[first author] 2005 Seminars in Avian and Exotic Pet Medicine 1

Avian &

Avian &
Exotic News

Edited by Flo Tseng, DVM

Lymphocytic
Choriomeningitis Virus
Infection in Organ
Transplant Recipients—
Massachusetts, Rhode
Island, 2005. ProMed
Mail, May 26, 2005

n early April 2005, a Rhode Is-
land woman with a medical his-
tory of hypertension and 1 week

of headache had a sudden onset of
hemiplegia caused by a stroke, fol-
lowed by brainstem herniation and
brain death. Family members con-
sented to organ donation, and 4 peo-
ple received liver, lungs, and kidneys
from the donor. Within 3 weeks of
the transplants, these individuals had
difficulties with liver function and
blood coagulation, along with dys-
function of the transplanted organs.
Three of the 4 organ recipients died
23 to 27 days after transplantation.
Hepatocellular necrosis was common
to all 3 patients on autopsy. When the
cause of death could not be identified
through extensive diagnostic testing,
tissue and blood samples from the do-
nor and recipients were submitted to
the Centers for Disease Control and
Prevention. Lymphocytic choriomen-
ingitis virus (LCMV) was identified
as the cause of illness in all 4
patients. Diagnosis was made
through

immunohistochemical

staining,

reverse

transcriptase

polymerase chain reaction, and

other means. Epidemiologic inves-
tigation traced the source of the
LCMV to a pet hamster that had
been acquired recently. The only
other family member of the donor
who cared for the hamster was de-
termined to have specific immu-
noglobulin G and immunoglobu-
lin M antibodies to LCMV. No
other family members had detect-
able antibodies. The house mouse
(Mus musculus) is the primary res-
ervoir for LCMV, though other
types of rodents can be infected
after contact with infected house
mice. Infection in humans occurs
primarily through exposure to se-
cretions or excretions of infected
animals. LCMV infection in other-
wise healthy people is either
asymptomatic or causes mild ill-
ness. Immunosuppression associ-
ated with transplantation proce-
dures is theorized to have in-
creased the disease severity of
LCMV in the donor.

Compounding from
Bulk Drugs. J Am Vet
Med Assoc, 227(1), 1
July 2005

Compounding is the manipula-
tion of a drug, other than in ac-
cordance with the Food and
Drug Administration (FDA)-ap-
proved label, to make a different

formulation of the drug to meet the
needs of a specific patient. Many
avian and exotic animal practitio-
ners make use of compounded
drugs to meet the needs of their
patients. Since the FDA revised its
Compliance Policy Guide in July
2003, the agency has been aggres-
sively enforcing drug compounding
laws. In June 2004, the American
Veterinary Medical Association re-
quested that the FDA amend its pol-
icy on drug compounding for ani-
mals. Specifically, the American Vet-
erinary Medical Association stated
that veterinarians should have the
discretion to compound bulk phar-
maceutical ingredients to produce a
medically necessary product that is
otherwise unavailable for a specific
nonfood animal patient. After re-
ceiving similar letters from other or-
ganizations, the FDA Center for Vet-
erinary Medicine announced that it
would again revise the guidelines,
though as of July 2005, these revi-
sions have not been released. Be-
cause pharmacies are selling these
compounded drugs, veterinarians
should be aware that the FDA
objects to the pharmacies com-
pounding for third parties who re-
sell

individual

patients,

opposed to compounding for indi-
vidual patients. Because compound-
ing regulations vary from state to
state, veterinarians are also encour-
aged to consult their own state’s reg-
ulations in addition to the FDA’s
guidelines.

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Seminars in Avian and Exotic Pet Medicine, Vol 14, No 4 (October), 2005: pp 226 –228

Multidrug-resistant
Salmonella
Typhimurium
Associated with
Pet Rodents

The Centers for Disease Control
and Prevention has issued a report
in the May 6, 2005 issue of Morbid-
ity and Mortality Weekly Report about
the potential health risks associ-
ated with handling pet rodents. In
particular, multidrug-resistant Sal-
monella typhimurium was isolated
from sick hamsters obtained from
a Minnesota pet distributor in
2004. The report describes two of
the first identified human cases as-
sociated with the outbreak, sum-
marizes the investigation of the in-
fections, and highlights methods
for reducing Salmonella transmis-
sion from pet rodents to people.
Veterinarians, breeders, and dis-
tributors are advised to submit
specimens for Salmonella isolation
if diarrhea-associated morbidity or
mortality occurs among pet ro-
dents intended for sale. The same
advice should also apply to pet ro-
dents seen in clinical practice. For
a copy of the issue of Morbidity and
Mortality Weekly Report, visit

www.

cdc.gov/mmwr/PDF/wk/mm5417.
pdf.

A fact sheet on how to choose a

pet rodent and tips for preventing
Salmonella transmission are also avail-
able online at

www.cdc.gov/healthy-

pers/diseases/salmonellosis.htm.

