INFECTIOUS DISEASE 2015 Symposium Proceedings
The opinions expressed in the articles in this publication are those of the authors and do not necessarily reflect the official label recommendations and points of view of the company or companies that manufacture and/ or market any of the pharmaceutical agents, products, or services mentioned. Published by Wilmington, Delaware 2015 ELEVATE DVM, Inc. All rights reserved. Printed in the United States.
CONTENTS ABOUT THE SPEAKERS 2 INFECTIOUS DISEASE: A WHODUNIT APPROACH TO DIAGNOSIS AND TREATMENT 5 Jane Sykes, BVSc(Hons), PhD, DACVIM (SAIM), and Leah A. Cohn, DVM, PhD, DACVIM (SAIM) CANINE INFECTIOUS RESPIRATORY DISEASE COMPLEX: UPDATE ON NOVEL AND EMERGING PATHOGENS 27 Stephan A. Carey, DVM, PhD, DACVIM (SAIM) HOTSPOTS OF LEPTOSPIROSIS IN THE UNITED STATES: HISTORIC, CURRENT, AND FUTURE SPATIAL DYNAMICS 45 William Karesh, DVM (Presenting at NAVC) Peter Daszak, PhD (Presenting at WVC) Proceedings of a Symposium held at the 2015 North American Veterinary Conference and the 2015 Western Veterinary Conference ACCESS THE PROCEEDINGS ONLINE! You can also access this proceedings at www.elevatedvm.com/proceedings/2015-infectiousdisease-symposium. 1
ABOUT THE SPEAKERS Stephan A. Carey, DVM, PhD, DACVIM (SAIM) Dr. Stephan A. Carey is an Assistant Professor of Small Animal Internal Medicine at the Michigan State University College of Veterinary Medicine. Dr. Carey completed his undergraduate training in Biological Anthropology at Duke University, and obtained his Doctor of Veterinary Medicine from the University of Wisconsin-Madison in 2000. He completed a Small Animal Rotating Internship in 2000 2001, and residency in Small Animal Internal Medicine from 2001 2004, both at Michigan State University. He obtained his PhD in Comparative Medicine and Integrative Toxicology from Michigan State University in 2008. Dr. Carey s clinical interests include canine and feline upper and lower airway disease, infectious respiratory disease, and evaluation of the role of environmental exposures on companion animal airways. Leah A. Cohn, DVM, PhD, DACVIM (SAIM) Dr. Leah Cohn is currently a Professor of Veterinary Medicine at the University of Missouri s College of Veterinary Medicine. After earning her BS and DVM degrees from the University of Tennessee, Dr. Cohn completed a residency in Small Animal Internal Medicine at North Carolina State University. Dr. Cohn also earned a PhD degree from NCSU studying Veterinary Microbiology and Immunology and completed a post-doctoral fellowship in cell biology before joining the faculty at the University of Missouri. Dr. Cohn s clinical interests include infectious and immune-mediated diseases as well as respiratory medicine. She has authored more than 100 publications in refereed journals as well as many book chapters, and is the immediate past chairman of the Board of Regents of the American College of Veterinary Internal Medicine. 2
Peter Daszak, PhD Dr. Peter Daszak is President of EcoHealth Alliance, a US-based organization that conducts research and outreach programs on global health, conservation and international development. Dr. Daszak earned a PhD in Parasitology from the University of East London. His research has been instrumental in identifying and predicting the impact of emerging diseases across the globe. His achievements include identifying the first case of a species extinction due to disease, the discovery of the disease chytridiomycosis as the cause of global amphibian declines, identification of the bat origin of SARS, identifying the causes of Nipah and Hendra virus emergence, coining the term pathogen pollution, and producing the first ever global emerging disease hotspots map. Dr Daszak has authored over 150 scientific papers, and his work has been the focus of extensive media coverage, ranging from popular press articles to television appearances. William Karesh, DVM Dr. William Karesh is the Executive Vice President for Health and Policy for EcoHealth Alliance. A graduate of the University of Georgia s College of Veterinary Medicine, Dr, Karesh is recognized internationally as an authority on the subject of wildlife health. He serves as the president of the World Animal Health Organization (OIE) Working Group on Wildlife Diseases and also chairs the International Union for the Conservation of Nature (IUCN) Wildlife Health Specialist Group, a network of wildlife and health experts around the world. Currently, Dr. Karesh is the Technical Director for the USAID Emerging Pandemic Threats PREDICT program, a $75 million effort