GEOGRAPHIC SPREAD OF CANINE DISTEMPER IN WILD CARNIVORES IN MICHIGAN, USA: PATHOLOGY AND EPIDEMIOLOGY, 2008-18.

Canine distemper is a widespread disease affecting both domestic and wild carnivores. This investigation of the geographic distribution, wildlife species infected, and relative prevalence rates was conducted over an 11-yr period and helps to document the disease spread, most highly infected wildlife species, and histologic lesions. Animals were collected as found dead, hunter and trapper harvested, and euthanized for displaying signs of abnormal behavior or neurologic disease. This disease appeared to spread from the Lower Peninsula of Michigan into the Upper Peninsula, was most frequently documented in raccoons (Procyon lotor), striped skunks (Mephitis mephitis), and gray fox (Urocyon cinereoargenteus), but also involved additional wildlife species. Three unique wildlife virus strains were identified. Two of these grouped within a separate subclade of the America 2 lineage. A third strain appeared to be a unique sequence type that is not associated with any existing subclade of America 2. We recommend the combined use of routine histology and immunohistochemical staining to confirm the diagnosis, and further recommend that both the lungs and spleen be collected as the optimal tissues to utilize for surveillance purposes.

Distribution of canine distemper virus and nectin-4 in raccoon (Procyon lotor) skin.

Raccoons (Procyon lotor) are abundant in urban/wildland interfaces and are key sources of canine distemper virus (CDV) outbreaks in domestic, zoo, and free-ranging wildlife species. CDV is pantropic, which provides multiple potential routes of transmission (urine, respiratory secretions, feces), but the specific role of skin as a target of infection, as a diagnostic sample, or as a potential source of environmental persistence and transmission is unknown. We have characterized the distribution of CDV and its known receptor, nectin-4, in skin samples of 36 raccoons. Even with skin samples that were grossly and histologically normal, immunohistochemistry of skin was useful in the diagnosis of CDV infection, which was found in both epithelium and endothelium. Nectin-4 was codistributed with cellular targets of viral infection. Skin secretions, shed keratinocytes, and hair of CDV infected raccoons are all potential environmental fomites.

FOOT INJURIES IN MICHIGAN, USA, GRAY WOLVES (CANIS LUPUS), 1992-2014.

The range of gray wolves (Canis lupus) in the contiguous US is expanding. Research and monitoring to support population recovery and management often involves capture via foothold traps. A population-level epidemiologic assessment of the effect of trap injuries on wolf survival remains needed to inform management. We describe the baseline rate, type, and severity of foot injuries of wolves born 1992-2013 in Michigan's Upper Peninsula, evaluate the reliability of field-scoring trap-related injuries, and the effect of injuries on wolf survival. We assessed foot injuries by physical and radiographic exam at postmortem and/or time of capture for 351 wolves using the International Organization for Standardization 10990-5 standard and the effects of injuries, sex, age, previous capture and body condition on survival using proportional hazards regression. We used ordinal regression to evaluate epidemiologic associations between sex, age, previous capture, body condition, cause of death and injury severity. Most wolves (53%) experienced no physically or radiographically discernable foot injuries over their lifetimes. Among those wolves that did experience injuries, 33% scored as mild. Foot injuries had little epidemiologically discernable effect on survival rates. Wolves with higher foot trauma scores did experience an increased risk of dying, but the magnitude of the increase was modest. Most limb injuries occurred below the carpus or tarsus, and scoring upper-limb injuries added little predictive information to population-level epidemiologic measures of survival and injury severity. There was little association between injury severity and cause of death. Based on necropsy exams, previous trap injuries likely contributed to death in only four wolves (1.1%). Our results suggest that injuries resulting from foothold traps are unlikely to be a limiting factor in recovery and ongoing survival of the Michigan gray wolf population.

Eastern Equine Encephalomyelitis in Michigan: Historical Review of Equine, Human, and Wildlife Involvement, Epidemiology, Vector Associations, and Factors Contributing to Endemicity.

Eastern equine encephalomyelitis (EEE) is a mosquito-borne viral disease that is an emerging public health concern in the state of Michigan. Although Michigan has one of the highest incidence rates of EEE in the United States, much of the information known about cases in humans, equines, and other animals residing in Michigan is unpublished. This article summarizes such information and explores spatial trends in the historic distribution of EEE in Michigan. Outbreaks in Michigan have occurred over an 80-yr interval, involving only horses in 1942-1943 and 1973-1976, and then episodically from 1980 to 2020, and involving horses, humans, and wild and domestic animals. An estimated 1,036 equine cases (confirmed and suspected) and 36 confirmed human cases have occurred, including 10 in 2019 (6 deaths) and 4 in 2020 (2 deaths). Human cases ranged in age from 1 to 81 yr; 70% were male, and fatality rate of 34.3%. Equine and human cases occurred from July to October, peaked in August, and cluster in space in southwestern and southeastern lower Michigan. Cases occurred in glacial outwash and ice-contact landscapes in glacial interlobate zones. EEE virus (EEEV) was recovered from Culiseta melanura, Coquillettidia perturbans, five species of Aedes, and other mosquito species near horse and human case sites. Virus isolations or presence of neutralizing antibodies in several passerine species of birds suggest broad EEEV-bird associations. White-tailed deer and other wildlife were also affected. Geographic spread to northern areas of the state suggests expansion of this disease system into new and unsuspected foci.

