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			<p class="Type-of-Article" lang="en-GB">&nbsp;</p>
			<p class="Type-of-Article" lang="en-GB"><span class="CharOverride-1">Review Article</span></p>
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			<p class="title- ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="title- ParaOverride-1" lang="en-GB">Zoonotic Pathogens Transmitted from Equines: Diagnosis and Control</p>
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			<p class="Authors ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Authors ParaOverride-1" lang="en-GB"><span class="CharOverride-2">Sandip Kumar Khurana</span><span class="CharOverride-3">1*</span><span class="CharOverride-2">, Kuldeep Dhama</span><span class="CharOverride-3">2</span><span class="CharOverride-2">, Minakshi Prasad</span><span class="CharOverride-3">3</span><span class="CharOverride-4">, </span><span class="CharOverride-2">Kumaragurubaran Karthik</span><span class="CharOverride-3">4</span><span class="CharOverride-2">, Ruchi Tiwari</span><span class="CharOverride-3">5</span></p>
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			<p class="Affiliations ParaOverride-1" lang="en-GB"><span class="CharOverride-5">1</span>National Research Centre on Equines, Hisar, 125 001, Haryana, India;&#160;<span class="CharOverride-5">2</span>Division of Pathology,<span class="CharOverride-5">&#160;4</span>Divison of Bacteriology and Mycology, Indian Veterinary Research Institute, Izatnagar, Bareilly, 243 122, Uttar Pradesh, India;&#160;<span class="CharOverride-5">3</span>Department of Biotechnology, College of Veterinary Sciences, LUVAS, Hisar, 125 004, Haryana, India;<span class="CharOverride-5">&#160;5</span>Department of Veterinary Microbiology, College of Veterinary Science and Animal Husbandry, Uttar Pradesh Pandit Deen Dayal Upadhayay Pashu Chikitsa Vigyan Vishwa&#160;Vidyalaya Evam Go-Anusandhan Sansthan (DUVASU), Mathura (UP) – 281001.</p>
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			<p class="Abstract ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Abstract ParaOverride-1" lang="en-GB"><span class="CharOverride-6">Abstract</span> | The diseases of equines and other animal species that are shared between animals and humans come under the category of zoonotic diseases, and always put threat to veterinarians, animal handlers, animal health personnel and general public. These pose a greater threat to pregnant women, infants, children, immunocompromised and old persons, individuals with stress of antibiotic therapy, and other susceptible humans. Equines also play an important role in transmitting several zoonotic diseases causing human illnesses such as those caused by encephalitic alphaviruses, hendravirus, West Nile virus and equine rabies, salmonellosis, glanders, anthrax, methicillin resistant <span class="CharOverride-7">Staphylococcus aureus</span> (MRSA) infection, brucellosis and <span class="CharOverride-7">Rhodococcus equi</span> infections, therefore acts as substantial global health threat. Among these zoonotic threat agents, anthrax and glanders are also potential biological weapons and at times have been used as bio-terroristic agents also. The emergence and re-emergence of equine zoonotic pathogens have been observed from time to time. Antibiotic resistance is a hot topic around the globe at present and certain strains like MRSA, extended spectrum beta lactamase producing Enterobacteriacea can also be transmitted between horses and humans. These drug resistant strains pose greater threat to human beings. Rapid detection of the causative agents of zoonosis, close attention to personal hygiene, identification of potential fomites and vectors, and the use of protective clothing, newer therapeutics and vaccines may contribute to reduce the risk of zoonoses. Equines are used for antivenom and antitoxin production against various antigens, therefore the serum being obtained from equines should be properly screened for various pathogens either by serological methods or molecular assays which are specific for detection of zoonotic agents. The present review discusses several important aspects of zoonotic diseases of equines with special focus on the recent advances in their diagnosis and control. </p>
		  <p class="Abstract ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Abstract ParaOverride-1" lang="en-GB"><span class="CharOverride-6"> Keywords </span>| Equine zoonotic diseases, Diagnosis, Control</p>
		  <p class="Abstract ParaOverride-1" lang="en-GB">&nbsp;</p>
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			<p class="Editor----Citation" lang="en-GB"><span class="CharOverride-9">Editor</span> | Ruchi Tiwari, College of Veterinary Sciences, Department of Veterinary Microbiology and Immunology Uttar Pradesh Pandit Deen Dayal Upadhayay Pashu Chikitsa, Vigyan Vishvidhyalaya Evum Go-Anusandhan Sansthan (DUVASU), Mathura (U.P.) – 281001, India.</p>
			<p class="Editor----Citation" lang="en-GB"><span class="CharOverride-9">Special Issue</span> | 2 (2015) “Reviews on Trends and Advances in Safeguarding Terrestrial /Aquatic Animal Health and Production”</p>
			<p class="Editor----Citation" lang="en-GB"><span class="CharOverride-6">Received</span> | January 20, 2015; <span class="CharOverride-6">Revised</span> | February 10, 2015; <span class="CharOverride-6">Accepted </span>| February 12, 2015; <span class="CharOverride-6">Published</span> | February 16, 2015&#9;&#9;</p>
			<p class="Editor----Citation" lang="en-GB"><span class="CharOverride-6">*Correspondence </span>| Sandip Kumar Khurana, National Research Centre on Equines, Hisar, Haryana, India; <span class="CharOverride-6">Email: </span>sandipkk2003@yahoo.co.in</p>
			<p class="Editor----Citation" lang="en-GB"><span class="CharOverride-6">Citation</span> | Khurana SK, Dhama K, Prasad M, Karthik K, Tiwari R (2015). Zoonotic pathogens transmitted from equines: diagnosis and control. Adv. Anim. Vet. Sci. 3(2s): 32-53.  </p>
			<p class="Editor----Citation" lang="en-GB"><span class="CharOverride-6">DOI </span>| <a href="http://dx.doi.org/10.14737/journal.aavs/2015/3.2s.32.53"><span class="Hyperlink">http://dx.doi.org/10.14737/journal.aavs/2015/3.2s.32.53</span></a></p>
			<p class="Editor----Citation" lang="en-GB"><span class="Editor---Citation CharOverride-6">ISSN (Online)</span> | 2307-8316; <span class="Editor---Citation CharOverride-6">ISSN (Print)</span> | 2309-3331</p>
			<p class="Editor----Citation" lang="en-GB"><span class="CharOverride-6">Copyright</span> © 2015 Khurana et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p>
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			<p class="Heading-1--Introduction----" lang="en-GB">&nbsp;</p>
			<p class="Heading-1--Introduction----" lang="en-GB">&nbsp;</p>
		  <p class="Heading-1--Introduction----" lang="en-GB">INTRODUCTION&#9;</p>
			<p class="Caps-on-First-Para ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Caps-on-First-Para ParaOverride-1" lang="en-GB"><span class="_idGenDropcap-1">Z</span>oonotic diseases, naturally transmitted between vertebrate animals and man, are highly variable on the basis of their severity and transmissibility. The “one medicine concept” involving a convergence of animal, human and environmental science professionals for prevention, control and eradication of cross-species disease transmission is gaining momentum, where zoonoses has assumed central position (<a href="#Dhama-K--Chakraborty-S--Kapoor-S--Tiwari-R--Kumar--2013a"><span class="Hyperlink">Dhama et al., 2013a</span></a>; <a href="#Mukarim-A--Dechassa-T--Mahendra-P--2015"><span class="Hyperlink">Mukarim et al., 2015</span></a>; <a href="#Plowright-RK--Eby-P--Hudson-PJ--Smith-IL--2015"><span class="Hyperlink">Plowright et al., 2015</span></a>). The emergence and re-emergence of zoonotic diseases poses a greater threat to pregnant women, infants and children, immunocompromised and old persons, persons under antibiotic therapy stress, veterinarians, animal handlers and animal health personnel (<a href="#Stull-JW--Slavic--D--Rousseau-J--Weese-JS--2012"><span class="Hyperlink">Stull et al., 2012</span></a>). </p>
		  <p class="Caps-on-First-Para ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Zoonoses constitute nearly 60% of all known human infections and over 75% of all emerging pathogens. They are caused by a diverse group of microorganisms and infectious syndromes caused by zoonotic pathogens are equally diverse. Classification of zoonoses is broadly based on the nature of the pathogen, animal host,<span class="CharOverride-6"> </span>severity of disease and mode of transmission between animals to humans. Zoonoses have major implications on economics, labour and health productivity globally. Preventing and controlling zoonoses is even more critical today in the context of globalization of international trade, changes in agricultural practices and global warming (<a href="#Dhama-K--Tiwari-R--Chakraborty-S--Kumar-A--Karikalan-M--Singh-R--Rai-RB--2013b-."><span class="Hyperlink">Dhama et al., 2013b</span></a>). They are responsible for affecting productivity of both humans and animals severely, thus contributing to aggravation of poverty.</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Equines are used for various purposes like riding, racing, sports, draught, transport, ceremonies, antitoxin/antibody production, etc., throughout the world (<a href="#Burnouf-T--Griffiths-E--Padilla-A--Seddik-S--Stephanoe-MA--Gutie-rrez-JM--2004-."><span class="Hyperlink">Burnouf et al., 2004</span></a>). There remains a contact between the human and these equines at various stages which pave way for the spread of various diseases of equines to human and hence human beings may acquire equine zoonotic bacterial, viral or other infectious diseases either directly or by indirect means. The number of diseases affecting horses and other members of the Equidae family carries zoonotic potential including viral, bacterial, rickettsial, anaplasma associated, fungal and parasitic infections, which will be elaborated through this review. Zoonotic diseases may occur as mild transient infection to severe lethal or highly contagious infection and thus can be a suitable candidate of bioterrorism also under certain circumstances. Veterinarians have a key role in revealing various emerging zoonotic infections due to their close involvement with both animals and owners. Growing possibilities of exploring zoonotic pathogens as bioterrorism agents is another worry which reflects the main functioning of veterinarians in early detection of bioterrorism-associated outbreaks of zoonotic diseases. Antivenom are commonly produced from equine serum, so critical attention should be given during this time as this can be a major source for the transmission of dangerous pathogens to human (<a href="#Lalloo-DG--Theakston-RD--2003-."><span class="Hyperlink">Lalloo and Theakston, 2003</span></a>; <a href="#Theakston-RD--Warrell-DA--Griffiths-E--2003"><span class="Hyperlink">Theakston et al., 2003</span></a>).<span class="CharOverride-6"> </span>Inference accredited to equine zoonoses depends on prevalence of particular disease along with its case-fatality rate in human population. Encephalitic alphaviruses, hendravirus, equine rabies, salmonellosis, glanders, anthrax, MRSA infection, brucellosis and <span class="CharOverride-7">Rhodococcus equi</span> are among the very important zoonoses. <a href="#Weese-JS--2002-."><span class="Hyperlink">Weese (2002)</span></a> has reviewed the risk of zoonotic diseases to veterinary practitioners with emphasis on occupational aspects. The present review covers several important diseases which may be transmitted through equines to man or vice-versa with emphasis on their epidemiology, diagnosis and control calling for emergent need of collaborative approach of medical doctors, horse breeders, veterinarians, other governmental and non-governmental agencies for early preparedness; however there could be several others which have not been described here. </p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-1--Introduction----" lang="en-GB">ZOONOTIC PATHOGENS TRANSMITTED FROM EQUINES VIRAL PATHOGENS</p>
