The foot-and-mouth disease epidemic in The Netherlands in 2001

An outbreak of foot-and-mouth disease (FMD) in Great Britain was reported on 21 February 2001, followed by an outbreak of FMD in The Netherlands a month later. This Dutch index outbreak occurred on a mixed, veal-calf/dairy-goat farm in Oene, in the central part of The Netherlands. The most-likely route of infection was the import of Irish veal-calves to this Dutch herd via an FMD-contaminated staging point in France. With hindsight, more herds seemed to be infected by the time the index outbreak was confirmed. The regular EU control measures were implemented, in combination with pre-emptive culling of herds within 1km of each outbreak. Nevertheless, more outbreaks of FMD occurred. Most of the virus infections on those farms were "neighborhood infections". Because the situation seemed out of control locally and the destruction capacity became insufficient, it was decided to implement an emergency vaccination strategy for all biungulates in a large area around Oene to stop further spread of the virus. All susceptible animals on approximately 1800 farms in this area were vaccinated. All farms subsequently were depopulated, starting from 2 weeks after vaccination. In total, 26 outbreaks were detected (the last outbreak on 22 April 2001). In total, approximately 260,000 animals were killed.     

Risk based culling for highly infectious diseases of livestock

ABSTRACT: The control of highly infectious diseases of livestock such as classical swine fever, foot-and-mouth disease, and avian influenza is fraught with ethical, economic, and public health dilemmas. Attempts to control outbreaks of these pathogens rely on massive culling of infected farms, and farms deemed to be at risk of infection. Conventional approaches usually involve the preventive culling of all farms within a certain radius of an infected farm. Here we propose a novel culling strategy that is based on the idea that farms that have the highest expected number of secondary infections should be culled first. We show that, in comparison with conventional approaches (ring culling), our new method of risk based culling can reduce the total number of farms that need to be culled, the number of culled infected farms (and thus the expected number of human infections in case of a zoonosis), and the duration of the epidemic. Our novel risk based culling strategy requires three pieces of information, viz. the location of all farms in the area at risk, the moments when infected farms are detected, and an estimate of the distance-dependent probability of transmission.     

Classical swine fever outbreak containment using antiviral supplementation: a potential alternative to emergency vaccination and stamping-out

Classical swine fever (CSF) outbreaks may result in huge economic losses to countries with densely populated pig areas (DPLAs). The EU minimum control measures require depopulation of infected farms, movement restrictions, zoning and surveillance (EU Minimum strategy). Emergency vaccination is authorised for DPLAs although the EU Minimum strategy plus culling in a 1-km ring around infected premises is preferred. Nonetheless, vaccination in a 2-km ring has been found equally effective as 1-km ring culling using stochastic modelling. Alternatives control measures (e.g. antiviral agents, in particular small molecule inhibitors of the CSFV replication) are being explored. Hence, the present study was set up to simulate inter-herd CSFV spread when antiviral molecules are supplemented to pig feed in a 1-km ring around infected farms. The effectiveness of the antiviral strategy for containing CSF outbreaks was compared to six other control scenarios including the EU Minimum strategy, the EU preferred policy for DPLAs and the use of 2-km ring vaccination. The InterSpread Plus model was adapted to the 2006 Belgian pig population and outbreak simulations were performed with a fast spreading CSFV strain entering a DPLA in Belgium. Four out of the seven control strategies resulted in outbreaks that were controlled by the end of the simulation period (i.e. 365 days). The distributions of the number of infected herds and the duration of the predicted outbreaks for these four control strategies were not different. This is the first report investigating CSF outbreak containment using antiviral molecules. Although antiviral supplementation was not found to perform any better than some other conventional strategies, such as pre-emptive culling and emergency vaccination, it might be worthwhile considering it further as additional tool in a response to CSF outbreaks.     

How do resources influence control measures during a simulated outbreak of foot and mouth disease in Australia?

An outbreak of foot and mouth disease (FMD) could seriously impact Australia's livestock sector and economy. As an FMD-free country, an outbreak would trigger a major disease control and eradication program that would include the culling of infected and at risk animals (‘stamping out’), movement restrictions and zoo-sanitary measures. Additional control measures may also include pre-emptive culling or vaccination. However, it is unclear what disease strategy would be most effective under Australian conditions and different resource levels. Using a stochastic simulation model that describes FMD transmission between farms in a livestock dense region of Australia, our results suggest that using current estimates of human resource capacity for surveillance, infected premises operations and vaccination, outbreaks were effectively controlled under a stamping out strategy. However, under more constrained resource allocations, ring vaccination was more likely to achieve eradication faster than stamping out or pre-emptive culling strategies.     

