Medical Review Board
Should You Care About What The Cat (or Dog) Dragged In? A Doctor's Advice
By Katia Hetter, CNN
(CNN) — Health officials in Alaska recently reported the first known human death from a virus called Alaskapox.
The man, who died in January, lived in a wooded area and cared for a stray cat that hunted small animals, according to health officials. He had a weakened immune system and is thought to have contracted Alaskapox through contact with animals.
At around the same time, an individual living in Oregon was diagnosed with bubonic plague. Health officials suspect this person was infected by a cat. The individual is reported to be in early stages of the illness, and the patient and close contacts are being treated with antibiotics.
These infections are reminders that diseases from nonhuman animals can sometimes be transmitted to humans. To get a better sense of what such diseases are and what precautions pet owners and animal lovers should take to keep themselves and their animals healthy, I spoke with CNN wellness medical expert Dr. Leana Wen.
Wen is an emergency physician and adjunct associate professor at George Washington University. She previously was Baltimore's health commissioner, where as part of her responsibilities, she also oversaw animal control and protection.
CNN: What types of diseases can household pets like cats and dogs transmit to humans?
Dr. Leana Wen: Just as humans can transmit diseases to other humans, animals can transmit diseases to others in their own species. Sometimes, animals can transmit diseases to other species, and that includes humans with whom pets have had close contact.
One way to classify the diseases that can be spread by household pets to humans is by method of transmission, such as the fecal-oral route. Someone who is in contact with the feces of infected animals could get the disease themselves if they don't wash their hands well or if the fecal contents end up contaminating water or food that is then ingested by the human.
These diseases include bacterial infections like campylobacter and salmonella and parasitic infections like cryptosporidium, giardia and tapeworm.
Symptoms can include abdominal cramping, diarrhea, fever and vomiting. Depending on the illness, people may need targeted treatment, such as antibiotics or antiparasitic medications. The infections are generally mild, although they can be serious for people with underlying medical conditions and those who are very young or elderly.
There is a specific parasitic infection called toxoplasmosis that is associated with cleaning cat litter boxes or eating food or drinking water that has been contaminated with cat feces. Most people with this infection have little or no symptoms, but there is a unique risk to pregnant women because toxoplasmosis can be transmitted through the placenta. Their infants could become infected before birth and then develop serious neurological problems such as seizures, vision loss and mental disability.
A second route of infection is through scratches and bites. Cat scratch disease, for instance, is a bacterial infection spread when a cat scratches or bites a person enough to break their skin. It also can be spread if an infected cat licks a person's open wound. People who are infected can develop swollen and painful lymph nodes, fever and headache.
Many people have heard of rabies, which is a deadly viral infection spread to humans through the bite of infected animals. Rabies is nearly universally deadly. Most domestic animals in the United States are vaccinated against rabies, but this is not the case in some other countries. Thankfully, there are rabies shots that can be taken after suspected exposure.
A third route of infection is through another vector such as ticks, fleas and mosquitoes. Ticks, for instance, can transmit infections that cause Lyme disease, babesiosis, ehrlichiosis and tularemia. These diseases spread when a person is bitten by an infected tick that has fed off an infected animal. Dogs that spend time in wooded habitats could have ticks that infect them, and the ticks could also spread the disease to humans.
CNN: What about Alaskapox and the bubonic plague? How could someone contract these diseases from animals?
Wen: Alaskapox is in the category of viruses called orthopoxvirus. There are several viruses in this category that can be transmitted from animals to humans, including mpox (formerly known as monkeypox) and cowpox, smallpox and vaccinia viruses. It's not known how the man who died from Alaskapox contracted it, but a possible route is an infected animal biting the individual or exposure of an infected animal to an existing break in the man's skin.
Bubonic plague is caused by the Yersinia pestis bacterium and can be transmitted through a break in the skin, too, if someone has an open wound and who comes into contact with an animal's infectious bodily fluids. It also could be transmitted through the bite of an infected flea.
CNN: What are steps people can take to reduce the risk of contracting diseases from their pets?
Wen: There are several important steps pet owners and animal lovers can take to protect themselves, their family members and their pets.
To begin with, they should ensure that their dogs and cats are fully vaccinated. Vaccines prevent not only many illnesses that can spread from animals to humans, but also diseases limited to the animal but that could be harmful and even fatal. Pets should also be cared for with regularly scheduled checkups.
It's also important to take your pet to the veterinarian if it becomes ill. Try to reduce contact with sick pets in the meantime. Identifying the cause of the illness can prompt quicker treatment for the animal and possible testing and treatment for the human.
