Powassan virus,a scoping review of the global evidence

Background

Powassan virus (POWV), a flavivirus discovered in 1958, causes sporadic but severe cases of encephalitis in humans. Since 2007, the number of human Powassan cases diagnosed each year in the USA has steadily increased. This is in agreement with predictions that Powassan cases may increase in North America as a result of increased exposure to infected ticks. However, the increase may also reflect improved diagnostics and reporting among other factors.

Methods

A scoping review was prioritized to identify and characterize the global literature on POWV. Following an a priori developed protocol, a comprehensive search strategy was implemented. Two reviewers screened titles and abstracts for relevant research and the identified full papers were used to characterize the POWV literature using a predetermined data characterization tool.

Results

One hundred and seventy‐eight articles were included. The majority of the studies were conducted in North America (88.2%) between 1958 and 2017. Both genotypes of POWV (Powassan lineage 1 and Deer Tick virus) were isolated or studied in vitro, in vectors, nonhuman hosts and human populations. To date, POWV has been reported in 147 humans in North America. The virus has also been isolated from five tick species, and several animals have tested positive for exposure to the virus. The relevant articles identified in this review cover the following eight topics: epidemiology (123 studies), pathogenesis (66), surveillance (33), virus characterization (22), POWV transmission (8), diagnostic test accuracy (8), treatment (4) and mitigation strategies (3).

Conclusion

The literature on POWV is relatively small compared with other vector‐borne diseases, likely because POWV has not been prioritized due to the small number of severe sporadic human cases. With the projected impact of climate change on tick populations, increases in the number of human cases are expected. It is recommended that future research efforts focus on closing some of the important knowledge gaps identified in this scoping review.     

Evaluation of biomarkers of kidney injury following 4% succinylated gelatin and 6% hydroxyethyl starch 130/0.4 administration in a canine hemorrhagic shock model

Objective : To investigate the association between synthetic colloids and biomarkers of acute kidney injury (AKI) in dogs with hemorrhagic shock. Design : Experimental interventional study. Setting : University. Animals : Twenty‐four healthy ex‐racing Greyhounds. Interventions : Anesthetized Greyhounds subjected to hemorrhage for 60 min were resuscitated with 20 mL/kg of fresh whole blood (FWB), 6% hydroxyethyl starch (HES) 130/0.4, 4% succinylated gelatin (GELO), or 80 mL/kg of isotonic crystalloid (CRYST) over 20 min (n = 6 per treatment). Concentrations of biomarkers of AKI were measured at baseline, end of hemorrhage, and at 40 (T60), 100 (T120), and 160 (T180) min after fluid bolus. Biomarkers included neutrophil gelatinase‐associated lipocalin in urine and serum (uNGAL; sNGAL), and urine cystatin C (uCYSC), kidney injury molecule‐1 (uKIM), clusterin (uCLUST), osteopontin, gamma‐glutamyl transferase, monocyte chemoattractant protein‐1 (uMCP), interleukin‐6, interleukin‐8, protein (uPROT), hyaluronan, and F₂‐isoprostanes. Renal histology was scored for tubular injury and microvesiculation. Biomarker fold‐change from baseline was compared between groups using mixed effects models (Bonferroni–Holm corrected P<0.05). Frequencies of histology scores were compared by Fisher's exact test. Measurements and main results : In dogs treated with GELO, uNGAL fold‐change was markedly greater compared with all other groups at T60, T120, and T180 (all P<0.001), and uCYSC was greater at T60 compared with CRYST (P<0.001), and at T120 and T180 compared with all other groups (all P<0.001). Smaller, albeit significant, between‐group differences in uKIM, uCLUST, uMCP, and urine protein concentration were observed across the FWB, GELO, and HES groups, compared with CRYST. The GELO group more frequently had marked tubular microvesiculation than the other groups (P = 0.015) although tubular injury scores were comparable. Conclusion : In dogs with hemorrhagic shock, GELO was associated with greater magnitude increases in urine biomarkers of AKI and more frequent marked tubular microvesiculation, compared with FWB, CRYST, and HES.     

An evaluation of methods used to cull invasive cane toads in tropical Australia

To identify cost-effective ways to control invasive species, we need to evaluate alternative methods. The invasion of tropical Australia by cane toads (Rhinella marina) has killed many native predators, prompting efforts to cull adult toads. We analyzed a dataset on >?17,500 toads killed by government-employed teams from 2005 to 2008, using a range of methods (incidental captures, targeted searches, traps) as well as records of toads found as road kills. The culling occurred in the northwestern part of the Northern Territory, moving west as the toad front expanded into Western Australia. Both season and method affected rates of capture and demographic attributes (sex ratio, proportion of adults) of the culled anurans, with a strong interaction between these factors. Most methods were more effective during and after the seasonal monsoons (when moist conditions facilitated anuran activity), but that seasonal variation was greater for numbers of toads found on the roads than captured in other ways. Juvenile toads and adult female toads constituted higher proportions of total captures in the Early Dry than in other times of year, reflecting seasonal breeding. Traps caught a higher proportion of adult female toads than did other methods, but overall had low capture rates. Rates of range expansion by toads were similar before, during and after the culling effort, suggesting that removing adult toads did not affect the speed of the invasion. Nonetheless, culling adult cane toads may be effective in some situations (“island” populations, extralimital translocations), and results from this program may be valuable for future toad-control efforts.     

