Surveys of rodent‐borne disease in Thailand with a focus on scrub typhus assessment

The epidemiology of many rodent‐borne diseases in South‐East Asia remains ill‐defined. Scrub typhus and lep‐tospirosis are common and medically significant, while other zoonotic diseases, such as spotted fever group Rickettsiae have been identified, but their overall medical significance is unknown. Rodent surveillance was conducted from June 2002 to July 2004 in 18 provinces from Thailand. Traps were set up for one to three nights. Blood and serum samples and animal tissue samples (liver, spleen, kidney and urinary bladder) were collected. Chiggermites, ticks and fleas were removed from captured rodents. A total of 4536 wild‐caught rodents from 27 species were captured over two years of animal trapping. Rattus rattus was the dominant species, followed by Rattus exulans and Bandicota indica. Almost 43 000 ectoparasites were removed from the captured animals. Approximately 98% of the ectoparasites were chigger‐mites, of which 46% belonged to the genus Leptotrombidium (scrub typhus vector). Other genera included Schoengastia and Blankaartia. Tick and flea specimens together comprised less than 1% of the sample. Among the five species of ticks collected, Haemaphysalis bandicota was the predominant species caught, followed by Ixodes granulatus other Haemaphysalis spp., Rhipicephalus spp. and Dermacentor spp. Only two species of fleas were collected and Xenopsylla cheopis (rat flea) was the predominant species. Using both commercial diagnostic kits and in‐house molecular assays, animal tissue samples were examined and screened for zoonotic diseases. Seven zoonotic diseases were detected: scrub typhus, leptospirosis, murine typhus, tick typhus, bartonella, babesiosis and trypanosomiasis. Most samples were positive for scrub typhus. Other zoonotic diseases still under investigation include borrelosis, ehrlichiosis, the plague, and other rickettsial diseases. Using geographic information systems, global positioning systems and remote sensing technology, epidemiological and environmental data were combined to assess the relative risk in different biotopes within highly endemic areas of scrub typhus in Thailand.     

Estimating direct healthcare costs attributable to laboratory‐confirmed Lyme disease in Ontario,Canada: A population‐based matched cohort study using health administrative data

The objective of this study was to determine healthcare costs attributable to laboratory‐confirmed Lyme disease (LD) from the healthcare payer perspective in Ontario, Canada. A cost‐of‐illness study was conducted for incident LD subjects from 1 January 2006 through 31 December 2013 ascertained from provincial laboratory and reportable disease databases, linked to health administrative data. All LD subjects included were laboratory‐confirmed, according to provincial case definitions. Incident LD subjects were propensity‐score matched to uninfected subjects on age, sex, comorbidities and urban/rural status. We used phase‐of‐care methods to calculate attributable costs for two phases of illness: initial care (≤30 days following “index date”) and continuing care (>30 days after index date to the end of the follow‐up period). A total of 663 incident, confirmed LD subjects were identified from 2006 through 2013. Mean age was 44.2 ± 20.1 years; 339 (51.1%) were female; and 31 (4.7%) were hospitalized ≤30 days after index date. Six hundred fifty‐eight (99.2%) LD subjects were matched to uninfected subjects; mean follow‐up time was 3.3 years. Mean attributable costs per case during the initial care phase and continuing care were $277 (95% CI: $197, $357) and ?$5 (?$27, $17), respectively. Attributable costs per LD subject aged 5–14 years were $440 ($132, $747), greater than the costs observed for other age strata. Expected 1‐year attributable costs were $832, given continuing care costs were negligible. Limitations to our study include estimating costs using a cohort of only laboratory‐confirmed LD cases, introducing selection bias for diagnosed and treated patients who may have a lower risk of developing sequelae. In conclusion, the initial care phase of LD is associated with increased healthcare costs, but without significant costs attributable to LD infection after 30 days. Estimates of costs attributable to LD are important for healthcare resource prioritization and the evaluation of novel interventions.     

Economic Assessment of Zoonoses Surveillance in a ‘One Health’ Context: A Conceptual Framework

Collaboration between animal and public health sectors has been highlighted as a means to improve the management of zoonotic threats. This includes surveillance systems for zoonoses, where enhanced cross‐sectoral integration and sharing of information are seen as key to improved public health outcomes. Yet, there is a lack of evidence on the economic returns of such collaboration, particularly in the development and implementation of surveillance programmes. The economic assessment of surveillance in this context needs to be underpinned by the understanding of the links between zoonotic disease surveillance in animal populations and the wider public health disease mitigation process and how these relations impact on the costs and benefits of the surveillance activities. This study presents a conceptual framework of these links as a basis for the economic assessment of cross‐sectoral zoonoses surveillance with the aim of supporting the prioritization of resource allocation to surveillance. In the proposed framework, monetary, non‐monetary and intermediate or intangible cost components and benefit streams of three conceptually distinct stages of zoonotic disease mitigation are identified. In each stage, as the final disease mitigation objective varies so does the use of surveillance information generated in the animal populations for public health decision‐making. Consequently, the associated cost components and benefit streams also change. Building on the proposed framework and taking into account these links, practical steps for its application are presented and future challenges are discussed.     

