Use of a voluntary testing program to study the spatial epidemiology of Johne's disease affecting dairy herds in Minnesota: a cross sectional study.

BACKGROUND: One of the key steps in the management of chronic diseases in animals including Johne's disease (JD), caused by Mycobacterium avium subsp. paratuberculosis (MAP), is the ability to track disease incidence over space and time. JD surveillance in the U.S. dairy cattle is challenging due to lack of regulatory requirements, imperfect diagnostic tests, and associated expenses, including time and labor. An alternative approach is to use voluntary testing programs. Here, data from a voluntary JD testing program, conducted by the Minnesota Dairy Herd Improvement Association, were used to: a) explore whether such a program provides representative information on JD-prevalence in Minnesota dairy herds, b) estimate JD distribution, and, c) identify herd and environmental factors associated with finding JD-positive cows. Milk samples (n = 70,809) collected from 54,652 unique cows from 600 Minnesota dairy herds between November 2014 and April 2017 were tested using a MAP antibody ELISA. Participant representativeness was assessed by comparing the number of JD-tested herds with the number of herds required to estimate the true disease prevalence per county based on official statistics from the National Agricultural Statistical Services. Multivariable logistic regression models, with and without spatial dependence between observations, were then used to investigate the association between herd status to JD (positive/negative), as indicated by milk ELISA results, and available covariates at the herd level. RESULTS: Within the study population, at least one test-positive cow was found in 414 of 600 (69%) herds. Results indicated that large herds that test frequently and herds located in loamy or silt soils are more likely to have at least one MAP test-positive cow. After adjusting for herd size, testing frequency, and soil type, there was no spatial dependence in JD risk between neighboring dairies within 5 to 20 km. Furthermore, the importance of collecting data on herd management, feed, and biosecurity for insightful interpretations was recognized. The study suggested that, although limited, the voluntary testing database may support monitoring JD status. CONCLUSIONS: Results presented here help elucidate the spatial characteristics of JD in Minnesota and the study may ultimately contribute to the design and implementation of surveillance programs for the disease.

[Interstitial nephritis in typhus]. / Interstitielle Nephritis bei Fleckfieber.

A 58-year-old man developed continuous fever of around 40 degrees C and a macular rash on the trunk and limbs one week after an eight-day visit to the island of Rhodos. Typhus was diagnosed on the basis of the clinical findings, the characteristic rash and a rise in antibody titre against Rickettsia prowazekii and mooseri (1:1280). The fever subsided and the patient's general state markedly improved within three days of starting antibiotic treatment with doxycycline. Five days after hospital admission renal function deteriorated, serum creatinine rising from 1.7 to maximally 8.7 mg/dl. Renal biopsy on the eighth day of illness revealed, in concordance with the diagnosis of a rickettsial infection, acute granulomatous interstitial nephritis. Doxycycline administration was continued for a total of 18 days and renal function improved. Two weeks after discharge serum creatinine had fallen to 1.8 mg/dl and to 1.2 mg/dl after 6 months. The antibody titre against Rickettsia prowazekii had fallen to 1:20 about 12 weeks after discharge. Early antibiotic treatment of typhus is of importance to avoid irreversible renal damage.

[Waldheim--the difficult task of investigation]. / Waldheim--Der schwierige Versuch der Aufarbeitung.

This is a report on a mental hospital--or, rather, a department of a mental hospital--called "Waldheim", (literal meaning: "hostal, or home in the woods") which is a section of the mental hospital at Hochweitzschen in Saxony in the former German Democratic Republic (GDR). Public opinion had been aroused some time ago by an article published in the German weekly "Stern" in which it was stated that psychotic patients were being subjected to leukotomy or stereotactic surgery, and that castration by x-ray treatment was being performed in mentally handicapped women, in that hospital. The article prompted the then Ministery of Health of the GDR to constitute an "expert committee" to investigate into the matter. The magazine's allegations were partly confirmed by the committee. The GDR parliament then constituted a "special parliamentary commission" for another inquiry. Again several allegations were confirmed. It was stated that the events and actions in that hospital had been unsatisfactorily assessed and digested. The authors undertake to make the procedures followed by the medical and nursing staff, accessible to a wider public and to render them more lucid. Important structural characteristics of the patterns that developed there, were the governmentally prescribed segregation of severely diseased persons to "treat" them far away from their residential community, the absence of a critical general public, and the amalgamation of supervisory institutions with those that require to be supervised.(ABSTRACT TRUNCATED AT 250 WORDS)

