Tetanus occurred by misuse of syringe in Korean native cattle

한우에서의 주사기 오사용으로 발생한 파상풍 증례

Abstract

Tetanus is an acute, often fatal, and infectious disease of all species of domestic animals caused by the neurotoxin of Clostridium tetani (C. tetani). This disease is usually known to develop after microbial contamination in the deep or penetrating wound sites. In February 2017, a farmer who was raising 76 cows injected foot and mouth disease vaccine to three or more cows with one syringe. Their clinical symptoms were observed 2 to 16 days after the vaccination. The initial symptoms were stiffness, rigidity of the neck and limbs, pricked ears, and prolapse of the third eyelid. Subsequently, there was recumbency with extension of the limbs, convulsions and opistotonus and the affected 20 cows were all died. Two dead cows were submitted to Animal and Plant Quarantine Agency for disease diagnosis. At necropsy, a focal edematous abscess of 15 to 20 cm in diameter was grossly observed in the subcutaneous and intramuscular tissue of scapular region and filled with a large amount of greenish pus. The feed was full in oral cavity and slightly observed in the trachea and lobes of lung. Histopathologically, focal granulomatous nodules with eosinophilic materials in the tissue were observed. In the lung, aspiration pneumonia and gram (+) bacteria were seen. The C. tetani was isolated in samples anaerobically cultured using reinforced clostridial medium and identified by PCR. To our knowledge, no previous outbreak of tetanus in cattle has affected such a high number of animals; neither has it been associated with misuse of the same syringe and needle to administer multiple individuals.

Fig. 1. Gross findings. Focal edematous abscess (about 20 cm) in the subcutaneous and intramuscular tissues of scapular region, cow 1 (A). Focal edematous abscess (about 20 cm) in the subcutaneous and intramuscular tissues of scapular region, cow 2 (B). A large amount of greenish pus from the open abscess, cow 1 (C). A large amount of greenish pus from the open abscess, cow 2 (D).

Fig. 2. Microscopic findings and results of bacterial isolation and multiplex PCR. HE stain. ×40 (A). Gram positive bacteria were observed in the subcutaneous and intramuscular tissues of scapular region. Gram stain. ×100 (B). Swarming pattern of Clostridium tetani in blood agar (C). Multiplex PCR of non-toxigenic Clostridium tetani and toxigenic Clostridium tetani. M: 100bp DNA ladder, lane 1: nontoxigenic Clostridium tetani, lane 2: toxigenic Clostridium tetani (the isolate). N: Negative control (D).