Estimation of the economic impact of a bluetongue serotype 4 outbreak in Tunisia.

Introduction: Since 1999, Tunisia has experienced multiple occurrences of Bluetongue (BT) outbreaks, leading to numerous reported cases of infection and mortality in flocks. The re-emergence of the disease in 2020 caused substantial economic losses in cattle, attributed to the incursion of serotype BTV-4. Methods: To evaluate the economic impact of the recent BT episode, we conducted a retrospective study on outbreaks that occurred in Tunisia between August and November 2020, focusing on the impact at the owner's level and its effects on both small ruminants and cattle. A total of 234 ruminant farms (sheep, cattle, and mixed) were randomly selected across Tunisian governorates and included in the study to estimate both the direct and indirect costs of these outbreaks. Results: Total costs were calculated as the sum of losses and expenditures resulting from the BT outbreaks. At the animal level, total losses were estimated to range between 116.280 and 207.086 TND for one infected ewe (€33.721 and 60.055). For one lactating cow, costs varied between 2,590.724 and 3,171.107 TND (€751.310 and 919.621). In cattle, exposure to BTV led to a daily unit milk yield decrease of 12.50 to 14.66 L over an average period of 5 months. Diseased sheep experienced weight loss ranging between 4 and 10 kg during the BT outbreaks. The total mean cost of the 2020 BT outbreak in Tunisian investigated farms was estimated at 1,935 million TND (million €561.15) (range: 1,489 and 2,474 million TND; 431.81 and million €717.46). The most influential costs of the total BT outbreaks were the decrease in milk yield, mortality, and veterinary treatment. Discussion: This study gives valuable insights on the economic impact of the incursion of a new serotype of BT in a naive population in Tunisia. Considering the substantial costs incurred, it is imperative that this disease receives increased attention from stakeholders, including animal owners, veterinary services, practitioners, and decision-makers.

Seroprevalence of zoonotic abortive diseases and their associated risk factors in Tunisian sheep.

BACKGROUND: Abortion is a serious problem for sheep flocks and it is responsible for considerable economic losses. The epidemiological situation of abortion causing agents in sheep is poorly documented in Tunisia. This study aims to investigate the status of three abortion causing agents (Brucella spp, Toxoplasma gondii, and Coxiella burnetii) among organized flocks in Tunisia. RESULTS: A total of 793 sample blood collected from twenty-six flocks in seven governorates in Tunisia, were tested by indirect enzyme-linked immunosorbent assay (i-ELISA) for antibodies against three abortion causing agents (Brucella spp, Toxoplasma gondii, and Coxiella burnetii). Risk factors for individual-level seroprevalence were analyzed using a logistic regression model. Results revealed that 19.7%, 17.2%, and 16.1% of the tested sera were positive for toxoplasmosis, Q fever, and brucellosis, respectively. Mixed infection was found in all the flocks with 3 to 5 responsible abortive agents simultaneously. Logistic regression showed that the management practices (control of new introduction, common grazing and watering point, workers exchange, presence of lambing box on the farm) and the history of infertility and the presence of abortion in neighboring flocks were likely to increase the probability of being infected by the three abortive agents. CONCLUSIONS: Evidence of the positive relationship between seroprevalence of abortion causing agents and several risk factors, suggests further investigations to better understand the etiology of infectious abortions in flocks to develop an applicable preventive and control program.

Presumed Protective Role for Anti-Hepatitis B Virus Antibodies Against COVID-19 Severe Cases: A Clinical Study Confirming in silico Hypothesis.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for COVID-19 disease which is known to have a broad clinical spectrum, from asymptomatic to critical presentation leading to death. Many researchers have investigated the factors impacting the course of the disease. Our previous in silico study suggested a possible protective effect of Hepatitis B, Tetanus and Measles vaccines against COVID-19. In continuity, we conducted a cross-sectional clinical study in order to confirm our in silico assumptions regarding the HBs-Ag antibodies. Methods: A representative sex- and age-matched sample of patients with confirmed COVID-19 was selected (n = 340). All clinical presentations were equally represented. Using an ELISA test, each patient benefited of a serology for the detection and measurement of the anti-HBs specific IgG antibodies. The obtained results allowed determining the different correlations between these antibody titers and the disease severity. The R® software and the MedCalc® software served to calculate the Spearman's coefficient of rank correlation (rho) for the obtained titers per severity group as well as the different other calculations and figure representations. Results: A significant positive correlation was found with the anti-HBs titers (rho = 0.107; p = 0.04). High anti-HBs titers were significantly associated with the mild presentation of COVID-19. A significant difference was found between the obtained titers per severity class (chi-2 test, p = 0.03). Discussion/Conclusion: Our findings demonstrated that anti-HBs titers were significantly higher for patients having mild COVID-19 presentations. We presume that being immunized against the HB may play a protective role in the course of the disease. Our study provided more key elements in understanding the disparity of the clinical spectrum among regions.

Implementation of zoning to guide management of foot and mouth disease in Tunisia.

