Bayesian estimation of the sensitivity and specificity of coprological and serological diagnostic tests for the detection of Ascaris suum infection on pig farms.

Coprological and serological diagnostic tests were compared to define the status of a pig farm with regard to Ascaris suum. On each of the 100 farms in France visited for the study, 10 blood samples were taken from pigs at the end of fattening (at least 22 weeks old) and 20 to 30 faecal samples were taken, depending on the category of animals present on the farm (10 sows, 10 piglets aged 10 to 12 weeks and 10 pigs at the end of fattening, aged at least 22 weeks). A SERASCA® ELISA test (Laboratory of Parasitology, Ghent University) was performed on each blood sample (cut-off 0.5) and a coprological analysis on each faecal sample. A Bayesian approach was used to estimate the sensitivity and specificity of the coprological and serological tests. A farm was considered positive if at least one A. suum egg was observed in the faecal samples. With regard to the serological test, various hypotheses were tested in order to define the number of seropositive animals required to consider a farm positive for A. suum. The coprological test has very good specificity in the search for A. suum, whether 20 or 30 samples are taken per farm. However, even with an increase in the number of samples, the sensitivity of this diagnostic approach is very low (less than 30%). On the other hand, the serological diagnostic method, which consists of taking blood samples from 10 animals at the end of fattening, has good sensitivity and seems better suited to defining the status of a farm with regard to A. suum, provided that a farm is considered seropositive only if two out of 10 samples are positive.

Quantitative risk assessment of rabies being introduced into mainland France through worldwide noncommercial dog and cat movements.

France has been rabies-free among nonflying mammals since 2001. Despite this status, the rabies virus has been introduced several times through noncommercial pet movements, posing a threat of infection by this 100%-lethal zoonosis among local animal and human populations. To quantify the risk of rabies being introduced through worldwide noncommercial dog and cat movements, we performed a quantitative risk assessment using stochastic scenario tree modeling. The mean annual probability of at least one rabies introduction incident was 0.35 (median: 0.24, 90% prediction interval (PI) [0.04; 0.98]) and the mean annual number of rabies-infected pets introduced through pet movements was 0.96 (median: 0.27, 90% PI [0.04; 3.88]). These results highlight a nonnegligible, even high risk due to the associated consequences of such events. In alternative scenario testing, preventive anti-rabies vaccination proved to be an effective measure since removing the vaccination requirement led to a > 15-fold increase in risk. The serological testing requirement had less of an effect (approximately two-fold increase when removed) and the posttest waiting period to ensure that antibodies were not linked to an infection had a negligible effect. Any change in pet owner compliance, especially regarding vaccination, could have a major impact on the risk. This study also shows that reinforced border control staff training could be more effective in reducing risk than more frequent checks. These results provide quantitative data for assessing the probability of the rabies virus entering France, and could help policymakers decrease this risk in rabies-free areas.

Foot and mouth disease virus: transmission, pathogenesis, diagnosis and surveillance / Le virus de la fièvre aphteuse : transmission, pathogenèse, diagnostic et surveillance

Foot-and-mouth disease (FMD) is one of the most contagious viral animal diseases. It is an old disease which still poses a permanent threat of re-emergence for free zones. Foot-and-Mouth Disease Virus (FMDV), a Picornavirus belonging to genus Aphthovirus affects domestic and wild artiodactyls. FMD has a considerable socio-economic impact on agricultural production and trade in endemic regions, but also when incursions occur into FMD free areas, as in Europe in 2001. FMDV is historically one of the most studied viruses. Due to its high genetic and antigenic variability, the absence of cross-immunity between its seven serotypes, its ability to survive in the environment, its high contagiousness, its wide range of hosts and its particular biology, FMDV remains of major interest in animal health and the subject of many research projects. This review presents different aspects of FMDV infection, ranging from basic biology to diagnosis, surveillance and control.

