Epidemiology and clinical features of human infection with Coxiella burnetii in Denmark during 2006-07

Query (Q) fever was virtually unknown in Denmark in 2005, when, after the introduction of new sensitive diagnostic methods for Coxiella burnetii, an increasing number of positive cattle created concern among people with frequent exposure. This led to a dramatic rise in examinations for Q fever among humans in the following 2 years. The aim of our study was to assess indication for testing and symptoms in individuals with serological signs of infection with C. burnetii. We performed a case-review study of seropositives among all humans tested for Q fever in 2006-07 in Denmark. Seropositive cases were categorized with acute infection: 4-fold increase in immunoglobulin G (IgG) phase II or concomitant IgM phase II ≥ 1 : 256 and IgG phase II ≥ 1 : 1024; and previous infection: IgG phase II ≥ 1 : 1024. A borderline result was defined as: IgG phase II = 1 : 512. Physicians completed a questionnaire retrospectively. Of the 1613 people tested, 177 (11%) were seropositive [37 (2%) acute infection, 140 (9%) previous infection], 180 had a borderline result. Among 127 seropositives responders, 31% were tested due to symptoms compatible with Q fever after a possible exposure to C. burnetii, 64% were asymptomatic and were tested following relevant exposure only; 64% were males, 43% farmers, 39% veterinarians, 84% had been exposed to cattle. The most frequently reported symptoms were asthenia (25%), myalgia (21%), fever (17%) and headache (13%). About two-thirds of seropositives reported asymptomatic infections, and were tested for Q fever because of concern for occupational exposure to cattle. One-third of the seropositives reported symptoms consistent with Q fever, the majority being mild. Our study provided important evidence that increased requests for Q fever testing in 2006-07 arose from heightened public awareness of the disease, and not from an outbreak of clinical disease. Nonetheless, Q fever should be considered endemic in Denmark.     

Guttural pouch hemorrhage associated with lesions of the maxillary artery in two horses

A two year old Thoroughbred gelding, presented with guttural pouch hemorrhage, had the internal and external carotid arteries ligated. Guttural pouch mycosis was detected on endoscopic examination. After one month of topical antifungal therapy, the horse was returned and euthanized because of recurrent epistaxis. A bacterial infection of the guttural pouch with associated ulceration and hemorrhage from the maxillary artery was found at necropsy.

A two year old grade gelding had ulceration and hemorrhage from the external carotid artery. Utilizing balloon-tipped catheters and arterial ligation, hemestasis was achieved in the internal carotid artery and the external carotid artery and its branches. Mycotic ulceration of the internal carotid artery was detected endoscopically and treated with local antifungal therapy for one month. Thirty-three days postoperatively the horse returned, bleeding from a lesion in the maxillary artery. The rationale for surgical intervention to prevent epistaxis associated with guttural pouch mycosis and possible etiologies for postsurgical epistaxis are discussed.

     

Implant sequence effects in intact male Holstein veal calves: live and slaughter traits

Seven sequences of growth promotant implants were used in special-fed intact male Holstein veal calves (n = 443). Calves received implants 4 d after arrival at the veal barn, 42, and 84. The following implants were used: placebo (0), Z (36 mg zeranol), ET (20 mg estradiol, 200 mg testosterone), EP/2 (10 mg estradiol, 100 mg progesterone), EP (20 mg estradiol, 200 mg progesterone), and EBA (24 mg estradiol, 120 mg trenbolone acetate). The following sequences were compared: 0-0-0 (negative control), 0-ET-ET, Z-ET-ET, 0-EP-EP, Z-EP-EP, 0-EP/2-EBA, and Z-0-EBA. From 0 to 42 d, Z implants increased (P<.05) ADG by 3.4% compared to placebo. However, implant schemes without an initial Z implant (0-ET-ET and 0-EP-EP) had higher (P<.05) mean ADG for the period from d 42 to 84. From 84 d to the end of the experiment, only the 0-EP/2-EBA treatment increased (P<.05) ADG compared to 0-0-0. Over the entire trial 0-ET-ET, 0-EP-EP, Z-EP-EP, and 0-EP/2-EBA implant sequences increased (P<.05) ADG by 3.2, 3.2, 2.4, and 4.7%, respectively, compared to the 0-0-0 sequence. Blood traits measured within 2 wk before slaughter were not affected by implant sequence, except that sequences with EP had higher (P<.05) leukocyte counts than were observed for the other sequences. Testicular weight was less (P<.01) for all of the implant sequences than for the negative control and less (P<.05) for Z-ET-ET than for 0-ET-ET, 0-EP-EP, 0-EP/2-EBA, and Z-0-EBA. The type and frequency of medical treatments did not differ among implant sequences for any of the 42-d phases, or over the entire trial. Generally, the growth promotant implants currently approved for beef cattle resulted in approximately 50% of the increase in growth rate in Holstein intact bull calves, as has been observed in beef-type steers or heifers.     

