Dear Ms Moss,
Thank you for your e mail of 6 April 2005.
I was not sure if you were seeking a response, but have decided it might be helpful to comment on some of the points you have raised. The American paper you cite concerns a case where transmission from pet to owner was considered to be a possibility rather than proven, as shown by the repeated use of the word 'likely'.To quote from it directly: "It is likely that the dog (which had not been ill or hospitalized or received antibiotics previously) initially became colonized by MRSA through contact (often intimate) with the patient, who had previously been hospitalized. In turn, the dog likely served as a source of reinfection or recolonization for both the patient and his wife. Direct person-to-person transmission of MRSA between the patient and his wife might have also occurred".
It may be an academic point but the animal appeared in this case to have been a reservoir rather than infected, hence the use of the word 'Asymptomatic' in the title of the case report.. However, this case does not really make any significant difference to HSE's position. I made it clear in my earlier note that, although no proven recorded case of pet to human transmission had occurred, this was not the same as saying such transmission could not happen, i.e. I accept it is a possibility.
But, HSE and all of the organisations mentioned in my previous note are satisfied that, currently, there is no hard scientific evidence of a serious risk to humans. In terms of other evidence coming to HSE, we have had no reports under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 of workers being harmed by MRSA transmission from animals. Similarly, we have had no complaints or other approaches, from any members of the public (apart from yourself) alleging that such harm has occurred to them.
The issues of prudent behaviour and the state of an individual's health/vulnerability have to be considered. In the American case above the couple involved were a male with diabetes, renal problems and a non-healing leg amputation; his wife had diabetes and a kidney transplant, yet "On further questioning, the couple reported that the dog routinely slept in their bed and frequently licked their faces".
In your own case it appears from what you said that you were in the Medivet Practice premises barefoot and with small open wounds, i.e. in a state where you would be more susceptible to infection. Keeping a pet gives real enjoyment to people, but it is important to recognise that, because of certain habits animals have, there are potential risks to human health.
While simple hygiene precautions such as hand washing before handling food are needed to prevent, for example, stomach upsets in a generally healthy person, further precautions would be needed for someone in a condition where they were more susceptible to infection. One of the authors of the letter to the editor of the 'Veterinary Microbiology' journal, Angela Kearns, is from the HPA Staphylococcus Reference Laboratory.
This fact suggests to me that HPA have their finger on the pulse of this potential reservoir of infection and are well placed to act should this prove to be a significant risk to the generally healthy population within the context of the continuing fight against MRSA. While there may well have been benefits from your own campaign, in terms of raising the general level of awareness of the issue, I do consider it is important that we keep the risks in proportion.
And, in saying this, I do hope that you will accept that I am in no way seeking to undermine or minimise your own sad loss. I have had several dogs and fully understand what an important part they play in our lives and how much we miss them when they are gone.
Frank J Perkins HM Principal Inspector of Health and Safety Agriculture and Food Sector - Health, Education & Chemicals Section VPN Tel. 513 2890 VPN Fax. 523 2869 (0115 971 2890) (0115 971 2802) firstname.lastname@example.org