Ringworm questions

2011-11-24 more from Worms & Germs, http://feeds.lexblog.com/~r/WormsAndGermsBlog/~3/bG6s5mw8FYU/

[revised 2008-10-12] Worms and Germs is posting about ringworm and will have a follow-up ( thank you!) Ringworm: skin fungus by any other name http://www.wormsandgermsblog.com/2008/10/articles/animals/dogs/ringworm-skin-fungus-by-any-other-name/
2008-10-18 Yippee! Ringworm Part 2: Cleaning Up from Worms and Germs
New reference 2011-03-05Cleaning and Disinfecting in Shelters This is from the University of California Davis, Koret Shelter Medicine Program.

I never expected ringworm to be a concern here, but it relates to Lysol / Dettol and to mass evacuations and shelters and recovery. Good questions, readers! Unfortunately, good information about controlling environmental contamination (something beyond the platitudes) still isn’t readily available from the Internet.

See earlier Ringworm questions:

“Ringworm is a skin infection caused by a fungus. Ringworm can affect skin on your body (tinea corporis), scalp (tinea capitis), groin area (tinea cruris, also called jock itch), or feet (tinea pedis, also called athlete’s foot).”

If an infected child plays on the couch with another child, then there may be a transfer of the fungus from child to couch to child. But fungus likes damp. Couches normally aren’t damp and children normally don’t play under the cushions on a couch (where dampness can linger).

Beds and clothing are another matter because the materials stay damp longer.

Regular vacuuming and airing of pillows and the couch itself should help prevent transfer (micro-organisms will die in inhospitable environments). If the couch has colorfast non-porous materials, you could try spraying with Lysol room spray (the disinfecting alcohol spray). But you have to leave the spray on long enough to be effective and then allow the couch to dry. Using a clean damp cloth followed by a clean dry cloth might be just as effective.

Even better would be to use a slip cover that can be washed. The pillow covers can be washed in hot water.

If the couch is moldy or damp, (not just the pillow or cushions) then it should be replaced. Some of the molds can create a form that would last in between drying out and then be ready to “bloom” when the couch is damp again.

Damp couches and mattresses would be the second most difficult clean-up problem after a flooding disaster. Damp house walls, ceilings, and flooring is the worst, I would think. Maybe some readers have better answers than mine.

Boulder Colorado suggests

revention Recommendations * Cover lesions * Wash bedding, towels, and clothes * Do not share towels, hats, hair brushes, or other personal items with those infected * Regularly scrub showers with fungicide or bleach * Exclude those infected from gyms, pools, and contact sports * Check pets * Treat infections * Wash hands frequently

The National Library of Medicine (with lovely pictures) also suggests

To prevent ringworm: * Keep your skin and feet clean and dry. * Shampoo regularly, especially after haircuts. * Do not share clothing, towels, hairbrushes, combs, headgear, or other personal care items. Such items should be thoroughly cleaned and dried after use. * Wear sandals or shoes at gyms, lockers, and pools. * Avoid touching pets with bald spots.

I would definitely recommend adding shower shoes or Zories / flip-flops / jandals / thongs to one’s personal evacuation bag. see What’s in a doctor’s disaster backpack

Resources for damp environments–
see previous post Top 50 reading list for emergency management

The National Library of Medicine keeps getting better as a resource–
“Enviro-Health Links – Hurricanes: Links to Health Information Including Toxicology and Environmental Health”

Lysol / Dettol posts here

Planning for “infectious disease shelters” in the Unorganized Borough, Alaska

Digger the dermatophyte

Digger the dermatophyte

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24 responses to “Ringworm questions

  1. Environmental Public Health Impacts of Disasters: Hurricane Katrina, Workshop Summary – (National Academies Press) is now available as Emergency and Terrorism Preparedness for Environmental Health Practitioners from http://www.cdc.gov/nceh/ehs/ETP/

  2. Suburban family discovers hidden room filled with toxic mold and a taunting note
    Marilyn sez, “A family doing chores in their recently purchased suburban house in South Carolina discovered a hidden room behind a bookcase, which revealed the truth about their house: it was permeated with toxic black mold.”