La fièvre aphteuse (FA) est l'une des maladies virales animales les plus contagieuses. Bien que très ancienne, la FA reste toujours d'actualité et représente une menace permanente de réémergence pour les pays indemnes. Le virus de la FA ou FMDV (pour foot-and-mouth disease virus), de la famille Picornaviridae, genre Aphthovirus, affecte les artiodactyles domestiques comme sauvages (principalement bovins, ovins, caprins, porcins, camélidés et cervidés). La fièvre aphteuse a un impact socio-économique considérable sur la production et le commerce agricoles en zone d'enzootie mais également en cas d'incursion dans une zone précédemment indemne comme ce fut le cas en 2001 en Europe. Le virus de la FA est historiquement l'un des virus les plus étudiés. Par sa grande variabilité génétique et antigénique, l'absence d'immunité croisée entre ses sept sérotypes, sa capacité de survie dans l'environnement, sa grande contagiosité, son large spectre d'hôtes ainsi que sa biologie particulière, ce virus reste d'intérêt majeur en santé animale et l'objet de nombreux travaux de recherche. Cette revue vise à présenter différents aspects de l'infection par le virus de la fièvre aphteuse et ses problématiques actuelles, de la biologie fondamentale au diagnostic en passant par la surveillance et les moyens de lutte.

How We Might Further Integrate Considerations of Environmental Impact When Assessing the Value of Health Technologies.

There is growing awareness of the impact health technologies can have on the environment and the negative consequences of these environmental impacts on human health. However, health system decision-makers may lack the expertise, data, or resources to incorporate environmental considerations when making decisions about the adoption and use of health technologies. In this article, we describe how health technology assessment (HTA) is evolving to address climate change by providing health system decision-makers with the information they can use to reduce the impact of health care systems on the environment. Our objective is to consider approaches for including the environment domain when conducting an HTA-in particular, the use of the deliberative process-and for determining when the domain should be included. We explore the challenges of gathering the relevant data necessary to assess the environmental impact of a health technology, and we describe a "triage" approach for determining when an in-depth environmental impact assessment is warranted. We also summarize related initiatives from HTA agencies around the world.

DESCRIPTIVE EPIDEMIOLOGY OF THE MAIN INTERNAL PARASITES ON ALTERNATIVE PIG FARMS IN FRANCE.

Alternative pig farms, which do not raise animals in closed buildings with slatted and/or concrete floors, have critical points that need particular attention. Internal parasitism is one, as the farming conditions in such structures are more favorable to the development and survival of parasites. The objectives of this study, carried out on 70 alternative farms in continental France, were to (i) estimate the frequency and level of infestation by the main internal parasites on these farms, and (ii) define their typology according to the level of parasitism. For this purpose, fecal samples were taken for coprological analysis from 10 sows, 10 pigs aged 10-12 wk, and 10 pigs at the end of the fattening period. Blood samples were also taken for serological analysis (targeting Ascaris suum and Toxoplasma gondii) from 10 sows and 10 pigs at the end of the fattening period. Of the 70 farms, only 5 had no helminth egg or coccidian oocyst. Coccidia oocysts were observed in 79% of the farms, while eggs of Oesophagostomum spp./Hyostrongylus rubidus, Ascaris suum, and Trichuris suis were found in 47%, 16%, and 36% of the farms, respectively. On each infested farm, an average of 56.8% of sows, 23.8% of grower pigs, and 38.9% of finisher pigs were parasitized. At least 1 Ascaris suum-seropositive finisher pig was found on 91% of the farms, and at least 1 Toxoplasma gondii-seropositive finisher pig or sow on 60% of the farms. Data on housing, animal management, and health management (particularly parasite control) were collected to characterize the typology of farms according to their level of parasitism. The variables defining these farm typologies differed according to the parasites. Access to the outdoors for breeding stock was a characteristic of the farms most heavily infested with helminths or T. gondii. Conversely, the farms with the lowest frequency of coccidia oocyst infestation were characterized by free-range farrowing facilities and also by the presence of slatted floors, mostly plastic in our study, rather than straw bedding in the farrowing rooms. The level of biosecurity concerning the storage of straw for pig bedding was another discriminating factor for parasitism level of helminths and T. gondii. Farms with the highest levels of helminth parasitism were more likely not to practice an all-in-all-out postweaning system and to deworm their grower/finisher pigs less frequently than farms with the lowest levels of helminth parasitism.

