Erysipelothrix rhusiopathiae infection in pigs, pork and raw pork handlers in Kamuli District, Eastern Uganda

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Presentation by Angella Musewa, Kristina Roesel, Damalie Nakanjako, Delia Grace, Ronald Ssenyonga, Joan Nangendo, Ismael Kawooya, Joseph Erume at the first joint conference of the Association of Institutions for Tropical Veterinary Medicine and the Society of Tropical Veterinary Medicine, Berlin, Germany, 4–8 September 2016.

Science

Erysipelothrix rhusiopathiae infection
in pigs, pork and raw pork handlers
in Kamuli district, Eastern Uganda
Angella Musewa, Kristina Roesel, Damalie Nakanjako, Delia Grace, Ronald Ssenyonga,
Joan Nangendo, Ismael Kawooya, Joseph Erume
.

Introduction – Erysipelothrix rhusiopathiae
Ubiquituous gram+ bacterium
Source: Quizlet.comSource: McGavin DM, Zachary JF, 2007.
Pathologic basis of veterinary disease, 4th ed.
Adapted from Reboli and Farrar, 1989
In people: erysipeloid
In pigs: erysipelas,
diamond skin disease

Why study E. rhusiopathiae in Uganda?
 No published research in Uganda
 CGIAR Research Program on Livestock & Fish
 Clinical signs of diamond skin disease in pigs
reported by farmers in 3 subcounties in
Kamuli district

Objectives
• To determine the prevalence of ER infection in
pigs, pork and raw pork handlers in Kamuli
district.
• To establish risk factors associated with infection
in raw pork handlers.

Methods
1. Serology
– Part of a multi-pathogen
assessment including 4
subcounties in Kamuli district
(Dione et al., 2014 and Erume et al., 2016)
– 426 pig sera
– IgG (CIVtest Suis SE/MR;
Laboratorios Hipra, Spain)
22 villages sampled in 3 districts of Uganda: Kamuli (6, red); Masaka (9,
blue), Mukono (7, yellow) © google maps/ Kristina Roesel/ILRI

Methods
2. microbiology
• 100 x 250g fresh pork samples from
67 butcheries
• 302 whole blood samples from raw
pork handlers:
– ER selective media
– Confirmatory tests: catalase, aesculin,
gelatine
3. Risk factors
• Semi-structured questionnaire, 6
focus group discussions, 3 key
informant interviews

Results – prevalence
Subcounty Pig serology Pork culture Abattoir
workers
Butchers Cooks**
Kitayunwa* 27/38
(71.1%)
5/14
(35.7%)
8/20
(40.0%)
3/19
(15.8%)
0/60
(0.0%)
Bugulumbya* 81/118
(68.6%)
11/24
(45.8%)
2/4
(50.0%)
1/6
(16.7%)
1/39
(2.6%)
Namwendwa* 49/79
(62.8%)
23/55
(41.8%)
4/14
(28.6%)
5/34
(14.7%)
6/106
(5.7%)
Butansi 128/192
(66.7%)
6/7
(85.7%)
- - -
Total 285/426
(66.9%)
45/100
(45.0%)
14/38
(36.8%)
9/59
(15.3%)
7/205
(3.4%)
* Subcounties where farmers reported clinical signs of ER in pigs
** 147 female, 58 male

Results – risk factors
11 variables in bivariate analysis,
included to multivariate analysis if
p<0.20
associated with ER infection
• Work in abattoir
(OR=26.13, p<0.001)
• Work at butchery
(OR=8.37, p<0.01)
• Alcohol consumption
(OR=4.01, p<0.05)
© Kristina Roesel/ILRI

Discussion & conclusion
• First report of ER in Uganda
• High level of occurence, especially among abattoir workers
• Findings consistent with previous research
• Low level of awareness that the disease exists
• More research needed on sources of infection
• Prevention in pigs: vaccination
• Prevention in humans: protective gear
• Treatment possible
• Cost versus benefits?

