An economic analysis of a contingency model utilising vaccination for the control of equine influenza in a non-endemic country.

BACKGROUND: Equine influenza (EI) is an infectious respiratory disease of horses that has never been reported in New Zealand (NZ). However, the 2007 EI outbreak in Australia, previously EI free, spurred the NZ government and stakeholders into evaluating alternative EI control strategies in order to economically justify any future decision to eradicate or manage EI. To build on the policy debate, this paper presents an epinomic (epidemiologic and economic) modelling approach to evaluate alternative control strategies. An epidemiologic model to determine how alternative EI control strategies influence the distribution of EI. Model results were then input into a cost-benefit analysis framework, to identify the return and feasibility of alternative EI eradication strategies in NZ. METHODS: The article explores nine alternative eradication scenarios and two baseline strategies. The alternative scenarios consisted of three vaccination strategies (suppressive, protective or targeted) starting at three time points to reflect the commercial breeding-cycle. These alternatives were compared to two breeding-cycle adjusted baselines: movement restriction in the breeding season (August to January) or non-breeding season (February to July). The economic loss parameters were incursion response, impact to the commercial racing industry (breeding, sales and racing), horse morbidity and mortality, and compensation to industry participants. RESULTS AND CONCLUSIONS: Results suggest that the economic viability of the EI eradication programme is dependent on when within the breeding-cycle the EI outbreak occurs. If an outbreak were to occur, the return on each dollar invested for protective or suppressive vaccination strategies would be between NZD$3.67 to NZD$4.89 and between NZD$3.08 to NZD$3.50 in the breeding and non-breeding seasons, respectively. Therefore, protective or suppressive vaccination strategies could be prioritised, regardless of season. As multiple industry stakeholders benefit from these strategies, the study will enable policy development and to better formulate a user-pays eradication programme.

Subtyping of Swine Influenza Viruses Using a High-Throughput Real-Time PCR Platform.

Influenza A viruses (IAVs) are important human and animal pathogens with high impact on human and animal health. In Denmark, a passive surveillance program for IAV in pigs has been performed since 2011, where screening tests and subsequent subtyping are performed by reverse transcription quantitative real-time PCR (RT-qPCR). A disadvantage of the current subtyping system is that several assays are needed to cover the wide range of circulating subtypes, which makes the system expensive and time-consuming. Therefore, the aim of the present study was to develop a high-throughput method, which could improve surveillance of swine influenza viruses (swIAVs) and lower the costs of virus subtyping. Twelve qPCR assays specific for various hemagglutinin and neuraminidase gene lineages relevant for swIAV and six assays specific for the internal genes of IAV were developed and optimized for the high-throughput qPCR platform BioMark (Fluidigm). The qPCR assays were validated and optimized to run under the same reaction conditions using a 48.48 dynamic array (48.48DA). The sensitivity and specificity was assessed by testing virus isolates and field samples with known subtypes. The results revealed a performance of the swIAV 48.48DA similar to conventional real-time analysis, and furthermore, the specificity of swIAV 48.48DA was very high and without cross reactions between the assays. This high-throughput system provides a cost-effective alternative for subtyping of swIAVs.

Pilot study of the financial and practice protocol impacts of canine influenza virus (H3N2) outbreaks in example veterinary practices.

Since March 2015, canine influenza virus (CIV) H3N2 has caused widespread outbreaks in dogs across the USA. The effects of local H3N2 outbreaks on veterinary practices were investigated using an online interface and followed with phone calls to respondents when necessary. An outbreak was defined as confirmed diagnosis of H3N2 by either PCR or serology in at least four dogs. Of 30 practices invited to participate, five met the entry criteria: at least one documented H3N2 outbreak in the previous 12 months, a predominantly (≥70%) small animal caseload, and adequate financial records to complete the survey. Respondents reported 1-3 H3N2 outbreaks/practice over the last 12 months, with 4-8 dogs diagnosed/outbreak. For each participating practice, self-reported direct financial impact data was collected from the single H3N2 outbreak that involved the most dogs. The two most substantial categories of self-reported financial loss occurred due to boarding facility closure (estimated cost per practice: median $5000), and treatment costs borne by the practice (estimated cost per practice: median $2850). Median extra biosecurity costs were $300/practice. Median total direct costs of an H3N2 outbreak were $8945/practice. Lost foot traffic included cancelled appointments, appointments redirected to other veterinary hospitals for the duration of the outbreak, and loss of revenue from ancillary services provided during usual business (calculated cost per practice: median $450). Cost/practice normalized by the number of fulltime veterinarians in each practice was calculated and additional effects, such as interruptions to daily practice routine, reduced productivity, reputation loss and poor staff morale, were also reported. Vaccination against H3N2 was introduced as part of routine practice vaccination protocols or was made mandatory before boarding in three of five practices. In the remaining two practices, a focus on client education about canine infectious disease, especially H3N2, emerged in response to outbreaks. H3N2 outbreaks had substantial impacts on veterinary practice finances, daily routines and staff morale, and was associated with enhancements in vaccination, biosecurity and client education protocols.

Identification of Infectious Salmon Anaemia Virus from Imported Iced Atlantic Salmons.

