Avian anaesthesia related mortality and the associated risk factors in a UK zoological collection

ObjectiveTo analyse avian anaesthesia-related mortality in a UK zoological collection over a 5-year period and identify risk factors for mortality.Study designRetrospective cohort study.AnimalsA total of 135 individual birds across 37 species, anaesthetized during 206 events in a UK zoological collection between 1 January 2014 and 30 June 2019 (inclusive).MethodsAnaesthesia records were reviewed and variables such as age, body condition, weight, sex, duration of anaesthesia and health status were collated. Anaesthesia-related mortality was defined as those deaths occurring during anaesthesia and up to 7 days postanaesthesia. Outcome was analysed using multivariable conditional logistic regression. Overall mortality was defined and included birds euthanised during anaesthesia for non-anaesthesia related reasons. Data were summarised as median (range). A value of p < 0.05 was considered significant. Relative risks and 95% confidence intervals (95% CI) were calculated for the association between risk factors and anaesthetic death where a statistically significant difference was found.ResultsThe overall mortality rate was 10.19% (95% CI = 6.06–14.3%), while anaesthesia-related mortality was 3.88% (95% CI = 1.69–7.51%). Birds with an abnormal health status had a 15.53-fold (95% CI = 1.95–123.63) increased risk of death compared with those with a normal health status. The duration of anaesthesia was also a statistically significant risk factor (p = 0.021) in the univariable analysis, but not when combined with health status. No other variables were associated with anaesthesia-related mortality.Conclusions and clinical relevanceAbnormal health status and longer anaesthetic procedures were associated with a significantly increased risk of anaesthesia-related death in this population of birds. It is recommended that anaesthetic duration is minimized, and pre-existing diseases are diagnosed where possible prior to general anaesthesia of birds. Anaesthetizing healthy birds was associated with a low risk of mortality.     

Peri-anaesthetic mortality and nonfatal gastrointestinal complications in pet rabbits: a retrospective study on 210 cases

Objective

The aim of this study was to determine the incidence and the associated risk factors of peri-anaesthetic mortality and gastrointestinal complications in pet rabbits.

The confidential enquiry into perioperative equine fatalities (CEPEF): mortality results of Phases 1 and 2

Objectives To document the equine perioperative mortality rate and to highlight any factor associated with an increased risk of death up to 7 days after anaesthesia. Study design A prospective observational epidemiological multicentre study. Methods Data were recorded from all equidae undergoing general anaesthesia in 62 clinics. Power calculations indicated that 45 000 cases were required to detect the significance of important variables. Details of each horse, operation, anaesthetic agents and clinic personnel were recorded. Outcome at 7 days was recorded as: alive, put to sleep (PTS) or dead. Data were analysed by a standard multilevel logistic regression approach, considering the effects of clustering at the level of clinic. Results Data were collected from 41 824 cases over 6 years. A total of 39 025 (93.3%) were alive on day 7 and 785 were dead giving an overall death rate of 1.9% (95% CI: 1.8–2.0) and 2014 (4.8%) were PTS. About 5846 horses undergoing emergency abdominal surgeries (‘colics’) were excluded from subsequent analyses. A total of 35 107 ‘noncolic’ horses were alive at 7 days and 328 dead giving a death rate for noncolics of 0.9% (95% CI: 0.8–1.0). Five hundred and forty‐three (1.5%) noncolic horses classified PTS were excluded from further analyses. There were 109 (33%) deaths from cardiac arrest or post‐operative cardiovascular collapse, with 107 (32%) from fractures and myopathies. Fracture repair, out of hours surgery, and age below 1 month was associated with increased risk of dying whereas the use of acepromazine and intravenous anaesthetic agent maintenance of anaesthesia was associated with reduced risk. Conclusions A number of potential contributors to the high risk of anaesthetic‐related mortality have been identified. Further investigation of the underlying mechanism for their apparent harmful effects and development of alternative techniques is merited.     

