{"id":62668,"date":"2023-01-25T11:19:13","date_gmt":"2023-01-25T17:19:13","guid":{"rendered":"https:\/\/lafeber.com\/vet\/?p=62668"},"modified":"2025-02-08T01:11:28","modified_gmt":"2025-02-08T07:11:28","slug":"fast-facts-on-rabbit-hemorrhagic-disease","status":"publish","type":"post","link":"https:\/\/lafeber.com\/vet\/fast-facts-on-rabbit-hemorrhagic-disease\/","title":{"rendered":"Fast Facts on Rabbit Hemorrhagic Disease"},"content":{"rendered":"<h2><strong>INTRODUCTION<\/strong><\/h2>\n<p><a href=\"https:\/\/lafeber.com\/vet\/rabbit-hemorrhagic-disease-and-vaccination\/\">Rabbit hemorrhagic disease<\/a> (RHD) is a highly infectious, fatal viral hepatitis affecting lagomorphs (rabbits, hares, and pikas), including the <a href=\"https:\/\/lafeber.com\/vet\/basic-information-for-european-rabbits\/\">European rabbit<\/a> (<em>Oryctolagus cuniculus)<\/em>.<sup><a href=\"#10\">10<\/a>,<a href=\"#24\">24<\/a><\/sup> RHD is considered a reportable disease of international concern by the <a href=\"https:\/\/www.woah.org\/en\/disease\/rabbit-haemorrhagic-disease\/\" target=\"_blank\" rel=\"noopener\">World Organization for Animal Health<\/a> (formerly OIE).<sup><a href=\"#10\">10<\/a>,<a href=\"#20\">20<\/a><\/sup><\/p>\n<p>Rabbit hemorrhagic disease virus (RHDV) is a non-enveloped, single-stranded, positive-sense RNA virus belonging to family <em>Caliciviridae <\/em>and genus <em>Lagovirus<\/em>.<sup><a href=\"#2\">2<\/a>,<a href=\"#10\">10<\/a>,<a href=\"#22\">22<\/a><\/sup> Historically, RHDV split into six highly pathogenic genotypes (G1-G6), however in 2010, a new, antigenically distinct genotype emerged:\u00a0 rabbit hemorrhagic disease virus type 2 (RHDV2) (Box 1).<sup><a href=\"#6\">9<\/a>,<a href=\"#24\">24<\/a>,<a href=\"#25\">25<\/a><\/sup><\/p>\n<table>\n<caption><strong>Box 1. Rabbit hemorrhagic disease virus genotypes primarily seen today <\/strong><sup><a href=\"#5\">5<\/a>, <a href=\"#10\">10<\/a>,<a href=\"#11\">11<\/a>,<a href=\"#12\">12<\/a>,<a href=\"#13\">13<\/a>,<a href=\"#22\">22<\/a><\/sup><\/caption>\n<tfoot>\n<tr>\n<td>*<small>RHDV1 and RHDVa are closely related<\/small><\/td>\n<\/tr>\n<\/tfoot>\n<tbody>\n<tr>\n<td>\n<ul>\n<li>RHDV\/RHDV1\/classical RHDV\/GI.1a-d\/rabbit hemorrhagic disease virus type 1<\/li>\n<li>RHDVa\/G6*<\/li>\n<li>RHDV2\/RHDVb\/GI.2\/rabbit hemorrhagic disease virus type 2<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>The European brown hare syndrome virus is another lagovirus that causes RHD-like disease in hares (<em>Lepus <\/em>spp.).<sup><a href=\"#10\">10<\/a>,<a href=\"#24\">24<\/a><\/sup><\/p>\n<p>&nbsp;<\/p>\n\n<table id=\"tablepress-666\" class=\"tablepress tablepress-id-666 tbody-has-connected-cells\">\n<thead>\n<tr class=\"row-1\">\n\t<td class=\"column-1\"><\/td><th class=\"column-2\"><P ALIGN=Center><b>RHDV1<\/b><\/p><\/th><th class=\"column-3\"><P ALIGN=Center><b>RHDV2<\/b><\/p><\/th>\n<\/tr>\n<\/thead>\n<tbody class=\"row-striping row-hover\">\n<tr class=\"row-2\">\n\t<td class=\"column-1\"><h2>GEOGRAPHIC RANGE<\/h2><\/td><td class=\"column-2\">Rabbit hemorrhagic disease virus type 1 (RHDV1) was first reported in China in 1984, resulting in the loss of millions of rabbits in less than 1 year. <sup><a href=\"#6\">6<\/a>,<a href=\"#8\">8<\/a>,<a href=\"#11\">11<\/a>,<a href=\"#22\">22<\/a><\/sup> Two years later,  RHDV1 was first reported in Europe. <\/td><td class=\"column-3\">In 2010, a new form of RHD, rabbit hemorrhagic disease virus type 2, emerged in France in wild and farmed rabbits. <sup><a href=\"#6\">6<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#8\">8<\/a>,<a href=\"#18\">18<\/a><\/sup> <\/td>\n<\/tr>\n<tr class=\"row-3\">\n\t<td class=\"column-1\"><\/td><td class=\"column-2\">Since that time, RHD has been reported in over 40 countries, occurring regularly across parts of Europe, Asia, Africa, the Americas, and Oceania.<sup><a href=\"#21\">21<\/a><\/sup> Outbreaks have also occurred in the Middle East.<sup><a href=\"#21\">21<\/a><\/sup> <\/td><td class=\"column-3\">Within 5 to 6 years, RHDV2 had spread across Europe and reached Africa, Israel, Australia, New Zealand, and North America.<sup><a href=\"#3\">3<\/a>,<a href=\"#6\">6<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#18\">18<\/a><\/sup> RHDV-2 has now become the dominant subtype of RHD in endemic countries. <\/td>\n<\/tr>\n<tr class=\"row-4\">\n\t<td class=\"column-1\"><\/td><td class=\"column-2\">Isolated cases have appeared intermittently in the US and Canada. <\/td><td class=\"column-3\">The first confirmed case of RHDV2 reported in North America was seen in Quebec in 2016.