Japanese encephalitis virus: epidemiology and risk-based surveillance approaches for New Zealand.

The introduction and subsequent rapid spread of Japanese encephalitis virus genotype IV across all Australian mainland states and the Northern Territory since late 2021 has increased the risk of an incursion of this mosquito-transmitted zoonotic virus disease into New Zealand, with serious implications for both animal and human health. The potential modes of entry are through introduction of infected mosquitoes as hitchhikers on ships or aircraft, windborne transfer of mosquitoes, or arrival of infected reservoir bird species. A competent vector mosquito, Culex quinquefasciatus, is endemic in New Zealand and other mosquito species may also become involved. If infection becomes established in New Zealand, the scale of transmission may be considerably less than has occurred in Australia because climatic and epidemiological factors are not so favourable. Early evidence of an incursion could come from detection of clinical disease in horses or pigs, or from human cases. Targeted surveillance to confirm or refute indications of an incursion could be undertaken by antibody detection in a number of species. Dogs have been shown to be a particularly valuable sentinel species due to their cohabitation with people and high seroconversion rate. Other novel methods of surveillance could include reverse transcriptase PCR (RT-PCR) on oronasal secretions of pigs. Should evidence of the disease be detected, prompt action would be required to vaccinate at-risk human populations and clarify the epidemiological situation with respect to mammalian hosts and mosquito vector species, including whether a new mosquito species had arrived in the country.Abbreviations: AHL: Animal Health Laboratory; JE: Japanese encephalitis disease; JEV: Japanese encephalitis virus; RT-PCR: Reverse transcriptase PCR.

Evaluation of post-exposure prophylaxis practices to improve the cost-effectiveness of rabies control in human cases potentially exposed to rabies in southern Bhutan.

BACKGROUND: Rabies is endemic in southern Bhutan, associated with 1-2 human deaths and high post exposure prophylaxis (PEP) costs annually. Evaluation of clinicians' management of human cases potentially exposed to rabies could contribute to improving PEP prescribing practices to both reduce unnecessary costs associated with PEP and reach the target of zero human deaths due to rabies by 2023. METHODS: A cross-sectional survey of 50 clinicians' management of human cases potentially exposed to rabies was conducted in 13 health centers in high-rabies-risk areas of Bhutan during February-March 2016. RESULTS: Data were collected on clinicians' management of 273 human cases potentially exposed to rabies. The 50 clinicians comprised health assistants or clinical officers (55%) and medical doctors (45%) with a respective median of 19, 21 and 2 years' experience. There was poor agreement between clinicians' rabies risk assessment compared with an independent assessment for each case based on criteria in the National Rabies Management Guidelines (NRMG). Of the 194 cases for which clinicians recorded a rabies risk category, only 53% were correctly classified when compared with the NRMG. Clinicians were more likely to underestimate the risk of exposure to rabies and appeared to prescribe PEP independently of their risk classification.. Male health assistants performed the most accurate risk assessments while female health assistants performed the least accurate. Clinicians in Basic Health Units performed less accurate risk assessments compared with those in hospitals. CONCLUSIONS: This study highlights important discrepancies between clinicians' management of human cases potentially exposed to rabies and recommendations in the NRMG. In particular, clinicians were not accurately assessing rabies risk in potentially exposed cases and were not basing their PEP treatment on the basis of their risk assessment. This has significant implications for achieving the national goal of eliminating dog-mediated human rabies by 2030 and may result in unnecessary costs associated with PEP. Recommendations to improve clinician's management of human cases potentially exposed to rabies include: reviewing and updating the NRMG, providing clinicians with regular and appropriately targeted training about rabies risk assessment and PEP prescription, and regularly reviewing clinicians' practices.

InterSpread Plus: a spatial and stochastic simulation model of disease in animal populations.

We describe the spatially explicit, stochastic simulation model of disease spread, InterSpread Plus, in terms of its epidemiological framework, operation, and mode of use. The input data required by the model, the method for simulating contact and infection spread, and methods for simulating disease control measures are described. Data and parameters that are essential for disease simulation modelling using InterSpread Plus are distinguished from those that are non-essential, and it is suggested that a rational approach to simulating disease epidemics using this tool is to start with core data and parameters, adding additional layers of complexity if and when the specific requirements of the simulation exercise require it. We recommend that simulation models of disease are best developed as part of epidemic contingency planning so decision makers are familiar with model outputs and assumptions and are well-positioned to evaluate their strengths and weaknesses to make informed decisions in times of crisis.

Likely effectiveness of pharmaceutical and non-pharmaceutical interventions for mitigating influenza virus transmission in Mongolia.

