The North American Veterinary Conference – 2007
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BACTERIAL AND VIRAL DISEASES OF Aeromonas
SNAKES This is a facultatively anaerobic, straight, gram-
negative rod, 0.3–1.0 µm in diameter and 1.0–3.5 µm in
length. It occurs singly, in pairs, or short chains and is
Peter Holz, BVSc, DVSc, MACVSc, Diplomate ACZM
motile by a single polar flagellum. Aeromonas is found
Healesville Sanctuary
worldwide, in water and soil. It can cause diarrhea and
Healesville, Victoria, Australia
wound infections in humans.
In snakes Aeromonas commonly causes mouth rot or
BACTERIA
ulcerative stomatitis. This is a disease of the oral cavity
Salmonella
that often begins as gingival petechial hemorrhages. If
These are facultatively anaerobic, straight, gram-
untreated the disease progresses to ulceration, tooth
negative rods, 0.7–1.5 µm in diameter and 2.0–5.0 µm in
loss, the appearance of caseous material in the oral
length. Motility is by peritrichous flagella. They are found
cavity and, finally, osteomyelitis of the maxilla and
worldwide, in water, soil, and the intestinal tract of
mandibles. Death results from septicemia. Internally,
numerous animal species including reptiles. Salmonella
hemorrhages are present in multiple organs and foci of
can cause gastroenteritis and septicemia in humans.
necrosis are spread throughout the liver. Transmission is
Most infections are asymptomatic in snakes. When
through the soil, water and by the mite, Ophionyssus
disease does occur symptoms are extremely variable
natricis.
including anorexia, bloody regurgitation, necrotic
Diagnosis is by culturing the organism from infected
stomatitis, subcutaneous abscesses, pneumonia, and
tissues. It grows well on ordinary media at either 20ºC or
sudden death. Lesions described at necropsy include
37ºC.
hepatitis, splenitis, pancreatitis, nephritis, pneumonitis,
Cases of stomatitis are treated with local
tracheitis, serositis, enteritis, gastritis, epicarditis, and
debridement and application of disinfectants such as
myocarditis. Granulomas can occur in multiple organs.
chlorhexidine. In severe cases systemic antibiotics are
Transmission is through the water, soil, and feces of
required.
animals that are infected and shedding the organism.
The organism is ubiquitous in the environment,
Salmonella survive in the environment for long
particularly in organic matter. There is some debate over
periods of time, particularly if moisture is present.
whether the organism is a part of the normal flora of the
Optimum growth occurs at 35 to 37ºC, but can occur
oral cavity. Disease likely occurs in debilitated or
between 6.7 and 45ºC. The pH for multiplication ranges
stressed animals. Prevention focuses on good
from 4.1 to 9.0.
husbandry practices, eliminating the snake mite, and
Diagnosis requires isolation and culture of the
good enclosure hygiene.
organism. However, this is complicated by the fact that
Salmonella is found in the gut of normal snakes. To
Pseudomonas
make a diagnosis of primary salmonellosis the affected
This is an aerobic, straight or slightly curved, gram-
snake must have compatible lesions with isolation of
negative rod, 0.5–1.0 µm in diameter and 1.5–5.0 µm
organisms from those lesions. Often Salmonella are
in length. Motility is by one or several polar flagella. It is
secondary pathogens causing disease in a debilitated or
found worldwide in water and soil. There is some debate
compromised individual.
over whether the organism is a part of the normal flora of
As reptiles are generally asymptomatic carriers of
the oral cavity.
salmonella treatment is not warranted. Treatment with
Clinical signs are similar to those seen with
antibiotics may stop shedding of the organism but is
Aeromonas infection. Pseudomonas also commonly
unlikely to clear it from the body. High rates of resistance
invades damaged skin, particularly in cases of burns.
are present to gentamicin, naladixic acid, novobiocin,
This leads to necrosis and sloughing of affected skin.
cephalothin, kanamycin, ampicillin, streptomycin and the
Transmission is through soil and water. The
sulfa drugs.
organism can be cultured from affected tissue at 27ºC to
All reptiles should be viewed as carrying Salmonella.