<sup><a href=\"#18\">18<\/a><\/sup> The first case in the US was seen in 2018. Since then, RHVD2 outbreaks have been seen sporadically throughout the US and Canada.<sup><a href=\"#7\">7<\/a>,<a href=\"#9\">9<\/a>,<a href=\"#18\">18<\/a><\/sup><\/td>\n<\/tr>\n<tr class=\"row-5\">\n\t<td colspan=\"3\" class=\"column-1\"><h2>SIGNALMENT<\/h2><\/td>\n<\/tr>\n<tr class=\"row-6\">\n\t<td class=\"column-1\">Species<\/td><td class=\"column-2\">Wild and domestic European rabbits (<em>O. cuniculus<\/em>)<sup><a href=\"#1\">1<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#18\">18<\/a><\/sup><\/td><td class=\"column-3\"><p>Wider host range, including many species of <a href=\"https:\/\/www.aphis.usda.gov\/aphis\/ourfocus\/wildlifedamage\/programs\/nwdp\/nwdp-rabbit-hdv\/\" target=\"_blank\" rel=\"noopener\">wild rabbits<\/a>, such as hares (<em>Lepus<\/em> spp.) and <a href=\"https:\/\/lafeber.com\/vet\/basic-information-for-the-cottontail-rabbit\/\" rel=\"noopener\">cottontails<\/a> (<em>Sylvilagus<\/em> spp.), pikas, and the domesticated European rabbit<sup><a href=\"#3\">3<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#9\">9<\/a>,<a href=\"#14\">14<\/a>,<a href=\"#18\">18<\/a><\/sup><\/p><\/td>\n<\/tr>\n<tr class=\"row-7\">\n\t<td class=\"column-1\"><\/td><td colspan=\"2\" class=\"column-2\"><p>Since the emergence of RHDV2, viral RNA has been identified in a few rodent species, presumably through the ingestion of rabbit-infected tissues or feces during scavenging.<sup><a href=\"#1\">1<\/a>, <a href=\"#5\">5<\/a>, <a href=\"#15\">15<\/a><\/sup> Although virus was found in wild mice living near RHDV2 outbreaks, the mice did not show clinical signs of disease.<sup><a href=\"#15\">15<\/a><\/sup> <br \/>\n<br \/>\nThe presence and replication of RHDV2 has also been identified in Eurasian badgers (<em>Meles meles<\/em>) found dead in Portugal between 2017 and 2020.<sup><a href=\"#1\">1<\/a><\/sup> This study showed that badgers are  susceptible to RHDV2, developing systemic infection and excreting the virus in the feces.<sup><a href=\"#1\">1<\/a><\/sup><\/p><\/td>\n<\/tr>\n<tr class=\"row-8\">\n\t<td class=\"column-1\">Age<\/td><td class=\"column-2\">Adult rabbits <sup><a href=\"#7\">7<\/a>,<a href=\"#21\">21<\/a><\/sup><br \/>\n<\/td><td class=\"column-3\"><p>Adults as well as kits as young as 7 to 15 days old <sup><a href=\"#20\">20<\/a><\/sup><\/p><\/td>\n<\/tr>\n<tr class=\"row-9\">\n\t<td class=\"column-1\">Zoonotic potential <\/td><td colspan=\"2\" class=\"column-2\"><p>RHD is not considered a food safety concern and is not associated with infection or disease in humans.<sup><a href=\"#12\">12<\/a>,<a href=\"#21\">21<\/a><\/sup><\/p><\/td>\n<\/tr>\n<tr class=\"row-10\">\n\t<td class=\"column-1\"><h2>TRANSMISSION<\/h2><\/td><td colspan=\"2\" class=\"column-2\"><p>RHDV is extremely contagious. RHDV is easily transmitted through direct rabbit-to-rabbit contact with bodily fluids (urine, feces, respiratory secretions) or hair from an infected animal.<sup><a href=\"#7\">7<\/a>,<a href=\"#21\">21<\/a><\/sup><\/p><br \/>\n<p>Transmission mainly occurs by the oral route but nasal or conjunctival exposure is also possible.<sup><a href=\"#2\">2<\/a>,<a href=\"#21\">21<\/a><\/sup><\/p><br \/>\n<p>RHDV is extremely stable in the environment.<sup><a href=\"#2\">2<\/a>,<a href=\"#7\">7<\/a><\/sup> Therefore exposure to fomites or mechanical vectors can transmit disease.<sup><a href=\"#7\">7<\/a>,<a href=\"#21\">21<\/a><\/sup> Virus can also persist for months in decomposing carcasses in the environment as well as frozen infected rabbit meat.<sup><a href=\"#2\">2<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#21\">21<\/a><\/sup> Importation of rabbit meat and byproducts may play an important role in the introduction of RHDV into new geographic regions.<sup><a href=\"#7\">7<\/a>,<a href=\"#21\">21<\/a><\/sup><\/p><\/td>\n<\/tr>\n<tr class=\"row-11\">\n\t<td class=\"column-1\"><h2>INCUBATION<\/h2><\/td><td class=\"column-2\"><p>Shorter incubation periods of 1-3 days <sup><a href=\"#2\">2<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#21\">21<\/a><\/sup><\/p> <\/td><td class=\"column-3\"><p>Longer, more variable incubation period of 3-9 days <sup><a href=\"#2\">2<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#16\">16<\/a><\/sup><\/p><\/td>\n<\/tr>\n<tr class=\"row-12\">\n\t<td colspan=\"3\" class=\"column-1\"><h2>CLINICAL PICTURE<\/h2><\/td>\n<\/tr>\n<tr class=\"row-13\">\n\t<td class=\"column-1\">Mortality rate<\/td><td class=\"column-2\">70-90% in adult rabbits <sup><a