Infectious Disease and Quarantine Communication

Use these five tips to communicate information about infectious diseases or quarantines while protecting client confidentiality and limiting disease spread. This article is brought to you by Boehringer Ingelheim.
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Communicating facts about an infectious disease and the steps to treat sick horses and prevent disease spread can be challenging.

No equine facility wants the stigma that often accompanies the discovery of infectious disease outbreak on the premises. The fear of losing business or having a tarnished reputation often discourages open communication.

This article is brought to you by Boehringer Ingelheim.

At large barns where multiple veterinarians serve different clients, some health care providers might not even know there is an active infection at the stable, according to Nicola Pusterla, DVM, PhD, DACVIM, DAVDC-Equine, a professor of medicine and epidemiology at the University of California, Davis, School of Veterinary Medicine.

In some segments of the industry, there are unspoken rules where veterinarians do not talk about health issues observed at other farms. Kentucky Department of Agriculture State Veterinarian Robert C. Stout, DVM, highlighted this problem when discussing the 2001 mare reproductive loss syndrome (MLRS). Although MRLS was not an infectious disease, the lack of communication made it difficult to identify a trend that had a significant impact on the industry.

“The first time we heard about the increased rate of abortions was in May 2001,” he said. “By that time, it had been going on for two to three months, but no one was seeing the bigger picture.”

Sometimes the owner of a single horse takes for granted the impact that just one sick horse can have on others it comes in contact with.

“Even if a person owns one horse, they have to think of horses as herd animals, and everyone in the barn has to get on the same page to help prevent further spread,” said Laura H. Javsicas, VMD, DACVIM, a veterinarian at Rhinebeck Equine LLP.

Controlling the spread of an infectious disease is a group effort that includes the barn manager, stable help, horse owners and veterinarians. Communicating facts about the disease and the steps to treat sick horses and prevent disease spread can be challenging.

“It can be difficult sometimes when there are a lot of people involved,” Pusterla said. “The issue arises when people don’t take ownership.”

Best practices for biosecurity are readily available and effective, but protocols for communication can be murky and constrained by client confidentiality. Ultimately, horse health for the greater good is the most important focus. 

In the article that follows, Javsicas, Pusterla and Stout offer five tips for communicating with clients about a quarantine while also protecting client confidentiality.

1. Be informed. Knowing which infectious diseases have been detected within your geographic area or at major industry events your clients are likely to attend provides the opportunity for mitigating risk to healthy horses. The Equine Disease Communication Center is one resource that provides timely information about disease outbreaks.

“Most of the state veterinary offices also send out an e-blast to all veterinarians that includes which diseases have been reported,” Javsicas said. “It varies by state as to which diseases they will do that for.”

Knowing the active diseases that might impact your clients provides an opportunity to remind horse owners or caretakers about the importance of staying up-to-date on vaccinations.

“If you know about a reported outbreak of strangles in your area, you can inform clients about the importance of vaccines and review biosecurity basics for reducing risk to educate horse owners about limiting risk to their horse,” Pusterla said.

Not every disease that is reportable is actionable, Stout explained. When a state veterinary office is contacted about a disease outbreak, an investigation is started. The magnitude of the disease and the management practices are considered before a quarantine is instituted.

“At my office, equine herpesvirus is an actionable disease,” he said. “Equine influenza is reportable, and it is something we observe; but it does not necessarily lead to a quarantine.”

Each state has its own laws regarding how and when to report a disease. Following those guidelines is legally required. However, working with the veterinarian on situations that fall outside the law is helpful for providing critical data on early health concerns that have the potential to become larger issues. “Vets are our eyes and ears out in the state,” Stout said. “We depend on them to tell us when they are observing something.”

2. Exercise caution in publicity. The ultimate goal is to contain the spread of infectious diseases. That includes reducing the risk for horses moving into and out of an affected facility for lessons, training or competition. There are tools that a veterinarian can use to inform clients about active diseases and promote biosecurity practices. For example, including information in an e-newsletter or on social media can inform local horse owners. However, there are client confidentiality considerations to take into account. Giving specific details that identify the specific affected barn is not permissible. However, there are ways to bring attention to an issue in broader terms.

