Public health implications of an outbreak of rabies in arctic foxes and reindeer in the Svalbard archipelago, Norway, September 2011.

Between 16 September and 5 October 2011 rabies was diagnosed in two arctic foxes and eight reindeer in the Svalbard archipelago, in Norway. This outbreak occurs at the end of the reindeer hunting season and poses an increased risk to many people that were involved in the hunt. As of 28 September 2011, 280 people had received post-exposure prophylaxis. No human cases of rabies have occurred.

Outbreak of tularaemia in central Norway, January to March 2011.

From January to March 2011, 39 cases of tularaemia were diagnosed in three counties in central Norway: 21 cases of oropharyngeal type, 10 cases of glandular/ulceroglandular type, two of respiratory and two of typhoid type. Three cases were asymptomatic and clinical information was unavailable for one case. The mean age was 40.3 years (range 2-89 years). Thirty-four reported use of drinking water from private wells. An increased rodent (lemming) population and snow melting may have led to contamination of the wells with infected rodents or rodent excreta.

Rabies in an Arctic fox on the Svalbard archipelago, Norway, January 2011.

We report a case of rabies in an Arctic fox. In January 2011 a fox attacked dogs belonging to a meteorological station in the Svalbard archipelago, Norway. Rabies virus was detected in the fox's brain post-mortem. The dogs had been vaccinated against rabies and their antibody levels were protective. Post-exposure prophylaxis was administered to staff at the station. Rabies vaccination is recommended for inhabitants and visitors to the Arctic who may be in contact with wild animals.

Digital necrobacillosis in Norwegian wild tundra reindeer (Rangifer tarandus tarandus).

Outbreaks of digital necrobacillosis in Norwegian wild tundra reindeer (Rangifer tarandus tarandus) are described. The outbreaks occurred in late summer and autumn 2007 and 2008, subsequent to periods with an unusually high number of days with precipitation and high air temperature. Lesions were generally restricted to one foot and the disease incidence was highest in calves. Single limbs from 20 animals and six whole carcasses were submitted for laboratory examination. Gross lesions were characterized by swelling of the fetlock to coronary band area and cutaneous sinus tracts with sparse discharge of pus. Subcutaneous tissue was inflamed and oedematous with focal necrosis. Tendons, tendon sheaths, joints and periosteum of the digital bones were often affected. Animals shot during winter showed severe chronic periostitis and osteomyelitis and necrotizing deforming arthritis. Microscopically, skin lesions were characterized by deep ulcers with centrally located necrotic tissue, bordered by a zone of oedema and intense inflammation with granulation tissue and fibrosis. Necrosis, suppurative inflammation and oedema were found in the synovial membranes, tendons and tendon sheaths. Digital bone lesions were characterized by necrosis, fibrosis and extensive bone proliferation. Vasculitis and thrombosis were common in all lesions. Elongate filamentous gram-negative bacteria in necrotic lesions from all animals were identified as Fusobacterium necrophorum by fluorescence in-situ hybridization. F. necrophorum was cultured from the foot lesions of six animals. Five of these isolates were examined by 16S rRNA sequencing. The sequences were identical and differed from all other strains listed in GenBank. These results are consistent with circulation of a reindeer-adapted pathogenic strain of F. necrophorum in the wild reindeer population, causing outbreaks of digital necrobacillosis following warm and humid summers.

Recent-onset childhood arthritis--association with Streptococcus pyogenes in a population-based study.

OBJECTIVES: To assess the frequency of Streptococcus pyogenes in children with early arthritis, compare the characteristics in patients with post-streptococcal ReA (PSReA) with those in patients with other types of arthritis, and describe the occurrence of carditis in PSRA. PATIENTS: In a population-based Norwegian study, the physicians were asked to refer all children with suspected arthritis. The arthritis patients were followed up at 6 weeks, 6 months and 18 months. The presence of S. pyogenes was based on throat smear or antibodies. Echocardiography was performed in the patients with ARF or PSRA. RESULTS: Thirty-two (18%) of the 173 children with arthritis tested positive for S. pyogenes. The percentage of positive tests rose steadily with age and peaked at ages 8-11 (35%). Six weeks after admission arthritis was present in 33% of the PSRA patients, which was less frequent than in the juvenile idiopathic arthritis (JIA) patients (P < 0.001), but more frequent than in the transient arthritis patients (P = 0.012). Hip arthritis was more frequent and knee/ankle arthritis, ANA and HLA-B27 were less frequent in PSRA than in JIA (P < 0.001, P = 0.009 and P = 0.029, respectively). The PSRA patients were older than those with transient arthritis (P = 0.007). One child with ARF had carditis. CONCLUSIONS: Streptococcus pyogenes was present in 18% of children with arthritis. The patient characteristics, clinical presentation and early disease course in PSRA was different from that of JIA and transient arthritis.

