National Equine Health Plan: Introduction
The United States (US) horse industry involves activities in all regions of the country and the world. Horses are considered livestock and are unique in the livestock sector because of their broad diversity. The equine industry involves business, working animals, sport, recreation, entertainment, gaming, and environmental support, all built on the agri-business of breeding and raising equine. In addition to economic benefits, it also produces other intangible benefits to people and the US, including recreation, exercise, working animals, stress reduction, and entertainment.
The horse industry is unique because horses are transported with more frequency and over greater distances than other livestock. This increases the risk of spread of a contagious equine disease, which can have a devastating effect on the equine industry. Every year there are tens of thousands of horse races, shows, competitions, and recreational activities involving horses in the U.S. Hundreds of thousands of horses are routinely transported intrastate, interstate and internationally to racetracks, horse shows and other competitions, from farm-to-farm for breeding and training, to sales, to veterinary clinics, to national and state parks for trail riding and locally to ride with a friend. During these movements horses commonly comingle with other horses of unknown health status. Domestic and foreign horses are exported and imported, permanently and temporarily, to and from countries around the world. Restrictions on movement, either nationally or internationally, can have a major economic impact.
The purpose of the National Equine Health Plan (NEHP) is to protect the health and welfare of the U.S. equine population, facilitate the continued interstate and international movement of equines and their products, ensure the availability of regulatory services, and protect the economic continuity of business in the equine industry. Ultimately, these goals support the larger mission of enhancing the health and economic viability of the US equine industry.
The overall goals of the NEHP are as follows:
- Protect the health and welfare of horses in the US and North America;
- Facilitate the continued interstate and international movement of equine and associated products with science-based requirements and standards;
- Protect the business continuity and economic viability of the equine industry;
- Establish the role of the industry, federal and state authorities, and tribal governments in equine disease prevention and control and in natural disasters; ensure the availability of current diagnostic testing, inspection, and certification services; create and maintain a communication system which provides timely and rapid dispersal of accurate information about disease outbreaks;
- Provide guidelines for control, identification, and containment of equine diseases;
- Support and make available educational programs for horse owners and industry representatives on disease identification and prevention.
The NEHP functions as a roadmap for coordinating owners and industry organizations with veterinarians and state and federal animal health officials to prevent, control, recognize and respond to diseases and environmental disasters. Organizational preparedness, effective rapid communication, and owner education make up the foundation for preventing diseases and disease spread. All stakeholders need to be aware of the roles and responsibilities of all segments of the horse industry when there is a risk of infectious disease spread or natural disaster, which can affect the health and welfare of horses as well as the economy of the equine industry.
Currently, federal and state animal health officials have specific guidelines and regulations which define the role of these agencies for equine regulatory disease prevention and mitigation. By integrating the roles of the regulatory agencies with industry stakeholders and equine health and welfare, both equine health care and the equine industry are improved; this helps decrease the impact of infectious diseases on the horse economy.
Continual updating of the NEHP is required in order to respond to environmental conditions and emerging diseases both in the United States and internationally. This document will be reviewed and updated annually to keep it current with changes in regulations or diseases.
TABLE OF CONTENTS
Chapter 1: Prevent the Introduction of Foreign Animal Diseases
- Import Regulations
- Quarantine Facilities and Procedures
- Transport Procedures
- Veterinarian and Horse Owner Response to a Suspected Foreign Disease
Chapter 2: Prevention, Control & Response to Disease or other Threats
- Foreign Disease
- Emerging Disease
- High Impact Endemic Disease
- Zoonotic Disease
- Toxicity/Bioterrorism Emergency
- Business Continuity
Chapter 3: Disease and Health Monitoring and Surveillance
Chapter 4: Communication, Education & Outreach
Chapter 8: Drugs/Vaccines/Biologics
Chapter 9: AHC Welfare Code of Practice
Chapter 1: Prevent the Introduction of Transboundary or Foreign Animal Diseases
Objective: To provide access to the regulations and information needed to identify, report, contain, and prevent transboundary or foreign animal disease (FAD) in the United States by all stakeholders in the horse industry.
