Five of 10 puppies transported from Puerto Rico to Vermont fell ill
NORWICH, Vermont––Posted Surfin’ Sato founder Aimee Porcaro Goodwin to Facebook two days before Thanksgiving 2017, “We just got the lepto PCR test results for Ollie. NEGATIVE!!! I’m so thankful!!”
The “all clear” for Ollie, a puppy from Puerto Rico whom Surfin’ Sato hopes to rehome soon, was the best news for the beleaguered rescue in the three weeks since leptospirosis symptoms appeared among five of the dogs in their care.
Transmitted by ingesting bacteria of the genus Leptospira, leptospirosis is a spirochetal disease carried most often by mice and rats, and by dogs who eat infected mice and rats. Leptospirosis can be carried by almost any mammal who ingests the bacteria, however, and can kill dogs, humans, or any other infected species.
Death, according to the U.S. Center for Disease Control & Prevention, may occur from any or all of a combination of effects including kidney damage, meningitis (inflammation of the membrane around the brain and spinal cord), liver failure, and respiratory distress.
Pups born in August
Recounted Goodwin on Facebook, “On November 9th, ten puppies were transported from a private home in Puerto Rico to the Upper Valley,” the region of central Vermont and New Hampshire straddling the Connecticut River, centering on White River Junction, where Interstate Highways 89 and 91 cross.
“These puppies were born just before the hurricanes [Irma and Maria] hit [on August 30 and September 16, respectively], and spent their first months in a home with several other dogs,” Goodwin said. “They survived on rainwater and whatever food their family could find for them. The puppies were vaccinated against major diseases, including leptospirosis. A week later they received their health certificates from a veterinarian and were cleared to fly to the mainland.
“On the evening of [Thursday] November 9,” Goodwin stated, “the puppies landed at Logan [International Airport, in Boston] and were driven to their foster families. The puppies saw a veterinarian on Saturday morning [November 11, 2017] and appeared healthy. By Sunday evening, one of the puppies began experiencing signs of illness and was admitted to the SAVES animal clinic in Lebanon [New Hampshire]. By Monday, we suspected leptospirosis but we could not get an accurate in-office test result because the puppies had been vaccinated against the disease.
“During the day Monday,” Goodwin continued, “we moved forward with prophylactic treatment (doxycycline) for the remaining nine puppies. Unfortunately, both the puppy at SAVES and one other in our care became acutely ill and had to be euthanized. While three other puppies were mildly symptomatic, we were able to administer doxycycline in time to save them. They are currently thriving.
“Since the hurricanes hit Puerto Rico,” Goodwin elaborated, “our policy has been to take dogs who had been isolated (in one home) and vaccinated for at least one week. With this strategy, we felt we could be sure that communicable diseases were kept at bay and thereby safeguard our local dogs and families.”
Standard veterinary advice is that puppies cannot be vaccinated effectively against most diseases, including rabies, before they are at least six to eight weeks of age, and must receive boosters at 10 weeks of age.
Lepto vaccine should be given at 12 weeks
But leptospirosis vaccination is trickier. The American Animal Hospital Association recommends that leptospirosis vaccination should not be given to puppies before they are 12 weeks old, with boosters to follow two to four weeks later.
According to Goodwin’s account, the puppies Surfin’ Sato imported from Puerto Rico were likely not more than ten weeks of age at arrival; if they were imported a week after vaccination, they were vaccinated at not more than nine weeks of age.
Vaccinations also tend to be ineffective in animals with compromised immune systems. While the photos posted by Surfin’ Sato of puppies from the group including some who developed leptospirosis show no obvious signs of ill health, photos posted on November 16, 2017 of puppies awaiting transport to the U.S. show indications of demodectic mange and/or ringworm, plus malnutrition possibly indicative of intestinal parasites.
Finally, the quality of any vaccines available in Puerto Rico in the wake of Hurricanes Irma and Maria might be called into question, since vaccines require constant refrigeration before use to remain effective, and electrical outages throughout the island have left most of Puerto Rico without reliable refrigeration into mid-November 2017, with full restoration of service not expected until well into 2018.
“As we’ve learned in the aftermath of this tragedy, leptospirosis is complicated,” Porcaro Goodwin acknowledged, adding “The vaccination is not wholly effective and the disease is rapidly spreading to private water sources in Puerto Rico.”
This was something of an understatement. ANIMALS 24-7 had mentioned on October 17, 2017 that “The Humane Society of Puerto Rico, like every other functioning animal and human aid organization on the islands hit by Hurricanes Irma and Maria, has focused for several days on educating the public about the risk to both animals and humans of contracting leptospirosis from drinking contaminated and inadequately boiled water.”
“Leptospirosis is endemic in Puerto Rico”
One day earlier, on October 16, 2017, Lemuel Martinez Bonilla, M.D., of Bayamon, Puerto Rico, warned via the Program for Monitoring Emerging Diseases (ProMED) that “Leptospirosis is endemic in Puerto Rico,” presenting “initial symptoms almost identical to dengue,” a mosquito-borne disease “which is also endemic in the island. Hurricane seasons promote a rise in mosquito and consequently dengue cases,” as well as in leptospirosis, Martinez pointed out.
New leptospirosis outbreaks were “first documented one to two weeks after Hurricane Maria,” Martinez said, “which is compatible with the bacteria incubation period.
“This first wave of cases should be the biggest,” Martinez suggested, “but as cleaning, reconstruction efforts, and seasonal rains continue, further exposure is expected.”
