[Evaluation of a woman's care program after pre-eclampsia]. / Évaluation d'un parcours de soin chez la femme au décours d'une prééclampsie.

INTRODUCTION: The medical treatment of preeclampsia is well structured in its acute phase but the required follow-up with patients in post-partum is discussed. However, preeclampsia is associated with an increased risk of cardiovascular morbi-mortality in the long term. In order to optimize the post-partum treatment, a care program has been developed for these patients in the city of Nantes, France. This includes a check-up of the cardiovascular risks at a day hospital. Our study presents the first results of this program. METHODS: The study included 134 patients who were diagnosed with preeclampsia between October 2016 and January 2019 in the Nantes area, France, and took part in the program within the year following their childbirth. A descriptive analysis was first carried out and then a multivariate logistic regression model was used to investigate the risk factors for persistent high blood pressure after preeclampsia. RESULTS: The study detected 28 cases of persistent hypertension (20.9%), 34 cases of obesity (25.3%) and 1 case of diabetes. Hypertension was predominantly diastolic, mild and sometimes masked (35.7%). In a third of the cases (32.1%), the hypertension was secondary. High blood pressure was found to be more frequent in older patients (OR: 2.26; 95% CI: 1.25-4.11, p=0.072), patients from sub-Saharan Africa (OR: 11.52; 95% CI: 2.67-49.86, p=0.01) and multiparous patients (OR: 7.82; 95% CI: 1.15-53.21, p=0.035). CONCLUSION: The study confirmed that this care program enables an earlier detection and therefore treatment of the cardiovascular risk factors of these young women.

Pharmaco-epidemiology and -economics should be developed more extensively in veterinary medicine.

Pharmaco-epidemiology, which has emerged within the last 20 years as a new discipline in human medicine, deals with the quantities of drugs consumed and their effects on populations in terms of epidemiological concepts and tools. To a lesser extent, it is also practised in veterinary medicine. The applications presented in this review are illustrative of pharmaco-epidemiological and -economical concepts. Assessment of drug consumption, the study of adverse drug effects, and the economic implications of drug use are the three main fields considered. Developments can be expected in veterinary medicine within the next few years relative to novel areas of interest such as antimicrobial resistance and new therapeutic class uses. These applications will require methodological progress and the elimination of current gaps. Pharmaco-epidemiological methods need to be developed, which implies close co-operation between statisticians, pharmacologists, veterinary practitioners and epidemiologists. A greater use of the term 'pharmaco-epidemiology' as a keyword in literature would facilitate recognition of this domain which associates closely epidemiology and pharmacology.

Efficacy of difloxacin in growing broiler chickens for the control of infection due to pathogenic Mycoplasma gallisepticum.

Chickens 14 days old were experimentally inoculated with Mycoplasma gallisepticum (MG) R-P10 strain. After development of respiratory symptoms, birds were left unmedicated or medicated for 5 consecutive days with Difloxacin 5, 7.5 or 10 mg/kg body weight per day or Enrofloxacin at the dose level of 10 mg/kg body weight per day. Evaluation of efficacy was based on body weight, symptoms, post-mortem findings, re-isolation of MG and serology. Results indicated that under the conditions of this experiment, treatment with 7.5 mg Difloxacin per kg body weight for 5 days was already effective against pathogenic MG infection. The dose of 10 mg/kg Difloxacin was equally effective as a dose of 10 mg/kg Enrofloxacin in treating respiratory symptoms.

Vaccination du pigeon contre Salmonella typhimurium.

Les salmonclles constituent l'une des preoccupations majeures des eleveurs de pigeons. Aussi, afin de diminuer le portage et d'assurer la protection des animaux ainsi que celle des consommateurs, des moyens de detection et de prevention doivent etre developpes. Dans ce cadre, il a ete mis au point une technique ELISA pour detecter les anticorps anti-Salmonella typhimurium chez des pigeons recevant un autovaccin. Le vaccin a entraine une protection de 85% des pigeons vaccines a 7 et 11 semaines et de 50% des sujets vaccines a 11 semaines, alors que les temoins non vaccines sont tous morts apres l'epreuve a 13 semaines. La vaccination n'exclut pas le portage ni l'excretion.

Passive protection of specific pathogen free chicks against infectious bursal disease by in-ovo injection of semi-purified egg-yolk antiviral immunoglobulins.

