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Topic:Disease Prevention

Disease prevention in horses encompasses strategies and practices aimed at minimizing the occurrence and spread of infectious and non-infectious diseases within equine populations. These practices include vaccination programs, biosecurity measures, and regular health monitoring. Vaccination helps to stimulate the horse's immune system to protect against specific pathogens, while biosecurity measures, such as quarantine and sanitation, reduce the risk of disease transmission. Regular health monitoring, including physical examinations and diagnostic testing, aids in early detection and management of potential health issues. This page compiles peer-reviewed research studies and scholarly articles that explore various methods and their effectiveness in preventing diseases in horses, as well as the development and implementation of prevention programs in different equine settings.
Infections caused by extended-spectrum beta-lactamase-producing Enterobacterales in hospitalized neonatal foals: Can colonization predict infection?
Journal of veterinary internal medicine    February 21, 2025   Volume 39, Issue 2 e17299 doi: 10.1111/jvim.17299
Shnaiderman-Torban A, Meltzer L, Zilberman-Daniels T, Navon-Venezia S, Cohen A, Sutton GA, Blum SE, Amit S, Steinman A.Infections with extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) contribute to morbidity and mortality in human neonates. In foals, data are scarce. Objective: Determine the association between ESBL-PE gastrointestinal colonization on hospital admission and infections in hospitalized neonates. Methods: Sixty-seven foals. Methods: Prospective study of foals admitted to a veterinary hospital. Foals were screened for ESBL-PE colonization and for infections. Risk factors and clinical outcomes were analyzed. Results: Seventy-six percent of foals suffered from at least 1 bacteri...
Ethnoveterinary practices for treating parasitic diseases in domestic animals among Kyrgyz farmers.
Veterinary parasitology, regional studies and reports    February 21, 2025   Volume 59 101226 doi: 10.1016/j.vprsr.2025.101226
Aldayarov N, Tulobaev A, Madumarov A, Risvanli A.While modern veterinary medicine offers effective treatments, traditional ethnoveterinary practices persist among many farming communities, reflecting centuries-old knowledge and cultural beliefs. This study aimed to document ethnoveterinary remedies and their methods of preparation and application, for treating various parasitic diseases in domestic animals used by Kyrgyz farmers. Data on plant, animal and mineral-based remedies, as well as chemicals used for these purposes, were collected through interviews with 173 dialogue partners (DPs). A total of 3403 use reports (URs) were recorded, in...
Equine Influenza: Epidemiology, Pathogenesis, and Strategies for Prevention and Control.
Viruses    February 21, 2025   Volume 17, Issue 3 doi: 10.3390/v17030302
Branda F, Yon DK, Albanese M, Binetti E, Giovanetti M, Ciccozzi A, Ciccozzi M, Scarpa F, Ceccarelli G.Equine influenza (EI) is a highly contagious respiratory disease caused by the equine influenza virus (EIV), posing a significant threat to equine populations worldwide. EIV exhibits considerable antigenic variability due to its segmented genome, complicating long-term disease control efforts. Although infections are rarely fatal, EIV's high transmissibility results in widespread outbreaks, leading to substantial morbidity and considerable economic impacts on veterinary care, quarantine, and equestrian activities. The H3N8 subtype has undergone significant antigenic evolution, resulting in the...
Prospective randomised comparison of different antimicrobial protocols for the prevention of surgical site infections in horses undergoing emergency exploratory celiotomy.
Equine veterinary journal    February 19, 2025   doi: 10.1111/evj.14489
Christie KD, Epstein KL, Tyma JF, Afonso T, Fultz LE, Giguère S.Surgical site infection (SSI) is an important complication following emergency celiotomy in the horse. Judicious antimicrobial use is important for the prevention of antimicrobial resistance and the limitation of antimicrobial-associated complications. Previous studies in horses have found no association between SSI and perioperative antimicrobial duration, but the ideal duration of antimicrobial administration in horses undergoing exploratory celiotomy remains unclear. Objective: To compare SSI and describe post-operative complications, survival, duration and cost of hospitalisation in horses...
Evaluation of a stent dressing and abdominal bandage on surgical site infection following emergency equine laparotomy: A randomised controlled trial.
