Analyze Diet

Topic:Animal Health

Animal Health encompasses a broad range of topics focused on maintaining and improving the well-being of equine species. This field addresses various aspects of horse care, including disease prevention, diagnosis, treatment, and management of health conditions. Key areas of interest include equine nutrition, vaccination protocols, parasite control, dental care, and the management of chronic conditions such as laminitis and colic. Additionally, animal health research in horses investigates the impact of exercise and training on physical health, the role of genetics in disease susceptibility, and the development of new therapeutic approaches. This page compiles peer-reviewed research studies and scholarly articles that explore the latest advancements, challenges, and best practices in preserving and enhancing the health of horses.
Safety and efficacy of a feed additive consisting of an essential oil derived from the flowering stems of Salvia sclarea L. (clary sage oil) for use in all animal species (FEFANA asbl).
EFSA journal. European Food Safety Authority    November 14, 2024   Volume 22, Issue 11 e9016 doi: 10.2903/j.efsa.2024.9016
Villa RE, Azimonti G, Bonos E, Christensen H, Durjava M, Dusemund B, Gehring R, Glandorf B, Kouba M, López-Alonso M, Marcon F, Nebbia C, Pechová A....Following a request from the European Commission, EFSA was asked to deliver a scientific opinion on the safety and efficacy of an essential oil from the fresh or dried flowering stems of L. (clary sage oil) when used as a sensory additive in feed and in water for drinking for all animal species. The EFSA Panel on Additives and Products or Substances used in Animal Feed (FEEDAP) concluded that the additive under assessment is considered safe up to the maximum use level in complete feed of 15 mg/kg for veal calves (milk replacers), cattle for fattening, sheep/goats, 10 mg/kg for horses, 20 mg/k...
Warmblood fragile foal syndrome: Pregnancy loss in Warmblood mares.
Equine veterinary journal    November 14, 2024   Volume 57, Issue 4 915-923 doi: 10.1111/evj.14435
Kehlbeck A, Blanco M, Venner M, Freise F, Gunreben B, Sieme H.Fragile foal syndrome (FFS) or warmblood FFS Type 1 (WFFS) is a recessive, autosomal, hereditary, genetic defect causing late abortions, stillbirths and non-viable foals. Whether early pregnancy losses occur is unknown. Objective: To investigate how WFFS affects pregnancies and whether early pregnancy losses occur in WFFS matings and if there is a difference in pregnancy success between matings where both parents were allele carriers and those where only mare or stallion were WFFS carriers. Methods: Retrospective cohort study. Methods: Breeding records from a Warmblood stud farm were evaluated...
Assessment of the modification of the authorisation of the feed additive consisting of Saccharomyces cerevisiae CNCM I-1077 for lambs and its extension of use to all ruminants and camelids reared for milk production/suckling/reproduction, all minor (young) ruminant species and camelids for fattening and Equidae other than horses (Lallemand SAS).
EFSA journal. European Food Safety Authority    November 13, 2024   Volume 22, Issue 11 e9075 doi: 10.2903/j.efsa.2024.9075
Villa RE, Azimonti G, Bonos E, Christensen H, Durjava M, Dusemund B, Gehring R, Glandorf B, Kouba M, López-Alonso M, Marcon F, Nebbia C, Pechová A....Following a request from the European Commission, EFSA was asked to deliver a scientific opinion on the safety and efficacy of a preparation of CNCM I-1077 as a zootechnical feed additive for several animal species. The additive, existing in a not-coated and a coated form, is currently authorised for use in feed for calves, cattle for fattening, dairy cows, dairy goats and dairy sheep, lambs, all minor ruminant species for fattening and rearing, horses and camelids for fattening and rearing. This application regards the request for the extension of use in all ruminants and camelids reared for...
National survey reveals elastic price sensitivity for select equine veterinary services.
Journal of the American Veterinary Medical Association    November 13, 2024   1-5 doi: 10.2460/javma.24.09.0576
Gibson OL, Zhao S, Adam E, Stowe CJ.The objective of this study was to estimate the price elasticity of demand for 3 common equine veterinary services: vaccinations (a routine service), lameness examinations (an elective service), and emergency colic surgery (an urgent service). Methods: Data were collected via a nationwide online survey of horse owners from August 15 to September 11, 2023, eliciting their willingness to pay for each service. The link to the online survey was distributed through participating organizations' social media and email lists to the target audience of US residents aged ≥ 18 years who were financially...
