Seroprevalence and Risk Factors Associated with Chlamydia abortus Infection in Sheep and Goats in North-Western Italy.

Chlamydia abortus, although poorly recognized as a human pathogen, is a zoonotic microorganism that can cause many different symptoms in humans, including subclinical infection and fatal illnesses in pregnant women. C. abortus is one of the most common causes of ovine and caprine infectious abortion worldwide, known as the causative agent of the enzootic abortion of ewes (EAE) or ovine enzootic abortion (OEA). To estimate C. abortus seroprevalence and the risk factors related to C. abortus in small ruminants, the sera from 3045 animals (both sheep and goat) belonging to 202 herds were tested and a questionnaire investigating flock management was administered. At the herd level, the true seroprevalence was 56.6% (CI95%: 46.9-66.3%), at sheep-farm and goat-farm level, the true seroprevalence was 71.4% (CI95%: 54.6-88.3%) and 44.8% (CI95%: 41.3-57.0%), respectively. The true seroprevalence was significantly higher among the sheep than the goats. The logistic regression model identified four factors associated with Chlamydia seropositivity: flock size (i.e., farms with >50 heads), contact with cattle, introduction of animals, and Coxiella seropositivity. The study evidenced a high seroprevalence of Chlamydia abortus in small ruminant farms in the Piedmont region. Considering its zoonotic potential and the health consequences in humans, communication to farmers on the importance of vaccination, as well as the sensibilization of farm vets, seem to be strategical.

Chlamydia Species and Related Risk Factors in Poultry in North-Western Italy: Possible Bird-to-Human Transmission for C. gallinacea.

Chlamydiaceae are obligatory intracellular bacteria causing acute and chronic diseases in animals and humans worldwide, with recently discovered species with a still unclear pathogenic potential (i.e., C. gallinacea). In Italy, Chlamydiaceae infections are underestimated both in animals and humans. To estimate the prevalence of Chlamydiaceae species in poultry and occupationally exposed workers on farm, a cross-sectional study was carried out in north-western Italy. A total of 2063 samples from 83 commercial and 31 backyard poultry farms were analysed using real-time PCRs for Chlamydiaceae screening and species typing. Chlamydiaceae were detected in 23 farms, with a herd prevalence of 20.2% (95%CI: 13.2-28.7), higher in backyard farms (38.7%; 95%CI: 21.8-57.8) compared to commercial ones (13.3%; 95%CI: 6.8-22.5). C. gallinacea was found in 18 chicken farms, both commercial and backyard, and C. psittaci only in 3 backyard farms. Exposure to wild birds and factors related to biosecurity resulted the main risk factors associated with Chlamydia positivity. Out of the 113 sputum samples collected from farmers, 16 tested positive to Chlamydiaceae, with a prevalence of 14.2% (95%CI: 8, 3-22). To the best of our knowledge, for the first time at international level, C. gallinacea was detected in humans with farmer positivity associated with farm infectious status, suggesting a bird-to-human transmission.

Process evaluation of integrated West Nile virus surveillance in northern Italy: an example of a One Health approach in public health policy.

West Nile virus (WNV) is endemic in the Po valley area in northern Italy. Regional health authorities have implemented integrated WNV surveillance following a One Health approach, based on collaboration between human, animal and environmental health institutions. We evaluated this integrated WNV surveillance system in Emilia-Romagna, Lombardy and Piedmont regions by means of a process evaluation. We examined the system's implementation fidelity, dose delivered and received, reach, and we identified strengths and weaknesses in the system. Qualitative and semi-quantitative data were obtained from three regional focus groups. Data were discussed in a follow up focus group, where participants suggested recommendations for improving the surveillance system. Inter-institutional and interdisciplinary integration and the creation of a 'community of practice' were identified as key elements for effective surveillance. We identified differences in the degree of interdisciplinary integration in the three regions, likely due to different epidemiological situations and years of experience in surveillance implementation. Greater collaboration and sharing of information, public engagement and economic assessments of the integrated surveillance approach would facilitate its social recognition and guarantee its sustainability through dedicated funding. We demonstrate that a transdisciplinary research approach based on process evaluation has value for designing and fine-tuning integrated health surveillance systems.