[Work-related MRSA CC398 carrier status had serious psychosocial consequences to a farmer]. / Arbejdsbetinget MRSA-bærertilstandmedførte alvorlige psykosociale konsekvenserfor en landmand.

We describe a case of work-related methicillin-resistant Staphylococcus aureus (MRSA) CC398 carrier status in a 33-year-old male working at a pig farm. The case was complicated since his pregnant girlfriend had also MRSA CC398 carrier status. Although she remained without contact to farm animals the MRSA could not be eradicated. Conflicting messages from healthcare workers complicated the case and the psychological consequences became traumatizing to the patient and caused sick leave and psychotherapy. This case shows the importance of better information of MRSA CC398-positive patients in the future, especially for MRSA-exposed occupations.

Infectious risk factors for individual postweaning multisystemic wasting syndrome (PMWS) development in pigs from affected farms in Spain and Denmark.

Two prospective longitudinal studies in 13 postweaning multisystemic wasting syndrome (PMWS)-affected farms from Spain (n=3) and Denmark (n=10) were performed. Blood samples from pigs were longitudinally collected from 1st week until the occurrence of the PMWS outbreak. Wasted and healthy age-matched pigs were euthanized, necropsied and histopathologically characterised. PMWS diagnosis was confirmed by means of lymphoid lesions and detection of porcine circovirus type 2 (PCV2) in these tissues by in situ hybridization or immunohistochemistry. Serological analyses were performed in longitudinally collected serum samples to detect antibodies against, PCV2, porcine reproductive and respiratory syndrome virus (PRRSV), porcine parvovirus (PPV), swine influenza virus (SIV) and Lawsonia intracellularis (law), Mycoplasma hyopneumoniae, Aujeszky's disease virus (ADV) and Salmonella spp. A Cox proportional hazards model was used to investigate the simultaneous effects of seroconversion and maternal immunity against the studied pathogens. Results showed that high levels of maternal immunity against PCV2 had a protecting effect in farms from both countries. Moreover, for the Danish dataset, seroconversion against law had an overall protecting effect, but for animals with very low levels of maternal antibody levels against this pathogen, the effect appeared neutral or aggravating. Otherwise, for the Spanish dataset, maternal immunity against PPV and PRRSV gave protective and aggravating effects, respectively. In conclusion, the present study reflects the complex interaction among different pathogens and their effects in order to trigger PMWS in PCV2 infected pigs.

Selection of method is crucial for the diagnosis of porcine circovirus type 2 associated reproductive failures.

During a 2-month period a newly repopulated Danish pig herd experienced an increase in numbers of stillborn and mummies, caused by porcine circovirus type 2 (PCV2) associated reproductive failure. Based on recordings of data over time, the progression of the clinical outbreak was studied and the diagnostic value of different techniques was evaluated. Foetal hearts (38 cases and 13 controls) were examined by immunohistochemistry (IHC) and real-time polymerase chain reaction (PCR) for the detection of PCV2; and total immunoglobulin G (IgG) was measured in pleura cavity fluid. PCV2 IHC was positive in 14/38 of the case foetuses, which were delivered during a 9 days period early in the outbreak. On the basis of the results obtained by IHC and PCR, the foetuses were divided into 3 categories: PCV2 negative; moderately positive (10(4) to 10(7) copies per 500 ng DNA); and massively positive for PCV2 (>10(7) copies per 500 ng DNA). All control- and IHC positive foetuses were included in the negative and massively positive groups, respectively. Ten case foetuses had elevated IgG levels, which did not correlate with the IHC or PCR results. Based on the clustering of the IHC positive foetuses, it is suggested that IHC only is suited for diagnosing acute stages of reproductive failure, whereas quantitative PCR can be used as a sensitive diagnostic method within a wider time span. It seems that IgG measurements are unpredictable as indication of intrauterine infection with PCV2.

Induction of porcine post-weaning multisystemic wasting syndrome (PMWS) in pigs from PMWS unaffected herds following mingling with pigs from PMWS-affected herds.