30ºC on sheep blood agar or MacConkey’s agar.
It is not feasible to treat animals with antibiotics in order
Treatment and prevention are as for Aeromonas. One
to eradicate the organism, as this may encourage the
study found that water acidified to a pH of 2.5 had lower
development of resistance. The main risk is not to the
levels of Pseudomonas than water at a higher pH.
animal but to the humans coming in contact with the
animal. With this in mind recommendations to decrease
Mycobacteria
the risk of human infection include avoiding contact with
Mycobacteriosis is caused by a group of bacteria
reptiles for immunocompromised people and people less
which are gram-positive, aerobic or facultatively
than 5 years of age, not allowing reptiles or reptile
anaerobic rods that form filaments in culture. The cell
equipment to come in contact with food preparation
wall is rich in lipids that are resistant to decolourization
areas or food utensils, not eating, drinking, or smoking
by acidified organic solvents ie, acid fast. Many different
while handling reptiles, and washing hands thoroughly
species have been isolated from cases of disease in
after handling as soap rapidly inactivates Salmonella.
snakes. These include M. avium, M. schlangen, M.
tropidonotus, M. marinum, M. thamnopheos and M.
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xenopi. These bacteria are found in soil, salt water, fresh weight loss and lethargy do. Affected snakes commonly
water, dust and can also be found living as commensals develop secondary diseases such as necrotic stomatitis,
in healthy snakes. pneumonia, and necrotising dermatitis.
Human infections generally occur through abraded or Histologically, eosinophilic intracytoplasmic inclusion
damaged skin leading to a localised granuloma, usually bodies are found in multiple organs. In boas inclusions
on the hand or fingers. M. avium can cause respiratory are most common in the kidney, pancreas and liver, but
disease in humans. can be found in any organ. Pythons usually have
Affected snakes may be found dead with no clinical inclusions in the central nervous system. Snakes with
signs. More commonly they show vague nonspecific neurological disease have a nonsuppurative
signs such as anorexia, lethargy, and emaciation. If meningoencephalitis with perivascular cuffing. Other
spinal involvement occurs the snake may present with lesions include exocrine pancreatic atrophy and
neurological abnormalities or spinal fractures. The necrosis, hepatocyte degeneration, renal tubular
chronic form of the disease develops over several necrosis, and lymphoid depletion. There is often a
months. Grossly multiple granulomas are spread through marked lymphocytosis.
a variety of organs. The most common primary sites in Transmission is unknown at present, but could
snakes are the liver, spleen, and gut. Secondary involve the mite, Ophionyssus natricis. The virus has
involvement commonly occurs in the lung, bone, and been found in faeces, and could be vertically
skin. Bone involvement produces osteomyelits, transmitted.
diskospondylitis, and pathologic fractures. Skin lesions No serological test is currently available. Clinical
present as well circumscribed subcutaneous nodules. signs are suggestive. A blood sample may reveal
Histologically granulomas often have a central core of inclusion bodies in the leucocytes or erythrocytes and a
caseation surrounded by mononuclear cells. In the later marked lymphocytosis. However, due to lymphoid
stages fibroplasia occurs. Acid-fast organisms are visible depletion, this is transitory and will return to normal with
within the granulomas. time. Biopsy of the oesophageal tonsils, liver, kidney, or
Transmission is by contact with organisms in the stomach lining can be performed to look for inclusion
environment. Mycobacteria have been found to remain bodies. However, as the number and distribution of
infectious in soil for up to 7 years. Ante mortem inclusions is variable this test is not very sensitive.
diagnosis is difficult unless granulomas are present in There is no treatment. Prevention is difficult as the
the skin or radiography detects osseous lesions. At route of transmission and incubation periods are
necropsy granulomas spread through multiple organs is unknown. Preliminary work indicates possible
highly suggestive of mycobacteriosis. A presumptive transmission by feces, vertically, and by the mite,
diagnosis can be made by finding acid-fast organisms Ophionyssus natricis, necessitating good mite control.
