Cat bite disease. Misleading poorly written article

[The Snark]

http://www.huffingtonpost.com/2012/09/15/oregon-plague-woman-disease-cat_n_1887053.html
Please note how this article typifies sensationalism and gives very few facts. For animal owners, this article could have been useful but as it was written, is a pile of noise.

The word 'plague' is used several times. That is referring to the Bubonic Plague which isn't directly mentioned. The Bubonic Plague, Yersinia Pestis, formerly known as Pasteurella Pestis, is spread primarily through flea bites. It is rarely contracted through contact of body fluids of the infected animal. Yersinia Pestis rapidly goes systemic, affecting the entire body, especially the lymph nodes.

The cousin of Yersinia is Pasteurella Multocida also known as cat scratch/bite fever. The infection from P Multocida usually is localized at first, causing acute pain and swelling around the wound and often rapidly spreading to the surrounding tissue.

Both infections are readily treatable but prompt medical help should be sought as soon as an infection is noticed. With Yersinia a fever quickly develops in most cases while with P Multocida, severe localized pain and swelling denotes it's presence (cellulitis).

Yersinia Pestis infections are extremely rare. P Multocida infections are quite common. Both can be life threatening. If in doubt, get it checked out.

Bottom line. Keep pets? 1. Be aware of potential troubles like this. 2. Get the facts. Don't trust sensationalist news media.

 

[Tarac]

It is rarely contracted through contact of body fluids of the infected animal.

Yikes! Looks terribly painful.

Y. pestis is of course rare, but note that many of our (few) annual plague infections here in the US are via contact with contaminated fluids OR inhalation of bacteria. Scary, huh? Good thing it is super rare.

Here is an article about it, this was in Colorado a couple years ago I believe:

http://cid.oxfordjournals.org/content/49/3/e33.full

 

[The Snark]

Yikes! Looks terribly painful.

Y. pestis is of course rare, but note that many of our (few) annual plague infections here in the US are via contact with contaminated fluids OR inhalation of bacteria. Scary, huh? Good thing it is super rare.

Here is an article about it, this was in Colorado a couple years ago I believe:

http://cid.oxfordjournals.org/content/49/3/e33.full

Quite an interesting article. Unusual in that Yersinia usually relies on a vector for dissemination. However, it is not as rare as some people think. It is often the precursor (or initial MOI) in Cholera outbreaks. It is often found in birds lungs, both wild and domestic. Fortunately in that wild state it's motility is quite low.

 

[PrettyHate]

Makes me really glad I didnt try cuddling wih that mouse I found in our attic...

 

[Tarac]

It is indeed fairly constant here, although the number of infections that are documented are only in the 0-20 per annum here, so out of the whole population it's nothing particularly ubiquitous. It just catches your attention when you hear someone has died of the plague, right?

However, it isn't that strange to catch plague from handling infected animals or via inhalation, both are equally as common (or uncommon as the case may be) as flea transmission, as far as human infections go in the US. It does spread via droplets that are expelled from an infected organism and also from fluids that remain in the environment, albeit not that long... but long enough, it is highly dependent on the conditions. It is generally not considered a highly transmissible infection in any form and usually burns itself out after a few unfortunate people are infected. Thank goodness. Not considered very deadly anymore either, more close to the survival rate of Vaccinia these days than Ebola or what have you.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC154802/

 

[The Snark]

I recall them cleaning up the park in El Monte when some squirrels turned up with Bubonic. Animal control wearing full haz mat suits and face masks. Overkill but showing the potential possibility.

 

[Thistles]

Snark, is there a difference between "cat bite disease" and "cat scratch fever?" I contracted "cat scratch fever" a few years ago, but was told it is Bartonella henselae. There was also confusion with Lyme disease, which I apparently also had. I've had a lot of frustrating misdiagnoses and stupid-doctor encounters, so I no longer really trust anything.

The story here in Central Oregon about this plague thing is the first man got the disease after contact with a cat with a mouse. A lot of people blame the cat, but the more educated say he got it from a flea the mouse had... or something.

 

[The Snark]

Snark, is there a difference between "cat bite disease" and "cat scratch fever?" I contracted "cat scratch fever" a few years ago, but was told it is Bartonella henselae. There was also confusion with Lyme disease, which I apparently also had. I've had a lot of frustrating misdiagnoses and stupid-doctor encounters, so I no longer really trust anything.

The story here in Central Oregon about this plague thing is the first man got the disease after contact with a cat with a mouse. A lot of people blame the cat, but the more educated say he got it from a flea the mouse had... or something.

Sheesh! You got the double whammy. I'm glad someone was thinking enough to check you for Lyme's.
'Cat scratch fever' or 'Cat bite fever' is of course a popularized term that by no means is considered a medical diagnosis. Over the years it has been used to describe numerous different infections. Both Bartonella and P Multocida have been called this. The term was supposedly even given to Yersinia infections back in the dark ages in America, during the 1800's and early 1900's prior to the discovery of Penicillin.

