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Bovine Petechial Fever

(Ondiri Disease)


Basil O. Ikede

, DVM, PhD, Faculty of Veterinary Medicine, University of Ibadan, Nigeria

Reviewed/Revised Apr 2021 | Modified Oct 2022

Bovine petechial fever is caused by the rickettsia Ehrlichia ondiri and affects cattle and some species of wildlife in the highlands of Kenya and Tanzania. Clinical signs include intermittent fever, depression, decreased milk production, and petechial hemorrhage affecting mucous membranes. Diagnosis is based on clinical signs and can be confirmed by histopathologic evaluation. Treatment with antimicrobials may be successful if started early in the course of disease.

Bovine petechial fever is a rickettsiosis of cattle characterized by high fever, hemorrhage, and edema. Its occurrence has been confirmed in the highlands of Kenya and Tanzania at altitudes >5,000 ft (1,500 m), although it is considered likely to also occur in neighboring countries with similar topography. The importance of bovine petechial fever lies in its threat to the development of dairy farming in the highlands of eastern Africa; however, no outbreak has been reported in recent decades.

Etiology and Epidemiology of Bovine Petechial Fever

Bovine petechial fever is caused by Ehrlichia ondiri, an intracellular rickettsia that resides in cytoplasmic vacuoles of circulating leukocytes. The organism can multiply after experimental infection in cattle, sheep, goats, bushbuck, duiker and impala antelopes, Thomson’s gazelles, wildebeest; and hence, probably in most domestic and wild ruminants. E ondiri is believed to be endemic in wild ruminants, particularly bushbuck; sporadic infection spreads to domestic cattle grazing forest edges or bush lands (scrubs).

The disease is restricted to scrub or forest edge areas that have heavy shade, a thick litter layer that provides high relative humidity, and a resident population of bushbuck and duiker antelopes, the two wild ruminant species believed to be the main reservoir and amplifying hosts. It is seen sporadically throughout the year in imported breeds of cattle. Breeds native to Kenya, such as Zebu (Bos indicus) are more resistant to infection. The method of disease transmission is not known. As for other rickettsial infections, an arthropod vector is suspected; however, extensive attempts to implicate ticks, biting insects, and mites have failed.

Pathogenesis of Bovine Petechial Fever

The route of infection with E ondiriis not known; however, the organism can be seen in circulating granulocytes (neutrophils and eosinophils) and monocytes while cattle are ill and in the spleen at necropsy. Electron microscopic studies have shown that E ondiri can also infect endothelial and Kupffer cells of the liver, and may also be detected in capillary lumens in the heart. It is believed that E ondiri initially multiplies in the spleen, with subsequent spread to other regions of the body. Damage to the vascular endothelium would explain the petechial hemorrhage and edema, as for many other rickettsial infections.

Clinical Findings of Bovine Petechial Fever

Bovine petechial fever is characterized by a high, fluctuating fever, signs of depression, decreased milk production, and widespread petechial hemorrhages affecting mucous membranes. Fever develops after an incubation period of 4–14 days, animals 2–3 days later most animals appear depressed with petechiae on mucous membranes, particularly the ventral surface of the tongue and the vaginal mucosa. The petechiae enlarge over several days and then resolve as the animal begins to recover. Marked conjunctival edema and hemorrhage (“poached egg eye”) are characteristic in some severe cases. The conjunctivae are swollen and everted surrounding a turgid and protruding eyeball, and there may be blood in the aqueous humor. Pregnant cows can abort, likely due to the high fever.

The mortality rate in untreated cases can be as high as 50% in imported animals or animals newly introduced to affected areas. Latent infections develop after recovery in some animals, including in bushbuck. After recovery, affected cattle are immune against experimental infection for ~2 years.


Typically, initial marked eosinopenia and lymphopenia occur, followed by equally pronounced neutropenia. Anemia is characteristically a sequela, and organisms are evident in Giemsa-stained smears of blood and splenic tissue samples. At necropsy, widespread serosal and mucosal hemorrhages and edema are accompanied by lymphoid hyperplasia. Organs frequently affected include the heart, GI tract from the forestomach to the colon, including the liver and gallbladder; the kidneys and urinary bladder. The edema is characterized by gelatinous fluid in the connective tissue, lymph nodes, and abomasum. No characteristic histologic abnormalities have been described, but there is vascular proliferation with prominent endothelial swelling and mild mononuclear infiltration.

Diagnosis of Bovine Petechial Fever

  • Based on history and clinical signs; confirmed by histopathologic examination of necropsy samples

  • Definitive diagnosis requires identification of Ehrlichia ondiri in blood smears or tissue samples

In areas where bovine petechial fever is endemic, a history of movement to forest edge areas, coupled with clinical signs and postmortem lesions, allows for a presumptive diagnosis. Definitive diagnosis requires demonstration of the causal organism in Giemsa-stained smears of blood or spleen or by electron microscopy. E ondiri appears blue with Giemsa stain and can be seen as small bodies (diameter, 0.4 mcm), larger bodies (diameter, 1–2 mcm), groups of small and large bodies, and groups or morulae of small bodies. Organisms are present in cytoplasmic vacuoles, most commonly in neutrophils. Tissue suspensions (spleen) can also be inoculated into susceptible cattle or sheep. Blood smears from the recipient animal should be evaluated daily for up to 10 days, at which time E ondiri should be detectable in neutrophils.

Treatment and Control of Bovine Petechial Fever

  • Experimental cases suggest that dithiosemicarbazone or tetracyclines might be successful, if started early

Dithiosemicarbazone and tetracyclines have been used successfully to treat experimental cases early in the disease course but are ineffective in advanced cases. The former is suggested to be more effective. In endemic areas, the disease can be prevented by avoiding areas associated with previous cases. However, this may not always be practical.

Key Points

  • Bovine petechial fever is a rickettsial infection affecting cattle in the highlands of Kenya and Tanzania.

  • The organism is endemic in some species of wildlife, primarily bushbuck antelopes; however, no outbreaks have been reported in recent decades.

  • Experimental data suggest that treatment with dithiosemicarbazone or tetracyclines can be successful, if started early.

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