Comparing Occurrence of Bovine Respiratory Pathogens Detected by High-Throughput Real-Time PCR in Nasal Swabs and Non-Endoscopic Bronchoalveolar Lavage Samples from Dairy and Veal Calves.

This study aimed to enhance our understanding of the agreement between two sampling methods for the detection of bovine respiratory disease (BRD) pathogens in calves using high-throughput real-time qPCR (ht-RT-qPCR). In total, 233 paired nasal swab (NS) and non-endoscopic bronchoalveolar lavage (nBAL) samples were collected from 152 calves from 12 Danish cattle herds. In 202 of the observations, the calves were examined using a standardized clinical protocol. Samples were tested for three viruses (bovine respiratory syncytial virus, bovine corona virus, and influenza D virus) and six bacteria (Histophilus somni, Mannheimia haemolytica, Mycoplasma bovis, Mycoplasma species, Pasteurella multocida, and Truepurella pyogenes). The results showed age-related differences in disease and pathogen occurrence, with the highest detection rates in calves aged 35 days or older. Poor to moderate agreement was found between the NS and nBAL results. The presence of Mannheimia haemolytica in both NS and nBAL in younger calves and in nBAL in older calves was associated with clinical BRD. There was a potential link between BRD and influenza D virus in older calves, although it was only found in one herd in a small sample size. Overall, NS was a relatively poor predictor of pathogens in the lower respiratory tract. The present study confirms the complexity of pathogen detection in BRD, with marked influences of age and the sampling method on pathogen detection and disease associations.

Monitoring bovine dairy calf health and related risk factors in the first three months of rearing.

BACKGROUND: Rearing replacement heifers is pivotal for the dairy industry and is associated with high input costs for the preweaned calves, due to their higher susceptibility to diseases. Ensuring calf health and viability calls for systematic approaches in order to mitigate the costs induced by managing sick calves and to ensure animal welfare. The objective of this study was to develop a systematic and feasible health-monitoring tool for bovine dairy calves based on repeated clinical observations and diagnostic results of calves at three time points; the 1st (T0), the 3rd (T1) and the 12th (T3) week of age. The study included observations from 77 dairy heifer calves in nine Danish commercial dairy herds. Immunisation status was assessed by serum Brix% at T0. Clinical scoring included gastrointestinal disease (GD) and respiratory disease (RD). The average daily weight gain (ADWG) was estimated from heart-girth measurements. Pathogen detection from nasal swabs and faecal samples were analysed for 16 respiratory and enteric pathogens by means of high-throughput real time-PCR. All measures obtained in each herd were visualised in a panel to follow the health status of each calf over time. RESULTS: The individual clinical observations combined with diagnostic information from immunisation and pathogen detection form each enrolled calf are presented in a herd dashboard illustrating the health status over the study period. This monitoring revealed failure of passive transfer (Brix% < 8.1) in 31% of the 77 enrolled calves, signs of severe GD peaked at T0 with 20% affected calves, while signs of severe RD peaked at T2 with 42% affected calves. ADWG over the first eight weeks was estimated to be 760 g (± 190 g). Pathogen profiles varied between herds. CONCLUSIONS: The large variation in both clinical disease and pathogen occurrence across herds emphasizes the need for herd specific monitoring. Combining the results of the present study from measures of immunisation, health and growth from individual calves in one visualisation panel allowed for the detection of patterns across age groups in the specific herds, showing promising potential for early detection and interventions that can lead to enhanced calf health and welfare.

Semi-Quantitative Biosecurity Assessment Framework Targeting Prevention of the Introduction and Establishment of Salmonella Dublin in Dairy Cattle Herds.

