Animal Health Agency Research Articles

High real-time reporting of domestic and wild animal diseases following rollout of mobile phone reporting system in Kenya.

BackgroundTo improve early detection of emerging infectious diseases in sub-Saharan Africa (SSA), many of them zoonotic, numerous electronic animal disease-reporting systems have been piloted but not implemented because of cost, lack of user friendliness, and data insecurity. In Kenya, we developed and rolled out an open-source mobile phone-based domestic and wild animal disease reporting system and collected data over two years to investigate its robustness and ability to track disease trends.MethodsThe Kenya Animal Biosurveillance System (KABS) application was built on the Java® platform, freely downloadable for android compatible mobile phones, and supported by web-based account management, form editing and data monitoring. The application was integrated into the surveillance systems of Kenya’s domestic and wild animal sectors by adopting their existing data collection tools, and targeting disease syndromes prioritized by national, regional and international animal and human health agencies. Smartphone-owning government and private domestic and wild animal health officers were recruited and trained on the application, and reports received and analyzed by Kenya Directorate of Veterinary Services. The KABS application performed automatic basic analyses (frequencies, spatial distribution), which were immediately relayed to reporting officers as feedback.ResultsOf 697 trained domestic animal officers, 662 (95%) downloaded the application, and >72% of them started reporting using the application within three months. Introduction of the application resulted in 2- to 14-fold increase in number of disease reports when compared to the previous year (relative risk = 14, CI 13.8–14.2, p<0.001), and reports were more widely distributed. Among domestic animals, food animals (cattle, sheep, goats, camels, and chicken) accounted for >90% of the reports, with respiratory, gastrointestinal and skin diseases constituting >85% of the reports. Herbivore wildlife (zebra, buffalo, elephant, giraffe, antelopes) accounted for >60% of the wildlife disease reports, followed by carnivores (lions, cheetah, hyenas, jackals, and wild dogs). Deaths, traumatic injuries, and skin diseases were most reported in wildlife.ConclusionsThis open-source system was user friendly and secure, ideal for rolling out in other countries in SSA to improve disease reporting and enhance preparedness for epidemics of zoonotic diseases.

How to…

Why is up-skilling in poultry medicine important? Have you buckled at the knees on seeing the word ‘chicken’ flash up on the appointment system? Rest assured – subsequent experience in the poultry industry has made clear these cases are often straightforward. Henrietta Kodilinye-Sims from the University of Surrey School of Veterinary Medicine and co-authors Kannan Ganapathy from the University of Liverpool, and Alex Schock and David Welchman from the Animal Plant and Health Agency offer some welcome guidance.

Antimicrobial Use in Companion Animals: Assessing Veterinarians' Prescription Patterns through the First National Survey in Chile.

Simple SummaryAntimicrobial resistance is a growing global health issue for both animal and public health agencies. One major driver for the development and spread of antimicrobial resistant bacteria is antimicrobial use by animal and health workers. Information about the use of antimicrobials in companion animals has been poorly described worldwide, and currently there is no data at the Latin American or national level, which represents a risk to public health. The aim of this study was to describe the antimicrobial prescription patterns of Chilean companion animal veterinarians by means of a nationally distributed survey. Three hundred twenty-three responses were collected, most of the respondents were female (59.4%). The most frequently reported bacterial diseases were pyoderma (17.2%), followed by otitis (7.4%) and abscesses (7.4%). Critically important or highly important drugs for veterinary and human use were the most frequently used. Only 15% of the veterinarians reported the use of laboratory diagnostic tests prior to prescribing antimicrobials. Our results show that different classes of antimicrobials are used in clinical practices for companion animals without the use of confirmatory laboratory tests, which represents a risk to animal and public health.Although the relationship between the use of antimicrobials and the development of resistant bacteria is well established, information about the use of antimicrobials in companion animals has been poorly described, which represents a risk to public health. The aim of this study was to describe the antimicrobial prescription patterns of Chilean companion animal veterinarians. A nationally distributed survey targeted at companion animal veterinarians was designed. The survey included questions about the veterinarian’s demographics, bacterial diseases treated, prescribed antimicrobials, and the use of laboratory diagnostic tools. Three hundred twenty-three responses were collected, most of the respondents were female (59.4%). The most frequently reported bacterial diseases were pyoderma (17.2%), followed by otitis and abscesses (7.4%). The antimicrobials most used corresponded with critically or highly important drugs for veterinary and human use, including β-lactams (65.3%), quinolones (36.2%) and tetracyclines (23.2%). Only 15% of the veterinarians reported the use of laboratory diagnostic tests, although 67% declared they were aware of the official antimicrobial classification schemes. Our results describe for the first time the usage of antimicrobials by veterinarian practitioners in Chile to treat different diseases in companion animals. The data presented here provide a baseline that could help to promote the implementation of clinical guidelines and regulations in order to improve current treatments.

