European Association of Zoo and Wildlife Veterinarians - Transmissible Diseases Handbook 2019

CASEOUS LYMPHADENITIS

B02.02 OIE BALAI EU AHL

Bacteria Corynebacterium pseudotuberculosis ZOONOSIS

SUSCEPTIBLE PREVENTION TRANSMISSION CLINICAL SIGNS SEVERITY TREATMENT ANIMAL GROUPS AND CONTROL

Domestic and Direct contact, via Abscessation of Rarely fatal Difficult: Quarantine exotic ungulates skin wounds and superficial lymph facultative Chronic and often Serological potentially oral nodes intracellular in Others: primates, lifelong disease, screening mucosa macrophages, porcupine, nutria, generally with no often Segregation of fowl, ducks systemic effects impenetrable to infected animals Vaccination

FACT SHEET COMPILED BY LAST UPDATE Parc Animalier d'Auvergne, France December 2017

FACT SHEET REVIEWED BY Graham Baird, Zoetis Limited, United Kingdom Gerry M. Dorrestein, Pathology Laboratory NOIVBD, The Netherlands

DISEASE AGENT Corynebacterium pseudotuberculosis, a Gram-positive facultative intracellular pathogen.

SUSCEPTIBLE ANIMAL GROUPS Domestic small ruminants, and horses (and pigs). Exotic ungulates: old and new world camelids, antelopes, wild and (Caprini), cervids, equids, buffalo, pronghorn. Also encountered in nutria, porcupine, primates, fowl and ducks.

ZOONOTIC POTENTIAL Human is possible but uncommon, mainly related to occupational exposure, e.g. farmers, sheep shearers and abattoir workers.

DISTRIBUTION Worldwide.

TRANSMISSION Direct contact via skin wounds and abrasions, with purulent discharge from fistulated or ruptured superficial abscesses from affected animals, or contaminated objects. Excretion of infectious organisms from the of affected animals has been suggested in sheep. It has also been suggested that humans may become infected from consuming unpasteurized milk.

INCUBATION PERIOD Incubation period is reported as 8-9 days in experimental conditions, but serologically only detectable after 15 days. Can be as long as 2-6 months in natural .

CLINICAL SIGNS Two forms exist in the typical ungulate hosts. An external or cutaneous form with abscessation of superficial lymph nodes, initially with liquid purulent content but in chronic conditions dry caseous material. Localized purulent lesions within the

Caseous Lymphadenitis - Fact Sheet B02.02 European Association of Zoo and Wildlife Veterinarians - Transmissible Diseases Handbook 2019 subcutaneous tissues are less frequently encountered. In the visceral form, abscesses are found in internal lymph nodes and organs. Clinical signs are dependent on the location of the abscessations and the organs affected. In horses, three disease forms are known: deep-seated subcutaneous abscessations, ulcerative lymphangitis and contagious folliculitis and furunculosis. In humans: chronic infection, presenting as localized suppurative granulomatous lymphadenitis and affecting axillary, inguinal and cervical lymph nodes. Lymphadenitis is often preceded by influenza-like symptoms and lethargy.

PATHOLOGY AND POST MORTEM FINDINGS Abscessation of external and/or internal lymph nodes. In the visceral form, abscesses and caseous lesions can be found in parenchyma, liver, kidney, udder and more rarely also in heart, testis, scrotum, uterus, joints, brain and spinal cord. In extreme cases lung lesions can develop into caseo-purulent bronchopneumonia and pleuritis. The necro-granulomatous lesions are characterized by central areas of variably mineralised necrotic debris surrounded by layers of multinucleated cells, macrophages and variable numbers of lymphocytes, delineated by a fibrous connective tissue capsule. In case of pneumonia, moderate to severe subacute eosinophilic bronchitis and bronchiolitis can be seen.

DIAGNOSIS Clinical signs of one or more abscessed is suggestive of caseous lymphadenitis (CLA). Diagnosis is confirmed by bacterial culture and identification Corynebacterium pseudotuberculosis. Serological tests: anti-hemolysin inhibition test (AHI), tube agglutination assay, indirect hemagglutination test, double immunodiffusion test, ELISA.

SAMPLES REQUIRED FOR LABORATORY ANALYSIS Swab of purulent material from abscessed lymph node.

TREATMENT In farmed livestock the treatment of CLA is generally regarded as being extremely unreliable and is therefore not recommended. However in other species and in particularly valuable breeding animals treatment has been attempted. Lancing and flushing of superficial abscesses or surgical removal of the lesions, with topical disinfection. treatment is possible but challenging, the walls make antibiotic penetration difficult and results are poor. Treatment should be continued for 4 weeks or more, and based on antibiotic sensitivity tests. Be aware that draining the abscesses will result in environmental contamination and proper care is recommended.

PREVENTION Commercial vaccines are available. Successful use of autogenous vaccines has been reported. Proper quarantine to prevent introduction of C. pseudotuberculosis, and segregation of infected animals to prevent disease spreading.

CONTROL Most common disinfectants, such as hypochlorite, formalin and cresol, are effective against C. pseudotuberculosis, but efficiency is significantly reduced by the presence of organic material. Surfaces should be cleaned before disinfection. The organism may survive in a contaminated environment for several months. Conditions for restoring disease-free status after an outbreak: Separate and remove affected animals from healthy animals, remove feces and topsoil in enclosures and clean and disinfect all surfaces in contact with animals. Monitor the animals to detect previous asymptomatic animals. Serological tests can identify positive animals, although existing tests have generally been used on sheep and goats only.

LEGISLATIVE REQUIREMENTS Not notifiable under OIE 2019, BALAI (Council Directive 92/65/ECC) or AHL (Regulation EU 2016/429). Nevertheless health authorities should be informed.

Caseous Lymphadenitis - Fact Sheet B02.02 European Association of Zoo and Wildlife Veterinarians - Transmissible Diseases Handbook 2019

CONTACTS FOR FURTHER INFORMATION 1. Graham Baird, Zoetis Limited, United Kingdom Email: [email protected]

RELEVANT DIAGNOSTIC LABORATORIES No specific reference laboratories.

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Caseous Lymphadenitis - Fact Sheet B02.02