Evaluation of effectiveness and efficiency of wild bird surveillance for avian influenza

Risk factors for avian influenza in Danish poultry and wild birds during the epidemic from June 2020 to May 2021

Exploring the risk factors of avian influenza (AI) occurrence helps us to monitor and control the disease. Since late 2020, the number of avian influenza outbreaks in domestic and wild birds has increased in most European countries, including Denmark. This study was conducted to identify potential risk factors for wild birds and poultry during the epidemic in 2020/2021 in Denmark. Using Danish AI surveillance data of actively surveyed poultry and passively surveyed wild birds from June 2020 to May 2021, we calculated geographical attributes for bird locations and assessed the potential risk factors of AI detections using logistic regression analyses. 4% of actively surveyed poultry and 39% of passively surveyed wild birds were detected with AI circulating or ongoing at the time. Of these, 10 and 99% tested positive for the H5/H7 AI subtypes, respectively. Our analyses did not find any statistically significant risk factors for actively surveyed poultry within the dataset. For passively surveyed wild birds, bird species belonging to the Anseriformes order had a higher risk of being AI virus positive than five other taxonomic bird orders, and Galliformes were of higher risk than two other taxonomic bird orders. Besides, every 1 km increase in the distance to wetlands was associated with a 5.18% decrease in the risk of being AI positive (OR (odds ratio) 0.95, 95% CI 0.91, 0.99), when all other variables were kept constant. Overall, bird orders and distance to wetlands were associated with the occurrence of AI. The findings may provide targets for surveillance strategies using limited resources and assist in risk-based surveillance during epidemics.

New Patterns for Highly Pathogenic Avian Influenza and Adjustment of Prevention, Control and Surveillance Strategies: The Example of France

From 2020 up to summer 2023, there was a substantial change in the situation concerning the high pathogenic avian influenza (HPAI) virus in Europe. This change concerned mainly virus circulation within wildlife, both in wild birds and wild mammals. It involved the seasonality of HPAI detections, the species affected, excess mortality events, and the apparent increased level of contamination in wild birds. The knock-on effect concerned new impacts and challenges for the poultry sector, which is affected by repeated annual waves of HPAI arriving with wild migratory birds and by risks due to viral circulation within resident wild birds across the year. Indeed, exceeding expectations, new poultry sectors and production areas have been affected during the recent HPAI seasons in France. The HPAI virus strains involved also generate considerable concern about human health because of enhanced risks of species barrier crossing. In this article, we present these changes in detail, along with the required adjustment of prevention, control, and surveillance strategies, focusing specifically on the situation in France.

A literature review of the use of environmental sampling in the surveillance of avian influenza viruses

This literature review provides an overview of use of environmental samples (ES) such as faeces, water, air, mud and swabs of surfaces in avian influenza (AI) surveillance programs, focussing on effectiveness, advantages and gaps in knowledge. ES have been used effectively for AI surveillance since the 1970s. Results from ES have enhanced understanding of the biology of AI viruses in wild birds and in markets, of links between human and avian influenza, provided early warning of viral incursions, allowed assessment of effectiveness of control and preventive measures, and assisted epidemiological studies in outbreaks, both avian and human. Variation exists in the methods and protocols used, and no internationally recognized guidelines exist on the use of ES and data management. Few studies have performed direct comparisons of ES versus live bird samples (LBS). Results reported so far demonstrate reliance on ES will not be sufficient to detect virus in all cases when it is present, especially when the prevalence of infection/contamination is low. Multiple sample types should be collected. In live bird markets, ES from processing/selling areas are more likely to test positive than samples from bird holding areas. When compared to LBS, ES is considered a cost-effective, simple, rapid, flexible, convenient and acceptable way of achieving surveillance objectives. As a non-invasive technique, it can minimize effects on animal welfare and trade in markets and reduce impacts on wild bird communities. Some limitations of environmental sampling methods have been identified, such as the loss of species-specific or information on the source of virus, and taxonomic-level analyses, unless additional methods are applied. Some studies employing ES have not provided detailed methods. In others, where ES and LBS are collected from the same site, positive results have not been assigned to specific sample types. These gaps should be remedied in future studies.

