infection control and hospital epidemiology july 2006, vol. 27, no. 7 original article Characteristics of Programs Involving Canine Visitation of Hospitalized People in Ontario Sandra L. Lefebvre, DVM; David Waltner-Toews, DVM, PhD; Andrew Peregrine, PhD, Diplomate EVPC, MRCVS; Richard Reid-Smith, DVM, DVSc; Leslie Hodge, MSc; J. Scott Weese, DVM, DVSc, Diplomate ACVIM objectives. To determine the distribution of canine-visitation programs in Ontario and to characterize the nature of the programs the dogs are affiliated with. design. A cross-sectional survey of hospitals in Ontario was used to determine whether they permitted dogs to visit patients and, if so, where the dogs originated. On the basis of this information, dog owners were then contacted through their respective associations and interviewed using a standardized questionnaire. setting. A cross-section of hospitals in Ontario. participants. A total of 223 (97%) of the 231 hospitals surveyed responded. Ninety owners of 102 visitation dogs were interviewed. results. A total of 201 (90%) of the 223 hospitals indicated that dogs were permitted in their facilities. Origins ranged from national therapy-dog agencies to the patients’ families. Acute care wards were 5.1 times as likely than other wards to disallow animals (95% confidence interval, 2.2-12.2; ). According to the 90 dog owners included in the study, the screening protocols that dogs were required to pass P ! .001 to participate in their respective visitation programs were highly variable, as were the owners’ infection control practices. Eighteen owners (20%) said they did not practice any infection control. Sixty-six owners (73%) allowed their dogs on patients’ beds, and 71 (79%) let their dogs lick patients. Thirty-six owners (40%) were unable to name one zoonotic disease that may be transmitted from their dog. conclusions. Although canine-visitation programs have become standard practice in nonacute human healthcare facilities, infection control and dog-screening practices are highly variable and potentially deficient. Hospital staff, visitation groups, pet owners, and veterinarians need to work together to protect both people and pets. Infect Control Hosp Epidemiol 2006; 27:754-758 From the Departments of Population Medicine (S.L.L., D.W.-T., R.R.-S.), Pathobiology (A.P.), and Clinical Studies (J.S.W.), Ontario VeterinaryCollege (L.H.), University of Guelph, Guelph, Ontario, Canada. Received May 2, 2005; accepted August 31, 2005; electronically published June 20, 2006.  2006 by The Society for Healthcare Epidemiology of America. All rights reserved. 0899-823X/2006/2707-0019$15.00. Spurred on by both scientific and anecdotal reports of the positive health effects of companion animals, visitation by animal-assisted activity (AAA) dogs at human hospitals and other healthcare facilities has become commonplace across North America. 1 The goal of these programs is typically to provide “opportunities for motivational, educational, recre- ational, and/or therapeutic benefits to enhance quality of life.” 2(p79) Within the hospital setting, these visits have been reported to reduce patient anxiety, distract patients from pain and loneliness, increase patient physical and social activity, and provide patients with nonjudgmental sources of affec- tion. 3-6 Paradoxically, the fact that these patients are in hos- pitals in the first place typically makes them more vulnerable than others to infectious risks posed by the animals. Thus, it is possible that dogs carrying any zoonotic pathogen will cause harm to persons they are intended to help. Opportu- nities also exist for the dogs, through either their normal exploratory behavior or their proximity to patients and staff, to acquire pathogens, such as methicillin-resistant Staphylo- coccus aureus (MRSA) or Clostridium difficile, that they may not usually encounter elsewhere. A dog might therefore serve as a subsequent source of infection to other patients it visits and to other people and animals within its community. More than a decade ago, a study examined the number and certain characteristics of AAA programs in North Amer- ica by selectively surveying animal care agencies in the United States and humane societies in Canada. 7 Although under these auspices hospital visitation by AAA dogs was found to be widespread, several shortcomings with respect to infection control were detected. Less than 50% of the programs had consulted healthcare workers about zoonotic infections, and only 10% had written protocols for preventing the spread of zoonoses. In 2004, we conducted a pilot, random telephone survey of 6 Ontario hospitals and 6 therapy-animal associations to determine their policies regarding pet visitation (S.L.L., un- published data). All hospitals reported that the only require- ments for animals to enter their facilities were current vac-