Interdisciplinary studies on Coxiella burnetii: From molecular to cellular, to host, to one health research.

The Q-GAPS (Q fever GermAn interdisciplinary Program for reSearch) consortium was launched in 2017 as a German consortium of more than 20 scientists with exceptional expertise, competence, and substantial knowledge in the field of the Q fever pathogen Coxiella (C.) burnetii. C. burnetii exemplifies as a zoonotic pathogen the challenges of zoonotic disease control and prophylaxis in human, animal, and environmental settings in a One Health approach. An interdisciplinary approach to studying the pathogen is essential to address unresolved questions about the epidemiology, immunology, pathogenesis, surveillance, and control of C. burnetii. In more than five years, Q-GAPS has provided new insights into pathogenicity and interaction with host defense mechanisms. The consortium has also investigated vaccine efficacy and application in animal reservoirs and identified expanded phenotypic and genotypic characteristics of C. burnetii and their epidemiological significance. In addition, conceptual principles for controlling, surveilling, and preventing zoonotic Q fever infections were developed and prepared for specific target groups. All findings have been continuously integrated into a Web-based, interactive, freely accessible knowledge and information platform (www.q-gaps.de), which also contains Q fever guidelines to support public health institutions in controlling and preventing Q fever. In this review, we will summarize our results and show an example of how an interdisciplinary consortium provides knowledge and better tools to control a zoonotic pathogen at the national level.

[Integrating Public Health Expertise in Research: a Series of Workshops about Vector-Borne and Other Zoonotic Diseases]. / ÖGD-Expertise in die Forschung bringen: eine Workshop-Reihe zu vektorübertragenen und weiteren zoonotischen Erkrankungen.

Research groups must understand the needs and requirements of the public health service to be able to develop tools and strategies for supporting it in risk assessment and risk communication. The zoonotic research consortia RoBoPub, Q-GAPS, TBENAGER and ZooBoCo used the format of workshops to include the expertise of the public health service system in their work. We present the results of three workshops that were held with representatives of the German public health service as part of the annual congress of the Federal Association of Physicians of German Public Health Departments in 2018, 2019 and 2022. Each workshop, held in a world-café format, lasted 90 minutes and had its own thematic focus. In the first workshop, information on the goals, problems, solutions and expectations of the public health service from the research consortia concerning exposure to rodent-borne infections during their occupational and leisure-time activities as well as the use of risk maps was collected. In the second and third workshops, participants developed risk communication strategies based on scenarios of outbreaks and identifications of new risk areas. Each workshop had more than 20 participants, of which at least half worked for local public health authorities. Foremost, participants expected practical, target group-specific material for risk communication from the research groups. According to the experience of most participants, direct contact with the affected groups was essential for risk communication. To raise awareness of the situation and establish contact with the relevant target groups, social media can complement traditional media, especially for hard-to-reach groups. However, their use should be considered and planned carefully. The workshop format was appropriate for integrating the public health expertise in the research activities. The expectations of the public health service on material for risk communication could be translated into a guideline, a risk management plan and pathogen descriptions by the research groups. When integrating the expertise of the public health authorities in their work, research groups should consider how to reach a suitable panel of representatives and how to keep the workload for those at an acceptably low level.

Correction to: Unexpected high frequency of neurofibroma in the celiac ganglion of German cattle.

An amendment to this paper has been published and can be accessed via the original article.

Unexpected high frequency of neurofibroma in the celiac ganglion of German cattle.

