What can mathematical models bring to the control of equine influenza?

A model-based approach to evaluate the effect of vaccination of the herd on transmission of equine herpesvirus 1 in naturally occurring outbreaks

Equine herpesvirus 1 (EHV-1) infection is the cause of high impact disease syndromes, affecting the global horse industry. The effect of vaccination on transmission dynamics of EHV-1 in naturally occurring outbreaks is not quantified. Our aims were to estimate R0 for EHV-1 in equine populations from outbreak data, and evaluate the effect of vaccination status of the herd on R through a systematic review, model-based estimations and meta-analysis. A literature search for outbreak reports was carried out. Depending on available data, the early epidemic growth rate (GR) or final attack rate (AR) approach was used to estimate the basic reproduction number for that outbreak. Herd vaccination status, as well as virus genotype and use of antivirals were recorded. Only outbreaks in herds where either none or all of the horses had been vaccinated were included. An overall estimate for R0 (non-vaccinated herds) and Rv (vaccinated herds) was computed by meta-analysis and the two groups were compared using a random effects model. Twelve outbreaks, in herds of 16-135 horses, met the inclusion criteria, of which six occurred in non-vaccinated herds and six in vaccinated herds. One R0 calculation from a report describing empirical determination of a herd immunity threshold was also included. We found no evidence for a significant difference between estimates of R0 and RV in outbreaks: Rˆ0=3.3(2.6-4.0) and RˆV=2.7(2.1-3.2), p = 0.15. Our main limitations were our inability to investigate the influence of genotype or antivirals on results. Sensitivity analyses gave volatile p-values. In conclusion, we found no robust evidence for a significant reduction on transmission of EHV-1 in herds where all horses were vaccinated vs non-vaccinated herds. Rˆ in herds where all horses were vaccinated was substantially > 1 and vaccination as a sole mitigating measure may have limited effect on transmission of EHV-1.

Estimation of the basic reproduction number for Streptococcus equi spp equi outbreaks by meta-analysis of strangles outbreak reports

BACKGROUND

Streptococcus equi spp equi (S. equi), the cause of strangles in horses, is considered a highly contagious pathogen affecting equines and the equine industry worldwide. Fundamental epidemiological characteristics of outbreaks, such as the basic reproduction number (R₀ ), are not well described.

OBJECTIVES

Estimate R₀ for S. equi in equine populations from outbreak data.

STUDY DESIGN

Systematic review and meta-analysis of published and unpublished data.

METHODS

A literature search for outbreak reports was carried out. Depending on data available in the reports, the early epidemic growth rate or final attack rate (AR) approach was used to estimate the basic reproduction number for that outbreak. Other recorded outbreak characteristics were the type of housing (group vs individual). An overall estimate for R₀ was computed by meta-analysis.

RESULTS

Data from 8 outbreaks were extracted from peer-reviewed publications. Data from two additional, non-published outbreaks was also included in the meta-analysis. A conservative estimate for R₀ was 2.2 (95% CI 1.9- 2.5). A less conservative estimate, including outbreaks with a 100% AR for which a lower limit R₀ was estimated, was 2.7 (95% CI 2.1- 3.3).

MAIN LIMITATIONS

Few papers describing longitudinal incidence data were found so most estimates were based on the outbreaks' final size. Several outbreaks had a 100% attack rate and could therefore only be included as a lower limit estimate in the meta-analysis. The reported result therefore may be an underestimation.

CONCLUSIONS

This estimate for R₀ for S. equi informs parameters for future mathematical modelling, quantifies desired preventive vaccine coverage and helps evaluate the effect of prevention strategies through future modelling studies.

