Forget about H1N1 for the moment. Let’s talk H3N8.
Now that more states have experienced this nasty strain of the Canine Influenza Virus (there was an outbreak in Virginia last week and now New York, New Jersey, Pennsylvania and Colorado are seeing it) the so-called “dog flu” is again in the news media.
Despite the occasional lull in the general press, you’ll be gratified to hear that for us veterinarians, Canine Influenza never left the spotlight. Thanks to the Veterinary News Network (VNN), I’ve been keeping abreast of all this disease’s twists and turns, geographic and otherwise.
First, a little background (courtesy of VNN, of course):
- “Canine Influenza (H3N8) is a novel canine virus first identified several years ago in groups of racing dogs in Florida. Although the virus has spread to 30 states, it is still not common in most pets.
- It appears to be more of a problem in a few isolated areas of the country and in shelters and kennels where dogs are housed closely together. Although all dogs are at risk, most cases have been found associated with these situations.
- The Canine Influenza Virus (CIV) is a different virus than the avian or human flu and it has not infected any humans.
- The virus apparently mutated from an equine strain of influenza. Influenza viruses can mutate. While rare, we do seem to be seeing more of such mutations. Five different mutations were needed to make this particular species jump from the horse to the dog.
- Canine Influenza is deadly to about 5% of dog infected with the disease. In addition, when the flu is diagnosed in a shelter, they are likely to euthanize all dogs in order to stop the spread of the virus.
- Consequently, the total mortality rate is about 8%, four times the mortality rate of the 1918 Spanish Flu pandemic in humans, a significant fact!
- The primary symptoms in a dog are a cough and a high fever. If you see any such symptoms you should visit your veterinarian. It is important to know that there are many less severe diseases that show similar symptoms.
- Currently the treatments we have are supportive care and antibiotics, even if a dog gets this flu virus, it is most likely it will recover with good care from your veterinary hospital.”
Despite the high recovery rate for well-treated pet dogs, Canine Influenza is nonetheless a huge concern for veterinarians. This is especially true when we're treating kenneled dogs and pets from rescue and shelter environments. Yes, dog parks are always a threat. But with the high percentage of well cared for pets in attendance, it wouldn’t keep me from taking my dog out for a well-deserved romp.
One novel possibility for those of you whose dogs are at a higher risk is the new vaccine recently devised to halt the dog flu’s progress. Now that it’s been tested in 700 dogs (none of which displayed any untoward effects post vaccination), the vaccine has received conditional approval by the FDA. Which means that any veterinarian who wants to start using it can do so as soon as the manufacturer (Intervet/Schering-Plough) sets the price and starts shipping (supposedly any day now).
The vaccine isn’t 100% effective, though. Like your standard, yearly flu shot, this inactivated virus-based vaccine can help stem the spread while reducing the severity of an individual’s viral infection. It’s a helpful start, right? I’d say it’s a no-brainer for a rescue or shelter. But whether it will fly in general practice is another story. (For my part, I’ll be waiting for some more safety data before using it even on my at-risk patients.)
The good news is that we’re making progress. Next on my wish list...a widely available quick test for H3N8. This is especially important for veterinarians like me because if the possibility of CIV is there, my current option is an expensive test performed at a faraway lab with a wait time that might not make it worth the effort...and that price! It's a non-starter if my patient’s recovering anyway. And they almost always will when clients follow our directions.
Still, knowing is better than not knowing. The presence of an accessibly inexpensive rapid detection process is the key to understanding how widespread the disease might be among individual dogs in the non-kenneled, non-sheltered real world.
But for now, for the average dog owner? Be aware. But don’t be scared. And keep your eye out for more news.
Add Comment49 Comments
Off topic but as an FYI. My USA Today column (which I promised to offer a link to once it was up) is here. It's getting LOADS of hits. Have fun!
Dr. Patty Khuly August 21st, 2009 09:43:21 AM
Dr K ~ Am I correct in saying that the new vaccine against this H3N8 flu will not prevent a dog from contracting the illness but might lessen the severity of it?
Ellie August 21st, 2009 09:56:36 AM
Ellie: If it doesn't outright prevent it (which it can) it will lessen the severity of the symptoms. Hope that helps clarify things.
Dr. Patty Khuly August 21st, 2009 10:07:09 AM
Hi Dr. K -
Can you clarify the following statement that you quoted? "Currently the treatments we have are supportive care and antibiotics..." What is the logic of treating a virus with antibiotics? Is there some other reason why a vet would do this, considering that an antibiotic treats bacterial infections and not viral infections? Are you worried about co-infection or underlying "good" bacteria that might take advantage of an immune compromised pet? I fear that this just contributes to antibiotic resistance.
