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Vet. Things. 38 (2007) 337– 337


354 c INRA, EDP Sciences, 2007
DOI: 10.1051/vetres:2006063
Review article

Feline herpesvirus

Rosalind Gÿÿÿÿÿÿa*, Susan Dÿÿÿÿÿb, Alan Rÿÿÿÿÿÿb, Etienne Tÿÿÿÿc


a
Department of Veterinary Pathology, Faculty of Veterinary Science, University of Liverpool, Leahurst,
Chester High Road, Neston, S. Wirral, CH64 7TE, United Kingdom
b
Department of Veterinary Clinical Sciences, Faculty of Veterinary Science, University of Liverpool,
Leahurst, Chester High Road, Neston, S. Wirral, CH64 7TE, United Kingdom
c
Virology, Department of Infectious and Parasitic Diseases, Faculty of Veterinary Medicine, University
of Liège, Boulevard de Colonster 20, B43b, 4000 Liège, Belgium

(Received 6 October 2006; accepted 14 December 2006)

Abstract – Feline herpesvirus (FHV-1; felid herpesvirus 1 (FeHV-1)) is an alphaherpesvirus of cats


closely related to canine herpesvirus-1 and phocine herpesvirus-1. There is only one serotype of
the virus and it is relatively homogenous genetically. FeHV-1 is an important cause of acute upper
respiratory tract and ocular disease in cats. In addition, its role in more chronic ocular disease and
skin lesions is increasingly being recognised. Epidemiologically, FeHV-1 behaves as a typical al
phaherpesvirus whereby clinically recovered cats become latently infected carriers which undergo
periodic episodes of virus reactivation, particularly after a stress. The primary site of latency is the
trigeminal ganglion. Conventional inactivated and modified-live vaccines are available and protect
reasonably well against disease but not infection, although viral shedding may be reduced. Genet ically
engineered vaccines have also been developed, both for FeHV-1 and as vector vaccines for
other pathogens, but none is as yet marketed.

feline herpesvirus / pathogenesis / epidemiology / review

Table of contents

1. Aetiology.......................................................................................................... 338
2. Pathogenesis...................................................................................................... 338
3. Epidemiology .................................................................................................... 339
4. Clinical signs..................................................................................................... 341
5. Treatment ......................................................................................................... 342
6. Diagnosis.......................................................................................................... 343
7. Immunity.......................................................................................................... 344
8. Vaccination ....................................................................................................... 344
9. Disease control .................................................................................................. 346
9.1. Household cats ........................................................................................... 346
9.2. Boarding catteries ....................................................................................... 346
9.3. Shelter facilities.......................................................................................... 347
9.4. Breeding catteries ....................................................................................... 347

* Corresponding author: r.m.gaskell@liverpool.ac.uk

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338 R. Gaskell et al.

