A genetically related cluster of Salmonella Typhimurium cases in humans associated with ruminant livestock and related food chains, United Kingdom, August 2021-December 2022.

Following an outbreak of Salmonella Typhimurium in Wales in July 2021 associated with sheep meat and offal, further genetically related cases were detected across the UK. Cases were UK residents with laboratory-confirmed Salmonella Typhimurium in the same 5-single-nucleotide polymorphism (SNP) single-linkage cluster with specimen date between 01/08/2021-2031/12/2022. We described cases using routine (UK) and enhanced (Wales only) surveillance data. Exposures in cases in Wales were compared with non-Typhimurium Salmonella case-controls. Environmental Health Practitioners and the Food Standards Agency investigated supply chains of food premises reported by ≥2 cases. Animal, carcass, and environmental samples taken for diagnostic or monitoring purposes for gastrointestinal pathogens were included in microbiological investigations. We identified 142 cases: 75% in England, 23% in Wales and 3% in Scotland. Median age was 32 years, and 59% were male. Direct contact with sheep was associated with becoming a case (aOR: 14, 95%CI: 1.4-145) but reported by few (6/32 cases). No single food item, premises, or supplier linked all cases. Multi-agency collaboration enabled the identification of isolates in the same 5-SNP single-linkage cluster from a sheep carcass at an English abattoir and in ruminant, wildlife, poultry, and environmental samples, suggesting multiple vehicles and pathways of infection.

An evaluation of wild bird avian influenza surveillance in Great Britain.

This study presents a method for evaluation of surveillance for avian influenza (AI) in wild birds and compares surveillance activities before and after changes in surveillance strategy in Great Britain (GB). In October 2008 the AI Wild Bird Surveillance (AIWBS) system in GB was modified to focus on passive surveillance (birds found dead), including those found during warden patrols of wetlands and wildlife reserves, with less emphasis on public reporting of birds found dead. The number of birds sampled by active surveillance (birds live-trapped or shot) was also reduced. In the present study the impact of these changes was investigated by comparing the 12 mo prior to October 2008 with the subsequent 12 mo. Four factors were considered for each surveillance system component: 1) the number of wild birds tested; 2) whether the tested wild birds were considered "higher risk species" (HRS) for being infected with AI; 3) the location of the birds tested with respect to counties designated as a priority for surveillance; and 4) the probability that the birds tested might yield a positive AI virus result based on surveillance results in wild birds across Europe. The number of birds tested by both surveillance types was greatly reduced after the strategy change. The proportion of birds sampled in priority counties also significantly decreased in the second year for both active and passive surveillance. However, the proportion of HRS sampled by active surveillance significantly increased, while a significant decrease in these species was seen for passive surveillance in the second year. The derived probability scores for detecting AI based on European surveillance results indicated a reduction in sensitivity for H5N1 highly pathogenic AI detection by passive surveillance. The methods developed to evaluate AIWBS in GB may be applicable to other European Union countries. The results also reflect the complex issues associated with evaluation of disease surveillance in wildlife populations in which the disease ecology is only partially understood.

Identifying antimicrobial resistance genes of human clinical relevance within Salmonella isolated from food animals in Great Britain.

OBJECTIVES: To investigate the occurrence of antimicrobial resistance genes of human clinical relevance in Salmonella isolated from livestock in Great Britain. METHODS: Two hundred and twenty-five Salmonella enterica isolates were characterized using an antimicrobial resistance gene chip and disc diffusion assays. Plasmid profiling, conjugation experiments and identification of Salmonella genomic island 1 (SGI1) were performed for selected isolates. RESULTS: Approximately 43% of Salmonella harboured single or multiple antimicrobial resistance genes with pig isolates showing the highest numbers where 96% of Salmonella Typhimurium harboured one or more resistance genes. Isolates harbouring multiple resistances divided into three groups. Group 1 isolates harboured ampicillin/streptomycin/sulphonamide/tetracycline resistance and similar phenotypes. This group contained isolates from pigs, cattle and poultry that were from several serovars including Typhimurium, 4,[5],12:i:-, Derby, Ohio and Indiana. All Group 2 isolates were from pigs and were Salmonella Typhimurium. They contained a non-sul-type class 1 integron and up to 13 transferrable resistances. All Group 3 isolates harboured a class 1 integron and were isolated from all animal species included in the study. Most isolates were Salmonella Typhimurium and harboured SGI1. CONCLUSIONS: Salmonella isolated from livestock was shown to harbour antimicrobial resistance genes although no or little resistance to third-generation cephalosporins or ciprofloxacin, respectively, was detected. The preponderance in pigs of multidrug-resistant Salmonella Typhimurium makes it important to introduce control measures such as improved biosecurity to ensure that they do not pass through the food chain and limit human therapeutic options.

