AN EPIDEMIOLOGICAL STUDY OF LISTERIOSIS IN DAIRY
Transcription
AN EPIDEMIOLOGICAL STUDY OF LISTERIOSIS IN DAIRY
AN EPIDEMIOLOGICAL STUDY OF LISTERIOSIS IN DAIRY CATTLE by Hidayet Metin ERDOGAN A thesis submitted to the University of Bristol in accordance with the requirements for the degree of Doctor of Philosophy Division of Animal Health and Husbandry, Department of Veterinary Clinical Science, University of Bristol July 1998 i SUMMARY The aim of this study was to provide some epidemiological information about the distribution and the dynamics of Listeria monocytogenes infection in dairy cattle. In an attempt to determine the frequency of clinical listeriosis in dairy cattle and risk factors associated with it, a postal questionnaire designed to identify farm level risk factors associated with disease was sent to a random sample of 1500 dairy farmers in England in August 1995. The questionnaire included questions about the disease and farm management practices (feeding, housing and dung disposal, etc.). The farm prevalence was 12.3% (95% CL, 10.0-14.8) overall 9.3% (95%CL, 7.4-11.7) in milking cows, 5% (95%CL, 3.6-6.8) in replacement heifers and 1.4% (95% CL, 0.7-2.6) in dairy calves. The farm prevalence in milking cows was significantly higher than others (P<0.001). The within herd incidence rates in milking cows, replacement heifers and dairy calves as per 1000 animal-years were respectively 39.7, 86.6, 73.7. In the affected herds the incidence rate was significantly greater in younger animals (heifers and calves) (P<0.001). The majority of the cases of listeriosis in dairy cattle were reported between December and May with a peak of 19.3% in January. Silage eye (83.7%) was the most frequently reported sign followed by nervous signs (4.9%). 99% of cases of silage eye and 68.4% of cases of nervous signs were reported to recover after a treatment. As a part of the cross-sectional study 5 outcome variables (overall cases, cases in milking cows, cases reported in winter, cases of silage eye and nervous signs) and 5 groups of farm level predictor variables (herd size, feeding practices, preparation of forages, housing and general management) were used to investigate the relationship between clinical listeriosis and farm management practices. 19 variables were associated with the disease after multivariate analysis. The following were associated with an increased risk of disease: cases of listeriosis in beef cattle and sheep; use of a mower conditioner; preserving grass silage in clamps; big bale silage; storage of big bale outside uncovered; maize silage feeding; outdoor ad libitum feeding of grass silage; indoor feeding grass silage in ring feeders; indoor feeding of maize silage in ring feeders, in a complete diet and ad libitum; vaccinating animals against Leptospirosis, use of straw bedding in cubicles and not storing manure. The following were associated with a decreased risk of disease: wilting grass prior to ensiling: controlling moles in the fields, use of big bale straw for bedding and grazing sheep on the same pasture as dairy cattle. ii In the second part of the study a longitudinal survey of five dairy farms was carried out to determine the infection rate with Listeria monocytogenes and its behaviour in the environment, individual cows, pastures, soil, water sources, forage and bulk milk tanks on the five farms monitored bacteriologically and serologically between August 96 and May 97. The infection rate varied between farms and months. Two patterns of infection rate were observed. On 3 farms the highest prevalence of infection rates were obtained between November and April, around 90% of animals excreted L. monocytogenes in their faeces during this period whereas on the other 2 farms the infection rate was lower, around 30% of animals excreted L. monocytogenes (that was only in March). An ELISA assay employing Listeriolysin O (LLO) was used to determine seroconversion before, during and after silage feeding and winter housing. Almost all animals examined on each farm had anti-LLO antibodies to L. monocytogenes before silage feeding and housing. The antibody level remained unchanged throughout the study with only a small number of animals exhibiting changes on only one farm. Three species of Listeria were isolated from the environmental samples (soil, grass, silage, water, bedding). The commonest isolate was L. monocytogenes. L. innocua was less common and the rarest was L. seeligeri. L. monocytogenes was isolated from bulk milk tank on three farms. Random amplified polymorphic DNA (RAPD) assays were used to identify the source of infection in dairy cows and to determine the variation between the strains of different origin. In total 113 isolates (40 from the environment and 73 from the animals) were examined and 12 different RAPD patterns were obtained. The results indicated that different “strains” exist between and within farms. There also were similar patterns of RAPD between environmental and animal strains. iii ACKNOWLEDGEMENTS I gratefully thank to the University of Kafkas, Kars, Turkey, for granting me the scholarship to carry out this work. I am grateful to the Heads of the Departments of Clinical Veterinary Science of Bristol University and Liverpool University for allowing me to use their facilities. I am particularly thankful to my supervisor, Prof. Kenton Morgan, for his constant support and encouragement. None of this work would have been possible without his direction, enthusiasm and vision. I also thank to Drs Peter Cripps and Laura Green, my other supervisors, for their advice and suggestions whenever needed I gratefully acknowledge the technical assistant I received from the members of Bristol University; Clinical Microbiology Unit, especially Geoffrey Werret, for the development of culture techniques and Dilip Patel for the development of an ELISA assay, Dr Alasdair MacGowan and Karen Bowker of the Department of Microbiology of Southmead Hospital, Bristol, for the development of a RAPD assay and finally the member of Liverpool University; Thelma Roscue for tirelessly making enormous volumes of culture media every month and Dr Malcolm Bennett and his group for allowing me to carry out molecular tests in his laboratories and for technical help. I would like to thank to all members of the epidemiology research group for inspiring discussions and their friendship, Dr Nigel French, Dr. Eduardo Berriatua, Dr. Burhan Cetinkaya, Dr. Niki Mouttato, Galip Kaya, Giles Paiba, Connor Carson, Mark Bronsvolt and especially Saad Al-Sultan for his help with data collection for longitudinal study and Sue Edwards for checking the reference list. Thanks are also due to the farmers who took part in the cross sectional and longitudinal studies. iv I would like to thank to Metin Ozturk, Ibrahim Gokce and other Turkish friends I have made in Bristol and Liverpool for their companionship and making my stay in the UK pleasant. Thanks are also due to the friends I have made during my stay in Langford and Leahurst. My special thanks are to my parents, Arif and Elife, for providing me with education and support and thanks are also to every single member of my family for their encouragement and support. My greatest appreciation and acknowledgement is to my wife, Hilal, for her patience and understanding. v DEDICATION This thesis is dedicated to my parents Arif and Elife (Bu calisma hakklarini asla odeyemeyecegim babama ve anneme atfolunur) vi DECLARATION I declare that apart from the advice and assistant acknowledged the work reported in this thesis is my own and has not been submitted for consideration for any other degree of qualification. Hidayet Metin Erdogan vii TABLE OF CONTENTS LIST OF TABLES AND FIGURES viii-xix CHAPTER 1 General Introduction: a literature review 1-45 1. 1. Listeriosis 1 1. 2. History of Listeria monocytogenes and Listeriosis 1 1. 3. Morphology and culture characteristics 2 1. 4. Taxonomy of Listeria 6 1. 5. Typing of Listeria monocytogenes 9 1. 6. Pathogenesis, infectious dose, virulence and resistance 16 1. 7. Epidemiology 21 1. 8. Clinical signs and pathology 28 1. 9. Diagnosis 32 1. 10. Treatment 34 1. 11. Control 36 1. 12. Listeriosis in people 38 1. 13 The objectives of this study 43 CHAPTER 2 The frequency and some characteristics of clinical Listeriosis in dairy cattle in England 46-64 2. 1. Introduction 46 viii 2. 2. Materials and Methods 47 2. 2. 1. Study Population 47 2. 2. 2. Study Design 47 2. 2. 3. The Questionnaire 47 2. 2. 4. Data Analysis 48 2. 2. 5. Data processing and analysis 50 2. 3. Results 50 2. 3. 1. Response rate 50 2. 3. 2. The prevalence of listeriosis at farm level 50 2. 3. 3. The incidence of listeriosis at herd level 52 2. 3. 4. Season 53 2. 3. 5. The prevalence of listeriosis in other animals 55 2. 3. 6. Clinical signs associated with reported cases of listeriosis 55 2. 3. 7 Treatment 57 2. 3. 8. Validation of the questionnaire 58 2. 3. 9. Herd size 60 2. 4. Discussion 60 CHAPTER 3 The relationship between farm management practices and clinical listeriosis in dairy cattle in England: univariate analysis 65-106 3. 1. Introduction 65 3. 2. Materials and Methods 66 3. 2. 1. Study design 66 ix 3. 2. 2. Outcome variables 66 3. 2. 3. Predictor variables 66 3. 2. 4. Data analysis 73 3. 3. Results: 3. 3. 1. Univariate relationship between farm management practices and listeriosis in dairy cattle (Overall cases ) 74 3. 3. 2. The univariate relationship between farming practices and clinical listeriosis in milking cows 80 3. 3. 3. The univariate relationship between farming practices and clinical listeriosis reported in winter months 84 3. 3. 4. The univariate relationship between farming practices and cases of listeriosis with silage eye (iritis) 88 3. 3. 5. The univariate relationship between farming practices and nervous signs listeriosis (encephalitis) 92 3. 3. 6. A summary of risk factors associated with the different forms of disease 3. 4. Discussion 96 98 CHAPTER 4 The multivariate relationship between farm management practices and clinical listeriosis in dairy cattle in England 107-128 4. 1 Introduction 107 4. 2. Materials and methods 107 4. 2. 1. Model building 4. 3. Results 109 109 x 4. 4. Discussion 125 CHAPTER 5 A pilot study of the bacteriological and serological techniques used to determine the infection of cows with Listeria monocytogenes 129-156 5. 1. Introduction 129 5. 2. Materials and methods 133 5. 2. 1. Study design 133 5. 2. 2. Bacteriology 134 5. 2. 3. Serology 139 5. 2. 4. Statistical analysis 143 5. 3. Results 143 5. 3. 1. Results of bacteriology 143 5. 3. 2. Results of serology 150 5. 4. Discussion 153 CHAPTER 6 A study of the dynamic of infection with Listeria monocytogenes, in herds of milking cows 157-214 6. 1. Introduction 157 6. 2. Materials and Methods 160 6. 2. 1. Study Design 160 6. 2. 2. Farm Management 160 xi 6. 2. 3. Sample size 162 6. 2. 4. Sampling procedure 162 6. 2. 5. Sample preparation and processing 165 6. 2. 6. Measurement of serum antibody to Listeria monocytogenes 165 6. 2. 7. Investigation of source of the bacteria 166 6. 2. 8. Data analysis 170 6. 3. Results 170 6. 3. 1. Bacteriology 170 6. 3. 2. Serology 192 6. 3. 3. RAPD 193 6. 4. Discussion 206 CHAPTER 7 Conclusion 215-218 REFERENCES 219-256 APPENDIX xii LIST OF TABLES AND FIGURES CHAPTER 1 Table 1. 1. Some characteristics of Listeria organisms 5 Table 1. 2. Serovar distribution of Listeria 8 Table 1. 3. Epidemic and sporadic cases of foodborne clinical listeriosis in people 40 Figure 1. 1. Pathogenesis of L. monocytogenes infection 18 Figure 1. 2. Epidemiology of L. monocytogenes infection 28 Figure 1. 3. Potential pathways of L. monocytogenes transmission to people 42 CHAPTER 2 Table 2. 1. The farm prevalence of listeriosis in dairy cattle in England in 1994 - 1995 51 Table 2. 2. The proportion of animals affected with listeriosis (animal-year/1000) 52 Table 2. 3. The proportion of animals affected with listeriosis according to the clinical signs (animal-year/1000) 53 Table 2. 4. Frequency of clinical signs in cases reported between June 1994 and June 1995 56 Table 2. 5. The frequency of clinical symptoms for the cases reported in three groups of dairy cattle between July 1994 and June 1995 57 Table 2. 6. Treatment of clinical listeriosis and its result for the cases reported between July 1994 and June 1995 58 Table 2. 7. The frequency of clinical signs chosen by farmers and xiii sensitivity of farmers reporting correct clinical signs Table 2. 8. Herd size in non-affected and affected groups 59 60 Figure 2. 1. Monthly distribution of cases of listeriosis between July 1994 and June 1995 54 Figure 2. 2. Monthly distribution of cases showing silage eye 54 Figure 2. 3. Monthly distribution of cases showing nervous signs 55 CHAPTER 3 Table 3. 1. Categorisation of forage analysis 70 Table 3. 2. Univariate relationship between herd sizes and clinical listeriosis 74 Table 3. 3. Effect of forages fed to dairy cattle on the occurrence of listeriosis 76 Table 3. 4. The relationship between listeriosis and duration of feeding grass silage 77 Table 3. 5. The univariate relationship between number of grass cuts and disease 78 Table 3. 6 .Effect of silage quality on listeriosis 78 Table 3. 7. Univariate relationship between housing practices and listeriosis 80 Table 3. 8. Univariate relationship between herd sizes and clinical listeriosis in milking cows 81 Table 3. 9. The univariate relationship between feeding practices and listeriosis in milking cows 82 Table 3. 10. The relationship between number of grass cuts and listeriosis in milking cows 82 xiv Table 3. 11. The relationship between housing and general management and listeriosis in milking cows 83 Table 3. 12. Univariate relationship between herd sizes and clinical listeriosis reported in winter months Table 3. 13. Effect of silage quality on listeriosis in winter months 84 86 Table 3. 14. The univariate relationship between feeding practices and cases of listeriosis reported in winter months 86 Table 3. 15. The relationship between housing and general management and listeriosis reported in winter months 87 Table 3. 16. The univariate relationship between herd sizes and silage eye 88 Table 3. 17 The relationship between feeding practices and silage eye (iritis) 90 Table 3. 18 The relationship between housing, general management and silage eye 92 Table 3. 19. The univariate relationship between herd sizes and nervous form of listeriosis 93 Table 3. 20. The relationship between feeding, housing and general management practices and risk of reporting nervous form of listeriosis 94 Table 3. 21. Effect of silage quality on the reporting of nervous form of listeriosis 95 Table 3. 22. The predictor variables associated with an increased risk of disease 97 Table 3. 23. The predictor variables associated with a decreased risk of disease 98 CHAPTER 4 Table 4. 1. The multivariate relationship between major farming practices and xv clinical listeriosis in dairy cattle (preliminary model) 111 Table 4. 2. The multivariate relationship between farming practices and listeriosis in dairy cattle (overall cases) 114 Table 4. 3. The multivariate relationship between farming practices and listeriosis in milking cows 115 Table 4. 4. The multivariate relationship between farming practices and cases of listeriosis occurring in winter months 116 Table 4. 5. The multivariate relationship between farming practices and cases of listeriosis with silage eye 117 Table 4. 6. The multivariate relationship between farming practices and cases of nervous signs Table 4. 7. The agreement between the two models for different outcomes 118 119 Table 4. 8. The multivariate relationship between farming practices and listeriosis 121 Table 4. 9. The multivariate relationship between farming practices and listeriosis in milking cows 122 Table 4. 10. The multivariate relationship between farming practices and listeriosis reported in winter months 122 Table 4. 11. The multivariate relationship between farming practices and cases of listeriosis with silage eye 123 Table 4. 12. The multivariate relationship between farming practices and cases of listeriosis showing nervous signs Table 4. 13. The agreement between the models for different outcome variables 124 125 xvi CHAPTER 5 Table 5. 1. Date of visits and number of samples collected 133 Table 5. 2. Effect of cold enrichment on the growth quantity of Listeria spp 144 Table 5. 3. Effect of saline on the isolation of Listeria 145 Table 5. 4. Effect of LSEB and NB on the growth of L. monocytogenes 145 Table 5. 5. Monthly excretion rates of Listeria spp. in faeces 147 Table 5. 6. The relationship between housing, silage feeding and Listeria excretion Table 5. 7. The relationship between age and excretion of L. monocytogenes 149 149 Table 5. 8. The effect of age on the frequency of animals becoming Listeria positive 150 Table 5. 9. Effect of different coating temperature on the assay 151 Table 5. 10. Plate plan and Optical densities 151 Table 5. 11. The relationship between frequency of becoming positive for Listeria and antibody level 152 Table 5. 12. Relationship between age and antibody level 153 Figure 5. 1. Isolation and identification procedure for Listeria spp 136 Figure 5. 2. Effect of cold enrichment on the growth of Listeria 146 Figure 5. 3. Monthly excretion of Listeria spp. and L. monocytogenes 148 CHAPTER 6 Table 6. 1. Some management practices followed by the five farms 161 Table 6. 2. Results of forage analysis 161 Table 6. 3. Age distribution of animals on the farms A, B and C 162 xvii Table 6. 4. Date of visits and number of animals sampled 163 Table 6. 5. Number of animals tested on more than one occasion 163 Table 6. 6. Dates and numbers of blood samples collected 166 Table 6. 7. Monthly excretion rate of Listeria spp. and L. monocytogenes in milking cows 172 Table 6. 8. The relationship between silage feeding and housing on the overall excretion of Listeria spp. and L. monocytogenes Table 6. 9. The relationship between age and excretion of Listeria spp. 174 175 Table 6. 10. The effect of age on the excretion of Listeria spp. and Listeria monocytogenes 176 Table 6. 11. Isolation of Listeria spp. from the environment on Farm A 177 Table 6. 12. Isolation of Listeria spp. from the environment on Farm B 179 Table 6. 13. Isolation of Listeria spp. from the environment on Farm C 182 Table 6. 14. Isolation of Listeria spp. from the environment on Farm D 185 Table 6. 15. Isolation of Listeria spp. from the environment on Farm E 188 Table 6. 16. Incidence rate of L. monocytogenes infection by month 191 Table 6. 17. Antibody changes during the period of the study 192 Table 6. 18 The isolates, their origin and their RAPD patterns with the primer 5 194 Table 6. 19. The distribution of the RAPD patterns by their origin and the farms 196 Table 6. 20. Comparison of environmental and animals isolates obtained at different visits Figure 6. 1. The scheme followed for the collection of environmental samples 197 164 Figure 6. 2. The monthly excretion of Listeria spp. and L. monocytogenes in faeces on Farm A 171 Figure 6. 3. The monthly faecal excretion of Listeria spp. and L. monocytogenes on Farm B 178 xviii Figure 6. 4. The monthly faecal excretion of Listeria spp. and L. monocytogenes on Farm C 182 Figure 6. 5. The monthly faecal excretion of Listeria spp. and L. monocytogenes on Farm D 185 Figure 6. 6. The monthly faecal excretion of Listeria spp. and L. monocytogenes on Farm E Figure 6. 7. Monthly incidence rate of L. monocytogenes infection 188 191 Figure 6. 8. The repeatability of RAPD and discrimination of different species of Listeria 200 Figure 6. 9. The discrimination of isolates of L. monocytogenes with different primers 201 Figure 6. 10. The distribution of strains in two persistently infected animals on farm A 202 Figure 6. 11. The RAPD pattern obtained from environmental and faecal isolates of farm C 203 Figure 6. 12a. The RAPD pattern obtained from the environmental isolates of farm D 204 Figure 6. 12b. The RAPD patterns obtained from faecal isolates on farm D 205 Figure 6. 13. Animal-environment cycle of L. monocytogenes 214 xix CHAPTER 1 General Introduction: a literature review 1. 1. Listeriosis Listeriosis is an infectious disease of man and animals with a world-wide distribution. It manifests itself in three major clinical forms, meningoencephalitis, abortion and septicaemia (Hird and Genegeogis 1990). Listeriosis is caused by a member of the genus Listeria. The majority of the clinical cases are associated with Listeria monocytogenes infection. Only a few reported cases have been associated with Listeria ivanovii, Listeria seeligeri and Listeria innocua (McLauchlin 1987). 1. 2. History of Listeria monocytogenes and Listeriosis: Although Gray and Killinger, in a review published in 1966, date the discovery of Listeria monocytogenes to the reports from France and Germany in the late nineteenth century, it was only in 1926 that Listeria was described by Murray, Webb and Swann. It was implicated in an outbreak of disease in laboratory rabbits and the bacterium was isolated from the liver of affected individuals. The disease was characterised by a leukocytosis in which the predominant cells were large mononuclear cells and the organism was named Bacterium monocytogenesis. In 1927 Piere isolated an identical organism from lesions in the liver of gerbils and named the organism 1 Listeralla hepatolytica. In the same year Nyfeldt made the first confirmed isolation of Listeria from man. The organism was recovered from an outbreak of an infectious mononucleosis-like disease (cited by Gray and Killinger 1966). The first report of the disease in ruminants was in 1929 when Gill reported a disease of sheep (locally called "circling disease") in New Zealand and two years later isolated the same organism from sick sheep and designated it Listeralla ovis (Gill 1937). The first report of listeriosis in cattle was by Jones and Little in 1934 where it was implicated in what is now known as “typical Listeriosis”, namely meningoencephalitis. The literature on Listeria and listeriosis has grown rapidly since that time. Almost every researcher who isolated this newly discovered bacteria named it differently which resulted in a list of names all referring to the same organism. In 1940 Pirie proposed the name Listeria monocytogenes for this new bacterium after the British surgeon and medical pioneer Lord Lister. The adoption of this name concluded the conflict about the name of this new bacteria. By the 1960s Listeria monocytogenes had been reported from over 50 species of diseased and healthy animals including dog, cat, horse, pig, fowl and many domesticated and wild animals (Gray and Killinger 1966). 1. 3. Morphology and culture characteristics: a) Morphology: Listeria are gram positive, non-sporeforming, non-capsular, short, regular rods. They are, 0.4-0.5μm in diameter and 0.5-2μm in length with rounded ends. They are motile with a characteristic tumbling movement, best seen at room temperature. Fresh mature cultures of Listeria show a typical diphtheroid palisade formation with V and/or Y shapes either singly or in short chains whereas in very young or old cultures they may be seen in coccoid forms. In fresh cultures they are always 2 gram positive whereas in old cultures gram staining is irregular (Seeliger and Jones 1986, Lovett 1990). b) Colony characteristics: Listeria form colonies which are 0.5-1.5mm round, translucent, with a low convex surface, a fine texture, an entire margin end and a dewdrop appearance. On agar plates, older colonies, between 3-7 days are larger, 3-5mm in diameter, with a more opaque centre and rough colonial forms. The colonies appear bluish grey by normal illumination and a characteristic bluish green sheen is produced by obliquely transmitted light. Under obliquely transmitted light the colony appearance is so characteristic that, with a little practice, colonies can easily and quickly be distinguished even in severely contaminated plates. Colonies may be sticky when removed from agar plates. After removal of haemolytic colonies they leave a haemolysed zone while non-haemolytic colonies leave an impression on the agar plate (Gray and Killinger 1966, Seeliger and Jones 1986, Lovett 1990). Three of the seven species of the genus Listeria are capable of lysing erythrocytes. L. ivanovii is markedly haemolytic whereas L. monocytogenes and especially L. seeligeri are less haemolytic. The haemolytic activity of these species is used to differentiate them in a modified CAMP test (Christie and others 1944) which employs Rhodococcus equi as well as Staphylococcus aureus. This test is widely used for the differentiation of the three species in spite of conflicting results (VazquezBoland and others 1990, McKellar 1993). The haemolytic activity of L. monocytogenes and L. seeligeri is enhanced when grown adjacent to Staphylococcus aureus whilst no reaction is observed with Rhodococcus equi. They are therefore CAMP test positive for S. aureus and negative for R. equi. In contrast L. ivanovii produces large shovel shaped areas of haemolysis when grown next to R. equi, but no reaction when grown next to S aureus. It is therefore CAMP test negative for S. aureus and positive for R. equi. 3 Listeriolysin O (Fernandaz-Garayzabal and others 1992a) or phospholipase C (Skalka and others 1982) are believed to be involved in the reaction seen with S. aureus and sphingomyelinase is involved in the reaction seen with R. equi (Vazquez-Boland and others 1989a, Kreft and others 1989). It has been reported that haemolytic activity of some strains of L. monocytogenes can also be enhanced when grown next to R. equi (Vazquaz-Boland and others 1990) thus caution should be exercised when interpreting the results. The rest of the genus is unreactive to CAMP test and uniformly nonhaemolytic. Some biochemical and physical characteristics of Listeria are given in the Table 1. 1. Speciation of the members of the genus Listeria are made on the basis of these properties. d) Antibiotic susceptibility: Although the antibiotic susceptibility of Listeria is ambiguous in diseased animals, especially in meningoencephalitis, in vitro examinations reveal them to be susceptible to Tetracycline, Penicillin G, Ampicillin, Erythromycin, Chloromphenicol, Neomycin, Novobiocin, Cephaloridine but resistant to Colistin, Sulfate, Nalidixic acid, Polymixin B, Acriflavin and Sulfonamides. Further investigation is required to develop satisfactory treatment regimes for encephalitic cases of Listeriosis (Seeliger and Jones 1986, Benedict 1990). e) Serogroups: The antigenic composition of Listeria has been the subject of intensive investigations (Gray and Kikllinger 1966, Seeliger 1984). The currently accepted scheme is based on the findings of Paterson (1940), Donker-Voet (1972) and Seeliger and Hohne (1979). The serogroups are based upon O (somatic) and H (flagellar) antigens. The scheme now consists of 16 serovars (Table 1. 2). 4 Table 1. 1. Some characteristics of listeria organisms monocytogenes ivanovii seeligeri innocua welshimeri grayi murrayi Gram + + + + + + + + Catalase + + + + + + + Oxidase - - - - - - - urease - - - - - - - β-haemolysis + ++ +? - - - - S. aureus + - + - - - - R.equi - + - - - - - Aesculin + + + + + + + Rhamnose + - - v v - v Glucose + + + + + + + Xylose - + + - + - - Mannitol - - - - - + + Galactose - - - - - + + Mannoside + - v + + - - Reduction of - - - - - - + + + + + + + + + + +v - - - - 1/2a, /2b, 1/2c, 1/2b, 5 6a, 6b, 6a, 6b 3a, 3b, 3c, 4a, 4c, 4d, 4b, 4ab, 4d, 4e, 6b, ud CAMP test Utilisation NO3 to NO2 enhancment of growth by iron Mouse virulance serovars 4ab, ud 7 + =positive reaction, - = negative reaction, v = variable reaction, ++ = strong haemolysin, +? = weak haemolysin, +v = variation in pathogenicity, ud = undesignated 1. 4. Taxonomy of Listeria: 5 L. monocytogenes was the only recognised species within the genus Listeria until 1961 when Listeria denitrificans was included in the genus. Listeria grayi was included in 1966 and Listeria murrayi in 1971 (Roucort and others 1982). In their taxonomic investigation of L. monocytogenes Seeliger and Hohne (1979) divided it into 16 different serogroups (Table 1. 2.). All serotype 5 strains were strongly βhaemolytic and in 1975 Ivanov, a Bulgarian scientist proposed a separate species, Listeria bulgarica. L. bulgarica was later named L. ivanovii by Seeliger and colleques (1984) after Ivanov. Two years later, non haemolytic and non pathogen serotype 6 strains were proposed as a new species, Listeria innocua by Seeliger (1981). Listeria welshimeri and Listeria seeligeri were included in the genus in 1983 (Rocourt and Grimont 1983). The original taxonomic classification of Listeria was based on biochemical and physical characteristics of the organism. The species are biochemically very similar to each other but differ in DNA sequences. Recent developments in DNA technology have extended our knowledge of the bacteria at molecular level. DNA-DNA hybridisation of Listeria has confirmed that Listeria monocytogenes, innocua, welshimeri, seeligeri and ivanovii are closely related to each other but still differ at the DNA sequence level (Rocourt and others 1982, Seeliger and Jones 1986, Farber and Peterkins 1991). The classification of L. denitrificans , L. murrayi and L. grayi became problematic after the study of the numerical taxonomic, DNA base composition and DNA-DNA hybridisation studies (Stuart and Welshimer 1973 and 1974, Rocourt and others 1982). These studies concluded that these three species were distinct from L. monocytogenes. However Fiedler and Seger (1983) examined the amino acid sequences of the cell wall of these species and concluded that the murein variation found in L. grayi and L. murrayi was also found in L. monocytogenes. The murein content of L. denitrificans was significantly different from those of other Listeria species which led to exclusion of 6 L. denitrificans from the genus. After serological studies and other related taxonomic works L. murrayi and L. grayi were kept within the genus (Rocourt and others 1987, Farber and Peterkins 1991). At the present time, the genus Listeria has seven species which are L. monocytogenes, L. ivanovii, L. seeligeri, L. innocua, L. welshimeri, L. murrayi and L. grayi. Although Listeria monocytogenes is widely considered to be the only pathogen of people and animals, L. ivanovii has been associated with abortion in sheep and rarely in cattle (Alexander and others 1992), L. seeligeri has been isolated from cases of encephalitis in people and L. innocua has been implicated in some encephalitic cases both naturally and experimentally in ruminants (Walker and others 1994). The other species are believed to be non pathogenic (McLauchlin 1987). 7 Table 1. 2. Serovar distribution of Listeria Paterson Seeliger Donker-Voet 1 1/2a I II (III) AB 1/2b I II (III) ABC 1/2c I II (III) BD 3a II (III) AB 3b II (III) IV (XII) (XIII) ABC 3c II (III) IV (XII) (XIII) BD 2 3 4 O antigen 4a (III) (V) 4b (III) V 4c (III) V 4d (III) (V) VI VIII 4e (III) V VI (VIII) 5 (III) (V) VI VIII 6a (4f) (III) V (VI) (VII) (IX) 6b (4g) (III) (V) (VI) (VII) IX 7 (III) XII (III) XII XIV E (III) XII (XIV) E L. grayi L. murrayi ( ) = not always present VII H antigen IX ABC VI ABC VII ABC ABC (IX) ABC X ABC (XV) X XI ABC ABC XIII ABC 8 1. 5. Typing of Listeria monocytogenes: Epidemiological studies of infectious diseases require methods to differentiate causative agents beyond the species and subspecies levels. A number of typing methods have been developed for this purpose based on the genotypic and phenotypic characteristics of the agent. The implication of L. monocytogenes in epidemic and sporadic listeriosis made it necessary to develop more discriminating typing techniques to understand the epidemiology of disease and thus to help epidemiologist develop preventive measures against L. monocytogenes infection. These techniques include serotyping (Seeliger and Hohne 1979), biotyping (Ralovich 1993), antibiotic susceptibility patterns (MacGowan and others 1990a), phage typing (McLauchlin and others 1986), pyrolysis mass spectrometry (PyMS) (Freemen and others, 1991), multilocus enzyme electrophoresis (MEE) (Bibb and others, 1990), plasmid typing (Facinelli and others 1989), restriction endonuclease analysis (REA) (Nocera and others 1990), pulsed field gel electrophoresis (PFGE) (Brosch and others, 1994), ribotyping (Graves and others, 1991) and random amplified polymorphic DNA (RAPD) (Mazurier and Wernars 1992). These techniques are required to fulfil three important criteria; (a) typeability, (b) repeatability or reproducibility and (c) discriminatory power, i.e. ability to differentiate similar but unrelated strains. As important as these three criteria are cost, rapidity, ease of the interpretation of the results and ease of performing the techniques (Maslow and others 1993, Arbeit 1995). Each typing technique has some advantages and disadvantages. The commonly used techniques are briefly explained below. Biotyping utilises the metabolic activities expressed by Listeria such as fermentation of carbohydrates and colony characteristics. This technique is widely used to differentiate the species and subspecies in the genus Listeria. Although it is an easy and cheap technique it fails to differentiate distinct strains within L. monocytogens (Ralovich, 1993). 9 Serotyping is based on the identification of antigenic determinants on the cell surface. Listeria has O and H antigens as defined by Paterson in 1940 and can be divided into 16 serogroups (Seeliger and Hohne 1979). This method is widely used because it is relatively cheap and easy to perform. However serological classification using polyclonal antiserum is of limited value in epidemiological studies because the method does not type all strains and few serotypes are implicated, i.e. 1/2a, 1/2b, 4b, in most of the incidents (Seeliger and Hohne 1979, Farber and Peterkins 1991). Antibiotic susceptibility of most bacteria is regularly carried out in clinical microbiological laboratories. Many antibiotics used in agar or automated systems are now in use (Arbeit 1995). The technique is cheap, inexpensive and easy to interpret but the major problem with it is that strains can develop resistance to antibiotics. This method has been used for typing L. monocytogenes (MacGowan and others 1990a). Since plasmid mediated resistance to Listeria has also been reported (Poyart-Salmeron and others 1990), its value is open to dispute. Phage typing utilises viruses capable of infecting or lysing bacterial cells. A set of bacteriophages were identified for L. monocytogenes (McLauchlin and others 1986). Although this method is more discriminatory and reproducible than serotyping not all L. monocytogenes strains are typeable because the number of suitable bacteriophages is limited. Furthermore only few laboratories perform this technique routinely (Ralovich 1993). Multilocus enzyme electrophoresis (MEE) utilises the difference in the electrophoretic mobilities of individual soluble metabolic enzymes. The cellular proteins of the micro-organisms are separated by gel electrophoresis and individual enzymes are detected using specific substrates. Variations in electrophoretic mobility reflect amino acid substitutions that alter the charge of the protein and thereby identify variations in the chromosomal genes encoding the enzymes. The use of multiple 10 metabolic enzymes ensure that all isolates are typeable and this technique also provides information on the genetic relationship between strains (Maslow and others 1993, Arbeit 1995). It has been successfully used to analyse strains of L. monocytogenes (Bibb and others 1990). However the technique is very demanding and is reported to be less discriminatory than other techniques (Lawrence and Gilmour 1995, Donachie and others 1992). Pyrolysis-mass spectrometry (Py-MS) has originally been developed for the analysis of insoluble polymeric materials. It has also been used for identifying, classifying and typing or chemically analysing bacteria (Freeman and others 1990). After cultivation the strains are smeared on pyrolysis foils, heat dried and pyrolysed at 5300C for 4s then the complex mixtures obtained are quantitatively analysed in mass spectrometry (Freeman and others 1990, Ralovich 1993). The technique has been used in the field of Listeria to analyse epidemic and sporadic strains and the strains isolated from sheep (Freeman and others 1991, Low and others 1992a). Py-MS is simple and cheap but it does not assign permanent type- designations, its assessment of strains is valid for only strains pyrolysed as a single batch of freshly prepared media. Results may vary with culture age, incubation conditions and technical factors (Freeman and others 1991, Low and others 1992a). Plasmid typing is carried out by separating isolated plasmids electrophoretically in agarose gel to determine their size and numbers. This technique has been used for L. monocytogenes (Facinelli and others, 1989). However most strains of L. monocytogenes do not carry plasmids (Perez-Diaz and others, 1982) and therefore this typing method is not of much value. Restriction enzyme analysis (REA) uses endonucleases with relatively frequent restriction sites to digest bacterial chromosomal DNA thereby generating numerous fragments. These fragments can be separated by size with use of agarose gel 11 electrophoresis. Different strains of the same species have different REA patterns because of variations in their DNA sequences that alters the number and distribution of restriction sites. Nocera and others (1990) typed L. monocytogenes with this technique. They found that although the technique was able to type all strains and was reproducible it did not completely discriminate between serotype 4b and 1/2b. In general interpretation of REA is difficult because of the numerous DNA fragments generated. These frequently overlap or are unresolved in agarose gels. Restriction enzymes are also expensive (Maslow and others 1993, Arbeit 1995). Ribotyping is a simplification of REA. Chromosomal DNA digested with endonuclease is separated by agarose gel electrophoresis. Resulting fragments are blotted on nitrocellulose or nylon membrane. The fragments containing specific sequences are then detected by using a labelled ribosomal operons (16S rRNA, 25S rRNA). It has been used in the field of Listeria (Graves and others 1991, Wiedmann and others 1996) with varying degrees of success. The technique is robust and easy to interpret comparing to REA but it is less discriminating than RAPD (Wiedmann and others 1996). Pulse field gel electrophoresis (PFGE) is also a variation of REA in which enzymes with relatively few restriction sites are used to digest bacterial DNA. As a result fewer but much larger restriction fragments are obtained. These fragments are then resolved using an agarose gel electrophoresis technique in which the orientation of electronic field is periodically changed rather than being kept constant as in conventional agarose gel electrophoresis used for REA. PFGE has been used to type L. monocytogenes by Brosch and others (1994). Although they were satisfied with the capacity of the technique to type all the strains tested and its reproducibility they found differences between the enzymes used (AscI and ApaI) in discriminating subtypes and also noted that some serotypes were not distinguishable. In general the technique is very 12 demanding and time consuming and the enzymes are expensive (Maslow and others 1993, Arbeit 1995). RAPD (Random Amplified Polymorphic DNA); method is a variation of the PCR in which primers of an arbitrarily chosen sequence, rather than two specifically designed primers, are used (Williams and others 1990). Any length of sequence will suffice and one or more can be used in reaction mixture. The method has the potential for typing since it exploits the fact that, for any given oligonucleotide sequence, the genomes of bacteria are likely to contain many sequences with partial, rather than complete, homology to the primer. Under non-stringent conditions the primer will anneal to these sequences with varying degrees of stability, as determined by the number of H-bonds that can be formed between the primer and a particular partially homologous sequence. If two such complementary sequences are located close together on the genome on opposite strands, and both have the same polarity, then PCR amplification of the intervening sequence can occur under conditions that permit the primer to anneal to both sequences. The distribution of these partially complementary sequences is random, and hence the result of PCR is a set of random amplified polymorphic DNA sequences. Single base change may destroy the ability of a sequence to anneal to a primer, or may create a new primer banding site. Hence, the pattern of amplified sequences obtained is primer and strain specific, and constitutes an identity profile of the organism. RAPD was first used to study the epidemiology of L. monocytogenes by Mazurier and Wernars (1992). This was followed by several other attempts with varying applications (MacGowan and others 1993, O`Donoghue and others 1995, Wiedmann and others 1994, Wernars and others 1996). RAPD is cheap, very easy to perform and results are easily interpreted. However before RAPD is used for large scale typing optimisation of the technique must be done and this may take some time. Boerlin 13 and others (1995) came to the conclusion that RAPD was the best typing technique when compared with the most commonly used techniques, namely REA, Ribotyping, Serotyping, Phage typing and MEE. Several comparisons of the available Listeria typing methods have been made. Lawrence and Gilmour (1995) used RAPD and MEE to determine the characteristics of L. monocytogenes in poultry product and processing plants. They concluded that although MEE was less discriminatory than RAPD it provided information on genetic relatedness of strains investigated and also added that reproducibility of RAPD was excellent provided that the method was standardised. In another study, Donachie and his colleagues (1992) typed strains of L. monocytogenes isolated from sheep by MEE and PyMS. They found PyMS was more discriminatory, rapid and inexpensive than MEE. However MEE was more reproducible than PyMS because strains used in PyMS could not permanently be labelled and this could result in the same strain being considered different when examined on more than one occasion. Norrung and Gerner-Smidt (1993) used four typing methods (MEE, Ribotyping, REA and Phage typing) to type isolates of L. monocytogenes of different origin. Their results indicate that typeability and reproducibility of RAE, MEE and Ribotyping were 100%. Typeability of phagetyping was 95% and also reproducibility was less than 100%. They found that different methods were more discriminatory for different serotypes of L. monocytogenes (REA for serotype 1, Phage typing for serotype 4 and the combination of RAE and MEE was more discriminatory for both strains than the use of each technique alone). Boerlin and colleagues (1995) compared the typing result obtained with RAPD to serotyping, ribotyping, MEE, REA and Phage typing. They concluded that the discriminatory power of RAPD was best and that the reproducibility was also good but that if RAPD was to be widely used the method should be standardised. In another study Boerlin and colleagues (1997) also used four different typing methods (MEE, REA, PFGE and 14 serotyping) and found that PFGE was the most powerful technique in discriminating subtypes while MEE and serotyping were less discriminating. Destro and others (1996) used PFGE and RAPD to trace the contamination of a shrimp processing plant with L. monocytogenes . They suggested that to reach the best conclusion the two methods should be used together. This brief summary of information about typing methods employed in the field of listeriosis may lead one to conclude that no single method meets the criteria stated above because each technique lacks one or more important factor. However the superiority of RAPD over some techniques has been acknowledged (Mazurier and others 1992, Boerlin and others 1995, Wiedmann and others 1996). Others have suggested that a combination of two or more techniques will allow the best results (Norrung and Gerner-Smidt 1993, Destro and others 1996 and Louie and others 1996). The use of typing methods in epidemiological investigations of listeriosis has enabled the discrimination of individual strains of L. monocytogenes. An epidemiological link between contaminated foodstuffs and listeriosis in people has been established (McLauclin and others 1986, Nocera and others 1990, Norrung and Skovgaard 1993). Similarly a link between silage (Vazquez -Boland and others 1992, Baxter and others 1993, Wiedmann and others 1994), bedding (Green and Morgan 1994) and clinical listeriosis in animals has been established using these techniques. However there is little detail regarding the distribution and temporal occurrence of these strains in the veterinary field (Low and Donachie 1997). 1. 6. Pathogenesis, infectious dose, virulence and resistance: a) Pathogenesis: The ways in which L. monocytogenes reaches and causes systemic illness and disturbances in the brain have long been the subject of interest. The existence of different forms of clinical listeriosis and their irregular distribution in 15 animals suggests that L. monocytogenes gains entry in several ways. Numerous naturally occurring epidemic and sporadic cases of listeriosis and experimental studies have shown the importance of the oral route as the initial exposure site. The clinical occurrence of encephalitis and experiments carried out by Asahi and others (1957) and Barlow and McGorum (1985) suggest that encephalitis follows infection of the brain stem, resulting from L. monocytogenes ascending via cranial nerves following minute wounds in buccal mucosa, inhalation and conjunctival contamination. Intranasal infection of sheep with L. monocytogenes (Gill 1933) and conjunctival inoculation of rabbits (Gray and others 1948) resulted in encephalitis. Asahi and others (1957) produced encephalitis by instilling L. monocytogenes into the conjunctiva, lips, gum, parotid region, oral cavity and tongue of mice, rabbits and goats after breaking the integrity of mucosal membranes, and also by feeding L. monocytogenes contaminated feed to the animals. Their histopathologic and clinical examination revealed that encephalitis occurred after instillation of L. monocytogenes through bruised and wounded membranes and feeding contaminated feed to goat, mice, rabbits. Mucosal damage played an important role in infecting the trigeminal nerve which then carried the organism to the brain. Barlow and McGorum (1985) produced encephalitis in sheep by inoculating L. monocytogenes into the dental cavity and they also acknowledged the role of the trigeminal nerve in the occurrence of encephalitis. These studies have contributed to the hypothesis that forages such as grass, silage, grain awns, straw and hay can break up the integrity of mucosal membranes and allow L. monocytogenes to penetrate them. Having penetrated the mucosal membrane L. monocytogenes can then travel along cranial nerves (especially trigeminal nerve) to reach the brain (Dennis 1993). Subcutaneous injection of mice with L. monocytogenes also resulted in encephalitis and this points to the role of infected wounds and the 16 transneural spread of the organism (Pohjanvirta and Huttunen 1985). Osebold (1963a) also suggested that encephalitis might follow a bacteraemic stage. Septicaemia and latent infection are possible results of being exposed to the agent by inhalation and ingestion (MacDonald and Carter 1980, Pohjanvirta and Huttunen 1985, Marco and others 1992, Bracegirdle and others 1994). Following oral intake the entry of L. monocytogenes has been shown to occur through various cells. It has been suggested that L. monocytogenes penetrates M cells overlying Payer's patches (MacDonald and Carter 1980) or intestinal epithelial cells (Racz and others 1972) from where they disseminate to other organs such as the liver, spleen, kidney, lung, genital organs and brain. Colonisation in the gut also results in an inapparent infection and prolonged faecal excretion (reviewed by Radostits and others 1994). In vitro studies have also demonstrated that L. monocytogenes can penetrate and multiply within various cells including epithelial cells and fibroblast-like cells (Cossart and Menguad 1989). Abortion and genital organ infections also occur after ingestion of L. monocytogenes contaminated feed and a resultant bacteremia. Experimental studies have shown that after ingestion or parenteral injection of L. monocytogenes the genital organs and foetus are invaded within 24 hours of the onset of bacteremia. This results in abortion in 5-10 days (Njoku and Dennis 1973, Low and Renton 1985, Lammerding and others 1992, reviewed by Radostits and others 1994). Although more research is required to fully understand the pathogenesis of L. monocytogenes infection, it is apparent from experimental and recent outbreaks of Listeriosis in people and animals (Low and Renton 1985, Gitter and others 1986a, Farber and Peterkins 1991, Schlech 1993) that the initial exposure is via the oral route and that L. monocytogenes spreads to other organs after colonisation in the intestine (Figure 1. 1) (Gronstol 1986, MacDonald and Carter 1980). 17 Infected feed Immunity reducing Septicaemia factors Abortion Epithelial phase Bacteremia Neuritis Encephalitis Figure 1. 