Histomonosis in German turkey flocks: possible ways of pathogen introduction.

Histomonosis has become an important disease of turkeys since the ban of effective feed additives and therapeutics. Some critical risk factors for pathogen introduction into a farm have already been identified but open questions remain. Therefore, a retrospective case-control-study was used to identify the most significant risk factors for Histomonas (H.) meleagridis-introduction into a turkey farm. A total of 113 questionnaires were collected from 73 control-farms and 40 Histomonas-positive case-farms in Germany between 20 April 2021 and 31 January 2022. The data were analysed for possible risk factors by descriptive and univariate, single- and multi-factorial analysis. The presence of earthworms, snails and beetles, as vectors of H. meleagridis, as well as the proximity to other poultry-keeping farms in addition to a frequent observation of wild birds nearby the turkey farm, showed the highest risk potential for histomonosis outbreaks. Furthermore, poor biosecurity measures seem to have increased the probability for an outbreak. Insufficient climate management, straw as litter material and an inadequate litter refill frequency might have promoted a favourable humidity for vector- or pathogen survival providing important areas for improved disease control measures in the future.RESEARCH HIGHLIGHTSA retrospective case-control-study was conducted to identify impactful risk factors for a H. meleagridis introduction.The probability of a histomonosis outbreak was increased by the presence of vectors and reservoirs nearby a farm.Impactful risk factors concerning biosecurity measures, climate and litter management were identified.

Within-herd prevalence threshold for the detection of Mycobacterium avium ssp. paratuberculosis antibody-positive dairy herds using pooled milk samples: A field study.

Herd-level diagnosis of paratuberculosis using a pool-milk ELISA (pool size: n ≤ 50) is a novel, economical, and convenient method to identify blood serological Mycobacterium avium ssp. paratuberculosis (MAP) antibody-positive herds. To date, the diagnostic performance of the pool-milk ELISA has been described only under laboratory conditions where herd prevalence was simulated by the preparation of milk pools consisting of milk samples of cows with a known MAP status determined by fecal culture. In our observational study, test performance under field conditions was studied using pooled milk and individual blood samples. A total of 486 herds within the MAP prevalence reduction program of Lower Saxony, from which pooled milk and individual blood ELISA results were available, were assigned to this study. Data were analyzed for the period between January 1 and December 31, 2018, the first year after herd testing became obligatory in this federal state of Germany. To evaluate whether pooled milk samples reliably distinguish between herds with a MAP-apparent blood serological within-herd prevalence (MAP-Ab-WHPapp) ≥5% and herds with a MAP-Ab-WHPapp <5%, the distribution of the MAP-Ab-WHPapp was compared between pool-positive and pool-negative herds. The MAP-Ab-WHPapp was 3.4% (median; 95% confidence interval = 0-11.4%) in pool-positive herds and 1.2% (median; 95% confidence interval = 0-6.4%) in pool-negative herds. Only 10.8% (n = 12) of the pool sample-negative herds had a MAP-Ab-WHPapp ≥5% and were therefore false negatives, given the aims of the MAP prevalence reduction program. Hence, the pool-milk sampling strategy seems well suited to distinguish between herds with a MAP-Ab-WHPapp ≥ 5% and herds with a MAP-Ab-WHPapp <5% since only 10% of serum MAP-ELISA positive herds were missed. Employing a logistic regression model, we estimated that the minimum blood serological MAP-Ab-WHPapp to detect a pool-positive herd with a probability of 95% was 8%, which fits well with the aim of the MAP prevalence reduction program to focus on herds with a MAP-Ab-WHPapp of ≥5%. Despite the limitations of the control approach, which include milk pool sample collection and a low sensitivity of the ELISA used in milk pools and serum samples, the aims of the MAP prevalence reduction program can be achieved. The results of these field data support that pool-milk sample ELISA is a useful, economical, and low labor-intensive tool to identify herds seropositive for MAP in a MAP prevalence reduction program.

Retrospective Investigations of Recurring Histomonosis on a Turkey Farm.