In this paper we present the results from two experimental studies (I and II) investigating whether post-weaning multisystemic wasting syndrome (PMWS) can be induced in pigs from PMWS unaffected herds by mingling with pigs from PMWS-affected herds and to observe whether transportation and/or mingling of healthy pigs from unaffected herds could induce PMWS. The studies comprised pigs from 12 different herds. Eight herds had PMWS while four were unaffected. All 12 herds were found to be infected with PCV2. Pigs from PMWS-affected herds were mingled with pigs from unaffected herds in four separate compartments in both study I and study II. In addition, in study II, four groups of pigs from unaffected herds were included. Two groups with pigs transported and mingled from unaffected herds and two groups with pigs which were only transported. The PMWS diagnoses on the individual pigs were based on lymphoid depletion, histiocytic proliferation and the presence of giant cells or inclusion bodies together with the demonstration of PCV2 in lymphoid tissue. Healthy pigs, in both studies, developed PMWS 4-5 weeks after mingling with pigs clinically affected with PMWS. None of the pigs from unaffected herds which had no contact with pigs from PMWS-affected herds developed clinical signs of PMWS. Transportation and mingling of pigs from PMWS unaffected herds in combination or alone was insufficient to provoke PMWS.

Infection, excretion and seroconversion dynamics of porcine circovirus type 2 (PCV2) in pigs from post-weaning multisystemic wasting syndrome (PMWS) affected farms in Spain and Denmark.

Longitudinal case-control studies were performed in post-weaning multisystemic wasting syndrome (PMWS) affected farms from Denmark and Spain using similar designs. Fourteen independent batches of 100-154 pigs per batch were monitored from birth to PMWS outbreak occurrence. Pigs displaying PMWS-like signs and matched healthy cohorts were euthanized during the clinical outbreak. PMWS was diagnosed according to internationally accepted criteria and pigs were classified as: (i) PMWS cases, (ii) wasted non-PMWS cases and (iii) healthy pigs. Porcine circovirus type 2 (PCV2) quantitative PCR (qPCR) and serology techniques were applied to analyse longitudinally collected sera and/or nasal and rectal swabs. Results showed that PCV2 load increased in parallel to waning maternal antibody levels, reaching the maximum viral load concurrent with development of clinical signs. PMWS affected pigs had higher PCV2 prevalence and/or viral load than healthy pigs in all collected samples at necropsy (p<0.0001-0.05) and even in sera and nasal swabs at the sampling prior to PMWS outbreak (p<0.01-0.05). Danish farms had a higher PCV2 prevalence in young piglets as well as an earlier PMWS presentation compared to Spanish farms. PMWS diagnoses were confirmed by laboratory tests in only half of pigs clinically suspected to suffer from PMWS. Positive and significant correlations were found among PCV2 viral loads present in sera, nasal swabs, rectal swabs and lymphoid tissues (R=0.289-0.827, p<0.0001-0.01), which indicates that nasal and rectal swabs were suitable indicators of PCV2 excretion. Sensitivity and/or specificity values observed from both tests used separately or combined suggested that qPCR and/or serology tests are not apparently able to substitute histopathology plus detection of PCV2 in tissues for the individual PMWS diagnosis within PMWS affected farms. However, qPCR appears to be a potential reliable technique to diagnose PMWS on a population basis.

Application of fluorescent in situ hybridisation for demonstration of Coxiella burnetii in placentas from ruminant abortions.