Equine veterinary journal    February 19, 2025   doi: 10.1111/evj.14482
Isgren CM, Pinchbeck GL, Salem SE, Hann MJ, Townsend NB, Cullen MD, Archer DC.Surgical site infection (SSI) is a frequent complication following emergency equine laparotomy, negatively impacting equine welfare, increasing treatment costs and presenting a hospital biosecurity risk. Objective: To determine if a sutured-on stent dressing for incisional protection during anaesthetic recovery reduced SSI following emergency laparotomy. Methods: Randomised controlled trial. Methods: Eligible horses were randomised to a sutured-on stent (intervention) or textile dressing (control) as the primary component of a 3-layer abdominal bandage placed for anaesthetic recovery. Horses w...
[Statement on the efficacy and immunological safety of EHV vaccines in horses].
Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere    February 18, 2025   Volume 53, Issue 1 39-48 doi: 10.1055/a-2518-1976
In February 2021, a serious EHV-1 outbreak occurred at an international jumping competition in Valencia, with several subsequent outbreaks in various European countries. As a consequence, several equestrian associations introduced compulsory vaccination against EHV-1, and in the immediate aftermath of the outbreak, demand for EHV vaccinations increased sharply. The initial concern has now dissipated. One equestrian association has abolished the compulsory vaccination that had only been introduced a year before, and a general debate began questioning the efficacy and safety of EHV-vaccines. Thi...
[Guidelines for the vaccination of horses – 5th edition].
Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere    February 18, 2025   Volume 53, Issue 1 33-38 doi: 10.1055/a-2517-4204
Vaccination is one of the most important measures for preventing infectious diseases. Vaccinations against tetanus and West-Nile-Virus are essential to protect the individual horse. These infections are not contagious and are not transmitted from animal to animal. By contrast, Equine Influenza and Equine-Herpes-Virus infections are highly contagious, transmissible diseases. In addition to protecting the vaccinated individual, vaccinating as many horses as possible aims at inducing a broad herd immunity, which interrupts infection chains and thus additionally protects the individual. Vaccinatio...
Cerebellar abiotrophy in a quarter horse foal.
Journal of equine veterinary science    February 16, 2025   Volume 147 105386 doi: 10.1016/j.jevs.2025.105386
Primo ALM, Assis DM, Santos VGS, de Melo LRB, da Nóbrega LD, Medeiros Dantas AF, Maciel TA.Cerebellar abiotrophy is a neurodegenerative disease that affects the Purkinje cells of the cerebellum, resulting in premature neuronal death. In horses, its occurrence has been reported mainly in the Arabian breed as a congenital mutation inherited in an autosomal recessive manner. The objective of this study was to describe the case of cerebellar abiotrophy in a Quarter Horse foal. An 8-day-old foal was treated after presenting signs of ataxia, hypermetria, difficulty maintaining a standing position, and decreased menace response. The foal was hospitalized for 26 days, received treatment wit...
A missense mutation in the KCNE4 gene is not predictive of equine anhidrosis.
Animal genetics    February 16, 2025   Volume 56, Issue 1 e70004 doi: 10.1111/age.70004
van der Graaf L, Leigh W, Szmatoła T, Roberts K, Ryan S, Brown B, Van Buren S, Finno CJ, Petersen JL.Anhidrosis is defined as a decreased or absent ability to sweat in response to heat and exercise. In horses, this condition can increase the risk of life-threatening hyperthermia. A prior study has suggested that equine anhidrosis is associated with a missense variant (rs68643109) in the Potassium Voltage-Gated Channel Subfamily E Regulatory Subunit 4 (KCNE4) gene. This project aimed to validate this association in a population of well-phenotyped horses and to determine the allele frequency of this variant in publicly available whole-genome sequence data. Fifty horses within the University of ...
Antagonistic activity of butanamine 2,2-dinitro-N-methyl- synthesized by endosymbiotic Bacillus amyloliquefaciens VITAPRJS1 acquired from horse milk.
International microbiology : the official journal of the Spanish Society for Microbiology    February 13, 2025   doi: 10.1007/s10123-025-00640-z
Chakraborty A, Dutta P, Amrit R, Dey P, Osborne WJ.Endosymbiotic bacteria are known to synthesize bioactive compounds which have biotechnological potentials that enhance immune responses by stimulating the production of immune cells. Horse milk is widely known to have nutraceutical and antimicrobial activities; however, there are no scientific reports on its inhibitory effects. VITAPRJS1, isolated from horse milk, showed non-hemolytic properties and was significantly tolerant to bile salt and NaCl. The isolate also exhibited potent antibacterial activity against pathogenic bacterial strains such as Escherichia coli, Pseudomonas aeruginosa, Sta...
