Suff
03-31-2005, 05:35 PM
From the weekly NTRA conference call
http://www.ntra.com/news.asp?type=news&id=13515
Eric Wing: Larry. First of all, let's start with (strangles 101), what is strangles and what is or are the dangers that the condition poses?
Larry Bramlage: Well, strangles is caused by a bacteria called Streptococcus equi. Streptococcus species are normal (popullants) of the horses respiratory track and skin. But there are different families of the Strep bacteria as opposed to the Strep equi which in and of itself it's not a particularly virulent bacteria with the exception of it has a tendency to colonize the lymph nodes around the horses throat.
You know, (breeders) would be familiar with the thickness you got in your throat that the doctor feels for when you have an upper respiratory infection, influenza or something, and the tenderness that you get in the little round swelling - swellings that develop on both sides of your larynx under your jaw whenever you have respiratory infection.
Well, this particular bacteria in horses has a tendency to make abscesses there. The bacteria itself is not dangerous to the horse, but the abscesses in the lymph nodes can constrict the airway and reduce the airflow even to the point, if they become very bad, that the horses would have trouble breathing.
And so it has a peculiar idiosyncrasy that can become dangerous to the horse, certainly it always interrupts a horses training significantly. And when you have the infection, while it's actively present, it's easy to spread to another horse if you directly contact the horse. Now most epidemics are caused by viruses.
Viruses are much more infective than is a bacteria such as this, meaning that the viruses can usually be spread by vectors, mosquitoes. It can even go airborne. Strep equi or the strangles causing bacteria doesn't have that capability. It has to be spread directly from horse to horse, or from one horse's (extradite) to the next horse, that would be the mucus that's coming out of their nose.
And so there are - there's an advantage there in controlling it, and that is if you basically keep horses apart, you don't have to worry about this going from horse to horse like you do in a situation where you may have mosquitoes or airborne transmission. So it's much easier to quarantine. With that said, the amount of yellow (extradite) that a horse produces when they have strangles is copious. So you do have to be careful with the horses that have the active infection.
Eric Wing: Could it be passed, Larry, from horse to human to horse? An example was cited earlier on the call about, you know, perhaps an exercise rider who might work a couple of different barns, that type of thing? Or is that not really the case?
Larry Bramlage: Well, just by physical transmission, it wouldn't actually infect the human and be transmitted. But if you for instance had it on your clothes and transported it directly to the horse where that horse could get it in it's mouth or nose, well, then it certainly could be transmitted that way.
And the other obvious place that you would worry about in horses in training is the starting gate. You know, if a horse goes in and snorts in the starting gate and leaves his (extradite) on the gate and the next horse that comes in to train out of the gate should bump up against that and get it directly in its nose, you could inoculate the horse.
It doesn't live for a very long time, meaning if you - if you dry it out, the bacteria are going to die. But as long as there would be tenacious mucus that would stick to anything, a person, clothes, water buckets, anything that would go from horse to horse, could physically transmit this.
Eric Wing: Dr. Bramlage, how is strangles treated?
Larry Bramlage: Well, the usual way is to let it run its course. There is a bacteria - I'm sorry, there is an antibiotic, penicillin, actually, is quite effective against the bacteria. But the reason you often try to let it run its course is horses get a stronger immunity from the natural disease if you don't interrupt the disease.
Now if the horse is sick, not eating, or has enlarged lymph nodes to the point that you have to worry about the other health concerns of the horse or one of those being just his ability to breathe easily, then you would have to intervene and give them antibiotics and possibly something for their fever.
But it normally is not a real debilitating disease like for instance a very hot strain of influenza, which is going to cause more overall generalized sickness, muscle aches. You know, you just feel worse with influenza than you would with the strangles bacteria with the exception of if it's affecting your ability to breathe.
The reason you allow it to run its course is the immunity that the horse got to become stronger and they wipe out the bacteria more readily, or that has been the thinking for years and years. And the reason you want them to do that, there are silent strangles carriers in the population.
And if you intervene and the horse does not develop a good immunity to the bacteria, then the ability of that bacteria to survive in the horse's throat and infect another horse, even though the horse that actually carries it may not be infected by it at all anymore is (in peace).
