Zoonoses and Public Health

SHORT COMMUNICATION

Survey of Zoonotic Dermatoses in Client-Owned Exotic Pet

Mammals in Southern Italy
D. d’Ovidio1 and D. Santoro2
1
Private Practitioner, Napoli, Italy
2
Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA

Impacts

• Several ‘exotic’ mammalian species (e.g. rabbits, rodents, ferrets and

hedgehogs) live in close proximity to humans as companion pets.
• Exotic pet mammals may serve as active carriers for many highly contagious
pathogens with zoonotic potential.
• An active routine screening examination and preventative treatments are
strongly recommended for every newly purchased pet mammal.

Keywords:
Exotic pet mammals; zoonotic dermatoses;
parasitic and fungal infections
Correspondence:
D. Santoro. Department of Small Animal
Clinical Sciences, University of Florida,
Gainesville, FL, USA. Tel.: +1 352 392 2235;
Fax: +1 352 846 2445;
E-mail: dsantoro@ufl.edu
Received for publication March 23, 2013
doi: 10.1111/zph.12100
Summary
Several ‘exotic’ mammalian species (e.g. rabbits, rodents, ferrets and hedge-
hogs) live in close proximity to humans as companion pets. Skin diseases (SD)
are frequent causes of morbidity in exotic pet mammals, and most of those
SDs have a zoonotic potential. The purpose of this study was to determine the
frequencies and types of zoonotic dermatosis (ZD) in client-owned, exotic pet
mammals in Southern Italy. Six-hundred and fifty-five medical records of exo-
tic pet mammals examined between 2011 and 2012, across twenty private prac-
tice veterinary clinics around the Naples area (Italy), were retrospectively
evaluated and screened for animals diagnosed with SDs (rabbits n = 455, gui-
nea pigs n = 93, ferrets n = 64, hedgehogs n = 19, chinchillas n = 13 and rats
n = 11). The records of animals diagnosed with SD, whose causative agents
had a zoonotic potential, were selected for analysis. The Mann–Whitney inde-
pendent test was used for statistical analysis. A P value ≤0.05 was considered
statistically significant. Eighty-two records (12.5%) of animals with ZD were
identified. Of those, 56.1% (46/82) were affected by fungal infections and
42.7% (35/82) by parasitic infections. No zoonotic bacterial or viral infections
were diagnosed. Dermatophytosis was significantly diagnosed more frequently
in younger animals. The results of this survey indicate that exotic pet mam-
mals may serve as active carriers for many highly contagious pathogens with
zoonotic potential. Awareness and vigilance by the veterinary practitioner is
crucial in the prevention of occurrences of ZDs. Children frequently come in
close contact with exotic pets. To prevent the unplanned transmission of path-
ogen from pet to human, an active routine screening examination and preven-
tative treatments are strongly recommended for every newly purchased pet
mammal.

dermatoses with zoonotic potential and zoonotic derma-

Introduction
Exotic companion mammals (e.g. rabbits, rodents, ferrets,
hedgehogs) are very popular household pets. As with
dogs and cats, they are a potential source of zoonotic
infections transmissible to their owners (Mitchell and
Tully, 2012). It has been previously demonstrated that
tosis (ZD) have a high health impact on the pet owner
population (Scott and Horn, 1987; Hoppmann and Bar-
ron, 2007; Kim et al., 2008; Rosen, 2011; Mitchell and
Tully, 2012).
The most common zoonoses with dermatological mani-
festation in exotic companion mammals include parasitic

100 © 2014 Blackwell Verlag GmbH  Zoonoses and Public Health, 2015, 62, 100–104
D. d’Ovidio and D. Santoro Exotic Pet Mammals Skin Diseases with Zoonotic Potential

