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Mycoplasma conjunctivae infection

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Mycoplasma conjunctivae infection

Summary

  • Last modified
  • 09 November 2017
  • Datasheet Type(s)
  • Animal Disease
  • Preferred Scientific Name
  • Mycoplasma conjunctivae infection
  • Pathogens
  • Mycoplasma conjunctivae
  • Overview
  • Introduction


    Mycoplasma conjunctivae (Mconj) is the cause of infectious keratoconjunctivitis (IKC), or pink-eye, in domestic and wild...

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Pictures

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PictureTitleCaptionCopyright
Eye of sheep infected with infectious keratoconjunctivitis showing redness of the conjunctival mucosa, neovascularization and pannus.
TitleSymptoms - sheep
CaptionEye of sheep infected with infectious keratoconjunctivitis showing redness of the conjunctival mucosa, neovascularization and pannus.
CopyrightJohn B. Bashiruddin
Eye of sheep infected with infectious keratoconjunctivitis showing redness of the conjunctival mucosa, neovascularization and pannus.
Symptoms - sheepEye of sheep infected with infectious keratoconjunctivitis showing redness of the conjunctival mucosa, neovascularization and pannus.John B. Bashiruddin
Eye of an Alpine ibex (Capra I. Ibex) affected with infectious keratoconjunctivitis showing conjunctival hyperaemia, perilimbic neovascularization and mucous secretions.
TitleSymptoms - Alpine ibex
CaptionEye of an Alpine ibex (Capra I. Ibex) affected with infectious keratoconjunctivitis showing conjunctival hyperaemia, perilimbic neovascularization and mucous secretions.
CopyrightJohn B. Bashiruddin
Eye of an Alpine ibex (Capra I. Ibex) affected with infectious keratoconjunctivitis showing conjunctival hyperaemia, perilimbic neovascularization and mucous secretions.
Symptoms - Alpine ibexEye of an Alpine ibex (Capra I. Ibex) affected with infectious keratoconjunctivitis showing conjunctival hyperaemia, perilimbic neovascularization and mucous secretions.John B. Bashiruddin
Eye of an Alpine ibex (Capra i. Ibex) affected with infectious keratoconjunctivitis showing corneal oedema.
TitleSymptoms - Alpine ibex
CaptionEye of an Alpine ibex (Capra i. Ibex) affected with infectious keratoconjunctivitis showing corneal oedema.
CopyrightJohn B. Bashiruddin
Eye of an Alpine ibex (Capra i. Ibex) affected with infectious keratoconjunctivitis showing corneal oedema.
Symptoms - Alpine ibexEye of an Alpine ibex (Capra i. Ibex) affected with infectious keratoconjunctivitis showing corneal oedema.John B. Bashiruddin
Eye of an Alpine chamois (Rupicapra r. rupicapra) affected with infectious keratoconjunctivitis showing corneal opacity caused by cellular infiltration in response to damaged corneal epithelium
TitleSymptoms - Alpine chamois
CaptionEye of an Alpine chamois (Rupicapra r. rupicapra) affected with infectious keratoconjunctivitis showing corneal opacity caused by cellular infiltration in response to damaged corneal epithelium
CopyrightJohn B. Bashiruddin
Eye of an Alpine chamois (Rupicapra r. rupicapra) affected with infectious keratoconjunctivitis showing corneal opacity caused by cellular infiltration in response to damaged corneal epithelium
Symptoms - Alpine chamoisEye of an Alpine chamois (Rupicapra r. rupicapra) affected with infectious keratoconjunctivitis showing corneal opacity caused by cellular infiltration in response to damaged corneal epitheliumJohn B. Bashiruddin
Eye of an Alpine chamois (Rupicapra r. rupicapra) affected with infectious keratoconjunctivitis showing corneal scar after perforation.  Corneal ulceration occurs in severe cases and may lead to anterior synechia and melanin deposits forming staphyloma.
TitleSymptoms - Alpine chamois
CaptionEye of an Alpine chamois (Rupicapra r. rupicapra) affected with infectious keratoconjunctivitis showing corneal scar after perforation. Corneal ulceration occurs in severe cases and may lead to anterior synechia and melanin deposits forming staphyloma.
CopyrightJohn B. Bashiruddin
Eye of an Alpine chamois (Rupicapra r. rupicapra) affected with infectious keratoconjunctivitis showing corneal scar after perforation.  Corneal ulceration occurs in severe cases and may lead to anterior synechia and melanin deposits forming staphyloma.
Symptoms - Alpine chamoisEye of an Alpine chamois (Rupicapra r. rupicapra) affected with infectious keratoconjunctivitis showing corneal scar after perforation. Corneal ulceration occurs in severe cases and may lead to anterior synechia and melanin deposits forming staphyloma.John B. Bashiruddin
Eye of an Alpine chamois (Rupicapra r. rupicapra) affected with infectious keratoconjunctivitis with a muscadid fly, Hydrotaea irritans on the affected cornea.|Eye of an Alpine chamois (Rupicapra r. rupicapra) affected with infectious keratoconjunctivitis with Hydrotaea irritans on the affected cornea.
TitleAdult|Symptoms - Alpine chamois
CaptionEye of an Alpine chamois (Rupicapra r. rupicapra) affected with infectious keratoconjunctivitis with a muscadid fly, Hydrotaea irritans on the affected cornea.|Eye of an Alpine chamois (Rupicapra r. rupicapra) affected with infectious keratoconjunctivitis with Hydrotaea irritans on the affected cornea.
CopyrightJohn B. Bashiruddin
Eye of an Alpine chamois (Rupicapra r. rupicapra) affected with infectious keratoconjunctivitis with a muscadid fly, Hydrotaea irritans on the affected cornea.|Eye of an Alpine chamois (Rupicapra r. rupicapra) affected with infectious keratoconjunctivitis with Hydrotaea irritans on the affected cornea.
Adult|Symptoms - Alpine chamoisEye of an Alpine chamois (Rupicapra r. rupicapra) affected with infectious keratoconjunctivitis with a muscadid fly, Hydrotaea irritans on the affected cornea.|Eye of an Alpine chamois (Rupicapra r. rupicapra) affected with infectious keratoconjunctivitis with Hydrotaea irritans on the affected cornea.John B. Bashiruddin

