Active animal health surveillance in European Union Member States: gaps and opportunities

Epidemiological Characteristics of Overseas-Imported Infectious Diseases Identified through Airport Health-Screening Measures: A Case Study on Fuzhou, China

BACKGROUND

This study aimed to examine the epidemiological characteristics of imported infections and assess the effectiveness of border health screening in detecting imported diseases.

METHODS

We obtained infection data for 2016 to 2019 from the Fuzhou Changle International Airport Infection Reporting System. The demographic, temporal, and spatial characteristics of travel-related infections were analyzed using r×c contingency tables, the Cochran-Armitage trend test, and seasonal-trend decomposition using LOESS (STL). Detection rates were used as a proxy for the effectiveness of border health-screening measures.

RESULTS

Overall, 559 travel-related infections were identified during the study period, with 94.3% being imported infections. Airport health screening demonstrated an overall effectiveness of 23.7% in identifying travel-associated infections. Imported infections were predominantly identified in males, with 55.8% of cases occurring in individuals aged 20-49. The peak periods of infection importation were from January to February and from May to August. The infectious diseases identified were imported from 25 different countries and regions. All dengue fever cases were imported from Southeast Asia. Most notifiable infections (76.0%) were identified through fever screening at the airport.

CONCLUSION

The increasing number of imported infections poses a growing challenge for public health systems. Multifaceted efforts including surveillance, vaccination, international collaboration, and public awareness are required to mitigate the importation and spread of infectious diseases from overseas sources.

Holistic One Health Surveillance Framework: Synergizing Environmental, Animal, and Human Determinants for Enhanced Infectious Disease Management

Recent pandemics, including the COVID-19 outbreak, have brought up growing concerns about transmission of zoonotic diseases from animals to humans. This highlights the requirement for a novel approach to discern and address the escalating health threats. The One Health paradigm has been developed as a responsive strategy to confront forthcoming outbreaks through early warning, highlighting the interconnectedness of humans, animals, and their environment. The system employs several innovative methods such as the use of advanced technology, global collaboration, and data-driven decision-making to come up with an extraordinary solution for improving worldwide disease responses. This Review deliberates environmental, animal, and human factors that influence disease risk, analyzes the challenges and advantages inherent in using the One Health surveillance system, and demonstrates how these can be empowered by Big Data and Artificial Intelligence. The Holistic One Health Surveillance Framework presented herein holds the potential to revolutionize our capacity to monitor, understand, and mitigate the impact of infectious diseases on global populations.

Rapid response screening for emerging zoonotic pathogens, barriers and opportunities: A study for enhanced preparedness of the Netherlands

Background

Outbreaks of zoonotic emerging infectious diseases (EIDs) require rapid identification of potential reservoir hosts and mapping disease spread in these hosts to inform risk assessment and adequate control measures. Animals are often understudied when a novel EID is detected in humans and acquisition of animal samples is hampered by practical, ethical, and legal barriers, of which there is currently no clear overview. Therefore, the three aims of this study are (1) to map potentially available collections of animal samples, (2) to assess possibilities and barriers for reuse of these samples and (3) to assess possibilities and barriers for active animal and environmental sampling in the Netherlands.

Methods

A literature search was performed to identify ongoing sampling activities and opportunities for reuse or active sampling. Semi-structured interviews with stakeholder organizations were conducted to gain further insight into the three research questions.

Results

Various sample collections of surveillance, diagnostic and research activities exist in the Netherlands. Sample size, coverage, storage methods and type of samples collected differs per animal species which influences reuse suitability. Organizations are more likely to share samples, for reuse in outbreak investigations, when they have a pre-existing relationship with the requesting institute. Identified barriers for sharing were, among others, unfamiliarity with legislation and unsuitable data management systems. Active sampling of animals or the environment is possible through several routes. Related barriers are acquiring approval from animal- or property owners, conflicts with anonymization, and time needed to acquire ethical approval.

Conclusion

The animal sample collections identified would be very valuable for use in outbreak investigations. Barriers for sharing may be overcome by increasing familiarity with legislation, building (international) sharing networks and agreements before crises occur and developing systems for sample registration and biobanking. Proactive setting up of ethical approvals will allow for rapid animal sample collection to identify EID hosts and potential spillovers.

