H9N2 avian influenza virus dispersal along Bangladeshi poultry trading networks.

Avian influenza virus subtype H9N2 is endemic in Bangladesh's poultry population. The subtype affects poultry production and poses a potential zoonotic risk. Insufficient understanding of how the poultry trading network shapes the dissemination of avian influenza viruses has hindered the design of targeted interventions to reduce their spread. Here, we use phylodynamic analyses of haemagglutinin sequences to investigate the spatial spread and dispersal patterns of H9N2 viruses in Bangladesh's poultry population, focusing on its two largest cities (Dhaka and Chattogram) and their poultry production and distribution networks. Our analyses suggest that H9N2 subtype avian influenza virus lineage movement occurs relatively less frequently between Bangladesh's two largest cities than within each city. H9N2 viruses detected in single markets are often more closely related to viruses from other markets in the same city than to each other, consistent with close epidemiological connectivity between markets. Our analyses also suggest that H9N2 viruses may spread more frequently between chickens of the three most commonly sold types (sunali-a cross-bred of Fayoumi hen and Rhode Island Red cock, deshi-local indigenous, and exotic broiler) in Dhaka than in Chattogram. Overall, this study improves our understanding of how Bangladesh's poultry trading system impacts avian influenza virus spread and should contribute to the design of tailored surveillance that accommodates local heterogeneity in virus dispersal patterns.

Continuing professional development for veterinarians in a changing world.

The veterinary profession has time and again successfully adapted to new challenges and developments, with considerable evolution of the skills needed. Different contexts, production systems and societal requirements continue to shape the profession, resulting in an increasing demand for specialisation, interdisciplinary collaboration along value chains, and preparedness for the omnipresent risk of emerging diseases. To keep up with changes, new insights, advances in research and novel ways to address challenges, continuing professional development (CPD) and the adaptation and updating of the veterinary curriculum have been essential to maintain and enhance the quality and performance of Veterinary Services. This paper reviews actors involved in the provision of Veterinary Services and discusses how vital CPD is in addressing current and future challenges, by focusing on veterinarians and allied veterinary professionals. The authors examine how providers of CPD contribute to the system and how the internal and external factors of a cohort or individual affect the quality and impact of capacity development. The paper further examines the landscape of veterinary CPD in terms of organisational structures, pedagogical approaches, the transition from input- to outcome-based learning, modern delivery tools, and the demands on the different actors involved in the delivery of animal health services. The authors conclude that CPD is essential if the quality of Veterinary Services is to keep pace with the ever-increasing and evolving demands of the 21st century. A CPD programme should therefore be constructed in a way that is tailored to the needs of veterinary professionals and to the requirements of their workplace, whether they work with animal keepers, livestock value chains, national governments or international regulatory bodies. An optimised and successful veterinary sector requires an evidencebased CPD programme that keeps those professionals who are involved in the delivery of animal health services both competent and relevant in a changing world.

