Livestock as sentinels for an infectious disease in a sympatric or adjacent-living wildlife reservoir host.

A central question to address in managing wildlife diseases is how much effort and resources are required to reduce infection prevalence to below a requisite threshold? This requires surveillance for infection in at least one species involved in the infection cycle, a process that is often expensive and time-consuming but one which could be enhanced using additional sources of readily-obtainable surveillance data. We demonstrate how surveillance data from ruminant livestock monitored for bovine tuberculosis (bTB) in New Zealand can be employed in spatially-explicit modelling to help predict the probability of freedom from Mycobacterium bovis infection in a sympatric wildlife reservoir species, the brushtail possum (Trichosurus vulpecula). We apply the model to a case study and compare resulting probabilities of freedom when utilizing (1) livestock data only, (2) wildlife data only, and (3) combined livestock-plus-wildlife surveillance data. Results indicated that the greatest probability of M. bovis eradication was achieved using wildlife monitoring data supplemented with livestock surveillance data. This combined approach lessened the time required for a confident (95% probability) declaration of regional eradication. However, the combined model was sensitive to the precision of the input parameters, and we describe ways to account for this. In a broad sense, this modelling approach is flexible in that any spatial arrangement of wildlife habitat and farms can be analysed, provided infection is readily detectable in both the wild and domestic animal(s) of interest. It is applicable to monitoring any communicable wildlife disease that affects regularly-tested livestock. The potential benefits to wildlife disease management include reduced surveillance costs and more rapid achievement of targeted reductions in disease prevalence.

Development of the New Zealand strategy for local eradication of tuberculosis from wildlife and livestock.

We describe the progressive development of New Zealand's national strategy for control of tuberculosis (TB) in its agricultural sector over the last four decades. The strategy is globally unique, reflecting the need for effective and co-ordinated management of TB in a wildlife maintenance host, the brushtail possum (Trichosurus vulpecula), in addition to controlling infection in cattle and farmed deer herds. Since the early 1990s, the strategy has been developed by the Animal Health Board (AHB), formed to empower the farming industry to take the leadership role in funding of TB control, policy development and administration. The AHB became the first non-government organisation to develop and gain acceptance by the funders (farming industry and government) of a National Pest Management Strategy (NPMS) under the Biosecurity Act 1993. A key outcome of the NPMS for TB control was the development and inclusion of very challenging objectives that provided direction for management, research and possum control. This paper describes the process whereby the NPMS was revised twice, following achievement of each successive set of strategy objectives within budget. Success was based on firstly, reorganisation of the AHB and its operational systems to achieve increased efficiency; secondly, improved efficiency through contracting possum and disease control, and thirdly research delivering effective and practical applications, while also providing a scientific basis for setting directions for future control strategies. The last revision of the NPMS was implemented in 2011, and included objectives to eradicate Mycobacterium bovis-infected wildlife populations over 2.5 million hectares by 2026. This ambitious objective was adopted only after extensive forecast modelling enabled stakeholders to identify and select the most cost-effective long-term solution for the management of M. bovis-infected possum populations. The accomplishment of New Zealand's TB control programme, in meeting successive sets of demanding NPMS objectives, has seen a 95% decrease in the number of infected cattle and deer herds since they peaked at 1,694 in 1994, and the eradication of TB from infected possum populations from 830,000 hectares. Provided the current level of funding continues, New Zealand is positioned to achieve national eradication of TB well in advance of the 40-50-year timeline forecast 3 years ago.

Managing and eradicating wildlife tuberculosis in New Zealand.

Tuberculosis (TB) due to Mycobacterium bovis infection was first identified in brushtail possums (Trichosurus vulpecula) in New Zealand in the late 1960s. Since the early 1970s, possums in New Zealand have been controlled as part of an ongoing strategy to manage the disease in livestock. The TB management authority (TBfree New Zealand) currently implements three strategic choices for disease-related possum control: firstly TB eradication in areas selected for eradication of the disease from livestock and wildlife, secondly Free Area Protection in areas in which possums are maintained at low densities, normally along a Vector Risk Area (VRA) boundary, and thirdly Infected Herd Suppression, which includes the remaining parts of VRA where possums are targeted to minimise the infection risk to livestock. Management is primarily through a range of lethal control options. The frequency and intensity of control is driven by a requirement to reduce populations to very low levels (usually to a trap-catch index below 2%), then to hold them at or below this level for 5-10 years to ensure disease eradication.Lethal possum control is implemented using aerial- and ground-based applications, under various regulatory and operational constraints. Extensive research has been undertaken aimed at improving the efficacy and efficiency of control. Aerial applications use sodium fluoroacetate (1080) bait for controlling possums over extensive and rugged areas of forest that are difficult to access by foot. Ground-based control uses a range of toxins (primarily, a potassium cyanide-based product) and traps. In the last 5 years there has been a shift from simple possum population control to the collection of spatial data on possum presence/absence and relative density, using simple possum detection devices using global positioning system-supported data collection tools, with recovery of possum carcasses for diagnostic necropsy. Such data provide information subsequently used in predictive epidemiological models to generate a probability of TB freedom.The strategies for managing TB in New Zealand wildlife now operate on four major principles: firstly a target threshold for possum population reduction is defined and set, secondly an objective methodology is applied for assessing whether target reductions have been achieved, thirdly effective control tools for achieving possum population reductions are used, and fourthly the necessary legislative support is in place to ensure compliance. TBfree New Zealand's possum control programme meets these requirements, providing an excellent example of an effective pest and disease control programme.

