe disease, such as people with severely weakened immune systems.
It is important to follow good personal and pet hygiene to prevent germs from spreading between people and animals. Puppies and dogs can carry Campylobacter germs that can make people sick, even while appearing healthy and clean. People who own or come in contact with puppies or dogs should take steps to stay healthy around their pet.
The CDC has the following advice for pet owners and pet store workers:
- Always wash hands thoroughly with soap and water right after touching your dog, after handling their food, and after cleaning up after them.
- Adults should make sure young children are washing their hands properly.
- If soap and water are not readily available, use hand sanitizer until you are able to wash your hands with soap and water.
- Don’t let dogs lick around your mouth and face.
- Don’t let dogs lick your open wound or areas with broken skin.
- Clean up any urine, feces, or vomit inside the house immediately. Then disinfect the area using a water and bleach solution.
- Take your dog to the veterinarian regularly to keep it healthy and to prevent the spread of disease.
- Only give your dog antibiotics when prescribed by the veterinarian and according to instructions.
- Within a few days after getting a new puppy or dog, take it to a veterinarian for a health check-up.
- If you are thinking of getting a pet dog, choose a dog that is bright, alert, and playful.
- Be aware that even a dog that appears healthy can spread germs to people and other animals.
- If your dog becomes sick soon after purchase or adoption, take your dog to a veterinarian promptly and inform the pet store, breeder, shelter or rescue organization about any illness.
- Thoroughly clean any area occupied by your pet using a water and bleach solution.
Pet Store Workers
- Ask store management for training about handwashing, clean-up procedures, and other illness prevention measures.
- Wash your hands with soap and water after handling dogs.
- Wash your hands thoroughly with soap and water every time you handle dogs or anything in the area where they live and roam, including their food, treats, and food and water containers. Even a dog that appears healthy can spread germs to people and other animals.
- Wash your hands immediately after cleaning up dog urine, feces, or vomit.
- Dry hands using a clean paper towel or air-dry them.
- Eat and store your food safely at the workplace.
- Wash your hands thoroughly before eating.
- Eat and drink in designated areas away from places where animals are kept and exercised.
- Keep your food away from areas where pet food and treats are stored, and away from areas where animals are kept or exercised.
- If a separate refrigerator isn’t available for pet food, store food for people on top shelves, above food, treats, and other supplies for pets.
- Clean up messes safely.
- Clean up any urine, feces, or vomit immediately, and disinfect the area according to store protocols.
- Use disposable gloves for clean-ups and wash your hands thoroughly afterwards.
- Wash work shoes or boots, clothes, and equipment regularly, and do so in an area that is not used to store or prepare food for people.
- If possible, do not wear shoes or boots that you wear at the workplace in your home or when you go anywhere else.
- Follow store protocols for identifying and reporting sick or injured animals.
- Let your employer know if you or other employees become ill, especially with diarrhea or vomiting.
- Practice responsible use of antibiotics in pet stores.
- Only give antibiotics to animals under the direct supervision of a veterinarian.
- Veterinarians should use appropriate diagnostic tests to ensure that antibiotics are needed and that animals receive the right treatment.
- Monitor and document antibiotic use.
- Communicate with suppliers about the importance of responsible use of antibiotics and the benefits of veterinary supervision of antibiotic use.
- Check with your local or state health department for guidance on reporting sick animals.
- CDC Investigation Notice: https://www.cdc.gov/campylobacter/outbreaks/puppies-12- 19/index.html
- CDC Campylobacter Questions and Answers: https://www.cdc.gov/campylobacter/faq.html
- CDC information on Campylobacter: https://www.cdc.gov/campylobacter/index.html
- Updates on this outbreak and other zoonotic issues on the PIJAC website: http://www.pijac.org/animal-welfare-and-programs/zoonotic-disease-prevention
- Campylobacter flyer from PIJAC’s Zoonotic Disease Prevention Series for Retailers: http://pijac.org/sites/default/files/pdfs/FLYERCampylobacter013118.pdf
- AVMA Policy on Judicious Use of Antimicrobials: https://www.avma.org/policies/judicious-therapeutic-use-antimicrobials
- PIJAC’s Recommendations for Antibiotic Stewardship in Companion Animals: https://pijac.org/sites/default/files/pdfs/PIJACAntibioticStewardship_March2019.pdf
- CDC information on outbreaks of zoonotic diseases spread between animals and humans in the United States: https://www.cdc.gov/healthypets/outbreaks.html