Immunocompromised people, AIDS and Pets

Pets are wonderful companions that add spark to many lives. They are "healing helpers" that exert a positive impact on the ill and are incorporated in many hospital patient recovery programs.  

People with compromised immune systems are a special need group as far as pets are concerned. These people are more vulnerable to infections, parasites and diseases transmitted from animals to people (zoonosis) and need to take extra precautions around pets.  

It is estimated that there are several millions of Immunocodeficient people in the United States. AIDS, organ transplant/cancer treatment, debilitating diseases, malnutrition, congenital immunodeficiencies, diabetes mellitus, chronic renal failure, alcoholism and liver cirrhosis, autoimmune diseases, major surgery, splenectomy, long-term hemodialysis, pregnancy and old/very young age are some of the causes of deficient immunity. Among the most common infections associated with animals include Toxoplasma gondii, Cryptosporidium spp, Salmonella spp, Campylobacter spp, Giardia sp, Rhodococcus equi, Bartonella (Rochalimaea) spp, Mycobacterium marinum, and Bordetella bronchiseptica. Salmonella and Campylobacter spp are the most common bacteriae transmitted from animals but most of these infections are acquired from sources other than pets. Many of these people are advised to give up having pets, but very few will part from their companions.  

For many, the pet is a need, not a luxury. With the proper care, the risk of pet related diseases becomes minimal. Immunocompromised pet owners should be observant and seek veterinary care as soon as they notice problems in their pets. They should be educated about common problems and available preventative programs. Pets should be fed only high-quality commercial pet foods. They should not be allowed to drink out of toilet bowls, outdoor water sources or have access to garbage and materials of unknown origin. They should be closely supervised while outside, unless they are in their own fenced yard. Pets should not be allowed to scavenge, hunt, or eat feces. Immunocompromised people should wash their hands after handling pets, especially before eating, and should avoid contact with their pet's feces.

Cats and dogs owned by immunocompromised people should receive routine semi-annual veterinary care, including a physical examination, standard immunizations, and a fecal examination for intestinal parasites. Animals with diarrhea should have a fecal exam screened also for Salmonella, Campylobacter, Cryptosporidium and Giardia spp and kept away from immunocompromised persons. Positive animals should be treated accordingly.

When acquiring a new pet, healthy adult animals are recommended. Young animals, especially those with diarrhea, should be avoided. Large breeding colonies and pet stores should be avoided because of sanitary variation and a closed infectious substrate.

A new pet needs to pass a veterinary exam and screening prior to contact with an immunosuppressed person. Cats are the definitive host of Toxoplasma gondii because they are the only animals that pass oocysts in their feces, which become infective. The shedding occurs during the first two to three weeks after infection. Prevention of Toxoplasmosis consists of daily cleaning of litter boxes that should never be placed near the kitchen. This should be done wearing rubber gloves or preferably by a healthy person. Direct transmission from cats is unlikely.

Cats should not be allowed to hunt and should not be fed raw or undercooked meat. Because outdoor cats frequently defecate in gardens and T gondii oocysts may survive for months under appropriate conditions, immunosuppressed people should wear gloves when gardening or working with soil and wash their hands afterwards. Salmonellosis and campylobacteriosis may be the most common infections acquired from cats and are prevented as described above. Bacillary angiomatosis or cat scratch disease causes fever, serious skin lesions, and life-threatening systemic disease. Prolonged antibiotic treatment is effective. Kittens pose a higher risk

Pet birds pose a low risk, but reptiles are a known source of Salmonella and are not recommended. Small rodents, such as hamsters and gerbils, can also transmit Salmonella, Campylobacter, Cryptosporidium, and Giardia infections.Ornamental fish have caused several Mycobacterium marinum infections in HIV-infected persons.Young farm animals, especially with diarrhea, may carry Cryptosporidium spp.

In conclusion, immunosuppressed people do not need to give up the joy of pet companionship. They simply need to know about the special care and to keep consistent communication with the veterinarian.