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Topic:Disease Transmission

Disease transmission in horses refers to the spread of infectious agents such as bacteria, viruses, fungi, and parasites among equine populations. These pathogens can be transmitted through various routes, including direct contact, vector-borne transmission, or environmental exposure. Factors influencing disease transmission include horse density, management practices, and biosecurity measures. Understanding the mechanisms and conditions that facilitate the spread of diseases is essential for developing effective prevention and control strategies. This page compiles peer-reviewed research studies and scholarly articles that investigate the modes of transmission, risk factors, and management practices related to infectious diseases in horses.
Fecal Carriage of Extended-Spectrum-β-Lactamase/AmpC-Producing Escherichia coli in Horses.
Applied and environmental microbiology    April 1, 2020   Volume 86, Issue 8 e02590-19 doi: 10.1128/AEM.02590-19
Hordijk J, Farmakioti E, Smit LAM, Duim B, Graveland H, Theelen MJP, Wagenaar JA.A nationwide study on the occurrence of extended-spectrum β-lactamase (ESBL)/AmpC in nonhospitalized horses in the Netherlands was performed. Molecular characterization was done, and questionnaires were analyzed to identify factors associated with carriage. In total, 796 horse owners were approached; 281 of these submitted a fecal sample from their horse(s), resulting in 362 samples. All samples were cultured qualitatively in Luria-Bertani (LB) broth and subsequently on MacConkey agar, both supplemented with 1 mg/liter cefotaxime (LB+ and MC+). Positive samples were subsequently cultured qu...
Tropism, pathology, and transmission of equine parvovirus-hepatitis.
Emerging microbes & infections    March 20, 2020   Volume 9, Issue 1 651-663 doi: 10.1080/22221751.2020.1741326
Tomlinson JE, Jager M, Struzyna A, Laverack M, Fortier LA, Dubovi E, Foil LD, Burbelo PD, Divers TJ, Van de Walle GR.Equine parvovirus-hepatitis (EqPV-H) has recently been associated with cases of Theiler's disease, a form of fulminant hepatic necrosis in horses. To assess whether EqPV-H is the cause of Theiler's disease, we first demonstrated hepatotropism by PCR on tissues from acutely infected horses. We then experimentally inoculated horses with EqPV-H and 8 of 10 horses developed hepatitis. One horse showed clinical signs of liver failure. The onset of hepatitis was temporally associated with seroconversion and a decline in viremia. Liver histology and in situ hybridization showed lymphocytic infiltrate...
Prevalence, Risk Factors, and Characterization of Multidrug Resistant and ESBL/AmpC Producing Escherichia coli in Healthy Horses in Quebec, Canada, in 2015-2016.
Animals : an open access journal from MDPI    March 20, 2020   Volume 10, Issue 3 523 doi: 10.3390/ani10030523
de Lagarde M, Fairbrother JM, Arsenault J.Although antimicrobial resistance is an increasing threat in equine medicine, molecular and epidemiological data remain limited in North America. We assessed the prevalence of, and risk factors for, shedding multidrug-resistant (MDR) and extended-spectrum β-lactamase (ESBL) and/or AmpC β-lactamase-producing in healthy horses in Quebec, Canada. We collected fecal samples in 225 healthy adult horses from 32 premises. A questionnaire on facility management and horse medical history was completed for each horse. Indicator (without enrichment) and specific (following enrichment with ceftriaxone)...
A Brief Introduction to Equine Influenza and Equine Influenza Viruses.
Methods in molecular biology (Clifton, N.J.)    March 15, 2020   Volume 2123 355-360 doi: 10.1007/978-1-0716-0346-8_26
Chambers TM.Equine influenza virus (EIV) is a common respiratory pathogen of horses and other equids in most parts of the world. EIV are Type A influenza viruses and two subtypes are known: H3N8 and H7N7. Both are believed to have evolved from avian influenza virus ancestors. The H3N8 subtype circulates widely, but the H7N7 subtype is thought to be extinct. The clinical disease in horses, caused by either subtype, is an upper respiratory infection of varying severity depending upon the immune status of the individual animal. It is not normally life-threatening in itself except in very young foals; however...
Spread of multidrug-resistant IncHI1 plasmids carrying ESBL gene blaCTX-M-1 and metabolism operon of prebiotic oligosaccharides in commensal Escherichia coli from healthy horses, France.