Protective efficacy of a bivalent equine influenza H3N8 virus-like particle vaccine in horses.
Vaccine    February 11, 2025   Volume 50 126861 doi: 10.1016/j.vaccine.2025.126861
O'Kennedy MM, Reedy SE, Abolnik C, Khan A, Smith T, du Preez I, Olajide E, Daly J, Cullinane A, Chambers TM.Equine influenza (EI) is a highly contagious acute respiratory disease of wild and domesticated horses, donkeys, mules, and other Equidae. EI is caused by the Equine Influenza virus (EIV), is endemic in many countries and outbreaks still have a severe impact on the equine industry globally. Conventional EI vaccines are widely used, but a need exists for a platform that facilitates prompt manufacturing of a highly immunogenic, antigenically matched, updated vaccine product. Here we developed a plant-produced bivalent EI virus-like particle (VLP) vaccine candidate which lacks the viral genome an...
Safety and immunogenicity of a sarcoid vaccine in horses.
Journal of equine veterinary science    February 10, 2025   Volume 146 105381 doi: 10.1016/j.jevs.2025.105381
Jacob O, Hause B, Peters-Smith K, Adam EN, Page AE, Floyd C, Tucker C, Eertink LG, Wang D, Li F.Equine sarcoids are the most identified skin tumors of horses, which are highly associated with bovine papillomavirus infection. Sarcoids can impair the use of the horse and are difficult to treat, resulting in significant economic losses and a welfare concern. There is no vaccine available to protect global equines from sarcoids. We aimed to determine the safety and protective antibody response in horses immunized with a recombinant baculovirus vector vaccine expressing the L1 protein of bovine papillomavirus type 1 (BPV1). A group of 10 clinically healthy, sarcoid-free horses were immunized ...
Spatial transcriptomics defines the cell-specific RNA landscape of equine dorsal root ganglia.
Veterinary pathology    February 6, 2025   3009858241312623 doi: 10.1177/03009858241312623
Finno CJ, Rogers SL, Donnelly CG, Affolter VK, Woolard K, Miller AD, Bellone RR, Petersen JL.Equine spinal neurodegenerative conditions are frequently encountered in sport and racing horses and may be career-ending diagnoses. To further define the spatial transcriptomic landscape of equine dorsal root ganglia (DRG) in healthy adult horses, we investigated gene expression differences in distinct DRG regions using the GeoMx Digital Spatial Profiling from NanoString. Four human cell markers demonstrated high fidelity for equine cells; microtubule-associated protein 2 (MAP2), myelin basic protein (MBP), allograft inflammatory 104 factor 1/ionized calcium-binding adaptor molecule 1 (IBA1/A...
Detection of Salmonella spp. in pooled environmental samples from an equine veterinary hospital using a novel point-of-care PCR assay.
Journal of equine veterinary science    February 5, 2025   Volume 146 105376 doi: 10.1016/j.jevs.2025.105376
Pusterla N, Lawton K, Barnum S, Vitomirov A, Anaya S, Naranatt P, Swadia H, Mendonsa E.The objective of this study was to evaluate a point-of-care (POC) PCR assay for the detection of Salmonella spp. in pooled environmental samples collected at an equine veterinary hospital. A total of 945 environmental samples were collected from high-risk areas, including ICU and isolation stalls, high-traffic areas, treatment rooms, and surgical suites. The environmental samples were collected using drag swabs placed in selenite broth and individually incubated at 35 °C for 20 h. Following the incubation period, 1 mL of up to 10 individual environmental samples were pooled together. Each poo...
Prevalence of anti-N. caninum and anti-N. hughesi antibodies in horses and associated risk factors in two selected equine zones of Punjab, Pakistan.