And those silent carriers are the dangerous ones in the population, the Typhoid (Annies), so to speak, who are not infected by the disease by themselves, but has the potential to infect additional horses. It most often is a relatively not innocuous but relatively minor respiratory disease from the aspect of potential danger to live and limb. It's only if the enlarge lymph nodes begin to restrict the airway.
And then there's one other aspect that people may ask about, and that is vaccination is a possibility but the immunity that's caused by the vaccination is relatively poor because this is a bacteria. In general, viruses create very good immunities, most classes of viruses. There's some classes that do not, which is the human cold. But most of the time, viruses such as influenza do create a good immune response.
Bacteria do not, and that's why the vaccine is not totally protected from a horse. Even if a horse has been vaccinated, they can still often get this disease and the vaccination process has more morbidity to it. You get more soreness at the vaccination site.
Occasionally you'll get abscesses at the vaccination site because you're vaccinating with a bacteria. And so the control of the disease, while it's easier to segregate the population, it's harder because you can't just vaccinate all the susceptible population and protect them.
Eric Wing: Interesting. Dr. Bramlage, I'm going to step back at this point. We'll shoot it over to our announcer, Abe, and he'll check to see if any of the media listening in have any questions for you regarding strangles.
Larry Bramlage: Sure, I'll try to answer them.
Operator: Thank you, Eric. Again, that is star one to signal to ask a question. Star one. And as always, we ask that you please check your mute button to make sure you're not muted. If you are muted, that would block your signal. Dr. Bramlage, we do have a couple of questions for you. We're going to go first to Tom Keyser with the "Baltimore Sun."
Tom Keyser: Just a couple of questions. How long does it take to run its course?
Larry Bramlage: About three weeks. Not always is the horse incapacitated for that period of time, but roughly in the two to three week neighborhood would be the average.
Tom Keyser: OK. And do you know or do the vets know how this came to Palm Meadows?
Larry Bramlage: You know, I have no first hand knowledge of that scenario and I really couldn't tell you. Someone down there might know, but I have not heard that it's been established. But, you know, it could come in on any horse, even a horse that was there last year - even a horse that was - I don't know whether they keep horses all year around, but even a horse that was a resident there, if another horse that was totally naïve to the disease contacted a carrier that, though he was not affected by the disease, happen to have some of the bacteria in their respiratory track, they could infect the horse and start the ball rolling.
Tom Keyser: OK. Thank you.
Operator: We'll go now to Jennie Rees at the "Louisville Courier Journal."
Jennie Rees: Yes, doctor, what would be the incubation period of this? Like where a horse may be seemingly healthy is allowed to ship …
Larry Bramlage: Well, the incubation period for strangles is going to be in that neighborhood of two weeks, plus or minus a little bit. That somewhat depends upon the horse's susceptibility, Jennie. So it would be less than that if you're totally naïve. If you have some exposure before, it might be longer - I'm sorry, yes, it might be longer because you might not be susceptible to the disease.
You're not going to come down with it as readily. So it's a little bit more difficult to establish an incubation period with a - with a bacteria than it is with a virus. And so, it's harder to say. That's why I don't know that I can really answer your question directly.
Jennie Rees: And how rare is it at a race track? I'm told that while yes, it does surface on a farm, a lot of people said they have not heard of it in decades.
Larry Bramlage: It's much more rare than it is on the farm. There are several reasons for that, and that is, there are fewer continuously resident horses, you know, the population tends to turnover and as I mentioned before, the Typhoid Mary, often you find eventually farms identify the carrier horse that they have. And if they can wipe those out, then they have the luxury like they have at the race track.
The other thing is, is there is a sort of passive immunity for vaccinations for virtually all respiratory diseases. And so the passive immunity from having a population of horses that is highly vaccinated will somewhat protect horses at the race tracks.
Jennie Rees: At the race track, you hear all these things, but people are telling me that once it takes hold like at a track or a farm, it's extremely tough to get rid of because it can like hang in the dirt?
Larry Bramlage: It's potentially possible. But the (silent) carrier is much more likely.
Jennie Rees: Are you advising race tracks on how to clean up the problem?
Larry Bramlage: No. They have much smarter people than me to do that. I mean, you know, infectious diseases have to be something that everybody knows something about. But Dr. (Ford) I think is doing most of the advising and they're much more involved with that kind of epidemiology than I am.
