Zoonotic Parasites of Selected
Exotic Animals
Cathy A. Johnson-Delaney, D VM
Parasitic zoonoses of ferrets, rabbits, rodents, reptiles,
pet birds, and nonhuman primates are reviewed. In-
cluded in discussion are ectoparasites, Dirofilaria, Toxo-
cara, Cryptosporidium, Giardia, Balantidium, Entamoeba
histolytica, Hymenolepis, pentastomids, and helminths
including those that cause sparganosis. Arthropod vec-
tors found on reptiles which may transmit zoonotic
disease are listed. Diagnostic tests and treatment regi-
mens are covered.
Copyright 9 1996 by W. B. Saunders Company.
Key words: Zoonoses, parasites, ferrets, rabbits, ro-
dents, reptiles, birds, nonhuman primates, arthropods,
helminths, protozoa.
XOtic animal practitioners must be familiar
th parasitic zoonoses and educate theircli-
ents regarding the i m p o r t a n c e of prevention.
Diagnostic tests and treatments are available for
most of the parasitic zoonoses, and practitioners
should make client education materials available
to owners and potential owners. Physicians are
less familiar with zoonoses of ferrets, rabbits,
rodents, reptiles, birds, and n o n h u m a n primates
than they are with zoonoses f r o m the m o r e
traditional c o m p a n i o n animals, namely, dogs
and cats, and are not familiar with veterinary
technology, diagnostics, and treatments that mini-
mize the risks of zoonoses f r o m pets. 1 Physicians
rarely seek consultation with their patients' veteri-
narians a b o u t potential or diagnosed problems
and may not even make the connection that the
p r o b l e m is a zoonosis. Veterinarians prefer to
educate the exotic pet client in responsible pet
care and prevention of zoonoses as well as
educate physicians regarding alternatives to the
removal of the pet f r o m the h o m e . A teamwork
a p p r o a c h to a zoonotic disease case by the
veterinarian, the physician, and the o w n e r /
patient will provide the best living a r r a n g e m e n t
for the pet-owning household.
Although it is d o c u m e n t e d that exotic pets
may potentially carry m a n y zoonotic parasites
that u n d e r the right circumstances may cause
infections in humans, very few actual transmis-
sions have b e e n d o c u m e n t e d . Veterinarians must
Seminars in Avian and Exotic Pet Medicine, Vol 5, No 2 (April), 1996: pp 115-124
work with potentials of transmission, particularly
in light of the consequences of the animal being
in contact with i m m u n o s u p p r e s s e d individuals.
H u m a n s that are particularly at risk to zoonoses
include i m m u n o s u p p r e s s e d or i m m u n o c o m p r o -
mised individuals: infants, children u n d e r the
age o f 10, the elderly, and those with chronic
disease that may c o m p r o m i s e the i m m u n e sys-
tem. Patients on immunosuppressive therapy
also are at greater risk. Recovery of a parasite
f r o m an animal does not necessarily m e a n that
the parasite will be passed to the h u m a n and
cause disease. To evaluate the risk potential, the
veterinarian m u s t identify the parasite, the
a m o u n t and type of contact the owner has with
the pet (ie, holding the animal v just cleaning its
caging), sources of infection or reinfection (ie,
food and water sources), sanitation measures,
housing, h u s b a n d r y practices, original source of
the animal (eg, wild-caught, domestically bred,
exposure to other animals), and e x p o s u r e to
sources of infection during transport a n d / o r
sale (eg, shipping conditions, pet store housing
and handling).
Ferrets
Zoonotic ectoparasites of pet ferrets include
fleas (Cten0phalides sp), Ear Mites (Otodectes cyano-
tis), and the Scabies Mange Mite (Sarcoptes sca-
bei). 2-4
Fleas f r o m the infested pet as well as those in
the e n v i r o n m e n t will feed on humans. In environ-
ments where the anilfial has been r e m o v e d or
topically protected, fleas may be m o r e likely to
feed on humans. Fleas may also carry the interme-
diate stage o f the D o g / C a t T a p e w o r m (Dipy-
From the Regional Primate Research Cent~ University qf
Washington, Seattle, WA; and the Exotic Pet & Bird Clinic,
Kirkland, WA.
Address reprint requests to Cathy A. Johnson-Delaney, D V214,PO
Box 2271, Lynnwood, WA 98036-2271.
Copyright 9 1996 by W. B. Saunders Company.
