Feline calicivirus infection. ABCD guidelines on prevention and management

OVERVIEW: Feline calicivirus (FCV) is a highly variable virus. More severe, systemic forms of FCV infection have been observed recently. INFECTION: Sick, acutely infected or carrier cats shed FCV in oronasal and conjunctival secretions. Infection occurs mainly through direct contact. DISEASE SIGNS: The main clinical signs are oral ulcers, upper respiratory signs and a high fever. Feline calicivirus may be isolated from nearly all cats with chronic stomatitis or gingivitis. Cats with 'virulent systemic FCV disease' variably show pyrexia, cutaneous oedema, ulcerative lesions on the head and limbs, and jaundice. Mortality is high and the disease is more severe in adult cats. DIAGNOSIS: Diagnosis of FCV can be achieved by virus isolation or reverse-transcriptase PCR. Viral RNA can be detected in conjunctival and oral swabs, blood, skin scrapings or lung tissue using PCR. Positive PCR results should be interpreted with caution, as these may be a consequence of low-level shedding by persistently infected carriers. The diagnosis of virulent systemic FCV disease relies on clinical signs and isolation of the same strain from the blood of several diseased cats. DISEASE MANAGEMENT: Supportive therapy (including fluid therapy) and good nursing care are essential. Anorexic cats should be fed highly palatable, blended or warmed food. Mucolytic drugs (eg, bromhexine) or nebulisation with saline may offer relief. Broad-spectrum antibiotics may be administered to prevent secondary bacterial infections. Feline calicivirus can persist in the environment for about 1 month and is resistant to many common disinfectants. VACCINATION RECOMMENDATIONS: Two injections, at 9 and 12 weeks of age, are recommended, followed by a first booster 1 year later. In high-risk situations, a third vaccination at 16 weeks is recommended. Boosters should be given every 3 years. However, cats in high-risk situations should be revaccinated annually. Cats that have recovered from caliciviral disease are probably not protected for life, particularly if infected with different strains. Vaccination of these cats is still recommended.