1. AETIOLOGY junctival mucous membranes, though ex


perimentally other routes have been inves
Feline herpesvirus 1 (FHV-1; felid her
tigated. In pregnant queens for example,
pesvirus 1 (FeHV-1)) is a member of the
intravaginal instillation of virus has led
Varicellovirus genus of the herpesvirus
to vaginitis and congenitally infected kit tens
subfamily Alphaherpesvirinae [17]. As
[5] and intravenous inoculation has
well as domestic cats, FeHV-1 infects sev
eral other members of the Felidae [16, 25, led to transplacental infection and abortion
54, 91, 101, 103, 121, 135, 140]. The virus [58]. However, unlike some other alpha
pherpesvirus infections, under natural con
is closely related genetically and antigeni
ditions abortion does not generally seem
cally to canine herpesvirus-1 (CHV-1) and
to occur [53], and reproductive disease
phocine (seal) herpesvirus-1 (PhV-1), and
in general does not seem to be a feature
cross-protection between feline and PhV-1
of FeHV-1 infection. Because of the in
has been reported [46–48, 71, 85–87, 153,
creasing recognition that FeHV-1 may be
154]. A herpesvirus similar to FeHV-1,
involved in both acute and chronic ocular
but distinct from CHV-1 has been isolated
disease, the corneal route of infection has
from dogs but the significance of this is un
clear [24, 67]. also been investigated experimentally [93].
All isolates of FeHV-1 appear to be Following infection, virus replication
relatively similar. Most produce a rela tively in the acute phase takes place predomi
uniform disease although some show nantly in the mucosae of the nasal septum,
reduced or increased virulence [39, 42]. turbinates, nasopharynx, and tonsils; other
Antigenically all isolates belong to one tissues including conjunctivae, mandibular
serotype, and they are relatively homo lymph nodes and upper trachea are also
often involved [32, 56]. Infectious virus
geneous on restriction enzyme analysis
of their DNA [41, 52]. Some minor ge netic can be detected in oropharyngeal and nasal
differences have been reported for swabs as early as 24 h after infection and
some strains, including differences in Mlu generally persists for 1 to 3 weeks, al
1 cleavage patterns, re-arrangements in the though viral DNA may be detected by PCR
gC gene, and differences in the Sal 1 site in for longer [141, 146].
the UL 17 herpes simplex virus gene ho Viraemia appears to be rare probably
mologue [43,44,59,76]. Despite this, there because, like some other respiratory her
is currently no useful method to study the pesviruses, viral replication may be re
role of individual FeHV-1 isolates in dis stricted to areas of lower body temper ature
ease. like the respiratory tract. However,
Like other herpesviruses, FeHV-1 con viraemia has occasionally been reported
tains double-stranded DNA and has a [56] when virus appears to be associated
glycoprotein-lipid envelope. It is therefore with peripheral blood leucocytes [134],
relatively fragile in the external environ ment and generalized disease may be seen par
and is highly susceptible to the effects ticularly in debilitated animals or in neona
of common disinfectants [22, 117]. It can tal kittens [119, 122, 139].
survive for only up to 18 h in a damp envi Infection of the respiratory epithelium
ronment, less in dry conditions, and is also leads to areas of multifocal epithelial
relatively unstable as an aerosol [20, 105]. necrosis with neutrophilic infiltration and
fibrin exudation [14, 15, 39, 56, 108]; in
tranuclear inclusion bodies may be seen.
2. PATHOGENESIS
Viral damage can also lead to oste olytic
The natural routes of infection for changes in the turbinate bones. A
FeHV-1 are via the nasal, oral, and con predilection of the virus for regions of
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Feline herpesvirus 339

skeletal growth, including the turbinates, detected in trigeminal ganglia by in situ


has been shown experimentally following hybridization [98] and more recently by
intravenous inoculation of young kittens detection of mRNA by RT-PCR [137].
[57]. Lesions normally take between 2 and In view of the increasing evidence that
3 weeks to resolve, although bone damage FeHV-1 may be involved in chronic ocu lar
to the turbinates may be permanent. Pri disease, and because of possible par allels
mary lung involvement may occur but is with herpes simplex virus, the lat ter study
rare [74]. [137] also examined corneas.
The disease is not dependent on the However, although FeHV- 1 DNA was de
presence of other microbial flora, as it tected by PCR in both trigeminal ganglia
has been reproduced experimentally in and corneas, LAT transcripts were detected
germfree cats [56]. However, secondary only in trigeminal ganglia suggesting true
bacterial infection may enhance the ef fect latency does not occur in the feline cornea.
of the virus and may lead to bacterial Taken together, these data strongly sug
pneumonia, or chronic rhinitis, sinusitis or gest the main site of viral latency in
conjunctivitis [39]. The role of FeHV-1 it self FeHV-1 is the trigeminal ganglia. How ever,
in chronic rhinosinusitis is not clear: viral DNA has also been detected by
a recent study in a small series of cats PCR in other neurological sites (including
found no difference in the proportion of olfactory bulb, optic nerve and cerebrum),
cases and controls in which FeHV-1 DNA and also in various ocular and respira tory
was detected using PCR [61]. However, in tissues (including nasal turbinates and
terestingly, the turbinates are the earliest cornea, and less consistently, oral fauces,
site of viral replication during reactivation conjunctivae, lacrimal and salivary glands,
[32], and FeHV-1 transcription is associ tonsils and submandibular lymph nodes)
ated with an increase in nasal cytokine [28,111,146]. Whether FeHV-1 is truly la
gene transcription, suggesting a role for tent in such tissues, or whether low grade
FeHV-1 in nasal inflammation [62]. viral reactivation is being detected is not
As with other alphaherpesviruses, la clear. Further studies of gene transcrip tion
tency occurs following the acute phase and expression in putatively latently
of disease, with periodic viral reactiva tion infected tissues would be required to de
which is sometimes associated with termine this.
recrudescence of clinical signs [39]. La tent
infection has been demonstrated in
trigeminal ganglia, using extended culture 3. EPIDEMIOLOGY
techniques such as explant or organ cul
ture [35, 94]. FeHV-1 DNA, indicative of FeHV-1 is shed in ocular, nasal, and oral
the presence of viral genome, has also secretions and transmission is largely by
been detected in trigeminal ganglia and in direct contact with an infected cat. Acutely
some other sites by PCR [111, 130, 146]. infected animals are clearly one of the most
However, detection of latency associated important sources of virus, but latently in
transcripts (LATs) is probably the most ac fected carrier cats may also shed virus and
curate way to determine whether the virus infect susceptible cats [34]. There is no ev
is truly in a latent state: such transcripts, idence of natural in utero transmission and
produced from the complementary strand there are no known non-feline reservoir
to the immediate early gene(s), are ex or alternative hosts. In some situations,
pressed in relative abundance compared particularly within a cattery, indirect trans
to other genes by alphaherpesviruses dur mission may also occur through contami
ing latency. In FeHV-1, LATs have been nation of housing, feeding and cleaning
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340 R. Gaskell et al.

