Monday 23 February 2015

Epidemiology of Aujeszky's disease

See official publication ISBN 978-87-994685-1-5: http://suhv1epidemiology.blogspot.com/



Principal Features of the Epidemiology of Aujeszky’s

 Disease –
Suid herpesvirus 1 Infection – in Swine and Cattle.


Respiratory airborne and genital infections have occurred worldwide in swine and cattle and there is strong evidence that vaginal infection of cattle resulting in pruritus on the hindquarters had regularly been sexually transmitted from sows by man.

Viggo Bitsch


viggo.bitsch@gmail.com
ISBN 978-87-994685-1-5      
© 2015 Viggo Bitsch



Abstract

     Aujeszky's disease – infection with Suid herpesvirus 1 (SuHV1) – is an infection of pigs, which under certain conditions can be spread to several other animal species, usually with a fatal outcome. It has been found worldwide but has now been eradicated in several countries. Denmark is the country, where Aujeszky's disease has been studied most intensively, and the results from investigations of cattle have been of greatest importance for understanding the epidemiology of the infection in swine. Denmark was the first country to initiate eradication and the first to complete eradication of the indigenous infection. In this review, important features are recapitulated at the end of each section or subsection.

     In cattle, the infection will most often give rise to an intense pruritus of a skin area. In iatrogenic cases, the site of virus introduction will determine the site of pruritus but naturally, pruritus will appear (1) in the head region or on the chest, which is associated with respiratory infection, or (2) on the hindquarters of females, which indicates vaginal infection. In cases of respiratory infection, the virus can be found in the mucous membranes of the nasal or pharyngeal cavity of animals with head pruritus, while in cases with chest pruritus virus can be found in lung tissue. In cases with pruritus on the hindquarters, the virus will most often be found in the vagina.  Pruritus must be considered a phantom sensation due to stimulation or damage of the central nervous system including sensory ganglia. Respiratory infection of cattle is a dead-end infection, as spread among cattle has never been demonstrated. Relatively high virus titers found in mucous membranes in a few cases, however, may be taken to indicate that transmission can not be totally excluded.

     The source of respiratory infection in cattle has always been pigs infected by the respiratory route. Cattle at risk need not necessarily be those placed near the infected pigs, as the virus in animal houses has been seen transmitted by air currents determined by ventilators over distances of 10-20 meters, even from pigs in a neighboring room.

     In swine, the infection was considered to be exclusively respiratory for decades, and naturally occurring genital infection was not demonstrated until 1981.  In herds with outbreaks in cattle characterized by pruritus on the hindquarters (vaginal infection), respiratory infection of pigs was never observed, but a sow had characteristically been served by a foreign boar from 5-14 days earlier. In some such cases investigated, genital infection was confirmed in sows, which clearly linked cases in cattle with a posterior localization of pruritus to a concurrent genital infection of swine. A naturally occurring genital infection has been found also in wild pigs in the USA. Respiratory infection of pigs was demonstrated late in the history of the disease. The first outbreak in Denmark was in 1964, and in the preceding 33 years there had been only 3 outbreaks in cattle showing an anterior localization of pruritus indicative of respiratory infection, but close to 60 outbreaks, where the cattle showed a posterior localization of pruritus indicative of genital infection.

     The development of the disease situation in pigs in Denmark has clearly illustrated that SuHV1 can change the degree of pathogenicity over time. The changes occurred in two steps. In the early 1960s, respiratory strains developed, which were spread rapidly between herds due to animal contacts, mainly by trade, and later in the 1970s strains developed, which had an even higher degree of pathogenicity for cattle and swine. These new strains were found syncytial in contrast to earlier isolates from traditional outbreaks. The new respiratory syncytial strains had not been introduced from abroad as restriction fragment pattern analyses of virus DNA documented that they possessed the Danish characteristics.

     That syncytial virus strains were more virulent than non-syncytial strains was later substantiated by results from examination of isolates from England and Northern Ireland.

    As concluded from the studies of respiratory SuHV1 infection in cattle, the decisive spread of the respiratory infection among swine in a ventilated animal house will be by air currents over many meters determined by the ventilation system and not by close animal-to-animal contacts.  This feature also illustrates that during an acute outbreak in a swine herd, considerable amounts of virus will be blown out into the surroundings by ventilators, exposing neighboring herds to the risk of infection. Early observations in Denmark led to the conclusion that airborne spread between swine herds might occur over several kilometers and after eradication of the indigenous infection, new infections were introduced from abroad, which demonstrated that airborne spread of the virus between herds might take place over even 10 to 30 kilometers. Syncytial strains of SuHV1 have shown to possess a pronounced tendency to airborne transmission among swine herds, which implies that if a syncytial strain is first introduced into an area, it is likely to become the prevailing type in that area within a few years.

    The special manifestation of Aujeszky's disease in cattle showing pruritus on the hindquarters has regularly been associated with the use of a boar from a boar center for natural service of a sow shortly before the appearance of the clinical disease. In most cases examined, the virus was found in the vagina of the affected bovine animals, although in low titers, and in three outbreaks, the only cases investigated early enough to be likely successful, the virus was demonstrated in the vagina of a sow. It was found that animal sodomy seemed to play a role in the transmission of genital infection from swine to cattle, and this conclusion is further substantiated by supplementary information given in this review. From the fact that genital infection in cattle is closely correlated with contemporary genital infection in swine on the same premises and from the many reports over the years on infection in cattle showing pruritus on the hindquarters, it can additionally be concluded that the SuHV1 infection in a great part of the 20th century was maintained as a porcine genital infection in many countries. 


1.   Introduction 

     Suid herpesvirus 1 (SuHV1) infection or Aujeszky’s disease was first identified as a new specific infectious disease in Hungary by Aujeszky (1902). The disease was found in a steer, a dog, and a cat from different premises, and all showed pruritus in the nose and mouth area.  In the following years, the infection was reported in many countries, especially in cattle.

     In Denmark, the infection was first seen in 1931 in cattle on two neighboring farms (Bang 1932). Five cows, one heifer, and two calves were affected.  Five had pruritus on their heads, two on one side of the chest, while in a calf no itching was noticed. The source of infection for cattle was not identified. In 1932, Burggraaf and Lourens reported on a great number of affected cattle on 5 farms in Holland situated within a few kilometers from each other. They observed that the disease in cattle had been preceded by symptoms in swine. Pruritus was seen in the head or chest regions of the cattle. In 1935, Köves and Hirt reported natural, widespread infection in swine in Hungary, but already in 1913, the infection had been demonstrated in that country in a domestic sow suspected of rabies and in a wild pig forwarded for examination because of unspecific disease in the wild swine population in a certain wood district. Here, a similar disease problem had been observed the previous year. No wild pigs were then submitted for laboratory examination, but Aujeszky’s disease was diagnosed in a dog, a badger, and a fox from the district (Ratz 1914). Shope (1935a, b) found the infection to be widespread among swine in some areas in the USA and concluded that pigs were the source of infection for cattle. He had observed that the affected cattle had been kept in close contact with pigs and suggested that infection took occurred when nasal secretions from infected pigs were rubbed into the abraded skin of the cattle. This notion of cutaneous or percutaneous infection of cattle was concordant with the general experience from experimental infection of cattle, rabbits, etc. that pruritus would appear at the site, where the virus had been injected.

