Canine parvovirus prevention-What influence do socioeconomics, remoteness, caseload and demographics have on veterinarians' perceptions and behaviors?

Canine parvovirus (CPV) is a cause of severe disease in dogs globally, yet is preventable by vaccination. A range of vaccination protocols are used by veterinary practitioners with evidence suggesting some protocols provide better protection than others in high infection-risk situations. This study investigated associations between veterinarians' vaccination recommendations and hospital remoteness, socioeconomic disadvantage, CPV caseload, and veterinarian perceptions and demographics. A national Australian veterinary survey in 2017 received 569 practitioner responses from 534 unique hospitals (23.6 % response rate). Respondents from major city hospitals had the lowest perceptions of the national CPV caseload (p < 0.0001). Those from hospitals with mild to moderate caseloads (6-40 cases per annum) recommended more frequent puppy revaccination - which is considered more protective - than those with the highest caseload (p = 0.0098), which might increase vaccination failure risk. Respondents from the most socioeconomically disadvantaged regions were over-represented in recommending annual revaccination of adult dogs; those from the least disadvantaged regions were over-represented in recommending triennial revaccination (p < 0.0001). Hospitals with higher CPV caseloads, greater socioeconomic disadvantage or increased remoteness did not favor two puppy vaccination protocols that are considered more protective (younger first vaccination age or older final vaccination age), despite these regions presenting higher CPV caseload risk. Titer testing to determine whether to revaccinate was more likely to be used in major city hospitals (p = 0.0052) and less disadvantaged areas (p = 0.0550). University of graduation was associated with CPV caseload, remoteness and level of socioeconomic disadvantage of the region where the graduate worked. University of graduation was significantly associated with age for final puppy vaccination and titer-testing recommendations. Graduates from one university were over-represented in recommending an earlier (10-week) finish protocol and titer testing, compared to all other universities. Year and university of graduation, and respondent's age were associated with a number of vaccination protocol recommendations suggesting that inherent biases might affect veterinarians' decisions. Emphasis on currently recommended vaccination protocols in undergraduate curricula and more protective vaccination protocol use in higher-risk regions could reduce immunization failure and CPV caseload.

Point of truth calibration for disease prioritisation-A case study of prioritisation of exotic diseases for the pig industry in Australia.

The objective of this study was to trial point of truth calibration (POTCal) as a novel method for disease prioritisation. To illustrate the application of this method, we used a previously described case-study of prioritisation of exotic diseases for the pig industry in Australia. Disease scenarios were constructed from criteria which described potential impact and pig-producers were asked to score the importance of each scenario. POTCal was used to model participants' estimates of disease importance as a function of the criteria, to derive a predictive model to prioritise a range of exotic diseases. The best validation of producers' estimates was achieved using a model derived from all responses. The highest weighted criteria were attack rate, case fatality rate and market loss, and the highest priority diseases were the vesicular diseases followed by swine fevers and zoonotic encephalitides. Comparison of results with a previous study in which probabilistic inversion was used to prioritise diseases for the same group of producers highlighted differences between disease prioritisation methods. Overall, this study demonstrated that POTCal can be used for disease prioritisation. An advantage of POTCal is that valid models can be developed that reflect decision-makers' heuristics. Specifically, this evaluation of the use of POTCal in animal health illustrates how the judgements of participants can be incorporated into a decision-making process. Further research is needed to investigate the influence of scenarios presented to participants during POTCal evaluations, and the robustness of this approach applied to different disease issues (e.g. exotic versus endemic) and production types (e.g. intensive versus extensive). To our knowledge, this is the first report of the use of POTCal for disease prioritisation.

Intangible and Economic Impacts of Hendra Virus Prevention Strategies.

