Survey of vector-borne agents in feral cats and first report of Babesia gibsoni in cats on St Kitts, West Indies.

BACKGROUND: As there is little data on vector-borne diseases of cats in the Caribbean region and even around the world, we tested feral cats from St Kitts by PCR to detect infections with Babesia, Ehrlichia and spotted fever group Rickettsia (SFGR) and surveyed them for antibodies to Rickettsia rickettsii and Ehrlichia canis. RESULTS: Whole blood was collected from apparently healthy feral cats during spay/ neuter campaigns on St Kitts in 2011 (N = 68) and 2014 (N = 52). Sera from the 52 cats from 2014 were used to detect antibodies to Ehrlichia canis and Rickettsia rickettsii using indirect fluorescent antibody tests and DNA extracted from whole blood of a total of 119 cats (68 from 2011, and 51 from 2014) was used for PCRs for Babesia, Ehrlichia and Rickettsia. We could not amplify DNA of SFG Rickettsia in any of the samples but found DNA of E. canis in 5% (6/119), Babesia vogeli in 13% (15/119), Babesia gibsoni in 4% (5/119), mixed infections with B. gibsoni and B. vogeli in 3% (3/119), and a poorly characterized Babesia sp. in 1% (1/119). Overall, 10% of the 52 cats we tested by IFA for E. canis were positive while 42% we tested by indirect fluorescent antibody (IFA) for R. rickettsii antigens were positive. CONCLUSIONS: Our study provides the first evidence that cats can be infected with B. gibsoni and also indicates that cats in the Caribbean may be commonly exposed to other vector-borne agents including SFGR, E. canis and B. vogeli. Animal health workers should be alerted to the possibility of clinical infections in their patients while public health workers should be alerted to the possibility that zoonotic SFGR are likely circulating in the region.

Individual and group treatment for patients with acquired brain injury in comprehensive rehabilitation.

PRIMARY OBJECTIVE: The aim of this study was to investigate the hypothesis that group rehabilitation is more effective than individual treatments and provides an improvement in clinical outcomes similar to that achieved by individual treatments alone. RESEARCH DESIGN: Two groups of patients were placed in different rehabilitation settings treated using the same rehabilitation approach. One received only individual treatments and the second group received a combination of both individual and group treatments. The independent variables were measured both pre- and post-treatment and compared between the two groups. METHODS AND PROCEDURES: Seventy-four patients treated with a comprehensive rehabilitation approach were divided into two groups: (a) individual treatment only and, (b) combined treatments (both individual and group). The outcome scales were LCF (Rancho Los Amigos Level of Cognitive Functioning), DRS (Disability Rating Scale) and FIM™ (Functional Independence Measure). RESULTS: The whole sample had obtained statistically significant improvements in all of the outcome scales: LCF (χ(2) = 45.26; p < 0.001), DRS (z = -3.92; p < 0.001) and FIM (z = -4.9; p < 0.001). The comparison between groups did not reveal any pre-treatment difference. Analysis of post-treatment, however, showed a greater improvement in the FIM scale for those in combined individual and group treatment (z = -0.2544, p = 0.01). CONCLUSIONS: Group rehabilitation integrated with individual treatments is more effective than individual treatments alone in improving independence measured by the FIM™ scale. Both groups had obtained statistically significant clinical improvements, the improvement in the FIM™ scale was significantly better in the combined treatment group.

Bacterial burden and molecular characterization of Coxiella burnetii in shedding pregnant and postpartum ewes from Saint Kitts.

This study aimed to evaluate the bacterial burden and perform molecular characterization of Coxiella burnetii during shedding in pregnant (vaginal, mucus and feces) and postpartum (vaginal mucus, feces and milk) ewes from Saint Kitts. Positive IS1111 DNA (n=250) for C. burnetii samples from pregnant (n=87) and postpartum (n=74) Barbados Blackbelly ewes in a previous investigation were used for this study. Vaginal mucus (n=118), feces (n=100), and milk (n=32) positive IS1111 C. burnetii-DNA were analysed by real time qPCR (icd gene). For molecular characterization of C. burnetii, selected (n=10) IS1111 qPCR positive samples were sequenced for fragments of the IS1111 element and the 16 S rRNA gene. nBLAST, phylogenetic and haplotype analyses were performed. Vaginal mucus, feces and milk had estimated equal amounts of bacterial DNA (icd copies), and super spreaders were detected within the fecal samples. C. burnetii haplotypes had moderate to high diversity, were ubiquitous worldwide and similar to previously described in ruminants and ticks and humans.