La profession vétérinaire s'est adaptée à maintes reprises et avec succès à de nouveaux défis et évolutions qui ont nécessité la mobilisation d'un grand nombre de compétences nouvelles. La diversité des contextes, des systèmes de production et des exigences sociétales impose à la profession vétérinaire des transformations continues, avec pour conséquences une demande croissante de spécialisation et de collaborations interdisciplinaires le long des chaînes de valeur et la nécessité de mieux se préparer au risque omniprésent de maladies émergentes. Face aux changements intervenus, aux nouvelles connaissances, aux progrès de la recherche et aux nouvelles manières de relever les défis, la formation professionnelle continue (FPC) et l'adaptation et actualisation des cursus d'enseignement vétérinaire ont joué un rôle déterminant pour maintenir et améliorer la qualité et les performances des Services vétérinaires. Les auteurs font le point sur les divers prestataires de services vétérinaires et examinent le rôle essentiel de la FPC pour relever les défis actuels et futurs, en mettant l'accent sur les vétérinaires et les professions connexes travaillant en lien avec les vétérinaires. Ils analysent la contribution des fournisseurs de FPC au système de santé animale, ainsi que l'influence sur la qualité et l'impact du renforcement des capacités d'un certain nombre de facteurs internes et externes à l'échelle des cohortes ou des individus. Les auteurs décrivent également le paysage de la FPC dans le domaine vétérinaire et plus particulièrement les structures organisationnelles, les approches pédagogiques, la transition d'un apprentissage axé sur les contenus à un apprentissage axé sur les résultats, les outils modernes de formation et les exigences imposées aux différents prestataires de services de santé animale dans un monde en constante évolution. En conclusion, les auteurs insistent sur l'importance cruciale de mettre en place des dispositifs de formation professionnelle continue destinés au secteur vétérinaire, afin que la qualité des services fournis soit à la hauteur des exigences croissantes et en constante évolution du 21e siècle. Les programmes de FPC doivent donc être conçus en veillant à s'adapter aux besoins des vétérinaires et des professionnels des domaines connexes concernant les compétences spécifiques qu'ils doivent déployer en fonction des exigences de leur activité, qu'ils travaillent auprès des gardiens d'animaux, des professionnels des filières issues de l'élevage, des gouvernements nationaux ou des organismes internationaux chargés de l'élaboration de normes. Un secteur vétérinaire optimisé et performant nécessite un programme de FPC fondé sur des données concrètes afin que les vétérinaires et les autres prestataires de services de santé animale puissent maintenir leur niveau de compétences ainsi que la pertinence de leurs interventions au regard des exigences évolutives d'un monde en pleine transformation. La profession vétérinaire s'est adaptée à maintes reprises et avec succès à de nouveaux défis et évolutions qui ont nécessité la mobilisation d'un grand nombre de compétences nouvelles. La diversité des contextes, des systèmes de production et des exigences sociétales impose à la profession vétérinaire des transformations continues, avec pour conséquences une demande croissante de spécialisation et de collaborations interdisciplinaires le long des chaînes de valeur et la nécessité de mieux se préparer au risque omniprésent de maladies émergentes. Face aux changements intervenus, aux nouvelles connaissances, aux progrès de la recherche et aux nouvelles manières de relever les défis, la formation professionnelle continue (FPC) et l'adaptation et actualisation des cursus d'enseignement vétérinaire ont joué un rôle déterminant pour maintenir et améliorer la qualité et les performances des Services vétérinaires. Les auteurs font le point sur les divers prestataires de services vétérinaires et examinent le rôle essentiel de la FPC pour relever les défis actuels et futurs, en mettant l'accent sur les vétérinaires et les professions connexes travaillant en lien avec les vétérinaires. Ils analysent la contribution des fournisseurs de FPC au système de santé animale, ainsi que l'influence sur la qualité et l'impact du renforcement des capacités d'un certain nombre de facteurs internes et externes à l'échelle des cohortes ou des individus. Les auteurs décrivent également le paysage de la FPC dans le domaine vétérinaire et plus particulièrement les structures organisationnelles, les approches pédagogiques, la transition d'un apprentissage axé sur les contenus à un apprentissage axé sur les résultats, les outils modernes de formation et les exigences imposées aux différents prestataires de services de santé animale dans un monde en constante évolution. En conclusion, les auteurs insistent sur l'importance cruciale de mettre en place des dispositifs de formation professionnelle continue destinés au secteur vétérinaire, afin que la qualité des services fournis soit à la hauteur des exigences croissantes et en constante évolution du 21e siècle. Les programmes de FPC doivent donc être conçus en veillant à s'adapter aux besoins des vétérinaires et des professionnels des domaines connexes concernant les compétences spécifiques qu'ils doivent déployer en fonction des exigences de leur activité, qu'ils travaillent auprès des gardiens d'animaux, des professionnels des filières issues de l'élevage, des gouvernements nationaux ou des organismes internationaux chargés de l'élaboration de normes. Un secteur vétérinaire optimisé et performant nécessite un programme de FPC fondé sur des données concrètes afin que les vétérinaires et les autres prestataires de services de santé animale puissent maintenir leur niveau de compétences ainsi que la pertinence de leurs interventions au regard des exigences évolutives d'un monde en pleine transformation. La profession vétérinaire s'est adaptée à maintes reprises et avec succès à de nouveaux défis et évolutions qui ont nécessité la mobilisation d'un grand nombre de compétences nouvelles. La diversité des contextes, des systèmes de production et des exigences sociétales impose à la profession vétérinaire des transformations continues, avec pour conséquences une demande croissante de spécialisation et de collaborations interdisciplinaires le long des chaînes de valeur et la nécessité de mieux se préparer au risque omniprésent de maladies émergentes. Face aux changements intervenus, aux nouvelles connaissances, aux progrès de la recherche et aux nouvelles manières de relever les défis, la formation professionnelle continue (FPC) et l'adaptation et actualisation des cursus d'enseignement vétérinaire ont joué un rôle déterminant pour maintenir et améliorer la qualité et les performances des Services vétérinaires. Les auteurs font le point sur les divers prestataires de services vétérinaires et examinent le rôle essentiel de la FPC pour relever les défis actuels et futurs, en mettant l'accent sur les vétérinaires et les professions connexes travaillant en lien avec les vétérinaires. Ils analysent la contribution des fournisseurs de FPC au système de santé animale, ainsi que l'influence sur la qualité et l'impact du renforcement des capacités d'un certain nombre de facteurs internes et externes à l'échelle des cohortes ou des individus. Les auteurs décrivent également le paysage de la FPC dans le domaine vétérinaire et plus particulièrement les structures organisationnelles, les approches pédagogiques, la transition d'un apprentissage axé sur les contenus à un apprentissage axé sur les résultats, les outils modernes de formation et les exigences imposées aux différents prestataires de services de santé animale dans un monde en constante évolution. En conclusion, les auteurs insistent sur l'importance cruciale de mettre en place des dispositifs de formation professionnelle continue destinés au secteur vétérinaire, afin que la qualité des services fournis soit à la hauteur des exigences croissantes et en constante évolution du 21e siècle. Les programmes de FPC doivent donc être conçus en veillant à s'adapter aux besoins des vétérinaires et des professionnels des domaines connexes concernant les compétences spécifiques qu'ils doivent déployer en fonction des exigences de leur activité, qu'ils travaillent auprès des gardiens d'animaux, des professionnels des filières issues de l'élevage, des gouvernements nationaux ou des organismes internationaux chargés de l'élaboration de normes. Un secteur vétérinaire optimisé et performant nécessite un programme de FPC fondé sur des données concrètes afin que les vétérinaires et les autres prestataires de services de santé animale puissent maintenir leur niveau de compétences ainsi que la pertinence de leurs interventions au regard des exigences évolutives d'un monde en pleine transformation.

