^"w" :«iiiUli '-^ Digitized by Microsoft® SF 5 d. Digitized by Microsoft® Cornell University Library SF 959.A5U18 Preliminary report on the recognition of 3 1924 002 959 751 Digitized by Microsoft® This book was digitized by Microsoft Corporation in cooperation witli Cornell University Libraries, 2007. You may use and print this copy in limited quantity for your personal purposes, but may not distribute or provide access to it (or modified or partial versions of it) for revenue-generating or other commercial purposes. Digitized by Microsoft® Preliminary Report on the Recognition of Swamp Fever or Infectious Anaemia in New York State BY DRUDALLind C P. FITCH rrHAcA, n:,y. Reprinted from the Cornell Veterinarian JULY. 1915 Digitized by Microsoft® Digitized by Microsoft® PRELIMINARY REPORT ON THE RECOGNITION OP SWAMP FEVER OR INFECTIOUS ANAEMIA IN NEW YORK STATE D. H. Udall and C. P. Fitch. SYNONYMS. This disease has been described under various names as Equine Infectious Anaemia, Pernicious Anaemia, Anemie epizootique, Ty- pho- anemie, Equine malaria, River-bottom disease. Loin distemper, Mountain fever. Swamp fever, etc. HISTORY. Infectious Anaemia was first described in veterinary literature by Lignee in 1843, and in the same year by Denoc and Charlier. The infectious nature of the disease was first shown by Anginiard in 1859. In 1883 Zschokke reported several cases in Switzerland. Carre and Vallee, during the years 1904- '06, carried on extensive studies of this affection. They were the first to establish the filter- ability of the virus and to show that the virus was present in the urine as well as in the blood. Their findings were later confirmed by Ostertag, Marek and Hempel working independently. In Amer- ica the disease was probably first described by Torrance in 1882 as existing in the province of Manitoba. It was not, however, until 1902 that Dr. Torrance gave a full description of this affection. Since this time many veterinarians have published accounts of the disease. Among them are Van Es, Kinsley, Francis and Marsteller, Mack, Mohler and many others. The most recent investigations published have been carried on by the Seyderhelm's in Germany and the. Japanese Commission appointed to study this disease. This Commission was established in 1909 and the results of their work have but recently been made public. GEOGRAPHICAL DISTRIBUTION Infectious Anaemia is apparently a wide spread disease. In France it occurs in many localities but particularly in the valley of the Meuse. In Germany it is not as widely distributed. It has, however, been observed in Bavaria. Marek has found the disease in Hungary upon three premises in three different counties. It also exists in Switzerland and probably in Sweden: Up to the Digitized by Microsoft® present time the disease has not been positively identified in Great Britain. In Canada, Infectious Anaemia seems to be quite wide spread, it being reported from Manitoba, Alberta, Saskatchewan and other districts. The disease also seems to be widely distributed in the United States west of the Mississippi river and has also been reported in Wisconsin. It seems to be particularly widely distrib- uted in South Dakota, Nebraska, Nevada, Kansas and Texas. Dr. Law makes the statement that "Two general features stand out prominently: first, it ii< a clisctisc of hot weather, and second, it shows a strong predilection for rich damp suits." It is because of this latter characteristic that the disease has been so often referred to under the name of Swamp Fever. AVe are unable to find any account of its existence in the Eastern United States. The out- break here reported extended over an area of about 25 miles sqiiare located in the northern part of St. Lawrence and Franklin counties, New York State and having for its northern boundary the St. Lawrence river. A considerable portion of the affected region is included in the St. Regis Indian Eeservation and the owners of many of the animals were Indians. The land in this section is in some places low and swampy but many cases were found on higher soil which was well drained. ANIMALS AFFECTED In France the disease seems to attack horses, and neither age nor breed seems to make any difference. According to the findings of Carre and Vallee, it can be communicated to the ass. In Amer- ica, mules are affected as well as horses. Sheep, cattle, pigs, dogs, goats and the small animals as guinea pigs and rabbits are