Analysis of reservoir sources of Campylobacter isolates to free-range broilers in Denmark

Campylobacter is a common cause of food poisoning in many countries, with broilers being the main source. Organic and free-range broilers are more frequently Campylobacter-positive than conventionally raised broilers and may constitute a higher risk for human infections. Organic and free-range broilers may get exposed to Campylobacter from environmental reservoirs and livestock farms, but the relative importance of these sources is unknown. The aim of the study was to describe similarities and differences between the genetic diversity of the Campylobacter isolates collected from free-range/organic broilers with those isolated from conventional broilers and other animal hosts (cattle, pigs, and dogs) in Denmark to make inferences about the reservoir sources of Campylobacter to free-range broilers. The applied aggregated surveillance data consisted of sequenced Campylobacter isolates sampled in 2015 to 2017 and 2018 to 2021. The data included 1,102 isolates from free-range (n = 209), conventional broilers (n = 577), cattle (n = 261), pigs (n = 30), and dogs (n = 25). The isolates were cultivated from either fecal material (n = 434), food matrices (n = 569), or of nondisclosed origin (n = 99). Campylobacter jejuni (94.5%) dominated and subtyping analysis found 170 different sequence types (STs) grouped into 75 clonal complexes (CCs). The results suggest that CC-21 and CC-45 are the most frequent CCs found in broilers. The relationship between the CCs in the investigated sources showed that the different CCs were shared by most of the animals, but not pigs. The ST-profiles of free-range broilers were most similar to that of conventional broilers, dogs and cattle, in that order. The similarity was stronger between conventional broilers and cattle than between conventional and free-range broilers. The results suggest that cattle may be a plausible reservoir of C. jejuni for conventional and free-range broilers, and that conventional broilers are a possible source for free-range broilers or reflect a dominance of isolates adapted to the same host environment. Aggregated data provided valuable insight into the epidemiology of Campylobacter sources for free-range broilers, but time-limited sampling of isolates from different sources within a targeted area would hold a higher predictive value.

Disease outbreak response: why epidemiology plays a central role

The need to control transboundary animal disease outbreaks is widely recognised, as is the need for evidence-based decisions regarding which control measures to implement. Key data and information are required to inform this evidence base. To ensure effective communication of the evidence, a rapid process of collation, interpretation and translation is required. This paper describes how epidemiology can provide the framework through which relevant specialists can be engaged to this end, and highlights the central role of epidemiologists, with their unique combination of skills, in this process. It provides an example of an evidence team led by epidemiologists, namely the United Kingdom National Emergency Epidemiology Group, which was established to address this need. It then goes on to consider the different strands of epidemiology, the need for a wide multidisciplinary approach, and the importance of training and preparedness activities to facilitate rapid response.

Simulation of Foot-and-Mouth Disease Spread and Effects of Mitigation Strategies to Support Veterinary Contingency Planning in Denmark

To forge a path towards livestock disease emergency preparedness in Denmark, 15 different strategies to mitigate foot-and-mouth disease (FMD) were examined by modelling epidemics initiated in cattle, pig or small ruminant herds across various production systems located in four different Danish regions (Scenario 1), or in one specific livestock production system within each of the three species geographically distributed throughout Denmark (Scenario 2). When additional mitigation strategies were implemented on top of basic control strategies in the European foot-and-mouth disease spread model (EuFMDiS), no significant benefits were predicted in terms of the number of infected farms, the epidemic control duration, and the total economic cost. Further, the model results indicated that the choice of index herd, the resources for outbreak control, and the detection time of FMD significantly influenced the course of an epidemic. The present study results emphasise the importance of basic mitigation strategies, including an effective back-and-forward traceability system, adequate resources for outbreak response, and a high level of awareness among farmers and veterinarians concerning the detection and reporting of FMD at an early stage of an outbreak for FMD control in Denmark.