International journal of antimicrobial agents    March 7, 2020   Volume 55, Issue 6 105936 doi: 10.1016/j.ijantimicag.2020.105936
de Lagarde M, Larrieu C, Praud K, Lallier N, Trotereau A, Sallé G, Fairbrother JM, Schouler C, Doublet B.The objective of the study was to identify the genetic determinants and characteristics of expanded-spectrum cephalosporin (ESC) resistance in commensal Escherichia coli from healthy horses in France in 2015. Faecal samples from 744 adult horses were screened for ESC-resistant E. coli isolates. The extended-spectrum beta-lactamase (ESBL)/AmpC resistance genes were identified using polymerase chain reaction (PCR) and sequencing. ESC phenotypes were horizontally transferred by conjugation or transformation. Plasmids carrying ESBL/AmpC genes were typed by PCR-based replicon typing, restriction fr...
Potential for residual contamination by Streptococcus equi subspp equi of endoscopes and twitches used in diagnosis of carriers of strangles.
Equine veterinary journal    March 2, 2020   Volume 52, Issue 6 884-890 doi: 10.1111/evj.13248
Svonni E, Andreasson M, Fernström LL, Rydén A, Pringle J, Riihimäki M.Endoscopic examinations are essential for diagnosis and treatment of strangles (S equi infection) in horses. However, even after disinfection, endoscopes may retain viable bacteria or bacterial DNA. Twitches are commonly used during endoscopic examinations and can thus also potentially transmit the organism to other horses. Objective: To evaluate the efficacy of different disinfectant methods to eliminate S equi from experimentally contaminated endoscopes and twitches and the effectiveness of field disinfection of endoscopes used in sampling carriers of S equi. Methods: Experimental contami...
Potential tick vectors for Theileria equi in Israel.
Medical and veterinary entomology    February 27, 2020   Volume 34, Issue 3 291-294 doi: 10.1111/mve.12435
Tirosh-Levy S, Steinman A, Einhorn A, Apanaskevich DA, Mumcuoglu KY, Gottlieb Y.Theileria equi Mehlhorn and Schein, 1998 (Piroplasmida: Babesiidae) is an important tick-borne pathogen of horses that is highly endemic in many parts of the world, including Israel. The present study evaluated the potential roles of five hard tick species [Hyalomma excavatum Koch, 1844; Hyalomma marginatum Koch, 1844; Rhipicephalus turanicus Pomerantsev 1936; Rhipicephalus annulatus Say, 1821; Haemaphysalis parva (Neumann, 1897) (all: Ixodida: Ixodidae)], previously found to infest horses in Israel, in acting as vectors for piroplasmosis. For this, DNA was extracted from whole ticks and, when...
The effect of different antimicrobial treatment regimens on the faecal shedding of ESBL-producing Escherichia coli in horses.
Veterinary microbiology    February 26, 2020   Volume 243 108617 doi: 10.1016/j.vetmic.2020.108617
Schoster A, van Spijk JN, Damborg P, Moodley A, Kirchgaessner C, Hartnack S, Schmitt S.Fourth-generation cephalosporins can select for extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in horses, but it is unknown to what extent this occurs compared to penicillin/gentamicin combination treatment. The objective was to evaluate the effect of different antimicrobial treatments on faecal shedding and diversity of ESBL-producing Escherichia coli (ESBL-EC) in horses. Upon hospital admission, 86 horses in need of antimicrobial treatment or prophylaxis were randomly allocated to receive penicillin and gentamicin (PG) or cefquinome (CEF). Untreated horses were included a...
Transplacental Transmission of Theileria equi Is Not a Common Cause of Abortions and Infection of Foals in Israel.
Animals : an open access journal from MDPI    February 21, 2020   Volume 10, Issue 2 341 doi: 10.3390/ani10020341
Tirosh-Levy S, Gottlieb Y, Mimoun L, Mazuz ML, Steinman A.Although the main route of transmission of is through tick feeding, transplacental transmission is also possible and may lead to abortion, or to the birth of a sick or carrier foal. The aim of this study was to evaluate the role of as a cause of abortions in Israel and the risk of foals being infected at a young age. Eight aborting mares were serologically evaluated for exposure to via the immunofluorescence antibody test (IFAT) and their aborted fetuses were evaluated using PCR and qPCR. In addition, five mares and their foals (aged 4-6 months) from a highly endemic farm were tested for i...
