Risk factors for post partum ovarian dysfunction in high producing dairy cows in Belgium: a field study

An epidemiological study of risk factors for postpartal ovarian disturbances was carried out on 334 high-yielding dairy cows in 6 well-managed Belgian herds. Ovarian activity was closely monitored using progesterone profiles, based on twice weekly RIA-analysis for progesterone in milk fat, starting at 10 d after calving and continuing until the confirmation of a new pregnancy. Attention was focused on abnormal cyclicity during the preservice, postpartum period; cows were divided into 6 different categories. Three of these categories (normal profile, delayed cyclicity, and prolonged luteal phase) were of major importance and were analyzed using a multiple variable logistic regression model. Season of calving (stable vs pasture, odds ratio (OR)=5.7), an extended length of the previous dry period (> 77 vs < or = 63 d, OR=2.9), problem calvings (OR=3.6), abnormal vaginal discharge (OR=4.5), health problems during the first month of lactation (clinical disease, OR=5.4; ketosis, OR=11.3), and clinical parameters illustrating the appearance of a severe negative energy balance significantly increased the risk for delayed cyclicity before service. Parity (> or = 4 vs 1, OR=2.5), problem calvings (OR=2.9), occurrence of puerperal disturbances (OR ranged from 3.5 to 11.0), health problems during the first month of lactation (OR=3.1), and an early resumption of ovarian cyclicity after calving (< 19 d vs > 32 d, OR=2.8) increased the risk for prolonged luteal cycles before service.

Effect of pathogen-specific clinical mastitis on milk yield in dairy cows

Our objective was to estimate the effects of the first occurrence of pathogen-specific clinical mastitis (CM) on milk yield in 3071 dairy cows in 2 New York State farms. The pathogens studied were Streptococcus spp.,Staphylococcus aureus, Staphylococcus spp., Escherichia coli, Klebsiella spp., Arcanobacterium pyogenes, other pathogens grouped together, and "no pathogen isolated." Data were collected from October 1999 to July 2001. Milk samples were collected from cows showing signs of CM and were sent to the Quality Milk Production Services laboratory at Cornell University for microbiological culture. The SAS statistical procedure PROC MIXED, with an autoregressive covariance structure, was used to quantify the effect of CM and several other control variables (herd, calving season, parity, month of lactation, J-5 vaccination status, and other diseases) on weekly milk yield. Separate models were fitted for primipara and multipara, because of the different shapes of their lactation curves. To observe effects of mastitis, milk weights were divided into several periods both pre- and postdiagnosis, according to when they were measured in relation to disease occurrence. Another category contained cows without the type of CM being modeled. Because all pathogens were modeled simultaneously, a control cow was one without CM. Among primipara, Staph. aureus, E. coli, Klebsiella spp., and "no pathogen isolated" caused the greatest losses. Milk yield generally began to drop 1 or 2 wk before diagnosis; the greatest loss occurred immediately following diagnosis. Mastitic cows often never recovered their potential yield. Among older cows, Streptococcus spp., Staph. aureus, A. pyogenes, E. coli, and Klebsiella spp. caused the most significant losses. Many multipara that developed CM were actually higher producers before diagnosis than their nonmastitic herd-mates. As in primipara, milk yield in multipara often began to decline shortly before diagnosis; the greatest loss occurred immediately following diagnosis. Milk loss persisted until at least 70 d after diagnosis for Streptococcus spp., Klebsiella spp., and A. pyogenes. The tendency for higher producing cows to contract CM may mask its impact on cow health and production. These findings provide dairy producers with more information on which pathogen-specific CM cases should receive treatment and how to manage these cows, thereby reducing CM impact on cow well being and profitability.

