Equid Blog

We're Moving...

Scott Weese — Thu, 10 Nov 2011 19:18:00 -0500

Unfortunately, because of funding challenges (translation... we have no money), we are no longer able to maintain equIDblog in its current form. However, based on the positive feedback we've had and the amount of traffic on the site, we still think it serves a role and are dedicated to maintaining it in some form. So, we are going to merge equIDblog with its sister-site, Worms & Germs Blog. There, we will maintain all of the site's current content and continue to provide information and commentary on equine infectious disease issues. We'll continue posting here until the end of the month, then move everything to http://www.wormsandgermsblog.com.

Beat The Bugs: New Biosecurity Venture For Equine Guelph

Scott Weese — Thu, 10 Nov 2011 19:07:00 -0500

Equine Guelph has received funding for Beat the Bugs, a new equine biosecurity venture. The program has been funded by the Agricultural Biosecurity Program, a Canadian federal-provincial-territorial initiative.

From ongoing cases of strangles to large outbreaks of EHV, it's abundantly clear that infection control is a critical area for the equine industry, and one that typically receives little attention in the absence of an outbreak. The new Beat the Bugs program will be launched in March 2012, and will facilitate development of farm-specific biosecurity programs through workshops and a two-week online program. The program is being developed by Equine Guelph with the cooperation of various academic and industry partners. More information can be found on the Equine Guelph website.

No Answer In Aussie Horse Deaths

Scott Weese — Fri, 04 Nov 2011 11:52:00 -0500

Despite relatively intensive efforts, no cause has been identified for the deaths of 22 horses ona Kooralbyn farm in Queensland, Australia. Readily identifiable causes have been ruled out, leaving two main theories:

As mentioned in an earlier post, one possibility is botulism. It can be very hard to diagnose botulism in horses, and the disease is often presumptively diagnosed by ruling out all other reasonable options.

The other possibility is tick paralysis, which unfortunately is equally difficult to diagnose definitively. Certain types of ticks can cause progressive and severe paralysis which may look similar to botulism in some ways. Scrub ticks (the name typically used for Ixodes holocyclus) were noted on one of the first affected horses, but there's no information about whether all of the other horses had ticks too, and if so whether they were ticks that can cause paralysis. Kooralbyn is in a region where these paralysis ticks can be found and spring (e.g. now in Australia) tends to be the peak time for paralysis cases, so it's a reasonable consideration.

It's frustrating but far from unusual not to be able to make a solid diagnosis in outbreaks. Beyond the frustration factor, it's also a concern because it makes it hard to take precautions to prevent it from happening again.

Image: Two Ixodes holocyclus ticks, one before and one after feeding (photo credit: Bjørn Christian Tørrissen, click for source)

Study Seeking "Superbugs" In Horses

Maureen Anderson — Fri, 28 Oct 2011 15:18:00 -0500

A two-part study (Maddox et al. 2011) was recently published online in the Equine Veterinary Journal looking at antimicrobial resistant "superbugs" in horses in the UK. The first part of the study had the simple objective of estimating the prevalence of both MRSA nasal colonization and fecal shedding of antimicrobial resistant E. coli in the UK horse population. The reason they were looking at E. coli is because this bacterium is part of the normal intestinal flora of most animals (including horses), so it's easy to find, and it is frequently exposed to antimicrobials whenever a horse is treated systemically (i.e. with either oral or injectable antibiotics), so researchers use it as an "indicator" for resistance that may develop in other bacteria as well. E. coli doesn't typically cause gastrointestinal disease in horses like it can in people, nonetheless E. coli is a common cause of uterine, urinary and wound infections in horses, as well as septicemia in foals, and antimicrobial resistant infections in these situations can certainly be a big problem.

Out of 678 nasal swabs (taken from horses on over 500 premises), only 4 (0.6%) were positive for MRSA. That's good to see, as it's very easy for MRSA to spread in a horse population "under the radar," because colonized horses do not have any outward signs that they are carrying the pathogen. The overall low prevalence in the community setting is similar to previous community studies in the UK and other areas. Out of 650 fecal samples, 452 (72.2%) were positive for an E. coli that was resistant to at least one antimicrobial. That's not too surprising. The bigger concern is that 233 (37.6% - over one third of all horses tested) samples contained multidrug-resistant E.coli (defined in this study as resistance to more than three antimicrobial classes) and 42 (6.3%) samples contained an E. coli that produced an extended-spectrum beta-lactamase (ESBL). ESBLs are particularly problematic because they can be relatively easily transferred between bacteria, they confer resistance to a large number of commonly used antimicrobials in the beta-lactam class (which includes penicillins and cephalosporins), and are frequently associated with genes that confer resistance to other antimicrobial classes as well. Bacteria that produce ESBLs are a significant problem in human medicine and have been reported to cause infection in horses as well.

