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Review Article Vet. Med. Czech, 47, 2002 (8): 234240

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1. INTRODUCTION

Haemorrhagic septicaemia (HS) has a widedistribution particularly in tropical countries inAfrica and Asia. In Asia, HS epidemics may occur

as an alarming and devastating disease problems incattle and bualoes and jeopardise, not only the

economic return of animal production but also,often more dramatically, animal traction and theharvest of vital crops such as rice. Livestock owners

Haemorrhagic septicaemia, its signicance,

prevention and control in Asia

A. BENKIRANE1, M.C.L. DE ALWIS2

1Dpartement de Microbiologie et Maladies Infectieuses, Institut Agronomique et Vtrinaire

Hassan II, Rabat, Morocco2Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya,

Sri Lanka

ABSTRACT: Haemorrhagic septicaemia (HS) is an endemic disease in most countries of Asia and sub-SaharanAfrica. Within the Asian Region, countries can be classied into three categories, on the basis of incidence anddistribution of the disease; these are respectively countries where the disease is endemic or sporadic, clinically sus-

pected but not conrmed, or free. Economic losses due to HS are not only conned to losses to the animal industry,but also rice production on account of its high prevalence among draught animals used in rice elds. Only a few

attempts have been made to estimate economic losses, the methodologies used in dierent countries have varied,and many are not based on active surveillance, and a consideration of all components of direct and indirect losses.

Most Asian countries rank HS as the most important contagious disease or the most important bacterial disease incattle and bualoes. Resource allocation for prevention and control of HSnationally or internationally will evidently

depend on a correct estimate of its economic impact. e key factors in prevention and control would be timelyand correct reporting, accurate and rapid diagnosis, strategic use of vaccines with the attainment of a high coverage

where necessary with a high quality vaccine. National level activities geared towards attainment of these objectives

may be with advantage supported and strengthened by international organisations involved in animal health. epresent paper attempts to review aspects related to the epidemiology, control and containment of HS in Asia and,proposes some key issues on which a regional programme for HS control in this continent should be centred.

Keywords: haemorrhagic septicaemia; prevention; control; vaccine; Asia

CONTENTS

1. Introduction2. Issues in HS epidemiology, diagnosis and con-

trol2.1. Geographical distribution2.2. Epidemiological patterns2.3. Detection and conrmation of disease

outbreaks/foci2.4. Approaches to treatment, prevention and

control

2.4.1. Treatment2.4.2. Prevention and control2.4.2.1. Measures during an outbreak2.4.2.2. Measures in endemic countries

(zones)2.4.2.3. Prevention of spread across borders2.5. Economic losses

3. Some key elements for a HS regional controlprogramme in Asia

4. Conclusion5. References

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generally fear this disease while they view foot-and-mouth disease and other major infectious disease inthe continent merely as a nuisance.

2. ISSUES IN HS EPIDEMIOLOGY,DIAGNOSIS AND CONTROL

2.1. Geographical distribution

On the basis of distribution of the disease, threedistinct categories of countries can be identied inthe Asian continent (FAO-WHO-OIE, 1994):

Category A: e disease is reported to be en-demic and is of utmost economic importance

in Bhutan, China, India, Indonesia, Mongolia,Myanmar, Philippines, Sri Lanka and Malaysia (ex-cept in Sabah region where only a low sporadic orexceptional occurrence is presently recorded). Mostof these countries have large cattle/bualo popula-tions, in respect to the existing infrastructures andthe limited operational capabilities of their vet-erinary services. Furthermore, livestock rearing islargely extensive and management is rather poor inview of the signicance of ruminants in the respec-tive national economies.

Category B: In this category of countries, al-

though sporadic outbreaks of the disease havebeen suspected clinically, its presence has not beenconrmed by isolation of the agent and serotyp-ing. Example: Kuwait, Qatar. ese countries arenet livestock importers and therefore, may see thedisease introduced occasionally through cattleimports.

Category C: In this group of countries which arespread throughout all the continent, clinical reportsof the disease in the past are on record, but present-ly, these countries are free of the disease (Singapore,

Chinese Province of Hong Kong, Israel) or the di-sease has never been reported (Japan, Jordan).