utensils, and personnel. However, because shedding during lactation is an ideal mech
FeHV-1 is relatively short-lived outside the anism for the virus to pass into the next
cat, the environment is usually not a long generation of susceptible kittens. Whether
term source of infection. Aerosols are not the kittens develop disease depends on
thought to be of major importance for the their levels of maternally derived antibody
spread of FeHV-1: cats do not appear to (MDA), but in some cases, kittens may be
produce an infectious aerosol for these infected subclinically from their dam and
agents during normal respiration, although become latent carriers under the protection
sneezed macrodroplets may transmit infec of MDA [34].
tion over a distance of 1–2 m [34, 105]. The mechanism of stress-induced vi ral
As with other alphaherpesviruses, virtu reactivation is not clear. Whatever the
ally all recovered cats become latently in event or series of events that lead to the
fected carriers, with intermittent episodes presence of detectable virus however, it
of detectable virus shedding (reactiva tion) seems probable that the immune response
occurring particularly after periods plays a role in determining the duration
of stress. During such episodes infectious of the shedding episode. Interestingly, in
The virus is present in oronasal and studies of cats in which FeHV-1 reacti vated
conjunctival secretions, acting as a source after the natural stress of re-housing,
of infec tion to other cats [ 29 , 30 ]. it was found that cats that did shed virus
Viral reactivation may occur sponta (i) had experienced significantly more se
neously but is most likely after stress, for vere primary disease than those that did
example, moving a cat into a boarding not; (ii) had a significantly greater ‘stress’
cattery, to a cat show, or to stud [39]. Ex response (i.e. loss of appetite and nervous
perimentally, the spontaneous viral shed withdrawal) to re-housing than those that
ding rate in clinically recovered carrier cats did not shed; and (iii) had a trend to wards
as assessed using virus isolation is about lower mean serum antibody levels
1%; corticosteroid treatment may induce (as assessed by antibody/complement lytic
shedding in approximately 70% of cats, a capacity) prior to re-housing compared to
change of housing in 18%, and lactation the non-shedder cats [36,40]. There is also
in 40% [23, 30, 34]. Episodes of detectable some evidence of a refractory period after
virus shedding do not immediately follow an episode of viral reactivation when ani
the stress. A lag phase of 4–11 days (mean mals are less likely to shed [29, 30, 80].
7.2 days) precedes the shedding of infec It is probable that, as in other alphaher
tious virus, which ranges in duration from pesvirus infections, virtually all clinically
1–13 days (mean 6.5 days) [29, 30]. In recovered cats are carriers. However, less
some cases, carriers show recrudescence of than half of these are likely to be of epi
mild clinical signs while they are shedding, demiological importance, i.e. shed virus
which can be a useful indicator that they under natural conditions, and even then,
are likely to be infectious [39]. transmission to susceptible animals is not
In practical terms this means that if necessarily easily achieved [30, 34]. More
a cat experiences a stress, such as going recent studies using PCR, including real
into a boarding cattery, then it is likely time PCR, have shown a higher sensitivity
to shed infectious virus in the 3-week pe riod for detecting carriers, with a more pro longed
following this event. This tendency of presence of viral DNA in the secre tions of
the virus to reactivate when the cat moves infected cats [8, 45, 83, 111, 125,
into a different environment obviously con 131, 141, 146, 147]. Whilst such molecular
fers a useful biological advantage in terms techniques help identify carriers, the epi
of transmission to new hosts. Similarly, demiological significance of cats in which
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Feline herpesvirus 341

