Outbreak of Severe Vomiting in Dogs Associated with a Canine Enteric Coronavirus, United Kingdom

Abstract

The lack of population health surveillance for companion animal populations leaves them vulnerable to the effects of novel diseases without means of early detection. We present evidence on the effectiveness of a system that enabled early detection and rapid response a canine gastroenteritis outbreak in the United Kingdom. In January 2020, prolific vomiting among dogs was sporadically reported in the United Kingdom. Electronic health records from a nationwide sentinel network of veterinary practices confirmed a significant increase in dogs with signs of gastroenteric disease. Male dogs and dogs living with other vomiting dogs were more likely to be affected. Diet and vaccination status were not associated with the disease; however, a canine enteric coronavirus was significantly associated with illness. The system we describe potentially fills a gap in surveillance in neglected populations and could provide a blueprint for other countries.

Keywords: United Kingdom; canine enteric coronavirus; dogs; enteric infections; gastrointestinal disease; outbreaks; statistical modeling; surveillance; syndromic surveillance; viruses; vomiting.

Figure 1

Observed prevalence of main presenting complaint (MPC) and maropitant use in cats and dogs, per 1,000 consultations, in investigation of dogs with vomiting, United Kingdom, January 2017–February 2020. A) Canine records labeled as gastroenteric MPC; B) canine records in which maropitant was prescribed; C) canine records labeled as respiratory MPC; D) feline records in which maropitant was prescribed; E) feline records labeled as gastroenteric MPC; and F) frequent vomiting in dogs based on regular expression searches of the clinical narratives. Red points represent the extreme outliers (outside the 99% credible interval [CrI]), orange points the moderate outliers (outside the 95% CrI, but within the 99% CrI), and green points the average trend (within the 95% CrI).

Figure 2

Rates of gastroenteric veterinary consults for dogs during November 4, 2019–March 21, 2020, in investigation of dogs with vomiting, United Kingdom. Consults were geolocated to owners’ postcodes, with gastroenteric main presenting complaint as a binary outcome (1 for gastroenteric consult, 0 for a nongastroenteric consult). Colored areas represent the number of weeks a given location had a 95% posterior probability of prevalence exceeding the national mean prevalence in any week. The geostatistical modeling approach used is further detailed in the Appendix.

Figure 3

Diagnostic test findings during January 2017–February 2020 in investigation of dogs with vomiting, United Kingdom. A) Canine enteric coronavirus PCR; B) canine parvovirus PCR; C) Giardia PCR; D) Salmonella spp. selective culture; E) Campylobacter spp. selective culture; F) Clostridium perfringens enterotoxin PCR results. Blue shading represents 95% CI.

Figure 4

Phylogenetic analysis of canine enteric coronavirus strains, including locations were sequences were obtained, in investigation of dogs with vomiting, United Kingdom. Trees are based on nucleotide sequences for M-gene (final alignment 299 positions) (A) and whole genome (final alignment 26,564 positions) (B). Evolutionary analysis was performed using the neighbor-joining method. Bootstrap testing using 1,000 replicates was applied; only values >70 are indicated. Sequences identified in this study are indicated in blue (strain 1), red (strain 2), and green (strain 3). Asterisks (*) indicate samples from animals meeting the case definition. Each phylogeny included closest matches in GenBank, as well as representative published canine coronavirus, feline coronavirus, and transmissible gastroenteritis virus isolates. Scale bars indicate substitutions per site. C) Approximate geographic location of sequences obtained in this study, number- and color-matched to sequences shown in panels A and B.