Jennie Rees: Well, yes, realizing that you're world famous for being a (surgeon) not for the treating strangles, but how serious a problem is this given that it's going on in Kentucky, what's going on in Florida, and we're five weeks from the Kentucky Derby?
Larry Bramlage: Well, I mean, it's certainly a problem that you need to be aware of. But there are good control methods for it, segregating the horses. There's also an additional tool that is available called the PCR test, which checks for DNA from that particular bacteria.
And that test is being used to weed out the carrier horses on farms with significant success. And that's the test, one of the two tests that they're running on the horses at Churchill Downs that they have under surveillance.
And so the control of the bacteria is a whole lot easier than what it used to be. And normally, because it doesn't tend to be transmitted other than direct contact, you don't have storms of infections like you would with influenza.
So you know, the timing is terrible. If it weren't right before the Kentucky Derby, it would be a whole lot easier to be comfortable with the fact that you can control it and it's not going to have a major impact. But most of the time, that's what you would expect, that you'd be able to isolate and control this.
Jennie Rees: Thank you.
Operator: Dr. Bramlage, are you OK to take a few more questions?
Larry Bramlage: Yes, I can take a few more.
Operator: OK, good. We'll go to David Joseph, the "Sun Sentinel."
David Joseph: Doctor, this is not a reportable disease in the State of Florida. Is it in Kentucky, do you know, or anywhere else?
Larry Bramlage: I don't know of anyplace that it is. The reason it's not reportable, it's one, generally manageable and two, it's present throughout the population in low numbers. And those carrier horses are - they're not badly affected by it. Most diseases that are reportable tend to be either very aggressive diseases in the individual or in the population. And strangles is not either with a few exceptions.
David Joseph: And Gulfstream Park is doing a lot of disinfecting. They're disinfecting the (test) barns, the gate, the holding barns and taking temperatures. That's what they told the horsemen the other day. But really the best thing to do is to continue taking horses temperatures and disinfecting wherever these horses might be.
Larry Bramlage: Absolutely. If you kill the bacteria in the mucus wherever the horse may leave it, then it's not going to affect the next horse that comes by.
Operator: We'll now go to John Scheinman at the "Washington Post."
John Scheinman: Hi, Dr. Bramlage. Thanks for all this information.
Larry Bramlage: You're welcome, John.
John Scheinman: I have a few quick questions. First, what is it - when you're talking about "reportable", what does that mean?
Larry Bramlage: Well, reportable diseases are diseases that if your horse has it, it would be potentially serious to either very serious to another individual or to the population as a whole. And diseases that are relatively innocuous, you can't possibly report every bacteria or every viral infection. And so the reportable diseases are the ones that would have a devastating effect on a large group or would potentially kill an individual. And strangles doesn't fit in either of those categories.
John Scheinman: You said Streptococcus equi.
Larry Bramlage: Equi, yes.
John Scheinman: Can you spell that word for us?
Larry Bramlage: Yes, E-Q-U-I.
John Scheinman: OK, oh - I spelled it right. Good for me.
Larry Bramlage: Streptococcus equi.
John Scheinman: You talked - you mentioned to Jennie that the incubation is two weeks, but we have horses shipping out of Palm Meadows like Kiaran's horses and Todd Pletcher's horses to Keeneland. But if the incubation period is two weeks, would possibly these horses that are shipping out be a threat to the local population at Keeneland?
Larry Bramlage: Well, I mean if they had unknown exposure, but, you know, I don't think they're shipping from areas where they haven't had the disease under control. Much more - it used to be we had to used incubation periods. Now a much better concept is not the incubation period but the PCR, and the temperature and culture that they're using at Churchill Downs.
John Scheinman: Right.
Larry Bramlage: So, you know, the concept of an incubation period is a little bit outmoded with current day techniques of monitoring.
John Scheinman: One other question, you mentioned a Dr. (Ford), can you tell me who this is?
Larry Bramlage: (Rusty Ford) is the state's veterinarian - State of Kentucky. He's been working with Churchill Downs.
John Scheinman: Well, that's all my questions, thanks very much.
Operator: And we'll go to Debbie Arrington, "Sacramento Bee."