Veterinary parasitology, regional studies and reports    February 2, 2025   Volume 58 101211 doi: 10.1016/j.vprsr.2025.101211
Talib MT, Nasir A, Kashif M, Rahman A, Rehman AU, Akbar H, Nadeem A, Howe DK, Azam MN.The aim of this study was to determine the prevalence of anti-Neospora (N.) caninum and anti-N. hughesi antibodies in horses and to appraise the associated risk factors in the two central districts (Jhang and Toba Tek Singh) of Punjab Province, Pakistan. A total of 300 horse sera were analyzed for the presence of antibodies to Neospora spp. using a competitive ELISA. The overall prevalence of antibodies against Neospora species in horses was 25 % (75/300; 95 % CI 20.1-29.9). The prevalence of antibodies to N. caninum and N. hughesi species was 12.3 % (37/300; 95 % CI 8.6-16) and 19.3 % (5...
Remodelling of the healthy foal’s conjunctival microbiome in the first two months of life.
Journal of veterinary research    January 31, 2025   Volume 69, Issue 1 131-140 doi: 10.2478/jvetres-2025-0001
Płoneczka-Janeczko K, Armstrong E, Siemieniuch-Tartanus M, Magdziarz M.The aim of the study was to explore and characterise healthy foals' eye microbiomes in the first two months of life. Unassigned: Conjunctival swabs were collected three times, not later than 12 h after delivery and again at the end of the first and the second months of life from six clinically healthy foals of the Polish Konik breed. The average interval between the first and second samplings was 33.3 days and between the second and third was 35.6 days. Next-generation sequencing performed on a MiSeq sequencer in paired-end technology was used to analyse the composition of the conjunctival mic...
Core genome multilocus sequence typing schemes for epidemiological investigation of Taylorella equigenitalis and Taylorella asinigenitalis.
Veterinary microbiology    January 30, 2025   Volume 302 110419 doi: 10.1016/j.vetmic.2025.110419
Kozak S, Merda D, Chesnais V, Breuil MF, Harrison M, Zdovc I, Golob M, Petry S, Duquesne F.Taylorella equigenitalis is the causative agent of contagious equine metritis, an internationally regulated sexually-transmitted infection in horses, which is of great concern as it usually results in temporary infertility. Taylorella asinigenitalis, the second member of the genus, is mainly found in donkeys and is considered non-pathogenic, although a first natural outbreak was reported in 2019 in the United Arab Emirates. Multilocus sequence typing (MLST) is currently used to study the epidemiology of Taylorella spp. but, while highly transposable and reproducible, it only focuses on < 0.5...
Circulating concentrations of vitamins C, D and E vary with age but not with pneumonia status in foals during the first 5 months of life.
Equine veterinary journal    January 30, 2025   doi: 10.1111/evj.14480
Helbig H, Berghaus LJ, Venner M, Berghaus R, Hart KA.Adequate vitamin availability is vital for cellular and immune function and for normal growth. Available data on age-related changes in serum concentrations of vitamins in foals are limited. In addition, associations between circulating vitamin concentrations and the development of bronchopneumonia in foals are not described. Objective: (1) To quantify circulating concentrations of vitamins C, D and E from birth to weaning in foals; (2) to determine associations between vitamin concentrations and the development of bronchopneumonia during this period. Methods: Prospective cohort study. Methods...
Vitamin E and Selenium-Related Manifestations of Muscle Disease.
The Veterinary clinics of North America. Equine practice    January 29, 2025   S0749-0739(24)00094-4 doi: 10.1016/j.cveq.2024.11.001
Finno CJ, McKenzie E.Nutritional deficiencies of vitamin E and selenium can occur alone or concurrently. Prolonged and sustained deficiency of either or both nutrients can lead to profound clinical disease. Selenium deficiency can also result in signs of cardiac disease, upper gastrointestinal dysfunction, and abortion or the birth of weak foals. Deficiencies can usually be readily established by evaluating the dietary intake of individuals and by measurement of blood concentrations of these nutrients. Treatment of clinical disease is not always successful and prolonged morbidity and mortality can be encountered; ...
Plain Language Summary of the Scientific opinion on welfare of horses during on-farm killing for purposes other than slaughter.
EFSA journal. European Food Safety Authority    January 28, 2025   Volume 23, Issue 1 ep230102 doi: 10.2903/j.efsa.2025.p230102
No abstract available
Welfare of horses at slaughter.