1055-93 7X/96/0502-000855.00/0
1 15
116 Cathy A. Johnson~Delaney
lidium caninum). Although h u m a n s do not serve
as hosts for b r e e d i n g in the life cycle of the flea,
the bites to h u m a n s can cause pruritus, p a p u l a r
urticaria, and in h u m a n s hypersensitive to the
flea saliva, large bullae. Self-trauma f r o m the
pruritus may lead to secondary dermatitis. In
humans, the p r e d o m i n a n t site for flea bites are
on the legs a n d feet, although bites are fre-
quently f o u n d o n the neck and shoulder areas if
the ferret is carried d r a p e d a r o u n d the owner's
neck or p e r c h e d in the shoulder. Diagnosis of
fleas on the ferret includes visualization of fleas
or of flea feces in the coat or on the examination
table after b r u s h i n g or r u b b i n g the ferret. T h e
ferret may or may not be showing signs of
pruritis, scaly skin, alopecia, or dermatitis depend-
ing on the load a n d degree of hypersensitivity.
Control of fleas on the ferret is the same as it is
for dogs or cats, with emphasis on environmental
treatment. To be effective, simultaneous control
of fleas on other m a m m a l i a n pets in the house-
hold must be u n d e r t a k e n , as well as eradication
measures for the premises. Chemicals designed
for residual effects in the environment, particu-
larly those of microencapsulated formulas or
insect growth retardants, are p r e f e r r e d for envi-
r o n m e n t a l control. T r e a t m e n t of the ferret is by
flea shampoos, dips, powders, or sprays contain-
ing pyrethrins or synthetics. Products considered
safe for kittens a n d cats are considered safe for
ferrets, although these products have not b e e n
through toxicological evaluation and the label-
ing process for ferrets. T h e author has f o u n d
that shampoos, dips, and flea powders and sprays
r e c o m m e n d e d for kittens and cats work well on
ferrets provided the label directions are followed
and has not observed toxic effects with these
products in ferrets. T h e author prefers to apply
sprays by spraying a soft brush or cloth and
brushing or r u b b i n g the ferret to distribute the
chemical, particularly a r o u n d the face and ears.
Powders can be sprinkled on the ferret, then
b r u s h e d or r u b b e d with a cloth, to distribute the
powder and remove the excess. A small a m o u n t
on a soft t o o t h b r u s h or cloth can be worked into
the fur on the face. Flea collars can be used, but
with caution, because the ferret may chew the
collar and ingest the i m p r e g n a t e d chemical, and
because collars do not seem as effective in
controlling fleas on the pet as the whole body
treatment d o n e with bathing, spraying, or pow-
dering.
T h e Ear Mite infesting ferrets can be transmit-
ted to humans, although direct transmission of
the mites is necessary, and the infection may only
be transient. O n e scenario for transmission could
include accidental p l a c e m e n t of some o f the
infested ferret ear wax a n d debris, lodged u n d e r
an owner's fingernails after swabbing, cleaning,
or manipulating the ferret's ears, into the own-
er's ear canal. Affected ferrets may or may not
show typical signs Of otitis externa as seen in dogs
or cats, including scratching of the ears or
shaking of the head. 4 0 t o s c o p i c examination of
the inner p i n n a and ear canal shows waxy brown-
ish-black sebum with mites and eggs. T r e a t m e n t
of the ferret is similar to treatment of dogs or
cats. Ivermectin may be administered systemi-
cally at 0.2 to 0.4 m g / k g by subcutaneous injec-
tion or the dosage may be divided and applied
topically in each ear canal after an initial removal
of wax and debris. It is r e c o m m e n d e d that the
ferret be b a t h e d within 24 hours and a r e p e a t
t r e a t m e n t be p e r f o r m e d 2 to 3 weeks later.
Pyrethrin-based or thiabendazole otic formula-
tions have also b e e n used for the control o f Ear
Mites. These preparations are applied topically
in each ear daily for 1 to 2 weeks after initial
removal of wax a n d debris and used in combina-
tion with a flea powder or spray applied to the
whole body on a weekly basis. 4
T h e Scabies Mange Mite causes primary podo-
dermatitis or intensely pruritic, focal, or general-
ized alopecia and dermatitis in the ferret. 24
Pododermatitis is associated with severe swelling
and scabbing of the toes and feetP If left un-
treated, the ferret may lose its claws. 4 Definitive
diagnosis can be m a d e by microscopic examina-
tion of skin scrapings and viewing the mites,
larvae, and eggs. T r e a t m e n t of the affected digits
includes removing the diseased portions o f the
claws and debriding any scabbed lesions after
soaking in warm water. Mites may be eliminated
by application of sulfa ointment, lime and sulfa
dips and washes (containing 30% to 32% cal-
cium polysulfide), 0.5% carbaryl pet s h a m p o o s
(weekly treatments for three treatments), iver-
mectin, or o r g a n o p h o s p h a t e topical insecticides
(flea/tick products, labeled for cats).~,40rgano-
phosphates, carbamates, and ivermectin should
be used with caution because toxicity in ferrets
has not b e e n determined. 4 Environmental sanita-
tion, with destruction of the bedding a n d re-
moval of porous toys, t h o r o u g h cleaning o f the
 Zoonotic Parasites of Exotic Animals
cage and any sleeping spots, as well as environ-
mental insecticidal treatment are necessary. Prod-
ucts designed for flea and tick control in the
h o m e are usually adequate. O t h e r m a m m a l i a n
pets in the household should be examined and
treated as well.