Debbie Arrington: Hi, doctor, thank you very much for coming on with us. Out here in California, we know very little about strangles. And how many horses are involved - have been diagnosed with it down in Florida?
Larry Bramlage: I can't tell you about Florida and I don't have the exact numbers off the top of my head. I think you should go to the Churchill Downs Web site for the Churchill numbers because they're on there.
Debbie Arrington: OK. When was the last outbreak of strangles at race tracks? Because it's something that, you know, we're totally unfamiliar with.
Larry Bramlage: Well, I'm not sure that I can answer that one effectively. Intermittently horses will have strangles even at a routine race track meet but it really becomes a widespread disease. And so I don't know the answer to that. It's just not a very - if this were not the time when horses are all moving from the south to the north, and all moving from places around the country to compete in the stakes races and in the derby, it wouldn't be such a big deal.
Because we're not normally all that concerned about a horse that's positive for Strep equi other than we keep them from other horses. You know, in our situation with the hospital, we'll have positive Strep equi horses coming in intermittently. But they rarely get - are a worry from transmission from horse to horse. They just get isolated in their own stall.
And that's how, if you happen to have an infection that crops up at a race track or even a group horses at a race track, or at a barn, or at a farm, that's how they're handled is to separate them out. And so it's not - there may have been fairly recently that I couldn't recall. It's just it doesn't hit the news because all of this perfect storm coming together at the same time.
Debbie Arrington: Yes, and were there any sort of conditions down in Florida that would, you know, kick this off? Like was it the weather conditions or anything like that?
Larry Bramlage: Well, the reason you don't see much of it in California is you're ambient conditions tend to be dry, and bacteria don't live very well in dry conditions. So in other words, the mucus that one horse would leave behind that another horse might contact is going to rapidly be dried out by warm weather with low humidity. And if you have higher humidity with less, you know, sunny conditions, the bacteria is going to live longer. So it always be easier to transmit in a warm humid climate than it will be in a dry area climate.
Debbie Arrington: It sounds sort of like Strep throat or mumps that, you know, is a comparable people disease. Would that …
Larry Bramlage: Mumps would be a pretty reasonable comparison with the exception of horses don't get as sick with Strep equi, most horses as people do with mumps. But the abscesses that can put pressure on the areas around the throat, would be somewhat comparable.
Debbie Arrington: Very good. Thank you very much.
Larry Bramlage: You're welcome.
Operator: Doctor, can you take one last question?
Larry Bramlage: Sure.
Operator: All right, thank you. This is Warren Alber at the "Glens Falls Post Standard."
Warren Alber: Doctor, it is a one-time infection, right, to horses?
Larry Bramlage: Not necessarily because they do develop some immunity, but as I said before, the immunity tends to be poor. For most race horses, it would be a one-time infection, but it is - it has the ability, depending upon the load of bacteria that you contaminate, that you could get it a second time.
Warren Alber: OK, and the other part I have sir, is with the carriers, I mean, they would be horses that never really came down with this, but they just happen to have it?
Larry Bramlage: Well, at some point they were exposed to the disease and they may have had a variable course of the disease. In actual fact, a very mild case of the disease, would likely have more chance to become a carrier than with a horse that has a very serious cases of the disease, because the serious disease is going to stimulate the horse to respond more. Therefore, the rational behind trying to let this run its course in a horse and not interrupt the course of the disease so that you allow the horse to respond and wipe the disease out and not become a carrier.
Warren Alber: OK, so then a horse directly could - once it runs through and it's wiped out, then it doesn't become a carrier and it doesn't always infect other horses?
Larry Bramlage: Most horses do not become carriers. And but, on an occasional one will, and unfortunately, those horses live in the normal population. And you could say that about almost any of the diseases. If you didn't have carrier horses, there would be no one around to carry these diseases from one year to the next to potentially start the epidemic in naïve horses again, or I should say infection because this is not an epidemic.
Warren Alber: All right. Thank you.
Operator: Eric, I'll turn the call back to you.
Eric Wing: All right. Well, Dr. Bramlage, your comments were very illuminating obviously on a topic that few of us know much about. We really appreciate you taking the time to share your knowledge with us and hopefully this will come to a close in a very - in a very near term.
