Basrah Journal of Veterinary Research,Vol.19, No.3, 2020. Proceeding of the 17th
International Conference. College of Veterinary Medicine. University of Basrah. Iraq
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QUESTIONNAIRE SURVEY WITH CATTLE OWNERS
REGARDING OUTBREAK OF LUMPY SKIN DISEASE (LSD) IN
BASRAH PROVINCE, SOUTH OF IRAQ
Mohanad Faris Abdulhameed *, Moaed Hanoon Sayhood*1, Tareq Hadi
Srayyih**
* Department of Public Health, College of Veterinary Medicine, University of Basrah,
Basrah, Iraq
** Department of Internal and Preventive Medicine, College of Veterinary Medicine,
University of Basrah, Basrah, Iraq
*Corresponding author: Mohanad.Abdulhameed@yahoo.com
Keywords: Lumpy Skin Disease, Questionnaire, Cattle.
ABSTRACT
Lumpy skin disease (LSD) is a highly contagious transboundary disease of
cattle with significant economic burden. Our study is based on a questionnaire
designed to describe the epidemiological features keys of LSD in Basrah and to
identify putative risk factors. The information obtained from this questionnaire
specifically included sex, age, vaccination status, clinical signs and the number of
death because of LSD in the cattle. This study was conducted from December 2018
to May 2019, with a total of 251 cattle owners participated in the interview. Out of
251 owners interviewed, 329 of their cattle were infected with LSD (accumulative
incidence estimated at 16.2%). The majority of owners (91.6%) admitted that they
did not segregate the infected animal from the rest of the herds. Respect to animal
management and farming system, the semi-intensive system of rearing animals was
the most common farming system adapted by farmers (70%) while only 30% were
kept under intensive system. The majority of the owners 97.2% (244/251) reported
they were not received any vaccine of LSD. The mortality rate; however, measured
at 2% and the case-fatality rate measured at 11%. The abortion rate among infected
pregnant cows was calculated at 10.5%. The study concluded LSD is newly
emerging disease in Basrah and various preventative measures including restriction
illegal movement of animals, vector control, farm biosecurity and, vaccination
Basrah Journal of Veterinary Research,Vol.19, No.3, 2020. Proceeding of the 17th
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program need to be considered to prevent further new incidence cases.
INTRODUCTION
Lumpy skin disease (LSD) is an important transboundary disease that causes
significant economic burden. The disease caused by Lumpy skin disease virus
classified under the genus of Capripoxvirus and family Poxviridae (1). This disease is
more likely and occurs rapidly during the wet season than a hot season; whereas,
introducing new animals to the herds and communal grazing/watering pattern are
considered inextricably potential factors in the spreading of LSD (2). However,
morbidity and mortality of Lumpy skin disease in cattle are variable which depends
on a host characterisation, including age and sex, immunity status, and type of cattle
breed (3,4). Most typical clinical signs manifested by LSD in the infected animals are
characterised by increasing of the body temperature that reaches up to more 40 0C
and various sizes of nodules excessively disperse on the animal skin (5,6).
Lumpy skin disease causes considerable implications by accounted for both
direct and indirect economic losses. The direct impact of LSD leads to enduring
losses of animal production, mainly reduce milk production, abortion, and reduce
fertility rate (7). Furthermore, restriction of animal movements and it trades represent
indirect economic impact caused by LSD during an outbreak (8). The animal treatment
and vaccination strategy for LSD requires a high expenditure to succeed the control
programmes (9). The Lumpy skin disease virus can be transmitted mechanically by
blood sucking arthropods. Some species of these arthropods such as a mosquito
(Aedes aegypti) and ticks (Rhipicephalus decoloratus and Amblyomma hebraeum),
play a potential role in the transmission of the virus in cattle herds (10-13). This virus
was experimentally isolated from a bull semen (14), and also has been confirmed that
transplacental infection with LSD occurs from an infected pregnant cow to its foetus
(5). To date, the probability of the transmission of LSD between infected and
susceptible animals occurs through direct contact but despite that it has not yet been
validated, although the virus was frequency isolated from saliva and nasal discharge
contents (15).
