Resilience of second year grazing cattle to parasitic gastroenteritis following negligible to moderate exposure to gastrointestinal nematode infections in their first year

The influence of gastrointestinal nematode infections on performance of four groups of female Holstein Friesian calves was monitored until the end of the second grazing season (SGS). In the first year three groups were grazed and one group (G4) was permanently housed. General and grazing management during the first grazing season (FGS) was arranged such that G1 acquired moderate infections, G2 low infections and G3 very low infections with gastrointestinal nematodes. These infections were monitored through faecal egg counts, differentiation of faecal larval cultures, pasture larval counts, serum pepsinogen values, ELISA with a recombinant Cooperia oncophora protein, weight gain, tracer worm counts and sentinel worm counts. In 1998 all four groups were grazed together as one herd from 23 April to 26 October and infections were monitored with the same techniques with the exception of sentinel calves. In the FGS weight gain was higher in G4 than in the other groups and higher in G3 (28. 6kg) than in G1. Weight gain of G2 was intermediate to G1 and G3 but did not significantly differ from either group. In the SGS weight gain in G4 was far less than in any other group and the mean weight at the end of the experiment was 41.9, 38.6 and 50.9kg lower than G3, G1 and G2, respectively. Though no significant differences were observed between G1, G2 and G3 at the end of the experiment it was obvious that the weight gain advantage of G3 over G1 at the end of the FGS had disappeared. Parasitological and serological findings in the SGS indicated that G3 and G4 had build up less immunity during the FGS compared to G1 and G2. The conclusion of the experiment is that resilience to parasitic gastroenteritis in the SGS depends on the level of exposure to nematodes in the FGS. However, problems with poor weight gain only will be expected when exposure is very low in the FGS and high in the SGS.

Prevalence of enteric pathogens among community based asymptomatic individuals

BACKGROUND AND AIMS

The objective of this study was to describe the prevalence of pathogenic microorganisms in asymptomatic individuals in a community study in Melbourne, Australia.

METHODS

The study population was a subset of 2803 individuals participating in the Water Quality Study; a community based randomized trial. Faecal specimens (1091) were collected over a 3-month period from asymptomatic individuals. Specimens were tested for a range of bacteria including Salmonella, Shigella and Campylobacter species. Rotavirus and adenovirus were detected using a Rota-Adeno latex kit, and protozoa were detected using a permanent stain (modified iron-haemotoxylin).

RESULTS

Twenty-eight known pathogens were identified from the 1091 faecal specimens, a total carriage rate of 2.6%. Giardia species were present in 18 specimens (1.6%), Salmonella in four (0.4%), Campylobacter in one (0.1%), Cryptosporidium in four (0.4%) and adenovirus in one (0.1%). Blastocystis hominis was found in 65 specimens. The median age of those without a pathogen was 12.5 years compared with 6.6 years for those with a pathogen (P=0.02).

CONCLUSIONS

Except for Giardia, pathogens were rarely found in asymptomatic individuals in the community. The prevalence of pathogens was higher in children than adults.

[Cyclospora cayetanensis infection. Laboratory diagnosis]

Cyclospora cayetanensis is an Apicomplexa protozoa which was found to cause gastroenteritis in humans in 1979. This paper reviews the laboratory diagnosis of the disease. The usefulness of direct examination of fresh fecal matter with special acid-fast stains is emphasized as well as the morphometric differentiation between this organism and other similar coccidia. The paper reviews the sporulation technique of Cyclospora cayetanensis for the recognition and differentiation of artifacts and green-blue algae. Another aspect discussed is the morphology of the parasite in histological sections and with electromicroscopic examination whereby tissue morphology changes caused by the microorganism can be identified. The experience of the Service and Laboratory of Parasitology of the Instituto Nacional de Pediatría of Mexico in the laboratory diagnosis of this protozoosis is described. The paper is oriented towards the inclussion of Cyclospora cayetanensis in the diagnostic protocols for the study of diarrheas in our health Institutions.

