Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere2021; 49(4); 281-286; doi: 10.1055/a-1519-4547

[Confirmed case of a West Nile virus infection in a horse with minimal neurological signs and a favorable clinical outcome].

Abstract: West Nile virus (WNV) is a mosquito-borne viral pathogen of global importance and is considered to be the most widespread flavivirus. In Germany, first infections with WNV were detected in 2018 and it is expected for these to become more frequent in consequence to warmer winters followed by a rainy/humid springtime. WNV is maintained in an enzootic cycle between ornithophilic mosquitoes and certain wild bird species. Humans and horses are so-called "dead-end hosts" of a WNV infection. They frequently do not fall ill, however occasionally develop overt infections ranging from mild febrile symptoms (so-called "West Nile fever") up to severe encephalitis with fatal outcome. Therefore, it is important to recognize the clinical signs and to be able to distinguish a WNV infection from other possible differential diagnoses. The presented case report highlights rather uncommon clinical signs of a WNV infection such as non-specific fever, anorexia, or colic-like symptoms. In addition, possible differential diagnoses as well as the treatment are discussed. The time course of neutralizing antibodies following natural infection is reported, showing high levels of antibodies 7 months following the infection. Finally, antibody measurements demonstrated a very good immunologic response following a single WNV vaccination. Das West-Nil-Virus (WNV) ist ein von Mücken übertragenes virales Pathogen mit weltweiter Bedeutung und eines der am meisten verbreiteten Flaviviren. Infektionen mit dem WNV wurden erstmalig im Jahr 2018 in Deutschland nachgewiesen und sind aufgrund der zunehmend milderen Winter mit feuchtwarmem Frühjahr in Zukunft häufiger zu erwarten. Das WNV zirkuliert hauptsächlich in einem enzootischen Zyklus zwischen ornithophilen Mücken und bestimmten Wildvogelarten. Menschen und Pferde sind Fehlwirte („dead-end hosts”) einer WNV-Infektion, erkranken häufig nicht, doch können einige von ihnen nach Viruskontakt milde fieberhafte Symptome (sog. „West-Nil-Fieber“) bis hin zu schweren Gehirnentzündungen mit tödlichem Ausgang entwickeln. Deshalb ist es wichtig, die klinischen Symptome beim Pferd zu kennen und von anderen Differenzialdiagnosen zu unterscheiden. Im Fokus dieses Fallberichts steht daher, weniger bekannte Symptome einer WNV-Infektion wie unspezifisches Fieber, Anorexie oder kolikähnliche Symptome konkret aufzuzeigen. Weiterhin werden mögliche Differenzialdiagnosen erläutert und durchgeführte Therapien dargelegt. Zudem wurde der Verlauf des Titers neutralisierender Antikörper nach einer Feldinfektion über mehrere Monate verfolgt. Auch 7 Monate nach der Infektion lag der Titer noch auf einem hohen Niveau. Anschließend konnte nach einmaliger WNV-Impfung eine sehr gute immunologische Reaktion nachgewiesen werden.
Publication Date: 2021-08-23 PubMed ID: 34425618DOI: 10.1055/a-1519-4547Google Scholar: Lookup
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Summary

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The research focuses on a confirmed case of West Nile virus (WNV) in a horse in Germany showing mild neurological signs and having a favorable outcome. The case furthers the understanding of the disease’s symptoms, diagnosis, treatment and the immune response following natural infection and vaccination.

Context and Importance of the Study

  • West Nile virus (WNV) is a mosquito-borne viral pathogen with global implications. It is the most widespread flavivirus, primarily circulating between ornithophilic mosquitoes and wild birds. In this enzootic cycle, humans and horses are considered “dead-end hosts.”
  • These hosts occasionally develop overt infections from mild febrile symptoms, known as “West Nile fever,” to severe encephalitis, which can be fatal. However, they often do not get sick.
  • In Germany, the first WNV infections were detected in 2018. Considering increasingly milder winters and moist warm springs, it is expected that these infections will become more frequent.
  • Therefore, understanding the clinical signs in horses and distinguishing WNV infection from other potential diseases are crucial.

Case Presentation and Unique Characteristics

  • This research presents a case report of a horse with a confirmed WNV infection. The horse displayed some uncommon clinical signs such as non-specific fever, anorexia, and symptoms similar to colic.
  • The minimal neurological signs and the favorable clinical outcome of the horse differentiate this case from typical severe manifestations of the disease.

Investigation of the Disease Progression

  • The time course of neutralizing antibodies following natural infection was monitored.
  • Even seven months after the infection, the horse still showed high levels of these antibodies, indicating a sustained immune response against the virus.

Vaccination and Immune Response

  • The study also examined the horse’s immune response following a single WNV vaccination.
  • Antibody measurements demonstrated a robust immunologic response, suggesting that the vaccine was effective against the disease.

Key Takeaways

  • This study highlights the importance of understanding the varied presentations of WNV infection in horses. Recognizing non-typical symptoms, like non-specific fever, anorexia, and colic-like symptoms, is essential for timely diagnosis and treatment.
  • The case also emphasizes the role of natural infection and vaccination in eliciting a robust immune response, evident through a persistent high level of neutralizing antibodies, offering protection against the disease.

Cite This Article

APA
Trachsel DS, Drozdzewska K, Bergmann F, Ziegler U, Gehlen H. (2021). [Confirmed case of a West Nile virus infection in a horse with minimal neurological signs and a favorable clinical outcome]. Tierarztl Prax Ausg G Grosstiere Nutztiere, 49(4), 281-286. https://doi.org/10.1055/a-1519-4547

Publication

ISSN: 2567-5834
NlmUniqueID: 9715779
Country: Germany
Language: ger
Volume: 49
Issue: 4
Pages: 281-286

Researcher Affiliations

Trachsel, Dagmar S
  • Klinik fu00fcr Pferde, allgemeine Chirurgie und Radiologie, Freie Universitu00e4t Berlin.
Drozdzewska, Karolina
  • Klinik fu00fcr Pferde, allgemeine Chirurgie und Radiologie, Freie Universitu00e4t Berlin.
Bergmann, Felicitas
  • Friedrich-Loeffler-Institut, Institut fu00fcr neue und neuartige Tierseuchenerreger, Greifswald-Insel Riems.
Ziegler, Ute
  • Friedrich-Loeffler-Institut, Institut fu00fcr neue und neuartige Tierseuchenerreger, Greifswald-Insel Riems.
Gehlen, Heidrun
  • Klinik fu00fcr Pferde, allgemeine Chirurgie und Radiologie, Freie Universitu00e4t Berlin.

MeSH Terms

  • Animals
  • Antibodies, Viral
  • Birds
  • Culicidae
  • Germany
  • Horse Diseases / diagnosis
  • Horses
  • West Nile Fever / diagnosis
  • West Nile Fever / veterinary
  • West Nile virus

Conflict of Interest Statement

Die Autoren bestätigen, dass kein Interessenkonflikt besteht.

Citations

This article has been cited 1 times.
  1. Bergmann F, Trachsel DS, Stoeckle SD, Bernis Sierra J, Lu00fcbke S, Groschup MH, Gehlen H, Ziegler U. Seroepidemiological Survey of West Nile Virus Infections in Horses from Berlin/Brandenburg and North Rhine-Westphalia, Germany.. Viruses 2022 Jan 25;14(2).
    doi: 10.3390/v14020243pubmed: 35215837google scholar: lookup