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July/August 2014 today's Veterinary Practice 77 Vital Vaccination: Kennel cough ReVisited | tvpjournal.com Scientific Studies To date, there are no published studies confirming human infection and illness associated with exposure to recent- ly vaccinated dogs. Special precautions to avoid human contact with recently vaccinated dogs (oral or intranasal route) do not appear warranted. Anecdotal Concerns Although anecdotal, I have voiced concern about the risks associated with veterinarians being directly exposed to intra- nasal (attenuated) vaccines at time of administration. To date, despite the large number of veterinarians reporting exposure, there is no evidence suggesting development of respiratory signs among those exposed to intranasal or oral vaccines. SUMMARY Canine infectious respiratory disease is still among the most frequently encountered respiratory infections report- ed in dogs. Despite the availability and widespread use of vaccines for many of the viral and bacterial pathogens implicated, infections are still reported. The discovery of new respiratory pathogens for which vaccines are not cur- rently available highlights the fact that even well vacci- nated dogs can still develop CIRD. Due to the contagious nature of the organisms involved, animal shelters, dog day-care centers, rescue organizations, and veterinary hos- pitals continue to be recognized as high-risk environments for development of CIRD. n caV-2 = canine adenovirus-2; cdV = canine distemper virus; ciRd = canine infectious respiratory disease; ciRdc = canine infectious respiratory disease complex; ciV = canine influenza virus; cnPnV = canine pneumovirus; cPiV = canine parainfluenza virus; cPV = canine parvovirus; cRcoV = canine respiratory coronavirus; itb = infectious tracheobronchitis References 1. Ford rB. Canine infectious respiratory disease. in Greene Ce (ed): infectious Diseases of the Dog and Cat, 4th ed. St. Louis: elsevier Saunders, 2012, pp 55-65. 2. Pecoraro HL, Bennett S, Huyvaert KP, et al. epidemiology and ecology of H3N8 canine influenza viruses in US shelter dogs. J Vet Intern Med 2014; 28(2):311-318. 3. Priestnall S, erles K. Streptococcus zooepidemicus: An emerging canine pathogen. Vet J 2011; 188(2):142-148. 4. renshaw rw, Zylich NC, Laverack MA, et al. Pneumovirus in dogs with acute respiratory disease. emerg Infect Dis 2010; 16(6):993-995. 5. decaro N, Martella v, Buonavoglia C. Canine adenoviruses and herpesvirus. Vet Clin north Am Small Anim Prac 2008; 38(4):799-814. 6. erles K, Brownlie J. Canine respiratory coronavirus: An emerging pathogen in the canine infectious respiratory disease complex. Vet Clin north Am Small Anim Pract 2008; 38(4):815-825. 7. Buonavoglia C, Martella v. Canine respiratory viruses. Vet Res 2007; 38(2):355-373. 8. Ford rB. Bordetella bronchiseptica: Beyond kennel cough. in Bonagura Jd, Twedt dC (eds): Kirk's Current Veterinary Therapy XIV, 14th ed. St. Louis: elsevier Saunders, 2009, pp 646-649. 9. Mattoo S, Cherry Jd. Molecular pathogenesis, epidemiology, and clinical manifestations of respiratory infections due to Bordetella pertussis and other Bordetella subspecies. Clin Microbiol Rev 2005; 18(2):326-382. 10. welborn Lv (chair), devries JG, Ford rB, et al. 2011 AAHA canine vaccination guidelines. JAAhA 2011; 47(5):1-42. Available at aahanet.org. 11. Gore T, Headley M, Laris r, et al. intranasal kennel cough vaccine protecting dogs from experimental Bordetella bronchiseptica challenge within 72 hours. Vet Rec 2005; 156(15):482-483. 12. Bey rF, Shade FJ, Goodnow rA, Johnson rC. intranasal vaccination of dogs with live avirulent Bordetella bronchiseptica: Correlation of serum agglutination titer and the formation of secretory igA with protection against experimentally induced infectious tracheobronchitis. Am J Vet Res 1981; 42(7):1130-1132. 13. Hess TJ, Parker dS, Hassall AJ, Chiang Y. evaluation of efficacy of oral administration of Bordetella bronchiseptica intranasal vaccine when used to protect puppies from tracheobronchitis due to B bronchiseptica infection. Intern J Appl Res Vet Med 2009; 9(3):300-305. 14. Larson LJ, Thiel Be, Sharp P, Schultz rd. A comparative study of protective immunity provided by oral, intranasal and parenteral canine Bordetella bronchiseptica vaccines. Intern J Appl Res Vet Med 2013; 11(3):153-160. 15. ellis JA, Krakowka GS, dayton Ad, Konoby C. Comparative efficacy of an injectable vaccine and an intranasal vaccine in stimulating Bordetella bronchiseptica-reactive antibody responses in seropositive dogs. JAVMA 2002; 220(1):43-48. 16. davis r, Jayappa H, Abdelmagid OY, et al. Comparison of the mucosal immune response in dogs vaccinated with either an intranasal avirulent live culture or a subcutaneous antigen extract vaccine of Bordetella bronchiseptica. Vet Ther 2007; 8(1):32-40. 17. Toshach K, Jackson Mw, dubielzig rr. Hepatocellular necrosis associated with the subcutaneous injection of an intranasal Bordetella bronchiseptica- canine parainfluenza vaccine. JAAhA 1997; 33(2):126-128. 18. Hemsworth S, Pizer B. Pet ownership in immunocompromised children—a review of the literature and survey of existing guidelines. eur J oncol nurs 2006; 10(2):117-127. 19. woolfrey BF, Moody JA. Human infections associated with Bordetella bronchiseptica. Clin Microbiol Rev 1991; 4(3):243-255. 20. Berkelman rL. Human illness associated with use of veterinary vaccines. Clin Infect Dis 2003; 37(3):407-414. Richard B. Ford, DVM, MS, Dip- lomate ACVIM & ACVPM (hon), is emeritus Professor of Medicine at north Carolina State university's Col- lege of Veterinary Medicine. he is a past president of the nAVC Confer- ence and is a member of the scien- tific program committee. he serves on the AAhA Canine Vaccination Task Force and AAFP Feline Vaccination Advisory Panel. he received his DVM from ohio State university and completed an internal medicine residency at Michigan State university. Was It the Vaccine? one unpublished case report described the case of a 14-year-old boy who was inadvertently sprayed in the face with a dose of intranasal B bronchiseptica + cPiV vaccine that was intended for the child's pet dog. 20 Five days later, the boy developed a pertussis- like cough that persisted for 3 to 4 months. however, confirmation that the illness was causally associat- ed with vaccine exposure was never accomplished. The intricacies of systemic versus mucosal immu- nity are rather complex , and few studies are avail- able that even attempt to "measure" mucosal immune responses. Mucosal immunity to B bronchiseptica does appear to involve mechanisms other than se- cretory iga. however, further discussion of this topic is outside the scope of this article.