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The veterinary practitioner is one of the most important advisors for farmers in the field of udder health. He or she has the tools to improve udder health if farmers are motivated to do so. Many farmers think that udder health is important, but this does not always mean that management of mastitis is up to standard. Many veterinarians are of the opinion that they are unable to convince their clients of the possible profits to be gained from investing in management of mastitis. Something is required to bridge this gap. This article, based on data and experiences from The Netherlands, describes the communication issues that can be considered in order to improve the role of the veterinarian as advisor, to achieve better udder health. The outcome is beneficial for both farmers and veterinarians, the former for reasons of economics, welfare and ease of work; the latter because it creates extra, challenging work. It is concluded that the veterinary practitioner is in an ideal situation to advise and motivate farmers to improve udder health but, to do this, the means of communication need to take account of the different learning styles of farmers. The most important aspects of such communication are found to be a pro-active approach, personalisation of messages, providing a realistic frame of reference for the farmer, and use of the farmer's social environment. Importantly, all persons and organisations in a farmer's social environment should articulate the same message.

Because of increasing bulk milk somatic cell counts and continuous clinical mastitis problems in a substantial number of herds, a national mastitis control program was started in 2005 to improve udder health in the Netherlands. The program started with founding the Dutch Udder Health Centre (UGCN), which had the task to coordinate the program. The program consisted of 2 parts: a research part and a knowledge-transfer part, which were integrated as much as possible. The knowledge-transfer part comprised 2 communication strategies: a central and a peripheral approach. The central approach was based on educating farmers using comprehensive science-based and rational argumentation about mastitis prevention and included on-farm study group meetings. Comprehensive education materials were developed for farmers that were internally motivated to improve udder health. In the peripheral approach it was tried to motivate farmers to implement certain management measures using nontechnical arguments. Mass media campaigns were used that focused on one single aspect of mastitis prevention. These communication strategies, as well as an integrated approach between various stakeholders and different scientific disciplines were used to reach as many farmers as possible. It should be noted that, because this intervention took place at a national level, no control group was available, as it would be impossible to isolate farmers from all forms of communication for 5 years. Based on several studies executed during and after the program, however, the results suggest that udder health seemed to have improved on a national level during the course of the program from 2005 to 2010. Within a cohort of dairy herds monitored during the program, the prevalence of subclinical mastitis did not change significantly (23.0 in 2004 vs. 22.2 in 2009). The incidence rate of clinical mastitis, however, decreased significantly, from 33.5 to 28.1 quarter cases per 100 cow years at risk. The most important elements of the farmers' mindset toward mastitis control also changed favorably. The simulated costs of mastitis per farm were reduced compared with a situation in which the mastitis would not have changed, with € 400 per year. When this amount is extrapolated to all Dutch farms, the sector as a whole reduced the total costs of mastitis by € 8 million per year. It is difficult to assign the improved udder health completely to the efforts of the program due to the lack of a control group. Nevertheless, investing € 8 million by the Dutch dairy industry in a 5-yr national mastitis control program likely improved udder health and seemed to pay for itself financially.

Mycoplasma bovis causes mastitis in dairy cows and is associated with pneumonia and polyarthritis in cattle. The present investigation included a retrospective case–control study to identify potential herd-level risk factors for M. bovis associated disease, and a prospective cohort study to evaluate the course of clinical disease in M. bovis infected dairy cattle herds in Switzerland. Eighteen herds with confirmed M. bovis cases were visited twice within an average interval of 75 d. One control herd with no history of clinical mycoplasmosis, matched for herd size, was randomly selected within a 10 km range for each case herd. Animal health data, production data, information on milking and feeding-management, housing and presence of potential stress- factors were collected. Composite quarter milk samples were aseptically collected from all lactating cows and 5% of all animals within each herd were sampled by nasal swabs. Organ samples of culled diseased cows were collected when logistically possible. All samples were analyzed by real-time polymerase chain reaction (PCR). In case herds, incidence risk of pneumonia, arthritis and clinical mastitis prior to the first visit and incidence rates of clinical mastitis and clinical pneumonia between the two visits was estimated. Logistic regression was used to identify potential herd-level risk factors for M. bovis infection. In case herds, incidence risk of M. bovis mastitis prior to the first visit ranged from 2 to 15%, whereas 2 to 35% of the cows suffered from clinical pneumonia within the 12 months prior to the first herd visit. The incidence rates of mycoplasmal mastitis and clinical pneumonia between the two herd visits were low in case herds (0–0.1 per animal year at risk and 0.1-0.6 per animal year at risk, respectively). In the retrospective-case-control study high mean milk production, appropriate stimulation until milk-let-down, fore-stripping, animal movements (cattle shows and trade), presence of stress-factors, and use of a specific brand of milking equipment, were identified as potential herd-level risk factors. The prospective cohort study revealed a decreased incidence of clinical disease within three months and prolonged colonization of the nasal cavity by M. bovis in young stock.