2.2. Epidemiological patterns

e major susceptible animal species consist ofbualoes and cattle. ere is ample evidence thatbualoes are more susceptible than cattle and that,in both species, young and young adult animalsare more susceptible than older animals (De Alwis,1990b).

e two common serotypes ofPasteurella multo-cida (Carter; Heddleston) associated with diseasein these species are types B:2 (in Asia) and E:2 (inAfrica). e Asian B:2 serotype has also been as-

sociated with sporadic septicaemic disease in pigs.Besides type B:2, several other B serotypes havebeen incriminated in sporadic outbreaks of dis-ease particularly in feral ruminants (Rimler, 1993;Jones and Husseini, 1982; OIE, 2000; Rimler andWilson, 1994).

e organism causing HS does not survive out-side the animal body to any signicant degree so asto be a source of infection. Moist conditions pro-long its survival. us the disease tends to spreadmore during the wet season. e onset of the

monsoon in Asian countries also set into motionother activities such as rice cultivation which bringabout movements of animals, work stress in workanimals, etc. all of which favour the precipitationof outbreaks (De Alwis, 1990a).

Infection occurs by inhalation or ingestion ofP. multocida bacteria. Higher incidence of HS isassociated with moist, humid conditions, highbualo population density, and extensive freegrazing system of management, where large herdsgraze freely in common pastures and are paddockedtogether at night. In situations where occasional

sporadic outbreaks occur in some regions withinendemic countries, mortality may be very highunlike endemic areas where regular, seasonal out-breaks occur, where losses in each outbreak are lowand conned to young animals. e phenomenonof naturally acquired immunity resulting from theso-called non-fatal infection largely controls themortality and morbidity patterns. It is, on theother hand the mechanism through which animalsthat have recovered from HS acquire a long lastingcarrier status which render the prevention of new

outbreaks rather dicult.ese losses in endemicareas may be of an insidious nature which may es-cape the notice of the animal health authorities butmay be of considerable economic signicance (DeAlwis, 1981). Once clinical signs appear, case fatal-ity is nearly 100%. Variable numbers of immunecarriers are present in animal populations, particu-larly in endemic areas. ey may be latent carriers,where the organisms are lodged in the tonsils, oractive carriers, where organisms are detectable inthe nasopharynx (De Alwis, 1990c; De Alwis et al.,1986, 1990).

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2.3. Detection and conrmation of diseaseoutbreaks/foci

A clinical, provisional diagnosis of HS is based on

a combination of clinical signs, gross pathologicallesions and a consideration of relevant epidemiolo-gical parameters and other similar diseases preva-lent in the locality.

A provisional diagnosis is important since preven-tive measures to control the spread of the diseaseare required immediately, without waiting for thenecessary laboratory conrmation. At the earliestopportunity, however, appropriate material shouldbe collected and dispatched to the nearest labora-tory. e mere isolation of P. multocida does not

mean that HS was diagnosed. On the one handit should be put in the epidemiological contextand, on the other hand the isolated strain mustbe serotyped. Anthrax, blackquarter and, morespecically rinderpest (due to its possible implica-tions in international animal health) should alwaysbe considered when investigating sudden deaths incattle and bualoes.

A variety of diagnostic techniques have been de-veloped over the years for HS. ese include: Blood smear, culture and biological tests for

isolation of the causative agent. Mouse isolation

may prove necessary as samples are often heavilycontaminated when they reach the diagnosticlaboratory. A mouse colony is therefore neces-sary in such laboratories.

Biochemical and serological tests (capsular suchas rapid slide agglutination and indirect haemag-glutination tests or somatic such as agar gel pre-cipitation test) for identication ofP. multocidaand determination of serotypes. An ELISA testhas recently been developed in Australia, howeverit fails to dierentiate between the Asian (B:2)

and African (E:2) types. is is not a seriouslimitation in Asia as only B:2 type ofP. multoc-ida has been encountered so far. us ELISA canbe a good test for screening a large number ofcultures from a collection in a laboratory wherethe turnover is high.

Nonserological tests for presumptive identica-tion of serotypes (e.g. acriavine occulationtest, hyaluronidase test).

