# [Fowl Cholera (Pasteurella multocida) in Poultry](/knowledge/bacteria/avian-bacteria/fowl-cholera-bacterial-poultry): Clinical Signs, Diagnosis, and Control

## Key Takeaways

- Fowl cholera is caused by *Pasteurella multocida*, a Gram-negative coccobacillus, with capsular serogroup A and somatic serotypes 1, 3, and 4 being most common in acute poultry infections; virulence is linked to factors like hyaluronic acid capsule production.
- Transmission occurs via direct contact, contaminated feed/water, and fomites, with asymptomatic carriers and wild waterbirds acting as reservoirs, and stress factors like overcrowding predisposing birds to disease.
- Clinical signs range from peracute sudden death to acute presentations with fever, depression, cyanosis, and diarrhea, and chronic forms characterized by localized lesions such as wattle edema and arthritis.
- Diagnosis relies on laboratory confirmation through bacterial isolation and identification (Gram stain, culture, biochemical tests), molecular methods (PCR, LAMP), and serological assays (ELISA) for flock monitoring.
- Antimicrobial therapy is most effective early and guided by susceptibility testing, though widespread resistance to tetracyclines, sulfonamides, and beta-lactams necessitates careful drug selection and surveillance.
- Control strategies integrate stringent biosecurity, management practices to reduce stress, and vaccination using bacterins or live attenuated vaccines, with ongoing research into subunit and plant-derived alternatives.

---

## Etiology

[Fowl cholera](/knowledge/bacteria/avian-bacteria/avian-cholera-fowl-cholera-in-poultry) is a contagious bacterial disease of domestic and wild birds caused by *Pasteurella multocida*, a Gram-negative, non-motile, facultatively anaerobic coccobacillus belonging to the family Pasteurellaceae [<a href="#ref-1">1</a>, <a href="#ref-2">2</a>]. The bacterium produces a polysaccharide capsule that is a critical virulence factor, and strains are classified into five capsular serogroups (A, B, D, E, F) and 16 somatic lipopolysaccharide (LPS) serotypes [<a href="#ref-3">3</a>, <a href="#ref-4">4</a>]. In poultry, capsular serogroup A and somatic serotypes 1, 3, and 4 are most frequently associated with acute [fowl cholera](/knowledge/bacteria/avian-bacteria/avian-cholera-fowl-cholera) [<a href="#ref-5">5</a>, <a href="#ref-6">6</a>]. The complete genome sequences of *P. multocida* isolates representing all LPS outer core loci have been determined, revealing substantial genetic diversity in the genes governing LPS biosynthesis [<a href="#ref-4">4</a>]. Phase variation in glycosyltransferase genes contributes to LPS heterogeneity and is linked to outbreaks on free-range layer farms [<a href="#ref-7">7</a>]. The virulence repertoire includes the *Pasteurella multocida* toxin (PMT), a potent mitogenic protein that activates cellular signaling pathways, though its role in avian disease is less pronounced than in porcine atrophic rhinitis [<a href="#ref-8">8</a>]. Filamentous hemagglutinin (FhaB1) is not essential for pathogenesis in turkey poults [<a href="#ref-9">9</a>], whereas hyaluronic acid capsule production, regulated by the stringent response via the *hyaD* gene, is a key determinant of virulence [<a href="#ref-10">10</a>, <a href="#ref-11">11</a>]. The stringent response negatively regulates capsule production, thereby modulating immune evasion [<a href="#ref-11">11</a>]. Isolates from poultry frequently carry multiple antimicrobial resistance genes and virulence-associated genes, including those encoding adhesins, iron acquisition systems, and toxins [<a href="#ref-3">3</a>, <a href="#ref-12">12</a>]. Capsular type B:2 strains with multidrug resistance have been reported in Bangladesh [<a href="#ref-12">12</a>].