Evaluation of the agreement of two oscillometric blood pressure devices with invasive blood pressure in anaesthetized chimpanzees (Pan troglodytes)

ObjectiveTo evaluate the agreement of two noninvasive blood pressure devices: a human device with the cuff placed on the wrist (Omron R1) and a veterinary device with the cuff placed on the upper brachium (Surgivet Advisor Vital Signs Monitor) with invasive blood pressure (IBP) measurement in anaesthetized chimpanzees.Study designProspective clinical study.AnimalsA convenience sample of 11 adult chimpanzees undergoing anaesthesia for translocation and routine health checks.MethodsSystolic (SAP) and diastolic arterial pressures (DAP) were continuously recorded via a transducer connected to a femoral artery cannula, and at 5 minute intervals from the two oscillometric devices. Agreement was explored using Bland-Altman analysis and bias defined as the mean difference between the two measurement methods. Spearman correlation coefficients were calculated. Significance was set at p < 0.05.ResultsBias and standard deviation for the Surgivet compared with IBP were 8.6 ± 18 for SAP and 8.4 ± 9.9 for DAP, showing a significant underestimation of both variables. Limits of agreement (LOA) were from –27 to 44 for SAP and from –11 to 28 for DAP. Correlation coefficients between the Surgivet and IBP values were 0.86 for SAP and 0.85 for DAP (p < 0.0001). Bias and standard deviation for the Omron compared with the IBP were –21 ± 25 for SAP and –18 ± 15 for DAP, showing a significant overestimation of both variables. LOA were from –70 to –28 for SAP and from –47 to 11 for DAP. Spearman correlation coefficients between the Omron and IBP values were 0.64 for SAP and 0.72 for DAP (p < 0.0001).Conclusions and clinical relevanceAlthough neither device met all the criteria for device validation, the Surgivet presented better agreement with IBP values than the Omron in adult anaesthetized chimpanzees.     

The risk of passive regurgitation during general anaesthesia in a population of referred dogs in the UK

Objective To evaluate the risk of passive regurgitation during anaesthesia, and to identify major factors associated with this in dogs attending the Queen Mother Hospital for Animals (QMHA), the Royal Veterinary College. Study design A case‐control study nested within the cohort of dogs undergoing anaesthesia with inhalation agents. Animal population All dogs undergoing general anaesthesia at the referral hospital between October 2006 and September 2008 (4271 cases). Methods All dogs anaesthetized at the QMHA during the study period were included. Regurgitating cases were defined as dogs for which reflux material was observed at the external nares or in the mouth, either during anaesthesia or before return to normal consciousness immediately after general anaesthesia. The risk of regurgitation was estimated and risk factors for regurgitation were evaluated with multivariable logistic regression (p < 0.05). Results The overall risk of regurgitation was 0.96% (41 cases out of 4271 anaesthetics, 95% confidence interval [95% CI] 0.67–1.25%). Exclusion of animals where pre‐existing disease was considered a contributing factor to regurgitation (n = 14) resulted in a risk of passive regurgitation of 0.63% (27 cases of 4257 anaesthetics, 95% CI 0.40–0.87%). In the multivariable logistic regression model, procedure and patient weight were significantly associated with regurgitation. Dogs undergoing orthopaedic surgery were 26.7 times more likely to regurgitate compared to dogs undergoing only diagnostic procedures. Dogs weighing more than 40 kg were approximately five times more likely to regurgitate than those weighing <20 kg. Conclusions and clinical relevance This study highlights the rare but important occurrence of perioperative regurgitation and identifies that dogs undergoing orthopaedic procedures, and those weighing more than 40 kg, are particularly at risk. Further work is required to evaluate the reasons for these observations.     

Mortality related to general anaesthesia and sedation in dogs under UK primary veterinary care

ObjectivesTo quantify and explore risk factors in dogs seen at primary care UK veterinary clinics for general anaesthetic (GA)/sedative-related death overall, in addition to neuter-specific procedures.Study designA nested case-control study within UK primary care veterinary electronic patient record surveillance programme, VetCompass, including over 300 UK veterinary practices.AnimalsA total of 157,318 dogs undergoing GA/sedative events.MethodsCases included dogs undergoing GA/sedative events between January 2010 and December 2013 with GA/sedative-related death recorded within 48 hours or 2 weeks of the event. Controls were randomly selected from dogs undergoing GA/sedation that did not die within these time periods. Risks of GA/sedative-related death for all surgeries and neuter-specific surgeries were estimated. Demographic and clinical associations with GA/sedative-related death were reported as odds ratios following multivariable logistic regression modelling. Statistical significance was set at 5%.ResultsFrom 157,318 dogs with a GA/sedative event, there were 159 (0.10%) within 48 hours and 219 (0.14%) GA/sedative-related deaths within 2 weeks. Within 89,852 dogs that underwent a neuter surgery, there were eight GA/sedative related (0.009%). Greater age, poorer American Society of Anaesthesiologists health status scores and more urgent procedures were associated with greater odds of death. Compared with mixed breeds, Rottweilers and West Highland White Terriers had greater odds and Cocker Spaniels had lower odds of GA/sedative-related death.Conclusions and clinical relevanceThe overall risk for GA/sedative related death was relatively low, particularly among the subset of dogs undergoing castration or ovariohysterectomy surgery. Associations and risk estimates may assist shared decision-making in clinical practice and provide benchmarks for audit.     