The United States Department of Agriculture-Animal and Plant Health Inspection Service (USDA-APHIS) has specific guidelines and regulations which control the mechanism for the importation of horses and horse products into the United States. The goal of import regulations is to ensure safe international movement of horses for trade and horse activity. Regulations and procedures involve sites for entry, immediate quarantine and monitoring of imported horses, maintenance of quarantine facilities, oversight of transport during importation, quarantine procedures and release, and surveillance and testing for foreign diseases. Temporary restrictions can be issued based on disease outbreaks in export countries.
- Import Regulations: Regulations for the importation of equines are established and enforced by the USDA-APHIS. Specific regulations are available on the USDA-APHIS website. Quarantine of horses entering the country is required. The length of quarantine depends on the FAD endemic in each country of export. Specific agreements with countries also affect importation and the need for quarantine or evidence of horse health are required for entry. For specific regulations USDA-Animal and Plant Health Inspection Service- Veterinary Services (USDA-APHIS) should be contacted.
- Import Quarantine Facilities and Procedures: USDA-APHIS import quarantine facilities or private animal quarantine facilities where horses can be isolated to prevent the spread of a foreign disease to the US horse population are used for monitoring horses during quarantine. Specific procedures include daily monitoring for signs of disease, testing for specific diseases, and husbandry during the quarantine period. Testing for foreign diseases must be completed by the National Veterinary Services Laboratories (NVSL).
- Transport Procedures: Transport regulations for horses imported from foreign countries and within the US depend on the risk a FAD poses to the US horse population and the need for quarantine. Transport is not allowed except to a USDA approved quarantine facility and is monitored by USDA inspection and oversight. USDA permits are required for the export and import of horses.
- Veterinarian and Horse Owner Response to a Suspected Foreign Disease: Veterinarians suspecting a FAD in the US are obligated to contact their State Veterinarian. Specific procedures for isolation should be initiated until evaluation and diagnosis of the disease can be determined. Horse owners and other stakeholders have the responsibility to inform their veterinarian about any potentially infectious disease in order to have appropriate testing to identify a FAD. Failure to report a potential FAD not only places the entire United States equine industry at risk but can result in significant financial penalties.
Chapter 2: Prevention, Control & Response to Disease or other Threats
Objective: To provide the definition and assignment of the roles and responsibilities of all stakeholders in order to help ensure appropriate prevention, monitoring, response-mitigation, biosecurity, owner education, diagnostics, epidemiology, business continuity, and funding for research.
The primary goal of the National Equine Health Plan (NEHP) is to coordinate horse owners and industry organizations with veterinarians and state and federal animal health officials to prevent, control and respond to diseases and environmental disasters. Organizational preparedness, effective rapid communication, and owner education make up the foundation for preventing diseases and disease spread. All stakeholders need to be aware of the roles and responsibilities for each segment of the horse industry when there is a risk of infectious disease spread, which can affect the health and welfare of horses and the industry’s economy.
- Foreign Diseases: Foreign diseases pose a constant threat to the United States horse population. Prevention relies on import quarantine testing and ongoing surveillance of the US equine population by equine practitioners trained to recognize foreign animal diseases intentionally or accidentally introduced. USDA-APHIS-VS oversees the national disease surveillance and investigations and provides foreign animal disease training courses for veterinarians (veterinary accreditation program). If a foreign disease is identified in the United States, the state and federal regulatory health officials will quarantine affected animals; restrict movement; identify exposed animals and potentially exposed animals; and implement appropriate control and eradication measures. Communications will be managed and coordinated by USDA-APHIS, State Animal Health Officials (SAHO offices, the Equine Disease Communication Center (EDCC) and the American Association of Equine Practitioners (AAEP).
- Emerging diseases: An emergent disease is new in a country or region and is one which demonstrates an increased prevalence, an expansion in geographic range or a change in clinical manifestation. These diseases require surveillance and recognition by equine owners and veterinarians. Prompt reporting of an emergent disease to the SAHOS, USDA-APHIS and the EDCC will ensure necessary surveillance, diagnostic testing and control measures such as movement restrictions or quarantine are rapidly implemented according to the USDA-APHIS-VS preparedness and response plan. Educational resources are published on the EDCC website and alerts released as needed.
