Visitor behaviour and public health implications associated with exotic pet markets: an observational study

Warwick, Clifford; Arena, Phillip C; Steedman, Catrina

More generally, a survey of 1410 human diseases found 61% to be of potentially zoonotic origin. 10 Also, 75% of global emerging human diseases are zoonotic. 11 It is believed that epidemics such as SARS (severe acute respiratory syndrome), monkey-pox and avian influenza H5N1 may have emerged from wildlife markets. 1, 5, 8, 11 The arbitrary mixing of a wide variety of species that would not normally meet together in conditions of highly questionable animal husbandry and public health protection measures, raises multifactorial concerns about these markets and their implications for public health. 1, 5, 8, 12, 13 Many cases of zoonotic disease are, however, probably misdiagnosed as other conditions and under-reporting in general is a likely major factor in under-ascertainment of cases. 2 Certain common zoonoses symptomatically superficially resemble common illnesses such as gastrointestinal, respiratory, influenzal and dermatological disorders and disease. General medical practitioners who are unfamiliar with zoonoses do not typically enquire of patients about direct or indirect contact with an exotic animal. 2 Significant zoonotic episodes arise from indirect contact with an animal. Indirect pathogen contamination and dissemination involving reptiles and intermediary surfaces, for example, door handles, clothes, table tops, walls, household utensils and shaking of hands, has been reported as an important factor in transmission. 7, 14, 15 One notable example involved over 300 public attendees to a zoo who acquired Salmonella infection via a wooden stand-off barrier around a lizard enclosure and despite having had no actual contact with the reptiles. 16 The presumed primary transmission route for many amphibian-and reptile-borne potential pathogens is via faecal -oral ingestion. 17 However, human skin scratches from the claws of lizards, 18 and bites from snakes and lizards also may transmit contaminants. 14, 18 Also, direct contact between any contaminated reptile and open human lesions, such as sores, or via reptile debris penetrating human orbital or aural sites, are further potential routes of infection. 14 Aquatic turtles and other species of waterdwelling reptiles may contaminate large bodies of water -resulting in contaminated splashes, droplets and smears that may lead to human infection. Lizards are handled more than turtles and are more likely to introduce infection via skin scratches. Snakes are handled far more frequently than even lizards and thus may spread contaminants more widely and consistently. Diverse surfaces may act as intermediary carriers of many biotic contaminants and once a surface is contaminated, potential contagions may long persist. 19 Hand washing and the use of disinfectant gels and sprays are commonly recommended and perceived as sufficient hygiene measures to eradicate Salmonella and any other potential pathogens. 14, 15 However, these hygiene methods, as generally practiced, do not provide reliable protection against diverse amphibian-and reptile-borne contaminants. 14, 15 Indeed, the use of these materials and methods may generate undue over-reliance and misplaced confidence in personal disease prevention and control that may lead to infection as a result of complacency. 20 The aim of this investigation was to assess public behaviour in the context of potential contamination threats at close-quarters in a probable zoonotic pathogen rich environment. We conducted on-site assessments at three key European