Presumptive keratoglobus in a great horned owl (Bubo virginianus)

A juvenile to young adult, male, great horned owl (Bubo virginianus,GHOW) was presented to the wildlife rehabilitation hospital at Lindsay Wildlife Museum (WRHLWM) due to trauma to the right patagium from barbed wire entanglement. On presentation, both corneas were irregular, dry, and no movement of the third eyelid was noted. A severe corneal enlargement/globoid appearance was the predominant ophthalmic feature. The fundus was normal in both eyes (OU). Over the course of several days, both corneas developed edema combined with further dessication at the ocular surface associated with diffuse dorsal fluorescein stain uptake. Repeated ophthalmic examinations found normal intraocular pressures and an inability to move the third eyelid over the enlarged corneas. The bird was deemed nonreleasable due to severe wing damage and poor prognosis associated with eye abnormalities and was humanely euthanized. Postmortem CT, enucleation, and histopathology were performed to evaluate the ocular anatomical abnormality and confirm the suspected diagnosis of keratoglobus. This GHOW represents the first reported case of presumptive keratoglobus in a raptor.     

Human seroprevalence to Coxiella burnetii (Q fever) in Northern Ireland

Despite the widespread prevalence of infection with Coxiella burnetii, there have been few large population-based studies examining the epidemiology of this infection. The aim of this study was to examine the distribution and determinants of C. burnetii past infection in Northern Ireland (NI). Coxiella burnetii phase II specific IgG antibodies were measured by enzyme-linked immunosorbent assay in stored serum from 2,394 randomly selected subjects, aged 12-64, who had participated in population-based surveys of cardiovascular risk factors performed in 1986 and 1987. The overall prevalence of C. burnetii antibody positivity was 12.8%. The prevalence of sero-positivity was slightly higher in males than that in females (14.3% versus 11.2%, P = 0.02). Sero-positivity was low in children (<10%), increasing to 19.5% and 16.4% in males and females, respectively, in the 25-34 age group and subsequently remaining fairly steady with increasing age. Sero-positivity among farmers, at 48.8%, was significantly higher than the general population. More sero-positive than sero-negative women had a history of a miscarriage or still-birth (19.5% versus 9.8%, P < 0.001). In conclusion, this study demonstrated a high prevalence of evidence of past C. burnetii infection in NI. Associations between past C. burnetii infection and age, sex, social class, occupation and reproductive history were seen. We estimate that 20% of Q fever infections in NI occur in farmers.     

Predictors of outcome in dogs undergoing thoracic surgery (2002–2011)

ObjectiveTo evaluate mortality in a canine population undergoing thoracic surgery and identify factors which may be associated with outcome.Study designRetrospective cohort study.Animals286 dogs anaesthetized for thoracic surgery at the Royal Veterinary College between June 2002 – June 2011.MethodsVariables examined included: signalment; ASA status; nature of disease; presence of co-morbidities; pre-anaesthetic oxygen requirement; surgical approach; anaesthesia management [anaesthetic agents; requirement for thoracocentesis; central venous pressure measurement; duration of surgery and anaesthesia; use of colloids, blood products, inotropes or neuromuscular blocking agents (NMBA)]. Outcome was defined as either non-survival to 24 hours after surgery or (having survived to 24 hours) to discharge. Univariate and multivariable logistic regressions were performed to identify risk factors associated with non-survival.ResultsOverall non-survival (excluding those euthanased) to discharge was 5.9%. Non-survival was 2.2% at 24 hours and 3.6% at time of discharge. Non-survival to 24 hours was associated with pre-anaesthetic oxygen requirement (odds ratio (OR) 12.2 [95% CI 1.8–84.5]) and NMBA use (OR 9.6 [95% CI 1.6–57.9]). Non-survival to discharge was associated with surgical duration, with surgeries >180 minutes having OR 16.9 [95% CI 2.0–144.0] compared to surgeries ≤90 minutes and blood product use (OR 4.6 [95% CI 1.3–14.6]). No association was found between ASA category and non-survival at 24 hours (OR 1.4 [95% CI 0.2–11.7]) or discharge (OR 4.4 [95% CI 0.6–34.3]). Significant associations were found between NMBA use and ASA category (p = 0.046), surgical duration (p = 0.002), use of colloids (p = 0.011), blood products (p = 0.001) and inotropes and/or vasopressors (p < 0.001).Conclusions and clinical relevanceVariables significantly associated with non-survival from canine thoracic surgery at 24 hours include NMBA use and pre-anaesthetic oxygen requirement. Blood product use and increasing surgical duration were associated with non-survival to hospital discharge. The associations may relate to the need for such products in the most complicated cases.     

