Diagnosis of preclinical scrapie in live sheep by the immunohistochemical examination of rectal biopsies

In most sheep infected with a transmissible spongiform encephalopathy (tse) the disease-associated prion protein (PrP(d)) accumulates in tissues of the lymphoreticular system, suggesting that it might be detected in biopsy specimens. A procedure has been developed to obtain biopsy specimens of rectal mucosa in which PrP(d) has been detected by immunohistochemistry in preclinically infected sheep of all susceptible PrP genotypes. It is probable that PrP(d) increases with the age of sheep or period of incubation. PrP(d) was detectable approximately halfway through the incubation period, with sheep of some PrP genotypes showing positive results earlier than others. For a preclinical diagnosis, the risk of a false negative result was approximately 9 per cent for samples containing 10 follicles, a figure that was reached in 87 per cent of the biopsies. The rectal biopsies had the same sensitivity and time of onset of PrP(d) accumulation as biopsies of the palatine tonsil, but provided larger numbers of follicles. The procedure is simple and quick, does not require dedicated specific instruments, sedation or general anaesthesia, and can be performed repeatedly on the same sheep without detrimental effects to either the animal or the number of follicles obtained.     

Classical natural ovine scrapie prions detected in practical volumes of blood by lamb and transgenic mouse bioassays

Scrapie is diagnosed antemortem in sheep by detecting misfolded isoforms of prion protein (PrP^Sc) in lymphoid follicles of the rectal mucosa and nictitating membranes. Assay sensitivity is limited if (a) the biopsy is collected early during disease development, (b) an insufficient number of follicles is collected, or (c) peripheral accumulation of PrP^Sc is reduced or delayed. A blood test would be convenient for mass live animal scrapie testing. Currently approved techniques, however, have their own detection limits. Novel detection methods may soon offer a non-animal-based, rapid platform with detection sensitivities that rival the prion bioassay. In anticipation, we sought to determine if diseased animals could be routinely identified with a bioassay using B lymphocytes isolated from blood sample volumes commonly collected for diagnostic purposes in small ruminants. Scrapie transmission was detected in five of six recipient lambs intravenously transfused with B lymphocytes isolated from 5~10 mL of blood from a naturally scrapie-infected sheep. Additionally, scrapie transmission was observed in 18 ovinized transgenic Tg338 mice intracerebrally inoculated with B lymphocytes isolated from 5~10 mL of blood from two naturally scrapie-infected sheep. Based on our findings, we anticipate that these blood sample volumes should be of diagnostic value.     

Characterization of membranous (M) cells in normal feline conjunctiva-associated lymphoid tissue (CALT)

Objective To characterize conjunctival lymphoid nodules obtained from the nictitans of healthy cats to determine if the follicle‐associated epithelium (FAE) of conjunctiva‐associated lymphoid tissue (CALT) in this species contains membranous (M)‐cells analogous to those described in other regions of mucosa‐associated lymphoid tissue (MALT). Methods Lymphoid follicles from nictitan bulbar surfaces of 10 healthy cats (20 eyes total) were examined. Nictitans from five cats were harvested immediately post‐mortem and a minimum of 12 lymphoid nodules from each third eyelid were isolated using a Zeiss operating microscope. At least three lymphoid follicles from each eye were examined using light microscopy (LM), transmission electron microscopy (TEM), and scanning electron microscopy (SEM) using standard fixation and embedding protocols. Nictitan‐lymphoid follicles from another five healthy cats were processed for immunohistochemistry to characterize the distribution of T‐ and B‐lymphocytes present beneath the FAE. Results The FAE overlying CALT from 10 healthy cats demonstrated morphology characteristic of M‐cells including attenuated apical cell surface with blunted microvilli and microfolds, invaginated basolateral membrane forming a cytoplasmic pocket, and diminished distance between the apical and pocket membrane. Immunohistochemistry of lymphoid tissue subtending the FAE demonstrated B‐cell dependent regions in the germinal centers surrounded by T‐cell dependent interfollicular zones. Conclusions Healthy feline CALT contains morphologic features analogous to those described in other regions of MALT. Documentation of feline conjunctival M‐cells is of clinical relevance in the study of primary infectious, allergic, and autoimmune ocular diseases, as well as a potential means of vaccination or drug delivery.     

