title: Prevention of equine herpesvirus myeloencephalopathy - Is heparin a novel option? A case report.
abstract: Equine herpesvirus myeloencephalopathy (EHM) is a severe manifestation of equine herpesvirus 1 (EHV-1) infection. Prevention and treatment of EHM during EHV-1 outbreaks is critical, but no reliable and tested specific medication is available. Due to the thromboischemic nature of EHM and due to the fact that EHV-1 entry in cells is blocked by heparin, it was hypothesized that this compound may be useful in reduction of EHM incidence and severity. Therefore, during an acute EHV-1 outbreak with the neuropathogenic G2254/D752Pol variant, metaphylactic treatment with heparin to prevent EHM was initiated. Clinical signs were present in 61 horses (fever n = 55; EHM n = 8; abortion n = 6). Heparin (25000 IU subcutaneously twice daily for 3 days) was given to 31 febrile horses from day 10 of the outbreak, while the first 30 horses exhibiting fever remained untreated. Treatment outcome was analyzed retrospectively. Heparin-treated horses showed a lower EHM incidence (1/31; 3.2%) than untreated horses (7/30; 23.3%; p = 0.03). Results indicate that heparin may be useful for prevention of EHM during an EHV-1 outbreak. These promising data highlight the need for randomized and possibly blinded studies for the use of heparin in EHV-1 outbreaks.
authors.affiliation: Dr. Jasmin Walter, Klinik für Reproduktionsmedizin, Vetsuisse-Fakultät der Universität Zürich, Winterthurerstrasse 260, 8057 Zürich, Schweiz, E-Mail: jwalter@vetclinics.uzh.ch.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Walter
authors.forename: Christoph
authors.initials: C
authors.lastname: Seeh
authors.forename: Kerstin
authors.initials: K
authors.lastname: Fey
authors.forename: Ulrich
authors.initials: U
authors.lastname: Bleul
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Osterrieder
mesh_terms: D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use*; D004196:Disease Outbreaks / Q000517:prevention & control / Q000662:veterinary*; D006493:Heparin / Q000627:therapeutic use*; D006566:Herpesviridae Infections / Q000188:drug therapy / Q000517:prevention & control / Q000662:veterinary*; D004861:Herpesvirus 1, Equid; D006734:Horse Diseases / Q000188:drug therapy / Q000517:prevention & control* / Q000821:virology; D006736:Horses; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D006493:Heparin
keywords: EHV-1; Equine herpesvirus type 1; metaphylaxis; neuropathogenicity; therapy