Title: Feline viral rhinotracheitis

{{short description|Infectious disease of cats}}
{{Virusbox
| name = Feline herpesvirus
| image = 
| image_alt = 
| image_caption = 
| parent = Varicellovirus
| species = Varicellovirus felidalpha1
| synonyms = 
* Felid alphaherpesvirus 1
* Felid herpesvirus 1
* Feline rhinotracheitis virus&lt;ref name=&quot;Herpesviridae&quot;&gt;{{cite web |title=ICTV 9th Report (2011) ''Herpesviridae'' |url=https://talk.ictvonline.org/ictv-reports/ictv_9th_report/dsdna-viruses-2011/w/dsdna_viruses/91/herpesviridae |archive-url=https://web.archive.org/web/20181222034214/https://talk.ictvonline.org/ictv-reports/ictv_9th_report/dsdna-viruses-2011/w/dsdna_viruses/91/herpesviridae |url-status=dead |archive-date=December 22, 2018 |website=International Committee on Taxonomy of Viruses (ICTV) |access-date=9 January 2019 |language=en |quote=''Felid herpesvirus 1'' Felid herpesvirus 1 [FJ478159=NC_013590] (FeHV-1) (Feline rhinotracheitis virus)}}&lt;/ref&gt;
| synonyms_ref = &lt;ref&gt;{{cite web|url=https://ictv.global/taxonomy/taxondetails?taxnode_id=202301453&amp;taxon_name=Varicellovirus%20felidalpha1|title=History of the taxon: Species: ''Varicellovirus felidalpha1'' (2023 Release, MSL #39)|author=&lt;!--Not stated--&gt;|date=|website=ictv.global|publisher=International Committee on Taxonomy of Viruses|access-date=29 January 2025|quote=}}&lt;/ref&gt;
}}

[[Image:Katzenschnupfen Herpes.jpg|thumb|Feline viral rhinotracheitis infection]]
'''Feline viral rhinotracheitis''' ('''FVR''') is an upper respiratory or pulmonary infection of [[cat]]s caused by '''Feline herpesvirus''', also called '''Feline herpesvirus 1''' (FeHV-1), of the family ''[[Herpesviridae]]''. It is also commonly referred to as '''feline influenza''', '''feline coryza''', and '''feline pneumonia''' but, as these terms describe other very distinct collections of respiratory symptoms, they are misnomers for the condition. [[Virus|Viral]] respiratory diseases in cats can be serious, especially in [[cattery|catteries]] and [[kennel]]s. Causing one-half of the respiratory diseases in cats,&lt;ref name=Carter&gt;{{cite web|author1=Carter, G.R. |author2=Flores, E.F. |author3=Wise, D.J. |year=2006|title=Herpesviridae|work=A Concise Review of Veterinary Virology| url=http://www.ivis.org/advances/Carter/Part2Chap11/chapter.asp?LA=1|access-date=2006-06-08}}&lt;/ref&gt; FVR is the most important of these diseases and is found worldwide. The other important cause of feline respiratory disease is ''[[feline calicivirus]]''.

FVR is very contagious and can cause severe disease, including death from [[pneumonia]] in young kittens. It may cause [[flat-chested kitten syndrome]], but most evidence for this is anecdotal. All members of the family [[Felidae]] are susceptible to FVR; in fact, FHV-1 has caused a fatal [[encephalitis]] in [[lion]]s in [[Germany]].&lt;ref name=Ettinger_1995&gt;{{cite book|author1=Ettinger, Stephen J. |author2=Feldman, Edward C. |title=Textbook of Veterinary Internal Medicine|edition=4th|publisher=W.B. Saunders Company|year=1995|isbn=978-0-7216-6795-9}}{{Page needed|date=March 2012}}&lt;/ref&gt;

==History==
FHV-1 was first isolated from cats in 1958 in the [[United States]].&lt;ref&gt;{{cite journal |doi=10.1292/jvms.60.881 |title=Properties and Functions of Feline Herpesvirus Type 1 Glycoproteins |year=1998 |last1=Maeda |first1=Ken |last2=Horimoto |first2=Taisuke |last3=Mikami |first3=Takeshi |journal=Journal of Veterinary Medical Science |volume=60 |issue=8 |pages=881–8 |pmid=9764399|doi-access=free }}&lt;/ref&gt;