Hendra virus (HeV), a potentially fatal zoonotic disease spread by flying foxes, to date has always infected humans via a spillover event from equine HeV infection. In a theoretical case study, we compared the impacts of two different HeV prevention strategies - vaccination and flying fox roost removal - using a recently developed framework that considers different stakeholder group perspectives. The perspectives of the four selected stakeholder groups regarding intangibles were inferred from public discussions and coverage in the media. For all stakeholder groups, the option to vaccinate horses was found to add value to the economic results when the intangible impacts were included in the analysis, while the option for roost removal unanimously detracted from economic analysis value when the intangible impacts were included. Both the mean and median stakeholder-adjusted value ratios (2.25 and 2.12, respectively) for vaccination were inflated when intangible impacts were included, by value-adding to the results of a traditional economic analysis. In the roost removal strategy, these ratios (1.19 and 1.16, respectively) were deflated when intangible impacts were included. Results of this theoretical study suggest that the inclusion of intangible impacts promotes the value of a two-dose initial vaccination protocol using a subunit vaccination considered to offer complete protection for horses, as a strategy to control HeV, whereas roost removal becomes an even more costly strategy. Outcome of the analysis is particularly sensitive to the intangible value placed on human health. Further evaluation - via sociological methods - of values placed on intangibles by various stakeholder groups is warranted.

Disease prioritization: what is the state of the art?

Disease prioritization is motivated by the need to ensure that limited resources are targeted at the most important problems to achieve the greatest benefit in improving and maintaining human and animal health. Studies have prioritized a range of disease types, for example, zoonotic and foodborne diseases, using a range of criteria that describe potential disease impacts. This review describes the progression of disease prioritization methodology from ad hoc techniques to decision science methods (including multi-criteria decision analysis, conjoint analysis and probabilistic inversion), and describes how these methods aid defensible resource allocation. We discuss decision science in the context of disease prioritization to then review the development of disease prioritization studies. Structuring the prioritization and assessing decision-makers' preferences through value trade-offs between criteria within the decision context are identified as key factors that ensure transparency and reproducibility. Future directions for disease prioritization include the development of validation techniques, guidelines for model selection and neuroeconomics to gain a deeper understanding of decision-making.

Import risk assessment incorporating a dose-response model: introduction of highly pathogenic porcine reproductive and respiratory syndrome into Australia via illegally imported raw pork.

Highly pathogenic porcine reproductive and respiratory syndrome (PRRS) has spread through parts of south-east Asia, posing a risk to Australia. The objective of this study was to assess the probability of infection of a feral or domestic pig in Australia with highly pathogenic PRRS following ingestion of illegally imported raw pork. A conservative scenario was considered in which 500 g of raw pork was imported from the Philippines into Australia without being detected by border security, then discarded from a household and potentially accessed by a pig. Monte Carlo simulation of a two-dimensional, stochastic model was used to estimate the probability of entry and exposure, and the probability of infection was assessed by incorporating a virus-decay and mechanistic dose-response model. Results indicated that the probability of infection of a feral pig after ingestion of raw meat was higher than the probability of infection of a domestic pig. Sensitivity analysis was used to assess the influence of input parameters on model output probability estimates, and extension of the virus-decay and dose-response model was used to explore the impact of different temperatures and time from slaughter to ingestion of the meat, different weights of meat, and the level of viraemia at slaughter on the infectivity of meat. Parameters with the highest influence on the model output were the level of viraemia of a pig prior to slaughter and the probability of access by a feral pig to food-waste discarded on property surrounding a household. Extension of the decay and dose-response model showed that small pieces of meat (10 g) from a highly pathogenic PRRS viraemic pig could contain enough virus to have a high probability of infection of a pig, and that routes to Australia by sea or air from all highly pathogenic PRRS virus endemic countries were of interest dependent on the temperature of the raw meat during transport. This study highlighted the importance of mitigation strategies such as disposal of food-waste from international traffic as quarantine waste, and the need for further research into the probability of access to food-waste on properties by feral pigs.

Controlling equine influenza: policy networks and decision-making during the 2007 Australian equine influenza outbreak.