1. Pathogenesis of L. monocytogenes infection (Gronstol 1986) b) Infectious dose: Most of the experimental studies in mice have shown that a variable number of L. monocytogenes is required for infection to develop, varying between 1.7 x 103 and 2.5 x 108 organisms (Ferber and Paterkins 1991). In ruminants the results of experimental studies have also varied, 1.5x103 cfu/ml injected into mammary gland induced mastitis in cattle (Bourry and others 1995), 3x107 to 7.5x1010 cfu/ml injected into the pulp cavity of sheep produced encephalitis (Barlow and McGorum 1985) and 8x109 cfu/ml given orally induced abortion in ewes (Gitter and other 1986a) while 106 and 1010 cfu/ml doses of the organism given orally to sheep and lambs produced no clinical signs (Low and Donachie 1991, Lhopital and others 1993). The infectious dose required to trigger disease in naturally occurring listeriosis in ruminants is not known. c) Virulence: Several virulence determinants of L. monocytogenes have been identified and all of them are associated with the entry, survival, multiplication and spread of organism in the host’s cells (Portnoy and others 1992, Sheehan and others 1994). 18 The infection of the host’s cell begins with internalisation of the bacterium either by host derived phagocytosis in the case of macrophages or by pathogen induced phagocytosis in the case of non-phagocytic cells (Dramsi and others 1996). In the process of entry two surface proteins which take part in the induced internalisation of L. monocytogenes by nonprofessional phagocytic cells have been identified. These are internalin, and a p60 extracellular protein which are regulated by genes called inlA and inlB, and iap respectively (Sheehan and others 1994). InlA has been shown to initiate entry into enterocyte like cell lines by binding to the host cell Ecadherin receptors, while inlB is required for entry into hepatocytes and some epithelial cell lines. The receptor for inlB is not known but it is suggested that phosphoinositic (PI)-3 kinase is required for L. monocytogenes uptake triggered by inlB (Dramsi and others 1997). In recent years 5 more internalin proteins of unknown functions have been identified. These are internalin C (inlC), C2 (inlC2), D (inlD), E (inlE) and F (inlF) (Dramsi and others 1997) and actin polymerase regulated by ActA has recently been identified as being involved in the entry process by interacting with heparin sulfateproteoglycan receptor (Kuhn and Goebel 1997). The studies have shown that strains lacking these genes failed to enter or adhere to cells (Sheen and others 1994). Following internalisation, Listeria are trapped within a phagosome where they produce haemolysin or listeriolysin O, a pore forming thiol-activated cell product and phospholipase C which together break up the phagosomal membrane so that the Listeria are released and enter the cell cytoplasm. Listeria then multiply using host cell nutrients. The production of Listeriolysin O and Phospholipase C is respectively regulated by genes called hlyA and plcA. (Sheehan and others 1994). Experimental studies have shown that strains lacking these genes were not able to multiply within the cell (Portnoy and others 1988, Goebel and others 1988, Camilli and others 1991). The strategy for survival in a host’s cell is believed to be a major virulence determinant of L. 19 monocytogenes and a prerequisite to successful infection by this bacterium (Dramsi and others 1996). After escape from the phagosome L. monocytogenes utilises cytoplasmic nutrients to sustain its growth within the cell. During the process of multiplication, actin, a product of actA gene, is produced. This enables the bacterium to move within the cell. While moving freely the bacterium makes contact with the macrophage membrane generating a pseudopod organelle. This is then taken up by an adjacent cell. The life cycle continues in this newly infected cell (Tilney and Portnoy, 1989, Tilney and Tilney 1993, Southwick and Purich 1996). d) Resistance: Having briefly explained virulence and its determinants the following is a brief description of mechanisms of resistance of the host to L. monocytogenes which involves elements that deal with the organism at each stage of infection. Within first hours of the internalisation around 90% of invading listeria are killed by phagocytes. The recruitment of inflammatory cells such as neutrophils is also induced by interleukin 1 produced by infected macrophages. Neutrophils play an important role by limiting L. monocytogenes access to host’s cells and aborting cell to cell spread by lysing infected cells. Macrophages activated by phagocytosing L. monocytogenes release interleukin-1, tumor necrosis factor-α and interleukin 12. TNF-α and IL-12 then stimulate natural killer cells to produce interferon-γ. INFγ and IL-1 are necessary for macrophages to express MHC class II molecules and for enhanced listeriocidal activity. The activated macrophages inhibit the release of the organism from the phagosome. Macrophage activation and the destruction of L. monocytogenes enable listeria specific antigens to be presented to T cells which together with the IL-12 production promote the induction of T helper 1 cells and CD8+ T cells resulting in a protective effect. L. monocytogenes remaining in the endocytic compartment will be presented through the MHC class II 20 molecules to CD4+ T helper 1 cells and those in the cytoplasmic compartment will be presented through MHC class I pathway to cytolytic CD8+ T cells. CD4+ T cells turn mononuclear phagocytes into potent effector cells by producing cytokines which allow the rapid killing of remaining organisms. Cytolytic CD 8+ T cells provide protection against infected non-professional phagocytes (Mackannes 1962, Kaufmann 1990, Portnoy 1992, Kaufmann 1993, Brombacher and Kopf 1996, North and Conlon 1998). 1. 7. Epidemiology a) Occurrence: Listeriosis is believed to be a sporadic disease, predominantly of ruminants. Sheep are affected frequently (Low and Donachie 1997) and a change in the pattern of disease from sporadic cases to outbreaks has been reported (Gitter 1986, Wilesmith and Gitter 1986, Gitter 1989) Clinical Listeriosis has been reported in a wide range of animals (more than 50 species) and L. monocytogenes has been isolated from reptiles, fishes, crustaceans, leeches, snails, arthropods and a variety of birds (pigeon etc.) (Gray and Killinger 1966, Hyslop 1975). The disease is rarely reported in the horse, pig, fowl, dog, cat, deer and in wild animals (rodents, birds) (Gray and Killinger 1966, Gitter 1989, reviewed by Radostits and others 1994) Although Listeriosis is of world wide distribution it has been an important problem in North America, Europe, Britain, New Zealand and Australia (reviewed by Radostits and others 1994). In the northern hemisphere, Listeriosis has a distinct seasonal occurrence with the highest prevalence in the winter months (between December and May) (Low and Linklater 1985, Ralovich 1987, reviewed by Radostits and others 1994). Sporadic cases of listeriosis have also been reported throughout the year. The morbidity is relatively low but mortality is high in the encephalitic form of the disease (reviewed by Radostits and others 1994). Wilesmith and Gitter (1986) reported 21 a variable number of cases of encephalitis in a survey of 60 flocks with the mean attack rate being 2.5%. This can be as high as 35% in serious outbreaks. The attack rate for abortion is reported in the region of 10% (reviewed by Radostits and others 1994). b) Distribution: L. monocytogenes is ubiquitous in the environment and has been isolated from a variety of animals and people (Gray and Killinger 1966). It has also been isolated from the faeces of healthy animals and people which indicates that it can live in the host’s intestine without causing any clinical illness. Several studies indicate that a variable proportion of animals excrete L. monocytogenes in their faeces. Kampelmacher and van Noorle-Jansen (1969) isolated L. monocytogenes from 15.3% and 6% of cattle kept in two different regions, similarly van Renterghem and colleagues (1991) isolated it from 20% of cattle faeces samples examined. In a survey carried out by Husu (1990) between 9. 2 % (indoor period) and 3.1% (outdoor period) of dairy cattle excreted L. monocytogenes in their faeces and the figures were higher when all Listeria spp. were considered. However Skovgaard and Morgen (1988) reported the highest excretion rates in cattle faeces 67% Listeria spp. and 51% L. monocytogenes. It has also been noted that the seasonal distribution of faecal carriage is the same as that of clinical Listeriosis in northern hemisphere (Husu 1990). The presence and concentration of L. monocytogenes in nature is believed to be influenced by environment and climate (Picar-Bonnaud and others 1989). L. monocytogenes has been isolated from soil, vegetation (soybean, corn, grass, forest, etc.), cultivated and uncultivated fields (Welshimer 1968, Welshimer and Donker-Voet 1971, Welshimer 1975, Weis 1975). This character of L. monocytogenes led some researchers to conclude that there was a saprophytic existence of the organism in the plant-soil environment wherein this environment served as a reservoir (Welshimer and 22 Donker-Voet 1971, Weis and Seeliger 1975, Seeliger 1989). The survival of L. monocytogenes at 50C was investigated by Dijkstra (1975); the organism was found to survive for 13 years in milk, 16 years in a brain sample, 12 years in faeces and 12 years in silage. It is reported to persist for 2 years in dry soil, 11.5 months in damp soil, 2 years in dry faeces, 3 months in sheep faeces, 16.5 months in cattle faeces and up to 7 months on dry straw (reviewed by Radostits and others 1994). Isolation of the organism from sewage, sewage sludge, and river water has also been reported (Kampelmacher and Van Noorle-Jansen 1975, Watkins and Sleath 1981, MacGowan and others 1994). It is also frequently isolated from surface water, bedding, feed, the walls of building and water (reviewed by Radostits and others 1994). Infective material also derives from infected animals, faeces, urine, the aborted foetus, uterine discharges and milk. Carrier animals (both domesticated and wild) can also introduce the organism into the herd or flock (Fenlon 1985, Dennis 1993). c. Risk Factors: In addition to the presence of L. monocytogenes a number of predisposing factors for the disease have been proposed. These include factors which lower the host’s resistance and factors which increase the infection pressure of the agent. Factors which may increase susceptibility of animals to disease include poor nutritional state, sudden changes to very cold and wet weather, the stress of late pregnancy and parturition, long periods of flooding with poor access to pasture and housing, and overcrowded and unsanitary conditions with poor access to feed supplies (Hyslop 1975, Vandegraaff and others 1981, Barlow and McGorum 1985). Poor flock management has also been associated with disease in sheep (Meredith and Schneider 1984). 23 The relationship between age and Listeriosis in animals is unclear. Studies to date have produced conflicting results. Wilesmith and Gitter (1986) found no association between age and disease but Nash and others (1995) reported lamb and yearlings to be at an increased risk. Barlow and McGorum (1985) noted that most cases occurred in lambs up to 4 months old or in adults of 2 years old. Scott (1993) also reported a preponderance of cases in 2 year-old ewes. Pregnancy is well known to be associated with Listeriosis in people and it is thought that this is associated with a decrease in cell mediated immunity (CMI) (Lorber 1990). The cell mediated immune response is known to play an important role in resistance to L. monocytogenes infection. Its role in animal Listeriosis is not well defined. The sex of animals has not been linked with clinical Listeriosis. However breed has been reported as a predisposing factor and Angora goats in the USA (Johnson and others 1996) and Rambouillets sheep in the USA (Nash and others 1995) have been reported to be more susceptible. No such link is reported for different breeds of cattle. The infection pressure of L. monocytogenes is influenced by environmental factors that either favour or hinder its growth and survival. Some factors have been identified to influence the life cycle of the organism in nature: temperature, pH and atmosphere. Their influence is often interdependent and of complex nature. Listeria organisms can multiply from around 00C to between 450C and 500C with optimal growth being between 300C and 370C (Juntilla and others 1988). The ability of Listeria to grow at refrigeration temperature poses great concern to human health. As the temperature decreases the duration of the lag phase increases and at 40C the lag phase lasts 5 - 10 days. Interestingly these cultures are highly motile, possess well-developed flagella and are more pathogenic for laboratory animals (Gray and Killinger 1966, Ralovich 1992). The organism also remains viable after repeated 24 freezing and thawing. The tolerance to this broad range of temperatures makes it possible for L. monocytogenes to survive and grow indefinitely in the environment. Studies to date indicate that L. monocytogenes can tolerate a wide range of pH (3.8-9.2). The relationship between pH and survival and growth of the organism has been reported in various samples. The survival of L. monocytogenes in three kinds of soil was investigated and it was found that its survival in peaty soil (pH 5.5), was shorter (156 days) than chalky (pH 8.3), and a mixture of both (pH 7.9) (1500 days) (Picard-Bonnaud and others 1989). Similar results were found when silage was studied. The role of pH in preserving silage will be dealt with below. Listeria spp. are aerobic or facultatively anaerobic organisms. The growth of L. monocytogenes was studied under both aerobic and anaerobic conditions at different temperatures by Buchanan and others (1989). They found that at pH 4.5 the aerobic growth of L. monocytogenes was dependent on incubation temperatures. An active growth (an increase in population density) was observed at 190C and 280C. It was also noted that the bacteria did not grow at 50C and 100C but managed to survive for extended periods. When the temperature was raised to 370C L. monocytogenes died off rapidly. Anaerobic preservation of silage is very important. Listeria spp. will continue to survive in silage exposed to air even if its pH is as low as 3.9 (Fenlon 1986a, 1988). A study done by Fenlon (1986a) confirms that Listeria could also grow and survive in anaerobic conditions if the pH is high. Although the organism is widespread in the environment L. monocytogenes infections have frequently been associated with the feeding of poor quality silage (Gray 1960a, Palsson 1963, Fenlon 1986b, Wilesmit and Gitter, 1986, Sargison 1993). The disease is therefore called "silage sickness" (Dennis 1993). However the way(s) in which silage acts as a risk factor is not clear. It may act as an enrichment medium allowing the organism to grow excessively (Blenden and others 1967, Fenlon 1986c), or 25 a reservoir from which it spreads to animals and the environment (Fenlon 1985) or alternatively as an immunsuppressing factor due to substances that it harbours (Gronstol 1980a), though this is disputed (Gitter and others 1986b). However silage appears to play a role it is virtually impossible to make silage free of L. monocytogenes. The multiplication of this organism can be kept to a minimum by proper silage making procedures and also by effectively preserving silage by anaerobic storage, a high concentration of organic acids and a pH between 4.2- 4.5. Listeria can multiply in silage above pH 5.0 - 5.5, the critical pH depending on its dry matter content (Irvin 1968, Fenlon 1986a). Growth of the organism increases as silage pH increases (Gronstol 1979a). Listeria can be present in silage which is poorly fermented but it can also occur in pockets of aerobic deterioration in otherwise good silage (Fenlon 1986b, Fenlon 1988). These areas are often indicated by mould growth and occur at the edges of the silage clamp and in the top few inches of the surface in plastic covered clamps where air has circulated under the plastic. The risk of contamination of silage with Listeria is higher when soil is present in the silage. Soil may be picked up from molehills present in the field or get into clamp or silo by other means such as tractor tyres or from the clamp or silo floor. Soil contamination is indicated when the ash content is high in the silage content (Fenlon 1988, Gitter 1989). Big bale silage is more prone to contamination with Listeria because of lower density, poorer fermentation and greater risk of mechanical damage to the plastic coverings (Fenlon 1986b, Sargison 1993). Moist preserved feeds are also considered to be a risk for Listerial growth and Listeriosis (Core and other 1990, Sergeant and others 1991). Cases due to feeding of moist brewer grains, wet spoiled hay and silage made from orange have been reported (reviewed by Radostits and others 1994). The disease can occur 2 - 30 days after silage has been introduced. However, the time from exposure to disease can vary and appears to depend on the distribution and 26 concentration of the bacteria in the silage. However, listeriosis is a disease of a complex aetiology and its epidemiology is not fully understood (Donachie and Low 1995). Cases have also been reported where the pasture was overflooded and poorly drained (Vandegraaff and others 1981) and also during droughts (Reuter and others 1989). The current understanding of epidemiology and pathogenesis of disease is schematised in the Figure 1. 2 (Dennis 1993). Figure 1. 2. Epidemiology of L. monocytogenes infection (Dennis 1993) 27 1. 8. Clinical signs and pathology Although Listeriosis is manifested by three major clinical signs; meningoencephalitis, abortion and septicaemia, only one clinical form of the disease usually occurs in a group of animals or an individual animal. However an overlap of clinical forms of disease have been reported (Gitter and Terlecki 1965, Gitter 1986, Low and Renton 1985, Ohshima and others 1974). In addition to these three major signs of disease, mastitis (Gitter and others 1980), myelitis (Gates and others 1967, Seamen and others 1990), iritis and/or keratoconjunctivitis (Kummeneje and Mikkelsen 1975, Morgan 1977, Bee 1993, Walker and Morgen 1993) have also been associated with L. monocytogenes . a) Meningo - encephalitis: This is the most commonly recognised form of Listeriosis in adult ruminants and is the most common bacterial infection of the Central Nervous System of adult cattle (Rebhun 1987). Although the clinical picture is similar in all adult ruminants the course of the disease (1-2 weeks) is longer in cattle (Gitter 1989). The basic clinical picture combines signs of the "dummy syndrome" with pressing against fixed objects and unilateral paralysis (reviewed by Radostits and others 1994). In the early stages, animals are depressed, disoriented, febrile, indifferent to their surroundings and usually separate themselves from the rest of the herd (Dennis 1993). As a consequence of the destruction in the trigeminal nerve there is usually a facial paralysis with a drooping ear, dilated nostril, and lowered eyelid on the affected side. This is more common in cattle than in sheep (Gitter 1989). As a result of facial paralysis animals become dehydrated and fluid-electrolyte balance deviates from normal (reviewed by Radostits and others 1994). 28 There is a degree of deviation from normal in the position of head. It may be retroflexed, ventroflexed or even normal depending on the localisation of the lesions in the brainstem (reviewed by Radostits and others 1994). The destruction of vestibulocochlear nuclei results in propulsive circling toward the affected side. This form of the disease is therefore called "circling disease" (Hird and Genegeorgis 1990). If the animal walks, it stumbles and moves in circles. There is ataxia, often with consistent falling to one side (Dennis 1993). Animals became recumbent and death is due to respiratory collapse. The morbidity rate is low but the mortality rate is usually high (Rebhun 1987). Cases of meningo - encephalitis have been reported in calves (Seimiye and others 1992) and in lambs (Green and Morgan 1994). However meningo - encephalitis is never observed in calves and lambs whose rumen is not yet functioning (Dennis 1993). There are usually no remarkable gross lesions in the brain of affected animals but occasionally slight clouding or pin-point greyish-white foci of the meninges may be observed. Microscopic lesions are always confined to the pons, medulla and anterior spinal cord. Both white and grey matter may be involved. In the brain substance and sometimes in the meninges a remarkable perivascular cuffing with varying degrees of focal necrosis develops which is typical of Listerial encephalitis. In this area there is collection of mononuclear cells, oedema, haemorrhage and neurone degeneration. The organism can be demonstrated in the focal lesions but not in the perivascular cuffs (Ladds and others 1974, Thomson 1988). b) Listerial Abortion: Abortions due to Listeria are usually sporadic in cattle. Outbreaks of abortion have been reported (Osebold and others 1960) but occur more commonly in sheep and goats. Abortion may occur at any stage of pregnancy but it occurs most commonly in the last third of gestation (reviewed by Radostits and others 1994). There 29 is seldom clinical illness in the dam. In sheep as well as in cattle the incidence of abortion in a group is low but may reach as high as 15%. Liveborn offspring are usually too weak to survive for long (reviewed by Radostits and others 1994). Abortions due to L. ivanovii have also been reported and are similar to those due to L. monocytogenes (Alexander and others 1992). In abortion the pathological picture depends on the stage of pregnancy. If it occurs in the early stages of the last trimester the placenta is quickly invaded by the bacteria and the foetus dies as a result of septicaemia. The dead foetus is expelled within 5 days and by this time autolytic changes cover the minor gross lesions produced by the organism. Metritis usually occurs and results in retention of the foetal membranes. If it occurs at a late stage the offspring may be born in the normal way but is usually unable to survive. In the aborted foetus the lesions are less severe. Gross lesions are tiny pin-point yellow foci in the liver. Similar foci but visible only microscopically are seen in the lung, myocardium, kidney, spleen and brain. The bacteria can be demonstrated in the centre of these focal areas (Ladds and others 1974, Thomson 1988). c) Septicaemia: Although it is believed to be a syndrome of young ruminants and monogastric species outbreaks of septicaemia have been reported both in cattle (Price 1975) and in sheep (Low and Renton 1985). This syndrome comprises depression, weakness, emaciation, pyrexia and diarrhoea. At necropsy some cases show hepatic necrosis, gastroenteritis, serofibrinous meningitis and ophthalmitis. d) Mastitis: Since listeric mastitis goes unnoticed due to lack of clinical illness, mastitis associated with L. monocytogenes is not well documented (Gitter 1989). In some cases skin discolorization on the udder or teats and firm and nodular tissue development may 30 be noticed with careful examination. Pain is not observed during examination. The milk is usually normal (Gitter and others 1980). L. monocytogenes has been isolated from raw milk. This has important implications in terms of its transmission to man and animals (Rea and others 1992). e) Keratoconjunctivitis and/or iritis: Kummeneje and Mikkelsen (1975), Morgan (1977), Baptista (1979), Watson (1989), Mee and Rea (1993) Walker and Morgan (1993) and Welchman and others (1997) reported cases of keratoconjunctivitis and /or iritis associated with silage feeding or L. monocytogenes. They reported a catarrhal conjunctivitis with epiphora and photophobia and a moderate ophthalmitis with hydrophthalmis, hypopion and in some cases keratitis. Animals are usually affected unilaterally. Conjunctivitis is not purulent and corneal changes are minimal. Uveitis is also reported with the encephalitic form (Ohshima and others 1974). In some cases blindness is also reported. There is, however, a need to establish the relationship between L. monocytogenes and iritis or keratoconjuntivitis. 1. 9. Diagnosis Diagnosis of Listeriosis relies on the combination of clinical signs and laboratory tests. Haematological examination (Dennis 1993) and serum biochemical tests (Rebhun and deLahunte 1982) are of limited value especially in the diagnosis of encephalitic listeriosis because there are no changes in these values to indicate listeriosis. Cerebrospinal fluid analysis may have a diagnostic value because an increase in White blood cells (WBC), protein and pressure have been reported (Rebhun and deLahunte 1982, Aslan and others 1991 and Scott 1993) and isolation of Listeria from CSF is possible. 31 Bacterial culture is widely used for the diagnosis of Listeriosis along with other tests. Several selective and non-selective culture media have been developed for detecting L. monocytogenes in food (Curtis and others 1995) and these have been used for isolating L. monocytogenes from clinical specimens (Gray and others 1948, Gray and Killinger 1966, Eld and others 1993). However, the value of bacteriological culture is disputable, because isolation of L. monocytogenes from clinical specimens does not necessarily reflect disease due to the fact that successful isolation from brain and faeces of healthy animals have been reported (Gronstol 1980b, Husu 1990). Histopathologic examination of organs, especially brains, of Listeria infected cases is currently the most reliable method for diagnosis of listeric encephalitis. Immunocytochemical techniques (peroxidase-antiperoxidase) using polyclonal sera (Domingo and others 1986, Marco and others 1988, Johnson and others 1995) have been used and compared with bacterial culture methods in the veterinary field. Johnson and others (1995) have reported the superiority of this technique over bacterial culture but the use of polyclonal anti-sera must be regarded with caution because of crossreaction with other Gram positive organisms (Low and Donachie 1997). McLauchlin and colleagues (1989) have used this technique using monoclonal sera in diagnosis of listeriosis in people, but this is not used in the veterinary field. An immunofluoroscent test using polyclonal anti-sera has also been used for diagnosis (Eveland 1963) but this test faces the same problems associated with polyclonal anti - sera. Serological tests are the only tools that can be used to detect L. monocytogenes infection or traces of infection in live animals. Complement fixation, agglutination, haemagglutination and precipitation tests (Gray and Killinger 1966) have been used but lack the predictive value needed for diagnostic use. These tests employ either crude cells or somatic (O) and flagellar (H) antigen. These antigens have been proved to cross react with other Gram positive bacteria such as streptococci, staphylococci and 32 enterococci (Gray and Killinger 1966, Peel 1987, Low and Donachie 1997). Attempts were made to improve the specificity of the agglutination test and to overcome the cross-reaction problem by pre-treating serum with 2-mercaptoethanol but Larsen and others (1974) reported a decreased sensitivity after such a treatment. Recently more specific antigens such as Listeriolysin O (LLO) have been developed for use in serological assays. ELISA and immunoblot assays employing LLO have successfully been used in experimental and field studies (Berche and others 1990, Low and others 1992b, Lhopital and others 1993, Baetz and Wesley 1995, Bourry and Poutrel 1996, Bourry and others 1997). Large scale field trials using such ELISA assays have not yet been made and cross reaction between LLO and other cytolysins such as Streptolysin O (SLO), produced by some gram-positive organisms should not be ruled out (Baetz and Wesley 1995, Gholizadeh and others 1996). In recent years molecular techniques have increasingly been used for the detection of L. monocytogenes in food and clinical cases of Listeriosis in people and animals (Datta 1990, Furrer and other 1991, Wiedmann and others 1994, Walker and others 1994, Bubert and others 1997). In these tests the primers prepared from genes that determine virulence factors of L. monocytogenes such as haemolysin (hlyA), p60 extracellular protein (iap) and actin polymerisation (actA) have been used. The use of PCR in investigating clinical listeriosis in sheep resulted in the detection of L. monocytogenes from CSF and brain tissues (Wiedmann and others 1994, Wiedmann and others 1997). However, Peters and colleagues` (1996) attempt to detect L. monocytogenes in CSF using PCR was not promising, they detected L. monocytogenes in only 1 of 11 confirmed cases of Listeriosis. Improvements in these techniques should result in the rapid detection of L. monocytogenes within hours. 33 Differential diagnosis: Listerial meningitis may be confused with bovine spongioform encephalopathy, the nervous form of ketosis, polioencephalomalacia, lead poisoning, otitis media and interna, thromboembolic meningoencephalitis, viral encephalitis, infectious keratoconjunctivitis and abortion and mastitis due to other agents (reviewed by Radostits and others 1994, Dennis 1993). 1. 10. Treatment Successful treatment of Listeriosis depends on the clinical form exhibited, the duration and severity of clinical signs and the species affected (Cooper and Walker 1998). Although the optimal antibiotic treatment regimes for the various forms of Listeriosis have not been established in experimental and clinical trials (Gellin and Brrome 1989), cases with non nervous signs (abortion, septicaemia, iritis) respond well to antibiotic treatments (Low and Renton 1985, Low and Donachie 1997). Success in treating encephalitic Listeriosis is generally poor and the reported recovery rate is around 30% in sheep (Donachie and Low 1995). The treatment is less effective in sheep than cattle because the course of the disease is shorter and more severe in sheep (Dennis 1993). Animals that remain ambulatory are likely to recover (Scott 1992), but recumbent or comatose animals rarely survive and spontaneous recovery rarely occurs (Cooper and Walker 1998). The difficulty in treating encephalitic Listeriosis has resulted in several in vitro and in vivo experimental studies to determine the best possible treatment regiments. In vitro studies have shown that the majority of antibiotics, penicillin, ampicillin, erythromycin, rifampicin, chloromphenicol, the tetracyclines, and the aminogylcosides, with the exception of cephalsporins are effective against L. monocytogenes (Hof 1991, Khan and others 1975). However, their in vivo use has proved controversial. Several drugs and their combinations were used in experimental Listeriosis in laboratory animals. Khan and others (1975) reported that a 34 combination of trimethoprim and tetracycline was more effective than a combination of trimethoprim and penicillin and these combinations were better than the use of each antibiotic alone. They also reported that both combinations failed in terms of complete recovery. Scheld and others (1979) also tried to evaluate the effect of rifampicin, penicillin, ampicillin and the combinations of gentamicin and penicillin or ampicillin and the mixture of rifampicin and penicillin. They found that ampicillin had a greater in vivo bactericidal effect than penicillin and rifampicin and penicillin was better than rifampicin and the combination of penicillin and rifampicin. Their findings also suggest that addition of gentamycin to penicillin or ampicillin enhances their bactericidal activity and ampicillin plus gentamycin was the most effective combination in experimental listeric encephalitis in rabbit. Penicillin in high dosages was reported to be successful in treatment of clinical cases of Listeriosis in cattle (Divers 1996) and was preferred to tetracyclines (Rebhun and deLahunte 1982). In ovine encephalitis cases prolonged treatment with high doses of ampicillin and amoxicillin with an amingylcoside are recommended (Scott 1992) Although antibiotic resistance in clinical isolates is rare (Facinelli and others 1991) resistance to tetracycline, minocycline, trimethoprim, streptomycin (Charpentier and others 1995), erythromycin (MacGowan and others 1990b) and transferable plasmid mediated resistance to chloramphenicol, erythromycin, streptomycin and tetracycline has been reported (Poyart-Salmeron and others 1990). Abortion and encephalitis caused by multi-resistant strains of L. monocytogenes have been reported in people (Quentin and others 1990, Tsakris and others 1997). It is not known if multiresistant strains have been involved in animal Listeriosis but it should be considered where response to the antibiotics mentioned above is negative. 1. 11. Control 35 Since elimination of L. monocytogenes from the farm environment is not possible due to its ubiquitous occurrence in nature, the lack of reliable and rapid methods of detecting the organism when it is present in low numbers and the lack of understanding of epidemiology of Listeriosis and L. monocytogenes infection, attempts can only be made to prevent Listeria organisms from multiplying to the level of an infectious dose, to minimise its presence in the farm environment by improving hygiene and cleanliness of the farm, and to minimise its intake by animals by preparing foodstuffs such that L. monocytogenes does not grow. The epidemiology of Listeriosis in animals is not fully understood (Gray and Killinger 1966, reviewed by Radostits and others 1994, Donachie and Low 1995) therefore risk factors other than silage feeding are not known. Where silage is implicated some recommendations can be made. The proportion of silage in the ration can be reduced, silage feeding can be introduced to the animals gradually and more attention can be paid to silage making. Spoiled and mouldy silage should be removed from the feed. When making silage, additives should be used, soil contamination should be avoided and the silo or clamp should be sealed off as quickly as possible (Fenlon 1988, reviewed by Radostits and others 1994). It has been reported that improvement in silage making resulted in a decrease in the incidence of Listeriosis in Holland (Dijsktra 1986). However, disease has also been reported in some parts of the world where silage feeding is not practised (Vandegraaff and others 1981, Aslan and others 1991, Meredith and Schneider 1984). In such circumstances better farm management practices, such as improvement of nutritional status of animals and better housing conditions, can also be of some value in preventing disease. Vaccination: Several attempts have been made to immunise animals against Listeriosis using killed or live L. monocytogenes. The results obtained using a vaccine prepared 36 from killed or inactivated Listeria have been controversial. The experiments carried out by Asahi (1963) and Von Koenig and Finger (1982) revealed that vaccines prepared from killed Listeria organisms did not offer any protection. However Szemeredi and Padanyi (1989) reported a reduction in the incidence of Listeriosis in sheep immunised with chemically killed L. monocytogenes. Use of live Listeria organisms as a vaccine resulted in protection against infection (Asahi 1963, Ivanov and others 1979, Gudding and others 1989, Linde and others 1995). It significantly reduced the incidence of listeriosis in the field trials (Gudding and other 1989, Linde and others 1995). Currently no vaccine is used in the United Kingdom. A vaccine, containing a combination of live 4b and 1/2b strains of L. monocytogenes, is available in some eastern European and Scandinavian countries. In these countries the vaccine is believed to reduce the annual incidence of the disease. However, the results of vaccine trials are not satisfactory in terms of complete protection, the efficacy of the vaccine has not been evaluated and no experimental model is available to test their efficacy (Donachie and Low 1995, Low and Donachie 1997). 1. 12. Listeriosis in People a) Occurrence: The first confirmed report of Listeriosis in people was made in 1929 by Nyfeld (Gray and Killinger 1966). Listeriosis is caused by predominantly L. monocytogenes and only three infections caused by L. ivanovii (2) and L. seeligeri (1) have been reported (McLauchlin 1987). Clinical Listeriosis manifests itself in three forms; encephalitis and abortion predominantly in adults, and septicaemia in neonates and rarely in adults (McLauchlin 1987, Farber and Peterkins 1991, Schuchat and others 1991, Schlech 1991). In addition focal infections such as septic arthritis, peritonitis, liver abscess, endophthalmitis and cutaneous infection, can also occur (Gellin and Broome 1989). Although reports of clinical Listeriosis have grown in number since its 37 first description, it was only 1980s that L. monocytogenes infection achieved prominence as a food borne disease (Farber and Peterkins 1991, McLauchlin 1996). Most cases of clinical listeriosis appears to be sporadic but epidemics have also been reported in recent years. The annual endemic rates have been reported to be between 2 and 15 cases per million (Farber and Peterkins 1991). The current incidence of clinical Listeriosis is about 2-3 cases per million per annum in England and Wales with case fatality rates being between 20 and 40% (McLauchlin 1996). In England and Wales there was a dramatic increase in the number of cases reported in people in the 1980s which coincided with an increase in animal Listeriosis reported by Veterinary Investigation Centre (VIC), in other human disease caused by intestinal pathogens and use of untreated human sewage sludge and animal slurry on agricultural land (McLauchlin 1987). A decline in the number of cases has been observed since 1990. This may be due to improved control measures associated with developments in isolation and typing methods or increasing public awareness. b) Risk factors: Listeriosis in people is believed to be a disease of those whose immune system is suppressed. However, a recent outbreak in the USA has shown that L. monocytogenes could equally be a potential health problem for immuncompetent individuals (Dalton and others 1997). Several predisposing factors have been identified to be associated with the occurrence of clinical Listeriosis. Extremes of age, pregnancy, malignancy, immunsuppression (HIV infection, organ transplantation) are the major risk factors (Lorber 1990, Farber and Peterkins 1991, Rocourt 1996). c) Transmission: The route of transmission of Listeriosis has long been the subject of debate. Direct contact with infected animals has been shown to be one way of transmission for the cutaneous form of Listeriosis. 10 cases have been reported in the UK and 7 cases in the rest of the world (McLauchlin and Low 1994, McLauchlin 1996). Hospital cross infections during the neonatal period have been reported on 29 occasions 38 in the UK and in 22 instances in the rest of the world (McLauchlin 1996). However L. monocytogenes is now a well recognised food borne pathogen. Many sporadic and epidemic cases of Listeriosis have been traced to food (Farber and Peterkins 1991, Schuchat and others 1991, McLauchlin 1996) and the role of food in the occurrence of Listeriosis has been established in a case control study (Pinner and others 1992, Schuchat and others 1992). Some food borne outbreaks and sporadic cases of Listeriosis are presented in the Table 1. 3. Table 1. 3. Epidemic and sporadic cases of foodborne clinical Listeriosis in people. Country Year No. of cases Implicated food Outbreaks Canada 1981 41 Coleslaw USA 1983 49 Milk USA 1985 142 Soft cheese United Kingdom 1987-89 >350 Pate Switzerland 1983-87 122 Soft cheese Australia 1991 4 Smoked mussels France 1992 279 Pork tongue France 1995 17 Soft cheese Sporadic cases USA 1987 Raw milk England 1988 Soft cheese England 1988 Rennet USA 1989 Sausage Italy 1989 Fish Finland 1989 Mushrooms Italy 1994 Pickled olives This table was extracted from a publication by McLauchlin (1996). The table indicates that a variety of foods has been linked with disease but in the majority of cases animal products have been implicated. Studies carried out to determine the presence of L. monocytogenes on vegetables, in nature, in dairy products 39 and meat products have resulted in an enormous number of publications (Johnson and others 1990, Jay 1996, Kozak and colleques 1996, Beuchat 1996). L. monocytogenes has frequently been isolated from soil, vegetation such as corn, soybean plants, grass (Welshimer and Donker-Voet 1971, Weis and Seeliger 1975), sewage sludge (MacGowan and others 1994), river waters, industrial effluent such as abattoirs, cattle market, poultry packing plants (Watkins and Sleath 1981), vegetables such as cabbage, cucumbers, potatoes, radishes (Beuchat 1996), salads containing cabbage, carrots, lettuce, cucumber, onion, leeks, watercress, celery and fennel (Sizmur and Walker 1988). Jay (1996) reviewed the overall prevalence of L. monocytogenes in meat and meat products by combining the results of several studies. The prevalence in meat (fresh or frozen) was 20% in pork, 16% in beef and lamb and 17% in poultry. He also estimated a 13% overall prevalence for processed meat such as sausages, bacon, salami, pate and corned beef. Kozak and colleagues (1996) reported the prevalence of L. monocytogenes in raw milk in the same way as Jay. It was 3.1% in the USA, 2.7% in Canada and 4.1% in Europe. In a national survey carried out in England and Wales by Greenwood and colleagues (1991) L. monocytogenes was isolated from 3.6% of raw milk samples. Fenlon and Wilson (1989) examined bulk milk tank for the presence of L. monocytogenes in Scotland over a period of time and found that 3.8% of samples were positive for L. monocytogenes. In another study Fenlon and colleagues (1995a) isolated L. monocytogenes from 25 of 160 bulk milk tank samples. L. monocytogenes organisms occur in low number in milk and are easily killed at pasteurisation temperatures (Farber and Peterkins 1991, Kozak and colleagues 1996). However, the isolation of L. monocytogenes in pasteurised milk and in several milk products such as cheese, ice cream, yoghurt, (Greenwood and others 1991) suggest that post 40 pasteurisation contamination can occur at the processing plants or retailers (Kozak and others 1996, Fenlon and others 1996) and outbreaks of Listeriosis due to a such contamination have been reported (Linnan and other 1988, Dalton and others 1997). These findings reflect the fact that L. monocytogenes is an environmental organism with a broad distribution. People are exposed mainly through the oral route and bacteria are possibly ingested at low dosages daily. The Figure 1. 3. shows the current understanding of potential ways of transmission for Listeriosis in people. d) Carrier status: L. monocytogenes is thought to be a normal inhabitant of the intestinal tract of people. The proportion of human carriers varies from 0.5% to 91.7% (Ralovich 1987). At any one time, between 5% to 10% of normal healthy population excrete L. monocytogenes in their faeces (Farber and Paterkins 1991). Faeces Insects harvesting, handling processing environment Sewage Animals Water Soil Plants silage, feed Vegetables People (cross contamination) meat, milk, eggs Figure 1. 3. Potential pathways of L. monocytogenes transmission to people (after Beuchat, 1996) e) Infectious dose: The number of L. monocytogenes required to cause illness depends on many factors, the most important appears to be the host’s susceptibility and genetically determined and phenotypically expressed properties of the pathogen. The 41 infectious dose for the infection in people is not known. From outbreaks and sporadic cases it can be concluded that the dose varies from 102 to 3.4x109 with the incubation period being between less than 24 hours and 23 days (Farber and Peterkins 1991) f) Control: L. monocytogenes is so widespread that its elimination from our environment is beyond our technical capacity. But some strict regulations and management practices such as HACCP (Hazard Analysis Critical Control Points) and hygiene in processing plants and at home, can be put in place so that L. monocytogenes does not exceed the level of infectious dose or propagate beyond the host’s ability to cope with it (Greenwood and others 1991, Farber and Peterkins 1991, Dalton and others 1997). 1. 13 The objectives of this study: L. monocytogenes has received tremendous attention owing not only to economic losses and public health concern but also to its use as a model bacterial pathogen in studying immunology, pathogenesis, behaviour of intracellular pathogens and their interaction with host. Economic losses due to Listeriosis and L. monocytogenes have been estimated in some studies. Low and Renton (1985) reported £5,130 loss due to a single outbreak of Listeriosis in a flock, similarly Nash and colleagues (1995) estimated that the economic loss would be £6,809 in a Rambouillet flock after an outbreak with 12% mortality. In countries such as the USA, where “zero tolerance” policies are applied the loss due to food recall could count for billions of dollars (Archer 1996). L. monocytogenes infections in people and its consequences are incalculable. This and the fact that there appears to be a close relationship between 42 human Listeriosis and animal Listeriosis prompted us to investigate this disease and its cause, L. monocytogenes , in more details in order to determine: a) the frequency of Listeriosis in dairy cattle in England. The figures on prevalence and incidence of clinical Listeriosis in dairy cattle were not known at the beginning of this study. Listeriosis is not a notifiable disease and the only figures available are those estimated from cases submitted to the Central Veterinary Laboratories (CVL) in most cases for the diagnoses of other disease such as BSE and Brucellosis. Cases of Listeriosis other than encephalitis are not usually reported to these centres. Therefore a cross sectional study using a postal questionnaire was carried out to determine the prevalence, incidence and some characteristics of clinical Listeriosis in dairy cattle in England (Chapter 2). b) risk factors associated with disease at the farm level. The relationship between silage feeding and L. monocytogenes is established but the exact manner in which silage plays a role is not known (Wilesmith and Gitter 1986, Gitter 1989). There is an evidence that farm management may also be important (Meredith and Schneider 1984). In the cross sectional study we also attempted to identify and test some hypothesises for farm level risk factor(s) associated with the occurrence of clinical Listeriosis (Chapters 3 and 4). c) infection rate in individual animals. Several studies have been carried out to determine carriage status of this organism (Skovgaard and Morgen 1988, Husu 1990). These studies lacked epidemiological and statistical design and differences were detected in excretion rate between them. There have been no studies in the United Kingdom aimed at determining the infection rate in dairy cattle. We therefore conducted 43 a longitudinal study involving five dairy herds to determine the infection rate using bacteriological and serological tests (Chapters 5 and 6). d) degree of environmental contamination. L. monocytogenes is well known for its commonness in the environment. During the longitudinal study we also tried to determine the degree of the environmental contamination on the farms that we studied (Chapter 6) f) source of infection. The use of typing methods has enabled researchers to easily trace the source of L. monocytogenes in sporadic and epidemic Listeriosis and epidemiological investigation. In this study we used a molecular typing method (Randomly amplified polymorphic DNA) to determine the relationship between the organism and infection on the farms studied (Chapter 6). 44 CHAPTER 2 The frequency and some characteristics of clinical listeriosis in dairy cattle in England 2. 1. Introduction Listeriosis is an infectious disease caused by micro-organisms of the genus Listeria (Farber and Peterkin 1991, reviewed by Radostits and others 1994). Three distinct patterns of clinical disease are recognised in both animals and people; encephalitis, abortion, septicaemia. (Gray and Killinger 1966). In addition, mastitis (Gitter and others 1980, Boury and others 1995), iritis and keratoconjunctivitis (Kummeneje and Mikkelsen 1975, Morgan 1977, Watson 1989, Bee 1993) have also been associated with Listeriosis in ruminants in recent years. Listeria has attracted considerable attention owing not only to increased reports of clinical disease in animals (Gitter 1989) and people (MacLauchlin and others 1991) but also to its implication as a food-borne pathogen (Schlech, 1991). Although much progress has been made in the isolation, identification and typing of listeria the epidemiology of listeriosis remains poorly understood (Donachie and Low 1995). There has been no study of the prevalence and incidence of listeriosis in dairy cattle 46 in Britain. In this part of the study the frequency of listeriosis and its clinical presentation in dairy cattle in England are presented. 2. 2. Materials and Methods 2. 2. 1. Study Population A random sample of 1500 dairy cattle farmers in England was selected. The sample size was calculated from an expected prevalence of 50% with 95% level of confidence, a desired accuracy of 3% and predicted response rate of 70% (Canon and Roe 1982). This sample represented 5.8% of the total dairy cattle holdings in England (MAFF 1994). 