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.
Tenbroeck C, Hurst EW, Traub E.Equine encephalomyelitis of the eastern type is a disease of the late summer and fall and cases are found in greatest numbers near salt marshes. The epidemiological findings are against its transmission by contact and favor the view that it is insect borne. Although virus can be demonstrated in the blood of infected horses it is present for a relatively short time, and the possibility that the disease is not primarily an infection of horses but that it is transmitted to them from another host is considered.
Hurst EW.The virus of equine encephalomyelitis (eastern strain) evokes in the horse, calf, sheep and dog an unusually intense encephalomyelitis characterized by acute primary degeneration of nerve cells, the appearance in neurons of the brain stem and elsewhere of nuclear inclusions resembling those in Borna disease and poliomyelitis, polymorphonuclear infiltration in the nervous tissues with early microglial proliferation, and perivascular cuffing with mononuclears and polymorphonuclears in varying proportions. The grey matter is affected more than the white. Lesions may be less marked in the striatum...
Olitsky PK, Cox HR, Syverton JT.We have studied certain properties, additional to those previously described (3), of the virus of vesicular stomatitis of horses, and of the characteristic biological reactions of the virus of equine encephalomyelitis. It has been found that the virus of stomatitis, ordinarily dermotropic, can acquire neurotropism and the neurotropic encephalomyelitis virus can, in turn, be rendered dermotropic in its action. The neurotropism in both instances is associated with definite, although not pronounced, viscerotropism. Both viruses can bring about a similar infection in the white mouse, rat, guinea p...
Woods AC, Chesney AM.A filterable agent has been obtained from the humors and tissues of the eyes of horses suffering from active periodic ophthalmia. The intra-vitreous injection of this filtrate produced in normal horses the same clinical and pathological picture observed in the natural disease. This filtrate injected into rabbits produced a different clinical picture, but the essential pathological lesions closely resembled those found in horses. After passage of the filterable agent through six generations of rabbits, it again produced the clinical and pathological picture of the natural disease when injected ...
Parker JT, McCoy MV.1. The serum of horses immunized with increasing doses of certain anaerobically produced autolysates of pneumococci contain potent neutralizing antibodies for the pneumotoxin. 2. The method for the in vitro titration of these horse antipneumotoxic serums is given.
Olitsky PK, Long PH.The virus of vesicular stomatitis is not readily killed by formalin. This chemical is one of a group which coagulates the proteins of the medium in which the virus is usually contained. It has already been found(7) that other reagents of the protein-coagulating group are not actively virucidal) and the effect of formalin in this instance is therefore characteristic of the group. The so called formalinized vaccines which give rise to immunity can be shown to have done so because of the presence of living virus. A single injection of such so called "vaccine," or of other material containing livi...
Wadsworth AB, Sickles GM.IT HAS BEEN SHOWN THAT THE PNEUMOCOCCUS MULTIPLYING IN THE TISSUES OF THE IMMUNIZED ANIMAL (HORSE) BECOMES ATTENUATED: loses, in varying degrees, its virulence, capacity of capsule formation, susceptibility to phagocytosis, and type specificity. The antigenic activity as an immunizing agent and the production of "soluble specific substance" are also altered. In some instances, the typical pneumococcus characteristics may be quickly restored by one or two passages through a susceptible animal (mouse). In others, virulence is not recovered and the organism remains atypical. Whether these changes...
Jungeblut CW.1. A flocculation reaction has been described which occurs between alcoholic extracts of pneumococci and antipneumococcus serum. 2. The reaction appears to be species-specific. It is not strictly type-specific, as slight or moderate cross-reactions occurred between Type I serums and Type II and Type III extracts. 3. The flocculating power of the serum from five horses undergoing immunization with pneumococcus, Type I, did not develop to any extent before the end of the 4th or 5th month. 4. In the case of two of these horses in which it was possible to carry out parallel tests on a larger numbe...
Jones FS.The lower nasal mucosa and the pharynx of thirty eastern and twenty-three western horses have been examined for streptococci. Eight of the eastern horses carried non-hemolytic streptococci on the nasal mucosa. From the pharynx of six, non-hepiolytic streptococci were cultivated. The throats of eighteen contained strains of the hemolytic type. The nasal mucosa of the eastern horses failed to show hemolytic streptococci. Eight western horses carried non-hemolytic streptococci in the nasal passage; eight also harbored the hemolytic type. Twenty-two strains were isolated from the pharynx. Eleven w...
