Herpes Viral Abortion in Domestic Animals

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The I'etetqnmyJournal 1997, 153, 253-268 Review + Herpesviral Abortion in Domestic Animals K. C. SMITH Centrefi~r Preventive Medicine, Animal Health Trust, P.O. Box 5, Newmarket, &tffolh CB8 7DW, UK SUMMARY Abortion or neonatal disease may follow infection with several c~, [3 and y-herpesviruses. The c~-herpesvirus, equid herpesvirus-1 (EHV-1), causes single or epizootic abortions or neonatal deaths in equids, and the closely related virus EHV-4 causes sporadic equine abortions. In cattle, the ~-herpesviruses, bovine herpesvirus-1 (infectious bovine rhinotracheitis virus) and bovine herpesvirus-5 (bovine encephalitis virus), and a y-herpesvirus, bovine herpesvirus-4, have all been implicated as causes of abortion. In pigs, suid herpesvirus-1 (SHV-I: pseudorabies virus), an 0~-herpesvirus, and SHV-2 (porcine cytonaegalovirus), a ~-herpesvirus, each cause abortion or neonatal piglet losses. Caprine herpesvirus-1, canine herpesvirus and feline herpesvirus-1, all ~-laerpesviruses, cause abortions or neonatal deaths in goats, dogs and cats, respectively. This review discusses the pathogenesis, pathology and laboratory diagnosis of these herpesviral abortions and neonatal diseases, with an emphasis on experimental studies of each disease. Alternative reviews covering other aspects of each infection, such as the genetic and antigenic structure of the viruses, host immune responses and approaches to vaccination and disease control are indicated at appropriate points in the text. KE:YWORDS: Virus; herpesvirus; abortion; neonatal; pathogenesis. HERPESVIRAL ABORTION IN HORSES Equid herpesvirus 1 Equid herpesvirns-1 (EHV-I: formerly EHV-1 subtype 1, or equine abortion virus) and EHV-4 (formerly EHV-1 subtype 2, or equine rhinopnen- monitis x4rus) are serologically cross-reactive, but show limited DNA homology on restriction endonuclease (RE) digests (Sabine et al., 1981; Studdert et al., 1981; Turtinen et al., 1981). EHV-1 causes acute respiratory disease in foals and year- lings, and is the most important viral cause of equine abortion (for reviews see Allen & Bryans, 1986; Crabb & Studdert, 1995). Some EHV-1 iso- lates also cause a neurological syndrome in horses (Jackson & Kendrick, 1971; Jackson et al., 1977; Edington et al., 1986), which may precede or accompany abortion epizootics. This syndrome differs from other neurotropic 0t-herpesvirus infections as viral antigen has not been demon- strated in neurones, but in endothelial cells of the brain and spinal cord, resulting in vascnlitis and local thrombo-ischaemic necrosis. Primary EHV-1 replication occurs in the upper respiratory tract and local lymph nodes (Patel et al., 1982; Kydd et al., 1994a,b) and may be succeeded by a cell- associated viraemia involving a latent or non-pro- ductive infection of T lymphocytes, monocytes or macrophages (Patel et al., 1982; Dutta & Myrup, 1983; Scott et al., 1983; Edington et al., 1986; Edington, 1992; Gibson et al., 1992; Slater et al., 1994a). Latent virus has been detected in lympho- reticular tissues and trigeminal ganglia (Welch et al., 1992; Edington et al., 1994; Slater et al., 1994b). EHV-1 research has been hampered by incon- sistent experimental reproduction of abortion in equids (Gleeson & Coggins, 1980), and most equine studies have employed highly virulent EHV-1 isolates also able to cause neurological dis- ease (Mumford et al., 1994). Respiratory disease, viraemia and abortion can be induced by intrana- sal challenge of young Balb/c mice (Awan et aL, 1090-0233/97/()30253-16/$12.00/0 © 1997 Bailli~re Tindall

Transcript of Herpes Viral Abortion in Domestic Animals

Page 1: Herpes Viral Abortion in Domestic Animals

The I'etetqnmyJournal 1997, 153, 253-268

Review

+

Herpesviral Abortion in Domestic Animals

K. C. SMITH

Centre fi~r Preventive Medicine, Animal Health Trust, P.O. Box 5, Newmarket, &tffolh CB8 7DW, UK

SUMMARY

Abortion or neonatal disease may follow infection with several c~, [3 and y-herpesviruses. The c~-herpesvirus, equid herpesvirus-1 (EHV-1), causes single or epizootic abortions or neonatal deaths in equids, and the closely related virus EHV-4 causes sporadic equine abortions. In cattle, the ~-herpesviruses, bovine herpesvirus-1 (infectious bovine rhinotracheitis virus) and bovine herpesvirus-5 (bovine encephalitis virus), and a y-herpesvirus, bovine herpesvirus-4, have all been implicated as causes of abortion. In pigs, suid herpesvirus-1 (SHV-I: pseudorabies virus), an 0~-herpesvirus, and SHV-2 (porcine cytonaegalovirus), a ~-herpesvirus, each cause abortion or neonatal piglet losses. Caprine herpesvirus-1, canine herpesvirus and feline herpesvirus-1, all ~-laerpesviruses, cause abortions or neonatal deaths in goats, dogs and cats, respectively. This review discusses the pathogenesis, pathology and laboratory diagnosis of these herpesviral abortions and neonatal diseases, with an emphasis on experimental studies of each disease. Alternative reviews covering other aspects of each infection, such as the genetic and antigenic structure of the viruses, host immune responses and approaches to vaccination and disease control are indicated at appropriate points in the text.

KE:YWORDS: Virus; herpesvirus; abortion; neonatal; pathogenesis.