Clinical and epidemiological aspects in equine aural plaques.
Veterinary research communications    November 13, 2024   Volume 49, Issue 1 1 doi: 10.1007/s11259-024-10572-0
Rodrigues GG, Alves DS, Bromberger CR, Nomelini QSS, Borges AS, de Oliveira-Filho JP, Delfiol DJZ.The association between aural plaques, Equus caballus papillomavirus (EcPV), and the different breeds of horses and risk factors is poorly described. The objective of this study was to determine the clinical prevalence of aural plaques in Mangalarga Marchador (MM) and Quarter Horse (QH) horses in Brazil, to evaluate the association of this prevalence with some risk factors, and to detect the presence of EcPV DNA (types 1-10) in aural plaques biopsies. A total of 400 MM and 425 QH horses, were clinically evaluated. For each horse, an identification form was completed, containing information on ...
A survey of ocular pathology in Warmblood horses in South Africa.
Equine veterinary journal    November 13, 2024   Volume 57, Issue 4 889-897 doi: 10.1111/evj.14427
Allen R, Goodhead AD.Warmblood horses are a popular breed around the world for equestrian sports. Previous studies have investigated ocular findings in other breeds of horses; however, no studies exist for the Warmblood breed. Objective: To determine the prevalence of ocular abnormalities in a convenience sample of Warmblood horses in South Africa and to determine if the prevalence of lens and chorioretinal lesions increase with age. Methods: Descriptive, observational study. Methods: Warmblood horses underwent a full ophthalmic examination which included a Schirmer tear test (STT), tonometry, fluorescein dye test...
Impact of the mare colostral immunoglobulins on the expression of TLR3, TLR4, and TLR7 in foals.
Animal science journal = Nihon chikusan Gakkaiho    November 13, 2024   Volume 95, Issue 1 e70007 doi: 10.1111/asj.70007
Migdał A, Migdał Ł, Oczkowicz M, Tombarkiewicz B, Okólski A.Colostrum contains substances such as hormones, enzymes, polyamides, nucleic acid derivatives, and amino acid derivatives and also includes immunomodulating substances, proline-rich polypeptides, immunoglobulins (Ig) as well as bacteriostatic compounds. The aim of the study was to evaluate the impact of colostral Ig on the level of expression of selected Toll-like receptor genes (TLR3, TLR4, and TLR7). The experiments were conducted on 25 Polish Pony foals. Blood samples were collected according to the following scheme: before first suckling, at the 1st, 3rd, 5th, 10th, 20th, and 30th, day of ...
Effect of Simple Oral Dental Extraction on Systemic Serum Amyloid A Concentrations in Horses.
Veterinary medicine and science    November 13, 2024   Volume 10, Issue 6 e70104 doi: 10.1002/vms3.70104
Sidwell AE, Duz M, Khan A, Bodnàr R, Hole SL.The translocation of gingival commensals resulting in measurable systemic inflammation has been described in humans and non-equine veterinary species with dental disorders, particularly periodontal disease. Routine odontoplasty does not result in increased serum amyloid A (SAA) concentration in horses, but a measurable increase in SAA concentration in horses undergoing dental extractions could suggest that local inflammation resulting from more severe dental disease has potential for wider, systemic consequences that warrants further study. To determine whether SAA increases in horses undergoi...
Quantifying head and withers movement asymmetry in sound and naturally forelimb lame horses trotting on a circle on hard and soft surfaces.
Equine veterinary journal    November 12, 2024   Volume 57, Issue 5 1219-1230 doi: 10.1111/evj.14430
Taddey CM, Roecken M, Kreling KM, Cruz AM.Reliable lameness thresholds for vertical head displacement for trotting on a circular path and on different surfaces have yet to be defined. Withers movement in lame horses could help improve the diagnostic accuracy of sensor technology. Objective: To define head movement lameness threshold ranges and describe the relationship between head and withers movement during trotting under different circumstances in sound and forelimb lame horses. Methods: Retrospective analysis of clinical data and comparison with control group. Methods: Fifty-five sound and thirty-four naturally lame horses were tr...