OBJECTIVE: To assess the likely benefit of the interventions under consideration for use in Mongolia during future influenza pandemics. METHODS: A stochastic, compartmental patch model of susceptibility, exposure, infection and recovery was constructed to capture the key effects of several interventions--travel restrictions, school closure, generalized social distancing, quarantining of close contacts, treatment of cases with antivirals and prophylaxis of contacts--on the dynamics of influenza epidemics. The likely benefit and optimal timing and duration of each of these interventions were assessed using Latin-hypercube sampling techniques, averaging across many possible transmission and social mixing parameters. FINDINGS: Timely interventions could substantially alter the time-course and reduce the severity of pandemic influenza in Mongolia. In a moderate pandemic scenario, early social distancing measures decreased the mean attack rate from around 10% to 7-8%. Similarly, in a severe pandemic scenario such measures cut the mean attack rate from approximately 23% to 21%. In both moderate and severe pandemic scenarios, a suite of non-pharmaceutical interventions proved as effective as the targeted use of antivirals. Targeted antiviral campaigns generally appeared more effective in severe pandemic scenarios than in moderate pandemic scenarios. CONCLUSION: A mathematical model of pandemic influenza transmission in Mongolia indicated that, to be successful, interventions to prevent transmission must be triggered when the first cases are detected in border regions. If social distancing measures are introduced at this stage and implemented over several weeks, they may have a notable mitigating impact. In low-income regions such as Mongolia, social distancing may be more effective than the large-scale use of antivirals.

A description of the management of itinerant grazing ducks in the Mekong river delta of Vietnam.

A cross-sectional survey of management practices of itinerant grazing ducks (known as field running ducks) was conducted during March 2008 in four districts of Can Tho and Bac Lieu provinces in the Mekong River Delta, Vietnam. The objective was to characterize the demographic structure of the itinerant grazing duck population and the management practices which might be related to the continuing outbreaks of H5N1 avian influenza in this region. Broiler duck flocks were owned by 55% of survey respondents, and layer flocks by 53%. Greater than 80% of ducks within 93% of villages and 99% of duck flocks were reported to have been vaccinated against H5N1 avian influenza, whereas only 19% of villages and 60% of chicken flocks had greater than 80% of chickens vaccinated. Fifty-nine percent of duck owners moved their ducks outside their home communes, whilst 37% and 28% of owners moved their ducks outside their home district and province, respectively. Larger flocks were more likely to be run outside their home district compared with smaller flocks. After adjusting for the effect of flock production type and district, the odds of an out-of-district field running duck flock movement was increased by a factor of 7.24 (95% CI 2.89-19.24) for households with flocks of more than 800 ducks, compared with flocks of less than 250. Most households sold ducks to traders (72%) or to neighbours (33%), whereas less than 20% sold their birds through markets. The findings of this study suggest that surveillance strategies for field running duck flocks should focus on layer flocks as well as larger flocks as they are more likely to be moved outside of their home district, facilitating long-distance disease spread.

Quantitative risk assessment for the annual risk of exposure to Trichinella spiralis in imported chilled pork meat from New Zealand to Singapore.

AIMS: To determine the annual likelihood of exposure to an infectious dose of Trichinella spiralis from consuming imported pork meat from New Zealand to Singapore. METHODS: Input values specific for chilled pork meat imported into Singapore from New Zealand were used in a quantitative risk-assessment model. The model, designed to allow any combination of importing and exporting countries, was divided into two components, viz the release assessment, and the exposure assessment that assessed the annual risk of exposure to the consumer (ARC). The former estimated the likelihood that a contaminated fresh meat product from New Zealand would arrive at Singapore's border, and took into consideration the prevalence of disease on different types of farms. The latter determined the likelihood over a year that a person in Singapore would consume one or more servings of imported fresh meat from New Zealand that contained a burden of greater than or equal to one larva(e) of T. spiralis per gram after preparation for consumption. RESULTS: The ARC for offal was 2.41 x 10(-7), which was below the pre-selected safety threshold of 1.00 x 10(-6). The ARC for lean meat was 2.39 x 10(-5), which was above the acceptable safety threshold. CONCLUSIONS: The study demonstrated that continued routine testing at slaughter is unnecessary for pig offal produced commercially, and provided a model with which to further assess management of the risk of exposure to T. spiralis in lean meat. CLINICAL RELEVANCE: The potential of Trichinella species to cause disease in humans is a public health concern, and has created adverse effects on the international trade of fresh lean meat without regard to the surveillance measures employed by particular pork-producing countries.

Association between human cases and poultry outbreaks of highly pathogenic avian influenza in Vietnam from 2003 to 2007: a nationwide study.