EFSA journal. European Food Safety Authority    January 28, 2025   Volume 23, Issue 1 e9178 doi: 10.2903/j.efsa.2025.9178
Nielsen SS, Alvarez J, Boklund A, Dippel S, Dorea F, Figuerola J, Herskin M, Miranda Chueca MA, Nannoni E, Nonno R, Riber A, Stahl K, Stegeman JA....The objective of this Scientific Opinion is to assess the hazards and welfare consequences associated with the slaughter of horses for human consumption. The entire slaughter procedure, from arrival at the slaughterhouse until death, is divided into three phases: Phase 1 - pre-stunning, Phase 2 - stunning and Phase 3 - bleeding. Phase 1 includes the following processes (in chronological order): (a) arrival, (b) unloading of the animals from the vehicle, (c) lairage, (d) handling and moving to the stunning area and (e) restraint before application of the stunning method. Phase 2 encompasses the...
Essential and risk elements in horses affect haematology, serum biochemistry and oxidative status parameters.
Scientific reports    January 28, 2025   Volume 15, Issue 1 3489 doi: 10.1038/s41598-025-87908-6
Halo M, Kirchner R, Tirpák F, Slanina T, Tokárová K, Kováčik A, Miškeje M, Greń A, Formicki G, Halo M, Madeddu R, Massányi P.The abundance of chemical elements in the blood of horses can indicate the physiological balance, health of animal as well as can be taken as an indicator of environmental pollution. The aim of this work was to analyse haematological, biochemical parameters, TOS, FRAP, SOD, Gpx, TAS and their correlations with concentrations of essential and risk elements in blood of horses stabled in two different locations: The National Stud Farm Topoľčianky (n = 11; 11 stallions, consisting of the breeds 6 Lipizzan, 3 Slovak warmblood, 2 Holsteiner) and Experimental Centre at Institute of Animal Husba...
Unravelling Faecal Microbiota Variations in Equine Atypical Myopathy: Correlation with Blood Markers and Contribution of Microbiome.
Animals : an open access journal from MDPI    January 26, 2025   Volume 15, Issue 3 doi: 10.3390/ani15030354
François AC, Cesarini C, Taminiau B, Renaud B, Kruse CJ, Boemer F, van Loon G, Palmers K, Daube G, Wouters CP, Lecoq L, Gustin P, Votion DM.Hypoglycin A and methylenecyclopropylglycine are protoxins responsible for atypical myopathy in equids. These protoxins are converted into toxins that inhibit fatty acid β-oxidation, leading to blood accumulation of acylcarnitines and toxin conjugates, such as methylenecyclopropylacetyl-carnitine. The enzymes involved in this activation are also present in some prokaryotic cells, raising questions about the potential role of intestinal microbiota in the development of intoxication. Differences have been noted between the faecal microbiota of cograzers and atypical myopathy-affected horses. Ho...
Fecal microbiota changes associated with pathogenic and non-pathogenic diarrheas in foals.
BMC research notes    January 23, 2025   Volume 18, Issue 1 34 doi: 10.1186/s13104-025-07110-9
Shi Y, Maga EA, Mienaltowski MJ.Diarrhea is a common disease that could threaten the welfare of newborn foals. While there are several forms of foal diarrhea, the etiologies can be considered known pathogenic or non-pathogenic in nature. Moreover, there are likely differences in the composition of microbial populations in the gastrointestinal tracts of foals depending upon the etiology of diarrhea. Our study aims to examine the microbial population in the feces of foals with both pathogenic and non-pathogenic diarrheas to discern differences in their microbial compositions. Results: Foal diarrhea samples tested positive or n...
Phenotypic and genotypic characterization of antimicrobial resistance and virulence profiles of Salmonella enterica serotypes isolated from necropsied horses in Kentucky.
Microbiology spectrum    January 23, 2025   Volume 13, Issue 3 e0250124 doi: 10.1128/spectrum.02501-24
Kabir A, Kelley WG, Glover C, Erol E, Helmy YA.Salmonella is a foodborne pathogen that poses a significant threat to global public health. It affects several animal species, including horses. Salmonella infections in horses can be either asymptomatic or cause severe clinical illness. Infections caused by Salmonella are presently controlled with antibiotics. Due to the formation of biofilms and the emergence of antimicrobial resistance, the treatment has become more complicated. Our study focused on investigating the prevalence of Salmonella enterica in necropsied horses, assessing the capability for biofilm formation, and motility, determi...
