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Topic:Streptococcus

Streptococcus spp. are a genus of bacteria that can affect horses, leading to various infections and health conditions. These bacteria are known for causing respiratory and systemic diseases, including strangles, which is primarily caused by Streptococcus equi subsp. equi. Streptococcal infections in horses can result in symptoms such as fever, nasal discharge, and lymph node abscessation. The transmission typically occurs through direct contact with infected animals or contaminated environments. Diagnosis often involves bacterial culture or PCR testing. This page compiles peer-reviewed research studies and scholarly articles that explore the epidemiology, pathogenesis, diagnosis, and treatment of Streptococcus infections in equine populations.
Molecular detection of Streptococcus equi subspecies equi in face flies (Musca autumnalis) collected during a strangles outbreak on a Thoroughbred farm.
Medical and veterinary entomology    July 7, 2019   Volume 34, Issue 1 120-122 doi: 10.1111/mve.12394
Pusterla N, Bowers J, Barnum S, Hall JA.The objective of this study was to detect Streptococcus equi subspecies equi (S. equi) (Lactobacillales: Streptococcaceae) using quantitative polymerase chain reaction (qPCR) in flies collected from a farm with a documented outbreak of strangles. A total of 1856 face flies [Musca autumnalis (Diptera: Muscidae)] were collected using conventional fly traps. The flies were processed for nucleic acid purification and tested for the presence of S. equi by qPCR. A total of 10/1856 flies (0.54%) tested qPCR-positive for S. equi. The results may implicate the presence of face flies as a risk factor...
Antimicrobial Activity of Ceftiofur and Penicillin With Gentamicin Against Escherichia coli and Streptococcus equi Subspecies zooepidemicus in an Ex Vivo Model of Equine Postpartum Uterine Disease.
Journal of equine veterinary science    June 20, 2019   Volume 79 121-126 doi: 10.1016/j.jevs.2019.06.005
Von Dollen KA, Jones M, Beachler T, Harris TL, Papich MG, Lyle SK, Bailey CS.The use of antimicrobials for the management of equine uterine disease is commonplace, with antibiotic selection generally based on empirical evidence or in vitro sensitivity results. However, the potential disconnect between these laboratory results and clinical efficacy in the mare raises concern for antibiotic failure and subsequent development of resistant organisms. In this work, we attempt to bridge this gap by using an ex vivo model of the equine postpartum uterus to quantitatively evaluate the antimicrobial activity of two commonly used antibiotic treatments in the mare (ceftiofur an...
Antimicrobial resistance in bacteria isolated from diseased horses in France.
Equine veterinary journal    June 17, 2019   Volume 52, Issue 1 112-119 doi: 10.1111/evj.13133
Bourély C, Cazeau G, Jarrige N, Haenni M, Gay E, Leblond A.Horses are one of the potential reservoirs of antimicrobial resistance (AMR) determinants that could be transferred to human subjects. Objective: To describe the AMR patterns of major bacteria isolated from diseased horses in France. Methods: Retrospective observational study. Methods: Data collected between 2012 and 2016 by RESAPATH, the French national surveillance network for AMR, were analysed. Only antimicrobials relevant in veterinary and human medicine for the isolated bacteria were considered. Mono- and multidrug resistance were calculated. The resistance proportions of major equine di...
Antibody kinetics and immune profile analysis of a Streptococcus equi DNA vaccine expressing the FljB and SeM fusion protein in murine and equine models.
Research in veterinary science    May 22, 2019   Volume 125 82-88 doi: 10.1016/j.rvsc.2019.05.014
Ma X, Wang C, Zhang B, Xia L, Su Y.Strangles is a highly prevalent, extremely contagious, and occasionally lethal infectious disease affecting horses worldwide. Prophylactic antibiotics are ineffective in prevention of disease but are recommended for exposed horses at the first sign of fever and any horse obviously ill from strangles or with complications and there is an urgent need of a cost-effective, safe, efficacious vaccine. In the present study, we sought to develop effective vaccines by fusing the Streptococcus equi subspecies equi (S. equi) antigen SeM with the flagellin of Salmonella abortus equi FljB. We also explored...
Equine placentitis is associated with a downregulation in myometrial progestin signaling†.