Participatory research
& feedback to communities

Acknowledgements
 Clinical Epidemiology Unit,
Makerere University
 Field research team
 Laboratory supervisor Mr. Musisi
Nathan Lubowa
 CEB cohort 2014
 Research participants in the study
 Supervisors and lecturers
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Erysipelothrix rhusiopathiae infection in pigs, pork and raw pork handlers in Kamuli District, Eastern Uganda

1. Erysipelothrix rhusiopathiae infection in pigs, pork and raw pork handlers in Kamuli district, Eastern Uganda Angella Musewa, Kristina Roesel, Damalie Nakanjako, Delia Grace, Ronald Ssenyonga, Joan Nangendo, Ismael Kawooya, Joseph Erume .

2. Introduction – Erysipelothrix rhusiopathiae Ubiquituous gram+ bacterium Source: Quizlet.comSource: McGavin DM, Zachary JF, 2007. Pathologic basis of veterinary disease, 4th ed. Adapted from Reboli and Farrar, 1989 In people: erysipeloid In pigs: erysipelas, diamond skin disease

3. Why study E. rhusiopathiae in Uganda?  No published research in Uganda  CGIAR Research Program on Livestock & Fish  Clinical signs of diamond skin disease in pigs reported by farmers in 3 subcounties in Kamuli district

4. Objectives • To determine the prevalence of ER infection in pigs, pork and raw pork handlers in Kamuli district. • To establish risk factors associated with infection in raw pork handlers.

5. Methods 1. Serology – Part of a multi-pathogen assessment including 4 subcounties in Kamuli district (Dione et al., 2014 and Erume et al., 2016) – 426 pig sera – IgG (CIVtest Suis SE/MR; Laboratorios Hipra, Spain) 22 villages sampled in 3 districts of Uganda: Kamuli (6, red); Masaka (9, blue), Mukono (7, yellow) © google maps/ Kristina Roesel/ILRI

6. Methods 2. microbiology • 100 x 250g fresh pork samples from 67 butcheries • 302 whole blood samples from raw pork handlers: – ER selective media – Confirmatory tests: catalase, aesculin, gelatine 3. Risk factors • Semi-structured questionnaire, 6 focus group discussions, 3 key informant interviews

7. Results – prevalence Subcounty Pig serology Pork culture Abattoir workers Butchers Cooks** Kitayunwa* 27/38 (71.1%) 5/14 (35.7%) 8/20 (40.0%) 3/19 (15.8%) 0/60 (0.0%) Bugulumbya* 81/118 (68.6%) 11/24 (45.8%) 2/4 (50.0%) 1/6 (16.7%) 1/39 (2.6%) Namwendwa* 49/79 (62.8%) 23/55 (41.8%) 4/14 (28.6%) 5/34 (14.7%) 6/106 (5.7%) Butansi 128/192 (66.7%) 6/7 (85.7%) - - - Total 285/426 (66.9%) 45/100 (45.0%) 14/38 (36.8%) 9/59 (15.3%) 7/205 (3.4%) * Subcounties where farmers reported clinical signs of ER in pigs ** 147 female, 58 male

8. Results – risk factors 11 variables in bivariate analysis, included to multivariate analysis if p<0.20 associated with ER infection • Work in abattoir (OR=26.13, p<0.001) • Work at butchery (OR=8.37, p<0.01) • Alcohol consumption (OR=4.01, p<0.05) © Kristina Roesel/ILRI

9. Discussion & conclusion • First report of ER in Uganda • High level of occurence, especially among abattoir workers • Findings consistent with previous research • Low level of awareness that the disease exists • More research needed on sources of infection • Prevention in pigs: vaccination • Prevention in humans: protective gear • Treatment possible • Cost versus benefits?

10. Participatory research & feedback to communities

11. Acknowledgements  Clinical Epidemiology Unit, Makerere University  Field research team  Laboratory supervisor Mr. Musisi Nathan Lubowa  CEB cohort 2014  Research participants in the study  Supervisors and lecturers 9/9/2016 11

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Erysipelothrix rhusiopathiae infection in pigs, pork and raw pork handlers in Kamuli District, Eastern Uganda