In a study originally designed to find potential risk factors for bovine spongiform encephalopathy (BSE) we examined tissues from 403 Holstein Frisian cattle in total. These included 20 BSE cattle and their 236 birth- and feeding cohort animals plus 32 offspring, 103 age, breed and district-matched control cattle and further twelve cattle with neurological signs. In addition to the obex, we examined the celiac ganglion, cervical cranial ganglion, trigeminal ganglion and proximal ganglion of the vagus nerve using histological techniques. Unexpectedly, we found a high number of neurofibroma, a benign peripheral nerve sheath tumor consisting of Schwann cells, fibroblasts and perineural cells. The neurofibroma were present only in the celiac ganglion and found during histologic examination. With a frequency of 9.91% in BSE cattle and their cohorts (case animals) and 9.09% in the age, breed and district matched control animals there seems to be no correlation between the occurrence of BSE and neurofibroma. Benign peripheral nerve sheath tumors have been described more often in cattle than in other domestic animals. Usually, they are incidental macroscopic findings in the thoracic ganglia during meat inspection. To our knowledge, there are no previous systematic histologic studies including bovine celiac ganglia at all. The high incidence of celiac ganglia neurofibroma may play a role in the frequently occurring abomasal displacements in Holstein Frisian cattle as the tumors might cause a gastrointestinal motility disorder. At present a genetic predisposition for these neoplasms cannot be ruled out.

Case-control study on factors associated with a decreased milk yield and a depressed health status of dairy herds in northern Germany.

BACKGROUND: In the past years, it became apparent that health status and performance differ considerably within dairy farms in Northern Germany. In order to obtain clues with respect to possible causes of these differences, a case-control study was performed. Case farms, which showed signs of health and performance problems, and control farms, which had none of these signs, were compared. Risk factors from different areas such as health management, housing, hygiene and nutrition were investigated as these are known to be highly influential. The aim of this study was to identify major factors within these areas that have the strongest association with health and performance problems of dairy herds in Northern Germany. RESULTS: In the final model, a lower energy density in the roughage fraction of the diet, more pens with dirty lying areas and a low ratio of cows per watering spaces were associated with a higher risk for herd health problems. Moreover, case farms were affected by infections with intestinal parasites, lungworms, liver flukes and Johne's Disease numerically more often than control farms. Case farms more often had pens with raised cubicles compared to the deep bedded stalls or straw yards found in control farms. In general, the hygiene of the floors and beddings was worse in case farms. Concerning nutrition, the microbiological and sensory quality of the provided silages was often insufficient, even in control farms. Less roughage was provided to early lactating cows and the feed was pushed to the feeding fence less frequently in case farms than in control farms. CONCLUSIONS: The results show that milk yield and health status were associated with various factors from different areas stressing the importance of all aspects of management for good animal health and performance. Moreover, this study confirmed well-known risk factors for health problems and performance losses. These should better be taken heed of in herd health management.

Diversity of Clostridium perfringens toxin-genotypes from dairy farms.

BACKGROUND: Clostridium (C.) perfringens is the causative agent of several diseases in animals and humans, including histotoxic and enteric infections. To gain more insight into the occurrence of its different toxin-genotypes in dairy herds, including those toxin genes previously associated with diseases in cattle or humans, 662 isolates cultivated from feces, rumen content and feed collected from 139 dairy farms were characterized by PCR (detecting cpa, cpb, iap, etx, cpe, and both allelic variants of cpb2). RESULTS: Isolates from feces were assigned to type A (cpa positive, n = 442) and D (cpa and etx positive, n = 2). Those from rumen content (n = 207) and feed (n = 13) were all assigned to type A. The consensus and atypical variants of the cpb2 gene were detected in 64 (14.5 %) and 138 (31.22 %) of all isolates from feces, and 30 (14.5 %) and 54 (26.1 %) of all isolates from rumen content, respectively. CONCLUSION: Both allelic variants of cpb2 occurred frequently in animals without signs of acute enteric disease, whereby the atypical variant dominated. Five (0.8 %) of all type A isolates were positive for the cpe gene. Therefore, the present study indicates that dairy cows are no primary source for potentially human pathogenic enterotoxin gene positive strains.

Detection of Clostridium botulinum neurotoxin genes (A-F) in dairy farms from Northern Germany using PCR: A case-control study.