Modulation of lethal HPAIV H5N8 clade 2.3.4.4B infection in AIV pre-exposed mallards

In 2016/2017, a severe epidemic of HPAIV H5N8 clade 2.3.4.4 group B (H5N8B) affected Europe. To analyse the role of mallards in the spatiotemporal dynamics of global HPAIV H5N8B dispersal, mallards (Anas platyrhynchos), naturally exposed to various AIV and therefore seropositive, were challenged with H5N8B. All experiments were controlled by infection and co-housing of seronegative juvenile Pekin ducklings. All ducks that survived the first infection were re-challenged 21 dpi with the homologous H5N8B strain. After the first H5N8B infection, seropositive mallards showed only mild clinical symptoms. Moderate to low viral shedding, occurring particularly from the oropharynx and lasting for 7 days maximum, led to severe clinical disease of all contact ducklings. All challenged seronegative Pekin ducks and contact ducklings died or had to be euthanized. H5-specific antibodies were detected in surviving birds within 2 weeks. Virus and viral RNA could be isolated from several water samples until 6 and 9 dpi, respectively. Conversely, upon re-infection with homologous H5N8B neither inoculated nor contact ducklings showed any clinical symptoms, nor was an antibody titer increase of seropositive mallards or any seroconversion of contact ducklings observed. Mallard ducks naturally pre-exposed to LPAIV can play a role as a clinically unsuspicious virus reservoir for H5N8B effective in virus transmission. Mallards with homologous immunity did not contribute to virus transmission.

Fireworks-like surveillance approach: The case of HPAI H5N1 in wild birds in Europe

Highly pathogenic avian influenza (HPAI) risk management requires efficient surveillance of the infection in wild birds for early warning purposes. In this study, our aim was to describe the spread of continent-wide infection cases using a fireworks model and therefore improve current surveillance systems. The fireworks model is a metaphor illustrating the spread of HPAI as a point source epizootic. The approach is based on early detection of the outbreak seeds (sparks from the fireworks) and uses a predictive model of the probability of the occurrence of new cases following a seed introduction; this then determines the spatiotemporal perimeter for intense surveillance investigations. For a case study, we used surveillance data on HPAI H5N1 in wild birds across Europe between 2005 and 2010 to describe the outbreaks and determine the success of the case detection used to inform management of the disease. The fireworks description assumes simultaneous introductions of 'seeds' of cases, which then 'explode' in local foci but do not merge into a progressive disease wave. This model fits the data well. Using this predictive approach for HPAI cases in EU countries, we found that the investigation radius needed to achieve a detection level of 90% of new cases after an outbreak ranged from 10 km to more than 300 km, depending on the outbreak pattern. Based on these findings, the fireworks approach can be a valuable method for identifying the perimeters and risk areas to be targeted for enhanced surveillance. The rationale of the fireworks approach is quite generic and can easily be adapted to different situations and contexts.

Systematic Review of Methods to Determine the Cost-Effectiveness of Monitoring Plans for Chemical and Biological Hazards in the Life Sciences

This study reviews the methods used to determine the cost-effectiveness of monitoring plans for hazards in animals (diseases), plants (pests), soil, water, food, and animal feed, and assesses their applicability to food safety hazards. The review describes the strengths and weaknesses of each method, provides examples of different applications, and concludes with comments about their applicability to food safety. A systematic literature search identified publications assessing the cost-effectiveness of monitoring plans in the life sciences. Publications were classified into 4 groups depending on their subject: food safety, environmental hazards, animal diseases, or pests. Publications were reviewed according to the type of model and input data used, and the types of costs included. Three types of models were used: statistical models, simulation models, and optimization models. Input data were either experimental, historical, or simulated data. Publications differed according to the costs included. More than half the publications only included monitoring costs, whereas other publications included monitoring and management costs, or all costs and benefits. Only a few publications were found in the food safety category and all were relatively recent studies. This suggests that cost-effectiveness analysis of monitoring strategies in food safety is just starting and more research is needed to improve the cost-effectiveness of monitoring hazards in foods.