## Epidemiology

[Fowl cholera](/knowledge/bacteria/avian-bacteria/fowl-cholera-avian-cholera-in-poultry) occurs worldwide and affects chickens, turkeys, ducks, geese, and many wild bird species [<a href="#ref-1">1</a>, <a href="#ref-13">13</a>, <a href="#ref-14">14</a>]. Turkeys are particularly susceptible to acute outbreaks, often with high morbidity and mortality [<a href="#ref-5">5</a>, <a href="#ref-13">13</a>]. In commercial slow-growing broiler chickens, mortality can reach 100% in acute cases [<a href="#ref-5">5</a>]. Coinfection with *Mycoplasmoides gallisepticum* has been associated with very high mortality in turkey flocks [<a href="#ref-13">13</a>]. The bacterium is shed in oral and nasal secretions and feces, and transmission occurs via direct contact, contaminated feed, water, and fomites [<a href="#ref-15">15</a>, <a href="#ref-16">16</a>]. Asymptomatic carrier birds, including recovered birds and healthy birds harboring *P. multocida* in the pharyngeal tonsils, serve as reservoirs [<a href="#ref-14">14</a>, <a href="#ref-17">17</a>]. Wild waterbirds may act as a source of infection for poultry, as demonstrated by the widespread sequence type ST20 in Australian poultry farms that also infects wild waterbirds [<a href="#ref-14">14</a>]. Land cover characteristics, such as proximity to water bodies and forested areas, influence the occurrence of [fowl cholera](/knowledge/bacteria/avian-bacteria/fowl-cholera-avian-cholera-poultry) [<a href="#ref-18">18</a>]. Compartmental models of transmission dynamics indicate that infection spreads rapidly through susceptible flocks in the absence of control measures [<a href="#ref-15">15</a>]. Stress factors including overcrowding, poor ventilation, nutritional deficiencies, and concurrent infections predispose birds to clinical disease [<a href="#ref-16">16</a>, <a href="#ref-17">17</a>].

## Clinical Signs

The clinical presentation of [fowl cholera](/knowledge/bacteria/avian-bacteria/fowl-cholera-avian-cholera) ranges from peracute to chronic forms, depending on the virulence of the strain, host susceptibility, and route of exposure [<a href="#ref-5">5</a>, <a href="#ref-16">16</a>, <a href="#ref-19">19</a>]. Peracute disease is characterized by sudden death in apparently healthy birds, often with no premonitory signs [<a href="#ref-5">5</a>]. Acute [fowl cholera](/knowledge/bacteria/avian-bacteria/fowl-cholera-avian-pasteurellosis-comprehensive-reference) presents with fever, depression, anorexia, ruffled feathers, cyanosis of the comb and wattles, oral and nasal mucous discharge, dyspnea, and diarrhea [<a href="#ref-16">16</a>, <a href="#ref-19">19</a>]. Swelling of the wattles and conjunctivitis are common [<a href="#ref-5">5</a>, <a href="#ref-16">16</a>]. Mortality can exceed 50% in untreated flocks [<a href="#ref-15">15</a>, <a href="#ref-17">17</a>]. Chronic infection manifests as localized lesions including wattle edema, swollen joints (arthritis), sternal bursitis, torticollis due to otitis media, and conjunctivitis [<a href="#ref-16">16</a>, <a href="#ref-17">17</a>]. In layers, a drop in egg production is observed [<a href="#ref-16">16</a>]. Ducklings infected with serogroup A strains exhibit similar signs, including lameness and neurological symptoms [<a href="#ref-6">6</a>].

## Pathology

Gross pathological findings in acute [fowl cholera](/knowledge/bacteria/avian-bacteria/fowl-cholera-avian-pasteurellosis-comprehensive-veterinary-reference) include generalized congestion and hemorrhage on serosal surfaces, petechiae on the epicardium and abdominal fat, hepatomegaly with multiple pale necrotic foci, splenomegaly, and pulmonary edema [<a href="#ref-5">5</a>, <a href="#ref-16">16</a>]. The liver often shows pinpoint necrotic foci, a hallmark of the disease [<a href="#ref-5">5</a>, <a href="#ref-16">16</a>]. Hemorrhagic enteritis and fibrinous pericarditis may be present [<a href="#ref-5">5</a>]. Chronic cases show caseous exudate in wattles, joints, and tendon sheaths, and occasionally fibrinopurulent meningitis [<a href="#ref-17">17</a>]. Histologically, acute lesions consist of multifocal hepatic necrosis with heterophilic infiltration, fibrin thrombi in small blood vessels, and bacterial emboli in parenchymatous organs [<a href="#ref-5">5</a>]. The presence of many short, bipolar-staining rods (safety-pin appearance) in tissue impression smears is suggestive of *P. multocida* infection [<a href="#ref-16">16</a>].