Unraveling the distinctive gut microbiome of khulans (Equus hemionus hemionus) in comparison to their drinking water and closely related equids.
Scientific reports    January 22, 2025   Volume 15, Issue 1 2767 doi: 10.1038/s41598-025-87216-z
Jarquín-Díaz VH, Dayaram A, Soilemetzidou ES, Desvars-Larrive A, Bohner J, Buuveibaatar B, Kaczensky P, Walzer C, Greenwood AD, Löber U.The microbial composition of host-associated microbiomes is influenced by co-evolutionary interactions, host genetics, domestication, and the environment. This study investigates the contribution of environmental microbiota from freshwater bodies to the gastrointestinal microbiomes of wild khulans (Equus hemionus hemionus, n = 21) and compares them with those of captive khulans (n = 12) and other equids-Przewalski's horse (n = 82) and domestic horse (n = 26). Using PacBio technology and the LotuS pipeline for 16S rRNA gene sequencing, we analyze microbial diversity and conduct ...
Australian guidelines for equine internal parasite management.
Australian veterinary journal    January 21, 2025   Volume 103, Issue 4 151-158 doi: 10.1111/avj.13424
Beasley A, Abbas G, Hughes K, El-Hage C, Jacobson C, Bauquier J, Wilkes E, Carrigan P, Cudmore L, Hurley J, Beveridge I, Nielsen M, Jabbar A.Over the past few decades, the emergence of resistance amongst intestinal parasites of horses to all available anthelmintic classes has emphasised the need for a paradigm shift in parasite control approaches within the Australian equine industry. Findings of a recent Australia-wide research project have provided new insights into intestinal parasites (i.e. strongyles and ascarids) and parasite control from the perspectives of Australian horse breeders and equine veterinarians. The published data have revealed recent trends in parasite prevalence and distribution, breeders' and veterinarians' a...
Sperm vitrification in horses and donkeys.
Journal of equine veterinary science    January 9, 2025   Volume 145 105340 doi: 10.1016/j.jevs.2024.105340
Hidalgo M.Sperm vitrification is an alternative freezing method, which includes high cooling rates and non-permeable cryoprotectants agents. The first attempt in equids was using the spheres technique by directly dropping small volumes of the sperm into liquid nitrogen. Later, vitrification was developed using 0.25 mL straws with outer covers, which resulted in similar progressive motility when compared to conventional freezing in donkeys (44.3 ± 15.0 % vs. 44.7 ± 18.2 %) or even higher in horses (48.2 ± 2.3 % vs. 37.3 ± 2.2 %). Subsequently, the vitrification of larger volumes of sperm in 0.5 mL st...
Muscle Rehabilitation Techniques and Prevention of Injury.
The Veterinary clinics of North America. Equine practice    January 8, 2025   S0749-0739(24)00103-2 doi: 10.1016/j.cveq.2024.11.010
King MR, Colla S.Rehabilitation following muscle injury is critical in restoring the equine athlete to full function. Rehabilitation protocols should be tailored to each patient's global functional assessment, taking into account sports-specific demands, goals for return-to-performance, and overall prognosis. Rehabilitation protocols are often designed to modulate pain, enhance repair, improve proprioception, increase flexibility, restore muscle strength, joint range-of-motion, and neuromotor control. This article will review mechanisms of muscle injury, various physical modalities commonly employed in the reh...
Phosphorylation of SNW1 protein associated with equine melanocytic neoplasm identified in serum and feces.
Scientific reports    December 28, 2024   Volume 14, Issue 1 30842 doi: 10.1038/s41598-024-81338-6
Vinijkumthorn R, Kingkaw A, Yanyongsirikarn P, Phaonakrop N, Roytrakul S, Vongsangnak W, Tesena P.Equine melanocytic neoplasm (EMN) represents a form of skin tumor observed predominantly in grey horses aged over 15 years. Despite its prevalence, current therapeutic and preventive strategies for EMN have been subject to limited investigation. This study endeavors to shed light on potential phosphoproteins present in equine serum and fecal samples, potentially linked to EMN, with a specific focus on functional interactions in EMN pathogenesis. We examined 50 samples (25 serum, 25 feces), divided into three groups based on EMN severity: normal (n = 16), mild (n = 18), and severe EMN (...
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