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Journal of veterinary internal medicine2025; 39(1); e17287; doi: 10.1111/jvim.17287

Comparison of clinical variables and outcome of 2 natural equine herpesvirus myeloencephalopathy outbreaks induced by equine herpesvirus-1 A2254/N752 strain in sport horses.

Abstract: Understanding of equine herpesvirus-1 (EHV-1) myeloencephalopathy (EHM) is complicated by disparities among studies. Objective: Compare clinical findings and outcome in horses involved in 2 recent EHM outbreaks. Methods: Twenty-five and 10 horses affected during 2 natural EHM outbreaks were admitted to a veterinary teaching hospital (VTH) in 2021 and 2023, respectively. Methods: Data collected from the VTH and surveys completed by riders and horse owners were analyzed retrospectively. Results: No risk factors associated with EHM development showed significant differences between the outbreaks; both outbreaks were caused by A2254/N752 strains. Treatments administered for EHM were not significantly different, whereas the duration was longer in 2021 for flunixin meglumine (P = .01) and dimethyl sulfoxide (P < .001). In 2021, more horses required hospitalization (P = .02), and fatality rate was 32%, whereas in 2023, no patient died. Hospitalization duration was longer in 2021 than in 2023 (P = .06) and 11.7% of horses from 2021 returned to competition within 6 months, whereas 100% in 2023 did (P < .001). Ataxia grade upon admission was equivalent in 2021 and 2023, but factors related to poor prognosis, such as simultaneous development of urinary and vascular complications, occurred in 2021 but not in 2023 (P = .01). Conclusions: Two EHM outbreaks caused by the A2254/N752 strain differed in disease severity. Urinary complications and systemic signs of vasculitis were important clinical variables associated with prognosis. Systemic complications in horses with EHM lead to a worse prognosis.
Publication Date: 2025-01-09 PubMed ID: 39778904PubMed Central: PMC11710857DOI: 10.1111/jvim.17287Google Scholar: Lookup
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  • Journal Article
  • Comparative Study

Summary

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Overview

  • This research compares clinical features and outcomes of two natural outbreaks of equine herpesvirus-1 myeloencephalopathy (EHM) in sport horses caused by the same viral strain.
  • The study identifies differences in disease severity and prognostic factors despite similarities in risk factors and treatment approaches.

Background

  • Equine herpesvirus-1 (EHV-1) can cause myeloencephalopathy (EHM), a serious neurological disease in horses.
  • Understanding EHM is challenging due to variations in clinical presentation and outcomes reported in different studies.
  • The specific EHV-1 strain studied was A2254/N752, known to cause EHM outbreaks.

Study Objective

  • To compare clinical findings, treatments, and outcomes of sport horses affected by two separate EHM outbreaks occurring in 2021 and 2023.
  • Assess differences in severity and factors influencing prognosis despite infections by the same viral strain.

Methods

  • Retrospective analysis of data from 25 horses affected in 2021 and 10 horses affected in 2023 admitted to a veterinary teaching hospital.
  • Data sources included hospital records and surveys completed by riders and owners.
  • Comparison focused on risk factors, treatments, hospitalization, clinical signs including ataxia and systemic complications, and outcomes such as mortality and return to competition.

Key Findings

  • Risk Factors and Strain:
    • No significant difference in risk factors for EHM between the two outbreaks.
    • Both outbreaks were caused by the same A2254/N752 strain of EHV-1.
  • Treatment:
    • Duration of some treatments (flunixin meglumine and dimethyl sulfoxide) was longer in the 2021 outbreak.
    • No significant difference in treatment types administered between outbreaks.
  • Hospitalization and Mortality:
    • More horses required hospitalization in 2021 than in 2023.
    • The fatality rate in 2021 was 32%; no deaths occurred in 2023.
    • Hospitalization tended to be longer in 2021 (~borderline significance).
  • Neurological Signs and Prognosis:
    • Ataxia severity on admission was similar in both outbreaks.
    • Complications associated with poor prognosis, such as urinary and vascular (vasculitis) issues, were present in 2021 but absent in 2023.
  • Return to Activity:
    • Only 11.7% of horses from 2021 returned to competition within 6 months versus 100% in 2023.

Interpretation and Conclusions

  • Despite the same EHV-1 strain and similar initial risk factors, the two outbreaks had markedly different clinical severities and outcomes.
  • Systemic complications, such as urinary problems and vasculitis, were important negative prognostic indicators.
  • Horses without these systemic signs had better survival and recovery rates, emphasizing the role of systemic involvement in EHM severity.
  • This study highlights that factors beyond viral strain alone influence disease outcome, possibly including host factors or management differences during outbreaks.
  • Findings can help veterinarians better predict prognosis and guide treatment strategies during EHV-1 outbreaks.