Rapid, evidence-based decision-making is critical during a disease outbreak response; however, compliance by stakeholders is necessary to ensure that such decisions are effective - especially if the response depends on voluntary action. This mixed method study evaluated technical policy decision-making processes during the 2007 outbreak of equine influenza in Australia by identifying and analysing the stakeholder network involved and the factors driving policy decision-making. The study started with a review of the outbreak literature and published policy documents. This identified six policy issues regarding policy modifications or differing interpretations by different state agencies. Data on factors influencing the decision-making process for these six issues and on stakeholder interaction were collected using a pre-tested, semi-structured questionnaire. Face-to-face interviews were conducted with 24 individuals representing 12 industry and government organizations. Quantitative data were analysed using social network analysis. Qualitative data were coded and patterns matched to test a pre-determined general theory using a method called theory-oriented process-tracing. Results revealed that technical policy decisions were framed by social, political, financial, strategic and operational considerations. Industry stakeholders had influence through formal pre-existing channels, yet specific gaps in stakeholder interaction were overcome by reactive alliances formed during the outbreak response but outside the established system. Overall, the crisis management system and response were seen as positive, and 75-100% of individuals interviewed were supportive of, had interest in and considered the outcome as good for the majority of policy decisions, yet only 46-75% of those interviewed considered that they had influence on these decisions. Training to increase awareness and knowledge of emergency animal diseases (EADs) and response systems will improve stakeholder participation in emergency disease management and preparedness for future EAD incursions.

Building a picture: Prioritisation of exotic diseases for the pig industry in Australia using multi-criteria decision analysis.

Diseases that are exotic to the pig industry in Australia were prioritised using a multi-criteria decision analysis framework that incorporated weights of importance for a range of criteria important to industry stakeholders. Measurements were collected for each disease for nine criteria that described potential disease impacts. A total score was calculated for each disease using a weighted sum value function that aggregated the nine disease criterion measurements and weights of importance for the criteria that were previously elicited from two groups of industry stakeholders. One stakeholder group placed most value on the impacts of disease on livestock, and one group placed more value on the zoonotic impacts of diseases. Prioritisation lists ordered by disease score were produced for both of these groups. Vesicular diseases were found to have the highest priority for the group valuing disease impacts on livestock, followed by acute forms of African and classical swine fever, then highly pathogenic porcine reproductive and respiratory syndrome. The group who valued zoonotic disease impacts prioritised rabies, followed by Japanese encephalitis, Eastern equine encephalitis and Nipah virus, interspersed with vesicular diseases. The multi-criteria framework used in this study systematically prioritised diseases using a multi-attribute theory based technique that provided transparency and repeatability in the process. Flexibility of the framework was demonstrated by aggregating the criterion weights from more than one stakeholder group with the disease measurements for the criteria. This technique allowed industry stakeholders to be active in resource allocation for their industry without the need to be disease experts. We believe it is the first prioritisation of livestock diseases using values provided by industry stakeholders. The prioritisation lists will be used by industry stakeholders to identify diseases for further risk analysis and disease spread modelling to understand biosecurity risks to this industry.

A framework for assessing the intangible impacts of emergency animal disease.

We present a novel framework for addressing the intangible impacts of emergency animal diseases (EADs). Intangible elements can have great impact on the response, control and prevention strategies that are ultimately used to address these EADs. These intangible elements have value and worth, although these are difficult express in dollar terms. Consequently, these elements are often lost in the scope of traditional economic analysis. Without the inclusion of these intangibles, the bottom-line for decision-making related to animal-health emergencies would be based only on financial measures. This does not reflect the reality of the consultative policy-making process. The framework we present allows a measurement of the trade-offs that stakeholders are willing to accept under different EAD control scenarios. The key attributes of the framework include both the consultative processes involving different stakeholders and the process of identification of intangibles and their personal value to these stakeholders. This consultation will ensure that the resulting analysis includes the full impacts of EADs, rather than only a narrow comparison of financial costs and benefits.

Review of rabies epidemiology and control in South, South East and East Asia: past, present and prospects for elimination.

