Helping working Equidae and their owners in developing countries: monitoring and evaluation of evidence-based interventions

There are an estimated 112 million Equidae (horses, donkeys, mules) in the developing world, providing essential resources for their owners' livelihoods and well-being. The impoverished situation of their owners and the often harsh conditions in which they work mean that the animals' welfare is a cause for concern. A number of equine non-governmental organisations (NGOs) operate within working equid communities providing veterinary care, education and training programmes aimed at improving equine welfare. However, there is little published information available that describes monitoring and evaluation (M&E) of such interventions using objective outcome-based indicators and where baseline data are available. The aim of this paper is to summarise the peer-reviewed reports of M&E in this sector and identify the key issues which need to be addressed in ensuring that such evaluations provide useful information on the work of these organisations. A rigorous evidence base for designing future interventions will provide an opportunity for enhancing the effectiveness of working equid NGO operations. Increased availability of M&E reports in the peer-reviewed literature will enable NGOs to learn from one another and disseminate to a wider audience information on the role of working Equidae and the issues they face.

Quantitative versus qualitative approaches: a comparison of two research methods applied to identification of key health issues for working horses in Lesotho

The relative merits and potential complementarity of participatory methods and classical epidemiological techniques in veterinary-related research is a current topic of discussion. Few reported studies have applied both methodologies within the same research framework to enable direct comparison. The aim of this study was to compare issues identified by a classical epidemiological study of horses and their owners with those identified by owner communities using participatory approaches. In 2009, a cross-sectional survey was undertaken as part of an impact assessment study of farrier and saddler training programmes, and a small-scale nutrition trial, implemented in Lesotho by a UK-based equine charity. In total, 245 horses and their 237 owners participated in the survey which comprised a face-to-face structured questionnaire covering knowledge and practices relating to equine husbandry and primary healthcare, clinical examination and sampling of horses, and examination of tack used on those horses. In early 2010, 56 owners in three survey regions, some of whom participated in the survey, attended a participatory workshop. Each workshop group created a local resource map whilst discussing and identifying key issues associated with horse ownership and what might have an adverse impact on horse health and work. Following map completion, each group began by prioritising the identified issues, and then ranked them using a pairwise/ranking matrix to reflect how important issues were in relation to each other. Overall priority issues were: mouth problems, hunger and nutrition, diseases (including infectious diseases, parasites and colic), husbandry (including wound management), and feet and limb problems. Major health issues identified by cross-sectional study included sharp enamel points on teeth, endo- and ectoparasite infestation, suboptimal nutrition, tack-associated wounds, overgrown and poorly balanced feet and poor owner husbandry knowledge and practices. Whilst common issues were identified through the two research approaches, key differences also emerged. The classical, more quantitative approach provided objective measurement of problem frequency, which was compared with owners' perceptions of importance. The qualitative participatory approach provided greater opportunity for researchers to gain detailed understanding of local issues and appreciate how owners defined and prioritised problems affecting them and their animals. Both approaches provided valuable and complementary information that can be used to inform interventions aimed at providing sustainable improvements in the health and wellbeing of working animals and their owners. It is recommended that both quantitative and qualitative approaches are employed as part of detailed needs assessment work prior to defining and prioritising the charity's future interventions.

Understanding and managing zoonotic risk in the new livestock industries

BACKGROUND

In many parts of the world, livestock production is undergoing a process of rapid intensification. The health implications of this development are uncertain. Intensification creates cheaper products, allowing more people to access animal-based foods. However, some practices associated with intensification may contribute to zoonotic disease emergence and spread: for example, the sustained use of antibiotics, concentration of animals in confined units, and long distances and frequent movement of livestock.

OBJECTIVES

Here we present the diverse range of ecological, biological, and socioeconomic factors likely to enhance or reduce zoonotic risk, and identify ways in which a comprehensive risk analysis may be conducted by using an interdisciplinary approach. We also offer a conceptual framework to guide systematic research on this problem.

