Condition of surplus dairy calves during marketing: A cross-sectional study.

In North America, surplus dairy calves are sold soon after birth and often marketed through a third party (e.g., live auction, livestock dealer) before entering veal or dairy beef production. Previous work has demonstrated that a percentage of calves have failed transfer of passive immunity (FTPI) and clinical signs of disease on arrival at calf-raising facilities, but little is known regarding calf condition during marketing. The objectives of this cross-sectional study were to (1) estimate the prevalence of FTPI and poor health outcomes in surplus calves on arrival at livestock dealers, and (2) investigate the association between calf-level variables (body weight, sex, source) and health outcomes. Two livestock dealers in Ohio were visited 2 to 3 times per week, with approximately 28 calves enrolled in the study per visit for a total of 1,119 calves. One blood sample per calf was obtained to evaluate FTPI by measuring serum total protein concentrations (using a cutoff <5.1 g/dL). Calves were clinically evaluated for signs of arthritis, broken ribs or tail, dehydration, depression, diarrhea, fever, navel inflammation, and respiratory disease by 2 observers; health outcomes were dichotomized using clinically relevant cut points. Descriptive statistics were used to estimate the prevalence of calves with poor health outcomes. Multivariable logistic regression models were built to investigate the effect of body weight, sex, and source on health outcomes. Nineteen percent (206/1,091) of calves had FTPI.

Evaluation of SexedULTRA 4M™ sex-sorted semen in timed artificial insemination programs for mature beef cows.

An experiment was designed to compare fertility of SexedULTRA 4M™ sex-sorted semen and conventional, non-sex-sorted semen following either fixed-time artificial insemination (FTAI) or split-time artificial insemination (STAI) of mature suckled beef cows. Units of sex-sorted and conventional semen were produced using contemporaneous ejaculates from three commercially available sires. Units of conventional semen were generated with 25.0 × 106 live cells per 0.25 ml straw prior to freezing, and units of sex-sorted semen were generated using the SexedULTRATM Genesis III sorting technology with 4.0 × 106 live cells per 0.25 ml straw prior to freezing. Sex-sorted units were sorted to contain X chromosome-bearing sperm cells at an accuracy level of >90%. Cows (n = 1620) across four herds were treated with the 7-d CO-Synch + CIDR protocol [administration of gonadotropin-releasing hormone (GnRH) and insertion of a progesterone insert (CIDR) on Day -10, followed by administration of prostaglandin F2α (PG) and removal of CIDR inserts on Day -3]. Cows were preassigned based on age, body condition score, and days postpartum to one of the following four treatments: FTAI with SexedULTRA 4M™ sex-sorted semen, FTAI with conventional semen, STAI with SexedULTRA 4M™ sex-sorted semen, or STAI with conventional semen. On Day -3, estrus detection aids (Estrotect®) were applied. For cows in FTAI treatments, AI was performed on Day 0 at 66 h after PG administration and CIDR removal, and 100 µg GnRH was administered concurrent with AI. For cows in STAI treatments, AI was performed on either Day 0 or 1, at 66 or 90 h after PG administration and CIDR removal, based on timing of estrus expression. On Day 1 at 90 h after PG administration and CIDR removal, 100 µg GnRH was administered concurrent with AI to any STAI-treated cows that had failed to express estrus. Pregnancy rates to AI were affected (P = 0.04) by the interaction of bull and semen type. Greater pregnancy rates were obtained with conventional semen versus SexedULTRA 4M™ sex-sorted semen when using semen from Bull A (64% [176/277] versus 36% [100/278]; P < 0.0001) and Bull B (72% [200/277] versus 57% [156/276]; P < 0.01), whereas pregnancy rates to AI did not differ between conventional and SexedULTRA 4M™ sex-sorted semen when using semen from Bull C (58% [149/258] versus 52% [131/254]). Pregnancy rates did not differ significantly between cows inseminated using a STAI versus FTAI approach, regardless of whether insemination was performed with conventional semen (65% [265/409] versus 65% [260/403] or SexedULTRA 4M™ sex-sorted semen (50% [200/403] versus 48% [187/405]). However, due to the additional 24 h for potential estrus expression when performing STAI, total estrous response prior to AI was greater (P < 0.001) among cows receiving STAI (84%; 686/812) compared to FTAI (72%; 585/808), and greater pregnancy rates (P < 0.0001) were obtained among cows that expressed estrus prior to AI. In summary, the relative fertility of SexedULTRA 4M™ sex-sorted semen and conventional semen varied across bulls. Although overall pregnancy rates to timed AI did not differ between STAI and FTAI approaches, use of a STAI approach allowed for greater total estrous response prior to AI. Therefore, to achieve acceptable conception rates per unit and service the maximum number of cows with sex-sorted semen, one viable approach may be to use STAI to maximize total estrous response and restrict use of SexedULTRA 4M™ sex-sorted to only those cows expressing estrus.