    Many houses for rent in Bethel have mold, not from basements (none) and not from flooding but from poorly ventilated construction. The City of Bethel says they won’t regulate habitation (health) standards because they figured they would be sued if sub-standard housing existed. This doesn’t make sense to me– the city collects sales tax and business license fees for rentals and therefore has liability for unhealthy homes. Plus, without any housing standards, the costs for utilities are out of hand (and still not calculated).

    Neither health nor arithmetic seem to matter as the city will be raising utility rates and city sales tax, January 2008.

  3. We currently have 3 children with the ringworm fungus. Two have then in the hair and one on the jawline near the ear. I am trying to prevent any further breakout. Is there a particular solution we need to use on the headphones to keep this from spreading? We have Lysol and Clorox products available.
    Thanks- Kim Patrick, Jan 14, 5:25 AM
    The doctor is in

    # For this one I will refer you to your public health office, because it sounds like you need a school-wide evaluation. Also, I haven’t been able to find any information specific to ringworm environmental treatments. I’ll keep looking for that info.

    Be sure to ask about items such as computer keyboards– recently an outbreak of norovirus (the contagious gastrointestinal virus) was traced to the computers in a primary school room.

    I believe the wipes would not be on the items long enough to be very effective, although they would help. [I don’t have much experience with the wipes] The sprays (the EPA disinfectants, especially if labelled as tuberculocidal) would be useful. I doubt the home varieties would be either cheap enough or strong enough for routine school use.

    As an interim action, I would recommend using either the Lysol-type spray or the pump disinfectants on the equipment. Be careful not to spray inside the electronics. You want the item to be damp but not soaking and allow the disinfectant to remain in contact for several minutes. Then wipe dry with plain disposable Kimwipes or tissues. Allow any equipment to be dry between uses.

    I know keyboards can be sprayed but not soaked (actually they can be run through a dishwasher) but must be dry before use. A disposable disinfectant wipe may be effective or a tissue or Kimwipe sprayed with the disinfectant and then used to wipe the keyboard. This might be the answer to the earphones for regular use (spray the tissue until damp then wipe the equipment).

    Depending on the age of the children, each child could learn to wipe their equipment before use (along with washing their hands) but only a teacher or technician should do the after use disinfecting.

    Alcohol pads or wipes have been used on eye examination equipment between patients. These are dampened, single-use swabs. They may be too small to be effective on the earphones. That is, any applied disinfectant needs to be on the item long enough and cover the entire contact area to be effective. Teachers make their own alcohol wipes.

    Please come back here and let us know what worked best for you.

  4. Here’s the recent norovirus and computer reference– The original report is in the Morbidity Mortality Weekly Report. The following summary comes from the invaluable ProMed. The suggestions for norovirus protection should be more than adequate for ringworm fungus, but double-check with public health or your school district industrial hygienist.

    Please support ProMED-mail by donating to the 2005 Internet-
    a-thon at http://www.isid.org/netathon2005.shtml
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    Date: Fri, 4 Jan 2008 12:11:13 -0500 (EST)
    A ProMED-mail post http://www.promedmail.org
    ProMED-mail is a program of the International Society for Infectious Diseases http://www.isid.org

    Date: Fri 4 Jan 2008
    Source: CDC MMWR Morb Mortal Wkly Rep; 56(51); 1340-3 [edited]

    … On 15 Feb 2007, DCDOH recommended the following additional interventions: 1) clean computer equipment (such as mice and keyboards) and other shared surfaces that were overlooked during the 8 Feb 2007 cleaning with a 1:50 concentration household bleach solution, and 2) exclude ill persons from school for at least 72 hours after resolution of illness because of continued fecal shedding of infectious virus (1). The last person reported with a case of illness had symptom onset 17 Feb 2007

    This outbreak is the 1st report of norovirus detected on a computer mouse and keyboard, which highlights the possible role of computer equipment in disease transmission and the difficulty in identifying and properly disinfecting all possible environmental sources of norovirus during outbreaks. The contaminated computer was located in 1st-grade classroom J, the only classroom that was independently associated with illness and the only classroom in which computers were shared by students and staff members.

