Retrospective Study on the Health Problems of Falcons in Al Ain, United Arab Emirates

Background Falcons are important animals in sociocultural events of the society of the United Arab Emirates (UAE). Like any other birds, falcons can be affected by different health problems. This study was conducted to investigate the major health problems of falcons presented to the City Vet Clinic in Al Ain during 2019. Methods Data were extracted from the records of 906 falcons presented to City Vet Clinic in 2019. Data extraction was made on the diagnostic methods used, diagnosed health problems and the type of treatment/veterinary services given to falcons. Analysis was done using descriptive statistics. Results The overall incidence rate of health problems detected in falcons presented to City Vet Clinic in 2019 was 26.5% (95% confidence interval, CI, 23.6-29.5%). The most incident health problems were ingluvitis (inflammation of crop), aspergillosis and bacterial enteritis with incidence rates of 8.1% (95%CI: 6.4–10.0%), 5.8% (95%CI: 4.4-7.6%) and 2.4% (95%CI: 1.5-3.7%), respectively. The relationship between the number of cases of falcon and months was polynomial with a regression (R2) of 42% indicating that only 42% of the variation in the number cases could be explained by monthly variation. The three main medical treatments given for the diagnosed health problems included antibiotics, anti-fungal and anti-parasitic with frequencies of 46.3% (95%CI: 39.8-52.8%), 21.7% (95%CI: 16.6-27.4%) and 12.0% (95%CI: 8.2-16.9%), respectively. Conclusion The major health problems of falcons were ingluvitis, aspergillosis and bacterial enteritis. Infections that occur in falcons can also be transmitted to owners. Therefore, regular check-up and control of diseases of falcons is recommended.


Background
Falcons are small to medium size, strong and rigid birds which are characterized by their swift, graceful and predatory skill [1,2]. Taxonomically, falcons belong to the Phylum Chordata, Family Falconinae, Subfamily Falconidae, Order Falconiformes and the Genus Falco [3]. There are over 35 species in the Genus Falco and they are distributed worldwide [2]. The most common species of the Genus Falco, which are found in the United Arab Emirates (UAE) are Falco cherrug (Saker), Falco rusticolus (Gyrfalcon), Falco peregrinus (Peregrine), hybrid of Saker-Gyrfalcon, and hybrid of Peregrine-Gyrfalcon [4].
Falconry is also termed as hawking is a type of sport, which employs primarily falcons and to certain extent, eagles or buzzards in hunting game [5]. The term falconry is directly linked to falcons as they are the primary birds involved in this sport and for which reason they are termed as true hawks [5]. In the UAE and other Middle East countries, the role of falcons has not only limited to sports and entertainment but also, they have special places in the tradition of the societies [6]. The special place given to the falcons by the Emirati people and other people of the Middle East originated from the historical relationship between the Bedouins and the falcons [7,8].
Bedouins are Arabic-speaking nomadic peoples of the Middle Eastern deserts, especially of North Africa, the Arabian Peninsula, Egypt, Israel, Iraq, Syria, and Jordan in the past [9]. Bedouins were living in the desert under harsh environment and thus, they used to trap wild falcons passing over the sky the of UAE and the Arabian Peninsula on the migratory route from Europe to Africa and train them for two weeks and used for hunting migratory birds [8]. The preys that were hunted by falcons and cooked as meals for Bedouins families [8]. Therefore, falconry was a matter of necessity for Bedouins to survive under harsh conditions in the desert, which lead the Emirati people to have a different view for falcons in which they do not regard falcons as only sport animals like the European but also consider them as the integral part of their families [4]. The Emirati people do not value falcons in terms of money; but rather they value them in the same way they value their sons and daughters, and as a result, falcons are living in a well-ventilated and furnished rooms, have their own places in their owners' cars and even in offices [6]. Falconry is a traditional sport, attracts the leaders and the ordinary people. The new generations of the Emirati people have inherited falconry from their ancestors and hence falconry is considered as the most common tradition of the UAE people [4]. Reports show that training of falcons for the legendary sport costs a huge amount of money and according to Jacobs [10], in the UAE, falconers train their falcons, which can cost up to $60,000 pet a bird, to race at hundreds of miles an hour in the President's Cup, a national competition in which the fastest falcons can win up to $7 million in prizes.
Falcons like any other birds can be affected by different health problems. Falcons can be infected by bacterial infections such as salmonellosis and parasitic diseases such as trichomoniasis and coccidiosis [4,11]. Besides, fungal infections such as aspergillosis and viral diseases including avian pox can affect falcons and result in morbidities and mortalities [12]. Moreover, falcons can be infested by external parasites including mites and lice [11]. Therefore, the prevailing socio-cultural situations of the UAE require adequate maintenance of the health of the falcons for two reasons; firstly, falcons are precious animals for the Emirate people and hence, they should be kept healthy and safe, and secondly, because of the strong physical contact between falcons and their owners, there could be a chance of transmission of zoonotic diseases from falcons to their owners, which necessities strict maintenance of the health of falcons.
To this effect, generation of epidemiological data on the diseases that affect falcons in UAE is important as it provides evidence to the control authorities and to the owners for appropriate actions. The present study was conducted to identify major health problems of falcons that were presented to City Vet Clinic in Al Ain, UAE in 2019.