Incisional complications following exploratory celiotomy: does an abdominal bandage reduce the risk?

REASONS FOR PERFORMING STUDY: Post operative complications following exploratory laparotomy can be potentially life-threatening, increase post operative morbidity and result in an increase in the length of hospitalisation of the affected individual. No study has evaluated the efficacy of specific strategies to reduce the incidence of post operative incisional complications. HYPOTHESIS: The use of an abdominal bandage following colic surgery through a celiotomy incision would significantly reduce the prevalence of post operative incisional complications. METHODS: A controlled, randomised clinical trial to test the hypothesis was devised. Horses eligible for inclusion in the study were assigned randomly either to the study or control group following recovery from general anaesthesia. Any post operative incisional complications occurring during hospitalisation were recorded. Long-term follow-up was obtained via telephone questionnaires. Absolute risk reduction (ARR) and number needed to treat (NNT) were calculated. Multivariable analyses were conducted for all outcomes of interest. RESULTS: There was an ARR of the likelihood of developing a post operative incisional complication of 45% when using compared to not using an abdominal bandage in the post operative period. Therefore, it would be necessary to treat 2.2 horses with an abdominal bandage in order to prevent one horse developing any post operative incisional complications. CONCLUSIONS: Although incisional complications continue to be a problem following an exploratory celiotomy for colic, the proportion of horses affected was significantly reduced by use of a bandage. POTENTIAL RELEVANCE: Using an abdominal bandage following an exploratory laparotomy may help reduce the prevalence of post operative incisional complications, and prevent the development of potentially life-threatening complications.     

Naturally occurring lethal parvovirus infection of juvenile and young-adult rats

A lethal disease characterized by hemorrhage and necrosis of the brain, testes, and epididymides developed in young adult rats housed in specific pathogen free quarters. Morphological, virological, and serological investigations of the outbreak indicated that the probable causative agent was rat virus (Kilham), a common parvovirus of rats that usually induces persistent, asymptomatic infection in adult rats.     

Endoscopic surgery in the treatment of contaminated and infected synovial cavities

REASONS FOR PERFORMING STUDY: Contamination and infection of synovial cavities are a common occurrence in clinical practice and, if inadequately treated, may have career or life threatening consequences for affected horses. HYPOTHESIS: The objectives in treating contamination and infection of joints, tendon sheaths and bursae are most effectively met by endoscopic surgery. METHODS: Over a 6 year period, cases of synovial contamination and infection admitted to a referral clinic were evaluated and treated endoscopically. The horses received local and systemic antimicrobial drugs with minimal nonsteroidal anti-inflammatory medication but no other medical or surgical treatment. All arthroscope and instrument portals and, whenever possible, all traumatic wounds were closed. Diagnostic information, endoscopic observations and results of treatment were evaluated retrospectively. RESULTS: A total of 140 affected animals were referred and 121 cases were treated endoscopically. These involved 70 joints, 29 tendon sheaths, 10 bursae and in 12 cases a combination of synovial cavities. The most common aetiologies were open wounds (n = 54) and self-sealing punctures (n = 41). Foreign material was identified endoscopically in 41 but predicted prior to surgery in only 6 cases. Osteochondral lesions were evident at surgery in 51 and recognised before surgery in 25 cases; 32 horses had intrathecal tendon or ligament defects. Follow-up information was obtained for 118 animals; 106 (90%) survived and 96 (81%) returned to their preoperative level of performance. The presence of osteitis/osteomyelitis, other osteochondral lesions and marked deposits of pannus were associated with nonsurvival. For those animals which survived, non-Thoroughbred horses, a combination of synovial structure involvement and regional i.v. antimicrobial administration were associated with reduced post operative performance. Marked pannus, regional i.v. antimicrobial administration and duration of systemic antimicrobial administration were associated with a group combining nonsurviving animals and those with reduced post operative performance. CONCLUSIONS: Endoscopic surgery makes a valuable contribution to the management of synovial contamination and infection. POTENTIAL RELEVANCE: The information obtained from and therapeutic options offered by endoscopy justify its early use in cases of synovial contamination and infection.     

