Anne-Marie: Pet detective
Transcript
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Megan Beahen: Hi and welcome to Healthy Canadians, your space for nuanced conversations and expert insights about the health topics that matter to all of us. I'm your host, Megan Beahen. Step aside Ace Ventura. My guest today is Anne-Marie Lowe, Public Health Agency of Canada's lead pet detective. Okay, not really. Anne-Marie is the manager of the Assessment and Detection Team, working in the Outbreak Management Division at the Public Health Agency of Canada. Today we're talking about pets... and enteric illnesses. If you have a pet at home or are thinking about getting one, this episode is for you.
Although Healthy Canadians is brought to you by Health Canada and the Public Health Agency of Canada, what we discuss won't always reflect the official positions or policies of the Government of Canada. But that's okay, these are conversations, not news releases.
Okay, let's talk about pets and enteric illnesses.
[Pulse sound]
Megan: Welcome, Anne-Marie. Thanks for joining us today at Healthy Canadians.
Anne-Marie Lowe: Thank you.
Megan: So, today we're talking about pets and enteric illnesses. We love our pets. We were just talking about our pets here in the studio. They are part of our families. We spend lots of time, energy,and honestly money, on them to keep them happy and healthy, but we also want to keep ourselves healthy. So, there's certain elements of owning a pet that can make us sick and we're going to talk about those today. And we're going to talk about what we can do about it. So, let's start with the basics. What is an enteric illness?
Anne Marie: So enteric diseases are caused by microorganisms such as viruses bacteria, parasites. They cause gastrointestinal illnesses, so an upset tummy, and these diseases most frequently result from consuming contaminated food or water. Or as we're talking today, can spread from animals to people, and can also spread from person to person as well.
Megan: Okay, so what... how would you know if you had that kind of illness? Like, what are the signs and symptoms?
Anne-Marie: So, there is a diversity of symptoms. They usually start, let's say in the case of salmonella, within 6 to 72 hours after the person has been exposed to a contaminated product. So, they may experience chills, fever, nausea, diarrhea, vomiting, sudden headache, and most symptoms will end within 4 to 7 days. Usually people recover completely on their own, but some people may develop more serious illness that will require hospital care. And they may lead to long lasting health effect or even death sometimes.
Megan: Who is most at risk of severe illness?
Anne-Marie: Usually, we see most severe diseases in kids who are less than 5 years old, in immuno-compromised people, in elderly people, and also pregnant people. When we talk about pet-related diseases for pregnant people, sometimes people will think about toxoplasmosis. When they have a cat, they're going to be recommended to behave differently around the cat while being pregnant, but there are other microorganisms that can make them quite sick, unfortunately.
Megan: Okay so those are like... some of those symptoms you just described are like pretty common. How would I know what I'm getting sick from?
Anne-Marie: That's a good question. So, with those symptoms as described, you may not necessarily seek, go see your doctor, let's say. But some people will get so sick that they're going to be like "okay, I got to go get help". So, they're going to the hospital and then the physician, the professionals there will test. So, they're going to test, let's say, a stool sample, and then they're going to look for what pathogen can make you sick. So, doing some laboratory testing. And then they're going to identify, let's say, a bacteria. Let's say they identify E. coli, salmonella.
Megan: Okay. So if you're really sick and you have those kinds of symptoms, good to talk to a healthcare provider. They're going to test - that's the only way to really find out, right? And they're also going to advise on your treatment.
Anne-Marie: Definitely. And like when... for each person who gets tested, we know that there are so many more who have been sick. But we will never know, because they will not have gone to the hospital.
Megan: Right. So, in the case of pets, how does a pet make us sick like that?
Anne-Marie: There are many, many ways.
Megan: [laughter]
Anne-Marie: Pets, per definition, can carry those microorganisms. So, they can live in their guts, and they can... those pets may not be clinically ill. They may not show any symptoms.
Megan: They might look fine, right?
Anne-Maire: They may look fine. Some could be sick, but some may look fine.
Megan: Okay.
Anne-Marie: So, they're not necessarily clean, and then per direct contact that we call - let's say a a dog licking the face, or an indirect contact like a a snake roaming free in the house. And then you have a little kid...
[Laughter]
Megan: I made a face about a snake roaming free the house, because it sounds scary, but...
Anne-Marie: Well, that's a thing. And then, you have an infant crawling on the floor, so that would be an indirect contact.
Megan: Okay.
Anne-Marie: The infant may not have held the snake, but just by being in the same environment, can become sick. So, it's going to be through ingestion of particles that hold those microorganisms.
