Diagnosis
Moderate or heavy clinical infection of fish with whirling disease can be presumptively diagnosed on the basis of changes in behavior and appearance about 35 to 80 days after initial infection, though "injury or deficiency in dietary tryptophan and ascorbic acid can evoke similar signs", so conclusive diagnosis may require finding myxospores in the fishs cartilage. In heavy infections, only examining cartilage microscopically may be necessary to find spores. In less severe infections, the most common test involves digestion of the cranial cartilage with the proteases pepsin and trypsin (pepsin-trypsin digest—PTD) before looking for spores. The head and other tissues can be further examined using histopathology to confirm whether the location and morphology of the spores matches what is known for M. cerebralis. Serological identification of spores in tissue sections using an antibody raised against the spores is also possible. Parasite identity can also be confirmed using polymerase chain reaction to amplify the 415 base pair 18S rRNA gene from M. cerebralis. Fish should be screened at the life stage most susceptible to the parasites, with particular focus on fish in aquaculture units. Impact
Although originally a mild pathogen of Salmo trutta in central Europe and other salmonids in northeast Asia, the introduction of the rainbow trout (Oncorhynchus mykiss) has greatly increased the impact of this parasite. Having no innate immunity to M. cerebralis, rainbow trout are particularly susceptible, and can release so many spores that even more resistant species in the same area, such as S. trutta, can become overloaded with parasites and incur 80%–90% mortalities.
These include gradual increase starting from low doses and supplemental administration of protein C (pure or from fresh frozen plasma).The necrotic skin areas are treated as in other conditions, sometimes healing spontaneously with or without scarring, sometimes going on to require surgical debridement or skin grafting. History
While skin necrosis in patients had been previously described, Verhagen was the first to publish a paper on this relationship in the medical literature, in 1954. See also
List of cutaneous conditions


== References ==