Preliminary insights into the occurrence of similar clones of extended‐spectrum beta‐lactamase‐producing bacteria in humans,animals and the environment in Tanzania: A systematic review and meta‐analysis between 2005 and 2016

The emergence and spread of extended‐spectrum beta‐lactamase producing Enterobacteriaceae (ESBL‐PE) are complex and of the public health concern across the globe. This review aimed at assessing the ESBL‐PE clones circulating in humans, animals and the environment to provide evidence‐based insights for combating ESBL‐PE using One Health approach. Systematic search from Medline/PubMed, Google Scholar and African Journals Online was carried out and retrieved nine eligible articles (of 131) based on phenotypic and genotypic detection of ESBL‐PE between 2005 and 2016 in Tanzania. Analysis was performed using STATA 11.0 software to delineate the prevalence of ESBL‐PE, phenotypic resistance profiles and clones circulating in the three interfaces. The overall prevalence of ESBL‐PE in the three interfaces was 22.6% (95% CI: 21.1–24.2) with the predominance of Escherichia coli (E. coli) strains (51.6%). The majority of ESBL‐PE were resistant to the commonly used antimicrobials such as trimethoprim–sulfamethoxazole and tetracycline/doxycycline, 38%–55% were resistant to ciprofloxacin and all were sensitive to meropenem/imipenem. ESBL‐PE infections were more associated with deaths compared to non‐ESBL‐PE infections. Strikingly, E. coli ST38, ST131 and ST2852 were found to intersect variably across the three interfaces. The predominant allele, bla_{CTX‐M‐15,} was found mostly in the conjugative IncF plasmids connoting transmission potential. The high prevalence of ESBL‐PE and shared clones across the three interfaces, including the global E. coli ST131 clone, indicates wide and inter‐compartmental spread that calls for One Health genomic‐driven studies to track the resistome flow.     

Pulmonary and hepatic eosinophilic granulomas and epistaxis in a horse suggestive of multi‐systemic eosinophilic epitheliotropic disease

Multi‐systemic eosinophilic epitheliotropic disease (MEED) is a relatively uncommon disease characterised by eosinophilic infiltration of more than one organ system, with the skin and gastrointestinal tract most commonly affected. This case report describes a gelding that presented for weight loss, increased respiratory rate and effort and chronic intermittent epistaxis. During post mortem examination diffuse eosinophilic granulomatous lesions were identified in the lung and liver, leading to a diagnosis of MEED. Veno‐occlusive pulmonary remodelling was also discovered, believed to be the cause of the chronic epistaxis and a result of the pulmonary fibrosis and eosinophilic granulomas.     

A longitudinal study on the acceptance and effects of a therapeutic renal food in pet dogs with IRIS‐Stage 1 chronic kidney disease

Currently, nutritional management is recommended when serum creatinine (Cr) exceeds 1.4 mg/dl in dogs with IRIS‐Stage 2 chronic kidney disease (CKD) to slow progressive loss of kidney function, reduce clinical and biochemical consequences of CKD, and maintain adequate nutrition. It is unknown if dietary interventions benefit non‐azotemic dogs at earlier stages. A prospective 12‐month feeding trial was performed in client‐owned dogs with IRIS‐Stage 1 CKD (n = 36; 20 had persistently dilute urine with urine specific gravity (USG) <1.020 without identifiable non‐renal cause; six had persistent proteinuria of renal origin with urine protein creatinine (UPC) ratio >0.5; 10 had both). Ease of transition to therapeutic renal food and effects on renal biomarkers and quality of life attributes were assessed. Dogs were transitioned over 1 week from grocery‐branded foods to renal food. At 0, 3, 6, 9, and 12‐months a questionnaire to assess owner's perception of their pet's acceptance of renal food and quality of life was completed. Renal biomarkers, including serum Cr, blood urea nitrogen (BUN), and symmetric dimethylarginine (SDMA), and USG and UPC ratio were measured. Of 36 dogs initially enrolled, 35 (97%) dogs were transitioned to therapeutic renal food. Dogs moderately or extremely liked the food 88% of the time, ate most or all of the food 84% of the time, and were moderately or extremely enthusiastic while eating 76% of the time. All renal biomarkers (Cr, BUN, and SDMA) were decreased (p ≤ .05) from baseline at 3‐months, and remained decreased from baseline at 12‐months in dogs completing the study (n = 20). Proteinuria was reduced in 12 of 16 dogs (p = .045) with proteinuria. Owners reported improvement in overall health and quality of life attributes, and hair and coat quality (all p < .01). In summary, dogs with IRIS‐Stage 1 CKD readily transition to renal food. Decreasing serum biomarker concentrations and reduction in proteinuria suggest stabilized kidney function.     