viral genome can be detected by PCR, but sion, marked sneezing, inappetence, and
from which infectious virus cannot be iso lated pyrexia, followed rapidly by serous ocular
is not clear, as transmission studies and nasal discharges [15, 39, 56]. These
have not been performed. Although PCR initial clinical signs may be accompanied
is more sensitive than virus isolation, it by excessive salivation with drooling.
has also been shown that the published Conjunctivitis, sometimes with severe
techniques vary considerably in sensitiv ity hyperemia and chemosis, typically de velops,
[83]. Further, as FeHV-1 can be shed and there are copious oculonasal
by clinically normal cats as well as dis eased discharges. These gradually become
animals, a higher detection rate does mucopurulent, and crusting of the external
not necessarily correlate with disease cau nares and eyelids can occur. In severe
sation. cases dyspnoea and coughing may also
These experimental studies on the ef fects develop. Oral ulceration can occur with
of stress associated with re-housing FeHV-1 infection but is relatively un common
on inducing virus reactivation and shed ding compared to feline calicivirus
have also been translated to the field. (FCV) infection, the other main cause
In one study, 3 of 75 cats monitored over of viral respiratory disease in cats [39].
a one month period reactivated virus 9– Occasionally, generalized infections and
12 days after entering a boarding cattery, primary viral pneumonia may occur, par
and showed mild clinical signs [36]. In two ticularly in young or debilitated animals
more recent studies in shelter cats, FeHV-1 [74, 119, 122, 139]. Neurological signs
shedding rose markedly approximately one have been described, but appear to be a
week after admission [1, 104], and al though very rare sequel to infection [31].
some of this may have been from
Although abortion may be associated
cross-infection, it is likely that reactivat ing
with other alphaherpesvirus infections, ex
carriers were contributing significantly
perimental studies have suggested that in
to these increased shedding rates. Sev eral
cats infected with FeHV-1, abortion is most
epidemiological studies have found
a number of risk factors associated with likely due to the severe systemic effects of
the illness, rather than a direct effect of the
FeHV-1 shedding, including contact with
virus itself [58]. Indeed, in an investigation
other cats, the presence of upper respira tory
of a natural outbreak of FeHV-1 infection
disease, younger cats, poor hygiene,
in specific pathogen free cats, no cases of
and larger households; in contrast, vacci
abortion were seen, even in severely af fected
nation is associated with a negative (i.e.
pregnant queens [53].
protective) effect against viral shedding [3,
51, 132]. Involvement of FeHV-1 in conjunctivi tis
and in some cases, ulcerative keratitis,
has long been known [4], but improved
4. CLINICAL SIGNS viral detection using PCR has led to in creased
recognition of this role in the acute
FeHV-1 infection generally causes se vere disease, and also in more chronic ocular le
upper respiratory disease in suscepti ble sions such as stromal keratitis[95,124,125,
animals. The incubation period is usu ally 2 to 128, 142]. The role of FeHV-1 in other oc ular
6 days but may be longer, and conditions such as corneal sequestrae,
disease signs may be milder, with lower eosinophilic keratitis, uveitis and kerato
levels of challenge virus [33]. conjunctivitis dry is however less clear
In both experimental and natural and needs further evaluation [78, 97, 124,
infections, early signs include depres 128, 142].
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342 R. Gaskell et al.

