Glycerol supplementation enhances the protective effect of dietary FloraMax-B11 against Salmonella Enteritidis colonization in neonate broiler chickens.

Two independent trials were conducted in the present study to evaluate the effect of 5% glycerol supplementation combined with dietary FloraMax-B11 (FM) against Salmonella Enteritidis colonization in neonate broiler chickens. In each trial, 60 chicks were randomly assigned into 4 groups. Group 1 received a control diet. Group 2 received a control diet supplemented with 5% glycerol. Group 3 received a control diet supplemented with FM, and group 4 received a control diet supplemented with 5% glycerol and FM. At placement, chickens were challenged with Salmonella Enteritidis at 10(4) cfu/bird. In each trial, 12 chicks were humanely killed 72 h postchallenge, respectively, for Salmonella Enteritidis colonization. Supplementation of 5% glycerol or FM by themselves, showed no significant effect on Salmonella Enteritidis recovery or incidence when compared with control nontreated chickens in both trials. However, no detectable Salmonella Enteritidis was observed in the chickens that received the supplementation of 5% glycerol combined with FM in both trials. Further studies are in progress in older birds to substantiate these findings.

Evaluation of germination, distribution, and persistence of Bacillus subtilis spores through the gastrointestinal tract of chickens.

Spores are popular as direct-fed microbials, though little is known about their mode of action. Hence, the first objective of the present study was to evaluate the in vitro germination and growth rate of Bacillus subtilis spores. Approximately 90% of B. subtilis spores germinate within 60 min in the presence of feed in vitro. The second objective was to determine the distribution of these spores throughout different anatomical segments of the gastrointestinal tract (GIT) in a chicken model. For in vivo evaluation of persistence and dissemination, spores were administered to day-of-hatch broiler chicks either as a single gavage dose or constantly in the feed. During 2 independent experiments, chicks were housed in isolation chambers and fed sterile corn-soy-based diets. In these experiments one group of chickens was supplemented with 10(6) spores/g of feed, whereas a second group was gavaged with a single dose of 10(6) spores per chick on day of hatch. In both experiments, crop, ileum, and cecae were sampled from 5 chicks at 24, 48, 72, 96, and 120 h. Viable B. subtilis spores were determined by plate count method after heat treatment (75°C for 10 min). The number of recovered spores was constant through 120 h in each of the enteric regions from chickens receiving spores supplemented in the feed. However, the number of recovered B. subtilis spores was consistently about 10(5) spores per gram of digesta, which is about a 1-log10 reduction of the feed inclusion rate, suggesting approximately a 90% germination rate in the GIT when fed. On the other hand, recovered B. subtilis spores from chicks that received a single gavage dose decreased with time, with only approximately 10(2) spores per gram of sample by 120 h. This confirms that B. subtilis spores are transiently present in the GIT of chickens, but the persistence of vegetative cells is presently unknown. For persistent benefit, continuous administration of effective B. subtilis direct-fed microbials as vegetative cells or spores is advisable.

Evaluation of a commercially available organic acid product on body weight loss, carcass yield, and meat quality during preslaughter feed withdrawal in broiler chickens: a poultry welfare and economic perspective.

The effect of a commercial organic acid (OA) product on BW loss (BWL) during feed withdrawal and transportation, carcass yield, and meat quality was evaluated in broiler chickens. Two experiments were conducted in Brazil. Commercial houses were paired as control groups receiving regular water and treated groups receiving OA in the water. Treated birds had a reduction in BWL of 37 g in experiment 1 and 32.2 g in experiment 2. In experiment 2, no differences were observed in carcass yield between groups. Estimation of the cost benefit suggested a 1:16 ratio by using the OA. In experiment 3, conducted in Mexico, significant differences on water consumption, BWL, and meat quality characteristics were observed in chickens that were treated with the OA (P < 0.05). These data suggest this OA product may improve animal welfare and economic concerns in the poultry industry by reducing BWL and improving meat quality attributes.

Evaluation of effects of EarlyBird associated with FloraMax-B11 on Salmonella Enteritidis, intestinal morphology, and performance of broiler chickens.

