One-Health Simulation Modelling: A Case Study of Influenza Spread between Human and Swine Populations using NAADSM

Modeling the Spread of Porcine Reproductive and Respiratory Syndrome Among Pig Farms in Lira District of Northern Uganda

Porcine Reproductive and Respiratory Syndrome (PRRS) is a viral swine disease that causes reproductive failure in breeding sows and respiratory distress in growing pigs. The main objectives were to simulate the transmission patterns of PRRS in Uganda using North American Animal Disease Spread Model (NAADSM) and to evaluate the potential effect of prevention and control options such as vaccination and movement control. The median number of infectious farms at the end of 52 weeks for the baseline scenario was 735 (36.75% of the 2,000 farms). The best effects of vaccination were observed in scenarios 60% farm coverage and 80% farm coverage, which resulted in 82 and 98.2% reduction in the median number of infectious farms at the end of the simulation, respectively. Vaccination of all medium and large farms only (33% of the farms) resulted in a 71.2% decrease in the median number of infectious farms at the end of 52 weeks. Movement control (MC) results showed that the median number of infectious farms at the end of 52 weeks decreased by 21.6, 52.3, 79.4, and 92.4% for scenarios MC 20, MC 40, MC 60, and MC 80%, respectively. This study provides new insights to the government of Uganda on how PRRS can be controlled. The large and medium farms need to be prioritized for vaccination, which would be a feasible and effective way to limit the spread of PRRS in Uganda. Scavenging pigs should be confined at all times, whether in the presence or absence of any disease outbreaks.

Quantitatively evaluating the cross-sectoral and One Health impact of interventions: A scoping review and case study of antimicrobial resistance

BACKGROUND

Current frameworks evaluating One Health (OH) interventions focus on intervention-design and -implementation. Cross-sectoral impact evaluations are needed to more effectively tackle OH-issues, such as antimicrobial resistance (AMR). We aimed to describe quantitative evaluation methods for interventions related to OH and cross-sectoral issues, to propose an explicit approach for evaluating such interventions, and to apply this approach to AMR.

METHODS

A scoping review was performed using WebofScience, EconLit, PubMed and gray literature. Quantitative evaluations of interventions that had an impact across two or more of the human, animal and environment sectors were included. Information on the interventions, methods and outcome measures found was narratively summarised. The information from this review informed the construction of a new approach to OH-related intervention evaluation, which then was applied to the field of AMR.

RESULTS

The review included 90 studies: 73 individual evaluations (from 72 papers) and 18 reviews, with a range of statistical modelling (n = 13 studies), mathematical modelling (n = 53) and index-creation/preference-ranking (n = 14) methods discussed. The literature highlighted the need to (I) establish stakeholder objectives, (II) establish quantifiable outcomes that feed into those objectives, (III) establish agents and compartments that affect these outcomes and (IV) select appropriate methods (described in this review) accordingly. Based on this, an evaluation model for AMR was conceptualised; a decision-tree of intervention options, a compartmental-microeconomic model across sectors and a general-equilibrium (macroeconomic) model are linked. The outcomes of this multi-level model (including cost-utility and Gross Domestic Product impact) can then feed into multi-criteria-decision analyses that weigh respective impact estimates alongside other chosen outcome estimates (for example equity or uncertainty).

CONCLUSION

In conclusion, stakeholder objectives are key in establishing which evaluation methods (and associated outcome measures) should be used for OH-related interventions. The stated multi-level approach also allows for sub-systems to be modelled in succession, where resources are constrained.

Challenges to the Application of Spatially Explicit Stochastic Simulation Models for Foot-and-Mouth Disease Control in Endemic Settings: A Systematic Review

Simulation modeling has become common for estimating the spread of highly contagious animal diseases. Several models have been developed to mimic the spread of foot-and-mouth disease (FMD) in specific regions or countries, conduct risk assessment, analyze outbreaks using historical data or hypothetical scenarios, assist in policy decisions during epidemics, formulate preparedness plans, and evaluate economic impacts. Majority of the available FMD simulation models were designed for and applied in disease-free countries, while there has been limited use of such models in FMD endemic countries. This paper's objective was to report the findings from a study conducted to review the existing published original research literature on spatially explicit stochastic simulation (SESS) models of FMD spread, focusing on assessing these models for their potential use in endemic settings. The goal was to identify the specific components of endemic FMD needed to adapt these SESS models for their potential application in FMD endemic settings. This systematic review followed the PRISMA guidelines, and three databases were searched, which resulted in 1176 citations. Eighty citations finally met the inclusion criteria and were included in the qualitative synthesis, identifying nine unique SESS models. These SESS models were assessed for their potential application in endemic settings. The assessed SESS models can be adapted for use in FMD endemic countries by modifying the underlying code to include multiple cocirculating serotypes, routine prophylactic vaccination (RPV), and livestock population dynamics to more realistically mimic the endemic characteristics of FMD. The application of SESS models in endemic settings will help evaluate strategies for FMD control, which will improve livestock health, provide economic gains for producers, help alleviate poverty and hunger, and will complement efforts to achieve the Sustainable Development Goals.

