Surveillance of strangles in UK horses between 2015 and 2019 based on laboratory detection of Streptococcus equi

'I want to be the sort of owner that he wants me to be': Rationales for biosecurity implementation among British horse owners

BACKGROUND

Horse owners play a critical role in mitigating the risk of pathogen spread between horses. However, little is known about how they view biosecurity and whether they experience barriers to the uptake of preventive measures.

OBJECTIVES

To explore horse owners' attitudes, perceptions, and experiences of biosecurity and identify how these factors shape horse owners' decisions for biosecurity implementation.

STUDY DESIGN

Qualitative study using semi-structured interviews.

METHODS

Interviews were conducted with 23 horse owners across Great Britain. Participants were purposively selected to include those in different geographic regions, with different management arrangements, and varied length of horse ownership experience. Interviews were audio-recorded, transcribed verbatim, and analysed using a critical realist thematic analysis.

RESULTS

Participants felt a moral obligation to prioritise their horse's happiness, which became a challenge when certain biosecurity measures (e.g., quarantine) were perceived as compromising their horse's happiness or comfort (Theme 1). A lack of biosecurity was the social norm among shared yards and competition venues (Theme 2), which made it difficult for participants to implement biosecurity measures effectively on their own. Combined with the sense of moral obligation participants felt towards their horse, this meant that participants had to 'care double' (i.e., be more vigilant than they would otherwise) to compensate for collective inaction (Theme 3).

MAIN LIMITATIONS

Participants may have been more interested in and/or knowledgeable about biosecurity than the general horse owning population.

CONCLUSIONS

The findings highlight several challenges that could be addressed to improve biosecurity implementation among horse owners. Efforts to encourage improved uptake of biosecurity measures should focus on communicating how reducing the risk of disease aligns with horse care. Further research on social norms in the horse industry is needed, in addition to identifying strategies to encourage a collective adoption of biosecurity measures.

Enhancement of loop-mediated isothermal amplification (LAMP) with guanidine hydrochloride for the detection of Streptococcus equi subspecies equi (Strangles)

Streptococcus equi subspecies equi, commonly referred to as "strangles", poses a significant biosecurity challenge across equine farms worldwide. The continuous prevalence and highly transmissibility of strangles necessitates a rapid and accurate diagnostic procedure. However, current "gold-standard" techniques, such as cultures and quantitative polymerase chain reaction (qPCR), are unreliable or inaccessible, and require lengthy periods between sample collection and results. Moreover, the lack of a standardized detection protocol can lead to variations in results. This study aimed to develop a reproducible and field-deployable diagnostic assay to detect strangles in real-time. Utilising the rapid technique loop-mediated isothermal amplification (LAMP), we developed an assay targeting a conserved region of the S. equi-specific M gene (SeM). Additionally, we optimised our assay with guanidine hydrochloride (GuHCl) to enhance the assay's performance and detection capabilities. The Str-LAMP was able to detect S. equi within 13 minutes and 20 seconds for both synthetic DNA and clinical isolates, with a limit of detection (LOD) of  53 copies/µl. Our assay demonstrated high repeatability with the inter-coefficient of variation ranging from 0.17% to 3.93%. Furthermore, the clinical sensitivity and specificity was calculated at 91.3% and 93.3%, respectively, with a correct classification rate of 91.8%. The implementation of this newly developed strangles assay can be employed as an efficient aid for in-field surveillance programs. The assay's reproducibility can allow for equine managers to undertake routine self-surveillance on their properties, without the requirement of specialised training. The Str-LAMP assay has the potential to be a valuable tool to help mitigate potential strangles outbreaks.

Development of a Real-Time Recombinase-Aided Amplification Method for the Rapid Detection of Streptococcus equi subsp. equi

Streptococcus equi subspecies equi (S. equi) is the causative pathogen of strangles in horses, donkeys, and other equine animals. Strangles has spread globally and causes significant losses to the horse industry. In response to the urgent need for effective disease control, this study introduces a novel nucleic acid diagnostic method known as a real-time recombinase-assisted amplification (RAA) assay, developed based on the eqbE gene, for the rapid detection of S. equi nucleic acid. The real-time RAA method employs specifically designed probes and primers targeting the eqbE gene, enhancing the overall specificity and sensitivity of the detection. After efficiency optimization, this real-time RAA method can detect 10 or more copies of nucleic acid within 20 min. The method demonstrates high specificity for S. equi and does not cross-react with other clinically relevant pathogens. Real-time RAA diagnostic performance was evaluated using 98 nasal swab samples collected from horses and compared with the real-time PCR detection method. Results revealed that 64 and 65 samples tested positive for S. equi using real-time RAA and real-time PCR, respectively. The overall agreement between the two assays was 96.94% (95/98), with a kappa value of 0.931 (p < 0.001). Further linear regression analysis indicated a significant correlation in the detection results between the two methods (R2 = 0.9012, p < 0.0001), suggesting that the real-time RAA assay exhibits a detection performance comparable to that of real-time PCR. In conclusion, the real-time RAA assay developed here serves as a highly specific and reliable diagnostic tool for the detection of S. equi in equine samples, offering a potential alternative to real-time PCR methods. In conclusion, the real-time RAA nucleic acid diagnostic method, based on the eqbE gene, offers rapid and accurate diagnosis of S. equi, with the added advantage of minimal equipment requirements, thus contributing to the efficient detection of strangles in horses.