2. 2. 2. Study Design This was a cross sectional study in which a postal questionnaire was used to collect data on the frequency of listeriosis in dairy cattle in England between July 1994 and June 1995. 2. 2. 3. The Questionnaire (Appendix 1) A self administered, eight-page, postal questionnaire was designed to collect data about listeriosis from dairy farmers in England. The questionnaire consisted of 7 parts. Parts one and two were designed to obtain information on the prevalence and incidence of Listeriosis, part three was designed to estimate herd size, replacement rate and number of 47 dairy calves in July 1994 and June 1995, the remaining parts collected information on farm level variables which might influence the occurrence of listeriosis. This included questions on feeding, (type, preparation, storage, feeding regime), housing, (season of housing, type of housing, type of bedding, storage of bedding, cleaning of house) and general information (cases of listeriosis in other species of animals, vaccine use etc.). Pilot questionnaires were tested by sending them to 9 dairy farmers on the 5th of August, 1995. The questionnaire, covering letter, and a stamped addressed envelope were sent to farmers on the 25th of August, 1995. Two reminder post cards and second copy of the questionnaire were sent to non-respondents and a final fourth reminder letter was sent to the remaining non-respondents on the 23rd of December, 1995 (Appendix 1). Questionnaires returned after the 12th of January, 1996 were not included in the study. 2. 2. 4. Data Analysis Two estimates of the frequency of listeriosis were calculated in this study; the farm level prevalence and the crude within herd incidence rate. They were estimated from clinical cases reported between July 1994 and June 1995 for three groups of dairy cattle; milking cows, replacement heifers and dairy calves. For the same groups, the incidence rates were recalculated for two clinical signs; silage eye and nervous signs. To calculate the within herd incidence rate the mean numbers of milking cows, replacement heifers and dairy calves reported in July 1994 and June 1995 were used to estimate the number of animals at risk in each group. The within herd incidence rate of listeriosis was calculated separately for herds reporting clinical disease and for all herds. Respondents who did not know if they had had any cases of listeriosis in any of these 48 groups were excluded from analysis. In calculating the within herd incidence rates for the different clinical signs those cases where clinical signs were not reported were excluded from the analysis. Three alternatives were given for the diagnosis of the disease; veterinary surgeon, veterinary investigation centre (V.I.C) or self diagnosis. In order to validate diagnosis by farmers, they were asked to select the clinical signs of listeriosis from a list of eight clinical signs, two commonly associated with listeriosis (nervous sign and silage eyekeratoconjunctivitis), four occasionally associated with the disease (abortion, sudden death, diarrhoea and mastitis) and the remaining two not linked to listeriosis (lameness, pneumonia). The criterion validity (Abramson 1988) of “self diagnoses” was made by comparing the reporting of clinical signs by farmers with the combination of veterinary surgeon or V.I.C. diagnoses. The questionnaire was also externally validated using data on the frequency of listeriosis collected by Central Veterinary Laboratory (CVL) during statutory Bovine Spongiform Encephalopathy (BSE) reporting between July 1994 and June 1995. Information about the month of illness, treatment and its outcome was also collected. Cases reported to occur over a period of two or more months were divided equally between the months in order to estimate their seasonal and monthly distribution. Those cases where no month of diagnosis was given were excluded from analysis. Cases where clinical signs and treatment were not indicated were also excluded from analysis. 2. 2. 5. Data processing and analysis: 49 All data were numerically coded, entered onto a database (Microsoft Access 2, Simpson 1994) and analysed using Epi-info version 6 (Dean and others 1994). A Yates corrected chi squared test was used to compare the differences between proportions. A Kruskal-Wallis test was used to compare the differences between median values (Dean and others 1994). A probability of p< 0.05 was accepted as statistically significant. 2. 3. Results: 2. 3. 1. Response rate: Of the 1500 dairy cattle farmers, 961 returned questionnaires, giving an overall response rate of 64.1%. 67 of the 961 questionnaires were returned unanswered because the farmers no longer kept dairy cattle (36 farms) or were unwilling to take part in the study. These were removed from the study leaving 61.1% usable questionnaires (894/1464). 2. 3. 2. The prevalence of listeriosis at farm level: Respondents who did not know whether they had clinical listeriosis in any of the groups of dairy cattle were removed from analysis. 12.3% (93/759) reported clinical listeriosis in dairy cattle on their farms between July 1994 and June 1995 . Cases were diagnosed by a veterinary surgeon or V.I.C. on 83.9% (78/93) of the affected farms. When the overall proportion of farms affected was estimated using only cases diagnosed by a veterinarian or V.I.C., the proportion was 10.3%. This was not statistically different from that of 12.3% (P=0.2). 50 The proportions of farms with cases in milking cows, replacement heifers and dairy calves were 9.3% (71/761), 5% (39/780) and 1.4% (11/781) respectively. The proportion of farmers reporting listeriosis in milking cows was significantly higher than those in replacement heifers and dairy calves (P<0.001). Diagnosis was made by a veterinarian or V.I.C. on 80.3% (57/71) of farms with cases in milking cows, 69.2% (27/39) of farms with cases in replacement heifers and 36.4% (4/11) of those with cases in dairy calves. The proportion of farms reporting cases in milking cows, replacement heifers and dairy calves estimated using veterinarian and V.I.C. diagnoses the proportions were 7.5% (57/761), 3.5% (27/780) and 0.5% (4/781) respectively. These estimates were not statistically different from those obtained without considering the method of diagnosis (Table 2. 1). Of the farms affected between July 1994 and June 1995, 5.3% (5/93) had clinical listeriosis in all three groups; milking cows, replacement heifers and dairy calves and 21.5% (20/93) of them reported cases in both milking cows and replacement heifers. Table 2. 1. The farm prevalence of listeriosis in dairy cattle in England in 1994 - 1995 all diagnoses (95%CL)β diagnosed by vet or VIC (95%CL) β Overall 12.3% (10.0-14.8) 10.3% (8.4-13.0) Milking cows 9.3% (7.4-11.7) 7.5% (5.9-9.9) Replacement heifers 5% (3.6-6.8) 3.5% (2.5-5.3) Dairy calves 1.4% (0.7-2.6) 0.5% (0.2-1.4) β statistically significant difference between the groups of animals (P<0.001) CL= Confidence Limits 2. 3. 3. The incidence of listeriosis at herd level: A total of 423 cases were reported between July 1994 and June 1995. Of these 239 were in milking cows, 142 in replacement heifers and 42 in dairy calves. The overall 51 incidence rate was 4/1000 animal-years (423/104 720) in all herds and 51.4/1000 animalyears (423/6 017) in affected herds. The incidence rate was estimated for each group. It was 39.7/1000cow-years (239/6017) in affected herds and 4.2/1000cow-years (239/56 849) in all herds for milking cows. For replacement heifers, it was 86.6/1000heifer-years (142/1639) in affected herds and 7.4/1000heifer-years (142/19174) overall. The incidence rate in dairy calves was 73.7/1000calf-years (42/570) in affected herds and 1.5/1000calf-years (42/28697) in all herds. The incidence rate in replacement heifers was significantly higher than in milking cows and dairy calves (P<0.001) both in affected herds and all herds (Table 2. 2). Table 2. 2. The proportion of animals affected with listeriosis (animal-year/1000) incidence rateβ affected all herds 51.4 (423/6 017) 4 (423/104 720) milking cows 39.7 (239/6 017) 4.2 (239/56 849) replacement heifers 86.6(142/1 639) 7.4 (142/19 174) dairy calves 73.7 (42/570) 1.5 (42/28 697) overall β significant difference between the groups of animals and also between the affected and all herds (P<0.001) The incidence rates of different clinical signs in these three groups were also calculated. The results are presented in Table 2. 3. The incidence rate of silage eye cases was significantly higher in replacement heifers and dairy calves than milking cows (P<0.001). No cases with nervous signs were reported in dairy calves. The incidence rate of cases with nervous signs was higher in replacement heifers than milking cows (P=0.009) (Table 2. 3). 52 Table 2. 3. The proportion of animals affected with listeriosis according to the clinical signs (animal-year/1000) incidence rateβ silage eye nervous signs affected all affected all 66.5 (355/5,337) 3.4 (355/104,720) 9.9 (20/2,011) 0.2 (20/104,720) milking cows 45.6 (194/4,259) 4.2 (194/56,849) 7.7 (14/1,809) 0.25 (14/56,849) replacement 148.4 (127/856) 6.6 (127/19,174) 29.7 (6/202) 0.3 (6/19,174) 153.2 (34/222) 1.2 (34/28,697) 0 0 overall heifers dairy calves β significant difference between the groups of animals and also between the affected and all herds (P<0.001) 2. 3. 4. Season: Farmers were also asked to specify the month of illness for cases on their farms. Most of the cases were reported between December and May with a peak in January, 19.3% (73/378), (Figure 2. 1). 44.2% (167/378) of the cases were reported in winter, 38.4% (145/378) in spring, 11.1% (42/378) in summer and 6.3% (24/378) in autumn. For 10.6% (45/423) of the cases, the farmers did not know when they occurred. The distribution of the different clinical presentations of listeriosis over time was also evaluated for three groups of dairy cattle but there was no difference between the groups and signs as most of the cases reported to have occurred late autumn, winter and spring. Figure 2. 2 and 2. 3 show monthly distribution of cases with silage eye and nervous signs separately. Figure 2. 1. Monthly distribution of cases of Listeriosis -between July 1994 and June 1995. 53 Monthly distribution of cases of Listeriosis n=403 50 45 percentage 40 35 30 25 20 15 10 5 0 J F M A M J J A S O N D MONTH Figure 2. 2. Monthly distribution of cases showing silage eye percentage silage eye n=316 50 45 40 35 30 25 20 15 10 5 0 J F M A M J J A S O N D MONTH Figure 2. 3. Monthly distribution of cases showing nervous signs. 54 Nervous signs n=20 percentage 50 45 40 35 30 25 20 15 10 5 0 J F M A M J J A S O N D MONTH 2. 3. 5. The prevalence of listeriosis in other animals: Farmers were asked whether they had any clinical cases of listeriosis in any other animals kept on their farms; 1.7% (14/810) reported cases in beef cattle and 4.3% (35/822) in sheep. 2. 3. 6. Clinical signs associated with reported cases of listeriosis: Farmers reporting clinical cases between July 1994 and June 1995 were asked to specify the clinical signs seen in the cases on their farm. No clinical signs were reported for 4.3% (18/423) of the cases. The frequency of clinical signs reported by farmers is given in the Table 2. 4. The most frequently reported clinical sign was silage eye (83.7%), followed by nervous signs (4.9%) and abortion (2.5%). In 7.2% (29/403) of the cases both nervous signs and silage eye were reported. A similar distribution was obtained when the diagnosis 55 was made by a veterinarian or V.I.C. The frequency of clinical signs seen in milking cows, replacement heifers and dairy calves is also given in Table 2. 5. Table 2. 4. Frequency of clinical signs in cases reported between June 1994 and June 1995 all diagnosis diagnosed by vet. Or VIC Clinical signs n=405 (%) n=222 (%) silage eye 339 (83.7) 177 (79.7) silage eye and nervous signs 29 (7.2) 12 (5.4) nervous signs 20 (4.9) 20 (9) abortion 10 (2.5) 9 (4.1) mastitis 4 (1) 1 (0.5) Sudden death 1 (0.2) 1 (0.5) Diarrhoea 1 (0.2) 1 (0.5) silage eye and sudden death 1 (0.2) 1 (0.5) n number of cases When re-estimated for the three age groups of dairy cattle the distribution of silage eye was similar in all groups but no cases of Listeriosis showing nervous signs were reported in dairy calves (Table 2. 5). Table 2. 5. The frequency of clinical signs for the cases reported in three groups of dairy cattle between July 1994 and June 1995 56 Milking cows (%) Rep. heifers (%) Dairy calves (%) nα =238 nß =146 nα =127 nß =65 nα =40 nß =11 194 (81.5) 117 (80.1) 111 (87.4) 52 (80) 34 (85) 8 (72.7) s. eye and n. signs 14 (5.9) 3 (2.1) 9 (7.1) 6 (9.2) 6 (15) 3 (27.3) nervous signs 14 (5.9) 14 (9.6) 6 (4.7) 6 (9.2) 0 0 abortion 10 (4.2) 9 (6.2) 0 0 0 0 mastitis 4 (1.7) 1 (0.7) 0 0 0 0 Sudden death 1 (0.4) 1 (07) 0 0 0 0 Diarrhoea 1 (0.4) 1 (0.7) 0 0 0 0 0 0 1 (0.8) 1 (1.6) 0 0 Clinical signs silage eye s. eye and s. death α diagnosed by all three given alternatives, self, veterinarian, VIC, number of cases ß diagnosed by veterinarian or VIC, n 2. 3. 7 Treatment : 91.7% (388/423) of the cases reported between 1994 and 1995 were treated. 95.6% (371/388) of treated cases recovered, 2.3% (9/388) died and 2.1% (8/388) were culled. 3.6% (15/423) were untreated and for the remaining 4.7% (20/423) treatment was not reported. When cases were grouped according to these presenting clinical signs recovery from silage eye was high (99%) while only 68.4% of the cases with nervous signs were reported to recover. This difference was statistically significant (P<0.001). All treated abortion cases recovered and no therapy was given to mastitic animals (Table 2. 6). Table 2. 6. Treatment of clinical listeriosis and its result for the cases reported between July 1994 and June 1995 Result Clinical signs n Treated Recovered Died Culled 57 all cases* 403 384 371 (96.6%) 9 (2.3%) 8 (2.1%) silage eye 339 331 328 (99%) 3 (1%) 0 s. eye and n. signs 29 29 26 (89.7%) 1 (3.4%) 2 (6.9%) nervous signs 20 19 13 (68.4%) 4 (21.1%) 2 (10.5) abortion 10 4 4 (100%) 0 0 mastitis 4 0 0 0 4 (100%) s. eye and s. death 1 1 0 1 0 n number of the cases * excluding those whose clinical signs were not reported 2. 3. 8. Validation of the questionnaire: The frequency of individual signs selected by farmers is given in the Table 2. 7. Abortion (57.8%), nervous sign (56.8%), silage eye (49.4%) and diarrhoea (24.1%) were reported most frequently. Of 894 respondents, 41% (366/894) did not answer this question, 6% (54/894) answered “don`t know” and 53% (474/894) identified one or more clinical signs of listeriosis. When the diagnosis made by veterinarian or V.I.C. was taken as the gold standard, the sensitivity of farmers reporting individual symptoms was 67.2% for silage eye, 49.2% for nervous signs and 21.9% for abortion The sensitivity was high when more than one clinical signs was reported. It was 96.1% (123/128) for farmers reporting a combination of nervous signs, silage eye or abortion and 87.5% (112/128) for farmers reporting nervous signs or silage eye. (Table 2.7). Table 2. 7. The frequency of clinical signs chosen by farmers and sensitivity of farmers reporting correct clinical signs. Frequency of clinical sensitivity of farmers Clinical signs signs nα=474 (%) reporting nβ=128 (%) 58 α Abortion 274 (57.8%) 28 (21.9%) Nervous signs 269 (56.8%) 63 (49.2%) Silage eye 234 (49.4%) 86 (67.2%) Diarrhoea 114 (24.1%) 8 (6.3%) Sudden death 87 (18.4%) 12 (9.4%) Mastitis 38 (8%) 4 (3.1%) Lameness 26 (5.5%) 0 Pneumonia 21 (4.4%) 2 (1.6%) N. sign + s. eye + abortion 435 (91.7%) 123 (96.1) Nervous sign + silage eye 356 (75.1%) 112 (87.5) diagnosed by all three given alternatives, β diagnosed only by veterinarian or V.I.C. During the period between July 1994 and June 1995, 99 cows which developed nervous signs and were reported to the state veterinary agency under the BSE notification scheme turned out to be cases of listeriosis on histopathological examination. This represents 4.1/100 000 cases/cattle in the United Kingdom (except Northern Ireland) (J. Wilesmith personal communication). For the same period in our survey the number of cases of Listerisosis reported as culled or dying of encephalitis were 5 and the number of total dairy cattle population reported between July 1994 and June 1995 was 119,123, giving a proportion of 4.2/100 000 cases/cattle. This is similar to the proportion estimated from the statutory reporting of cattle with nervous signs. 2. 3. 9. Herd size: 59 The reported number of milking cows ranged from 8 to 390 in unaffected herds and 23 to 242 in affected herds. The median number of cows in affected herds was significantly greater than that in unaffected herds (P<0.05). The number of replacement heifers in the herds ranged from 1 to 200 in unaffected herds and 15 to 250 in affected herds. The median number in affected herds was significantly greater than that in non-affected herds (P<0.05). Unlike milking cows and replacement heifers the median number of dairy calves in affected herds was no different to that in non-affected herds. It ranged from 1 to 451 in unaffected herds and 5-290 in affected herds (P=0.8) (Table 2. 8). Table 2. 8. Herd size in non-affected and affected groups. Unaffected herds Affected Herds June 1995 June 1995 Median (IR) Median (IR) Milking cows a 67 (43-100) 74 (58-110) Replacement heifers b 20 (8-39) 30 (15-40) Dairy calves 25 (14-45) 28 (18-37) a, b, = significant difference between affected herds and unaffected herds (a P=0.02, b P=0.01) IR= interquartile range 2. 4. Discussion: The objectives of this study were to determine the frequency of clinical listeriosis and some characteristics of clinical disease in dairy cattle in England. This information was obtained by means of a postal questionnaire. Postal questionnaire surveys are commonly used to collect epidemiological data because they are easier and cheaper to perform and allow the participants to refer to their records or consult 60 with others (Kanuk and Berenson 1975, Vaillancourt and others 1991). Farmer questionnaires are particularly useful when the disease is easily visible or has distinct clinical signs. In previous studies we have taken advantages of this to estimate the prevalence of blowfly strike (French and others 1992) and Johne`s disease (Cetinkaya and others 1996). Listeriosis differs from these diseases by manifesting itself by three different, rarely overlapping, syndromes; encephalitis, septicaemia and abortion. In spite of this we considered that three aspects of listeriosis would make it suitable for a farmer based questionnaire; its sporadic occurrence, the likelihood that a veterinarian would be involved in diagnosis and its distinctive name (reviewed by Radostits and others 1994). A key component in the use of questionnaires as measuring instruments is the repeatability and validity of these measures. In this study we have no measure of repeatability but we attempted to validate the questionnaire in three ways; by asking for the method of diagnosis and stratifying the results to include only those cases diagnosed by a veterinarian or V.I.C.; by asking farmers to identify the clinical signs of listeriosis from a list which included signs which were not typical of listeriosis and by comparing the proportion of culled nervous cases of listeriosis in our study with the proportion of nervous listeriosis diagnosed at necropsy during statutory BSE reporting where cows showing any nervous disorder had to be culled during the same period as our study covered. The majority of the cases were diagnosed by a veterinarian or V.I.C.. On 83.9% of farms reporting cases between July 1994 and June 1995 diagnoses were made by veterinarian or V.I.C.. When these data were used to calculate the farm prevalence, the results were within the confidence limits of the overall estimates and did not statistically differ from them. When we asked farmers to identify clinical signs of listeriosis the sensitivity of farmers reporting a single correct clinical sign was low ( range 61 from 3.1% to 67.2%) but it was high when three correct signs were examined (96.1%). This may indicate that the farmers were poor at self diagnosis or alternatively they were only reporting the clinical signs seen in cases on their farm. On the majority of farms only one type of clinical sign was seen. However, in view of the fact that there was no significant difference between the overall proportion and those estimates based on veterinarian and veterinary investigation centre diagnoses we do not consider that the farmers’ misdiagnoses introduced bias into the results. The failure of farmers to recognise clinical signs other than nervous disease and to call a veterinarian may have resulted in an underestimation of true prevalence. As a further validation measure the proportion of cattle with nervous signs culled or died in this survey was compared with confirmed Listeria cases submitted to CVL as suspect BSE cases. Those proportions were remarkably similar. The close similarity of the results adds credence to the results of this survey. The influence of non-respondents was not measured but an effort was made to maximise the response rate by sending a number of reminders to the farmers. The 64.1% response rate was good for the size of samples used in this study (Vailloncourt and others 1991). However, when compared with the two recent surveys conducted by our group in which response rates were 74.2% and 78.3% (French and others 1992, Cetinkaya and others 1996) the response rate was lower. The difference in the length, format and content of the questionnaire might have contributed to this lower response rate (del Garso and Wallop 1975). Our questionnaire consisted of 8 pages and 50 questions, where as Cetinkaya and others (1996) used 39 questions on 5 pages and French and others (1992) used 15 questions on 2 pages. At farm level, Listeriosis in milking cows was reported more frequently than in other groups of animals. However within the affected herds the highest incidence of disease 62 occurred in replacement heifers and dairy calves. These results suggest that the younger animals were at greater risk. This is also in agreement with reports of ovine listeriosis (Gudding and others 1989, Nash and others 1995) and has also been reported for human listeriosis (Lober 1990). Silage eye was the most frequent clinical sign reported in this study, this corresponds to an increasing number of field reports of iritis and/or keratoconjunctivitis (silage eye) in recent years. Although this is attributed to silage feeding contaminated with Listeria monocytogenes (Walker and Morgan 1993, Sargison 1994) there has been no epidemiological investigation of this problem. In naturally occurring cases of listeriosis an overlap of different forms of clinical signs is rare (Gitter 1989) and in this study only a small number of such cases were reported. The seasonal occurrence of listeriosis has long been known (Gray and Killinger 1966), most of cases occurring between January and May (Low and Linklater 1985). In this survey the occurrence of listeriosis was also seasonal. Most of the cases were reported in Winter and Spring mostly between January and May. This coincides with two key changes in management; silage feeding and winter housing (Low and Linklater 1985). Silage feeding has been identified as an important risk factor for listeriosis but housing also occurs at a time when the environment may be heavily contaminated with Listeria monocytogenes (Vandegraaff and others 1981). In this study the rate of recovery after treatment varied with the clinical presentation of disease. It was 99% for silage eye and 68.4% for nervous signs. It is suggested that if treatment is started at an early stage of the clinical disease a high chance of recovery is possible (reviewed by Radostitis and others 1994). This may have been the case in this study or success may have been attributed to the fact that clinical signs were mainly non- 63 nervous and therefore easier to treat. A similar statement was made for non-nervous clinical signs by Low and Linklater (1985). This is the first study of the frequency of clinical listeriosis in dairy cattle in England. Although L. monocytogenes is widespread in the environment and animals are exposed to it only 12.3% of farms had clinical listeriosis in their animals. This may be due to differences in farm practices. This relationship between the prevalence, incidence of clinical listeriosis and farm related factors is dealt with in the next two chapters. 64 CHAPTER 3 The relationship between farm management practices and clinical listeriosis in dairy cattle in England: univariate analysis 3. 1. Introduction: Infectious disease is the result of a complex set of interactions between the infectious agent, host and environment. The infectious agent is an essential component of disease but it may not be sufficient to trigger disease on its own. Other factors are also needed for disease to develop. Listeriosis is a good example of this disease process. Listeria organisms (mainly L. monocytogenes) are necessary causative agents of disease but the isolation of L. monocytogenes from the brain (Gronstol 1980b) and faeces (Husu 1990) of healthy individuals suggests that other factors are also involved. Some other risk factors have been identified both in epidemic and sporadic cases of human listeriosis; various physiological states of host such as extremes of age and pregnancy (Ciesielski and others, 1988), underlying conditions such as cancer (Niemen and Lorber 1980), immunosuppression, such as HIV infection (Jurado and others 1993), organ transplantation (Lorber 1990) and concurrent infections (Rocourt 1996). However less is known about the risk factors associated with listeriosis in animals. The association between silage feeding and the occurrence of Listeriosis is well documented (Gray 1960a, Wilesmith and Gitter 1986, Fenlon 1988, Sargison 1993) but the exact 65 manner in which silage plays a role is little known. Improper silage making practices have been suggested as an explanation for this association (Wilesmith and Gitter 1986) but more work is required to ascertain the role of silage. Stress of housing, pregnancy and weather have been considered as predisposing factors (Hyslop 1975). Poor flock management has also been associated with disease (Meredith and Schneider 1984). However no data is available to quantify these factors. A postal questionnaire survey was designed to determine the frequency of clinical listeriosis and the relationship between farm management factors and occurrence of clinical listeriosis in dairy cattle. The latter is described in this chapter. 3. 2. Materials and Methods: 3. 2. 1. Study design: Information about the questionnaire design and conduct of study is given in the Chapter 2. In studying the relationship between the occurrence of clinical listeriosis and farm related management factors, only those cases reported between July 1994 and June 1995 were considered. 5 outcome variables and 5 groups of predictor variables were used. 3. 2. 2. Outcome variables: (i) Total number of cases (Overall cases): Farms that reported clinical listeriosis in cattle of any age. 66 (ii) Cases in milking cows: Farms reporting at least one case of Listeriosis in milking cows. (iii) Cases in winter months: This includes only those farmers reporting cases of Listeriosis in winter months. (iv) Cases of silage eye (iritis): Farms reporting silage eye as a clinical sign. (v) Cases of nervous signs: Farms which reported cases of listeriosis showing nervous signs. 3. 2. 3. Predictor variables: The five groups of predictor variables were herd size, feeding practices, forage making, housing and general management. These included binary, categorical and continuous variables. Each group of predictor variables had subsets of variables that are dealt with under the related headings. When continuous variables were categorised the cut off points for each categories were set according to known biological influences e. g. pH, number of cuts and wilting. (i) Herd size: The herd size reported in July 1994 and June 1995 was used as a categorical variable with 3 herd sizes:-the number of animals on each farm less than or 50, 51-100, and greater than 100 animals. (ii) Feeding practices: 67 a) Type of forages fed to animals: Farmers were asked to state whether they fed any of the following forages; grass silage, maize silage, hay, feed straw and root crops. These variables were treated as binary variables except for straw and root crops which were first treated as binary then categorised according to type (barley, wheat, potatoes, sugar beet etc.). b) Source of forages: The farmers were asked about the source of their forages. Three options were provided; home-made, purchased and other sources. These were treated as binary variables. c) Month of feeding forages: To assess the relationship between the duration of feeding and Listeriosis farmers were asked to state the month in which forage feeding started and stopped. The duration of feeding forages was used as categorical variable with 4 levels: - less than 6 months, 6 months, more than 6 months and all year around. d) Methods of feeding forages: These were divided into those used during the outdoor period and indoor period. A list of feeding methods was given on the questionnaire. This included ad libitum, on the ground, at the clamp face, in hay racks, off the field, in ring feeders etc. (Appendix 1). These variables were treated as binary variables for each forage. iii) Making forage crops: 68 To assess the relationship between different harvesting practises and the occurrence of Listeriosis one section of the questionnaire was devoted to acquiring information about harvest of forages such as month of harvest, type of harvester used etc. a) Month of making forages: This variable was categorised into 3 levels:- before and during May, in June and during and after July. b) Type of harvesters or mowers used: Farmers were asked about the type of harvester used for forage. The options given were forage harvesters, discs and drums, mower conditioner and combine harvester. These variables were used as binary variables for each forage. c) Number of cuts made for grass silage and hay: This was a categorical variable. Farmers reported making up to 4 cuts for grass silage and up to 3 cuts for hay. d) Duration of wilting or drying forages: The length of wilting or drying of forages was assessed. This was first treated as a binary variable i.e. whether wilting or drying took place or not and then categorised according to number of days of wilting or drying (0, 1, 2, and 3 and more days). d) Type of additives used in the preparation of forages: Farmers were asked about the type of additives used in preserving their forages. This variable was first treated as a binary variable (i.e. whether or not additives were used) and then categorised according to composition of additives. For this 5 categories were used:- enzyme, inoculant, salt and acid, enzyme and inoculant and a combination of all 4. 69 e) Storage of forages: Information about the method of storing forage crops was gathered. These are listed in the questionnaire (Appendix 1). Where appropriate the type of floor used in the storage area was also investigated. These were used as binary variables. f) Use of clamp: Farmers were also asked if they used separate clamps for each cut of grass and whether they sealed the clamp between each cut. These were treated as binary variables. g) Analysis of forage crops: Farmers were asked if they had their forages analysed, if so, they were also asked to provide pH, Dry Matter (DM), Ash and Metabolisable Energy (ME). This was first treated as a binary variable and then categorised as shown in the Table 3. 1. Table 3. 1. Categorisation of forage analysis Categories pH DM Ash ME 1 <3.8 <22 <5 <10.3 2 3.8-4.2 22-30 5-10 10.3-11.6 3 >4.2 >30 >10 >11.6 iv) Housing practices: The questionnaire had a section investigating housing practises. Farmers were first asked whether animals were housed at any time of the year and then details of housing and bedding were gathered. a) Type of housing: Cubicles and loose yard were the alternatives given, the farmers were also asked to specify any other type of housing if these two were not in use. In analysing the data these were used as binary variables. 70 b) Duration of housing: If animals were housed farmers were asked to specify the months between which animals were kept in. This variable was categorised as less than 6 months, 6 months, more than 6 months or all year around. c) Type of floor: The farmers were asked to specify the type of floor of any building, used to house cattle, from the following list; earth, hard core, concrete, slatted and others. These were used as binary variables. d) Use and type of bedding: Farmers were asked if they used bedding and this was used as a binary variable. They were also asked to select given options; sawdust, straw or specify other types of bedding material used on their farms. These were treated as binary variables. Frequency of weekly adding and removing fresh bedding to and the frequency of cleaning out bedding from the house over the housing period was also used first as a binary variable and then as a categorical variable. e) Straw bedding: If straw was used for bedding, the farmers were asked about the month of making straw (categorical), duration of drying it (categorical), type (barley, wheat, etc.) (binary) and whether it was big bale or others (binary). f) Storage of bedding materials: The method of storing bedding was investigated by asking farmers to identify the method(s) of storage from the followings; storing in a covered barn, outside covered, outside uncovered and others. 71 g) Disposal of the dung: The farmers were asked about how the dirty bedding material was disposed. Three alternatives were given; solid manure, slurry and others. These were binary variables. h) Storing dung: The farmers were asked if the dung was stored. If it was stored then they were asked to select one or more of the following storage methods; beneath the slats, composted, in a slurry tank, in a lagoon and others (Appendix 1). These were used as binary variables. i) Spreading dung on the pasture: Farmers were asked if they spread dung on pasture where animals grazed or where hay and silage were made. This was used as a binary variable. v) General management practices: a) Cases of Listeriosis in other animals: The presence of listeriosis in other animals was investigated by asking farmers whether they had cases in beef cattle, sheep, goats and other. These were used as binary variables. b) Grazing practices: The farmers were asked whether other animals (beef cattle, sheep, goats and other) grazed the same pasture as dairy cattle. These were treated as binary variables. c) Use of vaccine: Farmers were asked if they vaccinated their herds against Salmonellosis, E. coli, Leptospirosis, Lungworm or other specified vaccines. These were treated as binary variables. 72 d) Presence of moles: Farmers were asked if they had seen mole hills in the fields where hay, grass silage and straw were made. This was used as a binary variable. e) Control of moles: If the mole hills were present, farmers were asked if they controlled moles and the methods of controlling. These were used as binary variables and categorical variables respectively . 3. 2. 4. Data analysis A Yates corrected chi-square test was used to determine differences between proportions. Odds ratios (OR) were calculated with 95% confidence limit (95%CL). Categorical data such as duration of wilting, frequency of adding fresh bedding were first treated as binary variables (the affect of presence or absence on the outcome) and then categorised and analysed using chi-square tests (2xk contingency tables and chi square for trend test using scores for each category) (Armitage and Berry, 1988). 3. 3. Results: 3. 3. 1. Univariate relationship between farm management practices and Listeriosis in dairy cattle (Overall cases ): 73 93 of the total number of respondents (894) reported cases of clinical Listeriosis in their dairy cattle between June 1994 and July 1995. 26 farm level predictor variables were associated with disease, 21 with an increased and 5 with a decreased risk. The overall results of the univariate analysis are also presented in the appendix 2. (i) Herd size: There was a statistically significant association between the number of milking cows in a herd and the occurrence of disease. The risk of reporting disease increased as the herd size increased (Table 3. 2.). Table 3. 2. Univariate relationship between herd sizes and clinical listeriosis June 1995 Herd July 1994 Y N OR <50R 14 209 50-100 48 >100 31 P valueX Y N OR 1.00 13 206 1.00 271 2.64 44 271 2.57 141 3.26 29 139 3.31 P valueX sizesn M. cows <0.001 <0.001 n number of animals, R reference category, X X2 for trend, Y number of farmers reporting cases, N number of farmers not reporting cases, OR, Odds Ratio. (ii) Feeding practices: a) Type of forages:5 types of forages were investigated and 3 were associated with risk of reporting disease. Those who did not feed grass silage did not report any cases of 74 listeriosis. Maize silage feeding also increased the risk of disease in dairy cattle and the Odds Ratio for this variable was 2.4 (95% CL 1.50-3.85). There was also a statistically significant association between feeding straw when animals were housed and a decreased risk of reporting disease in dairy cattle (OR 0.38, 95% CL 0.18-0.78). (Table 3. 3). When the individual types of straw (barley, wheat, wheat and barley and the combination of wheat, barley, oat and pea) or root crops (beet type, potatoes, brassica type, kale and others) were taken into consideration there was no association between these and the occurrence of listeriosis in dairy cattle. b) Sources of forage: Farmers were given three alternative sources of forage; purchased, home made and any other sources. There was a statistically significant association between purchased grass silage (OR 2.91, CL 1.22-6.8) and increased risk of reporting Listeriosis (Table 3. 3). c) Methods of feeding forages: 1) outdoor feeding: Feeding maize silage (OR 1.35, CL 1.59-13.04), hay (OR 2.98, CL 1.12-8.23) and straw (OR 3.72, CL 1.25-11.88) in ring feeders when animals were out were associated with an increased risk of disease (Table 3. 3). 2) indoor feeding: Two methods (feeding forages in ring feeders and on the floor) were associated with disease. Feeding grass silage (OR 1.93, CL 1.21-3.07), maize silage (OR 4.96, CL 2.17-11.46) and hay (OR 4.17, CL 1.83-9.61) in ring feeders was positively associated with disease whereas feeding grass silage (OR 0.23, CL 0.04-0.97) and hay (OR 0.0, CL 0.0-0.85) on the floor was negatively associated with disease (Table 3. 3). 75 Table 3. 3. Effect of forages fed to dairy cattle on the occurrence of listeriosis. Y N OR 95% CL P Value Grass silage 93 761 ? ? 0.05 Maize silage 39 185 2.4 1.50-3.85 <0.001 9 27 2.91 1.22-6.80 0.01 ring feeders for maize silage 26 32 4.5 1.59-13.4 0.002 ring feeders for hay 19 111 2.98 1.12-8.23 0.02 ring feeders for straw 20 114 3.72 1.25-11.88 0.01 straw 28 311 0.38 0.18-0.78 0.006 ring feeders for grass silage 53 310 1.93 1.21 0.008 ring feeders for maize silage 23 46 4.96 2.17-11.46 <0.001 ring feeders for hay 22 109 4.17 1.83-9.61 <0.001 grass silage on the floor 2 67 0.23 0.04-0.97 0.04 hay on the floor 0 52 0.0 0.0-0.85 0.03 68 437 2.02 1.21-3.37 0.005 big bale grass silage 71 453 2.19 1.29-3.75 0.002 hay outside covered 3 5 6.26 1.12-32.13 0.03 Straw outside covered 6 21 2.68 0.9-7.67 0.08 Type of forages source of forages purchased grass silage methods of feeding: - outdoor methods of feeding : - indoor type of harvester mower conditioner (g. silage) storage Y number of farmers reporting cases, N number of farmers not reporting cases, OR (95% CL) Odds Ratio with 95% confidence limit, ? undefined. d) Duration of feeding forages: There was a statistically significant association between the duration of feeding grass silage and disease (P= 0.03). As the duration of feeding grass silage increased the risk of disease also increased (Table 3. 4). No association was 76 found between the duration of feeding maize silage, hay, straw or root crops and clinical Listeriosis. Table 3. 4. The relationship between listeriosis and duration of feeding grass silage Duration of feeding Grass silage Maize silage Y N OR <6 monthsR 13 128 6 months 13 >6 months All year R P ValueX Y N OR 1.00 18 69 1.00 114 1.12 7 46 0.58 52 288 1.78 11 28 1.51 14 70 1.97 4 10 1.53 0.03 P ValueX 0.3 reference category, X X2 for trend, OR odds ratio (iii) Making forage crops: a) Type of harvesters: Using a mower conditioner in the process of making grass silage increased risk of reporting disease (OR 2.02, CL 1.21-3.37). This relationship was statistically significant (Table 3. 3). b) Number of cuts made for grass silage and hay: Although the relationship between number of cuts made for grass silage and Listeriosis was not statistically significant there was an increasing risk of disease as the number of cuts were increased (Table 3. 5). Table 3. 5. The univariate relationship between number of grass cuts and disease 77 Grass Silage Hay No of cuts Y N OR 1R 13 145 2 43 3 4 P Value Y N OR 1.00 36 292 1.00 382 1.26 3 7 3.48 27 180 1.67 0 3 0.00 2 9 2.48 0.09 P Value 0.4 NA R refence category, X X2 for trend, Y number of farmers reporting cases, N number of farmers not reporting cases, OR Odds Ratio c) Storage of forages: Different methods of storing forages were evaluated. Preserving grass silage in big bales (OR 2.19, CL 1.29-3.75), storage of hay outside covered (OR 6.26, CL 1.12-32.13) and straw outside covered (OR 2.68, CL 0.9-7.67) were associated with an increased risk of disease. These associations were statistically significant except for storage of straw outside covered (Table 3. 3). d) Analysis of forage crops: 57.8% (517/894) of the respondents reported having their forages analysed but not all of these provided complete information. There was an association between the pH of grass silage and disease. As the pH increased the risk of reporting disease increased. This was only statistically significant for pH of Clamp1 grass silage (Table 3. 6). Table 3. 6 .Effect of silage quality on listeriosis (univariate results) pH of Clamp 1 R Y N OR 1R (<3.8) 3 36 1.00 2 (3.8-4.2) 10 87 1.38 3 (>4.2) 10 28 4.29 p ValueX 0.02 reference category, X X2 for trend, OR odds ratio (iv) Housing practices: 78 a) Type of housing : Housing animals in buildings other than cubicles and loose yards was associated with a decreased risk of disease (OR 0.12, CL 0.01-0.83) (Table 3. 7). b) Use and type of bedding: Using straw bedding in cubicles increased the risk of disease (OR 2.56, CL 1.09-6.3) while use of straw in other types of housing decreased the risk (OR 0.0.0, CL 0.0-0.71) (Table 3. 7). c) Dung management: Disposal of dung as slurry was associated with an increased risk of disease (OR 1.73, CL 1.02-2.97). This association was statistically significant. Similarly, storing manure beneath the slats (OR 13.50, CL 1.74-121.23) was also found to increase the risk of disease (Table 3. 7). (v) General management: a) Cases of Listeriosis in other animals: The presence of listeriosis in beef cattle (OR 32.37, CL 8.07-151.24) and sheep (OR 1.03, CL 1.03-6.25) was associated with increased risk of disease (Table 3. 7). b) Vaccine use: Vaccinating dairy cattle against leptospirosis (OR 2.14, CL 1.34-3.42) was associated with an increased risk of reporting disease (Table 3. 7). Table 3. 7. Univariate relationship between housing practices and listeriosis Type of housing Y N OR 95% CL P Value 79 other housing (cow shed) 1 65 0.12 0.01-0.83 0.02 Straw bedding in cubicles 70 484 2.56 1.09-6.3 0.02 Straw bedding in loose yard 31 193 ? ? 0.07 straw bedding in others 0 56 0.0 0.0-0.71 0.02 slurry 71 521 1.73 1.02-2.97 0.04 manure beneath the slats 3 2 13.50 1.74-121.23 0.003 Beef cattle 11 3 32.37 8.07-151.24 <0.001 Sheep 8 27 2.58 1.03-6.25 0.04 39 168 2.14 1.34-3.42 <0.001 dung disposal Listeriosis in other animals Vaccine use Leptospirosis Y number of farmers reporting cases, N number of farmers not reporting cases, OR (95% CL) Odds Ratio with 95% confidence limit, ? undefined. 3. 3. 2. The univariate relationship between farming practices and clinical Listeriosis in milking cows. 71 of the respondents experienced clinical Listeriosis in their milking cows. 14 variables were associated with disease. 12 variables increased the risk and 2 decreased the risk of reporting disease in milking cows. (i) Herd size: The risk of reporting disease was greater in larger herds. As the herd size increased the risk of reporting disease in milking cows increased (Table 3. 8). Table 3. 8. Univariate relationship between herd sizes and clinical listeriosis in milking cows June 1995 July 1994 80 Herd Y N OR <50R 11 256 50-100 39 >100 21 P valuex Y N OR 1.00 10 255 1.00 321 2.83 34 323 2.68 195 2.51 21 191 2.80 P valueX sizesn M. cows 0.02 <0.001 n number of animals, R reference category, X X2 for trend, Y number of farmers reporting cases, N number of farmers not reporting cases, OR, Odds Ratio. (ii) Feeding practices: a) Type of forages: Feeding maize silage was associated with an increased risk of disease (OR 2.53, CL 1.49-4.29) (Table 3. 9). b) Source of forages: Feeding purchased grass silage increased the risk of reporting disease (OR 2.84, CL 1.08-7.2) (Table 3. 9). c) Methods of feeding: 1) outdoor feeding: Maize silage (OR 3.87, CL 1.28-12.03) and straw (OR 3.37, CL 1.00-12.57) fed to animals in ring feeders increased the risk of disease (Table 3. 9). 2) indoor feeding: Maize silage (OR 4.20, CL 1.72-10.39), grass silage (OR 2.11, CL 1.24-3.59) and hay (OR 2.67, CL 1.80-11.98) fed in ring feeders increased the risk of disease (Table 3. 9). Table 3. 9. The univariate relationship between feeding practices and Listeriosis in milking cows. Y N OR 95% CL P Value 81 Type of forages Maize silage source of forages purchased grass silage methods of feeding: - outdoor 31 193 2.53 1.49-4.29 <0.001 7 29 2.84 1.08-7.2 0.03 ring feeders for maize silage ring feeders for hay ring feeder for straw methods of feeding : - indoor ring feeders for grass silage ring feeders for maize silage ring feeders for hay grass silage on the floor hay on the floor 13 15 15 35 115 119 3.87 2.67 3.37 1.28-12.03 0.92-8.10 1.0-12.57 0.01 0.07 0.05 42 18 18 1 0 321 51 113 68 52 2.11 4.20 4.58 0.15 0.0 1.24-3.59 1.72-10.9 1.80-11.98 0.01-1.03 0.0-1.12 0.004 <0.001 <0.001 0.05 0.06 storage big bale grass silage big bale out uncovered straw outside covered 54 47 5 470 342 22 2.12 2.51 3.23 1.16-3.89 1.05-6.31 0.97-10.09 0.01 0.04 0.06 Y number of farmers reporting cases, N number of farmers not reporting cases, OR (95% CL) Odds Ratio with 95% confidence limit. (iii) Making Forage crops: a) Number of cuts: There was statistically significant relationship between an increased number of cuts made for grass silage and an increased risk of disease in milking cows (Table 3. 10). Table 3. 10. The relationship between number of grass cuts and Listeriosis in milking cows Grass Silage No of cuts 1R 2 3 4 R X Y N OR P Valuex 7 35 22 2 151 390 185 9 1.00 1.94 2.57 4.79 0.01 2 reference category, X for trend, Y number of farmers reporting cases, N number of farmers not reporting cases, OR, Odds Ratio. b) Storage: Grass silage preserved in big bales (OR 2.12, CL 1.16-3.89) and storing big bales outside uncovered (OR 2.51, CL 1.05-6.31) were associated with an increased risk 82 of disease. Similarly storing feed straw covered outside was also associated with an increased risk of disease (OR 3.23, CL 0.97-10.09) (Table 3. 9). (iv) Housing: a) Type of housing: Housing animals in houses other than loose yards or cubicles was associated with a decreased risk of disease in milking cows but this was not statistically significant (OR 0.16, CL 0.01-1.12) (Table 3. 11). b) Use of bedding: Straw bedding in other types of houses was also associated with a decreased risk of reporting disease (OR 0.0, CL 0.0-0.95) (Table 3. 11). Table 3. 11. The relationship between housing and general management and Listeriosis in milking cows Housing Y N OR 95% CL P Value other housing (cow shed) 1 65 0.16 0.01-1.12 0.07 straw bedding in others 0 56 0.0 0.0-0.95 0.04 6 8 15.78 4.73-53.78 <0.001 32 209 2.41 1.42-4.08 <0.001 Listeriosis in other animals Beef cattle Vaccine use Leptospirosis Y number of farmers reporting cases, N number of farmers not reporting cases, OR (95% CL) Odds Ratio with 95% confidence limit, (v) General management: 83 a) Cases of Listeriosis in other animals: Listeriosis in beef cattle was associated with an increased risk of reporting listeriosis in milking cows (OR 15.78, CL 4.73-53.78) (Table 3. 11). b) Vaccine use: Vaccinating animals against Leptospirosis was associated with an increased risk of disease in milking cows. (OR 2.41, CL 1.42-4.08) (Table 3. 11). 3. 3. 3. The univariate relationship between farming practices and clinical Listeriosis reported in winter months. Cases of listeriosis occurred between October1994 and June 1995 on 76 farms. 18 farm level predictor variables were associated with either an increased (14 variables) or a decreased (4 variables) risk of reporting cases of listeriosis between October 1994 and June 1995. (i) Herd size As the herd size increased the risk of reporting cases of listeriosis in winter months also increased (Table 3. 12). Table 3. 