Javier Sanchez

Veterinary syndromic surveillance: Current initiatives and potential for development.

This paper reviews recent progress in the development of syndromic surveillance systems for veterinary medicine. Peer-reviewed and grey literature were searched in order to identify surveillance systems that explicitly address outbreak detection based on systematic monitoring of animal population data, in any phase of implementation. The review found that developments in veterinary syndromic surveillance are focused not only on animal health, but also on the use of animals as sentinels for public health, representing a further step towards One Medicine. The main sources of information are clinical data from practitioners and laboratory data, but a number of other sources are being explored. Due to limitations inherent in the way data on animal health is collected, the development of veterinary syndromic surveillance initially focused on animal health data collection strategies, analyzing historical data for their potential to support systematic monitoring, or solving problems of data classification and integration. Systems based on passive notification or data transfers are now dealing with sustainability issues. Given the ongoing barriers in availability of data, diagnostic laboratories appear to provide the most readily available data sources for syndromic surveillance in animal health. As the bottlenecks around data source availability are overcome, the next challenge is consolidating data standards for data classification, promoting the integration of different animal health surveillance systems, and also the integration to public health surveillance. Moreover, the outputs of systems for systematic monitoring of animal health data must be directly connected to real-time decision support systems which are increasingly being used for disease management and control.

A longitudinal study of gastrointestinal parasites in Canadian dairy farms: The value of an indirect Ostertagia ostertagi ELISA as a monitoring tool

The general objective of this study was to evaluate a crude Ostertagia ostertagi antigen enzyme-linked immunosorbent assay (ELISA) for monitoring gastrointestinal parasites in lactating dairy cattle. A longitudinal study of gastrointestinal parasites in lactating dairy cows was carried out in 38 herds in four provinces of Canada (Prince Edward Island, Quebec, Ontario and Saskatchewan) from September 1999 to October 2000. Bulk tank milk, cow milk, serum and fecal samples were collected monthly or quarterly from all these farms. Information on herd management factors was collected by a standard questionnaire and individual cow production data were obtained from an electronic database. The overall mean optical density ratio (ODR) was 0.30 and ranged from -0.05 to 1.55. Although a clear seasonal pattern was not observed, the ODR values tended to decrease during the housing period and start increasing in the spring before the cows went out to pasture. The second and third or greater lactation cows had significantly higher ODR values compared with first lactation animals. The individual cow ODR had a very low correlation with individual squared root fecal egg counts but showed a reasonably high correlation when herd averages values were computed (r=0.73). A moderate correlation (r approximately 0.50) between the bulk tank and herd average ODR was observed. Milk yield was negatively associated with individual cow milk ODR and a quadratic effect on ODR was observed for days in milk. Twenty-eight of the herds participated in a clinical trial of eprinomectin (Ivomec Eprinex) treatment at calving. The cow level ODR values determined late in the previous lactation had a marginally significant effect (P=0.07) on treatment response, suggesting that high OD cows responded better to the anthelmintic treatment. However, because of the small sample size available in this model, more research is needed to better understand this relationship. In conclusion, the indirect ELISA using an O. ostertagi crude antigen appears useful as a technique for monitoring gastrointestinal parasite burdens in adult dairy cows and holds promise as a potential predictor of response to anthelmintic treatment.

Increase in milk yield following eprinomectin treatment at calving in pastured dairy cattle

Gastrointestinal nematodes rarely cause signs of clinical disease in adult cattle. However, they have been shown to exert a negative impact on production in lactating animals, as seen by improved production following elimination of the worms using anthelmintics. A double blind, randomized clinical trial was performed in 28 dairy herds in Canada. The objective of the study was to evaluate the effect of treatment with eprinomectin pour-on solution (IVOMEC EPRINEX) at calving on production, in cattle that have had some exposure to pasture. Cows were randomly allocated to treatment or placebo in blocks of 10, based on calving date, and treated with eprinomectin or placebo on the day of calving. Information on milk production was obtained from all animals, as well as recorded cases of selected diseases. Milk production results from the Canadian dairy herd management system database were analysed using a mixed model with herd as a random effect and test within-cow as a repeated measurement. Test day milk yields from the first six tests after treatment were included in the model, representing a period of between 180 and 200 days in milk (dim). Treated cows produced an additional 0.94 kg of milk per day when compared to the controls over this period. The production effect was independent of calving season, age of the animal and geographical location. No effect of treatment was seen on milk composition, somatic cell count (scc) or on the selected health parameters that were recorded for all included animals. Monthly fecal egg counts (FEC) were performed for eight randomly selected animals in each herd. The observed FEC were low in this study, with a range from 0 to 419 trichostrongyle type eggs per 5g (ep5g) of feces in animals not yet treated with the anthelmintic. The average count was 9.8 and the median was 1.0. FECs dropped immediately after calving and stayed lower for at least 100 days in treated animals when compared to controls. In conclusion, gastrointestinal nematodes appear to have an effect on milk production in Canadian dairy cows that have had some degree of pasture exposure. Eliminating the present subclinical parasite burdens produced a consistent increase in milk production that can yield economic benefits for the dairy producer.