A framework for multicriteria decision-aid analyses in animal health surveillance applied to periodic screening for French bovine tuberculosis.

In animal health surveillance, decision-makers must allocate limited financial and human resources, choosing appropriate protocols that consider technical, economic and human aspects (i.e. test sensitivity, cost benefits and policy acceptability respectively). Choosing in an objective manner and considering all these criteria can be challenging, especially where criteria have a tendency to be at odds with one another. In France, there are several mandatory protocols implemented to screen for bovine tuberculosis (TB), each with advantages and drawbacks concerning effectiveness, cost and acceptability. Previous studies have developed scenario tree models in order to evaluate mandatory periodic screening protocols and alternative protocols. Using these previously developed models, we estimated protocol sensitivity, costs at the level of State and farmer, probability of false suspects, and probability of culling an uninfected animal, which influence stakeholders' acceptability. We then assessed the level of difficulty for protocol implementation for veterinarians, farmers and State through the use of surveys. Using these criteria, we rank the protocols with the PROMETHEE method, a multicriteria decision-aid method, by considering the relative importance of each criterion from the decision-maker point of view in four administrative areas with contrasting epidemiological context. This method can be considered a tool to aid decision-makers in choosing the appropriate protocol to apply to a heard while considering the technical and socio-economic facets of the problem. Additionally, by adapting the criteria to specific issues with regards to decision-making, there is potential for applying the PROMETHEE method to other animal health surveillance problems.

Management practices of dog and cat owners in France (pet traveling, animal contact rates and medical monitoring): Impacts on the introduction and the spread of directly transmitted infectious pet diseases.

A number of owner practices among the pet dog and cat population can influence the dynamics of directly transmitted infectious dog and cat diseases, including zoonotic ones. To better depict these management practices, which include pet traveling, contact rates with other companion animals and their medical monitoring (which herein includes prevention aspects), we surveyed 2,122 dog- and/or cat-owning French households through an anonymous online questionnaire. Trips with dogs within the European Union (EU) were frequent, while cats travelled less frequently within the EU and both cats and dogs travelled less frequently outside the EU. Recurrent illegal trips with dogs and cats (non-compliant with regulatory measures) were observed in a context of non-systematic pet border controls. We found that a large proportion of dogs are taken for walks in metropolitan France, with frequent intraspecific contacts (1.4 contacts/day on average), but only a minority (1.4%) of dogs were allowed to roam freely. On the other hand, 59.7% of cat owners allowed their cats to roam freely. We classified pet owners according to different profiles, some of which may be considered 'at risk' for directly transmitted infectious pet diseases. Indeed, one dog owner profile and one cat owner profile depict 'spreaders' of pet diseases (high connectivity with other individuals, little medical monitoring but no traveling) and another dog owner profile describes a potential 'introducer' and 'spreader' of pet diseases (foreign travel, high connectivity with other individuals, and intermediate medical monitoring). While these 'at risk' profiles represent only a minority of French pet owners, they should be better characterized to reinforce targeted prevention designed to minimize the risk of (re)introduction and (re)emergence of directly transmitted infectious dog and cat diseases in France, especially when considering zoonoses with a significant potential impact, such as rabies.

Benefit-Risk Assessment of the French Surveillance Protocol of Apparently Healthy Biting Dogs and Cats for Human Rabies Prevention.

