Group C streptococcus (GCS) and group G streptococcus (GGS) are commonly regarded as commensals usually found in association with the normal flora of human skin, pharynx, and intestine. Antibodies of the IgG and IgA class recognizing the SeM are passively transferred to the foal through colostrum and are also present in the milk of immune mares.33 Antibodies of predominantly the IgGb isotype are absorbed from colostrum and redistribute to the nasopharyngeal mucosa.32 These IgGb antibodies, along with the SeM-specific IgA antibodies that are present in milk and passively coat the pharyngeal mucosa of nursing foals, provide protection to most nursing foals up to the time of weaning.32,33,133 Resistance of nursing foals to strangles during the first few months of life appears to be mediated by IgGb antibodies in nasal secretions and milk and not by IgA.33 Serologic (ELISA) responses to M-protein vaccines are poor in foals, most likely because of the inhibitory effect of maternal antibodies. Recent research has led to the development of a modified avirulent strain of S. equi, which, when introduced intranasally or orally, stimulates a specific secretory response and a solid resistance to challenge. Definitive diagnosis is usually based on progression of clinical signs and bacterial culture results (Schultz, 1988). The main sites of human streptococcal infection are the throat, especially in the winter and early spring, and the skin, especially in the late summer and early fall. Interestingly, both genes, sepeH and sepeI, were not found in the closely related Streptococcus zooepidemicus, and it was suggested that the acquisition of the sag genes might be an important event in the formation of a more virulent S. equi strain from its putative S. zooepidemicus ancestor [81]. Outbreaks of strangles generally persist for several months to more than 1 year, particularly on breeding farms, where each foal crop adds new susceptible animals to the population. We use cookies to help provide and enhance our service and tailor content and ads. To avoid inadvertent contamination of other vaccines, syringes, and needles, it is advisable and considered good practice to administer all parenteral vaccines before handling and administering the intranasal strangles MLV. Identification of S. equi via culture or PCR testing can generally be achieved 2 to 3 days after the onset of fever. Therefore, the HA capsule serves P. multocida and the streptococci as molecular camouflage. Samples should be tested for S. equi by both culture and PCR; animals testing positive should be kept in isolation for further investigation and treatment. This will help prevent the spread of infection. Complications associated with strangles are estimated to occur in up to 20% of cases. This form of strangles is often fatal. For this reason, when determining the indications for vaccination against S equi equi, consideration should be made to vaccinate only horses at high risk for exposure to this bacterium. The organism survives for only a few weeks in the environment. Interestingly, no orthologs of smez or speJ were found on any non-GAS genomes, which is most likely because these genes are not associated with mobile DNA elements, preventing them from horizontal gene transfer. Rehabilitating malnourished, or even undernourished horses, can be fraught with difficulties because horses are “hind gut” fermenters and metabolize readily fermentable grains much differently than other species. Strangles primarily affects young horses (weanlings and yearlings), although horses of any age can become infected if not protected by previous exposure to the organism or by vaccination. The earliest detectable clinical sign is fever (up to 103° F/39° C or higher), which may coincide with early suppurative inflammation within the regional lymph nodes—mandibular or retropharyngeal—often before detectable lymph node enlargement. Lymphadenitis may initially present as painful enlargement of affected lymph nodes, followed by exudation of serum through the overlying skin and eventual rupture and drainage of the affected lymph node. The streptococcal HAS enzymes are ∼70% identical to each other and ∼20% identical to the vertebrate enzymes. In Clinical Veterinary Advisor: The Horse, 2012, Commingling with many horses of unknown origin and medical history, Contagious: Spread by direct (horse-to-horse) or indirect (contaminated feed, water, equipment, or handlers) contact, Purulent discharge from horses with active and recovering strangles, Nasal secretions of outwardly healthy horses, including horses incubating disease or recovering or subclinical carriers (carrier state develops in up to 10% of affected animals; the guttural pouch is the most common site of prolonged carriage), Prolonged environmental persistence unlikely, Purpura hemorrhagica: Immune-mediated vasculitis; may occur after exposure to S. equi antigens by natural exposure or vaccination. The antigen present in immune complexes is SeM, along with antibodies of the IgA class. The fact that all GAS counterparts of GCS/GGS sag genes, except speG, were found on prophages and the strong homology between the orthologues suggests that commensal GCS/GGS strains might have acquired these sag genes from pathogen GAS generating more virulent GCS and GGS. The same is likely true for staphylococcal and other etiologic agents. The most common copathogen was S. aureus, probably secondary to the presence of skin and soft tissue infection, with the background of surgical procedures and invasive diagnostic maneuvers. Vaccines have proven to be of some benefit in herds where the disease is endemic. Are you familiar with how to spot less-obvious symptoms, treat, and prevent its spread? Investigations by others into “wool sorter's disease,” now referred to as anthrax, used rabbits, suckling pigs, guinea pigs, as well as dogs, to establish a transmissible, bacterial agent as the cause of the disease. The bacteria are primarily transmitted through nose-to-nose contact with an infected horse, but horses can catch the illness by encountering something contaminated with the bacteria, such as a water bucket. Some cases are caused by unusual strains with an animal origin, such as