DISCUSSION

We recommend that interdisciplinary work on zoonotic risk should take into account the complexity of risk environments, rather than limiting studies to simple linear causal relations between risk drivers and disease emergence and/or spread. In addition, interdisciplinary integration is needed at different levels of analysis, from the study of risk environments to the identification of policy options for risk management.

CONCLUSION

Given rapid changes in livestock production systems and their potential health implications at the local and global level, the problem we analyze here is of great importance for environmental health and development. Although we offer a systematic interdisciplinary approach to understand and address these implications, we recognize that further research is needed to clarify methodological and practical questions arising from the integration of the natural and social sciences.

An assessment of the feasibility of a poultry tracing scheme for smallholders in Vietnam

Tracing movements could assist the implementation of bio-containment measures during a disease outbreak. To evaluate the potential for implementing a tracing system for a poultry supply chain in northern Vietnam, a four-month longitudinal study was conducted to identify marketing practices associated with poultry traceability. Poultry sold in batches were traced between farms and markets, and their traceability was assessed upon market arrival. A total of 315 batches were released from the farms; 37% arrived at a market, from which 57.3% were 'traceable'. The results of the multivariable analysis showed that traceability was associated with farms operating through no more than two traders (Odds ratio [OR] = 5.97, 95% CI 1.15-30.92) and batches brought to the market on the day of purchase (OR = 4.05, 95% CI 1.23-13.27). No specific incentives were provided to farmers or traders. Results suggest that there is potential for implementing a poultry traceability scheme, although the tracing methodology should be refined.

The incidence of feline injection site sarcomas in the United Kingdom

Background

Feline injection site sarcomas (FISS) are aggressive neoplasms that have been associated with vaccination. In North America the incidence estimates have varied from 1 case of FISS per 1,000-10,000 cats vaccinated. The aim of this study was to estimate the incidence of FISS in the United Kingdom (UK) in 2007. The ratio of FISS to vaccines sold in the UK was also estimated.

Fourteen FISS were diagnosed by a convenience sample of 34 small animal veterinary practices in the United Kingdom in 2007 and were used as the numerator for the incidence estimates. Denominator data was obtained from the computer systems of each practice. Considering that a single cause relationship with vaccination is not proven, three different denominators (number of cats registered, the number of cat consultations undertaken and the number of vaccination visits for cats at the practices) were used to express the potential variation in risk.

Results

The incidence risk of FISS per year was estimated to be 1/16,000 -50,000 cats registered by practices, 1/10,000-20,000 cat consultations and 1/5,000-12,500 vaccination visits.

Conclusion

When interpreting these findings, it needs to be taken into consideration that this sample of practices and their cats may not be representative of veterinary practices and cats at risk of FISS in the UK. However it can still be concluded with reasonable certainty that the incidence of FISS in the UK is very low.

Rinderpest virus sequestration and use in posteradication era

After the 2011 declaration of rinderpest disease eradication, we surveyed 150 countries about rinderpest virus stocks. Forty-four laboratories in 35 countries held laboratory-attenuated strains, field strains, or diagnostic samples. Vaccine and reagent production and laboratory experiments continued. Rigorous standards are necessary to ensure that stocks are kept under safe conditions.

Live poultry trade in Southern China provinces and HPAIV H5N1 infection in humans and poultry: the role of Chinese New Year festivities

Background

The number of outbreaks of highly pathogenic avian influenza virus of the H5N1 subtype (HPAIV H5N1) over the past 5 years has been drastically reduced in China but sporadic infections in poultry and humans are still occurring. In this study, we aimed to investigate seasonal patterns in the association between the movement of live poultry originating from southern China and HPAIV H5N1 infection history in humans and poultry in China.