In France, apparently healthy dogs and cats that bite humans must undergo an observation period of 15 days with three veterinary visits to ascertain that they remain healthy, indicating that no zoonotic transmission of rabies virus occurred via salivary presymptomatic excretion. This surveillance protocol is mandatory for all pets that have bitten humans, despite France's rabies-free status in non-flying mammals (i.e., a very low rabies risk). In this context, we aimed to perform a benefit-risk assessment of the existing regulatory surveillance protocol of apparently healthy biting animals, as well as alternative surveillance protocols. A scenario-tree modelling approach was used to consider the possible successions of events between a dog or cat bite and a human death attributed to either rabies or to lethal harm associated with the surveillance protocol (e.g., lethal traffic accidents when traveling to veterinary clinics or anti-rabies centers). The results demonstrated that the current French surveillance protocol was not beneficial, as more deaths were generated (traffic accidents) than avoided (by prompt post-exposure prophylaxis administration). We showed here that less stringent risk-based surveillance could prove more appropriate in a French context. The results in this study could allow policy-makers to update and optimize rabies management legislation.

Relative Contribution of Each Component of the French Ante-Mortem Surveillance System for Bovine Tuberculosis in Its Overall Sensitivity.

The aim of this study was to assess the contribution to the sensitivity of the French ante-mortem surveillance system for bovine tuberculosis in cattle of each of the system's components (periodic screening, epidemiological investigations, and screening exchanged animals), on a local scale defined by administrative areas. These components were individually assessed in previous studies by scenario tree modeling. We used scenario tree modeling at the herd level and combined the results to evaluate the overall sensitivity of the ante-mortem surveillance system. The probability to detect at least one infected herd was consistent with the location of the outbreaks detected in 2016. In areas with a high apparent incidence, the probability of an infected herd to be detected was satisfactory (for an infected herd there was a 100% probability to be detected over a two-year period). Periodic screening was the most important component for the overall sensitivity in infected areas. In other areas, where periodic screening had stopped, tracing-on epidemiological investigation was the most sensitive component of the system. Screening exchanged animals had a negligible part in the overall sensitivity of the surveillance system.

Using a participatory qualitative risk assessment to estimate the risk of introduction and spread of transboundary animal diseases in scarce-data environments: A Spatial Qualitative Risk Analysis applied to foot-and-mouth disease in Tunisia 2014-2019.

This article presents a participative and iterative qualitative risk assessment framework that can be used to evaluate the spatial variation of the risk of infectious animal disease introduction and spread on a national scale. The framework was developed through regional training action workshops and field activities. The active involvement of national animal health services enabled the identification, collection and hierarchization of risk factors. Quantitative data were collected in the field, and expert knowledge was integrated to adjust the available data at regional level. Experts categorized and combined the risk factors into ordinal levels of risk per epidemiological unit to ease implementation of risk-based surveillance in the field. The framework was used to perform a qualitative assessment of the risk of introduction and spread of foot-and-mouth disease (FMD) in Tunisia as part of a series of workshops held between 2015 and 2018. The experts in attendance combined risk factors such as epidemiological status, transboundary movements, proximity to the borders and accessibility to assess the risk of FMD outbreaks in Tunisia. Out of the 2,075 Tunisian imadas, 23 were at a very high risk of FMD introduction, mainly at the borders; and 59 were at a very high risk of FMD spread. To validate the model, the results were compared to the FMD outbreaks notified by Tunisia during the 2014 FMD epizootic. Using a spatial Poisson model, a significant alignment between the very high and high-risk categories of spread and the occurrence of FMD outbreaks was shown. The relative risk of FMD occurrence was thus 3.2 higher for imadas in the very high and high spread risk categories than for imadas in the low and negligible spread risk categories. Our results show that the qualitative risk assessment framework can be a useful decision support tool for risk-based disease surveillance and control, in particular in scarce-data environments.

Evaluation of the Worldwide Occurrence of Rabies in Dogs and Cats Using a Simple and Homogenous Framework for Quantitative Risk Assessments of Rabies Reintroduction in Disease-Free Areas through Pet Movements.