Ecological meta-analysis of density-dependent processes in the transmission of lymphatic filariasis: survival of infected vectors.

The survival rate of infected vectors represents one of the fundamental components that influence the transmission dynamics of mosquito-borne diseases. Despite the occurrence of a number of studies investigating mosquito survival after infection with filarial worms, there remains conflicting evidence from both laboratory and field experiments as to the existence and mechanism for parasite-induced mortality among filarial mosquitoes. Here, we used a mixed effects meta-analytical framework to combine the data from all available vector-human host blood feeding experiments to evaluate the evidence for the impact of parasite load on the mortality rates of the three major lymphatic filariasis transmitting mosquito genera, Culex, Aedes, and Anopheles mosquitoes, over the extrinsic incubation period of parasitic infection. The results show that, despite the application of this approach, or in the case of Anopheles using a convention fixed effects logistic regression analysis supplemented with additional survival analysis of longitudinal data, no strong association between mortality rate and microfilariae (mf) uptake for either of the three mosquito genera is apparent in the combined data. Instead, a key finding is that study effects played a more crucial role in determining the levels of mortality observed in these experimental studies. This was most revealing in the case of Culex, given that the largest single study in terms of both the number of data points and range of mf intensities, in contrast to smaller studies, showed a significant positive association between mf intensity and mortality, indicating that in this genus at least, the detrimental effect of infection may be manifested only at the highest mf intakes. Although no density dependence in vector mortality was also observed for Aedes, possibly because of the use of restricted human mf intensity range in previous studies, an intriguing finding was that a significantly higher overall mortality was observed for this genus over mfintake ranges that produced much less corresponding mortality in Culex and Anopheles. The results also indicate that currently very little can be said about the survival rate of Anopheles mosquitoes infected with filarial worms because of the striking paucity of data for this genus. Further studies, using standardized methods and covering an appropriate range of mf uptake intensities and using study frameworks that allow the design and comparison of data from both experimental and field experiments, are clearly indicated if we are to reliably quantify the likely effect of filarial infection on vector survival.

Quantifying the spatial risk of Avian Influenza introduction into British poultry by wild birds.

The transmission of pathogens across the interface between wildlife and livestock presents a challenge to the development of effective surveillance and control measures. Wild birds, especially waterbirds such as the Anseriformes and Charadriiformes are considered to be the natural hosts of Avian Influenza (AI), and are presumed to pose one of the most likely vectors for incursion of AI into European poultry flocks. We have developed a generic quantitative risk map, derived from the classical epidemiological risk equation, to describe the relative, spatial risk of disease incursion into poultry flocks via wild birds. We then assessed the risk for AI incursion into British flocks. The risk map suggests that the majority of AI incursion risk is highly clustered within certain areas of Britain, including in the east, the south west and the coastal north-west of England. The clustering of high risk areas concentrates total risk in a relatively small land area; the top 33% of cells contribute over 80% of total incursion risk. This suggests that targeted risk-based sampling in a relatively small geographical area could be a much more effective and cost-efficient approach than representative sampling. The generic nature of the risk map method, allows rapid updating and application to other diseases transmissible between wild birds and poultry.

Control of a highly pathogenic H5N1 avian influenza outbreak in the GB poultry flock.

The identification of H5N1 in domestic poultry in Europe has increased the risk of infection reaching most industrialized poultry populations. Here, using detailed data on the poultry population in Great Britain (GB), we show that currently planned interventions based on movement restrictions can be expected to control the majority of outbreaks. The probability that controls fail to keep an outbreak small only rises to significant levels if most transmission occurs via mechanisms which are both untraceable and largely independent of the local density of premises. We show that a predictor of the need to intensify control efforts in GB is whether an outbreak exceeds 20 infected premises. In such a scenario neither localized reactive vaccination nor localized culling are likely to have a substantial impact. The most effective of these contingent interventions are large radius (10 km) localized culling and national vaccination. However, the modest impact of these approaches must be balanced against their substantial inconvenience and cost.

Identification of management risk factors for VTEC O157 in young-stock in England and Wales.

