OUTBREAK!
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What you need to know about the Canine Influenza Virus!
By Peri Norman
We have seen it on the evening news, read about it on Facebook and talked about it with our friends. Sorting out the “real” information about the Canine Influenza outbreak and being well-informed is the first step toward effective stewardship of the health of our treasured companions.
Rule number one is the first source of information needs to be your trusted veterinarian. The current outbreak of Canine Influenza Virus (CIV) in the Chicago area is a very fluid situation. Your vet is on the front line of receiving information and translating it into a useful protocol for your individual situation. Since I am planning to attend two nationals in the month of May with all my dogs in tow, I emailed one of my most trusted veterinarians on April 9th about her thoughts on vaccinating my dogs. On April the 12th I received a response regarding my particular dogs, a general paper on Canine Influenza and updated information on the outbreak in Chicago, the most recent of which was dated that same day. If your vet responds with phrases like, “Well, I don’t really know much about it. We have not seen that here. I would not worry about it. ” you need to think carefully about whom you trust to advise you about your dog’s care and health.
The current Canine Influenza Virus outbreak is a complicated situation. The first cases of CIV were reported in the US in Florida in 2004. This outbreak was caused by strain of virus identified as H3N8. This strain of influenza virus was believed to have mutated from an equine version of a similar strain. Cases of H3N8 have been reported in much of the United States as this virus continues to spread. The current outbreak in Chicago was originally thought to be H3N8, but testing at Cornell and the University of Wisconsin determined that this particular outbreak is actually caused by a “new to the US” strain identified as H3N2. This is a strain of CIV found in South Korea and southern China, but how that particular strain of the virus arrived in the US has not been determined.
We do know that Merck Animal Health has sponsored a testing program for Chicago area veterinarians. “Testing has been taking place at the Cornell Veterinary Diagnostic Laboratory. Around 250 samples have been finalized (between March 16 and April 7, 2015), of these 138 dogs tested positive for Canine Influenza.”
So how did we get from 138 dogs testing positive for Canine Influenza Virus to the evening news reporting a thousand cases of doggie flu and, more importantly, what is the “real” risk to our dogs. First we need to know the following, “Dr. Donna Alexander, Director of Cook County Department of Animal and Rabies Control, is working closely with the Chicago Veterinary Medical Association. Based upon the preliminary data from Chicago area veterinarians that has been reviewed and compiled by her through March 31, 2015, Dr. Alexander has stated:
“The summary of those hospitals that reported through the CVMA to our offices and those who reported directly to this office indicates that 73% of those responding note an increase in CIRD. For those that supplied exact number of animals, we can report that there have been 1,013 cases of CIRD since January and 5 mortalities. The age of the animals presenting vary but show more severe forms in dogs under 1 year of age and greater than 7 years of age. Few veterinarians are submitting diagnostic specimens for evaluation. Of those submitted for PCR or other testing, the majority came back negative, some are still pending. Of those reporting positive, 93% are positive for Canine Influenza.”
We have a lot of acronyms going on here and they all begin with C.
CIV = Canine Influenza Virus (strain not identified)
CIRD = Canine Infectious Respiratory Disease
CVMA = Chicago Veterinary Medical Association
Whether they were genuinely confused, or the news reports were deliberately sensationalized, somewhere along the way, over a thousand cases of Canine Infectious Respiratory Disease became thousands of cases of Canine Influenza. Remember that Canine Infectious Respiratory Disease includes many viruses for which we already vaccinate. We also have to remember that the vast majority of cases are NOT tested at any laboratory. It is a hassle and it is an additional expense. So unless either the veterinarian or the owner are particularly concerned by the severity of the symptoms or slow/lack of response to therapy, testing probably didn’t happen.
