Quarterly Update
Arkansas State
Veterinarian's Office
Summer 2020 (Volume 7) 
Randolph Chick, DVM (501) 823-1733 randolph.chick@agriculture.arkansas.gov
FDA advises consumers not to use nine hand sanitizers manufactured by Eskbiochem that contain methanol  
Guardian, 1 Jul 2020.

The FDA warned that nine brands of hand sanitizers ‘can be toxic when absorbed through the skin or ingested’. The US government has advised consumers not to use nine different types of hand sanitizer and warned that they can be toxic.

The US Food and Drug Administration (FDA) regulator issued a warning against using hand sanitizer manufactured by Eskbiochem, a company based in Mexico, because of the potential presence of methanol (wood alcohol), a substance that the FDA warned “can be toxic when absorbed through the skin or ingested”. The agency identified Eskbiochem’s products called All-Clean Hand Sanitizer, Esk Biochem Hand Sanitizer, CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol, Lavar 70 Gel Hand Sanitizer, The Good Gel Antibacterial Gel Hand Sanitizer, CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol, CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol, CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol, and Saniderm Advanced Hand Sanitizer….

 The FDA reported that it tested samples and found some containing various proportions of methanol, and no ethyl alcohol, the typical ingredient. “Methanol is not an acceptable ingredient for hand sanitizers and should not be used due to its toxic effects,” the FDA warned. The agency added that “substantial methanol exposure can result in nausea, vomiting, headache, blurred vision, permanent blindness, seizures, coma, permanent damage to the nervous system or death.” Consumers who have been exposed to hand sanitizer containing methanol should seek immediate treatment, the agency said. The FDA contacted Eskbiochem to recommend the company remove its hand sanitizer products from the market due to the risks associated with methanol poisoning. Meanwhile, it recommended consumers stop using the hand sanitizers and dispose of them immediately in appropriate hazardous waste containers, but not to flush or pour the products down the drain.

A family of five that suffered recurring streptococcus throat infections began to suspect their recently adopted cat was a vector, but scant scientific evidence supported the idea, and the cat appeared healthy. Veterinarian Caitlin Barry-Heffernan, who was a fourth-year veterinary resident at the time, agreed to culture the cat's throat, found group A strep, and prescribed antibiotics and a fur disinfectant for the cat, which solved the problem. The Washington Post (tiered subscription model)  

Scientific understanding of SARS-CoV-2 and COVID-19 is evolving. These resources keep you abreast of the latest developments, including the first confirmed case of SARS-CoV-2 in a U.S. dog. On-line AVMA Vitals 6 29 2020

SARS CoV2 in Animals - https://www.avma.org/resources-tools/animal-health-and-welfare/covid-19/sars-cov-2-animals-including-pets?utm_source=email-mem&utm_medium=vitals-2006&utm_campaign=protect-promote-advance&utm_term=link&utm_content=coronavirus&dlv-emuid=4b8f91c3-02b4-4814-a729-083885ae08e0&dlv- mlid=2269645                                                                                                                                          
Confirmed Cases - https://www.avma.org/resources-tools/animal-health-and-welfare/covid-19/depth-summary-reports-naturally-acquired-sars-cov-2-infections-domestic-animals-and-farmed-or?utm_source=email-mem&utm_medium=vitals-2006&utm_campaign=protect-promote-advance&utm_term=link&utm_content=coronavirus&dlv-emuid=4b8f91c3-02b4-4814-a729-083885ae08e0&dlv- mlid=2269645                                                                                                                                 
Rural areas at risk for COVID-19
By Alaina Dismukes, Farm Progress , June 03, 2020

Rural areas are at risk for COVID-19. "We can see as COVID-19 is moving into rural areas, and as time passes, the case fatality rate is increasing and becoming more significant in rural areas, which are currently being hit," said Emma Bergqvist, an intern with AgriSafe during an AgriSafe webinar, part of the weekly COVID-19 Ag Task Force Response. "Meanwhile, big metro areas that were epicenters for the disease earlier on, such as New York, Detroit, New Orleans, Seattle, etc., have mostly flattened their curve. A lot of other counties in total still have increasing cases, so this means that a lot of our rural areas are continuing to have the disease and haven't had a chance to flatten the curve yet. "What we'll see continuing from here in this wave or possibly a subsequent wave are spikes of the disease occurring at different times and places. It won't be this big rush of cases we've seen in the past, like in big cities. We'll see them more in small spikes across the country."                                                                                                   