    Person-to-person contact also likely played a role in this outbreak. Contact with an ill person was one of 2 significant risk factors for illness in bivariate and multivariable analyses. School children might be at increased risk for person-to-person norovirus transmission because of close quarters and poor hygiene. Because an ill person is infectious while symptomatic and possibly for 3-14 days or longer after recovery because of continued fecal shedding, the short exclusion time of ill persons from school (median: one day after symptom onset) might have facilitated person-to-person transmission in this outbreak. Student person-to-person contact during the weekend was reported anecdotally, and onset of new cases continued after the weekend.

    Proper washing with soap and water can eliminate norovirus from hands; alcohol-based sanitizers also reduce feline calicivirus on hands. Potentially (but non-visibly) soiled surfaces are best disinfected with a solution of 1:50 to 1:10 concentration of household bleach in water (1000-5000 ppm chlorine) by vigorous wiping for more than 10 seconds. However, because a 1:10 [1000 ppm] household bleach solution is caustic, only corrosion-resistant surfaces should be cleaned with this concentration. Laptop computer keyboards have been shown to withstand more than 300 disinfections with 80 ppm bleach solution without visible deterioration. When cleaning environmental surfaces that are visibly soiled with feces or vomitus, masks and gloves should be worn, a disposable towel soaked in dilute detergent should be used to wipe the surface for more than 10 seconds, and a 1:10 household bleach solution should then be applied for more than one minute. Disposable towels used to clean visibly soiled surfaces should be discarded appropriately after use because they can transfer norovirus to fingers and other surfaces. Although quaternary ammonium compound-based cleaners [the Lysol and Clorox pump spray disinfecting cleaners] typically are not recommended for eliminating norovirus, certain newer formulations* are effective; alcohol-only cleaners are less effective.

    [* newer than 2005 I would think but was not stated in the summary]

    References [see the article for the complete set. Only the following is available on-line without a subscription.]
    – ———-
    CDC. Norovirus: technical fact sheet. Atlanta, GA: US Department of Health and Human Services, CDC; 2006. Available at http://www.cdc.gov/ncidod/dvrd/revb/gastro/noro-factsheet.pdf

  5. Author : Nadine
    My three girls have been diagnosed with ringworm. I’ve never had it nor am I familiar with how to treat it with the exception of what the girls pediatrician told us. He basically gave an oral medication to my middle girl and told us to use Lamisil on all three of them. Well, as I’ve read more about this it seems that I need to be doing more. Is it really necessary to clean all the couch pillows, carpets, sheets? I’m so overwhelmed. I had no idea there was so much involved in making these fungus spores go away! Part of the problem is that they contracted it from a cat that we adopted. The vet told us he didn’t think it had ringworm. He was obviously wrong. Anyway, this cat has been everywhere in our house – under beds, walking around the living room, on the stairs… Does this mean, that every little place he has gone I will have to steam clean or disinfect?

    Really looking for some help in my overwhelmed state!

    Thanks – Nadine

  6. Turns out that cats, Yorkshire terriers (+), and cows also transmit ringworm to people. It isn’t always obvious when a cat has the fungus.

    What your pediatrician prescribed is the recommended treatment.

    I think there are two major things to keep in mind–
    ** treat the infection (cat or person)
    ** keep the environment hostile (dry, airy).

    A damp environment, including skin, a damp hat (recently removed), damp bedding (during a night’s sleep), head wrestling, sharing combs, etc. is why ringworm is transmitted through “direct contact”. It really seems a fungal transmission has to be nurtured in some way. Therefore, unless the infection is severe, people are immunocompromised, or you live in a damp house, you shouldn’t need special efforts for ordinary items.

    The cat’s/child’s bedding should be changed or washed & dried daily as long as the cat/child is still infected. [Remember the amount of time one spends in contact with a sweaty pillow when asleep.] Don’t let the cat sleep on the couch but an occasional footprint is very unlikely to transmit anything, especially as the floors, steps, etc. are kept dry. Maybe use a slipcover that can be washed daily if the cat must nap there.

    Since petting the cat is what transmitted the fungus, wash and dry hands before and after petting the cat. After cat is healthy, then handwashing is useful after petting the animal.

    There seems to be very little explicit information on-line about living through the diagnosis and treatment stages of ringworm, other than what is stated in the post above. In humid areas fungal infections are more common, which is why the concern after flooding and public shelters (animal and people).