La profesión veterinaria siempre ha sabido adaptarse con éxito a las novedades y nuevos problemas que han ido surgiendo, y que requieren la adquisición de nuevos conocimientos y aptitudes. Los diferentes contextos, sistemas productivos y necesidades sociales siguen configurando la profesión veterinaria y generando una creciente demanda de especialización, de colaboración interdisciplinar en todos los eslabones de las cadenas de valor y de preparación ante el omnipresente riesgo que plantean las enfermedades emergentes. El perfeccionamiento profesional continuo (PPC) y la adaptación y actualización de los planes de estudios veterinarios han sido factores esenciales para seguir el ritmo de las transformaciones, las nuevas ideas, los avances científicos y las novedosas respuestas a los problemas y, gracias a ello, mantener y mejorar la calidad y el desempeño de los Servicios Veterinarios. Los autores pasan revista a cuantos agentes intervienen en la prestación de servicios veterinarios y, centrándose en los veterinarios y cuerpos profesionales conexos, exponen la función crucial que cumple el PPC para hacer frente a los problemas de hoy y de mañana. También explican cómo contribuyen al sistema los proveedores de PPC y cómo los factores internos y externos de una cohorte o un individuo afectan a la calidad y la repercusión del desarrollo de capacidades. Además, describen el panorama que ofrece el PPC en veterinaria desde el punto de vista de las estructuras organizativas, los planteamientos pedagógicos, la transición del aprendizaje de asimilación al aprendizaje por resultados, las modernas herramientas de trabajo y las exigencias que deben satisfacer los distintos agentes que intervienen en la prestación de servicios zoosanitarios en un mundo en plena evolución. Los autores concluyen que es de la máxima importancia ocuparse del PPC para que los servicios veterinarios dispensados sigan siendo de calidad y respondiendo a las crecientes y mudables exigencias que trae consigo el siglo XXI. Hay que establecer pues un programa de PPC especialmente adaptado a las necesidades de los veterinarios y cuerpos profesionales conexos, pensando en dotarlos de las competencias necesarias para satisfacer los requisitos propios de su lugar de trabajo, ya obren al servicio de la producción animal, de cadenas de valor ganaderas, de administraciones nacionales o de organismos internacionales de reglamentación. Un sector veterinario optimizado y eficaz requiere un programa de PPC científicamente fundamentado, que sirva a los veterinarios y demás agentes de la prestación de servicios zoosanitarios para seguir siendo a la vez competentes y útiles ante las cambiantes exigencias que les plantea un mundo en plena evolución.

Planetary boundaries and Veterinary Services.

National Veterinary Services (NVS) play a crucial role in animal health, production and welfare. They are also intimately involved with safeguarding global health security and the health of the planet. Climate change is just one of the nine planetary boundaries (PBs), i.e. Earth system processes, that can be used to monitor the vital signs of our living planet. In this paper, the authors identify the positive and negative impacts of humaninduced management of aquatic and terrestrial animals in relation to these PBs. In the context of NVS, the authors provide an overview of the real and potential impacts of NVS policies on Earth systems and offer suggestions as to how new sustainability paradigms may assist with reviewing and revising NVS mandates and facilitating stakeholder engagement. Opportunities are proposed for the World Organisation for Animal Health to contribute to the global debate on the role of aquatic and terrestrial animal agriculture and wildlife in sustainable development. In addition, the paper suggests that a wider debate is required in relation to recent significant increases in domestic animal populations and PBs. Intersectoral and interdisciplinary collaboration are required to achieve the transformation of the framework in which NVS operate. While such transformations cannot be driven by the veterinary profession alone, veterinarians have proven very effective operators in the One Health arena. By building on these intersectoral linkages, it will be possible for our profession and NVS to actively contribute to the crucial discussions and transformations required to pull Earth system metrics back within safe boundaries.

Les Services vétérinaires nationaux jouent un rôle crucial dans les domaines de la santé animale, de la production animale et du bien-être des animaux. Mais ils sont aussi fortement engagés dans la protection de la sécurité sanitaire mondiale et de la santé de la planète. Le changement climatique est l'une des neuf frontières planétaires existantes, c'est-à-dire les neuf processus du système terrestre qui peuvent nous aider à surveiller les signes vitaux de notre planète vivante. Les auteurs font le point sur les impacts positifs et négatifs de la gestion par l'homme des animaux aquatiques et terrestres dans la perspective de ces frontières planétaires. S'agissant des Services vétérinaires nationaux, les auteurs donnent un aperçu de l'impact réel des politiques des Services vétérinaires sur les systèmes terrestres ainsi que des possibilités en la matière et font quelques propositions pour que les mandats de ces Services soient repensés et modifiés et la participation des parties prenantes facilitée à la lumière des nouveaux paradigmes de durabilité. Ils évoquent plusieurs occasions au cours desquelles l'Organisation mondiale de la santé animale (OIE) pourrait contribuer aux discussions à l'échelle mondiale sur le rôle des animaux terrestres et aquatiques, tant d'élevage que sauvages, dans le développement durable. En outre, les auteurs estiment qu'un débat plus général est nécessaire concernant l'augmentation récente et significative des populations d'animaux domestiques et les frontières planétaires. Une collaboration intersectorielle et interdisciplinaire sera nécessaire pour transformer le cadre dans lequel interviennent les Services vétérinaires nationaux. Certes, une transformation de cette nature ne peut être menée par la profession vétérinaire seule, mais les vétérinaires ont déjà fait preuve de l'efficacité de leurs capacités opérationnelles dans l'arène Une seule santé. En s'appuyant sur ces liens intersectoriels, la profession vétérinaire et les Services vétérinaires nationaux seront à même de contribuer activement aux discussions cruciales ainsi qu'aux transformations indispensables pour ramener les variables mesurables de la Terre à l'intérieur de frontières sûres.

