- An article in an upcoming edition of Transplant
Infectious Disease (>Gisel et al) describes a case of Bordetella
bronchiseptica pneumonia in a person who had received a kidney and
pancreas transplant. This person had to board her dogs at a veterinary
clinic while she was hospitalized for a bowel obstruction that occurred
after surgery. The clinic required her dogs to be vaccinated against Bordetella
bronchiseptica, a cause of canine "kennel cough." They were vaccinated
intranasally (i.e. up the nose) with a modified live vaccine comprised
of live B. bronchiseptica that is modified so it is unlikely
to cause disease but can still induce a good immune response.
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- The owner developed pneumonia after returning home and B.
bronchiseptica was isolated. Specific testing was not performed to
confirm that the vaccine strain caused disease, so it's possible that she
was infected by the normal (i.e. "wild type") B. bronchiseptica (which
still would have presumably come from the dogs). Immunosuppressed individuals
are at high risk for infection by microorganisms that usually don't cause
disease in otherwise healthy people. Bordetella bronchisepticais a
good example of this. Care should be taken around pets by anyone whose
immune system is compromised.
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- Here are some recommendations pertaining to kennel cough
vaccination:
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- Immunosuppressed individuals should not receive modified
live vaccines themselves, and it is probably prudent to extend this recommendation
to avoid modified live vaccination of their pets with vaccines like the Bordetella (kennel
cough) vaccine.
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- If vaccination for kennel cough is required for entering
a kennel or vet clinic, an exemption should be sought because of the potential
risk to the immunocompromised person.
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- If vaccination must be performed, injectable vaccination
is preferred. It doesn't produce as good immunity in the dog compared with
intranasal vaccination but the risks to the immunocompromised owner would
be much less.
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- If intranasal vaccination with modified live kennel cough
vaccine is used, immunocompromised owners should not be in the same room
during vaccination. They should avoid contact with the dog's mouth, nose
and face for at least a few days after vaccination and should wash their
hands (or use a hand sanitizer) regularly after contact with the dog.
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- If respiratory disease develops in someone exposed to
a dog recently vaccinated against kennel cough, the potential for vaccine-associated
disease should be mentioned to the physician.
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- Patricia A. Doyle DVM, PhD Bus Admin, Tropical Agricultural
Economics Univ of West Indies Please visit my "Emerging Diseases"
message board at: http://www.emergingdisease.org/phpbb/index.php Also
my new website: http://drpdoyle.tripod.com/ Zhan le Devlesa tai
sastimasa Go with God and in Good Health
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