Post on 31-May-2018
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OutbreakInvestigation ofAcute Sudden Death
Syndrome in Mule herdsof Udayapur 2063
Dr.Kedar Karki
Dr. Purnima Manandhar
Dr.Pragya Koirala
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Objective of Study
Identification of the possible cause of the
Syndrome.
To identify the causative agent involved.
To correlate similar outbreak
To Suggest the possible treatment and
prevention Methods.
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Material and Methods
Field investigation.
Laboratory investigation of the relevantsample.
Review of clinical and laboratory finding.
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s ory p em o ogy
The DLSO Udayapur reported
the periodic acute sudden
death of total 31 adult mules ina herd of 900, during May
October,2006
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History: SymptomsReported before death
Increased respiratory rate,
Trembling, Tremor,Excessive , Sweating,
Sudden death,
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Review of World wide
Epidemiology of Syndrome In 1995, 38 horses died to moldy corn poisoning in
Kentucky and Virginia (U.S.A).
From 1995-2004, 75 horses affected byneurological disorder in Norway due to feeding of
moldy silage
Purdue Indiana,(U.S.A.)1/6 horse died due tomoldy corn poisoning from1997-2004
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World wide Epidemiology of
syndrome
Southern Brazil (spring of 1996) 3 males and 1 female; died (3 to 4 years
old thoroughbred horses) native grass supplemented with 2 kg of
corn/horse/day.
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World wide Epidemiology of
syndrome
Brazil (1994)
41/58 died
caused by fumonisin concentration lowerthan 10 ppm.
Oaxaca, Mexico (1998) donkeys died showing a neurological
syndrome,
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World wide Epidemiology of
syndrome
Iran (2003),
Equine Leukoencephalomalacia
Spain(1988)leukoencephalomalacia (eaten corn with a pinkish fungal
growth)
The fumonisins were discovered in 1988 following the1970 outbreak ofEquine Leukoencephalomalacia in
South Africa.
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World wide Epidemiologyof syndrome
North Carolina (1989)
white-tailed deer
Leukoencephalomalacia
moldy field corn (Fusarium moniliforme)
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Preliminary outbreak
InvestigationOn field investigation/ physical
examination
mule/horses - normal health, fed 20-25% cracked and moldy corn.
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Aspergillus affected Maize
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MOLDY CORN
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Moldy maiz
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Preliminary FieldInvestigation
Post-mortem examinationSevere congestion of liver, lung, spleen,
heart,Serosangqinus fluid in thoracic cavity.Hemorrhage in stomach mucosa.
Preliminary cause of sudden death wassuspected for moldy grain poisoning.
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Samples for Laboratoryfrom dead/healthy mule
Bacteriologicalexamination
Nasal swab, blood (healthy mules)
Histopathology examination
Liver, lung, spleen, heart tissue
Parasitological examination
Blood, Fecal samples (healthy mules)
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Samples for Laboratoryfrom dead/healthy mule
Toxicological analysis
Liver, lung, spleen, heart, intestine (dead)
Serological examination
Serum (healthy mules)
Mycological culture
Feed grains: Maize, Gram
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Result and Discussion
Bacteriological culture of tissue specimen,
swab blood - revealed no growth of any bacteria.
Blood parasite - Negative.
Chemical toxin in tissue Negative
Intestinal parasite - Mixed Stongyles spp.
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Laboratory Investigation:
Results
Penicillium, Aspergillus, Candida sppon mycological media (CVL).
60-110 CFU/gm Penicillium coloniesrecorded in feed samples.
(Department of Food Tech and Quality
Control Kathmandu)
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Unacceptably High Fungal Levels
Identified in Horse Feeds
Common fungus
(Aspergillus, Fusarium, and Penicillium) Equine feed
(proposed limit of 104 cfu per gram).
