Infectious diseases in horses encompass a range of illnesses caused by bacteria, viruses, fungi, or parasites. These diseases can affect various systems within the equine body, leading to symptoms that range from mild discomfort to severe systemic illness. Common infectious diseases in horses include equine influenza, strangles, equine herpesvirus, and West Nile virus. These diseases can be transmitted through direct contact with infected animals, contaminated surfaces, or vectors such as insects. Understanding the mechanisms of transmission, pathogenesis, and immune response is essential for effective prevention and control. This page compiles peer-reviewed research studies and scholarly articles that explore the epidemiology, diagnosis, treatment, and management of infectious diseases in horses.
Sebastian MM, Stewart I, Williams NM, Poonacha KB, Sells SF, Vickers ML, Harrison LR.Pathological, entomological and avian investigations were conducted during the summer of 2002, in a horse farm that had four cases of West Nile virus (WNV) infection in horses. All the four horses had encephalitis and WNV infection was confirmed by RT-PCR and in situ hybridization procedure. Forty-seven per cent of house sparrows that resided on the farm were tested positive for WNV infection. Mosquitoes (98%Culex pipiens) collected by trapping at the farm, during this period were positive for WNV. The meteorological data for year 2002 were compared to previous 16 years. The precipitation and ...
Picavet T, Butler CM, Daha TJ, van Dooam DC, van Duijkeren E, Goehring LS, Houwers DJ, Laan TT, van Maanen C, Sloet van Oldruitenborgh-Oosterbaan MM.No abstract available
Reisen WK, Fang Y, Brault AC.Historically, western equine encephalomyelitis virus (WEEV) caused large equine and human epidemics in the Americas from Canada into Argentina. Despite recent enhanced surveillance for West Nile virus, there have been few reports of equine or human cases and little documented enzootic activity of WEEV. During the past three years, WEEV has been active again in California, but without human or equine cases. In the current study, we compared host and vector competence of representative WEEV isolates made during each decade over the past 60 years using white-crowned sparrows, house sparrows, and ...
Chaffin MK, Cohen ND, Martens RJ.To determine the effect of azithromycin chemoprophylaxis on the cumulative incidence of pneumonia caused by Rhodococcus equi, age at onset of pneumonia, and minimum inhibitory concentration (MIC) of azithromycin for R equi isolates cultured from fecal and clinical samples. Methods: Controlled, randomized clinical trial. Methods: 338 foals born and raised at 10 equine breeding farms; each farm had a history of endemic R equi infections. Methods: Group 1 foals were control foals, and group 2 foals were treated with azithromycin (10 mg/kg [4.5 mg/lb], PO, q 48 h) during the first 2 weeks after bi...
Cunha AP, Bello AC, Leite RC, Ribeiro AC, Freitas CM, Bastianetto E, Oliveira PR.The objective of this study was to evaluate the effect of the Amblyomma cajennense strategic control program on the Anocentor nitens population. The acaricide treatments were carried out every seven days and divided in two series, the first one beginning in April 2004 (eight treatments) and the second beginning in July of the same year (five treatments), using pyrethroid chemical base - cypermethrin in the concentration of 0,015%. Monthly it was evaluated the infestation of A. nitens in the ear and nasal diverticulum of the equines before (October 2003 to March 2004) and after (October of 2004...
Laha R, Sasmal NK.The western blot analysis for identification of immunogenic proteins in whole cell lysate (WCL) antigens (Ags) prepared from the Trypanosoma evansi of buffalo, horse and cattle origins using hyperimmune sera (HIS) showed 11 immunogenic proteins and naturally T. evansi infected immune sera (IS) of horse detected 19 immunogenic proteins. HIS and IS of horse recognized five common immunogenic proteins of relative molecular weight (M(r)) ranges 61-64, 44-47, 33-34, 25-26 and 14-16 kilo Dalton (kDa). HIS rose against WCL Ags of T. evansi of buffalo origin and immune sera of horse cross reacted with...
Blitvich BJ.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 ...
