Prevalence of ovine footrot in the tropical climate of southern India and isolation and characterisation of Dichelobacter nodosus

The present communication records the first determination of the prevalence of footrot in the unexpected situation of the tropical climate of Andhra Pradesh and Tamil Nadu, two states in southern India where the maximum temperature rises to 42 degrees C. In total, 73 outbreaks of footrot in Nellore brown sheep were investigated in 11 districts of Andhra Pradesh and one district of Tamil Nadu during the period March 2009 to March 2011.The overall prevalence of ovine footrot was 15%, with severity scores of 2 to 4 (lesion severity scale 0 to 4). The outbreaks occurred mostly during the rainy season, which is usually from June to December. From a total of 1,050 samples of lesions in naturally infected sheep, 478 (45.5%) were positive for Dichelobacter nodosus. Serogrouping of the isolates revealed six serogroups: A, B, C, E, F and I. Among the positive samples, 448 (93.7%) were a single serogroup and 30 (6.3%) carried a mixed infection with two serogroups. Taking single and mixed infections together, serogroup B was most frequent at 50.4% and was found in all districts, followed by serogroup I in 29.3% of samples, A in 14%, F in 6.7% and C in 5.6%. Serogroup E was detected in only one sample. Serogroups A and F were detected for the first time in India. All of 58 D. nodosus isolates in a sub-sample representing different serogroups were found to be virulent, based on the production of thermostable proteases and the presence of the integrase A gene intA. Thus, the present paper reporting isolation and characterisation of D. nodosus confirms the occurrence of virulent footrot in the tropical climate of southern India.

Clinical and dermoscopic characteristics of Merkel cell carcinoma

BACKGROUND

Merkel cell carcinoma (MCC) is an aggressive cutaneous malignancy with a high mortality rate. Diagnosis is often delayed.

OBJECTIVES

To characterize the dermoscopic features of MCC.

METHODS

Clinical and dermoscopic images of 12 biopsy-proven MCCs were analysed in a retrospective manner, with existing dermoscopic criteria being scored independently by three dermatologists.

RESULTS

The four most frequent clinical features were cherry red colour, shiny surface, sharp circumscription and nodular morphology. Significant dermoscopic features included linear irregular and polymorphous vessels, poorly focused vessels, milky pink areas, white areas, structureless areas and architectural disorder. Pigmented structures were absent from all lesions.

CONCLUSIONS

The dermoscopic features described herein help the clinician to distinguish MCC from other benign and malignant red nodules. Increasing recognition of the presenting features will facilitate earlier diagnosis of MCC and reduced mortality.

Identification of antibodies against hydropericardium syndrome in wild birds

1. Domestic fowl and free-living birds were examined for the presence or absence of antibodies against hydropericardium syndrome (HPS) using an indirect haemagglutination assay. 2. Two-hundred and eighty serum samples of commercial (45 broilers, 20 adult layers and 15 Fayoumi fowl) and wild birds, including 65 peafowl, 45 pigeons, 10 crows, 30 house sparrows, 10 doves, 15 ducks, 10 parrots and 15 guinea fowl, were collected and examined. 3. The percentage of HPS-positive serum samples was 80% in house crows, 78% in pigeons, 7% in house sparrows and 6% in peafowl. 4. The sera obtained from parrots, doves, ducks and guinea fowl were all negative. 5. This study suggests that crows and pigeons could be carriers of the HPS agent.

Detection and seroprevalence of foot and mouth disease in sheep and goats in Punjab, Pakistan

Foot and mouth disease (FMD) is a highly contagious disease of ruminants that causes huge economic losses around the globe. However, the prevalence of FMDV in small ruminants has been overlooked in Pakistan. A seroepidemiological study was conducted in Chakwal, Faisalabad and Khanewal districts of Punjab, Pakistan to determine the prevalence of FMD in sheep and goats. A total 1200 serum samples were collected from sheep (n = 180) and goats (n = 920) and were subjected to 3ABC non-structural protein enzyme-linked immunosorbent assay for detection of antibodies against non-structural proteins of FMD virus. Samples collected from clinical cases were also confirmed for FMDV using RT-PCR. The overall seroprevalence of FMD in sheep and goats was 21% (n = 252) while 19.44% (n = 35) in sheep and 21.27% (n = 217) prevalence was recorded in goats. Highest seroprevalence (32.5%) was observed in southern Punjab (Khanewal), followed by (25.75%) central Punjab (Faisalabad) and the lowest seroprevalence (4.75%) was detected in northern Punjab (Chakwal). There was no statistically significant difference in seroprevalence between sheep and goats. Among different risk factors tested, age and sex were found to be significantly associated with the prevalence of disease while pregnancy and herd type had no association with the prevalence of the disease. This study illustrate that FMD is highly prevalent in sheep and goats in Punjab. Therefore, a broader study is needed to ascertain the countrywide prevalence of FMD in small ruminants.