La función de los Servicios Veterinarios nacionales, además de ser crucial para la sanidad, la producción y el bienestar animales, guarda estrecha relación con la salvaguarda de la seguridad sanitaria mundial y la salud del planeta. El cambio climático es solo uno de los nueve límites planetarios, esto es, procesos del sistema terrestre, que cabe utilizar para seguir de cerca los signos vitales del ser vivo que es nuestro planeta. Los autores exponen los efectos tanto positivos como negativos que en relación con estos límites planetarios trae consigo la gestión antrópica de animales acuáticos y terrestres. Por lo que respecta a los Servicios Veterinarios nacionales, los autores presentan a grandes líneas las repercusiones que las políticas de estos Servicios Veterinarios tienen o pueden tener en los sistemas terrestres y proponen fórmulas para que los nuevos paradigmas de la sostenibilidad ayuden a examinar y revisar el mandato de los Servicios Veterinarios nacionales y a facilitar la participación de los demás interlocutores. También señalan las oportunidades que tiene ante sí la Organización Mundial de Sanidad Animal para contribuir a las deliberaciones mundiales sobre la función de la producción de animales acuáticos y terrestres y de la gestión de la fauna silvestre con vistas al desarrollo sostenible. Los autores, además, consideran necesario un debate más amplio en relación con el reciente y considerable crecimiento de las poblaciones de animales domésticos y los límites planetarios. Para lograr una transformación de las coordenadas en las que operan los Servicios Veterinarios de los países se requiere una colaboración tanto intersectorial como interdisciplinar. Aunque estos cambios no pueden venir únicamente de la mano de la profesión veterinaria, la labor de los veterinarios en el ruedo de Una sola salud ha demostrado que son agentes muy eficaces. Profundizando en estos vínculos intersectoriales, será posible que nuestra profesión y los Servicios Veterinarios nacionales contribuyan activamente a las cruciales deliberaciones y transformaciones que se necesitan para que el valor de los parámetros del sistema terrestre vuelva a situarse dentro de los márgenes de seguridad.

A large-scale study of a poultry trading network in Bangladesh: implications for control and surveillance of avian influenza viruses.

BACKGROUND: Since its first report in 2007, avian influenza (AI) has been endemic in Bangladesh. While live poultry marketing is widespread throughout the country and known to influence AI dissemination and persistence, trading patterns have not been described. The aim of this study is to assess poultry trading practices and features of the poultry trading networks which could promote AI spread, and their potential implications for disease control and surveillance. Data on poultry trading practices was collected from 849 poultry traders during a cross-sectional survey in 138 live bird markets (LBMs) across 17 different districts of Bangladesh. The quantity and origins of traded poultry were assessed for each poultry type in surveyed LBMs. The network of contacts between farms and LBMs resulting from commercial movements of live poultry was constructed to assess its connectivity and to identify the key premises influencing it. RESULTS: Poultry trading practices varied according to the size of the LBMs and to the type of poultry traded. Industrial broiler chickens, the most commonly traded poultry, were generally sold in LBMs close to their production areas, whereas ducks and backyard chickens were moved over longer distances, and their transport involved several intermediates. The poultry trading network composed of 445 nodes (73.2% were LBMs) was highly connected and disassortative. However, the removal of only 5.6% of the nodes (25 LBMs with the highest betweenness scores), reduced the network's connectedness, and the maximum size of output and input domains by more than 50%. CONCLUSIONS: Poultry types need to be discriminated in order to understand the way in which poultry trading networks are shaped, and the level of risk of disease spread that these networks may promote. Knowledge of the network structure could be used to target control and surveillance interventions to a small number of LBMs.

Incidence of contamination of live bird markets in Bangladesh with influenza A virus and subtypes H5, H7 and H9.

In the absence of robust active surveillance of avian influenza viruses (AIV) affecting poultry in South Asian countries, monitoring of live bird markets (LBMs) can be an alternative. In a longitudinal study of 32 LBM, five environments were sampled as follows: market floor, stall floor, slaughter area, poultry holding cage and water used for meat processing. Samples were taken monthly for 5 months, September 2013-January 2014. Incidence rates (IRs) of LBM contamination with AIV and its subtypes H5, H7 and H9 were assessed. In 10 of the LBM selected, biosecurity measures had been implemented through FAO interventions: the other 22 were non-intervened. Standard procedures were applied to detect AIV and three subtypes in pooled samples (1:5). An LBM was considered positive for AIV or a subtype if at least one of the pooled samples tested positive. The incidence rates of LBM contamination with AIV, H5, H7 and H9 were 0.194 (95% confidence interval (CI) 0.136-0.276), 0.031 (95% CI 0.013-0.075), 0 and 0.175 (95% CI 0.12-0.253) per LBM-month at risk, respectively. The log IR ratio between the FAO-intervened and non-intervened LBM for contamination with AIV was -0.329 (95% CI -1.052 to -0.394, p = .372), 0.598 (95% CI -1.593 to 2.789, p = .593) with subtype H5 and -0.500 (95% CI -1.249 to 0.248, p = .190) with subtype H9, indicating no significant difference. The results obtained suggest that both H5 and H9 were circulating in LBM in Bangladesh in the second half of 2013. The incidence of contamination with H9 was much higher than with H5.

