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Meetin (real) chimps (SAFE PET GUIDELINES) (PAWS)
Jun 5, 2007

This may seem like a weird question but here goes.

Me: 34-year-old gay man, HIV positive for 21 months. Four lab results: CD4s 700 to 900, percentages 38% to 40%, VL just above 50 (53 copies, 70 copies etc). Not on any ARVs. So far so good. (BTW, not to tempt fate, but what are the odds that I'll turn out to be an LTNP?)

Ever since I've been a little boy I've loved chimps (and oranguatans and bonobos and gorillas). I have a chance, this summer, to visit a great primatology center and actually interact with these wonderful animals.

But should I not go? Are there precautions poz folk need to take when "dealing" with non-human species? Next year I'd like to go swimming with dolphins; should I shelve that thought. I guess I'm asking, in general, about zoonosis/zoonoses.

Don't want to be a worry-wart but thought I'd ask.

Thanks!

Response from Dr. Frascino

Hello,

At this point your immune system is holding up well. Consequently your risks would not be the same as an HIVer who has more significant immune deficiency. That said, I must also warn you that non-human primates (monkeys) carry the greatest risks for folks who are immunosuppressed, because these primates have a close genetic relationship with humans. I'll reprint some information below from PAWS (Pets are Wonderful Support). Should you take the risk and "monkey-around" this summer? Well at this point you have HIV but are not immunodeficient. Consequently your risks would be minimized. Perhaps it would depend on how much "interaction" you were planning to have with King Kong. Discuss the specific details of your summer plans with your HIV specialist. He can provide you with more specific advice about precautions and risk.

Swimming with dolphins shouldn't pose a significant threat.

Regarding LTNP, well it's possible! You could have the Delta 32 mutation, a wimpy strain or a really strong host immune response. Only time will tell.

By the way, I adore chimps as well. I think it's most unfortunate that Dubya bears such a striking resemblance to these wonderful creatures. It's a real insult to their intelligence!

Stay well.

Dr. Bob

Anyone who has ever lived with a companion animal knows that the unconditional love and acceptance we receive from them is unlike what we generally experience with our human relationships. This is especially important to us when our human contact diminish through, for example, aging or isolation because of disease.

Animals can bring a unique sense of continuity, stability, and love to our lives; in fact, studies indicate that companion animals have a positive influence on the quality of life for the aging and ill. If our immune system becomes suppressed through age, disease, or medical treatments, we become more vulnerable to infections, and may become fearful of contact with other living creatures, including our companion animals.

While there are a number of diseases we can catch from animals, cases of people with HIV/AIDS who have contracted infections from their pets are rare. The Centers for Disease Control and Prevention also states that there is no evidence that dogs, cats, or any other non-primate animals can contract the Human Immunodeficiency Virus (HIV) or transmit it to people.

Zoonoses No, its not what you find on the faces of elephants. Zoonoses (pronounced ZO-uh-NO-seez) refers to those diseases that humans can contract from other animals. Until recently, zoonotic diseases touched few lives in this country.

Am I at risk for contracting a disease from my pet? Current evidence supports the fact that pets pose a minimal risk. Your risk may be slightly higher if you fall into one of the following groups: > People with compromised immune systems > People with AIDS/HIV > People on chemotherapy > People who have received organ or bone marrow transplants > People who are aged People born with congenital immune deficiencies > Pregnant women (a fetus's immune system is not fully developed)

This brochure will review general guidelines for minimizing your risk of catching a disease from an animal. If you are immunosuppressed and either have an animal companion or want to adopt one, carefully review these guidelines with your physician and your animal's veterinarian.

THE BENEFITS OF PET OWNERSHIP OUTWEIGH THE RISKS Follow these guidelines to help keep your pets healthy. Keep in mind that a little preventive care can go a long way in maintaining your animal's health, and a healthy animal is less likely to pick up diseases and transmit them to you.