Zoonotic Diseases from Horses: A Systematic Review.
Vector borne and zoonotic diseases (Larchmont, N.Y.)    February 20, 2020   Volume 20, Issue 7 484-495 doi: 10.1089/vbz.2019.2541
Sack A, Oladunni FS, Gonchigoo B, Chambers TM, Gray GC. Worldwide, horses play critical roles in recreation, food production, transportation, and as working animals. Horses' roles differ by geographical region and the socioeconomic status of the people, but despite modern advances in transportation, which have in some ways altered humans contact with horses, potential risks for equine zoonotic pathogen transmission to humans occur globally. While previous reports have focused upon individual or groups of equine pathogens, to our knowledge, a systematic review of equine zoonoses has never been performed. Using PRISMA's systematic review guidelines...
Spread of equine arteritis virus among Hucul horses with different EqCXCL16 genotypes and analysis of viral quasispecies from semen of selected stallions.
Scientific reports    February 19, 2020   Volume 10, Issue 1 2909 doi: 10.1038/s41598-020-59870-y
Socha W, Sztromwasser P, Dunowska M, Jaklinska B, Rola J.Equine arteritis virus (EAV) is maintained in the horse populations through persistently infected stallions. The aims of the study were to monitor the spread of EAV among Polish Hucul horses, to analyse the variability of circulating EAVs both between- and within-horses, and to identify allelic variants of the serving stallions EqCXCL16 gene that had been previously shown to strongly correlate with long-term EAV persistence in stallions. Serum samples (n = 221) from 62 horses including 46 mares and 16 stallions were collected on routine basis between December 2010 and May 2013 and tested f...
Genetic Characterization of Piroplasms in Donkeys and Horses from Nigeria.
Animals : an open access journal from MDPI    February 18, 2020   Volume 10, Issue 2 324 doi: 10.3390/ani10020324
Sunday Idoko I, Tirosh-Levy S, Leszkowicz Mazuz M, Mohammed Adam B, Sikiti Garba B, Wesley Nafarnda D, Steinman A.Equine piroplasmosis (EP) is a tick-borne disease of equids, caused by the two haemoprotozoal parasites: and Nigeria constitutes a major crossroads of animal transport in West Africa and may serve as a factor in EP dissemination in the region. The study aim was to characterize EP parasites in donkeys and horses in northern Nigeria using a molecular approach. Blood was collected from 57 donkeys and 47 horses. EP infection was detected and characterized by polymerase chain reaction (PCR). Twenty five donkeys (43.8%) were infected with , five (8.8%) with three (5.3%) with dual infections. Four...
An Overview of Eastern Equine Encephalitis (EEE).
The Neurohospitalist    February 17, 2020   Volume 10, Issue 3 161-162 doi: 10.1177/1941874420905762
Kapadia RK, Chauhan L, Piquet AL, Tyler KL, Pastula DM.No abstract available
Annual booster vaccination and the risk of equine influenza to Thoroughbred racehorses.
Equine veterinary journal    February 12, 2020   Volume 52, Issue 4 509-515 doi: 10.1111/evj.13210
Gildea S, Lyons P, Lyons R, Gahan J, Garvey M, Cullinane A.Equine influenza (EI) outbreaks occurred among horses on four racing yards (two National Hunt, one Flat, one mixed National Hunt racing/breeding yard) in Ireland within a 4-week period. Objective: To carry out a detailed analysis of racing yards affected in order to identify the source of infection and monitor virus spread among a vaccinated population. Methods: Observational field study. Methods: Epidemiological and vaccination data along with repeat clinical samples were collected from 118 horses on four premises. Results: Failure to implement appropriate biosecurity measures following the i...
Extended-Spectrum β-lactamase-Producing Enterobacteriaceae Shedding in Farm Horses Versus Hospitalized Horses: Prevalence and Risk Factors.