Dose response models for infectious gastroenteritis

When pathogenic microorganisms enter the human body via ingestion with food or drinking water, they encounter a system of barriers mounted by the host. In order to reach parts of the intestinal tract that are suitable for growth and attachment, each of the barriers must be overcome successfully. The present view on infection states that at least one of the ingested pathogens must survive to start colonization. This is the basis for dose response models, used for quantitative risk assessment. In this paper, the usefulness of the Beta Poisson model for multiple barriers is corroborated. Infection is associated with the presence of elevated numbers of reproducing pathogens in the intestinal tract. This does not necessarily imply illness symptoms: when intestinal microorganisms engage in damaging activities, this may lead to illness symptoms. At the same time, these activities probably elicit defensive measures from the host, promoting the removal of pathogens and terminating infection. The duration of the period of colonization reflects the balance between the colonization potential of pathogens and the strength of host defenses. Starting from the assumption that during infection the host has a certain hazard of becoming ill, a simple dose response relation for acute gastroenteritis is developed. With the use of literature data from volunteer experiments, we show that examples can be found for three possible alternatives: an increase in the probability of illness with increasing dose, a decrease with higher doses, and a probability of illness (given infection) independent of the ingested dose. These alternatives may reflect different modes of interaction between pathogens and host.

Norwalk-like virus and bacterial pathogens associated with cases of gastroenteritis onboard a US Navy ship

Acute gastroenteritis is a potential cause of substantial morbidity in U.S. military personnel during deployment. This study investigated the microbial causes of diarrhea in U.S. troops on exercises in Southeast Asia aboard the U.S.S. Germantown from March through May 1996. A total of 49 (7%) patients with diarrhea reported to sick call during a 3-month deployment involving 721 personnel. Diarrheal samples from 49 patients were subjected to bacterial and parasitologic examination, but sufficient samples from only 47 of 49 were available for analysis of the presence of Norwalk-like virus (NLV). Of the 49 diarrhea cases, 10 (20.4%) appeared to be due to bacterial etiology alone, 10 (20.4%) due to bacteria and the prototype Taunton agent (TNA), 11 (22.4%) due to TNA only, and 4 (8.0%) due to parasites. Norwalk-like virus RNA was present in 21 (45%) of 47 stool samples from the diarrhea cases, 10 with bacterial etiologies and 11 without bacterial or parasitic etiologies. No pathogen was detected in 14 (29%) of the cases. Four of the controls showed the presence of parasitic organisms. Of the 11 cases in which enterotoxigenic Escherichia coli was isolated, 8 were positive for colonization factor antigen (CFA/IV), and 3 were CFA-negative. The bacterial pathogens tested were all susceptible to gentamicin, and furadantin, but were resistant to ceftriaxone and norfloxacin, including 75% of the Campylobacter spp. These data support the view that the major cause of diarrhea for troops deployed in this geographic area is most likely NLVs.

Comparative anthelmintic activity of strategic sustained low-level administration of albendazole in feed pellets compared to single doses of closantel and tetramisole against natural ovine parasitic gastroenteritis

The strategic use of single therapeutic doses of closantel, tetramisole or sustained low-level administration of albendazole in feed pellets in controlling naturally acquired parasitic gastroenteritis in sheep was investigated on a farm in semi-arid Rajasthan, India. A total of 303 5- to 6-month-old sheep were divided into three groups. Two groups were dosed with single therapeutic doses of closantel and tetramisole and the third group was given a low-level medication with albendazole through feed pellets for 30 days. Faecal egg counts revealed significantly lower counts (p<0.001) in the group treated with closantel compared to the other two groups. The faecal egg counts in the group receiving sustained low-level albendazole rose after withdrawal of the medication but remained significantly lower than those in the group treated with tetramisole up to 7 weeks after treatment (p<0.05). On the other hand, in the group treated with tetramisole, the mean faecal egg count rose from 3 weeks after treatment and remained continuously higher than those in any other group up to 12 weeks after treatment. The closantel-treated group gained more body weight but the first six-monthly greasy fleece yield was greater in the group treated with medicated pellets. During the first 3 months of the experiment, three animals in the group treated with tetramisole died of parasitic gastroenteritis. Following sustained low-level administration of albendazole in feed pellets, the plasma disposition curve of both the sulphoxide and sulphone metabolites reached its plateau level by day 5 and remained almost constant thereafter. The comparative cost-effectiveness of the three treatment regimes during the first 3 months of treatment was best for the group treated with closantel followed by the group treated with medicated feed pellets.