## Diagnosis

Definitive diagnosis of [fowl cholera](/knowledge/bacteria/avian-bacteria/fowl-cholera-avian-pasteurellosis-poultry) requires laboratory confirmation of *P. multocida* infection through bacterial isolation, molecular detection, or serological methods. A diagnostic algorithm is presented in Figure 1.

```mermaid
flowchart TD
 A["Suspected FC based on clinical signs & lesions"] --> B["Collect samples: liver, spleen, bone marrow, wattle exudate"]
 B --> C{"Direct smear: Gram-negative coccobacilli, bipolar staining?"}
 C -->|"Positive"| D["Culture on blood agar & MacConkey agar, 37°C, 24h"]
 C -->|"Negative"| E["Consider other diagnoses (CRD, coryza, salmonellosis, avian influenza)"]
 D --> F{"Colonies: smooth, iridescent, non-hemolytic?"}
 F -->|"Positive"| G["Biochemical confirmation: oxidase +, catalase +, indole +"]
 F -->|"Negative"| H["Re-culture or use selective media"]
 G --> I{"Molecular confirmation"}
 I --> J["PCR: kmt1 gene or capsular typing PCR"]
 I --> K["LAMP assay: faster, same sensitivity"]
 J --> L["Final diagnosis: positive for P. multocida"]
 K --> L
 G --> M["Serology: indirect ELISA for flock antibody monitoring"]
 M --> L
 L --> N["Antimicrobial susceptibility testing (disk diffusion / MIC)"]
 N --> O["Implement control measures: biosecurity, vaccination, treatment"]
```

**Figure 1. Diagnostic workflow for suspected [fowl cholera in poultry](/knowledge/bacteria/avian-bacteria/fowl-cholera-drug-choice).**

### Bacterial Isolation and Identification

*P. multocida* can be isolated from liver, spleen, bone marrow, heart blood, or wattle exudate of acutely ill or dead birds [<a href="#ref-16">16</a>, <a href="#ref-19">19</a>]. Samples are streaked onto blood agar (5% sheep blood) and [MacConkey agar](/knowledge/diagnostics/microbiology/macconkey-agar-selective-differential-enteric) and incubated at 37°C for 24 hours. Colonies are smooth, grayish, and non-hemolytic on blood agar; the bacterium does not grow on MacConkey agar [<a href="#ref-16">16</a>]. Biochemical tests reveal positive reactions for oxidase, catalase, indole, and nitrate reduction, and fermentation of glucose and sucrose but not lactose [<a href="#ref-16">16</a>]. Bipolar staining with methylene blue or Wright stain is characteristic [<a href="#ref-16">16</a>, <a href="#ref-19">19</a>].

### Molecular Detection

Conventional PCR targeting the *kmt1* gene (species-specific) and capsular typing PCR are widely used for confirmation and typing [<a href="#ref-3">3</a>, <a href="#ref-12">12</a>, <a href="#ref-20">20</a>]. [Loop-mediated isothermal amplification](/knowledge/diagnostics/molecular/lamp-assay-rapid-detection-african-swine-fever-virus-oral-fluids) (LAMP) assays offer comparable sensitivity and specificity to PCR with reduced turnaround time and simpler equipment requirements, making them suitable for on-site diagnosis [<a href="#ref-20">20</a>]. Genomic profiling and whole-genome sequencing have been applied to characterize outbreak strains and track transmission dynamics [<a href="#ref-1">1</a>, <a href="#ref-4">4</a>, <a href="#ref-14">14</a>]. Single nucleotide polymorphism analysis can differentiate closely related isolates [<a href="#ref-14">14</a>].

### Serological Assays

Indirect enzyme-linked immunosorbent assays (ELISAs) are employed for flock-level seromonitoring, particularly to assess vaccine-induced antibody responses [<a href="#ref-5">5</a>, <a href="#ref-21">21</a>]. In-house ELISAs using whole-cell antigens have been developed and optimized for chickens, showing good sensitivity and specificity [<a href="#ref-21">21</a>]. Subunit vaccines incorporating lipoprotein E with flagellin adjuvant have been evaluated using ELISA for immunogenicity [<a href="#ref-5">5</a>, <a href="#ref-22">22</a>]. Gamma-irradiated vaccines also elicit measurable antibody responses detected by ELISA [<a href="#ref-23">23</a>, <a href="#ref-24">24</a>].