Epidemiology of reproductive performance in dairy cows

The objectives of this presentation are to review results of our previous and on-going research with respect to the risk factors and consequences of poor reproductive performance in dairy cows, and to develop an economic framework to optimize decisions related to dairy cow reproductive performance. To make profitable breeding and replacement decisions, the farmer must account for factors including age, production level, lactation stage, pregnancy status, and disease history of the cows in the herd. Establishing the interrelationships among disease, milk yield, reproduction, and herd management is necessary for developing a decision model for disease treatment, insemination, and replacement. The data for the studies reviewed in this presentation incorporate health, production, and management components from Holsteins in the Northeast USA and Ayrshires from Finland. Data were analyzed using the Cornell Theory Center Supercomputer. The effect of risk factors on reproductive disorders was modeled with logistic regression, and on conception, insemination, and culling with survival analysis. The effect of reproductive disorders on milk yield was analyzed with mixed models. Economic optimization of reproductive performance was done with dynamic programming (DP). High milk yield, high parity, and calving in winter were risk factors for several reproductive disorders. These disorders, in turn, delayed insemination and conception in dairy cows, and some of them increased the risk of culling. Dystocia, retained placenta, and early metritis led to a short-term drop in milk production. High milk yield was not a major factor in delaying conception, except in first parity cows. However, higher yielders were more likely to be inseminated, and less likely to be culled. Non-pregnant cows had a higher risk of being culled. Reproductive performance of dairy cows influenced a herd's profitability, and good heat detection and conception rates provided opportunities for management control. It was not always economically advantageous to get cows pregnant as soon as possible, and there was no one optimal value for the calving interval length for all cows in a herd.

Landscape and meteorological factors affecting prevalence of three food-borne pathogens in fruit and vegetable farms

Produce-related outbreaks have been traced back to the preharvest environment. A longitudinal study was conducted on five farms in New York State to characterize the prevalence, persistence, and diversity of food-borne pathogens in fresh produce fields and to determine landscape and meteorological factors that predict their presence. Produce fields were sampled four times per year for 2 years. A total of 588 samples were analyzed for Listeria monocytogenes, Salmonella, and Shiga toxin-producing Escherichia coli (STEC). The prevalence measures of L. monocytogenes, Salmonella, and STEC were 15.0, 4.6, and 2.7%, respectively. L. monocytogenes and Salmonella were detected more frequently in water samples, while STEC was detected with equal frequency across all sample types (soil, water, feces, and drag swabs). L. monocytogenes sigB gene allelic types 57, 58, and 61 and Salmonella enterica serovar Cerro were repeatedly isolated from water samples. Soil available water storage (AWS), temperature, and proximity to three land cover classes (water, roads and urban development, and pasture/hay grass) influenced the likelihood of detecting L. monocytogenes. Drainage class, AWS, and precipitation were identified as important factors in Salmonella detection. This information was used in a geographic information system framework to hypothesize locations of environmental reservoirs where the prevalence of food-borne pathogens may be elevated. The map indicated that not all croplands are equally likely to contain environmental reservoirs of L. monocytogenes. These findings advance recommendations to minimize the risk of preharvest contamination by enhancing models of the environmental constraints on the survival and persistence of food-borne pathogens in fields.

The effect of lameness on milk production in dairy cows

Data were collected prospectively for 1.5 yr on two New York dairy farms to investigate the effect of lameness on milk production. The numbers of study cows (percentages treated at least once for lameness) in each herd were 1796 (52%) and 724 (40%), respectively. Lame cows were identified and treated by farm employees or a professional hoof trimmer. Weekly averages of total milk production per day were recorded based on automated milk weight measurements at each milking. The effect of lameness on milk production was analyzed separately for each herd using repeated measures ANOVA. In both herds, milk production decreased significantly for cows diagnosed lame. Milk production was 1.5 kg/d lower > or = 2 wk after lameness compared with cows that had not yet been diagnosed lame in the current lactation in the larger herd. In the second herd, milk production of lame cows was 0.8 kg/d lower in the first and second wk after lameness and 0.5 kg/d lower > or = 3 wk after diagnosis. The decrease in milk production associated with lameness was larger for cows in second or greater lactation and for more severe cases. In one herd, the decrease in milk production was greater for cows with sole ulcers or foot abscesses than for foot rot or foot warts. Cows with abscesses or foot rot tended to have larger decreases in milk production in the other herd. The inconsistent results between farms may have resulted from differences in the relative frequencies of specific causes of lameness in the two herds and in the way lame cows were identified and defined for the study.

