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METHODS: Several public health agencies collaborated to investigate the case.
RESULTS: The child, who had been asymptomatic since discharge, was treated with 45 days of antibiotics. Post-exposure prophylaxis was recommended for 19 laboratory workers, none of whom developed symptoms. The child’s family had purchased an eight-week-old male Yorkshire terrier from a NYC store in March 2012; the child had had frequent contact with it. Though the puppy was asymptomatic, its blood also grew B. canis, and it was subsequently euthanized. Both isolates were compared by multiple-locus variable-number tandem repeat analysis (MLVA); genetic similarity was close. The puppy originated from an Iowa commercial breeding facility, which was subsequently quarantined by the Iowa Department of Agriculture and Land Stewardship. The NYC pet store had sold the puppy’s litter mate to a Pennsylvania (PA) family. After investigation, the PA Department of Health reported that this puppy also tested positive for B. canis(by serology) and was treated. Among those exposed to the second puppy were a child and a pregnant woman who were advised to limit contact with the puppy until it could be re-tested. Neither the woman nor the child had blood cultures collected.
CONCLUSIONS: Genetic analysis suggests this is the first confirmed report of B. canis transmission from a canine to a child in the U.S. Although most known human cases have been due to occupational exposures, a substantial proportion occurs in pet owners. Because no serologic test for B. canis exists for humans, the epidemiology in humans is poorly described and the prevalence may be underestimated. B. canis infection in dogs is well described, and outbreaks have been reported in breeding kennels, though seroprevalence is unknown. Changes in canine breeding practices may be contributing to an increase in B. canis among dogs; disease control will require coordinated efforts of animal and human health agencies.