Scabies in h u m a n s is manifested by pruritus of
areas of skin that h a d contact with the affected
animal. In hypersensitive individuals, the rash
may be described as papular urticaria, with a
range of vesicles, papules, wheals, and burrows.
The skin frequently becomes encrusted and
excoriated as the disease progresses and is exac-
erbated by self-trauma f r o m scratching. 2,3
Ferrets may be infected with some of the
helminths c o m m o n l y f o u n d in dogs and cats,
which are also potentially zoonotic. T h e ferret
appears to serve as a definitive carnivore host
with the same potential for transmission to hu-
mans as o t h e r domestic animals. T h e Feline
R o u n d w o r m (Toxocara cati) can cause visceral
larva migrans or ocular larva migrans f r o m
ingestion of eggs shed in f e c e s . 5-7 T h e Canine
H o o k w o r m (Ancylostoma caninum) can cause cuta-
neous larva migrans after penetration of the skin
by infective larvae that are shed in feces. 4,8Young
ferrets affected by the parasites often have dull
hair coats, p o t bellies, weight loss, and diarrhea.
Diagnosis is by standard fecal flotation or by
direct smear. T r e a t m e n t is based on medications
developed for use in dogs and cats and appears
to be effective in ferrets. Although there are
m a n y reports of h u m a n s with either visceral,
ocular, or cutaneous larva migrans f r o m dog or
cat origin, there are no d o c u m e n t e d reports of
transmission f r o m ferrets. 5 H u m a n cases are
primarily r e p o r t e d in children, who have close
exposure to a pet d o g or cat, a history of eating
dirt, or close association with dirt in playfields
and yards that may be c o n t a m i n a t e d with dog or
cat feces. Precautions for ferret owners to pre-
vent exposure include sanitary disposal of fecal
material, the washing of hands after handling
the ferret or the ferret's litter box, and not
allowing the ferret to lick h u m a n faces or hands.
Educational materials available for dog and cat
owners are suitable for ferret owners for the
helminthic parasites. The D o g / C a t Tapeworm
occasionally infects humans, particularly in-
fants. 9 Transmission is by ingestion o f a flea
carrying the t a p e w o r m eggs, or by ingestion of
shed segments. In humans, the symptoms are
117
often nonspecific and may include diarrhea and
pruritus ani. Motile, seedlike segments (proglot-
tids) may be noticed in the stool. Cestodicidal
medications developed for cats and dogs a p p e a r
to be effective in ferrets as well, but control of
flea infestation is critical to preventing r e c u r r e n t
infections.
Ferrets can be infected with the heartworm,
Dirofilaria immitis, a filarial n e m a t o d e . 4,1~ The
microfilaria may be transmitted to h u m a n s
through the bites of infected mosquitoes. Hu-
mans are accidental hosts, and d e v e l o p m e n t of
the filarid is arrested, usually without microfilaria-
sis. An infection may result in intravascular and
p u l m o n a r y dirofilariases, with usually only one
or two adult worms located in the c h a m b e r s of
the heart, associated great vessels, or lung where
the w o r m impacts, producting a solitary nodule.
Secondary granulomatous and fibrotic reactions
occur when antigen from the degnerating w o r m
diffuses into the surrounding tissues. 8,]o T h e r e
have b e e n no h u m a n cases traced to infection in
ferrets at this time.
Although most ferrets are housed primarily
indoors, in endemic heartworm areas as desig-
nated for dogs and cats, it is r e c o m m e n d e d that
ferrets u n d e r g o prophylactic antihelmintics. It is
also r e c o m m e n d e d that ferrets be k e p t indoors
during mosquito season. Ferrets infected with
the h e a r t w o r m generally present clinically with a
history of exercise intolerance, anorexia, loss of
condition, coughing, dyspnea, variable dehydra-
tion, lethargy, and pale mucous m e m b r a n e s .
Radiographically an enlarged heart m a y be de-
tected, along with other signs of cardiac disease
or failure including p u l m o n a r y congestion, pro-
tracted cough, pleural effusion, a n d / o r ascites.