Biosecurity and Circulation of Influenza A (H5N1) Virus in Live-Bird Markets in Bangladesh, 2012.

Bangladesh has been considered as one of the five countries endemic with highly pathogenic avian influenza A subtype H5N1 (HPAI H5N1). Live-bird markets (LBMs) in south Asian countries are believed to play important roles in the transmission of HPAI H5N1 and others due to its central location as a hub of the poultry trading. Food and Agriculture Organization (FAO) of the United Nations has been promoting improved biosecurity in LBMs in Bangladesh. In 2012, by enrolling 32 large LBMs: 10 with FAO interventions and 22 without assistance, we assessed the virus circulation in the selected LBMs by applying standard procedures to investigate market floors, poultry stall floors, poultry-holding cases and slaughter areas and the overall biosecurity using a questionnaire-based survey. Relative risk (RR) was examined to compare the prevalence of HPAI H5N1 in the intervened and non-intervened LBMs. The measures practised in significantly more of the FAO-intervened LBMs included keeping of slaughter remnants in a closed container; decontamination of poultry vehicles at market place; prevention of crows' access to LBM, market/floor cleaning by market committee; wet cleaning; disinfection of floor/poultry stall after cleaning; and good supply of clean water at market (P < 0.05). Conversely, disposal of slaughter remnants elsewhere at market and dry cleaning were in operation in more of the FAO non-intervened LBMs (P < 0.05). The RR for HPAI H5N1 in the intervened and non-intervened LBMs was 1.1 (95% confidence interval 0.44-2.76), suggesting that the proportion positive of the virus in the two kinds of LBM did not vary significantly (P = 0.413). These observations suggest that the viruses are still maintained at the level of production in farms and circulating in LBMs in Bangladesh regardless of interventions, albeit at lower levels than in other endemic countries.

Systemic lupus erythematosus presenting as acute lupus pneumonitis in a young female.

Acute lupus pneumonitis is a rare initial presentation of systemic lupus erythematosus (SLE). We report a 19-year-old female presenting with fever and recurrent hemoptysis with radiological evidence of parenchymal lung involvement with mild pleural effusion. Subsequent development of malar and discoid rash with anti-nuclear antibodies (ANA) and anti-dsDNA positivity clinched the diagnosis. Her clinical signs and symptoms resolved with a course of intravenous pulse methyl-prednisolone along with radiological resolution.

Factors limiting the health of semi-scavenging ducks in Bangladesh.

Duck rearing is well suited to coastal and lowland areas in Bangladesh. It is an important component of sustainable livelihood strategies for poor rural communities as an additional source of household income. An epidemiological study was conducted during January 2005-June 2006 on 379 households in Chatkhil of the Noakhali District, Bangladesh which were using the recently devised "Bangladesh duck model". The overall objective of the study was to identify factors that significantly contributed to mortality and constrained productivity and to generate sufficient knowledge to enable establishment of a disease surveillance system for household ducks. The overall mortality was 15.0% in Chatkhil, with predation causing a significantly higher mortality compared with diseases (p < 0.001). Common diseases were duck plague and duck cholera. Morbid ducks frequently displayed signs associated with diseases affecting the nervous and digestive systems. Haemorrhagic lesions in various organs and white multiple foci on the liver were frequently observed in dead ducks. Epidemiological analysis with a shared frailty model that accounted for clustering of data by farm was used to estimate the association between survival time and risk factors. The overall mortality rate due to disease was significantly lower in vaccinated than in non-vaccinated ducks in all zones except zone 2 (p < 0.001). Only vaccinated ducks survived in zone 1. In conclusion, duck mortality and untimely sale of ducks appeared to be important constraints for household duck production in Chatkhil. Vaccination against duck plague appears to be an effective preventive strategy in reducing the level of associated duck mortality. A successful network was established amongst farmers and the surveillance team through which dead ducks, with accompanying information, were readily obtained for analysis. Therefore, there is an opportunity for establishing a long-term disease surveillance programme for rural ducks in Chatkhil of the Noakhali District of Bangladesh.

Monitoring the health and production of household Jinding ducks on Hatia Island of Bangladesh.