Eastern Equine Encephalitis Virus in Visibly Affected Ruffed Grouse (Bonasa umbellus) in Michigan, Minnesota, and Wisconsin, USA.

Eastern equine encephalitis virus (EEEV) infects many avian species but has rarely been described in Ruffed Grouse (Bonasa umbellus). Between September and December 2019, 40 Ruffed Grouse, most in poor physical condition, were submitted to the Michigan, Wisconsin, and Minnesota (US) Departments of Natural Resources; eight were positive for EEEV.

Lead poisoning from ingestion of fishing gear: A review.

Many publications have investigated the ingestion and toxicity of metallic lead from hunting and the shooting sports. However, there is limited literature on toxicity associated with the ingestion of lead fishing weights, despite our knowledge of damage caused to many species from entanglement in lines, nets, and fish-hooks. This paper surveys current knowledge of species poisoned by ingestion of lead fishing gear and the types of gear that have been implicated. We review the impacts of lead fishing tackle on wildlife species and human health and describe the efficacy of efforts to reduce the use of lead tackle through voluntary, educational, and regulatory approaches to encourage adoption of non-toxic fishing gear. The authors emphasize the need for further research and policy initiatives to deal with this serious problem.

Mortality Due to Toxoplasmosis in Suburban Eastern Fox Squirrels ( Sciurus niger) in Michigan, USA.

Three separate mortality events affecting wild eastern fox squirrels ( Sciurus niger) were investigated in suburban areas within southeastern Michigan, US over a 3-yr period from the summer of 2015 through the winter of 2017. A total of seven squirrels were submitted for investigation. The squirrels were generally in fair to good body condition with moderate fat deposits. The tissues that most commonly exhibited gross or histologic lesions included the lungs, liver, and heart, whereas spleen and brain exhibited lesions less frequently. Lung lesions in all seven squirrels consisted of moderate interstitial pneumonia with necrosis and moderate to high numbers of protozoal organisms. Livers in four out of seven squirrels had multifocal necrosis associated with low to moderate numbers of protozoal organisms. Three out of seven brains examined had mild nonsuppurative meningoencephalitis with widely scattered protozoal cysts. Protozoal organisms observed in various tissues were strongly immunoreactive to Toxoplasma gondii antibody by immunohistochemical staining. Other primary disease conditions tested for included West Nile virus infection, pesticides, and anticoagulants. Toxoplasma gondii can cause disease and mortality in a variety of wild squirrel species, especially near human settlements, and would merit more attention.

Harmonization of technology across an integrated delivery network.

PURPOSE: A standardized blueprint for use when harmonizing or standardizing pharmacy automation and technology resources across individual institutions or an integrated delivery network (IDN) of institutions is described. SUMMARY: Whether to strive for standardization (use of the same vendors and equipment) versus harmonization (use of various technologies to meet patient-specific needs and organizational stability requirements) and how to coordinate activities across IDNs consisting of 3-30 or more hospitals are common questions due to consolidations in the healthcare industry. For most IDNs with legacy systems, harmonization may be the better option. Large-scale harmonization initiatives require significant planning and coordination involving all affected parties. Detailed project plans should include the compiling of all associated harmonization costs that involve human resources, information on ongoing services and equipment, and program schedules for multiple concurrent projects in order to provide a framework for planning and coordination. Part of the planning process for harmonization efforts should include an extensive current-state analysis that includes review of contracts and vendors. Final harmonization decisions should be based on a mix of vendor recommendations, best practices, and accommodation of current practices that result in the lowest complexity of system redesign with regard to existing systems. When harmonizing existing technologies, planning must also consider the impact of the change to both the organization and individual users. CONCLUSION: Harmonization is an evaluative process whereby process variation due to automation and technology variability can be reduced and organizational interoperability to meet patient-specific needs can be promoted.

Hepatic polybrominated diphenyl ether (PBDE) levels in Wisconsin river otters (Lontra canadensis) and Michigan bald eagles (Haliaeetus leucocephalus).