Rural areas are more at risk for a few different reasons. "Over 20% of the rural population is over the age of 65, compared to 13% in urban areas," Bergqvist said. "Furthermore, there are higher rates of smoking, cardiovascular disease, and high blood pressure. These factors are shown to have a higher rate of mortality when someone is infected with COVID-19." Lack of access to healthcare is another issue, especially if hospitals are overrun with cases. "Data of rural counties show there is, at least in part, a shortage of healthcare if not a full shortage," she said. "There are few areas that don't have any shortages."           
A Princeton study that considered a high infection rate of COVID-19 and a low infection rate of COVID-19 shows which healthcare systems became overwhelmed, and most "at-risk" systems do happen to be rural areas, which means rural areas do not have the threshold that urban areas have to handle many cases of COVID-19. "We can learn from other countries' approaches to handling COVID-19 in rural areas," Bergqvist said. "Looking at Sweden and Norway, Sweden has been very open, and they've had a lot more deaths and have used more of their healthcare resources. Norway has been the opposite. They've been very closed off, and they have had fewer deaths and fewer ICU ventilators used." Rural areas can use and apply this information to use more protective measures, such as social distancing, to stay well. "The fewer resources used are vital because rural areas do not have as high of thresholds, so they need to help preserve resources for those that are critically sick. Too many cases of COVID-19 at once could overwhelm the system," she said.                                                
Why Cattlemen Should Care About Dog Import Legislation
By Art Parola, Drovers , June 15, 2020

The opinions in the following commentary are those of Art Parola, a native of Kentucky and a consultant with over a decade of experience in the pet industry…. Heartwater.

Even hearing the word can make any beef or dairy producer shudder. The rickettsial disease threatens protein food supplies by infecting and killing cattle, sheep, goats, and other ruminants, potentially within hours of the first development of symptoms. The disease is native to sub-Saharan Africa but has spread to other regions including the Caribbean, where eradication efforts have been unsuccessful. A small arachnid known as the Bont tick is the main vector, although once established other tick species may be able to disperse outbreaks further.

While the US has been successful in preventing the importation of Bont ticks and heartwater thus far, pathways still exist that could potentially allow the vector and disease into the US. Adult ticks feed on the blood of mammals including cattle and canines. Last year, over a million dogs and puppies were imported into the US to be rescued from alleged homelessness or abuse. Unfortunately, the real sources of these animals are largely unknown. A significant portion were imported from the Caribbean region, the same area that is infested with, and has been unable to control, heartwater disease. A massive threat to the US food supply could be hiding beneath the fur of an imported dog.  See the article…. https://www.drovers.com/article/why-cattlemen-should-care-about-dog-import-legislation

The wellbeing of veterinary professionals is one of the most important issues facing our profession, and a critical focus of the American Veterinary Medical Association. The AVMA has many free tools and resources that empower veterinarians and all team members to prioritize self-care and make the short- and long-term investments needed for personal wellbeing. Visit AVMA's Wellbeing web page for tips and resources on how to manage stress in healthy ways, practice self-care, lend a hand to struggling peers and more.
CVM: US cat, horse populations down 20% from 2014
By Jordan Tyler, June 6, 2020                    
The US Food and Drug Administration’s (FDA) Center for Veterinary Medicine (CVM) on June 2 significantly revised its estimates for cat and horse ownership in the United States, which was last updated in 2014. The agency said the number of cats across the country has decreased 21% from 74 million to 58.4 million, and the number of horses has decreased 22% from 4.9 million to 3.8 million. These new estimates are based on information it received from the American Veterinary Medical Association (AVMA) and the US Department of Agriculture (UDSA). The CVM maintains estimates for pet populations in the United States to determine the eligibility of “minor use” animal drugs, which include medicines for uncommon or geographically limited diseases or conditions in seven major animal species: horses, dogs, cats, cattle, pigs, turkey and chickens. “In essence, if the population decreases, the likelihood of a particular disease or condition being considered a minor use increases,” the CVM said…. This updated demographic data is expected to help the agency better determine minor use drug needs for major animal species in the United States.    https://www.petfoodprocessing.net/articles/13888-cvm-us-cat-horse-populations-down-20-from-2014
By Greg Cima, JAVMA, June 2020

