Twice in the past year I've written about diseases that people can pick up from their household animals. They remain my highest-traffic posts (here and here) and also my most contentious. So knowing that readers respond to that topic, this recent paper caught my eye. It's another account of what you can, possibly, catch from your pet – but for any pet owner (which includes me), it's terribly sad.

Three physicians who work in Akron, Ohio happened to notice that, in a single year, they treated three people – two in the emergency department, one in a doctor's office – who had serious, fast-moving and somewhat puzzling infections.

One woman was 55 years old, had had a sore throat for about 8 hours, and was having so much difficulty swallowing that when the medical resident checked her out, she found the woman "sitting upright with saliva dripping from her mouth." A second woman, 63 years old, had been experiencing sore-throat symptoms for only 12 hours, but in that time the infection had ramped up to "difficulty swallowing solid food, and marginal ability to swallow liquids. Two hours before coming to the ED she noted onset of hoarseness, swollen anterior cervical lymph nodes, chills, and a sensation of fever." The third patient, 66 and female, had pneumonia.

The women did not know each other and did not, to their knowledge, cross paths in their day-to-day lives. Here's what they had in common:

Patient 1: ... the patient’s pet dog died several days previously, that the patient had provided palliative care to the terminally ill dog by dropper-feeding honey to the dog, and that the patient had co-consumed honey with the dog by licking the same dropper used to comfort-feed the dog.

Patient 2: ... the patient’s pet cat had died 6 weeks previously and that the patient had continuously held, caressed, hugged, and kissed her cat during its last 7 days of life.

Patient 3: ... 2 weeks prior to her illness, the patient had provided palliative care to her dying cat by holding, hugging, and kissing the head of the cat and allowing the cat to lick her hands and arms.

All three women turned out to be infected with Pasteurella multocida, a bacterium that lives benignly in the mouths of most cats and about two-thirds of dogs. Human infections can be treated with antibiotics, if the right ones are chosen, but they are very serious if they go untreated: About one-third of Pasteurella infections examined in one review went on to cause septic shock, which can be life-threatening. Pasteurella is a common infection in cat bites, but these appear to be the first infections linked to caring for a dying pet.

The authors warn that neither pet-owners nor physicians may put the pieces together; for instance, Patient 2 initially told the physician treating her that she didn't have a pet, because her cat had been dead for 6 weeks. They caution:

... we may be on the cusp of a potential increase in the number of recognized non-bite–associated P. multocida infections, including those associated with palliative pet care. Only diligence and very detail-oriented, pet-related histories will likely uncover further patients with invasive P. multocida infection related to the pet owner’s provision of palliative pet care to dying animals.

(I wrote this, by the way, with my 17-year-old cat on my lap. So for me, it's not a hypothetical risk at all.)

Cite: Myers EM, Ward SL, Myers JP. Life-threatening respiratory pasteurellosis associated with palliative pet care. Clin Infect Dis. 2012 Mar;54(6):e55-7. Epub 2012 Jan 11. DOI: 10.1093/cid/cir975

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