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Topic:Infectious Disease

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.
West Nile Virus Mosquito Vectors (Diptera: Culicidae) in Germany.
Viruses    April 28, 2020   Volume 12, Issue 5 493 doi: 10.3390/v12050493
Kampen H, Holicki CM, Ziegler U, Groschup MH, Tews BA, Werner D.In 2018, West Nile virus (WNV) broke out for the first time in Germany, with continuation of the epidemic in 2019, involving birds, horses and humans. To identify vectors and characterize the virus, mosquitoes were collected in both years in zoological gardens and on a horse meadow immediately following the diagnosis of disease cases in birds and horses. Mosquitoes were identified and screened for WNV by qRT-PCR, with virus-positive samples being sequenced for the viral envelope protein gene. While no positive mosquitoes were found in 2018, seven mosquito pools tested positive for WNV in 2019 ...
Smartphone-based multiplex 30-minute nucleic acid test of live virus from nasal swab extract.
Lab on a chip    April 26, 2020   Volume 20, Issue 9 1621-1627 doi: 10.1039/d0lc00304b
Sun F, Ganguli A, Nguyen J, Brisbin R, Shanmugam K, Hirschberg DL, Wheeler MB, Bashir R, Nash DM, Cunningham BT.Rapid, sensitive and specific detection and reporting of infectious pathogens is important for patient management and epidemic surveillance. We demonstrated a point-of-care system integrated with a smartphone for detecting live virus from nasal swab media, using a panel of equine respiratory infectious diseases as a model system for corresponding human diseases such as COVID-19. Specific nucleic acid sequences of five pathogens were amplified by loop-mediated isothermal amplification on a microfluidic chip and detected at the end of reactions by the smartphone. Pathogen-spiked horse nasal swab...
[Theileria equi-infection in 2 German horses returning from a trail ride in southern France].
Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere    April 23, 2020   Volume 48, Issue 2 124-129 doi: 10.1055/a-1110-2998
Springer A, Ehrmann C, Lembcke M, Roscher K, Strube C.Equine piroplasmosis, caused by the protozoan pathogens or , is endemic in many (sub-)tropical regions worldwide, including Southern Europe. In Germany, it mainly plays a role as an imported parasitosis. Nevetherless, tick species with known vector potential for equine piroplasms occur in Germany. Thus, a long-term establishment of autochthonous cycles after introduction via infected equids or ticks cannot be excluded. In the present case, 2 horses developed clinical infection after returning from a trail riding trip to southern France. During treatment, a feeding tick was discovered on one ...
Post-outbreak African horse sickness surveillance: A scenario tree evaluation in South Africa’s controlled area.
Transboundary and emerging diseases    April 21, 2020   Volume 67, Issue 5 2146-2162 doi: 10.1111/tbed.13566
Grewar JD, Porphyre T, Sergeant ES, Theresa Weyer C, Thompson PN.An African horse sickness (AHS) outbreak occurred in March and April 2016 in the controlled area of South Africa. This extended an existing trade suspension of live equids from South Africa to the European Union. In the post-outbreak period ongoing passive and active surveillance, the latter in the form of monthly sentinel surveillance and a stand-alone freedom from disease survey in March 2017, took place. We describe a stochastic scenario tree analysis of these surveillance components for 24 months, starting July 2016, in three distinct geographic areas of the controlled area. Given that AH...
Atypical Multibacterial Granulomatous Myositis in a Horse: First Report in Italy.
Veterinary sciences    April 21, 2020   Volume 7, Issue 2 47 doi: 10.3390/vetsci7020047
Infectious causes of myositis are reported relatively uncommonly in horses. Among them, bacterial causes include subsp. , , spp. spp, and . Infection can be spread to muscles via haematogenous or extension from skin lesions. Parasitic myositis has also been documented. In this report, a 12 year-old Italian Quarter Horse mare presented with diffuse subcutaneous nodules and masses ranging from 2 × 3 to 5 × 20 cm in size, and adherent to subcutis and muscles that were first macroscopically and cytologically diagnosed as pyogranulomas. Subsequently, histological, molecular, bacteriological, a...
