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This study evaluates the high electricity costs faced at a carpet manufacturing company. Research was conducted by focusing on the supply and availability of electricity in South Africa and alternative energy sources. Modelling methods were investigated to determine an appropriate approach to solving the high-cost problem at the company to ensure that the model could be reused for similar scenarios. The findings provide an electricity minimisation solution that requires the installation of a solar system. Using generated solar energy, and consuming generator power to maintain optimal monthly municipal thresholds, electricity costs would be reduced by over R100 000 monthly. [ABSTRACT FROM AUTHOR]

Summary: A 17‐year‐old Thoroughbred gelding was admitted for arthroscopic examination and lavage of the right tarso‐crural joint under general anaesthesia. Based on preanaesthetic examination, the patient was considered clinically healthy. No complications were experienced during induction and maintenance of anaesthesia. During the recovery period, the patient experienced acute pulmonary haemorrhage resulting in death. Post‐mortem examination revealed macroscopic and histopathological lesions indicative of exercise‐induced pulmonary haemorrhage (EIPH) with associated acute rupture of the pulmonary vessels (primarily venous). The cause of acute pulmonary blood vessel rupture in this case was speculated to be a result of increased transmural pressures in weakened blood vessels. Partial airway obstruction, catecholamine release, hypoxic pulmonary vasoconstriction, the use of the alpha‐2 adrenoreceptor agonists, fluid overload and blunt trauma may have led to the increase in pulmonary blood vessel transmural pressures. To the best of the authors' knowledge, this is the first description of acute pulmonary haemorrhage in the peri‐anaesthetic period in a horse with underlying EIPH. In addition to describing the case, this case report also looks at anaesthetic management options in horses with known EIPH. [ABSTRACT FROM AUTHOR]

A 10-year-old Hanoverian mare was evaluated for a right buccal sweffing that recurred 3 months following surgical resection. Ultrasonographic examination showed a broadly pedunculated subcutaneous mass at the level of 106-109 and 406-409 cheek teeth associated with an erosive mucosal lesion on the inside of the cheek Histological examination of a biopsy specimen revealed a well-demarcated, malignant, dermal schwannoma. Following subcutaneous placement of platinum coated Ir192 wires under general anaesthesia, low-dose radiation of 5 gray per day was delivered for 14 days. Short-term complications included loss of patency of the right nasolacrimal duct, erythema, dermatitis, leukotrichia and left-sided deviation of the muzzle. Ten months later, there has been no tumour recurrence. Findings suggest that the use of interstitial brachytherapy should be considered for a malignant, dermal schwannoma that has recurred or is not amenable to surgery [ABSTRACT FROM AUTHOR]

Various zoonotic microorganisms cause reproductive problems such as abortions and stillbirths, leading to economic losses on farms, particularly within livestock. In South Africa, bovine brucellosis is endemic in cattle, and from 2013-2018, outbreaks of Brucella melitensis occurred in sable. Coxiella burnetii, the agent responsible for the zoonotic disease known as Q-fever and/or coxiellosis, also causes reproductive problems and infects multiple domestic animal species worldwide, including humans. However, little is known of this disease in wildlife. With the expansion of the wildlife industry in South Africa, diseases like brucellosis and coxiellosis can significantly impact herd breeding success because of challenges in identifying, managing and treating diseases in wildlife populations. This study investigated samples obtained from aborted sable and roan antelope, initially suspected to be brucellosis, from game farms in South Africa using serology tests and ruminant VetMAX™ polymerase chain reaction (PCR) abortion kit. The presence of C. burnetii was confirmed with PCR in a sable abortion case, while samples from both sable and roan were seropositive for C. burnetii indirect enzyme-linked immunosorbent assay (iELISA). This study represents the initial report of C. burnetii infection in sable and roan antelope in South Africa. Epidemiological investigations are crucial to assess the risk of C. burnetii in sable and roan populations, as well as wildlife and livestock in general, across South Africa. This is important in intensive farming practices, particularly as Q-fever, being a zoonotic disease, poses a particular threat to the health of veterinarians and farm workers as well as domestic animals.Contribution: A report of clinical C. burnetii infection in the wildlife industry contributes towards the limited knowledge of this zoonotic disease in South Africa.