Amoss HL, Marsh P.Experiments were made for the purpose of testing the reaction of protection against infection as a measure of potency of antimeningococcic serum. The results of the experiments were extremely variable and bore no relation to the quality of the sera as determined by the period of immunization of the horses from which they were obtained, or the indications of efficiency based upon their employment in human cases of epidemic meningitis. The results also failed entirely to conform to the agglutination titer of the sera tested and to be affected by the different type forms of the meningococci. We r...
Wadsworth AB, Kirkbride MB.Horses immunized to Type I pneumococci developed serum, 0.1 cc. of which protected against 0.5 cc. of a virulent culture, 0.000001 cc. of which killed mice in less than 40 hours. Protective tests of serum from horses immunized to Type II organisms varied, 0.1 cc. protecting, however, in certain instances against 0.1 and 0.01 cc. of virulent homologous culture. Types I and II sera obtained in our experiments with culture sediment and whole culture did not vary markedly for a given type and corresponded closely in their protective titer with samples of sera received from The Rockefeller Institut...
Inada R, Ido Y, Hoki R, Ito H, Wani H.Horses immunized with cultures of Spirochaeta icterohaemorrhagiae yield an immune serum having therapeutic properties. With rare exceptions the serum destroys completely the spirochetes contained in the circulating blood. The development of antibodies is promoted by the serum injections. The number of spirochetes in the organs is reduced by the treatment. Secondary manifestations due to the serum are slight and disappear promptly. The ultimate effects of the serum treatment on the symptoms and final outcome of the disease have still to be determined.
Wollstein M.The parameningococci of Dopter are culturally indistinguishable from true or normal meningococci, but serologically they exhibit differences as regards agglutination, opsonization, and complement deviation. Because of the variations and irregularities of serum reactions existing among otherwise normal strains of meningococci it does not seem either possible or desirable to separate the parameningococci into a strictly definite class. It appears desirable to consider them as constituting a special strain among meningococci not, however, wholly consistent in itself. The distinctions in serum rea...
Lintz W.This research article focuses on the study of distemper, also known as influenza or shipping fever, in horses, specifically focusing on its bacteriology and potential vaccine therapies. The research was […]
Hubbert WR.1. Better results in the production of diphtheria antitoxin can be obtained with greater experience in the selection of the most suitable type of horses to be used. Young animals are usually to be preferred. Over one-half of all such horses can be made to yield 300-unit serum, while a third will yield (5)oo-unit serum. 2. High-test horses require a shorter time to immunize and will yield a potent serum for a longer period than will low-test horses. 3. The period of usefulness of an antitoxin horse is short, and on an average endures only a few months. 4. A horse having attained a maximal antit...
Moore RM, Moulthrop JI, Sather GE, Holmes CL, Parker RL.Field studies were conducted in 1972 to determine the immunization status of equines along the Mexico, Arizona, and New Mexico borders. Interviews with horse owners were conducted along roads selected at random in the counties of Santa Cruz and Yuma, Ariz., and in Dona Ana County, N. Mex. At least 450 horse owners in each county were asked about the vaccination status of their animals, and information was taken on 1,260 animals. Blood specimens were obtained from every third equine, regardless of stated vaccination status, and tested for the presence of Venezuelan equine encephalitis (VEE), we...
Guillot J, Sarfati J, Ribot X, Jensen HE, Latgé JP.To detect antibodies against Aspergillus fumigatus antigens in serum samples from horses and to evaluate the relevance of this method as an alternative approach to the diagnosis of mycosis of the auditory tube diverticulum (guttural pouch mycosis [GPM]). Methods: Twelve clinically normal horses (controls) and 12 horses with GPM diagnosed by endoscopic observation of characteristic mycotic plaques. Methods: Antibodies to A fumigatus antigens were detected in serum by use of an ELISA and immunoblot analysis with extracellular antigens. Results: Antibodies against A fumigatus antigens were found ...