A Review on Equine Influenza from a Human Influenza Perspective

Influenza A viruses (IAVs) have a main natural reservoir in wild birds. IAVs are highly contagious, continually evolve, and have a wide host range that includes various mammalian species including horses, pigs, and humans. Furthering our understanding of host-pathogen interactions and cross-species transmissions is therefore essential. This review focuses on what is known regarding equine influenza virus (EIV) virology, pathogenesis, immune responses, clinical aspects, epidemiology (including factors contributing to local, national, and international transmission), surveillance, and preventive measures such as vaccines. We compare EIV and human influenza viruses and discuss parallels that can be drawn between them. We highlight differences in evolutionary rates between EIV and human IAVs, their impact on antigenic drift, and vaccine strain updates. We also describe the approaches used for the control of equine influenza (EI), which originated from those used in the human field, including surveillance networks and virological analysis methods. Finally, as vaccination in both species remains the cornerstone of disease mitigation, vaccine technologies and vaccination strategies against influenza in horses and humans are compared and discussed.

Equine Influenza

Horses are the third major mammalian species, along with humans and swine, long known to be subject to acute upper respiratory disease from influenza A virus infection. The viruses responsible are subtype H7N7, which is believed extinct, and H3N8, which circulates worldwide. The equine influenza lineages are clearly divergent from avian influenza lineages of the same subtypes. Their genetic evolution and potential for interspecies transmission, as well as clinical features and epidemiology, are discussed. Equine influenza is spread internationally and vaccination is central to control efforts. The current mechanism of international surveillance and virus strain recommendations for vaccines is described.

Re-parameterisation of a mathematical model of African horse sickness virus using data from a systematic literature search

African horse sickness (AHS) is a vector‐borne disease transmitted by Culicoides spp., endemic to sub‐Saharan Africa. There have been many examples of historic and recent outbreaks in the Middle East, Asia and Europe. However, not much is known about infection dynamics and outbreak potential in these naive populations. In order to better inform a previously published ordinary differential equation model, we performed a systematic literature search to identify studies documenting experimental infection of naive (control) equids in vaccination trials. Data on the time until the onset of viraemia, clinical signs and death after experimental infection of a naive equid and duration of viraemia were extracted. The time to viraemia was 4.6 days and the time to clinical signs was 4.9 days, longer than the previously estimated latent period of 3.7 days. The infectious periods of animals that died/were euthanized or survived were found to be 3.9 and 8.7 days, whereas previous estimations were 4.4 and 6 days, respectively. The case fatality was also found to be higher than previous estimations. The updated parameter values (along with other more recently published estimates from literature) resulted in an increase in the number of host deaths, decrease in the duration of the outbreak and greater prevalence in vectors.

Equine influenza: a comprehensive review from etiology to treatment

Influenza is an extremely contagious respiratory disease, which predominantly affects the upper respiratory tract. There are four types of influenza virus, and pigs and chickens are considered two key reservoirs of this virus. Equine influenza (EI) virus was first identified in horses in 1956, in Prague. The influenza A viruses responsible for EI are H7N7 and H3N8. Outbreaks of EI are characterized by their visible and rapid spread, and it has been possible to isolate and characterize H3N8 outbreaks in several countries. The clinical diagnosis of this disease is based on the clinical signs presented by the infected animals, which can be confirmed by performing complementary diagnostic tests. In the diagnosis of EI, in the field, rapid antigen detection tests can be used for a first approach. Treatment is based on the management of the disease and rest for the animal. Regarding the prognosis, it will depend on several factors, such as the animal's vaccination status. One of the important points in this disease is its prevention, which can be done through vaccination. In addition to decreasing the severity of clinical signs and morbidity during outbreaks, vaccination ensures immunity for the animals, reducing the economic impact of this disease.

Equine influenza vaccination as reported by horse owners and factors influencing their decision to vaccinate or not

BACKGROUND

Equine influenza virus is a highly contagious respiratory pathogen that causes pyrexia, anorexia, lethargy and coughing in immunologically naïve horses. Vaccines against equine influenza are available and vaccination is mandatory for horses that participate in affiliated competitions, but this group forms a small proportion of the total horse population. The aims of this study were to: i) identify the equine influenza vaccination rate as reported in 2016 by horse owners in the United Kingdom (UK); ii) examine the demographics of owners and horses which were associated with significantly lower influenza vaccination rates and iii) explore factors that influence horse owners' decisions around influenza vaccine uptake.