An increasing average herd size and complexity in farm structures call for a higher level of biosecurity. It can reduce the risk of introducing and establishing pathogens with multiple-pathway and indirect spread mechanisms, such as Salmonella Dublin, a pathogen with an increasing occurrence in dairy cattle farms across different countries and continents. Therefore, this study aimed to use existing knowledge to develop a framework with a supporting tool allowing for a time-efficient, yet comprehensive, assessment of biosecurity measures that can help prevent the introduction and establishment of S. Dublin in dairy herds. Based on the literature review, a seven-step biosecurity assessment framework was developed and evaluated in collaboration with biosecurity experts. The resulting framework includes a weighted semi-quantitative assessment method with a scoring guide in an electronic supporting tool for 12 biosecurity sections assessed through on-farm observations and farmer interviews. The framework and tool provide a novel approach to comprehensively assess the overall (mainly external) on-farm biosecurity level by a trained biosecurity assessor. They can be used for systematic data collection in epidemiological studies on risk factors for the introduction and establishment of S. Dublin in dairy farms. Preliminary interrater reliability testing indicated moderate reliability between assessors with varying biosecurity skills.

Monitoring antimicrobial usage in companion animals: exploring the use of the Danish VetStat database.

BACKGROUND: In the Danish Veterinary Statistics Program, VetStat, sales data on medicinal products prescribed for veterinary consumption is collected. The Danish Food and Veterinary Administration (DVFA) manages the database and each purchase contains detailed product-specific information linked with a species-specific ID. National surveillance systems are also implemented or being developed in the other European Union Member States. By 2029, all Member States are required to report data on antimicrobial usage for companion animals to the European Medicines Agency. This study aimed to assess the challenges encountered when using the VetStat database to quantify antimicrobial use in Danish companion animals. Raw VetStat data were propagated by the DVFA and originated from veterinary practitioners and Danish pharmacies. RESULTS: Comprehensive estimates of antimicrobial use in Danish companion animals were not readily available due to database construct. Antimicrobials sold for use in companion animals (linked to a companion animal ID) comprised a large number of products licensed solely for horses or livestock, while data assigned a replacement code encompassed both topical and peroral antimicrobials licensed for companion animals. Additionally, antimicrobials sold from pharmacies to veterinary practitioners presented the biggest challenge in data retrieval and validation. Treatment data are only transferred to VetStat through the billing systems when Danish veterinarians are treating livestock, but not companion animals. Information on products sold for in-house use in companion animals is only available from pharmacy records without a species-specific ID. As a result, parenteral antimicrobials with multi-species authorization utilized by small animal veterinary practitioners are not accounted for in the overall estimate for companion animals. CONCLUSIONS: Owing to the database structure and requirements for data entry, antimicrobial use in companion animals is an approximation. The actual consumption may be significantly higher than what is currently calculated from the database, as the majority of parenteral products are not included. Consumption data can be measured more accurately provided treatment data from veterinary practitioners in small or mixed practices are transferred to the database through the billing system. This would equal the legal requirements for Danish veterinary practitioners treating livestock.

Application of Methods to Assess Animal Welfare and Suffering Caused by Infectious Diseases in Cattle and Swine Populations.

Control of infectious diseases in livestock has often been motivated by food safety concerns and the economic impact on livestock production. However, diseases may also affect animal welfare. We present an approach to quantify the effect of five infectious diseases on animal welfare in cattle (three diseases) and pigs (two diseases). We grouped clinical manifestations that often occur together into lists of clinical entities for each disease based on literature reviews, and subsequently estimated "suffering scores" based on an aggregation of duration, frequency, and severity. The duration and severity were based on literature reviews and expert knowledge elicitation, while frequency was based mainly on estimates from the literature. The resulting suffering scores were compared to scores from common welfare hazards found under Danish conditions. Most notably, the suffering scores for cattle diseases were ranked as: bovine viral diarrhoea and infection with Mycobacterium avium subsp. paratuberculosis > infectious bovine rhinotracheitis, and for pigs as: porcine respiratory and reproductive syndrome > Aujeszky's disease. The approach has limitations due to the limited data available in literature and uncertainties associated with expert knowledge, but it can provide decision makers with a tool to quantify the impact of infections on animal welfare given these uncertainties.