     Denmark is the country, where Aujeszky’s disease has been surveyed and studied most intensively, not only right from its first appearance in 1931 until the completed eradication of the indigenous infection by the end of 1985, but also in the following years, when new infections were introduced from abroad.  The results concerning the infection in cattle and swine were comprehensive and of extreme importance, not only for understanding the epidemiology of this particular infection but also for evaluating the possibilities of its control and elaborating adequate eradication schemes. Epidemiological characteristics such as (1) respiratory airborne and (2) genital infection of cattle, (3) airborne spread with air currents among swine and from swine to cattle within herds, (4) airborne spread between swine herds, (5) correlation between virulence of virus strains and their ability to form syncytia in cell cultures, (6) higher risk of airborne herd-to-herd spread for syncytial virus strains, (7) naturally occurring genital infection of pigs, and (8) long-distance airborne spread between swine herds over 10-30 kilometers were original Danish findings, all by this author except for the last-mentioned long-distance airborne spread. This particular feature was a conclusion from investigations of outbreaks introduced from herds south of the Danish-German border after 1985, i.e. after the indigenous infection had been eradicated, and after this author had left the National Veterinary Research Institute. 
     This article dealing with the principal epidemiological features of Aujeszky’s disease will naturally focus on results from Danish observations and investigations including all relevant results from other countries.  The latency of the SuHV1 infection in swine is well documented, and its significance for maintaining the infection in herds and possible transmission into other herds is well understood. It will consequently not be dealt with here as a separate epidemiological characteristic.

2. The infection in cattle

2.1. Background
     
     
In 1965, Bendixen et al. reported on 64 outbreaks recorded in cattle since its first appearance in 1931. Until 1964 they all occurred on the island of Zealand. (Figure 1), and a considerable number of affected animals could therefore be brought to the veterinary clinic at the Royal Veterinary College in Copenhagen. In every case, that institute had been contacted directly by the veterinary practitioner or the National Veterinary Service and detailed information on the outbreaks was carefully journalized.



Figure 1.  Outbreaks of Aujeszky's disease in cattle in Denmark 1931-1964. Up to 1964, all outbreaks occurred on the island of Zealand (from Bendixen et al. 1965).


     It is striking that the affected animals in 61 of the 64 outbreaks showed pruritus on the hindquarters. Many outbreaks in cattle have been reported without information about the exact location of pruritus, but the cases observed by Burggraaf and Lourens (1932) in 5 herds in Holland (cf. above) were associated with an anterior localization of pruritus, i.e. on head or chest. Jansen (1957), however, concluded from questionnaires returned from veterinary practitioners that most Dutch cases observed had posterior pruritus, as did animals from 3 outbreaks examined by Jansen and Kunst (1957). Rosenberger  (1940) reported from 1925 to 1940 nine outbreaks in the Hanover area in Germany, most of them with posterior pruritus. Two to four animals were affected in each outbreak, and the animals showed disease practically simultaneously. Lamont (1947) referred to outbreaks in cattle in Northern Ireland, in a few of which the animals showed pruritus on the head or chest, but in most of them, pruritus was seen in the anal/vulvar region. In Sweden, Aujeszky’s disease was not seen until 1965 (Estola et al. 1965). In the first outbreak, some litters of piglets died, and several cows and heifers became infected showing head pruritus.  Also in that country posterior pruritus was seen in later outbreaks in cattle (Rockborn and Hugoson 1972).

     For many years the significance of the localization of pruritus with the route of infection was not understood, and percutaneous infection was thought to be most likely (cf. Lamont 1947).  Kretschmar,(1970) in his monograph on Aujeszky’s disease expressed the opinion that this mode of infection in cattle could be taken for granted and suggested that biting insects like Stomoxys calcitrans were responsible.

2.2.  The two-year study 1971-1973 and relevant results from later Danish outbreaks

     From the point of view that the port of entry for a virus like SuHV1 was likely to be mucous membranes, this author decided in 1971 to study future outbreaks in cattle.

     Three possible sites of primary infection were considered, namely the respiratory tract, the alimentary tract, and the genital tract. Unfortunately, only in a few cases did veterinary practitioners contact the State Veterinary Serum Laboratory (the National Veterinary Research Institute) before submitting material for laboratory examination, so only seldom material of interest in addition to the head or the thoracic or lumbar parts of the vertebral column necessary for the diagnosis could be examined. Results from the two years from December 1971 through November 1973 comprising 29 outbreaks were published in 1975 (Bitsch 1975a, 1975b) with results from a few selected outbreaks from 1974 and 1975 (Bitsch 1975c). 

2.2.1.  Outbreaks with an anterior localization of pruritus

     It was of extreme significance that the outbreaks could be divided into two groups based on the localization of pruritus: (1) the outbreaks where affected animals showed an anterior localization of pruritus, and (2) outbreaks where animals showed a posterior localization of pruritus. In none of the herds were both manifestations seen.

     In 12 outbreaks animals showed anterior pruritus. Of the 31 animals affected, 19 showed pruritus of the head and 7 on one side of the chest, while 5 showed no signs of pruritus (Table 1). Four animals without pruritus were examined virologically, and three had virus in the medulla thoracalis and not at all in brain material, and one animal had virus in brain material and samples from mucous membranes of the head, but not in the medulla thoracalis.


Table 1. Outbreaks in cattle from December 1971 through November 1973.
_______________________________________________

                     No. of outbreaks       No. of animals affected                                                                                 total                 average_

Anterior 

pruritus               12                          31*                   2.6

                      Posterior                                                                                    

pruritus_______ 17_______            23________   _1.4__  

 Total                  29                          54                     9                        

*Pruritus, in head area: 19; on chest: 7; no pruritus: 5. 


     Mucous membranes of the heads of 11 animals with head pruritus and one without pruritus but with brain involvement were examined for the presence of virus, and samples from eight animals were found positive: a strong indication of infection by the respiratory route (Bitsch 1975a). The virus titers were usually low, demonstrating that cells of these membranes of this species do not readily support the uptake and growth of the virus. In one of the cases, however, and in one later case (Bitsch 1975c), the titers in mucous membranes and in swabs here-from were remarkably high (approx. 102.5 TCID50  per 0.1 ml tissue or swab material suspensions). 

     In none of the cases from the two-year study with chest pruritus and/or medulla thoracalis involvement were lung material forwarded for examination. In an outbreak shortly after, however (Bitsch 1975c), a cow showing beginning symptoms of the disease was transported to the veterinary clinic at the Royal Veterinary College (together with the cow with head pruritus mentioned above with relatively high titers of virus in mucous membranes). This cow showed a slight itching on the right side of its chest. It was euthanized after two days of disease, and when it was skinned, the right side of the chest was found remarkably hyperaemic. Several samples collected aseptically from the lungs, using cauterization were found virus-positive (Bitsch 1975c). Later, the virus was found in lung material from another six cases in cattle and a goat, all showing chest pruritus (Bitsch 1984a). So altogether the virus has been demonstrated in the lungs of eight ruminants showing chest pruritus.

     The results from the virological examinations provided strong evidence of the facts (1) that outbreaks with anterior localization of pruritus are due to respiratory infection and (2) that the sites of virus entry and of pruritus are not identical but related to a common part of the central nervous system (Bitsch 1975a). In fact, many years earlier Hurst (1933) observed that after intradermal, subcutaneous, or intramuscular injection of the virus (mainly into rabbits), histological degenerative lesions could be found in the corresponding part of the central nervous system and ganglia and that symptoms of pruritus started shortly after the appearance of these changes. On these grounds he suggested that pruritus was not caused by a stimulus of nerve endings but by an involvement of parts of the central nervous system.


Figure 2.  Plan of a cowhouse, where two cows received a respiratory SuHV1 infection from pigs in a neighboring room. Arrows indicate air currents through two windows with broken panes created by a ventilator (V). The virus was isolated from the lungs of one of the cows showing chest pruritus (Bitsch 1984a).