Duck rearing is an important component of sustainable living in poor rural communities, especially as a source of subsistence. A study was conducted on 118 households (N = 1,373 Jinding ducks, Anas platyrhynchus) from December 2002 to February 2004 on Hatia Island in Bangladesh with the aim of identifying the factors that limit the health and production of Jinding ducks. Overall duck mortality was 29.3%, with disease (19.7%) being a more significant factor than predation (9.6%; p = 0.001). Duck mortality also varied significantly among study zones (p < 0.001). Common diseases were duck plague (21.1%) and duck cholera (32.1%). Helminth infection was prevalent, with endemic trematode (Prosthogonimus spp., Trichobilharzia spp., Echinostoma spp.) and nematode (Cyathostoma bronchialis, Amidostomum anseris, Heterakis gallinarum, Capillaria spp., and Echinuria spp.) infections and epidemic cestode infections due to Hymenolepsis setigera. The median egg production rate per duck per household was 93 for a 6-month laying period. The odds of diminished egg production (average ≤ 93 eggs per duck per household for a 6-month laying period) was 25.4 times higher in ducks that were kept in traditional duck houses (p < 0.001) and 14.2 times higher in ducks that experienced delays in the onset of sexual maturity (days 191 and 280; p < 0.001). Ducks that were provided snails for a shorter period of time over the laying period were 18.2 times more likely to produce fewer eggs than their longer fed peers (p = 0.002). In conclusion, duck mortalities due to diseases and predation and parasitic infections appear to be common constraints on household duck production on Hatia Island. Additionally, improving duck housing and providing longer nutritional supplementation with snails increased the production capabilities of household-raised Jinding ducks on Hatia Island.

Mortality rate and clinical features of highly pathogenic avian influenza in naturally infected chickens in Bangladesh.

A retrospective study was performed to assess the mortality rates and clinical signs in commercial and backyard chickens naturally infected with the highly pathogenic avian influenza (HPAI) H5N1 virus in Bangladesh. All of the 33 commercial and 25 backyard farms, recorded during the first wave of HPAI outbreaks (January to November 2007) in Bangladesh, were enrolled in this study. The farm profile data, stock information and major clinical signs recognised by the farmers and/or farm attendants, were collected through a prototype questionnaire. The investigating veterinarians' retrospective appraisals of the clinical signs were recorded by interview. After the clinical onset, the incidence rates of mortality in breeder, commercial broiler, commercial layer and backyard chickens were, respectively: 0.0215, 0.0341, 0.0179 and 0.0703 per chicken-day at risk. The four major clinical signs observed were cyanotic combs and wattles, oedema of the head and face, drowsiness and huddling and ecchymotic discoloration of the leg shanks. The first sign (cyanotic combs and wattles) was equally observed in chickens from commercial and backyard farms (p = 0.44) but the second (oedema of the head and face) was more common in backyard farms (p = 0.03).

Factors limiting traditional household duck production in Bangladesh.

A cross sectional survey of duck production was carried out in 2002 on 771 traditional, semiscavenging household duck farms on the coastal Island of Hatia. We determined the socioeconomic characteristics of duck farmers and their management systems, identified the factors associated with egg production, and measured the level of selected duck diseases and current preventive strategies. Household family size varied from 1 to 14 individuals and women were the main caretakers of ducks. Around 34% of keepers were illiterate. Most duck products (eggs and meat; 85%) were sold at the local market. Duck houses were poorly ventilated and a variety of bedding materials were used. Feed was available in nearby scavenging areas; however, additional feed was frequently supplied by farmers. Almost all farmers (96%) ranked the rainy season as the best time for rearing ducks due to greater feed availability. The annual egg production was 79 eggs per layer with a weight of 48 g and a hatchability rate of 87%. Egg production varied by zone (p < 0.05). The odds of suboptimal egg production was 0.5 times lower in educated farmers (p = 0.001). The odds of suboptimal egg production was 2.5 times more likely in ducks that attained sexual maturity at >22 weeks (p<0.001). Most farmers ranked duck plague as the most important disease, followed by duck cholera, botulism, and duck viral hepatitis. Preventive vaccination was sporadic and used by few farmers (28%). There are significant opportunities for improved duck production on the Island of Hatia and in Bangladesh generally.

Bacterial incidence and antibiotic sensitivity pattern in moderate and severe infections in hospitalised patients.

Infectious diseases are among the leading causes of death and sometimes curable. Bacteria are the most common aetiology in hospitalised patients. Objectives of this study were to evaluate the incidence of bacterial infections and their pattern of susceptibility to antibiotics in moderate and severe infections in hospitalised patients. The study was performed in the apical teaching hospital of West Bengal in the first half of 2005. Patients admitted in medical wards and medical ICU, suffering from moderate and severe infections having APACHE-II score > 5 were studied. Clinical evaluation, routine and specific investigations were done in each case. Microbiological samplings were tried on day 1, after completion of antibiotic therapy and in between as required. Aerobic BACTEC bacterial culture and sensitivity tests were done. Pending initial culture and sensitivity report empiric antibiotic therapy was started, which was modified on getting the culture and sensitivity report. Outcome was observed as no response, cured, resolved, inconclusive, died and left against medical advice. Out of 40 patients total number of samples were 54 and that of sites of infections were 48. Primary site could not be detected in 11 infections (22.9%). Commonest form was urinary tract infection and abdominal infection in community acquired infection (n=18) and pneumonia in hospital acquired infection (n = 15). Culture was positive in 33 (61.11%), Gram-negative infection was more common in general, but incidence of Gram-positive infection was also quite high and Gram-positive infection was more common in community acquired infection. In general S aureus was most common bacteria -8 (24.24%). In community acquired infection S aureus 4 (22.22%) predominated followed by E coli and in hospital acquired infection S aureus -4 (26.66%) followed by E coli and P aeruginosa. Incidence of methicillin resistant Staph aureus was low. But it constituted 50% of S aureus. No methicillin resistant Staph aureus was found in community acquired infection. Two isolates of vancomycin intermediate sensitive Staph aureus were observed. Methicillin resistant Staph aureus showed maximum sensitivity to linezolid (100%) and all methicillin resistant Staph aureus but one vancomycin intermediate sensitive Staph aureus were sensitive to vancomycin. Coagulase negative Staph aureus were all sensitive to vancomycin and linezolid. Gram-negatives were mostly resistant to aminoglycosides and P aeruginosa were all sensitive to aztreonam. Single strain of S typhi as isolated was resistant to ceftriaxone and ciprofloxacin. P miribalis, P aeruginosa and coagulase negative Staph aureus were notoriously multidrug resistant; 82.5% of cases responded to treatment of which 35% were cured microbiologically. Gram-negative infection was more common overall, but incidence of Gram-positive infection was also very high. Gram-negative infections were responsible for more severe infections and case fatality. Multidrug resistant Gram-positive infections are rising.

