Field observations and experiences gained from the implementation of control measures against lumpy skin disease in South-East Europe between 2015 and 2017.

The first epidemics of lumpy skin disease (LSD) reported in Europe in 2015 severely affected the cattle farming sector in several Balkan countries. After the first incursion into Greece in 2015, the disease quickly spread across the Balkan region with over 7000 outbreaks reported by the end of 2016. Thanks to a coordinated regional control and eradication policy, the spread of the disease was halted by the end of 2017. Regional large-scale vaccination campaign with effective homologous vaccines and high vaccination coverage revealed to be essential for the successful control the disease, supported by other measures such as early detection of outbreaks, total or partial stamping out and restrictions on cattle movements. The aim of this paper is to discuss the field observations, challenges and lessons learnt while dealing with the first LSD epidemics in Europe. The cross-border collaboration by the veterinary authorities of all affected countries, coordinated by the European Commission and the technical support provided by many other international organizations played a fundamental role in stopping the spread of a disease that otherwise could have expanded further to the European territory causing a large damage to the whole European cattle farming industry. The experience obtained during the control of LSD epidemics indicates that in the future LSD spread can be effectively halted, provided that appropriate surveillance plans and vigilance remains in place in the areas at risk of re-incursion, especially those bordering endemic countries.

First Report on the Efficiency of Oral Vaccination of Foxes against Rabies in Serbia.

Rabies is one of the oldest known zoonotic diseases that has significant impact on public health, but still remains neglected in Serbia. Rabies virus can infect humans and other mammals and causes inflammation of the brain associated with encephalomyelitis and neurological symptoms. In 2010, Veterinary Directorate (national Competent Authority for animal health in Serbia) has started multi-annual project of oral rabies vaccination of foxes and other wild carnivores (e.g. jackals), as support of long-term programme of eradication of rabies in Serbia, co-funded by EU (financed by Instrument for Pre-Accession Assistance). Monitoring of the effectiveness of oral vaccination campaigns has been carried out in continuation from 2011 and was based on: (i) post-mortem laboratory examination of brain tissue of target animals (foxes, jackals and other carnivores) by fluorescent antibody test (FAT), (ii) detection of antibodies against rabies virus in serum samples by ELISA and (iii) detection of tetracycline biomarker in the mandibles for the evaluation of vaccine bait uptake. From September 2011 to May 2014, the total number of 4943 brain tissue samples, 4241 sera and 4971 mandibles were analysed. Confirmed rabies-positive brains decreased from 10 in 2011/2012 to 6 in 2012/2013 and eventually to 1 positive case in 2013/2014. The seroconversion rate increased from 10.48% (133/1269) in 2011/2012 to 20.11% (362/1800) in 2012/2013 and 42.23% (495/1172) in 2013/2014. Along with the seroconversion, the number of detected tetracycline-positive mandibles demonstrated an increasing tendency in the same period, being 49.67% (682/1373) in 2011/2012, 62.60% (1294/2067) in 2012/2013 and 90.33% (1383/1531) in the monitoring programme carried out in 2013/2014. Presented results confirmed that ORV of foxes and other wildlife in Serbia against rabies was successful and characterized by steady increase of vaccine baits uptake and immunization of animals.

Trichinella infection in Serbia in the first decade of the twenty-first century.

In Serbia, infection with Trichinella spp. has been recognized as a human health and animal husbandry problem for almost a century. The rate of swine infection gradually decreased from 0.14% to 0.02% between 2001 and 2010. For the past 5 years, Trichinella infections among swine were detected at levels higher than 0.05% in 3 districts of Serbia while prevalence persisted at lower levels for the rest of the country. During this 10-year period, there were 2257 cases of human trichinellosis, including 3 deaths; however, a significant decrease in the number of cases was reported during the last 5 years (fewer than 200 cases per year). The fact that prevalence data presented here are similar to prevalence data from 1990 indicates that this period of 10 years was needed to overcome the re-emergence of Trichinella infection in swine and humans that occurred during the last decade of the previous century.

Trichinella infections in different host species of an endemic district of Serbia.

Trichinella infections are endemic in the Balkan region of Europe. Though trichinellosis and agents thereof are serious problems for human health and animal husbandry, only a limited number of Trichinella isolates from Serbia have been identified at the species level so far. The aim of the present study was the surveillance and monitoring of Trichinella in domestic pigs and wild animals from the endemic district of Branicevo. Investigations performed during the 2009-2010 period revealed Trichinella infections in 344 out of 282,960 (0.12%) domestic pigs. Among wildlife, Trichinella infections were detected in 11 out of 94 (11.7%) wild boars (Sus scrofa), 7 out of 57 (12.3%) red foxes (Vulpes vulpes), 7 out of 13 (53.8%) golden jackals (Canis aureus), and in all three examined wolves (Canis lupus). Trichinella spiralis and Trichinella britovi were the only two species identified. T. britovi was identified in 31% of isolates from wildlife of the Branicevo district and T. spiralis was found in 53% of wild animals; mixed infections were observed in 16% of the animals examined. Findings form the basis of an information campaign for veterinary services, pig owners and the hunter's associations about the risk of the transmission of these zoonotic agents. The application of control programs as established at the Veterinary Specialist Institute of Pozarevac resulted in a decline in Trichinella infections among domestic pigs and the absence of human trichinellosis in the last three years in the Branicevo district.

Early ovarian cancer: 3-D power Doppler.