A viral disease that kills wild and domesticated rabbits is spreading in the Western USA. Dr. Ralph Zimmerman, state veterinarian in New Mexico, said, "There are areas around the state where we're not seeing rabbits at all." In April [2020], his state became the 1st in the USA with confirmed infections in wildlife with rabbit hemorrhagic disease virus serotype 2 (RHDV-2), which affects the European rabbits raised as pets or farmed and at least some wild rabbits and hares native to North America. It may affect related species, such as pika. The disease threatens wild ecosystems and a domestic rabbit industry valued by the US Department of Agriculture at more than USD 2 billion, mostly in pet supplies and care.

USDA Animal and Plant Health Inspection Service spokesman Mike W. Stepien said May 27, 2020 that RHDV-2 had been detected this spring in domestic species, wildlife, or both in Arizona, California, Colorado, Nevada, New Mexico, and Texas. Among wild species, infections occurred in desert cottontail, mountain cottontail, black-tailed jackrabbits, and antelope jackrabbits. Study results also indicate Eastern cottontails are susceptible to the virus. It also is spreading among domestic and wild rabbits in northern Mexico. The World Organization for Animal Health (OIE) indicates observed death rates for the virus have ranged from 5% to 70%, with a mean mortality rate of 20% under experimental conditions. An April 2017 scientific article in the journal Veterinary Record indicates the death rate associated with RHDV-2 infections appeared to rise as the virus spread into Italy, citing 2 strains isolated in 2014 and 2015 that induced mortality rates of at least 80%.

A May 2020 scientific article in Veterinary Clinics of North America: Exotic Animal Practice indicates those rising death rates in Europe and recent study results suggest RHDV-2 has become more lethal. In one study, experimental infection of New Zealand white rabbits showed similar pathogenicity among RHDV-2 and RHDV strains, which kill 70% to 90% of susceptible adult rabbits. "Rapidly increasing fatality and infection rates suggest that RHDV-2 has evolved into a highly pathogenic calicivirus," the article states. Dr. Olivia A. Petritz is one of the report authors and an assistant professor of avian and exotic animal medicine at North Carolina State University College of Veterinary Medicine. She said estimating mortality rates for RHDV-2 in wildlife is difficult without good data on animal population sizes and infection status, which includes infected animals without clinical signs. She thinks additional RHDV-2 outbreaks are likely in the USA. Classic RHDV strains are highly contagious and lethal to only one species, the European rabbit, according to the OIE. Those strains emerged worldwide in the 1980s and 1990s, and they since have caused limited outbreaks in the USA among domestic European rabbits.

RHDV-2, discovered in 2010 in France, infected and killed European rabbits, European brown hares, Sardinian Cape hares, and Italian hares as it spread across Europe. In Australia, where European rabbits and brown hares were introduced as game species, RHDV-2 arrived in 2015 and has since reduced rabbit populations in some areas up to 80%, the Veterinary Clinics of North America article states.

The virus reached North America by 2016, when animal health authorities confirmed infections on hobby farms in Quebec, APHIS information states. From February 2018 to March 2020, it caused sporadic outbreaks among pet and feral European rabbits in British Columbia, Washington state, Ohio, and in one New York City veterinary clinic. APHIS identified infections among pet rabbits in New Mexico in March 2020, and the state saw die-offs among wild rabbits before APHIS confirmed in April that the disease had spread to wildlife. Rabbit hemorrhagic disease (RHD), whether from classical RHDV strains or RHDV-2, often kills rabbits without outward signs of disease. "Many times, the only signs of the disease are sudden death and blood-stained noses caused by internal bleeding," APHIS information states. "Infected rabbits may also develop a fever, be hesitant to eat, or show respiratory or nervous signs." California Department of Fish and Wildlife information states that the disease causes liver inflammation and prevents blood from clotting. "Death is due to massive internal hemorrhaging and liver impairment," CDFA information states. RHDV-2 infection has an incubation period of 3 to 5 days, and animals may develop subacute to chronic disease, with lesions, lethargy, anorexia, weight loss, and jaundice, according to the OIE. Subclinical carriers may shed the virus for months. Infected animals have developed gastrointestinal dilation, cardiac arrhythmias, heart murmurs, and neurologic abnormalities, OIE information states. The CDFA's list of clinical signs also includes breathing difficulties, blue lips or mucous membranes, and bleeding from body cavities. The virus spreads through contact with an infected animal or exposure to contaminated bodily fluids, hair, or carcasses, according to OIE information. Fomites and vectors -- insect or animal -- also spread the virus.