Marenzoni ML, Passamonti F, Cappelli K, Veronesi F, Capomaccio S, Supplizi AV, Valente C, Autorino G, Coletti M.Fifteen unweaned thoroughbred foals, born on a stud farm to vaccinated mares, were clinically monitored during their first six months of life and repeatedly tested for equine herpesvirus type 1 (EHV-1) and equine herpesvirus type 4 (EHV-4). Nasopharyngeal swabs and blood samples were collected and screened respectively by PCR and seroneutralisation to detect the presence of the virus, explore its role as a possible cause of respiratory disease, and to assess the efficiency of the pcr for the diagnosis of this disease. The foals were divided into three groups on the basis of their clinical sign...
Wong DM, Belgrave RL, Williams KJ, Del Piero F, Alcott CJ, Bolin SR, Marr CM, Nolen-Walston R, Myers RK, Wilkins PA.5 horses were evaluated because of decreased appetite, weight loss, fever, cough, tachypnea, and respiratory distress. Results: Tachycardia, tachypnea, increased respiratory effort, lethargy, fever, poor body condition, and nasal discharge were detected in various combinations on initial physical examination. Evaluation of the lower portion of the respiratory tract via radiography and ultrasonography revealed a severe nodular interstitial pattern. Histologic examination of lung tissue revealed interstitial expansion of alveolar parenchyma with collagen, intraluminal accumulation of neutrophils...
Sparks WO, Dorman KS, Liu S, Carpenter S.Equine infectious anemia virus (EIAV) exhibits a high rate of genetic variation in vivo, and results in a clinically variable disease in infected horses. In vivo populations of EIAV have been characterized by the presence of distinct, genetic subpopulations of Rev that differ in phenotype and fluctuate in dominance in a manner coincident with each clinical stage of disease. This study examined the specific mutations that arose in vivo and altered the phenotype. The Rev protein was found to be highly conserved, and only 10 aa mutations were observed at a frequency greater than 10 % in the sampl...
Auty H, Mundy A, Fyumagwa RD, Picozzi K, Welburn S, Hoare R.Horses kept for recreational riding purposes by a wildlife tourism company in a heavily tsetse fly-infested region of north-western Tanzania were systematically monitored to investigate the occurrence, presentation and management of tsetse-transmitted trypanosomosis. During a 23-month period, 18 clinical cases were diagnosed (Trypanosoma brucei or Trypanosoma congolense were identified) and treated and trypanosomes were implicated of involvement in four deaths. Pyrexia consistently aided early detection (17 cases). Ataxia, weight loss and anaemia were seen in chronic cases and conferred a poor...
Zoonoses and public healthMarch 12, 2008
Volume 55, Issue 3 149-155 doi: 10.1111/j.1863-2378.2008.01106.x
Vedovello Filho D, Jorge FA, Lonardoni MV, Teodoro U, Silveira TG.American cutaneous leishmaniasis (ACL) is an endemic disease in the north-west of Paraná state, Brazil, where it occurs in humans and dogs. Few studies have been undertaken on the occurrence of the disease in other domestic animals and horses. In this study we investigated the infection of horses by Leishmania in ACL-endemic rural areas. Direct agglutination test (DAT) and polymerase chain reaction (PCR) were employed. Fifty-five horses from rural areas in the municipalities of Doutor Camargo, Ourizona, São Jorge do Ivaí, Ivatuba and Santa Fé (Agua do O) were analysed. DAT-detected antibod...
Torfason EG, Thorsteinsdóttir L, Torsteinsdóttir S, Svansson V.The horse population in Iceland is a special breed, isolated from other horses for at least 1000 years. This provides an exceptional opportunity to investigate old and new pathogens in an inbred herd with few infectious diseases. We have developed a high sensitivity semi-nested PCR to study equid gammaherpesviruses 2 and 5 (EHV-2 and 5) in Iceland. The first PCR is group specific, the second type-specific, targeting a 113bp sequence in the glyB gene. DNA isolated from white blood cells and 18 different organs was tested for the presence of EHV-2 and 5. This was done in adult horses and foals, ...