Infectious Salmon anaemia virus (ISAV) has become a threat to the salmon industry worldwide and has caused considerable economic loss. In the present study, 9 suspect cases of ISAV infection were identified from iced Atlantic salmons imported from Norway in 2014 through Shenzhen port (Shenzhen, China) using methods recommended by the World Organization for Animal Health. However, the results of virus isolation were negative., Based on the sequence analysis of ISAV segment 6, the 9 ISAV isolates belonged to the HPRO type, had high homology (98.3%~100.0%) and closest relationship with Norway strains. We identified the 9 positive HPRO ISAVs from 491 iced Atlantic salmons (1. 8%). Therefore, we should strengthen the quarantine of iced Atlantic salmons from Norway in case of HPRO ISAV into China.

Overview of the industry and social impacts of the 2007 Australian equine influenza outbreak.

The equine influenza (EI) outbreak occurred at the worst time of the year as far as the horse industry was concerned. All horse sports and horse breeds had events planned in the spring, including those relating to qualification for the 2008 Beijing Olympic Games. These were all disrupted and many were cancelled. The social and industry impacts were extensive, and included difficulties related to communication, animal welfare, vaccination, movement restrictions, economics, as well as the psychological stresses experienced by those involved, especially those for whom their primary source of income was horse related.

Insights into the economic consequences of the 2007 equine influenza outbreak in Australia.

We estimate and describe the financial costs of the equine influenza (EI) outbreak in Australia, including the costs of emergency response measures and lost income/assets to businesses, associations and private horse owners. Costs to associations, governments and industry are discussed. We identify a lack of reliable data about the financial costs of the EI outbreak to the non-racing sectors of the horse industry.

Impact of the Australian equine influenza outbreak on a small business that was not infected.

At the outbreak of equine influenza (EI) we chose to close our horse-based business, as we did not want to risk our horses contracting the disease and the demand for our services ceased. We report our experiences of the outbreak.

Vaccine-preventable influenza disease burden from clinical trials of Vaxigrip - an inactivated split virion influenza vaccine - supports wider vaccine use.

Trivalent inactivated split influenza virus vaccine has been used for more than 35 years, and is currently licensed in over 100 countries. To determine vaccine-preventable influenza burden in different populations and geographic regions, we reviewed studies of vaccine effectiveness against non-specific outcomes such as upper respiratory infection, hospitalization, and death in addition to confirmed microbiologically confirmed influenza. The vaccine-preventable disease incidence was high in most studies, regardless of the outcome or population evaluated. This indicates that routine influenza vaccination can improve overall population health under a broad range of circumstances.

An economic evaluation of the control of three notifiable fish diseases in the United Kingdom.

We summarised the challenges faced in an ex ante cost-benefit appraisal of United Kingdom government spending on disease surveillance for three notifiable fish diseases: infectious salmon anaemia (ISA), viral haemorrhagic septicaemia (VHS) and infectious haemorrhagic necrosis (IHN). We used a social cost-benefit analysis and adopted a national perspective. We compared costs of current public and private surveillance effort with the benefits stated in terms of the avoided private and social costs of potential disease outbreaks. Spending on ISA and VHS were predicted to be efficient; the benefit-cost ratios were always >or=3.2 for ISA and >or=5.8 for VHS for all nine scenarios examined for each infection. However, the benefit-cost ratio for IHN was predicted never to exceed 1.6, and was <1.0 in five of the nine scenarios-so spending on IHN would be harder to justify.

Economic impact of community-acquired and nosocomial lower respiratory tract infections in young children in Germany.

Data on the economic burden of lower respiratory tract infections (LRTI) in young children are lacking in Germany. The objective of the cost-of-illness study was to estimate the economic impact of community-acquired LRTI and nosocomial LRTI as well as of infections due to respiratory syncytial virus (RSV), parainfluenza viruses (PIV) and influenza viruses (IV). The economic analysis is part of the PRIDE study, a prospective, multi-centre, population-based epidemiological study on the impact of LRTI in children aged 0 to 36 months in Germany. The analysis includes children with community-acquired infections (1329 cases treated as outpatients, 2039 cases treated as inpatients) and nosocomial infections (90 cases). Medical services consumed were generated by chart abstraction and parental expenses data by telephone interviews within four weeks after physician visit or hospitalisation. Costs were evaluated from following perspectives: third party payer, parent and society. Total costs for outpatient treatment are Euro 123 per LRTI case. Stratified by virus type, total costs per case are Euro 163 (RSV), Euro 100 (PIV) and Euro 223 (IV). Total costs per hospitalised LRTI case amount to Euro 2579. Stratified by virus type, total costs per case are Euro 2772 (RSV), Euro 2374 (PIV) and Euro 2597 (IV). Total costs per nosocomial case are Euro 2814. Economic burden due to LRTI is Euro 213 million annually. It is concluded that treatment of LRTI in children up to age three causes a considerable economic burden in Germany. Presented results are the first data describing the economic burden of LRTI in young children assessed by means of the incidence data for Germany. This cost-of-illness study provides basic data for further decision-making, focusing on the economic assessment of preventive strategies for RSV, PIV and IV infections.