Quantitative and qualitative assessment of the bovine abortion surveillance system in France

Flow of information for bovine health surveillance: Two socio-economic models demonstrating the impact of the organisational profiles of local actors

Passive surveillance is based on spontaneous reporting to veterinary authorities of disease suspicions by farmers and other stakeholders in animal production. Stakeholders are considered "actors" in sociology of organisations research. In veterinary public health, passive surveillance is considered to be the most effective method to detect disease outbreaks and to generate epidemiological information for decision-making on surveillance and control strategies. Nevertheless, under-reporting of cases is an inherent problem, reducing the ability of the system to rapidly detect infected animals. Previous studies have shown, for example, that passive surveillance for bovine brucellosis in France, through compulsory reporting of all bovine abortions, has limited sensitivity, with variability in reporting rates despite similar cattle farming profiles. Based on this observation and on sociological literature in health surveillance, we hypothesised that oversight organisational factors in different areas influence health actor contributions to passive surveillance. Therefore, to improve the efficiency of surveillance systems, we need to understand the organisational levers (supporting factors) and organisational drags (hindering factors) on the production and dissemination of health information. We conducted semi-structured interviews with the surveillance actors in two administrative geographic divisions in France (Departments A and B) with similar cattle farming profiles but contrasting abortion reporting rates (low and high, respectively). We assumed that these rates were related to health actor organisation in each administrative division. We mapped actor relationships and looked for behavioural recurrences and differences between the two departments. This analysis led to two socio-economic models explaining the configurations observed: pro-curative in Department A, and pro-preventive in Department B. These models showed a link between the level of competition endured by veterinarians on the sale of veterinary medicinal products and the overall contribution of the actors to health surveillance. The pro-preventive model had a higher contribution to surveillance than the pro-curative model. Importantly, the nature of the information produced in this configuration of actors corresponded to the needs of surveillance, providing collective and early information that circulated more readily between actors. We highlighted three characteristics that help to identify the configuration of a system of actors: 1) the pressure of competition exerted on veterinarian activities; 2) the dominant business model and form of organisation of veterinary clinics; and 3) the frequency of interactions between the main surveillance actors outside of crises. The first two characteristics affect the local contribution to data reporting for surveillance, and the third affects network responsiveness in a health crisis.

Factors influencing the performance of voluntary farmer disease reporting in passive surveillance systems: A scoping review

The impacts of exotic disease incursions on livestock industries can be mitigated by having robust surveillance systems in place that decrease the time between disease introduction and detection. An important component of this is having farmers routinely observe their animals for indications of clinical disease, recognise the existence of problems, and then decide to notify their veterinarian or animal health authorities. However, as highlighted by this literature review, farmers are believed to be underreporting clinical events due to factors such as (1) uncertainty around the clinical signs and situations that warrant reporting, (2) fear over the social and economic consequences from both positive and false positive reports, (3) negative beliefs regarding the efficacy and outcomes of response measures, (4) mistrust and dissatisfaction with animal health authorities, (5) absence of sufficiently attractive financial and non-financial incentives for submitting reports, and (6) poor awareness of the procedures involved with the submission, processing, and response to reports. There have been few formal studies evaluating the efficacy of different approaches to increasing farmer engagement with disease reporting. However, there is a recognised need for any proposed solutions to account for farmer knowledge and experience with assessing their own farm situation as well as the different identities, motivations, and beliefs that farmers have about their role in animal health surveillance systems. Empowering farmers to take a more active role in developing these solutions is likely to become even more important as animal health authorities increasingly look to establish public-private partnerships for biosecurity governance.