Validation of Vetscan Imagyst®, a diagnostic test utilizing an artificial intelligence deep learning algorithm, for detecting strongyles and Parascaris spp. in equine fecal samples.
Parasites & vectors    November 12, 2024   Volume 17, Issue 1 465 doi: 10.1186/s13071-024-06525-w
Steuer A, Fritzler J, Boggan S, Daniel I, Cowles B, Penn C, Goldstein R, Lin D.Current methods for obtaining fecal egg counts in horses are often inaccurate and variable depending on the analyst's skill and experience. Automated digital scanning of fecal sample slides integrated with analysis by an artificial intelligence (AI) algorithm is a viable, emerging alternative that can mitigate operator variation compared to conventional methods in companion animal fecal parasite diagnostics. Vetscan Imagyst is a novel fecal parasite detection system that uploads the scanned image to the cloud where proprietary software analyzes captured images for diagnostic recognition by a d...
Monitoring of Non-Lame Horses and Horses with Unilateral Hindlimb Lameness at Rest with the Aid of Accelerometers.
Sensors (Basel, Switzerland)    November 11, 2024   Volume 24, Issue 22 7203 doi: 10.3390/s24227203
Uellendahl A, Schramel JP, Tichy A, Peham C.The aim of this study was to determine whether horses exhibiting unilateral hindlimb lameness unload (rest) the lame limb more than the contralateral limb. The resting/unloading of the hindlimbs and the time spent lying down were measured using accelerometers. Ten non-lame horses and 20 lame horses were recruited for participation and monitored for 11 h overnight with accelerometers (MSR145, sampling rate: 1 Hz, and measuring range: ±15 g) attached to the lateral metatarsal and metacarpal regions of each limb. Metatarsal and metacarpal orientation were used to determine whether the limb was u...
Optimizing equine sperm quality: an alternative to single layer centrifugation for sperm isolation.
Reproduction & fertility    November 11, 2024   Volume 5, Issue 4 e230081 doi: 10.1530/RAF-23-0081
Medica AJ, Gibb Z, Aitken RJ.In vitro semen purification techniques have been developed that seek to mimic the in vivo selection process in order to generate the highest possible chance of oocyte fertilization following artificial insemination. Numerous methods have been developed to isolate functional spermatozoa for artificial insemination, yet only one method, single-layer centrifugation using commercial preparations like EquiPure, has been widely employed. In this study, we have introduced a novel approach for isolating spermatozoa and compared their quality to those isolated using EquiPure. The AI port system (Mempha...
Hydroallantois in a mare associated with schistosomus and unilateral ovarian agenesis in the fetus.
Journal of equine veterinary science    November 10, 2024   Volume 144 105228 doi: 10.1016/j.jevs.2024.105228
Arroyo E, Whitelock LM, Stanton ME, Stevenson V, de Aguiar LH, Kelleman A.Hydropsical conditions in domestic animals are characterized by abnormal fluid accumulation. While their complete pathophysiology remains unclear, factors such as changes in chorioallantoic membranes, placentitis, or fetal abnormalities may contribute. Hydrops present as a medical emergency that can cause complications for the mare. Early diagnosis and treatment are crucial for the mare's prognosis, as fetal survival is often poor. This report describes a case of hydroallantois in a 9-year-old pregnant Quarter mare at 271 days of gestation, leading to dystocia of a non-viable foal with multipl...
Preliminary Functional Analysis of the Gut Microbiome in Colic Horses.
Animals : an open access journal from MDPI    November 10, 2024   Volume 14, Issue 22 3222 doi: 10.3390/ani14223222
Thomson P, Garrido D, Santibáñez R, Lara F.The gut microbiome plays a critical role in maintaining horse health, influencing digestion, immunity, and overall well-being. However, in certain conditions like colic, there is evidence of significant alterations in the microbial community. To analyze the composition of the fecal microbiome and the enriched predicted metabolic functions of horses with colic compared to a control group, 14 horses with colic and 14 control horses were recruited. From a stool sample, DNA extraction was carried out for subsequent 16S rRNA metagenomic analysis. The composition of the microbiome was analyzed from ...
Peptidomic Analysis of Potential Bioactive Peptides in Mare Milk Under Different Heat Treatment Conditions.
