Pasteur discovered the causative agent of fowl cholera (Pasteurella multocida) in 1880. Since then, multiple zoonotic infections affecting humans have been reported. P. multocida infections usually result from bites of cats or dogs. The earliest reports of nonbite transmissions (NBTs) were attributed to cat scratches and lung colonization. More recently, multiple modes of unusual NBTs have been reported, including animal exposures with no direct contact. Here, we report 79 cases of pet-associated infections, with 34 NBTs. Previously unreported and unsuspected, novel modes of NBTs presented include stepping on dog drool infecting a submetatarsal ulcer, contamination of a wound by socks covered with cat hair and dander resulting in P. multocida bacteremia, stumbling over a dog and falling while drunk and abrasions contaminated with dog saliva resulting in wound infection, and severe epiglottitis and supraglottitis after eating peanut butter and crackers half eaten by a dog. Cat bites were more common than dog bites. Both bite and nonbite infections were more common in the elderly, with more older patients in the nonbite group. Upper extremity bites were more than lower extremity bites for both cats and dogs. NBTs were associated with more co-morbidities and resulted in more life-threatening infections than bites, confirming the findings of a prior smaller series. Open wounds were the most common point of entry for nonbite infections, with majority in the lower extremity. Based on this study and prior reports, pet owners must protect open wounds and individuals with certain underlying conditions and infants should avoid pet exposure completely. Our findings and animal transmission of bite and nonbite P. multocida infections reported in literature are summarized.

Pasteurella multocida Infections with Unusual Modes of Transmission from Animals to Humans: A Study of 79 Cases with 34 Nonbite Transmissions.

Meningitis is an inflammation of the brain and spinal cord meninges caused by infectious and non-infectious agents. Infectious agents causing meningitis include viruses, bacteria, and fungi. Viral meningitis (VM), also termed aseptic meningitis, is caused by some viruses, such as enteroviruses (EVs), herpesviruses, influenza viruses, and arboviruses. However, EVs represent the primary cause of VM. The clinical symptoms of this neurological disorder may rapidly be observed after the onset of the disease, or take prolonged time to develop. The primary clinical manifestations of VM include common flu-like symptoms of headache, photophobia, fever, nuchal rigidity, myalgia, and fatigue. The severity of these symptoms depends on the patient's age; they are more severe among infants and children. The course of infection of VM varies between asymptomatic, mild, critically ill, and fatal disease. Morbidities and mortalities of VM are dependent on the early recognition and treatment of the disease. There were no significant distinctions in the clinical phenotypes and symptoms between VM and meningitis due to other causative agents. To date, the pathophysiological mechanisms of VM are unclear. In this scientific communication, a descriptive review was performed to give an overview of pediatric viral meningitis (PVM). PVM may occasionally result in severe neurological consequences such as mental retardation and death. Clinical examinations, including Kernig's, Brudzinski's, and nuchal rigidity signs, were attempted to determine the clinical course of PVM with various success rates revealed. Some epidemiological correlates of PVM were adequately reviewed and presented in this report. They were seen depending mainly on the causative virus. The abnormal cytological and biochemical features of PVM were also discussed and showed potentials to distinguish PVM from pediatric bacterial meningitis (PBM). The pathological, developmental, behavioral, and neuropsychological complications of PVM were also presented. All the previously utilized techniques for the etiological diagnosis of PVM which include virology, serology, biochemistry, and radiology, were presented and discussed to determine their efficiencies and limitations. Finally, molecular testing, mainly PCR, was introduced and showed 100% sensitivity rates.

/pdf/etiology-clinical-phenotypes-epidemiological-correlates-2jj75pcl.pdf

Etiology, Clinical Phenotypes, Epidemiological Correlates, Laboratory Biomarkers and Diagnostic Challenges of Pediatric Viral Meningitis: Descriptive Review

Pasteurella multocida (P. multocida) is an immobile, anaerobic, Gram-negative coccobacillus fermenting bacterium. This pathogen is commonly prevalent in the upper airways of healthy pets, such as cats and dogs, but was also confirmed in domestic cattle, rabbits, pigs, birds, and various wild animals. Infection in humans occurs as a result of biting, scratching, or licking by animals and contact with nasopharyngeal secretions. Inflammation at the site of infection develops within the first day from the injury. It is usually confined to the skin and subcutaneous tissue but, in particular situations, may spread to other organs and manifest as a severe systemic infection. Careful history-taking and microbiological confirmation of the infection enable diagnosis and appropriate treatment. Any wound resulting from an animal bite should be disinfected. The preferred and highly effective treatment against local P. multocida infection is penicillin or its derivatives. The prognosis for P. multocida infections depends on the infected site and the patient’s comorbidities.

Pasteurella Multocida Infection in Humans

The actions of Pasteurella multocida toxin on neuronal cells

Animal-assisted therapy (AAT) is a non-pharmacological therapy aimed at people with physical and/or mental disabilities. Therefore, it is necessary to carry out interventions that guarantee its benefits for patients while also avoiding the risk of zoonoses due to contact with the animals or their mucous membranes. The present study aimed to detect the occurrence of Pasteurella multocida in the oral cavity of dogs attending a "dog educational centre" and training for AAT interventions. In addition, some of the potential predictable factors of infection (i.e., age, sex, breed, and living conditions) were analyzed. In total, 25/200 dogs examined (12.5%; 95% confidence interval = 8.4-18.1%) were positive for P. multocida, as confirmed by PCR. Sex, breed, and living conditions were risk factors associated with P. multocida as revealed by the logistic regression analysis. Specifically, cross-bred female dogs living prevalently outdoors were significantly associated with the presence of P. multocida (p < 0.05). This study represents the first epidemiological survey of the prevalence of P. multocida in the oral cavity of dogs involved subsequently in AAT interventions, highlighting the potential risk of P. multocida infection in patients, often belonging to risk categories (e.g., children, the elderly, and immunocompromised individuals). Therefore, healthcare guidelines could be suggested to integrate the current literature related to the health check of dogs involved in AAT. In this way, it could be ensured that, even with bodily contact during AAT, the risk of pathogen transmission by the co-therapist dog can be avoided.

https://www.mdpi.com/1660-4601/17/17/6385/pdf

Occurrence of Pasteurella multocida in Dogs Being Trained for Animal-Assisted Therapy.

We report on six cases of Pasteurella multocida (P. multocida) meningitis occurring between 2001 and 2011 by a French nationwide active surveillance network of paediatric bacterial meningitis (ACTIV/GPIP). The cases accounted for 0.15 % of the paediatric meningitis cases reported between 2001 and 2011 in France, all in infants <4 months old. A review of the literature allowed us to gather information on 42 other cases of P. multocida meningitis in infants <1 year old reported since 1963. Among all 48 cases, 44 % were newborns. An animal source of the infection, including 39 household dogs and cats, was suspected or identified in 42 of 48 cases. A traumatic contact between the child and a pet occurred in 8 % of cases, and a vertical transmission from mother to child during birth in 10.4 %. Most of the time, the infection resulted from non-traumatic contact between the child and the pet, through licking or sniffing. The absence of host risk factors suggests that an immature immune system is responsible, given the young age of the children. Although complications, especially neurological lesions, were not rare (37.5 %), the long-term outcome was usually good. Four infants died of meningitis. This rare disease could be prevented by reducing contact between infants and household pets, and by performing simple hygiene measures before handling babies.

Paediatric epidemiology of Pasteurella multocida meningitis in France and review of the literature

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Paediatric epidemiology of Pasteurella multocida meningitis in France and review of the literature