Narrative Review Comparing Principles and Instruments Used in Three Active Surveillance and Control Programmes for Non-EU-regulated Diseases in the Danish Cattle Population.

The objective of this paper is to provide a comparative review of three active surveillance and control programmes in the Danish cattle sector to highlight important differences for decision makers to develop successful programmes. The focus is on differences in purpose, principles, design and instruments applied to achieve the goals stated for each programme for bovine viral diarrhoea (BVDV), paratuberculosis and Salmonella Dublin. The purposes of the programmes are to reduce economic consequences and improve animal welfare, and for S. Dublin also to prevent zoonotic risk, with varying importance as motivation for the programmes over time. The targets of the BVDV and S. Dublin programmes have been to eradicate the diseases from the Danish cattle population. This goal was successfully reached for BVDV in 2006 where the programme was changed to a surveillance programme after 12 years with an active control programme. The S. Dublin dairy herd-level prevalence decreased from 25% in 2003 to 6% in 2015, just before the milk quota system was abandoned. Over the last 5 years, the prevalence has increased to 8-9% test-positive dairy herds. It is mandatory to participate, and frequent updates of legislative orders were used over two decades as critical instruments in those two programmes. In contrast, participation in the paratuberculosis programme is voluntary and the goals are to promote participation and reduce the prevalence and economic and welfare consequences of the disease. The daily administration of all three programmes is carried out by the major farmers' organisation, who organise surveillance, IT-solutions and other control tools, projects and communication in collaboration with researchers from the universities, laboratories and, for BVDV and S. Dublin, the veterinary authorities. Differences among the programme designs and instruments are mainly due to the environmental component of paratuberculosis and S. Dublin, as the bacteria able to survive for extended periods outside the host. This extra diffuse source of infection increases the demand for persistent and daily hygiene and management efforts. The lower test sensitivities (than for BVDV) lead to a requirement to perform repeated testing of herds and animals over longer time periods calling for withstanding motivation among farmers.

Field Experience of Antibody Testing against Mycoplasma bovis in Adult Cows in Commercial Danish Dairy Cattle Herds.

Mycoplasma bovis in cattle is difficult to diagnose. Recently, the ID screen® mycoplasma bovis indirect ELISA (ID screen) was commercially released by IDVet. The objectives of this study were to: (1) gain and share experience of using the ID screen in adult dairy cows under field conditions; (2) determine the correlation between antibody levels in milk and serum and (3) compare the ID screen results with those of the Bio K 302 (BioX 302) ELISA from BioX Diagnostics. Paired serum and milk samples were collected from 270 cows from 12 Danish dairy herds with three categories of M. bovis disease history. The ID screen tested nearly all cows positive in all, but the three non-infected herds, while the BioX 302 tested very few cows positive. The ID screen is therefore a much more sensitive test than the BioX 302. However, cows in five exposed herds without signs of ongoing infection and two herds with no history of M. bovis infection also tested ID screen positive. Therefore, the performance and interpretation of the test must be investigated under field conditions in best practice test evaluation setups. A concordance correlation coefficient of 0.66 (95% CI: 0.59-0.72) between the ID screen serum and milk results indicates that milk samples can replace serum samples for the ID screen diagnosis of M. bovis in adult cows.

Evaluating integrated surveillance of antimicrobial resistance: experiences from use of three evaluation tools.

