Estimation of the basic reproduction number for Streptococcus equi spp equi outbreaks by meta-analysis of strangles outbreak reports

A model-based approach to evaluate the effect of vaccination of the herd on transmission of equine herpesvirus 1 in naturally occurring outbreaks

Equine herpesvirus 1 (EHV-1) infection is the cause of high impact disease syndromes, affecting the global horse industry. The effect of vaccination on transmission dynamics of EHV-1 in naturally occurring outbreaks is not quantified. Our aims were to estimate R0 for EHV-1 in equine populations from outbreak data, and evaluate the effect of vaccination status of the herd on R through a systematic review, model-based estimations and meta-analysis. A literature search for outbreak reports was carried out. Depending on available data, the early epidemic growth rate (GR) or final attack rate (AR) approach was used to estimate the basic reproduction number for that outbreak. Herd vaccination status, as well as virus genotype and use of antivirals were recorded. Only outbreaks in herds where either none or all of the horses had been vaccinated were included. An overall estimate for R0 (non-vaccinated herds) and Rv (vaccinated herds) was computed by meta-analysis and the two groups were compared using a random effects model. Twelve outbreaks, in herds of 16-135 horses, met the inclusion criteria, of which six occurred in non-vaccinated herds and six in vaccinated herds. One R0 calculation from a report describing empirical determination of a herd immunity threshold was also included. We found no evidence for a significant difference between estimates of R0 and RV in outbreaks: Rˆ0=3.3(2.6-4.0) and RˆV=2.7(2.1-3.2), p = 0.15. Our main limitations were our inability to investigate the influence of genotype or antivirals on results. Sensitivity analyses gave volatile p-values. In conclusion, we found no robust evidence for a significant reduction on transmission of EHV-1 in herds where all horses were vaccinated vs non-vaccinated herds. Rˆ in herds where all horses were vaccinated was substantially > 1 and vaccination as a sole mitigating measure may have limited effect on transmission of EHV-1.

Risk Factors and Long-Term Outcomes in Horses After the 2021 Outbreak of Equine Herpesvirus 1 Myeloencephalopathy, Valencia, Spain

BACKGROUND

Equine herpesvirus myeloencephalopathy (EHM) is a persistent threat to horses, with unclear risk factors and disease severity.

OBJECTIVES

To evaluate risk factors, effective reproduction rate (Rt), and long-term athletic outcomes of an EHM outbreak.

METHODS

Retrospective study of the 2021 EHM outbreak in Valencia, Spain, examining associations between risk factors (sex, age, breed, country of origin, and vaccination status) and case fatality rate, EHM development, and odds of returning to competition using odds ratios [95% CI] and Rt via the Robert Kochs Institute method.

RESULTS

Among 191 horses, 38 (20%) were clinically normal, 13 (7%) were subclinical, and 140 (73%) presented clinical signs (89 EHM, 64%). One hundred sixty horses were isolated at the show, while 47 were treated in hospitals. The mean age was 9.8 ± 3.0 years; 85 (45%) were mares, 79 (41%) geldings, and 27 (14%) stallions. The EHM case fatality rate was 11/89 (12%). Vaccination was associated with EHM development (4.54[2.23-9.27]; OR[95% CI]; p < 0.001) and case fatality rate (3.9[1.1-14.4]; OR[95% CI]; p < 0.043). EHV-1-infected horses without EHM were more likely to return to competition (54/61; 89%) than those recovering from EHM (65/89; 73%; p = 0.024). It was initially 4.2 and decreased to < 1 within 2 weeks of the outbreak.

CONCLUSIONS

During the 2021 EHV-1 outbreak in Valencia, vaccination status appears to be associated with EHM development. Horses recovering from EHM had slightly lower chances of returning to competition than those shedding EHV-1 without EHM. The high Rt value underscores the contagious nature of EHV-1.