Biology of reproduction    May 21, 2019   Volume 101, Issue 1 162-176 doi: 10.1093/biolre/ioz059
El-Sheikh Ali H, Legacki EL, Loux SC, Esteller-Vico A, Dini P, Scoggin KE, Conley AJ, Stanley SD, Ball BA.The current study aimed to elucidate the mechanisms underlying myometrial activation during equine placentitis related to progestogens and the progesterone receptor signaling pathways. Placentitis was induced via intracervical inoculation with Streptococcus equi ssp zooepidemicus in mares at approximately 290 days of gestation (placentitis group; n = 6) with uninoculated gestationally matched mares as controls (n = 4). Mares in the placentitis and control groups were euthanized, and myometrial samples were collected from two regions: region 1-parallel to active placentitis lesion with plac...
Fetal-fluid proteome analyses in late-term healthy pregnant mares and in mares with experimentally induced ascending placentitis.
Reproduction, fertility, and development    May 17, 2019   Volume 31, Issue 9 1486-1496 doi: 10.1071/RD18460
Canisso IF, Loux S, Scoggin KE, Squires EL, Troedsson MH, Ball BA.Characterisation of fetal fluids in healthy and disease states of pregnant mares can help to unravel the pathophysiology and to identify putative markers of disease. Thus, this study aimed to compare the protein composition of: (1) amniotic and allantoic fluids of healthy mares obtained immediately after euthanasia and (2) allantoic fluid harvested via centesis before and after experimental induction of placentitis via transcervical inoculation of Streptococcus equi ssp zooepidemicus in healthy mares. Fetal fluids were analysed with a high-throughput proteomic technique after in-gel digestion....
A microbiome analysis of equine peripheral dental caries using next generation sequencing.
Equine veterinary journal    May 16, 2019   Volume 52, Issue 1 67-75 doi: 10.1111/evj.13126
Borkent D, Reardon RJM, McLACHLAN G, Glendinning L, Dixon PM.Although, peripheral caries (PC) affects almost half of UK horses, no comprehensive microbiological study has been performed on this disorder. As a high proportion of oral bacteria cannot be conventionally cultured, molecular microbiological techniques such as Next Generation Sequencing are required to examine the complex oral bacteria community. Objective: To identify the microbiota involved in equine PC, including comparing microbiota at the more commonly and severely affected three caudal cheek teeth with the less commonly affected three rostral cheek teeth. Methods: Equine dental plaque sa...
Efficacy of Tea Tree Oil in the Treatment of Equine Streptothricosis.
Journal of equine veterinary science    May 16, 2019   Volume 79 79-85 doi: 10.1016/j.jevs.2019.05.011
Frye CC, Bei D, Parman JE, Jones J, Houlihan AJ, Rumore A.Streptothricosis is a dermatitis characterized by matted tufts of hair and coalescing, pustular crusts that affects many livestock species, including horses. It results from cutaneous infection by the actinobacterium Dermatophilus congolensis. For economic reasons, the ailment is often treated with commercially available over-the-counter (OTC) products or home remedies rather than prescribed medications. This study aimed to determine the efficacy of tea tree oil (TTO), an essential oil of Melaleuca alternifolia, as an OTC treatment for streptothricosis. Bacteria were isolated from presumptive ...
Genetic analysis of Streptococcus equi subsp. equi isolated from horses imported into Japan.
The Journal of veterinary medical science    April 24, 2019   Volume 81, Issue 6 924-927 doi: 10.1292/jvms.18-0656
Kasuya K, Tanaka N, Oshima F, Fujisawa N, Saito M, Tagami K, Niwa H, Sasai K.Strangles is a commonly diagnosed and important infectious disease of equids worldwide, caused by Streptococcus equi subsp. equi. We determined the SeM genotypes of S. equi isolated from imported horses at the Japanese border within the past 8 years, which allowed us to classify 12 strains isolated from these horses from each exporter into four allelic groups. These alleles were different from the alleles of past isolates found in Japan. Furthermore, four strains classified into the same allele were isolated from horses from one exporter over several years. In this study, S. equi isolates from...
An outbreak of strangles associated with a novel genotype of Streptococcus equi subspecies equi in donkeys in China during 2018.