BACKGROUND: Integrated antimicrobial resistance (AMR) surveillance programmes require regular evaluation to ensure they are fit for purpose and that all actors understand their responsibilities. This will strengthen their relevance for the clinical setting, which depends heavily on continued access to effective treatment options. Several evaluation tools addressing different surveillance aspects are available. OBJECTIVES: The aim was to understand the strengths and weaknesses of three evaluation tools, and to improve guidance on how to choose a fit-for-purpose tool. SOURCES: Three tools were assessed: (a) AMR-PMP-the Progressive Management Pathway tool on AMR developed by the Food and Agriculture Organization (FAO) of the United Nations, (b) NEOH developed by the EU COST Action 'Network for Evaluation of One Health' and (c) SURVTOOLS developed in an FP7-EU project 'RISKSUR'. Each tool was assessed with regard to contents, required evaluation processes including stakeholder engagement and resource demands, integration coverage across relevant sectors and applicability. They were compared using a predefined scoring scheme and a strengths-weaknesses-opportunities-threats (SWOT)-like format for commenting. CONTENT: All three tools address multiple decision-making levels and aspects of stakeholder engagement. NEOH focuses on system features, learning, sharing, leadership and infrastructure, and requires a description of the underlying system in which AMR develops. AMR-PMP focuses on four areas: awareness, evidence, governance and practices and assesses the implementation degree of pre-chosen aspects within these areas. This requires less of the evaluator, but warrants participation of multiple stakeholders. SURVTOOL provides information and references on how to evaluate effectiveness, process and comprehensiveness of surveillance programmes. All three tools require veterinary epidemiology expertise and varying levels of evaluation methodology training to use appropriately. IMPLICATIONS: The tools covered AMR surveillance and One Health aspects to varying degrees. This study provides guidance on aspects to consider when choosing between available tools and embarking on an evaluation of integrated surveillance.

Herd typologies based on multivariate analysis of biosecurity, productivity, antimicrobial and vaccine use data from Danish sow herds.

The use of antimicrobials in livestock constitutes an increasing global concern, and many countries pursue approaches to reduce the amount used, particularly in the pig production industry. The EU Commission has decided, due to environmental concerns, to phase out use of zinc oxide in pigs by 2022. This poses an additional challenge to efforts to reduce antimicrobial use (AMU) in European pig production. The pig production sector needs further information about how to comply with official AMU requirements without losing competitiveness. The most efficient approaches are likely to involve a combination of multiple factors. Therefore, the objective of this study was to explore multidimensional associations between biosecurity, productivity, vaccination and AMU. A cross sectional study was conducted using data from 160 Danish sow herds in 2014-2015. Biosecurity data were collected through computer-assisted telephone interviews using a pre-developed questionnaire (Biocheck.UGent®) supplemented with additional country-specific questions and translated into Danish. Herd-specific data, consisting of antimicrobial prescriptions, purchase of vaccines against five endemic infections, herd health status and one productivity measure (i.e. number of weaned piglets per sow per year) were extracted from various databases. Factor analysis was conducted on a subset of the data from 152 herds with sufficiently complete data. The identified factors were explained by evaluating data from herds with extreme loadings on the respective factor. The results were further discussed based on plots combining herd factor loadings on two factors at a time. Four factors were selected based on the break-point in the scree-plot. Factor 1 included herd type, herd size, and age of farm buildings. Factor 2 covered general biosecurity, including several internal and external biosecurity measures. Factor 3 represented preventive measures implying specific focus on avoiding introduction of ASF by foreign employees. Lastly, Factor 4 covered vaccination status, specifically regarding vaccination against Mycoplasma hyopneumoniae and Porcine Reproductive and Respiratory Syndrome virus. These factors were used to group the 152 sow herds into herd typologies. Feasible strategies aimed at improving health by reducing AMU without hampering animal welfare were identified and discussed for each typology. AMU and productivity correlated only weakly with other variables. This is probably due to limited variability in both these variables in study herds, which might be attributed to official restrictions on AMU, and a general high level of health and biosecurity in Danish sow herds.

Combining Salmonella Dublin genome information and contact-tracing to substantiate a new approach for improved detection of infectious transmission routes in cattle populations.