Is there a higher risk of exposure to Coxiella burnetii for pre-clinical veterinary students?

Coxiella burnetii is globally distributed but evidence of zoonotic transmission in the Caribbean region is scarce. The bacterium presence is suspected on the Caribbean island of St. Kitts. The risk of exposure of veterinary students was reported in other regions of the world but is not documented in the Caribbean region. The present study aimed to evaluate the risk of exposure to C. burnetii for pre-clinical veterinary students (mostly coming from the U.S.) attending an island-based veterinary school. A cross-sectional study was conducted to compare incoming and outgoing veterinary students' seroprevalence. Serology was performed using indirect immunofluorescence assay to test Coxiella burnetii Phase I and Phase II immunoglobulins M and G. Background data were gathered using a standardized questionnaire. A parallel study enrolled veterinary school employees in the same university. Of the 98 participants (48 incoming and 50 outgoing students), 41 (41.8%, 95 %CI: 31.9-52.2) were seropositive to C. burnetii. There was no significant difference between the two groups (45.8% for incoming vs. 38.0% for outgoing students) (p = 0.4). No risk factors (demographic, animal handling practices or background) were significantly more reported in the seropositive group. In the employee study, the seroprevalence was high with 8/15 seropositives (53.3%, 95 %CI: 26.6-78.7). Pre-clinical veterinary students do not have a higher risk of exposure to C. burnetii by attending the veterinary school in St. Kitts, but they are highly exposed before arrival on the island (seroprevalence of 45.8%). Most of these participants had experience with animals either through farming or previous veterinary technician employment. This indicates a high exposure in the U.S. young population aiming to become veterinarians. There is an urgent need to increase C. burnetii surveillance in animals and humans to apply relevant prevention and control measures, including recommendations for vaccination of students and professionals at risk.

Update on the Geographic Distribution of the Intermediate Host Snails of Schistosoma mansoni on St. Lucia: A Step Toward Confirming the Interruption of Transmission of Human Schistosomiasis.

To provide information to guide considerations of declaring interruption of transmission of human schistosomiasis due to Schistosoma mansoni on St. Lucia, we undertook an island-wide survey in June-July 2022 to determine the presence of Biomphalaria snails, the intermediate hosts of S. mansoni, and their infection status. Snail surveys were carried out at 58 habitats to determine presence of Biomphalaria snails followed by examination of the collected snails for evidence of infection with S. mansoni. Furthermore, water samples were collected at the snail habitats and screened for presence of S. mansoni DNA using an eDNA approach. We found B. glabrata present in one habitat (Cul de Sac) where it was abundant. Specimens provisionally identified as Biomphalaria kuhniana were recovered from 10 habitats. None of the Biomphalaria specimens recovered were positive for S. mansoni. None of the eDNA water samples screened were positive for S. mansoni. Experimental exposures of both field-derived and laboratory-reared St. Lucian B. glabrata and B. kuhniana to Puerto Rican and Kenyan-derived S. mansoni strains revealed B. glabrata to be susceptible to both and B. kuhniana proved refractory from histological and snail shedding results. We conclude, given the current rarity of B. glabrata on the island and lack of evidence for the presence of S. mansoni, that transmission is unlikely to be ongoing. Coupled with negative results from recent human serological surveys, and implementation of improved sanitation and provision of safe water supplies, St. Lucia should be considered a candidate for declaration of interruption of human schistosomiasis transmission.

Coxiella burnetii shedding and serological status in pregnant and postpartum ewes.