Scope and challenges of one health approach in Nepal

Background: The burden of infectious diseases is high in developing countries. Many infectious diseases are still a public health problem in Nepal. Different types of emerging and re-emerging infection are in endemic situation in Nepal. However, as a result of various interventions and public health program, the overall trend of infectious diseases is now in a declining trend. Nepal faces burden of zoonotic diseases of epidemic; endemic and pandemic potentials are major public health concern. 60 different zoonotic diseases have been identified in Nepal as emerging and re-emerging diseases. There is strong connection and effect of climate change, global warming. Nowadays, the interrelation of human, environment and animals is also concern about antimicrobial resistance. One Health approach is an important approach for effective prevent and control of zoonotic diseases in Nepal. Methods and materials: To prepare this paper, journal, articles & national reports were retrieved and analyzed to prepare a manuscript. Informal discussion as made with government officials who are working at Epidemiology and Disease Control Centre, Kathmandu. This paper was prepared by using various secondary data sources available on internet webpages, journals, government reports and articles. Results: Nepal has been experiencing various flu like seasonal infections every year. The six zoonoses Taeniosis, Leptospirosis, Hydatidosis, Brucellosis; Toxoplasmosis and Avian Influenza have been identified as Priorities Zoonotic Diseases in Nepal. Influenza is the more common outbreak observed in Nepal. It was estimated that almost half of Nepal's population is at high risk and a quarter at moderate risk of rabies. The cooperation and joint policy level decision was not yet done to formulate one health policy and conduct joint activities. One health approach is not yet institutionalized from government sector to deal with underlying condition. Conclusion: Lack of strong coordination between two agencies l.e human health and animal health agencies is one of the major problems in Nepal. Since, Nepal is facing frequent outbreak of seasonal infections borne from animals, at least joint effort from the veterinary and human medical & public health professional is required to prevent the possible threats from zoonotic diseases in Nepal.

Equine seroprevalence of West Nile virus antibodies in the UK in 2019

BackgroundWest Nile virus (WNV) is a single-stranded RNA virus that can cause neurological disease in both humans and horses. Due to the movement of competent vectors and viraemic hosts, WNV has repeatedly emerged globally and more recently in western Europe. Within the UK, WNV is a notifiable disease in horses, and vaccines against the virus are commercially available. However, there has been no investigation into the seroprevalence of WNV in the UK equine population to determine the extent of vaccination or to provide evidence of recent infection.MethodsEquine serum samples were obtained from the Animal and Plant Health Agency’s equine testing service between August and November 2019. A total of 988 serum samples were selected for horses resident in South East England. WNV seroprevalence was determined using two enzyme-linked immunosorbent assays (ELISAs) to detect total flavivirus antibodies and WNV-specific immunoglobulin M (IgM) antibodies. Positive IgM results were investigated by contacting the submitting veterinarian to establish the clinical history or evidence of prior vaccination of the horses in question.ResultsWithin the cohort, 274 samples tested positive for flavivirus antibodies, of which two subsequently tested positive for WNV-specific IgM antibodies. The follow-up investigation established that both horses had been vaccinated prior to serum samples being drawn, which resulted in an IgM-positive response. All the samples that tested positive by competition ELISA were from horses set to be exported to countries where WNV is endemic. Consequently, the positive results were likely due to previous vaccination. In contrast, 714 samples were seronegative, indicating that the majority of the UK equine population may be susceptible to WNV infection.ConclusionsThere was no evidence for cryptic WNV infection in a cohort of horses sampled in England in 2019. All IgM-seropositive cases were due to vaccination; this should be noted for future epidemiological surveys in the event of a disease outbreak, as it is not possible to distinguish vaccinated from infected horses without knowledge of their clinical histories.Graphical