Study setting
The study was conducted at City Vet Clinic, which is located in Al Ain, the United Arab

Study design and data collection
The design of this study was a cross-sectional in which retrospective longitudinally recorded data of health problems of falcons were extracted from City Vet Clinic records and analyzed. The City Vet Clinic was first approached and the plan of the study was explained to the Senior Vet Clinician and owner of the Clinic. The Head of the Clinic welcomed the plan and permitted the investigator to use the computerized health data of falcons. The health data of 906 falcon were extracted from the Microsoft Word file of the Clinic and then the data were entered into Microsoft Excel. The extracted data included reasons for which the owners bring their falcons to the clinic, the diagnostic method used by the clinic, the detected falcon health problems, and the treatment given to falcons.

Data analysis
The data were collected from the City Vet Clinic's website and re-entered into the Microsoft Excel and then analyzed using descriptive statistics. The overall incidence rate was calculated by Year was assessed using regression analysis and 95% confidence interval was calculated for the incidence rates and frequencies for the evaluation of statistical significance. Incidence rates or proportions having no overlapping confidence intervals were considered as statistically different.

Purpose of visit of falcon to the City Vet Clinic
A total of 906 falcons visited the City Vet Clinic for various reasons ( Table 1). The majority of falcons (68.9%) were brought to the Clinic for the check-up of their health conditions. Following check-up for health conditions, 11.6% and 8.6% of falcons were brought to the City Vet Clinic for tail mounting and feather fixing, respectively.  Table 2, a combination fecal examination and crop endoscopy was the most frequently (32.5%) used diagnostic method in the diagnosis falcon health problem at the City Vet Clinic. Next to the combination of the fecal examination and crop endoscopy, general clinical examination and a combination of three tests (fecal examination, endoscopy and crop endoscopy) were most frequently used and as such 14.1% and 11.9% of falcons were examined by these methods, respectively (Table 2). Fecal examination alone, endoscopy alone, crop endoscopy alone, and X-ray alone were used in 11.8%, 9.9%, 5.4% and 3.1% of the falcons examined at the City Vet Clinic in 2019, respectively.

Number of falcons visited City Vet Clinic during each Month of 2019
The number of falcons visited City Vet Clinic during the 12 months of 2019 is depicted in Figure   1. The relationship between the number of the cases and the months was not linear; but it was rather polynomial. Quadratic curve was able to fit the data better than the linear line and the value of polynomial regression (R²) was 42% (equation of curve: y = 3.1933x 2 -38.541x + 153.05), which implied that only 42% of the variation in number of monthly cases was explained by monthly variations. As it can be seen from Figure 1, the number of cases visited the Clinic during January was high and thereafter the number of cases started to decrease and reached the lowest level in April and stayed low until August when it started to rise and stayed high from August to December.

