The first five days: field and laboratory investigations during the early stages of the equine influenza outbreak in Australia, 2007

[Management and hygiene measures during an outbreak of herpes, influenza, strangles or infections with multidrug resistant bacteria]

The aim of this review is to describe general guidelines of hygiene measures in the horse stable as well as to provide current recommendations for an outbreak of a common infectious disease. General cleanliness, hand hygiene, avoidance of stress, regular deworming, and vaccinations belong to the basic hygiene measures in a horse herd. All new or returning equids should be submitted to a quarantine period as an important prevention measure. Repeated washing and disinfection of hands may prevent spreading of infectious agents to people and horses.The conception of a hygiene plan, including general biosecurity procedures and standard operating procedures in a case of an outbreak of an infectious disease, zoonosis, or colonization with multi-resistant bacteria is strongly recommended. As soon as the disease is suspected, extended hygiene measures including protective clothing, cleaning, disinfection, and isolation of potentially infected animals should be implemented. Prompt confirmation of the causative agent by examination of appropriate samples is crucial. It is important to adjust all safety measures based on the contagious nature of the respective pathogen and its major transmission routes. Apart from a lock-down of the stable, clinic or show grounds, the segregation of horses plays an important role. Implementation of the "traffic light system" is recommended. In this, the red group ("infected") include animals with clinical signs of the disease or that have been tested positive. All horses with possible pathogen contact should be allocated to a yellow group ("suspected") and regularly controlled for the signs of infection and fever. Clinically normal horses without contact to the infected animals belong to the green group ("healthy"). A change of protective clothing and an extensive disinfection should be performed when moving between the groups.The extended hygiene measures are to be maintained until all animals have been tested negative or fail to exhibit clinical signs of the disease for a certain time period.

Association of Equine Herpesvirus 5 with Mild Respiratory Disease in a Survey of EHV1, -2, -4 and -5 in 407 Australian Horses

Simple Summary

Infectious respiratory diseases in horses represent a major health and welfare problem. Although equine influenza is well reported as a cause of respiratory disease in most continents, Australia is free of EIV despite an outbreak in two states in 2007. Horses in Victoria were tested to demonstrate proof of freedom from EIV, hence samples were able to be subsequently tested for this study with the knowledge that EIV was not present as a potential cause of any disease. The equine alphaherpesviruses, EHV1 and -4 are well known agents of equine respiratory disease. The gammaherpesviruses EHV2 and -5 on the other hand are often isolated from clinically healthy horses despite a known association in some disease processes. The consequences of infection with these enigmatic viruses remains unknown. The investigation of several hundred horses with and without respiratory disease provided valuable information in terms of association. The salient findings of this study determined that a large proportion of normal horses were positive for the gammaherpesviruses EHV2 and -5 using PCR methods. However, horses shedding EHV5 were more likely to have had signs of respiratory disease. Like EHV2, EHV5 is a gammaherpesvirus commonly found in horses: its significance is unclear, though it is closely related to the Epstein–Barr virus, the agent responsible for glandular fever in humans. These viruses are known to interfere with the immune response and have potentially wide-ranging effects on infected hosts. This study has added to our awareness of these equine herpesviruses and should stimulate further studies to determine exact causation and consequences of infection.

Abstract

Equine herpesviruses (EHVs) are common respiratory pathogens in horses; whilst the alphaherpesviruses are better understood, the clinical importance of the gammaherpesviruses remains undetermined. This study aimed to determine the prevalence of, and any association between, equine respiratory herpesviruses EHV1, -2, -4 and -5 infection in horses with and without clinical signs of respiratory disease. Nasal swabs were collected from 407 horses in Victoria and included clinically normal horses that had been screened for regulatory purposes. Samples were collected from horses during Australia’s equine influenza outbreak in 2007; however, horses in Victoria required testing for proof of freedom from EIV. All horses tested in Victoria were negative for EIV, hence archived swabs were available to screen for other pathogens such as EHVs. Quantitative PCR techniques were used to detect EHVs. Of the 407 horses sampled, 249 (61%) were clinically normal, 120 (29%) presented with clinical signs consistent with mild respiratory disease and 38 (9%) horses had an unknown clinical history. Of the three horses detected shedding EHV1, and the five shedding EHV4, only one was noted to have clinical signs referable to respiratory disease. The proportion of EHV5-infected horses in the diseased group (85/120, 70.8%) was significantly greater than those not showing signs of disease (137/249, 55%). The odds of EHV5-positive horses demonstrating clinical signs of respiratory disease were twice that of EHV5-negative horses (OR 1.98, 95% CI 1.25 to 3.16). No quantitative difference between mean loads of EHV shedding between diseased and non-diseased horses was detected. The clinical significance of respiratory gammaherpesvirus infections in horses remains to be determined; however, this survey adds to the mounting body of evidence associating EHV5 with equine respiratory disease.