Identity

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Preferred Scientific Name

  • Mycoplasma conjunctivae infection

International Common Names

  • English: conjunctivitis in sheep and goats; contagious conjunctivo-keratitis; contagious ophthalmia; contagious ovine ophthalmia; epidemic caprine keratoconjunctivitis; infectious caprine keratoconjunctivitis; infectious keratoconjunctivitis; infectious ovine keratoconjunctivitis; keratoconjunctivitis; kerato-conjunctivitis; mycoplasma conjunctivae keratoconjunctivitis in sheep and goats; ovine infectious keratoconjunctivitis; ovine keratoconjunctivitis; pink eye; pink-eye; pinkeye of sheep and goats
  • French: kératoconjonctivite

English acronym

  • ICK
  • IKC
  • IOK

Pathogen/s

Top of page Mycoplasma conjunctivae

Overview

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Introduction


Mycoplasma conjunctivae (Mconj) is the cause of infectious keratoconjunctivitis (IKC), or pink-eye, in domestic and wild ovine and caprine species (Jones et al, 1976; Giacometti et al, 1998), although M. arginini and Acholeplasma oculi have also been isolated from sheep with ocular infections (Leach, 1970; Arbuckle and Bonson, 1980). M. agalactiae, the classical cause of contagious agalactia, and some members of the M. mycoides cluster may also cause keratoconjunctivitis (Bergonier et al., 1997). Bacterial causes of the disease include Chlamydia and Rickettsia (Egwu, 1991). IKC is a localized inflammatory condition of the conjunctiva and cornea in domestic and wild small ruminants. In the early stages, the disease may present as a unilateral or bilateral conjunctivitis with hyperaemia of the vessels but untreated cases may progress to mucopurulent keratitis and corneal ulceration resulting in opaque or perforated corneas and transient blindness. IKC with M. conjunctivae may be exacerbated by exposure to sunlight. In Scotland it occurs most frequently in the autumn: black face and Cheviot ewes are equally susceptible (Hosie, 1989). M. conjunctivae may be isolated with some difficulty in most mycoplasma media; it ferments glucose but does not use arginine or urea (Jones et al., 1976). Topical or parenteral administration of tetracyclines has been recommended for treatment (Hosie, 1989) although a report by Waseem Shahzad et al. (2013) indicated topical treatment with a sterile solution of gentamycin at 100mg/ml was suitable in Pakistan.