Rabies is a serious public health problem in Asia. It causes substantial animal welfare, economic and human health impacts, with approximately 39,000 human deaths each year. Domestic dogs are the main reservoir and source of rabies in Asia. Common constraints for the control of rabies in the countries of Asia include inadequate resources; lack of political commitment to control programs; lack of consensus on strategy; weak intersectoral coordination and inadequate management structure; insensitive surveillance systems; limited accessibility to modern rabies vaccine and supply problems; lack of public awareness and public cooperation; and the existence of myths and religious issues. In this review, we summarize the epidemiology of rabies in both human and animals in each South and South East Asian country, the past and current approaches to control and the prospect for rabies elimination. We conclude that defining the cost of rabies to society and communicating this to decisionmakers might be the key to achieving such an advance.

Canine parvovirus in Australia: the role of socio-economic factors in disease clusters.

To identify clusters of canine parvoviral related disease occurring in Australia during 2010 and investigate the role of socio-economic factors contributing to these clusters, reported cases of canine parvovirus were extracted from an on-line disease surveillance system. Reported residential postcode was used to locate cases, and clusters were identified using a scan statistic. Cases included in clusters were compared to those not included in such clusters with respect to human socioeconomic factors (postcode area relative socioeconomic disadvantage, economic resources, education and occupation) and dog factors (neuter status, breed, age, gender, vaccination status). During 2010, there were 1187 cases of canine parvovirus reported. Nineteen significant (P<0.05) disease clusters were identified, most commonly located in New South Wales. Eleven (58%) clusters occurred between April and July, and the average cluster length was 5.7 days. All clusters occurred in postcodes with a significantly (P<0.05) greater level of relative socioeconomic disadvantage and a lower rank in education and occupation, and it was noted that clustered cases were less likely to have been neutered (P=0.004). No significant difference (P>0.05) was found between cases reported from cluster postcodes and those not within clusters for dog age, gender, breed or vaccination status (although the latter needs to be interpreted with caution, since vaccination was absent in most of the cases). Further research is required to investigate the apparent association between indicators of poor socioeconomic status and clusters of reported canine parvovirus diseases; however these initial findings may be useful for developing geographically- and temporally-targeted prevention and disease control programs.

Modelling the feasibility of bovine tuberculosis eradication in Argentina.

The ability of countries to control and eradicate bovine tuberculosis (TB) has been jeopardised by various epidemiological and ecological features of the disease. The authors have used epidemiological modelling to develop an analytical framework to assess the likely success of a national TB eradication programme in Argentina. Study results suggest that the current control programme is financially feasible in the long term. However, considering that the costs of the TB eradication programme in Argentina are entirely borne by the producer, the initial investment required and the long-term horizon needed to gain revenue may prevent producers from endorsing the programme. Regionalised programmes that allow differential control strategies to be implemented in specific regions may increase the likelihood of success. This methodological approach could be extended to design and evaluate control and eradication programmes for TB and other infectious diseases in other regions of the world.

Attitudes towards biosecurity practices relevant to Johne's disease control on beef cattle farms.

The success of control programs can be improved when producers' attitudes towards these programs are positive. Implementation of control programs for chronic diseases are more challenging than those for acute diseases because of the absence of the "cues-to-action" that are associated with acute diseases. Johne's disease (JD) is a chronic diarrheal disease of ruminants, and national voluntary control programs exist in several countries. We used a mailed cross-sectional survey to describe the attitudes of producers towards biosecurity practices and veterinarians' beliefs relevant to the control of JD on beef farms. Another objective was to describe and compare the attitudes of producers and veterinarians towards specific measures recommended by the Texas Voluntary Johne's Disease Program (TVJDP) for cattle. Questionnaires were mailed to 1100 producers and 840 veterinarians in the state of Texas, USA. Two hundred and eighty-five producers (26%) and 153 veterinarians (18%) returned questionnaires for analysis. Fifty-nine percent of producers and 50% of veterinarians agreed that JD is responsible for substantial losses in beef cattle production. Sixty-four percent of veterinarians had educated producers on management strategies for the control or elimination of JD. However, only 36% had participated in the training program and 29% were certified to develop risk assessments and implement testing. Only 20% of producers reported that they were familiar with the TVJDP and 16% had considered participating in this program. There is a need for greater promotion of the control program among veterinarians and producers. Reasons for the apparent difference in opinions need to be understood to increase the likelihood of control measures adoption and to subsequently reduce the impact of JD on beef cattle operations.

