Pilot study of the financial and practice protocol impacts of canine influenza virus (H3N2) outbreaks in example veterinary practices.

Since March 2015, canine influenza virus (CIV) H3N2 has caused widespread outbreaks in dogs across the USA. The effects of local H3N2 outbreaks on veterinary practices were investigated using an online interface and followed with phone calls to respondents when necessary. An outbreak was defined as confirmed diagnosis of H3N2 by either PCR or serology in at least four dogs. Of 30 practices invited to participate, five met the entry criteria: at least one documented H3N2 outbreak in the previous 12 months, a predominantly (≥70%) small animal caseload, and adequate financial records to complete the survey. Respondents reported 1-3 H3N2 outbreaks/practice over the last 12 months, with 4-8 dogs diagnosed/outbreak. For each participating practice, self-reported direct financial impact data was collected from the single H3N2 outbreak that involved the most dogs. The two most substantial categories of self-reported financial loss occurred due to boarding facility closure (estimated cost per practice: median $5000), and treatment costs borne by the practice (estimated cost per practice: median $2850). Median extra biosecurity costs were $300/practice. Median total direct costs of an H3N2 outbreak were $8945/practice. Lost foot traffic included cancelled appointments, appointments redirected to other veterinary hospitals for the duration of the outbreak, and loss of revenue from ancillary services provided during usual business (calculated cost per practice: median $450). Cost/practice normalized by the number of fulltime veterinarians in each practice was calculated and additional effects, such as interruptions to daily practice routine, reduced productivity, reputation loss and poor staff morale, were also reported. Vaccination against H3N2 was introduced as part of routine practice vaccination protocols or was made mandatory before boarding in three of five practices. In the remaining two practices, a focus on client education about canine infectious disease, especially H3N2, emerged in response to outbreaks. H3N2 outbreaks had substantial impacts on veterinary practice finances, daily routines and staff morale, and was associated with enhancements in vaccination, biosecurity and client education protocols.