Potential impact of species and livestock density on the epidemic size and effectiveness of control measures for foot-and-mouth disease in Japan

The characteristics of a livestock area, including farm density and animal species, influence the spread of foot-and-mouth disease (FMD). In this study, the impact of livestock area on FMD epidemics was examined using an FMD transmission model. For this simulation, three major livestock areas were selected: the 2010 FMD epidemic area in Japan as the baseline area (BS), a cattle and pig mixed production area (CP) and a cattle production area (C). Simulation results demonstrated that under the 24-hr culling policy, only 12% of epidemics among 1,000 simulations were abated within 100 days in the CP area, whereas 90% of the epidemics ceased in the BS area. In the C area, all epidemics were successfully contained within 100 days. Evaluation of additional control measures in the CP area showed that the 0.5-km pre-emptive culling, even when only targeting pig farms, raised the potential for successful containment to 94%. A 10-km vaccination on day 7 or 14 after initial detection was also effective in halting the epidemics (80%), but accompanied a large number of culled or vaccinated farms. The combined strategy of 10-km vaccination and 0.5-km pre-emptive culling targeting pig farms succeeded in containing all epidemics within 100 days. The present study suggests the importance of preparedness for the 24-hr culling policy and additional control measures when an FMD outbreak occurs in a densely populated area. Considering the characteristics of the livestock area is important in planning FMD control strategies.     

Comparison of different control strategies for foot-and-mouth disease: a study of the epidemics in Canada in 1951/52, Hampshire in 1967 and Northumberland in 1966

The measures used to control the epidemics of foot-and-mouth disease in Canada in 1951/52 (29 outbreaks) were compared with those used in the epidemic in Hampshire in 1967 (29 outbreaks). In both epidemics the disease spread more from premises where the disease was reported late and the imposition of quarantine or restrictions on infected premises was delayed. In Hampshire, area restrictions were imposed, susceptible livestock on infected premises and on premises in direct contact were slaughtered, and contacts were traced. In Canada, the initial diagnosis was vesicular stomatitis, no area restrictions were imposed, no tracing was carried out and the animals on infected premises were allowed to recover. However, apart from the disease's spread through infected meat and by unknown or airborne routes, it did not spread from infected premises once quarantine was imposed, partly owing to the low population density of livestock in the area. The effects of the slaughter of infected premises and direct contacts in the Fareham area of Hampshire in 1967 and in the Chathill area of Northumberland in 1966 were compared with what might have happened if, in addition, culling on contiguous premises or culling on premises within 3 km or emergency vaccination had been put into effect. The slaughter of cattle, sheep, goats and pigs on premises within 3 km two days after confirmation of the first outbreak would have resulted in fewer outbreaks and a shorter period to complete slaughter, but more animals would have been slaughtered. In the Chathill area, the slaughter of sheep, goats and pigs only on premises within 3 km two days after confirmation of the first outbreak would not have resulted in fewer outbreaks and more animals would have been slaughtered. Fewer premises and animals would have been slaughtered by a contiguous cull than by a 3 km cull but more than by the slaughter of infected premises and direct contacts. Emergency vaccination within 3 km, providing protection at four days (but not to animals already infected before the development of immunity), would have resulted in the fewest animals being slaughtered and could have reduced the number of outbreaks in the Fareham area by one and in the Chathill area by two or three. All the procedures would have had a greater effect the sooner they were introduced. However, with many foci of infection, priorities for action would have had to have been established. Earlier tracing of the last outbreak in the Fareham area could have shortened the Hampshire epidemic. Surveillance of a farm identified as at risk through animal movements and by the use of an airborne-prediction model could have eliminated the source of further outbreaks in the Chathill area.     