RNA Extraction from Equine Samples for Equine Influenza Virus

The primary goals of this chapter are to discuss common viral RNA isolation and purification methods that are routinely used by various diagnostic laboratories and to highlight the advantages and drawbacks of each method and to identify the most suitable and reliable method to increase the sensitivity and specificity of RT-PCR assays for the detection of equine influenza virus (EIV) in clinical specimens. Our experiences and review of literature show that magnetic bead-based nucleic extraction methods (manual and automatic) work well for isolation and purification of EIV RNA from nasal swab specimens. Furthermore, most of the information presented in this chapter could be directly applicable to isolation and purification of nucleic acids (both DNA and RNA) from other equine clinical samples.

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.

Descriptive and network analyses of the equine contact network at an equestrian show in Ontario, Canada and implications for disease spread

Background

Identifying the contact structure within a population of horses attending a competition is an important element towards understanding the potential for the spread of equine pathogens as the horses subsequently travel from location to location. However, there is limited information in Ontario, Canada to quantify contact patterns of horses. The objective of this study was to describe the network of potential contacts associated with an equestrian show to determine how this network structure may influence potential disease transmission.

Results

This was a descriptive study of horses attending an equestrian show in southern Ontario, Canada on July 6 and 7, 2014. Horse show participants completed a questionnaire about their horse, travel patterns, and infection control practices. Questionnaire responses were received from horse owners of 79.7% (55/69) of the horses attending the show. Owners reported that horses attending the show were vaccinated for diseases such as rabies, equine influenza, and equine herpesvirus. Owners demonstrated high compliance with most infection control practices by reporting reduced opportunities for direct and indirect contact while away from home. The two-mode undirected network consisted of 820 nodes (41 locations and 779 horses). Eight percent of nodes in the network represented horses attending the show, 87% of nodes represented horses not attending the show, but boarded at individual home facilities, and 5% represented locations. The median degree of a horse in the network was 33 (range: 1–105).

Conclusions

Developing disease management strategies without the explicit consideration of horses boarded at individual home facilities would underestimate the connectivity of horses in the population. The results of this study provides information that can be used by equestrian show organizers to configure event management in such a way that can limit the extent of potential disease spread.

RNA extraction from equine samples for equine influenza virus

The primary goals of this chapter are to discuss common viral RNA isolation and purification methods that are routinely used by various diagnostic laboratories, to highlight the advantages and drawbacks of each method, and to identify the most suitable and reliable method to increase the sensitivity and specificity of RT-PCR assays for the detection of equine influenza virus (EIV) in clinical specimens. Our experiences and review of literature show that magnetic bead-based nucleic extraction methods (manual and automatic) work well for isolation and purification of EIV RNA from nasal swab specimens. Furthermore, most of the information presented in this chapter could be directly applicable to isolation and purification of nucleic acids (both DNA and RNA) from other equine clinical samples.

Little evidence of human infection with equine influenza during the 2007 epizootic, Queensland, Australia

BACKGROUND

Equine influenza virus (EIV) is considered enzootic in Europe (except Iceland), Asia, North Africa, and North and South America. When EIV outbreaks occur they may severely impact the equine and tourist industries. Australia faced its first EIV outbreak beginning in August of 2007. The outbreak was concentrated in New South Wales and Queensland, with more than 1400 confirmed EIV infections in horses during the first month. Rapid response from the equine industry and the federal government was successful and Australia was declared free from EIV by the end of 2007.

OBJECTIVES

This cross-sectional study was designed to examine associations between exposure to EIV-infected horses and evidence of EIV infection in humans.

STUDY DESIGN

Employing informed consent, between October 2007 and April 2008, 100 subjects (89 with horse exposures and 11 non-exposed) were enrolled during equine events and at the University of the Sunshine Coast. All subjects provided a blood sample and were asked to complete an online questionnaire including health history, animal exposure and demographic information. Sera samples were tested for the presence of antibodies against two H3N8 EIV strains using microneutralization, hemagglutination inhibition, and enzyme-linked lectin assays.

RESULTS

Evidence for H3N8 infection was sparse, with only 9 study participants having any indication of H3N8 infection and the seroreactivity seen was low and easily explained by cross-reactions against human influenza strains or vaccines.

CONCLUSIONS

These data provide little evidence to support the premise that EIV infections occurred among humans exposed to EIV-infected horses during the 2007 Australian epizootic.

Building a picture: Prioritisation of exotic diseases for the pig industry in Australia using multi-criteria decision analysis