HERPESVIRAL A B O R T I O N IN H O R S E S

E q u i d herpesv i rus 1 Equid herpesvirns-1 (EHV-I: formerly EHV-1

subtype 1, or equine abortion virus) and EHV-4 (formerly EHV-1 subtype 2, or equine rhinopnen- monitis x4rus) are serologically cross-reactive, but show limited DNA homology on restriction endonuclease (RE) digests (Sabine et al., 1981; Studdert et al., 1981; Turtinen et al., 1981). EHV-1 causes acute respiratory disease in foals and year- lings, and is the most important viral cause of equine abortion (for reviews see Allen & Bryans, 1986; Crabb & Studdert, 1995). Some EHV-1 iso- lates also cause a neurological syndrome in horses (Jackson & Kendrick, 1971; Jackson et al., 1977; Edington et al., 1986), which may precede or accompany abortion epizootics. This syndrome differs from other neurotropic 0t-herpesvirus infections as viral antigen has not been demon- strated in neurones, but in endothelial cells of the

brain and spinal cord, resulting in vascnlitis and local thrombo-ischaemic necrosis. Primary EHV-1 replication occurs in the upper respiratory tract and local lymph nodes (Patel et al., 1982; Kydd et al., 1994a,b) and may be succeeded by a cell- associated viraemia involving a latent or non-pro- ductive infection of T lymphocytes, monocytes or macrophages (Patel et al., 1982; Dutta & Myrup, 1983; Scott et al., 1983; Edington et al., 1986; Edington, 1992; Gibson et al., 1992; Slater et al., 1994a). Latent virus has been detected in lympho- reticular tissues and trigeminal ganglia (Welch et al., 1992; Edington et al., 1994; Slater et al., 1994b).

EHV-1 research has been hampered by incon- sistent experimental reproduction of abortion in equids (Gleeson & Coggins, 1980), and most equine studies have employed highly virulent EHV-1 isolates also able to cause neurological dis- ease (Mumford et al., 1994). Respiratory disease, viraemia and abortion can be induced by intrana- sal challenge of young Balb/c mice (Awan et aL,

1090-0233/97/()30253-16/$12.00/0 © 1997 Bailli~re Tindall

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1990, 1991), but basic differences in the anatomy of murine and equine placentae limit extrapol- ation of findings on the abortigenic disease in this model. Early experimental studies in ponies (Prickett, 1970; Jackson el aL, 1977) demonst ra ted vasculitis or perivascular cuffing of deep endo- metrial blood vessels in mares exalnined prior to and after abortion, and it was suggested that abor- tion occurred due to oedema between trophol)last and endometr ia l epithelia (BD,ans & Prickett, 1970), possibly as a result of an imnaulae reaction between the infected toetus and sensitized maternal lymplaocytes.

An ilnportant breaktlarougla came in 19t)l (Edington et aL, 1991) in an experimental study which demonst ra ted that transplacental spread of EH-V-1 was preceded bv viral replication in endo- thelial cells of the uterus in a paralysed pregnant pony mare infected by the intranasal route. There was an associated lymphocytic vasculitis, local thrombosis and infarction of the microcotyledons of the pregnant uterus. EI-D/-1 antigen was also demonst ra ted in endothelial cells of the allanto- chorion and umbilical vein. This work was corrob- orated by Smith et al. (1992, 1993) who infected a series of ponies intranasally with a different EHV-I paresis isolate and detected viral antigen expression in endothelial cells of deep endometr- ill arterioles fi'om 6 days post infection (PI). A novel f inding fi'om these studies was that EHV-I antigen expression was widespread in endometr ia l blood vessels over days 9-13 PI, and the associated severe vasculitis and multifocal thronabo- ischaemic microcotTledonm T necrosis could result in precipitate abort ion of a virologically negative foetus before detectable transplacental infection had occurred (Smith el ak, 1992). Comparable abortions had occurred early in previous EHV-1 challenges and field outbreaks (Gleeson & Coggins, 1983; Carrigan el aL, 1991) but had been assumed to be due to maternal stress or pyrexia (Daels el aL, 1989; Swerczek, 1990), and the inci- dence and epidemiological significance of such abortions in natural EHV-1 epizootics is not known.

Focal thrombosis and cotyledonary infarction have been demonst ra ted in mares experimental ly infected with EHV-1 and examined over days 14-91 PI, ei ther when carrTing an infected foetus or immediately after abort ion of an infected foe- tus, with a more limited EHV-1 replication in endometr ia l blood vessels (Smith et aL, 1993). In contrast, endometr ia l thrombi w e r e r a r e i n

infected mares carrying normal foetuses. These data formed the basis of tile hypothesis that the degree of viral vasculitis and tln'ombosis ill tile pregnant uterus following an EFIV-I infection could de termine the outcome of the pregnancy (Smith, 1994), possihly as a resuh of local prostag- landin release in addition to direct leakage of free virus or infected cells into the placental circu- lation at sites of infarction.

Endothel iotropism has not been demonst ra ted in all abortigenic EH\/-I isolates (Patel el al., 1982), and experimental studies suggest that dilI'- erent EH\:-I isolates vm-v in abortigenic potential (Mumtbrd et aL, 1994). The possibiliD' of an ahernative meclaanism of foetal infection not reliant on vascular compromise cannot therefore be ignored. The role of latently infected, or ' inamunologically privileged', leucocytes in the transfer of EHV-1 across the placenta (BD'ans, 1969, 1980) is uncertain, as is the relative import- ance of prolonged low-level viraemia versus lymphoid or ganglionic latency as sites of viral per- sistence prior to abortions occurr ing after pro- longed incubation periods in mares with high levels of neutralizing antil)ody. Answers to these important questions require sensitive molecular assays such as the in situ polymerase chain reac- tion (PCR) to visualize cells harbour ing latent viral DNA in the blood, endomet r ium, local lympla nodes and senso D, ganglia.

Up to 95% of EHV-1 abortions occur in the last third of pregnancy, and have rarely been observed under natural condit ions before 4 months (Doll, 1952; Allen & BD,ans, 1986). This increased sus- ceptibility of the late pregnant mare to abortig- enic infection is likely to relate tO anatomical and endocr ine changes in the placental barrie," which facilitate cotTledonm T infarction as pregnancy proceeds, a l though EHV-1 infection of uterine blood vessels does occur at low level in mares chal- lenged intranasally with virus as early as three months of gestation (Smith, 1994; Smith et al., 1996). A potential association between EHV-1 infection, early embD,onic death and resorption has not been investigated.