Evaluation of the benefit of emergency vaccination in a foot-and-mouth disease free country with low livestock density

Foot-and-mouth disease (FMD) is highly contagious and one of the most economically devastating diseases of cloven-hoofed animals. Scientific-based preparedness about how to best control the disease in a previously FMD-free country is therefore essential for veterinary services. The present study used a spatial, stochastic epidemic simulation model to compare the effectiveness of emergency vaccination with conventional (non-vaccination) control measures in Switzerland, a low-livestock density country. Model results revealed that emergency vaccination with a radius of 3 km or 10 km around infected premises (IP) did not significantly reduce either the cumulative herd incidence or epidemic duration if started in a small epidemic situation where the number of IPs is still low. However, in a situation where the epidemic has become extensive, both the cumulative herd incidence and epidemic duration are reduced significantly if vaccination were implemented with a radius of 10 km around IPs. The effect of different levels of conventional strategy measures was also explored for the non-vaccination strategy. It was found that a lower compliance level of farmers for movement restrictions and delayed culling of IPs significantly increased both the cumulative IP incidence and epidemic duration. Contingency management should therefore focus mainly on improving conventional strategies, by increasing disease awareness and communication with stakeholders and preparedness of culling teams in countries with a livestock structure similar to Switzerland; however, emergency vaccination should be considered if there are reasons to believe that the epidemic may become extensive, such as when disease detection has been delayed and many IPs are discovered at the beginning of the epidemic.     

The 2010 foot-and-mouth disease epidemic in Japan

Foot-and-mouth disease (FMD) occurred recently for the first time in a decade in Japan. The index case was detected on a beef-breeding farm in Miyazaki Prefecture, Southern Japan, on April 20, 2010. After confirmation of this first case, control measures such as stamping out, movement restriction and disinfection were implemented. However, these strategies proved insufficient to prevent the spread of FMD and emergency vaccination was adopted. Up until the last outbreak on July 4, 2010, a total of 292 outbreaks had been confirmed, with about 290,000 animals having been culled. The epidemic occurred in an area with a high density of cattle and pigs, making disease control difficult. Invasion of the disease into a high-density area aided its rapid spread and led to difficulties in locating suitable burial sites. Epidemiological investigations indicated that the disease was introduced into Japan approximately one month before detection. This delay in initial detection is considered to have allowed an increased number of outbreaks in the early stage of the epidemic. Nevertheless, the epidemic was contained within a localized area in Miyazaki Prefecture and was eradicated within three months because of intensive control efforts including emergency vaccination. Although this epidemic devastated the livestock industry in Japan, many lessons can be learnt for the future prevention and control of infectious diseases in animals.     

Modeling spatial and temporal transmission of foot-and-mouth disease in France: identification of high-risk areas

Foot-and-mouth disease is one of the most contagious diseases of animal livestock. We used statistical tools to explore the dynamics of epidemics and to evaluate the consequences of virus reintroduction in France. We developed a stochastic farm-based model adapted to the French farm structure from previous modeling works following the 2001 epidemic in the United Kingdom. This model depends upon the distance between the 280,000 French farms and on species type (e.g. cows and sheep) and it tracks each animal's farm status at any given day. Since data were only available at the town scale, the farm location and the number of animals in each farm were simulated over the surface area of each French town, as well as the number of mixed farms. Based on 200 simulations of the model, our results allowed for the study of local disease transmission, since it begins simulations once limitation of movement is put into place. On average, the same 50 randomly chosen initially infected farms would lead to 1,110 infected farms (610; 1,590) when two control strategies (culling within 0.5 km from an infected farm and vaccination within 3 km) are put into place. Regions with high densities of cows and sheep (e.g. Pays-de-la-Loire) are high-risk zones, confirming that the epidemic process depends upon the location and the type of initially infected farms (size, species type). The results of this model highlight the importance of Geographical Information Systems (GIS) to obtain more precise data concerning herds.     

The role of movement restrictions and pre-emptive destruction in the emergency control strategy against CSF outbreaks in domestic pigs

Classical swine fever (CSF) outbreaks in domestic pig herds lead to the implementation of standard control measures according to legislative regulations. Ideal outbreak control entails the swift and efficient culling of all pigs on premises detected positive for CSF virus. Often all pig holdings around the detected cases are pre-emptively destroyed to exclude transmission into the neighbourhood. In addition to these measures, zones are defined in which surveillance and protection measures are intensified to prevent further distant disease spread. In particular, all movements are prohibited within standstill areas. Standstill also excludes the transport of fattened pigs to slaughter. Historical outbreaks provide evidence of the success of this control strategy. However, the extent to which the individual strategy elements contribute to this success is unknown. Therefore, we applied a spatially and temporally explicit epidemic model to the problem. Its rule-based formulation is tailored to a one-by-one model implementation of existing control concepts. Using a comparative model analysis the individual contributions of single measures to overall control success were revealed. From the results of the model we concluded that movement restrictions had the dominant impact on strategy performance suggesting a reversal of the current conceptual thinking. Additional measures such as pre-emptive culling only became relevant under imperfect compliance with movement restrictions. The importance of movement restrictions for the overall control success illustrates the need for explicit consideration of this measure when contingency strategies are being amended (e.g. emergency vaccination) and associated risks assessed.     