Contaminated rabbit meat may be one of the main methods of transmitting RHD to new countries, according to the OIE. How the disease entered the USA is unknown, according to APHIS. APHIS officials are allowing the purchase of 2 inactivated-virus vaccines that are made in Europe and unlicensed in the USA, but only under the direction of state animal health officials. The agency recommends using them only where the virus circulates in feral and wild rabbits. The Washington State Department of Agriculture reported USDA officials had granted veterinarians permission to buy and distribute vaccine in their state, and Dr. Zimmerman hopes vaccination will help protect domestic herds in his state as well. By 21 May [2020], about 480 domesticated rabbits in New Mexico had died of RHDV-2 infection, and another 500 had been depopulated, Dr. Zimmerman said. Most of those rabbits lived on farms, which ranged from a few dozen to hundreds of rabbits, although some were pets that likely became infected after their owners stepped in wild rabbit waste.

Dr. Zimmerman said his state stopped testing wild rabbits after confirming the disease was spreading in native populations, but the effects seem to vary by region. Members of the public were reporting more deaths among cottontails, which tend to live closer to people than do jackrabbits. Kerry Mower, PhD, wildlife health specialist for the New Mexico Department of Game and Fish, said that the number of deaths had been high among jackrabbits and cottontails in affected areas, but the impact remained unknown. His department received reports of areas where rabbits disappeared while adjacent areas seemed to be unaffected. "We do expect the species that depend on rabbits as a prey base will be affected, but we cannot predict the extent," he said. Rabbits are ubiquitous in New Mexico, although the state has not monitored or estimated population sizes.

Dr. Deana Clifford, senior wildlife veterinarian for the California Department of Fish and Wildlife, said a black-tailed jackrabbit found dead 7 May [2020] became California's 1st confirmed case. It was among 10 to 20 dead jackrabbits found that week by a biological survey team working near Palm Springs in Riverside County. In the subsequent 2 weeks, members of the public submitted about 35 reports of sick or dead rabbits, most in Riverside County and most describing a single dead rabbit, Dr. Clifford said.

"We are very early in the outbreak in California, so at this point we do not have a sense of how much mortality will occur," Dr. Clifford said. "Large numbers of dead rabbits have been reported in other states, but there have also been continued sightings of live rabbits, so that provides some hope that some individuals will survive." The CDFW tested 3 more wild rabbits but found none positive for the virus, Dr. Clifford said. The state is focusing testing on counties neighboring Riverside County, areas of Riverside County that are distant from the 1st reported case, and species without known infections in the state, such as desert cottontail. Dr. Clifford said the virus may have population-wide effects on rabbits, which are an important prey species. Her agency would need to conduct systematic surveys to estimate the mortality rate and potential population effects. "The virus is very hardy in the environment, so we have focused on reducing the chances that human activities will spread the virus to new areas," Dr. Clifford said. "We have a few small isolated rabbit populations in California, including the endangered riparian brush rabbit, so we are evaluating efforts we could do to protect that species."

Dr. Zimmerman said in May [2020] that New Mexico authorities already were receiving increasing reports of coyotes in Albuquerque and other populated areas. He said the spread of the hemorrhagic disease raised concerns for the many species above rabbits in the food chain.

APHIS encourages veterinarians nationwide to watch for RHDV-2, report any suspicious illnesses or deaths to state and federal regulators, and submit samples for testing through the National Veterinary Services Laboratories' Foreign Animal Disease Diagnostic Laboratory. RHDV-2 is a reportable disease in the USA. The agency was supporting diagnostic testing of wild rabbit carcasses, sharing information with state wildlife partners, and coordinating sample submissions and disease investigations. Dr. Zimmerman urges biosecurity for anyone with rabbits, whether they own pets, show flocks, or meat-production herds. "Lock down and be cautious," he said.

