A longitudinal study of respiratory disease in racehorses was carried out to assess its relative associations with different infectious agents and to examine any role that the environmental conditions might play. The relationships between coughing, nasal discharge, pyrexia and lower respiratory tract disease were also examined to provide information for improving clinical diagnosis, particularly of disease of the lower respiratory tract. Lower airway disease was closely associated with infection with Streptococcus zooepidemicus. It was also found that equine herpesvirus seroconversions and S pneumoniae infections were independently associated with the development of nasal discharge. Coughing was a specific, but insensitive measure of lower respiratory tract disease (specificity 84 per cent, sensitivity 38 per cent). However, horses that coughed were very likely to have had lower airway disease for more than one month. Horses housed on straw in loose boxes were twice as likely to suffer from lower airway disease as those kept on shredded paper in American barns. The study was not large enough to assess the significance of rarer infections but it did improve the definition of the problem of respiratory disease in racehorses and revealed some of the trends in the associations between viruses, bacteria and the environment in respiratory disease.
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