Benefits of obtaining test-negative Level 4 classification for beef producers in the Voluntary Bovine Johne's Disease Control Program.

The US Voluntary Bovine Johne's Disease Control Program (VBJDCP) stipulates the national standards for Johne's disease (JD) control, and herds classified as test-negative at Level 4 of the VBJDCP have the greatest likelihood of being non-infected. A questionnaire survey of owners of VBJDCP test-negative Level 4 beef herds was conducted to describe perceived benefits of attaining Level 4 status. Thirty-nine of the 40 producers returned completed or partially completed surveys. Sixty-four percent (23/36) of herds contained 50 or less test eligible cattle. Twenty-seven percent (10/37) of producers reported increased marketing opportunities as a goal for enrollment in the VBJDCP. Classification at test-negative Level 4 status in the VBJDCP led to increased marketing opportunities for more than one-third (13/35) of the producers. Twenty-five percent (9/36) of the producers reported significant and 39% (14/36) marginal benefits (financial and non-financial) as a result of participation in the VBJDCP. The median (range) reported annual benefit was $0 ($0, $10,000), whilst the median (range) annual cost of implementing and sustaining the VBJDCP on ranches was $200 ($0, $5000). It is suggested that greater publicity about the VBJDCP in the beef cattle industry will increase its chances of success by increasing awareness amongst producers concerned about herd health/disease monitoring, and through improved marketing opportunities.

Time-series growth in the female labor force.

PIP: This paper investigates the reasons for the growth in the female labor force in the US during the 20th century. Female labor force participation rates increased by 50% from 1950 to 1970. Real wages have played a significant but hardly exclusive role both in the long term growth in female employment and in the more accelerated growth after 1950. At the beginning of this century, fewer than 1 woman in 5 was a member of the labor force; by 1981 more than 6 in 10 were. Increases in female participation were slightly larger among younger women during the 1970s; for the next 20 years the age shape tilted toward older women. For US women 25-34 years old, labor force participation rates have been rising by more than 2 percentage points per year. Closely intertwined with decisions regarding women's work are those involving marriage and family formation. 2 demographic factors that would play a part in subsequent developments are: nuclearization of the US family and urbanization. Time-series trends in education are observed because schooling affects female labor supply independently of any influence through wages; increased years of schooling across birth cohorts shows that an increase of 1.33 years of schooling increased labor participation by 6.9 percentage points during the pre-World War II era. The swing in marriage rates also affects timing, especially for younger women. Based on disaggregated time series data across the period 1950-1981, mean values at single years of age of labor supply, education, work experience, weekly wages, and fertility are determined. Profiles indicate that female labor supply varies considerably not only across cohorts but also over life cycles within birth cohorts. Results show that: 1) relative female wages defined over the work force were lower in 1980 than in 1950, 2) children, especially when young, reduce labor supply, 3) large negative elasticities are linked to female wages, and 4) with all fertility induced effects included, real wage growth explaines 58% of the postwar increase in female labor supply. Therefore, real wages do explain a considerable part of the postwar increases in female labor supply.^ieng

Asset accumulation and family size.

Utilizing panel data on families, estimates are made of the effects of children on asset accumulation, asset composition, consumption, and family income. Young children are found to depress savings for young families but to increase savings for marriages of duration greater than five years. The principal channel through which children act to reduce savings is the decline in female earnings associated with the child-induced withdrawal of wives from the labor force. Family consumption actually decreases with the birth of a child, but this reduction is insufficient, for young families, to offset the fall in income. For families in which the wife does not work the estimates suggest that savings may actually increase with children.

Countercyclical U.S. fertility and its implications.

The following article is the verbatim text of a report based on research funded by the Social Security Administration and the National Institute of Child Health and Human Development to the Rand Corporation. The report looks at changing fertility rates in the United States and their implications for future population size and age distributions. An economic model of fertility rate is used to explain observed differences in fertility rates amond couples and to predict future rates. The focus is on trends since 1947 because post-World War II data are the most complete. Several explanations for changing fertility rates are examined, and their usefulness in predicting the future is evaluated.