The incubation period for EHV-1 abortion var- ies fi'om 9-121 days (Mumford el aL, 1987), and premonitor T signs of respirator 3, disease in the abort ing mare are tmusual. Following abortion, virus is cleared rapidly from the genital tract, and future breeding capacit T is not impaired unless some uterine damage has occurred due to dysto- cia. The post-aborting mare is not immune to sub-

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sequent infection, but abortions in successive pregnancies are rare (Doll et al., 1955; Osthmd, 1993). Since the aborted foetus and placenta are a major source of infection for in-contact mares, management practices to nlinimize foetal losses during an abortion epizootic rely on rapid diag- nosis and isolation of the aborting mare (Horserace Betting Le W Board, 1994).

EHV-1 infected foetuses aborted in late preg- nancy are often fresh and enclosed in the pla- centa, with death due to suffocation following rapid placental separation. Gross examination D, pically reveals some combination of icterus, mec- oniuna staining of the integument, transudation into the body cavities, splenomegaly, perirenal oedema, puhnonary oedema or haemorrhage and pale miliary loci on the capsule and cut surfaces of the liver. Histological examination shows necrosis in the liver, adrenal gland, thymus, spleen, lung and small intestine (Dimock, 1940; Westerfield & Dimock, 1946; Hong el al., 1993). If infection occurs close to term, the infected foal may be born weak, and usually dies within 7 days dne to interstitial pneumonia and viral damage to the liver, lymphoreticular system and adrenal glands, often complicated by seconda D, bacterial infection (Bryans el aL, 1977; Hartlev & Dixon, 1979). In the rare early gestational EHV-I abortion (Doll el aL, 1955; Prickett, 1970), the foetus is grossly auto- lysed, indicating prior death in utero, with a diffuse scattering of viral inclusion bodies in the major viscera.

Diagnosis of EHV-I abortion or neonatal dis- ease is achieved by recognition of pathognomonic lesions accompanied by virus isolation (\q) or application of the polymerase chain reaction (PCR) using a pooled sample of foetal hmg, liver, thymus and spleen (.Jones el aL, 1948; Randall el aL, 1953; Ballagi-Pord~ny et aL, 1990; Lawrence el al., 1994; O'Keefe et al., 1994). Imnmnofluoresc- ent (IF) (Smith et al., 1972; Gunn, 1991) or immu- noperoxidase (IP) staining of tissue sections (Gimeno el al., 1987;Jonsson el aL, 1989; Whitwell el al., 1992; Schultheiss el al., 1993) are also required in some cases. Immunoperoxidase tech- niques are of value in examination of autolysed tis- sues (Whitwell et aL, 1992), and may occasionally serve to demonstrate viral antigen in blood vessels of the allantochorion if the aborted foetus is not available. Neither maternal nor foetal serology are reliable diagnostic aids for EHV-1 abortion (Whitwell et al., 1995a).

In addition to mares, colts, stallions and geld-

ings are also susceptible to EHV-1 paresis (Saxegaard, 1966; Crowhurst et aL, 1981; Meyer et al., 1987; Carman et al., 1993), and may develop scrotal oedema and loss of libido in field cases (Greenwood & Simson, 1980; Carman et al., 1993; McCartan et al., 1995). Recent experimental stud- ies on pony colts and stallions have shown that virus localizes in blood vessels of the testes and epididymides in association with vasculitis and thrombosis on days 8 and 9 after intranasal chal- lenge, and that infectious virus may subsequently be shed venereally (Tearle et al., 1996). The epide- miological implications of these findings for abor- tions occurring on studs remain to be assessed.

E q u i d herpesvirus-2 There is no evidence that equid herpesvirus-2

(EHV-2), a y-herpesvirus, has abortigenic potential (for re~ew see Agius & Studdert, 1994). Exper- imental infection of a mid-gestational equine foe- tus i~l utero resulted in normal term delivery, although the foal did show mild rhinitis and con- junctivitis, with nasal shedding of EHV-2 for 65 days (Gleeson & Studdert, 1977).

E qu id helpesvirus-3 Equid herpesvirus-3 (EHV-3) causes the self-lim-

iting venereal infection equine coital exanthema (for review see Blanchard el al., 1992). Vesicular and ulcerative lesions occur on the external geni- talia of mares and stallions, and generally resolve in 10-14 days, often leaving areas of depigmented epithelium. Repeated infections can occur in suc- cessive covering seasons, although it is not clear whether these represent periodic reactivations fi'om latency (Burrows & Goodridge, 1984). Im,oh,ement of the teats of a nursing mare resulted in minor lesions on the lips and nostrils of the suckling foal (Crandell & Davis, 1985). There is a single experimental report of inocu- lation of EHV-3 into the amniotic sac of a mid-ges- rational mare, resuhing in abortion after 11 days (Gleeson et al., 1976), but there is no evidence that the virus is abortigenic in natural infections.

E q u i d herpesvinls 4 Equid herpesvirus-4 (EHV-4) is a major cause of

acute respiratory disease (for review see Crabb & Studdert, 1995), but is only occasionally recovered from aborted equine foetuses (Shimuzu et al., 1959; Studdert & Blackney, 1979; Allen et al., 1983). The infection accounted for less than 1% of equine herpes~dral abortions occurring in Ken-

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tucky broodmares between 1983 and 1992 (Ostlund, 1993), but represented up to 16% of such virus abortions diagnosed in England between 1987 and 1993 (Whitwell et al., 1995b). EHV-4 ~4raemias have been observed but are rare (Matsumura et aL, 1992).

