EPIDEMIOLOGY & ROLLBACK OF MASTITIS IN PAKISTAN

Prof. (R) Dr. Ghulam MuhammadDr. Imaad RashidDepartment of Clinical Medicine and Surgery, University of Agriculture, Faisalabad5-12-2015

What is mastitis?Inflammation of the mammary

gland in response to injury for the purpose of destroying or neutralizing the infectious agents and to prepare the way for healing and return to normal function

National Mastitis Council, Inc., USANormal Udder Inflamed Udder

How common is mastitis and what is its significance?Every cow or buffalo develops mastitis before

she diesField surveys of major livestock diseases in

Pakistan……… mastitis is one of the most important health problems of dairy animals. Nearly 20% of cows and buffaloes at any given time have mastitis. Probably the most important cause of poor milk quality in Pakistan

(Cady et al., 1983; Ajmal, 1990; Ali, 2008; Hussain et al., 2005 )One of the most important causes of involuntary

culling in Pakistan

How common is mastitis and what is its significance?

In a survey conducted in 28 randomly selected villages in Tehsil Samundri, Faisalabad……… overall prevalence of mastitis (Clinical and Sub-clinical)……….14.14% in buffaloes and 20% in cows (Ali, 2009)

Mastitis causes nearly 25% production losses (Radostits et al.,2007; Arshad, et al., 1998)

Clinical vs Sub-clinical mastitis

How common is mastitis and what is its significance?Human health hazard:

Brucellosis, TB, Q fever, Listeriosis, Leptospirosis etc.

Problems to dairy processing industry due to increased SCC and antibiotic residues

What causes mastitis?“If you know your enemies and know yourself, you will not be imperiled in a hundred battles. If you do not know your enemies, but do know yourself, you will win one and lose one. If you do not know your enemies and do not know yourself, you will be imperiled in every battle”(Excerpt from the famous philosophy book “The Art of War” written by Sun Tzu. This book was distributed by FIFA World Cup 2002 Brazilian coach, Luiz Felipe Scolari to each of his players before the big match against England)

Agent – Host- Environment triad Etiologic agents: 1) Contagious mastitis pathogens: S.aureus, Str.agalctiae, Mycoplasma bovis, C. pyogenes (Truperella pyogenes) etc.

◦ The most important etiologic agents in Pakistan ◦ Usually transmitted from infected to healthy animals at the time of

milking

What causes mastitis? ….continued

2) Environmental pathogens: E.coli, Klebsiella, Environmental streptococci, Pseudomonas etc.◦Exposure is round the clock3)Opportunistic mastitis pathogens: Mainly coagulase negative staphylococci (CNS); part of normal flora of the skin of cows and buffaloes

E.coli Klebsiella Pseudomonas

What causes mastitis? ….continuedHost related factors1. Old age2. Species of the dairy animals ……. Mastitis is much more prevalent in dairy cows than in dairy buffaloes

What causes mastitis? ….continuedEnvironmental related factors1. Management2. Nutrition3. Over crowding4. Faulty milking practices5. Incomplete milking6. Diseases which cause lesions on

the teats e.g. FMD, pox etc.7. Mycotoxins in feed

Mastitis rollback measuresBasic premise

Mastitis in Pakistan: Predominantly contagious in nature

Transmission of contagious pathogens occurs primarily by milker’s hand at milking time

Mastitis control measuresObjectives of an effective mastitis control program:1. New infections must be prevented2. Duration of existing infections must be reducedMEANS TO REALIZE THESE OBJECTIVES1.Post-milking antiseptic teat dipping/spraying:“Dipping/spraying of teats in a germicidal solution

immediately after milking”The most effective managemental practice to prevent

contagious mastitis, not effective against environmental mastitis pathogens

Mastitis control measures…..Teat dipClasses of teat-dip: Iodophores

◦ Quaternary ammonium compounds◦ Chlorhexidine◦ Sodium hypochlorite◦ Physical barriers dip◦ Dodecyl benzene sulfonic acid (DDBSA)◦ ANTISEPTIC AVAILABLE IN PAKISTAN FOR TEAT-

DIPPING1. Lanodip™2. Masodine™3. Fight bac ™

Mastitis control measures ….2. PRE-DIPPING – Optional: required sometimes for environmental pathogens in machine milked herds3. DRY COW THERAPY - The most effective managemental practice to treat existing infections; also prevents new infections during the dry period