The histology and growth of reptilian and crocodilian claws (ungues) have been extensively studied; however, Nile crocodile (Crocodylus niloticus) claws have not received adequate attention. Furthermore, age estimations for reptilian claws remain unexplored, despite Nile crocodile claws being used in long-term dietary reconstruction studies, assuming certain age-related patterns. In this study, we investigate the histology and growth patterns of Nile crocodile claws, aiming to infer axes for sampling cornified material for radiocarbon dating and establish age estimations for crocodilian claws. Our findings reveal that Nile crocodile claws exhibit growth patterns similar to other reptilians, presenting as modified scutes/scales with an age profile along the sagittal plane. This profile starts at the basal germ matrix and progressively expands in thickness and age dorsoventrally towards the apex or "tip." Consequently, the oldest corneous material is concentrated at the most dorsal point of the claw's apex. To validate previous dietary reconstruction assumptions, we conducted radiocarbon dating on this region of the claw, which supported the idea that retained corneous material in the claws is typically relatively young (5-10 years old) due to abrasion. Our study contributes insights into the histology and growth dynamics of Nile crocodile claws, shedding light on their use in dietary reconstruction studies and emphasizing the significance of considering age-related assumptions in such investigations., (© 2023 The Authors. Journal of Morphology published by Wiley Periodicals LLC.)

Background: In humans, muscle-invasive bladder cancer (MIBC) is highly aggressive and associated with a poor prognosis. With a high mutation load and large number of altered genes, strategies to delineate key driver events are necessary. Dogs and cats develop urothelial carcinoma (UC) with histological and clinical similarities to human MIBC. Cattle that graze on bracken fern also develop UC, associated with exposure to the carcinogen ptaquiloside. These species may represent relevant animal models of spontaneous and carcinogen-induced UC that can provide insight into human MIBC., Results: Whole-exome sequencing of domestic canine (n = 87) and feline (n = 23) UC, and comparative analysis with human MIBC reveals a lower mutation rate in animal cases and the absence of APOBEC mutational signatures. A convergence of driver genes (ARID1A, KDM6A, TP53, FAT1, and NRAS) is discovered, along with common focally amplified and deleted genes involved in regulation of the cell cycle and chromatin remodelling. We identify mismatch repair deficiency in a subset of canine and feline UCs with biallelic inactivation of MSH2. Bovine UC (n = 8) is distinctly different; we identify novel mutational signatures which are recapitulated in vitro in human urinary bladder UC cells treated with bracken fern extracts or purified ptaquiloside., Conclusion: Canine and feline urinary bladder UC represent relevant models of MIBC in humans, and cross-species analysis can identify evolutionarily conserved driver genes. We characterize mutational signatures in bovine UC associated with bracken fern and ptaquiloside exposure, a human-linked cancer exposure. Our work demonstrates the relevance of cross-species comparative analysis in understanding both human and animal UC., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Wild animals are commonly captured for conservation, research, and wildlife management purposes. However, capture is associated with a high risk of morbidity or mortality. Capture-induced hyperthermia is a commonly encountered complication believed to contribute significantly to morbidity and mortality. Active cooling of hyperthermic animals by dousing with water is believed to treat capture-induced pathophysiological effects, but remains untested. This study aimed to determine the pathophysiological effects of capture, and whether cooling by dousing with cold water effectively reduces these effects in blesbok (Damaliscus pygargus phillipsi). Thirty-eight blesbok were randomly allocated into three groups: a control group that was not chased (Ct, n=12), chased not cooled (CNC, n=14), and chased plus cooled group (C+C, n=12). The CNC and C+C groups were chased for 15 min prior to chemical immobilization on day 0. Animals in the C+C group were cooled with 10 L of cold water (4 C) for 10 min during immobilization. All animals were immobilized on days 0, 3, 16, and 30. During each immobilization, rectal and muscle temperatures were recorded, and arterial and venous blood samples collected. Blesbok in the CNC and C+C groups presented with capture-induced pathophysiological changes characterized by hyperthermia, hyperlactatemia, increased markers of liver, skeletal, and cardiac muscle damage, hypoxemia, and hypocapnia. Cooling effectively returned body temperatures to normothermic levels, but neither the magnitude nor the duration of the pathophysiological changes differed between the CNC and C+C groups. Therefore, at least in blesbok, capture-induced hyperthermia appears not to be the primary cause of the pathophysiological changes, but is more likely a clinical sign of the hypermetabolism resulting from capture-induced physical and psychological stress. Although cooling is still recommended to prevent the compounding cytotoxic effects of persistent hyperthermia, it is unlikely to prevent stress- and hypoxia-induced damage caused by the capture procedure., (© Wildlife Disease Association 2023.)