Methodology/Principal Findings

During January to April 2010, longitudinal questionnaire surveys were carried out monthly in four wholesale live bird markets (LBMs) in Hunan and Guangxi provinces of South China. Using social network analysis, we found an increase in the number of observed links and degree centrality between LBMs and poultry sources in February and March compared to the months of January and April. The association of some live poultry traders (LPT’s) with a limited set of counties (within the catchment area of LBMs) in the months of February and March may support HPAIV H5N1 transmission and contribute to perpetuating HPAIV H5N1 virus circulation among certain groups of counties. The connectivity among counties experiencing human infection was significantly higher compared to counties without human infection for the months of January, March and April. Conversely, counties with poultry infections were found to be significantly less connected than counties without poultry infection for the month of February.

Conclusions/Significance

Our results show that temporal variation in live poultry trade in Southern China around the Chinese New Year festivities is associated with higher HPAIV H5N1 infection risk in humans and poultry. This study has shown that capturing the dynamic nature of poultry trade networks in Southern China improves our ability to explain the spatiotemporal dissemination in avian influenza viruses in China.

Epidemiology of African swine fever virus

African swine fever virus used to occur primarily in Africa. There had been occasional incursions into Europe or America which apart from the endemic situation on the island of Sardinia always had been successfully controlled. But following an introduction of the virus in 2007, it now has expanded its geographical distribution into Caucasus and Eastern Europe where it has not been controlled, to date. African swine fever affects domestic and wild pig species, and can involve tick vectors. The ability of the virus to survive within a particular ecosystem is defined by the ecology of its wild host populations and the characteristics of livestock production systems, which influence host and vector species densities and interrelationships. African swine fever has high morbidity in naïve pig populations and can result in very high mortality. There is no vaccine or treatment available. Apart from stamping out and movement control, there are no control measures, thereby potentially resulting in extreme losses for producers. Prevention and control of the infection requires good understanding of its epidemiology, so that targeted measures can be instigated.

Risk factor modelling of the spatio-temporal patterns of highly pathogenic avian influenza (HPAIV) H5N1: a review

Highly pathogenic avian influenza virus (HPAIV) H5N1 continues to impact on smallholder livelihoods, to constrain development of the poultry production sector, and to cause occasional human fatalities. HPAI H5N1 outbreaks have occurred in a variety of ecological systems with economic, agricultural and environmental differences. This review aimed to identify common risk factors amongst spatial modelling studies conducted in these different agro-ecological systems, and to identify gaps in our understanding of the disease's spatial epidemiology. Three types of variables with similar statistical association with HPAI H5N1 presence across studies and regions were identified: domestic waterfowl, several anthropogenic variables (human population density, distance to roads) and indicators of water presence. Variables on socio-economic conditions, poultry trade, wild bird distribution and movements were comparatively rarely considered. Few studies have analysed the HPAI H5N1 distribution in countries such as Egypt and Indonesia, where HPAIV H5N1 continues to circulate extensively.

Exploratory space-time analyses of Rift Valley Fever in South Africa in 2008-2011

BACKGROUND

Rift Valley fever (RVF) is a zoonotic arbovirosis for which the primary hosts are domestic livestock (cattle, sheep and goats). RVF was first described in South Africa in 1950-1951. Mechanisms for short and long distance transmission have been hypothesised, but there is little supporting evidence. Here we describe RVF occurrence and spatial distribution in South Africa in 2008-11, and investigate the presence of a contagious process in order to generate hypotheses on the different mechanisms of transmission.

METHODOLOGY/PRINCIPAL FINDINGS

A total of 658 cases were extracted from World Animal Health Information Database. Descriptive statistics, epidemic curves and maps were produced. The space-time K-function was used to test for evidence of space-time interaction. Five RVF outbreak waves (one in 2008, two in 2009, one in 2010 and one in 2011) of varying duration, location and size were reported. About 70% of cases (n = 471) occurred in 2010, when the epidemic was almost country-wide. No strong evidence of space-time interaction was found for 2008 or the second wave in 2009. In the first wave of 2009, a significant space-time interaction was detected for up to one month and over 40 km. In 2010 and 2011 a significant intense, short and localised space-time interaction (up to 3 days and 15 km) was detected, followed by one of lower intensity (up to 2 weeks and 35 to 90 km).