Tatarov G, Martinov S, Panova M.It was established that the complement binding reaction (CBR) is a suitable and very fast method for horse rhino-pneumonitis diagnostics. Cell cultural virus produced in cell cultures of pig kidneys was used as antigen. The antigen lots tested have no anticomplementary properties. Highest complement binding activity was evident in the non-diluted antigen, which discovered specific antibodies in immune serums. The CBR specificity was tested by the aid of homologous and heterologous serums and antigens. The titers of complement binding antibodies in the serums of 255 horses recovered from the di...
Witte W, Strommenger B, Stanek C, Cuny C.Methicillin-resistant Staphylococcus aureus of clonal lineage ST398 that exhibits related spa types and contains SCCmec elements of types IVa or V has been isolated from colonized and infected humans and companion animals (e.g., dog, pig, horse) in Germany and Austria. Of particular concern is the association of these cases with cases of nosocomial ventilator-associated pneumonia.
Boyle AG, Stefanovski D, Rankin SC.Streptococcus equi subsp equi (S. equi) is the cause of "equine strangles" which is a highly infectious upper respiratory disease. Detection of S. equi is influenced by site of specimen collection, method of sampling, and type of diagnostic test that is performed. We hypothesized i) that a loop-mediated isothermal amplification (LAMP) assay that targets the S. equi-specific eqbE gene would be more sensitive than a realtime PCR assay that targets the S. equi-specific seeI gene and ii) that LAMP of specimens obtained by guttural pouch lavage (GPL) would be more sensitive than LAMP of nasopharyng...
Hamond C, Martins G, Lawson-Ferreira R, Medeiros MA, Lilenbaum W.The objective of this study was to demonstrate the presence of leptospires in equine urine, as evidence for a potential role of horses in transmission of this organism. Thoroughbred horses (aged 2-5 years, n = 276) from Rio de Janeiro, Brazil, were studied. After a severe storm, the premises of the animals remained flooded for 72 h. Blood samples for serology were collected on days 20 and 35 (day of storm = day 0). On day 20, 132 (47·8%) horses were seroreactive (titre ≥200) and, of these, 23 (31·0%) had increased antibody titres on day 35. Furthermore, 34 urine samples (for PCR and cultur...
Uprety T, Sreenivasan CC, Hause BM, Li G, Odemuyiwa SO, Locke S, Morgan J, Zeng L, Gilsenan WF, Slovis N, Metcalfe L, Carter CN, Timoney P, Horohov D....Equine rotavirus group A (ERVA) is one of the most common causes of foal diarrhea. Starting in February 2021, there was an increase in the frequency of severe watery to hemorrhagic diarrhea cases in neonatal foals in Central Kentucky. Diagnostic investigation of fecal samples failed to detect evidence of diarrhea-causing pathogens including ERVA. Based on Illumina-based metagenomic sequencing, we identified a novel equine rotavirus group B (ERVB) in fecal specimens from the affected foals in the absence of any other known enteric pathogens. Interestingly, the protein sequence of all 11 segment...
Harry TO, McCollum WH.The Bucyrus strain of equine arteritis virus, previously modified to avirulence and vaccinal virus by 131 serial passages in primary cell cultures of horse kidney followed by 111 passages in primary cell cultures of rabbit kidney, was further passaged in cultures of the E. Derm (NBL-6) cell line, a continuous diploid cell line. Pools of the 16th and 25th passages of the virus in this last equine dermal cell line were lyophilized and stored in lots at 37 C, 23 to 28 C, 4C, and -20 C. The viability of the vaccinal virus deteriorated rapidly during storage at 37 C and at 23 to 28 C, but was relat...
Uchida-Fujii E, Niwa H, Senoh M, Kato H, Kinoshita Y, Mita H, Ueno T.We encountered 34 Clostridioides difficile (C. difficile) infection (CDI) cases among Thoroughbred horses in Japan from 2010 to 2021. Among them, 79.4% (27/34) either died or were euthanised. The risk factors associated with CDI and mortality among Japanese Thoroughbred horses remain unclear. We used genetic methods to examine C. difficile strains and their relationships with prognosis. Twenty-two (64.7%) cases were hospitalised at the onset of colitis. Outcomes were balanced for hospitalisation rates at the onset of colitis. The mortality rates of cases treated with metronidazole (65.0%) were...