This study aimed to evaluate the occurence C. burnetii-DNA shedding by pregnant (vaginal mucus and feces) and postpartum (vaginal mucus, feces and milk) meat breed ewes from Saint Kitts. Additionally, antibodies anti-C. burnetii were detected in serum, and milk. Barbados Blackbelly ewes (n=187) were sampled using stratified convenience cross-sectional sampling. There were two animal groups: pregnant (n=96) and postpartum (n=91). Vaginal mucus (n=187), feces (n=177) and milk (n=83) samples were subjected to a TaqMan real time qPCR assay for C. burnetii based on the IS1111 multi copy element. IgG antibodies against C. burnetii were tested in blood serum (n=187) and milk (n=61) samples, via indirect ELISA. McNemar and Fischer exact tests were used to compare occurrence between routes and between groups, respectively. Overall, 86.6% of all the animals (162/187) were shedding C. burnetti DNA through at least one route (vaginal and/or fecal and/or milk). The DNA shedding occurrence via vaginal (73% vs 51%, p-value=0.003) and fecal routes (64% vs 47%, p-value=0.001) was higher in the pregnant compared to the postpartum animals. There was no prevalent shedding route among vaginal, fecal or milk in all ewes. Overall, 38% of the ewes were seropositive for C. burnetii IgG and a total of 19.7% of the tested postpartum ewes had IgG antibodies in milk. The vaginal and fecal DNA shedding were not associated with the blood serology, nor was milk DNA shedding related to the milk serology status, thus there was no association between C. burnetii seropositivity and bacterial DNA shedding. In short, high occurrence of C. burnetii DNA shedding was observed within ewes in St. Kitts, and represents the first detection of the Q fever agent within the Caribbean islands. Bacterial shedding was more prevalent in pregnant ewes, highlighting the importance of gestating animals as a source of C. burnetii.

Efficacy and Safety of Native and Recombinant Zona Pellucida Immunocontraceptive Vaccines Formulated with Non-Freund's Adjuvants in Donkeys.

This study aimed to test zona pellucida (ZP) vaccines' immunocontraceptive efficacy and safety when formulated with non-Freund's adjuvant (6% Pet Gel A and 500 Μg Poly(I:C)). Twenty-four jennies were randomly assigned to three treatment groups: reZP (n = 7) received three doses of recombinant ZP vaccine; pZP (n = 9) received two doses of native porcine ZP; and Control group (n = 8) received two injections of placebo. Jennies were monitored weekly via transrectal ultrasonography and blood sampling for serum progesterone profiles and anti-pZP antibody titres. In addition, adverse effects were inspected after vaccination. Thirty-five days after the last treatment, jacks were introduced to each group and rotated every 28 days. Vaccination with both pZP and reZP was associated with ovarian shutdown in 44% (4/9) and 71% (4/7) of jennies, 118 ± 33 and 91 ± 20 days after vaccination, respectively (p > 0.05). Vaccination delayed the chances of a jenny becoming pregnant (p = 0.0005; Control, 78 ± 31 days; pZP, 218 ± 69 days; reZP, 244 ± 104 days). Anti-pZP antibody titres were elevated in all vaccinated jennies compared to Control jennies (p < 0.05). In addition, only mild local injection site reactions were observed in the jennies after treatment. In conclusion, ZP vaccines formulated with non-Freund's adjuvant effectively controlled reproduction in jennies with only minor localised side effects.

Efficacy and safety of native and recombinant zona pellucida immunocontraceptive vaccines in donkeys.

Feral and semi-feral donkeys are recognised as a problem in some world regions. The main problem associated with uncontrolled donkey populations is habitat degradation and competition for feed resources, especially in arid climes. Controlling population numbers would reduce the impact of donkeys and other species. While removal by various means is effective, it has been shown to stimulate reproductive rate. Probably the most effective and humane solution is reducing reproduction using minimally invasive methods including immunocontraception. This study tested the immunocontraceptive efficacy and safety of zona pellucida (ZP) vaccines, both recombinant (reZP; three treatments) and native porcine (pZP; two treatments) vaccines formulated with Freund's modified complete (primary) and Freund's incomplete (boosters) adjuvants in donkey jennies. Control jennies received adjuvants only (two treatments). Twenty-five non-pregnant jennies were randomly assigned to reZP (n = 9), pZP (n = 8) or control (n = 8) groups. Weekly monitoring of the reproductive tract and ovaries via transrectal palpation and ultrasound and inspection of injection sites was conducted and anti-pZP antibody titers were measured. Five weeks after last treatment, one donkey jack was introduced to each group and rotated every 21 days. By 232 days after last treatment the number pregnant and median days to pregnancy was 2/9 and 214 (reZP group), 1/8 and 196 (pZP group) and 8/8 and 77 (control group). Median time to ovarian shut-down was 77 (9/9) and 56 (7/8) days for reZP and pZP groups, respectively. This was observed in association with a distinct reduction in mean uterine diameter. The antibody response was equally good for both ZP-treated groups. Incorporation of Freund's adjuvants initially produced a high incidence of side effects from local swelling and intermittent lameness followed weeks later by sterile abscesses (reZP, 9/9; pZP, 7/8; control, 3/8). Both ZP vaccines effectively controlled reproduction in jennies, albeit with a high incidence of adjuvant-associated side effects.

