Seroprevalence and risk factors for infection with West Nile virus in Saskatchewan horses, 2003

The primary objectives of this study were to determine the seroprevalence of West Nile virus (WNV) infection of horses in Saskatchewan in 2003 and to identify risk factors for the infection. Blood samples were collected in August and October from 212 horses in 20 herds in 5 geographic zones. After accounting for within-herd clustering, the proportion of horses that had been infected with WNV, as determined by IgG and IgM antibody response, was 55.7% (95% confidence interval, 44.9% to 65.8%). The proportion of antibody-positive horses differed among herds (0% to 100%) and across ecoregions (20% to 76%). Horses in southern ecoregions were more likely to have either IgM antibodies or IgG concentrations suggesting infection than were horses in northern ecoregions. The use of mosquito-control measures was associated with decreased risk. After accounting for ecoregion, there was no difference between recipients of an inactivated WNV vaccine and nonrecipients in the occurrence of antibodies reflecting natural infection.     

Incidence and effects of West Nile virus infection in vaccinated and unvaccinated horses in California

A prospective cohort study was used to estimate the incidence of West Nile virus (WNV) infection in a group of unvaccinated horses (n = 37) in California and compare the effects of natural WNV infection in these unvaccinated horses to a group of co-mingled vaccinated horses (n = 155). Horses initially were vaccinated with either inactivated whole virus (n = 87) or canarypox recombinant (n = 68) WNV vaccines during 2003 or 2004, prior to emergence of WNV in the region. Unvaccinated horses were serologically tested for antibodies to WNV by microsphere immunoassay incorporating recombinant WNV E protein (rE MIA) in December 2003, December 2004, and every two months thereafter until November 2005. Clinical neurologic disease attributable to WNV infection (West Nile disease (WND)) developed in 2 (5.4%) of 37 unvaccinated horses and in 0 of 155 vaccinated horses. One affected horse died. Twenty one (67.7%) of 31 unvaccinated horses that were seronegative to WNV in December, 2004 seroconverted to WNV before the end of the study in November, 2005. Findings from the study indicate that currently-available commercial vaccines are effective in preventing WND and their use is financially justified because clinical disease only occurred in unvaccinated horses and the mean cost of each clinical case of WND was approximately 45 times the cost of a 2-dose WNV vaccination program.     

Predictive risk mapping of West Nile virus (WNV) infection in Saskatchewan horses

The objective of this study was to develop a model using equine data from geographically limited surveillance locations to predict risk categories for West Nile virus (WNV) infection in horses in all geographic locations across the province of Saskatchewan. The province was divided geographically into low-, medium-, or high-risk categories for WNV, based on available serology information from 923 horses obtained through 4 studies of WNV infection in horse populations in Saskatchewan. Discriminant analysis was used to build models using the observed risk of WNV in horses and geographic division-specific environmental data as well as to predict the risk category for all areas, including those beyond the surveillance zones. High-risk areas were indicated by relatively lower rainfall, higher temperatures, and a lower percentage of area covered in trees, water, and wetland. These conditions were most often identified in the southwest corner of the province. Environmental conditions can be used to identify those areas that are at highest risk for WNV. Public health managers could use prediction maps, which are based on animal or human information and developed from annual early season meteorological information, to guide ongoing decisions about when and where to focus intervention strategies for WNV.     

Clinical West Nile virus infection in 2 horses in western Canada

Two horses had a history of ataxia and weakness or recumbency. One recovered and was diagnosed with West Nile virus (WNV) infection by serologic testing. The other was euthanized; it had meningoencephalomyelitis, WNV was detected by polymerase chain reaction. West Nile virus infection is an emerging disease. Year 2002 is the first year in which cases have been seen in Saskatchewan.     

The economic impact of West Nile virus infection in horses in the North Dakota equine industry in 2002

This study estimated economic impacts associated with the West Nile virus (WNV) outbreak in horses for North Dakota in 2002.The 2002 epidemic in the United States was the largest meningoencephalitis epidemic reported in the Western Hemisphere. Over 15,257 horse cases were reported in 43 states with most cases occurring in central United States. North Dakota reported over 569 horse cases, with a mortality rate of 22%. The total costs incurred by the state were approximately US$1.9 million. The costs incurred by horse owners were about US$1.5 million. Of the US$1.5 million, about US$781,203 and US$802,790 were spent on medical costs and losses due to inability to use animals because of the disease, respectively. Medical costs included the cost of vaccinating 152 horses, and the treatment costs for 345 horses which were US$4,803 and US$524,400 respectively. Costs associated with mortality were US$252,000 for the 126 horses which died of WNV. The state government spent US*$400,000 on WNV monitoring, control, and surveillance under the WNV-control program in 2002. Despite these conservative estimates, the data suggest that economic costs attributable to WNV epidemic to horse owners in North Dakota were substantial.     

