Molecular epidemiology of strangles outbreaks in the UK during 2010

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.

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.

Molecular Features and Antimicrobial Susceptibilities of Streptococcus equi ssp. equi Isolates from Strangles Cases in Indonesia

Strangles, caused by Streptococcus equi ssp. equi (S. equi equi), is a highly infectious and frequent disease of equines worldwide. No data are available regarding the molecular epidemiology of strangles in Indonesia. This study aimed to characterize S. equi equi isolates obtained from suspected strangles cases in Indonesia in 2018. Isolates originated from seven diseased horses on four different farms located in three provinces of Indonesia. Whole genome sequences of these isolates were determined and used for seM typing, multilocus sequence typing (MLST), and core genome MLS typing (cgMLST). Genomes were also screened for known antimicrobial resistance genes and genes encoding for the recombinant antigens used in the commercial Strangvac^® subunit vaccine. All seven S. equi equi isolates from Indonesia belonged to ST179 and carried seM allele 166. Isolates differed from each other by only 2 to 14 cgSNPs and built an exclusive sub-cluster within the Bayesian Analysis of Population Structure (BAPS) cluster 2 (BAPS-2) of the S. equi equi cgMLST scheme. All isolates revealed predicted amino acid sequence identity to seven and high similarity to one of the eight antigen fragments contained in Strangvac^®. Furthermore, all isolates were susceptible to beta-lactam antibiotics penicillin G, ampicillin, and ceftiofur. Our data suggest that the horses from this study were affected by strains of the same novel sublineage within globally distributed BAPS-2 of S. equi equi. Nevertheless, penicillin G can be used as a first-choice antibiotic against these strains and Strangvac^® may also be protective against Indonesian strains.

Conservation of vaccine antigen sequences encoded by sequenced strains of Streptococcus equi subsp. equi

BACKGROUND

Streptococcus equi subspecies equi (S equi) is the cause of Strangles, one of the most prevalent diseases of horses worldwide. Variation within the immunodominant SeM protein has been documented, but a new eight-component fusion protein vaccine, Strangvac, does not contain live S equi or SeM and conservation of the antigens it contains have not been reported.

OBJECTIVE

To define the diversity of the eight Strangvac antigens across a diverse S equi population.

STUDY DESIGN

Genomic description.

METHODS

Antigen sequences from the genomes of 759 S equi isolates from 19 countries, recovered between 1955 and 2018, were analysed. Predicted amino acid sequences in the antigen fragments of SEQ0256(Eq5), SEQ0402(Eq8), SEQ0721(EAG), SEQ0855(SclF), SEQ0935(CNE), SEQ0999(IdeE), SEQ1817(SclI) and SEQ2101(SclC) in Strangvac and SeM were extracted from the 759 assembled genomes and compared.

RESULTS

The predicted amino acid sequences of SclC, SclI and IdeE were identical across all 759 genomes. CNE was truncated in the genome of five (0.7%) isolates. SclF was absent from one genome and another encoded a single amino acid substitution. EAG was truncated in two genomes. Eq5 was truncated in four genomes and 123 genomes encoded a single amino acid substitution. Eq8 was truncated in three genomes, one genome encoded four amino acid substitutions and 398 genomes encoded a single amino acid substitution at the final amino acid of the Eq8 antigen fragment. Therefore, at least 1579 (99.9%) of 1580 amino acids in Strangvac were identical in 743 (97.9%) genomes, and all genomes encoded identical amino acid sequences for at least six of the eight Strangvac antigens.

MAIN LIMITATIONS

Three hundred and seven (40.4%) isolates in this study were recovered from horses in the UK.

CONCLUSIONS

The predicted amino acid sequences of antigens in Strangvac were highly conserved across this collection of S equi.

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

BACKGROUND

Previously national surveillance data for monitoring strangles (Streptococcus equi infection) in UK horses was limited. Improved awareness and knowledge of positive diagnoses would permit the optimisation of biosecurity protocols, decreasing the prevalence of strangles.

METHODS

Seven UK laboratories reported positive strangles diagnoses between 1 January 2015 and 31 December 2019 based on identifying Streptococcus equi via agent detection assays from field-based practitioner-submitted samples. Associated clinical history and animal signalment were collected where provided, and descriptive analysis undertaken.

RESULTS

Within the study period, 1617 laboratory-confirmed diagnoses occurred from samples submitted by 315 veterinary practices. Of these, 51.6% were swabs and 44.0% guttural pouch lavages. Diagnoses were primarily based on qPCR alone (59.6%), qPCR and culture (35.8%), or culture alone (4.6%). A total of 1791 clinical signs were reported for 713 diagnoses, where nasal discharge (31.3%) and pyrexia (20.5%) were most frequently reported. Regions with the highest number of diagnoses included North Yorkshire (n = 75, 4.6%), Staffordshire (n = 71, 4.4%) and West Sussex (North East) (n = 63, 3.9%).

CONCLUSION

This study presents important insights into the diagnosis and clinical features of strangles in UK horses, even though limited and/or missing clinical history and signalment on laboratory submission forms restricts the completeness of the data.

Surveillance of equine strangles: a new initiative

Abigail McGlennon from the Animal Health Trust introduces a new project to gather information on cases of strangles in horses throughout the UK.