Megan: Okay. So, let's talk about some specific ways that it happens. I'll speak to my only experience with this, and to be honest I didn't know that much about this until I started working at the Public Health Agency, and when I got a dog. So, one of the ways I know is through raw dog food, right? And so, when I had a dog, I, you know and raw dog food started to become very popular or trendy, I considered giving my dog raw food, because a lot of other people were doing it.
And I'll be honest, I went to my vet and her her advice was, this is a very personal decision and there are a lot of risks around it. You kind of have to make the decision that's right for your family. Maybe you can unpack what is the risk around raw dog food, or what a dog eats that can make it sick?
Anne-Marie: Indeed, raw pet food is a new thing... well, I don't know if it's a new thing. I wouldn't say that. But like, people love their pets, as we said in the introduction. The people in Canada, like there are 60% of Canadian households that report having at least one cat or a dog. So and, they want to make sure that they're having the best diet, the best environment, and that those pets are living their best lives.
Megan: Yes.
Anne-Marie: And what's happening is that in the in the raw food there are some microorganisms that can make humans sick. So, by giving this type of food to the, let's say a dog, the dog will eat it, so it's going to carry those germs in their mouth, in their... on them. There is also a possibility of contamination of the environment. It's going to be in their bowl. How do people clean the food bowl in the same kitchen sink that they wash their dishes? So there may be many, many ways of contamination. And as we said, like the animal itself will not necessarily become sick from that.
Megan: So, then if a dog... you're then interacting with the dog, you're kissing the dog, you're petting the dog, the kids are getting on the floor with the dog, that's when the illness could be passed on from the dog to you, right?
Anne- Marie: Yeah, exactly. And like, in those what we call zoonotic outbreaks – zoonotic, it means that it's the microorganisms are transmitted from animals to humans. We always see a higher proportion of children among ill people, so they're most at risk of becoming sick. They may not be that compliant with hand hygiene, with good hygiene. They may not just be aware and that's not the type of thing that you want to, you know, talk about that much in a household. You don't want to focus on the risk associated with your furry.
[Laughter]
Megan: Right. Of course. You don't want to say your dog is making you sick, or the risk of the dog making you sick. You don't you don't want to like say don't pet the dog, don't kiss the dog. We want to pet the dog.
Anne-Marie: But at the same time... so kids are disproportionately represented in those zoonotic outbreaks. And, but at the same time, I think it's the right thing to talk about that to make sure that the right behaviors are done by everybody in the house, especially if there are some members of the family who are part of what we say like a vulnerable population, like kids under 5 years old, pregnant people, elder people, people who are immuno-compromised. So not saying don't have a pet or get rid of your pet, but it's more like having the right pet for each family. I think that is what matters and to make sure that...
Megan: Right.
Anne-Marie:... those people who may be more at risk know how to behave.
Megan: Right. And I guess, like coming back to the raw dog food thing, because... and I don't want... we could do a whole episode probably on raw dog food, and I think people are interested in it. But I think also what you're saying is that, like, that's a personal choice about whether you're going to even have that level of risk or not. Because having, using raw dog food does present a level of risk, right?
Anne-Marie: It does. And as you're saying, it's a personal choice. I'm not sure what veterinaries are recommending. Yours didn't necessarily encourage you.
[laughter]
Megan: She she was discouraging me. I'll be honest. She, you know, she left the choice with me, which is a good thing, but she was not um enthusiastic about it, let's say.
Anne-Marie: Yeah, and from the enteric outbreaks that we've investigated at the Public Health Agency of Canada, that's something that we don't recommend as well.
Megan: Right. Right. And you would want to apply your same food safety practices that you have probably for yourself in your own kitchen to the dog food as well, right? So, probably I could see people like letting their guard down a little bit when you're thinking about like cleaning the dog's bowl really well all the time, and the area. You want to make sure you're just like doing the same thing that you would do for your own food, right?
Anne Marie: Yeah, definitely. And like to make sure that it's the direct contact - so when preparing the food and giving it to the animal - but also all of the environment around. So, if you put it in the bowl and it splashes on the floor.
Megan: Right.
Anne-Marie: Those types of considerations, I think that they're not to be taken lightly.
Megan: Right. And then just managing the, sort of if you are doing it, managing the behaviors of everyone in the household, and being mindful of who's in the household, and who might be vulnerable, as well.
Okay. Let's talk about some other ways, or some other pets. What are some other ways that pets can make us sick that are in the house?