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.

Cost-effectiveness evaluation of bovine tuberculosis surveillance in wildlife in France (Sylvatub system) using scenario trees

Bovine tuberculosis (bTB) is a common disease in cattle and wildlife, with health, zoonotic and economic implications. Infected wild animals, and particularly reservoirs, could hinder eradication of bTB from cattle populations, which could have an important impact on international cattle trade. Therefore, surveillance of bTB in wildlife is of particular importance to better understand the epidemiological role of wild species and to adapt the control measures. In France, a bTB surveillance system for free-ranging wildlife, the Sylvatub system, has been implemented since 2011. It relies on three surveillance components (SSCs) (passive surveillance on hunted animals (EC-SSC), passive surveillance on dead or dying animals (SAGIR-SSC) and active surveillance (PSURV-SSC)). The effectiveness of the Sylvatub system was previously assessed, through the estimation of its sensitivity (i.e. the probability of detecting at least one case of bTB infection by each SSC, specie and risk-level area). However, to globally assess the performance of a surveillance system, the measure of its sensitivity is not sufficient, as other factors such as economic or socio-economic factors could influence the effectiveness. We report here an estimation of the costs of the surveillance activities of the Sylvatub system, and of the cost-effectiveness of each surveillance component, by specie and risk-level, based on scenario tree modelling with the same tree structure as used for the sensitivity evaluation. The cost-effectiveness of the Sylvatub surveillance is better in higher-risk departments, due in particular to the higher probability of detecting the infection (sensitivity). Moreover, EC-SSC, which has the highest unit cost, is more efficient than the surveillance enhanced by the SAGIR-SSC, due to its better sensitivity. The calculation of the cost-effectiveness ratio shows that PSURV-SSC remains the most cost-effective surveillance component of the Sylvatub system, despite its high cost in terms of coordination, sample collection and laboratory analysis.

Effectiveness and Cost Efficiency of Different Surveillance Components for Proving Freedom and Early Detection of Disease: Bluetongue Serotype 8 in Cattle as Case Study for Belgium, France and the Netherlands

Quick detection and recovery of country's freedom status remain a constant challenge in animal health surveillance. The efficacy and cost efficiency of different surveillance components in proving the absence of infection or (early) detection of bluetongue serotype 8 in cattle populations within different countries (the Netherlands, France, Belgium) using surveillance data from years 2006 and 2007 were investigated using an adapted scenario tree model approach. First, surveillance components (sentinel, yearly cross-sectional and passive clinical reporting) within each country were evaluated in terms of efficacy for substantiating freedom of infection. Yearly cross-sectional survey and passive clinical reporting performed well within each country with sensitivity of detection values ranging around 0.99. The sentinel component had a sensitivity of detection around 0.7. Secondly, how effective the components were for (early) detection of bluetongue serotype 8 and whether syndromic surveillance on reproductive performance, milk production and mortality data available from the Netherlands and Belgium could be of added value were evaluated. Epidemic curves were used to estimate the timeliness of detection. Sensitivity analysis revealed that expected within-herd prevalence and number of herds processed were the most influential parameters for proving freedom and early detection. Looking at the assumed direct costs, although total costs were low for sentinel and passive clinical surveillance components, passive clinical surveillance together with syndromic surveillance (based on reproductive performance data) turned out most cost-efficient for the detection of bluetongue serotype 8. To conclude, for emerging or re-emerging vectorborne disease that behaves such as bluetongue serotype 8, it is recommended to use passive clinical and syndromic surveillance as early detection systems for maximum cost efficiency and sensitivity. Once an infection is detected and eradicated, cross-sectional screening for substantiating freedom of infection and sentinel for monitoring the disease evolution are recommended.