Surveillance and Early Warning of West Nile Virus Lineage 2 Using Backyard Chickens and Correlation to Human Neuroinvasive Cases

In 2010, a West Nile virus (WNV) epidemic was reported in Central Macedonia, Northern Greece, with 197 neuroinvasive disease (WNND) cases in humans. The following 3 years, WNV spreads to new areas of Greece and human cases reoccurred during the transmission periods. After the initial outbreak, a WNV surveillance system using juvenile backyard chickens was established in Central Macedonia (after the 2011 outbreak) and Eastern Macedonia‐Thrace (after the 2012 outbreak). Sera were screened for the presence of antibodies against WNV using cELISA and serum neutralization test, to monitor the spread of WNV and to assess the correlation between the WNV point seroprevalence in chickens and the incidence rates of human WNND cases in the aforementioned areas. WNV seroprevalence in chickens was 10.4% (95% CI: 7–15) in Central Macedonia (2011) and 18.1% (95% CI: 14–23) in Eastern Macedonia‐Thrace (2012). Seroprevalence in chickens and incidence rates of human WNND cases in Eastern Macedonia‐Thrace were strongly positively correlated (ρ = 0.98, P = 0.005) at the regional unit level, with the incidence of WNND in humans increasing with increasing WNV point seroprevalence in chickens. In Central Macedonia, the correlation was weaker (ρ = 0.68, P = 0.20), apparently due to small number of reported human WNND cases. Another study was also conducted using juvenile backyard chickens in Central Macedonia, aiming to detect early WNV enzootic circulation, before the onset of human cases during 2011 and 2013. The first seroconverted chickens were detected about 1.5 months before the laboratory diagnosis of any human WNND cases in Central Macedonia, for both years. WNV surveillance, using juvenile backyard chickens, was reliable for the identification of areas with WNV enzootic and silent transmission, and for early warning. Timely diffusion of information to public health authorities facilitated the successful implementation of preparedness plans to protect public health.     

A metapopulation model to simulate West Nile virus circulation in Western Africa, Southern Europe and the Mediterranean basin

In Europe, virological and epidemiological data collected in wild birds and horses suggest that a recurrent circulation of West Nile virus (WNV) could exist in some areas. Whether this circulation is permanent (due to overwintering mechanisms) or not remains unknown. The current conception of WNV epidemiology suggests that it is not: this conception combines an enzootic WNV circulation in tropical Africa with seasonal introductions of the virus in Europe by migratory birds. The objectives of this work were to (i) model this conception of WNV global circulation; and (ii) evaluate whether the model could reproduce data and patterns observed in Europe and Africa in vectors, horses, and birds. The model was calibrated using published seroprevalence data obtained from African (Senegal) and European (Spain) wild birds, and validated using independent, published data: seroprevalence rates in migratory and resident wild birds, minimal infection rates in vectors, as well as seroprevalence and incidence rates in horses. According to this model, overwintering mechanisms are not needed to reproduce the observed data. However, the existence of such mechanisms cannot be ruled out.     

Detection of antibodies to West Nile virus in equine sera using microsphere immunoassay.

One hundred and ninety-one sera from horses that recently were exposed to West Nile virus (WNV) by either vaccination or natural infection or that were not vaccinated and remained free of infection were used to evaluate fluorescent microsphere immunoassays (MIAs) incorporating recombinant WNV envelope protein (rE) and recombinant nonstructural proteins (rNS1, rNS3, and rNS5) for detection of equine antibodies to WNV. The rE MIA had a diagnostic sensitivity and specificity, respectively, of 99.3% and 97.4% for detection of WNV antibodies in the serum of horses that were recently vaccinated or naturally infected with WNV, as compared to the plaque reduction neutralization test (PRNT). The positive rE MIA results were assumed to be WNV-specific because of the close agreement between this assay and the PRNT and the fact that unvaccinated control horses included in this study were confirmed to be free of exposure to the related St Louis encephalitis virus. The NS protein-based MIA were all less sensitive than either the rE MIA or PRNT (sensitivity 0-48.0), although the rNSI MIA distinguished horses vaccinated with the recombinant WNV vaccine from those that were immunized with the inactivated WNV vaccine (P < 0.0001) or naturally infected with WNV (P < 0.0001). The rE MIA would appear to provide a rapid, convenient, inexpensive, and accurate test for the screening of equine sera for the presence of antibodies to WNV.     