Dog and cat rabies cases imported from rabies enzootic countries represent a major threat for areas that have acquired rabies-free status and quantitative risk analyses (QRAs) are developed in order to assess this risk of rabies reintroduction through dog and cat movements. Herein we describe a framework to evaluate dog and cat rabies incidence levels in exporting countries along with the associated uncertainty for such QRAs. For enzootic dog rabies areas (EDRAs), we extended and adapted a previously published method to specify the relationship between dog rabies vaccination coverage and canine rabies incidence; the relationship between dog and cat rabies incidences; and then to predict annual dog and cat rabies incidences. In non-enzootic dog rabies areas (nEDRAs), we provided annual incidence based on declared dog and cat rabies cases. For EDRAs, we predicted an annual incidence potentially greater than 1.5% in dogs and about ten times lower in cats with a high burden in Africa and Asia but much lower in Latin America. In nEDRAs, the occurrence of rabies was lower and of similar magnitude in dogs and cats. However, wildlife could still potentially infect dogs and cats through spillover events. This framework can directly be incorporated in QRAs of rabies reintroduction.

Investigation of field intradermal tuberculosis test practices performed by veterinarians in France and factors that influence testing.

Bovine tuberculosis infection remains at a low but persistent level in French cattle herds and requires for its surveillance the use of tests with limited sensitivity and specificity. It thus appears essential to understand the reality of the field situation, to identify parameters which could affect how veterinarians perform these tests and how it can affect the sensitivity of the bovine tuberculosis surveillance system. We surveyed rural veterinarians (n = 1084), major stakeholders of the bovine tuberculosis surveillance system, after judgement (non-random) sampling to investigate their skin-test practices and their perception of the surveillance and control programs for this disease. The response rate was 19.4% (210/1084). The responses highlighted that veterinarians were aware of the importance of the fight against bovine tuberculosis and were resilient to the challenges and issues faced during fieldwork. However, we identified several areas of noncompliance with regulatory recommendations, particularly regarding the choice of injection site, verifying the quality of the injection, the method of test reading, and the reporting of non-negative test results. Multivariate analysis showed that veterinarians who had worked for fewer years in large-animal practice had better skin-test procedures. A higher proportion of performed comparative tests and a more positive perception of surveillance and control programs by veterinarians were associated with better skin-test practices. The areas of noncompliance identified in this study could be detrimental to the sensitivity of bovine tuberculosis surveillance but our results suggest that improving the information provided to veterinarians and increasing their awareness are feasible solutions to improve the surveillance efficacy.

Assessment of the specificity of a gamma-interferon test performed with specific antigens to detect bovine tuberculosis, after non-negative results to intradermal tuberculin testing.

In cattle herds in France, cervical skin tests (STs) using simple intradermal tuberculin (SIT) are performed to detect bovine tuberculosis (bTB). When positive results are found on ST screening, the herd is considered to be 'under suspicion' and confined, raising economic issues. The suspicion can be lifted by carrying out a single intradermal cervical comparative test (SICCT) at least six weeks later. The authors conducted an experimental study in France between 2013 and 2015 to assess the accuracy of the gamma-interferon test (IFN-γ), used in series after a non-negative result to ST screening, and to study the possibility of replacing the SICCT performed six weeks later by an IFN performed within a few days. Data were collected concerning 40 infected and 1825 bTB-free animals from herds with non-negative results to ST screening. This study showed that the IFN-γ test based on specific antigens and performed within a few days of a non-negative result to the ST has higher sensitivity than the SICCT performed six weeks later and equal specificity. The IFN test is more convenient to perform; however, it is more expensive. The IFN-γ test based on MIX antigens may be a useful alternative to the SICCT, to shorten the confinement period of suspect herds without underdetecting bTB.

Perceptions and acceptability of some stakeholders about the bovine tuberculosis surveillance system for wildlife (Sylvatub) in France.

