Johne’s Disease

Todayโ€™s path rounds are on ๐‰๐จ๐ก๐ง๐žโ€™๐ฌ ๐๐ข๐ฌ๐ž๐š๐ฌ๐ž, otherwise known as paratuberculosis!

๐–๐ก๐š๐ญ ๐ข๐ฌ ๐ข๐ญ?
๐‰๐จ๐ก๐ง๐žโ€™๐ฌ ๐๐ข๐ฌ๐ž๐š๐ฌ๐ž is a bacterial disease of ruminants that primarily affects the intestinal tract. It is a huge source of production loss, particularly for dairy cattle, so it is a very important disease!

๐–๐ก๐จ ๐ ๐ž๐ญ๐ฌ ๐ข๐ญ?
This disease is most common in domestic ruminants, like sheep, cattle and goats. However, it can also occur in other species. Interestingly, it only seems to affect older animals, due to a long ๐ฌ๐ฎ๐›๐œ๐ฅ๐ข๐ง๐ข๐œ๐š๐ฅ ๐ฉ๐ž๐ซ๐ข๐จ๐ where the animal shows no clinical signs, despite being infected.

๐–๐ก๐š๐ญ ๐œ๐š๐ฎ๐ฌ๐ž๐ฌ ๐ข๐ญ?
Johneโ€™s is caused by ๐Œ๐ฒ๐œ๐จ๐›๐š๐œ๐ญ๐ž๐ซ๐ข๐ฎ๐ฆ ๐š๐ฏ๐ข๐ฎ๐ฆ ๐ฉ๐š๐ซ๐š๐ญ๐ฎ๐›๐ž๐ซ๐œ๐ฎ๐ฅ๐จ๐ฌ๐ข๐ฌ (MAP). This bacteria is primarily transmitted through fecal contamination of feed, but can also be transmitted in milk or water.

Once in the intestinal tract, the bacteria invades the cells lining the small intestine, and is taken up by ๐ฆ๐š๐œ๐ซ๐จ๐ฉ๐ก๐š๐ ๐ž๐ฌ (the bodyโ€™s main clean-up cell) into a ๐ฉ๐ก๐š๐ ๐จ๐ฌ๐จ๐ฆ๐ž (a storage bag within a macrophage). Normally, things ingested by macrophages are broken down quickly by ๐ฅ๐ฒ๐ฌ๐จ๐ฌ๐จ๐ฆ๐ž๐ฌ (big bags of enzymes that fuse with the phagosome). However, MAP is able to prevent fusion of lysosomes to phagosomes, allowing it to survive within the macrophage.

The bacteria will live happily in these macrophages for up to 2-5 years, with the animal constantly shedding low levels of bacteria in the feces that can infect other animals. After a long period of time, the bodyโ€™s immune system finally takes notice, and begins a rapid, but not very effective, immune response against the bacteria, leading to clinical signs for the affected animal.

๐–๐ก๐ฒ ๐ข๐ฌ ๐ญ๐ก๐ข๐ฌ ๐š ๐ฉ๐ซ๐จ๐›๐ฅ๐ž๐ฆ?
Once the immune system has kicked in, a ๐ ๐ซ๐š๐ง๐ฎ๐ฅ๐จ๐ฆ๐š๐ญ๐จ๐ฎ๐ฌ ๐ซ๐ž๐ฌ๐ฉ๐จ๐ง๐ฌ๐ž, accumulation of large numbers of macrophages, occurs in the intestine and nearby lymph nodes. This accumulation leads to thickening of the intestinal mucosa, which prevents proper absorption of nutrients and water from the intestinal tract. As a result, these animals develop diarrhea and severe weight loss, because they canโ€™t get any of the nutrients they need to survive. Eventually these animals will die.

๐‡๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐๐ข๐š๐ ๐ง๐จ๐ฌ๐ž๐?
Usually this disease is diagnosed based on clinical suspicion, as it is one of the main causes of diarrhea and weight loss in an older ruminant. However, if a clinician wants to confirm their diagnosis, they can run a culture or PCR test on the feces to detect the bacteria. At necropsy, the classic lesion is thickening of the intestinal mucosa, which produces thick folds along the inner intestinal surface. Often, you can also see ๐ฅ๐ฒ๐ฆ๐ฉ๐ก๐š๐ง๐ ๐ข๐ญ๐ข๐ฌ (swelling of the lymphatics) in the lymph vessels of the ๐ฆ๐ž๐ฌ๐ž๐ง๐ญ๐ž๐ซ๐ฒ (the connective tissue that holds the intestines together).

๐‡๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐ญ๐ซ๐ž๐š๐ญ๐ž๐?
Unfortunately, there is no treatment for clinical Johneโ€™s disease. Prevention is the key to management. Animals should be tested before being introduced to a herd, and young animals should be kept in clean environments with minimal exposure to older animals.

๐๐ก๐จ๐ญ๐จ๐ฌ
1) A segment of thickened intestine due to Johneโ€™s disease.
2) The classic appearance of thickened intestinal mucosa forming folds.
3) Dilated lymphatics due to Johneโ€™s disease.

๐’๐จ๐ฎ๐ซ๐œ๐ž๐ฌ
Maxie, G. Jubb, Kennedy and Palmerโ€™s Pathology of Domestic Animals, Volume 2. Sixth Edition.

Photos 1-3 courtesy of University of Calgary Diagnostic Services Unit.

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