Larry Bramlage: Well, I hope so, and I think it has a good chance of being controlled and being a topic of interest, but not really an epidemic.
http://www.ntra.com/news.asp?type=news&id=13515
Eric Wing: Larry. First of all, let's start with (strangles 101), what is strangles and what is or are the dangers that the condition poses?
Larry Bramlage: Well, strangles is caused by a bacteria called Streptococcus equi. Streptococcus species are normal (popullants) of the horses respiratory track and skin. But there are different families of the Strep bacteria as opposed to the Strep equi which in and of itself it's not a particularly virulent bacteria with the exception of it has a tendency to colonize the lymph nodes around the horses throat.
You know, (breeders) would be familiar with the thickness you got in your throat that the doctor feels for when you have an upper respiratory infection, influenza or something, and the tenderness that you get in the little round swelling - swellings that develop on both sides of your larynx under your jaw whenever you have respiratory infection.
Well, this particular bacteria in horses has a tendency to make abscesses there. The bacteria itself is not dangerous to the horse, but the abscesses in the lymph nodes can constrict the airway and reduce the airflow even to the point, if they become very bad, that the horses would have trouble breathing.
And so it has a peculiar idiosyncrasy that can become dangerous to the horse, certainly it always interrupts a horses training significantly. And when you have the infection, while it's actively present, it's easy to spread to another horse if you directly contact the horse. Now most epidemics are caused by viruses.
Viruses are much more infective than is a bacteria such as this, meaning that the viruses can usually be spread by vectors, mosquitoes. It can even go airborne. Strep equi or the strangles causing bacteria doesn't have that capability. It has to be spread directly from horse to horse, or from one horse's (extradite) to the next horse, that would be the mucus that's coming out of their nose.
And so there are - there's an advantage there in controlling it, and that is if you basically keep horses apart, you don't have to worry about this going from horse to horse like you do in a situation where you may have mosquitoes or airborne transmission. So it's much easier to quarantine. With that said, the amount of yellow (extradite) that a horse produces when they have strangles is copious. So you do have to be careful with the horses that have the active infection.
Eric Wing: Could it be passed, Larry, from horse to human to horse? An example was cited earlier on the call about, you know, perhaps an exercise rider who might work a couple of different barns, that type of thing? Or is that not really the case?
Larry Bramlage: Well, just by physical transmission, it wouldn't actually infect the human and be transmitted. But if you for instance had it on your clothes and transported it directly to the horse where that horse could get it in it's mouth or nose, well, then it certainly could be transmitted that way.
And the other obvious place that you would worry about in horses in training is the starting gate. You know, if a horse goes in and snorts in the starting gate and leaves his (extradite) on the gate and the next horse that comes in to train out of the gate should bump up against that and get it directly in its nose, you could inoculate the horse.
It doesn't live for a very long time, meaning if you - if you dry it out, the bacteria are going to die. But as long as there would be tenacious mucus that would stick to anything, a person, clothes, water buckets, anything that would go from horse to horse, could physically transmit this.
Eric Wing: Dr. Bramlage, how is strangles treated?
Larry Bramlage: Well, the usual way is to let it run its course. There is a bacteria - I'm sorry, there is an antibiotic, penicillin, actually, is quite effective against the bacteria. But the reason you often try to let it run its course is horses get a stronger immunity from the natural disease if you don't interrupt the disease.
Now if the horse is sick, not eating, or has enlarged lymph nodes to the point that you have to worry about the other health concerns of the horse or one of those being just his ability to breathe easily, then you would have to intervene and give them antibiotics and possibly something for their fever.
But it normally is not a real debilitating disease like for instance a very hot strain of influenza, which is going to cause more overall generalized sickness, muscle aches. You know, you just feel worse with influenza than you would with the strangles bacteria with the exception of if it's affecting your ability to breathe.
The reason you allow it to run its course is the immunity that the horse got to become stronger and they wipe out the bacteria more readily, or that has been the thinking for years and years. And the reason you want them to do that, there are silent strangles carriers in the population.
And if you intervene and the horse does not develop a good immunity to the bacteria, then the ability of that bacteria to survive in the horse's throat and infect another horse, even though the horse that actually carries it may not be infected by it at all anymore is (in peace).