Bovine tuberculosis (bTB) is a common disease of cattle and wildlife, with economic repercussions and implications for animal and human health. The surveillance of bTB in wildlife is particularly important, to shed light on the epidemiological role of wild species and for the adaptation of control measures. In France, a bTB surveillance system for free-ranging wildlife, the Sylvatub system, was launched in 2011 on wild boars, red deer, roe deer and badgers. It relies on active and passive surveillance activities, constrained by practical difficulties, such as the accessibility of wild animals, and regulatory rules for the trapping of badgers, for example. We report here the first assessment of stakeholders' perceptions of the Sylvatub system and its acceptability, based on 20 individual semi-structured interviews with three types of stakeholder (collectors, coordinators, officers) in areas with different rates of bTB infection. With the caveat that these findings cannot be assumed to be representative of the national situation, we found that the Sylvatub system was considered useful by all the stakeholders interviewed. Those from the world of hunting participate in surveillance mostly to help livestock farmers, who are not systematically involved in bTB surveillance in wildlife. Many practical and regulatory constraints were raised, which could be offset by recognition of the work done by the "hunting community", to maintain the willingness of these individuals to participate. We also identified a need for improvements in communication and information. Qualitative information, such as that collected here, is essential to improve our understanding of the reasons favoring and disfavoring participation in surveillance, and should be taken into account in the evaluation process. These results are relevant to hunters and to veterinary authorities wishing to identify the determinants of participation in the Sylvatub system. They could provide support for decision-making processes to improve surveillance strategies.

The importance of communication in promoting voluntary participation in an experimental trial: A qualitative study based on the assessment of the gamma-interferon test for the diagnosis of bovine tuberculosis in France.

Understanding the factors leading each stakeholder to participate in an experimental trial is a key element for improving trial set-up and for identifying selection bias in statistical analyses. An experimental protocol, validated by the European Commission, was developed in France to assess the ability of the gamma-interferon test in terms of accuracy to replace the second intradermal skin test in cases of suspected bovine tuberculosis. Implemented between 2013 and 2015, this experimental trial was based on voluntary participation. To determine and understand the motivation or reluctance of farmers to take part in this trial, we carried out a sociological survey in France. Our study was based on semi-structured interviews with the farmers and other stakeholders involved. The analysis of findings demonstrated that shortening the lock-up period during tuberculosis suspicion, following the use of a gamma-interferon test, was an important aim and a genuine challenge for the animal health stakeholders. However, some farmers did not wish to continue the trial because it could potentially have drastic consequences for them. Moreover, misunderstandings and confusion concerning the objectives and consequences of the trial led stakeholders to reject it forcefully. Based on our results, we offer some recommendations: clear and appropriate communication tools should be prepared to explain the protocol and its aims. In addition, these types of animal health trials should be designed with the stakeholders' interests in mind. This study provides a better understanding of farmer motivations and stakeholder influences on trial participation and outcomes. The findings can be used to help design trials so that they promote participation by farmers and by all animal health stakeholders in general.

Cost-effectiveness evaluation of bovine tuberculosis surveillance in wildlife in France (Sylvatub system) using scenario trees.

