Sunday, December 13, 2009

Update from Haiti!

Haiti is currently facing an outbreak of Teschen Disease in its pigs. This is like polio for pigs. It is NOT contagious to humans but humans can spread the disease. As a volunteer travelling in Haiti you do risk accidently bringing this disease back to the USA if you are not careful. Therefore it is important that you wash your hands well after handling animals or soil. I carry disinfectant wipes with me since soap and water are not always easy to find. I also clean and disinfect my shoes if I think I may have been in contact with a contaminated area. I always do this the night before I leave Haiti and again when I get home. All my travel clothes go straight into the washing machine.
I am not telling you this to discourage you or to make you paranoid. As a veterinarian working with FTF in Haiti for 3 years, I have my hands literally in lots of diseases. I am also a farmer in California which makes me a high risk traveler and a potential threat to our food chain and my personal farm business. None of us wants to accidently be the point person who starts an epidemic. Luckily a little precaution goes a long way.
As an FTF volunteer in agriculture you will likely be asked about this disease by many Haitians. Here is some advice you can pass on that may help them get through this difficult impact to their economy and their food supply.
In Creole this disease is called Ren Casse or broken kidneys. The symptoms are as follows: Initially the pig may go off its feed and be a little depressed for a day or two. After that it may be fine with a good appetite and normal temperature. The pig then partially loses the use of its back legs. This may progress to its thighs, then rear end of its body and become a total paralysis. Severe cases are irreversible and the pigs die within a week.
There currently is no vaccine available because it has not been seen in Haiti in the last 15 years. It started in the Artibonite valley. It is suspected that it came in on a ship. I have been told that it will take a year before a vaccine can be available if at all. The incubation period is about 2 weeks. Isolation will protect the pigs but will be difficult in the long run as the virus spreads. Not all the pigs will die. The survivors will become resistant and the epidemic will pass. The big problem is that all the pigs are susceptible because it has been so long since the last infection. The good news is that it is not contagious to humans and the meat is safe to eat. What is a big problem is that the water used to wash the intestines out and rinse the meat is contaminated and will infect the area where it is dumped and infect more pigs. It is very important that this water not be fed to pigs, especially piglets who are just weaned.
It is of no value to treat the animals with antibiotics since it is a virus. Instead spend the money on feeding the pigs really well and keeping them clean. Give them lots of water and make sure it is not already contaminated. This will hopefully keep their exposure levels low so they only have a mild case and can then become resistant. Good nutrition will keep their immune systems strong. If they have parasites, worming them will help, but is best done before they get sick. Don't breed any sows while the disease is in the neighborhood as pregnancy makes them more susceptible. Once it has passed they may cautiously start breeding again. Most of the piglets will have some immunity from the mother’s colostrum and maternal antibodies, but will be susceptible to a mild form of the disease after weaning. Hygiene is thus very important at this point. After this they are resistant. These animals will then help rebuild the pig herds.
Here is some more information:
Please feel free to contact me with any new information or questions.
Good luck and happy holidays,


  1. Dr. Keith Flanagan and Dr. Kelly Crowdis of IICA, both veterinarians in Port au Prince, Haiti and Dr. Max Millien, the head veterinarian of the Department of Agriculture in Haiti are working to address the current epidemic of Teschen Disease.Patience is required. In the meantime it is important to keep the pigs as clean as possible and as well nourished as possible to keep their immune systems strong.

  2. Hello all,

    I did contact Dr. Max Millien (the head Veterinarian in Haiti and director of Animal Health with the Ministry of Agriculture). He response was if we can find a source of vaccine, that would be Fantastic! Anyone who has more information should also contact Dr. Millien. I am also copying this email to him.
    The Ministry was contacted in March 2009 about pigs dying that didn't fit any of the diseases we have had in the past. The complaint was "renn kase" (down in the lower back). The pigs that I first saw in March were showing a variety of neurological signs including ascending paralysis in the hind legs. A senior vet student from Tufts who was here at the time did some reading and it fit Teschens disease to a "T". However we couldn't figure out (and still can't) where it came from. It probably started in the St.Marc (maybe a ship docked there) area and spread up the Artibonite valley. From there it has spread to most of the departments. Dr. Millien decided right away that we needed to send samples to the US and get a diagnosis. With a great contact at Plum Island (Dr. Ming Deng) we were able to get approval to ship samples. A team from the Ministry of Ag and IICA took both serum samples from recovering pigs and postmortem tissue samples. Within a week of the samples being sent, Plum Island and Ames Iowa had a virus isolate of an enterovirus/teschovirus and the diagnosis was made from both the samples and the symptoms as a teschovirus. USDA and FAO personnel have visited Haiti.(since FAO was involved in the outbreak in Madagascar, Dr. Millien also contacted them). FAO has been searching for vaccine, but have not yet found exactly what we might need. Most companies who made the vaccine quit making it more than 15 years ago when the disease somewhat died out on it's own in Eastern Europe. We have also talked about producing vaccine either in Cuba or in the DR. That would take some money and time to get things going. We know that the disease is on the Haiti-DR border, but the last I talked with DR officials, they didn't believe it had jumped the border. They have increase surveillance along the border, but since it is so open, it is just a matter of time.
    The big question is whether a vaccine from somewhere else will be effective against the strain we have here in Haiti. The USDA, IICA, and FAO people should be able to help us determine that. They have been extremely helpful! Also I want to commend Dr. Millien and his staff for the quick and professional response to this disease. The problem is that now we have hit a brick wall with no vaccine available and no treatment. With nursing care, some of the pigs will recover. It is hard to know the real mortality as many of the sick pigs are butchered before they die. This is not a zoonotic threat, but we are discouraging people from selling the meat. Usually the meat is "washed' before cooking and the water is often given to other pigs, thus spreading the disease even more. I believe that people trying to treat these animals are probably part of the problem of spreading it, as they often go house to house looking at pigs. Education and discouraging the movement of pigs is probably the best recourse we have at this time. Strict isolation is the best preventative!
    Again, any input you have, especially for a source of vaccine would be greatly appreciated and don't forget to copy Dr. Millien.

    Keith Flanagan DVM
    Veterianry Programs Coordinator
    Inter-American Institute for Cooperation on Agriculture/Haiti