The difference is Bartonella is a low motility infector that usually does not present a significant hazard to healthy people. On the other hand, Multocida is extremely virulent very high motility, capable of going from initial infection to cellulitis in as little as one hour and life threatening systemic in less than 24 hours. The hazard is amplified in that once cellulitus forms, blood profusion to the infected area becomes restricted and antibiotic drugs experience difficulty delivering their payload. Multocida infections with cellulitis commonly require a course of 10 to 20 days of intravenous antibiotics. I know of one patient that was on 2 different IV antibiotics for nearly 2 months. When I was infected (for the second time) I was given the twin antibiotic course IV (augmented Amoxy and Ancef) for 25 days.

Additionally, Bartonella commonly, though not always, uses a vector in it's transmission while Multocida rarely does. However, multocida is extremely common, found living in the saliva of many dogs and most cats, therefore making it readily available to enter the body through any wound.

So the bottom line would be to throw that terminology out the window and I apologize for even using it. I have even heard Multocida referred to by the term 'Kitten disease' or 'Playful cat disease', used by a medical physician. I hope I clarified a little.

As for catching Yersinia Pestis, the 'Plague', it is usually transmitted by vector, but not always. It can be transmitted through any bodily fluid as well as feces and does go airborne. It too is extremely high motility though the organism is much rarer than either Bartonella or multocida.

PS I'll toss in a little black humor here. The above, and general 'how to prevent infection' lecture I give to people living in remote areas, with the aid of a competent interpreter, can and often does take 2 days to explain. I often have to follow up multiple times. I've given the infection prevention instruction course to one village about 20 times. Most educated people would not believe the 'old wives tales' commonly encountered that have to be debunked in the process.

The very worst situation, which has become extremely prevalent, is missionaries strolling into the villages - obviously highly educated - or so they appear, and informing people that if you visit their little buildings every Sunday and hang a picture of some bearded white guy on your wall, you will be immune to most if not all diseases. (Their 1 hour informative lectures do not translate very well and are a tad light on medical science). Following the missionary invasion in the province of Chiang Rai, the people testing HIV positive has shot up to over 20% of the overall population. (WHO statistics). In the villages, Multocida and Leptospirosis infections (from their pigs) are almost as common as the flu. If our 4th generation end all be all life saver, Augmentin, starts to fail as organisms mutate and develop resistance, we are going to face a nightmare. Physicians hand that stuff out by the fistful. They did the same some years ago (and still do) with Erythromycin and most common infections are now resistant or immune to it.

My commonest plaintive refrain: "ALL pig housing MUST be DOWNHILL from human habitation!!" and "No, you can NOT let chickens (or piglets) run free in your houses."

 

[Thistles]

Thanks, that was extremely informative. "Playful cat disease" doesn't sound half bad... must have a good agent! I have a friend with MRSA, and so far the docs haven't been able to do anything for him. It's pretty frightening how over medicated we are.

 

[Tarac]

Thanks, that was extremely informative. "Playful cat disease" doesn't sound half bad... must have a good agent! I have a friend with MRSA, and so far the docs haven't been able to do anything for him. It's pretty frightening how over medicated we are.

That one always catches my attention. Best of luck on the MRSA, it's really painful for what it is and potentially really dangerous. Sounds like he's getting care so it will eventually be taken care of. Is the infection site open and draining yet? That is the number one key thing to ensure is done when fighting this type of infection- cut it open, express the nastiness inside and make sure it stays open and weeping until the infection is under control. Has to be "breathing" actively for any further antibiotic treatment to be effective, and frankly you often don't even need further antibiotics if you are a healthy individual once the wound is draining (although continue your course til it's done lest you encourage further resistance and an ongoing infection- never good to not finish the antibiotics). A lot of times you will be prescribed something for dermal infections (clindamycin, for example) or those commonly used in dentistry because they are better at getting to infections that are found in low oxygen environments such as staph. If it gets really bad they will likely put him in the hospital for IV vancomycin. Can't be administered any other way unfortunately. And it is fairly contagious, can be spread from that wound to any other places where you have compromised tissue so CLEAN CLEAN CLEAN is very important. I hope that gets resolved for him as soon as possible!

On over-medication; there is a common misconception that MRSA appeared because so many people take antibiotics when they have the slightest cold. This is not true. It appeared because there is a portion of the population that will require long term antibiotic treatments while they are not well- people that are having major surgery and will be immune compromised and in a hospital for long periods, etc. This is why it is so prevalent in medical facilities. It wasn't the mom that got an antibiotic scrip every time her kid had a runny nose, rather the host of people who are long term patients that have to stay in hospitals because of major medical issues. They need the antibiotics to prevent known common infections from causing major harm or death but it's a catch-22 because it also causes those average pathogens to become more than average and therefor more challenging to the patients who required the heavy medication to keep them healthy in the first place- it happened with staph, it happened with TB, etc. When people get MRSA it is nearly always from visiting a doctor or hospital that has regular contact with the aforementioned category of patients or from contact with someone else (or their things- it can survive outside the body for an alarming amount of time- so gyms and the like where people's bodies intimately share space and equipment are also hot spots during local outbreaks) who has just been to a doc. It does get out into the general population this way, but the reservoirs are medical facilities where the chronically ill and those who interact with them are found. It's why new mothers and their babies are sent home as quickly as possible these days. Not to save money for the insurance companies but to minimize the exposure of both of them to everyone else in the hospital.