Seroprevalence of Louping Ill virus (LIV) antibodies in sheep submitted for post mortem examination in the North West of Ireland in 2011

Blood samples were collected opportunistically at routine post mortem examination from 199 sheep which came from 152 flocks. The location of each submitting flock was mapped. Sera were tested using a goose blood haemagglutination inhibition assay for louping ill virus. There was an animal level prevalence of 8.5%, and a flock level prevalence of 9.8%. The greatest proportion of seropositive animals was identified among the animals older than 24 months of age. The elevation of the land associated with positive flocks was greater than that of negative flocks. Lesions of non-suppurative meningoencephalitis were observed in three of the 199 animals.     

Neospora caninum is a cause of perinatal mortality in axis deer (Axis axis)

Neospora caninum is a worldwide distributed protozoan that may cause neuromuscular disease in dogs and reproductive failure in domestic and wild ruminants. One axis fawn (Axis axis) and four neonates from the same deer herd died at a zoo in Argentina within a four-month period. The fawn presented with dilatation of the anal sphincter at birth and incontinence, developed weakness and ataxia and died at 14 days of age. At necropsy, a mega formation of the distal large intestine was observed. Microscopically, non-suppurative encephalitis, suppurative bronchopneumonia, fibrin necrotic enteritis and degenerative changes in the liver were observed in hematoxilin and eosin-stained tissue sections, and thick-walled N. caninum-like cysts were observed in fresh brain samples. Serologic studies for N. caninum revealed an IFAT titer of 1:6400 in the fawn and 1:25, 1:400, 1:3200 and 1:6400 in the neonates. N. caninum DNA was detected in brain samples from the fawn and from one neonate by PCR, and the parasite was isolated in vitro from the fawn’ brain after passage through gerbils (Meriones unguiculatus) and gamma-interferon knock-out mice. N. caninum DNA obtained from the fawn, neonate and isolated parasites showed the same microsatellite pattern. This suggests a common infection source for both animals.The diagnosis of N. caninum infection was confirmed, suggesting its association with perinatal mortality in captive axis deer. To the best of our knowledge, this is the first report of clinical disease associated to N. caninum infection in axis deer and of isolation of the parasite from this wild ruminant species.     

Prevalence and distribution of paratuberculosis (Johne's disease) in cattle herds in Ireland

