Changes

|'''EPM<br>

|'''EPM<br>

'''Equine protozoal myelitis'''

'''Equine protozoal myelitis'''

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====Epidemiology====

====Epidemiology====

   

   

In endemic areas of the United States, around a quarter of referrals for equine neurological disease are attributed to EPM.(22,23 in Furr)  According to the United States Department of Agriculture, the average incidence of the disease is 14 cases per 10,000 horses per year.  However, the challenges of obtaining a definitive diagnosis may mean this figure is an underestimate (Furr).  The disease has been identified in parts of Central and South America, southern Canada and across most of the USA.(Furr) EPM is noted occasionally in other countries, in horses that have been imported from the Americas.(28,29 in Furr).  It is likely that these animals underwent transportation carrying a silent but persistent infection.  There have been reports of EPM in horses that have not travelled to or from endemic regions(Furr), although cross-reacting Ags on the immunoblot test may explain this discrepancy(Furr).

In endemic areas of the United States, around a quarter of referrals for equine neurological disease are attributed to EPM.<ref>Reed, S.M, Granstrom, D, Rivas, L.J, Saville, W.A, Moore, B.R, Mitten, L.A (1994) Results of cerebrospinal fluid analysis in 119 horses testing positive to the Western blot test on both serum and CSF to equine protozoal encephalomyelitis.  In ''Proc Am Assoc Equine Pract'', Vancouver BC, AEEP, Lexington, KY, p199.  In: Furr, M (2010) ''Equine protozoal myeloencephalitis'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), ''Saunders'', Chapter 12.</ref> According to the United States Department of Agriculture, the average incidence of the disease is 14 cases per 10,000 horses per year.  However, the challenges of obtaining a definitive diagnosis may mean this figure is an underestimate.<ref name="Furr">Furr, M (2010) ''Equine protozoal myeloencephalitis'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), ''Saunders'', Chapter 12.</ref> The disease has been identified in parts of Central and South America, southern Canada and across most of the USA.(Furr) EPM is noted occasionally in other countries, in horses that have been imported from the Americas.<ref>Pitel, P.H, Pronost, S, Gargala, G, Anrioud, D, Toquet, M-P, Foucher, N, Collobert-Laugier, C, Fortier, G, Ballet, J-J (2002) Detection of ''Sarcocystis neurona'' antibodies in French horses with neurological signs, ''Int J Parasitol'', 32:481-485.  In: Furr, M (2010) ''Equine protozoal myeloencephalitis'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), ''Saunders'', Chapter 12.</ref><ref>Goehring, L.S (2001) Sloet van Oldruitenborgh-Oosterbaan MM: Equine protozoal myeloencephalitis in the Netherlands?  An overview, ''Tijdschr Diergeneeskd'', 126:346-351.  In: Furr, M (2010) ''Equine protozoal myeloencephalitis'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), ''Saunders'', Chapter 12.</ref> It is likely that these animals underwent transportation carrying a silent but persistent infection.  There have been reports of EPM in horses that have not travelled to or from endemic regions,<ref name="Furr">Furr, M (2010) ''Equine protozoal myeloencephalitis'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), ''Saunders'', Chapter 12.</ref> although cross-reacting Ags on the immunoblot test may explain this discrepancy. <ref name="Furr">Furr, M (2010) ''Equine protozoal myeloencephalitis'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), ''Saunders'', Chapter 12.</ref>

The route of infection remains unconfirmed, (Pasq) but there is an increased risk associated with a young age (1-4yrs) (IVIS 3) and autumn months (24 in Furr).  The reported age range for EPM cases is currently 2 months (34 in furr) to 24 years (35 in Furr).  Thoroughbreds, Standardbreds and Quarterhorses are most commonly affected across the US and Canada (30 in Furr).  This may relate to a breed predispostion or alternatively, managemental factors associated with these breeds(32 in Furr).  Showing, racing (25 in Furr) and stress(25 in Furr) have been linked to a greater risk of clinical disease(IVIS 2).   

The route of infection remains unconfirmed, (Pasq) but there is an increased risk associated with a young age (1-4yrs) (IVIS 3) and autumn months (24 in Furr).  The reported age range for EPM cases is currently 2 months (34 in furr) to 24 years (35 in Furr).  Thoroughbreds, Standardbreds and Quarterhorses are most commonly affected across the US and Canada (30 in Furr).  This may relate to a breed predispostion or alternatively, managemental factors associated with these breeds(32 in Furr).  Showing, racing (25 in Furr) and stress(25 in Furr) have been linked to a greater risk of clinical disease(IVIS 2).