The ban of effective feed additives and therapeutics in the European Union and in other parts of the world led to a dramatic increase of histomonosis in turkeys. Despite the impact of the disease on the health and welfare of poultry, many questions remain open regarding the epidemiology of the pathogen. In this study, we retrospectively monitored a farm with recurring cases of histomonosis to identify possible routes of pathogen introduction and predisposing factors that may influence the disease development. We included 32 consecutive turkey flocks, which were fattened between 2007 and 2021 on the same farm under the same management and housing conditions. During this period, Histomonas meleagridis was detected in eight flocks of toms and four flocks of hens with a high variability in disease development. Outbreaks in toms led to significantly (P ≤ 0.05) higher mortality rates (5.3%-98.3%) than in hens (2.6%-6.1%). Most of the outbreaks (9/12) were diagnosed between June and September with a peak in August, suggesting a possible impact of higher temperatures either on the host or on the pathogen and pathogen-transmitting vectors. Further investigation is necessary to determine why hens might cope better with histomonosis than toms. Continuous flock and hygiene management is important to prevent an introduction of the causative pathogen and to control potential vectors.

Investigaciones retrospectivas de histomoniasis recurrente en una granja de pavos. La prohibición de aditivos alimentarios y productos terapéuticos efectivos en la Unión Europea y en otras partes del mundo condujo a un aumento dramático de histomoniasis en pavos. A pesar del impacto de la enfermedad en la salud y el bienestar de las aves, quedan muchas interrogantes abiertas con respecto a la epidemiología del patógeno. En este estudio, se monitoreó retrospectivamente una granja con casos recurrentes de histomoniasis para identificar posibles rutas de introducción de patógenos y factores predisponentes que puedan influir en el desarrollo de la enfermedad. Se incluyeron 32 lotes de pavos consecutivos, que fueron engordados entre 2007 y 2021 en la misma granja bajo las mismas condiciones de manejo y alojamiento. Durante este período, se detectó Histomonas meleagridis en ocho parvadas de machos y cuatro parvadas de gallinas con una alta variabilidad en el desarrollo de la enfermedad. Los brotes en machos llevaron a tasas de mortalidad significativamente más altas (P ≤ 0.05) (5.3 %­ - 98.3 %) que en gallinas (2.6 %­ - 6.1 %). La mayoría de los brotes (9/12) se diagnosticaron entre junio y septiembre con un pico en agosto, lo que sugiere un posible impacto de las temperaturas más altas sobre el huésped o en el patógeno y los vectores transmisores del patógeno. Se necesita más investigación para determinar por qué las gallinas pueden sobrellevar mejor la histomoniasis que los machos. El manejo continuo de la parvada y la higiene es importante para prevenir la introducción del patógeno causante y controlar a los vectores potenciales.

Risk factors for an infection with Coxiella burnetii in German sheep flocks.

In Germany, sheep are the main source of human Q fever epidemics, but data on Coxiella burnetii (C. burnetii) infections and related risk factors in the German sheep population remain scarce. In this cross-sectional study, a standardised interview was conducted across 71 exclusively sheep as well as mixed (sheep and goat) farms to identify animal and herd level risk factors associated with the detection of C. burnetii antibodies or pathogen-specific gene fragments via univariable and multivariable logistic regression analysis. Serum samples and genital swabs from adult males and females of 3367 small ruminants from 71 farms were collected and analysed using ELISA and qPCR, respectively. On animal level, univariable analysis identified young animals (<2 years of age; odds ratio (OR) 0.33; 95% confidence interval (CI) 0.13-0.83) to reduce the risk for seropositivity significantly (p < 0.05). The final multivariable logistic models identified lambing all year-round (OR 3.46/3.65; 95% CI 0.80-15.06/0.41-32.06) and purchases of sheep and goats (OR 13.61/22.99; 95% CI 2.86-64.64/2.21-239.42) as risk factors on herd level for C. burnetii infection detected via ELISA and qPCR, respectively.

Prevalence of Coxiella burnetii in German sheep flocks and evaluation of a novel approach to detect an infection via preputial swabs at herd-level.