This study presents a new method for detection of between-herd livestock movements to facilitate disease tracing and more accurately describe network behaviour of relevance for spread of infectious diseases, including within-livestock business risk-carrying contacts that are not necessarily recorded anywhere. The study introduces and substantiates the concept of grouping livestock herds into business-units based on ownership and location in the tracing analysis of animal movement-based contact networks. To test the utility of this approach, whole core genome sequencing of 196 Salmonella Dublin isolates stored from previous surveillance and project activities was combined with information on cattle movements recorded in the Danish Cattle Database between 1997 and 2017. The aim was to investigate alternative explanations for S. Dublin circulation in groups of herds connected by ownership, but without complete records of livestock movements. The EpiContactTrace R-package was used to trace the contact networks between businesses and compare the network characteristics of businesses sharing strains of S. Dublin with different levels of genetic relatedness. The ownership-only definition proved to be an unreliable grouping approach for large businesses, which could have internal distances larger than 250 km and therefore do not represent useful epidemiological units. Therefore, the grouping was refined using spatial analysis. More than 90% of final business units formed were composed of one single cattle property, whereas multi-property businesses could reach up to eight properties in a given year, with up to 15 cattle herds having been part of the same business through the study period. Results showed markedly higher probabilities of introduction of infectious animals between proposed businesses from which the same clone of S. Dublin had been isolated, when compared to businesses with non-related strains, thus substantiating the business-unit as an important epidemiological feature to consider in contact network analysis and tracing of infection routes. However, this approach may overestimate real-life contacts between cattle properties and putatively overestimate the degree of risk-contacts within each business, since it is based solely on information about property ownership and location. This does not consider administrative and individual farmers behaviours that essentially keep two properties separated. Despite this, we conclude that defining epidemiological units based on businesses is a promising approach for future disease tracing tasks.

Opportunities for Improved Disease Surveillance and Control by Use of Integrated Data on Animal and Human Health.

The global challenges and threats from infectious diseases including antimicrobial drug resistance and emerging infections due to the rapidly changing climate require that we continuously revisit the fitness of our infrastructure. The databases used for surveillance represent an important infrastructure. Historically, many databases have evolved from different needs and from different organizations. Despite growing data storage and computing capacities, data are, however, rarely used to their full potential. The objective of this review was to outline different data sources available in Denmark. We applied a one-health perspective and included data sources on animal demographics and movements, medicine prescription, diagnostic test results as well as relevant data on human health. Another objective was to suggest approaches for fit-for-purpose integration of data as a resource for risk assessment and generation of evidence for policies to protect animal and human health. Danish databases were reviewed according to a systematic procedure including ownership, intended purposes of the database, target and study populations, metrics and information used, measuring methods (observers, diagnostic tests), recording procedures, data flow, database structure, and control procedures to ensure data quality. Thereby, structural metadata were gathered across available Danish databases including animal health, zoonotic infections, antimicrobial use, and relevant administrative data that can support the overall aim of supporting risk assessment and development of evidence. Then illustrative cases were used to assess how combinations and integration of databases could improve existing evidence to support decisions in animal health policies (e.g., combination of information on diseases in different herds or regions with information on isolation of pathogens from humans). Due to the complexity of databases, full integration at the individual level is often not possible. Still, integration of data at a higher level (e.g., municipality or region) can provide important information on risks and hence risk management. We conclude by discussing how databases by linkage can be improved in the future, and emphasize that legal issues are important to address in order to optimize the use of the available data.

Additive Bayesian Network analysis of associations between antimicrobial consumption, biosecurity, vaccination and productivity in Danish sow herds.

