An Official Outbreak Investigation of Acute Haemorrhagic Diarrhoea in Dogs in Norway Points to Providencia alcalifaciens as a Likely Cause.

An outbreak investigation was initiated in September 2019, following a notification to the Norwegian Food Safety Authority (NFSA) of an unusually high number of dogs with acute haemorrhagic diarrhoea (AHD) in Oslo. Diagnostic testing by reporting veterinarians had not detected a cause. The official investigation sought to identify a possible common cause, the extent of the outbreak and prevent spread. Epidemiological data were collected through a survey to veterinarians and interviews with dog owners. Diagnostic investigations included necropsies and microbiological, parasitological and toxicological analysis of faecal samples and food. In total, 511 dogs with acute haemorrhagic diarrhoea were registered between 1 August and 1 October. Results indicated a common point source for affected dogs, but were inconclusive with regard to common exposures. A notable finding was that 134 of 325 faecal samples (41%) cultured positive for Providencia alcalifaciens. Whole genome sequencing (WGS) of 75 P. alcalifaciens isolates from 73 dogs revealed that strains from 51 dogs belonged to the same WGS clone. Findings point to P. alcalifaciens as implicated in the outbreak, but investigations are needed to reveal the pathogenic potential of P. alcalifaciens in dogs and its epidemiology.

Human to animal transmission of influenza A(H1N1)pdm09 in a turkey breeder flock in Norway.

Introduction: Routine surveillance samples disclosed seropositivity to influenza A virus (IAV) in a Norwegian turkey breeder flock. Simultaneous reports of influenza-like symptoms in farm workers and a laboratory confirmed influenza A(H1N1)pdm09 (H1N1pdm09) infection in one person led to the suspicion of a H1N1pdm09 infection in the turkeys. Animals and methods: H1N1pdm09 infection was confirmed by a positive haemaggutinin inhibition test using H1N1pdm09 antigens, and detection of H1N1pdm09 nucleic acid in reproductive organs of turkey hens. The flock showed no clinical signs except for a temporary drop in egg production. Previous reports of H1N1pdm09 infection in turkeys suggested human-to-turkey transmission (anthroponosis) during artificial insemination. Results and discussion: The flock remained seropositive to IAV and the homologous H1N1pdm09 antigen throughout the following 106 days, with decreasing seroprevalence over time. IAV was not detected in fertilised eggs or in turkey poults from the farm, however, maternally derived antibodies against H1N1pdm09 were found in egg yolks and in day-old poults. Genetic analyses of haemagglutinin gene sequences from one of the infected farm workers and turkeys revealed a close phylogenetic relationship, and confirmed human-to-turkey virus transmission.

Climate and environmental change drives Ixodes ricinus geographical expansion at the northern range margin.

BACKGROUND: Global environmental change is causing spatial and temporal shifts in the distribution of species and the associated diseases of humans, domesticated animals and wildlife. In the on-going debate on the influence of climate change on vectors and vector-borne diseases, there is a lack of a comprehensive interdisciplinary multi-factorial approach utilizing high quality spatial and temporal data. METHODS: We explored biotic and abiotic factors associated with the latitudinal and altitudinal shifts in the distribution of Ixodes ricinus observed during the last three decades in Norway using antibodies against Anaplasma phagocytophilum in sheep as indicators for tick presence. Samples obtained from 2963 sheep from 90 farms in 3 ecologically different districts during 1978 - 2008 were analysed. We modelled the presence of antibodies against A. phagocytophilum to climatic-, environmental and demographic variables, and abundance of wild cervids and domestic animals, using mixed effect logistic regressions. RESULTS: Significant predictors were large diurnal fluctuations in ground surface temperature, spring precipitation, duration of snow cover, abundance of red deer and farm animals and bush encroachment/ecotones. The length of the growth season, mean temperature and the abundance of roe deer were not significant in the model. CONCLUSIONS: Our results highlight the need to consider climatic variables year-round to disentangle important seasonal variation, climatic threshold changes, climate variability and to consider the broader environmental change, including abiotic and biotic factors. The results offer novel insight in how tick and tick-borne disease distribution might be modified by future climate and environmental change.

Effect of climate and farm environment on Campylobacter spp. colonisation in Norwegian broiler flocks.

