What is ECE
Where did
it come from
Comment on ECE
How is it spread
More on Epizootic Catarrhal Enteritis
Who gets it
ECE: The FACT
Sheet
Can you protect against it
Uncomplicated ECE in a young, healthy ferret generally lasts 7-10 days, but in about 20% of cases, there is an extended illness due to an overaggressive immune response, which may lead to a chronic wasting syndrome for some time afterward. Ferrets who have had the disease remain carriers for some time afterward -- nobody's quite sure how long, but the best estimate is now six months, maybe longer. It's currently believed that ferrets who have had ECE can't get it again, but the irritated gut, especially in ferrets with the prolonged illness, is very sensitive to stress or upset, so "cured" ferrets may look like they've come down with it again when they haven't.
See the following sections for more information. Since this is a
fairly new disease, information about it is still being collected.
Please keep the dates of the articles in mind as you read them; where
the suggestions or theories in two articles conflict, the newer
article is likely to be more accurate.
Index
I spoke to Dr. Williams at great length about our experience and my thoughts on the disease and here is what I can tell you: The disease in question is an enteritis, or inflammation/infection of the intestine. It damages the mucosa (the delicate intestinal lining which is instrumental in absorbing nutrients and water into the body) resulting in diarrhea and excess mucous production. In severe cases there may be deep ulcerations and bleeding into the intestinal lumen. Stools can range from bright green, loose and slimy to dark red, black and tarry. Dr. Williams has seen the lining of the intestine remain abnormal for up to one year after the ferret initially showed signs of the disease. The cause is as yet unknown, but Dr. Williams, who has a great deal of experience looking microscopically at tissues affected by this problem, feels strongly that it may be a corona or rota virus.
The virus can be transmitted by infected fluids from the body. It can be spread through the air on tiny fluid particles or by direct contact with an infected ferret. The incubation period, according to Dr. Williams, is about 2 days and he feels there can be carrier animals for at least 4 months after the initial onset of disease. Carriers are those ferrets that have survived the disease and appear healthy but are shedding the virus in their stools and are therefore still infective to other ferrets.
The disease has a very high morbidity (number of animals affected by it) but a very low mortality (those that die as a result of infection). Ferrets do not die from the disease directly, but from a combination of factors that may have been exacerbated by the infection. In a multi-ferret household, once it enters it will affect nearly 100% of the population regardless of how sanitary the conditions are. With careful monitoring of sick animals and appropriate treatment, the mortality may be 0 to 2%.
In ferrets under three years of age, that have no other major health problems, the disease is fairly swift, causing only a few days of slimy green stool and then it is gone. Most of the youngsters do not need any medications, but one should watch closely to see that they are eating, drinking and urinating. If a ferret stops eating, becomes lethargic or dehydrated, then it may be necessary to give fluids either by mouth or under the skin by injection. Some ferrets benefit from a more bland diet until the stools form again, such as meat type baby food, or Science Diet AD. We sometimes give antibiotics to prevent secondary bacterial infections. It may also be helpful to use an intestinal coating agent such as Pepto Bismol or Kaopectate (1-2 cc two to three times daily) to coat the intestinal tract and soothe potentially ulcerated areas. [Carafate and Cytotec may also help; ask your vet.] There are a variety of other herbal and homeopathic remedies that have been tried. None have had consistent reproducible success, but if you would like to try any remedies, please consult your veterinarian first. Some products, such as vitamin C may actually make the problem worse because it is very irritating to the intestinal lining in the presence of inflammation.
The older ferrets, that likely have concurrent health problems such as lymphoma, insulinoma, adrenal disease, heart or kidney disease, may be more seriously affected. Although the percentage of animals that actually die even in this age group is very small, the disease can take a much longer time to resolve. Older ferrets are more likely to become dehydrated and develop bleeding intestinal ulcers. We treated one ferret successfully with multiple blood transfusions because her red blood cell count dropped dangerously low from intestinal bleeding. These patients need more intensive nursing care and have to be watched very carefully. Of course one will need to stay on top of all the other diseases that may be present and potentially weakening the pets immune system.
There is another part to this disease that we have observed over the
last few months and it has only been in the older ferret. We have
seen a number of ferrets over three years of age, usually with other
serious health problems, who successfully survive the diarrhea, only
to lose significant amounts of weight up to three weeks later. In my
discussion with Dr. Williams, he concurred that this was a problem of
absorption of nutrients from the intestinal lining. As mentioned, the
intestinal mucosa may continue to be abnormal for up to a year after
the initial infection. These animals have good appetites and normal
stools, but can't seem to keep the weight on. Each pet has to be
evaluated individually, but one may be able to keep the weight from
dropping by adding more fat to the diet, such as whipping cream or
egg yolk along with supplemental feedings of ferret or high quality cat
food. (Do NOT use dairy products when the ferret is experiencing
diarrhea, as it may make the problem worse.) Using high carbohydrate
foods doesn't seem to work. Ferrets use fat more efficiently for
energy than carbohydrates, so in a wasting situation, it is likely
more effective to increase the fat content of the diet. Be careful
about increasing the protein content (overuse of eggs) because some of
these older ferrets have underlying kidney disease which will worsen
in the presence of excess protein. Dr. Williams suggested that in
some cases, the use of corticosteroids may aid in keeping the weight
on because it may suppress the ongoing intestinal inflammation.