Equine veterinary journal    April 10, 2019   Volume 51, Issue 6 743-748 doi: 10.1111/evj.13114
Dong J, Gao N, Waller AS, Cook FR, Fan S, Yuan D, Du Y, Li F, Norimine J, Zhu W.Strangles is a highly contagious respiratory disease of equids caused by the bacterium Streptococcus equi subspecies equi. Objective: To identify the cause of an outbreak of strangles that occurred on donkey farms within the Shandong Province of China and determine the prevalence of the disease. Methods: Cross-sectional. Methods: Samples were taken from clinically affected animals to measure the prevalence of strangles within the population of donkeys at six intensive farms in China and identify the SeM type of isolate recovered from affected animals. Diagnosis was confirmed by bacterial isola...
Small RNA (sRNA) expression in the chorioallantois, endometrium and serum of mares following experimental induction of placentitis.
Reproduction, fertility, and development    April 6, 2019   Volume 31, Issue 6 1144-1156 doi: 10.1071/RD18400
Loux SC, Fernandes CB, Dini P, Wang K, Wu X, Baxter D, Scoggin KE, Troedsson MHT, Squires EL, Ball BA.Intrauterine infection and inflammation remain a major cause of preterm labour in women and mares, with little known about small RNA (sRNA) expression in tissue or circulation. To better characterise placental inflammation (placentitis), we examined sRNA expression in the endometrium, chorioallantois and serum of mares with and without placentitis. Disease was induced in 10 mares via intracervical inoculation of Streptococcus equi ssp. zooepidemicus, either with moderate or high levels of inoculum; three uninoculated gestationally matched mares were used as controls. Matched chorioallantois an...
In vitro antimicrobial susceptibility of equine clinical isolates from France, 2006-2016.
Journal of global antimicrobial resistance    March 15, 2019   Volume 19 144-153 doi: 10.1016/j.jgar.2019.03.006
Duchesne R, Castagnet S, Maillard K, Petry S, Cattoir V, Giard JC, Leon A.This study aimed to analyse antimicrobial susceptibility evolution of equine pathogens isolated from clinical samples from 2006-2016. A collection of 25 813 bacterial isolates was studied, clustered according to their origins (respiratory tract, cutaneous, genital and other), and analysed for their antimicrobial susceptibility using the disk diffusion method. The most frequently isolated pathogens were group C Streptococci (27.6%), Escherichia coli (20.0%), Staphylococcus aureus (7.8%), Pseudomonas aeruginosa (4.0%), Enterobacter spp. (3.4%), Klebsiella pneumoniae (2.4%), and Rhodococcus equi ...
Long term silent carriers of Streptococcus equi ssp. equi following strangles; carrier detection related to sampling site of collection and culture versus qPCR.
Veterinary journal (London, England : 1997)    February 11, 2019   Volume 246 66-70 doi: 10.1016/j.tvjl.2019.02.003
Pringle J, Venner M, Tscheschlok L, Bächi L, Riihimäki M.After strangles outbreaks, Streptococcus equi ssp. equi (S. equi) can persist in clinically normal silent carriers for months to years. Two naturally occurring outbreaks of strangles with 53 and 100% morbidity, respectively, were followed longitudinally to assess occurrence of carrier state and optimal detection methods Outbreak A involved 98 yearling warmbloods, and outbreak B 38 mature Icelandic horses. Fully recovered horses were sampled at least 6 months after index cases using nasal swabs (one sampling occasion only) nasopharyngeal lavage and guttural pouch visualisation and lavages for c...
Strangles, convalescent Streptococcus equi subspecies equi M antibody titers, and presence of complications.
Journal of veterinary internal medicine    December 6, 2018   Volume 33, Issue 1 275-279 doi: 10.1111/jvim.15388
Delph KM, Beard LA, Trimble AC, Sutter ME, Timoney JF, Morrow JK.Streptococcus equi subspecies equi infection elicits M protein antibody titers in equids. Interpretation of titers is not generally accepted. Objective: The magnitude of S. equi M protein (SeM) antibody titer after infection (titer ≥1:12 800) will be useful to monitor for the presence of complications or the risk of development of complications. Methods: Forty-eight horses on 1 farm involved in strangles outbreak. Methods: Clinical and observational study. S. equi M protein antibody titers were measured on all horses 8 weeks after infection and select horses 12 and 28 weeks after infecti...
Changes in maternal pregnane concentrations in mares with experimentally-induced, ascending placentitis.
