Strangles, convalescent Streptococcus equi subspecies equi M antibody titers, and presence of complications

• Main Authors: Katherine M. Delph, Laurie A. Beard, Amanda C. Trimble, Maureen E. Sutter, John F. Timoney, Jennifer K. Morrow
• Format: Article
• Language: English
• Published: Wiley 2019-01-01
• Series: Journal of Veterinary Internal Medicine
• Subjects: SeM antibody titer; strangles carrier; strangles complications; Streptococcus equi subspecies equi
• Online Access: https://doi.org/10.1111/jvim.15388
• ISSN: 0891-6640; 1939-1676

Background Streptococcus equi subspecies equi infection elicits M protein antibody titers in equids. Interpretation of titers is not generally accepted. Hypothesis The magnitude of S. equi M protein (SeM) antibody titer after infection (titer ≥1:12 800) will be useful to monitor for the presence of complications or the risk of development of complications. Animals Forty‐eight horses on 1 farm involved in strangles outbreak. Methods Clinical and observational study. S. equi M protein antibody titers were measured on all horses 8 weeks after infection and select horses 12 and 28 weeks after infection. Horses were categorized: no disease, uncomplicated case, persistent guttural pouch (GP) infection, or complicated cases (metastatic abscesses, purpura hemorrhagica, secondary infections, and dysphagia). Category was compared to titer. Results Twenty‐eight of 48 (58%) developed clinical signs of S. equi infection. Of those, 11 (39%) had uncomplicated strangles, 9 (21%) had persistent GP infection, 5 (18%) were complicated cases, and 3 (11%) had both persistent GP infection and complications. Thirty‐three percent of horses (16 of 48) had SeM antibody titers ≥1:12 800 eight weeks after infection. Of horses with titers ≥1:12 800, 6 of 16 had evidence of complications. Of complicated cases, 6 of 8 had titers ≥1:12 800. In this outbreak, the sensitivity (75%; 95% CI [confidence interval] 45‐105) for a SeM antibody titer ≥1:12 800 detecting complications was higher than the specificity (43%; 95% CI 23‐64). Conclusions and Clinical Importance This outbreak demonstrates that SeM antibody titers can be increased after infection (≥1:12 800) in the absence of complications of strangles.