Anne-Marie: Um, if we get it back to the outbreaks that we've investigated through the years, we've had some that were related to reptiles.
Megan: Right.
Anne-Marie: So, reptiles meaning snakes. The feeder rodent - the rodent that are fed to those snakes, geckos, bearded dragons. So, those animals are known to carry... those were salmonella outbreaks. So, they carry this bacteria and they can shed it intermittently. So, sometimes they're going to shed it less, sometimes they're going to shed it more. If they're stressed this will increase. And they don't look sick. They may not look sick at all.
Megan: Right.
Anne-Marie: So, the environment where they live, again, may be contaminated. So, in those outbreaks, again, there was a dipropionate percentage of ill people who were children. And some... it was really interesting, because some parents would answer our questions for the kids because they were too small, right.
Megan: Right.
Anne-Marie: Like, we can't call an infant, a one-year-old kid and say "what did you get into contact with?".
Megan: Yeah.
Anne-Marie: And then the parents would be surprised. They would be like "yeah, we have a snake at home, but my baby is one year old. Like, they don't clean their cage. They don't hold it." But then, the snake roams free in the house, or the parent holds the reptile...
Megan: Right.
Anne-Marie:... and then they hold their little one in their arms, and it's, let's say, the shirt that is contaminated. So, that's what we call indirect contact.
Megan: Okay.
Anne-Marie: And so, those are pets that, kind of, they're known. They're known to carry salmonella. And throughout the years, we also had hedgehog, pet hedgehogs-related outbreaks.
Megan: Oh, no.
Anne-Marie: Yeah. They're cute.
Megan: They're so cute.
Anne-Marie: I know they're cute. And with Sonic movie, everybody wanted a hedgehog.
[Laughter]
Megan: Okay. So, tell me how a hedgehog then passes on bacteria.
Anne-Marie: That's the same concept in a sense that they carry some microorganisms that don't necessarily make themselves sick, but that can be harmful to humans. And people like to cuddle their hedgehog. They want to kiss them. They want to pet them. They put little buckles on them. And that's the same, the same contamination process of, like, if I kiss my hedgehog and the hedgehog decided that it was covering itself in into their own saliva - because that's what they do as a behavior - well, then you just end up catching whatever they're carrying.
And that was, yeah. So, we've seen, we've seen that. And like encountering a hedgehog is pretty memorable, so people would remember, fully remember, when we were asking "did you touch a hedgehog?" or "do you have a hedgehog?". It was, like, fully "yes. I know when." And it makes sense.
Megan: Yeah. That makes sense. Okay. So, if I own a reptile or a hedgehog, am I worried about this risk could happen at any point, or is it at the point of like I'm buying a hedgehog and it might come with bacteria? Or I'm buying a gecko and there might be salmonella? Like, can this risk happen at, like, any time?
Anne-Marie: That's a really good question, because when you get a pet into your home it's a change in your lifestyle, right.
Megan: Right.
Anne-Marie: Well, it is in theirs as well. And it causes stress. So, let's say we talk about reptiles. The stress may increase the shedding of the microorganisms. So, yes indeed, when having a new pet may increase the risk. But I wouldn't cut the risk into slices, in a sense of I think we have to assume that those microorganisms are there...
Megan: Okay.
Anne-Marie: ... and that it can happen. And we will not know necessarily when it's a higher risk or not. But introducing a new pet in a home is a stressor for them.
Megan: Okay. I think that's really good advice for people, that like the risk is all... let's just assume for these certain kinds of pets that there's a certain risk there, and you just want to be really mindful of how you're handling them, keeping things clean, secondary sort of exposure to other people. And I'm just going to reiterate what you already said - we're not saying don't get a hedgehog, right. We love hedgehogs. We're not saying don't get a reptile. We're just saying you need to be aware of these risks and make some certain decisions around them, right?
Anne-Marie: Exactly. It's like the right pet for each family. And maybe it's not the right time if you have a baby crawling around, or you're holding them, or maybe you want to give a responsibility to your kid of cleaning the raw pet food bowl.
Megan: Right.
Anne-Marie: Maybe it's not the right responsibility.
Megan: Yeah.
Anne-Marie: Those types of considerations... yeah.
Megan: Yeah. You just want to make an informed choice.
Anne-Marie: Yeah.
Megan: Okay. So, you touched a little bit about on like what an investigation looks like for the Public Health Agency, or how you talk to people when these things happen. I think this is super interesting. Can you just like unpack for us a little bit about, like, how does an investigation happen? How do you find out something, there might be a problem?