No evidence for sylvatic cycles of chikungunya, dengue and Zika viruses in African green monkeys (Chlorocebus aethiops sabaeus) on St. Kitts, West Indies.

BACKGROUND: Dengue, chikungunya and Zika viruses (DENV, CHIKV and ZIKV) are transmitted in sylvatic transmission cycles between non-human primates and forest (sylvan) mosquitoes in Africa and Asia. It remains unclear if sylvatic cycles exist or could establish themselves elsewhere and contribute to the epidemiology of these diseases. The Caribbean island of St. Kitts has a large African green monkey (AGM) (Chlorocebus aethiops sabaeus) population and is therefore ideally suited to investigate sylvatic cycles. METHODS: We tested 858 AGM sera by ELISA and PRNT for virus-specific antibodies and collected and identified 9704 potential arbovirus vector mosquitoes. Mosquitoes were homogenized in 513 pools for testing by viral isolation in cell culture and by multiplex RT-qPCR after RNA extraction to detect the presence of DENV, CHIKV and ZIKVs. DNA was extracted from 122 visibly blood-fed individual mosquitoes and a polymorphic region of the hydroxymethylbilane synthase gene (HMBS) was amplified by PCR to determine if mosquitoes had fed on AGMs or humans. RESULTS: All of the AGMs were negative for DENV, CHIKV or ZIKV antibodies. However, one AGM did have evidence of an undifferentiated Flavivirus infection. Similarly, DENV, CHIKV and ZIKV were not detected in any of the mosquito pools by PCR or culture. AGMs were not the source of any of the mosquito blood meals. CONCLUSION: Sylvatic cycles involving AGMs and DENV, CHIKV and ZIKV do not currently exist on St. Kitts.

Infections and pathology of free-roaming backyard chickens on St. Kitts, West Indies.

Free-roaming chickens on Caribbean islands are important sentinels for local avian diseases and those introduced by birds migrating through the Americas. We studied 81 apparently healthy unvaccinated free-roaming chickens from 9 parishes on St. Kitts, an eastern Caribbean island. Using commercial ELISAs, no chickens had antibodies against avian influenza virus, West Nile virus, or Salmonella Enteritidis, although seropositivity was high to infectious bursal disease virus (86%), infectious bronchitis virus (84%), Mycoplasma (37%), and avian avulavirus 1 (Newcastle disease virus, 31%). Examination of small and large intestinal contents revealed cestodes in 79% and nematodes in 75% of the chickens. Although ectoparasites and endoparasites were common (74% and 79%, respectively), only a few chickens had lesions at postmortem examination, mainly intestinal serosal nodules (12%) and feather loss (6%). Histologic examination of 18 organs from each bird revealed lesions in high percentages of organs, mainly the liver (86%), lung (75%), spleen (60%), small intestine (56%), skin (42%), and kidney (40%). Lesions included degenerative, reactive, inflammatory, and neoplastic, and were not correlated with the serologic status of the chickens except in one case of infectious bursal disease. Microscopically, Paratanaisia bragai was seen in the kidneys of 3 chickens and intestinal coccidiasis in 1 chicken. Pulmonary silicate aggregates were common, were present in intestinal serosal nodules, and were suggestive of environmental exposure.

Mind-body therapies: an intervention to reduce work-related stress in veterinary academia.