Knowledge and attitudes towards food safety among Canadian dairy producers

The Canadian dairy industry has recently begun implementing an on-farm food-safety (OFFS) program called Canadian Quality Milk (CQM). For CQM to be effective, producers should be familiar with food-safety hazards in their industry and have an adequate understanding of on-farm good production practices that are necessary to ensure safe food. To assess their knowledge and attitudes towards food safety, a postal questionnaire was administered to all (n=10,474) Canadian dairy producers enrolled in dairy herd-improvement organizations in 2008. The response rate was 20.9% (2185/10,474). Most producers (88.7%) reported that they or their families consume unpasteurized milk from their bulk milk tanks and 36.3% indicated that consumers should be able to purchase unpasteurized milk in Canada. Producers who reported completion of a dairy-health management course (OR=0.74, 95% CI: 0.60, 0.92) and participation in CQM (OR=0.79, 95% CI: 0.64, 0.97) were less likely to support the availability of unpasteurized milk for consumers, while organic producers (OR=2.10, 95% CI: 1.27, 3.47), younger producers (aged <30) and producers with smaller herds were more likely to favour this practice. Two-thirds of producers (66.7%) were concerned that antimicrobial resistance (AMR) might preclude successful treatment of sick cattle. Producers who completed a dairy-health management course (OR=1.37, 95% CI: 1.11, 1.69), organic producers (OR=2.00, 95% CI: 1.09, 3.69) and producers from Quebec compared to each other province were more likely to indicate concern about AMR. Most producers reported that Salmonella (74.2%) and Escherichia coli (73.0%) could be transmitted through contaminated beef or milk to humans, while most were not sure or did not think that Brucella (70.3%) and Cryptosporidium (88.5%) could be transmitted via these routes. Most producers did not perceive that any type of farm visitor has a high risk of introducing infectious agents into their herds. Producers rated veterinarians as very knowledgeable about OFFS (90.9% answered 4 or 5 on a five-point scale) and a favoured (73.1%) source of information about food safety. In contrast, only 13.2% and 30.2% of producers, respectively, indicated that consumers and government personnel are knowledgeable about OFFS. Targeted continuing education for dairy producers in Canada should address the major gaps in knowledge and attitudes towards food safety identified in this study, and veterinarians should be included as key knowledge-transfer informants.

The effect of eprinomectin treatment at calving on reproduction parameters in adult dairy cows in Canada

A clinical trial was carried out in two provinces of Canada to investigate the effect of treatment with eprinomectin at calving on production parameters in adult dairy cattle in 1999-2000. One of the objectives of this study was to evaluate the impact of treatment on reproductive performance as measured by: calving-to-conception interval, calving-to-first service interval and number of services per conception. The ability of an indirect ELISA using a crude adult Ostertagia ostertagi antigen to predict response to treatment also was evaluated. All lactating cows in 20 dairy herds were allocated randomly to receive either eprinomectin pour-on or placebo at calving. Information on reproductive parameters was obtained from computerised cow records. Survival models were used to evaluate the effect of treatment on the two intervals and a Poisson model was used to evaluate the number of services to conception. A total of 549 cows were included in these analyses. A marginally significant treatment effect on calving-to-conception interval was observed (hazard ratio=1.24, P=0.06) but not on calving-to-first service interval. A significant reduction in the number of breedings to conception for treated animals also was observed with a longer effect in cows with short interval to first service. Milk samples from a subset of 109 late-lactation cows were tested for antibodies against O. ostertagi. The ELISA optical-density ratio (ODR) values obtained between 120 days before calving and drying off were categorised as high ODR (>or=0.5) and low ODR (<0.5). Among untreated animals, the hazard of conception was lower (hazard ratio=0.38, 95% CI=[0.19,0.75]) for high-ODR cows compared to low ODR cows suggesting that higher parasite burdens had an adverse effect on reproductive performance. Treated high-ODR cows had a hazard of conception equivalent to the hazard for all cows in the low-ODR group (indicating that treatment prevented the negative effect associated with these higher parasite burdens).