Cryptosporidium and concurrent infections with other major enterophatogens in 1 to 30-day-old diarrheic dairy calves in central Spain

Faeces samples from 218, 1 to 30-day-old, diarrheic dairy calves in 65 dairy herds were screened for the presence of Cryptosporidium and concurrent infections with rotavirus, coronavirus, F5 Escherichia coli and Salmonella spp. Calves were grouped according to their age as follows: 1-7, 8-14, 15-21 and 22-30 days. Cryptosporidium infection was detected in 43.8%, 71.9%, 63.2% and 6.9% of the calves in the respective age groups. Significant differences in the detection rate of Cryptosporidium were found between the age group 22-30 days and all other age groups, and between the age group 1-7 days and the age groups 8-14 days and 15-21 days. Cryptosporidium was the only enteropathogen detected in 60 of the 114 (52.6%) diarrheic calves. Concurrent infections with other enteropathogen(s) were detected in 64.3%, 46.3%, 39.5% and 0% of the Cryptosporidium-infected calves in the age groups 1-7, 8-14, 15-21 and 22-30 days, respectively. A significant age-associated decrease in the detection rate of mixed infections (p < 0.05) was found. The detection rates of the other enteropathogens considered in calves with Cryptosporidium infection were 87% for rotavirus, 11.1% for coronavirus, 27.8% for F5+ E. coli and 1.8% for Salmonella.

Eosinophilic gastroenteritis and Anisakis

BACKGROUND

The differential diagnosis of eosinophilic gastroenteritis (EG) includes, among other diseases, parasitic infections such as anisakiasis, which has acquired worldwide importance.

METHODS

We reviewed all patients referred to our allergy service who had been diagnosed as having primary EG to determine the possible role of Anisakis simplex in the etiopathology of the disease. All patients (n = 10) were studied and diagnosed as having primary EG between 1989 and 1996, inclusive. Two different groups of subjects were used as controls: group A (149 subjects without digestive disorder) and group B (10 subjects with digestive disorder different from EG). Cutaneous prick tests were performed with the main foods, aeroallergens, and commercial extract of A. simplex. Total and specific serum IgE was measured in all patients. Gastric or gut histologic specimens were re-examined in five cases.

RESULTS

Peripheral eosinophilia was detected in 40% of the patients with EG, and sensitization to A. simplex was detected in 80% of these. In both control groups, the rate of sensitization to A. simplex was 10%. Sensitization to A. simplex in EG patients with respect to control groups A and B showed odds ratios (OR) of 36 and 40, respectively. In one case, serialization of the histologic section allowed us to observe a whole Anisakis larva.

CONCLUSIONS

Immunologic methods to detect specific antibodies against Anisakis should be used routinely before diagnosing EG as primary disorder. Preventive measures are of capital importance.

The pharmacokinetics and efficacy of long-term low-level and split-dose administration of albendazole through in-feed formulations against ovine and caprine parasitic gastroenteritis

Two trials were conducted against natural and experimentally induced parasitic gastroenteritis in sheep and goats using an in-feed formulation of albendazole to evaluate its therapeutic and prophylactic efficacy. In the first trial, albendazole was incorporated in feed pellets to deliver an average daily dose of 0.7 mg/kg body weight in order to evaluate its prophylactic efficacy. In the second trial, feed pellets were offered to deliver an average total dose of 8.0 mg/kg body weight in two equal split doses in order to evaluate its curative efficacy. Sustained plasma concentrations of the active compound, albendazole sulphoxide, and its metabolite albendazole sulphone, sufficient to prevent establishment of infection, were achieved when the animals were allowed to feed on medicated pellets for 10 consecutive days. The bioavailability of the metabolites of albendazole following the administration of a therapeutic dose in two split doses of the in-feed formulation was sufficient to remove established adult nematodes. The concentrate feed pellets could be used for self-medicating small ruminants for therapeutic use as well as for prophylaxis based on their strategic use appropriate to the epidemiology of the parasitic disease.