The second part of the study used information collected from questionnaires filled out by the horse owners to try to determine risk factors that affected the odds of a particular horse shedding antimicrobial-resistant E. coli. They used some pretty heavy-duty statistical analysis because they were looking at so many factors and different outcomes, and any time that happens you have to take the final numbers with a grain of salt. Nonetheless, the results can help point the way for future studies to help determine which factors may have the biggest impact on the risk. The authors found recent hospitalization and veterinary treatment for various conditions over the last six months were associated with higher odds of shedding multidrug-resistant strains of E. coli, and the type of farm/facility also affected the odds. In addition, having a recently hospitalized horse on the premises (among other things) increased the odds of a horse shedding ESBL E.coli.

What does all this mean for the average horse owner? The results really aren't new or startling. We already know that antimicrobial resistance is a growing problem in equine medicine, as it is in veterinary and human medicine in general, and this is one more set of studies that provides evidence to that effect. I have no doubt that if a similar study was performed in North America the same kinds of resistant bacteria would be detected, although the numbers may vary somewhat one way or another. The second part of the study also re-emphasize the role that antimicrobial use plays in promoting development of and selection for resistant bacteria, and the potential for the treatment of certain horses to affect the microbes being carried and shed by the animals around them. In the end, it comes down to being responsible about how we use antimicrobials in order to curb the development of resistance, so that these important drugs remain effective for treating serious infections in the future. This applies equally to their use in people and animals of all kinds.

NDM-1 In Salmonella...Ugh!

Scott Weese — Sat, 15 Oct 2011 07:42:00 -0500

NDM-1 (New Delhi metalloproteinase 1) is a little bacterial gene that's attracted a lot of attention (and controversy, due to its name). NDM-1 can be picked up by certain types of bacteria, making them resistant to a whole lot of antibiotics. Some bacteria that carry NDM-1 are resistant to virtually every available antibiotic, which raises the spectre of the "untreatable infection."

Since it's discovery, NDM-1 has been found in multiple countries, often in people that were in India as tourists (or "medical tourists" who traveled to India for medical procedures they couldn't have done in their own countries), and in a few different types of bacteria. Recently, NDM-1 was found in an American upon his return from India, this time in Salmonella (Savard et al. 2011, Antimicrobial Agents and Chemotherapy).

The 61-year-old man was hospitalized in India in late December 2010 following a severe bleed in his brain. He was transferred back to the US on January 25, 2011. Upon arrival, he developed a fever and a multidrug-resistant bacterium, Klebsiella pneumoniae, was isolated from his breathing tube. This was concerning by itself, but later, Salmonella Senftenberg was isolated from the man's rectum. The strain was highly atimicrobial-resistant and was determined to carry the NDM-1 gene.

There have been complaints from people in India about the stigma associated with the "New Delhi" component of the name. In hindsight, many people wish it had been named differently because of this, but at least at the moment, it's undeniable that India is a (or the) hotbed of NDM-1. It's been found in various bacteria from water and seepage samples in New Delhi, but this is the first report in Salmonella. It's concerning because of the difficulty that would be encountered treating highly resistant Salmonella in infected people. Usually, antibiotics aren't needed when someone has salmonellosis, but when they are needed, it's important that they work. Highly drug resistant strains increase the chance of a bad outcome if ineffective antibiotics are used initially (before it's determined that the strain is resistant).

NDM-1 has not been reported in animals... yet. I assume it's inevitable that it will occur, since this gene appears quite able to move between bacterial species. If it increases in humans and in human-feces-contaminated sources like water, exposure of animals will certainly occur. If NDM-1 containing bacteria establish themselves in the intestinal tracts of healthy animals, it's going to be much harder to control.

This equIDblog entry was originally posted on the Worms & Germs blog on 15-Oct-11.