Jones SL, Maggi R, Shuler J, Alward A, Breitschwerdt EB.Bartonella spp. are emerging zoonotic agents that have been found in a wide variety of domestic animals and wildlife and cause a number of clinical syndromes. Bartonella sp. infection has been identified in a growing number of animal species, including cats, rodents, porpoises, and canids, but has not been reported in horses. Objective: To document the presence of Bartonella sp. in the blood of horses. Methods: One horse with chronic arthropathy and 1 horse with presumptive vasculitis. Methods: Blood samples were tested for the presence of Bartonella sp. by a combination of multiplex real-time...
Patterson-Kane JC, Carrick JB, Axon JE, Wilkie I, Begg AP.The first outbreak of equine influenza virus (EIV) infection was confirmed in Australia in 2007. Some EIV-positive young foals died with bronchointerstitial pneumonia, an rare disease process in this age group that is often postulated to be caused by viral infection. Objective: The aim of this study was to describe post mortem lesions in EIV-infected foals. Methods: Post mortem examinations were conducted on 11 young foals (age 2-12 days) submitted to the Scone Veterinary Hospital, NSW over a 2-month period in 2007. The foals had presented with or developed fatal pneumonia, and were known or s...
Borisevich IV, Potryvaeva NV, Mel'nikov SA, Evseev AA, Krasnianskiĭ VP, Maksimov VA.Immunoglobulin (Ig) against Marburg fever (MF) has been obtained from the equine serum. In terms of physicochemical and immunobiological properties, the obtained preparation corresponds to the quality of heterologous commercial immunoglobulins. The application of Marburg virus (MV) Ig with a titer of no less than 1:2048 by the emergency prevention scheme 1-2 hours after intraperitoneal inoculation of guinea pigs with MV in a dose of 20-50 LD50 protected 88-100% of the animals from death. MV Ig is recommended for emergency prevention of human MF.
Lu Z, Branscum AJ, Shuck KM, Zhang J, Dubovi EJ, Timoney PJ, Balasuriya UB.Two previously developed TaqMan fluorogenic probe-based 1-tube real-time reverse transcription polymerase chain reaction (real-time RT-PCR) assays (T1 and T2) were compared and validated for the detection of Equine arteritis virus (EAV) nucleic acid in equine semen and tissue culture fluid (TCF). The specificity and sensitivity of these 2 molecular-based assays were compared to traditional virus isolation (VI) in cell culture. The T1 real-time RT-PCR had a higher sensitivity (93.4%) than the T2 real-time RT-PCR (42.6%) for detection of EAV RNA in semen. However, the T1 real-time RT-PCR was les...
Yamanaka T, Tsujimura K, Kondo T, Matsumura T.In this study, we evaluated whether five rapid antigen detection kits for human influenza could be used for the diagnosis of equine influenza (EI). Limiting dilution analyses showed that Directigen Flu A+B and ESPLINE INFLUENZA A&B-N had the highest sensitivities to equine-2 influenza viruses (EIVs) among the kits investigated. From the results of virus detection in nasal swabs taken from horses infected with EIV, these two kits could produce positive results in reasonable agreement with those obtained by virus isolation or RT-PCR, suggesting that these kits could be useful for rapid diagn...
Heskett KA, Mackay RJ.To investigate the use of a specific antibody index (AI) that relates Sarcocystis neurona-specific IgG quotient (Q(SN)) to total IgG quotient (Q(IgG)) for the detection of the anti-S neurona antibody fraction of CNS origin in CSF samples obtained from horses after intragastric administration of S neurona sporocysts. Methods: 18 adult horses. Methods: 14 horses underwent intragastric inoculation (day 0) with S neurona sporocysts, and 4 horses remained unchallenged; blood and CSF samples were collected on days - 1 and 84. For purposes of another study, some challenged horses received intermitten...