focused on predicting and preventing pandemic diseases. In addition to having published over 100 scientific papers, Dr. Karesh has written a book for general audiences called Appointment at the Ends of the World: Memoirs of a Wildlife Veterinarian. Jane Sykes, BVSc(Hons), PhD, DACVIM (SAIM) Dr. Jane Sykes is a Professor of Small Animal Medicine at UC Davis with a special interest in small animal infectious diseases. She has a clinical appointment in, and is the Director of Small Animal Clinical Services, at the UC Davis Veterinary Medical Teaching Hospital. She has coauthored more than 80 peer-reviewed publications and is the editor of the new textbook Canine and Feline Infectious Diseases. She co-founded the International Society of Companion Animal Infectious Diseases (ISCAID) and is currently President of the ACVIM Specialty of Small Animal Internal Medicine. Her research interests are focused on antimicrobial drug-resistant bacterial infections, hemotropic mycoplasma infections, tickborne infectious diseases, leptospirosis and deep mycoses, especially cryptococcosis. 2015 Infectious Disease Proceedings 3
4
Jane Sykes, BVSc(Hons), PhD, DACVIM (SAIM) Professor of Small Animal Medicine School of Veterinary Medicine University of California, Davis INFECTIOUS DISEASE: A WHODUNIT APPROACH TO DIAGNOSIS AND TREATMENT Leah A. Cohn, DVM, PhD, DACVIM (SAIM) Professor of Veterinary Medicine College of Veterinary Medicine University of Missouri Infectious diseases are commonly encountered in veterinary practice but diagnosis can be confounding and the initial treatment doesn t always produce the desired outcome. In this session, Dr. Sykes and Dr. Cohn share their process for working through a series of actual clinical infectious disease cases in dogs and cats from presentation through resolution. Starting with signalment, history, and clinical signs in eight cases, they will consider the possible differentials for the presenting problems and the decisions involved in selection of diagnostics and interpretation of test results. With the diagnosis in hand, Drs. Sykes and Cohn discuss step-by-step treatment recommendations for each case. Cases include a wide range of infectious diseases from the polyarthritic Boxer, the Labrador retriever in rental failure, the young cat with seizures, and a recently adopted coughing Shepherd cross, and more as well as the management of an outbreak of canine infectious respiratory disease (CIRD) complex at a municipal shelter. The zoonotic implications and current vaccination recommendations are also discussed for each of the diseases diagnosed in this session. 2015 Infectious Disease Proceedings 5
INFECTIOUS DISEASE: A WHODUNIT APPROACH TO DIAGNOSIS AND TREATMENT 6
Jane Sykes, BVSc(Hons), PhD, DACVIM (SAIM), and Leah A. Cohn, DVM, PhD, DACVIM (SAIM) 2015 Infectious Disease Proceedings 7
INFECTIOUS DISEASE: A WHODUNIT APPROACH TO DIAGNOSIS AND TREATMENT 8
Jane Sykes, BVSc(Hons), PhD, DACVIM (SAIM), and Leah A. Cohn, DVM, PhD, DACVIM (SAIM) 2015 Infectious Disease Proceedings 9
INFECTIOUS DISEASE: A WHODUNIT APPROACH TO DIAGNOSIS AND TREATMENT 10
Jane Sykes, BVSc(Hons), PhD, DACVIM (SAIM), and Leah A. Cohn, DVM, PhD, DACVIM (SAIM) 2015 Infectious Disease Proceedings 11
INFECTIOUS DISEASE: A WHODUNIT APPROACH TO DIAGNOSIS AND TREATMENT 12
Jane Sykes, BVSc(Hons), PhD, DACVIM (SAIM), and Leah A. Cohn, DVM, PhD, DACVIM (SAIM) 2015 Infectious Disease Proceedings 13
INFECTIOUS DISEASE: A WHODUNIT APPROACH TO DIAGNOSIS AND TREATMENT 14
Jane Sykes, BVSc(Hons), PhD, DACVIM (SAIM), and Leah A. Cohn, DVM, PhD, DACVIM (SAIM) 2015 Infectious Disease Proceedings 15
INFECTIOUS DISEASE: A WHODUNIT APPROACH TO DIAGNOSIS AND TREATMENT 16
Jane Sykes, BVSc(Hons), PhD, DACVIM (SAIM), and Leah A. Cohn, DVM, PhD, DACVIM (SAIM) 2015 Infectious Disease Proceedings 17
INFECTIOUS DISEASE: A WHODUNIT APPROACH TO DIAGNOSIS AND TREATMENT 18
Jane Sykes, BVSc(Hons), PhD, DACVIM (SAIM), and Leah A. Cohn, DVM, PhD, DACVIM (SAIM) 2015 Infectious Disease Proceedings 19
INFECTIOUS DISEASE: A WHODUNIT APPROACH TO DIAGNOSIS AND TREATMENT 20
Jane Sykes, BVSc(Hons), PhD, DACVIM (SAIM), and Leah A. Cohn, DVM, PhD, DACVIM (SAIM) 2015 Infectious Disease Proceedings 21
INFECTIOUS DISEASE: A WHODUNIT APPROACH TO DIAGNOSIS AND TREATMENT 22
Jane Sykes, BVSc(Hons), PhD, DACVIM (SAIM), and Leah A. Cohn, DVM, PhD, DACVIM (SAIM) 2015 Infectious Disease Proceedings 23
INFECTIOUS DISEASE: A WHODUNIT APPROACH TO DIAGNOSIS AND TREATMENT 24
Jane Sykes, BVSc(Hons), PhD, DACVIM (SAIM), and Leah A. Cohn, DVM, PhD, DACVIM (SAIM) 2015 Infectious Disease Proceedings 25