A global analysis of One Health Networks and the proliferation of One Health collaborations

There has been a renewed focus on threats to the human-animal-environment interface as a result of the COVID-19 pandemic, and investments in One Health collaborations are expected to increase. Efforts to monitor the development of One Health Networks (OHNs) are essential to avoid duplication or misalignment of investments. This Series paper shows the global distribution of existing OHNs and assesses their collective characteristics to identify potential deficits in the ways OHNs have formed and to help increase the effectiveness of investments. We searched PubMed, Google, Google Scholar, and relevant conference websites for potential OHNs and identified 184 worldwide for further analysis. We developed four case studies to show important findings from our research and exemplify best practices in One Health operationalisation. Our findings show that, although more OHNs were formed in the past 10 years than in the preceding decade, investment in OHNs has not been equitably distributed; more OHNs are formed and headquartered in Europe than in any other region, and emerging infections and novel pathogens were the priority focus area for most OHNs, with fewer OHNs focusing on other important hazards and pressing threats to health security. We found substantial deficits in the OHNs collaboration model regarding the diversity of stakeholder and sector representation, which we argue impedes effective and equitable OHN formation and contributes to other imbalances in OHN distribution and priorities. These findings are supported by previous evidence that shows the skewed investment in One Health thus far. The increased attention to One Health after the COVID-19 pandemic is an opportunity to focus efforts and resources to areas that need them most. Analyses, such as this Series paper, should be used to establish databases and repositories of OHNs worldwide. Increased attention should then be given to understanding existing resource allocation and distribution patterns, establish more egalitarian networks that encompass the breadth of One Health issues, and serve communities most affected by emerging, re-emerging, or endemic threats at the human-animal-environment interface.

Systematic review of products with potential application for use in the control of Campylobacter spp. in organic and free-range broilers

Campylobacter spp. are some of the most important food-borne zoonoses in Europe and broiler meat is considered the main source of Campylobacter infections. Organic and free-range broilers have access to outdoor reservoirs of Campylobacter and are more frequently infected at slaughter than the conventional broiler flocks. Limitations to biosecurity and treatment options in these production types calls for additional solutions. This review examines intervention methods with sufficient strength and quality, which are able to reduce the load of Campylobacter safely and efficiently and discuss their applicability in organic and free-range broiler production. Four different products passed the inclusion criteria and their quality examined: ferric tyrosine chelate, a prebiotic fermentation product of Saccharomyces cerevisiae, short-chain fatty acid butyrate coated on microbeads added to feed, and a mix of organic acids added to the drinking water. Though potential candidates for reducing Campylobacter in broilers were identified, there is a lack of large scale intervention studies that demonstrate an effect under field conditions of a free-range broiler production.

A one health glossary to support communication and information exchange between the human health, animal health and food safety sectors

Collaboration across sectors, disciplines and countries is a key concept to achieve the overarching One Health (OH) objective for better human, animal and environmental health. Differences in terminology and interpretation of terms are still a significant hurdle for cross-sectoral information exchange and collaboration within the area of OH including One Health Surveillance (OHS). The development of the here described glossary is a collaborative effort of three projects funded within the One Health European Joint Programme (OHEJP). We describe the infrastructure of the OHEJP Glossary, as well as the methodology to create such a cross-sectoral web resource in a collaborative manner. The new OHEJP Glossary allows OH actors to identify terms with different or shared interpretation across sectors. Being aware of such differences in terminology will help overcome communication hurdles in the future and consequently support collaboration and a more inclusive development of OHS. The OHEJP Glossary was implemented as a web-based, user-friendly and searchable infrastructure that complies with the Findable, Accessible, Interoperable, Reusable (FAIR) data principles. Maintenance, enrichment and quality control of the OHEJP Glossary is supported through a flexible and updatable curation infrastructure. This increases the uptake potential and exploitation of the OHEJP Glossary by other OH initiatives or tools and services.

Prevalence of Antimicrobial Resistant of Vibrio parahaemolyticus Isolated from Diarrheal Patients - Six PLADs, China, 2016-2020

What is already known on this topic?

Vibrio parahaemolyticus (V. parahaemolyticus) is frequently resistant to common antimicrobials such as ampicillin and generally highly susceptible to most clinically used antimicrobials.

What is added by this report?

V. parahaemolyticus were highly resistant to cefazolin and ampicillin: 94.4% and 37.0%, respectively. However, it was below 3% resistance to all 10 other antimicrobials including clinically relevant agents and even imipenem. The overall levels of antimicrobial resistance and multidrug resistance were 95.1% and 3.3%, respectively. The distribution of antimicrobial resistance and the multidrug resistance had regional, temporal, sexual, and isolated source strain variation.

What are the implications for public health practice?

This study provides data on drug resistance of V. parahaemolyticus in Chinese clinical settings, which will help develop a public health strategy.