A posthatch fasting period of 24 to 72 h is a common and inevitable practice in commercial poultry production. This delay in start of feed intake has been reported to negatively affect yolk utilization, gastrointestinal development, slaughter weight, breast meat yield, performance, and to also depress immunological development, making the birds more susceptible to infection from pathogens such as Salmonella. Furthermore, public concerns regarding the considerable human rates of illness reported and the emergence of antibiotic-resistant strains of Salmonella have doubled the challenge on the poultry industry to find alternative means of Salmonella control. In the present study, we evaluated the effects of a combination of early feeding with probiotic supplementation on morphological development of mucosa, control of Salmonella, and overall performance in broiler chickens. We used a blend of a commercially available perinatal supplement, EarlyBird (EB; Pacific Vet Group USA Inc., Fayetteville, AR), and a successful probiotic supplement, FloraMax-B11 (FM; Pacific Vet Group USA Inc.), to evaluate the effects on gut morphology, Salmonella intestinal colonization, and horizontal transmission, along with its effects on BW and related performance in broiler chickens under simulated commercial hatching management and shipping conditions. Morphometric analysis showed increased villus height, villus width, villus to crypt ratio, and villus surface area index in chickens treated with EB + FM groups. Significant reductions in Salmonella recovery, incidence, and horizontal transmission were also observed among the same groups, suggesting beneficial effects of early feeding and competitive exclusion by probiotic bacteria. Improved gut morphology and Salmonella exclusion was very well supported by BW data with significantly lower early BW loss and overall BW gains in birds treated with EB + FM mixture. The results of this study demonstrated that the combination of EB and FM improved gut morphology, reduced the amount of Salmonella that could be recovered, as well as improved BW when compared with controls and each product individually. These data address both animal welfare and food safety concerns faced by the poultry industry.

Evaluation of recombinant Salmonella expressing the flagellar protein fliC for persistence and enhanced antibody response in commercial turkeys.

Salmonella enterica serovar Enteritidis (SE) is one of the most common causes of human foodborne illness in the United States. Previous research indicates that antibodies against the fliC protein can provide protection against Salmonella challenge in mice. To generate a vaccine that effectively protects poultry against multiple Salmonella serotypes, novel attenuated strains of SE were developed to express a fliC peptide sequence on the outer membrane protein lamB in association with an M2e (marker) epitope. In 3 separate trials, poults were immunized with 10(7) to 10(8) cfu/poult of the appropriate recombinant Salmonella strains (ΔSE-M2e or ΔSE-M2e-fliC) via oral gavage on the day of hatch and again on d 21 posthatch. Liver, spleen, and cecal tonsils were aseptically removed on d 7, 14, 21, 28, 35, and 42 posthatch for detection of Salmonella, and blood samples were obtained at these same time points for determination of an M2e-specific antibody response. In all 3 trials, the ΔSE-M2e-fliC strain exhibited significantly less invasion of the liver and spleen at d 7 and 14 when compared with ΔSE-M2e or SE phage type 13A (P < 0.05). Similarly, colonization of the cecal tonsils was decreased in the poults immunized with the ΔSE-M2e-fliC strain. By d 21, the ΔSE-M2e-fliC strain exhibited a significantly higher M2e-specific antibody response when compared with the negative control and SE phage type 13A groups (P < 0.05). However, no significant differences in M2e-specific antibody responses were observed between the ΔSE candidate vaccine strains throughout the study. Overall, these data suggest that oral live attenuated Salmonella-vectored vaccines expressing a fliC peptide sequence are able to elicit a humoral immune response in commercial poults and may contribute to a reduction in Salmonella organ invasion and colonization.

Experimental reproduction of porcine circovirus type 2 (PCV2)-associated enteritis in pigs infected with PCV2 alone or concurrently with Lawsonia intracellularis or Salmonella typhimurium.

Porcine circovirus (PCV)-associated disease (PCVAD) has emerged to become one of the most economically important pig diseases globally. One of the less commonly recognized clinical manifestations of PCVAD is PCV2 type 2 (PCV2)-associated enteritis in growing pigs; however, experimental confirmation of the ability of PCV2 alone or PCV2 coinfection with other agent(s) to induce enteritis is lacking. In this study, 120 specific-pathogen-free (SPF) pigs were divided randomly into six groups: controls (negative control pigs), PCV2 (inoculated with PCV2), LAW (inoculated with Lawsonia intracellularis), SALM (inoculated with Salmonella typhimurium), PCV2-LAW (concurrently inoculated with PCV2 and Lawsonia intracellularis) and PCV2-SALM (concurrently inoculated with PCV2 and Salmonella typhimurium). One half of the pigs in each group were subject to necropsy examination 14 days postinoculation (dpi) and the remaining pigs were examined at 28 dpi. The average daily weight gain was not different (P>0.05) between groups. Individual pigs inoculated orally with PCV2 regardless of coinfection status (2/10 PCV2, 1/10 PCV2-LAW, 3/10 PCV2-SALM) developed PCVAD with diarrhoea and reduced weight gain or weight loss between 14 and 28 dpi. Those pigs had characteristic microscopic lesions in lymphoid and enteric tissues associated with abundant PCV2 antigen. Enteric lesions were characterized by necrosuppurative and proliferative enteritis with crypt elongation and epithelial hyperplasia in LAW and PCV2-LAW pigs by 14 dpi, ulcerative and necrosuppurative colitis in SALM and PCV2-SALM pigs by 14 dpi, and lymphohistiocytic enteritis with depletion of Peyer's patches in PCV2, PCV2-SALM and PCV2-LAW pigs by 28 dpi. To the authors' knowledge, this is the first report documenting that under experimental conditions, PCV2 can induce enteritis independently from other enteric pathogens and that oral challenge is a potentially important route and perhaps the natural route of PCV2 transmission in growing pigs.