Transvaginal sonography plays an important role in the assessment of the morphology of ovarian lesions. However, the accuracy of the technique is limited due to the significant number of false-positive results. Color Doppler imaging and pulsed Doppler spectral analysis enable evaluation of ovarian tumor blood flow, analysis of the distribution of blood vessels, and quantitative measurement of blood flow velocity waveforms. These parameters increase the sensitivity and specificity of ultrasound evaluation of ovarian tumors. Unfortunately, there is no consensus as to which Doppler parameters and cutoff values are the most predictive of malignancy. Three-dimensional (3-D) power Doppler ultrasound provides a new tool to evaluate features of tumor vascularity. Three-dimensional ultrasound and 3-D power Doppler imaging in patients with "positive" findings on standard ultrasound tests, which encompass annual gray-scale transvaginal sonography followed by transvaginal color Doppler ultrasound in selected cases, represent a novel approach for early and accurate detection of ovarian cancer through screening. Combined evaluations of morphology and neovascularity by 3-D power Doppler ultrasound may improve early detection of ovarian carcinoma. Contrast-enhanced 3-D power Doppler sonography facilitates visualization of adnexal tumor vessels, which may aid in differentiating benign from malignant adnexal lesions.

Intramural pseudodiverticulosis of the esophagus detected on barium esophagograms: increased prevalence in patients with esophageal carcinoma.

OBJECTIVE: We tested the hypothesis that intramural pseudodiverticulosis of the esophagus is more prevalent in patients with esophageal carcinoma than in randomly selected patients who undergo esophagography for other indications. Such an association would prompt a careful search for carcinoma after esophageal intramural pseudodiverticulosis is found. MATERIALS AND METHODS: Single- and double-contrast esophagograms of 245 patients with esophageal carcinoma were retrospectively reviewed. A control group of 6400 esophagograms obtained for indications other than esophageal carcinoma was also reviewed. The statistical significance of the difference in prevalence of esophageal intramural pseudodiverticula between patients with esophageal carcinoma and the control group was tested using the chi-square test. The significance of difference between the number of esophageal intramural pseudodiverticula in patients with esophageal dilatation and the number in those without dilatation was tested using a small-sample nonparametric test. RESULTS: Intramural pseudodiverticulosis of the esophagus was found in 11 patients with esophageal carcinoma (4.5%) and in six control subjects (0.09%). Intramural pseudodiverticulosis of the esophagus was present opposite the tumor as well as both proximally and distally. The number of cases of intramural diverticulosis in patients with esophageal carcinoma and dilatation was not significantly higher than that in patients with carcinoma but without dilatation (p > .1) CONCLUSION: The prevalence of esophageal intramural pseudodiverticulosis is significantly higher in patients with esophageal carcinoma than in patients who underwent esophagography for other indications (p < .0002). This association implies increased risk of esophageal carcinoma in patients with intramural pseudodiverticulosis. Periodic surveillance of patients with intramural pseudodiverticulosis of the esophagus for esophageal carcinoma may be worthwhile.

Association of rectal diverticula and scleroderma.

Barium enema examinations of 7,200 patients were analyzed to determine the presence of rectal diverticula. Five patients with rectal diverticula, a prevalence of 0.07%, were found. Their diameters varied from 10 to 80 mm. Each of the patients had a single rectal diverticulum. Two patients had scleroderma with no other diverticula in the large bowel. None of our patients had symptoms referable to the rectal diverticula.

Melanoma metastatic to the bronchus: radiologic features in two patients.

Two patients with cutaneous melanoma metastatic to the bronchus are described. Chest radiographs revealed only indirect signs of bronchial obstruction. Computed tomography (CT) clearly demonstrated the intraluminal lesion. Magnetic resonance (MR) imaging signal characteristics were not specific for melanoma.

Variations in gastrointestinal melanoma metastases.

In 10 patients with gastrointestinal metastases from cutaneous malignant melanoma, metastases to the stomach were found in 2, the small bowel in 9, and the large bowel in 3. Gastric metastases typically appeared as target lesions. However, the morphology of secondary melanoma deposits to the small and large intestine varied significantly, target lesions being only one possible manifestation. Less common appearances of gut metastases were found in 4 patients. One presented atypically with matted loops of distal ileum resulting in prolonged stasis of barium in the affected areas. In 3 patients, infiltrative and stenotic lesions were found in the distal ileum, terminal ileum and cecum. One stenotic lesion of the distal ileum was accompanied by multiple small polypoid lesions more proximally, and the cecal lesion was ulcerated. Six of the patients presented with polypoid and, occasionally, ulcerated and multiple secondary melanoma deposits. Possible causes for variations in morphology are discussed.

Radiologic and endoscopic diagnosis of duodenal angioma.

Two patients with lymphangioma and one with hemangioma of the duodenum are described. The radiologic presentation of duodenal angiomas is that of multiple submucous, soft, polypoid, non-infiltrating tumors. During propagation of peristalsis, on compression, or gas distension of the duodenum, they change in shape and dimensions. Deep peristaltic waves could cause apparent vanishing of the angiomas. Possible mechanisms of such behaviour of angiomas are discussed. Listed characteristics enabled the radiologic distinction of angiomas from solid submucous duodenal tumors. Duodenoscopy allows differentiation of duodenal lymphangiomas from hemangiomas and duodenal varices. Final diagnoses were based on histologic analysis of surgical specimens.