Modeling the spread and control of foot-and-mouth disease in Pennsylvania following its discovery and options for control

In this paper, we simulate outbreaks of foot-and-mouth disease in the Commonwealth of Pennsylvania, USA - after the introduction of a state-wide movement ban - as they might unfold in the presence of mitigation strategies. We have adapted a model previously used to investigate FMD control policies in the UK to examine the potential for disease spread given an infection seeded in each county in Pennsylvania. The results are highly dependent upon the county of introduction and the spatial scale of transmission. Should the transmission kernel be identical to that for the UK, the epidemic impact is limited to fewer than 20 premises, regardless of the county of introduction. However, for wider kernels where infection can spread further, outbreaks seeded in or near the county with highest density of premises and animals result in large epidemics (>150 premises). Ring culling and vaccination reduce epidemic size, with the optimal radius of the rings being dependent upon the county of introduction. Should the kernel width exceed a given county-dependent threshold, ring culling is unable to control the epidemic. We find that a vaccinate-to-live policy is generally preferred to ring culling (in terms of reducing the overall number of premises culled), indicating that well-targeted control can dramatically reduce the risk of large scale outbreaks of foot-and-mouth disease occurring in Pennsylvania.     

Theoretical epidemiology on bovine ephemeral fever outbreaks in Tanegashima Island, Kagoshima Prefecture of Japan in 1988.

From the end of September to November 1988, a compact scale of bovine ephemeral fever (BEF) outbreaks occurred suddenly in Tanegashima island of Kagoshima Prefecture, southern part of Kyusyu island of Japan. The BEF outbreak pattern showed epidemical characteristics as follows; (1) outbreak spread from few foci to zone during one month, and (2) the disease might be transmitted in farms with a fixed probability of adequate contact. By using the above aspects, we attempted to analyze the disease theoretically with the application of Poisson distribution and Reed-Frost model. The BEF incidence in farms was in well accord with the Poisson distribution. As the very rare event occurred in unit time or in unit area in this epidemic, the cattle population at risk were equivalently susceptible to BEF virus in this island, due to the influence of no vaccination to BEF control before the first outbreak. Similarly, the epidemic curve of the Reed-Frost model was proved to fit well the incidence observed in a farm, and the probability of adequate contact was induced as p = 0.226. If the cattle population is less than 5 in this farm, the outbreak would not occur in the first instance.     

Control of foot-and-mouth disease through vaccination and the isolation of infected animals

Foot-and-mouth disease (FMD) within Saudi Arabian dairy herds has been controlled for the past decade through vaccination. Data from 19 outbreaks on Saudi farms has suggested that the durability of these vaccines extended for 2.5 months, providing an 81–98% level of protection. Vaccination has nevertheless failed to prevent the establishment and sometimes persistence of the disease. This is probably because the highly contagious nature of FMD creates increasing levels of viral excretion during an outbreak, and the co-habitation in Saudi farms of affected/susceptible animals following diagnosis, predisposes the herds to re-infection. Pre-clinical excretion of the virus leads to the infection of additional in-contact susceptible animals prior to diagnosis, so the isolation of clinically infected animals does not guarantee a removal of infection. Saudi Arabian farms are subdivided into managed farm pens and isolation (away from the farm) of all animals in infected pens not only removes the infectious individuals showing clinical signs, but also those that are sub-clinical and excreting virus. Simulations suggest that removing all infectious animals from the herd significantly reduces the per cent infected in the herd.     

