Health officials have recommended puppies be banned from aged care facilities after two outbreaks of potentially deadly Campylobacter gastroenteritis in a Canberra nursing home. But trained adult dogs will still be able to visit aged care homes.
According to a paper to be presented at a Communicable Diseases Conference in Canberra on 19 March 2013, 15 people were infected during two separate gastroenteritis outbreaks in the nursing home between April and June 2012. A healthy four-month-old puppy was identified as the likely cause of the outbreaks and excluded from the facility.
An expert panel was established to investigate the case. “Campylobacter jejuni was recovered from both human and canine fecal samples,” the study findings said. “A review of published literature showed puppies extensively shed Campylobacter species. The aged care setting and low infective dose also made transmission likely, despite the varying degrees of contact between the puppy and cases. While infection control practices were generally appropriate, the facility’s animal policy did not adequately address potential zoonotic risk.”
Elderly people infected with Campylobacter have an increased risk of hospitalization and death. The panel recommended the puppy be excluded from the aged care home until it was at least a year old and assessed as being suited for an aged care environment. The panel decided puppies should not be considered as aged care companions due to “high rates of Campylobacter carriage and shedding; their social immaturity; susceptibility of elderly residents to infection; and poor outcomes”.
In 2012, health authorities were officially notified of 477 campylobacteriosis cases in the Australian Capital Territory and 15,645 cases nationally.
State health officials said on 5 March 2013 that a total of 24 people have fallen ill, two of whom were hospitalized, after drinking tainted raw milk from a Kenai Peninsula dairy. Among the ill is an infant who did not directly imbibe the raw milk, but got sick through a secondary transmission from an adult who had. State epidemiologists said the illnesses are the result of milk tainted with Campylobacter, a bacterium commonly found in cow manure.
After receiving multiple reports of sick people, state health officials traced the source of the outbreak to a cow share program at the Peninsula Dairy. State veterinarians visited the farm to take samples and said the farm owner is being cooperative with their investigation. Dr. Brian Yablon, an epidemiologist with the State of Alaska, said that, with raw milk, infections like this are virtually unavoidable. “The bottom line for any operation that is providing raw milk,” Yablon said, “there’s no way to make a sterile product… and that’s why, from a public health perspective, we encourage people if they’re going to drink milk, to just drink pasteurized milk.”
Backers of the nationwide raw milk movement have claimed that unpasteurized, unhomogenized raw milk — from appropriately clean farms — can provide a range of health benefits. But Yablon said the realities of milk production make raw milk inherently risky. “No matter how safe the process is thought to be, there is always potential for contamination,” he said. “You have the absolute best of intentions, and the best of practices, but just the way the cow’s anatomy is, the udder being so close to where the cow is excreting, the fact that the tail can flick things around, there are many different steps along the way where contamination can be introduced.”
The last outbreak of campylobacteriosis state epidemiologists dealt with was from a 2011 outbreak in the Mat-Su Valley that sickened 18 people. That outbreak was also linked to raw milk from a cow-share program. “It’s just not a product that’s ever going to be 100% safe,” Yablon said. “There’s always the potential for contamination, and this is the latest example here in Alaska.”
The purpose of this Health Advisory is to alert the public to new information about the recent and potentially ongoing outbreak of Campylobacter infections associated with consuming raw milk distributed by a Kenai-based cow-share program.
As of 22 February 2013, a total of 18 individuals have been identified in this outbreak. Some of these individuals have had recurrent illness. Two required hospitalization. The Section of Epidemiology is planning to contact individuals suspected of receiving or consuming raw milk from the involved farm, and it is expected that the number of probable and confirmed cases will rise.
All probable and confirmed cases have been linked to consumption of raw milk from a farm on the Kenai Peninsula that operates a cow-share program. The milk is distributed to shareholders throughout the Kenai Peninsula, in Anchorage, and in Sitka. There is at least one secondary case of an infant who became ill after having close contact with a laboratory-confirmed case.
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