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Producers report bovine respiratory disease and neonatal calf diarrhea as the 2 most common diseases in preweaned calves, both of which can affect calf performance and welfare. Housing calves in groups during the preweaning period has increased in popularity and has the potential to improve calf welfare, but only if producers can detect and treat disease efficiently. A health-screening tool is needed that allows producers to identify suspect animals but minimize the time spent examining healthy animals. The objective of this study was to determine if disease in preweaned, group-housed dairy calves was associated with behavioral measures of illness. This cross-sectional study included the evaluation of preweaned, group-housed calves (n = 206) on 4 farms in Wisconsin, United States. Farm visits included the scoring of key behaviors (abnormal posture when lying or standing, isolation from the group, lethargy, and 2 approach tests that tested the willingness of calves to approach a stationary person) that were hypothesized to be components of sickness behavior. Following the behavior scoring, calves underwent an individual health assessment for bovine respiratory disease, neonatal calf diarrhea, and umbilical infections. Each behavior category was scored as normal (0 points) or abnormal (1 point), and then categories were summed to obtain a total behavior score for each calf. Behavior scores ranged from 0 (normal) to 5 (severely abnormal). A total behavior score of 3 or greater was considered positive for disease. The outcome of a positive or negative test on the behavior score were analyzed using PROC LOGISTIC (SAS Institute Inc., Cary, NC) and the model controlled for calf age and farm. Bovine respiratory disease was significantly associated with a behavior score of 3 or greater. The use of a behavior score shows promise as a screening tool for disease in preweaned calves. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the utility of a digital Brix refractometer for the assessment of success of passive transfer of maternal immunoglobulin compared with the measurement of serum total protein (STP) by refractometry. Blood samples (n = 400) were collected from calves at 3 to 6 d of age. Serum IgG concentration was determined by radial immunodiffusion (RID), and STP and percentage Brix (%Brix) were determined using a digital refractometer. The mean IgG concentration was 24.1 g/L [standard deviation (SD) ± 10.0] with a range from 2.1 to 59.1 g/L. The mean STP concentration was 6.0 g/dL (SD ± 0.8) with a range from 4.4 to 8.8 g/dL. The mean %Brix concentration was 9.2% (SD ± 0.9) with a range of 7.3 to 12.4%. Brix percentage was highly correlated with IgG (r = 0.93). Test characteristics were calculated to assess failure of passive transfer (FPT; serum IgG <10 g/L). The sensitivity and specificity of STP at 5.5 g/dL were 76.3 and 94.4%, respectively. A receiver operating characteristic curve was created to plot the true positive rate against the false positive rate for consecutive %Brix values. The optimal combination of sensitivity (88.9%) and specificity (88.9%) was at 8.4% Brix. Serum total protein was also positively correlated with %Brix (r = 1.00) and IgG (r = 0.93). Dairy producers can successfully monitor their colostrum management and the overall success of passive transfer using a digital Brix refractometer to estimate IgG concentration of colostrum and calf serum. [ABSTRACT FROM AUTHOR]

The primary objective of this cross-sectional study was to identify associations between the diversity and composition of the nasopharyngeal (NP) microbiota and pneumonia status, as diagnosed by ultrasonography (US), in preweaned dairy calves. Characteristics of the NP microbiota were compared between calves with and without pneumonia, as diagnosed by US. Secondary objectives were to compare the composition of the NP microbiota between calves by age, clinical respiratory score (CRS), and previous antibiotic therapy. Holstein heifer calves (n = 50) from a southern Wisconsin dairy were enrolled at either 3 or 6 wk of age; 4 calves were sampled at both time points. Antibiotic treatment history was also collected for the 30 d before enrollment. For the purpose of this study, pneumonia was defined as having lobar pneumonia, as diagnosed by US, in at least 1 lung lobe. Following examination by CRS and US, a deep nasopharyngeal swab was obtained for 16S rRNA amplicon sequencing. Alpha diversity was reduced in calves that were CRS positive, and beta diversity tended to be different in calves previously treated with antibiotics and in calves that were CRS positive. Microbial diversity was not different between calves with and without pneumonia. The most dominant genus identified was Mycoplasma spp.; however, there was no association between relative abundance (RA) and pneumonia status. The median RA of Mycoplasma spp. was increased by 25 (95% confidence interval, CI: 3, 40) in calves at 3 wk of age compared with 6 wk of age. The median RA of Pasteurella spp. was increased by 1.5 (95% CI: 0.1, 3) in calves with pneumonia, as diagnosed by US, compared with calves without pneumonia. Additionally, Pasteurella spp. was increased by 2.3 (95% CI: 0, 9) in CRS-positive calves compared with CRS-negative calves. The median RA of Psychrobacter spp. was increased by 2 (95% CI: 0, 12) and median RA of Chryseobacterium spp. was increased by 0.15 (95% CI: 0, 2) in calves that were not treated previously with antibiotics compared with calves previously treated with antibiotics., (Copyright © 2021 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