And those silent carriers are the dangerous ones in the population, the Typhoid (Annies), so to speak, who are not infected by the disease by themselves, but has the potential to infect additional horses. It most often is a relatively not innocuous but relatively minor respiratory disease from the aspect of potential danger to live and limb. It's only if the enlarge lymph nodes begin to restrict the airway.
And then there's one other aspect that people may ask about, and that is vaccination is a possibility but the immunity that's caused by the vaccination is relatively poor because this is a bacteria. In general, viruses create very good immunities, most classes of viruses. There's some classes that do not, which is the human cold. But most of the time, viruses such as influenza do create a good immune response.
Bacteria do not, and that's why the vaccine is not totally protected from a horse. Even if a horse has been vaccinated, they can still often get this disease and the vaccination process has more morbidity to it. You get more soreness at the vaccination site.
Occasionally you'll get abscesses at the vaccination site because you're vaccinating with a bacteria. And so the control of the disease, while it's easier to segregate the population, it's harder because you can't just vaccinate all the susceptible population and protect them.
Eric Wing: Interesting. Dr. Bramlage, I'm going to step back at this point. We'll shoot it over to our announcer, Abe, and he'll check to see if any of the media listening in have any questions for you regarding strangles.
Larry Bramlage: Sure, I'll try to answer them.
Operator: Thank you, Eric. Again, that is star one to signal to ask a question. Star one. And as always, we ask that you please check your mute button to make sure you're not muted. If you are muted, that would block your signal. Dr. Bramlage, we do have a couple of questions for you. We're going to go first to Tom Keyser with the "Baltimore Sun."
Tom Keyser: Just a couple of questions. How long does it take to run its course?
Larry Bramlage: About three weeks. Not always is the horse incapacitated for that period of time, but roughly in the two to three week neighborhood would be the average.
Tom Keyser: OK. And do you know or do the vets know how this came to Palm Meadows?
Larry Bramlage: You know, I have no first hand knowledge of that scenario and I really couldn't tell you. Someone down there might know, but I have not heard that it's been established. But, you know, it could come in on any horse, even a horse that was there last year - even a horse that was - I don't know whether they keep horses all year around, but even a horse that was a resident there, if another horse that was totally naïve to the disease contacted a carrier that, though he was not affected by the disease, happen to have some of the bacteria in their respiratory track, they could infect the horse and start the ball rolling.
Tom Keyser: OK. Thank you.
Operator: We'll go now to Jennie Rees at the "Louisville Courier Journal."
Jennie Rees: Yes, doctor, what would be the incubation period of this? Like where a horse may be seemingly healthy is allowed to ship …
Larry Bramlage: Well, the incubation period for strangles is going to be in that neighborhood of two weeks, plus or minus a little bit. That somewhat depends upon the horse's susceptibility, Jennie. So it would be less than that if you're totally naïve. If you have some exposure before, it might be longer - I'm sorry, yes, it might be longer because you might not be susceptible to the disease.
You're not going to come down with it as readily. So it's a little bit more difficult to establish an incubation period with a - with a bacteria than it is with a virus. And so, it's harder to say. That's why I don't know that I can really answer your question directly.
Jennie Rees: And how rare is it at a race track? I'm told that while yes, it does surface on a farm, a lot of people said they have not heard of it in decades.
Larry Bramlage: It's much more rare than it is on the farm. There are several reasons for that, and that is, there are fewer continuously resident horses, you know, the population tends to turnover and as I mentioned before, the Typhoid Mary, often you find eventually farms identify the carrier horse that they have. And if they can wipe those out, then they have the luxury like they have at the race track.
The other thing is, is there is a sort of passive immunity for vaccinations for virtually all respiratory diseases. And so the passive immunity from having a population of horses that is highly vaccinated will somewhat protect horses at the race tracks.
Jennie Rees: At the race track, you hear all these things, but people are telling me that once it takes hold like at a track or a farm, it's extremely tough to get rid of because it can like hang in the dirt?
Larry Bramlage: It's potentially possible. But the (silent) carrier is much more likely.
Jennie Rees: Are you advising race tracks on how to clean up the problem?
Larry Bramlage: No. They have much smarter people than me to do that. I mean, you know, infectious diseases have to be something that everybody knows something about. But Dr. (Ford) I think is doing most of the advising and they're much more involved with that kind of epidemiology than I am.