Elastic strain engineering for ultralow mechanical dissipation.

Extreme stresses can be produced in nanoscale structures; this feature has been used to realize enhanced materials properties, such as the high mobility of silicon in modern transistors. We show how nanoscale stress can be used to realize exceptionally low mechanical dissipation when combined with "soft-clamping"-a form of phononic engineering. Specifically, using a nonuniform phononic crystal pattern, we colocalize the strain and flexural motion of a free-standing silicon nitride nanobeam. Ringdown measurements at room temperature reveal string-like vibrational modes with quality (Q) factors as high as 800 million and Q × frequency exceeding 1015 hertz. These results illustrate a promising route for engineering ultracoherent nanomechanical devices.

Whole-Genome Sequencing Reveals the Contribution of Long-Term Carriers in Staphylococcus aureus Outbreak Investigation.

Whole-genome sequencing (WGS) makes it possible to determine the relatedness of bacterial isolates at a high resolution, thereby helping to characterize outbreaks. However, for Staphylococcus aureus, the accumulation of within-host diversity during carriage might limit the interpretation of sequencing data. In this study, we hypothesized the converse, namely, that within-host diversity can in fact be exploited to reveal the involvement of long-term carriers (LTCs) in outbreaks. We analyzed WGS data from 20 historical outbreaks and applied phylogenetic methods to assess genetic relatedness and to estimate the time to most recent common ancestor (TMRCA). The findings were compared with the routine investigation results and epidemiological evidence. Outbreaks with epidemiological evidence for an LTC source had a mean estimated TMRCA (adjusted for outbreak duration) of 243 days (95% highest posterior density interval [HPD], 143 to 343 days) compared with 55 days (95% HPD, 28 to 81 days) for outbreaks lacking epidemiological evidence for an LTC (P = 0.004). A threshold of 156 days predicted LTC involvement with a sensitivity of 0.875 and a specificity of 1. We also found 6/20 outbreaks included isolates with differing antimicrobial susceptibility profiles; however, these had only modestly increased pairwise diversity (mean 17.5 single nucleotide variants [SNVs] [95% confidence interval {CI}, 17.3 to 17.8]) compared with isolates with identical antibiograms (12.7 SNVs [95% CI, 12.5 to 12.8]) (P < 0.0001). Additionally, for 2 outbreaks, WGS identified 1 or more isolates that were genetically distinct despite having the outbreak pulsed-field gel electrophoresis (PFGE) pulsotype. The duration-adjusted TMRCA allowed the involvement of LTCs in outbreaks to be identified and could be used to decide whether screening for long-term carriage (e.g., in health care workers) is warranted. Requiring identical antibiograms to trigger investigation could miss important contributors to outbreaks.

Detailed Vascular Anatomy of the Human Retina by Projection-Resolved Optical Coherence Tomography Angiography.

Optical coherence tomography angiography (OCTA) is a noninvasive method of 3D imaging of the retinal and choroidal circulations. However, vascular depth discrimination is limited by superficial vessels projecting flow signal artifact onto deeper layers. The projection-resolved (PR) OCTA algorithm improves depth resolution by removing projection artifact while retaining in-situ flow signal from real blood vessels in deeper layers. This novel technology allowed us to study the normal retinal vasculature in vivo with better depth resolution than previously possible. Our investigation in normal human volunteers revealed the presence of 2 to 4 distinct vascular plexuses in the retina, depending on location relative to the optic disc and fovea. The vascular pattern in these retinal plexuses and interconnecting layers are consistent with previous histologic studies. Based on these data, we propose an improved system of nomenclature and segmentation boundaries for detailed 3-dimensional retinal vascular anatomy by OCTA. This could serve as a basis for future investigation of both normal retinal anatomy, as well as vascular malformations, nonperfusion, and neovascularization.

Measurement-based control of a mechanical oscillator at its thermal decoherence rate.