Botulism Suspected In Aussie Outbreak

Scott Weese — Thu, 13 Oct 2011 09:14:00 -0500

A couple of days ago, I reported about a deadly outbreak on a Queensland farm that had killed a significant number of horses. A definitive diagnosis has still not been made, but it is starting to look like botulism might be the cause. In my previous assessment, I said botulism was a potential cause of an outbreak like this, but that this particular disease has a pretty consistent clinical presentation so it was probably unlikely if no one was talking about it as a leading option. It looks like now they are, with the owner stating "I've been talking to vets all over Queensland and they're saying the symptoms are spot-on for botulism." It's unclear whether the first vet(s) didn't consider it or whether there wasn't much veterinary involvement at all initially. Regardless, botulism makes sense, particularly with the description of the type of illness that's now being provided.

Botulism testing is underway, but it's often hard to get a positive lab test for this disease in horses. Often, it's a presumptive diagnosis made based on the clinical appearance and lack of any other identifiable cause. Botulism outbreaks on horse farms can be devastating, as in this case. They are often associated with feeding improperly fermented silage or haylage, but there are a variety of ways horses can ingest feed (or water) contaminated with the toxins produced Clostridium botulinum.

The good thing that comes out of this, if botulism is diagnosed, is that there's not much risk to other horses in the region, or at least not any higher risk than is always present. Whenever a large number of horses die from an unknown cause, it's always a concern that a new disease might be involved, something that fortunately does not seem to be likely here.

Image: Poor tongue tone is one of the classic signs of botulism in horses, which results in difficulty eating and drinking (click image for source).

Queensland Horse Deaths Being Investigated

Scott Weese — Mon, 10 Oct 2011 07:05:00 -0500

There's still no confirmed cause of death for 19 horses that died within a short period of time on a Kooralbyn, Queensland (Australia) farm. Sudden death and Queensland invariably conjures up thoughts of Hendra virus, considering the large number of Hendra cases that have occurred in the area this year, but that particular disease has already been ruled out.

Large numbers of horses dying on a farm around the same time obviously raises a lot of concern. Often, diagnosis is difficult and takes time. One problem is even deciding where to start. For an outbreak like this there are various considerations:

The usual (infectious) suspects: Common things occur commonly, and strange things are often caused by atypical presentations of common diseases. Hendra's been ruled out but other infectious causes can't be ignored.
Toxin-associated bacterial diseases: This mainly refers to botulism, which causes adult horses to get sick after eating feed contaminated with botulinum toxin. Poorly fermented feed or feed that has (accidentally) incorporated the remains of an animal that died of botulism can be the source. Botulism outbreaks are usually fairly characteristic clinically since animals with botulism have pretty consistent and remarkable clinical signs of illness. Presumably, it's low on the list here as I haven't seen it mentioned in any reports.
Toxins: A toxic cause is pretty high on the list, and can be hard to trace. Potential culprits include toxic plants or inadvertent access to toxic chemicals (I remember an outbreak of dead horses I was involved with a few years ago in which the horses died of pesticide exposure... on an organic beef farm!). Malicious poisoning always has to be considered as well.
New diseases: New diseases don't come along very often, but they can. Similarly, diseases that have been rare can sometimes peak out of nowhere, but something like this is much less likely than the categories above.
Miscellaneous: For example, if all the horses died inside, electric shock would have to be considered. I assume that's not the case here.

Diagnosis of the cause in an outbreak like this requires a lot of effort, including careful consideration of any signs of illness that were identified before death, good post mortem examinations (necropsies) of dead animals, thorough investigation of the farm looking for toxic plants and other toxic substances, investigation of other farms in the area to see if there are any unexplained horse deaths, investigation of any unexplained deaths of other animals in the area (e.g. looking for abnormal numbers of dead birds on the farm or in the area), testing of samples from horses for various toxins and testing tissues for possible infectious causes. Not easy or cheap, but hopefully effective, and hopefully will ultimately help save other horses from the same fate.

Equine Quarantine Recommendations

Scott Weese — Thu, 06 Oct 2011 19:01:00 -0500

Quarantine is an important, effective and underused practice on horse farms. Quarantine can reduce the risk of introducing new infectious agents to animals on the farm or limit the spread of something that’s already starting to circulate through the herd.

A recent article from TheHorse.com gives a good overview of why and how to implement quarantine. Importantly, it emphasizes that quarantine is not just for large, high-risk farms, and that any farm can and should have a quarantine plan. Not everyone can implement a quarantine protocol easily. We know and accept that, but the inability to implement a textbook quarantine program can't be used as an excuse to do nothing. Even a cursory quarantine program, with some basic practices to reduce direct and indirect contact of quarantined horses with other horses, can be very useful.