Assessment of Evaluation Tools for Integrated Surveillance of Antimicrobial Use and Resistance Based on Selected Case Studies

Regular evaluation of integrated surveillance for antimicrobial use (AMU) and resistance (AMR) in animals, humans, and the environment is needed to ensure system effectiveness, but the question is how. In this study, six different evaluation tools were assessed after being applied to AMU and AMR surveillance in eight countries: (1) ATLASS: the Assessment Tool for Laboratories and AMR Surveillance Systems developed by the Food and Agriculture Organization (FAO) of the United Nations, (2) ECoSur: Evaluation of Collaboration for Surveillance tool, (3) ISSEP: Integrated Surveillance System Evaluation Project, (4) NEOH: developed by the EU COST Action "Network for Evaluation of One Health," (5) PMP-AMR: The Progressive Management Pathway tool on AMR developed by the FAO, and (6) SURVTOOLS: developed in the FP7-EU project "RISKSUR." Each tool was scored using (i) 11 pre-defined functional aspects (e.g., workability concerning the need for data, time, and people); (ii) a strengths, weaknesses, opportunities, and threats (SWOT)-like approach of user experiences (e.g., things that I liked or that the tool covered well); and (iii) eight predefined content themes related to scope (e.g., development purpose and collaboration). PMP-AMR, ATLASS, ECoSur, and NEOH are evaluation tools that provide a scoring system to obtain semi-quantitative results, whereas ISSEP and SURVTOOLS will result in a plan for how to conduct evaluation(s). ISSEP, ECoSur, NEOH, and SURVTOOLS allow for in-depth analyses and therefore require more complex data, information, and specific training of evaluator(s). PMP-AMR, ATLASS, and ISSEP were developed specifically for AMR-related activities-only ISSEP included production of a direct measure for "integration" and "impact on decision making." NEOH and ISSEP were perceived as the best tools for evaluation of One Health (OH) aspects, and ECoSur as best for evaluation of the quality of collaboration. PMP-AMR and ATLASS seemed to be the most user-friendly tools, particularly designed for risk managers. ATLASS was the only tool focusing specifically on laboratory activities. Our experience is that adequate resources are needed to perform evaluation(s). In most cases, evaluation would require involvement of several assessors and/or stakeholders, taking from weeks to months to complete. This study can help direct future evaluators of integrated AMU and AMR surveillance toward the most adequate tool for their specific evaluation purpose.

Base protocol for real time active random surveillance of coronavirus disease (COVID-19) - Adapting veterinary methodology to public health

The pandemic of new coronavirus disease COVID-19 is threatening our health, economy and life style. Collaborations across countries and sectors as a One Health World could be a milestone.

We propose a general protocol, for setting timely active random surveillance of COVID-19, at the human community level, with systematic repeated detection efforts. Strengths and limitations are discussed.

If considered applicable by public health, the protocol could evaluate the status of COVID-19 epidemics consistently and objectively.

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A base protocol is proposed for setting active random surveillance of COVID-19.

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The protocol is based on widely known veterinary surveillance methodologies.

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By applying the protocol, COVID-19 epidemics could be consistently assessed.

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The protocol could be a milestone in the battle against the pandemic.

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Authorities could consider if the protocol is applicable for public health.

Surveillance to improve evidence for community control decisions during the COVID-19 pandemic - Opening the animal epidemic toolbox for Public Health

During the first few months of 2020, the COVID-19 pandemic reached Europe and spread around the world. Health systems all over the world are trying to control the outbreak in the shortest possible time. Exotic disease outbreaks are not uncommon in animal health and randomised surveillance is frequently used as support for decision-making. This editorial discusses the possibilities of practicing One Health, by using methods from animal health to enhance surveillance for COVID-19 to provide an evidence base fort decision-making in communities and countries.

Evaluating integrated surveillance of antimicrobial resistance: experiences from use of three evaluation tools

BACKGROUND

Integrated antimicrobial resistance (AMR) surveillance programmes require regular evaluation to ensure they are fit for purpose and that all actors understand their responsibilities. This will strengthen their relevance for the clinical setting, which depends heavily on continued access to effective treatment options. Several evaluation tools addressing different surveillance aspects are available.

OBJECTIVES

The aim was to understand the strengths and weaknesses of three evaluation tools, and to improve guidance on how to choose a fit-for-purpose tool.

SOURCES

Three tools were assessed: (a) AMR-PMP-the Progressive Management Pathway tool on AMR developed by the Food and Agriculture Organization (FAO) of the United Nations, (b) NEOH developed by the EU COST Action 'Network for Evaluation of One Health' and (c) SURVTOOLS developed in an FP7-EU project 'RISKSUR'. Each tool was assessed with regard to contents, required evaluation processes including stakeholder engagement and resource demands, integration coverage across relevant sectors and applicability. They were compared using a predefined scoring scheme and a strengths-weaknesses-opportunities-threats (SWOT)-like format for commenting.