Polybrominated diphenyl ethers (PBDEs) are persistent and toxic flame-retardant chemicals widespread in the Great Lakes ecosystem. These chemicals are now being regulated and phased-out of the region; therefore it remains important to understand the extent of contamination in order to track the efficacy of recent actions. Here, Σ4PBDE congeners (PBDE-47, 99, 100, 153;wetweight basis unless indicated)were determined in liver tissues from Wisconsin river otters (Lontra canadensis; n = 35; 2009-2010) and Michigan bald eagles (Haliaeetus leucocephalus; n = 33; 2009-2011). In otters, Σ4PBDE ranged from0.5 to 72.9 ng/g, with a mean (±SD) and median (25th-75th percentile inter-quartile range) of 16.3 ± 16.4 ng/g and 11.3 (5.6-18.9) ng/g, respectively. The mean lipid-adjusted Σ4PBDE was 1377 ± 1485 ng/g. In eagles, Σ4PBDE ranged from 0 to 1,538.8 ng/g, with a mean and median of 74.3 ± 266.7 ng/g and 21.2 (5.7-28.9) ng/g, respectively. The mean lipid-adjusted Σ4PBDE was 5274.5 ± 19,896.1 ng/g. In both species, PBDE-47 accounted for >50% of the Σ4PBDE, followed by PBDE-99 and PBDE-100 (each ~17-19% of the total). The PBDE levels reported here in otters are similar to mammalian wildlife elsewhere, though the levels in eagles are among the highest worldwide across studied birds. The findings indicate that apex Great Lakes wildlife remain exposed to appreciable levels of PBDEs and more work is needed to understand whether such exposures are associated with adverse health outcomes.

Implementation of computerized prescriber order entry in four academic medical centers.

PURPOSE: Lessons learned through the transition to computerized prescriber order entry (CPOE) at four academic medical centers are reviewed. SUMMARY: CPOE is an important strategy in efforts to improve medication and patient safety and achieve compliance with federal health care information technology objectives. Pharmacy-led CPOE implementation teams at Brigham and Women's Hospital, Georgia Health Sciences Health System, UC Health University Hospital, and University of Utah Hospitals and Clinics were challenged to overcome different types of resource, staffing, and hardware-software constraints. Their collective experience points to a number of factors that are essential to successful CPOE implementation, including (1) involvement by all ancillary personnel in system planning, development, implementation, and refinement, (2) selection of CPOE equipment that offers a high level of interoperability with existing information systems and automated dispensing machines, (3) development of electronic order sets and clinical decision support (CDS) tools that are designed for ease of use and tailored to the hospital's clinical workflows, and (4) dedication of adequate resources and time for staff training, technical support, and system troubleshooting and maintenance. In particular, facilities transitioning to CPOE must secure initial and ongoing physician input and feedback to ensure patient safety and reduce CDS-related problems and other barriers to broad system acceptance. CONCLUSION: Before implementing CPOE, addressing institutional considerations pertaining to system selection, preimplementation preparation, staff training, necessary equipment, program rollout, and postimplementation maintenance can increase the likelihood of a smooth transition to CPOE and optimal system performance.

Mercury exposure and neurochemical impacts in bald eagles across several Great Lakes states.

In this study, we assessed mercury (Hg) exposure in several tissues (brain, liver, and breast and primary feathers) in bald eagles (Haliaeetus leucocephalus) collected from across five Great Lakes states (Iowa, Michigan, Minnesota, Ohio, and Wisconsin) between 2002-2010, and assessed relationships between brain Hg and neurochemical receptors (NMDA and GABA(A)) and enzymes (glutamine synthetase (GS) and glutamic acid decarboxylase (GAD)). Brain total Hg (THg) levels (dry weight basis) averaged 2.80 µg/g (range: 0.2-34.01), and levels were highest in Michigan birds. THg levels in liver (r(p) = 0.805) and breast feathers (r(p) = 0.611) significantly correlated with those in brain. Brain Hg was not associated with binding to the GABA(A) receptor. Brain THg and inorganic Hg (IHg) were significantly positively correlated with GS activity (THg r(p) = 0.190; IHg r(p) = 0.188) and negatively correlated with NMDA receptor levels (THg r(p) = -0245; IHg r(p) = -0.282), and IHg was negatively correlated with GAD activity (r(s) = -0.196). We also report upon Hg demethylation and relationships between Hg and Se in brain and liver. These results suggest that bald eagles in the Great Lakes region are exposed to Hg at levels capable of causing subclinical neurological damage, and that when tissue burdens are related to proposed avian thresholds approximately 14-27% of eagles studied here may be at risk.

Estimating the true prevalence of Mycobacterium bovis in free-ranging elk in Michigan.