History


Mycoplasmas from sheep and goats with naturally occurring IKC were characterised biochemically and serologically from samples obtained from two farms in Maryland, USA, in the late 1960s and found to be a different species. They were not related to any known mycoplasmas isolated from sheep and goats with IKC but were similar to some conjunctival strains from Australia and Canada and named M. conjunctivae (Surman, 1968; McCauley et al., 1971; Barile et al., 1972;). IKC progresses slowly and it was not considered economically important at the time. Although a causal relationship between M. conjunctivae and IKC was not firmly established, the disease was subsequently reproduced experimentally (Jones et al., 1976; Trotter et al., 1977; ter Laak et al., 1988; Dagwall, 1993). Further isolations from sheep and Swiss chamois and ibex revealed that the disease was more severe in wild animals in which it caused total blindness (Nicolet and Freundt, 1975; Mayer et al., 1996). The M. conjunctivae genome is 846,214 bases, it has a G+C content of 29% with an estimated 734 genes (Calderon-Copete et al., 2009).

Host Animals

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Animal nameContextLife stageSystem
Capra hircus (goats)Domesticated host
Ovis aries (sheep)Domesticated host

Hosts/Species Affected

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Experimentally, M. conjunctivae has been shown to infect sheep (Jones et al., 1976; van Halderen et al., 1994), goats (Trotter et al., 1977), Alpine ibex, (Capra ibex) (Giacometti et al., 1998) and European mouflon (Terrier, 1998). Sheep strains were infectious for ibex (Giacometti et al., 1998). M. conjunctivae has been isolated from cases of IKC in Alpine chamois (Rupicapra rupicapra) (Nicolet and Freundt, 1975; Degiorgis et al., 2000a), Pyrenean chamois (Rupricapra p. pyrenaica) (Arnal et al., 2013), mouflon (Terrier, 1998), and Himalayan thar (Hemitragus jemlahicus) (Belloy et al., 2001).

Systems Affected

Top of page skin and ocular diseases of small ruminants

Distribution

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IKC caused by M. conjunctivae is probably present worldwide (Jones, 1991), but the prevalence is not well known anywhere.

Distribution Table

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The distribution in this summary table is based on all the information available. When several references are cited, they may give conflicting information on the status. Further details may be available for individual references in the Distribution Table Details section which can be selected by going to Generate Report.

Pathology

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In acute cases of M. conjunctivae infection, the conjunctiva and cornea are infiltrated with large numbers of neutrophils and small numbers of plasma cells and lymphocytes. In one study the neutrophil count rose on the 1st day after inoculation, peaked 8 days afterwards, and decreased subsequently from day 13 to 25 when it was negligible (Dagnall, 1993). Cells scraped from the conjunctival fornix and stained by Giemsa show large numbers of uni-, bi- or tripolar bodies about 250-1100 µm in diameter closely associated with epithelial cells. Specific immufluorescence staining of such cells shows that these bodies are aggregations of M. conjunctivae.

In alpine ibex, the course of infection and pathogenesis (both clinically and histologically) seems to be more severe than in sheep. Mucopurulent and purulent discharges develop more rapidly and mononuclear infiltrates in conjunctival and limbic areas is more progressed. Vascularisation, ulceration and serious disruption of ocular structures are also more apparent (Mayer et al., 1997).

Diagnosis

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Clinical Diagnosis



Clinical diagnosis is made after the elimination of the existence of foreign bodies and entropions. The differential diagnoses include pine or cobalt deficiency, pasteurellosis, bluetongue and IKC caused by other mycoplasmas or Chlamydia spp.


Laboratory Diagnosis



Growth, Isolation and Biochemical Identification


Laboratory diagnosis is the only means of confirming the cause of IKC. Isolation of M. conjunctivae is more successful in the early stage of the disease because heavy bacterial contamination is usually found in chronic cases (Nicolet and Freundt, 1975). Although isolation is difficult and cumbersome, a variety of liquid and solid culture media such as Eaton’s (Nicholas and Baker, 1998), enriched PPLO broth (Difco, USA) (Giacometti et al., 1998), and commercially available mycoplasma media from Mycoplasma Experience (Reigate, UK) support its growth.