Death usually occurs caused by occlusion of
major vessels by the adult parasite, with compli-
cating features of congestion, hypoxia, and pul-
m o n a r y edema. Microfilaremia is n o t a consis-
tant f n d i n g in ferrets, and diagnostic tests
developed for use in dogs have not proved
reliable for use in ferrets. Diagnosis is often
m a d e on the basis o f cardiac signs, geography,
and lack of prophylactic therapy. Adulticide
t r e a t m e n t has b e e n a t t e m p t e d using cat proto-
cols.4,11,12
Cryptosporidia are protozoan parasites in the
genus Cryptosporidium, s u b - o r d e r Eimerio-
rina. 3,6,13,14Although taxonomic and further iden-
tification of organisms isolated from h u m a n a n d
118 Cathy A. Johnson-Delaney
animal outbreaks are continuing to be classified,
it now appears that most m a m m a l i a n outbreaks
are caused by C parvum or C muris.13-15 Docu-
m e n t e d infections with Cryptosporidium are listed
in Table 1. Epidemiologic evidence at this time
indicates that the Cryptosporidia of reptiles are
infective only to reptiles, those of birds infective
for birds, and the m a m m a l i a n species apparently
are infective only to mammals. 6,16,17 Infections in
i m m u n o c o m p e t e n t h u m a n s may be a s y m m p t o m -
atic or associated with a self-limiting diarrhea;
however, in i m m u n o s u p p r e s s e d individuals, the
diarrhea may be severe, persistent, and life-
threating as there are currently no effective
c h e m o t h e r a p e u t i c means to eliminate the para-
site. Transmission has b e e n r e p o r t e d person-to
person, zoonotic, or cross-species via contami-
nated water sources. 15
Cryptosporidiosis has been diagnosed in fer-
rets. 3,1s,19 A well-documented prevalence study
involving ferrets arriving at a research facility
over a 6-month p e r i o d showed that 66% of the
ferrets had cryptosporidial oocysts in at least 1
out of 3 fecal specimens. 3,18 Infection in these
ferrets was without clinical signs; however, micro-
scopic examination showed mild intestinal vil-
lous atrophy a n d eosinophilic infiltrate o f the
lamina propria o f the small intestine. Organisms
were not seen in the crypts, colon, or gastric
mucosa. T h e ileum was the most heavily infected
site. Pancreatic duct infection was observed in
one dexamethsaone-treated ferret. Diagnosis is
made by identification of 4- to 6-txm oocysts in
feces. Transmission of cryptosporidia in ferrets
involves ingestion of oocysts f r o m feces, the
environment, water, or raw m e a t products. Cryp-
tosporidial cysts are resistant to most disinfec-
tants. Formalized saline solution or 5% to 10%
a m m o n i a are c o n s i d e r e d effective disinifec-
tants. 3 T h e cysts are highly resistant to chlorina-
tion a n d require exposure to 80 m g / L chlorine
for 2 hours at 25~ for inactivation, c o m p a r e d
with the 2 to 10 m g / L used in animal facilities to
control microbial agents and 0.5 to 1.0 m g / L
chlorine in public water systems. 15 Cysts are also
unaffected by ultraviolet water treatment. Abso-
lute filtration to 1 ~ m and reverse osmosis are
effective. T r e a t m e n t of infected animals has so
far b e e n ineffective. P r o p e r caging, hygiene, and
the use of commercially available ferret foods,
along with the restriciton of children and i m m u -
n o c o m p r o m i s e d adults f r o m contact with fer-
rets, decreases the risk of zoonotic infection, is
Rabbits
T h e Fur Mite (Cheyletiella parasitovorax) of
rabbits is a significant zoonotic ectoparasite (Figs
1 a n d 2). It is a n o n b u r r o w i n g species of mite,
and infection may be asymptomatic particularly
in adult rabbits, dogs, and cats but m a y be
m a r k e d by the presence o f scurf, alopecia, with
or without pruritus. 9~ In humans, the p r i m a r y
lesion is described as a small erythematous pap-
ule s u r m o u n t e d by a fragile vesicle. The lesions
are usually pruritic. T h e lesions in h u m a n s are
self-limiting, once the source of infestation is
eliminated. 1,~,2~Diagnosis of the parasite in rab-
bits can be c o n f i r m e d with skin scrapings taken
f r o m the edges o f the affected areas. T r e a t m e n t
of the rabbit and its e n v i r o n m e n t with carbaryl
or p e r m e t h r i n / p y r e t h r i n - b a s e d ectoparasiticides
such as those used for flea/tick control in the cat
are effective. 21
In addition to Cryptosporidium, rabbits may
also be infected with Giardia, a n o t h e r i m p o r t a n t
flagellate p r o t o z o a with zoonotic potential. As
with Cryptosporidium, identification of species of
Giardia, taxonomy, and host specificity are still
being investigated. 6,13,2~-24 G duodenalis has b e e n
r e p o r t e d as the Giardia isolated from rabbits and
rodents (Table 2). Giardia infect primarily the
small intestine, which may a p p e a r distended with
yellow to white watery contents, although organ-
isms may also be located in the crypts and villus
of the colon. 23 Histologically, there may be a
reduction in the c r y p t / c o l o n villus ratio associ-
ated with an increase in infiltrating lyrnphocytes
and plasma cells. 23 In m a n y cases, infections will
be subclinical unless other disease or stress
factors are present. T r e a t m e n t in rabbits and
rodents is with dimetridazole (not currently
available in the United States) or metronidazote.