CONTENT

All three tools address multiple decision-making levels and aspects of stakeholder engagement. NEOH focuses on system features, learning, sharing, leadership and infrastructure, and requires a description of the underlying system in which AMR develops. AMR-PMP focuses on four areas: awareness, evidence, governance and practices and assesses the implementation degree of pre-chosen aspects within these areas. This requires less of the evaluator, but warrants participation of multiple stakeholders. SURVTOOL provides information and references on how to evaluate effectiveness, process and comprehensiveness of surveillance programmes. All three tools require veterinary epidemiology expertise and varying levels of evaluation methodology training to use appropriately.

IMPLICATIONS

The tools covered AMR surveillance and One Health aspects to varying degrees. This study provides guidance on aspects to consider when choosing between available tools and embarking on an evaluation of integrated surveillance.

Assessment of the Risk to Public Health due to Use of Antimicrobials in Pigs-An Example of Pleuromutilins in Denmark

Antibiotic consumption in pigs can be optimized by developing treatment guidelines, which encourage veterinarians to use effective drugs with low probability of developing resistance of importance for human health. In Denmark, treatment guidelines for use in swine production are currently under review at the Danish Veterinary and Food Administration. Use of pleuromutilins in swine has previously been associated with a very low risk for human health. However, recent international data and sporadic findings of novel resistance genes suggest a change of risk. Consequently, a reassessment was undertaken inspired by a risk assessment framework developed by the European Medicines Agency. Livestock-associated methicillin-resistant Staphylococcus aureus of clonal complex 398 (MRSA CC398) and enterococci were identified as relevant hazards. The release assessment showed that the probability of development of pleuromutilin resistance was high in MRSA CC398 (medium uncertainty) and low in enterococci (high uncertainty). A relatively small proportion of Danes has an occupational exposure to pigs, and foodborne transmission was only considered of relevance for enterococci, resulting in an altogether low exposure risk. The human consequences of infection with pleuromutilin-resistant MRSA CC398 or enterococci were assessed as low for the public in general but high for vulnerable groups such as hospitalized and immunocompromised persons. For MRSA CC398, the total risk was estimated as low (low uncertainty), among other due to the current guidelines on prevention of MRSA in place at Danish hospitals, which include screening of patients with daily contact to pigs on admittance. Moreover, MRSA CC398 has a medium human–human transmission potential. For enterococci, the total risk was estimated as low due to low prevalence of resistance, low probability of spread to humans, low virulence, but no screening of hospitalized patients, high ability of acquiring resistance genes, and a limited number of alternative antimicrobials (high uncertainty). This assessment reflects the current situation and should be repeated if pleuromutilin consumption increases substantially, resulting in increased prevalence of mobile, easily transmissible resistance mechanisms. Continuous monitoring of pleuromutilin resistance in selected human pathogens should therefore be considered. This also includes monitoring of linezolid resistance, since resistance mechanisms for pleuromutilins and oxazolidones are often coupled.

Factors associated with bovine neonatal pancytopenia (BNP) in calves: a case-control study

Bovine neonatal pancytopenia (BNP; previously known as idiopathic haemorrhagic diathesis and commonly known as bleeding calf syndrome) is a novel haemorrhagic disease of young calves which has emerged in a number of European countries during recent years. Data were retrospectively collected during June to November 2010 for 56 case calves diagnosed with BNP between 17 March and 7 June of the same year. These were compared with 58 control calves randomly recruited from herds with no history of BNP. Multivariable logistic regression analysis showed that increased odds of a calf being a BNP case were associated with its dam having received PregSure® BVD (Pfizer Animal Health) vaccination prior to the birth of the calf (odds ratio (OR) 40.78, p<0.001) and its herd of origin being located in Scotland (OR 9.71, p = 0.006). Decreased odds of a calf being a BNP case were associated with the calf having been kept outside (OR 0.11, p = 0.006). The longer that a cattle herd had been established on the farm was also associated with decreased odds of a calf in that herd being a BNP case (OR 0.97, p = 0.011).