The type strain of M. conjunctivae is inhibited by digitonin, requires serum or cholesterol for growth, ferments glucose, does not hydrolyse arginine or urea, does not have phosphatase activity, reduces tetrazolium aerobically and anaerobically, does not digest serum, and does not produce film and spots (Barile et al., 1972). However, Dutch, Swiss and British strains of M. conjunctivae produce film and spots and reduce tetrazolium aerobically to a variable extent (ter Laak et al., 1988).


Growth Inhibition test


The growth inhibition (GI) test, where specific hyperimmune serum directly inhibits mycoplasma growth on solid media, and epifluorescence tests are probably the most popular test for the identification of M. conjunctivae (Bradbury, 1998; Poveda and Nicholas, 1998).


Serological tests


A direct fluorescent antibody test performed on fixed conjunctival scrapings has shown some success (Welchman, 1998).

Cross reactions with other mycoplasmas in particular M. ovipneumoniae have been seen in Western blots in sera from wild and domestic Caprinae (Grattarola et al., 1999; Degiorgis et al., 2000a). An indirect ELISA made with Tween-20 extracted antigens was developed that showed useful specificity and was used for the assessment of the prevalence of M. conjunctivae in domestic sheep (Belloy et al., 2001).


Molecular Diagnosis


A polymerase chain reaction (PCR) test based on the 16S rRNA genes has been used for the detection of M. conjunctivae from goats, sheep, ibex and chamois (Giacometti et al., 1999). This PCR with purified sample DNA and primers McoR1 and McoF1 was adequate for detection and rapid identification (Bashiruddin, 1998; Baker et al., 2001), however a nested PCR is probably necessary to achieve equivalent sensitivity to cultural methods (Giacometti et al., 1999). A PCR method using the 16S rDNA gene followed by the use of denaturing gradient gel electrophoresis has been able to detect and identify the majority of Mycoplasma species including M. conjunctivae (McAuliffe et al., 2005). Additionally a TaqMan rt-PCR based on the lppS gene is also used (Vilei et al., 2007).

List of Symptoms/Signs

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SignLife StagesType
Digestive Signs / Anorexia, loss or decreased appetite, not nursing, off feed Sign
General Signs / Fever, pyrexia, hyperthermia Sign
General Signs / Generalized weakness, paresis, paralysis Sign
General Signs / Lack of growth or weight gain, retarded, stunted growth Sign
General Signs / Orbital, periorbital, periocular, conjunctival swelling, eyeball mass Sheep & Goats:All Stages Sign
General Signs / Underweight, poor condition, thin, emaciated, unthriftiness, ill thrift Sign
General Signs / Weight loss Sign
Nervous Signs / Dullness, depression, lethargy, depressed, lethargic, listless Sign
Ophthalmology Signs / Anisocoria Sign
Ophthalmology Signs / Blepharospasm Sheep & Goats:All Stages Sign
Ophthalmology Signs / Blindness Sheep & Goats:All Stages Sign
Ophthalmology Signs / Chemosis, conjunctival, scleral edema, swelling Sheep & Goats:All Stages Sign
Ophthalmology Signs / Conjunctival, scleral, injection, abnormal vasculature Sheep & Goats:All Stages Sign
Ophthalmology Signs / Conjunctival, scleral, papules Sign
Ophthalmology Signs / Conjunctival, scleral, redness Sheep & Goats:All Stages Sign
Ophthalmology Signs / Corneal edema, opacity Sheep & Goats:All Stages Sign
Ophthalmology Signs / Corneal neovascularization, pannus Sheep & Goats:All Stages Sign
Ophthalmology Signs / Corneal ulcer, erosion Sheep & Goats:All Stages Sign
Ophthalmology Signs / Entropion, inverted eyelid Sheep & Goats:All Stages Sign
Ophthalmology Signs / Hypopyon, lipid, or fibrin, flare, of anterior chamber Sign
Ophthalmology Signs / Lacrimation, tearing, serous ocular discharge, watery eyes Sheep & Goats:All Stages Sign
Ophthalmology Signs / Microphthalmia, small globe, cornea, phthisis bulbi Sign
Ophthalmology Signs / Miosis, meiosis, constricted pupil Sign
Ophthalmology Signs / Photophobia Sign
Ophthalmology Signs / Purulent discharge from eye Sheep & Goats:All Stages Sign
Ophthalmology Signs / Synechia Sheep & Goats:All Stages Sign
Pain / Discomfort Signs / Ocular pain, eye Sheep & Goats:All Stages Sign