(Cheyletiella parasitovorax, Leporacarus gibbus, Trixacarus
caviae, Sarcoptes scabiei, Notoedres cati and Otodectes cyno-
tis) and fungal infections (Trichophyton mentagrophytes and
Microsporum spp.). While not as common, bacterial (Staph-
ylococcus aureus, Salmonella spp., Corynebacterium kutscheri
and Francisella tularensis) (Beck and Pfister, 2006; Hill and
Brown, 2011; Pignon and Mayer, 2011; Rosen, 2011; Mitch-
ell and Tully, 2012) and viral infections (monkeypox virus
and cowpox virus) have also been reported (Souza, 2011;
Mitchell and Tully, 2012).
Transmission of ZD from pets to humans primarily
occurs through direct contact with infected animals, but
also by a contaminated environment or through ectopara-
sites serving as vectors. The most common clinical signs, of
the above-mentioned ZD in people, include vesicular or
papular dermatitis, wheals, localized pruritus, alopecia and
crusts (Mitchell and Tully, 2012). Dermatological signs
associated with systemic manifestations (systemic hypereo-
sinophilia) have also been reported (Dobrosavljevic et al.,
2007).
To the authors’ knowledge, no epidemiological studies
to determine the risk of zoonotic potential transmission
from pet mammals to humans have been published. To
address this lack of information, the purpose of this survey
was to evaluate the frequency and types of ZDs present in
exotic companion mammals in Southern Italy.
Materials and Methods
Study population
Six-hundred and fifty-five medical records of exotic pet
mammals seen across 20 private veterinary clinics around
the Naples, Italy, area from 2011 to 2012 were retrospec-
tively reviewed. The exotic pet mammals included rabbits
(Oryctolagus cuniculus) n = 455, guinea pigs (Cavia porcel-
lus) n = 93, ferrets (Mustela putorius furo) n = 64, hedge-
hogs (Ateletrix albiventris) n = 19, chinchillas (Chinchilla
lanigera) n = 13 and rats (Rattus norvegicus) n = 11. The
medical records of exotic pet mammals with SD in which
zoonotic potential aetiologies were proven were selected for
analysis. Cases with ZD were included only if information
on the cutaneous and systemic clinical signs, as well as a
definitive diagnosis of ZD, was documented in the patients’
records. From each medical record, the following data were
retrieved and analysed: sex, weight, age of onset of ZD,
general husbandry and feeding history.
Statistical analysis
Median, range and the lowest and highest values were cal-
culated for all data sets. The Mann–Whitney independent
test was used for the statistical analysis of age and weight.
Ninety-five per cent confidence intervals (CI) were calcu-
lated. The chi-squared test was used for the statistical analy-
sis of the mammals’ sex. Differences with a value of
P ≤ 0.05 were considered statistically significant. Age, sex
and weight were the variables analysed in both groups
(infected versus non-infected). The variables were analysed
for each species to facilitate the interpretation of the data.
Statistical analyses were performed using MEDCALC 12.0 sta-
tistical software (MedCalc Software, Mariakerke, Belgium).
Results
All data for the animals included in this study are reported
in Table 1.
Medical records for 82 exotic pet mammals diagnosed
with ZD were selected and analysed. Parasitic ZD occurred
in 42.7% (35/82) of cases. Of those cases with parasitic ZD,
51.4% (18/35) were pet rabbits in which the following para-
sites were identified: C. parasitovorax (12/18), L. gibbus (4/
18), S. scabiei (2/18). Ferrets comprised 25.7% (9/35) of
the cases with parasitic ZD, in which the following parasites
were identified: O. cynotis (5/9) and S. scabiei (4/9).
Twenty per cent (7/35) of cases with parasitic ZD were gui-
nea pigs, and all were infested by T. caviae. 2.9% (1/35) of

Table 1. Details of 82 exotic pet mammals diagnosed with zoonotic dermatosis (ZD) in Southern Italy

Sex
a
Total No. of No. of cases No. of cases No. of Average Average
Species cases enrolled affected parasites cases fungi age (years) weight (kgs) M F

Rabbits 455 33 18 15 2.2 1.5 20 13

Guinea pigs 93 30 7 23 1.5 0.7 12 18
Ferrets 64 12 9 3 1.5 1.0 4 8
Hedgehogs 19 1 1 0 1 0.4 0 1
Chinchillas 13 4 0 4 1.4 0.5 3 1
Rats 11 1 0 1 0.6 0.3 1 0
Total 655 82 35 46

F, female; M, male.
a
Age of animals when the skin disorder was diagnosed.