Combretastatin A4‐phosphate and its potential in veterinary oncology: a review

For many years, research on anticancer therapy has focussed almost exclusively on targeting cancer cells directly, to selectively kill them or restrict their growth. But limited advances in this strategy have led researchers to shift their attention to other potential targets. Active research is now on‐going on targeting tumour stroma. Vascular disrupting agents (VDAs) appear a promising class of anticancer drugs that are currently under investigation as a sole or combined therapy in human cancer patients. This article will briefly touch on the history and biology of combretastatin A4‐phosphate (CA4P) as a typical example of VDAs and will concentrate on the side effects that can be expected when used in veterinary patients. Particularly, the pathogenesis of these side effects and how they may be prevented and/or treated will be discussed. The purpose of this article is to illustrate the potentials of CA4P as anticancer therapy in veterinary oncology patients.     

Effects of exposure to plant‐derived odorants on behavior and the concentration of stress‐related hormones in steers isolated under a novel environment

This study was conducted to investigate physiological and behavioral effects of the exposure to plant‐derived odorants in Holstein steers (8 month of age) under the acute stress of social isolation in a novel environment. Each steer was tethered in a new room alone and exposed to one of three odorants: a mixture of equal amounts of trans‐2‐hexenal and cis‐3‐hexenol (green odor, GO; n = 5), essential oil of grapefruits (EOG; n = 5) and solvent (SOL; n = 6). Behaviors were recorded and blood samples were taken at intervals of 10–15 min for 6 h. Compared with SOL, exposure to GO or EOG decreased the frequency of vocalization (P < 0.05), shortened the latency period before the onset of rumination (P < 0.05) and increased the duration of rumination (P < 0.05). Plasma cortisol concentrations in steers exposed to plant‐derived odorants (GO and EOG) during 90–130 min from commencement of sampling were significantly lower (P < 0.05) compared with SOL. These results suggest that appeasing effects of plant‐derived odorants on behavioral and physiological stress responses previously reported in laboratory rodents could be also be expected in steers.     

Apoptosis: A review of pro‐apoptotic and anti‐apoptotic pathways and dysregulation in disease

Objective – To review the human and veterinary literature on the biology of apoptosis in health and disease. Data Sources – Data were examined from the human and veterinary literature identified through Pubmed and references listed in appropriate articles pertaining to apoptosis. Human Data Synthesis – The role of apoptosis in health and disease is a rapidly growing area of research in human medicine. Apoptosis has been identified as a component of human autoimmune diseases, Alzheimer's disease, cancer, and sepsis. Veterinary Data Synthesis – Research data available from the veterinary literature pertaining to apoptosis and its role in diseases of small animal species is still in its infancy. The majority of veterinary studies focus on oncologic therapy. Most of the basic science and human clinical research studies use human blood and tissue samples and murine models. The results from these studies may be applicable to small animal species. Conclusions – Apoptosis is the complex physiologic process of programmed cell death. The pathophysiology of apoptosis and disease is only now being closely evaluated in human medicine. Knowledge of the physiologic mechanisms by which tissues regulate their size and composition is leading researchers to investigate the role of apoptosis in human diseases such as cancer, autoimmune disease and sepsis. Because it is a multifaceted process, apoptosis is difficult to target or manipulate therapeutically. Future studies may reveal methods to regulate or manipulate apoptosis and improve patient outcome.     