Campylobacter spp., Salmonella spp., verocytotoxic Escherichia coli, and antibiotic resistance in indicator organisms in wild cervids.

Faecal samples were collected, as part of the National Health Surveillance Program for Cervids (HOP) in Norway, from wild red deer, roe deer, moose and reindeer during ordinary hunting seasons from 2001 to 2003. Samples from a total of 618 animals were examined for verocytotoxic E. coli (VTEC); 611 animals for Salmonella and 324 animals for Campylobacter. A total of 50 samples were cultivated from each cervid species in order to isolate the indicator bacterial species E. coli and Enterococcus faecalis / E. faecium for antibiotic resistance pattern studies. Salmonella and the potentially human pathogenic verocytotoxic E. coli were not isolated, while Campylobacter jejuni jejuni was found in one roe deer sample only. Antibiotic resistance was found in 13 (7.3%) of the 179 E. coli isolates tested, eight of these being resistant against one type of antibiotic only. The proportion of resistant E. coli isolates was higher in wild reindeer (24%) than in the other cervids (2.2%). E. faecalis or E. faecium were isolated from 19 of the samples, none of these being reindeer. All the strains isolated were resistant against one (84%) or more (16%) antibiotics. A total of 14 E. faecalis-strains were resistant to virginiamycin only. The results indicate that the cervid species studied do not constitute an important infectious reservoir for either the human pathogens or the antibiotic resistant microorganisms included in the study.

Screening of feral pigeon (Colomba livia), mallard (Anas platyrhynchos) and graylag goose (Anser anser) populations for Campylobacter spp., Salmonella spp., avian influenza virus and avian paramyxovirus.

A total of 119 fresh faecal samples were collected from graylag geese migrating northwards in April. Also, cloacal swabs were taken from 100 carcasses of graylag geese shot during the hunting season in August. In addition, samples were taken from 200 feral pigeons and five mallards. The cultivation of bacteria detected Campylobacter jejuni jejuni in six of the pigeons, and in one of the mallards. Salmonella diarizona 14: k: z53 was detected in one graylag goose, while all pigeons and mallards were negative for salmonellae. No avian paramyxovirus was found in any of the samples tested. One mallard, from an Oslo river, was influenza A virus positive, confirmed by RT-PCR and by inoculation of embryonated eggs. The isolate termed A/Duck/Norway/ 1/03 was found to be of H3N8 type based on sequence analyses of the hemagglutinin and neuraminidase segments, and serological tests. This is the first time an avian influenza virus has been isolated in Norway. The study demonstrates that the wild bird species examined may constitute a reservoir for important bird pathogens and zoonotic agents in Norway.

Prevalence of Salmonella typhimurium infection in Norwegian hedgehog populations associated with two human disease outbreaks.

Faecal carriage of salmonella was investigated in 320 hedgehogs from Moss municipality in south-eastern Norway, Askøy, Bergen and Os municipalities in central-western Norway, and five municipalities in south-western and central Norway. The sampling in Moss was carried out 1 year after a human outbreak of salmonellosis, whereas the sampling in Askøy, Bergen and Os was carried out during a human outbreak. Both outbreaks were caused by Salmonella Typhimurium 4,5,12:i:1,2. No salmonella were detected in the hedgehogs from south-western (0/115) and central (0/24) Norway. Thirty-nine percent (39/99) of the animals sampled on Jeløy, and 41% (34/82) of those from Askøy, Bergen and Os, carried S. Typhimurium 4,5,12:i:1,2. The PFGE profile of isolates from hedgehogs and human beings were identical within each of the two outbreak areas. A significantly higher carrier rate of S. Typhimurium occurred among hedgehogs sampled at feeding places, compared to those caught elsewhere. The salmonella-infected hedgehog populations most likely constituted the primary source of infection during both of the human disease outbreaks, and the Norwegian hedgehog is suggested as a reservoir host of S. Typhimurium 4,5,12:i:1,2.