Lungworm outbreaks in adult dairy cows: estimating economic losses and lessons to be learned

Two lungworm outbreaks in dairy herds were investigated in order to estimate the resulting economic costs. On the two farms, with 110 and 95 cows, total costs were estimated at ?59 and ?67 per cow, respectively. Overall, milk production reduced by 15 to 20 per cent during the outbreaks. Five cows died on one farm, while on the other farm seven cows died as a result of the lungworm outbreak. On one farm, 51.7 per cent of the total costs was due to reduced milk production and 33.1 per cent was due to disposal of dead animals. On the other farm, it was 36.3 and 50.9 per cent, respectively. The remaining 13 to 15 per cent of the total costs were due to extra inseminations, laboratory diagnosis and treatments. The history and development of the outbreaks are described. One lesson from these outbreaks is that recognising that potentially lungworm-na?ve animals are to be introduced into the adult herd allows for timely measures (for example, vaccination) to prevent a lungworm outbreak.     

Adoption and failure rates of vaccinations for disease prevention in chicken farms in Jos,Nigeria

Vaccinations against diseases to prevent disease outbreaks are strategic to disease prevention, but vaccination failures may constitute a challenge in practice. This study was aimed at assessing the adoption and failure rates of vaccinations in 80 chicken farms in Jos, Nigeria. Data were obtained through a structured questionnaire validated by interviews and checking of farm and veterinary records. Vaccination score (0–1) from the vaccination checklist (5 for broilers and 12 for layers) and vaccination procedure score (0–1), based on scored adopted procedures, were calculated for each farm. Vaccine effectiveness was calculated for each vaccine using the odds ratio from the association of frequencies of disease outbreaks in vaccinated and unvaccinated flocks. Farmers used more of imported than local vaccines. Vaccination procedure and vaccination scores did not influence frequencies of disease outbreaks, but vaccination scores tended to non-robustly correlate (r = − 0.89, p > 0.05) with rates of disease outbreak. Vaccination rates were highest against Newcastle disease and infectious bursal disease, and their vaccinations also had the highest effectiveness. There was an association (p = 0.009) between composite vaccination rates and disease outbreaks with 2.1 odds of outbreaks in vaccinated than unvaccinated flocks. Vaccination failures occurred in the use of 11 out of 12 vaccines and the highest failure rate (47.9%) was in vaccination against coccidiosis. Therefore, vaccination failure is a critical factor in poultry vaccination practice within the locality. The adoption of poultry vaccinations needs to be strategised in the context of a national poultry vaccination policy in order to promote effective poultry disease prevention and control.

     

Outbreak of bovine virus diarrhea on Dutch dairy farms induced by a bovine herpesvirus 1 marker vaccine contaminated with bovine virus diarrhea virus type 2

On 23 February 1999, the Dutch Animal Health Service advised all Dutch veterinary practices to postpone vaccination against bovine herpesvirus 1 (BHV1) immediately. The day before severe disease problems were diagnosed on four dairy farms after vaccination with the same batch of BHV1 marker vaccine. Using monoclonal antibodies, bovine virus diarrhoea virus (BVDV) type 2 was found in the vaccine batch. This paper describes an outbreak of BVDV type 2 infection caused by the use of a batch of modified live BHV1 marker vaccine contaminated with BDVD. Sources of information used were reports of farm visits, minutes of meetings, laboratory results, and oral communications from the people involved. The first symptoms of disease were observed on average six days after vaccination. Morbidity was high on 11 of the 12 farms. On five farms more than 70% of the animals became ill, while on one farm no symptoms could be detected. During the first week after vaccination, feed intake and milk production decreased. During the second week, some animals became clinically diseased having nasal discharge, fever, and diarrhoea. At the end of the second week and at the start of the third week, the number of diseased animals increased rapidly, the symptoms became more severe, and some animals died. Mortality varied among herds. Necropsy most often revealed erosions and ulcers of the mucosa of the digestive tract. In addition, degeneration of the liver, hyperaemia of the abomasum, and swollen mesenterial lymph nodes and swollen spleen were found. On 11 of the 12 farms all animals were culled between 32 and 68 days after vaccination after an agreement was reached with the manufacturer of the vaccine. This was the third outbreak of BVD in cattle after administration of a contaminated vaccine in the Netherlands. The possibilities to prevent contamination of a vaccine as a consequence of infection of fetal calf serum with BVDV are discussed. Improvement of controls to prevent contamination before and during vaccine production, and improvement of the monitoring of side-effects is necessary.     

