Potomac Horse Fever (PHF) is an equine disease caused by the bacterium Neorickettsia risticii. This disease primarily affects horses and is transmitted through the ingestion of aquatic insects that carry the bacterium. Clinical signs of PHF include fever, diarrhea, laminitis, and colic, which can vary in severity among affected horses. Diagnosis is typically confirmed through polymerase chain reaction (PCR) testing or serology to detect the presence of N. risticii. Management of PHF involves supportive care and antibiotic treatment, with early intervention being beneficial in reducing complications. This page compiles peer-reviewed research studies and scholarly articles that explore the epidemiology, pathogenesis, clinical presentation, diagnosis, and management strategies of Potomac Horse Fever in horses.
Perry BD, Schmidtmann ET, Rice RM, Hansen JW, Fletcher M, Turner EC, Robl MG, Hahn NE.A serological study of antibodies to Ehrlichia risticii was carried out on 10 species of wild and domestic mammals found on or near 21 horse farms in an area of the USA in which Potomac horse fever is endemic. No antibodies were found in 133 peridomestic rodents (Norway rats and house mice), nor in 108 wild rodents (white-footed mice and meadow voles) captured on farms. Three of the six domestic animal species examined, cats, pigs and a goat, showed serological evidence of exposure to E risticii. Seropositive animals were detected on three of the 21 premises. The eight seropositive cats (of 48...
Carroll JF, Schmidtmann ET, Rice RM.One hundred ten white-footed mice (Peromyscus leucopus) were captured on horse farms in south-central Maryland, examined for ticks, and tested for specific antibodies to Ehrlichia risticii, the causative agent of Potomac horse fever. Peromyscus leucopus were consistently infested with immature American dog ticks (Dermacentor variabilis), with monthly prevalences as high as 80%. Sera from all 97 P. leucopus tested for antibodies to E. risticii were negative. This indicates that P. leucopus is not a reservoir of E. risticii, and suggests that immature D. variabilis do not acquire E. risticii in ...
Rikihisa Y, Pretzman CI, Johnson GC, Reed SM, Yamamoto S, Andrews F.Ehrlichia risticii has a close antigenic relationship to E. sennetsu. Sera of ponies experimentally infected with E. risticii, the etiologic agent of Potomac horse fever, consistently reacted with E. sennetsu, a human pathogen, in indirect fluorescent-antibody (IFA) testing, while human E. sennetsu convalescent serum reacted with E. risticii by IFA testing and immunoferritin labeling of cells infected in vitro. Two ponies injected intravenously with live E. sennetsu did no develop clinical illness. Subsequent injection with live E. sennetsu did not develop clinical illness. Subsequent injectio...
Dutta SK, Penney BE, Myrup AC, Robl MG, Rice RM.Fifty-five horses were inoculated IV and/or SC with materials containing Ehrlichia risticii, ie, infected whole blood, buffy coat cells, or cell culture, to study clinical and hematologic features of equine monocytic ehrlichiosis (Potomac horse fever). Major clinical and hematologic features of induced E risticii infection were biphasic increase in rectal temperature with peak increases of 38.9 C and 39.3 C on postinoculation days (PID) 5 and 12, respectively; depression; anorexia; decreased WBC count (maximal decrease of 47% on PID 12); and diarrhea from PID 14 to PID 18. Increased WBC count ...
Dutta SK, Rice RM, Hughes TD, Savage PK, Myrup AC.An indirect enzyme-linked immunosorbent assay (ELISA) was developed which was specific and sensitive in detecting antibodies to Ehrlichia risticii in Potomac horse fever (PHF). The ELISA antibody titers were correlated with the indirect fluorescent antibody (IFA) titers. E. risticii propagated in human histiocyte culture was purified on renografin gradient and the band of the organisms at a density of 1.182 g/ml was used as antigen. ELISA antibody titers were determined through computer assisted analysis, the observed antibody titers were derived by serial serum dilutions and using a resultant...
Ziemer EL, Whitlock RH, Palmer JE, Spencer PA.The clinical and hematologic variables of 10 ponies with experimentally induced equine ehrlichial colitis (EEC; syn: Potomac horse fever) were studied for a 30-day period (6 ponies) or until death (4 ponies). The earliest clinical sign indicative of EEC was fever (rectal temperature exceeding 39 C). All ponies became depressed (CNS) at various times during the disease, and 90% of the ponies developed diarrhea between 9 and 15 days after infection was induced. The most significant hematologic change was an increase in plasma protein concentration after the onset of fever (P less than 0.05). The...