Risk factors for infection with highly pathogenic influenza A virus (H5N1) in commercial chickens in Bangladesh.

A matched case-control study was carried out to identify risk factors for highly pathogenic avian influenza A virus (subtype H5N1) infection in commercial chickens in Bangladesh. A total of 33 commercial farms diagnosed with H5N1 before September 9, 2007, were enrolled as cases, and 99 geographically matched unaffected farms were enrolled as control farms. Farm data were collected using a pretested questionnaire, and analysed by matched-pair analysis and multivariate conditional logistic regression. Two factors independently and positively associated with H5N1 infection remained in the final model. They were 'farm accessible to feral and wild animals' (odds ratio [OR] 5.71, 95 per cent confidence interval [CI] 1.81 to 18.0, P=0.003) and 'footbath at entry to farm/shed' (OR 4.93, 95 per cent CI 1.61 to 15.1, P=0.005). The use of a designated vehicle for sending eggs to a vendor or market appeared to be a protective factor (OR 0.14, 95 per cent CI 0.02 to 0.88, P=0.036).

Serosurvey of five viruses in chickens on smallholdings in Bangladesh.

A serologic survey was undertaken in chickens in smallholdings in Bangladesh for avian influenza A virus (AIV), egg drop syndrome '76 virus (EDS'76V), infectious bronchitis virus (IBV), Newcastle disease virus (NDV) and reovirus (RV) in three phases: January 2002-May 2003, September 2003-August 2004, and August 2005-March 2006. Four hundred thirty-six sera collected in the 2nd phase, 295 in the first phase, 755 in the 1st plus 2nd phases and 295 in the 1st phase were investigated for AIV, EDS'76V, IBV and RV, respectively, using enzyme linked immunosorbent assays. All 854 sera collected in the three phases were screened for NDV using hemagglutination inhibition test. In chickens 20% were seropositive to AIV, 3% to EDS'76V, 74% to IBV, 88% to NDV, and 47% to RV. The seroprevalence in flocks was 23% to AIV, 6% to EDS'76V, 79% to IBV, 89% to NDV and 56% to RV. Twenty-five percent chickens had > or = 10log(2)HI titers to NDV.

Opportunistic infections of central nervous system in AIDS.

HIV/AIDS is a new epidemic in current century. Predominant route of transmission is sexual. Virtually all systems are affected either directly by virus or by oppurtunistic infections or by malignancy. Neurological complications may occur at any stage of disease. Clinical manifestations may be acute, subacute or chronic. Presentation and diagnosis are often confusing. Central nervous system toxoplasmosis and tuberculous meningitis are commonest opportunistic infections in advanced HIV patients. Patients frequently present with focal neurodeficit. Mortality is high i.e., 13 (54%) out of 24 cases of opportunistic infectious in the study carried out at the SSKM Hospital during the period January 2005 to December 2006.

Survivability and causes of loss of broody-hen chicks on smallholder households in Bangladesh.

We determined the flock sizes and rates of loss caused by different factors in broody-hen chicks (BHC) up to 60 days of age on 600 randomly selected smallholdings in Bangladesh. The smallholders were beneficiaries of a village poultry production chain called 'Smallholder Livestock Development Project-2' (SLDP-2) which was undertaken with the financial assistance of the Danish International Development Agency (DANIDA). For estimating survival time of BHC, we observed chicks in 80 smallholdings. SLDP-2 aims at ameliorating poverty among women by poultry rearing at village level; in total, 104,000 key rearers, constituting 96% of all of the beneficiaries of the SLDP-2 area, were enrolled in 26 upazilas (a lower administrative unit of Bangladesh). A key rearer is a smallholder who rears at least five 'Sonali' (RIR x Fayoumi) and some indigenous (desi) chickens in a semi-scavenging system. Sonali chickens are supplied from the development project, and have higher egg production while the broodiness of the desi hens is exploited to get chicks hatched for future stocks; thus, the chicks hatched and reared to 60 days old at key rearers' households are called BHC. In this study 32% of the smallholders had BHC each month. At the beginning of a month, the median number of chicks in a flock was 8, and the mean survival time was 50.5 days. Incidence rates of loss of BHC from disease, predation, selling and slaughtering were 0.102, 0.086, 0.009 and 0.002 per chick-month at risk, respectively. The major predators were crows, mongooses and eagles with incidence rates of loss being 0.018, 0.016 and 0.010 per chick-month at risk, respectively. Colibacillosis (both single and mixed infections) contributed to the death of 21% of dead BHC collected; Newcastle disease and salmonellosis contributed to the next highest (14 and 12%) proportional mortalities.