We conducted a cross-sectional study on 255 cattle farms in England and Wales to identify risk factors for verocytotoxin-producing E. coli O157 (VTEC). Exposure variables were collected at the levels of the farm and of the group of young-stock within the farms. On each farm a group of young-stock (6-18 months of age) was sampled to establish VTEC status. In our multiple logistic regression, farm VTEC status was associated with access to springs (OR: 0.31, CI95%: 0.12, 0.78) and assessing the wetness of the bedding material less frequently than daily (OR: 3.89 CI95%: 1.5, 10.2). At group-level we found no associated risk factors for animals housed outdoors in fields. Significant for groups housed in pens were wet bedding (wet OR: 3.43, CI95%: 1.3, 9.4; very wet OR: 4.24, CI95%: 1.2, 14.6), number of animals in the group (10-15 OR: 2.72, CI95%: 0.75, 9.9, 16-24, OR: 3.78, CI95%: 1.2, 12.3; >25 OR: 3.78, CI95%: 1.1, 12.7) and feeding straw (OR: 2.29, CI95%: 1.2, 5.5).

Mathematical models and lymphatic filariasis control: endpoints and optimal interventions.

The current global initiative to eliminate lymphatic filariasis is a major renewed commitment to reduce or eliminate the burden of one of the major helminth infections from resource-poor communities of the world. Mathematical models of filariasis transmission can serve as an effective tool for guiding the scientific development and management of successful community-level intervention programmes by acting as analytical frameworks for integrating knowledge regarding parasite transmission dynamics with programmatic factors. However, the power of these tools for supporting control interventions will be realized fully only if researchers address the current uncertainties and gaps in data and knowledge of filarial population dynamics and the effectiveness of currently proposed filariasis intervention options.

Epidemiology of extended spectrum beta-lactamase E. coli (CTX-M-15) on a commercial dairy farm.

The epidemiology of an extended spectrum beta-lactamase Escherichia coli (CTX-M-15) was observed and described on a commercial dairy farm located in the United Kingdom. During 2008 longitudinal sampling of faecal pat samples from different cattle groups comprising milking and non-milking cows, calving cows, calves, and the environment was carried out. The proportion of CTX-M-15 E. coli positive samples was significantly (p<0.0.01) higher in milking cows (30.3%, CI(95%) 26.8; 33.8) than in the herd as a whole (17.0%, CI(95%) 14.9; 19.0). In 2008 95.6% of sampled calves tested positive for CTX-M-15 E. coli at two days of age. A more detailed investigation in 2009 revealed that cows and heifers were approximately eight times more likely to test positive in the 10 days after calving than the 9 days before (OR 7.6, CI(95%) 2.32; 24.9). The CTX-M15 E. coli was also readily isolated from the immediate calving pen environment, including the water troughs. A cyclic pattern was apparent where cows immediately after calving and as high yielders were highly positive, but where the prevalence decreased during the dry period. The increased prevalence of the CTX-M-15 E. coli in certain cattle groups and farm environments including calving pens suggested that husbandry, antimicrobial usage and hygiene may play a significant role on a farm with regards to the epidemiology of CTX-M-15. This may offer a practical opportunity to reduce further dissemination through good practice and hygiene around calving.

Farm practices to control E. coli O157 in young cattle--a randomised controlled trial.

A randomised controlled trial was used to investigate the effect of three complex management intervention packages to reduce the burden of E. coli O157 in groups of young-stock on cattle farms in England and Wales. All intervention farms were assigned measures to avoid buying in new animals and having direct contact or sharing water sources with other cattle. Furthermore, package A (7 farms) aimed to keep a clean environment and closed groups of young-stock; package B (14 farms) aimed for improved water and feed hygiene, whilst package C was assigned both A and B. The control farms (26 farms) were asked not to alter their practices. Farms, which were assigned intervention package A, exhibited a 48% reduction in E. coli O157 burden over the 4.5 months (average) of observation, compared to 18% on the control farms. The effect of package A compared to the control farms in a crude intention-to-treat model was RR = 0.26 (p=0.122). When the risk ratio was adjusted for actual application of the different measures, the effect of intervention package A became stronger and statistically significant (RR = 0.14 p=0.032). Statistical evidence (p< 0.05) showed that dry bedding and maintaining animals in the same groups were the most important measures within the package and weak evidence (p< 0.1) showed that a closed herd policy and no contact with other cattle may also be of importance. Compliance with the other measures in package A had no influence on the effect of the package. No evidence of effect of the other two intervention packages was found.