Animals : an open access journal from MDPI    February 11, 2020   Volume 10, Issue 2 282 doi: 10.3390/ani10020282
Shnaiderman-Torban A, Navon-Venezia S, Dor Z, Paitan Y, Arielly H, Ahmad WA, Kelmer G, Fulde M, Steinman A. We aimed to investigate the prevalence, molecular characteristics and risk factors of extended-spectrum β-lactamase (ESBL)-producing (ESBL-E) shedding in horses. A prospective study included three cohorts: (i) farm horses (13 farms, n = 192); (ii) on hospital admission (n = 168) and; (iii) horses hospitalized for ≥72 h re-sampled from cohort (ii) (n = 86). Enriched rectal swabs were plated, ESBL-production was confirmed (Clinical and Laboratory Standards Institute (CLSI)) and genes were identified (polymerase chain reaction (PCR)). Identification and antibiotic susceptibility were determi...
Bearing the brunt: Mongolian khulan (Equus hemionus hemionus) are exposed to multiple influenza A strains.
Veterinary microbiology    February 5, 2020   Volume 242 108605 doi: 10.1016/j.vetmic.2020.108605
Soilemetzidou ES, de Bruin E, Eschke K, Azab W, Osterrieder N, Czirják GÁ, Buuveibaatar B, Kaczensky P, Koopmans M, Walzer C, Greenwood AD.The majority of influenza A virus strains are hosted in nature by avian species in the orders of Anseriformes and Charadriformes. A minority of strains have been able to cross species boundaries and establish themselves in novel non-avian hosts. Influenza viruses of horses, donkeys, and mules represent such successful events of avian to mammal influenza virus adaptation. Mongolia has over 3 million domestic horses and is home to two wild equids, the Asiatic wild ass or khulan (Equus hemionus hemionus), and Przewalski's horse (Equus ferus przewalskii). Domestic and wild equids are sympatric acr...
Not playing by the rules: Unusual patterns in the epidemiology of parasites in a natural population of feral horses (Equus caballus) on Sable Island, Canada.
International journal for parasitology. Parasites and wildlife    February 5, 2020   Volume 11 183-190 doi: 10.1016/j.ijppaw.2020.02.002
Jenkins E, Backwell AL, Bellaw J, Colpitts J, Liboiron A, McRuer D, Medill S, Parker S, Shury T, Smith M, Tschritter C, Wagner B, Poissant J....Sable Island, Nova Scotia, Canada hosts one of few natural populations of feral horses (Equus caballus) never exposed to anthelmintics. Coproculture revealed cyathostomes, Strongylus equinus, S. edentatus, and S. vulgaris, with S. equinus (unusually) dominating in adult horses and cyathostomes dominating in young horses (<3 years of age). We examined 35 horses found dead in the springs of 2017 and 2018, as well as fecal samples from live horses in spring (n = 45) and summer 2018 (n = 236) using McMaster fecal flotation and Baermann larval sedimentation on fresh samples, and modified Wiscon...
Nasogastric Intubation as Health and Safety Risk in Equine Practice-A Questionnaire.
Journal of equine veterinary science    February 1, 2020   Volume 88 102951 doi: 10.1016/j.jevs.2020.102951
Drozdzewska K, Potocnik E, Schwarz B.Placing a nasogastric tube can be a life-saving act for a horse but is considered an occupational hazard for veterinarians. An online questionnaire was performed to assess and specify potential risks. 123 equine veterinarians completed the survey, and the majority admitted using the mouth to handle the end of the nasogastric tube (sucking or blowing air) and having accidentally swallowed or aspirated stomach content or medications. This can potentially lead to aspiration pneumonia or pneumonitis. Mineral oil seems to be especially dangerous as aspiration may be asymptomatic at the beginning an...
Zoonotic potential of Enterocytozoon bieneusi and Giardia duodenalis in horses and donkeys in northern China.
Parasitology research    January 31, 2020   Volume 119, Issue 3 1101-1108 doi: 10.1007/s00436-020-06612-8
Li F, Wang R, Guo Y, Li N, Feng Y, Xiao L.Limited data are available on infection rates and genetic identity of Enterocytozoon bieneusi and Giardia duodenalis in horses and donkeys. In this study, 865 fecal specimens were collected from donkeys (n = 540) and horses (n = 325) in three provinces and autonomous regions in northern China during 2015-2019. Enterocytozoon bieneusi was detected and genotyped by PCR and sequence analyses of the ribosomal internal transcribed spacer (ITS) and G. duodenalis was detected and genotyped by PCR and sequence analyses of the β-giardin, glutamate dehydrogenase, and triosephosphate isomerase g...
