Bacterial outbreak that sickened 100+ people linked to contact with pet store puppies

Dozens hospitalized across 18 states

A team of epidemiologists has been credited with discovering what caused more than 100 people in 18 states to get sick after they were exposed to a drug-resistant strain of bacteria.

The researchers at the Florida Department of Health in Orange County found that all the infected people had contact with puppies at pet stores.

"Your own pet might be making you sick," said Jennifer Jackson, the lead epidemiologist at the Department of Health, who was part of the team that made the discovery. 

The disease detectives, including Jackson, program manager Alvina Chu, surveillance specialist Heyda Rodriguez and epidemiologist Ashley Vineyard, started their investigation last summer after five residents of Orange County, Florida got sick from exposure to the bacteria called Campylobacter jejuni.

They determined this particular strain, which caused abdominal pain, fever, cramps and diarrhea, was normally found in sick puppies.

They also discovered it was resistant to most antibiotics. 

According to the Center for Disease Control, most Campylobacter infections are associated with eating raw or undercooked poultry, or from contamination of other foods by these items. People can get infected when a cutting board that has been used to cut and prepare raw chicken isn’t washed before it is used to prepare foods that are served raw or lightly cooked, such as salad or fruit.

But people also can get infected through contact with dog or cat feces.

So how did these five people get exposed to this particular bacterial infection? It is not because of something they ate. It is because of something they touched. In these cases, it was a cute but infected puppy. The team determined all had been exposed to the puppies at two Orlando Petland stores.

"We noticed that all five people said that they had animal contact at this local pet store," Jackson said. "They either had contact with those puppies or they were a worker at one of the pet stores."

Then they discovered something else that alarmed them.

"We see customers just handling the puppies and playing with them (and) not washing their hands," Rodriguez said. "The same thing with the staff members." 

The Orange County team then contacted members from the Department of Agriculture and Consumer Services about the discovery and went back to both Orlando Petland locations to collect fecal samples.

They said through DNA testing and searching the national health databases, they discovered some of the puppies they tested had the same strain of bacteria that had made people sick in another state.

That's when they got other state and federal health agencies involved, along with the federal CDC.

Their research determined that not only did they have a small outbreak in Central Florida, but a national outbreak as well, involving a total of 18 states.

Ohio and Florida had the highest number of people infected. The other states included in the outbreak were Connecticut, Georgia, Illinois, Kansas, Massachusetts, Maryland, Michigan, Missouri, New Hampshire, New York, Oklahoma, Pennsylvania, Tennessee, Utah, Wisconsin and Wyoming. The researchers discovered a total of 118 people got sick from contact with a puppy infected with the Campylobacter bacteria from Jan. 5, 2016, to Feb. 4 this year. Of those, 29 were pet store workers. Although no one died, 26 people were hospitalized. 

According to the CDC, a total of six pet store chains were linked to the outbreak, but most of the cases involved Petland puppies. The CDC reports a review of store records revealed that among 149 investigated puppies, 142, or 95 percent, received one or more courses of antibiotics, raising concern that antibiotic use might have led to development of resistance. But their research also revealed that they could not identify any single breeder, distributor or transporter as the infection source.

Public health authorities issued infection prevention recommendations to affected pet stores and recommendations for testing puppies to veterinarians.

Petland, an Ohio-based national pet store, has two stores in Orlando.

The owners of both Orlando Petland locations sent the following statement from the company's corporate office:

"As a result of the inquiry which ended in February, the CDC had no new recommendations for Petland other than to continue our established practice of in store hand sanitization and education. As for any new antibiotic practices, at Petland all decisions relating to the use of antibiotics is determined by each of our store's independent licensed consulting veterinarians who are responsible for examining each of our puppies and determining any medical treatment. We expect veterinarians to practice appropriate discretion with antibiotics on puppies, just as we would expect the same from pediatricians with babies."
--Eric Davies, Petland South Orlando.

The manager at another nearby Petland location said the store has signs advising people to wash and sanitize their hands after handling the animals.

Reporters checked and did notice multiple signs at both Orlando-area locations encouraging people to wash and sanitize their hands. They also had several laminated fliers warning people about possible exposure to Campylobacter.

The Florida Department of Health said washing and sanitizing hands before and after any exposure to animals is the recommended course of action in trying to prevent this kind of bacterial infection.

"I'm very delighted to see they actually took our recommendations," Jackson said. "The corporate umbrella of this corporation seems like they are on board to spreading the message and keeping their customers safe."

Rodriguez said they are seeing the changes.

"We see the changes in the store. We see the changes in our numbers. So it worked," Rodriguez said.