- Reportable Diseases (High Impact Endemic Diseases): Reportable diseases are those deemed by the state, national or international community as having the potential to cause significant impact to the animal industry. Equine reportable diseases may include: Equine Herpesvirus Myeloencephalopathy (EHM), Equine Influenza, Streptococcus equi (Strangles), Western Equine Encephalitis (WEE), Eastern Equine Encephalitis (EEE), West Nile Virus (WNV), Equine Infectious Anemia (EIA), Equine Piroplasmosis (EP), Equine Viral Arteritis (EVA), Rabies, and Vesicular Stomatitis (VS). Owners and veterinarians should be familiar with reportable diseases in their state as diseases listed vary from state-to-state. If a reportable disease is suspected, the horse owner or veterinarian is obligated to report the suspicion to the local animal health official. Non-reportable infectious diseases are reported to the EDCC by veterinarians based on a confirmed diagnosis or positive laboratory tests.
- Zoonotic Diseases: Zoonotic diseases affecting humans and horses include, among others, Rabies, WEE, EEE, Leptospirosis, WNV encephalitis, Salmonellosis, Anthrax, Clostridiosis (Clostridial Enteritis), and Ringworm. The risk of contracting diseases from horses is relatively low and is described on the EDCC disease information page. Transmission from humans to horses is rare and restricted to bacterial infections. The reporting of diseases in horses such as West Nile Virus and Eastern Equine Encephalitis can alert human medical officials of the increased risk to humans in a particular location. Information on local zoonotic disease issues is available from the county or state public health officials. The CDC is alerted when there is an increased risk of human infection.
- Disasters/Emergencies: Horse owners should work with their veterinarian to develop disaster emergency plans for their animals. Consideration should be given to temporary stabling such as fairgrounds or vacant farms. Emergencies are predominately managed by town, county and state officials depending on severity. When horses are involved alerts will be sent from the EDCC with information about contacts and emergency responses for horses. Information about the Federal Emergency Management Agency (FEMA), which is part of Homeland Security, is available on the EDCC website.
- Toxicity/Bioterrorism Emergency: A national emergency due to exposure to toxins or bioterrorism is managed by Homeland Security. The most common cause of toxicity in horses is accidental contamination of feed. The Food and Drug Administration (FDA) regulates livestock feed to ensure feed does not contain contaminants. Veterinarians will be the first to recognize a disease due to exposure to toxins and will contact the EDCC to provide a source of information about risk to unaffected horses. The EDCC serves as an alert system for a toxic or bioterrorism event.
- Business Continuity: Maintaining business continuity during an animal disease outbreak aims to limit disease spread while facilitating normal equine activities through implemented biosecurity measures and permitting controlled movement of non-exposed horses. Non-reportable diseases are usually not actionable by SAHOs, but veterinarians are encouraged to report diseases to the EDCC, which allows local communities to implement biosecurity measures. Communication is key to maintaining horse activity where there is no disease risk. Early communication of the outbreak status is completed by the EDCC, and by state and federal veterinary offices for reportable diseases. Knowledge of current equine disease situations enables horse owners and veterinarians to make a risk-based decision regarding the movement of horses and participation in equine events. Event organizers utilize EDCC outbreak status information to assess event risk and implement biosecurity measures to avoid cancellation of an event. USDA-APHIS helps coordinate emergency management through the National Preparedness and Incident Coordination Center (NPIC)
Chapter 3: Disease and Health Monitoring, Surveillance and Reporting (epidemiology)
Objective: To monitor horse health for early detection of infectious disease and new/emerging disease in populations at high risk for disease spread.
Surveillance and monitoring rapidly identify disease and/or spread of diseases. Surveillance, including appropriate diagnostic testing by veterinarians, provides insight into the health status of the population. State and Federal Animal Health Officials utilize the surveillance laboratory data to identify potential disease trends and evaluate the potential impact on the health of the national equine population. The goal is to quickly identify diseases and increases in disease incidence through a system of reporting and communication. Baseline information is critical to identification of disease trends and the relationship to horse health.
- Census: An accurate census of equine population is essential for locating potentially exposed horses and assessing the risk of disease spread. A United States horse census is conducted every 5-10 years. The census includes an estimate of the total population as well as the numbers of horses in each breed, the cost of horse ownership, the economic impact of transportation, agriculture, jobs and veterinary care as well as horse population in each state. The census is a cooperative effort of the American Horse Council and USDA.
