How mechanistic modelling supports decision making for the control of enzootic infectious diseases.

Controlling enzootic diseases, which generate a large cumulative burden and are often unregulated, is needed for sustainable farming, competitive agri-food chains, and veterinary public health. We discuss the benefits and challenges of mechanistic epidemiological modelling for livestock enzootics, with particular emphasis on the need for interdisciplinary approaches. We focus on issues arising when modelling pathogen spread at various scales (from farm to the region) to better assess disease control and propose targeted options. We discuss in particular the inclusion of farmers' strategic decision-making, the integration of within-host scale to refine intervention targeting, and the need to ground models on data.

The Effect of Wind on Coxiella burnetii Transmission Between Cattle Herds: a Mechanistic Approach.

There is a consensus that wind plays a key role in the transmission of Coxiella burnetii, the causative agent of Q fever, between ruminants and from ruminants to humans. However, no observational study so far has focused on the mechanisms associated with this airborne transmission. This study applied a mechanistic epidemiological approach to investigate the processes underlying the wind effect and to assess its influence on the risk for a dairy herd to become C. burnetii infected. Ninety-five dairy cattle herds located in the Finistère department (western France) were subjected to samplings of bulk tank milk and indoor dust every 4 months over a 1-year period to determine their C. burnetii status using PCR tests. A total of 27 incident herd-periods (negative-tested on both PCR tests and becoming positive-tested at least once at the subsequent sampling time) and 71 negative herd-periods were retained for analysis. Using logistic regression, we assessed the effect of (i) the cumulated number of bacteria in herds located under the main wind direction and (ii) the mean wind speed in this area, on a given herd's risk of becoming incident. Compared to herds in areas with low wind speed (≤5.5 m/s), the risk was significantly higher (OR = 3.7) in herds in areas with high wind speed (>5.5 m/s) and high bacterial load (>10), whereas it was not significantly different from unity in other situations. In agreement with our assumptions, C. burnetii transmission to a previously infection-free herd occurs only when (i) the wind transporting from infected sources and (ii) the load in the contaminated particles/aerosols generated are high enough to act jointly.

Identifying main drivers and testing control strategies for CCHFV spread.

Crimean Congo Haemorrhagic Fever (CCHF) is an emerging zoonotic disease. The causative agent is a virus (CCHFV), mainly transmitted by ticks of the species Hyalomma marginatum in Eastern Europe and Turkey. In order to test potential scenarios for the control of pathogen spread, the basic reproduction number (R0) for CCHF was calculated. This calculation was based on a population dynamics model and parameter values from the literature for pathogen transmission. The tick population dynamics model takes into account the major processes involved and gives estimates for tick survival from one stage to the other and number of feeding ticks. It also considers the influence of abiotic (meteorological variables) and biotic factors (host densities) on model outputs, which were compared with data collected in Central Anatolia (Turkey). R0 computation was thereafter used to test control strategies and especially the effect of acaricide treatment. Simulation results indicate that such treatments could have valuable effects provided that the acaricide is applied regularly throughout the spring and summer, and over several years. Furthermore, a sensitivity analysis to abiotic and biotic factors showed that, even though temperature has a strong impact on model outputs, host (mainly hare) densities also play a role. The kind of model we have developed provides insight into the ability of different strategies to prevent and control disease spread and has proved its relevance when associated with field trials.

Within-herd biosecurity and Salmonella seroprevalence in slaughter pigs: a simulation study.

In Europe, on-farm biosecurity measures, involving a strict all-in/all-out batch-management system and decontamination of the rearing rooms between consecutive batches, are recommended to control Salmonella infection in growing pigs. However, implementation of these measures is often relaxed under common farming conditions. Therefore, this study was conducted to assess the relative contributions of batch-management system and room decontamination efficacy on Salmonella seroprevalence for different growing rates and subsequent slaughter ages of pigs. Because the impact of these factors cannot be easily evaluated by an observational approach in commercial farms, a stochastic simulation model representing the population dynamics, herd management, and Salmonella infection within a farrow-to-finish pig herd was used. Realistic levels were set for each factor under study (3 for batch-management system and slaughter age; 4 for room decontamination) to generate 54 simulation scenarios. Salmonella shedding prevalence in groups of slaughter pigs was then compared. A sensitivity analysis was performed to rank the impacts of the 3 factors on output. Batch-management system had little effect. In contrast, room decontamination efficacy had the greatest impact on Salmonella prevalence in pigs at slaughter. A drop in decontamination efficacy from 100 to 50%, with a strict all-in/all-out batch-management system and for all slaughter ages tested, noticeably increased (P<0.001) the prevalence and almost doubled it for the reference slaughter age. Our results suggest that the control of Salmonella in pig herds should primarily focus on room decontamination efficacy. Provided that a good level of room decontamination is ensured, some flexibility in batch management, in terms of pig mixing, would be acceptable to limit the number of underweight pigs delivered to the slaughterhouse.

Modelling batch farrowing management within a farrow-to-finish pig herd: influence of management on contact structure and pig delivery to the slaughterhouse.

