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Cats Indoors! update:
Evidence is mounting to link toxoplasmosis with schizophrenia

Keep pet cats inside, stop feeding strays, cook meat sufficiently and reconsider the way the veterinary profession and public health agencies think - and teach - about the zoonotic pathogen Toxoplasma gondii.

Such are the recommendations of Milton M. McAllister, a professor of pathobiology in the College of Veterinary Medicine at the University of Illinois at Urbana-Champaign. He delivered that message in Christchurch, New Zealand, at the 20th International Conference of the World Association for the Advancement of Veterinary Parasitology.

McAllister, also a clinical professor of pathology in the U. of I. College of Medicine at Urbana-Champaign, made his case based on his review of numerous studies on the animal-carried pathogen during the past decade. His review, prepared for the conference, appeared in the Sept. 30 issue of the journal Veterinary Parasitology.

"Our profession needs to come to grip with the accumulating body of evidence about the tremendous burden wrought on society by toxoplasmosis," McAllister wrote. "Further research is needed to clarify the association between toxoplasmosis and mental health, but until such time that this association may be refuted, it is my opinion that the current evidence is strong enough to warrant an assumption of validity."

Toxoplasma can infect most warm-blooded animals, as well as humans and birds. Domestic cats and some wild cats are the only animals that can transmit the parasite by shedding the organism in feces. Other animals become infected when they consume the organisms shed by cats. This method of parasite transmission is called fecal-oral, but it doesn't actually mean that feces are directly ingested.

The organisms survive in soil long after feces have decomposed. Dust contaminates paws, fingers, feedstuffs and water, ultimately leading to ingestion by animals and people.

McAllister and colleagues are beginning to work on a new vaccine, which, if successful, would be administered to cats orally, possibly incorporated into a treat. The vaccine would be used to prevent cats from shedding toxoplasma.

"Cats usually become infected with toxoplasma by ingesting an infected animal, or raw meat from an infected animal," he said. "So a cat gets infected by catching and eating mice or birds, or by eating meat scraps from such things as poultry, pork, lamb or game."

In his review, McAllister noted a long list of maladies made worse by toxoplasma infection in people with suppressed immunity, and he cited a growing list of studies that link problems in people whose immune systems are not impaired. Among the latter problems are fever, enlarged lymph nodes, weakness and debilitation, damaged vision, or multi-systemic infections with serious complications such as pneumonia and hepatitis. Toxoplasma also is a causative agent of encephalitis in AIDS patients.

People can get infections either by fecal-oral transmission -- even through inhaling oocysts in dusty conditions -- or by eating undercooked infected meat. Oocysts, the egg-like forms of a parasite, can survive for more than a year in soil, dust or water, McAllister said.
"Cats that remain indoors have a low potential to become infected if they don't have access to mice and if they are not fed raw meat or meat products," McAllister said. Owners can safely keep an indoor cat simply by practicing good hygiene with the litter box and washing hands after daily cleanings, he added.

Infected mice, he noted, show altered behavior, including being less aware of cats in an area, leaving the mice open to predation that renews the parasite's life cycle. Mice may not be the only creatures susceptible to behavioral changes from infections, he said.

"Evidence is mounting to link toxoplasmosis with schizophrenia or similar psychiatric disorders (in people)," McAllister wrote. "Recent studies from three countries found that schizophrenic patients had higher antibody levels to T. gondii than did matched control subjects."

He also cited older studies that used a toxoplasma skin test that "showed highly significant associations between toxoplasmosis and psychiatric disorders." Recent studies also have linked infections with reduced average intelligence.

Toxoplasmosis is the third leading cause of food-related deaths in the United States, behind salmonella and listeria infections. Exposure in the womb is considered "one of the most common infectious causes of birth defects, mental retardation and visual problems worldwide, including industrialized nations," McAllister wrote. Studies in the last three years have estimated that toxoplasma has infected 25 percent of adult Americans, 40 percent of adults in the Netherlands and 70 percent in Jakarta, Indonesia.

Marine mammals also are at risk, possibly from cat-feces-contaminated surface water going into the oceans. He cited infections of seals, dolphins and sea otters.

Simply put, McAllister said, domestic cats should not be allowed to roam outdoors. The feeding of stray cats, he added, by cat protectionist groups including some veterinary organizations that wish to spare homeless cats from the threat of euthanasia, unfortunately increases the spread of toxoplasmosis to wildlife, domestic animals and people.