Amy B August 21st, 2009 10:22:33 AM
I took my dog to the Fairfax County shelter for the rabies clinic the day before they announced the outbreak. We didn't go inside, the event was held in a trailer owned by the vet clinic that sponsored it, but I was afraid we might have brought it home. Luckily it doesn't look like we did.
Kristie August 21st, 2009 11:01:59 AM
Thank you for your very informative and helpful article. I hope that these dogs I came across will also find helpful souls willing to take care of them and give the love they truly deserve: http://apps.facebook.com/save-a-dog/
Carly August 21st, 2009 11:58:27 AM
My dog Lola got the flu, and I thought it was kennel cough (my vet too). Go figure. The worst thing is that there are no ober-the-counter medications for pets, so everytime my 6 pets get sick, it's a ton of money...
Daniela
www.TheDailyTail.com
Publisher
Daniela Caride August 21st, 2009 12:48:31 PM
Amy B: By the time we diagnose this infection, it's usually progressed to a point where secondary bacterial infections play a role. Not always, mind you, but commonly. Each situation must be addressed on it own merits, of course. The other issue is that because we have no quick test, as I mentioned, most of these dog flu cases are dealt with via antibiotics first-which is the standard treatment for the bacterial tracheitis (kennel cough) type infections the dog flu most resembles. Given the issue of bacterial resistance, the reality is that we're loathe to simply discontinue antibiotic treatment once initiated, despite the fact that secondary infections are not immediately apparent. Hope that helps to clarify the how's and why's of treating these flu cases at ground zero.
Dr. Patty Khuly August 21st, 2009 01:08:36 PM
Great article Dr. Khuly! It's a shame so many people just don't get it.
Pam August 21st, 2009 01:30:37 PM
Thank you, your explanation makes sense. I am a fan of your blog, and figured there was a good reason why antibiotics would be used, and suspected it was concurrent infections. And your statement about continuing the course even after flu has been identified is right on the money. Thanks again.
Amy B August 21st, 2009 01:39:48 PM
VNN says: "Canine Influenza is deadly to about 5% of dog infected with the disease. In addition, when the flu is diagnosed in a shelter, they are likely to euthanize all dogs in order to stop the spread of the virus. Consequently, the total mortality rate is about 8%, four times the mortality rate of the 1918 Spanish Flu pandemic in humans, a significant fact!"
Um, not really significant or even germaine.
When we start killing people to prevent the spread of a virus, or killing people because we can't to treat them (as happens with pets), then and only then is ii accurate to compare mortality rates that include such killings in the respective populations. Until then, it is pure BS to add shelter disease-control killing and owned-pet economic euthanasias for dogs who technically COULD be saved to the mortality rate, and then compare that combined rate to that for the Flu of 1918.
Gina Spadafori August 21st, 2009 01:43:15 PM
Germain=Germane
:::sigh:::
I can either think numbers or words, but not, apparently, both at the same time. :)
Gina Spadafori August 21st, 2009 01:45:38 PM
Unrelated to this current post, excellent article in USA Today Dr. K. Some of the commenters are a little wacky. I especially like the one that calls you a MOFO numerous times and believes that Patty is a male name. :) If only that person knew the amazing work you do. Keep up the good work.
Jason August 21st, 2009 02:05:00 PM
"Next up...a widely available quick test for H3N8. This is especially important for veterinarians like me because if the possibility of CIV is there, my current option is an expensive test performed at a faraway lab with a wait time that might not make it worth the effort...and that price"
I work in a human hospital laboratory, where we do the "quickie" screens for H1N1 (IE Swine flu falls in the Influenza A category of viruses, and the kits screen for Influenza A and B). Problem is, the quickie test only picks it up 70% of the time, leaving 30% false negatives. Which is the reason why we also send, if they fit certain criteria, negative screens to Public Health for PCR testing. The testing, if Infuenza A virus is present, will tell us whether it's the run of the mill Influenza A, or Swine flu Influenza A. So... because H1N1 has become so prevalent here, doctors have been instructed not to depend on the test or wait for Public Health PCR confirmation. They are to treat based on symptoms. There are antiviral drugs for this. Are there antiviral drugs for dogs? Also what do dogs do to prevent spread? They can't exactly cover their mouths when they cough, or diligently wash their paws while in the vet's waiting room. ;)
lyn August 21st, 2009 03:18:53 PM
lyn: Precious few antivirals. In fact, none we employ in this circumstance. :-(
Gina: Exc. point, as always!
Jason: MOFO is as much a term of endearment as I could hope for given the wide circulation of USA Today. ;-) Gotta take the good with the bad, right?