Secondary lymphoid areas in calf ileal Peyer's patch

The secondary lymphoid tissues appear in sheep ileum after involution of ileal Peyer's patch (PP). However, the existence of the secondary lymphoid tissues before involution of ileal PP has not yet been studied. We examined morphological characteristics of the full length of calf ileal PP using gross and microscopic anatomical techniques. Most areas of ileal PP consisted of densely packed lymphatic follicles contained very few follicular T-cell and associated with only scant interfollicular areas. However, the proximal end of ileal PP consisted of widely dispersed lymphatic follicles contained many follicular T-cell and associated with large interfollicular areas. The histological architectures of the proximal end of ileal PP strongly resembled those of the secondary lymphoid tissue in calf.     

Quantification of Peyer's patches in Cheviot sheep for future scrapie pathogenesis studies

Peyer's patches (PPs) are the most probable sites of intestinal uptake of the transmissible spongiform encephalopathy (TSE) agent. The amount of PP tissue varies considerably between different age groups of individuals, and whether this variation is related to susceptibility to TSE infection raises an intriguing possibility. The purpose of this study was to determine the surface area of PP tissue and the number of associated lymphoid follicles in different age groups of Neuropathogenesis Unit (NPU) Cheviot sheep. Terminal ilea were obtained from 33 sheep of different ages. Samples of ileal tissue were collected for immunocytochemistry and immunolabelled for prion protein (PrP). Specimens were then fixed in acetic acid, stained with methylene blue and transilluminated. Image analysis software was used to calculate the area of intestinal and PP tissue. The number of associated lymphoid follicles was determined using a dissecting microscope. Results showed a marked fall in surface area of PP tissue and lymphoid follicle density around puberty (about 8-9 months of age in NPU Cheviot sheep) and both measures remained low throughout adulthood. Using the Spearman's rank correlation coefficient, r(s), these two measures were found to be closely correlated (r(s)=0.899, n=33, P<0.0001). There was also a significant (negative) correlation between age and the two respective measures (surface area of PP tissue versus age, r(s)=-0.879 (n=33, P<0.0001); lymphoid follicle density versus age r(s)=-0.943 (n=33, P<0.0001). Immunolabelling for PrP was observed primarily in the light zone of lymphoid follicles. Results obtained from this study are useful for future oral pathogenesis studies of the NPU Cheviot flock. They may also offer a possible biological explanation for the apparent age-susceptibility relationship observed in natural cases of TSEs and might help to explain the young age-distribution of cases.     

Reduced apoptosis in sheep ileal Peyer's patch is associated with low levels of follicle centre carbonic anhydrase reactivity

Apoptosis in lymphoid follicles of the ileal Peyer's patch (IPP) in 21 sheep of two different age groups was visualized by the TdT-mediated dUTP nick end-labelling (TUNEL) method, and quantified using computer-assisted image analysis. The IPP follicle carbonic anhydrase (CA) reactivity was evaluated in the same samples. No significant differences with respect to apoptosis and CA reactivity were found between sheep aged 5 and 11 months. Individual variation in apoptotic activity correlated with the follicle centre CA reactivity. The group of animals found to have predominantly atypical ileal lymphoid follicles (more than 80% of total number of follicles) with features resembling jejunal Peyer's patch follicles, had lower number of apoptotic cells and reduced CA reactivity compared to the rest of the animals. The differences in CA reactivity in the follicle centres probably represent a variation in the presence of CA rich approximately 50 nm membrane-bounded particles known to be a feature of the sheep IPP. The present results suggest that the particles are involved in the modulation of the lymphocyte proliferation of the IPP follicles.     

Adaptation and evaluation of a rapid test for the diagnosis of sheep scrapie in samples of rectal mucosa.

In recent publications, it was shown that disease-associated prion protein (PrP(d)) accumulates in the lymphoid tissue of the rectal mucosa of a high proportion of scrapie-infected sheep at clinical and preclinical stages, regardless of several host factors; PrP(d) can also be detected in biopsy specimens of rectal mucosa, with an increased probability proportional to age or incubation period and with an efficiency almost identical to that of tonsil biopsies. Rectal biopsies have the advantages of providing higher numbers of lymphoid follicles and of being simpler to perform, which makes them suitable for scrapie screening in the field. In biopsy samples, PrP(d) could be demonstrated by immunohistochemical (IHC) and Western immunoblotting methods, and the purpose of the present study was to optimize and evaluate a "rapid test" for the diagnosis of scrapie in rectal biopsy samples. The HerdChek CWD (chronic wasting disease) antigen EIA (enzyme immunoassay) test was chosen and, once optimized, provided specificity and sensitivity figures of 99.2% and 93.5%, respectively, compared with IHC results in the same samples obtained at a postmortem. The sensitivity of the assay increased from 82.1%, when a single rectal mucosa sample was tested to 99.4% for those sheep in which 3 or more samples were analyzed. Similarly, sensitivity values of the HerdChek CWD antigen EIA test on biopsy samples increased from 95% to 100% for sheep subjected to 1 or 2 sequential biopsies 4 months apart, respectively. Thus, a preclinical diagnosis of scrapie in live sheep can be achieved by a combination of a simple sampling procedure, which can be repeated several times with no detrimental effect for the animals, and a rapid and efficient laboratory method.     