- Baseline Health and Husbandry Practices: Horse owners and veterinarians are responsible for utilizing preventive health practices through biosecurity and vaccination. The national animal health monitoring system (NAHMS) survey occurs every 5-10 years. This helps assess how husbandry and medical care affect horse health and the horse economy. The survey assesses husbandry and veterinary care practices and associated costs. The survey results increase awareness of disease prevalence, identify areas for improved horse husbandry, highlight the economic impact of equine diseases and identify knowledge gaps for further research. Based on the survey specific practices for infectious disease control are recommended by USDA-APHIS and the EDCC. Specific recommendations for monitoring and preventing disease during horse transportation and during activities where horses comingle are available on the EDCC website.
- Foreign Animal Disease: Foreign animal diseases (FAD) are a constant threat to horses in the US. The primary concern is recognition of a FAD so it can be contained and eliminated or, at the very least, mitigated. After recognition by veterinarians, SAHOs initiate quarantine with isolation and testing. Owners are informed of the quarantine by the EDCC and risk is assessed and reported. Surveillance by the USDA is increased. State and Federal animal health officials communicate the need for increased surveillance and monitoring to veterinarians. A framework for management of FAD is available at the USDA website which includes roles and responsibilities during an outbreak. Veterinarians communicate increased incidence to the USDA-APHIS. The USDA-APHIS maintains surveillance.
- Re-emerging Threats: State and federal animal health officials monitor the health status of the equine population to identify, evaluate, and respond to re-emerging equine diseases. This may be due to increased pathogenicity, change in climate or geography, or increased morbidity/mortality. APHIS-VS is responsible for surveillance, preparedness, and response services of reportable diseases. SAHOs notify the National Animal Health Reporting System (NAHRS) and the EDCC of reportable diseases. Practicing veterinarians notify the EDCC about increased or unusual disease prevalence.
- Endemic Disease: Diseases commonly found in the US are endemic diseases. USDA APHIS-VS is responsible for overseeing surveillance, preparedness, and response activities for reportable diseases in the United States. SAHOs report confirmed detections of reportable diseases to the USDA through the National Animal Health Reporting System (NAHRS) and to the EDCC. The EDCC reports increases in endemic reportable and non-reportable disease locally and regionally so veterinarians and owners are aware and can initiate methods for prevention.
Chapter 4: Communication, Education & Outreach
Objective: To provide real-time, reliable information about disease outbreaks; decrease misinformation during disease outbreaks; be the source of accurate information about diseases, vaccination, and biosecurity; and provide contact information and available responses for state and federal animal health officials.
Coordination of responses to disease threats and outbreaks between USDA-APHIS-VS, SAHOs, practicing veterinarians, and horse organizations requires reliable and accurate distribution of information to enact the roles and responsibilities of each group. Readily available and updated educational material and disease management procedures are essential to keep all stakeholders informed.
- Communication: The EDCC serves as the communication hub for seeking and distributing verified information to all segments of the horse industry. At the same time, it serves as an educational resource with up-to-date medical information and essential contact information needed during a disease outbreak. The EDCC is an alert system which collects, corroborates, and distributes disease outbreak information in real time in order to accurately describe a situation and to help avoid rumors that can create unnecessary cancelling of events and activities. Information disseminated includes date, disease, location by county and state, number of horses affected, breed affected, the status of the outbreak, and the source of the information. The status of outbreaks includes confirming quarantines, quarantine release, and ongoing investigations. Outbreak information is confirmed by USDA-APHIS-VS, a SAHO or an attending veterinarians. Alerts are posted on the EDCC Website and the link is sent to owners and horse organizations by email, Facebook, and Twitter. Information about specific diseases and biosecurity as well as contact information for state and federal health officials is available on the website (equinediseasecc.org).
- Education & Outreach: Education of all constituents in the equine industry is necessary for the NEHP to be successful. Each segment of the industry must understand the roles and responsibilities of each group in order to respond to a disease outbreak. Educational material on the EDCC website Includes disease information, biosecurity materials and methods, vaccinations, and a glossary of terms. Each equine stakeholder organization, including USDA-APHIS-VS, state veterinary and extension offices, also provide educational materials on respective websites. Horse and breed or discipline organizations and equine councils provide equine health or biosecurity related educational materials on respective websites, social media accounts or via presentations at meetings. Equine stakeholders are encouraged to view or link to information on the EDCC to ensure consistent messaging is reaching the various entities of the equine industry.