“Look at how things are being reported through resources like the Equine Disease Communication Center,” Pusterla suggested. “The alerts include information about the pathogen and the activity within a certain area without pinpointing a specific town or barn.”

Routine visits can be a good time to remind clients about vaccinations and biosecurity best practices. It is appropriate for veterinarians to tell clients that “we’re experiencing a greater frequency of flu,” for example.

“Then educate the lay person on the signs they need to watch for, and encourage them to take proper precautions to reduce the risk of infection,” Pusterla said.

3. Identify a point person. When an infectious disease has been diagnosed, disseminating timely, factual information is critical. In large facilities that involve multiple stakeholders, it’s imperative that one person be appointed as a designated point person in charge of communicating updates. Pusterla emphasized that this should be the barn owner or manager and not the veterinarian.

“Clients often think it’s the veterinarian’s responsibility to communicate the disease and action for control, but it’s really the barn manager or stable owner,” he said. “In larger facilities that have more than one veterinarian serving clients, it’s really up to the stable owner to communicate the message.”

Asking the state veterinarian to take the lead can be helpful. These neutral third parties can dispense information and protocols without having a personal investment in the situation.

Most disease communication is focused on the barn manager and horse owner. However, veterinarians working at practices with other staff should also have a procedure in place for sharing information with colleagues. Having one person who takes the lead on providing updates can be helpful.

4. Nurture relationships. Competition between practices is an inherent part of veterinary business. When it comes to infectious diseases, however, it’s necessary to work with other practices treating horses in the same facility. Open communication regarding diagnosis, treatment and biosecurity protocols ensures that all efforts are supporting the desired outcome.

“If I know another vet working in the same barn, I will let them know as much as I can about what is going on, while maintaining confidentiality, so that we are on the same page,” Javsicas said.

Developing open lines of communication extends beyond veterinarians to all health care professionals, such as farriers, chiropractors and others coming in and out of facilities. “The owner of an unaffected horse may be boarding at a facility with an outbreak,” Pusterla said. “A farrier who comes to shoe a healthy horse needs to be aware of the situation to reduce the risk of becoming a source of spreading the pathogen.”

5. Visit the affected site. Stopping the spread of an infectious disease is the number one goal. A phone call is a good starting point for discussing biosecurity practices when a disease has been identified, but there is no substitute for observing a barn’s routine. When Javsicas learns of an infectious disease at a client’s barn, she prefers to visit the barn before making a plan of action. This gives her the opportunity to physically observe the daily routines and flow of horses and people in the barn, and allows for modifications that might not be considered via a phone conversation.

“I try to find ways to prevent the spread by seeing the barn’s routine,” she said. “For example, if a barn uses a hose to fill each water pail and there’s been an outbreak of strangles, dipping the hose end into each pail can inadvertently spread the disease. Same thing with barns that stack feed buckets on top of one another. Each horse is eating out of his own tub, but when the bucket goes into the stall, it could pick up pathogens and transmit them to another stall when stacked on top of each other. Those are things you just can’t discover through a phone call.”

It’s everyone’s inclination to move a horse once it is learned that one horse in the barn is sick with an infectious disease. Encouraging horse owners to stay put until it’s determined whether that animal has been exposed is critical to halting the spread of disease.

“Even a horse that appears healthy can potentially take that infectious disease elsewhere, whether it’s a secondary barn on the same property or a different facility altogether,” Javsicas said. “Keeping horses where they are until the appropriate testing is done is important.” 

This article is brought to you by Boehringer Ingelheim.

Disease Reporting Resources 

State rules and regulations specify which diseases must be reported. State veterinarians review each situation and determine a plan of action to control the spread of the disease. There are several options you can use to stay informed of disease outbreaks in your area or around the country.

Equine Disease Communications Center http://www.equinediseasecc.org

American Association of Equine Practitioners Biosecurity https://aaep.org/news/updated-biosecurity-guidelines-available-aaep-website

World Animal Health OIE List http://www.oie.int/animal-health-in-the-world/oie-listed-diseases-2019 

This article is brought to you by Boehringer Ingelheim.

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