Cure rates higher than during lactation

Conventional dry cow therapy: infusion of Long-acting antibiotics at drying off into all four teats

Pakistani farmers generally averse to intramammary infusion – they think that intramammary infusion leads to mastitis

Systemic dry cow therapy ( = dry cow therapy by injection) a suitable alternative to intramammary infusions

(Soback et al., 1990; Tarabal and Canavesio, 2003)

Lincomycin-Spiramycin (Inj. Lincospira, Selmore Pharma) probably a good preparation for systemic dry cow therapy – two intramuscular injections; one at drying off & second 7-10 days before calving

Mastitis control measures ….4. Use of teat sealers at drying offBeing intensively investigated in New

zealand, UK, and elsewhere as alternative to conventional dry cow therapy

(Huxley et al., 2002; Woolford, et al., 1998)

Teat sealers – 65% w/w Bismuth subnitrate in a paraffin base

PROMPT TREATMENT OF CLINICAL CASES

Use macrolide/lincosamide antibiotics (e.g., tylosin, lincomycin, spiramycin) by parenteral route × 4-5 days; they tend to concentrate in the udder

Antibiotics like gentamycin, kanamycin, not effective in mastitis– they do not diffuse from blood into the udder Give first generation cephalosporins e.g., Inj. Velosef™ 500

mg/affected quarter/day in 30 mL water by intramammary route aseptically using branulla 22 G

Ideally, antibiotic therapy should be based on the results of antibiotic susceptibility testing; MIC90

MIC90 – the best guide for selection of dosages Always give some immuno-activators (e.g., Lisovit –

50gm/animal/day for 4-6 days; PO) or Nilverm – 80mL/animal/day for 3-5 days (PO), Zinc Sulfate 3 grams PO daily for 8 days

PROMPT TREATMENT OF CLINICAL CASES….

An extremely cheap prescription Rx:

4 grams of boric acid 120 ml of sterile distill water or boiled waterSig: Infused aseptically into the affected teat with the help of brannula 22 G. Allow to remain in the mammary gland for 3-4 hours and then milk out. Unless absolutely necessary, the infusion should not be repeated, otherwise milk secretion is liable to be permanently diminished (Wooldrige, 1917)

PROMPT TREATMENT OF CLINICAL CASES….

Increasing the citrate contents of milk together with decrease in pH of milk:

Trisodium citrate @ 60 mg/kg or roughly about 30 grams plus water PO X 4days

Trisodium citrate 30 grams PO plus Trisodium citrate 5% b.i.d. IV better than Trisodium citrate orally only

Trisodium citrate therapy very effective; no antibiotic residues (Singh et al., 2007; Dhillon and Singh, 2009)

Evaluation of Trisodium citrate therapy in progress at CMS

FAQ about mastitis treatment Fibrosis of teat (Naurh par jana)

1. (a)DMSO-iodized oil containing 375 mg iodine S/C in the brisket region X 3 days

(b) Penicillin 20-40 lac IU plus 30ml distilled water for injection intramammary infusion with the help of branulla 22G X 5 days

(c) Injection Linco-spira 25 ml IM X 4days (d) Zinc Sulfate 3 g PO X 8 days

2. a + c and d + Mastiveex-1™ intramammary tube (marketed in Pakistan by BinSadiq International) containing Cloxacillan sodium, Framycetin sulphate, Sulfadimerazine and Chymotrypsin X 4 days

FAQ about mastitis treatmentEfficacy of homeopathic mastitis

preparations ……. Questionable efficacy

Indigenous mastitis treatment …… most preparations particularly those based on Tartree, lemon, ammonium chloride, red chillies, Kali zeeri make sense

OTHER MANAGEMENTAL PRACTICES TO CONTROL MASTITIS

◦ Segregation of healthy & infected animals and◦ Milking of healthy animals (SURF Test negative) before

milking SURF Test positive animals ◦ Culling chronic cases◦ Purchasing healthy (mastitis-free i.e. SURF Test negative)

animals only◦ Mastitis control in heifers◦ Proper treatment of teat and udder wounds◦ Fly control, feeding balanced ration ◦ General cleanliness at the farm◦ Proper disposal of mastitic milk of clinical cases◦ Prepartum milking (Animals which develop mastitis close to

calving)

Why Pakistani farmers do not adopt mastitis control program?Incentive-penalty programs

lackingDairying is a way of life rather

than an enterpriseMost herds are very small