Selected Articles

Genetic study informs new understanding of dog-years . Dogs age quickly when they are young, then age less quickly after reaching maturity, with one-year-old dogs equivalent to 30-year-old people and 4-year-old dogs equivalent to 52-year-old people, according to a study published in Cell Systems. Researchers studied changing patterns of methyl groups in the genomes of Labrador retrievers and believe the formula translates across breeds and could help evaluate anti-aging products. https://www.cnn.com/2020/07/03/us/new-study-updates-dog-years-to-human-years-formula-trnd-scn/index.html

Interactive maps: COVID-19 and the veterinary profession . The American Veterinary Medical Association has developed a series of maps that present different lenses to view the COVID-19 outbreak and its impact on veterinary medicine and veterinary professionals. https://www.avma.org/resources-tools/animal-health-and-welfare/covid-19/interactive-maps-covid-19-and-veterinary-profession

Frontline sponsors playlist for dogs left alone again . Frontline is sponsoring a playlist on streaming music service Spotify designed to calm anxious dogs in addition to a podcast that mixes soothing music, speech, and sounds. https://www.adweek.com/digital/frontline-spotify-team-up-on-playlist-to-help-dogs-adjust-to-being-alone-again/

Zoonotic TB goes beyond M. bovis, study suggests . Animal-to-human transmission of mycobacteria that cause tuberculosis appears to be more frequent than previously believed, researchers reported in The Lancet Microbe. The team did not isolate Mycobacterium bovis from any samples collected from human patients, but they did find a number of M. orygis-positive samples, suggesting M. bovis "may not be an adequate proxy for zoonotic TB infection in humans," and that other mycobacteria should be considered zoonotic TB risks. https://www.sciencedaily.com/releases/2020/06/200615115814.htm
Rabies Map - Arkansas Public Health Veterinarian,
Dr. Laura Rothfeldt
For 2019, Arkansas had 26 Positive Rabies samples of the 785 animals tested (795 submissions, 10 not tested due to damaged/decomposed tissue *, 759 negative tests) for a positive test rate of 3%. *Please remember when submitting brains for rabies testing, include the brainstem .  
Arkansas Veterinary Diagnostic Lab - AVDL Corner -
Dr. Russell Summers

Tips on How to Improve the Diagnostic Quality of Your Surgical Biopsy Samples and Prevent Processing Delays - Histopathological analysis of surgical biopsies provide veterinarians with critical information that they need to develop appropriate treatment plans for patients. In most cases, it isn’t possible to get a second sample. It’s important that you and your staff pay attention to how you package and ship surgical biopsy samples. Problems with sample preparation and packaging result in delays in processing your sample at the VDL. 

Very large sample in very small jar. By far, this is the most common problem we see with surgical biopsies. The ratio of formalin to tissue needs to be 10:1 for proper fixation. This sample will require at least two more days in the larger jar before we can attempt to work with it. 

Wildly inappropriate sample container. Leaking formalin is a hazard to everyone who handles the package and the sample. Putting a paper towel in the bag tells us that you knew it wasn’t an appropriate container.

Submission form placed in the same bag as a leaking sample container. We must call your clinic to get a new form. 

Failure to check that the sample jar is properly closed. In this example, an excessively long suture used to identify a mass was not completely placed inside the jar, preventing the threads of the lid from sealing. Most of the formalin leaked out and the sample was not fixed when we received it. 

Submitting a sample with no information about anatomical location, tissue type, or clinical history. This can delay both processing and interpretation.
Continuing Education - Upcoming Veterinary CE Opportunities

Food Animal Medicine Workshops – UA Cooperative Extension / ARVMA – varied sites https://www.uaex.edu/farm-ranch/animals-forages/food-animal-medicine-workshop.aspx
Arkansas VMA is periodically offering CE opportunities – make sure you are on their list!

Vet Vacation CE - https://www.vetvacationce.com/ Various locations may be open, check website.

September 24-27, 2020 – Southwest Veterinary Symposium in Fort Worth, TX

October 15-18, 2020 - American Board of Veterinary Practitioners in Chicago, IL

April 19-20, 2021 - Austin Veterinary Conference in Austin, TX

January 21-24, 2021 - Missouri VMA 129th Annual Convention in Columbia, MO

February 5-7, 2021 - Arkansas VMA 114th Annual Winter Meeting in Hot Springs, AR
Arkansas Department of Agriculture