Recent rapid changes in the spatio‐temporal distribution of West Nile Neuro‐invasive Disease in Italy

In Italy, the first human case of West Nile Virus (WNV) infection was reported in 2008 and, since then, the number of cases has been steadily increasing. In this study, we describe the temporal and spatial pattern of WNV infection risk among humans in Italy, focusing on the human cases of West Nile Neuro‐invasive Disease (WNND) observed between 2008 and 2017. Incidence rates are estimated for each year and province under study. The incidence temporal trend is estimated using Poisson regression, and a spatio‐temporal cluster detection analysis is performed to detect high‐risk areas. In total, 231 WNND cases were notified in Italy between 2008 and 2017. The annual incidence rates increased during the study period (annual percentage change: 11.7%; 95%CI: ?0.9%; 26.1%). A geographical spread of the disease was observed during the study period throughout Northern Italy, with an increasing number of affected provinces. Provinces close to the Po River (the main river in the north of Italy) and the Oristano province (in the Sardinia Island) experienced the highest incidence rates during the study period. Our study shows a gradual, but rapid spread of WNND across Northern Italy from east to west and suggests the hypothesis that provinces close to Po River might present ecological and climatic conditions favourable to the virus circulation.     

Equine encephalomyelitis outbreak caused by a genetic lineage 2 West Nile virus in Hungary

Background: The spread of lineage 2 West Nile virus (WNV) from sub‐Saharan regions to Europe and the unpredictable change in pathogenicity indicate a potential public and veterinary health threat and requires scientific awareness. Objectives: To describe the results of clinical and virological investigations of the 1st outbreak of a genetic lineage 2 WNV encephalomyelitis in horses. Animals: Seventeen horses with neurologic signs. Methods: Information regarding signalment, clinical signs, and outcome was obtained for each animal. Serology was performed in 15 cases, clinicopathological examination in 7 cases, and cerebrospinal fluid was collected from 2 horses. Histopathology was carried out in 4 horses, 2 of which were assessed for the presence of WNV in their nervous system. Results: WNV neutralizing antibody titers were between 10 and 270 (median, 90) and the results of other serological assays were in agreement with those of the plaque reduction neutralization test. Common signs included ataxia, weakness, asymmetric gait, muscle tremors, hypersensitivity, cranial nerve deficits, and recumbency. Twelve animals survived. Amplicons derived from the infection‐positive specimens allowed molecular characterization of the viral strain. Conclusions and Clinical Importance: From our results, we conclude that this outbreak was caused by a lineage 2 WNV strain, even though such strains often are considered nonpathogenic. Neurological signs and survival rates were similar to those reported for lineage 1 virus infections. The disease occurrence was not geographically limited as had been the typical case during European outbreaks; this report describes a substantial northwestern spread of the pathogen.     

Characteristics of an outbreak of West Nile virus encephalomyelitis in a previously uninfected population of horses

Equine West Nile virus (WNV) encephalomyelitis cases - based on clinical signs and ELISA serology test results - reported to Texas disease control authorities during 2002 were analyzed to provide insights into the epidemiology of the disease within a previously disease-free population. The epidemic occurred between June 27 and December 17 (peaking in early October) and 1,698 cases were reported. Three distinct epidemic phases were identified, occurring mostly in southeast, northwest and then central Texas. Significant (P<0.05) disease clusters were identified in northwest and northern Texas. Most (91.1%) cases had no recent travel history, and most (68.9%) cases had not been vaccinated within the previous 12 months. One-third of cases did not survive, 71.2% of which were euthanatized. The most commonly reported presenting signs included ataxia (69%), abnormal gait (52%), muscle fasciculations (49%), depression (32%) and recumbency (28%). Vaccination status, ataxia, falling down, recumbency and lip droop best explained the risk of not surviving WNV disease. Results suggest that the peak risk period for encephalomyelitis caused by WNV may vary substantially among regions within Texas. Recumbent horses have a poor prognosis for survival. Vaccines, even if not administered sufficiently in advance of WNV infection within a district, may reduce the risk of death by at least 44%.     