Role of Toll-like receptor 2 (-196 to -174) polymorphism in susceptibility to pulmonary tuberculosis in Pakistani population

Tuberculosis (TB) is a global public health problem and a source of preventable deaths each year, with 8.8 million new cases of TB and 1.6 million deaths worldwide. Pakistan ranks sixth on the list of 22 high-burden tuberculosis countries in the world. The transitions from infection to clinical disease are very few signifying that host-defence factors could lead to the development of active disease. Toll-like receptor (TLR) 2 polymorphisms have been associated with regulation of TLR expression and development of active TB. In this study, blood samples of 187 subjects including 100 healthy and 87 TB positive were collected from three districts of Pakistan. DNA was extracted from blood and TLR 2 (-196 to -174del) polymorphism was analysed by polymerase chain reaction (PCR). The results suggest that the frequency of -196 to -174del/del polymorphism of TLR2 was significantly higher in TB-positive patients compared with healthy. Results revealed that (-196 to -174del) polymorphism may increase the susceptibility to TB in healthy population of Pakistan. Moreover, males with heterozygous genotype (I/D) are more prone to TB than females with the same genotype. The occurrence of TB infection has been found positively associated with the age, suggesting that the population within the range of 21-45 years is more susceptible to Mycobacterium tuberculosis than other age groups studied. A significant association is also observed between smoking and the chances of developing TB, confirming that smoking strongly promotes its incidence.

Putative Virulence Genes and Biofilm Production Among Typical Enteroaggregative Escherichia coli Isolates from Diarrhoeic Children in Kashmir and Andhra Pradesh

Fifty-eight typical EAEC isolates from children with diarrhoea were examined for HEp-2 cell adherence assay, presence of dispersin (aap), yersiniabactin (irp2), plasmid encoded toxins (pet), Shigella enterotoxin1 (set1A) and cryptic open reading frame (shf) putative virulence genes by polymerase chain reaction as well as for biofilm production. All the isolates showed aggregative adherence pattern on HEp-2 cells. All but five isolates (91.3 %) carried aap gene. While irp2, pet, set1A and shf genes were detected in 68.9, 5.1, 39.6, and 60.3 % isolates, respectively. Thirty-three (64.7 %) isolates out of 51 tested were found to produce biofilm which was found to be significantly associated only with set1A virulence gene (P = 0.025). Highest amount of biofilm was produced by a strain that possessed all the genes studied. Out of 14 isolates in which the most frequent gene combination (aap, irp2 and shf) was observed, only six produced biofilm. It is concluded that there is significant heterogeneity in putative virulence genes of EAEC isolates from diarrhoeic children and biofilm formation is associated with multiple genes.

Fluoride in the drinking water of Nagaur tehsil of Nagaur District, Rajasthan, India

Fluoride concentration of groundwater samples from 100 villages of Nagaur tehsil was determined, 85 villages were found to have fluoride concentration more than 1.5 mg/L. The maximum fluoride concentration was recorded 6.6 mg/L in groundwater of Singhani village, while the minimum was recorded in Kurchhi village. As per the desirable and maximum permissible limit for fluoride in drinking water, determined by World Health Organization, the groundwater of about 85 villages of the studied sites is unfit for drinking purpose.

A clinical trial comparing parenteral oxytetracyline and enrofloxacin on time to recovery in sheep lame with acute or chronic footrot in Kashmir, India

BACKGROUND

No clinical trials have been conducted in India on the efficacy of parenteral antibacterials to treat footrot in sheep. In addition, there are no studies worldwide on the efficacy of parenteral antibacterials to treat chronic footrot. Sixty two sheep with acute footrot and 30 sheep with chronic footrot from 7 villages in Kashmir, India were recruited into two separate trials. Sheep with acute footrot were allocated to one of three treatments using stratified random sampling: long acting parenteral oxytetracycline, long acting parenteral enrofloxacin and topical application of potassium permanganate solution (a traditional treatment used by sheep farmers in India). In a quasi pre-post intervention design, sheep with chronic footrot that had not responded to treatment with potassium permanaganate were randomly allocated to treatment with one of the two parenteral antibacterials mentioned above. Sheep with acute footrot were treated on day 0 and those with chronic footrot on days 0, 3, 6 and 9. Sheep were monitored for up to 28 days after treatment. Time to recovery from lameness and initial healing of lesions was assessed using Kaplan-Meier survival curves, nonparametric log-rank and Wilcoxon sign-rank tests.

RESULTS

There was significant correlation in recovery from lameness and presence of healing lesions in sheep with acute (r = 0.94) or chronic (r = 0.98) footrot. Sheep with acute footrot which were treated with parenteral antibacterials had a significantly more rapid recovery from lameness and had healing lesions (median = 7 days) compared with those treated with topical potassium permanganate solution (less than 50% recovered in 28 days). The median time to recovery in sheep with chronic footrot treated with either antibacterial was 17 days; this was significantly lower than the median of 75 days lame before treatment with antibacterials. The median time to recovery for both acute and chronic footrot increased as the severity of lesions increased. There was no difference in time to recovery by age, body condition score, duration lame, or presence of pus in the foot within acute and chronically affected sheep.

