Few diseases rival Strangles for generating myth, misunderstanding and anxiety among equestrians. Despite our better understanding of how Streptococcus equi bacteria operates, along with significant recent developments in our ability to diagnose, treat and prevent Strangles, cases in the UK remain stubbornly high. This suggests that knowledge has not influenced the behaviour change that is needed at yard level, leaving Strangles unchallenged as the most commonly diagnosed equine infectious disease.
An overview of equine biosecurity practices by Crew et al (2023) noted that ‘…overall biosecurity on equestrian premises is suboptimal.’
This is also reflected in the laboratory findings from McGlennon et al (2021) which confirmed Strangles diagnoses in the UK quickly returned to pre-pandemic levels in 2022 (Figure 1).
Strangles Awareness Week
Currently, the most common time for people to improve their biosecurity is during and immediately after experiencing an outbreak (Figure 2). Client information events are likely to see good attendance when there are outbreaks in the area, as people are actively seeking information and are prepared to upgrade their biosecurity habits. However, evidence suggests this does not lead to the formation of sustainable habits on a scale that could cause a reduction in cases. Part of the reason for this is likely to be that in an outbreak situation, people are behaving reactively to an acute threat, rather than taking a proactive approach to the chronic risk that Strangles presents to all UK equines.
Strangles Awareness Week wants to empower horse owners, yard managers and equine professionals with key facts and practical actions that make taking routine steps to reduce the spread of disease both manageable and effective. Now in its fourth year, the collaborative campaign is led by Redwings in partnership with 11 other welfare, veterinary and research organisations with a keen interest in tackling Strangles. A team combining equine charities with research institutions means the campaign is rooted in scientific evidence, but crafted to encourage and support equestrians to build biosecurity into their everyday horse care practices. Without better biosecurity practices becoming the norm, large numbers of horses will continue to experience what is unquestionably an unpleasant, debilitating and potentially fatal infection.
A simple message
Simplicity is key when it comes to changing behaviour. Strangles can be a complex topic, and good biosecurity has multiple components to consider. Both these factors can deter owners and yard managers from taking any steps at all when there is no immediate sense that Strangles is a risk to their horses.
Routinely checking horses' temperatures is now the key call to action for Strangles Awareness Week. After targeting stigma and promoting the need for openness and support where Strangles outbreaks occur early in the campaign, there was a need to identify an action that was more straightforward to understand and execute, had wider relevance for individual owners, and which could allow impact to be more readily measured.
The value and suitability of temperature checking as a focus had not always been obvious. Stigma had been identified as a barrier to good biosecurity by findings from Redwings' (2016) Strangles survey, whereas the importance of temperature checking hadn't been addressed as a direct question in the research.
However, the 2018 American College of Veterinary Medicine Strangles consensus statement (Boyle et al, 2018) clearly states that ‘Nasal shedding of S. equi usually begins 2–3 days after the onset of fever’. This key fact was also supported by a study showing that fever consistently presents before abscesses trigger significant shedding of bacteria (Figure 3; unpublished data).
This finding highlights early identification of fever as a window of opportunity to catch nascent infection and take preventative action to limit the spread of disease. Yet, other data make it clear that most horse owners do not routinely monitor horses' temperatures. In a 2021 horse owner questionnaire, fewer than one in ten owners habitually took temperatures, either as part of their horse care routine or on returning from events. (Figure 4)
In addition to sound scientific relevance, temperature checking also has several other advantages as a call to action for horse owners:
- It is a quick, simple procedure that can be easily learnt
- It is cost eflective as it only requires the cost of a thermometer
- It can be easily carried out by any owner in almost any situation
- It has relevance and value beyond infectious disease monitoring
- It can be presented as the action of a caring and responsible horse owner
- It is a visible action that can be seen and normalised in a social setting
Horse owners are encouraged to use the free online Temp Checker (https://qrco.de/Temp-Checker) to upload their horse's temperatures each day, where the average is automatically calculated. This is a useful resource for owners and helps to measure the impact of the campaign. It also provides data on average equine temperatures and contributes to the debate on what should promoted as a healthy reference range for horses, aft er the traditional range of 36.5°–38.5°c was called into question (Hall et al, 2019).
Vets are key
Redwings' (2016) Strangles survey clearly showed the importance of vets on the issue of infectious disease. Horse owners were eight times more likely to turn to a vet than a horsey friend in the event of a Strangles outbreak, compared to being less than twice as likely to turn to a vet than a friend regarding other horse care issues.
Strangles Awareness Week aims to make it as easy as possible for vets to help their clients to form good biosecurity habits. Ready-to-post social media content can be downloaded from the Strangles Awareness Week calendar or shared from the Strangles Awareness Week Facebook page. A Strangles presentation is also free to download from the Strangles Awareness Week webpage and is ready to use or can be edited for your own needs.
Strangles remains one of the most distressing and disruptive diseases within our equine communities, but making simple actions like spotting fever and taking precautions part of our horse care routines puts better biosecurity within reach of any horse owner and has the potential to reduce the number of infected horses and address the misinformation and anxiety that undermine our ability to tackle the disease eflectively.
Strangles Awareness Week is a collaborative project, and all contributing organisatitons can be seen in Figure 5.
- Strangles Awareness Week is taking place from 1 – 7 May 2023. Please promote the Temp Check Challenge and sign-up to become an Ambassador at www.redwings.org.uk/strangles/strangles-awareness-week
