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Fifteen lambs from a flock of 1,000, 5-month-old Romney lambs in the Manawatū region of New Zealand, developed unusual postural and gait abnormalities during the summer of 2020. In mid-January, the lambs were grazing a raphanobrassica crop (xRaphanobrassica; Brassica oleracea x Raphanus sativus) but were removed from this crop soon after as they developed dermal lesions on the pinnae consistent with photosensitisation (colloquially known as "rape scald"). The lambs were placed onto a shaded paddock containing a pasture of predominantly perennial ryegrass (Lolium perenne) and white clover (Trifolium repens). One week following removal from the crop (late January), the 15 lambs developed abnormal postures and gaits that were described by farm staff as "neurological" and "swayback-like". From a distance, all 15 lambs exhibited remarkably similar abnormal posture and gait whereby their weight was borne on their carpi, and they appeared to crawl while walking due to crouched hindquarters and prominent lordosis. Of the affected lambs, five were submitted for clinical examination. All five had normal vital signs. The results of neurological examinations were within normal limits. In response to palpation of the dorsum, the lambs performed an exaggerated and unusual dipping motion, particularly when pressure was applied over the lumbar spine. Parting of the fleece over the dorsum revealed thickened, indurated skin that cracked and tore easily. The shorn pelt of a euthanised lamb revealed a large (100 cm × 40 cm), locally extensive, irregular ovoid region of the skin of the dorsum that was markedly thickened, indurated and crusted. Impression smears of the lesions revealed long filamentous chains of plump coccoid bacteria separated by transverse and longitudinal septa, consistent with Dermatophilus congolensis. Histopathology of the lesions revealed severe, chronic-active, locally extensive, necrosuppurative dermatitis with marked acanthosis, orthokeratotic and parakeratotic hyperkeratosis, ulceration, filamentous bacteria and coccoid zoospores. Cutaneous dermatophilosis due to Dermatophilus congolensis. Painful dermal lesions due to severe dermatophilosis of the dorsal skin of sheep are capable of causing postural and gait abnormalities that may be misinterpreted as signs of neurological abnormality. Such dermal lesions may be concealed by an apparently normal fleece. [ABSTRACT FROM AUTHOR]

Case history: In July and August 2019, 15/40, ≤48-hour-old calves became acutely ill. The calves were all born on-farm, transferred to pens soon after birth, and fed with "gold" colostrum. The hygiene, biosecurity and ventilation in the pens were poor. Of the 15 calves, 11 died or were euthanised and four calves, ≤48-hour-old, that became acutely ill later in the outbreak were treated with cefquinome, a fourth-generation cephalosporin, and recovered. Clinical findings: The affected calves presented with acute recumbency, lethargy, tachypnoea, tachycardia, increased lung sounds, inability to stand or feed, and dehydration without pyrexia. Pathological findings: Gross findings in a calf that died naturally included fibrinous pleuropneumonia, marked oedematous expansion of the interlobular septa, especially in the ventral lung lobes, fibrinous polyserositis and fibrinous polyarthritis. A second calf that was euthanised had strikingly similar lung lesions. Histologically, the pulmonary interlobular septa of both calves were prominently expanded by oedema, dilated lymphatics and the infiltration of numerous neutrophils and macrophages interspersed with small Gram-negative rod bacteria. Likewise, the visceral pleura showed fibrinopurulent inflammation with numerous small Gram-negative rods. Microbiological findings: Microbial culture and matrix-assisted laser desorption ionisation time-of-flight (MALDI-TOF) mass spectrometry identified Bibersteinia trehalosi in the lung, stifle joint and peritoneal cavity of the first calf and lung of the second. Diagnosis: B. trehalosi acute fibrinous pleuropneumonia and septicaemia. Clinical relevance: This is the first report of the clinical findings and histological lesions of B. trehalosi pleuropneumonia and septicaemia in calves in New Zealand. The pathogen is isolated with increasing frequency from cases of bovine respiratory disease in dairy cows, feedlot cattle and calves in the United Kingdom and North America. The importance of microbial culture in cases such as this with unusual lung lesions in calves <48 hours of age, cannot be over emphasised. Cefquinome was administered to all remaining heifer calves and four calves that became ill later in the outbreak recovered after cefquinome treatment.

Background: Rheumatic heart disease (RHD), caused by acute rheumatic fever (ARF), is a major health problem in Australian Aboriginal communities. Progress in controlling RHD requires improvements in the delivery of secondary prophylaxis, which comprises regular, long-term injections of penicillin for people with ARF/RHD., Methods/design: This trial aims to improve uptake of secondary prophylaxis among Aboriginal people with ARF/RHD to reduce progression or worsening of RHD. This is a stepped-wedge, randomised trial in consenting communities in Australia's Northern Territory. Pairs of randomly-chosen clinics from among those consenting enter the study at 3-monthly steps. The intervention to which clinics are randomised comprises a multi-faceted systems-based package, in which clinics are supported to develop and implement strategies to improve penicillin delivery, aligned with elements of the Chronic Care Model. Continuous quality improvement processes will be used, including 3-monthly feedback to clinic staff of adherence rates of their ARF/RHD clients. The primary outcome is the proportion of people with ARF/RHD receiving ≥ 80% of scheduled penicillin injections over a minimum 12-month period. The sample size of 300 ARF/RHD clients across five community clusters will power the study to detect a 20% increase in the proportion of individuals achieving this target, from a worrying low baseline of 20%, to 40 %. Secondary outcomes pertaining to other measures of adherence will be assessed. Within the randomised trial design, a mixed-methods evaluation will be embedded to evaluate the efficiency, effectiveness, impact and relevance, sustainability, process and fidelity, and performance of the intervention. The evaluation will establish any causal link between outcomes and the intervention. The planned study duration is from 2013 to 2016., Discussion: Continuous quality improvement has a strong track record in Australia's Northern Territory, and its use has resulted in modest benefits in a pilot, non-randomised ARF/RHD study. If successful, this new intervention using the Chronic Care Model as a scaffold and evaluated using a well-developed theory-based framework, will provide a practical and transferable approach to ARF/RHD control., Trial Registration: Australian New Zealand Clinical Trials Registry: ACTRN12613000223730. Date registered: 25 February 2013.