Ileitis猪回肠炎课件

1、這是什麼病?.這是什麼病?.答案豬增生性腸炎(PPE, Procine Proliferative Enterpathy)又叫迴腸炎(Ileitis).答案豬增生性腸炎(PPE, Procine Prolifer這是新的豬病嗎?不，這不是一種新病。但我們對它卻到最近才有完整的了解。我們發現迴腸炎是造成養豬業重大損失的疾病。.這是新的豬病嗎?不，這不是一種新病。但我們對它卻到最近才有完豬迴腸炎Ileitis 美國禮來大藥廠.豬迴腸炎Ileitis 美國禮來大藥廠.過去我們認為這些疾病不相關豬增生性腸炎PPE增生性出血性腸炎PHE迴腸炎Ileitis壞死性腸炎Necrotic Enteritis出

2、血性迴腸炎bloody form ileitis增生性腸道病變Proliferative Enteropathy水管腸道病Garden hose Gut豬腸道Porcine intestinal adenomatosis ( PIA ).過去我們認為這些疾病不相關.現在我們知道這些疾病都是同一種病原所引發的不同型態及臨床症狀迴腸炎亞臨床型迴腸炎非出血型迴腸炎急性出血型迴腸炎.現在我們知道這些疾病都是同一種病原所引發的不同型態及臨床症狀過去我們認為這些疾病可能是由許多不同病原所引發榛狀菌Campylobacter sputorum類棒狀菌微生物Campylobacter-like organis

3、m.過去我們認為這些疾病可能是由許多不同病原所引發.現在我們知道1995年發現且正式命名迴腸炎的致病原為一種專門寄生在腸道上皮細胞內的:細胞內寄生拉森菌Lawsonia Intracellularis免疫螢光.現在我們知道1995年發現且正式命名免疫螢光.過去我們不重視迴腸炎,因為 病原不明診斷方法不明(僅能經由死後剖檢)容易與沙門氏菌或豬赤痢混淆對於該病的亞臨床型及慢性型了解有限豬場的流行狀況及經濟損失不明罹病率及疾病在豬場的重要性被低估.過去我們不重視迴腸炎,因為 病原不明.增生性腸病最常被稱為增生性腸炎或迴腸炎仔豬離乳後的腸道疾病目前已知是造成豬隻下痢及生長不良的重要疾病.增生性腸病最常

4、被稱為增生性腸炎或迴腸炎.病原細胞內寄生拉森菌Lawsonia Intracellularis對腸道細胞具親和力，因而感染腸細胞G(-)專性厭氧菌專性細胞內寄生之細菌.病原細胞內寄生拉森菌Lawsonia Intracellu致病機制拉森菌寄生於迴腸及結腸上段的腸道上皮細胞中受感染的細胞開始不正常增生，增生細胞多為未成熟上皮細胞增生的細胞使腸壁厚度增加腸道失去正常的消化及吸收功能其它細菌的二次感染.致病機制拉森菌寄生於迴腸及結腸上段的腸道上皮細胞中.上皮細胞不正常增生不成熟的上皮細胞增生因而使腸壁不正常增厚增厚的腸壁影響腸道正常功能細菌性二次感染機會增加受感染的上皮細胞脫落後經由糞便排出並感染

5、其它豬隻寄生於細胞內的拉森菌豬迴腸橫切面.上皮細胞不正常增生不成熟的上皮細胞增生因而使腸壁不正常增厚增臨床症狀潛伏期約2-3週急性出血性迴腸炎亞臨床型迴腸炎亞臨床型慢性.臨床症狀潛伏期約2-3週.急性出血性迴腸炎又稱增生性出血性腸炎(PHE)急性好發於後備母豬及肥育豬(15-17 週齡)長途運輸後或新進場母豬好發於規模大豬場雜菌清除後造成拉森菌增生?豬隻感染後糞便呈現黑色瀝青狀豬隻呈現蒼白貧血高死亡率(約6-20%)未死亡可逐漸康復.急性出血性迴腸炎又稱增生性出血性腸炎(PHE)豬隻感染後.非出血性迴腸炎亞臨床型迴腸炎最常發生於哺育豬(15-30 Kg體重)肥育前期豬隻次之生長性能不良整齊度差

6、攝飼料減少增重降低籵肉比增加.非出血性迴腸炎亞臨床型迴腸炎.非出血性迴腸炎慢性迴腸炎最常發生於肥育後期豬隻(30-70 Kg體重)哺育豬次之10-50%豬隻下痢呈現半固體軟便顏色不規則通常不帶血絲糞便中含有壞死性組織病程可維持數天至數週逐漸變成壞死性腸炎,預後不良體重減輕,皮毛粗剛,生長不良死亡.非出血性迴腸炎慢性迴腸炎.慢性迴腸炎經常發生於哺育豬及肥育前期豬隻(20-50 Kg).病豬生長不良，整齊度差10-50%豬隻呈現軟便至下痢生長性能不良飼養管理的改變經常造成疾病爆發換欄或運輸換料(攝飼料減少)停藥或換藥溫差過太密飼黴菌毒素可能的二次感染病原梭菌榛狀菌大腸桿菌.慢性迴腸炎經常發生於哺育

