This is the first description of heart and skeletal muscle inflammation (HSMI), a novel disease affecting farmed Atlantic salmon Salmo salar in Norway. HSMI was first diagnosed in 1999, and there has since been a yearly increase in the number of recorded outbreaks. Atlantic salmon are commonly affected 5 to 9 mo after transfer to sea, but outbreaks have been recorded as early as 14 d following seawater transfer. Affected fish are anorexic and display abnormal swimming behaviour. Autopsy findings typically include a pale heart, yellow liver, ascites, swollen spleen and petechiae in the perivisceral fat. While mortality is variable (up to 20%), morbidity may be very high in affected cages. Until more accurate tests are available, HSMI is diagnosed on the basis of histopathology. The major pathological changes occur in the myocardium and red skeletal muscle, where extensive inflammation and multifocal necrosis of myocytes are evident. HSMI is transmissible and, although most likely caused by a virus, the causal agent has not yet been isolated. This paper describes clinical signs and pathology of HSMI from 3 field outbreaks in Norway. Microscopic lesions are compared and discussed in relation to published descriptions of pancreas disease (PD) and cardiomyopathy syndrome (CMS). It is concluded that HSMI is histopathologically distinguishable from PD and CMS.
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