{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:52:14Z","timestamp":1791237134928,"version":"4.1.0"},"reference-count":43,"publisher":"American Association of Zoo Veterinarians","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Zoo and Wildlife Medicine"],"published-print":{"date-parts":[[2026,5,5]]},"abstract":"<jats:p>Elephant endotheliotropic herpesvirus hemorrhagic disease (EEHV-HD) is an important cause of morbidity and mortality in juvenile Asian (Elephas maximus) and African (Loxodonta africana) elephants in human care. Measures of disease frequency have not been rigorously established for EEHV in any elephant population. The objective of this retrospective descriptive epidemiologic study was to determine period prevalence, cumulative incidence, and incidence rate (IR) for EEHV infection and EEHV-HD in the US elephant population between 2014 and 2024. A case of EEHV infection was defined as an elephant of any age with an episode of EEHV viremia with levels &gt;1,000 viral genome equivalents (vge)\/ml, and a case of EEHV-HD was defined as a juvenile elephant with EEHV viremia levels &gt;5,000 vge\/ml, along with the presence of clinical signs, blood work abnormalities, or pathologic evidence suggesting vasculopathy. After institutional approval for data transfer, deidentified whole-blood EEHV qPCR results from the National Zoo Elephant Herpesvirus Laboratory were analyzed. The data originated from 30 zoos, encompassing 234 elephants, and included &gt;23,000 PCR reactions. EEHV1A and 3A were the most prevalent and incident EEHV types for Asian and African elephants, respectively. Analyses indicated that if 100 juvenile Asian elephants were monitored over 1 yr, 7.91 new cases of EEHV1A-HD would occur in the United States. Similarly, 4.81 new cases of EEHV3A-HD would be expected to occur if 100 juvenile African elephants were monitored over 1 yr in the United States. EEHV6-HD appears to pose an underreported threat to African elephants with an IR of 1.46\/100 elephant years.<\/jats:p>","DOI":"10.1638\/2025-0073","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:46:48Z","timestamp":1777952808000},"page":"378-387","source":"Crossref","is-referenced-by-count":0,"title":["MEASURES OF DISEASE FREQUENCY FOR ELEPHANT ENDOTHELIOTROPIC HERPESVIRUS INFECTION AND HEMORRHAGIC DISEASE IN THE UNITED STATES ELEPHANT POPULATION FROM 2014 TO 2024"],"prefix":"10.1638","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7076-3842","authenticated-orcid":false,"given":"Marjorie","family":"Bercier","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Latimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1213","reference":[{"key":"5","doi-asserted-by":"publisher","unstructured":"K Boonprasert, V 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probosciviruses (EEHV5 and EEHV6) and two new gammaherpesviruses (EGHV3B and EGHV5).\" 28 (2011)","DOI":"10.1016\/j.vetmic.2010.05.042"},{"key":"27","unstructured":"KL Perrin, S Saxmose Nielsen, T Martinussen, et al.  \"J Zoo Aquar Res.\"  9, \"Quantification and risk factor analysis of elephant endotheliotropic herpesvirus-haemorrhagic disease fatalities in Asian elephants (Elephas maximus) in Europe (1985\u20132017).\" 8 (2021)"},{"key":"35","doi-asserted-by":"crossref","unstructured":"JJ Stanton, J-C Zong, E Latimer, et al.  \"Am J Vet Res.\"  71, \"Detection of pathogenic elephant endotheliotropic herpesvirus in routine trunk washes from healthy adult Asian elephants (Elephas maximus) by use of a real-time quantitative polymerase chain reaction assay.\" 925 (2010)","DOI":"10.2460\/ajvr.71.8.925"},{"key":"1","doi-asserted-by":"publisher","unstructured":"M Ackermann, JM Hatt, N Schetle, et al.  \"PLoS One.\"  \"Identification of shedders of elephant endotheliotropic herpesviruses 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G Maurer, et al.  \"Viruses.\"  \"Elephant endotheliotropic herpesvirus is omnipresent in elephants in European zoos and an Asian elephant range country.\" 2021","DOI":"10.3390\/v13020283"},{"key":"19","doi-asserted-by":"crossref","unstructured":"TJ Kerr, J van Heerden, WJ Goosen, et al.  \"J Wildl Dis.