|
Helicobacter pylori
and gastric ulcers-
a zoonosis? |
|
Might animals play a role in the epidemiology
of H. pylori in humans? |
Helicobacter pylori infection in cats and
dogs:
Cats:
Of most importance in terms of widespread zoonotic potential
are recent reports of H. pylori in domestic cats.
- Helicobacter pylori has been cultured or PCR-amplified
from the feces, salivary secretions and dental plaque of naturally-infected
cats.
- Fox et al. demonstrated multifocal gastritis in cats
experimentally infected with H. pylori.
- Helicobacter pylori has been isolated from the stomachs
of cats and, in one study by Handt et al., 88% of the
infected cats had moderate to severe lymphofollicular gastritis.
- Gastritis with lymphoid aggregates or follicles is typical
of Helicobacter-induced gastritis in both cats and people.
- Clinical signs of infection in cats may include chronic vomiting,
weight loss and possibly diarrhea, though infections are often
subclinical.
- Diagnosis of Helicobacter-induced disease in cats
can be challenging, since these organisms can be difficult to
isolate and culture, and other spiral bacteria (see below) may
colonize the stomachs of dogs and cats without causing disease.
Demonstration of histologic evidence of inflammatory changes
accompanied by spiral organisms in the mucosa may be the most
reasonable approach for diagnosis in cats.
- Feline isolates of H. pylori have been shown to be
genetically similar (99.7% sequence identity in 16S rRNA) to
human isolates.
Dogs?
Any possible role for dogs in the epidemiology of human H.
pylori infections is more tenuous. Dogs can be experimentally
infected, but there is limited evidence of GI pathology in dogs.
In addition, it appears that many, if not most, Helicobacter
spp. recovered from naturally infected dogs are species other
than H. pylori, e.g., H. bizzozeronii.
Humans to cats to humans transmission of H. pylori
as a reverse zoonosis?
Helicobacter pylori infections in animals may be an
example of a "reverse zoonosis." Epidemiologic
studies of the relationship between H. pylori infection
and animal contact are conflicting. In addition, although H.
pylori has been isolated at a high frequency from commercial
colony-raised research cats, the overall rate of colonization
of stray cats appears to be much lower than that of humans. Thus,
it is more likely that humans are the primary reservoir of the
organism. In this scenario, humans transmit the organism to cats,
but might cats have the potential for transmission back to humans?
Animal to human transmission of Helicobacter bizzozeronii
as a true zoonosis?
Spiral bacteria that are larger and more tightly coiled than
H. pylori, can be isolated very commonly from the stomachs
of cats, dogs and pigs. In addition, such an organism has been
isolated from 2 cats and their owner, who suffered from gastric
ulcers. The human and feline isolates were indistinguishable.
Recent phylogentic analyses suggest that Gastrospirillum hominis,
later named H. heilmannii (the names given to the human
isolate) and H. bizzozeronii (the name given to the animal
isolates) are highly related, and therefore, H. bizzozeronii
may be an example of a true zoonosis.
Helicobacters in other species
- Helicobacter pylori:
- Helicobacter pylori has been detected in tissues from
piglets with gastric ulcers, does not appear to be associated
with the development of gastric ulcers in equine foals.
- Helicobacter pylori has been isolated from sheep milk.
- Helicobacter mustelae:
- This Helicobacter causes hypergastrinemia in ferrets,
but is of no known zoonotic risk.
- Helicobacter acinomyx:
- This Helicobacter has been associated with gastritis
in cheetahs, but is of no known zoonotic risk.
- Intestinal Helicobacters
- In 1998, a novel Helicobacter was isolated from kittens
with severe diarrhea instead of gastric pathology, but nothing
is known yet about its infectivity for humans. Intestinal Helicobacter
spp. known to cause colitis in immunocompromised humans
have also been isolated from dogs, but any risk for direct transmission
from infected dogs or cats to humans remains to be determined.
- Helicobacter cinaedi can be part of the normal flora
of hamsters. Additionally, this Helicobacter has also
been isolated from a human neonate with septicemia and meningitis.
The child's mother had had contact with hamsters during her pregnancy.