Pretzman CI, Rikihisa Y, Ralph D, Gordon JC, Bech-Nielsen S.An enzyme-linked immunosorbent assay (ELISA) for immunoglobulin G (IgG) and IgM in natural and experimental infections of equids with Ehrlichia risticii was developed. Ehrlichial organisms purified from an infected mouse macrophage cell line were used as the antigen. IgM was separated from serum IgG by the expedient of spun-column chromatography, allowing the use of an indirect ELISA for quantitation of both IgG and IgM in the test sera. Among 16 paired sera from horses exhibiting clinical signs of Potomac horse fever, 8 were positive by the indirect fluorescent-antibody test (IFA), 11 were po...
Schmidtmann ET, Robl MG, Carroll JF.The capability of field-collected American dog ticks, Dermacentor variabilis, to infect horses with Ehrlichia risticii, causative agent of Potomac horse fever (PHF), was examined by allowing adult ticks collected from horse farms with a history of PHF to feed on susceptible horses. More than 500 male and female ticks attached and fed on 3 test horses; however, no clinical or serologic evidence of PHF was observed in treated or control horses. All horses were challenge exposed with E risticii-infective blood by inoculation at 60 to 65 days after ticks fed, and all developed clinical PHF with su...
Palmer JE, Whitlock RH, Benson CE.Equine ehrlichial colitis (Potomac horse fever), a newly identified colitis of the horse, was first recognized in Maryland. In this report, we document occurrence of the disease in Pennsylvania, New Jersey, New York, Ohio, Idaho, and Connecticut. Enzootic areas were recognized by a characteristic pattern. Frequently there was a seasonal pattern and high prevalence of sporadic colitis in unstressed horses. The attack rate per farm generally was low. Horses on pasture, as well as those stabled, were affected. Clinical signs varied from fever and depression to severe diarrhea and laminitis. Occas...
Ristic M, Holland CJ, Dawson JE, Sessions J, Palmer J.The recent establishment of a system for the continuous in vitro propagation of Ehrlichia risticii, the causative agent of equine monocytic ehrlichiosis (EME; synonym, Potomac horse fever), has facilitated the development of an indirect fluorescent antibody test for the diagnosis of this disease under laboratory and field conditions. The field diagnostic application of the test has aided in the recognition of the disease in 16 states of the United States and in 1 province of Canada. A limited epidemiologic study conducted between January and September 1985, in an area where the disease is know...
Cordes DO, Perry BD, Rikihisa Y, Chickering WR.Potomac horse fever was reproduced in 15 ponies by transfusion of whole blood originally from two natural cases and subsequently from ponies infected by the transfusions. Incubation periods varied from 9 to 15 days. Affected ponies developed varying degrees of fever, diarrhea, anorexia, depression, and leukopenia. Eleven affected ponies were killed, three died in the acute phase of the disease, and one did not show clinical signs. The most consistent post-mortem findings were fluid contents in the cecum and large colon, and areas of hyperemia (of inconstant degree and distribution) in mucosae ...
Carroll JF, Schmidtmann ET.The American dog tick, Dermacentor variabilis (Say), was the only ixodid tick found feeding on horses in Montgomery County, Md., from May to August. Average tick burdens were low (less than one tick per horse per week), but >80% of 33 horses examined weekly were exposed to tick feeding during the summer. Of the 98 ticks collected, 78% were attached to the tail and 12% were present in the mane. Host-seeking adult D. variabilis were active on vegetation in pastures from May to early August, with most specimens along hedgerows, woods margins, and horse paths.
Rikihisa Y, Perry BD.An ehrlichia was consistently isolated from the peripheral blood leukocyte fraction of ponies that had been experimentally infected with Potomac horse fever by whole blood transfusion from naturally infected horses. The organism was propagated in a human histiocyte cell line for 3 to 5 weeks and then inoculated intravenously or intradermally into healthy adult ponies. Clinical signs of Potomac horse fever, which varied in the degree of severity, occurred 9 to 14 days post-inoculation in all of the ponies. One pony died 20 days post-inoculation. The ehrlichial organism was reisolated in the hum...