In order to develop an experimental model for passive immunity in SPF chickens, active neutralizing immunoglobulins (Ig) directed against infectious bursal disease virus (IBDV) were extracted from the yolk of eggs laid by conventional layers immunized against IBDV. Concentrated Ig extracts were inoculated via the intra-vitellin route into 7-day-old embryonated SPF hen eggs. Although detrimental to hatchability, Ig inoculation resulted in hatching two series of SPF chicks with passive immunity against IBDV. The neutralizing and ELISA antibody titres at 1 day-old (respectively 12.64 and 13.15 log2; and 4915 and 4277), the kinetics of decay of the anti-IBDV antibodies and the protection afforded by passive antibodies against highly virulent IBDV challenge proved highly consistent with data previously reported on conventional chicks. In-ovo inoculation of purified egg-yolk immunoglobulins may hence be a good experimental model for anti-IBDV maternally-transmitted immunity. This experimental model might possibly be adapted to other pathogens or vaccines for which interference with maternally derived antibodies is a matter of concern at 1 day-old.

[Risk for the transmission of Newcastle disease by contaminated poultry products]. / Risques de transmission de la maladie de Newcastle par des produits avicoles contaminés.

Poultry products contaminated with pathogenic strains of Newcastle disease virus are a source of virus transmission to susceptible poultry flocks. The probability of contamination varies according to the type of product. Research conducted by various laboratories in Europe has shown that pathogenic virus can be isolated from the carcasses of chickens, whether vaccinated or not, during a brief period after experimental infection. Eggs laid by hens infected with Newcastle disease virus present a very low risk. Furthermore, feathers, bones, blood and offal present potential risks if they are incorporated in poultry feed. Finally, poultry droppings used as a fertiliser can present a major risk of infection in certain circumstances.

Modified activity of a VP2-located neutralizing epitope on various vaccine, pathogenic and hypervirulent strains of infectious bursal disease virus.

Nine monoclonal antibodies (Mabs) to a vaccine strain of infectious bursal disease virus (IBDV) of intermediate virulence were characterized in Western-blot, radioimmunoprecipitation, ELISA additivity, and neutralization assays. At least two distinct serotype 1-specific conformation-dependent overlapping neutralizing antigenic domains were shown to be present on IBDV-VP2, and were respectively probed by Mabs 3 and 4, and by Mabs 6 and 7. Ten serotype 1 vaccine or pathogenic IBDV strains were tested for neutralization. Most mild or intermediate vaccine strains were efficiently neutralized by all Mabs, whereas US variant A, European pathogenic strain Faragher 52/70 and French hypervirulent isolate 89163 were not neutralized by Mabs 3 and 4. In addition, these two Mabs were shown to bind to the Faragher 52/70 strain, but not to the 89163 isolate, in an antigen-capture ELISA. These results suggest that a neutralizing epitope is possibly modified in European pathogenic IBDV strains, and that Mabs 3 and 4 may prove useful for antigenic differentiation between European classical and hypervirulent isolates.

Limited antigenic variation among recent infectious bursal disease virus isolates from France.

Seven neutralizing monoclonal antibodies (Mabs) to infectious bursal disease virus (IBDV) were used in an antigen-capture ELISA for the antigenic characterization of 58 IBDV isolates obtained in France since 1989. Fifty-six isolates exhibited an antigenic profile which was different from reference strain Faragher 52/70, and similar to French very virulent IBDV strain 89,163 (no binding of two Mabs). Two strains (3.4%), isolated in 1991 and 1994, showed additional antigenic modifications resulting in suppressed or reduced binding activity of three other Mabs. The two atypical viruses were not re-identified in field samples subsequently collected, hence showing that antigenic variants of IBDV do not tend to replace the antigenically dominant 89,163-like strains that have prevailed in France since 1989.

Efficacy of tilmicosin in the control of experimental Mycoplasma gallisepticum infection in chickens.