Potential and Challenges of Community-Based Surveillance in Animal Health: A Pilot Study Among Equine Owners in Switzerland

Animal owners' potential to observe and report clinical signs, as the persons with the closest contact to their animals, is an often neglected source of information in surveillance. Allowing community members other than health care professionals, such as animal owners, to report health events can contribute to close current surveillance gaps and enhance early detection. In the present study, we tested a community-based surveillance (CBS) approach in the equine community in Switzerland. We aimed at revealing the attitudes and intentions of equine owners toward reporting clinical signs by making use of an online questionnaire. We further set up and operated an online CBS tool, named Equi-Commun. Finally, we investigated potential reasons for the lack of its use by applying qualitative telephone interviews. The majority of the respondents of the online questionnaire (65.5%, 707/1,078) answered that they could see themselves reporting clinical observations of their equine. The multivariate logistic regression analysis indicated that French-speaking equine owners and those belonging to the positive attitude cluster are more likely to report to a CBS tool. Equi-Commun operated between October 2018 and December 2019 yet received only four reports. With the addition of qualitative interviews, we identified three critical, interlinked issues that may have led to the non-use of Equi-Commun within the Swiss equine community: (1) for successfully implementing CBS, the need for surveillance within the community of interest must be given; (2) the respective population under surveillance, here the equine, needs to show enough clinical cases for owners to be able to maintain the memory of an existing tool and its possible use; and (3) targeted and high effort communication of the system is key for its success. While CBS relying only on lay animal owners, complementary to existing surveillance systems, could potentially provide a good proxy of timely surveillance data, it is questionable whether the added value of generated surveillance knowledge is in balance with efforts necessary to implement a successful system. With this study, we showcased both the potential and challenges of CBS in animal health, as this may be of relevance and guidance for future initiatives.

Overview of Control Programs for EU Non-regulated Cattle Diseases in Italy

The cattle industry is a major driving force for the Italian agricultural sector totalling about 5. 6 million heads for dairy and meat production together. It is particularly developed in the northern part of the country, where 70% of the whole Italian cattle population is reared. The cattle industry development in the rest of the country is hampered by the hard orography of the territories and a variety of socioeconomic features leading to the persistence of the traditional rural farming systems. The differences in the farming systems (industrial vs. traditional) also affect the health status of the farms. Whereas, Enzootic Bovine Leukosis (EBL) is almost eradicated across the whole country, in Southern Italy where Bovine Tuberculosis and Brucellosis are still present and Bluetongue is endemic due to the presence of the competent vector (Culicoides imicola), less investments are aimed at controlling diseases with economic impact or at improving farm biosecurity. On the other hand, with the eradication of these diseases in most part of the country, the need has emerged for reducing the economic burden of non-regulated endemic disease and control programs (CPs) for specific diseases have been implemented at regional level, based on the needs of each territory (for instance common grazing or trading with neighboring countries). This explains the coexistence of different types of programs in force throughout the country. Nowadays in Italy, among cattle diseases with little or no EU regulations only three are regulated by a national CP: Enzootic Bovine Leukosis, Bluetongue and Paratuberculosis, while Bovine Genital Campylobacteriosis and Trichomonosis are nationwide controlled only in breeding bulls. For some of the remaining diseases (Infectious Bovine Rhinotracheitis, Bovine Viral Diarrhea, Streptococcus agalactiae) specific CPs have been implemented by the regional Authorities, but for most of them a CP does not exist at all. However, there is a growing awareness among farmers and public health authorities that animal diseases have a major impact not only on the farm profitability but also on animal welfare and on the use of antibiotics in livestock. It is probable that in the near future other CPs will be implemented.

Towards an integrated animal health surveillance system in Tanzania: making better use of existing and potential data sources for early warning surveillance

BACKGROUND

Effective animal health surveillance systems require reliable, high-quality, and timely data for decision making. In Tanzania, the animal health surveillance system has been relying on a few data sources, which suffer from delays in reporting, underreporting, and high cost of data collection and transmission. The integration of data from multiple sources can enhance early detection and response to animal diseases and facilitate the early control of outbreaks. This study aimed to identify and assess existing and potential data sources for the animal health surveillance system in Tanzania and how they can be better used for early warning surveillance. The study used a mixed-method design to identify and assess data sources. Data were collected through document reviews, internet search, cross-sectional survey, key informant interviews, site visits, and non-participant observation. The assessment was done using pre-defined criteria.