Diet Feed your pet a high quality commercial diet that is designed for your animal and his or her stage of life. Don't feed your animal raw or undercooked meats or unpasteurized milk. Keep in mind that microwaving may not heat the meat sufficiently to kill organisms in it. Prevent coprophagy (stool-eating). Never let your animal eat his or her own or another animal's feces. Provide plenty of clean, fresh water. Don't let your animal drink from the toilet. Prevent your animal from raiding the trash. Prevent your animal from hunting or eating other animals. Cats can catch toxoplasmosis from eating rodents. If your cat goes outdoors, consider placing two bells on the collar to help warn potential prey.

Veterinary Care Have all new animals examined by a veterinarian. Take your animals to the veterinarian for a check up at least once each year. Keep vaccinations current. Have your pet's feces checked by a veterinarian periodically for parasites. Have your cat (particularly a new cat or an outdoor cat) checked for the Feline Leukemia Virus (FeLV) and Feline Immunodeficiency Virus (FIV).

Grooming/Flea Control Have your animal bathed, brushed, and combed as needed to keep the skin and coat healthy. Keep your animal's toenail's trimmed to minimize the risk of your being scratched. If necessary, ask your vet about rubber caps that can be placed on your cat's nails. Use good flea control. Consult with your veterinarian about the best available products. A clean environment is important. Keep your pet's living and feeding areas clean. Wash your pet's bedding regularly.

A HEALTHY PET IS A SAFE PET

About Dogs Dogs pose a minimal risk for transmitting a disease. Dogs, particularly puppies, however, do carry some diseases that could be harmful to someone at higher risk. Parasites which dogs can transmit to people include roundworms, hookworms, whipworms, cryptosporidia and Giardia. In rare instances, dogs can also transmit bacteria such as Salmonella and Campylobacter. These parasites and bacteria are most often associated with puppies or with adult dogs who are in unsanitary environments. Any new dog or any dog having diarrhea may need to have his or her stools tested for these infections by a veterinarian.

Can I reduce the risk of contracting a disease from my dog? Yes. PAWS recommends that people at risk only get dogs more than 9 months old. Puppies are more likely to harbor infections than healthy adult dogs. Following the guidelines in this brochure will help to reduce your risk of acquiring any infections your dog may have.

About Cats Most cats pose a minimal risk for transmitting a disease. Cats kept indoors are exposed to fewer diseases. For more information on those diseases that cats occasionally transmit, see the PAWS brochure, Questions You May Have About Your Cat and Your Health. This brochure includes information about toxoplasmosis, cat scratch disease (Bartonellosis), and ringworm.

Safe Litter Box Guidelines Keep the box away from the kitchen and eating areas and change the litter box daily. It takes the Toxoplasma parasite at least 24 hours to become infectious. If possible, have someone do it who's not at risk. Use disposable plastic liners and change them each time you change the litter. Don't dump! If inhaled, the dust could possibly infect you. Gently seal the plastic liner with a twist tie and place in a plastic garbage bag for disposal. Disinfect the litter box at least once month by filling it with boiling water and letting it stand for five minutes. This will kill the Toxoplasma organism. Wear disposable gloves for extra protection, and, always wash your hands after cleaning the litter box.

About Birds Most birds pose a minimal risk for transmitting a disease. For more information on those diseases that birds occasionally transmit, see the PAWS brochure, Questions You May Have About Your Bird and Your Health. This brochure includes information about MAC (Mycobacterium infection, a type of tuberculosis), Psittacosis (parrot fever), Salmonella, and Allergic alveolitis.

About Aquarium Fish Aquarium fish can occasionally be the source of infectious diseases. Mycobacterial infections (a type of tuberculosis) can be transmitted by aquarium fish and some skin infections can be spread by contact with infected aquarium water.

What can I do to reduce my risk if I decide to keep aquarium fish? Wear gloves when cleaning an aquarium or when handling fish. Fish suspected of having Mycobacterium or any fish showing unusual lumps should be removed from the tank, and the aquarium should be disinfected before new fish are introduced. Follow the general guidelines in this brochure.