Classical botulism in cattle mainly occurs after ingestion of feed contaminated with preformed toxin. In 2001 a form of botulism ("visceral botulism") was postulated to occur after ingestion of Clostridium (C.) botulinum cells or spores, followed by colonization of the intestine, and local production of botulinum neurotoxin (BoNT) causing chronic generalized disease. To verify the potential role of C. botulinum in the described syndrome, a case-control study was conducted, including 139 farms. Fecal samples, rumen content, water and silage samples were collected on each farm. Real time BoNT gene PCR assays were conducted after enrichment in RCM (Reinforced Clostridial Medium) at 37 °C and conventional PCRs after enrichment in MCM (Modified Cooked Meat Medium) at 30 °C. Furthermore, a direct detection of BoNT genes without prior enrichment was attempted. BoNT A, B, C, D, E and F genes were detected in animal samples from 25 (17.99%), 3 (2.16%), 0 (0.0%), 2 (1.44%), 1 (0.72%), and 3 (2.16%) farms, respectively. Eleven feed samples were positive for BoNT A gene. By enrichment a significant increase in sensitivity was achieved. Therefore, this should be an essential part of any protocol. No significant differences regarding BoNT gene occurrence could be observed between Case and Control farms or chronically diseased and clinically healthy animals within the particular category. Thus, the postulated form of chronic botulism in cows could not be confirmed. This study supports the general opinion that C. botulinum can occasionally be found in the rumen and intestine of cows without causing disease.

[Selective dry cow therapy on dairy farms in Rhineland-Palatinate, Saarland and Hesse, Germany - a survey among farmers]. / Selektives antibiotisches Trockenstellen bei Milchkühen in Rheinland-Pfalz, dem Saarland und Hessen ­ eine Umfrage unter Landwirten.

OBJECTIVE: With the Regulation (EC) 6/2019, antibiotic drying off of the entire dairy herd is no longer permissible. Hence, it is necessary to establish selective antibiotic drying off (SDCT: Selective Dry Cow Therapy) in dairy herds. With the publication of the PraeRi study in 2020, systematic data for the implementation of SDCT on farms became available for several German states. For Rhineland-Palatinate, Saarland and Hesse this type of information is only available from individual projects. Therefore, the aim of this survey was to increase the knowledge concerning the implementation of SDCT in dairy farms located in these states. MATERIAL AND METHODS: An online questionnaire was sent via newsletters to farmers and was published in the regional farmers' bulletins in the described catchment area. The questionnaire inquired about the saving of antibiotics during drying off, the criteria guiding the farmer's decision (cell count from monthly dairy herd improvement data (DHI), mastitis history, microbiological examination of quarter foremilk samples, California mastitis test), use of teat sealants and the type of dry off procedure (abrupt/gradual). RESULTS: A total of 103 questionnaires were evaluated, making the response rate ~1% for Hesse, ~3% for Saarland, and ~5% for Rhineland-Palatinate based on the number of included farms. Approximately 29% of the farmers dried off one out of four cows, 20% half, 23% three out of four and 13% all cows without using antibiotics. Eighty-nine farm managers based their decision on the somatic cell counts of DHI. Additional criteria influencing the decision were the mastitis history, results of the California Mastitis Test, or a combination of both. In 76 farms cows were dried off abruptly. In 79 farms teat sealers were used. CONCLUSIONS: Application of SDCT is established in most of the farms that participated in the survey, even though the proportion varied between farms. Legal requirements are not the only reason farmers need to increasingly deal with SDCT; sustainability programs of the dairies rely on selective drying off as well. Herd veterinarians should be supportive in implementing these measures to achieve good udder health while reducing the use of antimicrobials to a necessary minimum.

Biosecurity measures for the prevention of African swine fever on German pig farms: comparison of farmers' own appraisals and external veterinary experts' evaluations.