==Transmission==
FVR is transmitted through direct contact only.&lt;ref name=&quot;thiry&quot;&gt;{{cite journal |doi=10.1016/j.jfms.2009.05.003 |pmid=19481034 |title=Feline herpesvirus infection. ABCD guidelines on prevention and management |year=2009 |last1=Thiry |first1=Etienne |last2=Addie |first2=Diane |last3=Belák |first3=Sándor |last4=Boucraut-Baralon |first4=Corine |last5=Egberink |first5=Herman |last6=Frymus |first6=Tadeusz |last7=Gruffydd-Jones |first7=Tim |last8=Hartmann |first8=Katrin |last9=Hosie |first9=Margaret J. |last10=Lloret |first10=Albert |journal=[[Journal of Feline Medicine &amp; Surgery]] |volume=11 |issue=7 |pages=547–55|display-authors=8 |pmc=7129359 }}&lt;/ref&gt; It replicates in the nasal and [[nasopharynx|nasopharyngeal]] tissues and the [[tonsil]]s. [[Viremia]] (the presence of the virus in the blood) is rare. The [[viral shedding|virus is shed]] in saliva and eye and nasal secretions, and can also be spread by [[fomite]]s. FVR has a two- to five-day [[incubation period]].&lt;ref name=Carter/&gt; The virus is shed for one to three weeks postinfection.&lt;ref name=Ettinger_1995/&gt; Latently infected cats (carriers) will shed FHV-1 intermittently for life, with the virus persisting within the [[semilunar ganglion|trigeminal ganglion]]. Stress and use of [[corticosteroid]]s precipitate [[viral shedding|shedding]]. Most disinfectants, antiseptics and detergents are effective against the virus.&lt;ref name=&quot;thiry&quot;/&gt;

==Clinical signs==
[[Image:Weepy eye.jpg|right|thumb|Chronic epiphora in a carrier of FVR]]
Initial signs of FVR include [[cough]]ing, [[Sneeze|sneezing]], nasal discharge, [[conjunctivitis]], and sometimes fever (up to {{convert|106|F|C}}) and loss of appetite. These usually resolve within four to seven days, but secondary bacterial infections can cause the persistence of clinical signs for weeks.&lt;ref name=Ettinger_1995/&gt; Frontal [[sinusitis]] and [[empyema]] can also result.

FHV-1 also has a predilection for [[cornea]]l epithelium, resulting in [[Corneal ulcers in animals|corneal ulcer]]s, often pinpoint or [[dendrite|dendritic]] in shape. Other ocular signs of FHV-1 infection include conjunctivitis, [[keratitis]], [[keratoconjunctivitis sicca]] (decreased tear production), and [[Corneal sequestrum|corneal sequestra]].&lt;ref&gt;{{cite journal |pmid=7649774 |year=1995 |last1=Stiles |first1=J |title=Treatment of cats with ocular disease attributable to herpesvirus infection: 17 cases (1983–1993) |volume=207 |issue=5 |pages=599–603 |journal=[[Journal of the American Veterinary Medical Association]]|doi=10.2460/javma.1995.207.05.0599 }}&lt;/ref&gt; Infection of the [[nasolacrimal duct]] can result in chronic [[Epiphora (medical)|epiphora]] (excess tearing). Ulcerative skin disease can also result from FHV-1 infection.&lt;ref&gt;{{cite journal |doi=10.2460/javma.229.9.1442 |title=Detection of feline herpesvirus 1 DNA in skin biopsy specimens from cats with or without dermatitis |year=2006 |last1=Holland |first1=Jessica L. |last2=Outerbridge |first2=Catherine A. |last3=Affolter |first3=Verena K. |last4=Maggs |first4=David J. |journal=[[Journal of the American Veterinary Medical Association]] |volume=229 |issue=9 |pages=1442–6 |pmid=17078806|doi-access=free }}&lt;/ref&gt; FHV-1 can also cause abortion in pregnant queens, usually at the sixth week of [[gestation]],&lt;ref name=Carter/&gt; although this may be due to systemic effects of the infection rather than the virus directly.

