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The neurological form of equine herpes virus-1 (EHV-1) is a worrying disease for horse owners on several levels. The death rate among infected horses is concerning enough, but the highly infectious nature of the virus and an apparent marked growth in the number of cases in recent years have scientists working overtime to find a vaccine and medications that will improve survival rates.
On top of that, nearly a third of horses that contract the neurological form die or are euthanized. Scientists are piecing together the puzzle around a potentially fatal virus that is little different from the standard EHV-1 strain that usually causes little more than a cold.
Researchers at Cornell University in New York have found that a change in just one amino acid is the difference between the milder strain and the life-threatening neurological form, which is sometimes called the mutant or neuropathogenic strain. Cornell microbiologists discovered that a single amino acid variation in an enzyme that is part of the DNA copying process of EHV-1 creates a different type of EHV-1, which causes the neurological disorders in horses. Although the mutant strain of EHV-1 is most frequently associated with neurological disease, the more common strain, sometimes referred to as the wild-type, has also been known to be associated with such cases. The researchers postulate that herpes viruses tend to evolve toward strains that produce less disease, so they think that the more virulent neurological strain of EHV-1 is older than the milder type. Three of these — EHV-1, EHV-3, and EHV-4 — pose the most serious health risks for domesticated horses and can have significant economic impacts on the equine industry.
EHV-1 can cause four manifestations of disease in horses, including a neurological form, respiratory disease, abortion, and neonatal death. EHV-3 causes a venereal disease called equine coital exanthema that affects the external genitalia.
EHV-4 causes a non-fatal upper respiratory tract disease in foals and is uncommonly associated with abortion and rarely with neurologic disease. The neurologic form of EHV-1 causes what veterinarians call Equine Herpes Virus Myeloencephalopathy (EHM). Neurological signs appear as a result of damage to blood vessels in the brain and spinal cord associated with EHV infection. Initial exposure generally occurs in foals from contact with their mothers, usually by respiratory shedding.
It can also be spread indirectly through contact with physical objects contaminated with the virus, such as tack, rugs, water containers, feed buckets, people’s hands and clothing. The incubation period for the disease may be as little as 24 hours, but is typically 4-6 days.
Respiratory disease caused by EHV-1 is most common in weaned foals and yearlings, often in autumn and winter. Normally, EHV-1 infection takes hold in the upper respiratory tract, causing a mild respiratory disorder.
Cases of abortion triggered by the disease usually occur without warning, typically late in pregnancy – after eight months. As indicated, the neuropathogenic, or mutant, strain is associated with most of the neurologic cases identified. The mutation appears to result in more rapid reproduction of the virus, resulting in higher levels of circulating virus in the bloodstream, causing more severe symptoms and leading to abortion and neurological disease.
Scientists have shown through testing that this mutation has been present in outbreaks throughout the world for at least 30 years. Shedding of both forms of the EHV-1 virus by the respiratory route typically lasts for 7-10 days, but can persist much longer, possibly for three weeks or more. After infection with EHV-1, the virus eventually becomes inactive in the horse’s body, setting up a carrier state that is life-long. It is this ability to reside as a silent and persistent infection in horses which provides a reservoir of virus for continual transmission. Authorities acknowledge the growing prevalence of EHV-1, saying it appears to meet the criteria of an emerging disease, in that the neurological form appears to be growing in severity. The Animal and Plant Health Inspection Service (Aphis) of the US Department of Agriculture points out it is possible that the reporting of EHV-1 cases has increased, rather than an actual increase in the number and severity of cases.
Symptoms from the neurological form include a fever, usually before the neurological signs. Care for a horse extends to minimising the effects of the illness, in the hope that the horse will remain well enough to survive the infection. Antiviral drugs have been used to treat some cases, but research is not entirely clear on their effectiveness, or what constitutes the ideal time to give them to an infected horse. In the absence of a vaccine labelled as being able to prevent the neurological form, horse owners must minimise risk by adopting prudent biosecurity measures. These include rigid quarantining of the sick animal until the risk of transmitting the infection has passed.