Objective: To illustrate the need for research; identify research priorities; coordinate research resources; identify possible sources of funding; promote regulatory recognition and adoption of new research results and diagnostic tests.
The NEHP’s ultimate mission is to coordinate, facilitate, and support surveillance and research activities in an effort to prevent the occurrence of equine diseases. Furthermore, the NEHP’s goal is to minimize the economic impact of a disease on the U.S. equine population and horse owners. Research into equine infectious diseases, vaccination, advanced diagnostic testing, and treatment is needed to meet these goals.
- Identify Research Priorities: Industry stakeholder participation in meetings and forums to identify and prioritize infectious diseases and disease-related problems ensures needs of the industry are met through prioritized research activities. Surveys by AAEP, and NAHMS seek stakeholder input on priority for equine health issues including infectious diseases. Survey results are shared with USDA-APHIS-VS, USAHA-Equine Committee, the AAEP’s Infectious Disease Committee, industry-related research entities and research foundations.
- Research Funding Sources: Research funding for horses is predominantly provided by private foundations, allied medical stakeholders, universities, a state’s equine specific funds or the USDA. The following are potential sources for research funding:
- Private Research Foundations
- Breed/Discipline/Industry Organizations
- National Agricultural Statistics Service
- National Institute of Food and Agriculture
- Agriculture Research Service
Although the entities within the USDA have funding sources for horses, this is not specific for infectious disease. Owners and the allied industry are encouraged to make contributions to research foundations and universities to increase available funding designated for equine health research. Stakeholder meetings are sponsored by the AAEP, allied medical stakeholders and horse organizations to help organize collaboration between researchers and for efficient use of resources.
- Research Reporting: Research findings are reported in scientific journals and subsequently published in the lay press. Results are also presented at scientific veterinary and animal science meetings as well as to horse owner organizations. Reports from new research are distributed by the EDCC, the AAEP, and the American Horse Council (AHC).
Objective: To have a consistent and systematic approach to disease diagnosis and reporting. Accurate and rapid diagnostic tests are sought through research.
Due to the nature of infectious diseases, rapid diagnosis of a disease is essential to decrease disease spread and provide time to initiate treatment. Some diseases require diagnosis by approved laboratories to ensure that testing meets specific standards. Some reportable diseases require confirmation of a diagnosis at NVLS. The following factors and procedures are essential to diagnose an infectious disease:
- Methods of Diagnosis: Veterinarians use clinical signs to make a presumptive or tentative diagnosis. Because diseases, specifically infectious diseases, can have similar clinical signs, laboratory tests are necessary to confirm a diagnosis. Although some diagnostic tests can be completed when examining the horse, most diagnostic testing requires submission of a sample to a laboratory for confirmation. Laboratories differ based on available tests, the accuracy of tests, and time required for testing. Laboratory testing is available at veterinary practices, veterinary industry laboratories, university diagnostic laboratories, and USDA-APHIS certified laboratories (NVSL). Consultation with the laboratory at the time of examination of the animal ensures appropriate sample collection, handling, and testing is performed.
- Laboratory Diagnosis: Laboratory diagnosis utilizes specimens such as blood, different secretions or excretions, and tissue samples to complete a variety of tests which indicate exposure to or the identity of an infectious disease agent. Various technologies are utilized for infectious diseases, such as bacterial or viral culture, serologic antibody tests or polymerase chain reaction (PCR). The sample must be collected and handled appropriately to ensure an accurate diagnosis. Laboratory tests can take a variable amount of time depending on the procedure and technology involved, States may require certain reportable disease tests be conducted at a designated state-approved laboratory which has implemented a quality control program that ensures accuracy and reliability of diagnostic testing. Laboratory testing for specific diseases that are reportable to USDA-APHIS must be confirmed at NVSL.
- Laboratory Reporting: Laboratory reports of disease are reported to veterinarians or, in the case of reportable diseases, to SAHOs. Reportable disease information is released to owners by SAHOs (reportable diseases vary between states). The accuracy of laboratory tests is variable for some diseases and results are interpreted by the attending veterinarian or SAHO.
