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CDC Telebriefing Transcript
Outbreak of Tularemia in Commercially Sold Prairie Dogs
in Texas
August 6, 2002
MR. SKINNER: I'd like to welcome all the reporters who have joined us on
today's call, where we'll be providing an update to you all about an
investigation that the Texas Department of Health and the Centers for
Disease Control and Prevention have been collaborating on in regard to an
outbreak of tularemia in some captive prairie dogs in a facility there in
Texas.
On the phone with us today is Dr. Lisa [sic] Rawlings. She is the deputy
state epidemiologist for the Texas Department of Health. As well as Dr.
David Dennis, a medical epidemiologist for the Centers for Disease Control
and Prevention, and a tularemia expert.
What we'll do is we'll turn the call over to Dr. Rawlings, who's going to
provide a brief overview of the investigation there in Texas, and then we'll
turn the call over to Dr. David Dennis, who will provide a brief overview of
some of the activities that CDC's been involved in. And then we'll turn it
over to reporters for Q&A.
So at this point I'd like Dr. Rawlings to take it away.
DR. RAWLINGS: Okay. Well, as you heard, the Texas Department of Health and
CDC are investigating an outbreak of tularemia in wild--caught; they were
caught in the wild--but captive prairie dogs. These prairie dogs were
imported and exported from a commercial exotic animal distribution center in
Denton County. Denton County is just north of Dallas.
Now, may of the prairie dogs which arrived at the Denton County facility in
June began showing signs of illness in mid-July. The testing of the prairie
dogs was done at CDC, and they were able to show that the outbreak was due
to a bacterial disease called tularemia.
TDH received the report from CDC in late July, and then, with assistance
from CDC, began an investigation. The goals of the investigation are to
trace the prairie dogs, find out where they were sent to; determine whether
there has been any human investigation; and to formulate control measures.
MR. SKINNER: Okay. Dr. Dennis?
DR. DENNIS: Yes, as Julie mentioned, CDC learned from the Texas state health
authorities about one week ago of sick and dead prairie dogs at a commercial
animal dealership. Animal specimens received by CDC the next day were tested
and found to be positive for the bacterium causing tularemia, a serious
infectious disease commonly known as rabbit fever.
Within 24 hours, scientists were dispatched to assist Texas health
authorities with on-site investigations, with the tracing of prairie dogs in
the pathways of distribution and with interstate and international
notifications. Joint Texas-CDC investigations have revealed shipments of
potentially infected animals to nine states and to seven countries in Europe
and Asia. The Division of Quarantine, CDC Atlanta, has coordinated
international notifications with the World Health Organization and with the
European Disease Surveillance Networks.
To date, we have been notified of sick animals in one shipment to Europe and
in several shipments in the United States. There have been no known human
cases of tularemia associated with these prairie dogs shipments. We believe
that the risk is very low to persons who have contact only with healthy
prairie dogs, but there is concern about persons who have handled sick or
dead animals.
The disease is treatable with the proper antibiotics. We are recommending
that persons developing an illness with fever, chills, and other flu-like
symptoms within three weeks of handling a prairie dog be seen by a physician
without delay. Persons who have handled sick or dead animals should seek
advice about possible preventive treatment with antibiotics.
MR. SKINNER: Thinks, Dr. Dennis. Jeanine, I think we're ready for some
questions, please.
QUESTION: Anita Manning, USA Today.
Hi, thanks. Where do these prairie dogs come from? They were caught in the
wild where? In Texas?
DR. RAWLINGS: We have prairie dogs that were collected in Texas and then in
another state, and we're not sure where the origin of the disease occurred.
That's why we're conducting investigations.
QUESTION: Can you say what the other state was?
MR. SKINNER: Dr. Dennis, I--you know, I mean, I think that's okay.
DR. DENNIS: Right. We still are in the early stages of investigation, but it
appears that animals from the infect lot most likely came from a facility in
South Dakota, and most likely were caught in the area--in South Dakota.
QUESTION: John Lauerman [sp], Bloomberg News.
Yeah, thank you. Do you know exactly how many prairie dogs were sent out?
MR. SKINNER: Dr. Dennis?
DR. DENNIS: There were in total hundreds of prairie dogs sent. I would say
somewhere between 1,000 and 2,000 animals that may have come from that
affected lot. Some of these shipments contained only one animal; some
shipments contained as many as 500 animals.
QUESTION: And approximately how many pet stores were they sent to?
DR. DENNIS: That is something that is only being determined now. Because
there is a network of distributors, and then the distributors send them out
to individual pet shops.