The primary objective of this randomized field study was to assess the effect of antibiotic therapy on health and growth of preweaned dairy calves diagnosed with naturally occurring respiratory disease, using respiratory scoring and portable lung ultrasound. A secondary objective was to determine whether treatment response depended on clinical presentation at the time of diagnosis. Holstein calves (n = 357) were enrolled at 3 to 6 d of age and followed until 52 d on 2 commercial dairies. Calves were examined twice weekly by blinded members of the research team. Clinical respiratory and ultrasonographic lung scores were assigned at each exam and used to classify the first detected respiratory disease event (BRD1) into upper respiratory tract disease (clinical, no significant consolidation); subclinical lobular pneumonia (not clinical, patchy consolidation ≥1 cm 2 ); clinical lobular pneumonia (clinical, patchy consolidation ≥1 cm 2 ); subclinical lobar pneumonia (not clinical, ≥1 lobe consolidated); and clinical lobar pneumonia (clinical, ≥1 lobe consolidated). At BRD1, calves were blocked by their respiratory disease status and randomized to receive an antibiotic (tulathromycin, 2.5 mg/kg subcutaneous) or placebo (sterile saline, equal volume subcutaneous). Multivariable linear and logistic regression analyses were used to model response to therapy. At BRD1 (n = 289), the distribution of diagnoses was 29% (upper respiratory tract disease), 43% (subclinical lobular pneumonia), 13% (clinical lobular pneumonia), 8% (subclinical lobar pneumonia), and 7% (clinical lobar pneumonia). Early antibiotic therapy limited progression of lung consolidation immediately following treatment, reduced the likelihood of requiring treatment within 7 d of BRD1, and improved growth and mortality before weaning. Despite receiving multiple doses of antibiotics after BRD1, calves treated with either antibiotic or placebo were equally likely to enter the weaning phase with pneumonia. Clinical presentation was associated with response to treatment for worsening of consolidation, early treatment failure, days to retreatment, and average daily gain. Overall, treatment was associated with short-term benefits, but more research is needed to develop treatment protocols that more effectively treat pneumonia and ensure that calves enter the weaning period with ultrasonographically clean lungs., (Copyright © 2020 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

The objective of this study was to describe the prevalence and trends in antimicrobial resistance for bacterial pathogens associated with bovine respiratory disease (BRD) isolated from samples submitted to the Wisconsin Veterinary Diagnostic Laboratory (WVDL). Data were retrospectively collected from bovine respiratory isolates including Pasteurella multocida, Mannheimia haemolytica, Histophilus somni, and Bibersteinia trehalosi identified at the WVDL between January 2008 and December 2017. Antimicrobial susceptibility testing data were queried from antimicrobial resistance databases at the WVDL. A total of 4,261 isolates were identified. Pasteurella multocida was most frequently identified, accounting for 2,094 isolates (49% of total) over the study period. Mannheimia haemolytica was the second most frequently isolated bacterial respiratory pathogen (n = 1,267, 30%) followed by H. somni (n = 749, 18%) and B. trehalosi (n = 151, 4%). Over the 10-yr period, B. trehalosi had the highest median percentage of isolates that were resistant to at least one antibiotic at 33% (interquartile range: 24, 47) followed by M. haemolytica (13%; 8, 23). For P. multocida, 10% (4, 26) of isolates were classified as resistant to at least one antibiotic, whereas H. somni had the fewest resistant isolates (9%; 3, 15). When comparing 2013-2017 to 2008-2012, the overall percentage of resistant isolates for P. multocida and B. trehalosi decreased, whereas the percentage of resistant isolates for M. haemolytica and H. somni increased. Increased resistance against florfenicol, fluoroquinolones, gentamicin, tilmicosin, and tulathromycin was observed for M. haemolytica. These data show that antimicrobial susceptibility for BRD bacterial pathogens has changed in the population served by the WVDL over this 10-yr period. For P. multocida, resistance is relatively low and has either improved or at least remained constant for the majority of drugs labeled for treatment of respiratory disease in dairy cattle. Veterinarians and producers should be aware of the bacterial pathogens most commonly associated with BRD and work toward early disease detection, proper antibiotic administration, and monitoring lung lesions to ensure that their treatment protocols improve lung health., (Copyright © 2020 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