Studies investigating perceived stress and mindfulness awareness support mind-body therapy (MBT) effectiveness in reducing stress and anxiety and, thus, has potential to decrease work-related stress. A pre/postexperimental design involved 30 faculty and staff working at Ross University School of Veterinary Medicine, Saint Kitts and Nevis, who experienced a two-day MBT intervention programme. An additional 16 faculty and staff not involved in MBT who went about their daily work schedules served as contemporary controls. Demographics, Perceived Stress Scale 10 (PSS-10), Mindful Attention Awareness Scale (MAAS), 16 Personality Factor (16PF) Openness to Change subscale and saliva cortisol concentrations were analysed. Control participants reported significantly perceived less stress (PSS-10: M=13; sd=1.4) than intervention participants (M=20; sd=6.6) during pretest. However, at post-test the intervention group reported a significant decrease in perceived stress (M=11; sd=6.0). MAAS pretest results indicated the intervention group displayed a lower average score (M=54; sd=15.3) than control participants (M=68; sd=2.0). Post-MAAS intervention scores showed improvements in mindfulness (M=63; sd=15.3). Correlations between the 16PF Openness to Change subscale and MAAS were r=0.03 and r=-0.17 for the intervention and control groups, respectively. Mean concentrations of saliva cortisol indicated a larger and significant decline in cortisol for the intervention group both during day 1 (P=0.0001) and day 2 (P=0.0008). In conclusion, these preliminary results provide support that MBTs in veterinary academia can improve psychological and physiological aspects of personal wellbeing.

Detection of Antibodies to Seven Priority Pathogens in Backyard Poultry in Trinidad, West Indies.

Backyard poultry farms in Trinidad and Tobago (T&T) play a vital role in providing food and income for rural communities. There is currently no information on the presence and circulation of pathogens in backyard poultry farms in T&T, and little is known in relation to the potential risks of spread of these pathogens to the commercial poultry sector. In order to address this, serum samples were collected from 41 chickens on five backyard farms taken from selected locations in Trinidad. Samples were tested for antibodies to seven priority pathogens of poultry by enzyme-linked immunosorbent assay (ELISA). Antibodies were detected in 65% (CI 95%: 50-78%) of the sampled birds for Infectious bronchitis virus (IBV), 67.5% (CI 95%: 52-80%) for Infectious bursal disease virus (IBDV), 10% (CI 95%: 4-23%) for Newcastle disease virus (NDV), 0% (CI 95%: 0-0%) for Avian influenza virus (AIV), 0% (CI 95%: 0-0%) for West Nile virus (WNV), 31.7% (CI 95%: 20-47%) for Mycoplasm gallisepticum/synoviae and 0% (CI 95%: 0-0%) for Salmonella enterica serotype Enteritidis. These results reveal the presence and circulation of important pathogens of poultry in selected backyard farms in Trinidad. The results provide important information which should be taken into consideration when assessing the risks of pathogen transmission between commercial and backyard poultry farms, as well as between poultry and wild birds.

Detection of West Nile Virus and other common equine viruses in three locations from the Leeward Islands, West Indies.

Equines in the West Indies are used for recreational purposes, tourism industry, racing and agriculture or can be found in feral populations. Little is known in the Caribbean basin about the prevalence of some major equine infectious diseases, some with zoonotic potential, listed as reportable by the OIE. Our objective was to study the prevalence of antibodies for West Nile Virus (WNV), Equine Herpes Virus-1 and 4 (EHV-1 and EHV-4), Equine Influenza (EI), Equine Viral Arteritis (EVA) and Equine Infectious Anemia Virus (EIAV) using a retrospective serological convenience study. We used 180 equine serum samples, 140 from horses and 40 from donkeys in St. Kitts, Nevis, and Sint Eustatius, collected between 2006 and 2015 that were tested with ELISA kits and virus neutralization (for WNV and EVA). Combining ELISA with virus neutralization testing, 25 (13.8%) equine sera were WNV positive (a mixture of indigenous and imported equines) and 3 sera (1.6%) showed doubtful results. For EHV-1, 41 equines (23.7%), mean age 6.7 years, were seropositive. For EHV-4, 138 equines were found seropositive (82.8%), mean age 6.3 years. For EI, 49 equines (27.2%), mean age 7.5 years, were seropositive on ELISA, some previously vaccinated horses. No antibodies against EAV were found on virus neutralization testing, although one animal (0.6%), was EAV positive on ELISA. All samples were EIAV negative. The seroprevalence for EHV-1 and EHV-4 is similar to other parts of the world. For the first time in the study location serologic evidence of antibodies against WNV and EI is reported. This was found in both indigenous and imported animals, highlighting the need for developing proper surveillance plans based on complementary methods of virus detection. Further studies will be needed to define the prevalence, rates of transmission, characterize local virus strains, and study their impact on these populations.