Evaluation of Salmonella-vectored Campylobacter peptide epitopes for reduction of Campylobacter jejuni in broiler chickens.

Campylobacter is a leading cause of bacterial gastroenteritis in humans and is often linked to contaminated poultry products. Live Salmonella vectors expressing three linear peptide epitopes from Campylobacter proteins Cj0113 (Omp18/CjaD), Cj0982c (CjaA), and Cj0420 (ACE393) were administered to chicks by oral gavage on the day of hatch, and the chicks were challenged with Campylobacter jejuni on day 21. All three candidate vaccines produced consistent humoral immune responses with high levels of serum IgG and mucosal secretory IgA (sIgA), with the best response from the Cj0113 peptide-expressing vector. Campylobacter challenge following vaccination of three candidate vaccine groups decreased Campylobacter recovery from the ileum compared to that for controls on day 32. The Cj0113 peptide-expressing vector reduced Campylobacter to below detectable levels. The Salmonella-vectored Cj0113 subunit vaccine appears to be an excellent candidate for further evaluation as a tool for the reduction of Campylobacter in poultry for improved food safety.

Development and evaluation of candidate recombinant Salmonella-vectored Salmonella vaccines.

Attenuated Salmonella Enteriditis (ΔSE) recombinant vaccine vectors incorporating a Salmonella flagellar filament protein (fliC) subunit, a putative cell-mediated epitope, for expression of the lamB gene (encoding a maltose outer membrane porin), with or without co-expression of a putative immune-enhancing CD154 oligopeptide, were developed and compared with wild-type Salmonella Enteriditis (experiments 1 and 2) or the attenuated ΔSE empty vector (experiment 3) as initial vaccine candidates against Salmonella infection. A total of 3 experiments were performed to assess the infection and clearance rate of each of these constructs. Each construct or Salmonella Enteriditis was orally administered to broiler chicks at day of hatch by oral gavage (~10(8) cfu/chick). In experiments 1 to 3, liver-spleen and cecal tonsils were removed aseptically for recovery of wild-type Salmonella Enteriditis or ΔSE mutants. These experiments suggested that cell surface expression of fliC alone markedly increased the clearance rate of the vector at or before 21d postvaccination in all 3 experiments. In a fourth experiment, broilers were vaccinated with one of the vaccine constructs or the ΔSE empty vector and then challenged with wild-type Salmonella Typhimurium. At 19 d posthatch, 16 d postinfection, neither candidate protected against challenge significantly better than the ΔSE empty vector, although there was significantly less Salmonella recovered from vaccinated chickens as compared with nonvaccinated controls. These experiments indicate that these experimental vaccines did not protect against heterologous challenge or enhance clearance after Salmonella Typhimurium challenge; as such, their value as vaccines is limited. The increased clearance of the candidate vaccines, particularly the vector expressing fliC alone, may have value in that the fliC epitope may decrease the clearance time of other recombinant vectored Salmonella vaccines.

Evaluation of recombinant Salmonella expressing CD154 for persistence and enhanced antibody response in commercial turkeys.

