Use of laboratory data to reduce the time taken to detect new diseases: VIDA to FarmFile.

The analysis of laboratory data can provide information about the health of livestock populations; in Great Britain the Veterinary Investigation Diagnosis Analysis (VIDA) system has provided such data since 1975. However VIDA covers only known diagnoses, with limited epidemiological characterisation. The unexpected outbreak of bse showed that it was necessary to improve surveillance to detect new diseases, and a necessary update of the VIDA database for the millennium date change provided the opportunity. The information required to enhance the value of laboratory data was identified, a new form and database, 'FarmFile', were designed to record it, and they began to be used in 1999. The detection of new diseases depends on making comparisons with the expected or 'usual' levels of unexplained disease. The data are analysed quarterly to assess any changes in the levels of unexplained disease in different species, categorised in terms of clinical sign or body system, by comparison with previous years. No new diseases have been detected either through FarmFile or more traditional means since the new analyses started in earnest in 2004, but they have indicated that an unexplained event was not a new disease of concern, and developments continue to improve the system's sensitivity and specificity.

An immunohistochemical assessment of the cutaneous immune response to louse infestation in cattle.

Skin samples were taken from 10 experimental cattle exposed naturally, during a period extending over two winters, to Bovicola bovis and Solenoptes capillatus, five becoming infested and five being protected from infestation by repeated treatment with ectoparasiticides. Skin sections were examined histopathologically and immunohistochemically for expression of the immune cell markers CD3, CD4, CD8 and class II antigens of the major histocompatibility complex (MHC). Louse-infested cattle had a mixed infiltration of the superficial dermis and perifollicular regions with eosinophils and mononuclear cells. The skin of infested cattle differed from that of non-infested cattle in showing significantly more cells expressing CD3, CD4 and MHC class II (P<0.05). Many of the MHC class II(+) cells had dendritic morphology, suggesting active antigen presentation within the lesions. Louse infestations have previously been thought to produce a type 1 hypersensitivity response, mediated by Th2 lymphocytes. However, the increased number of lymphocytes and antigen-presenting cells observed in the present study suggests that in chronic infestation there is activation of local cell-mediated (Th1) immunity.

Retrospective study of noroviruses in samples of diarrhoea from cattle, using the Veterinary Laboratories Agency's Farmfile database.

A collaborative study was undertaken by the Veterinary Laboratories Agency (vla) and the Royal Veterinary College (rvc) to determine the prevalence of bovine noroviruses in cattle with diarrhoea. Samples of bovine diarrhoea were provided by the vla from routine diagnostic submissions and a reverse transcription-pcr was used by the rvc to detect the viruses. Epidemiological information about the samples was provided retrospectively by the Farmfile database. Noroviruses were detected in 44 (11 per cent) of the 398 samples tested, and Farmfile data were used to investigate the differences between the positive and negative animals.

Prevalence and regional distribution of scab, lice and blowfly strike in Great Britain.

The prevalence of psoroptic mange (sheep scab), louse infestation and blowfly strike in sheep in Great Britain between March 2003 and February 2004 was investigated by means of a retrospective postal survey, stratified by region. Of the 3530 questionnaires sent out, 1067 were returned completed, a response rate of 30.2 per cent. Overall, 9 per cent of the farmers reported at least one outbreak of scab, 10.7 per cent reported an outbreak of lice and 75 per cent reported at least one case of blowfly strike. A mean of 1.4 per cent of ewes were struck by blowfly and 2.8 per cent of lambs. There were strong regional variations in disease prevalence, with scab and lice infestation being highest in Wales, Scotland and the north of England and blowfly strike highest in the south west of England.

Effect of NaF and pH on the growth and glycolytic rate of recently isolated strains of oral Lactobacillus species.

