Pet Columns, Office of Public Engagement, College of Veterinary Medicine at the University of Illinois at Urbana-Champaign

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Physicians or Veterinarians: Who Should Advise Immune Compromised People With Pets?

Pet Column for the week of February 8, 2010

Related information:

Services - Public Health

Office of Public Engagement
2001 S. Lincoln Ave.
Urbana, Illinois 61802
Phone: 217/333-2907
Ashley Mitek
Information Specialist

Source - Yvette J. Johnson-Walker, DVM, MS, PhD
YOPI. It sounds like a breed of alien, but it is an acronym public health experts use on a daily basis. Standing for the young, old, pregnant, and immunocompromised, it summarizes the four categories of people that do not have a "robust" immune system and are therefore more likely to contract diseases from their pets (aka zoonotic diseases).

Dr. Yvette Johnson is a veterinarian and public health expert at the University of Illinois College of Veterinary Medicine in Urbana. She notes that, "it has been estimated that there are over 10 million people within the United States alone that are immunocompromised due to being organ transplant recipients, HIV and AIDS, and those diagnosed with cancer. This number does not include the growing portion of the population that take immune suppressing medications for other conditions."

Since more than half of Americans own pets, it's easy to see that there are several million people in this country who need to be highly concerned with preventing zoonotic disease.

Take for example the case where parents of a newborn baby adopted a puppy so the two could "grow up together." The puppy was reported to have a poor appetite and loose stool at the time it arrived in the household. Six days later the baby was admitted to the hospital and eventually diagnosed with systemic Campylobacter infection.

Laboratory testing revealed that the puppy was infected with a genetically identical strain of Campylobacter.

Though campylobacter may just cause diarrhea in a healthy person, in an infant (a category in the YOPI acronym) it can be much more serious. In this case the baby became septic -- the bacteria entered its bloodstream. The baby was hospitalized for 10 days and treated with intravenous antibiotics. Fortunately the baby recovered.

There are similar cases such as this every year and it begs the question: should physicians be responsible for talking about zoonotic disease with their patients? Or should veterinarians be obligated to talk to clients about the risk of acquiring various infections from their animals?

In a large study published in the Center for Disease Control's journal, researchers surveyed physicians anonymously about their comfort level in advising immune compromised pet owners. The overwhelming majority said that they were, "not very comfortable," and they felt veterinarians should play a larger role.

But when veterinarians were surveyed, most explained that their clients rarely confided their health status to them and they did not feel comfortable asking if the client or any members of their household were YOPIs.

To avoid veterinarians from neglecting to address a pertinent issue, Dr. Johnson recommends that "they need to ask the client who is at home," to find out if anyone is high risk. For example, take the case of the veterinarian who administered a modified live Bordatella bronchiseptica vaccine (aka "kennel cough") to a client's dog. The owner recently had a kidney transplant and was on immune-suppressing drugs. Shortly after the dog was vaccinated, the client came down with a Bordetella bronchiseptica pneumonia. The only exposure to the agent that investigators were able to identify was the recent vaccination of her pet with a modified live virus vaccine.

Humans are usually not at risk for infection with Bordetella bronchiseptica. The related human pathogen is Bordetella pertussis which causes "whooping cough." However several case reports in the literature have indicated that organ transplant recipients in particular are at risk for sometimes fatal infections caused by exposure to pets with Bordetella bronchiseptica.

Although the kennel cough vaccine is routinely given and is usually not a risk to owners, "if you have the right person, even a vaccine strain of Bordetella bronchiseptica may be zoonotic," notes Dr. Johnson.

In the end, even if you fall into one of the YOPI categories, you should not be fearful that your pet will give you a disease. But you should discuss your concerns and ways to minimize risk with a veterinarian as well as your physician.