12. Univariate relationship between herd sizes and clinical listeriosis reported in winter months July 1994 June 1995 M. cows n Herd sizesn Y N OR <50R 50-100 >100 13 39 24 254 321 192 1.00 2.37 2.44 R X P value* Y N OR P valueX 0.01 12 37 22 253 320 190 1.00 2.44 2.44 0.01 2 number of animals, reference category, X for trend, Y number of farmers reporting cases, N number of farmers not reporting cases, OR, Odds Ratio. (ii) Feeding practices: 84 a) Type of forages: Feeding maize silage (OR 1.97, CL 1.17-3.32) and grass silage (OR not calculated) was associated with an increased risk of reporting disease (Table 3. 14). b) Source of forages: Purchased grass silage was associated with an increased risk of disease (OR 2.62, CL 1.00-6.61) (Table 3. 14). c) Methods of feeding forages; 1) indoor feeding: Feeding grass silage (OR 2.55, CL 1.51-4.32), maize silage (OR 6.37, CL 2.42-17.19) and hay (OR 4.86, CL 2.02-11.97) in ring feeders was positively associated with disease. Feeding maize silage ad libitum was also found to increase the risk of reporting disease (OR 3.57, CL 0.96-12.74). Feeding hay on the floor was negatively associated with disease (OR 0.0, CL 0.0-0.95) (Table 3. 14). (iii) Making forage crops: a) Type of harvesters: Using a mower conditioner for making grass silage was associated with an increased risk of disease (OR 1.91, CL 1.10-3.35) (Table 3. 14). b) Storage: Preserving grass silage as big bales (OR 2.00, CL 1.13-3.57) and storing hay outside covered (OR 6.86, CL 1.22-35.41) were found to increase the risk of reporting disease (Table 3. 14). c) Analysis of forages: There was an association between increasing pH and increasing risk of disease reported in winter months, as the pH value increased the risk of reporting disease also increased (Table 3. 13). 85 Table 3. 13 .Effect of silage quality on listeriosis in winter months pH of Clamp 1 R Y N OR 1R (<3.8) 2 44 1.00 2 (3.8-4.2) 8 108 1.38 3 (>4.2) 10 34 4.29 P ValueX 0.003 reference category, X X2 for trend, OR odds ratio Table 3. 14 The univariate relationship between feeding practices and cases of Listeriosis reported in winter months N OR 95% CL P Value Y Type of forages Grass silage 76 778 ? ? 0.09 Maize silage 29 195 1.97 1.17-3.32 0.008 7 29 2.62 1.00-6.61 0.05 ring feeders for grass silage 48 315 2.55 1.51-4.32 <0.001 maize silage adlibitum 5 11 3.57 0.96-12.74 0.056 ring feeders for maize silage 19 50 6.37 2.42-17.19 <0.001 ring feeders for hay 21 110 4.86 2.02-11.97 <0.001 hay on the floor 0 52 0.0 0.0-0.95 0.04 55 450 1.91 1.10-3.35 0.02 big bale grass silage 57 467 2.00 1.13-3.57 0.01 hay outside covered 3 5 6.86 1.22-35.41 0.02 source of forages purchased grass silage methods of feeding : - indoor type of harvester mower conditioner (g. silage) storage Y number of farmers reporting cases, N number of farmers not reporting cases, OR (95% CL) Odds Ratio with 95% confidence limit, ? undefined. (iv) Housing: a) Type of housing: The use of alternative housing to cubicles or loose yards was associated with a decreased risk of disease (OR 0.15, CL 0.01-1.05) (Table3. 15). 86 b) Use of bedding: Using straw bedding in cubicles was associated with an increased risk of disease (OR 3.0, CL 1.12-8.76) while its use in other house types (OR 0.0 CL 0.0-0.89) was associated with a decreased risk of disease (Table 3. 15). c) Dung disposal: Disposing of dung as slurry and not storing manure were associated with an increased risk of reporting disease, but these relationships were not statistically significant (Table 3. 15). Storing manure beneath the slats increased the risk of reporting disease in winter months (OR 17.72, CL 2.26-160.7). Table 3. 15 The relationship between housing and general management and Listeriosis reported in winter months Housing Y N OR 95% CL P Value other housing (cow shed) 1 65 0.15 0.01-1.05 0.057 Straw bedding in cubicles 59 495 3.0 1.12-8.76 0.02 straw bedding in others 0 56 0.0 0.0-0.89 0.03 slurry 58 534 1.71 0.96-3.1 0.06 not storing manure 4 14 3.37 0.87-12.04 0.08 manure beneath the slats 2 3 17.72 2.26-160.7 <0.001 5 9 19.91 5.82-71.35 <0.001 30 211 1.88 1.12-3.15 0.01 24 397 0.49 0.29-0.83 0.006 dung disposal Listeriosis in other animals Beef cattle Vaccine use Leptospirosis Mole hills controlling moles Y number of farmers reporting cases, N number of farmers not reporting cases, OR (95% CL) Odds Ratio with 95% confidence limit. (v) General management: a) Cases of Listeriosis in other animals: Reporting cases of listeriosis in beef cattle was associated with an increased risk of disease (OR 19.91, CL 5.82-71.35) (Table 3. 15). 87 b) Vaccine use: Vaccinating animals against Leptospirosis was also associated with an increased risk of disease (OR 1.88, CL 1.12-3.15) (Table 3. 15). c) Mole control: Controlling moles was associated with a decreased risk of reporting disease (OR 0.49, CL 0.29-0.83) (Table 3. 15). 3. 3. 4. The univariate relationship between farming practices and cases of Listeriosis with silage eye (iritis). 65 of the respondents reported cases of Listeriosis with silage eye on their farms. 17 of the farm level predictor variables were associated with disease (silage eye). (i) Herd size: As the herd size in milking cows increased the risk of disease also increased. This was only statistically significant for herd sizes reported in July 1994 (Table 3. 16) Table 3. 16. The univariate relationship between herd sizes and silage eye June 1995 Herd July 1994 Y N OR <50R 11 256 50-100 36 >100 18 P valuex Y N OR 1.00 9 256 1.00 324 2.59 34 323 2.99 198 2.21 17 195 2.48 P valueX sizesn M. cows 0.06 0.04 n number of animals, R reference category, X X2 for trend, Y number of farmers reporting cases, N number of farmer not reporting cases, OR, Odds Ratio. (ii) Feeding practices: a) Type of forages: Feeding maize silage was associated with an increased risk of reporting silage eye cases (OR 2.12, CL 1.21-3.70) (Table 3. 17). 88 b) Source of forages: Home made grass silage was negatively associated with reporting silage eye in dairy cattle (OR 0.22, CL 0.06-0.84) (Table 3. 17). c) Methods of feeding; 1) outdoor feeding: The use of ring feeders to feed maize silage (OR 5.0, CL 1.4717.98), grass silage (OR 1.98, CL 1.0-4.01), hay (OR 4.08, CL 1.21-15.17) and straw (OR 5.23, CL 1.38-23.39) were associated with an increased the risk of reporting silage eye in dairy cattle (Table 3. 17). 2) indoor feeding: The use of ring feeders to feed maize silage (OR 5.06, CL 1.8813.94), grass silage (OR 2.72, CL 1.54-4.83) and hay (OR 4.29, 1.67-11.30) increased the risk of reporting silage eye whereas feeding hay (OR 0.0, CL 0.0-1.17) on the floor was associated with a reduced risk of reporting silage eye but this was not statistically significant (Table 3. 17). (iii) Making forage crops: a) Type of harvesters: The use of a mower conditioner in the process of making grass silage was associated with an increased risk of reporting silage eye (OR 1.74, CL 0.973.16) but this was not statistically significant (Table 3. 17). b) Storage: Preserving grass silage in big bales (OR 4.27, CL 1.99-9.46) and storing hay outside covered (OR 9.55, CL 1.67-50.3.8) were associated with an increased risk of reporting silage eye in dairy cattle (Table 3. 17). Table 3. 17 The relationship between feeding practices and silage eye (iritis) 89 Y N OR 95% CL P Value 26 198 2.12 1.21-3.70 0.006 61 778 0.22 0.06-0.84 0.02 ring feeders for maize silage 12 36 5.00 1.47-17.98 0.005 ring feeders for grass silage 42 365 1.98 1.0-4.01 0.05 ring feeders for hay 15 115 4.08 1.21-15.17 0.01 ring feeder for straw 17 117 5.23 1.38-23.39 0.009 ring feeders for grass silage 42 321 2.72 1.54-4.83 <0.001 ring feeders for maize silage 16 53 5.06 1.88-13.94 <0.001 ring feeders for hay 17 114 4.29 1.67-11.30 <0.001 hay on the floor 0 52 0.0 0.0-1.17 0.07 big bale grass silage 56 468 4.27 1.99-9.46 <0.001 hay outside covered 3 5 9.55 1.67-50.38 0.004 55 450 1.74 0.97-3.16 0.06 Type of forages Maize silage source of forages home made grass silage methods of feeding: - outdoor methods of feeding : - indoor storage type of harvester mower conditioner (g. silage) Y number of farmers reporting cases, N number of farmers not reporting cases, OR (95% CL) Odds Ratio with 95% confidence limit. (iv) Housing: a) Use of bedding: The use of straw as bedding material was associated with an increased risk of reporting silage eye (OR 4.79, CL 1.12-29.11) (Table 5. 18 ). Straw bedding in cubicles similarly increased the risk of reporting silage eye (OR 4.42, CL 90 1.29-18.22) whereas straw bedding in houses other than cubicles and loose yards was associated with a decreased risk of disease (OR 0.0, CL 0.0-1.05) (Table 3 18). (v) General management: a) Cases of Listeriosis in other animals: Reporting cases of Listeriosis in beef cattle (OR 51.4, CL 12.63-243.04) and in sheep (OR 3.94, CL 1.55-9.71) was associated with an increased risk of reporting silage eye cases (Table 3. 18). b) Vaccine use: Vaccinating animals against Leptospirosis was associated with an increased risk of disease (OR 1.77, CL 1.01-3.10) (Table 3. 18). c) Mole hills: The presence of mole hills in fields was associated with an increased risk of reporting silage eye (OR 1.80, CL 1.01-3.23) (Table 3. 18). Table 3. 18 The relationship between housing, general management and silage eye Housing Y N OR 95% CL P Value straw as bedding 62 686 4.79 1.12-29.11 0.03 Straw bedding in cubicles 52 502 4.42 1.29-18.22 0.01 straw bedding in others 0 56 0.0 0.0-1.05 0.05 11 3 51.4 12.63-243.04 <0.001 Listeriosis in other animals Beef cattle 91 Sheep 8 27 3.94 1.55-9.71 0.001 25 216 1.77 1.01-3.10 0.04 35 362 1.80 1.01-3.23 0.05 Vaccine use Leptospirosis Mole hills mole hill Y number of farmers reporting cases, N number of farmers not reporting cases, OR (95% CL) Odds Ratio with 95% confidence limit. 3. 3. 5. The univariate relationship between farming practices and nervous signs of Listeriosis (meningo-encephalitis). Only 26 farms reported having had cases with nervous signs of Listeriosis and 10 of the predictor variables were associated with reporting this form of the disease. (i) Herd size: There was a statistically significant association with herd sizes in all age groups (milking cows, replacement heifers and dairy calves). As the herd sizes increased the risk of reporting Listeriosis with nervous signs increased (Table 3. 19). Table 3. 19. The univariate relationship between herd sizes and nervous form of listeriosis June 1995 Milking cows Replacement heifers July 1994 Herd sizes Y N OR <50R 3 264 50-100 11 >100 P value Y N OR 1.00 3 262 1.00 349 2.77 11 346 1.78 12 204 5.78 11 201 4.78 <50 16 634 1.00 17 627 1.00 50-100 8 92 3.45 6 79 2.80 0.005 X P value 0.009 X 92 Dairy calves >100 2 34 2.33 <50 16 601 1.00 50-100 7 113 2.33 >100 3 37 3.05 0.01 X 2 22 3.35 0.01 X NA 0.02 X R reference category, X X2 for trend, Y number of farmers reporting cases, N number of farm not reporting cases, OR, Odds Ratio, NA not applicable. (ii) Feeding practices: a) Type of forages: Feeding maize silage was associated with an increased risk of reporting cases of nervous signs (OR 3.11, CL 1.32-7.32) (Table 3. 20). b) Source of forages: Purchased grass silage was associated with an increased risk of reporting nervous signs (OR 6.12, CL 1.86-18.88) (Table 3. 20). Methods of feeding (indoor): Feeding straw (OR 0.31, CL 0.09-1.05) was negatively associated with risk of reporting cases with nervous signs and this approached statistical significance (Table 3. 20). Table 3. 20. The relationship between feeding, housing and general management practices and risk of reporting the nervous form of Listeriosis Y N OR 95% CL P Value Type of forages Maize silage 13 211 3.11 1.32-7.32 0.005 5 31 6.12 1.86-18.88 <0.001 8 331 0.31 0.09-1.05 0.06 source of forages purchased grass silage methods of feeding : - indoor straw storage 93 straw outside covered 3 24 4.36 0.89-18.79 0.07 manure beneath the slats 2 3 24.18 2.47-211.43 <0.001 manure in slurry tank 2 8 8.95 1.15-55.61 0.03 Beef cattle 3 11 9.17 1.86-39.51 0.001 Sheep 4 31 4.95 1.33-16.78 0.01 dung disposal Listeriosis in other animals Y number of farmers reporting cases, N number of farmers not reporting cases, OR (95% CL) Odds Ratio with 95% confidence limit. (iii) Making forage crops: a) Storage: Storing straw outside covered (OR 4.36, CL 0.89-18.79) was associated with an increased risk of reporting cases of Listeriosis with nervous signs and this approached statistical significance (Table 3. 20). c) Analysis of forages: There was an association between the pH of clamp 1 grass silage and increasing risk of reporting nervous form of Listeriosis and this approached statistical significance (Table 3. 21). Table 3. 21 .The effect of silage quality on the reporting of the nervous form of listeriosis pH of Clamp 1 R Y N OR 1R (<3.8) 1 45 1.00 2 (3.8-4.2) 1 115 0.39 3 (>4.2) 4 40 4.29 X P ValueX 0.06 2 reference category, X for trend, OR odds ratio (iv) Housing: 94 a) Dung disposal: Storage of manure beneath slats (OR 24.18, CL 2.47-211.43) and in slurry tanks (OR 8.95, CL 1.15-55.61) were associated with an increased risk of cases of Listeriosis with nervous signs (Table 3. 20). (v) General management: a) Cases of Listeriosis in other animals: The presence of Listeriosis in beef cattle (OR 9.17, CL 1.86-39.51) and in sheep (OR 4.95, CL 1.33-16.78) was associated with an increased risk of reporting cases with nervous signs (Table 3. 20). 3. 3. 6. A summary of risk factors associated with the different forms of disease A summary of the predictor variables associated with different outcome variables is given in Table 3. 22 and 3. 23. Overall 36 predictor variables were associated with the outcome variables. Table 3. 22. shows that 29 variables were associated with an increased risk of disease. 4 predictor variables were consistently associated with all outcome variables, 5 with 4 of them, 6 with 3 of them, 3 with 2 and the rest with 1 of the outcome variables. 95 In Table 3. 23, 7 predictor variables were associated with a decreased risk of disease. None of the predictor variables was consistently associated with all of the outcome variables. Only 1 variable was associated with the 4 of the outcome variables, 3 with 2 of them and the rest with 1 of the outcome variables. Table 3. 22. The predictor variables associated with an increased risk of disease Outcome variables Predictor Variables O MC WC SE NS herd size + + + + + Listeriosis in beef cattle + + + + + feeding maize silage + + + + + ring feeder for maize silage (indoor) + + + + + big bale + + + + - purchased grass silage + + + - + ring feeders for grass silage (indoor) + + + + - ring feeders for hay (indoor) + + + + 96 vaccination against Leptospirosis + + + + - ring feeders for maize silage (outdoor) + + NA + - ring feeders for straw (outdoor) + + NA + - storing hay out covered + - + + - Listeriosis in sheep + - - + + straw bedding in cubicles + - + + - storing manure beneath the slats + - + - + mower conditioner (grass silage) + - + - - ring feeders for hay (outdoor) + - NA + - pH (Clamp1) + - + - - feeding grass silage + - - - - ring feeders for grass silage (outdoor) - - NA + - storing big bale out uncovered - + - - - duration of feeding grass silage + - - - - number of cuts for grass silage - + - - - maize silage ad libitum (indoor) - - + - - storing straw out covered - + - - - straw as bedding - - - + - disposing dung as slurry + - - - - storing manure in slurry tanks - - - - + presence of mole hills in the fields - - - + - O overall cases, MC milking cows, WC cases reported in winter months, SE silage eye, NS nervous signs. + associated with outcome, - not associated with outcome, NA not applicable. Table 3. 23. The predictor variables associated with a decrease risk of disease Outcome variables Predictor Variables O MC WC SE NS straw bedding in other housing + + + + - grass silage on the floor (indoor) + + - - - hay on the floor (indoor) + - + - - other types of housing + - + - - feeding straw (indoor) + - - - - home made grass silage - - - + - controlling moles - - + - - O overall cases, MC milking cows, WC cases reported in winter months, SE silage eye, NS nervous signs. + associated with outcome, - not associated with outcome. 97 3. 4. Discussion: In this study we tried to determine the farm level risk factors associated with different outcome variables. Different variables were associated with different outcomes. This difference may be due to the small number of farms with some of the outcome or predictor variables: for example nervous signs of disease were only reported by 26 farms. Alternatively it may reflect true differences in the models. However we think this may not be the case because 26 of 36 variables examined were associated with Listeriosis when the total number of cases “overall” was the outcome. The other associated variables were closely related to these 26 variables. Of the 36 variables 16 were consistently associated with at least 3 of the outcome variables. This consistency of associations is in agreement with the Evan’s postulates of disease causation (Thrusfield 1995). Feeding grass silage and maize silage was associated with clinical Listeriosis. The relationship between feeding silage and Listeriosis is well documented (Gray 1960a, Gray and Killinger 1966, Gronstol 1979a, Kalac and Woolford 1982, Fenlon 1986b, Fenlon 1988, Wilesmith and Gitter 1986, Sargison 1993) and disease is therefore called “silage sickness” (Gray and Killinger 1966, Dennis 1993). However the determinants of this association are not well known. The possible ways in which silage may play a role have already been explained in the Chapter 1. Where silage has been implicated its quality has always been described as “inferior” (Gray 1960a, Fenlon 1988, Sargison 1993). There are several factors that influence the quality of silage. These factors include the whole silage making process; time and stage of harvesting, type of harvester used, soil contamination, wilting, method of storing etc. A lack of care at any of these stages will result in poor quality silage that is manifested by improper fermentation (aerobic fermentation) where the critical pH (4.2) is exceeded and the 98 suppression of the growth of Listeria organisms is lifted, resulting in rapid multiplication of L. monocytogenes to the level of the infectious dose (Gronstol 1979a, Anon 1983, Fenlon 1988, Husu and others 1990a, Sargison 1993). It has been demonstrated that the multiplication of L. monocytogenes is related to pH. As pH rises the number and frequency of isolation of L. monocytogenes also increases (Irvin 1968, Gronstol 1979b, Fenlon 1988). As important as silage quality is the method or methods of feeding silage. Some clinical forms of Listeriosis (encephalitis, iritis) have been attributed to physical injuries of mucosal membranes such as buccal or conjunctival membranes caused by rough forages (Asahi 1957, Dennis 1993). These facts prompted us to further evaluate the role of silage by gathering information on preparation, the method and time of feeding and quality. This was done for both grass silage and maize silage. The stage of growth or time of cutting grass for silage is known to be important. (Anon 1983, Wilesmith and Gitter 1986, Gitter 1989). To ensure perfect fermentation grass must be harvested at the right stage when it contains a sufficient level of carbohydrates and has a Digestibility (D) value around 70%. This covers the period between May, June and July (Anon 1983). In our study there was no association between the month of making silage and disease. This may be explained by the fact that most of the farms (90%) made silage within the recommended period (May and June for grass silage or October for maize silage). However the number of times the grass was cut to make grass silage was associated with an increased risk of Listeriosis in milking cows. It is known that first cut grass silage achieves better fermentation (Fenlon 1988) but second or later cuts grass may lack the necessary components (high sugar, correct dry matter level, 25-30%) to achieve optimal fermentation (Anon 1983, Fenlon 1988). Another important factor at cutting which helps determine silage quality is soil contamination. Soil causes butyric acid fermentation which results in higher pH values 99 (Anon 1983, Fenlon 1988). Soil contamination occurs through harvesters or from mole hills in the field. It is known that some harvesters are more prone to soil contamination than others (Anon 1983, Gitter 1986, Fenlon 1988). The risk of soil contamination is reported as high with a flail mower, moderate with mower conditioner and low with discs and drums (Anon 1983). In this study the use of a mower conditioner was associated with an increased risk of reporting disease. Another explanation for this association may be that mower conditioner bruises grass during cutting, resulting in loss of carbohydrates in grass and poorer fermentation condition. The presence of mole hills in the field where grass silage is made also increases the risk of soil contamination and in this study it was associated with an increased risk but only in relation to silage eye. This was also supported by the negative association between controlling moles and the risk of Listeriosis reported in winter months, but these two variables were not associated with other outcome variables. Considerable publicity has been given to the potential importance of soil contamination as result of mole hills and it is possible that some reporting bias was introduced into the study by farmers who were aware of this hypothesis. Ash content is used as a proxy measure of soil contamination. However in this study there was no association between ash content and disease. A statistically significant association between increasing pH of clamp 1 silage and increasing risk of reporting overall cases and cases in winter months was found in this study but this association was not found with other outcome variables. The value of forage analyses was questionable because only a small proportion of farms reported complete information and this made the comparisons difficult. Storing grass silage as big bales increased the risk of disease. Big bale silage has been reported to be more prone to L. monocytogenes contamination (Fenlon 1988, Sargison 1993), because of its very nature it is difficult to maintain conditions for ideal fermentation (Fenlon 1985, Fenlon 1986a, Fenlon 1988, Fenlon and others 1989, Gitter 100 1989, Sargison 1993). It is also possible that the bags are subjected to physical damage by birds, mice or other rodents when stored outside and that this results in rapid deterioration (Fenlon 1985, Sargison 1993). Storing big bales outside uncovered was associated with an increased risk of reporting Listeriosis in milking cows. Similarly the association between storing hay outside covered and an increased risk of disease in milking cows may be due to the fact that outside storage exposed hay to factors (wet, cold, air and physical damage) that may have led to the propagation of L. monocytogenes to the level of an infectious dose. But only small number of farms reported storing their hay outside covered. In this study feeding maize and grass silage, hay and straw in ring feeders or ad libitum (indoor or outdoor), increased the risk of disease whereas feeding on the floor decreased the risk. This may be an effect of the clinical forms of the disease reported in this study. The predominant clinical sign was silage eye (iritis). Although the exact relationship between L. monocytogenes and silage eye awaits further studies, the association between silage feeding and silage eye cases has been acknowledged (Morgan1977, Watson 1989, Mee and Rea 1989, Sargison 1993, Bee 1993, Welchman and others 1997). It may well be that animals eating silage in ring feeders were at greater risk of physically damaging their conjunctival membranes which may have led to infection by L. monocytogenes (Sargison 1993, Welchman and others 1997). It is also possible that encephalitis may follow eye infection (Asahi 1957, Dennis 1993). Another explanation may be that in ring feeding systems animals are in very close contact with a possibility of animal to animal spread. Alternatively unlike other methods, ring feeders are not cleaned regularly and silage remaining in the feeder may have created an ideal environment for L. monocytogenes to multiply. This suggestion is supported with the finding that feeding forages (hay and grass silage) on the floor was 101 associated with a decreased risk of disease as the floors (feeding passage) are cleaned after feeding. The association of grass silage with disease may also be explained by the length of exposure to L. monocytogenes as an increased duration of grass silage feeding was associated with an increased risk of disease. Another finding was that purchased grass silage increased the risk of disease whilst home made grass silage decreased the risk of reporting silage eye. This may be explained by the fact that purchased silage would be mainly in the form of big bale silage or if bought in as clamp silage might be of poor quality because it had been exposed to air. Air in silage has been associated with an increase in Listeria growth (Fenlon 1986, Woolford 1990, Fenlon and others 1995b). Alternatively farmers may sell inferior quality or old silage which is surplus of their own needs. Feeding straw during housing had a protective effect. Straw feeding may have played a role by reducing silage intake therefore decreasing the exposure to L. monocytogenes or the provision feed straw may have reduced the intake of dirty bedding straw. Wilesmith and Gitter (1986) suggested that housing animals did not have any association with the occurrence of ovine Listeriosis. This was also the case in our study although only a small number of farmers did not house their animals. When different types of housing were evaluated it was found that housing cattle in buildings (mainly cow sheds) other than cubicles and loose yards had a protective effect. It is difficult to provide a biological explanation for this association, it may be due to a confounding effect. The use of straw as bedding material and straw bedding in cubicles was associated with an increased risk of disease. The use of straw as bedding and straw bedding in cubicles may result in a build up of L. monocytogenes in the environment. 102 L. monocytogenes has been isolated from straw bedding (Husu 1990, van Retrigham and others 1991) and cases of listeriosis associated with the same serotype as those found in the bedding material have been reported (Green and Morgan 1994). Housed animals often eat their bedding and they may have eaten Listeria contaminated dirty bedding. One likely explanation may be that animals housed in cubicles were more likely to have eaten their bedding than those housed in loose yards where bedding straw would be too dirty for a cow to eat. Environmental contamination with L. monocytogenes may also occur through the use of manure or slurry as a fertiliser and this was examined in this study. The disposal of dung as a slurry was associated with disease. This may have been due to failure of storage to kill or inactivate listeria (Al-Gazali and Al-Azawi 1986). No such association was seen in farms disposing of dung as manure. There was an association between storing dung beneath the slats, storing manure in slurry tanks and disease but only a small number of farmers used these systems. Larger herd sizes were also associated with an increased risk of Listeriosis. This may be explained in several ways. Stocking density may have increased the risk of sick animals coming into contact with others and hygienic conditions may have been poor owing to overcrowding. Overcrowding and related factors have been reported as predisposing factors (Hyslop 1975, Meredith and Schnieder 1984, Vandegraaff 1981). An alternative explanation may be that these herds may have been higher producing units and therefore animals may have been highly stressed resulting in a decrease of the host resistance to infection. It is also possible that these farms had a better observation system whereby quicker veterinary intervention may have occurred when animals showed signs of disease. Human Listeriosis due to contact with animals with Listeriosis has been reported (Gray and Killinger 1966, McLauchlin and Low 1994) but it is not known if direct 103 transmission between animals occurrs. In our study listeriosis in beef cattle and sheep increased the risk of disease. This may be explained in a number of ways. Dairy cattle might have contracted the disease from sick beef cattle or sheep by direct contact or beef cattle or sheep with Listeriosis may have been the source of more pathogenic L. monocytogenes strains and environmental contamination with these virulent strains resulted in indirect transmission. Alternatively, farmers who reported cases in beef cattle and sheep may have had a better knowledge of disease and therefore easily recognised the signs of disease in their dairy cattle. This association may also be due to a confounding effect e.g. ring feeders are usually used for beef cattle. The association between vaccinating animals against Leptospirosis and an increased risk of Listeriosis is without an obvious biological explanation. It might be explained by the fact that concurrent infections have been reported to make animals and human more susceptible to L. monocytogenes (Gray and Killinger, 1966, Rocourt 1996) or the stress caused by the vaccine may have made animals more susceptible. An alternative explanation may be that farmers experiencing abortion may have vaccinated against Leptospirosis with or without advice from a veterinarian because the majority of cases of abortion are attributed to Leptospirosis in this country without thorough investigation of actual cause. There may have been even a confusion of name between the two diseases. Such confusion of name was seen in a study from the USA (Schwartz 1967). In this study 5 groups of farm level predictor variables were used to determine their relationship with 5 different outcome variables using univariate analysis techniques. One of the major drawbacks of univariate analysis is that it does not deal with confounders. A confounder is a variable that is positively or negatively associated with both the outcome variable and hypothesised predictor variable that are being studied. Confounding may result in either overestimation or underestimation of an 104 association (Kirkwood 1988, Thrusfield 1995). This problem is overcome by several ways i.e. stratifying data to adjust for possible confounders or employing more complex multivariate techniques. This is dealt with in the following chapter. However there also are advantages of this technique. In univariate analysis it is possible to examine the association between all predictor variables and an outcome. All observations obtained can be used in the univariate analysis whereas in the multivariate analysis missing values can result in a considerable reduction in the number of observations. In the analysis of this data, possible confounders were not taken into account but a number of predictor variables were found to be associated with the outcome variables. However demonstration of a statistically significant association between a predictor variable and an outcome variable does not necessarily mean that a relationship is causal. In a biological sense for a predictor variable to be causal it must be experimentally proved that it leads to the occurrence of disease. However in the absence of experimental evidence epidemiological identification of an association is of considerable value because it indicates a risk factor and removal of such a factor may result in the reduction of disease (Thrusfield 1995). In the following chapter the association between the predictor variables and the different outcome variables is investigated using multivariate techniques. 105 CHAPTER 4 The multivariate relationship between farm management practices and clinical listeriosis in dairy cattle in England 4. 1 Introduction In the previous chapter we identified some simple relationships between farming practices and Listeriosis using univariate techniques. One of the problems with univariate methods is that they do not have the power to adjust for the effect of confounding. In this part of the study multivariate techniques are used to provide quantitative estimates of the relationship between individual predictor variables and the outcome variable when adjusted for the effect of other predictor variables. 4. 2. Materials and methods: In studying the multiple relationship between farming practices and clinical listeriosis in dairy cattle, the predictor variables used were those that were either significantly associated with disease or had P values of less than 0.25 in univariate analysis or those that were considered biologically important. Unconditional logistic regression using EGRET (Statistics and Epidemiology Research Corporation, 1993) was used to develop statistical models using a forward stepwise technique followed backwards elimination. The predictor variables that met our inclusion criteria are listed below. Forage feeding Grass silage indoor feeding storage Grass silage fed fed big bale Maize silage source ad libitum storage of big bale Hay purchased on the floor outside uncovered Straw home made in ring feeders clamp use Root crops outdoor feeding number of cuts separate clamp fed type of harvester sealing clamp Herd size ad libitum mower conditioner forage analysis cows in 1995 in ring feeders wilting pH of Clamp 1 Maize silage outdoor feeding ad libitum type of harvester fed fed on the floor forage harvester source in complete diet in complete diet additive use home made in ring feeders in ring feeders used indoor feeding in troughs storage heifers in 1995 clamp fed Housing use of bedding type of bedding dung disposal housed adding bedding sawdust solid manure cubicles removing bedding straw slurry used cleaning out use of bedding storage type of bedding loose yard adding bedding not stored sawdust used removing bedding straw cleaning out other houses General pasture management grazing beef cattle management spread dung on the grazing sheep field Listeriosis in others Vaccine mole hills beef cattle Leptospirosis in grass silage field sheep Lung worm controlling moles 4. 2. 1. Model Building: It was not possible to fit all the selected variables in a single model. This caused us to develop first a preliminary model that included all the major variables like herd size, types of forages fed to animals, housing, dung disposal variables and general management as binary variables. The effects of more qualitative aspects of each variable e.g. method of feeding forage, silage analysis that were statistically significant in the preliminary model were then investigated in detail by including more explanatory variables in other models. Finally variables which reduced the statistical power of the model because of large numbers of missing values, e.g. herd size (84 observations), or the variables which had strong effect on the model, e.g. cases in beef cattle (reported by 14 farms), were excluded from the data set. 4. 3. Results: (i) Preliminary Model: Using the overall cases reported in dairy cattle as an outcome variable a model was developed to include the variables listed below, namely feeding forages, housing, dung disposal, general management. Grass silage feeding was not included at this stage because those who did not feed grass silage did not report any cases of Listeriosis. The list of variables used in the preliminary model is as follows: Forage feeding Housing General Listeriosis in others Maize silage housed management beef cattle Hay dung disposal pasture sheep Straw solid manure management Vaccine Root crops slurry spread dung on the Leptospirosis field Lung worm Herd size grazing beef cattle mole hills cows (1995) grazing sheep in grass silage field heifers (1995) controlling moles Variables associated with disease. Cases of Listeriosis in beef cattle: Listeriosis in beef cattle was associated with an increased risk of reporting clinical Listeriosis in dairy cattle (OR 26.06, CL 6.8499.31)(Table 4. 1). Cases of Listeriosis in sheep: The presence of Listeriosis in sheep was associated with an increased risk of disease (OR 3.86, CL 1.57-9.44) (Table 4. 1). Maize silage feeding: Feeding maize silage (OR 2.7, CL 1.25-3.43) was associated with an increased risk of reporting clinical Listeriosis in dairy cattle (Table 4. 1). Vaccination against Leptospirosis: Vaccinating animals against Leptospirosis was associated with an increased risk of reporting clinical Listeriosis in dairy cattle (OR 1.7, CL 1.0-2.9) (Table 4. 1). Grazing sheep on the same pasture: Grazing sheep on the same pasture as dairy cattle was associated with a decreased risk of disease in dairy cattle (OR 0.58, CL 0.36-0.95) (Table 4. 1). Table 4. 1. The multivariate relationship between major farming practices and clinical Listeriosis in dairy cattle (preliminary model) N= 690 OR* 95% CL p Value Listeriosis in beef cattle 26.06 6.84-99.31 <0.001 Listeriosis in sheep 3.86 1.57-9.44 0.003 Maize silage feeding 2.07 1.25-3.43 0.005 Vaccination against Leptospirosis 1.7 1.0-2.9 0.04 Grazing sheep on the same pasture 0.58 0.36-0.95 0.03 N number of observations, OR adjusted odds ratio, 95% CL, 95% confidence limit. (ii) Model 1: In this model we tried to examine in more detail the effect of preparation, storage and feeding of grass silage and housing on the risk of reporting clinical listeriosis in dairy cattle. Only those farms feeding grass silage were included in this data set. 854 farms reported feeding grass silage to their animals. The variables offered to the model are listed below. Forage feeding Grass silage outdoor feeding Maize silage Herd size fed fed Hay cows in 1995 source ad libitum Straw heifers in 1995 purchased in ring feeders Root crops home made indoor feeding number of cuts fed type of harvester storage separate clamp ad libitum mower conditioner big bale sealing clamp on the floor wilting storage of big bale forage analysis outside uncovered pH of Clamp 1 in ring feeders clamp use Housing use of bedding sawdust dung disposal housed adding bedding straw solid manure cubicles removing bedding use of bedding slurry used cleaning out adding bedding storage type of bedding loose yard removing bedding not stored sawdust used cleaning out straw type of bedding other houses General pasture management Listeriosis in others Lung worm management spread dung on the beef cattle mole hills field sheep in grass silage field grazing beef cattle Vaccine controlling moles grazing sheep Leptospirosis 1) Overall cases: After adjusting for possible confounders, 9 variables were found to be associated with either increasing or decreasing risk of reporting listeriosis in dairy cattle. Cases of Listeriosis in beef cattle: The presence of Listeriosis in beef cattle was associated with an increased risk of the disease, OR 23.5 (CL 5.5-100) (Table 4. 2). Cases of Listeriosis in sheep: Listeriosis in sheep was associated with an increased risk of disease (OR 2.9, CL 1.0-8.2) (Table 4. 2). Maize silage feeding: When adjusted for possible cofounders feeding maize silage was still significantly associated with an increased risk of reporting Listeriosis in dairy cattle (OR 2.1, CI 1.2-3.6) (Table 4. 2). Use of a mower conditioner: An increased risk of disease was recorded for the farms who reported having used mower conditioner in the process of grass silage making, OR 3.8 (CL 1.9-7.6) (Table 4. 2). Ring feeders: Feeding grass silage in ring feeders when animals were housed increased the risk of reporting Listeriosis, OR 2.4 (CL 1.4-4.2) (Table 4. 2). Big Bale silage: Preserving grass silage as big bale silage increased the risk of reporting disease, OR 1.9 ( CL 1.0-3.5) (Table 4. 2) Wilting: There was linear relationship between wilting grass for silage and clinical Listeriosis. As the duration of wilting increased the risk of disease decreased (Table 4. 2). Table 4. 2. The multivariate relationship between farming practices and listeriosis in dairy cattle (overall cases) Number of observations=603 OR* 95% CL p Value cases of Listeriosis in beef cattle 23.5 5.5-100 <0.001 cases of Listeriosis in sheep 2.9 1.0-8.2 0.04 maize silage feeding 2.1 1.2-3.6 0.01 use of a mower conditioner 3.8 1.9-7.6 <0.001 ring feeders for grass silage 2.4 1.4-4.2 0.002 1.9 1.0-3.5 0.04 1 0.12 0.02-0.5 0.02 2 0.08 0.01-0.5 0.006 >3 0.06 0.008-0.5 0.008 not storing manure 2.1 1.1-3.9 0.02 vaccinating against Leptospirosis 1.7 1.0-2.9 0.04 (indoor) big bale silage Wilting (days)R Number of observations (715)@ OR adjusted odds ratio, 95% CL, 95% confidence limit, R baseline category was day 0, @ identified when rerun excluding herd size and cases of listeriosis in beef cattle. The model was re-run in an attempt to increase the number of observation in the model. The herd size was first removed which increased the number of observation to 687. This did not result in any changes. Herd size and cases of listeriosis in beef cattle were then excluded from the model which increased the number of observations to 715. The same variables as above were still significant with slight changes in odds ratios, in addition, vaccinating cattle against Leptospirosis was associated with an increased risk of disease (OR 1.7, CL 1.0-2.9) and not storing manure was also associated with an increased risk of disease (OR 2.1, 95% CL 1.1-3.9). 2) Milking cows: Model 1 was used to determine the farm level predictor variables associated with clinical Listeriosis in milking cows. The presence of Listeriosis in beef cattle and sheep, feeding maize silage to milking cows, the use of a mower conditioner in the preparation of grass silage, feeding grass silage in ring feeders when animals were housed, and the use of vaccine against Leptospirosis were still associated with an increased risk of Listeriosis in milking cows and in addition storage of big bale silage uncovered outside was associated with an increased risk of disease (OR 2.0, CL 1.1-3.7) (Table 4. 3). When the same model was rerun excluding first herd size and then herd size and cases of listeriosis in beef cattle respectively, the same predictor variables were associated with an increased risk of reporting Listeriosis in milking cow (Table 4. 3). Table 4. 3. The multivariate relationship between farming practices and listeriosis in milking cows. Number of observations=603 OR 95% CL p Value cases of Listeriosis in beef cattle 9.8 2.8-33.7 <0.001 cases of Listeriosis in sheep cases 3.2 1.1-9.0 0.4 maize silage feeding 2.1 1.1-3.9 0.02 use of a mower conditioner 2.1 1.0-4.3 0.04 ring feeders for grass silage (indoor) 2.7 1.5-5.2 0.002 storing big bale silage out uncovered 2.0 1.1-3.4 0.03 vaccinating against Leptospirosis 1.9 1.0-3.4 0.049 OR adjusted odds ratio, 95% CL, 95% confidence limit, R baseline category was day 0 3) Winter cases: Model 1 was run in the same way with the outcome variable being cases of Listeriosis reported in dairy cattle between October 1994 and June 1995. Cases of Listeriosis in beef cattle and sheep, the use of a mower conditioner in the preparation of grass silage, feeding grass silage in ring feeders during the indoor period and preparing grass silage in big bales were still associated with an increased risk of reporting disease in winter months and feeding maize silage was no longer associated with disease. In addition to these variables, use of straw bedding in the cubicles was associated with an increased risk of the disease (OR 2.1, CL 1.0-4.5) while wilting grass before ensiling and controlling moles in fields were associated with a decreased risk of disease in winter months (OR 0.54, CL 0.3-0.9) (Table 4. 4). Exclusion of herd size and then herd size and cases of Listeriosis in beef cattle did not change the results (Table 4. 4). Table 4. 4. The multivariate relationship between farming practices and cases of listeriosis occurring in winter months. Number of observations=603 OR 95% CL p Value cases of Listeriosis in beef cattle 29 7.6-111 <0.001 cases of Listeriosis in sheep 3.1 1.1-8.8 0.03 use of a mower conditioner 3.6 1.7-7.5 <0.001 ring feeders for grass silage 3.9 2.1-7.2 <0.001 big bale silage 2.0 1.0-3.9 0.04 use of straw bed in cubicles 2.1 1.0-4.5 0.47 controlling moles 0.54 0.3-0.9 0.04 1 0.12 0.02-0.7 0.02 2 0.07 0.01-0.5 0.006 >3 0.06 0.008-0.5 0.009 (indoor) wilting (day)R OR adjusted odds ratio, 95% CL, 95% confidence limit, R baseline category was day 0 4) Silage eye: Cases of Listeriosis in beef cattle and sheep, feeding grass silage in ring feeders indoor, using mower conditioner, conserving silage as big bale were significantly associated with an increased risk of reporting cases of silage eye and additionally feeding grass silage ad libitum during the outdoor period was also associated with an increased risk of risk of disease (OR 2.7, CL 1.0-7.2) (Table 4. 5). The same model was run after the removal of herd size. The same predictor variables as above were still significantly associated with the exception of feeding grass silage ad libitum during the outdoor period which was no longer significant, additionally the use of straw bedding in cubicles was associated with an increased risk of reporting silage eye (OR 2.3 95% CL 1.0-5.2). After the exclusion of herd size and cases of Listeriosis in beef cattle, preserving grass silage in clamps (OR 2.4, 95% CL 1.0-5.5) and not storing manure (OR 2.1, 95% CL 1.1-4.1) were also associated with an increased risk of disease but the use of straw bedding in cubicles was no longer significant (Table 4. 5). Table 4. 5. The multivariate relationship between farming practices and cases of Listeriosis with silage eye Number of observations=603 OR 95% CL p Value cases of Listeriosis in beef cattle 34.5 8.2-146 <0.001 cases of Listeriosis in sheep 3.9 1.3-11.3 0.01 use of a mower conditioner 4.2 1.9-9.3 <0.001 big bale silage 2.9 1.3-6.9 0.01 ring feeders for grass silage 2.6 1.3-5.2 0.006 2.7 1.0-7.2 0.048 2.1 1.0-4.3 0.04 clamp grass silage 2.4 1.0-5.5 0.04 not storing manure 2.1 1.1-4.1 0.03 (indoor) grass silage ad libitum (outdoor) Number of observations=687@ straw bedding in cubicles Number of observations=715# OR adjusted odds ratio, 95% CL, 95% confidence limit, of herd size and cases of listeriosis in beef cattle. 5) Nervous signs: @ after exclusion of herd size, # after exclusion Cases of Listeriosis in beef cattle and sheep were associated with an increased risk of reporting cases of Listeriosis with nervous signs. Controlling moles in fields was associated with a decreased risk of disease (OR 0.4, 95% CL 0.1-0.9) (Table 4. 6). No changes in the results were observed after the removal of herd size from the model but maize silage feeding was associated with an increased risk of reporting cases of nervous signs (OR 2.9, 95% CL 1.3-6.6) (Table 4. 6) after the removal of herd size and cases of Listeriosis in beef cattle from the data set. Table 4. 6. The multivariate relationship between farming practices and cases of nervous signs. Number of observations=603 OR 95% CL p Value cases of Listeriosis in beef cattle 5.2 1.1-25.5 0.04 cases of Listeriosis in Sheep 4.9 1.3-18.9 0.02 controlling moles 0.4 0.1-0.9 0.04 2.9 1.3-6.6 0.01 Number of observations=715@ maize silage feeding OR adjusted odds ratio, @ after the exclusion of herd size and cases of Listeriosis in beef cattle. The results obtained using the model for each different outcome variables were remarkably consistent. 14 variables were associated with the outcome variables. 12 of them were associated with an increased risk of disease. Cases of Listeriosis in beef cattle and sheep were found to be consistently associated with all outcome variables, the use of a mower conditioner in preparation of grass silage, feeding grass silage in ring feeders were also consistently associated with the outcome variables with the exception of nervous signs. Three predictor variables were associated with three different outcome variables; preserving grass silage as big bales (associated with overall cases, winter cases and silage eye), maize silage feeding (associated with overall cases, milking cows and nervous signs) and not storing manure (associated with overall, milking cows and silage eye), two predictor variables were associated with two outcome variables; vaccinating against Leptospirosis (associated with overall cases and milking cows) and the use straw bedding in cubicles (associated with winter cases and silage eye). The rest of the variables were associated with one outcome variable (Table 4. 7). 2 variables were associated with a decreased risk of disease; wilting grass prior to ensiling (associated with overall cases and winter cases) and controlling moles in fields (associated with winter cases and nervous signs). 10 of the 14 predictor variables were also found significant in the univariate analysis. Table 4. 