One Health: Lessons Learned from East Africa

Africa is faced with many of the most daunting challenges of our time. It comprises roughly 15% of the world's human population, and most of its countries are perpetually ranked "Low" on the United Nations' Human Development Index. On the other hand, Africa has arguably the largest proportion of intact natural ecosystems, biodiversity, and sociocultural capital and the lowest impact on global warming of any continent. Thus, African leaders are faced with competing demands and values among a multitude of complex issues, such as high human population growth, extreme poverty, food insecurity, land use policy, climate change, and biodiversity conservation. In this context, building sustainable national systems for human and/or animal health is one of the grand challenges of this generation. Today's complex global health and development challenges require long-term commitment and a range of approaches that are too broad for any one discipline, institution, or country to implement on its own. The One Health concept recognizes the interconnectedness of global health issues and, as such, promotes the importance of and need for international, interdisciplinary, and cross-sectoral communication and collaboration at local, national, and international levels. By taking advantage of natural cultural tendencies for shared leadership, resource allocation, and community values, African leaders are currently proactively demonstrating the principles of One Health, and thus becoming a model for this global vision. And by focusing on partnerships rather than donor-recipient relationships, they are fostering the development of shared priorities and are increasingly driving their own health agenda to fulfill their own needs.

Wild bird surveillance for highly pathogenic avian influenza H5 in North America

It is unknown how the current Asian origin highly pathogenic avian influenza H5 viruses arrived, but these viruses are now poised to become endemic in North America. Wild birds harbor these viruses and have dispersed them at regional scales. What is unclear is how the viruses may be moving from the wild bird reservoir into poultry holdings. Active surveillance of live wild birds is likely the best way to determine the true distribution of these viruses. We also suggest that sampling be focused on regions with the greatest risk for poultry losses and attempt to define the mechanisms of transfer to enhance biosecurity. Responding to the recent outbreaks of highly pathogenic avian influenza in North America requires an efficient plan with clear objectives and potential management outcomes.

Reconciling surveillance systems with limited resources: an evaluation of passive surveillance for rabies in an endemic setting

Surveillance systems for rabies in endemic regions are often subject to severe constraints in terms of resources. The World Organisation for Animal Health (OIE) and the World Health Organisation (WHO) propose the use of an active surveillance system to substantiate claims of disease freedom, including rabies. However, many countries do not have the resources to establish active surveillance systems for rabies and the testing of dead dogs poses logistical challenges. This paper explores the potential of using a scenario tree model parameterised with data collected via questionnaires and interviews to estimate the sensitivity of passive surveillance, assessing its potential as a viable low-cost alternative to active surveillance systems. The results of this explorative study illustrated that given a large enough sample size, in this case the entire population of Colombo City, the sensitivity of passive surveillance can be 100% even at a low disease prevalence (0.1%), despite the low sensitivity of individual surveillance components (mean values in the range 4.077×10(-5)-1.834×10(-3) at 1% prevalence). In addition, logistic regression was used to identify factors associated with increased recognition of rabies in dogs and reporting of rabies suspect dogs. Increased recognition was observed amongst dog owners (OR 3.8 (CI, 1.3-10.8)), people previously bitten by dogs (OR 5.9 (CI, 2.2-15.9)) and people who believed they had seen suspect dogs in the past (OR 4.7 (CI, 1.8-12.9)). Increased likelihood of reporting suspect dogs was observed amongst dog owners (OR 5.3 (CI, 1.1-25)). Further work is required to validate the data collection tool and the assumptions made in the model with respect to sample size in order to develop a robust methodology for evaluating passive rabies surveillance.