Lumpy skin disease, however, remains a notifiable disease listed by the World
Organisation of Animal Health (OIE) as one of the most endemic diseases in Africa
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countries (16), and become an epidemic disease in the Middle East regions (17). Lumpy
Skin Disease has been reported in several countries of the Middle East, included
Turkey, Jordan, Lebanon and Syria, Israel, and Iran (18,19). Between 2013 to 2014,
multiple-outbreaks were reported in the south, north and middle of Iraq regions, with
more than 7, 000 cattle cases to have been infected with LSD, of which believed the
disease crossed the borders of Iraq because of illegal animal transportation from other
the neighbouring countries, particularly Syria and Turkey (18,20). In Basrah, recent
serological study indicated the prevalence of infection with LSD were reported as
18%(21). However, the objective of the present study was to describe different
epidemiological outcomes and risk factors are associated with LSD outbreak in the
cattle populations.
MATERIALS AND METHODS
Area of study
The current study was conducted in Basrah province. Basrah is located in the
south of Iraq, proximal to the gulf region with the latitude and longitude coordinate is
30.5258° N, 47.7738° E, respectively. This province is constructed from nine districts
including Al-Midaina, Al-Qurnah, Ad Dayer, Al-Hartha, Al-Zubair, Al-Basrah, Abu
Al Khasib, Al-Faw, and Shatt Alarab. The ecosystem of Basrah is extremely hot in
the summer, with a mean temperature of 37.4 °C and a maximum temperature of 45
°C. The lowest mean summer temperature is 29.2°C. The annual humidity is below
50% and less than 30% during the daytime (22).
Study design and administration questionnaire
This study was conducted between December 2018 to May 2019 entail five
districts of Basrah province included Abu Al-Kasib, Al-Basrah, Ad-Dayer, Al-
Qurnah, and Shatt-Alarab. A structured questionnaire was prepared to investigate and
assess putative risk factors that may be associated with the outbreak of LSD among
cattle populations in Basrah. The questionnaire form is closed-ended questions and
consists of twenty-three questions that integrated into two sections. The first section
included variables related to the socio-demographic characterization of the cattle
owners and animal herd species. The second part was pertinent to herd/animal
management, intensive and semi-intensive system, and vaccination status. To enable
to involve a large number of participations and cover the area of Basrah, seven
Basrah Journal of Veterinary Research,Vol.19, No.3, 2020. Proceeding of the 17th
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experience veterinarians were recruited to help to investigate on LSD cases and
administrate the questionnaire with farmers where the outbreaks were notified. The
questionnaire survey interviewed 251 cattle owners whose one/or more of their
animal/s were infected with this disease. The herd size of these owners was
categorized as a small (1-3), medium (4-6), and large (7 above). The questionnaire
was revised several times to ensure the validity of each single questions; therefore,
five owners were involved for a pre-test to ascertain clarity of these questions, but
later they disregarded in the study. Importantly, all respondents were above 18 years
old considered to be eligible to involve in the questionnaire survey. Prior to
administrating the questionnaire, an oral-consent was obtained from an individual
owner to be involved in the questionnaire interview and readily address the questions
point to point. The questionnaire was written in the English language and afterward
translated to the local language (Arabic) as the local communities speak only Arabic.
Statistical analysis
The data were entered into an excel sheet. SPSS statistical package (version 23)
was used for the analysis of data. The descriptive statistics for each single variable
was given by frequency and confidence interval. A Chi-square test was performed to
observe any significant difference of animal variables (P≤ 0.05) categorized by age
and sex with a case-fatality. The distribution of outbreak cases on monthly bases was
illustrated by using a graph made in the excel sheet and represented the frequency of
cattle infected with LSD .
Approval of study
Approval of the study was obtained from the scientific committee at the College of
Veterinary Medicine/Basrah University before commencement the study.
RESULTS
Socio-demographic characteristics of the owners
A total of 251 animal owners were interviewed in this survey. The age of the
respondents ranged from 18 to 82 years and the vast majority (98.4%) were males
(table 1). Regarding farmers’ level of education, 44% of the interviewed animal
owners completed their primary school, while 12% of them were never been in
school.
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Table 1. Sociodemographic characterisation of the interviewed owners regarding the
outbreak of LSD in Basrah (number of the owners were 251).