Errico JA, Trumble TN, Bueno AC, Davis JL, Brown MP.To compare isolated limb retrograde venous injection (ILRVI) and isolated limb infusion (ILI) for delivery of amikacin to the synovial fluid of the distal interphalangeal and metacarpophalangeal joints and to evaluate the efficacy of use of an Esmarch tourniquet in standing horses. Methods: 6 healthy adult horses. Methods: Horses were randomly assigned in a crossover design. In ILRVI, the injection consisted of 1 g of amikacin diluted to a total volume of 60 mL administered during a 3-minute period. In ILI, the infusion consisted of 1 g of amikacin diluted to 40 mL administered during a 3-minu...
Patel JR, Heldens JG.This article has been withdrawn consistent with Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). The Publisher apologizes for any inconvenience this may cause.
Picavet T, Butler CM, Daha TJ, van Doom DC, van Duijkeren E, Goehring LS, Houwers DJ, Laan TT, van Maanen C, Sloet van Oldruitenborgh-Oosterbaan MM.No abstract available
Wittich CA, Ward MP, Fosgate GT, Srinivasan R.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. Methods: Reports of 1,907 horses with WNV disease in Texas from 2002 to 2004. Methods: 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 consiste...
Cohen ND, Carter CN, Scott HM, Chaffin MK, Smith JL, Grimm MB, Kuskie KR, Takai S, Martens RJ.To determine whether soil concentrations of total or virulent Rhodococcus equi differed among breeding farms with and without foals with pneumonia caused by R equi. Methods: 37 farms in central Kentucky. Procedures-During January, March, and July 2006, the total concentration of R equi and concentration of virulent R equi were determined by use of quantitative bacteriologic culture and a colony immunoblot technique, respectively, in soil specimens obtained from farms. Differences in concentrations and proportion of virulent isolates within and among time points were compared among farms. Resul...
Pischke S, Knoop EV, Mader M, Kling L, Wolski A, Wagner A, Mueller K, Horvatits T, Stiller J, Wisnewski K, Kohn B, Schulze Zur Wiesch J, Groschup MH....Hepatitis E virus (HEV) genotype 3 infections in Germany are mainly transmitted zoonotically through the consumption of swine meat. Furthermore, there is evidence that pets might come into contact with HEV, but the relevance of companion animals as possible sources of HEV transmission in Germany still needs to be defined. A monitoring study was therefore carried out on dogs, cats, and horses from Germany. In total 365 serum samples from pets (124 dogs, 119 cats, and 122 horses) were tested for HEV by PCR and for anti-HEV antibodies by a commercial ELISA. The HEV seroprevalence determined by th...
Holguin-Rocha AF, Calle-Tobon A, Vásquez GM, Astete H, Fisher ML, Tobon-Castano A, Velez-Tobon G, Maldonado-Ruiz LP, Silver K, Park Y....Ticks are obligatory hematophagous ectoparasites that transmit pathogens among various vertebrates, including humans. The microbial and viral communities of ticks, including pathogenic microorganisms, are known to be highly diverse. However, the factors driving this diversity are not well understood. The tropical horse tick, Dermacentor nitens, is distributed throughout the Americas and it is recognized as a natural vector of Babesia caballi and Theileria equi, the causal agents of equine piroplasmosis. In this study, we characterized the bacterial and viral communities associated with partial...
Gonzálvez M, Franco JJ, Barbero-Moyano J, Caballero-Gómez J, Ruano MJ, Martínez R, Cano-Terriza D, García-Bocanegra I.The largest epidemic of West Nile virus (WNV) reported ever in Spain in both humans and equines occurred in 2020, affecting 77 humans and 139 equine herds. Here, we aimed to monitor the outbreaks detected in equid herds in Andalusia (southern Spain), the Spanish region where 89.9% of the outbreaks were reported, and to evaluate the virus circulation and risk factor associated with WNV exposure in the affected herds. The first WNV case was detected in mid-July 2020, the number of outbreaks peaked in mid-August and the last one was confirmed on 26th October 2020. WNV lineage 1 was detected in 12...
