The changing nature of the equine disease threat facing the United Kingdom

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Acknowledgements The changing nature of the equine disease threat facing the United Kingdom Richard Newton FRCVS Animal Health Trust Overview Human diseases in the headlines In the headlines Some disease threats to non-equine health Drawing parallels with threats to equine health Understanding the threats Cross-species; Vector-borne; Re-emerging Remembering diseases still close to home Overview of EHV-1 Some final thoughts on EHV-1.. 26 th May 2015 18 th June 2015 4 th February 2016 Animal disease threats Perhaps even more frightening! 2 nd March 2012 27 th October 2015 20 th March 2015 20 th January 2016 8 th February 2016 Aren t these chronic Mycobacterial diseases of antiquity that we had eradicated? 1

So what has all of this got to do with UK horses? They illustrate important exotic disease risk features that currently apply to UK horses of diseases Changing global ecology of insect vector-borne diseases Re-emergence of old and previously presumed conquered diseases But don t forget the endemic disease threats! Threat of novel influenza strains in equids Threat of novel influenza strains in equids Equine H3N8 viruses since Miami in 1963 High mortality H3N8 virus in Jilin, China in 1989 Threat of novel influenza strains in equids Threat of novel influenza strains in equids 2

Hendra virus: from bats to horses to humans Hendra virus: from bats to horses to humans WNV: a mosquito-borne threat WNV: a mosquito-borne threat 3

February 2012 February 2015 What to scan in horizon scanning WNV-USA since 1999- breeders cup horses from Europe- threat in area visiting in southern states Glanders-awareness raising via CPD BEVA Congress 2011-heightened surveillance/report case investigation EIA- threat from commodities, new trade with Romania(EU accession)-new routes of Tx-CoPlegislation-awareness-report 4

Dealing with the threat of AHS African Horse Sickness Working Group Successful Defra/industry liaison Legislation and contingency plan published in 2012 Challenges remain wrt AHS Old and conquered if only! Summary of the vaccine discussion group at irespe seminar on AHS held at OIE, Paris, 29 th January 2016: Horse trade with Africa remains a concern because of AHS Current vaccines, although critically useful in the past, have severe limitations to be globally acceptable Equine industries in non-endemic countries are highly reluctant to accept live attenuated AHSV vaccines Vaccines represent a vital tool to combat outbreaks of AHS and should be used along with effective diagnostic tests and appropriate surveillance strategies The discussion group concluded that safe, cheap, universal and DIVA AHSV vaccines are needed, that can be used safely in any ecosystem or region Old and conquered if only! Re-emergence of old and previously presumed conquered equine diseases Dourine (Trypanosoma equiperdum) Italy in 2011 and Botswana in 2016 Glanders (Burkholderia mallei) Brazil and Germany in 2015 Swamp fever (EIA virus) EU regularly since Ireland in 2006 Canada + FL, NY, PA in 2016 Old and conquered if only! Re-emergence of old and previously presumed conquered equine diseases Dourine (Trypanosoma equiperdum) Italy in 2011 and Botswana in 2016 Glanders (Burkholderia mallei) Brazil and Germany 2015 Swamp fever (EIA virus) EU regularly since Ireland in 2006 Florida 2016 5

Headlines only a year from Rio! Summing up this bit Nature of the threat of infectious diseases facing humans and animals is not dissimilar Emerging and re-emerging infections/zoonoses Insects as vectors Changing global distributions Recognising & understanding these threats are key to prevention & effective control Although impacts from new diseases may be very large, the burden of endemic disease remains high Still challenges closer to home And some even closer to home Think of EHV-1, think of cold sores (herpes simplex virus-1) Think of EHV-1, think of cold sores (herpes simplex virus-1) 6

EHV-1 syndromes Respiratory disease Abortion Paralysis Equine Herpes Virus-1 (EHV-1) EHV-1 can cause respiratory disease, abortion and neurological disease in equids Most horses latently infected with EHV-1 Latent = not always infectious But have potential to become infectious Appropriate management of index cases can prevent major problems (Codes of Practice) Mis-management of them can spell disaster! Disaster may strike despite good management EHV-1 s life cycle. Generational cycles of infection with: Latent infection Most healthy horses are latently infected with EHV from an early age Reactivation of virus Recrudescence of disease means EHV-1 is here to stay Viral latency is widespread & difficult to control EHV-1 disease may spontaneously occur due to reactivation of latent virus Affects horses attending all types of events/premises Vaccination is currently not optimal (or available!) for prevention and/or control of EHV-1 EHV-1 can only be managed and NOT eradicated EHV-1 has ability for significant disease and death with associated financial and welfare consequences Abortion storms affecting multiple mares (UK 2016) Large neurological outbreaks (UK 2012/2013; USA) After a quiet 2014 & 2015. Increased EHV-1 activity in TBs in 2016 Neurological disease The National Stud: more details coming up Training yard in Epsom Multiple abortions/foal deaths on studs in Hertfordshire: more details to come from Julian Sussex Suffolk The National Stud Large public stud farm on edge of Newmarket Purpose built isolation unit (Heath Yard) for mares arriving from overseas separate from the main stud and with dedicated staff Incoming animals routinely bled for health monitoring purposes 7

The National Stud 4yo maiden filly developed neurological signs on 26/1/16 Ataxia, bladder dysfunction & periods of recumbency (bleed 2) Filly was from a pre-training yard in France and travelled by lorry with 2 pregnant mares & another maiden mare Consignment had arrived at Heath Yard on 20/1/16 (bleed 1) Filly was NP swabbed 4-times in the following days All samples NEGATIVE for EHV-1 by PCR Paired CFT serology though showed seroconversion (1:10 to 1:160) to EHV-1/-4, with samples only 6dd apart between bleeds The National Stud Neurological EHV-1 diagnosed based on serology but case apparently not infectious at time of clinical signs Road transport a potential high risk period of exposure for other animals in Heath Yard, esp. co-transported mares 2 co-transported pregnant mares at risk of EHV-1 abortion Inadvertent indirect transmission e.g. isolation unit staff Biosecurity measures implemented as per HBLB CoP Whole stud closed immediately & issued press release The National Stud All 24 mares in the isolation unit were screened clear No clinical disease, no seroconversions Post-foaling placentae PCR negative Affected filly made good recovery 3 mares from France tested negative by PCR on NP swabs on 3 occasions & did not abort or seroconvert Main stud re-opened on 15 th February 2016 & isolation yard reopened on 23 rd February 2016 Control of EHV-1 Follow the HBLB Codes of Practice Hard copy printed for TBA members Online at http://codes.hblb.org.uk/ Something new Celia to tell you more next! Some final thoughts on EHV-1 There is never zero risk of EHV-1 with horses as they can spontaneously reactivate the virus from a latent state No pregnancy should be considered safe wrt EHV-1 until there is a healthy foal at foot that is at least a week old Always aspire to wrap pregnant mares in cotton wool so minimal stress, in small groups & away from other horses EHV-1 abortions pose high infection risks to other mares so must deal with them promptly & appropriately Separate potentially exposed mares until they abort or foal Routine management & index case handling are arguably more important than vaccination of pregnant mares 8