Risk of zoonotic transmission of swine influenza at the human-pig interface in Guangdong Province, China

A cross-sectional survey was conducted from 2015 to 2018 to assess the risk of zoonotic influenza to humans at the human-pig interface in Guangdong Province, south China. One hundred and fifty-three pig farmers, 21 pig traders and 16 pig trade workers were recruited using convenience sampling and surveyed at local pig farms, live pig markets and slaughterhouses, respectively. Questionnaires were administered to collect information on the biosecurity and trading practices adopted and their knowledge and beliefs about swine influenza (SI). Most (12 of 16) trade workers said they would enter piggeries to collect pigs and only six of 11 said they were always asked to go through an on-farm disinfection procedure before entry. Only 33.7% of the interviewees believed that SI could infect humans, although pig farmers were more likely to believe this than traders and trade workers (p < .01). Several unsafe practices were reported by interviewees. 'Having vaccination against seasonal flu' (OR = 3.05, 95% CI: 1.19-8.93), 'Believe that SI can cause death in pigs' (no/yes: OR = 8.69, 95% CI: 2.71-36.57; not sure/yes: OR = 4.46, 95% CI: 1.63-14.63) and 'Keep on working when getting mild flu symptoms' (OR = 3.80, 95% CI: 1.38-11.46) were significantly and positively correlated to 'lacking awareness of the zoonotic risk of SI'. 'Lacking awareness of the zoonotic risk of SI' (OR = 3.19, 95% CI: 1.67-6.21), 'Keep on working when getting mild flu symptoms' (OR = 3.59, 95% CI: 1.57-8.63) and 'Don't know SI as a pig disease' (OR = 3.48, 95% CI: 1.02-16.45) were significantly and positively correlated to 'not using personal protective equipment when contacting pigs'. The findings of this study would benefit risk mitigation against potential pandemic SI threats in the human-pig interface in China.

African Swine Fever: Fast and Furious or Slow and Steady?

Since the introduction of African swine fever (ASF) into Georgia in 2007, the disease has been spreading in an unprecedented way. Many countries that are still free from the disease fear the emergence of ASF in their territory either in domestic pigs or in wild boar. In the past, ASF was often described as being a highly contagious disease with mortality often up to 100%. However, the belief that the disease might enter a naïve population and rapidly affect the entire susceptible population needs to be critically reviewed. The current ASF epidemic in wild boar, but also the course of ASF within outbreaks in domestic pig holdings, suggest a constant, but relatively slow spread. Moreover, the results of several experimental and field studies support the impression that the spread of ASF is not always fast. ASF spread and its speed depend on various factors concerning the host, the virus, and also the environment. Many of these factors and their effects are not fully understood. For this review, we collated published information regarding the spreading speed of ASF and the factors that are deemed to influence the speed of ASF spread and tried to clarify some issues and open questions in this respect.

Comparison of the efficacy of a commercial inactivated influenza A/H1N1/pdm09 virus (pH1N1) vaccine and two experimental M2e-based vaccines against pH1N1 challenge in the growing pig model

