Infectious keratoconjunctivitis in free-ranging mule deer (Odocoileus hemionus) from Zion National Park, Utah

An epizootic of infectious keratoconjunctivitis (IK) was studied opportunistically in free-ranging mule deer (Odocoileus hemionus) from Zion National Park, Utah (USA), from November 1992 to March 1994. Moraxella sp. and Chlamydia sp. were isolated from the conjunctiva of two of seven deer. In addition, Thelazia californiensis occurred on the conjunctivas of six of seven deer. Based on field observations, adults appeared to be affected clinically at a higher incidence during both years as opposed to juveniles. Corneal opacity was the most apparent clinical sign from 1992 to 1993. However, in the following year, blepharospasm and epiphora were noted more often. We were also able to document the clinical recovery of three affected deer. In addition, Moraxella sp. was recovered from the eyes of a clinically unaffected deer 1 year after the epizootic occurred.

Infectious and parasitic diseases of captive carnivores, with special emphasis on the black-footed ferret (Mustela nigripes)

Captive carnivores are susceptible to a wide array of infectious and parasitic diseases, which reflects the diversity of the seven families of Carnivora. Unfortunately, relatively few in-depth studies have been conducted on diseases of non-domestic carnivores, and much remains to be learned, especially regarding diseases of small carnivores (e.g. mustelids, viverrids and procyonids). The more important infectious diseases of carnivores include rabies, canine distemper, and diseases caused by parvoviruses, coronaviruses and herpesviruses. Few parasitic or bacterial pathogens are significant in captive populations, and appropriate husbandry, therapy, vaccines and quarantine minimize the risk of disease. Extrapolations from one species to another regarding disease susceptibility may be incorrect. The black-footed ferret (Mustela nigripes) serves as an example of a carnivore significantly affected by infectious diseases, some of which were expected while others could not have been predicted from generalized knowledge of diseases of mustelids. This highlights the need to understand the natural history of each species maintained in captivity.

Morphometric analysis of ventral mesencephalic neurons retrogradely labeled with Fluoro-Gold following injections in the shell, core and rostral pole of the rat nucleus accumbens

Morphologically distinct subsets of mesotelencephalic neurons were sought following retrograde transport of Fluoro-Gold from iontophoretic injections relatively restricted to the medial shell, core or rostral pole subterritories of the nucleus accumbens. The diameter and lengths of Fluoro-Gold immunolabeled dendrites of medial shell-projecting neurons were less than those of core and rostral pole-projecting neurons.

Primary malignant small bowel tumors: an atypical abdominal emergency

Primary malignant tumors of the small bowel are uncommon in the United States. They comprise less than 1% of all gastrointestinal malignancies, with an incidence of 2200 cases per year. The clinical presentation of small bowel tumors is frequently insidious and often overlooked by physicians. The low incidence and lack of pathognomonic symptoms are the reasons that the early diagnosis of malignant small bowel tumor is uncommon. To better understand the clinical presentation, diagnostic evaluation, management, and outcome, a review of Howard University patients with primary malignant small bowel tumors between 1970 and 1990 was conducted. Our experience concurs with the reported literature and supports the conclusion that a high index of suspicion is necessary. The diagnosis of a malignant small bowel tumor should be considered in patients with vague chronic abdominal complaints.

A prevalence survey of multiple sclerosis in Sussex

A first survey of the Brighton and Mid-Downs health districts in Sussex showed a prevalence of multiple sclerosis of 111 per 100,000 (95% confidence interval (95% CI) 103-120) in a population of 596,594 on prevalence day, 1 July 1991. Cases were notified by multiple sources and to maximise case notification patients were not contacted. Cases were classified by hospital and family practitioner notes. The Poser criteria were used for classification. These criteria are precise and exclude cases of isolated spinal cord syndrome. The Allison and Millar criteria used in the surveys in Scotland may lack specificity and it is concluded that the high prevalence of multiple sclerosis in Scotland needs to be reassessed with the more precise criteria. Until this is done, the latitude effect within the United Kingdom remains not proved.