 

[The Snark]

Thanks, that was extremely informative. "Playful cat disease" doesn't sound half bad... must have a good agent! I have a friend with MRSA, and so far the docs haven't been able to do anything for him. It's pretty frightening how over medicated we are.

I sincerely wish your friend a speedy uneventful recovery. It sounds like the infection has gone systemic. I hope not.

One of the greatest fears in the medical profession right now is resistance to Augmentin. That's 4th gen and there is no 5th on the horizon. In most of the villages I visit nearly every person in the village has been dosed with the crap at one time or another. The big BIG bitch is the docs are using the last line of defense instead of prescribing an interim stop gap, culturing the infection, then using a narrow spectrum antibiotic that will specifically target the infector and little if anything else. From my observations, I'd guess only one in every 500 infections gets the organism properly identified.

The problem is exemplified by MRSA. With each antibiotic treatment some bacteria always become immune. Repeat enough times and tada, MRSA or gads knows what. Modern medicine is turning into it's, and ours, worst enemy.

 

[Thistles]

Tarac, it's open as much as it can be. It's on his chest. He's in Maryland and I'm in Oregon, so I haven't seen him for a few years but it sounds pretty bad from what he's described and this has been going on for several months. I don't know how he contracted it, but I do know it is usually found in hospitals.

Snark, I don't know much of anything about human medicine, but I work with tropical fish. I've noticed that most people don't bother to figure out what their fish have when they're sick. They just toss any medication they can get into the tank, when usually the problem is just dirty water. Stores medicate their tanks on a prophylactic weekly basis. It's getting harder and harder to treat fish, even if I know what they have. I also love how they never finish the course of treatment. Fish look better? Great! These meds are too expensive to add any more!

 

[The Snark]

Tarac, it's open as much as it can be. It's on his chest. He's in Maryland and I'm in Oregon, so I haven't seen him for a few years but it sounds pretty bad from what he's described and this has been going on for several months. I don't know how he contracted it, but I do know it is usually found in hospitals.

Snark, I don't know much of anything about human medicine, but I work with tropical fish. I've noticed that most people don't bother to figure out what their fish have when they're sick. They just toss any medication they can get into the tank, when usually the problem is just dirty water. Stores medicate their tanks on a prophylactic weekly basis. It's getting harder and harder to treat fish, even if I know what they have. I also love how they never finish the course of treatment. Fish look better? Great! These meds are too expensive to add any more!

Excessive nitrogen precluding the presence of oxygen in the water then wham the fish with tetracycline?

 

[Louise E. Rothstein]

MRSA carriers turn up everywhere.
Few of them know what they carry...but it happens that "hot spots" of numerous MRSA carriers have been tracked to the enormous "factory farms"
that give their overcrowded animals antibiotics ALL the time...AND to the almost equally gargantuan slaughterhouses that serve the factory farms.

Since most of the infected employees look "healthy" they think that they are.

Rest assured that very few,if any,of their corporate employers have ever told them otherwise.

Let us hope that those men get outdoors in the sun,for far more should be done with ultraviolet's action...even some hospitals use ultraviolet now...
And it is about time that they did,for as doctors resort to bigger and bigger and BIGGER doses of antibiotics they overdose more and more people.

I do know of MRSA patients who were drugged to death.
Overdosing can kill.
Victims who escape that kind of "care" sometimes just stay away because it is safer for many antibiotic sensitives to learn to live with
a chronic infection than to ever go back.

Let us learn how to use ultraviolet effectively.

Some hospitals already have.

 

[The Snark]

Just to clarify.

Hospitals use UV as a passive bactericide in conjunction with their positive pressure ventilation systems to reduce infection transmission. I fully agree with the use of UV but we need to keep things clear. 'Hospitals' do not treat patients. Hospitals provide the facilities, equipment, drugs and trained personnel which medical practitioners utilize. A hospital cannot go out and purchase a piece of medical equipment then apply it directly to a patient.

 

[Thistles]

Excessive nitrogen precluding the presence of oxygen in the water then wham the fish with tetracycline?

Right? I'm so glad I'm not a goldfish. It's even worse for scaleless fish. I can't even begin to guess how many times otherwise healthy fish that were stressed by poor care have died because someone dosed them with some harsh antiparasitic.

Louise, when I had Lyme's, I was put on 4 different antibiotics (at different times) and the meds made me far sicker than the disease ever did. I missed weeks of work because of the side effects. I had another doctor suggest I stop my antibiotics and change my diet. After being vegan for a year, all of my symptoms disappeared. Medicine is there for a reason, but sometimes the "cure" is worse than the disease!