Avian Cholera (Fowl Cholera) in Poultry: Etiology, Clinical Signs, and Control
Introduction
Avian cholera, also known as fowl cholera, is a highly contagious bacterial disease of domestic and wild birds caused by Pasteurella multocida [1, 2, 3]. The disease manifests in peracute, acute, and chronic forms and is responsible for significant economic losses in poultry production worldwide [4, 3, 5]. Mortality can reach 100% in susceptible flocks, particularly in slow-growing broiler chickens and turkeys [6, 3]. This article provides a detailed review of the etiology, epidemiology, clinical signs, pathology, diagnostic approaches, treatment options, and control measures for fowl cholera in poultry, with emphasis on recent molecular and immunological advances.
Etiology: Fowl Cholera Is Caused by Which Bacteria
Fowl cholera is caused by the Gram-negative, non-motile, facultative anaerobic coccobacillus Pasteurella multocida [1, 7, 8]. The bacterium is classified into five capsular serogroups (A, B, D, E, F) and 16 lipopolysaccharide (LPS) genotypes based on the Heddleston scheme [8, 9]. In poultry, serogroup A (especially A:1, A:3, and A:4) is most frequently isolated, although serogroups B and D have also been reported [5, 10, 11]. The complete genome sequences of multiple P. multocida isolates have been published, revealing extensive genomic diversity and the presence of virulence-associated genes such as kmt1, toxA, fhaB1, hyaD, and LPS outer core transferase genes (pcgD, hptE) [12, 8, 13, 14].
The bacterium produces a polysaccharide capsule that inhibits phagocytosis and a lipopolysaccharide that triggers a strong inflammatory response [1, 15]. Key virulence factors include filamentous hemagglutinin (FhaB1), which mediates adhesion to host epithelial cells, and the enzyme hyaluronidase (HyaD), which degrades hyaluronic acid in connective tissues and facilitates bacterial dissemination [12, 13]. The LPS outer core structure is critical for full virulence; truncation of the outer core attenuates the bacterium in ducks [16, 14]. Phase variation in glycosyltransferase genes can alter LPS structure and contribute to immune evasion during outbreaks [9].
Epidemiology
P. multocida is carried asymptomatically in the nasopharynx of many healthy birds and mammals, serving as a reservoir for transmission [17, 18]. Outbreaks often occur following stress factors such as overcrowding, poor ventilation, nutritional deficiencies, or concurrent infections (e.g., Mycoplasma gallisepticum) [6, 4]. Transmission occurs via direct contact with infected birds, inhalation of aerosolized respiratory droplets, or ingestion of contaminated feed and water [4, 17]. Fomites, equipment, and personnel can also mechanically spread the bacterium [4].
The disease has a global distribution and affects chickens, turkeys, ducks, geese, and numerous wild bird species [3, 5, 17, 11]. In Bangladesh, multidrug-resistant P. multocida type B:2 has been reported in fowl cholera outbreaks, highlighting the need for region-specific control strategies [10]. In Australia, sequence type ST20 is widespread in poultry farms and can infect wild waterbirds, indicating potential spillover events [17].
Avian Cholera Transmission to Humans
Pasteurella multocida is primarily an animal pathogen, but zoonotic transmission to humans can occur through bites, scratches, or direct contact with infected birds or their secretions [7, 18]. Human infections typically manifest as localized wound infections, cellulitis, or, rarely, respiratory disease [7]. However, avian cholera is not considered a major public health concern, and human cases are sporadic [18]. The risk is elevated for immunocompromised individuals and poultry workers [7].
Clinical Signs
The clinical presentation of fowl cholera varies with the virulence of the strain, host species, and route of infection [3, 19]. Three main forms are recognized:
- Peracute form: Sudden death with no premonitory signs. Mortality can reach 100% within 24–48 hours [3, 19]. This form is common in highly susceptible flocks, such as slow-growing broilers and turkeys [6, 3].
- Acute form: Fever (up to 44°C), depression, anorexia, ruffled feathers, mucoid or bloody diarrhea, increased respiratory rate, and cyanosis of the comb and wattles [3, 15, 20]. Swelling of the wattles and sinuses is characteristic [3]. Mortality peaks within 3–5 days [4].
- Chronic form: Localized infections including swollen joints (arthritis), sternal bursitis, conjunctivitis, and torticollis due to otitis media [3, 20]. Chronic cases are more common in flocks with partial immunity or following subacute outbreaks [20].
In ducks, liver injury mediated by inflammatory, apoptotic, and autophagic pathways has been described [15]. In broilers, P. multocida induces liver pyroptosis through the MAPK-NLRP3-GSDMD signaling pathway [1].
Pathology
Gross lesions in acute fowl cholera include petechial hemorrhages on the heart, epicardium, and serosal surfaces; multifocal hepatic necrosis (small, pale foci); splenomegaly; and pulmonary congestion [1, 3, 15]. The liver may appear friable and mottled [1]. In chronic cases, caseous exudate is found in the wattles, joints, and sinuses [3].
Histopathological examination reveals hepatocellular necrosis, infiltration of heterophils and macrophages, and fibrin thrombi in hepatic sinusoids [1, 15]. In the lungs, interstitial pneumonia and congestion are common [6]. The MAPK-NLRP3-GSDMD pathway mediates pyroptosis in broiler hepatocytes, characterized by caspase-1 activation and gasdermin D cleavage [1]. In ducks, autophagy and apoptosis contribute to liver injury [15].
Diagnostics
Definitive diagnosis of fowl cholera requires isolation and identification of P. multocida from affected tissues (liver, spleen, bone marrow, or exudate) [3, 21, 19]. The bacterium grows on blood agar or MacConkey agar (weak growth) as small, gray, mucoid colonies [19]. Gram staining reveals Gram-negative coccobacilli with bipolar staining (safety pin appearance) [19].
Molecular methods offer rapid and specific detection. Conventional PCR targeting the kmt1 gene is widely used [7, 21]. Loop-mediated isothermal amplification (LAMP) assays provide a field-deployable alternative with sensitivity comparable to PCR [21]. Real-time PCR and whole-genome sequencing are employed for epidemiological typing and antimicrobial resistance gene profiling [2, 8, 18].
Serological diagnosis using indirect ELISA kits has been developed for detecting antibodies against P. multocida in chickens [22]. These assays are useful for monitoring vaccine responses and herd immunity [22, 23, 24].
The following diagnostic workflow summarizes the recommended approach:
flowchart TD
A[Clinical suspicion: sudden death, fever, cyanosis], > B[Postmortem examination: petechiae, liver necrosis]
B, > C[Sample collection: liver, spleen, bone marrow, wattle exudate]
C, > D[Gram stain: bipolar coccobacilli]
D, > E[Culture on blood agar: mucoid colonies]
E, > F[Biochemical identification: oxidase+, catalase+]
F, > G[PCR: kmt1 gene detection]
G, > H[Serotyping: capsular and LPS typing]
H, > I[Antimicrobial susceptibility testing]
I, > J[Confirm outbreak and guide treatment]
Treatment
Antimicrobial therapy is the mainstay of treatment for acute fowl cholera. Historically, tetracyclines, sulfonamides, and penicillin derivatives have been used [2, 7]. However, multidrug resistance is increasingly reported, particularly against tetracycline, sulfonamides, and aminoglycosides [2, 7, 10]. Resistance genes such as tet(H), blaROB-1, and strA-strB have been identified in avian isolates [2, 7].
Antimicrobial susceptibility testing is essential to guide therapy [2]. In cases of confirmed resistance, alternative agents such as fluoroquinolones or florfenicol may be considered, although resistance to these has also emerged [2, 7]. Phage therapy using lytic bacteriophages (e.g., vB_PmuM_CFP3) has shown promise as an alternative or adjunct to antibiotics [25]. Probiotic formulations containing multiple Lactobacillus and Bacillus strains have reduced mortality in broilers experimentally infected with P. multocida [26]. Plant extracts, such as wild Egyptian artichoke extract, have demonstrated in vitro antibacterial activity against P. multocida [27].
Control and Prevention
Control of fowl cholera relies on biosecurity, management practices, and vaccination [4, 28, 5]. Biosecurity measures include all-in-all-out production, cleaning and disinfection of facilities, control of rodents and wild birds, and quarantine of new stock [4, 17].
Vaccination
Both inactivated (bacterin) and live attenuated vaccines are available [29, 28, 5, 30]. Inactivated vaccines are commonly used in commercial poultry and are often adjuvanted with aluminum hydroxide or oil emulsions [28, 23, 30]. Novel vaccine approaches include:
- Subunit vaccines: Recombinant lipoproteins such as PlpE and VacJ, and outer membrane protein H, have shown immunoprotective effects in chickens and ducks [23, 31, 32, 33, 34]. Multi-epitope proteins incorporating PlpE epitopes enhance immunogenicity [23].
- Outer membrane vesicle (OMV) vaccines: E. coli-derived OMVs displaying PlpE protein induce strong antibody responses [31].
- Gamma-irradiated vaccines: Irradiated whole-cell vaccines formulated with various adjuvants elicit both humoral and cell-mediated immunity [24, 35].
- Hydrogel-based vaccines: Gel 01 hydrogel inactivated vaccine provides sustained antigen release and improved protection [28].
- Live attenuated vaccines: Serial passage-derived strains (e.g., PMZ8 in ducks) show reduced virulence and good immunogenicity [29].
Vaccination strategies should be tailored to the prevalent serotypes and local epidemiological conditions [5, 10]. In Bangladesh, for example, type B:2 is common, and vaccines should include this serotype [10].
Fowl Cholera Meaning in Bengali
In Bengali, fowl cholera is commonly referred to as "মুরগির কলেরা" (murgir cholera), reflecting the disease's clinical similarity to human cholera (diarrhea and rapid death) [10]. The term is used in veterinary extension materials and outbreak reports in Bangladesh [10].
Conclusion
Avian cholera remains a major threat to poultry health worldwide. Advances in genomics, immunology, and vaccine technology have improved our understanding of P. multocida pathogenesis and host responses [1, 2, 15, 18]. Integrated control programs combining biosecurity, antimicrobial stewardship, and effective vaccination are essential to reduce the impact of this disease [4, 5, 30]. Continued surveillance of antimicrobial resistance and genomic diversity will inform future control strategies [2, 7, 10].
References
[1] Yan D, Xu G, Cheng Y, et al. Pasteurella multocida causes liver pyroptosis in broilers through the MAPK-NLRP3-GSDMD signaling pathway. Vet Microbiol. 2026. https://pubmed.ncbi.nlm.nih.gov/42139792/
[2] Miao F, Dai B, Li Z, et al. Antimicrobial resistance and genomic characteristics of avian Pasteurella multocida. Poult Sci. 2026. https://pubmed.ncbi.nlm.nih.gov/41637789/
[3] Miller I, Jerry C, Nguyen V, et al. 100% Mortality in Commercial Slow-Growing Broiler Chickens with Acute Fowl Cholera. Avian Dis. 2025. https://pubmed.ncbi.nlm.nih.gov/40643942/
[4] Malek A. Dynamics of cholera transmission in poultry farm: insights from a compartmental model and control strategies. Br Poult Sci. 2026. https://pubmed.ncbi.nlm.nih.gov/40960429/
[5] Semmate N, Bamouh Z, Elkarhat Z, et al. Isolation and Characterization of Pasteurella multocida A from an Outbreak in Turkeys in Morocco and Vaccine Preparation and Evaluation. Avian Dis. 2025. https://pubmed.ncbi.nlm.nih.gov/40643939/
[6] Gornatti-Churria CD, Jerry C, Ramsubeik S, et al. High mortality in a commercial turkey flock associated with coinfection by Pasteurella multocida and Mycoplasmoides (Mycoplasma) gallisepticum. J Vet Diagn Invest. 2026. https://pubmed.ncbi.nlm.nih.gov/40996859/
[7] El-Tarabili RM, Enany ME, Alenzi AM, et al. Unveiling resistance patterns, kmt1 sequence analyses, virulence traits, and antibiotic resistance genes of multidrug-resistant Pasteurella multocida retrieved from poultry and rabbits. Sci Rep. 2025. https://pubmed.ncbi.nlm.nih.gov/39948418/
[8] Hashish A, Johnson TJ, Ghanem M, et al. Complete genome sequences of eight Pasteurella multocida isolates representing all lipopolysaccharide outer core loci. Microbiol Resour Announc. 2024. https://pubmed.ncbi.nlm.nih.gov/39365089/
[9] Omaleki L, Blackall PJ, Cuddihy T, et al. Phase variation in the glycosyltransferase genes of Pasteurella multocida associated with outbreaks of fowl cholera on free-range layer farms. Microb Genom. 2022. https://pubmed.ncbi.nlm.nih.gov/35266868/
[10] Saha O, Islam MR, Rahman MS, et al. First report from Bangladesh on genetic diversity of multidrug-resistant Pasteurella multocida type B:2 in fowl cholera. Vet World. 2021. https://pubmed.ncbi.nlm.nih.gov/34840474/
[11] Xiao J, Li Y, Hu Z, et al. Characterization of Pasteurella multocida isolated from ducks in China from 2017 to 2019. Microb Pathog. 2021. https://pubmed.ncbi.nlm.nih.gov/34534643/
[12] Dassanayake RP, Briggs RE, Kaplan BS, et al. Pasteurella multocida filamentous hemagglutinin B1 (fhaB1) gene is not involved with avian fowl cholera pathogenesis in turkey poults. BMC Vet Res. 2025. https://pubmed.ncbi.nlm.nih.gov/40140814/
[13] Gao P, Wang L, Wang S, et al. The activity of hyaD contributed to the virulence of avian Pasteurella multocida. Microb Pathog. 2024. https://pubmed.ncbi.nlm.nih.gov/38960217/
[14] Zhao X, Shen H, Liang S, et al. The lipopolysaccharide outer core transferase genes pcgD and hptE contribute differently to the virulence of Pasteurella multocida in ducks. Vet Res. 2021. https://pubmed.ncbi.nlm.nih.gov/33663572/ *** Disclaimer: This article is for educational and informational purposes only. It is not intended to substitute for professional veterinary advice, diagnosis, treatment, or regulatory guidance. Always consult a licensed veterinarian or qualified specialist regarding animal health, disease diagnosis, and therapeutic decisions.
[15] Cai Q, Li Y, Chang YF, et al. Pasteurella multocida causes liver injury in ducks by mediating inflammatory, apoptotic and autophagic pathways. Microb Pathog. 2023. https://pubmed.ncbi.nlm.nih.gov/37683832/
[16] Zhao X, Yang F, Shen H, et al. Immunogenicity and protection of a Pasteurella multocida strain with a truncated lipopolysaccharide outer core in ducks. Vet Res. 2022. https://pubmed.ncbi.nlm.nih.gov/35236414/
[17] Allen JL, Bushell RN, Noormohammadi AH, et al. Pasteurella multocida ST20 is widespread in Australian poultry farms and may infect wild waterbirds. Vet Microbiol. 2024. https://pubmed.ncbi.nlm.nih.gov/38228079/
[18] Smith E, Miller E, Aguayo JM, et al. Genomic diversity and molecular epidemiology of Pasteurella multocida. PLoS One. 2021. https://pubmed.ncbi.nlm.nih.gov/33822782/
[19] Shalaby AG, Bakry NR, El-Demerdash AS. Virulence attitude estimation of Pasteurella multocida isolates in embryonated chicken eggs. Arch Microbiol. 2021. https://pubmed.ncbi.nlm.nih.gov/34554268/
[20] Kannaki TR, Priyanka E, Haunshi S. Research Note: Disease tolerance/resistance and host immune response to experimental infection with Pasteurella multocida A:1 isolate in Indian native Nicobari chicken breed. Poult Sci. 2021. https://pubmed.ncbi.nlm.nih.gov/34217907/
[21] Poussard M, Pant SD, Huang J, et al. Comparative evaluation of PCR and loop-mediated isothermal amplification (LAMP) assays for detecting Pasteurella multocida in poultry. N Z Vet J. 2025. https://pubmed.ncbi.nlm.nih.gov/39448061/
[22] Beyene D, Shite A, Getachew B. Development and optimization of in-house made indirect ELISA kit for the detection of antibodies against Pasteurella multocida in chicken. BMC Immunol. 2026. https://pubmed.ncbi.nlm.nih.gov/41724974/
[23] Xiang X, Sun Y, Zhang H, et al. Evaluation of immunoprotective effects of PlpE multi-epitope protein incorporated within the aluminum hydroxide-adjuvanted inactivated vaccine against Pasteurella multocida infection in chickens. Poult Sci. 2025. https://pubmed.ncbi.nlm.nih.gov/40561824/
[24] Belay E, Bitew M, Ibrahim SM, et al. Gamma-irradiated fowl cholera vaccines formulated with different adjuvants induced antibody response and cytokine expression in chickens. Front Immunol. 2025. https://pubmed.ncbi.nlm.nih.gov/40103817/
[25] Chen H, Jiang N, Fu G, et al. Characterization and Potential Application of Phage vB_PmuM_CFP3 for Phage Therapy Against Avian Pasteurella multocida. Animals (Basel). 2024. https://pubmed.ncbi.nlm.nih.gov/39595321/
[26] Reuben RC, Sarkar SL, Ibnat H, et al. Novel multi-strain probiotics reduces Pasteurella multocida induced fowl cholera mortality in broilers. Sci Rep. 2021. https://pubmed.ncbi.nlm.nih.gov/33903662/
[27] Wahdan A, Elsebai MF, Elhaig MM, et al. Innovative use of wild Egyptian artichoke extract to control fowl cholera in vitro. Vet World. 2025. https://pubmed.ncbi.nlm.nih.gov/40182829/
[28] Chen J, Sun Y, Hu Y, et al. Evaluation of the immunoprotective effect of gel 01 hydrogel inactivated vaccine against Pasteurella multocida infection in chickens. Microb Pathog. 2025. https://pubmed.ncbi.nlm.nih.gov/40934985/
[29] Ji X, Meng Y, Yang H, et al. Attenuation mechanisms and vaccine potential of the serial passage-derived Pasteurella multocida strain PMZ8 in ducks. Poult Sci. 2026. https://pubmed.ncbi.nlm.nih.gov/41747463/
[30] Ghadimipour R, Ghorbanpoor M, Gharibi D, et al. Effects of Selected Adjuvants on Immunogenicity and Protectivity of Pasteurella multocida Bacterin Vaccine in Chickens. Arch Razi Inst. 2021. https://pubmed.ncbi.nlm.nih.gov/35096310/
[31] Li Y, Chen L, Xiao J, et al. Immunoprotective efficacy of Escherichia coli-derived outer membrane vesicles displaying PlpE protein of Pasteurella multocida. Vaccine. 2025. https://pubmed.ncbi.nlm.nih.gov/39603075/
[32] Chung YC, Cheng LT, Chu CY, et al. Flagellin Enhances the Immunogenicity of Pasteurella multocida Lipoprotein E Subunit Vaccine. Avian Dis. 2024. https://pubmed.ncbi.nlm.nih.gov/39400212/
[33] Cheng LT, Chu CY, Vu-Khac H, et al. Signal sequence contributes to the immunogenicity of Pasteurella multocida lipoprotein E. Poult Sci. 2023. https://pubmed.ncbi.nlm.nih.gov/36423524/
[34] Li Y, Xiao J, Chang YF, et al. Immunogenicity and protective efficacy of the recombinant Pasteurella multocida lipoproteins VacJ and PlpE, and outer membrane protein H from P. multocida A:1 in ducks. Front Immunol. 2022. https://pubmed.ncbi.nlm.nih.gov/36275745/
[35] Dessalegn B, Bitew M, Asfaw D, et al. Gamma-Irradiated Fowl Cholera Mucosal Vaccine: Potential Vaccine Candidate for Safe and Effective Immunization of Chicken Against Fowl Cholera. Front Immunol. 2021. https://pubmed.ncbi.nlm.nih.gov/34917086/