Campylobacteriosis is the most frequently reported zoonosis in the EU. A recent report states that between 50% and 80% of the human campylobacteriosis cases could be attributed to broiler as a reservoir. The current study was conducted to investigate associations between the presence of Campylobacter spp. in Norwegian broiler flocks and factors related to the climate and the farm environment. Data from 18,488 broiler flocks from 623 different farms during 2002-2007 were included in the study. A logistic regression analysis was conducted where Campylobacter spp. status of a broiler flock at the time of slaughter was defined as the dependent variable and farm was modelled as a random effect. The following factors were found to increase the probability for a broiler flock to test positive for Campylobacter spp.: daily mean temperature above 6°C during the rearing period, private water supply, presence of other livestock farms within a distance of 2 km, presence of other broiler farms within a distance of 4 km with flocks positive for Campylobacter spp. within 30 days prior to slaughter, heavy rainfall 11-30 days prior to slaughter, region and year. Daily mean temperature below 0°C reduced the probability. The study emphasises the importance of the farm environment and the climate for the occurrence of Campylobacter spp. in broiler flocks. The farm environment is probably a part of the Campylobacter spp. pathway into and between broiler flocks where farmyard run-off and humans or flies entering the houses might constitute vehicles transporting the organism. Fly activity is temperature-driven and flies might be a part of the explanation of the increased risk for Campylobacter spp. related to increased temperature demonstrated in the study.

Multi-source analysis reveals latitudinal and altitudinal shifts in range of Ixodes ricinus at its northern distribution limit.

BACKGROUND: There is increasing evidence for a latitudinal and altitudinal shift in the distribution range of Ixodes ricinus. The reported incidence of tick-borne disease in humans is on the rise in many European countries and has raised political concern and attracted media attention. It is disputed which factors are responsible for these trends, though many ascribe shifts in distribution range to climate changes. Any possible climate effect would be most easily noticeable close to the tick's geographical distribution limits. In Norway- being the northern limit of this species in Europe- no documentation of changes in range has been published. The objectives of this study were to describe the distribution of I. ricinus in Norway and to evaluate if any range shifts have occurred relative to historical descriptions. METHODS: Multiple data sources - such as tick-sighting reports from veterinarians, hunters, and the general public - and surveillance of human and animal tick-borne diseases were compared to describe the present distribution of I. ricinus in Norway. Correlation between data sources and visual comparison of maps revealed spatial consistency. In order to identify the main spatial pattern of tick abundance, a principal component analysis (PCA) was used to obtain a weighted mean of four data sources. The weighted mean explained 67% of the variation of the data sources covering Norway's 430 municipalities and was used to depict the present distribution of I. ricinus. To evaluate if any geographical range shift has occurred in recent decades, the present distribution was compared to historical data from 1943 and 1983. RESULTS: Tick-borne disease and/or observations of I. ricinus was reported in municipalities up to an altitude of 583 metres above sea level (MASL) and is now present in coastal municipalities north to approximately 69°N. CONCLUSION: I. ricinus is currently found further north and at higher altitudes than described in historical records. The approach used in this study, a multi-source analysis, proved useful to assess alterations in tick distribution.

Bayesian temporal source attribution of foodborne zoonoses: Campylobacter in Finland and Norway.

Statistical source attribution approaches of food-related zoonoses can generally be based on reported diagnosed human cases and surveillance results from different food sources or reservoirs of bacteria. The attribution model, or probabilistic classifier, can thus be based on the (sub)typing information enabling comparison between human infections and samples derived from source surveillance. Having time series of both data allows analyzing temporal patterns over time providing a repeated natural experiment. A Bayesian approach combining both sources of information over a long time series is presented in the case of Campylobacter in Finland and Norway. The full model is transparently presented and derived from the Bayes theorem. Previous statistical source attribution approaches are here advanced (1) by explicit modeling of the cases not associated with any of the sources under surveillance over time, (2) by modeling uncertain prevalence in a food source by bacteria type over time, and (3) by implementing formal model fit assessment using posterior predictive discrepancy functions. Large proportion of all campylobacteriosis can be attributed to broiler, but considerable uncertainty remains over time. The source attribution is inherently incomplete if only the sources under surveillance are included in the model. All statistical source attribution approaches should include a model fit assessment for judgment of model performance with respect to relevant quantities of interest. It is especially relevant when the model aims at a synthesis of several incomplete information sources under significant uncertainty of explanatory variables.