Multicenter Placebo-Controlled Randomized Study of Ethyl Pyruvate in Horses Following Surgical Treatment for ≥ 360° Large Colon Volvulus.
Frontiers in veterinary science    April 21, 2020   Volume 7 204 doi: 10.3389/fvets.2020.00204
Johnson LM, Holcombe SJ, Shearer TR, Watson V, Gandy J, Southwood LL, Lynch TM, Schroeder EL, Fogle CA, Sordillo LM.Identifying therapies that mitigate ischemic colonic injury and improve mucosal healing and intestinal viability are crucial to improving survival in horses with ≥360° large colon volvulus (LCV). Ethyl pyruvate is the ethyl ester of pyruvate with diverse pharmacologic effects that limit ischemic injury and hasten intestinal mucosal repair in preclinical rodents, sheep and swine models. The objective of this study was to determine the effects of ethyl pyruvate on systemic indices of colon viability, expression of inflammatory genes in whole blood, morbidity and survival after surgical correc...
Preparation of Monoclonal Antibody Against EMA-1 and Development of Rapid Serological Detection Method for Theileria equi Infection, Xinjiang, China.
The Journal of parasitology    April 17, 2020   Volume 106, Issue 2 283-290 doi: 10.1645/19-98
Song J, Song R, Wang P, Zhang Y, Yan Y, Zhou J, Chahan B, Liao M.The erythrocytic-stage surface protein equi merozoite antigen 1 (EMA-1) of Theileria equi is a major candidate for the development of a diagnostic antigen for equine piroplasmosis. In this study, BALB/c mice were immunized with purified recombinant EMA-1 to prepare monoclonal antibody (mAb) against T. equi EMA-1, and 1 mAb 5H2 was obtained that showed good reaction with infected red blood cells (RBC) in the indirect immunofluorescence assay (IFA). To develop a rapid serological detection method for T. equi infection in Xinjiang Uygur Autonomous Region, China, recombinant EMA-1 originating from...
Horizontal Spread of Rhodococcus equi Macrolide Resistance Plasmid pRErm46 across Environmental Actinobacteria.
Applied and environmental microbiology    April 17, 2020   Volume 86, Issue 9 e00108-20 doi: 10.1128/AEM.00108-20
Álvarez-Narváez S, Giguère S, Berghaus LJ, Dailey C, Vázquez-Boland JA.Conjugation is one of the main mechanisms involved in the spread and maintenance of antibiotic resistance in bacterial populations. We recently showed that the emerging macrolide resistance in the soilborne equine and zoonotic pathogen is conferred by the (46) gene carried on the 87-kb conjugative plasmid pRErm46. Here, we investigated the conjugal transferability of pRErm46 to 14 representative bacteria likely encountered by in the environmental habitat. mating experiments demonstrated conjugation to different members of the genus as well as to and spp. at frequencies ranging from ∼10...
Serological and molecular detection of Anaplasma phagocytophilum in Thoroughbred horses from Chilean racecourses.
Ticks and tick-borne diseases    April 16, 2020   Volume 11, Issue 4 101441 doi: 10.1016/j.ttbdis.2020.101441
Hurtado C, Torres R, Pérez-Macchi S, Sagredo K, Uberti B, de Souza Zanatto DC, Machado RZ, André MR, Bittencourt P, Müller A.Anaplasma phagocytophilum is the causative agent of equine granulocytic anaplasmosis (EGA). This study aimed to perform serological and molecular surveys of A. phagocytophilum in thoroughbred horses from racecourses in Chile. Additionally, hematological findings related to A. phagocytophilum molecular positivity were addressed, and phylogenetic analysis of selected positive samples was performed. Complete blood count and msp2 gene real-time PCR were performed in 457 thoroughbred horses from three racecourses located in three different cities of Chile (Santiago, Viña del Mar and Concepción). ...
Epidemiological and virological findings during an outbreak of equine influenza in Uruguay in 2018.
