Salome Esther Dürr

Transmission dynamics and economics of rabies control in dogs and humans in an African city

Human rabies in developing countries can be prevented through interventions directed at dogs. Potential cost-savings for the public health sector of interventions aimed at animal-host reservoirs should be assessed. Available deterministic models of rabies transmission between dogs were extended to include dog-to-human rabies transmission. Model parameters were fitted to routine weekly rabid-dog and exposed-human cases reported in N′Djaména, the capital of Chad. The estimated transmission rates between dogs (βd) were 0.0807 km2/(dogs·week) and between dogs and humans (βdh) 0.0002 km2/(dogs·week). The effective reproductive ratio (Re) at the onset of our observations was estimated at 1.01, indicating low-level endemic stability of rabies transmission. Human rabies incidence depended critically on dog-related transmission parameters. We simulated the effects of mass dog vaccination and the culling of a percentage of the dog population on human rabies incidence. A single parenteral dog rabies-mass vaccination campaign achieving a coverage of least 70% appears to be sufficient to interrupt transmission of rabies to humans for at least 6 years. The cost-effectiveness of mass dog vaccination was compared to postexposure prophylaxis (PEP), which is the current practice in Chad. PEP does not reduce future human exposure. Its cost-effectiveness is estimated at US

Zoonotic Mycobacterium bovis- induced Tuberculosis in Humans

46 per disability adjusted life-years averted. Cost-effectiveness for PEP, together with a dog-vaccination campaign, breaks even with cost-effectiveness of PEP alone after almost 5 years. Beyond a time-frame of 7 years, it appears to be more cost-effective to combine parenteral dog-vaccination campaigns with human PEP compared to human PEP alone.

Roaming behaviour and home range estimation of domestic dogs in Aboriginal and Torres Strait Islander communities in northern Australia using four different methods.

We aimed to estimate the global occurrence of zoonotic tuberculosis (TB) caused by Mycobacterium bovis or M. caprae infections in humans by performing a multilingual, systematic review and analysis of relevant scientific literature of the last 2 decades. Although information from many parts of the world was not available, data from 61 countries suggested a low global disease incidence. In regions outside Africa included in this study, overall median proportions of zoonotic TB of ≤1.4% in connection with overall TB incidence rates ≤71/100,000 population/year suggested low incidence rates. For countries of Africa included in the study, we multiplied the observed median proportion of zoonotic TB cases of 2.8% with the continental average overall TB incidence rate of 264/100,000 population/year, which resulted in a crude estimate of 7 zoonotic TB cases/100,000 population/year. These generally low incidence rates notwithstanding, available data indicated substantial consequences of this disease for some population groups and settings.

Canine Rabies in Australia: A Review of Preparedness and Research Needs

Disease transmission parameters are the core of epidemic models, but are difficult to estimate, especially in the absence of outbreak data. Investigation of the roaming behaviour, home range (HR) and utilization distribution (UD) can provide the foundation for such parameter estimation in free-ranging animals. The objectives of this study were to estimate HR and UD of 69 domestic dogs in six Aboriginal and Torres Strait Islander communities in northern Australia and to compare four different methods (the minimum convex polygon, MCP; the location-based kernel density estimation, LKDE; the biased random bridge, BRB; and Time Local Convex Hull, T-LoCoH) for investigation of UD and estimating HR sizes. Global positioning system (GPS) collars were attached to community dogs for a period of 1-3 days and positions (fixes) were recorded every minute. Median core HRs (50% isopleth) of the 69 dogs were estimated to range from 0.2 to 0.4 ha and the more extended HR (95% isopleth) to range from 2.5 to 5.3 ha, depending on the method used. The HR and UD shapes were found to be generally circular around the dog owners house. However, some individuals were found to roam much more with a HR size of 40-104 ha and cover large areas of their community or occasionally beyond. These far roaming dogs are of particular interest for infectious disease transmission. Occasionally, dogs were taken between communities and out of communities for hunting, which enables the contact of dogs between communities and with wildlife (such as dingoes). The BRB and T-LoCoH are the only two methods applied here which integrate the consecutiveness of GPS locations into the analysis, a substantial advantage. The recently developed BRB method produced significantly larger HR estimates than the other two methods; however, the variability of HR sizes was lower compared to the other methods. Advantages of the BRB method include a more realistic analytical approach (kernel density estimation based on movements rather than on locations), possibilities to deal with irregular time periods between consecutive GPS fixes and parameter specification which respects the characteristics of the GPS unit used to collect the data. The BRB method was therefore the most suitable method for UD estimation in this dataset. The results of this study can further be used to contact rates between the dogs within and between communities, a foundation for estimating transmission parameters for canine infectious disease models, such as a rabies spread model in Australia.