Twenty-eight fresh and seven type strains of Lactobacillus species were tested for their ability to grow and metabolize glucose in the presence of fluoride. While there was variation between the test organisms, freshly isolated strains were generally more fluoride-tolerant than were the type strains, and a group of seven strains would grow well at pH 4.5 with 5.3 mm NaF. Glucose metabolism by representative strains of this latter group required average fluoride concentrations of 204, 64, and 9.3 mM to inhibit glycolysis completely at pH 7.0, 6.0, and 5.0, respectively. These values are ten times higher than those required to inhibit glucose metabolism by Streptococcus mutans.

A longitudinal study of a natural lice infestation in growing cattle over two winter periods.

A group of 61 cattle which were naturally infested with lice was followed over two winter periods. Data were collected on the number of lice found at various body sites over this period. Summary statistics were produced and due to the repeated measured and hierarchical structure of the data, multi-level analysis was used to model the population dynamics of Bovicola bovis and assess the influence of the various hierarchical levels. A four level Poisson model was produced--level one, the individual number of lice at each parting; level two, the body site examined (shoulder, midline or rump); level three, the time of the inspection and level four, the animal. Seasonal fluctuation in lice numbers was modelled using a cosine function transformation of time. A seasonal pattern was seen in both year's with lice counts higher in the first than the second year. The midline area was the most sensitive to detection of B. bovis. Variance contributed by the individual animal was less than that contributed by the body site examined and the time of the inspection. The model suggested that lice numbers within the shoulder and rump sites were near random following a Poisson distribution, but aggregation of lice occurred at the midline site with the distribution between animals following a Negative Binomial Pattern. The midline site was the most sensitive site for detecting B. bovis. Infestation numbers were higher in the first winter when cattle were younger. In the second winter, there was no difference in lice numbers between cattle exposed to infection for the first or second time.

A longitudinal study of a natural lice infestation in growing cattle over two winter periods.

A group of 61 cattle which were naturally infested with lice was followed over two winter periods. Data were collected on the number of lice found at various body sites over this period. Summary statistics were produced and due to the repeated measured and hierarchical structure of the data, multi-level analysis was used to model the population dynamics of Bovicola bovis and assess the influence of the various hierarchical levels. A four level Poisson model was produced-level one, the individual number of lice at each parting; level two, the body site examined (shoulder, midline or rump); level three, the time of the inspection and level four, the animal. Seasonal fluctuation in lice numbers was modelled using a cosine function transformation of time. A seasonal pattern was seen in both years with lice counts higher in the first than the second year. The midline area was the most sensitive to detection of B. bovis. Variance contributed by the individual animal was less than that contributed by the body site examined and the time of the inspection. The model suggested that lice numbers within the shoulder and rump sites were near random following a Poisson distribution, but aggregation of lice occurred at the midline site with the distribution between animals following a Negative Binomial Pattern. The midline site was the most sensitive site for detecting B. bovis. Infestation numbers were higher in the first winter when cattle were younger. In the second winter, there was no difference in lice numbers between cattle exposed to infection for the first or second time.

A retrospective analysis of the costs associated with the treatment of nursing caries in a remote Canadian aboriginal preschool population.

Nursing caries is a specific form of rampant dental caries affecting the majority of preschool aboriginal children who live in the Province of Manitoba, Canada. Since the majority of these individuals live in remote regions of the province access to dental treatment is difficult, resulting in long delays in the provision of treatment and, most likely, significant morbidity associated with dental pain and oral infection. Travel to distant centres for treatment under general anesthesia by pediatric dentists has become the usual method by which treatment is provided to the majority of affected children. We believed that this was an expensive method of providing these necessary services and our purpose was to document all costs associated with the treatment of nursing caries in this population. We analyzed the records of 884 children who were treated for nursing caries between 1980 and 1988 in Manitoba and collected data for costs in the following categories: travel, lodging, medical, dental, hospital and nursing. Our results show that the remote band groups had significantly higher costs (P < 0.001) than groups which were located closer to treatment centres. The costs which accounted primarily for this significant difference were travel and medical costs associated with hospitalization and the administration of general anesthesia. Our results support the need for the redeployment of resources on the basis of regional need and the development of community-based preventive programs and treatment programs which will significantly reduce the incidence of nursing caries in preschool Canadian aboriginal children.