Toward eradication: the effect of Mycobacterium bovis infection in wildlife on the evolution and future direction of bovine tuberculosis management in New Zealand.

New Zealand's bovine tuberculosis (TB) control programme has greatly reduced the burden of tuberculosis on the farming industry, from 11% of mature cattle found with TB at slaughter in 1905 to <0.003% in 2012/13. New Zealand implemented TB control measures in cattle from the mid-twentieth century, and later in farmed deer. Control was based on established methods of tuberculin testing of herds, slaughter of suspect cases, and livestock movement control. Unexplained regional control failures and serious disease outbreaks were eventually linked to wildlife-vectored infection from the introduced Australian brushtail possum (Trichosurus vulpecula), which also triggered a wildlife disease complex involving a range of introduced species. This paper reviews the progressive elucidation of the epidemiology of Mycobacterium bovis in New Zealand's wildlife and farmed livestock, and the parallel development of research-led, multi-faceted TB control strategies required to protect New Zealand's livestock industries from damaging infection levels. The adoption of coordinated national pest management strategies, with increasingly ambitious objectives agreed between government and industry funders, has driven a costly but very successful management regime targeted at controlling TB in the possum maintenance host. This success has led to initiation of a strategy designed to eradicate TB from New Zealand's livestock and wildlife, which is considered a realistic long-term prospect.

A strategic approach to eradication of bovine TB from wildlife in New Zealand.

A review and amendment of New Zealand's National Pest Management Strategy for bovine tuberculosis (TB) has led to adoption of new strategy objectives for localized eradication of disease from the principal wildlife maintenance host and infecting vector for farmed cattle and deer, the brushtail possum Trichosurus vulpecula. Historic programmes have been based on management of disease within herds and control of wildlife directed towards reducing infected herd prevalence. From July 2011, the TB strategy has been redirected towards eradication of TB from possums and other wildlife over a total area of at least 2.5 million hectares over a 15-year period. The amended strategy is intended to provide large-scale proof of concept, using two extensive bush areas, that TB can be eradicated from wildlife in New Zealand in the longer term, leading to eventual savings in control programmes needed to protect cattle and deer herds from infection. Achievement of strategy objectives will be supported by major research together with technical and managerial improvements in wildlife TB control and surveillance, and these are reviewed.

A novel approach to assess the probability of disease eradication from a wild-animal reservoir host.

Surveying and declaring disease freedom in wildlife is difficult because information on population size and spatial distribution is often inadequate. We describe and demonstrate a novel spatial model of wildlife disease-surveillance data for predicting the probability of freedom of bovine tuberculosis (caused by Mycobacterium bovis) in New Zealand, in which the introduced brushtail possum (Trichosurus vulpecula) is the primary wildlife reservoir. Using parameters governing home-range size, probability of capture, probability of infection and spatial relative risks of infection we employed survey data on reservoir hosts and spillover sentinels to make inference on the probability of eradication. Our analysis revealed high sensitivity of model predictions to parameter values, which demonstrated important differences in the information contained in survey data of host-reservoir and spillover-sentinel species. The modelling can increase cost efficiency by reducing the likelihood of prematurely declaring success due to insufficient control, and avoiding unnecessary costs due to excessive control and monitoring.

Advances in ante-mortem diagnosis of tuberculosis in cattle.

The tuberculin skin test is effective in the early detection of pre-clinical cases of Mycobacterium bovis infection in cattle. This allows the rapid removal of infected animals, thus limiting transmission of the disease, and has resulted in the eradication of bovine tuberculosis (Tb) from many countries. This test is very likely to remain the primary screening test for M. bovis infection in cattle as it is a simple, robust and inexpensive test. However, a number of ancillary tests are being used, or are currently being validated. These ancillary tests are likely to provide a more accurate diagnosis following skin-testing. The blood-based BOVIGAM interferon-gamma (IFN-gamma) test is a cellular immune assay which can detect early infection, and has become the main ancillary test in New Zealand. It can be used for re-testing skin test-positive animals, to improve specificity and minimise wastage from slaughtering animals with false-positive tests. Alternatively, it can be used in locations of increased risk of infection in parallel with skin-testing, for examining skin test-negative animals for pre-movement testing or in problem herds to identify M. bovis-infected animals that do not respond to the skin test. Several modifications of the test are now being used to improve specificity by altering the cut-off or using specific antigens present in virulent mycobacteria such as the 6 kDa early secreted antigenic target (ESAT-6) and 10 kDa culture filtrate protein (CFP-10). While antibody based tests generally lack sensitivity, as high levels of antibodies tend to occur late in the disease process, they may have unique desirable properties such as the ability to be used as a cow-side test. The use of these new ancillary tests in association with skin-testing will improve the detection of M. bovis-infected cattle and reduce the unnecessary slaughter of false-positive reactors.

