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Symptoms include bleeding, seizures, hair loss, skin lesions and kidney failure. September 21, 2000The Centers For Disease Control and prevention calls it Visceral Leishmaniasis in North America -- A Multi-Site Outbreak in Dogs. We call it a sometimes lethal parasite that has affected Foxhounds in the United States and Ontario, Canada, and other breeds in the past. This article is based on a summary of the investigation of the disease provided by Peter M. Schantz, VMD, PhD, Division of Parasitic Diseases, National Center of Infectious Diseases, CDC, and a September 20 interview with Dennis Foster, Executive Director of the Master of Foxhounds Association. An article in the New York Times in late August, 2000 and inquiries from Woof Gazette readers, prompted this more detailed story. The Division of Parasitic Diseases has been collaborating since February 2000 with the Dutchess County, New York Department of Health, the Walter Reed Army Institute of Research, the New York State Department of Agriculture & Markets, the New York State Department of Health, the Virginia Department of Health and the North Carolina State University College of Veterinary Medicine to investigate an outbreak of visceral leishmaniasis among Foxhounds first noted at the Millbrook Hunt kennel in Dutchess County last year. The culprit was first diagnoses by researchers at North Carolina State University. Symptoms of the disease Beginning in the late summer of 1999, a number of Foxhounds at the club developed illness with manifestations that included bleeding, wasting, seizures, hair loss, skin lesions, kidney failure, and swollen limbs and joints. Twenty-one of the dogs were reported to have died from the disease. This was confirmed at autopsy of several of the dogs. Dogs that appear to be perfectly healthy may have the disease without having any of the symptoms. Dogs that show titers in testing may later show no sign of the disease in future testing to confirm Leishmaniasis. Diagnostic screening of foxhounds at the NY kennel revealed a high rate of leishmanial seropositivity (42%). Tests to demonstrate infection in dogs in neighboring hunt clubs in Dutchess County and in pet dogs, horses, and wild rodents in the vicinity of the affected kennel have been negative. Leishmaniasis is considered an important zoonotic infection. Dogs are reservoirs of transmission in other countries, but there have been no cases of human visceral leishmaniasis reported in the United States. Investigations have continued since April 2000 to identify infections in dogs and other potential hosts, to determine how the infection is being transmitted, and to determine the potential public health significance. The disease has killed humans in other countries but has rarely been diagnosed in humans in the United States. Titers found in 21 states and Ontario, Canada Screening of Foxhounds in numerous states has revealed evidence of more widespread infection. Through (September 1, 2000), samples from 9,160 Foxhounds and other hunting dogs had been tested. Positive Foxhound samples have been detected in 21 states and Ontario, Canada. Samples from 455 dogs of other breeds not associated with the Foxhounds have all tested negative. Foster stated that not all the detections mean that those dogs have the disease. When titers are founf, it means that (1) the dog has been exposed but does not have the disease, (2) the dog has the disease, (3) the results of the test were not valid or (4) additional tests are needed for confirmation. Although the Masters of Foxhound Hunters Association recommended a temporary halt to interstate movement of foxhounds pending the collection of more detailed information, the association confirms that all of their members' dogs have participated in a thorough testing that includes additional tests to confirm or deny titers found in the first test. Kennels now determined to be "clean" are continuing with their activities. Kennels with suspect titers that have not yet received results of the second tests for confirmation are not yet participating in Foxhound trials and activities that expose them to other dogs. Transmission of the disease The disease is transmitted by sand flies. According to the CDC, species of sand flies known to transmit the disease have not been identified in the areas investigated. Foster's question is "How did any Foxhound get the disease," referring to recent infection of dogs in the U.S. and Ontario, Canada. He emphasized that cases in other dogs discovered in the United States in the past, including such breeds as Greyhounds, German Shepherd Dogs, Beagles and Bassett Hounds, involved dogs that had contracted the disease outside the United States, but that does not appear to be the case with these Foxhounds. The association includes mounted Foxhounds, but there are many more night hunters, which have not been part of the intensive self-imposed quarantine and testing of association member dogs. It is thought at this time that direct dog-to-dog transmission may be occurring. Foxhounds commonly live in close contact with each other and the annual cycle of hunting activities bring dogs from different states together. Although direct transmission from an infected dog to humans has never been reported, it is speculated to be possible, and people with compromised immune systems would theoretically be at greatest risk. The investigation continues The CDC confirms continued sampling of Foxhounds, surveys of stray dogs, isolation of the infective organism from positive canines, surveys of humans" at risk", i.e., foxhound handlers and hunters, as well as the investigation of sand flies. Other sources state that Leishmaniasis is known in the tropical and sub-tropical regions of Africa, Asia, the Mediterranean, Southern Europe, South and Central America. It is obvious that there are still a lot of unanswered questions. We will attempt to up-date this information as it becomes available. Other reference material published by the CDC states that an estimated 12 million persons in the tropics and subtropics have leishmaniasis transmitted by the bite of infected sandflies. Through December 1991, cutaneous leishmaniasis had been diagnosed in 16 military personnel from Operation Desert Storm. What should you do; additional information sources While all sources agree that this disease is not something to be overly concerned about at this time, there are some things you may want to consider doing. If you brought a dog into the country from somewhere else, or purchased an imported dog from another country --- especially Africa, Asia, the Mediterranean, Southern Europe, South and Central America., you may want to consult your veterinarian. Have your dog tested for Leishmaniasis. Another reason for testing is if you feel your dog has been exposed or shows any of the known symptoms listed above. If you are a dog owner, dog association, breeder, reseller of dogs, shelter or anyone who needs general information about the disease and specifics related to the Foxhound episode, contact Dennis Foster, Executive Director of the Master of Foxhounds Association via e-mail at at dennis@mfha.com (The MFHA does not include information about Leishmaniasis on their web site.) Physicians needing information about Leishmaniasis in humans should contact the CDC's Parasitic Diseases Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, telephone 404-488-4050. For more information about Leishmaniasis in humans, visit the Centers for Disease Control at http://www.cdc.gov/health/diseases.htm |
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