A prevalence study was conducted on German sheep flocks including goats if they cohabitated with sheep. In addition, a novel approach was applied to identify an infection at the herd-level before lambing season with preputial swabs, suspecting venereal transmission and ensuing colonisation of preputial mucosa with Coxiella (C.) burnetii. Blood samples and genital swabs were collected from breeding males and females after the mating season and were analysed by enzyme-linked immunosorbent assay (ELISA) and quantitative polymerase chain reaction (qPCR) respectively. In total, 3367 animals were sampled across 71 flocks. The true herd-level prevalence adjusted for misclassification probabilities of the applied diagnostic tests using the Rogan-Gladen estimator for the prevalence estimate and a formula by Lang and Reiczigel (2014) for the confidence limits, ranged between 31.3% and 33% (95% confidence interval [95% CI] 17.3-45.5) detected by the ELISA and/or qPCR. Overall 26-36.6% (95% CI 13-56.8) were detected by ELISA, 13.9% (95% CI 4.5-23.2) by the qPCR and 7.9-11.2% (95% CI 0.08-22.3) by both tests simultaneously. The range of results is due to data obtained from literature with different specifications for test quality for ELISA. Among eight farms with females shedding C. burnetii, three farms (37.5%) could also be identified by preputial swabs from breeding sires. This indicates less reliability of preputial swabs if used as a single diagnostic tool to detect C. burnetii infection at the herd-level.

Invited review: Examining farmers' personalities and attitudes as possible risk factors for dairy cattle health, welfare, productivity, and farm management: A systematic scoping review.

We aimed to determine how research regarding farmers' personalities and attitudes as risk factors is reported (methodological approaches to assessing, extracting, and processing data and analyzing risk factors) and to explore evidence for the effect of farmers' attitudes and personalities on dairy cattle health, welfare, productivity, and management. Therefore, we conducted a systematic review of studies on personality and attitude as risk factors for dairy cattle health, welfare, productivity, and farm management. Database searches captured 1,144 records, and 38 were finally included in the review. Thirty-three manuscripts assessed farmers' attitudes, 1 assessed their personalities, and 4 assessed both as risk factors. These potential risk factors were checked for relationships with more than 50 different outcome variables regarding farm management (17 manuscripts), animal health (13 manuscripts), animal productivity (11 manuscripts), and animal welfare (4 manuscripts). The approaches to assessing risk factors and processing and interpreting data varied greatly; thus, drawing conclusions regarding the effects of attitude and personality as risk factors is impeded because manuscripts are difficult to compare. Our findings highlight the need for harmonization of attitudes and personality assessments in future research. Furthermore, researchers should carefully consider which depth of detail to apply when planning and evaluating related research. Nevertheless, results highlight the importance of the effect of personality and attitude on outcomes. Farmers' personality and attitudes are associated with dairy cattle health, welfare, productivity, and management. In general, attitudes indicating higher degrees of technical knowledge, affection with problems, perceived responsibility, perception of control of a situation, a better human-animal relationship, or a positive evaluation of the benefits of management decisions tended to affect outcomes in a beneficial way. "Agreeableness" and "conscientiousness" were shown to promote better farm performance, whereas "neuroticism" had a negative effect. Therefore, further research on attitude and personality and their consideration by professionals and decision-makers within the dairy sector and politics is strongly recommended. This might provide the chance to better understand the needs of dairy farmers and therefore develop tailored advice and support strategies to improve both satisfactory and constructive cooperation.

Analysis of the influences on plumage condition in laying hens: How suitable is a whole body plumage score as an outcome?

An important indicator of the health and behavior of laying hens is their plumage condition. Various scoring systems are used, and various risk factors for feather damage have been described. Often, a summarized score of different body parts is used to describe the overall condition of the plumage of a bird. However, it has not yet been assessed whether such a whole body plumage score is a suitable outcome variable when analyzing the risk factors for plumage deterioration. Data collected within a German project on farms keeping laying hens in aviaries were analyzed to investigate whether and the extent to which information is lost when summarizing the scores of the separate body parts. Two models were fitted using multiblock redundancy analysis, in which the first model included the whole body score as one outcome variable, while the second model included the scores of the individual body parts as multiple outcome variables. Although basically similar influences could be discovered with both models, the investigation of the individual body parts allowed for consideration of the influences on each body part separately and for the identification of additional influences. Furthermore, ambivalent influences (a factor differently associated with 2 different outcomes) could be detected with this approach, and possible dilutive effects were avoided. We conclude that influences might be underestimated or even missed when modeling their explanatory power for an overall score only. Therefore, multivariate methods that allow for the consideration of individual body parts are an interesting option when investigating influences on plumage condition.