Skin ulcers have been reported in the cidofovir appear to have greater efficacy in
past with FeHV-1 in domestic cats and vitro against FeHV-1, and may prove to be
also in cheetahs [26,63,65]. More recently, useful clinically [81, 114, 138].
an ulcerative facial and nasal dermatitis The current treatment of FeHV-1 ker atitis
and stomatitis syndrome characterized by is therefore based on the topical use
eosinophilic infiltration, which is occasion ally of nucleoside analogues. Trifluridine, idox
persistent, has been described in a uridine, vidarabine, and to a lesser extent
series of cats [49, 50], with a similar syn acyclovir have all been suggested as pos
drome also being reported in cheetahs [91]. sible topical treatments for FeHV-1 ocular
The role of FeHV-1 and the utility of PCR disease, though efficacy is difficult to as sess
in the diagnosis of herpetic dermatitis has in the absence of large-scale clinical
recently been shown by Holland et al. [55]. trials [13, 123, 128]. Although acyclovir is
A possible role for FeHV-1 in chronic less efficacious in vitro than vidarabine,
gingivostomatitis in cats has also recently idoxuridine, and trifluridine [92], in some
been suggested, on the basis of a relatively countries it may be the most readily avail
high viral isolation rate from cases com pared able, and may have some beneficial effect
to controls [73]. However a similar on FeHV-1-induced conjunctivitis and ker
number of cats were also shedding FCV, atitis when applied frequently [152].
and previous studies have generally de In vitro studies have shown that FeHV-1
tected FCV rather than FeHV-1 from cats is susceptible to feline interferon (IFN) or
with this syndrome [66,110,133,136,145]. recombinant human IFN-alpha, and that
Because of the propensity of FeHV-1 to the effect of acyclovir and recombinant hu
replicate in the turbinates during the acute man IFN-alpha is synergistic [27,115,148].
phase of disease, and in the early stages of Although the authors are aware of no data
reactivation, a role for FeHV-1 in chronic from controlled clinical trials, it has been
rhinitis has also been considered. However suggested that interferon may be useful
a recent study has found no difference in for cats with either acute respiratory her
detection rates between a small number of pesvirus infection, or ocular disease [13,
cases and controls [61] (see Section 2). 128]. Feline omega interferon is now regis
tered in Europe as an antiviral drug against
feline leukemia and feline immunodefi ciency
5. TREATMENT
viruses [19]. Some clinicians are
Numerous nucleoside analogs have starting to use this to treat FeHV-1 kerati tis,
been developed with activity against hu man but as yet no controlled trials have been
herpesviruses, mainly herpes sim plex and undertaken.
varicella-zoster viruses. Several The effect of L-lysine on FeHV-1 repli
of these compounds have been also tested cation has recently been explored both
against FeHV-1, largely in vitro, though in vitro and in experimental cat stud ies [79,
some limited clinical and experimental cat 80, 127]. L-lysine is an antago nist of arginine,
studies have been carried out. Acyclovir, which has been shown
which is widely used in human medicine, to be essential for human herpes simplex
does not seem to have good activity in virus and FeHV-1 replication [80]. Treat ment
vitro against FeHV-1 [81,92,138,148,152] with L-lysine therefore decreases vi ral
and both acyclovir and the acyclovir pro drug proteosynthesis and has been shown
valacyclovir, are too toxic at thera peutic to have some inhibitory effect against
levels for oral administration to cats both human herpesvirus and FeHV-1 infec
[96,102,126]. However, a number of other tion. Oral supplementation with L-lysine
antiviral agents such as ganciclovir and reduces the severity of experimentally-
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Feline herpesvirus 343

induced FeHV-1 conjunctivitis when ad conjunctival signs than other feline respi
ministered prior to primary infection [127] ratory pathogens, but where specific diag
and the number of shedding episodes asso nosis is required, laboratory tests should be
ciated with reactivation of latent infection carried out for confirmation.
induced by re-housing [80]. It may there fore Although FeHV-1 is shed in oropha
be of use early in acute disease or as ryngeal, conjunctival and nasal secretions,
a means of reducing the severity of disease unless ocular disease is specifically be ing
and virus shed at times of stress: suggested investigated, oropharyngeal swabs are
dosage regimens are described elsewhere generally used for diagnosis. Traditionally
[82, 128]. There is evidence that dietary such swabs are placed in viral transport
lysine supplementation is not effective in medium and inoculated into feline cell
groups of cats and that maybe bolus admin cultures where the presence of FeHV-1
istration is essential [84]. Bovine lactofer rin can be identified by its characteristic cyto
has shown some in vitro activity most pathic effect. Immunofluorescence, partic
likely by preventing attachment and pene ularly of conjunctival smears, has also been
tration of FeHV-1 into susceptible cells [2], used [9, 125].
but in vivo efficacy has not yet been evalu In many laboratories PCR is now be ing
ated. used rather than culture. PCR, which
The use of broad-spectrum antibiotic targets specific regions of the genome,
therapy is advocated to help control sec demonstrates that viral DNA is present in
ondary bacterial infection in cases of acute the swab, rather than the presence of infec
upper respiratory tract disease. Cats should tious virus. PCR is generally more sensi tive
be reexamined after 4 to 5 days and, if nec than virus isolation, detecting virus for
essary, bacterial culture and susceptibility longer in the acute stages of the disease,
tests performed. Good nursing care is es and in more chronic stages [124, 125, 131,
sential, and in milder cases is generally 141, 146]. However, a comparison of the
best given at home by the owner. Affected various PCR tests available does show con
cats should be encouraged to eat by of siderable differences in sensitivity between
fering strongly flavored aromatic foods. If the published tests [83].
eating is painful, baby foods or specialized Interpretation of the clinical relevance
proprietary or blended food may be help ful. of detecting virus in a cat either by isola tion
Severe cases may require hospitaliza tion or by PCR can be problematic [39,83].
and fluid therapy, and when anorexia If cats are showing characteristic clinical
is prolonged a nasogastric or gastrotomy signs of acute FeHV-1 induced-disease, a
tube may be indicated. Nasal deconges positive sample can strongly support the
tants (e.g., phenylephrine) in the acute diagnosis, particularly where cats are pos
phase and mucolytic drugs (e.g., bromhex itive by virus isolation as well as by PCR.
ine hydrochloride) in the more chronic However, since virtually all clinically re
phase have been suggested to help clear covered cats become latent viral carriers
airways, but conventional steam inhalation which intermittently may shed virus, it is
(e.g., placing the cat in steamy room) or always possible that a positive result is an
nebulizing saline may also be useful. incidental finding unrelated to any present
ing clinical signs, or is a result of the stress
6. DIAGNOSIS from another disease or other process. In
an epidemiological context, however, any
Diagnosis may be based initially on positive result indicates that the cat has
clinical signs. FeHV-1 generally induces been infected with FeHV-1, and as such is
more severe upper respiratory tract and likely to be a carrier with the potential to
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344 R. Gaskell et al.

