Absence of equid herpesvirus-1 reactivation and viremia in hospitalized critically ill horses

Updated ACVIM consensus statement on equine herpesvirus-1

Equine herpesvirus-1 (EHV-1) is a highly prevalent and frequently pathogenic infection of equids. The most serious clinical consequences of infection are abortion and equine herpesvirus myeloencephalopathy (EHM). The previous consensus statement was published in 2009 and considered pathogenesis, strain variation, epidemiology, diagnostic testing, vaccination, outbreak prevention and control, and treatment. A recent survey of American College of Veterinary Internal Medicine large animal diplomates identified the need for a revision to this original consensus statement. This updated consensus statement is underpinned by 4 systematic reviews that addressed key questions concerning vaccination, pharmaceutical treatment, pathogenesis, and diagnostic testing. Evidence for successful vaccination against, or effective treatment of EHV-1 infection was limited, and improvements in experimental design and reporting of results are needed in future studies of this important disease. This consensus statement also updates the topics considered previously in 2009.

Equine Herpesvirus-1 Myeloencephalopathy

Although equine herpesvirus myeloencephalopathy (EHM) is a relatively uncommon manifestation of equine herpesvirus-1 (EHV-1) infection, it can cause devastating losses during outbreaks. Antemortem diagnosis of EHM relies mainly on the molecular detection of EHV-1 in nasal secretions and blood. Management of horses affected by EHM is aimed at supportive nursing and nutritional care, at reducing central nervous system inflammation and preventing thromboembolic sequelae. Horses exhibiting sudden and severe neurologic signs consistent with a diagnosis of EHM pose a definite risk to the surrounding horse population. Consequently, early intervention to prevent the spread of infection is required.

Investigation of the Use of Non-Invasive Samples for the Molecular Detection of EHV-1 in Horses with and without Clinical Infection

The purpose of this study was to explore sampling options for a reliable and logistically more feasible protocol during a large EHV-1 outbreak. Seventeen horses with clinical infection as well as nineteen healthy herdmates, all part of an EHM outbreak, were enrolled in the study. Each horse was sampled two–four times at intervals of 2–6 days during the outbreak. All samples were collected using 6′′ rayon-tipped swabs. Nasal secretions were used as the diagnostic sample of choice. Additional samples, including swabs from the muzzle/nares, swabs from the front limbs, rectal swabs, swabs of the feed bin, and swabs of the water troughs were collected as well. All swabs were tested for the presence of EHV-1 by qPCR. With the exception of two EHV-1 qPCR-positive swabs from two different horses, all remaining swabs collected from healthy herdmates tested qPCR-negative for EHV-1. For horses with clinical infection, EHV-1 was detected in 31 nasal swabs, 30 muzzle/nares swabs, 7 front limb swabs, 7 feeders, 6 water troughs and 6 rectal swabs. Not all positive muzzle/nares swabs correlated with a positive nasal swab from the same set, however, and all other positive swabs did correlate with a positive nasal swab in their respective set. The agreement between nasal swabs and muzzle/nares swabs was 74%. The sampling of non-invasive swabs from the muzzle/nares should facilitate the identification of EHV-1 shedders during an outbreak, allowing for prompt isolation and implementation of biosecurity measures.

Failure to detect equid herpesvirus types 1 and 4 DNA in placentae and healthy new-born Thoroughbred foals

Equid herpesvirus type 1 is primarily a respiratory tract virus associated with poor athletic performance that can also cause late gestation abortion, neonatal foal death and encephalomyelopathy. Horizontal transmission is well described, whereas evidence of vertical transmission of equid herpesvirus type 1 associated with the birth of a healthy foal has not been demonstrated. This study sampled a population of Thoroughbred mares (n = 71), and their healthy neonatal foals and foetal membranes, to test for the presence of both equid herpesvirus types 1 and 4 using a quantitative polymerase chain reaction assay. Foetal membrane swabs and tissue samples were taken immediately post-partum, and venous blood samples and nasal swabs were obtained from both mare and foal 8 h after birth. Neither equid herpesvirus type 1 nor equid herpesvirus type 4 nucleic acid was detected in any sample, and it was concluded that there was no active shedding of equid herpesvirus types 1 and 4 at the time of sampling. Consequently, no evidence of vertical transmission of these viruses could be found on this stud farm during the sampling period.

Antiherpetic Drugs in Equine Medicine

Since vaccination may not prevent disease, antiherpetic drugs have been investigated for the therapy of several equine herpesviruses. Drug efficacy has been assessed in horses with disease, but most evidence is in vitro, in other species, or empirical. Oral valacyclovir is most often administered in the therapy of equine herpesvirus type-1 (EHV-1) to protect adult horses from equine herpesvirus myeloencephalopathy, while oral acyclovir is frequently administered for EHV-5 infection in the therapy of equine multinodular pulmonary fibrosis. Other antiherpetic drugs are promising but require further investigation. Several topical drugs are also empirically used in the therapy of equine viral keratitis.