David C. Van Metre

Characteristics of biosecurity and infection control programs at veterinary teaching hospitals

OBJECTIVE To characterize biosecurity and infection control practices at veterinary teaching hospitals located at institutions accredited by the AVMA. DESIGN Cross-sectional survey. POPULATION 50 biosecurity experts at 38 veterinary teaching hospitals. PROCEDURES Telephone interviews were conducted between July 2006 and July 2007, and questions were asked regarding policies for hygiene, surveillance, patient contact, education, and awareness. Respondents were also asked their opinion regarding the rigor of their programs. RESULTS 31 of 38 (82%) hospitals reported outbreaks of nosocomial infection during the 5 years prior to the interview, 17 (45%) reported > 1 outbreak, 22 (58%) had restricted patient admissions to aid mitigation, and 12 (32%) had completely closed sections of the facility to control disease spread. Nineteen (50%) hospitals reported that zoonotic infections had occurred during the 2 years prior to the interview. Only 16 (42%) hospitals required personnel to complete a biosecurity training program, but 20 of the 50 (40%) respondents indicated that they believed their hospitals ranked among the top 10% in regard to rigor of infection control efforts. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that differences existed among infection control programs at these institutions. Perceptions of experts regarding program rigor appeared to be skewed, possibly because of a lack of published data characterizing programs at other institutions. Results may provide a stimulus for hospital administrators to better optimize biosecurity and infection control programs at their hospitals and thereby optimize patient care.

Selenium and Vitamin E

Deficiency of selenium and vitamin E has recently been identified as a major health concern of sheep producers in certain regions of the United States, and familiarity with published data on these nutrients seems to be of value to small ruminant practitioners. This article begins with a description of the biochemical roles and metabolism of selenium and vitamin E. A literature review follows in which the influence of these nutrients on the musculoskeletal, reproductive, and immune systems, as well as on flock productivity, is discussed. Methods for detection of deficiency and supplementation strategies are also described.

Development of a syndromic surveillance system for detection of disease among livestock entering an auction market

OBJECTIVE To develop a syndromic surveillance system based on visual inspection from outside the livestock pens that could be used for detection of disease among livestock entering an auction market. DESIGN Cross-sectional study. ANIMALS All livestock (beef and dairy cattle, sheep, goats, horses, and pigs) entering a single auction market in Colorado during 30 business days. Procedures-Livestock were enumerated and visually inspected for clinical signs of disease by a veterinarian outside the pens, and clinical signs that were observed were categorized into 12 disease syndromes. Frequency of clinical signs and disease syndromes was then calculated. RESULTS Data were recorded for a total of 29,371 animal observation days. For all species combined, the most common disease syndrome was respiratory tract disease (218.9 observations/10,000 animal observation days), followed by thin body condition and abnormal ambulation or posture (80.7 and 27.2 observations/10,000 animal observation days, respectively). Together, these 3 disease syndromes accounted for 92.8% of all clinical signs of disease observed. The syndromes least commonly identified were non-injury-related hemorrhage, death, and injury-related hemorrhage (0.0, 0.3, and 0.7 observations/10,000 animal observation days, respectively). CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that a syndromic surveillance system based on visual inspection alone could be developed to identify possible disease conditions among livestock at an auction market. Further studies are needed to determine the sensitivity and specificity of visual observation in detecting disease.

Diagnosis of Enteric Disease in Small Ruminants

Diagnosis of gastrointestinal disease in small ruminants requires integration of information obtained in the signalment, history, physical or necropsy examination, and ancillary diagnostic tests. The purpose of this article is to provide the practitioner with a review of the clinical features of several common gastrointestinal diseases of sheep and goats. Rumen acidosis, enterotoxemia, gastrointestinal parasitism, neonatal diarrhea, and salmonellosis are discussed, and where appropriate, reviews of the pathophysiology, prevention, and control of these diseases are cited for further reading.

Salmonella enterica shedding in hospitalized horses and associations with diarrhea occurrence among their stablemates and gastrointestinal-related illness or death following discharge.