Please use such drugs only under the supervision of your veterinarian.
Index
More on Epizootic Catarrhal Enteritis (May 95)
We know that asymptomatic ferrets can harbor this virus for four months, perhaps even longer [updated to 6 months in Jan 1996], and shed it in small amounts in the feces. When you use the term "fully recovered" I assume you mean that the ferret no longer shows symptoms. That does not mean that the virus is totally gone from the body. Just because your ferret meets a ferret with the virus does not mean that your ferret will get it -- as it is probably spread via contact with the feces, there must be oral-fecal contact to spread this disease (ferrets using the same litter, etc.) [But it is -very- contagious -- see below].
The virus is most likely carried in the body for prolonged periods of time and animals may show disease over a period of time, especially under times of stress. It doesn't go dormant and hide in nervous tissue (as far as we know) like herpes viruses do, but probably maintains a low level by infecting low numbers of intestinal cells at any one given time.
Latest news on the ECE research - still haven't been able to propagate this virus in the lab. It appears to be extremely finicky in its requirements for continued growth, and until we can maintain cultures of the virus, any further developments, including vaccines, diagnostic tests, etc. must wait - as all require a stock of virus to develop.
Remember, research is a slow, painstaking process,and we appear to be
the only facility in the country doing any work on this virus.
(Remember it took YEARS to identify the HIV virus, and many many
facilities all over the world were working on that one....)
Index
This article is not intended to replace the advice of a good veterinarian.
We first saw this illness in our shelter in the last week of June, 1993. It was well over a month since we had attended any show, fun fest, or visited anywhere with our animals. Dr. Williams', other vets', and our own experience all indicate the virus, after exposure, manifests itself in 3 to 5 days. Also, it first hit three older ferrets who lived exclusively in our "rescue room." We have seen ourselves, and other owners have remarked upon, how any illness will travel from room to room or cage to cage when your animals are kept separate. This certainly happened here. First the rescue was hit, then our own animals.
The first few months were very hard. No one understood how the illness operated; what symptoms to watch for, or how to treat it. Two of our own animals were also hospitalized, and both lost over half their body weight. In those first six months, we lost two ferrets. One animal had insulinoma, which was the real culprit; another animal suffered severe intestinal collapse. Again, while the ECE triggered the problem, it was not the only cause. Through trial and error, we gradually learned more and more. Since that time, we have lost no further ferrets to this disease. We've had to fight to keep some going, but all the rest have struggled through.
Now we simply live with it on a daily basis, as a fact of our lives.
I'm sure many of the people who were hit with it initially are doing
the same thing. But now it seems to be spreading further west. Many
people who only heard of it before are now being faced head-on with
the problem and are understandably nervous. This article is meant to
dispel some of the myths and misconceptions as well as offer care
suggestions should your ferret be diagnosed with this illness. Please
consult with your vet for specific treatments and medicines.
Index
The disease was first publicly identified in the mid-Atlantic states
(Virginia, Maryland) in the spring of 1993. At the time, the area was
just recovering from a distemper outbreak that frightened many people
and forced shows to become very strict with vaccine proof and
disinfecting show tables. These were precautions that should have been
enforced all along, but had become lax. In retrospect, stiffer rules
probably helped prevent the spread of this virus via the East Coast
show circuit. However, as people were unaware of its "contagiousness,"
local breeders and friends who swapped animals for stud service or
visited may have unwittingly passed it on.
Index
Cases have been documented of this illness affecting a home without any contact of the ferrets or owners with shows, infected animals or homes. Often someone in the home had recently recovered from the flu. Several people in the ferret community believe this virus may have begun as a mutated human flu virus. The initial outbreak coincided with a particularly nasty flu season. Two years ago, Mary Van Dahm of F.A.I.R. ferret shelter in Illinois related how a similar type of virus had been reported there some years ago, also coinciding with a flu outbreak. Further evidence of this conclusion is that when Dr. [James] Fox and Dr. Susan Erdman of the Massachusetts Institute of Technology first began to study the illness, we understand the only infection they were able to isolate was an influenza strain. I am quite sure this is how the FACT, Inc. shelter became exposed.
Early on, rumors abounded in the absence of any real information.
There have been scattered reports of people claiming to have become
infected at shows. Every event I have attended had required champion
judges as well as specialty ring judges to disinfect tables and their
hands between animals with Nolvasan or a similar bacterial cleanser,
and I have heard of no instances of transmission from these specific
events. Many shows also now standardly issue a health notice that
warns attendees not to "pass around" ferrets and to wash hands
thoroughly before and after handling another person's animal. I cannot
speak for how some other events may operate; however, IF these
procedures are faithfully followed, there should be little risk of
exposure. Unconfirmed rumors currently exist that say some pet shop
kits may recently have become carriers as well.
Index