AN ANALYTICAL STUDY OF THE AN ANALYTICAL STUDY OF THE PERCEPTIONS, PREVENTIONS PERCEPTIONS, PREVENTIONS STRATEGIES, TREATMENT AND STRATEGIES, TREATMENT AND

ECONOMIC IMPACT OF EQUINE WEST ECONOMIC IMPACT OF EQUINE WEST NILE VIRUSNILE VIRUS

R. GALVAN, A. Rene, S. Bae, K. SinghR. GALVAN, A. Rene, S. Bae, K. Singh

BACKGROUNDBACKGROUND

West Nile Virus Transmission CycleWest Nile Virus Transmission Cycle

Source: Pennsylvania State University, 2002

1999 Coverage

1999 Coverage2000 Coverage

1999 Coverage

2000 Coverage

2001 Coverage

1999 Coverage2000 Coverage2001 Coverage2002 Coverage

WNV 1999 - 2002

PURPOSEPURPOSE

The purpose of this study is to focus on The purpose of this study is to focus on gathering information regarding the gathering information regarding the perception, knowledge, concerns and perception, knowledge, concerns and treatment of the WNV among Texas treatment of the WNV among Texas VeterinariansVeterinarians

To determine the economic impact of the To determine the economic impact of the WNV on the equine population in TexasWNV on the equine population in Texas

No other study regarding equine WNV has No other study regarding equine WNV has been undertaken in the State of Texasbeen undertaken in the State of Texas

Epidemiology of West Nile VirusEpidemiology of West Nile Virus

Horses are affected by WNV more Horses are affected by WNV more than other animalsthan other animals

Annual Summary of WNV Annual Summary of WNV CasesCases

20022002 %% 20032003 %%

BirdBird 519519 19.419.4 534534 19.419.4

HumanHuman 202202 7.57.5 437437 15.915.9

MosquitoMosquito 260260 9.79.7 10581058 38.438.4

HorseHorse 16991699 63.463.4 717717 26.026.0

OtherOther 00 00 1111 0.40.4

TOTALTOTAL 26802680 27572757Source: Texas Department of Health, Zoonosis Control Division 2004

Equine Population in TexasEquine Population in Texas

Home to over 1 million horsesHome to over 1 million horses 280,000+ horse owners280,000+ horse owners $13 billion invested in horse industry $13 billion invested in horse industry

(barns, vehicles etc.)(barns, vehicles etc.) Texas horses valued at $4.2 billionTexas horses valued at $4.2 billion Horse industry impact to Texas Horse industry impact to Texas

economy is $11 billion per yeareconomy is $11 billion per year

Source :Texas A&M University; Animal Science 1998

Economic Impact:Economic Impact: WNV and Equines WNV and Equines

Colorado and Nebraska Equine Study Colorado and Nebraska Equine Study Estimates of $163,000 lost revenueEstimates of $163,000 lost revenueEstimates of $600,000 due to deathsEstimates of $600,000 due to deaths

(estimates for 1478 equines)(estimates for 1478 equines) Cost of vaccination vs. effectiveness in Cost of vaccination vs. effectiveness in

equine populationequine population Colorado/Nebraska $2.75 million on Colorado/Nebraska $2.75 million on

preventionprevention Further studies need to be conducted for Further studies need to be conducted for

clarityclarity

Source: Animal and Plant Health Inspection Service 2003 (www.aphis.usda.gov)

Research MethodsResearch Methods

Study PurposeStudy Purpose

Collect data on cases of West Nile Virus Collect data on cases of West Nile Virus (WNV)(WNV)

Collect information regarding the Collect information regarding the knowledge, concerns and treatment WNV knowledge, concerns and treatment WNV by veterinarians in Texasby veterinarians in Texas

Estimate the economic impact of WNV on Estimate the economic impact of WNV on the equine population in Texasthe equine population in Texas

HypothesesHypotheses

Veterinarians who have treated West Nile Veterinarians who have treated West Nile Virus have the same perceptions, Virus have the same perceptions, understanding and awareness as the understanding and awareness as the Veterinarians who have not treated West Veterinarians who have not treated West Nile VirusNile Virus

There is no difference among There is no difference among Veterinarians that recommend different Veterinarians that recommend different treatment regimens with respect to treatment regimens with respect to perceptions of the West Nile Virusperceptions of the West Nile Virus

HypothesesHypotheses

There is no difference among There is no difference among Veterinarians that recommend different Veterinarians that recommend different treatment regimens with respect to treatment regimens with respect to recommendations on mosquito mitigation recommendations on mosquito mitigation of West Nile Virusof West Nile Virus