Most of the time, quarantine goes uneventfully and no problems are encountered. That sometimes leads to complacency, but it's the few cases where quarantine contains a problem that makes it all worthwhile. The implications of a single horse getting past quarantine can be huge, both for the individual farm and more broadly (e.g. Australian influenza outbreak). The article has some sound, practical advice that all horse owners should consider.

Who's Better At Biosecurity?

Maureen Anderson — Fri, 30 Sep 2011 12:57:00 -0500

There are a lot of recommendations out there for establishing or improving sound infection control practices on horse farms, many of which can be found on this very blog. Some refer to such practices as "biosecurity," but what's done on horse farms compared to the often very strict biosecurity protocols at facilities such as swine or poultry operations (e.g. all-in all-out management, closed barns, shower in) is very different, so we prefer to call it an infection control program, rather than "biosecurity." Regardless, one of the biggest challenges with regard to infection control, in almost any setting, is getting people to comply with all the various policies and recommendations. Unfortunately, it's not enough to just tell people what needs to be done (that'd be too easy!) - knowledge by itself usually won't change people's behaviour. They also need to be motivated to change their behaviour, for example by the potential for a positive reward (e.g. they get to take their horses to shows) or the potential to avoid a negative outcome (e.g. their horses don't get sick). Furthermore, individuals need to really believe they are capable (physically and mentally) of performing the required tasks - if they don't think they can do it or be effective at it, they're unlikely to try. In reality, getting people to change their behaviour to adopt sound infection control practices can be quite complex.

A study soon to be published in Preventative Veterinary Medicine (Schemann et al. in press) looked at some of the factors that affect horse owners' biosecurity practices and perceptions. The study was performed in Australia one year after the devastating equine influenza outbreak that occurred in 2007, using an online questionnaire to which 759 horse owners responded. Each owner's biosecurity compliance was rated as low (30%), medium (20%) or high (50%) based on how often they reported using 16 different infection control measures.

Factors that were associated with low compliance or poor biosecurity practices included people who:

were younger in age
had two or more children
were not involved with horses commercially
had no long-term business impact from the 2007 equine flu outbreak
were not fearful of a future outbreak of equine flu in Australia
thought their current hygiene and access control practices were not very effective in protecting their horses

Now, studies based on surveys of this kind always need to be taken with a grain of salt, as the study population itself was difficult to define and the information was all self-reported by owners, which can lead to confounding and misclassification bias. Nonetheless, the results are still interesting and on the whole are consistent with behaviour theory. Those whose income and livelihood were not dependent on the horse industry, and those who were not fearful of another outbreak, would be less motivated to put the effort into infection control measures. Furthermore, those who felt that what they were doing already wasn't really effective (for whatever reason) would be less motivated to try harder because they can't see the benefit. It's quite possible (as the authors speculate) that having two or more children results in less compliance with infection control simply due to the time constraints associated with having kids. Lack of time to properly perform infection control procedures is a major barrier to compliance, even in human hospitals, particularly with understaffing issues. The lower compliance among young people is also common to studies looking at protective behaviour in human health, possibly because young people have a sense of certain degree of invulnerability that results in riskier behaviour overall.

When it comes to infection control, the old adage "a chain is only as strong as its weakest link" is very important to remember. Although 50% of the horse owners in this study reported having high biosecurity compliance, the 30% with low compliance could ruin all their efforts should another outbreak occur, by contributing to the transmission and propagation of the disease on their own farms as well as to others. Hopefully this study will help the horse industry and government identify specific groups (i.e. young people, those not financially dependent on horses) at which educational and motivational campaigns can be targeted in the future.

Another EHV-1 Equine Hospital Quarantine

Scott Weese — Tue, 20 Sep 2011 14:44:00 -0500

Once again, an equine hospital is under quarantine because of equine herpesvirus type 1 (EHV-1). There have been a number of such incidents this year, highlighting both the increasing concern with this important pathogen and perhaps more transparency and willingness on the part of hospitals to take aggressive infection control measures when it is detected.

The latest incident involves the University of Tennessee Equine Hospital. The entire situation is related to identification of EHV-1 infection in one horse that was admitted on September 15 and euthanized a few hours later because of severe and progressive neurological disease. The next day, the Tennessee state veterinarian implemented a seven-day quarantine, while the hospital voluntarily implemented a 14-day quarantine. Seven days is pretty short and if you're concerned enough that you think quarantine is needed - if it's going to be done at all, it should be done right (i.e. for longer than a week).