Rikihisa Y, Perry BD, Cordes DO.Potomac horse fever is characterized by fever, anorexia, leukopenia, profuse watery diarrhea, dehydration, and high mortality. An ultrastructural investigation was made to search for any unusual microorganisms in the digestive system, lymphatic organs, and blood cells of ponies that had developed clinical signs after transfusion with whole blood from horses naturally infected with Potomac horse fever. A consistent finding was the presence of rickettsial organisms in the wall of the intestinal tract of these ponies. The organisms were found mostly in the wall of the large colon, but fewer organ...
Dutta SK, Myrup AC, Rice RM, Robl MG, Hammond RC.Potomac horse fever, a recently recognized disease of equines, characterized by high fever, leukopenia, and a profuse diarrhea, was studied for its etiology. An Ehrlichia organism was isolated in equine macrophage-fibroblast cell cultures and mouse macrophage cell cultures from the mononuclear cells of blood of infected horses. The agent was continuously propagated in mouse macrophage cell cultures. The organism multiplied in the cytoplasm of mouse macrophage cells and was identified by Giemsa staining, acridine orange staining, and by indirect immunofluorescence with convalescent sera from in...
Science (New York, N.Y.)February 1, 1985
Volume 227, Issue 4686 522-524 doi: 10.1126/science.3880925
Holland CJ, Ristic M, Cole AI, Johnson P, Baker G, Goetz T.Potomac horse fever, a disease characterized by fever, anorexia, leukopenia, and occasional diarrhea, is fatal in approximately 30 percent of affected animals. The seasonal occurrence of the disease (June to October) and evidence of antibodies to the rickettsia Ehrlichia sennetsu in the serum of convalescing horses suggested that a related rickettsia might be the causative agent. Such an agent was isolated in cultured blood monocytes from an experimentally infected pony. This intracytoplasmic organism was adapted to growth in primary cultures of canine blood monocytes. A healthy pony inoculate...
Taylor SD.Potomac horse fever (PHF) is a common cause of equine colitis in endemic areas. Until recently, the only causative agent known to cause PHF was Neorickettsia risticii. However, N. findlayensis has been isolated from affected horses. Horses typically become infected upon ingestion of Neorickettsia spp.-infected trematodes within aquatic insects. The most common clinical signs include diarrhea, fever, anorexia, lethargy and colic. The diagnostic test of choice for PHF is PCR of blood and feces. Tetracyclines remain an effective treatment. Supportive care, including fluid therapy, colloid ad...
Atwill ER, Mohammed HO, Dubovi E, Lopez J.A retrospective study was designed to determine the distribution of equine monocytic ehrlichiosis among the equine population in New York state, and to identify factors associated with risk of disease. Serum samples submitted to the diagnostic laboratory of the university during the period from January 1985 through December 1986 were examined for antibodies to Ehrlichia risticii, using the indirect fluorescent antibody technique. Factors evaluated included geographic origin and date of submission of the sample, and age, breed, and sex of the horse. Logistic regression analysis was used to iden...
Coffman EA, Abd-Eldaim M, Craig LE.A pregnant 18-year-old Quarterhorse mare presented with fever, anorexia, tachycardia, tachypnea, and gastrointestinal hypermotility at day 68 of gestation. Potomac horse fever was diagnosed based on polymerase chain reaction (PCR) analysis of whole blood and a high antibody titer to Neorickettsia risticii. The mare made a rapid clinical recovery following antibiotic therapy, but aborted 98 days later. Necropsy on the aborted fetus revealed lymphohistiocytic colitis, lymphadenitis, myocarditis, and hepatitis. The placenta was grossly and histologically normal. Formalin-fixed lymph node, thymus,...
Mulville P.In the late 1970s, a new infectious disease in horses, involving acute enteritis, was recognised in the Potomac River area of Maryland, U.S.A. The causative agent was identified subsequently as a new species of rickettsial organism, later named Ehrlichia risticii. Since then, the disease has been reported in many other states, and in enzootic areas vaccination is common. Signs associated with the clinical disease included depression, fever, anorexia, decreased or absent intestinal sounds, profuse watery diarrhoea and laminitis. However, considerable variation in clinical manifestations has bee...