Characteristics and comparative performance of direct culture, direct PCR and enumeration methods for detection and quantification of Campylobacter spp. in broiler caeca

Detection and enumeration of Campylobacter spp. in broiler chicken flocks are key components of research and surveillance studies aimed at reducing Campylobacter infections in people. Direct culture of caecal contents onto selective agar is the typical method used to confirm flock colonisation. Modified charcoal cefoperazone deoxycholate agar (mCCDA) is commonly used for this method, although alternative selective media have been used. Additionally, PCR methods to detect Campylobacter DNA from caecal contents may provide a rapid alternative. However comparative performance data for these methods is limited and therefore required to ensure optimal detection methods for this sample type. In this study, 306 broiler caeca were tested for Campylobacter using direct culture on mCCDA, Skirrows and Preston agars and two real-time PCR methods, one specific for mapA/ceuE regions and another for the flaA gene region. Additionally, the suitability of spread plating and spiral plating methods for enumeration of Campylobacter and the impact of sample storage were assessed. This study confirmed modified CCDA as an optimal media for detection of Campylobacter in broiler caeca. It was significantly more sensitive than Skirrows or Preston agars. This study also demonstrated that the mapA/ceuE PCR had excellent agreement with culture on mCCDA and is a genuine alternative method. Spread plating and spiral plating methods were suitable for enumeration although spiral plating appeared more sensitive for stored samples (72 h). A 1 log reduction in viable Campylobacters was observed in stored samples, therefore storage effects should be considered for quantitative studies with broiler caeca.

Risk factors for transmission of foot-and-mouth disease during an outbreak in southern England in 2007

During an outbreak of foot-and-mouth disease (FMD) in southern England in 2007, a case-control study was conducted to identify risk factors for infection and to investigate the relative impact of risk factors on transmission between the infected farms. Seven of the eight case farms in the outbreak and 22 control farms participated. Data were collected via questionnaires and subjected to comparative statistical analysis. Case farms were further classified as primary or secondary according to the likely source of infection during the study. On primary case farms, it was plausible that infection had been introduced directly from the original source. On secondary case farms, FMD infection was more likely to have originated from another infected premises. Calving occurred more frequently on case farms than on control farms during the risk period, and the two primary case farms had a larger proportion of youngstock than the other farms. Secondary case farms (n=5) had a higher composite environmental risk score and a lower biosecurity score than control farms.

Q fever outbreak in Cheltenham, United Kingdom, in 2007 and the use of dispersion modelling to investigate the possibility of airborne spread

We describe the investigation of an outbreak of Q fever in the town of Cheltenham, England. The outbreak was detected in June 2007, and prospective and retrospective case finding identified 30 confirmed or probable human cases. The investigation identified windborne spread of Coxiella burnetii from nearby sheep farms as the most likely source of infection. A telephone survey was conducted to identify risk practices at local farms. Subsequently the atmospheric dispersion model NAME was used to identify whether air from the identified farms with high risk practices had been carried into Cheltenham town centre during the risk period. Three high risk farms were identified and the modelling showed that air from all of these farms was carried over Cheltenham in the estimated risk period. The investigation resulted in an information campaign to farmers and production of improved advice for livestock farmers on reducing the risks of transmitting Q fever to humans.

Q fever outbreak in Cheltenham, United Kingdom, in 2007 and the use of dispersion modelling to investigate the possibility of airborne spread

We describe the investigation of an outbreak of Q fever in the town of Cheltenham, England. The outbreak was detected in June 2007, and prospective and retrospective case finding identified 30 confirmed or probable human cases. The investigation identified windborne spread of Coxiella burnetii from nearby sheep farms as the most likely source of infection. A telephone survey was conducted to identify risk practices at local farms. Subsequently the atmospheric dispersion model NAME was used to identify whether air from the identified farms with high risk practices had been carried into Cheltenham town centre during the risk period. Three high risk farms were identified and the modelling showed that air from all of these farms was carried over Cheltenham in the estimated risk period. The investigation resulted in an information campaign to farmers and production of improved advice for livestock farmers on reducing the risks of transmitting Q fever to humans.

