Animals in healthcare facilities: recommendations to minimize potential risks

The role of animals in the transmission of zoonotic pathogens and cross-transmission of human pathogens in these settings remains poorly studied. [...]more definitive information is available, priority should be placed on patient and healthcare provider safety, and the use of standard infection prevention and control measures to prevent animal-to-human transmission in healthcare settings. A national poll of pet owners revealed that in 2013–2014, 68% of US households included a pet with the number of households owning specific animals as follows: dogs 56.7 million, cats 45.3 million, freshwater fish 14.3 million, birds 6.9 million, small animals 6.9 million, reptiles 5.6 million, horses 2.8 million, and saltwater fish 1.8.1 Patients in healthcare facilities come into contact with animals for 2 main reasons: the use of animals for animal-assisted activities (animal-assisted activities encompass “pet therapy,” “animal-assisted therapy,” and pet volunteer programs) and the use of service animals such as guide dogs for the sight impaired. Infection Direct or indirect contact Flea bites, mites Fungal infection (Malassezia pachydermatis, Microsporum canis, Trichophyton mentagrophytes) Staphylococcus aureus infection Mites (Cheyletiellidae, Sarcoptidae) Fecal-oral Campylobacteriosis (Campylobacter spp.) Paratyphoid (Salmonella spp.) Giardiasis (Giardia duodenalis) Salmonellosis (Salmonella enterica subsp enterica serotypes) Droplet Chlamydophila psittaci Vector-borne Ticks (dogs passively carry ticks to humans; disease not transmitted directly from dog to human) Rocky Mountain spotted fever (Rickettsia ricksettsii) Ehrlichiosis (Ehrlichia spp.) Fleas Dipylidium caninum Bartonella henselaeTABLE 2 Studies of Pathogens and Outbreaks Associated with Animals in Healthcare (AHC) Author, Year, (Ref. [...]human strains of methicillin-resistant Staphylococcus aureus (MRSA) have increasingly been described in cats, dogs, horses, and pigs, with animals potentially acting as sources of MRSA exposure in healthcare facilities.2 MRSA is just one of many potential pathogens; a wide range of pathogens exist, including common healthcare-associated pathogens (eg, Clostridium difficile, multidrug-resistant enterococci), emerging infectious diseases (eg, extended spectrum β-lactamase (ESBL)–producing Enterobacteriaceae), common zoonotic pathogens (eg, Campylobacter, Salmonella, and dermatophytes), rare but devastating zoonotic pathogens (eg, rabies virus), and pathogens associated wit