At last report, there was no evidence of transmission to other horses. Presumably university personnel are closely watching horses in the hospital and are hopefully in contact with people who had horses they after the EHV-1 horse was admitted but before quarantine was implemented.

The need for facility closure or quarantine is always something of debate. EHV-1 should be a containable problem with prompt recognition of affected horses, proper isolation facilities and compliance with infection control procedures. Identifying infectious horses is a key aspect, as they are not always screaming "I have EHV!" when you see them. If a horse with EHV isn't identified as a potentially infectious animal and isolated from the start, the risk of transmission goes up. In this case, it was stated that the horse was kept in a "separate area of the equine hospital." It's not clear whether this was in an isolation unit or not. If it was admitted directly to isolation and was handled with appropriate protocols, the risk of other horses being infected should be very low. Given the time frame involved (it was only in the hospital for a few hours), even if it was in the main hospital, the likelihood of transmission to other horses is probably still relatively low, but it's certainly possible.

From a disease control standpoint, it's much better to be overly aggressive at the start while you are sorting out what's going on rather than sitting back and hoping for the best. While this often results in negative publicity, it's better than ending up with an outbreak which results in even worse publicity, as well as more sick animals.

EPM Testing

Scott Weese — Sun, 18 Sep 2011 06:11:00 -0500

Equine protozoal myeloencephalitis (EPM) is a frustrating disease. It's been referred to as one of the most overdiagnosed, underdiagnosed and misdiagnosed equine diseases - an apt description. In some areas, every horse (particularly every racehorse) that has any real or perceived abnormality (such as not running fast enough) gets treated, usually without any attempt to make a true diagnosis. Most of these animals don't have EPM, but some might, along with horses displaying a range of sometimes vague neurological signs. When an effort is made to really establish a diagnosis, unfortunately it's not straightforward, which leads to more confusion about the disease and how to manage it.

The Animal Health Diagnostic Center at Cornell University have released a document on EPM testing and diagnosis. This document discusses when and why to test, along with important information about the available, recommended tests. It's a nice, comprehensive overview of the subject and worth a look for equine veterinarians as well as horse owners wondering whether their horse may have this enigmatic disease.

Equine Infectious Neurological Disease Update: Ontario

Scott Weese — Thu, 15 Sep 2011 13:03:00 -0500

The latest update on equine infecious neurological diseases in Ontario (Eastern equine encephalitis (EEE), West Nile virus (WNV), rabies and neuropathic equine herpevirus type 1 (EHV-1)) is available from the Ontario Ministry of Agriculture, Food and Rural Affairs.

There aren't a lot of surprises, and it's good to see the numbers of cases have remained relatively low. Most notably, there have been three EEE and five WNV cases confirmed, from different regions of the province. This shows that these diseases are still occurring in Ontario horses, albeit at a very low rate.

You always have to consider the limitations of surveillance data like this. To make the list, a horse has to get infected, get sick enough for someone to notice, a veterinarian has to be called and proper samples have to be taken for diagnostic testing. There's certainly no guarantee that this happens in all instances, and it's reasonable to assume that a few more cases of these diseases have occurred in Ontario this year.

In Ontario, August and September tend to be the months of highest activity for EEE and WNV, and as we move into cooler weather (and decreased mosquito activity) the risk of EEE and WNV will start to plummet. I wouldn't be surprised if the numbers increase slightly by the time the final tally is made, but there are no indications that we have major disease activity at the moment.

Surveillance data such as this, including total numbers of cases in the province and an indication of areas where case occur, are important for horse owners and veterinarians to consider when determining their vaccination programs.

Equine Biosecurity Risk Calculator

Scott Weese — Thu, 15 Sep 2011 09:38:00 -0500

After an extensive development and review process, an Equine Biosecurity Risk Calculator (click here) is now available online on the Equine Guelph website. This joint venture of Equine Guelph and Colorado State University, with support from the AAEP Foundation and Vetoquinol, is designed to offer practical advice on equine infectious disease risk and control.

While no one can really give an exact number regarding "risk" of infectious diseases on any particular equine facility, it is possible to identify areas in need of improvement. That's what this "calculator" is designed to do. Horse owners can complete the online questionnaire and get a general assessment of risk, plus detailed information about areas of concern. The calculator is free to use and no identifying information is collected.