In real-time quantum feedback protocols, the record of a continuous measurement is used to stabilize a desired quantum state. Recent years have seen successful applications of these protocols in a variety of well-isolated micro-systems, including microwave photons and superconducting qubits. However, stabilizing the quantum state of a tangibly massive object, such as a mechanical oscillator, remains very challenging: the main obstacle is environmental decoherence, which places stringent requirements on the timescale in which the state must be measured. Here we describe a position sensor that is capable of resolving the zero-point motion of a solid-state, 4.3-megahertz nanomechanical oscillator in the timescale of its thermal decoherence, a basic requirement for real-time (Markovian) quantum feedback control tasks, such as ground-state preparation. The sensor is based on evanescent optomechanical coupling to a high-Q microcavity, and achieves an imprecision four orders of magnitude below that at the standard quantum limit for a weak continuous position measurement--a 100-fold improvement over previous reports--while maintaining an imprecision-back-action product that is within a factor of five of the Heisenberg uncertainty limit. As a demonstration of its utility, we use the measurement as an error signal with which to feedback cool the oscillator. Using radiation pressure as an actuator, the oscillator is cold damped with high efficiency: from a cryogenic-bath temperature of 4.4 kelvin to an effective value of 1.1 ± 0.1 millikelvin, corresponding to a mean phonon number of 5.3 ± 0.6 (that is, a ground-state probability of 16 per cent). Our results set a new benchmark for the performance of a linear position sensor, and signal the emergence of mechanical oscillators as practical subjects for measurement-based quantum control.

Antenatal hepatitis B in a large teaching NHS Trust - implications for future care.

OBJECTIVES: To establish the workload expected as a result of introducing antenatal antivirals for the prevention of vertical transmission of hepatitis B virus. METHODS: Retrospective review of all HBsAg-positive women and their infants, between 2005 and 2011, in a large (population 1 million) teaching NHS Trust in Leicester, UK, a highly ethnically diverse city. RESULTS: 7% of pregnancies occurred in women who were taking, or would now be recommended to take, antenatal antivirals. 176 infants were born to 140 HBsAg-positive women through 172 pregnancies (mean 29 pregnancies/year). Two (1.1%) were vertically infected, including one born to a mother with HBeAg(-)/HBeAb(+) disease and HBV viral load 2 million IU/ml who would not currently be recommended for antenatal antivirals. 81.1% infants completed all HBV vaccinations; 79.5% completed serology testing. 96.4% women were referred to the hepatitis clinic, but 30% disengaged from clinic follow-up, with no significant difference between ethnic groups in terms of maternal disengagement, or failure to complete infant vaccinations or serology testing. CONCLUSIONS: Only a small percentage of HBsAg-positive women are likely to meet the newly published criteria for antenatal anti-viral treatment. Strengthened community engagement across multiple ethnic groups is of paramount importance to improve maternal and infant outcomes.

Genome sequencing of an extended series of NDM-producing Klebsiella pneumoniae isolates from neonatal infections in a Nepali hospital characterizes the extent of community- versus hospital-associated transmission in an endemic setting.

NDM-producing Klebsiella pneumoniae strains represent major clinical and infection control challenges, particularly in resource-limited settings with high rates of antimicrobial resistance. Determining whether transmission occurs at a gene, plasmid, or bacterial strain level and within hospital and/or the community has implications for monitoring and controlling spread. Whole-genome sequencing (WGS) is the highest-resolution typing method available for transmission epidemiology. We sequenced carbapenem-resistant K. pneumoniae isolates from 26 individuals involved in several infection case clusters in a Nepali neonatal unit and 68 other clinical Gram-negative isolates from a similar time frame, using Illumina and PacBio technologies. Within-outbreak chromosomal and closed-plasmid structures were generated and used as data set-specific references. Three temporally separated case clusters were caused by a single NDM K. pneumoniae strain with a conserved set of four plasmids, one being a 304,526-bp plasmid carrying bla(NDM-1). The plasmids contained a large number of antimicrobial/heavy metal resistance and plasmid maintenance genes, which may have explained their persistence. No obvious environmental/human reservoir was found. There was no evidence of transmission of outbreak plasmids to other Gram-negative clinical isolates, although bla(NDM) variants were present in other isolates in different genetic contexts. WGS can effectively define complex antimicrobial resistance epidemiology. Wider sampling frames are required to contextualize outbreaks. Infection control may be effective in terminating outbreaks caused by particular strains, even in areas with widespread resistance, although this study could not demonstrate evidence supporting specific interventions. Larger, detailed studies are needed to characterize resistance genes, vectors, and host strains involved in disease, to enable effective intervention.