Effect of Lameness on Culling in Dairy Cows

The purpose of this study was to assess the effect of lameness on dairy cow survival. Cox's proportional hazards regression models were fitted to single-lactation data from 2520 cows in 2 New York State dairy herds. Models were controlled for the time-independent effects of parity, projected milk yield, and calving season, and for the time-dependent effects of lameness and culling. Other common diseases were found to be nonconfounding and so were not included in any of the final models. Survival was measured as the time from calving until death or sale. Cows were censored if they reached the start of the next lactation or end of the study, whichever occurred first. All models were stratified by herd. For all lameness diagnoses combined, survival in the herd decreased for those cows becoming lame during the first half of lactation, with a hazard ratio of up to 2 times that of a nonlame cow. Foot rot diagnosed during the second or third months of lactation decreased survival during the same time period (hazard ratio=5.1; 95% confidence interval=1.6 to 16.2). Sole ulcers diagnosed in the first 4 mo of lactation decreased survival in several subsequent periods in which the strongest association was between diagnosis in the third and fourth months of lactation and exit from the herd during that same period (hazard ratio=2.7; 95% confidence interval=1.3 to 6.0). Foot warts were not associated with decreased survival in this analysis. Lameness was never associated with increased survival in any of the models.

Effect of diseases on the culling of Holstein dairy cows in New York State

The effect of seven diseases on culling was measured in 7523 Holstein cows in New York State. The cows were from 14 herds and had calved between January 1, 1994 and December 31, 1994; all cows were followed until September 30, 1995. Survival analysis was performed using the Cox proportional hazards model to incorporate time-dependent covariates for diseases. Different intervals representing stages of lactation were considered for effects of the diseases. Five models were fitted to test how milk yield and conception status modified the effect of diseases on culling. Covariates in the models included parity, calving season, and time-dependent covariates measuring diseases, milk yield of the current lactation, and conception status. Data were stratified by herd. The seven diseases and lactational risks under consideration were milk fever (0.9%), retained placenta (9.5%), displaced abomasum (5.3%), ketosis (5.0%), metritis (4.2%), ovarian cysts (10.6%), and mastitis (14.5%). Older cows were at a much higher risk of being culled. Calving season had no effect on culling. Higher milk yield was protective against culling. Once a cow had conceived again, her risk of culling dropped sharply. In all models, mastitis was an important risk factor throughout lactation. Milk fever, retained placenta, displaced abomasum, ketosis, and ovarian cysts also significantly affected culling at different stages of lactation. Metritis had no effect on culling. The magnitude of the effects of the diseases decreased, but remained important, when milk yield and conception status were included as covariates. These results indicated that diseases have an important impact on the actual decision to cull and the timing of culling. Parity, milk yield, and conception status are also important factors in culling decisions.

Cow- and quarter-level risk factors for Streptococcus uberis and Staphylococcus aureus mastitis

This study was designed to identify risk factors for intramammary infections with Streptococcus uberis and Staphylococcus aureus under field conditions. An 18-mo survey with sampling of all quarters of all lactating cows at 3-wk intervals was carried out in three Dutch dairy herds with medium bulk milk somatic cell count (200,000 to 300,000 cells/ml). Quarter milk samples were used for bacteriology and somatic cell counting. Data on parity, lactation stage, and bovine herpesvirus 4-serology were recorded for each animal. During the last year of the study, body condition score, and teat-end callosity scores were recorded at 3-wk intervals. A total of 93 new infections with Strep. uberis were detected in 22,665 observations on quarters at risk for Strep. uberis infection, and 100 new infections with Staph. aureus were detected in 22,593 observations on quarters at risk for Staph. aureus infection. Multivariable Poisson regression analysis with clustering at herd and cow level was used to identify risk factors for infection. Rate of infection with Strep. uberis was lower in first- and second-parity cows than in older cows, and depended on stage of lactation in one herd. Quarters that were infected with Arcanobacterium pyogenes or enterococci, quarters that had recovered from Strep. uberis- or Staph. aureus-infection in the past, and quarters that were exposed to another Strep. uberis infected quarter in the same cow had a higher rate of Strep. uberis infection. Teat-end callosity and infection with coagulase-negative staphylococci or corynebacteria were not significant as risk factors. Rate of Staph. aureus infection was higher in bovine herpesvirus 4-seropositive cows, in right quarters, in quarters that had recovered from Staph. aureus or Strep. uberis infection, in quarters exposed to other Staph. aureus infected quarters in the same cow, and in quarters with extremely callused teat ends. Infection with coagulase-negative staphylococci was not significant as a risk factor. The effect of infection with corynebacteria on rate of infection with Staph. aureus depended on herd, stage of lactation, and teat-end roughness. Herd level prevalence of Strep. uberis or Staph. aureus, and low quarter milk somatic cell count were not associated with an increased rate of infection for Strep. uberis or Staph. aureus.