A rationale to unify measurements of effectiveness for animal health surveillance

Surveillance systems produce data which, once analysed and interpreted, support decisions regarding disease management. While several performance measures for surveillance are in use, no theoretical framework has been proposed yet with a rationale for defining and estimating effectiveness measures of surveillance systems in a generic way. An effective surveillance system is a system whose data collection, analysis and interpretation processes lead to decisions that are appropriate given the true disease status of the target population. Accordingly, we developed a framework accounting for sampling, testing and data interpretation processes, to depict in a probabilistic way the direction and magnitude of the discrepancy between "decisions that would be made if the true state of a population was known" and the "decisions that are actually made upon the analysis and interpretation of surveillance data". The proposed framework provides a theoretical basis for standardised quantitative evaluation of the effectiveness of surveillance systems. We illustrate such approaches using hypothetical surveillance systems aimed at monitoring the prevalence of an endemic disease and at detecting an emerging disease as early as possible and with an empirical case study on a passive surveillance system aiming at detecting cases of Highly Pathogenic Avian Influenza cases in Vietnamese poultry.

Risk assessment and cost-effectiveness of animal health certification methods for livestock export in Somalia

Livestock export is vital to the Somali economy. To protect Somali livestock exports from costly import bans used to control the international spread of disease, better certification of livestock health status is required. We performed quantitative risk assessment and cost-effectiveness analysis on different health certification protocols for Somali livestock exports for six transboundary diseases.

Examining stock at regional markets alone without port inspection and quarantine was inexpensive but was ineffective for all but contagious bovine pleuropneumonia, contagious caprine pleuropneumonia and peste des petits ruminants. While extended pre-export quarantine improves detection of infections that cause clinical disease, if biosecurity is suboptimal quarantine provides an opportunity for transmission and increased risk. Clinical examination, laboratory screening and vaccination of animals for key diseases before entry to the quarantine station reduced the risk of an exported animal being infected. If vaccination could be reliably performed weeks before arrival at quarantine its effect would be greatly enhanced.

The optimal certification method depends on the disease. Laboratory diagnostic testing was particularly important for detecting infections with limited clinical signs in male animals (only males are exported); for Rift Valley fever (RVF) the probability of detection was 99% or 0% with and without testing.

Based on our findings animal inspection and certification at regional markets combined with quarantine inspection and certification would reduce the risk of exporting infected animals and enhance disease control at the regional level. This is especially so for key priority diseases, that is RVF, foot-and-mouth disease and Brucellosis. Increased data collection and testing should be applied at point of production and export.

SERVAL: a new framework for the evaluation of animal health surveillance

Animal health surveillance programmes may change in response to altering requirements or perceived weaknesses but are seldom subjected to any formal evaluation to ensure that they provide valuable information in an efficient manner. The literature on the evaluation of animal health surveillance systems is sparse, and those that are published may be unstructured and therefore incomplete. To address this gap, we have developed SERVAL, a SuRveillance EVALuation framework, which is novel and aims to be generic and therefore suitable for the evaluation of any animal health surveillance system. The inclusion of socio-economic criteria ensures that economic evaluation is an integral part of this framework. SERVAL was developed with input from a technical workshop of international experts followed by a consultation process involving providers and users of surveillance and evaluation data. It has been applied to a range of case studies encompassing different surveillance and evaluation objectives. Here, we describe the development, structure and application of the SERVAL framework. We discuss users' experiences in applying SERVAL to evaluate animal health surveillance systems in Great Britain.

Situation-based survey of avian influenza viruses in possible "bridge" species of wild and domestic birds in Nigeria