    Ringworm usually responds well to self-care within 4 weeks without having to see a doctor. * Keep your skin clean and dry. … * Wash sheets and nightclothes every day while infected. A severe or persistent infection may require treatment by a doctor. Antifungal pills may be given and are necessary if your hair is infected. Prescription antifungal skin medications, such as ketoconazole, are stronger than over-the-counter products and may be needed. Antibiotics may also be needed to treat related bacterial infections. Infected pets also should be treated. (

    (+) http://www.cdc.gov/ncidod/eid/vol11no07/05-0045_05-0410.htm

  7. Mostly a reminder of earlier advice (this was directed towards a boys residential school).

    “Fungal Skin and Nail Infections: Practical Advice for Advanced Practice Clinicians “Breaking the Cycle

    Both infections (tinea pedis and tinea cruris) will fail to clear or promptly return if measures are not taken to prevent the growth and spread of the fungus among the school’s residents. Changing poor hygiene practices will require significant behavioral modification on the part of the school’s residents. Students must wear clean, dry socks and undershorts and learn to put their socks on before putting on their undershorts to avoid contaminating the groin area. Boys should not go barefoot in bathrooms, showers, or locker rooms; instead they should wear foot thongs or flip-flops. After showering, they should dry their feet thoroughly, especially the area between each toe. A separate clean towel should be used to dry the groin area, drying the crural folds thoroughly. Students must understand the concept of cross-contamination between the feet, hands, and groin area and practice good handwashing.

    Shower stalls and bathroom floors must be scrubbed regularly using a solution containing bleach. Towels, socks, shoes, and other personal items should not be shared. When possible, athletic shoes should be of the well-ventilated type and allowed to dry completely before being worn again.”

  8. When was the worst case of an epidemic for Ringworm?

  9. I’m not sure if there was ever an epidemic; I’ve never heard of one. But it isn’t much tracked, except by schools.

    There are periodic flare-ups, such as school starting and during floods. Certainly there may be more incidents in warmer, wetter seasons and during civil unrest. Think of epidemics of athlete’s foot or jock itch– more likely the fungus is endemic (present naturally) but not resulting in great numbers of afflicted people.

    Anyone else have an idea?

  10. Is there a cheap antifungal spray cleaner for ringworm that I can clean my house and car with so that I don’t get reinfected? I don’t know where I got it. My cat doesn’t have it–no one else I know has it.

  11. Dilute bleach is pretty cheap but it isn’t recommended for non-colorfast materials. Also, I’d be leery of general spraying.

    On hard surfaces, like the steering wheel, you could try using a use-once disinfectant wipe or make one out of an old rag. Just be sure you don’t wipe back and forth because all that does is spread germs around.

    You might try first to “map” your environment. That is, where are your outbreaks and then try to identify where you have warm damp conditions. For example, if athlete’s foot, do you use a gym?

    do you use headphones that others might use? sleep on a plane? read in a comfy chair without a fresh antimassacar?

    You might even write down what you do in a day or the places you go. Kind of like the equivalent to forensic epidemiology and tomatoes.

    Anyone else have suggestions?

  12. My 3.5 year old son had scalp ringworm. He took the medicine his doctor prescribed Griseofulvin) for 8 weeks. How do you know if one is cured afterwards? I am worried about the scalp ringworm coming back. I went to a dermatologost to have a scalp culture done. Is this necessary, how do you know if he is truly cured? Also, I am trying to disinfect my house. I do not want the scalp ringworm to spread througout my home or to anyone else.

    Should we all get tested even if we are not showing signs?? I am going bonkers here.

    Does Lysol kill ring worm spores or ringworm germs on surfaces?

    Specifically – Does Lysol kill scalp ringworm (tinea capitis) on surfaces?

    Does Lysol kill ring worm spores or ringworm germs on matresses and sofas?

    Specifically – Does Lysol kill scalp ringworm (tinea capitis) on matresses and sofas?

    If not what does?
    Thank you

  13. @ SW:

    As far as disinfecting hard surfaces. I would use any product labelled as a disinfectant or anti-fungal.

    Your doctor or public health nurse would still be the best to consult for actual treatments. From what I read, it can be helpful to identify the specific cause of the lesions, as your son’s doctor did.