Revue scientifique et technique (International Office of Epizootics)    April 15, 2020   Volume 38, Issue 3 737-749 doi: 10.20506/rst.38.3.3023
Castro ER, Perez R, Rodriguez S, Bassetti L, Negro R, Vidal R.Equine influenza is one of the major respiratory infectious diseases in horses. In 2018, equine influenza virus (EIV) was confirmed as the cause of outbreaks of respiratory disease in horses in Chile and Argentina. In the same year, for the first time in Uruguay, EIV infection was confirmed by isolation and molecular analysis to be the cause of respiratory disease among hundreds of clinically affected thoroughbred horses in training and racing facilities. The virus was detected in nasopharyngeal swabs by a pan-reactive influenza type A realtime reverse transcription polymerase chain reaction (...
Development of a microsphere-based immunoassay for the serological detection of glanders in equids.
Acta tropica    April 14, 2020   Volume 207 105463 doi: 10.1016/j.actatropica.2020.105463
Laroucau K, Saqib M, Martin B, Deshayes T, Bertin C, Wernery U, Joseph S, Singha H, Tripathi BN, Beck C.Burkholderia mallei is the etiologic agent of glanders, an infectious disease of solipeds, with renewed scientific interest due to its increasing incidence in different parts of the world. More rapid, sensitive and specific assays are required by laboratories for confirmatory testing of this disease. A microsphere-based immunoassay consisting of beads coated with B. mallei recombinant proteins (BimA, GroEL, Hcp1, and TssB) has been developed for the serological diagnosis of glanders. The proteins' performance was compared with the OIE reference complement fixation test (CFT) and an indirect en...
Management Strategies for Reducing the Risk of Equines Contracting Vesicular Stomatitis Virus (VSV) in the Western United States.
Journal of equine veterinary science    April 14, 2020   Volume 90 103026 doi: 10.1016/j.jevs.2020.103026
Peck DE, Reeves WK, Pelzel-McCluskey AM, Derner JD, Drolet B, Cohnstaedt LW, Swanson D, McVey DS, Rodriguez LL, Peters DPC.Vesicular stomatitis viruses (VSVs) cause a condition known as vesicular stomatitis (VS), which results in painful lesions in equines, cattle, swine, and camelids, and when transmitted to humans, can cause flu-like symptoms. When animal premises are affected by VS, they are subject to a quarantine. The equine industry more broadly may incur economic losses due to interruptions of animal trade and transportation to shows, competitions, and other events. Equine owners, barn managers, and veterinarians can take proactive measures to reduce the risk of equines contracting VS. To identify appropria...
Information delivery and the veterinarian-horse owner relationship in the context of Hendra virus in Australia.
Preventive veterinary medicine    April 13, 2020   Volume 179 104988 doi: 10.1016/j.prevetmed.2020.104988
Hii C, Dhand NK, Toribio JLML, Taylor MR, Wiethoelter A, Schembri N, Sawford K, Kung N, Moloney B, Wright T, Field H, Schemann K.Hendra virus (HeV) is an emerging bat-borne virus endemic in Australia that can be transmitted from horses to humans and has a high fatality rate for horses and people. Controversy surrounding HeV risk mitigation measures have strained the veterinarian-horse owner relationship. This study aimed to characterise the veterinarian-horse owner relationship in general and also in the context of HeV by analysing data derived from the 'Horse Owners and Hendra Virus: A Longitudinal Study to Evaluate Risk' (HHALTER) study. Australian horse owners were recruited via emails, social media and word-of-mouth...
Contagious equine metritis: A 2020 vision on control of a notifiable equine disease in the United Kingdom.
Equine veterinary journal    April 8, 2020   Volume 52, Issue 3 347-348 doi: 10.1111/evj.13247
Meldrum KC, Newton JR.No abstract available
Genome-wide association study for host genetic factors associated with equine herpesvirus type-1 induced myeloencephalopathy.
Equine veterinary journal    April 6, 2020   Volume 52, Issue 6 794-798 doi: 10.1111/evj.13261
Dunuwille WMB, YousefiMashouf N, Balasuriya UBR, Pusterla N, Bailey E.Equid herpesvirus (EHV-1) infections in horses can lead to equine herpesvirus myeloencephalopathy (EHM), characterised by neurological clinical signs. The sporadic occurrence of the disease in horse herds suggests a host genetic component. A recent study reported an association between the occurrence of EHM and genetic markers on horse chromosome 6 (ECA6). Objective: To investigate the association of EHM with genetic host factors, especially with reference to the association reported for ECA6. Methods: Genome-wide association study (GWAS) was conducted based on 94 horses that had EHV-1 infecti...