href=\"#6\">6<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#18\">18<\/a>,<a href=\"#20\">20<\/a><\/sup><\/td><td class=\"column-3\">RHDV2 strains have become progressively more virulent over time, ranging from 70-100%<sup><a href=\"#6\">6<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#20\">20<\/a><\/sup><\/td>\n<\/tr>\n<tr class=\"row-14\">\n\t<td class=\"column-1\">Duration<\/td><td class=\"column-2\">Death usually occurs 12\u201336 hours after the onset of fever <sup><a href=\"#7\">7<\/a>,<a href=\"#18\">18<\/a>,<a href=\"#20\">20<\/a>,<a href=\"#21\">21<\/a><\/sup><\/td><td class=\"column-3\">More prolonged period of illness before death (up to 5  days)<sup><a href=\"#16\">16<\/a><\/sup><\/td>\n<\/tr>\n<tr class=\"row-15\">\n\t<td class=\"column-1\"><\/td><td colspan=\"2\" class=\"column-2\">The clinical syndromes caused by RHDV and RHDV2 are similar.<sup><a href=\"#6\">6<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#18\">18<\/a><\/sup> RHD often presents as peracute to acute disease. <br \/>\n<br \/>\nIn peracute cases, the only clinical signs may be sudden death without premonitory clinical signs except for vocalizations followed rapidly by collapse and death.<sup><a href=\"#7\">7<\/a>,<a href=\"#18\">18<\/a><\/sup> <br \/>\n<br \/>\nThe acute form of disease often begins as fever (>40\u00b0C or 104\u00b0F) followed by a wide range of progressive clinical signs related to circulatory shock, liver failure, and <a href=\"https:\/\/lafeber.com\/vet\/laboratory-assessment-of-the-bleeding-exotic-animal-patient\/#Disseminated_intravascular_coagulation\"> disseminated intravascular coagulation <\/a> or DIC: <sup><a href=\"#2\">2<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#8\">8<\/a>,<a href=\"#18\">18<\/a>,<a href=\"#20\">20<\/a><\/sup>  <br \/>\n<ul><br \/>\n<li>Neurologic signs, such as loss of balance, opisthotonos, ataxia, paralysis, or terminal seizure activity <\/li><br \/>\n<li>Respiratory signs (dyspnea)<\/li><br \/>\n<li>Congestion of palpebral conjunctiva<\/li><br \/>\n<li>Non-specific signs of illness, such as lethargy and hyporexia or anorexia<\/li><br \/>\n<li>Jaundice<\/li><br \/>\n<li>Fever can progress to hypothermia<\/li><br \/>\n<li>Bleeding from the eyes, nose, mouth, and rectum, and hematochezia secondary to anemia and coagulopathies.<\/li><br \/>\n<li>Death can occur within 12-36 (possibly up to 48) hours after clinical signs appear. Free-ranging lagomorphs may be found dead.<\/li><br \/>\n<\/ul><br \/>\nApproximately 5 to 10% of rabbits display a subacute to chronic clinical course.<sup>1,21<\/sup> The clinical picture is often similar to that seen with the acute form, but with less severe clinical signs:<sup><a href=\"#4\">4<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#18\">18<\/a>,<a href=\"#21\">21<\/a><\/sup><br \/>\n<ul><br \/>\n<li>Non-specific signs of illness:  lethargy, anorexia, weight loss<\/li><br \/>\n<li>Jaundice<\/li><br \/>\n<li>Gastrointestinal dilation <\/li><br \/>\n<li>Cardiac arrhythmia, heart murmur<\/li><br \/>\n<li>Neurologic deficits <\/li><br \/>\n<li>Death can occur within 1\u20132 weeks, although some adult rabbits survive.<\/li><br \/>\n<\/ul><\/td>\n<\/tr>\n<tr class=\"row-16\">\n\t<td class=\"column-1\"><h2>DIAGNOSIS<\/h2><\/td><td colspan=\"2\" class=\"column-2\">A presumptive diagnosis of RHD is often based on history, risk assessment, and clinical findings.<br \/>\n<br \/>\nAmerican veterinarians that suspect RHD should contact their <a href=\"https:\/\/www.fsis.usda.gov\/sites\/default\/files\/media_file\/2022-04\/STATE_ANIMAL_HEALTH_OFFICIALS%202022.pdf\" target=\"_blank\" rel=\"noopener\">state veterinarian<\/a> to receive instructions on testing and reporting.  <\/td>\n<\/tr>\n<tr class=\"row-17\">\n\t<td class=\"column-1\"><br \/>\n<a href=\"https:\/\/lafeber.com\/vet\/clinical-pathology-for-exotic-small-mammals\/\">Minimum database<\/a> <sup><a href=\"#7\">7<\/a>,<a href=\"#18\">18<\/a><\/sup><\/td><td class=\"column-2\"><br \/>\nComplete blood count<\/td><td class=\"column-3\"><ul><br \/>\n<li>Leukopenia<\/li><br \/>\n<li>Thrombocytopenia<\/li><br \/>\n<\/ul>  <\/td>\n<\/tr>\n<tr class=\"row-18\">\n\t<td class=\"column-1\"><\/td><td class=\"column-2\"><br \/>\n<a href=\"https:\/\/lafeber.com\/vet\/laboratory-assessment-of-the-bleeding-exotic-animal-patient\/\">Coagulation tests<\/a><\/td><td class=\"column-3\"><ul><br \/>\n<li>Decreased fibrinogen<\/li><br \/>\n<li>Prolonged prothrombin and activated partial thromboplastin times<\/li><br \/>\n<\/ul><\/td>\n<\/tr>\n<tr class=\"row-19\">\n\t<td class=\"column-1\"><\/td><td class=\"column-2\"><br \/>\nBiochemistry panel<\/td><td class=\"column-3\"><ul><br \/>\n<li>Elevated gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP)<\/li><br \/>\n<li>Elevated bile acids<\/li><br \/>\n<li>Hyperbilirubinemia <\/li><br \/>\n<li>Changes in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activity *<\/li><br \/>\n<li>Hypoglycemia <\/li><br \/>\n<li>Hypocholesterolemia<\/li><br \/>\n<\/ul><br \/>\n*<small>Liver enzymes can be decreased <sup>6<\/sup> or elevated (M. Gleeson, written communication, Mar 18, 2023).