Disease Course

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Four clinical stages of disease are recognised in ovine and caprine IKC (and apply for both bacterial and mycoplasmal causes of ocular infections) (Egwu, 1991).

Stage 1: Hyperaemia of the palperbral and the bulbar conjunctival vessels, serous lachrymation, increased blinking and blepharospasm. The corneoscleral junction may show congestion prior to vascular migration (pannus) into the cornea. Most cases do not progress beyond this stage, but regress spontaneously.

Stage 2: Continuation of stage 1, characterised by corneal inflammation with blood vessels and pannus spreading from the corneoscleral margin. Early keratitis causes great irritation and, consequently, the blepahospasm and lachrymation are more obvious. Again spontaneous regression may occur.

Stage 3: Progress from stage 2, to a mucopurulent keratitis with extension of migrating blood vessels and a more purulent lachrymal discharge. Sometimes shallow corneal ulceration is apparent, which affects vision. These cases are very obvious and usually receive treatment.

Stage 4: A corneal ulcer develops and vision is lost. Pus may be present in the anterior chamber of the eye (hypopyon). These cases are slow to resolve, even with treatment. Corneal scarring may persist permanently following resolution. Lymphoid follicle hyperplasia causes the conjunctiva and third eyelid to appear granular and nodular.

Frequently, the disease is less severe in lambs and most cases do not progress through all stages described. Corneal ulceration also is rare in lambs. Relapses in treated and naturally recovering animals commonly occur in keratoconjunctivitis associated with mycoplasmas.

Epidemiology

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The main reservoirs of M. conjunctivae are populations of domestic sheep. In an infected sheep the organisms can persist for up to 23 weeks, even after clinical recovery (Janovsky et al., 2001). Therefore, domesticated sheep in which the agent is self-maintained, are sometimes considered as reservoirs also for wild animals (Giacometti et al., 2002; Belloy et al., 2003; Egwu et al., 1989). Transmission from animal to animal is presumed to be by physical contact. One study recorded few contacts between wild and domestic animals in the Swiss Alps, and in this case the observation of Muscidid flies from the genera Hydrotaea, Musca, Morellia and Polietes frequenting infected eyes led to the suggestion of a possible role of these flies as vectors of M. conjunctivae (Giacometti et al., 2002). Another study observed that short-distance encounters between free-ranging individuals of different domestic and wild Caprinae species, are not uncommon events in the Alps (Degiorgis, 1998). In a study of wild Caprinae with and without clinical signs of infectious keratoconjunctivitis Mavrot et al. (2012) concluded that the mycoplasma load was significantly lower in eyes from healthy carriers; therefore the presence and severity of signs are related to the quantity of M. conjunctivae in the eyes.

Impact: Economic

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The economic evaluation of IKC is difficult because of the variability of the clinical manifestations. At tupping time the occurrence of IKC was reported to reduce twining and induce toxaemia in affected ewes and temporarily reduce growth in lambs (Axelsen, 1961). Blindness, either unilateral or bilateral, leading to the accidental suffocation with placenta, or trampling of lambs, starvation, weight-loss, death or drowning of adult animals are among the losses ascribed to M. conjunctivae infection. The cost of treatment is probably the most significant economic loss (König, 1983; Hosie, 1988). M. conjunctivae-causing IKC has most severe consequences from blindness for wild chamois and ibex; a welfare concern for conservationists.

Disease Treatment

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The use of corticosteroids is contra-indicated in keratitis especially where ulceration is present because it often antagonises rather than complements ocular defence mechanisms. Ophthalmic preparation of 350 mg of chlortetracycline twice a day for 3 days may eliminate M. conjunctivae. A single intramuscular dose of long-acting oxytetracycline may be used to supplement topical therapy or given on its own (König, 1983; Hosie and Greig, 1989).