7. The agreement between the different outcomes Predictor variables that Overall MC WC SE NS cases of Listeriosis in beef cattle* + + + + + cases of Listeriosis in sheep* + + + + + use of a mower conditioner* + + + + - ring feeders for grass silage (indoor)* + + + + - big bale silage* + - + + - maize silage feeding* + + - - + not storing manure + + - + - vaccinating against Leptospirosis* + + - - - straw bedding in cubicle* - - + + - big bale silage out uncovered* - + - - - grass silage ad libitum (outdoor) - - - + - clamp grass silage - - - + - wilting + - + - - controlling moles* - - + - + increased the risk of disease decreased the risk of disease MC milking cows, WC winter cases, SE silage eye, NS nervous signs, + association with outcome variables, - no association with outcome variables, * also statistically significant in univariate analysis (iii) Model 2: This model was similar to the Model 1 but included only those farmers who fed maize silage (224 farms reported feeding maize silage). Maize silage related variables (making, storing, feeding etc.), all housing, dung disposal and general management variables were also included in the model. The variables used in this model are listed below. Forage feeding Maize silage indoor feeding type of harvester Grass silage fed fed forage harvester Maize silage source ad libitum additive use Hay home made on the floor used Straw outdoor feeding in complete diet storage Root crops fed in ring feeders clamp in complete diet in troughs in ring feeders Housing use of bedding straw dung disposal housed adding bedding use of bedding solid manure cubicles removing bedding adding bedding storage used cleaning out removing bedding not stored type of bedding loose yard cleaning out slurry sawdust used other houses disposed straw type of bedding sawdust General pasture management Listeriosis in others Lung worm management spread dung on the beef cattle Herd size field sheep cows in 1995 grazing beef cattle Vaccine heifers in 1995 grazing sheep Leptospirosis 1) Overall cases: Cases of Listeriosis in beef cattle: Listeriosis in beef cattle was found to increase the risk of disease (OR 13.7, CL 1.31-144.0) (Table 4. 8). Maize silage feeding: During indoor period feeding maize silage in ring feeders (OR 5.09, CL 2.19-11.87) and ad libitum feeding maize silage (OR 3.69, CL 1.04-13.17) were associated with an increased risk Listeriosis in dairy cattle (Table 4. 8). Exclusion of herd size and herd size and cases of listeriosis beef cattle did not alter the results but slight changes in odds ratio were observed. Table 4. 8. The multivariate relationship between farming practices and Listeriosis Number of observations=176 OR 95% CL p value cases of Listeriosis in beef cattle 13.71 1.31-144 0.03 ring feeder for maize silage 5.09 2.19-11.87 <0.001 3.7 1.04-13.17 0.44 (indoor) maize silage ad libitum (indoor) OR adjusted odds ratio, 95% CL, 95% confidence limit. 2) Milking cows: Maize silage feeding: Feeding maize silage ad libitum (OR 4.14, CL 1.04-16.4) and in ring feeders (OR 6.5, CL 2.48-17.15) when animals were housed were associated with an increased risk of reporting clinical Listeriosis in milking cows (Table 4. 9). Use of straw bedding: Use of straw bedding in cubicles was negatively associated with risk of disease in milking cows (OR 0.3, CL 0.11-0.8) (Table 4. 9). Table 4. 9. The multivariate relationship between farming practices and Listeriosis in milking cows Number of observations=176 OR 95% CL p value ring feeder for maize silage (indoor) 6.5 2.48-17.15 <0.001 maize silage ad libitum (indoor) 4.14 1.04-16.4 0.043 maize silage in complete diet (indoor) @ 3.6 1.01-12.92 0.048 straw bedding in cubicles 0.3 0.11-0.8 0.018 OR adjusted odds ratio, 95% CL, 95% confidence limit, @ identified after removal of herd size and cases of Listeriosis in beef cattle. After exclusion of herd size the same results were obtained (Table 4. 9) with odds ratios being slightly different. After the removal of herd size and beef cattle from the model, feeding maize silage in a complete diet was also associated with an increased risk of disease (OR 3.6, CL 1.01-12.92) (Table 4. 9). 3) Winter cases: Maize silage feeding: Feeding maize silage ad libitum (OR5.77, CL 1.43-23.24) and in ring feeders (OR 9.6, CL 3.55-26.3) when animals were housed were associated with an increased risk of Listeriosis reported in the winter months (Table 4. 10). The exclusion of herd size and herd size and beef cattle from the model did not result in any changes. Table 4. 10. The multivariate relationship between farming practices and Listeriosis reported in winter months Number of observations=176 ring feeder for maize silage OR 95% CL p value 9.6 3.55-26.3 <0.001 5.77 1.43-23.24 <0.001 (indoor) maize silage ad libitum (indoor) OR adjusted odds ratio, 95% CL, 95% confidence limit. 4) Silage eye cases: Cases of Listeriosis in beef cattle: The presence of Listeriosis in beef cattle was associated with an increased risk of reporting cases of silage eye (OR 35.5, CL 3.08409) (Table 4. 11). Maize silage feeding: Feeding maize silage in ring feeders when animals were housed (OR 4.37, CL 1.54-12.4) was associated with an increased risk of reporting silage eye cases (Table 4. 11) Use of straw bedding: Big bale straw bedding was negatively associated with reporting silage eye cases (OR 0.18, CL 0.04-0.87) (Table 4. 11) When herd size and herd size and cases of Listeriosis in beef cattle were excluded from the model the same variables were still associated with disease (Table 4. 11). Table 4. 11. The multivariate relationship between farming practices and cases of Listeriosis with silage eye Number of observations=176 OR 95% CL p value cases of Listeriosis in beef cattle 35.5 3.08-409 0.004 ring feeder for maize silage 4.37 1.54-12.4 0.006 0.18 0.08-0.87 0.034 (indoor) big bale straw bedding OR adjusted odds ratio, 95% CL, 95% confidence limit. 5) Nervous signs: Cases of Listeriosis in sheep: The presence of Listeriosis in sheep was associated with an increased risk of reporting cases of Listeriosis with nervous signs (OR 10.15, CL 1.3-78.5) (Table 4.12). Maize silage feeding: Feeding maize silage ad libitum (OR 7.68, CL 1.59-37.08) and in ring feeders (OR 4.3, CL 1.07-17.9) when animals were housed was associated with an increased risk of disease (Table 4. 12). The exclusion of herd size and herd size and cases of Listeriosis in beef cattle did not alter the results. Table 4. 12. The multivariate relationship between farming practices and cases of Listeriosis showing nervous signs Number of observations=176 OR 95% CL p value cases of Listeriosis in sheep 10.15 1.3-78.5 0.02 maize silage feeding ad libitum (indoor) 7.68 1.59-37.08 0.01 ring feeder for maize silage (indoor) 4.3 1.07-17.9 0.04 OR adjusted odds ratio, 95% CL, 95% confidence limit. Overall 7 predictor variables were associated with any of the outcome variables. Of these 5 were associated with an increased risk of reporting disease and 2 were with a decreased risk of disease (Table 4. 13). Only feeding maize silage in ring feeders when animals were housed was associated with all outcome variables. Feeding maize silage ad libitum when animals were housed was also associated with the outcome variables with the exception of silage eye cases. Cases of listeriosis in beef cattle were associated with only two outcome variables (associated with overall and nervous signs) and the rest were associated with one outcome variable (Table 4. 13). 5 of the 7 variables were also significant in the univariate analysis. However, the use straw bedding in this model was associated with a decreased risk of disease. Table 4. 13. The agreement between the different outcome variables. Predictor variables that O MC WC SE NS increased the risk of disease ring feeders for maize silage (indoor)* + + + + + maize silage ad libitum (indoor)* + + + - + cases of Listeriosis in beef cattle * + - - + - maize silage in complete diet (indoor) - + - - - cases of Listeriosis in sheep* - - - - + big bale straw bedding - - - + - straw bedding in cubicle* - + - - - decreased the risk of disease MC milking cows, WC winter cases, SE silage eye, NS nervous signs, + association with outcome variables, - no association with outcome variables, * also statistically significant in univariate analysis 4. 4. Discussion: A statistically significant association was found between 19 predictor variables and the outcome variables using 3 separate models. In the first model major risk factors were identified and these were investigated in more details in subsequent models. When different outcomes were considered fewer predictor variables were associated with cases of Listeriosis showing nervous signs than other outcomes, this may be due to fact that a small number of farms reported cases of Listeriosis showing nervous signs. Of these 19 variables 12 were also found to be significant in the univariate analysis. Cases of Listeriosis in beef cattle and sheep, use of a mower conditioner, maize silage feeding, big bale silage, storage of big bale outside uncovered, indoor feeding grass silage in ring feeders, maize silage feeding in ring feeders and ad libitum when animals were housed, vaccinating animals against Leptospirosis, use of straw bedding in cubicles and controlling moles in the fields were associated with the disease in both multivariate and univariate analysis. The ways in which these variables may play a role in the occurrence of disease have already been dealt with in the previous chapter. In addition, 7 more variables were statistically associated with the outcome variables in the multivariate analysis, 1 (grazing sheep on the same pasture and dairy cattle) in the preliminary model, 4 variables (wilting grass prior to ensiling, storing grass silage in the clamps, outdoor feeding grass silage ad libitum and not storing manure) in model 1 and 2 variables (indoor feeding maize silage in a complete diet and use of big bale straw as bedding) in model 2. In the previous chapter the importance of proper silage making has been pointed out. It is known that one of the most important components of perfect silage fermentation is the carbohydrate concentration of grass which ensures lower pH by allowing Lactic acid bacteria (LAB) to outgrow other organisms in the silage resulting in more production of lactic acids. Increases in dry matters mean an increase in carbohydrate concentration and therefore in the number of LAB (Anon 1983, Fenlon and others 1995b). One way of achieving an increase in number of LAB is wilting grass prior to ensilage. In this study wilting grass was associated with a decreased risk of disease. Storage of grass silage in clamps and outdoor ad libitum feeding grass silage were associated with an increased risk of reporting cases of silage eye. This may be explained in several ways. Silage fed from the clamps may have contained the top of clamp where the growth of organisms was enhanced due to air exposure and spoilage, or alternatively animals may have had free access to the clamp where they may have eaten silage at the clamp face which as explained in the previous chapter, may have caused damage on the conjunctival membranes allowing L. monocytogenes to penetrate these membranes. The latter assumption may find some support from the association found between outdoor ad libitum feeding grass silage and an increased risk of reporting silage eye in this study. Another explanation for the effect of outdoor ad libitum feeding may be that the quality of silage would be poorer due to exposure to air and unfavourable weather conditions therefore the quantity of L. monocytogenes would be much higher than at the beginning of silage feeding. Maize silage feeding in a complete diet when animals were housed was associated with an increased risk of reporting Listeriosis in milking cows. This may have been due to an increase in the numbers of the organism in the diet because a complete diet contains several forages including hay, straw, grass silage. It is known that spreading animal waste on fields plays an important role in environmental contamination with L. monocytogenes and poses great a health hazard to animals and humans (Wray 1975, Jones 1980, Pell 1997). In this study there was a statistically significant association between not storing manure and an increased risk of disease (overall cases and cases in milking cows). These farms may have spread manure on the fields where animals were grazing or grass and maize silage, hay or straw was made. This variable was also included in all the multivariate models but it was not significantly associated with any of the outcome variables. An association was found between the use of big bale straw as a bedding material and a decreased risk of reporting cases of silage eye. This was only significant in the models 2 where the analysis was restricted to those who fed maize silage. It may be that baling reduced the exposure of straw to unfavourable weather conditions or extra contamination with L. monocytogenes originating from other sources, resulting in the straw being free of L. monocytogenes or harbouring very low numbers of the organism. A contradictory finding was made about the use of straw bedding in cubicles. This was associated with an increased risk of disease in univariate analysis and in model 1. However, it was associated with a decreased risk of reporting Listeriosis in milking cows in model 2. It may be speculated that the majority of farmers may have had better management system or cubicle housing system on those farms who fed only maize silage. There was a negative association between grazing sheep on the same field as dairy cattle and the risk of disease. This may have been due to better pasture management. It may be possible that sheep grazed on the pasture during winter months when animals were housed. Even if sheep excreted the organism during this period, by the time that dairy cattle were turned out sheep had long been moved to other fields and the organism may have decreased significantly in number. It is known that L. monocytogenes survives in sheep faeces for 3 months (reviewed by Radostits and others 1994) The analysis of the questionnaire data has enabled us to identify some important risk factors for clinical Listeriosis in dairy cattle at farm level. These factors are mainly related to the infection pressure of the organism. The study has shown the importance of proper silage making, preservation and methods of feeding. It has also suggested the importance of better management at housing (e.g. use of bedding, dung disposal) and some general management factors (e.g. control of moles in the fields, separation of sick animals). However to reach a better understanding of the disease L. monocytogenes infection should also be investigated at individual animal level. The next two chapters consider the infection in dairy cattle and its possible risk factors. CHAPTER 5 A pilot study of the bacteriological and serological techniques used to determine the infection of cows with Listeria monocytogenes 5. 1. Introduction: Sensitive techniques for the isolation and identification of L. monocytogenes are essential for the diagnosis of outbreaks and sporadic cases of Listeriosis. They are also important in epidemiological investigations and in assessing the bacteriological safety of food. Listeria grow well on most of the commonly used bacteriological culture media after initial isolation (Gray and Killinger 1966). However initial isolation from contaminated materials has always been challenging (Murray and others 1926, Farber and Peterkin 1991). This difficulty stimulated a search for more selective methods of isolation which was also fuelled by the increasing number of outbreaks of Listeriosis in people associated with the consumption of food contaminated with L. monocytogenes. The aim of these developments was to detect small numbers of L. monocytogenes, in a shorter period of time and also to increase the probability of recovering injured organisms (Buchanan, 1990). Several techniques were employed; direct plating on selective and non-selective agar and the use of selective and non- 129 selective enrichment broth, at refrigeration or higher temperatures, prior to plating (Curtis and Lee 1995). Direct plating is rapid but unreliable. The limit of detection is often too low to recover L. monocytogenes from samples containing small number of bacteria and L. monocytogenes is outgrown when heavily contaminated samples such as faeces are examined. This gave rise to a need for an enrichment step prior to plating. The first enrichment procedure used for Listeria was “cold enrichment”. This was first advocated by Gray and others (1948) when they found that exposure of the Listeria negative samples of cow brain in tryptose broth to refrigeration temperature (40C) prior to plating resulted in growth of L. monocytogenes after a period of up to 3 months. This procedure was the only enrichment procedure used for a number of years and is still used successfully to examine clinical specimens such as brain (Gray and others 1950), milk (Larsen 1966) and silage (Gray 1960b, Fenlon 1985). Its major drawback is that it takes months to reach any conclusion. This makes it unsuitable for epidemiological investigations and the microbiological examination of food. The emergence of Listeria as a food borne pathogen resulted in the development of more rapid selective culture media. These culture media incorporated antibiotics to which Listeria are resistant. Polymixin B in tryptose phosphate broths (Bojsen-Moller 1972) and trypaflavin and nalidixic acid in Levithal broth (Ralovich and others 1972) were the first selective liquid media to be developed. Watkins and Sleath (1981) also developed an enrichment broth containing nalidixic acid and thiocyanate to recover listeria from sewage. Nalidixic acid was used in all selective enrichment broths to inhibit Gram negative bacteria. Acriflavin was also used for this purpose. Further developments were L-PALCAM (van Netten and others 1989) which contains polymixin, ceftazidine and lithium chloride in place of nalidixic acid and Fraser`s Broth (Fraser and Sperber 1988) in which Lithium bromide was incorporated in 130 addition to nalidixic acid. Lovett and others (1987) included cyclohexamide in the FDA (United States Food and Drug Administration) broth to inhibit yeast and moulds. This original formulation of Lovett and others (1987) was further developed by USDA (United States Department of Agriculture) to trace Listeria in meat samples (McClain and Lee 1988). In parallel to the development of selective enrichment broths, several selective agars were developed incorporating the same antibiotics. Gray and colleagues (1950) were again the first researchers to use selective agar by including potassium tellurate to inhibit Gram negative organisms. McBride and Girard (1960) developed a selective phenyl ethanol agar containing lithium chloride, glycine and blood. This was the only commercially available selective agar for a considerable time. A major problem was its inability to inhibit enterococci. Lee and McClain (1986) later modified McBride agar by removing glycine and blood, adding moxalactam and glycine anhydride and increasing the concentration of lithium chloride. Ralovich and colleagues (1971) also used trypaflavin and nalidixic acid in a serum based agar. The discovery that Listeria organisms were resistant to higher concentrations of lithium chloride led to development and modification of many agars and overcame the problem of enterococcal growth. Most of the agars currently used are a modification of McBride (McBride and Girard 1960) and the Oxford formulation (Curtis and others 1989a). In addition to antibiotics, one or more indicators for Listeria were also included in the medium such as aesculin in Oxford agar (Curtis and others 1989), blood in enhanced haemolysis agar (EHA, Cox and others 1991) and Fenlon Listeria agar (Fenlon 1985), mannitol and phenol red in PALCAM agar (van Netten and others 1989) and rhamnose in Modified Despeirres agar (Golden and other 1988). Although the selectivity of media was increased by incorporating antibiotics in the culture medium it was noticed that highly selective media could also inhibit the 131 growth of some strains of Listeria (Seeliger and Jones 1986, Curtis and other 1989b). To obtain maximum success in isolation of Listeria a three stage procedure was recommended (Curtis and Lee 1995); (a) resuscitation or pre-enrichment (selective or non-selective) (b) selective enrichment and (c) selective plating. This procedure has been used to isolate Listeria from food (Lewis and Cory 1991, McLain and Lee, USDA method, 1988), sewage (Watkins and Sleath 1981), clinical samples (Eld and others 1993) and environmental samples (Fenlon 1985, Husu 1990). The difficulty in isolating L. monocytogenes means that bacteriological methods are not always satisfactory when attempting to determine the exposure of animals to Listeria organisms (Gray and Killinger 1966) and serological techniques have been used as supplementary tools for this purpose. Specific ELISA tests, employing cell products involved in pathogenesis such as listeriolysin O, have been used in experimental studies. No large scale use of these ELISA assays, involving field studies has, yet been conducted (Berche and others 1990, Low and Donachie 1991, Low and others 1992b, Gholizadeh and others 1996). A pilot study involving a dairy herd was carried out to develop and standardise bacteriological and serological techniques which would be used in a longitudinal survey of L. monocytogenes infection. 5. 2. Materials and methods 132 5. 2. 1. Study design : This pilot study was carried out over a 12 month period, between September 1994 and August 1995 and involved a dairy herd of 99 Holstein cows on the University of Bristol’s farm. The herd was housed between October, 24th 1994 and April, 12th 1995. Silage was fed to animals from the beginning of September 1994 to 12th April 1995. The herd was visited monthly with the exception of February 1995. Rectal faeces samples were collected from the animals available at the time of each visit using lubricated (Lubrel, Arnolds, UK) rectal gloves. The first visit was made on 5th September, 1994 and the last visit was made on 16th August 1995. Samples of silage were also taken from the cutting face of the clamp on four occasions. The dates of the visits and the number of samples collected are shown in Table 5. 1. Table 5. 1. Date of visits and number of samples collected a) Indoor period Date b) Outdoor period N Month November 17/11/1994 69 May 17/5/1995 77 December 15/12/1994 74 June 13/6/1995 75 January* 31/1/1995 77 July 18/7/1995 67 February* ND ND August 16/81995 57 March* 7/3/1995 79 April* 12/4/1995 74 Month Total 373 Date Total N 276 ND not done, N number of animals sampled, * silage samples were also collected On the 12th of April 1995 the milking cows present on the farm were bled. A total of 77 sera were prepared and held at -200C until use. 133 5. 2. 2. Bacteriology : a) Culture procedure: (Appendix 3) A three stage procedure was used to isolate Listeria. This involved cold enrichment followed by the use of selective broth culture and selective solid medium at higher temperatures. This was adapted from the technique described by Fenlon (1985) and Lewis and Corry (1991). Samples were first cultured when fresh and then held at 40C for a period of up to 7 weeks to enhance the probability of isolating Listeria by cold enrichment. Samples which were negative at first culture were re-cultured at predetermined optimal times (at the 3rd and 7th weeks of cold storage). An aliquot of the sample was placed into Listeria Selective Enrichment Broth (LSEB) (Lovett and others 1987) in a universal container to give a final concentration of approximately 1/10 (w/v) and incubated for 24 or 48 hours at 300C. One loopful of this broth culture was streaked out on to Listeria Selective Agar (LSA) (Curtis and others 1989a) and incubated at 300C for 48 hours (Figure 5. 1). Faecal samples collected in September (30 samples) and in October (70 samples) were cultured without cold enrichment. Listeria spp. were isolated from 3 of the 100 samples. To investigate the effect of cold enrichment on the number of isolates, 20 samples were collected in October 1994 and stored at 40C and cultured weekly for 7 weeks and then again on weeks 13, 14 and 15. The effect of storing the samples at 40C in three liquid media, -saline, LSEB and NB,- on the growth quantity was compared. The results obtained using these media 134 were also compared with those obtained at 40C in the absence of medium. For this study the 20 faecal samples collected in October 1994 (20) and an additional 79 samples collected in March 1995 were used. Cold enrichment was carried out by keeping samples in either saline, LSEB, nutrient broth (NB) or no medium at 4°C and culturing periodically for up to 7 weeks. Isolation and identification was carried out according to the methods given below (Figure 5. 1). b) Identification procedure: (Appendix 3) At least five colonies of Listeria were picked off the LSA plates and subcultured on 5% Sheep Blood Agar (SBA) or Horse Blood Agar (HBA) plates at 370C overnight. The following tests were carried out to identify the isolates as Listeria species:- Gram staining, Catalase test, Motility test, Haemolytic activity, CAMP test and Carbohydrate utilisation. Information provided in Table 1. 1. was used to aid identification. Fresh sample Re-culture after Cold enrichment 3 weeks at 40C for 7 weeks 135 culturing negative LSEB (1/10w/v) at 300C for 48 h samples at 4 week and 7 weeks intervals Plating on LSA at 300C for 48 h Identification tests: Gram staining Catalase Oxidase Motility Sub-culturing Haemolytic on SBA CAMP at 370C for 24h Sugar utilisation Figure 5. 1. Isolation and identification procedure for Listeria spp. 1) Gram staining: Bacterial colonies smeared onto a clean microscope slide were air dried, fixed by passing through the Bunsen flame two or three times and placed on a staining rack. The slides were flooded with Crystal violet for 1 minute, washed under a running tap, stained with Gram’s iodine for 1 minute and then washed a second time. The slides were then decolourised with acetone for 15 seconds, washed and counter stained with Safronin for 30 seconds. The slides were washed, dried and then examined under a light microscope. Listeria were identified as Gram positive rods with a purpleblue colour. 2) Haemolytic test: The haemolytic activity of the bacteria was assessed visually after culture on 5% Sheep (Horse) Blood Agar. Some members of the genus Listeria induce varying degrees of erythrocyte lysis (L. monocytogenes, L. ivanovii more haemolytic, 136 and L. seeligeri less haemolytic). A haemolytic colony selected from the plate was inoculated into sterile saline for further tests (CAMP test, Sugar fermentation test etc.) in order to identify the isolate at the species level. 3) Catalase test: A colony was placed on a microscope slide and a drop of 3% hydrogen peroxide was added. Listeria have a catalase enzyme which converts hydrogen peroxide to water and oxygen causing air bubbles to appear on the slide. It is important to note that catalase negative strains of L. monocytogenes have recently been reported to be implicated in human Listeriosis (Swartz and others 1991, Bubert and others 1997). 4) Motility test: The motility of Listeria was examined at 250C using a hanging-drop technique. A bacterial suspension was prepared by adding 2-3 colonies of Listeria to saline. It was then left at room temperature for 1-2 hours. A drop of the bacterial suspension was placed on a cover-slip and inverted over a glass ring fixed to a microscope slide. The preparation was examined under a microscope. Listeria showed a tumbling movement. 5) CAMP test: An isolate of Staphylococcus aureus and Rhodococcus equi was streaked in one direction on 5% SBA plates and L. monocytogenes, L. seeligeri and L. ivanovii were streaked at 900 angles to (but not touching) them. After overnight incubation at 370C the plate was examined for haemolysis. Enhanced haemolysis of L. monocytogenes and L. seeligeri in the vicinity of S. aureus was observed while haemolysis of L. ivonavii was enhanced (shovel-shaped haemolysis) in the vicinity of R. equi. 137 6) Sugar tests: Listeria are capable of producing acid from some carbohydrates (Rhamnose, Glucose, Xylose, Mannitol,) and reducing nitrate to nitrite. 1% sugar plates containing different carbohydrates were prepared (Appendix 3) and divided into four quarters. An isolate of Listeria was streaked out on each quarter and incubated at 370C overnight. A change in the colour of medium from red to yellow due to acid production confirmed the presence of Listeria. 7) Storage of isolates: All isolates identified as Listeria spp. were placed on preservative beads as instructed by the manufacturer (TSC, Lancashire, UK) and kept at -200C. c) Investigation of the limit of detection: The method of Miles-Misra (reviewed by Corry 1982) was used to determine the detection limit of the culture method used in this study. Briefly a colony of L. monocytogenes grown on SBA was inoculated into 10ml of LSEB and incubated overnight at 300C. Twelve tenfold dilutions were prepared. Four 20μl drops from each dilutions were spotted on quartered LSA plates incubating at 370C for 48 hours and 2ml into 10 g of faeces, previously autoclaved. The mixture was held at 40C and cultured weekly for three successive weeks and again at the 7th week to determine the effect of cold enrichment on the limit of detection. The number of colony forming units in the original suspension was calculated by selecting LSA plates on which colonies could be easily counted. The weighted mean of the number of colonies in each quarter was then calculated for 4 different dilutions of the starting inoculum using the following formula: cx + cx+1 + cx+2 .+ cx+3.. 138 mx = nx + 101nx+1 + 102nx+2 .+103nx+3.. where cx and nx refer to the counts and number of plates at lowest dilution and cx+1 and cx+1 etc. refer to successively higher dilution. The best estimate of the mean count in the starting inoculum was then calculated as below M= mx x 10x x y where y is the number of drops per ml of the dropping pipette. The values calculated for the bacterial concentration in the original inoculum were then used to calculate the limit of detection. 1g of known Listeria - positive faeces sample was inoculated into 9ml of LSEB and incubated at 370C for 48 hours and processed as above. The detection limit was determined in a similar manner using the same method of calculation. 5. 2. 3. Serology a) Antigen Preparation : Serum antibody to L. monocytogenes was detected using an ELISA. The antigen used in this test was cholesterol precipitated Listeriolysin O (CP-LLO). This was prepared according to the method of Vazquaz-Boland and others (1989b) and Jagger (1993) and is described below. L. monocytogenes serotype 4b was streaked out onto a Horse (Sheep) Blood Agar plate and incubated at 37ºC for 24 hours. A colony from the plate was inoculated into 10ml Brain Heart Infusion Broth (BHIB) and incubated at 37ºC for 24 hours. The growth was harvested by centrifuging the BHIB at 2000g for 20 minutes. The supernatant was poured off and the pellet was washed twice in sterile phosphate 139 buffered saline (PBS), pH 7.2, centrifuging at 2000g for 20 minutes. The supernatant was discarded and the pellet was re-suspended in 50ml PBS. This inoculum was placed within a dialysis membrane previously inserted into 1 litre of BHIB and incubated overnight, on a shaker, at 37ºC. The contents of the dialysis tube were harvested, after checking the broth for evidence of contamination, and then centrifuged at 2800g for 20 minutes. The supernatant was pipetted off, filtered through a sterile 0.45µl filter unit and diluted with an equal volume of 0.20µM L-cysteine (Sigma, Dorset, UK), in PBS pH 6.0. For every 10ml of mixture 0.5ml of cholesterol (10mg in1ml of ethanol) (Sigma, Dorset, UK), were added. The mixture was then incubated at 37ºC for 30 minutes on a shaker. The mixture was centrifuged at 25,000g for 30 minutes at 4ºC and the supernatant discarded. The pellet was washed twice in PBS pH 7.2, centrifuged at 25,000xg for 30 minutes at 4ºC and finally re-suspended in 2ml of Carbonatebicarbonate buffer and frozen at -20ºC. The haemolytic activity of Listeriolysin O obtained above was determined according to the method of Kreft and others (1989). Briefly 200µl of the Listeriolysin O was put into a sterile tube and diluted with equal volume of PBS pH 6.0. 10µl of 0.1M dithioerythritol (Sigma, Dorset, UK) and 10µl of the washed sheep erythrocytes were added to this mixture and it was incubated at 37ºC for 30 minutes on shaker. A positive result was one in which complete haemolysis was observed. b) ELISA assay procedure: (Appendix 3) The ELISA procedure was adapted from that described by Low and others (1991) and Jagger (1993) and is described below. The Listeriolysin O (LLO) antigen was sonicated for 1 minute and diluted to a working dilution. 100 μl of antigen diluted in Carbonate-bicarbonate buffer, pH 9.6, (1:50) was used to coat a 96 well microtitre plate (Greiner Laboratories, Glasgow, UK). 140 The plate was incubated at 37ºC overnight. The plate was washed 6 times in PBS Tween 20, standing for 5 minutes at the last wash. 100µl volumes of blocking buffer (1% Fetal Calf Serum in PBS) were added to each well and the plate was left at room temperature for 4-5 hours. The plate was then washed 6 times in PBS Tween and 100µl of serum diluted 1:50 in PBS were added to each well and incubated at room temperature for 4-5 hours. The plate was then washed again 6 times and 100µl of Alkaline phosphatase conjugated Rabbit α Bovine IgG (Sigma, Dorset, UK) diluted 1:5000 was added to each well. The plate was incubated at 40C overnight, washed 6 times and 100µl phosphatase substrate (Sigma, Dorset, UK) (1mg/ml in carbonatebicarbonate buffer) was added to each well. After standing for 15-20 minutes the reading was taken at 405nm absorbance using an ELISA reader (Dynex Tech., Guernsey UK). c) Optimisation of the assay and specificity: Determination of the optimal antigen and serum: The optimal working dilution of antigen and positive control serum was worked out using chequerboard titration in which different two fold dilutions of the antigen were tested against goat hyperimmune serum. 100μl of coating buffer was put in to each well 100μl of the antigen was added to the first row of the plate and doubling dilutions were made from 1:2 to 1:256. 100μl hyper-immune serum were put into the first column of the plate and doubling dilutions made from 1:2 to 1:4096. Determination of coating conditions: Three different temperatures, 40C, room temperature and 370C, were used to optimise coating. 100μl of LLO in carbonate bicarbonate buffer at 1:50 dilution was used to coat 3 identical plates. The ELISA was done as described earlier. 141 Investigation of non-specific bindings: This was done by inserting an extra step between coating and adding the sample serum in which Bovine Serum Albumin (BSA), Fetal Calf Serum (FCS), dried skimmed milk (Marvel) and Pig Albumin were tested for their capacity to reduce non-specific binding. Investigating the specificity of the ELISA: A bovine serum sample and goat hyperimmune serum were incubated with LLO heat killed L. monocytogenes and L. monocytogenes culture supernatant to investigate whether antibody in the serum was specific to the L. monocytogenes antigen. LLO was prepared as mentioned before. The culture supernatant was obtained from BHIB during the process of making LLO. Listeria organisms were prepared as follows; L. monocytogenes was grown on a blood agar plate and the growth obtained was suspended in 2ml saline. The mixture was exposed to heat at 650C for 30 minutes. An equal volume (0.5ml) of the serum was mixed with an equal volume (0.5ml) of the antigen (LLO), heat killed L. monocytogenes and culture supernatant. The mixtures were incubated at room temperature overnight and centrifuged at 20,000 rpm for 50 minutes. The supernatant was poured into a sterile test tube and filtered through 0.45μl filter unit. The resulting supernatant was used in the ELISA as described earlier. 5. 2. 4. Statistical analysis: Epi-info version 6 (Dean and others 1994) was used to analyse the data. A Yates’ corrected chi squared test was used to compare the differences between proportions. A Kruskal-Wallis test was used to compare the differences between median 142 values (Dean and others 1994). A probability of P< 0.05 was accepted as statistically significant. 5. 3. Results: 5. 3. 1. Results of bacteriology: The effect of extending the incubation period: There was no change in the frequency of isolating Listeria with the extended incubation period but it enhanced the quality of the Listeria growth by reducing contamination on the plates. The effect of cold storage: The samples collected in September (30) and October (70) were cultured without cold enrichment to detect the presence of the organism. Only 3 of them were presumably positive for L. monocytogenes. The samples collected in subsequent months were cold enriched. Cold enrichment increased the frequency of isolation of Listeria spp especially after the 3rd week (Table 5. 2.). As the length of cold storage was extended the number of Listeria isolates increased. After cold enrichment and weekly culture for 15 weeks, Listeria spp. had been identified in 18 of the 20 samples. This was taken as a “gold standard” to evaluate the sensitivity of culture after cold enrichment for different lengths of time. The sensitivity of culture was 0.72 (13/18) after 3 weeks of cold enrichment and was highest after 7 weeks of cold enrichment (0.94, 17/18). Similar results were found for L. monocytogenes. The sensitivity of the test was 0.56 (10/18) after 3 weeks of cold enrichment and 0.61 (11/18) after 7 weeks. When these results of culture after 3 and 7 weeks of cold enrichment were combined the sensitivity was 1 for Listeria spp. (18/18) 143 and 0.94 for L. monocytogenes (17/18). The results are shown in the Table 5. 2. On the basis of these results it was decided to culture faecal samples immediately after collection, then after 3 and 7 weeks of cold enrichment. Table 5. 2. Effect of cold enrichment on the growth quantity of Listeria spp. weeks of cold enrichment N = 20 0 1 2 3* 4 5 6 7* 13 14 15 Listeria spp 0 4 9 13 13 12 14 17 15 16 15 (20) (45) (65) (65) (60) (85) (85) (75) (80) (75) (%) Sensitivity 0 0.22 0.5 0.72 0.72 0.67 0.78 0.94 0.83 0.89 0.83 monocytogenes 0 4 7 10 10 6 10 11 11 12 13 (20) (35) (50) (50) (30) (50) (55) (55) (60) (65) 0.22 0.39 0.56 0.56 0.33 0.56 0.61 0.61 0.67 0.72 (%) Sensitivity 0 ( ) percentage, 0 cultured when fresh,* high sensitivity and number of isolates, N number of samples examined The effect of different storage media during cold enrichment: Saline had an adverse affect on the growth quantity of Listeria after cold enrichment when compared with those kept with no media (Table 5. 3.) but this effect was not statistically significant (P=0.7 for first culture, P=1 for second culture). Table 5. 3. Effect of saline the isolation of Listeria. Listeria spp Culture Samples in no media N=20 (%) Samples in saline N=20 (%) 1 14 (70) 12 (60) 2 16 (80) 15 (75) N number of samples tested LSEB and NB were used to increase the chance of obtaining the maximum number of isolates of L. monocytogenes. 79 samples (collected in March) were used in this study. Culture was carried out weekly for the first 3 weeks then after 7 weeks of cold enrichment. Although an increase in number of isolates was observed after the 1st 144 week of cold enrichment these liquid media did not significantly increase the number of isolates over time. These results are given in the table 5. 4. Table 5. 4. Effect of LSEB and NB on the growth of L. monocytogenes. weeks of cold enrichment 0 n=79 1 2 3 7 LSEB NB LSEB NB LSEB NB LSEB NB Listeria spp. 4 20 21 20 22 21 23 22 24 % 5 25.3 26.5 25.3 27.8 26.5 29.1 27.8 30.4 monocytogenes 3 9 7 11 9 9 11 9 10 % 3.7 11.3 8.8 13.9 11.3 11.3 13.9 11.3 12.6 LSEB Listeria Selective Enrichment Broth, NB Nutrient Broth The overall results are shown in the Figure 5. 2. This indicates that cold enrichment improved the detection of Listeria positive samples. For example in December the proportion of samples in which Listeria were identified was 10.6 % after fresh culturing, and 70% after 7weeks of cold enrichment. Figure 5. 2. Effect of cold enrichment on the growth of listeria. Percentage (J* and A* not cultured at 3rd week of cold enrichment, F* not done) Period of cold enrichment 100 90 80 70 60 50 40 30 20 10 0 fresh 3 weeks 7 weeks N D J* F* M A* Month M J J A 145 Detection limit of the method: A single colony inserted into 10ml of LSEB resulted in the growth of 3.17x107 cfu/ml from which 3.17 organisms/ml were isolated by the culture media as the lowest concentration detected. The lowest concentration of organisms that could be isolated from the known Listeria positive faecal sample was 7 organisms/g. The faecal samples spiked with each dilution of L. monocytogenes and subjected to refrigeration temperature were cultured weekly for the first three successive weeks and then after 7 weeks of cold enrichment for the presence of L. monocytogenes. It was observed that the sample spiked with 3.17x10-1 cfu/ml organisms revealed growth after the second week of cold enrichment. Pattern and rate of excretion: The results of monthly herd visits are shown in the Figure 5. 2. A total of 99 milking cows were sampled over one year. All animals shed Listeria spp. at least once during the study, 92.9% (92/99) of the cows excreted L. monocytogenes in their faeces at some stage whilst 7.1% excreted other Listeria spp., mainly L. innocua and on one occasion L. seeligeri. The proportion of animals excreting Listeria was calculated for each month (Table 5. 5). The highest proportion was observed in January when 89.9% (69/77) of the cows were shedding Listeria spp. It remained high during the winter months. The excretion level decreased in May (16/77, 20.8%) and thereafter. Similarly for L. monocytogenes, the highest excretion level was in January, 51/77 animals (63.2%) were shedding the bacteria (Figure 5. 3). The difference between the months was statistically significant (P<0.001). Higher proportions of animals excreted Listeria spp. and L. monocytogenes in their faeces between November and April. Table 5. 5. Monthly excretion rates of Listeria spp. in faeces Visits NS L spp (%) Lm (%) Li* 146 NovemberS 69 49 71 45 65.2 4 5.8 December 74 57 77 49 66.2 8 10.8 January 77 69 89.6 51 66.2 18 23.4 February ND ND ND ND ND ND ND March 79 41 51.9 28 35.4 13 16.5 April 74 61 82.4 41 55.4 20 27 May 77 16 20.8 16 20.8 0 0 June 75 2 2.6 2 2.6 0 0 July 67 4 6 4 6 0 0 August 57 1 1.8 1 1.8 0 0 NS number of samples, L spp Listeria spp., Lm L. monocytogenes, Li L. innocua, * L. seeligeri on one occasion, ND not done, S statistically significant difference between months (P<0.001). Figure 5. 3. Monthly excretion of Listeria spp.(L. spp) and L. monocytogenes (Lm). (F* not done) 100 percentage 90 80 Lspp 70 Lm 60 Li 50 40 30 20 10 0 N D J F* M A Month M J J A 147 Relationship between housing, silage feeding and excretion rates: Although the silage fed to the herd during the winter months was generally of good quality (pH 3.9. DM 26.6, Ash 6.7, ME 10.3) both L. monocytogenes and L. innocua were isolated from the samples of silage. The cows were not sampled before silage feeding commenced. 89.9% (89/99) of the cows excreted Listeria spp. and L. monocytogenes during silage feeding while 21.2% (21/99) excreted listeria after silage feeding. This difference was statistically significant (OR 33.06, 95%CL 13.8-81.6, P<0.001) (Table 5. 6).Housing had a similar effect on the excretion of the organism, but housing and silage feeding ended at the same time of year. Although animals were housed almost 2 months after silage feeding started, animals were not tested during this time therefore the proportion of animals positive for Listeria could not be calculated. Table 5. 6. The relationship between housing, silage feeding and Listeria excretion proportion of animals positive for p value Listeria spp. (%) L. monocytogenes (%) during silage feeding* 89/99 (89.9) 89/99 (89.9) after silage feeding 21/99 (21.2) 21/99 (21.2) <0.001 * animals were not examined before silage feeding The relationship between age and excretion: The age of animals in the herd ranged from 3 to 13 years with an average age 5.6 years (Table 5. 8). There was no relationship between the average age of animals and the monthly excretion of L. monocytogenes with the exception of April where the number of animals excreting L. monocytogenes was significantly higher in younger animals (P=0.02). The results also indicate that, 148 with the exception of March, younger animals were more prone to shed L. monocytogenes (Table 5. 7). Table 5. 7. The relationship between age and excretion of L. monocytogenes. L. monocytogenes A P Visits NovemberS December January March April May June July August M (IR) (n) M (IR) (n) p value 6 (4-7) 6 (4-6) 5 (3.5-6.5) 4.5 (4-6) 7 (5-8) 5 (4-7) 5 (4-7) 5 (4-7) 5 (4-7) 20 17 8 38 13 61 73 63 56 5 (4-6) 5 (4-7) 4 (4-6) 5.5 (4-7) 4 (3-6) 5 (4-8) 4 (4-4) 4.5 (3.5-5) 4 (4-4) 45 49 51 28 41 16 2 4 1 0.1 0.8 0.2 0.7 0.02* 0.3 0.4 0.25 0.5 A negative for L. monocytogenes, P positive for L. monocytogenes, M median age IR interquartale range, n number of animals, * statistically significant Since there were animals excreting the bacteria on more than one occasion (the range was from 1 to 7) the relationship between the age of animals and the maximum number of times Listeria was detected in faeces samples was also assessed. There was a negative correlation between age and the maximum frequency of detection of Listeria spp.; the older the animals were the less frequently they became positive, correlation coefficient was -0.82 (95% CL -2.1-0.6). This was statistically significant (P=0.003) (Table 5. 8). Table 5. 8. The effect of age on the frequency of animals becoming Listeria positive Frequency of positivity Age N 1 2 3 4 5 6 7 3 20 5 1 5 6 3 0 0 4 22 2 5 2 7 4 1 1 149 5 13 3 3 1 3 1 1 1 6 14 1 4 5 3 1 0 0 7 11 2 2 2 5 0 0 0 8 5 1 1 3 0 0 0 0 9 8 1 1 1 3 2 0 0 10 3 2 1 0 0 0 0 0 11 2 1 1 0 0 0 0 0 13 1 0 1 0 0 0 0 0 Total 99 18 20 19 27 11 2 2 N number of cows in each age category 5. 3. 2. Results of serology: Coating regime: None of the plates incubated at three temperatures, 40C, room temperature or 370C, gave rise to non-specific binding with fetal calf serum but the plate incubated at 37°C gave optical density (OD) value higher than the others (Table 5. 9). Table 5. 9. Effect of different coating temperature on the assay Sample serum * B 40C RT 370C 0.052 0.472 0.527 0.711 0.058 0.339 0.501 0.501 0.059 0.250 0.411 0.386 0.058 0.204 0.252 0.262 0.057 0.134 0.199 0.176 0.056 0.105 0.168 0.141 0.054 0.086 0.124 0.112 0.055 0.073 0.081 0.092 RT room temperature, B blank 40C 0.511 0.452 0.333 0.285 0.204 0.167 0.051 0.051 Goat hyper-immune serum RT 370C 0.567 0.732 0.644 0.841 0.727 0.479 0.597 0.666 0.719 0.567 0.369 0.437 0.505 0.512 0.522 0.287 0.359 0.386 0.417 0.382 0.248 0.300 0.337 0.318 0.279 0.211 0.249 0.237 0.242 0.262 0.053 0.052 0.052 0.069 0.069 0.051 0.052 0.053 0.072 0.068 B 0.052 0.052 0.054 0.055 0.054 0.053 0.054 0.054 Chequerboard Titration of CP-LLO : The optimum CP-LLO and goat hyperimmune serum dilutions giving the highest OD were 1:64 and 1:64 respectively. 150 Investigating Non-specific Bindings : Some non-specific binding was still detectable when BSA, Marvel or Pig Albumin were used whereas this was not detectable when FCS was used. FCS was used in the blocking step in all subsequent tests. Investigating Specificity of ELISA: Absorption of hyper-immune serum to L. monocytogenes with CP-LLO and culture supernatant abolished the antibody activity. Table 5. 10. indicates that antigen-antibody binding was specific. Table 5. 10. Plate plan and Optical densities SD B Sample serum Standard Goat hyper-immune serum B 1 2 3 4 5 6 7 8 9 10 11 12 2 0.055 0.059 0.078 0.063 0.505 0.800 0.833 0.056 0.289 0.057 0.465 0.048 4 0.055 0.058 0.068 0.060 0.554 0.696 0.736 0.058 0.236 0.055 0.406 0.049 8 0.055 0.058 0.061 0.057 0.214 0.568 0.630 0.057 0.173 0.057 0.306 0.051 16 0.055 0.058 0.061 0.058 0.163 0.523 0.493 0.057 0.115 0.057 0.271 0.052 32 0.055 0.057 0.059 0.058 0.121 0.361 0.344 0.057 0.094 0.057 0.211 0.052 64 0.055 0.058 0.058 0.058 0.090 0.268 0.239 0.055 0.075 0.055 0.150 0.052 128 0.052 0.055 0.055 0.056 0.071 0.055 0.054 0.054 0.065 0.054 0.114 0.052 256 0.054 0.055 0.055 0.054 0.062 0.054 0.054 0.054 0.061 0.056 0.86 0.050 SD Serum dilution, B Blank, Columns 2 and 8 treated with LLO, Columns 3 and 9 treated with culture supernatant, Columns 4 and 10 heat killed Listeria organisms, Columns 5 and 11 untreated serum (control). Immune Status of the animals (a field trial of the ELISA) : Blood samples were taken only once from 77 animals. The OD values obtained were converted to Log values and then the relationship between age, bacteriological results and antibody level was investigated. When animals were grouped by the frequency of being positive for Listeria there was a negative correlation between the frequency of detection of Listeria and the concentration of the antibody to Listeria. This was statistically significant (Pearson’s correlation coefficient = -0.35, 95% CL -0.54-0.13, P=0.03). Animals that became positive for Listeria on 6 and 7 occasions were excluded because there were very small numbers in these groups (Table 5. 11). 151 Table 5. 11. The relationship between frequency of becoming positive for Listeria and antibody level Frequency N=77 EU (range) S 1 11 2.3 (1.8-2.7) 0.3 2 12 2.12 (1.76-2.63) 0.29 3 17 1.97 (1.36-2.7) 0.38 4 23 1.97 (1.46-2.5) 0.25 5 9 1.91 (1.08-2.4) 0.4 6* 2 2.2 (2.14-2.3) 0.1 7* 2 2.05(1.9-2.2) 0.2 N number of cows tested, EU mean log ELISA Unit, S standard deviation, * the difference between the mean values were significant when these were excluded There was no association between age and ELISA results (Table 5. 12). However, there was a non significant positive correlation between age and antibody level (Correlation coefficient 0.16, 95% CL -0.06-0.37). When animals were grouped by age the animals under the age 5 (47 of 77 animals) had ELISA values of 2.02 (1.3-2.6) and the animals over the age of 5 (30 of 77 animals) had similar ELISA values of 2.06 (1.1-2.7). Table 5. 