By Marwa Eltagouri, The Washington Post

A disease linked to puppies sold at Petland, a nationwide chain of about 80 pet stores, has sickened 55 people and hospitalized 13, according to the Centers for Disease Control and Prevention.

Since the outbreak began in mid-September, the disease has spread from seven states to 12 states, with cases reported in Florida, Kansas, Maryland, Missouri, New Hampshire, New York, Ohio, Pennsylvania, Tennessee, Utah, Wisconsin and Wyoming.

While Campylobacter is a fairly common bacteria among puppies and dogs, it’s unusual to see a large, multistate outbreak of human infections, said Mark Laughlin, a CDC veterinarian, in an email. Most cases are associated with eating raw or undercooked poultry or meat, or from cross-contamination of these and other foods.

The infection can cause bloody diarrhea, vomiting and fever.

Lab results show that puppies sold through Ohio-based Petland are probably the source of the outbreak. About 35 of the people diagnosed recently purchased a puppy from Petland, visited one of the chain’s stores or visited a home with a Petland puppy that was sold before the outbreak began. Fourteen of the people diagnosed are Petland employees.

But animals can also be infected, and can spread the disease to people even though they might not show any symptoms. People who touch even a small amount of feces on a dog’s fur or food bowl, and then inadvertently touch their mouths, can get an infection, Laughlin said.

The Campylobacter strain in the recent outbreak appears to be resistant to commonly recommended antibiotics, Laughlin said. But most people who get sick don’t need antibiotics and can recover within a week without any specific treatment.

Children under 5, adults over 65 and people with a weakened immune systems might require additional treatment, Laughlin said.

Petland said in a statement Tuesday that “regardless of where they are from, any puppies and dogs may carry Campylobacter germs.” Petland said it has been able to provide traceback for any puppy purchased as requested by the CDC. The company is redoubling its efforts on education regarding proper hand sanitation as well.

“The CDC has no new recommendations for Petland but continues to advise that Petland reinforces proper hand sanitization before and after playing with any of our puppies with the many sanitation stations in each store,” Petland officials said in the statement.

The CDC estimates that about 1.3 million cases of Campylobacter occur in people each year, about two-thirds of which are food-borne. The remainder of cases come from animals and other sources. Most of the people infected during the current outbreak are in Florida or Ohio.

The CDC has seen 13 human outbreaks of Campylobacter infections linked to contact with dogs since January 2009, Laughlin said. Those outbreaks have caused 47 illnesses and two hospitalizations.

Most infections related to this bacteria do not spread from one person to another, but activities like changing an infected person’s diapers or sexual contact with an infected person can lead to an infection. During the current outbreak, one person contracted the disease from sexual contact with a person with a confirmed illness linked to Petland, according to the CDC.

The CDC announcement has spurred criticism of pet stores that source puppies from commercial breeding operations, which increasingly have become the targets of animal protection groups. More than 200 cities and counties have enacted laws that ban pet shops from selling so-called puppy mill puppies, and Petland is now the only major national chain selling dogs from commercial breeders.

As the CDC continues to investigate the outbreak, the American Society for the Prevention of Cruelty to Animals is calling on states to protect their residents and consumers by stopping the importation of puppies for resale until the source of the outbreak is fully determined.

Last month, The Post’s Karin Brulliard and Lena H. Sun reported that the Animal Legal Defense Fund filed a class-action lawsuit in July against Petland, saying it defrauded customers by “guaranteeing” puppies it knew were prone to illnesses and other defects:

“The company, which says it only sells puppies from breeders licensed by the U.S. Department of Agriculture and with clean federal inspection reports, provides a ‘Health Warranty’ to purchasers of puppies and kittens saying the animal has been examined by two or three veterinarians before being offered for sale.

“But the animal group’s director of litigation, Matthew Liebman, said Monday that those inspections are cursory at best and sometimes ‘rubber-stamped’ by veterinarians who are beholden to the company. While Campylobacter is not among the conditions that customers have reported to the group, Liebman said he was not surprised to hear about the outbreak.

” ‘It’s not hard to see how animals raised in these cramped and unsanitary conditions, trucked hundreds of miles from puppy mills to the pet stores, intermingled with other fragile young animals and handled by numerous employees and customers could become disease vectors,’ he said.”

To avoid contracting the illness, the CDC advises puppy and dog owners to wash their hands well after handling their pets and to promptly clean up feces, urine or vomit. It’s also a bad idea to let a dog lick your mouth or face, CDC officials said.