National Equine Health Plan: A resource for equine practitioners

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Nearly a decade ago, the USDA approached the American Horse Council (AHC) with a question: If we have a disaster-level equine disease outbreak, what are you folks going to do about it?

According to Cliff Williamson, current director of health and regulatory affairs for the AHC, before that meeting the horse industry had believed it was the federal government's responsibility to manage biosecurity and protect U.S. herd health. But the more the groups talked, the more they realized everyone had a role-and they needed to educate the various stakeholders.

The result was the creation of the National Equine Health Plan (NEHP), a document emphasizing the responsibilities of veterinarians, horse owners, regulatory officials and others in preventing and mitigating disease outbreaks. But the plan wasn't finalized until 2017, and it took the cooperation and leadership of a number of key individuals to make it a reality.

Early development of the NEHP

Early on in the development process, USDA equine representatives and individuals at the AHC created a draft of the plan. Its stated mission was to protect the health and welfare of horses in the United States by describing the roles and responsibilities of the equine industry, the federal government, state equine health officials, veterinarians and the U.S. diagnostic laboratory networks. “The initial effort was to lay out all the stakeholders' responsibilities so we all knew where we stood,” Williamson says.

In 2011, a working group met several times to begin to develop these roles and responsibilities, but they struggled to make things work. “Unfortunately, the initial drafts never hit the mark,” notes Williamson. “They were either too comprehensive or not comprehensive enough, too technical or not technical enough. There were tone issues, logistical issues and other various issues that did not satisfy the true need as had been planned.”

Nat White, DVM, MS, DACVS, professor emeritus of equine surgery at the Virginia-Maryland College of Veterinary Medicine, echoes these thoughts. “The initial description of the plan was not acceptable,” he says. “It was not going to serve its purpose as a resource for everyone in the horse industry.”

When the initial work on the NEHP stalled, the AAEP set up a task force to evaluate the biosecurity and communications segments of the plan. As a result, Williamson was recruited to draft the plan, the Equine Disease Communication Center (EDCC) was created as a communication hub for the process, and Dr. White assumed the role of EDCC director.

“White, with his longstanding AAEP leadership, stepped up and took it upon himself to lead the initiative of putting all the segments of the NEHP together,” Williamson says. He and Dr. White, along with Rory Carolyn, DVM, of the USDA, met and finally wrote the National Equine Health Plan as published in 2017. Contributing important input to the final document were individuals representing the USDA, state animal health departments, the AAEP and the equine industry.

“What was eventually published was the ‘30,000-foot view' of all aspects of the U.S. horse industry, including stakeholders that need to be involved to protect the national horse herd's health,” Williamson says.

“It should be emphasized that the National Equine Health Plan is a resource that veterinarians can use to educate their clients and for owners to use it as a resource,” Dr. White adds. “Now veterinarians can go to the EDCC website to view the NEHP and learn what's available to help people learn about equine disease risk and disease outbreaks.”

NEHP goal: Protect the U.S. horse herd

The goal of the NEHP is to help decrease the risk of disease spread throughout the U.S. horse population. The EDCC is NEHP's communication outlet, also providing administrative oversight and leadership.

According to the EDCC, the horse industry is unique because horses are transported with greater frequency and over greater distances than other livestock. Interstate, intrastate and international transport of horses is common-hundreds of thousands of horses are routinely transported to horse shows and other competitions, to racetracks in the U.S. and other countries, to other farms for breeding and training, and to veterinary clinics for treatment.

This extensive movement of horses makes it essential that veterinarians and owners know how to prevent and mitigate disease outbreaks, whether they occur at the home stable or in new and stressful environments. It's critical that veterinarians know what resources are available to help during disease outbreaks-which is where the NEHP comes in. According to Dr. White, the plan was purposefully kept as concise as possible, especially the roles and responsibilities of the various stakeholders, so the information would be easily accessible and relevant in a crisis.

Some of the key goals of the NEHP are to:

• Protect the health and welfare of horses in the U.S. and North America.
• Facilitate continued interstate and intrastate movement, as well as international movement of horses safely without jeopardy of disease.
• Educate members of the equine industry on how to prevent and control disease during equine events and in the case of natural disaster.
• Ensure the availability of current diagnostic testing and inspection information, which provides a way to rapidly disperse accurate information about disease outbreaks.
• Provide guidelines for control, identification and containment of equine diseases.
• Educate horse owners and the equine industry on disease identification and prevention.

Roles and responsibilities of veterinarians

The specific roles and responsibilities for veterinarians fall into in several categories:

Disease prevention

• Maintain current knowledge of all aspects of equine disease prevention, monitoring, containment, mitigation, biosecurity and business continuity.
• Take part in the education of horse owners and the industry about diseases and biosecurity.
• Promote disease prevention to all horse owners.
• Assist horse owners and event organizers in the development of disease prevention and infectious disease control plans.
• Utilize cleaning and disinfection strategies between client horse visits.
• Maintain proper horse disease records in an electronically searchable format.
• Recommend isolation and diagnostic testing of all sick individual equines.
• Encourage appropriate vaccinations for the prevention of equine diseases.

Disease surveillance and monitoring

• Monitor equine disease prevalence and risk factors within the geographic area.
• Perform diagnostic procedures to fully assess the clinical situation.
• Monitor the effectiveness of preventive and therapeutic measures.
• Identify and report suspected cases of reportable diseases to appropriate authorities.
• Understand the critical role private practitioners play in the National Comprehensive Equine Disease Surveillance System, which reports to veterinary diagnostic labs, academic institutions and other equine clinics.  

