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Available As A Peer reviewed Case study Three cases of porcine respiratory disease complex associated with porcine circovirus type 2 infection Perry A. Harms, DVM, MS; Patrick G. Halbur, DVM, PhD; Steven D. Sorden, DVM, PhD, Dipl ACVP Summary cal cases are described in which there were pneumonia cases. Porcine circovirus type 2 Pneumonia associated with porcine concurrent infections with PCV2 and was diagnosed in 22% of cases, SIV in circovirus type 2 (PCV2) is being diag- PRRSV, PCV2 and SIV, and PCV2 and M 17%, and M hyopneumoniae in 14%. nosed in an increasing number of respira- hyopneumoniae. Prolonged and unusually Porcine circovirus type 2 was commonly tory disease cases in growing swine. Mul- severe clinical disease, unique histologic found in combination with other patho- tiple viral infections are commonly lesions of lymphoid depletion and airway gens. Of the 694 cases that were diagnosed diagnosed in cases of porcine respiratory fibrosis, and abundant PCV2 antigen with PCV2-associated pneumonia, both disease complex (PRDC) at the Iowa State within these lesions suggest that PCV2 is PCV2 and PRRSV were demonstrated in University Veterinary Diagnostic Labora- playing a pathogenic role in PRDC. 388 (56%), which is greater than the 42% tory. In the year 2000, porcine reproduc- Keywords: swine, porcine circovirus type prevalence of PRRSV in the total pool of tive and respiratory syndrome virus 2, porcine reproductive and respiratory pneumonia cases, suggesting an interaction (PRRSV) was present in 42% of these syndrome virus, swine influenza virus, por- between these two viruses. Concurrent in- cases, PCV2 was present in 22%, swine cine respiratory disease complex fection with PCV2 and M hyopneumoniae influenza virus (SIV) was present in 19%, was confirmed in 134 of the 694 cases and Mycoplasma hyopneumoniae was Received: May 14, 2001 (19%), and concurrent infection with present in 22%. In this report, three clini- Accepted: August 7, 2001 PCV2 and SIV was demonstrated in 83 cases (12%). espiratory disease is a major health in multiple organs, such as intestine, kid- Case One: Concurrent infection problem in growing swine in the ney, lymphoid tissue, liver, and lung. Inter- with PCV2 and PRRSV United States. Cases of respiratory stitial pneumonia is evident histologically A group of 2000 pigs averaging 34 kg ex- R 3, 5–7 1–4, 8 disease involving multiple pathogens are in many cases. Several reports perienced respiratory disease 2 to 3 weeks often referred to as porcine respiratory dis- describe cases of PMWS associated with after placement in a finishing barn. The ease complex (PRDC). Porcine reproduc- PCV2; however, the literature lacks clinical primary clinical signs, observed in 10 to tive and respiratory syndrome virus reports describing the involvement of 15% of the pigs, were inactivity, anorexia, (PRRSV) and swine influenza virus (SIV) PCV2 in PRDC. The following case re- and dyspnea. Though anorexia was ob- are the common viral agents associated ports exemplify the association of PCV2 served in some pigs, wasting was not a pre- with PRDC. Mycoplasma hyopneumoniae, with PRDC in the accessions of a US diag- senting sign. At necropsy, lungs of affected Pasteurella multocida, Streptocccus suis, and nostic laboratory with a heavy swine case pigs failed to collapse and were diffusely other bacterial agents may also be associ- load. mottled, red to purple, and rubbery. No ated. Porcine circovirus type 2 may be other gross lesions were present. Fresh and identified in cases of pneumonia. However, Case reports formalin-fixed tissues (lung, tonsil, spleen, it has most often been associated with In the year 2000, swine pneumonia was and ileum) from two pigs representative of postweaning multisystemic wasting syn- diagnosed in 3163 cases presented to the the group (healthy except for respiratory 1–4 drome (PMWS), which is characterized Iowa State University Veterinary Diagnos- signs) were submitted to the ISU-VDL by wasting, dyspnea, and occasionally jaun- tic Laboratory (ISU-VDL)(Table 1). Diag- early in the course of the outbreak. dice or pallor. This syndrome commonly nosis was based on gross and microscopic occurs in pigs between 8 and 16 weeks of lesions and demonstration of an agent by Histopathology revealed severe, diffuse, age. The defining histologic features of isolation, antigen detection, or identifica- lymphohistiocytic interstitial pneumonia PMWS include depletion of lymphocytes tion of nucleic acid by polymerase chain with marked type 2 pneumocyte hyperpla- in lymphoid tissues, occasional intracyto- reaction (PCR) or in situ hybridization in sia and hypertrophy, necrotic cellular de- plasmic inclusion bodies, and lympho- the tissues. The most common etiologic bris within alveolar spaces, moderate multi- histiocytic