In modern livestock farming, there is an increasing understanding that antimicrobial (AM) consumption must be kept low - preferably without compromising animal welfare or productivity. This requires an understanding of the relationship between AM use, productivity, biosecurity, vaccination and herd demographics. To obtain this, we undertook an Additive Bayesian Network analysis using data from 2014 to 2015, covering 157 Danish sow herds with weaners. In general, productivity and biosecurity were high, and AM consumption low. No association was found between prescribed AM and productivity. Other variables, such as biosecurity and enrolment in the Danish Specific Pathogen Free (SPF) system, had stronger associations with sow productivity than AM consumption. In the weaner unit, an association between AM consumption and certain vaccination practices was found, suggesting that vaccines might be used to control preexisting problems. The results reveal that most Danish sow producers are able to maintain productivity while using low amounts of AMs. This conclusion must be interpreted within the context of Danish pig farming i.e. generally high biosecurity and many years of official restrictions aiming at reducing AM consumption.

Increased incidence rate of undesired early heifer departure in Mycoplasma bovis-antibody positive Danish dairy cattle herds.

Mycoplasma bovis infections cause disease and production losses in cattle worldwide. The long-term consequences are not well described despite being important for management decisions during and after disease outbreaks. We investigated the association between M. bovis antibody-positivity and undesired early departure (UED, i.e. death, euthanasia or slaughter) before first calving in a cohort of 636 heifers from 36 Danish dairy herds with and without a history of M. bovis-associated disease. The herds were visited 4 times at 3-month intervals and blood samples from young stock and milk samples from lactating cows were collected. Poisson regression was performed to examine the association with UED as outcome, logarithmic transformation of risk time as offset and herd as a random effect. Individual antibody measurements and group-level variables representing the infection level among young stock and cows, age and mortality variables were included in the model. The incidence rate ratio of UED increased by 1.23 times for every 10% increase in M. bovis young stock seroprevalence, while the effect of individual antibody level was modified by age and influenced UED less. In conclusion, UED in heifers was associated with M. bovis antibody-positivity in young stock and should be controlled in dairy herds to reduce losses.

Expert opinion on livestock antimicrobial usage indications and patterns in Denmark, Portugal and Switzerland.

We aimed at describing antimicrobial usage patterns throughout livestock production cycles, and comparing them across three countries from Northern, Central and Southern Europe. Given the difficulties to collect such detailed usage data, an expert opinion was deemed the most appropriate study design. This study provides new insights into the time periods and indications for which specific antimicrobial substances are used in different livestock sectors. Veterinary experts (n=67) from different livestock sectors (broilers, pigs, dairy cattle and veal/fattening calves) and countries (Denmark, Portugal and Switzerland) replied to a questionnaire focusing on the time periods in the production cycle when antimicrobial substances were administered, and the respective indications for treatment. Our results showed that for several antimicrobials, between-country and within-country variations exist regarding the temporal distributions of treatments and indications for use. These differences were also true for several critically important antimicrobials, which is a matter of concern. Furthermore, differences between countries were also evident regarding the antimicrobial substances licensed. Based on our results, it is recommended to establish and promote treatment guidelines, invest in the prevention of diseases during critical moments of the production cycle and target undifferentiated use of antimicrobials. Moreover, discrepancies between countries should be further investigated to better understand the factors underlying the identified patterns and to distinguish prudent from non-prudent use. The results can inform decision-making with the aim to foster antimicrobial prudent use in the veterinary setting and, therefore, protect public health from the threat of antimicrobial resistance.

European dog owner perceptions of obesity and factors associated with human and canine obesity.

Obesity is a common nutrition-related disorder leading to reduced life expectancy in both humans and dogs. With the aim of identifying new prevention and control options, the study objectives were (1) to investigate dog-owner perceptions about obesity in terms of themselves and their dogs, and (2) to identify factors associated with obesity and possible social, environmental and economic drivers for its development in dog owners and their pets. A cross-sectional questionnaire-based study was performed across multiple countries. The questionnaire focused on human and canine obesity, associated factors and potential drivers, and was distributed online and in the form of hard copies among dog owners in 11 European countries. In total, 3,185 responses from ten countries were included in multivariable analyses. Between 19.1% and 48.8% of the dog owners reported to be overweight/obese. Owner-reported overweight/obesity in dogs ranged from 6.0% to 31.3% based on body condition score charts, and 31.8% to 69.4% based on body fat index charts. Common factors associated with obesity in owners and their dogs were age, gender and owners' attitudes to diet and physical activity. Dog owners who did not consider obesity to be a disease were more likely to have obese dogs.