Foodborne illness due to Salmonella is a worldwide public health concern and epidemiological evidence has identified poultry and poultry products as a significant source of human Salmonella infection. To discover an effective vaccine that protects poultry against multiple Salmonella serotypes, several novel attenuated Salmonella Enteritidis strains (DeltaSE) were developed to express variations of a potential immune-enhancing CD154 peptide sequence on the outer membrane protein lamB in association with a M2e (marker) epitope. The 3 CD154 peptide sequences evaluated in this study correspond to those naturally occurring in turkeys, humans, and chickens. In 3 separate trials, poults were immunized with 10(7) to 10(8) cfu/poult of the appropriate recombinant Salmonella strains (DeltaSE-M2e, DeltaSE-M2e-T/CD154, DeltaSE-M2e-H/CD154, DeltaSE-M2e-C/CD154) via oral gavage on day of hatch and again on 21 d posthatch. Liver, spleen, and cecal tonsils were aseptically removed on d 7, 14, 21, 28, 35, and 42 posthatch for detection of Salmonella and blood samples were obtained at these same time points for determination of an M2e-specific antibody response. In all 3 trials, DeltaSE strains exhibited significantly less invasion of the liver and spleen at d 7 when compared with Salmonella Enteritidis phage type 13A (P < 0.05). In 2 of the 3 trials, the DeltaSE strains expressing a CD154 peptide sequence further decreased invasion of the liver and spleen. Similarly, colonization of the cecal tonsils was also decreased in the poults immunized with the DeltaSE strains. However, there were no differences in colonization or invasion due to the amino acid sequence of the CD154 insert in all 3 trials. By d 21, the DeltaSE strains exhibited a significantly higher M2e-specific antibody response when compared with the negative control and SE13A groups (P < 0.05). However, no significant differences in M2e-specific antibody responses were observed between any of the DeltaSE candidate vaccine strains expressing CD154 throughout the study. Overall, these data suggest that oral live attenuated Salmonella-vectored vaccines expressing a foreign peptide sequence are able to elicit a humoral immune response in commercial poults and may contribute to a reduction in Salmonella organ invasion and colonization.

Vaccination of chickens with recombinant Salmonella expressing M2e and CD154 epitopes increases protection and decreases viral shedding after low pathogenic avian influenza challenge.

Avian influenza (AI) is a significant public health concern and serious economic threat to the commercial poultry industry worldwide. Previous research demonstrates that antibodies against M2e confer protection against influenza challenge. Using the Red recombinase system in combination with overlapping extension PCR, we recently developed several novel attenuated Salmonella Enteritidis strains that express a protective M2e epitope in combination with a potential immune-enhancing CD154 peptide sequence on the Salmonella outer membrane protein lamB. Commercial Leghorn chicks were orally immunized (immunization dose: 10(6) to 10(8) cfu/chick) with saline (negative control) or one of the recombinant Salmonella strains [DeltaaroA M2e-CD154, DeltahtrA M2e-CD154, DeltaaroA-DeltahtrA M2e(4)-CD154] on day of hatch and 21 d posthatch. These candidate vaccine strains were evaluated for their ability to invade, colonize, and persist in tissues and elicit an M2e-specific antibody response. The vaccine candidate strain DeltaaroA M2e-CD154 exhibited significantly greater organ invasion in the liver and spleen at d 7 (P > 0.05); however, no marked differences in colonization of the cecal tonsils were observed. Vaccinated chickens exhibited significantly increased M2e-specific IgG responses, which were further enhanced by simultaneous expression of CD154 (P < 0.05). Virus neutralization assays gave neutralizing indices of 6.6, 6.3, and 6.3 for DeltaaroA M2e-CD154, DeltahtrA M2e-CD154, and DeltaaroA-DeltahtrA M2e(4)-CD154 seven days post booster immunization, respectively, indicating effective neutralization of AI by serum IgG of vaccinated chickens. In a subsequent direct challenge study, specific-pathogen-free Leghorn chicks immunized with DeltaaroA-DeltahtrA M2e(4)-CD154 offered significant protection against direct challenge with low pathogenic AI H7N2, but not highly pathogenic H5N1 AI. Taken together, these data suggest that these Salmonella-vectored vaccines expressing M2e in association with CD154 are effective at protecting chickens against low pathogenic AI.

Cervicofacial infection of dental origin presenting to maxillofacial surgery units in the United Kingdom: a national audit.

INTRODUCTION: Local studies have shown an increase in cervicofacial infections of dental origin presenting to oral and maxillofacial surgery units in the UK. A lack of access to National Health Service (NHS) primary care dental services has been implicated as a root cause. STUDY DESIGN: Cross-sectional national audit.Method Oral and maxillofacial surgery units in the UK were asked to report details of severe cervicofacial infection of dental origin presenting in October and November 2006. Data were collected regarding: patient demographics, referral source, management in primary care, management by maxillofacial surgery, and outcome. RESULTS: Two hundred and sixty-six episodes of cervicofacial infection of dental origin were reported during the audit period. At the time of presentation, 56.4% of patients were registered with a general dental practitioner (GDP). One hundred and forty (52.6%) patients sought treatment from primary care dental services for their episode of cervicofacial infection and only 20 patients were unsuccessful in obtaining treatment. Forty-seven percent of patients did not seek treatment from primary care dental services. Fifty percent of patients were referred by accident and emergency. Sixty-six percent of patients were prescribed oral antibiotics without operative intervention by primary dental care services. Eighty-one percent of patients required hospital admission and 46% of patients required a surgical procedure under general anaesthesia. Eighty-nine percent of patients made a full recovery and 3% recovered with complications. There were no deaths reported during the audit period. DISCUSSION: This audit provides a benchmark from which future comparisons can be made and by design cannot prove an increase in the presentation of cervicofacial infection of dental origin. Lack of access to NHS primary care dental services may be less significant than originally thought. A significant proportion of patients preferentially present to primary care medical services rather than dental services. Two thirds of patients treated by primary care dental services received oral antibiotics only which represents an inadequate level of treatment for odontogenic infection.