Anne-Marie: So, as I said, when someone is sick, they're going to go seek health care. And then they're going to test to find what's causing your illness. So, if it's a bacteria, it's going to go get the genome sequence. So, that's a highly technical type of test that they do it in the laboratory where they're going to find exactly the genetic profile of a given bacteria.
Megan: How do they get that sample from people?
Anne-Marie: Most are from stool. So, it's stool sample. Then they do whatever they have to do in the lab, and then they extract the bacteria and they sequence their genome. And then... this is happening... and at the Public Health Agency of Canada, my team, the Assessment and Detection Team, is within the Outbreak Management Division, so we work really closely with the National Laboratory, National Microbiology Laboratory in Winnipeg, where they're going to identify clusters of cases.
Megan: Okay.
Anne-Marie: So, who in Canada was ill because of the same pathogen, and by saying same it's genetically related bacteria.
Megan: Okay.
Anne-Marie: So, then it can be a listeria cluster, it can be a salmonella cluster, an E. coli cluster. And then we're going to get those clusters of cases. So, the only information we have is that those people in X Y or Z province or territory were ill. They seem like they have the same pathogen. What could be the cause? So, we're going to be following up with our provincial and territorial, public health counterparts. And on their side, they will likely have already investigated their case - the person who's ill. So a public nurse...
Megan: They've already talked to them.
Anne-Marie: They will have called them on the phone, asked questions from a questionnaire, predetermined questions. And then we're going to ask "Okay. Can you share with us this epidemiological information?", so we can do our detective work and find out is there something common that they report having been exposed to? When we talk about food, it can be, well, 7 days before their illness they all reported, I don't know, romaine lettuce or kimchi.
Megan: Or cantaloupe.
Anne-Marie: Or cantaloupe. Exactly. So, sometimes it's not that simple. We're not necessarily going to be able to identify from the get-go that there is something common. So, we have to do some more work, some more digging to understand... Is it something common that they all experienced that made them sick?
And if we, through signals that were picking up, if we, if it seems like it is, then we have a whole response team who will take this cluster of cases, and then we activate, nationally in Canada. What we call an Outbreak Investigation Coordination Committee. And so, this committee will bring around the table all of the right partners to be able to investigate, but also to mitigate the risk, what caused this illness? So yeah. So, that's how it all happens.
Megan: So, you kind of like, through your like detective work, which I love that you use that word, you're eventually going to start drilling down to like what the cause is, right? Because, at the surface, you're thinking, like... Okay. It could be food related. It could be pet related. We don't know. And eventually, you drill down to find out what the suspected cause is, right?
Anne-Marie: Exactly. And if there's... we call that signal, so if there's a pet signal...
Megan: Right.
Anne-Marie:... then it's going to take a different tangent...
Megan: Okay.
Anne-Marie:... than it would for a food signal. Because if it's a foodborne outbreak at the end of the day if the cause, if the source is identified, the product can be recalled from the market...
Megan: Right.
Anne-Marie:... to make sure that no more people will get sick.
Megan: Right.
Anne-Marie: But if it's a pet, we cannot recall pets.
Megan: We can't. Thank God, we can't recall pets.
Anne-Marie: We cannot recall pets. So, but... but, what we have is to be able to communicate with Canadians. So, we're going to be releasing Public Health Notices that are going to be picked up by the media. People will hear about "Well, there's another outbreak related to snakes and their feeder rodents. Canadians please pay attention to those recommendations." So, it's really through educational messages that that we can reach out. We also reach out to the industry. We have different manners of doing our public health interventions, but they're different than when it's a foodborne outbreak.
Megan: So, I guess a lot of people probably need to know when it is a pet situation, right. Like you said, it gets picked up by the media, but then there's also probably industry that needs to know. Like, if I have a pet gecko, I might hear about that on the news, right? But like, do you need to let like pet stores know, and veterinarians? Like, what's their role in this?
Anne-Marie: Through years, we're connecting, we're trying to replicate what we're doing for foodborne outbreaks, where we're going to reach out to industry members. We're doing that also for pet related outbreaks. Connecting with some networks to penetrate those professionals, but they sometimes, they're already aware, but it's not necessarily like shared with customers. So...
Megan: Oh, okay.
Anne-Marie: Yeah. But at the end of the day, no one wants people to be sick.
Megan: To get sick. Right.
Anne-Marie: So, it's in everybody's interest to make things right.