Molecular methods such as PCR, ribotyping orrestriction endonuclease analysis which have anepidemiological signicance because they enablestrain dierentiation within serotypes and hence

some epidemiological inferences, for investiga-tions extending beyond routine diagnosis.

2.4. Approaches to treatment, prevention andcontrol

2.4.1. Treatment

HS is a primary bacterial disease and, theoretical-ly, could be eectively treated by the wide range ofantibiotics currently available. However, treatmentis constrained by a host of practical considerations.Animals can be cured only if they have been treatedin the very early stages of the disease. e conditionsfor an early detection of the disease and hence itseective treatment are usually lacking in primitivehusbandry systems. In organised farms, however,early detection and eective treatment are achievedthrough regular checking of rectal temperatures ofin-contact animals. Usually chemotherapy resortsto either streptomycin or oxytetracycline adminis-tered by intramuscular route at fairly high dosage.Penicillin and Ampicilline are also widely used.Antibiotic resistance ofP. multocida may occur andit has been reported at least vis--vis streptomycinand sulfonamides (Abeynayake et al., 1993; Kedrakand Borkowska-Opacka, 2001).

2.4.2. Prevention and control

2.4.2.1. Measures during an outbreak

Vaccination is a major control measure in the faceof a new epidemic. Various vaccine types havebeen developed among which the broth bacterin,the oil adjuvant vaccine, the double emulsionvaccine and a live vaccine (Verma and Jaiswal,1998). e latter is a deer strain aerosol vaccine

developed in Myanmar. Although this vaccine isthe sole vaccine used (apparently with success) inMyanmar, it does not seem to have gained popu-lar acceptance outside this country. e reasonsadvanced to explain this are numerous: the factthat the strain concerned (Pasteurella multocidaserotype B:3.4) has occasionally been associatedwith sporadic outbreaks of disease due to hith-erto unexplained reasons (Jones and Husseini,1982; Rimler and Wilson, 1994; OIE, 2000)and its occasional virulence to young animalswhen administered by the subcutaneous route

(Myint and Carter, 1989, 1990) are the possible

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reasons, apart from the general reluctance to usea live vaccine and the fact that antibiotics can-not be administered simultaneously to this livevaccine.

During an outbreak, one should resort to im-mediate whole herd vaccination, irrespective ofprevious vaccination history. e use of eitherbroth bacterin or oil adjuvant vaccine is recom-mended;

Sanitary measures include early detection andisolation of new cases and their immediate treat-ment with antibiotics, deep burial of carcasses orincineration, and the prevention of movementsof animals to disease free areas.

2.4.2.2. Measures in endemic countries/zones

Vaccination on a routine prophylactic basis pref-erably two to three months before the high-riskseason (monsoon).

Awareness of the disease among farmers backedup by a good disease reporting/disease informa-tion systm.

Segregation of animals from endemic and nonen-demic areas to avoid contact with carriers.

2.4.2.3. Prevention of spread across bordersIt has been said above that HS was an endemic

disease unlikely to spread in a way such as it easilycrosses borders. However, import of animals froman area of unknown status vis--vis HS to a freearea should comply with some practical procedureswhich should take into account the high percentageof carriers that occur in endemic areas than was ear-lier believed, and the persistence of the carrier sta-tus for long periods (De Alwis et al., 1990). Briey,these are: (a) ensure that the animals originate from

a region where no outbreaks of HS have occurredfor a minimum period of one year; (b) carry outan indirect haemagglutination (IHA) testing (a testwhich can reveal recent infection) on the animalsto be exported as well as on a random sample of in-contacts in the country of origin whenever possible;(c) hold animals under observation for 23 weeksbefore transport (while carrying out the above test-ing); (d) quarantine them for the same period oftime upon arrival to destination and; (e) vaccinateall animals at the end of the quarantine period.

Whenever animals are exported from HS endemiccountries, even after observing all the above precau-tions, it is important to vaccinate all susceptible

stock in the importing country that are likely tocome into contact with the imported animals.

Whilst these above-mentioned measures may befeasible and meaningful in island situations, the

Asian continent has to contend with many landborders, across which considerable unquarantinedanimals may be moving.