Specific pathological findings in EHV-4 versus EHV-I abortion have been summarized (Whitwell et aL, 1995b). Lesions common to abortions caused by both EHV-I and EHV-4 included infec- tion of foetal endothelium. The recent finding of a field EHV-4 isolate capable of replicating in vas- cular endothelial cells of a conventionally reared 6-week-old Welsh pony foal (Bhmden et al., 1995) suggests that EI-~*-4 abortions may have a uterova- scular basis similar to that described for EHV-I.

HERPESVIRAL A B O R T I O N IN CATTLE

Bov ine he~pesvirus-1 Bovine laerpesvirus-1 (BHV-1) causes repeated

outbreaks of respiratm T disease (infectious bovine rhinotracheitis: IBR) and abortion in cattle, and is also the cause of the venereal infections, infec- tious pustular vulvovaginitis and infectious balano- posthitis (for reviews see Gibbs & Rweyemamn, 1977; Wentick et aL, 1993). Concurrent outbreaks of respiratm T and genital disease are rare (McKercher & Wada, 1964), suggesting that virus usually remains localized at the site of primary infection, with latency in regional sensm y ganglia (Homan & Easterday, 1983; Ackermann & Wyler, 1984). The virus is commonly isolated fi'om bull semen (for rexqew see Afshar & Eaglesome, 1990), and natural or artificial insemination with such semen can cause endometritis, poor conception rates and shortened oestrous periods (Parsonson & Snowdon, 1975). The risk of disease transmission by emblTo transfer is low (tbr review see Philpott, 1993). It is difficult to differentiate respiratmy and genital isolates by RE subtyping (Kennedy & Miller, 1993), and both can cause foetal death and abortion, with some strain vari- ation in abortigenic potential (Miller el al., 1991). Some highly virulent IBR isolates can also cause endometritis, oophoritis, mastitis, dermatitis and fatal diarrhoea in young calves. BHV-I is occasion- ally recovered from abortions in pigs and sheep.

BHV-1 abortion is a sequel to respiratory infec- tion and viraemia rather than an extension fi'om the vagina. Viral replication has been demon- strated in monocytes (Nyaga & McKercher, 1980),

although the number of circulating infected cells is considered to be low and the form of the virae- mia remains controversial (Yates, 1982). The incu- bation period between intranasal, intravenous or imramnscular challenge with BHV-1 and abortion is 15-64 days, regardless of the stage of gestation (Gibbs & Rweyemamu, 1977). Virus can be iso- lated fi'oln tbe placenta as early as day 8 PI in experimental infections and slow cell-to-cell spread of virus within placentomes may account for the variable delay between maternal and foetal infection (Kendrick, 197"8). The route of BHV-1 fl-om the placentome to the foetus is unknown, but as viral lesions occur consistently in the liver, baematogenons spread via the umbilical vein is likely. Foetal death occurs within 24 48 h of the onset ot" ioetal infection, but expulsion is delayed for up to 7 days, and virus titres may decline in the foetus over this period, despite remaining stable or increasing in the placenta (Kendrick & Straub, 1967).

Positive virus isolations fi'om the placenta may occur in the absence of placental lesions (Kendrick el al., 1971), and Molello el al. (1966) have suggested that late placental degeneration of BHV-I abortion is seconda D, to the effects of virus activi D, on the foetus. Their study of experimen- tall}, infected pregnant heifers demonstrated extensive placental oedema and detachment, with abundant debris at the uteroplacental interface. Histological examination of the placenta revealed marked stromal and perivascular oedema, necrosis and sloughing of endothelial cells, and extensive coagulative necrosis of villous and non- villous chorioallantois. Lesions were hard to find in the infected foetus owing to death in ulero and autolysis, and viral lesions were not recognized'in the maternal uterus. It was concluded that tbe foe- tal infection had resulted in severe visceral dam- age, gradual cessation of placental circulation and generalized placental degeneration leading to detachment and abortion. Experimental infection of heifers has also indicated a role for BHV-1 in earl}, embD,onic death, with viral antigen in nec- rotic follicles, corpora lutea and embuonic rem- nants (Miller & Van der Maaten, 1986). Maternal uterine lesions were confined to infection of occasional epithelial cells in the horn containing embD, onic debris, with a mononuclear cell infil- tration of the underlying stroma. When expel'- imentally infected heifers were reactivated by dexamethasone, infectious virus was most com- monly recovered from the maternal adrenal

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glands, which contained necrotic BHV-1 lesions, but specific pathological changes were not recog- nized in reproductive tissues despite virus iso- lation fi'om the ovaries of one out of six animals tested (Miller and Van der Maaten, 1987).

A 10 year survey of 8995 bovine abortions in the United States of America revealed BHV-1 in 5.41% of cases (Kirkbride, 1992). Major outbreaks of abortion have occurred in American beef herds, with over 60% of cows aborting, although the prevalence of abortion in a region generally declines with a reduction in the naive cattle popu- lation owing to natural exposure or vaccination (Kirkbride, 1990a). In a smaller British study of causes of abortion in dairy cattle, BHV-1 was diag- nosed in 19 out of 149 cases (12.75%) (Murray, 1990). Naturally occurring BHV-1 abortions are usually observed at 4--8 months of gestation, ahhough intrafoetal or parenteral inoculations of susceptible heifers prior to 3 months reproduces fk)etal disease experimentally (Chow et aL, 1964). There are no premonitory signs, and there may be so little maternal readiness for birth that traction is required to remove the foetus. Placental reten- tion and co~,ledonary degeneration are common, and the aborted foetal carcase is in an advanced stage of autolysis (Gibbs & Rweyemamu, 1977).

Gross BHV-I foetal lesions are usually obscured by antolysis, but there may be white to tan 1-3 mm diameter foci on the liver and lung, serosanguin- ous perirenal oedema and massive renal cortical necrosis and haemorrhage (Owen et al., 1964; Kendrick, 1973; Kirkbride, 1990a). Histologically, there are foci of necrosis with minimal cellular infiltrate in the liver, adrenal, kidney, intestine, lymph node, lung and spleen. Inchlsion bodies may be recognized in cells of the adrenal cortex adjacent to necrotic loci. A necrotizing placental vasculitis is connnon (Kennedy & Richards, 1964).