12. Relationship between age and antibody level Age N=77 EU* (range) S 3 15 1.92 (1.36-2.5) 0.3 4 20 2.02 (1.48-2.6) 0.3 5 12 2.2 (1.86-2.5) 0.2 6 9 2.1 (1.6-2.7) 0.3 7 9 2.04 (1.08-2.4) 0.3 8 3 1.9 (1.76-2.15) 0.2 9 6 1.9 (1.08-2.4) 0.5 10 3 2.3 (2.05-2.73) 0.4 N number of cows tested, EU* mean log ELISA Unit, S standard deviation 5. 4. Discussion : 152 The primary aim of this pilot study was to develop and standardise techniques which would allow cattle infected with L. monocytogenes to be detected in a longitudinal study. A three stage procedure, cold enrichment prior to LSEB (Lovett and others 1987) and LSA (Curtis and others 1989a) was used to identify animals shedding Listeria spp. in their faeces. No comparison of LSEB and LSA was made with any other Listeria isolation media. However the superiority of LSEB and especially LSA has been acknowledged by other researchers. LSA was found to be more effective in isolating L. monocytogenes from artificially seeded clinical specimen such as faeces and vaginal swabs (Curtis and others 1989a) and from food (Tiwari and Aldenrath 1990, Curtis and Lee 1995) but less effective in isolating the bacteria from silage (Fernandez-Garayzabal and others 1992b) Cold enrichment was also reported to be inefficient in isolating L. monocytogenes from food (Pini and Gilbert 1988), faecal samples (Hayes and others 1991) and autopsy material (Eld and others 1993) when compared with liquid selective enrichment at higher temperatures. The variability between the isolation techniques and the failure of our attempts to isolate L. monocytogenes from faeces without exposure to cold storage led us to combine cold enrichment with selective enrichment and selective plating at higher temperature. This application enabled us to identify more Listeria positive samples. This is in agreement with other findings. The successful use of cold enrichment followed by selective media and plating at higher temperature for the isolation of L. monocytogenes from food by Lewis and Corry (1991) and clinical specimens by Gray (1948) and Pittman and others (1967), and for epidemiological investigation by Husu (1990) has been reported. In conventional cold enrichment procedures a liquid medium (selective or non selective) has always been used (Gray and Killinger 1966 and Hayes and others, 1991). The use of NB, Saline and LSEB as cold enrichment media failed to improve the 153 frequency of isolation of L. monocytogenes from faeces when compared with the samples held at 40C without any medium. Both NB and LSEB increased the number of positive samples after the first week of cold enrichment but there was no further increase during the cold enrichment period. In contrast, the use of saline as a cold enrichment medium had an adverse effect on the growth of Listeria organisms. A similar effect of saline was stated by Gray and Killinger (1966). Our results indicate that holding faecal samples at refrigeration temperature without any liquid media was the better application. The duration of cold enrichment used by other researchers varied between 1 to several months (Gray 1948, Pittman and others 1967). We attempted to reduce this time by determining the sensitivity of the isolation technique at different times of cold enrichment. The best result was obtained after 7 weeks of cold enrichment when the sensitivity was 100% and 94% for Listeria spp. and L. monocytogenes respectively. Investigation of the lowest limit of detection revealed that it was 3.17 cfu/ml for broth spiked with Listeria organisms and 7 cfu/g for the known Listeria positive faeces sample. The difference between the two figures could be explained with the nature of samples as the faecal sample would contain many more bacteria other than Listeria. After the second week of cold enrichment of faecal samples inoculated with 3.17x10-1 cfu/ml of L. monocytogenes revealed growth. This supports the idea that cold enrichment favours the multiplication of Listeria organisms (Gray and Killinger 1966). This pilot study revealed some preliminary information about the behaviour of Listeria spp. especially L. monocytogenes. Unlike other researchers we found a very high excretion level of Listeria spp. and more importantly L. monocytogenes (Skovgaar and Morgen 1988, Husu 1990). There was also a seasonal pattern of excretion which coincided with silage feeding, housing and the seasonal occurrence of clinical listeriosis (Chapter 2). This seasonal variation may have been the result of different feeding 154 practices during the indoor and outdoor periods. Housing may have also played an important role in the higher excretion rates. In this study it was impossible to differentiate the effect of these two practices. Both changed at the same time. No apparent association between age and monthly excretion rate was observed. However there was a statistically significant association between age and frequency of detection of the organism. Younger animals shed the organism more frequently than older animals. This concurs with experimental findings in which it has been shown that younger animals excrete L. monocytogenes in their faeces for longer period than older animals (Miettinen and Husu 1991). In this study the ELISA assay was optimised by carrying out coating with different concentrations of antigen and at different temperatures and inserting an extra step to avoid non-specific binding. The specificity of the ELISA assay using different antigens demonstrated that LLO and antibody binding was specific; antibody activity was absorbed using LLO, culture supernatant and heat killed organisms. The absorption of antibody activity using heat killed organisms was surprising because LLO is not considered to be a cell associated antigen. This result probably reflects the fact that the heat killed bacteria was prepared from unwashed organisms which contained LLO. In this study serum samples were collected once and that was at the end of the silage feeding and housing period. The results indicate that all animals tested seemed to have antibodies to L. monocytogenes and this supports the results of our bacteriological investigations. However, it was not possible to determine whether there were animals exposed to L. monocytogenes before silage feeding or winter housing commenced. In the following chapter the optimised and standardised culture and ELISA techniques were used to identify animals infected with L. monocytogenes in a longitudinal survey. 155 CHAPTER 6 A study of the dynamic of infection with Listeria monocytogenes, in herds of milking cows 6. 1. Introduction: L. monocytogenes is ubiquitous in the environment and it is frequently isolated from healthy or diseased individuals (Gray and Killinger 1966, Farber and Paterkins 1991). One of the routes of transmission of L. monocytogenes infections in people is the ingestion of contaminated food. Many outbreaks and sporadic cases of Listeriosis follow the consumption of contaminated foodstuffs (Blenden and others 1987, Ralovich 1987, Lund 1990, Broome and others 1990, Farber and Paterkins1991, McLauchlin 1996). Contamination can occur at the primary production stage (at farm level), at the processing stage (factories, slaughterhouses, etc.) or alternatively after the processing stage (at home, retailers etc.). Many studies have been carried out to determine the degree of contamination with L. monocytogenes and its isolation pattern at all of these stages (Fenlon and Wilson 1989, Carosella 1990, Husu and others 1990b, Greenwood and others 1991, Jacquet and others 1993, Fenlon and others 1995a, Fenlon and others 1996). Studies have also revealed that different strains of L. monocytogenes may be better adapted to different stages of production and processing (Greenwood and others 157 1991, Boerlin and Piffaretti 1991, Norrung and Skovgaard 1993, Fenlon and others 1996). At the primary production stage silage has long been associated with L. monocytogenes infection and is thought to be the source of the organism (Gill 1933, Gray 1960a, Gray and Killinger 1966, Fenlon 1985, Gitter 1989). The contamination of the agricultural ecosystem with L. monocytogenes is well documented and L. monocytogenes is thought to be a saprophytic organism living in a plant-soil environment (Welshimer 1968, Welshimer and Donker-Voet 1971, Welshimer 1975, Weis and Seeliger 1975, Watkins and Sleath 1981, van Renterghem and others 1991, MacGowan and others 1994). Carrier humans and animals are thought to play an essential role in the contamination of their environment (vegetation, soil, water etc.) and therefore foodstuffs. However the primary source of contamination is unknown although it has been the subject of research for many years. Research has been carried out to determine the excretion rate in humans (Kampelmacher and van Noorle-Jansen 1969, Lamont and Postlethwaite 1986, MacGowan and others 1991, Gray and others 1993, MacGowan and others 1994), sheep (Gronstol 1979b), wild and domesticated birds, (Fenlon 1985, Skovgaard and Morgen 1988, Idia and others 1991, Casanovas and others 1995) pigs, cats, dogs (Iida and others 1991, van Renterghem and others 1991) and cattle (Kampelmacher and van NoorleJansen 1969, Hofer 1983, Skovgaard and Morgen 1988, Husu 1990, Iiada and others 1991, van Renterghem and others 1991, Ueno and others 1996,). These studies have reported considerable variation in the proportion of animals excreting L. monocytogenes in their faeces, from 0% in cats (Iida and others 1991) to 64% in sheep (Gronstol 1979b). The proportions reported for cattle vary between 1.9% (Iida and others 1991) and 51% (Skovgaard and Morgen 1988). However little attention has been paid to rigorous epidemiological sampling strategies in the design of these studies. 158 There were no sample size calculations and the studies involved different study populations. Some studies involved sampling from slaughterhouses (Hofer 1983, van Renterghem and others 1991) others from freshly excreted cow pats on the farm (Skovgaard and Morgen 1988). In only three studies was the source of the organism investigated (Skovgaard and Morgen 1988, Husu 1990, Ueno and others 1995) and in only two of these was it done by comparing environmental and animal isolates of L. monocytogenes on the same farms using serotyping and phagetyping methods. The same strains have been identified in both environmental and animal isolates (Skovgaard and Morgen 1988 and Ueno and others 1995). But the usefulness of these techniques has already been disputed by some researchers (Seeliger and Hohne 1979, Ralovich 1993). Animal derived foodstuffs such as soft cheese have been implicated in human Listeriosis in England (McLauchlin 1996) and studies have been carried out to determine the contamination of these products with L. monocytogenes (Greenwood and others 1991, MacGowan and others 1994). But there have been no studies to determine carriage rate of Listeria spp. and L. monocytogenes in dairy cattle in England and little is known about the contamination of their environment. In a pilot study carried out between September 1994-August 1995 involving only one dairy farm, a large proportion of animals were found to be excreting Listeria spp. and L. monocytogenes in their faeces (Chapter 5). However it is known that differences occur in excretion rate within and between farms (Kampelmacher and van Noorle Jansen 1969, Skovgaard and Morgen 1988). A longitudinal study was therefore designed to include five dairy farms in order to investigate the infection rate of L. monocytogenes in individual milking cows over a 10 month period. Infection was assessed using bacteriological and serological methods. Factors which might be 159 associated with the infection rate were measured and individual isolates of L. monocytogenes were identified using molecular typing methods. 6. 2. Materials and Methods: 6. 2. 1. Study Design: The dairy herds studied in this part of the project were selected from those served by the Farm Animal Practice of the Faculty of Veterinary Medicine, University of Liverpool. Initially an explanatory letter was written to all the dairy farmers in the practice (Appendix 5). Phone calls were made to the same clients to arrange a meeting to explain what the study would involve, to discuss the project in more details and to obtain information about their farming practices such as herd size, milking routines, feeding regimes, housing, and handling facilities. After this process five dairy herds were selected for the study. 6. 2. 2. Farm Management: All five farms had similar farming practices; (Table 6. 1) all kept Holstein milking cows which were milked twice a day (morning and evening) and milk was stored in a bulk tank until collection. Milk was collected daily on all farms. The cattle were housed in winter in cubicle houses on straw bedding. Pastures were only grazed by cows. Grass silage was fed to animals on all farms. On Farms B and E it was fed all year around and on Farms A, B, and E maize silage was also fed. The cows were also fed concentrates at milking. The farmers were interviewed using a questionnaire (Appendix 5) in order to find out more details about their animals and to record changes in management practices which took place during the study. 160 4 of the farms had their silage analysed (Table 6. 2). Information on the age of milking cows was available for three farms (Farms A, B and C) (Table 6. 3). Table 6. 1. The management practices followed by the five farms Farm A Farm B Farm C Farm D Farm E type of herd closed closed closed open open herd sizea 110 90 60 130 160 time of calving all year all year all year all year all year type of housing cubicles cubicles cubicles cubicles cubicles all year 5.10.96 10.11.96b all year 14.10.96 NF NF 30.10.96 straw yard start of grass silage start of 21.9.96 maize 4.1.97 silage start of housing 15.10.96 8.11.96 30.10.96 24.11.96 30.10.96 end of grass silage 30.4.97 all year 30.4.97 1.4.97 all year end of maize silage 31.3.97 continuedd NF NF 30.3.97 end of housing 31.3.97 23.4.97 30.4.97 12.4.97 30.3.97 storage of silage clamp clamp clamp clamp clamp additives in silage N Y Y Y Y dungc Y Y Y Y Y of Y N Y N N history listeriosis a the numbers changed over the period of study, b mix of grass silage and whole wheat crops and bought in grass silage in February, c dung spread on the field where animals grazed or silage was made from, d still being fed when the study finished, NF not fed, Y yes, N no Table 6. 2. Results of forage analysis Farm A* Farm B Farm C Farm E GS MS MS C1 C2 C1 C2 GS MS pH 4.3 4.0 3.5 3.5 3.4 4.3 4.4 4.4 4.0 Ash (%) 7.7 3.5 NK 11.1 8.2 7.0 8.1 9 10 161 DM (%) 23.8 46.0 25.9 21.1 23.2 27.5 27.4 39.5 34.0 D (%) 65.1 78.9 NK 65.8 71.0 NK NK 62.9 69.4 ME (MJ/kg) 10.4 12.4 12.7 11.4 11.4 10.4 10.1 10.1 10.9 GS grass silage, MS maize silage, C1 first cut, C2 second cut, DM dry matter, D digestibilty value, ME metabolisable energy,* no data available for the Farm D, NK not known. Table 6. 3. Age distribution of animals on the farms A, B and C Number of animals Age* Farm A Farm B* Farm C* 2 3 4 5 6 7 5 25 26 13 12 18 5 30 24 15 12 9 6 1 1 6 4 5 8 9 10 11 12 13@ 6 5 6 4 1 3 3 3 1 4 3 1 5 3 4 1 1 4 * age records were not available for some animals and for the farm D and E , @ 13 and greater 6. 2. 3. Sample size: The sample size required to detect the minimum level of excretion was calculated from the figure obtained during our pilot study where the lowest excretion rate was 1.8%. As nearly as all the animals on the farms needed to be sampled in order to detect this excretion rate with 95% confidence limit (Canon and Roe 1982), it was decided, for convenience, to sample the whole milking herd. 6. 2. 4. Sampling procedure: 162 a) Faecal samples: Faecal samples were collected freshly from the rectum of animals and immediately transferred to sterile 60ml universal containers (Sterilin, Staffordshire, UK). Individual disposable rectal examination gloves (Arnolds, Shropshire UK) and a lubricant (Lubrel, Arnolds, Shropshire UK) were used for each sampling. Samples were taken monthly from all milking cows and dry cows present at the time of visit (Table 6. 4). Since cows were leaving and entering the milking herd on all farms during the survey the frequency of sampling is given in the Table 6. 5. Table 6. 4. Date of visits and number of animals sampled Farm A Farm B Farm C Farm D Farm E Visit D N D N D N D N D N 1 12/8/96 111 14/8/96 90 19/8/96 58 16/8/96 126 21/8/96 141 2 9/9/96 110 11/9/96 96 20/9/96 58 13/9/96 124 19/9/96 138 3 15/10/96 110 9/10/96 95 18/10/96 57 11/10/96 126 17/10/96 155 4 18/11/96 83 13/11/96 78 25/11/96 53 15/11/96 128 27/11/96 145 5 13/12/96 83 11/12/96 79 18/12/96 57 16/12/96 121 20/12/96 139 6 13/1/97 83 15/1/97 80 16/1/97 56 20/1/97 135 23/1/97 128 7 10/2/97 89 12/2/97 81 13/2/97 53 17/2/97 132 20/2/97 135 8 10/3/97 85 12/3/97 80 13/3/97 53 17/3/97 120 20/3/97 155 9 14/4/97 84 16/4/97 81 24/4/97 53 21/4/97 111 1/5/97 158 10 12/5/97 91 14/5/97 78 15/5/97 55 19/5/97 102 ND ND D = date of visit, N= number of animals sampled, ND = not done Table 6. 5. Number of animals tested on more than one occasion Frequency of Number of animals tested Sampling Farm A Farm B Farm C Farm D Farm E 1 2 3 4 5 6 8 0 27 6 0 0 2 5 18 5 0 8 2 0 7 1 1 5 17 25 26 13 12 10 11 13 12 15 21 29 163 7 8 9 10 4 1 0 78 1 8 9 60 2 2 6 41 21 9 10 59 31 42 37 ND Total 124 111 67 202 211 ND =not done b) Environmental samples: Samples of soil, grass, water, silage, bedding and milk were collected monthly from each farm. Samples of soil and grass were collected from pastures where animals grazed and where silage was made using the sampling scheme shown in the Figure 6. 1. During pasture sampling maximum care was taken to avoid cross-contact between grass and soil. The samples were placed in separate bags. Silage samples were taken from the clamp face using the same sampling procedure as that for soil and grass. An individual rectal glove was used for each sample. During the housing period bedding samples were also collected monthly from the cubicles and straw yards. Water samples were collected monthly from troughs located in the houses, yards and fields. Monthly bulk tank milk samples were also taken. Sterile 60 ml pots were used to take water and milk samples. Figure 6. 1. The scheme followed for the collection of environmental samples 3 • •2 7 • •4 •6 11 • •8 •10 164 • 1 • 5 • 9 6. 2. 5. Sample preparation and processing: Soil, grass, bedding and silage samples were treated as follows; each sample was first pooled in a sterile bag and mixed well then homogenised in LSEB using a stomacher (Seward Medical, London, UK) at normal speed for 2 minutes and then the mixture was transferred to at least three sterile pots. The samples were cultured immediately and stored at refrigeration temperatures for further culturing as explained in the Chapter 5. 6. 2. 6. Measurement of serum antibody to Listeria monocytogenes An ELISA was used to measure serum antibody as described in Chapter 5. Cows were bled during the first, 5th and last visit i.e. at the start, in the middle and at the end of the study period. The date of the visits and number of samples taken are given in the Table 6. 6. The three samples of serum collected from each animal were tested on the same plate at a 1:50 dilution. Doubling dilutions of a positive (standard) control (goat hyperimmun serum) and a negative control (fetal calf serum) were used for each plate at dilutions from 1:50 to 1:6400. A serum sample was considered positive if the optical density value at 405nm was equal to or greater than three times that of the negative control serum. The difference in antibody level between first and second, first and third and second and third collections was investigated in the following way. The differences between the OD values measured at each point were calculated for each animal. 165 Negative values (i.e. a decrease in OD values) and positive values (i.e. an increase in OD values between the two sampling points) were obtained. The maximum positive or negative changes in OD on each farm were then selected and the lower of these was taken as the cut off point. Animals with values above this cut off point were then considered to have undergone a change in antibody level. Antibody levels increased on some farms and decreased on others. The plate lay out and the ELISA results are presented in the appendix 6. Table 6. 6. Dates and numbers of blood samples collected farm A Farm B Farm C Farm D Farm E date n date n date n date n date n 12/8/96 109 14/8/96 96 19/8/96 61 16/8/96 122 21/8/96 141 2 13/12/96 83 11/12/96 78 18/12/96 55 16/12/98 119 20/12/96 136 3 85 14/5/97 81 15/5/97 54 19/5/97 106 1/5/97 157 1 12/5/97 n number of samples 6. 2. 7. Investigation of source of the bacteria : Random amplified polymorphic DNA (RAPD) technique was used to identify individual isolates of L. monocytogenes. This method was adapted from that described by MacGowan and others (1993) and O`Donoghue and others (1995). The method was standardised by using a single bacterial colony for the DNA extraction, standardising the DNA extraction method, testing the primers ability to differentiate the different species and finally testing the repeatability of RAPD. (i) Selection of isolates for RAPD: 166 A total of 944 isolates of L. monocytogenes were obtained over the study period, because of limitations of time and resources it was impossible to examine all isolates. A selected number of isolates were therefore tested. All the isolates of L. monocytogenes from environmental samples (soil, grass, water, bedding, silage) and milk which were recovered following storage were examined. Faecal isolates recovered from the first three visits were examined to determine the “strains” present prior to housing. A representative number of isolates obtained at the visit when the highest number of animals excreted L. monocytogenes (10% of isolates were randomly selected where the number of isolates exceeded 10) was taken to determine the isolates present at the peak of infection. The number and the origin of the animal isolates examined are given in Table 6. 19. (ii) L. monocytogenes isolates and culture conditions All L. monocytogenes isolates used in RAPD were maintained on preservative beads (TSC, Lancashire, UK) at -200C. Listeria cultures were prepared by inoculating 1-2 beads into 5ml of non-selective broth (peptone water (PW) or LEB with no antibiotic supplement, Appendix 3) to allow injured organisms to recover and incubating at 370C overnight. This mixture was transferred to LSEB and incubated overnight at 370C. A loopful of this broth was then streaked on to 5% SBA and the plates were incubated at 370C overnight in order to recheck the haemolytic activity of isolates. A colony was sub-cultured on SBA at 370C overnight. The purity of the plate was evaluated by further sub-culturing a single haemolytic colony on to SBA at 370C for 24 hours. (iii) DNA extraction: 167 A single colony was picked off a culture plate and put into 5ml of sterile LEB with no antibiotic supplement and incubated at 370C overnight. The culture was harvested by centrifugation for 5 minutes at 2500 g. The pellet was washed twice with sterile distilled water and then suspended in 150μl sterile distilled water, boiled for 4 minutes and centrifuged at 1300xg for 30 seconds. The supernatant was used as template DNA. No attempt was made to quantify the amount of DNA but the total number of bacteria used to extract DNA was calculated as approximately 4x107 cfu/ml. This was calculated as explained earlier. The same culture conditions and methods were used prior to DNA extraction so as to standardise the number of bacteria used for extraction. (iv) DNA primers: The primers (primer Universal, 2, 3, 4, 5 and 6) were obtained from the Department of Medical Microbiology, Southmead Health Services NHS Trust, Bristol. The primers and their DNA sequence are given below. Primer -mer DNA Sequence universal 21 TTATGTAAAACGACGGCCACT primer 2 21 ATCTGCAGCTGAACGGTCTGG primer 3 20 CAGAATTCATGCCACGTCCC primer 4 20 GGGCGTTGTCGGTGTTCATG primer 5 20 ACAGGTCCAACAAAAGCTGG primer 6 19 AACAGCACTCTGTTCAGGC (v) RAPD amplification conditions: DNA amplification reactions were performed in a reaction mixture containing; 10mM Tris-HCl, pH 9.0, 1.5mM MgCl2, 50mM KCl, gelatin 0.1% w/v, Triton X100 0.1% w/v, 200μM each of dATP, dGTP, dTTP and dCTP (Pharmacia, Hertfordshire, 168 UK), 0.5μM DNA primer, 1 unit Supertaq DNA polymerase (Stratech Scientific, Cambridge, UK) and 10μl of cell supernatant (final volume 50μl). Single primer (Cruachem Ltd., Glasgow UK), at concentration of 25μM, was added to each reaction mixture which was then overlaid with 3-4 drops of liquid paraffin. The mixture was then placed in a PCR Thermal Reactor (Hybaid, Middlesex, UK) with temperature programming as follows; -one cycle at 940C for 3 minutes to denature template DNA, -four low stringency cycles at 940C for 45 seconds, 260C for 2 minutes, and 720C for 2 minutes with ramp setting of 2, to anneal template DNA and primer, -thirty cycles at 940C for 45 seconds, 360C for 1 minute, 720C for 2minutes with ramp default setting, -finally one cycle at 720C for 5 minutes to extend the reaction with Taq polymerase. (vi) Test repeatability: The repeatability of the test was evaluated by using 2 isolates of L. monocytogenes and 1 isolate of L. innocua in the test on two occasion using the same procedure. (vii) Analysis of PCR product: The PCR products were analysed by electrophoresis in 1% w/v agarose with TBE buffer (0.089M Tris base, 0.089M orthoboric acid, 0.002M EDTA, pH8.0). 2μl of loading buffer (containing bromophenol blue 0.25% w/v and sucrose 40% w/v in distilled water) was added to 10μl of final PCR product and mixed well. 10μl of this mixture was loaded onto the gel and run at 100-115 volts for about 2-3 hours. The gel was then soaked in ethidium bromide (0.5mg/L) for about 30 minutes the bands 169 visualised over a UV-Transilluminator. Results were recorded on Polaroid type 665 instant positive/negative film (Polaroid, Hertfordshire, UK). 6. 2. 8. Data analysis: In estimating the effect of silage feeding and housing on the overall excretion of Listeria spp. and L. monocytogenes, all animals examined (i.e. animals left or entered the milking herd included) before, during and after silage feeding and housing were taken into account and then the proportions of animals positive for the organism before, during and after housing and silage feeding were estimated and compared. All data were entered onto a database (Microsoft Access 2, Simpson 1994) and analysed using Epi-info version 6 (Dean and others 1994). A Yates corrected chi squared test was used to compare the differences between proportions. A KruskalWallis test was used to compare the differences between median values (Dean and others 1994). A probability of P< 0.05 was accepted as statistically significant. 6. 3. Results: 6. 3. 1. Bacteriology : Farm A: a) Faecal samples: A total of 124 milking cows were examined on this farm. Of these, 72.6% (90/124) shed L. monocytogenes and 1.6% (2/124) other species of Listeria. Animals 170 entered and left the herd over the study period, so that only 78 (62.9%) animals were examined at all visits and the rest (37.1%) were either removed from or included in the herd at different times during the survey (Table 6. 5). All 78 milking cows shed L. monocytogenes at some stage during the study. The proportion of milking cows excreting Listeria spp. varied between 1% in September to 96.5% in March (Figure 6. 2). The highest frequencies of excretion were observed between November and April inclusive. A similar pattern of excretion was observed for L. monocytogenes (1% in September and 90% in February). The proportion of animals excreting L. innocua gradually increased and reached the highest level in December (Figure 6. 2). The difference between the months was statistically significant (P<0.001) (Table 6.7). A small number of animals also excreted L. seeligeri. Figure 6. 2. The monthly excretion of Listeria spp. and L. monocytogenes in faeces on Farm A 171 % 100 90 L.spp Lm Li Ls 80 70 60 50 40 30 20 10 0 A S O N D J F M A M 172 Table 6. 7. Monthly frequency of excretion of Listeria spp. and L. monocytogenes in milking cows. Farm A Visits August (A) September (S) October (O) November (N) December (D) January (J) February (F) March (M) April (A) May (M) P value* Farm B Farm C Farm D Farm E L spp (%) L. m (%) L spp (%) L. m (%) L spp (%) L. m (%) L. spp (%) L. m (%) L spp (%) L. m (%) 5/111 (4.5) 1/110 (1) 9/110 (8.2) 5/111 (4.5) 1/110 (1) 5/110 (4.5) 12/90 (13.3) 10/96 (11.4) 48/95 (50.5) 7/90 (7.7) 6/96 (7.3) 2/95 (2.1) 3/58 (5.1) 4/58 (6.9) 3/57 (5.3) 1/58 (1.7) 4/58 (6.9) 1/57 (1.8) 2/126 (1.6) 10/128 (8.1) 30/126 (23.8) 0 20/141 (14.2) 7/138 (5.1) 18/155 (11.6) 11/141 (7.8) 3/138 (2.2) 6/155 (3.9) 33/83 (39.8) 67/83 (80.7) 76/83 (91.6) 85/89 (95.5) 82/85 (96.5) 80/84 (95.2) 15/91 (16.5) <0.001 11/83 (13.3) 21/83 (25.3) 54/83 (65.1) 80/89 (89.9) 67/85 (78.8) 71/84 (84.5) 13/91 (14.3) <0.001 66/78 (84.6) 43/79 (54.4) 77/80 (96.3) 78/81 (96.3) 61/80 (76.3) 40/81 (49.4) 47/78 (60.2) <0.001 39/78 (50) 7/79 (8.9) 45/80 (56.3) 69/81 (81.5) 11/80 (13.9) 17/81 (20.9) 11/78 (14.1) <0.001 28/53 (52.8) 10/57 (17.5) 9/56 (16.1) 4/53 (7.5) 20/53 (37.7) 19/55 (34.5) 1/55 (1.9) <0.001 1/53 (1.9) 1/57 (1.8) 1/56 (1.9) 0 1/128 (0.8) 1/121 (0.8) 0 1/132 (0.8) 24/120 (20) 2/111 (2.7) 0 125/145 (86.2) 130/139 (93.5) 107/128 (83.6) 101/135 (74.8) 123/155 (79.4) 44/158 (27.8) ND 49/145 (33.8) 93/139 (66.9) 62/128 (48.3) 34 (25.4) <0.001 <0.001 <0.001 18/53 (33.9) 1/55 (1.9) 0 <0.001 2/132 (1.5) 52/120 (43.3) 30/111 (27) 6/102 (5.9) <0.001 9/128 (7.0) 27/126 (21.4) 0 1/121 (0.8) 0 40/155 (25.8) 13/158 (8.2) ND L spp., Listeria spp., L. m L. monocytogenes, (%) percentage, * statistically significant difference between the months 173 On this farm, grass silage was introduced in September 12 days after the visit (9/9/1996). By the October visit the proportion of animals shedding Listeria spp. and L. monocytogenes had increased slightly but was similar to that seen in August before silage feeding. The cows were housed on the same day as the October visit and by the November visit the proportion of animals shedding Listeria spp. had increased significantly. This was mainly due to an increase in the number of animals shedding L. innocua. The proportion of animals shedding L. monocytogenes continued to increase in December and showed a significant increase in January 9 days after the introduction of maize silage. Maize silage feeding ended at the end of March, 14 days before the April visit and this was also the time when animals were turned out. The proportion of animals shedding L. monocytogenes was still high in April but it dramatically decreased in May 12 days after grass silage feeding ended. The total proportion of examined animals excreting Listeria spp. before (5.4%, 6/111) and after (16.5%, 15/91) grass silage feeding was significantly lower than the proportion obtained during grass silage feeding (76.9%, 90/117) (p<0.001). Similarly the proportion of all animals examined that were excreting Listeria spp. during (100%, 89/89) maize silage feeding was significantly higher than that observed before maize feeding (64.8%, 72/111) (p=0.001). However there was little change after the end of maize silage feeding when the proportion was 89% (81/91). Housing started 1 month after grass silage feeding had commenced. The proportions of animals excreting Listeria spp. were 11.7% (13/111) before housing, 100% (89/89) during and 16.5%, (15/91) after housing. This difference was statistically significant (p<0.001). Similar effects of housing, grass and maize silage feeding were seen on the proportion of animals which were positive for L. monocytogenes (Table 6. 8). 174 Table 6. 8. The relationship between silage feeding and housing on the overall excretion of Listeria spp. and L. monocytogenes. Listeria spp. Farm A L monocytogenes before during after P value before during after P value grass silage 6/111 (5.4) 90/117 (76.9) 15/91 (16.5) <0.001 6/111 (5.4) 87/117 (74.4) 13/91 (14.3) <0.001 maize silage 72/111 (64.8) 89/89 (100) 81/91 (89) 0.001 32/111 (28.8) 87/89 (97.8) 73/91 (80.2) <0.001 housing 13/111 (11.7) 89/89 (100) 15/91 (16.5) <0.001 9/111 (8.1) 87/89 (97.8) 13/91 (14.3) <0.001 maize silage 60/98 (61.2) 88/91 (96.7) NA <0.001 15/98 (15.3) 80/91 (87.9) NA <0.001 housing 60/98(61.2) 88/91 (96.7) 47/78 (60.2) <0.001 15/98 (15.3) 80/91 (87.9) 11/78 (14.1) <0.001 grass silage 6/58 (10.3) 48/65 (73.8) 1/55 (1.8) <0.001 5/58 (8.6) 23/65 (35.3) 0/55 <0.001 housing 8/62 (12.9) 46/61 (75.4) 1/55 (1.8) <0.001 5/62 (8.1) 22/61 (36.1) 0/55 <0.001 grass silage 39/144 (27.1) 55/158 (34.2) 35/114 (30.7) 0.3 35/144 (24.3) 25/158 (15.8) 3/114 (2.6) <0.001 housing 40/168 (23.8) 54/141 (38.3) 35/114 (30.7) 0.02 35/168 (20.8) 25/141 (16.9) 3/114 (2.6) <0.001 maize silage 42/177 (23.7) 175/190 (92.1) 44/158 (27.8) <0.001 20/177 (11.3) 144/190 (75.8) 13/158 (8.2) <0.001 housing 42/177 (23.7) 175/190 (92.1) 44/158 (27.8) <0.001 20/177 (11.3) 144/190 (75.8) 13/158 (8.2) <0.001 Farm B* Farm C Farm D Farm E* * grass silage feed all year around, NA not applicable 175 The mean age of herd was 5.6 (range 2-14). The relationship between age and Listeria excretion was investigated by comparing the mean age of cows excreting Listeria in their faeces with non-excretors. Age had no effect on faecal excretion each month (Table 6. 9) but the cows excreting Listeria spp. were always younger than nonexcretors. When all the animals examined during the study were taken into account there was a significant effect of age on Listeria excretion. The mean age of Listeria shedders was 5 years while it was 7.5 years in non-shedders. This difference was statistically significant (p<0.001). Similar results were obtained for L. monocytogenes (Table 6. 10.) Table 6. 9. The relationship between age in years and excretion of Listeria spp. Farm A Farm B Farm C Listeria - Listeria + Listeria - Listeria + Listeria - Listeria + MA (n) (R) MA (n) (R) MA (n) (R) MA (n) (R) MA (n) (R) MA (n) (R) 6.1 (106) (3-14) 5.6 (5) (4-8) 5.8 (78) (3-13) 4.3 (12) (3-10) NA NA NA NA 5.2 (86) (3-12) 6.1 (10) (3-11) 8.1 (30) (2-16) 4.7 (3) (4-5) October 6.1 (101) (3-14) 5.0 (9) (3-8) 5.3 (47) (3-12) 5.1 (48) (3-12) NA NA November 5.1 (50) (3-9) 5.2 (33) (3-9) 4.2 (12) (3-7) 4.7 (66) (3-11) 8.4 (12) (3-13) 6.7 (18) (2-16) December 5.4 (16) (3-9) 5.1 (67) (3-9) 4.2 (36) (2-8) 4.4 (43) (3-9) 7.9 (29) (2-21) 4.0 (5) (2-8) January 5.4 (7) (3-9) 5.1 (76) (3-9) 3.7 (3) (3-4) 4.4 (77) (2-9) 6.4 (26) (2-13) 10.7 (7) (5-21) February 5.3 (4) (3-7) 4.9 (85) (3-9) 5.0 (3) (3-8) 4.3 (78) (2-9) 7.5 (29) (2-21) 4.0 (2) (2-6) March 5.0 (3) (3-7) 4.9 (82) (3-9) 4.0 (18) (2-7) 4.3 (61) (2-9) 6.5 (19) (2-16) 7.5 (15) (2-21) April 6.5 (4) (4-9) 4.8 (80) (3-9) 4.2 (40) (2-9) 4.1 (40) (2-7) 6.2 (23) (2-13) 8.5 (10) (2-21) May 4.5 (76) (2-9) 5.5 (15) (3-9) 4.3 (31) (2-9) 4.1 (47) (2-8) NA NA Visits August September 176 (MA) mean age, (n) number, (R) range, NA not applicable. Table 6. 10. The effect of age on the excretion of Listeria spp. and Listeria monocytogenes. N MA (years) Range +ve 32 7.5 2-14 -ve 92 5 3-9 L. monocytogenes +ve 34 7.5 2-14 -ve 90 4.9 3-9 +ve 14 7.1 2-13 -ve 96 4.8 2-12 L. monocytogenes +ve 22 7.5 2-13 -ve 88 4.4 2-11 +ve 13 7.9 2-15 -ve 28 7.1 2-21 L. monocytogenes +ve 24 7.5 2-16 -ve 17 6 2-21 P Value Farm A Listeria spp. <0.001 <0.001 Farm B* Listeria spp. <0.001 <0.001 Farm C* Listeria spp. N number of animals, * excluding those whose age was not known, MA median age, significant. 0.3a 0.4a a statistically not b) Environmental samples: Listeria were detected in the environmental samples and milk (Table 6. 11). L. innocua was isolated from the soil on two occasions but no isolate of L. monocytogenes was obtained from soil. L. monocytogenes and L. innocua were isolated from water, bedding, grass, grass silage, maize silage and from the bulk milk tank. L. seeligeri was also isolated from maize silage on one occasion. L. monocytogenes and L. innocua were isolated from the grazing field even during the period when animals were housed. In February, March and April the environment was highly contaminated with L. monocytogenes. This also coincided with the highest frequency of excretion in faeces. 177 Table 6. 11. Isolation of Listeria spp. from the environment on Farm A. Months Samples A S O N D J F M A M Soil 0 0 0 0 Li 0 Li 0 0 0 Grass 0 0 Lm Lm Li 0 Lm 0 Lm Lm Water 0 0 Lm Li Lm Lm Lm Lm Lm 0 Milk 0 0 0 0 0 Li Li Lm Lm ND G. Silage NF NF Li 0 Li Li Lm Lm Lm NF M. Silage NF NF NF NF NF Lm Lm Ls Lm NF Bedding NH NH NH Lm Lm Li Lm Lm Lm NH Lm L. monocytogenes, Li L. innocua, Ls L. seeligeri, ND not done, NF not fed, NH not housed. Farm B: a) Faecal samples: A total of 111 animals were examined throughout the study period. 79.3% (88/111) of the animals excreted L. monocytogenes, 7.2% (8/111) other Listeria spp. and the rest did not shed Listeria (14.4%, 15/111) during their participation in the study. Only 54.1% (60/111) of the milking cows were examined at all visits. When only these animals were taken into account, the proportion of animals shedding L. monocytogenes was 98.3% (59/60). The remaining animal shed another species of Listeria. The monthly proportion of animals shedding Listeria spp. varied from 11.4 % in September to 96.3% in January. A higher proportion of animals were shedding Listeria organisms in their faeces between October and May with a peak of 96.3% in January and February. For L. monocytogenes and L. innocua there was a fluctuating rise. The highest proportion of animals excreting L. monocytogenes and L. innocua was in February (81.8%) and March (62.5%) respectively. The proportion decreased thereafter (Figure 6. 3). There was statistically a significant difference between the monthly 178 frequency of excretion (P<0.001) (Table 6. 7). L seeligeri was also isolated from some animals during the survey. Figure 6. 3. The monthly faecal excretion of Listeria spp. and L. monocytogenes on Farm B. % 100 90 L.spp Lm Li Ls 80 70 60 50 40 30 20 10 0 A S O N D J F M A M Grass silage was fed to the animals all year around. In October there was an increase in the proportion of animals shedding Listeria spp. in their faeces 50.5% (48/95). The cows were not housed at this time and although maize silage was introduced in October it was only introduced five days after the visit. The proportion of animals shedding L. monocytogenes remained low and the increase in faecal excretion was associated with L. innocua in October. The proportion of animals shedding L. innocua also remained high until the end of the study. In November the proportion of animals shedding Listeria spp. showed a further rise. This was associated with an increase in the proportion of cows shedding L monocytogenes from 2.1% (2/95) to 50% (39/78). At this time the cows had been fed maize silage for a month but had only been 179 housed for 5 days. The proportion of animals shedding Listeria spp. fell in December and this was mainly due to the decline in cows shedding L. monocytogenes. It rose again in January associated with an increase in the proportion of animals shedding L. monocytogenes. The latter reached a peak in February and fell to low level in March This fall preceded the end of winter housing. Maize silage continued beyond the end of the study. The effect of age on excretion was similar to the Farm A (Table 6. 9). The mean age of cows that were excreting Listeria spp. was lower than non-excretors (Table 6. 10). b) Environmental samples: Both L. innocua and L. monocytogenes were isolated from all environmental samples and milk. L. monocytogenes was isolated from one environmental sample each month with the exception of October. In February L monocytogenes was detected in all the environmental samples except grass silage and milk. This was also the time when the highest proportion of animals were excreting L. monocytogenes (Table 6. 12). Table 6. 12. Isolation of Listeria spp. from the environment on Farm B. VISITS Samples A S O N D J F M A M Soil 0 0 0 0 Li 0 Lm Li Lm Lm Grass 0 Lm 0 Li Li 0 Lm Li 0 Lm Water 0 Lm Li 0 Lm Li Lm Li 0 Li Milk Lm Li 0 0 0 0 0 0 0 0 G. Silage 0 Lm Li Li Li Li Li Li Li ND M. Silage NF NF NF Li 0 Lm Lm Lm Lm ND Bedding NH NH Li Lm Li Lm Lm Li Lm NH Lm L. monocytogenes, Li L. innocua, Ls L. seeligeri, ND not done, NF not fed, NH not housed. 180 There was no evidence from this farm that grass silage feeding alone was associated with a high frequency of faecal shedding of Listeria. Grass silage was fed all year round and in October L. monocytogenes was isolated from it at a time when the proportion of animals shedding this organism was low. There was a dramatic increase in the proportion of animals shedding L. monocytogenes in November but it was difficult to attribute this to any one management factor as both the introduction of maize silage feeding and housing had occurred. L. monocytogenes was only isolated from bedding at the November visit. The peak prevalence of L. monocytogenes excretion in February corresponded with the highest frequency of recovery from food and environmental samples This was also the case for L. innocua in March. The proportion of animals shedding L. monocytogenes declined in March at a time when maize silage from which L. monocytogenes had been isolated was still being fed. This continued to be the case in April. L. monocytogenes was isolated from the liver of an aborted foetus in January on this farm. Farm C: a) Faecal samples: 67 milking cows were examined. 37.3% (25/67) of them shed L. monocytogenes, 25.4% (17/67) L. innocua and 6.0% (4/67) L. seeligeri. Listeria spp. were not isolated from the remainder (31.3%, 21/67) during their stay in the herd. When the animals that left or entered the herd during the study were excluded only 41 (61.2%) animals were consistently tested. Of these 46.3% (19/41) shed L. monocytogenes, 181 24.4% (10/41) L. innocua and 9.7% (4/41) L. seeligeri. No Listeria were isolated from the remaining 24.4% (10/41). The proportion of animals shedding Listeria spp. and L. monocytogenes varied between 1.9% to 52.8% and 0 to 33.3% respectively. The highest proportion of cows excreting Listeria spp. and L. monocytogenes was in November and March respectively (Figure 6. 4). Grass silage was introduced 13 days before the October visit but the proportion of animals shedding Listeria spp. remained low. The cattle were housed 26 days before the November visit and by this time the proportion of animals shedding Listeria spp. had increased to 52.8% (28/53). However the proportion of animals shedding L. monocytogenes remained low throughout the winter months. (Table 6. 1). The proportion of animals excreting L. monocytogenes in March was significantly higher (P<0.001) than those obtained in the other months (Table 6. 7). In contrast, the proportion of animals shedding other Listeria spp. was higher during the winter months. The proportion of animals excreting Listeria spp. and L. monocytogenes during the winter housing period (November and April) was significantly higher than that observed either before or after housing. (P<0.001). Housing and silage feeding ended in April, 6 days after the visit. The proportion of animals shedding Listeria spp. was still high at this time but this was mainly because of the high proportion of L. innocua (Table 6. 8). Information on age was available for 41 animals. The mean herd age was 7.4 years (range 2-21) (Table 6. 9). Listeria were isolated more frequently from younger animals but this difference was not significant (Table 6. 10). 182 b) Environmental samples: Both L. innocua and L. monocytogenes were isolated from environmental samples but not from milk. L. monocytogenes and L. innocua were also isolated from grass and soil during the period when animals were housed (Table 6. 13). Figure 6. 4. The monthly faecal excretion of Listeria spp. and L. monocytogenes on Farm C. % 100 90 80 L.spp Lm Li Ls 70 60 50 40 30 20 10 0 A S O N D J F M A M Table 6. 13. Isolation of Listeria spp. from the environment on Farm C. VISITS Samples A S O N D J F M A M 0 0 0 Li Lm 0 0 Li 0 0 Grass Lm 0 0 Li Li 0 Lm 0 0 0 Water 0 0 0 0 Li 0 Lm 0 0 Lm Milk 0 0 0 0 0 0 0 0 0 0 Grass silage NF NF 0 Lm Lm Li Li Li 0 NF Bedding NH NH NH Li Lm 0 Lm Li Li NH Soil Lm L. monocytogenes, Li L. innocua, Ls L. seeligeri, ND not done, NF not fed, NH not housed. Farm D: 183 a) Faecal samples: A total of 202 milking cows were examined on this farm. Of these 28.2% (57/202) shed L. monocytogenes, 18.3 (37/202) L. innocua, 1.5% (3) L. seeligeri and 52% (105/202) no Listeria spp. During the period of the study only 29.2% (59/202) milking cows were consistently sampled at each visit. The rest (70.2%, 143/202) were either removed from or included in the milking herd during the survey, therefore were sampled less frequently (Table 6. 5). Of these 59 animals, 40.7% shed L. monocytogenes (24/59) 20.3% L innocua (12/59), 3.4% L. seeligeri (2/59) and the rest (35.6% 21/59) did not excrete any species of Listeria. When the frequency of excretion was estimated for each month the lowest rates were observed between November and February inclusive, around 1% of animals shed Listeria spp. and L. monocytogenes (Figure 6. 5). The highest proportion of animals excreting Listeria spp. and L. monocytogenes were detected in March (43.3%, 52/120) and October (21.4%, 27/126) respectively. These figures were significantly higher than those obtained in other months (P<0.001) (Table 6. 7). The proportion of animals excreting Listeria spp. increased sequentially during the first 3 months and this was mainly due to an increase in L. monocytogenes. No silage was being fed at this time. In November the proportion of animals excreting Listeria spp. declined to 0.8% (1/128) in spite of the fact that grass silage from which L. monocytogenes had been isolated had been introduced 5 days before the visit. The cows were housed in November, 9 days after sample collection but the proportion of animals shedding Listeria spp. was low in December and remained so until March. In March there was a significant increase in the proportion of cattle shedding Listeria spp. with approximately equal proportions of L. innocua and L. 184 monocytogenes. By April the proportion of cows excreting L. monocytogenes had fallen whereas the proportion excreting L. innocua was similar to that seen in March. Grass silage feeding ended 20 days before the April sampling and winter housing also ended 9 days before this visit (Table 6. 8). This farm had bought in silage three weeks before the 8th visit (17/3/1997). b) Environmental samples: Listeria was not isolated from soil but L. innocua was isolated from water, grass and bedding and L. monocytogenes was also isolated from grass, silage, bedding and milk. Milk samples collected between October and March were persistently positive for L. monocytogenes. L. seeligeri was isolated from bedding materials on one occasion. (Table 6. 14). Concentrate bulk feed stored in a shed was sampled on one occasion and L. monocytogenes was isolated from it. Figure 6. 5. The monthly faecal excretion of Listeria spp. and L. monocytogenes on Farm D. 185 % 100 90 L.spp Lm Li Ls 80 70 60 50 40 30 20 10 0 A S O N D J F M A M Table 6. 14. Isolation of Listeria spp. from the environment on Farm D. Visits Samples A S O N D J F M A M Soil 0 0 0 0 0 0 0 0 0 0 Grass 0 0 Lm Lm 0 0 0 0 0 Li Water Li 0 0 0 0 0 0 0 0 0 Milk 0 0 Lm Lm Lm Lm Lm Lm 0 0 Grass silage NF Lm 0 Lm 0 0 0 Lm NF NF Bedding NH NH NH NH 0 Lm 0 Li Ls NH Lm L. monocytogenes, Li L. innocua, Ls L. seeligeri, ND not done, NF not fed, NH not housed. Farm E: a) Faecal samples: 186 A total of 211 milking cows were examined. 10.9% (23/211) of the animals did not excrete any species of Listeria, 73.9% (156/211) shed L. monocytogenes, 12.8% (27/211) L. innocua and 2.4% (5/211) L. seeligeri during their participation in the study. When the animals examined at all visits were taken into account only 37 animals were tested, the rest either left or entered the study or not tested at some visits. Of these 37, L. monocytogenes was excreted by 35 milking cows and 2 animals shed L. innocua. There was difference in the frequency of excretion each month. The frequency of excretion of Listeria spp. and L. monocytogenes varied from 5% in September to 95.6% in November (P<0.001) (Table 6. 7). The highest frequencies of excretion for L. monocytogenes and Listeria spp. were seen between November and March with a peak in December, of 66.5% and 93.5% respectively (Figure 6. 6). Less than 15% of animals shed Listeria between August and October in spite of the fact that the herd was fed silage all year round. The herd was housed in October and maize silage feeding was introduced but this occurred 13 days after the sampling visit. There was a dramatic rise in the proportion of animals shedding Listeria spp. in November to 86.2%. 33.8% of cows were shedding L. monocytogenes at this time. This visit was made, 28 days after the start of housing and maize silage feeding. The proportion of animals shedding L. monocytogenes reached a peak of 66.9% in December and declined thereafter to 8.2% in April. This pattern was not seen in the case of L. innocua. The proportions fluctuated between 25-50% between December and March and fell to 20% in April. Maize silage feeding and housing ended in March 10 days after the visit and 30 days before the April visit. When the proportions of animals that excreted Listeria before (23.7%, 42/177), during (92.1%, 175/190) and after (27.8%, 44/158) housing and maize silage feeding were compared there was statistically significant difference (P<0.001). The proportion 187 was higher during these practices. Similar results were found for L. monocytogenes (Table 6. 