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Epidemiology and Prevention of Rhodococcus Equi Pneumonia
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Introduction - The epidemiology of infectious diseases are often considered in terms of the triad of agent, environment and host. Our laboratory has investigated each of the elements of this triad in regards to foal pneumonia caused by Rhodococcus equi.
Agent – The age at which foals become infected with R. equi remains unknown. Traditionally, it has been assumed that foals become infected around the time when maternally-transferred serum antibody concentrations wane (typically between 4 and 6 weeks of age). This assumption has been based on the facts that hyperimmune plasma has protective effects against R. equi pneumonia in foals, and that - in the absence of screening for early detection - foals most commonly first demonstrate clinical signs of disease between 4 and 8 weeks of age. Based on the fact that the pyogranulomatous lesions of R. equi appear to be be slowly developing and the finding that experimental infection of pony foals indicated that foals < 2 weeks of age were more sensitive to challenge, we postulated that foals become infected very early in life. This hypothesis was evaluated epidemiologically, using Sartwell’s model for the logarithmically normal distribution of incubation periods. Results of analysis were consistent with the hypothesis that foals were infected at or near the time of birth.
We have demonstrated the importance of iron for growth of R. equi (Jordan et al.). This led us to explore preventive and therapeutic strategies targeting R. equi that exploit the iron-dependence of the bacterium, viz., using the semi-metal gallium. We have demonstrated that gallium can result in suppression and death of R. equi grown in culture and within macrophages, can reduce tissue concentrations of mice experimentally infected with R. equi when given orally prior to challenge, can be absorbed from the intestinal tract of foals in its maltolate formulation, and is safe when given to foals at doses that produce blood levels consistent with those deemed likely to be of therapeutic efficacy. Thus, gallium maltolate has potential as a chemotherapeutic or chemoprophylactic agent against R. equi. [...]
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