Why Can't We Eradicate Equine Herpesvirus?
Eradication of infectious diseases is a great goal, but it's rarely practical. The best known (and perhaps only) example of infectious disease eradication is the elimination of smallpox. So, why is it so hard to do?
The following general criteria need to be in place to eradicate a disease:
- It must have a clearly defined host range and that range is ideally only one species. A disease that can affect multiple species is very hard to control.
- It must predictably cause disease in individuals that are infected.
- There must be no long-term carriage state. Once a person/animal gets over the illness, he/she/it must get rid of the infection completely in a defined and predictable period of time.
- A highly effective vaccine should be available.
- There must be a commitment to put in lots of time, money and effort everywhere the disease exists.
This isn't the case with most diseases, and equine herpesvirus (EHV) has many characteristics that make eradication impossible:
- Unpredictable disease: EHV infection doesn't always cause signs of disease. When it does cause disease the signs can be quite variable and difficult to easily differentiate from other infections.
- Longterm carriage: This is the biggest problem with herpesviruses. EHV is able to survive in a latent (dormant) state in the body after infection. It can lie dormant for a long period of time, but infected animals can always start shedding the virus again. A large percentage of horses are carrying EHV in their bodies and there's no way to get rid of it.
- Vaccine: Vaccines are available but they are by no means 100% effective at preventing infection.
- Time, effort, money and cooperation are terms that are not commonly associated with disease control in horses. Getting everyone to follow a standard recommendation (if one were able to control disease) would be difficult to impossible. The entire horse-owning population would not be willing to spend the money for broad control measures, and there's no real impetus for governments to do so. Even getting people to agree to follow basic vaccination and infection control recommendations is difficult. If there is any negative impact on use of horses, ease of management or any other minor inconvenience, 100% compliance with any recommendation becomes impossible to obtain.
We have to live with EHV. It will always be a risk to horses. Good infection control measures and vaccination of certain groups (e.g. pregnant mares) can help control the impact of the virus.
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Rhodococcus equi is a very well recognized pathogen in horses – it is a common cause of pneumonia in foals between the ages of 1-6 months, and infection is also sometimes associated with
Rhodococcus equi is a common pathogen in foals between the ages of 1 and 6 months of age that is most infamous for its ability to cause pneumonia. Classic R. equi infection results in the formation of large abscesses throughout the lungs of young foals (see picture left), which can be especially difficult to treat because the bacteria are able to hide from the body’s immune system by living within white blood cells. However, this organism’s bag of tricks doesn’t end with lung abscesses – it can also travel to other parts of the body and cause all sorts of trouble. These kinds of infections may occur with or without the classic lung infection, and are referred to as extrapulmonary disorders (EPDs).
Infectious diseases are a major problem in young foals. Diseases, including diarrhea, pneumonia, meningitis, umbilical infections and joint infections can range from mild to rapidly fatal. Even in foals that survive the initial infection, these conditions can sometimes result in permanent problems. A study published in a recent edition of the
Transportation, particularly over long distances, is likely the single most important predisposing factor for pleuropneumonia (aka "shipping fever") in horses. Pleuropneumonia is a very serious condition in horses that occurs when an infection in the lungs (pneumonia, typically bacterial pneumonia) spreads to the outer surface of the lungs (the pleura) and contaminates the space between the lungs and the chest wall (the pleural cavity). The inflammation of the pleura (which is also very painful) usually results in accumulation of infected fluid around the lungs (photo right: drainage of pleural fluid in a horse using a chest tube). The disease can be difficult to treat, and affected horses can end up with a lot of scarred lung and adhesions between their lungs and chest wall, as well as lung abscesses and other problems.
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I'm trying not to sound like a broken record when it comes to antibiotics, but it's a very important topic so you'll see many posts on the subject. When you consider that antibiotic-associated diarrhea is a potentially life-threatening problem in horses, and that antibiotic-resistant bacteria are becoming more common in general, it should be obvious that we need to limit the use antibiotics to when they are actually needed, and potentially effective. Horses with respiratory disease are commonly treated with antibiotics. However, as discussed in a previous post (
Respiratory tract disease is a very common problem in horses that has a wide range of causes, including bacterial and viral infections, as well as non-infectious conditions. Nasal discharge (i.e. a "snotty nose") is often one of the first signs of respiratory disease noticed by owners. Unfortunately, the nasal discharge itself cannot tell you what the problem is, nor how to deal with it. If your horse develops nasal discharge, you should contact your veterinarian to determine the best approach to diagnose the cause and the best way to treat the animal. Here are just a few of the factors that need to be considered:
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The described clinical signs in affected horses are very non-specific, so it's hard to speculate about the causative pathogen. There are a variety of potential culprits, including equine influenza virus (EIV), but so far testing has not detected EIV or any other known pathogens. This "mystery" disease does not appear to affect other animals or people (but without knowing what is causing it, this is difficult to say for certain). It is possible that this is a "new" disease, but the vast majority of infectious disease outbreaks are caused by pathogens that we already know about. Specialists from Britain have been called in to help with the investigation. Hopefully more information will be available soon.