Latent class regression models for simultaneously estimating test accuracy, true prevalence and risk factors for Brucella abortus.

In 2003/2004 a field trial was conducted in Northern Ireland to assess the diagnostic accuracy of six serological tests for bovine brucellosis caused by Brucella abortus. Whereas between-test comparisons have been used to calculate test performances so far, the present study used a latent class approach to estimate diagnostic test accuracy parameters in the absence of a gold standard for these six tests simultaneously and to estimate the true prevalence, while accounting for clustering in the study population and risk factors for true prevalence. Results obtained in this study with regard to prevalence, sensitivity and specificity were largely in accordance with previous findings. Screening tests (SAT and EDTA) appeared to be the most sensitive; however, at low prevalences the EDTA and CFT showed the highest positive predictive values of all investigated tests. The specificities and negative predictive values of all diagnostic tests were found to be very high. Differences of prevalence between three groups of the study population with different risk of exposure could be attributed to the mode of sampling indicating that a more risk-based sampling will result in a higher prevalence than a cross-sectional sampling mode. Age, dairy status and history of abortion were shown to influence the prediction of the latent true infection status.

Joint use of Disparate Data for the Surveillance of Zoonoses: A Feasibility Study for a One Health Approach in Germany.

Zoonotic diseases concern human and animal populations and are transmitted between both humans and animals. Nevertheless, surveillance data on zoonoses are collected separately for the most part in different databases for either humans or animals. Bearing in mind the concept of One Health, it is assumed that a global view of these data might help to prevent and control zoonotic diseases. In following this approach, we wanted to determine which zoonotic data are routinely collected in Germany and whether these data could be integrated in a useful way to improve surveillance. Therefore, we conducted an inventory of the existing data collections and gathered information on possible One Health surveillance areas in Germany by approaching experts through a scoping survey, personal interviews and during a workshop. In matching the information between the status quo for existing data collections and the possible use cases for One Health surveillance, this study revealed that data integration is currently hindered by missing data, missing pathogen information or a lack of timeliness, depending on the surveillance purpose. Therefore, integrating the existing data would require substantial efforts and changes to adapt the collection procedures for routine databases. Nevertheless, during this study, we observed a need for different stakeholders from the human and animal health sectors to share information to improve the surveillance of zoonoses. Therefore, our findings suggest that before the data sets from different databases are integrated for joint analyses, the surveillance could be improved by the sharing of information and knowledge through a collaboration of stakeholders from different sectors and institutions.

Sporadic salmonellosis in Lower Saxony, Germany, 2011-2013: raw ground pork consumption is associated with Salmonella Typhimurium infections and foreign travel with Salmonella Enteritidis infections.

To investigate risk factors for sporadic salmonellosis, for each notified case four randomly selected population controls matched for age, sex and geographical region were interviewed via self-administered questionnaire. Conditional logistic regression analysis of 285 matched pairs revealed significant associations for raw ground pork consumption [odds ratio (OR) 6·0, 95% confidence interval (CI) 1·8-20·1], taking antacids (OR 5·8, 95% CI 1·4-24·5), eating meat outside the home (OR 5·7, 95% CI 2·2-14·6) and daily changing or cleaning of dishcloth (OR 2·1, 95% CI 1·2-3·9). Animal contact and ice cream consumption were negatively associated with salmonellosis (OR 0·5, 95% CI 0·2-1 and OR 0·3, 95% CI 0·1-0·6, respectively). S. Typhimurium infections were significantly associated with raw ground pork consumption (OR 16·7, 95% CI 1·4-194·4) and S. Enteritidis infections with having travelled abroad (OR 9·7, 95% CI 2·0-47·3). Raw egg consumption was not a risk factor, substantiating the success of recently implemented national control programmes in the poultry industry. Unexpectedly, hygienic behaviour was more frequently reported by cases, probably because they overestimated their hygiene precautions retrospectively. Although animal contact might enhance human immunocompetence, underreporting of salmonellosis by pet owners could have occurred. Eating raw pork products is the major risk factor for sporadic human S. Typhimurium infections in Lower Saxony.

Zoonotic disease surveillance--inventory of systems integrating human and animal disease information.

