Introduction/Objective: This study evaluates 4 years of data from the Seattle One Health Clinic (OHC), a novel model for clinical care which integrates human and animal health care services for youth and young adults experiencing homelessness (YPEH) and their pets. Methods: We analyzed deidentified data from standardized OHC visit forms, electronic medical records, and veterinary records from 2019 to 2022. We assessed the overlaps between human and animal healthcare provided and the impact of environmental stressors on both human and animal patients. Results: Over 50% of all human clients established healthcare for the first time in 2 years, with 85% attending one or more follow-up appointments with non-emergency healthcare services within 2 years following their initial OHC appointment. All animals received care during their visit. Needs addressed at the human-animal interface included zoonotic infections, animal allergies, and mental/behavioral health. The most common client-pet reported environmental concerns were food insecurity, heat, and cold. Conclusion: Our results suggest integrated human and animal healthcare is a feasible and acceptable model of care for YPEH to access acute and preventative care at the human-animal-environmental interface. This approach holds promise for increasing health-seeking behaviors, and engagement in preventative, therapeutic, and follow-up care.

Escherichia coli (E. coli) is a predominant pathogen of urinary tract infections (UTIs) in the United States. We analyzed resistance patterns by geographic location in Washington State to assess the need for regional antibiograms. The study included urinary E. coli antibiotic susceptibility tests performed by Quest Diagnostics on Washington outpatient isolates from 2013 to 2019. We conducted logistic regressions with robust standard errors for five antibiotics (ceftriaxone, ciprofloxacin, gentamicin, trimethoprim-sulfamethoxazole), with isolates classified as “susceptible” or “resistant” for each antibiotic tested. Analyses were adjusted for sex, year of isolate collection, and age group (0–18, 19–50, >50). The state’s nine Public Health Emergency Preparedness Regions (PHEPRs) were used as the geographic level for the analysis. The analysis included 40,217 isolates (93% from females, mean age 47 years). Compared to the Central PHEPR (containing Seattle), most other regions had significantly lower adjusted prevalence ratios (aPORs) of antimicrobial resistance (AMR), with aPORs as low as 0.20 (95% CI: 0.06–0.63) for ceftriaxone in the North Central region. Additionally, no regions had significantly higher aPOR of resistance for any antibiotic. Differences in resistance between the Central and other regions varied by antibiotic with the largest difference for ceftriaxone and smallest for ampicillin. The finding of regional variation of E. coli AMR calls for more specific community antibiograms to enable a precise approach to antibiotic prescribing and stewardship.

Since 2022, numerous H5N1 highly pathogenic avian influenza virus (HPAIV) detections have been reported in wild and domestic mammals in North America. Although H5N1 HPAIV detections in dogs are rare, hunting dogs that retrieve waterfowl are at increased exposure risk due to their physical contact with reservoirs (waterfowl) and contaminated environments. A cross-sectional survey of hunters was conducted during 2024 to characterize hunting procedures, disease prevention practices, and interactions between humans and their hunting dogs to identify potential risks for zoonotic disease transmission. Descriptive analysis (N = 112) indicated a majority of participants considered their hunting dog as part of the family (93.8%), and less than half considered their dog a pet (42.9%). Of the 112 individuals, 96.4% did not utilize personal protective equipment (PPE) when handling a sick dog and 81.3% did not use PPE when handling harvested birds. This research demonstrated complex, sustained physical and personal connections between individuals and their hunting dogs. Additional research utilizing a One Health approach is necessary to define H5N1 HPAIV risk factors in hunting dogs and the environment’s role in the transmission of viruses among wildlife and domestic animals. Understanding zoonotic disease transmission in these populations can inform approaches to mitigate viral exposure.