title: An assessment of risk posed by a Campylobacter-positive puppy living in an Australian residential aged-care facility.
abstract: BACKGROUND
  In April and June 2012, two outbreaks of Campylobacter gastroenteritis were investigated in an Australian aged-care facility (ACF); a Campylobacter-positive puppy was identified as a potential source of infection.
  
  
  METHODS
  An expert panel was convened to assess transmission risk from the puppy to elderly residents and to guide further public health action. Criteria considered as part of the panel's assessment included the puppy's infectivity, the bacterium's transmissibility, puppy-resident contact, infection control and cleaning practices and animal management at the facility. A literature review was used to assist the panel, with a final risk being determined using a likelihood and consequence matrix.
  
  
  RESULTS
  The panel determined that the setting and low infective dose made transmission likely despite varying degrees of contact between the puppy and cases. While infection control practices were generally appropriate, the facility's animal policy did not adequately address potential zoonotic risk.
  
  
  CONCLUSIONS
  In summary, puppies should not be considered as companion animals in ACFs due to high rates of Campylobacter carriage and the underlying susceptibility of the elderly. Infection control and animal policies in ACFs should reflect an awareness of zoonotic disease potential.
authors.affiliation: OzFoodNet, Communicable Disease Control Section, Health Protection Service, ACT Government Health Directorate, Canberra, Australia .
authors.forename: Cameron
authors.initials: C
authors.lastname: Moffatt
authors.affiliation: Office of the Chief Health Officer, ACT Government Health Directorate, Canberra, Australia .
authors.forename: Ranil
authors.initials: R
authors.lastname: Appuhamy
authors.affiliation: Territory and Municipal Services Directorate, Canberra, Australia .
authors.forename: Will
authors.initials: W
authors.lastname: Andrew
authors.affiliation: Infection Control, Health Protection Service, ACT Government Health Directorate, Canberra, Australia .
authors.forename: Sandy
authors.initials: S
authors.lastname: Wynn
authors.affiliation: Infection Control, Community-based Services, ACT Health Directorate, Canberra, Australia .
authors.forename: Jan
authors.initials: J
authors.lastname: Roberts
authors.affiliation: Department of Microbiology and Infectious Diseases, Canberra Hospital and Health Services, Canberra, Australia .
authors.forename: Karina
authors.initials: K
authors.lastname: Kennedy
mesh_terms: D000368:Aged; D000818:Animals; D001315:Australia / Q000453:epidemiology; D002167:Campylobacter; D002169:Campylobacter Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control* / Q000635:transmission; D002353:Carrier State; D004196:Disease Outbreaks; D004285:Dogs / Q000382:microbiology*; D005759:Gastroenteritis / Q000209:etiology / Q000382:microbiology; D006707:Homes for the Aged; D006801:Humans; D017053:Infection Control; D057805:Pets / Q000382:microbiology*; D012306:Risk; D012866:Skilled Nursing Facilities; D015047:Zoonoses / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*