Cite This Article

APA
de la Cuesta-Torrado M, Velloso Alvarez A, Cárdenas-Rebollo JM, Neira-Egea P, Vitale V, Cuervo-Arango J. (2025). Comparison of clinical variables and outcome of 2 natural equine herpesvirus myeloencephalopathy outbreaks induced by equine herpesvirus-1 A2254/N752 strain in sport horses. J Vet Intern Med, 39(1), e17287. https://doi.org/10.1111/jvim.17287

Publication

ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 39
Issue: 1
Pages: e17287
PII: e17287

Researcher Affiliations

de la Cuesta-Torrado, María
  • Department Animal Medicine and Surgery, Universidad CEU-Cardenal Herrera, CEU Universities, Alfara del Patriarca, Valencia, Spain.
  • Veterinary Teaching Hospital, Universidad Cardenal Herrera CEU, Alfara del Patriarca, Valencia, Spain.
Velloso Alvarez, Ana
  • Department Animal Medicine and Surgery, Universidad CEU-Cardenal Herrera, CEU Universities, Alfara del Patriarca, Valencia, Spain.
  • Veterinary Teaching Hospital, Universidad Cardenal Herrera CEU, Alfara del Patriarca, Valencia, Spain.
Cárdenas-Rebollo, José Miguel
  • Department of Mathematics and Data Science, Faculty of Economic and Business Sciences, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain.
Neira-Egea, Patricia
  • Veterinary Teaching Hospital, Universidad Cardenal Herrera CEU, Alfara del Patriarca, Valencia, Spain.
Vitale, Valentina
  • Department Animal Medicine and Surgery, Universidad CEU-Cardenal Herrera, CEU Universities, Alfara del Patriarca, Valencia, Spain.
  • Veterinary Teaching Hospital, Universidad Cardenal Herrera CEU, Alfara del Patriarca, Valencia, Spain.
Cuervo-Arango, Juan
  • Department Animal Medicine and Surgery, Universidad CEU-Cardenal Herrera, CEU Universities, Alfara del Patriarca, Valencia, Spain.
  • Veterinary Teaching Hospital, Universidad Cardenal Herrera CEU, Alfara del Patriarca, Valencia, Spain.

MeSH Terms

  • Animals
  • Horses
  • Horse Diseases / virology
  • Horse Diseases / epidemiology
  • Herpesvirus 1, Equid
  • Herpesviridae Infections / veterinary
  • Herpesviridae Infections / epidemiology
  • Herpesviridae Infections / virology
  • Disease Outbreaks / veterinary
  • Retrospective Studies
  • Male
  • Female
  • Clonixin / analogs & derivatives
  • Clonixin / therapeutic use
  • Encephalomyelitis / veterinary
  • Encephalomyelitis / virology
  • Dimethyl Sulfoxide / therapeutic use

Grant Funding

  • Fundación Universitaria San Pablo CEU
  • GIR23-33 / Universidad Cardenal Herrera-CEU

Conflict of Interest Statement

Authors declare no conflict of interest.