Much like in humans, respiratory tract infections can be caused by numerous different organisms. The tricky part is that just like in humans, that initial moment of “Ugh, I feel sick” might be followed by a day or two of stuffy nose, or a weeklong cold with a cough that seemingly never ends or one of those bouts of the flu that lands the healthiest of individuals in bed for a couple of weeks. To that end, the Illinois State Veterinary Medical Association notes the following, “This is a highly contagious virus, with symptoms which can mimic other, more benign respiratory infections.” Research is ongoing, but it seems that some of the challenges with this particular strain of Canine Influenza Virus include the contagious nature of the virus, and severe and rapidly progressing symptoms. Rapid onset has been reported in as little as 4-6 hours after exposure! So far, in another parallel to human influenza outbreaks, affected but otherwise healthy adult dogs that are treated seem to recover. It is the young, old and immune-compromised animals that are likely mortalities.
Another area of confusion is vaccinations. There are two companies that make a Canine Influenza vaccine for H3N8, but because H3N2 is brand new, there is no vaccine. All the information currently available through the testing programs at Cornell and the University of Wisconsin indicate that none of the dogs confirmed with H3N2 were vaccinated for H3N8. Even the Merck website admits that no one has any information about whether the H3N8 vaccine will have any effect on the H3N2 virus. Veterinarians seem to be split on vaccinating for H3N8 in the face of H3N2. Those in favor of full vaccination for all Canine Infectious Respiratory Diseases indicate that it might help. We know that in humans, if the strains in the vaccine are not an exact match, they still may help mitigate symptoms, and of course, they are strongly preventative for the included strains. Other veterinarians are recommending a more circumspect approach to the Canine Influenza Vaccine. The risk of exposure, unless your dogs are out and about in the communities with a diagnosed case, is actually quite small… so far. The current H3N8 vaccine requires an initial vaccine and a booster in two weeks. So if you were thinking you were going to vaccinate your dogs today before the show this weekend, you may need to re-evaluate. Vaccinating dogs who may have already been exposed is problematic because if they are asymptomatic but already incubating any Canine Infectious Respiratory disease, their immune systems are already under attack. The trays of H3N8 vaccine come in fairly large numbers and I understand they run about $300 a tray. If a vet is not doing a brisk business in influenza vaccines, the cost may be significant. Lastly, we come back to that common concern of over-vaccinating. Balancing the risk of exposure against concern about over-vaccination, particularly in the face of the fact that we have no idea if the H3N8 vaccine will have any effect on the H3N2 strain, is a complicated and scary concept.
As previously stated, the current Canine Influenza Virus outbreak in the greater Chicago area is a new strain of CIV. Right now, there are more questions than answers, but as responsible stewards for the health of our dogs, we need to focus on the things we can and should do.
1. Have a serious talk with your veterinarian. Be sure to discuss not only the possibility of using the H3N8 vaccine, but also any other appropriate vaccine to prevent or mitigate diseases of the canine respiratory tract.
2. Be extra vigilant about washing hands after touching/working with other dogs and keep all the dog stuff (bowls, buckets, pens, crates and bedding) as clean as possible.
3. Avoid exposure to infected animals. People in the greater Chicago area are being advised to avoid dog parks, dog beaches, groomers, doggie day care and kennels.
4. Educate yourself regarding risk factors and prevention strategies for your area and your unique situation. Here is a list of websites likely to have current and accurate information about the H3N2 outbreak:
Cornell Animal Health Diagnostic Center
https://ahdc.vet.cornell.edu/news/civchicago.cfm
Chicago Veterinary Medical Association
http://www.chicagovma.org/canine-infectious-respiratory-disease-strikes-chicago-metropolitan-area/
Illinois Veterinary Medical Association
http://www.isvma.org/
Center for Disease Control and Prevention
http://www.cdc.gov/flu/news/canine-influenza-update.htm
American Veterinary Medical Association
https://www.avma.org/KB/Resources/FAQs/Pages/Control-of-Canine-Influenza-in-Dogs.aspx
Until further notice, RUN, don’t walk to your veterinarian at the first sign of any “kennel cough-like” symptoms.
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