infect other animals. In countries where in 8. VACCINATION


tranasal vaccines are available, a positive
result, either by virus isolation or by PCR, Vaccination against FeHV-1 has been
may also be indicative of vaccine virus available for a number of years and has
rather than wild-type virus: clearly the in been relatively successful in controlling
troduction of marker vaccines would help disease. However, disease can still be a
distinguish between these two possibilities. problem, especially when cats are kept
grouped together and when kittens lose
their MDA before vaccination can take ef fect.
Infection is widespread in the cat pop ulation
7. IMMUNITY
and carriers are common, ensuring
many opportunities for exposure particu larly
in situations that might precipitate
Immunity to FeHV-1 has generally shedding – e.g., change of housing or kit
been measured by serum virus neutralizing tening and lactation. Prevention and con trol,
(VN) antibody levels, although as for other therefore, often require a combined
alphaherpesviruses, cell-mediated immu nity approach of vaccination and management.
is likely to be a better reflection of Several types of FeHV-1 vaccines are
immune status. Local immune responses commercially available and they are in variably
are also likely to be important [11]. The given in association with FCV
ultimate test of immunity is, of course, re vaccines. Both modified live virus (MLV)
sponse to challenge with infectious virus. vaccines and adjuvanted inactivated virus
After primary FeHV-1 infection, cats vaccines given parenterally are widely
are largely resistant to disease following available; in some countries intranasal
further challenge but after six months or MLV vaccines are also marketed. All types
more, protection may only be partial [30, of vaccine induce reasonable protection
143]. VN antibody titers are generally low against disease in previously unexposed
and in some cases undetectable after pri mary cats. However, none of the vaccines ap pears
infection, but after further exposure to protect against infection or the
to virus, they tend to rise to more moder ate development of the carrier state, although
levels and thereafter remain reasonably both viral shedding and latency load of
stable. Immunity following vaccination is wild-type virus after viral challenge may
considered below. be reduced in vaccinated cats compared to
MDA to FeHV-1 is essentially colostral unvaccinated controls [28, 70, 99, 100, 130,
in kittens and generally persists for 2 to 10 147]. Although intranasal vaccine virus
weeks, with mean titres falling below de can become latent [147], the situation with
tectable levels (< 1:2) by nine weeks of age parenterally vaccinated cats is still unclear
[34]. However, there is considerable indi [130]. Whether vaccination helps control
vidual variation. In a more recent study, reactivation of already latent virus is not
25% of kittens had antibody titres of < 1 known, though parallels with other alpha
in 4 at six weeks of age, and such kit tens herpesviruses suggest that this might be the
may respond to early vaccination [18]. case [7].
However, in some individuals, MDA may FeHV-1 vaccines are generally safe, and
still be at interfering levels at 12–14 weeks although occasional mild transient clinical
of age [18, 72]. It should also be noted signs can follow their use, in most in stances
that low levels of MDA do not necessarily it is not clear if this is due to the
protect against subclinical infection and la FeHV-1 or the FCV component [37, 38].
tency [34]. Mild transient signs have been reported
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Feline herpesvirus 345