appar- ently immune. ETIOLOGY Many agents of both bacterial and protozoan nature have been described as the apparent cause of this disease. Various helminths have been thought to be the carriers of the virus. Mack describes a small body which he finds inside of the red blood corpuscles. We have never observed corpuscular inclusions in the cases of the out- break here reported. Van Es mentions several bacteria which he iso- lated from the cases in Dakota. We have persistently found B. coli present in the organs of the animals dead of this disease. It remained for Carre and ^^allee in Europe to establish the nature of the virus. These investigators passed the blood serum of an infected anim0lMi?©fi'^s&%£§l^^lter and produced the disease by the injection of the filtrate into solipeds. This placed the cause of the disease among the ultra microscopic or as usually termed a "filterable virus". In this country Francis and Mars- teller working in Texas were apparently the first to produce the disease by the injection of filtrates of blood. This experiment sup- ports the theory that the disease in Europe is the same as that occur- ring in this country. The virus is present in the urine as well as in the blood. It seems to be absent from the feces. Carre and Vallee found that the virus was destroyed by heating at 58°C. for &ne hour. Drying at room temperature does not alter its virulence. It was only after seven months drying that the virus was rendered inert. It resists putrefaction for a long time. Van Es states that in natural conditions the virus is able to withstand the climatic conditions of our severe northern winters. Among the later reports of this disease it is well to note the op- posing views of the Seyderhelms' and the Japanese Commission. The German investigators find in their experiments that the disease IS produced by the larvae of bot-flies (Gastrus larva) which occur in large numbers in the stomach and intestines of infected animals. They claim to have produced the disease by the injection of an ex- tract prepared from these larvae. On the other hand the Japanese Conimission as a result of their experiments dismiss "bots" as hav- ing nothing to do with the disease. They believe, however, that the biting horse flies (belong to the genera Chrysopus Hematopota and Tabanus) are the transmitters of infectious anaemia in Japan. MODES OF INFECTION The disease may be produced artiflcially in horses by the sub- cutaneous or intravenous injection of virulent blood. The size of the dose does not seem to make any difference. Carre and Vallee pro- duced the disease by the injection of amounts varying from 1 to 750 c. c. Infection may also take place through the digestive tract by contaminated litter, forage, etc. But more of the virus seems to be necessary to produce the disease by this channel of infection. As has been pointed out the urine contains the virus and this probably plays a large part in its dissemination. It is important to note that animals which are apparently healthy but which have been infected with the disease may become "carriers" and introduce it into a healthy stable. Digitized by Microsoft® Many experiments have been conducted to determine whether the disease is transferred directly from animal to animal. Francis and Marsteller in particular have conducted experiments of this kind. They liave allowed healthy animals to mingle with infected ones for months without the well animals contracting the disease. MORBID ANATOMY The anatomical changes which characterize infectious anaemia a're similar to those of septicemia. They are, however, subject to great variation due to the course of the disease, whether acute or chronic. Blood: The changes present in the blood will be referred to under symptoms. It should be noted, however, that usually the changes are those of an anaemia, dimunition in the hemoglobin and number of red corpuscles. (One of our experimental animals showed polychromemia and polycythemia just before death.) Heart: In the acute type the heart shows sub-serous and sub- pericardial hemorrhages. These may be either single or multiple and are either petechiae, ecchymoses or suffusions. In one of the cases post mortemed by us the myocardium contained many ecchy- moses. The endocardium also is often studded with petechiae and the chordae tendineae are enlarged sometimes edematous and accord- ing to Carre and Vallee this oedema may extend to the valves. These