Challenges to exotic disease preparedness in Great Britain: The frontline veterinarian's perspective

BACKGROUND

Exotic diseases pose a significant risk to horse health and welfare. Several stakeholder groups, including primary care veterinarians, share responsibility for maintaining freedom from pathogens that cause exotic diseases. However, little is known about the current state of exotic disease preparedness within the British horse industry.

OBJECTIVES

The aim of this study was to explore equine veterinarians' experiences of, and attitudes towards, exotic disease preparedness in Great Britain.

STUDY DESIGN

This is a qualitative interview-based study.

METHODS

Semistructured interviews were conducted with 14 primary care equine veterinarians in Great Britain. Participants were purposively selected to include perspectives across varying levels of experience, clientele and location. All interviews were recorded, transcribed verbatim and analysed using thematic analysis.

RESULTS

Three themes were developed: (a) the reactive generalist, relating to participants' self-concept of their role as primary care practitioners; (b) working within the bounds of influence, encompassing participants' perceived inability to influence their clients' knowledge and behaviours and (c) a fragmented horse industry, illustrating the wider culture in which participants worked, characterised by a lack of cohesion amongst its members.

MAIN LIMITATIONS

Only veterinarians' perspectives have been captured, so viewpoints from other stakeholders, such as horse owners and government officials, should be used to triangulate these findings.

CONCLUSIONS

The findings suggest that improvements are required before an optimal level of exotic disease preparedness can be achieved. Additional support provided to frontline veterinarians, such as skills-based training (ie, clinical reasoning and collaborative relationship building), accessible and trusted emergency support networks and clear expectations and responsibilities during an outbreak are recommended to optimise exotic disease preparedness.

Information delivery and the veterinarian-horse owner relationship in the context of Hendra virus in Australia

Hendra virus (HeV) is an emerging bat-borne virus endemic in Australia that can be transmitted from horses to humans and has a high fatality rate for horses and people. Controversy surrounding HeV risk mitigation measures have strained the veterinarian-horse owner relationship. This study aimed to characterise the veterinarian-horse owner relationship in general and also in the context of HeV by analysing data derived from the 'Horse Owners and Hendra Virus: A Longitudinal Study to Evaluate Risk' (HHALTER) study. Australian horse owners were recruited via emails, social media and word-of-mouth for a series of five surveys that were administered online at six-monthly intervals over a two-year period to capture baseline knowledge, attitudes and practices of horse owners regarding HeV and any changes over time. In the current study, descriptive analyses of information sources were performed to understand the use of veterinarians as a HeV information source (Surveys 1 and 5; n = 1195 and n = 617). Ordinal logistic regression analyses were conducted to determine factors associated with the frequency of horse owner contact with a veterinarian (Survey 3; n = 636). This study found a relative increase over the study period in the proportion of horse owners who had used veterinarians as HeV information source in the last 12 months (from 51.9% to 88.3%). Owning more horses, being older, having a 'duty of care' for other people working with horses and deriving the main income from horse related business were factors associated with more frequent veterinary contact. Results suggest that traditional information sources such as workshops, information packs and risk training are likely to be used by horse owners. Smart phone applications should be considered for use in the future and require further investigation for horse health communication. The findings of this study may be helpful in optimising strategies for horse health information delivery.

Equine helminth prevalence and management practices on Australian properties as shown by coprological survey and written questionnaire

Context Parasite control is an essential part of a broader equine health-management strategy and is often completely administered by the horse owner, with little or no supporting evidence on which to base decisions. Practical and sound advice relies on knowledge of the resident parasite species, the anthelmintic resistance status of important species, and the strategies currently being utilised by owners and managers of horses. Much of this farm-level information is lacking in the Australian literature. Aims The present study aimed to gather both farm- and horse-level prevalence data for four important equine helminth species and to gather information on the current worm-management practices conducted on Australian horse farms. Methods We conducted a coprological survey of cyathostomins, Strongylus vulgaris, Parascaris spp. and equine tapeworm on 102 horse properties, using a combination of classical and molecular parasitological methods, including a tapeworm polymerase chain reaction developed as part of the study. A questionnaire canvasing horse owners on internal parasite-control practices was also distributed. Key results Cyathostomin were present on all farms surveyed and S. vulgaris, despite being considered rare, was present on 7.8% (95% CI: 3.9–15.0) of farms. The prevalence of Parascaris spp. and equine tapeworm was 33.3% (95% CI: 19.6–50.6) and 3.9% (95% CI: 1.5–10.1) respectively. Questionnaire responses showed that the majority (85.0%) of horse owners administer anthelmintics at regular intervals of 12 weeks or less, and only 2.6% utilise faecal egg counts to inform treatment decisions. Conclusions Prevalence data confirmed the endemic nature of cyathostomin and P. equorum infections, as well as low levels of tapeworm and S. vulgaris infections on Australian horse farms. Worm-management practices were reminiscent of traditional interval-style treatment regimens that rely heavily on macrocyclic lactone anthelmintics. Implications These results suggest a need for more strategic approaches to internal-parasite control in horses to slow the development of anthelmintic resistance. Such programs need to consider the risk of re-establishment of the pathogenic S. vulgaris in significant numbers.