Prediction of Staphylococcus aureus antimicrobial resistance by whole-genome sequencing.

Whole-genome sequencing (WGS) could potentially provide a single platform for extracting all the information required to predict an organism's phenotype. However, its ability to provide accurate predictions has not yet been demonstrated in large independent studies of specific organisms. In this study, we aimed to develop a genotypic prediction method for antimicrobial susceptibilities. The whole genomes of 501 unrelated Staphylococcus aureus isolates were sequenced, and the assembled genomes were interrogated using BLASTn for a panel of known resistance determinants (chromosomal mutations and genes carried on plasmids). Results were compared with phenotypic susceptibility testing for 12 commonly used antimicrobial agents (penicillin, methicillin, erythromycin, clindamycin, tetracycline, ciprofloxacin, vancomycin, trimethoprim, gentamicin, fusidic acid, rifampin, and mupirocin) performed by the routine clinical laboratory. We investigated discrepancies by repeat susceptibility testing and manual inspection of the sequences and used this information to optimize the resistance determinant panel and BLASTn algorithm. We then tested performance of the optimized tool in an independent validation set of 491 unrelated isolates, with phenotypic results obtained in duplicate by automated broth dilution (BD Phoenix) and disc diffusion. In the validation set, the overall sensitivity and specificity of the genomic prediction method were 0.97 (95% confidence interval [95% CI], 0.95 to 0.98) and 0.99 (95% CI, 0.99 to 1), respectively, compared to standard susceptibility testing methods. The very major error rate was 0.5%, and the major error rate was 0.7%. WGS was as sensitive and specific as routine antimicrobial susceptibility testing methods. WGS is a promising alternative to culture methods for resistance prediction in S. aureus and ultimately other major bacterial pathogens.

Healthcare-associated outbreak of meticillin-resistant Staphylococcus aureus bacteraemia: role of a cryptic variant of an epidemic clone.

BACKGROUND: New strains of meticillin-resistant Staphylococcus aureus (MRSA) may be associated with changes in rates of disease or clinical presentation. Conventional typing techniques may not detect new clonal variants that underlie changes in epidemiology or clinical phenotype. AIM: To investigate the role of clonal variants of MRSA in an outbreak of MRSA bacteraemia at a hospital in England. METHODS: Bacteraemia isolates of the major UK lineages (EMRSA-15 and -16) from before and after the outbreak were analysed by whole-genome sequencing in the context of epidemiological and clinical data. For comparison, EMRSA-15 and -16 isolates from another hospital in England were sequenced. A clonal variant of EMRSA-16 was identified at the outbreak hospital and a molecular signature test designed to distinguish variant isolates among further EMRSA-16 strains. FINDINGS: By whole-genome sequencing, EMRSA-16 isolates during the outbreak showed strikingly low genetic diversity (P < 1 × 10(-6), Monte Carlo test), compared with EMRSA-15 and EMRSA-16 isolates from before the outbreak or the comparator hospital, demonstrating the emergence of a clonal variant. The variant was indistinguishable from the ancestral strain by conventional typing. This clonal variant accounted for 64/72 (89%) of EMRSA-16 bacteraemia isolates at the outbreak hospital from 2006. CONCLUSIONS: Evolutionary changes in epidemic MRSA strains not detected by conventional typing may be associated with changes in disease epidemiology. Rapid and affordable technologies for whole-genome sequencing are becoming available with the potential to identify and track the emergence of variants of highly clonal organisms.

Radiation-induced cancer: a modern view.

Diagnostic medical radiation has been the most rapidly increasing component of population background radiation exposure in Western countries over the past decade. This trend is set to increase as CT scanning is readily available with burgeoning use in everyday clinical practice. Consequently, the issue of cancer induction from the doses received during diagnostic medical exposures is highly relevant. In this review we explain current understanding of potential cancer induction at low doses of sparsely ionising radiation. For cancers that may be induced at low doses, a mechanistic description of radiation-induced cancer is discussed, which, in combination with extrapolation of data based on population cohort studies, provides the basis of the currently accepted linear no-threshold model. We explore the assumptions made in deriving risk estimates, the controversies surrounding the linear no-threshold model and the potential future challenges facing clinicians and policy-makers with regards to diagnostic medical radiation and cancer risk, most notably the uncertainties regarding deriving risk estimates from epidemiological data at low doses.