Foods (Basel, Switzerland)    November 10, 2024   Volume 13, Issue 22 3592 doi: 10.3390/foods13223592
Lou X, Shao W, Wu Y, Ma H, Chen H, Zheng N, Zhao Y.Active peptides in mare milk have unique biological activities, but how the bioactive protein in mare's milk changes under the influence of temperature has not been fully studied. Therefore, in this study, the differential expression of bioactive peptides potentially present in horse milk under different heat treatment conditions was investigated for the first time using peptidomic and bioinformatic techniques. We collected a total of 15 samples. In this study, we divided the samples into five groups, specifically, 65 °C, 30 min; 72 °C, 15 min; 83 °C; 10 min; 95 °C, 5 min; and an untreated...
Identification and differentiation of somapacitan, a long-acting growth hormone derivative, and recombinant human growth hormone in equine plasma by LC-HRMS for doping control purpose. Shimizu Y, Sugai-Bannai M, Saito K, Hirano-Kodaira M, Leung GN.Somapacitan, a long-acting growth hormone derivative, and recombinant human growth hormone (rhGH) are protein-based drugs generally used to treat growth disorders and GH deficiency in humans. Due to their potential to enhance the horse performance, the use of these drugs is prohibited at-all-times by the International Federation of Horseracing Authorities for horseracing and the Fédération Equestre Internationale for equestrian sports. In this study, we developed a test method for the identification and differentiation of somapacitan and rhGH in equine plasma by using liquid chromatography h...
Detection of fungal and bacterial organisms from clinical uterine samples of horses using Next-Generation Sequencing in comparison with culture.
Journal of equine veterinary science    November 9, 2024   105214 doi: 10.1016/j.jevs.2024.105214
Cheong SH, Franklin-Guild R, Goodman LB, Lago-Alvarez Y, Lee YL, de Aguiar LH, de Amorim MD, Altier C.Fungal and bacterial culture is currently the primary method for pathogen detection and identification. Next-generation sequencing is a powerful method for detecting and identifying the presence of microbial DNA in samples. We evaluated the correlation between fungal and bacterial culture with next-generation sequencing in equine uterine samples. Fungal cultures (n=63) were evaluated based on their culture results. In culture positive (n=16) samples, next-generation sequencing identified the same organism in 10 samples (62.5%), 5 samples did not identify fungal agents, and 1 sample identified ...
Application of the horse grimace scale in horses with dental disease: Preliminary findings.
The Veterinary record    November 9, 2024   Volume 196, Issue 3 e4800 doi: 10.1002/vetr.4800
Sidwell AE, Duz M, Hill B, Freeman S, Hole SL.Dental disease is a common but often under-recognised condition in horses, possibly due to an inability to recognise clinical signs of oral discomfort. Some dental disorders are reportedly more painful than others, but there is no current metric by which dental pain can be objectively assessed. This study aimed to determine whether a facial expression-based pain scale offered an objective and reliable method for assessing dental pain in horses. It was hypothesised that dental disorders affecting the periodontium would produce high pain scores. Twelve horses with dental disease were evaluated f...
Hair and Blood Trace Elements (Cadmium, Zinc, Chrome, Lead, Iron and Copper) Biomonitoring in the Athletic Horse: The Potential Role of Haematological Parameters as Biomarkers.
Animals : an open access journal from MDPI    November 8, 2024   Volume 14, Issue 22 3206 doi: 10.3390/ani14223206
Aragona F, Giannetto C, Piccione G, Licata P, Deniz Ö, Fazio F.The aim of the present study was the evaluation of the bioaccumulation of cadmium (Cd), Zinc (Zn), Chrome (Cr), Lead (Pb), Iron (Fe) and Copper (Cu), in the blood, serum, tail and mane of horses from the industrialized area of Milazzo (Messina, Sicily), to understand the relationships between haematological parameters: Red Blood Cells (RBCs), White Blood Cells (WBCs), Haemoglobin (Hb), Haematocrit (Hct), Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC), Platelets (PLTs) and the concentrations of trace elements. Blood and hair ...
Is Butyrate Concentration in the Equine Gastrointestinal Tract Altered During and After Surgery for Treatment of Large Colon Obstruction?
