Animal Contact Research Articles

Using codon usage analysis to speculate potential animal hosts of hepatitis E virus: An exploratory study

There has been an increase in the reported number of animals worldwide that carry the hepatitis E virus (HEV). This study aimed to explore potential animal hosts for HEV through codon usage analysis. Full-length HEV sequences of six genotypes as well as codon usage of potential animal hosts were collected. Moreover, nucleotide composition and codon usage bias were compared across HEV genotypes and animal hosts. Based on the analysis for human HEV-1 and humans, the results were basically consistent with epidemiology evidence. Among 17 potential animal hosts, all HEV genotypes exhibited a preference for guanine/cytosine in the third position of synonymous codons. Furthermore, non-human primates and humans have large high-frequency codons identical to HEV in addition to a high correlation of codon fraction with HEV. Some animals in close contact with humans showed high preference for HEV, including cattle, dogs, and rats with HEV-A, cats, dogs, and swine with HEV-C1. Codon usage bias has limited efficiency in determining the hosts for HEV, but it may provide indicative clues for potential animal hosts when combined with experimental and epidemiological evidence.

DERMATOPHYTOSIS: ETIOLOGICAL AGENTS AND ASSOCIATED RISK FACTORS

Dermatophytes are fungi that grow and multiply in keratinized tissues (skin, hair and nails) causing infections that are commonly referred to as “Tinea” or “ring-worm”. This study was aimed to identify the dermatophytes that commonly isolated from dermatophytoses patients and to study the relationship between dermatophytosis and the risk factors that might associated with dermatophytoses patients in Khartoum State, Sudan. Three hundred samples were collected from patients who were apparently suffering from dermatophytoses. Patients were questionnaired pertaining to age, sex, family history, animal contact, residence, type of infection, season. From the collected specimens, 180 (60%) of cases were positive for isolating of dermatophytes. Tinea corporis was the most common type of dermatophytoses. The sequence of effect factors among patients were shown that : age (11-20), sex (males), chronicity of infection, summer season, animal contact and rural residence were the most parameters that increased the occurrence of the dermatophytoses.

Influence of ecological and climatic conditions on the spread of Borrelia burgdorferi in domestic dogs in Ukraine

Lyme-borreliosis is a zoonotic, infectious disease that has a complex chain of transmission of the pathogen Borrelia burgdorferi sensu lato and includes the relationship between ixodid ticks, vertebrate hosts, humans and companion animals in the environment. The article shows general trends in the prevalence of canine Lyme-borreliosis in Ukraine depending on environmental, climatic and physiographic factors. The results of a comparative cartographic analysis of the prevalence of Lyme borreliosis among domestic dogs in Ukraine are presented by systematizing, mathematical and statistical processing of the data obtained by surveying veterinarians engaged in clinical veterinary practice. The paper includes generalized data on the clinical manifestations, methods of diagnosis and treatment of Lyme borreliosis in dogs. We determined the dependence of the prevalence of Lyme borreliosis in dogs on the types of physical and geographical territories – natural zones of Ukraine. Each of the natural zones differs in types of relief, climatic conditions, soil types, composition of fauna and flora, which affect the epizootic chain of Lyme disease. There is a clear correlation between the incidence of Lyme borreliosis in dogs and the types of natural areas. The highest incidence of Lyme borreliosis in dogs was observed in the forest-steppe zone and the zone of broad-leaved forests. A sharp decrease in the incidence of dogs was recorded in areas of mixed forests, the Ukrainian Carpathians and in the South of Ukraine in the steppe zone. The study also confirmed that the prevalence of Lyme disease among domestic dogs was influenced by the climatic factors, in particular: gross moisture of territories, average annual air temperature and soil temperature. In Ukraine, veterinarians in the vast majority of cases use serological diagnostic methods: immunochromatographic analysis, immunoenzymatic assay, and western blot, which are insufficient, since the presence of antibodies to the Lyme borreliosis pathogen is only a confirmation of the animal's contact with the antigen and may not indicate the presence of the disease in the clinical form. The generalized data on the use of antimicrobial drugs in the treatment of Lyme borreliosis in dogs indicate the predominant use of tetracycline antibiotics and cephalosporins. The majority of veterinarians reported symptoms of Lyme arthritis, somewhat fewer reported Lyme nephritis, neuroborreliosis, Lyme carditis and in rare cases, veterinarians observed erythema at the site of tick bite. About half of the veterinarians in Ukraine observed an increase in the incidence of Lyme disease in dogs, indicating a probable deterioration of the epizootic and epidemiological situation regarding Lyme borreliosis, especially in areas with favourable conditions for the circulation of Lyme borreliosis pathogens in natural and urban ecotopes. The results substantiate the need for the further study of the circulation of Borrelia burgdorferi sensu lato and their ability to cause disease in humans and animals, as well as the need to implement the principles of the One Health concept for the control and management of Lyme borreliosis.