Network analysis of swine shipments in Ontario, Canada, to support disease spread modelling and risk-based disease management

Understanding contact networks are important for modelling and managing the spread and control of communicable diseases in populations. This study characterizes the swine shipment network of a multi-site production system in southwestern Ontario, Canada. Data were extracted from a companys database listing swine shipments among 251 swine farms, including 20 sow, 69 nursery and 162 finishing farms, for the 2-year period of 2006 to 2007. Several network metrics were generated. The number of shipments per week between pairs of farms ranged from 1 to 6. The medians (and ranges) of out-degree were: sow 6 (1-21), nursery 8 (0-25), and finishing 0 (0-4), over the entire 2-year study period. Corresponding estimates for in-degree of nursery and finishing farms were 3 (0-9) and 3 (0-12) respectively. Outgoing and incoming infection chains (OIC and IIC), were also measured. The medians (ranges) of the monthly OIC and IIC were 0 (0-8) and 0 (0-6), respectively, with very similar measures observed for 2-week intervals. Nursery farms exhibited high measures of centrality. This indicates that they pose greater risks of disease spread in the network. Therefore, they should be given a high priority for disease prevention and control measures affecting all age groups alike. The network demonstrated scale-free and small-world topologies as observed in other livestock shipment studies. This heterogeneity in contacts among farm types and network topologies should be incorporated in simulation models to improve their validity. In conclusion, this study provided useful epidemiological information and parameters for the control and modelling of disease spread among swine farms, for the first time from Ontario, Canada.

Parameterization of the duration of infection stages of serotype O foot-and-mouth disease virus: an analytical review and meta-analysis with application to simulation models

Foot-and-mouth disease (FMD) is considered one of the most important infectious diseases of livestock because of the devastating economic consequences that it inflicts in affected regions. The value of critical parameters, such as the duration of the latency or the duration of the infectious periods, which affect the transmission rate of the FMD virus (FMDV), are believed to be influenced by characteristics of the host and the virus. Disease control and surveillance strategies, as well as FMD simulation models, will benefit from improved parameter estimation. The objective of this study was to quantify the distributions of variables associated with the duration of the latency, subclinical, incubation, and infectiousness periods of FMDV transmission. A double independent, systematic review of 19 retrieved publications reporting results from experimental trials, using 295 animals in four reference laboratories, was performed to extract individual values related to FMDV transmission. Probability density functions were fitted to data and a set of regression models were used to identify factors associated with the assessed parameters. Latent, subclinical, incubation, and infectious periods ranged from 3.1 to 4.8, 2 to 2.3, 5.5 to 6.6, and 3.3 to 5.7 days, respectively. Durations were significantly (p < 0.05) associated independently with route of exposure, type of donor, animal species, strains, characteristics of sampling, and clinical signs. These results will contribute to the improvement of disease control and surveillance strategies and stochastic models used to simulate FMD spread and, ultimately, development of cost-effective plans to prevent and control the potential spread of the disease in FMD-free regions of the world.

The application of knowledge synthesis methods in agri-food public health: recent advancements, challenges and opportunities.