Factor Category Frequency Percentage (95% Confidence
interval)
Owner gender Male
Female
247
4
98.4 (96.0,99.6)
1.6 (0.4, 4.0)
Education level of
owners
Never been in school
Literacy only
Primary school
Secondary school
Tertiary
32
9
111
70
29
12.7 (8.8, 17.5)
3.6 (1.7, 6.7)
44.2 (38.0, 50.6)
27.9 (22.4, 33.9)
11.6 (7.9, 16.2)
Owner location (by
District)
Abu Alkasib
AL-Basrah
AL-Dyer
Al-Qurna
Shatt-Alarab
38
25
38
51
99
15.2 (11.0, 20.2)
10.0 (6.6, 14.4)
15.2 (11.0, 20.2)
20.3 (15.5, 25.8)
39.3 (33.2, 45.6)
Consequences of the outbreak of Lumpy skin disease in cattle
Of 329 cattle were reported infected with LSD, 60% (198/329) of these animals
with age ≤1 year and 40% (131/329) were >1 year (table 2). The accumulative
incidence was estimated to be 16.2%. The symptoms of sick animals with LSD
were recorded including displayed excessive skin nodules, enlarge lymph nodes,
lacrimation and nasal discharge, and conjunctivitis (figure 1).
Out of 329 cattle infected with LSD, only 36 were reportedly died and a case
fatality rate calculated to be 11% while the mortality rate measured at 2%. Male
case- fatality (16.9 %) was significantly higher (P. value was < 0.05) compared to
females (7.3%). Regarding animal age, no significance was observed between the
case fatality rates and age group with less/or equal one year and above one year (P.
value=0.1). Importantly, the abortion rate of the pregnancy cows which infected
with LSD was estimated at 10.5% during this outbreak events, as reported by
owners. Figure.2 illustrates the temporal pattern of LSD outbreak reported during
the period of this study. The month of March had been the highest proportion (52%)
of the infection with Lumpy skin disease were reported, but the number of cases
dramatically dropped to 8% from April to May.
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Table 2. Morbidity, abortion, and case-fatality rates as a result of LSD outbreak in
Basrah in cattle population.
Variables Category Frequency 95% Confidence
interval
Animal age ≤ 1 year
> 1 year
198
131
60.2 (53.0, 67.1)
39.8 (34.5, 45.3)
Animal sex Female
Male
205
124
62.3 (55.3, 69.0)
37.7 (29.2, 46.8)
Abortion status Aborted
Non-aborted
8
68
10.5 (4.7, 19.7)
89.5 (80.3, 95.3)
Case-fatality (within age group)
≤ 1 year
> 1 year
26
10
13.1 (8.8, 18.6)
7.6 (3.7, 13.6)
Case-fatality (within sex group)
Female
Male
21
15
16.9 (10.8, 24.7) *
7.32 (4.2, 11.8)
* Significant found using Pearson’s chi-square tests (P ≤ 0.05).
Figure 1. Clinical pictures of Lumpy skin disease in young and adult cattle shows
clear skin nodules displayed on the head, neck, and body.
Figure 1. Temporal pattern of LSD outbreak reported between the period
of December 2018 to May 2019.
0
50
100
150
200
Dec-18 Jenuary February March April May
Number of Infected cattle
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Association of risk factors with animal management and their practices
Throughout the questionnaire survey, only 21% of the owners reported the
presence of ticks on the infected cattle and half of them did not use any type of
insecticides for treatment (table 3). The majority of owners 91.6% (230/251) reported
they did not segregate the infected animal from rest of the herds. A very small
number of owners 2.4% (6/251) sold their infected animal with LSD to butchers/other
owners. Nearly, three-quarters of the owners reported 70.3% (179/251) usually allow
to graze their animals outside the farm average hours on a daytime (Semi-intensive
system adopted), while only 28.7% (72/251) of them restrictively feeding their
animals all the time at the barn yard (Intensive system adopted). Concerning housefarming
system, the majority of owners 80% (201/251) housed their animals as a
group and only a few 20% (50/251) keep the animal at the individual pens. More
importantly, the high majority of the owners 97.2% (244/251) reported they were not
received any vaccine before or during the outbreak to protect healthy animal from
LSD infection.
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Table 3. Association of animal management and practices factors with LSD in cattle
(number of the owners were 251).