Description and epidemiology of nursing caries.

Nursing caries is a virulent form of tooth decay that affects the primary dentition of infants and preschool children. The purpose of this paper is to review the scientific literature to describe the clinical characteristics of this disease and to report on its prevalence in various locations and populations around the world. A Medline search was completed using the key words below. All English-language articles that reported on the prevalence of caries involving the primary maxillary incisors in preschool children in association with feeding habits were included in the review. Nursing caries is associated with ad libitum bottle feeding, particularly at naptime or nighttime, and has been reported in children who engage in demand breastfeeding. A substantial body of literature from numerous countries now exists that documents the prevalence of nursing caries. In developed countries the prevalence is reported to vary between 1 percent and 12 percent. However, in developing countries and within disadvantaged populations in developed countries, the prevalence has been reported to be as high as 70 percent in the preschool population. A universally accepted definition for nursing caries does not exist and methods used to define the condition, establish study populations, and collect prevalence data vary widely among studies. This review provides a detailed clinical description of nursing caries, reviews the characteristics of children who may be at risk for nursing caries, and reviews the prevalence data for nursing caries for countries that have reported it, and suggests directions for research into nursing caries etiology and prevalence.

Prevalence of lice on dairy cattle in England and the bordering counties of Wales.

A postal questionnaire was used to collect information on the prevalence of lice on cattle on a random sample of dairy farms in England and the bordering counties of Wales. Replies were received from 1040 (52.8 per cent) of the 1970 farms which were mailed. Fifty per cent of farmers reported having ever seen or suspected lice in their herds and 29 per cent reported possible infestations in the winter of 1996/97. Visits were made to 24 farms in the south west of England during February 1998. Twelve of the farmers said that they had seen or suspected lice in their herd since October 1997, and that lice were more frequently observed on the adult cattle. However, examination revealed lice on 18 of the 24 farms, and adult cattle were the least likely group to be infested.

Relationship between lice infestation and leather damage in cattle.

The relationship between lice infestation and leather damage was investigated in a trial involving 61 cattle, half of which were treated with ectoparasiticides for lice control either in their first or second year. Hides from the lice-free and lousy calves were removed manually at an abattoir, tanned and inspected for lice-related damage, commercially referred to as light spot and/or fleck. In both the first- and second-year animals there was a significant difference between the hides of the lousy and lice-free animals, confirming that the chewing louse Bovicola bovis is a cause of winter light spot. There was also a difference between the two groups in the levels of scratch damage. After the infested animals had been treated with fenvalerate and eprinomectin to kill all the lice, the damage to the hides had not been fully reversed 13 weeks later.

Intravenous sedation in pediatric dentistry using midazolam, nalbuphine and droperidol.

PURPOSE: The purpose of this pilot investigation was to study the efficacy, physiologic responses, and safety of a multi-drug intravenous conscious sedation technique in an outpatient setting in children who demonstrated uncooperative behavior when comprehensive restorative dental treatment was attempted. METHODS: Using a time-based sedation record, the physiologic responses of 153 healthy children, age range 23 months to 14.5 years, were measured after they had received midazolam (Versed), nalbuphine (Nubain), and droperidol (Inapsine), each administered intravenously, and nitrous oxide and oxygen administered by nasal mask, while each child received comprehensive restorative or surgical dental care. Each patient was monitored according to the American Academy of Pediatrics Sedation Guidelines. Heart rate and rhythm, blood pressure, respiratory rate, hemoglobin oxygen saturation, end-tidal CO2, level of sedation, and behavioral responses were recorded preoperatively, at 5 minute intervals during treatment and in recovery until discharge. Sedation was titrated to Level 2 or 3 during treatment as defined by the American Academy of Pediatric Dentistry Reference Manual. RESULTS: For each child, the sedation level was judged to be either acceptable or optimal for the completion of all planned dental treatment. There were no sedation failures. Children under 20 kg required significantly higher dosages of each sedative medication than children more than 20 kg to achieve the same level of sedation (P < 0.001, ANOVA). There were no episodes of intraoperative vomiting, hypotension, cardiac arrhythmias, respiratory depression requiring respiratory support, or dysphoria during treatment, in the recovery period, or after discharge. CONCLUSION: This multi-drug intravenous conscious sedation technique is a safe and effective method to control the behavior of uncooperative children who require comprehensive dental treatment.

