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Equine Viral Arteritis (EVA) Is a Reportable, Highly Contagious Disease Associated with Sporadic Outbreaks of Acute Respiratory Disease and Abortion in Horses

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Equine Viral Arteritis (EVA) Is a Reportable, Highly Contagious Disease Associated with Sporadic Outbreaks of Acute Respiratory Disease and Abortion in Horses CE Article #1 ) d t 0 L 6 4 s r e e EquineViral Arteritis g h a s i p l , b 1 u P e r n u a g l i l DVM , PhD i Julita Ramirez, F ( m c a University of Colorado, Denver M ABSTRACT: Equine viral arteritis (EVA) is a reportable, highly contagious disease associated with sporadic outbreaks of acute respiratory disease and abortion in horses. EVA is a disease syndrome characterized by a wide variety of clinical signs. Although EVA is transmitted primarily by the respiratory route, the disease’s greatest economic impact is on the horse -breeding industry. Infection with the etiologic agent of the disease, equine arteritis virus, most commonly results in subclinical infection. Horses with clinical signs usually recover fully from the disease and gain immunity against reinfection. Proper vaccination of susceptible breeding stock can prevent spread of the disease. EVA is manageable through public and professional education that emphasizes prevention and control measures. quine viral arteritis (EVA ) made headlines because of the impact of outbreaks on horse during the 2006 multistate outbreak, which owners. A solid understanding of the basics E resulted in vaccine shortages. 1 EVA has of EVA epidemiology, testing, prevention, and generated fear and controversy in the horse control strategies can help prepare practicing industry since a 1984 outbreak in the Kentucky veterinarians to address owners’ questions and Thoroughbred industry. Because outbreaks of concerns. Equine veterinarians should strive to this disease are uncommon and clinical signs actively educate horse owners to help prevent are nonspecific, many veterinarians do not the mass confusion that outbreaks can engender. include EVA in the differential diagnosis (Box 1) in appropriate situations and are unfamiliar EQUINE ARTERITIS VIRUS with effective prevention and control strategies. It is crucial to recognize the difference between Many horse owners are also uninformed about EVA and equine arteritis virus (EAV ) and to use the disease. The 1998 National Animal Health these terms properly. EVA is the disease syn - Monitoring Survey (NAHMS) conducted by drome characterized by a variety of clinical signs USDA-APHIS found that about 60% of sur - (Box 2), while EAV refers to the viral disease veyed horse operations were unaware of EVA, agent itself (Figure 1). EAV can cause sporadic and only 2.9 % of operations vaccinated one or outbreaks of respiratory disease and abortion in more horses against the virus. 2 In 2005, the horses worldwide. It is not a newly discovered number of operations vacci - organism; it was first isolated in 1953 from lung nating horses against EVA tissue of aborted fetuses during an outbreak of rose to 11.7%, indicating a respiratory disease and abortion on a Standard - •Take CE tests modest increase in public bred breeding farm in Bucyrus, Ohio. 3 The virus • See full-text articles awareness of the disease. It is infects equids only: ponies, horses, donkeys, and 4 CompendiumEquine.com especially important for veteri - mules are susceptible to natural infection. His - narians to understand EVA torically, the breeds of horse most affected in the COMPENDIUM EQUINE 456 November/December 2008 458 CE Equine Viral Arteritis Box 1. Primary Differential Diagnosis Box 2. Clinical Signs of Equine of EquineViral Arteritis a Viral Arteritis a • Equine herpesvirus 1 or 4 infection • Abortion • Equine influenza • Anorexia • Purpura hemorrhagica • Ataxia • Allergic reaction causing inflammation and urticaria • Conjunctivitis • Toxicosis due to a plant (e.g., hoary alyssum) • Depression • Equine infectious anemia • Edema (of the limbs, mammary glands, prepuce, • African horse sickness b scrotum, and ventral body wall as well as above or • Dourine b around the eyes ) • Getah virus infection b • Excessive lacrimation • Fever a Applicable differentials vary depending on the clinical signs. • Leukopenia A definitive diagnosis of EVA in clinically ill horses can be made only through diagnostic testing. • Petechial hemorrhage of mucous membranes bDiseases currently exotic to the United States. • Rhinitis and nasal discharge • Stiff gait • Urticaria (on the head and/or neck ; sometimes United States are the Standardbred, Thoroughbred, and generalized) Warmblood. The 1998 NAHMS study of US horses • Diarrhea found that 23.9% of unvaccinated Standardbreds, 4.5% of • Icterus Thoroughbreds, 3.6% of Warmbloods, and 0.6% of aAny or all of these signs may be present. No individual sign or Quarter Horses were seropositive for antibodies against set of signs is specific to the disease. However, if both respira - EAV. 5 In 2006, there was a significant outbreak of EVA tory disease and edema are present, EVA should be a top differ - ential. The most consistent clinical signs are fever, leukopenia, in the immunologically naive Quarter Horse population. and dependent limb edema. 