The primary objective of this randomized controlled challenge study was to investigate the effect of ampicillin on ultrasonographic (US) lung consolidation after experimental challenge with Pasteurella multocida in preweaned dairy calves. The secondary objectives were to determine whether ampicillin affected respiratory score, gross consolidation, or the detection of P. multocida in lung tissue at postmortem exam (PME). Holstein bull calves (n = 39) were transported to the University of Wisconsin-Madison School of Veterinary Medicine isolation facility at the mean (±SD) age of 52 ± 6 d. After a 7-d acclimation period, 30 calves were inoculated intratracheally with 10 10 cfu of ampicillin-sensitive P. multocida. Lung US and respiratory scoring were performed 2, 6, 12, and 24 h post-challenge, then US once daily and respiratory scoring twice daily until d 14. Calves were randomized to receive ampicillin [n = 17, treatment (TX), 6.6 mg/kg i.m. once daily for 3 d] or placebo [n = 11, control (CON), saline, equal volume, i.m. once daily for 3 d] when ≥1 cm 2 of lung consolidation was observed and ≥6 h had elapsed since challenge. Lung lesions ≥1 cm 2 were considered positive for consolidation. Calves were respiratory score positive if ≥2 in 2 or more categories based on the Wisconsin respiratory health score chart. Area under the curve (AUC) was calculated for US score and respiratory score as a proxy for time with consolidation and clinical respiratory disease, respectively. Gross lung lesions and pathogens were quantified following PME. At the time of first treatment, consolidation had developed in 28/30 calves (TX, n = 17; CON, n = 11) and 6% (1 out of 17) of TX and 9% (1 out of 11) of CON calves had a positive respiratory score. The TX calves had a significantly lower median (interquartile range given in parentheses) AUC for US score [TX: 23 (20, 29), CON: 47 (33, 53)], whereas mean AUC for respiratory score was not different between groups (TX: 93 ± 28, CON: 96 ± 17). On d 14, 70% (12 out of 17) of TX and 100% (11 out of 11) of CON calves had lung consolidation, and 24% (4 out of 17) of TX and 27% (3 out of 11) of CON calves had clinical respiratory disease. On PME, median consolidation was 10% (6, 15) for TX and 10% (2, 28) for CON calves. Lung cultures were positive for P. multocida in 77% (13 out of 17) of TX and 91% (10 out of 11) of CON calves. Lung health benefited from a 3-d ampicillin therapy, but benefits were short-lived. Treatment failures might be due to incomplete resolution of the initial lung infection. Future studies are needed to optimize TX strategies to improve long-term lung health., (Copyright © 2019 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

The objective of this study was to determine whether calves exhibit differences in behavioral attitude when diagnosed with their first bovine respiratory disease (BRD) event and whether fever (≥39°C) at the time of BRD diagnosis affected attitude. Preweaned dairy calves (n = 280; 21 ± 6 d) were examined twice weekly until weaning using a clinical respiratory score (CRS; CRS+: 2 respiratory categories with scores of 2 or greater; CRS-: 1 respiratory category with a score of 2 or greater or all respiratory categories scoring less than 2), lung ultrasound, and attitude score (normal = bright, alert, responsive; depressed = dull but responds to stimulation, slow to stand, or reluctant to lie down). Bovine respiratory disease was categorized as subclinical BRD (SBRD; CRS- and lung consolidation ≥1 cm 2 ; n = 164) or clinical BRD (CBRD; CRS+, with or without lung consolidation; n = 79). Calves without BRD (NOBRD; n = 37) remained CRS- with lung consolidation <1 cm 2 for the study. Depressed attitudes were found in 23, 6, and 0% of CBRD, SBRD, and NOBRD calves, respectively. In calves with CBRD, the odds of having a depressed attitude were 5.2 (95% confidence interval, confidence interval: 1.1-23.7) and 4.5 (95% confidence interval: 2.0-10.4) times higher compared with the odds of NOBRD and SBRD calves having a depressed attitude, respectively. The odds of having a depressed attitude did not differ between SBRD and NOBRD calves. Fever was associated with the odds of having a depressed attitude score, whereby calves with a fever had 6.2 (95% confidence interval: 2.8-14) times higher odds of having a depressed attitude score compared with calves without a fever. Sensitivity and specificity of the attitude score for identifying CBRD were 23% (95% confidence interval: 14-33) and 95% (95% confidence interval: 82-99), respectively. Producers should be cautious when using this attitude score as the primary means of detecting calves affected by BRD., (Copyright © 2019 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

