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Birds

Question
Is there a problem for children with CF to have a paroquet as a pet?
Answer
Paroquets can be carriers or can be contaminated with different germs. These germs may be transmitted to humans and cause disease. The best known disease in medical terms is called Psittacose or parrot fever. This disease is transmitted from animal to human and is caused by the bacteria Chlamydophila psittaci. While birds are commonly infected, human disease is rare. It can however be serious, resulting in pneumonia. Disease can occur after contact with contaminated birds. Transmission of this germ occurs via the respiratory tract by inhaling small airborn particles coming from a diseased animal or an animal carrying disease but being healthy itself. The small particles can consist of saliva, stool particles or even dust particles from the feathers or the contaminated sand. Exceptionally direct contact with the animal (beak-mouth) or manipulating birds will result in infection. Also cleaning the cage or even sleeping in the same room where the cage is present are considered as risk activities. Pneumonia caused by this germ has to be treated with specific antibiotics.
Other disease causing bacteria that can be transmitted from birds to cystic fibrosis patients are atypical mycobacteria, including Mycobacterium avium intracellulare. Avium is derived from the Latin word Avis meaning bird. The mode of transmission is not yet well known. We do however know that paroquets may carry these bacteria and some cases have been reported from human disease possibly after contact with a contaminated bird. The impact of mycobacterial infection in cystic fibrosis patients is not fully know, but some patients may have a complicated course of this disease. Another germ from the same family, called Mycobacterium abscessus can cause severe lung infection with progressive loss of lung function. These infections are very difficult to treat. Apart from these two groups of infections, molds like Aspergillus can also be transmitted by birds. Some CF patients infected with Aspergillus have little disease. However, Aspergillus infection may cause severe illness including allergic reaction to Aspergillus molds, named ‘allergic bronchopulmonary aspergillosis’. This complication may cause severe lung damage (bronchiectasis). Some patients may have a combination of atypical mycobacterium infection combined with allergic bronchopulmonary aspergillosis.
Prevention of airway infection is an important issue in patients with CF. Additional infectious risks with difficult to treat germs, for example after contact with paroquets should be avoided. Birds in general and paroquets in particular can carry difficult germs, possibly contaminating CF patients. We therefore disencourage CF patients to choose paroquets as pets. It is safer not to have contact with these animals. Risk for infections is highest with cleaning cages, contact with feces and keeping paroquet cages in the sleeping room or in small rooms not sufficiently ventilated.
Kind regards
K. Cosyns
23.03.2010