9 Although the venereal transmission route is better known, most EAV infections are transmitted via the res - piratory route. These dual routes of transmission make respiratory secretions from infected horses, may help the virus an economic threat to shows, sales and per - propagate an abortion storm in a herd of pregnant formance events, and the breeding industry. Mares mares. 8 Fetal tissues are often partially autolyzed, and infected by the venereal route develop viremia and can there are no pathognomonic lesions for EVA. 9 disseminate the virus to other susceptible horses through Most EAV infections are subclinical or result in mild respiratory secretions. There is no evidence to suggest clinical disease. Those that result in signs of disease gen - that mares exposed to semen from a carrier stallion will erally resolve in 1 to 2 weeks with simple supportive abort later in gestation .6 Pregnant mares abort 1 to 4 care. Mortality is rare , except in very young, old, immuno- In 1998, approximately 60% of surveyed US horse operations were unaware of equine viral arteritis. weeks after respiratory infection, not as a result of being compromised, or debilitated horses. Mares infected late bred to a carrier stallion. Abortion can take place any in pregnancy may give birth to infected foals that can time between 3 and 10 months of gestation. EAV infec - die from interstitial pneumonia and/or enteritis. Ad- tion does not seem to affect the subsequent fertility of ministration of colostrum from immune mares has been mares, although stallions can have a transient decrease in found to attenuate or prevent infection in newborn the number of morphologically normal sperm cells due foals. 10 While EAV seroprevalence is fairly high in many to fever when they are first infected. 7 Many times, sus - horse populations worldwide, most equine abortions are ceptible pregnant mares abort without exhibiting signs of caused by other agents. disease. The aborted fetus and its associated tissues and Horses that are immunologically naive to EAV become fluids are infective to susceptible horses and, along with either subclinically or acutely clinically infected after COMPENDIUM EQUINE November/December 2008 460 CE Equine Viral Arteritis Box 3. LaboratoriesThat ConductVirus NeutralizationTesting for EAV a • California Animal Health and Food Safety Laboratory System (University of California, Davis) • Clemson Veterinary Diagnostic Laboratory (Columbia, South Carolina) • Colorado State University (Fort Collins) • CS Roberts Veterinary Diagnostic Laboratory (Auburn, Alabama) • Kansas State University (Manhattan) • Kissimmee Diagnostic Laboratory (Kissimmee, Florida) • Murray State University (Breathitt, Kentucky) Figure 1. Rabbit Kidney –13 cells were infected with EAV • National Veterinary Services Laboratory (Ames, for 8 hours, and cryosections were labelled with anti-nsp2 followed Iowa) by protein-A –gold detection (bar = 0.1µm; reprinted by permission from Macmillan Publishers Ltd: Kirkegaard K, Taylor MP, Jackson • New Jersey Department of Agriculture (Trenton) WT. Nature Rev Microbiol 2:301-314 [April 2004; doi:10.1038/ • New York State Animal Health Diagnostic nrmicro865] ©2004). Laboratory (Ithaca) • Ohio Department of Agriculture (Reynoldsburg) • Oklahoma Animal Diagnostic Laboratory exposure to the virus. Mares, foals, and geldings stop (Stillwater) shedding the virus after recovering from infection and do • Oregon State University (Corvallis) not become permanent carriers . Stallions, however, can • Texas Veterinary Medical Diagnostic Laboratories become chronically infected without showing overt clini - (Amarillo and College Station) cal signs of infection and can continuously shed virus in • The University of Georgia Diagnostic Laboratory their semen for years while remaining apparently healthy. (Athens) Chronically infected stallions can spontaneously and per - • University of Illinois (Urbana) manently stop shedding the virus for unknown reasons. Castration of chronically infected stallions terminates • University of Kentucky Livestock Disease Diagnostic Center (Lexington) viral shedding, as testosterone is necessary to maintain the carrier state . Temporarily decreasing the testosterone level • Veterinary Diagnostic and Investigational Laboratory (Tifton, Georgia) has shown limited success as a therapy for reducing or eliminating viral shedding in the semen of carrier stal - • Washington Animal Disease Laboratory (Pullman) lions , although further studies of this method are aLaboratories approved by the USDA National Veterinary needed .6 Cooled and frozen semen from infected stal - Services Laboratory to conduct this testing
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