following experimental subcutaneous in in pregnant queens, and vaccination during


oculation of an FeHV-1 vaccine strain pregnancy can help protect kittens by pro
[68], and most conventionally attenuated longing MDA [60].
FeHV-1 vaccines do retain the capacity The issue of duration of immunity for
to induce disease if inadvertently adminis FeHV-1 vaccines is of practical importance
tered via the oro-nasal route [68,106,107]. in that it determines appropriate vaccina tion
Thus care should be taken to ensure that the intervals for cats. Traditionally, vac cination
cat does not lick the injection site and that has taken place annually and in
the veterinary surgeon does not make an the EU, this is still the data sheet recom
aerosol of the vaccine with the syringe. For mendations. However in the USA, vacci
further investigation of such situations it nation guidelines are proposed by various
would be helpful to have a reliable molec scientific authorities, and largely because
ular typing system, or alternatively marker of concerns over adverse effects such as
vaccines, to enable differentiation between vaccine-associated sarcomas, triennial vac
vaccine and field viruses. However, such a cination is now being recommended after
system is not currently available. the first annual booster [112, 113]: at the
Intranasal MLV vaccine induces better time of writing, a vaccine marketed in
protection but often induces some mild the USA now has this claim. Both in the
side effects, such as transient sneezing and USA and the EU it has also been proposed
occasionally other clinical signs [70, 100]. that an individual risk-benefit assessment
Intranasal vaccines, however, are useful should be carried out to determine the most
for rapid onset of protection, with partial appropriate vaccination strategy for a par
protection seen after 2 days and signifi cant ticular animal [37, 38, 112, 113] (EU guid
protection after 4 and 6 days [10, 11, ance note EMEA/CVMP/205/03). Thus in
70]. Intranasal vaccines used in conjunc tion cats with a previously low risk of exposure
with parenteral vaccine on entry into going into a high risk situation such as a
shelters have reduced the severity of upper boarding or rescue shelter for example, an
respiratory disease in such establishments nual vaccination might still be considered
[21]. They have also been advocated for appropriate.
use in young kittens, to induce protection Despite the trend towards increasing the
in the face of MDA, although there is ev vaccination interval, information on the
idence that some injectable vaccines may duration of immunity following FeHV-1
also be effective at an early age [18,36,64]. vaccination is relatively limited. Although
Inactivated adjuvanted vaccines can be the majority of cats are protected against
reasonably effective, and modern adjuvants disease following the use of modified live
have led to improvements in immuno or inactivated FeHV-1 vaccines, a propor
genicity. However, adjuvanted vaccines tion of cats will still show mild signs, even
cause a significantly higher proportion of if challenge takes place within 3 months
injection site reactions in comparison with of the initial vaccination [6, 64, 99, 109,
MLV vaccines, although the actual report ing 116, 155]. However a significant reduction
rate is still relatively low [37, 38]. in overall clinical scores can generally be
Very rarely, sarcomas may develop at the shown in vaccinates compared to controls,
site of injection, particularly following the although the level of protection does de
use of aluminium-based adjuvants [37, 38, crease as the vaccination interval increases.
75, 90]. Inactivated vaccines are helpful in Thus in studies with an inactivated vaccine,
virus-free colonies because there is no risk the relative efficacy was shown to decrease
of spread or reversion to virulence. Some from 95% shortly after primary vaccina tion,
inactivated vaccines are licensed for use to 52% after 7.5 years [109, 118].
Machine Translated by Google

