Letters to the Editor

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Memories of Dr. Terry Curtin

I read with sadness of the passing of Dr. Terry Curtin.1 I graduated from the North Carolina State University College of Veterinary Medicine in 1990 and was a member of one of the college's early classes (known as the School of Veterinary Medicine when first established, the college changed its name while I was a student). Dr. Curtin's push to have North Carolina fund the institution, his acquisition of a top-notch staff, and his decision to have the teaching hospital up and running before the first veterinary class enrolled helped quickly propel the college into the top ranks.

I was a Jersey girl when I was accepted in 1986, the first year the college accepted out-of-state residents. My class was an interesting mix of rural Southerners to type-A Duke University and University of North Carolina graduates. We had an amazing faculty, including Drs. Ben Harrington, Don Meuten, Joe Kornegay, and many others, who helped develop us into successful veterinary graduates. I am still in practice today in a small animal and exotics hospital back in New Jersey. Thank you, Dr. Curtin. You left quite a legacy.

Bethany (Heidler) Summers, dvm

VCA Blairstown Animal Hospital Blairstown, NJ

1. Obituaries. J Am Vet Med Assoc 2021;258:571574.

Veterinarians' role in preventing zoonotic salmonellosis from hedgehogs

A recent outbreak of human salmonellosis linked to contact with pet hedgehogs1 highlights the need to address Salmonella carriage in hedgehogs as an issue of public health importance. Three multistate outbreaks involving a single Salmonella strain linked to hedgehogs have caused 129 human illnesses in the United States since 2011; 17% (21/122) of these illnesses occurred in children < 5 years of age.2,3,4 The finding of a genetically nearly identical strain over multiple years indicates this strain might be persisting in the pet hedgehog population, including the breeding population, representing a continued health risk to hedgehog owners. Despite public health outreach and recommendations made during outbreak investigations, continued occurrence of this strain in human illness outbreaks indicates additional efforts are needed to engage with hedgehog breeders to reduce the burden of Salmonella spp in hedgehog populations, which may prevent disease transmission to people.

Over 57 hedgehog breeders or dealers were identified as suppliers of pets to people identified as ill during these investigations. The complex distribution of hedgehogs from breeder to consumer, including the practice of sharing and trading breeding stock, has complicated investigation of the strain and likely resulted in the wide geographic distribution of illnesses.2,3,4 The burden and strains of Salmonella spp in hedgehogs in the United States are largely unknown,4 and there is no standard set of recommendations to mitigate Salmonella carriage in breeding populations. There is a need to examine the efficacy and economic feasibility of prevention efforts such as routine testing of breeding animals, removing Salmonella carriers from breeding, isolating and testing new animals, and increasing sanitation and cleaning.

Exotic mammal veterinarians, especially those in academia, may be uniquely suited to partner with breeders as well as public health and animal health officials to fill this knowledge gap and develop additional tools to mitigate Salmonella carriage. These recommendations might help veterinarians work with breeders to evaluate and characterize Salmonella strains in their breeding herds through diagnostic testing, implement effective biosecurity measures and sanitation practices in their facilities, and disseminate disease prevention information to pet owners.5 These efforts can help reduce the risk of Salmonella introduction and spread in hedgehogs and potentially prevent transmission of Salmonella organisms to people.

Human salmonellosis from contact with hedgehogs can occur when owners don't wash their hands after handling or feeding their pets, when hedgehogs roam freely in the household, or when owners clean items used to care for hedgehogs in areas where food is stored and prepared. Hedgehogs carry Salmonella asymptomatically and shed bacteria in their feces intermittently, and their behavior can lead to widespread environmental contamination.5 Owners, especially new owners, may not understand the risk of indirect exposure posed by contaminated areas where hedgehogs live and roam. To protect public health and prevent future outbreaks linked to contact with hedgehogs, owners must have access to information regarding the risk and prevention of Salmonella transmission from hedgehogs. Veterinarians are well positioned to provide this information and educate owners on preventive disease care, animal husbandry, and responsible pet ownership, including that hedgehogs may be inappropriate pets for children < 5 years of age.6

Disclaimer

The conclusions and opinions in this letter are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Michelle A. Waltenburg, dvm, mph

Colin Basler, dvm, mph

Megin Nichols, dvm, mph

Division of Foodborne, Waterborne, and Environmental Diseases

National Center for Emerging and Zoonotic Infectious Diseases

Centers for Disease Control and Prevention

Atlanta, Ga

Joni Scheftel, dvm, mph

Minnesota Department of Health Saint Paul, Minn

Mary Grace Stobierski, dvm, mph

Michigan Department of Health and Human Services

Lansing, Mich

  • 1. CDC. Outbreak of Salmonella infections linked to pet hedgehogs. Available at: www.cdc.gov/salmonella/typhimurium-09-20/index.html. Accessed Mar 30, 2021.

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  • 2. Anderson TC, Marsden-Haug N, Morris JF, et al. Multistate outbreak of human Salmonella Typhimurium infections linked to pet hedgehogs–United States, 2011–2013. Zoonoses Public Health 2017;64:290298.

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  • 3. CDC. Outbreak of Salmonella infections linked to pet hedgehogs (final update). Available at: www.cdc.gov/salmonella/typhimurium-01-19/index.html. Accessed Mar 30, 2021.

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  • 4. Riley PY, Chomel BB. Hedgehog zoonoses. Emerg Infect Dis 2005;11:15.

  • 5. Keeble E, Koterwas B. Salmonellosis in hedgehogs. Vet Clin North Am Exot Anim Pract 2020;23:459470.

  • 6. CDC. Stay healthy around small pets. Available at: www.cdc.gov/healthy-pets/publications/stay-healthy-around-small-pets.html. Accessed Mar 30, 2021.

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Epidemic

Another epidemic is quietly sweeping our country: veterinarians of retirement age are unable to find buyers for the practices they have spent a lifetime building. They are told their property cannot be included in the sale because it is worth too much. They are told their equipment, even if new, has no value and must be included in the sale price for nothing. They are told their client lists have no value. They are told they must sell for less than the practice's valuation.

For many of us, the sale of our practice was meant to fund our retirement. I have tried to sell my own practice for several years now. I tried to list it with large brokers, and they all declined because my gross income did not meet their threshold. I listed it in journals and with regional veterinary medical associations but had no luck. I hired associates who claimed to have an interest in purchasing a practice. They all found closed practices that were bargains.

One long-term associate purchased a clinic in a nearby town that had closed its doors after the owner had spent years trying to sell it before finally retiring. He purchased it all—property, equipment, client list, and office materials—for far less than the value of the real estate. Another clinic in the same town closed after the owner died while trying to sell and retire; his spouse had a 3-year-long garage sale, taking pennies on the dollar for everything.

Is this all older veterinarians are worth to our profession? Without us, there would be no modern veterinary medicine. Clients would not know the value of regular health examinations, blood work, radiography, sterile surgery, and preventative medicine. There would be no human-animal bond to celebrate. Is this our penance for working long hours and keeping prices affordable for our clients? Who will serve people who can't afford the prices being charged at multidoctor practices?

Here I am, 65 years old with health issues. My clinic is modern with new equipment, and I am making a good living. The clients are wonderful, and there are lots of them. The location is ideal for any veterinarian wanting to raise a family and enjoy the outdoors. A buyer could literally walk in and go to work without having to struggle to build up a new business. There are no takers. The brokers tell me this is a national problem that is only going to get worse. Hopefully my going-out-of-business sale will be because I can't continue to work and not because I died trying to keep my life's work alive.

Richard Boulette, dvm

Wind River Veterinary Services Lander, Wyo

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