Classification, diagnostic criteria, and treatment recommendations for orofacial manifestations in HIV-infected pediatric patients. Collaborative Workgroup on Oral Manifestations of Pediatric HIV Infection.

The criteria for diagnosis of HIV-related oral lesions in adults are well established, but corresponding criteria in the pediatric population are not as well defined. The Collaborative Workgroup on the Oral Manifestations of Pediatric HIV infection reached a consensus, based upon available data, as to the presumptive and definitive criteria to diagnose the oral manifestations of HIV infection in children. Presumptive criteria refer to the clinical features of the lesions, including signs and symptoms, whereas definitive criteria require specific laboratory tests. In general, it is recommended that definitive criteria be established whenever possible. Orofacial manifestations have been divided into three groups: 1) those commonly associated with pediatric HIV infection; 2) those less commonly associated with pediatric HIV infection; and 3) those strongly associated with HIV infection but rare in children. Orofacial lesions commonly associated with pediatric HIV infection include candidiasis, herpes simplex infection, linear gingival erythema, parotid enlargement, and recurrent aphthous stomatitis. In contrast, orofacial lesions strongly associated with HIV infection but rare in children include Kaposi's sarcoma, non-Hodgkin's lymphoma, and oral hairy leukoplakia. Treatment recommendations, specific for this age group, have been included for some of the more common HIV-related orofacial manifestations.

Nonpharmacological techniques help practitioners manage young patients.

Occasionally, a child will have neither previous experience with a dentist nor exposure to the attitudes of others. In this case, the dentist has to worry about the child's fear of the unknown. Managing this is relatively easy in comparison to managing children who have had bad experiences or have been influenced by the fears of their parents, siblings, or peers. For the non-problematic child, management techniques are based largely on communicative skills, starting at the first contact with the parents or guardian. Even problematic children should be handled in a similar manner during non-episodic times. As an initial assessment of a possible problematic child, dentists should determine to what extent the child is fearful, incorrigible, and overindulged. When episodes occur, the management procedure should address the culprit. If it is fear only, the child can be taught to cope with the situation through any of the behavior modification techniques, ideally in a preventive manner. The specific technique used is the operator's preference, since all depend on a high degree of suggestibility. The operator must be confident in his choice, but must keep in mind that a certain amount of maturity is required of the child for successful use of these techniques. Dentists should never display emotions that can be construed as malice. An overworked, tired, time-pressured dentist would be better to end the session and start on another occasion. However, the child must not be aware that the dentist is "quitting" the struggle. When the child returns to a productive, positive behavior it should be positively reinforced by praise and other social reinforcers. The time and effort required to treat children and the desire to teach them coping strategies will be rewarded in the long run. They will remain your patients.

Impact of Schmallenberg virus on British sheep farms during the 2011/2012 lambing season.

British sheep farmers were invited to complete a questionnaire about the impact of Schmallenberg virus (SBV) on animal health, welfare and their own emotional wellbeing during the 2011-2012 lambing season, through Defra and Farming Industry websites, letters to farmers who had requested SBV laboratory tests and advertisement at Sheep 2012. The 494 responders included SBV confirmed (positive by RT-PCR) (n=76), SBV suspected by farmer (n=140) or SBV not suspected (n=278). Percentage of barren ewes was similar across SBV groups, however, lamb and ewe losses were higher on responder farms where SBV was confirmed or suspected. The median percentages of all lambs born (and lambs born deformed ) that died within one week of birth was 10.4 per cent (5.5 per cent), 7.0 per cent (2.9 per cent) and 5.3 per cent (0 per cent), respectively, on SBV confirmed, suspected and not suspected farms (P<0.001). Eight to 16 per cent of SBV confirmed or suspected farms reported lamb mortality of ≥40 per cent. Farmer perceived impact was greater where SBV was confirmed or suspected (P<0.001): 25 per cent reported a high impact on emotional wellbeing (4 per cent of SBV not suspected), 13 per cent reported a high impact on flock welfare and financial performance and 6 per cent were less likely to farm sheep next year because of SBV (<2 per cent in SBV not suspected). Overall, SBV impact has been large relative to reported sheep loss.