Although 65% of recent major disease outbreaks throughout the world have a zoonotic origin, there is still a sharp division among the disciplines into the human and animal health sectors. In the last few decades, a global integrative concept, often referred to as 'One Health', has been strongly endorsed. Surveillance and monitoring efforts are major components for effective disease prevention and control. As human health and animal health are inextricably linked, it is assumed that a cross-sectoral data interpretation of zoonotic disease information will improve their prevention, prediction and control. To provide an overview of existing systems throughout the world which integrate information from humans and animals on zoonotic diseases, a literature review was conducted. Twenty projects were identified and described regarding their concepts and realization. They all vary widely depending on their surveillance purpose, their structure and the source of information they use. What they have in common is that they quite often use data which have already been collected for another purpose. Therefore, the challenges of how to make use of such secondary data are of great interest.

Risk factors associated with sporadic salmonellosis in children: a case-control study in Lower Saxony, Germany, 2008-2011.

We conducted a case-control study based on 884 laboratory-confirmed sporadic Salmonella cases reported to the German infectious disease notification system. For controls, we recruited 510 rotavirus cases via the same system. Univariable and multivariable logistic regression analyses were performed separately for children aged 0-3 years and 4-14 years. In both age groups, the highest odds ratios (OR) were found for raw ground pork consumption [0-3 years: OR 8·6, 95% confidence interval (CI) 2·4-30·8; 4-14 years: OR 4·5, 95% CI 1·1-19]. Further risk factors were exposure to animals (OR 1·6, 95% CI 1·1-2·1), consumption of poultry (OR 1·5, 95% CI 1·1-2·1), food items containing eggs (OR 1·5, 95% CI 1·1-2) and black pepper (OR 1·7, 95% CI 1·1-3·5) in children aged 0-3 years, and consumption of uncooked pork sausage (OR 3·6, 95% CI 1·4-9·3) in children aged 4-14 years. This study highlights the significance of raw pork products ('Mett' in German) as risk factors for sporadic salmonellosis in children in Germany.

Assessment of long-term donor-site morbidity after harvesting the latissimus dorsi flap for neonatal myelomeningocele repair.

BACKGROUND AND AIM: The latissimus dorsi flap (LDF) has been employed very successfully over decades to cover large soft-tissue defects. Its donor-site morbidity has been extensively investigated in adults - but not in children - and is considered to be nonrestrictive. The aim of this long-term study was to assess donor-site morbidity with the modified Constant score more than 8 years after coverage of large myelomeningocele (MMC) defects with a reverse latissimus dorsi flap. METHODS: Within the first days after birth, the reverse latissimus dorsi muscle flap was used uni- or bilaterally in three neonates to cover a large MMC defect. Bilateral shoulder function was tested more than 8 years postoperatively according to the modified Constant score. RESULTS: The mean age at follow-up was 11.7 years. None of the patients experienced any pain or shoulder restrictions during normal daily activities. They all managed to position both of their arms comfortably above the head. Forward flexion was normal in all patients as was abduction and external rotation. Dorsal extension was minimally reduced on the operated side. Internal rotation was symmetric in all patients; the extent of active movement varied from excellent to poor. CONCLUSIONS: Our long-term data suggest that there is no specific and significant impairment of shoulder function after using the distally pedicled reverse LDF for neonatal MMC repair.

Statistical tools to improve assessing agreement between several observers.

In the context of assessing the impact of management and environmental factors on animal health, behaviour or performance it has become increasingly important to conduct (epidemiological) studies in the field. Hence, the number of investigated farms per study is considerably high so that numerous observers are needed for investigation. In order to maintain the quality and validity of study results calibration meetings where observers are trained and the current level of agreement is assessed have to be conducted to minimise the observer effect. When study animals were rated independently by the same observers by a categorical variable the exclusion test can be performed to identify disagreeing observers. This statistical test compares for each variable and each observer the observer-specific agreement with the overall agreement among all observers based on kappa coefficients. It accounts for two major challenges, namely the absence of a gold-standard observer and different data type comprising ordinal, nominal and binary data. The presented methods are applied on a reliability study to assess the agreement among eight observers rating welfare parameters of laying hens. The degree to which the observers agreed depended on the investigated item (global weighted kappa coefficients: 0.37 to 0.94). The proposed method and graphical description served to assess the direction and degree to which an observer deviates from the others. It is suggested to further improve studies with numerous observers by conducting calibration meetings and accounting for observer bias.

