The Centers for Disease Control and Prevention issued a warning that pet store puppies have been the cause for an outbreak of an antibiotic resistant bacterial illness called Campylobacteriosis.

Between January 2016 and February 2018, pet store puppies caused an estimated 118 illnesses. Of those who were infected, patients were between less than one year old to 85 years old, and 65 percent were female. Campylobacteriosis infects about 1.3 million Americans each year, the CDC reports.

Of the people infected in the report issued in the CDC Morbidity and Mortality Weekly Report, 29 had been employed at a pet store and 99 percent had been exposed to a dog. People in Connecticut, Florida, Georgia, Illinois, Kansas, Massachusetts, Maryland, Michigan, Missouri, New Hampshire, New York, Ohio, Oklahoma, Pennsylvania, Tennessee, Utah, Wisconsin and Wyoming were included in the report.

Campylobacteriosis is suspected to be caused by dogs who have built up a resistance to antibiotics. The CDC report indicates that 95 percent of the dogs at 20 stores received one course of antibiotics they were resistant to.

The CDC linked the outbreak to six pet stores, eight distributors and 25 breeders. The agency said it would be examining a closer look at antimicrobial use with commercial dogs.

Though no one died, campylobacteriosis can cause a varying range of symptoms in humans. The side effects include diarrhea, vomiting, headaches and abdominal pain. At least 26 people were sent to the hospital within the last two years of the outbreak.

The infection isn’t known for spreading person to person, however changing the diaper of a child who has been exposed, or having sex with an infected person may increase the risk.

Patients typically recover within five days without treatment. Drinking extra fluid helps offset the dehydration that may occur. Those with compromised immune systems can be severely afflicted and complications can lead to paralysis or even death.

The investigation of the outbreak began in August of last year after the Florida Department of Health notified the CDC of campylobacteriosis infections that stemmed from a pet store chain in Ohio.

Mike Bober, president and CEO of the Pet Industry Joint Advisory Council, said pet store employees and owners should follow hygiene and safe-handling practices when interacting with puppies. “Outbreaks of this kind certainly point to a need to make sure that everyone involved in the handling of animals is well-trained,” he said.

Precautionary measures for both human and animal wellness include washing your hands frequently after interacting with animals, as the disease can be transmitted through fecal matter, and seeking veterinary care for an animal that may seem sick.

Bober said that disease will arise on occasion, but the reward of having a pet far outweighs the risks of becoming infected. “Pet ownership is a tremendously positive thing in people’s lives,” he said.