The objectives of this cohort study were to identify a cut point on a previously described 6-level ultrasound score (USS6) at which average daily gain (ADG) is affected and to determine whether there is any additional benefit of using a clinical respiratory score. Calves from a commercial herd in Ohio were enrolled at entry to an automated calf feeder barn at (mean ± standard deviation) 21 ± 6 d of age (n = 308). Calves that survived until 50 d (n = 233) were included in the analyses. Twice-weekly health exams included a clinical respiratory score (CRS), USS6 (0-5, based on lung mass involved), and body weight. For the CRS, the nose, eyes, ears, cough, and rectal temperature were assigned a score (0-3), and calves were considered positive (CRS+) when at least 2 areas scored ≥2. For analysis, USS6 and CRS status were based on a calf's first bovine respiratory disease event identified during the study period. The first multivariable linear model was fit to determine whether USS6 was associated with ADG and controlled for CRS. We detected no difference in ADG among calves with USS6 scores of 2, 3, 4, and 5. Based on this finding, we proposed a simplified 2-level ultrasound score (USS2; without lung consolidation or with lung consolidation ≥1 cm 2 ). A second multivariable model was fit to assess the association between USS2 and ADG; this model controlled for CRS, birth weight category, breed, and cohort. Calves with lung consolidation (n = 169) had lower ADG than calves without lung consolidation (n = 64; 0.73 vs. 0.85 kg/d, respectively). Calves that were CRS+ (n = 61) had lower ADG than calves that were CRS- (n = 172; 0.74 vs. 0.84 kg/d, respectively). Although CRS did not affect the relationship between USS2 and ADG, both CRS and USS2 are necessary to explain variation in ADG. We simplified USS6 and proposed USS2 based on how lung consolidation affected ADG. A simplified 2-level ultrasound score may be more practical for veterinarians to identify calves that may be at risk for poor growth. The effect on ADG was similar between calves with lung consolidation and calves identified as CRS+. Therefore, both thoracic ultrasonography and CRS should be used to identify calves with all types of respiratory disease that affect growth. However, this study represents calves in group housing from 21 to 50 d of age on 1 farm with high disease incidence. We encourage studies that investigate the effects of lung consolidation and CRS on ADG in different management systems., (Copyright © 2019 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

The objective of this field trial was to evaluate the effect of a vaccine protocol using a commercially available trivalent vaccine designed for intranasal use. Experimental challenge studies have demonstrated varying efficacies of vaccines administered via the intranasal route. A total of 468 calves from 3 herds were enrolled and randomized into 3 treatment groups (positive control, PC, n = 211; intranasal vaccine, IN, n = 215; negative control, NC, n = 42) and followed for 8 to 12 wk. The PC consisted of one dose of commercially available multivalent injectable vaccine against bovine respiratory syncytial virus, infectious bovine rhinotracheitis, parainfluenza 3, and bovine viral diarrhea administered subcutaneously at 6 wk of age. The IN was administered at enrollment and 6 wk of age, and contained antigen against bovine respiratory syncytial virus, infectious bovine rhinotracheitis, and parainfluenza 3. The NC was sterile saline administered intranasally and subcutaneously at enrollment and 6 wk of age. Clinical illness was assessed using systematic respiratory scoring, and thoracic ultrasonography was used to identify the lung consolidation associated with pneumonia. Rib fractures were identified in 6% of calves, and an association was observed between rib fractures and calving ease. Overall, 54% of the calves had at least one episode of an abnormal respiratory score (ILL). Vaccination protocol did not affect the occurrence of ILL. Similarly, 54% of the calves had at least one episode of lung consolidation ≥3 cm (CON). Vaccine protocol affected the odds of CON. The odds of CON in PC were 1.63 (95% confidence interval: 1.04-2.56) times the odds of CON in IN, and 0.38 (95% confidence interval: 0.16-0.93) times the odds of CON in NC. The odds of CON in IN were 0.23 (95% confidence interval: 0.09-0.59) times the odds of CON in NC. The outcomes ILL and CON were associated; however, the measure of agreement was only fair (kappa = 0.38). Multivariable linear regression revealed an interaction between vaccine protocol and herd on average daily gain (ADG); therefore, these data were stratified. In herd 1, IN (0.53 ± 0.03 kg/d) decreased ADG compared with PC (0.63 ± 0.03 kg/d). In herd 2, IN increased ADG (0.41 ± 0.03 kg/d) compared with PC (0.38 ± 0.03 kg/d). In contrast, none of the protocols affected ADG at herd 3. In conclusion, this commercially available trivalent IN vaccine protocol did not alter the incidence of ILL, reduced the risk of lung lesions associated with pneumonia, and improved the ADG of the calves in one of the commercial study herds., (Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