Diagnosis of BHV-1 abortion is based on immunostaining of foetal tissues (Reed et al., 1971; Edwards et al., 1988), or in situ hybridization for viral DNA (Ayers et al., 1989). The IP tech- nique using BHV-1 monoclonal antibodies is more sensitive than VI (Smith et al., 1989), which is hindered by autolysis and may only be successful in approximately one-third of cases with histologi- cal lesions (Kirkbride, 1990a). Maternal antibody titres are usually low at abortion, but examination of paired sera by ELISA from at least 10 in-contact animals may provide indirect evidence of a herd problem. Although the bovine foetus is immunoc- olnpetent for responding to BHV-1 from 5

months, there is little e~fdence of foetal antibody production, owing to rapid foetal death following virus infection (Kendrick & Osburn, 1973).

Neonatal calves may experience a fatal congeni- tal or early post-natal infection with BHV-1 (Reed et al., 1973; Miller et al., 1978; Higgins & Edwards, 1986). Colostrum-deprived calves are especially at risk, and show clinical signs of pyrexia, excessive salivation, nasal discharge and diarrhoea. Post mortem examination reveals multifocal mucosal necrosis in the nasal cavity, oropharynx, oesoph- agus, forestomachs, abomasum, small and large intestines, and miliary foci of necrosis may also be recognized in the liver, spleen, thymus, Peyers patches and adrenal glands. Inclusion bodies are consistently present at the periphery of necrotic lesions outside the alimentary tract, but may only be demonstrable in the epithelial surfaces of early cases. Confirmation of the diagnosis may be achieved by VI, IF or electron microscopy of affec- ted tissues.

B o v i n e he~pesv i rus -4 The boxfine herpesvirus4 (BHV-4) group com-

prises several antigenically related y-herpesviruses (for reviews see Thiry et al., 1989; Gol~ & Ludwig, 1991). The majority of BHV-4 isolates are only mildly pathogenic or avirulent for cattle, and their role as primary abortigenic pathogens is debat- able. Relatively higher prevalences of BHV-4 anti- bodies have been recorded in aborting compared with clinically normal animals (Naeem et aL, 1989; Fitton et aL, 1990), and recovery of BHV4 from 47 out of 8995 aborted bovine foetuses is recorded (Kirkbride, 1992), but these data must be bal- anced against the fact that viruses of the BHV4 group are frequently isolated from a varie D, of organs in clinically normal cattle (Thiry et al., 1989). Co-infections with other agents such as bov- ine diarrhoea virus may occur in aborted calves (Reed et al., 1979). BHV-4 has also been associated with metritis, particularly in the post-parturient period, when the ~firus may be excreted for long periods in uterine exudate (Parks & Kendrick, 1973; Wellemans et al., 1984; Castrucci et al., 1986; Abraham & Zissman, 1989).

BHV-4 viraemia involves circulating mononu- cleat" cells, which may facilitate transplacentai infection (Osorio & Reed, 1983). There is a single report of lesions in an aborted calf (Schiefer, 1974): microscopy revealed alveolar thickening in the lungs, with cytomegalovirus-like inclusions demonstrated by electron microscopy in pneumo-

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cytes, bile ducts, myocardium, spleen and renal tubules, but no attempt was made to confirm the diagnosis by virus isolation. Kendrick et al. (1976) inoculated an isolate recovered fi'om a case of metritis into foetuses in ulero at various stages of gestation, and this resulted in the death of two foetuses at 3--4 months of gestation with lesions of lymphoid hyperplasia in the lungs and lymph nodes. The pathogenic potential of different BHV-4 isolates has also been studied in rabbits (Naeem et al., 1990): all strains showed a predilec- tion for the reproductive tract, but the fl'equency of abortion and severity of disease varied. Viral DNA could be detected by DNA hybridization and PCR in the rabbit ovary, uterus, placentome and foetus (Naeem el al., 1991a, b). Caution should however be exercised in extrapolating data fi'om these rabbit studies unless parallel experiments have been done in cattle.

Bovine he~pesvirus-5 Bovine herpesxdrus-5 (B\q-I-5) is antigenically

cross-reactive with BHV-1, but is genetically dis- tinct (tor review see Brake & Studdert, 1985; Stud- dert, 1989). The virus causes sporadic cases of infectious encephalitis in calves and yearling cattle, and has occasionally been isolated fi'om aborted boxqne foetuses.

HERPESVIRAL A B O R T I O N IN PIGS

Su id herpesvirus-1 Suid herpesvirus-1 (pseudorabies virus: PRV)

causes reduced fertility, abortion, stillbirth, foetal resorption and mummification in pigs (for reviews see Basker~flle et al., 1973; Christianson, 1992; Mengeling et aL, 1993). Mortality in nursing and young weaner pigs is high, while the disease in older pigs is generally mild (McNutt, 1943). The virus is unusual among the ~-herpesviruses in hav- ing a wide host range, with high mortality rates in species other than pigs. Molecular and imlnunol- ogical factors contributing to virulence have been reviewed (Mettenleiter, 1991; Chinsakchai & Moli- tor, 1994). In pigs, latency is established in both lymphoid and neural tissues (Sabo & Raicani, 1976; Sabo, 1985; Rziha et aL, 1986).

PRV ~4raemia involves latent infections of the lymphocyte and neutrophil fractions of peripheral blood (Wittmann et aL, 1980), which facilitate hae- matogenous and lymphatic dissemination of virus to secondary sites such as the pregnant uterus.

Viraemia is not considered to be important in PRV neurological disease, with signs being ascrib- able to ascending spread of virus along peripheral nerves. Spread of PRV between pigs is usually by the respiratory route, although other species may be infected either intranasally or by local inoculation.