valvular changes were observed by us in one case. The above mentioned authors state that in the chronic form the myocardium is discolored and spotted with rose colored or grayish patches which are the remains of former hemorrhages. Spleen : This organ often shows marked changes. It is usual- ly enlarged, some investigators tinding it two or three times its normal size. We have had one case in which the spleen was en- larged and have seen several \frhere it appeared normal in size. In some cases the spleen pulp appears harder than normal due un- doubtedly to the increase in the connective tissue stroma. The surface of the spleen is spotted with numerous petechiae and ecchy- moses. Microscopic examination of properly stained sections show that the splenic pulp is congested and that in many areas the trabeculae are apparently enlarged. (See Plate No. I, Fig. 1.) Liver: This organ is often enlarged and has numerous pete- chiae on the surface. Carre and Vallee report that it may become so iriable that a rupture may result from the animal suddenly lying Digitized by Microsoft® down. The liver of one of our experimental cases showed consider- able interlobular congestion. Lungs: In the acute form of the disease petechiae and ecchy- moses are present on the surface. Kidneys: Often no changes are present on the surface. Oc- casionally congestion and petechiae are noted. On section paren- chymatous degeneration is noted especially in the cortical portion, Carre and Vallee state that small abscesses are sometimes found in this portion of the kidney. One of the cases postmortemed by us had an abscess 8 cm. in diameter in the left kidney. Intestines: Sub serous hemorrhages are found. The mucous membrane is often hemorrhagic and in several eases small ulcers 1-6 mm. in diameter were found. These changes are found in both the large and small intestines. Peritoneum: This is usually congested and may show petechiae and ecchymoses. The abdominal cavity usually contains varying amounts of more or less sanguinous fluid. Bone: On sectioning, the long bones, particularly the femur and humerus show the most pronounced lesions. In the proximal ends of these bones the bone marrow is changed either wholly or in circumscribed portions. These areas are a brownish red or a bright red. (See Plate No. II. ) The spongy bone marrow of the ribs, vertebrae, etc, show similar changes. The microscopical ex- amination of properly stained sections of the bone and marrow show that these red areas are not hemorrhages as would be supposed on macroscopic examination. They do show some congestion but are as stated by Hutyra and Marek due apparently to the increased ac- tivity of the blood forming elements of the red marrow. ( See Plate No. Ill, Fig. 1.) The spongy bone marrow in some areas shows degeneration and likewise congestion. Lymph glands : ' The lymph glands, particularly the mesen teric are often enlarged and some are usually much congested. (See Plate No. I, Fig. 2.) They are usually darker in color than normal. SYMPTOMS In the middle of August, 1914. Doctor A. W. Baker of Brasher Falls, N. y. reported to the New York State Veterinary College at Cornell University the death from apparent influenza of four horses owned by the St. Regis Indian Reservation in St. Lawrence County. Digitized by Microsoft® The early symptoms were like those of influenza, but as the symp- toms progressed glanders were suspected. Early in September Mr. P. of Bombay, who had already lost a colt, had a brood mare taken sick, and the following symptoms were reported by Doctor Baker: "Patient an old animal with a temperature of 105° ; could hardly move on account of weakness was unable to go forward but could back, and on turning quickly would almost fall" ; this animal died September 8th. On the same visit an examination was made of a three-year-old colt owned by Mr. M. near Hogansburg ; this animal was very sick, temperature 107°, could hardly walk, appeared partially blind, and showed general stiffness ; Mr. M. had already lost one four-year-old mare, and reported a third case on September 6th. On September 12th a second animal died, leaving two with a temperature of 106°. Another case reported by Doctor Baker, September 6th, three weeks after the first call, is described as "going to die, pulse 108, respiration hurried, temperature 103°, eats some, and has a choking spell at times when eating. ' ' September 15th and 16th we saw a number of cases