1. AN ANALYTICAL STUDY OF THE PERCEPTIONS, PREVENTIONS STRATEGIES, TREATMENT AND ECONOMIC IMPACT OF EQUINE WEST NILE VIRUS R. GALVAN, A. Rene, S. Bae, K. Singh

2. BACKGROUND

3. West Nile Virus Transmission Cycle Source: Pennsylvania State University, 2002

4. 1999 Coverage

5. 2000 Coverage

6. 1999 Coverage 2000 Coverage 2001 Coverage

7. 1999 Coverage 2000 Coverage 2001 Coverage 2002 Coverage WNV 1999 - 2002

8. PURPOSE The purpose of this study is to focus on gathering information regarding the perception, knowledge, concerns and treatment of the WNV among Texas Veterinarians The purpose of this study is to focus on gathering information regarding the perception, knowledge, concerns and treatment of the WNV among Texas Veterinarians To determine the economic impact of the WNV on the equine population in Texas To determine the economic impact of the WNV on the equine population in Texas No other study regarding equine WNV has been undertaken in the State of Texas No other study regarding equine WNV has been undertaken in the State of Texas

9. Epidemiology of West Nile Virus Horses are affected by WNV more than other animals Horses are affected by WNV more than other animals Annual Summary of WNV Cases 2002%2003% Bird51919.453419.4 Human2027.543715.9 Mosquito2609.7105838.4 Horse169963.471726.0 Other00110.4 TOTAL26802757 Source: Texas Department of Health, Zoonosis Control Division 2004

10. Equine Population in Texas Home to over 1 million horses Home to over 1 million horses 280,000+ horse owners 280,000+ horse owners $13 billion invested in horse industry (barns, vehicles etc.) $13 billion invested in horse industry (barns, vehicles etc.) Texas horses valued at $4.2 billion Texas horses valued at $4.2 billion Horse industry impact to Texas economy is $11 billion per year Horse industry impact to Texas economy is $11 billion per year Source :Texas A&M University; Animal Science 1998

11. Economic Impact: WNV and Equines Colorado and Nebraska Equine Study Colorado and Nebraska Equine Study Estimates of $163,000 lost revenue Estimates of $600,000 due to deaths (estimates for 1478 equines) Cost of vaccination vs. effectiveness in equine population Cost of vaccination vs. effectiveness in equine population Colorado/Nebraska $2.75 million on prevention Colorado/Nebraska $2.75 million on prevention Further studies need to be conducted for clarity Further studies need to be conducted for clarity Source: Animal and Plant Health Inspection Service 2003 (www.aphis.usda.gov)

12. Research Methods

13. Study Purpose Collect data on cases of West Nile Virus (WNV) Collect data on cases of West Nile Virus (WNV) Collect information regarding the knowledge, concerns and treatment WNV by veterinarians in Texas Collect information regarding the knowledge, concerns and treatment WNV by veterinarians in Texas Estimate the economic impact of WNV on the equine population in Texas Estimate the economic impact of WNV on the equine population in Texas

14. Hypotheses Veterinarians who have treated West Nile Virus have the same perceptions, understanding and awareness as the Veterinarians who have not treated West Nile Virus Veterinarians who have treated West Nile Virus have the same perceptions, understanding and awareness as the Veterinarians who have not treated West Nile Virus There is no difference among Veterinarians that recommend different treatment regimens with respect to perceptions of the West Nile Virus There is no difference among Veterinarians that recommend different treatment regimens with respect to perceptions of the West Nile Virus

15. Hypotheses There is no difference among Veterinarians that recommend different treatment regimens with respect to recommendations on mosquito mitigation of West Nile Virus There is no difference among Veterinarians that recommend different treatment regimens with respect to recommendations on mosquito mitigation of West Nile Virus There is no difference among Veterinarians that recommend different treatment regimens with respect to recommendations on prevention strategies for West Nile Virus There is no difference among Veterinarians that recommend different treatment regimens with respect to recommendations on prevention strategies for West Nile Virus

16. Survey Design Tools used in the development of the survey Tools used in the development of the surveyInstrument 2002 Veterinarian Survey West Nile Survey Survey included Survey included 13 close-ended questions and 1 open- ended question

17. Data Collection 4,177 total surveys were sent out 4,177 total surveys were sent out Two options were given for survey response Two options were given for survey response Online response Paper survey response

18. Data Entry A numbering system was created to distinguish between surveys entered manually and online by the respondent A numbering system was created to distinguish between surveys entered manually and online by the respondent 700 surveys were completed 700 surveys were completed

19. Data Analysis Descriptive Analyses Descriptive AnalysesSummationsFrequenciesCross-tabulations

20. Results

21. Results 700 Surveys were returned 700 Surveys were returned 684 were mailed in (98%) 16 were completed online (2%) Response rate of 16.8% Response rate of 16.8%

22. 73.4% of respondents believed they were knowledgeable about WNV

23. 49.7% of respondents believed they are receiving enough education and training