2.5. Economic losses

HS is a disease of utmost economic importanceparticularly in Asia and to a lesser extent in Africa.In Asia the susceptible animal population consistsof 432 million cattle and 146 million bualoes,which constitute 30% and 95% of the worlds cattle

and bualo population, respectively. In India wherethe production of milk is highest in Asia, around50% of the milk come from the more susceptiblebualoes. In Asia as a whole, the contribution ofthe bualo to the milk production is 37%. Most ofthe cattle and bualoes are used as draught animalsin the rice elds, and rice is the staple diet in manycountries. us, the high population of bualo inAsia, the high susceptibility of bualo to HS andthe high case fatality, all point to the signicanceof the economic losses due to the disease (FAO,1994, 1995).

Few countries have attempted to quantify thelosses due to HS, and there is no uniformity inthe methods adopted. us, these studies are notstrictly comparable, but will reect the trends.Most of the available information is derived frompassive reporting systems.

In India, during the past four decades it has beenfound that HS accounted for 4655% of all bovinedeaths. During the twelve years period since 1974to 1986 it accounted for 58.7% of the aggregate ofdeaths due to ve endemic diseases, viz. foot-and-

mouth disease (FMD), rinderpest, blackquarter,anthrax and HS (Dutta et al., 1990). In an activesurveillance study in Sri Lanka, it was shown that inthe 1970s, around 15% bualoes and 8% cattle inthe HS endemic areas died of HS annually. Duringthe same period, the passive reporting systems re-corded only 1 200 to 1 500 deaths a year in a cattleand bualo population of approximately 2.5 mil-lion (De Alwis and Vipulasiri, 1981).

Other countries in South Asia also ranked HSas the most economically important infectious dis-

ease or the most economically important bacterialdisease. Pakistan reports that 34.4% of all deathsin susceptible stock is due to HS. With a cattle

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and bualo population of 17.7 and 18.8 millionrespectively, the annual economic losses have beenestimated at 1.89 billion rupees (350 million USD)(Chandry and Khan, 1978; FAO, 1979; Sheikh et

al., 1994).In the South-East Asian region, countries such

as Indonesia, Malaysia, ailand, Myanmar, Laos,Cambodia and the Philippines rank HS highamong the economically important diseases of cat-tle and bualoes (Patten et al., 1993). In Myanmarit is reckoned that 50% of the governments eortin animal disease control is directed towards HS(Patten et al., 1993). Malaysia, with a relativelysmall population of 735 000 cattle and 186 000bualoes, estimates the animal losses due to HS

to be 2.25 million Malaysian Ringit (0.85 millionUSD) (FAO, 1979).Most estimates of losses take into account only

direct losses, i.e. value of animals that die of HS.A true estimate of losses should take into accounta variety of factors which constitute indirect losses.ese are listed below:(i) Loss of productivity milk, meat, draughtpower, and cost of alternate sources of draughtpower.(ii) Impairment of the reproductive potential ofthe animals.

(iii) A reliable dierential diagnosis as there istendency during the Monsoon to attribute anymortality to HS. us a possible over-estimationof these losses should be taken into account. How-ever, it must also be borne in mind that reportedlosses constitute only a fraction of the actual losses.is is bound to be so since HS is a disease thatoccurs in situations where husbandry practices arepoor and therefore disease reporting system willalso be poorly developed.In a study in Bangladesh (Ahmed, 1996), an at-

tempt was made to compute the economic lossesresulting from three important endemic diseases,anthrax, blackquarter and HS. It was found thatthe direct losses which took into account the mar-ket value of the animals that died and the cost oftreatment was 2.3 million US dollars. eir com-putation of indirect losses took into account thevalue of the rice that would have been producedfrom the land left uncultivated as a result of lossof draught power. ese losses amounted to 148million USD annually due to these three diseases(Ahmed, 1996). It may therefore be concluded thatno accurate estimates are available on the actualdeaths due to HS, and the available information on

direct and indirect economic losses is incomplete.e available information, however, suggests thatHS is a disease of considerable economic impor-tance in the Asian Region.