Any horse that has aborted or shown signs of fever, respiratory disease, or neurologic disease should be separated from healthy horses. Ideally, sick horses should be moved into a separate building or paddock on the premises, or be taken to a veterinary hospital with an isolation facility. Do not share equipment among horses on the property, given that the virus can be spread through contaminated objects such as water and feed buckets, even bridles.
Horses carrying EHV may appear to be perfectly healthy yet spread the virus via the secretions from their nostrils. Wearing gloves and using disinfectant to sanitize footwear can also help minimize the risk of people spreading the virus between animals.
Evidence indicates that the virus will typically remain capable of infecting a horse for probably less than seven days in most practical field situations, but in ideal conditions may persist for up to 35 days.
Vaccines exist to control the respiratory and abortion manifestations of EHV-1, but are not proven against the neurological form.
Aphis acknowledges that the increase in EHV-1 outbreaks is worrying, because they likely fit the criteria of a disease that is evolving and changing in virulence and behavior.
In the United States, reports of neurologic EHV-1 outbreaks were sporadic before 2003, with typically none or few outbreaks identified annually.
The number of reported outbreaks in the US has increased, and the numbers infected in an outbreak appear to be much higher than what was seen before 2001. It is also unclear what role the poor immune response to the mutated strain is playing in the outbreaks of recent years.
The factors involved in this emergence are not clear as yet, but several have been suggested. An Aphis paper entitled Equine Herpesvirus Myeloencephalopathy: Mitigation Experiences, Lessons Learned, and Future Needs, noted that EHV was a focus of presentations at multiple equine industry and veterinary meetings in 2007, illustrating concern within the equine industry related to the disease.


Much remains to be learned about the disease, but clinicians largely agree there is ongoing need for critical evaluation of available literature, vaccine development and further research into the potential effectiveness of exisiting vaccines, and a faster test for detecting the disease that distinguishes between the neurological strain and the non-neurological strain.
They have also identified the need for more information on individual animal risk factors, transmission characteristics, latency studies, and prevention options.
A 2009 consensus statement from a panel of the American College of Veterinary Internal Medicine, published in the Journal of Veterinary Internal Medicine in 2009, laid out the challenges ahead. Past exposure produces a limited period of protection from re-infection, of as little as 3 to 6 months, but there are no reports of horses repeatedly affected by EHM, although the rarity of the disease may be a contributing factor. Pregnancy: Abortion can occur in mares of any age, although it is largely restricted to the last trimester of pregnancy. Rectal temperature: Horses with high fever and high fevers occurring several days after the initial onset of fever, are more likely to develop EHM.
Introduction of horses to a herd is commonly reported before the development of EHV-1 outbreaks, and specifically before EHM outbreaks.
Breed and sex were identified as risk factors for EHM in 1 epidemiological survey, with ponies and smaller breeds less commonly affected, and females more commonly affected.
Stress factors: Outbreaks of EHV-1 disease are anecdotally associated with stress factors, including weaning, commingling, transportation, and concurrent infections.
Immunological status has been proposed to have an association with the development of EHM, specifically as a result of vaccination.
Professor Peter Timoney, of the Gluck Equine Research Center at the University of Kentucky and chairman of the Infectious Diseases of Horses Committee of the United States Animal Health Association, notes that the mutant strain that causes neurological disease has been identified among isolates of EHV-1 made before 2000.
Based substantially on materials from the Animal and Plant Health Inspection Service of the US Department of Agriculture, and the consensus statement from a panel of the American College of Veterinary Internal Medicine published in the Journal of Veterinary Internal Medicine. On February 28th, the Melody Riders Saddle Club presented a Horse Health Education Seminar.
The Washington State University Veterinary Teaching Hospital is again open to clients seeking service for horses, llamas and alpacas following the recent outbreak of equine herpes virus (EHV-1).