RESULTS

A total of 13 data sources were identified and assessed. Most surveillance data came from livestock farmers, slaughter facilities, and livestock markets; while animal dip sites were the least used sources. Commercial farms and veterinary shops, electronic surveillance tools like AfyaData and Event Mobile Application (EMA-i) and information systems such as the Tanzania National Livestock Identification and Traceability System (TANLITS) and Agricultural Routine Data System (ARDS) show potential to generate relevant data for the national animal health surveillance system. The common variables found across most sources were: the name of the place (12/13), animal type/species (12/13), syndromes (10/13) and number of affected animals (8/13). The majority of the sources had good surveillance data contents and were accessible with medium to maximum spatial coverage. However, there was significant variation in terms of data frequency, accuracy and cost. There were limited integration and coordination of data flow from the identified sources with minimum to non-existing automated data entry and transmission.

CONCLUSION

The study demonstrated how the available data sources have great potential for early warning surveillance in Tanzania. Both existing and potential data sources had complementary strengths and weaknesses; a multi-source surveillance system would be best placed to harness these different strengths.

Highly Pathogenic Avian Influenza Viruses at the Wild-Domestic Bird Interface in Europe: Future Directions for Research and Surveillance

Highly pathogenic avian influenza (HPAI) outbreaks in wild birds and poultry are no longer a rare phenomenon in Europe. In the past 15 years, HPAI outbreaks—in particular those caused by H5 viruses derived from the A/Goose/Guangdong/1/1996 lineage that emerged in southeast Asia in 1996—have been occuring with increasing frequency in Europe. Between 2005 and 2020, at least ten HPAI H5 incursions were identified in Europe resulting in mass mortalities among poultry and wild birds. Until 2009, the HPAI H5 virus outbreaks in Europe were caused by HPAI H5N1 clade 2.2 viruses, while from 2014 onwards HPAI H5 clade 2.3.4.4 viruses dominated outbreaks, with abundant genetic reassortments yielding subtypes H5N1, H5N2, H5N3, H5N4, H5N5, H5N6 and H5N8. The majority of HPAI H5 virus detections in wild and domestic birds within Europe coincide with southwest/westward fall migration and large local waterbird aggregations during wintering. In this review we provide an overview of HPAI H5 virus epidemiology, ecology and evolution at the interface between poultry and wild birds based on 15 years of avian influenza virus surveillance in Europe, and assess future directions for HPAI virus research and surveillance, including the integration of whole genome sequencing, host identification and avian ecology into risk-based surveillance and analyses.

An index for multidimensional assessment of swine health

Pork accounts for almost one-third of the meat consumed worldwide. Infectious diseases have a marked impact on pig production. Epidemiological indicators are considered the most useful criteria in decision-making; however, a health status assessment remains a challenge at the national and regional levels. This study proposes a health index including herd-losses, morbidity, fatality, and type of diseases, to rate the health situation in a region or country; it contributes to assessing the effectiveness of control, damage manifestation, and trends. It is a multidimensional index with a structure of triads and simple quantitative, semi-quantitative, and qualitative expressions that use flexible and dynamics limits. With it, we analyzed twenty-one countries in 2005-2018, focusing on African swine fever, classical swine fever, foot-mouth-disease, and porcine respiratory and reproductive syndrome, diseases that caused 72% of the morbidity. Our multidimensional approach estimates farm, local, and regional impact from infectious agents and outbreaks, and apprises trends aiming to be useful to control measures, strategic actions, and animal health policies.