References

This article includes 39 references
  1. Lunn DP, Burgess BA, Dorman DC, et al. Updated ACVIM consensus statement on equine herpesvirus‐1. J Vet Intern Med [Internet]. 2024;38(3):1290‐1299. doi: 10.1111/jvim.17047
    doi: 10.1111/jvim.17047pmc: PMC11099706pubmed: 38497217google scholar: lookup
  2. Allen GP. Epidemic disease caused by equine herpesvirus‐1: recommendations for prevention and control. Equine Vet Educ. 2002;14(3):136‐142.
  3. Ma G, Azab W, Osterrieder N. Equine herpesviruses type 1 (EHV‐1) and 4 (EHV‐4)—masters of co‐evolution and a constant threat to equids and beyond. Vet Microbiol. 2013;167(1–2):123‐134.
    pubmed: 23890672
  4. Vandenberghe E, Boshuizen B, Delesalle CJG, et al. New insights into the management of an ehv‐1 (equine hospital) outbreak. Viruses. 2021;13(8):2‐12.
    pmc: PMC8402800pubmed: 34452295
  5. Pusterla N, Hussey SB, Mapes S, et al. Molecular investigation of the viral kinetics of equine herpesvirus‐1 in blood and nasal secretions of horses after corticosteroid‐induced recrudescence of latent infection. J Vet Intern Med. 2010;24(5):1153‐1157.
    pubmed: 20584139
  6. Pusterla N, Mapes S, Wilson WD. Prevalence of equine herpesvirus type 1 in trigeminal ganglia and submandibular lymph nodes of equids examined postmortem. Vet Rec. 2010;167(10):376‐379.
    pubmed: 20817899
  7. Pusterla N, Hussey GS. Equine herpesvirus 1 myeloencephalopathy. Veterinary Clinics of North America—Equine Practice. Vol 30. WB Saunders; 2014:489‐506.
    pubmed: 25300635
  8. Oladunni FS, Horohov DW, Chambers TM. EHV‐1: a constant threat to the horse industry. Front Microbiol. 2019;10:2668.
    pmc: PMC6901505pubmed: 31849857
  9. Goehring LS, Winden SC, Maanen C, Oldruitenborgh‐Oosterbaan MMS. Equine herpesvirus type 1‐associated myeloencephalopathy in the Netherlands: a four‐year retrospective study (1999‐2003). J Vet Intern Med. 2006;20(3):601‐607.
    pubmed: 16734096
  10. Walter J, Seeh C, Fey K, Bleul U, Osterrieder N. Clinical observations and management of a severe equine herpesvirus type 1 outbreak with abortion and encephalomyelitis. Acta vet Scand. 2013;55(19):1‐9.
    pmc: PMC3630004pubmed: 23497661
  11. Dunowska M. A review of equid herpesvirus 1 for the veterinary practitioner. Part A: Clinical presentation, diagnosis and treatment. N Z Vet J. 2014;62:171‐178.
    pubmed: 24597778
  12. Borchers K, Thein R, Sterner‐Kock A. Pathogenesis of equine herpesvirus‐associated neurological disease a revised. Equine vet J. 2006;38(3):283‐287.
    pubmed: 16706288
  13. Lunn DP, Davis‐Poynter N, Flaminio MJBF, et al. Equine herpesvirus‐1 consensus statement. J Vet Intern Med. 2009;23(3):450‐461.
    pubmed: 19645832
  14. Pusterla N, David Wilson W, Madigan JE, Ferraro GL. Equine herpesvirus‐1 myeloencephalopathy: a review of recent developments. Vet J. 2009;180:279‐289.
    pubmed: 18805030
  15. Nugent J, Birch‐Machin I, Smith KC, et al. Analysis of equid herpesvirus 1 strain variation reveals a point mutation of the DNA polymerase strongly associated with neuropathogenic versus nonneuropathogenic disease outbreaks. J Virol. 2006;80(8):4047‐4060.
    pmc: PMC1440451pubmed: 16571821
  16. Pusterla N, Barnum S, Lawton K, Wademan C, Corbin R, Hodzic E. Investigation of the EHV‐1 genotype (N752, D752, and H752) in swabs collected from equids with respiratory and neurological disease and abortion from the United States (2019‐2022). J Equine vet Sci. 2023;123:104244.
    pubmed: 36773852
  17. Friday PA, Scarratt WK, Elvinger F, Timoney PJ, Bonda A. Ataxia and paresis with equine herpesvirus type 1 infection in a herd of riding school horses. J Vet Intern Med. 2000;14(2):197‐201.
    pubmed: 10772493
  18. Van Galen G, Leblond A, Tritz P, Martinelle L, Pronost S, Saegerman C. A retrospective study on equine herpesvirus type‐1 associated myeloencephalopathy in France (2008‐2011). Vet Microbiol. 2015;179(3–4):304‐309.
    pubmed: 26228835
  19. de la Cuesta‐Torrado M, Velloso Alvarez A, Neira‐Egea P, Cuervo‐Arango J. Long‐term performance of show‐jumping horses and relationship with severity of ataxia and complications associated with myeloencephalopathy caused by equine herpes virus‐1. J Vet Intern Med. 2024;38(3):1799‐1807.
    pmc: PMC11099729pubmed: 38609161
  20. Barbić L, Lojkić I, Stevanović V, et al. Papers: two outbreaks of neuropathogenic equine herpesvirus type 1 with breed‐dependent clinical signs. Vet Rec. 2012;170(9):227.
    pubmed: 22262701