Transmission is t h r o u g h direct fecal to oral
routes or, m o r e commonly, through contami-
nated water. Water-borne transmission m o s t of-
ten occurs because of ineffective filtration or
inadequate p r e t r e a t m e n t of surface water by
municipal utilities. Filtration is necessary to re-
move Giardia f r o m water as chlorination alone is
insufficient without p r o l o n g e d contact times and
high concentrations. 6,7,22
 Zoonotic Parasites of Exotic Animals 119

Table 1. Cryptosporidium Infections In Animals la,aS,16,23,zs

Parasite Host
Cryptosporidium sp Fishes
Naso Tang (Naso lituratus)
Carp (Cypnnus ca~t~io)
C serpentis Reptiles
Red-Bellied Black Snake (Pseudechisporphyriacus)
Corn Snake (Elapheguttata)
Trans-Pacos Ratsnake (Elaphe subocularis)
Madagascar Boa ( Sansinia madagasca~easis)
Timber Rattlesnake (Cr0talus horridus)
C baileyi, C melea g~idis Birds
Chicken (Callus gaUus)
Jungle Fowl (Gallus sonner-
atiz)
Turkey (Meleagrisgallopavo)
Bobwhite Quail (C01inus virginianus)
Peafowl (Pavo cristatus)
Domestic Goose (Anser a,nse0
Domestic Duck (Anas platyrhynchos)
Black-Throated Finch (Poephila cincta)
Red-Lored Parrot (A mazona autumnalis)
Budgerigar (Melopsittacus undulatus)
Cockatiel (Nymphicus hollandicus)
Lovebird (Agapornis sp)
C parvum, C mu,ris; C wraire Mammals
Macaques (Macaca mulatta, M radiata, M fascicularis, M nemestrina)
Marmoset (Callithrixjacchus)
Calf (Bos taurus)
Lamb ( Ovis roles)
Goat (Capra hircus)
Horse (Equus caballus)
Swine (Sus scrofa)
Roe Deer (Capre0lus capreolus)
Red Deer ( Cervus elaphus)
White Tail Deer (Odocoileusvirginianas)
Exotic Ungulates (14 species)
Fox Squirrel (Sciurus niger)
Gray Squirrel (Sciurus carolinensis)
Flying Squirrel (Glauc0mys volan)
13-Lined Ground Squirrel (Spermophilus tridecemlineatus)
Pocket Gopher (Ge0mysbursa~ius)
Chipmunk (Tamias striatus)
Beaver (Castor canadensis)
Muskrat (Ondatra zibethicus)
Woodchuck (Marmota monax)
Domestic Mouse (Mus musculus)
Guinea pig (Cavia pocellus)
Hamster (Mesocvicetus auratus)
Domestic rabbit (Oryct01aguscuniculus)
Cottontail rabbit (Sylvilagusflayidanus)
Domestic dog (Canisfamiliaris)
Coyote (Canis latrans)
Red Fox ( Vulpes vulpes)
Grey Fox (Orocy0n cinereoargenteus)
Domestic cat (Felis catus)
Domestic ferret (Mustelaputoriusfuro)
Striped Skunk (Mephitis mephitis)
Racoon (Procyon lotor)
Black Bear ( Ursus americanus)
Opossum (Didelphis virginianas)
Human (Homo sapiens)
120 Cathy A. Johnson-Delaney
Figure 1. Alopecia in a rabbit infested with the Fur
Mite (Cheyletiella parasitovorax). Lesions may also in-
clude scurf and scabs, with or without pruritus. Diagno-
sis can be confirmed by microscopic examination of
skin scrapings taken from the edges of the affected
areas. (Reprinted with permission. 39)
Rodents
In addition to the protozoan parasites Crypto-
sporidium and Giardia, Balantidium coli has b e e n
f o u n d in direct smears of r o d e n t feces, particu-
larly of guinea pigs, but the pathogenic signifi-
cance is not conclusive. Balantidium coliis primar-
ily considered a c o m m e n s a l organism of the
cecum a n d / o r colon, but it has b e e n linked with
diarrhea and ulcerative colitis in several species
of n o n h u m a n primates, z~,26
Rodents, particularly hamsters, may also carry
Figm'e 2. Microscopic photograph of the rabbit Fur
Mite (Cheyletiellaparasit0v0rax).(Reprinted with permis-
sion. 39)
Table 2. Giardia Species Specificity as Reported in
the Literature 23,34,35
GiardiaSpecies Host
G mur/~ Mice, rats, hamsters
G duo&nalis (synonym G Rats, guinea pigs, rabbits,
lamblia, G intestinalis, G dogs, cats, humans, non-
caT)iae) human primates, beaver
G duodenalisrace psittad Birds (budgerigars, cocka-
tiels)
G ag///s (amphibia) Various (parasite is water-
borne)
the Dwarf T a p e w o r m (Hymenolepis nana), which
is pathogenic for h u m a n s and can cause enteric
disease. 21,27 This t a p e w o r m has three cycle varia-
tions. In the direct cycle, ova are passed in the
feces from one definitive host and are directly
ingested by another. Autoinfection may occur
with the host ingesting ova passed in its own
stool. T h e r e is tissue migration, with the ova
maturing in the intestinal l u m e n of the host. In