A multi-provincial Salmonella Typhimurium outbreak in Canada associated with exposure to pet hedgehogs, 2017-2020.

In October 2020, an investigation began in Canada on an outbreak of Salmonella Typhimurium infections of the same strain as a concomitant outbreak in the United States (US) that was linked to pet hedgehogs. The objective of this article is to identify the source of the outbreak, determine if there was a link between the Canadian and US outbreaks and identify risk factors for infection to inform public health interventions. Cases were identified through whole genome sequencing of S. Typhimurium isolates. Information was collected on case exposures, including animal contact. Hedgehog and environmental specimens were tested for S. Typhimurium and a trace back investigation was conducted. There were 31 cases in six provinces, with illness onset dates from June 1, 2017, to October 15, 2020. Median case age was 20 years and 52% were female. Isolates grouped together between 0-46 whole genome multi locus sequence typing allele differences. Of 23 cases with available exposure information, 19 (83%) reported contact with hedgehogs in the seven days prior to symptoms; 15/18 (83%) reported direct contact and 3/18 (17%) reported indirect contact. Trace back investigation did not identify a common source of hedgehogs but uncovered an industry with a complex distribution network. The outbreak strain was detected in samples collected from a hedgehog in one case's home and from a hedgehog in a Québec zoo. Direct and indirect contact with hedgehogs was identified as the source of this S. Typhimurium outbreak. Public health communications aimed to increase awareness about the risks of zoonoses from hedgehogs and shared key hygienic practices to reduce disease transmission.

Factors associated with zoonosis and reverse zoonosis of mycobacterium tuberculosis and mycobacterium bovis in Ethiopia

Zoonotic TB (M.bovis) is transmitted from animals to people. Mycobacterium tuberculosis is responsible for the transmission of reverse zoonotic tuberculosis from humans to animals. Without sufficient proof, a few recommendations can be made regarding zoonotic and reverse zoonotic transmission. The researchers aimed to review and meta-analysis of risk variables for zoonotic and reverse transmission of bovine tuberculosis. Until May 2022, 13 published publications from Pub-Med, Scopus, Web of Science, and Google Scholar were identified for review using the PRISMA checklist. The findings revealed that increasing age, raw milk and meat consumption, lack of knowledge, human and animal contacts were strongly associated with zoonotic TB. A house without ventilation and presence of TB case in the household were all strongly linked to the risk of reverse zoonotic tuberculosis, but gender being male was not significantly associated with the reverse zoonosis of tuberculosis (p > 0.05). Addressing these risk factors would aid in preventing and controlling zoonotic and reverse zoonotic tuberculosis in Ethiopia.