Treatment of mild hypertension in primary health care: results of a physicians' inquiry, Stuttgart, 1986.

One of the most widely discussed problems in the field of hypertension is the treatment of mild hypertension: 90-104 mmHg diastolic BP. Organizations like the WHO recommend caution with respect to drug therapy. To investigate the actual treatment of hypertension by primary health care services, a standardised questionnaire, based on the study protocol of the WHO-coordinated HYRAP project, was sent to all private practitioners, internists and gynaecologists in private practice in Stuttgart in 1986 (n = 480). The response rate among the general practitioners and internists was 68%. The data indicate that a major part of the physicians favour treatment by health counselling. In contrast, the vast majority (89%) of the physicians report treating mild hypertension exclusively by drug therapy. This wide use of drug therapy may be due to the influence of certain reference groups and the health care system itself. The results support recommendations that special attention be given to the training of physicians in health counselling.

[The appearance of specific IgG and IgA antibodies to Streptococcus pneumoniae in serum and in lung lavage fluid of mice after the administration of different antigens. 1. Development of an enzyme immunoassay (EIA) for the detection of specific IgG and IgA antibodies to Streptococcus pneumoniae]. / Auftreten von spezifischen IgG- und IgA-Antikörpern gegen Streptococcus pneumoniae im Serum und in der Lungenspülflüssigkeit von Mäusen nach unterschiedlicher Antigenapplikation. 1. Mitteilung: Aufbau eines Enzymimmunoassay (EIA) zum Nachweis von spezifischen IgG- and IgA-Antikörpern gegen Streptococcus pneumoniae.

Immunization against streptococcus pneumoniae is for the prophylaxis of pneumococcus diseases in an increased number of risk patients and because of an increasing presence of antibiotica resistance in present days necessary. In order to get better possibilities to test the immunization effect, improved methods for detection of antibodies are applied. In this publication a double sandwich-EIA and a protein-coupled EIA are presented and compared. The double sandwich-EIA has proved to be superior with regard to its day by day variability of 12.5% and its series variability of 3.5% and to be of the same value compared with international developments. The production of most of antigens and antisera is described and the application of gamma-irradiated micro-plates is proposed.

[The appearance of specific IgG and IgA antibodies to Streptococcus pneumoniae in serum and lung lavage fluid of mice after the administration of different antigens. 2. IgG and IgA antibody detection after intraperitoneal, aerosol and oral immunization with Streptococcus pneumoniae]. / Auftreten von spezifischen IgG- und IgA-Antikörpern gegen Streptococcus pneumoniae im Serum und in der Lungenspülflüssigkeit von Mäusen nach unterschiedlicher Antigenapplikation. 2. Mitteilung: IgG- und IgA-Antikörpernachweis nach intraperitonealer, aerogener und oraler Immunisierung mit Streptococcus pneumoniae.

The stimulation of secretory and systemic IgG- and IgA-antibodies in the lung lavage fluid was examined in an animal test. It was also examined in the serum of mice after once to four times oral, aerosol or intraperitoneal immunization with total formalin destroyed bacteria of the species Streptococcus pneumoniae type I. Not only in the lung lavage fluid, but also in the sera specific antibodies could be found with the enzyme immunoassay. An intraperitoneal antigen application mainly resulted in increase of the specific IgG in the serum, whereas an oral and especially aerosol antigen application mainly developed a stimulation of IgA in the lung lavage fluid.