<\/small><\/td>\n<\/tr>\n<tr class=\"row-20\">\n\t<td class=\"column-1\"><\/td><td class=\"column-2\"><br \/>\nUrinalysis <\/td><td class=\"column-3\"><ul><br \/>\n<li>Bilirubinuria<\/li><br \/>\n<li>Proteinuria<\/li><br \/>\n<li>Elevated urinary GGT<\/li><br \/>\n<\/ul><br \/>\n<\/td>\n<\/tr>\n<tr class=\"row-21\">\n\t<td class=\"column-1\">Gross necropsy lesions<\/td><td colspan=\"2\" class=\"column-2\"><p>Common necropsy lesions include pallor and a friable liver due to necrosis, splenomegaly, and epistaxis. There may also be evidence of disseminated intravascular coagulation, such as petechiation and hyperemia or hemorrhage of the trachea, lungs, heart, liver, spleen, and kidneys.<sup><a href=\"#2\">2<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#21\">21<\/a><\/sup> It is also possible for there to be no gross necropsy findings in rabbits that die peracutely.<sup><a href=\"#14\">14<\/a><\/sup><\/p> <\/td>\n<\/tr>\n<tr class=\"row-22\">\n\t<td class=\"column-1\">Histopathology<\/td><td colspan=\"2\" class=\"column-2\"><p>The most common histopathologic findings include extensive, multifocal to massive hepatocellular necrosis and multifocal to diffuse splenic necrosis. <sup><a href=\"#7\">7<\/a>,<a href=\"#18\">18<\/a> <\/sup>Bronchopneumonia, pulmonary hemorrhage or pulmonary edema, and cardiomyocyte necrosis, may be seen in some subacute to chronic cases.<sup><a href=\"#7\">7<\/a><\/sup><\/p><\/td>\n<\/tr>\n<tr class=\"row-23\">\n\t<td class=\"column-1\">Laboratory testing<\/td><td colspan=\"2\" class=\"column-2\"><p>Reverse transcription (RT) PCR and antigen ELISA are the most commonly used tests to identify the presence of virus.<sup><a href=\"#2\">2<\/a>,<a href=\"#6\">6<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#20\">20<\/a>,<a href=\"#21\">21<\/a><\/sup> Test results typically take only 1-5 business days, but unfortunately, many animals have already succumbed to the virus. Most animals will also die before an antibody response can be detected by Ab ELISA. Therefore testing is most helpful in caring for other animals at risk of exposure and preventing viral spread.<\/p><br \/>\n<p>PCR testing is best performed on fresh or frozen liver samples, but virus may also be detected in the spleen.<sup><a href=\"#2\">2<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#20\">20<\/a><\/sup> Formalin fixed tissue can also be submitted for histopathology.<sup><a href=\"#7\">7<\/a>,<a href=\"#21\">21<\/a><\/sup><\/p> <br \/>\n<p>For antemortem testing, PCR can be performed on urine, feces, or serum collected from convalescent rabbits up to 15 weeks post-infection but results can be inconsistent.<sup><a href=\"#7\">7<\/a>,<a href=\"#20\">20<\/a><\/sup><\/p><br \/>\n<br \/>\nLaboratories currently offering RHD testing include (but are not limited to):  <br \/>\n<ul><br \/>\n<li><a href=\"https:\/\/battlab.com\/rabbit-haemorrhagic-disease-rhd-pcr-testing-available-battlab\/\" target=\"_blank\" rel=\"noopener\">Batt Laboratories<\/a>; United Kingdom<\/li><br \/>\n<li><a href=\"https:\/\/vetmed.iastate.edu\/rabbit-hemorrhagic-disease-virus-2\" target=\"_blank\" rel=\"noopener\">Iowa State University<\/a>, Veterinary Diagnostic Laboratory<\/li><br \/>\n<li><a href=\"https:\/\/laboklin.com\/sk\/products\/infectious-diseases-pathogenic-agents-and-antibody-detection\/viruses\/rabbit-haemorrhagic-disease-virus-rhdv\/\" target=\"_blank\" rel=\"noopener\">Laboklin<\/a>; Germany <\/li><br \/>\n<li><a href=\"https:\/\/www.aphis.usda.gov\/animal_health\/lab_info_services\/downloads\/FADDLDiagnosticTestingCatalog.pdf\" target=\"_blank\" rel=\"noopener\">National Veterinary Services Laboratory<\/a>; FADDL, Plum Island, NY**<\/li><br \/>\n<li> <a href=\"https:\/\/vetmed.oregonstate.edu\/diagnostic\/tests\/rabbit-hemorrhagic-disease-virus-2-pcr-rhdv2-2\/\" target=\"_blank\" rel=\"noopener\">Oregon State University<\/a>, Carlson College of Veterinary Medicine<\/li><br \/>\n<li> <a href=\"https:\/\/palsvetlab.co.uk\/about-us\/\" target=\"_blank\" rel=\"noopener\">Pinmoore