Re: New H1N1 PCR for dogs, cats and ferrets

Niall Taylor — Tue, 22 Dec 2009 18:50:11 GMT

[quote user="Graham Bilbrough"]Earlier this month, I asked you if you thought it was desirable to have access to H1N1 Influenza Virus PCR in the UK. I took note that there was no response. Does this latest news from my colleagues in the US change your opinion?[/quote]

Sorry Graham, I didn't see your original post.

Speaking as a practitioner and a confirmed sceptic I can't see the point. You have given us confirmed cases numbering one only, in a dog which may have had other problems and anyway was treated symptomatically. A list of "likely" clinical signs, based on other respiratory infections fails to convince in any way. The risk of zoonotic transmission seems such an unlikely extrapolation that we shouldn't even be considering it based on such low figures.

So I'm afraid I can't see the purpose of offering such a test. We are verging on "first invent a disease, then invent a test for it" here I feel .

Hope that helps, I look forward to IDEXX executives beating a path to my door for further comments!

Cheers,

Niall

Re: New H1N1 PCR for dogs, cats and ferrets

Graham Bilbrough — Tue, 22 Dec 2009 13:10:51 GMT

Earlier this month, I asked you if you thought it was desirable to have access to H1N1 Influenza Virus PCR in the UK. I took note that there was no response. Does this latest news from my colleagues in the US change your opinion?

INDUSTRY ALERT from IDEXX Reference Laboratories:

H1N1 influenza virus infection confirmed in household pets

A dog from the Katonah Bedford Veterinary Center in Bedford Hills, New York, has tested positive for the H1N1 virus on the IDEXX H1N1 Influenza Virus RealPCR^{^TM} Test.

A 13-year-old dog had a several-day history of not feeling or eating well, a dry cough and a fever on presentation to its veterinarian. The dog was treated for pneumonia and improved with hospitalization and supportive care. The dog tested positive on the IDEXX H1N1 Influenza Virus RealPCR Test. A more detailed case description is available.

Background
In the United States, the H1N1 influenza virus has been confirmed recently as the cause of respiratory disease in several ferrets and cats resulting in more than one death in each of these species. These infections were believed to have been contracted from infected owners. There was an unconfirmed report of dogs infected in China in late November. The case described here is what is believed to be the first reported case of a dog infected with the H1N1 influenza virus in the United States. The dog's owner had also recently tested positive for H1N1 influenza virus. The Iowa State University Veterinary Diagnostic Laboratory has confirmed independently that the influenza strain is the new pandemic strain circulating in the human population and not a swine-specific H1N1 strain.

For up-to-date news on the 2009 H1N1 flu virus outbreak and FAQs from the American Veterinary Medical Association go to http://www.avma.org/public_health/influenza/new_virus/default.asp

Clinical Signs
The clinical signs of H1N1 virus infection are likely to resemble those of other common respiratory infections. However, more severe respiratory disease, including pneumonia, may be possible. Clinical signs may include:

Coughing, sneezing and oculonasal discharge
Fever, lethargy and loss of appetite
Dyspnea and tachypnea

Because the clinical signs of H1N1 virus infection resemble those of other respiratory infections, IDEXX has included the H1N1 Influenza Virus RealPCR^{^TM} Test in the Feline Upper Respiratory Disease (URD) and Canine Respiratory Disease (CRD) RealPCR^{^TM} panels at no additional cost. These panels include PCR tests for the more common feline and canine pathogens, which are still more likely causes of respiratory disease in patients. The H1N1 Influenza Virus RealPCR Test also can be ordered as a stand-alone test.

When to Test
Testing should be considered in any pet with evidence of respiratory disease. The shedding period of influenza viruses is short. Samples should be submitted for testing within 7 days of the onset of clinical signs to avoid negative results in infected animals.

Specimen Requirements
Deep pharyngeal swab (with visible organic material on swab; please rub firmly) and a conjunctival swab (wipe eye clean; swab inside of eyelid) in the same tube. Please submit dry, plastic-stemmed swabs, without transport media, in a serum tube or an empty, sterile tube; keep refrigerated.

Turnaround time: 1-3 working days

Expert Feedback on Possible H1N1 Influenza Virus Cases When You Need It
Our team of internal medicine specialists is always available for complimentary consultation. Please call 1-888-433-9987, option 4, option 2, if you have questions.

H1N1 Influenza Virus Infection

13-year-old neutered male mixed-breed dog

History and Clinical Presentation
The 13-year-old neutered male mixed-breed dog was taken in on emergency to the Katonah Bedford Veterinary Center in Bedford Hills, New York, on Sunday, December 13, 2009. Two days prior, he was seen by his regular veterinarian after several days of not feeling well. The patient was placed on antibiotics and anti-inflammatories with no response. On presentation to the emergency veterinarian, the dog had dry cough, was reported to be lethargic and not eating; he was also febrile with a temperature of 103.6ºF. The owner reported that he himself had tested positive earlier in the week for the H1N1 influenza virus.

Diagnostic Testing
The veterinarian informed the owner that there was an H1N1 influenza virus test available through IDEXX Reference Laboratories. The owner agreed to have the test run.

Thoracic radiographs were taken and revealed evidence of pneumonia with consolidation of the right cranial and middle lung lobes and prominent air bronchograms.

A tracheal wash was performed and submitted for culture and sensitivity and cytology.

Treatment
The dog was hospitalized, placed on intravenous fluids and antibiotics.

In addition, the dog received saline nebulization and coupage four times daily.

The dog improved with treatment and was released after 48 hours of hospitalization and supportive care.

Laboratory Results
Culture and sensitivity results from the tracheal wash were negative.

Cytology of fluid recovered from tracheal wash revealed chronic active inflammation with the presence of degenerate neutrophils, and no organisms were seen.

The H1N1 Influenza Virus RealPCR^{^TM} Test result was positive. A complete Canine Respiratory RealPCR^{^TM} Panel was then performed, and all other respiratory pathogens, including canine influenza virus (H3N8), were negative.

Assessment
Focal lung lobe consolidation can be a consequence of influenza infections; however, other possible etiologies need to be considered in this older dog. Therefore, it is unknown at this time if the H1N1 influenza virus infection is the primary cause of this dog's illness; however, it is likely to have contributed to the dog's clinical signs.

Follow-up
The dog is reported to be doing very well at home and is scheduled for a recheck visit with repeat thoracic radiographs this week.

For consultation on a possible H1N1 influenza virus case, please contact an IDEXX internal medicine specialist at 1-888-433-9987, option 4, option 2.