Bovine cysticercosis outbreak in an indoor beef finisher farm in the North of England

Bovine cysticercosis is a parasitic infection of cattle caused by the human tapeworm Taenia saginata. Bovine cysticercosis was identified by meat inspection in 4.7 per cent (18 out of 380)...

Shifting to foot-and-mouth disease-free status without vaccination: Application of the PROMETHEE method to assist in the development of a foot-and-mouth national program in Uruguay

Foot-and-mouth disease (FMD) is highly contagious, and the introduction of FMD virus in countries free of the disease can result in large epidemics, similar to those observed in the United Kingdom, Japan, and Uruguay. Many countries or regions of South America are recognized as “FMD-free with vaccination” or “FMD-free without vaccination.” Uruguay has been certified as FMD-free with vaccination, and the transition to the status of FMD-free without vaccination has been discussed among the stakeholders of the Ministry of Livestock Agriculture and Fisheries (MGAP in Spanish). This study illustrates how the Preference Ranking Organization Method for Enrichment Evaluation (PROMETHEE) can identify and rank alternative actions to be used in the national FMD program in Uruguay. It uses multiple-criteria decision analysis (MCDA) to structure the problem comprehensively. This helps to identify critical issues and potential solutions when planning a national FMD program for a country with a disease-free without vaccination status. The analysis highlighted the following perspectives: i) the importance of communication strategies as the country changes to “FMD-free without vaccination” status, as well as potential challenges such as a lack of trust in government; ii) the importance of enhancing epidemiological capacity and data management to allocate resources better and provide feedback from the surveillance system; iii) the need to re-evaluate the animal health compensation strategy to stimulate biosecurity and disease reporting; and iv) the importance of assisting the backyard pig sector given the risks it carries and the complexity of dealing with because of its informality, the educational status of its owners, and the lack of formal assistance by veterinary services. The results suggests that the MCDA approach could be a useful tool for animal health agencies when planning a program to eliminate FMD (as well as other diseases) in a structured way because it helps to identify which alternatives would yield more effective results and it helps to address future challenges.

Mesothelioma in two sheep with pericardial effusion and ascites

Mesotheliomas are rare tumours in domestic animals. These tumours have a range of clinical presentations, and a range of gross and microscopic features can be present. We report mesotheliomas in...

Review on Outbreak Dynamics, the Endemic Serotypes, and Diversified Topotypic Profiles of Foot and Mouth Disease Virus Isolates in Ethiopia from 2008 to 2018.

Foot and mouth disease (FMD) endemicity in Ethiopia’s livestock remains an ongoing cause for economic concern, with new topotypes still arising even in previously unaffected areas. FMD outbreaks occur every year almost throughout the country. Understanding the outbreak dynamics, endemic serotypes, and lineage profiles of FMD in this country is very critical in designing control and prevention programs. For this, detailed information on outbreak dynamics in Ethiopia needs to be understood clearly. In this article, therefore, we review the spatial and temporal patterns and dynamics of FMD outbreaks from 2008 to 2018. The circulating serotypes and the topotypic profiles of the virus are also discussed. FMD outbreak data were obtained from; reports of MoARD (Ministry of Agriculture and Rural Development)/MoLF (Ministry of livestock and Fishery, NVI (National Veterinary Institute), and NAHDIC (National Animal Health Diagnostic and Investigation Center); published articles; MSc works; PhD theses; and documents from international organizations. To effectively control and prevent FMD outbreaks, animal health agencies should focus on building surveillance systems that can quickly identify and control ongoing outbreaks and implement efficient preventive measures.