Diseases that are exotic to the pig industry in Australia were prioritised using a multi-criteria decision analysis framework that incorporated weights of importance for a range of criteria important to industry stakeholders. Measurements were collected for each disease for nine criteria that described potential disease impacts. A total score was calculated for each disease using a weighted sum value function that aggregated the nine disease criterion measurements and weights of importance for the criteria that were previously elicited from two groups of industry stakeholders. One stakeholder group placed most value on the impacts of disease on livestock, and one group placed more value on the zoonotic impacts of diseases. Prioritisation lists ordered by disease score were produced for both of these groups. Vesicular diseases were found to have the highest priority for the group valuing disease impacts on livestock, followed by acute forms of African and classical swine fever, then highly pathogenic porcine reproductive and respiratory syndrome. The group who valued zoonotic disease impacts prioritised rabies, followed by Japanese encephalitis, Eastern equine encephalitis and Nipah virus, interspersed with vesicular diseases. The multi-criteria framework used in this study systematically prioritised diseases using a multi-attribute theory based technique that provided transparency and repeatability in the process. Flexibility of the framework was demonstrated by aggregating the criterion weights from more than one stakeholder group with the disease measurements for the criteria. This technique allowed industry stakeholders to be active in resource allocation for their industry without the need to be disease experts. We believe it is the first prioritisation of livestock diseases using values provided by industry stakeholders. The prioritisation lists will be used by industry stakeholders to identify diseases for further risk analysis and disease spread modelling to understand biosecurity risks to this industry.

Equine influenza--a global perspective

To date, equine influenza outbreaks have been reported all over the world with the exception of a small number of island nations including New Zealand and Iceland. Influenza is endemic in Europe and North America and is considered to be of potentially major economic significance to the equine industry worldwide. The importation of subclinically infected vaccinated horses, and inadequate quarantine procedures have resulted in several major outbreaks in susceptible populations for example, in Australia (2007) when more than 76,000 horses on over 10,000 properties were reported as infected. This review summarises the current understanding of, and recent research on, equine influenza, including epidemiology, pathogenesis, clinical characteristics, laboratory diagnosis, management and prevention. Recent advances in diagnostic techniques are discussed as are the merits of different vaccination regimes.

Infection of dogs with equine influenza virus: evidence for transmission from horses during the Australian outbreak

During the equine influenza (EI) outbreak, respiratory disease was observed in dogs that were in close proximity to infected horses. Investigations were undertaken to exclude influenza virus infection. Of the 23 dogs that were seropositive in tests using the influenza A/Sydney/2007 virus as the test antigen, 10 showed clinical signs. EI virus appeared to be readily transmitted to dogs that were held in close proximity to infected horses, but there was no evidence of lateral transmission of the virus to other dogs that did not have contact with or were not held in close proximity to horses.

Evaluation of the response to an accelerated immunisation schedule using a canarypox-vectored equine influenza vaccine, shortened interdose intervals and vaccination of young foals

The results of an accelerated immunisation schedule for horses used as part of the emergency response plan to contain and eradicate equine influenza in Australia in 2007 is described. The horses studied were vaccinated with a recombinant canarypox-vectored vaccine (ProteqFlu®, Merial) with a shorter interdose interval. Vaccinated horses included foals aged less than 4 months.

Overview of the epidemiology of equine influenza in the Australian outbreak

This overview of the equine influenza (EI) epidemic as it occurred in two Australian states, New South Wales and Queensland, in 2007 describes the functions and activities of the epidemiology teams that were engaged during the outbreak and also identifies key features of the epidemiology of EI during the outbreak.

Longitudinal study describing the clinical signs observed in horses naturally infected with equine influenza

We describe the clinical signs and disease course during an outbreak of equine influenza (EI) in naïve horses in a police stables in Sydney, New South Wales, Australia.

Quantitative analysis of the risk of spread of equine influenza associated with movements of vaccinated horses from infected areas during the Australian outbreak

Simulation models were developed to quantify the likelihood of equine influenza virus infection entering pre-movement isolation, persisting through pre- and post-movement isolation periods without being detected by scheduled laboratory testing, and escaping to infect susceptible horses at a destination. The mean probability of escape ranged from 1 in 1,200,000 to 1 in 600,000 depending on lot size. For 95% of iterations the probability of escape was less than 1 in 200,000, regardless of lot size. For a large group of 600 horses processed as multiple separate lots, the mean probability of escape ranged from 1 in 10,000 to 1 in 56,000 depending on lot size. As a result of this analysis, a modified protocol, with two tests during pre-movement isolation and an additional test during post-movement isolation at the Chief Veterinary Officer's discretion, was implemented.

Role of the diagnostic laboratories during the 2007 equine influenza outbreak in Australia

During the 2007 equine influenza (EI) outbreak in Australia, diagnostic laboratories and the use of appropriate tests played a pivotal role in the response to the crisis. This role began with the detection of EI virus in New South Wales (NSW) on the evening of 24 August 2007 and culminated in providing the final 'proof of freedom' from EI in March 2008. The tests that were used during the EI response were able to provide results quickly, and with high sensitivity and specificity. This section of the supplement describes the roles and functions of the Australian laboratories; tests used and their performance characteristics; improvements made and methods used to validate assays; strategies that were followed during the response; the characterisation of viruses detected; and the resources that were available to laboratories.

Surveillance and prevention in a non-affected state: Victoria

The equine influenza outbreak detected in August 2007 in New South Wales and Queensland did not enter Victoria, which was, however, considered at risk because of its sizable border with New South Wales. Accordingly, Victoria implemented a response plan to prevent disease entry and enable early detection of any disease. Horse movement restrictions, surveillance strategies and public awareness formed a large part of this response.