Pathological changes in the lungs and mammary glands of sheep and their relationship with maedi-visna infection.

Maedi-visna, a multisystemic disease of adult sheep, was first described in Spain in 1984. To get an idea of the seroprevalence of the disease locally and to estimate the number of seropositive animals with lesions, samples of blood, lungs and mammary glands were taken from 124 randomly selected sheep killed in the main slaughterhouse of Zaragoza. In the agar gel immunodiffusion test, 74 (59.7 per cent) of the sheep were positive and 50 were negative. Among the 74 seropositive animals, 19 (25.6 per cent) had no lesions in any organ, 12 (16.2 per cent) had lesions in the lungs only, 15 (20.2 per cent) had lesions in the mammary glands and 28 (37.8 per cent) had lesions in both organs. In the lungs hyperplasia of lymphoid follicles was more evident than an interstitial infiltrate but in the mammary glands this relationship was not observed. Even when the lesions occurred in both organs, they did not show the expected proportion in terms of either type or severity. Among the 50 seronegative sheep, eight (16 per cent) showed maedi-like lesions, formed exclusively by the hyperplasia of lymphoid follicles.     

Evaluation of hemorrhage, sample size, and collateral damage for five hepatic biopsy methods in dogs

OBJECTIVES: To compare the volume of hemorrhage, number of lobules, and portal triads available for histologic evaluation, and resultant collateral damage between 5 hepatic biopsy methods: biopsy punch, biopsy needle, ligature method, laparoscopic biopsy forceps, and ultrasonically activated scalpel (UAS). STUDY DESIGN: Experimental, repeated measures, block. ANIMALS: Twelve adult dogs. METHODS: Biopsies were obtained from the periphery and center of the left lateral liver lobe of each dog using each of 5 biopsy techniques. Hemorrhage was quantified and compared between methods and sites. Biopsy samples were evaluated histologically to characterize collateral damage and determine the number of lobules and portal triads sampled. RESULTS: Regardless of technique, liver biopsy resulted in minimal hemorrhage (<2 mL). For peripheral biopsies, UAS was comparable with the ligature method, but caused significantly less hemorrhage than all other methods, whereas for central biopsies, UAS caused significantly less hemorrhage than other methods. Except for the laparoscopic biopsy forceps, UAS caused significantly more collateral damage than other methods. UAS and ligature biopsy methods yielded specimens that had more portal triads per sample than other methods. Eight of 48 biopsy needle samples were inadequate for histologic evaluation, whereas other methods yielded adequate specimens. CONCLUSIONS: All biopsy methods produced minimal hemorrhage and except for needle biopsy yielded adequate tissue samples for histologic evaluation. CLINICAL RELEVANCE: Use of UAS is a reliable, safe alternative technique for liver biopsy and can be used laparoscopically to obtain large tissue samples.     

Postmortem diagnosis of preclinical and clinical scrapie in sheep by the detection of disease-associated PrP in their rectal mucosa

Samples of tissue from the central nervous system (cns), the lymphoreticular system (lrs) and the rectal mucosa of a large number of scrapie-exposed sheep, with and without signs of clinical disease, were examined immunohistochemically for evidence of disease-associated prion protein (PrP(d)). The rectal mucosa has received almost no attention so far in scrapie diagnosis, despite its abundant rectoanal mucosa-associated lymphoid tissue, and its accessibility. The scrapie-confirmed cases included 244 with clinical disease, of which 237 (97.1 per cent) were positive in the rectal mucosa, and 121 apparently healthy sheep, of which 104 (86 per cent) were positive in the rectal mucosa. PrP(d) was detected in 86.4 to 91.5 per cent of the other lrs tissues of the healthy sheep examined and in 77.7 per cent of their cns tissues. The stage of infection, therefore, affected the probability of a positive result in the rectal mucosa, whereas the breed, PrP genotype, age and sex had little or no independent effect. Accumulations of PrP(d) were observed in the rectal mucosa and other lrs tissues of vrq/arr sheep with preclinical and clinical scrapie, albeit with a lower frequency and magnitude than in sheep of other PrP genotypes. Western immunoblotting analyses of samples of rectal mucosa gave the characteristic PrP glycoprofile, with a sensitivity similar to that of immunohistochemistry.     