BACKGROUND: Since its first introduction into the German wild boar population in 2020, African swine fever (ASF) has been spreading slowly from the eastern border westwards and has been introduced into eight domestic pig farms thus far. The European Food Safety Authority has named deficits in farm biosecurity and increased human activity as major risk factors for the introduction of the ASF virus into pig farms. Studies have shown that pig farms in Germany generally have a high level of biosecurity. However, veterinary practitioners and policy-makers have expressed concerns that not all pig farmers are appropriately prepared to deal with the threat of ASF. This study aimed to evaluate the level of biosecurity on pig farms in Lower Saxony and explore the reasons for deficits in the implementation of biosecurity measures. For this purpose, pig farmers were interviewed in open structured face-to-face interviews about their perception of ASF and biosecurity, and the implemented measures on their farms were assessed with a checklist. In the data analysis, the farmers' answers and the results of the biosecurity check were compared to gain further insights into the factors influencing the implementation of biosecurity measures on the farms. RESULTS: The biosecurity check showed that on most farms, a high level of biosecurity had been implemented. Nevertheless, deficits were found concerning the fences and the delimitation of clean and dirty areas on farm grounds and in the anteroom. Overall, the farmers were well informed about ASF and had a realistic perception of their own biosecurity. They considered the farm layout, financial means and practicality of hygiene measures to be the main barriers to implementing biosecurity measures against ASF. However, the results also suggested that farmers' attitudes and legal regulations were major influencing factors. CONCLUSION: The results indicated a high level of biosecurity against ASF on most pig farms and a realistic perception of their own biosecurity by the farmers. Current knowledge transfer and information should focus on building upon the farmers' own motivation and expertise and supporting them to put existing knowledge into practice.

Application of Epidemiological Methods in a Large-Scale Cross-Sectional Study in 765 German Dairy Herds-Lessons Learned.

From 2016 to 2020, the "PraeRi" study, conducted by three German veterinary universities, was aimed at enhancing animal health and welfare in dairy farms. With 765 dairy farms visited and 101,307 animals examined, this study provided a basis for improving animal health and welfare. The study population comprised three different regions representing a broad variety of characteristics. To ensure representative estimates, a sample size of 250 farms was determined for each region, employing a stratified sampling plan based on farm size. According to the information provided by the farmers, the most commonly occurring disease in their herds was mastitis without general disorder (14.2% to 16.3% of the herd-depending on the region). For most disorders, prevalence data were lowest for the region South compared with the two remaining regions. Multivariable regression analyses were performed to identify risk factors for various target variables, and the results were communicated through individual reports and benchmarking flyers to participating farmers. The authors encountered challenges in management and communication due to the project's size in terms of personnel, data, and farms examined. Harmonizing data management and hypothesis testing across all involved parties added complexity.

Epidemiology of influences on the performance in broiler flocks--a field study in Germany.

To establish which factors influence performance and bird welfare during a fattening period and to identify those factors to be investigated during routine monitoring of farms by veterinary authorities, a questionnaire-based field study was conducted in districts of Lower Saxony, Germany, with the highest density of broiler chickens. Mortality and BW of farms with different stocking densities (≤33, 33.1-39, and >39 kg/m(2)) were investigated. Analyses of 79 farms with 176 stables and 634 fattening periods revealed that flock mortality and BW appeared to be greatly influenced by weather conditions and litter material. In general, it is an advantage to grow broilers under warm weather conditions. However, the longer the fattening period lasts the more important it becomes that the outside weather conditions are not too warm. Therefore, weather conditions should be considered when determining the length of the fattening period, especially before the background of the growing demands of broilers regarding ventilation, absorption of feces by the litter material, and so on. Apart from the length of the fattening period, the weather conditions determine the choice of the litter material, as well. Under cold-humid weather conditions, it is better to use litter material other than wood shavings. In particular in older buildings it is not possible to provide the required conditions, which results in a lower weight gain the longer the fattening period lasts. The study identified differences in the final BW of flocks, which indicate different (farm) management policies. Regardless of the underlying policy, the performance of a fattening period can be improved by optimizing the farm management according to the prevalent conditions. Future routine monitoring, which should be cost effective regarding personnel and finance, should be generally risk based and consider weather conditions, litter material, the age of the building, and the length of the fattening period.

Investigations of Histomonosis-Favouring Conditions: A Hypotheses-Generating Case-Series-Study.

