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Emerging
Diseases: Lessons from the
UK PMWS Experience Eric
Neumann, DVM, MS, Director,
Swine Health Information and Research, National Pork Board
Introduction Surveillance
for emerging animal diseases is an important tool for maintaining the
health of livestock in the U.S. Both
industry and government share in the need for this tool as all farm
sizes and types are likely to be affected, spread between farms and
between regions of the country can be expected to be rapid, and access
to existing and new export markets would be reduced.
In the swine industry alone, several diseases have emerged or
“re-emerged in the last 15 years.
These include Porcine Reproductive and Respiratory Syndrome
virus, numerous strains of swine influenza virus, E.
coli F18, Salmonella DT104, Erysipelas
rhusiopathiae, and porcine circovirus-associated diseases such as
postweaning multisystemic wasting syndrome and porcine dermatitis and
nephropathy syndrome. Circovirus
(PCV-2) associated diseases in swine have been recognized in many
countries around the world, including the US and the UK.
The most well known PCV-2 associated clinical diseases have been
termed Postweaning Multi-systemic Wasting Syndrome (PMWS) and Porcine
Dermatitis and Nephropathy Syndrome (PDNS). Based
on the presence of PCV-2 and similar lesion descriptions, many believe
that these clinical syndromes are the same in both the UK and the US.
However, distinct clinical differences do exist raising the issue
as to whether the diseases exist in the US at all or if they simply
differ in their significance in the respective countries.
PMWS primarily affects nursery pigs (6-12 weeks of age) in the UK
while PMWS is more frequently associated with finishing or older nursery
pigs (10-16 weeks of age) pigs in the US.
UK mortality rates associated with PMWS and PDNS has been
described in the 20-40% range. Mortality
in the US and Canada typically ranges from 3-10%.
Britain’s Meat and Livestock Commission estimated the two
syndromes cost its swine industry $31 million in 2001. The
National Pork Board in conjunction with USDA, sponsored a study trip to
the UK in an effort to further understand the differences between the US
and the UK in regard to the prevalence and severity of PMWS.
A cross-functional team of veterinarians, producers,
epidemiologists, pathologists, and clinicians spent a week in the UK
during November of 2002 to carry out this mission.
Representatives from industry, production, and government in the
UK were instrumental in helping to coordinate our trip and we are very
grateful for their help and participation. Current
Status of the Disease in the UK The
label “PMWS” contains such wide variation in actual clinical disease
that it is important to define a “case.”
The scientific literature has suggested that the presence of
wasting accompanied by histologic evidence of lymphoid depletion and
presence of the virus defines PMWS.
In reality, a trip to an affected farm displays an array of
clinical specimens that paint a much fuzzier picture.
For example, does a typical PMWS pig waste over a matter of a few
days or a few weeks? Is
PMWS preceded by, followed by, or unrelated to the occurrence of PDNS in
pigs/farms? Does PMWS make
other disease conditions worse or do other diseases make PMWS worse?
Is a PMWS pig predestined to become a case or is each new day in
the life of a pig an independent event with respect to his risk of
becoming affected? The
relationship between PDNS and PMWS is far from understood.
Some producers and veterinarians adamantly believe PMWS infection
on a farm begins with an outbreak of PDNS but that it would eventually
disappear or “change into” very classical PMWS over a period of
months. Others are
convinced of the opposite sequence of events.
Rarely do both syndromes show up on the same pig.
Occasionally, both syndromes can be represented in an affected
group. Many
other diseases seem to occur concurrently with PMWS.
Both PRRS and M.
hyopneumoniae infections (PRDC in US terms) are common respiratory
pathogens. Systemic
infections including PRRS, H.
parasuis, and S. suis are also present.
The frequency of enteric infections occurring along with PMWS is
unknown but is apparent in some groups. Reproductive
failure associated with PCV2 in the UK has been suggested but is not
thought to be a frequent event. What
is the cause of PMWS? Researchers
in the US and elsewhere have produced convincing evidence that PCV2
alone can cause the lesions and clinical signs commonly seen in PMWS. However, we also know that many farms in the US and the UK
are positive for the PCV2 organism but don’t show the classical
clinical signs of the disease. Clearly,
there must be more to the story than simply being PCV2 positive. One
theory is that additional risk factors must be present (in addition to
the presence of PCV2) in order for clinical signs of PMWS to appear.
These possible triggers may include: 1.
Other infectious agents
including PRRSV, Haemophilus
parasuis, Salmonella spp.
and others. 2.
Unique feeding practices or ingredients. 3.
Various management or
pigflow techniques. 4.
The potential role of
mycotoxins. 5.
Genetic, parity, gender,
and individual pig factors. 6.
Gilt isolation and
acclimatization procedures. 7.
Weaning age. The
relative importance of any of these potential risk factors is unknown.
However, they should provide a good framework for further study
of the disease in the US and the UK. Challenges
in Developing an Emerging Disease Surveillance System Countries
need to begin working together to protect their industries from emerging
diseases that are yet-to-be identified, but can be diagnosed
symptomatically in conjunction with defined case criteria.
While overly broad application of a system like this could be
used inappropriately by countries wishing to limit their trade
obligations, proper use of the same system could improve the future
health of all country’s livestock industries.
Early detection of emerging diseases would be expected to
minimize the impact on production and allow rapid implementation of
prevention strategies. Development
of emerging disease surveillance programs will require a coordinated
effort by governments and an international exchange of information,
scientists, diagnostic technology, and disease surveillance tools in
order for creation of a successful model.
Participants should be encouraged to review information outlined
in the 1999 Swine Futures Report for guidance. Summary The
UK has clearly experienced a much severe form of PMWS, and at a higher
prevalence than the US. Research
needs to be continued to sort out the importance of different risk
factors as well as to elaborate the interaction between PCV2 and other
swine pathogens. The National Pork Board has identified the issues of
disease surveillance, and detection of emerging diseases (specifically,
PMWS) as important priorities for Pork Checkoff.
We will continue to fund work in these areas and help to support
US swine producers in their need to maintain farms with the highest
standards of health. |