Animal Laboratory Services<\/a>; United Kingdom <\/li><br \/>\n<li><a href=\"https:\/\/www.uoguelph.ca\/ahl\/services\/rabbit-hemorrhagic-disease-virus-2-pcr\" target=\"_blank\" rel=\"noopener\">University of Guelph<\/a>, Animal Health Laboratory<\/li><br \/>\n<li><a href=\"https:\/\/zoologix.com\/rodent\/Datasheets\/RabbitHemorrhagicDisease.htm\" target=\"_blank\" rel=\"noopener\">Zoologix Molecular Diagnostic Testing for Animals<\/a>; California<\/li><br \/>\n<\/ul><br \/>\nAdditional test methods that are used less commonly include electron microscopy, immunohistochemistry, Western blotting, in-situ hybridization, <a href=\"https:\/\/lafeber.com\/vet\/the-importance-of-next-generation-sequencing-in-avian-veterinary-medicine\/#What_is_next-generation_sequencing\"> next-generation sequencing<\/a>, and hemagglutination inhibition.<sup><a href=\"#2\">2<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#20\">20<\/a> <\/sup><\/p><br \/>\n<br \/>\n**<small>Plum Island currently does not offer antemortem testing because of inconsistent test results; Ab ELISA is performed for export purposes. <\/small><\/td>\n<\/tr>\n<tr class=\"row-24\">\n\t<td class=\"column-1\">Definitive diagnosis <\/td><td colspan=\"2\" class=\"column-2\"><p>Like most caliciviruses, RHDV cannot be grown in cell culture. Therefore rabbit inoculation is necessary to isolate virus. This method is not used for routine diagnosis due to animal welfare concerns. <sup><a href=\"#2\">2<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#20\">20<\/a>,<a href=\"#21\">21<\/a><\/p> <p>When sudden deaths of multiple rabbits occur within a household or collection, the most useful diagnostic test is necropsy and testing of samples from deceased rabbits.<\/p><\/td>\n<\/tr>\n<tr class=\"row-25\">\n\t<td class=\"column-1\"><h2>THERAPY<\/h2><\/td><td colspan=\"2\" class=\"column-2\"><p>There is no specific treatment for RHDV, however <a href=\"https:\/\/lafeber.com\/vet\/exotic-icu-nursing-care-for-exotic-companion-mammals\/\">supportive care<\/a> can be rewarding, particularly in adult rabbits suffering from the subacute to chronic form of disease.<sup><a href=\"#7\">7<\/a><\/sup><\/p><\/td>\n<\/tr>\n<tr class=\"row-26\">\n\t<td colspan=\"3\" class=\"column-1\"><h2>PREVENTION AND CONTROL<\/h2><\/td>\n<\/tr>\n<tr class=\"row-27\">\n\t<td class=\"column-1\">Where RHD is absent...<\/td><td colspan=\"2\" class=\"column-2\"><p>Prevent the introduction of virus through restrictions on importation of animals or products from endemic areas.<sup><a href=\"#7\">7<\/a>,<a href=\"#19\">19<\/a><\/sup><\/p><\/td>\n<\/tr>\n<tr class=\"row-28\">\n\t<td class=\"column-1\">When an outbreak occurs...<\/td><td colspan=\"2\" class=\"column-2\"><p>Eradicate disease through strict quarantine, depopulation, disinfection, and serosurveillance.<sup><a href=\"#7\">7<\/a><\/sup> Vaccination of all animals is also recommended as successful post-exposure prophylaxis has been seen.<sup><a href=\"#7\">7<\/a><\/sup><\/p><\/td>\n<\/tr>\n<tr class=\"row-29\">\n\t<td class=\"column-1\"><br \/>\nWhen disease is endemic... <\/td><td colspan=\"2\" class=\"column-2\"><ol><br \/>\n<li>Isolate infected rabbits <\/li><br \/>\n<ul><br \/>\n<li>Any animal known or suspected to be infected should be immediately isolated; surviving rabbits can carry virus for up to 2 months.<sup><a href=\"#7\">7<\/a><\/sup> <br \/>\n<li>Also strive to identify subclinical carriers that can shed virus for months without obvious signs of disease.<sup><a href=\"#7\">7<\/a>,<a href=\"#21\">21<\/a><\/sup><\/li><br \/>\n<\/ul><br \/>\n<li>Practice proper biosecurity, such as hand washing, clothes changes between rabbit groups, etc.<\/li><br \/>\n<li>Disinfect and sanitize<\/li><br \/>\n<ul><br \/>\n<li>RHDV can be inactivated using sodium hypochlorite (0.5%\u20131%), phenolics such as 1-Stroke Environ<sup>\u00ae<\/sup> (2%) (Vestal Lab Inc., St. Louis, MO, USA), accelerated hydrogen peroxide products like REScue<sup>TM<\/sup> (Virox Animal Health, ON, Canada), chloramine, sodium hydroxide (1%), or formalin (1%\u20132%).<sup><a href=\"#7\">7<\/a>,<a href=\"#21\">21<\/a> <\/sup><\/li><br \/>\n<li>Higher concentrations of formalin (3%) are recommended for disinfecting pelts.<sup><a href=\"#7\">7<\/a>,<a href=\"#21\">21<\/a><\/sup><\/li><br \/>\n<li>Incineration of infected material and cremation of carcasses is also recommended.