Body condition related to ketosis and reproductive performance in Norwegian dairy cows

The relationships between body condition score (BCS) and ketosis, and between BCS and reproductive performance in 732 moderate yielding, dual-purpose cows were studied. The cows were of the breed Norwegian Cattle. Farms with tie-stall barns and a history of high ketosis incidence were chosen for the study. Sixteen assessors visited the farms monthly and the same assessor assigned a BCS to each cow once a month. A BCS of 3.5 or higher at calving was associated with increased risk for ketosis. Cows that subsequently developed ketosis had higher BCS than healthy cows before the disease was diagnosed, and they lost more body condition than did the latter after ketosis had occurred. Summer calving cows and primiparous cows showed the lowest risk of ketosis. A history of ketosis before first service decreased the likelihood of conception to that service. Loss in body condition during the postpartum period was associated with decreased likelihood of conception to first service, prolonged calving to conception intervals and increased number of artificial inseminations per conception. Reproductive performance was not associated with BCS at calving. We concluded that BCS is a useful method of monitoring relations among nutritional management, reproduction, and ketosis in moderate yielding dual-purpose cows.

Effects of milk fever, ketosis, and lameness on milk yield in dairy cows

The effects of milk fever, ketosis, and lameness were studied using data from 23,416 Finnish Ayrshire cows that calved in 1993 and were followed for one lactation (i.e., until culling or the next calving). Monthly test day milk yields were treated as repeated measurements within a cow in a mixed model analysis. Disease index variables were created to relate the timing of a disease to the measures of test day milk. Statistical models for each parity and disease included fixed effects of calving season, stage of lactation, and disease index. An autoregressive correlation structure was used to model the association among the repeated measurements. The milk yield of cows contracting milk fever was affected for a period of 4 to 6 wk after calving; the loss ranged from 1.1 to 2.9 kg/d, depending on parity and the time elapsed after milk fever diagnosis. Despite the loss, cows with milk fever produced 1.1 to 1.7 kg more milk/d than did healthy cows. Milk yield started to decline 2 to 4 wk before the diagnosis of ketosis and continued to decline for a varying time period after it. The daily milk loss was greatest within the 2 wk after the diagnosis, varying from 3.0 to 5.3 kg/d, depending on parity. Cows in parity 4 or higher were most severely affected by ketosis; the average total loss per cow was 353.4 kg. Lameness also affected milk yield; milk loss of cows diagnosed with foot and leg disorders varied between 1.5 and 2.8 kg/d during the first 2 wk after the diagnosis.

The effect of calfhood diseases on growth of female dairy calves during the first 3 months of life in New York State

Our objective was to study the effects of pneumonia (cumulative incidence, 25%), diarrhea (29%), umbilical infection (14%), and umbilical hernia (15%) on BW and height gains during the first 3 mo of life. Female dairy calves (n = 410) born from January to December 1990 in 18 commercial herds in New York state were used. Average daily gains during the 1st, 2nd, and 3rd mo were 374, 596, and 719 g, respectively; average gain was 565 g during the 3-mo period. Average monthly height gains during the 1st, 2nd, and 3rd mo were 4.4, 5.6, and 5.7 cm, respectively. Use of multiple linear regression, with farms treated as random effects, indicated that treated, verified pneumonia was associated with a reduction in average daily gain of 66 g and that failure of passive transfer reduced average daily gain by 48 g during the 1st mo. During the 2nd mo, neither disease nor failure of passive transfer affected average daily gain. During the 3rd mo, each additional week of pneumonia reduced average daily gain by 14 g, and umbilical infection reduced average daily gain by 96 g. Each additional week of diagnosed pneumonia reduced total BW gain during the first 3 mo by 0.8 kg. Similarly, each week of pneumonia reduced total height gain by 0.2 cm and failure of passive transfer by 0.9 cm. Prevention of chronic pneumonia and umbilical infection may improve average daily gain of calves.