There are also commonsense precautions people should take to reduce disease transmission. This includes washing your hands well after handling feces and other waste. Make sure the pet's living area is clean. Keep away from wild animals and animals that are behaving strangely.
Children who are helping out with cleaning litter boxes or picking up after their dogs should be reminded to wash their hands well. Kids should also be reminded to avoid kissing their pet's mouth and reduce activities that could result in accidental bites. They should be sure to wash their hands after going to friends' houses with animals and visiting farms with petting zoos. And it's important to clean waste outdoors, including in your own yard, and not to let kids play in areas with animal feces.
To lower the risk of fleas, it's important to maintain good hygiene and reduce rodents in and around the animal's living space. To decrease tick-borne illness, look carefully for ticks after going to wooded areas and remove ticks right away after spotting them.
CNN: Does it mean no one should have animals?
Wen: Certainly not. People seek animal companionship for many reasons. For many people, having a dog or cat is essential to their own well-being and mental health. There are simple steps everyone can take to reduce the risk of animal to human disease transmission. Individuals who should take additional care include those who are immunocompromised, babies and pregnant women.
The-CNN-Wire™ & © 2024 Cable News Network, Inc., a Warner Bros. Discovery Company. All rights reserved.
Assam Witnesses Rise In HIV Infections Due To Injection Of Drugs: Here Are The Other Possible Reasons
The recent surge in HIV infections in Assam, primarily attributed to drug injection, has sparked significant concern among health authorities and policymakers. According to reports shared by Assam's Health Minister, Keshab Mahanta, the state has witnessed a troubling uptick in HIV/AIDS cases, with injecting drugs identified as the primary cause. Collaborative efforts between the government and NGOs have been initiated to support those affected by the disease, although patient anonymity remains a priority.
While drug addiction and trafficking are identified as the leading factors driving the increase in infections, it's essential to understand other modes of HIV transmission. HIV can spread through various means, including:
Engaging in vaginal or anal intercourse without protection can lead to HIV transmission. Although oral sex carries a lower risk, open sores or tears in the genital area increase vulnerability to infection.
Sharing NeedlesSharing needles and syringes for drug injection significantly heightens the risk of HIV transmission. In environments where drug use is prevalent, the sharing of contaminated injection equipment poses a significant public health challenge.
Blood TransfusionWhile rare, HIV transmission can occur through blood transfusions, particularly in settings where rigorous screening measures are lacking. Hospitals and blood banks typically screen donated blood for HIV to minimize this risk.
Also Read: Difference Between HIV And AIDS
Pregnancy, Childbirth, and BreastfeedingPregnant individuals living with HIV can transmit the virus to their babies during pregnancy, childbirth, or breastfeeding. However, with timely treatment and medical interventions, the risk of mother-to-child transmission can be substantially reduced.
Recognizing HIV SymptomsThe symptoms of HIV and AIDS can vary depending on the individual's immune status and the stage of infection:
Primary Infection (Acute HIV)Following exposure to the virus, some individuals may experience flu-like symptoms within 2 to 4 weeks. These symptoms may include fever, headache, muscle aches, rash, sore throat, swollen lymph nodes, diarrhoea, and weight loss.
Chronic HIV InfectionDuring this stage, HIV continues to replicate within the body, often without noticeable symptoms. However, some individuals may experience persistent fever, fatigue, swollen lymph nodes, diarrhoea, weight loss, oral thrush, and other opportunistic infections.
Symptomatic HIV InfectionAs the virus progresses, individuals may develop more severe symptoms, including recurring infections, oral thrush, shingles, pneumonia, and unexplained weight loss.
Progression to AIDSWithout proper treatment, HIV infection can progress to AIDS, resulting in severe immune system damage. Opportunistic infections and cancers become more common, leading to symptoms such as chronic fatigue, persistent fever, recurrent infections, and drastic weight loss.
Also Read: What You Need To Know About Living With HIV
Risk Factors for HIV/AIDSWhile HIV/AIDS can affect individuals of all demographics, certain factors increase susceptibility to infection:
Unprotected Sexual ActivityHaving unprotected sex, particularly with multiple partners, significantly elevates the risk of HIV transmission.
Sexually Transmitted Infections (STIs)Many STIs can create open sores or lesions, providing an entry point for HIV.
Injection Drug UseSharing needles and syringes during drug injection exposes individuals to infected blood, facilitating HIV transmission.