Timoney PJ, O'Reilly PJ, Harrington AM, McCormack R, McArdle JF.The ability of Haemophilus equigenitalis, the causal agent of contagious equine metritis 1977, to survive in various antibiotic-containing semen extenders was studied at different environmental temperatures. Gentamicin sulphate was found to be markedly superior to ampicillin or a combination of sodium benzyl penicillin and polymyxin B sulphate, Semen treated with the former antibiotic was either sterile at cultural examination or else yielded appreciably fewer colonies of H. equigenitalis than the untreated semen control. Ampicillin had no observable effect on the survival of this organism. Ge...
Schlottau K, Fereidouni S, Beer M, Hoffmann B.Hepatitis C virus (HCV) is a positive-sense RNA virus belonging to the genus Hepacivirus, family Flaviviridae. Its genome has a length of 9.6 kb and encodes a single polyprotein flanked by two untranslated regions. HCV can cause liver cirrhosis and hepatocellular carcinoma, and approximately 2% of the world's population is chronically infected. The investigation of pathogenesis is complicated due to the lack of an animal model. The origin of this virus remains unclear, but in the last few years, relatives of HCV were initially identified in dogs and later in horses, rodents, bats and Old World...
Sampieri F, Allen AL, Alcorn J, Clark CR, Vannucci FA, Pusterla N, Mapes SM, Ball KR, Dowling PM, Thompson J, Bernstein LR, Gebhart CJ, Hamilton DL.Antimicrobial efficacy against Lawsonia intracellularis is difficult to evaluate in vitro, thus, the effects of gallium maltolate's (GaM) were investigated in a rabbit model for equine proliferative enteropathy (EPE). Juvenile (5-6-week-old) does were infected with 3.0 × 10(8) L. intracellularis/rabbit and allocated into three groups (n = 8). One week postinfection, one group was treated with GaM, 50 mg/kg; one, with doxycycline, 5 mg/kg; and one with a sham-treatment (control). Feces and blood were collected daily and weekly, respectively, to verify presence of L. intracellularis fec...
Zhang J, Go YY, Huang CM, Meade BJ, Lu Z, Snijder EJ, Timoney PJ, Balasuriya UB.A stable full-length cDNA clone of the modified live virus (MLV) vaccine strain of equine arteritis virus (EAV) was developed. RNA transcripts generated from this plasmid (pEAVrMLV) were infectious upon transfection into mammalian cells, and the resultant recombinant virus (rMLV) had 100% nucleotide identity to the parental MLV vaccine strain of EAV. A single silent nucleotide substitution was introduced into the nucleocapsid gene (pEAVrMLVB), enabling the cloned vaccine virus (rMLVB) to be distinguished from parental MLV vaccine as well as other field and laboratory strains of EAV by using an...
Ybañez AP, Sato F, Nambo Y, Fukui T, Masuzawa T, Ohashi N, Matsumoto K, Kishimoto T, Inokuma H.A total of 87 Thoroughbred horses and 10 ixodid ticks from a ranch in Hidaka district, Hokkaido were tested for tick-borne diseases. Using the indirect fluorescent antibody (IFA) method, 3.4, 92.0 and 97.7% of the horses showed antibody titers of ≥ 80 against Anaplasma phagocytophilum, Rickettsia helvetica, and Borrelia garinii, respectively. This is the first report of infection with the 3 pathogens in horses in Japan. Using PCR, DNAs from the peripheral blood of all horses were found negative with any Anaplasma, Rickettsia and Borrelia spp., while those from Haemaphysalis megaspinosa ticks...
Reisen WK, Meyer RP, Presser SB, Hardy JL.The extrinsic incubation rate (inverse of the time in days from infection to median transmission) of western equine encephalomyelitis (WEE) and St. Louis encephalitis (SLE) viruses by laboratory strains of Culex tarsalis Coquillett increased as a linear function of incubation temperatures from 10 to 30 degrees C. The estimated temperatures for zero transmission thresholds (intercept of the X axis) were 10.9 and 14.9 degrees C, and the number of degree days above these thresholds required for median transmission (inverse of the slope) was 67.6 and 115.2, respectively. Although the bodies of mos...
