RETROSPECTIVE STUDY OF MORBIDITY AND MORTALITY IN A CAPTIVE POPULATION OF CRYPTOSPORIDIUM-POSITIVE LOUISIANA PINE SNAKES (PITUOPHIS RUTHVENI).

The Louisiana pine snake (Pituophis ruthveni) is a diurnal colubrid species native to Louisiana and eastern Texas whose free-ranging populations have been declining over at least the past 30 yr. The creation and maintenance of sustainable captive breeding programs of P. ruthveni to restore native populations has also provided ample opportunity for research into this species and for P. ruthveni to serve as a research model for other colubrid snakes. However, no investigation into prevalent causes of morbidity and mortality in captive populations of this species has been described. A research population of P. ruthveni was maintained at Louisiana State University (LSU) for over 4 yr due to unsuitability for breeding after testing positive for Cryptosporidium serpentis. Since arrival at LSU, the snakes were under close veterinary surveillance. Complete postmortem examinations were performed on 12 snakes that died or were euthanized. The aim of this study was to further understanding of common factors influencing morbidity and mortality in captive P. ruthveni infected with C. serpentis, by retrospectively reviewing postmortem exam findings from the 12 deceased members of the population at LSU. A predominant finding across individuals included bacterial infections, which were responsible for major illness or death in 37.5% of the animals. Fifty percent of snakes tested positive for Cryptosporidium sp. based on PCR performed from postmortem samples; it was directly implicated as cause of death or morbidity in 83.3% of positive cases. Although infectious disease represented the most common pathologic postmortem finding, several noninfectious disease processes were identified, including gout, goiter, and neoplasia. These findings mirror those of other retrospective investigations of reptile collections at various institutions and highlight the need for appropriate emphasis on the identification, treatment, and prevention of infectious disease as part of routine veterinary care.

Risk factors for death among children 0-59 months of age with moderate-to-severe diarrhea in Manhiça district, southern Mozambique

In spite of very significant decreasing trends in the last three decades, childhood mortality remains unacceptably high globally, with 5.6 million children dying every year before reaching their 5th birthday, the majority of which in low and middle-income countries (LMIC) [1]. Diarrheal diseases still represent a major cause of morbidity and mortality in childhood, and are believed to account for 499,000­526,000 annual child deaths, nearly 9% of all under five global mortality [2, 3], in spite of the good intake of life-saving interventions such as oral rehydration solution (ORS) [3] and the rotavirus vaccine [4]. Deaths in sub-Saharan Africa and Southeast Asia account for ~ 78% of deaths due to diarrhea worldwide [5, 6], underscoring the inequities related to this particular syndrome. The Global Enteric Multi-center Study (GEMS) reported that most episodes of moderate-to-severe diarrhea (MSD) among children under 5 years old were primarily due to four pathogens: Rotavirus, Cryptosporidium, Enterotoxigenic Escherichia coli (ST-ETEC), and Shigella [7]. The risk of dying from diarrheal disease was reported to be higher among children younger than 2 years of age, albeit with relatively different rates from one region to another [7]. The advent of the HIV/AIDS pandemic has also changed the incidence [8], clinical presentation and outcome of diarrheal diseases, as the immunosuppression derived from the infection favors a higher incidence of gastrointestinal infections, not only from "classical" diarrhea pathogens, but also from more aggressive opportunistic infections, typical of the immunocompromised host. This has resulted in significant changes in the last decades in the spectrum, clinical presentation, duration and prognosis of diarrheal episodes in those countries where HIV is highly prevalent [9, 10].