     The circumstances observed in the herds, where cattle showed an anterior localization of pruritus, were in full accordance with this conclusion of a respiratory infection mode (Bitsch 1975b). Practically always were the cattle housed together with swine, most often feeder pigs, although not in close contact with them.  Three different situations could be observed: (1) if the room was equipped with a ventilator expelling the air, the affected animals were typically placed between the ventilator and the pigs; (2) if there was only a simple air duct in the ceiling without a fan, affected animals were often placed close to the air duct with pigs just opposite, as if the air had circulated around the duct before leaving through it (like water let out of a sink or a bathtub); and (3) if there were no ventilation installations in the room, cases in cattle might appear almost everywhere.  A special situation was seen in two later outbreaks, where the source of infection obviously was feeder pigs in an adjacent room: in one case there was a permanent aperture in the separating wall, while in the other one  (Figure 2) the wall was supplied with windows, where some panes were broken (Bitsch 1984a). The affected animals, five and two, respectively, were placed just between these wall openings and ventilators, which were found to expel air from the rooms with swine through the apertures described. On average, 2.6 animals were infected in each outbreak. In one of the herds, however, where the shared cattle and swine house was poorly ventilated, an outbreak had occurred one year earlier affecting 14 head of cattle. In none of these outbreaks did the animals show a posterior localization of pruritus, and in no case was a transmission of the infection among cattle found likely to have occurred. However, the finding of relatively high virus titers in mucous membranes or swabs here-from in the few cases mentioned above may be taken to indicate that cattle-to-cattle transmission may occur occasionally. 

     The duration of clinical disease is shorter in animals with a head involvement than in animals with a lung infection. Typically the first group died after approximately 24 hours, while the second group showed symptoms for a couple of days (Bitsch 1975a).

     Sufficient evidence has been accumulated for the following conclusions concerning outbreaks of      Aujeszky’s disease in cattle with an anterior localization of pruritus:

     1.   Cases regularly result from respiratory infection.

     2.  Cases with head pruritus are associated with primary infection of mucous membranes of the
    nasal or pharyngeal cavities.

     3.  Chest pruritus is associated with a primary lung infection.

     4.   Primary infection of the upper and lower respiratory tract may proceed without
    signs of pruritus.

     5.   Animals infected by the upper respiratory tract typically die after one day of disease, while
    animals suffering from lung infection show symptoms for approximately 2 days.

     6.   Individual cases in cattle regularly receive the infection airborne directly from swine.

     7.   Respiratory Aujeszky’s disease is a dead-end infection in cattle.

     8.   Animals at risk are those exposed to air currents from pigs infected by the respiratory route.

     9.   The site of pruritus, iatrogenic cases disregarded, is not the site of virus entry. Still, those two
     sites are related to a common part of the central nervous system, most probably also involving
     sensory ganglia. Pruritus in Aujeszky’s disease thus appears to be a neurological condition due
     to damage or stimulation of the central nervo
us system, and the intense itching of a skin area
     must be considered a phantom sensation.
 


2.2.2.  Outbreaks with a posterior localization of pruritus

     In 61 of the 64 outbreaks occurring from 1931-1964 reported by Bendixen et al. (1965), all 114 infected animals showed a posterior localization of pruritus. In 60 percent of these, only one animal was infected, the average number being 1.7. In two herds, cases appeared at a one-year interval, and in a third herd, an outbreak reappeared after 5 years. For 16 affected calves under one year of age, their sex was not recorded, but the remaining 98 animals were all females. The cattle and swine herds were relatively small. In 39 cases the veterinary practitioners had informed about the size of the swine herd. All had sows, and 19 herds informed about the regular use of boars from boar centers for natural service.  From the size of the swine herds, however, the authors judged that such boars had regularly been used in the large majority of the herds.

     In the material from the two-year study, 17 of the 29 outbreaks were associated with posterior pruritus (Table 1). Again, most often only one animal was infected in each outbreak, the average number being as low as 1.4.  If more than one animal was infected, they usually showed symptoms on the same day, in a few cases up to two days apart (Bitsch 1975a). One outbreak deviated from the rest by the finding that the infection had obviously been transmitted by the veterinary practitioner, just as it was also found in a few later cases (Bitsch 1975c). This outbreak was on a farm with cattle and a big swine herd. The remaining 16 outbreaks all occurred on farms with small swine herds and in none of these herds were symptoms of the disease in swine observed. Of special interest was that the affected animal on one farm was a bull calf. Samples were collected from the rectum and several sections of the intestines of that calf, but no virus could be found (see later).      Only in three cases from two herds were vaginas received for examination, but the virus was found in all three of them, although at low titres. Veterinary practitioners were therefore encouraged to contact the laboratory before forwarding material for examination, and over the following years, vaginal samples from a further 22 animals from 21 outbreaks were found virus-positive, while vaginal samples from 14 animals from 13 outbreaks were found virus-negative (Bitsch 1984a). Generally, however, the titers demonstrated in vaginal samples were very low, indicating that a negative result did not exclude vaginal infection. These additional results show that in the majority of outbreaks in cattle with a posterior localization of pruritus, animals are infected by the vaginal route. It was characteristic that there were relatively few sows in the herds and that boars from boar centers had been used for natural service of the sows.

(More details are given below in the section on genital infection in swine).

     Animals showing pruritus on the hindquarters typically die after 2 days of disease just as the animals suffering from lung infection (Bitsch 1975a).

     In one case from the two-year study (Bitsch 1975a, 1975b) and three later cases (Bitsch 1975c) the findings indicated iatrogenic infection. Two of these animals showed pruritus on their hindquarters, while the remaining two showed pruritus in the flank area, in one of them involving a surgical wound.

     The possibility of alimentary infection was left open after the early studies 1971-1973, especially because of the case in a bull calf mentioned above, most probably being the only natural case ever in a male bovine animal with posterior pruritus1. Alimentary infection of cattle must now be considered unrealistic.


[1] The farmer's wife explained that this calf was their special pet animal. It was not tied up and followed persons around in the cowhouse like a dog. 


The conclusions concerning cases in cattle with a posterior localization of pruritus are therefore:

concerning cases in cattle with a posterior localization of pruritus are hereafter:

      1.     Cases have regularly been associated with vaginal infection. The vagina must accordingly be
            considered the port of virus entry.

      2.   Clinical disease typically lasts two days.

3.      Outbreaks have regularly occurred in combined swine and cattle herds, where boars from boar centers have been used for natural service.

4.     Generally, one or two animals are infected in each outbreak.

5.      If several animals are infected, they usually become infected at the same time.

  1.   A center boar regularly served a sow 5-8 days before symptoms.
  2.   Some extreme cases have been iatrogenic.
  3.   Cases have never been reported associated with observed clinical disease in swine.
  4.   Percutaneous infection is unlikely except in iatrogenic cases.
  5.   Alimentary infection is not a realistic possibility.

3.  The infection in swine

3.1.   Pathogenicity of virus strains

3.1.1.    Syncytial and non-syncytial virus strains

     SuHV1 exhibits a virus strain-specific cytopathogenic effect (CPE) in susceptible tissue cultures of mainly two types: where the infected cells (1) form syncytia (syncytial virus strains) or (2) become rounded or ballooned (non-syncytial virus strains), cf. Kaplan 1969. All cases in cattle in Denmark up to 1964 occurred on the island of Zealand (Figure 1). But in 1964 three outbreaks were diagnosed in Jutland. The structure of the swine production was changing. From 1950 to 1964 the annual number of pigs slaughtered gradually rose by 300 percent (Bendixen et al. 1965), and this tendency continued over the following years. Conventional breeding herds and herds with specialized production of fattening pigs became steadily larger. 