Mycoplasma bovis antibody dynamics in naturally exposed dairy calves according to two diagnostic tests.

BACKGROUND: Inexpensive and convenient diagnostic tests for use in clinical work and for the surveillance of infection with Mycoplasma bovis are in demand. The objective of this longitudinal field study was to gain knowledge about the dynamics of antibodies against M. bovis in sera from naturally exposed calves with and without different clinical signs, measured by two different ELISA tests. RESULTS: A total of 83 calves were subject to between one and five blood samples and clinical examinations using a standard protocol during five herd visits to each of four outbreak dairy herds. The blood samples were analysed for the presence of antibodies against M. bovis using the commercial IgG ELISA test BioX K302 (BioX) and an in-house indirect IgG ELISA test (MilA ELISA). Linear mixed models were used to describe and compare the antibody dynamics as measured by the two tests in relation to the disease status and age of the animals. The BioX ELISA response was below the recommended cut-off (37 ODC%) for the entire study period in many of the calves. The estimated mean ODC% increased slowly but did not reach the recommended individual animal cut-off in three of the four herds. The highest estimated ODC% was not reached until the calf was 110-130 days old. The MilA ELISA response rose above the recommended cut-off (135 antibody units (AU)) in almost all calves, and in two herds, the estimated mean was above the individual animal cut-off shortly after the birth of the calf. The highest estimated antibody concentration was reached when the calf was approximately 60 days old. Disease status of the calf was not significantly associated with the results of either test. CONCLUSIONS: We conclude that the BioX ELISA cannot be recommended for use in calves below 3 months of age. The MilA ELISA was able to detect antibodies shortly after birth (i.e. from approximately 3 weeks of age and onwards) and is therefore a more sensitive test for M. bovis exposure in young calves. Neither ELISA seemed able to differentiate between calves with arthritis and/or otitis media, and respiratory disease.

A Systems Approach to Evaluate One Health Initiatives.

Challenges calling for integrated approaches to health, such as the One Health (OH) approach, typically arise from the intertwined spheres of humans, animals, and ecosystems constituting their environment. Initiatives addressing such wicked problems commonly consist of complex structures and dynamics. As a result of the EU COST Action (TD 1404) "Network for Evaluation of One Health" (NEOH), we propose an evaluation framework anchored in systems theory to address the intrinsic complexity of OH initiatives and regard them as subsystems of the context within which they operate. Typically, they intend to influence a system with a view to improve human, animal, and environmental health. The NEOH evaluation framework consists of four overarching elements, namely: (1) the definition of the initiative and its context, (2) the description of the theory of change with an assessment of expected and unexpected outcomes, (3) the process evaluation of operational and supporting infrastructures (the "OH-ness"), and (4) an assessment of the association(s) between the process evaluation and the outcomes produced. It relies on a mixed methods approach by combining a descriptive and qualitative assessment with a semi-quantitative scoring for the evaluation of the degree and structural balance of "OH-ness" (summarised in an OH-index and OH-ratio, respectively) and conventional metrics for different outcomes in a multi-criteria-decision-analysis. Here, we focus on the methodology for Elements (1) and (3) including ready-to-use Microsoft Excel spreadsheets for the assessment of the "OH-ness". We also provide an overview of Element (2), and refer to the NEOH handbook for further details, also regarding Element (4) (http://neoh.onehealthglobal.net). The presented approach helps researchers, practitioners, and evaluators to conceptualise and conduct evaluations of integrated approaches to health and facilitates comparison and learning across different OH activities thereby facilitating decisions on resource allocation. The application of the framework has been described in eight case studies in the same Frontiers research topic and provides first data on OH-index and OH-ratio, which is an important step towards their validation and the creation of a dataset for future benchmarking, and to demonstrate under which circumstances OH initiatives provide added value compared to disciplinary or conventional health initiatives.

