Emerg Infect DisEmerging Infect. DisEIDEmerging Infectious Diseases1080-60401080-6059Centers for Disease Control and Prevention21762619338138211-031710.3201/eid1707.110317Letters to the EditorLetterComment on Zoonoses in the BedroomZoonoses in the BedroomMontgomerySusan P.XiaoLihuaCamaVitalianoAuthor affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USAAddress for correspondence: Susan P. Montgomery, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop F22, Atlanta, GA 30341-3724, USA; email: zqu6@cdc.gov7201117713401341ChomelBB , SunB . Zoonoses in the bedroom.Emerg Infect Dis. 2011;17:16772. 10.3201/eid1707.110590Keywords: zoonosesparasitic diseasesparasitesChagas diseaseGiardiaCryptosporidiumToxocarariskletter

To the Editor: In response to Chomel and Sun (1), we would like to correct potentially misleading representations of risk factors for parasitic diseases. The authors correctly described risk for Chagas disease from exposure to infected insect vectors but included Chagas disease in the table, “Zoonoses acquired by close contact with pet, 1974–2010.” The bloodborne protozoan that causes Chagas disease is transmitted not by contact with an infected mammal but by contact with a vector insect that has bitten an infected mammal (2).

For some parasitic zoonoses, contact with pets may not be a major source of infection. Molecular studies indicate that risk for human infection with Giardia and Cryptosporidium spp. from dogs and cats may be lower than previously believed. Infections with these parasites are usually with species-specific genotypes. Human infections with assemblages C, D (dog specific), and F (cat specific) of G. duodenalis have not been confirmed. Infections with assemblages A or B have been reported for humans and other animal species, including dogs and cats, but no direct transmission has been documented (3,4). Most human cryptosporidial infections are caused by C. hominis and C. parvum (5); a smaller percentage are caused by C. canis and C. felis.

Human infection with Toxocara canis or T. cati occurs when embryonated eggs are ingested; however, embryonation requires 2–4 weeks in the environment, suggesting that the risk from eggs in pet fur may be less than risk from exposure to eggs in contaminated soil. Other more serious zoonotic parasitic disease risks from contact with pet feces, including toxoplasmosis, are mentioned only briefly, if at all.

Physicians need information that accurately communicates zoonotic parasitic disease risks to their patients. However, inaccurate or overstated risk communication can also lead to unnecessary prevention efforts and misdirected concerns about dogs and cats as sources of disease.

Suggested citation for this article: Montgomery SP, Xiao L, Cama V. Comment on zoonoses in the bedroom [letter]. Emerg Infect Dis [serial on the Internet]. 2011 Jul [date cited]. http://dx.doi.org/10.3201/eid1707.110317

ReferencesChomel BB, Sun B Zoonoses in the bedroom. Emerg Infect Dis. 2011;17:16772 10.3201/eid1707.11059021291584Gürtler RE, Cécere MC, Rubel DN, Petersen RM, Schweigmann NJ, Lauricella MA, et al. Chagas disease in north-west Argentina: infected dogs as a risk factor for the domestic transmission of Trypanosoma cruzi. Trans R Soc Trop Med Hyg. 1991;85:741–5.Feng Y, Xiao L Zoonotic potential and molecular epidemiology of Giardia species and giardiasis. Clin Microbiol Rev. 2011;24:11040 10.1128/CMR.00033-1021233509Ballweber LR, Xiao L, Bowman DD, Kahn G, Cama VA Giardiasis in dogs and cats: update on epidemiology and public health significance. Trends Parasitol. 2010;26:1809 10.1016/j.pt.2010.02.00520202906Xiao L, Feng Y Zoonotic cryptosporidiosis. FEMS Immunol Med Microbiol. 2008;52:30923 10.1111/j.1574-695X.2008.00377.x18205803
Emerg Infect DisEmerging Infect. DisEIDEmerging Infectious Diseases1080-60401080-6059Centers for Disease Control and Prevention DOI: 10.3201/eid1707.110590ArticleComment on Zoonoses in the BedroomChomelBruno B.SunBenjaminAuthor affiliations: University of California, Davis, California, USA (B.B. Chomel);California Department of Public Health, Sacramento, California, USA (B. Sun)Address for correspondence: Bruno B. Chomel, Department of Population Health and Reproduction, School of Veterinary Medicine, 1114 Tupper Hall, University of California, Davis, CA 95616, USA; email: bbchomel@ucdavis.eduMontgomerySP , XiaoL , CamaV . Comment on zoonoses in the bedroom[letter]. Emerg Infect Dis. 2011;17:1340. 10.3201/eid1707.110317 Keywords: zoonosespetbedroomparasitesletter

In Response: We agree with Montgomery et al. (1) that Chagas disease is not directly transmitted by dogs to humans. However, we emphasize that Chagas disease is in the southern United States even if risk for infection is extremely low. A study in Mexico found direct correlation of seropositivity between humans and dogs, suggesting that testing dogs may help identify prevalence of Trypanosoma cruzi infection among humans. They stated, “Dogs may be domestic reservoir hosts and help maintain human transmission of T. cruzi” (2).

For toxocariasis, indeed only embryonated eggs are infectious. In a study in the Netherlands (3), ≈25% of Toxocara eggs found on fur were fertilized, but none were viable after 6 weeks; presence of embryonated eggs on dog fur is uncommon but can occur.

We did not mention all zoonoses that could be transmitted in a bedroom, such as toxoplasmosis or ringworm, because we could not identify publications specifically documenting contamination in that environment. We can, however, cite examples of other infections, such as Cheyletiella blakei dermatitis in a woman who shared her bed with a recently acquired cat (4). We also reiterate the potential risk for human infection by the plague bacillus (Yersinia pestis) as a result of bed sharing, as illustrated by the case reported from Oregon in 2010 (5).

Although the risk of contracting a zoonosis in the bedroom is low, it remains possible. Bed sharing with pets should be avoided, especially for those who are immunocompromised, young, or elderly.

Suggested citation for this article: Chomel BB, Sun B. Comment on zoonoses in the bedroom [letter]. Emerg Infect Dis [serial on the Internet]. 2011 Jul [date cited]. http://dx.doi.org/10.3201/eid1707.110590

ReferencesMontgomery SP, Xiao L, Cama V Comment on zoonoses in the bedroom [letter] Emerg Infect Dis. 2011;17:1340 10.3201/eid1707.11031721762619Estrada-Franco JG, Bhatia V, Diaz-Albiter H, Ochoa-Garcia L, Barbabosa A, Vazquez-Chagoyan JC, Human Trypanosoma cruzi infection and seropositivity in dogs, Mexico. Emerg Infect Dis. 2006;12:6243016704811Overgaauw PA, van Zutphen L, Hoek D, Yaya FO, Roelfsema J, Pinelli E, Zoonotic parasites in fecal samples and fur from dogs and cats in the Netherlands. Vet Parasitol. 2009;163:11522 10.1016/j.vetpar.2009.03.04419398275Tsianakas P, Polack B, Pinquier L, Levy Klotz B, Prost-Squarcioni C Cheyletiella dermatitis: an uncommon cause of vesiculobullous eruption [in French] Ann Dermatol Venereol. 2000;127:826911060386Centers for Disease Control and Prevention Notes from the field: two cases of human plague—Oregon, 2010. MMWR Morb Mortal Wkly Rep. 2011;60:21421346709