Intramuscular vaccination with Strangvac is safe and induces protection against equine strangles caused by Streptococcus equi

The equine disease strangles, caused by Streptococcus equi, remains a major cause of welfare and economic cost to the global horse industry. Here we report the safety, immunogenicity and efficacy of a novel multi-component chimeric fusion protein vaccine, called Strangvac, when administered to ponies via the intramuscular route. Across the four studies, Strangvac was safe and induced robust antibody responses towards the vaccine components in blood serum and the nasopharynx, which were boosted by revaccination up to 12 months after a primary course of 2 vaccinations 4 weeks apart. The vaccine response did not cross-react with a commercial strangles iELISA, which identifies horses that have been exposed to S. equi, demonstrating that it was possible to differentiate infected from vaccinated animals (DIVA). Following challenge with S. equi strain 4047 (Se4047), all 36 control ponies that had received an adjuvant-only placebo vaccine developed clinical signs of strangles. In contrast, intramuscular vaccination with Strangvac protected ponies significantly from challenge with Se4047 at two weeks (5 of 16 ponies protected (31%), P = 0.04) and two months (7 of 12 ponies protected (58%), P = 0.0046 (including pooled control data) after second vaccination. Optimal protection (15 of 16 ponies protected (94%), P < 0.0001) was observed following challenge at two weeks post-third vaccination. Our data demonstrate that Strangvac is safe, has DIVA capability and provides a rapid onset of protective immunity against strangles. We conclude that Strangvac is a valuable tool with which to protect horses from strangles, particularly during high-risk periods, whilst maintaining the mobility of horse populations as required by the global equine industry.

Serological responses of Australian horses using a commercial duplex indirect ELISA following vaccination against strangles

OBJECTIVE

To determine the nature of serological responses in Australian horses using a commercial duplex indirect ELISA (iELISA) following vaccination against strangles.

DESIGN

A group (n = 19) of client-owned horses from five properties were recruited to receive a primary course of a Streptococcus equi subsp. equi (S. equi) extract vaccine. Serological responses were determined by duplex iELISA incorporating S. equi-specific fragments of two cell wall proteins, SEQ2190 and SeM (antigens (Ag) A and C, respectively).

METHODS

The horses were administered a primary strangles vaccination course. Blood was collected immediately prior to each of the three vaccinations at 2-week intervals and additionally at 28 and 56 days following the 3rd vaccination (V3).

RESULTS

Significant increases in mean antibody levels of horses following vaccination were limited only to AgC, which was significantly increased at T2/V3, 14 days following V2 (ratio of geometric means = 3.7; 95% confidence interval (CI): 1.6, 8.4; P = 0.003). There was no increase in mean antibody to Ag A (ratio of geometric means = 1.4; 95% CI: 0.6, 3.2; P = 0.39). Four horses (22%) exceeded the test cut-off for AgC following vaccination.

CONCLUSION

Vaccination of Australian horses is unlikely to interfere greatly with detection of strangles using the duplex iELISA. No responses would be anticipated to AgA following vaccination with Equivac© S/Equivac© 2in1 and only a minority are likely to respond to AgC. We conclude that the results of this study validate the usefulness of the duplex iELISA to assist control measures for strangles outbreaks in Australian horse populations.

Genetic analysis of Streptococcus equi subsp. equi isolated from horses imported into Japan

Strangles is a commonly diagnosed and important infectious disease of equids worldwide, caused by Streptococcus equi subsp. equi. We determined the SeM genotypes of S. equi isolated from imported horses at the Japanese border within the past 8 years, which allowed us to classify 12 strains isolated from these horses from each exporter into four allelic groups. These alleles were different from the alleles of past isolates found in Japan. Furthermore, four strains classified into the same allele were isolated from horses from one exporter over several years. In this study, S. equi isolates from different exporters had different SeM alleles. Attention to the hygiene status of farms will be necessary to prevent the incursion of strangles.

Strangles: a pathogenic legacy of the war horse

Strangles, characterised by pyrexia followed by abscessation of the lymph nodes of the head and neck, was first described in 1251 (Rufus 1251) and the causative agent, Streptococcus equi, was identified in 1888 (Schutz 1888). However, despite more than a century of research into this disease, strangles remains the most frequently diagnosed infection of horses with over 600 outbreaks being identified in the UK alone each year (Parkinson and others 2011). Here, Andrew Waller reviews some of the recent advances in the understanding of the evolution of S equi and puts this into the context of preventing and resolving outbreaks of infection.

New perspectives for the diagnosis, control, treatment, and prevention of strangles in horses

Strangles, characterized by abscessation of the lymph nodes of the head and neck, is the most frequently diagnosed infectious disease of horses worldwide. The persistence of the causative agent, Streptococcus equi, in a proportion of convalescent horses plays a critical role in the recurrence and spread of disease. Recent research has led to the development of effective diagnostic tests that assist the eradication of S equi from local horse populations. This article describes how these advances have been made and provides advice to assist the resolution and prevention of outbreaks. New perspectives on preventative vaccines and therapeutic interventions are discussed.

Strangles: taking steps towards eradication

Strangles, caused by the host adapted Lancefield group C bacterium Streptococcus equi sub-species equi (S. equi), is one of the oldest recognised infectious diseases of horses and continues to cause significant welfare and economic cost throughout the world. The ability of S. equi to establish sub-clinical persistent infections primarily in the guttural pouches of convalescent horses has been instrumental to its success. However, the implementation of simple control measures that permit the identification and treatment of persistently infected carriers can prevent further outbreaks of disease at a local level. This review summarises some of the molecular mechanisms exploited by S. equi to cause disease. New qPCR and iELISA diagnostic tests replace culture methodologies as the gold standard for the detection of infected animals. A strategy to maximise the effective application of these tests to direct management methods for the eradication of S. equi infection is presented and the role of preventative vaccines is discussed. In contrast to current understanding, emerging data illustrates the dynamism of the global S. equi population and potential consequences for the effectiveness of currently available vaccines. The ability to use modern vaccines alongside conventional biosecurity and screening procedures will be critical to the large-scale prevention and even eradication of strangles, providing an opportunity to finally break the stranglehold that this disease has on the world's equine industry.