DISCUSSION
In the current study, a face to face questionnaire survey was administrated
with 251 animal owners regarding LSD outbreak in Basrah province. The
questionnaire was also recorded the clinical symptoms of infected animals with LSD
veterinary practitioners, who were recruited in this study. From this perspective, the
clinical differential diagnosis of LSD was taken in consideration as may be caused
misclassification and misdiagnosed with other skin diseases, for instance ring worm,
dermatophilus infection, bovine herps mammilitis, photosensitization, insect bites,
Themes Category Frequency 95% Confidence
interval
Herd size Small (1-3 animal)
Medium (4-6 animal)
Large (7 above)
63
81
107
25.1 (19.9, 30.9)
32.3 (26.6, 38.5)
42.6 (36.4, 49.0)
Presence ticks on the
infected cattle
Yes
No
72
257
21.9 (17.5, 26.8)
78.1 (73.2, 82.5)
Use insecticide Yes
No
36
36
50.0 (38.0, 62.0)
50.0 (38.0, 62.0)
Last time was used an
insecticide
Before six months
Before one year
Cannot remember
5
15
16
14.0 (4.7, 29.6)
41.6 (25.5, 59.2)
44.4 (27.9, 61.9)
Segregate an infected
animal from the herd
Yes
No
21
230
8.4 (5.3,12.5)
91.6 (87.5, 94.7)
Distance were the infected
animal kept from the rest
of the herd
Less than 50 meters
100 meters or more
10
11
47.6 (25.7, 70.2)
52.4 (29.8, 74.3)
Sell any infected animal to
a butcher
Yes
No
6
245
2.4 (0.9, 5.1)
97.6 (94.9, 99.1)
Sell any infected animal to
another owner
Yes
No
16
235
6.4 (3.7, 10.2)
93.6 (89.8, 96.3)
Farming system adopted Intensive system
Semi-intensive system
179
72
71.3 (65.3, 76.8)
28.7 (23.2, 34.7)
Housing system adopted Animal housed as group
Animal housed in individual pen
201
50
80.1 (74.6, 84.9)
19.9 (15.1, 25.4)
Introduce an infected
animal with LSD to the
herd
Yes
No
7
244
97.2 (1.1, 5.7)
2.8 (94.3, 98.9)
Vaccinated used against
LSD
Yes
No
7
244
2.8 (1.1, 5.7)
97.2 (94.3, 98.9)
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urticaria, and demodectic manage. However, this study recorded the total of 329
cattle were severally infected with lumpy skin diseases. Geographically, Iraq as
known, has an important localization in the Middle East region and extensive border
with other countries, including Turkey and Syria from the north, Jordan from the
west, Iran from the east, and Saudi Arabia and Kuwait from the south. It has been
indicated that Lumpy skin disease was introduced to Iraq from other neighboring
countries by illegal transportation of animals as failure to control borders because of
influential political instability of Iraq (20). These factors may be linked and caused
widely distribution of this disease among other provinces of Iraq.
In the present study, the age distribution of the disease was found different, showing
that LSD occurred more frequently in the young cattle 60% (≤ 1 year) compared to
the adult cattle 40% (> 1 year). This result is in the line with the previous reports
indicated the higher frequency of the disease in the younger than older animals (23,24).
The better explanation of this finding, young animals could have acquired a low level
of maternal immunity which might be contributed to increase susceptibility of
infection with LSD (25). Management practices that aim to segregate young animals
from the herd might have contributed to reduce exposure risk of the susceptible to the
source of infection. In addition to that, the disease was observed highly frequent in
the female (62.3%) compared with male animals (37.7%). Similar to this finding was
also reported by Ayelet and Abate (26), showing the morbidity of LSD was higher in
females than male animals. This may be cows, especially those in lactating period
and milk production have stress factor and exhausted rather than attribution to the
biological reason (27).
Several factors including management practices and environmental conditions
could have contributed to the higher number of cases of LSD in cattle. Despite little
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owners whose animals were infested with ticks (21.9%) besides half of them had
never used any type of insecticides, which indeed we believe that there were various
types of biological vectors being a source of infection for the virus of LSD
transmission. For example, a study has been conducted in Israel ascertained that
Stomoxys calcitrans services as a potential vector for LSD transmission(28). Control of
mechanical vectors via using insecticides or repellents in agreement with the
environmental safety is considered one of the most important effective elements in
control programmes, aid to reduce an opportunity of the transmission of LSD amid
cattle populations.
The fewer number of owners admitted they did not separate the infected animal from
the rest of the herd. Neglecting isolation of the animal infected with LSD may be
posed a potential risk factor of transmitting the virus from an infected to the healthier
animals, especially if they were not immunized against this disease (29). Although the
congregation of animals share a similar watering troughs and feed bunks are of
significant association with increase the risk of LSD occurrence in animals, but the
disease is not considered a contagious disease as it is an inefficient pathway of the
transmission (23,30). Hence, the biosecurity preventive procedures are highly
recommended and encompass routine cleanliness and disinfection all types of fomites
that belongings to the animal farms, to prevent or at least minimize the probability of
transmission of the disease to the animals grazing nearby.