Types of treatment given to falcons with different health problems
The different types treatment used to treat falcons at the City Vet Clinic are presented in Table 4.
Antibiotics were used for the treatment of 46.3% (95% CI: 39.8, 52.8%) of the total cases. Next to antibiotics, antifungal drugs were the second most commonly used drugs and used for the treatment of 21.7% (95% CI: 16.6, 27.4%).
The other types of treatments and services provided to falcons at the City Vet Clinic are presented in Table 5. These include supportive treatments such as rehydration and administration of vitamins. Over 13% of the total falcon were rehydrated while tail mounting and feather fixing were done for 11. 9% (95%CI: 9.9, 14.2%) and 8.7% (95% CI: 7.0, 10.8%), respectively.

Discussion
The systemic mycosis in birds and can lead to death in captive falcons [17,18,19]. Aspergillosis affects the lower respiratory tract and isolated from the air sacs of falcons [20]. Aspergillus species are widespread in the environment and become pathogenic mainly under stressful conditions such as poor ventilation, malnutrition, toxins, vaccinations, long-term use of antibiotics and corticosteroids, hot-humid climate, and stress-associated conditions, such as recent capture, training, and change of ownership [21,22,23].
Bacterial enteritis was recorded as the 3 rd most frequent health problem of falcons visited the City Vet Clinic in Al Ain in 2019. Bacterial enteritis is usually caused by Escherichia coli (E. coli) and Salmonella species. Earlier study indicated that among bacterial isolates, E. coli was isolated from 35% of 663 diseased raptors with clinical signs of septicemia or respiratory disorders while Pseudomonas aeruginosa was isolated from 7% of the same group of raptors [24]. Another study indicated that the common bacterial diseases in falcons are chlamydiosis, salmonellosis, avian tuberculosis and mycoplasmosis [25]. However, in the present study, bacterial identification was not performed and hence, identification of the bacteria using standard procedures is required in order to detect the bacterial species affecting falcons in Al Ain.
The incidence of infection with Coccidia was about 2% and it was in the order of the important infections. Similar to the observation of the present study, coccidiosis was reported in raptors earlier [26]. From among the coccidian parasites, the Genus Caryospora infects predatory birds and reptiles [27]. According to the existing literature, least 25 species of Caryospora have been identified from birds worldwide [28] of which 15 have been identified from raptors [29][30][31].
However, in the present study, species level identification has not been made and hence a better designed and more detail study is required on coccidiosis in falcons in Al Ain and UAE.  [32]. Besides, Avian flu, particularly the highly pathogenic avian influenza A (HPAI) virus is a major threat to the avian species and humans in the worldwide [33]; and in 2000, H7N3 was isolated from a Peregrine falcon (Falco peregrinus) kept as a falconry bird in UAE [34]. Additionally, during the outbreak of H7N7 in poultry in Italy, H7 subtype was isolated from a Saker falcon (Falco cherrug) [35]. Similarly, experimental infection of falcons with H5N1 lead to death of infected falcons [36]. The isolation of HPAI from falcons has a very serious public health implication as falconers have close physical contacts with their falcons. Hence, regular vaccination of falcons against Avian Influenza A should be considered priority. Similar to Avian flu and Newcastle disease, Poxviruses were also reported in species of falconidae imported to Germany from Arabian or Asian countries [12].
Helminth parasites such as Strigea and Tapeworm were detected in the feces of falcons with the incidence rates of about 1% each. These parasites can cause different problems such as anemia, weight loss, loss of appetite, diarrhea, and even death in severe cases. Therefore, regular checkup and deworming are required in order to control parasitic infections in falcons.

Conclusion
The result of this study showed that majority of falcons visited the City Vet Clinic for health checkup following which tail mounting and feather fixing were the second and third purposes for visit to the Clinic, respectively. The identified major health problems of falcons were ingluvitis aspergillosis, bacterial enteritis, coccidiosis, injuries and eye abnormalities in decreasing frequency of occurrence. These health problems can threaten falcons and can also be transmitted to owners. Therefore, regular checkup of falcons, and control of diseases of falcons were recommended.