Effects of dystocia, retained placenta, and metritis on milk yield in diary cows

The effects of dystocia, retained placenta, and metritis on milk yield were studied in 37,776 Finnish Ayrshire cows that calved during 1993; cows were studied for one lactation. Monthly test day milk yields were treated as repeated measurements within a cow in a mixed models analysis. Index categories were created to relate the time of disease occurrence to the test dates and to capture the short-term effects of diseases on milk yield. Diseases other than dystocia, retained placenta, or metritis were categorized into two groups: diseases occurring within 42 d after calving or diseases occurring later than that. The statistical models for each parity included calving season, stage of lactation, and disease variables as fixed effects. For parities 2, 3, and 4 or higher, the cows were grouped into four categories based on previous lactation milk yield, and the disease effect was studied separately for each yield level. An autoregressive covariance structure was used to model the association among the repeated measurements. Models with a 305-d yield as the outcome were also run; the diseases were treated as binary covariates in these models. Dystocia, retained placenta, and early metritis significantly affected milk yield, as indicated by monthly test day milk yields. Late metritis was not associated with milk loss. The impact of the diseases differed across parities and also across different levels of milk yield. Using 305-d milk yield as the milk measure, no diseases were associated with reduced milk yield.

Effects of clinical mastitis on milk yield in dairy cows

The effect of clinical mastitis on milk yield was studied in 24,276 Finnish Ayrshire cows that calved in 1993 and were followed for one lactation (i.e., until culling or the next calving). Cows that had only mastitis, but no other diseases, and cows that had no diseases (healthy cows) during the lactation were included in the study. Monthly test day milk yields were treated as repeated measurements within an animal in a mixed model analysis. Mastitis index categories were created to relate the timing of mastitis to the test day milk measures. Statistical models (a separate model for each parity) included fixed effects of calving season, stage of lactation, and mastitis index. An autoregressive correlation structure was used to model the association among the repeated measurements. The effect of mastitis occurring at different periods during the lactation was studied. The daily loss during the first 2 wk after the occurrence of mastitis varied from 1.0 to 2.5 kg, and the total loss over the entire lactation varied from 110 to 552 kg and depended on parity and the time of mastitis occurrence. Regardless of the time of occurrence during the lactation, mastitis had a long-lasting effect on milk yield; cows with mastitis did not reach their premastitis milk yields during the remainder of the lactation after onset of the disease.

Epidemiology of metabolic disorders in dairy cattle: association among host characteristics, disease, and production

Logistic regression was used to investigate the effects of host characteristics, production, and 23 veterinary diagnoses on the odds of contracting seven metabolic disorders among 61,124 Finnish Ayrshire cows that calved during 1983. Cows in higher producing herds were at increased risk of parturient paresis, udder edema, and ketosis. Cows that had higher previous yields were at increased risk of parturient and nonparturient paresis and ketosis. All of the metabolic disorders except udder edema were directly interrelated. Dystocia, prolapsed uterus, other infertility, and abortion were not risk factors for any of the seven metabolic disorders; however, retained placenta, early metritis, traumatic reticuloperitonitis, acute and chronic mastitis, and foot or leg injury each were direct risk factors for at least two metabolic disorders.

The effect of maternally derived immunoglobulin G on the risk of respiratory disease in heifers during the first 3 months of life

The objectives were to investigate the association between postcolostral serum IgG and the development of calf pneumonia, to elaborate the risk factors for pneumonia, and to compare the risk factors for clinician- and caregiver-diagnosed respiratory disease. In a prospective observational cohort study, 410 heifer calves were clinically examined weekly by a veterinarian during their first 3 months of life. With an initial questionnaire and during these weekly visits, management data were collected. A nested matched case-control design was used to compare risk factors between 105 calves with respiratory disease and their 59 control calves from the same initial population. The IgG levels were determined from blood samples taken within 2 weeks after colostrum intake. The appropriate cutoff point for the postcolostral IgG level to indicate failure of passive antibody transfer when predicting pneumonia appeared to be between 800 and 1300 mg/dl (values < or = the cutoff point indicated failure). Calves with low IgG levels had 2-times higher odds of pneumonia than calves with higher IgG concentrations. Housing mostly in the presence of adult cattle was a risk factor for pneumonia, whereas housing mostly alone in a hutch was protective. Feeding of mastitic colostrum was a risk factor for clinician-diagnosed pneumonia in the analysis of the cohort study but not in the matched case-control design. There was a three-times higher risk of pneumonia if calves were given their dam's colostrum for the first feeding and the dam had clinical mastitis at the time of first milking. Caregiver- and clinician-diagnosed pneumonia had slightly different risk factors which implies that caution should be used when comparing studies based on different definitions of pneumonia. The practical implications of this study are that more attention should be paid to proper housing conditions of the calves in order to reduce incidence of pneumonia.