Modelling the Spatial Distribution of ASF-Positive Wild Boar Carcasses in South Korea Using 2019-2020 National Surveillance Data

Simple Summary

Since African swine fever (ASF) virus in wild boar populations can spill over to domestic pigs, it is crucial to understand the disease determinants in the wild compartment. However, the imperfect detection sensitivity of wild boar surveillance jeopardizes our ability to understand ASF spatial distribution. In this study, we used national surveillance data of ASF in wild boars collected in the Republic of Korea from 2019–2020 to model the spatial distribution of ASF-positive carcasses for two successive study periods associated with different surveillance intensity. The model allowed us to identify disease risk factors in the Republic of Korea, determine the spatial distribution of the risk of ASF, and estimate the sensitivity of surveillance. The outputs of this study are relevant to policy makers for developing and improving risk-based surveillance programs for ASF in wild boars.

Abstract

In September 2019, African swine fever (ASF) was reported in South Korea for the first time. Since then, more than 651 ASF cases in wild boars and 14 farm outbreaks have been notified in the country. Despite the efforts to eradicate ASF among wild boar populations, the number of reported ASF-positive wild boar carcasses have increased recently. The purpose of this study was to characterize the spatial distribution of ASF-positive wild boar carcasses to identify the risk factors associated with the presence and number of ASF-positive wild boar carcasses in the affected areas. Because surveillance efforts have substantially increased in early 2020, we divided the study into two periods (2 October 2019 to 19 January 2020, and 19 January to 28 April 2020) based on the number of reported cases and aggregated the number of reported ASF-positive carcasses into a regular grid of hexagons of 3-km diameter. To account for imperfect detection of positive carcasses, we adjusted spatial zero-inflated Poisson regression models to the number of ASF-positive wild boar carcasses per hexagon. During the first study period, proximity to North Korea was identified as the major risk factor for the presence of African swine fever virus. In addition, there were more positive carcasses reported in affected hexagons with high habitat suitability for wild boars, low heat load index (HLI), and high human density. During the second study period, proximity to an ASF-positive carcass reported during the first period was the only significant risk factor for the presence of ASF-positive carcasses. Additionally, low HLI and elevation were associated with an increased number of ASF-positive carcasses reported in the affected hexagons. Although the proportion of ASF-affected hexagons increased from 0.06 (95% credible interval (CrI): 0.05–0.07) to 0.09 (95% CrI: 0.08–0.10), the probability of reporting at least one positive carcass in ASF-affected hexagons increased from 0.49 (95% CrI: 0.41–0.57) to 0.73 (95% CrI: 0.66–0.81) between the two study periods. These results can be used to further advance risk-based surveillance strategies in the Republic of Korea.

Investigation of bovine abortion and stillbirth/perinatal mortality - similar diagnostic challenges, different approaches

This pracademic paper reviews current bovine foetopathy (abortion and stillbirth) case definitions, reporting and triage, and causes and time-of-death and proposes veterinary practitioner-focused investigative standard operating procedures (SOPs). Issues of under- and over-triage and intra-institutional SOP harmonisation are also discussed. It is proposed that an ‘observable abortion’ (120–260 days of gestation) is a more practitioner-friendly definition of abortion for reporting and benchmarking purposes and that the term ‘peristillbirth’ can replace stillbirth and perinatal mortality. Diagnosis of bovine foetopathy involves an investigative triad of the farmer, veterinary practitioner and the veterinary diagnostic laboratory. However, the poor sensitivity of abortion reporting undermines the value of currently adopted scanning/passive surveillance; parallel active surveillance/sentinel herd models should also be employed. The approach to abortion investigation differs from that of peristillbirth. The former should include collecting a herd and case history, examination and sampling of dam and cohorts and sampling of the foetus and placenta. A sample selection decision tree is provided to assist test selection. In peristillbirths, non-infectious and periparturient causes-of-death are more important hence the anamnesis must focus on peristillbirth risk factors and calving management. The foetopsy, while including the sampling menu appropriate to aborted foetuses, must also include a detailed internal and external examination of the carcass for lesions indicative of periparturient causes-of-death. In addition, for aborted foetuses the time-of-death is not important as the foetus is generally not viable; however, for the peristillbirth the time-of-death is critical as it provides useful information for the farmer to address modifiable risk factors and to alter their perinatal management. Reporting of the ultimate cause-of-death is more useful to prevent future abortions and peristillbirths though the proximate cause-of-death is often reported in the absence of a complete clinical anamnesis. Finally, the common reasons for diagnosis not reached (DNR) and the limitations of current investigative approaches are discussed.