Since the ban of effective feed additives and therapeutics, histomonosis has become an important disease and, subsequently, a welfare issue for turkey production. We conducted an interview-based case series study to generate hypotheses about possible disease-favouring conditions in 31 H. meleagridis-infected flocks. The determined parameters were related to the general farm (flock management, biosecurity measures, etc.) as well as the histomonosis-specific disease management. Some inadequate biosecurity measures were observed. An inappropriate usage of the hygiene lock and cleaning as well as the disinfection frequency of equipment, clothes, and the hygiene lock could possibly be histomonosis-favouring conditions. These factors could increase the risk for the introduction of H. meleagridis and the risk of a pathogen spread on an affected farm. Insects, wild birds, litter materials, and contaminated dung could be potential vectors of H. meleagridis. Predisposing gastrointestinal diseases were observed in 71% of the affected flocks. Additionally, stress events related to higher temperature, movement of birds, and vaccination were documented in association with clinical histomonosis. The results emphasise the need for both good disease control and health management to ensure sustainable animal health and welfare.

High-Impact Risk Factors for Mycobacterium avium ssp. paratuberculosis in Dairy Herds in Germany.

In a cross-sectional study, it was identified that three regions in Germany differed with respect to their herd-level prevalence for paratuberculosis in dairy cattle. In the study presented here, the same farms were analyzed to identify those components of biosecurity and farm management with the highest impact on Mycobacterium avium ssp. paratuberculosis (MAP) introduction and establishment in a farm. Hence, the data analyzes included 183, 170 and 104 herds from the study regions north, east and south, respectively. A herd was considered MAP-positive if at least one fecal environmental sample was positive. Twenty-six different possible risk factors from five different components of biosecurity and farm management were analyzed. We show that the average management of calf feeding increased the odds for a MAP-positive farm by 5.22 times (95% confidence interval (CI) = 1.25-21.83). With every 100-cow increase in farm size, the risk for a farm to test MAP-positive increased by 1.94 times (CI = 1.15-3.27), 1.14 times (CI = 1.02-1.27) and 5.53 times (CI = 0.44-68.97) in the north, east and south study regions, respectively. Furthermore, the purchase of cattle with an unknown MAP status increased the risk for a farm testing MAP-positive by 2.86-fold (CI = 1.45-5.67). Our results demonstrate that herd size, unknown MAP status of the purchased cattle and different aspects of calf feeding play an important role in the MAP status of a farm and should be in focus in regions with different MAP between-herd prevalence. Additionally, farm individual risk patterns should be identified during (veterinary) biosecurity consultancy.

Exploring pig farmers' decision-making concerning biosecurity measures against African Swine Fever.

African Swine Fever (ASF) is a growing threat to the German pig production sector. Rigorous biosecurity measures can prevent the introduction of ASF in domestic pig farms. Increased efforts have been made to inform pig farmers and other stakeholders in the industry regarding disease prevention measures for ASF. As part of quality management in animal disease prevention, we investigated the extent to which these efforts were successful and how knowledge transfer needs to be improved. Applying a qualitative study design with open, structured face-to-face interviews, this study aimed at assessing pig farmers' decision-making processes concerning the implementation of biosecurity measures against ASF and deducing the best-fitted pathways to improve the dissemination of information among pig farmers. We developed a modified theoretical model using the Health Belief Model, Protection Motivation Theory, and Theory of Planned Behaviour as the basis for our interview questionnaire and analysis. We showed that despite the steady spread of ASF into and within Germany, most pig farmers did not perceive an increased threat to their farms. However, many pig farmers communicated their uncertainty on how to correctly implement biosecurity measures according to the law. This study identified the importance of veterinary officials and farm veterinarians as referents on the topic of biosecurity and the need for clear standards concerning biosecurity regulations. Further, it suggests the need for closer cooperation between pig farmers and these referents, and a focus on joint decision-making, taking into account the individual circumstances of the farmers.

Multinomial logistic regression based on neural networks reveals inherent differences among dairy farms depending on the differential exposure to Fasciola hepatica and Ostertagia ostertagi.

