The perfect horse article “Equine Infectious Anemia Continues
to Kill,” was not complete and is somewhat misleading, as anyone who has endured
an outbreak of EIA positives can attest.
Such an outbreak occurred circa 1990 in southeastern
Pennsylvania. EIA as a disease was reported to be 30% fatal in symptomatic
horses at the time. However, the Coggins test was 100% fatal—regardless of
symptoms. While Dr. Eleanor Kellon describes the tests and symptoms accurately,
she does not state that regardless of the outcome of other tests, a positive
Coggins is a death sentence in all jurisdictions that use it.
The Coggins test does not test for the actual virus that
causes EIA. It tests for antibodies to the virus. This virus is similar to HIV
and, like any pathogen, causes the exposed body to generate antigens and
antibodies. Most vaccines for humans and horses use killed viruses or viruses
that are genetically altered not to be infectious. The first AIDS tests were for
the antibodies and there were some who thought positive for antibodies should be
a death sentence for the infected.
We cannot vaccinate against EIA because the only legally
recognized test for the disease does not test for the disease itself, but for
the antibodies the vaccine will stimulate. The statutes regarding EIA are what
are killing horses, not the disease, in most cases.
The disease requires a serum transfer with a sufficient
dosage of the live virus to cause active infection. The natural vector is the
large horse fly. A horse with a large pool of the virus when bitten may coat the
mandibles of the fly with enough serum to infect another horse if the fly bites
while the serum is still wet and the virus viable. The latency seemed to be
about 30 days.
To add insult to injury, the owner must pay his vet to draw
and test the blood samples that will condemn his horse, pay to have the animal
destroyed and disposed of, and cannot collect insurance or any compensation for
the animal.
Even if the owner opts for a more expensive test that
actually detects the virus, he cannot save an animal that has antibodies because
the only test that counts is the Coggins test. In some jurisdictions, a
two-in-a-row, 30-days-apart rule applies, but many owners cannot live with the
quarantine signs on their barns for 60-90 days and just kill the horse or sell
it for meat.
If you want to eradicate a disease, make it attractive for
owners to do so. Make the tests free and mandatory on an annual basis. Test for
the virus, not the antibodies, at least on the verification tests, and do not
kill unless the virus is present. Compensate owners of horses as we compensate
cattle owners, chicken owners, and others who lose animals to mandated
destruction programs.
The disease did not kill my horse, a government order did. A
symptomatic horse survived in quarantine, and another came clear on the second
and third tests. All were in the same barn, same paddocks, and we rode together
for years. There were no other positives in an 80-stall barn over a 120-day
period that surveillance was in place.
New Vaccine May Offer Reprieve
By Eleanor Kellon, VMD
Mr. Lichtenstein very eloquently expresses the anguish,
confusion
and anger that every owner feels if his or her apparently healthy
horse
turns out to have a positive Coggins test. However, a
few more details
about this disease may help owners understand
why the Coggins test
continues to
be used.
The virus that causes equine infectious anemia is a
lentivirus, part
of the same family of viruses that causes AIDS in people. One
of the
most important things to realize is that once infected
with this virus,
the horse remains infected for life. The first wave of
symptoms occur 3
to 4
weeks after initial infection, ranging
from a fever that may go
undetected to
more severe signs of
fever, lethargy, edema, anemia, low
platelet counts, and
even
diarrhea.
During the first year after infection, the horse will show
symptoms
in cycles, with period of weeks to months separating them. During the
time the horse has symptoms, virus is readily detected in the
blood and
infection easily spread by biting insects.
The
fatality rate in the
first year
of infection
varies from 30%
to as high as 60%, being
influenced by such
things
as the
general health and immunocompetence of
the horse, and the dose of virus
that was received.
After the first year or so, a horse that survives may enter a
long
period where it is free of symptoms, maybe for life. Virus may not be
detectable in the blood at this point, but research has
clearly shown
that the
horse is still infected. The
virus is
present in all the body
tissues, and in
the
white blood cells,
called macrophages. As long as a
horse in
the chronic,
asymptomatic phase remains healthy, there is
minimal risk of
transmitting the
disease to other
horses by biting
flies, but
researchers have shown that as
little as 1 cc of whole blood
(1/5th teaspoon) from
such a horse, blood
containing the
cells, not
just
serum, can transmit the infection to another
horse.
If this horse has an injury, and its blood comes into contact
with
an area of open skin/abrasion on another horse, transmission may occur.
Even more importantly, if the carrier horse is stressed in any way by
another
illness, injury, shipping, use of corticosteroid drugs, etc.,
his immune system
can lose the precarious control it has over
multiplication of the EIA viruses in
his tissue and begin again to have
virus circulating in the blood. At this
point, the horse is again a
threat to other horses via biting insects. These are
not hypotheticals.
The scenarios have been confirmed by research. This is why a
positive
Coggins test for antibodies is the most sensitive test for
infection.
As agonizing and pointless as it seems to lose the life or
use of an
apparently healthy horse with a positive Coggins test, it’s important
to understand that the horse poses a threat to the life and health of
horses
around him. It’s impossible to predict when the horse may have a
stressor that
causes his body to lose control over virus circulating
freely in the blood, or
to guarantee that it will never happen.
In addition to the options Mr. Lichtenstein mentioned
(euthanasia or
sale for meat), states also have an option of donating the horse
to a
research facility, or the quarantine of the horse under specific conditions
if the owner does not want to euthanize. The quarantine does require
branding,
isolation from other horses, and obviously the horse cannot
be moved. A specific
state’s statues regarding EIA can be viewed by
logging onto the Internet site:
http://tarlton.law.utexas.edu/dawson/eia/eia.htm
Research is progressing rapidly on a vaccine for EIA, thanks
in
large part to interest in one for AIDS. China already claims to have
eliminated EIA in that country by widespread mandatory use of a
modified live
vaccine, but researchers have been unable to get
sufficient details to confirm
this.
Vaccine-induced antibodies causing a “false positive” Coggins
test
is really the least of the worries and could be handled in a variety of
ways, such as serial negative Coggins tests before the vaccination is
done, or
antibody testing for the vaccine strain of the virus to make
sure the antibodies
are specifically for that.
The difficulty with producing an effective vaccine is the
same one
that plagues AIDS vaccine development, and also explains how the virus
manages to elude complete elimination by the immune system. These
viruses have
the ability to change their outer coating easily. When the
immune system has
developed antibodies that recognize one makeup and
drive the virus to seek
shelter inside blood cells, it works on
changing its coating to one that the
antibodies do not recognize. This
is what causes the initial cycling of
symptomatic and asymptomatic
periods.
Eventually the horses that survive to enter the prolonged, apparently healthy
stage have a
sufficient array of different antibodies to keep
the virus
at bay as long as
they avoid significant stresses on
their immune
system. However, the antibodies
can’t destroy it
completely in its
hiding places. The task before EIA
researchers is to find a vaccine
strain, or combination of
strains, that covers
enough of the possible
different outer
coating arrays to stop the virus in its
tracks.