Heart failure and acquired immune deficiency syndrome: report of 2 cases.

Acquired immune deficiency syndrome (AIDS) patients usually present with prolonged fever, chronic diarrhoea, weight loss and other opportunistic infections. Congestive heart failure is not a usual presentation of AIDS. Here two cases, one a female of 38 years and another a male of 22 years presented with fever and breathlessness. On examination they were found to have features of congestive heart failure. Echocardiography revealed dilated cardiomyopathy. Laboratory investigations suggested human immunodeficiency virus was reactive in both cases with immune deficiencies of different degrees. The first patient expired during hospital stay, but the second one is progressing well with antiretroviral therapy.

Causes of loss of Sonali chickens on smallholder households in Bangladesh.

In a 1-year-long prospective longitudinal study, we determined the causes of loss of 'Sonali' (male symbol Rhode Island Red x female symbol Fayoumi) chickens at key-rearers' households of the smallholder livestock development project-2 (SLDP-2) area in Bangladesh. A key rearer is a smallholder of chickens in the 'village poultry-production chain' (undertaken by SLDP-2 under the financial assistance of the DANIDA) who rears at least five Sonali and some 'Deshi' (non-descriptive and indigenous) chickens in their homesteads based on semi-scavenging system. The aim of this program is to ameliorate poverty, especially among women. Two co-ordination centers (set at the Potuakhali and Noakhali districts) supervised the development activities. We selected two upazilas (lower administration units) randomly from each of the two districts and in every selected upazila, we selected at random 125 key-rearer households. Incidence rates of loss of Sonali chickens from disease, predation, selling and slaughtering were 0.025, 0.023, 0.081 and 0.039 per bird-month at risk, respectively. The major predators of Sonali chickens in the study area were foxes, a kind of wild cat (Felis chaus), mongooses and human thieves. Colibacillosis (both single and mixed infections) had a contributory role in the death of 28% of dead Sonali birds collected for diagnosis; salmonellosis, Newcastle disease and internal parasites contributed to the next highest (14, 11and 10%) proportional mortalities.

A longitudinal study of the incidence of major endemic and epidemic diseases affecting semi-scavenging chickens reared under the Participatory Livestock Development Project areas in Bangladesh.

A 17-month (from January 2002 to May 2003) longitudinal study was undertaken to elucidate the epidemiology of important endemic and epidemic diseases affecting semi-scavenging chickens reared in the Participatory Livestock Development Project area in Bangladesh. This project was implemented in 17 northern and north-central districts of Bangladesh, under which 361 839 rural poor people were assisted to undertake poultry-rearing activity as a tool of poverty reduction. Of the total beneficiaries 93% were "key rearers". A key rearer is defined as a beneficiary who generally rears 10 to 13 hens in a semi-scavenging system with little additional feed supply. Households of 650 key rearers and some chick rearers were observed. During the study period 1227 birds, which belonged to different age, breed and sex categories, were found dead as a result of disease occurrence. From every dead bird organ samples such as the liver, heart, spleen, brain lung, trachea and bursa of Fabricius were collected. The incidence rate of mortality was 0.01976 per bird-months at risk. Of the total deaths 58.44% had single or mixed type of infections. Newcastle disease had the highest proportional mortality rate (15.81%). The proportional mortality caused by fowlpox, fowl cholera, salmonellosis, colibacillosis, aspergillosis, infectious bursal disease, mixed infections and undiagnosed cases were 8.96%, 6.76%, 7.09%, 6.93%, 0.33%, 2.04%, 10.51% and 41.56%, respectively. Newcastle disease affected a significant higher proportion (18.81%) of birds older than 60 days of age (P=0.00). Younger birds (age < or = 60 days) had a higher proportional mortality due to fowlpox and infectious bursal disease than older birds (P=0.00). Sonali (male Rhode Island Red x female Fayoumi) birds reared under the semi-scavenging system had a higher infection rate with Newcastle disease virus compared with indigenous and Fayoumi birds (P=0.00). Fowlpox was more prevalent in Fayoumi birds compared with Sonali. Surprisingly, Newcastle disease was more common in the vaccinated birds rather than the unvaccinated birds.

A study of bone mineral density in diabetes mellitus in eastern India.

To measure bone mineral density in diabetic patients at the time of clinical diagnosis of diabetes mellitus and to find out correlation, if any, with microvascular complication of diabetes mellitus and glycosylated haemoglobin, a study was conducted at Medical College and Hospital, Kolkata among 138 cases of diabetes and 212 controls. All patients were screened for ophthalmoscopy, routine blood and urine examinations. Bone ultrasound attenuation study of the calcaneus was performed in all cases. The bone ultrasound attenuation result was compared to a mean normal population result and expressed as Z score and T score. The age of diabetic patients varied from 11 years to 70 years. Of 138 diabetics, 32 (23.18%) had type 1 diabetes and rest type 2 diabetes. Forty-two diabetic patients had retinopathy, 42 nephropathy and 48 had neuropathy. Glycosylated haemoglobin was above 7% in 124 patients. The broadband ultrasound attenuation of type 1 diabetics ranged from 38 to 95 dB/MHz and in type 2 it was 35 to 104 dB/MHz. There was no statistically significant correlation between neuropathy, nephropathy, retinopathy and bone mineral density status. It was also found no correlation between glycosylated haemoglobin values and ultrasound attenuation.