Fasciola hepatica and Ostertagia ostertagi are cattle parasites with worldwide relevance for economic outcome as well as animal health and welfare. The on-farm exposure of cattle to both parasites is a function of host-associated, intrinsic, as well as environmental and farm-specific, extrinsic, factors. Even though knowledge on the biology of both parasites exists, sophisticated and innovative modelling approaches can help to deepen our understanding of key aspects fostering the exposure of dairy cows to these pathogens. In the present study, multiple multinomial logistic regression models were fitted via neural networks to describe the differences among farms where cattle were not exposed to either F. hepatica or O. ostertagi, to one parasite, or to both, respectively. Farm-specific production and management characteristics were used as covariates to portray these differences. This elucidated inherent farm characteristics associated with parasite exposure. In both studied regions, pasture access for cows, farm-level milk yield, and lameness prevalence were identified as relevant factors. In region 'South', adherence to organic farming principles was a further covariate of importance. In region 'North', the prevalence of cows with a low body condition score, herd size, hock lesion prevalence, farm-level somatic cell count, and study year appeared to be of relevance. The present study broadens our understanding of the complex epidemiological scenarios that could predict differential farm-level parasite status. The analyses have revealed the importance of awareness of dissimilarities between farms in regard to the differential exposure to F. hepatica and O. ostertagi. This provides solid evidence that dynamics and relevant factors differ depending on whether or not cows are exposed to F. hepatica, O. ostertagi, or to both.

Associations of production characteristics with the on-farm presence of Fasciola hepatica in dairy cows vary across production levels and indicate differences between breeds.

Fasciola hepatica is one of the economically most important endoparasites in cattle production. The aim of the present work was to evaluate the relevance of production level on the associations of on-farm presence of F. hepatica with farm-level milk yield, milk fat, and milk protein in Holstein cows, a specialised dairy breed, and in Simmental cows, a dual purpose breed. Furthermore, we investigated whether differential associations were present depending on breed. Data from 560 dairy farms across Germany housing 93,672 cows were analysed. The presence of F. hepatica antibodies was determined via ELISA on bulk tank milk samples. Quantile regression was applied to model the median difference in milk yield, milk fat, and milk protein depending on the interaction of breed and fluke occurrence. Whereas a reduction in milk yield (-1,206 kg, p < 0.001), milk fat (-22.9 kg, p = 0.001), and milk protein (-41.6 kg, p <0.001) was evident on F. hepatica positive German Holstein farms, only milk fat (-33.8 kg, p = 0.01) and milk protein (-22.6 kg, p = 0.03) were affected on F. hepatica positive German Simmental farms. Subsequently, production traits were modelled within each of the two breeds for low, medium, and high producing farms in the presence of F. hepatica antibodies and of confounders. On Holstein farms, the presence of F. hepatica seropositivity was associated with lower production, while on German Simmental farms such an association was less evident. This work demonstrates that production level is relevant when assessing the associations between the exposure to F. hepatica with production characteristics. Moreover, both models indicate a breed dependence. This could point towards a differential F. hepatica resilience of specialised dairy breeds in comparison with dual purpose breeds.

Hock Lesions in Dairy Cows in Cubicle Housing Systems in Germany: Prevalence and Risk Factors.

Hock lesions in dairy cows are an important indicator of animal welfare, in particular housing conditions. The aim of this study was to assess the prevalence of hock lesions in dairy cows kept in cubicle housing systems in three structurally different regions of Germany and to derive recommendations from risk factor analyses. Lactating and dry cows kept in cubicle housing systems were assessed for hock lesions (north: 206 farms with 20,792 cows; south: 156 farms with 8050 cows; east: 192 farms with 37,839 cows). Risk factor analyses were conducted using multi-factorial logistic regression models. The median prevalence of hock lesions (hairless patches, wounds, and/or swelling) at farm level was 79.8% (SD: 25.0; north), 66.2% (SD: 31.0; south), and 78.5% (SD: 26.3; east). The mean prevalence of severe hock lesions (wounds and/or swelling) at farm level was 12.5% (SD: 11.3; north), 8.0% (SD: 13.5; south), and 14.4% (SD: 17.9; east). Cows kept in pens with rubber mats or mattresses (with or without a small amount of litter) had a particularly higher chance of hock lesions compared with cows kept in pens with deep-bedded cubicles (OR: north: 3.1 [2.3-4.2]; south: 8.7 [5.9-13.0], east: 2.0 [1.7-2.4]). The study showed that hock lesions are a widespread problem on German dairy farms with cubicle housing systems. Deep-bedded cubicles are likely to reduce hock lesions and increase cows' comfort.