© 2014 Blackwell Verlag GmbH  Zoonoses and Public Health, 2015, 62, 100–104 101
Exotic Pet Mammals Skin Diseases with Zoonotic Potential
parasitic ZD were hedgehogs with only one case of N. cati
diagnosed. Compiling the results from all animals, the most
common parasites were C. parasitovorax (14.9%) and
T. caviae (8.6%), followed by S. scabiei (7.4%), O. cynotis
(6.2%), L. gibbus (4.9%) and N. cati (1.2%). Age was not
statistically associated with parasitic SD in any of the
species analysed.
Fungal ZD occurred in 56.1% (46/82) of reviewed cases.
Of those cases with fungal ZD, 50% (23/46) were guinea
pigs, 32.6% (15/46) were rabbits and 8.7% (4/46) were
chinchillas. In all cases, T. mentagrophytes was the only der-
matophyte identified. The remaining 8.7% were composed
of ferrets [6.5% (3/46)], in which both Microsporum spp.
(2/3) and T. mentagrophytes (1/3) were identified. 2.2% (1/
46) were rats affected by dermatophytosis due to Microspo-
rum spp. Compiling the results from all enrolled animals,
the most common dermatophyte identified was T. mentag-
rophytes (53.1%), whereas Microsporum spp. occurred only
in 3.7% of cases. The age of animals infected with a derma-
tophyte was significantly less (younger) than animals not
infected with a dermatophyte [median ages: 0.7 (CI = 0.5–
0.77) versus 3.2 (CI = 3–3.6) years (rabbit) (P < 0.0001),
1.6 versus 3.6 (CI = 2.6–5.7) years (chinchillas) (P =
0.0054), and 0.5 versus 2.4 (CI = 2–3) years (ferret)
(P = 0.0036)].
No bacterial or viral ZD was reported. Both sex and
weight were not statistically associated with the develop-
ment of SD in any of the species analysed.
Discussion
The results from the data reviewed in this survey indicate
that the prevalence of ZD in exotic pet mammals in South-
ern Italy is 12.5%. The most common aetiological agent
was T. metagrophytes followed by C. parasitovorax. The
only ZDs observed in this study were parasitic and fungal
dermatoses involving all the species enrolled. Bacterial and
viral dermatoses were not present in any of the enrolled
cases.
Superficial fungal infections were the most common
types of ZD identified in this study. Fungal infections were
diagnosed in 56.1% of the cases. T. mentagrophytes was
the most prevalent dermatophyte isolated in almost all
species analysed, whereas Microsporum spp. occurred only
in 3.7% of the cases. Both of the fungi isolated are com-
monly diagnosed in both people and animals. They are
keratinophilic fungi affecting the stratum corneum, hair
shafts and nails (Canny and Gamble, 2003; Rosen, 2011).
Dermatophytosis is considered one of the most common
and important zoonotic skin diseases worldwide (Moriello,
2003). The prevalence of dermatophytosis in people is
unknown as the disease is not reportable. Exotic compan-
ion mammals (rabbits, guinea pigs, chinchillas, hedge-
102
D. d’Ovidio and D. Santoro
hogs) represent one of the primary environmental host for
dermatophytes as they can be asymptomatic carriers for
T. mentagrophytes (Chomel et al., 2007; Rovid-Spickler
and Dvorak, 2008; Kraemer et al., 2012). Asymptomatic
exotic pet mammals represent a source for fungal infec-
tions in people where heavily colonized, even if the con-
tact time is very short (Rosen and Jablon, 2003; Riley and
Chomel, 2005).
The age of onset was analysed to determine whether
there was a statistically significant association between the
age of animal and the development of fungal diseases. We
found that dermatophytosis was more prominent in young
animals. This finding fits with current immunological
trends, as it is well known that younger and sick animals
are more pre-disposed to be affected by infectious diseases
(Moriello, 2003; Hess and Tater, 2012).
In this study, the most common parasitic ZD was chey-
letiellosis (14.9%). C. parasitovorax is a common parasite
in rabbits, but can affect any mammalian species. In rab-
bits, C. parasitovorax can cause subclinical disease or, more
frequently, signs of pruritic dermatitis associated with scal-
ing, alopecia or broken hairs in several regions of the rab-
bit’s body. In people, a large number of infestations by
Cheyletiella spp. have been documented (Wagner and Stall-
meister, 2000; Dobrosavljevic et al., 2007; Jofr
e et al.,
2009), and it is estimated that in households with infested
animals, 20% of pet owners are also infected (Wagner and
Stallmeister, 2000). However, because the mites adopt the