Ultrasound elastography for musculoskeletal applications.

Ultrasound elastography (EUS) is a method to assess the mechanical properties of tissue, by applying stress and detecting tissue displacement using ultrasound. There are several EUS techniques used in clinical practice; strain (compression) EUS is the most common technique that allows real-time visualisation of the elastographic map on the screen. There is increasing evidence that EUS can be used to measure the mechanical properties of musculoskeletal tissue in clinical practice, with the future potential for early diagnosis to both guide and monitor therapy. This review describes the various EUS techniques available for clinical use, presents the published evidence on musculoskeletal applications of EUS and discusses the technical issues, limitations and future perspectives of this method in the assessment of the musculoskeletal system.

Enhancement of mechanical Q factors by optical trapping.

The quality factor of a mechanical resonator is an important figure of merit for various sensing applications and for observing quantum behavior. Here, we demonstrate a technique to push the quality factor of a micromechanical resonator beyond conventional material and fabrication limits by using an optical field to stiffen or trap a particular motional mode. Optical forces increase the oscillation frequency by storing most of the mechanical energy in a nearly lossless optical potential, thereby strongly diluting the effect of material dissipation. By placing a 130 nm thick SiO2 pendulum in an optical standing wave, we achieve an increase in the pendulum center-of-mass frequency from 6.2 to 145 kHz. The corresponding quality factor increases 50-fold from its intrinsic value to a final value of Q=5.8(1.1)×10(5), representing more than an order of magnitude improvement over the conventional limits of SiO2 for this geometry. Our technique may enable new opportunities for mechanical sensing and facilitate observations of quantum behavior in this class of mechanical systems.

Use of a long acting injectable formulation of moxidectin to control the periparturient rise in faecal Teladorsagia circumcincta egg output of ewes.

A field study was conducted in a sheep flock in the south east of Scotland with a history of ivermectin resistance in Teladorsagia circumcincta. The objective of the study was to compare the effects of single anthelmintic treatments in ewes before turn-out onto pasture that was contaminated with a moderate level of overwintered, ivermectin resistant, T. circumcincta infective larvae. The ewes were treated according to label directions with either a long acting injectable formulation of moxidectin (1mg/kg; affording up to 14 weeks persistent action against macrocyclic lactone (ML)-susceptible T. circumcincta) or an oral formulation of moxidectin (0.2mg/kg; affording up to 5 weeks persistent action against ML-susceptible T. circumcincta). The lambs were enrolled in the normal management of the farm, and received a total of three oral ivermectin treatments during the 16 week study. The efficacy of both treatment strategies in controlling the periparturient rise in faecal nematode worm egg counts and subsequent pasture contamination was assessed from the faecal worm egg counts of the ewes and their lambs between lambing and weaning. Ewes that were treated with the oral formulation of moxidectin shed approximately 3.5 times more T. circumcincta eggs between lambing and weaning than ewes that were treated with the long acting formulation of moxidectin. This difference was reflected in the faecal worm egg counts of the lambs that were grazed alongside the different treatment groups of ewes. The results of the current study demonstrate persistent efficacy of the long acting formulation of moxidectin against an ivermectin resistant T. circumcincta population. The decreased pasture contamination after treatment could lead to improved lamb growth and a need for fewer anthelmintic treatments, thus potentially reducing one possible selection pressure for anthelmintic resistance. However, treatment with the long acting formulation of moxidectin would give rise to fewer susceptible nematodes being present in refugia, which could increase another possible selection pressure for anthelmintic resistance, depending on the subsequent grazing management of that pasture. The rationale for use of a persistent anthelmintic drug to control the periparturient rise in faecal ML-resistant T. circumcincta egg output of the ewes is discussed and potential differences in selection for macrocyclic lactone anthelmintic resistance using the different formulations of moxidectin are acknowledged.

Supplemental butyrate does not enhance the absorptive or barrier functions of the isolated ovine ruminal epithelia.