Impact of foot-and-mouth disease on mastitis and culling on a large-scale dairy farm in Kenya

Foot and mouth disease (FMD) is a highly transmissible viral infection of cloven hooved animals associated with severe economic losses when introduced into FMD-free countries. Information on the impact of the disease in FMDV-endemic countries is poorly characterised yet essential for the prioritisation of scarce resources for disease control programmes. A FMD (virus serotype SAT2) outbreak on a large-scale dairy farm in Nakuru County, Kenya provided an opportunity to evaluate the impact of FMD on clinical mastitis and culling rate. A cohort approach followed animals over a 12-month period after the commencement of the outbreak. For culling, all animals were included; for mastitis, those over 18 months of age. FMD was recorded in 400/644 cattle over a 29-day period. During the follow-up period 76 animals were culled or died whilst in the over 18 month old cohort 63 developed clinical mastitis. Hazard ratios (HR) were generated using Cox regression accounting for non-proportional hazards by inclusion of time-varying effects. Univariable analysis showed FMD cases were culled sooner but there was no effect on clinical mastitis. After adjusting for possible confounders and inclusion of time-varying effects there was weak evidence to support an effect of FMD on culling (HR = 1.7, 95% confidence intervals [CI] 0.88-3.1, P = 0.12). For mastitis, there was stronger evidence of an increased rate in the first month after the onset of the outbreak (HR = 2.9, 95%CI 0.97-8.9, P = 0.057).

Electronic supplementary material

The online version of this article (doi:10.1186/s13567-015-0173-4) contains supplementary material, which is available to authorized users.     

Monte Carlo simulation of classical swine fever epidemics and control. I. General concepts and description of the model

A Monte Carlo simulation has been developed to describe the spread of classical swine fever virus between farms within a certain region. The data of the farms can be imported and considered individually. Transmission occurs via the infection routes direct animal and indirect person and vehicle contact, as well as by contaminated sperm and local spread. Parameters, such as incubation period and probability of detection, can be varied by the user and their impact on disease spread can be studied. The control measures stamping-out, movement control and pre-emptive slaughter in circular restriction areas as well as contact tracing can be applied and their effect on disease spread can thus be analysed. The numbers of culled and restricted farms and animals per epidemic and per day within an epidemic, the epidemic duration and the total length of restrictions per restricted farm are given. In an example, simulation runs were performed under the condition of application of all four-control measures. Because no real farm data were available, a test area was generated stochastically with a farm density of 1.3 farms/km(2). The distributions of the number of infected farms per epidemic and the epidemic length are shown.     

Investigation of infectious laryngotracheitis outbreaks in Namibia in 2018

Between July and August 2018, two outbreaks of infectious laryngotracheitis caused the death of over 116,000 commercial poultry (layers and broilers) near the city of Windhoek, Namibia. A third outbreak occurred in September 2018 in the north of the country approximately 800 km from the original outbreaks. Sample collection and molecular epidemiological analyses revealed that the outbreaks were most likely caused by poor vaccination practices leading to the reversion to virulence of an ILT vaccine strain. The analyses also indicate that inaccurate declarations were made by one of the farms involved and that illegal movement of animals most likely occurred.

     

Reasons for culling in French Holstein cows

The study describes the profiles of culled cows in order to assess the possible contribution to economic losses due to health disorders. Data regarding dates of birth, final calving and culling, parity at culling, milk yield at the two first test-days of the final lactation and reason(s) for culling were collected in a 5-year survey, carried out from 1989 to 1994 in 84 commercial Holstein farms in western France. Polytomous logistic regression was used to assess the relationship between parity, calving-to-culling interval, milk yield and eight groups of primary culling reasons (i.e. udder disorders; infertility or reproductive disorders; lameness or foot/leg defects; emergency culling reasons; other health disorders; low milk yield; sales for dairy purpose; and other voluntary culling reasons). Out of a total of 5133 culled cows, the proportions of culls, for each of these groups of reasons, were 12.4, 28.4, 2.7, 3.9, 4.6, 16.7, 5.9, and 25.4%, respectively. Cows culled for udder disorders left the herd earlier in lactation and were more frequently at parities 4–6 than cows culled for voluntary reasons. In contrast, cows culled for infertility were younger and culled later within lactation. They were also higher yielding cows than those culled for other reasons. Cows culled for lameness were similar to those of the voluntarily culling group. Cows culled for emergency reasons were more frequently younger cows in early lactation. Cows culled for other health disorders left the herd early in lactation, but at a higher parity than the voluntarily culled cows. These results suggest that most of the culls related to health could be contributing to economic loss. However, special priority should be given to reduce culling for reproductive problems, which is the most costly exit reason.