in company with Doctor Baker. It was learned that all of the sick' animals have been pastured at some time during the summer, that some are very stiff, like tetanus, that the upper part of the parotid region is often painful, and that slight nosebleed is frequent. We first called at the farm of Mr. M. where two horses have died after a sickness of three days, and nine days ; one horse that has been sick is apparently better ; and the fourth horse, the first of this group to be taken down, shows the following symptoms after five weeks of sickness. The patient is a nine-year-old bay gelding, attitude very dull, condition fair, edematous swelling of the prepuce, conjunctival and scleral mucous membranes very yellow, pulse 55, respiration 60, temperature 103.2°. The respirations are irregu- lar, increased in frequency, but normal in type. The appetite is fair. A differential blood count was as follows: Lymphocytes 45.1 % Large mononuclears 2.1% Polymorphonuclears 52.2 % Eosinophiles 0.8% Bascmhiles 0.3% This animal die-dW^mrM'.' We next examined ease No. 3, a four-year-old grey gelding owned by Doctor M. of Hogansburg. This animal has been at pas- ture until about ten days ago. The attitude is very much depressed legs carried slowly, some difficulty in backing out of the stall, ■edematous swelling at the fetlocks, conjunctival mucous membrane a very reddish -yellow, pulse 60, respiration 28, temperature 105°., There is a slight serous nasal discharge, but no cough or induced cough. The appetite is good, though the animal eats and drinks slowly, the feces are soft. There is a small area of pain about two inches below the ear in the parotid region. Lymphocytes 43.4 % Large mononuclears 1.2 % Polymorphonuclears 55.4 % This horse was "cured" with quinine, but up to February 1, 1915, has passed through three attacks and on account of general weakness when worked was finally "traded off"; death followed about March 1st. Case No. 4 owned by Mr. A. near Hogansburg was an aged black gelding (Plate IV, Fig. 1) that had been sick two weeks. He got down and was unable to rise for a time. At present he is able to get up but staggers when walking and "stocks badly". The at- titude is depressed, eyes half closed, ears drooped, condition very poor, slight edema of the legs and abdomen, serous discharge from both eyes, conjunctival mucous membranes reddish-yellow, pulse 60, respiration 18, temperature 103.6°. The superficial veins are dis- tended. There is a slight bilateral serous nasal discharge. On pinching the trachea the horse gives a soft, moist, long cough, eas- ily induced, vesicular murmur increased. The bowels rumble free- ly at times. When first taken this horse was given one quart of raw linseed oil with no effect. Urine normal in appearance ; death occurred September 18, 1914. Case No. 5 owned by Mr. C, wh6 has lost two colts at pasture. Patient a two-year-old light chestnut mare with white face, out at pasture with three other colts, (Plate No. Ill, Fig. 2.) This ani- mal has been sick about ten days and has lost rapidly in condition. She was found lying down away from the others. Depression and weakness are marked, condition very poor, slight edema of the chest, conjunctival mucous mSmbranes reddish-yellow, pulse 95, respira- tion 25, temperature l©4?'?'zg^^t/lfefl?aS#®creased. Bats slowly, and bowels rumble loudly. Lymphocytes - 39.3%' Large mononuclears 3.0 % Polymorphonuclears 56.4 % Eosinophiles 1.3 % On September 16th the pulse was 96, respiration 45, tempera- ture 101° ; death occurred September 19, 1914. Case No. 6 owned by Mr. C, in pasture with case No. 5. The patient is a four-year-old chestnut mare not previously known to be sick. Her depressed attitude, (Plate No. IV, Pig. 2) led us to make a further examination. Temperature 104.6°, Case No. 7, owned by Mr. H., who has lost four horses. The patient is a fifteen-year-old mare that has been sick about two weeks, ' ' She fell down when backed out of the stall, and was very uncertain when moving." Condition fair, pulse 60, respiration 60, tempera- ture 102°. This mare had been treated to liberal doses of brandy, and when examined the 16th of September appeared to be nearly normal. On September 24th she was reported as bleeding at the nose, pulse 84, respiration 30, temperature 104°, eating well, but losing rapidly in condition. In November this animal was reported "dead about a week after apparent recovery". Cj,se No. 8 owned by