  21. Bryant NA, Wilkie GS, Russell CA, et al. Genetic diversity of equine herpesvirus 1 isolated from neurological, abortigenic and respiratory disease outbreaks. Transbound Emerg Dis. 2018;65(3):817‐832.
    pmc: PMC5947664pubmed: 29423949
  22. Marenzoni ML, De Waure C, Timoney PJ. Efficacy of vaccination against equine herpesvirus type 1 (EHV‐1) infection: systematic review and meta‐analysis of randomised controlled challenge trials. Equine vet J. 2023;55(3):389‐404.
    pubmed: 35946376
  23. Van Maanen C, Van Sloet Oldruitenborgh‐Oosterbaan MM, Damen EA, Derksen AGP. Neurological disease associated with EHV‐1‐infection in a riding school: clinical and virological characteristics. Equine vet J. 2001;33(2):191‐196.
    pubmed: 11266070
  24. Henninger RW, Reed SM, Saville WJ, et al. Outbreak of neurologic disease caused by equine Herpesvirus‐1 at a university equestrian center. J Vet Intern Med. 2007;21(1):157‐165.
    pubmed: 17338164
  25. Stephen M, Reed WMB, Stephen DCS, Reed M, Andrews FM. Disorders of the neurologic system [Chapter 10]. Equine Internal Medicine. Vol 2018. Philadelphia, PA: WB Saunders; 1998:539.
  26. Petersen JL, Mickelson JR, Cothran EG, et al. Genetic diversity in the modern horse illustrated from genome‐wide SNP data. PLoS One. 2013;8(1):e54997.
    pmc: PMC3559798pubmed: 23383025
  27. Klouth E, Zablotski Y, Petersen JL, et al. Epidemiological aspects of equid herpesvirus‐associated myeloencephalopathy (EHM) outbreaks. Viruses. 2022;14(11):2576.
    pmc: PMC9695031pubmed: 36423188
  28. nWebsite. Accessed April 8, 2024. https://www.vetmed.ucdavis.edu/sites/g/files/dgvnsk491/files/local_resources/pdfs/lab_pdfs/UC_Davis_VMTH_Hematology_Reference_Intervals.pdfn
  29. Traub‐Dargatz JL, Pelzel‐Mccluskey AM, Creekmore LH, et al. Case‐control study of a multistate equine herpesvirus myeloencephalopathy outbreak. J Vet Intern Med. 2013;27(2):339‐346.
    pubmed: 23398291
  30. Couroucé A, Normand C, Tessier C, et al. Equine herpesvirus‐1 outbreak during a show‐jumping competition: a clinical and epidemiological study. J Equine vet Sci. 2023;128:104869.
    pubmed: 37339699
  31. Hussey GS, Giessler KS. Contribution of the immune response to the pathogenesis of equine herpesvirus‐1 (EHV‐1): are there immune correlates that predict increased risk or protection from EHV‐1 myeloencephalopathy? Vet J. 2022;282:105827.
    pubmed: 35405348
  32. Allen GP. Risk factors for development of neurologic disease after experimental exposure to equine herpesvirus‐1 in horses. Am J Vet Res. 2008;69(12):1595‐1600.
    pubmed: 19046006
  33. Caterina T, Göran A, Goncalo P. Management of an EHV‐1 outbreak at FEI events and its international impact. Vet Rec. 2021;189(5):905.
    pubmed: 34505682
  34. Carvelli A, Nielsen SS, Paillot R, Broglia A, Kohnle L. Clinical impact, diagnosis and control of equine herpesvirus‐1 infection in Europe. EFSA J. 2022;20(4):00333‐21.
    pmc: PMC8985062pubmed: 35414834
  35. Pusterla N, Mapes S, Wademan C, et al. Emerging outbreaks associated with equine coronavirus in adult horses. Vet Microbiol. 2013;162(1):228‐231.
    pmc: PMC7117461pubmed: 23123176
  36. Lunn D, Holmes MA, Gibson J, Field HJ, Kydd JH, Duffus WPH. Haematological changes and equine lymphocyte subpopulation kinetics during primary infection and attempted re‐infection of specific pathogen free foals with EHV‐1. Equ Vet J. 1991;23:25‐40.
  37. Bumgardner MK, Dutta SK, Campbell DL, Myrup AC. Lymphocytes from ponies experimentally infected with equine herpesvirus 1: subpopulation dynamics and their response to mitogens. Am J Vet Res. 1982;43(7):1308‐1310.
    pubmed: 6285778
  38. Goodman LB, Loregian A, Perkins GA, et al. A point mutation in a herpesvirus polymerase determines neuropathogenicity. PLoS Pathog. 2007;3(11):1583‐1592.
    pmc: PMC2065875pubmed: 17997600
  39. Vereecke N, Carnet F, Pronost S, Vanschandevijl K, Theuns S, Nauwynck H. Genome sequences of equine herpesvirus 1 strains from a European outbreak of neurological disorders linked to a horse gathering in Valencia, Spain, in 2021. Microbiol Resour Announc. 2021;10(20):e00333‐21.
    pmc: PMC8188346pubmed: 34016681

Citations

This article has been cited 1 times.
  1. de la Cuesta-Torrado M, Vitale V, Velloso Alvarez A, Neira-Egea P, Diss C, Cuervo-Arango J. The Effect of Vaccination Status on Total Lymphocyte Count in Horses Affected by Equine Herpes Virus-1 Myeloencephalopathy.. Animals (Basel) 2025 Apr 1;15(7).
    doi: 10.3390/ani15071019pubmed: 40218411google scholar: lookup