In chronic nasal and sinus disease of cats, FHV-1 may play more of an initiating role than an ongoing cause. Infection at an early age may permanently damage nasal and sinus tissue, causing a disruption of [[cilium|cilia]]ry clearance of [[mucus]] and bacteria, and predispose these cats to chronic bacterial infections.&lt;ref&gt;{{cite journal |doi=10.2460/javma.2005.227.579 |title=Assessment of infectious organisms associated with chronic rhinosinusitis in cats |year=2005 |last1=Johnson |first1=Lynelle R. |last2=Foley |first2=Janet E. |last3=De Cock |first3=Hilde E. V. |last4=Clarke |first4=Heather E. |last5=Maggs |first5=David J. |journal=[[Journal of the American Veterinary Medical Association]] |volume=227 |issue=4 |pages=579–85 |pmid=16117066}}&lt;/ref&gt;

==Diagnosis==
Diagnosis of FVR is usually by clinical signs, especially corneal ulceration. Definitive diagnosis can be done by direct [[immunofluorescence]] or [[virus isolation]]. However, many healthy cats are subclinical carriers of feline herpes virus, so a positive test for FHV-1 does not necessarily indicate that signs of an upper respiratory tract infection are due to FVR. Early in the course of the disease, [[Histology|histological]] analysis of cells from the tonsils, nasal tissue, or [[nictitating membrane]] (third eyelid) may show [[inclusion bodies]] (a collection of viral particles) within the [[cell nucleus|nucleus]] of infected cells.&lt;ref&gt;{{cite web | title = Feline Respiratory Disease Complex | work = The Merck Veterinary Manual | date = 2006 | url = http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/121604.htm | access-date = 2007-04-01 | archive-date = 2007-03-11 | archive-url = https://web.archive.org/web/20070311181027/http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm%2Fbc%2F121604.htm | url-status = dead }}&lt;/ref&gt;

==Treatment and prevention==
Polyprenyl immunostimulant is the only currently-approved treatment in the US for feline rhinotracheitis caused by herpesvirus.&lt;ref&gt;{{Cite web|url=https://www.aphis.usda.gov/sites/default/files/currentprodcodebook.pdf|title=Veterinary Biological Products|publisher=[[USDA]]|date=April 1, 2020}}&lt;/ref&gt; Effectiveness was demonstrated in a clinical study with cats experimentally infected with feline herpesvirus: 20 cats were treated with polyprenyl immunostimulant and 20 received a placebo. The study established that the severity of the disease was lower in the group treated with polyprenyl.&lt;ref name=&quot;Legendre 2017&quot;&gt;{{cite journal |last1=Legendre |first1=Al |title=Polyprenyl Immunostimulant in Feline Rhinotracheitis: Randomized Placebo-Controlled Experimental and Field Safety Studies |journal=Front. Vet. Sci. |year=2017 |volume=4 |page=24 |doi=10.3389/fvets.2017.00024|pmid=28289684 |pmc=5326765 |doi-access=free }}&lt;/ref&gt; Safety was demonstrated in 390 personally-owned cats from 2 days to 16 years of age, residing in 10 states.&lt;ref name=&quot;Legendre 2017&quot;/&gt;

[[Antibiotic]]s are commonly used to prevent secondary bacterial infection. There are no specific [[antiviral drug]]s in common use at this time for FVR, although one study has shown that [[ganciclovir]], [[PMEDAP]], and [[cidofovir]] hold promise for treatment.&lt;ref&gt;{{cite journal |doi=10.1186/1746-6148-2-13 |year=2006 |last1=Van Der Meulen |first1=K |last2=Garré |first2=B |last3=Croubels |first3=S |last4=Nauwynck |first4=H |journal=BMC Veterinary Research |volume=2 |pages=13 |pmid=16640781 |title=In vitro comparison of antiviral drugs against feline herpesvirus 1 |pmc=1475582 |doi-access=free }}&lt;/ref&gt; More recent research has indicated that systemic [[famciclovir]] is effective at treating this infection in cats without the side effects reported with other anti-viral agents.&lt;ref&gt;{{Cite journal | doi = 10.1016/j.jfms.2008.11.012| pmid = 19154974| title = Treatment of feline herpesvirus-1 associated disease in cats with famciclovir and related drugs| journal = Journal of Feline Medicine &amp; Surgery| volume = 11| issue = 1| pages = 40–48| year = 2009| last1 = Malik | first1 = R. | last2 = Lessels | first2 = N. S. | last3 = Webb | first3 = S. | last4 = Meek | first4 = M. | last5 = Graham | first5 = P. G. | last6 = Vitale | first6 = C. | last7 = Norris | first7 = J. M. | last8 = Power | first8 = H. | s2cid = 24590918| doi-access = free | pmc = 11135480 }}&lt;/ref&gt; More severe cases may require supportive care such as [[intravenous therapy|intravenous fluid therapy]], [[oxygen therapy]], or even a [[feeding tube]]. Conjunctivitis and corneal ulcers are treated with topical antibiotics for secondary bacterial infection. [[Lysine]] is commonly used as a treatment; however, in a 2015 [[systematic review]], the authors investigated all clinical trials with cats as well as ''[[in vitro]]'' studies and concluded that lysine supplementation is likely not effective for the treatment or prevention of feline herpesvirus 1 infection.&lt;ref name=&quot;Bol2015&quot;&gt;{{cite journal|last1=Bol|first1=Sebastiaan|last2=Bunnik|first2=Evelien M.|title=Lysine supplementation is not effective for the prevention or treatment of feline herpesvirus 1 infection in cats: a systematic review|journal=BMC Veterinary Research|date=2015|volume=11|page=284|doi=10.1186/s12917-015-0594-3|pmid=26573523|pmc=4647294 |doi-access=free }}&lt;/ref&gt;

