Salmonella Heidelberg: An Emerging Problem in the Dairy Industry

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2 Salmonella Heidelberg: An Emerging Problem in the Dairy Industry D.C. Sockett DVM, MS, PhD, DACVIM 1 N. A. Aulik PhD 1 K.M. Deering MS, DVM, DACVP 1 R.F. Klos DVM, MPH 2 A.M. Valley BS 3 1 Wisconsin Veterinary Diagnostic Laboratory, Madison, WI 2 Wisconsin Division of Public Health, Madison, WI 3 Wisconsin State Laboratory of Hygiene, Madison, WI 12/19/2017 University of Wisconsin Madison 2

3 Salmonella in Humans Estimated 1.2 million cases occur each year 42,000 culture confirmed cases reported annually in U.S. 11% of infections are due to contact with animals (CID 2012; 54:S472-9) Symptoms: diarrhea, fever, abdominal cramps; Can be invasive and lead to blood stream infections Infection and severe illness more common in children, elderly, immunecompromised persons Duration of symptoms: usually 4-7 days Transmission: food, zoonotic (animal contact), person-to-person, water, environment. 3

4 Salmonella Heidelberg Not all Salmonella behave the same!!! Current outbreak started in 2015 Peaked in summer of humans cases confirmed in 14 different states 30% of confirmed cases required hospitalization 33% of hospitalizations were children under age 5 66% of confirmed cases had direct contact with dairy beef calves that were sick from Salmonella Heidelberg vs. national average of 11% for other Salmonella 12/19/2017 University of Wisconsin Madison 4

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6 States Ill People California 1 Iowa 2 Idaho 1 Indiana 2 Kentucky 3 Minnesota 5 Missouri 7 North Dakota 1 New Jersey 1 Ohio 1 Oklahoma 1 South Dakota 5 Texas 1 Wisconsin 16 12/19/2017 University of Wisconsin Madison 6

7 *n=36 for whom information was reported as of 3/10/2017. Some illness onset dates have been estimated from other reported information. 12/19/2017 University of Wisconsin Madison 7

8 S. Heidelberg isolates submitted by WVDL to WSLH for PFGE subtyping Updated 4/5/17

9 PFGE-XbaI PFGE-XbaI KP SourceSite SOPIsolatDate. Bovine stool Bovine stool Bovine intestine TISSUE Bovine Liver and Kidney Bovine intestine TISSUE intestine Bovine isolate Animal stool Bovine intestine Bovine, "pooled LIV/LU/LN" Bovine liver Animal stool Bovine pool of lung and liver Bovine, "dry cow waterer" Animal stool stool Lung Bovine intestine Human Boot TISSUE stool stool Bovine intestine :00:00. Animal Stool Bovine intestine Animal Stool Predominant outbreak pattern Updated: 12/28/16

10 Salmonella Heidelberg Dairy beef calves (37 of 44 (84%) cases confirmed by WVDL) History of trucking to calf raising facility Start dying 5-10 days post-arrival at calf raising facility. Typically 7-14 days of age Colostrum (FPT) not protective Death loss 20-65% Die 4-8 hours after first noticed to be ill or found dead Die of a generalized bacteremia/septicemia (invasive disease) Diarrhea not a consistent finding

11 Salmonella Heidelberg Grossly: May see enlarged mesenteric lymph nodes and occasionally peritonitis as well Histologically may see a suppurative enteritis and lymphadenitis (mesenteric LN) Mild interstitial pneumonia MDR: Only susceptible to gentamicin Proper cleaning and disinfection of affected premises and trucks problematic Probiotics: May help

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17 Final Thoughts Not all Salmonella behave the same It is very important to know the serotype. Calf killers (well managed herds) Salmonella Dublin (D1) Salmonella Heidelberg (B) Salmonella Schwarzengrund (B) Salmonella Newport (C2) Cow killers (well managed herds) Salmonella Newport (C2) 12/19/2017 University of Wisconsin Madison 17

18 Final Thoughts More Veterinary Diagnostic Laboratories need to do serotyping Collaboration of State Veterinary Diagnostic Laboratories with Public Health Laboratories and CDC is essential Need Agriculture equivalent of PulseNet for Salmonella and other zoonotic disease pathogens Salmonella vaccines (important tool) Proper cleaning (biofilm removal) using low pressure foam cleaning and disinfection (contact time and concentration) are obligatory (high risk areas) in affected herds Verification cleaning done properly (ATP meter) Biggest problem is inadequate facilities (sanitary) design for proper C&D 12/19/2017 University of Wisconsin Madison 18

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20 ATP Meter

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