Different isolates of PRV may differ in vil-ulence (Baskerville el al., 1973; Iglesias & Harkness, 1988). The latter authors used two clones from a PRV isolate to infect 12 sows at 85 days of ges- tation, and noted that whereas one clone (Ls-1) produced severe and acute illness, the other (Ls- 2) caused only mild transient or subclinical infec- tion. Some sows infected with Ls-1 produced munanfified virus-negative piglets, but transpla- cental infection only occurred in one sow infected with Ls-2. Perinatal infection occurred in piglets fi-om both groups. This study confirms that while abortion may occur due to viral infection of toe- tuses and placentae, reproductive failure can he due to the non-specific effects of severe maternal pyrexia. The latter presentation involves abortion or term deliver)' of mummified foetuses which do not yield infectious virus or contain viral lesions, and maternal anorexia or neurological dysflmc- tion may precede or accompany abortion. This phenomenon has also been reproduced exper- imentally in gilts by Kluge and Mare (1973), who did not demonstrate viral lesions in aborted foe- tuses, placentae or maternal uteri, but estimated that the time of intrauterine foetal death of mumnaified toetuses had coincided roughly with the peak of pyrexia in the dam.

Uterine patholo~, associated with establish- ment of a toetal infection has not been detailed, and it was suggested by Hsu el aL (1980) that foe- tal death was generally due to severe placental pathology. Nau~3,nck and Pensaert (1992) used surgical inoculation of the uterine artel T with either PRV-infected mononuclear cells or cell-fi'ee virus to demonstrate that only cell-associated PRV was abortigenic by this route in vaccinated sows. These data suggest a critical role for cell-to-cell spread of virus within the porcine endometrium in allowing transplacental infection of piglets despite high levels of neutralizing antibody. The authors further suggested that the likelihood of transplacental PRV spread would be related to the number of circulating virus-infected cells. A corre- lation was noted between the experinaental incu- bation period for abortion, the pathological and virological findings in the aborted foetuses and

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l-I ERPESVI RAL A B O R T I O N 259

the duration of virus excretion in vaginal dis- charges. Abortions occurring 3 clays PI were associated with grossly normal loetuses presenting small early visceral lesions on inamunofluoresc- ence, and virus was excreted in vaginal discharges for 4-5 da},s after abortion. By contrast, abortions occurring 10-12 days PI showed variable foetal mummification, large foci of necrosis affecting the liver and skin positive by immunofluorescence, and absent or short-lived (24-48 hours) vaginal excretion of virus.

The effects of PRV infection on unborn pigs vary with the stage of gestation. Sows infected in the first third of gestation may resorb or abort the embD'os, and return earl}* to oestrus. D, qaen infec- tion occurs in mid-gestation, most of the litter may die in ulero, and such sows commonly deliver a mixture of live normal piglets and mumnaified foetuses at term (Morrison &Joy, 1985). If infec- tion occurs during the last month, then both weak live piglets and dead foetuses showing variable degrees of autolysis will be delivered.

Characteristic gross and microscopic PRV lesions are produced when foetuses and placentae are infected in late gestation. Pale miliary foci may be recognized grossly on dissection of the liver and spleen. Microscopic lesions of coagulative necrosis are present in liver, spleen, adrenal gland and hmgs, with viral inclusion bodies occasionally evident in surrounding hepatocytes and inter- stitial cells (Wohlgenmth et aL, 1978). Examin- ation of the loetal brain may reveal non-suppurat- ive meningo-encephalitis. The tissues of munanaified fbetuses seldom have histological lesions. A proportion of placentae show multifocal coagulative necrosis of the chorionic villi, with viral inclusion bodies in the trophoblast and occasionally in naesenchvnaal cells (Hsu el aL, 1980); in less severe cases, extensive searching is required to find trophoblast inclusions. In piglets with disseminated neonatal disease, viral repli- cation has been demonstrated in epithelial sur- faces, endothelial cells and local parenchyma, with an organ distribution similar to EHV-1 in aborted foetuses (Corner, 1965).

Laboratory diagnosis of PRV abortion may be assisted by IF, IP and VI (Allan el aL, 1985; Kirk- bride, 1990b). Virus isolation in cell culture or in rabbits is more sensitive than IF, and both tests are more likely to yield positive results where infec- tion has occurred late in gestation without sub- sequent mummification. The preferred tissues for examination are foetal lung, liver, and spleen for

IF, with the addit ion of kidney and brain in a tis- sue pool for VI. The mummif ied tissues o f piglets which have died prior to 12 weeks of gestation and been carried to term are se ldom diagnostic, but col lect ion of paired sera from at least 10 in-con- tact pigs should demonstrate seroconversion in a proport ion of animals in which PRV is circulating.

S u i d he~pesvirus-2 Suid herpesvirus-2 ( S H V - 2 : porcine

cytomegalovirus) is a [3-herpesvirus (for review see Ohlinger, 1989). Infection of pregnant sows results in small litters and a combination of mummified, premature and weak undel-weight or stillborn term fbetuses. Subsequent conception rates and litter sizes may be reduced. Neonatal infection canses valTing degrees of necrotizing non-suppurative rhinitis with cytomegalic inclusions in nasal glands (inclusion body rhinitis) (Done, 1955). Pigs up to 12 weeks old may be affected in naive herds, but high mortality occurs only in animals younger than 4 weeks (Corner et al., 1964). Severe systemic disease in mature pigs is unusual.

Transplacental SHV-2 infection has been repro- duced experimentally by intranasal challenge of pregnant sows between 31 and 85 days of ges- tation and post mortem examination of piglets removed by Caesarean section at term (Edington el aL, 1977). Foetal death occurred 4-6 weeks PI regardless of the stage of gestation, and decom- posing or mummified foetuses were retained in ulero. Autolysis often hampered VI and histopa- tholo~;, but cytomegaly and intranuclear inclusion bodies were noted in the liver and lung of better preserved piglets. SHV-2 was never iso- lated from placental tissues, and no histological lesions were seen in the placentae of virologically positive foetuses which had recently died.