\"  59, \"Detection of elephant endotheliotropic herpesvirus (EEHV) in free-ranging African elephants (Loxodonta africana) in the Kruger National Park, South Africa.\" 128 (2023)","DOI":"10.7589\/JWD-D-22-00015"},{"key":"20","doi-asserted-by":"publisher","unstructured":"S Khammesri, Y Mathura, K Boonprasert, et al.  \"J Vet Med Sci.\"  \"Successful treatment of elephant endotheliotropic herpesvirus infection in an Asian elephant (Elephas maximus) calf by oral acyclovir medication: case report.\" 2021","DOI":"10.1292\/jvms.20-0375"},{"key":"23","doi-asserted-by":"crossref","unstructured":"P Ling  and E Latimer  \"Fowler's zoo and wild animal medicine, Volume 10, Current therapy.\"  \"Elephant endotheliotropic herpesvirus update.\" 633 (2023)","DOI":"10.1016\/B978-0-323-82852-9.00091-5"},{"key":"25","doi-asserted-by":"publisher","unstructured":"S Pavulraj, K Eschke, A Prahl, et al.  \"Microorganisms.\"  \"Fatal elephant endotheliotropic herpesvirus infection of two young Asian elephants.\" (2019)","DOI":"10.3390\/microorganisms7100396"},{"key":"26","unstructured":"KL Perrin, J Lopez, F Molenaar, et al.  \"J Zoo Aquar Res.\"  10, \"Current surveillance practices for shedding of elephant endotheliotropic herpesviruses in breeding and bachelor Asian elephant (Elephas maximus) herds in Europe.\" 183 (2022)"},{"key":"28","doi-asserted-by":"crossref","unstructured":"P Prompiram, W Wiriyarat, B Bhusri, et al.  \"Vet World.\"  14, \"The occurrence of elephant endotheliotropic herpesvirus infection in wild and captive Asian elephants in Thailand: investigation based on viral DNA and host antibody.\" 545 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Vaughan-Higgins, et al.  \"Arch Virol.\"  165, \"Subclinical infection of captive Asian elephants (Elephas maximus) in Thailand with elephant endotheliotropic herpesvirus.\" 397 (2020)","DOI":"10.1007\/s00705-019-04469-6"},{"key":"36","doi-asserted-by":"crossref","unstructured":"C Stremme, A Priadi, GS Hayward, et al.  \"J Zoo Wildl Med.\"  51, \"Identification of two lethal cases of elephant endotheliotropic herpesvirus hemorrhagic disease in Sumatran elephant calves in Indonesia.\" 985 (2021)","DOI":"10.1638\/2020-0003"},{"key":"37","doi-asserted-by":"crossref","unstructured":"H Sylvester, J Raines, A Burgdorf-Moisuk, et al.  \"J Zoo Wildl Med.\"  55, \"Selected instances of elephant endotheliotropic herpesvirus shedding in trunk secretions by African elephants (Loxodonta africana) in comparison to shedding by Asian elephants (Elephas maximus).\" 182 (2024)","DOI":"10.1638\/2022-0046"},{"key":"38","doi-asserted-by":"crossref","unstructured":"M. Thrusfield,  \"Veterinary epidemiology.\"  \"Describing disease occurrence.\" 58 (2018)","DOI":"10.1002\/9781118280249.ch4"},{"key":"39","doi-asserted-by":"publisher","unstructured":"SE Titus, S Patterson, J Prince-Wright, et al.  \"Viruses.\"  \"Effects of between and within herd moves on elephant endotheliotropic herpesvirus (EEHV) recrudescence and shedding in captive Asian elephants (Elephas maximus).\" 2022","DOI":"10.3390\/v14020229"},{"key":"40","doi-asserted-by":"crossref","unstructured":"A Wald  and L Corey  \"Human herpesviruses: biology, therapy, and immunoprophylaxis.\"  \"Persistence in the population: epidemiology, transmission.\" (2007)","DOI":"10.1017\/CBO9780511545313.037"},{"key":"41","doi-asserted-by":"crossref","unstructured":"TJ Willis, A Burgdorf-Moisuk, M Connolly, et al.  \"Am J Vet Res.\"  86, \"Elephant endotheliotropic herpesvirus 2 infection in 5 African elephants (Loxodonta africana) at multiple North American zoological institutions.\" (2025)","DOI":"10.2460\/ajvr.25.02.0060"},{"key":"42","doi-asserted-by":"publisher","unstructured":"N Yang, M Bao, B Zhu, et al.  \"Viruses.\"  \"Elephant endotheliotropic herpesvirus 1, 4 and 5 in China: occurrence in multiple sample types and implications for wild and captive population surveillance.\" 2022","DOI":"10.3390\/v14020411"},{"key":"13","doi-asserted-by":"crossref","unstructured":"A Fuery, J Tan, R Peng, et al.  \"J Zoo Wildl Med.\"  47, \"Clinical infection of two captive Asian elephants (Elephas maximus) with elephant endotheliotropic herpesvirus 1b.\" 319 (2016)","DOI":"10.1638\/2015-0074.1"},{"key":"32","doi-asserted-by":"crossref","unstructured":"S Sripiboon, T Angkawanish, K Boonprasert, et al.  \"J Zoo Wildl Med.\"  48, \"Successful treatment of a clinical elephant endotheliotropic herpesvirus infection: the dynamics of viral load, genotype analysis, and treatment with acyclovir.\" 1254 (2017)","DOI":"10.1638\/2016-0141R1.1"},{"key":"11","doi-asserted-by":"publisher","unstructured":"A Fuery, GR Browning, J Tan, et al.  \"J Zoo Wildl Med.\"  47, \"Clinical infection of captive Asian elephants (Elephas maximus) with elephant endotheliotropic herpesvirus 4.\" 311 (2016)","DOI":"10.1638\/2015-0072.1"},{"key":"14","doi-asserted-by":"crossref","unstructured":"MM Garner, K Helmick, J Ochsenreiter, et al.  \"Vet Pathol.\"  46, \"Clinicopathologic features of fatal disease attributed to new variants of endotheliotropic herpesviruses in two Asian elephants (Elephas maximus).\" 97 (2009)","DOI":"10.1354\/vp.46-1-97"},{"key":"24","doi-asserted-by":"crossref","unstructured":"ZM Oo, YH Aung, TT Aung, et al.  \"Emerg Infect Dis.\"  26, \"Elephant endotheliotropic herpesvirus hemorrhagic disease in Asian elephant calves in logging camps, Myanmar.\" 63 (2020)","DOI":"10.3201\/eid2601.190159"},{"key":"34","doi-asserted-by":"crossref","unstructured":"JJ Stanton, SA Nofs, A Zachariah, et al.  \"J Wildl Dis.\"  50, \"Detection of elephant endotheliotropic herpesvirus infection among healthy Asian elephants (Elephas maximus) in south India.\" 279 (2014)","DOI":"10.7589\/2012-09-236"},{"key":"6","doi-asserted-by":"crossref","unstructured":"E Bronson, M McClure, J Sohl, et al.  \"J Zoo Wildl Med.\"  48, \"Epidemiologic evaluation of elephant endotheliotropic herpesvirus 3B infection in an African elephant (Loxodonta africana).\" 335 (2017)","DOI":"10.1638\/2016-0063R.1"},{"key":"18","doi-asserted-by":"crossref","unstructured":"R Kendall, L Howard, N Masters, et al.  \"J Zoo Wildl Med.\"  47, \"The impact of elephant endotheliotropic herpesvirus on the captive Asian elephant (Elephas maximus) population of the United Kingdom and Ireland (1995\u20132013).\" 405 (2016)","DOI":"10.1638\/2015-0217.1"},{"key":"43","doi-asserted-by":"crossref","unstructured":"Y Yun, S Sripiboon, K Pringproa, et al.  \"Vet Q.\"  41, \"Clinical characteristics of elephant endotheliotropic herpesvirus (EEHV) cases in Asian elephants (Elephas maximus) in Thailand during 2006\u20132019.\" 268 (2021)","DOI":"10.1080\/01652176.2021.1980633"},{"key":"3","doi-asserted-by":"publisher","unstructured":"L Atkins, JC Zong, J Tan, et al.  \"J Zoo Wildl Med.\"  44, \"Elephant endotheliotropic herpesvirus 5, a newly recognized elephant herpesvirus associated with clinical and subclinical infections in captive Asian elephants (Elephas maximus).\" 136 (2013)","DOI":"10.1638\/1042-7260-44.1.136"},{"key":"9","doi-asserted-by":"crossref","unstructured":"MA Fayette, EE Brenner, MM Garner, et al.  \"J Zoo Wildl Med.\"  52, \"Acute hemorrhagic disease due to elephant endotheliotropic herpesvirus 3A infection in five African elephants (Loxodonta africana) at one North American zoological institution.\" 357 (2021)","DOI":"10.1638\/2020-0126"},{"key":"17","doi-asserted-by":"crossref","unstructured":"ML Iyer, CM Molter, JP Flanagan, et al.  \"J Zoo Wildl Med.\"  53, \"Novel diagnostic and therapeutic approaches to elephant endotheliotropic herpesvirus 1A hemorrhagic disease in a captive juvenile Asian elephant (Elephas maximus).\" 232 (2022)","DOI":"10.1638\/2021-0096"}],"container-title":["Journal of Zoo and Wildlife Medicine"],"original-title":[],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:57:04Z","timestamp":1791233824000},"score":1,"resource":{"primary":{"URL":"https:\/\/bioone.org\/journals\/journal-of-zoo-and-wildlife-medicine\/volume-57\/issue-2\/2025-0073\/MEASURES-OF-DISEASE-FREQUENCY-FOR-ELEPHANT-ENDOTHELIOTROPIC-HERPESVIRUS-INFECTION-AND\/10.1638\/2025-0073.full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,5]]},"references-count":43,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6,1]]}},"URL":"https:\/\/doi.org\/10.1638\/2025-0073","relation":{},"ISSN":["1042-7260","1937-2825"],"issn-type":[{"value":"1042-7260","type":"print"},{"value":"1937-2825","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,5]]}}}