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July/August 2014 Today's Veterinary Practice 31 Bordetella BronchiSeptica & CanIne Influenza VIRus (H3n8) | tvpjournal.com Note that a positive antibody titer in a population of dogs with no signs of respiratory disease likely indicates prior exposure to the virus, rather than active infection. In shelter dogs with signs of respiratory disease, seroprev- alence is as high as 50%, depending on length of time since intake to the shelter. 7,8 Given the population, these patients are likely co-infected with other common viral and bacterial pathogens that encompass the CIRDC (Table 1). Howe ver, veter i n a r i a n s should recognize that the prev- alence of CIV is much lower in client-owned dogs with respi- ratory signs, especially if they have not been recently exposed in a shelter or boarding kennel. Geographic Location. CIV is associated with geographic hot spots, and practitioners should become familiar with the partic- ular areas in which it has been identified. In a recent study, sero- prevalence of CIV in dogs with influenza-like illness was highest in the northeast, west, and south- west United States, with the high- est representation being in New York, Colorado, and Florida. 7 RISK FACTORS Both CIV and B bronchiseptica infections are highly con- tagious, and dogs of any age and breed may become infect- ed. Those at most risk for exposure and infection include: • Dogs housed in boarding facilities, shelters, kennels, and pet shops 8,9 • Puppies, especially those in the above housing situa- tions, due to reduced immunity (both local and system- ic), which may result in severe infection and death. 9 Factors that contribute to risk and severity of infection in puppies include: • Close contact with other dogs and puppies • Immature immune systems • Immune dysfunction due to concurrent infections (viral, bacterial, parasitic). Because puppies housed in shelters and pet shops are often in closed ventilation spaces with other puppies from various environments, they are at highest risk. PREVENTION Vaccination can help protect against infection and reduce severity of clinical disease. Turn to page 72 to read Dr. Richard Ford's article, Kennel Cough Revisited, for a discussion on current advances in vaccination for canine respiratory disease. TRANSMISSION Mode of Transmission Transmission of B bronchiseptica and CIV occurs via: 1 • Oronasal contact with other dogs, caregivers, or fomites • Inhalation of aerosolized microdroplets of respiratory secretions. In high-density housing situations, direct contact among dogs is most common. Less commonly, fomites serve as a source of transmission. CONSIDERATIONS IN HOSPITAL Considering modes of transmission and environ- mental survival of the agent is important when dis- cussing management of patients in hospital. Cli- nicians should take precautions when handling these patients and make efforts to limit exposure throughout the hospital. • Hospitalize patients in isolation facilities within the clinic to limit exposure to other dogs, especially those that are immunocompromised. as much as possible, manage infected patients as outpatients. • Ensure that staff wear protective clothing, such as gloves and disposable gowns, when working with infectious patients. • Keep the veterinary team from handling other patients of the same species during the same shift in which they have handled infectious patients. • Limit contact between critical patients that require oxygen therapy and close monitoring— who are not candidates for an isolation area— and other patients in the critical care unit. • Implement precautions to limit fomite contami- nation. an in-depth review of preventing CIV in the hospital setting is presented in the article Is Your Practice Proactive or Reactive? (January/ february 2012), available at tvpjournal.com (article library). Figure 1. Map of canine influenza cases, including all CIV positives between 2007 and 2014 (207 positives). Individual pins may represent multiple cases. Courtesy IDeXX Laboratories