    Keep your child’s towels and personal items separate and don’t re-use without washing and drying– at least until the infection abates. Remember, fungus, like ringworm or athlete’s foot, like damp.

    I don’t think I would worry too much about trying to disinfect sofas and beds and such, as long as the covers or bedding is clean and dry.

    It’s worrisome now but it does go away, mostly because kids grow older. In the meantime– maybe increase handwashing (and drying) and be sure everyone has their own towels and such. Keep an eye out for infections on other family members. But check with your doctor whether you would all need testing It would be hard to test generally anyway without a specific spot on the skin to examine. [Anyone else with coping suggestions?]

  14. I recently contracted ringworm (1st time in my life!)

    I am only in my 40’s but have somewhat recently become permanently disabled with several devastating conditions – ranging from a rare collagen & connective tissue disease I was born w/ that has created its fair share of subsequent disabling conditions (too many to list) and as of 2 yrs ago, severe degenerating spine with numerous subsequent conditions – bottom line – I have enough trouble getting through the day as it is w/ being unable to get around & chronic severe pain w/ medication.

    I have 3 dogs (2 small pet, 1 larger service dog) & NONE OF THEM HAVE RINGWORM. I live w/ my sis, her boyfriend & 2 kids (upstairs – I’m down in a basement apartment – w/ air conditioner & fans constantly running), windows open – when it hasn’t been humid – and NONE OF THEM HAVE RINGWORM!

    Where the heck did I get this from & how the heck am I going to get rid of it – FAST??? I know it takes time – I know all about the treatments & have been diligent using them. I cannot get to a doctor in the shape I’m in (haven’t been able to sit for almost 3 yrs now) – have a tough enough time 1x month w/ my pain mngt doctor!

    I absolutely cannot afford to have ringworm – feel like I am just forever cursed w/ one thing after another! But w/ all the diligence, this is not going anwhere fast – and I know it takes time (4 wks minimum). My immunie system is definitely more compromised than most – could this be a factor in it not going away like it should by now?

    I try my hardest to keep things clean – even in my condition. I admit I am a clean freak even before this (dad calls me Howard Hughes) b/c of how much I disinfect EVERYTHING . . . but w/ my condition, it has to be. Somehow ringworm has found itself a nice spot on the inside of my thighs – not the most convenient place to air out unless I just walk around in my undies :-)

    I am deathly afraid of contaminating anything further (still have not figured out the source – unless a little black mold has anything to do with it?) – but I suppose that’s proof enough that I have perfect thriving conditions – and this place is all brand new – just built last summer! I have cork floors (which I bought b/c they have natural anti-microbial properties)& a few throw rugs which I constantly am bleaching.

    + How to I find the exact source?

    + Can I cover my legs w/ treatment & apply bandages over to avoid recontamination (of everything) or will this promote more moisture darkness to thrive, even w/ topical treatment?

    + Are there any additional ‘home’ remedies I can use in addition to the topical anti-fungals?
    (I have seen a lot of crazy things on the web – from using diluted bleach to vinegar to applying & eating garlic and even putting nail polish or liquid bandage on it to suffocate it!) Are there any sane/ valid additional things I can do?

    It has transferred from one leg to the other (identical spots & shapes too that line up perfectly!) It is hard to wear even shorts & using the bathroom is quite difficult (pulling pants up/ down) & afraid of spreading it – though I wipe the seat down w/ bleach.

    Should I be nervous showering w/ the water running down my leg – will it contaminate my lower legs/ feet somehow? Will soap irritate it further (which I don’t apply it directly/ contaminate)?

    Washing hands after removing possibly contaminated clothing – is regular anti-bacterial soap good enough? Then again, I have a huge problem washing my hands too much b/c my skin is fragile & splits open – I also don’t want to infect my dogs, have to take care of them w/ ringworm & get it back (if I ever get rid of it) or make it worse now

    I also am using a towel where ever I lay down (all I can pretty much do) – will the spores go through somehow?

    Laundry is also difficult for me – can I accumulate a little laundry tied up in a bag (w/ lysol sprayed in there) or should I be washing everything immediately after use?

    If bleach is not appropriate for some laundry, is vinegar, soap & hot water a good enough replacement (for colors, etc.)? In an High Efficiency washer?