		  <p class="Heading-1--Introduction----" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB">Encephalitic Alphaviruses</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Western equine encephalitis virus (WEEV), eastern equine encephalitis virus (EEEV) and Venezuelan equine encephalitis virus (VEEE) are common zoonotic encephalitic alphaviruses. These have been isolated from horses, humans, mosquitoes, birds, rodents and some other animals also. These are vector borne and transmitted through blood sucking arthropods, thus considered as arboviral infection and condition is referred as Arboviral Encephalitis including EEE, WEE, VEE and WNV as a cause of encephalitis in horse<span class="CharOverride-6"> </span>(<a href="#Strauss-JH--Calisher-CH--Dalgarno-L--Dalrymple--JM--Frey-TK--Petterson-RF--Rice-CM--Spaan-WJM--1995"><span class="Hyperlink">Strauss et al., 1995</span></a>; <a href="#Smith-JF--Davis-K--Hart-MK--Luwig-GV--McClain-DJ--Parker-MD--Pratt-WD--1997"><span class="Hyperlink">Smith et al., 1997</span></a>; <a href="#Kapoor-S--Dhama-K--Pawaiya--RVS--Mahendran-M--Mathew-T--2010-"><span class="Hyperlink">Kapoor et al., 2010</span></a>). Ordinarily arboviruses are not directly transmitted from horses to humans under usual circumstances, though aerosolization could be one possible risk factor. As per the recommendations of the Centers for Disease Control and Prevention (CDC), suspected clinical specimens such as cerebrospinal fluid and serum must be handled under level 2 biocontainment facility equipped laboratories with limited entrance. <a href="#Lundstrom-K--2014-."><span class="Hyperlink">Lundstrom (2014)</span></a> has reviewed progress in alphavirus vector development and vaccine technology which enabled clinical trials in humans. </p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB">Eastern Equine Encephalitis Virus (EEEV) Infection</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">EEEV was first isolated from horses in 1933 (<a href="#Giltner-LT--Shahan-MS--1933-."><span class="Hyperlink">Giltner and Shahan, 1933</span></a>; <a href="#TenBroeck-C--Merrill-MH--1933-"><span class="Hyperlink">TenBroeck and Merrill, 1933</span></a>). The virus is propagated in nature between birds and mosquitos. The virus is considered to be most virulent among the alphaviruses causing encephalitis with case-fatality rate of up to 70% in human beings (<a href="#Zacks-MA--Paessler-S--2010"><span class="Hyperlink">Zacks and Paessler, 2010</span></a>). EEEV infections has greater significance American continent where it was responsible for more than 180 cases in human (<a href="#Aguilar-PV--Robich-RM--Turell-MJ--O-Guinn-2007"><span class="Hyperlink">Aguilar et al., 2007</span></a>). Mosquito vectors have a role in the transmission of the virus form horses from human. The incubation period is 4-10 days, fever, headache, vomiting, respiratory distress, seizures and coma may occur in human encephalitis cases. The mortality rate in horses is higher than in WEEV infection. Diagnosis is done by ELISA, haemagglutination-inhibition, neutralization assay and virus isolation. Formalin inactivated vaccine is used in horses as double vaccine with WEEV. <a href="#Honnold-SP--Baken-RR--Fisher-D--Lind-CM--Cohen--2014"><span class="Hyperlink">Honnold et al. (2014)</span></a> demonstrated that chimeric live-attenuated EEEV vaccine candidates protest mice against a lethal aerosol challenge. <a href="#Trobaugh-DW--Ryman-KD--Klimstra-WB--2014-."><span class="Hyperlink">Trobaugh et al. (2014)</span></a> have reviewed recent advances in alphavirus virulence mechanisms that could be used to design live-attenuated vaccine against EEEV/ alphaviruses.</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB">Western Equine Encephalitis Virus (WEEV) Infection</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">WEEV was first isolated from brain of a horse (<a href="#Meyer-KF--Haring-CM--Howitt-B--1931"><span class="Hyperlink">Meyer et al., 1931</span></a>). First human WEEV was confirmed in 1938. WEEV is naturally propagated in enzootic cycle between passerine birds and specific mosquito vector. Some rodents and lagomorphs also act as reservoir hosts (<a href="#Pfeffer-M--Dobler-G--2010"><span class="Hyperlink">Pfeffer and Dobler, 2010</span></a>). Horses and humans are dead end hosts (<a href="#Go-YY--Balasuriya-UBR--Lee-C--2014-"><span class="Hyperlink">Go et al., 2014</span></a>). WEEV infections generally have an incubation period of 2-7 days with early non-specific symptoms like fever, anorexia, headache, nausea and vomiting. Diagnosis of WEEV infection is done by ELISA, haemagglutination-inhibition and neutralization assay (<a href="#Martin-DA--Muth-DA--Brown-T--Johnson-AJ--Karabatsos-N--Roehrig-JT--2000-."><span class="Hyperlink">Martin et al., 2000</span></a>). RT-PCR has also been developed for its diagnosis (<a href="#Linssen-B--Kinney-RM--Aguilar-P--Russel-KL--Watts-DM--Kaaden-OR--Pfeffer-M--2000-"><span class="Hyperlink">Linssen et al., 2000</span></a>; <a href="#Lambert-AJ--Martin-DA--Lanciotti-RS--2003-."><span class="Hyperlink">Lambert et al., 2003</span></a>). Formalin inactivated vaccine is used in horses as double vaccine with EEEV. </p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB">Venezuelan Equine Encephalitis Virus (VEEV) Infection</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">VEEV is propagated in nature in enzootic cycle between rodents and mosquito vector (<a href="#Taylor-KG--Paessler--2013-"><span class="Hyperlink">Taylor and Paessler, 2013</span></a>; <a href="#Carossino-M--Thiry-E--Grandiere-A--Barrandeguy-ME--2014-"><span class="Hyperlink">Carossino et al., 2014</span></a>; <a href="#Go-YY--Balasuriya-UBR--Lee-C--2014-"><span class="Hyperlink">Go et al., 2014</span></a>). Epidemics occur when mosquitoes transmit the virus to humans and equids (<a href="#Tigrett-WD--Downs--WG--1962"><span class="Hyperlink">Tigrett and Downs, 1962</span></a>; <a href="#Walton-TE--Alvarez-JO--Buckwalter-RM--Johnson-KM--1973"><span class="Hyperlink">Walton et al., 1973</span></a>). Horses, donkeys and mules have sufficient viremia and are able to transmit the infection through mosquitoes (<a href="#Young-NA--1972-."><span class="Hyperlink">Young, 1972</span></a>; <a href="#Mackenzie-RM--De-SJ--Parra-D--1976-"><span class="Hyperlink">Mackenzie et al., 1976</span></a>). Some reports suggest that humans are also able to transmit the infection especially in urban settings (<a href="#Watts-DM--Lavera-V--Callahan-J--Rossi-C--1997"><span class="Hyperlink">Watts et al., 1997</span></a>, <a href="#Watts-DM--Callahan-J--Rossi-C--Oberste-MS--1998"><span class="Hyperlink">1998</span></a>; <a href="#Morrison-AC--Forshey-BM--Notyce-D--2008"><span class="Hyperlink">Morrison et al., 2008</span></a>). <a href="#Madsen-C--Hooper-I--Lundberg-L--Shafagati-N--2014"><span class="Hyperlink">Madsen et al. (2014)</span></a> demonstrated that inhibition of Ago2, an important component of RNA-induced silencing complex (RISC), resulted in decreased replication of encephalitic alphaviruses and thus may be a future therapeutic. A live attenuated vaccine TC83 is thought to available option for humans as well as horses (<a href="#Engler-RJ--Mangiafico-JA--Jahrling-P--Ksiazek-TG--Pedrotti-krueger-M--Peters-CJ--1992-"><span class="Hyperlink">Engler et al., 1992</span></a>). However, formalin inactivated whole viral vaccines are also available (<a href="#Taylor-KG--Paessler--2013-"><span class="Hyperlink">Taylor and Paessler, 2013</span></a>). DNA based vaccines are also available which can be produced rapidly and are cost effective (<a href="#Dupuy-LC--Richards-MJ--Ellefsen-B--Chau--2011"><span class="Hyperlink">Dupuy et al., 2011</span></a>; <a href="#Tretyakova-I--Lukashevich-IS--Glass-P--Wang-E--Weaver-S--Pushko-P--2013"><span class="Hyperlink">Tretyakova et al., 2013</span></a>; <a href="#Carossino-M--Thiry-E--Grandiere-A--Barrandeguy-ME--2014-"><span class="Hyperlink">Carossino et al., 2014</span></a>). Encouraging results have also been obtained with chimeric vaccines (<a href="#Paessler-S--Fayzulin-RZ--Anishchenko-M--Greene-IP--Weaver-SC--Frolov-I--2003"><span class="Hyperlink">Paessler et al., 2003</span></a>; <a href="#Paessler-S--Weaver-SC--2009"><span class="Hyperlink">Paessler and Weaver, 2009</span></a>; <a href="#Carossino-M--Thiry-E--Grandiere-A--Barrandeguy-ME--2014-"><span class="Hyperlink">Carossino et al., 2014</span></a>).</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB">Japanese Encephalitis (JE)</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Japanese encephalitis (JE) is very important and common mosquito borne flavivirus causing encephalitis and is regarded a major public health problem in Asian countries (<a href="#Van-den-Hurk-AF--Ritchie-SA--Johansen-CA--Mackenzie-JS--Smith-GA--2008"><span class="Hyperlink">van-den Hurk et al., 2008</span></a>, <a href="#Van-den-Hurk-AF--Ritchie-SA--Mackenzie-JS--2009-"><span class="Hyperlink">2009</span></a>; <a href="#Pawaiya-RVS--Dhama-K--Kapoor-S--Mahendran-M--Mathew-T--2010a"><span class="Hyperlink">Pawaiya et al., 2010a</span></a>). The disease affects primarily human beings, horses and pigs. The infection in horses is usually subclinical with signs of pyrexia, depression, tremors and ataxia. Abortions and stillbirths are common manifestations in pigs.