Although relatively small, Michigan's elk (Cervus elaphus nelsoni) herd is highly valued by both hunters and the general public. Elk and red deer (Cervus elaphus elaphus) are highly susceptible to infection with Mycobacterium bovis, the causative agent of bovine tuberculosis (TB), and outbreaks have been documented worldwide. The Michigan elk range lies entirely within counties where TB is known to be enzootic in white-tailed deer (Odocoileus virginianus). Consequently, a project was undertaken to estimate the true prevalence of TB in Michigan's free-ranging elk herd. All elk harvested by licensed hunters during 2002-2004, and all nonharvest elk mortalities examined by the Michigan Department of Natural Resources Wildlife Disease Laboratory from November 2002-May 2005, were screened for gross lesions of TB with samples of cranial lymph nodes and palatine tonsils collected for histopathology and mycobacterial culture. In all, 334 elk were included in the study. Twenty-three elk with gross lesions were considered TB suspects; all were culture-negative for M. bovis. However, M. bovis was cultured from two elk without gross lesions. The sensitivity, specificity, and negative predictive value of the current TB surveillance protocol were 0%, 100%, and 99.4%, respectively, while the apparent prevalence and true prevalence calculated directly from the sample were 0% and 0.6%, respectively. The positive predictive value and the estimated true prevalence of the population were undefined. The poor sensitivity of current surveillance was likely an artifact of its application to a relatively small sample, in order to detect a disease present at very low prevalence. The low prevalence of TB in Michigan elk, and the early stage of pathogenesis of the few infected animals, does not suggest elk are maintenance hosts at the present time.

Statistical characterization of hyperspectral background clutter in the reflective spectral region.

Hyperspectral imaging systems for daylight operation measure and analyze reflected and scattered radiation in p-spectral channels covering the reflective infrared region 0.4-2.5 microm. Consequently, the p-dimensional joint distribution of background clutter is required to design and evaluate optimum hyperspectral imaging processors. In this paper, we develop statistical models for the spectral variability of natural hyperspectral backgrounds using the class of elliptically contoured distributions. We demonstrate, using data from the NASA AVIRIS sensor, that models based on the multivariate t-elliptically contoured distribution capture with sufficient accuracy the statistical characteristics of natural hyperspectral backgrounds that are relevant to target detection applications.

Sarcoptic mange and Pelodera dermatitis in an American black bear (Ursus americanus).

An adult female free-ranging American black bear (Ursus americanus) was presented in poor body condition, with advanced skin disease. Skin changes included hair loss, lichenification, crusting, and focal erosions. Skin scrapings and histopathology identified two distinct parasitic conditions that were contributing to this animal's dermatitis. Large numbers of larvae, nymphs, and adults of Sarcoptes scabiei were present in the superficial epidermis, and nematodes consistent with Pelodera strongyloides were abundant within the hair follicles. This appears to be the first reported case of Pelodera dermatitis in a bear species, adding a new differential agent to the list for dermatitis in bears. The sarcoptic mange and poor body condition of this bear may have been contributing factors to the development of the opportunistic Pelodera infestation.

An outbreak of Eastern equine encephalitis virus in free-ranging white-tailed deer in Michigan.

Eastern equine encephalitis (EEE) virus has been recognized as affecting horses and humans in the eastern United States for 70 yr. Evidence of exposure with EEE virus has been reported in a variety of free-ranging wild birds and mammals but cases of clinical disease are much less commonly reported. In Michigan, reports of outbreaks of EEE virus in equine species extend back more than a half century. We report diagnosis of EEE virus infection of multiple free-ranging white-tailed deer (Odocoileus virginianus) from three Michigan counties during late summer of 2005. Infection was confirmed in seven of 30 deer collected based on reported neurologic signs and results from immunohistochemistry, polymerase chain reaction, and/or virus isolation. One of the deer also was infected with West Nile virus and an eighth deer had microscopic lesions in the cerebrum consistent with those reported for EEE. To our knowledge, this is the first report of multiple cases of EEE in free-ranging white-tailed deer, and highlights several issues of significance to wildlife managers and public health officials.

Sarcoptic mange in raccoons in Michigan.

Sarcoptic mange is a cause of pruritic skin disease in domestic dogs and a wide range of wildlife species. We describe sarcoptic mange in free-ranging raccoons (Procyon lotor). Three adult raccoons from upper Wayne County, Michigan (USA), were captured, killed, and submitted for diagnostic evaluation. The animals were intensely pruritic, and two had advanced alopecic and crusting lesions over their dorsum and hind limbs. Skin scrapings and skin biopsies revealed crusting and hyperkeratotic dermatitis with high numbers of Sarcoptes scabiei adults, larvae, nymphs, and eggs. These raccoons were not otherwise debilitated, with minimal internal parasites, good body condition, and no evidence of infectious bacterial or viral diseases. Because sarcoptic mange is highly contagious and affects many species, including humans, transiently, it is important that wildlife biologists and rehabilitators include sarcoptic mange in their differential list for raccoons exhibiting pruritus and alopecia.