Does a "hub and spoke" maxillofacial trauma service affect management decisions?

AIM: Using mandibular fractures (excluding those of the condyle) as a model, to find out how management is influenced by whether patients present at the "hub" or "spoke" of a maxillofacial trauma service. MATERIALS: Data on non-condylar mandibular fractures from a maxillofacial trauma database over a 5-year period. RESULTS: Significantly more non-condylar mandibular fractures were treated conservatively in patients who presented at the peripheral spoke hospitals than in those who presented at the hub hospital, despite the populations being similar. CONCLUSION: Geographical presentation of a patient with a non-condylar mandibular fracture in a hub and spoke maxillofacial trauma service influences management decisions.

Living with dignity project.

When most people think of the AIDS (acquired immune deficiency syndrome) virus, what comes to mind is 'doctors, nurses, drugs and suffering people'. This paper looks at the work of a group of technologists for whom, when they think of the AIDS virus, 'buckets, garden hoses and broom-sticks' come to mind. With the help of a number of people who are antibody positive for HIV (human immunodeficiency virus), ATprojects (a Papua New Guinea-based non-government organization) developed a range of household implements that are now allowing people living with HIV and AIDS (PLWHA) to live the remaining months of their lives with a greater degree of dignity. The Living with Dignity Project has taken an unconventional approach to the task of helping PLWHA that uses unique participatory methods to identify the need for and to actually design products for use by PLWHA. Its thoroughgoing focus is on the practical daily needs of the poorest and sickest in our community.

Maxillofacial fractures: a study of recurrent victims.

A study of 760 patients treated for maxillofacial fractures over a 2 year period revealed 3 per cent of them to have had one or more previous fractures in the maxillofacial region. This group of patients are nearly all victims of assault but are indistinguishable from a control group of patients with maxillofacial injuries on the grounds of age, sex, anatomical type of injury or socioeconomic status. They are however more likely to have been drinking alcohol at the time of their injury than the control group. We advocate targeting of this sub-group of patients with maxillofacial fractures for appropriate counselling.

Cutaneous leishmaniasis. An unusual cause of facial swelling.

Tropical disease may not figure highly in the differential diagnosis of a facial swelling in the United Kingdom but should be considered in those who have been in a tropical area. This case history documents details of the presentation and investigation of a case of leishmaniasis that appeared as a facial swelling in a 4-year-old boy who had recently returned from the Middle East.

Informed consent in oral and maxillofacial surgery: a study of the value of written warnings.

OBJECTIVE: To determine if written preoperative warnings about risks and outcomes of surgery improves patients' recall and recognition of these warnings postoperatively compared to traditional verbal warnings and to determine if the timing of these warnings is significant. DESIGN: Prospective study of patients given written warnings compared to a control group of patients warned in the traditional verbal way. SETTING: Oral and Maxillofacial unit of a District General Hospital. SUBJECTS: Patients undergoing removal of third molars under general anaesthesia. MAIN OUTCOME MEASURES: Patients' recall and recognition of warnings about pain, swelling, trismus and lingual and labial dysaesthesias given before surgery for removal of third molars. RESULTS: Written information significantly improves patients recall and recognition of important warnings such as the risk of dysaesthesia of the tongue (p < 0.001) and lip (p < 0.01) when compared with just verbal warnings. It seems to make no difference if this information is given to the patient a week before on a preadmission clinic or on admission. CONCLUSIONS: Written preoperative information about routine operations would improve the quality of the informed consent process.

Bilateral parotid swelling associated with chronic obstructive pulmonary disease. A case of pneumoparotid.

Acute enlargement of the parotid glands due to air insufflation is well reported under various names, the most appropriate of which is pneumoparotid. We report an unusual example of pneumoparotid, which was difficult to diagnose, that involved background swelling of the parotids because of the respiratory effort of chronic obstructive pulmonary disease and acute exacerbations associated with episodes of coughing.