The African buffalo (Syncerus caffer) is an iconic species of South African megafauna. As the farmed buffalo population expands, the potential impacts on population health and disease transmission warrant investigation. A retrospective study of skin biopsy and necropsy samples from 429 animals was performed to assess the spectrum of conditions seen in buffaloes in South Africa. Determination of the cause of death (or euthanasia) could not be made in 33.1% (136/411) of the necropsy cases submitted due to autolysis or the absence of significant lesions in the samples submitted. Infectious and parasitic diseases accounted for 53.5% (147/275) of adult fatal cases and non-infectious conditions accounted for 34.9% (96/275). Abortions and neonatal deaths made up 11.6% (32/275) of necropsy cases. Rift Valley fever, bovine viral diarrhoea, malignant catarrhal fever, tuberculosis, bacterial pneumonia, anaesthetic deaths, cachexia and hepatotoxic lesions were the most common causes of death. The range of infectious, parasitic and non-infectious diseases to which African buffaloes were susceptible was largely similar to diseases in domestic cattle which supports concerns regarding disease transmission between the two species. The similarity between diseases experienced in both species will assist wildlife veterinarians in the diagnosis and treatment of diseases in captive African buffaloes. The present study likely does not represent accurate disease prevalence data within the source population of buffaloes, and diseases such as anthrax, brucellosis and foot and mouth disease are under-represented in this study. Hepatic ductal plate abnormalities and haemorrhagic septicaemia have not, to our knowledge, been previously reported in African buffaloes.

In this study, Brucella melitensis infection in sable antelope ( Hippotragus niger ) was investigated on two wildlife ranches in South Africa over a 12-year period in order to determine the origin of the outbreaks and the role of livestock in maintaining the disease. Retrospective data were obtained from farm records and interviews as well as samples tested from different disease scenarios and clinical settings. On one ranch, 10 of 74 sable tested seropositive for B. melitensis in 2004 but were certified clear of infection after no further brucellosis cases were detected following repeated serological tests and culling over a five-year period. Recrudescence occurred in 2013 (7 of 187 brucellosis positives) and in 2014 (one positive), with persistent, latent infection being the most reasonable explanation. In a second case study, linked to the first one through a common vendor, 15 of 80 sable tested positive in 2016, some five years after the acquisition of the animals from a putative source. Brucella melitensis biovar 1 and/or 3 were isolated from each outbreak on both ranches. Both outbreaks resulted in substantial losses for the owners, arising from testing and culling and significant resource expenditure by the state. The study identified the diagnostic challenges for identifying and resolving disease outbreaks in wildlife, the persistence of B. melitensis in sable, the risks associated with animal movements, and the need for a wildlife-sensitive disease control scheme. Although the actual source of infection could not be identified, the investigation points away from local livestock as a source of ongoing infection while the persistent infection is consistent with the disease circulating within small, ranched populations and being spread through the keeping and trading of high-value animals. The implications of the study findings to disease control in wildlife are discussed.

Impalas (Aepyceros melampus) are common African antelope. A retrospective study was conducted of 251 impala cases from game farms, national parks and zoos submitted by veterinarians and pathologists in South Africa (2003-2016). Histopathology slides as well as records of macroscopic lesions and additional diagnostic tests performed were examined. Non-infectious conditions, such as acute pulmonary congestion and oedema, cachexia, traumatic injury and anaesthetic-related mortality were the most common causes of morbidity and mortality. Bacterial sepsis was the most common infectious disease, whilst skeletal muscle and myocardial sarcocystosis and verminous cholangitis and pneumonia were the most common parasitic diseases. Although the retrospective nature of this study limits the significance of the relative prevalence of lesions in the three locations, management decisions and diagnostic plans may be informed by the results. Impala from game farms had significantly more cachexia cases than those from other locations. Impala from zoos had significantly more lymphoid depletion than those from other locations. These findings suggest that nutrition and pasture management, enclosure design, management of intra- and interspecies aggression and improved anaesthetic protocols could improve animal welfare and survival of impala on game farms and in zoos. This report presents a detailed survey of diseases and conditions found in impala that provides baseline data for veterinary pathologists.

