Tularemia in Imported Hamsters

1
Tularemia in Imported Hamsters

• Laura MacDougall, MSc
• Epidemiologist, BCCD

2
Tularemia - Overview

• Bacterial zoonosis caused by Fransicella
  tularensis
• Multiple routes of infection
• Clinical signs and severity of illness depend on
  route of transmission and strain
• Type A and Type B

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Tularemia - Overview (2)

• F. tularensis biovar tularensis (type A)
• Highly virulent in humans and animals
• Most common biovar isolated in North America
• Typically associated with rabbits, muskrats,
  beavers
• F. tularensis biovar palaearctica (type B)
• Generally less virulent
• Most common biovar in Europe and Asia
• Typically associated with rodents or wet
  environments

4
The Phone Call

• Sept 29, 2004 Manitoba Health informs BCCDC.

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The Phone Call

• Sept 29, 2004 Manitoba Health informs BCCDC.

6
BC Public Health Concerns

• Dwarf hamster death at BC distributor?
• Did BC distributor sell any dwarf hamsters to
  local pet stores?
• Was there illness in other animals from the same
  shipment?
• Health of staff at BC pet distributor and BC pet
  stores?

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BC Public Health Concerns

• Dwarf hamster death at BC distributor?
• 63 dwarf hamsters arrived ill
• Separate cabinet in same stock room
• All died within 1 week of arrival
• Did BC distributor sell any dwarf hamsters to
  local pet stores?
• NO!!!

BUT..
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BC Public Health Concerns

• Was there illness in other animals from the same
  shipment?
• 12 chinchillas
• 18 degus
• 100 gerbils
• Shipped to
• 13 BC pet stores
• 12 in one chain
• 2 ON locations, 3 AB, 1SK

Chinchilla
Degu
Gerbil
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Enhanced Rodent Surveillance

• Obtained sales records with shipment dates and
  locations
• Questionnaire to affected retail stores
• Illness or mortality since Aug 25th
• General and shipment-specific
• Included in-store reports and customer reports
• Quarantined, euthanized and tested remaining
  rodents

10
Enhanced Human Surveillance

• Questionnaire to staff of BC pet stores
• Integrated with rodent surveillance questionnaire
• Face-to-face interviews at BC Distributor
• Degree of exposure to dwarf hamsters
• Serology
• Employees of BC distributor
• Symptomatic individuals from BC pet stores that
  received shipments

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Results Rodent Surveillance
The store that reported illness in the degu did
not report illness in chinchillas.
6/12 chinchillas, 11/21 degus and 23/70 gerbils
remained for testing - all negative by PCR
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Results Human Surveillance

• BC Distributor
• 4 employees tested
• 1 with positive titre (1128)
• Blood drawn 5 wks after arrival of dwarf hamsters
• Only person in contact with ill dwarf hamsters
• Question current or previous infection?
• Retested at 6 months

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Results Human Surveillance (2)

• BC Pet Stores
• Human illness reported at 4 stores
• 1 of these stores also reported an animal death
  from the suspect shipment
• Mild flu-like symptoms
• 1 individual with more severe sx
• Bitten by hamster (not from suspect shipment)
• Headaches, sore throat, stuffy nose, vomiting,
  high fever, chills, body aches, swollen lips
• Tested for tularemia negative

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BC Conclusions

• Rapid public health response
• Excellent cooperation with pet industry
• Interaction with veterinarians critical
• No evidence of spread from ill dwarf hamsters to
  others animals in shipment
• No evidence of human infection among pet store
  employees
• Asymptomatic infection at distributor?

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What happened in Manitoba?

• July 2004
• Mouse infestation in breeding shed
• Poison used as control agent
• August 2004
• Hamsters and guinea pigs begin dying
• ?? Poison
• Dwarf hamsters moved to another location
• Breeding shed sealed and decontaminated
• August / Sept
• Dwarf hamsters distributed to BC, Minnesota, MN
• October
• Breeder shut down

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Investigation - MN

• Sampling of animals (n72)
• PCR positive animals included
• Hamsters and dwarf hamsters
• 2 dogs, 1 rabbit asymptomatic, ve serology
• Other environmental swabs positive
• Well water - negative
• At least one human case identified
• Field trapping studies of wild mice
• F. tularensis of different strain!
• Hypothesis introduction from wild mice

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Discussion points

• Who takes ownership of a zoonotic disease issue?
• Public Health authorities?
• Animal authorities? MAFF? CFIA?
• Recommendations to Pet Industry Joint Advisory
  Council (PIJAC)
• Rodent-proofing for breeders
• Disease prevention
• Record-keeping disease tracking
• Consumer information

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Questions?
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Timeline of Public Health Actions

• Wed Sep 29 notified by Manitoba Health
• Thu Sep 30 contacted BC distributor
• Fri Oct 1
• Contacted BC pet stores communications docs
  prepared
• Enhanced human/animal surveillance
• Remaining animals isolated
• Sat/Sun Oct 2/3
• Enhanced animal/human surv. continued
• Mon Oct 4
• Euthanization/testing of BC animals from suspect
  shipment
• Received notification that Type B identified in
  Minnesota
• Letter to BC physicians

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Timeline of Public Health Actions

• Tues Oct 5
• Letter to BC Vets
• Testing of BC rodents (AHC)
• Oct 6, 7
• Preliminary negative results BC animals
• Negative human surveillance results
• Fri Oct 8
• All animal results negative
• Remaining animals in quarantine released
• Public update on website no press release