Mr. J. Patient is a ten-year-old bay mare in fair condition, staggers when walking, has edema of the legs, pulse 70, respiration 40, temperature 102.2° ; this animal was reported worse September 20th. This was the last patient seen on our trip of September 15th and 16th. September 20th Doctor Baker reported three new eases, they wore very poor, and two were nearly dead. September 24th, three more new cases. One a ten-year-old brown horse owned by Mr. C, walking around in the meadow and eating, pulse 120, respiration 62, temperature 102°, has been sick two weeks. A second owned by Mr. C. was taken sick the 21st of September with a temperature of 105°. On the 24th the pulse was 58, respiration 30, temperature 101°, dull and eats slowly. September 29th, three new cases yesterday ; two of the horses were worked Saturday, were sick Sunday, and carried a tempera- ture of 105.4° and 106° on Monday morning. October 1st, another new case taken sick September 29th, pulse 66, respiration 18, temperature 103.4°, eating fairly well. November 8th, Dr. Baker reported 64 deaths, and 11 sick. Digitized by Microsoft® November '23d, two new cases, the cold weather does not im- Tjrove the situation. November 28th, 74 deaths, and 5 "recoveries". January 25th, 82 deaths out of 85 cases. February 2nd, another colt at Hogansburg that has recovered three times is sick again. March 2nd, 91 deaths to date ; only four patients that have not died, and they have sick spells occasionally. June 1st, 1915, 100 deaths and five sick. EXPERIMENTAL INOCULATION WITH BLOOD PBOM SICK HORSES. Experimental animal No. 1 (18008), an aged bay gelding, was inoculated per vein with blood collected in the practice of Dr. Baker of Brasher Palls. January 26, 1915, 10 c. c. of blood serum from a sick colt. February 4, 1915, 40 c. e. of blood serum from dead horse. February 4, 1915, 20 c. c. of blood serum from dead horse. The pulse, respiration, and temperature of this animal are shown on Plate No. V. After the development of fever there was a gradual lo.ss in condition and strength, the appetite for food and w^ater was often decreased, and at times there was difficulty in swallowing so that the horse ate and drank very slowly. After the second week a slight nasal hemorrhage was noted at frequent inter- vals. A blood examination February 17th showed hemoglobin (Dare) 42%; Erythrocytes 5,316,000% Lymphocytes 15.6% Large mononuclear 1.6 % Polymorphonuclear 82.8% February 22nd the horse being down and unable to rise without assistance, was killed an autopsied. POSTMORTEM EXAMINATION General condition poor, very little adipose tissue present. Mus- cular tissue apparently normal. Thoracic cavity contained about one quart sanguinous fluid. Lungs showed a few petechiae. Peri- cardium contained a few petechiae. Endocardium studded with petechiae, ecchymoses and bloody suffusions. Peritoneum contained many petechiae. Serous surface of intestines in many places hem- orrhagic. Mucous surface congested in small areas (2-5 em. in Digitized by Microsoft® length) . KTo ulcers could be found. Spleen enlarged, coveTed with petechiae and ecehymoses. Liyer apparently normal in size, color- rather paler than normal, liver substance very friable. Kidneys', apparently normal. On sectioning, the femurs and humeri, the changes characteristic of this disease were found. The red marrow was a bright red. The spongy marrow showed red areas 1-3 cm. in diameter. These areas macroscopically appeared to be hemorrhagic but oil microscopical examination showed that hemorrhage was not present but that the appearance was due to an increased activity of the bone marrow. Cultures were made from the various organs and incubated at 37°C. They remained sterile. Experimental Animal No. 2, (18018), an aged bay mare, was inoculated per vein with blood received from Brasher Falls. Feb- ruary 5, 1915, 40 c. c. of blood serum taken from a dead horse. The pulse, respiration, and temperature are shown on Plate No. VI, the other physical symptoms were essentially identical with those of experimental animal No. 1. A blood examination February 17th showed hemoglobin (Dare) 69% ; Erythrocytes 7,900,00% Lymphcocytes 16.3% Large mononuclear 2.0 % Polymorphonuclear 80.3% Eosinophiles 0.2 % Basophiles 0.6 % On February 25th the animal was down and could not get up. It was killed and a careful postmortem examination made. Prac- tieally the same changes were noted as in No. 1 above. The