Analysis of simultaneous space-time clusters of Campylobacter spp. in humans and in broiler flocks using a multiple dataset approach.

BACKGROUND: Campylobacteriosis is the most frequently reported zoonosis in the EU and the epidemiology of sporadic campylobacteriosis, especially the routes of transmission, is to a great extent unclear. Poultry easily become colonised with Campylobacter spp., being symptom-less intestinal carriers. Earlier it was estimated that internationally between 50% and 80% of the cases could be attributed to chicken as a reservoir. In a Norwegian surveillance programme all broiler flocks under 50 days of age were tested for Campylobacter spp. The aim of the current study was to identify simultaneous local space-time clusters each year from 2002 to 2007 for human cases of campylobacteriosis and for broiler flocks testing positive for Campylobacter spp. using a multivariate spatial scan statistic method. A cluster occurring simultaneously in humans and broilers could indicate the presence of common factors associated with the dissemination of Campylobacter spp. for both humans and broilers. RESULTS: Local space-time clusters of humans and broilers positive for Campylobacter spp. occurring simultaneously were identified in all investigated years. All clusters but one were identified from May to August. Some municipalities were included in clusters all years. CONCLUSIONS: The simultaneous occurrence of clusters of humans and broilers positive for Campylobacter spp. combined with the knowledge that poultry meat has a nation-wide distribution indicates that campylobacteriosis cases might also be caused by other risk factors than consumption and handling of poultry meat.Broiler farms that are positive could contaminate the environment with further spread to new broiler farms or to humans living in the area and local environmental factors, such as climate, might influence the spread of Campylobacter spp. in an area. Further studies to clarify the role of such factors are needed.

An evaluation of sampling- and culturing methods in the Norwegian action plan against Campylobacter in broilers.

The Norwegian Action Plan against Campylobacter in broilers was implemented in May 2001 with the objective of reducing human exposure to Campylobacter through Norwegian broilers. From each flock, samples collected at the farm about one week prior to slaughter, and then again at the slaughter plant, are examined for the presence of Campylobacter. All farmers with positive flocks are followed up with bio-security advice. Sampling of broiler products at retail level is also included in the Action Plan. The aim of this study was to evaluate the existing sampling and culturing methods of the Norwegian Action Plan against Campylobacter in broilers. The material collected was pooled faecal samples, pooled cloacae samples and caecae samples from individuals. The highest number of positives, from culturing of the pooled faecal samples, the pooled cloacae swabs and the caecae swabs from individuals, were obtained at incubation temperature 41.5 degrees C. When comparing the results at incubation temperature 37 and 41.5 degrees C, the faecal samples from the farms demonstrated a high concordance, with a kappa value of 0.88. The results from culturing cloacae swabs and caecae samples from slaughter plant level at two temperatures did not agree very well with a kappa value of 0.21 and moderate value of 0.57, respectively, but were both disconcordant at a level of 0.05. Modelling farm level data indicated that if increasing the number of pooled samples per flock from two (in existing regime) to three, the flock sensitivity increases from 89% to 95%. Modelling of slaughter plant data indicated that three pooled cloacae swabs are needed to identify 90% of the positive flocks. The results from the modelling of caecae data indicated that samples from seven individuals are sufficient to identify 90% of the positive flocks and caecae samples could thus be an alternative to cloacae sampling at slaughter plant level.

Reduction in flock prevalence of Campylobacter spp. in broilers in Norway after implementation of an action plan.