Estimation of the frequency of Q fever in sheep, goat and cattle herds in France: results of a 3-year study of the seroprevalence of Q fever and excretion level of Coxiella burnetii in abortive episodes

A study was carried out, from 2012 to 2015, in 10 French départements to estimate the serological prevalence of Q fever and the frequency of abortive episodes potentially related to Coxiella burnetii in a large sample of cattle, sheep and goat herds. The serological survey covered 731 cattle, 522 sheep and 349 goat herds, randomly sampled. The frequency of abortive episodes potentially related to C. burnetii was estimated by investigating series of abortions in 2695 cattle, 658 sheep and 105 goat herds using quantitative polymerase chain reaction analyses and complementary serological results when needed. The average between-herd seroprevalence was significantly lower for cattle (36·0%) than for sheep (55·7%) and goats (61·0%) and significantly higher for dairy herds (64·9% for cattle and 75·6% for sheep) than for meat herds (18·9% for cattle and 39·8% for sheep). Within-herd seroprevalence was also significantly higher for goats (41·5%) than for cattle (22·2%) and sheep (25·7%). During the study period, we estimated that 2·7% (n = 90), 6·2% (n = 48) and 16·7% (n = 19) of the abortive episodes investigated could be ‘potentially related to C. burnetii’in cattle, sheep and goat herds, respectively. Overall, strong variability was observed between départements and species, suggesting that risk factors such as herd density and farming practices play a role in disease transmission and maintenance.

Evaluation of the cost-effectiveness of bovine brucellosis surveillance in a disease-free country using stochastic scenario tree modelling

Surveillance systems of exotic infectious diseases aim to ensure transparency about the country-specific animal disease situation (i.e. demonstrate disease freedom) and to identify any introductions. In a context of decreasing resources, evaluation of surveillance efficiency is essential to help stakeholders make relevant decisions about prioritization of measures and funding allocation. This study evaluated the efficiency (sensitivity related to cost) of the French bovine brucellosis surveillance system using stochastic scenario tree models. Cattle herds were categorized into three risk groups based on the annual number of purchases, given that trading is considered as the main route of brucellosis introduction in cattle herds. The sensitivity in detecting the disease and the costs of the current surveillance system, which includes clinical (abortion) surveillance, programmed serological testing and introduction controls, were compared to those of 19 alternative surveillance scenarios. Surveillance costs included veterinary fees and laboratory analyses. The sensitivity over a year of the current surveillance system was predicted to be 91±7% at a design prevalence of 0.01% for a total cost of 14.9±1.8 million €. Several alternative surveillance scenarios, based on clinical surveillance and random or risk-based serological screening in a sample (20%) of the population, were predicted to be at least as sensitive but for a lower cost. Such changes would reduce whole surveillance costs by 20 to 61% annually, and the costs for farmers only would be decreased from about 12.0 million € presently to 5.3–9.0 million € (i.e. 25–56% decrease). Besides, fostering the evolution of the surveillance system in one of these directions would be in agreement with the European regulations and farmers perceptions on brucellosis risk and surveillance.