Petry S, Py JS, Wilhelm A, Duquesne F, Bäyon-Auboyer MH, Morvan H, Gassilloud B.Misidentification between Taylorella equigenitalis, the causative agent of contagious equine metritis (CEM), and Taylorella asinigenitalis is observed by the gold standard culture method. The performance of matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) for Taylorella species identification was evaluated using 85 T. equigenitalis and 28 T. asinigenitalis strains selected on the basis of multilocus sequence typing data. Seven of the T. equigenitalis and 9 of the T. asinigenitalis strains were used to generate in-house reference spectra to expand ...
Petrucciani A, Yu G, Ventresca M.Eastern Equine Encephalitis (EEE) is an arbovirus that, while it has been known to exist since the 1930's, recently had a spike in cases. This increased prevalence is particularly concerning due to the severity of the disease with 1 in 3 symptomatic patients dying. The cause of this peak is currently unknown but could be due to changes in climate, the virus itself, or host behavior. In this paper we propose a novel multi-season deterministic model of EEE spread and its stochastic counterpart. Models were parameterized using a dataset from the Florida Department of Health with sixteen years of ...
Malik P, Singha H, Khurana SK, Kumar R, Kumar S, Raut AA, Riyesh T, Vaid RK, Virmani N, Singh BK, Pathak SV, Parkale DD, Singh B, Pandey SB....Glanders, a bacterial disease of equines caused by Burkholderia mallei, is a fatal infectious disease of equines and has zoonotic significance. The disease has been eradicated from many countries by statutory testing, elimination of infected animals and import restrictions. However, it is still endemic in parts of Africa, Asia, the Middle East and Central and South America. In India, major glanders outbreaks were reported from different parts of the country between 1976 and 1982. Later, sporadic cases of the disease were reported in 1988, 1990 and 1998. The country remained free of glanders fo...
Marsh GA, Haining J, Hancock TJ, Robinson R, Foord AJ, Barr JA, Riddell S, Heine HG, White JR, Crameri G, Field HE, Wang LF, Middleton D.Hendra virus (HeV) is a highly pathogenic zoonotic paramyxovirus harbored by Australian flying foxes with sporadic spillovers directly to horses. Although the mode and critical control points of HeV spillover to horses from flying foxes, and the risk for transmission from infected horses to other horses and humans, are poorly understood, we successfully established systemic HeV disease in 3 horses exposed to Hendra virus/Australia/Horse/2008/Redlands by the oronasal route, a plausible route for natural infection. In 2 of the 3 animals, HeV RNA was detected continually in nasal swabs from as ea...
Valerio L, Marini F, Bongiorno G, Facchinelli L, Pombi M, Caputo B, Maroli M, Della Torre A.Knowledge of the frequency of contact between a mosquito species and its different hosts is essential to understand the role of each vector species in the transmission of diseases to humans and/or animals. However, no data are so far available on the feeding habits of Aedes albopictus in Italy or in other recently colonized temperate regions of Europe, due to difficulties in collecting blood-fed females of this diurnal and exophilic species. We analyzed Ae. albopictus host-feeding patterns in two urban and two rural sites within the area of Rome (Italy). Ae. albopictus was collected using stic...
Romantsov MG, Galimzianov KhM, Lokteva OM, Kovalenko AL, Stepanov AV.Search for drugs efficient in prophylaxis and treatment of dangerous infections (especially arboviral ones) is rather actual, since no specific therapy is available. Many-year investigations of interferon inductors showed that they had immunomodulating, antiviral and antiinflammatory effects and were low toxic. The present study demonstrated that the protective effect was the following: Venezuelan equine encephalitis (VEE)--cycloferon > amixin = ridostin, Rift Valley fever (RVF)--cycloferon > amixin > ridostin, predator pox (PP)--cycloferon > amixin = ridostin, that was obvious tha...
Taylor MA, Hunt KR.The term 'anthelmintic drug resistance' describes the heritable ability of some nematode parasites to survive treatment with anthelmintic drugs at the recommended therapeutic dose levels. Genes for resistance appear to be present in many of the important pathogenic nematodes of ruminants and horses. Under intensive management systems, where heavy reliance is placed on anthelmintic drugs for worm control, the selection of resistant genotypes may result in increased reports of the drugs failing to control the nematode populations against which they are aimed. Anthelmintic resistance has been rep...