In natural outbreaks of disease, transplacental infection close to farrowing results in congenitally infected foetuses which usually die within the frst week of life. Post mortem examination reveals pul- monary oedema, congestion or consolidation; hydrothorax; and haemorrhages on the heart, lungs, intestines and kidneys. .Cytomegalic inclusions may be recognized in capillary endo- thelium, macrophages and renal tubules. Some piglets may show a non-suppurative meningoenca- phalitis.

Studies in young piglets have demonstrated a striking age-related variation in the outcome of SHV-2 infection. Experimental infection of 1-day-

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260 THE VETERINARY .|OURNAL, 153, 3

old gnotobiotic piglets resulted in severe dissemi- nated infection, with viral replication in endo- thelial cells and macrophages leading to haemor- rhage and oedema in the hmg, kidney, adrenal and lymph nodes. Less severe and non-fatal cases in piglets infected at 16 days of age showed a more epitheliotropic pattern of viral replication, with infection of nasal glands, renal tubules, salivary glands, seminiferous and epithelium, gastrointesti- nal mucosa and hepatocytes. A number of cases showed infection of both reticulo-endothelial and epithelial cells (Edington et al., 1976).

HERPESVIRAL A B O R T I O N IN GOATS

Caprine heTpesvirus Caprine herpesvirus-1 (CHV-1) causes abortion

and neonatal mortality, vulvovaginitis and balano- posthitis in goats (Hornet, 1987; Merrall, 1987; Thompson, 1987; Tarigan et al., 1990; for review see Koptopoulos, 1992). Abortion can be induced experimentally by the intravenous or intranasal infection of pregnant goats with CHV-1 at 3-4 months of gestation (Berrios et al., 1975; Waldvo- gel et al., 1981). The latter authors were able to recover infectious virus from the placentae of two goats and from the lung of one foetus following experimental CHV-1 abortion, but nonetheless suggested that the abortions had occurred primar- ily due to maternal disease and pyrexia. Severe dis- ease may occur in neonatal kids, which show clini- cal signs of pyrexia, conjunctivitis, oculonasal discharge, dyspnoea, abdominal pain and weak- ness leading to death within 1-4 days (Be,'rios et aL, 1975; Brake & Studdert, 1985). Post mortem examination reveals erosive, ulcerative and nec- rotic mucosal lesions throughout the gastrointesti- nal tract, but especially the large intestine. Local epithelial cells are swollen and vacuolated on microscopy, and may contain intranuclear inclusion bodies. In the caecum and colon, exten- sive mucosal ulceration may progress to transmu- ral necrosis and oedema, with accompanying sub- mucosal inflammation. Viral replication outside the alimentary tract is very restricted following intranasal administration, but specific lesions can also occur in the brain, adrenal glands, urinary bladder, heart, liver, kidneys, spleen, hmgs, lymph nodes and skeletal muscles of kids infected with CHV-1 by the intravenous route (Waldvogel et al., 1981; Papanastasopoulou, 1991). Diagnosis may be confirmed by VI on bovine turbinate, foetal

lung or caprine choroid plexus cultures, or by immunostaining or electron microscopy of tissue sections.

HERPESVIRAL A B O R T I O N IN D O G S

Canine he~pesvirus Canine herpesvirus (CHV) is associated with

abortion, stillbirth, infertility and neonatal disease in bitches (for review see Anvik, 1991). Self-linfit- ing lesions occur on the penis and prepuce of male dogs and vagina of bitches, and generally involve hyperaemia and lymphoid nodules rather than vesiculation or ulceration (Poste & King, 1971; Hill & Marc 1973; Ladds, 1993). Infection may also cause mild upper respiratory tract dis- ease in puppies over 5 weeks of age and in aduh dogs (Appel et al., 1969; Huxsoll & Hemelt, 1970). Canine herpesvirus viraemia is difficult to detect in bitches, and is entirely leucocyte-associated (Carmichael, 1970). Foetal infection has been produced by intravenous inoculation of bitches with CHV at 47-53 days of gestation, resulting in term delivery of stillborn or congenitally infected puppies (Hashimoto et al., 1982), although the more usual clinical presentation is of neonatal or early post-natal infections acquired either on pass- age through the birth canal at whelping or from oronasal secretions from the bitch or infected lit- termates (Carmichael el at , 1965; Stewart el at , 1965; Carmichael, 1970). Microscopic examin- ation of tissues from stillborn or premature pupp- ies following suspect intra-uterine infection reveals foci of necrosis with intranuclear inclusion bodies in the liver, spleen, kidney and heart. Foe- tal endothelium is commonly involved, and virus can be recovered from many foetuses (Hashimoto et al., 1979). Where placentae are available for examination, multifbcal necrosis may be recog- nized in the labyrinth, with viral antigen and inclusion bodies in trophoblast epithelium and endothelial cells, and mural degeneration and vas- culitis may affect allantoic blood vessels (Hashimoto et al., 1979, 1982). Recent work (Okuda et al., 1993a, b) has demonstrated that natural CHV infection in bitches is succeeded by latency, and that recrudescence and repeated nasal and vaginal shedding may be achieved by prednisoione administration.

Infection of puppies up to 3 weeks of age is facilitated by the sub-adult body temperature and incompletely developed thermoregulatory

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HERPESVIRAL ABORTION 261

capacity of the canine neonate, and viral repli- cation and mortality can be reduced by artificial elevation of the body temperature (Carmichael, 1970). Signs of neonatal disease generally appear from 5-14 days of age, and are characterized by anorexia, abdominal pain, diarrhoea, dyspnoea and crying. Some puppies may show opisthotonus and paddling of the limbs (Cornwell & Wright, 1969). Post mortem examination of affected pups characteristically reveals ecchymotic renal haem- orrhages, accompanied by splenomegaly and sero- sanguinous effusions into the body cavities, with muhifocal necrosis and haemorrhage in the kid- neys, liver, spleen, hmgs and adrenal glands (Cornwell el al., 1966; Yanagisawa et al., 1987; Kojima et aL, 1990). Inclusion bodies are rare, but may be recognized in renal endothelium or in the

adrenal cortex, and viral antigen is also present in reticulo-endothelial cells of lymph nodes and spleen. Infection of the brain resuhs in non-sup- purative meningo-encephalitis (Percy et aL, 1968), with spread to the central nervous system being primarily haematogenous, ahhough viral antigen has been demonstrated by IF in nerve trunks and trigeminal ganglia. The virus may be isolated fi'om infected visceral tissues on canine cell monolayers. Mortaliu, approaches 100% in infected litters, and residual granulomatous encephalitis, interstitial pneumonitis, segmental renal necrosis and renal, cerebellar and retinal dysplasia may be present in stuMving puppies (Percy et al., 1971; Albert el al., 1976).