About Reptiles We do not recommend that people at risk keep or handle reptiles. Salmonella infection can be transmitted by almost any reptile. Many reptiles are carriers of Salmonella without showing any signs of illness. Because reptiles have a tendency to lie in their own feces, these bacteria can be found anywhere (and everywhere) on the animal's body.

What can I do to reduce my risk if I decide to keep a reptile in my home? Use gloves and a face masks when handling or cleaning these animals or their habitat. Better yet, have someone not at risk do the cleaning. Thoroughly wash your hands after handling a fish or reptile. Feed a commercial reptile diet and avoid feeding raw meat and eggs to reduce your animal's risk of acquiring Salmonella. If possible, dead prey rather than live should be offered to your reptile.

About Ferrets Zoonosis transmitted by pet ferrets are quite rare. Intestinal parasites are common in young ferrets and can potentially be spread to people. PAWS does not recommend that people at risk come in contact with an immature ferret. Ferrets are also susceptible to human influenza and can easily pass it back to the human. Following the guidelines in this brochure will help to reduce your risk of acquiring any infections your ferret may have.

About Horses Zoonoses transmitted by horses are quite rare. Intestinal parasites and infections such as Salmonella can potentially be spread to people. PAWS does not recommend that people at risk come in contact with an immature horse, a horse with diarrhea, or areas where horses are raised. Adult horses kept in a clean environment pose a minimal risk for transmitting a disease.

About Rabbits and Rodents Zoonosis transmitted by pet rabbits and rodents (rats, mice, guinea pigs, hamsters, or gerbils) are quite rare. The most common problems usually stem from reactions to rabbit scratches, or infections from rabbit or rodent bites. The Pasteurella bacteria carried by most rabbits may infect scratches or bite wounds. Scratches and bite wounds should be immediately washed and disinfected. Some external parasites of the rabbit including fur mites and ringworm (a type of fungal infection) may be transmitted to humans.

Guinea pigs, mice, and rats can occasionally be the source for a variety of intestinal ailments including some bacterial infections (Salmonella and Campylobacter) and some intestinal parasites (Giardia or Cryptosporidium) These diseases can be spread to people by direct contact with the feces of an infected animal or by contact with soil that has been contaminated by the feces of an infected animal.

How can I reduce the risk of contracting a disease from my rabbit or rodent? Do not feed your animal raw eggs or raw meat. Be diligent about washing your hands after handling your animal. Follow the general guidelines in this brochure.

HUMAN HEALTH MEASURES

First Aid for Bites/Scratches Rinse a bite wound or scratch right away with plenty of cool running water. Wash the area with a mild soap or with a tamed iodine solution such as Betadine® solution that has been diluted with water Contact your physician.

Hygiene Wash your hands frequently, especially before eating or smoking. Avoid contact with your pet's bodily fluids such as vomit, feces, urine or saliva. In the event of an accident, clean up the mess with a disinfectant (an ounce of bleach in a quart of water works nicely to kill many infectious organisms) then wash your hands thoroughly. Better yet, wear gloves, or have someone not at risk clean it up. Don't let your pet lick a wound on your face or body. You never know where that tongue has been.

Adopting a New Animal Adopting a new animal companion is always exciting, but keep in mind that new pets, especially puppies and kittens, present more of a risk. If you are going to adopt a new pet, an adult animal is safer. Consult with your veterinarian and physician before adopting a new animal. Your veterinarian may recommend some tests for parasites and other diseases on a new animal. It is best not to take a new animal into your home until you know that he or she is healthy.

Animals to Avoid Unfortunately, some animals simply present too much risk to immunosuppressed people and should be avoided altogether: Stray animals, Animals with diarrhea, reptiles (turtles, lizards, and snakes) and amphibians, wild animals and birds (including pigeons), farm animals, non-human primates (monkeys). Non-human primates carry the greatest risk because of their close genetic relationship to humans. These animals should not be pets under any circumstances. It is also good to remember that the humans in the household pose just as many risks to the animal.



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