We screened nonequine animals with unexplained neurologic signs or death in South Africa during 2010-2018 for Shuni virus (SHUV). SHUV was detected in 3.3% of wildlife, 1.1% of domestic, and 2.0% of avian species. Seropositivity was also demonstrated in wildlife. These results suggest a range of possible SHUV hosts in Africa.

Alphaviruses from Africa, such as Middelburg virus (MIDV), and Sindbis virus (SINV), were detected in horses with neurologic disease in South Africa, but their host ranges remain unknown. We investigated the contribution of alphaviruses to neurologic infections and death in wildlife and domestic animals in this country. During 2010-2018, a total of 608 clinical samples from wildlife and nonequine domestic animals that had febrile, neurologic signs or unexplained deaths were tested for alphaviruses. We identified 32 (5.5%) of 608 alphavirus infections (9 SINV and 23 MIDV), mostly in neurotissue of wildlife, domestic animals, and birds. Phylogenetic analysis of the RNA-dependent RNA polymerase gene confirmed either SINV or MIDV. This study implicates MIDV and SINV as potential causes of neurologic disease in wildlife and nonequine domestic species in Africa and suggests a wide host range and pathogenic potential.

West Nile virus (WNV) lineage 2 is associated with neurologic disease in horses and humans in South Africa. Surveillance in wildlife and nonequine domestic species during 2010-2018 identified WNV in 11 (1.8%) of 608 animals with severe neurologic and fatal infections, highlighting susceptible hosts and risk for WNV epizootics in Africa.

Pigmentation of the skin is a crucial component in the pathogenesis of melanocytic neoplasms and other skin-related tumors, as melanin is known to function in both the absorbance of ultraviolet radiation and as an antioxidant. Very limited information exists regarding the incidence and metastatic potential of neoplastic conditions of the skin in game animals, especially wildebeests, relative to domestic animals. Four cases of cutaneous melanoma in color-variant golden and king wildebeests ( Connochaetes taurinus) (from 2014 to 2015) in South Africa were investigated. Melanoma in these captive animals was characterized using histopathology, transmission electron microscopy, and an immunohistochemistry panel, which consisted of monoclonal antibodies against three melanocytic markers: Melan A, PNL2, and S100. Overall, 2/4 cases (50%) of the melanocytic neoplasms stained strongly positive for all the melanocytic markers, while 4/4 cases (100%) stained positively for at least one of the markers. Cutaneous melanocytic neoplasia has not been reported in wildebeests; the current study suggests that selection of wildebeests for coat color potentially predisposes to this condition.

The steenbok (Raphicerus campestris) is a small antelope of the family Bovidae native to the African continent. Urolithiasis, the formation of urinary calculi in the urinary tract, can be caused by a variety of factors such as diet, dehydration, infection and anatomical predisposition. Urolithiasis, with uroliths identified as magnesium calcium phosphate carbonate in composition, was diagnosed in a hand-reared 5-month-old steenbok. Perineal urethrostomy was performed as a component of the broad treatment regime that included fluid therapy, antibiotic and anti-inflammatory treatment. However, the animal died 4 days later as a result of systemic hypoxia and energy depletion because of stress and cachexia. The challenges of post-surgical treatment, the importance of positive energy balance in small ruminants under stressful circumstances, as well as the role of diet of hand-reared antelope in predisposition to urolith formation are highlighted.

Although nasal masses are uncommon in sheep and may have several causes, including neoplasia and bacterial, fungal and viral infections, these lesions may lead to economic losses resulting from weight loss and even death. It is therefore important to differentiate between various categories of upper respiratory tract obstructions and lower respiratory tract infections. The correct aetiological diagnosis of obstructive masses is essential for appropriate treatment and management to be given or action to be taken. The presentation, clinical signs, treatment and pathology of a case of suspected mycotic rhinitis in a 6-year-old Mutton Merino ewe, are described.

A privately owned, 2-yr-old, 600-kg, intact male white rhinoceros presented with a progressive lameness of the left front limb of 8-mo duration with a focal swelling situated over the dorsoproximal aspect of third metacarpophalangeal joint. Radiographs of the affected limb showed a 28 mm × 26 mm exostosis at the dorsodistal third metacarpal bone. Surgical removal of the exostosis was performed and histopathologic examination confirmed a solitary osteochondroma. A follow-up examination 1 yr after surgical removal revealed total abolishment of the left front limb lameness. This report documents the first diagnosis and treatment of solitary osteochondroma in a white rhinoceros.