Figure 3. Outbreaks of Aujeszky's disease in swine herds in Denmark1964-1984. The spread in the 1960s followed the development of the respiratory virus and the increased number of outbreaks from 1982 to 1983 in Jutland was caused by the spread of the new syncytial virus strains.


     In Denmark, as in many other countries in Europe, Aujeszky’s disease was not seen as a disease problem in pigs until many years after its clinical appearance in cattle. The first Danish outbreak in swine was seen in 1964 in Zealand (Andersen et al. 1964), and over the next years, the infection was spread rapidly, especially in Jutland (Figure 3) (Bitsch and Andersen 1982, Bitsch 1983). But clinical symptoms other than fever were seen only in piglets, and generally only litters under two weeks of age were clinically affected. On average, two litters died in each outbreak.

     In the 1970's the situation changed further, when more severe outbreaks appeared in especially big herds. Whole litters over 2 weeks of age died as might also older pigs, and sows were seen to abort infected fetuses. 
     This new situation with more severe respiratory disease in pigs was reflected also by a higher frequency of outbreaks in cattle with an anterior localization of pruritus caused by respiratory infection (Figure 4).




Figure 4. Outbreaks of Aujeszky's disease in cattle in Denmark 1968-1983. Note the increased number of outbreaks with anterior pruritus associated with the appearance and spread of syncytial virus strains after 1979.     

    At the same time, it was observed that the higher degree of pathogenicity of the virus isolates could be related to their cytopathic effect (CPE) in tissue cultures. Virus isolates from cattle with pruritus on the hindquarters were consistently non-syncytial, while most isolates from cases with anterior pruritus were syncytial (Table 2), but also isolates from severe outbreaks in swine herds were - in contrast to isolates from most other outbreaks in swine - found to be syncytial (Bitsch 1980[1]. In the following years, syncytial strains became the predominating isolates (Figure 5), especially from big herds in Jutland (Bitsch and Andersen 1982, Bitsch 1983, 1984a). This correlation between virulence and type of CPE was later found also in other countries. Harkness and Sands (1985) found concording results with British isolates and a series of coded virus isolates from Northern Ireland received from J.B. McFerran examined by this author gave similar results[2]. The highly virulent virus strains introduced by the airborne mode into Denmark from herds south of the Danish-German border after 1985 were all found syncytial (see later).

Table 2. Prevalence of syncytial and non-syncytial virus in Aujeszky's disease cattle up to 1980 (Bitsch 1980)       _________

                        No. of                              Type of virus strain involved                                       outbreaks*                       syncytial        non-syncytial       

Anterior

pruritus               17                                     14                          3**         

              Posterior                                                                     

pruritus______  25______________            0                         25***_       

 Total                    42                                   14              __   _   28____ _   

    *Isolates from all 29 outbreaks in 1978 and 1979 were supplemented       with isolates from 1972 to 1977.

 **Only one animal was infected in each of these three outbreaks.

***All isolates from the many later outbreaks of this type were also non-syncytial. 



_______________________

[1] Of the isolates from swine evaluated, four were judged to be of an intermediary type. For practical reasons, they were later included among the non-syncytial strains.

[2]   The CPE produced by one of the isolates, the NIA 4 virus strain of obscure origin and similar, if not identical, to the Hungarian Bartha vaccine strain, showed a CPE clearly uncharacteristic of herpesviruses. 

3.1.2.  Restriction fragment pattern analysis of virus DNA

     It was evident from the results in 1978 and 1979 that Aujeszky’s disease had become a more severe disease over the last few years. This was the main reason for the decision in 1980 to control and eradicate the infection. An important question was the origin or the cause of the new more virulent strains. In this context it should be noted that import of swine had been prohibited for many years up to 1972, when Denmark joined the European Common Market, most probably to protect the Danish landrace from foreign genes, and after 1972 all animals imported were subjected to control of Aujeszky’s disease, both before import but also after a quarantine period as required by the farmers' organizations. So infected pigs had not been imported for decades.

    Gielkens and Berns and Ludwig et al. reported in 1982 on the differentiation of SuHV1 virus isolates using restriction fragment pattern analysis of the virus DNA.  A.L.J. Gielkens agreed to test some Danish isolates receiving four isolates: a syncytial respiratory and a non-syncytial genital strain from cattle, and a syncytial and a non-syncytial respiratory strain from swine, all from outbreaks in 1982. He responded immediately (May 1982) with the information that the four isolates appeared identical but differed from all other European strains, he had tested so far. One characteristic difference was that fragment/band 9 from the BamHI analysis of the Danish isolates was missing. These results were published in a later report (Gielkens et al. 1985).  

     H. Ludwig received a syncytial respiratory strain from swine and a non-syncytial genital strain isolated in 1981 from cattle and found them to be identical to a Danish cattle isolate from1962 (posterior pruritus) and a Swedish pig isolate from 1982, but again different from all other SuHV1 strains investigated (Herrmann et al. 1984). They found that European isolates could be divided into three major groups, which were designated I, II, and III. Group III comprised exclusively the Danish-Swedish strains. Todd and McFerran (1985) tested two syncytial and two non-syncytial Danish isolates, one of which was the first genital isolate directly from pigs, from 1980 and 1981 with identical results. Christensen and Sørensen (1988) tested approx. 70 Danish isolates which all, apart from six isolates from herds infected within one month in the winter of 1985 in an area not far from the German border (Figure 6, cf. section on airborne transmission), were found to be Group III strains.



Figure 5. Outbreaks of Aujeszky's disease in pigs 1978-1983 by syncytial and non-syncytial virus (Bitsch 1984a).  In 1985 there were 38 outbreaks, of which 32 (84%) were caused by syncytial strains (cf. Figure 6).


     The important conclusion made in 1982 after the response from A.L.J. Gielkens on his preliminary analyses that the new virulent Danish strains had not been introduced from abroad but had developed from Danish strains of lower pathogenicity (virulence) was in this way substantiated by the results from many later investigations.


     In summary, the main conclusions concerning the degree of pathogenicity (virulence) of SuHV1 strains are:

1.      Syncytial virus strains a higher degree of pathogenicity to both cattle and swine than non-syncytial strains.

2.      Isolates from cattle exhibiting posterior pruritus (iatrogenic cases not considered) are regularly non-syncytial.

3.      SuHV1 appears to vary in degree of pathogenicity. Over time, the virus may become more virulent along with changes in the pig breeding and production structure.

4.      Danish virus strains are unique and constitute a separate group of SuHV1 viruses. No foreign strains were introduced into Denmark before 1985.

5.      Danish virus strains are unique and constitute a separate group of SuHV1 viruses. No foreign strains were introduced into Denmark before 1985.

6.      Changes in virulence occurred in two major steps. The first step was the establishment about 1964 of respiratory virus strains from genital strains, which were spread vigorously over the following years causing outbreaks in pig herds and the death of piglets a few weeks old, and the second step was associated with the development and spread in the 1970's of the more virulent syncytial, respiratory strains.

7.      The ability of a SuHV1 isolate to cause syncytium formation in cell cultures is a valuable characteristic or marker of virulence.