A simple random survey was conducted in Ireland during 2005 to estimate the ELISA-prevalence of paratuberculosis, commonly called Johne's disease (JD), in the cattle population. Serum samples were collected from all 20,322 females/breeding bulls over 12 months-of-age in 639 herds. All samples were tested using a commercially available absorbed ELISA. The overall prevalence of infected herds, based on the presence of at least one ELISA-positive animal, was 21.4% (95% CI 18.4%-24.9%). Herd prevalence levels amongst dairy herds (mean 31.5%; 95% CI: 24.6%, 39.3%) was higher than among beef herds (mean 17.9%; 95% CI: 14.6%-21.8%). However, the animal level prevalence was similar. The true prevalence among all animals tested, was calculated to be 2.86% (95%CI: 2.76, 2.97) and for animals >= 2 yrs, it was 3.30% (95%CI: 3.17, 3.43). For animals in beef herds, true prevalence was 3.09% (95%CI: 2.93, 3.24), and for those in dairy herds, 2.74% (95%CI: 2.59, 2.90). The majority of herds had only one ELISA-positive infected animal. Only 6.4% (95% CI 4.7%-8.7%) of all herds had more than one ELISA-positive infected animal; 13.3% (CI 8.7%-19.7%) of dairy herds ranging from two to eight ELISA-positive infected animals; and, 3.9% beef herds (CI 2.4%-6.2%) ranging from two to five ELISA-positive infected animals. The true prevalence of herds infected and shedding Mycobacterium avium subspecies paratuberculosis is estimated to be 9.5% for all herd types; 20.6% for dairy herds; and 7.6% for beef herds. If ELISA positive animals <2-years-of-age are excluded, the true herd prevalene reduces to: 9.3% for all herd types; 19.6% for dairy herds; and 6.3% for beef herds based on a test specificity (Sp) of 99.8% and test sensitivity (Se) (i.e., ability to detect culture-positive, infected animals shedding at any level) of 27.8-28.9%.     

Rethinking equine anaesthetic risk: Development of a novel Combined Horse Anaesthetic Risk Identification and Optimisation tool (CHARIOT)

The most widely used method of assessing the physical status of humans presented for anaesthesia is the American Society of Anaesthesiologists Physical Status Classification System (ASA-PS). The ASA-PS has been applied to animals including horses, but its use is problematic. The authors virtually convened a group of internationally recognised equine veterinary anaesthesiologists with the goal of developing a risk assessment tool for the evaluation of healthy and diseased horses presented for anaesthesia. With this survey and analysis, the authors aim to develop a simple rubric system to assess equine anaesthetic risk that augments the ASA-PS system. The goal is to identify both diseased and healthy horses at increased anaesthetic risk prior to induction of anaesthesia so that measures might be implemented to potentially reduce morbidity and mortality.     

Risk factors for mortality associated with respiratory disease among Menz and Horro sheep in Ethiopia

A retrospective case-control study was conducted on 6718 sheep of two breeds (2772 Horro and 3946 Menz) on risk factors for mortality associated with respiratory disease (MARD) in Ethiopia, based on data collected between October 1993 and December 1997. Potential risk factors examined were breed, gender, age, month, and air temperatures.Fifty-four per cent of total deaths in the flock could be attributed to respiratory disease and the annual MARD rate ranged between 6.3 and 19.0%. There was significant breed (P<0.0001) and gender (P<0.0001) difference in MARD. The Horro breed had a higher (P<0.0001) annual MARD than the Menz breed (16.5+/-0.18 vs. 12.4+/-0.15%). A higher (P<0.0001) proportion of males suffered than females (15.1+/-0.23% vs. 13.8+/-0.13%). Age was also an important risk factor for MARD: there was a strong polynomial relationship (R(2)=0.91, P<0.0001) between MARD and age; the risk of being young if a sheep was a MARD case was high. MARD was high between October and March but relatively low between the months of April and September. There was a significant (P<0.05) negative cubic relationship (R(2)=0.49) between monthly MARD and monthly average minimum air temperatures. There was also a significant (P<0.01) positive exponential relationship (R(2)=0.61) between monthly MARD and average monthly daily deviation between maximum and minimum air temperatures.Timely health and management interventions focusing on these factors are necessary to alleviate losses from MARD. Understanding variations in MARD risk within a population can enhance early response to potential outbreaks, reducing losses.     

Alfaxalone anaesthesia in the green iguana (Iguana iguana)

