Petting Zoo Perils Point to Poor Hand Hygiene

GUELPH, Ontario, June 12 -- A visit to a petting zoo can expose youngsters to creatures that aren't so cute and cuddly -- Escherichia coli, Cryptosporidium, and Salmonella, among others.

And soap and water or alcohol disinfectant, the simple hand-hygiene expedient that can prevent an unwanted infection by nasty pathogens, are often not used or not even available, according to researchers here.

In 36 Canadian petting zoos -- some permanent but most temporary -- 94% had some form of hand hygiene for customers to use, according to Scott Weese, D.V.M., of the University of Guelph.

But at some events, none of the customers used the hand-hygiene facilities, Dr. Weese and colleagues reported in the July 1 issue of Clinical Infectious Diseases. Even at the best site, 26% of people left the zoo without washing,

The mean compliance with hand hygiene was 30.9% and the median compliance was 26.5%, the researchers found.

"On average, only 30% of people washed or disinfected their hands after leaving a petting zoo," Dr. Weese said. "This is concerning because hands are the most likely route of transmission of infectious agents from petting zoos."

The issue of hygiene at petting zoos arises regularly in North America. In March 2006, the CDC reported on the risk of children developing enteric disease from outings at petting zoos.

And in companion studies, researchers in two states found that hand-hygiene facilities were not being used properly. (EID: Petting Zoo Patrons Don't Recognize Risks or Wash Hands)

According to the Society for Intestinal Diseases, there were at least 55 outbreaks of intestinal disease associated with animals in public settings in the United States between 1991 and 2005.

For the current study, Dr. Weese and colleagues sent a trained observer to study 36 petting zoos within a 125-mile radius of the Canadian province of Ontario. The observer noted the presence or absence and placement of hygiene stations, as well as what facilities were provided, where signs were located, and how often they were used by customers.

In a multivariate analysis, four factors significantly predicted that customers would use the facilities:

• If the petting zoo had a single location, instead of several scattered through a larger event, customers were nearly three times as likely to use the facilities. The odds ratio was 2.89, with a 95% confidence interval from 1.62 to 5.15, which was significant at P<0.001.
• If the hand hygiene station was near the exit, customers were more than twice as likely to use it. The odds ratio was 2.438, with a 95% confidence interval from 1.66 to 3.58, which was significant at P<0.001.
• If running water was available, customers were more than four times as likely to wash. The odds ratio was 4.19, with a 95% confidence interval from 2.35 to 7.46, which was significant at P<0.001.
• And if hand hygiene signs were present, customers were 49% more likely to use the facilities. The odds ratio was 1.49, with a 95% confidence interval from 1.07 to 2.07, which was significant at P=0.017.

"While petting zoos are common and can be an excellent educational and social event, there are potential health risks that are not always being properly addressed," Dr. Weese said.

He said the study shows that simple measures -- such as locating the hygiene station near the exit and providing running water - can make a substantial difference in customer compliance.

He and colleagues also noted that food and beverages were carried into 82% of the petting zoos and that items that would come into contact with the mouths of infants - such as pacifiers - were carried into half of the events.

"It was a common occurrence to see people with items such as baby bottles, pacifiers, and baby toys in the petting zoo, which is of concern because these items would be put in the mouths of babies, who are at higher risk for acquiring certain zoonotic diseases," he said.