346 R. Gaskell et al.

The use of in vitro correlates of protec tion, 9. DISEASE CONTROL


such as virus neutralising antibody, to
determine the level of protection would be Disease prevention and control should
useful, but as VN antibody titres are of ten low be approached through a combination
and sometimes undetectable, and of vaccination and management. Since
because cell mediated immunity is also FeHV-1 infection is highly prevalent, eas ily
important, antibody tests do not necessar ily transmitted and disease can be rela tively
accurately predict whether disease, or severe, vaccination of all animals is
indeed what level of disease, will occur fol recommended. However the risk for each
lowing FeHV-1 challenge. A recent study individual cat and situation should be as
however showed a reasonable correlation sessed by the veterinary surgeon in consul
in that most cats with detectable FeHV-1 tation with the owner, so that an informed
antibodies (91% for VN antibodies; 90.5% choice can be made about the frequency of
for ELISA) had a greater than 50% reduc tion vaccination [37, 38].
in clinical signs compared to controls.
In contrast, two of three cats with no de
9.1. Household cats
tectable VN antibody were reported to be
susceptible to disease [69].
Pets should be vaccinated regularly, but
A number of attempts have been made the re-vaccination intervals should be eval
to try to improve FeHV-1 vaccines, through uated depending on the risk of exposure.
genetic engineering. Thus recombinant If the cat goes into a boarding cattery or
poxviruses and baculoviruses have been enters other high risk situations it should
constructed expressing the FeHV-1 gly be vaccinated every year; otherwise after
coprotein D to characterize its properties the first annual vaccine, triennial vaccina tion
and potential as an immunogen [77, 120]. may be sufficient. To reduce exposure
A number of FeHV-1 deletion/insertional to such environments, ideally a friend or
mutants have been developed including neighbour should feed the cat while the
thymidine kinase deletion mutants, some owner is on holiday. Individual cats should
of which have incorporated other genes in be protected from stress as much as possi ble
cluding the FCV capsid gene [12, 88, 89, to avoid exposure and reactivation from
144,156–159]; gE-gI deletion mutants [68, carriers.
129, 130]; a gI insertional mutant (which
also appeared to affect the transcription
pattern and expression of the upstream 9.2. Boarding catteries
gene gD) [150, 151]; and an insertional
mutant of ‘ORF2’, downstream of glyco protein All cats entering the cattery should have
C [149]. In general, these dele tion/insertional an up-to-date vaccination record. Since en
mutants are less virulent tering a boarding cattery is a high risk situ
for cats and offer some protection against ation, annual vaccination is recommended.
disease, especially via the oro-nasal route. Where rapid protection is required (i.e. in
However, none has so far been marketed, the face of an outbreak of disease) in tranasal
probably because the protection offered is vaccine may be given in countries
not superior to conventionally attenuated where this is available; otherwise a MLV
vaccines. In some cases – for example injectable vaccine is likely to induce a
those containing deletions in non-essential more rapid response than an inactivated
genes such as the gE-gI deletion mutants – one. Clients should be aware that intranasal
such vaccines do offer some utility as po vaccines themselves may induce mild clin ical
tential marker vaccines. signs.
Machine Translated by Google

Feline herpesvirus 347

Cattery owners should not rely on vac to disease-free households is from stud cats
cination alone for disease control, because and new breeding stock when exposure is
pathogens will inevitably be present either prolonged.
from the occasional cat incubating disease Cats entering a disease-free colony
or from reactivating carriers. Thus, mea should be quarantined for three weeks to
sures should be taken to prevent spread of identify animals incubating the disease.
infection and reduce the concentration of Swabs should be collected from each cat at
infectious agents in the environment [39]. least twice a week during this time, and
Such measures may appear complicated, evaluated for the presence of FeHV-1.
but in practice they are not difficult to If possible, PCR should be used rather than
implement and, in our experience, can ac virus isolation, because of the for mer’s
tually increase efficiency within a cattery. greater sensitivity. However, even with
negative results, there is still the risk of
importing a latent FeHV-1 carrier that may
9.3. Shelter facilities subsequently be a source of infection.
In breeding colonies where the disease
In general, the same management mea is endemic, it is difficult to achieve or
sures apply as with boarding catteries. maintain virus free status. For most situ
Since the immune status of the cats in a ations, the only reasonable course is to at
rescue shelter is often unknown, in-coming tempt disease control, largely by ensuring
animals should be quarantined and iso lated queens are regularly vaccinated, reducing
from others. Those with clinical signs should stress, isolating queens and their kittens,
be kept apart from clinically normal animals. and considering early weaning kittens into
Unless animals can be isolated on arrival isolation or initiating kitten vaccination at an
for 3 to 4 weeks, parenteral vaccines may earlier age [18, 39]. In some cases, it may
not have time to become effective. In these be necessary to reduce the number of cats
circumstances, it may be advisable to use in the colony.
the intranasal vaccines if available; otherwise
MLV injectable vaccines are ad vocated.
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