CONCLUSIONS/SIGNIFICANCE

The description of the spatiotemporal patterns of RVF in South Africa between 2008 and 2011 supports the hypothesis that during an epidemic, disease spread may be supported by factors other than active vector dispersal. Limitations of under-reporting and space-time K-function properties are discussed. Further spatial analyses and data are required to explain factors and mechanisms driving RVF spread.

A cross-sectional study to compare changes in the prevalence and risk factors for feline obesity between 1993 and 2007 in New Zealand

It has been suggested that the prevalence of feline obesity has increased recently in parallel with the prevalence of obesity in the human population. We had previously determined the prevalence of obesity in an urban New Zealand population of cats in 1993. This study was conducted to determine the prevalence and risk factors of obesity in the same population base, one generation (15 years) later. It was also designed to test the hypothesis that the increase in feeding of energy dense "premium" dry foods to cats in the region was associated with any change in obesity prevalence. A door-to-door survey, conducted within the city limits of Palmerston North, obtained data on the environment, diet, health and behaviour of 200 cats. The interviewers used a validated scoring system to assess the body condition score (BCS) of each cat and this was used as the outcome variable of interest. Variables were grouped into four risk-factor groupings for stepwise logistic regression, namely cat characteristics, feeding variables, owner's perception of their cat, and household characteristics. Using the same definition for overweight and obese as that used in the 1993 study (BCS>6/9), the prevalence of obesity was 27%, compared with 26% in 1993. In this study, 63% of cats had a BCS of 6/9 or greater. Variables that were identified as significant from each model (p ≤ 0.1) were included in a combined model. In this model, only three variables were significant: owner underestimation of the body condition of the cat, the cat's leg length, and its age. Thus, we found no evidence to support the hypothesis that the prevalence of obesity in this population has increased, or that changes in feeding practices have affected obesity incidence. The lack of any feeding variables in the combined model is noteworthy. From a population health perspective, the association between obesity and owner's perception of their cat's body condition suggests that more attention should be directed towards 'normalising' the public's view of what a cat's normal body condition is, rather than placing the educational emphasis on changing cats' feeding patterns or food types.

Identification of potential risk factors associated with highly pathogenic avian influenza subtype H5N1 outbreak occurrence in Lagos and Kano States, Nigeria, during the 2006-2007 epidemics

Highly pathogenic avian influenza HPAI H5N1 was first reported in Africa in 2006, in Nigeria. The country experienced severe outbreaks in 2006 and 2007, strongly affecting the poultry population. Current knowledge on potential risk factors for HPAI H5N1 occurrence in poultry farms in Nigeria is limited. Therefore, we conducted a case-control study to identify potential farm-level risk factors for HPAI H5N1 occurrence in two areas of the country that were affected by the disease in 2006 and 2007, namely the States of Lagos and Kano. A case-control study was conducted at the farm level. A convenience sample of 110 farms was surveyed. Data on farm characteristics, farm management and trade practices were collected. Logistic regression was used to identify factors associated with farms that confirmed positive for HPAI. Having a neighbouring poultry farm was identified as a potential risk factor for disease occurrence [OR, 5.23; 95% CI, (0.88-30.97); P-value = 0.048]. Farm staff washing their hands before handling birds was a protective factor [OR, 0.14; 95% CI, (0.05-0.37); P-value <0.001], as well as not allowing traders to enter the farm [OR, 0.23; 95% CI, (0.08-0.70); P-value = 0.008]. Our study highlighted the importance of trade and proximity between poultry farms in the epidemiology of HPAI H5N1 and the role of biosecurity in disease prevention in Kano and Lagos States. Despite the limitations owing to the sampling strategy, these results are consistent with other risk factor studies previously conducted on HPAI H5N1 in both Africa and other regions, suggesting similar risk factor patterns for HPAI H5N1 virus spread and substantiating current knowledge regarding the epidemiology of the disease. Finally, this study generated information from areas where data are difficult to obtain.