strangles in horses (Streptococcus equi), mastitis in cows (Streptococcus zooepidemicus), and Streptococcus suis causing AGN in Asian butchers carving pork. Horses recovered from strangles or immunized with SePE I were seropositive and resistant to the pyrogenic effects of SePE I, suggesting a potential role for this toxin in strangles. Is this declining incidence just the consequence of better socioeconomic conditions? Practice Tip: Some forms of purpura hemorrhagica can result in acute and rapidly progressive immune-mediated myositis or infarctive lesions within the skeletal muscles (see Chapter 35, p. 615). For these reasons, it is important for the equine clinician to carefully consider vaccine risks and consult the ACVIM 2005 Consensus Statement to ensure that the risk for adverse events is minimized. Considering that on farms where strangles is endemic, foals often become infected around the time of weaning, at 4 to 8 months of age, it is difficult to protect them if vaccination is delayed until 9 months of age. Recently, there have been an increasing number of reports implicating GCS and GGS with severe invasive infections, such as necrotizing fasciitis and toxic shock syndrome (Oster and Bisno, 2000). equisimilis (3 speA alleles, 1 speC allele, 16 speG alleles, 1 speH allele, 3 speK alleles, 1 speL allele, and 1 speM allele), S. dysgalactiae subsp. Kalia and Bessen (2003) analyzed 34 genetically distinct group C/G streptococci and found the speA gene in three isolates and speC in one isolate. Parasitism is also a major health concern for horses worldwide. Scott W. Sinner, Allan R. Tunkel, in Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition), 2015, Group C streptococci are rarely isolated from blood cultures, accounting for fewer than 1% of all bacteremias.131,132 However, in patients with group C streptococcal infections, bacteremia is frequently detected. Retropharyngeal enlargement from abscesses may lead to compression of the pharynx and subsequent respiratory stridor and dysphagia. is a highly contagious equine pathogen, which causes the important equine disease, Biochemistry of Glycoconjugate Glycans; Carbohydrate-Mediated Interactions, Bacterial superantigens and superantigen-like toxins, The Comprehensive Sourcebook of Bacterial Protein Toxins (Fourth Edition), Current Therapy In Oral and Maxillofacial Surgery. Adult horses receiving the killed vaccine should be vaccinated with an initial intramuscular series of three vaccinations at 4- to 6-week intervals, with booster vaccination at 6- to 12-month intervals based on risk assessment and manufacturer instructions. Studies from both the United States and Western Europe have documented a decline in poststreptococcal AGN during recent decades in urban areas, contrasting with a stable incidence in rural areas. Moreover, both toxins were pyrogenic for rabbits, but only SePE I was pyrogenic in ponies. Abscesses may rupture and discharge pus through a sinus to the skin surface or spread medially into guttural pouches, where residual pus dries and hardens to form chondroids (which serve as a nidus for live bacteria to persist in carrier animals). High standards of hygiene should also always be maintained to avoid indirect transmission between quarantined and resident horses. Furthermore, HA is not immunogenic since the polymer is a normal component of the vertebrate host body. We use cookies to help provide and enhance our service and tailor content and ads. In severely starved horses, owners should consider feeding small meals of a high-quality forages such as alfalfa hay and withholding any highly soluble carbohydrates such as grain or sweet grain concentrates to minimize the “refeeding syndrome” (Witham and Stull, 1998). It usually subsides on its own. For the common horse, donkey, or mule owner, however, general health management should include proper vaccinations, hoof trimming, parasite control, and care of teeth. Prevention through quarantining and screening is further complicated where frequent moving and mixing of horses occur during the breeding season and at racetracks and where strangles outbreaks have not been appropriately investigated and controlled. For example, speGdys would be named speG11 and sdm would become speM6. In some areas insect control is extremely important! The intranasal vaccine has been administered to foals as young as 5 or 6 weeks of age during outbreaks. Over time, animals came to be seen as important tools in efforts to more clearly understand diseases affecting man. Once finished with cleaning the infected horse, Dr. Gruntman recommends changing all clothes, including shoes, so that bacteria aren’t spread around. In another review of 56 cases of group G streptococcal bacteremia from 11 hospitals in northeastern Ohio,96 polymicrobial infection, including bacteremia, was an important feature. PCR has greater diagnostic sensitivity compared with bacterial culture and may detect SeM DNA for weeks in guttural pouch lavages after the disappearance of live organisms.236 Upper airway endoscopy has become commonplace in field settings and may provide superior diagnostic capability for examination and sample collection, particularly when the goal is to identify carrier animals.220 It is useful in detecting asymptomatic carriers, in establishing S. equi infection status before or after transport or commingling, and in establishing success of treatment.223, Screening of horses suspected to be suffering from complications of S. equi infection includes serologic assessment of the SeM-specific antibody. The prevalence remains high in the countries of Mediterranean Africa, which have a dry climate but a low per capita income. The amount of clinically detectable discharge may be a reflection of the individual's immunity against the organism. Such precautions will aid in avoiding inadvertent intramuscular injection of live bacterial organisms. The bacterial MLV is generally preferred over inactivated injectable vaccines for primary vaccination of foals and weanlings and for routine use in older horses that are at high risk for infection. Similar findings were noted in a review of 45 cases of S. equi subsp.

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