There is no difference among There is no difference among Veterinarians that recommend different Veterinarians that recommend different treatment regimens with respect to treatment regimens with respect to recommendations on prevention strategies recommendations on prevention strategies for West Nile Virusfor West Nile Virus

Survey DesignSurvey Design

Tools used in the development of the Tools used in the development of the surveysurvey

InstrumentInstrument

2002 Veterinarian Survey2002 Veterinarian Survey

West Nile SurveyWest Nile Survey

Survey includedSurvey included

13 close-ended questions and 1 13 close-ended questions and 1 open-open- ended questionended question

Data CollectionData Collection

4,177 total surveys were sent out4,177 total surveys were sent out Two options were given for survey Two options were given for survey

responseresponse

Online responseOnline response

Paper surveyPaper survey responseresponse

Data EntryData Entry

A numbering system was created to A numbering system was created to distinguish between surveys entered distinguish between surveys entered manually and online by the manually and online by the respondentrespondent

700 surveys were completed700 surveys were completed

Data AnalysisData Analysis

Descriptive AnalysesDescriptive AnalysesSummationsSummations

FrequenciesFrequencies

Cross-tabulationsCross-tabulations

ResultsResults

ResultsResults

700 Surveys were returned700 Surveys were returned684 were mailed in (98%)684 were mailed in (98%)

16 were completed online (2%)16 were completed online (2%) Response rate of 16.8%Response rate of 16.8%

73.4% of respondents believed they were 73.4% of respondents believed they were knowledgeable about WNVknowledgeable about WNV

I am Knowledgeable about WNV

Responses

Strongly Disagree

Disagree

Neutral

Agree

Strongly agree

Pe

rce

nt

60

50

40

30

20

10

0

49.7% of respondents believed they are 49.7% of respondents believed they are receiving enough education and training receiving enough education and training

Veterinarians get Enough WNV Education

Responses

Strongly Disagree

Disagree

Neutral

Agree

Strongly agree

Pe

rce

nt

50

40

30

20

10

0

56.1% of respondents believed a 56.1% of respondents believed a vaccination regimen is effective and reliablevaccination regimen is effective and reliable

The Vaccination Regimen is Effective

q3

Strongly Disagree

Disagree

Neutral

Agree

Strongly agree

missing

Fre

qu

en

cy400

300

200

100

0

Logistic RegressionLogistic Regression Veterinarians that did not treat for WNV Veterinarians that did not treat for WNV

were 95% less likely to agree that they were 95% less likely to agree that they were knowledgeable about WNVwere knowledgeable about WNV

Veterinarians that did not treat for WNV Veterinarians that did not treat for WNV were 82% less likely to agree that were 82% less likely to agree that Veterinarians were receiving enough Veterinarians were receiving enough training training

Eighty percent (80%) of practicing Eighty percent (80%) of practicing Veterinarians that did not treat horses for Veterinarians that did not treat horses for WNV did not agree that the treatment WNV did not agree that the treatment regimen for WNV was effective and regimen for WNV was effective and reliablereliable

ResultsResults

Respondents reported 2022 cases of Respondents reported 2022 cases of WNVWNV

1256 were laboratory confirmed1256 were laboratory confirmed

766 were not confirmed by 766 were not confirmed by laboratory testinglaboratory testing

441 horses died441 horses died418 by euthanasia418 by euthanasia

23 as a direct result of the disease23 as a direct result of the disease

Criteria for EuthanasiaCriteria for Euthanasia

Criterion

Other

No Resoultion

Prolonged Recumbency

Quality of Life

Perceived Cost

To

tal N

um

be

r o

f C

rite

rio

n U

sed

100

80

60

40

20

0

48% of respondents recommend prevention 48% of respondents recommend prevention strategies for equine ownersstrategies for equine owners

Recommend Prevention Strategies

52.0%

48.0%

no

yes

38.8% of the respondents recommended 38.8% of the respondents recommended control strategies to equine ownerscontrol strategies to equine owners

Recommend Control Strategies

61.2%

38.8%

no

yes

Results of Cross-TabulationResults of Cross-Tabulation

97.2% of 97.2% of respondents who respondents who treated WNV treated WNV agree that they are agree that they are knowledgeable knowledgeable about WNVabout WNV

65.5% of 65.5% of respondents who respondents who did not treat agreedid not treat agree