Every horse owner should try this and see what areas are identified that could be improved. While facilities are quite variable in their application of infection control practices, I've yet to encounter a "perfect" facility - undoubtedly everyone will get at least a few ideas to consider to help reduce the risk of infectious disease in their animals.

MRSA From Foal To Girl

Scott Weese — Mon, 12 Sep 2011 15:55:00 -0500

A case report highlighted by TheHorse.com and presented at the ASM/ESCMID MRSA conference in Washington DC last week described a horse-associated methicillin-resistant Staphylococcus aureus (MRSA) infection in Dutch girl.

The girl, a 16-year-old with a severe neuromuscular disease who was wheelchair-bound and on a ventilator, developed an infection following an insect bite. When the infection didn't respond to initial treatment, a sample was taken for culture and MRSA was identified. The girl didn't have any known risk factors for MRSA infection but had had close contact with a foal. The Friesian foal had been at a veterinary hospital prior to the girl's infection. It had a wound infection that was successfully treated with antibiotics, but no culture was taken at the time. The foal was considered a possible source of the MRSA, particularly since the strain that was recovered was ST398, which is widely found in livestock and which is regularly seen in horses in the Netherlands. After the girl's infection was identified, the foal was tested and was also found to be carrying MRSA. The girl's infection was successfully treated and the foal eliminated MRSA carriage without treatment (which is expected in horses because long-term carriage of MRSA seems to be rare to non-existent in this species).

The source of the infection could not be definitively proven, but given the fact that the horse was at a facility that regularly sees MRSA cases, that the strain involved is typically associated with livestock, and that the girl had no other livestock contact, it's a reasonable to assume it came from the foal.

We've known for a few years that MRSA is an issue in horses, and that it can be passed between horses and people - in both directions. Equine veterinarians and horse owners have abnormally high MRSA carriage rates. MRSA carriers are people who have MRSA living in or on them (most often in the nose) without any signs of infection. Most carriers never have a problem, but disease can develop in some situations. The incidence of human MRSA infections transmitted from horses is low, although it's almost certain that many horse-associated MRSA infections are not reported because the link with horses isn't made or people don't mention the horse contact. TheHorse.com article is incorrect in stating that this is only the third case of horse-to-human MRSA infection, since we've already published two such reports, one of which included multiple cases. Regardless, it's an uncommon problem but it is probably also under-recognized. Horse owners shouldn't panic about MRSA, but they should realize that MRSA is circulating in the horse population and that by nature of their frequent and close contact with horses, they are at higher risk for MRSA carriage, and likely also infection.

More information about MRSA in horses can be found on the equIDblog Resources page.

(click image for source)

Safe Sex For Horses

Scott Weese — Mon, 12 Sep 2011 07:48:00 -0500

The recent (or, I guess, not so recent, since it seems to have been lingering in the background for a while) contagious equine metritis (CEM) outbreak in the US was a good demonstration of the potential impact venereally transmitted diseases can have on the horse industry. Concerns about such things are greatest in breeds that only allow live cover, since an individual stallion may be exposed to a large number of mares every year, and with the mobile nature of the horse population, it's possible for one infected horse to disseminate an infection widely across or between countries.

While CEM is probably the highest profile venereal disease in horses, it's not the only one. Other pathogens like equine arteritis virus and equine herpesvirus type-3 (equine coital exanthema virus) are also of concern, along with various opportunistic bacteria.

Proper management and infection control practices can greatly reduce, but not eliminate, the risk of sexually transmitted infections in horses. Unfortunately, such practices aren't always used. Sometimes it's because of lack of consideration or laziness. Sometimes it's because of lack of awareness. To help improve awareness and make it easier for people to take appropriate precautions, the American Association of Equine Practitioners (AAEP) has recently released Biosecurity Guidelines for Control of Venereally Transmitted Diseases. It's an excellent resource for veterinarians and horse owners, and should be part of the infection control program for anyone breeding horses.

Economic Impact Of Aussie Horse Flu

Scott Weese — Wed, 07 Sep 2011 06:59:00 -0500

A huge equine influenza virus outbreak occurred in Australia in 2007 - a classic example of what can happen when a virus gets into an area where it's never been before. There were huge numbers of affected horses and a massive disruption to the industry due to quarantines and other control measures.

A special edition of the Australian Veterinary Journal (July 2011) includes a series of papers covering different aspects of this outbreak. In one paper (Smyth et al) the authors look at the economic consequences and tried to determine the financial costs of the outbreak. Such estimates are always tough to make and can never be 100% accurate, but they can give a general idea of the scope and impact of an outbreak. Not surprisingly, the costs were pretty astounding.