7、豬及肥育前期豬隻(20-50 Kg).整齊度不佳.整齊度不佳.迴腸部位出現血塊.迴腸部位出現血塊.迴腸粘膜出血.迴腸粘膜出血.粘膜增厚.粘膜增厚.腸壁增厚.腸壁增厚.疾病傳播-經口感染人員散播污染的糞便鼠類傳播外來後備母豬母豬傳播給仔豬平行感染鳥類傳播.疾病傳播-經口感染人員散播污染的糞便鼠類傳播外來後備母豬母豬迴腸炎的經濟損失豬隻消化道的吸收消化等功能受損增重降低料肉比增加整齊度下降豬場生產線受阻淘汰豬隻增加死亡率增加1-5%治療投藥成本增加人工及管理費用增加.迴腸炎的經濟損失豬隻消化道的吸收消化等功能受損.Impact of ileitis on the performance. 5 ex

8、perimental infections. Ref: McOrist et al., 1997 Veterinary Record, 140: 579-581迴腸炎的經濟損失第一組第二組第三組第四組第五組.Impact of ileitis on the perfo迴腸炎診斷.迴腸炎診斷.鑑別診斷豬赤痢病原:Brachyspira hyodysenteriae下痢糞便中夾帶粘膜及鮮血死亡率較高螺旋體結腸炎病原:Brachyspira pilosicoli下痢帶粘膜，但不帶血腸道沙門氏桿菌病原:傷寒沙門氏桿菌水痢發高熱死亡率高鞭蟲腸扭轉胃潰瘍黴菌毒素慢性傳染性胃腸炎.鑑別診斷豬赤痢腸道沙門氏桿

9、菌.屠宰場剖檢屠宰後以腸壁變厚作為判斷標準無特異性敏感性低(容易低估真正感染比率).屠宰場剖檢屠宰後以腸壁變厚作為判斷標準.組織病理學死後豬隻採腸道組織進行Warthin Starry鍍銀法或Hematoxylin Eosin染色法.組織病理學死後豬隻採腸道組織進行.實驗室PCR(Polymerase chain reaction)以拉森菌存在與否決定高特異性(100%)低敏感性(39%)活體動物亦可進行(糞便)極少量菌體即可測得，但感染豬隻必須在排毒期方可測得，所以測得結果僅能針對單一豬隻，無法判斷全場感染狀況成本昂貴.實驗室PCR(Polymerase chain react實驗室血清學方

10、法-Ileitest利用免疫螢光抗體法檢測感染(曾感染)豬隻的IgG抗體最新研發科技高持異性91%高敏感性97%好處可知全場疾病感染動向,進而可進行治療或控制成本低廉一般實驗室即可進行.實驗室血清學方法-Ileitest利用免疫螢光抗體法檢測感陽性結果判讀陰性.陽性結果判讀陰性.Ileitest 流行率調查陽性比率豬場%.Ileitest 流行率調查陽性比率豬場%.15%35%35%25%35%50%30%全球流行率 屠宰時以PCR檢查.15%35%35%25%35%50%30%全球流行率 屠宰時迴腸炎的治療及控制.迴腸炎的治療及控制.控制 1飼養管理全進全出強力清潔及消毒(使用非氛類消毒劑)

11、檢測外來的後備母豬避免應激因子, 包括密飼, 通風不良,溫差太大*Bane y col. Proc. 15 IPVS Congress ,1998.控制 1飼養管理.泰農(泰樂菌素)控制 2含藥飼料添加物選擇有效的抗生素藥物敏感性高(MIC值低)可以進入腸道細胞並在細胞中蓄積進入細胞後仍能保持藥物活性.泰農(泰樂菌素)控制 2含藥飼料添加物.拉森菌附著在腸道上皮細胞表面,2小時鑽入細胞內後泰農穿透進入上皮細胞阻斷拉森菌的核醣體作用xxx腸道上皮細胞拉森菌x泰農進入腸道細胞蓄積潛伏期二週.拉森菌附著在腸道上皮細胞表面,2小時鑽入細胞內後泰農xxx腸預防及控制預防高爆發期或預期應激出現時開始投藥每

12、噸飼料投予100克泰農,連續投予21天之後21天每噸飼料投予40克泰農之後至上巿為止每噸飼料投予20克泰農控制出現臨床症狀即開始在每噸飼料中投予100克泰農,連續投予21天之後21天每噸飼料投予40克泰農之後至上巿為止每噸飼料投予20克泰農.預防及控制預防控制.我們的未知帶原者?豬場的感染狀態?分娩時是否會排菌?保毒者?如何撲滅?免疫反應及疫苗?.我們的未知帶原者?.Macroscopic lesionsProliferation (thickening of the mucosa)Last 20 cm of the ileum- proximal colon.Mucosal foldings