First report of papillomatosis due to papillomavirus in a Eurasian badger (Meles meles)

A live Eurasian badger (Meles meles) was admitted to the Royal Society for the Prevention of Cruelty to Animals Wildlife Rehabilitation Centre, West Hatch, Somerset, on August 10, 2018. It...

First report of dermatophilosis in wild European red squirrels (Sciurus vulgaris)

The carcases of two wild red squirrels (Sciurus vulgaris) from Anglesey, North Wales, which had severe skin lesions, were presented to the Animal and Plant Health Agency. One was found...

Science-based wildlife disease response

In 2007, the current outbreak of African swine fever (ASF), which severely affects wild boar populations and pigs, reached the Caucasus region. Since then, the virus has spread into eastern Europe and some places in central and western Europe (such as Belgium) through wild boar, domestic pigs, and human activities. The virus has raised serious concerns in countries with large pork industries, which may suffer economic losses due to trade restrictions ([ 1 ][1]). To control the outbreak, national authorities have taken drastic but likely ineffective measures that disregard the science of wildlife management. Poland, for example, has massively increased culling of wild boar to minimize ASF spread and the risk of transmission to domestic pigs, despite opposition by experts ([ 2 ][2], [ 3 ][3]). The policy does not include population monitoring that could evaluate its effectiveness ([ 4 ][4]). It also does not limit wild boar access to agricultural crops and game feed, which is a key driver of population growth ([ 5 ][5]). Meanwhile, Denmark is building a 70-km border fence to exclude cross-border migration of wild boar ([ 6 ][6]). The fence will disrupt wildlife habitats ([ 6 ][6]), but it will not stop the virus from spreading through the transportation of live pigs, wild boar, or pig- and wild boar–derived tissues and products or through the movement of other objects carrying the virus, such as human clothing ([ 1 ][1]). Factors that govern wild boar abundance and virus spread are not bound by national borders. Instead of haphazard policies, we urge governments to agree on a coordinated response that adheres to the principles of modern wildlife management ([ 7 ][7]). Adaptive wildlife management strategies consider the human dimension and prevent unsound reactive management. Improved wildlife population monitoring ([ 4 ][4]) and analysis are the best ways to determine which approaches to wildlife management are successful ecologically, economically, and socially. Sustainable management will depend on local circumstances and national wildlife management regulations, but science-based strategies can be implemented at the continental scale. Legislators across Europe should consult scientists and wildlife and animal health agencies before making decisions about wildlife policy. European countries should coordinate population monitoring and management. Shared responsibility for wildlife management among countries will enable funding for research that can critically evaluate its success. The ASF crisis can serve as a chance to develop a science-based wildlife policy for Europe. 1. [↵][8]EFSA Panel on Animal Health and Welfare (AHAW)et al., EFSA J. 16, 5344 (2018). [OpenUrl][9] 2. [↵][10]1. K. Schmidt, 2. R. Kowalczyk, 3. H. Okarma, 4. T. Podgorski, 5. P. Chylarecki , “Experts against the proposal to depopulate wild boar in Poland,” ENETWILD (2019); . 3. [↵][11]1. S. Walker , “Planned wild boar cull in Poland angers conservationists,” The Guardian (2019); . 4. [↵][12]ENETWILD Consortiumet al., EFSA Supporting Publication 15, EN-1523 (2018). [OpenUrl][13] 5. [↵][14]1. G. Massei et al ., Pest Manag. Sci. 71, 492 (2015). [OpenUrl][15] 6. [↵][16]1. A. Mysterud, 2. C. M. Rolandsen , J. Appl. Ecol. 56, 519 (2019). [OpenUrl][17] 7. [↵][18]1. M. Apollonio et al ., Mammal Res. 62, 209 (2017). [OpenUrl][19] [1]: #ref-1 [2]: #ref-2 [3]: #ref-3 [4]: #ref-4 [5]: #ref-5 [6]: #ref-6 [7]: #ref-7 [8]: #xref-ref-1-1 View reference 1 in text [9]: {openurl}?query=rft.jtitle%253DEFSA%2BJ.%26rft.volume%253D16%26rft.spage%253D5344%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [10]: #xref-ref-2-1 View reference 2 in text [11]: #xref-ref-3-1 View reference 3 in text [12]: #xref-ref-4-1 View reference 4 in text [13]: {openurl}?query=rft.jtitle%253DEFSA%2BSupporting%2BPublication%26rft.volume%253D15%26rft.spage%253DEN-1523%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [14]: #xref-ref-5-1 View reference 5 in text [15]: {openurl}?query=rft.jtitle%253DPest%2BManag.%2BSci.%26rft.volume%253D71%26rft.spage%253D492%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [16]: #xref-ref-6-1 View reference 6 in text [17]: {openurl}?query=rft.jtitle%253DJ.%2BAppl.%2BEcol.%26rft.volume%253D56%26rft.spage%253D519%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [18]: #xref-ref-7-1 View reference 7 in text [19]: {openurl}?query=rft.jtitle%253DMammal%2BRes.%26rft.volume%253D62%26rft.spage%253D209%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx

Knowledge, attitudes, and practices associated with avian influenza along the live chicken market chains in Eastern China: A cross-sectional survey in Shanghai, Anhui, and Jiangsu.

The avian influenza (AI) virus of the H7N9 subtype emerged in China in 2013. Live bird markets (LBMs) selling live meat chickens were indicated to present a high-risk of the virus dissemination. This study aimed to quantify the level of knowledge, attitudes, and practices (KAP) on AI and to measure the associated risk factors among different actors along the live chicken market chain within H7N9-affected Eastern provinces in China. A cross-sectional survey was conducted in these provinces from June to July 2014. Structured questionnaires about KAP on AI were delivered to chicken farmers, chicken vendors, and consumers in LBMs. Multivariable generalized least squares regression models were developed to identify predictors of KAP scores among different actors. Our results indicate that KAP scores of chicken farmers were generally higher than those of chicken vendors. Chicken farmers who worked for more than 15years had significantly lower total KAP scores than those who worked for less than 6 years. Chicken farmers who worked more than 15hrs in a day had significantly lower attitude scores than those who worked less than 6hrs. For chicken vendors, females and individuals>35 years old had significantly lower knowledge scores compared to the reference categories. Practice scores were significantly higher in female vendors and those vendors who also conducted slaughter compared to males and vendors who did not conduct slaughter. Consumers who bought chicken at least once every month had better risk awareness compared to those who bought chicken at least once every week. In addition, female consumers had significantly better practice scores than male consumers. In conclusion, risk-based health promotion interventions should be developed and implemented by animal health agencies (targeting farmers and vendors) and public health agencies (targeting frequent and male consumers) to prevent transmission of H7N9 along the market chain in China.

Economic evaluation of low pathogenic avian influenza in northeastern US live bird markets

SUMMARY Avian influenza in domestic poultry can have varied impacts on the health and welfare of birds and an economic burden on producers, consumers, and animal health agencies including the cost to control and eradicate avian influenza. Low pathogenic avian influenza has historically been a recurring issue in U.S. live bird markets, but rarely studied. Live bird markets source various species of birds and mammals from a variety of wholesalers and sell either live animals or freshly harvested animals. Using cost estimates from the 2016 outbreak of low pathogenic avian influenza in northeastern U.S. live bird markets, estimates of the mean per market costs were calculated for responding government agencies ($804) and the market itself ($3,997), including traceback investigation, testing costs, and cleaning and disinfection. The economic impact also included market impacts which the majority are affected by income that the live bird markets forego during cleaning and disinfection ($3,998 per market) with an expected shutdown of 3–5d. Animal health agencies' responses to a disease depend on the established disease response and resources, such as labor and funding. Understanding the economic costs of disease management improves the decision-making process for these agencies and markets as a whole to limit disease introduction, spread, longevity, and market impacts through business disruptions and foregone income.

Can resistant infections be perceptible in UK dairy farming?