Improving the Utility of Voluntary Ovine Fallen Stock Collection and Laboratory Diagnostic Submission Data for Animal Health Surveillance Purposes: A Development Cycle

There are calls from policy-makers and industry to use existing data sources to contribute to livestock surveillance systems, especially for syndromic surveillance. However, the practical implications of attempting to use such data sources are challenging; development often requires incremental steps in an iterative cycle. In this study the utility of business operational data from a voluntary fallen stock collection service was investigated, to determine if they could be used as a proxy for the mortality experienced by the British sheep population. Retrospectively, Scottish ovine fallen stock collection data (2011-2014) were transformed into meaningful units for analysis, temporal and spatial patterns were described, time-series methods and a temporal aberration detection algorithm applied. Distinct annual and spatial trends plus seasonal patterns were observed in the three age groups investigated. The algorithm produced an alarm at the point of an historic known departure from normal (April 2013) for two age groups, across Scotland as a whole and in specific postcode areas. The analysis was then extended. Initially, to determine if similar methods could be applied to ovine fallen stock collections from England and Wales for the same time period. Additionally, Scottish contemporaneous laboratory diagnostic submission data were analyzed to see if they could provide further insight for interpretation of statistical alarms. Collaboration was required between the primary data holders, those with industry sector knowledge, plus veterinary, epidemiological and statistical expertise, in order to turn data and analytical outcomes into potentially useful information. A number of limitations were identified and recommendations were made as to how some could be addressed in order to facilitate use of these data as surveillance "intelligence." e.g., improvements to data collection and provision. A recent update of the fallen stock collections data has enabled a longer temporal period to be analyzed, with evidence of changes made in line with the recommendations. Further development will be required before a functional system can be implemented. However, there is potential for use of these data as: a proxy measure for mortality in the sheep population; complementary components in a future surveillance system, and to inform the design of additional surveillance system components.

Development of Reporting Guidelines for Animal Health Surveillance-AHSURED

With the current trend in animal health surveillance toward risk-based designs and a gradual transition to output-based standards, greater flexibility in surveillance design is both required and allowed. However, the increase in flexibility requires more transparency regarding surveillance, its activities, design and implementation. Such transparency allows stakeholders, trade partners, decision-makers and risk assessors to accurately interpret the validity of the surveillance outcomes. This paper presents the first version of the Animal Health Surveillance Reporting Guidelines (AHSURED) and the process by which they have been developed. The goal of AHSURED was to produce a set of reporting guidelines that supports communication of surveillance activities in the form of narrative descriptions. Reporting guidelines come from the field of evidence-based medicine and their aim is to improve consistency and quality of information reported in scientific journals. They usually consist of a checklist of items to be reported, a description/definition of each item, and an explanation and elaboration document. Examples of well-reported items are frequently provided. Additionally, it is common to make available a website where the guidelines are documented and maintained. This first version of the AHSURED guidelines consists of a checklist of 40 items organized in 11 sections (i.e., surveillance system building blocks), which is available as a wiki at https://github.com/SVA-SE/AHSURED/wiki. The choice of a wiki format will allow for further inputs from surveillance experts who were not involved in the earlier stages of development. This will promote an up-to-date refined guideline document.

Assessing the Adoption of Recommended Standards, Novel Approaches, and Best Practices for Animal Health Surveillance by Decision Makers in Europe

Animal health surveillance is an important tool for disease mitigation and helps to promote animal health and welfare, protect human health, support efficient animal production, and enable trade. This study aimed to assess adoption of recommended standards and best practice for surveillance (including risk-based approaches) in Europe. It included scoping interviews with surveillance experts in Denmark, the Netherlands, Norway, and Switzerland to gather information on knowledge acquisition, decisions and implementation of surveillance, and perceptions. This was followed by an online survey among animal health and food safety surveillance users in EU, EEA, and Schengen countries. A total of 166 responses were collected from 27 countries; 111 were eligible for analysis. A strong preference for legislation and established standards was observed, with peer-reviewed publications, conferences, symposia, and workshops to be major sources of information. The majority of respondents indicated a need for international evaluation for surveillance and implied that considerations of cost-effectiveness were essential when making a decision to adopt new surveillance standards. However, most of the respondents did not use a formal evaluation to inform the adoption of new standards or only conducted a descriptive assessment before their implementation or adaptation. Only a few respondents reported a quantitative economic evaluation despite economic efficiency being considered as a highly relevant criterion for surveillance implementation. Constraints mentioned in the adoption of new surveillance standards included insufficient time, financial and human resources, and lack of competency. Researchers aiming to achieve impact by their surveillance work are advised to consider ways of influencing binding standards and to disseminate their work pro-actively using varied channels of engagement tailored to relevant target audiences and their needs. Generally, a more formal linkage between surveillance information and disease mitigation decisions-for example, by using systematic evaluation-could help increase the economic value of surveillance efforts. Finally, a collaborative, international platform for exchange and learning on surveillance as well as co-design and dissemination of surveillance standards is recommended.