Park CS, Hwang JY, Cho GJ.Clostridium (C.) perfringens was isolated from 25 (11.1%) of 225 sampled horses and from 16 (35.56%) of 45 farms. All of the samples were negative for cpe, etx, itx, NetF genes and cpa gene were detected in 100% (25 of 25) of the samples that were positive for C. perfringens. cpb and cpb2 were detected in 40.0% (10 of 25) and 60.0% (15 of 25) of the samples that were positive for C. perfringens, respectively. Of the 25 C. perfringens isolates, 15 (60%) were type A and 10 (40%) were type C. Type C was observed on all the farms where the foals' deaths occurred. None of the isolates were positive...
Hayes RO, Francy DB, Lazuick JS, Smith GC, Jones RH.A virus surveillance project was established and maintained during 1972 along 10 major river drainages in six states. Mosquitoes, biting flies, and blood specimens from sentinel equines were collected during 83 field trip visits to 141 arthropod collecting sites and 22 sentinel locations from April into December 1972. There were 173,074 mosquitoes tested and 303 arboviruses isolated from 11 of 41 species. From 13,388 biting flies tested, 8 arbovirus isolations were obtained in 1 of 5 species. There was no isolation of Venezuelan equine encephalitis (VEE) virus. Western equine encephalitis (WEE...
Mohammed MN, Yasmin AR, Ramanoon SZ, Noraniza MA, Ooi PT, Ain-Najwa MY, Natasha JA, Nur-Fazila SH, Arshad SS, Mohammed HO.West Nile virus is a mosquito-borne neurotropic pathogen with a wide host range that constitutes a significant risk to public and animal health. There is limited information on WNV infection in domesticated mammals in Malaysia; however, current reports indicate infections in birds, macaques, bats and pigs from Malaysia. In this study, 203 serum samples from cattle, goats, and horses were tested for the presence of anti-WNV IgG using a competitive enzyme-linked immunosorbent assay (c-ELISA). Additionally, using one-step RT-PCR, nasopharyngeal swabs were analyzed for WNV RNA from all 203 animals...
Jahrling PB, Beall JL.Hydroxylapatite column chromatography methods were developed to characterize selected alphavirus populations. Different conditions of pH and phosphate molarity were required to obtain satisfactory elution profiles and separations for Western equine encephalomyelitis virus strains, compared with Eastern equine encephalomyelitis virus and Semliki Forest virus strains. Raising the pH of the buffers effected earlier elutions of all viruses. Selection of phosphate gradients with more gentle slopes and adjustment to the proper pH effected better separations of virus subpopulations. Elution profiles ...
Srihongse S, Grayson MA, Morris CD, Deibel R, Duncan CS.An extensive outbreak of eastern equine encephalomyelitis (EEE) occurred in upstate New York during the summer of 1976, with 37 cases confirmed in horses by isolation of virus and/or by serologic examination. Other specimens collected in the affected area yielded 16 further isolates: 9 from 818 pools of 33,365 mosquitoes, 5 from tissues of 64 birds and 2 from 4 sentinel pheasants with serologic conversions. EEE antibodies were also detected in 81 of 499 wild birds tested. Our data implicate sparrows, cowbirds, and catbirds in the amplification of EEE virus and Culiseta melanura mosquitoes as v...
Caol S, Divers T, Crisman M, Chang YF.Lyme disease in humans is predominantly treated with tetracycline, macrolides or beta lactam antibiotics that have low minimum inhibitory concentrations (MIC) against Borrelia burgdorferi. Horses with Lyme disease may require long-term treatment making frequent intravenous or intramuscular treatment difficult and when administered orally those drugs may have either a high incidence of side effects or have poor bioavailability. The aim of the present study was to determine the in vitro susceptibility of three B. burgdorferi isolates to three antibiotics of different classes that are commonly us...
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...
Ferreira CGT, Campos MG, Felix DM, Santos MR, Carvalho OV, Diaz MAN, Fietto JLR, Bressan GC, Silva-Júnior A, Almeida MR.Equid herpesvirus 1 (EHV-1) is a pathogen of high economic importance in equine breeding operations around the world. EHV-1 infection causes respiratory, neurologic and reproductive disease. The absence of an efficient therapy has caught the attention of the scientific community and the therapeutic activities of natural products with its antivirals effects might be effective for the disease's treatment. Herein it was evaluated the prophylactic and therapeutic potential of quercetin and ethanolic extracts of Bacharis dracunculifolia formulations compared to Penciclovir® in an in vivo EHV-1 inf...