</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">JE virus was first isolated from a case of fatal human encephalitis in Japan in 1935 (<a href="#Lewis-L--Taylor-HG--Sorem-MB--Norcross-JW--Kindsvatter-VH--1947"><span class="Hyperlink">Lewis et al., 1947</span></a>). In human beings incubation period is 5 to 15 days with majority of cases being asymptomatic. Encephalitis is reported in about 0.04% cases only. Severe rigors, pyrexia and malaise are non-specific symptoms lasting one to six days. Signs of encephalitis are neck rigidity, cachexia, hemiperesis, convulsions and pyrexia. There is only one serotype of JEV and four genotypes (<a href="#Chen-W--Tesh-RB--Rico-Hesse-R--1990-."><span class="Hyperlink">Chen et al., 1990</span></a>, <a href="#Chen-W--Rico-Hesse-R--Tesh-RB--1992-."><span class="Hyperlink">1992</span></a>; <a href="#Tsarev-SA--Sanders-ML--Vaughn-DW--Innis-BL--2000"><span class="Hyperlink">Tsarev et al., 2000</span></a>). Urbanization, population spurt in tropical areas, increased transportation and global warming are responsible for spread of infections to newer areas (<a href="#Go-YY--Balasuriya-UBR--Lee-C--2014-"><span class="Hyperlink">Go et al., 2014</span></a>).</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">JEV is transmitted by <span class="CharOverride-7">Culex tritaeniorhynchus, C annulus, C annulirostris</span> and <span class="CharOverride-7">Aedis</span> mosquitoes (<a href="#Rosen-L.--1986"><span class="Hyperlink">Rosen, 1986</span></a>). Pigs and aquatic birds are amplifying hosts that have high titre viremia which acts as a source of infection for mosquitoes (<a href="#Rosen-L.--1986"><span class="Hyperlink">Rosen, 1986</span></a>). Humans and horse do not have sufficient viremia to transmit the infection and thus are dead end hosts. <a href="#Yeh-J--Lee-J--Park-J--Seo-H--Park-J--Moon-J--Cho-I--Lee-J--Park-S--Song-C--Choi-I--2010"><span class="Hyperlink">Yeh et al. (2010)</span></a> developed a duplex reverse transcriptase PCR for rapid differential detection of west nile and japanese encephalitis viruses which is rapid, sensitive and specific and is useful both in humans and horses. <a href="#Yeh-J--Lee-J--Park-J--Seo-H--Moon-J--Cho-I--Kim-H--Yang-Y--Ahn-K--Kyung-S--Choi-I--Lee-J--2012-."><span class="Hyperlink">Yeh et al. (2012)</span></a> developed a diagnostic algorithm to serologically differentiate west nile virus from japanese encephalitis virus infection and its validation in field surveillance of horses.</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Earlier inactivated vaccines were used. A purified vaccine from vero-cell adapted SA 14-14-2 strain has been developed (<a href="#Tauber-E--Kolluritsch-H--Korinek-M--2007"><span class="Hyperlink">Tauber et al., 2007</span></a>). Another chimeric vaccine containing pr M and E proteins of JEV has also been developed and found to show high level of immunogenicity (<a href="#Guy-B--Guirakhoo-F--Barban-V--Higgs-S--Monath-TP--Lang-J--2010-."><span class="Hyperlink">Guy et al., 2010</span></a>; <a href="#Halstead-SB--Thomas-SJ--2011-."><span class="Hyperlink">Halstead and Thomas, 2011</span></a>). <a href="#Singh-A--Mitra-M--Sampath-G--Venugopal-P--Rao-JV--2015"><span class="Hyperlink">Singh et al. (2015)</span></a> demonstrated JENVAC, a Vero-cell derived vaccine with a long lasting, broadly protective immunity.&#9;</p><br>
			<p class="Heading-2--History-in-MM-" lang="en-GB">West Nile Virus (WNV) Infection</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">West Nile virus (WNV), a member of the <span class="CharOverride-7">Flavivirus </span>genus of the <span class="CharOverride-7">Flaviviridae </span>family, is one of the most widely distributed mosquito–transmitted arbovirus having potential global public health concerns (<a href="#Gulati-BR--Gupta-AK--Kadian-SK--2014-."><span class="Hyperlink">Gulati et al., 2014</span></a>).<span class="CharOverride-6"> </span>WNV was first isolated in Uganda in 1937 (<a href="#Smithburn-KC--Hughes-TP--Burke-AW--Paul-JH--1940"><span class="Hyperlink">Smithburn et al., 1940</span></a>). There have been outbreaks in Africa, the Middle East, Asia, and Australia before spread to USA and Canada (<a href="#Weaver-SC--Barrett-AD--2004-."><span class="Hyperlink">Weaver and Barrett, 2004</span></a>). The infection is maintained in nature between <span class="CharOverride-7">Culex</span> mosquitoes and birds, whereas horses, humans and other mammals are dead end hosts (<a href="#Blitvich-BJ--2008-."><span class="Hyperlink">Blitvich, 2008</span></a>; <a href="#Dhama-K--Pawaiya-RVS--Kapoor-S--Mathew-T--2010a-."><span class="Hyperlink">Dhama et al., 2010a</span></a>; <a href="#Beck-C--Jimenez-Clavero-MA--Leblond-A--Durand-2013"><span class="Hyperlink">Beck et al., 2013</span></a>; <a href="#Go-YY--Balasuriya-UBR--Lee-C--2014-"><span class="Hyperlink">Go et al., 2014</span></a>). Birds like crow are also affected by this viral infection (<a href="#Mishra-N--Kalaiyarasu-S--Nagarajan-S--2012"><span class="Hyperlink">Mishra et al., 2012</span></a>). <a href="#Molaei-G--Cummings-RF--Su-T--Armstrong-PM--Williams-GA--Cheng-M--Webb-JP--Andreadis-TG--2010"><span class="Hyperlink">Molaei et al. (2010)</span></a> have studied the vector and host interactions governing the epidemiology of WNV in Southern California. Most of the WNV infections are subclinical and only less than 1% humans develop neurologic disease (<a href="#Mostashari-F--Bunning-ML--Kitsutani-PT--2001-."><span class="Hyperlink">Mostashari et al., 2001</span></a>; <a href="#Hayes-EB--Komar-N--Nasci-RS--Montogomery-SP--O-Leary-DR--Campbell-GL--2005-"><span class="Hyperlink">Hayes et al., 2005</span></a>; <a href="#Hayes-EB--Gubler-DJ--2006-."><span class="Hyperlink">Hayes and Gubler, 2006</span></a>; <a href="#Porter-RS--Leblond-A--Lecolilinet-S--Tritz-P--2011"><span class="Hyperlink">Porter et al., 2011</span></a>).</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB"><a href="#Yeh-J--Lee-J--Park-J--Seo-H--Park-J--Moon-J--Cho-I--Lee-J--Park-S--Song-C--Choi-I--2010"><span class="Hyperlink">Yeh et al. (2010)</span></a> developed a duplex reverse transcriptase PCR for rapid differential detection of West Nile and Japanese encephalitis viruses which is useful both in humans and horses. <a href="#Yeh-J--Lee-J--Park-J--Seo-H--Moon-J--Cho-I--Kim-H--Yang-Y--Ahn-K--Kyung-S--Choi-I--Lee-J--2012-."><span class="Hyperlink">Yeh et al. (2012)</span></a> could serologically differentiate West Nile from Japanese encephalitis by a diagnostic algorithm. Currently, there is no suitable therapy for WNV infection (<a href="#Paterson-BJ--Mackenzie-JS--Durrheim-DN--Smith-D--2011"><span class="Hyperlink">Paterson et al., 2011</span></a>). A number of vaccines have been explored for horses including inactivated whole West Nile virus (West Nile–Innovator<span class="CharOverride-5">®</span>, Vetera<span class="CharOverride-5">®</span> WNV vaccine) and chimeric recombinant canarypoxvirus - Recombitek® Equine WNV Vaccine (<a href="#De-Filette-M--Ulbert-S--Diamond-M--Sanders-NN--2012-."><span class="Hyperlink">De Filette et al., 2012</span></a>; <a href="#Gulati-BR--Gupta-AK--Kadian-SK--2014-."><span class="Hyperlink">Gulati et al., 2014</span></a>). DNA vaccine for WNV has been licensed in USA, and with the use of prime boost approaches it may protect WNV (<a href="#Kumaragurubaran-K--Kaliaperumal-K--2013-"><span class="Hyperlink">Kumaragurubarn and Kaliaperumal, 2013</span></a>), but such vaccine (West Nile–Innovator<span class="CharOverride-5">®</span> DNA) has recently been discontinued by Pfizer (<a href="#Brandler-S--Tangy-F--2013-."><span class="Hyperlink">Brandler and Tangy, 2013</span></a>; <a href="#Gulati-BR--Gupta-AK--Kadian-SK--2014-."><span class="Hyperlink">Gulati et al., 2014</span></a>).</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB">Hendra Virus (HeV) Infection</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Hendra virus (HeV) was first isolated in 1994 from an outbreak among humans and horses (<a href="#Selvey-LA--Wells-RM--McCormack-JG--1995"><span class="Hyperlink">Selvey et al., 1995</span></a>; <a href="#Murray-PK--1996-"><span class="Hyperlink">Murray, 1996</span></a>). This is one of deadliest human and veterinary pathogen causing respiratory and encephalitic illness in humans with high mortality rate which may exceed 70% (<a href="#Dhama-K--Pawaiya-RVS--Kapoor-S--2010b-"><span class="Hyperlink">Dhama et al., 2010b</span></a>; <a href="#Croser-EL--Marsh-GA--2013-."><span class="Hyperlink">Croser and Marsh, 2013</span></a>). Hendra virus (HeV) is a zoonotic paramyxovirus in the genus <span class="CharOverride-7">Henipavirus. </span>There had been 48 outbreaks with increasing number of outbreaks with each passing year since it was first reported (<a href="#Aljofan-M--2013-."><span class="Hyperlink">Aljofan, 2013</span></a>). Horses acquire infection from flying foxes. Clinical signs in horses include fever, anorexia followed by respiratory signs that include frothy nasal discharge. Human beings get infection through direct contact with secretions from infected horses. No evidence of human to human, human to horse and flying fox to human has been reported (<a href="#Selvey-LA--Taylor-R--Arklay-A--Gerrard-J--1996-"><span class="Hyperlink">Selvey et al., 1996</span></a>), however, <a href="#Williamson-MM--Hooper-PT--Selleck-PW--Gleeson-LJ--Daniels-PW--Westbury-HA--Murray-PK--1998"><span class="Hyperlink">Williamson et al. (1998)</span></a> have shown the role of fruit bats, horses and cats in transmission of Hendra virus. Flying fox bats acts as reservoirs and horses may encounter the infection from contaminated secretions or excretions through environment. Veterinarian get the disease while physical examination of oral cavity of horses. Human have flu like symptoms with mainly respiratory signs. The diagnosis of this infection is based on ELISA (IgG and IgM), RT-PCR and isolation of virus. There are no effective therapeutics against HeV infections and protective measures while examining horses are the only way to minimize the risk of its spread (<a href="#Mahalingam-S--Herrero-LJ--Playford-EG--2012"><span class="Hyperlink">Mahalingam et al., 2012</span></a>). Human monoclonal antibody against HeV glycoprotein (G) protein is considered to be most promising passive immunotherapy (<a href="#Bossart-KN--Geisbert-TW--Feldmann-H--Zhu-ZY-2011"><span class="Hyperlink">Bossart et al., 2011</span></a>).</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			
