I was lucky to be able to interview Rob Boswell DVM of the Palm Beach Equine Clinic as he was preparing to re-open his vet clinic in Wellington, Florida today. The clinic has been affected by a long voluntary quarantine since December 15.
Now that things have settled down a bit, and no horses have been diagnosed outside the quarantine area (several barns are still under quarantine), there is time to reflect on the outbreak and how it was handled and reported.
When I first heard about the outbreak, I had just stepped off the plane from Palm Beach, where I had coincidentally spent a day in a meeting with Dr. Boswell. He had no idea that a sick horse at his clinic had EHV-1. He wouldn't have been chatting with me if that had been the case.
When I heard the news, I wanted to turn around and be there, on the front lines, so that I could experience the horsiest hamlet in the USA going into prevention mode. I was sure that it would only be one horse, or maybe two, that would be directly affected, but that we could all learn about how a disease is headed off at the pass. Then I thought, "Silly, it will be over before you can get there."
Now it's almost three weeks later, and a lot of people's lives have been turned upside down. They say the outbreak itself is over, but the quarantines go on. And horses are arriving to begin the show season.
As it turned out, I never went back to Wellington, and had to depend on the local press, the state of Florida, the Florida Association of Equine Practitioners, and whoever I could reach by phone to report from the scene. Sandy Johnson was terrific as my remote eyes and ears, describing what she saw and heard and touched and, most of all, felt. She reported that some farms slammed their gates, while some people ventured out and sought advice and expert opinions. But it is obvious that advice was in short supply and the horse world rumor mill was at an all-time high.
At stake were the reputations of horsemen, veterinarians, state officials, federal officials. Also at stake of course, were the lives of horses.
Since I couldn't report in the first person on these stories, I provided links to stories from the local press in South Florida. Many of these articles may have implied that Palm Beach Equine Clinic was the source of the virus, but a more careful reading of each of these articles should disclose that the source was a group of horses that arrived in Wellington from the import station in New York. These horses arrived and were stabled in Wellington for several days. One of these horses went to Palm Beach Equine on December 2, and was discharged on December 3. The horse did not contract the disease at the clinic; it was sick on admission.
According to Dr. Boswell, his clinic was not informed that the horse that had been in the clinic had EHV for quite some time.
At the heart of this problem is that, according to Dr. Boswell, in the state of Florida, EHV is not a "reportable" disease in the eyes of state government health officials. It is "reportable" in New York, New Jersey and some other states. For public health reasons, some diseases are listed so that veterinarians must report any cases to state officials, but this list varies from state to state.
While the people in Wellington, Florida associated with the sick horses may have discovered the cause of the illness, they had no mandate to report it. The "gray areas" surrounding this virus--which horses actually "test" positive for the disease, when and how horses show symptoms, and how the disease is transmitted--make this a tangled web for public health enforcement. Add in the high mobility of race and show and polo horses in the USA, and you have a recipe for outbreaks that can occur anytime the tipping point is reached.
The question harkens back to the old Watergate hearing days: "What did you know and when did you know it?"
In my conversations with horse owners here, I find that few if any really know what EHV is and most believed that their vaccinations would protect their horses. After a brief scare at nearby Fairfield Equine Clinic last week, many started to ask me for resources to more information on the disease. I have not spoken to one owner who understood that a new strain of EHV causes neurological symptoms.
A meeting will be held on Thursday in Wellington so that community members and the media can hear comments on how the outbreak was handled and how the ongoing quarantines and prevention methods might be handled. The comments will be from Doug Byars DVM of Lexington, Kentucky, an expert on infectious diseases and internal medicine. Dr. Byars' opinions are being sought by two leading area veterinarians, John Steele DVM and Ben Schacter DVM, because they respect his opinion and they want to know what is in the best interest of their clients and the horses in their care.
We should all be listening closely to Thursday's meeting. I hope someone tape records it and posts it online as a podcast.
What if it happened in your community, at a show where your horse was stabled, or in your very own barn? Is EHV a reportable disease in your state? Do you know how to find out?
It can happen anywhere. The fact that it has happened recently at a college (Findlay University in Ohio), and at racetracks may make it seem like a remote possibility for your barn.
Ask anyone in Wellington, Florida and they will likely raise an eyebrow and smirk, "Think again."
Background article for horse owners on Equine Herpes Virus and, in particular, EHV-1, from the American Association of Equine Practitioners