An action plan against thermophilic Campylobacter spp. in Norwegian broilers was implemented in May 2001. The action plan consists of three parts: a surveillance program including all Norwegian broiler flocks slaughtered before 50 days of age, a follow-up advisory service on farms delivering flocks positive for Campylobacter spp., and surveys of broiler meat products at the retail level. This article presents results covering the inclusive 3-year period between 2002 and 2004. During this period, a total of 10,803 flocks from 562 broiler farms were tested; altogether, 521 (4.8%) of the flocks were identified as positive for Campylobacter spp., primarily Campylobacter jejuni. The positive flocks originated from 257 (45.7%) of the farms. During the period 2002 to 2004, there was a large and steady reduction in flock prevalence, from 6.3% in 2002 to 3.3% in 2004. Also, the proportion of farms producing flocks positive for Campylobacter spp. each year reduced substantially, from 28.4% in 2002 to 17.8% in 2004. The proportion of flocks positive for Campylobacter spp. varied considerably with season and region. The action plan is a successful collaboration between academia, regulatory agencies, and the poultry industry that has resulted in a significant reduction in the number of broiler carcasses positive for Campylobacter spp. on the market. The temporal associations between implementation of the control program and the drop in the number of infected chickens and contaminated carcasses indicate that this collaborative action plan has been instrumental in achieving the goals of enhancing food safety.

Survival of Campylobacter on frozen broiler carcasses as a function of time.

In the Norwegian Action Plan against Campylobacter in broilers, carcasses from flocks identified as positive before slaughter are either heat treated or frozen for 5 weeks to reduce the number of Campylobacter. The objective of this study was to estimate the effect of freezing time and predict the number of Campylobacter on naturally infected or contaminated broiler carcasses following freezing for 2, 4, 6, 8, 10, 13, 21, 35, and 120 days by nonparametric and parametric linear statistical models. From each of the five flocks, 27 carcasses were sampled. Each carcass was cut in two pieces along the chest bone. Half was put into the freezer (-20 degrees C), whereas the other was deskinned and quantitative culturing was conducted from a 10-g sample of the skin. Fifteen frozen halves were selected at random at each time point following freezing from 2 to 120 days, and skin samples from these were cultured quantitatively and qualitatively. In regard to the log reduction of Campylobacter, almost similar results were obtained using three statistical methods; median regression on the change in Campylobacter counts, zero-inflated negative binomial regression, and a Bayesian Markov chain Monte Carlo (decay) model on original counts. Overall, a 2-log reduction of Campylobacter was obtained after 3 weeks of freezing. Only a marginal extra effect was observed when extending the freezing to 5 weeks. Although freezing appears to be an efficient way to reduce the level of Campylobacter on broiler carcasses, in 80% of the carcasses Campylobacter could still be detected using quantitative culturing following 120 days of freezing. Based on the high number of zeros, these data should be modeled by a zero-inflated model. The best statistical fit in regard to goodness-of-fit measures was the zero-inflated negative binomial log link model, closely followed by the Poisson model. Thus, in our continued search for a better way to describe the data, we used the Poisson distribution in the mixed Bayesian decay models.

Harmonization of antimicrobial susceptibility testing among veterinary diagnostic laboratories in the five Nordic countries.

A total of 100 bacterial strains (25 Escherichia coli, 25 Salmonella enterica, 25 Staphylococcus aureus, and 25 Enterococcus strains) and four reference strains were tested for susceptibility toward 8-12 antimicrobial agents in 12 veterinary diagnostic laboratories in the five Nordic countries using routine methodology. In addition, the 25 Enterococcus strains were identified to species level. A total of 22,598 (97.2%) out of 23,259 test results were in accordance when the data were categorized as susceptible or resistant. When the reported results were categorized according to the National Committee of Clinical Laboratory Standards breakpoints, the percentage of concordant results increased to 98.4% and the performance between laboratories varied between 94.2 and 99.4% concordant results. For E. coli, S. aureus, and Salmonella, all laboratories except one had more than 97% concordant results, whereas for Enterococcus spp., two laboratories had less than 90% concordant results. Susceptibility testing of Salmonella to fluoroquinolones gave rise to almost 0.5% nonconcordant results and susceptibility testing of S. aureus to vancomycin resulted in that 1.8% of the strains were incorrectly reported as vancomycin resistant. Ten laboratories identified the Enterococcus spp. to species level. All five Enterococcus faecium and 10 Enterococcus faecalis selected from the strain collection at the Danish Veterinary Institute were correctly identified by all laboratories, whereas some problems were observed identifying other enterococcal species. This study showed a good performance and agreement in antimicrobial susceptibility testing at the 12 participating laboratories and that surveillance data covering susceptibility test results of E. coli, S. aureus, and Salmonella from animals in the Nordic countries are comparable. But it also showed that some aspects can be improved. In addition, the study showed that the different laboratories are capable of identifying E. faecalis and E. faecium.