Durán MC, Marqués FJ.A horse with colitis from Manitoba referred to the Veterinary Medical Centre, Western College of Veterinary Medicine, was diagnosed with Potomac horse fever (PHF). Polymerase chain reaction analysis of the feces confirmed Neorickettsia risticii infection. This is the first reported case of PHF in Manitoba. Détection deNeorickettsia risticii,agent de la fièvre du Potomac, chez un étalon Gypsy Vanner du Manitoba. Un diagnostic de fièvre du Potomac a été posé pour un cheval du Manitoba atteint de colite qui avait été recommandé au Veterinary Medical Centre du Western College of Veterina...
Paulino PG, Almosny N, Oliveira R, Viscardi V, Müller A, Guimarães A, Baldani C, da Silva C, Peckle M, Massard C, Santos H.An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Thirumalapura NR, Livengood J, Beeby J, Wang W, Goodrich EL, Goodman LB, Erol E, Tewari D.Neorickettsia risticii, an obligate intracellular bacterium, is the causative agent of Potomac horse fever (PHF). Diagnosis of PHF is based on demonstration of serum antibodies, isolation of N. risticii, and/or detection of nucleic acid by a PCR assay. An existing real-time PCR assay targeting the N. risticii 16S rRNA has been validated using blood samples from horses with colitis, and snails; to our knowledge, the performance of the assay for other sample types has not been reported. We describe here a modification of the 16S rRNA gene assay by the addition of a set of primers and probe targe...
Dutta SK, Myrup AC, Rice RM, Robl MG, Hammond RC.Potomac horse fever, a recently recognized disease of equines, characterized by high fever, leukopenia, and a profuse diarrhea, was studied for its etiology. An Ehrlichia organism was isolated in equine macrophage-fibroblast cell cultures and mouse macrophage cell cultures from the mononuclear cells of blood of infected horses. The agent was continuously propagated in mouse macrophage cell cultures. The organism multiplied in the cytoplasm of mouse macrophage cells and was identified by Giemsa staining, acridine orange staining, and by indirect immunofluorescence with convalescent sera from in...
Atwill ER, Mohammed HO, Lopez JW, McCulloch CE, Dubovi EJ.To locate counties within New York state with a high seroprevalence among the equine population, to determine host, management, and environmental factors that were associated with seropositivity to Ehrlichia risticii, and to determine evidence for arthropod- or helminth-mediated transmission of E risticii to horses. Methods: Cross-sectional study. Methods: A random sample of 3,000 of the 39,000 equine operations in New York state was selected, and 2,587 horses from 511 operations were tested. Methods: Blood samples were collected from horses and tested for seropositivity, using the indirect fl...
Kaneene JB, Miller R, Ross W, Gilbert L.Data from two 12 month prospective monitoring programs that followed management, economics and animal health from randomly-sampled equine operations in Michigan were used to determine patterns of health maintenance. Health maintenance measures were grouped, and average uses per year were computed for the most-common measures reported: respiratory, Potomac Horse Fever, neurological and multiple-system vaccinations, deworming, and general farrier work. Factors examined for potential association with health maintenance measure use were numbers of equids and horse-days on the operation, average ag...
Park MK, Kim EH, Cho MR, Yi YH, Lee MJ, Shah DH, Park JH, Park BK, Eo SK, Lee JH, Chae JS.Neorickettsia (Ehrlichia) risticii is a causative agent of acute diarrheal syndrome in horses, commonly known as Potomac horse fever. Korean isolate of N. risticii NR-JA1 was cultivated in mouse macrophage cell line P388D1. A complete ORF of p51 antigenic protein gene was amplified and cloned into pQE32 and pcDNA3.1 vectors and the resultant clones were named as pQE32/Nr-51 and pcDNA3.1/Nr-51, respectively. Recombinant p51 (rp51) protein antigen was expressed in E. coli (pQE32/Nr-51) and cos-7 cell line (pcDNA3.1/Nr-51). The rp51 protein showed immunoreactivity with anti- mouse p51 antibodies....
Burg JG, Roberts AW, Williams NM, Powell DG, Knapp FW.Experimental transmission of Ehrlichia risticii, the causal agent of Potomac horse fever, was attempted with adult stable flies, Stomoxys calcitrans, (L.) using two feeding schedules. In schedule A, a set of 140 flies was allowed to feed once on an experimentally infected donor pony and once 24 h later on a recipient pony. A different set of flies was used each day for a 12-d period. In schedule B, 240 flies were allowed to feed once daily for 12 consecutive d on the donor pony followed by five consecutive daily feedings on the recipient pony. E. risticii was isolated from the blood of the exp...
