Is botulism type C transmissible to human by consumption of contaminated poultry meat? Analysis of a suspect outbreak in French Guyana.

Botulism type C was suspected in a 46-year old man after consumption of sick poultry from a flock where botulism type C was confirmed. The patient developed characteristic signs of botulism, but investigation of biological samples did not confirm the presence of Clostridium botulinum or botulinum toxin. Despite having classical botulism symptoms, the man recovered very quickly. This raises the question of botulism transmission to humans by ingestion of contaminated poultry.

Defining syndromes using cattle meat inspection data for syndromic surveillance purposes: a statistical approach with the 2005-2010 data from ten French slaughterhouses.

BACKGROUND: The slaughterhouse is a central processing point for food animals and thus a source of both demographic data (age, breed, sex) and health-related data (reason for condemnation and condemned portions) that are not available through other sources. Using these data for syndromic surveillance is therefore tempting. However many possible reasons for condemnation and condemned portions exist, making the definition of relevant syndromes challenging.The objective of this study was to determine a typology of cattle with at least one portion of the carcass condemned in order to define syndromes. Multiple factor analysis (MFA) in combination with clustering methods was performed using both health-related data and demographic data. RESULTS: Analyses were performed on 381,186 cattle with at least one portion of the carcass condemned among the 1,937,917 cattle slaughtered in ten French abattoirs. Results of the MFA and clustering methods led to 12 clusters considered as stable according to year of slaughter and slaughterhouse. One cluster was specific to a disease of public health importance (cysticercosis). Two clusters were linked to the slaughtering process (fecal contamination of heart or lungs and deterioration lesions). Two clusters respectively characterized by chronic liver lesions and chronic peritonitis could be linked to diseases of economic importance to farmers. Three clusters could be linked respectively to reticulo-pericarditis, fatty liver syndrome and farmer's lung syndrome, which are related to both diseases of economic importance to farmers and herd management issues. Three clusters respectively characterized by arthritis, myopathy and Dark Firm Dry (DFD) meat could notably be linked to animal welfare issues. Finally, one cluster, characterized by bronchopneumonia, could be linked to both animal health and herd management issues. CONCLUSION: The statistical approach of combining multiple factor analysis with cluster analysis showed its relevance for the detection of syndromes using available large and complex slaughterhouse data. The advantages of this statistical approach are to i) define groups of reasons for condemnation based on meat inspection data, ii) help grouping reasons for condemnation among a list of various possible reasons for condemnation for which a consensus among experts could be difficult to reach, iii) assign each animal to a single syndrome which allows the detection of changes in trends of syndromes to detect unusual patterns in known diseases and emergence of new diseases.

Designing a Syndromic Bovine Mortality Surveillance System: Lessons Learned From the 1-Year Test of the French OMAR Alert Tool.

Between May 2018 and 2019, a syndromic bovine mortality surveillance system (OMAR) was tested in 10 volunteer French départements (French intermediate-level administrative unit) to assess its performance in real conditions, as well as the human and financial resources needed to ensure normal functioning. The system is based on the automated weekly analysis of the number of cattle deaths reported by renderers in the Fallen Stock Data Interchange Database established in January 2011. In our system, every Thursday, the number of deaths is grouped by ISO week and small surveillance areas and then analyzed using traditional time-series analysis steps (cleaning, prediction, signal detection). For each of the five detection algorithms implemented (i.e., the exponentially weighted moving average chart, cumulative sum chart, Shewhart chart, Holt-Winters, and historical limits algorithms), seven detection limits are applied, giving a signal score from 1 (low excess mortality) to 7 (high excess mortality). The severity of excess mortality (alarm) is then classified into four categories, from very low to very high, by combining the signal scores, the relative excess mortality, and the persistence of the signal(s) over the previous 4 weeks. Detailed and interactive weekly reports and a short online questionnaire help pilot départements and the OMAR central coordination cell assess the performance of the system. During the 1-year test, the system showed highly variable sensitivity among départements. This variability was partly due not only to the demographic distribution of cattle (very few signals in low-density areas) but also to the renderer's delay in reporting to the Fallen Stock Data Interchange Database (on average, only 40% of the number of real deaths had been transmitted within week, with huge variations among départements). As a result, in the pilot départements, very few alarms required on-farm investigation and excess mortality often involved a small number of farms already known to have health or welfare problems. Despite its perfectibility, the system nevertheless proved useful in the daily work of animal health professionals for collective and individual surveillance. The test is still ongoing for a second year in nine départements to evaluate the effectiveness of the improvements agreed upon at the final meeting.