Bilateral phacofragmentation in a New Zealand fur seal (Arctocephalus forsteri).

Ophthalmic examination under anesthesia of a 5-yr-old, captive, male New Zealand fur seal (Arctocephalus forsteri) with reduced visual capacity revealed bilateral cataracts. Surgical extraction of the lenses was performed by phacofragmentation. Preoperative mydriasis was unsuccessful using common topical mydriatic agents. Intraoperative intracameral epinephrine 1:10,000 produced minimal pupillary dilation, but excellent dilation was achieved with intracameral epinephrine at 1:1,000. Postoperative uveitis was controlled with oral prednisolone. Postoperative complications included generalized corneal edema persisting for approximately 1 wk and corneal ulceration caused by the lateral canthotomy sutures. Vision was restored in both eyes.     

Pitfalls in immunofluorescence testing in dermatology. III. Pemphigus-like antibodies in the horse and direct immunofluorescence testing in equine dermatophilosis

Indirect immunofluorescence testing for pemphigus-like antibodies was performed on 79 horses: 28 horses with various nonpemphigus dermatologic diseases, 21 horses with various nondermatologic diseases, and 30 normal horses. Pemphigus-like antibodies were detected in 6 horses: 3 normal horses with titers of 1:40, 2 horses with dermatophilosis at titers of 1:10 and 1:80, and 1 horse with lymphosarcoma at a titer of 1:320. It was concluded that equine pemphigus-like antibodies are a potential source of misinterpretation and misdiagnosis in indirect immunofluorescence testing. Direct immunofluorescence testing for whole immunoglobulin, IgG, IgM, and IgA was performed on skin lesions from 2 horses with dermatophilosis. Diffuse intercellular deposition of whole immunoglobulin and IgG was found in both horses. It was concluded that equine dermatophilosis is a potential source of misinterpretation and misdiagnosis in direct immunofluorescence testing.     

Reorganizing small animal gross anatomy: improving the faculty and student experience and incorporating non-technical competency development

The organization of the small animal gross anatomy course at Washington State University's College of Veterinary Medicine was modified in several ways over a two-year period. These modifications were motivated in part by the need to accommodate a larger number of students, but also by our desire to make more efficient use of faculty and student time as well as physical resources and to give our students opportunities to develop non-technical competencies such as communication and teamwork skills. The four major changes were (1) increasing dissection group size, (2) assigning specimens to dissection groups on a rotating basis, (3) reducing the amount of dissection time relative to time spent studying prepared specimens, and (4) introducing 'transition reviews,' a limited form of peer teaching meant to emphasize peer interaction and communication skills rather than conveyance of specific and detailed subject matter. This article describes the details of these changes and evaluates their effectiveness based on faculty assessments, results from surveys of participating students, and comparison of examination performance and formal end-of-course student evaluations before and after reorganization of the course. Increasing the dissection group size and reducing per-student dissection time did not adversely affect student performance and were viewed at least neutrally or favorably by most students. Notably, the rotation of specimens and the transition reviews elicited strongly favorable responses from a large majority of students and had several beneficial effects of which students may not have been aware but which were apparent to participating faculty. Overall, the changes were well received by both faculty and students and were, in our view, of sufficient value that this course organization plan would be used regardless of class size.     

Estimation of linkage disequilibrium in a sample of the United Kingdom dairy cattle population using unphased genotypes

The association between genetic marker alleles was estimated for two regions of the bovine genome from a random sample of 50 young dairy bulls born in the United Kingdom between 1988 and 1995. Microsatellite marker genotypes were obtained for six markers on chromosome 2 and seven markers on chromosome 6, spanning 38 and 20 cM, respectively. Two different methods, which do not require family information, were used to estimate population haplotype frequencies. Haplotype frequencies were estimated for pairs of loci using the expectation-maximization algorithm and for all linked loci using a Bayesian approach via a Markov chain-Monte Carlo algorithm. Significant (P = 0.0007) linkage disequilibrium was detected between pairs of loci in syntenic groups (that is, loci in the same linkage group), extending to about 10 cM. No significant linkage disequilibrium was detected between markers in nonsyntenic regions. Given the observed level of linkage disequilibrium, mapping methods based on population-wide association might provide a better resolution than traditional quantitative trait loci mapping methods in the U.K. dairy cattle population and may reduce the required sample sizes of the experiments.