Pet Guidelines For People Living With HIV/AIDS
According To USPHS/IDSA: Guidelines For The Prevention Of Opportunistic Infections In Persons Infected With HIV
- Ascarid Infections
- Chlamydial Infection
- Mycobacterium Avium Complex Infection
- Psittacosis - Ornithosis
(Clinical Infectious Diseases 1995; 21(Suppl 1):S1-11)
"When obtaining a new pet, HIV-infected patients should avoid animals less than six months of age, especially those with diarrhea. Because the hygienic and sanitary conditions in pet breeding facilities, pet stores and animal shelters are highly variable, the patient should exercise caution when obtaining a pet from these sources. Stray animals should be avoided. Animals less than six months of age, especially those with diarrhea, should be examined by a veterinarian for Cryptosporidium, Salmonella and Campylobacter...
Those who elect to obtain a cat should adopt or purchase an animal that is less than one year of age and in good health to reduce the risk of cryptosporidiosis, bartonella infection, salmonellosis and campylobacteriosis...
HIV-infected persons who wish to assume the small risk of acquiring a puppy or kitten less than six months of age should request that their veterinarian examine the animal's stool for Cryptosporidium before they have contact with the animal...
Gloves should be worn during the cleaning of aquariums to reduce the risk of infection with Mycobacterium marinum. Contact with exotic pets, such as non-human primates, should be avoided."
Ascarids are worms. Toxocara canis most common to dogs, Toxocara cati (T. mystax) to cats and Toxascaris leonina to both cats and dogs. Eggs of T. canis are passed in the feces and larva develop to the infective stage within the egg. Eggs are extremely resistant to adverse conditions. Extremes of heat or cold and many usual cleaning agents/disinfectants will not effectively kill the eggs. Infection can occur from contact with dog feces, dirt, earthworms, mice, etc. Expulsion of the worm in infected cats can be through the feces or vomitus. Rodent ingestion is a common mode of transmission to the cat. Infection in humans by T. canis is usually termed visceral larva migrans (VLM). Transmission to humans is usually by ingestion of infective eggs from soil contaminated with dog or cat feces or by directly handling of the feces. Dogs should be kept away from feces found on the street. Cats or dogs suspected of having worms should be treated by a veterinarian immediately and care should be taken to avoid direct contact with both feces and vomitus.
Bartonella (formerly Rochalimaea) - "Cat Scratch Fever" Declawing is not usually suggested to avoid cat scratch fever. Rough play and situations where scratches are a possibility should be avoided. Wounds should be washed promptly. It is believed that the organism harbored in the oral cavity and, therefore, cats should not be allowed to lick open wounds or cuts. Rigid flea control should be maintained.
Campylobacter is a gram-negative enteric organism. In people living with AIDS this organism is usually associated with severe diarrhea, cramping, nausea and fever. The most common form of this pathogen is Campylobacter jejuni. The organism has been found in dogs, cats and birds. As with other enteric infections the most common mode of transmission is via the fecal-oral route, though person to person transmission is possible.
"In the general population, the most common cause of sporadic C. jejuni infections appears to be eating or handling raw or undercooked poultry. This source is likely to be the same for HIV-infected persons."
Proper hygiene practices should include avoiding contact with animal feces.
Chlamydial infections can be carried by all warm blooded animals and by birds. Positive identification in animals is difficult as test results are not reliable. Vaccinations are available but it should be kept in mind that there are many different strains of Chlamydia. Cats are subject to Chlamydia infection especially with respiratory symptoms, swollen/runny eyes and stuffed/runny nose.
Cryptococcus neoformans is an encapsulated yeast-like fungus. It has been most commonly isolated from pigeon droppings. Transmission to humans occurs by inhalation of airborne organisms. Proper hygiene practices should include daily changes in cage liners and wearing gloves when changing the cage bottom and cleaning the cage.
Cryptosporidium is an enteric coccidian protozoan. It is commonly found in the gastrointestinal tract of fish, birds, reptiles and mammals. Animals with an immune system suppressed by drug therapy and cats with feline leukemia for feline immunovirus are especially susceptible to the organism. Cryptosporidium is transmitted to humans by exposure to contaminated food or water, person to person contact and animal contact, though this latter is the least likely means of transmission. Proper hygiene should include a clean litter box (cats) and, whenever possible, avoiding direct contact with both dog and cat feces. Because gerbils and hamsters can be carriers of Cryptosporidium their cages should be frequently cleaned.
Giardia is a flagellate protozoan with Giardia lamblia being the most significant with respect to human infection. Giardiasis is one of the most common causes of diarrhea in people living with AIDS. Transmission of the organism most commonly occurs through the fecal-oral route by the ingestion of cysts. Cats, dogs and small rodents such as hamsters and gerbils may carry the disease. Although Giardia can also be transmitted through contaminated water supplies, proper hygiene for people with a compromised immune system who have pets should include avoiding contact with the animal's feces.