Cellular and molecular characterisation of the ovine rectal mucosal environment

Immunohistological characterisation of ovine rectal tissue has revealed the presence of lymphoid follicles, predominantly in the submucosa, that closely resemble those found in intestinal Peyer's patches (PPs). Distinct T (CD4+, CD8+, gammadelta-TCR+) and B (CD21+, CD45R+) lymphocyte staining patterns were observed within and around follicles of the rectal mucosa. In addition, IgA+ and IgE+ cells were also found at this tissue site, with both phenotypes commonly residing in the lamina propria. RT-PCR examination of the cytokines expressed in the rectal mucosal tissue revealed consistently high levels of TGFbeta and IL-8 mRNA, low levels of IL-2 mRNA and no detectable IL-4 mRNA. The presence of lymphoid follicles, IgA+ plasma cells and IgA-inducing cytokines in rectal tissue of sheep indicate that this may be a suitable route for delivering mucosal vaccines.     

Histological characteristics and stereological volume assessment of the ovine tonsils

Tonsils form a first line of defence against foreign antigens and therefore play a key role in immunity. Since documented information about ovine tonsils is limited, a study was performed in which the morphological characteristics and the volume of lymphoid tissue present in each ovine tonsil were determined. The tonsils of five adult healthy sheep were examined histologically and the volumes were estimated using the Cavalieri method. The pharyngeal tonsil had a mean volume of 1296.1 ± 205.9 mm³ and was by far the largest ovine tonsil, followed by the paired palatine tonsil with a mean volume of 715.0 ± 110.5 mm³. The tonsil of the soft palate, the paired tubal and paraepiglottic tonsils and the lingual tonsil were much smaller with a mean volume of, respectively, 90.3 ± 24.9 mm³, 80.1 ± 24.3 mm³, 29.7 ± 11.8 mm³ and 10.1 ± 2.8 mm³. The folds and crypts of the pharyngeal and palatine tonsils were covered by a reticular and a non-reticular epithelium. Both tonsils were mainly composed of primary and secondary lymph follicles. The palatine tonsils contained 1–3 crypts with a few secondary infoldings. Lymphoid tissue in the tonsil of the soft palate was located at the nasopharyngeal (dorsal) side of the soft palate. The tubal tonsil was lined with a pseudostratified columnar ciliated epithelium and consisted of scattered lymphoid cells and lymph follicles. The paraepiglottic tonsil consisted of lymph follicles and aggregated lymphoid cells. Its overlying keratinized stratified squamous epithelium was folded and often heavily infiltrated by lymphocytes. The ovine lingual tonsil was not macroscopically visible and did not contain clearly distinguishable lymph follicles. It consisted of aggregations of lymphoid cells that were mainly located within the vallate lingual papillae.     

Lymph Drainage from the Ovine Tonsils: An Anatomical Study of the Tonsillar Lymph Vessels

Although the tonsils of sheep have gained much attention during the last decade, only few data are available on their lymph vessel architecture. Tonsillar lymph vessels are immunologically important as they form the efferent routes for locally activated immune cells to reach the draining lymph nodes. To gain insight into the tonsillar lymph drainage in the sheep, Indian ink and a casting polymer were injected into the interstitium of the five tonsils present in the heads of slaughtered sheep. This enabled us to determine the draining lymph node and to examine the microscopic organization of lymph vessels using light and scanning electron microscopy. No lymph vessels were observed within the tonsillar lymphoid follicles. The corrosion casts demonstrated that the lymphoid follicles are surrounded by numerous sacculated lymph sinuses that drain into a dense interfollicular lymph vessel network. From here, the lymph flows into single small lymph vessels that in turn drain into larger lymph vessels extending towards the medial retropharyngeal lymph node. The presented results can be valuable for immunological studies, for example during oral or intranasal vaccine development.     