         <div class="pt" > <a href="http://nexusacademicpublishers.com/uploads/figures/20150219025220.png" target="new"><img class="img_display" src="http://nexusacademicpublishers.com/uploads/figures/20150219025220.png" width="80" height="80"></a>
            
            <p class="Figure--and-Table-Heading" lang="en-GB"><span class="CharOverride-6"><a id="Figure-1-"></a>Figure 1:</span><a href="http://nexusacademicpublishers.com/uploads/figures/20150219025220.png"> An overview on equine zoonoses</a></p>
       </div>
      	
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB">Equine Rabies</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Rabies is a well-documented zoonotic disease that causes huge fatalities throughout the world. Rabies is a fatal neurological disease of mammals which is not an exception in equines, affects horses, mules and donkeys (<a href="#Pawaiya--RVS--Dhama-K--Kapoor-S--Mahendran-M--2010b"><span class="Hyperlink">Pawaiya et al., 2010b</span></a>). It is caused by <span class="CharOverride-7">Lyssavirus</span> of Rhabdoviridae family.<span class="CharOverride-6"> </span>The major animal involved is the dog and affected dogs can transmit the virus through their saliva. Inspite of low incidences in horses, literature reveal documented reports of equine rabies in past years as 82 reports of rabies in 1998, 65 cases in 1999 and 52 reports of equine rabies in 2000 have been from United States.<span class="CharOverride-6"> </span>Rabies in horse’s do not have the typical symptomps as in dog but the animal seems alert, lack of muscular in-coordination and seizures are common (<a href="#Hudson-LC--Weinstock-D--Jordan-T--Bold-Fletcher-NO--1996"><span class="Hyperlink">Hudson et al., 1996</span></a>). Though as compared to small animal practice probability of acquiring rabies from equines in veterinarian is low but possibility cannot completely be ignored due to severity of infection and variation in expression of symptoms. In equines, among furious and dumb form, paralytic or dumb form is more reported with the signs of rubbing of site of wound, gradual lameness and colic (<a href="#Krebs-JW--Rupprecht-CE--Childs-JE--2000-"><span class="Hyperlink">Krebs et al., 2000</span></a>, <a href="#Krebs-JW--Mondul-AM--Rupprecht-CE--Childs--JE--2001-"><span class="Hyperlink">2001</span></a>; <a href="#Weese-JS--2002-."><span class="Hyperlink">Weese, 2002</span></a>). Animal handlers, veterinarians and horse owners are at highest risk for the transmission of rabies virus to them. Humans experience various symptoms like ataxia, loss of awareness, paralysis of muscles, etc. Vaccines are available for animals and humans that can prevent rabies, however history of vaccination does not necessarily exclude the risk of rabies, as one report described that even among 21 vaccinated horse, 5 animals could acquire the rabies (<a href="#Green-SL--Smith-L--Vernau-W--Beacock-SM--1999-."><span class="Hyperlink">Green et al., 1999</span></a>). Initial diagnosis can be made by differentially diagnosing all undifferentiated neurological diseases or encephalitis from Rabies. Animals may die due to cardiac arrest within 2-7 days or 14 days after appearance of clinical symptoms as nerves are affected in this disease. In infected animals, central nervous system components, saliva and salivary glands all are rich source of rabies virus hence any contact between infected saliva and breached skin or mucous membrane of horse or handler, jockey, owner must be avoided by taking biosecurity precautions. If any case is observed or suspected, higher authorities must be notified.</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">An overview on equine zoonosis is presented in <a href="#Figure-1-"><span class="Hyperlink">Figure 1</span></a>.</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-1--Introduction----" lang="en-GB">BACTERIAL PATHOGENS</p>
		  <p class="Heading-1--Introduction----" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB"><span class="CharOverride-14">Rhodococcus equi</span> Infection</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB"><span class="CharOverride-7">Rhodococcus equi</span> is a gram positive, aerobic soil actinomycete responsible primarily for severe respiratory disease of young foals with high mortality rate (<a href="#Prescott-JF--1991"><span class="Hyperlink">Prescott, 1991</span></a>; <a href="#Yager-JA--Prescott-CA--Kramar-DP--Hannah-H--Y-1991"><span class="Hyperlink">Yager et al., 1991</span></a>; <a href="#Khurana-SK--Malik-P--Virmani-N--Singh-BR--2009-."><span class="Hyperlink">Khurana et al., 2009</span></a>; <a href="#Gigu-re-S--Cohen-ND--Keith-Chaffin-M--Hines--2011a"><span class="Hyperlink">Giguere et al., 2011a</span></a>, <a href="#Gigu-re-S--Cohen-ND--Keith-Chaffin-M--Slovis-NM--Hondalus-MK--Hines-SA--Prescott-JF--2011b-."><span class="Hyperlink">b</span></a>; <a href="#Khurana-SK--2014-"><span class="Hyperlink">Khurana, 2014</span></a>; <a href="#Khurana-SK--Kanu-Priya--Singh-N--Singha-H--Punia-S--2014"><span class="Hyperlink">Khurana et al., 2014</span></a>; <a href="#Khurana-SK--2015-"><span class="Hyperlink">Khurana, 2015</span></a>). <span class="CharOverride-7">R. equi</span> also causes extra-pulmonary complications in equines including enteritis, arthritis and abscesses in abdomen (<a href="#Gigue-re-S--Prescott-JF--1997-."><span class="Hyperlink">Giguere and Prescott, 1997</span></a>). <span class="Emphasis">R. equi</span> was first recovered from lung of a foal as <span class="Emphasis">Corynebacterium equi</span><span class="Emphasis CharOverride-15"> (</span><a href="#Magnusson-H--1923-."><span class="Hyperlink">Magnusson, 1923</span></a>) and was reclassified as <span class="CharOverride-7">R. equi</span> (<a href="#Goodfellow-M--Alderson-G--1977-"><span class="Hyperlink">Goodfellow and Alderson, 1977</span></a>). This organism is emerging as an important pathogen in AIDS patients (<a href="#Weinstock-DM--Brown-AE--2002"><span class="Hyperlink">Weinstock and Brown, 2002</span></a>), drug therapy (<a href="#Mizuno-Y--Sato-F---Sakamoto-M---Yoshikawa-K--2005"><span class="Hyperlink">Mizuno et al., 2005</span></a>) and some other immunosuppressive conditions (<a href="#Napole-o-F--Damasco--P-V--Camello--T-C--2005"><span class="Hyperlink">Napoleao et al., 2005</span></a>). The most common manifestation of human <span class="CharOverride-7">R. equi</span> infections is pneumonia, others include fever, diarrhoea, abscesses in various internal organs and arthritis.</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Virulence associated protein A (Vap A), a cell surface lipoprotein is essentially required for virulence in foals whereas virulence associated protein B (Vap B) is often associated with disease in human beings and pigs. Intracellular localization of <span class="CharOverride-7">R. equi </span>is responsible for its prolonged and difficult therapeutic management. No suitable serodiagnostic test or vaccination is available for <span class="CharOverride-7">R. equi</span> infection of equines as well as humans till date (<a href="#Khurana-SK--2015-"><span class="Hyperlink">Khurana, 2015</span></a>).</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Human beings acquire infection mainly through inhalation of dust harboring bacteria, from domestic animals including equines and wound, however man to man transmission is thought to be rare (<a href="#Weinstock-DM--Brown-AE--2002"><span class="Hyperlink">Weinstock and Brown, 2002</span></a>).</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Agar gel diffusion test developed by <a href="#Nakazawa-M--Isayama-Y--Kashiwazaki-M--Yasui-T--1987-"><span class="Hyperlink">Nakazawa et al. (1987)</span></a> and ELISA by <a href="#Giguere-S--Hernandez-J--Baskin-J--Prescott-JF--Takai-S--Miller-C--2003-"><span class="Hyperlink">Giguere et al. (2003)</span></a> have not been found to be of much promise for diagnosis of <span class="CharOverride-7">R. equi</span> serologically. In India, diagnosis through post-mortem examination (<a href="#Garg-DN--Manchanda-VP--Chandramani-NK--1985-."><span class="Hyperlink">Garg et al., 1985</span></a>; <a href="#Saxena-V--Narwal-PS--2009"><span class="Hyperlink">Saxena and Narwal, 2009</span></a>) and isolation of <span class="CharOverride-7">R. equi</span> from clinical samples (<a href="#Khurana-SK--Malik-P--Virmani-N--Singh-BR--2009-."><span class="Hyperlink">Khurana et al., 2009</span></a>). Various PCR assays have been developed (<a href="#Sellon-DC--Besser-TE--Vivrette-SL--McConnico-RS--2001"><span class="Hyperlink">Sellon et al., 2001</span></a>; <a href="#Arriaga-JM--Cohen-ND--Derr-JN--Chaffin-MK--Martens-RJ--2002-."><span class="Hyperlink">Arriaga et al., 2002</span></a>; <a href="#Ladro-n-N--Ferna-ndez-M--Agu-ero-J--Zo-rn-BG--Va-zquez-Boland-JA--Navas-J---2003-"><span class="Hyperlink">Ladron et al., 2003</span></a>; <a href="#Oldfield-C--Bonella-H--Renwick-L--Dodson-HI--Alderson-G--Goodfellow-M--2004-"><span class="Hyperlink">Oldfield et al., 2004</span></a>; <a href="#Ocampo-Sosa-AA--Lewis-DA--Navas-J--2007"><span class="Hyperlink">Ocampo-Sosa et al., 2007</span></a>; <a href="#Pusterla-N--Wilson-WD--Mapes-S--Leutenegger-CM--2007-"><span class="Hyperlink">Pusterla et al., 2007</span></a>; <a href="#Letek-M--Ocampo-Sosa-AA--Sanders-M---2008"><span class="Hyperlink">Letek et al., 2008</span></a>; <a href="#Monego-F--Maboni-F--Krewer-C--Vargas-A--Costa-M--Loreto-E--2009"><span class="Hyperlink">Monego et al., 2009</span></a>). The most valuable diagnostic procedures are combination of cultural methods along with PCR assay (<a href="#Khurana-SK--2015-"><span class="Hyperlink">Khurana, 2015</span></a>).</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Rifampicin along with macrolides is the drug of choice for treatment of <span class="CharOverride-7">R. equi</span> infection. R<span class="Emphasis CharOverride-15">ifampicin resistance have been reported which is posing a challenge in therapy (</span><a href="#Asoh-N--Watanabe-H--Fines-Guyon-M--Watanabe-2013"><span class="Hyperlink">Asoh et al., 2013</span></a><span class="Emphasis CharOverride-15">; </span><a href="#Burton-AJ--Gigu-re-S--Sturgill-TL---Berghaus--2013"><span class="Hyperlink">Burton et al., 2013</span></a><span class="Emphasis CharOverride-15">; </span><a href="#Goldstein-BP--2014-."><span class="Hyperlink">Goldstein, 2014</span></a><span class="Emphasis CharOverride-15">; </span><a href="#Liu-H--Wang-Y--Yan-J--Wang-C--He-H--2014-."><span class="Hyperlink">Liu et al., 2014</span></a><span class="Emphasis CharOverride-15">). </span>Proper management and sanitation at farms is very important for control of disease at equine farms. Hygiene is important in immunocompromised human beings.