Infectious Abortions in Small Ruminants: Challenges for Diagnosis and Public Health.

In this study, we report an abortion outbreak in a ruminant herd consisting of goats, sheep, and cows, with scenarios in two consecutive years. In early 2017, abortions occurred in ∼70% of goats and 66% tested positive for Coxiella burnetii (C. burnetii) and 40% of goats were positive for Chlamydophila abortus (C. abortus). In February 2018, the same herd reported an abortion rate of 75%, with 55% positive for C. burnetii, 36% for C. abortus, and 22% for Toxoplasma gondii. Six goat milk samples were positive for C. burnetii by molecular analysis. Three family members were positive for C. burnetii. C. burnetii could be considered as the main cause of abortions in the first and second year. Animals that undergo an infection and abortion are prone to secondary infections. Vaccination or other rapid interventions should be initiated to protect animals and humans.

A case report of sporadic ovine listerial meningoencephalitis in Kosovo.

In 2018, a case of neural disease suspected of listeriosis was reported in a flock of sheep in Kosovo with the death of ewes and 5 lambs. Samples from the brain of only three dead animals were subjected to histopathological and bacteriological analysis. MALDI-TOF MS was applied to confirm suspected Listeria spp. isolates from culture and multiplex PCR was applied for molecular serotyping. All isolates were tested for antimicrobial susceptibility by microdilution broth method. The histopathological analysis of the brain specimens showed typical changes for Listeria monocytogenes. Listeria spp. was isolated in brain samples from all three animals, and all the isolates were confirmed using MALDI-TOF MS and PCR down to the species level (Listeria monocytogenes). The molecular characterisation using multiplex PCR revealed all isolates as Listeria monocytogenes serotype 4b. All L. monocytogenes isolates were found to be susceptible to penicillin, erythromycin, tetracycline, streptomycin, trimethoprim/sulfamethosazole, quinupristin/dalfopristin, kanamycin, vancomycin, and gentamicin but resistant to nitrofurantoin and lincomycin. This study shows the emergence of a highly virulent strain in sheep farms in Kosovo and a possible threat to public health.

Prevalence of Foodborne Pathogenic Bacteria, Microbial Levels of Hygiene Indicator Bacteria, and Concentrations of Biogenic Amines in Ready-to-Eat Meat Products at Retail in the Republic of Kosovo.

HIGHLIGHTS: RTE meat products from the Republic of Kosovo were tested for contamination. L. monocytogenes was more prevalent in dried or fermented than in cooked-cured meats. E. coli and Enterobacteriaceae were more prevalent in nonpackaged dried or fermented meats. Concentrations of biogenic amines were higher in dried or fermented than in cooked-cured meats.

Towards harmonisation of entomological surveillance in the Mediterranean area.

