Canine Influenza Updates and Current Trends
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Published by the American Animal Hospital Association with a generous educational grant from Merck Animal Health Canine Influenza Updates and Current Trends CIV_AAHAMerck_2020.indd 1 1/28/20 12:56 PM Contents A Brief History of Canine Influenza Virus in the United States Current Canine Influenza Trends (2017–2019) Which Dogs Are at Risk of Canine Influenza Virus? Canine Influenza Presentation in Infected Dogs Canine Infectious Respiratory Disease—Test, Don’t Guess Lessons Learned from Previous Canine Influenza Outbreaks Canine Influenza Outbreak Management Preventing Canine Influenza Virus Protecting Your Patients from Canine Influenza Before an Outbreak What Every Pet Owner Needs to Know About Canine Influenza What Every Pet-Care Business Needs to Know About Canine Influenza Talking to Pet Owners About Vaccinating for Canine Infectious Respiratory Disease CIV_AAHAMerck_2020.indd 2 1/28/20 12:56 PM Dear colleague, Canine influenza emerged as a novel disease in the United States more than 15 years ago, and it has significantly affected canine health. Those of you who have had direct experience with an outbreak understand how devastating canine influenza can be to your clients and their pets. If you have not yet seen the spread of canine influenza in your local area, consider yourself fortunate. We have seen businesses close or lose substantial revenue during outbreaks. Plus, the disease is not slowing down. Whatever your experience is with this disease, what prevention protocol do you have in place for your patients? Today’s dog owners seek socialization opportunities patients seems like an easy decision; however, a large for their pets, such as: percentage of pets remain unprotected from canine • Spending time at doggy daycare influenza. As veterinarians, we owe it to our clients • Taking trips to the dog park and their pets to remain at the forefront of protecting • Playing with neighborhood dogs the human-animal bond. These interactions provide not only important I challenge you to have a conversation as a veterinary benefits but also opportunities for potential disease healthcare team and talk with every dog owner exposure. Every social dog is at risk for exposure about the importance of protecting their best friend to canine influenza, and we have seen the virus from canine influenza. Your clients are interested in sweep through boarding kennels and doggy daycare learning information about infectious diseases, and facilities. Our mission in publishing this booklet you are the best person to educate them. is to provide up-to-date information regarding canine influenza’s impact on patient health, to equip you to educate clients so that they can make an informed decision regarding the disease, and to help you establish a protocol to protect your patients, Christine Royal, DVM facilities, and community. Director, Veterinary Professional Services US Companion Animal and Equine Business Unit Preserving animal health is our primary job as Merck Animal Health veterinarians, and vaccination is a powerful tool to accomplish that goal. When a highly efficacious vaccine is available to prevent a potentially fatal disease or when prevention is more cost-effective than treatment, recommending vaccination for 1 CIV_AAHAMerck_2020.indd 1 1/28/20 12:56 PM A Brief History of Canine When a respiratory infection outbreak occurred among greyhounds at several Florida race tracks in Influenza Virus in the 2004, veterinarians assumed a particularly virulent United States strain of Bordetella bronchiseptica or parainfluenza Canine influenza is a highly contagious viral virus was circulating. However, diagnostic testing for infection that has caused significant respiratory common respiratory pathogens turned up no clues disease outbreaks over the past 15 years. Two surface until an influenza-like virus was discovered and glycoproteins, hemagglutinin and neuraminidase sequenced. The virus was determined to be H3N8, (HxNx), are used to identify influenza viruses, and which had originated in horses but had developed different subtypes and strains vary in their ability to not only the ability to infect dogs but also the ability infect specific host species. Influenza viruses cause for transmission between dogs. Influenza viruses well-described disease in many species, including had never been associated with clinical disease in horses, birds, pigs, and humans. They can mutate US dogs before, and the finding was unexpected. easily, and their shifts from one host species to Additional isolated outbreaks were reported at another are well documented. When a new influenza other racetracks over the next year, with eventual subtype or strain enters an immunologically naive transmission to the pet dog population.1 population, an outbreak is likely. In March 2015, influenza was believed to have Canine influenza is caused by an influenza A virus, caused a surge of respiratory disease, characterized with two variants currently circulating among dogs by cough and fever, in Chicago-area dogs; however, in