This study quantifies the spatio-temporal association between outbreaks of highly pathogenic avian influenza H5N1 in domestic poultry (n = 3050) and human cases (n = 99) in Vietnam during 2003-2007, using rare events logistic regression. After adjusting for the effect of known confounders, the odds of a human case being reported to authorities increased by a factor of 6.17 [95% confidence interval (CI) 3.33-11.38] and 2.48 (95% CI 1.20 - 5.13) if poultry outbreaks were reported in the same district 1 week and 4 weeks later respectively. When jointly considering poultry outbreaks in the same and neighbouring districts, occurrence of poultry outbreaks in the same week, 1-week later, and 4 weeks later increased the odds of a human case by a factor of 2.75 (95% CI 1.43-5.30), 2.56 (95% CI 1.31-5.00) and 2.70 (95% CI 1.56-4.66) respectively. Our study found evidence of different levels of association between human cases and poultry outbreaks in the North and the South of the country. When considering the 9-week interval extending from 4 weeks before to 4 weeks after the week of reporting a human case, in the South poultry outbreaks were recorded in 58% of cases in the same district and 83% of cases in either the same or neighbouring districts, whereas in the North the equivalent results were only 23% and 42%. The strength of the association between human and poultry cases declined over the study period. We conclude that owner reporting of clinical disease in poultry needs to be enhanced by targeted agent-specific surveillance integrated with preventive and other measures, if human exposure is to be minimized.

Informing surveillance programmes by investigating spatial dependency of subclinical Salmonella infection.

The aim of this paper is to investigate local spatial dependency with regard to Salmonella seropositivity in data from the Danish swine salmonellosis control programme and its application in informing surveillance strategies. We applied inhomogeneous and observed-difference K-function estimation, and geo-statistical modelling to data from the Danish swine salmonellosis control programme. Slaughter-pig farm density showed large variation at both the country-wide and local level in Denmark (median 0.23, range 0.02-0.47 farms/km(2)). The spatial distribution of pig farms followed a random inhomogeneous Poisson process but was not aggregated. We found evidence for aggregation of Salmonella case farms over that of all farms at distances of up to 6 km and semivariogram analyses of Salmonella seropositivity revealed spatial dependency between pairs of farms up to 4 km apart. The strength of the spatial dependency was positively associated with slaughter-pig farm density. We proposed sampling more intensively those farms within a 4 km radius of farms that were identified with a high Salmonella status, and reduced sampling of farms that are within this radius of 'Salmonella-free' farms. Our approach has the potential to optimize sampling strategies while maintaining consumer confidence in food safety and also has potential to be used for other zoonotic disease surveillance systems.

Epidemiology of bovine spongiform encephalopathy in cattle in Hokkaido, Japan, between September 2001 and December 2006.

Between October 2001 and December 2006 an estimated total of 6 million cattle in Japan were tested for BSE, with 31 returning a positive result. Exploratory mapping, the space-time scan statistic, and ordinal logistic regression have been used to describe the epidemiology of the 24 cases identified in the prefecture of Hokkaido, and to quantify the risk factors for the disease. Two birth cohort groups were affected: cattle born during a period of seven months in 1996, and cattle born between 1999 and 2001. The descriptive spatial analyses showed that eight of the 10 cases born in 1996 were born in areas with a relatively high density of dairy farms in the east of Hokkaido, but that the 14 later cases were more widely distributed throughout the prefecture, with equal numbers of cases in the east and the west. These findings provide indirect evidence of a single localised contamination of the cattle feed supply in 1996, and recycling of the infection after 1999.

Temporal and longitudinal analysis of Danish Swine Salmonellosis Control Programme data: implications for surveillance.

The control programme for Salmonella infection in Danish swine has reduced the number of human cases attributable to pork consumption and the focus is now on cost-effectiveness. We applied time-series and longitudinal analyses to data collected between January 1995 and May 2005 to identify if there were predictable periods of risk that could inform sampling strategy; to investigate the potential for forecasting for early aberration detection; and to explore temporal redundancy within the sampling strategy. There was no evidence of seasonality hence no justification to change to targeted sampling at high-risk periods. The forecast of seropositivity made using an ARIMA (0, 1, 2) model had a root-mean-squared percentage error criterion of 8.4% indicating that accurate forecasts are possible. The lorelogram identified temporal redundancy at up to 10 weeks suggesting little value in sampling more frequently than this on the 'average' farm. These findings have practical applications for both farm-level sampling strategy and national-level aberration detection which potentially could result in a more cost-effective surveillance strategy.

Decision support systems for monitoring and maintaining health in food animal populations.