<sup><a href=\"#7\">7<\/a><\/sup><\/li><br \/>\n<li>Visit <a href=\"https:\/\/www.aphis.usda.gov\/animal_health\/downloads\/rhdv-cleaning-guidance.pdf\" target=\"_blank\" rel=\"noopener\">General Guidance for Cleaning and Disinfection of Rabbit Hemorrhagic Disease Virus (RHDV) Contaminated Premises<\/a> by the United States Department of Agriculture, Animal Plant Health Inspection Services for additional information.<\/li><br \/>\n<\/ul><br \/>\n<li>Institute appropriate vaccination protocols<\/li><br \/>\n<ul><br \/>\n<li>In many countries where RHD is endemic, vaccinations have been administered to susceptible rabbits and high-risk populations for many years. <\/li><br \/>\n<li>In Europe, vaccines available include highly efficacious inactivated (killed), commercial vaccines available as well as recombinant vaccines:<sup><a href=\"#5\">5<\/a>,<a href=\"#6\">6<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#21\">21<\/a><\/sup> <br \/>\n<ul><br \/>\n<li><a href=\"https:\/\/www.ema.europa.eu\/en\/medicines\/veterinary\/EPAR\/eravac\" target=\"_blank\" rel=\"noopener\">Eravac<\/a> (Spain) is a monovalent RHDV2 vaccine primarily used in the rabbit-meat farming industry. <br \/>\n<li><a href=\"https:\/\/www.harcourt-brown.co.uk\/media\/documents\/filavac.doc\" target=\"_blank\" rel=\"noopener\">Filavac<\/a> (VHD K C+V, France) is a bivalent vaccine effective against both RHDV and RHDV2 that is widely used in pet rabbits in the United Kingdom and continental Western Europe. <br \/>\n<li><a href=\"https:\/\/www.ema.europa.eu\/en\/medicines\/veterinary\/EPAR\/fatrovax-rhd\" target=\"_blank\" rel=\"noopener\">Fatrovax RHD<\/a> (Italy) is effective against RHDV1 and RHDV2.<br \/>\n<li><a href=\"https:\/\/www.ema.europa.eu\/en\/medicines\/veterinary\/EPAR\/nobivac-myxo-rhd\" target=\"_blank\" rel=\"noopener\">Nobivac Myxo-RHD<\/a> (The Netherlands) is a recombinant vaccine that protects against RHDV1 and myxomatosis. <br \/>\n<li><a href=\"https:\/\/www.ema.europa.eu\/en\/medicines\/veterinary\/EPAR\/nobivac-myxo-rhd-plus\" target=\"_blank\" rel=\"noopener\">Nobivac Myxo-RHD Plus<\/a> protects against RHDV1, RHDV2,  and myxomatosis.<br \/>\n<li>Visit the <a href=\"https:\/\/www.harcourt-brown.co.uk\/articles\/infectious-disease\/rabbit-haemorrhagic-disease\/vaccination-against-rhd\" target=\"_blank\" rel=\"noopener\">Frances Harcourt-Brown website<\/a> for detailed information on vaccines against RHD available in the UK<\/li><br \/>\n<\/ul><br \/>\nThe vaccines available in Europe are not licensed in the United States and are only available on a limited basis.<sup><a href=\"#5\">5<\/a><\/sup> In 2021, the US Department of Agriculture authorized emergency use of the <a href=\"https:\/\/medgenelabs.com\/rhdv2\/\" target=\"_blank\" rel=\"noopener\">Medgene RHDV2 vaccine<\/a> (Medgene Labs, Brookings, SD, USA).<sup><a href=\"#5\">5<\/a>,<a href=\"#13\">13<\/a><\/sup><br \/>\n<ul><br \/>\n<li>In a challenge study, this inactivated, recombinant subunit vaccine was administered subcutaneously as a two-dose regimen (0.5-ml), administered 21 days apart.<sup><a href=\"#5\">5<\/a>,<a href=\"#13\">13<\/a><\/sup>. More research is needed for full protocol recommendations.<br \/>\n<li>The vaccine proved effective in preventing mortality in 100% of rabbits challenged with live virus (n=9).<sup><a href=\"#5\">5<\/a>,<a href=\"#13\">13<\/a><\/sup> <br \/>\n<li>Clinicians using this vaccine should ideally maintain a record of vaccinated rabbits that includes any adverse effects or breakthrough cases.<\/li><br \/>\n<\/ul><br \/>\n<\/ol><br \/>\nCross protection between RHDV2 vaccines and RHDV\/RHDVa vaccines is poor.<sup><a href=\"#6\">6<\/a>,<a href=\"#7\">7<\/a>,<a href=\"#20\">20<\/a>,<a href=\"#21\">21<\/a><\/sup> Current recommendations in endemic countries is to vaccinate against both variants RHDVa and RHDV-2.<\/p><br \/>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<!-- #tablepress-666 from cache -->\n<p>&nbsp;<\/p>\n<h2><strong>SUMMARY<\/strong><\/h2>\n<p>Rabbit hemorrhagic disease is a highly infectious, fatal viral hepatitis of lagomorphs caused by a calicivirus<em>.<\/em> There are three major pathogenic rabbit hemorrhagic disease virus genotypes: \u00a0\u00a0classical RHDV, RHDVa, and RHDV2. Rabbit hemorrhagic disease virus type 2 has now become the dominant subtype in endemic countries, and outbreaks affecting both domestic and wild rabbits have occurred in North America. Virus is easily transmitted through direct rabbit-to-rabbit contact with bodily fluids or hair through the oral, nasal, or conjunctival routes. Disease can also be transmitted through indirect contact with fomites or mechanical vectors. The incubation period often ranges from 1 to 6 days. While disease caused by RHDV1\/RHDVa is restricted to domestic European rabbits, the host range is wider for RHDV2 and includes not only the European rabbit but several species of wild lagomorphs. Also, disease caused by RHDV1\/RHDVa occurs primarily in adult rabbits, while disease caused by RHDV2 is seen in rabbits of all ages as young as 7-15 days old.