BACKGROUND: The Mediterranean Basin is historically a hotspot for trade, transport, and migration. As a result, countries surrounding the Mediterranean Sea share common public health threats. Among them are vector-borne diseases, and in particular, mosquito-borne viral diseases are prime candidates as (re)emerging diseases and are likely to spread across the area. Improving preparedness and response capacities to these threats at the regional level is therefore a major issue. The implementation of entomological surveillance is, in particular, of utmost importance. Guidance in designing entomological surveillance systems is critical, and these systems may pursue different specific objectives depending on the disease. The purpose of the proposed review is to draw up guidelines for designing effective and sustainable entomological surveillance systems in order to improve preparedness and response. However, we make it clear that there is no universal surveillance system, so the thinking behind harmonisation is to define evidence-based standards in order to promote best practises, identify the most appropriate surveillance activities, and optimise the use of resources. Such guidance is aimed at policymakers and diverse stakeholders and is intended to be used as a framework for the implementation of entomological surveillance programmes. It will also be useful to collaborate and share information with health professionals involved in other areas of disease surveillance. Medical entomologists and vector control professionals will be able to refer to this report to advocate for tailored entomological surveillance strategies. The main threats targeted in this review are the vectors of dengue virus, chikungunya virus, Zika virus, West Nile virus, and Rift Valley fever virus. The vectors of all these arboviruses are mosquitoes. METHODS: Current knowledge on vector surveillance in the Mediterranean area is reviewed. The analysis was carried out by a collaboration of the medical entomology experts in the region, all of whom belong to the MediLabSecure network, which is currently funded by the European Union and represents an international effort encompassing 19 countries in the Mediterranean and Black Sea region. FINDINGS: Robust surveillance systems are required to address the globalisation of emerging arboviruses. The prevention and management of mosquito-borne viral diseases must be addressed in the prism of a One Health strategy that includes entomological surveillance as an integral part of the policy. Entomological surveillance systems should be designed according to the entomological and epidemiological context and must have well-defined objectives in order to effect a tailored and graduated response. We therefore rely on different scenarios according to different entomological and epidemiological contexts and set out detailed objectives of surveillance. The development of multidisciplinary networks involving both academics and public authorities will provide resources to address these health challenges by promoting good practises in surveillance (identification of surveillance aims, design of surveillance systems, data collection, dissemination of surveillance results, evaluation of surveillance activities) and through the sharing of effective knowledge and information. These networks will also contribute to capacity building and stronger collaborations between sectors at both the local and regional levels. Finally, concrete guidance is offered on the vector of the main arbovirus based on the current situation in the area.

Identification of mosquitoes (Diptera: Culicidae): an external quality assessment of medical entomology laboratories in the MediLabSecure Network.

BACKGROUND: Identification of vectors is of prime importance in the field of medical entomology for both operational and research purposes. An external quality assessment of mosquito identification capacities was carried out within the MediLabSecure Network, which is composed of laboratories located in 19 countries close to the European Union around the Mediterranean and Black seas. METHODS: A set of blind samples consisting of 7 or 8 adult mosquitoes and 4 larvae was given to each participant laboratory. In all, 138 adult mosquitoes and 76 larvae of different species were distributed for genus and species identification. RESULTS: All identifications were exclusively morphology based. Overall, 81% of identifications were correct at the genus level, 64% at the species level. The results were highly varied among the 19 participating laboratories. The levels of correct identifications were: 100% (three laboratories), 90-95% (four laboratories), 50-75% (six laboratories) and < 50% (six laboratories). CONCLUSIONS: This evaluation showed the need to maintain efforts in capacity building and quality control in the field of medical entomology and, more specifically, in the morphological identification of the Culicidae.

Short communication: A countrywide survey of antimicrobial-resistant indicator bacteria in Kosovo's dairy farms.

The World Health Organization recently recognized the Republic of Kosovo as one of the highest consumers per capita of antibiotics for human use among non-European Union Eastern European countries; however, data are limited regarding antimicrobial usage and antimicrobial resistance in the livestock sector for this recently formed country. The objective of this study was to conduct the first nationwide survey of antimicrobial resistance phenotypes in indicator bacteria collected from dairy farms in Kosovo. Composite fecal samples were collected from 52 farms located within all 7 administrative districts of Kosovo in the summer of 2014. Isolation and characterization of the indicator bacteria Escherichia coli (n = 165) and Enterococcus spp. (n = 153) from these samples was achieved by culturing on selective/differential media with and without select antibiotics, followed by MALDI-TOF (matrix-assisted laser desorption/ionization time-of-flight) mass spectrometry-based identification and antimicrobial susceptibility testing using the disk diffusion method. When no selective pressure was applied in culture-based isolation, the majority of E. coli and Enterococcus spp. collected were resistant to ≤1 of 16 and ≤2 of 12 antibiotics tested, respectively. In contrast, E. coli and Enterococcus spp. isolated using sub-minimum inhibitory concentrations of cefoxitin, ciprofloxacin, or erythromycin were typically resistant to at least one and often multiple antibiotic types, which primarily consisted of certain ß-lactams, quinolones, sulfonamides, phenicols, and tetracyclines for E. coli isolates and macrolides, tetracyclines, and rifamycins for enterococci isolates.