Jennie Rees: Well, yes, realizing that you're world famous for being a (surgeon) not for the treating strangles, but how serious a problem is this given that it's going on in Kentucky, what's going on in Florida, and we're five weeks from the Kentucky Derby?
Larry Bramlage: Well, I mean, it's certainly a problem that you need to be aware of. But there are good control methods for it, segregating the horses. There's also an additional tool that is available called the PCR test, which checks for DNA from that particular bacteria.
And that test is being used to weed out the carrier horses on farms with significant success. And that's the test, one of the two tests that they're running on the horses at Churchill Downs that they have under surveillance.
And so the control of the bacteria is a whole lot easier than what it used to be. And normally, because it doesn't tend to be transmitted other than direct contact, you don't have storms of infections like you would with influenza.
So you know, the timing is terrible. If it weren't right before the Kentucky Derby, it would be a whole lot easier to be comfortable with the fact that you can control it and it's not going to have a major impact. But most of the time, that's what you would expect, that you'd be able to isolate and control this.
Jennie Rees: Thank you.
Operator: Dr. Bramlage, are you OK to take a few more questions?
Larry Bramlage: Yes, I can take a few more.
Operator: OK, good. We'll go to David Joseph, the "Sun Sentinel."
David Joseph: Doctor, this is not a reportable disease in the State of Florida. Is it in Kentucky, do you know, or anywhere else?
Larry Bramlage: I don't know of anyplace that it is. The reason it's not reportable, it's one, generally manageable and two, it's present throughout the population in low numbers. And those carrier horses are - they're not badly affected by it. Most diseases that are reportable tend to be either very aggressive diseases in the individual or in the population. And strangles is not either with a few exceptions.
David Joseph: And Gulfstream Park is doing a lot of disinfecting. They're disinfecting the (test) barns, the gate, the holding barns and taking temperatures. That's what they told the horsemen the other day. But really the best thing to do is to continue taking horses temperatures and disinfecting wherever these horses might be.
Larry Bramlage: Absolutely. If you kill the bacteria in the mucus wherever the horse may leave it, then it's not going to affect the next horse that comes by.
Operator: We'll now go to John Scheinman at the "Washington Post."
John Scheinman: Hi, Dr. Bramlage. Thanks for all this information.
Larry Bramlage: You're welcome, John.
John Scheinman: I have a few quick questions. First, what is it - when you're talking about "reportable", what does that mean?
Larry Bramlage: Well, reportable diseases are diseases that if your horse has it, it would be potentially serious to either very serious to another individual or to the population as a whole. And diseases that are relatively innocuous, you can't possibly report every bacteria or every viral infection. And so the reportable diseases are the ones that would have a devastating effect on a large group or would potentially kill an individual. And strangles doesn't fit in either of those categories.
John Scheinman: You said Streptococcus equi.
Larry Bramlage: Equi, yes.
John Scheinman: Can you spell that word for us?
Larry Bramlage: Yes, E-Q-U-I.
John Scheinman: OK, oh - I spelled it right. Good for me.
Larry Bramlage: Streptococcus equi.
John Scheinman: You talked - you mentioned to Jennie that the incubation is two weeks, but we have horses shipping out of Palm Meadows like Kiaran's horses and Todd Pletcher's horses to Keeneland. But if the incubation period is two weeks, would possibly these horses that are shipping out be a threat to the local population at Keeneland?
Larry Bramlage: Well, I mean if they had unknown exposure, but, you know, I don't think they're shipping from areas where they haven't had the disease under control. Much more - it used to be we had to used incubation periods. Now a much better concept is not the incubation period but the PCR, and the temperature and culture that they're using at Churchill Downs.
John Scheinman: Right.
Larry Bramlage: So, you know, the concept of an incubation period is a little bit outmoded with current day techniques of monitoring.
John Scheinman: One other question, you mentioned a Dr. (Ford), can you tell me who this is?
Larry Bramlage: (Rusty Ford) is the state's veterinarian - State of Kentucky. He's been working with Churchill Downs.
John Scheinman: Well, that's all my questions, thanks very much.
Operator: And we'll go to Debbie Arrington, "Sacramento Bee."
Debbie Arrington: Hi, doctor, thank you very much for coming on with us. Out here in California, we know very little about strangles. And how many horses are involved - have been diagnosed with it down in Florida?