Aspects of the life cycle and pathogenesis of Elaphostrongylus alces in moose (Alces alces).

Aspects of the migratory life cycle and pathogenesis of Elaphostrongylus alces were studied in 7 randomly selected moose calves and 7 yearlings killed during August to November. One calf and 1 yearling were uninfected. The 6 infected calves had recent infections, whereas the 6 yearlings showed older infections from the summer of the previous year. The 2 calves killed in September had a total of 26 adult E. alces in the epidural space of the caudal vertebral canal and none in the skeletal muscles, whereas the remaining calves killed 1 to 2 mo later had 25 nematodes in the caudal and cranial vertebral canal and 7 in the skeletal muscles. The yearlings had a total of 101 adult E. alces in the skeletal muscles and 2 in the vertebral canal. There were no findings indicating involvement of the central nervous system in the life cycle of E. alces. Our findings suggest that E. alces migrates directly from the gut to the epidural space of the caudal vertebral canal where development to the adult stage takes place. During development, the nematode produces inflammation of the epidural tissue and spinal nerves. Development in the caudal vertebral canal is followed by some anterior dispersion of nematodes along the canal, and migration into skeletal muscles. Here the nematodes seem to live in reproductive pairs and groups. The predilection site for E. alces in moose is the muscles of the thigh.

Experimental Elaphostrongylus alces infection in goats.

Five goats aged 4 months were each inoculated with approximately 300 third-stage larvae of Elaphostrongylus alces, and killed for post-mortem examination after 14-150 days. No clinical signs of disease were observed during the experiment. Pathological examination revealed that the larvae penetrated the walls of the abomasum and small intestine and migrated towards the caudal vertebral canal. However, the great majority of larvae were apparently destroyed along the migratory route, and development to adult parasites in the vertebral canal was not seen. During migration, the larvae caused focal inflammation and necrosis in the gastrointestinal wall, liver, mesentery and lungs. The study suggests that the only effect of E. alces infection on goats is the formation of focal visceral lesions during abdominal larval migration; it also confirms the infectivity of E. alces for domestic ruminants.

Ehrlichiosis in a moose calf in Norway.

A case of granulocytic ehrlichiosis in a moose calf (Alces alces) in Norway is described. The animal was heavily infested with ticks (Ixodes ricinus), and died from a Klebsiella pneumoniae septicemia. Examination of blood smears from the calf revealed cytoplasmic inclusions (morulae) typical of infection with Ehrlichia phagocytophila in the granulocytes. Ehrlichia sp. was detected by polymerase chain reaction (PCR) in blood from the calf, and in the ticks. Sequence determination identified it as E. phagocytophila. This is the first report of ehrlichiosis in moose.

Aspects of the life cycle and pathogenesis of Elaphostrongylus cervi in red deer (Cervus elaphus).

Aspects of the migratory life cycle and pathogenesis of Elaphostrongylus cervi were studied in red deer (Cervus elaphus) using 2 farmed calves experimentally infected with 450 third-stage larvae killed 40 and 45 days postinfection and using 3 wild calves and 3 wild yearlings with natural infections killed during autumn hunting. A full necropsy was carried out on the experimental calves, but only the head, eviscerated carcass, and lungs were examined from the naturally infected animals. Histological examination included extensive studies of the central nervous system (CNS), spinal nerve roots, and lungs. The experimental calves had prepatent infections, with many immature adult nematodes in the CNS, whereas the wild calves showed CNS lesions indicating a very recent E. cervi infection. The yearlings had patent infections, with many mature E. cervi in their skeletal muscles, reflecting acquisition of infection during the previous summer. Our findings showed that E. cervi develop to the adult stage in the CNS (subarachnoid spaces) and subsequently migrate into the skeletal muscles, where the mature nematodes live in reproductive pairs and groups. In the nervous system, the nematode caused encephalomyelitis, focal encephalomalacia and gliosis, meningitis, radiculitis, ganglionitis, and perineuritis.