This study was conducted to evaluate the efficacy of 5-day, "in water" tilmicosin medication for the prevention of experimental Mycoplasma gallisepticum (MG) disease in 10-day-old specific-pathogen-free (SPF) chickens. Birds were inoculated intratracheally and into the sinus with the MG R-P10 strain. A limited dose titration of the antibiotic over the expected effective range was included, using six groups of 60 birds each: UI: uninfected untreated group; IUT: infected untreated group; IT1 to IT4: four infected treated groups, which were administered 50, 100, 200, or 300 mg/liter of tilmicosin. The birds were given tilmicosin from 8 to 13 days of age and were inoculated at 10 days of age. The birds were observed for 11 days postchallenge before terminal postmortem examination was completed including, assessment of lesions and sampling for mycoplasma culture and serology. Body-weight gains of the different groups were compared. The results showed that tilmicosin medication at dose levels of 50-300 mg/liter significantly decreased growth losses and respiratory signs due to MG infection (P < 0.05). Significant reduction in air sac and peritonitis lesions were obtained by treatment with 100, 200 or 300 mg/liter for 5 days (P < 0.05). A significant reduction in the proportion of MG-culture-positive birds was obtained at a dose level of 50 mg/liter (P < 0.05). Increasing the dose resulted in a further decrease in the number of MG shedding chickens to the extent that with the two highest doses of tilmicosin, no bird was serologically positive on day 21, compared to 46/58 positively infected untreated birds (day 21).

Experimental infection of chickens with an atypical Mycoplasma gallisepticum strain: comparison of diagnostic methods.

Fifteen chickens were inoculated with the atypical Mycoplasma gallisepticum (MG) K703 strain. On different dates post inoculation, tracheal swab samples were collected for mycoplasma culture and blood samples were analysed by slide agglutination test (SA) with commercial or homologous antigen and enzyme-linked immunosorbent assay (ELISA) with three different kits. Results showed that MG isolation rate was low on several sampling dates. The SA with commercial antigen did not yield positive results, although birds were positive when tested with homologous antigen. With commercial ELISA kits, the numbers of positive samples remained low. These results illustrate the difficulty of diagnosis of infections with such MG variant strains.

World Health Organisation--supervised interlaboratory comparison of ELISAs for the serological detection of Salmonella enterica serotype Enteritidis in chickens.

A collaborative exercise, supervised by the World Health Organisation, was set up to compare ELISAs used for the serological detection of Salmonella enteritica serotype Enteritidis in chickens. The aim was to ascertain how far agreement could be reached on the interpretation of optical density readings for high titre, intermediate titre and low titre sera. Two sets of sera were sent to 14 participants. The first set compared high, medium and low titre sera raised in specified-pathogen-free and commercial broiler breeder chickens. The second set comprised 20 sera of different antibody titres raised in commercial birds reared under laboratory conditions and sent blind. Both indirect and double-antibody sandwich blocking ELISAs were used with a number of different detecting antigens. With a few exceptions good agreement was reached on the interpretation of results obtained from high and low titre sera from the optical density obtained with a single serum dilution. Differences were observed in the interpretation of medium titre sera. The results suggested that most ELISAs produce reasonably comparable results and that practical problems may arise from interpretation of the results mainly as a result of the choice of the criteria used for differentiating sera obtained from infected and uninfected chickens. These problems are discussed.

Replication-defective adenovirus type 5 as an in vitro and in vivo gene transfer vector in chickens.

The capacity of E1A gene-deleted and thus replication-defective adenovirus type 5 (Ad5) to transduce foreign genes in chicken embryo fibroblasts (CEF) as well as in chickens was investigated. The lacZ and luciferase genes were successfully transduced in CEF by replication-defective Ad5, demonstrating that these cells possess receptor(s) for binding and penetration of Ad5. A single intramuscular inoculation of Ad-gD, a replication-defective Ad5 harbouring the gD gene of pseudorabies virus, in adult and 1-day-old chickens led to the production of a very high titres of specific antibodies. These gD-specific antibodies persisted for at least 56 days. These results demonstrate that replication-defective Ad5, despite its mammalian origin and the deletion of the E1A gene, is a good candidate for developing non-spreading vaccines in poultry.

Dose titration study of enrofloxacin (Baytril) against respiratory colibacillosis in Muscovy ducks.

Four-week-old specific-pathogen-free Muscovy ducks were inoculated with reovirus. One week later, they were inoculated intratracheally with a O78:K80 strain of Escherichia coli. The next day, they were given enrofloxacin at different doses in the drinking water. Comparison of mortality rates, weight gain, macroscopic lesions, and E. coli re-isolations among treated and untreated birds showed that a 5-day treatment course with 12.5 or 25 ppm enrofloxacin in water for 4 hours in the morning provided good therapeutic efficacy against respiratory colibacillosis.