Owner Valuation of Rabies Vaccination of Dogs, Chad

Australia is unique as a populated continent in that canine rabies is exotic, with only one likely incursion in 1867. This is despite the presence of a widespread free‐ranging dog population, which includes the naturalized dingo, feral domestic dogs and dingo‐dog cross‐breeds. To Australias immediate north, rabies has recently spread within the Indonesian archipelago, with outbreaks occurring in historically free islands to the east including Bali, Flores, Ambon and the Tanimbar Islands. Australia depends on strict quarantine protocols to prevent importation of a rabid animal, but the risk of illegal animal movements by fishing and recreational vessels circumventing quarantine remains. Predicting where rabies will enter Australia is important, but understanding dog population dynamics and interactions, including contact rates in and around human populations, is essential for rabies preparedness. The interactions among and between Australias large populations of wild, free‐roaming and restrained domestic dogs require quantification for rabies incursions to be detected and controlled. The imminent risk of rabies breaching Australian borders makes the development of disease spread models that will assist in the deployment of cost‐effective surveillance, improve preventive strategies and guide disease management protocols vitally important. Here, we critically review Australias preparedness for rabies, discuss prevailing assumptions and models, identify knowledge deficits in free‐roaming dog ecology relating to rabies maintenance and speculate on the likely consequences of endemic rabies for Australia.

Decision-making for foot-and-mouth disease control: objectives matter

We estimated the association between amount charged and probability that dog owners in N’Djaména, Chad, would have their dogs vaccinated against rabies. Owners would pay ≈400–700 CFA francs (US

Differences in primary sites of infection between zoonotic and human tuberculosis : results from a worldwide systematic review

0.78–

Evaluation of control and surveillance strategies for classical swine fever using a simulation model

1.36)/animal. To vaccinate >70% of dogs, and thus interrupt rabies transmission, health officials should substantially subsidize these vaccinations.

Development of a Novel Rabies Simulation Model for Application in a Non-endemic Environment

Formal decision-analytic methods can be used to frame disease control problems, the first step of which is to define a clear and specific objective. We demonstrate the imperative of framing clearly-defined management objectives in finding optimal control actions for control of disease outbreaks. We illustrate an analysis that can be applied rapidly at the start of an outbreak when there are multiple stakeholders involved with potentially multiple objectives, and when there are also multiple disease models upon which to compare control actions. The output of our analysis frames subsequent discourse between policy-makers, modellers and other stakeholders, by highlighting areas of discord among different management objectives and also among different models used in the analysis. We illustrate this approach in the context of a hypothetical foot-and-mouth disease (FMD) outbreak in Cumbria, UK using outputs from five rigorously-studied simulation models of FMD spread. We present both relative rankings and relative performance of controls within each model and across a range of objectives. Results illustrate how control actions change across both the base metric used to measure management success and across the statistic used to rank control actions according to said metric. This work represents a first step towards reconciling the extensive modelling work on disease control problems with frameworks for structured decision making.

Evaluation of the benefit of emergency vaccination in a foot-and-mouth disease free country with low livestock density

Tuberculosis (TB) is one of the most devastating infectious diseases worldwide. Whilst global burden estimates for M. tuberculosis infection (MtTB) are well established, accurate data on the contribution of zoonotic TB (zTB) caused by M. bovis or M. caprae to human TB are scarce. The association of M. bovis infection with extrapulmonary tuberculosis has been suggested repeatedly, though there is little scientific evidence available to support this relationship. The present study aimed to determine globally the occurrence of extrapulmonary TB and the primary site (i.e. primary body location affected) of zTB in comparison with MtTB, based on previously published reports. A systematic literature review was conducted in 32 different bibliographic databases, selecting reports on zTB written in English, French, German, Spanish or Portuguese. Data from 27 reports from Africa, America, Europe and the Western Pacific Region were extracted for analyses. Low income countries, in Africa and South-East Asia, were highly underrepresented in the dataset. The median proportion of extrapulmonary TB cases was significantly increased among zTB in comparison with data from registries of Europe and USA, reporting mainly MtTB cases (47% versus 22% in Europe, 73% versus 30% in the USA). These findings were confirmed by analyses of eight studies reporting on the proportions of extrapulmonary TB in comparable populations of zTB and MtTB cases (median 63% versus 22%). Also, disparities of primary sites of extrapulmonary TB between zTB and MtTB were detected. Our findings, based on global data, confirm the widely suggested association between zTB and extrapulmonary disease. Different disability weights for zTB and MtTB should be considered and we recommend separate burden estimates for the two diseases.