Using mortality data to describe geographic variations in health status at sub-district level

OBJECTIVE

To describe sub-district variations in health status, using mortality data that are processed locally.

DESIGN

A descriptive study of routinely collected death registration data, using multicause coding.

SETTING

The London Borough of Croydon, with a population of 319,200 divided into 27 electoral wards.

SUBJECTS

Deaths of Croydon residents, registered with the Registrar of Births and Deaths, which occurred between January 1990 and December 1992 inclusive.

MAIN OUTCOME MEASURES

Variations in life expectancy, all-cause standardised mortality ratios (SMRs), and disease-specific mortality ratios between selected wards. Deaths in nursing homes were excluded to avoid bias.

RESULTS

Data from 8,930 death registrations, of which 852 occurred in nursing homes, were analysed by electoral ward. The range for all-cause SMRs, including nursing home deaths, was 153 (139-168) to 66 (58-75). When nursing home deaths were excluded, the SMRs for two wards that were significantly higher than the Croydon average fell into the average range. The range, excluding nursing home deaths, was 133 (113-153) to 71 (62-80). Life expectancy at birth varied from 79.8 years to 74.4 years, and life expectancy at age 65 by three years between wards at the two ends of the spectrum. The geographic distribution of ischaemic heart disease and diabetes showed significant differences.

CONCLUSIONS

We contend that death registration data are a useful tool for describing sub-district variations in health status. Deaths of nursing home residents are a source of bias and should be excluded from the analysis. Multicause coding allows a more accurate description of geographic variations in specific diseases, such as ischaemic heart disease and diabetes.

Effects of a modified-live virus canine distemper vaccine on captive badgers (Taxidea taxus)

We vaccinated six captive badgers housed with five controls, and monitored blood antibody titers and white cell counts of both groups for 63 days postvaccination between 29 August and 3 December 1992. Five vaccinated badgers responded with antibody titers ranging from 1:64 to 1:1024 by 63 days postvaccination, whereas the sixth badger did not respond. Treatment badgers also had significant (P < 0.05) decreases in lymphocytes on days 16, 29, and 63. No badgers developed clinical signs of distemper. Control badgers did not produce antibodies against CD virus; thus, the vaccine virus probably was not transmitted between treatment and control animals. The vaccine appears safe for use in healthy badgers, but additional safety and efficacy study is needed.

Plague in a black-footed ferret (Mustela nigripes)

Diagnosis of sylvatic plague in a captive black-footed ferret (Mustela nigripes) was based on gross and microscopic lesions, fluorescent antibody tests, culture of Yersinia pestis, and immunohistochemistry. Gross lesions consisted of acute hemorrhage and necrosis associated with cervical and mesenteric lymph nodes, subcutaneous hemorrhages, and pulmonary edema. Acute edema, hemorrhage, and necrosis with numerous bacteria in blood vessels and sinusoids characterized microscopic lesions. Occurrence of fatal plague in a black-footed ferret potentially has significant implications for recovery of this endangered species due to the widespread distribution of plague in prairie dog colonies throughout historic black-footed ferret range.

Is there gender bias in JAMA's peer review process?

OBJECTIVE

To assess whether manuscripts received by JAMA in 1991 possessed differing peer review and manuscript processing characteristics, or had a variable chance of acceptance, associated with the gender of the participants in the peer review process.

DESIGN

Retrospective cohort study of 1851 research articles.

SETTING

JAMA editorial office.

PARTICIPANTS

Eight male and five female JAMA editors, 2452 male and 930 female reviewers, and 1698 male and 462 female authors.

MAIN OUTCOME MEASURE

Statistically significant gender bias.