3.2. Airborne transmission within and between herds

     The results from the study of Aujeszky’s disease in cattle referred to above demonstrated clearly, not only that cases in cattle exhibiting pruritus on the head or chest were due to respiratory infection, but also that the individual cases received the infection directly from swine in practically all instances. At the same time, it was illustrated that virus from respiratorily infected pigs was carried away by air currents over relatively long distances, not even to animals in the same room, but also in some instances to animals in adjacent rooms (Bitsch 1975a, Bitsch and Andersen 1982, Bitsch 1984a). Transmission of an infectious agent by air currents was demonstrated clearly. The spread among pigs of a respiratory virus like SuHV-1 with a diameter almost 10 times that causing foot and mouth disease and acknowledged to be spread airborne, was thought to require close or relatively close contact between individuals. However, the findings with Aujeszky’s disease in cattle, which were relatively resistant to infection by the respiratory route, implied that the predominating or decisive spread among swine in ventilated rooms would be by air currents over many meters rather than transmission among animals in close contact. Furthermore, the ventilation system would send considerable amounts of virus out into the surroundings exposing other herds to a risk of infection.

    Donaldson et al. (1983) demonstrated under controlled experimental conditions that a respiratory virus could be sampled from the air in loose boxes with infected animals and that infection could be transmitted by air from infected pigs in one box through an air duct to uninfected pigs in another box. 

    The Danish observation that air containing considerable amounts of virus was moved by ventilators and blown out into open air furthermore implied that the infection might also be spread by the airborne mode to swine farms in the surroundings.  The risk of infection for other herds would naturally depend on (1) the effect and construction of the ventilation system (2) the size of the infected herd as well as that of those at risk, (3) weather conditions, (4) length of time of exposure for herds at risk, (5) characteristics of the virus strain and (6) distance from the source of infection. After the appearance of syncytial virus strains (Bitsch 1980) a growing number of especially closed big herds became infected. Some cases concluded to have been caused by airborne virus transmission were described by Bitsch and Andersen (1982), and others later (Bitsch 1984a). Transmission had been noted to occur over distances of up to 3 kilometers. In one of the early caseswhere an SPF herd was concluded to have received the infection from a large herd with sows and fattening pigs 500 meters away, the air blown out by ventilators of the latter could actually under certain weather conditions be followed over considerable distances as relatively thin “wisps of smoke”.


     

Figure 6. Outbreaks in swine herds 1985.
Symbols:         Encircled dots:   6 outbreaks caused by non-syncytial strains.
                        
Triangles           32 outbreaks by syncytial strains.
                                                  
The 6 outbreaks close to Germany were by a foreign syncytial strain.


     In 1984 Gloster et al. reported on the possibility of airborne herd-to-herd spread of Aujeszky’s disease between herds in Yorkshire and concluded that meteorological and epidemiological data suggested that airborne transmission might have occurred in some of these cases.

     In 1987 Christensen et al. reported on restriction pattern analyses of virus DNA from all isolates of SuHV1 from 1985 (cf. Figure 6). The analyses were extended in a subsequent paper (Christensen and Sørensen 1988) referred to above in the section on the pathogenicity of SuHV1 strains.  The main finding was that all Danish isolates  -  apart from those from six outbreaks in swine herds in the south of Jutland, which occurred early in 1985 within one month  -  belonged to Group III of the SuHV1 virus. Virus of this group has been recovered only from outbreaks in Denmark and Sweden, cf. above. The six deviating isolates were Group II viruses and were from herds situated within 10 kilometers of each other. It was concluded that the primary source of infection for these six herds was herds south of the Danish-German border[1].

     As seen in Figure 6, the outbreaks in 1985 caused by syncytial virus appeared in clusters, which was due to airborne spread of the infection among the herds.

     In two later papers (Christensen et al. 1990, Christensen et al. 1993) was reported on introductions of

Aujeszky’s disease virus identified as various subtypes of group II viruses into Denmark in the winters of 1986/1987, 1987/88, 1988/89 and 1989/90. On basis of comparison with isolates from Northern Germany, and of meteorological data and other special conditions it was concluded that the infection had been transmitted by the airborne mode from German herds to some Danish herds in the south of Jutland, from where it was further spread similarly to other herds. In the winters of 1987/1988 and 1989/90, it was even spread more than 30 kilometers over waters to the island of Funen[2].

________________________

[1]  All isolations of SuHV1 from outbreaks in 1985 were made by this author, and these isolates together with earlier isolates were forwarded to the Danish Veterinary Virus Research Institute by the end of 1985 for further investigations. Unfortunately, in the two papers giving the results (Christensen et al. 1987 and      Christensen and Sørensen 1988) it is erroneously mentioned that one of the six isolates differing from the traditional Danish virus strains originated from a herd in the mid-part of Jutland. But all six deviating isolates were from herds situated in a small area in the south of Jutland, cf. Figure 6.

[2] Another respiratory disease of domestic animals,, infectious bovine rhinotracheitis, IBR,   by   Bovine herpesvirus 1 was eradicated in Denmark from 1984 to 1991.  During the eradication period, several acutely infected herds were concluded to have received the infection by airborne mode from a neighboring acutely infected herd.  And already in the winters of 1990 and 1991, some new infected herds close to the German border were concluded to have been infected from herds south of the border.  But also in the years 1992 to 1995 and in 2001 after the final eradication in herds in the border county were found infected in the winter period. Airborne transmission from German herds was concluded to be the only possible explanation. Most infected herds were situated within a few kilometers from the border, but two were 10 and 25 kilometers away. In some instances, neighboring herds got infected subsequently. In one particular case, a dairy herd 300 meters from an infected herd showed a low reaction in bulk tank milk shortly after the outbreak, but only one animal had gotten infected in this herd. Of special interest was that this cow was placed in the cowhouse just between a ceiling ventilator and air intake in the wall facing the infected farm.  The risk of airborne herd-to-herd transmission of IBR is considerable, although not of quite the same magnitude as the risk of herd-to-herd spread of syncytial strains of SuHV1. The investigations were performed by this author.
_____________________

     The most important conclusions related to airborne transmission of SuHV1 are hereafter:

    1. Within a herd the decisive transmission of the respiratory virus will follow air currents over
        many meters, in ventilated rooms determined by the ventilation system. Spread from close 
        animal
-to-animal contact will generally be of minor importance.
   2. The risk of herd-to-herd transmission will be high in areas with big swine herds with
        effective ventilation systems. An infection may be spread over distances of many kilometers.
   3.  S
yncytial virus strains are more likely to be spread by the airborne mode than are
        non-syncytial respiratory strains.