The highly pathogenic avian influenza (H5N1 subtype) recurred in Nigeria after 9 months period of no reported case. A critical look at possible sources of the re-occurrence was desirable. The objective of this study was to determine whether avian influenza viruses were present at reasonably detectable levels (0.5%) in possible “bridge” species of wild and domestic birds. The study was conducted in 8 Nigerian states. A total of 403 birds from 40 species were sampled. Virus isolation was done in embryonated chicken eggs according to standard protocols. The test results were all negative for avian influenza viruses. The overall confidence interval (CI) calculated in R using the exact binomial confidence interval function was 0–0.007406. Tawny Eagle (Aquila rapax) was the lowest sampled 0.3% (1/403) and Red-billed Firefinch (Lagonosticta senegala) the highest 11.7% (47/403). The limitations of the sample size and possibly designing effects on the study, as to make concrete conclusions were acknowledged. Species of wild birds, so identified in the study could be useful in future surveys. Furthermore, multidisciplinary and community oriented approach, blending targeted and passive surveillances was suggested. This approach was envisaged to bring about wider coverage of “bridge” species and clearer insight of their possible roles in avian influenza re-occurrences and spread in Nigeria.

Towards a new, ecologically targeted approach to monitoring wild bird populations for avian influenza viruses

Prevalence monitoring of avian influenza in wild bird populations is important to estimate risks for the occurrence of potentially zoonotic and economically disastrous outbreaks of highly pathogenic avian influenza virus (AIV) in poultry worldwide. A targeted, cost-effective monitoring method for AIV in wild birds was developed, which is based on monitoring results for AIV in Germany and information on the distribution and abundance of wild bird species in selected habitat types. Spatial data were combined with virological and outbreak data for the period of 1 January 2006 to 31 December 2010. Using Germany as an example, we identified 11 indicator species. By concentrating monitoring efforts on these species in spatially confined locations, we propose a targeted and more cost-effective risk-based AIV monitoring approach that can be adapted universally for the identification of wild bird indicator species worldwide with the perspective of reducing sample sizes (and costs) without impairing the validity of the results.

Consecutive natural influenza a virus infections in sentinel mallards in the evident absence of subtype-specific hemagglutination inhibiting antibodies

Dabbling ducks, particularly Mallards (Anas platyrhynchos) have been frequently and consistently reported to play a pivotal role as a reservoir of low pathogenic avian influenza viruses (AIV). From October 2006 to November 2008, hand-raised Mallard ducks kept at a pond in an avifaunistically rich area of Southern Germany served as sentinel birds in the AIV surveillance programme in Germany. The pond was regularly visited by several species of dabbling ducks. A flock of sentinel birds, consisting of the same 16 individual birds during the whole study period, was regularly tested virologically and serologically for AIV infections. Swab samples were screened by RT-qPCR and, if positive, virus was isolated in embryonated chicken eggs. Serum samples were tested by the use of competitive ELISA and hemagglutinin inhibition (HI) assay. Sequences of full-length hemagglutinin (HA) and neuraminidase (NA) genes were phylogenetically analysed. Four episodes of infections with Eurasian-type AIV occurred in August (H6N8), October/November (H3N2, H2N3) 2007, in January (H3N2) and September (H3N8) 2008. The HA and NA genes of the H3N2 viruses of October 2007 and January 2008 were almost identical rendering the possibility of a re-introduction of that virus from the environment of the sentinel flock highly likely. The HA of the H3N8 virus of September 2008 belonged to a different cluster. As a correlate of the humoral immune response, titres of nucleocapsid protein-specific antibodies fluctuated in correlation with the course of AIV infection episodes. However, no specific systemic response of hemagglutination inhibiting antibodies could be demonstrated even if homologous viral antigens were used. Besides being useful as early indicators for the circulation of influenza viruses in a specific region, the sentinel ducks also contributed to gaining insights into the ecobiology of AIV infection in aquatic wild birds.