Epidemiology and economic impact of bovine cysticercosis and taeniosis caused by Taenia saginata in northeastern Spain (Catalonia).

BACKGROUND: In Catalonia (north-eastern Spain), Taenia saginata has been described in cattle but its occurrence in humans is unclear. Moreover, whether cattle acquired the infection in Catalonia or outside Catalonia and its economic impact have not been investigated. This study aimed to estimate the prevalence and spatial distribution of bovine cysticercosis in Catalonia (2008-2015), and the burden from T. saginata upon the animal and human sectors in Catalonia (2013-2015). METHODS: Data on cattle diagnosed with cysticercosis at meat inspection were collected and analysed. Cattle movement history was used to identify the most likely place of bovine cysticercosis infection and to investigate its spatial distribution. Data on taeniosis treatment (niclosamide and praziquantel) costs and their supply in Catalonia as well as data on patients attending primary care with diagnosis of taeniosis were collected. The financial impact associated with T. saginata due to carcasses condemned and frozen, meat inspection and human taeniosis was estimated. RESULTS: During 2008-2015, between 18 and 107 cattle were found positive for cysticercosis each year (prevalence at slaughter of 0.010%). Movement history was available for 44% of the infected cattle and in 53% of them Catalonia was identified as the place where the infection was acquired with highest probability. Two significant bovine cysticercosis clusters were detected. The number of patients diagnosed with taeniosis in primary care during the period 2013-2016 was 41-63/year. The overall economic impact of T. saginata (2013-2015) amounted to 154,903 €/year (95% CI: 113,075-196,762). Meat inspection accounted for 81.9% (95% CI: 75.8-86.2%) of the costs, followed by costs due to carcass condemnation and freezing (9.4%; 95% CI: 6.9-12.8%), and taeniosis-associated costs (8.7%; 95% CI: 6.7-11.6%). Costs due to freezing and condemnation of carcasses reached 19,442 €/year (95% CI: 17,528-21,391) (509 €/lightly infected carcass and 1,140 €/heavily infected carcass). Taeniosis-associated costs were estimated at 12,848.5 €/year (237 €/patient). CONCLUSIONS: The public health risk of T. saginata in the area seems to be low. The economic impact due to T. saginata was mainly attributed to meat inspection. The cost due to carcass condemnation and freezing was limited compared to the revenue of the beef sector. Developing and implementing risk-based surveillance is needed to lower the costs of meat inspection. Considering cattle movements might be useful in the development of such a strategy.

Economic impact of bovine cysticercosis and taeniosis caused by Taenia saginata in Belgium.

BACKGROUND: Bovine cysticercosis (BCC) (due to Taenia saginata) is often claimed to cause considerable economic losses to the livestock industry, particularly in beef cattle, but recent studies estimating the economic impact are lacking. The current study aimed to quantify the annual economic impact of BCC in Belgium from 2012 to 2016, by gathering data from diverse sources in the meat and human health sectors. RESULTS: In Belgium, on average, 15 carcasses with generalised infections and 1168 carcasses with localised ones are detected upon meat inspection each year. The highest proportion of the total economic losses due to bovine cysticercosis were borne by the cattle owners with an average economic cost of €3,408,455/year: €2,954,061/year due to BCC insurance, €453,024/year due to value losses of beef of uninsured carcasses (i.e. freezing process) and €1370/year due to destruction costs of uninsured carcasses with generalised infections. The slaughterhouses suffered an economic impact of €210,806/year. They were responsible for inspection costs related to meat inspection in general, administration, processing and deboning of infected carcasses (€597,856/year), value losses (€34,848/year) and destruction costs (€105/year) of carcasses insured by the slaughterhouses (unofficial insurance) (5% of slaughtered animals). On the other hand, the slaughterhouses gained a total of €422,004/year due to unofficial insurance fees. Thirty percent of all slaughtered animals were officially insured against BCC and the insurance company generated an income of €2,322,337/year. The economic impact related to taeniosis (10,991 patients annually) amounted to a maximum of €795,858/year. CONCLUSION: BCC and taeniosis due to T. saginata have a large economic impact in Belgium, mainly due to the insurance costs for BCC. These results indicate the need for reducing the number of BCC and taeniosis cases to avoid the costs and losses related to this parasite.