Bovine tuberculosis (bTB) is a common disease in cattle and wildlife, with health, zoonotic and economic implications. Infected wild animals, and particularly reservoirs, could hinder eradication of bTB from cattle populations, which could have an important impact on international cattle trade. Therefore, surveillance of bTB in wildlife is of particular importance to better understand the epidemiological role of wild species and to adapt the control measures. In France, a bTB surveillance system for free-ranging wildlife, the Sylvatub system, has been implemented since 2011. It relies on three surveillance components (SSCs) (passive surveillance on hunted animals (EC-SSC), passive surveillance on dead or dying animals (SAGIR-SSC) and active surveillance (PSURV-SSC)). The effectiveness of the Sylvatub system was previously assessed, through the estimation of its sensitivity (i.e. the probability of detecting at least one case of bTB infection by each SSC, specie and risk-level area). However, to globally assess the performance of a surveillance system, the measure of its sensitivity is not sufficient, as other factors such as economic or socio-economic factors could influence the effectiveness. We report here an estimation of the costs of the surveillance activities of the Sylvatub system, and of the cost-effectiveness of each surveillance component, by specie and risk-level, based on scenario tree modelling with the same tree structure as used for the sensitivity evaluation. The cost-effectiveness of the Sylvatub surveillance is better in higher-risk departments, due in particular to the higher probability of detecting the infection (sensitivity). Moreover, EC-SSC, which has the highest unit cost, is more efficient than the surveillance enhanced by the SAGIR-SSC, due to its better sensitivity. The calculation of the cost-effectiveness ratio shows that PSURV-SSC remains the most cost-effective surveillance component of the Sylvatub system, despite its high cost in terms of coordination, sample collection and laboratory analysis.

[The causes of the emergence of infectious diseases]. / Les causes de l'émergence des maladies infectieuses.

The most infectious diseases that veterinarians and doctors believed to have vanquished in the 1980s in developed countries, have repeatedly talked about them in an often dramatic way in the 2000s. Foot-and-mouth disease devastated British herds in 2001, bovine tuberculosis, which had been hoped for eradication after 50 years of fighting, has re-emerged in the United Kingdom and France... At the same time, new infectious diseases, often zoonotic, have appeared in animals and in humans : HP avian influenza H5N1 in 2003, SARS in 2003, the MERS-CoVin2012…The reasons for these emergences are multiple because each disease has its own determinants. However, three main groups of factors can be cited: the evolution of pathogens (RNA viruses in particular), environmental changes favoring the development of vectors and reservoirs, and human behavior. The constant movement of humans, animals and their products on the planet, densification of populations and massive displacements linked to conflicts are probably at the heart of these evolutions.For the future, the challenges are to understand the infectious risks linked to these evolutions in order to try to prevent them. Epidemiology through surveillance and investigation will be tomorrow more than ever, at the heart of the prevention of infectious diseases.

Wildlife Interactions on Baited Places and Waterholes in a French Area Infected by Bovine Tuberculosis.

Interactions among wildlife species are major drivers for the transmission of multi-host pathogens, such as Mycobacterium bovis, which also affect livestock. Although France is officially free from bovine tuberculosis (bTB), some areas are still harboring infection in cattle and wildlife. We aimed at characterizing the visits of susceptible wild species (badger, red deer, and wild boar) at baited places and waterholes, considered as possible hotspots for contacts. We described the visits in terms of frequency, duration, and number of individuals and studied the influence of the season. Then, we estimated the frequency of intraspecies and interspecies interactions occurring at baited places and waterholes which may lead to bTB transmission, including direct and indirect contacts through the soil or water. We used camera traps placed on baited places and waterholes on 13 locations monitored during 21 months. The number of visits, their duration, and the number of individuals per visit were analyzed by generalized linear mixed models for each targeted species. The frequency of the interspecies and intraspecies interactions was also analyzed separately. The season, the type of site (baited place or waterhole), and the location were the explanatory variables. Badgers' visits and interactions were more frequent than for other species (mean: 0.60 visit/day and 5.42 interactions/day) especially on baited places. Red deer only visited waterholes. Wild boars visited most often baited places in spring-summer and waterholes in autumn-winter. They came in higher number than other species, especially on baited places. Direct interactions were uncommon. The most frequent interspecies interactions occurred between red deer and wild boar (mean: 4.02 interactions/day). Baited places and waterholes are important interfaces between the different wild species involved in the bTB multi-host system in this area. They can thus promote intraspecies and interspecies bTB transmission. Baiting ban should be carried on and management of waterholes should be considered as tool to limit the spread of bTB in wildlife.