References

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Akerstedt J; Hofshagen M, 2004. Bacteriological investigation of infectious keratoconjunctivitis in Norwegian sheep. Acta Veterinaria Scandinavia, 45(1-2):19-26.

Arbuckle JBR; Bonson MD, 1980. The isolation of Acholeplasma oculi from an outbreak of ovine keratoconjunctivitis. Veterinary Record, 106(1):15.

Arnal M; Herrero J; Fe Cde la; Revilla M; Prada C; Martínez-Durán D; Gómez-Martín Â; Fernández-Arberas O; Amores J; Contreras A; García-Serrano A; Luco DFde, 2013. Dynamics of an Infectious Keratoconjunctivitis outbreak by Mycoplasma conjunctivae on Pyrenean chamois Rupicapra p. pyrenaica. PLoS ONE, 8(4):e61887. http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0061887

Axelsen A, 1961. Effect of contagious ophthalmia of multiple lambing and sheep liveweight. Australian Veterinary Journal, 37:60-62.

Baker SE; Bashiruddin JB; Ayling RD; Nicholas RAJ, 2001. Molecular detection of Mycoplasma conjunctivae in English sheep affected by infectious keratoconjunctivitis. Veterinary Record, 148(8):240-241; 14 ref.

Barile MF; Del Giudice RA; Tully JG, 1972. Isolation and characterization of Mycoplasma conjunctivae sp. n. from sheep and goats with keratoconjunctivitis. Infection and Immunity, 5:70-76.

Bashiruddin JB, 1998. Extraction of DNA from mycoplasmas. In: Miles R, Nicholas R, eds. Methods in Molecular Biology, Vol. 104. Mycoplasma Protocols. Totowa, New Jersey, USA: Humana Press, 141-144.

Belloy L; Giacometti M; Abdo El-M; Nicolet J; Krawinkler M; Janovsky M; Bruderer U; Frey J, 2001. Detection of specific Mycoplasma conjunctivae antibodies in the sera of sheep with infectious keratoconjunctivitis. Veterinary Resarch, 32:155-164.

Belloy L; Janovsky M; Vilei EM; Pilo P; Giacometti M; Frey J, 2003. Molecular epidemiology of Mycoplasma conjunctivae in Caprinae: transmission across species in natural outbreaks. Applied and Environmental Microbiology, 69(4):1913-1919.

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Dagnall GJR, 1993. Experimental infection of the conjunctival sac of lambs with Mycoplasma conjunctivae. British Veterinary Journal, 149(5):429-435; 13 ref.

Degiorgis MP, 1998. Infektiöse Keratokonjunktivitis bei Alpensteinbock (Capra ibex ibex), Gemse (Rupicapra r. rupicapra) und Schaf (Ovis ammon f. dom.) - Beiträge zur Aetiologie, Immunologie und Epidemiologie. Dissertation Faculty of Veterinary Medicine, University of Berne, Berne, Switzerland.

Degiorgis MP; Abdo EM; Nicolet J; Frey J; Mayer D; Giacometti M, 2000a. Immune response to infections of M. conjunctivae in alpine ibex, alpine chamois, and domestic sheep in Switzerland. Journal of Wildlife Disease, 36:265-271.

Degiorgis MP; Frey J; Nicolet J; Abdo EM; Fatzer R; Schlatter Y; Reist S; Janovsky M; Giacometti M, 2000. An outbreak of infectious keratoconjunctivitis in Alpine chamois (Rupicapra r. rupicapra) in Simmental-Gruyères, Switzerland. SAT, Schweizer Archiv für Tierheilkunde, 142(9):520-527; 34 ref.

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Giacometti M; Nicolet J; Frey J; Krawinkler M; Meier W; Welle M; Johansson K-E; Degiorgis M-P, 1998. Susceptibility of alpine ibex to conjunctivitis caused by inoculation of a sheep strain of Mycoplasma conjunctivae. Veterinary Microbiology, 61:279-288.

Giacometti M; Nicolet J; Johansson KE; Naglic T; Degiorgis MP; Frey J, 1999. Detection and identification of Mycoplasma conjunctivae in infectious keratoconjunctivitis by PCR based on the 16S rRNA gene. Journal of Veterinary Medicine. Series B, 46(3):173-180; 23 ref.