Factors associated with offal, partial and whole carcass condemnation in ten French cattle slaughterhouses.

The proportion of cattle with offal, partial or whole carcass condemnation could be a useful indicator for animal health syndromic surveillance purposes. It requires first highlighting the factors associated with condemnation in order to include them in a modeling process. This study aims to identify and quantify these factors. It was based on data from ten French cattle slaughterhouses from 2006 to 2010 (n=1,439,868 cattle). Multivariable multinomial logistic regression analyses were performed. Sex, age and slaughterhouse were the main effects for offal, partial and whole carcass condemnation and have to be taken into account when implementing syndromic surveillance systems based on meat inspection data. The presence of an error in cattle identification was identified as a potential indicator for a higher risk of condemnation and should be explored as a potential factor for risk-based meat inspection.

Construction of standardized surveillance indicators for bovine cysticercosis.

Bovine cysticercosis is a zoonotic parasitic disease due to Cysticercus bovis. This study aimed to identify factors that could have an impact on the prevalence of cysticercosis and to use them to build standardized indicators of prevalence. Multivariate logistic regression analyses were performed on data from 4,564,065 cattle (91.3% of the cattle population slaughtered in France in 2010) among which 6491 cattle (0.14%) were found to harbor at least one lesion of cysticercosis (including 611 cattle harboring viable cysts, 0.01%). Two multivariate logistic models were fit to the data using as outcome variables either the presence or absence of viable cysts and the presence or absence of cysts whatever their level of development. Age and sex were identified as the main factors influencing bovine cysticercosis prevalence and were used for the construction of standardized prevalence and standardized cysticercosis rate. To illustrate the use of such indicators, they were calculated for the first and second semester of 2010 and for two different areas in France. The differences between raw prevalence and standardized prevalence highlight the use of standardized indicators for comparisons of prevalence between different areas and time periods as the structure of the slaughtered populations differ considerably from one to another.

Toward One Health: are public health stakeholders aware of the field of animal health?

Motivated by the perception that human and veterinary medicines can cooperate in more ways than just fighting zoonoses, the authors organized a roundtable during the 2013 annual meeting of the International Society for Disease Surveillance (ISDS). Collaborations between human and animal health sectors were reported to often rise in response to zoonotic outbreaks (during crisis time) and be mainly based on personal networks. Ways to maintain and strengthen these links were discussed.

Prevalence of Taenia saginata cysticercosis in French cattle in 2010.

Bovine cysticercosis is a foodborne disease caused by the cestode Taenia saginata with cattle as the intermediate host and humans as the final host. This disease is responsible for direct financial losses for farmers. It is also economically important because human infestation through raw or undercooked meat consumption can have a negative impact on the confidence the consumer has in the food industry. This study aimed to determine the apparent and true prevalence of bovine cysticercosis in France and describe the locations of identified cysticercosis lesions. The study sample included 4,564,065 cattle slaughtered in 2010 in France, among which 6491 were detected as harbouring cysticercosis lesions using the current EU meat inspection process. The overall apparent prevalence (including both viable and degenerated cysticerci) was estimated at 0.142% [0.142-0.143]. The true overall prevalence defined as the estimation of the prevalence after taking into account the sensitivity of meat inspection (detection fraction) was 1.23% [0.83-1.93]. The true prevalence of cattle with at least one viable cysticercus was 0.113% [0.076-0.189]. Taking into account both our results and those of a previous study on the prevalence of human cysticercosis in France, we estimated that one carcass could infest an average of 8-20 individuals. The spatial distribution of viable cysticerci showed that the highest apparent prevalence was found in eastern France. This study, the largest survey ever conducted on bovine cysticercosis in France, indicated a low but spatially heterogeneous prevalence of the parasite among the cattle population. Considering French eating habits, according to which it is not uncommon to consume undercooked meat, the possibility of humans being infested even though viable cysticerci are not detected during meat inspection is high. Increasing the detection sensitivity of meat inspection through the use of a risk-based meat inspection procedure should improve prevention of human infestation.

A preliminary investigation of farm-level risk factors for cattle condemnation at the slaughterhouse: a case-control study on French farms.