    Do you think it would be smarter to sleep on the couch in my air conditioned room w/ ceiling fan going vs. my darker/ less airy bedroom? Though there is a water closet in there . . .

    Sorry about all the questions (especially any stupid ones) – I am just scared to death of this infection b/c of the already compromised condition I am in. HELP???!!!!

    (P.S. and really sorry about the mini novel – I am just desperate to get rid of this!)

  15. @ Gem:

    Don’t worry about the mini-novel– you describe your situation well so that ‘most anyone can empathize. You certainly seem to be doing everything right, from what I can tell, but my experience is limited.

    re: anti-bacterial soap. If you mean the usual off-the-shelf stuff with triclosan, that won’t do any more good than plain soap (and does contribute to environmental contamination). You are right to be concerned about over-washing, but the drying after washing is important.

    re: black mold. Mold is a type of fungus ( http://www.newton.dep.anl.gov/askasci/gen01/gen01952.htm) but the specific lifeforms are different creatures, even thought they share similarities in habitats.

    re: laundry. Don’t bag it up but allow it to dry (I use a chair or exercise equipment overnight then place in a mesh pop-up laundry “basket”)

    re: spores. They are likely everywhere and even if they migrated through a towel wouldn’t be able to reproduce without the right conditions.

    re: bandages as shields. I suspect this would make things worse, even if loosely applied. Have you tried “bloomers” (whatever the male equivalent) or “snuggies” I think my grandmother called them– drawers which cover the thighs. But I have no idea whether long-spun cotton or something like Capilene (wicking, synthetic, some with embedded silver for antimicrobial effects) would work.

    Now, you have exhausted all I contribute so I’ll post a separate note to see if other readers can help. Before I do so, have you been diagnosed with ringworm by a medical professional (could be something else entirely)? Is there any way to get a house call if you can’t get out to the doctor? Have the animals been checked [I contacted the veterinary Worms-and-germs folks http://www.wormsandgermsblog.com/ to see if they can write up or vet (sic) the ringworm discussions]

    Especially with any condition affecting connective tissue, which is also skin, and which may also compromise your immunity (especially as skin is the first line barrier), trial-and-error remedies for unknown conditions may do more harm than good.

  16. my whole family has ring worm now thanks to this cat we adopted from this “animal shelter”.It infected my other cat and them spread to the rest of the family.It is a horrible nasty infection.I am typing on a keyboard that is wrapped with clear rap and im wearing plastic gloves.Im fed up of having a dirty house.Its embarrassing!
    what should i do to get rid of this horrible infection in my house?
    cleaning wise?
    and should i stop brushing my persian? if i dont he gets knots and if i do the fur goes in the air and im afraid it might spread.

  17. It’s of little comfort to know that “fungus happens” and, like headlice in kids, isn’t a sign of unhygienic living.

    The links below from Worms and Germs (Univ of Guelph) have some suggestions, similar to the ones in the post above. It’s going to take awhile to get environmental items dry and less infective. In some cases, you may even have to throw out contaminated items.

    I would check with your vet about the Persian. It may be they advise a shaving for awhile to be sure the skin gets medicated and stays dry. Brushing and grooming evidently can continue but you have to be careful to disinfect the brushes each time and be sure the skin (dander and dandruff) attached to the brushed-out fur doesn’t get blown around. You could try a wet sponge bath before brushing, to keep the hair from blowing about (My cat loves sponge baths) A wet comb/brush might help too. Don’t soak the cat or leave it damp– the fungus would love that.

    Anyone else with success stories?

    Ringworm Part 2: Cleaning Up

    Ringworm: skin fungus by any other name

  18. Submitted on 2009/10/03 at 1:31pm

    i have two quesitions one can you get ring worms bye touching the spot where the ring worms are or can you get them from standing in the house they’re in


  19. Alicia–

    Don’t forget that ringworm is a microscopic fungus, not an actual animal. Like athlete’s foot, bits of the fungus can be transferred to your fingers which then can be spread to another spot. However, the fungus needs a hospitable environment in which to grow. So, a simple touch once is unlikely to spread the fungus– skin is a very difficult physical barrier to break through.

    Simply standing in a house with ringworm won’t infect anything, but continual exposure (living or working in a contaminated room) means it is far more likely you will keep contacting the fungus and that the fungus can find a nice warm, moist area on you to grow.