As an example, there were--there was a considerable lot of animals sold to a
dealer in a European country. He held these animals for a week, gave them
antibiotics, actually, but then the next day sold them at an open market
that we presume is a market of pet shops.
MR. SKINNER: Yeah, I think it's safe to say that this has continued to be a
work in progress, and contact with the various distributors within the
states continues to, you know, to go on. I think what is important for us
having this call is what Dr. David Dennis alluded to in his brief
introductory comment, that we really want people that have handled these,
you know, dead animals within the last few weeks, if they develop illness,
to, you know, seek medical attention. And that's really why we are having
this call.
Next question?
QUESTION: Tina Hessman, St. Louis Post-Dispatch.
Can you tell me what states had shipments with prairie dogs that were known
to be infected?
MR. SKINNER: Either one--Dr. Rawlings or Dr. Dennis.
DR. RAWLINGS: Sure. We can tell you that there were shipments to Florida,
Illinois, Ohio, Virginia, West Virginia, Washington State, Mississippi, and
Nevada. And, of course, Texas.
DR. DENNIS: Now, I'd like to qualify that in that we do not know that
infected animals have been received by all those states. These are states
that received shipments from a time period when there was a lot of animals
at the Texas facility that became ill and died.
QUESTION: So you haven't seen the illness in animals that were sent in any
of those shipments to those states?
DR. DENNIS: Yes, there--there was word that we received back, notification
from one European country, of animals that had
actually been held in quarantine becoming sick and dying. And on testing,
they determined that these animals were infected with the germ that causes
tularemia. And we have been notified by several pet distributors in at least
two states in the United States that have had animals that have been sick or
dead. But those have not yet been tested in our laboratories.
MR. SKINNER: Dr. Dennis, do you think it's important to allude to the
incubation period and, you know, stress that we continue to work with these
states, though? So I--you know, this is--like I said, it's an investigation
in progress, wouldn't you agree?
DR. DENNIS: I think the status of the investigation now--you know, we've
done the ground work there with the Texas Health Department in Texas and
we're--have been notifying the state and local health authorities that had
received shipments from the lot that--or for the time period that we're
concerned about. And they are now going out and doing the individual
investigations to identify the pet shops and the sickness or health of the
animals.
So that's where we are in this investigation. It will take some time before
we identify animals that may have been sick or dead and then have a system
to receive and test those for the illness.
MR. SKINNER: Next question, please.
QUESTION: Steve Mitchell, UPI.
Oh, yeah, hi. Can you give me some idea of how this disease is transmitted,
in terms of what kind of contact a person would need, like with body fluids
or airborne or whatever?
DR. DENNIS: The disease in nature is usually transmitted by the handling of
infected animals, particularly infected carcasses and especially rabbits. Or
a person can be infected by tick or fly bites. But in this concern with the
prairie dogs, we think that the risk is very small to persons who are
handling healthy animals. But persons who are handling sick or dead animals
and come into contact with their secretions, or have been bitten or
scratched by these animals when they are sick, is of concern to us about
transmitting the disease.
MR. SKINNER: Next question, please.
QUESTION: Ann Carnes [sp], Wall Street Journal.
Hi. I joined the call a little late, so I apologize if I'm repeating a
question here. But these prairie dogs were shipped for sale in pet shops for
people to keep as pets in their homes as opposed to some sort of research
purpose? Is that correct?
DR. RAWLINGS: Yes, prairie dogs are kept as pets. It's actually more common
than you might think.
QUESTION: And have you identified the facility in Texas where the pets
originated?
DR. RAWLINGS: Yeah, the distribution center was in Denton County, Texas.
That county is just north of Dallas.
QUESTION: Does the facility have a name? I mean, is it a commercial
enterprise?
DR. RAWLINGS: Yeah, it has a name. It's just that we generally don't give
out the names of these facilities.
QUESTION: So you're not giving that out. I mean, has it been identified in
press reports in Texas, for example? I mean...
DR. RAWLINGS: No, it hasn't.
QUESTION: Okay. Okay, thanks.
MR. SKINNER: Next question, please.
QUESTION: Regina McEnery [sp], Plain Dealer.
Yes, can you tell us which two states reported the sick or dead animals,
reported having the sick or dead animals? And also, which of those states
that you mentioned received the most dogs, and how many did those particular
states receive?