Prevalence of equine hepacivirus infection in Mongolia.
Virus research    April 4, 2020   Volume 282 197940 doi: 10.1016/j.virusres.2020.197940
Date T, Sugiyama M, Lkhagvasuren D, Wakita T, Oyunsuren T, Mizokami M.Equine hepacivirus (EHV) belongs to the hepacivirus A and is related to hepatitis C virus (HCV). This virus shows hepatic tropism and is known to chronically infect horses. EHV has been reported from various countries, but the prevalence in Mongolia, where large horse populations are pastured, remains unknown. This study collected serum samples from horses in six areas across Mongolia, in order to investigate the status of infection. The possibility of human infection was also examined. The results showed an infection rate among horses of about 40 % in all regions. However, no evidence of EHV ...
First record of Hyalomma rufipes in the Czech Republic, with a review of relevant cases in other parts of Europe.
Ticks and tick-borne diseases    April 3, 2020   Volume 11, Issue 4 101421 doi: 10.1016/j.ttbdis.2020.101421
We found a male Hyalomma rufipes Koch, 1844 tick feeding on a horse grazing near Valtice, south Moravia, Czech Republic on October 24, 2019. The horse was born in Czechland and did not leave the country at least during the last five years. Relevant findings of Hyalomma ticks in other parts of central Europe are reviewed, including also records of pre-imaginal Hyalomma marginatum complex ticks on migrating birds all over Europe.
Characterization and phylogenetic analysis of the first complete mitochondrial genome of Cylicocyclus radiatus.
Veterinary parasitology    April 3, 2020   Volume 281 109097 doi: 10.1016/j.vetpar.2020.109097
Hu L, Zhang M, Sun Y, Bu Y.Cylicocyclus spp. are common parasites in the intestine of equine animals. Hosts infected by these strongylid nematodes might face emaciation, anemia, and even death, all of which lead to significant economic losses. In the present study, the complete mitochondrial genome (mitogenome) of Cylicocyclus radiatus, the type species of the genus Cylicocyclus, was sequenced and characterized for the first time using next-generation sequencing technology. Results show that the mitogenome of C. radiatus is a double-stranded 13,836 bp circular molecule, containing 12 protein-coding genes, 22 tRNA genes,...
A case series highlighting the role of different gamma-herpesviruses in Equine Multinodular Pulmonary Fibrosis.
Schweizer Archiv fur Tierheilkunde    April 3, 2020   Volume 162, Issue 4 245-256 doi: 10.17236/sat00255
Scheurer L, Bachofen C, Herteman N, Hilbe M, Wolfer N, Schoster A.This case series describes three cases of equine multinodular pulmonary fibrosis (EMPF) diagnosed at the Clinic for Equine Internal Medicine at the University of Zurich between 2012 and 2017. Current information on etiology and treatment options are presented. Two horses showed mild signs of chronic lower respiratory tract disease and one horse was presented with acute signs of disease including recurrent fever spikes and tachypnea. Diagnosis was achieved by physical examination, radiographic findings, and PCR testing for equine herpesviruses (EHV) of bronchoalveolar lavage (BAL) fluid or lung...
Indications for the use of highest priority critically important antimicrobials in the veterinary sector.
The Journal of antimicrobial chemotherapy    April 3, 2020   Volume 75, Issue 7 1671-1680 doi: 10.1093/jac/dkaa104
Lhermie G, La Ragione RM, Weese JS, Olsen JE, Christensen JP, Guardabassi L.Among the measures taken to preserve the clinical efficacy of highest priority critically important antimicrobials (HP-CIAs), the WHO has recommended avoiding their use in food-producing animals. Little is known regarding the indications for which different antimicrobial classes are used in animals, even in countries where data on antimicrobial use are available. To outline, in a narrative review, the diseases for which HP-CIAs are used in veterinary medicine, highlighting incongruences with international guidelines and disease conditions where effective alternatives to HP-CIAs are missing. Sc...
Metagenomic sequencing of clinical samples reveals a single widespread clone of Lawsonia intracellularis responsible for porcine proliferative enteropathy.