An outbreak of feline panleukopaenia virus (FPLV) infection was diagnosed by pathology, electron microscopy and polymerase chain reaction (PCR) in vaccinated captive-bred subadult cheetahs in South Africa. Subsequent to this disease outbreak, 12 cases of FPLV diagnosed on histology were confirmed by PCR in captive African black-footed cat, caracal, cheetah, lion, ocelot and serval. Phylogenetic analyses of the viral capsid protein gene on PCR-positive samples, vaccine and National Center for Biotechnology Information (NCBI) reference strains identified a previously unknown strain of FPLV, present since at least 2006, that differs from both the inactivated and the modified live vaccine strains. A previously described South African strain from domestic cats and cheetahs was identified in a serval. Surveys of FPLV strains in South African felids are needed to determine the geographical and host species distribution of this virus. Since non-domestic species may be reservoirs of parvoviruses, and since these viruses readily change host specificity, the risks of FPLV transmission between captive-bred and free-ranging carnivores and domestic cats and dogs warrant further research.

Anatomy and mortuary technical staff faces an ever existing risk of contracting an infectious disease, such as Mycobacterium tuberculosis (MTB), when exposed to human remains. The transfer and handling of a corpse expels air from the lungs of the diseased and this aerosolizes the bacilli. It is for this reason that personal protective equipment and work space precautions such as ultraviolet germicidal irradiation is a necessity. In this study, the authors explore the viability of MTB before and after embalming. Briefly, lung tissue samples, both apical and hilar, were obtained from 20 cadavers whose death certificate indicated MTB as cause of death. The first sample was taken before embalming and second set 3 weeks after embalming. Tissue was deposited into sterile specimen containers and transported for analysis which included Mycobacterium growth indicator tube cultures and polymerase chain reaction. Results demonstrated that both the apical and the perihilar sample tested positive prior to embalming, 36 days after death. After three weeks post-embalming none tested positive. The results demonstrated that MTB can remain viable after death for up to 36 days. This viability extends beyond the documented cases and highlights the need for precautionary measures and standard operating procedures in accordance with occupational health and safety guidelines., (Copyright © 2013 Wiley Periodicals, Inc.)

A 3-week-old female white Bengal Tiger cub (Panthera tigris tigris) presented with acute onset tachypnoea, cyanosis and hypothermia. The cub was severely hypoxaemic with a mixed acid-base disturbance. Echocardiography revealed severe pulmonic stenosis, right ventricular hypertrophy, high membranous ventricular septal defect and an overriding aorta. Additionally, an atrial septal defect was found on necropsy, resulting in the final diagnosis of Tetralogy of Fallot with an atrial septal defect (a subclass of Pentalogy of Fallot). This report is the first to encompass arterial blood gas analysis, thoracic radiographs, echocardiography and necropsy findings in a white Bengal Tiger cub diagnosed with Tetralogy of Fallot with an atrial septal defect.

Background: Infectious livestock diseases remain a major threat to attaining food security and are a source of economic and livelihood losses for people dependent on livestock for their livelihood. Knowledge of the vital infectious diseases that account for the majority of deaths is crucial in determining disease control strategies and in the allocation of limited funds available for disease control. Here we have estimated the mortality rates in zebu cattle raised in a smallholder mixed farming system during their first year of life, identified the periods of increased risk of death and the risk factors for calf mortality, and through analysis of post-mortem data, determined the aetiologies of calf mortality in this population. A longitudinal cohort study of 548 zebu cattle was conducted between 2007 and 2010. Each calf was followed during its first year of life or until lost from the study. Calves were randomly selected from 20 sub-locations and recruited within a week of birth from different farms over a 45 km radius area centered on Busia in the Western part of Kenya. The data comprised of 481.1 calf years of observation. Clinical examinations, sample collection and analysis were carried out at 5 week intervals, from birth until one year old. Cox proportional hazard models with frailty terms were used for the statistical analysis of risk factors. A standardized post-mortem examination was conducted on all animals that died during the study and appropriate samples collected., Results: The all-cause mortality rate was estimated at 16.1 (13.0-19.2; 95% CI) per 100 calf years at risk. The Cox models identified high infection intensity with Theileria spp., the most lethal of which causes East Coast Fever disease, infection with Trypanosome spp., and helminth infections as measured by Strongyle spp. eggs per gram of faeces as the three important infections statistically associated with infectious disease mortality in these calves. Analysis of post-mortem data identified East Coast Fever as the main cause of death accounting for 40% of all deaths, haemonchosis 12% and heartwater disease 7%., Conclusion: The findings demonstrate the impact of endemic parasitic diseases in indigenous animals expected to be well adapted against disease pressures. Additionally, agreement between results of Cox models using data from simple diagnostic procedures and results from post-mortem analysis underline the potential use such diagnostic data to reduce calf mortality. The control strategies for the identified infectious diseases have been discussed.