8). b) Environmental samples: L. innocua was isolated from all environmental samples including milk on one occasion but not from maize silage. L. seeligeri was isolated from soil, grass and on one occasion from maize silage. L. monocytogenes was isolated from soil, grass, water, grass silage, maize silage and bedding but not from milk. In December when the highest frequency of excretion was seen, only L. monocytogenes was isolated from environmental samples (water, grass silage, maize silage and bedding) (Table 6. 15). Concentrate bulk feed stored in a shed was also sampled once and L. monocytogenes was isolated. Figure 6. 6. The monthly faecal excretion of Listeria spp. and L. monocytogenes on Farm E. 188 % 100 90 L.spp Lm Li Ls 80 70 60 50 40 30 20 10 0 A S O N D J F M A Table 6. 15. Isolation of Listeria spp. from the environment on Farm E. Visits Samples A S O N D J F M M Soil 0 0 Li Ls 0 Ls Lm 0 0 Grass 0 0 Li Li 0 Li Ls Li Lm Water 0 0 0 Lm Lm Li Lm Li Li Milk 0 0 0 0 0 0 0 Li 0 Grass silage 0 0 Lm Lm Lm Li 0 0 Lm NF NF NF Ls Lm 0 Lm 0 NF NH NH NH Lm Lm Lm Lm Li Lm Maize silage Bedding Lm L. monocytogenes, Li L. innocua, Ls L. seeligeri, ND not done, NF not fed, NH not housed. Overall: 189 The overall proportion of animals excreting Listeria spp. and L. monocytogenes varied between the farms. The overall proportion of animals excreting Listeria spp. was significantly higher on farm A, (74.2%, 92/124), B (86.5%, 96/111) and E (89.1%, 188/211) than on farm C (68.7%, 46/67) and D (48%, 97/202) (P<0.001). Similarly the proportion of animals excreting L. monocytogenes was higher on the farm A (72.5%, 90/124), B (79.3%, 88/111) and E (73.9%, 156/211) than on farm C (37.3%, 25/67) and D (28.2%, 57/202) (P<0.001). Monthly prevalence When the results were evaluated monthly for each farm there were two distinct patterns of excretion. The monthly prevalence of faecal shedding on farms A, B and E, were similar with the majority of the herd excreting Listeria spp. during the winter months. This was different to farms C and D where only a small proportion of the herd excreted Listeria spp. during this period.(Table 6. 16 ). On farms A, B and E there was little evidence that the increase in prevalence of faecal shedding was associated with grass silage feeding. There appeared to be an association with housing and maize silage feeding on these farms and closer examination of the results suggested that for L. monocytogenes this association was with maize silage feeding rather than housing. This was evident on Farm A where housing in November was associated with an increase in Listeria excretion which was mainly species other than L. monocytogenes. In contrast the introduction of maize silage in January was associated with an increase in the proportion of animals shedding L. monocytogenes. Farms C and D did not feed maize silage and the monthly prevalence of infection was much lower on these farms. Incidence rate: 190 The number of new cases each month and the monthly incidence rate (i.e. the number of new cases per 100 animal-months at risk) were calculated separately for each farm (Table 6. 16 and Figure 6. 7). On Farm A there was a gradual increase in incidence rate until all animals had become infected. The maximum number of cases in any month occurred in January. On Farm B there were two peaks; for the incidence rate these occurred in November and February and for the number of new cases November and January. On Farm E there was a peak in the incidence rate and number of new cases in December. On Farm C the incidence rate showed a small peak in March. The number of new cases was small with a slight increase in September and highest in March. On Farm D the incidence rate showed peaks in October and March and the number of new cases follows a similar pattern. When compared with management variables the data provide further support for the association between maize silage feeding and faecal shedding seen using the prevalence data. The introduction of maize silage in October on Farms B and E is associated with rapid rise in the number of faecal shedders and incidence rate. On farm A where maize silage was introduced in January the epidemic curve is less steep between housing and the introduction of maize silage Table 6. 16. Incidence rate of L. monocytogenes infection by month. Farm A (%) Farm B (%) Farm C (%) Farm D (%) Visit Farm E (%) 191 August 5/111 (4.5) 7/90 (7.8) 1/58 (1.7) 0/126 (0) 11/141 (7.8) September 1/105 (1) 7/89 (7.9) 4/57 (7) 9/124 (7.3) 3/129 (2.3) October 3/104 (2.9) 1/82 (1.2) 0/52 (0) 26/118 (22) 6/141 (4.2) November 10/75 (13.3) 33/65 (50.8) 1/48 (2.1) 0/99 (0) 44/128 (34.3) December 16/65 (24.6) 2/37 (5.4) 1/51 (1.9) 1/96 (1) 58/87 (66.7) January 33/49 (67.3) 20/36 (55.6) 1/49 (2) 0/110 (0) 15/28 (53.6) February 18/22 (81.8) 13/18 (72.2) 0/45 (0) 0/107 (0) 8/29 (27.5) March 2/3 (66.7) 0/8 (0) 16/46 (34.8) 19/97 (19.6) 5/37 (13.5) April 1/1 (100) 2/10 (20) 0/31 (0) 2/70 (2.9) 5/40 (12.5) May 1/7 (14.3) 2/7 (28.6) 0/31 (0) 0/65 (0) ND ND= not done Figure 6. 7. Monthly incidence rate of L. monocytogenes infection. % 100 Farm A 90 Farm B Farm C 80 Farm D 70 Farm E 60 50 40 30 20 10 0 A S O N D J F M A M Environment: Listeria spp. were isolated from the samples of soil, grass, water, grass silage, maize silage and bedding on all farms with the exception of soil on farm D. L. 192 monocytogenes was also isolated from these samples with the exception of soil on farms A and D and water on farm D. Listeria spp. were isolated from bulk milk tank on 4 of the 5 farms and L. monocytogenes was isolated from 3 farms (Farm A, B and D). L. monocytogenes was persistently isolated from the bulk milk tank between October and March on farm D. 6. 3. 2. Serology The results of ELISA assays for each farm are presented in the appendix 6. There were only few animals that were seronegative at the beginning of the study. 0.9% (1/109), 1% (1/96) and 1.6% (2/122) of animals were seronegative on farms A, B and D respectively. There were no seronegative animals on farms C and E. The number of animals that had increased or decreased level of antibodies to L. monocytogenes is presented in the table 6. 17. A significant number of animals had increased antibodies on the farm A after the first and second sampling and only few animals were found to have increased or decreased antibodies on the other farms (Table 6.17). Table 6. 17. Antibody changes during the period of the study difference collections between Farm A Farm B Farm C Farm D Farm E first and second 32.9% (27/82) i 1.4% (1/71)d 3.8% (2/53)d 9.1% (7/77)d 1.1% (1/87)i second and third 30.8% (24/78)i 1.4% (1/72)i 15.4% (8/52)d 5.2% (5/97)i 1.5% (1/65)d first and third 42.8% (33/77)i 1.5% (1/67)i 9.4% (5/53)d 1.6 (1/64)d 2.2% (2/93)d i number of animals that had increased antibodies, d number of animals that had decreased antibodies 6. 3. 3. RAPD: 193 Repeatability of RAPD was evaluated by repeating the procedure on two separate occasions. L. monocytogenes (2 strains) and L. innocua (1 strain) were used. As it is shown in the Figure 6. 8 the same results were obtained on both occasions. The ability of RAPD to differentiate between different species was also evaluated. For this 2 isolates of L. monocytogenes and an isolate of L. innocua were tested. The result indicated that the two species were distinct from each other (Figure 6. 8). The results obtained with all primers used in this study were the same, therefore only the results obtained with the primer 5 are presented here (Figure 6. 9). 194 Table 6. 18 The isolates, their origin and their RAPD patterns with the primer 5. Farm A Water Grass 1 Maize silage Milk Grass silage visit* 3 4 6 9 9 RAPD 1 2 3 4 4 Silage 1 Soil Water 1 Silage 2 Bedding water 2 4 5 5 5 7 10 1 1 8 1 9 5 2 3 4 5 6 7 Animal 1 Animal 2 Animal 3 Animal 4 Animal 5 Animal 6 Animal 7 Animal 8 Animal 1 Animal 11 Animal 12 Animal 13 1 1 2 3 3 3 7 7 7 7 7 7 5 5 1 2 5 1 5 3 1 5 6 6 Animal 1 Animal 1 Animal 2 Animal 3 Animal 4 Animal 5 2 3 8 8 8 8 1 1 1 1 1 2 8 9 10 11 12 13 Farm B Milk Grass silage Grass 1 Soil 1 Grass 2 Bedding 1 Water Maize silage Bedding 2 Soil 2 1 2 2 7 7 7 7 9 9 9 1 6 5 1 5 5 7 1 6 5 Animal 1 Animal 2 Animal 3 Animal 4 Animal 5 Animal 6 Animal 7 Animal 8 Animal 9 Animal 10 Animal 11 Animal 12 Animal 13 Animal 14 1 1 1 1 1 1 2 3 3 3 7 7 7 7 6 1 1 1 6 6 6 2 6 5 1 5 1 1 2 4 3 4 4 4 8 8 9 7 2 2 2 2 2 2 2 2 3 3 3 5 7 9 9 9 8 8 8 8 8 8 5 6 5 6 5 6 5 5 5 5 2 1 1 2 1 5 2 10 10 10 10 5 11 5 6 2 1 1 1 1 6 1 Lane# 2 3 4 5 6 7 8 9 10 11 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 visit* RAPD visit* RAPD Farm C Farm D Silage 1 Grass Milk 1 Feed Milk 2 Silage 2 Milk 3 Silage 3 Milk 4 Milk 5 Animal 1 Animal 2 Animal 3 Animal 4 Animal 5 Animal 6 Animal 7 Animal 8 Animal 9 Animal 10 Animal 11 Animal 12 Animal 12 Animal 13 Animal 14 Animal 15 Animal 16 Animal 17 Animal 18 Animal 19 Animal 20 Animal 21 Lane @ Farm E 195 Bedding 1 Water 1 Feed Maize silage Water 2 Bedding 2 Bedding 3 Water 3 Grass silage 4 4 5 5 5 6 6 7 9 6 6 1 1 1 6 7 1 1 Animal 1 Animal 2 Animal 3 Animal 4 1 1 1 1 7 7 7 12 Farm E Animal 5 Animal 6 Animal 7 Animal 8 Animal 9 Animal 10 Animal 11 Animal 12 Animal 13 Animal 14 Animal 15 Animal 16 Animal 17 Animal 18 Animal 19 visit* 1 1 1 1 2 2 3 3 3 3 5 5 5 5 5 RAPD 5 7 7 7 12 7 1 1 7 7 6 5 5 1 5 * visit on which isolate was made from the environment and faeces, @Figure 6. 11, #Figure 6. 12a and 12b. A total of 113 isolates of L. monocytogenes (40 environmental and 73 faecal isolates) were examined (Table 6. 18). 12 distinct patterns were obtained. 9 different patterns were detected in environmental isolates and 9 in faecal isolates. 6 patterns were common to both. Patterns 1, 5, 6 and 7 were sequentially the most commonly identified in both samples (Table 6. 19). Patterns 10, 11 and 12 were not detected in environmental isolates and patterns 4, 8 and 9 were not detected in faecal isolates. On farms, a maximum 4 environmental patterns and 6 faecal patterns were identified. Pattern 1 was the most common in environmental (30%) and faecal isolates (34%). It shared this proportion with pattern 5 in environmental samples (30%). There were differences between the farms. Pattern 1 was most frequent on farms C and D. The predominant patterns on farms A, B and E were different. On farm A pattern 5 was most common, on farm B pattern 6 and 1 were present in similar proportions and on farm E pattern 7 was predominant (Table 6. 19). 196 Table 6. 19. The distribution of the RAPD patterns by their origin and the farms. RAPD patterns Farm A Farm B Farm C Farm D Farm E Total O N 1 2 3 4 5 6 7 8 9 10 11 12 E 5 1 1 1 2 0 0 0 0 0 0 0 0 A 12 3 1 1 0 5 2 0 0 0 0 0 0 E 10 3 0 0 0 4 2 1 0 0 0 0 0 A 14 6 1 0 0 2 5 0 0 0 0 0 0 E 6 3 0 0 0 1 0 0 1 1 0 0 0 A 6 5 1 0 0 0 0 0 0 0 0 0 0 E 10 0 0 0 0 7 3 0 0 0 0 0 0 A 22 8 4 0 3 2 0 0 0 0 4 1 0 E 9 5 0 0 0 0 3 1 0 0 0 0 0 A 19 3 0 0 0 4 1 9 0 0 0 0 2 E 40 12 (30) 1 (2.5) 1 (2.5) 2 (5) 12 (30) 8 (20) 2 (5) 1 (2.5) 1 (2.5) 0 0 0 A 73 25 (34) 7 (9.6) 1 (1.4) 0 14 (19) 10 (14) 9 (12.3) 0 0 4 (5.5) 1 (1.4) 2 (2.8) 113 37 (33) 8 (7) 2 (1.8) 2 (1.8) 26 (23) 18 (16) 11 (9.7) 1 (0.9) 1 (0.9) 4 (3.6) 1 (0.9) 2 (3.9) O origin, N number of isolates examined, E environment, A animals (faecal isolates), ( ) proportions. 197 All environmental samples were examined in order to compare the RAPD patterns with those found in faecal isolates. A comparison of environmental and faecal isolates obtained at the first three visits and the visit when the highest prevalence of infection observed is given in the table 6. 20. Table 6. 20. Comparison of environmental and animals isolates obtained at different visits. RAPD patterns obtained at first three visits environment animal peak prevalence environment animal Farm A 1, 2 12, 2, 53 3, 4 1, 3, 52, 62 Farm B 1, 5, 6 13, 2, 5, 65 12, 53, 6, 7 13, 5 Farm C 1 12 12, 5, 8, 9 13, 2 Farm D 53 ,63 13, 23,5,104 54 15, 2, 5, 62, 11 Farm E 62 12, 5, 79, 122 14, 6, 7 1, 53, 6 number refers to the pattern, superscript number refers to the number of times a pattern was detected. Examination of these isolates failed to reveal any obvious relationship between environmental and faecal isolates or between faecal isolates present before or at housing and those at peak excretion (Table 6. 20). On farm A patterns 1 and 2 were present in animals and the environment at the first three visits (before housing) and pattern 5 was also present in animals. At the highest prevalence of infection patterns 1 and 5 were still present in faecal isolates, 2 was not detected and the patterns 3 and 6 had appeared. Patterns 1 and 2 were no longer present, but 3 and 4 were detected. On farm B patterns 1, 5, 6 were present in the environment and faeces prior to housing and pattern 2 was also detected in faecal isolates. At the highest prevalence of infection patterns 1 and 5 were still present in faecal isolates, 1, 5 and 6 were still present in the environment and pattern 7 was also detected in the environment. 198 On farm C pattern 1 was detected in the faecal and environmental isolates before housing. This pattern was still common at the highest prevalence of infection but pattern 2 in faeces had appeared. In addition to pattern 1, patterns 5, 8 and 9 were also detected in the environment. On farm D pattern 5 was identified in animals and the environment prior to housing. Pattern 6 was also detected in the environment, and patterns 1, 2 and 10 in faeces. At the highest prevalence of infection, patterns 1, 2, 5 and 6 were detected in faeces along with pattern 11. Pattern 5 was the only one detected in the environment. On farm E, there was no common pattern in the environment and faeces prior to housing. Pattern 6 in the environment and pattern 1, 5, 7 and 12 in faeces. At the peak prevalence of infection, patterns 1 and 5 were still present in animals and pattern 6 had also appeared. Pattern 6 was still present in the environment and patterns 1 and 7 were also detected. Repeat faecal and environmental isolates obtained from the farms were also evaluated. On farm A, repeat isolates from the same animal (animal 1) on 2 different visits, 6 visits apart (visit 1 and 7), had different patterns (pattern 5 and 1 respectively). 8 isolates obtained from two persistently L. monocytogenes positive animals (4 isolates from each) were tested in an attempt to determine if the animals were excreting the same strains. One animal had the same pattern but the second animal had 3 different patterns (Figure 6. 10). On farm B, 2 isolates from grass (visits 2 and 7) had the same pattern, pattern 5, whereas 2 soil isolates (visit 7 and 9) and 2 isolates from bedding (visit 7 and 9) had different patterns (1 and 5 and 5 and 6 respectively). On farm C, repeat isolates from the same animal on consecutive visits (visits 2 and 3) had the same pattern, pattern 1. 2 isolates from silage (visits 4 and 5) also had the 199 same pattern, pattern 1, while 2 isolates from water (visits 5 and 10) had different patterns, patterns 8 and 9 respectively (Figure 6. 11). On farm D, 2 different patterns were obtained from the repeat isolates from silage (visits 2, 4 and 8), pattern 5 in silage collected at visits 2 and 8 and pattern 6 in silage collected at visit 4. Repeat isolates from the same animal (animal 12) on 2 different visits, 2 visits apart (visits 5 and 7), had two different patterns, patterns 5 and 11 respectively. (Figure 12a and 12b). On the farm E, 2 different patterns were detected in repeat isolates from water, pattern 6 in the isolate from water collected at visit 4 and pattern 1 in isolates from water collected at visits 5 and 7. The pattern 6 was detected in bedding collected at visits 4 and 6 and pattern 7 in bedding collected at visit 7. L. monocytogenes was isolated from milk on 3 farms (A, B and D). Three different patterns were obtained from the milk samples, pattern 4 was in milk samples collected from farm A, pattern 1 in milk from farm B. On farm D the same pattern (pattern 5) was detected in all of the isolates from milk samples examined. This pattern was also detected in 2 of the 5 environmental samples and only 3 of the 22 faecal samples. 200 Figure 6. 8. The repeatability of RAPD and discrimination of different species of Listeria Lane 1; λ DNA Marker Lane 3; L. monocytogenes 1, 4; L. monocytogenes 2, 5; L. innocua, 8; L. monocytogenes 1, 9; L. monocytogenes 2, 10; L. innocua, (universal primer) 201 Figure 6. 9. The discrimination of isolates of L. monocytogenes with different primers Lane 1; λ DNA Marker, Lane 2; Lm1, 4; Lm3, 5; Lm4, 6; Lm5 and 7; Lm6 (primer 2). Lane 8; Lm1, 9: Lm2, 10; Lm3, 11; Lm4, 12; Lm5 and 13; Lm6 (primer 3). Lane 14; Lm1, 15; Lm2, 16; Lm3, 17; Lm4 and 18; Lm5 (primer 5). 202 Figure 6. 10. The distribution of strains in two persistently infected animals on farm A (primer 3). Lane 4 and 8; λ DNA Marker, Lane 1; animal 1(visit 5), 2; animal 1 (visit 6), 3; animal 1 (visit 8), 5; animal 1 (visit 9), 6; animal 2 (visit 4), 7; animal 2 (visit 6), 9; animal 2 (visit 7), 10; animal 2 (visit 8) and 11; animal 2 (visit 9). 203 Figure 6. 11. The RAPD pattern obtained from environmental and faecal isolates on farm C (primer 5). Lane 1; λ DNA Marker, Lane 2, 3, 4, 5, 6 and 7; L. monocytogenes from silage1, soil, water1, silage2, bedding and water2 respectively and Lane 8, 9, 10, 11, 12 and 13; L. monocytogenes from animal 1, 1, 2, 3, 4 and 5 (Table 6. 18). 204 Figure 6. 12a. The RAPD pattern obtained from the environmental isolates on farm D (primer 5). Lane 1; λ DNA Marker, Lane 2, 4, 5, 6, 7, 8, 9, 10 and 11; L. monocytogenes isolates from silage1, grass, milk1, feed, milk2, silage2, milk3, silage3, milk4, milk5 respectively (Table 6. 18). 205 Figure 6. 12b. The RAPD patterns obtained from faecal isolates on farm D (primer 5) Lane 1; λ DNA Marker, Lane 2, 4, 5, 6 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, and 23; L. monocytogenes isolates from animals 1,2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 12, 13, 14, 15, 16, 17, 18, 19, 20 and 21 respectively (Table 6. 18). 6. 4. Discussion: The aims of this study were to investigate the dynamics of L. monocytogenes infection in dairy cattle and the distribution of the strains of the organism present in the environment and in faecal samples. These were achieved by conducting a longitudinal study of five dairy farms in Northwest of England. Five farms were chosen because this was the maximum number that could be studied within the constraints of the project. Listeria are widespread in the environment and have been isolated from a variety of animal species and people (Gray and Killinger 1966). Faecal excretion of Listeria spp. and L. monocytogenes has been studied in dairy cattle and differences in the frequency of excretion have been reported between studies and between farms. Reports vary from a small proportion to 67% for Listeria spp. in different studies (Kampelmacher and van Noorle Jansen 1969, Ralovich 1987, Skovgaar and Morgen 206 1988, Husu 1990) and from zero to all animals on different farms (Skovgaar and Morgen 1988, Husu 1990). The use of different culture techniques and media has been suggested as a reason for these different frequencies (Husu 1990) and the difference between the farms has been attributed to different feeding practices (Skovgaar and Morgen 1988, Husu 1990). In this study too, there were differences between the farms in the proportion of animals positive for Listeria spp. and L. monocytogenes. It varied from 48% of cows on farm D to 89.1% on farm E for Listeria spp. and from 28.2% of cows on farm D to 79.3% on farm B for L. monocytogenes. Similarly differences in the monthly frequency of excretion were also observed between the farms in this study. The monthly frequency of excretion reported here showed a seasonal pattern but there were two distinct patterns of excretion. The first pattern seen on farms A, B and E was characterised by the high frequency of excretion between October and May. This was similar to the pattern observed in our pilot study (Chapter 5). This seasonality is also similar to that reported for clinical listeriosis (Chapter 2). A similar seasonality of excretion of Listeria spp. and L. monocytogenes in faeces was also reported by Husu (1990). However the frequency of excretion reported in our study was much higher than those observed by Husu (1990), where the excretion rates for L. monocytogenes were 0.9 % (3.5% for Listeria spp.) in September and 16.1% in December (19.4% for Listeria spp.). In contrast to the first group of the farms, the excretion rates on farms C and D were lower especially between October and April. The use of different culture techniques would not explain the differences seen between the farms in this study because the same culture technique was used throughout the study. There are a number of possible explanations for these differences between farms. They may be related to the strains of organism, the systems of husbandry or the proportion of susceptible animals. The difference in frequency of excretion may also be explained by the absence of some 207 of the factors required to initiate or sustain an epidemic on some farms in this study. The presence of the infectious agent in a sufficient quantity and sufficient proportion of susceptible animals with close contact are major requirements for an epidemic to occur (Thrusfield 1995). On the farms studied the farming practices were similar but there were some important differences. Grass silage was fed all year round on two farms (farms B and E) and seasonally on the others (farms A, C and D). Maize silage was not fed on 2 farms (farm C and D) and the start and finish dates of maize silage feeding were also different on farms A, B and E. Farm D was a flying herd i.e. there was no internal breeding of replacement cows. Cows were bought in, milked and then sold at the end of lactation. Farm E was also an open herd but this farm bought in only 10% of their replacement heifers and the movement of animals in and out of the herd was more restricted and controlled. Farm C had the smallest number of animals in their herd. The frequency of isolation of Listeria organisms from the faeces has been associated with the prevalence of the organism in feed (Husu 1990). In this study no measure was made of the number of organisms in the feed but the major difference between the farms with a high and low monthly prevalence of L. monocytogenes excretion was in the feeding of maize silage. The farms with a low monthly prevalence of excretion did not feed maize silage. Maize silage feeding was also identified as a risk factor for clinical Listeriosis in the questionnaire survey and this provides supporting evidence for the role of this factor in Listeria infection. The exact manner in which maize silage may have played a role in the excretion of the organism is not known. It may have had a direct effect either because of the numbers of Listeria organisms it contained or because of alterations in the gut flora of the cow which may have initiated faecal shedding of L. monocytogenes. It may have contributed indirectly by a build up of L. monocytogenes in the environment. It has 208 experimentally been shown that there is a relationship between the excretion of the organism in faeces and infectious dose. Lhopital and colleagues (1993) reported that sheep challenged orally with 6x106 did not excrete the organism in any samples examined (blood, buccal and nasal swabs and faeces) but those challenged with 6x1010 shed the organism in the samples, including faeces. Although this could not be proved in our study, the inclusion of maize silage in the diet may have increased the quantity of Listeria organisms in the diet, as the organism was isolated more frequently from maize silage than grass silage on farms A, B and E. An alternative explanation may be that the strains of L. monocytogenes obtained from maize silage were responsible for the epidemics. However, when the strains obtained from maize silage were compared with those detected in animals at the highest peak of infection it was difficult to support this. The strains detected in maize silage were not predominant in faecal isolates obtained at the peak prevalence of infection on farms A and E and the strain detected in maize silage and animals on farm B were also predominant in the isolates from faeces on farm C and D. It is also possible that the strains of L. monocytogenes on these 2 farms (farm C and D) may have not been capable of propagating in the environment, feed or cows. This is unlikely. Pattern 1 was predominant in faecal samples on farms B, C and D and in the environment on farm C. The absence of a high prevalence of infection on farms C and D may also have been due to demographic features of these herds. Farm C was the smallest herd and therefore the number of contacts with susceptible animals might have been too low to initiate an epidemic. Farm D was a flying herd which by its nature would contain a small proportion of young animals. There was a negative association between age and faecal excretion on the farms where ages were available. This was also a feature of the pilot study. It was reflected also in the much higher incidence of clinical Listeriosis 209 reported in heifers in the questionnaire survey (Chapter 2). Although the influence of age on clinical Listeriosis is controversial younger animals have been reported to be more susceptible (Barlow and McGorum 1985, Nash and others 1995). In this study younger animals were more likely to excrete the organism in their faeces than the older animals. This finding contradicts with the finding of Hofer (1983) where the organism was more frequently isolated from beef cattle older than 5 years. However, in the study of Hofer the sampling was not statistically based and samples were collected from an abattoir. It is possible that stress induced shedding contributed to this finding or that the older animals had taken longer to reach slaughter weight because of intercurrent disease. This negative association suggests that animals may became immune to infection following repeated exposure to Listeria organisms. In our study measurement of serum antibody indicated that almost all animals had been exposed to Listeria infection prior to the study. It has experimentally been demonstrated that anti-LLO antibodies develop after oral challenge (Low and Donachie 1991, Low and others 1992b, Miettinen and Husu 1991) and that antibodies developed against L. monocytogenes could sustain at higher levels for as long as 4 (Lhopital and others 1993) or 6 (Miettinen and Husu 1991) or 7.5 months after initial exposure (Baetz and Wesley 1995). This long lasting nature of anti-LLO antibodies may explain the seropositivity of almost all animals at the beginning of this study. Whilst the measurement of serum antibody may not correlate with protection against infection because Listeria is an intracellular organism, it may however be considered as a measure of exposure to infection or re-infection. On only one of the farms, farm A, was there an increase in serum antibody between August and December and December and April. This increase showed a broad agreement with the proportion of new faecal excretors observed during these two 210 periods. However, on farms B and E there was little change in serum antibody and the patterns of the epidemics on both of these farms were different to farm A. The incidence rate on farm A continued to rise throughout the study whereas on farms B and E it peaked in November and February and December respectively and then fell in spite of the presence of susceptible animals. It is possible that this occurred because of the higher level of herd immunity on these farms. On farms C and D, there was a fall in serum antibody between August and December. On farm D this coincided with a small increase in the frequency of faecal shedding although there were differences in the proportions; 9.1% of animals showed a decrease in serum antibody and 26% of animals showed new infections; on farm C 12% of animals became faecal excretors for the first time during this period and 3. 8% showed a decrease in serum antibody. In the period between December and April there was a further decrease in serum antibody in 15% of animals on farm C. This coincided with 29% of animals becoming faecal excretors for the first time. It is difficult to explain how infection might be associated with a decrease in antibody titers unless it was a reflection of the immunosuppressive process which increased the susceptibility to infection. It is more likely that this is a chance observation as on farm D the new cases occurring between December and April were associated with an increase in serum antibody. Serum antibody measurements were included in this study because of concerns that the presence of L. monocytogenes in faeces represented “intestinal transient” rather than true colonisation. The increase in serum antibody on farm A indicates that infection did occur and the association between the start of maize silage feeding and faecal shedding, but the continuation of faecal shedding beyond the feeding of maize silage suggest that this is true infection rather than simple transient. A relationship 211 between increased anti-LLO antibodies and faecal excretion has also been suggested in an experimental infection of L. monocytogenes (Mietinnen and others 1991). The sources of infection on these farms were investigated using RAPD test. One criticism of RAPD is its lack of reproducibility (Wernars and others 1996). The RAPD technique used in this study had been validated in another laboratory (O’Donoghue and others 1995). The use of 6 primers allowed internal validation and the experiments showed that the technique was repeatable. Similar results were reported by other researchers (Mazurier and Wernars 1992, MacGowan and others 1993, O’Donoghue and others 1995). Alternative typing methods such as serotyping, ribotyping, restriction enzyme analysis (REA) multilocus enzyme electrophoresis (MEE) and pulsed field gel electrophoresis (PFGE), have been used for L. monocytogenes (Ralovich 1993) and a comparison with RAPD has also been made (Boerlin and others 1995, Louie and others 1996). RAPD was compared with serotyping, ribotyping, MEE and REA by Boerlin and others (1995). They acknowledged the superiority of RAPD. RAPD was also compared with ribotyping and PFGE. RAPD and PFGE were found to be the most discriminating typing methods and their ability to differentiate between strains was comparable (Louie and others 1996). However PFGE may take several days, it is costly and sophisticated laboratory equipment is required to perform it. RAPD, on the other hand, is cheap, rapid (results are obtained within several hours) and easy to perform (O’Donoghue and others 1995, Louie and others 1996). The wide diversity of L. monocytogenes found on five study farms makes it difficult to link environmental strains with faecal strains. Because of the lack of understanding of the population dynamics of strains of L. monocytogenes it is also not known if temporal distribution of strains occurs (Low and Donachie 1997). This was also the case in this study. 212 A large number of L. monocytogenes isolates were obtained from the environment and animals. It was impossible to examine all the isolates because of time and financial constraints. However the limited results obtained in this study provide some interesting information. A total of 12 “strains” were identified but on individual farms this was limited to 5 or 6 different “strains”. The maximum number in environmental samples was 4 and in faecal samples it was 6. This diversity within the strains of L. monocytogenes is in accordance with the results reported by other researchers (Boerlin and Piffaretti 1991, Fenlon and others 1996, Wiedmann and others 1996). In interpreting the difference between the isolates made at different times care has to be taken because of the potential influence of the sampling procedure. Competition between the strains invariably takes place during the enrichment procedure and the selection of only 5 colonies from a plate means that only “strains” present at a prevalence of 50% will be detected. However, given these constraints the results suggest that the predominant faecal isolates may vary with time. It is possible that the epidemic curves observed for L. monocytogenes are composite results from a large number of “strains” related epidemic curves. If this is the case then any potential vaccine against L. monocytogenes infection would need to incorporate immunogens from a number of different “strains”. The isolates from milk in the bulk tank on three farms (farm A, B and D) revealed that each farm had different patterns; the pattern 4 on farm A, 1 on farm B and 5 on farm D. Except for the pattern 4, this pattern 4 was not detected in any other samples. Both pattern 1 and 5 were also detected in the environmental and faecal isolates on these farms. This may suggest that milk was contaminated with the organism either by animals excreting it in milk or the organism got into the tank via environmental contamination where the refrigeration temperature allowed the organism 213 to propagate. The latter may have been the case on the farm D because the “strain” detected in the isolates obtained from milk samples was detected in 2 of 5 environmental samples but only in 3 of 22 animal isolates. The “strains” detected in bedding, water, soil and grass were also seen in faeces and grass and maize silage on some farms. This is in agreement with the results of other studies (Skovgaar and Morgen 1988, Ueno and others 1995). This study has demonstrated that a large proportion of cattle can become infected and shed L. monocytogenes in their faeces without any apparent clinical symptom. L. monocytogenes was isolated from the liver of an aborted foetus on farm B but this isolate was not typed. In spite of the inconclusive analysis of the strains, it also suggested that environmental contamination and infection of animals with L. monocytogenes may have been a continuing cycle as illustrated in the figure 6. 13. bedding grass grass silage ANIMAL faeces soil maize silage water Milk 214 Figure 6. 13. Animal-environment cycle of L. monocytogenes 215 CHAPTER 7 Conclusion The aim of this study was to identify risk factors at both the farm level and the individual animal level which were associated with Listeriosis and L. monocytogenes infection in dairy cattle. An ultimate aim of epidemiological studies is to control disease. This can be achieved by a better understanding of the factors associated with infection and clinical disease. In this study two observational studies, cross-sectional and longitudinal, were conducted to determine: a) the frequency of clinical listeriosis in dairy cattle, its clinical characteristic and risk factors associated with disease at farm level; b) the infection rate in individual animals, risk factors associated with it, the degree of environmental contamination and the source of infection. In the cross sectional study, a postal survey, was carried out. 12% of dairy farmers reported clinical Listeriosis and on these farms around 5 out of 100 cattle were at risk of contracting the disease each year (Chapter 2). The most frequently reported clinical sign was silage eye. This corresponds with the recent increased number of field reports of this disease. However there is a need for a detailed investigation to establish the exact relationship between silage eye and L. monocytogenes and the dynamics of this relationship. 215 Some important farming practices were identified as risk factors for clinical listeriosis. These were mainly forage and forage related practices (Chapter 3 and 4). This study demonstrated that the methods of making and feeding grass silage are an important component of the association between silage feeding and Listeriosis. Clinical Listeriosis was associated with the time and stage of harvest (number of cuts made to grass for grass silage), soil contamination (presence of mole hills in the fields, control of moles, use of mower conditioner), type of harvesters (mower conditioner), wilting, storage of grass silage (clamp, big bale silage and storage of big bales outside uncovered). These factors are also believed to be involved in the production of good quality silage. These have been discussed in the relevant chapters. As important as silage quality are the method or methods of feeding silage. Some clinical forms of Listeriosis (encephalitis, iritis) have been attributed to physical injuries of mucosal membranes such as buccal or conjunctival membranes caused by rough forages. In addition to the factors stated above methods of feeding grass silage were also associated with disease. These were the feeding of grass silage both in ring feeders and ad libitum feeding during the indoor or outdoor period. This study has also established an association between maize silage feeding and disease. Although we gathered information about the preparation of maize silage and its quality, we failed to identify risk factors in the preparation of maize silage. The methods of maize silage feeding were significantly associated with disease; maize silage feeding ad libitum, in ring feeders or in a complete diet during the indoor or outdoor period. Maize silage feeding is an increasing practice in the UK. There is a need for more research to establish the factor or factors that influence its quality. In the second part of the study a longitudinal study, employing bacteriological, serological and molecular techniques, was carried out. This study demonstrated that a large proportion of animals excrete L. monocytogenes during the winter months without 216 showing signs of disease. Although the analysis of data collected in this study is not conclusive some farming practices were associated with the excretion of the organism. A significant number of isolates of L. monocytogenes were obtained from animals and the environment over a 10 month period. A complete analysis of these isolates with the use of newer molecular typing methods (e.g. RAPD) could have provided information on temporal distribution of the strains of L. monocytogenes and its relation with the infection in animals but this was not possible because of the time and financial constraints. However the limited number of isolates examined provided some information about the distribution of strains obtained from the faeces and the environment. The use of animal waste on agricultural land is known to help maintain the existence of the organism in the farm environment. The importance of dung management was demonstrated in both the cross-sectional and the longitudinal study. In this part of the study there were two distinct patterns of excretion on the farms. The first pattern fitted well with the seasonal occurrence of clinical Listeriosis in the northern hemisphere but the second pattern was distinct (Chapter 6). As explained earlier it was difficult to establish why this difference occurred. The main factor associated with this difference was the feeding of maize silage but it is possible that this was a confounder. It may have been that different “strains” of L. monocytogenes were involved in infection on these farms. This could only be explained if all the isolates made during the study were analysed. Control of clinical listeriosis is complex due to scarcity of representative field data and a lack of understanding of its epidemiology. This study indicates that a large proportion of cattle may excrete the organism without showing overt nervous signs or silage eye. It is possible that there were more subtle clinical signs and the 217 chance finding of L. monocytogenes in the only 1 of the abortion samples examined supports this. L. monocytogenes is also known to be associated with mastitis and the observation that “strains” of L. monocytogenes which were found in faecal samples were also found in the bulk tank merits further investigation of udder infection and the presence of L. monocytogenes in milk. The isolates collected in this study have partially been identified. Further analysis of these strains will allow a more detailed analysis of the strain specific patterns of infection in these herds. The data obtained during the longitudinal study will also provide empirical data which will be of value in developing theoretical models of the disease process. In conclusion, this study has identified farm level risk factors which may be utilised to try and reduce the incidence of clinical disease. 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(1975) Survival and spread of pathogenic bacteria of veterinary importance within the environment. The Veterinary Bulletin, 45 (8), 543-550. 255 APPENDIX 3 PREPARATION OF BACTERIOLOGICAL MEDIUM: LSEB (Listeria Selective Enrichment Broth): Listeria enrichment broth base (Oxoid, code:CM862) 18g Sterile Distilled Water 500ml Autoclave at 115atm for 20 minutes Cool to 500C Dissolve a vial of Listeria selective enrichment supplement (Oxoid, code:SR141E) in 2ml of ethanol or distilled water and add to 500ml of LEAB Dispense into 30ml sterile universal containers LSA (Listeria Selective Agar, Oxford formulation): Listeria agar base (Oxoid, code:CM856) 28g Sterile Distilled Water 500ml Autoclave at 115atm for 20 minutes Cool to 500C Dissolve a vial of Listeria selective supplement (oxford formulation) (Oxoid, code:SR140E) in 2ml of ethanol or distilled water and add to 500ml of LAB. Pour 20ml into sterile petri dishes Sugar Plates (SP): Solution A: Nutrient Agar Base (Oxoid, code: CM3) 12.6g Sterile Distilled Water 450ml Phenol red (Sigma, code:P-4633) 0.2% w/w Autoclave at 115atm for 20 minutes Cool to 500C Solution B: Sugars* 5g (2%v/w) Sterile Distilled Water 50ml Autoclave at 115atm for 20 minutes (except for Xylose which should be filter sterilised) Cool to 500C Mix Solution A with Solution B and then pour 20ml into petri dishes. * Sugars used in fermentation test are Glucose (BDH, code: 10117), Rhamnose (BDH, code: 38057), Mannitol (BDH, code: 10330) and Xylose (BDH, code:103723A) Blood Agar (5%): Sheep Blood Agar Base (Oxoid, code:CM854) 20g Sterile Distilled Water 500ml Autoclave at 115atm for 20 minutes Cool to 500C Add 5% sheep blood or horse blood and pour 20ml into petri dishes. Brain Heart Infusion Broth (BHIB): Brain Heart Infusion Broth Base (Oxoid, code:CM225) 37g Sterile Distilled Water 1000ml Autoclave at 115atm for 20 minutes Cool to 500C Peptone Water (PW): Peptone Water (Oxoid, code:CM9) 15g Sterile Distilled Water 1000ml Dispense in to 5ml test tubes. Autoclave at 115atm for 20 minutes Store at 40C until use Liquid growth medium for RAPD: Listeria enrichment broth base (Oxoid, code:CM862) 18g Sterile Distilled Water 500ml Dispense 5 ml into 5ml test tubes Autoclave Store at 40C until use. at 115atm for 20 minutes APPENDIX 4 PREPARATION OF SOLUTION FOR SEROLOGY: Phosphate buffered saline (PBS; 10x concentrate), pH NaCl 80g KCl 2g Na2HPO4 11.5g KH2PO4 2g Sterile Distilled Water 1000ml PBS Tween 20 PBS 10x concentrate 500ml Tween 20 2.5ml Sterile Distilled Water 5000ml Coating Buffer (pH 9.8): Na2C03 NaHC03 Sterile Distilled Water 1.59g 2.93g 1000ml APPENDIX 1 THE QUESTIONNAIRE, COVERING LETTERS AND REMINDERS USED IN THE CROSS-SECTIONAL STUDY APPENDIX 2 THE OVERALL RESULTS OF UNIVARIATE ANALYSIS Outcome variable being “overall” cases Abbreviations: n number of animals, reference category, X 2 X for trend, Y number of farmers reporting cases, N number of farm not reporting cases, OR, (95% CL) Odds Ratio with 95% confidence limit, *statistically significant, M median, IR, interquartale range, NF number of farms. R Herd size: Milking cows June 1995 July 1994 Herd Sizen Y N OR <50R 14 209 1.00 14 209 1.00 50-100 48 271 2.64 48 271 2.64 >100 31 141 3.26 31 141 3.26 p <0.001* Y N OR p <0.001* Herd size: Replacement heifers July 1994 June 1995 Herd Sizen Y N OR <50R 71 478 50-100 11 >100 7 p Y N OR 1.00 67 473 1.00 72 1.03 9 62 1.02 26 1.81 6 16 2.65 0.27 p 0.12 Herd size: Dairy calves June 1995 Herd Sizen Y N OR <50R 66 456 1.00 50-100 9 62 0.98 >100 6 46 2.30 July 1994 p Y NA 0.15 N OR p Grass silage Y N OR (95% CL) p Value 93 761 ? 0.05* home made 89 750 0.3 (0.1-1.3) 0.1 purchased 9 27 2.9 (1.2-6.8) 0.01* fed 77 567 1.7 (0.9-3.0) 0.1 ad libitum 9 50 1.4 (0.6-3.1) 0.5 on the ground 1 18 0.4 (0.0-2.9) 0.5 in complete diet 9 71 0.9 (0.4-2.0) 0.9 in ring feeders 55 352 1.5 (0.9-2.7) 0.14 in troughs 16 157 0.7 (0.4-1.3) 0.25 fed source outdoor feeding in hay racks off the field NA 2 23 0.6 (0.1-2.9) 0.7 fed 92 750 1.4 (0.2-28.7) 0.8 ad libitum 17 107 1.4 (0.7-2.5) 0.35 at the clamp face 23 158 1.3 (7-2.1) 0.46 on the floor 2 67 0.2 (0.04-0.97) 0.04* in complete diet 12 89 1.1 (0.6-2.2) 0.8 in ring feeders 53 310 1.9 (1.2-3.1) 0.004* in troughs 27 242 0.9 (0.5-1.4) 0.6 indoor feeding in hay racks NA off the field NA duration of feeding <6 monthsR 13 128 1.00 6 months 13 114 1.12 >6 months 52 288 1.78 All year 14 70 1.97 Grass silage 0.03* Y N OR (95% CL) p Value May and before 59 411 1.00 June 23 250 0.64 July and after 6 64 0.63 1R 13 145 1.00 2 43 382 1.26 3 27 180 1.67 4 2 9 2.48 0.09X forage harvester 58 468 1.0 (0.7-1.7) 0.9 discs and drums 33 287 0.9 (0.6-1.5) 0.75 mower conditioner 68 437 2.0 (1.2-3.4) 0.005* combine harvester 2 3 5.6 (0.6-42) 0.16 89 749 0.40 (0.1-1.5) 0.22 0R 4 12 1.00 1 61 487 0.38 2 23 181 0.38 3 5 78 0.19 0.12X 34 267 1.1 (0.7-1.7) 0.8 inoculant 10 73 0.9 (0.4-1.99) 0.9 inoculant and 16 84 1.7 (0.9-3.1) 0.1 enzyme 0 14 0.0 (0.0-3.4) 0.4 acid and salt 5 73 0.5 (0.2-1.4) 0.25 combinations 3 23 1.07 (0.3-3.8) 0.8 Month of making 0.08X number of cuts type of harvester wilting wilted days additive use used enzyme Grass silage Y N OR (95% CL) p Value clamp 76 585 1.3 (0.8-2.4) 0.35 silo 2 15 1.1 (0.0-5.2) 0.7 big bale 71 453 2.2 (1.3-3.8) 0.002* in covered barn 2 11 1.2 (0.0-5.8) 0.8 outside covered 11 83 0.8 (0.4-1.7) 0.68 outside uncovered 57 332 1.5 (0.8-2.9) 0.26 compacted soil 1 9 0.9 (0.0-6.8) 0.7 concrete 69 534 0.9 (0.4-2.4) 0.9 separate clamp 38 252 1.4 (0.9-2.2) 0.16 sealing clamp 33 312 0.8 (0.5-1.3) 0.36 storage storage of big bale floor of storing area clamp use Forage analysis Grass silage: Clamp 1 pH DM Ash ME NF Median IR p Value no cases 178 4.1 3.9-4.4 cases 23 4.0 3.9-4.2 no cases 183 26.7 23.8-32.3 cases 23 26.0 22.9-29.9 no cases 138 8.0 6.8-9.1 cases 19 7.9 7.1-8.9 no cases 181 11.0 10.5-11.4 cases 23 10.8 10.4-11.0 0.08 0.4 0.8 0.2 Grass silage: Clamp 2 NF Median IR p Value pH DM Ash ME no cases 82 4.1 3.9-4.3 cases 11 4.1 3.9-4.5 no cases 82 28.6 24.6-31.9 cases 11 30.5 21.9-34.1 no cases 69 7.9 6.9-8.8 cases 11 8.0 7.5-8.4 no cases 80 10.9 10.6-11.3 cases 11 10.6 10.3-11.0 0.2 NF Median IR p Value no cases 19 4.1 3.9-4.4 cases 4 4.3 4.1-4.5 no cases 20 30.2 24.4-34.8 cases 4 26.5 23.9-28.9 no cases 17 8.0 7.3-8.9 cases 4 8.4 7.4-10.0 no cases 20 11.0 10.8-11.2 cases 4 10.5 10.2-10.5 0.003* NF Median IR p Value no cases 16 4.9 4.3-5.3 cases 2 4.6 4.2-4.9 no cases 18 34.2 30.0-45.0 cases 2 31.2 27.5-34.9 no cases 12 7.2 3.9-8.5 cases 2 8.0 6.5-9.5 no cases 18 10.5 10.1-10.8 cases 2 10.1 9.3-10.9 0.8 0.6 0.6 Grass silage: Clamp 3 pH DM Ash ME 0.4 0.3 0.7 Grass silage: Big bale pH DM Ash ME 0.5 0.4 0.5 0.9 Maize silage fed Y N OR (95% CL) p Value 39 185 2.4 (1.5-3.9) <0.001* source home made 38 182 0.6 (0.1-16.3) 0.8 purchased 0 6 0.0 (0.0-4.6) 0.5 fed 24 104 1.3 (0.6-2.7) 0.6 ad libitum 1 7 0.6 (0.0-5.4) 1.0 on the ground 0 1 0.0 (0.0-79.3) 0.3 in complete diet 7 37 0.8 (0.3-2.2) 0.7 in ring feeders 16 32 4.5 (1.6-13.0) 0.002* in troughs 5 39 0.4 (0.1-1.4) 0.2 fed 38 175 0.7 (0.2-3.4) 0.8 ad libitum 5 11 2.4 (0.7-8.3) 0.2 at the clamp face 2 11 0.9 (0.0-4.6) 0.8 on the floor 0 14 0.0 (0.0-1.8) 0.16 in complete diet 10 51 0.9 (0.4-2.2) 0.9 in ring feeders 23 46 4.9 (2.2-11.5) <0.001* in troughs 12 71 0.7 (0.3-1.7) 0.5 <6 monthsR 18 69 1.00 6 months 7 46 0.58 >6 months 11 28 1.51 All year 4 10 1.53 September and before 6 27 1.00 October 23 109 0.95 November and after 7 39 0.81 0.7X Y N OR (95% CL) p Value 36 155 2.3 (0.6-10.3) 0.26 outdoor feeding indoor feeding duration of feeding 0.3X Month of making Maize silage type of harvester forage harvester discs and drums 2 2 4.9 (0.5-51.9) 0.28 mower conditioner 0 4 0.0 (0.0-7.6) 0.8 combine harvester 0 2 0.0 (0.0-20.2) 0.8 20 99 0.97 (0.5-2.1) 0.9 inoculant 9 35 1.3 (0.5-3.2) 0.7 inoculant and 5 38 0.6 (0.2-1.7) 0.3 enzyme 3 20 0.7 (0.2-2.6) 0.7 acid and salt 2 3 3.3 (0.2-29.5) 0.5 combinations 1 3 1.6 (0.0-20.5) 0.8 clamp 38 168 3.85 (0.5-81.2) 0.28 silo 1 2 2.4 (0.0-35.7) 0.9 additive use used enzyme storage big bale NA floor of storing area compacted soil 2 9 0.98 (0.0-5.3) 0.7 concrete 33 145 1.1 (0.3-3.4) 0.8 Forage analysis: Maize silage pH DM Ash ME NF Median IR no cases 36 3.9 3.8-5.5 cases 2 4.7 3.5-5.8 no cases 38 30.8 27.1-34.4 cases 2 26.9 23.5-30.2 no cases 25 5.0 3.8-6.2 cases 2 3.8 3.5-4.1 no cases 36 11.0 10.7-11.3 cases 2 10.8 10.7-10.9 p Value 0.9 0.3 0.2 0.5 Hay fed Y N OR (95% CL) p Value 40 391 0.8 (0.5-1.3) 0.9 source home made 34 345 0.8 (0.3-2.1) 0.7 purchased 7 60 1.2 (0.5-2.95) 0.8 fed 26 223 1.3 (0.6-2.7) 0.6 ad libitum 0 9 0.0 (0.0-5.5) 0.6 on the ground 4 31 1.2 (0.3-4.0) 0.9 in complete diet 2 6 3.2 (0.4-19.1) 0.4 in ring feeders 19 111 2.98 (1.1-8.2) 0.02* in troughs 3 32 0.8 (0.2-3.1) 0.9 in hay racks 4 65 0.5 (0.1-1.5) 0.25 off the field 1 13 0.7 (0.0-5.4) 0.9 fed 33 336 0.8 (0.3-2.0) 0.7 ad libitum 0 7 0.0 (0.0-8.4) 0.8 on the floor 0 52 0.0 (0.0-0.85) 0.03* in complete diet 1 10 1.0 (0.0-8.3) 0.6 in ring feeders 22 109 4.2 (1.8-9.6) <0.001* in troughs 10 78 1.4 (0.6-3.4) 0.5 in hay racks 7 116 0.5 (0.2-1.3) 0.17 outdoor feeding indoor feeding duration of feeding <6 monthsR 23 140 1.00 6 months 3 71 0.26 >6 months 6 97 0.38 All year 5 36 0.85 0.13X Hay Y N OR (95% CL) 17 170 1.00 Month of making June and before p Value July 9 105 0.86 after July 10 72 1.39 1R 36 292 1.00 2 3 7 3.48 3 0 3 0.00 0.4X discs and drums 19 223 1.0 (0.5-2.3) 0.3 mower conditioner 14 117 1.3 (0.6-2.6) 0.6 34 335 0.9 (0.3-2.5) 0.9 0R 6 52 1.00 1 0 3 0.00 2 1 7 1.24 3 33 325 0.88 0.8X in covered barn 35 365 0.5 (0.2-1.6) 0.3 outside covered 3 5 6.3 (1.1-32.1) 0.03* outside uncovered 2 7 2.9 (0.0-16.2) 0.4 Y N OR (95% CL) p Value 44 378 1.0 (0.6-1.6) 0.9 0.5X number of cuts type of harvester wilting wilted days storage Straw fed type barley 27 251 0.93(0.6-1.6) 0.8 barley and wheat 6 34 1.6 (0.6-4.6) 0.5 wheat 5 40 1.2 (0.4-3.5) 0.9 combinations 6 53 1.1(0.4-2.9) 0.9 home made 18 156 0.99 (0.5-1.95) 0.9 purchased 26 235 0.9 (0.4-1.8) fed 25 220 0.9 (0.5-1.9) 0.9 ad libitum 4 17 2.3 (0.6-8.2) 0.3 on the ground 1 19 0.4 (0.0-3.4) 0.7 in complete diet 2 25 0.7 (0.1-3.3) 0.8 in ring feeders 20 114 3.7 (1.3-11.9) 0.01* in troughs 1 40 0.2 (0.0-1.4) 0.1 in hay racks 3 28 0.9 (0.2-3.6) 0.8 fed 28 31 0.4 (0.2-0.8) 0.006 ad libitum 2 10 1.8 (0.0-9.9) 0.7 on the floor 4 67 0.7 (0.2-2.4) 0.8 in complete diet 2 31 0.8 (0.3-2.4) 0.8 in ring feeders 10 95 1.3 (0.5-3.0) 0.8 in troughs 4 66 0.6 (0.2-1.99) 0.5 in hay racks 6 48 1.5 (0.5-4.2) 0.5 Y N OR (95% CL) p Value <6 monthsR 21 131 1.00 6 months 7 63 0.69 source outdoor feeding indoor feeding Straw duration of feeding >6 months 5 99 0.32 All year 5 35 0.89 July and before 6 58 1.00 August 8 116 0.67 September 3 26 1.12 0.13X Month of making 0.5X type of harvester combine harvester 1.2 (0.6-2.3) drying dried 21 178 1.02 (0.52-2.0) 0R 23 199 1.00 1 12 78 1.33 2 6 49 1.06 3 3 51 0.51 0.5X in covered barn 30 295 0.6 (0.3-1.3) 0.2 outside covered 6 21 2.68 (0.9-7.67) 0.08 outside uncovered 3 29 0.9 (0.2-3.25) 0.9 Y N OR (95% CL) p Value 16 116 1.2 (0.7-2.3) 0.6 5 49 0.5 (0.1-1.9) 0.4 days 0.9 storage Root crops fed type beet type potatoes 2 11 1.4 (0.