Experimental Elaphostrongylus cervi infection in sheep and goats.

The pathogenesis and migratory life cycle of Elaphostrongylus cervi were studied in four sheep and six goats killed and examined 6 days to 5 months after inoculation with infective third-stage larvae (L3). Detailed histological studies demonstrated that the L3 followed a porto-hepatic, and probably also a secondary lymphatic, migratory route from the abomasum and small intestine to the lungs, with subsequent spread via the general circulation to the central nervous system (CNS) and other tissues. In addition, the results suggested that haematogenously spread L3, arrested in arterial vessels outside the spinal cord, migrated into the cord along the spinal nerves. During migration, the L3 caused focal inflammation and necrosis in the organs and along the spinal nerve roots, and infarcts occurred in the myocardium, kidneys and CNS. Nematode development took place in the CNS. During development, there was a gradual die-off of nematodes and patent infections were not observed. However, in one animal many mature nematodes were demonstrated in the CNS. In the nervous system, the nematodes caused encephalomyelitis, focal traumatic encephalomalacia, gliosis, meningitis, choroiditis, radiculitis and perineuritis. Two goats and one sheep displayed long-lasting paraparesis starting 6 weeks after inoculation. The signs apparently resulted from nematode-induced spinal nerve root lesions. From 19 weeks after inoculation the sheep also showed signs of severe brain disturbances due to traumatic and inflammatory lesions caused by adult E. cervi in the cerebral parenchyma. We conclude that E. cervi represents a potential cause of neurological disease in small ruminants grazing areas inhabited by red deer. This is the first report confirming the infectivity of E. cervi for domestic ruminants.

Osteoporosis, bone mineralization, and status of selected trace elements in two populations of moose calves in Norway.

This study was conducted to clarify the etiology of a high frequency of bone fractures and osteoporosis in the moose (Alces alces) population in southern Norway. Liver samples, both metacarpi, and carcass data were collected from 21 and 22 moose calves shot in 1994 in Birkenes (southern Norway), and Naerøy (central Norway), respectively. The liver samples were analyzed for copper, manganese, zinc, cobalt, chromium, molybdenum, and selenium. Bone samples were subject to histologic, radiologic, and chemical examinations. Three of the calves from Birkenes and one calf from Naerøy showed histologic and radiologic evidence of generalized osteoporosis consistent with osteoporosis due to starvation. The calves with osteoporosis had the lowest carcass weights and radio-opacities recorded. There was a positive correlation between carcass weight and bone radio-opacity. Density, ash content, phosphorus, and calcium contents and phosphorous/calcium ratio in bone samples, as well as hepatic trace element status, were within the normal range for all calves in both populations. Two of the osteoporotic calves, were reported to have been orphaned. Our results indicate that the high frequency of bone fractures reported in moose in southern Norway is not associated with regional differences in trace element status or bone mineral balance. We propose that the occurrence of osteoporosis in moose calves in Birkenes may have resulted from inadequate nutrition following general overcrowding and high pressure on feed resources in the southernmost part of Norway.

Experimental Narthecium ossifragum nephrotoxicity in cervids from Norway.

One moose (Alces alces), two red deer (Cervus elaphus), two reindeer (Rangifer tarandus) and two fallow deer (Dama dama) were dosed intraruminally with an aqueous extract made from 30 g of bog asphodel (Narthecium ossifragum) (wet weight) per kg live weight. The moose and one of the two reindeer were mildly depressed and had reduced appetite 3 to 7 days and 1 to 4 days after dosing, respectively. The serum creatinine and urea concentrations increased markedly in the moose and red deer, and moderately in the reindeer. No increase in serum creatinine and urea was observed in the fallow deer. Histopathological examination of the kidneys of the animals, killed 8 to 10 days after dosing, revealed tubular epithelial cell degeneration, necrosis, and regeneration in the moose, red deer and reindeer. The renal lesions were severe in the moose, moderate in the red deer and mild in the reindeer. No histopathological lesions were seen in the kidneys of the fallow deer.