A fluorescent in situ hybridisation (FISH) assay targeting 16S ribosomal RNA was developed for detection of the zoonotic bacterium Coxiella burnetii in formalin-fixed, paraffin-embedded tissue, and applied on placentas from ruminant abortions. The applicability of the FISH assay was compared to immunohistochemistry (IHC) using human positive control serum in 12 cases of C. burnetii-associated placentitis as well as 7 negative control tissue samples. In all 12 cases the bacterium was detected within trophoblasts as well as free in the placental debris by both FISH and IHC. Extensive and significant infection by C. burnetii was revealed in 10 of the cases, whereas a slighter and focal distribution of the bacterium was observed in two cases. 90 aborted placentas from Danish ruminants were investigated by FISH. C. burnetii was detected in one bovine case only, representing the first confirmation of C. burnetii in Danish animals. The study shows that FISH targeting 16S ribosomal RNA is a feasible diagnostic tool for detection of C. burnetii in tissue samples and fully comparable to IHC.

Spatial and temporal patterns of pig herds diagnosed with Postweaning Multisystemic Wasting Syndrome (PMWS) during the first two years of its occurrence in Denmark.

The clinical syndrome Postweaning Multisystemic Wasting Syndrome (PMWS) in pigs has emerged globally during the last decade. In October 2001, the first pig herd diagnosed with PMWS was reported in Denmark, and since then the number of herds diagnosed with PMWS has increased markedly. The etiology of PMWS is not well understood, but increased knowledge of the causal factors is prerequisite for applying preventive interventions. In this study we described the temporal (time of diagnosis), spatial (location of herds) and spatio-temporal pattern of Danish pig herds diagnosed with PMWS during the first two years after the first herd was diagnosed, and we tested for spatial and spatio-temporal clustering using scan statistics. The study population consisted of pig herds that during the study period (October 2001-September 2003) performed diagnostic submissions to the two major veterinary diagnostic laboratories in Denmark (6724 herds). Of these, 277 herds were diagnosed with PMWS. Two statistically significant spatial clusters of herds diagnosed with PMWS were identified. These clusters included 11% and 8% of the study herds, respectively. Within these two clusters the relative risk for a herd to be diagnosed with PMWS was twice as high as expected. One statistically significant spatio-temporal cluster was identified between February and May 2002. We discuss different hypotheses that could explain why pig herds diagnosed with PMWS were clustered both spatially and spatio-temporally, and conclude that the results support the hypothesis that PMWS is caused by introduction of a new, unidentified, pathogen into the Danish pig production.

Exudative epidermitis in pigs caused by toxigenic Staphylococcus chromogenes.

Staphylococcus chromogenes is closely related to Staphylococcus hyicus, which is recognised as the causative agent of exudative epidermitis (EE) in pigs. S. chromogenes is part of the normal skin flora of pigs, cattle and poultry and has so far been considered non-pathogenic to pigs. A strain of S. chromogenes producing exfoliative toxin type B, ExhB, was identified by the use of a multiplex PCR specific for the exfoliative toxins from S. hyicus. The exfoliative toxin from S. chromogenes reacted in immunoblot analysis with polyclonal and monoclonal antibodies specific to ExhB from S. hyicus and had an apparent molecular weight of 30 kDa. Sequencing the gene encoding the exfoliative toxin from S. chromogenes revealed that the molecular weight of the toxin with the signal peptide and the mature toxin was 30,553 and 26,694 Da, respectively. Comparison of the exhB genes from S. chromogenes strain VA654 and S. hyicus strain 1289D-88 showed differences in seven base pairs of the DNA sequences and in two amino acid residues in the deduced amino acid sequences. Pigs were experimentally inoculated with S. chromogenes strain VA654. By clinical observations and histopathological evaluation of the skin alterations, all pigs revealed development of generalized exudative epidermitis. No toxin producing S. hyicus was isolated from the pigs and all ExhB-positive bacterial isolates were identified as S. chromogenes. This confirmed that the disease-causing agent was the inoculated S. chromogenes strain VA654. The results of this study show that S. chromogenes may cause exudative epidermitis in pigs.

Emission of di-2-ethylhexyl phthalate from PVC flooring into air and uptake in dust: emission and sorption experiments in FLEC and CLIMPAQ.