Associations Between the Level of Biosecurity and Occurrence of Dermanyssus gallinae and Salmonella spp. in Layer Farms.

Salmonella and the poultry red mite (Dermanyssus gallinae) remain very challenging diseases for the poultry industry worldwide because of the inefficiency of implementing and integrating eradication and control programs, which results in very high economic losses to the poultry industry. The aim of this study was to determine the association between biosecurity levels in layer farms and the occurrence of both D. gallinae and Salmonella spp., as well as the relationship between D. gallinae infestations on farms and Salmonella occurrence. For this purpose, 22 layer farms using the common battery cage housing system in different parts of Kosovo were randomly selected and analyzed for the presence of D. gallinae and Salmonella in samples, such as feces, water, feed, and dust. Two pooled samples of D. gallinae (2n = 100) were directly analyzed for the presence of Salmonella in the outer and inner parts of cuticula from D. gallinae. A chi-square test was used to determine the association between experience in poultry production, rearing, and level of different biosecurity elements in relation to the occurrence of D. gallinae and Salmonella. Dermanyssus gallinae was found on 15 farms, whereas Salmonella was found on eight of those 15 farms from different environmental samples and on one farm where D. gallinae was not found. In two pooled samples Salmonella was isolated directly from the inner part of the cuticula from D. gallinae, which represents the first direct isolation of Salmonella from D. gallinae mites. Association between the level of biosecurity and the occurrence of D. gallinae and Salmonella was strong. The study indicates that proper biosecurity measures should be in place to lower the occurrence of D. gallinae and Salmonella.

Detection of patent infections of Echinococcus granulosus ("sheep-strain", G1) in naturally infected dogs in Kosovo.

A survey was carried out to assess the occurrence of canine echinococcosis in naturally infected dogs in Kosovo. Using the flotation-ovassay technique, taeniid eggs were found in 23 (7.5%) out of a total of 305 dogs. Eggs from other helminths were detected as well: hookworms 139 (45.5%), Trichuris sp. 87 (28.5%), Toxocara sp. 42 (13.7%), Toxascaris leonina 21 (6.8%) and Dipylidium caninum eight (2.6%). From 21 of the 305 samples (6.9%), taeniids eggs could be collected. Using PCR primers specific for Echinococcus granulosus ("sheep strain", G1), four of these samples (1.3%) resulted positive. The E. granulosus isolates originated from each one stray dog, hunting dog, sheepdog and pet dog. A semi-quantitative analysis showed low to moderate egg counts (2-10 per 1 g faeces) in dogs positive for E. granulosus ("sheep strain", G1) whereas specimens with high (11-20) or very high numbers (> 20) of taeniid eggs were negative in the E. granulosus PCR. Using specific primers for the detection of E. multilocularis, all samples containing taeniid eggs were negative. This is the first report on identification of E. granulosus in dogs from Kosovo where human cystic echinococcosis is a significant medical problem.

Dermanyssus gallinae in layer farms in Kosovo: a high risk for Salmonella prevalence.

BACKGROUND: The poultry red mite (PRM), Dermanyssus gallinae (D.g.) is a serious ectoparasitic pest of poultry and potential pathogen vector. The prevalence of D. g. and the prevalence of Salmonella spp. within mites on infested laying poultry farms were investigated in Kosovo. FINDINGS: In total, 14 populated layer farms located in the Southern Kosovo were assessed for D. g. presence. Another two farms in this region were investigated 6 months after depopulation. Investigated flocks were all maintained in cages, a common housing system in Kosovo. A total of eight farms were found to be infested with D. g. (50%) at varying levels, including the two depopulated farms. The detection of Salmonella spp. from D. g. was carried out using PCR. Out of the eight layer farms infested with D. g., Salmonella spp. was present in mites on three farms (37.5%). CONCLUSIONS: This study confirms the high prevalence of D. g. in layer flocks in Kosovo and demonstrates the link between this mite and the presence of Salmonella spp. on infested farms.