Modes of Transmission of Brucellosis in Anbar Governorate, Iraq

Background: Brucellosis is a common and endemic disease in the Anbar governorate. Besides,the Brucella microorganism has different ways of transmission.Objectives: The study aimed to determine the ways of transmission of Brucella organisms tohuman beings in the Al-Anbar governorate.Materials and methods: A retrospective study was carried out on patients visiting the two mainRamadi Teaching Hospitals in Ramadi city, Iraq for the diagnosis and treatment of Brucellosis.Patients with blood-culture-positive brucellae were enrolled in the study. The study includedthe period between February 2002 and March 2005. Data were collected and recorded regardingage, gender, and residence. The possible ways of acquiring the disease were recorded too. Theseincluded ingestion of possibly contaminated foods, butchering of animals, meat cutting, keepinganimals in homes or nearby their livings, cleaning animal places, caring for, milking of them, aidingin their delivery and if they wear gloves, blowing in the mouth of delivered fetuses, their work, andpossible laboratory worker exposure.Results: A total of 312 patients with brucellosis were enrolled in the study. The disease appearsto be more common in rural areas (P-value<0.001). More cases were females in all age groups,and it was more common in the age group 31-40 years. The main mode of transmission is director indirect contact with infected domestic animals (P-value<0.001). Lab workers and ingestionof raw milk and unsafe milk products were the least recorded expected risk for infection. Threerisky behaviors for acquiring brucellosis were also recognized in this study: milking animals, aidingdomestic animals in delivery, and blowing in the mouth of delivered fetuses to promote breathingof the newly delivered animals.Conclusion: Direct or indirect animal contact was the main way of Brucella transmission in theAl-Anbar governorate

Skin symptoms in veterinary assistant staff and veterinarians: A cross-sectional study.

Veterinary assistants and veterinarians are at an increased risk of developing an occupational skin disease, for example, irritant/allergic contact dermatitis, contact urticaria and hand eczema (HE). We aimed to investigate the prevalence of skin problems and the influence of predisposing factors especially among veterinary assistants. We conducted a cross-sectional study among veterinary assistant staff (n= 103) and veterinarians (n= 19). A questionnaire, specific IgE determination and photographs of hands were evaluated for skin symptoms. Logistic regression models assessed predisposing factors. Over 50% (n= 62/122) of our study population reported hand eczema (HE) in the last 12 months (1-year prevalence). Twenty-seven subjects reported redness and contact urticaria directly after animal contact, 35 had a positive history of allergic contact dermatitis. HE was associated with (i) increased frequency of hand washing (11-15 times per day; OR 4.15, confidence interval [CI] 95% 1.18-14.6, p= 0.027, univariate model) and (ii) unprotected contact to fluids and tensides >5 times per day (OR 4.56, CI 95% 1.53-13.6, multivariate model). We observed a high prevalence of self-reported HE among staff in veterinary practices. Excessive hand washing, unprotected contact with irritants and long-term glove use should be avoided.

Experimental Infection of Domestic Pigs with an African Swine Fever Virus Field Strain Isolated in 2021 from the Dominican Republic.

African swine fever virus (ASFV) is the etiological agent of African swine fever (ASF), a disease of domestic and wild swine that has spread throughout a large geographical area including Central Europe, East and Southeast Asia, and Southern Africa. Typically, the clinical presentation of the disease in affected swine heavily depends on the virulence of the ASFV strain. Very recently, ASFV was detected in the Dominican Republic (DR) and Haiti, constituting the first diagnosis of ASFV in more than 40 years in the Western hemisphere. In this report, the clinical presentation of the disease in domestic pigs inoculated with an ASFV field strain isolated from samples collected in the DR (ASFV-DR21) was observed. Two groups of domestic pigs were inoculated either intramuscularly (IM) or oronasally (ON) with ASFV-DR21 (104 hemadsorbing dose-50% (HAD50)). A group of naïve pigs (designated as the contact group) was co-housed with the ASFV-DR21 IM-inoculated animals to evaluate ASFV transmission and disease manifestation. Animals inoculated IM with ASFV-DR21 developed an acute disease leading to humane euthanasia at approximately day 7 post-inoculation (pi). Interestingly, animals inoculated via the ON route with ASFV-DR21 developed a heterogeneous pattern of disease kinetics. One animal developed an acute form of the disease and was euthanized on day 7 pi, another animal experienced a protracted presentation of the disease with euthanasia by day 16 pi, and the remaining two animals presented a milder form of the disease, surviving through the 28-day observational period. The contact animals also presented with a heterogenous presentation of the disease. Three of the animals presented protracted but severe forms of the disease being euthanized at days 14, 15 and 21 pi. The other two animals presented with a milder form of the disease, surviving the entire observational period. In general, virus titers in the blood of animals in all study groups closely followed the clinical presentation of the disease, both in length and extent. Importantly, all animals presenting with a prolonged form of the disease, as well as those surviving throughout the observational period, developed a strong ASFV-specific antibody response. These results suggest that ASFV-DR21, unless inoculated parenterally, produces a spectrum of clinical disease, with some animals experiencing an acute fatal form while others presented with a mild transient disease accompanied by the induction of a strong antibody response. At the time of publication, this is the first report characterizing the virulent phenotype of an ASFV field strain isolated from samples collected in the DR during the 2021 outbreak and provides information that may be used in developing epidemiological management measures to control ASF on the island of Hispaniola.