This paper interrogates the claim that antimicrobial-resistant infections are rarely encountered in animal agriculture. This has been widely reiterated by a range of academic, policy and industry stakeholders in the UK. Further support comes from the UK's Animal and Plant Health Agency’s (APHA) passive clinical surveillance regime, which relies on veterinarians to submit samples for analysis and similarly reports low levels of resistance amongst key animal pathogens. Building on social science work on knowledge-practices of animal health and disease, and insights from emerging literature on non-knowledge or ‘agnotology’, we investigate the conditions shaping what is known about antimicrobial-resistant infections on farms. In so doing, we find that how on-farm knowledge is produced about resistant infection is concurrently related to domains of imperceptibility or what cannot be known in the context of current practices. The paper discusses the findings of ethnographic research undertaken on an East Midlands dairy farm that highlight the following specific findings. First, farmers and veterinarians, when observing instances of treatment failure, draw on an experiential repertoire that effaces resistances and instead foregrounds the complexities of host-pathogen interaction, or failings in human behaviour, over pathogen-antibiotic interactions. Second, the knowledge-practices of both farmers and veterinarians, although adept at identifying and diagnosing infectious disease are not equipped to make resistance perceptible. Third, this imperceptibility has implications for antibiotic use practices. Most notably, veterinarians anticipate resistance when making antibiotic choices. However, because of the absence of farm level knowledge of resistance this anticipatory logic is informed through the prevalence of resistance ‘at large’. The analysis has implications for the existing passive resistance surveillance regime operating in the dairy sector, which relies on veterinarians and farmers voluntarily submitting samples for diagnostic and susceptibility testing. In effect this entrenches farm level imperceptibility and effacement by farmers and veterinarians within the national dairy surveillance regime. However, we also highlight opportunities for providing farm specific knowledge of resistance through the anticipatory logic of veterinarians and a more active regime of surveillance.

Annual Report of the Scientific Network on BSE‐TSE 2018

The EFSA Scientific Network on bovine spongiform encephalopathies and other transmissible spongiform encephalopathies (BSE-TSE) held its 13th meeting on 15-16 October 2018 in Parma. The meeting served as an opportunity to exchange scientific information on BSE-TSE related issues among EU Member States, countries from the European Free Trade Association (EFTA), EFSA, the European Commission and ad hoc participants. In this occasion, ad hoc representation included the World Animal Health Organisation (OIE), the Department of Food Safety, Nutrition and Veterinary Public Health of the Istituto Superiore di Sanità (Italy), and the Animal and Plant Health Agency, UK. The topics discussed included: an update on BSE-TSE-related activities at national and international level and results from recent TSE-related research projects and risk assessments in several EU countries. In addition, the Network discussed: updates on the situation of Chronic Wasting Disease (CWD) in Norway; state of play of CWD surveillance in six member states; the zoonotic potential of TSEs, ongoing EFSA, OIE and EC activities on this area, the new TSE EURL, the preliminary results of the 2017 EU TSE summary report, and the update on recent published research including came prion disease, analyses of BSE surveillance data and the impact of changes in SRM on BSE infectivity in edible tissues (small ruminants and cattle).

Use of whole-genome sequencing for public health intervention: outbreak investigation of a cluster of cases of salmonella foodborne illness in England, 2016

BackgroundPreventing foodborne outbreaks of gastrointestinal disease is a public health priority; however, outbreak investigations into non-typhoidal Salmonella enterica infections are challenging. Only cases with confirmed microbiological diagnoses are investigated, and links are hard to identify. Microbiological tests that offer greater discrimination between isolates are thus, in theory, attractive public health tools to identify, and interrupt, transmission. Whole-genome sequencing (WGS) was introduced in England in 2016 as part of routine surveillance. Here we describe its usefulness to support public health action. MethodsWe were alerted to a cluster of isolates of Salmonella enterica subsp enterica serovar Enteritidis (S Enteritidis) that were linked by single nucleotide polymorphism (SNP) comparison to a reference genome to determine genetic relatedness of bacterial isolates after whole-genome sequencing. The isolates (from stool samples) were from 18 individuals living in London in 2016 with gastrointestinal disease. We contacted all cases and undertook a standard questionnaire, and then focused questioning on, and food sampling at, the suspected infectious source, to direct public health intervention, in collaboration with environmental health officers. FindingsAll 18 cases were adults (age 21–70 years), five of whom were admitted to hospital. From whole-genome sequencing data, nine of the 18 isolates had no SNP differences, and nine had fewer than five SNP differences from these, of which six were identical. We identified an epidemiological link, in all cases, to a food establishment in London. S Enteritidis was subsequently isolated from food samples from this establishment and linked to isolates from the cases through whole-genome sequencing. An enforcement action and notice was served by environmental health officers to the establishment because of breaches in food hygiene, and we notified the Food Standards Agency, the Department for Environment, Food and Rural Affairs, and the Animal and Plant Health Agency. The contaminated food source was successfully removed to prevent further linked cases. InterpretationThe introduction of whole-genome sequencing to public health surveillance, despite demanding resources, refines the microbiological data provided to public health practitioners, allowing focused epidemiological investigation on likely linked cases. As illustrated here, this can allow identification of an ongoing source, and action to prevent further transmission. FundingNone.