Theriogenology    September 7, 2018   Volume 122 130-136 doi: 10.1016/j.theriogenology.2018.09.001
Wynn MAA, Ball BA, May J, Esteller-Vico A, Canisso I, Squires E, Troedsson M.The objectives of this study were to compare via liquid chromatography-tandem mass spectrometry (LC-MS/MS) progesterone (P4), 5α-dihydroprogesterone (DHP), allopregnanolone, 3β-hydroxy-5α-pregnan-20-one (3β5P), 20α-hydroxy-5α-pregnan-3-one (20α5P), 5α-pregnan-3β,20α-diol (βα-diol), and 5α-pregnan-3β,20β-diol (ββ-diol) concentrations in plasma of mares with experimentally-induced, ascending placentitis compared to gestationally age-matched control mares. Placentitis was induced via intracervical inoculation of Streptococcus equi spp. zooepidemicus between 260 and 280 days of ge...
Steam Sterilization of Equine Bone Block: Morphological and Collagen Analysis.
BioMed research international    August 13, 2018   Volume 2018 9853765 doi: 10.1155/2018/9853765
Lo Giudice R, Rizzo G, Centofanti A, Favaloro A, Rizzo D, Cervino G, Squeri R, Costa BG, La Fauci V, Lo Giudice G.The use of equine bone blocks is widely reported for bone augmentation techniques. The block must be shaped according to the form of the defect that should be regenerated. The shaping could be performed by hand before or during the surgery, in a sterile ambient, or using a CNC milling machine that could not be sterile. The aim of our study was to evaluate if a steam sterilization could provide a medical grade sterilization of the blocks and to evaluate if bone microstructure and collagen structures change after different steam sterilization protocols provided by mainstream autoclave. Methods: ...
Long term dynamics of a Streptococcus equi ssp equi outbreak, assessed by qPCR and culture and seM sequencing in silent carriers of strangles.
Veterinary microbiology    July 27, 2018   Volume 223 107-112 doi: 10.1016/j.vetmic.2018.07.016
Riihimäki M, Aspán A, Ljung H, Pringle J.The aim of the study was to use culture, qPCR and seM sequencing to map Streptococcus equi subspec. equi (S.equi) isolates in long term carrier animals. A strangles outbreak affecting 41 Icelandic horses was followed to determine strangles free status using nasal and/or guttural pouch lavages collected serially on eleven separate occasions over 13 months. Ten persistent carriers, of which eight had repeated culture positive samples for S. equi, were selected for the study. Of 115 samples collected, 61 were S. equi positive on qPCR; from which 32 were also culture positive. Amplification of par...
A prospective study on the microbiological examination of secretions from the paranasal sinuses in horses in health and disease.
Acta veterinaria Scandinavica    July 5, 2018   Volume 60, Issue 1 43 doi: 10.1186/s13028-018-0394-4
Gergeleit H, Verspohl J, Rohde J, Rohn K, Ohnesorge B, Bienert-Zeit A.Diagnostics in equine sinusitis can be challenging and often require a combination of different imaging tools to ascertain its underlying aetiology. The bacterial flora of healthy and diseased paranasal sinuses, respectively, has only sporadically been assessed in horses. The objectives of this study were to determine whether assessment of microbiological features of secretions from the paranasal sinuses displays a useful diagnostic tool in equine sinusitis to distinguish between different aetiologies. Secretion samples from 50 horses with sinusitis and from 10 healthy horses were taken transe...
Cortisol, progesterone, 17αOHprogesterone, and pregnenolone in foals born from mare’s hormone-treated for experimentally induced ascending placentitis.
Theriogenology    June 30, 2018   Volume 123 139-144 doi: 10.1016/j.theriogenology.2018.06.024
Müller V, Curcio BR, Toribio RE, Feijó LS, Borba LA, Canisso IF, Nogueira CEW.This study aimed to evaluate steroid hormones in foals born from mares treated for ascending placentitis with different combinations of trimethoprim-sulfamethoxazole (TMS), flunixin meglumine (FM), long-acting altrenogest (ALT) and estradiol cypionate (ECP) for ten consecutive days, starting two days after experimental induction of placentitis with Streptococcus zooepidemicus. Fourty-six pregnant mares and respective foals were assigned as healthy group (Control, n = 8) or treated groups as follows: TMS+FM (n = 8), TMS+FM+ALT (n = 8), TMS+FM+ALT+ECP (n = 6), TMS+FM+ECP (n = 6) and no...