Human enteric pathogens identified in a London teaching hospital and a rural public health laboratory: 1994

Two microbiology laboratories, one serving an inner city hospital and one a rural public health laboratory, collected data on the outcome of examining faecal specimens in 1994. Overall, 6.7% of the investigations were positive, but the rates were lower for hospital inpatients, for recently described pathogens, and in the absence of relevant clinical details; rates were higher for patients with a history of foreign travel. No benefit was gained by examining more than two specimens from any patient. Clostridium difficile was the only investigation frequently positive among patients already in hospital, and virological tests were often positive in patients investigated by general practitioners.

Gastrointestinal nematode infections of first-grazing season calves in Western Europe: associations between parasitological, physiological and physical factors

Analysis of 85 studies on gastrointestinal nematode infections in first-grazing season (FGS) calves is presented. The studies cover a 26-year period and were carried out in 13 countries in Western Europe. Both control and chemoprophylactic-treated (early in the season) FGS calf groups were included. In 53 of the 85 studies, clinical outbreaks of parasitic gastroenteritis (PGE) were observed during the FGS in the control groups. The mean initial age (and weight) of the control calf group was significantly associated with PGE outbreaks: 82% of control calf groups < or = 6 months of age had outbreaks of PGE, compared to only 33% of control calf groups > 6 months of age. In 92% of trials where the geometric mean faecal egg count (MFEC) was > or = 200 EPG on Day 56, PGE outbreaks were observed, but where it was < 200 EPG, only 29% had PGE. The use of these two factors in assessing the likelihood of PGE outbreaks in untreated calf groups in the future FGS is therefore, proposed. No chemoprophylactic-treated groups had PGE, but there was a highly significant negative relationship between maximum faecal egg counts in the chemoprophylactic-treated calves and the proportion of the trial covered by the different chemoprophylactic systems. Higher stocking densities were significantly associated with higher pasture contamination in both control and chemoprophylactic-treated calves. A highly significant positive relationship between the weight gained in the chemoprophylactic-treated groups and the estimated duration of the various chemoprophylactic systems was found, but there were large variations in weight gains (60-160 kg) between groups even with the same chemoprophylactic. Despite this and other highly significant associations, it was not possible to indicate what weight gains were obtained by the end of the FGS, from factors measured early in the FGS.

The effect of different infection levels on acquired resistance to gastrointestinal nematodes in artificially infected cattle

The objective of this study was to evaluate the effect of different infection levels of Ostertagia ostertagi and Cooperia oncophora in a simulated 'first grazing season' on the resistance of calves to an artificial challenge infection. The infection levels were determined by the infection schedules and the chemoprophylaxis used. Thirty six 7-11-month old Holstein-Friesian bull calves were randomly divided into four groups. The animals of group B received an ivermectin sustained release bolus (ISRB) on day 0. The calves of group D were treated on days 0 and 56 with a subcutaneous injection of doramectin (0.2 mg kg(-1) BW). Group C was the untreated control group. The calves of group N were used as helminth-naive controls, while the animals of groups B, C and D were trickle infected for 24 weeks. The infection schedules were designed to simulate the expected infection pattern for each treatment group under set-stocked conditions in temperate climate areas. After the last infection, all animals were treated with oxfendazole. One week later, all animals received a challenge infection of 50,000 O. ostertagi L3 and 100,000 C. oncophora L3, spread over 10 consecutive days. During the primary infection period the faecal egg output and the serum pepsinogen and antibody levels reflected the different levels of host-parasite contact between the groups (group C > group D > group B > group N). After the challenge infection, faecal egg counts, total Ostertagia burden, size of the adult worms and abomasal globule leucocyte counts all indicated a positive relationship between the level of Ostertagia infection during the primary infection period and the level of acquired resistance. A reduction of host-parasite contact during the primary infection period, as a consequence of the infection schedule and the chemoprophylaxis used, resulted in a diminished level of resistance to the artificial challenge infection with O. ostertagi. Faecal cultures and small intestine worm counts indicated that all previously infected groups had acquired a high degree of resistance to the Cooperia challenge infection.