Use of the Human Vaccine, Mycobacterium bovis Bacillus Calmette Guérin in Deer.

The only vaccine ever approved for human tuberculosis was developed a century ago from an isolate of Mycobacterium bovis derived from a tuberculous cow. Initial safety and efficacy studies of an attenuated version of this isolate were conducted in cattle and other animals. In 1921 the first human, an infant, was orally dosed with this attenuated strain that came to be known as M. bovis bacillus Calmette-Guérin (BCG); named for Albert Calmette and Camille Guérin, the two French scientists that developed the strain. Since 1921, billions of people have been vaccinated with BCG making it the oldest, most widely used, and safest vaccine in use today. It is also the tuberculosis vaccine most studied for use in wildlife, including deer. While BCG vaccination of deer may not reliably prevent infection, it consistently decreases lesion severity, minimizing large, necrotic lesions, which often contain large numbers of bacilli. It is believed that decreased lesion severity correlates with decreased disease transmission; however, this hypothesis remains to be proven. Safety studies in white-tailed deer show BCG may persist in lymphoid tissues for up to 12 months; a factor to be considered in deer used for food. Beyond efficacy and safety, methods of vaccine delivery to free-ranging deer are also under investigation, both in the laboratory and in the field. The ideal delivery method is effective, efficient and safe for non-target species, including livestock. Ingestion of BCG by cattle is of special concern as such cattle may present as “false positives” using currently approved diagnostic methods, thus interfering with efforts by animal health agencies to monitor cattle for tuberculosis. An effective BCG vaccine for deer would be of value in regions where free-ranging deer represent a potential source of M. bovis for livestock. Such a vaccine would also be beneficial to farmed deer where M. bovis represents a serious threat to trade and productivity.

Has the red sheep tick, Haemaphysalis punctata, recently expanded its range in England?

The red sheep tick, Haemaphysalis punctata (Ixodida: Ixodidae), has been reported as present in the U.K. for more than a century; however, very little has been written about its distribution. In recent years, numbers of detections of this tick species reported to the Public Health England (PHE) Tick Surveillance Scheme have increased. This rise in the number of records may be attributable to increased tick surveillance activities or to the increased distribution of this species of tick in parts of England. This paper reviews published reports of H.punctata and all data held by the Biological Records Centre and PHE, and summarizes a number of field studies conducted by PHE and the Animal and Plant Health Agency over the past 8 years. It would appear from the evidence presented here that H.punctata may be expanding its range across the eastern part of the South Downs National Park, where there have also been reports of this tick species biting humans. It is possible that the movement of sheep between grassland sites is facilitating this spread. Further studies that better elucidate the ecology of this tick and its possible role as a vector of human and veterinary diseases are now warranted.