Animals : an open access journal from MDPI    November 8, 2024   Volume 14, Issue 22 3203 doi: 10.3390/ani14223203
Barton CK, Hassel DM, Anders K, Weir TL.A major cause of morbidity and mortality in horses with large colon obstructive lesions is injury to the colonic mucosal barrier from ischemic injury. Since butyrate has been shown to play a critical role in the maintenance of a healthy mucosal barrier, it may play a role in the recovery process. This study's objective was to determine whether the differences in butyrate concentrations existed between horses with surgical large colon obstructive lesions and healthy horses both during and after surgery. Eleven horses presenting with surgical colic lesions were enrolled; colonic samples were acq...
Reproducibility and agreement of radiographic assessment of carpal deformities in foals.
Frontiers in veterinary science    November 7, 2024   Volume 11 1479790 doi: 10.3389/fvets.2024.1479790
Charles A, Peeters X, Verbrugghe C, Vandersmissen M, Evrard L, Busoni V.The Pivot Point (PP) method is commonly used in the radiographic assessment of carpal deformities in young foals, as the range of deviation may influence treatment choice. The aims of this study were to assess the intra- and interobserver reproducibility of the PP method and subjective radiographic evaluation without line drawing to establish the anatomical site responsible for carpal deviation in foals and to evaluate the agreement between these two techniques. Unassigned: Anonymized radiographs of foals presented for investigation of carpal deformity or prematurity were retrospectively and i...
The microRNAome of Strongylus vulgaris larvae and their excretory/secretory products with identification of parasite-derived microRNAs in horse arterial tissue.
International journal for parasitology    November 6, 2024   S0020-7519(24)00199-1 doi: 10.1016/j.ijpara.2024.10.005
Toft K, Honoré ML, Ripley NE, Nielsen MK, Fromm B, Mardahl M, Nielsen LN, Nejsum P, Thamsborg SM, Cirera S, Pihl TH.The equine bloodworm, Strongylus vulgaris, is a highly pathogenic parasite causing potentially fatal vascular and intestinal damage. Parasites express and release microRNAs (miRNAs) for internal regulation and to modulate host immunity. The complete set of miRNAs expressed by S. vulgaris (the S. vulgaris miRNAome) remains unannotated and the aim of this study was to annotate the miRNAome of L4 and L5 stages of S. vulgaris, and to examine differences in miRNA abundance between larval stages and sexes. Furthermore, we aimed to determine if miRNAs were detectable in excretory/secretory products (...
The Role of the Equestrian Professional in Bridle and Bit Fit in the United Kingdom.
Animals : an open access journal from MDPI    November 6, 2024   Volume 14, Issue 22 doi: 10.3390/ani14223188
Nankervis K, Williams JM, Fisher D, MacKechnie-Guire R.To ensure the comfort of ridden horses, equipment including bridles and bits should be suitable and fit correctly. Horse owners employ a variety of equestrian professionals with varying degrees of responsibility regarding bridle and bit fit. This study aimed to compare the frequency and manner in which equestrian professionals within a multidisciplinary team (MDT) engage with clients on matters of bridle and bit fit, and to capture their perceptions of the key issues in bridle and bit fit. The participants completed an online questionnaire to obtain information regarding participant demographi...
Detection of equine parvovirus-hepatitis and efficacy of governmental regulation for equine biologics purity. Scupham AJ, Tong C.In 2018, a new virus, named equine parvovirus-hepatitis (EqPV-H), was discovered in a biologic product that had been administered to horses that subsequently developed clinical signs of equine serum hepatitis (Theiler disease). Further correlation of the virus with the disease sparked federal requirements that all equine biologics be free of EqPV-H. The initial quantitative real-time PCR (qPCR) test for EqPV-H has proved to be sensitive to co-extracted PCR inhibitors in template nucleic acids, causing false-negative results. We investigated the use of digital PCR (dPCR) as a more robust test. ...
Electrointestinography, ultrasonographic contractility, and borborygmi of the cecum and colon are not altered by a single episode of hand walking exercise in healthy horses.
Journal of the American Veterinary Medical Association    November 6, 2024   1-9 doi: 10.2460/javma.24.07.0486
Munsterman AS, Rogers-Tirado JM, Kottwitz J.To evaluate the effect of hand walking exercise on myoelectrical activity and contractility in normal, healthy horses. Methods: Prospective experimental design. A convenience sample of 8 horses were randomized to a control or hand walking treatment group; each horse underwent both treatments. After a 30-minute baseline electrointestinography (EIG), horses were stall rested or hand walked for 15 minutes. Electrointestinography was repeated immediately and at 2 hours. Ultrasonography and auscultation monitored cecal and left ventral colon (LVC) contractions during EIG. Electrointestinography spe...