13、.Reticulated serosa.Secondary infections might form necrotic pseudomembranes.Macroscopic lesionsProliferati迴腸炎的經濟損失Up to 0.8 increase in FCR and 14 days more to slaughter.Winkelman, Proc. AASP, 1987From 1 to 6% increase in mortalityWard y Winkelman, Vet. Med., 1990Clinical duration between 6 and 8 w

14、eeks and up to 15% cullsWinkelman, The compendium, 1996McOrist, J. Comp. Pathol, 1996.迴腸炎的經濟損失Up to 0.8 increase in Ref: McOrist et al., 1997 Veterinary Record, 140: 579-581迴腸炎的經濟損失Indirect effects of ileitisNegative impact on growth during a critical period for lean deposition (12-20 weeks)Changes

15、the fat/lean ratio, devaluating the value of the carcass. (increase in back fat).Ref: McOrist et al., 1997 VeteIleiTest : Mexico farms%39 farmsAGE weeks.IleiTest : Mexico farms%39 far%Age weeks19 Companies, 500 - 8000 Sows each one,120 samples by company / 20 samples each group of ageIleitest : Prof

16、ile / Mexico Region.%Age weeks19 Companies, 500 - IleiTest : Profile on farm AAge weeks% Positivesamples20 blood samples each group of age for Ileitest20 fecal samples each group of age for PCR.IleiTest : Profile on farm AAgUnderstanding: Ileitest / Other disease ( PRRS ) Farm A S/P.727S/P1.915S/P1.

17、024S/P1.708S/P1.294S/P1.123-Viremia of PRRS, destabilization-Increase (+) to Lawsonia but without clinical signs Pigs stabilize to PRRS- Increase pigs % ( + ) to LawsoniaIleitis cause: - clinical signs - Lesion%Age weeks.Understanding: Ileitest / OtheFarm B Understanding Dynamic Diseases%Age weeksS/

18、P1.367S/P0.870S/P1.3S/P1.645S/P1.639S/P1.433.Farm B Understanding Dynamic Farm CS/P0.667S/P2.64S/P1.942S/P1.744S/P1.706%Age weeks.Farm CS/P0.667S/P2.64S/P1.942SFarm D / Ileitis%Age weeks.Farm D / Ileitis%Age weeks.Seroprofile / IleiTestTo understand who Lawsonia is moving in the farmTo get the corre

19、lation with clinical signsIs important to know which others diseases there are at the farmTo know which others disease increase the dissemination of Lawsonia and the economical impact of Ileitis .Seroprofile / IleiTestTo underLawsonia at the infectionOrally inoculated pigs using L. intracellularisDo

20、se: 1.0 X 108 to 8.0 X 108 organisms Diarrhea began 2 weeks post challengepersisted 1-2 weeksNot necessary all the pigs sick show diarrhea.Excretion during weeks 2 to 10 after the challenge in 20-50% of the pigsSome of the pig shed 7.0 X 108 organisms/gram of fecesStudy suggests one infected pig may

21、 shed enough to infect othersDisease may persist in few who infect othersThe effect on the ADG is from 3 to 9 weeks after inoculateSmith & McOrist. Res Vet Sci. 1997;62(1):6-10.Lawsonia at the infectionOrallRef: McOrist et al., 1997 Veterinary Record, 140: 579-581Economic impact of ileitisIleitis ma

22、y cost from US $ 1.48 to US $ 22.19 per affected pig, depending on disease severity, duration, feed convertion mortality and numer of culled pigsIndirect effects of ileitisNegative impact on growth during a critical period for lean deposition (12-20 weeks)Changes the fat/lean ratio, devaluating the

23、value of the carcass. (increase in back fat).Ref: McOrist et al., 1997 VeteControl StrategyDiagnosisDisease ( Ileitest/IFA, PCR, Histophatology)Disease form ( subclinic, chronic, hemorrhagyc ) Control risk factorsSerologic profile Ileitest to understand the correlation with clinical signsStrategic m

24、edication programAccording to Ileitest and clinical signs Control other disease Salmonella, PRDC, PRRS, etc.Control StrategyDiagnosis.Control risk factorsReduce stress associated to movement.Decrease mixing.Reduce vicious environment:Incorrect ventilation.Temperature fluctuation.Avoid overcrowding.A

25、dequate feeder space and water flow.High quality diets.Control of other diseases.Control risk factorsReduce strMedication Program Farm AAccording to Ileitest and clinical signs.Use of intracelular activity antibiotic.Tylan 110 ppm weeks 16 to 18S/P.437S/P.202S/P.718S/P1.708S/P1.294S/P1.123.Medicatio

26、n Program Farm AAccorMedication Program. Farm D%Tylan 110 ppm weeks 6 - 9 .Medication Program. Farm D%TylMedication Program. Acute haemorrhagic form:Replacement gilts: Tylan* 110 ppm at least 3 weeks.Grower and Finisher: 70kg. to Market, use 110 ppm, Tylan* (control and prevention)Note: The dose in mg/kg bw with Tylan* for control of Ileitis is 3 - 5 mg/ke bw with 110 ppm, for this reason in the case of gilt and sows is necessary to review the feed intake to adjust the dose according to consumption.Medicati