OBJECTIVE To evaluate the potential association between Salmonella enterica shedding in hospitalized horses and the risk of diarrhea among stablemates, and to characterize gastrointestinal-related illness and death following discharge among horses that shed S. enterica while hospitalized. DESIGN Retrospective cohort study [corrected]. ANIMALS 221 horses (59 that shed S. enterica during hospitalization and 162 that tested negative for S. enterica shedding ≥ 3 times during hospitalization). PROCEDURES Information from medical records (signalment, results of microbial culture of fecal samples, clinical status at the time of culture, and treatment history) was combined with data collected through interviews with horse owners regarding formerly hospitalized horses and their stablemates. Data were analyzed to investigate risk factors for death and diarrhea. RESULTS Occurrence of diarrhea among stablemates of formerly hospitalized horses was not associated with S. enterica shedding in hospitalized horses but was associated with oral treatment with antimicrobials during hospitalization. Salmonella enterica shedding during hospitalization was not associated with risk of death or gastrointestinal-related illness in study horses ≤ 6 months after discharge, but shedding status and history of gastrointestinal illness were associated with increased risk of death during the preinterview period. CONCLUSIONS AND CLINICAL RELEVANCE Stablemates of horses that shed S. enterica during hospitalization did not appear to have an increased risk for diarrhea, but comingling with horses that receive orally administered antimicrobials may affect this risk. Salmonella enterica shedding during hospitalization may be a marker of increased long-term risk of death after discharge. Risks are likely influenced by the S enterica strain involved and biosecurity procedures used.

Sodium Balance and the Dysnatremias

The dysnatremias are defined as abnormalities in serum sodium concentration. Depending on the magnitude and duration of the sodium abnormality and the nature of any concurrent or primary disease, hypernatremia and hypernatremia may result in no consequences, subclinical impairment of health and productivity, or severe clinical disease. Dysnatremias can be the sequelae to diseases or environmental conditions that promote fluid gain or loss from the body, as well as medical interventions that add excessive amounts of sodium or water to the extracellular fluid. Extreme, sustained dysnatremia may result in central nervous system dysfunction and death.

Pathogenesis and Treatment of Bovine Foot Rot

Bovine foot rot (BFR) is an infectious disease of the interdigital skin and subcutaneous tissues of beef and dairy cattle that occurs under a variety of management and environmental settings. The anaerobic, gram-negative bacteria Fusobacterium necrophorum, Porphyromonas levii, and Prevotella intermedia are commonly isolated from lesions. A multitude of host, agent, and environmental factors contribute to the development of BFR. Initiation of systemic antimicrobial therapy early in the course of disease commonly leads to resolution. Delays in treatment may result in extension of infection into deeper bone, synovial structures, or ligamentous structures, and the prognosis for recovery is reduced.

Factors affecting use of veterinarians by small-scale food animal operations

OBJECTIVE To identify factors associated with use of a veterinarian by small-scale food animal operations. DESIGN Cross-sectional descriptive survey. SAMPLE 16,000 small-scale farm or ranch operations in all 50 states. PROCEDURES Surveys were conducted via mail or telephone during 2011 for small-scale operations (gross annual agricultural sales between

Management of C oxiella burnetii infection in livestock populations and the associated zoonotic risk: A consensus statement

10,000 and

Evaluation of the efficacy of disinfectant footbaths as used in veterinary hospitals

499,999) in which an animal or animal product comprised the highest percentage of annual sales. RESULTS 8,186 (51.2%) operations responded to the survey; 7,849 surveys met the inclusion criteria. For 6,511 (83.0%) operations, beef cattle were the primary animal species. An estimated 82.1% of operations (95% confidence interval [CI], 81.1% to 83.0%) had a veterinarian available ≤ 29 miles away; 1.4% (95% CI, 1.2% to 1.7%) did not have a veterinarian available within 100 miles of the operation. Operations for which the nearest veterinarian was ≥ 100 miles away or for which a veterinarian was not available were located in 40 US states. Overall, 61.7% of operations (95% CI, 60.6% to 62.9%) had used a veterinarian during the 12 months prior to the survey. Producers with college degrees were significantly more likely to use a veterinarian (675%) versus those who did not complete high school (52.9%). CONCLUSIONS AND CLINICAL RELEVANCE Results of this study indicated most small-scale operations had adequate access to veterinarians during 2011, but there seemed to be localized shortages of veterinarians in many states.