Risk-based surveillance for avian influenza control along poultry market chains in South China: The value of social network analysis

Over the past two decades, the poultry sector in China went through a phase of tremendous growth as well as rapid intensification and concentration. Highly pathogenic avian influenza virus (HPAIV) subtype H5N1 was first detected in 1996 in Guangdong province, South China and started spreading throughout Asia in early 2004. Since then, control of the disease in China has relied heavily on wide-scale preventive vaccination combined with movement control, quarantine and stamping out. This strategy has been successful in drastically reducing the number of outbreaks during the past 5years. However, HPAIV H5N1 is still circulating and is regularly isolated in traditional live bird markets (LBMs) where viral infection can persist, which represent a public health hazard for people visiting them. The use of social network analysis in combination with epidemiological surveillance in South China has identified areas where the success of current strategies for HPAI control in the poultry production sector may benefit from better knowledge of poultry trading patterns and the LBM network configuration as well as their capacity for maintaining HPAIV H5N1 infection. We produced a set of LBM network maps and estimated the associated risk of HPAIV H5N1 within LBMs and along poultry market chains, providing new insights into how live poultry trade and infection are intertwined. More specifically, our study provides evidence that several biosecurity factors such as daily cage cleaning, daily cage disinfection or manure processing contribute to a reduction in HPAIV H5N1 presence in LBMs. Of significant importance is that the results of our study also show the association between social network indicators and the presence of HPAIV H5N1 in specific network configurations such as the one represented by the counties of origin of the birds traded in LBMs. This new information could be used to develop more targeted and effective control interventions.

Cross-sectional survey of owner knowledge and husbandry practices, tack and health issues affecting working horses in Lesotho

REASONS FOR PERFORMING STUDY

To establish baseline parameters of equine health, owner knowledge and husbandry practices and tack against which benefits to local horses arising from an equine charity's training programme in Lesotho could be measured.

OBJECTIVES

To describe and investigate associations between owner knowledge and equine husbandry practices, horse health and tack-related parameters prior to the start of the training programme.

METHODS

A cross-sectional survey was undertaken in the catchment area of students attending the first training course. Owners from randomly selected villages were interviewed about horse care using a standardised, structured questionnaire, administered face to face in local language. Horses were clinically examined and tack assessed according to standardised protocols.

RESULTS

Clinical examinations were performed on 312 horses and 287 owners were interviewed. Owners had variable knowledge of equine husbandry and limited understanding of appropriate primary and preventive healthcare. Equine health problems identified included ecto- and endoparasite infestation, mouth lesions, overgrown and unbalanced feet and tack-associated wounds. The majority of tack was in poor condition, dirty and ill-fitting. With the exception of below-average body condition score, no associations were found between key adverse horse-related clinical findings and owners reporting their horse as being 'unhealthy'.

CONCLUSIONS

Working horses in Lesotho have a range of physical problems, many of which could be ameliorated through targeted owner education. With limited access to veterinary advice and scarce resources, improved availability of affordable local equine trade skills is key to improving equine health.

POTENTIAL RELEVANCE

Findings could be used to inform and direct training programmes to maximise benefits to equine health and to serve as a baseline against which to monitor effects of educational and other interventions.

Spatial modelling of disease using data- and knowledge-driven approaches

The purpose of spatial modelling in animal and public health is three-fold: describing existing spatial patterns of risk, attempting to understand the biological mechanisms that lead to disease occurrence and predicting what will happen in the medium to long-term future (temporal prediction) or in different geographical areas (spatial prediction). Traditional methods for temporal and spatial predictions include general and generalized linear models (GLM), generalized additive models (GAM) and Bayesian estimation methods. However, such models require both disease presence and absence data which are not always easy to obtain. Novel spatial modelling methods such as maximum entropy (MAXENT) and the genetic algorithm for rule set production (GARP) require only disease presence data and have been used extensively in the fields of ecology and conservation, to model species distribution and habitat suitability. Other methods, such as multicriteria decision analysis (MCDA), use knowledge of the causal factors of disease occurrence to identify areas potentially suitable for disease. In addition to their less restrictive data requirements, some of these novel methods have been shown to outperform traditional statistical methods in predictive ability (Elith et al., 2006). This review paper provides details of some of these novel methods for mapping disease distribution, highlights their advantages and limitations, and identifies studies which have used the methods to model various aspects of disease distribution.