“Decided to take a break”
“With this new knowledge,” Goodwin of Surfin’ Sato said, “our organization has decided to take a break from evacuating dogs as we evaluate the best strategy for ensuring everyone’s safety. We are consulting with veterinarians, physicians and the Department of Health, who will help us develop best practices for screening dogs. In addition, we hope to work with our partners on the ground in Puerto Rico to develop a realistic, enhanced screening protocol for their rescue operations.”
“No human cases of leptospirosis had been reported from this incident,” as of November 20, 2017, reported Rob Wolfe of the Valley News, “although state health officials are looking for people who may have come into contact with the dogs during a November 12 event at Ramunto’s Brick & Brew Pizzeria’s outdoor patio in Hanover, New Hampshire.
“In an interview on Monday,” Wolfe added, “Goodwin said two of the dogs had been out in public for other events, including a football game at Hanover High School,” in Hanover, New Hampshire.
Met potential adopter
Wrote Wolfe, “The dogs were meeting a potential adopter at the game, and Goodwin was holding them in blankets throughout, she said. ‘There might have been some light contact’ with a friend of Goodwin’s, who held a dog while she replaced a blanket, she said. One of those dogs later was euthanized but never received an official diagnosis of leptospirosis.”
Reported Molly O’Hara of for the Norwich Times in March 2017, “Goodwin, a Norwich local, has been rescuing dogs for many years,” taking part “in helping to transport dogs from high-kill shelters to New England and into the hands of various nonprofit rescue groups, foster families, or adoptive families.
“Would meet the rescue transports”
“When my now 16-year-old son was younger, we would meet the [rescue] transports in White River Junction, Vermont, where they would switch over, just to walk the dogs, to find a way for him to participate,” Goodwin told O’Hara.
Goodwin admitted having failed herself at fostering dogs for rehoming, because “We can’t really move the dogs along.”
She and her family themselves adopted several dogs who had initially arrived to be fostered for rehoming.
Rincon, Puerto Rico
Wrote O’Hara, “Recently, Aimee has become interested in working with Animal Welfare Foundation Rincon, in Rincon, Puerto Rico,” at the extreme western end of Puerto Rico in a beach area known for surfing.
“One of the catalysts for this,” O’Hara said, “was a desire to keep her kids interested in rescue. She was finding that work in the Southeast was traumatic for them, having to walk into shelters filled with dogs who only have five days to live.”
Goodwin formed Surfin’ Sato as umbrella to raise funds for a field trip to Rincon undertaken with “a group of 14 students and Tim Berube, a social studies teacher, and another chaperone from Hanover High School” during the 2017 spring break, O’Hara said.
The March field trip apparently established the contacts facilitating the post-hurricane involvement of Surfin’ Sato.
More outbreaks likely
Further transmissions of leptospirosis to the mainland U.S. are possible and perhaps even likely, given the dozens of often inexperienced rescue organizations that are now involved in importing dogs not only from Puerto Rico but also from other hurricane-stricken Caribbean islands where the disease is endemic.
Pre-hurricane season rescue transports of dogs are suspected but not confirmed as the source of a leptospirosis outbreak afflicting Halifax, Nova Scotia, at least since early August 2017. Twelve suspected cases were in quarantine care as of November 3, 2017, CTV Atlantic News reported, twice as many as one week earlier.
A possible link to dog rescue transport is not strongly suspected, however, in connection with the recent deaths of at least eight sea lions from leptospirosis along the Oregon coast.
“The outbreak began in September  and likely will last into December ,” Oregon Marine Mammal Stranding Network coordinator Jim Rice told Dylan Darling of the Eugene Register-Guard.
While dogs are not believed to have caused the leptospirosis outbreak among sea lions, Oregon public health officials have warned the public against allowing dogs to interact with sea lions or sea lion carcasses, since dogs can become infected and can then transmit leptospirosis to humans.
Back in the Caribbean, “Agricultural economist Omardath Maharaj is calling for the government to be more proactive regarding post-flooding food safety policies after a number of leptospirosis cases were reported in South Trinidad,” reported The Loop, serving the island nation of Trinidad & Tobago, on November 10, 2017.
Thirteen humans had reportedly fallen ill with leptospirosis, according to the San Fernando General Hospital in Trinidad, included two who died.
“Persons at greatest risk of getting leptospirosis are farmers and agricultural workers, sanitation workers, and sewer workers,” commented ProMED bacterial disease moderator Matthew Levison, of the Drexel University School of Public Health in Philadelphia.
“However,” Levison explained, “anyone exposed to rat-contaminated water and soil is also at risk of contracting the disease,” including people who handle street dogs, who may have survived in part by hunting rats.
“Hantavirus is the great imitator of leptospirosis”
Added Jan Clement of the National Reference Laboratory for Hantavirus Infections at the University Hospital Gasthuisberg & Rega Institute for Medical Research, in Leuven, Belgium, “It perhaps useful to remember that the great imitator of leptospirosis in all aspects, clinical and epidemiological, is hantavirus infection, particularly if induced by Seoul virus, which happens to be spread also by the wild rat, the main reservoir for both pathogens.
“Both zoonoses present, often in outbreaks after floods,” Clements explained, “with flu-like fever, acute kidney injury, liver involvement, proteinuria (overproduction of proteins by the infected body), together with microscopic haematuria (bloody urine), and, most importantly, varying degrees of thrombocytopenia (low blood platelet count), which can serve as a severity indicator.”
Hantavirus, barely recognized in the U.S. until a severe outbreak in the Four Corners region of the southwest killed at least 21 people in 1993, kills about 38% of the known victims. There is no vaccine against it.