<\/p>\n<p>Rabbit hemorrhagic disease is characterized by high morbidity and high mortality. Clinical signs associated with acute disease can include neurologic and respiratory signs, non-specific signs of illness, jaundice, and bleeding. Death usually occurs 12\u201336 hours after the onset of fever. A presumptive diagnosis of RHD is often based on history, risk assessment, and clinical findings. When sudden deaths of multiple rabbits occur within a household or collection, the most useful diagnostic test is necropsy and testing of samples from deceased rabbits. Viral loads are particularly high in the liver and spleen. PCR is most commonly used to identify the presence of virus. Prevention and control of disease relies upon strict biosecurity protocols, stringent disinfection, and vaccination.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h2 class=\"ref\">REFERENCES<\/h2>\n","protected":false},"excerpt":{"rendered":"<p>Rabbit hemorrhagic disease is a highly infectious fatal viral hepatitis affecting lagomorphs, including the European rabbit. There are three major pathogenic RHDV genotypes:  classical RHDV (RHDV1), RHDVa, which is closely related to RHDV1, and rabbit hemorrhagic disease virus type 2 (RHDV2). RHDV2 has now become the dominant subtype in endemic countries, and sporadic cases have been confirmed in North America. Use \u201cFast Facts\u201d to review the basics of this condition,  from etiologic agent, pathogenesis, and clinical signs to diagnosis, prevention, and control. <\/p>\n","protected":false},"author":5,"featured_media":61894,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[1335,707,5770,5601,5771,1357],"class_list":["post-62668","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-hepatitis","tag-lagomorph","tag-rhd","tag-rhdv","tag-rhdv-2","tag-vaccination","topics-hepatology","topics-infectious-disease","topics-preventive-medicine","procedures-clinical-pathology","procedures-diagnostics","species-mammals","species-rabbit","contributor-pollock","contributor-mohamed","contributor-murray-ji","contributor-gleeson"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Fast Facts on Rabbit Hemorrhagic Disease - LafeberVet<\/title>\n<meta name=\"description\" content=\"Rabbit hemorrhagic disease is a highly infectious fatal viral hepatitis affecting lagomorphs, including the European rabbit. There are three major pathogenic RHDV genotypes: classical RHDV (RHDV1), RHDVa, which is closely related to RHDV1, and rabbit hemorrhagic disease virus type 2 (RHDV2). RHDV2 has now become the dominant subtype in endemic countries, and sporadic cases have been confirmed in North America. 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RHDV2 has now become the dominant subtype in endemic countries, and sporadic cases have been confirmed in North America. Use \u201cFast Facts\u201d to review the basics of this condition, from etiologic agent, pathogenesis, and clinical signs to diagnosis, prevention, and control.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/lafeber.com\/vet\/fast-facts-on-rabbit-hemorrhagic-disease\/\" \/>\n<meta property=\"og:site_name\" content=\"LafeberVet\" \/>\n<meta property=\"article:published_time\" content=\"2023-01-25T17:19:13+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-02-08T07:11:28+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2022\/10\/EnglishSpot-cropped-square.png\" \/>\n\t<meta property=\"og:image:width\" content=\"700\" \/>\n\t<meta property=\"og:image:height\" content=\"700\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Christal Pollock, DVM, DABVP (Avian Practice)\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Christal Pollock, DVM, DABVP (Avian Practice)\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/lafeber.com\\\/vet\\\/fast-facts-on-rabbit-hemorrhagic-disease\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/lafeber.com\\\/vet\\\/fast-facts-on-rabbit-hemorrhagic-disease\\\/\"},\"author\":{\"name\":\"Christal Pollock, DVM, DABVP (Avian Practice)\",\"@id\":\"https:\\\/\\\/lafeber.com\\\/vet\\\/#\\\/schema\\\/person\\\/c81ad95bd36f6c15774985ab6dc5d274\"},\"headline\":\"Fast Facts on Rabbit Hemorrhagic