Rift Valley fever epidemiology, surveillance, and control: what have models contributed?

BACKGROUND

Rift Valley fever (RVF) is an emerging vector-borne zoonotic disease that represents a threat to human health, animal health, and livestock production, particularly in Africa. The epidemiology of RVF is not well understood, so that forecasting RVF outbreaks and carrying out efficient and timely control measures remains a challenge. Various epidemiological modeling tools have been used to increase knowledge on RVF epidemiology and to inform disease management policies.

AIM

This narrative review gives an overview of modeling tools used to date to measure or model RVF risk in animals, and presents how they have contributed to increasing our understanding of RVF occurrence or informed RVF surveillance and control strategies.

METHODOLOGY

Systematic literature searches were performed in PubMed and ISI Web of Knowledge. Additional research work was identified from other sources.

RESULTS

Literature was scarce. Research work was highly heterogeneous in methodology, level of complexity, geographic scale of approach, and geographical area of study. Gaps in knowledge and data were frequent, and uncertainty was not always explored. Spatial approaches were the most commonly utilized techniques and have been used at both local and continental scales, the latter leading to the implementation of an early warning system. Three articles using dynamic transmission models explored the potential of RVF endemicity. Risk factor studies identified water-related environmental risk factors associated with RVF occurrence in domestic livestock. Risk assessments identified importation of infected animals, contaminated products, or infected vectors as key risk pathways for the introduction of RVF virus into disease-free areas.

CONCLUSIONS

Enhanced outbreak prediction and control and increased knowledge on RVF epidemiology would benefit from additional field data, continued development, and refinement of modeling techniques for exploring plausible disease transmission mechanisms and the impact of intervention strategies.

Within-herd contact structure and transmission of Mycobacterium avium subspecies paratuberculosis in a persistently infected dairy cattle herd

Within-herd transmission of pathogens occurs either by direct or by indirect contact between susceptible and infected animals. In dairy herds that are structured into groups, the way in which animals encounter each other and share an environment can affect pathogen transmission. Dairy cattle are heterogeneous in terms of susceptibility and infectivity with respect to Mycobacterium avium subspecies paratuberculosis (Map) transmission. It is mainly young animals that are susceptible and adults that are infectious. Both vertical and horizontal transmission through the ingestion of Map shed into the environment by adults and transiently infected calves can occur. Our objective was to assess the effect of contact structure on Map transmission in persistently infected dairy herds and to examine the effect of isolating calves from other calves or from adults before weaning. We developed a stochastic compartmental model of Map transmission in a closed dairy herd. The model reflects the Map infection process and herd management characteristics. Indirect transmission via the environment was modelled explicitly. Six infection states (susceptible, resistant, transiently infectious, latently infected, subclinically infected, and clinically affected) and two contaminated farm area environments (whole farm and calf area) were modelled. Calves were housed in hutches, individual indoor pens, or group indoor pens. Two different levels of exposure of calves to a farm environment contaminated by adults were possible: no exposure and indirect exposure through fomites. Three herd sizes were studied. We found that contacts between calves before weaning did not influence Map transmission in a herd, whereas the level of exposure of calves to an environment contaminated by adults and the starting age of exposure of calves to adults were pivotal. Early culling of clinically affected adults led to a lower prevalence of infectious adults over time. The results were independent of herd size. Despite the many transmission routes that are known, the best control approach is to limit the exposure of calves to adult faeces through the systematic separation of adults and calves in combination with hygiene measures. Reducing contact between calves does not appear effective.