To mitigate the effects of risks to food safety and infectious disease outbreaks in farmed animals, animal health authorities need to have systems in place to identify and trace the source of identified problems in a timely manner. In the event of emergencies, these systems will allow infected or contaminated premises (and/or animals) to be identified and contained, and will allow the extent of problems to be communicated to consumers and trading partners in a clear and unambiguous manner. The key to achieving these goals is the presence of an effective animal health decision support system that will provide the facilities to record and store detailed information about cases and the population at risk, allowing information to be reported back to decision makers when it is required. Described here are the components of an animal health decision support system, and the ways these components can be used to enhance food safety, responses to infectious disease incursions, and animal health and productivity. Examples are provided to illustrate the benefit these systems can return, using data derived from countries that have such systems (or parts of systems) in place. Emphasis is placed on the features that make particular system components effective, and strategies to ensure that these are kept up to date.

Analysis of the risk of introduction and spread of porcine reproductive and respiratory syndrome virus through importation of raw pigmeat into New Zealand.

AIMS: To determine the frequency with which porcine reproductive and respiratory syndrome (PRRS) virus (PRRSv) would become established in a non-commercial pig herd in New Zealand due to illegal feeding of uncooked food waste containing virus-contaminated pigmeat. To determine the likelihood of a single incursion resulting in a multi-farm outbreak of the disease, and describe the spatio-temporal characteristics of such an outbreak. METHODS: A Monte Carlo simulation model was constructed to determine the expected annual frequency of PRRSv infection being initiated in a non-commercial pig herd as a result of inadvertent feeding of pigmeat imported from countries endemically infected with the disease. Once the likelihood of PRRSv becoming established in a single pig herd was determined, stochastic spatially explicit infectious disease modelling software was utilised to model the temporal and spatial characteristics of the resulting epidemic. RESULTS: Assuming the proportion of imported pigmeat remained at current levels, consumption patterns of pigmeat in households in New Zealand remained steady, and limited compliance with recently reintroduced regulations to prevent feeding of uncooked food waste, at least 4.3 pig herds per year were predicted to become infected with PRRSv. Simulation modelling of PRRSv epidemics related to initial infection of a non-commercial farm produced an estimate that 36% of these incursions would spread from the initial herd, and that these outbreaks would involve 93 herds on average in the first year. By increasing the estimated persistence of PRRSv infection in small herds, an average of 205 herds became infected in the first year. CONCLUSIONS: Given a mean of 4.3 infected premises per year and a 36% probability of infection spreading beyond the initial infected herd, there was a 95% likelihood of a multi-farm PRRS outbreak occurring within 3 years. CLINICAL RELEVANCE: Introduction of PRRSv through importation of virus-contaminated pigmeat presents a high risk for establishment of the disease in the pig industry in New Zealand.

Descriptive summary of an outbreak of porcine post-weaning multisystemic wasting syndrome (PMWS ) in New Zealand.

CASE HISTORY: Investigations were conducted to determine the cause of an acute, multi-farm outbreak of porcine respiratory disease that included diarrhoea and subsequent loss of body condition in affected pigs. A definition for post-weaning multisystemic wasting syndrome (PMWS) including both clinical and pathological features, previously developed for the pig industry in New Zealand, was applied to the current outbreak. In addition to self-reporting by owners of affected farms, local veterinarians, disease and epidemiology consultants, and animal health officials from the Ministry of Agriculture and Forestry (MAF) were involved in conducting farm visits and submission of diagnostic specimens. CLINICAL FINDINGS AND DIAGNOSIS: Pathogens known to be endemic in the pig industry in New Zealand as well as likely exotic diseases were excluded as causative agents of the outbreak. Clinical signs including dyspnoea, diarrhoea, and rapid loss of body condition were consistent with the New Zealand case definition for PMWS. Interstitial pneumonia, pulmonary oedema, generalised lymph-node enlargement, and presence of porcine circovirus type 2 (PCV2) inclusion bodies were consistently identified in affected pigs. Classical swine fever virus (CSFv), Porcine reproductive and respiratory syndrome virus (PRRSv), and Influenza virus were ruled out, using molecular and traditional virological techniques. Spread of the disease between farms was hypothesised to be facilitated by locally migrating flocks of black-backed seagulls. The original source of the disease incursion was not identified. DIAGNOSIS: Based on the consistent presence of circovirus-associated lesions in lymphoid tissues in combination with generalised enlargement of lymph nodes, histiocytic interstitial pneumonia, clinical wasting, and poor response to antibiotic therapy, a diagnosis of PMWS was made. CLINICAL RELEVANCE: PMWS should be considered in the differential diagnoses of sudden onset of respiratory dyspnoea, diarrhoea, and rapid loss of body condition in young pigs in New Zealand pig herds.