RESULTS

Female editors were assigned manuscripts from female corresponding authors more often than were male editors (P < .001). Female editors used more reviewers per manuscript if sent for other review. Male reviewers assisted male editors more often than female editors, and male reviewers took longer to return manuscripts than did their female counterparts (median, 25 vs 22 days). Content reviewer recommendations were independent of corresponding author and review gender, while male statistical reviewers recommended the highest and lowest categories more frequently than did female statistical reviewers (P < .001). Manuscripts handled by female editors were rejected summarily at higher rates (P < .001). Articles submitted to JAMA in 1991 were not accepted at significantly different rates based on the gender of the corresponding author or the assigned editor (P < .4).

CONCLUSIONS

Gender differences exist in editor and reviewer characteristics at JAMA with no apparent effect on the final outcome of the peer review process or acceptance for publication.

Cataract surgery in South West Thames Region: an analysis of age-adjusted surgery rates and length of stay by district

Although the frequency of cataract surgery has increased in the UK, the demand is still not being met. There is no evidence of whether Regional Health Authorities are meeting the national target of 150 cataract operations per 100,000 population. This paper describes variations in age-standardised rates of cataract surgery and lengths of hospital stay (LOS) between the 13 health districts in South West Thames Regional Health Authority (SWTRHA). A retrospective analysis of cataract surgery performed on South West Thames (SW Thames) residents during 1990 was undertaken using the Korner hospital activity data system. The residents of SW Thames Region had 6,729 cataract operations in 1990, producing an overall surgery rate of 266 per 100,000 resident population. Two-thirds of the operations were performed on women, and the greatest number of operations were in the 75-79 and 80-84 year age bands. Women aged over 75 had significantly higher age-specific surgery rates than their male counterparts. The mean age for women was 76.6 years and for men 71.9 years; 12% of cases had a length of stay less than a day (day cases) and 49% were discharged within two days. There were substantial variations in LOS between health districts. Age-adjusted rates revealed significant variations between districts, four of which had rates below the regional average. The crude cataract surgery rate for SW Thames residents has increased threefold since 1975. Women have a significantly higher rate of surgery, which may be due to social factors. Variations in LOS between districts cannot be explained by difference in age structure and may be caused by local custom and practice. It is possible for national, regional and district cataract rates to be calculated, and they are a useful indicator of how the need for cataract surgery is being met in the population.

Prevalence of bluetongue virus expression in leukocytes from experimentally infected ruminants

Replication of bluetongue virus (BTV) in leukocytes from the blood of sheep, cattle, elk, and mule deer inoculated with BTV serotype 10 or 17 was assessed by immunocytochemical staining and dot blot northern hybridization to determine if differences in the prevalence of infection in this blood fraction might account for the differences in clinical disease among these species. Viremia was confirmed by virus isolation in all inoculated animals. Analysis of leukocytes with monoclonal antibodies specific for BTV proteins revealed low numbers of infected leukocytes in only 2 sheep 8 days after inoculation with BTV serotype 10. Most of the cells expressing BTV were identified morphologically as monocytes; approximately 10% of infected cells were lymphocytes. Bluetongue virus was not detected by use of dot-blot hybridization on samples of blood. Our results suggest that differential infection of leukocytes does not account for the pronounced differences in clinical signs and pathologic changes among ruminants.

Subepidermal vesiculobullous filarial dermatitis in free-ranging American badgers (Taxidea taxus)