Subtype specific risk factor analyses for sporadic human salmonellosis: a case-case comparison in Lower Saxony, Germany.

With the intention to deepen the knowledge of the vertical transmission of particular subtypes of Salmonella enterica from "the stable to the table" a case1-case2 analysis in Lower Saxony, Germany, was conducted. The data collection was based on standardised telephone interviews with 1741 Salmonella case persons. Single-factor-analyses revealed statistically significant associations between S. Typhimurium infections and animal keeping (odds ratio (OR): 1.4; 95%-Confidence-interval (CI): 1.2-1.7), especially rodents (OR 1.5; CI 1.2-2.1), and with consumption of meat (OR 1.9; CI 1.3-2.8), raw ground pork (OR 3.0; CI 2.1-4.2) and uncooked pork sausage (OR 2.1; CI 1.6-2.9). The S. Typhimurium phage type DT 104 was associated most with consumption of uncooked pork sausage (OR 3.6; CI 1.3-8.5). Multiple logistic regression analyses confirmed the associations between S. Typhimurium infection and consumption of raw ground pork and with animal contact. The results circumstantiate the assumption of raw pork products still being a relevant source for S. Typhimurium infections in Germany. Therefore, it is recommended to intensify efforts to reduce salmonella infections caused by raw pork products. S. Enteritidis infection was associated statistically significantly with travelling abroad (OR 2.1; CI 1.6-3.3), consumption of raw tomatoes (OR 1.8; CI 1.5-2.1), dried herbs (OR 2.1; CI 1.0-1.8), and undercooked eggs (OR 1.3; CI 1.1-1.6) compared with other serovars. These results were confirmed in multiple logistic regression analyses, as well.

Risk factors associated with sporadic salmonellosis in adults: a case-control study.

In order to identify and assess recent risk factors for sporadic human infections with Salmonella enterica, we conducted a case-control study in Lower Saxony, Germany. The data collection was based on standardized telephone interviews with 1017 cases and 346 controls aged >14 years. Odds ratios were calculated in single-factor and multi-factor analyses for Salmonella cases and two different control groups, i.e. population controls and controls with rotavirus infection. Multi-factor analysis revealed associations between sporadic Salmonella infections for two exposures by both sets of controls: consumption of raw ground pork [adjusted odds ratio (aOR) 2·38, 95% confidence interval (CI) 1·27-4·44] and foreign travel (aOR 2·12, 95% CI 1·00-4·52). Other exposures included consumption of food items containing eggs (aOR 1·43, 95% CI 0·80-2·54), consumption of chicken meat (aOR 1·77, 95% CI 1·26-2·50), outdoor meals/barbecues (aOR 3·96, 95% CI 1·41-11·12) and taking gastric acidity inhibitors (aOR 2·42, 95% CI 1·19-4·92), all were significantly associated with respect to one of the two control groups. The impact of consuming food items containing eggs or chicken meat was lower than expected from the literature. This might be a consequence of Salmonella control programmes as well as increased public awareness of eggs and chicken products being a risk factor for salmonellosis. Efforts to reduce Salmonella infections due to raw pork products should be intensified.

[Photography in Hand Surgery. Basic knowledge and standards]. / Fotografie in der Handchirurgie. Grundlegende Kenntnisse und Standards.

Photo documentation plays an important role in hand surgery. Pre- and postoperative documentation, planning of interventions, patient information as well as publications and presentations all require high quality images. Last but not least an accurate documentation is necessary for legal reasons. We present basic knowledge of equipment, photo and processing methods and illustrate imaging techniques and photographic standards for professional work flows in daily hand surgery.

[A case of nerve angiomatosis associated with neurofibromatosis type I]. / Ein Fall Neuroangiomatose bei Neurofibromatose Typ I.

We present the case of a patient suffering from Neurofibromatosis type I (NF-1) with acute, very painful neuropathy of the right lower extremity. The preoperative electro neuro- physiological study showed an impaired function of the peroneal nerve. The MRI revealed an extended diffuse plexiform tumour of the sciatic nerve and at thigh level. Biopsies showed marked diffuse angiomatosis within the sciatic nerve.To our knowledge, this is the first description of an intraneural vascular malformation in NF-1.Treatment of such an entity is a challenge and must be individually defined.