The association between previous 305-day milk yield and disease in New York State dairy cows

Logistic regression was used to examine the association between milk yield and disease. We studied 8070 cows of second or higher parity from 25 New York State Holstein herds, calving between June 1990 and November 1993. Previous 305-d mature equivalent milk yield was used because most of the disorders studied occurred too early in lactation for current milk yield to be considered. Seven disorders were studied: retained placenta, metritis, ovarian cyst, milk fever, ketosis, abomasal displacement, and mastitis. A separate model was used for each disorder. Each model included, in additional to milk yield, parity, calving season, and heard. Results showed that higher milk yield was not a risk factor for any disease except mastitis. However, the association between higher previous milk yield and mastitis does not necessarily imply causation.

Associations Between Pathogen-Specific Cases of Clinical Mastitis and Somatic Cell Count Patterns

Associations were estimated between pathogen-specific cases of clinical mastitis (CM) and somatic cell count (SCC) patterns based on deviations from the typical curve for SCC during lactation and compared with associations between pathogen-specific CM and lactation average SCC. Data from 274 Dutch herds recording CM over an 18-mo period were used. Pathogens found were Staphylococcus aureus, coagulase-negative staphylococci, Escherichia coli, Streptococcus dysgalactiae, Streptococcus uberis, streptococci other than Strep. dysgalactiae and Strep. uberis, and culture-negative samples. The dataset contained 245,595 test-day records on SCC, recorded in 24,012 lactations of 19,733 cows of different parities. Pattern definitions were based on three or five consecutive test-day records. The patterns differentiated between a short or longer period of increased SCC and also between lactations with and without recovery. Logistic regression was applied to identify associations between presence of patterns and occurrence of pathogens. Occurrence of overall CM in a lactation is equally or even more accurately predicted by the presence of SCC in that lactation, than by a lactation average SCC of more than 200,000 cells/mL. Patterns can also distinguish between chances of risk for specific mastitis-causing pathogens. Clinical E. coli mastitis was significantly associated with the presence of a short peak in SCC, whereas Staph. aureus was associated with long increased SCC. Streptococcus dysgalactiae was not strongly associated with any of the defined patterns of peaks in SCC, and no single unambiguous pattern was found for Strep. uberis.

Listeria monocytogenesin Multiple Habitats and Host Populations: Review of Available Data for Mathematical Modeling

Listeria monocytogenes has the ability to survive and multiply in diverse habitats and to cause infection in a variety of animal species and humans. We evaluated the literature on survival and multiplication within and transmission among multiple host populations and habitats, including man, sewage, general environment (soil, water, and vegetation), silage (fermented plant material), animals (including wild and domestic animals), and food processing plants. The available knowledge on L. monocytogenes transmission dynamics was translated into the key process nodes of interrelated host- and habitat-specific mathematical models, providing a starting framework for future modeling work and the ultimate development of a system-wide model for evaluation of its transmission, and strategies to reduce human exposure. Because of the ability of L. monocytogenes to survive and multiply in many habitats and hosts, and the number of possible transmission routes, it is highly unlikely that it could be eradicated from any habitat or host, including man. However, L. monocytogenes load within and transmission among habitats and host populations could probably be reduced. Based on the published information, we hypothesize that three recent anthropogenic practices increase the load within and transmission among reviewed habitats and host populations: extended refrigerated storage of ready-to-eat foods allowing L. monocytogenes growth in foods that are contaminated during production or subsequent handling; feeding domestic ruminants with silage often contaminated with L. monocytogenes; and dispersal of contaminated products of sewage treatment to agricultural fields and waters. Future mathematical modeling work could test how much the reduction of L. monocytogenes load and transmission in hosts and habitats associated with these anthropogenic practices would reduce human exposure and consequently human listeriosis.