the indirect life cycle, there is no tissue migra-
tion: The ova are passed in the feces f r o m a
definitive host t h r o u g h beetles, cockroaches, or
fleas to a n o t h e r definitive host. The insects are
then ingested. T h e infected rodents m a y be
asymptomatic or infection may cause a catarrhal
enteritis, emaciation, and, indirectly, abscessa-
tion of mesenteric lymph nodes. Adult tape-
worms are f o u n d in the small intestine and
occasionally in the pancreatic and biliary ducts.
Intestinal obstruction and impaction in heavy
infections can occur. T r e a t m e n t of tapeworms in
rodents is with praziquantel. 27
Rodents can be infested with Scabies Mange
Mites (Sarcoptes sp), which are transmissible to
humans. Diagnosis and control is similar to that
outlined for ferrets.
Birds
As discussed previously, m a n y avian species
may be infected by Cryptosporidium and Giardia,
although transmission o f these organisms f r o m
infected birds to h u m a n s has not b e e n docu-
mented. Ratites have b e e n d o c u m e n t e d with B
coli, but zoonotic potential has not been p r o v e n 2 4
Caryospora is a coccidian that infects the intes-
tinal tract of birds. Nine species have b e e n
described f r o m birds2 s Although oocysts are
p r o d u c e d in enterocytes of birds and carnivo-
 Zoonotic Parasites of Exotic Animals
rous reptiles, rodents may serve as intermediate
hosts after ingesting the sporulated oocysts. Dogs
and pigs may be infected by ingesting secondary
hosts bearing caryocysts. T h e sporozoites de-
velop in the connective tissue and dermis of the
rodent, dog, pig, and human, resulting in a
pyogranulomatous dermatitis. H u m a n s are acci-
dental hosts, most likely b e c o m i n g infected by
ingesting oocysts passed in the feces o f other
animals. 2s
Birds may also carry Entamoeba histolytica and E
pole&i, which cause amebic dysentery in h u m a n s
and other animals. Amebiasis may be asymptom-
atic or progress to dysentery, fever, chills, and
diarrhea. Birds originating f r o m endemic areas
may be asymptomatic, yet shed the organism in
their droppings. Diagnosis is m a d e by trichrome
stains of fresh feces submitted in polyvinyl alco-
hol. T r e a t m e n t with metronidazole is recom-
m e n d e d . 29
Reptiles
Although large n u m b e r s of protozoal organ-
isms are f o u n d in reptiles, most are e c t o t h e r m
specific. T h e r e are m a n y varieties that are not
associated with known disease in the reptile, and
their significance as zoonotic pathogens is also
unknown. Many are opportunistic pathogens of
the reptile and can be classified as opportunistic
zoonotic pathogens to susceptible humans, with
infants, the elderly, the i m m u n o c o m p r o m i s e d ,
or the debilitated being most at risk. ~7
Pentastomiasis (Armilliferiasis)
T h e pentastomes are currently classified in a
separate phylum, Pentastomida, because they
exhibit characteristics of both the phylum Ar-
t h r o p o d a and Annelida. 3~ Nine genera have
been identified in snakes, three in lizards, four in
crocodiles, a n d two in turtles. A variety o f herbivo-
rous vertebrates may serve as intermediate hosts
including rodents and artiodactylids; carnivores,
n o n h u m a n primates, and h u m a n s may serve as
incidental hosts. H u m a n s contract the infection
by c o n s u m i n g water or foods c o n t a m i n a t e d with
eggs eliminated in the saliva or feces of snakes by
consuming raw or u n d e r c o o k e d snake meat, or
by handling infected reptiles and then placing
c o n t a m i n a t e d hands in the mouth. 32 In inciden-
121
tal hosts such as humans, dogs, or cats, pentas-
tomes may cause minimal to m o d e r a t e inflamma-
tory responses. T h e larvae are eventually
s u r r o u n d e d by scar tissue with a m i n i m u m m o n o -
nuclear infiltrate. Despite this, the p e n t a s t o m e s
can excyst and migrate. It is believed that the
majority of larvae die and calcify within 2 years of
infection? ~ Usually the incidental host is asymp-
tomatic and larvae or migrating n y m p h s are
f o u n d at necropsy, or calcified cysts are f o u n d
radiographically. An exception is a r e p o r t of a