Skin and superficial lymph nodes from the 65 juvenile (< 1 year old) and adult free-ranging American badgers (Taxidea taxus) of both sexes that were killed from late July to late October 1991 as part of the recovery program for the endangered black-footed ferret (Mustela nigripes) were examined for evidence of Filaria taxideae. Fifty-one badgers (51/64, 80%) were infected. Both adult badgers (30/32, 94%) and juvenile badgers (21/32, 67%) were infected by adult filarial worms, which occurred most commonly in subcutaneous tissues of the inguinal area, proximal thigh, and ventral abdomen. Sections of formalin-fixed skin and, from many badgers, subcutaneous lymph nodes were stained with hematoxylin and eosin, Jones' methenamine silver (for basement membrane), and an avidin biotin peroxidase complex method (for factor VIII-related antigen). Superficial dermatitis attributable to embryonated filarial ova and larvae was present in 26/64 badgers (41%), all of them adult (> 1 year old). Acute lesions consisted of multifocal vesiculobullous dermoepidermal separation and superficial perivascular dermatitis. Ultrastructural examination and Jones' silver-stained sections revealed separation between basal keratinocytes and the basal lamina (subepidermal vesiculation). Older lesions consisted of ulcerative superficial granulomatous dermatitis associated with ova and larvae. Multifocal granulomatous endolymphangitis, which involved afferent lymphatics of subcutaneous lymph nodes, was associated with viable as well as degenerative ova and larvae. Adult filarial worms were found in the subcutis alone and did not provoke an inflammatory reaction.

Fibrils in brain of Rocky Mountain elk with chronic wasting disease contain scrapie amyloid

Chronic wasting disease (CWD), a progressive, fatal neurological disorder of captive mule deer and Rocky Mountain elk, is characterized neuropathologically by spongiform change in the neuropil, intraneuronal vacuolation and astrocytic hypertrophy and hyperplasia. Recently, scrapie amyloid-immunoreactive plaques have been demonstrated in brain tissues of CWD-affected captive mule deer, Rocky Mountain elk and hybrids of captive mule deer and white-tailed deer. We now report on the presence of abnormal fibrils isolated from brain tissues of Rocky Mountain elk using negative-stain electron microscopy. These fibrils resemble those found in scrapie-infected hamster brain. Furthermore, protein bands with relative molecular masses of 26 to 30 kilodaltons were shown to be immunoreactive to antibodies raised against scrapie amyloid by Western immunoblotting. Immuno-dot blot showed similar reactivity. Our data support the clinical and pathological diagnosis of the disease and provide further evidence that CWD belongs to the subacute spongiform encephalopathies.

Proteins isolated from the venom of the common tiger snake (Notechis scutatus scutatus) promote hypotension and hemorrhage

Notechis scutatus scutatus venom contains several toxic acidic proteins called HTa-i which promote hypotension and hemorrhage in mice. They have apparent mol. wts in the 18,000-21,000 range, i.v. LD50 values between 0.5 and 1.5 micrograms/g, and no detectable phospholipase, arginine esterase, proteolytic or hemolytic activities. A polyclonal antibody raised against HTg binds to other purified proteins, suggesting that they are isoforms of the same protein. Many other elapid crude venoms contain proteins which recognize the polyclonal antibody raised against HTg. Crotalid and viperid crude venoms do not recognize this antibody, although some of their component proteins are known to exhibit hypotensive and hemorrhagic activities. A combination of gel-filtration on Sephacryl S-200, cation-exchange and anion-exchange chromatography allows isolation of the N. s. scutatus proteins in high purity. They are the first hypotension-inducing proteins to be purified from an Australian elapid.

Brucellosis in free-ranging bison (Bison bison) from Teton County, Wyoming

Brucellosis was studied opportunistically in bison (Bison bison) in the free-ranging Jackson herd of approximately 120 in Teton County, Wyoming (USA) in March 1989. Recent abortion was diagnosed in a 2-yr-old cow and Brucella abortus biovar 1 was isolated from vaginal discharge, uterine contents, uterus, and supramammary lymph nodes. Endometritis was characterized by lymphoplasmacytic infiltrates in the lamina propria and neutrophils in uterine glands and within necrotic debris and exudate in the uterine lumen. A 5-yr-old bull had diffuse lymphoplasmacytic infiltrates in epididymis and accessory sex glands; B. abortus was isolated from seminal vesicle and ampulla. Twenty-seven (77%) of 35 bison tested from 1989 to 1990 were serologically positive or suspect on tests for Brucella antibodies. We report the occurrence of abortion due to brucellosis in free-ranging bison in the Jackson herd, suggest that bison in this herd are capable of transmitting brucellosis to other susceptible hosts, and report the first confirmation of brucellosis in this herd.