RESULTS

Responses from 4837 UK horse owners who were responsible for 10,501 horses were analysed. An overall equine influenza vaccination rate of 80% (8385/10501) was reported. Several owner demographic characteristics were associated with significantly lower (p<0.05) reported equine influenza vaccination rates including: some geographical locations, increasing horse owner age, annual household income of less that £15,000 and owning more than one horse. Horse-related features which were associated with significantly lower reported equine influenza vaccination rates included age ranges of <4 years and > 20 years, use as a companion or breeding animal or leaving their home premises either never or at most once a year. The most common reasons cited for failing to vaccinate horses was no competition activity, lack of exposure to influenza and expense of vaccines. In contrast, the most common underlying reasons given by horse owners who vaccinated their horse were protection of the individual horse against disease, veterinary advice and to protect the national herd. Owners of vaccinated horses had less previous experience of an influenza outbreak or adverse reaction to vaccination compared with owners of unvaccinated horses.

CONCLUSIONS

This study documented a high rate of equine influenza vaccination as reported by owners in a substantial number of horses in the UK, but this does not reflect the level of protection. Sub-populations of horses which were less likely to be vaccinated and the factors that influence each owner's decision around vaccination of their horses against equine influenza were identified, but may alter following the 2019 European influenza outbreak. This information may nevertheless help veterinary surgeons identify "at-risk" patients and communicate more personalised advice to their horse-owning clients. It may also influence educational campaigns about equine influenza directed to horse owners, which aim to improve uptake of vaccination against this pathogen.

Comparing the effects of non-homogenous mixing patterns on epidemiological outcomes in equine populations: A mathematical modelling study

Disease transmission models often assume homogenous mixing. This assumption, however, has the potential to misrepresent the disease dynamics for populations in which contact patterns are non-random. A disease transmission model with an SEIR structure was used to compare the effect of weighted and unweighted empirical equine contact networks to weighted and unweighted theoretical networks generated using random mixing. Equine influenza was used as a case study. Incidence curves generated with the unweighted empirical networks were similar in epidemic duration (5-8 days) and peak incidence (30.8-46.4%). In contrast, the weighted empirical networks resulted in a more pronounced difference between the networks in terms of the epidemic duration (8-15 days) and the peak incidence (5-25%). The incidence curves for the empirical networks were bimodal, while the incidence curves for the theoretical networks were unimodal. The incorporation of vaccination and isolation in the model caused a decrease in the cumulative incidence for each network, however, this effect was only seen at high levels of vaccination and isolation for the complete network. This study highlights the importance of using empirical networks to describe contact patterns within populations that are unlikely to exhibit random mixing such as equine populations.

Using a computer simulation model to examine the impact of biosecurity measures during a facility-level outbreak of equine influenza

On-farm biosecurity measures are an important part of a control plan to minimize the introduction and spread of infectious diseases, such as equine influenza, in an equine facility. It can be challenging, however, to evaluate the efficacy of biosecurity measures under field conditions. We used an agent-based computer simulation model to describe the impact of: i) preventive vaccination; ii) reduced horse-to-horse contact; and iii) a combination of vaccination and reduced contact during an outbreak of equine influenza in a simulated horse facility. The model demonstrated that the most effective intervention was a combination of a high proportion of recently vaccinated horses and a substantial reduction in horse-to-horse contact once equine influenza had been identified in the facility. This study highlights the importance of compliance when implementing biosecurity measures, such as facility-level infection control practices, on horse farms.

A Systematic Review of Recent Advances in Equine Influenza Vaccination

Equine influenza (EI) is a major respiratory disease of horses, which is still causing substantial outbreaks worldwide despite several decades of surveillance and prevention. Alongside quarantine procedures, vaccination is widely used to prevent or limit spread of the disease. The panel of EI vaccines commercially available is probably one of the most varied, including whole inactivated virus vaccines, Immuno-Stimulating Complex adjuvanted vaccines (ISCOM and ISCOM-Matrix), a live attenuated equine influenza virus (EIV) vaccine and a recombinant poxvirus-vectored vaccine. Several other strategies of vaccination are also evaluated. This systematic review reports the advances of EI vaccines during the last few years as well as some of the mechanisms behind the inefficient or sub-optimal response of horses to vaccination.