Microbial genomics    April 2, 2020   Volume 6, Issue 4 doi: 10.1099/mgen.0.000358
Bengtsson RJ, Wee BA, Yebra G, Bacigalupe R, Watson E, Guedes RMC, Jacobson M, Stadejek T, Archibald AL, Fitzgerald JR, Ait-Ali T.Lawsonia intracellularis is a Gram-negative obligate intracellular bacterium that is the aetiological agent of proliferative enteropathy (PE), a common intestinal disease of major economic importance in pigs and other animal species. To date, progress in understanding the biology of L. intracellularis for improved disease control has been hampered by the inability to culture the organism in vitro. In particular, our understanding of the genomic diversity and population structure of clinical L. intercellularis is very limited. Here, we utilized a metagenomic shotgun approach to directly sequenc...
Comparative analysis of CpG islands in equine infectious anemia virus strains.
Virus genes    April 1, 2020   Volume 56, Issue 3 339-346 doi: 10.1007/s11262-020-01749-1
Liu Q, Yu YY, Wang HY.Increasing evidence suggests that DNA methylation has key roles in the replication of retroviruses, including lentiviruses, and pathogenesis of diseases. However, the precise characteristics of CpG islands are not known for many retroviruses. In this study, we compared the distribution of CpG islands among strains of equine infectious anemia virus (EIAV), a lentivirus in the family Retroviridae and a model for HIV research. We identified CpG islands in 32 full-length EIAV genomic sequences obtained from the GenBank database using MethPrimer. Only one CpG island, from 100 to 120 bp, was identi...
Detection of the epidemic of the H3N8 subtype of the equine influenza virus in large-scale donkey farms.
International journal of veterinary science and medicine    March 31, 2020   Volume 8, Issue 1 26-30 doi: 10.1080/23144599.2020.1739844
Yongfeng Y, Xiaobo S, Nan X, Jingwen Z, Wenqiang L.To monitor the occurrence of equine influenza in large-scale donkey farms in Liaocheng City, Shandong Province, serological investigation and sequence analysis of HA/M protein gene of equine influenza virus (EIV) were carried out. Samples (n = 65) of the lung and nasal swab were collected in six different large-scale donkey farms and detected with RT-PCR for HA and M protein gene. The homology and evolution of HA and M genes were analysed with known sequences. Antibody titres of serum samples (n = 120, unvaccinated) level was determined by the HI test. The average seropositive rate was 32....
An Alphaherpesvirus Exploits Antimicrobial β-Defensins To Initiate Respiratory Tract Infection.
Journal of virology    March 31, 2020   Volume 94, Issue 8 e01676-19 doi: 10.1128/JVI.01676-19
Van Cleemput J, Poelaert KCK, Laval K, Vanderheijden N, Dhaenens M, Daled S, Boyen F, Pasmans F, Nauwynck HJ.β-Defensins protect the respiratory tract against the myriad of microbial pathogens entering the airways with each breath. However, this potentially hostile environment is known to serve as a portal of entry for herpesviruses. The lack of suitable respiratory model systems has precluded understanding of how herpesvirus virions overcome the abundant mucosal β-defensins during host invasion. We demonstrate how a central alphaherpesvirus, equine herpesvirus type 1 (EHV1), actually exploits β-defensins to invade its host and initiate viral spread. The equine β-defensins (eBDs) eBD1, -2, and -3...
Borna disease outbreak with high mortality in an alpaca herd in a previously unreported endemic area in Germany.
Transboundary and emerging diseases    March 29, 2020   doi: 10.1111/tbed.13556
Schulze V, Große R, Fürstenau J, Forth LF, Ebinger A, Richter MT, Tappe D, Mertsch T, Klose K, Schlottau K, Hoffmann B, Höper D, Mundhenk L....Borna disease virus 1 (BoDV-1) is the causative agent of Borna disease, an often fatal neurologic condition of domestic mammals, including New World camelids, in endemic areas in Central Europe. Recently, BoDV-1 gained further attention by the confirmation of fatal zoonotic infections in humans. Although Borna disease and BoDV-1 have been described already over the past decades, comprehensive reports of Borna disease outbreaks in domestic animals employing state-of-the-art diagnostic methods are missing. Here, we report a series of BoDV-1 infections in a herd of 27 alpacas (Vicugna pacos) in t...