Systematic review of gastrointestinal nematodes of horses from Australia

Background

Equine gastrointestinal nematodes (GINs) have been the subject of intermittent studies in Australia over the past few decades. However, comprehensive information on the epidemiology of equine GINs, the efficacy of available anthelmintic drugs and the prevalence of anthelmintic resistance (AR) in Australasia is lacking. Herein, we have systematically reviewed existing knowledge on the horse GINs recorded in Australia, and main aspects of their pathogeneses, epidemiology, diagnoses, treatment and control.

Methods

Six electronic databases were searched for publications on GINs of Australian horses that met our inclusion criteria for the systematic review. Subsets of publications were subjected to review epidemiology, diagnoses, pathogeneses, treatment and control of GINs of horses from Australia.

Results

A total of 51 articles published between 1950 to 2018 were included. The main GINs reported in Australian horses were cyathostomins (at least 28 species), Draschia megastoma, Habronema muscae, H. majus, Oxyuris equi, Parascaris equorum, Strongyloides westeri and Trichostrongylus axei across different climatic regions of Queensland, New South Wales, Victoria, and Western Australia. Nematodes are diagnosed based on the traditional McMaster egg counting technique, though molecular markers to characterise common GINs of equines were characterised in 1990s. The use of anthelmintic drugs remains the most widely-used strategy for controlling equine GIN parasites in Australia; however, the threshold of faecal egg count that should trigger treatment in horses, remains controversial. Furthermore, anthelmintic resistance within GIN population of horses is becoming a common problem in Australia.

Conclusions

Although GINs infecting Australian horses have been the subject of occasional studies over the past few decades, the effective control of GIN infections is hampered by a generalised lack of knowledge in various disciplines of equine parasitology. Therefore, coordinated and focused research is required to fill our knowledge gaps in these areas to maximise equine health and minimise economic losses associated with the parasitic infections in Australia.

Electronic supplementary material

The online version of this article (10.1186/s13071-019-3445-4) contains supplementary material, which is available to authorized users.

Australian horse owners and their biosecurity practices in the context of Hendra virus

In recent years, outbreaks of exotic as well as newly emerging infectious diseases have highlighted the importance of biosecurity for the Australian horse industry. As the first potentially fatal zoonosis transmissible from horses to humans in Australia, Hendra virus has emphasised the need to incorporate sound hygiene and general biosecurity practices into day-to-day horse management. Recommended measures are widely publicised, but implementation is at the discretion of the individual owner. This cross-sectional study aimed to determine current levels of biosecurity of horse owners and to identify factors influencing the uptake of practices utilising data from an online survey. Level of biosecurity (low, medium, high), as determined by horse owners' responses to a set of questions on the frequency of various biosecurity practices performed around healthy (9 items) and sick horses (10 items), was used as a composite outcome variable in ordinal logistic regression analyses. The majority of horse owners surveyed were female (90%), from the states of Queensland (45%) or New South Wales (37%), and were involved in either mainly competitive/equestrian sports (37%) or recreational horse activities (35%). Seventy-five percent of owners indicated that they follow at least one-third of the recommended practices regularly when handling their horses, resulting in medium to high levels of biosecurity. Main factors associated with a higher level of biosecurity were high self-rated standard of biosecurity, access to personal protective equipment, absence of flying foxes in the local area, a good sense of control over Hendra virus risk, likelihood of discussing a sick horse with a veterinarian and likelihood of suspecting Hendra virus in a sick horse. Comparison of the outcome variable with the self-rated standard of biosecurity showed that over- as well as underestimation occurred. This highlights the need for continuous communication and education to enhance awareness and understanding of what biosecurity is and how it aligns with good horsemanship. Overall, strengthened biosecurity practices will help to improve animal as well as human health and increase preparedness for future disease outbreaks.