Evaluation of different turkey rhinotracheitis viruses used as antigens for serological testing following live vaccination and challenge.

Two enzyme-linked immunosorbent assays (ELISA) developed in the authors' laboratory for turkey rhinotracheitis serological testing, a commercial ELISA kit, and two virus-neutralization (VN) assays were compared with respect to the efficiency of these assays for serological monitoring in specific-pathogen-free (SPF) turkeys inoculated with four pathogenic isolates of turkey rhinotracheitis virus, with or without previous live vaccination. Both the live vaccine and the different isolates of virus were shown to induce antibody rises, the detectability of which varied depending on the ELISA or VN assay used for serological testing. The results show that 3 weeks after vaccination with an attenuated strain, the choice of an inadequate antigen for serological testing may be the cause of an apparent lack of immunogenicity of the vaccine, and that 2 weeks after challenge, such a choice in ELISA can also hinder the early diagnosis of a TRT virus infection in both vaccinated and unvaccinated turkeys.

Mycoplasma gallisepticum infection in drug-treated chickens: comparison of diagnosis methods including polymerase chain reaction.

Ten chickens were inoculated with Mycoplasma gallisepticum (MG) and treated with enrofloxacine. On eight different dates post-inoculation (PI), tracheal swab samples were collected for mycoplasma culture or detection by polymerase chain reaction (PCR), and blood samples were analysed by slide-agglutination test (SA) and enzyme-linked immunosorbent assay (ELISA). Results showed that culture and PCR detected MG from 14/80 or 20/80 samples, respectively. The last culture-positive sample was collected on day 26 PI, whereas PCR still gave positive results on day 54 PI. This difference may be attributed to the high sensitivity of PCR and to its ability to detect non-viable or non-culturable pathogens. Sera were SA positive as early as 5 days PI and some of them remained positive up to day 47 PI. ELISA detected 53 suspicious or positive sera.

Evaluation of two commercial enzyme-linked immunosorbent assay kits for the detection of Mycoplasma gallisepticum antibodies.

Sensitivity and specificity of two commercial Mycoplasma gallisepticum (MG) enzyme-linked immunosorbent assay (ELISA) kits, rapid slide agglutination (SA) and haemagglutination inhibition (HI) tests were compared using sera from specific pathogen free chickens, turkeys or ducks which had been inoculated with various avian mycoplasmas, bacteria or with a reovirus. Results show that sensitivity of SA was superior to ELISA and HI tests in the ability to detect antibodies formed in early response to MG infection. However, both ELISA kits and HI tests had a higher degree of specificity.

Comparison of antigenic and pathogenic properties of Mycoplasma iowae strains and development of a PCR-based detection assay.

The six reference strains of Mycoplasma iowae (I, J, K, N, Q and R) and 12 field strains, most of them isolated from turkeys, were studied with a growth-inhibition test and a dot immunobinding test with rabbit antisera to the different serovars of M iowae, 16S rDNA gene amplification by polymerase chain reaction, and pathogenicity for chicken or turkey embryos. Antigenic tests tended to be strain specific and showed that most field strains were closely related to serovars K or N. The two pairs of primers chosen in 16S rDNA guided the amplification of 332 base pairs (bp) or 892 bp fragments from all the M iowae strains tested. All the field strains tested were highly pathogenic for turkey embryos.

The polymerase chain reaction for Mycoplasma gallisepticum detection.

On the basis of the aligned 16S rRNA sequences of Mollicutes, a pair of primers was chosen for the detection of Mycoplasma gallisepticum. When used in the polymerase chain reaction (PCR), the primers detected a specific amplification of all Mg strains tested, yielding an expected 330 bp product. Amplification was not detected when other Mollicutes or E. coli were used as PCR templates. SPF chickens were experimentally inoculated with two strains of M. gallisepticum or Mycoplasma iowae. Tracheal swabs were collected 8, 15, 20 and 28 days after inoculation, and cultured for mycoplasma or tested by PCR. PCR products were detected by hybridization with a digoxigenin-labeled probe and by chemiluminescence. The results showed that culture was positive for 49/73 swabs while PCR detected 70/72 positive samples. Thus, PCR can provide the basis of a sensitive, specific, rapid and non-radio-active method for detecting M. gallisepticum.