3.3. Genital infection of pigs 
     Aujeszky's disease in cattle showing pruritus on the head or chest is due to respiratory infection. After the appearance of the highly pathogenic, syncytial virus strains, such outbreaks become predominating (cf. Figure 4). But up to 1964, the large majority of the outbreaks in cattle was associated with pruritus of the hindquarters. In later such cases, the virus was demonstrated, although in low titers,  in the vagina of most of the animals examined, and the obvious conclusion was that the vagina was the port of virus entry (cf. Section 2 above). But still, up to 1980, the way of transmission from infected swine remained to be demonstrated. The fact, however, that cases regularly appeared in small herds using centre boars for natural service (at least in Denmark and Sweden, where this particular characteristic had been observed) made it logical to anticipate that these boars had introduced the infection to sows in a genital form.
     Akkermans (1963) (see also Akkermans 1964) tested 40 boars aged 6 months to several years from boar centers in the Netherlands. He concluded that they originated from uninfected herds and found that practically all had become antibody-positive by the age of one year. Furthermore, a boar was infected nasally with a respiratory strain whereafter the infection was transmitted to the vagina of two sows served 6 and 16 days later, although preputial swabs consistently were virus-negative. In another experiment, a sow was infected by the vagina using the same virus strain. Virus was demonstrated in vaginal swabs for 8 days, and after four days she was mated with a boar, after which the virus could be found in preputial swabs from this boar for nine days. However, no genital strain was used in the experiments, so no particular conclusions can be made from these results. Natural genital infection has never been demonstrated in the Netherlands.
     In  1967 in Sweden, Rockborn and Hugoson (1972) noticed in a herd with Aujeszky's disease in a cow that a center boar had visited the herd two weeks earlier. Of 9 boars from the center, 5 were found antibody-positive. Sows from herds, where boars from that center had been used, were then blood-tested at slaughterhouses in 1968.  Of 424 sows from 149 herds, 123 (29%)  from 64 herds (45%) were found antibody-positive. No clinical signs of the infection had been seen in pigs in these herds. 
   The close correlation between outbreaks in cattle and the use of center boars was reported already by Bendixen et al. (1965).  The first 60 outbreaks up to 1964 all occurred on the island of Zealand (Figure 1). In early 1984, one-third of boars from boar centers on that island were found serologically positive, and when small herds in the area were tested, a usual finding was single reactors among the sows. 
    Demonstrating porcine genital infection was attempted in 5 outbreaks (Bitsch 1984b, Outbreaks 1 to 5), the first time (Outbreak 1) in 1981. A sow had been served by a center boar (Day 0) before the appearance of disease symptoms in two calves (Day 5). The virus was demonstrated in the vagina of both calves and also in a vaginal swab collected on Day 7 from the sow at a titer of 106.2 TCID50  per ml of the swab fluid (further details of this outbreak are given in Section 4). 
     In an outbreak from 1983, where the virus was demonstrated in the vagina of a cow (Bitsch 1984b, Outbreak 4), the virus was found in a vaginal swab collected from a sow served by a center boar close to one week before the death of the cow. The virus titer was 105.5 TCID50 per ml swab fluid.  The affected cow was reported to be in oestrus on the day of insemination of the sow (cf. suspicion of sodomy, Section 4). In an outbreak from 1982 (Bitsch 1984b, Outbreak 3) a sow (Sow 1) had been served by a center boar on November 15 (Day 0), and a cow showed clinical disease on Day 15. There were only 2 sows on the premises, and vaginal swabs were taken from these and the cow on Day 17. The samples from Sow 1 and the cow were negative, while the sample from the second sow showed a virus titer of 10.3.5 TCID50 per ml of the swab fluid. Unfortunately, only the lumbar spinal cord and not additionally the vagina of that cow was forwarded to the laboratory for examination. The boar mentioned was the only contact with swine from other herds for several months, and a logical conclusion was that virus had been transmitted from the vagina of Sow 1 to the other sow and the cow at practically the same time approximately one week after the mating of Sow 1 (for more details, see Section 4).
     In a further two outbreaks (Bitsch 1984b, Outbreaks 2 and 5) vaginal swabs from sows were examined virologically, but with a negative result. In Outbreak 2 from 1982, two heifers showed clinical disease on February 23, and the virus was found in the vagina of the one examined. Two sows had been served by center boars 7 and 11 days earlier, but vaginal swabs taken from the sows five days after the clinical outbreak,  i.e. 16 and 12 days after service, respectively, were found negative. In Outbreak 5, where a calf showed signs of Aujeszky's disease on September 19, 1983, virus was found in the vagina of the calf. Vaginal swabs collected from two gilts, which had been served by a center boar nine days before disease in the calf, were found negative, but the sampling was not performed until 12 days after service. Blood samples, however, taken of both of them showed low antibody titers. Apart from the gilts, there were only some feeder pigs in this herd. So, for these two outbreaks, it must be concluded, that although vaginal infection was most likely introduced as a genital infection approximately one week before the disease in cattle, the samples from the sows had not been collected early enough, as the development of antibody will hamper virus recovery after more than one week.
     The main conclusion from the investigation of the five outbreaks reported in 1984, where center boars were suspected of introducing the infection, was that the genital infection could be confirmed in sows in three of them while in the remaining two, samples were collected too late for confirmation of the expected vaginal infection of the sows. The results closely linked cases of Aujeszky's disease in cattle with pruritus on the hindquarters to genital infection in swine on the same premises.  At the same time, they convincingly documented two special epidemiological features of Aujeszky's disease in pigs, namely (1) the natural occurrence of a true porcine genital infection and (2) the spread of this manifestation of infection between swine herds by center boars used for natural service.
     Romero et al. (1997) subjected naturally infected wild pigs in the USA to immunosuppression using dexamethasone and isolated SuHV1 primarily from the vagina and prepuce and less frequently from the respiratory tract of these animals.  When 6 naturally infected boars were placed together with 5 uninfected and non-pregnant gilts and were examined over eight weeks, virus could be demonstrated in vaginal samples, but not in nasal swabs from any of the animals. In a later experiment (Romero et al., 2001), infected non-pregnant sows were kept with uninfected boars for six weeks and virus could be demonstrated in preputial swabs and not in nasal swabs from the boars. Likewise, when infected boars were kept together with uninfected gilts, virus could be found in vaginal swabs and not in nasal swabs taken from the gilts. Their conclusion was that the SuHV1 infection in wild pigs was primarily maintained as a venereal infection.
     According to various web sources, wild pigs in the USA were originally escaped domestic swine. About a century ago, however, wild pigs were imported into the USA from Europe, and the wild pigs today are a mixed breed population.  It is noteworthy that the SuHV1 infection appears to occur in wild pigs in the USA in the form that was prevailing in domestic swine in Europe before the development and intensive spread of the respiratory strains

 

      The main conclusions related to yhe occurrence of porcine genital infection with SuHV1 are hereafter:

  1. Genital infection is a specific epidemiological entity of the infection.
  2. It has been maintained in domestic swine in many countries for long periods by center boars used for the natural service of sows in different herds.
  3. It has always been asymptomatic in infected pigs.It has always been asymptomatic in infected pigs.
  4. Indications of respiratory spread of an infection introduced in a venereal mode have never been observed.
  5. The many genital isolates from swine and cattle in Denmark have consistently been found to be non-syncytial, and there is no reason to suspect that this should not account also for genital strains from other countries. 
  6. The natural genital infection has been demonstrated also in wild pigs.  

4.  Selected outbreaks in cattle with a posterior localization of pruritus: supplementary details pointing to the involvement of animal sodomy (zoophilia/bestiality) in the transmission of the infection

     Sodomy is a delicate subject, so when investigating outbreaks, it will be unacceptable to suggest a such action to have taken place, also to the local veterinary practitioner. Relevant information therefore had to be collected indirectly and with much care. Naturally, the most valuable sources of information were the farmer or his wife and their practicing veterinarian.

     The first outbreak, where sodomy was found likely to have been involved, also was the first case ever, where the virus was demonstrated in the vagina of an affected bovine animal (Bitsch 1975b, Outbreak 14). The farmer had brought a sow to a boar center for service about 5 days before the disease appeared in the calf. From the veterinary practitioner, I learned (1) that the owner was a bachelor and (2) that he - early in the afternoon, shortly after having returned home from the center – had brought the affected calf in from the field and placed it in the house next to the sow, where it remained until it got sick. When talking to the farmer I suggested that he might have gotten his hands contaminated by pulling the tail of the sow and that he thereafter by dragging the calf by its tail might have transferred the virus to the perineal region. But the farmer did not respond at all hereto.

