Risks associated with animal-assisted intervention programs: A literature review

Kathryn R Dalton; Kaitlin B Waite; Kathy Ruble; Karen C Carroll; Alexandra DeLone; Pam Frankenfield; James A Serpell; Roland J Thorpe Jr; Daniel O Morris; Jacqueline Agnew; Ronald C Rubenstein; Meghan F Davis

doi:10.1016/j.ctcp.2020.101145

Risks associated with animal-assisted intervention programs: A literature review

Complement Ther Clin Pract. 2020 May:39:101145. doi: 10.1016/j.ctcp.2020.101145. Epub 2020 Mar 18.

Affiliations

¹ Johns Hopkins University Bloomberg School of Public Health, Department of Environmental Health and Engineering, Baltimore, MD, USA. Electronic address: kdalton4@jhu.edu.
² Johns Hopkins University Bloomberg School of Public Health, Department of Environmental Health and Engineering, Baltimore, MD, USA.
³ Johns Hopkins University School of Medicine, Department of Pediatric Oncology, Baltimore, MD, USA.
⁴ Johns Hopkins University School of Medicine, Department of Pathology, Division of Medical Microbiology, Baltimore, MD, USA.
⁵ University of Pennsylvania School of Veterinary Medicine, Department of Clinical Sciences & Advanced Medicine, Philadelphia, PA, USA.
⁶ Johns Hopkins University Bloomberg School of Public Health, Department of Health, Behavior and Society, Baltimore, MD, USA.
⁷ The Children's Hospital of Philadelphia, Cystic Fibrosis Center, Philadelphia, PA, USA; The University of Pennsylvania Perelman School of Medicine, Department of Pediatrics, Philadelphia, PA, USA.
⁸ Johns Hopkins University Bloomberg School of Public Health, Department of Environmental Health and Engineering, Baltimore, MD, USA; Johns Hopkins Medicine, Department of Molecular and Comparative Pathobiology, Baltimore, MD, USA.

Abstract

The benefits of animal-assisted interventions (AAI), to utilize companion animals as an adjunctive treatment modality, is well-established and a burgeoning research field. However, few studies have evaluated the potential hazards of these programs, such as the potential for therapy animals to transfer hospital-associated pathogens between individuals and the hospital environment. Here we review the current literature on the possible risks of hospital-based AAI programs, including zoonotic pathogen transmission. We identified twenty-nine articles encompassing reviews of infection control guidelines and epidemiological studies on zoonotic pathogen prevalence in AAI. We observed substantial heterogeneity in infection control practices among hospital AAI programs. Few data confirmed pathogen transmission between therapy animals and patients. Given AAI's known benefits, we recommend that future research utilize a One Health framework to evaluate microbial dynamics among therapy animals, patients, and hospital environments. This framework may best promote safe practices to ensure the sustainability of these valuable AAI programs.

Keywords: Animal-assisted interventions; Hospital infection control; Hospital-associated infections; Zoonotic infections.

Risks associated with animal-assisted intervention programs: A literature review

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