Distribution pattern of bovine viral diarrhoea virus type 1 genome in lymphoid tissues of experimentally infected sheep

In this study, cellular localization and the distribution pattern of BVDV genome in lymphoid tissues during the course of experimental acute BVDV-1 infection of sheep was investigated. Tonsils, mesenteric lymph nodes (MLN) and spleen were collected on 3, 6, 9, 12 and 15 days post infection (dpi) from twenty 4-month-old lambs, experimentally inoculated intra-nasally with 5?×?10⁵ TCID₅₀ of a non-cytopathic (ncp) BVDV-1 isolate, Ind-17555. Tissues collected from ten mock-infected lambs served as controls. In situ hybridization (ISH) was carried out in paraformaldehyde fixed paraffin embedded tissue sections using digoxigenin labelled riboprobe targeting 5′-UTR of BVDV-1. BVDV genome was detected at all the intervals from 3 dpi to 15 dpi in the lymphoid tissues with variations between the intervals and also amongst the infected sheep. During the early phase of acute infection, presence of viral genome was more in tonsils than MLN and spleen, whereas the distribution was higher in MLN during later stages. BVDV-1 genome positive cells included lymphocytes, macrophages, plasma cells, reticular cells and sometimes crypt epithelial cells. Genome distribution was frequently observed in the lymphoid follicles of tonsils, MLN and spleen, besides the crypt epithelium in tonsils, paracortex and medullary sinus and cords of MLN. Most abundant and widespread distribution of BVDV-1 genome was observed on 6 dpi while there was a reduction in number and intensity of positive signals by 15 dpi in most of the infected animals. This is the first attempt made to study the localisation of BVDV-1 in lymphoid tissues of acutely infected sheep by in situ hybridization. The results show that the kinetics of BVDV-1 distribution in lymphoid tissues of experimentally infected non-pregnant sheep follows almost a similar pattern to that demonstrated in BVDV infected cattle.     

Removal of a metallic foreign body from the tongue of three horses

The objective of this case report is to describe the diagnostic and surgical techniques for removal of a metallic foreign body in the tongue of three adult horses. The three horses were presented for evaluation and treatment of dysphagia and marked hypersalivation of 3–5 days duration. Radiographs of the head revealed the presence of a metallic foreign body in the tongue of each horse. The foreign bodies could be precisely localised under general anaesthesia using palpation and lingual ultrasonography and/or lingual radiography in combination with a forceps as a marker. The foreign bodies were successfully removed using laparoscopic instruments creating minimal soft tissue trauma. The use of long (43 cm) small laparoscopic (5 mm) instruments enabled good visualisation of the surgical field, providing optimal conditions for successful minimally invasive surgical treatment of horses with foreign bodies in the tongue. The three horses made uneventful recoveries and 12 months after surgery were eating normally and could be ridden with a bit as per usual routine. It was concluded that using long laparoscopic instruments in combination with palpation, ultrasonography and/or radiography allowed removal of the foreign body creating minimal soft tissue trauma and allowing optimal conditions for a fast recovery.     

Preparation and characterization of a monoclonal antibody against bovine CD5 lymphocyte surface antigen.

The M1 monoclonal antibody (mAb) was proved to recognize 51-70% of Bovine peripheral blood lymphocytes (PBL). The M1+ cells were SIg-. In spleen and lymph nodes, the M1 positive lymphocytes were located within the T cell areas. All the lymphoid follicles remained negative. In the thymus, 10% of thymocytes were M1+, most of them were located in the medulla. The M1 mAb did not inhibit spontaneous rosette formation by sheep erythrocytes and bovine lymphocytes. On the other hand, biochemical analysis of membrane antigen with bovine thymic tumor cell line LB203 gave a molecular weight of 75 kDa. Despite a slight difference in biochemical results (75 vs 67-69 kDa). Our data permit us to consider M1 mAb as a possible homologous of human anti-CD5 mAb. Finally, M1 cross-reacted with sheep peripheral blood T lymphocytes.     