Regionalization: a strategy that will assist with bovine tuberculosis control and facilitate trade.

It is expected that the revised chapter on bovine tuberculosis in the Terrestrial Animal Health Code of the Office Internationale des Epizooties (OIE) will embrace regionalization as a functional means of assisting countries, states or regions to meet the requirements for freedom from tuberculosis and to facilitate trade. The benefits and applications of regionalization, which comprises zoning and compartmentalisation, are discussed. Regionalization requires that a country's veterinary administration is able to implement transparent and auditable biosecurity measures that will ensure that the tuberculosis-free status of a subpopulation of cattle is maintained despite the presence of infection in another cattle subpopulation, or in other domestic or wild animal species. Zoning, which requires cattle subpopulations to be separated by geographic boundaries, provides a practical basis whereby countries, states or regions, can progress towards freedom from tuberculosis, regardless of the source of infection for defined cattle subpopulations. Compartmentalisation however, requires that husbandry or management practices will be used to prevent a tuberculosis-free cattle subpopulation from contacting interspecific and intraspecific sources of infection. This will be difficult to achieve except for specialised cases such as artificial breeding centers.

Advances in understanding disease epidemiology and implications for control and eradication of tuberculosis in livestock: the experience from New Zealand.

A deteriorating tuberculosis problem in cattle and deer in New Zealand has been halted and then reversed over the last decade. Mycobacterium bovis infection in both wild and domestic animal populations has been controlled. This has been achieved by applying a multi-faceted science-based programme. Key features of this have been a comprehensive understanding of the epidemiology of tuberculosis in animals, confidence in sampling wild animal populations, effective application of diagnostic tests in cattle and deer, and the ability to map M. bovis genotypes.

A simulation model for the spread of bovine tuberculosis within New Zealand cattle herds.

Bovine tuberculosis, caused by Mycobacterium bovis, presents a major problem to New Zealand agriculture because of the risk that it poses to export-market access. New Zealand research has focused largely on the epidemiology of the disease in wildlife reservoirs, and relatively little is known about the dynamics of the disease in cattle. This study, therefore, investigates bovine tuberculosis (Tb) dynamics within cattle herds, by construction and application of a simple simulation model of disease transmission. The model was designed firstly to estimate rates of disease transmission within herds, and secondly to identify likely consequences of changes in herd Tb-testing policies. Both deterministic and stochastic versions of the model were used to achieve these aims. The model suggests that within-herd Tb transmission does occur and contributes to the reactor rates observed under annual herd testing regimens. The mass-action disease transmission coefficient (proportion of susceptible animals infected per unit time per infectious animal, i.e. not per diseased animal or per reactor), appears to be in the order of 2.7 x 10(-5) per cow per day for a typical herd of around 200 animals, resulting in a contact rate (number of potentially infectious contacts made per infectious cow per day) of about 0.0073. These are average estimates for both beef and dairy herds. Model results suggest that improving the sensitivity of the test used to diagnose bovine Tb would improve control in areas where wildlife reservoirs are absent but have little effect where they are present. Reducing the time between tests of herds on Tb-induced movement control from the current 6 months to 2 or 3 months reduces the average time a herd spends on movement control and hence national Tb prevalence. In the presence of wildlife reservoirs of infection, both the total number of tests and total reactors per unit time increase, but the extent depends on the level of external infection. In all scenarios examined, involving thousands of model runs in total, infection was invariably absent from the modelled herd by the time it was considered clear of Tb based on testing results. This suggests that the caudal fold test is a realistic measure of herd Tb status and that Tb is unlikely to persist in herds under current testing practices in the absence of anergic cattle or an external source of infection. Specificity of the caudal-fold test as used in practice was estimated to be greater than 99%.

Bovine tuberculosis control and eradication programs in Australia and New Zealand.

This paper reviews the current and future programs for control of bovine tuberculosis in Australia and New Zealand. The paper highlights the similarities between the approach taken in these countries and compares and contrasts the strengths and weaknesses of these campaigns. The successful Australian campaign was based on a sound technical program, with good cattle control and strong industry support. In contrast, the presence of a significant wildlife reservoir (brushtail possum) of Mycobacterium bovis in New Zealand has hindered the eradication of bovine tuberculosis.

Management of failed endotracheal intubation at caesarean section.

A review of the history of endotracheal intubation and endotracheal tubes is presented and a plan of management of failed endotracheal intubation at caesarean section is described. The importance of preparation for such an event by incorporation of certain features into anaesthesia training programs is emphasised.