A Cross‐Sectional Study of Hepatitis E Virus Infection in Healthy People Directly Exposed and Unexposed to Pigs in a Rural Community in Northern Thailand

A cross‐sectional study of the association between occupational pig exposure and hepatitis E virus (HEV) infection in adult pig farmers and the general population who were not directly exposed to pigs was conducted in Nan Province, Thailand, from November 2010 to April 2011. All participants were interviewed to provide information on their job history, eating habits and other potential confounders. The prevalence of anti‐HEV immunoglobulin G antibodies (IgG) among 513 subjects was 23.0%. Hand washing with water and soap was associated with a lower seroprevalence of HEV infection, whereas living in an area with frequent flooding (OR 1.64, 95% CI: 1.00–2.68) and consuming internal pig organs more than twice per week (OR 3.23, 95%CI: 1.15–9.01) were both associated with a higher seroprevalence of anti‐HEV IgG. There was no association between HEV seroprevalence and frequent, direct occupational pig contact.     

Alfaxalone or ketamine‐medetomidine in cats undergoing ovariohysterectomy: a comparison of intra‐operative parameters and post‐operative pain

ObjectiveTo compare post-operative pain in cats after alfaxalone or ketamine- medetomidine anaesthesia for ovariohysterectomy (OHE) and physiologic parameters during and after surgery.Study designProspective ‘blinded’ randomized clinical study.AnimalsTwenty-one healthy cats.MethodsCats were assigned randomly into two groups: Group A, anaesthesia was induced and maintained with alfaxalone [5 mg kg^?1 intravenously (IV) followed by boli (2 mg kg^?1 IV); Group MK, induction with ketamine (5 mg kg^?1 IV) after medetomidine (30 μg kg^?1 intramuscularly (IM)], and maintenance with ketamine (2 mg kg^?1 IV). Meloxicam (0.2 mg kg^?1 IV) was administered after surgery. Basic physiological data were collected. At time T = -2, 0, 0.5, 1, 2, 4, 6, 8, 12, 16, 20, and 24 hours post-operatively pain was assessed by three methods, a composite pain scale (CPS; 0–24 points), a visual analogue scale (VAS 0–100 mm), and a mechanical wound threshold (MWT) device. Butorphanol (0.2 mg kg^?1 IM) was administered if CPS was scored =13. Data were analyzed using a general linear model, Kruskal–Wallis analyses, Bonferroni-Dunn test, unpaired t-test and Fisher's exact test as relevant. Significance was set at p < 0.05.ResultsVASs were significantly higher at 0.5, 1, 2, 4, and 20 hours in group A; MWT values were significantly higher at 8 and 12 hours in group MK. Post-operative MWT decreased significantly compared to baseline in both groups. There was no difference in CPS at any time point. Five cats required rescue analgesia (four in A; one in MK).Conclusion and clinical relevanceAnaesthesia with ketamine-medetomidine was found to provide better post-surgical analgesia than alfaxalone in cats undergoing OHE; however, primary hyperalgesia developed in both groups. Alfaxalone is suitable for induction and maintenance of anaesthesia in cats undergoing OHE, but administration of additional sedative and analgesic drugs is highly recommended.     

Evidence of Powassan/deer tick virus in adult black‐legged ticks (Ixodes scapularis) recovered from hunter‐harvested white‐tailed deer (Odocoileus virginianus) in Pennsylvania: A public health perspective

Studies reporting tick infection rates for Powassan virus (POWV), an emerging zoonotic arthropod‐borne pathogen responsible for POWV disease in the Commonwealth of Pennsylvania, are limited. To determine the presence and ascertain a statewide prevalence of POWV, ticks were collected from 9,912 hunter‐harvested white‐tailed deer (Odocoileus virginianus) heads presented to six regional Pennsylvania Game Commission Chronic Wasting Disease sampling stations in early December of 2013, 2014 and 2015. Of the 2,973 ticks recovered, 1,990 (66.9%) were identified as adult Ixodes scapularis (black‐legged tick). The 1,990 I. scapularis ticks were PCR‐tested for the presence of POWV. The ticks had a statewide Powassan/deer tick virus infection rate of 0.05%, providing evidence of this pathogen in Pennsylvania's adult I. scapularis ticks and supporting the need for more comprehensive pathogen prevalence assessment strategies, as well as increased public health awareness for this emerging zoonotic arthropod‐borne pathogen of public health concern.     

Fibro‐osseous tumour of the fourth metacarpal bone in a horse: Clinical,radiographic and long‐term post operative findings

This case study describes a rare case of a fibro‐osseous tumour in the distal part of the fourth metacarpal bone of a 13‐year‐old horse. The tumour was surgically removed and wound healing occurred without complications. A specific diagnosis was reached by considering the clinical and histological features of the mass. However, the process was complicated by the different classification systems for this type of tumour. When classified according to the veterinary literature, ossifying fibroma is the appropriate diagnosis, whereas in human medicine this term has been replaced.