Animals in Healthcare Settings

Animals may be present in healthcare facilities for multiple reasons. Although specific laws regarding the use of service animals in public facilities were established in the United States in 1990, the widespread presence of animals in hospitals, including service animals, animals used to assist in patient therapy, and research animals, has resulted in the increased presence of animals in acute care hospitals and ambulatory medical settings. The role of animals in the transmission of zoonotic pathogens and cross-transmission of human pathogens in these settings remains poorly studied. Until more definitive information is available, healthcare facilities should establish policies and procedures to prioritize patient and healthcare provider safety and to use standard infection prevention and control measures to prevent animal-to-human transmission in healthcare settings. This paper is based on recently published consensus recommendations from a panel of experts, representing the Society of Healthcare Epidemiology of America (SHEA), regarding the management of animals in healthcare (AHC) (Murthy R, Bearman G, Brown S, Bryant K, Chinn R, Hewlett A et al, Infect Control Hosp Epidemiol 36:495–516, 2015). However, this paper aims to review the controversies related to animals in healthcare with respect to infection prevention, identify potential steps for mitigation of risks and areas for future study, and provide updated information where available; any opinions noted beyond the consensus SHEA guidance document reflect the opinions of only the authors of this document.