Simulation of the seasonal cycles of bird, equine and human West Nile virus cases

The West Nile virus (WNV) is an arthropod-borne virus (arbovirus) circulating in a natural transmission cycle between mosquitoes (enzootic vectors) and birds (amplifying hosts). Additionally, mainly horses and humans (dead-end hosts) may be infected by blood-feeding mosquitoes (bridge vectors). We developed an epidemic model for the simulation of the WNV dynamics of birds, horses and humans in the U.S., which we apply to the Minneapolis metropolitan area (Minnesota). The SEIR-type model comprises a total of 19 compartments, that are 4 compartments for mosquitoes and 5 compartments or health states for each of the 3 host species. It is the first WNV model that simulates the seasonal cycle by explicitly considering the environmental temperature. The latter determines model parameters responsible for the population dynamics of the mosquitoes and the extrinsic incubation period. Once initialized, our WNV model runs for the entire period 2002-2009, exclusively forced by environmental temperature. Simulated incidences are mainly determined by host and vector population dynamics, virus transmission and herd immunity, respectively. We adjusted our WNV model to fit monthly totals of reported bird, equine and human cases in the Minneapolis metropolitan area. From this process we estimated that the proportion of actually WNV-induced dead birds reported by the Centers for Disease Control and Prevention is about 0.8%, whereas 7.3% of equine and 10.7% of human cases were reported. This is consistent with referenced expert opinions whereby about 10% of equine and human cases are symptomatic (the other 90% of asymptomatic cases are usually not reported). Despite the restricted completeness of surveillance data and field observations, all major peaks in the observed time series were caught by the simulations. Correlation coefficients between observed and simulated time series were R=0.75 for dead birds, R=0.96 for symptomatic equine cases and R=0.86 for human neuroinvasive cases, respectively.     

Survey on 'lumpy jaw' on deer farms in western Canada: prevalence and distribution, and identification of associated factors

AIM: To investigate the prevalence and geographical distribution of 'lumpy jaw' (LJ) in a population of white-tailed deer (WTD; Odocoileus virginianus) and mule deer (MD; Odocoileus hemionus) farms from the western Canadian provinces of Saskatchewan and Alberta, and to identify factors associated with its occurrence. METHODS: A cross-sectional study, in which the target population was all farmers of WTD and MD registered in Saskatchewan and Alberta, was conducted between July 2004 and January 2005. A questionnaire was mailed to all farmers requesting information about the presence of LJ and other necrobacillosis- related syndromes (footrot and fawn death syndrome), and various farm characteristics, during 2002, 2003 and 2004. Herd and within-herd incidences of disease were estimated. Global and local spatial analyses were performed to identify possible clusters of occurrence of LJ in the region. Logistic regression analysis was used to identify factors associated with the occurrence of LJ. RESULTS: A total of 139/268 (52%) deer farmers responded to the survey. Over the entire study period, 108/139 (78%) of farmers reported having cases of LJ in their herds, and in any given year the incidence amongst herds was about 40%. The presence of footrot was not associated with the presence of LJ. The proportion of fawns dying suddenly in 2004 was higher on farms affected by LJ than in those considered LJ-free (median of 11.1% and 0%, respectively; p<0.001). Two areas in Saskatchewan were identified as having a higher herd prevalence of LJ (clusters) than all other areas. Density of animals, moving and handling animals, lack of basic hygiene measures, and bottle- feeding of fawns increased the odds of a herd being affected by LJ. CONCLUSIONS AND CLINICAL RELEVANCE: LJ should be considered a common disease in farmed deer in western Canada. The observed relationship between the occurrence of LJ and acute mortality of fawns emphasises the potential of this infection to result in significant economic loss. Intensive management of deer, characterised by high densities and frequent moving and handling of animals, may contribute significantly to the occurrence of LJ. Observed geographical clusters may reflect areas where management of deer was more intensive or the trading of deer more common.     

Immunologic responses to West Nile virus in vaccinated and clinically affected horses

OBJECTIVE: To compare neutralizing antibody response between horses vaccinated against West Nile virus (WNV) and horses that survived naturally occurring infection. DESIGN: Cross-sectional observational study. ANIMALS: 187 horses vaccinated with a killed WNV vaccine and 37 horses with confirmed clinical WNV infection. PROCEDURE: Serum was collected from vaccinated horses prior to and 4 to 6 weeks after completion of an initial vaccination series (2 doses) and 5 to 7 months later. Serum was collected from affected horses 4 to 6 weeks after laboratory diagnosis of infection and 5 to 7 months after the first sample was obtained. The IgM capture ELISA, plaque reduction neutralization test (PRNT), and microtiter virus neutralization test were used. RESULTS: All affected horses had PRNT titers > or = 1:100 at 4 to 6 weeks after onset of disease, and 90% (18/20) maintained this titer for 5 to 7 months. After the second vaccination, 67% of vaccinated horses had PRNT titers > or = 1:100 and 14% had titers < 1:10. Five to 7 months later, 33% (28/84) of vaccinated horses had PRNT titers > or = 1:100, whereas 29% (24/84) had titers < 1:10. Vaccinated and clinically affected horses' end point titers had decreased by 5 to 7 months after vaccination. CONCLUSIONS AND CLINICAL RELEVANCE: A portion of horses vaccinated against WNV may respond poorly. Vaccination every 6 months may be indicated in certain horses and in areas of high vector activity. Other preventative methods such as mosquito control are warranted to prevent WNV infection in horses.     