</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB">Anthrax</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Anthrax is caused by <span class="CharOverride-7">Bacillus anthracis</span>, an extremely resistant spore forming bacteria. Horses generally get infection by grazing in areas contaminated by anthrax. The typical incubation period is 3 to 7 days. Bacteria multiply and disseminate throughout the body through blood and lymphatic system, and release lethal toxin causing cell death and breakdown of tissues.</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Symptoms appear very rapidly which include high fever, agitation, chills, colic, anorexia, dullness, laboured breathing and seizures. Bloody diarrhoea, swelling around the neck may also be observed. Chest, abdomen and genitals may also get swollen. Death may occur in 2 to 3 days after occurrence of first symptoms. This is controlled by vaccination in endemic areas, early diagnosis and treatment, burning and burial of dead animals.</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Horses are usually less susceptible than ruminants, but reports of outbreaks of anthrax are available in horses from Minnesota and North Dakota. Horses may have prolonged course of disease. Affected horses exhibit symptoms of marked pyrexia, colic, dyspnea, and subcutaneous edema and death may occur abruptly. </p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Human beings contract infection from contaminated horses and their accessories and are often associated with three forms cutaneous, gastrointestinal and inhalation (<a href="#Hicks-CW--Sweeney-DA--Cui-X--Li-Y--Eichacker-PQ--2012-."><span class="Hyperlink">Hicks et al., 2012</span></a>). One more form of injectional anthrax has also been reported (<a href="#Lalitha-MK--Anandi-V--Walter-N--DevaduttaJO--Pulimood-BM--1988-"><span class="Hyperlink">Lalitha et al., 1988</span></a>; <a href="#Beamont-G--2010-."><span class="Hyperlink">Beaumont, 2010</span></a>; <a href="#Booth-MG--Hood-J--Brooks-TJ--Hart-A--2011-."><span class="Hyperlink">Booth et al., 2011</span></a>; <a href="#Jallali-N--Hettianatchy-S--Gordon-AC--Jain-A--2011-"><span class="Hyperlink">Jallali et al., 2011</span></a>). Spores of anthrax bacilli are so sturdy that they can survive for years in the environment and that can cause major problem for human population.</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Control of anthrax is done through vaccination, early detection and reporting, quarantine, antibiotic therapy of exposed animals, burning or burial of dead animals that had suspected or confirmed anthrax infection. Vaccination of horses is done only in endemic farms and areas. </p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB">Glanders</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Glanders is a contagious and fatal disease of horse, mules and donkey with zoonotic potential (<a href="#Malik-P--Khurana-SK--Dwivedi-SK--2010"><span class="Hyperlink">Malik et al., 2010</span></a>; <a href="#Varga-JJ--Vigil-A--DeShazer-D--Waag-DM--Felgner-P--Goldberg-JB--2012"><span class="Hyperlink">Varga et al., 2012</span></a>; <a href="#Verma-AK--Saminathan-M--Neha--Tiwari-R--Dhama-K--Singh-SV--2014a"><span class="Hyperlink">Verma et al., 2014a</span></a>). This is a disease known since ancient times and was identified in 4<span class="CharOverride-5">th</span> century BC by Hippocrates (<a href="#Colahan-PT--Mayhew-IG--Merritt-AM--Moore-JN--1999-."><span class="Hyperlink">Colahan et al., 1999</span></a>). The disease is caused by a non-spore forming gram negative bacillus called <span class="CharOverride-7">Burkholderia mallei.</span> Most common mode of transmission of this organism is inhalation and ingestion of contaminated feed and water. The disease occurs in chronic form in horses, where bacteria are found in nasal discharges and skin lesions (<a href="#OIE--2004-"><span class="Hyperlink">OIE 2004</span></a>, <a href="#OIE--2008-"><span class="Hyperlink">2008</span></a>), whereas in mules and donkeys the disease occurs in acute form (<a href="#Hunting-W--1913-."><span class="Hyperlink">Hunting, 1913</span></a>; <a href="#Gulati--RL--Gautam-OP--1962-."><span class="Hyperlink">Gulati and Gautam, 1962</span></a>). The acute form of glanders involves pulmonary, cutaneous and nasal sites (<a href="#Jubb-KVF--Kennedy-PC--Palmer-N--1993-."><span class="Hyperlink">Jubb et al., 1993</span></a>), and is characterized by pyrexia, cough, discharges from nostrils, ulcers on nasal mucosa and nodules on the skin finally leading to death.</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Chronic form in horse also shows all three clinical manifestations which include pulmonary, nasal and cutaneous forms. The human glanders is not very common, but it is having very high mortality rate of 90-95% in untreated septicaemic infection and 50% in treated humans. Human outbreaks have not been reported. </p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">This organism is very important from biological warfare angle due to high rate of mortality and ability of small number of organisms to establish the infection. The diagnosis of glanders is done by isolation and allergic test (Mallein test) which is prescribed test for international trade. The test is not very specific, so it should be used along with complement fixation test which is also prescribed for international trade. The test is not very specific, so it should be used along with complement fixation test (CFT), which is also prescribed for international trade. Various serological tests for diagnosis of glanders include complement fixation test (CFT), indirect haemagglutination assay (IHA) and ELISA. <a href="#Singha-H--Malik-P--Goyal-SK--Khurana-SK--Mukhopadyaya-C--Eshwara-VK--Singh-RK--2014"><span class="Hyperlink">Singha et al. (2014)</span></a> have developed an indirect ELISA using truncated TssB protein for serodiagnosis of glanders.</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Various PCR assays have been developed (<a href="#Grishkina-TA--Samygin-VM--2010-."><span class="Hyperlink">Grishkina and Samygi, 2010</span></a>; <a href="#Zhang-B--Wear-DJ--Kim-HS--Weina-P--Stojadinovic-A-Izadjoo-M--2012-"><span class="Hyperlink">Zhang et al., 2012</span></a>) which have been found to be rapid, sensitive and specific. <a href="#Janse-I--Hamidjaja-RA--Hendriks-AC--von-Rotterdam-BJ--2013-."><span class="Hyperlink">Janse et al. (2013)</span></a> developed a multiplex qPCR for detection and differentiation of <span class="CharOverride-7">B. mallei</span> and <span class="CharOverride-7">B. pseudomallei</span>. Diagnosis in human beings is generally done by CFT and imaging studies.</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">No vaccine is available for prevention of glanders for animals or humans (<a href="#Burtnick-MN--Heiss-C--Roberts-RA--Schweizer-HP--Azadi-P--Brett-PJ--2012-."><span class="Hyperlink">Burtnick et al., 2012</span></a>). In case of death suspected due to glanders, the carcass should not be opened and must be buried deep or incinerated.</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB">Brucellosis</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Brucellosis is one of the most important disease problems of animals and human beings. This is caused by <span class="CharOverride-7">Brucella abortus</span> in equines, and is manifested by fistulous withers, poll evil, lameness due to joint infection and rarely late abortions in mares. Horizontal transfer of <span class="CharOverride-7">Brucella</span> spp. to horses from cattle and pigs has been documented (<a href="#Forbes-LB--1990-."><span class="Hyperlink">Forbes, 1990</span></a>). Brucellosis is considered to be an occupational disease from public health point of view that mainly affects slaughter house workers, butchers and veterinarians. This causes undulant fever in human beings. </p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB"><a href="#Ehizibolo-DO--Gusi-AM--Ehizibolo-PO--Mbuk-EU--Ocholi-RA.--2011-"><span class="Hyperlink">Ehizibolo et al. (2011)</span></a> have reported a sero-prevalence of 14.7% of equine brucellosis in Nigeria. <a href="#Tahamtan-Y--Namavari-MM--Mohammadi-G--Jula-GM--2010-"><span class="Hyperlink">Tahamtan et al. (2010)</span></a> have reported a sero-prevalence of 2.5% for brucellosis in horses in Iran. A sero-prevalence of 5.88%, 12.89% and 5.78% has been reported from Egypt (<a href="#Montasser-AM--Saleh-S--Ibrahim-SI--Gilaby-SE--1999-"><span class="Hyperlink">Montasser et al., 1999</span></a>), India (<a href="#Sharma-VD--Sethi-MS--Yadav-MP--Dube-DC--1979-."><span class="Hyperlink">Sharma et al., 1979</span></a>) and Pakistan (<a href="#Ahmed-R--Munir-M--1995a-"><span class="Hyperlink">Ahmed and Munir, 1995a</span></a>, <a href="#Ahmed-R--Munir-M--1995b-"><span class="Hyperlink">b</span></a>), respectively.</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">The incubation period in humans varies from 1-3 weeks. The symptoms may include irregular fever, headache, weakness, malaise, profuse sweating especially during night. Coughing, chest pain, irritation, insomnia, depression are occasionally encountered. In many patients, the symptoms last for 2 to 4 weeks and are followed by spontaneous recovery. Others develop recurrent bouts at 2-14 day intervals. Most people with this undulant form recover completely in 3 to 12 months. A few patients become chronically ill, with symptoms of chronic fatigue, depressive episodes and arthritis. Relapses can be seen months after the initial symptoms, even in successfully treated cases. Occasional complications include arthritis, endocarditis, granulomatous hepatitis, meningitis, uveitis, orchitis, cholecystitis, osteomyelitis, and rare cases of encephalitis.<span class="Strong"> </span><span class="Strong CharOverride-15">Asymptomatic infections are also common in humans.</span></p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Diagnosis relies on the detection of circulating antibodies followed by the bacteriological isolation and serum agglutination tests [Rose Bengal plate agglutination test (RBPT) and standard tube agglutination test (STAT)]. Molecular diagnostic assays can be used for detection instead of serological tests because serological assays like RBPT, STAT have the disadvantage of false positive reaction against other gram negative bacteria (<a href="#Karthik-K--Rathore-R--Thomas-P--Arun-TR-2014a"><span class="Hyperlink">Karthik et al., 2014a</span></a>). Various molecular assays like polymerase chain reaction (PCR), Real time-PCR, etc., can be employed for detection of the pathogen. Recent field assays like loop mediated isothermal amplification assay and lateral flow assay can be employed (<a href="#Karthik-K--Rathore-R--Thomas-P--Arun-TR-2014a"><span class="Hyperlink">Karthik et al., 2014a</span></a>, <a href="#Karthik-K--Rathore-R--Thomas-P--Arun-TR--Viswas-KN--Dhama-K--Agarwal-RK--2014b-"><span class="Hyperlink">2014b</span></a>).