Mycobacterium Avium Complex Infection
MAC organisms are acid-fast bacilli with Mycobacterium avium and Mycobacterium intracellulare being of most concern to people with a compromised immune system. The most common form of transmission is through ingestion. Contrary to what the name may imply Mycobacterium avium birds are not usually involved in the transmission of this disease to people living with AIDS.
Psittacosis - Ornithosis
Harbored by birds, especially psittacines. The organism is an avian form of Chlamydia. Psittacosis is the usual term for the disease in birds of the family Psittacidae (parrots, parakeets, cockatoos, macaws, etc.) and ornithosis for birds of other avian families. The disease can also be carried by canaries, South American parrot species, lorikeets, rosellas, finches and rice birds. In man the disease is usually called psittacosis. The use of a face mask and disposable gloves when cleaning cages is strongly recommended.
Ringworm is really a fungal infection, not a worm. Infection causes raised ring-like patterns on the skin and invades the superficial layers of the skin. Transmission is through contact with spores which can live for months or by direct contact with an infected dog or cat. Newly acquired dogs or cats should not be introduced to a household with other animals until the new dog or cat is checked by a veterinarian. Most cases of ringworm respond well to topical antifungals in both humans and animals. Oral medications are also available. Care should be taken to wash hands after handling a potentially infected animal. Because shedding hair can carry the fungus, a thorough airing out of the house will help.
Salmonellae are gram-negative rods and belong to the family Enterobacteriaceae. The most common forms of Salmonellae isolated in people living with AIDS are Salmonella typhimurium and Salmonella enteritidis. The most common form of transmission is via the fecal-oral route through the ingestion of contaminated food (meats, especially pork) or water. Poultry and poultry products such as eggs have also been implicated. Cats, dogs, birds, reptiles and insects can carry the disease ... pet turtles, especially. Proper hygiene practices should include avoiding contact with feces and hand washing after contact with possible vectors. Food products, especially poultry, should be well cleaned before cooking. Eggs should be cooked, not used raw as in Caesar salads.
Toxoplasmosis gandii is a ubiquitous, obligate, intracellular protozoan. The definitive host for T. gondii is the cat. The cat is the only animal that passes oocysts in their feces. The oocysts are not infective until they sporulate. This occurs 1-5 days after they are excreted in the feces. Infected cats will usually shed the T. gondii organism for only a short period of time. Once the organism is no longer in the feces, the feces is not a potential source of infection to you from T. gondii. Under some circumstances, however, an infected cat may begin passing the organism, again, in the feces. Severe stress can contribute to a second shedding.
Cats can become infected with T. gondii:
- if they are allowed outdoors and rummage in soil contaminated with the organism,
- by contact with a cat that is already infected with the organism,
- if they are allowed to hunt mice or other rodents,
- if they are fed raw or undercooked human food,
- if the queen was infected and passed the organism transplacentaly to the litter.
Once tested negative for T. gondii a housebound cat for whom (a)-(d) above do not pertain cannot develop the disease.
It is strongly suggested, especially in the case of cats that have not been tested for T. gondii by a veterinarian, that the following measures be observed:
- use litterbox liners,
- change the litterbox (liner and litter) every day,
- have someone change the litter box for you, if possible, or use gloves,
- dispose of the gloves when done or wash them,
- a mask may be worn if you desire,
- wash your hands when done.
Do not squeeze the air out of the twist-tied liner containing the litter; it will blow clay dust into the air.
The unconditional love and affection provided by a companion animal is a strong and positive therapeutic for people living with HIV/AIDS. By observing a few simple guidelines for general cleanliness the possibility of disease transmission is significantly reduced. People living with HIV/AIDS who are planning to adopt or buy a companion animal must also act responsibly by planning ahead before the adoption/purchase is made to ensure that all aspects of the animal's health, maintenance and future are taken into account. POWARS can assist with this, but it would be an act of irresponsibility to assume that we will do it all or to assume that we will take over complete responsibility for the animal.
We strongly urge anyone considering adoption or purchase to talk with us first. Ensuring the general well being of a companion animal or a companion animal to be means:
- adopting or purchasing only so long as doing so does not exceed yours and our combined ability to maintain a healthy and happy animal;
- attending to the annual vaccinations and rabies vaccinations necessary for both cats and dogs;
- spaying or neutering all cats and dogs as early as is possible;
- registering all animals with the appropriate authority.
Ensuring the general well being of the companion person or companion person-to-be means acting responsibly, not out of self-indulgence and following the general guidelines for people and pets as described in this brochure.
Pet Guidelines for People Living With HIV/AIDS is prepared and edited by POWARS with the participation of: Jane Bicks, D.V.M., Tom DeVincentis, D.V.M., Steve Kohn, Executive Director. POWARS, once located in New York City was dissolved in late 1998.
This brochure is intended to present information to people with HIV/AIDS and concerned friends. It is not to be regarded as providing medical advice. Please consult with your own health care provider(s) for medical advice related to your particular situation. Additional information concerning zoonoses can also be obtained from your veterinarian.
Bacterial Enteric Infections in Persons Infected with Human Immunodeficiency Virus, Frederick J. Angulo and David L. Swerdlow.
U.S. Department of Health and Human Services. From the Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Myotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention.