Fowl Pox and Mycoplasma Gallisepticum Vaccine Considerations in Poultry

Introduction

Fowl pox, caused by fowlpox virus (FWPV), a member of the genus Avipoxvirus within the family Poxviridae, remains a globally significant disease of poultry, leading to substantial economic losses through decreased egg production, retarded growth, and mortality [76]. Concurrently, Mycoplasma gallisepticum (MG) is a major respiratory pathogen of chickens and turkeys, responsible for chronic respiratory disease and significant economic impact [63, 65]. The development of effective vaccination strategies against both pathogens is a cornerstone of modern poultry health management. A particularly innovative approach involves the use of recombinant fowlpox virus (rFPV) as a live vector to deliver protective antigens from MG and other avian pathogens, offering the potential for dual protection from a single vaccine [1, 2, 3]. This article provides a detailed, technical review of the biological, immunological, and diagnostic considerations surrounding FWPV and MG vaccines, with a focus on recombinant vector technologies.

Fowlpox Virus: Virology and Pathogenesis

FWPV is a large, enveloped, double-stranded DNA virus with a genome size of approximately 260-310 kbp [4, 5, 6]. The virus replicates entirely within the cytoplasm of infected cells, a characteristic feature of poxviruses [6]. The genome encodes numerous proteins involved in immune evasion, host range determination, and viral replication [7, 8]. Complete genome sequencing of field and vaccine strains has revealed significant genetic diversity, with strains classified into clades A, B, and C, with most FWPV isolates belonging to clade A, subclade A1 [5, 9, 7, 74]. The presence of integrated reticuloendotheliosis virus (REV) sequences within the FWPV genome is a common finding, particularly in field isolates, and can influence viral pathogenicity and vaccine safety [10, 11, 12, 13, 14, 15, 16, 107, 149].

Transmission of FWPV occurs through mechanical vectors, primarily mosquitoes (e.g., Culex and Aedes spp.), and through direct contact with infected birds or contaminated fomites [104, 121]. The virus enters through skin abrasions or via the respiratory epithelium [76]. Clinically, fowl pox manifests in two forms: the cutaneous form, characterized by proliferative nodular lesions on unfeathered skin (comb, wattle, eyelids), and the diphtheritic form, involving fibronecrotic lesions on the mucous membranes of the upper respiratory tract and oral cavity [76, 80, 143]. Atypical manifestations, including severe respiratory involvement and systemic infection, have been increasingly reported, often associated with co-infections with REV or other immunosuppressive agents [17, 16, 84].

Mycoplasma gallisepticum: Pathogenesis and Immunity

MG is a cell-wall-less bacterium belonging to the class Mollicutes [63]. It colonizes the respiratory epithelium of chickens and turkeys, causing ciliostasis, inflammation, and exudation, leading to tracheitis, airsacculitis, and sinusitis [61, 63]. The organism's primary adhesin, GapA, and other cytadherence-related proteins (e.g., PvpA) are critical for host cell attachment and are key targets for protective immunity [62]. The host immune response to MG infection involves both humoral and cell-mediated components, with local IgA and systemic IgG antibodies playing a role in protection, alongside a Th1-biased cellular response [61]. Chronic infection can lead to significant economic losses due to reduced egg production, increased feed conversion ratios, and increased condemnations at processing [63, 65].

Vaccine Platforms for Fowlpox Virus

Live-Attenuated Fowlpox Vaccines

Traditional FWPV vaccines are live-attenuated viruses propagated on the chorioallantoic membrane (CAM) of embryonated chicken eggs or in cell culture systems such as chicken embryo fibroblasts (CEF) or duck embryo fibroblasts (DEF) [67, 68, 78, 82, 96, 105]. These vaccines are typically administered via the wing-web stab method, which induces a localized "take" reaction characterized by swelling and scab formation at the inoculation site, indicative of a successful immune response [67, 86, 106]. The safety and efficacy of these vaccines depend on the degree of attenuation, the viral titer, and the absence of contaminating agents, particularly REV [11, 67, 149]. Cell culture-adapted vaccines offer advantages in terms of production scalability, cost-effectiveness, and reduced risk of extraneous contamination compared to CAM-propagated vaccines [67, 68, 78, 81, 94]. However, outbreaks of fowl pox in vaccinated flocks have been reported, potentially due to the emergence of antigenically divergent field strains, insufficient vaccine coverage, or immunosuppression [18, 13, 19, 20, 74, 101].

Recombinant Fowlpox Virus Vector Vaccines

The large genome of FWPV allows for the insertion and expression of multiple heterologous genes, making it an ideal vector for the development of multivalent vaccines [2, 3, 76]. Recombinant fowlpox virus (rFPV) vaccines have been constructed to express protective antigens from a wide range of avian pathogens, including Newcastle disease virus (NDV), infectious laryngotracheitis virus (ILTV), infectious bursal disease virus (IBDV), avian influenza virus (AIV), and MG [1, 21, 22, 23, 24, 25, 26, 102]. The use of rFPV vaccines offers several advantages: they can differentiate vaccinated from infected animals (DIVA) when appropriate diagnostic tests are used, they are generally stable and safe, and they can induce both humoral and cell-mediated immune responses [2, 3]. The immune response to rFPV vaccines involves the activation of CD4+ and CD8+ T cells, as well as the production of specific antibodies [27, 28, 29, 30]. The choice of promoter, insertion site, and the inclusion of cytokine adjuvants (e.g., chicken IL-18, IL-2) can significantly influence the immunogenicity of the vectored antigen [22, 25, 144].

Vaccine Platforms for Mycoplasma gallisepticum

Live-Attenuated Mycoplasma gallisepticum Vaccines

Several live-attenuated MG vaccines are commercially available, including the F-strain, ts-11, and 6/85 strains [1, 31, 32]. These vaccines are typically administered via eye drop, spray, or drinking water to pullets before the onset of lay [1]. The F-strain vaccine is known to be more virulent than ts-11 or 6/85 and can persist in the flock, potentially causing disease in susceptible birds [1]. The ts-11 and 6/85 strains are more attenuated and provide good protection against respiratory disease and egg production losses [31, 32]. The mechanism of protection involves the induction of local and systemic antibody responses, as well as cell-mediated immunity [61]. A key challenge with live MG vaccines is the difficulty in differentiating vaccinated birds from those naturally infected using standard serological tests, although molecular methods such as mismatch amplification mutation assays (MAMA) have been developed to distinguish vaccine strains from field isolates [58].

Bacterins and Recombinant Mycoplasma gallisepticum Vaccines

Inactivated MG vaccines (bacterins) are also available and are often used in layers and breeders to reduce egg production losses [32, 66]. Bacterins induce a strong humoral immune response but are less effective at stimulating local mucosal immunity and cell-mediated responses compared to live vaccines [32, 66]. More recently, recombinant vaccines, including those delivered by viral vectors (e.g., rFPV) or bacterial vectors (e.g., recombinant Salmonella), have been developed [1, 33, 102]. These platforms offer the potential for improved safety, DIVA capability, and the induction of broader immune responses.

Recombinant Fowlpox Virus Expressing Mycoplasma gallisepticum Antigens

The construction of an rFPV vaccine expressing MG antigens represents a significant advancement in poultry vaccinology [1, 102]. This approach combines the proven safety and immunogenicity of the FWPV vector with the specific protective antigens of MG. The rFPV-MG vaccine is typically administered in ovo or to day-old chicks, providing early protection against both fowl pox and MG [1]. A comparative study evaluated the efficacy of a commercial rFPV-MG vaccine against commercially available F-strain live MG vaccines in layer pullets [1]. The study assessed vaccine safety, immune response, and protection against MG challenge. The rFPV-MG vaccine demonstrated a favorable safety profile and induced specific antibody responses against both FWPV and MG [1]. Protection against MG challenge, as measured by reduced airsacculitis lesions and MG re-isolation, was comparable to or better than that provided by the F-strain vaccine [1]. This dual-protection strategy simplifies vaccination schedules and reduces labor costs associated with multiple vaccine administrations.

Diagnostic Considerations for Vaccine Monitoring

Effective vaccination programs require robust diagnostic tools to monitor vaccine take, immune response, and to differentiate vaccine from field strains.

Detection of Fowlpox Virus

Molecular detection of FWPV is primarily achieved through polymerase chain reaction (PCR) targeting conserved genes such as the P4b core protein gene [34, 35, 69, 72, 74, 93, 100, 141]. Multiplex PCR assays have been developed for the simultaneous detection of FWPV, ILTV, and REV [35]. Real-time PCR and isothermal amplification methods, such as multienzyme isothermal rapid amplification (MIRA), offer rapid and sensitive detection [36]. Whole-genome sequencing provides the highest resolution for strain identification and epidemiological investigations [4, 5, 37, 38, 39]. Serological monitoring of FWPV vaccination can be performed using agar gel immunodiffusion (AGID) or enzyme-linked immunosorbent assay (ELISA) [68, 139, 142]. The presence of a "take" reaction at the wing web is a practical indicator of vaccine take in the field [67, 86, 106].

Detection of Mycoplasma gallisepticum

MG detection relies on culture, serology, and molecular methods. Culture is slow and requires specialized media, but it remains a reference standard [63]. Serological tests, including the rapid serum agglutination (RSA) test, hemagglutination inhibition (HI) test, and commercial ELISA kits, are widely used for flock screening [60, 63]. PCR, including real-time PCR and multilocus sequence typing (MLST), provides rapid and specific detection and genotyping of MG strains [58, 59, 64]. The MAMA PCR assay is specifically designed to differentiate the ts-11 vaccine strain from field isolates [58]. For rFPV-MG vaccines, DIVA strategies rely on the detection of antibodies to MG antigens that are not expressed by the vaccine vector, or on the molecular detection of the vaccine-specific FWPV backbone.

Vaccine Safety and Adverse Events

The safety of live viral vaccines, including FWPV and MG vaccines, is a primary concern [40, 67]. Potential adverse events include residual virulence, reversion to virulence, immunosuppression, and contamination with extraneous agents [40, 149]. The integration of REV into FWPV vaccines has been a documented safety issue, as REV can cause immunosuppression and runting in vaccinated birds [11, 149]. Rigorous quality control, including testing for extraneous agents and confirmation of attenuation, is essential for all live vaccines [67]. The use of cell culture systems for vaccine production can reduce the risk of contamination compared to CAM-derived vaccines [67, 68]. For MG vaccines, the F-strain has been associated with more severe reactions and potential spread to unvaccinated birds, whereas ts-11 and 6/85 are considered safer [1, 31].

Decision Framework for Vaccine Selection

The selection of an appropriate vaccination strategy depends on several factors, including the disease prevalence in the region, the production system (e.g., layer, broiler, breeder), the presence of immunosuppressive agents, and the cost-benefit analysis. The following decision tree outlines a general framework for selecting between traditional and recombinant vaccine approaches.

graph TD
    A[Assess Flock Risk] --> B{High MG Prevalence?};
    B -- Yes --> C{High Fowl Pox Risk?};
    B -- No --> D[Standard Fowl Pox Vaccine];
    C -- Yes --> E[Consider rFPV-MG Vaccine];
    C -- No --> F["Consider Live MG Vaccine (ts-11/6/85")];
    E --> G[Monitor Take & Serology];
    F --> G;
    D --> G;
    G --> H[Evaluate Protection & Adjust Program];

This framework emphasizes the utility of the rFPV-MG vaccine in high-risk environments where both diseases are endemic. In lower-risk scenarios, monovalent vaccines may be more cost-effective.

Future Directions

Future research in FWPV and MG vaccinology will likely focus on several key areas. The development of next-generation rFPV vectors with enhanced immunogenicity, potentially through the inclusion of multiple cytokine adjuvants or the deletion of viral immune evasion genes, is a promising avenue [29, 41]. The use of computational biology and bioinformatics to predict protective epitopes and design optimized vaccine antigens will accelerate vaccine development [42]. Furthermore, the development of more sophisticated DIVA diagnostic tests, including multiplex serological assays and high-resolution genotyping methods, will be critical for the successful implementation of eradication programs. The continued surveillance of circulating FWPV and MG strains through genomic epidemiology is essential to ensure that vaccine strains remain antigenically relevant [9, 7, 59].

Conclusion

Vaccination remains the most effective strategy for controlling fowl pox and MG in commercial poultry. The advent of recombinant vector vaccines, particularly the rFPV-MG vaccine, represents a significant technological advance, offering the potential for safe, effective, and convenient dual protection. A thorough understanding of the virology, immunology, and diagnostic considerations associated with these vaccines is essential for veterinary practitioners and poultry health professionals to design and implement successful vaccination programs. Ongoing research and field surveillance will continue to refine these tools and strategies to meet the evolving challenges of infectious disease management in poultry.

References

[1] Hashish A, Chaves M, Osemeke O et al. Evaluation of Vaccination Programs in Layer Pullets Using Recombinant Fowl-Pox Mycoplasma gallisepticum Vaccine in Comparison to Commercially Available F-Strain Live Vaccines. Avian Dis. 2026.

[2] Hein R, Koopman R, García M et al. Review of Poultry Recombinant Vector Vaccines. Avian Dis. 2021.

[3] Francis MJ. Spotlight on avian pathology: the importance of recombinant vector platform technologies in poultry vaccination. Avian Pathol. 2021.

[4] Akter MS, Das A, Piyel SH et al. Complete genome sequencing of the fowlpox virus vaccine strain from the Livestock Research Institute, Bangladesh. Microbiol Resour Announc. 2026.

[5] Mozumder A, Mia R, Das A et al. First complete genome of a fowlpox virus isolated in Bangladesh reveals Asian lineage and clade A1. Microbiol Spectr. 2026.

[6] Verma RK, Gangwar AK. Characterization of Fowlpox Virus. Adv Exp Med Biol. 2024.

[7] Kim HR, Jang I, Song HS et al. Genetic Diversity of Fowlpox Virus and Putative Genes Involved in Its Pathogenicity. Microbiol Spectr. 2022.

[8] Li N, Shi K, Rao T et al. Structural insights into the promiscuous DNA binding and broad substrate selectivity of fowlpox virus resolvase. Sci Rep. 2020.

[9] Yehia N, Elsayed S, Al-Saeed FA et al. Current situation and genomic characterization of fowlpox virus in lower Egypt during 2022. Poult Sci. 2023.

[10] Liu H, Li T, Tang J et al. Complete genome sequence analysis of Reticuloendotheliosis virus integrated in nonhomologous Avipoxvirus. Microb Pathog. 2024.

[11] Roy Chowdhury N, Mondal B, Biswas SK et al. Isolation of Reticuloendotheliosis Virus from Chorio-allantoic Membrane of SPF Chicken Eggs inoculated with Fowl Pox Virus. Vet Ital. 2023.

[12] Willis B, Trautman C, Cox F et al. Genome Sequence of Fowlpox Virus-Integrated Reticuloendotheliosis Virus from a Rio Grande Wild Turkey (Meleagris gallopavo intermedia). Microbiol Resour Announc. 2022.

[13] Matos M, Bilic I, Palmieri N et al. Epidemic of cutaneous fowlpox in a naïve population of chickens and turkeys in Austria: Detailed phylogenetic analysis indicates co-evolution of fowlpox virus with reticuloendotheliosis virus. Transbound Emerg Dis. 2022.

[14] Sarker S, Athukorala A, Bowden TR et al. Characterisation of an Australian fowlpox virus carrying a near-full-length provirus of reticuloendotheliosis virus. Arch Virol. 2021.

[15] Mosad SM, El-Tholoth M, El-Kenawy AA et al. Molecular Detection of Reticuloendotheliosis Virus 5' Long Terminal Repeat Integration in the Genome of Avipoxvirus Field Strains from Different Avian Species in Egypt. Biology (Basel). 2020.

[16] Chacón RD, Astolfi-Ferreira CS, De la Torre DI et al. An atypical clinicopathological manifestation of fowlpox virus associated with reticuloendotheliosis virus in commercial laying hen flocks in Brazil. Transbound Emerg Dis. 2020.

[17] Mirzazadeh A, Matos M, Emadi-Jamali S et al. Atypical Manifestation of Cutaneous Fowlpox in Broiler Chickens Associated with High Condemnation at a Processing Plant. Avian Dis. 2021.

[18] Chacón RD, Astolfi-Ferreira CS, Pereira PC et al. Outbreaks of Avipoxvirus Clade E in Vaccinated Broiler Breeders with Exacerbated Beak Injuries and Sex Differences in Severity. Viruses. 2022.

[19] Fallah Mehrabadi MH, Ghalyanchilangeroudi A, Charkhkar S et al. laying Farm: Up to Date Data on a Fowlpox Outbreak in Phylogenetic Analysis in Iran, 2018. Arch Razi Inst. 2021.

[20] Lebdah M, Ali AM, Ali AA et al. Insights into pathological and molecular characterization of avipoxviruses circulating in Egypt. Br Poult Sci. 2019.

[21] Ma X, Zhang M, Zhang X et al. Construction and Immunogenicity Evaluation of a Recombinant Fowlpox Virus Expressing VP2 Gene of African Horse Sickness Virus Serotype 1. Microorganisms. 2025.

[22] Eldaghayes I, Rothwell L, Skinner M et al. Efficacy of Fowlpox Virus Vector Vaccine Expressing VP2 and Chicken Interleukin-18 in the Protection against Infectious Bursal Disease Virus. Vaccines (Basel). 2023.

[23] Chen S, Xu N, Ta L et al. Recombinant Fowlpox Virus Expressing gB Gene from Predominantly Epidemic Infectious Larygnotracheitis Virus Strain Demonstrates Better Immune Protection in SPF Chickens. Vaccines (Basel). 2020.

[24] Zhao Y, Han Z, Zhang X et al. Construction and immune protection evaluation of recombinant virus expressing Newcastle disease virus F protein by the largest intergenic region of fowlpox virus NX10. Virus Genes. 2020.

[25] Majid NN, Omar AR, Mariatulqabtiah AR. Negligible effect of chicken cytokine IL-12 integration into recombinant fowlpox viruses expressing avian influenza virus neuraminidase N1 on host cellular immune responses. J Gen Virol. 2020.

[26] Bertran K, Criado MF, Lee DH et al. Protection of White Leghorn chickens by recombinant fowlpox vector vaccine with an updated H5 insert against Mexican H5N2 avian influenza viruses. Vaccine. 2020.

[27] Mohammad Reza A, Ismail A. Cytokine Immune Response Following Vaccination against Fowl Pox Disease in Specific Pathogen Free Chickens. Arch Razi Inst. 2025.

[28] Azizi MR, Asli E, Behroozikhah AM et al. Flow Cytometric Evaluation of CD4(+) and CD8(+) T-cell Immune Response in SPF Chickens Induced by Fowlpox Vaccine. Arch Razi Inst. 2021.

[29] Li Z, Roy S, Ranasinghe C. IL-13Rα2 Regulates the IL-13/IFN-γ Balance during Innate Lymphoid Cell and Dendritic Cell Responses to Pox Viral Vector-Based Vaccination. Vaccines (Basel). 2021.

[30] Oliveira M, Rodrigues DR, Guillory V et al. Chicken cGAS Senses Fowlpox Virus Infection and Regulates Macrophage Effector Functions. Front Immunol. 2020.

[31] Kamathewatta KI, Kanci Condello A, Ekanayake D et al. Day-old vaccination with the Vaxsafe MG304 live-attenuated vaccine protects chickens from tracheal transcriptional changes induced by chronic infection with Mycoplasma gallisepticum. Vaccine. 2025.

[32] Wu S, Wang M, Yang X et al. Research Progress in the Development of Vaccines against Mycoplasma gallisepticum and Mycoplasma synoviae. Microorganisms. 2024.

[33] Sabir R, Liu M, Saeed HA et al. Next-generation live vector vaccine targeting Mycoplasma synoviae and Mycoplasma gallisepticum via recombinant Salmonella. Vaccine. 2026.

[34] Özgünlük İ, Yücetepe AG, Çetiner B et al. Development of a Multiplex PCR Assay for Rapid Differentiation of Fowlpox and Pigeonpox Viruses. Avian Dis. 2024.

[35] Song H, Kim H, Kim S et al. Research Note: Simultaneous detection of infectious laryngotracheitis virus, fowlpox virus, and reticuloendotheliosis virus in chicken specimens. Poult Sci. 2021.

[36] Zhu Y, Huo S, Chen L et al. Rapid detection of avipoxvirus using a fluorescent probe-based multienzyme isothermal amplification assay. Front Vet Sci. 2025.

[37] Mozumder A, Akter S, Mia R et al. Genome sequence of fowlpox virus from a field outbreak in Bangladesh. Microbiol Resour Announc. 2025.