MR. SKINNER: Dr. Dennis, I--you know, I don't know if you're prepared to go
into that detailed information at this point, but--
DR. DENNIS: But Julie may have more information or more up-to-date
information than I do. But we have heard about sick and dead animals in pet
shops or dealers that--in Texas, other than the principal exporter; and as
well in West Virginia. And then internationally, in the Czech Republic.
QUESTION: And the states that received most of the dogs, do you know what
the breakdown...
DR. DENNIS: Let me see here.
MR. SKINNER: We might be--you know, if we don't have that readily available,
we might be able to provide that to you after this call.
DR. DENNIS: I would say that most states received a hundred or fewer
animals. It looks as if Texas received the most animals.
QUESTION: Okay.
MR. SKINNER: Next question, please?
QUESTION: John Lauerman, Bloomberg News.
Could you describe the circumstances under which--I understand that the
disease takes different forms depending on how it is acquired. And can you
describe the circumstances under which the most serious infections might
take place? That is, I understand, like, a lung infection is most likely to
cause serious disease.
DR. DENNIS: Yes, that's correct. Tularemia can take many forms depending
upon where the germ was inoculated. If it's inoculated through the skin, it
most typically results in an open sore and then in swollen, tender lymph
nodes draining that sore--still accompanied by all the usual general
systemic manifestations of illness--fever, chills, feeling of weakness.
If the organism is ingested, then it can cause--
QUESTION: In other words, if you eat it?
DR. DENNIS: Yeah, if you eat it or drink contaminated water, it can cause
lesions in the mouth and throat and usually results in enlarged lymph glands
in the neck region.
If you inhale it, you can get a primary pneumonia from tularemia, which is
probably the most severe form.
Any form can result in what's called a typhoidal form of illness, in which
the person has a general toxic reaction that people have when they have
septicemia or [inaudible] of the organism in the blood stream. And that also
can be very serious.
So it can result from inoculation through any means. As well, there can be
secondary pneumonia that develops in persons who've been inoculated through
the skin or mucous membranes.
QUESTION: So in other words, the serious consequences that could happen in
an untreated person could happen no matter what the route of infection is?
Or is the inhalation the most likely route, like, sort of, with anthrax, to
cause a serious infection?
DR. DENNIS: No, I think you're right--the first. We take any infection as
being potentially serious, because the organism often goes through the lungs
or, if not treated early, can result in that systemic typhoidal type of
disease.
MR. SKINNER: Next question, please.
QUESTION: Deborah Dennis [sp], Dallas Morning News.
Hi. Dr. Rawlings, I'm trying to find out where in Denton County specifically
these prairie dogs may have been. And are there other towns in Texas?
DR. RAWLINGS: The facility in Denton County is in Lewisville. And the pet
shops have been in Williamson County--I'm sorry, I don't--okay, it would be
Belton, Houston, and Round Rock. And Arlington.
QUESTION: And Arlington. Okay, very good. Thank you.
QUESTION: Anita Manning, USA Today.
Oh, hi, I'm sorry. I had you on mute.
Just, finally, your--Tom, your mission here is to get people who have been
handling animals that seem sick to call their own doctor or should they call
a public health person? What are you telling them to do?
MR. SKINNER: I think--Dr. Dennis may allude to this, but I think we want
people, if they've been handling, you know, a sick or dead prairie dog
within the past three weeks or so to--if they--you know, they should contact
their state and local health department or their health care provider right
away. Is that correct, Dr. Dennis?
DR. DENNIS: Yes. And of course, if they have an illness with fever, chills,
and other flu-like symptoms, they should be seen by a physician in the
office without delay.
And I'd like to, sort of, emphasize the prevention methods that Tom was
citing earlier. I mean, the investigation right now is to try to reach
people who may have had contact with animals in the shipment of concern. And
if they have been in contact with healthy animals, we think the risk is very
small. If they've been in contact with sick or dead animals, then we have a
concern and they should notify their health care provider and/or their
health department about that situation. Because even though they may not be
ill, it is possible to provide protection by giving preventive treatment
with antibiotics.
MR. SKINNER: Okay, thanks, Jeanine, and thank you, everybody, for joining us
on this conference call. I want to remind you that both the CDC and the
Texas Department of Health have both put out press releases about this with
featured website links with additional information on tularemia. Feel free
to access those press releases, if necessary.
Thank you once again for joining us.
DR. DENNIS: Tom, just one last thing. I think you introduced Julie Rawlings
as Lisa Rawlings.
MR. SKINNER: Oh, I'm sorry. Gee whiz, yes. I'm sorry. Yeah, Julie Rawlings.
My apologies.