to granulomatous inflammation diagnosis was PRRSV, in 42% of the swine focal suppurative bronchopneumonia, and mild peribronchiolar fibrosis. Mild lym- PAH, PGH, SDS: Veterinary Diagnostic and Production Animal Medicine, College of Veterinary phocyte depletion was observed in Peyer’s Medicine, Iowa State University, Ames, IA 50011. patches, but not in tonsil or spleen. Nu- This article is available online at http://www.aasv.org/shap.html. merous cells positive for PCV2 antigen were detected in the alveolar septa and Harms PA, Halbur PG, Sorden SD. Three cases of porcine respiratory disease complex associated with porcine circovirus type 2 infection. J Swine Health Prod. 2002;10(1):27–30. around bronchioles by immunohistochem- Journal of Swine Health and Production — Volume 10, Number 1 27 airways (Figure 2). Swine influenza virus Table 1: Pathogens identified in 3163 swine pneumonia cases at the Iowa State University Veterinary Diagnostic Laboratory in the year 2000. H1N1 and Pasteurella multocida type A were isolated from the lung tissue. Immu- nohistochemistry did not detect PRRSV No. of cases Pathogen (% of total) antigen, and direct IFA on frozen lung sec- tions did not detect M hyopneumoniae anti- P4orcine reproductive and respiratory syndrome virus 1)32 (42% gen. The diagnosis was bronchiolitis and Pasteurella multocida 7)15 (23% bronchopneumonia due to SIV, PCV2, P4orcine circovirus type 2 6)9 (22% and P multocida infections. S9wine influenza virus 5)5 (17% The outbreak lasted for approximately 2 Mycoplasma hyopneumoniae 4)52 (14% weeks, with the group experiencing mortal- Streptococcus s8pp 3)9 (13% ity near 10% despite aggressive antibiotic Haemophilus parasuis 2)41 (8% therapy. Five percent of the pigs failed to Salmonella s5erovars 2)2 (7% reach market weight and were sold at a re- Actinobacillus pleuropneumoniae 1)73 (5% duced value. Case Three: Concurrent infection istry (IHC) using antibodies derived Lung was the only formalin-fixed tissue with PCV2 and M hyopneumoniae against PCV2, and alveolar macrophages examined. Histopathology revealed multi- A group of 300 pigs weighing 77 to 82 kg were positive for PRRSV antigen by IHC.9 focal bronchial and bronchiolar epithelial experienced 10% morbidity and 2% mor- Small numbers of non-pathogenic bacteria necrosis, squamous metaplasia, and hyper- tality, with clinical signs of gauntness and were isolated from the lungs, spleen, and plasia. Moderate to marked multifocal peri- dyspnea, over a 2- to 3-week period. Two small intestine. Mycoplasma hyopneumoniae bronchial and peribronchiolar fibrosis and pigs were selected to represent the more was not detected by direct immuno- macrophages were present and often ex- recently affected pigs in the group. Nec- fluoresence assay (IFA), nor was SIV de- tended into the airway lamina propria. In ropsy revealed dark purple cranioventral tected by IHC in the lung tissues. On the addition, there was multifocal suppurative consolidation of 20 to 30% of the lungs, basis of these findings, the diagnosis was bronchopneumonia. Swine influenza virus and no other lesions. severe interstitial pneumonia due to con- antigen was identified by IHC in the nuclei Histopathology revealed fibrinosuppurative current PCV2 and PRRSV infections. of numerous bronchial and bronchiolar pleuritis, multiple neutrophil-rich thrombi, epithelial cells and occasional cells within Although the pigs were treated with antibi- mild to moderate peribronchiolar lym- the lung parenchyma (Figure 1). Immuno- otics in the water and feed, new pigs con- phoid hyperplasia, and mild fibrosis of the histochemistry also demonstrated large tinued to become affected for a 3- to 4- peribronchiolar alveolar septa. Lymphoid amounts of PCV2 antigen both within week period, with a total of 5% of the pigs tissues were not examined histologically. bronchial and bronchiolar epithelial cells removed and placed in hospital pens. Many Immunohistochemistry on formalin-fixed pigs continued to lose body condition de- and in mononuclear cells surrounding the spite individual treatments and were Figure 1: euthanized for humane reasons. Total mor- Section of lung from a pig with pneumonia associated with swine influenza virus (SIV) and porcine circovirus type 2, showing SIV antigen tality for the group was 9%, with an addi- (arrows) primarily within the bronchiolar epithelium (Case 2). tional 8% marketed as cull pigs at a significantly reduced value. ➜ Case Two: Concurrent infection ➜ with PCV2 and SIV This farm received feeder pigs weighing 23 kg from a single source every 3 weeks. One group of 700 pigs, housed in outside lots and weighing 54 to 64 kg, experienced an acute onset of respiratory disease with clini- cal signs (coughing, dyspnea, and lethargy) in 40% of the pigs. Field necropsies re-
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