Transmission dynamics and changing epidemiology of West Nile virus

West Nile virus (WNV) is a flavivirus that is maintained in a bird-mosquito transmission cycle. Humans, horses and other non-avian vertebrates are usually incidental hosts, but evidence is accumulating that this might not always be the case. Historically, WNV has been associated with asymptomatic infections and sporadic disease outbreaks in humans and horses in Africa, Europe, Asia and Australia. However, since 1994, the virus has caused frequent outbreaks of severe neuroinvasive disease in humans and horses in Europe and the Mediterranean Basin. In 1999, WNV underwent a dramatic expansion of its geographic range, and was reported for the first time in the Western Hemisphere during an outbreak of human and equine encephalitis in New York City. The outbreak was accompanied by extensive and unprecedented avian mortality. Since then, WNV has dispersed across the Western Hemisphere and is now found throughout the USA, Canada, Mexico and the Caribbean, and parts of Central and South America. WNV has been responsible for >27,000 human cases, >25,000 equine cases and hundreds of thousands of avian deaths in the USA but, surprisingly, there have been only sparse reports of WNV disease in vertebrates in the Caribbean and Latin America. This review summarizes our current understanding of WNV with particular emphasis on its transmission dynamics and changing epidemiology.     

Identification of hyperendemic foci of horses with West Nile virus disease in Texas

OBJECTIVE: To determine whether West Nile virus (WNV) disease hyperendemic foci (hot spots) exist within the horse population in Texas and, if detected, to identify the locations. SAMPLE POPULATION: Reports of 1,907 horses with WNV disease in Texas from 2002 to 2004. Procedures: Case data with spatial information from WNV epidemics occurring in 2002 (1,377 horses), 2003 (396 horses), and 2004 (134 horses) were analyzed by use of the spatial scan statistic (Poisson model) and kriging of empirical Bayes smoothed county attack rates to determine locations of horses with WNV disease in which affected horses were consistently (in each of the 3 study years) clustered (hyperendemic foci, or hot spots). RESULTS: 2 WNV hot spots in Texas, an area in northwestern Texas and an area in eastern Texas, were identified with the scan statistic. Risk maps of the WNV epidemics were qualitatively consistent with the hot spots identified. Conclusions and CLINICAL RELEVANCE: WNV hot spots existed within the horse population in Texas (2002 to 2004). Knowledge of disease hot spots allows disease control and prevention programs to be made more efficient through targeted surveillance and education.     

Prediction of human cases of West Nile virus by equine cases, Saskatchewan, Canada, 2003

In 2003, an outbreak of West Nile virus (WNV) occurred in Saskatchewan, Canada from July to September. One-hundred thirty-three horse cases and 947 human cases were recorded and data were analyzed retrospectively for evidence of clustering to determine if clinical infection in the horse population could be used to estimate human risk of infection with WNV. Kulldorff's scan statistic was used to identify spatial-temporal clusters in both the human and horse cases. In most areas, human clusters were not preceded by horse clusters. In one area, a significant cluster of horse cases preceded human cases by 1 week; however, 1 week does not provide sufficient time for human-health authorities to act and provide advance warning for the public.     

West Nile virus infection in horses in Saudi Arabia (in 2013–2015)

West Nile virus (WNV) is an important emerging zoonotic arbovirus giving rise to clinical syndromes of varying severity in humans and horses. Culex mosquitoes are the main vector. Although WNV has been reported in many countries in the Middle East and Asia, little is known about its prevalence in equine populations in the Arabian Peninsula. We have carried out a serological study on 200 horses to assess WNV infection in the Eastern and Central regions of Saudi Arabia in 2013–2015. Sera were tested for the presence of WNV antibodies in parallel using a commercial enzyme‐linked immunosorbent assay (ELISA) kit and microneutralization (MN) tests. In comparison with the MN assay used as “gold standard,” we find the ELISA had a sensitivity of 94.7% and specificity of 80.1%. The prevalence of WNV neutralizing antibody ranged from 5 (17.3%) of 29 sera collected in Riyadh up to 15 (55.6%) of 27 sera collected from Al‐Qateef. These findings highlight the need to be aware of the possibility of WNV disease in humans and horses presenting with central nervous system disease in the Kingdom of Saudi Arabia.