spleen however, appeared normal in size. Cultures made from the various organs and tissues remained sterile. DIAGNOSIS The symptoms described show that the disease may be acute or chronic, and that the acute symptoms are often recurrent ; these symptoms in connection with the high mortality, progressive loss in condition, nasal hemorrhage, recurrent fever, post-mortem findings, and reproduction of the disease by means of blood inoculation into solipedes reveal conclusive evidence that it is identical with the dis- ease described in veterinary literature as infectious anaemia. Since the occurrence of infectious anaemia has not been re- ported previously in this part of the United States it is natural Digitized by Microsoft® that the symptomatology of the acute types should have been eon- fused with other septicemic diseases such as influenza, glanders, and hemorrhagic septicemia — the latter disease being prevalent in cat- tle in this district during the summer and fall of 1914. This outbreak of disease among cattle has been reported by one ■of us and it was during the investigation of this disease, that the deaths among horses were noted. It was but natural that hemor- rhagic septicemia should be suspected. Careful bacteriolocal ex- aminations including animal inoculation were repeatedly made with- out finding the septicemia organism. Many of the cultures made directly from the tissues of animals dead of the disease remained sterile. A few showed the presence of B. coli or one of the pyo- genic micrococci. The animals (rabbits) inoculated as a rule re- mained healthy. Some died two or three weeks after inoculation and a careful' examination of these revealed usually B. coli as the cause of death. Sometimes a pyogenic micrococcus was found. The blood of a number of horses sick with this disease was tested by the complement fixation test using a polyvalent antigen prepared from a number of different strains of Bad. septicemia hemorrhagica. These tests were uniformly negative. It was due to these negative bacteriological findings that we were led to believe that the disease was not septicemia hemorrhagica. On looking up the literature it was found that horses w^ere very rarely affected with this disease. On reading the report of the Japanese Commission on -infec- tious anaemia we were struck with the similarity of the symptoms described by them and those shown by the animals in. this outbreak. We then made the inoculations into horses here reported and ob- tained evidence that the disease was infectious anaemia. EEFERENGES Caere, H. et Vallee, H. Recherches Cliniques et Experiiuentales sur I'anemie pernicieuse du cheval (Typho-anemie infeetieuse) Eev. Gen. de Med. Vet. T. YIII. 1906, p. 593. Francis M. and Marstellae, R. P. Infectious Anaemia of the Horse. Bull. No. 119. Texas Ag. Exp. Sta. Japanese Commission. Report on the results obtained by the special commit- tee for investigation of infectious anaemia of the horse. The Vet. Jour. Vol. 70 (191i) p. 604. Digitized by Microsoft® HoAEE, E. W. Edit. A System of Veterinary MecTicine. Vol. I, p. 9-7. HiiTyRA u. Maeek. Spezielle Pathologie und Tlierapie iler Haustiere. 4th Auf, 1st Bd. S. 8«2. Law, .J. Veterinary Medicine. Vol. 1 3rd ed. p. 519. Mack, W. B. Equine Anemia. Bull. No. 68, Nevada Kg. Exp. Sta. Mack, W. B. Intracellular bodies associated with equine anemia. Proceed- ings of the Amer. Vet. Med. Ass. 1911. MoHLEK, J. R. Infectious Anaemia or Swamp Fever. Cir. 138, B. A. I. Wash- ington, D. C. Setdbrhelm, K. E. u. Setderhelm, R. Wesen, Ursache und Therapie der per- niziosen Anamie der Ffenle. Arch. f. wiss. u. prak. tier. Bd. 41 (1914) S. 50. Van Es L., Harris, E. B. and ScHAiK, A. F. Swamp Fever in Horses. Bull. 94. N. Dak. Agr. Exp. Sta. Digitized by Microsoft® DESCRIPTION OF I'LATES Plate No. I. Pig. 1. Micropliotograph of section of spleen of experimental horse No. 1, show ing increase in size of the trabeculae, and congestion. rig. 2. Microphotograph of section of mesenteric lymph gland of experimental horse No. 1, showing congestion. Plate No. II. Photograph of longitudinal section of femur of e.'Jiierimental horse No. 2, show- ing changes in bone marrow. Plate No. III. Pig. 1. Microphotograph of section of the red bone marrow of the femur of experimental horse No. 2. This shows the increased activity of the cells of the red bone marrow, giant cells, and congestion. Pig. 2. 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