Surveillance for Mass Gatherings: NCAA Final Four 2017 in Maricopa County, Arizona

Objective: To describe and present results for the enhanced epidemiologic surveillance system established during the 2017 National Collegiate Athletic Association Division I Men’s College Basketball Championship (Final Four) events.Introduction: Final Four-associated events culminated in four days of intense activity from March 31st through April 3rd, and added an estimated 400,000 visitors to Maricopa County's 4.2 million residents.Methods: Preparation included: refinements in enhanced surveillance for previous events (including Super Bowl XLII); a rehearsal on information sharing for team leads; just in time training for field team members; a tabletop exercise on 2/22; and solicitation of lessons learned from jurisdictions recently hosting the Final Four.Enhanced surveillance began on 3/24 and continued through 4/10 (one week before the first major event until one week after the championship game) with intensified surveillance from 3/31-4/3. Subject matter experts for each enhanced surveillance component functioned as team leads. A surveillance coordinator was assigned to review data and prepare reports. Team members were sent a plan of the day detailing daily surveillance activities.An enhanced surveillance (SURV) alert requesting an increased index of suspicion for events of public health significance was sent to pre-established lists of healthcare providers. Urgent care clinics within five miles of venues were asked to report influenza-like, gastrointestinal, rash, and neurological illness visits daily. Emergency department records in the National Syndromic Surveillance Program, Electronic Surveillance System for Early Notification of Community-Bases Epidemics (ESSENCE) were monitored daily for influenza-like illness, gastrointestinal illness, injury, records of interest, heat-related illness and event-specific terms. Mumps and meningitis were added after outbreak reports were received from home jurisdictions of Final Four teams. Death certificate data, Office of the Medical Examiner line lists and preliminary reports of death were reviewed daily for reportable diseases or circumstances of public health significance. Communicable disease data was reviewed daily for notifiable disease cases of concern, aberration detection as compared to the previous four years, outbreak review, and Influenza-like-illness.Field teams of staff and volunteers were deployed to three days of Music Fest, four days of Fan Fest, and three Final Four games. Attendees presenting to first aid stations were requested to complete an electronic questionnaire capturing illness and injury syndromes. These were submitted and epidemiologically assessed in near-real-time. Syndrome-specific data were geo-located on venue maps during events to identify spatial clustering. Patient Presentation Rates (PPR) and Transport to Hospital Rates (TTHR) per 10,000 attendees were calculated.To enhance animal health system surveillance, veterinarians and agencies that work with animals were notified to increase the index of suspicion for unusual animal disease, keep alert for outbreaks with zoonotic potential, and update 24/7 emergency contact lists.Health-related media reports, Final-Four-specific reports, health-aggregated Twitter reports, and breaking news alert subscriptions were monitored. Poison Control Center (PCC) reports were assessed by conducting regular queries of the National Poison Data System (NPDS). Reports from the 24/7 Disease Reporting Line were monitored.A one page enhanced surveillance report was developed for daily distribution to inter-disciplinary partners; a more detailed report was distributed to health and medical partners. Physicians overseeing the health/medical care of teams were included in information sharing. Public health intelligence information was exchanged with epidemiologists from home jurisdictions of Final Four teams.Results: 301 field questionnaires were completed, including 146 from Final Four games, 127 from the Music Fest, and 28 from the Fan Fest. Final Four games experienced a PPR of 9.5, and a TTHR of 0.52. Music Fest results were a PPR of 9.4, and a TTHR of 0.15. For the Fan Fest, there was a PPR of 5.5, and a TTHR of 0.PCC data review resulted in investigation of four cases for potential ricin exposure. These reports were determined to be exposure to castor beans and the castor bean plant (Ricinus communis) only. One report indicating potential phosgene occupational exposure to an air conditioning system worker was reviewed, and judged unlikely to cause noted symptoms.Outbreak information from home jurisdictions of Final Four teams resulted in increased index of suspicion for mumps, additional surveillance and mentions in media surveillance reports.Review of communicable disease, mortality, and ESSENSE data resulted only in routine investigations.Conclusions: Surveillance information from disparate surveillance systems was synthesized into reports which enhanced health and medical situational awareness and information sharing; interdisciplinary partners highlighted the utility of the one-page report. Enhanced surveillance allowed the rapid identification and characterization of potential threats, and provided an evidence base for public health decisions. Establishment of field teams allowed for near-real-time tracking of patient presentations and transports and rapid identification and characterization of syndromes of concern and potential threats. Public health intelligence information exchange with home jurisdictions of Final Four teams resulted in targeted surveillance for mumps and meningitis.