The World Organisation for Animal Health advocates the zoning approach for the surveillance and monitoring of foot and mouth disease (FMD), a highly contagious animal disease. Our purpose is to implement the zoning approach in Tunisia by identifying existing natural and artificial barriers to the movement of live animals. A Geographic Information System (GIS)-based MultiCriteria Evaluation approach was developed. Eight national and international experts were asked to identify the barriers and prioritize them, characterized by a percentage weight between 0 and 100. These barriers were mapped and combined, taking into account their relative importance, to create a friction map that makes it possible to visualize areas where animal movements are restricted. Uncertainty analysis was performed to assess the robustness of the model. The results showed that the selected barriers were in order of decreasing importance: maritime borders with a weight of 33.5%, rivers (13.8%), slopes equal to or greater than 10% (13.8%), wetlands (13.3%), forests (7.7%), land borders (7.7%), railway networks (5%) and main roads (4.9%). The Cap Bon zone is the only favourable zoning area for the control of FMD in Tunisia. A regional approach resulting from this work could be a major asset in identifying regions suitable for zoning in North Africa.

Risk based serological survey of Rift Valley fever in Tunisia (2017-2018).

Rift Valley fever (RVF) has been reported in the sub-Saharan region of Africa, Egypt and Arabian Peninsula - Yemen and Saudi Arabia, over the past 20 years and is a threat to both the animal and human populations in Tunisia. Tunisia is considered as a high-risk country for the introduction of RVF due to the informal movements of diseased animals already reported in the neighboring countries. The objective of this study was to assess the status of RVF in small ruminants and camels in Tunisia. A risk-based serological survey was conducted to evaluate the presence of RVF based on spatial qualitative risk analysis (SQRA). Samples were collected from small ruminants (sheep and goats) (n = 1,114), and camels (n = 173) samples, belonging to 18 breeders in 14 governorates between November 2017 and January 2018. Samples were tested using an RVF specific multispecies competitive ELISA. Out of the 1,287 samples tested for the presence of RVF IgG antibodies by ELISA, only one positive sample 0.07% (1/1 287) was detected but not confirmed with the virus neutralization test (VNT) used for confirmation. So far, no RVF outbreaks have been reported in Tunisia and our study confirmed the absence of RVF in livestock up to January 2018. Further investigations are needed to confirm the RVF-free status of Tunisia today.

Temporal and spatial distributions of animal and human rabies cases during 2012 and 2018, in Tunisia.

Rabies is one of the most important zoonosis in Tunisia. In the last 6 years, a dramatic increase in the number of cases in animals had raised concern about the transmission dynamics of rabies and the effectiveness of established control measures. For a better understanding of the epidemiological features of rabies in Tunisia, data on animal and human rabies cases and post-exposure prophylaxis (PEP) protocol, for the period from 2012 to 2018, were analysed to describe the spatial and the temporal distributions of the disease and to guide targeted rabies control measures. Thus, the analysed data have shown that 2,642 animal and 25 human rabies cases were recorded between 2012 and 2018; only few case numbers were reported in wildlife. Time-related distribution showed that the incidence of dog rabies increases over the period of study, from 24,8/100,000 dog population in 2012 to 35,2/100,000 dog population in 2018. Dog seems to be the main reservoir of rabies as it accounted for more than 59% of the animal confirmed cases and the source for more than 80% of the human confirmed cases. Geographical distribution of animal rabies cases revealed the presence of clusters in the North and the Center of Tunisia; only a little number of animal cases were reported in the South. In contrast, the overall human rabies incidence was 0.03 per 100,000 population, during the period of the study. We have found that the incidence of human rabies increases by 13.6% from 2012 to 2015 and drops steadily by 23.41% over the second period (2015 to 2018). A high number of PEP was recorded during the 7-year period, with an average of 360 PEP per 100,000 inhabitants per year. Spatial analysis revealed the presence of clusters of PEP in the Northern and Central governorates. The present study pointed out the need to review the control strategy of rabies in Tunisia and conduct further studies on dog population to provide the basis for a new and efficacious policy of interventions and control program for rabies.

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.

Seroprevalence and associated risk factors of Chlamydia abortus infection in ewes in Tunisia.

Enzootic abortion of ewes (EAE) caused by Chlamydia abortus is a disease of ruminants that results in serious economic losses in livestock industry. The zoonotic potential of the pathogen adds a public health concern on the efforts to control the disease. We report herein a cross-sectional study that was conducted during the lambing season (June and July) in Tunisia to estimate the seroprevalence of C. abortus infection in large sheep herds with abortion history. A total of 803 ewes were sampled and tested using indirect enzyme linked immunosorbent assay (iELISA). The overall apparent seroprevalence at herd and individual levels were 58 % (95 %CI = 39-74.5 %) and 6.6 % (95 %CI = 4.9-8.3 %), respectively. Significant risk factors investigated using univariate and multivariate analyses were history of infertility (OR = 5.7; 95 %CI = 3.05-10.66), the number of reproductive ewes (OR = 2.1; 95 %CI = 1.12-3.94), the control of new animals at introduction (OR = 4.35; 95 %CI = 2.46-7.68), the sharing of drinking water (OR = 2.18; 95 %CI = 1.22-3.9), the exchange of breeding males (OR = 2.56; 95 %CI = 1.003-6.54), the disposal of abortion materials without precaution (OR = 4.36; 95 %CI = 2.42-7.87), the lack of lambing barn (OR = 2.39; 95 %CI = 1.13-5.04), the non-application of hygienic post-abortion measures (OR = 10.35; 95 %CI = 5.28-20.26) and the manure management (OR = 11.35; 95 %CI = 3.26-39.48). To the best of our knowledge, this is the first sero-epidemiological survey conducted on an abortive disease in Tunisian ewes that investigated the risk factors of C. abortus infection.