Grattarola C; Frey J; Abdo EM; Orusa R; Nicolet J; Giacometti M, 1999. Mycoplasma conjunctivae infections in chamois and ibexes affected with keratoconjunctivitis in the Italian alps. Veterinary Record, 145:588-589.

Halderen Avan; Rensburg WJJvan; Geyer A; Vorster JH, 1994. The identification of Mycoplasma conjunctivae as an aetiological agent of infectious keratoconjunctivitis of sheep in South Africa. Onderstepoort Journal of Veterinary Research, 61(3):231-237; 12 ref.

Hosie BD, 1988. Keratoconjunctivitis in a hill sheep flock. Veterinary Record, 122(2):40-43.

Hosie BD, 1989. Infectious keratoconjunctivitis in sheep and goats. Veterinary Annual, 29:93-97; 15 ref.

Hosie BD; Greig A, 1995. Role of oxytetracycline dihydrate in the treatment of mycoplasma-associated ovine keratoconjunctivitis in lambs. British Veterinary Journal, 151(1):83-88.

Janovsky M; Frey J; Nicolet J; Belloy L; Goldschimidt-Clermont E; Giacometti M, 2001. Mycoplasma conjunctivae infection is self-maintained in the Swiss domestic sheep population. Veterinary Microbiology, 83:11-22.

Jones GE, 1991. Infectious keratoconjunctivitis. Diseases of sheep., 280-283; 12 ref.

Jones GE; Foggie A; Sutherland A; Harker DB, 1976. Mycoplasmas and ovine keratoconjunctivitis. Veterinary Record, 99:137-141.

Konig CDW, 1983. 'Pink eye' or 'zere oogjes' or Keratoconjunctivis Infectiosa Ovis (KIO). Clinical efficacy of a number of antimicrobial therapies. Veterinary Quarterly, 5:122-127.

Laak EAter; Schreuder BEC; Kimman TG; Houwers DJ, 1988. Ovine keratoconjunctivitis experimentally induced by instillation of Mycoplasma conjunctivae.. Veterinary Quarterly, 10(4):217-224; 17 ref.

Langford EV, 1971. Mycoplasma and associated bacteria isolated from ovine pink-eye. Canadian Journal of Comparative Medicine, 35:18-21.

Leach RH, 1970. The occurrence of Mycoplasma arginini in several animal hosts. Veterinary Record, 87:319-320.

Mavrot F; Vilei EM; Marreros N; Signer C; Frey J; Ryser-Degiorgis MP, 2012. Occurrence, quantification, and genotyping of Mycoplasma conjunctivae in wild caprinae with and without infectious keratoconjunctivitis. Journal of Wildlife Diseases, 48(3):619-631. http://www.jwildlifedis.org/content/48/3/619.full

Mayer D; Degiorgis MP; Meier W; Nicolet J; Giacometti M, 1997. Lesions associated with infectious keratoconjunctivitis in alpine ibex. Journal of Wildlife Diseases, 33:413-419.

Mayer D; Nicolet J; Giacometti M; Schmitt M; Wahli T; Meier W, 1996. Isolation of Mycoplasma conjunctivae from conjunctival swabs of alpine ibex (Capra ibex ibex) affected with infectious keratoconjunctivitis. Journal of Veterinary Medicine. Series B, 43(3):155-161; 29 ref.

McAuliffe L; Ellis RJ; Lawes JR; Ayling RD; Nicholas RAJ, 2005. 16S rDNA PCR and denaturing gradient gel electrophoresis; a single generic test for detecting and differentiating Mycoplasma species. Journal of Medical Microbiology, 54(8):731-739.

McCauley EH; Surman PG; Anderson DR, 1971. Isolation of Mycoplasma from goats during an epizootic of keratoconjunctivitis. American Journal of Veterinary Research, 32:861-870.

Motha MXJ; Frey J; Hansen MF; Jamaludin R; Tham KM, 2003. Detection of Mycoplasma conjunctivae in sheep affected with conjunctivitis and infectious keratoconjunctivitis. New Zealand Veterinary Journal, 51(4):186-190.

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