9/27/2022:  From 2021 onwards, the basic health monitor conducted by GD as a statutory task, has been supplemented with the equine animal group, following the introduction of the European Animal Health Regulation. What is the importance of this health monitor? And what form does this relatively new cooperation take? We asked two people involved from Utrecht University’s Faculty of Veterinary Medicine and the Ministry of Agriculture, Nature and Food Quality.

We are able to react quickly thanks to the monitoring structure

Henk Lommers: equine chain manager, board for Animal Agricultural Chains and Animal Welfare, of the Ministry of Agriculture, Nature and Food Quality

Henk Lommers: “The roots of the equine health monitor lie in a 2013 covenant between the Ministry of Agriculture, Nature and Food Quality and the Equine Sectoral Committee. Two compulsory notification diseases were actively monitored over a period of three years: the West Nile virus and infectious anaemia. The Equine Help Desk was also established, as was the sectoral health consultation organisation. In the end, there were no indications for the presence of the two monitored diseases in the Netherlands during that three-year period. The Equine Help Desk did however prove to be particularly useful in the meantime, as it was good to be able to gauge the equine world. This active equine monitoring was then discontinued. We still monitor the West Nile virus via birds and there is the possibility of submitting voluntary samples for West Nile virus testing. A three-year study is currently underway, subsidised by the Ministry of Health, Welfare and Sport, in which GD tests blood samples taken from horses with neurological clinical signs, for antibodies to the West Nile virus.

Quick detection essential

Since the introduction of the European Animal Health Regulation last year, the equine sector has been added to the broader animal health monitoring system. One of the requirements of the new legislation is that European member states are prepared to monitor so-called emerging diseases. This may be a result of climate change for example, which causes migration of diseases to Europe, which were previously only found elsewhere in the world. Large-scale human migration flows from other parts of the world can also cause spread of infectious diseases previously unknown to the Netherlands. That is why our structure for rapid detection is so important. Veterinarians can report any cases in their practice and region to the Equine Help Desk. This may concern diseases in which the government has no direct involvement, but which may be problematic for horse owners and can often cause regional issues: rhinopneunomia (EHV-1 and -4) and strangles.

Equine Help Desk provides important input

The Equine Help Desk provides important input. There are also regular health consultations for the equine sector, involving GD, the Faculty of Veterinary Medicine, the Netherlands Food and Consumer Product Safety Authority (NVWA), the Royal Netherlands Veterinary Society (KNMvD), the Dutch National Institute for Public Health and the Environment (RIVM), Wageningen Bioveterinary Research and the Ministry of Agriculture, Nature and Food Quality. Specialised equine veterinarians also participate. The current monitoring system ensures that everyone knows each other and that communication lines are kept short. This lowers the threshold for approaching each other when required by the situation. The information from the Equine Help Desk serves as important input for the animal health consultations. Together, we formulate a risk analysis of the notifications, even if they concern non-compulsory notification diseases such as rhinopneunomia or strangles. GD can be requested to identify which virus strains are involved in a rhino outbreak, for example. As a ministry, it is extremely important that we know what is going on. We are then able to take quick action and communicate proactively, for example when an outbreak is published in the press. If there is an outbreak of a compulsory treatment disease, for example African Horse Sickness, we have to adhere to European legislation and have primary responsibility as a ministry, together with the NVWA.

Charting and sharing risks

Unfortunately, in the equine world, outbreaks are not always reported to the official bodies and to the surrounding area. In addition, strangles and rhinopneumonia are not compulsory reportable. It is therefore very useful that the veterinarian in question calls the Equine Help Desk. If a number of veterinarians report the same issue, it becomes clear that it is a regional problem. Anonymous notifications are therefore equally important. It is all about charting risks and being able to advise the sector. Such advice may be to ‘lock down’ certain stables to prevent spread of the disease. Veterinarians can also be warned within a certain region. If we believe that such action should be taken, that is generally done via the Equine Sectoral Committee.”

It is all about short lines of communication, cooperation and monitoring of what you see in practice

Robin van den Boom: Associate Professor, Utrecht University

Robin van den Boom: “The Equine Help Desk is jointly staffed by the Faculty of Veterinary Medicine and GD, each for a number of days per week. We communicate the findings to each other and combine all the information. We also contact each other whenever necessary. We meet up once or twice a year, and the NVWA also attends, among other bodies. This allows us to jointly keep an overview, even if it is less formal than in the case of farm animals. It is all about short lines of communication, frequent direct cooperation and monitoring of what you see in practice. We often also make interim comparisons, to check whether we share the same impression, for example in the case of an unusually high number of notifications of a disease. This gives us a much more complete picture, and quicker awareness of any issues.

Notifications provide clarity

It is good to get an understanding of how often certain infectious diseases occur in horses in the Netherlands, and where they occur. There are a number of compulsory notification diseases, including glanders (malleus), infectious anaemia, West Nile virus and a number of types of meningitis. However, there is no compulsory notification for most of the diseases for which we receive notifications in horses. These are mainly strangles or rhinopneumonia. The help desk can sometimes discover certain new symptoms. Luckily it is extremely unusual for people to become infected due to equine diseases. We have seen occasional cases in which the person treating the horse became ill. There is clearly less transmission between humans and equines than there is in other sectors.

Low threshold notification

The monitoring is of course intended to detect emerging (compulsory notification) diseases. These are mainly diseases that do not occur in the EU, and that we wish to keep at bay. The West Nile virus was detected in people, birds and mosquitoes in the Netherlands back in 2020, but not yet in horses. However, it would only seem to be a question of time, and we therefore wish to be able to immediately detect it. We aim to keep any other compulsory notification infections outside the EU. The monitoring system also gives us the opportunity to keep a closer eye on diseases not found on the list. In the past, there was very little insight into cases of strangles and rhinopneumonia, and we were only aware of the cases in which we were personally involved. Information is now shared and there is close contact between ourselves, the treating veterinarians and GD. We now have much more information, thanks to the SEIN information network, which also allows for anonymous notification using the first two digits of the postal code. SEIN has been active for horse owners since 2019. This provides a very effective overview, giving us much better insight into the location of infections in the Netherlands. Luckily a reasonably large share of the diseased horses are reported, giving us a much better overall picture than before. This is partially due to the low-threshold notification system: veterinarians receive advice and we receive the signal. Thanks to the monitoring, we are more likely to think of a certain infection in some patients, therefore also allowing us to more quickly advise our colleagues to exercise caution or use certain tests.

Further research

Moreover, the monitoring results in interesting research questions. In the future, GD and the Faculty of Veterinary Medicine would like to undertake joint research into signals received from the monitoring process. What are the trends? Why is a certain infection more prevalent in one year versus another year? And how will this affect the equine sector and trade? It all starts with effective charting of the exact situation.”