Sánchez MD, Pierson TC, Degrace MM, Mattei LM, Hanna SL, Del Piero F, Doms RW.A major neutralizing epitope (here referred to as the T332 epitope) located on the lateral surface of domain III (DIII) of the West Nile virus (WNV) envelope protein has been identified based on the analysis of murine monoclonal antibodies. However, little is known about the humoral immune response against WNV in a natural host or whether DIII in general or the T332 epitope in particular are important targets of neutralizing antibodies in vivo. To characterize the types of antibodies produced during infection with WNV, we studied a group of naturally infected horses. Using immune adsorption as...
Shchit IY, Ignatov KB, Biketov SF.Results of detection of Burkholderia mallei and Burkholderia pseudomallei DNA strains by LAMP (Loop-mediated Isothermal Amplification) and Real Time PCR are shown. It has been revealed that, in Real Time PCR, primers steadily detected DNA of those microorganism for the sequences of which they were designed. The above mentioned primers did not detect DNA of heterologous strains. During LAMP method no set of primers showed high analytical sensitivity and specificity. Primers did not detected DNA of all the strains under research to target genes of which they were not intended, but they were capa...
Balasuriya UB, Dobbe JC, Heidner HW, Smalley VL, Navarrette A, Snijder EJ, MacLachlan NJ.We have used an infectious cDNA clone of equine arteritis virus (EAV) and reverse genetics technology to further characterize the neutralization determinants in the GP5 envelope glycoprotein of the virus. We generated a panel of 20 recombinant viruses, including 10 chimeric viruses that each contained the ORF5 (which encodes GP5) of different laboratory, field, and vaccine strains of EAV, a chimeric virus containing the N-terminal ectodomain of GP5 of a European strain of porcine reproductive and respiratory syndrome virus, and 9 mutant viruses with site-specific substitutions in their GP5 pro...
Zhang Y, Wen X, Xiao P, Fan X, Li M, Chahan B.Ticks in Xinjiang distribute widely and account for one third of China. Ticks can carry and transmit bacteria, virus, and parasite. However, the research of tick-borne pathogens in Xinjiang is rather little. To understand the situation of hard tick carry Theileria equi, Babesia caballi and Rickettsia spp. of Zhaosu and Altay in Xinjiang. In this study, 119 tick samples were obtained from horses in Xinjiang, China, Ticks were identified morphologically to determine species and PCR was used to investigate the situation of pathogens by hard ticks. One hundred and seven belong to Dermacentor margi...
Newton-Clarke MJ, Divers TJ, Delahunta A, Mohammed HO.A study was conducted over a 12 month period to assess the specificity and sensitivity of the 'slap test', using endoscopic evaluation, in the detection of cervical spinal cord and caudal brainstem lesions in horses. Fifteen ataxic horses were subjected to the 'slap test' and subsequently examined post mortem. Twelve out of the 15 had histopathological lesions consistent with their clinical signs. Thirteen horses with no history of neurological dysfunction and no histopathological evidence of cervical spinal cord or brainstem disease were used as controls. The laryngeal adductory responses exh...
Sabine M, Feilen C, Herbert L, Jones RF, Lomas SW, Love DN, Wild J.Until 1977 no case of abortion caused by equine herpesvirus 1 (EHV1) had been recorded in Australia although the virus, called equine rhinopneumonitis virus, had been known to have been present at least since 1962. Outbreaks of EHV1 abortion occurred in New South Wales in 1977 and in 1981. Sporadic cases of EHV1 abortion had been confirmed in some parts of Australia each year since 1975. It was concluded that an abortigenic subtype of EHV1 had been introduced to Australia in 1977 and that the previously endemic respiratory subtype occasionally caused abortion. Virus isolation in a variety of c...
Peel AJ, Field HE, Reid PA, Plowright RK, Broder CC, Skerratt LF, Hayman DT, Restif O, Taylor M, Martin G, Crameri G, Smith I, Baker M, Marsh GA....No abstract available