Dr. Patty Khuly August 21st, 2009 03:26:31 PM
Dr.K, - Sorry, for the long previous post, but what I was getting at was, is the rapid screen for H3N8 going to be sensitive enough to trust? thx
lyn August 21st, 2009 03:29:44 PM
I had never heard of Canine Influenza before reading this! I live in Australia but originate from the UK and haven't heard about it in either countries. Does anyone know if it is a US only disease? It would be good to know as we see a lot of kennel cough cases. Can the disease be mistaken for kennel cough?
Lorelei August 21st, 2009 11:07:00 PM
Lyn's comment leads to a question I've had for some time: Should i be (trying to) keep my dog from sniffing everything at the vet clinic? She sniffs the floor, the chairs, the walls, etc. I'm concerned that if her nose touches where a sick dog's nose has touched, she might catch kennel cough, canine flu, etc. Thank you, Dr K.
Selena's Mom August 22nd, 2009 01:14:35 AM
lyn: No idea since I don't even know the sensitivity and specificity of the current test. Wish I could be more helpful. I've never yet run one.
Lorelei: It looks a lot like kennel cough but tends to be accompanied by a higher fever than we'd expect with an uncomplicated case of tracheitis. I don't know if your area has seen any cases and I would imagine it hasn't based on your strict import requirements for US dogs.
Selena's Mom: I don't know how long this airborne virus lives so I can't tell you what degree of risk you face at the vet's office, but it would likely be minimal unless there's some contact with an infected animal. (Lots of unanswered questions, I know.)
Dr. Patty Khuly August 22nd, 2009 05:30:57 AM
I am curious about the new Canine Influenza vaccine recently approved (Schering-Plough, I think?) Apparently they are recommending all dogs be vaccinated. I also heard that the vaccine was very expensive ($80 per dose client cost). Could you please update me on any current recommendations about this vaccine? I looked on VIN, but didn't find anything pertinent to the vaccine.
DrRox August 22nd, 2009 01:47:35 PM
Sorry, I just rechecked VIN (something new everyday!!!) It appears this vaccine may be indicated in very dense dog populations, such as animal shelters, dog shows, and such, but there are currently NO recommendations that this vaccine be considered a Core vaccine for all dogs. The vaccine does not prevent disease or shedding of the disease, it will only decrease the severity of the infection, which is considered to be mild in the majority of cases. If you have found different recommendations (other than from the manufacturer) please let us know.
DrRox August 22nd, 2009 02:08:05 PM
Swine flu, Dog flu, AIDS, Heartworms, Hookworms... And people wonder why I don't much like going for a "fun" day at the dog park. With every warning of new and/or rapidly spreading disease, comes the "be aware but don't panic" statement. "It's officially a pandemic but don't be too concerned." Really? How many diseases do we have to encounter on a daily basis before it's rational to panic or at least be concerned? How many fewer diseases would we have to deal with if we'd panicked a little, just enough to warrant some old fashioned quarantines and eradication instead letting these diseases literally fly around the planet in days or weeks? AIDS, Heartworms, FIP, and FIV would most certainly be on that list. My cats used to get a rabies vaccination and live to be 18-20 on Cat Chow. Not a chance I'm going to believe the rapid spread and increasing number of diseases AND new vaccines isn't what's killing my babies faster. Oh yeah, environment and food quality too but I can't help thinking the diseases and their "treatments" are biggies. Being a hermit sounds more attractive every day.
PJBoosinger August 23rd, 2009 04:19:10 AM
DrRox: Yeah, I've come across that recommendation from multiple sources, too. Definitely NOT core vaccine material. But then, I don't consider Bordetella core vax material, either.
As to the price, I'm not sure. I tried to find out but I'll have to call my Intervet rep. Though I know some veterinarians in Florida are using it, I'm afraid it's not yet available for wide distribution, despite my claims to 'immediacy' above. (Just noticed this--sorry.) I'll find out more tomorrow and amend the post until my reps can inform me more accurately.
Dr. Patty Khuly August 23rd, 2009 08:35:51 AM
I seem to recall getting pooh-poohed more than a little a while back for suggesting viruses can mutate and jump species more easily than scientists generally believe they can. The dog flu came from an equine virus; Human swine flu from pigs. Hm, seems I might not have been so far off the mark, diseases jumping species are on the rise and I'm not the only one calling for screening and quarantine. I guess we can keep waiting for more and more scientific proof positive and be after-the-fact reactive when it may be too late rather than common sense proactive. I think I'd prefer a bit of common sense pre-emptive proactive organized panic.
PJBoosinger August 23rd, 2009 08:50:56 AM
I just got a 3 month old dog from our local human society and she got sick right after I got her. Fever of 105.6 congestion and eye drainage. The vet said it was upper resportority infection and contacted it from the human society and put her on antibotics. She still has alot of they symtoms after 4 days of meds is this normal? Does it take a while for the meds to kick in?
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