Knowledge synthesis refers to the integration of findings from individual research studies on a given topic or question into the global knowledge base. The application of knowledge synthesis methods, particularly systematic reviews and meta-analysis, has increased considerably in the agri-food public health sector over the past decade and this trend is expected to continue. The objectives of our review were: (1) to describe the most promising knowledge synthesis methods and their applicability in agri-food public health, and (2) to summarize the recent advancements, challenges, and opportunities in the use of systematic review and meta-analysis methods in this sector. We performed a structured review of knowledge synthesis literature from various disciplines to address the first objective, and used comprehensive insights and experiences in applying these methods in the agri-food public health sector to inform the second objective. We describe five knowledge synthesis methods that can be used to address various agri-food public health questions or topics under different conditions and contexts. Scoping reviews describe the main characteristics and knowledge gaps in a broad research field and can be used to evaluate opportunities for prioritizing focused questions for related systematic reviews. Structured rapid reviews are streamlined systematic reviews conducted within a short timeframe to inform urgent decision-making. Mixed-method and qualitative reviews synthesize diverse sources of contextual knowledge (e.g. socio-cognitive, economic, and feasibility considerations). Systematic reviews are a structured and transparent method used to summarize and synthesize literature on a clearly-defined question, and meta-analysis is the statistical combination of data from multiple individual studies. We briefly describe and discuss key advancements in the use of systematic reviews and meta-analysis, including: risk-of-bias assessments; an overall quality-of-evidence approach; engagement of stakeholders; Bayesian, multivariate, and network meta-analysis; and synthesis of diagnostic test accuracy studies. We also highlight several challenges and opportunities in the conduct of systematic reviews (e.g. inclusion of grey literature, minimizing language bias, and optimizing search strategies) and meta-analysis (e.g. inclusion of observational studies and approaches to address the insufficient reporting of data and significant heterogeneity). Many of these developments have yet to be comprehensively applied and evaluated in an agri-food public health context, and more research is needed in this area. There is a need to strengthen knowledge synthesis capacity and infrastructure at the regional, national, and international levels in this sector to ensure that the best available knowledge is used to inform future decision-making about agri-food public health issues.

Multi-Criteria Decision Analysis Tools for Prioritising Emerging or Re-Emerging Infectious Diseases Associated with Climate Change in Canada

Global climate change is known to result in the emergence or re-emergence of some infectious diseases. Reliable methods to identify the infectious diseases of humans and animals and that are most likely to be influenced by climate are therefore required. Since different priorities will affect the decision to address a particular pathogen threat, decision makers need a standardised method of prioritisation. Ranking methods and Multi-Criteria Decision approaches provide such a standardised method and were employed here to design two different pathogen prioritisation tools. The opinion of 64 experts was elicited to assess the importance of 40 criteria that could be used to prioritise emerging infectious diseases of humans and animals in Canada. A weight was calculated for each criterion according to the expert opinion. Attributes were defined for each criterion as a transparent and repeatable method of measurement. Two different Multi-Criteria Decision Analysis tools were tested, both of which used an additive aggregation approach. These were an Excel spreadsheet tool and a tool developed in software ‘M-MACBETH’. The tools were trialed on nine ‘test’ pathogens. Two different methods of criteria weighting were compared, one using fixed weighting values, the other using probability distributions to account for uncertainty and variation in expert opinion. The ranking of the nine pathogens varied according to the weighting method that was used. In both tools, using both weighting methods, the diseases that tended to rank the highest were West Nile virus, Giardiasis and Chagas, while Coccidioidomycosis tended to rank the lowest. Both tools are a simple and user friendly approach to prioritising pathogens according to climate change by including explicit scoring of 40 criteria and incorporating weighting methods based on expert opinion. They provide a dynamic interactive method that can help to identify pathogens for which a full risk assessment should be pursued.

A review of simulation modelling approaches used for the spread of zoonotic influenza viruses in animal and human populations.

Increasing incidences of emerging and re‐emerging diseases that are mostly zoonotic (e.g. severe acute respiratory syndrome, avian influenza H5N1, pandemic influenza) has led to the need for a multidisciplinary approach to tackling these threats to public and animal health. Accordingly, a global movement of ‘One‐Health/One‐Medicine’ has been launched to foster collaborative efforts amongst animal and human health officials and researchers to address these problems. Historical evidence points to the fact that pandemics caused by influenza A viruses remain a major zoonotic threat to mankind. Recently, a range of mathematical and computer simulation modelling methods and tools have increasingly been applied to improve our understanding of disease transmission dynamics, contingency planning and to support policy decisions on disease outbreak management. This review provides an overview of methods, approaches and software used for modelling the spread of zoonotic influenza viruses in animals and humans, particularly those related to the animal‐human interface. Modelling parameters used in these studies are summarized to provide references for future work. This review highlights the limited application of modelling research to influenza in animals and at the animal‐human interface, in marked contrast to the large volume of its research in human populations. Although swine are widely recognized as a potential host for generating novel influenza viruses, and that some of these viruses, including pandemic influenza A/H1N1 2009, have been shown to be readily transmissible between humans and swine, only one study was found related to the modelling of influenza spread at the swine‐human interface. Significant gaps in the knowledge of frequency of novel viral strains evolution in pigs, farm‐level natural history of influenza infection, incidences of influenza transmission between farms and between swine and humans are clearly evident. Therefore, there is a need to direct additional research to the study of influenza transmission dynamics in animals and at the animal‐human interface.