Sepsis, Endocarditis, and Purulent Arthritis due to a Rare Zoonotic Infection with Streptococcus equi Subspecies zooepidemicus.
Case reports in infectious diseases    June 14, 2018   Volume 2018 3265701 doi: 10.1155/2018/3265701
Høyer-Nielsen AK, Gaini S, Kjerulf A, Kollslíð R, Steig TÁ, Stegger M, Jóanesarson J. subspecies () is mostly known as an opportunistic pathogen found in horses and as a rare human zoonosis. An 82-year-old male, who had daily contact with horses, was admitted in a septic condition. The patient presented with dyspnea, hemoptysis, impaired general condition, and severe pain in a swollen left shoulder. Synovial fluid from the affected joint and blood cultures showed growth of subsp. . Transesophageal echocardiography showed a vegetation on the aortic valve consistent with endocarditis. Arthroscopic revision revealed synovitis and erosion of the rotator cuff. Technetium-99m scin...
Respiratory disease and sero-epidemiology of respiratory pathogens in the working horses of Ethiopia.
Equine veterinary journal    May 17, 2018   Volume 50, Issue 6 793-799 doi: 10.1111/evj.12834
Laing G, Christley R, Stringer A, Aklilu N, Ashine T, Newton R, Radford A, Pinchbeck G.Pathogens are frequently implicated in equine respiratory disease. In Ethiopia, respiratory disease is a frequent cause for presentation at veterinary clinics and a priority concern for users of working horses. However, there is little existing literature on possible aetiologies. Objective: Determine prevalence of respiratory signs and exposure to major respiratory pathogens through a serological survey. Methods: Cross-sectional. Methods: Systematically selected horses from 19 sites in central Ethiopia were examined clinically and sampled once (August-December 2013). A face-to-face interview c...
Frequency of shedding of respiratory pathogens in horses recently imported to the United States.
Journal of veterinary internal medicine    May 15, 2018   Volume 32, Issue 4 1436-1441 doi: 10.1111/jvim.15145
Smith FL, Watson JL, Spier SJ, Kilcoyne I, Mapes S, Sonder C, Pusterla N.Imported horses that have undergone recent long distance transport might represent a serious risk for spreading infectious respiratory pathogens into populations of horses. Objective: To investigate the frequency of shedding of respiratory pathogens in recently imported horses. Methods: All imported horses with signed owner consent (n = 167) entering a USDA quarantine for contagious equine metritis from October 2014 to June 2016 were enrolled in the study. Methods: Prospective observational study. Enrolled horses had a physical examination performed and nasal secretions collected at the ti...
A study of the environmental survival of Streptococcus equi subspecies equi.
Equine veterinary journal    May 7, 2018   Volume 50, Issue 6 861-864 doi: 10.1111/evj.12840
Durham AE, Hall YS, Kulp L, Underwood C.Streptococcus equi represents a common hazard to equids worldwide. Environmental contamination with bacteria shed from an infected horse may represent a significant source of contagion and further knowledge of ex vivo bacterial survival under different conditions is important for disinfection and isolation protocols. Objective: To determine the potential duration of survival and vigour of growth of S. equi inoculated onto surfaces relevant to equine veterinary practice and stabling in summer and winter. Methods: Repeat sampling of environmental inocula of S. equi. Methods: Cultures of S. equi ...
Diagnostic methods to detect uterus illnesses in mares.
Theriogenology    April 9, 2018   Volume 114 285-292 doi: 10.1016/j.theriogenology.2018.03.042
Rua MAS, Quirino CR, Ribeiro RB, Carvalho ECQ, Bernadino MLA, Bartholazzi Junior A, Cipagalta LF, Barreto MAP.Uterine illnesses are the major problem in horse reproductive programs. The diagnosis of these pathologies is often neglected or does not provide enough information about the cause. The aim of this study was to evaluate different diagnoses to provide more accurate information about endometritis and the real endometrial profile at the beginning of a breeding season. Fifty-one mares with reproductive failure were evaluated. Two different uterine cytology diagnoses, culture of uterine flush material and biopsy assay, were performed. The data were analyzed by the Chi-squared test to compare differ...
Phagocytosis, bacterial killing, and cytokine activation of circulating blood neutrophils in horses with severe equine asthma and control horses.