Gastroenteritis, diarrhoea and breast feeding

In this paper we review the literature in regard to possible relationships between breast feeding and diarrhoea or gastroenteritis. We show that in the developed as well as the developing world, there is consistent evidence of a protective effect of exclusive breast feeding in the first 4-6 months of life. The odds ratios were generally in excess of 3.0 for non-breast milk feeds. The relationship was not consistent for rotavirus infections but was consistently strong for non-viral pathogens. There are a number of indicators that suggest biological plausibility, in both the developing and developed world. The triple indicators of consistency and strength of the epidemiological associations, together with biological plausibility are major arguments for believing that there is a causal sequence involved.

An attempt to control lungworm disease and parasitic gastroenteritis on commercial dairy farms by the use of an adaptation of Michel's dose-and-move system

On seven dairy farms an attempt was made to control lungworm disease in calves by turnout on a pasture grazed earlier by cows, followed by a move to aftermath and ivermectin treatment 2 months later. Transmission of lungworm was observed on all farms. Lungworm disease occurred on four farms at treatment. Coughing re-occurred on three of these farms in some animals 2 months later. Owing to poor performance between turnout and treatment, weight gain was below the norm on the farm with the highest infections and most severe respiratory signs. On the other farms respiratory signs did not result in poor weight gain. Gastrointestinal nematode infections remained low on all farms. The conclusion is that this dose and move scheme cannot be recommended for the control of lungworm.

An outbreak in 1996 of cyclosporiasis associated with imported raspberries. The Cyclospora Working Group

BACKGROUND

Cyclospora cayetanensis is a parasite that causes gastroenteritis. Until last year most of the documented cases of cyclosporiasis in North America were in overseas travelers. In 1996, a large outbreak of cyclosporiasis occurred in North America. We investigated this outbreak.

METHODS

Health departments solicited information from clinicians and laboratories on cases of cyclosporiasis, which were then reported to the Centers for Disease Control and Prevention and to Health Canada. We conducted retrospective cohort studies for the cases associated with events (e.g., luncheons) and attempted to identify the sources of the implicated food.

RESULTS

A total of 1465 cases of cyclosporiasis were reported by 20 states, the District of Columbia, and 2 provinces. Of these cases, 978 (66.8 percent) were laboratory confirmed and 725 (49.5 percent) were associated with 55 events that were held from May 3 through June 14. Raspberries were definitely served at 50 events and may have been served at 4 events. For 27 of the 41 events for which adequate data were available (65.8 percent), the associations between the consumption of berries (raspberries with or without other berries) and cyclosporiasis were statistically significant (P<0.05). For all 29 events for which there were good data, the raspberries definitely came from Guatemala (21 events, 72.4 percent) or may have come from Guatemala (8 events, 27.6 percent). As few as five Guatemalan farms could have accounted for the 25 events for which the raspberries could be traced to a single exporter per event. The mode of contamination of the raspberries remains unclear.

CONCLUSIONS

This large outbreak of cyclosporiasis in North America in 1996 was associated with the consumption of Guatemalan raspberries. The outbreak illustrates the need to consider that a local cluster of foodborne illness may be part of a widespread outbreak and to pursue investigations to the source of the implicated vehicle.

Longitudinal study of rotavirus infection in child-care centres

OBJECTIVE

To describe the epidemiology of symptomatic and asymptomatic rotavirus infection among young children attending Sydney child-care centres during the 1994 rotavirus season.

METHODS

Children aged 0-36 months in 11 child-care centres participated in the study. A weekly stool specimen was collected from each subject and tested for rotavirus antigen by commercial enzyme immunoassay.

RESULTS

One hundred and seventy-eight children (76 girls and 102 boys) with a mean age of 18.2 +/- 6.5 (SD) months were enrolled for a total of 2249 child-weeks. Of 1653 weekly faecal specimens, 59 (3.6%) were positive for rotavirus antigen. Positivity for rotavirus antigen peaked at 8.0% and 7.4% of specimens in weeks 6 and 7, respectively. The 59 positive specimens were obtained from 44 children in eight of the 11 study centres. One child appeared to suffer a second episode. Eighty-two per cent of episodes were associated with symptoms of gastroenteritis. Overall, 32% of the children in the eight affected centres were infected; 52% of those < 12 months were infected compared to 26% of older children. Secondary spread to household contacts was also documented.