The emission of di-2-ethylhexyl phthalate (DEHP) from a PVC flooring was studied for up to 472 days in both the FLEC (Field and Laboratory Emission Cell) and the CLIMPAQ (Chamberfor Laboratory Investigations of Materials, Pollution, and Air Quality). The loading of the CLIMPAQs was varied but was constant in the FLECs. The sorption properties of FLEC and CLIMPAQ were investigated using different methods. In addition, the uptake of DEHP by office floor dust on the PVC flooring was studied in CLIMPAQ experiments. The concentration versus time curves in both FLECs and CLIMPAQs increased slowly over about 150 days and reached a quasi-static equilibrium at 1 microg m(-3). The main conclusions were that (i) the emission rate of DEHP was limited by gas-phase mass transport and (ii) the dust layer increased the emission rate by increasing the external concentration gradient above the surface of the PVC. These conclusions were based on the facts that the specific emission rate was inversely proportional to the loading and that the dust had sorbed about four times as much DEHP over a 68-day period as emitted in the gas-phase experiments. About one-half of the emitted DEHP was deposited on the internal surfaces of both the FLEC and the CLIMPAQ.

Simultaneous extraction of di(2-ethylhexyl) phthalate and nonionic surfactants from house dust. Concentrations in floor dust from 15 Danish schools.

Static extraction, supercritical fluid extraction (SFE), pressurized liquid extraction (PLE) and Soxhlet extraction were compared for simultaneous extraction of di(2-ethylhexyl) phthalate (DEHP) and nonionic surfactants from house dust. Homogenized office floor dust from a vacuum cleaner dust bag ("standard dust") was used for the evaluation. One portion of the extracts was used for analysis of nonionic surfactants with LC-MS and another portion was used for DEHP analysis with GC-MS. The extraction yield of DEHP was comparable for all the methods whereas SFE and PLE were the most efficient extraction techniques for the nonionic surfactants. The PLE extraction was found most suitable as a routine method for simultaneous extraction of both types of compounds and was used in a field study of floor dust from 15 Danish schools. The mean concentration of DEHP in the school dust samples was approximately 4 times higher than observed in other studies of dust from homes in different countries. The concentrations of nonionic surfactants were one order of magnitude lower than soap and linear alkylbenzene sulfonates measured in other studies of floor dust from offices and other public buildings. However, for the first time nonionic surfactants have been identified in house dust.

Prevalence and diversity of Arcobacter spp. isolated from the internal organs of spontaneous porcine abortions in Denmark.

A study was conducted to determine the prevalence and possible significance of campylobacteria in pig abortions in Denmark. Surface-cauterised liver and kidney samples from 55 aborted pig fetuses submitted to the Danish Veterinary Laboratory were taken and a sensitive isolation procedure used to examine pooled tissue samples for Campylobacter, Arcobacter and Helicobacter spp. Routine microbiological, immunological, and histopathological examinations were also performed to identify concurrent infections or histopathological changes. The abortions tested negative for established abortifacient pathogens (Brucella, Leptospira, PPV, PRRSV), but Arcobacter spp. were recovered from 23/55 abortions. Co-infections with Streptococcus suis, Escherichia coli, and haemolytic streptococci were observed in 7/23 Arcobacter-positive fetuses, and in 4/32 Arcobacter-negative fetuses. Histopathological analyses identified placentitis, pneumonia, hepatitis and encephalitis among the study group. However, no obvious pathologic features were solely associated with Arcobacter-positive cases, nor were Arcobacter-like bacteria observed in tissue samples. Protein profile analyses of the 27 Arcobacter isolates identified 11 as A. cryaerophilus and 10 as A. skirrowii. Six strains could not be classified into any existing species and were phenotypically distinct, thus, potentially representing at least one new species. The identification results showed that multiple taxa could be found in a single fetus, and in distinct aborted fetuses from a single sow. The high prevalence of arcobacters in Danish pig abortions may account for at least some of the >90% of cases in which no established abortifacient agent is detected, but further studies are needed to define the role of each species, especially where co-infections with other bacteria are present.