Animal health syndromic surveillance: a systematic literature review of the progress in the last 5 years (2011-2016)

This review presents the current initiatives and potential for development in the field of animal health surveillance (AHSyS), 5 years on from its advent to the front of the veterinary public health scene. A systematic review approach was used to document the ongoing AHSyS initiatives (active systems and those in pilot phase) and recent methodological developments. Clinical data from practitioners and laboratory data remain the main data sources for AHSyS. However, although not currently integrated into prospectively running initiatives, production data, mortality data, abattoir data, and new media sources (such as Internet searches) have been the objective of an increasing number of publications seeking to develop and validate new AHSyS indicators. Some limitations inherent to AHSyS such as reporting sustainability and the lack of classification standards continue to hinder the development of automated syndromic analysis and interpretation. In an era of ubiquitous electronic collection of animal health data, surveillance experts are increasingly interested in running multivariate systems (which concurrently monitor several data streams) as they are inferentially more accurate than univariate systems. Thus, Bayesian methodologies, which are much more apt to discover the interplay among multiple syndromic data sources, are foreseen to play a big part in the future of AHSyS. It has become clear that early detection of outbreaks may not be the principal expected benefit of AHSyS. As more systems will enter an active prospective phase, following the intensive development stage of the last 5 years, the study envisions AHSyS, in particular for livestock, to significantly contribute to future international-, national-, and local-level animal health intelligence, going beyond the detection and monitoring of disease events by contributing solid situation awareness of animal welfare and health at various stages along the food-producing chain, and an understanding of the risk management involving actors in this value chain.

Assessment of fallen equine data in France and their usefulness for epidemiological investigations

Quantitative information about equine mortality is relatively scarce, yet it could be of great value for epidemiology purposes. Several European projects based on the exploitation of data from rendering plants have been developed to improve livestock surveillance. Similar data are available for equines in France but have never been studied to date. The objective of this research was to evaluate the potential of the French Ministry of Agriculture's Fallen Stock Data Interchange (FSDI) database to provide quantitative mortality information on the French equine population. The quality of FSDI equine data from 2011 to 2014 was assessed using complementary data registered in the French equine census database, SIRE. Despite a perfectible quality, the FSDI database proved to be a valuable source for studying the basal patterns of mortality over time in the French equine population as illustrated by the spatial representation of the number of deaths. However, improvements in the FSDI database are needed, in particular regarding the registration of animal identification numbers, in order to detail equine mortality for epidemiology purposes.

One Health surveillance - More than a buzz word?

One Health surveillance describes the systematic collection, validation, analysis, interpretation of data and dissemination of information collected on humans, animals and the environment to inform decisions for more effective, evidence- and system-based health interventions. During the second International Conference on Animal Health Surveillance (ICAHS) in Havana, Cuba, a panel discussion was organised to discuss the relevance of One Health in the context of surveillance. A number of success stories were presented which generally focused on the obvious interfaces between human and veterinary medicine such as zoonoses and food safety. Activities aimed at strengthening inter-sectoral networking through technical collaboration, conferences, workshops and consultations have resulted in recommendations to advance the One Health concept. There are also several One Health educational programmes offered as Masters programmes. Continuing challenges to One Health surveillance were identified at both technical as well as organisational level. It was acknowledged that the public health sector and the environmental sector could be engaged more in One Health activities. Legal issues, hurdles to data sharing, unclear responsibilities and structural barriers between ministries prevent integrated action. Policy makers in the health sector often perceive One Health as a veterinary-driven initiative that is not particularly relevant to their priority problems. Whilst some funding schemes allow for the employment of scientists and technicians for research projects, the development of a sustainable One Health workforce has yet to be broadly demonstrated. Funding opportunities do not explicitly promote the development of One Health surveillance systems. In addition, organisational, legal and administrative barriers may prevent operational implementation. Strategies and communication across sectors need to be aligned. Whilst at the technical or local level the formal separation can be bridged, separate funding sources and budgets can jeopardise the overall strategy, especially if funding cuts are later required. To overcome such challenges, a strong business case for One Health surveillance is needed. This should include the costs and benefits of One Health activities or projects including consequences of different strategies as well as risks. Integrated training should also be further promoted. Future ICAHS conferences should continue to provide a platform for discussing surveillance in the One Health context and to provide a forum for surveillance professionals from all relevant sectors to interact.