Untangling the stranglehold through mathematical modelling of Streptococcus equi subspecies equi transmission

Strangles, a disease caused by infection with Streptococccus equi subspecies equi (S. equi), is endemic worldwide and one of the most frequently diagnosed infectious diseases of horses. Recent work has improved our knowledge of key parameters of transmission dynamics, but important knowledge gaps remain. Our aim was to apply mathematical modelling of S. equi transmission dynamics to prioritise future research areas, and add precision to estimates of transmission parameters thereby improving understanding of S. equi epidemiology and quantifying the control effort required. A compartmental deterministic model was constructed. Parameter values were estimated from current literature wherever possible. We assessed the sensitivity of estimates for the basic reproduction number on the population scale to varying assumptions for the unknown or uncertain parameters of: (mean) duration of carriership (1∕γC), relative infectiousness of carriers (f), proportion of infections that result in carriership (p), and (mean) duration of immunity after natural infection (1∕γR). Available incidence and (sero-)prevalence data were compared to model outputs to improve point estimates and ranges for these currently unknown or uncertain transmission-related parameters. The required vaccination coverage of an ideal vaccine to prevent major outbreaks under a range of control scenarios was estimated, and compared available data on existing vaccines. The relative infectiousness of carriers (as compared to acutely ill horses) and the duration of carriership were identified as key knowledge gaps. Deterministic compartmental simulations, combined with seroprevalence data, suggest that 0.05 Collapse

Key Words

• Epidemiology
• Infectious disease modelling
• Streptococcus equi

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MESH Headings

• Animals
• Horses
• Streptococcal Infections/veterinary
• Streptococcal Infections/epidemiology
• Streptococcal Infections/transmission
• Horse Diseases/transmission
• Horse Diseases/epidemiology
• Horse Diseases/microbiology
• Models, Theoretical
• Prevalence
• Incidence
• Streptococcus equi
• Models, Biological
• Streptococcus

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Affiliation(s)

R M A C Houben Department of Clinical Sciences, faculty of Veterinary medicine, Utrecht University, the Netherlands.
J R Newton Equine Infectious Disease Surveillance (EIDS), Department of Veterinary Medicine, Cambridge, UK
C van Maanen Royal GD, Deventer, the Netherlands
A S Waller Intervacc AB, Stockholm, Sweden; Department of Biomedical Science and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
M M Sloet van Oldruitenborgh-Oosterbaan Department of Clinical Sciences, faculty of Veterinary medicine, Utrecht University, the Netherlands
J A P Heesterbeek Department of Population Health Sciences, faculty of Veterinary Medicine, Utrecht University, the Netherlands

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Dynamics analysis of strangles with asymptomatic infected horses and long-term subclinical carriers

Strangles is one of the most prevalent horse diseases globally. The infected horses may be asymptomatic and can still carry the infectious pathogen after it recovers, which are named asymptomatic infected horses and long-term subclinical carriers, respectively. Based on these horses, this paper establishes a dynamical model to screen, measure, and model the spread of strangles. The basic reproduction number $ \mathcal{R}_0 $ is computed through a next generation matrix method. By constructing Lyapunov functions, we concluded that the disease-free equilibrium is globally asymptotically stable if $ \mathcal{R}_0 < 1 $, and the endemic equilibrium exits uniquely and is globally asymptotically stable if $ \mathcal{R}_0 > 1 $. For example, while studying a strangles outbreak of a horse farm in England in 2012, we computed an $ \mathcal{R}_0 = 0.8416 $ of this outbreak by data fitting. We further conducted a parameter sensitivity analysis of $ \mathcal{R}_0 $ and the final size by numerical simulations. The results show that the asymptomatic horses mainly influence the final size of this outbreak and that long-term carriers are connected to an increased recurrence of strangles. Moreover, in terms of the three control measures implemented to control strangles(i.e., vaccination, implementing screening regularly and isolating symptomatic horses), the result shows that screening is the most effective measurement, followed by vaccination and isolation, which can provide effective guidance for horse management.