Australian Government

A series of measures were implemented to assist individuals and organization that were impacted. The total cost of those packages was over $263 million AusD.

State/Territory Governments

New South Wales and Queensland were most seriously affected, but all states and territories were impacted. These governments provided support in addition to the federal funds. For example, Queensland allocated over $27 million to various efforts, while New South Wales contributed more than $46 million.

Racing and Wagering Western Australia

This is the government body that regulates racing in Western Australia. The outbreak cost this agency around $500 000, a figure that does not include lost employee time and approximately $15 million in lost wagering revenue. Some of this was recovered through insurance, but it's now unlikely that they will be able to get further insurance to cover outbreaks.

Harness Racing Industry

It's always hard to figure out the true costs to an industry after a major disaster because the trickle down effect goes so far, affecting people who provide support and services (e.g. hay suppliers) to various businesses that are affected directly because people in those groups don't have money to spend. The total identifiable costs were calculated to be over $23 million, about half of which was to owners and trainers. The authors acknowledge the true costs were probably much higher.

Inquiry

A large inquiry was commissioned after the outbreak. This cost over $5 million.

Animal Health Australia

This group coordinated the emergency response and had to divert tremendous personnel time and resources. This included the vaccination program that distributed 670 000 doses of vaccine.

Households and businesses

Overall, it was estimated that horse associations lost $281 million, horse businesses $65 million and households $34 million.

Horse deaths

The value of horses that were reported to have died was close to $1 million, despite the fact that equine flu is uncommonly fatal. This number doesn't include intangible costs associated with losing a horse. However, reported deaths may be a minority and it was estimated that true horse death costs may have been $44 million. (However, I suspect the death rate estimate used for this value is high.)

Veterinary treatment

Estimated costs...$35.7 million.

Do the exact numbers matter? No. They simply show that an infectious disease outbreak can cost a lot. In many areas, horses receive little government attention because they are not food animals, despite the fact that the highly mobile horse population is probably at much higher risk of importing a new disease, and despite the fact that the economic impact of the industry is huge (and often overlooked by governments and groups that fund agricultural research).

If nothing else, this should serve as a reminder to government and industry groups that attention needs to be paid to infection control and emergency planning. While groups are often reluctant to put much or any time, effort and funds into these areas, the amount of money that would be spent is inconsequential compared to the potential impact of even a small outbreak.

Image source: www.dailyclipart.net

Ontario Equine Influenza Activity

Scott Weese — Tue, 30 Aug 2011 10:17:00 -0500

Like human influenza, equine influenza can be a seasonal disease with periods of particularly high activity. It's possible that we are in a period of high flu activity in horses in Ontario, based on cases we've seen and anecdotal information from the general population. We've seen a couple of confirmed cases of influenza over the past week (which is rather unusual), and unconfirmed rumours suggest that there may be many influenza cases in horses in the province, particularly at racetracks. Given the non-reportable nature of influenza, the often tight-lipped nature of horse owners when it comes to disease, and the typical lack of diagnostic testing to confirm flu in horses with flu-like disease, it's hard to say what's really happening.

Regardless, people should be on the lookout for influenza. Horses that develop a fever and/or signs of respiratory disease should be evaluated and isolated unless a non-infectious cause is identified. Facilities with affected horses should implement effective infection control practices to reduce the spread both on the farm and to other farms. People should discuss the risk of influenza exposure in their horses and talk to their veterinarian about whether influenza vaccination is indicated. Veterinarians can also use this situation as a reminder to owners of the ever-present risk of various infectious diseases, and as a lead-in to an assessment of the regular farm infection control plan (and if the farm doesn't have one, get started on it).

EIA Outbreak In Arkansas

Scott Weese — Fri, 26 Aug 2011 20:02:00 -0500

A large equine infectious anemia (EIA) outbreak has claimed the lives of 40 Arkansas horses. The outbreak has hopefully been contained to one farm in Johnson County. Two horses on the farm died from this viral disease, while 38 others were euthanized, presumably because they tested positive. Approximately 40 other horses are on the farm, and are presumably negative (at this time).

So far, the outbreak seems to be limited to this single farm. There is one neighbouring farm, which is being investigated to see if the insect-borne disease has spread. The affected farm does not show horses or 'sell any horses to any extent,' so hopefully the odds of the outbreak being contained are good.