A qualitative approach to measure the effectiveness of active avian influenza virus surveillance with respect to its cost: a case study from Switzerland

The aim of the project was to apply cost-effectiveness analysis to the economic appraisal of avian influenza virus (AIV) surveillance, using the implemented surveillance programme in Switzerland as a case study. First a qualitative risk assessment approach was used to assess the expected impact of surveillance on the transmission and spread of AIV. The effectiveness of surveillance was expressed as the difference in defined probabilities between a scenario with surveillance and a scenario without surveillance. The following probabilities were modelled (i) transmission of highly pathogenic AIV (HPAIV) from wild birds to poultry, (ii) mutation from low pathogenic AIV (LPAIV) into HPAIV in poultry, and (iii) transmission of HPAIV to other poultry holdings given a primary outbreak. The cost-effectiveness ratio was defined conventionally as the difference in surveillance costs (ΔC) divided by the change in probability (ΔP), the technical objective, on the presumption that surveillance diminishes the respective probabilities. However, results indicated that surveillance in both wild birds and poultry was not expected to change the probabilities of primary and secondary AIV outbreaks in Switzerland. The overall surveillance costs incurred were estimated at 31,000 €/year, which, to be a rational investment of resources, must still reflect the value policy makers attribute to other benefits from having surveillance (e.g. peace of mind). The advantage of the approach adopted is that it is practical, transparent, and thus able to clarify for policy makers the key variables to be taken into account when evaluating the economic efficiency of resources invested in surveillance, prevention and intervention to exclude AIV.

Evaluation of animal and public health surveillance systems: a systematic review

Disease surveillance programmes ought to be evaluated regularly to ensure they provide valuable information in an efficient manner. Evaluation of human and animal health surveillance programmes around the world is currently not standardized and therefore inconsistent. The aim of this systematic review was to review surveillance system attributes and the methods used for their assessment, together with the strengths and weaknesses of existing frameworks for evaluating surveillance in animal health, public health and allied disciplines. Information from 99 articles describing the evaluation of 101 surveillance systems was examined. A wide range of approaches for assessing 23 different system attributes was identified although most evaluations addressed only one or two attributes and comprehensive evaluations were uncommon. Surveillance objectives were often not stated in the articles reviewed and so the reasons for choosing certain attributes for assessment were not always apparent. This has the potential to introduce misleading results in surveillance evaluation. Due to the wide range of system attributes that may be assessed, methods should be explored which collapse these down into a small number of grouped characteristics by focusing on the relationships between attributes and their links to the objectives of the surveillance system and the evaluation. A generic and comprehensive evaluation framework could then be developed consisting of a limited number of common attributes together with several sets of secondary attributes which could be selected depending on the disease or range of diseases under surveillance and the purpose of the surveillance. Economic evaluation should be an integral part of the surveillance evaluation process. This would provide a significant benefit to decision-makers who often need to make choices based on limited or diminishing resources.

Assessment of different surveillance systems for avian influenza in commercial poultry in Catalonia (North-Eastern Spain)

Compulsory surveillance programmes for avian influenza (AI) have been implemented in domestic poultry and wild birds in all the European Member States since 2005. The implementation of these programmes is complex and requires a close evaluation. A good indicator to assess their efficacy is the sensitivity (Se) of the surveillance system. In this study, the sensitivities for different sampling designs proposed by the Spanish authorities for the commercial poultry population of Catalonia were assessed, using the scenario tree model methodology. These samplings were stratified throughout the territory of Spain and took into account the species, the types of production and their specific risks. The probabilities of detecting infection at different prevalences at both individual and holding level were estimated. Furthermore, those subpopulations that contributed more to the Se of the system were identified. The model estimated that all the designs met the requirements of the European Commission. The probability of detecting AI circulating in Catalonian poultry did not change significantly when the within-holding design prevalence varied from 30% to 10%. In contrast, when the among-holding design prevalence decreased from 5% to 1%, the probability of detecting AI was drastically reduced. The sampling of duck and goose holdings, and to a lesser extent the sampling of turkey and game bird holdings, increased the Se substantially. The Se of passive surveillance in chickens for highly pathogenic avian influenza (HPAI) and low pathogenicity avian influenza (LPAI) were also assessed. The probability of the infected birds manifesting apparent clinical signs and the awareness of veterinarians and farmers had great influence on the probability of detecting AI. In order to increase the probability of an early detection of HPAI in chicken, the probability of performing AI specific tests when AI is suspected would need to be increased.