Neuropathology of chronic wasting disease of mule deer (Odocoileus hemionus) and elk (Cervus elaphus nelsoni)

The pathology of the central nervous system of nine mule deer (Odocoileus hemionus) and six elk (Cervus elaphus nelsoni) with chronic wasting disease, a spongiform encephalopathy of mule deer and elk, was studied by light microscopy. Lesions were similar in both species and were characterized by spongiform transformation of gray matter, intracytoplasmic vacuolation of neurons, neuronal degeneration and loss, astrocytic hypertrophy and hyperplasia, occurrence of amyloid plaques, and absence of significant inflammatory response. Distribution and severity of lesions were evaluated at 57 locations; there were only minor differences between deer and elk. Consistent, severe lesions occurred in olfactory tubercle and cortex, hypothalamus, and the parasympathetic vagal nucleus of deer, and sections examined from these regions would be sufficient to establish a diagnosis of chronic wasting disease. Lesions were milder in these locations in elk but were sufficiently apparent to be of diagnostic value. Other differences included increased severity of lesions in some thalamic nuclei in elk in contrast to deer, the occurrence of amyloid plaques demonstrable by hematoxylin and eosin and histochemical stains in deer in contrast to elk, and the presence of mild white matter lesions in elk but not in deer. Lesions of chronic wasting disease were qualitatively comparable to those of scrapie, bovine spongiform encephalopathy, transmissible mink encephalopathy, and the human spongiform encephalopathies. Topographic distribution and lesion severity of chronic wasting disease were most similar to those of scrapie and bovine spongiform encephalopathy. Duration of clinical disease did not significantly influence lesion distribution or severity in either species.

Ultrastructural neuropathology of chronic wasting disease in captive mule deer

Chronic wasting disease (CWD), a progressive and uniformly fatal neurological disorder, is characterized neuropathologically by intraneuronal vacuolation, spongiform change of the neuropil and astrocytic hyperplasia and hypertrophy. Ultrastructural neuropathological findings consist of (1) extensive vacuolation in neuronal processes, within myelin sheaths, formed by splitting at the major dense lines or within axons; (2) dystrophic neurites (dendrites, axonal preterminals and myelinated axons containing degenerating mitochondria and pleomorphic, electron-dense inclusion bodies); (3) prominent astrocytic gliosis; (4) amyloid plaques; and (5) giant neuronal autophagic vacuoles. Other findings include activated macrophages and occasional spheroidal structures containing densely packed fibrillar material of unknown origin, abundant structures suggestive of degenerating microtubules entrapped in filamentous masses, vacuoles and myelin figures. Similar findings have been previously observed in scrapie-infected hamsters and Creutzfeldt-Jakob disease (CJD)-infected mice, bovine spongiform encephalopathy, and CJD indicating that CWD in captive mule deer belongs to the subacute spongiform encephalopathies (transmissible brain amyloidoses).

Gross and microscopic lesions of naturally occurring tuberculosis in a captive herd of wapiti (Cervus elaphus nelsoni) in Colorado

A Mycobacterium bovis-infected herd of captive wapiti (Cervus elaphus nelsoni) in Colorado was depopulated after lesions of bovine tuberculosis were confirmed in 8 of 10 tuberculin skin test reactors. Of the 43 animals > 1 year of age, 26 had gross lesions suggestive of tuberculosis, 24 had microscopic lesions of tuberculosis, and 23 had acid-fast bacilli associated with the lesions. Lungs and retropharyngeal lymph nodes were the most frequently affected sites. Most lesions grossly and microscopically resembled tuberculosis in cattle; however, some lesions resembled abscesses or ovine caseous lymphadenitis lesions. Special stains and immunohistochemical techniques labeled few to numerous mycobacteria associated with the lesions.