Special Issue “Equine Viruses”: Old “Friends” and New Foes?
Viruses    January 29, 2020   Volume 12, Issue 2 doi: 10.3390/v12020153
Paillot R.The Food and Agriculture Organization of the United Nations has recently estimated that the world equid population exceeds 110 million (FAOSTAT 2017).[...].
An emerging equine parvovirus circulates in thoroughbred horses in north Xinjiang, China, 2018.
Transboundary and emerging diseases    January 28, 2020   Volume 67, Issue 3 1052-1056 doi: 10.1111/tbed.13443
Xie J, Tong P, Zhang A, Song X, Zhang L, Shaya N, Kuang L.In 2015, a novel equine parvovirus, equine parvovirus-cerebrospinal fluid (EqPV-CSF), was identified from cerebrospinal fluid of a horse with neurological signs and lymphocytosis in USA. In our study, an EqPV-CSF-like virus was detected from 15 serum samples of 65 imported thoroughbred horses during custom quarantine in north Xinjiang province, China. Further field investigation in several major horse-producing areas in Xinjiang using specific PCR showed that this virus was detected mainly in thoroughbred horses (39/154 positive) previously imported, not in local breeds (0/127 positive). Phylo...
Drug Efficacy of Ivermectin Against Primary Nematodes Parasitizing Captive Przewalski’s Horse (Equus Ferus Przewalskii) after Ten Years of Annually Treatment.
Helminthologia    January 25, 2020   Volume 57, Issue 1 57-62 doi: 10.2478/helm-2020-0004
Tang L, Xiu Y, Yan L, Cui Y, Ma X, Ente M, Zhang Y, Li K, Zhang D.Reintroduction of endangered species to natural habitat is considered as an important tool for conservation. The effect of drug management on captive population of reintroduced species is largely neglected. Decreased drug efficacy could pose a substantial threat to health of animals. More importantly, captive population without proper drug administration could act as transmission medium of resistance nematodes to wild population, making it important to delay the occurrence of drug resistance in captive population. Ivermectin have been used in captive Przewalski's horse () to eradicate intestin...
Overview of spatio-temporal distribution inferred by multi-locus sequence typing of Taylorella equigenitalis isolated worldwide from 1977 to 2018 in equidae.
Veterinary microbiology    January 24, 2020   Volume 242 108597 doi: 10.1016/j.vetmic.2020.108597
Duquesne F, Merlin A, Pérez-Cobo I, Sedlák K, Melzer F, Overesch G, Fretin D, Iwaniak W, Breuil MF, Wernery U, Hicks J, Agüero-García M....The accurate identification of Taylorella equigenitalis strains is essential to improve worldwide prevention and control strategies for contagious equine metritis (CEM). This study compared 367 worldwide equine strains using multilocus sequence typing according to the geographical origin, isolation year and equine breed. The strains were divided into 49 sequence types (STs), including 10 described for the first time. Three major and three minor clonal complexes (CCs), and 11 singletons, were identified. The genetic heterogeneity was low (0.13 STs/strain) despite the wide diversity of geographi...
Do you know about neck threadworm in horses?
The Veterinary record    January 19, 2020   Volume 186, Issue 2 70 doi: 10.1136/vr.m107
Mansell S.No abstract available
Prevalence and multilocus analysis of Giardia duodenalis in racehorses in China.
Parasitology research    January 9, 2020   Volume 119, Issue 2 483-490 doi: 10.1007/s00436-019-06594-2
Qi M, Ji X, Zhang Y, Wei Z, Jing B, Zhang L, Lin X, Karim MR, Wang H, Sun M.Giardia duodenalis is a zoonotic intestinal parasite infecting humans and mammals worldwide. In this study, we evaluated the prevalence of G. duodenalis in racehorses in China and genetically characterized it. In total, 621 fecal samples were collected from racehorses at 17 equestrian clubs in 15 cities in China. Forty-eight (7.7%) animals from 11 equestrian clubs were positive for G. duodenalis of assemblages A (n = 10), B (n = 36), and E (n = 2), based on the small subunit ribosomal RNA (SSU rRNA) gene. Statistically significant differences in the prevalence of this parasite were...
Biosafety Evaluation of Equine Umbilical Cord-Derived Mesenchymal Stromal Cells by Systematic Pathogen Screening in Peripheral Maternal Blood and Paired UC-MSCs.
