Covering sickness

Covering sickness, or dourine (French, from the Arabic darina, meaning mangy (said of a female camel), feminine of darin, meaning dirty),[1] is a disease of horses and other members of the family Equidae. The disease is caused by Trypanosoma equiperdum, which belongs to an important genus of parasitic protozoa.[2] The occurrence of dourine is notifiable in the European Union under legislation from the OIE.[3] There currently is no vaccine and although clinical signs can be treated,[2] there is no cure.[4]

Mohler, John R., Dourine of horses – its cause and suppression (1911)

Parasite
Trypanosoma equiperdum

Out of the Trypanosoma genus, Trypanosoma equiperdum has been discovered to be most closely linked to Trypanosoma evansi, so much so that even observation under microscope is not sufficient to differentiate between the two as their structure is very similar.[5]

Dourine has no known vectors or fomites existing in the natural world, being known only as a sexually transmitted disease of members of the equine family, including donkeys, mules, and horses.[2] In a laboratory setting, Trypanosoma equiperdum has been manipulated to adapt to and proliferate in other species, such as dogs, rabbits, mice and rats, but this has never been observed to occur naturally.[4] Although this limits spread of the disease because it is restricted to the equine population alone, the organism has developed complex mechanisms over time to better equip itself for prolonged survival in the equine species. As normal for its genus, the parasite efficiently evades the host animal's immune system through the use of variable surface glycoproteins or VSGs.[6] These VSGs allow the organism to constantly manipulate and change the surface structure of its proteins, which means it is constantly being presented to the immune system as a new foreign organism and this prevents the body from mounting a large enough immune response to eradicate the disease.[6]

Transmission and symptoms

Dourine is spread venereally,[7] and causes disc-shaped[8] lesions of the reproductive organs, nervous system and skin,[7] acute inflammation and edema of the genitals, followed by hindlimb paralysis, paraplegia and death in more than fifty percent of cases.[8][3]

Treatment

Because this disease is highly durable in its equine host, it has proved very difficult to develop a vaccine for it. There are four main drugs on the market that are used to treat the clinical signs of dourine: Suramin, Diminazen, Cymerlarsan, and Quinapyramin.[2][9] However, none of the listed drugs are a cure and even the individual animals that are treated will experience relapses.[4] Although this disease is not fatal in all cases and spontaneous recovery can occur, the death rate is relatively high and listed at a mortality rate of over fifty percent.[3]

This lack of a cure or vaccine is a definite problem in the equine industry, especially in developing countries where equines are highly valuable for both agriculture and transportation.[5] Dourine is considered an endemic problem in developing countries, where over sixty percent of equines in the world are located.[4] The protocol for this disease, as stated by OIE, currently stands at slaughter of seropositive animals.[10] This is not an economically feasible option for many people who depend on horses for their livelihood. Therefore, it is crucial to continue research in this field and develop a viable vaccine.

References
  1. "Dourine". American Heritage Dictionary of the English Language: Fifth Edition. 2017. Retrieved 2017-05-19.
  2. Gillingwater, K.; Büscher, P.; Brun, R. (September 2007). "Establishment of a panel of reference Trypanosoma evansi and Trypanosoma equiperdum strains for drug screening". Veterinary Parasitology. 148 (2): 114–121. doi:10.1016/j.vetpar.2007.05.020. PMID 17624671.
  3. Codes of Practice 2020 (PDF). Horserace Betting Levyboard. pp. 59–65. Archived (PDF) from the original on 4 April 2022. Retrieved 24 May 2022.
  4. Hagos, A; Goddeeris, BM; Yilkal, K; Alemu, T; Fikru, R; Yacob, HT; Feseha, G; Claes, F (4 August 2010). "Efficacy of Cymelarsan and Diminasan against Trypanosoma equiperdum infections in mice and horses". Veterinary Parasitology. 171 (3–4): 200–6. doi:10.1016/j.vetpar.2010.03.041. PMID 20417035.
  5. Brun, Reto; Hecker, Hermann; Lun, Zhao-Rong (October 1998). "Trypanosoma evansi and T. equiperdum: distribution, biology, treatment and phylogenetic relationship (a review)". Veterinary Parasitology. 79 (2): 95–107. doi:10.1016/S0304-4017(98)00146-0. PMID 9806490.
  6. Raibaud, A; Gaillard, C; Longacre, S; Hibner, U; Buck, G; Bernardi, G; Eisen, H (July 1983). "Genomic environment of variant surface antigen genes of Trypanosoma equiperdum". Proceedings of the National Academy of Sciences of the United States of America. 80 (14): 4306–10. Bibcode:1983PNAS...80.4306R. doi:10.1073/pnas.80.14.4306. PMC 384026. PMID 6308614.
  7. Gizaw, Yonas; Megersa, Mulisa; Fayera, Teka (2017). "Dourine: a neglected disease of equids". Tropical Animal Health and Production. 49 (5): 887–897. doi:10.1007/s11250-017-1280-1. PMC 5432633. PMID 28439783.
  8. Tibary, Ahmed; Pearson, Lisa K.; Fite, Cheryl L. "Chapter 8 - Reproductive Tract Infections". Equine Infectious Diseases (Second ed.).
  9. Merck Veterinary Manual. "Trypanosomiasis". Retrieved 19 May 2017.
  10. "OIE Technical Disease Card: Dourine" (PDF).
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