CONCLUSIONS

We conclude that use of parenteral antibacterials to treat sheep lame with either acute or chronic footrot in India is highly effective. This is likely to improve welfare and give economic benefits to the farmers.

Molecular epidemiology and in vitro antimicrobial susceptibility of Salmonella isolated from poultry in Kashmir

A total of 480 samples, comprising 429 faecal samples from healthy adult birds and 51 tissue samples from dead birds, were collected from four government poultry farms in the Kashmir valley from September 2007 to April 2008. In all, 33 Salmonella isolates were obtained. Of these, 28 (84.85%) isolates were Salmonella Gallinarum, 3 (9.09%) were Salmonella Enteritidis and the remaining 2 (6.06%) were Salmonella Typhimurium. All the isolates harboured the invA, sefA, stn and spvC virulence-specific genes. However, the sopB gene was found in only 90.9% of the isolates. Pulsed-field gel electrophoresis analysis of representative isolates revealed that the majority were related but a few belonged to different clones. The majority of the isolates were resistant to cefpodoxime, nalidixic acid and sulphadiazine and sensitive to chloramphenicol, cefotaxime and tetracycline. Isolation of multidrug-resistant Salmonella, including the zoonotically important serovars, revealed a potential threat not only to poultry but also to human health in Kashmir.

Testicular abscess caused by Salmonella para-typhi

This case is the first report of a bacteriologically proven testicular abscess in a child caused by Salmonella paratyphi 'A' in Pakistan that clinically simulates a testicular tumour. The case also emphasises that a course of 2 weeks antibiotic is sufficient for testicular abscess if complete surgical debridement is done.

Detection & characterization of Shiga toxin producing Escherichia coli (STEC) & enteropathogenic Escherichia coli (EPEC) in poultry birds with diarrhoea

BACKGROUND & OBJECTIVES

Limited information is available on shiga toxin producing Escherichia coli (STEC) in animals and birds from India. An outbreak of acute diarrhoea in poultry birds at Aizawl, Mizoram was investigated for detection and characterization of STEC and enteropathogenic E. coli (EPEC).

METHODS

E. coli was isolated and identified from rectal swabs, intestinal contents, heart blood and spleen of 19 poultry birds that died due to acute diarrhoea during the outbreak. Phenotypic characterization was done by standard bacteriological and biochemical techniques. All the isolates were serotyped based on their somatic antigens. Virulence genes (stx 1, stx 2, eaeA and hlyA) were detected by multiplex PCR assay.

RESULTS

A total of 42 E. coli isolates were obtained, of which 24 belonged to 3 serogroups (O64, O89 and O91) and the remaining 18 were untypable (UT). Altogether, 14 (33.33%) isolates carried at least 1 virulence gene, of which 10 (23.81%) and 4 (9.52%) were recorded as STEC and EPEC, respectively. Of the 10 STEC isolates, one carried only stx2 , one carried stx 2 and hlyA, four carried stx1 , stx2 and hlyA, two carried stx 1, eaeA and hlyA genes and two carried stx 1 and eaeA. Of the four EPEC isolates, two carried eaeA and hlyA, one carried only eaeA gene and 1 carried only hlyA gene.

INTERPRETATION & CONCLUSIONS

This is the first report on the involvement of STEC in poultry in India.

Peritoneal hydatidosis in a young girl

We report a case of peritoneal hydatidosis that occurred post laparotomy. Patient was diagnosed nine months after she had laparotomy for suspected acute appendicitis. The whole peritoneal cavity was studded with cysts. In view of diffuse involvement, patient was managed conservatively and showed response to medical therapy.

Collaboration between general practice and community psychiatric service, evaluation of consultation-liaison model

Background

There are many advantages to improve communication between primary care and Psychiatric services. In Ireland various models of liaison with primary care are still in early stages of experimentation in some parts. We devised a pilot project of consultation-liaison model in west of Ireland.

Methodology

There are 11 general practitioners working in the catchment area. All of them were given information and five agreed to participate. Based on random allocation two general practitioners were placed in experimental group. Three other general practitioners were allocated to control group. All patients from these surgeries were enrolled in study. In experimental group face to face meetings between psychiatrist and general practitioners were arranged before and after seeing patients in clinics. Feedback and exchange of information took place during these meetings. Meetings were arranged on monthly basis for six month starting in December 2009. While in the control group communication and referral was through usual method of writing letters.

Results

Assessment of data was based on comparison of outcome in two sets of patients and surgeries. We collected data regarding number of admissions, compliance with appointments, changes in medications, number of referrals to secondary care, number of discharges back to general practitioners. Results show quantitative benefits of collaborative model in the lines of more patients being discharged back to GP and less missed appointments. There was also trend of reduced admission rate but this was statistically not significant.