title: Investigation of an outbreak of encephalomyelitis caused by West Nile virus in 136 horses.
abstract: OBJECTIVE
  To describe an outbreak of encephalomyelitis caused by West Nile virus (WNV) in horses in northern Indiana.
  
  
  METHODS
  Case series.
  
  
  METHODS
  170 horses.
  
  
  METHODS
  Horses with clinical signs suggestive of encephalomyelitis caused by WNV were examined. Date, age, sex, breed, and survival status were recorded. Serum samples were tested for anti-WNV antibodies, and virus isolation was attempted from samples of brain tissue. Climate data from local weather recording stations were collected. An epidemic curve was constructed, and case fatality rate was calculated.
  
  
  RESULTS
  The most common clinical signs were ataxia, hind limb paresis, and muscle tremors and fasciculations. Eight horses had been vaccinated against WNV from 2 to 21 days prior to the appearance of clinical signs. West Nile virus was isolated from brain tissue of 2 nonvaccinated horses, and anti-WNV IgM antibodies were detected in 132 nonvaccinated horses; in 2 other nonvaccinated horses, anti-WNV antibodies were detected and WNV was also isolated from brain tissue. Thirty-one (22.8%) horses died or were euthanatized. The peak of the outbreak occurred on September 6, 2002. Ambient temperatures were significantly lower after the peak of the outbreak, compared with prior to the peak.
  
  
  CONCLUSIONS
  The peak risk period for encephalomyelitis caused by WNV in northern Indiana was mid-August to mid-September. Reduction in cases coincided with decreasing ambient temperatures. Because of a substantial case fatality rate, owners of horses in northern Indiana should have their horses fully protected by vaccination against WNV before June. In other regions of the United States with a defined mosquito breeding season, vaccination of previously nonvaccinated horses should commence at least 4 months before the anticipated peak in seasonal mosquito numbers, and for previously vaccinated horses, vaccine should be administered no later than 2 months before this time.
authors.affiliation: Department of Veterinary Pathobiology, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907-2027, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Ward
authors.forename: Michel
authors.initials: M
authors.lastname: Levy
authors.forename: H Leon
authors.initials: HL
authors.lastname: Thacker
authors.forename: Marianne
authors.initials: M
authors.lastname: Ash
authors.forename: Sandra K L
authors.initials: SK
authors.lastname: Norman
authors.forename: George E
authors.initials: GE
authors.lastname: Moore
authors.forename: Paul W
authors.initials: PW
authors.lastname: Webb
mesh_terms: D000818:Animals; D000914:Antibodies, Viral / Q000097:blood*; D001921:Brain / Q000821:virology; D004196:Disease Outbreaks / Q000662:veterinary*; D005260:Female; D006734:Horse Diseases / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D006736:Horses; D007074:Immunoglobulin G / Q000097:blood; D007196:Indiana / Q000453:epidemiology; D008297:Male; D012621:Seasons; D016019:Survival Analysis; D013696:Temperature; D014611:Vaccination / Q000662:veterinary; D014765:Viral Vaccines / Q000008:administration & dosage; D014901:West Nile Fever / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control / Q000662:veterinary*; D014902:West Nile virus / Q000276:immunology* / Q000302:isolation & purification
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D014765:Viral Vaccines