[38] Asif K, O'Rourke D, Legione AR et al. Whole-genome based strain identification of fowlpox virus directly from cutaneous tissue and propagated virus. PLoS One. 2021.

[39] Le Net R, Provost C, Lalonde C et al. WHOLE GENOME SEQUENCING OF AN AVIPOXVIRUS ASSOCIATED WITH INFECTIONS IN A GROUP OF AVIARY-HOUSED SNOW BUNTINGS (PLECTROPHENAX NIVALIS). J Zoo Wildl Med. 2020.

[40] Ganapathy K, Parthiban S. Pros and Cons on Use of Live Viral Vaccines in Commercial Chicken Flocks. Avian Dis. 2024.

[41] Giotis ES, Laidlaw SM, Bidgood SR et al. Modulation of Early Host Innate Immune Response by an Avipox Vaccine Virus' Lateral Body Protein. Biomedicines. 2020.

[42] El-Hema HS, El Fekey HM, Abdel-Rahman AA et al. Design and Multi-Level Biological Evaluation of Naphthyridine-Based Derivatives as Topoisomerase I/II-Targeted Anticancer Agents with Anti-Fowlpox Virus Activity Supported by In Silico Analysis. Int J Mol Sci. 2026.

[43] Fulton RM, Hengesbach L, Dodd KA. Fowlpox Virus Infection in a Pekin Duck (Anas platyrhynchos domesticus) Breeder Flock. Avian Dis. 2025.

[44] Elshwihdi MHA, Kammon AM, Asheg AA. Molecular characterization of fowl and pigeon pox viruses: A recent outbreak in Libya. Open Vet J. 2025.

[45] Mohamed RI, Elsamadony HA, Alghamdi RA et al. Molecular and pathological screening of the current circulation of fowlpox and pigeon pox virus in backyard birds. Poult Sci. 2024.

[46] Andrews SJ, Makundi A, Mwanadota J et al. The co-administration of live fowlpox and Newcastle disease vaccines by non-invasive routes to chickens reared by smallholders in Tanzania and Nepal. Trop Anim Health Prod. 2022.

[47] van der Meer CS, Paulino PG, Jardim THA et al. Detection and molecular characterization of Avipoxvirus in Culex spp. (Culicidae) captured in domestic areas in Rio de Janeiro, Brazil. Sci Rep. 2022.

[48] Molini U, Mutjavikua V, de Villiers M et al. Molecular characterization of avipoxviruses circulating in Windhoek district, Namibia 2021. J Vet Med Sci. 2022.

[49] Sarker S, Bowden TR, Boyle DB. Evidence of a Possible Viral Host Switch Event in an Avipoxvirus Isolated from an Endangered Northern Royal Albatross (Diomedea sanfordi). Viruses. 2022.

[50] Assen AM, Yegoraw AA, Walkden-Brown SW et al. Molecular-based monitoring of live vaccines in dust samples from experimental and commercial chicken flocks and its potential use as a screening test. Res Vet Sci. 2022.

[51] Abd El Hafez MS, Shosha EAE, Ibrahim SM. Isolation and molecular detection of pigeon pox virus in Assiut and New Valley governorates. J Virol Methods. 2021.

[52] Ribeiro LC, Monteiro FL, Chagas DB et al. Identification of Clade E Avipoxvirus in Brazil. Avian Dis. 2020.

[53] MacDonald AM, Gibson DJ, Barta JR et al. Bayesian Phylogenetic Analysis of Avipoxviruses from North American Wild Birds Demonstrates New Insights into Host Specificity and Interspecies Transmission. Avian Dis. 2019.

[54] Sarma G, Kersting BA, Spina G. Field safety and efficacy of a unique live virus vaccine for controlling avian encephalomyelitis and fowlpox in poultry. Vet World. 2019.

[55] Rahman S, Islam MA, Islam MS et al. Isolation and molecular detection of Avipoxvirus from field outbreaks in Mymensingh, Bangladesh. J Adv Vet Anim Res. 2019.

[56] Sharma B, Nashiruddullah N, Bhat MA et al. Occurrence and phylogenetic analysis of avipoxvirus isolated from birds around Jammu. Virusdisease. 2019.

[57] Fagrach A, Arbani O, Karroute O et al. Prevalence of major infectious diseases in backyard chickens from rural markets in

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.