INFECTIOUS DISEASE: A WHODUNIT APPROACH TO DIAGNOSIS AND TREATMENT 26
Stephan A. Carey, DVM, PhD, DACVIM (SAIM) Assistant Professor of Small Animal Internal Medicine College of Veterinary Medicine Michigan State University CANINE INFECTIOUS RESPIRATORY DISEASE COMPLEX: UPDATE ON NOVEL AND EMERGING PATHOGENS Canine infectious respiratory disease (CIRD) is a multifactorial disease complex that can be caused by a variety of pathogens. In this session you ll learn how to develop effective strategies to treat and prevent CIRD by understanding the complex relationship between primary pathogens and the immune system. Colonization of the upper airway mucosa by primary respiratory pathogens is important in the pathogenesis of CIRD. In a susceptible host and a proper environment, the pathogens can bypass mechanical barriers and inhibit the innate immune response, allowing bacterial and viral pathogens to colonize the lower respiratory tract. In this session, Dr. Carey covers the current understanding of the known bacterial and viral pathogens, and an introduction to emerging pathogens, such as canine respiratory coronavirus, canine influenza virus, Mycoplasma cynos, Streptococcus equi subsp zooepidemicus, canine herpesvirus, and other pathogens potentially associated with CIRD. Dr. Carey discusses the prevention of CIRD, including the concept of prime-boost vaccination, as well as environmental management. The diagnosis and treatment of CIRD are demonstrated in a casebased approach. 2015 Infectious Disease Proceedings 27
CANINE INFECTIOUS RESPIRATORY DISEASE COMPLEX Stephan A. Carey, DVM, PhD, DACVIM (SAIM) 28
2015 Infectious Disease Proceedings 29
CANINE INFECTIOUS RESPIRATORY DISEASE COMPLEX Stephan A. Carey, DVM, PhD, DACVIM (SAIM) 30
2015 Infectious Disease Proceedings 31
CANINE INFECTIOUS RESPIRATORY DISEASE COMPLEX Stephan A. Carey, DVM, PhD, DACVIM (SAIM) 32
2015 Infectious Disease Proceedings 33
CANINE INFECTIOUS RESPIRATORY DISEASE COMPLEX Stephan A. Carey, DVM, PhD, DACVIM (SAIM) 34
2015 Infectious Disease Proceedings 35
CANINE INFECTIOUS RESPIRATORY DISEASE COMPLEX Stephan A. Carey, DVM, PhD, DACVIM (SAIM) 36
2015 Infectious Disease Proceedings 37
CANINE INFECTIOUS RESPIRATORY DISEASE COMPLEX Stephan A. Carey, DVM, PhD, DACVIM (SAIM) 38
2015 Infectious Disease Proceedings 39
CANINE INFECTIOUS RESPIRATORY DISEASE COMPLEX Stephan A. Carey, DVM, PhD, DACVIM (SAIM) 40
2015 Infectious Disease Proceedings 41
CANINE INFECTIOUS RESPIRATORY DISEASE COMPLEX Stephan A. Carey, DVM, PhD, DACVIM (SAIM) 42
2015 Infectious Disease Proceedings 43
44
William Karesh, DVM (Presenting at NAVC) Executive Vice President for Health and Policy EcoHealth Alliance New York, NY HOTSPOTS OF LEPTOSPIROSIS IN THE UNITED STATES: HISTORIC, CURRENT, AND FUTURE SPATIAL DYNAMICS Peter Daszak, PhD (Presenting at WVC) President EcoHealth Alliance New York, NY What is the true risk of leptospirosis in your area? Leptospira is an important emerging pathogen due to its increasing incidence in both developing and developed countries. Veterinarians practicing in geographic areas where leptospirosis may not have been diagnosed in the past will want to add leptospirosis to their list of differentials for dogs presenting with acute renal failure. Given the severity of the disease in dogs as well as its zoonotic risk, vaccination against leptospirosis may also now be prudent in areas where it was not considered necessary in the past. In this session, Dr. Karesh reports on a research study to identify the current leptospirosis outbreak hotspots in the continental United States as well as the environmental and socioeconomic factors that may explain them. Based on what is now known about those factors, researchers intend to target surveillance and develop prevention strategies. Analysis of study data was still in progress at the time this proceedings went to press, but Dr. Karesh will be presenting the complete analysis of the study data and how veterinarians can apply this information in practice during the session. 45 2015 Infectious Disease Proceedings 45
HOTSPOTS OF LEPTOSPIROSIS IN THE UNITED STATES William Karesh, DVM, and Peter Daszak, PhD 46
47
HOTSPOTS OF LEPTOSPIROSIS IN THE UNITED STATES William Karesh, DVM, and Peter Daszak, PhD 48
2015 Infectious Disease Proceedings 49
HOTSPOTS OF LEPTOSPIROSIS IN THE UNITED STATES William Karesh, DVM, and Peter Daszak, PhD 50
2015 Infectious Disease Proceedings 51
HOTSPOTS OF LEPTOSPIROSIS IN THE UNITED STATES William Karesh, DVM, and Peter Daszak, PhD 52
2015 Infectious Disease Proceedings