The effect was quantified of coagulase-negative staphylococci (CNS) intramammary infections on quarter- and cow-level somatic cell count (SCC) and on bulk milk somatic cell count (BMSCC) in different BMSCC cohorts in Dutch dairy herds. Two datasets were used for this purpose. In the first dataset, on 49 randomly selected dairy farms a total of 4220 quarter milk samples of 1072 cows were collected of all cows and heifers with a test-day SCC 250 000 and 150 000 cells/ml, respectively, and of 25% of cows and heifers below these thresholds. In the second dataset, on 39 selected dairy farms a total of 8329 quarter milk samples of 2115 cows were collected of all cows with a test-day SCC 250 000 cells/ml following two consecutive SCC <250 000 cells/ml, and of heifers using the same SCC criteria but with a threshold of 150 000 cells/ml. These cows and heifers were defined as new high SCC. In both datasets, CNS was the most frequently isolated pathogen, 11% in the first dataset and 12% in the second dataset. In both datasets, quarters with CNS IMI had a lower SCC than quarters infected with major pathogens, and a higher SCC than culture-negative quarters. The same was found for SCC at cow level. Coagulase-negative staphylococci were more often found in quarters with SCC 200 000 cells/ml in dairy farms with a BMSCC<150 000 cells/ml compared with dairy farms with a higher BMSCC. Prevalence of CNS in cows and heifers with a high SCC was higher in dairy farms with a BMSCC <150 000 cells/ml compared with dairy farms with a medium or high BMSCC: 30, 19 and 18%, respectively. This indicates that CNS IMI as a cause of subclinical mastitis is relatively more important in dairy farms with a low BMSCC and may become a point of attention in udder health management on that type of farm.

Staphylococcus aureus causes a wide range of diseases in multiple species. Some sequence types (ST) are observed in a variety of hosts, whereas other strains are mainly associated with bovine mastitis, suggesting host adaptation. We propose that host adaptation of Staph. aureus may influence bacteriological cure of bovine subclinical mastitis after antimicrobial treatment. To test this hypothesis, multilocus sequence typing was performed on Staph. aureus isolates from 60 treated and 79 untreated control quarters that were obtained from well-defined cohorts of dairy cows from a recently conducted randomized field trial on early treatment of subclinical mastitis. Bovine-associated ST were distinguished from non-bovine-associated ST based on the literature and public databases. The association between host adaptation and bacteriological cure was investigated using population-averaged logistic regression models. Thirteen ST were identified, with approximately 80% of isolates belonging to bovine-associated ST. The odds for cure were around 2.5 times as high for non-bovine-associated ST as for bovine ST in treated quarters, whereas no difference in spontaneous cure was observed in untreated control quarters. In addition, host adaptation was related to known predictors of cure, such as penicillin susceptibility and somatic cell count. All isolates belonging to non-bovine-associated ST were resistant to penicillin, whereas the majority of isolates belonging to bovine-associated ST were penicillin susceptible. Penicillin-resistant bovine-associated strains were associated with high somatic cell counts compared with other strains. The correlation between penicillin resistance, cell counts, and host adaptation may affect the association between host adaptation and cure. For diagnostic purposes, a simple and fast alternative to multilocus sequence typing of Staph. aureus to determine host adaptation may be valuable.

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