Dynamics analysis of strangles with asymptomatic infected horses and long-term subclinical carriers

Strangles is one of the most prevalent horse diseases globally. The infected horses may be asymptomatic and can still carry the infectious pathogen after it recovers, which are named asymptomatic infected horses and long-term subclinical carriers, respectively. Based on these horses, this paper establishes a dynamical model to screen, measure, and model the spread of strangles. The basic reproduction number $ \mathcal{R}_0 $ is computed through a next generation matrix method. By constructing Lyapunov functions, we concluded that the disease-free equilibrium is globally asymptotically stable if $ \mathcal{R}_0 < 1 $, and the endemic equilibrium exits uniquely and is globally asymptotically stable if $ \mathcal{R}_0 > 1 $. For example, while studying a strangles outbreak of a horse farm in England in 2012, we computed an $ \mathcal{R}_0 = 0.8416 $ of this outbreak by data fitting. We further conducted a parameter sensitivity analysis of $ \mathcal{R}_0 $ and the final size by numerical simulations. The results show that the asymptomatic horses mainly influence the final size of this outbreak and that long-term carriers are connected to an increased recurrence of strangles. Moreover, in terms of the three control measures implemented to control strangles(i.e., vaccination, implementing screening regularly and isolating symptomatic horses), the result shows that screening is the most effective measurement, followed by vaccination and isolation, which can provide effective guidance for horse management.

Streptococcus equi Subspecies equi

Strangles, caused by the bacteria Streptococcus equi subsp equi, is a highly contagious disease of equids classically characterized by a high fever and enlarged lymph nodes of the head. Diagnostic sampling depends on the stage of the disease. The goal of treating strangles is to control transmission and to eliminate infection while providing future host immunity. Daily temperature checking and isolation of febrile horses is the key to controlling outbreaks. Eradication of this disease will not be possible until S equi carriers are eliminated from the equine population.

Strangles in equines: An overview

Strangles, caused by Streptococcus equi subspecies equi, is a highly infectious respiratory disease affecting horses and other equines. The disease is economically important and compromises the productivity of equine farm significantly. The disease is characterized by pyrexia, mucopurulent nasal discharge, and abscess formation in the lymph nodes of the head and neck of horses. The disease transmission occurs either directly by coming in contact with infectious exudates or indirectly via fomite transmission. Besides this, carrier animals are the primary and most problematic source of disease infection. The organism not only initiates outbreaks but also makes the control and prevention of the disease difficult. The diagnosis of strangles is best done by isolating and characterizing the bacteria from nasal discharge, pus from abscesses, and lymphoid tissues or by using PCR. ELISA can also be used to detect serum protein M (SeM) antibodies for diagnosis. The most popular treatment for strangles is with penicillin; however, the treatment is affected by the stage, feature and severity of the disease. Prevention and control of strangles can be achieved through vaccination and good hygiene practices. Basically, this review describes the global prevalence of S. equi, as well as general aspects of the disease, like pathogenesis, diagnosis, treatment, prevention, control and management of the disease.

Voluntary Biosurveillance of Streptococcus equi Subsp. equi in Nasal Secretions of 9409 Equids with Upper Airway Infection in the USA

This study aimed to describe selected epidemiological aspects of horses with acute onset of fever and respiratory signs testing qPCR-positive for S. equi and to determine the effect of vaccination against S. equi on qPCR status. Horses with acute onset of fever and respiratory signs from all regions of the United States were included in a voluntary biosurveillance program from 2008 to 2020 and nasal secretions were tested via qPCR for S. equi and common respiratory viruses. A total of 715/9409 equids (7.6%) tested qPCR-positive for S. equi, with 226 horses showing coinfections with EIV, EHV-1, EHV-4, and ERBV. The median age for the S. equi qPCR-positive horses was 8 ± 4 years and there was significant difference when compared to the median age of the S. equi qPCR-negative horses (6 ± 2 years; p = 0.004). Quarter Horse, Warmblood, and Thoroughbred were the more frequent breed in this horse population, and these breeds were more likely to test qPCR-positive for S. equi compared to other breeds. There was not statistical difference for sex between S. equi qPCR-positive and qPCR-negative horses. Horses used for competition and ranch/farm use were more likely to test qPCR-positive for S. equi (p = 0.006). Horses that tested S. equi qPCR-positive were more likely to display nasal discharge, fever, lethargy, anorexia, and ocular discharge compared to horses that tested S. equi qPCR-negative (p = 0.001). Vaccination against S. equi was associated with a lower frequency of S. equi qPCR-positive status.