A model (BSurvE) for estimating the prevalence of bovine spongiform encephalopathy in a national herd.

We developed the BSurvE spreadsheet model to estimate the true prevalence of bovine spongiform encephalopathy (BSE) in a national cattle population, and evaluate national BSE surveillance programs. BSurvE uses BSE surveillance data and demographic information about the national cattle population. The proportion of each cohort infected with BSE is found by equating the observed number of infected animals with the number expected, following a series of probability calculations and assuming a binomial distribution for the number of infected animals detected in each surveillance stream. BSurvE has been used in a series of international workshops, where analysis of national datasets demonstrated patterns of cohort infection that were consistent with infection-control activities within the country. The results also reflected the timing of known events that were high-risk for introduction of the infectious agent.

Application of portfolio theory to risk-based allocation of surveillance resources in animal populations.

Distribution of finite levels of resources between multiple competing tasks can be a challenging problem. Resources need to be distributed across time periods and geographic locations to increase the probability of detection of a disease incursion or significant change in disease pattern. Efforts should focus primarily on areas and populations where risk factors for a given disease reach relatively high levels. In order to target resources into these areas, the overall risk level can be evaluated periodically across locations to create a dynamic national risk landscape. Methods are described to integrate the levels of various risk factors into an overall risk score for each area, to account for the certainty or variability around those measures and then to allocate surveillance resources across this risk landscape. In addition to targeting resources into high risk areas, surveillance continues in lower risk areas where there is a small yet positive chance of disease occurrence. In this paper we describe the application of portfolio theory concepts, routinely used in finance, to design surveillance portfolios for a series of examples. The appropriate level of resource investment is chosen for each disease or geographical area and time period given the degree of disease risk and uncertainty present.

A model (BSurvE) for evaluating national surveillance programs for bovine spongiform encephalopathy.

Our BSurvE spreadsheet model estimates the BSE prevalence in a national cattle population, and can be used to evaluate and compare alternative strategies for a national surveillance program. Each individual surveillance test has a point value (based on demographic and epidemiological information) that reflects the likelihood of detecting BSE in an animal of a given age leaving the population via the stated surveillance stream. A target sum point value for the country is calculated according to a user-defined design prevalence and confidence level, the number of cases detected in animals born after the selected starting date and the national adult-herd size. Surveillance tests carried out on different sub-populations of animals are ranked according to the number of points gained per unit cost, and the results can be used in designing alternative surveillance programs.

A description of cattle movements in two departments of Buenos Aires province, Argentina.

We present a descriptive analysis of cattle movement information retrieved from the Argentinean animal movement database for two departments in the province of Buenos Aires during 2004. For each quarter of the year (January to March, April to June, July to September, and October to December) we report the number of on- and off-farm movement events for the purpose of finishing. Our analyses show that the distribution of the number of finishing-related movement events per farm was skewed, with the majority of farms reporting at least 1 and less than 5% of farms of reporting greater than 15 finishing related movement events throughout the year. The frequency of finishing-related movement events varied over time, with a 1.2-1.8-fold increase in reported movement events from April to September, compared with the rest of the year. These analyses indicate that cattle movement patterns in these departments are dependent on the relative mix of constituent cattle enterprise types. Departments with a mixture of breeding and finishing enterprises behave as potential recipients and distributors of infectious disease, whereas departments comprised of primarily finishing enterprises are predominantly recipients of infectious disease, rather than distributors. Data integrity audits of the Argentinean animal movement database, on a regular or intermittent basis, should allow the presence of bias in these data to be quantified in greater detail.

Simulation analyses to evaluate alternative control strategies for the 2002 foot-and-mouth disease outbreak in the Republic of Korea.

Using the stochastic and spatial simulation model of between-farm spread of disease, InterSpread Plus, we evaluated the effect of alternative strategies for controlling the 2002 epidemic of foot-and-mouth disease (FMD) in the Republic of Korea. InterSpread Plus was parameterised to simulate epidemics of FMD in the population of farms containing susceptible animal species in the Korean counties of Yongin, Icheon, Pyongtaek, Anseong, Eumseong, Asan, Cheonan, and Jincheon. The starting point of our analyses was the simulation of a reference strategy, which approximated the real epidemic. The results of simulations of alternative epidemic-control strategies were compared with this reference strategy. Ring vaccination (when used with either limited or extended pre-emptive depopulation) reduced both the size and variability of the predicted number of infected farms. Reducing the time between disease incursion and commencement of controls had the greatest effect on reducing the predicted number of infected farms.