Solitary choroidal metastasis from atypical carcinoid of the lung detected by (68)Ga DOTATATE PET/CT.

A 71-year-old woman with a history of surgically treated bronchial atypical carcinoid underwent Ga DOTATATE PET/CT for restaging. Somatostatin receptor PET/CT revealed a focal area of mild radiopharmaceutical uptake corresponding to a thickening of the right choroid. No other areas of abnormal tracer uptake were detected in the rest of the body. Based on these PET/CT findings, the patient underwent examination of fundus oculi, MRI, and fluoroangiography, which confirmed the presence of a choroidal lesion interpreted as solitary choroidal metastasis of neuroendocrine tumor. Subsequently, the patient was referred for brachytherapy with radical intent.

Sucçäo näo nutritiva de recém-nascidos a termo e pré-termo: um estudo descritivo comparativo / Nonnutritive sucking of full-term infants: comparative study

A sucçäo näo nutritiva de 10 recém-nascidos pré-termo, foi avaliada e comparada à sucçäo näo nutritiva do grupo controle de 10 recém-nascidos a termo, antes da intervençäo Fonoaudiológica, após a intervençäo fonoaudio lógica, e após os bebês pré-termo ter atingido uma idade pós-conceptual equivalente aos recém-nascidos a termo. Investigou-se também, entre os recém-nascidos pré-termo de baixo peso, muito baixo peso e recém-nascidos pré-termo que foram submetidos a intubaçäo oro-traqueal, os que apresentaram maiores dificuldades de sucçäo. Todos os bebês, foram admitidos no Berçário do Hospital do Servidor Público Estadual. Os resultados indicaram que após a intervençäo Fonaudiológica, verrificou-se que houve uma evoluçäo do padräo de sucçäo dos bebês pré-termo com idade pós-conceptual equivalente aos bebês a termo, apresentaram uma defasagem no que diz respeito ao padräo de sucçäo näo nutritiva; a intervençäo Fonoaudiológica com sucçäo näo nutritiva, permite um avaliar constante do padräo da sucçäo, determinando de maneira segura se o bebê tem condiçöes de receber sucçäo nutritiva; a idade gestacional pareceu ser a maior responsável pelo padräo de sucçäo dos recém-nascidos

Aplicação do método mãe canguru para recém- nascidos a termo: avaliação do tempo de aleitamento / Use the Kangaroo-Mother Method i full-term newborns: avaliation of period of breast feeding

O objetivo do trabalho foi verificar se a manutenção do contato pele a pela, com o uso do Método Mãe Canguru, após a alta hospitalar, em recém-nascidos a termo, seria capaz de prolongar o tempo de aleitamento. A amostra foi randomizada entre o grupo GI, exposto ao Método Canguru e o grupo GII, controle. O Estudo foi dividido em três etapas. Etapa I, realizada entre o 1º e o 4º dia após o parto. Etapa II por volta do 15º dia de vida e a Etapa III por volta do 4º mês de vida. As mães do grupo GI foram mais positivas em relação aos seus filhos do que as mães do grupo GII; mantiveram o aleitamento materno exclusivo por maior tempo. Os lactentes submetidos ao Método Mãe Canguru, segundo relato das mães, charavam menos do que os lactentes não submetidos ao método, além de terem menor ocorrência de cólica. Os resultados permitem concluir que a prática do Método Mãe Canguru em recém nascidos a termo, contribui para melhorar a relação mãe/filho, para menor ocorrência de cólica no grupo exposto, diminuindo também o choro, fatores estes, que facilitaram o prolongamento do aleitamento materno exclusivo.