"Public lawmakers should consider developing effective solutions that protect the best interests of society," he wrote. Health educators teaching new students, McAllister writes, "should be careful to distinguish sub-clinical infections from the possibilities of undiagnosed infections and latent disease." He noted that proper diagnosis likely is frequently missed.

If a practical vaccine to prevent cats from shedding toxoplasma organisms can be developed, he said, then its use could be made mandatory, similar to rabies vaccine laws in many states.


A Killer Outside:
Free-roaming cats kill millions of birds each year

There are more than 73 million pet cats in the United States. A poll shows approximately 35 percent are kept exclusively indoors, leaving more than 45 million owned cats free to kill birds and other wildlife -- and these are only the pet cats. In addition, millions of stray and feral cats roam our cities, suburbs, farmlands and natural areas.

How many birds and other wildlife do cats kill each year in the U.S.? No one knows for sure, although it is estimated that they kill hundreds of millions of birds each year. In January 1997, the American Bird Conservancy (ABC) set out to tackle the divisive and emotionally charged issue of domestic cat predation on birds. With initial funding from the Geraldine R. Dodge Foundation, ABC launched Cats Indoors! The Campaign for Safer Birds and Cats. Now in its fifth year, the campaign is receiving broad support from the conservation community, local cat ordinances are being passed, and cat owners all over the country know about the issue.

ABC initially formed partnerships with The Humane Society of the United States and American Humane Association to help convince cat owners to keep their cats indoors for the safety of cats as well as wildlife. A brochure and poster were produced (Keeping Cats Indoors Isn't Just For The Birds), along with fact sheets on cat predation on birds and other wildlife, hazards to free-roaming cats, and how to make an outdoor cat a contented indoor pet. Over the years, more fact sheets were added, as well as print and broadcast public service announcements, posters, and the award-winning Cats Indoors! Educator's Guide for Grades K-6. Most campaign materials are available from the ABC Website.

Scientific studies
Several scientific studies have been conducted during the past five years which bring important new information to the debate. A PhD study compared two grassland parks -- one with more than 20 cats that were being fed daily, and one without cats. Almost twice as many birds were seen in the park without cats as in the park with cats. California Thrasher and California Quail, two common ground-dwelling birds in the San Francisco parks, were not seen in the park with cats but were always observed in the park without cats.

A study of managed cat colonies in two Miami-Dade County parks in Florida by masters student Dan Castillo failed to support the claims of cat feeders that cats are territorial and will prevent additional cats from joining a colony; that cat colonies die out through attrition; and that well-fed cats don't kill birds and other wildlife. Castillo found that cats would not prevent additional cats from joining the colony, nor did they prevent any cats from eating the abundant cat food. He also boserved well-fed cats in both colonies stalk and kill. Although one cat colony remained about the same size, the other colony acutally increased.

Making a difference on the ground
Cats Indoors! is supported by dedicated activists who are working in their own communities to educate the public and to encourage the adoption of cat ordinances. The campaign's network of supporters has grown from 64 ABC Policy Council members to include more than 3,200 individuals and organizations representing the veterinary, animal welfare, wildlife rejabilitation, birding retail, military, fish and wildlife agency, and conservation communities. The states of Florida and Minnesota are both distributing thousands of brochures and posters to veterinarians, animal shelters, nature centers and wildlife rehabilitators throughout their states.

Since cat owners rely on veterinarians for most cat care advice, having their support and the support of their professional associations is crucial to the success of the campaign. In June, 2001, the American Veterinary Medical Association (AVMA) passed a resolution strongly encouraging cat owners in urban and suburban areas to keep their cats indoors. Other veterinary organizations and adopted similar platforms. The Association of Avian Veterinarians (AAV) and the Alliance of Veterinarians for the Environment (AVE) have joined ABC, the NJ Audubon Society, the NJ Department of Fish and Wildlife and the Cape May National Wildlife Refuge in a media campaign to discourage cat abandonment in Cape May, designated a globally Important Bird Area.

The campaign has funded humane feral cat trapping efforts at wildlife refuges in Massachusetts, North Carolina and at Gateway National Recreation Area in New York. Feral cats are a serious threat to beach nesters such as the Piping Plover, Black Skimmer, American Oystercatcher and Least Terns.

What you can do
If you have friends, tell them to keep their pet cats indoors, and explain why. Practice what you preach; if you have a cat, be sure to keep it indoors, too. Ask your veterinarian to discuss the subject with the owners of his feline patients. For additional information, please visit the American Bird Conservancy on the Web.


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