Gorino AC, Oliveira-Filho JP, Taniwaki SA, Basso RM, Zakia LS, Araujo JP, Borges AS.Aural plaques occur on the skin of the medial surface of the pinnae of horses. In this study the presence of Equus caballus papillomavirus (EcPV)-3 and -4 DNA was assessed in 45 such plaques using a 'touchdown' PCR. Papillomaviruses (PVs) were detected in 62.3% (28/45) of samples: EcPV-3 and -4 DNA in 8.89% (4/45) and 37.78% (17/45) of samples, respectively, with 15.56% (7/45) of samples exhibiting co-infection. Viral DNA was not detected in 37.78% (17/45) of samples, suggesting the possible existence of other equine PVs. Neither EcPV-3 nor -4 were detected in negative control skin. This study...
Sallé G, Cortet J, Koch C, Reigner F, Cabaret J.In the face of an increased prevalence of drug-resistant cyathostomin populations, a targeted selective treatment (TST) strategy based on Faecal Egg Counts (FECs) has been proposed as an alternative management strategy. However, associated costs may be a barrier to the uptake of this strategy. Our study aims to provide an economic assessment of FEC-based TST. FECs were determined in a Welsh pony herd thrice a year from 2010 to 2014. This database was used to explore the impact of FEC price, sampling strategy (individual or pooled) and labour-associated costs. Drug price was set at the cheapest...
GAIDAMAKA MG, VAGANOV GP, DROMASHKO AS, SHVETSKAVA BD, FYADINA DD.The research examines an incident of upper respiratory tract disease in horses, marked by severe symptoms, which followed a human influenza epidemic in Kharkov in 1957, challenging previous notions that […]
Boyle AG.Strangles, caused by the bacteria Streptococcus equi subsp equi, is a highly contagious disease of equids classically characterized by a high fever and enlarged lymph nodes of the head. Diagnostic sampling depends on the stage of the disease. The goal of treating strangles is to control transmission and to eliminate infection while providing future host immunity. Daily temperature checking and isolation of febrile horses is the key to controlling outbreaks. Eradication of this disease will not be possible until S equi carriers are eliminated from the equine population.
Rivas J, Neira V, Mena J, Brito B, Garcia A, Gutierrez C, Sandoval D, Ortega R.A novel equine arteritis virus (EAV) was isolated and sequenced from feral donkeys in Chile. Phylogenetic analysis indicates that the new virus and South African asinine strains diverged at least 100 years from equine EAV strains. The results indicate that asinine strains belonged to a different EAV genotype.
Cray C, Perritt E, Hughes C, Belgrave RL.Encephalitozoon cuniculi is an obligate intracellular microsporidian parasite that can result in clinical and subclinical infection in many species. In the present study, a serological survey was conducted using samples from 105 horses in the state of New Jersey; 49 of the samples were obtained from clinically abnormal animals. Five or 4.8% of 105 serum samples were found to demonstrate reactivity by ELISA with titers of 1:64 to 1:1,024. One of the samples was obtained from a clinically normal horse. Clinical signs and diagnoses from the other animals included lameness, colic, osteochondritis ...
Bohórquez A, Meana A, Luzón M.The tapeworm responsible for equine colic, Anoplocephala perfoliata, is considered the most common intestinal tapeworm of horses worldwide. However, there is evidence that Anoplocephala magna has a similar prevalence in North America and Spain, and possibly in other countries, highlighting the need for diagnostic methods capable of distinguishing between these two species. Currently, immunodiagnosis of A. perfoliata is based on the identification of the 12/13 kDa excretory/secretory (E/S) A. perfoliata immunoreactive antigen, which while apparently specific, has never been tested in sera from ...