Megan: So, what if... like say I have a a reptile, or a hedgehog, or I guess any pet, what is my role? Like, what should I be paying attention to? And then, if I'm sick, should I be reporting it always to my doctor?
Anne-Marie: Well, I think that knowing the risk is the first thing.
Megan: Yeah.
Anne-Marie: So, being aware that those pets, they're cute, they're fascinating, kids are curious about them, but knowing that they can carry those germs is the first thing.
Megan: Right.
Anne-Marie: You don't want to be ignorant about those risks.
Megan: Right.
Anne-Marie: So, once you know that, you can adapt how you're going to care for them and give them their best life. So, I think that's the role of everybody who owns those pets. And make sure that if the pet is sick to seek veterinary care. If someone in the household is sick, well, could it be this? Could, couldn't it be? But like, if of course, like, it gets back to if someone is super sick, seek your doctor.
Megan: Right.
Anne-Marie: You know, go get help, healthcare. Get in the health care system, but...
Megan: Was there any investigation that you worked on that was, like, particularly interesting or tricky?
Anne-Marie: Well...
Megan: Or are they all?
Anne-Marie: Well, I'd say that they're all tricky...
[Laughter]
Megan: Are they all tricky? Deciding whether something is making someone sick like romaine, or cantaloupe or a hedgehog.
Anne-Marie: They're definitely tricky. Some unfold really rapidly. Some others we really have to dig and ask questions, and we feel we're turning around, you know, something, and we cannot put our fingers. We don't solve them all. That's obviously like the goal...
Megan: Right.
Anne-Marie:... to be able to identify common source, but...
Megan: Some go away and then you never actually figure out what the source is.
Anne-Marie: Oh, yeah. Yeah. And then you have to move away because... to move on because.
Megan: Wow. Because there's something else that you need to pay attention to.
Anne-Marie: Exactly, exactly. Yeah. But like we were talking about pets. I remember, um, the hedgehog related one, where we learned so much about the behavior of that animal. And how when they smell something that they like, or a new smell, they kind of start frothing and like just saliva, and they literally cover themselves and their environment with their saliva, because of... I don't know why. But that's a behavior that was somehow surprising. And you're like, well, if they're doing that like no wonder.
Megan: Yeah. No wonder that people are getting sick, because then they're handling it with their bare hands, and they're touching their face. and all that.
Anne Marie: Yeah. Yeah.
Megan: That's so cool. I think you've provided a lot of practical information. I would love to know, also, just about you. Like, what got you into this work? I can tell you're like very excited by it and very passionate about it. How did you get... How did you get here?
Anne-Marie: Wow. The one million dollar question.
[Laughter]
Anne-Marie: I'm curious by nature.
Megan: Okay.
Anne-Marie: I've always been interested in understanding why things happen. I studied biology. After that, public health epidemiology. And to me, outbreak investigations they're related to action. It's.. There... We're never bored. There is never a dull moment. There is always something new. We have to work as teams. The collaboration is central. It's key. I'm a team player.
So yeah, I think, and working for a common goal, which is to make sure that people in Canada are as healthy as they can. And I think that we make a difference. Like, when there's something that is identified, a source that's identified and we know that it's moving forward, and that it's something can be recalled or that we can communicate publicly about, something to share with Canadians. Like, that's a... Yeah, I think that's the right emotion.
Megan: Yeah, totally. That's so cool. Thank you for giving us that little behind the scenes sort of sense of how it all works. It's awesome. Where can people learn more about enteric illnesses?
Anne-Marie: Oh, there are many web pages that we encourage people to go visit. So, on canada.ca there are fact sheets on all of those pathogens. We also have brand new fact sheets on raw pet food safety, on pet food and treats, and they can follow Public Health Agency of Canada on social media, like Facebook, Instagram, LinkedIn. So when we release a Public Health Notice during an outbreak investigation those will be picked up on social media and also by um by the media themselves so um make sure to follow your your local um media and newspapers.
Megan: Thank you so much for joining us today. I think you've given us, like, a great background on all of this, and really practical information that we can take to keep our family safe and our pets safe
Anne-Marie: Thanks to you. It was a pleasure.
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Learn more
- Public Health Notices - Canada.ca
- Pet food and treats - Canada.ca
- Pet food safety - Canada.ca
- Raw pet food safety - Canada.ca
- Salmonella and Reptiles - Canada.ca
- Pets: Healthy animals, healthy people - Canada.ca
- Reptiles and amphibians: Healthy animals, healthy people - Canada.ca
- Rodents: Healthy animals, healthy people - Canada.ca
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