Larry Bramlage: I can't tell you about Florida and I don't have the exact numbers off the top of my head. I think you should go to the Churchill Downs Web site for the Churchill numbers because they're on there.
Debbie Arrington: OK. When was the last outbreak of strangles at race tracks? Because it's something that, you know, we're totally unfamiliar with.
Larry Bramlage: Well, I'm not sure that I can answer that one effectively. Intermittently horses will have strangles even at a routine race track meet but it really becomes a widespread disease. And so I don't know the answer to that. It's just not a very - if this were not the time when horses are all moving from the south to the north, and all moving from places around the country to compete in the stakes races and in the derby, it wouldn't be such a big deal.
Because we're not normally all that concerned about a horse that's positive for Strep equi other than we keep them from other horses. You know, in our situation with the hospital, we'll have positive Strep equi horses coming in intermittently. But they rarely get - are a worry from transmission from horse to horse. They just get isolated in their own stall.
And that's how, if you happen to have an infection that crops up at a race track or even a group horses at a race track, or at a barn, or at a farm, that's how they're handled is to separate them out. And so it's not - there may have been fairly recently that I couldn't recall. It's just it doesn't hit the news because all of this perfect storm coming together at the same time.
Debbie Arrington: Yes, and were there any sort of conditions down in Florida that would, you know, kick this off? Like was it the weather conditions or anything like that?
Larry Bramlage: Well, the reason you don't see much of it in California is you're ambient conditions tend to be dry, and bacteria don't live very well in dry conditions. So in other words, the mucus that one horse would leave behind that another horse might contact is going to rapidly be dried out by warm weather with low humidity. And if you have higher humidity with less, you know, sunny conditions, the bacteria is going to live longer. So it always be easier to transmit in a warm humid climate than it will be in a dry area climate.
Debbie Arrington: It sounds sort of like Strep throat or mumps that, you know, is a comparable people disease. Would that …
Larry Bramlage: Mumps would be a pretty reasonable comparison with the exception of horses don't get as sick with Strep equi, most horses as people do with mumps. But the abscesses that can put pressure on the areas around the throat, would be somewhat comparable.
Debbie Arrington: Very good. Thank you very much.
Larry Bramlage: You're welcome.
Operator: Doctor, can you take one last question?
Larry Bramlage: Sure.
Operator: All right, thank you. This is Warren Alber at the "Glens Falls Post Standard."
Warren Alber: Doctor, it is a one-time infection, right, to horses?
Larry Bramlage: Not necessarily because they do develop some immunity, but as I said before, the immunity tends to be poor. For most race horses, it would be a one-time infection, but it is - it has the ability, depending upon the load of bacteria that you contaminate, that you could get it a second time.
Warren Alber: OK, and the other part I have sir, is with the carriers, I mean, they would be horses that never really came down with this, but they just happen to have it?
Larry Bramlage: Well, at some point they were exposed to the disease and they may have had a variable course of the disease. In actual fact, a very mild case of the disease, would likely have more chance to become a carrier than with a horse that has a very serious cases of the disease, because the serious disease is going to stimulate the horse to respond more. Therefore, the rational behind trying to let this run its course in a horse and not interrupt the course of the disease so that you allow the horse to respond and wipe the disease out and not become a carrier.
Warren Alber: OK, so then a horse directly could - once it runs through and it's wiped out, then it doesn't become a carrier and it doesn't always infect other horses?
Larry Bramlage: Most horses do not become carriers. And but, on an occasional one will, and unfortunately, those horses live in the normal population. And you could say that about almost any of the diseases. If you didn't have carrier horses, there would be no one around to carry these diseases from one year to the next to potentially start the epidemic in naïve horses again, or I should say infection because this is not an epidemic.
Warren Alber: All right. Thank you.
Operator: Eric, I'll turn the call back to you.
Eric Wing: All right. Well, Dr. Bramlage, your comments were very illuminating obviously on a topic that few of us know much about. We really appreciate you taking the time to share your knowledge with us and hopefully this will come to a close in a very - in a very near term.
Larry Bramlage: Well, I hope so, and I think it has a good chance of being controlled and being a topic of interest, but not really an epidemic.