commonly termed ‘bite and run’ behaviour, by biting peo-
ple and returning rapidly to their animal host, it is often
difficult to find them on human patients (Wagner and
Stallmeister, 2000). Main clinical signs in people include
pruritus, erythematous papules, papulovesicles, urticaria,
vesiculobullous eruptions and excoriations usually on fore-
arms, chest and abdomen (Parish and Schwartzman, 1993;
Wagner and Stallmeister, 2000). Rarely, cheyletiellosis is
also associated with severe and persistent peripheral eosino-
philia (Dobrosavljevic et al., 2007).
The second most common parasitic ZD in this survey
was caused by T. caviae followed by S. scabiei. In guinea
pigs, the main clinical signs include intense pruritus, alope-
cia, crusting and unthrifty-looking coat. Similarly, pruritic
lesions produced in pets are also the main clinical signs
reported in people, predominantly children (Mitchell and
Tully, 2012). In both ZDs, T. caviae and S. scabiei, regular
routine clinical examination of the pet and a regular anti-
parasitic treatment is fundamental for the prevention of
T. caviae or S. scabiei infections. In fact, due to the high
rate of false-negative skin scrapings, a definitive diagnosis
of T. caviae or S. scabiei can be highly challenging for both
veterinarians and physicians (Aydıng€ oz and Mansur, 2011).
Proper pet examinations and preventative treatment are
most crucial for S. scabiei, as human scabies is a common
© 2014 Blackwell Verlag GmbH  Zoonoses and Public Health, 2015, 62, 100–104
D. d’Ovidio and D. Santoro
public health concern worldwide with an estimated
300 million infected individuals (Burkhart, 2006).
Otodectes cynotis was detected in 6.2% of the animals in
this survey. This parasite is not host specific and may
affect many species of pets such as dogs, cats, rabbits,
rodents and ferrets causing mild to severe otitis and pru-
ritic dermatitis. Occasional human infections have also
been reported, and primary signs included pruritic papu-
lar lesions on the skin or even true otic parasitic infesta-
tions (Van de Heyning and Thienpont, 1977; Moriello,
2003; Jofr
e et al., 2009).
Finally, Leporacarus gibbus (formerly Listrophorus gibbus)
and Notoedres cati were identified in <5% and 2% of the
animals analysed, respectively, confirming the results of
previous surveys in which these ZDs were not extremely
common in pet mammals (Kirwan et al., 1998; Kim et al.,
2008; Ivey and Carpenter, 2012). Although uncommon,
infections due to N. cati and L. gibbus have been reported
in people (Burns, 1987; Moriello, 2003). In both cases, the
most common clinical signs include a papular eruption on
the forearms (Burns, 1987; Moriello, 2003). It is notewor-
thy to remember that, like C. parasitovorax, L. gibbus is
able to survive in the surrounding environment increasing
the risk for inter-species transmission.
Weight was not statistically associated with any ZD.
Obesity may increase the chance of dermatological condi-
tions in exotic pets due to the lack of regular grooming.
However, none of the pets enrolled in this study were over-
weight. This supports and offers possible explanation for
the lack of statistical association of this variable with the
development of ZDs.
Conclusions
The results of this survey confirm previous reports, indicat-
ing that client-owned exotic companion mammals may
serve as carrier for many contagious pathogens with zoo-
notic potential. Although the reported ZDs are predomi-
nantly self-limiting in immunocompetent people, it should
be taken into account that hemophage mites have the
potential of transmitting zoonotic agents (Jofr
e et al.,
2009) This highlights how crucial the role of the veterinary
practitioner is in preventing the occurrences of ZD
humans, predominantly in children or immunosuppressed
adults. Furthermore, fungal cultures on asymptomatic ani-
mals should be recommended for newly purchased pets to
detect asymptomatic carriers and prevent the transmission
of dermatophytosis to the owners.
Acknowledgement
The authors would like to thank Dr. Marcello Ferrara for
his contribution to this study.
© 2014 Blackwell Verlag GmbH  Zoonoses and Public Health, 2015, 62, 100–104
Exotic Pet Mammals Skin Diseases with Zoonotic Potential
Source of Funding
This study was self-funded.
Conflict of Interest
None declared.
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