Towards a conceptual framework to support one-health research for policy on emerging zoonoses

In the past two decades there has been a growing realisation that the livestock sector was in a process of change, resulting from an expansion of intensive animal production systems and trade to meet a globalised world's increasing demand for livestock products. One unintended consequence has been the emergence and spread of transboundary animal diseases and, more specifically, the resurgence and emergence of zoonotic diseases. Concurrent with changes in the livestock sector, contact with wildlife has increased. This development has increased the risk of transmission of infections from wildlife to human beings and livestock. Two overarching questions arise with respect to the real and perceived threat from emerging infectious diseases: why are these problems arising with increasing frequency, and how should we manage and control them? A clear conceptual research framework can provide a guide to ensure a research strategy that coherently links to the overarching goals of policy makers. We propose such a new framework in support of a research and policy-generation strategy to help to address the challenges posed by emerging zoonoses.

Spatial distribution and risk factors of highly pathogenic avian influenza (HPAI) H5N1 in China

Highly pathogenic avian influenza (HPAI) H5N1 was first encountered in 1996 in Guangdong province (China) and started spreading throughout Asia and the western Palearctic in 2004-2006. Compared to several other countries where the HPAI H5N1 distribution has been studied in some detail, little is known about the environmental correlates of the HPAI H5N1 distribution in China. HPAI H5N1 clinical disease outbreaks, and HPAI virus (HPAIV) H5N1 isolated from active risk-based surveillance sampling of domestic poultry (referred to as HPAIV H5N1 surveillance positives in this manuscript) were modeled separately using seven risk variables: chicken, domestic waterfowl population density, proportion of land covered by rice or surface water, cropping intensity, elevation, and human population density. We used bootstrapped logistic regression and boosted regression trees (BRT) with cross-validation to identify the weight of each variable, to assess the predictive power of the models, and to map the distribution of HPAI H5N1 risk. HPAI H5N1 clinical disease outbreak occurrence in domestic poultry was mainly associated with chicken density, human population density, and elevation. In contrast, HPAIV H5N1 infection identified by risk-based surveillance was associated with domestic waterfowl density, human population density, and the proportion of land covered by surface water. Both models had a high explanatory power (mean AUC ranging from 0.864 to 0.967). The map of HPAIV H5N1 risk distribution based on active surveillance data emphasized areas south of the Yangtze River, while the distribution of reported outbreak risk extended further North, where the density of poultry and humans is higher. We quantified the statistical association between HPAI H5N1 outbreak, HPAIV distribution and post-vaccination levels of seropositivity (percentage of effective post-vaccination seroconversion in vaccinated birds) and found that provinces with either outbreaks or HPAIV H5N1 surveillance positives in 2007-2009 appeared to have had lower antibody response to vaccination. The distribution of HPAI H5N1 risk in China appears more limited geographically than previously assessed, offering prospects for better targeted surveillance and control interventions.

Epidemiological study of pasture-associated laminitis and concurrent risk factors in the South of England

A retrospective study of laminitis was carried out to identify risk factors associated with this disease on an East Anglian farm with approximately 1000 animals living in an area of 1000 acres. Medical records between January 1997 and May 2000 and between April 2005 and March 2008 were reviewed, and the age, sex, weight (kg), height (inches [in] and hands [H]) and weight-to-height ratio (kg/in) was recorded. The prevalence, incidence and seasonality of laminitis were determined and their relationship to the monthly temperature, rainfall and hours of sunshine was evaluated. Averaged over the six years, the highest prevalence (2.6 per cent) and incidence (16 cases/1000 animals) of laminitis occurred in May. The findings of a multivariate analysis revealed that females (P=0.007, odds ratio [OR] 1.46, 95 per cent confidence interval [CI] 1.1053 to 1.9646) and light animals (P ≤ 0.001, OR=0.995, 95 per cent CI =0.9932 to 0.9963) had the greatest risk of developing laminitis. A positive association was found between hours of sunshine and incidence (P=0.007, relative risk [RR] 1.009, 95 per cent CI 1.001 to 1.012) and prevalence (P=0.002, RR 1.008, 95 per cent CI 1.003 to 1.012) of laminitis. The data suggest that there is a relationship between season, sex of the animal and the development of laminitis.