Culling of dairy cows. Part I. Effects of diseases on culling in Finnish Ayrshire cows

The effects of 15 diseases on time until culling were studied in 39,727 Finnish Ayrshire cows that calved during 1993 and were followed until the next calving or culling. The diseases studied were: dystocia, milk fever, retained placenta, displacement of the abomasum, metritis, non-parturient paresis, ketosis, rumen disorders, acute mastitis, hypomagnesemia, lameness, traumatic reticuloperitonitis, anestrus, ovarian cysts, and teat injuries. Survival analysis, using the Cox proportional hazards model, was performed and diseases were modeled as time-dependent covariates. Different stages of lactation when culling can occur were also considered. Parity, calving season and herd were included as covariates in every model. Parity had a significant effect on culling, the risk of culling being four times higher for a cow in her sixth or higher parity than for a first parity cow. The effects of diseases varied according to when the diseases occurred and when culling occurred. Mastitis, teat injuries and lameness had a significant effect on culling throughout the whole lactation. Anestrus and ovarian cysts had a protective effect against culling at the time when they were diagnosed. In general, diseases affected culling decisions mostly at the time of their occurrence. The effect seemed to decrease with time from the diagnosis of the disease. However, milk fever, dystocia and metritis also had a significant effect on culling at the end of the lactation.

Comparison of seven antibiotic treatments with no treatment for bacteriological efficacy against bovine mastitis pathogens

Milk culture results were retrospectively reviewed from 9007 cases of subclinical mastitis affecting cows housed in dairy herds located in New York and northern Pennsylvania. Cases included in this analysis had at least one mastitis pathogen isolated from the initial milk sample, were recultured within 1 mo, had permanent cow identification, and had records of whether mastitis was treated with an antibiotic or no treatment at all. Overall bacteriological cure rate for 21 mastitis pathogens was 68% (6097 of 9007). Antibiotic treated cases had a higher cure rate (75%) than did untreated cases (65%). Antibiotic treatments that significantly differed from the untreated cure rate of 65% were amoxicillin (82%), erythromycin (76%), cloxacillin (73%), and pirlimycin (44%). Cure rates for antibiotic treatments with cephapirin, hetacillin, or penicillin did not differ from the untreated cure rate. Agents for which some antibiotics were associated with increased cure rates compared with no treatment were Streptococcus agalactiae, streptococci other than Strep. agalactiae, and coagulase-negative staphylococci. The antibiotic most commonly associated with higher cure rates was amoxicillin. Most of the 21 mastitis agents showed no difference in bacteriologic cure rates between any of the 7 antibiotic treatments and no treatment.

Epidemiological model for Clostridium difficile transmission in healthcare settings

OBJECTIVE

Recent outbreaks of Clostridium difficile infection (CDI) have been difficult to control, and data indicate that the importance of different sources of transmission may have changed. Our objectives were to evaluate the contributions of asymptomatic and symptomatic C. difficile carriers to new colonizations and to determine the most important epidemiological factors influencing C. difficile transmission.

DESIGN, SETTING, AND PATIENTS

Retrospective cohort study of all patients admitted to medical wards at a large tertiary care hospital in the United States in the calendar year 2008.

METHODS

Data from six medical wards and published literature were used to develop a compartmental model of C. difficile transmission. Patients could be in one of five transition states in the model: resistant to colonization (R), susceptible to colonization (S), asymptomatically colonized without protection against CDI (C(-)), asymptomatically colonized with protection against CDI (C(+)), and diseased (ie, with CDI; D).

RESULTS

The contributions of C(-), C(+), and D patients to new colonizations were similar. The simulated basic reproduction number ranged from 0.55 to 1.99, with a median of 1.04. These values suggest that transmission within the ward alone from patients with CDI cannot sustain new C. difficile colonizations and therefore that the admission of colonized patients plays an important role in sustaining transmission in the ward. The epidemiological parameters that ranked as the most influential were the proportion of admitted C(-) patients and the transmission coefficient for asymptomatic carriers.

