19 Aug 2019
Amelia Lawrence and Emily Haggett emphasise the critical importance of horse owner education for maintaining adequate “herd immunity”.
Image: © highwaystarz / Adobe Stock
“My old boy just lives out in the field – he doesn’t go anywhere, so we just vaccinate him for tetanus.”
Equine influenza is a highly contagious viral respiratory disease with significant economic and equine health implications. Following increased viral activity earlier this year, the British Horseracing Authority took precautionary action by cancelling race meets, resulting in the discussion of equine influenza in the national press and owners across the country digging out their horses’ passports to assess if their last “flu and tet” really was 2016.
Of course, many horse owners and yard managers, alongside their vets, are very diligent in ensuring vaccines are up to date. Horses competing within certain spheres are obliged to be vaccinated in line with set policies; Fédération Equestre Internationale requirements state the primary course of two vaccines 21 to 92 days apart, with a third vaccine (first booster) within 7 months of the second vaccination.
In light of these recent outbreaks, some regulatory bodies have adopted more stringent protocols; clients should check the current policies pertinent to their sport.
This all sounds well and good; however, the need to vaccinate out of necessity only applies to a small proportion of the UK’s horse population. For the remainder, the decision or choice to vaccinate is in the hands of the owner, influenced to a degree by yard policies and veterinary advice.
Horse owner education, therefore, is critical to maintain adequate “herd immunity” with regards to equine influenza and to minimise cases of tetanus.
So how do we persuade owners to vaccinate their horses? Raising awareness is crucial, and has certainly increased off the back of the media interest in equine influenza and its impact on the racing industry. This interest was harnessed by many practices, with some offering vaccination clinics to address the increased demand. Now the interest has somewhat subsided, albeit the risk largely unchanged, we need to look for more sustainable ways of raising awareness.
Monthly newsletters and organised client evenings were previously the mainstay of client education, and a means of nurturing the client/practice bond. These continue to be an important means of disseminating information, but have obvious limitations – including the small numbers of people reached, and the costs in time and money of organising events and printing newsletters.
Most practices now realise the benefits of an online presence, with professional websites and social media pages.
Social media can be used to direct your clients and followers to websites with further information, be it your own practice’s or other resources. The AHT has set up Equiflunet – a site dedicated to raising awareness of equine influenza, with excellent maps published on a monthly basis indicating outbreaks, as well as other useful information. At the time of going to press, in 2019 so far, 219 cases of equine influenza in the UK have been laboratory confirmed – with all of those determined at the AHT identified as the Florida clade 1 virus in predominantly unvaccinated animals.
The Florida clade 1 strain is endemic to North and South America, whereas in Europe, the clade 2 strain is endemic. The outbreaks seen in 2019 are the first major outbreaks in Europe of the clade 1 strain since 2009. The World Organisation for Animal Health continues to recommend vaccines containing both the clade 1 and clade 2 viruses of the Florida sublineage.
Vaccination doesn’t eliminate transmission, but reduces clinical signs and the quantity of virus shed. Horses become infected with equine influenza by the inhalation of aerosolised viral particles from infected horses and contaminated fomites.
Research in Australia – following its 2007 outbreak – found equine influenza could spread between 1km to 2km, depending on wind patterns; therefore, in most areas in the UK, the concept that horses that don’t leave the yard aren’t at risk cannot be supported.
Horses with suspected or confirmed infections should be isolated where possible; however, given the airborne nature of the disease, it is understandably difficult to prevent transmission. Nasopharyngeal swabs should be taken within three days of onset of clinical signs, otherwise paired serology can be used with samples taken more than two weeks apart.
Reports from the AHT have indicated increased viral activity continues to exist. With the summer holidays under way, more movement of horses will occur within the pleasure horses spheres – be it hacking, showing, competitions or camps.
The threat of equine influenza infection has, therefore, not diminished, so ongoing efforts should be made to recommend vaccination and boosters.
If economically viable, zone visits and group discounts can be used to encourage client participation in vaccination schemes; however, practices should be wary of offers that undersell the service you are providing.
Everyone at some stage has experienced the “while you’re here can you just look at…”, at which point you’re providing specialist advice, but likely charging your time at a reduced rate. Routine procedures, such as vaccinations or dental examinations, are opportunities to discuss the horse’s general health and perform clinical examinations, which may highlight issues that warrant further investigation.
When restarting a vaccination course, it is useful to number the vaccine 1/2/3 within the margin, so it is clear to the owner and next vet looking at it. This is particularly useful if there have been multiple restarts.
Additionally, if a designated box exists within the passport, or simply on a compliment slip, it is useful to write down when the next vaccine is due.
It should be emphasised that it is the owner’s responsibility to ensure the vaccines are kept up to date, even if your practice provides text or email reminders. Text or email vaccine reminders can also be used to provide further background information, such as links to the aforementioned Equiflunet or your practice’s own information pages.
So let’s assume, given the current climate, that your older horse and pet pony population that “never leaves the yard”, but has previously been treated to a tetanus vaccination, is now grazing happily, developing some antibodies to equine influenza following a reconsideration of its vaccination plan.
What about the horses that have never seen a vet, whose owners perhaps don’t believe in vaccination or are even aware that it is recommended – how can vets educate clients they don’t have?
For the majority of horse owners, the dream of having your horses at home and watching them graze out the kitchen window isn’t financially achievable. Horses are kept on yards, of varying expense depending on facilities, location and degree of input with regards to daily care.
By encouraging yard managers to adopt vaccination policies, you can extend the reach of your vaccine education to target horse owners who aren’t clients and perhaps haven’t stumbled on your excellent resources on social media.
Alongside worming programmes and new horse protocols, vaccine recommendations can be brought together into streamlined veterinary guided yard policies. Again, many yards and horse owners across the country are already doing this, but it’s worth considering how proactive your practice is in encouraging this.
It is the nature of our profession that even within a practice, different vets will offer different advice; however, the approach to yard management is something that could easily be formalised into a practice standard operating procedure (SOP), and tweaked for different yards’ requirements.
With increasing resources of evidence-based medicine, development of SOPs across other aspects of clinical work could aid delivery of a uniform, justified approach.
Of course, some vets may consider such SOPs a restriction on their clinical freedom. Does it really matter if I give three days’ worth of phenylbutazone after a castration, yet my colleague gives five? Perhaps not, but in other situations – for example, antimicrobial use – SOPs are an important way of encouraging appropriate use and consistency among clinicians in light of increasing resistance.
So, how can you persuade owners and yards to comply? No silver bullet exists; without a legal requirement, increasing the number of vaccinated horses comes down to increased horse owner awareness, education and requirement.
As individual clinicians, we should make the most of opportunities to educate owners, but be supported by practices with a considered targeted approach.
Vaccination is just one item on a list of many things vets would like to educate owners on, so having a whole practice approach to address topics pertinent to your demographic will ensure efforts will be more productive and relevant.