ObjectiveTo characterise the anaesthetic effects of alfaxalone administered intramuscularly (IM) at 10, 20, and 30 mg kg^?1.Study designProspective, randomized cross-over study.AnimalsTen juvenile green iguanas (Iguana iguana) of mean body weight (±SD) 480 ± 134 g.MethodsAlfaxalone was administered IM in the triceps of both thoracic limbs. Times for anaesthetic induction, plateau and recovery periods were recorded. Skeletal muscle tone of the jaw, neck, thoracic limbs, pelvic limbs, and tail was scored. The palpebral, corneal and righting reflexes, and the response to painful stimuli were also assessed. Pulse rate and respiratory rate were recorded. Comparisons between different dosages and over time were made using anova.ResultsTimes are given for 10, 20 and 30 mg kg^?1 dosages respectively: mean time to maximal effect was 7.7 ± 2.2, 5.4 ± 1.7 and 3.9 ± 1.2 minutes; duration of the plateau phase was 11.3 ± 3.8, 22.1 ± 6.5 and 39.1 ± 11.5 minutes; recovery time was 10 ± 2.4, 17.5 ± 8.6 and 25 ± 7.1 minutes; and total anaesthetic duration was 29 ± 35.7, 45 ± 8.2 and 68 ± 9.8 minutes. Endotracheal intubation was possible in 40% of the subjects given 10 mg kg^?1 and in 100% subjects given both 20 and 30 mg kg^?1. Loss of response to a painful stimulus was seen in 0/10, 8/10 and 9/10 animals at 10, 20, and 30 mg kg^?1 respectively. There was an initial dose-dependent depression of respiration followed by a significant increase in frequency over time. In contrast, pulse rates decreased by 20% over the duration of the anaesthetic events.Conclusions and clinical relevanceIntramuscular administration of alfaxalone is a simple, rapid and reliable means of achieving relatively brief sedation or anaesthesia in healthy green iguanas. A dosage of 10 mg kg^?1 provides light sedation, appropriate for examination and venipuncture; 20 mg kg^?1 provides a level suitable for minor procedures or for endotracheal intubation and supplementation with inhalational anaesthesia; 30 mg kg^?1 produces an anaesthetic plane suitable for surgical procedures of limited duration (up to 40 minutes).     

Risk of anaesthetic mortality in dogs and cats: an observational cohort study of 3546 cases

Objective To evaluate the anaesthetic death risk for dogs and cats in a French private practice. Study design Observational cohort study. Animal population All small animals anesthetized at the Centre Hospitalier Vétérinaire des Cordeliers between April 15th, 2008 and April 15th, 2010. Methods General anaesthesia was defined as a drug‐induced unconsciousness characterised by a controlled and reversible depression of the central nervous system and analgesia, sufficient to allow endotracheal intubation. Patient outcome (alive or dead) was assessed at the end of anaesthesia defined as the meeting point of the return of consciousness, rectal temperature >36 °C and ability to maintain sternal recumbency. Death occurring during anaesthesia was recorded. Relationship between anaesthetic death and ASA status, species, age, nature of the procedure, anaesthetic protocol and occurrence of epidural administration of a combination of morphine and bupivacaine were analysed. Results During the study period 3546 animals underwent general anaesthesia. The overall death rate in the present study was 1.35% (48 in 3546, 95% CI 0.96–1.75). The death rate of healthy animals (ASA 1 and 2) was 0.12% (3 in 2602 95% CI 0.02–0.34). For sick animals (ASA status 3 and over), the overall death rate was 4.77% (45 in 944 95% CI 3.36–6.18). The death rates in the ASA 3, 4 and 5 categories were 2.90%, 7.58% and 17.33%, respectively. The main factor associated with increased odds of anaesthetic death in ASA categories 3 and over was poor health status (ASA physical status classification). The nature of the procedure the patient underwent and epidural administration of a combination of morphine and bupivacaine were not correlated with the occurrence of death during anaesthesia. Neither species nor age effects were detected. Conclusion and clinical relevance Specific factors were associated with increased odds of anaesthetic death, especially poor health status. Efforts must be directed towards thorough preoperative patient evaluation and improvement of clinical conditions if possible. Identification of risk factors before anaesthesia should lead to increased surveillance by trained staff. This could result in better outcomes.     

Isolation and antimicrobial susceptibility of Plesiomonas shigelloides from great cormorants (Phalacrocorax carbo hanedae) in Gifu and Shiga Prefectures,Japan

Plesiomonas shigelloides is a causal agent of gastroenteritis, sepsis and meningitis in humans. We examined the prevalence of P. shigelloides among great cormorants (Phalacrocorax carbo hanedae) in Japan and the antimicrobial susceptibility of isolates. P. shigelloides was isolated from 33 (47.8%) of 69 fecal samples from great cormorants in 2014. All 33 isolates were subjected to antimicrobial susceptibility testing using broth microdilution methods, which showed resistance to ampicillin (31 isolates, 93.9%), tetracycline (two isolates, 6.1%) and trimethoprim (one isolate, 3.0%). The high prevalence of P. shigelloides in the great cormorants implicates the possible microbiological risk to public health.