The mesenchymal stromal cell secretome impairs methicillin-resistant Staphylococcus aureus biofilms via cysteine protease activity in the equine model.
Stem cells translational medicine    March 26, 2020   Volume 9, Issue 7 746-757 doi: 10.1002/sctm.19-0333
Marx C, Gardner S, Harman RM, Van de Walle GR.Mesenchymal stromal cells (MSCs) from various species, such as humans, mice, and horses, were recently found to effectively inhibit the growth of various bacteria associated with chronic infections, such as nonhealing cutaneous wounds, via secretion of antimicrobial peptides. These MSC antimicrobial properties have primarily been studied in the context of the planktonic phenotype, and thus, information on the effects on bacteria in biofilms is largely lacking. The objectives of this study were to evaluate the in vitro efficacy of the MSC secretome against various biofilm-forming wound pathogen...
First report of equine parvovirus-hepatitis-associated Theiler’s disease in Europe.
Equine veterinary journal    March 25, 2020   Volume 52, Issue 6 841-847 doi: 10.1111/evj.13254
Vengust M, Jager MC, Zalig V, Cociancich V, Laverack M, Renshaw RW, Dubovi E, Tomlinson JE, Van de Walle GR, Divers TJ.Equine parvovirus-hepatitis (EqPV-H) has been proposed as the aetiological cause of Theiler's disease, also known as serum hepatitis. EqPV-H-associated Theiler's disease has not been previously reported in Europe. Objective: To determine whether EqPV-H infection was associated with a 2018-2019 outbreak of Theiler's disease in four horses on a studfarm. Methods: Descriptive case series. Methods: The medical records of four horses from the same farm diagnosed with fatal Theiler's disease were examined retrospectively. Information collected included a clinical history, physical examination findin...
Seroprevalence and molecular characterization of West Nile Virus in Egypt.
Comparative immunology, microbiology and infectious diseases    March 24, 2020   Volume 71 101473 doi: 10.1016/j.cimid.2020.101473
Selim A, Radwan A, Arnaout F.West Nile Virus (WNV) is a flavivirus, mosquito-borne infection and have public health importance worldwide. WNV infection have highly significant impact on animal and human health. The virus has been detected serologically in Egypt among equids. Therefore, the aim of the present study to investigate the serological situation of WNV among horse in north of Egypt and identification of WNV in vector. The serological survey was conducted on 500 serum samples that collected from horses from four governorates at north of Egypt. The infection rate was non-significant differed between four localities...
Mortality, clinical findings, predisposing factors and treatment of Clostridioides difficile colitis in Japanese thoroughbred racehorses.
The Veterinary record    March 22, 2020   Volume 187, Issue 2 e14 doi: 10.1136/vr.105605
Nomura M, Kuroda T, Tamura N, Muranaka M, Niwa H.Although Clostridioides difficile-associated diseases (CDAD) is considered to be associated with colitis in horses, few studies have been performed with a focus on the characteristics of CDAD in thoroughbred racehorses. Between 2010 and 2018, a test for C. difficile was performed using faecal samples from 137 thoroughbred racehorses with colitis presenting with diarrhoea and fever. The mortality rate, clinical findings, predisposing factors and the selected treatments were investigated in a retrospective manner. Twenty-four cases were diagnosed as CDAD and 113 as non-CDAD. The mortality rate w...
Variation in disease phenotype is marked in equine trypanosomiasis.
Parasites & vectors    March 21, 2020   Volume 13, Issue 1 148 doi: 10.1186/s13071-020-04020-6
Raftery AG, Jallow S, Coultous RM, Rodgers J, Sutton DGM.Equine trypanosomiasis is a severe and prevalent disease that has the greatest impact globally upon working equids due to its distribution across lower income countries. Morbidity and mortality rates are high; disease management strategies in endemic regions are ineffective and cost prohibitive. Individual variation in disease phenotype in other species suggests host factors could reveal novel treatment and control targets but has not been investigated in equids. Methods: A prospective clinical evaluation of equines presenting for a free veterinary examination was performed in hyperendemic vil...
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