Disease\",\"datePublished\":\"2023-01-25T17:19:13+00:00\",\"dateModified\":\"2025-02-08T07:11:28+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/lafeber.com\\\/vet\\\/fast-facts-on-rabbit-hemorrhagic-disease\\\/\"},\"wordCount\":428,\"image\":{\"@id\":\"https:\\\/\\\/lafeber.com\\\/vet\\\/fast-facts-on-rabbit-hemorrhagic-disease\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/lafeber.com\\\/vet\\\/wp-content\\\/uploads\\\/2022\\\/10\\\/EnglishSpot-cropped-square.png\",\"keywords\":[\"hepatitis\",\"lagomorph\",\"RHD\",\"RHDV\",\"RHDV-2\",\"vaccination\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/lafeber.com\\\/vet\\\/fast-facts-on-rabbit-hemorrhagic-disease\\\/\",\"url\":\"https:\\\/\\\/lafeber.com\\\/vet\\\/fast-facts-on-rabbit-hemorrhagic-disease\\\/\",\"name\":\"Fast Facts on Rabbit Hemorrhagic Disease - LafeberVet\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/lafeber.com\\\/vet\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/lafeber.com\\\/vet\\\/fast-facts-on-rabbit-hemorrhagic-disease\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/lafeber.com\\\/vet\\\/fast-facts-on-rabbit-hemorrhagic-disease\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/lafeber.com\\\/vet\\\/wp-content\\\/uploads\\\/2022\\\/10\\\/EnglishSpot-cropped-square.png\",\"datePublished\":\"2023-01-25T17:19:13+00:00\",\"dateModified\":\"2025-02-08T07:11:28+00:00\",\"author\":{\"@id\":\"https:\\\/\\\/lafeber.com\\\/vet\\\/#\\\/schema\\\/person\\\/c81ad95bd36f6c15774985ab6dc5d274\"},\"description\":\"Rabbit hemorrhagic disease is a highly infectious fatal viral hepatitis affecting lagomorphs, including the European rabbit. 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Use \u201cFast Facts\u201d to review the basics of this condition, from etiologic agent, pathogenesis, and clinical signs to diagnosis, prevention, and control.","og_url":"https:\/\/lafeber.com\/vet\/fast-facts-on-rabbit-hemorrhagic-disease\/","og_site_name":"LafeberVet","article_published_time":"2023-01-25T17:19:13+00:00","article_modified_time":"2025-02-08T07:11:28+00:00","og_image":[{"width":700,"height":700,"url":"https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2022\/10\/EnglishSpot-cropped-square.png","type":"image\/png"}],"author":"Christal Pollock, DVM, DABVP (Avian Practice)","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Christal Pollock, DVM, DABVP (Avian Practice)","Est. reading time":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/lafeber.com\/vet\/fast-facts-on-rabbit-hemorrhagic-disease\/#article","isPartOf":{"@id":"https:\/\/lafeber.com\/vet\/fast-facts-on-rabbit-hemorrhagic-disease\/"},"author":{"name":"Christal Pollock, DVM, DABVP (Avian Practice)","@id":"https:\/\/lafeber.com\/vet\/#\/schema\/person\/c81ad95bd36f6c15774985ab6dc5d274"},"headline":"Fast Facts on Rabbit Hemorrhagic Disease","datePublished":"2023-01-25T17:19:13+00:00","dateModified":"2025-02-08T07:11:28+00:00","mainEntityOfPage":{"@id":"https:\/\/lafeber.com\/vet\/fast-facts-on-rabbit-hemorrhagic-disease\/"},"wordCount":428,"image":{"@id":"https:\/\/lafeber.com\/vet\/fast-facts-on-rabbit-hemorrhagic-disease\/#primaryimage"},"thumbnailUrl":"https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2022\/10\/EnglishSpot-cropped-square.png","keywords":["hepatitis","lagomorph","RHD","RHDV","RHDV-2","vaccination"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/lafeber.com\/vet\/fast-facts-on-rabbit-hemorrhagic-disease\/","url":"https:\/\/lafeber.com\/vet\/fast-facts-on-rabbit-hemorrhagic-disease\/","name":"Fast Facts on Rabbit Hemorrhagic Disease - LafeberVet","isPartOf":{"@id":"https:\/\/lafeber.com\/vet\/#website"},"primaryImageOfPage":{"@id":"https:\/\/lafeber.com\/vet\/fast-facts-on-rabbit-hemorrhagic-disease\/#primaryimage"},"image":{"@id":"https:\/\/lafeber.com\/vet\/fast-facts-on-rabbit-hemorrhagic-disease\/#primaryimage"},"thumbnailUrl":"https:\/\/lafeber.com\/vet\/wp-content\/uploads\/2022\/10\/EnglishSpot-cropped-square.png","datePublished":"2023-01-25T17:19:13+00:00","dateModified":"2025-02-08T07:11:28+00:00","author":{"@id":"https:\/\/lafeber.com\/vet\/#\/schema\/person\/c81ad95bd36f6c15774985ab6dc5d274"},"description":"Rabbit hemorrhagic disease is a highly infectious fatal viral hepatitis affecting lagomorphs, including the European rabbit. There are three major pathogenic RHDV genotypes: classical RHDV (RHDV1), RHDVa, which is closely related to RHDV1, and rabbit hemorrhagic disease virus type 2 (RHDV2). RHDV2 has now become the dominant subtype in endemic countries, and sporadic cases have been confirmed in North America. 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