Objective: To present guidelines and educational material illustrating the need for biosecurity as a part of normal husbandry; when planning for a disease outbreak during horse activities; for transport; and during disease outbreaks.
Biosecurity applied to horses and their environment is crucial in preventing disease spread and is particularly critical during a disease outbreak to prevent exposure of non-exposed animals to diseased horses. Specific guidelines must be followed for sanitation, quarantine, and isolation.
- Biosecurity for Prevention: When assessing disease risk of methods of disease spread such as direct contact, aerosolization, or environmental contamination must be considered. Biosecurity measures target these modes of potential disease spread. Knowledge of basic horse husbandry and disease spread will assist in protecting equine health. Ideally, to limit the potential spread of disease agents, horses should be maintained in a clean environment with limited horse-to-horse contact or limited horse-to-human contact. Basic biosecurity practices are available on the EDCC biosecurity webpage.
- Quarantine and Isolation: Immediate isolation of sick horses is critical to limiting the spread of infectious diseases. Equine events where horses are commingled from multiple sources should develop an isolation plan for handling sick horses. Guidelines for how to set up an isolation area on a farm or at a horse event are available on the EDCC Website. Creating a quarantine/isolated area for affected and exposed animals is critical to preventing disease spread. SAHOs and attending veterinarians provide instruction in setting up quarantine and isolation and will enact quarantine and isolation for reportable diseases.
- Event Planning: Equine events and horse activities, including horse shows, racing, rodeos, sales, etc., when horses are transported to new environments or have contact with new horses, should have a biosecurity plan in place. This includes ensuring only healthy horses enter the event grounds, appropriate cleaning and disinfection protocols are being implemented, and quarantine and isolation measures are outlined in advance of the event. Plans for each type of activity are available on the EDCC website.
Chapter 8: Drugs/Vaccines/Biologics
Objective: To provide resources for stakeholders to better utilize drug therapy and vaccines to treat and prevent infectious disease.
Use of drugs and biologics such as vaccines are critical to treatment and prevention of disease. Vaccination is a critical component of a disease prevention plan and may or may not be indicated in the face of a disease outbreak. Development of drugs and vaccines and their recommended use is regulated by FDA and USDA respectively.
- FDA-CVM (drugs): The Food and Drug Administration Center for Veterinary Medicine (FDA-CVM) oversees the use and development of drugs used for all animal species, including horses. Drug approval, recommended use, and investigating adverse drug reactions are the responsibility of FDA-CVM. Prescribing non-approved drugs for horses is termed “off-label use” and is the responsibility of the attending veterinarian.
- USDA-CVB (vaccines, bacterins, antisera, diagnostic kits, other): The USDA Center for Veterinary Biologics (USDA-CBV) is responsible for the development, use and adverse effects of vaccines, and biologic medicines used to treat animal species.
- Vaccination: Vaccination for diseases is a critical component for disease prevention. Recommendations for vaccines are made by companies manufacturing the vaccines based on testing by the USDA-CBV and should be followed by horse owners and veterinarians. Specific information and guidelines for vaccination are available on the AAEP webpage.
Chapter 9: AHC Welfare Code of Practice
Objective: To provide a definition and specific recommendations for a commitment to horse welfare.
Equine welfare is a critical component to the health and productivity of the U.S. equine population. Many equine associations have undertaken studies, reviews, and initiatives that indicate their commitment to the welfare of their horses. These associations address the expectations of their members and the welfare of their horses individually, in such a way as to meet their breed or discipline-specific needs. The Welfare Code of Practice is simply a continuation of that effort and is not intended to replace or pre-empt those activities or any rules and regulations specific to a particular segment of the industry.
a) Code of Practice: The Code outlines what it means for an organization to be committed to the responsible breeding, training, care, use, enjoyment, transportation, and retirement of horses. Organizations supporting the Code address equine welfare and responsible care:
(1) by supporting a uniform Welfare Code of Practice regarding the responsible breeding, training, competing, care, use, enjoyment, health, transportation, and retirement of horses; and
(2) by initiating communication with the public, the media, federal and state officials and within the horse community regarding welfare issues.