CONCLUSION

Our study underscores the need to further evaluate the role of asymptomatically colonized patients in C. difficile transmission in healthcare settings.

Effects of repeated gram-positive and gram-negative clinical mastitis episodes on milk yield loss in Holstein dairy cows

The objective of this study was to estimate the effects of recurrent episodes of gram-positive and gram-negative cases of clinical mastitis (CM) on milk production in Holstein dairy cows. We were interested in the severity of repeated cases in general, but also in the severity of the host response as judged by milk production loss when a previous case was caused by a similar or different microorganism. The results were based on data from 7,721 primiparous lactations and 13,566 multiparous lactations in 7 large dairy herds in New York State. The distribution of organisms in the CM cases showed 28.5% gram-positive cases, 31.8% gram-negative cases, 15.0% others, and 24.8% with no organism identified. Mixed models, with a random herd effect and an autoregressive covariance structure to account for repeated measurements, were used to quantify the effect of repeated CM and several other control variables (parity, week of lactation, other diseases) on milk yield. Our data indicated that repeated CM cases showed a very similar milk loss compared with the first case. No reduction of severity was present with increasing count of the CM case. Gram-negative cases had more severe milk loss compared with gram-positive and other cases irrespective of the count of the case in lactation. Milk loss in multipara (primipara) due to gram-negative CM was approximately 304 kg (228 kg) in the 50 d following CM. This loss was approximately 128 kg (133 kg) for gram-positive cases and 92 kg (112 kg) for other cases. The severity of a second case of gram-negative CM was not reduced by previous cases of gram-negative CM in multipara and only slightly less severe in a similar scenario in primipara cows. Similarly, a previous gram-positive case did not reduce severity of a second or third gram-positive case. Hence, our data do not support that immunological memory of previous exposure to an organism in the same generic class provides protection for a next case of CM with an organism in the same class.

The cost and management of different types of clinical mastitis in dairy cows estimated by dynamic programming

The objective of this study was to estimate the cost of 3 different types of clinical mastitis (CM) (caused by gram-positive bacteria, gram-negative bacteria, and other organisms) at the individual cow level and thereby identify the economically optimal management decision for each type of mastitis. We made modifications to an existing dynamic optimization and simulation model, studying the effects of various factors (incidence of CM, milk loss, pregnancy rate, and treatment cost) on the cost of different types of CM. The average costs per case (US$) of gram-positive, gram-negative, and other CM were $133.73, $211.03, and $95.31, respectively. This model provided a more informed decision-making process in CM management for optimal economic profitability and determined that 93.1% of gram-positive CM cases, 93.1% of gram-negative CM cases, and 94.6% of other CM cases should be treated. The main contributor to the total cost per case was treatment cost for gram-positive CM (51.5% of the total cost per case), milk loss for gram-negative CM (72.4%), and treatment cost for other CM (49.2%). The model affords versatility as it allows for parameters such as production costs, economic values, and disease frequencies to be altered. Therefore, cost estimates are the direct outcome of the farm-specific parameters entered into the model. Thus, this model can provide farmers economically optimal guidelines specific to their individual cows suffering from different types of CM.

Optimizing replacement of dairy cows: modeling the effects of diseases

We modified an existing dairy management decision model by including economically important dairy cattle diseases, and illustrated how their inclusion changed culling recommendations. Nine common diseases having treatment and veterinary costs, and affecting milk yield, fertility and survival, were considered important in the culling decision process. A sequence of stages was established during which diseases were considered significant: mastitis and lameness, any time during lactation; dystocia, milk fever and retained placenta, 0-4 days of lactation; displaced abomasum, 5-30 days; ketosis and metritis, 5-60 days; and cystic ovaries, 61-120 days. Some diseases were risk factors for others. Baseline incidences and disease effects were obtained from the literature. The effects of various disease combinations on milk yield, fertility, survival and economics were estimated. Adding diseases into the model did not increase voluntary or total culling rate. However, diseased animals were recommended for culling much more than healthy cows, regardless of parity or production level. Cows in the highest production level were not recommended for culling even if they contracted a disease. The annuity per cow decreased and herdlife increased when diseases were in the model. Higher replacement cost also increased herdlife and decreased when diseases were in the model. Higher replacement cost also increased herdlife and decreased the annuity and voluntary culling rate.