The applicability of animal health surveillance systems for post-market monitoring of potential adverse effects of genetically modified (GM) feed

A facultative post market monitoring of potential health impacts of genetically modified (GM) feedstuffs on livestock consuming these feeds after pre-market risk assessment is under ongoing consideration. Within the IPAFEED database, scientific studies on health effects beyond performance in livestock and the results of a systematic search for evidence of outcome effects due to GM feed are consolidated. These outcomes were reviewed and checked for consistency in order to identify plausible syndromes suitable for conducting surveillance. The 24 selected studies showed no consistent changes in any health parameter. There were no repeated studies in any species by GM crop type and animal species. As such, there is insufficient evidence to inform the design of surveillance systems for detecting known adverse effects. Animal health surveillance systems have been proposed for the post market monitoring of potential adverse effects in animals. Such systems were evaluated for their applicability to the detection of hypothetical adverse effects and their strengths and weaknesses to detect syndromes of concern are presented. For known adverse effects, applied controlled post-market studies may yield conclusive and high-quality evidence. For detecting unknown adverse effects, the use of existing surveillance systems may still be of interest. A simulation tool developed within the project can be adapted and applied to existing surveillance systems to explore their applicability to the detection of potential adverse effects of GM feed.

Information management and ante-mortem inspection procedures for the emerging diseases control: Experiences acquired in the epidemiological surveillance of bluetongue and lumpy skin disease

The spread of exotic, emerging and reemerging diseases, has become, in the last years, one of the most important threats to the animal productions and public health, representing a new challenge for the European Community. In a global-market framework, where trade and contacts between countries are simplified, effective and well-developed surveillance systems are necessary. Multiple factors are, in fact, associated with the emergence of new, known or exotic diseases in this new economic panorama and for these reasons controls on animal imports, traceability and timeliness detection of infected animals should be considered the basis of a sound surveillance. In this work, we focused our attention on the management of Bluetongue and on the risk of introduction of the Lumpy Skin Disease in Italy, in order to describe the national and European surveillance systems for these diseases. In particular, we underlined the crucial role of information that reach the Official Veterinarian at the slaughterhouse concerning the epidemiological situation of the sending countries. Information that are important for the management of the ante-mortem inspection and for increasing the awareness of the Veterinary Inspectors of their role in the surveillance.

The use of animals as a surveillance tool for monitoring environmental health hazards, human health hazards and bioterrorism

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It discusses the use of animal sentinels for surveillance.

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It discusses the use of animals as a surveillance tool for monitoring environmental health hazards.

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It discusses the use of animals as a surveillance tool for monitoring human health hazards.

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It discusses the use of animals as a surveillance tool for monitoring bioterrorism.

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It discusses the One Health approach.

This review discusses the utilization of wild or domestic animals as surveillance tools for monitoring naturally occurring environmental and human health hazards. Besides providing early warning to natural hazards, animals can also provide early warning to societal hazards like bioterrorism. Animals are ideal surveillance tools to humans because they share the same environment as humans and spend more time outdoors than humans, increasing their exposure risk. Furthermore, the biologically compressed lifespans of some animals may allow them to develop clinical signs more rapidly after exposure to specific pathogens. Animals are an excellent channel for monitoring novel and known pathogens with outbreak potential given that more than 60 % of emerging infectious diseases in humans originate as zoonoses. This review attempts to highlight animal illnesses, deaths, biomarkers or sentinel events, to remind human and veterinary public health programs that animal health can be used to discover, monitor or predict environmental health hazards, human health hazards, or bioterrorism. Lastly, we hope that this review will encourage the implementation of animals as a surveillance tool by clinicians, veterinarians, ecosystem health professionals, researchers and governments.