-7.7) 0.9 brassica type 2 31 0.4 (0.1-1.9) 0.4 kale 3 10 2.5 (0.5-11.6) 0.4 combinations 4 15 2.5 (0.6-10) 0.3 home made 14 74 3.97 (0.8-27.0) 0.1 purchased 2 32 0.4 (0.1-1.9) 0.3 fed 13 64 3.5 (0.9-16.7) 0.08 ad libitum 2 1 11.5 (0.7-358.3) 0.1 on the ground 1 11 0.4 (0.0-3.6) 0.7 in complete diet 1 5 0.98 (0.0-10.5) 0.61 in ring feeders 1 5 0.98 (0.0-10.5) 0.6 in troughs 3 14 1.1 (0.2-5.2) 0.8 off the field 8 28 2.1 (0.5-8.4) 0.4 fed 7 64 0.6 (0.2-2.0) 0.5 on the floor 0 15 0.0 (0.0-2.7) 0.3 in complete diet 1 8 1.2 (0.0-12.8) 0.6 in ring feeders 1 6 1.6 (0.0-19) 0.8 in troughs 5 32 2.5 (0.4-20.6) 0.5 Y N OR (95% CL) p Value <6 monthsR 10 76 1.00 6 months 3 11 2.07 >6 months 2 121 1.27 source outdoor feeding indoor feeding Root crops duration of feeding 1 3 2.53 0.3X clamp 5 27 1.5 (0.4-5.3) 0.7 silo 0 2 0.0 (0.0-32.4) 0.6 Y N OR (95% CL) p Value 91 775 1.5 (0.3-9.6) 0.8 not housed 2 26 1.00 <6 months 31 234 1.72 6 months 31 226 1.78 >6 months 23 269 1.11 all year 1 9 1.44 All year storage Housing housed duration of housing 0.26X Bedding: Sawdust Y N OR (95% CL) p Value 12 146 0.6 (0.3-1.3) 0.2 home made 0 1 0.0 (0.0-234.8) 0.1 purchased 12 135 ? 0.6 in a covered barn 11 121 2.5 (0.3-53.9) 0.6 outside covered 0 10 0.0 (0.0-7.1) 0.75 Y N OR (95% CL) p Value 85 668 2.2 (0.9-5.7) 0.09 home made 34 257 1.1 (0.7-1.7) 0.9 purchased 56 472 0.8 (0.5-1.3) 0.4 used source storage Bedding: Straw used source storage in a covered barn 73 595 0.8 (0.4-1.5) 0.5 outside covered 6 55 0.9 (0.3-2.2) 0.9 outside uncovered 13 85 1.2 (0.6-2.4) 0.6 July 8 63 1.00 August 28 193 1.14 September 3 41 0.58 0.5X 34 264 1.02 (0.62-1.6) 0.9 0R 51 396 1.00 1 7 73 0.74 2 11 82 1.04 3 16 109 1.14 0.7X 26 163 1.4 (0.8-2.3) 0.3 wheat 18 110 1.34 (0.7-2.5) 0.4 barley 10 106 0.77 (0.35-1.66) 0.6 combinations 12 85 1.2 (0.57-2.47) 0.7 Y N OR (95% CL) p Value 77 608 1.5 (0.8-2.9) 0.2 earth 13 88 1.2 (0.6-2.4) 0.7 hard core 6 62 0.7 (0.3-1.9) 0.6 concrete 55 461 0.8 (0.5-1.4) 0.5 month of making drying dried days big bale straw type of straw Type of housing: Cubicles used type of floor slatted 0 21 0.0 (0.0-1.9) 0.2 sawdust 12 122 0.7 (0.4-1.5) 0.4 straw 70 484 2.6 (1.1-6.3) 0.02* adding fresh bedding 77 584 ? 0.15 removing dirty bedding 70 521 1.9 (0.8-5.1) 0.2 cleaning out 15 165 0.7 (0.3-1.2) 0.2 Y N OR (95% CL) p Value 31 221 1.3 (0.8-2.1) 0.3 earth 5 20 1.9 (0.6-6.2) 0.36 hard core 5 42 0.8 (0.3-2.5) 0.9 concrete 21 162 0.8 (0.3-1.9) 0.66 sawdust 0 7 0.0 (0.0-5.8) 0.8 straw 31 193 ? 0.07 adding fresh bedding 30 199 3.3 (0.4-69.6) 0.4 removing dirty bedding 5 60 0.7 (0.2-1.8) 0.6 cleaning out 20 161 0.7 (0.3-1.6) 0.45 Y N OR (95% CL) p Value 1 65 0.12 (0.0-0.83) 0.02* earth 0 3 0.0 (0.0-527) 0.02* hard core 0 1 0.0 (0.0-7248) <0.001* concrete 1 58 ? 0.2 type of bedding use of bedding Type of housing: Loose yards used type of floor type of bedding use of bedding Type of housing: Others used type of floor type of bedding sawdust 0 16 0.0 (0.0-2.73) 0.3 straw 0 56 0.0 (0.0-0.7) 0.01* adding fresh bedding 0 57 0.0 (0.0-2.8) 0.3 removing dirty bedding 0 56 0.0 (0.0-3.2) 0.3 cleaning out 0 37 0.0 (0.0-14.1) 0.9 Y N OR (95% CL) p 44 371 1.04 (0.7-1.6) 0.9 not stored 4 14 2.6 (0.7-8.95) 0.2 beneath the slats 3 2 13.5 (1.7-121.2) 0.003* composted 27 217 1.13 (0.6-2.3) 0.8 in a slurry tank 2 8 2.2 (0.0-11.7) 0.6 in a lagoon 9 64 1.2 (0.5-2.9) 0.75 Y N OR (95% CL) p Value disposed storage 71 521 1.73 (1.0-2.97) 0.03* not stored beneath the slats composted in a slurry tank in a lagoon General management 13 3 1 26 27 84 53 8 191 196 1.2 (0.6-2.3) 0.4 (0.1-1.4) 0.92 (0.0-7.5) 1.0 (0.6-1.7) 1.0 (0.6-1.8) 0.75 0.16 0.66 0.9 0.9 Y N OR (95% CL) p Value spread dung on the field 65 594 0.8 (0.5-1.3) 0.4 grazing beef cattle 17 194 0.7 (0.4-1.3) 0.25 grazing sheep 44 437 0.8 (0.5-1.2) 0.22 beef cattle 11 3 32.4 (8.1-151.2) <0.001* sheep 8 27 2.6 (1.0-6.3) 0.04 use of bedding Dung disposal: Solid manure disposed storage Dung disposal: Slurry pasture management Listeriosis in others Vaccine Salmonellosis 2 19 0.9 (0.0-4.2) 0.9 E. coli 2 11 1.6 (0.0-7.8) 0.9 Leptospirosis 39 202 2.1 (1.3-3.4) <0.001* Lungworm 32 217 1.4 (0.9-2.3) 0.17 in hay field 19 183 0.9 (0.5-1.6) 0.7 in grass silage field 44 353 1.3 (0.8-2.1) 0.3 in straw field 4 42 0.8 (0.2-2.5) 0.9 36 385 0.7 (0.4-1.1) 0.1 chemical methods 19 173 0.9 (0.5-1.6) 0.9 physical methods 19 234 0.6 (0.4-1.1) 0.09 mole hills controlling moles APPENDIX 5 THE QUESTIONNAIRE AND THE EXPLANATION LETTER USED IN THE LONGITUDINAL STUDY APPENDIX 6 THE OVERALL RESULTS OF ELISA Abbreviations: 1 first blood sampling second blood sampling 3 third blood sampling ODs optical densities (beneath the thick black line) B blank wells S standard (positive) control serum N negative control serum 2 Farm A: Plate 1 Layout and ODs 12 B 11 1 B 4 42 B 7 72 1 B 9 92 1 B 12 122 B 151 152 1 B 17 172 1 B 20 202 13 43 73 93 123 153 173 203 21 51 8 101 131 161 181 211 22 52 82 102 132 162 182 212 2 53 83 103 133 163 183 213 31 33 62 111 113 142 191 193 32 61 63 112 141 143 192 221 S S S S S S S S N N N N N N N N B B B B B B B B 0.124 0.111 0.108 0.114 0.105 0.114 0.111 0.122 1.290 0.551 0.723 0.666 0.761 0.683 0.551 0.887 1.210 0.573 0.685 0.552 0.602 0.724 0.647 1.251 1.489 0.495 0.607 0.541 0.609 0.659 0.748 1.338 1.156 0.684 0.643 0.572 0.459 0.747 0.788 1.441 0.954 0.641 0.591 0.688 0.649 0.611 0.773 0.820 1.057 0.743 0.663 0.680 0.615 0.742 0.838 0.522 0.743 0.435 0.425 0.304 0.240 0.208 0.188 0.182 0.168 0.121 0.107 0.107 0.099 0.098 0.101 0.107 0.142 0.120 0.119 0.114 0.119 0.121 0.122 0.129 Plate 2 Lay out and ODs 232 233 B 231 1 2 B 26 26 263 B 291 292 293 1 2 B 31 31 313 B 341 342 343 1 2 B 37 37 373 1 2 B 39 39 393 B 421 422 423 241 271 301 321 351 381 401 431 242 272 302 322 352 382 402 432 243 273 303 323 353 383 403 433 251 253 282 331 333 362 411 413 252 281 283 332 361 363 412 441 S S S S S S S S N N N N N N N N B B B B B B B B 0.107 0.215 0.116 0.106 0.102 0.090 0.089 0.101 1.176 0.916 0.851 0.685 0.845 0.860 0.694 0.769 1.100 0.972 0.812 0.670 0.821 0.686 0.839 0.915 1.163 0.773 0.647 0.725 0.815 1.017 0.735 0.881 1.021 0.897 0.530 0.640 0.748 0.728 0.575 0.841 1.258 0.751 0.680 0.684 0.493 0.705 0.669 0.578 0.593 0.560 0.356 0.406 0.247 0.226 0.169 0.155 0.138 0.121 0.117 0.112 0.105 0.105 0.110 0.106 0.124 0.117 0.120 0.119 0.119 0.126 0.128 0.125 1.035 0.567 0.546 0.632 0.696 0.736 0.846 0.928 0.476 0.491 0.559 0.635 0.501 0.561 0.588 0.594 1.001 0.546 0.535 0.730 0.774 0.717 0.859 0.889 0.779 0.692 0.705 0.643 0.565 0.729 0.581 0.759 Plate 3 Layout and ODs 1.079 0.650 0.863 0.752 0.593 0.740 0.738 0.775 B B B B B B B B 451 481 511 531 561 591 611 641 452 482 512 532 562 592 612 642 453 483 513 533 563 593 613 643 461 491 521 541 571 601 621 651 462 492 522 542 572 602 622 652 463 493 523 543 573 603 623 653 471 473 502 551 553 582 631 633 472 501 503 552 581 582 632 661 S S S S S S S S N N N N N N N N B B B B B B B B 0.126 0.122 0.126 0.117 0.119 0.131 0.120 0.152 0.773 0.879 0.774 0.749 0.795 0.684 0.944 0.714 0.904 0.858 0.684 0.717 0.544 0.807 0.816 0.810 0.973 0.886 0.876 0.842 0.691 0.793 0.858 0.847 1.072 0.755 0.790 0.994 0.872 0.806 0.538 0.763 1.125 1.058 0.713 0.907 0.986 0.961 0.925 0.797 1.056 0.678 0.598 0.779 0.952 0.949 0.801 0.854 0.982 0.668 0.687 0.638 0.864 0.759 0.807 0.759 0.789 0.867 1.027 0.670 0.839 0.824 0.653 0.875 0.438 0.536 0.446 0.339 0.262 0.230 0.207 0.199 0.145 0.191 0.126 0.122 0.115 0.128 0.118 0.125 0.218 0.146 0.149 0.141 0.141 0.154 0.167 0.160 Plate 4 Layout and ODs 672 B 671 1 B 70 702 1 B 73 732 B 761 762 1 B 79 792 1 B 82 822 B 851 852 3 B 89 903 673 703 733 763 793 823 853 913 681 711 741 771 801 831 861 923 682 712 742 772 802 832 862 933 683 713 743 773 803 833 863 943 691 721 752 781 811 841 871 953 692 722 753 782 812 842 881 961 S S S S S S S S N N N N N N N N B B B B B B B B 0.127 0.118 0.124 0.139 0.141 0.117 0.123 0.125 1.010 0.815 0.512 0.869 0.773 0.765 0.682 0.889 0.928 0.620 0.762 0.620 0.708 0.689 0.600 0.722 0.821 0.849 0.833 0.704 0.421 0.809 0.702 0.751 0.860 0.712 0.792 0.693 0.741 0.707 0.608 0.941 0.967 0.758 0.584 0.640 0.676 0.799 0.849 1.027 0.868 0.879 0.705 0.777 0.704 0.842 0.791 0.836 0.588 0.402 0.323 0.254 0.242 0.212 0.178 0.145 0.145 0.120 0.124 0.109 0.110 0.110 0.106 0.111 0.110 0.108 0.111 0.119 0.115 0.125 0.133 0.140 1001 1081 1011 1091 1021 1101 1031 1111 1041 1121 S S N N B B 0.757 0.703 0.586 0.833 0.651 0.661 0.512 0.175 0.459 0.809 0.609 0.858 0.659 0.670 0.687 0.363 Plate 5 Layout and ODs 981 991 B 971 1 1 B 105 106 1071 B B B B B B 1131 B B B B B 1141 B B B B B 1151 B B B B B 1161 B B B B B 1171 B B B B B 1181 B B B B B 1191 B B B B B B B B B B B S S S S S S N N N N N N B B B B B B 0.126 0.116 0.109 0.120 0.117 0.122 0.111 0.119 0.702 1.092 1.000 0.113 0.116 0.119 0.115 0.118 1.017 1.063 1.058 0.117 0.107 0.117 0.116 0.126 1.052 1.012 0.912 0.108 0.108 0.117 0.123 0.129 0.970 0.431 0.803 0.105 0.115 0.112 0.125 0.131 0.368 0.540 1.011 0.112 0.106 0.119 0.132 0.139 0.669 0.789 0.904 0.103 0.102 0.124 0.114 0.125 1.023 0.953 0.768 0.098 0.098 0.101 0.104 0.106 1.108 1.128 0.099 0.110 0.108 0.109 0.102 0.117 0.585 0.665 0.437 0.559 0.398 0.299 0.180 0.149 0.133 0.132 0.122 0.120 0.111 0.099 0.115 0.118 0.097 0.108 0.106 0.103 0.101 0.098 0.100 0.104 Plate 1 Layout and ODs 12 B 11 B 41 42 B 7 72 1 B 10 102 B 131 132 1 B 16 162 1 B 19 192 B 221 222 13 43 73 103 133 163 193 223 21 51 8 111 141 171 201 231 22 52 82 112 142 172 202 232 23 53 83 113 143 173 203 233 31 61 91 121 151 181 212 242 32 62 92 122 155 182 213 243 S S S S S S S S N N N N N N N N B B B B B B B B 0.161 0.134 0.148 0.133 0.139 0.166 0.139 0.159 1.039 0.464 0.810 1.130 1.033 0.643 1.235 1.319 0.854 1.045 0.817 1.180 1.193 0.504 0.948 1.121 1.359 1.271 0.943 1.189 0.823 0.671 0.970 1.172 1.109 1.408 1.013 1.182 1.151 0.662 1.140 1.343 1.175 1.134 1.128 1.030 1.170 1.082 1.078 1.286 1.188 1.126 1.263 0.999 0.840 1.074 1.068 1.156 0.986 0.724 0.679 0.377 0.323 0.234 0.200 0.136 0.179 0.150 0.125 0.118 0.109 0.106 0.114 0.103 0.115 0.119 0.113 0.119 0.114 0.114 0.110 0.114 253 283 313 343 261 291 321 351 262 292 322 352 263 293 323 353 271 302 332 362 273 303 333 363 S S S S N N N N B B B B Farm B 1.130 1.215 0.735 1.303 1.164 1.260 1.234 1.139 1.368 1.389 0.932 1.300 1.066 1.038 1.135 0.994 Plate 2 Layout and ODs 252 B 251 B 281 282 1 B 31 312 1 B 34 342 B B B B 371 401 431 461 372 402 432 462 373 403 433 463 381 411 441 471 382 412 442 472 383 413 443 473 392 422 451 483 393 423 453 491 S S S S N N N N B B B B 0.179 0.168 0.173 0.209 0.171 0.161 0.213 0.156 1.526 1.671 1.556 1.581 1.573 1.633 1.686 1.341 0.648 1.735 1.305 1.745 1.285 1.383 1.637 1.308 0.589 0.549 0.965 1.486 1.662 1.472 1.623 1.628 0.699 1.519 1.670 1.526 1.504 1.433 1.394 1.439 1.396 1.399 1.266 1.337 0.900 0.847 1.411 1.528 1.173 1.246 1.031 1.095 1.227 1.275 1.567 1.184 1.132 1.382 1.274 1.245 1.108 0.928 1.448 1.212 1.357 1.093 1.310 1.509 1.159 1.170 1.322 0.965 0.872 0.794 0.580 0.428 0.411 0.248 0.201 0.149 0.192 0.140 0.135 0.282 0.119 0.120 0.120 0.120 0.136 0.117 0.121 0.112 0.119 0.122 0.126 0.149 Plate 3 layout and ODs 502 B 501 1 B 54 542 B 581 582 1 B 62 622 B 661 662 1 B 70 702 1 B 74 742 B 781 782 503 543 582 623 663 703 743 783 511 551 591 631 671 711 751 791 512 552 592 632 672 712 752 792 513 553 593 633 673 713 753 793 521 561 601 641 681 721 761 801 531 571 611 651 691 731 771 811 S S S S S S S S N N N N N N N N B B B B B B B B 0.160 0.151 0.149 0.149 0.143 0.146 0.155 0.155 1.586 1.265 1.323 1.452 1.367 1.322 1.432 1.691 1.360 1.375 0.968 1.352 1.451 1.440 1.549 1.530 1.522 1.397 1.476 1.431 1.429 1.340 1.375 1.535 1.003 1.136 1.468 1.086 0.974 1.286 0.955 1.528 1.269 1.495 1.433 1.214 1.542 1.490 1.484 1.612 1.596 1.140 1.371 1.484 1.294 1.244 1.727 1.339 1.018 0.766 0.762 0.449 0.370 0.219 0.198 0.962 0.261 0.169 0.148 0.161 0.155 0.146 0.158 0.137 0.147 0.148 0.145 0.152 0.135 0.139 0.139 0.131 823 853 873 913 963 1003 831 861 881 921 971 1011 832 862 882 922 972 1012 833 863 883 923 973 1013 841 843 891 931 981 1021 842 B 903 943 993 1033 S S S S S S N N N N N N B B B B B B 1.685 1.515 1.387 1.551 1.029 1.265 1.391 1.670 1.670 1.319 1.536 1.541 1.540 1.314 1.280 1.594 Plate 4 Layout and ODs 822 B 821 B 851 852 1 B 87 872 B 911 912 1 B 95 952 1 B 100 1002 B B 1041 1071 1042 1072 1043 1073 1051 1081 1052 1082 1053 1083 1061 1093 1063 1103 S S N N B B 0.186 0.194 0.185 0.191 0.179 0.177 0.177 0.172 1.524 1.413 0.787 1.726 1.293 1.401 1.436 0.649 1.909 1.511 1.636 1.458 1.445 1.388 1.208 0.673 1.589 1.515 1.802 1.861 1.869 1.857 1.690 1.412 1.843 1.763 1.454 1.420 1.607 1.683 1.507 1.453 1.537 1.592 1.738 1.306 1.464 1.431 1.493 1.194 1.869 1.548 1.494 1.537 1.577 1.405 1.560 1.635 1.557 1.079 1.465 1.547 1.302 1.451 1.495 1.393 1.848 0.132 1.359 1.631 1.331 1.578 1.402 1.520 0.967 0.917 0.787 0.391 0.374 0.294 0.223 0.199 0.232 0.250 0.155 0.141 1.660 0.163 0.146 0.140 0.135 0.144 0.156 0.134 0.137 0.145 0.149 0.151 Plate 1 Layout and ODs 41 B 11 2 B 1 42 3 B 1 43 B 21 51 2 B 2 52 B 23 53 1 B 3 61 2 B 3 62 71 72 73 81 82 83 91 92 101 102 103 111 112 113 121 122 131 132 133 141 142 143 151 153 161 162 163 171 172 173 182 183 191 192 193 201 202 203 211 212 221 222 223 231 232 233 242 243 S S S S S S S S N N N N N N N N B B B B B B B B 0.154 0.142 0.151 0.139 0.140 0.134 0.166 0.168 1.459 1.686 1.751 1.440 1.514 0.930 1.093 1.131 1.671 1.748 1.292 1.610 1.561 1.477 1.300 1.379 1.620 1.817 1.410 1.428 1.533 1.604 1.472 1.531 1.853 1.953 1.506 1.502 1.433 1.210 1.232 1.495 1.760 2.009 1.485 1.684 1.759 1.423 1.416 1.761 1.503 1.585 1.142 1.680 1.347 0.963 1.359 1.588 1.459 0.919 0.738 0.571 0.334 0.225 0.258 0.262 0.341 0.249 0.184 0.164 0.132 0.132 0.141 0.154 0.165 0.165 0.152 0.164 0.170 0.175 0.190 0.178 321 322 323 331 332 333 341 361 362 363 371 372 373 381 401 402 403 411 412 413 421 441 442 443 451 452 453 462 481 482 483 491 492 493 501 511 512 513 521 522 523 503 S S S S S S S N N N N N N N B B B B B B B Farm C 1.275 1.173 1.161 1.414 1.374 1.188 1.417 1.341 1.582 1.323 1.433 1.440 1.514 0.930 1.175 1.263 Plate 2 Layout and ODs 281 B 251 2 B 25 282 3 B 25 283 B 261 291 2 B 26 292 B 263 293 1 B 27 301 B 272 311 352 392 432 473 502 531 S N B 0.137 0.303 0.321 0.125 0.118 0.122 0.129 0.133 1.251 1.002 1.195 1.353 1.615 1.429 1.701 1.503 1.181 1.315 1.268 1.606 1.772 1.766 1.454 1.458 1.334 1.124 1.347 1.498 1.378 1.564 1.312 1.653 1.590 1.383 1.593 1.400 1.321 1.222 1.419 1.462 1.480 1.188 0.996 1.076 0.902 0.830 1.412 1.126 1.300 1.210 1.053 1.361 1.054 1.254 1.429 1.266 1.318 1.206 1.019 1.242 1.113 1.245 1.296 1.333 1.765 1.321 1.187 1.237 1.290 1.273 1.401 1.341 0.976 0.748 0.616 0.385 0.284 0.192 0.165 0.176 0.263 0.193 0.145 0.133 0.124 0.114 0.113 0.130 0.173 0.128 0.113 0.121 0.115 0.123 0.134 0.181 Plate 3 Layout and ODs 561 B 541 2 B 54 562 B 543 563 1 B 55 571 2 B 55 572 B 553 573 B B B B B B 581 582 583 591 592 593 B B 601 602 603 611 612 613 B B 621 622 623 631 632 633 B B 641 642 643 651 652 653 B B 661 662 663 671 672 673 B B B B B B B B B B S S S S S S S S N N N N N N N N B B B B B B B B 0.132 0.234 0.111 0.123 0.116 0.115 0.111 0.127 0.936 0.806 0.781 1.250 1.185 1.441 0.118 0.139 1.072 0.928 0.803 1.233 1.263 1.101 0.116 0.134 1.161 1.214 0.944 0.998 0.889 1.264 0.122 0.143 1.390 1.252 1.076 0.875 1.045 1.239 0.114 0.143 1.293 0.903 1.109 1.495 1.211 1.144 0.118 0.138 0.122 0.119 0.123 0.112 0.116 0.105 0.113 0.138 0.994 0.610 0.518 0.360 0.261 0.235 0.171 0.179 0.196 0.163 0.144 0.134 0.129 0.120 0.124 0.135 0.136 0.126 0.131 0.168 0.137 0.133 0.135 0.186 13 43 73 93 123 153 173 21 51 81 101 131 161 181 22 52 82 102 132 162 182 23 53 83 103 133 163 183 31 33 62 111 112 142 191 32 61 63 113 141 143 192 S S S S S S S N N N N N N N B B B B B B B 1.401 1.166 1.224 0.952 1.191 1.271 0.116 0.120 1.244 1.244 1.211 0.902 0.868 1.048 0.112 0.125 Farm D Plate 1 Layout and ODs 12 B 11 1 B 4 42 1 B 7 72 B 91 92 1 B 12 122 B 151 152 1 B 17 172 B 201 202 203 211 212 213 193 221 S N B 0.162 0.163 0.159 0.140 0.143 0.129 0.136 0.132 1.639 1.740 2.209 1.731 2.021 1.981 2.210 2.194 1.347 1.530 2.051 1.943 2.079 2.043 2.151 2.170 1.260 1.537 1.856 1.817 2.054 1.744 2.055 2.010 1.322 1.648 1.577 1.944 1.930 1.787 1.879 2.149 1.139 1.073 1.605 1.548 1.597 1.701 2.048 2.117 0.943 1.309 1.310 1.711 1.555 1.737 1.870 1.935 0.876 1.208 1.309 1.686 1.801 1.197 1.714 1.789 1.001 1.137 1.470 1.394 1.420 1.259 1.658 2.113 0.592 0.639 0.422 0.328 0.273 0.180 0.169 0.183 0.162 0.202 0.141 0.127 0.123 0.124 0.118 0.119 0.121 0.134 0.124 0.113 0.130 0.136 0.125 0.132 Plate 2 Layout and ODs 232 B 231 1 B 26 262 B 291 292 1 B 31 312 1 B 34 342 B 371 372 1 B 39 392 B 421 422 233 263 293 313 343 373 393 423 241 271 301 321 351 381 401 431 242 272 302 322 352 382 402 432 243 273 303 323 353 383 403 433 251 253 282 331 333 362 411 413 252 281 283 332 361 363 412 441 S S S S S S S S N N N N N N N N B B B B B B B B 0.109 0.120 0.132 0.125 0.169 0.141 0.132 0.129 1.181 1.558 1.489 1.681 1.970 1.958 2.137 2.106 1.298 1.142 1.271 1.598 2.096 1.815 2.006 2.005 1.243 1.472 1.294 1.839 1.865 1.860 1.397 1.557 1.178 1.368 1.205 1.007 1.132 2.071 1.877 1.606 1.105 1.310 1.367 1.929 1.971 1.529 1.462 1.429 0.990 1.040 1.387 1.945 1.879 1.789 1.563 1.506 0.785 0.602 0.660 0.438 0.328 0.238 0.193 0.148 0.196 0.164 0.144 0.148 0.134 0.131 0.119 0.117 0.131 0.117 0.133 0.128 0.142 0.133 0.132 0.142 Plate 3 Layout and ODs 452 B 451 1 B 48 482 B 511 512 1 B 53 532 1 B 56 562 B 591 592 1 B 61 612 B 641 642 453 483 513 533 563 593 613 643 461 491 521 541 571 601 621 651 462 492 522 542 572 602 622 652 463 493 523 543 573 603 623 653 471 473 502 551 553 582 631 661 472 501 503 552 581 583 633 662 S S S S S S S S N N N N N N N N B B B B B B B B 0.151 0.175 1.954 1.891 1.890 1.418 0.606 1.416 1.515 1.423 2.171 1.787 1.910 1.985 1.455 1.057 0.273 0.199 0.210 0.142 1.091 1.417 1.648 1.685 2.059 1.698 2.045 1.786 2.112 2.207 1.179 1.502 1.523 1.594 1.883 1.734 2.218 2.052 1.909 1.888 0.150 0.140 0.137 0.143 0.131 0.151 1.838 2.287 2.486 2.496 1.798 2.072 1.855 2.071 2.086 2.318 1.510 0.789 1.834 2.078 2.172 1.298 2.134 1.445 1.194 1.792 2.100 1.844 1.847 1.217 1.537 1.827 2.121 2.037 1.103 1.680 1.977 1.868 2.109 2.116 1.737 2.017 2.058 2.092 1.918 2.423 2.296 2.030 0.796 0.709 0.589 0.657 0.540 0.192 0.148 0.151 0.209 0.152 0.149 0.132 0.136 0.130 0.131 0.196 0.134 0.135 Plate 4 Layout and ODs 672 B 671 B 711 712 1 B 75 752 B 791 792 1 B 83 832 1 B 87 872 B 911 912 1 B 95 952 681 721 761 801 842 882 922 961 682 722 762 802 843 883 923 962 692 732 772 812 852 892 932 972 693 733 773 813 853 893 933 973 702 742 782 822 862 902 942 982 703 743 783 823 863 903 943 983 S S S S S S S S N N N N N N N N B B B B B B B B 0.132 0.140 0.125 0.136 0.115 0.128 0.116 0.126 1.662 1.452 1.331 1.517 1.572 1.317 1.577 1.499 1.157 1.176 0.649 1.383 1.359 1.229 0.900 1.458 1.434 0.969 1.513 1.272 1.331 0.826 0.873 1.768 1.139 1.277 1.345 1.357 1.321 1.768 1.251 1.696 1.222 1.204 1.402 0.794 1.744 1.818 1.733 0.783 1.127 1.239 1.569 1.728 1.802 1.789 1.888 2.020 0.774 0.654 0.593 0.366 0.249 0.227 0.201 0.147 0.182 0.237 0.169 0.164 0.139 0.134 0.180 0.134 0.176 0.122 0.130 0.128 0.135 0.124 0.148 0.143 Plate 5 Layout and ODs 993 B 992 2 B 102 1023 B 1052 1053 2 B 108 1083 2 B 111 1113 B 1132 1133 2 B 115 1153 2 B 118 1183 1002 1032 1062 1092 1122 1141 1163 1193 1003 1032 1063 1093 1123 1142 1173 1203 101 104 107 110 B B B B B B B B B B B B B B B B B B B B B B B B B B B B S S S S S S S S N N N N N N N N B B B B B B B B 0.116 0.121 0.141 0.147 0.549 0.920 1.405 1.270 0.902 0.657 1.162 1.588 0.621 0.858 1.829 1.221 0.137 0.117 0.154 0.156 0.138 0.140 0.143 0.137 0.157 0.131 0.137 0.130 1.049 0.752 0.677 0.572 0.284 0.289 0.188 0.168 0.173 0.141 0.178 0.173 1.268 1.271 1.269 1.753 1.481 1.466 1.452 1.205 0.711 1.114 1.086 1.157 1.194 2.153 2.603 2.246 1.597 1.233 1.122 1.502 1.599 1.456 1.702 1.444 1.494 1.551 0.803 0.715 1.022 1.337 0.169 0.155 0.145 0.120 1.157 1.458 1.383 1.452 1.467 1.794 1.375 1.727 1.356 1.819 1.179 1.208 0.145 0.145 0.143 0.143 0.126 0.140 0.135 0.140 0.170 0.130 0.129 0.131 0.147 0.140 0.143 0.130 0.339 0.254 0.203 0.178 0.145 0.150 0.141 0.133 0.171 0.173 0.168 0.138 Plate 6 Layout and ODs 1291 B 1211 1 B 122 1301 1 B 123 1311 B 1241 1321 1 B 125 1331 B 1261 1341 1 B 127 1351 1 B 128 1361 1371 1381 1391 1401 1411 1421 1431 1441 1451 1461 1471 1481 1491 1501 1511 1521 1531 1541 1551 1561 1571 1581 1591 1601 1611 1621 1631 1641 1651 1662 1672 1681 1692 1702 1712 1722 1732 1742 1752 1762 1773 1783 1793 1803 1813 1823 1833 1843 S S S S S S S S N N N N N N N N B B B B B B B B 0.116 0.178 0.123 0.118 0.123 0.110 0.109 0.120 1.088 1.148 1.415 1.139 1.065 1.408 1.227 1.017 0.805 1.187 0.583 1.546 1.129 1.209 1.640 1.943 1.093 1.261 0.598 1.393 1.603 1.318 1.538 1.752 1.102 1.228 1.514 1.317 1.016 0.467 1.359 1.597 1.795 1.366 1.330 1.583 1.581 0.729 1.617 1.438 0.928 1.278 1.433 1.560 1.601 0.687 1.815 1.549 0.878 0.660 0.527 0.394 0.314 0.248 0.203 0.192 0.221 0.252 0.176 0.152 0.137 0.140 0.155 0.160 0.135 0.123 0.140 0.151 0.132 0.257 0.191 0.146 Plate 1 Layout and ODs 12 B 11 1 B 4 42 1 B 7 72 B 101 102 1 B 13 132 1 B 16 162 B 191 192 1 B 22 222 13 43 73 103 133 163 193 223 21 51 81 111 141 171 201 231 22 52 82 112 142 172 202 232 23 53 83 113 143 173 203 233 31 61 91 121 151 181 211 241 33 63 92 123 153 183 213 243 S S S S S S S S N N N N N N N N B B B B B B B B 0.109 0.108 0.105 0.111 1.547 1.189 1.330 1.363 1.565 1.195 1.186 1.101 1.885 1.137 0.977 1.037 1.575 0.980 0.949 0.817 1.180 1.130 0.983 1.166 1.257 1.072 1.012 1.271 0.795 0.827 0.614 0.504 0.119 0.132 0.135 0.129 0.105 0.110 0.108 0.106 0.971 1.153 1.012 1.355 1.479 1.232 1.108 0.893 1.134 1.644 1.988 1.523 0.996 0.893 1.349 1.455 1.838 1.254 1.337 1.243 Farm E 0.565 1.235 1.378 1.679 1.334 1.347 1.476 1.616 0.102 0.105 0.108 0.111 1.537 1.390 1.582 1.700 1.434 1.549 1.335 1.591 1.456 1.009 1.252 1.404 0.881 1.184 1.385 1.518 1.361 1.200 1.214 1.367 1.476 1.208 1.124 1.443 1.449 1.289 1.189 1.528 0.306 0.244 0.183 0.145 0.116 0.217 0.102 0.112 0.111 0.102 0.106 0.107 Plate 2 Layout and ODs 252 B 251 1 B 28 282 1 B 31 312 B 341 342 1 B 37 372 B 401 402 1 B 43 432 1 B 46 462 253 283 313 343 373 403 433 463 261 291 321 351 381 411 441 471 262 292 322 352 382 412 442 472 263 293 323 353 383 413 443 473 271 301 331 361 391 421 451 481 272 302 332 362 393 422 453 483 S S S S S S S S N N N N N N N N B B B B B B B B 1.305 0.105 0.104 0.107 0.106 0.104 0.107 0.113 1.139 1.249 0.107 1.478 1.600 1.406 1.469 1.615 1.293 1.553 1.154 1.275 1.216 1.267 1.422 1.767 1.330 1.342 1.514 1.704 1.392 1.480 1.597 1.511 1.257 1.518 1.372 1.029 1.486 1.413 1.504 1.475 1.406 1.190 1.241 1.021 1.661 1.247 1.348 1.412 1.480 1.417 1.330 1.188 1.474 1.602 1.516 1.343 0.775 0.777 0.753 0.576 0.473 0.291 0.223 0.182 0.162 0.153 0.156 0.144 0.130 0.127 0.120 0.131 0.121 0.117 0.117 0.120 0.119 0.119 0.121 0.123 Plate 3 Layout and ODs 492 B 491 1 B 52 522 B 551 552 1 B 58 582 1 B 61 612 B 641 642 1 B 67 672 1 B 70 702 493 523 553 583 613 643 673 703 501 531 561 591 621 651 681 711 502 532 562 592 622 652 682 712 503 533 563 593 623 653 683 713 511 541 571 601 631 661 691 721 513 543 573 603 633 663 692 723 S S S S S S S S N N N N N N N N B B B B B B B B 0.117 0.114 0.110 0.107 0.104 0.111 0.122 0.125 1.864 1.693 1.395 1.460 1.362 1.575 1.308 1.050 1.653 1.396 1.285 1.214 1.272 1.227 1.301 1.646 1.562 1.650 1.085 1.386 1.466 1.585 1.422 1.687 1.682 1.531 1.184 1.271 1.519 1.546 1.441 1.585 1.652 1.637 1.282 1.298 1.640 1.612 1.633 1.493 1.453 1.639 1.371 1.715 1.757 1.768 1.576 1.677 1.182 0.940 0.625 0.510 0.358 0.237 0.220 0.172 0.203 0.175 0.137 0.138 0.126 0.118 0.128 0.139 0.132 0.131 0.125 0.124 0.126 0.128 0.131 0.132 1.338 1.279 1.313 1.367 1.789 1.439 1.362 1.624 1.994 1.965 1.394 1.310 1.459 1.580 0.808 1.292 1.612 1.496 1.415 1.521 1.205 1.308 1.350 1.417 1.593 1.477 1.501 1.641 1.876 1.727 1.318 1.439 1.621 1.581 1.367 1.249 Plate 4 Layout and ODs 732 B 731 1 B 76 762 B 791 792 1 B 81 812 B 841 842 1 B 87 872 1 B 89 892 B 921 922 733 763 793 813 843 873 893 923 741 771 801 821 851 881 901 931 742 772 802 822 852 882 902 932 743 773 803 823 853 883 903 933 751 753 782 831 833 862 911 913 752 781 783 832 861 863 912 941 S S S S S S S S N N N N N N N N B B B B B B B B 0.114 0.581 0.108 0.104 0.099 0.106 0.104 0.111 1.547 1.226 1.180 1.167 1.323 1.135 1.284 1.327 1.324 1.124 0.883 1.094 1.128 1.175 1.241 1.210 1.728 1.179 0.891 1.062 1.259 1.160 1.430 1.300 1.382 1.014 1.037 0.937 1.147 1.102 1.138 1.225 1.119 1.202 0.847 1.037 1.039 1.307 1.092 0.558 1.116 1.031 0.814 0.875 1.031 1.096 1.092 0.917 0.260 0.254 0.326 0.191 0.156 0.148 0.139 0.164 0.133 0.121 0.117 0.111 0.104 0.104 0.105 0.105 0.123 0.109 0.111 0.110 0.104 0.101 0.103 0.116 Plate 5 Layout and ODs 952 B 951 1 B 99 992 1 B 103 1032 B 1071 1073 1 B 111 1113 1 B 115 1153 B 1191 1193 1 B 123 1233 961 1001 1041 1081 1121 1161 1201 1241 963 1003 1043 1083 1123 1163 1203 1243 972 1012 1052 1092 1132 1172 1212 1252 973 1013 1053 1093 1133 1173 1213 1253 982 1022 1062 1102 1142 1182 1222 1262 983 1023 1063 1103 1143 1183 1223 1263 S S S S S S S S N N N N N N N N B B B B B B B B 0.101 0.102 0.105 0.104 0.101 0.101 0.102 0.115 1.356 1.333 1.547 1.872 1.448 1.575 1.720 1.144 1.377 0.944 1.361 1.376 1.226 1.422 1.536 1.609 1.373 1.559 1.312 1.322 1.329 1.428 1.522 1.545 1.462 1.288 1.221 1.000 1.156 1.514 1.466 1.299 1.268 0.692 1.082 1.365 1.061 1.265 0.852 1.318 1.183 1.172 1.228 1.621 1.463 1.397 1.303 1.359 0.912 0.711 0.541 0.464 0.264 0.197 0.181 0.137 0.131 0.115 0.116 0.183 0.122 0.116 0.108 0.112 0.139 0.111 0.106 0.109 0.494 0.110 0.114 0.111 1.404 1.186 0.576 1.249 1.324 1.354 1.407 1.170 1.446 1.665 1.722 1.943 1.699 1.013 1.563 1.402 1.642 1.275 0.814 1.159 1.240 1.041 1.302 0.956 1.496 1.653 1.591 1.845 1.650 0.533 1.664 1.350 Plate 6 Layout and ODs 1263 B 1262 2 B 130 1303 B 1342 1343 2 B 138 1383 2 B 142 1423 B 1462 1463 2 B 151 1513 2 B 156 1563 1271 1312 1352 1392 1432 1472 1522 1572 1272 1313 1353 1393 1433 1473 1523 1573 1281 1321 1362 1402 1442 1481 1531 1581 1282 1322 1363 1403 1443 1482 1532 1582 1292 1331 1372 1412 1452 1491 1541 1591 1293 1332 1373 1413 1453 1501 1551 1601 S S S S S S S S N N N N N N N N B B B B B B B B 0.107 0.110 0.104 0.106 0.109 0.107 0.108 0.105 1.190 1.095 1.065 1.357 1.161 1.203 1.298 1.148 1.281 0.922 0.801 1.287 0.704 1.183 1.457 1.386 0.926 1.450 0.904 1.164 1.120 0.968 1.279 1.030 0.933 0.928 1.036 1.226 0.980 1.319 1.497 1.094 0.982 0.765 0.788 1.016 1.098 0.937 1.084 1.013 1.016 1.305 1.082 0.997 1.302 1.369 0.951 1.257 0.870 0.569 0.466 0.294 0.223 0.190 0.149 0.117 0.114 0.113 0.109 0.105 0.100 0.098 0.093 0.084 0.099 0.102 0.099 0.097 0.100 0.091 0.096 0.095 Plate 7 Layout and ODs 1691 B 1611 B 1621 1701 1 B 163 1711 1 B 164 1721 B 1651 1731 1 B 166 1741 1 B 167 1751 B 1681 1761 1771 1781 1791 1801 1811 1821 1831 1841 1852 1862 1872 1882 1892 1902 1912 1922 1933 1943 1953 1963 1973 1983 1993 2003 2013 2023 2033 2043 2053 2063 2073 2083 2093 2103 2113 B B B B B B B B B B B B B S S S S S S S S N N N N N N N N B B B B B B B B 0.102 0.103 0.097 0.091 0.083 0.092 0.089 0.110 0.563 0.978 0.966 1.073 1.392 1.731 1.234 1.319 1.018 0.790 1.066 1.238 1.198 1.336 1.256 1.097 1.505 0.981 1.439 1.164 1.209 1.281 1.327 1.436 1.632 0.360 0.937 1.135 1.127 1.291 1.477 1.319 0.910 0.439 0.292 0.100 0.107 0.105 0.138 0.108 0.126 0.110 0.115 0.105 0.611 0.119 0.115 0.630 0.835 0.664 0.438 0.307 0.222 0.197 1.905 0.132 0.134 0.121 0.116 0.112 0.108 0.111 0.110 0.111 0.118 0.114 0.110 0.110 0.114 0.108 0.115 0.111 0.985 1.193 0.500 1.054 0.746 0.862 1.136 0.665 1.204 1.166 1.184 0.893 1.106 0.920 1.148 1.690 1.114 1.008 1.110 1.146 1.025 0.994 1.198 1.174 0.786 1.011 1.044 0.664 1.005 0.172 0.637 0.436 UNIVERSITY OF BRISTOL LISTERIOSIS IN DAIRY CATTLE PART A : CASES OF LISTERIOSIS 1. Have you ever had any cases of listeriosis in your :Don’t know Yes No (please circle one) milking cows/heifers ? replacement heifers No Don’t know No Don’t know ? dairy calves ? Yes Yes IF NO OR DON'T KNOW PLEASE GO TO QUESTION 3 2. Who made the diagnosis of listeriosis in your :? Self Vet. V.I.centre (please circle) replacement heifers Vet. milking cows/heifers ? dairy calves ? Vet. Self V.I.centre Self V.I.centre 3. Which of the following are symptoms of listeriosis ? nervous signs (please circle one or more) lameness silage eye sudden death diarrhoea abortion pneumonia mastitis IF YOU HAVE NEVER HAD CASES OF LISTERIOSIS PLEASE GO TO PART C OF THE QUESTIONNAIRE PART B : CASES OF LISTERIOSIS:--BETWEEN JULY 1994 AND JUNE 1995 1. Between 1st July 1994 and 30th June 1995 How many cases of listeriosis did you see in your :cows/heifers ? ______________ milking replacement heifers ? ______________ dairy calves ? ______________ 2. Please provide details, in the table below, of any cases of listeriosis seen from July 1994June 1995. Month of illness Status M-milking cow/heifer H-replacement heifer C-dairy calf Other (please specify) Pregnant Y-yes N-no D-don't know Housing C-cubicle L-loose yard O-outside Other (please specify) Symptoms N-nervous A-abortion S-silage eye M-mastitis D-sudden death Other (please specify) Diagnosed by S-self V-vet VI-VI centre Treated Y-yes N-no D-don't know Res R-r D-d C-c Oth (ple PART C : HERD SIZE :--BETWEEN JULY 1994 AND JUNE 1995 1. How many milking cows/heifers were there in your herd ? on 30th June 1995 ______________ on 1st ______________ 2. How many replacement heifers were there in your herd ? July 1994 on 30th June 1995 ______________ on 1st ______________ July 1994 3. Between 1st July 1994 and 30th June 1995 how many dairy calves were born ? ______________ PART D : FORAGE CROPS FED:--BETWEEN JULY 1994 AND JUNE 1995 1. Which of the following did you feed to your herd between 1st July 1994 and 30th June 1995 ? (please tick or complete the following boxes) Grass silage Maize silage Hay Feed Straw Root crops (please specify type) (please specify type) Other (please speci 2. What was the source of the forage crops ? (please tick the appropriate boxes) Source home made purchased other (please specify) Grass silage Maize silage Hay Feed Straw Root crops Oth 3. From 1st July 1994 to 30th June 1995 between which months did you feed your herd ? (please state the month for each) Grass silage Maize silage Hay Feed Straw Root crops Other 4. When the cows were outside how did you feed forage crops to your herd ? (please tick the appropriate boxes) Feeding Grass silage Maize silage Hay Feed Straw Root crops O not fed ad libitum on the ground in a complete diet in ring feeders in hay racks in troughs off the field other (please specify) 5. When the cows were housed how did you feed forage crops to your herd ? (please tick the appropriate boxes) Feeding Grass silage Maize silage Hay Feed Straw Root crops Ot ad libitum at the clamp face on the floor in a complete diet in ring feeders in hay racks in troughs other (please specify) PART E : MAKING FORAGE CROPS FED:--BETWEEN JULY 1994 AND JUNE 1 1. In which month did you make or harvest the forage crops fed between 1st July 1994 and 30th June 1995 ? (please state in the following boxes) Grass silage Maize silage Hay Feed Straw Root crops 2. How many grass cuts did you make for grass silage ? 1 2 3 Other (please circle one for each) and hay ? 2 1 3 3. What type of mower or harvester did you use ? (please tick the appropriate boxes) Type of mowers or harvesters Grass silage Maize silage Hay Feed St forage harvester discs or drums mower conditioner combine harvester other (please specify) 4. For how long did you wilt, dry or leave the forage crops in the field ? (please circle one or state other) Grass silage please circle one 0 ½ Hay 1 2 3 days 0 ½ Feed Straw 1 2 3 4 5 6 7 days 0 ½ 1 2 3 4 5 6 7d other (please specify) 5. What type of additives or treatments did you use ? (please give the trade names or tick the appropriate boxes) Additives/Treatments Grass silage Maize silage Hay Feed Straw Root cr please specify trade names or type none 6. How did you store grass silage, maize silage and root crops ? (please tick the appropriate boxes) Type of storage clamp silo big bale other Grass silage Maize silage Root crops (please specify) IF YOU DID NOT USE A CLAMP OR SILO PLEASE GO TO QUESTION 10 7. If you used a clamp or silo please describe the floor type. (please tick the appropriate boxes) Type of floor compacted soil concrete other (please specify) Grass silage Maize silage Root crops 8. Did you use separate clamps or silos for each grass cut ? Yes No Yes No Don’t know (please circle one) 9. If you used the same clamp or silo for more than one cut did you seal the clamp or silo between each cut ? Don’t know (please circle one) 10. How did you store hay, straw and big bale silage if fed ? (please tick the appropriate boxes) Type of storage in a covered barn outside covered outside uncovered other (please specify) Hay Feed Straw Big bale silag 11. Did you have your forage analysed ? Yes No Don’t know (please circle one) 12. IF YES, please provide details of analysis of the forage fed between July 1994 and June 1995 ? (please state the results in the appropriate boxes) Forage Clamp - 1 Clamp - 2 Clamp - 3 Big bale Maize silage Hay pH DM Ash PART F : HOUSING :--BETWEEN JULY 1994 AND JUNE 1995 1. From 1st July 1994 to 30th June 1995 ME between which months were your milking cows/heifers housed ? ______________ 2. Which type of housing did you use for your milking cows/heifers ? cubicle (please circle one or more) loose yard other (please specify) ______________ 3. Please provide details of the type of floor (please tick the appropriate boxes) Type of floor earth hard core concrete slatted other (please specify) Cubicle Loose yard Other 4. What type of bedding did you use ? (please tick the appropriate boxes) Type of bedding none sawdust straw other (please specify) Cubicle Loose yard Other 5. What was the source of the bedding ? (please tick the appropriate boxes) Source home made purchased other (please specify) Sawdust 6. For home made straw bedding month was it made ? Straw Other in which ______________ (please complete) how long was it left in the field ? was it big bale ?(please circle) ______________ Yes No what type of straw was it ? (please specify) ______________ 7. How did you store the bedding ? (please tick the appropriate boxes) Type of storage in a covered barn outside covered outside uncovered other (please specify) Sawdust Straw Other 8. How many times each week did you add fresh bedding when the cows were housed ? (please state the frequency per week) please circle one other (please specify) Cubicle Loose yard 1 2 3 4 5 6 7 times 1 2 3 4 5 6 7 times Other 1 2 3 4 5 6 7t 9. How many times each week did you remove the dirty bedding when the cows were housed ? (please state the frequency per week) please circle one other (please specify) Cubicle Loose yard 0 1 2 3 4 5 6 7 times 0 1 2 3 4 5 6 7 8 9 times Other 0 1 2 3 4 5 6 7t 10. How many times was the bedding cleaned out completely while the cows were housed ? (please state the frequency per housing period) please circle one other (please specify) Cubicle Loose yard 0 1 2 3 4 5 times 0 1 2 3 4 5 6 7 8 9 times Other 0 1 2 3 4 5 tim 11. How did you dispose of the dung ? solid manure (please circle one or more) slurry other (please specify) ______________ 12. Where did you store the dung ? (please tick the appropriate boxes) Type of storage Solid manure Slurry Other not stored beneath the slats composted in a slurry tank in a lagoon other (please specify) 13. Did you spread the dung on your pasture ? Yes No Don't know (please circle one) PART G : GENERAL INFORMATION:--BETWEEN JULY 1994 AND JUNE 1995 1. Did you have any cases of listeriosis in Yes (please circle one or more) Yes No beef cattle ? : Don’t know sheep ? No : Don’t know goat ? Yes No : Don’t know other (please specify) ______________ 2. Did any of the following species graze Beef cattle the same pasture as your dairy herd ? Sheep (please circle and specify) Other (please specify) ______________ 3. Against which of the following diseases None were your milking cows/heifers vaccinated ? Salmonellosis (please circle one or more) E. coli Leptospirosis Lungworm Other (please specify) ______________ 4. Were there mole hills in the field where you made : know (please circle) No Yes hay ? No grass silage?: Yes Don’t know straw ? Yes Don’t No : Don’t know 5. What did you use to control moles ? Nothing (please circle and specify) specify) Chemicals (please ______________ Other (please specify) ______________ Thank you very much for filling in this questionnaire. Please return it to us using the stamped addressed envelope provided. STUDY OF LISTERIOSIS IN DAIRY CATTLE Dear Sir / Madam, At Bristol Veterinary School we are working on Listeriosis in dairy cattle, trying to improve its diagnosis and to find out more details of the risk factors associated with the disease, which will help to improve its control. As a part of our study we need to get some background information and would be grateful if you could help us. Enclosed is a questionnaire which asks you about your farm and dairy herd. Please fill it in even if you did not have or have never had any cases of Listeriosis on your farm. All information will be treated confidentially and will be used only for our study. Many thanks for your co-operation. Yours sincerely H. M. Erdogan, DVM P. J. Cripps, BSc, MSc (Epid), BVSc, PhD, MRCVS L. E. Green, BVSc, MSc (Epid), PhD, MRCVS K. L. Morgan, BA, VetMB, PhD, MRCVS STUDY OF LISTERIOSIS IN DAIRY CATTLE Dear Sir / Madam We are conducting a study on Listeriosis in dairy cattle. This questionnaire is a part of our study. We are currently pretesting the questionnaire and would be most grateful if you could fill in and state any comments on the questionnaire and any difficulty you faced while filling in. Thanks very much for your help. Yours sincerely H. M. Erdogan, DVM P. J. Cripps, BSc, MSc (Epid), BVSc, PhD, MRCVS L. E. Green, BVSc, MSc (Epid), PhD, MRCVS K. L. Morgan, BA, VetMB, PhD, MRCVS STUDY OF LISTERIOSIS IN DAIRY CATTLE Dear Sir/ Madam, The response rate in this study is now 60%. We need a response rate of 70% in order to obtain information which will help to prevent Listeriosis in cattle. Please help us to do this by completing your questionnaire over the Christmas period and returning to us. We will close the study on the 12th January 1996. It is important that you return the questionnaire even if you have not had any cases of Listeriosis in your herd. We need your help and thank you in anticipation. Merry Christmas Yours sincerely H. M. Erdogan, DVM P. J. Cripps, BSc, MSc (Epid), BVSc, PhD, MRCVS L. E. Green, BVSc, MSc (Epid), PhD, MRCVS K. L. Morgan, BA, VetMB, PhD, MRCVS UNIVERSITY OF LIVERPOOL STUDY OF LISTERIOSIS IN DAIRY CATTLE I would like to ask you some questions about the history of listeriosis on your farm. I may have already asked some of these questions partially but for completeness I will ask them again. 1. Have you ever had any cases of listeriosis in your :-milking cows/heifers? (please circle one) replacement heifers? dairy calves? Yes Yes Yes No No No 2. If yes, could you please state when the last case was seen in your milking cows?_____________ in your replacement heifers? _____________ in your dairy calves? _____________ 3. If you had a case of listeriosis, which of the following symptoms were seen in listeriosis case(s) ? nervous signs (please circle one or more) silage eye sudden death diarrhoea abortion mastitis Now I would like to get some details about feed, feeding and feed preparation. 4. Between 30th July 1996 and 1st May 1997 which of the following did you feed to your milking cows? -on what date did you start feeding ……..? (please state the exact dates)? -on what date did you stop feeding ……..? Date Type of forage Grass silage Fed Started Stopped Maize silage Hay Feed Straw (please specify type) (barley, wheat, etc.) Root crops (please specify type) (sugar beet, etc.) Others (please specify type) Concentrate(please specify type) 5. What was the source of forage crops FED between 30th July 1996 and 1st May 1997? ( please circle one or more) Grass silage: Home made Bought in Maize silage: Bought in Home made Hay made : Bought in Home Feed Straw : Bought in Home made Root crops : Bought in Home made Others made Concentrate _______________(from which company) : Bought in Home : 6. In which month did you make or harvest forage crops FED between 30th July 1996 and 1st May 1997? (please specify month) Grass silage: ______________________ Maize silage: ______________________ Hay : ______________________ Feed Straw : ______________________ Root crops : ______________________ Others : ______________________ 7. What type of treatment or additives did you use? ______________________ (please specify it) Grass silage : Maize silage : ______________________ Hay : ______________________ Feed Straw : ______________________ Root crops : ______________________ Others : ______________________ 8. Were there mole hills in the field where you made hay ? : No Don’t know (please circle) or grass silage?: No Don’t know or straw ? : No Don’t know Yes Yes Yes 9. For how long did you wilt, dry or leave the forage crops FED between July 1996 and May 1997 in the field ? (please circle one or state other) Grass silage please circle one 0 ½ Hay 1 2 3 days 0 ½ Feed Straw 1 2 3 4 5 6 7 days 0 ½ 1 2 3 4 5 6 7d other (please specify) 10. Did you have your forage analysed? Yes No 11. Can you please give us a copy of all analyses? Yes No 12. If no, please provide details of analysis of the forage FED between 30th July 1996 and 1st May 1997? (please state the result in the appropriate boxes) Forage Clamp - 1 (Grass Silage) Clamp - 2 (Grass Silage) Maize silage pH DM Ash ME Hay Now I have some questions to ask about housing and bedding. 13. From 30th July 1996 to 1st May 1997 Start End between which months were your milking cows housed at night only? __________ __________ (please state the EXACT DATE) and between which months were they housed day and night? __________ __________ 14. What type of straw bedding did you use? Big bale (please circle one) Small bale Other (please specify) _________________ 15. What was the source of the bedding straw used between 30th July 1996 and 1st May 1997? (please circle one or more) Home made Bought in 16. If bought in where did you get your bedding straw? ________________ (please state from what part of country) 17. How often did you add fresh bedding each week? 1 2 3 4 5 (please circle one) 18. 6 7 8 9 10 How often did you remove dirty bedding each week? 1 2 3 4 5 6 (please circle one) 7 8 9 10 In this section I will be asking questions about dung disposal and field management. 19. How did you dispose of the dung ? (please circle one or more) solid manure slurry other (please specify) ______________ 20. Where did you store the dung ? (please tick the appropriate boxes) Type of storage not stored in a slurry tank in a lagoon other (please specify) Solid manure Slurry 21. What fertiliser did use on the field that your milking cows grazed : No between 30th July 1996 and 1st May 1997? Other Dung Yes Artificial Yes : No (please specify) ____________ 22. Please specify the source of the fertiliser used ? Dung :_______________ (from which company) Artificial :_______________ 23. Did you spread human sludge on the field from sewage works? Yes 24. If human was used, where did you get human sludge? ________________ No 25. When was animal dung spread on the field ________________ between 30th July 1996 and 1st May 1997? (exact date) ________________ ________________ 26. Did cattle graze the fields after dung spread? Yes No 27. What dates did you spread human sludge on the field between 30th July 1996 and 1st May 1997? (please give exact dates) ______________ ______________ _____________ 28. Did cattle graze the pasture after slurry spread? Yes 29. If yes, when did cattle graze the field? No _______________ 30. Did any of the following species graze Beef cattle the same pasture as your dairy herd ? (please circle and specify) Sheep Other (please specify) ______________ I would like to move on to ask you about water supply. 31. What was the source of water on your farm? Mains Bore hole Well 32. If the source of water was mains could you please indicate from which companies did you get water? ………………………………………………………………………………………………… I now have some question about milk storage and collection. 33. Which days of the week bulk tank milk was collected by dairy? -Monday Thursday -Friday -Tuesday -Saturday -Wednesday -Sunday - 34. How often milk was collected by dairy? -Daily -Every other day -Weekly -Monthly -Other (please specify)___________ 35. Did you clean bulk milk tank between each collection? -Fortnightly Yes No 36. If no, how often the bulk milk tank was cleaned ? -Daily -Every other day -Weekly -Monthly -Other (please specify)___________ -Fortnightly 37. Do you use disinfectant or sterilising agent when cleaning your bulk tank? Yes 38. If yes, what disinfectant steriliser did you use? No __________________ Now I would like to ask some question about your dry cows. 39. Were your dry cows separated from your milking cows? Yes No 40. Between 30th July 1996 and 1st May 1997 which of the following did you feed to dry cows? -on what date did you start feeding …..? (please state the exact dates)? -on what date did you stop feeding……? Date Type of forage Grass silage Maize silage Hay Feed Straw (please specify type) (barley, wheat, etc.) Root crops (please specify type) (sugar beet, etc.) Others (please specify type) Fed Started Stopped Concentrate(please specify type) 41. Between July 1996 and May 1997 where did you house your dry cows ? between which months they were housed at night only? Between which months they were housed day and night? Date NIGHT Start End Start Type of housing Cubicle DAY Loose yard Straw yard Others (please specify) In this section I would like to ask some questions about diseases and their treatments 42. If you used any treatment or vaccine against any disease between 30th July 1996 and 1st May 1997, could you please answer the following questions? (if necessary please use back of the page) -which vaccines did you use? -which groups of animals did you vaccinate? (please give ID) -when did you vaccinate? Treatment or Vaccine (please specify) Animal ID Date of administration 43. If you had any clinical problem between 30th July 1996 and 1st May 1997, could you please answer the following questions? (if necessary please use back of the page) -did any animal suffer from any illness? Yes No -if yes, could you give me a list of the animals, their ID? -what was the date of illness? End -what was used to treat? -what was the result? Animal ID Clinical illness (i.e. mastitis, salmonellosis etc.) Date of illness Treated Y= Yes N= No Result R= Recovered D= Died C= Culled Finally I shall be asking some questions about your own health or health of your family or anybody working on the farm. 44. Did you or your family or any worker have any illness between 30th July 1996 and 1st May 1997? Yes No 45. If yes could please state the illness and its duration in the table below? who had illness? when did it start? (exact date) how long did it last? Illness 46. What type of dairy herd do you have? Person Started Duration Open Closed Other (please specify) _________________ 47. Could you please provide information on the age, stage of lactation, pregnancy, and annual milk yield of the milking cows kept in your herd between 30th July 1996 and 1st May 1997? THANK YOU VERY MUCH FOR TIME TO COMPLETE THIS QUESTIONNAIRRE