Palmer JE, Benson CE, Whitlock RH.Eighteen ponies were inoculated IV with Ehrlichia risticii-infected P388D1 mouse monocyte cells. Twenty-four hours after onset of fever (rectal temperature > 38.8 C), 9 ponies were treated with oxytetracycline (6.6 mg/kg of body weight, IV, q 24 h) for 5 days. The remaining 9 ponies served as infected nontreated controls. Mean scores of the following variables were not significantly different between groups on the day treatment was begun: rectal temperature, diarrhea, borborygmal sounds, feed intake, mental attitude, and evidence of a hyperresonant area in the abdomen. All ponies were observed...
Bertin FR, Reising A, Slovis NM, Constable PD, Taylor SD.The epidemiology of equine neorickettsiosis (EN) has been extensively studied but limited clinical and clinicopathological data are available concerning naturally infected horses. Objective: Factors predictive of survival will be identified in horses diagnosed with EN. Methods: Convenience sample of 44 horses with EN admitted to 2 referral institutions. Methods: A retrospective study was performed. A diagnosis of EN was based on the presence of positive blood or fecal PCR. Results: The most common clinical signs included diarrhea (66%), fever (50%), anorexia (45%), depression (39%), colic (39%...
Madigan JE, Pusterla N.Equine granulocytic and monocytic ehrlichiosis caused by Ehrlichia equi and E. risticii, respectively, are seasonal diseases in horses that occur throughout the United States E. equi is transmitted by lxodes ticks and causes high fever, depression, anorexia, limb edema, petechiation, icterus, ataxia, and stiffness in gait. E. risticii, also known as the agent of Potomac horse fever, causes a febrile illness with a colitis of variable severity. Its occurrence is associated with aquatic habitats. The natural route of transmission is oral, through the ingestion of E. risticii infected trematode s...
Ziemer EL, Whitlock RH, Palmer JE, Spencer PA.The clinical and hematologic variables of 10 ponies with experimentally induced equine ehrlichial colitis (EEC; syn: Potomac horse fever) were studied for a 30-day period (6 ponies) or until death (4 ponies). The earliest clinical sign indicative of EEC was fever (rectal temperature exceeding 39 C). All ponies became depressed (CNS) at various times during the disease, and 90% of the ponies developed diarrhea between 9 and 15 days after infection was induced. The most significant hematologic change was an increase in plasma protein concentration after the onset of fever (P less than 0.05). The...
Corstvet RE, Gaunt SD, Karns PA, Burgermeister D, McBride JW, Nicholson SM, Battistini RA.Four horses were inoculated with Ehrlichia risticii contained in either infected murine P388 D1 cells or heparinized blood from an infected horse. All 4 horses produced serum antibody, plasma antigen, and clinical signs of the disease. An enzyme-linked immunosorbent assay was used to detect antibody in the serum and was also used in conjunction with an anti-E. risticii monoclonal antibody to detect antigenemia. These laboratory and clinical findings were correlated to determine the efficiency of the antigen detection method for discerning E. risticii infection.
McKenzie HC, Funk RA, Trager L, Werre SR, Crisman M.Potomac horse fever (PHF) is a potentially fatal enterocolitis of horses caused by Neorickettsia risticii. The disease was originally recognised almost 40 years ago in the state of Maryland in the US. It is now known to occur in many areas of North America, as well as having been described in South America and Europe. Monocomponent PHF vaccines are available, but clinical protection with vaccination has been reported to be inconsistent. Objective: This study was designed to assess the immunogenicity of a commercially available Potomac Horse Fever (PHF) vaccine when administered as either a mo...
Fortin-Trahan R, Sjolin E, Lack A, de Arbina CL, McFadden-Bennett A, Wang L, Baird JD, Rikihisa Y, Arroyo LG.Potomac horse fever (PHF) is characterized by fever, depression, anorexia, ileus, diarrhea, and occasionally, laminitis. The disease is caused by infection with and/or . Equids of all ages may be affected; however, the condition has not been well-characterized in foals. This report describes clinical signs, laboratory findings, and treatment of 2 foals diagnosed with PHF in southwestern Ontario. Feces submitted for an equine PCR panel tested positive for spp. and were subsequently confirmed to be (Case 1) and (Case 2). Both foals recovered following hospitalization and intensive care. Key ...