Swine influenza A viruses (IAV-S) found in North American pigs are diverse and the lack of cross-protection among heterologous strains is a concern. The objective of this study was to compare a commercial inactivated A/H1N1/pdm09 (pH1N1) vaccine and two novel subunit vaccines, using IAV M2 ectodomain (M2e) epitopes as antigens, in a growing pig model. Thirty-nine 2-week-old IAV negative pigs were randomly assigned to five groups and rooms. At 3 weeks of age and again at 5 weeks of age, pigs were vaccinated intranasally with an experimental subunit particle vaccine (NvParticle/M2e) or a subunit complex-based vaccine (NvComplex/M2e) or intramuscularly with a commercial inactivated vaccine (Inact/pH1N1). At 7 weeks of age, the pigs were challenged with pH1N1 virus or sham-inoculated. Necropsy was conducted 5 days post pH1N1 challenge (dpc). At the time of challenge one of the Inact/pH1N1 pigs had seroconverted based on IAV nucleoprotein-based ELISA, Inact/pH1N1 pigs had significantly higher pdm09H1N1 hemagglutination inhibition (HI) titers compared to all other groups, and M2e-specific IgG responses were detected in the NvParticle/M2e and the NvComplex/M2e pigs with significantly higher group means in the NvComplex/M2e group compared to SHAMVAC-NEG pigs. After challenge, nasal IAV RNA shedding was significantly reduced in Inact/pH1N1 pigs compared to all other pH1N1 infected groups and this group also had reduced IAV RNA in oral fluids. The macroscopic lung lesions were characterized by mild-to-severe, multifocal-to-diffuse, cranioventral dark purple consolidated areas typical of IAV infection and were similar for NvParticle/M2e, NvComplex/M2e and SHAMVAC-IAV pigs. Lesions were significantly less severe in the SHAMVAC-NEG and the Inact/pH1N1pigs. Under the conditions of this study, a commercial Inact/pH1N1 specific vaccine effectively protected pigs against homologous challenge as evidenced by reduced clinical signs, virus shedding in nasal secretions and oral fluids and reduced macroscopic and microscopic lesions whereas intranasal vaccination with experimental M2e epitope-based subunit vaccines did not. The results further highlight the importance using IAV-S type specific vaccines in pigs.

Control of endemic swine flu persistence in farrow-to-finish pig farms: a stochastic metapopulation modeling assessment

Swine influenza viruses (swIAVs) are known to persist endemically in farrow-to-finish pig farms, leading to repeated swine flu outbreaks in successive batches of pigs at a similar age (mostly around 8 weeks of age). This persistence in European swine herds involves swIAVs from European lineages including H1_avN1, H1_huN2, H3N2, the 2009 H1N1 pandemic virus and their reassortants. The specific population dynamics of farrow-to-finish pig farms, the immune status of the animals at infection-time, the co-circulation of distinct subtypes leading to consecutive or concomitant infections have been evidenced as factors favouring swIAV persistence within herds. We developed a stochastic metapopulation model representing the co-circulation of two distinct swIAVs within a typical farrow-to-finish pig herd to evaluate the risk of reassortant viruses generation due to co-infection events. Control strategies related to herd management and/or vaccination schemes (batch-to-batch or mass vaccination of the sow herd and vaccination of growing pigs) were implemented to assess their relative efficacy regarding viral persistence. The overall probability of a co-infection event for France, possibly leading to reassortment, was evaluated to 16.8%. The export of consecutive piglets batches was identified as the most efficient measure facilitating swIAV infection fade-out. Although some vaccination schemes (batch-to-batch vaccination) had a beneficial effect in breeding sows by reducing the persistence of swIAVs within this subpopulation, none of vaccination strategies achieved swIAVs fade-out within the entire farrow-to-finish pig herd.

One-Health Simulation Modelling: Assessment of Control Strategies Against the Spread of Influenza between Swine and Human Populations Using NAADSM

Simulation models implemented using a range of parameters offer a useful approach to identifying effective disease intervention strategies. The objective of this study was to investigate the effects of key control strategies to mitigate the simultaneous spread of influenza among and between swine and human populations. We used the pandemic H1N1 2009 virus as a case study. The study population included swine herds (488 herds) and households-of-people (29,707 households) within a county in Ontario, Canada. Households were categorized as: (i) rural households with swine workers, (ii) rural households without swine workers and (iii) urban households without swine workers. Seventy-two scenarios were investigated based on a combination of the parameters of speed of detection and control strategies, such as quarantine strategy, effectiveness of movement restriction and ring vaccination strategy, all assessed at three levels of transmissibility of the virus at the swine-human interface. Results showed that the speed of detection of the infected units combined with the quarantine strategy had the largest impact on the duration and size of outbreaks. A combination of fast to moderate speed of the detection (where infected units were detected within 5-10 days since first infection) and quarantine of the detected units alone contained the outbreak within the swine population in most of the simulated outbreaks. Ring vaccination had no added beneficial effect. In conclusion, our study suggests that the early detection (and therefore effective surveillance) and effective quarantine had the largest impact in the control of the influenza spread, consistent with earlier studies. To our knowledge, no study had previously assessed the impact of the combination of different intervention strategies involving the simultaneous spread of influenza between swine and human populations.