clinically symptomatic case of pentastomiasis in a
cystic ovary and fallopian tube. 33 At present,
there is no successful therapy against the larval
forms in the incidental hosts, although surgical
removal of free or encysted larvae has b e e n
tried. 3~ Diagnosis of pentastomid infection in
reptiles is by examination of at least two succes-
sive fecal specimens. T r e a t m e n t of infected rep-
tiles may be attempted, but anthelminthic drugs
may not be effective because of the extraintesti-
hal location of the adult parasites. 17 Some sug-
gest euthanasia should be an option because of
zoonotic potential. Intracoelomic levamisole hy-
drochloride has b e e n tried in snakes, along with
supportive care. P r o m p t removal of feces f r o m a
reptile's habitat should be stressed. Owners
should be instructed to wear gloves when dispos-
ing of reptile feces, and disposal o f the feces
should be down the toilet rather than in the
garbage. R o d e n t prey should not be allowed
contact with reptile feces.
Reptiles may act as the second intermediate
hosts for cestodes in the genera Spirometra and
DiphyUobothrium. Spirometra mansoni, S mansonoi-
des, S erinaceieuropaei (D erinacei), S theileri, a n d S
proliferum have b e e n associated with sparganosis
in humans, an infection with the second stage
larvae called the s p a r g a n u m or plerocercoid. 17
Definitive hosts include mainly domestic and
wild canids and felids. 'Amphibians and reptiles
b e c o m e infected after ingesting the first interme-
diate host, a c o p e p o d (Cycl0ps sp) f o u n d in water
environments worldwide, or by ingesting other
animals that h a r b o r the second stage larvae.
H u m a n s are an accidental host and do n o t play a
role in the life cycle of the parasite. They are
usually infected through ingestion of raw or
u n d e r c o o k e d infected amphibian, reptile, bird,
or wild m a m m a l m e a t or through direct contact
with infected a m p h i b i a n m e a t used as a poultice
122 Cathy A. Johnson-Delaney

Table 3. Reptilian Arthropods of Zoonofic Significance 17,32,34,36

Stage of Geographic Disease in
Parasite Parasite Distribution Host Humans
Mosquitos (Aedes, Adult (res- Western hemi- Various Western equine encephalitis
Culex) ervoir) sphere
Relapsing Fever Adult US, Mexico Box Turtle (Terrapenespp), Relapsing fever, borreliosis,
Tick (Ornith0dor0s Gopher Tortoise spirochetosis; Leptospira
tuTicat~) ( Gopheruspotyphemus), pomona
rattlesnakes (Crotalus
spp)
Haemaphysalispunc- Immature Europe, north- Lizards, European Viper Siberian Tick typhus (R/ckett-
tata western Africa, ( Vipera berua) sia siberica/Dermacentrox-
southwestern enus s~encus)
Asia
Haemaphysalis con- Immature Europe, northern Various Russian spring-summer
cinna Asia encephalitis; Siberian
Tick typhus
California Black- Immature North America Garter Snakes ( Thamn@his Irritation/trauma from bite,
Legged Tick (Pacific Coast) spp), lizards (Sceloporus transmit tularemia (Fran-
(Ixodespacificus) spp) cisella tularensis); Lyme
disease (Barrelia burgdor-
f~)
Ixodes ricinus hmnature Europe Lizards Irritation, paralysis from
bite, transmit European
tick-borne encephalitis,
Lyme disease, Bouton-
neuse fever (R conorii/D
c0n0rh)
Common Chigger Larvae North America Box Turtles (Terrapenespp), Dermatitis
(Eutrombicula racers (Masticaphisspp),
alfreddugesi; Trom- Hog-nose Snakes (Heter-
bicula irritans) od0n spp), Kingsnakes
(Lampmpdtis spp), Garter
Snakes (Thamnaphis spp),
various lizards
Eutrombic'utasplen- Larvae Southeastern US Various snakes, lizards Dermatitis
dens
Common Harvest Larvae Europe Various snakes, lizards Dermatitis
Mite (Neotrom-
bicula autumnalis)
Snake Mite (Ophi- Adult Worldwide Various snakes, lizards Dermatitis
onyssus natncis)

for antiphlogistic effects in s o m e southeast Asian
cultures. 32 H u m a n s also can be infected by drink-
ing water c o n t a i n i n g infected copepods. Risk o f
a c q u i r i n g sparganosis f r o m captive a n d p e t rep-
tiles is low, as life cycle a n d e n v i r o n m e n t a l
conditions n e e d e d are n o t m e t in m o s t captive
habitats along with the fact that pets are n o t
g o i n g to be used as a f o o d source.