The primary objective of this randomized controlled trial was to determine whether anti-IL-10 egg yolk antibodies fed upon arrival to a calf ranch would lower the prevalence of Cryptosporidium parvum shedding in naturally challenged preweaned dairy calves. The secondary objectives included measuring the effect of anti-IL-10 antibodies on calf health, performance, and shedding of less common diarrheal pathogens. A total of 133 calves, enrolled at 24 to 72 h of age, received a daily dose of 0.96 g of egg yolk powder with anti-IL-10 antibodies (MAB, n = 71) or without anti-IL-10 antibodies (MEP, n = 62) split between 2 feedings for the first 11 d on feed at a calf ranch. Daily health evaluations were completed for 15 d after arrival and on d 56. Digital weights were collected at enrollment and d 56, and hipometer weights were collected at enrollment and d 7 and 56. Packed cell volume and serum total protein concentration were measured at enrollment and on d 7 and 14. Fecal pH was measured at enrollment and on d 5 and 14, and fecal pathogen (C. parvum, coronavirus, rotavirus, and Salmonella spp.) shedding was assessed at d 5 and 14. Continuous outcomes were compared between groups using a Student's t-test or Wilcoxon rank sum test. Fecal pathogen shedding at d 14, respiratory disease at d 56, and antibiotic usage were compared using relative risk (RR) and chi-squared test. Fecal pH (median and interquartile range) on d 14 was 6.65 (6.39-6.99) and 6.52 (5.97-6.81) for MAB and MEP, respectively. On d 56, the risk of respiratory disease was lower for MAB compared with MEP (RR = 0.40; confidence interval = 0.16-0.99). The risk for antibiotic treatment was lower for MAB- compared with MEP-treated calves (RR = 0.38; confidence interval = 0.17-0.88). The risk of shedding rotavirus was higher in MAB (RR = 1.38; confidence interval = 1.10-1.81) calves. After multivariable analyses, hipometer weights (least squares means ± standard error) were 1.7 ± 0.8 kg greater on d 56 in MAB compared with MEP; however, ADG was 0.04 ± 0.02 kg/d lower in MAB calves. Total health score, diarrhea days, average respiratory score, packed cell volume, and serum total protein were not affected by feeding anti-IL-10 egg antibodies. In summary, feeding anti-IL-10 antibodies was associated with increased fecal pH, reduced risk of respiratory disease later in the preweaning period, and decreased antibiotic usage despite higher rotavirus infection. These findings might be associated with improved mucosal immunity, enhanced host defenses, or reduced susceptibility and warrant further investigation., (Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

Bovine respiratory disease (BRD) is a complex disease process and many reports emphasize the negative implications of clinical BRD in dairy calves. Early diagnosis can be difficult because of inconsistent or absent clinical signs; however, the use thoracic ultrasonography has the potential to improve detection of respiratory disease. Earlier detection of BRD may result in actions to improve calf welfare and production. The objective of this prospective cohort study was to determine if lung consolidation (LC) in young dairy calves influenced age at first calving (AFC), first-lactation milk production, and survival to the end of first lactation. A total of 215 female calves from 3 dairy herds in southwestern Ontario were enrolled and assessed weekly during their first 8 wk of life for evidence of LC using thoracic ultrasonography (Ibex Pro, Loveland, CO). Consolidation was measured, using gridlines on the screen of the ultrasound, in the first 10 intercostal spaces on both sides of the thorax. Calves were considered LC positive if ≥3 cm of consolidated lung was present. Multivariable linear regression models were used to identify risk factors associated with AFC and first-lactation 305-d milk production. A survival analysis was conducted to determine differences in survival from enrolment until the end of first lactation between calves with and without consolidation. In the study population, the following calfhood conditions were detected: twins (4%; n = 8), diarrhea in the first 21 d of life (31%; n = 66), rib fractures (7%; n = 14), lung abscesses (3%; n = 6), and at least one diagnosis of LC (57%; n = 123). Overall, 7% (n = 15) of calves died, and 18% (n = 38) of animals were sold before the end of first lactation. The presence of LC, at least once in the first 8 wk of life, did not influence AFC, but did result in a 525 kg (95% confidence interval: -992.81 to -60.25) decrease in first-lactation 305-d milk production. No difference in survival was detected between LC groups. These results indicate that LC during the first 56 d of life has a long-term effect on dairy calves, manifested as reduced milk production during first lactation., (Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