===Vaccine===
There is a [[vaccine]] for FHV-1 available ([[ATCvet]] code: {{ATCvet|I06|AA08}}, plus various combination vaccines), but although it limits or weakens the severity of the  [[viral shedding]], it does not prevent infection with FVR.&lt;ref name=Gaskell&gt;{{cite journal |doi=10.1051/vetres:2006063 |title=Feline herpesvirus |year=2007 |last1=Gaskell |first1=Rosalind |last2=Dawson |first2=Susan |last3=Radford |first3=Alan |last4=Thiry |first4=Etienne |journal=Veterinary Research |volume=38 |issue=2 |pages=337–54 |pmid=17296160|url=https://hal.archives-ouvertes.fr/hal-00902876/file/hal-00902876.pdf |doi-access=free }}&lt;/ref&gt; Studies have shown a duration of immunity of this vaccine to be at least three years.&lt;ref&gt;{{cite journal |pmid=17039444 |year=2006 |last1=Gore |first1=TC |last2=Lakshmanan |first2=N |last3=Williams |first3=JR |last4=Jirjis |first4=FF |last5=Chester |first5=ST |last6=Duncan |first6=KL |last7=Coyne |first7=MJ |last8=Lum |first8=MA |last9=Sterner |first9=FJ |title=Three-year duration of immunity in cats following vaccination against feline rhinotracheitis virus, feline calicivirus, and feline panleukopenia virus |volume=7 |issue=3 |pages=213–22 |journal=Veterinary Therapeutics: Research in Applied Veterinary Medicine }}&lt;/ref&gt; The use of [[serology]] to demonstrate circulating [[antibody|antibodies]] to FHV-1 has been shown to have a positive predictive value for indicating protection from this disease.&lt;ref&gt;{{cite conference | last = Lappin | first = Michael R. | title = Use of serological tests to determine vaccine needs | work = Proceedings of the North American Veterinary Conference | year = 2006}}&lt;/ref&gt; The combination vaccine, Purevax RC, against feline viral rhinotracheitis and feline calicivirus was authorised for medical use in the European Union in February 2005.&lt;ref&gt;{{cite web | title=Purevax RC EPAR | website=European Medicines Agency (EMA) | date=14 March 2008 | url=https://www.ema.europa.eu/en/medicines/veterinary/EPAR/purevax-rc | access-date=19 October 2024}}&lt;/ref&gt;&lt;ref&gt;{{cite web | title=Purevax RC PI | website=European Medicines Agency (EMA) | date=25 February 2005 | url=https://ec.europa.eu/health/documents/community-register/html/v051.htm | access-date=19 October 2024}}&lt;/ref&gt;

===Preventing spread of virus===
Most household [[disinfection|disinfectants]] will inactivate FHV-1. The virus can survive up to 18 hours in a damp environment, but less in a dry environment and only shortly as an [[aerosol]].&lt;ref name=Gaskell/&gt;

==See also==
*[[Feline vaccination]]

==References==
{{Reflist|2}}

==External links==
{{Commons category}}
* [http://www.veterinarypartner.com/Content.plx?P=A&amp;S=0&amp;C=0&amp;A=613 ''Feline Upper Respiratory Disease'' from The Pet Health Library]

{{Herpesvirales}}
{{Domestic cat}}
{{Taxonbar|from=Q15660578|from2=Q11752015|from3=Q24808714}}

{{DEFAULTSORT:Feline Viral Rhinotracheitis}}
[[Category:Cat diseases]]
[[Category:Animal viral diseases]]
[[Category:Herpesviridae]]
[[Category:Vaccine-preventable diseases]]