CONCLUSIONS

Rotavirus infection poses a significant health problem in under-3-year-old children attending child-care centres in Sydney. We believe that these results are applicable to all Australian children of this age attending group child care.

The effects of a controlled-release albendazole capsule (Proftril-Captec) on parasitism in grazing Corriedale ewes in the Nyandarua district of Kenya

The effects of intraruminal sustained-release capsules (IRSRCs) on parasitism in grazing Corriedale ewes were investigated over a period of 119 days (4 June-30 September 1993) using 40 ewes aged approximately 2 years and randomly divided into two groups of 20 ewes each. Each of the ewes in the treatment group received an IRSRC while the controls were left untreated. The groups were placed on adjacent 2.5-acre paddocks obtained by subdividing a 5.0-acre permanent pasture which had previously been grazed by young untreated sheep, so exposing both groups of ewes to a similar challenge from a contaminated paddock. The faecal egg counts, herbage larval counts and worm burdens of the major gastrointestinal parasites of sheep were significantly reduced by the use of the IRSRC. These parasitological effects were reflected in the increased live weight gains and heavier fleeces of the IRSRC-treated ewes. The control ewes required occasional salvage treatments during the trial period and the herbage on their paddock was heavily contaminated with infected larvae, reflected in the high worm burdens in the control ewes necropsied at the end of the trial and in tracer sheep introduced into the paddocks during the initial (day 30), interim (day 58) and final (day 89) stages of the experiment. Most capsules were exhausted within 95 days of administration, leading to a rise in the count of eggs per gram in the faeces in the treated group towards the end of the study.

Enteric pathogens in severe forms of acute gastroenteritis in Ghanaian children

Diarrheal disease is the major cause of childhood morbidity in developing countries. Although malnutrition is known as a risk factor for severe gastroenteritis, the role of enteric pathogens in the clinical severity is unclear. The present study was conducted in well nourished Ghanaian preschool children during a 3 month period of the rainy season to assess the relationship between enteric pathogens and severe gastroenteritis. Two hundred and twenty-five children with acute gastroenteritis and 64 age-matched control children were prospectively examined for the severity of dehydration and enteric pathogens in their stools. Of the 225 children with gastroenteritis, 69.8% (157/225) had mild dehydration and 30.2% (68/225) had severe dehydration. Bacteria were similarly isolated in stool samples from children with mild and severe dehydration and controls. Rotavirus accounted for 20.6% of children with severe dehydration and was more often isolated in stools from patients with severe dehydration than those from controls. Furthermore, the mixed infections associated with rotavirus and bacteria were more often found in patients with severe dehydration than those with mild dehydration or controls. Parasites were similarly found at low incidences among the three groups. The present study implied that rotavirus was more responsible for severe gastroenteritis than bacteria or parasites. However, factors other than enteric pathogens must be sought in a considerable number of severe cases. A large scale study throughout a year is recommended to obtain more precise information that would reflect the seasonal variation of rotavirus infections.

A 4-year study on the effectiveness of alternate grazing of cattle and sheep in the control of bovine parasitic gastro-enteritis

In many farming enterprises, animal management systems which could provide a practical and effective alternative to chemotherapy for the control of bovine helminthosis would be readily accepted. One system which has been proposed and shown to be effective in the short or medium term involves grazing different host species on a rotational basis. The study described here examined the effect of alternating cattle and sheep annually over an extended period of 4 years. Up to the second grazing season the system appeared to be successful, with a marked reduction in the cattle worm burdens. However, by the end of the study period the parasite burdens in calves grazed on the alternated pasture were equal to, or greater than, those of set-stocked control animals. It was thus clear that the alternate grazing strategy had failed. Data obtained from other parameters measured, i.e. faecal egg counts, pasture larval numbers and plasma pepsinogen levels, confirmed this observation.