Biopreservation and biobanking    January 3, 2020   Volume 18, Issue 2 73-81 doi: 10.1089/bio.2019.0071
Denys M, Léon A, Robert C, Saulnier N, Josson-Schramme A, Legrand L, Wimel L, Maddens S, Pronost S. The growing interest in mesenchymal stromal cells (MSCs) in equine medicine, together with the development of MSC biobanking for allogeneic use, raises concerns about biosafety of such products. MSCs derived from umbilical cord (UC) carry an inherent risk of contamination by environmental conditions and vertical transmission of pathogens from broodmares. There is yet no report in the scientific literature about horses being contaminated by infected MSC products, and no consensus about systematic infectious screening of umbilical cord-derived mesenchymal stromal cells (UC-MSCs) to ensure micro...
The association of Equine Parvovirus-Hepatitis (EqPV-H) with cases of non-biologic-associated Theiler’s disease on a farm in Ontario, Canada.
Veterinary microbiology    January 2, 2020   Volume 242 108575 doi: 10.1016/j.vetmic.2019.108575
Baird J, Tegtmeyer B, Arroyo L, Stang A, Brüggemann Y, Hazlett M, Steinmann E.Theiler's disease was confirmed within a group horses located on a farm in southwestern Ontario during the summer and autumn of 2005. Five sudden deaths occurred between 3 July and 21 August, 2005, none of which were necropsied, however two of the horses showed clinical signs compatible with hepatic encephalopathy prior to death. No horse on the farm had received a biologic product of equine blood origin in the preceding six months. The only biologics used on the property were the administration of killed vaccines for rabies, tetanus and West Nile Virus to all horses 30 days prior to the onset...
Evidence of Leptospiral Presence in the Cumberland Gap Region.
PLoS neglected tropical diseases    December 26, 2019   Volume 13, Issue 12 e0007990 doi: 10.1371/journal.pntd.0007990
Verma A, Beigel B, Smola CC, Kitts-Morgan S, Kish D, Nader P, Morgan J, Roberson J, Christmann U, Gruszynski K, Brandt L, Cho E, Murphy K, Goss R.Leptospirosis is a widespread zoonotic disease that causes reproductive losses and/or hepatorenal failure in a number of animal species. Wild reservoirs of the disease, such as rodents, harbor the causative bacterium, Leptospira spp., in their kidneys and contaminate the environment by excreting infected urine. In this study, we tested small wild mammals, environmental water, and livestock in the Cumberland Gap region of southeastern Appalachia for the presence of pathogenic Leptospira or leptospiral antibodies. Small wild mammals (n = 101) and environmental water samples (n = 89) were screene...
Human Relationships with Domestic and Other Animals: One Health, One Welfare, One Biology.
Animals : an open access journal from MDPI    December 24, 2019   Volume 10, Issue 1 43 doi: 10.3390/ani10010043
Tarazona AM, Ceballos MC, Broom DM.Excessive human population growth, uncontrolled use of natural resources, including deforestation, mining, wasteful systems, biodiversity reduction by agriculture, and damaging climate change affect the existence of all animals, including humans. This discussion is now urgent and people are rethinking their links with the animals we use for clothing, food, work, companionship, entertainment, and research. The concepts of one health, one welfare, and one biology are discussed as a background to driving global change. Nothing should be exploited without considering the ethics of the action and t...
Leptospira Seroprevalence in Bardigiano Horses in Northern Italy.
Animals : an open access journal from MDPI    December 20, 2019   Volume 10, Issue 1 23 doi: 10.3390/ani10010023
Vera E, Taddei S, Cavirani S, Schiavi J, Angelone M, Cabassi CS, Schiano E, Quintavalla F.A cross-sectional study was carried out in Bardigiano horses in the Province of Parma, Northern Italy, to assess the seroprevalence of spp. and to investigate risk factors associated with the infection. A representative sample of 134 horses from 43 farms was selected by stratified systematic randomization. Blood sera were examined by MAT for the presence of antibodies against seven serovars. Ninety animals (67.2%; 95% Confidence Interval 63.2-71.1) and 41 farms (95.3%; 95% CI 92.2-98.5%) were found positive to at least one of the serovars. The most frequently detected reactions were against ...
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