</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Brucellosis being intracellular requires the need for antibiotics that can target intracellular pathogen. Treatment in humans can be done with combination of various antibiotics like doxycyline, streptomycin and rifampicin. Combinational therapy is followed to reduce the infection quickly and also to reduce the toxicity (<a href="#MacMillan-AP--Baskerville-A--Hambleton-P--Corbel-MJ--1982"><span class="Hyperlink">MacMillan et al., 1982</span></a>; <a href="#Yousefi-Nooraie-R--Mortaz-Hejri-S--Mehrani-M--Sadeghipour-P--2012-"><span class="Hyperlink">Yousefi-Nooraie et al., 2012</span></a>). </p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB">Salmonellosis</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Salmonellosis is an enteric disease with clinical manifestation of chronic diarrhea, fever which may turn into acute toxic enterocolitis or septicaemia in various vertebrate hosts including horses and human beings. Etiological agent is Gram negative bacteria of Salmonella genus with multiple serotypes. Horses of all age groups are susceptible. Multidrug resistant <span class="CharOverride-7">S.</span> Typhimurium DT104 (<span class="CharOverride-7">Salmonella enterica</span> subspecies <span class="CharOverride-7">enterica</span> Serotype Typhimurium Definitive Type 104) has been recovered from many horses in Ontario and has significant zoonotic potential due to its high lethality rate in human beings as well. Initially <span class="CharOverride-7">S.</span> Typhimurium DT104 was isolated from cattle in 1988 in England and Wales but consequently was reported from sheep, pigs, poultry and horse. Fecal-oral route with high inoculums size containing more number of bacteria is the most common way for zoonotic spread of salmonellosis in human population, though in immunocompromised persons low inoculums may also produce the disease. Higher mortality rate and resistance to commonly preferred antibiotics further aids to the potential of this pathogen for zoonotic transmission.<span class="A4 CharOverride-16"> </span>Suspected cases should be monitored and treated separately. Strict follow up of personal hygienic measures and proper disinfection of stables, contaminated equipments and utensils will help in reducing the menace of zoonotic transmission (<a href="#Fone-D--Barker-R--1994-"><span class="Hyperlink">Fone and Barker, 1994</span></a>; <a href="#Weese-JS--Baird-JD--Poppe-C--Archambault-M--2001a"><span class="Hyperlink">Weese et al., 2001a</span></a>; <a href="#Weese-JS--2002-."><span class="Hyperlink">Weese, 2002</span></a>). </p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB"><span class="CharOverride-14">Streptococcus equi</span> Subspecies <span class="CharOverride-14">zooepidemicus</span> Infection</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB"><span class="CharOverride-7">Streptococcus equi</span> subspecies <span class="CharOverride-7">zooepidemicus</span> is considered opportunistic pathogen in horse, but causes infection in cattle, sheep, goat, pig and dog also.<span class="CharOverride-7"> S. equi</span> subspecies <span class="CharOverride-7">zooepidemicus</span> has more than 98% DNA sequence homology with <span class="CharOverride-7">S. equi</span> subspecies <span class="CharOverride-7">equi.</span> <a href="#Pelkonen-S--Lindahl-SB--Suomala-P--Karhukorpi-J--2013"><span class="Hyperlink">Pelkonen et al. (2013)</span></a> have shown that <span class="CharOverride-7">S. equi</span> subspecies <span class="CharOverride-7">zooepidemicus</span> is transmitted from horse to human beings and they found that human and equine isolates were identical or closely related. <a href="#Lindahl-S--Asp-n-A--B-verud-V--Paillot-R--Pringle-J--Rash-NL--S-derlund-R--Waller-AS--2013"><span class="Hyperlink">Lindahl et al. (2013)</span></a> reported an outbreak of repiratory disease due to<span class="CharOverride-7"> S. equi</span> subspecies <span class="CharOverride-7">equi.</span><span class="CharOverride-6"> </span><a href="#Downar-J--Willey-BM--Sutherland-JW--Mathew-K--Low-DE--2001-."><span class="Hyperlink">Downar et al. (2001)</span></a> have documented infection of Streptococcal meningitis from close contact with an infected horse (<a href="#Downar-J--Willey-BM--Sutherland-JW--Mathew-K--Low-DE--2001-."><span class="Hyperlink">Downar et al. (2001)</span></a>).</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB"><span class="CharOverride-7">S. equi</span> subspecies <span class="CharOverride-7">zooepidemicus</span> is <span class="CharOverride-17">β</span>-haemolytic streptococci in Lancefield group C (<a href="#Lancefield-RC--1993-."><span class="Hyperlink">Lancefield, 1933</span></a>). The equine Lancefield group C streptococci are differentiated biochemically by their ability to ferment sorbitol, lactose and trehalose (<a href="#Quinn-PJ--Carter-ME--Markey-B--Carter-GR--1994"><span class="Hyperlink">Quinn et al., 1994</span></a>). In addition, PCR can be used to genetically identify different species and subspecies (<a href="#Alber-J--El-Sayed-A--Lammler-C--Hassan-AA--Weiss-R--Zschock-M--2004-."><span class="Hyperlink">Alber et al., 2004</span></a>; <a href="#Baverud-V--Johansson-SK--Aspan-A--2007-."><span class="Hyperlink">Baverud et al., 2007</span></a>; <a href="#Preziuso--S.--Laus--F.--Tejeda--A.R.--Valente--C.---Cuteri--V--2010-"><span class="Hyperlink">Preziuso et al., 2010</span></a>).</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB"><span class="CharOverride-14">Clostridium difficile </span>Infection</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB"><span class="CharOverride-7">Clostridium difficile</span> (<span class="CharOverride-7">C. difficile</span>) is an anaerobic causative agent for colitis in horses and human (<a href="#Jones-RL--Adney-WS--Shideler-RK--1987-."><span class="Hyperlink">Jones et al., 1987</span></a>; <a href="#George-RH--Symonds-JM--Dimock-F--Brown-JD--Arabi-Y--Shinagawa-N--1978-"><span class="Hyperlink">George et al., 1978</span></a>; <a href="#Weese-JS--Staempfli-HR--Prescott-JF--2001b-."><span class="Hyperlink">Weese et al., 2001b</span></a>). <span class="CharOverride-7">C. difficile </span>associated diarrhoea can be mild, self-limiting or peracute leading to fatal outcomes in horses. It affects all ages of horses ranging from neonatal to adults. In acute cases of diarrhea rapid diagnosis is based on detection of bacterial toxins in fecal samples. <span class="CharOverride-7">C. difficile</span> is a well-recognized pathogen of human also. The infection in man varies from mild to severe pseudomembranous colitis leading to intestinal perforation and death. Transmission between animals and humans has been poorly studied. Equines suffering with <span class="CharOverride-7">C. difficile</span> diarrhoea should be considered infectious, particularly to people undergoing antimicrobial or chemotherapeutic treatment. Proper precautions (gloves, gowns and boots) and close attention to personal hygiene may prevent the chance of zoonotic transmission. Sporicidal disinfectant (5–10% bleach solution) should be used to clean the contaminated equipment and the areas under use. The veterinarians who develop acute diarrhoea following contact with suspected or confirmed case of infection in a horse should take medical help to confirm the infection.</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB">Methicillin Resistant <span class="CharOverride-14">Staphylococcus </span>spp.</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">In the era of antibiotic resistance, methicillin resistant <span class="CharOverride-7">Staphylococcus</span> <span class="CharOverride-7">aureus</span> (MRSA) is one of the prime concerns. Different <span class="CharOverride-7">Staphylococcus </span>spp<span class="CharOverride-7">. </span>can harbour horses of which <span class="CharOverride-7">S. aureus</span> and its variant MRSA are the important species as they can be transmitted to humans and can cause major infections. In the early phase of MRSA, concern was restricted to humans and community associated MRSA which were increasing throughout the world. Livestock associated MRSA has spread recently among animals (<a href="#Hartmann-FA--Trostle-SS--Klohnen-AAO--1997-."><span class="Hyperlink">Hartmann et al., 1997</span></a>; <a href="#McCarthy-AJ--Breathnach-AS--Lindsay-JA--2012-"><span class="Hyperlink">McCarthy et al., 2012</span></a>). Though the report of MRSA in horses was late but there are arrays of documentation after its first report in later part of nineteenth century (<a href="#Stull-JW--Slavic--D--Rousseau-J--Weese-JS--2012"><span class="Hyperlink">Stull et al., 2012</span></a>).<span class="Heading-3-Char CharOverride-13"> </span>Literature reveal that approximately 10% of healthy vigorous horses cart MRSA in their nasal passages, intestinal tracts and on their skin, thereafter these colonized horses act as reservoirs of MRSA in the community which are efficiently capable of transmitting MRSA in the human population in and across the globe due to frequent international movement and trading of horses (<a href="#Weese-JS--Rousseau-J--Traub-Dargatz-JL--Willey-BM--McGeer-AL--Low-DE--2005"><span class="Hyperlink">Weese et al., 2005</span></a>, <a href="#Weese-JS--Caldwell-F--Willey-BM--Kreiswirth-BN--McGeer-A--Rousseau-J--Low-DE--2006"><span class="Hyperlink">2006</span></a>).<span class="A4 CharOverride-16"> </span>Most of the methicillin resistant <span class="CharOverride-7">Staphylococcus</span> organisms affect soft tissues and joints in horses but these are resistant to treatment with antibiotics. Some instances pneumonia, metritis and sinusitis are also documented in horses (<a href="#Smiet-E--Grinwis-GCM--van-den-Top-JGB--Sloet-van-Oldruitenborgh-Oosterbaan-MM--2012-."><span class="Hyperlink">Smiet et al., 2012</span></a>). There is always danger of transfer of these drug resistance bacteria from animals to humans, and these methicillin resistant organisms can jump both ways from human to animal and also from animal to human (<a href="#Weese-JS--Lefebvre-SL--2007"><span class="Hyperlink">Weese and Lefebvre, 2007</span></a>). Veterinarians top the list of humans suffering from this methicillin resistant <span class="CharOverride-7">Staphylococcus</span> spp. transmission form horses (<a href="#van-Duijkeren-E--Ten-Horn-L--Wagenaar-JA--2011"><span class="Hyperlink">van Duijkeren et al., 2011</span></a>). Bacteriophage therapy has yielded good response against MRSA (<a href="#Karthik-K--Muneeswaran-NS--Manjunathachar-HV--Gopi-M--Elamurugan-A--Kalaiyarasu-S.