American journal of veterinary research    March 28, 2018   Volume 79, Issue 4 455-464 doi: 10.2460/ajvr.79.4.455
Vanderstock JM, Lecours MP, Lavoie-Lamoureux A, Gottschalk M, Segura M, Lavoie JP, Jean D.OBJECTIVE To evaluate in vitro phagocytosis and bactericidal activity of circulating blood neutrophils in horses with severe equine asthma and control horses and to determine whether circulating blood neutrophils in horses with severe equine asthma have an increase in expression of the proinflammatory cytokine tumor necrosis factor (TNF)-α and the chemokine interleukin (IL)-8 and a decrease in expression of the anti-inflammatory cytokine IL-10 in response to bacteria. ANIMALS 6 horses with severe equine asthma and 6 control horses. PROCEDURES Circulating blood neutrophils were isolated from h...
The proteome of fetal fluids in mares with experimentally-induced placentitis.
Placenta    March 20, 2018   Volume 64 71-78 doi: 10.1016/j.placenta.2018.03.004
Loux SC, Ball BA.Placental inflammation (placentitis) is one of the leading causes of late-term abortion in mares. Although prognosis is good assuming early diagnosis and treatment, diagnostics are limited. To better characterize the disease and identify potential biomarkers, we analyzed the proteome of fetal fluids (amniotic and allantoic) in both control mares (n = 5) and mares with experimentally-induced placentitis (n = 5) using LTQ-Orbitrap mass-spectrometry. Placentitis was induced via trans-cervical inoculation of Streptococcus equi ssp. zooepidemicus. In total, 130 proteins were identified in e...
Streptococcus equi: breaking its strangles-hold.
The Veterinary record    March 17, 2018   Volume 182, Issue 11 316-318 doi: 10.1136/vr.k1231
Waller A., head of bacteriology at the AHT, describes the causative agent of strangles in horses, and discusses progress with the latest research aimed at improving vaccines against this global disease.
The association between gut microbiome, sex, age and body condition scores of horses in Maiduguri and its environs.
Microbial pathogenesis    March 9, 2018   Volume 118 81-86 doi: 10.1016/j.micpath.2018.03.018
Mshelia ES, Adamu L, Wakil Y, Turaki UA, Gulani IA, Musa J.The equine gut harbours complex microbial populations which influence physiology, metabolism, nutrition and immune functions, while disruption to the gut microbiota has been linked with conditions such as lameness, diabetes and obesity. Therefore, the present study was conducted to determine the association between microbial dysbiosis, sex, age and body condition scores (BCS) of horses (Equus equus caballus) in Maiduguri and its environs. Forty horses were assessed by convenient sampling, while faecal samples were collected and analyzed to determine the microbiomes in the various age groups wi...
Use of quantitative real-time PCR to determine viability of Streptococcus equi subspecies equi in respiratory secretions from horses with strangles.
Equine veterinary journal    February 10, 2018   Volume 50, Issue 5 697-700 doi: 10.1111/evj.12809
Pusterla N, Leutenegger CM, Barnum SM, Byrne BA.In recent years, molecular approaches have been able to characterise the viability of equine upper respiratory tract pathogens using absolute molecular quantitation as well as detection of transcripts for virulence genes. Objective: The objective of this study was to investigate molecular surrogates for S. equi subspecies equi (S. equi) viability in biological samples from horses with strangles. Methods: Retrospective cross-sectional study. Methods: S. equi culture-positive and culture-negative upper airway secretions were assessed by qPCR at the genomic (gDNA) and complimentary DNA (cDNA) ...
Streptococcus equi Infections in Horses: Guidelines for Treatment, Control, and Prevention of Strangles-Revised Consensus Statement.
Journal of veterinary internal medicine    February 9, 2018   Volume 32, Issue 2 633-647 doi: 10.1111/jvim.15043
Boyle AG, Timoney JF, Newton JR, Hines MT, Waller AS, Buchanan BR.This consensus statement update reflects our current published knowledge and opinion about clinical signs, pathogenesis, epidemiology, treatment, complications, and control of strangles. This updated statement emphasizes varying presentations in the context of existing underlying immunity and carrier states of strangles in the transmission of disease. The statement redefines the "gold standard" for detection of possible infection and reviews the new technologies available in polymerase chain reaction diagnosis and serology and their use in outbreak control and prevention. We reiterate the impo...
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