within the granulomas, but culture is required for a Quarantine recommendations range from 30 days to six
definitive diagnosis. months. However, there is an anecdotal report of
Treatment is generally unsuccessful. Because disease in a snake which had been kept isolated for
mycobacteria exist in the environment and healthy 10 months. Recommended disinfectants are sodium
snakes can carry the organisms disease occurs if the hypochlorite (bleach) and chlorhexidine.
animal is stressed or debilitated in some way. Prevention
focuses on providing optimal husbandry and appropriate Paramyxovirus
management practices. Gluteraldehyde and phenolics This is an enveloped RNA virus with a diameter of
are appropriate disinfectants to use against 120 to 150 µm. Paramyxovirus has been isolated from
mycobacteria. all snake families but crotalids appear to be the most
susceptible.
VIRUSES Clinical signs are variable, but the respiratory tract is
Inclusion Body Disease a target. In the peracute form the affected snake may
Inclusion body disease (IBD) is caused by a virus simply be found dead with no previous signs. Acutely
averaging 110 nm in diameter that morphologically affected snakes may display anorexia, regurgitation,
resembles C-type particles of the family Retroviridae. It respiratory signs including gaping and blood or a
is mainly a disease of boids but has also been brownish discharge emerging from the glottis, and,
diagnosed in kingsnakes and palm vipers. terminally, neurologic signs such as convulsions. Snakes
In boas IBD is a slowly progressive disease affected chronically generally present with anorexia,
developing over several months. The first signs are regurgitation, emaciation, poor muscle tone, and
regurgitation, occurring about a week after feeding. This lethargy. Over a period of several months they may
is followed by anorexia, weight loss, and lethargy. develop respiratory signs, diarrhea, and neurologic
Terminally, neurologic signs such as head tremor, signs.
mydriasis, disorientation, incoordination, stargazing, Grossly, blood and caseous material is present in the
opisthotonus, and loss of the righting reflex appear. In lung and airways. The lung is often thickened and
pythons neurologic signs are more pronounced, edematous. Multiple foci of necrosis and granulomas
occurring over a few weeks. Signs are similar to those may be present throughout the liver. Pancreatic
seen terminally in boas and include a flaccid ascending hyperplasia often occurs in crotalids. Histologically the
paralysis. Regurgitation does not occur, but anorexia, lung is full of macrophages, exudate and cellular debris.
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The North American Veterinary Conference – 2007
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Epithelial cells undergo hypertrophy, hyperplasia and Tennessee, and the Texas State Diagnostic Laboratory.
metaplasia. Intracytoplasmic inclusion bodies are A minimum of 0.2 mL of plasma is required.
occasionally detected within these cells. Pulmonary Seroconversion takes approximately 8 weeks. Antibody
septa are thickened with oedema fluid and infiltrated with levels decline after approximately 6 months. A single
mixed inflammatory cells. Giant cells are occasionally positive result is indicative of exposure only. To
seen. If the pancreas is grossly enlarged then demonstrate recent infection a greater than twofold
hyperplasia of acinar cells and terminal duct epithelium increase in titre needs to be demonstrated.
can be detected microscopically. Occasionally There is no treatment. Snakes should be quarantined
demyelination, degeneration of axon fibers, and for a minimum of 90 days. Good mite control is
ballooning of axon sheaths occurs in the brainstem and important. If possible, the hemagglutination-inhibition
upper spinal cord. test should be used to determine exposure. Sodium
Transmission is by aerosol and through faeces. The hypochlorite is an effective disinfectant to clean cages
mite, Ophionyssus natricis, has also been implicated as that have contained infected snakes. Recent work has
a possible vector. demonstrated seroconversion in western diamondback
Diagnosis is based on finding the histological lung rattlesnakes when treated with a killed paramyxovirus
changes described above. It is also possible to culture vaccine. However, results were variable and transient,
virus from affected tissue and an immunoperoxidase seventeen of the 18 snakes having become
stain is available. A hemagglutination-inhibition test is seronegative 296 days after vaccination.
available through the University of Florida, University of
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