24. 56.1% of respondents believed a vaccination regimen is effective and reliable

25. Logistic Regression Veterinarians that did not treat for WNV were 95% less likely to agree that they were knowledgeable about WNV Veterinarians that did not treat for WNV were 95% less likely to agree that they were knowledgeable about WNV Veterinarians that did not treat for WNV were 82% less likely to agree that Veterinarians were receiving enough training Veterinarians that did not treat for WNV were 82% less likely to agree that Veterinarians were receiving enough training Eighty percent (80%) of practicing Veterinarians that did not treat horses for WNV did not agree that the treatment regimen for WNV was effective and reliable Eighty percent (80%) of practicing Veterinarians that did not treat horses for WNV did not agree that the treatment regimen for WNV was effective and reliable

26. Results Respondents reported 2022 cases of WNV Respondents reported 2022 cases of WNV 1256 were laboratory confirmed 766 were not confirmed by laboratory testing 441 horses died 441 horses died 418 by euthanasia 23 as a direct result of the disease

27. Criteria for Euthanasia

28. 48% of respondents recommend prevention strategies for equine owners

29. 38.8% of the respondents recommended control strategies to equine owners

30. Results of Cross-Tabulation 97.2% of respondents who treated WNV agree that they are knowledgeable about WNV 97.2% of respondents who treated WNV agree that they are knowledgeable about WNV 65.5% of respondents who did not treat agree 65.5% of respondents who did not treat agree

31. Results of Cross-Tabulation 78.4 % of veterinarians who treated WNV believe they are receiving enough education/training 78.4 % of veterinarians who treated WNV believe they are receiving enough education/training Only 40.1 % of veterinarians who did not treat believe they are receiving enough education/training Only 40.1 % of veterinarians who did not treat believe they are receiving enough education/training

32. Results of Cross-Tabulation 81.8 % of veterinarians who treated WNV believe the vaccine is effective and reliable compared to 47.5 % of those who did not treat WNV 81.8 % of veterinarians who treated WNV believe the vaccine is effective and reliable compared to 47.5 % of those who did not treat WNV

33. Cost of vaccination regimen for equine WNV

34. Results Anti-inflammatory drugs were the main type of treatment used in all stages of WNV Anti-inflammatory drugs were the main type of treatment used in all stages of WNV 63.4% for mild WNV 57.76% for moderate WNV 44.2% for severe WNV Other treatments reported for all stages of WNV included Other treatments reported for all stages of WNV includedantibioticsfluidssteroids

35. Implications of Results Equine WNV case fatality rate of 40.0% Equine WNV case fatality rate of 40.0% Need for equine WNV education among veterinarians Need for equine WNV education among veterinarians Future research may include knowledge/beliefs of equine owners Future research may include knowledge/beliefs of equine owners

36. Implications of Results Estimated Economic Impact Estimated Economic Impact Equine WNV fatalities- 2002 - $2,856,000 2002 - $2,856,000 2003 - $1,205,400 2003 - $1,205,400 average purchase price of horse  total number of horses lost due to WNV Vaccination against equine WNV- 2002 - $6,250,000 2003 - $6,250,000 2003 - $6,250,000 average cost of vaccination for equine WNV  25% of the equine population in Texas

37. Implications of Results Estimated Combined Economic Impact for 2002-2003 Estimated Combined Economic Impact for 2002-2003 2002- $9,106,000 2002- $9,106,000 2003 - $7,455,400 2003 - $7,455,400 Total - 16,561,400 Total - 16,561,400

38. Discussion Understanding the effects and treatment of the WNV is essential Understanding the effects and treatment of the WNV is essential More WNV research and education is needed More WNV research and education is needed This study can be used as a benchmark in future WNV studies This study can be used as a benchmark in future WNV studies Additional WNV education is needed among Veterinarians in areas of prevention strategies, control and treatment. Additional WNV education is needed among Veterinarians in areas of prevention strategies, control and treatment.

39. Discussion Less than one half of the Veterinarians who have treated WNV believed they were receiving enough education on the disease Less than one half of the Veterinarians who have treated WNV believed they were receiving enough education on the disease One half of the Veterinarians recommended prevention strategies One half of the Veterinarians recommended prevention strategies One half of the Veterinarians believed the vaccination regimen was effective One half of the Veterinarians believed the vaccination regimen was effective

40. Discussion The economic impact to horse owners in 2002 was estimated at $9,106,000 The economic impact to horse owners in 2002 was estimated at $9,106,000 The economic impact to horse owners for 2003 was estimated at $7,455,400 The economic impact to horse owners for 2003 was estimated at $7,455,400

41. Limitations of Study Information in surveys is self- reported but still an effective method Information in surveys is self- reported but still an effective method Values given for number of cases in the survey were ranges Values given for number of cases in the survey were ranges Full economic impact of equine WNV could not be determined Full economic impact of equine WNV could not be determined Many respondents had small animal practices Many respondents had small animal practices

42. QUESTIONS????