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European outbreaks of atypical myopathy in grazing equids (2006–2009): spatiotemporal distribution, history and clinical features

G van Galen, C Marcillaud Pitel, C Saegerman, F Patarin, H Amory, JD Baily, D Cassart, V Gerber, C Hahn, P Harris, et al.
(2012) EQUINE VETERINARY JOURNAL. 44(5). p.614-620
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Abstract
Reasons for performing study: Improved understanding of the epidemiology of atypical myopathy (AM) will help to define the environmental factors that permit or support the causal agent(s) to exert toxicity. Objectives: This European survey of AM aimed to describe spatiotemporal distribution, survival, clinical signs, circumstances in which AM develops and its different expressions between countries and over time. Methods: The spatiotemporal distribution, history and clinical features of AM cases reported to the Atypical Myopathy Alert Group from 2006 to 2009 were described. Comparisons of data from the most severely affected countries and from the large outbreaks were made with Fisher's exact and Welch's tests with Bonferroni correction. Results: Of 600 suspected cases, 354 met the diagnostic criteria for confirmed or highly probable AM. The largest outbreaks occurred during the autumns of 2006 and 2009 in Belgium, France and Germany. For the first time, donkeys, zebras and old horses were affected, and clinical signs such as gastrointestinal impaction, diarrhoea, penile prolapse, buccal ulceration and renal dysfunction were observed. Affected horses spent >6 h/day on pastures that almost always contained or were surrounded by trees. The latency period was estimated at up to 4 days. Overall survival rate was 26%. Although differences between countries in affected breeds, body condition, horse management and pasture characteristics were recognised, the common presenting clinical signs and mortality were similar between countries. Conclusions and potential relevance: This study describes new data on case details, history and clinical course of AM that is of preventive, diagnostic and therapeutic value. However, the true impact of the findings of this study on the development of or severity of AM should be tested with casecontrol studies.
Keywords
HORSES, MYOGLOBINURIA, COA DEHYDROGENASE-DEFICIENCY, atypical myopathy, prognostic predictors, rhabdomyolysis, epidemiology, horse, pasture, GRASS

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MLA
van Galen, G., et al. “European Outbreaks of Atypical Myopathy in Grazing Equids (2006–2009): Spatiotemporal Distribution, History and Clinical Features.” EQUINE VETERINARY JOURNAL, vol. 44, no. 5, 2012, pp. 614–20, doi:10.1111/j.2042-3306.2012.00556.x.
APA
van Galen, G., Marcillaud Pitel, C., Saegerman, C., Patarin, F., Amory, H., Baily, J., … Votion, D. (2012). European outbreaks of atypical myopathy in grazing equids (2006–2009): spatiotemporal distribution, history and clinical features. EQUINE VETERINARY JOURNAL, 44(5), 614–620. https://doi.org/10.1111/j.2042-3306.2012.00556.x
Chicago author-date
Galen, G van, C Marcillaud Pitel, C Saegerman, F Patarin, H Amory, JD Baily, D Cassart, et al. 2012. “European Outbreaks of Atypical Myopathy in Grazing Equids (2006–2009): Spatiotemporal Distribution, History and Clinical Features.” EQUINE VETERINARY JOURNAL 44 (5): 614–20. https://doi.org/10.1111/j.2042-3306.2012.00556.x.
Chicago author-date (all authors)
van Galen, G, C Marcillaud Pitel, C Saegerman, F Patarin, H Amory, JD Baily, D Cassart, V Gerber, C Hahn, P Harris, JA Keen, N Kirschvink, Laurence Lefère, B McGorum, JMV Muller, MTJE Picavet, RJ Piercy, K Roscher, D Serteyn, L Unger, JH van der Kolk, Gunther van Loon, D Verwilghen, CM Westermann, and DM Votion. 2012. “European Outbreaks of Atypical Myopathy in Grazing Equids (2006–2009): Spatiotemporal Distribution, History and Clinical Features.” EQUINE VETERINARY JOURNAL 44 (5): 614–620. doi:10.1111/j.2042-3306.2012.00556.x.
Vancouver
1.
van Galen G, Marcillaud Pitel C, Saegerman C, Patarin F, Amory H, Baily J, et al. European outbreaks of atypical myopathy in grazing equids (2006–2009): spatiotemporal distribution, history and clinical features. EQUINE VETERINARY JOURNAL. 2012;44(5):614–20.
IEEE
[1]
G. van Galen et al., “European outbreaks of atypical myopathy in grazing equids (2006–2009): spatiotemporal distribution, history and clinical features,” EQUINE VETERINARY JOURNAL, vol. 44, no. 5, pp. 614–620, 2012.
@article{2123116,
  abstract     = {{Reasons for performing study: Improved understanding of the epidemiology of atypical myopathy (AM) will help to define the environmental factors that permit or support the causal agent(s) to exert toxicity. Objectives: This European survey of AM aimed to describe spatiotemporal distribution, survival, clinical signs, circumstances in which AM develops and its different expressions between countries and over time. Methods: The spatiotemporal distribution, history and clinical features of AM cases reported to the Atypical Myopathy Alert Group from 2006 to 2009 were described. Comparisons of data from the most severely affected countries and from the large outbreaks were made with Fisher's exact and Welch's tests with Bonferroni correction. Results: Of 600 suspected cases, 354 met the diagnostic criteria for confirmed or highly probable AM. The largest outbreaks occurred during the autumns of 2006 and 2009 in Belgium, France and Germany. For the first time, donkeys, zebras and old horses were affected, and clinical signs such as gastrointestinal impaction, diarrhoea, penile prolapse, buccal ulceration and renal dysfunction were observed. Affected horses spent >6 h/day on pastures that almost always contained or were surrounded by trees. The latency period was estimated at up to 4 days. Overall survival rate was 26%. Although differences between countries in affected breeds, body condition, horse management and pasture characteristics were recognised, the common presenting clinical signs and mortality were similar between countries. Conclusions and potential relevance: This study describes new data on case details, history and clinical course of AM that is of preventive, diagnostic and therapeutic value. However, the true impact of the findings of this study on the development of or severity of AM should be tested with casecontrol studies.}},
  author       = {{van Galen, G and Marcillaud Pitel, C and Saegerman, C and Patarin, F and Amory, H and Baily, JD and Cassart, D and Gerber, V and Hahn, C and Harris, P and Keen, JA and Kirschvink, N and Lefère, Laurence and McGorum, B and Muller, JMV and Picavet, MTJE and Piercy, RJ and Roscher, K and Serteyn, D and Unger, L and van der Kolk, JH and van Loon, Gunther and Verwilghen, D and Westermann, CM and Votion, DM}},
  issn         = {{0425-1644}},
  journal      = {{EQUINE VETERINARY JOURNAL}},
  keywords     = {{HORSES,MYOGLOBINURIA,COA DEHYDROGENASE-DEFICIENCY,atypical myopathy,prognostic predictors,rhabdomyolysis,epidemiology,horse,pasture,GRASS}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{614--620}},
  title        = {{European outbreaks of atypical myopathy in grazing equids (2006–2009): spatiotemporal distribution, history and clinical features}},
  url          = {{http://doi.org/10.1111/j.2042-3306.2012.00556.x}},
  volume       = {{44}},
  year         = {{2012}},
}
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