A 10-year-old Hanoverian mare was evaluated for a right buccal swelling that recurred 3 months following surgical resection. Ultrasonographic examination showed a broadly pedunculated subcutaneous mass at the level of 106-109 and 406-409 cheek teeth associated with an erosive mucosal lesion on the inside of the cheek. Histological examination of a biopsy specimen revealed a well-demarcated, malignant, dermal schwannoma. Following subcutaneous placement of platinum coated Ir192 wires under general anaesthesia, low-dose radiation of 5 gray per day was delivered for 14 days. Short-term complications included loss of patency of the right nasolacrimal duct, erythema, dermatitis, leukotrichia and left-sided deviation of the muzzle. Ten months later, there has been no tumour recurrence. Findings suggest that the use of interstitial brachytherapy should be considered for a malignant, dermal schwannoma that has recurred or is not amenable to surgery.

Here we describe the in vitro isolation, propagation, and characterization of a Theileria species from roan antelope (Hippotragus equinus). Cultures were initiated using parts of a prescapular lymph node of an infected roan antelope. After 16 days of culture propagation, the first subculture was carried out; thereafter, subcultures were carried out twice a week. Standard methods for the cultivation of Theileria macroschizonts were applied. DNA was extracted from culture material and a partial polymerase chain reaction amplification of the 18S ribosomal RNA (rRNA) gene was carried out using Theileria genus-specific primers. It has been shown that Theileria sp. (roan) had high levels of nucleic acid identity with sequence data of the 18S rRNA gene of a Theileria sp. previously isolated from a sable antelope. The phylogenetic analysis showed that this isolate is closely related to several undescribed Theileria spp. which have previously been identified from a dog and some other antelope species in South Africa.

Serologic evidence suggests that West Nile virus (WNV) is widely distributed in horses in southern Africa. However, because few neurologic cases have been reported, endemic lineage 2 strains were postulated to be nonpathogenic in horses. Recent evidence suggests that highly neuroinvasive lineage 2 strains exist in humans and mice. To determine whether neurologic cases are being missed in South Africa, we tested 80 serum or brain specimens from horses with unexplained fever (n = 48) and/or neurologic signs (n = 32) for WNV. From March 2007 through June 2008, using reverse transcription-PCR (RT-PCR) and immunoglobulin (Ig) M ELISA, we found WNV RNA or IgM in 7/32 horses with acute neurologic disease; 5 horses died or were euthanized. In 5/7 horses, no other pathogen was detected. DNA sequencing for all 5 RT-PCR-positive cases showed the virus belonged to lineage 2. WNV lineage 2 may cause neurologic disease in horses in South Africa.

Neonatal, poikilocytic anaemia in some members of the Hippotragini has previously been documented but not fully investigated. This study was undertaken to describe the erythrocyte morphology of roan antelopes (Hippotragus equinus) during the first 4 weeks after birth and to identify aspects of haemoglobin (Hb) production that might be implicated in this syndrome. Twenty-nine roan antelope calves were sampled on, or close to, 1, 7, 14 and 28 days after birth. Erythrocyte morphology was characterized, and microhaematocrit values and Hb parameters determined, for each sampling occasion. Findings indicated a significant change in erythrocyte morphology during the neonatal period and two haemoglobin types, fetal and adult, were identified. The perinatal onset of adult Hb synthesis was delayed relative to the termination of fetal Hb production, resulting in the observed anaemia. Haemoglobin concentration and erythrocyte morphology were significantly correlated. These findings suggest an intimate relationship between Hb synthesis and the observed poikilocytosis. An imbalance in the synthesis of the alpha- and beta-globin chains of Hb (a thalassaemia) may prove to be the underlying pathophysiology of this syndrome.