Temporal patterns and risk factors for Escherichia coli O157 and Campylobacter spp, in young cattle

Escherichia coli O157 and Campylobacter jejuni and Campylobacter coli are zoonotic pathogens originating from farm animals. Cattle are the main reservoir for E. coli O157 and also contribute to human cases of campylobacteriosis through contaminated milk, direct contact, and environmental contamination. Thirty groups of young cattle on 30 farms were observed for 7 months and sampled on 4 to 6 separate occasions for E. coli O157 and C. jejuni/coli to characterize shedding patterns and identify risk factors. The within herd prevalence of E. coli O157 per sampling occasion ranged from 0 to 60% (mean = 24%) and average Campylobacter spp. within herd prevalence was 47% ranging from 0 to 100%. The prevalence of E. coli O157-positive herds declined with a linear trend throughout the study from 100 to 38% (OR: 0.5, P < 0.01), whereas time in the study was not significantly associated with Campylobacter prevalence (P = 0.13). Larger herds were more likely to be positive with either or both agents, whereas the number of suckler calves on the farm reduced the risk of both organisms (OR: 0.4/0.6, P < 0.01). Poultry on the premises reduced the risk of E. coli O157, but was not associated with Campylobacter. Emptying and cleaning the water troughs more often than once monthly reduced the risk of detecting Campylobacter and cattle sourced by private water supplies were more likely to be Campylobacter positive. No drinking water management practices were associated with E. coli O157. The risk of detecting both organisms were almost five times higher when the cattle were housed indoors (OR: 4.9, P = 0.03).

Short communication: turbidity as an indicator of Escherichia coli presence in water troughs on cattle farms

Studies have shown that water-drinking troughs are an important source of Escherichia coli infection on cattle farms, and a study was designed to provide farmers with an easy-to-use tool to monitor trough contamination and help determine when to empty and clean water troughs. A total of 164 water troughs were sampled on 33 cattle farms, and the on-farm turbidity tester results were found to be significantly correlated with laboratory turbidity results. Turbidity was associated with E. coli concentration, although the association was not linear. Emptying the troughs within a week of sampling was shown to reduce the turbidity score, but no linear association between time of emptying and E. coli concentration was discovered. A turbidity score of 4 was set as a cutoff point for when to clean a trough, yielding a sensitivity of 0.94 and a specificity of 0.03 for identifying a level of E. coli concentration that was more likely to contain E. coli O157 (>5,800 cfu/100 mL).

Investigation into the Effectiveness of Pooled Fecal Samples for Detection of Verocytotoxin-Producing Escherichia Coli O157 in Cattle

Verocytotoxin-producing Escherichia coli O157 (VTEC O157) may cause severe illness in people. Cattle are regarded as an important source of VTEC O157, and in an outbreak investigation, there is a necessity to establish whether or not the putative contact herd shares infection with the human case. The effectiveness of a herd investigation is impacted by the number of samples required, which will influence the time taken to collect samples and then process these in the laboratory. The objective of this study was to investigate the effectiveness of pooled sampling for detecting VTEC O157 in cattle herds in the United Kingdom. On farm 1, 150 individual fecal samples were collected during the course of a VTEC O157 outbreak investigation. One-gram and 10-g subsamples were tested from each individual sample. Once the culture results of the individual sample were known, pools comprising 5 and 10 individual samples were formed, with each pool containing a known number of positive samples. This data showed that the sensitivity of pooled sampling depended upon the proportion of positive samples in the pool. Further samples were collected from 2 more infected farms (2 and 3). Each individual sample was tested in duplicate. Pools of 5 feces were formed on-farm, and half the number of pooled feces were tested as individual feces. There was no significant difference between the number of cultures required for pooled sampling, as was the same for individual sampling, and therefore pooling did not improve the effectiveness of detection of VTEC O157.

Identification of management risk factors for VTEC O157 in young-stock in England and Wales

We conducted a cross-sectional study on 255 cattle farms in England and Wales to identify risk factors for verocytotoxin-producing E. coli O157 (VTEC). Exposure variables were collected at the levels of the farm and of the group of young-stock within the farms. On each farm a group of young-stock (6-18 months of age) was sampled to establish VTEC status. In our multiple logistic regression, farm VTEC status was associated with access to springs (OR: 0.31, CI95%: 0.12, 0.78) and assessing the wetness of the bedding material less frequently than daily (OR: 3.89 CI95%: 1.5, 10.2). At group-level we found no associated risk factors for animals housed outdoors in fields. Significant for groups housed in pens were wet bedding (wet OR: 3.43, CI95%: 1.3, 9.4; very wet OR: 4.24, CI95%: 1.2, 14.6), number of animals in the group (10-15 OR: 2.72, CI95%: 0.75, 9.9, 16-24, OR: 3.78, CI95%: 1.2, 12.3; >25 OR: 3.78, CI95%: 1.1, 12.7) and feeding straw (OR: 2.29, CI95%: 1.2, 5.5).