Pathogen spread within pig host populations can vary depending on within-herd interactions among pigs also called the contact structure. The recommended batch farrowing management, allowing for a fixed-interval mating for groups of sows of equal size, called batches, leads to an all-in/all-out management of pigs in which animals in different batches have no contact. To maintain a profitable pig delivery, producers have to deliver groups of pigs at a given weight, what needs sometimes herd management adaptations. However, producers' adaptations that avoid delivering pigs below slaughtering weight (out-of-range pigs), result in increasing the contact between animals from different batches. To study the influence of herd management on contact structure and on pig delivery, a stochastic mathematical model representing population dynamics within a farrow-to-finish herd was elaborated. Sixteen management systems were represented combining or not the all-in/all-out management system with producers' decisions: batch mixing, use of an extra room, suppression of the drying period and sale of post-weaning batches. Two types of contact were considered: via the animals themselves, when batch mixing occurred; and via the room, when decontamination was not complete. The impact of producers' decisions on contact structure and on pig delivery, differed radically when pig growth was normal and when it was slow (i.e. mean age at slaughtering weight increased by 20%). When pig growth was normal, the all-in/all-out management prevented both contact via the animals and via the room but resulted in 9% of pigs delivered out of range. The use of an extra room or batch mixing decreased this percentage, the latter resulting in very frequent contact between batches via the animals. When pig growth was slow, the all-in/all-out management led to a very high percentage of pigs delivered out of range (almost 80%). The suppression of the drying period at the end of the finishing period and the sale of post-weaning batches induced a significant decrease in this percentage (down to 2% to 20%), the latter allowing to reduce the percentage of batches that made contact via the room (40% instead of 80%). This pig herd model helped to understand the compromise for producers between implementing internal biosecurity or maintaining a profitable pig delivery. Our results show that there was no unique optimal system and that efficient producers' decisions (for biosecurity and delivery) may differ, depending on pig growth.

Influence of the transmission function on a simulated pathogen spread within a population.

The mathematical function for the horizontal transmission of a pathogen is a driving force of epidemiological models. This paper aims at studying the influence of different transmission functions on a simulated pathogen spread. These functions were chosen in the literature and their biological relevance is discussed. A theoretical SIR (Susceptible-Infectious-Recovered) model was used to study the effect of the function used on simulated results. With a constant total population size, different equilibrium values for the number of infectious (NI) were reached, depending on the transmission function used. With an increasing population size, the transmission functions could be assimilated to either density-dependent (DD), where an equilibrium was obtained, or frequency-dependent (FD), with an exponential increase in NI. An analytical study corroborated the simulated results. As a conclusion, the choice between the different transmission functions, particularly between DD and FD, must be carefully considered for a varying population size.

A swallow induction avoidance procedure to establish eating.

Swallow induction has been used to shape swallowing behavior in dysphagic children and to accelerate swallowing in nondysphagic children with profound mental retardation who display primitive swallows. Swallow induction may be considered a type of prompt. This project coupled swallow induction with a modified delayed prompting paradigm to establish eating in a 3.5-year-old girl. Coupling these procedures produced prompt swallowing and established oral consumption. Follow-ups at 1, 2, 6 and 12 months demonstrated maintenance and further improvement of the newly acquired feeding skills. Implications for treatment and further research are discussed.

Behavioral assessment and treatment of pediatric feeding disorders.

Pediatric feeding disorders are estimated to occur in as many as one in every four infants and children, and when serious can require numerous, costly and sustained interventions. For over a decade research has cumulated evidence on the contributions of Behavior Analysis in understanding and remediating some types of pediatric feeding disorders. The systematic use of this body of evidence in conjunction with other approaches (medical, nutrition, occupational therapy, physical therapy, and so forth) is being carried out on an inpatient treatment unit at the Kennedy Krieger Institute. Key aspects are described here, including direct observation behavior assessment, approaches for increasing and decreasing feeding behavior, skill acquisition, transfer of treatment gains, and parent training. The results based on case studies and overall program evaluation indicate that medically complicated, severe feeding disorders can be treated successfully in a few months with a multidisciplinary approach which incorporates behavioral procedures.

Contingency contacting. Combining positive reinforcement and escape extinction procedures to treat persistent food refusal.

Chronic food refusal has traditionally been treated with forced feeding and other physical prompting-based procedures when positive reinforcement procedures prove inadequate. Potential problems with such procedures, however, include exacerbation of feeding difficulties and health risks, as well as low parental approval and probability of implementation. Contingency contacting maximizes contact between oral acceptance and positive reinforcement, prevents escape functions of inappropriate behaviors, and requires minimal physical contact between feeder and child. Performances of two children exhibiting chronic food refusal were observed under baseline, positive reinforcement, and contingency contacting conditions. Positive reinforcement increased acceptance only slightly and did not change negative vocalization or interruption for one child. Contingency contacting rapidly increased acceptance and grams of food consumed, and decreased negative vocalization and interruption for both children. Withdrawal to positive reinforcement decreased acceptance for both children and grams consumed for one. Reinstituting contingency contacting rapidly increased acceptance and recovery of grams consumed for one child. Parental approval ratings and treatment and research implications are discussed.