the US. Both strains, H3N8 and H3N2, originated PCR testing for H3N8, as well as other respiratory in other species, mutated to gain the ability to infect pathogens, was consistently negative. Further testing dogs, and caused severe disease in unprotected eventually characterized the virus as an influenza canine populations. virus that was a new strain to North America— H3N2. The H3N2 virus originated in birds, and Significant Events in the Emergence of Canine Influenza H3N8 is identified as the cause of Confirmed H3N2 is isolated in a contagious Merck Animal cases of canine 104 dogs in Ontario, respiratory disease H3N2 emerges as Merck Animal Health and influenza are Canada, from outbreak in Florida a canine pathogen Health develops Zoetis develop documented in December 2017 to racing greyhounds in Asia H3N8 vaccine H3N2 vaccines 46 states October 2018 2004 2005 2006 2009 2009 2015 2015 2015 2016 2017 2017 2019 Additional isolated H3N8 spreads to H3N2 is identified as Merck Animal Several new Canine influenza H3N8 outbreaks affect dogs in 30 the cause of massive Health and introductions of continues to cause continue, affecting US states canine influenza Zoetis develop H3N2 into the US infection in US dogs racetracks in 11 outbreaks in Chicago bivalent occur, likely from states and eventually and Atlanta vaccines that dogs imported extending to the pet contain H3N8 from South Korea dog population and H3N2 and China 2 CIV_AAHAMerck_2020.indd 2 1/28/20 12:56 PM canine infection was previously documented only in to Chicago were transported to Ontario.4 Recent South Korea, China, and Thailand. An infected dog outbreaks include diagnosis of H3N2 in a significant likely was brought from Asia to Chicago, possibly as number of dogs in the San Francisco Bay area in a rescue or military dog, and served as an infection early 2018, and again in the summer of 2019, as well source for other dogs.1,2 as outbreaks in Northern California and Oregon in June and July 2019.5 Current Canine According to Melissa Bourgeois, DVM, PhD, Influenza Trends DACVM, associate director of professional services for Merck Animal Health, “It [canine influenza] pops (2017–2019) up in areas that we don’t expect. We’ve detected Since the initial H3N8 and H3N2 outbreaks, cases of the virus in many states across the country, influenza has persisted in the canine population in both rural and urban areas. We can never predict by quietly causing consistent, low-level incidence where the virus is going to come next based on punctuated by occasional larger outbreaks. Viral any historical precedence.” The fact that the virus genomic sequencing has also shown that several new remains quiet for months at a time, and then emerges introductions of H3N2 into the US have occurred, over and over again during sudden outbreaks, lends likely from dogs imported from South Korea and to its unpredictability and the need to protect dogs China, that caused outbreaks in the southeastern in areas with previous exposure, as well as areas that US and Los Angeles in 2017.3 The first introduction have remained largely unaffected. of H3N2 to Canada was documented in December 2017, when two dogs imported from South Korea The number of dogs who tested positive during each outbreak is documented; however, this data inadequately represents the actual number Meet the Expert of infected dogs, which can be misleading to Canine influenza expert: Melissa Bourgeois, veterinarians and pet owners who are making DVM, PhD, DACVM decisions about the necessity of vaccination. Bourgeois was part of Merck Animal Health’s Title: Associate director of professional Respiratory Disease Surveillance Program during services (south zone), Merck Animal Health the 2015 outbreak, when more than 800 dogs from the Chicago area and more than 500 dogs in the Why she’s an expert: Bourgeois promotes Atlanta area tested positive. Thousands of dogs the canine influenza vaccine, educates likely contracted influenza during the outbreak, but veterinarians about its use, and is part since canine influenza is not a reportable disease, of the Respiratory Disease Surveillance and testing is optional, the data reflects only dogs Program. She has also worked in the who were tested. Canine influenza continues to cause influenza division of the Centers for infection in US dogs Disease Control and Prevention. The unfortunate result of inadequate representation of true disease prevalence is a misconception that canine influenza is not widespread, and that only a 3 CIV_AAHAMerck_2020.indd 3 1/28/20 12:56 PM Continued transmission of infection among unprotected dogs, along with new H3N2 Meet the Expert introductions by means of imported dogs, makes Canine influenza expert: Christopher Lee, canine influenza a constant threat. DVM, MPH, DACVPM Title: Senior professional services Which Dogs Are at Risk of veterinarian, Merck Animal Health Canine Influenza Virus? Why he’s an expert: Lee is a Canine influenza is an airborne infection that is shed preventive medicine expert who via aerosolized droplets when dogs sneeze, cough, educates veterinarians about canine or bark.