    Therefore, wash (and dry) your hands. Follow the other recommendations for reducing the presence of ringworm fungus.

    A ProMED-mail post http://www.promedmail.org ProMED-mail is a program of the International Society for Infectious Diseases http://www.isid.org

    Mr Godfrey said one reason the infection got out of hand was that “protocols” for identifying contagious conditions were not followed.
    When widespread signs of ringworm appeared a few weeks ago, animals were not immediately isolated as they should have been. A manager of the shelter has been fired as a result, he said.

    However, Mr Godfrey said, while better practices might have mitigated the situation, they likely would not have stopped the spread of the infection entirely. “This is such an extraordinary strain of ringworm that we can’t say that even following those protocols would have prevented this altogether,” he said. The “particularly vicious strain” is highly contagious and spreads quickly, he added.

    With 6 workers in the shelter also infected, the OSPCA’s veterinary advisers said the outbreak was so bad that most of the animals had to be put down to insure that more animals and people do not catch the virulent fungal infection.

    Still, not all of the 350 animals in the shelter will be euthanized, Mr Godfrey said. About 20 animals that are less severely infected have
    been identified and will be put into isolation at other vets’ offices. …

    Maureen Anderson, an infectious-disease expert at the University of
    Guelph, said some strains of ringworm can be more easily transmitted
    to animals or people, and sometimes the fungi that cause it may be
    resistant to antifungal drugs.

    Ringworm is treatable, she said on a university blog, “but it is not cheap or easy. Animals typically require systemic therapy (usually
    oral medication, which can be very expensive particularly in large dogs) as well as whole-body topical therapy Š and they need to be treated for several weeks.”

    [In dogs, approximately 70 percent of cases are caused by _Microsporum canis_, 20 percent by _M. gypseum_, and 10 percent by _Trichophyton mentagrophytes_; in cats, 98 percent are caused by _M. canis_.

    The Wood’s lamp is useful in establishing a tentative diagnosis of dermatophytosis in dogs and cats but cannot be used to rule out this type of infection. Definitive diagnosis is established by DTM (dermatophyte test medium) culture. Detection of infection in asymptomatic carrier animals is facilitated by brushing the coat with a new toothbrush and then inoculating a culture plate by pressing the bristles to the surface of the medium.

    The clinical appearance of ringworm in cats is quite variable. Kittens are affected most commonly. Typical lesions consist of focal alopecia, scaling, and crusting; most are around the ears and face or on the extremities. Cats with clinically inapparent infections can still serve as a source of infection to other cats or people. Occasionally, dermatophytosis in cats causes feline miliary dermatitis and is pruritic. Cats with generalized dermatophytosis occasionally develop cutaneous ulcerated nodules, known as dermatophyte granulomas or pseudomycetomas.

    Lesions in dogs are classically alopecic, scaly patches with broken hairs. Dogs may also develop regional or generalized folliculitis and furunculosis with papules and pustules. A focal nodular form of dermatophytosis in dogs is the kerion reaction. Generalized ringworm in adult dogs is uncommon and is usually accompanied by immunodeficiency, especially endogenous or iatrogenic hyperadrenocorticism. Differential diagnoses in dogs for classic ringworm lesions include demodicosis, bacterial folliculitis, and seborrheic dermatitis.

