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Viruses2021; 13(8); 1474; doi: 10.3390/v13081474

Clinical Presentation and Laboratory Diagnostic Work-Up of a Horse with Tick-Borne Encephalitis in Switzerland.

Abstract: Tick-borne encephalitis is an important viral tick-borne zoonosis in Europe and Asia. The disease is induced by tick-borne encephalitis virus (TBEV). This report describes a 16-year-old Warmblood gelding presenting with sudden onset of lethargy, ataxia, and muscle fasciculations on the nostrils, the lips, and the eye lids as the most important clinical findings. The horse further had a mild facial nerve paralysis with drooping of the right upper and lower lip. Diagnosis was based on paired serum samples using TBEV-ELISAs revealing high serum IgM in the first sample with normal IgM in the second sample and an increase in serum IgG and neutralizing antibodies, indicating acute and recent infection. TBEV was confirmed by a virus-neutralization test, revealing a fivefold increase in antibodies 32 days after of the onset of clinical signs. Although the specific PCR on cerebrospinal fluid (CSF) was negative, TBEV-specific IgG and IgM were identified in the CSF of the horse. Treatment consisted of anti-inflammatory and anti-oxidative treatment and the horse recovered with a mild drooping of the right nostril as the only remaining clinical sign. TBEV infection is a potential differential diagnosis of neurological disease in horses living in endemic areas and this is the first report to describe the diagnostic criteria in a horse as recommended in humans with suspected TBEV infection.
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Publication Date: 2021-07-28 PubMed ID: 34452340PubMed Central: PMC8402657DOI: 10.3390/v13081474Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article covers a case of a horse diagnosed with Tick-Borne Encephalitis virus (TBEV) in Switzerland. It emphasizes the value of considering TBEV as a differential diagnosis for horses showing symptoms of neurological disease in regions where the virus is endemic.

Clinical Presentation

  • The horse, a 16-year-old Warmblood gelding, showed several symptoms indicative of neurological issues. This included lethargy, ataxia (loss of body control), muscle fasciculations (muscle twitching) particularly in the nostrils, lips, and eyelids, and mild facial nerve paralysis leading to the drooping of the upper and lower right lip.

Diagnosis

  • The TBEV diagnosis was made based on tests carried out on two distinct serum samples using TBEV-ELISAs (Enzyme-Linked Immunosorbent Assays) assays—a common laboratory technique used to measure the concentration of antibodies, antigens, proteins, and glycoproteins in biological samples.
  • The first sample showed a high level of IgM (Immunoglobulin M), a type of antibody that plays a crucial role in the primary immune response. The second sample, however, showed normal IgM levels, but increased levels of IgG (Immunoglobulin G) and neutralizing antibodies, indicating a recent and acute infection.
  • A virus-neutralization test further confirmed the presence of TBEV. This test recorded a fivefold increase in antibodies 32 days after the initial onset of clinical signs.
  • Despite the negative results of the PCR (Polymerase Chain Reaction) on the cerebrospinal fluid (CSF), both TBEV-specific IgG and IgM were identifiable in the horse’s CSF guaranteeing the diagnosis of tick-borne encephalitis.

Treatment and Recovery

  • The horse was treated with anti-inflammatory and anti-oxidative treatments.
  • Post-treatment, the horse recovered with only a minor residual symptom – a slight drooping of the right nostril.
  • This case study demonstrated the need to consider TBEV as a potential diagnosis in horses exhibiting neurological symptoms in areas where TBEV is prevalent.

Significance

  • The report is the first to provide diagnostic criteria for TBEV infection in a horse, similar to the guidelines used in diagnosing the virus in humans, therefore adding to the existing knowledge base regarding viral zoonotic diseases.

Cite This Article

APA
Fouché N, Oesch S, Ziegler U, Gerber V. (2021). Clinical Presentation and Laboratory Diagnostic Work-Up of a Horse with Tick-Borne Encephalitis in Switzerland. Viruses, 13(8), 1474. https://doi.org/10.3390/v13081474

Publication

Viruses
ISSN: 1999-4915
NlmUniqueID: 101509722
Country: Switzerland
Language: English
Volume: 13
Issue: 8
PII: 1474

Researcher Affiliations

Fouché, Nathalie
  • Swiss Institute of Equine Medicine, University of Bern, and Agroscope, 3012 Bern, Switzerland.
Oesch, Solange
  • Swiss Institute of Equine Medicine, University of Bern, and Agroscope, 3012 Bern, Switzerland.
Ziegler, Ute
  • Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, 17493 Greifswald, Insel Riems, Germany.
Gerber, Vinzenz
  • Swiss Institute of Equine Medicine, University of Bern, and Agroscope, 3012 Bern, Switzerland.

MeSH Terms

  • Animals
  • Antibodies, Viral / blood
  • Encephalitis Viruses, Tick-Borne / genetics
  • Encephalitis Viruses, Tick-Borne / immunology
  • Encephalitis Viruses, Tick-Borne / isolation & purification
  • Encephalitis Viruses, Tick-Borne / physiology
  • Encephalitis, Tick-Borne / blood
  • Encephalitis, Tick-Borne / diagnosis
  • Encephalitis, Tick-Borne / veterinary
  • Encephalitis, Tick-Borne / virology
  • Enzyme-Linked Immunosorbent Assay
  • Horse Diseases / blood
  • Horse Diseases / diagnosis
  • Horse Diseases / virology
  • Horses
  • Male
  • Polymerase Chain Reaction
  • Switzerland

Conflict of Interest Statement

The authors declare no conflict of interest.

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Citations

This article has been cited 6 times.
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