Thought the ferret list readers might be interested in this article from the September '91 issue of the FDA VETERINARIAN, a journal for vets published by the U.S. Food and Drug Administration (FDA). According to the editor, Linda Grassie, all articles are free of copyright and may be reprinted. The author of the rebuttal portion of this article, Dr. Freddie Hoffman, is Vice President of the mid-Atlantic Ferret Association (AFA). To contact the AFA or to receive a complimentary newsletter, write to P.O. Box 3986, Frederick, Md. 21701. LETTERS TO THE EDITOR As we mentioned in the last issue of the FDA Veterinarian, we have been contacted by readers concerned about the article, "The Domestic Ferret-Pet of the Nineties?" by Dr. Freddie Ann Hoffman, which appeared in our May/June 1991 issue. Comments have been received from Dr. John I. Freeman, Chief of the Environmental Epidemiology Section of the North Carolina State Department of En- vironment, Health, and Natural Resources; Dr. F.T. Satalowich, State Public Health Veterinarian in Missouri; Dr. Russell J. Martin, President of the National Association of State Public Health Veterinarians, Inc.; and Dr. R.A. Robinson, Professor and President, Association of Teachers of Veterinary Public Health and Preventive Medicine. All of these individuals were concerned about possible injury to children by pet ferrets. Dr. Martin stated that ". . . I am concerned that the overall thrust of the article is in support of the use of ferrets as pets. The scientific literature contains numerous reports of severe, often mutilating, bites of humans inflicted by ferrets. Infants and small children often suffer the most gruesome of these injuries serious consideration should be given to the use of ferrets as pets, especially in settings where infants and small children are present." Drs. Freeman and Satalowich voiced these same concerns. In his letter, Dr. Freeman stated "The article portrays the ferret as the panacea of pets . . . . The most shocking information omitted by Dr. Hoffman is the compilation of 64 small children and infants traumatized by 'pet' ferrets as reported by Dr. Denny G. Constantine . . . . The traumatic injury potential for infants and small children is a major public health issue and it is quite disturbing that this fact was omitted. Dr. Hoffman states 'the ferret provides the best qualities of the dog and cat.' In my 27 years as a public health veterinarian, I know of not one case where a dog or cat deliberately climbed into a child's crib in the night and inflicted serious traumatic injury or death." Dr. Robinson wrote with similar concerns about the safety of ferrets around children. He was surprised that the article contained "absolutely no mention whatsoever of unprovoked biting incidents by ferrets, the great majority of which were inflicted on infants and young children and were of considerable severity. While it is a moot point as to whether the rate of biting humans by ferrets exceeds or is similar to that from dogs or cats, nevertheless I would have expected the author . . . to present clearly the risks of owning a ferret particularly where there is a young infant in the home." The Food and Drug Administration does not advocate any particular type of pet. The article was included in the FDA Veterinarian to provide information on a pet which is becoming in- creasingly popular in the U.S. We have asked Dr. Hoffman to reply to the concerns of these readers who contacted us about her article. [Dr. Hoffman replies to these concerns below.] Although I considered the following information outside the scope of the original article, I appreciate the opportunity to address the important public health issues raised by the above cor- respondents. As a pediatrician and member of the public health community, I certainly acknowledge that a pet may pose potential hazards to human health. Zoonotic diseases, allergies, dermatologic conditions, scratches, and bites are well recognized risks of pet ownership. Much of the criticism in the letters stems from a questionable report by Drs. Constantine and Kizer entitled "Pet European ferrets: A hazard to public health, small livestock, and wildlife." This report identified 452 ferret "attacks," including 64 "unprovoked attacks" involving infants and children over a 10-year period. The authors admitted that "Available reports, which were usually retrospective, generally lacked uniformity, and reflected varying degrees of effort" and that the "animal control personnel and laboratory workers needed help differentiating ferrets and weasels." Also, in one case, the attack was "blocked by a parent, so that the infant was not actually harmed . . ." Five of the 63 bite cases received plastic or reconstructive surgery, and one case was an apparent bite-related death reported from the United Kingdom. A second ferret bite-related fatality involving a 10-week old infant was recently reported from Oregon. Details of this incident are not publicly available due to a continuing investigation