Take cover the next time your dog sneezes – it could be passing on a new strain of a deadly flu virus with the potential to infect and kill millions around the world.
Scientists have warned that domestic dogs – anything from a loyal labrador to a precious pug – could be harbouring the virus that sparks the next big influenza pandemic.
New flu viruses are incubated in animals before they jump to humans.
The 1918 Spanish flu that killed between 50 and 100 million people is thought to have started in geese. And the milder 2009 "swine flu" pandemic was transmitted to humans via pigs, killing an estimated 245,000 people globally.
Now scientists have found domestic dogs are harbouring flu viruses with the potential to jump to humans, potentially turning man's best friend into one of our greatest threats.
The researchers from Icahn School of Medicine in New York sequenced the genomes of 16 influenza viruses obtained from pet dogs in southern China and found they contained segments similar to the H1N1 strain responsible for the 2009 swine flu outbreak.
Flu viruses have been observed in dogs before but now the viruses are changing and starting to interact with each other, creating the possibility they will mutate further and be passed to humans.
"This is very reminiscent of what happened in swine 10 years before the H1N1 pandemic," said Adolfo Garcia-Sastre, principal investigator of the study published in the journal mBio.
"In 2009 we were all looking for viruses in birds - there was no surveillance in pigs. Then, that pandemic came from pigs," he said.
The researchers found the new viruses in pet dogs in China that had been taken to vets because they had respiratory problems. Previous research has only found pandemic-type flu viruses in dogs kept in confined conditions, such as kennels and dog farms in China where breeds such as golden retrievers and English sheep dogs are bred for their meat.
Dr Garcia-Sastre said the findings meant that pet dogs should be seen as a potential breeding ground for influenza.
"The type of combinations of viruses that can [now] be created in dogs represent potential risk for a virus to jump to a dog into a human", he said.
The next steps will be to investigate whether humans have immunity against canine H1N1.
"If there is a lot of immunity against these viruses they will represent less of a risk but we now have one more host in which influenza virus is starting to have diverse genotypic and phenotypic characteristics, creating diversity in a host which is in very close contact to humans."
Culling birds such as chickens or turkeys in their tens of thousands is the key to stopping an avian influenza outbreak but Dr Garcia-Sastre did not advocate such a drastic move for dogs, Chinese or otherwise.
"We should be thinking about better ways of reducing the burden of flu in dogs," he said. "Vaccinating them is something that's feasible, as well as preventing transmission in overcrowded conditions. We should also be monitoring dogs as potential sources of influenza - that's not something that's done at all at the moment," he said.
He said pet owners did not need to change the way they treat their dogs - but should take them to the vet if they have any breathing problems.
People become infected with dog hookworms through contact with the faeces of infected animals. Hookworm larvae enter the top layers of skin and cause an itchy reaction. Symptoms usually resolve without medical treatment in four to sixweeks.
Rabies
Rabies is a fatal neurological disease, with humans commonly infected after being bitten by rabid animals. The first symptoms in people can start days or even months after exposure and include weakness, fever and headache. Within a few days symptoms will progress to confusion, anxiety, behaviour changes and delirium.
Roundworm
Toxocara roundworms cause a parasitic disease known as toxocariasis. Dogs and people can become infected by accidentally swallowing roundworm eggs. Children are most commonly affected with roundworm and the disease can lead to blindness or damage to the liver, lungs and central nervous system.