The intensive farming system is the most common farming system adopted
and announced by the cattle owners in this questionnaire. Keeping of the animals
under intensive care without grazing activities may be increased the risk of the
vectors to feed, multiply, and spread of infection within the herds (30-32). Within the
housing system, also the majority of owners 80% adopted housing animals as a
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group. Animal group rearing system includes intermingle all animals either from
different ages and species (pre-weaning, post-weaning, and adult), are more likely to
be increasing the risk of contracting with the disease infection. To elaborate
biosecurity of farming system, farmers need to be promoted their awareness toward
separation of young from adult animals through building an individual pen or
maternity private section in the barn. The advantage of the segregation of animals is
not only avoided overcrowding but also can maintain the hygienic level and reduce
the probability of infection even to the neonate’s calves (33).
Only three percent (3%) of cattle owners reported they vaccinated their animals
against LSD. This may be amount of vaccines were inadequately available or
capacity of the veterinary health discipline authority being less satisfied in the
response to the disease outbreaks. Although there is no specific treatment has been
used to treat the infected cattle from lumpy skin disease, ulceration lesion and
nodules can be treated with sprays and antibiotics to prevent secondary skin
infections and pneumonia. Also, an emergency mass vaccine has been recommended
to be the most effective control intervention utilizing an attenuated live Capripoxvirus
vaccine at least to prevent the spreading of this disease (34,35). Another disease control
program necessary to be established is a combination of the passive monitoring and
surveillance system which needs to continue over a period of time to deal with a new
incidence cases may be emerged.
The mortality in the present study was measured at 2% which is relatively
similar to mortality rates that were reported in Egypt and Jordan 1.8, 1.9%,
respectively (9,23). Besides, the cases fatality was estimated at 11% among the infected
animals. Previous epidemiological studies stated the cases fatality rate could be
varied between regions. For instance, the cases fatality in Jordan has been reported of
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7.5% (9), and in Iran has been reported of 19.7% (36). As regards, the mortality and
case fatality rates could be influenced by many exposure factors, including animal
breeding, immunological status of cattle, and population of the vectors (30,37).
Another important epidemiological finding in this study is that the abortion rate
reported at 10.5% in the pregnancy cow infected with LSD. This result is consistent
with Abdulqa, Rahman (38), who pointed out that the abortion rate in the infected
cattle with LSD can be reach to 10%. The current study raise possibility of occurring
vertical transmission when the virus can passed through the placenta and afterward
causes an inflammation (Placentitis) as similar as to the pathogenicity that caused by
other diseases, such as brucellosis and Rift Valley fever (39,40). Supporting to this
evidence, a descriptive study was performed by Rouby and Aboulsoud (5), who
indicated ability of the virus to be transferred from a cow to foetus through the intrauterine
route after isolated the virus from both placenta and stillbirth calve.
In respect to the number of LSD cases recorded in the present study, the
highest peak of infection was observed in the month of March. During this time of
the year, when turning to the winter season, temperature commonly in Iraq usually
falls to less than 20C0 and humidity is relatively higher. Concomitantly, climate
factors including humidity and temperature are considered to be a greater influential
factor influences upon abundance of insect populations which can enhances the
transmission of the disease in the susceptible animals (13,14,41).
In conclusion, Lumpy skin disease is an epizootic viral disease affected a large
number of cattle in Basrah province. The risk factors underlined in this study were
potentially associated with the outbreak of LSD in Basrah. Therefore, a vaccination
zone or ring vaccine campaigns are importantly needed to be implemented to flatten
the disease spreading occasionally from nearby provinces or neighbouring countries.
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In conjunction with vaccination, vectors control and animal quarantine policy are
additional important control measurements must to be sanctioned. Also, strict
quarantine policy and regulations must be imperatively considered to avoid
introducing asymptomatic infected cattle to Iraq, including banned illegal movement
of animals and testing imported animals at each entry border.
ACKNOWLEDGEMENTS
The authors would like to thank all veterinarians who greatly assisted us to
achieve administration the questionnaire survey. Also, we are deeply grateful to the
College of Veterinary Medicine in Basrah to allow us to set out this study in Basrah
province. The current study was not received any fund support.
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