More on the Equine Disease Communication Center

The Equine Disease Communication Center, which was part of the initial concept for the NEHP, was eventually developed as a separate AAEP initiative.

“The EDCC came about after the initial draft of a health plan was being developed,” says Dr. Nat White, the center's director. “An equine herpesvirus outbreak at a cutting horse show in 2011 in Ogden, Utah-an event with about 2,000 horses-highlighted the need for a disease communication system. The result of the Utah outbreak was a social media deluge of misinformation about the disease and its spread to other horses and locations.”

The real story is that a total of 425 primarily exposed horses returned home to 19 states, 12 of which had confirmed or suspected equine herpesvirus cases. Because there was no coordination of information about the outbreak, equine activities in several states were severely curtailed. For example, quarantines set up to stop spread of the disease in California that year resulted in the canceling of more than 400 horse shows and events. It caused a huge negative economic impact.

As a result of that outbreak, an AAEP task force was established under Dr. White's leadership. “For the future, we needed to tell people about biosecurity so they would be knowledgeable and prepared to do what is needed when they faced an outbreak,” Dr. White says. “The task force came up with the idea of the EDCC. I then worked setting up the program from 2012 until 2015, when we began posting information. Once state and practicing veterinarians were convinced of the EDCC's benefit, we were able to post real-time and accurate information about the current status of disease outbreaks to keep all parties informed.”

The evidence speaks for the success of the EDCC today. In total, 47 states and four Canadian provinces have sent disease outbreak reports for posting on the EDCC website. Additionally, practitioners are sending in reports of diseases that are not reportable in their state, per se, but obviously can be a health concern.

“The EDCC is its own entity, supported by AHC member organizations and horse owners,” states Dr. White. “We're trying to keep the EDCC an independent service, owned by the entire horse industry.”

Although the EDCC model has been modified over time, the most important role continues to be providing a better method of communicating to get disease information to the public, to the industry and to the animal health officials responsible for protecting the national horse herd. When a veterinarian or a state veterinarian sends a report of a disease outbreak, the EDCC utilizes not only its website but also an email Listserv. “We essentially punch a button that directs information to about 6,000 veterinarians, state veterinarians and owners,” Dr. White says.

Anyone can sign up to receive EDCC alerts and NEHP information. The same information is also posted on Facebook and Twitter. For example, during a recent herpesvirus outbreak in New York state, the state veterinarian sent the EDCC information that the center posted on its website and then immediately made available to the public via social media.

The EDCC is funded by the horse industry through donations made to the AAEP Foundation, which are tax-deductible. The USDA provided initial funding, but the primary support comes from organizations and owners. All the sponsors are listed on the EDCC website.

The other major role for the EDCC is providing access to educational resources for veterinarians and horse owners. This includes information about diseases and biosecurity, contact information for animal health officials and the NEHP, and resources such as interstate animal movement requirements. Owner fact sheets for diseases and the recently revised AAEP Infectious Disease Guidelines are also linked on the EDCC website. “We're trying to ensure everyone in the horse industry is proactive and ready to prevent and respond to infectious diseases,” Dr. White says.

Response, containment and mitigation of outbreaks

• Report suspected reportable diseases to the appropriate animal health official.
• Work with state animal health officials to monitor equine disease outbreaks.
• Direct stakeholders to sources of information and education, including the EDCC.
• At the request of state and federal officials, provide assistance during an equine disease response.
• Maintain a situational awareness of equine disease incidents and provide timely and accurate disease information updates to clients and to the EDCC.

Biosecurity

• Promote biosecurity for the prevention of infectious diseases.
• Recommend and initiate biosecurity during disease outbreaks.
• Conduct biosecurity risk assessments and develop a plan for equine facilities prior to an outbreak and a plan for events and horse gatherings.

Communication, outreach, education

Educate the equine industry about infectious diseases, prevention and biosecurity.

Diagnostics

• Work with diagnostic laboratories to ensure proper testing and sampling procedures.
• Collect and send samples from diseased animals.
• Report outcomes regarding cause of clinical presentations and determine if additional diagnostic testing is necessary to definitively diagnose a disease.

Epidemiology

• Provide pertinent equine disease data to epidemiologists.
• Assist in gathering such data during a disease outbreak.

Business continuity

Maintain a working partnership with regulatory officials and stakeholders in the equine industry to develop disease response plans, paying particular attention to business continuity.

Drugs and vaccines

Ensure the appropriate uses of antimicrobials, drugs and medicines for the treatment of equine illnesses and injuries.

Funding needs

Identify equine industry research needs and support funding of the EDCC.

How everything fits together

Here's how the components of the NEHP system work: The AHC serves as the umbrella organization responsible for the leadership, fundraising and governmental relations for the EDCC, the communication arm of the NEHP. The AAEP Foundation serves as EDCC's “bank,” so tax-deductible donations can be used directly to support the EDCC. The AAEP also provides office staff space and HR resources for the EDCC. The United States Equestrian Federation supports IT and is the home for the EDCC website.

The purpose of the EDCC is to get disease information out as soon as possible to the veterinary community and to horse owners to curtail health outbreaks and limit disease spread. Once the disease is under control, veterinarians, horse owners and other industry stakeholders can proceed with business as usual without fear of further disease spread or morbidity. This helps protect the horse economy.

For equine practitioners, a full exploration of the entire NEHP and the breadth of the roles of responsibilities for veterinarians-along with those of other major equine stakeholders-are available from the EDCC at equinediseasecc.org/national-equine-health-plan.

Ed Kane, PhD, is a researcher and consultant in animal nutrition. He is an author and editor on nutrition, physiology and veterinary medicine with a background in horses, pets and livestock. Kane is based in Seattle.