    Dermatophytosis in dogs and shorthaired cats is usually self-limiting, but resolution can be hastened by treatment. Another primary objective of therapy is to prevent spread of infection to other animals and people. However, whole-body topical therapy is controversial, and recent studies have not confirmed that any currently available topical rinse or shampoo is truly effective. Enilconazole, a rinse not currently available in North America, is most likely to be effective. Local lesions can be treated effectively with topical miconazole or clotrimazole. For chronic or severe cases and for ringworm in longhaired breeds of cats, systemic treatment is indicated. The microsized formulation of griseofulvin can be used in dogs (25-100 mg/kg, sid (once a day) or divided doses) and in cats (25-50 mg/kg, daily in divided doses). These dosages are higher than those approved by the FDA. The ultramicrosized formulations used in human medicine can be used at lower dosages (10-15 mg/kg). Cats may develop bone marrow suppression, especially neutropenia, at higher doses or as idiosyncratic reactions. In both dogs and cats, GI upset is a fairly common sequela of griseofulvin administration. Alternative and effective treatments include terbinafine (30 mg/kg) or itraconazole (5-10 mg/kg, sid), but neither of these drugs is approved for use in domestic animals. Systemic and topical treatments for dermatophytosis should be continued for 2-4 weeks past clinical cure or until a negative brush culture is obtained. This may require treatment for 1-3 months with griseofulvin or for more than 1 month with azole antifungals. A killed fungal cell wall vaccine is approved for treatment and prevention of _M. canis_ ringworm in cats. The vaccine hastens clinical resolution but apparently does not affect time to mycologic cure. It also reduces the severity, but not the frequency, of infection in kittens that are subsequently exposed. Use of the vaccine in management of dermatophytosis in pet cats or multicat facilities remains to be defined. Recent reports of the efficacy of lufenuron in treating ringworm in dogs and cats have not been confirmed in controlled studies.

    While all of these treatments have varying degrees of effects, an old treatment not mentioned here is betadine (an iodine preparation) scrub. While it may be a bit labor intensive to wash all the animals in betadine, it could prevent the euthanasia of a large number of animals.

    It seems somehow out of place for the name of the agency to be the society for the prevention of cruelty to animals, yet be euthanizing such a large number of animals. While some may argue that it may be humane to do this, one has to wonder since the disease can be self-limiting, why euthanasia is the only answer here? – Mod.TG]

  21. Thank you, I have recently been searching for information about this topic for ages and yours is the best I have discovered so far

  22. My househole has been completely saturated with ringworm. My doctor told me I should get my carpets cleaned with a high temp steam cleaning company. The person brought up a good point about bringing any special additives to their equipment. Are there any? I have an antimicrobial lotion I have been using as well. I see that moist is bad here time and time aagain. Should I not get my carpets cleaned and not be using lotion? I live in oregon and I am in the dead of the rainy season so can can’t leave my windows open. We are all affected scalp to hand to toes after taking in a st. Bernard with many issues. Ringworm was not thought of now I am paying a hefty monitary and healthcare relateded price. Its that bad. Please please please help me I am so desperate for help. How long will it be present in the house after not having a host to live on?

    • I did a little search on this and discovered the UC-Davis Koret Shelter Medicine Program that I added at the beginning of this post. Your local municipal shelter might be a good resource to check with.

      As ubiquitous as household ringworm seems to be becoming, there aren’t many primary sites for information available from the Internet. Unfortunately, I don’t have any real feel for whether an infected household can ever be eradicated. But there should be a way to manage it. Some of the breeding cat kennel references seem to indicate eradication isn’t possible, even with an “all-steel” environment.

      At any rate, the high-temperature cleaning seems to be a recommended procedure. The only additive would have to be one which is EPA-approved for fungus. However, the temperature itself would be the most effective. The key then is whether the cleaners can extract the water without ruining the carpet. An alternative is to replace the carpet.

      Some tests for laundry temperatures would suggest that hot water reduces the spread, Washing at 60°C [140 F] however, eliminated both pathogens, T. rubrum and C. albicans.

      As far as skin lotions go, if these are over the counter type things, such as those that may contain triclosan or even chlorhexadine, it is unlikely they will help. Something like regular sanitizer (62% alcohol) would be better as would regular soap and water with careful drying afterward.

      In Oregon, OSU has partnered with the Humane Society. You might check with them–
      There’s the vet school,
      Cyril R. Clarke, Dean
      200 D Magruder Hall
      Corvallis, OR 97331
      (541) 737-2098

      There is also an extension program (such as 4-H) which has advice for non-commercial animal housing.

      Any research university would have a lab animal program. I suspect they would be the least helpful because their animals are under a more controlled environment.
      Raymond Baggs, Director
      101 Lab Animal Resource Center
      OSU, Corvallis, Oregon 97331
      (541) 737-2263

      As always, if readers have experience to share– whether it worked or wasn’t effective– please return to help others.

  23. I think the seats and carpet in my car are infected with ringworm. What we need is a business which will expose inanimate objects to lethal radiation in order to quickly sterilize them. I would gladly pay say $50 to have my car sterilized like this.

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