As of this morning, according to the State Veterinarian's Office, there have been 3 confirmed cases of Equine Herpes Virus and 3 suspect cases in the state of Washington. Here is a link to an aggregation of news and updates on the current Equine Herpes Virus outbreak traced to Ogden, Utah National Cutting Horse Association Western National Championships.
For general questions, or to sign up for email reminders for your pet's vaccinations, please feel free to contact us via email. Pregnant women who are infected with either herpes simplex virus 2 (HSV-2) or herpes simplex virus 1 (HSV-1) genital herpes have a higher risk for miscarriage, premature labor, retarded fetal growth, or transmission of the herpes infection to the infant while in the uterus or at the time of delivery.. During a first infection, the virus is shed for longer periods, and more viral particles are excreted. An infection that first occurs in the late term does not allow the mother to develop antibodies that would help her baby fight off the infection at the time of delivery.
The risk for transmission also increases if infants with infected mothers are born prematurely, if there is invasive monitoring, or if instruments are required during vaginal delivery. Very rarely, the virus is transmitted across the placenta, a form of the infection known as congenital herpes.
Infants may acquire congenital herpes from a mother with an active herpes infection at the time of birth. Unfortunately, only 5% of infected pregnant women have a history of symptoms, so in many cases herpes infection is not suspected, or symptoms are missed, at the time of delivery.
Obtaining routine herpes cultures on all women during the prenatal period is not recommended. Performing chorionic vilus sampling, amniocentesis, and percutaneous fetal blood draws can safely be performed during pregnancy. If lesions in the genital area are present at the time of birth, Cesarean section is usually recommended.
If lesions erupt shortly before the baby is due then samples must be taken and sent to the laboratory. Some doctors recommend anti-viral medication for pregnant women who are infected with HSV-2. Herpes infection in a newborn can cause a range of symptoms, including skin rash, fevers, mouth sores, and eye infections. Herpes meningitis, an inflammation of the membranes that line the brain and spinal cord, occurs in up to 10% of cases of primary genital HSV-2.
Iridocyclitis is another serious complication of ocular herpes, in which the iris and the area around it become inflamed. Herpes simplex is particularly devastating when it occurs in immunocompromised patients and, unfortunately, coinfection is common.
The majority of patients with HIV are co-infected with HSV-2 and are particularly vulnerable to its complications. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Quarantines and tracing efforts funded by authorities to prevent its spread amount to millions of dollars annually in the United States.
Scientists are not entirely sure over what distance the virus can spread in this manner under typical horse management and environmental conditions.
Older horses are more likely than younger ones to transmit the virus without showing signs of infection.
It can, however, infect deeper respiratory tissues and get into the blood stream, giving it a route to the uterus and nervous system, where abortion or neurological disease can result. They are capable of shedding virus, with or without clinical disease, particularly at times of stress, for the rest of their lives.
However, most researchers appear to agree there has been an increase in the number of cases involving neurological disease triggered by the mutant strain.
An affected horse is likely to show poor coordination, urine dribbling, loss of tail tone, hind limb weakness, and may lean against a wall to help maintain balance. Researchers are studying several existing vaccines to determine if they may offer some degree of protection against the neurological form, and new vaccines are also being assessed. The economic impact is substantial, not only through horses lost to the disease, but the many costs associated with treatment, quarantines, cancelled events, and the inability of horses to compete. EHM can occur in horses of all ages, and has been reported in weanlings, both naturally occurring and experimentally induced. However, the association between increased use of vaccines and development of EHM described in that study was completely confounded by the fact that vaccination frequency was greatest in older horses, and EHM was strongly associated with greater age.


Reopening is slightly ahead of schedule because there have been no new cases of EHV-1 in Washington for more than two weeks. In all likelihood, none of our clients will be affected by this outbreak, so please don't panic. Possible ComplicationsThe severity of symptoms depends on where and how the virus enters the body. Although about 25 - 30% of pregnant women have genital herpes, less than 0.1% of babies are born with neonatal herpes. Transmission can occur if the amniotic membrane of an infected woman ruptures prematurely, or as the infant passes through an infected birth canal. Also rarely, newborns may contract herpes during the first weeks of life from being kissed by someone with a herpes cold sore. Aggressive treatment with antiviral medication is required, but may not help systemic herpes.