BottomlineThe rise in HIV infections in Assam underscores the critical importance of comprehensive prevention strategies and awareness initiatives. By addressing the root causes of transmission and promoting safer behaviours, communities can mitigate the spread of HIV/AIDS and safeguard public health.
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Nanoparticles That Can Light Up The Lymph Node Cancer Cells Otherwise Undetectable By MRI
Our lymph nodes are the canaries in the coal mine of our immune system -- firing into gear at the first indication of illness, then sending immune cells where they're needed in the body to fight infection and disease.
For the nearly 20 million patients around the world diagnosed with cancer each year, the lymph nodes are an invaluable early indicator of whether their cancer has metastasized -- when cancer cells begin to spread to another organ. Catching metastasis as early as possible means that the patient can be administered the necessary chemotherapy and immune therapies that will vastly improve their prognosis.
Researchers at USC's Alfred E. Mann Department of Biomedical Engineering have developed a new nanoparticle that can "hitch a ride" on immune cells, or monocytes. Because of its tiny size, the particle can tag along directly into lymph nodes and help metastasis show up on MRIs where it would otherwise be too hard to detect. The results could lead to more advanced contrast agents that can be injected into patients to improve MRI cancer screenings of the lymph nodes.
The work has been published in ACS Nano and was led by Eun Ji Chung, the Dr. Karl Jacob Jr. And Karl Jacob III Early-Career Chair, and Noah Trac, a Ph.D. Student in the Chung Lab.
While lymph nodes are an essential factor in cancer detection, screening them via biopsy is painful and invasive, and can lead to unwanted side effects like infection, lymphedema and thrombosis. Imaging tools such as MRI detection are non-invasive. Still, they also have significant shortcomings when it comes to screening lymph nodes,
"MRIs will look at the lymph node's size, but that does not have a great connection and correlation to the fact that it is metastatic," Chung said. "Even if you have a cold, your lymph nodes will start inflaming."
"The major issue with current MRI techniques is not that they don't detect the immune cells," Trac said. "A major issue with current contrast agents is that there is no cancer-targeting mechanism, so most lymph nodes are lit up equally, regardless of whether or not there is cancer."
To address this challenge, Chung, Trac and their co-authors developed a nanoparticle that targets a receptor present on both tumor cells and immune cell monocytes -- cells that travel to the lymph nodes and are increasingly prevalent under disease conditions.
"The idea behind this nanoparticle is to try and direct the delivery of the gadolinium contrast agent to lymph nodes that have cancer, so that they show up brighter on the MRI than healthy lymph nodes," Trac said.
The diagnostic tool would also offer strong clinical value for doctors to not only catch first-time metastasis during an initial cancer diagnosis, but it will also allow clinicians to keep track of cancer recurrence.
"Just say a primary tumor has been removed, but perhaps they didn't get all of it, or the cancer comes back and it's metastatic for the second time. Recurrent metastasis is much harder to detect and can lead to worse outcomes for the patient," Chung said.
Hitching a ride to light up cancer
The nanoparticles work by targeting a protein expressed by cancer cells, known as C-C chemokine receptor 2 (CCR2). The particles "hitchhike" onto the immune cell monocytes that the body produces that also express this same receptor in response to the cancer. The monocytes then give the particles a free ride into the lymph nodes, where the particles can effectively highlight the metastatic cancer cells and enable clearer detection via MRI.
"The reason why this mechanism works, in addition to the targeting elements, is because our particle size is also very unique, and it can reach the lymph nodes," Chung said. "We found there's a size cut-off and our particle type is able to pass into the lymph nodes and target cancer cells that have gotten there, along with the monocytes that express this receptor."
The process offers game-changing benefits for the early detection of cancer metastasis in the lymph nodes. While previously, metastasis could only be assessed by an increase in lymph node size; the new Chung Lab particles could lead to MRI contrast agents that can highlight metastatic cells in lymph nodes that may otherwise appear normal. In experiments using a mouse model, the team demonstrated that the particles increased the signal detected by MRI by up to 50%.
"The particles are amplifying the signal, and we can see that at points where the lymph nodes haven't yet changed in size, and the metastasis is very early. We're providing this benefit where, clinically, you wouldn't be able to see metastasis at all," Chung said.
The next step for the research team is to get their work closer to clinical applications for MRI contrast agents. The work has been submitted to the Nanoparticle Characterization Laboratory at the National Institutes of Health, where a third party will assess and validate the work to enable it to move closer to human trials.
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