Random forest classification as a tool in epidemiological modelling: Identification of farm-specific characteristics relevant for the occurrence of Fasciola hepatica on German dairy farms.

Fasciola hepatica is an internal parasite of both human and veterinary relevance. In order to control fasciolosis, a multitude of attempts to predict the risk of infection such as risk maps or forecasting models have been developed. These attempts mainly focused on the influence of geo-climatic and meteorological features. Predicting bovine fasciolosis on farm level taking into account farm-specific settings yet remains challenging. In the present study, a new methodology for this purpose, a data-driven machine learning approach using a random forest classification algorithm was applied to a cross-sectional data set of farm characteristics, management regimes, and farmer aspects within two structurally different dairying regions in Germany in order to identify factors relevant for the occurrence of F. hepatica that could predict farm-level bulk tank milk positivity. The resulting models identified farm-specific key aspects in regard to the presence of F. hepatica. In study region North, farm-level production parameters (farm-level milk yield, farm-level milk fat, farm-level milk protein), leg hygiene, body condition (prevalence of overconditioned and underconditioned cows, respectively) and pasture access were identified as features relevant in regard to farm-level F. hepatica positivity. In study region South, pasture access together with farm-level lameness prevalence, farm-level prevalence of hock lesions, herd size, parity, and farm-level milk fat appeared to be important covariates. The stratification of the analysis by study region allows for the extrapolation of the results to similar settings of dairy husbandry. The local, region-specific modelling of F. hepatica presence in this work contributes to the understanding of on-farm aspects of F. hepatica appearance. The applied technique represents a novel approach in this context to model epidemiological data on fasciolosis which allows for the identification of farms at risk and together with additional findings in regard to the epidemiology of fasciolosis, can facilitate risk assessment and deepen our understanding of on-farm drivers of the occurrence of F. hepatica.

Q fever expertise among human and veterinary health professionals in Germany - A stakeholder analysis of knowledge gaps.

Q fever is a zoonosis caused by Coxiella burnetii. In Germany, the common sources of human infections include small ruminants that excrete the pathogen. Q fever in humans can be asymptomatic or nonspecific. However, severe disease progression is also possible, which can lead to death. Q fever in small ruminants is usually asymptomatic, although reproductive disorders may occur. To protect humans from Q fever, it is important that human and veterinary health professionals (practitioners/health authority employees) have comprehensive knowledge of the diagnosis, control and prevention of Q fever, and its zoonotic potential. To ensure and enhance this understanding, this stakeholder analysis assessed Q fever expertise in human and veterinary health professionals in Germany and investigated how these knowledge gaps can best be resolved. For this purpose, an online survey and two focus group discussions were conducted with 836 and 18 participants, respectively. Knowledge gaps are due to a lack of awareness of Q fever, especially among human health practitioners. Moreover, colleagues who have heard about Q fever still lack the necessary cross-species knowledge to successfully diagnose, control and prevent this zoonosis. Additionally, differences exist between stakeholders regarding their work context and the region in which they work. In this study, stakeholders in southwestern Germany had slightly better Q fever knowledge than their colleagues in northeastern Germany. In addition, information sources aimed at resolving knowledge gaps involve direct conversations between the stakeholders, as well as reading materials and seminars. Each of these information sources should focus on interdisciplinary resources to strengthen the cooperation between human and veterinary health professionals and to raise awareness of the strengths of each stakeholder group. These results have already been implemented by the Q-GAPS project, with goals of raising awareness of Q fever and filling knowledge gaps.