Experimental tuberculosis in red deer (Cervus elaphus)

This study was designed to investigate experimental Mycobacterium bovis infection of red deer (Cervus elaphus). Three intravenously inoculated deer (dose 10µg–1000µg) developed miliary tuberculosis of the lungs and all died within 28 days of being infected. No clinical illnesses were observed in four subcutaneously (dose 1 uµg–100uµg) and three intratracheally (dose lµg–100µg) inoculated deer. At the conclusion of the experiment six weeks post inoculation, these seven animals reacted to 2 mg/ml of bovine purified protein derivative. The principal lesions in the intravenously inoculated deer were in the lungs which had multiple foci of necrosis containing very large numbers of acid fast bacilli. A gradation of changes was seen in the subcutaneously inoculated deer. The animal receiving the 1µg dose only had lesions at the injection site and the draining prescapular lymph node. Deer receiving higher doses also had histopathological changes in the lungs and liver. Microscopic changes in the intratracheally infected animals were restricted to the thoracic cavity. The ability of the deer to control infection was related to the route of inoculation.     

Clinicopathologic Characterization of Six Cases of Equine Granulocytic Anaplasmosis In a Nonendemic Area (2008-2011)

Six adult horses (four geldings and two intact mares; age range, 4-22 years) were evaluated for acute development of nonspecific malaise during a 3-year period. Clinical signs included lethargy, anorexia, fever, limb edema, and ataxia. Physical examination findings included depression, anorexia, tachycardia, fever, poor body condition, hind limb ataxia, and dehydration. Hematologic examination in these horses most commonly revealed thrombocytopenia, mild anemia, and leukopenia. Inclusion bodies consistent with the presence of Anaplasma phagocytophilum morulae were observed within circulating neutrophils in all horses. Clinical biochemistry findings were nonspecific. Infection of each horse with A. phagocytophilum was confirmed by polymerase chain reaction. All horses showed resolution of clinical signs after initiation of treatment with intravenous oxytetracycline or oral doxycycline, combined with flunixin meglumine and additional supportive care as needed. Hematologic parameters paralleled clinical recovery and returned to reference limits in patients that underwent repeated analysis. Equine granulocytic anaplasmosis is likely under-recognized in regions where it has not been previously reported; therefore, equine practitioners should be cognizant of relevant clinical signs and laboratory findings in acute infection. Additionally, horses may represent sentinels for infection in other species, including humans.     

Short interval intradermal skin testing in farmed red deer (Cervus elaphus) inoculated with Mycobacterium bovis

Two groups of 26 red deer (Cervus elaphus) were tuberculin skin tested for 41 weeks at three and six week intervals respectively, except at 17 weeks when the internal was two and five weeks. Seventeen weeks after the start of the experiment 36 deer were inoculated intratracheally with Mycobacterium bovis, and the remaining 16 were run in-contact. At six weeks post inoculation, 35 of the 36 inoculated deer reacted to the skin test with a mean skin thickness difference (STD) of 6.3 mm. In inoculated deer further testing led to a suppression of skin sensitivity which was significantly greater in the three-weekly tested group. There was no statistical difference in skin thickness response between 1 and 2 mg/ml bovine purified protein derivative (PPD). Of 454 tests on noninoculated deer (noninfected), 107 produced reactions. These reactions were small and 96% had a STD of less than 2 mm.     

Bovine leukaemia virus infection in New Zealand cattle

Bovine Leukaemia Virus (BLV) infection in New Zealand cattle was investigated. In a national survey of 5000 sera from 500 herds, BLV antibody was not detected. An additional 1062 sera from 140 herds were tested and 3 sera were positive. In the herd of origin of one of these 3 sera, 22.6% of cattle were serologically positive for BLV. Where cases of bovine lymphosarcoma had been diagnosed, 38 of 39 herds tested were negative for BLV antibody. Within the remaining herd, 36% of cows tested were serologically-positive. BLV was isolated from 2 serologically positive cows in this herd.     

What is your diagnosis? Perifemoral mass in a cow

Abstract: A 15‐year‐old female Simmental cross‐breed cow was presented to the Purdue University Veterinary Teaching Hospital for evaluation of a perifemoral soft tissue mass. Impression smears made from an excisional biopsy contained a population of pleomorphic mesenchymal cells with abundant, periodic acid–Schiff‐positive (PAS), intracytoplasmic granular material, and rare elongated multinucleated cells consistent with strap‐like cells. A second population of small round cells suggestive of lymphocytes or progenitor cells was also noted. A cytologic diagnosis of sarcoma was made, with rhabdomyosarcoma considered most likely based on the large amount of PAS‐positive material (presumed to be glycogen) and the rare strap‐like cells. Histopathologic sections contained an unencapsulated, densely cellular neoplasm composed of haphazardly arranged highly pleomorphic mesenchymal cells and a few small round cells. The mesenchymal cells were positive for vimentin, non‐specific muscle actin, and myoglobin, and negative for phosphotungstic acid‐hematoxylin, smooth muscle actin, and desmin. Glycogen granules were confirmed by transmission electron microscopy. A diagnosis of pleomorphic rhabdomyosarcoma was made. While cytologic findings may suggest rhabdomyosarcoma, cytologic features can be highly variable, and a definitive diagnosis usually requires cytochemical and immunohistochemical staining.