Our objective was to determine if increasing the ruminal butyrate concentration would improve the selective permeability of ruminal epithelia. Suffolk wether lambs (n = 18) with an initial BW of 47.4 ±1.4 kg were housed in individual pens (1.5 × 1.5 m) with rubber mats on the floor. Lambs were blocked by initial BW into 6 blocks and, within block, were randomly assigned to either the control (CON) or 1 of 2 butyrate supplementation amounts (i.e., 1.25% or 2.50% butyrate as a proportion of DMI). With the exception of butyrate supplementation, all lambs were fed a common diet (90% concentrate and 10% barley silage). After a 14-d feeding period, lambs were killed, and ruminal epithelia from the ventral sac were mounted in Ussing chambers. To facilitate the Ussing chamber measurements, only 1 lamb was killed on an individual day. Thus, the starting date was staggered so that all lambs were exposed to the same experimental protocol. In Ussing chambers, epithelia were incubated using separate mucosal (pH 6.2) and serosal (pH 7.4) bathing solutions. Then 1-14C-butyrate (74 kBq/10 mL) was added to the mucosal side and was used to measure the mucosal-to-serosal flux (J(ms-butyrate)) in 2 consecutive 60-min flux periods with simultaneous measurement of transepithelial conductance (G(t)). During the first (challenge) flux period, the mucosal buffer solution was either acidified to pH 5.2 (ACID) or used as a control (pH 6.2; SHAM). Buffer solutions bathing the epithelia were replaced before the second flux period (recovery). Total ruminal short-chain fatty acid and butyrate concentrations were greater (P = 0.001) in lambs fed 2.50% compared with those fed 0% or 1.25% butyrate. The J(ms-butyrate) was less for lambs fed 1.25% and 2.50% butyrate [3.00 and 3.12 µmol/(cm2·h), respectively] than for CON [3.91 µmol/(cm2· h)]. However, no difference (P = 0.13)was observed for G(t). An ex vivo treatment × flux period interaction was detected (P = 0.003) for J(ms-butyrate), where no differences were present between ACID and SHAM during the challenge period, but the Jms-butyrate was less for ACID than for SHAM during recovery. These results indicate that large increases in the ruminal butyrate concentration decrease the selective permeability of the isolated ruminal epithelia.

Observations on the epidemiology of autumn nematodirosis in weaned lambs in a Scottish sheep flock.

Nematodirosis was diagnosed in the south-east of Scotland during two consecutive autumns in lambs which were grazed on the same field. The problem was unpredicted based on the knowledge of the pasture and animal management, and rudimentary understanding of the behaviour of free-living stages of Nematodirus battus in the region. Unlike the epidemiology that has been described in the south of England, whereby autumn infection of lambs is believed to arise from autumn hatching of eggs shed during the previous spring without prior chilling, it is concluded that the autumn nematodirosis in a particular sheep flock in Scotland most likely arose following prolonged survival of larvae hatched during the spring from eggs shed during the previous summer, following periods of cold exposure over the previous winter. The infective larvae survived in large numbers in a small, sheltered strip of rough grazing, where they would have been protected from harmful ultraviolet radiation and heavy rainfall, before infecting lambs during the autumn. Understanding of the evolutionary potential, nematode parasites to adapt to changing environmental conditions depends on a thorough clinical investigative approach, and is a prerequisite for future preventive management.

Utilizing a combination of molecular and spatial tools to assess the effect of a public health intervention.

Until recently New Zealand had one of the highest rates of human campylobacteriosis reported by industrialized countries. Since the introduction of a range of control measures in the poultry production chain a reduction in human cases of around 50% has been observed nationwide. To inform risk managers a combination of spatial, temporal and molecular tools - including minimum spanning trees, risk surfaces, rarefaction analysis and dynamic source attribution modelling - was used in this study to formally evaluate the reduction in disease risk that occurred after the implementation of control measures in the poultry industry. Utilizing data from a sentinel surveillance site in the Manawatu region of New Zealand, our analyses demonstrated a reduction in disease risk attributable to a reduction in the number of poultry-associated campylobacteriosis cases. Before the implementation of interventions poultry-associated cases were more prevalent in urban than rural areas, whereas for ruminant-associated cases the reverse was evident. In addition to the overall reduction in prevalence, this study also showed a stronger intervention effect in urban areas where poultry sources were more dominant. Overall a combination of molecular and spatial tools has provided evidence that the interventions aimed at reducing Campylobacter contamination of poultry were successful in reducing poultry-associated disease and this will inform the development of future control strategies.