If there is evidence of an active outbreak, doctors usually advise a Cesarean section to prevent the baby contacting the virus in the birth canal during delivery. Samples are cultured to detect the virus at 3 - 5-day intervals prior to delivery to determine whether viral shedding is occurring.
Recent studies indicate that acyclovir (Zovirax) or valacyclovir (Valtrex) or famciclovir (Famvir)Valtrex can help reduce the recurrence of genital herpes and the need for Cesarean sections. It is important to treat babies quickly, before the infection spreads to the brain and other organs. In most cases, ocular herpes causes inflammation and sores on the lids or outside of the cornea that go away in a few days. In children, this is often caused by thumbsucking or finger sucking while they have a cold sore. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Events are canceled to reduce the risk of spread and dozens of competition horses end up confined to their stalls or properties.
Antibiotics may be used to treat a secondary bacterial infection if one develops, but they will have no effect on the herpes infection itself. Movement could result in introduction of the virus to a new population; it is also possible that transport stress plays a role in allowing the disease to express itself or re-emerge from the latent stage.
However, in a large epidemiological study conducted in The Netherlands, EHM was largely restricted to horses over 3 years of age, and age 4 to 5 years was similarly associated with an increased risk of EHM in a recent large North American outbreak. For example, the authors found only one published report of this condition in Australia or New Zealand and, anecdotally, there have been only a very small number of cases recorded in those countries.
The association of increased age with EHM risk is reported in populations of horses in which vaccination is not practiced. All horses that were at the Ogden event have been traced and isolated, along with all of the horses in-contact with those horses. Transmission is direct horse-to-horse via aerosols or fluids (sneezing, nasal discharge, saliva).
Except in very rare instances and in special circumstances, the disease is not life threatening, although it can be very debilitating and cause great emotional distress. The baby is at greatest risk from an asymptomatic infection during a vaginal delivery in women who acquired the virus for the first time late in the pregnancy. This increased risk is present if the woman is having or has recently had an active herpes outbreak in the genital area. If no lesions are present and cultures indicate no viral shedding, a vaginal delivery can be performed and the newborn is examined and cultured after delivery.
Women begin to take the drug on a daily basis beginning in the 36th week of pregnancy (last trimester). Neonatal herpes can spread to the brain and central nervous system causing encephalitis and meningitis and leading to mental retardation, cerebral palsy, and death. Scarring and corneal thinning develop, which may cause the eye's globe to rupture, resulting in blindness. It can also occur in adult health care workers, such as dentists, because of increased exposure to the herpes virus.
HSV-2 infection increases HIV levels in the genital tract, which makes it easier for the HIV virus to be spread to sexual partners. Clients wishing to bring horses to WSUa€™s Veterinary Teaching Hospital will best be served by calling ahead first so the screening and admission process can be streamlined. Fortunately, rapid diagnostic tests and treatment with acyclovir have both significantly improved survival rates and reduced complication rates.
Fortunately, herpes meningitis usually resolves without complications, lasting for up to a week, although recurrences have been reported. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. If a local club, show, rodeo, or event has been canceled, it was at the behest of the organizer of that particular event. If you or any of your horses have been in contact with horses that traveled to the Championships, please contact a veterinarian. Recurring herpes and a first infection that is acquired early in the pregnancy pose a much lower risk to the infant. For those who recover, nearly all suffer some impairment, ranging from very mild neurological changes to paralysis.
You may still ride and move your horses, unless you or your horse have been in contact with one of the horses that participated at the National Cutting Horse Championships. The best chances for a favorable outcome occur in patients who are treated with acyclovir within 2 days of becoming ill.
Any duplication or distribution of the information contained herein is strictly prohibited. If you or your horse were at that event and have not yet been contacted by the State Veterinary Office, please contact them at 360-902-1878.



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