Avian Influenza, Wild
Waterfowl—China.
ProMed Mail, July
7, 2005

The highly pathogenic H5N1 in-
fluenza virus has become endemic
in poultry in southeast Asia since
2003 and constitutes a major pan-
demic threat to humans. H5N1
has occasionally been isolated

from dead wild birds, usually
within the flight range of infected
poultry farms, leading to the
thought that these birds were
dead-end hosts of virus acquired
from poultry. However, on April
30, 2005, an outbreak of H5N1 vi-
rus was detected in barheaded
geese (Anser indicus) at Qinhai
Lake in western China, in a pro-
tected nature reserve with no
nearby

poultry

farms.

Clinical

findings included paralysis, un-
usual head tilt, and staggering,
which are all known features of the
infection in waterfowl. Up to 6,000
waterfowl of 5 species have been
estimated to have died since the
beginning of the outbreak. Over
90% of the dead birds have been
barheaded geese, with the remain-
der primarily being brown-headed
gulls (Larus brunnicephalus) and
great black-headed gulls (Larus
ichthyaetus). H5N1 virus was iso-
lated from cloacal, tracheal, and
fecal swabs from all 3 species.
Gene sequencing has determined
that the viruses are clearly distin-
guishable from those that have
caused human infection in Thai-
land and Vietnam. This indicates
that the virus causing the outbreak
at Qinhai Lake was a single intro-
duction, probably from poultry in
southern China, with subsequent
transmission between migratory
birds at the lake. There is a danger
that the virus might be carried
along the birds’ winter migration
routes to densely populated areas
in the South Asian subcontinent
and spread along migratory fly-
ways linked to Europe.

14th Annual Mid-
Western Exotic Animal
Medicine Conference

The 14th Annual Mid-Western Ex-
otic Animal Medicine Conference
will be held in Manhattan, Kansas,
November 5-6, 2005. Drs. Mark

Mitchell and Teresa Bradley are
among the speakers. An optional
wet laboratory on “Diagnostic and
Surgical Procedures in Cheloni-
ans” and a master class on “Rabbit
Medical and Surgical Cases” will
be offered. For more information,
contact Dr. James W. Carpenter,
College of Veterinary Medicine,
Kansas State University, Manhat-
tan, KS 66506 USA; phone: 785-
532-5690; fax: 785-532-4309; email:
carpentr@vet.ksu.edu.

Association of Avian
Veterinarians
Research Grants

Preproposal forms are available
November 6 and must be received
by January 13, 2006. Grants are
limited to $10,000 for an individ-
ual project. Invitations for full pro-
posals are sent out April 9, and full
proposal applications are due May
9. Awards are announced at the
Annual Conference. Visit the Asso-
ciation of Avian Veterinarians web
site,

www.aav.org/research.html,

for more information.

Association
of Reptilian and
Amphibian Veterinarians

The 2006 Association of Reptilian
and

Amphibian

Veterinarians

Conference will take place in Bal-
timore, Maryland, at the Sheraton
Inner Harbor Hotel from April 23-
27, 2006. Wetlabs will be held on
Sunday, April 23, and the confer-
ence will get underway on Mon-
day, April 24. Session topics are
Amphibian,

Chelonian,

Snake,

Crocodilian/Lizard, Conservation/
General, and Clinical Medicine.
Please see

www.arav.org

for a listing

of session chairs. A student paper
competition will be held this year, as
well as a session devoted to techni-
cians on Sunday, April 23.

AVIAN AND EXOTIC NEWS

227

Wildlife
Disease Association

Each year, the Wildlife Disease
Association (WDA) sponsors a
competition for student awards.
The WDA Scholarship acknowl-
edges outstanding academic and
research accomplishment, com-
mitment, and potential in pur-
suit of new knowledge in wildlife
disease or health. The WDA
Graduate Student Research Rec-
ognition Award is given to the
student judged to have the best
research project in the field of
wildlife disease, based on written
communication

and

scientific

achievement. The Terry Amund-
sen Student Presentation Award
acknowledges outstanding oral

presentation of research find-
ings. The student must give an
oral presentation of his or her
topic of choice at the annual
meeting of the WDA. Please see

www.wildlifedisease.org

for more

details about the 2006 annual
meeting as well as submission
guidelines for student awards.

University of Georgia
College of Veterinary
Medicine Presents
Training in Minimally
Invasive Surgery/
Endoscopic Surgery

This course is designed to teach
the uses and practical applica-

tions of diagnostic and surgical
endoscopy in birds, reptiles, and
small mammals. In addition to
lectures and video presentations,
there are 9 hours of practical lab-
oratory time to practice and de-
velop skills in birds (pigeons)
and reptiles (iguanas). Please see

www.vet.uga.edu/mis/exotics/
training

for further details.

Flo Tseng, DVM

228

AVIAN AND EXOTIC NEWS