     A second outbreak was the very first case of proven naturally occurring genital infection in pigs (Bitsch 1984b, Outbreak 1). Fortunately, the practitioner phoned to me early about two suspected cases of Aujeszky's disease in calves showing posterior pruritus. Without hesitation, I then told him (1) that the two calves would be females, (2) that they would be placed next to each other and that the neighboring calves would be males, and (3) that a sow would have been served by a center boar approximately one week earlier. He immediately confirmed the two first postulates. In fact, 11 calves were stalled in a row, where No. 2 and No. 3 - the affected ones - and No.10 were females, while the rest were males. He promised to forward the vaginas of the calves and a vaginal swab from the sow for laboratory examination.  The virus was found in both vaginas, and a high virus titer was demonstrated in the vaginal swab from the sow, cf. Section 3.3.  According to the farmer's wife, sows to be served were usually pointed out to the one bringing the boar by herself or her husband, but in this particular case, they had both been away and had been substituted by their son. According to the practicing veterinarian, their son was “15 years old or so”.  When the boar had left, their son was quite alone at home.  

     In a third case (Bitsch 1984b, Outbreak 3) I was first contacted by the practitioner, who reported that a cow in a herd had shown symptoms of Aujeszky's disease with pruritus in the tail region. I then responded that a sow in the herd would have been served by a center boar about a week earlier, and asked him to collect a vaginal swab from that sow for examination. However, at the farm, he phoned back and told me that the sow (Sow 1) had been served two weeks earlier. There were only two sows on the premises, so he agreed to take a vaginal swab also from the second sow (Sow 2). The vaginal swab from Sow 1 was found negative, as expected because it was collected too late after service. But the vaginal swab from Sow 2, which had not been served recently, showed a relatively high virus titer (see Section 3.3). It appears unquestionable that the infection originated from the boar, but the virus had not been transmitted to the cow shortly after the mating. Actually, the findings were consistent with a transmission of the infection from the vagina of Sow 1 to the vagina of Sow 2 and the affected cow approximately one week later. In this respect it is of interest that Sows 1 and 2 were housed in a separate building, while the infected cow and other bovine animals were in the cowhouse on the other side of the farmyard. The center boar had been the only contact with swine from other herds for several months.

     In a later outbreak, we came as close to a confession of animal sodomy as one can get without using that particular term. The virus was found in the vagina of a heifer, which was placed immediately next to the sow served a week earlier by a center boar. When I phoned the farmer some days after the delivery of the laboratory results, I got into contact with his wife. I explained to her about the situation: that virus would have been introduced by the boar, and that the heifer would have received a vaginal infection. Furthermore, I suggested that if a person later that day had brushed the hindquarters of the sow and then in immediate succession with the same brush also the tail region of the heifer, I would realize a risk of transmission of the infection to the heifer.  I then heard her speak to someone in the room, saying: “Peter (name changed), it is the laboratory veterinarian. He tells me, that if one has brushed the hindquarters of the sow and thereafter the hindquarters of the heifer, one may have transmitted the infection from the sow to the heifer. I saw you were out there in the evening. The lights were on”. I could not hear the other person speak, but after a while, she returned and said shortly: “I was speaking to our assistant. He tells me that he has done so”.  It was striking that she did not hesitate at all. She knew immediately which day the sow had been served, and that the lights had been on in the animal house in the evening on that particular day. Most probably, she and her husband had already talked about what might have taken place. And that the assistant that evening should have brushed the hindquarters of those two animals is definitely unlikely.

     Finally, one particular outbreak deserves to be mentioned. A cow and her calf, both showing posterior pruritus, died close to one week after delivery of the calf. We demonstrated the virus in the vagina of the cow, but the calf was not examined. When I later visited the farm, I inspected the farm buildings together with the owner and his young male assistant. In the barn there was in one corner a pen with a sow, which had been served by a center boar some days before the appearance of the disease,  and in another one a calving box, where the cow had been with her calf. There were no other animals in that room. 

     As mentioned earlier, one or two animals were usually infected in each outbreak with posterior pruritus, which fits with the notion of involvement of sodomy.  But in extreme cases, several more animals have been infected. Shope (1931) mentions an outbreak, where 9 animals showed pruritus on the hindquarters.  Bendixen et al. (1965) informed of an outbreak with 7 cases and in a later Danish outbreak even 10 cows got infected. But from the details of this last outbreak given in the footnote below, it will be seen that also here sodomy may very well have been involved.[1]

     Concluding remarks on sexual transmission of SuHV1 from swine to cattle by man:
     
Although animals in the first outbreaks in cattle in European countries (Aujeszky 1902, Bang 1932, Burggraaf and Lourens 1932) showed pruritus on the head or chest (respiratory infection, cf. above), the manifestation associated with pruritus on hindquarters was predominating in cattle in Europe for many years. The port of virus entry and the way of transmission of the infection from swine to cattle remained obscure. One step forward in the understanding of these questions was the finding that viral vaginal infection could readily be demonstrated in most of the bovine cases. Another feature was that cases were linked to using center boars for service of sows in the herd and vaginal infection of a sow. The virus could be demonstrated in the vagina of a sow if not tested later than the time of death of the bovine animal.  The. evidence that the genital infection in sows had been sexually transmitted to the cattle by man must be considered substantial, as all findings are consistent with that explanation.



[1] Unfortunately, the laboratory was not contacted during that acute outbreak, and just lumbar CNS material of one cow was received from an incineration plant several days after the outbreak. The animals got sick at the end of one week. Later, we received detailed information from the veterinary practitioner about the onset of the disease, the time of death of the individual animals, and their location in the animal house, where 34 dairy cows, calves, and pigs were housed. According to the farmer's wife, a center boar had served a sow the preceding Saturday. When I later phoned the farmer to learn if pigs had been loose in the house that particular weekend, I talked with his daughter, who explained that to their knowledge no pigs had been loose. However, they still needed to ask her brother, because that weekend he had been home on leave from military service and that Saturday evening,, he had been the only one at home.  



References

Akkermans, J.P.W.M., 1963:

     Ziekte van Aujeszky bij het varken in Nederland (Aujeszsky’s disease in swine in the
      Netherlands).      Dissertation. Centraal diergeneeskundig Instituut, Rotterdam 1963.

Akkermans, J.P.W.M., 1964:

     Ziekte van Aujeszky bij het varken in Nederland (Aujeszky's disease in swine the Netherlands).     Tijdschr. Diergeneesk., 1964, 89, 146-159.

Andersen, H.K., Basse, A., Møller, T., 1964:

     Enzootisk optrædende morbus Aujesky hos pattegrise ( Aujeszky's disease in pigs in Denmark).      Medlbl. danske Dyrlægeforen. 1964, 47, 968-978.

Aujeszky, A., 1902:

     Über eine neue Infektionskrankheit bei Haustieren (a new infectious disease in domestic animals).      Zentralbl. Bakt. Parasitenk. Infektionskr. Hyg., I. Abt. Orig., 1902, 32, 353-357.

Bang, O., 1932:

     Pseudowut (acute infectiöse Bulbärparalyse) beim Rind in Dänemark (Aujeszky's disease in cattle
     in Denmark).

     Acta path. microbiol. scand., Suppl. 11, 1932, 180-182.

Bendixen, H.C., Bendixen, H.J., Christensen, N.O., 1965:

     Morbus Aujeszkyi’s forekomst og optræden hos kvæg i Danmark (Aujeszky’s disease in cattle
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     Nord. Vet.-Med. 1965, 17, 249-279.

Ben-Porat, T., Deatly, A.M., Easterday, B.C., Galloway, D., Kaplan, A.S., McGregor, S., 1984:

     Latency in pseudorabies virus.

     In: Wittmann, G., Gaskell, R.M., Rziha, H-J. (eds), Latent herpesvirus infections in veterinary
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     A study of outbreaks of Aujeszky’s disease in cattle. I. Virological and epidemiological
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     A study of outbreaks of Aujeszky’s disease in cattle. II. Further investigations on the routes of
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     A study of outbreaks of Aujeszky’s disease in cattle. III. Further outbreaks of special interest
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     Acta vet. scand. 1975, 16, 449-455.