Perinatal development of lymphoid tissue and its associated epithelium in the ovine pharyngeal tonsil: A morphological study

The perinatal development of lymphoid tissue and its associated epithelium in the pharyngeal tonsil of sheep was investigated by light and electron microscopy. The lymphoid cells first appeared in the subepithelium in a scattered form at about 92 days gestation. These cells proliferated rapidly during the last trimester of gestation, and had formed many dense aggregates at the time of parturition. At birth, the epithelium overlying the aggregates was extensively infiltrated with lymphocytes and showed early transformation of follicle-associated epithelium. The lymphoid tissue and its associated epithelium did not, however., fully develop until after birth, when well-differentiated follicle-associated epithelium and lymphoid follicles with vigorous lymphopoiesis were present. In l–2 week old lambs, these structures were ultrastructurally similar to those seen in adult sheep although their size was smaller. The results of this study suggest that the lymphoid tissue of the ovine pharyngeal tonsil and its associated epithelium are morphologically ready to cope with antigens in the extra-uterine environment at birth, but that their full development and maturation are dependent on postnatal antigen stimulation.     

An efficient isolation method for domestic hen (Gallus domesticus) ovarian primary follicles

An enzymatic method of isolating primary follicles in the turkey has been described previously, but no similar work has been done in the hen. In this study, primary follicles from domestic hens (Gallus domesticus) were isolated using an enzymatic method, and the isolated follicular quantity, quality, and development in vitro were assessed. About 400 primary follicles ranging from 60 to 1125 microm in diameter were recovered with trypsin and collagenase from hen ovaries (per ovary). Of these, 76.5% were intact follicles with a complete single layer of granulose cells surrounded by the basement membrane, and their ultrastructures appeared this way in situ. Follicles (351 to 500 microm in diameter) were cultured in vitro, and 46.67% of them survived after 5 days. Ultrastructural examination showed that elongated mitochondria forming a ring were distributed to the periphery of the oocyte, the Golgi was oriented with the maturing face toward the granulosa cell layer, and the oocyte plasma membrane presented a few short microvilli lying on the oocyte surface, which confirmed that the surviving follicles were developmental. These results suggest that a simple, rapid, effective enzymatic method can be used to isolate a great number of intact primary follicles from the hen ovary.     

Perinatal development of lymphoid tissue and its associated epithelium in the ovine pharyngeal tonsil: a morphological study

The perinatal development of lymphoid tissue and its associated epithelium in the pharyngeal tonsil of sheep was investigated by light and electron microscopy. The lymphoid cells first appeared in the subepithelium in a scattered form at about 92 days gestation. These cells proliferated rapidly during the last trimester of gestation, and had formed many dense aggregates at the time of parturition. At birth, the epithelium overlying the aggregates was extensively infiltrated with lymphocytes and showed early transformation of follicle-associated epithelium. The lymphoid tissue and its associated epithelium did not, however, fully develop until after birth, when well-differentiated follicle-associated epithelium and lymphoid follicles with vigorous lymphopoiesis were present. In 1-2 week old lambs, these structures were ultrastructurally similar to those seen in adult sheep although their size was smaller. The results of this study suggest that the lymphoid tissue of the ovine pharyngeal tonsil and its associated epithelium are morphologically ready to cope with antigens in the extra-uterine environment at birth, but that their full development and maturation are dependent postnatal antigen stimulation.     

Detection of PrP(CWD) in postmortem rectal lymphoid tissues in Rocky Mountain elk (Cervus elaphus nelsoni) infected with chronic wasting disease.

Preclinical diagnostic tests for transmissible spongiform encephalopathies have been described for mule deer (Odocoileus hemionus), using biopsy tissues of palatine tonsil, and for sheep, using lymphoid tissues from palatine tonsil, third eyelid, and rectal mucosa. The utility of examining the rectal mucosal lymphoid tissues to detect chronic wasting disease (CWD) was investigated in Rocky Mountain elk (Cervus elaphus nelsoni), a species for which there is not a live-animal diagnostic test. Postmortem rectal mucosal sections were examined from 308 elk from two privately owned herds that were depopulated. The results of the postmortem rectal mucosal sections were compared to immunohistochemical staining of the brainstem, retropharyngeal lymph nodes, and palatine tonsil. Seven elk were found positive using the brainstem (dorsal motor nucleus of the vagus nerve), retropharyngeal lymph nodes, and palatine tonsil. Six of these elk were also found positive using postmortem rectal mucosal sections. The remaining 301 elk in which CWD-associated abnormal isoform of the prion protein (PrP(CWD)) was not detected in the brainstem and cranial lymphoid tissues were also found to be free of PrP(CWD) when postmortem rectal mucosal sections were examined. The use of rectal mucosal lymphoid tissues may be suitable for a live-animal diagnostic test as part of an integrated management strategy to limit CWD in elk.