3. SOME KEY ELEMENTS FOR A HSREGIONAL CONTROL PROGRAMMEIN ASIA

It must be noted that, unlike FMD and rind-erpest, HS eradication does not seem to be feasi-ble presently, with the limited experience in theLombok Island in Indonesia (Syamsudin, 1993).With the present information on economic losses

and a knowledge of its epidemiology in the coun-tries of the region, the key factors in preventionand control appear to be quick reporting, accurateand rapid diagnosis, strategic use of vaccines withattainment of a high prophylactic vaccinationcoverage with a high quality vaccine, i.e., potent,economical, and easily administrable. All of thesewould constitute national level activities within thecountries of the region.

A regional programme aiming at reducing theeconomic losses associated with the disease should,therefore, focus on strengthening of these activi-ties within the countries and co-ordinating theireorts.

e proposed elements articulate around the fol-lowing range of outputs and activities: Develop simple, accurate and rapid diagnostic

tests that can be carried out even in the modestlyequipped laboratories in the region.

Identify simple, accurate and rapid diagnostictests, standardise the techniques and make themavailable to all countries of the region.

Make available, through the regional HS Refer-

ence Laboratory (Peradenyia, Sri Lanka) typecultures, reference sera or any other biologicalsthat may be necessary.

Produce a Manual of Diagnostic Procedures, foruse in all countries of the Region.

Acquire sucient knowledge of the epidemiologyof the disease in each country so as to formulatea strategic control programme.

Strengthen disease reporting and surveillancesystems in general.

Develop protocols for collection of relevantepidemiological data and the management andprocessing of such data so as to obtain a clearepidemiological picture in each country.

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Develop standard protocols for active surveillancestudies on HS in particular.

Develop standard procedures for estimating eco-nomic losses.

Assist in the development of a strategic vaccina-tion programme for each country based on theabove information.

Make available the technology for the produc-tion of a vaccine that is potent, economical, thatcan be easily administered and with a productiontechnology simple and sustainable in countries ofthe region.

Identify vaccines such as the new oil adjuvantvaccines, double emulsion vaccines and live vac-cines for further development.

Encourage and support research and develop-ment (R & D) activities on these vaccines. Enlist a range of tested and proven vaccines of

acceptable standard which the countries of theregion could select from, depending on their re-sources and level of technology available withinthe country.

Publish a Manual of Standard Procedures forProduction and Quality Control of HS Vac-cines, incorporating the range of vaccines iden-tied above.

Develop training programmes for veterinarians

and other animal health eld ocers. Also, en-hance awareness among the livestock farmers soas to improve their co-operation and stimulatetheir participation in the control programme.is would require a serious investment gearedtowards the improvement of the quality of theveterinary extension services.

4. CONCLUSION

e incidence and prevalence of HS in South andSouth-East Asia is undermining both the livestockindustry and the agriculture sector as a whole. A setof activities, as described above, if put in motion,may contribute to reducing the pressure exertedby this disease on the fragile economies of mostcountries where it occurs. It remains that somecritical gaps are still encountered in the knowledgeof disease patterns and the true economic impacton livestock.

Periodic meetings organised within the region,will undoubtedly assist in planning HS surveillanceand control programmes and monitoring progresstowards the attainment of the overall objective.

Since the eradication of HS is not a realistic op-tion for the time being (Syamsudin, 1993), massprophylactic vaccination, combined with treat-ment where possible, should theoretically suce

to contain mortality associated with HS. A soundHS control programme may be adopted at nationallevel provided that the tools used for the diagno-sis and control of the disease meet internationalstandards (OIE, 2000). erefore, focus should beplaced on supporting the applied research and awell designed programme of work for action to betaken in the continent, as well as standardisationof products and procedures, to the extend possible,with due consideration to the national situation.Training and extension activities should backup

these eorts.

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Received: 020605

Accepted after corrections: 020726

Corresponding Author

Prof. Abdelali Benkirane, Dpartement de Microbiologie et Maladies Infectieuses, Institut Agronomique

et Vtrinaire Hassan II, B.P 6202, Rabat-Instituts, Rabat, MoroccoTel. +212 6 138 24 38, e-mail: [email protected]

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