Background: Thoracic ultrasonography (US) and bronchoalveolar lavage fluid (BALF) analysis are antemortem methods used to identify the lung lesions associated with bovine respiratory disease (BRD). Accuracy of US and the cell distributions in BALF have not been characterized in calves with subclinical disease., Objectives: To evaluate the accuracy of US and BALF and describe BALF characteristics in calves with subclinical lung lesions., Animals: Twenty-five Holstein calves, 1-12 weeks old., Methods: In this prospective study, calves with low respiratory scores underwent US, BALF and postmortem examination (normal US, n = 5; comet-tails, n = 5; consolidation, n = 15). Bronchoalveolar lavage fluid was collected and analyzed for total and differential cell counts. Lung lesions were assessed by gross and histopathologic examination. Data were analyzed using nonparametric methods and relative risk analysis. The accuracy of US and BALF were estimated relative to postmortem examination., Results: The sensitivity and specificity of US for detecting lung lesions was 94% (95% CI, 69-100%) and 100% (95% CI, 64-100%), respectively. A cut-point of ≥4% BALF neutrophils was associated with the highest BALF sensitivity and specificity, 81% (95% CI, 56-94%) and 75% (95% CI, 36-95%). The presence of consolidation on US increased the risk of having a BALF neutrophil proportion ≥4% (RR, 3.9; 95% CI, 1.13-13.45; P = .003)., Conclusions and Clinical Importance: Ultrasonography accurately detects lung lesions in calves with subclinical disease. Clinicians should use a cut-point of ≥4% BALF neutrophils to diagnose subclinical respiratory disease., (Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of American College of Veterinary Internal Medicine.)

Cryptosporidium is a zoonotic protozoan that is most often diagnosed in association with diarrhea in 1- to 3-wk-old dairy calves. There are neither consistently effective nor approved antimicrobial drugs for treatment in animals. The objective of this study was to test nitazoxanide (NTZ) as a treatment for cryptosporidiosis in experimentally infected dairy calves. A randomized, controlled, and blinded trial was performed using Holstein bull calves obtained from a large commercial dairy. All births were attended by study personnel and calves were fed 4 L of heat-treated colostrum within 1 h of birth. Calves were randomly assigned to treatment or placebo group and maintained for a 32-feeding (16 d) study period. Twenty-three calves were enrolled with 3 lost to follow up. Thirteen calves were assigned to the treatment group and 7 calves to the placebo group. All calves were inoculated with 1 x 10(6) viable Cryptosporidium parvum oocysts at feeding 3. Treatment was a commercially available NTZ product and the placebo was the carrier of the same product. Nitazoxanide was administered at 1.5 g twice per day for 5 d. Nitazoxanide or placebo treatment began after feeding 10 and when the fecal score was greater than 1 out of 3. Outcome measurements included twice-daily fecal and health scores and a once-daily oocyst count by an immunofluorescent antibody assay. Data were analyzed by nonparametric and time-to-event methods. Measures of passive transfer of antibodies, initial body weight, and onset of oocyst shedding were not different between treatment and control calves. Eighty-five percent of the NTZ-treated calves stopped shedding oocysts by the end of the observation period whereas only 15% of the placebo group stopped shedding. The median number of feedings with a fecal score equal to 3 was 2 in the NTZ group while it was 6 in the placebo group. Calves receiving NTZ were 0.13 times as likely to have severe and sustained diarrhea than control calves (95% confidence interval, 0.02-0.98). Treating calves with NTZ reduced the duration of oocyst shedding and improved fecal consistency.