by local authorities. This case represents the only ferret-related fatality ever reported in the U.S. The California report concluded by stating "ferrets are miscast as pets. Even though some pet ferret owners are willing to suffer bites as a price of pet ownership, it is not reasonable to expect their neighbors and other persons to do so, especially in light of the potential for devastating attacks on infants . . . ." The issue of whether ferrets pose a greater threat to human health and welfare than do other companion animals has sparked a heated debate, generating a written rebuttal by the California Domestic Ferret Association and continuing dialogue within the veterinary community. This exchange was summarized in a 1988 Journal of the American Veterinary Medical Association (JAVMA) article entitled "Fur Flies Over Ferret Issue." The article stated "Statistics from the Center [sic] for Disease Control and an article in the [Journal of the American Medical Association] JAMA indicate that the number of bites inflicted by ferrets appears to be substantially lower than those by dogs and cats. These statistics were compiled from 1978-1988 and were reported on a yearly basis: between one and three million dog bites, compared with 65 ferret bites in 10 years. Serious bite injuries were recorded as 44,000/year for dogs and 12/year for ferrets. Severe facial injuries requiring plastic or reconstructive surgery number 16,000/year for dogs and 12/year for ferrets . . . ." Although relative bite "rates" between animals may be inconclusive as suggested by Dr. Robinson, the incidence (rate adjusted for population) cannot be disregarded. Estimates of the 1988 U.S. populations of dogs and ferrets were 50 million and 3 million, respectively. Using the above statistics, the bite incidence rate for dogs (8.8 bites/year per 10,000 dogs) is more than 200 times that for ferrets (0.04 bites/year per 10,000 ferrets). The strikingly lower bite incidence for ferrets is supported by trends observed in actual bite reports from various parts of North America, including New York City, Toronto, Pima Arizona, Minneapolis Minnesota, and Maryland. In a survey conducted of Frederick County, Maryland, known for its large number of ferret sales, ferrets were responsible for less than 1 percent (6 of 1012 of the animal bites reported during the 29-month period from January 1989 through May 1991 (see Table). Animal size correlates with traumatic injury potential. The above data demonstrate the lower frequency and severity of injuries resulting from a 26 pound ferret, when compared to a 20-100 pound dog. [26 pound ferret !!??? Chip? Typo in the article or your transcription? CRL] Infants and children are particularly susceptible to animal attacks. In a U.S. survey, Jones and Beck found that 45 percent of children had been bitten by their pet dog. Another study reported that of children under 4 years of age who were bitten by dogs, in 85 percent of the cases the dog had no prior history of biting. In young children, dog, cat, and ferret bites result in greater morbidity and are more often multiple and distributed about the head and neck regions. According to an article by J.J. Sachs, R.W. Sattin, and S.E. Bonzo in JAMA, of the 157 dog bite-related fatalities in the U.S. between 1979-1988, 70 percent occurred in children less than 1 year of age. For the 25 deaths among infants less than 1 year of age, circumstances surrounding attacks were reported in 19 cases. "All involved pet dogs, and all but one attack occurred in the home and involved a single animal. Ten attacks occurred while the infant was sleeping or in a crib." It is important to alert the public to the potential risks pets may pose to small children and infants. Since the most frequent victims of pet attacks are the very young, the weak, and the elderly, a common sense approach is necessary. No animal should be considered "safe" and left unattended with an individual incapable of removing itself from the presence of the animal. Incidents involving children, particularly infants, should raise the suspicion of child neglect. Responsible pet owners are the single most important element in reducing the incidence of injuries from pets. Veterinarians and physicians must work together to educate their colleagues and the pet owner regarding the facts. References available from the FDA Veterinarian. Animal Bites Reported in Frederick County, Maryland (Reported from the Frederick County Animal Control) Animal 1991 1990 1989 TOTALS (5 months) (29 months) dog 122 311 266 699 (69%) cat 35 124 112 271 (27%) hamster 3 5 3 11 (1%) ferret 1 2 3 6 (<1%) horse 0 2 2 4 (<1%) ground hog 1 1 2 4 (<1%) rabbit 2 1 0 3 (<1%) mouse 0 3 0 3 (<1%) squirrel 0 3 0 3 (<1%) gerbil 1 0 1 2 (<1%) bat 1 1 0 2 (<1%) rat 0 1 0 1 (<1%) chipmunk 0 1 0 1 (<1%) raccoon 0 1 0 1 (<1%) opossum 0 1 0 1 (<1%) TOTAL 166 457 389 1012 (5 months) [end of article] The mid-Atlantic Ferret Association (AFA) can be reached at P.O. Box 3986, Frederick, Md. 21701. [Posted in FML 0172]