The classic syndrome is divided into five phases: an incubation period, a prodromal fever, an erosive-mucosa phase, a diarrhoeic phase and convalescence in surviving animals.
Although the onset of the prodromal fever is sudden, it is frequently missed because other clinical signs are minimal, except in lactating cows whose milk yield falls. Overt illness is clearly evident 24 to 48 hours later, when the animal becomes restless and then stands depressed, apart and alone. Respirations are shallow and rapid. The coat hairs stand erect, the muzzle dries, tears are wept and the nose runs. Appetite is impaired, rumination is retarded and defecation stops. Visible mucous membranes are congested but intact.
The first suggestive sign of rinderpest occurs two to five days after the onset of the prodromal fever, when raised pinheads of necrotic epithelium emerge from the surfaces of the mucous membranes lining the mouth, nasal passages and urogenital tracts. These are readily abraded to expose a haemorrhagic layer of basal cells. Salivation is profuse. The erosions enlarge and coalesce. Thick yellow patches of necrotic cells begin to coat the nasal passages and mix with the nasal secretions, producing a fetid mucopurulent discharge. Lacrimal secretions likewise become mucopurulent. Thirst is intense but the appetite is lost. Soft faeces are voided frequently.
The diarrhoea proper begins as the fever falls, two to three days after the first appearance of the mucosal erosions. The dark, fluid faeces contain excess mucus and shreds of epithelium and necrotic debris streaked with blood. The smell is memorably sweet, fetid and offensive. Affected animals arch their backs and strain frequently, exposing congested and eroded rectal mucosae. Respirations are laboured and painful, characterized by an audible grunt when exhaling.
In fatal cases the diarrhoea worsens progressively, causing rapid dehydration. Affected animals waste visibly; they have sunken eyes and stand with lowered heads and arched backs. Most collapse and die six to 12 days after the onset of the prodromal fever. Some, however, linger on for three weeks.
In surviving cases, the diarrhoea stops within a week of its onset. Pregnant animals, however, will abort during convalescence, which is prolonged, and a return to full health will take many weeks.
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