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Mammals (other)
To treat or not to treat?
  1. Mathias Ackermann1 and
  2. Jean-Michel Hatt2
  1. 1Institute of Veterinary Virology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
  2. 2Clinic for Zoo Animals, Exotic Pets and Wildlife, University of Zurich, Zurich, Switzerland
  1. Correspondence to Jean-Michel Hatt; jmhatt{at}


In a world of ever-increasing liability, the decision not to treat a patient comes less and less easily, even though both evidence-based medical and financial reasons may speak against treatment. Elephant haemorrhagic disease (EHD), associated with viraemia with elephant endotheliotropic viruses (EEHV), may kill within hours after onset of clinical signs. Here, the authors present a case, where a three-year-old female Asian elephant (Elephas maximus) developed viraemia with EEHV1 but was deliberately left without antiviral treatment and survived without developing clinical signs. Considering the mostly fatal outcome of EHD, this decision may at first glance appear hazardous. However, the reasoning included knowledge about herpesviruses in general, past and present EEHV status of the individual, EEHV epidemiology within the herd as well as stress and costs involved in treatment. It is important to consider those parameters for each impeding case separately in order to assure the best welfare of the animal.

  • herpesviruses
  • zoo animals
  • elephants
  • treatment
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  • Contributors MA: performed analyses, evaluated the data and wrote case report. J-MH: managed the clinical case, took samples, evaluated the data and edited the case.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement The data that support the findings of this study are available from the corresponding author, [JMH], upon reasonable request.

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