Clinical features of psoroptic mange in cattle in England and Wales.

The clinical signs, treatments used and spread of psoroptic mange in cattle from October 2007 until March 2011 are described. The disease was first diagnosed in South West Wales, having not been reported in Great Britain since the 1980s. The likely source was identified as a farm that had imported two animals from mainland Europe in the summer of 2006. Since that time, disease has been diagnosed on a further 22 premises, the majority in South West Wales but also in South East and Mid Wales and on one farm in England. Bought in animals harbouring the Psoroptes species mite but not showing clinical signs were considered the greatest risk of introducing the infestation into a herd. This, together with the difficulties of treatment to eliminate the parasite, means that it is unlikely that this outbreak has been controlled. There is also a continuing threat of importing the disease from abroad. The disease is not notifiable in the UK.

Evaluation of methods for measuring coverage and representativeness of an early-warning disease surveillance system.

Early-warning surveillance provides an essential component of the evidence required to protect animal health. Assessing the proportion of the population included in surveillance systems (coverage) provides a measure of the effectiveness of early-warning surveillance, and contributes to ensuring that these systems are efficient. This paper describes an investigation of methods used for assessing the coverage and representativeness of the 'FarmFile' early-warning surveillance system. This system uses information collected with samples submitted to diagnostic laboratories by private veterinary practitioners in England and Wales. Available data on pig holdings and veterinary practices in four English counties, selected to represent a range of diverse population characteristics, were supplemented using surveys of veterinary practices. Coverage assessments were based on submissions made to FarmFile in 2009. The proportion of holdings covered varied from 5-62 per cent in Devon and Cumbria, and 16-97 per cent in Norfolk and East Riding of Yorkshire. The results suggest that while the proportion of individual pigs covered by the current early-warning surveillance system is high, small and breeding-only holdings in some regions may be poorly covered. Coverage assessments vary depending on the methods used for their assessment, and multiple assessment methods can provide a 'range' within which coverage lies.

Factors related to the carriage of Verocytotoxigenic E. coli, Salmonella, thermophilic Campylobacter and Yersinia enterocolitica in cattle, sheep and pigs at slaughter.

A 12-month abattoir study was undertaken from January 2003. We collected 7492 intestinal samples from cattle, sheep and pigs at slaughter. Rectal samples were taken from cattle and sheep and caecal samples from pigs. They were examined for verocytotoxigenic E. coli (VTEC) O157, Salmonella, thermophilic Campylobacter and Yersinia enterocolitica. Data were collected on the animal from which the sample came and this information was analysed to look at potential risk factors for carriage of these organisms. Logistic regression models were run where an adequate number of positive results were available. This revealed that VTEC O157 carriage in cattle was associated with the summer period and that age was a protective factor. Salmonella carriage in pigs was associated with lairage times >12 h, the North East and not feeding when there was no bedding available. In cattle, carriage was associated with the summer period, the Eastern region of GB and dairy animals. In sheep a spring seasonal effect was seen, which coincided with the lambing period. The carriage of thermophilic Campylobacter in cattle was associated with single-species abattoirs, with age a protective factor. In sheep, winter was a risk period with lairage management influential. For pigs, lairage times of <12 h were found to be associated with carriage. A seasonal trend for carriage of Y. enterocolitica in all species was demonstrated with the period December-May a risk. For cattle, age was also a risk factor; for sheep feeding in the lairage and for pigs being held overnight were risk factors.