Environmental impacts and daily voluntary movement of horses housed in pasture tracks as compared to conventional pasture housing.
Journal of equine veterinary science    November 5, 2024   Volume 143 105215 doi: 10.1016/j.jevs.2024.105215
Farmer Long J, Duberstein J, Costin K, Callaway T, Abrams A, Wassel B, Toal K, Duberstein K.Pasture tracks are a modern equine housing trend often implemented as a weight control strategy due to the belief that they promote movement, though this is not proven experimentally. To test movement of horses housed in pasture tracks as compared to conventional pasture housing, two experiments were performed using a track (0.2ha, 3.5m in width, 561 m total distance) created around the perimeter of a 2.0 ha pasture. In experiment 1, eight horses were paired and rotated between three treatment locations: track (T), small 2 ha pasture housed within the track (SP), and a larger 20 ha pasture on ...
Prevalence of gastrointestinal and blood parasites in horses of Nakhon Si Thammarat province, Thailand.
Veterinary world    November 5, 2024   Volume 17, Issue 11 2460-2468 doi: 10.14202/vetworld.2024.2460-2468
Phetkarl T, Fungwithaya P, Lewchalermvong K, Sontigun N.The global prevalence of gastrointestinal (GI) and blood parasite infections in horses is a significant concern due to their substantial impact on morbidity, mortality, and economic losses in the horse industry. In Thailand, limited research has been conducted on these parasites in horse populations, and data from southern Thailand are lacking. Consequently, this study aimed to estimate the prevalence of GI and blood parasites in horses in Nakhon Si Thammarat province, Thailand. Unassigned: In total, 79 fecal and blood samples were collected from horses across 11 farms in Nakhon Si Thammarat p...
Congenital urachal and urinary bladder defects leading to uroperitoneum in a neonatal quarter horse colt.
The Canadian veterinary journal = La revue veterinaire canadienne    November 4, 2024   Volume 65, Issue 11 1119-1123 
Karam B, Arndt S, Magdesian KG, Cullen T, Dechant JE.A newborn (5 h old) quarter horse colt was presented because of lethargy and severe abdominal distention. Uroperitoneum was suspected during initial workup, based on sonographic imaging and peritoneal fluid analysis. Definitive diagnosis was confirmed during exploratory celiotomy. Surgery revealed a congenitally abnormal allantoic stalk/urachal remnant and a failure of embryological fusion of the dorsal bladder wall. Recovery was successful and the animal is now a healthy, 4-year-old western performance gelding. These specific congenital abnormalities have not been previously documented in the...
Evaluation of the Rostral Inferior Alveolar Nerve Block via the Mental Foramen in Equids: In Vivo Efficacy Testing.
Journal of veterinary dentistry    November 3, 2024   8987564241295586 doi: 10.1177/08987564241295586
Broman A, Rawlinson JE, Bass L, Boscan P, Rao S.The use of proper sedative and regional anesthetic protocols is essential when performing equine dental surgical procedures under standing sedation. The efficacy of the rostral inferior alveolar nerve block via the mental foramen has not been previously studied. Aims of this study included determining the efficacy of the block, investigating whether any region (labial mucosa, alveolar mucosa, or teeth) was more reliably anesthetized, and if differences in efficacy existed between bilateral and unilateral blocks. In this blinded trial, 10 horses each were randomly assigned to receive a left uni...
Equine Encephalomyelitis Outbreak, Uruguay, 2023-2024.
Emerging infectious diseases    November 2, 2024   Volume 31, Issue 1 doi: 10.3201/eid3101.240915
Frabasile S, Morel N, Pérez R, Marrero LM, Burgueño A, Cortinas MN, Bassetti L, Negro R, Rodríguez S, Bórmida V, Gayo V, de Souza VC, Naveca FG....We report the genomic analysis from early equine cases of the Western equine encephalitis virus outbreak during 2023-2024 in Uruguay. Sequences are related to a viral isolate from an outbreak in 1958 in Argentina. A viral origin from South America or continuous enzootic circulation with infrequent spillover is possible.
1 44 45 46 47 48 633