## Treatment

Antimicrobial therapy is most effective if initiated early in the course of disease, preferably based on in vitro susceptibility testing [<a href="#ref-16">16</a>, <a href="#ref-17">17</a>, <a href="#ref-19">19</a>]. Commonly used antimicrobials include oxytetracycline, chlortetracycline, sulfonamides, trimethoprim-sulfonamide combinations, penicillin, and fluoroquinolones [<a href="#ref-16">16</a>, <a href="#ref-19">19</a>]. However, antimicrobial resistance is widespread: studies from Ethiopia, Bangladesh, China, and Egypt have reported high frequencies of resistance to tetracyclines, sulfonamides, aminoglycosides, and β-lactams [<a href="#ref-2">2</a>, <a href="#ref-3">3</a>, <a href="#ref-12">12</a>, <a href="#ref-16">16</a>, <a href="#ref-19">19</a>]. Multidrug-resistant (MDR) strains harboring resistance genes such as *blaROB-1*, *tetH*, *tetB*, *strA*, *strB*, and *sulII* are common [<a href="#ref-2">2</a>, <a href="#ref-3">3</a>]. The emergence of MDR *P. multocida* complicates therapeutic management and underscores the need for routine antimicrobial susceptibility surveillance [<a href="#ref-2">2</a>, <a href="#ref-16">16</a>]. Alternative control strategies include the use of probiotics: novel multi-strain probiotics have been shown to reduce [fowl cholera](/knowledge/bacteria/avian-bacteria/fowl-cholera-causal-agent) mortality in broilers, likely through competitive exclusion and immune modulation [<a href="#ref-25">25</a>]. Plant-derived compounds, such as wild Egyptian artichoke extract, exhibit in vitro antibacterial activity against *P. multocida* [<a href="#ref-26">26</a>].

## Control

### Biosecurity and Management

Effective control of [fowl cholera](/knowledge/bacteria/avian-bacteria/fowl-cholera-causative-agent) relies on stringent biosecurity measures to prevent introduction and spread of *P. multocida* [<a href="#ref-15">15</a>, <a href="#ref-17">17</a>]. Key practices include all-in/all-out flock management, thorough cleaning and disinfection of houses and equipment, control of rodent and feral bird access, and segregation of different age groups [<a href="#ref-17">17</a>]. Reduction of environmental stressors such as overcrowding, poor ventilation, and nutritional deficiencies is critical to reduce susceptibility [<a href="#ref-17">17</a>]. Compartmental models suggest that culling of infected flocks and quarantine of contacts can substantially reduce transmission [<a href="#ref-15">15</a>].

### Vaccination

Vaccination is a cornerstone of [fowl cholera](/knowledge/bacteria/avian-bacteria/fowl-cholera-etiology-clinical-manifestations-control-poultry) control in high-risk areas or flocks with a history of outbreaks [<a href="#ref-2">2</a>, <a href="#ref-5">5</a>, <a href="#ref-27">27</a>]. Both bacterins (killed whole-cell vaccines) and live attenuated vaccines are available [<a href="#ref-2">2</a>, <a href="#ref-28">28</a>]. Bacterins are typically administered parenterally and provide serotype-specific protection; they require two doses and annual boosters [<a href="#ref-5">5</a>, <a href="#ref-28">28</a>]. Adjuvants such as oil-in-water emulsions, aluminum hydroxide, and saponin can enhance immunogenicity [<a href="#ref-23">23</a>, <a href="#ref-24">24</a>, <a href="#ref-28">28</a>]. Gamma-irradiated vaccines have been developed as safer alternatives to formalin-killed bacterins, as they preserve antigenic structure while inactivating the pathogen [<a href="#ref-23">23</a>, <a href="#ref-24">24</a>]. Hydrogel-based inactivated vaccines incorporating gel 01 hydrogel induce robust immune responses and protection in chickens [<a href="#ref-27">27</a>]. Live attenuated vaccines derived from serial passage (e.g., PMZ8 strain in ducks) confer strong protection but carry a risk of reversion to virulence [<a href="#ref-2">2</a>]. Subunit vaccines targeting lipoprotein E (PlpE) with signal sequences or flagellin as an adjuvant have shown promise in inducing protective immunity in chickens and turkeys [<a href="#ref-5">5</a>, <a href="#ref-22">22</a>]. Additionally, a strain with a truncated LPS outer core has been shown to be immunogenic and protective in ducks [<a href="#ref-29">29</a>].

### Integrated and Alternative Strategies

Integrated control combining vaccination, biosecurity, antimicrobial stewardship, and health monitoring is recommended [<a href="#ref-17">17</a>]. The use of probiotics as feed additives can reduce colonization and mortality [<a href="#ref-25">25</a>]. Plant extracts with antibacterial activity represent a potential alternative for treatment or prophylaxis [<a href="#ref-26">26</a>]. Farm-level risk assessment and land cover management may help reduce the likelihood of outbreaks [<a href="#ref-18">18</a>].

## References

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