Mesocestoidiasis is a rare infection in h u m a n s
caused by Mesocestoides lineatus or M variabilis.
T h e definitive hosts are dogs, cats, a n d several
species o f wild carnivores. M a n y vertebrates act
as intermediate hosts, including reptiles, a m p h i b -
ians, birds, a n d m a m m a l s . H u m a n s can be in-
fected t h r o u g h the ingestion o f raw m e a t o f the
i n t e r m e d i a t e host. However, as pet a n d captive
reptiles are n o t used as f o o d sources, mesocestoi-
diasis is n o t c o n s i d e r e d a z o o n o t i c risk. 17,3~
Ophionyssus nat'ricis, the dermanyssid mite o f
snakes and occasionally lizards, may be transmit-
ted to h u m a n s a n d cause a pruritic, p a p u l a r
dermatitis with s o m e vesicular a n d / o r bullous
lesions. 34 Direct identification o f the mites f r o m
the skin o f the reptile as well as the h u m a n s will
c o n f i r m the infestation. T r e a t m e n t o f the snake,
its cage, a n d e n v i r o n m e n t with p y r e t h r u m pow-
d e r is effective. 34
Most a r t h r o p o d s affecting reptiles d o n o t
 Zoonotic Parasites of Exotic Animals 123

Table 4. Selected N o n h u m a n Primate Parasites of Zoonotic Significance 25,37,38

Parasite Primate Host~ Disease in Humans Treatment (Primates)

Balantidium coli All Diarrhea, dysentery Metronidazole, doxycycline
Cryptosparidium sp Macaques, callitrichids Diarrhea None, supportive care
Entamoeba histolytica All Gut ulceration, hepatic Metronidazole, paromo-
abscesses, diarrhea mycin
Giardia duodenalis All Diarrhea Metronidazole
Plasmodium sp All Malaria Chloroquine, primaquine
Need mosquito vector
Tox@lasma gondii Natural infection in New Anorexia, neurological Sulfadiazine, pyrimeth-
World Primates disease, etc amine, clindamycin
Tnchomonas sp All Pathogenicity unknown Metronidazole
Trypanosoma cruzi Calliu-ichids, cebids Chagas disease Control of insect vector
Needs insect vector
Pinworms (Enterobius v e r - Chimpanzees, humans, Perianal pruritus, irrit- Pyrantel pamoate
micularis) caUitrichids, cebids ability, enteritis
H u m a n Hookworm (Necator Cebids, humans Diarrhea, debilitation, Thiabendazole, mebenda-
amedcanus) cachexia zole, levamisol, iver-
mectin
Nodular worms (Oesophagos- Old World Primates Diarrhea, enteritis, Thiabendazole
tomumspp) adhesions
Dwarf Tapeworm (Hymenol- All Cestodiasis Praziquantel
epis nana)
Pediculus sp Various Dermatitis Pyrethrin ectoparasiticides
Pediculus humanus capitis Humans transmit to non- Head lice Pyrethrin ectoparasiticides
human primates
Sarcoptic mange (Sarceptes All Pruritus, dermatitis Pyrethrin ectoparasiticides
scabez)

pose a direct zoonotic threat. However, they may
b e i m p o r t a n t as v e c t o r s f o r viral o r b a c t e r i a l
d i s e a s e s w i t h t h e r e p t i l e s e r v i n g as a r e s e r v o i r .
A r t h r o p o d s a n d p o t e n t i a l z o o n o s e s a r e l i s t e d in
T a b l e 3.
Nonhuman Primates
Nonhuman primates carry the greatest poten-
tial f o r z o o n o t i c p a r a s i t e t r a n s m i s s i o n as t h e y a r e
closely r e l a t e d to h u m a n s , zl T a b l e 4 lists a n u m -
ber of zoonotically significant parasitic infections
h a r b o r e d by n o n h u m a n p r i m a t e s .
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