The financial impact of condemnation for farmers and the importance of efficiency in the meat inspection process to guarantee food safety are well known. Identifying farm-level risk factors for condemnation are useful in order to find a way for farmers to potentially reduce their condemnation rates and to build a risk-based farm classification for veterinary services to target both meat inspection and farms inspections. To our knowledge, this has not yet been done, probably due to a lack of available meat inspection data. A preliminary investigation was performed through a case-control study on 36 French farms, from a dairy production region to identify farm-level risk factors for high condemnation rates (i.e. more than 45% of cattle with at least one portion of the carcass condemned). Multivariable exact logistic regression was performed to take into account the small sample size. The final model identified two significant risk factors. The odds of having a high condemnation rate was at least twice as greater for farmers who did not adhere to the quality charter of an international retailer and was significantly higher when the most qualified worker on the farm had a degree in agriculture. This latter effect was unexpected and is reviewed in the discussion section. The protective effect of the quality charter could be explained by the annual control of farms performed to guarantee compliance with good farming practices in the adhering farms. It led us to believe that compliance with well known good farming practices could be a way for farmers to reduce their condemnation rates. This study is a preliminary investigation performed on a small sample size of farms that were mainly dairy farms. It is a first step for further investigations that need to be done on this topic at a larger scale to fill the current lack of knowledge.

Inventory of veterinary syndromic surveillance initiatives in Europe (Triple-S project): current situation and perspectives.

Within the current context that favours the emergence of new diseases, syndromic surveillance (SyS) appears increasingly more relevant tool for the early detection of unexpected health events. The Triple-S project (Syndromic Surveillance Systems in Europe), co-financed by the European Commission, was launched in September 2010 for a three year period to promote both human and animal health SyS in European countries. Objectives of the project included performing an inventory of current and planned European animal health SyS systems and promoting knowledge transfer between SyS experts. This study presents and discusses the results of the Triple-S inventory of European veterinary SyS initiatives. European SyS systems were identified through an active process based on a questionnaire sent to animal health experts involved in SyS in Europe. Results were analyzed through a descriptive analysis and a multiple factor analysis (MFA) in order to establish a typology of the European SyS initiatives. Twenty seven European SyS systems were identified from twelve countries, at different levels of development, from project phase to active systems. Results of this inventory showed a real interest of European countries for SyS but also highlighted the novelty of this field. This survey highlighted the diversity of SyS systems in Europe in terms of objectives, population targeted, data providers, indicators monitored. For most SyS initiatives, statistical analysis of surveillance results was identified as a limitation in using the data. MFA results distinguished two types of systems. The first one belonged to the private sector, focused on companion animals and had reached a higher degree of achievement. The second one was based on mandatory collected data, targeted livestock species and is still in an early project phase. The exchange of knowledge between human and animal health sectors was considered useful to enhance SyS. In the same way that SyS is complementary to traditional surveillance, synergies between human and animal health SyS could be an added value, most notably to enhance timeliness, sensitivity and help interpreting non-specific signals.

First human rabies case in French Guiana, 2008: epidemiological investigation and control.

BACKGROUND: Until 2008, human rabies had never been reported in French Guiana. On 28 May 2008, the French National Reference Center for Rabies (Institut Pasteur, Paris) confirmed the rabies diagnosis, based on hemi-nested polymerase chain reaction on skin biopsy and saliva specimens from a Guianan, who had never travelled overseas and died in Cayenne after presenting clinically typical meningoencephalitis. METHODOLOGY/PRINCIPAL FINDINGS: Molecular typing of the virus identified a Lyssavirus (Rabies virus species), closely related to those circulating in hematophagous bats (mainly Desmodus rotundus) in Latin America. A multidisciplinary Crisis Unit was activated. Its objectives were to implement an epidemiological investigation and a veterinary survey, to provide control measures and establish a communications program. The origin of the contamination was not formally established, but was probably linked to a bat bite based on the virus type isolated. After confirming exposure of 90 persons, they were vaccinated against rabies: 42 from the case's entourage and 48 healthcare workers. To handle that emergence and the local population's increased demand to be vaccinated, a specific communications program was established using several media: television, newspaper, radio. CONCLUSION/SIGNIFICANCE: This episode, occurring in the context of a Department far from continental France, strongly affected the local population, healthcare workers and authorities, and the management team faced intense pressure. This observation confirms that the risk of contracting rabies in French Guiana is real, with consequences for population educational program, control measures, medical diagnosis and post-exposure prophylaxis.