A Blueprint to Evaluate One Health.

One Health (OH) positions health professionals as agents for change and provides a platform to manage determinants of health that are often not comprehensively captured in medicine or public health alone. However, due to the organization of societies and disciplines, and the sectoral allocation of resources, the development of transdisciplinary approaches requires effort and perseverance. Therefore, there is a need to provide evidence on the added value of OH for governments, researchers, funding bodies, and stakeholders. This paper outlines a conceptual framework of what OH approaches can encompass and the added values they can provide. The framework was developed during a workshop conducted by the "Network for Evaluation of One Health," an Action funded by the European Cooperation in Science and Technology. By systematically describing the various aspects of OH, we provide the basis for measuring and monitoring the integration of disciplines, sectors, and stakeholders in health initiatives. The framework identifies the social, economic, and environmental drivers leading to integrated approaches to health and illustrates how these evoke characteristic OH operations, i.e., thinking, planning, and working, and require supporting infrastructures to allow learning, sharing, and systemic organization. It also describes the OH outcomes (i.e., sustainability, health and welfare, interspecies equity and stewardship, effectiveness, and efficiency), which are not possible to obtain through sectoral approaches alone, and their alignment with aspects of sustainable development based on society, environment, and economy.

Comparison of risk-based versus random sampling in the monitoring of antimicrobial residues in Danish finishing pigs.

In Denmark, a monitoring program for residues of antimicrobials in pork is in place involving annual testing of around 20,000 samples from finishing pigs corresponding to 0.1% of the animals slaughtered. Annually, zero to two samples are found above the maximum residue limit. Both authorities and industry have expressed interest in adjusting the monitoring to a risk-based system. The objective of this study was to assess the opportunities and consequences of the monitoring considering: 1) replacing the current bioassay with high-performance liquid chromatography-mass spectrometry (HPLC LC-MS/MS), 2) replacing kidney with muscles as sample matrix, and 3) using indicators to identify high-risk (HR) herds and increase sampling intensity in these herds, lowering sampling in the low-risk (LR) herds, while aiming at continued detection of similar numbers of test-positives at the lowest possible costs. A state-of-the-art stochastic scenario tree modelling approach including economic evaluation of different model outcomes was used. A total of six scenarios were run for penicillin and tetracycline, respectively. Relevant information was obtained through the literature, statistical analysis of existing data as well as consultations with laboratory and slaughterhouse experts. Abattoir recordings of chronic pleuritis were used as an indicator for finishing pig herds (HR=within-herd prevalence>40%). Such risk-based monitoring would have to use muscles and not kidneys, because of logistic challenges in identifying and storing of plucks until testing. However, the bioassay cannot be used on muscle tissue due to low sensitivity for tetracyclines. Different plausible combinations of sample sizes were also modelled. The HPLC LC-MS/MS method detected the same number of cases compared to the bioassay when kidney was used as matrix. HPLC LC-MS/MS has a higher sensitivity when used on muscle but it is almost twice as costly as the bioassay. Risk-based sampling resulted in detection of more residue cases with higher cost-effectiveness than random monitoring. Sampling 7500 HR pigs and 5000 LR pigs resulted in the most cost-effective monitoring among the alternative scenarios. The associated costs would increase by 4%. A scenario involving testing of 5000 HR and 5000 LR animals would result in slightly fewer positives, but 17% savings in costs. The advantages of using HPLC LC-MS/MS compared to the bioassay are a fast response and a high sensitivity for all relevant substances used in pigs. The Danish abattoir companies have implemented a risk-based monitoring similar to the above per January 2016.