--2014c"><span class="Hyperlink">Karthik et al., 2014c</span></a>). Similarly, broad spectrum beta lactamase producing Enterobacteriacea can also be transmitted from horses to human (<a href="#Boyen-F--Smet-A--Hermans-K--Butaye-P--Martens-A--Martel-A--Haesebrouck-F--2013-"><span class="Hyperlink">Boyen et al., 2013</span></a>). </p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB">Tuberculosis </p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Tuberculosis (TB) affects different mammals and many variants including extremely drug resistant TB has emerged which poses serious threat to human beings (<a href="#Karthik--K--2012-."><span class="Hyperlink">Karthik, 2012</span></a>; <a href="#Karthik-K--Kesavan-M--Tamilmahan-P--Saravanan-M-and-Dashprakash-M--2013-."><span class="Hyperlink">Karthik et al., 2013</span></a>). Incidences of TB are sparse in horses mainly due to established control programmes, however few workers have reported the disease as confirmed by the presence of causative agent (<a href="#Pavlik-I--Jahn-P--Dvorska-L--M-Bartos--L-Novotny--R-Halouzka--2004"><span class="Hyperlink">Pavlik et al., 2004</span></a>). TB is a zoonotic disease caused by <span class="CharOverride-7">Mycobacterium tuberculosis, M. bovis,</span> and members of <span class="CharOverride-7">M. tuberculosis</span> complex in several mammalian hosts including horses though they are considered comparatively resistant. Horses residing in close proximity with infected cattle acquire the infection as evidenced from the earlier reports showing presence of <span class="CharOverride-7">M. tuberculosis</span> and <span class="CharOverride-7">M. bovis</span> as well and advocate a possibility of interspecies transmission and zoonotic prospective of <span class="CharOverride-7">M. tuberculosis</span>. Horses infected with pulmonary TB illustrate lesions of multiple tuberculoid granulomas in lung with manifestation of granulomatous lymphadenitis in mediastinal and tracheobronchial lymph nodes, which can be further confirmed by laboratory culture techniques and quantitative real-time PCR (<a href="#Keck-N--Dutruel-H--Smyej-F--Nodet-M--Boschiroli-ML--2010-"><span class="Hyperlink">Keck et al., 2010</span></a>; <a href="#Blahutkova-M--Fictum-P--Skoric-M--2011-."><span class="Hyperlink">Blahutkova et al., 2011</span></a>; <a href="#Konstantin-PL--Rena-G--Javan-E--Alexis-L--2012"><span class="Hyperlink">Konstantin et al., 2012</span></a>). </p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-1--Introduction----" lang="en-GB">PARASITIC PATHOGENS</p>
		  <p class="Heading-1--Introduction----" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB">Cryptosporidiosis</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Equine cryptosporidiosis is caused by a protozoal pathogen, <span class="CharOverride-7">Cryptosporidium parvum, </span>causing enteric disease in several species including humans and is most commonly associated with foals and immunodeficient animals. Infected horses shed oocysts with the shedding rate of 0–21% which have infective potential, horses develop asymptomatic cryptosporidiosis. High prevalence of disease with 71% infection rate is documented in foals and zoonotic transmission of Cryptosporidium from foal to handling veterinarians is also reported (<a href="#Coleman-SU--Klei-TR--French-DD--Chapman-MR--Corstvet-RE--1989-."><span class="Hyperlink">Coleman et al., 1989</span></a>; <a href="#Cole-DJ--Cohen-ND--Snowden-K--Smith-R--1998-."><span class="Hyperlink">Cole et al., 1998</span></a>). Humans express symptoms of copious watery diarrhea which may lead to critical grave condition. In immunocompromised persons, the disease exists in a self-limiting form. Zoonotic implications occur due to high shedding rates, hence precautions must be taken while dealing with diarrhoic animals to minimize the risk of zoonosis (<a href="#Snyder-SP--England-JJ--McChesney-AE--1978-."><span class="Hyperlink">Snyder et al., 1978</span></a>; <a href="#Konkle-DM--Nelson-KM--Lunn-DP--1997-"><span class="Hyperlink">Konkle et al., 1997</span></a>; <a href="#Majewska-AC--Werner-A--Sulima-P--Luty-T--1999-."><span class="Hyperlink">Majewska et al., 1999</span></a>; <a href="#McKenzie-DM--Diffay-BC--2000"><span class="Hyperlink">McKenzie and Diffay, 2000</span></a>).</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp; </p>
			<p class="Heading-2--History-in-MM-" lang="en-GB">Giardiasis</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Fecal shedding of Giardia oocysts from horses is an indication of zoonotic risk. Giardiasis caused by <span class="CharOverride-7">Giardia intestinalis</span> is the most common intestinal parasitic disease characterized by mild or severe diarrhea. Zoonotic transmission of Giardia is supported by feco-oral route. Asymptomatic shedding of Giardia in 25% of adult horses and 71% cumulative infection rate in foals further suggest possibility of zoonotic potential of this pathogen in horses besides other species (<a href="#Xiao-L--Herd-RP--1994"><span class="Hyperlink">Xiao and Herd, 1994</span></a>). Fecal cyst detection and ELISA are available for diagnosis for giardiasis (<a href="#Rishniw-M--Liotta-J--Bellosa-M--Bowman-D--Simpson-KW--2010"><span class="Hyperlink">Rishniw et al., 2010</span></a>).</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp; </p>
			<p class="Heading-2--History-in-MM-" lang="en-GB">Other Zoonotic Diseases of Equines</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">Several important zoonoses shared between man and equines have been described above, however all the possible zoonotic threats related to equines are not detailed and still there are many others like Borna virus, Nipah virus infection as geographically limited zoonotic, dourine, crytosporidisis (<a href="#Sellon-DC--2007-."><span class="Hyperlink">Sellon, 2007</span></a>; <a href="#Xiao-L--Feng-Y--2008"><span class="Hyperlink">Xiao, 2008</span></a>), giardiasis, leptospirosis, dermatophytosis, Halicephalobus gingivalis (Micronema deletrix) under certain specific conditions,<span class="CharOverride-6"> </span>are also among the several other infections capable of being transmitted from equines to human beings thus adding to the disease burden. Besides viral and bacterial pathogens, parasitic, protozoan and fungal agents are also involved in equine zoonoses. Leptospirosis is another important disease of public health concern that can be transmitted from various animals. Leptospirosis is a zoonosis of global concern caused by spirochetes of genus Leptospira<span class="A4 CharOverride-16"> </span>(<a href="#Ebani-VV--Bertelloni-F--Pinzauti-P--Cerri-D--2012-"><span class="Hyperlink">Ebani et al., 2012</span></a>). <span class="CharOverride-7">Leptospira</span> spp. is endemic in various parts of the world. Various serovars like Pomana, Icterohaemorrhagiae and Bratislava are recorded in horses but risk of zoonotic transmission of leptospirosis from horses is not immense. <a href="#Hall-CE--Bryan-JT--1952-."><span class="Hyperlink">Hall and Bryan (1952)</span></a> and other workers have reported leptospirosis in horse, which harbor the infection as accidental host (<a href="#Hall-CE--Bryan-JT--1952-."><span class="Hyperlink">Hall and Bryan, 1952</span></a>; <a href="#Hogg-GG--1974-"><span class="Hyperlink">Hogg, 1974</span></a>; <a href="#Barwick-RS--Mohammed-HO--McDonough-PL--White-ME--1998-."><span class="Hyperlink">Barwick et al., 1998</span></a>). Symptoms in horse include anorexia, fever, lethargyness, renal dysfunction, jaundice; abortion and still birth can also occur in pregnant mares (<a href="#Divers-TJ--Byars-TD--Shin-SJ--1992-."><span class="Hyperlink">Divers et al., 1992</span></a>; <a href="#Timoney-JF--Kalimuthusamy-N--Velineni-S--Donahue-JM--Artiushin-SC--Fettinger-M--2011"><span class="Hyperlink">Timoney et al., 2011</span></a>). Equine recurrent uveitis or moon blindness occurs after weeks or months after the onset of systemic leptospirosis in horses. Symptoms in human include jaundice, fever, muscular pain, vomiting, uveitis etc. (<a href="#Hartskeerl-RA--Goris-MG--Brem-S--Meyer-P--Kopp-H--Gerhards-H--Wollanke-B--2004-."><span class="Hyperlink">Hartskeerl et al., 2004</span></a>; <a href="#Verma-A--Stevenson-B--Adler-B--2013-"><span class="Hyperlink">Verma et al., 2013</span></a>). Microscopic agglutination test is the gold standard test for diagnosis of leptospirosis but several disadvantages makes it difficult to perform. Various recombinant proteins are used in ELISA and latex agglutination assay formats for diagnosis of leptospirosis which are effective in diagnosis (<a href="#Deneke-Y--Sabarinath-T--Gogia-N--Lalsiamthara-J--Viswas-KN--Chaudhuri-P--2014-."><span class="Hyperlink">Deneke et al., 2014</span></a>). Dermatophytosis (ringworm)<span class="CharOverride-6"> </span>is a fungal dermatologic disease of zoonotic concern affecting variety of animals including horses, caused by species of <span class="CharOverride-7">Microsporum</span> or <span class="CharOverride-7">Trichophyton</span>. Horses are mainly affected by <span class="CharOverride-7">T. equinum</span> with the clinical presentation of mild or subclinical form of disease to severe lesions imitating to pemphigus foliaceus. Dermatophytosis can be transmitted from horses to persons in contact through direct and indirect routes (<a href="#Pascoe-RR--1976"><span class="Hyperlink">Pascoe, 1976</span></a>; <a href="#Pier-AC--Zancanella-PJ--1993"><span class="Hyperlink">Pier and Zancanella, 1993</span></a>; <a href="#Huovinen-S--Tunnela-E--Kuijpers-AF--Suhonen-R--Huovinen-P--1998-."><span class="Hyperlink">Huovinen et al., 1998</span></a>).</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-2--History-in-MM-" lang="en-GB">Preparedness and strategic planning to counter equine zoonosis</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB">To protect the public and animal health of equine sector from devastating effects of zoonoses, equine emergency preparedness plans are required to be implemented by collaboration of local, regional, state officials, academic institutions, tribal and other allied government agencies to safeguard the equine industry and personnel involved by providing public education, following integrated surveillance plans, epidemiological disease investigations and prevention strategies on zoonotic threats of already mentioned emerging equine zoonotic diseases. As swiftly as possible any suspected incidence should be detected and controlled, and containment of the incidence should be arranged to protect the health and environment for stabilizing the economy. Local veterinary surgeon and state personnel should assure educating equine veterinarians, owners, trainers and farm managers about equine industry organizations and effective disease management practices.