Responses to Question 1

SDA/DisagreeSA/AgreeNeutral

400

300

200

100

0

Treated for WNV

Did Not Treat

Did Treat

Results of Cross-TabulationResults of Cross-Tabulation

78.4 % of veterinarians who treated 78.4 % of veterinarians who treated WNV believe they are receiving WNV believe they are receiving enough education/trainingenough education/training

Only 40.1 % of veterinarians who did Only 40.1 % of veterinarians who did not treat believe they are receiving not treat believe they are receiving enough education/trainingenough education/training

Results of Cross-TabulationResults of Cross-Tabulation

81.8 % of 81.8 % of veterinarians who veterinarians who treated WNV treated WNV believe the vaccine believe the vaccine is effective and is effective and reliable compared reliable compared to 47.5 % of those to 47.5 % of those who did not treat who did not treat WNVWNV Responses to Question 3

SDA/DisagreeSA/AgreeNeutral

300

200

100

0

Treated for WNV

Did Treat

Did Not Treat

Cost of vaccination regimen for equine Cost of vaccination regimen for equine WNVWNV

Cost of Vaccination Regimen

Cost

$101 or greater$51-$100$25-$50$25 or less

Pe

rce

nt

50

40

30

20

10

0

ResultsResults Anti-inflammatory drugs were the main type of Anti-inflammatory drugs were the main type of

treatment used in all stages of WNVtreatment used in all stages of WNV63.4% for mild WNV63.4% for mild WNV57.76% for moderate WNV57.76% for moderate WNV44.2% for severe WNV44.2% for severe WNV

Other treatments reported for all stages of WNV Other treatments reported for all stages of WNV includedincluded

antibioticsantibioticsfluidsfluidssteroidssteroids

Implications of ResultsImplications of Results

Equine WNV case fatality rate of Equine WNV case fatality rate of 40.0%40.0%

Need for equine WNV education Need for equine WNV education among veterinarians among veterinarians

Future research may include Future research may include knowledge/beliefs of equine ownersknowledge/beliefs of equine owners

Implications of ResultsImplications of Results Estimated Economic ImpactEstimated Economic Impact

Equine WNV fatalities- Equine WNV fatalities-

2002 - $2,856,0002002 - $2,856,000

2003 - $1,205,4002003 - $1,205,400average purchase price of horse average purchase price of horse total number of horses lost total number of horses lost

due to WNV due to WNV

Vaccination against equine WNV- Vaccination against equine WNV- 2002 - $6,250,0002002 - $6,250,000

2003 - $6,250,0002003 - $6,250,000average cost of vaccination for equine WNV average cost of vaccination for equine WNV 25% of the 25% of the

equine population in Texasequine population in Texas

Implications of ResultsImplications of Results

Estimated Combined Economic Estimated Combined Economic Impact for 2002-2003Impact for 2002-2003

2002- $9,106,0002002- $9,106,000 2003 - $7,455,4002003 - $7,455,400

Total - 16,561,400Total - 16,561,400

DiscussionDiscussion

Understanding the effects and treatment Understanding the effects and treatment of the WNV is essentialof the WNV is essential

More WNV research and education is More WNV research and education is needed needed

This study can be used as a benchmark in This study can be used as a benchmark in future WNV studiesfuture WNV studies

Additional WNV education is needed Additional WNV education is needed among Veterinarians in areas of among Veterinarians in areas of prevention strategies, control and prevention strategies, control and treatment.treatment.

DiscussionDiscussion

Less than one half of the Less than one half of the Veterinarians who have treated WNV Veterinarians who have treated WNV believed they were receiving enough believed they were receiving enough education on the diseaseeducation on the disease

One half of the Veterinarians One half of the Veterinarians recommended prevention strategiesrecommended prevention strategies

One half of the Veterinarians One half of the Veterinarians believed the vaccination regimen believed the vaccination regimen was effective was effective

DiscussionDiscussion

The economic impact to horse The economic impact to horse owners in 2002 was estimated at owners in 2002 was estimated at $9,106,000$9,106,000

The economic impact to horse The economic impact to horse owners for 2003 was estimated at owners for 2003 was estimated at $7,455,400$7,455,400

Limitations of StudyLimitations of Study

Information in surveys is self-reported Information in surveys is self-reported but still an effective method but still an effective method

Values given for number of cases in Values given for number of cases in the survey were rangesthe survey were ranges

Full economic impact of equine WNV Full economic impact of equine WNV could not be determinedcould not be determined

Many respondents had small animal Many respondents had small animal practicespractices

QUESTIONS????QUESTIONS????