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The Mycobiota and Toxicity of
Equine Feeds
Feed mould counts -
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Mycoflora of the toxic feeds associated withmoldy corn poisoning in equine outbreaks
in Brazil
The Mycoflora of 39 feed samples associated with29 EquineLeukoencephalomalacia (ELEM)outbreaks was studied from in Brazil. mostfrequent mold which occurred Fusarium spp. in
97.4% of samples followed by Penicillium spp. in61.5% and Aspergillusspp. in 35.9%, (1988 to1990,)
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Molds, Mycotoxins and Their Effect
on Horses
Pasture grasses, hay, grain, straw and stubble can
all support the growth of various fungi.
Aspergillus,Claviceps, Stachybotrys, Fusarium
and Penicillium. Ontario Canada (September2003 )
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Horse Feed Recall Affects East
Coast U.S.A.
The products might contain an ingredient
with an unacceptably high level of
aflatoxin. Aflatoxins are a form of
mycotoxins, and are secondary
metabolites produced by Aspergillus spp.
fungi. by: Erin Ryder, TheHorse.comNews Editor
May 05 2008, Article # 11810
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Histopathological changes
Liver Fatty degeneration of hepatocytes Mononuclear cells infiltration in the form of
few nodules.
Lungs
Perivascular cuffing Infiltration of mononuclear cells in the formof nodules.
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Histopathological changes
Kidney
Deep medullary region reveals infiltrationof mononuclear cells.
Spleen
The number of white cells seems to be
increased in the area of white pulp.Suggestive ofchronic/viral disease.
(C.V.L.Patholigy Unit)
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Animal Disease Diagnostic Laboratory
Purdue University
Histological description of hepatocytes necrosisand vacuolization with bile duct proliferation ismore characteristic of poisoning by themycotoxins, Aflatoxins, also produced primarily
by Aspergillus sp. molds. In many species otherthan horses, fumonisin does cause liver damage,however in horses, the lesions are primarily in thebrain and can often be seen at post-mortem andhistologically..
Animal Disease Diagnostic Laboratory
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Animal Disease Diagnostic LaboratoryPurdue University
It is unfortunate that there still is not a post-mortem test for fumonisins in tissues and that westill must rely on analysis of feed for confirmationof the presence of fumonisins.
Steve Hooser
Stephen B. Hooser, DVM, PhD, DABVT
Head, Toxicology Sect. & Asst. Director,
Animal Disease Diagnostic LaboratoryPurdue University
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Cardiovascular change with
Moldy corn poisoning
Interfere the metabolism of fat -sphingolipids.
Increased serum, sphingolipids, decreased cardiac
function preceding neurological signs.
Uncontrolled dilatation of blood vessels ofbrain,swelling,increased itracranial pressure, brain
damage
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Laboratory Investigation:
Results
Serum sample-
Revealed positive for Japanese's
Encephalitis (Elisa)
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Treatment and Control Measure
advised
Advised for proper drying of grain before
feeding.
Commercial toxin binders, (Varishta,
Toxicurb) @ 1kg/tone of grain for 15days
along with Liver tonic, (Hepatocare,bioliv),
Immunomodulaters, (immunocare),
Promin,Vitamin B complex).
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Final Diagnosis
Moldy Corn Poisoning in Mule
Situation Today- Mortality under control
1200 mules plying on Udayapur Khotang
Rout
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Conclusion Findings of this investigation indicates that moldy feed
grains and ingredients are infested with toxic fungus isemerging as a new health hazard for livestock andpoultry. Seasonal prevalence of mycobiota of feed
forage need to be assessed.
Simultaneous use of toxinbinder,adaptogen likelivertonic,mineralmixture and Immunomodulaters drugspromises to help in minimizing health risk in livestock
and poultry production should be looked into.
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Acknowledgement Dr.Rebatiman Shrestha, Dr.Sadananda Deo, Dr.Ganesh Raj Panta, Dr.Salina Manandhar, Dr.Vinaya Kumar Karna, Dr.Keshab P.Shah, Dr.Shanker Yadav Mr.Sonfi Shah, Mr. .B.B.Kunwar,
Mr.Tek B.Air. Mr.Gyan B.Bogti. Mr.Samir Gurung Polchem Hygiene lab Pune Mr.Nishant Bhattarai Varsha Multi tech.Banglore
For their contribution in Field and laboratory investigation and
control of this disease syndrome
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