</p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB"><span class="citation">In the current era of increasing global population, </span>globalization trends, tourism expansion, ecosystem and biodiversity changes like global warming, <span class="citation">emerging drug resistance, need for effective </span>therapeutics and vaccines, immune stresses, <span class="citation">we need to strengthen </span>research and development programmes, implement strategic and planned veterinary and medical approaches, <span class="citation">the one world health one medicine concept, m</span>ulti-disciplinary and international level surveillance /networking employing geographical information system (GIS), early warning systems and to tackle <span class="citation">emerging/re-emerging infectious diseases of animals and their increasing zoonotic and pandemic risk </span>(<a href="#Slingenbergh-J--Gilbert-M--de-Balog-K--Wint-W--2004-"><span class="Hyperlink">Slingenbergh et al., 2004</span></a>; <a href="#Kahn-LH--Kaplan-B--Steele-JH--2007-."><span class="Hyperlink">Kahn et al., 2007</span></a>; <a href="#Jones-KE--Patel-NG--Levy-MA--Storeygard-A--Balk-D--2008-"><span class="Hyperlink">Jones et al., 2008</span></a>; <a href="#Bergquist-R--2011-"><span class="Hyperlink">Bergquist, 2011</span></a>; <a href="#Dhama-K--Chakraborty-S--Kapoor-S--Tiwari-R--Kumar--2013a"><span class="Hyperlink">Dhama et al., 2013a</span></a>, <a href="#Dhama-K--Tiwari-R--Chakraborty-S--Kumar-A--Karikalan-M--Singh-R--Rai-RB--2013b-."><span class="Hyperlink">2013b</span></a>, <a href="#Dhama-K--Verma-AK--Tiwari-R--Chakraborty-S-2013c"><span class="Hyperlink">2013c</span></a>, <a href="#Dhama-K--Chakraborty-S--Tiwari-R---2014a"><span class="Hyperlink">2014a</span></a>; <a href="#Tiwari-R--Chakraborty-S--Dhama-K--Rajagunalan-S--Singh-SV--2013"><span class="Hyperlink">Tiwari et al., 2013</span></a>; <a href="#Verma-AK--Dhama-K--Chakraborty-S--Kumar-A--Tiwari-R--Rahal-A--Mahima--Singh-SV--2014b"><span class="Hyperlink">Verma et al., 2014b</span></a>). Important vectors and reservoirs of infectious zoonotic pathogens need to be brought under control to prevent the spread of infectious agents and disease risks and threats to equines and related public health concerns (<a href="#Daszak-P--Cunningham-AA--Hyatt-AD--2000-."><span class="Hyperlink">Daszak et al., 2000</span></a>; <a href="#Bengis-RG--Leighton-FA--Fischer-JR--Artois-M--M-rner-T--Tate-CM--2004-."><span class="Hyperlink">Bengis et al., 2004</span></a>; <a href="#Zinsstag-J--Schelling-E--Roth-F--Bonfoh-B--De-Savigny-D--Tanner-M--2007-"><span class="Hyperlink">Zinsstag et al., 2007</span></a>; <a href="#Dhama-K--Karthik-K--Chakraborty-S--Tiwari-R--Kapoor-S.--2013d-."><span class="Hyperlink">Dhama et al., 2013d</span></a>).<span class="CharOverride-6"> </span>Recent advances in diagnostics and molecular detection tools for delivering rapid and confirmatory diagnosis of zoonotic infectious pathogens of animals and affecting humans need to be explored to their full potential, including PCR, real-time PCR, multiplex PCR, LAMP, recombinant protein based diagnostics, biosensors, biochips, microarrays, gene sequencing, phylogenetic analysis and nanodiagnostics (<a href="#Schmitt-B--Henderson-L--2005"><span class="Hyperlink">Schmitt and Henderson, 2005</span></a>; <a href="#Belak-S--2007-."><span class="Hyperlink">Belak, 2007</span></a>; <a href="#Belak-S--Thoren-P--Le-Blanc-N--Viljoen-G--2009-."><span class="Hyperlink">Belak et al., 2009</span></a>; <a href="#Bollo-E--2007-."><span class="Hyperlink">Bollo, 2007</span></a>; <a href="#Ratcliff-RM--Chang-G--Kok-T--Sloots-TP--2007-"><span class="Hyperlink">Ratcliff et al., 2007</span></a>; <a href="#Balamurugan-V--Venkatesan-G--Sen-A--Annamalai-L--Bhanuprakash-V--Singh-RK--2010-"><span class="Hyperlink">Balamurugan et al., 2010</span></a>; <a href="#Bergquist-R--2011-"><span class="Hyperlink">Bergquist, 2011</span></a>; <a href="#Deb-R--Chakraborty-S--2012-"><span class="Hyperlink">Deb and Chakraborty, 2012</span></a>; <a href="#Dhama-K--Wani-MY--Tiwari-R--Kumar-D--2012-."><span class="Hyperlink">Dhama et al., 2012</span></a>, <a href="#Dhama-K--Karthik-K--Chakraborty-S--Tiwari-R--Kapoor-S--Kumar-A--Thomas-P--2014b-"><span class="Hyperlink">2014b</span></a>; <a href="#Ayyar-BV--Arora-S--2013-"><span class="Hyperlink">Ayyar and Arora, 2013</span></a>). Apart from conventional killed and live vaccines, due priority need to be given for developing effective and safer new generation prophylactics comprising of DNA vaccines, plant based (edible) vaccines, reverse genetics vaccines, vector vaccines, protein/peptide vaccines, gene deleted mutant vaccines, reassortant vaccines, chimeric vaccines, virus like particles (VLP), vaccine cocktails, and vaccine delivery systems (oral, spray administration) (<a href="#Meeusen-EN--Walker-J--Peter-A--Pastorate-PP--Jungersen-G--2007-."><span class="Hyperlink">Meeusen et al., 2007</span></a>; <a href="#Dhama-K--Mahendran-M--Gupta-PK--Rai-A--2008-."><span class="Hyperlink">Dhama et al., 2008</span></a>, <a href="#Dhama-K--Wani-MY--Deb-R--Karthik-K---2013e"><span class="Hyperlink">2013e</span></a>; <a href="#Koff-WC--Burton-DR--Johnson-PR--Walker-BD--King-CR--Nabel-GJ--Ahmed-R--Bhan-MK--Plotkin-SA--2013"><span class="Hyperlink">Koff et al., 2013</span></a>). Adaptation of regular and judicious vaccination strategies, DIVA strategy, prime boost regimens and giving booster vaccinations must be implemented appropriately. Emphasis should be given in utilizing potential of novel and alternative/complementary immunomodulatory and treatment regimens comprising of immunotherapy, cytokine therapy, si-RNAs, avian egg antibodies, toll like receptors, phages, enzybiotics, probiotics, nutritional immunomodulation, herbs and nanomedicines for devising appropriate prevention and control programmes to counter infectious pathogens including zoonosis (<a href="#Mahima-Rahal-A--Deb-R--Latheef-SK--Samad-HA--Tiwari-R--Verma-AK--Kumar-A--Dhama-K--2012"><span class="Hyperlink">Mahima et al., 2012</span></a>; <a href="#Dhama-K--Chakraborty-S--Mahima-Wani-MY--Verma-AK--Deb-R--Tiwari-R--Kapoor-S--2013f"><span class="Hyperlink">Dhama et al., 2013f</span></a>, <a href="#Dhama-K--Chakraborty-S--Tiwari-R---2014a"><span class="Hyperlink">2014a</span></a>; <a href="#Malik-YS--Sharma-K--Jeena-LM--Kumar-N--Sircar-S--Rajak-KK--Dhama-K--2013-"><span class="Hyperlink">Malik et al., 2013</span></a>; <a href="#Tiwari-R--Chakraborty-S--Dhama-K--Wani-MY--Kumar-A--Kapoor-S--2014"><span class="Hyperlink">Tiwari et al., 2014</span></a>). RNA interference has been used successfully in various parasitic infections which can be adopted for other diseases (<a href="#Sudhakar-NR--Manjunathachar-HV--Karthik-K--2013"><span class="Hyperlink">Sudhakar et al., 2013</span></a>). Implementation of good management practices, strict biosecurity rules, proper hygiene and sanitation procedures, follow up of isolation and quarantine, and trade restrictions need to be taken care of very timely for checking and controlling the transmission and spread of zoonotic pathogens. This holistic approach would pave road to lower the disease incidences / outbreaks as well as in controlling the zoonotic pathogens of equines and their public health concerns. </p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
			<p class="Heading-1--Introduction----" lang="en-GB">CHALLENGES AHEAD AND FUTURE OUTLOOK</p>
		  <p class="Heading-1--Introduction----" lang="en-GB">&nbsp;</p>
			<p class="Body-Text ParaOverride-1" lang="en-GB"><span class="Emphasis CharOverride-15">Lack of awareness,</span> inadequate communication between veterinarians and public health organizations, and w<span class="Emphasis CharOverride-15">eak surveillance systems for zoonoses are the major problem areas.</span> Infections that affect animals and humans fall in ‘no man’s land’. In most human-animal episodes, neither the human nor the veterinary health systems have the capacity to deal with the outbreaks. Strengthening of risk assessments and early warning systems, laboratory capacity for diagnosis, monitoring and treatment are the much needed priorities. Monitoring and testing of all antivenom or antitoxin produced from horse serum against various pathogens like <span class="CharOverride-7">Brucella, Streptococcus, Burkholderia mallei</span> and other viral pathogens using different specific diagnostic assays can prevent spread of zoonotic diseases. Zoonotic illnesses can infect humans by entering the body in a variety of ways: animal bites, insect bites, by ingestion, by inhalation, through cuts/scratches and through the eyes or contact with other mucous membranes. A combination of precautions including breaking the transmission cycle especially in arboviral infections is effective in preventing zoonotic infections. Appropriate follow up of early diagnosis; maintain high personal hygiene and precautions while handling animals, fomites, tissues and various specimens effectively reduces the probability of disease transmission to a great extent. Physicians, veterinarians and public health professionals must work together to recognize and control zoonotic diseases. Approaches to the control of zoonoses differ according to the type of zoonoses, because majority of direct and cyclozoonoses and some saprozoonoses are most effectively controlled by techniques involving the animal host, and methods used to combat these diseases are almost entirely the responsibility of veterinary medicine. The control of metazoonoses may be directed at the infected vertebrate host, at the infected invertebrate vector or both. National and international agencies with mandates to control zoonotic diseases should coordinate their activities and share resources to accomplish prevention and control of zoonotic diseases. The key success to prevent and control equine zoonotic pathogens lies in optimum utilization of recent developments in advances in diagnostics, surveillance /networking, vaccines, therapeutics and good management practices. Proper hygienic and sanitary practice while handling horses or any other animals can prevent spread of infectious agents not only from animals but also vice versa. Veterinarians who are at most risk should wear protective clothings as gloves, mask, boots etc., while examining animals to prevent spread of zoonotic infection. </p>
		  <p class="Body-Text ParaOverride-1" lang="en-GB">&nbsp;</p>
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