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     Correlation between the pathogenicity of field strains of Aujeszky’s disease virus and their ability
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 Acta vet. scand. 1980, 21, 708-710.

Bitsch, V., Andersen, J.B., 1982:

     On the epidemiology of Aujeszky’s disease in Denmark and the possibilities of its control.

     In: Wittmann, G., Hall, S.A. (eds.), Aujeszky’s disease
      Current topics in veterinary medicine and
      animal science, Vol. 17, 227-236. Martinus Nijhof Publ., The Hague, Boston, London 1982. Bitsch, V., 1983:

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     Proc. Almänt veterinärmöte, Stokholm 1983, 262-271.

Bitsch, V., 1984a:

     The main epidemiological features of Aujeszky’s disease.

     Proc. 11th Conference of the OIE Commission for Europe, Vienna 1984, 381-391.

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     Naturally occurring genital infection with Aujeszky's disease virus in pigs.  

     Proc. 8th International  Pig Veterinary Society Congress, Gent 1984, 23.      

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     Infectieuse bulbair-paralyse (ziekte van Aujeszky ) (Aujeszky's disease).

     Tijdschr. Diergeneesk. 1932, 59, 981-1002.

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     Restriction fraction pattern (RFP) analysis of genomes from Danish isolates of
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     Arch. Virol. 1987, 97, 215-224.

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     Arch. Virol. 1988, 100, 109-113.

Christensen, L.S., Mousing J., Sørensen, K.J., Strandbygaard, S.B., Henriksen, C.A., Andersen, J.B.,
     1990:     
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     Vet. Rec. 1990, 127, 471-474.

Christensen, L.S., Mortensen, S., Bøtner, A., Strandbygaard, S.B., Rønsholt, L., Henriksen, C.A.,
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     Vet. Rec. 1993, 132, 317-321.

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     Experimental Aujeszky’s disease in pigs: excretion, survival and transmission of the virus.

     Vet. Rec. 1983, 113, 490-494.

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     Nord. Vet.-Med. 1965, 17, 649-656.

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     Differentiation of Aujeszky’s disease virus strains by restriction endonuclease analysis of the viral
     DNA.
     
In: Wittmann, G., Hall, S.A. (eds.). Aujeszky’s disease.  Current topics in veterinary
      medicine and animal science, 17,  p. 1-13. Martinus Nijhof Publ., The Hague, Boston, London
     1982.

Gielkens, A.L.J., Oirshott, J.T. van, Berns, A.J.M., 1985:

     Genome differences among field isolates and vaccine strains of pseudorabies
      virus
.     
      J. Gen. Virol. 1985, 66, 69-82.

Gloster, J., Donaldsen, A.I., Hough, M.N., 1984:

     Analysis of a series of outbreaks of Aujeszky’s disease in Yorkshire in 1981-1982: the possibility
     of airborne disease spread.

     Vet. Rec. 1984, 114, 234- 239.

Herrmann, S-C., Heppner, B., Ludwig, H., 1984:

     Pseudorabies virus from clinical outbreaks and latent infections grouped into four major genome
     types.
In: Wittmann, G., Gaskell, R.M., Rziha, H-J. (eds), Latent herpesvirus infections in veterinary
     medicine

     Curr. Top. Vet. Med. Anim. Sci. 1984, 27, 387-401. Martinus Nijhof Publ., The Hague,
     Boston 1984.

Harkness, J.W., Sands, J.J., 1985:

     Quantitative evaluation of syncytium formation in cell culture by British isolates of Aujeszkyi’s
     disease virus.

     Br. vet. J. 1985, 141, 151-159.

Hurst, E.W., 1933:

     Studies on pseudorabies (infectious bulbar paralysis, mad itch). I. Histology of the disease, with a
     note on the symptomatology.

     J. exp. Med. 1933,58, 415-433.

Jansen, J., 1957:

     De ziekte van Aujeszky in Nederland  (Aujezky's disease in The Netherlands).

     Tijdschr. Diergeneesk. 1957, 82, 631-634.

Jansen, J., Kunst, H., 1957:

     On the localization of the virus of Aujeszky in the central nervous system.      Tijdschr. Diergeneesk. 1957, 82, 674-679.

Kaplan, A.S., 1969:

     Herpes simplex and pseudorabies viruses

     Virol. Monogr. 5, 1969. Springer Verlag, Wien, New York.

Kretschmar, C., 1970:

     Die Aujeszkysche Krankheit (Aujeszky's disease).

     VEB. Gustav Fischer Verlag, Jena 1970.

Köves, J., Hirt, G., 1935:

     Über die Aujszkysche Krankheit der Schweine (On Aujeszky's disease in swine).

     Arch. f. Tierheilk. 1935, 68, 1-23.

Lamont, H.G., 1946/1947:

     Observations on Aujeszky’s disease in Northern Ireland.

     Vet. Rec. 1946, 58, 621-625 and 1947, 59, 1-3.

Ludwig, H., Herrmann, S-C., Heppner, B., 1982:

     The genomes of different field isolates of Aujeszky’s disease virus.

     In: Wittmann, G., Hall, S.A. (eds.). Aujeszky’s disease
     Current topics in veterinary medicine
     and animal science, 17,  p. 15-20. Martinus Nijhof Publ., The Hague, Boston, London 1982.

Ratz, S. von, 1914:

     Die Empfänglichkeit der Tiere für Paralysis bulbaris infectiosa (susceptibility of various animal
     species to Aujeszky's disease).

     Zeitschr. Infektionskrh. parasit. Krh. Hyg. Haust. 1914, 15, 99-106.

Rockborn,G., Hugoson, G., 1972:

     On the occurrence of pseudorabies in Sweden. I. Incidence of latent infections in sows and boars..

     Zentralbl. Vet.-Med., Rh. B, 1972, 633-640.

Romeo, C.H., Meade, P., Santagata, J., Gillis, K., Lollis, G., Hahn, E.C., Gibbs, E.P.J., 
     1997:  Genital infection and transmission of pseudorabies virus in feral swine in Florida,
     USA

     Vet. Microbiol. 1997, 55, 131-139.

Romero, C.H., Meade, P.N., Schultz, J.E., Chung, H.Y., Gibbs, E.P., Hahn, E.C., Lollis, G.,
     2001: Venereal transmission of pseudorabies viruses indigenous to feral swine.     
     
Journ. Wildlife Dis. 2001, 37, 289-296.

Rosenberger, G., 1940:

     Beobachtungen über die Aujeszkysche Krankheit in Deutschland (observations on Aujeszky's
     disease in Germany).

     Deutsche Tierärztl. Wschr. 1940, 48, 485-488.

Shope, R.E., 1931:

     An experimental study of „mad-itch“with especial reference to its relationship to 
     pseudorabies.     
     
J. Exp. Med. 1931, 54, 233-248.

Shope, R.E., 1935a:

     Experiments on the epidemiology of pseudorabies. I. Mode of transmission of the disease in swine
     and its possible role in its spread to cattle.
   
     J. exp. Med. 1935, 62, 85-99.

Shope, R.E., 1935b:

     Experiments on the epidemiology of pseudorabies. II. Prevalence of the disease among Middle
     Western swine and the possible role of rats in herd-to-herd infections.
      
     J. exp. Med. 1935, 62, 85-99.

Todd, D., McFerran, J.D. 1985:

     Restriction endonuclease analysis of Aujeszky’s disease (pseudorabies) virus DNA: comparison
     of Northern  Ireland isolates and isolates from other countries.

     Arch. Virol. 1985, 167-176.