has resulted in abortion, stillbirth or generalized neonatal infection, but abortion is difficult to reproduce by intranasal inoculation (Johnson, 1964; Hoover & Griesemer, 1971a), and Gaskell and Dawson (1994) have suggested that abortions occuring after FHV-1 infection are usually due to severe maternal rhinopneumonitis rather than foetal infection. Isolation of virus from the tissues of foetuses aborting during naturally occurring feline viral rhinotracheitis has not been reported, although virus has been recovered from the uterus, placenta, amniotic fluid and vagina of intravenously infected queens with aborted or still- born foetuses, and necrotic lesions with viral antigen expression occurred in the uterus, pla- centa, vagina and foetal liver of these experimen- tal cases (Hoover & Griesemer, 1971a). Congeni- tal infection of kittens has also been induced as a resuh of intravaginal instillation of virus (Bittle & Peckham, 1971). In this study, kittens died due to generalized herpesvirus infection in the first 3 weeks of life, and post mortem examination revealed fibrinosuppurative rhinotracheitis, bron- chopneumonia and muhifocal hepatic necrosis, with viral inclusion bodies in respiratory epi- thelium and hepatocytes. In young kittens, an unusual predilection of this herpesvirus for grow- ing bone at a variety of sites including the nasal turbinates has been recognized, with necrosis and viral inclusion bodies at sites of osteogenesis (Hoover & Griesemer, 1971b).

HERPESVIRAL ABORTION IN CATS

Feline herpesvirus-1 Feline viral rhinotracheitis is caused by feline

herpesvirus 1 (FHV-1). The respiratory disease is a problem in unvaccinated kittens and cats, particu- larly in catteries (for reviews see Crandell, 1972; Gaskell, 1988; Dawson & Gaskell, 1993). Most cats recover in 7-14 days, but mortality can be high in kittens and debilitated animals, particularly if immunosuppressed by concurrent infection with feline immtmodeficiency virus or feline leukaemia virus. Since respiratory infection is not usually suc- ceeded by viraemia, subsequent abortion is rare (Kennedy & Miller, 1993). A carrier state is com- mon in cats, and it is likely that latency is estab- lished in trigeminal ganglia (Gaskell & Povey, 1979; Gaskell et al., 1985). Intravenous inoculation of specific pathogen-free queens in late gestation

CONCLUSIONS

Most pathogenesis research on the abortigenic herpesviruses has concentrated on horses, cattle and pigs, and has been based upon intensive investigations of the aborted foetus and placenta. Studies of the experimentally infected pregnant uterus and factors affecting transplacental infec- tion and foetal expulsion are less frequent. It will be apparent fi'om this review that the ability of a number of herpesviruses to initiate a leucocyte- associated viraemia is critical to the pathogenesis of abortion, and that abortigenic disease rarely resuhs from spread of infection from the l o w e r genital tract. Research into factors affecting the establishment and maintenance of viraemia in each infection is therefore crucial to an under- standing of herpesviral abortion. As a general rule, those herpesviruses which rarely cause virae-

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262 THE VETERINARY JOURNAL, 153, 3

mia, such as FHV-1 in cats and EHV-4 in equids, have a low abor t igenic potential .

Viral infect ion of vascular e n d o t h e l i u m in the uterus, p lacenta and foetus is also a COmlnon and pathogenical ly i m p o r t a n t feature of abor t igenic herpesvirus infections, p resen t ing a rneans for virus to cross the placental barr ier , and result ing in a characteris t ic spec t rum of foetal and pla- cental lesions due to vascular damage , such as vas- culitis, o edema , perivascular necrosis, haemor - rhage and effusion into bodv cavities. Variation in the clinical p resen ta t ion of herpesviral abor t ion , such as the t endency for foetal autolysis or m u m - mificat ion in cattle and pigs r a the r than precipi- tate expuls ion in equids may relate to the increased i m p o r t a n c e of the corpus luteunt over the foe toplacenta l uni t in main ta in ing p regnancy in the f o r m e r group, and need not reflect funda- ntental d i f ferences in the m e c h a n i s m of transpla- cental infection. T h e spec t rum of herpet ic lesions in the abor t ed foetus or early neona t e is remark- ably consis tent between species, with the liver, kid- ney, spleen and adrenal glands be ing c o m m o n target sites. Post-natal infect ions due to inhala t ion or ingest ion of infect ious virus, such as BI-B/-1 in calves, SI-W-2 in o lder piglets and capr ine her- pesvirus in goat kids, typically assume a m o r e epi- thel iotropic pat tern . Herpes- re la ted abor t ions in which the foetus and p lacenta do not b e c o m e infected, e i ther due to severe mate rna l disease or to d i sp ropor t iona te u ter ine damage , have been recognized in the case of El-IV-l, PRV and FHV-I infections, and may presen t a p r o b l e m in labora- to D, diagnosis. In the case of those infections, such as El-IV-l, for which vaccines fully protect ive against abor t ion are not current ly available, the cont inual i m p r o v e m e n t of labora tory techniques for rapid diagnosis is central to effective disease contro l in o rde r that infected anintals may be p rompt ly isolated fi 'om susceptible in-contacts.

A C K N O W L E D G E M E N T S

T h e author is grateful to Dr ] . A. Mumfbrd and Dr A. S. B lunden for constructive criticisms o f this manuscript . Mrs Sandra Tatum was most helpful in undertak ing literature searches.

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