A big question remains unanswered and is critical for determining whether this outbreak will be controlled: Where did the virus come from? Viruses don't just spontaneous pop out of nowhere (although sometimes it seems that way at first) - there had to be source of infection, and that source could have spread it elsewhere. With the large number of positive horses on this farm, it's concerning that the virus could have been introduced a while ago, and the longer the time frame, the harder it is to both track and control.

MRSA In Aussie Horses

Scott Weese — Tue, 23 Aug 2011 19:04:00 -0500

In the early 2000s, we took a lot of bad publicity in Ontario (particularly at the Ontario Veterinary College) because of MRSA in horses. While MRSA had been found in horses before and there were anecdotal reports of MRSA infections and outbreaks in different areas, the fact that we intensively investigated the issue and published a lot of our findings made it look like we were the hotbed of MRSA internationally. We suspected at the time that MRSA was widespread in horses and that the limited reports were because few people were looking or publishing their observations. That suspicion has been supported by reports over the past few years of MRSA in horses in many countries, and it appears that MRSA is present in horses around the world.

A recent study from Australia (Axon et al, Australian Veterinary Journal 2011) provides more support for this conclusion. In the study, horses that were admitted to a veterinary hospital's intensive care unit over a 30 day period in 2008 were tested for MRSA carriage by culturing swabs from their noses. MRSA was isolated from 3.7% of horses, which is similar to the prevalence here based on data we've gathered over the years.

For the second part of the study, the authors looked at medical records from horses at the hospital from 2004-2009 and collected data on MRSA infections. During that time, MRSA was isolated from 75 horses.

That number (75) surprises me a little, since it's much higher than what we see here. Even though we see approximately 2% of horses carrying MRSA when they arrive at the hospital, we have a very low MRSA infection rate in our patient population. A few of those 75 horses probably didn't really have MRSA infections, since nine horses only had positive nasal samples which is more likely to be from subclinical colonization rather than infection of the nasal passages. A few others had MRSA isolated from catheter sites, and it's hard to say whether those are truly infection or just contamination of the skin. So, the number of true infections might be lower, but it's still a significant issue. It would be interesting to know how many of those horses came in with MRSA infections versus how many picked up MRSA in hospital.

Wound infections were most common, accounting for 43 (57%) of the cases. Five horses were euthanized because of the MRSA infection, all of which had joint infections that did not respond to intensive treatment.

One farm accounted for 18 MRSA-positive results in the second part of the study, as well as two positive horses in the surveillance part of the study. This farm would seem to have a pretty big MRSA problem, which we've seen occasionally on a few biohazardous breeding farms that we've found over the years. MRSA can be controlled on farms like that but it takes effort. We've had some farms address the issue properly and eliminate MRSA, while others essentially ignored the problem and continued to have widespread MRSA for years.

Not surprisingly, most of the MRSA isolates in the Australian study belonged to sequence type 8 (ST8), the group of MRSA that we find in horses here in Ontario and internationally. This is a recognized human strain that seems to have become adapted to horses. It's also found in a disproportionately high percentage of horse owners and horse vets, likely indicating movement of teh strain between horses and people.

Overall, the results of this study are not surprising, but are very useful in that they support the notion that MRSA is present in horses around the world, and the situation with MRSA in horses is probably quite similar in many different countries.

More information about MRSA can be found in on the equIDblog Resources page.

Rabies In New Mexico Horse

Scott Weese — Mon, 22 Aug 2011 18:00:00 -0500

Rabies is pretty rare in horses, but there have been a few reports this summer. Though rare, rabies is still a major concern because it's invariably fatal in horses, and almost always fatal in people.

Rabies was recently diagnosed in a horse in Eddy County, New Mexico. It started showing undefined signs of rabies and was euthanized two days later. Several people who worked with the horse are undergoing post-exposure treatment.

While rabies can potentially be spread from horses to people, I'm not aware of any confirmed cases of such transmission. Since rabies usually kills people, even a plausible risk is cause for concern. Additionally, and perhaps more importantly, rabid horses can be very dangerous, and multiple people have been killed by aggressive rabid horses.

Rabies should be a core component of a horse's vaccination program in any part of the world where rabies is present in the wildlife population. Unfortunately, that's not always understood. One area resident stated she'd never heard of rabies in horses, and while she has her dogs and cats vaccinated, she hasn't vaccinated her livestock. No vaccine is 100% preventative, but rabies vaccination is a cheap and very effective way to reduce the risk of this fatal disease significantly.