Behavioral–biological surveillance of emerging infectious diseases among a dynamic cohort in Thailand

BackgroundInteractions between humans and animals are the key elements of zoonotic spillover leading to zoonotic disease emergence. Research to understand the high-risk behaviors associated with disease transmission at the human-animal interface is limited, and few consider regional and local contexts.ObjectiveThis study employed an integrated behavioral–biological surveillance approach for the early detection of novel and known zoonotic viruses in potentially high-risk populations, in an effort to identify risk factors for spillover and to determine potential foci for risk-mitigation measures.MethodParticipants were enrolled at two community-based sites (n = 472) in eastern and western Thailand and two hospital (clinical) sites (n = 206) in northeastern and central Thailand. A behavioral questionnaire was administered to understand participants’ demographics, living conditions, health history, and animal-contact behaviors and attitudes. Biological specimens were tested for coronaviruses, filoviruses, flaviviruses, influenza viruses, and paramyxoviruses using pan (consensus) RNA Virus assays.ResultsOverall 61/678 (9%) of participants tested positive for the viral families screened which included influenza viruses (75%), paramyxoviruses (15%), human coronaviruses (3%), flaviviruses (3%), and enteroviruses (3%). The most salient predictors of reporting unusual symptoms (i.e., any illness or sickness that is not known or recognized in the community or diagnosed by medical providers) in the past year were having other household members who had unusual symptoms and being scratched or bitten by animals in the same year. Many participants reported raising and handling poultry (10.3% and 24.2%), swine (2%, 14.6%), and cattle (4.9%, 7.8%) and several participants also reported eating raw or undercooked meat of these animals (2.2%, 5.5%, 10.3% respectively). Twenty four participants (3.5%) reported handling bats or having bats in the house roof. Gender, age, and livelihood activities were shown to be significantly associated with participants’ interactions with animals. Participants’ knowledge of risks influenced their health-seeking behavior.ConclusionThe results suggest that there is a high level of interaction between humans, livestock, and wild animals in communities at sites we investigated in Thailand. This study highlights important differences among demographic and occupational risk factors as they relate to animal contact and zoonotic disease risk, which can be used by policymakers and local public health programs to build more effective surveillance strategies and behavior-focused interventions.

Use of a Modified Preexposure Prophylaxis Vaccination Schedule to Prevent Human Rabies: Recommendations of the Advisory Committee on Immunization Practices - United States, 2022.

Human rabies is an acute, progressive encephalomyelitis that is nearly always fatal once symptoms begin. Several measures have been implemented to prevent human rabies in the United States, including vaccination of targeted domesticated and wild animals, avoidance of behaviors that might precipitate an exposure (e.g., provoking high-risk animals), awareness of the types of animal contact that require postexposure prophylaxis (PEP), and use of proper personal protective equipment when handling animals or laboratory specimens. PEP is widely available in the United States and highly effective if administered after an exposure occurs. A small subset of persons has a higher level of risk for being exposed to rabies virus than does the general U.S. population; these persons are recommended to receive preexposure prophylaxis (PrEP), a series of human rabies vaccine doses administered before an exposure occurs, in addition to PEP after an exposure. PrEP does not eliminate the need for PEP; however, it does simplify the rabies PEP schedule (i.e., eliminates the need for rabies immunoglobulin and decreases the number of vaccine doses required for PEP). As rabies epidemiology has evolved and vaccine safety and efficacy have improved, Advisory Committee on Immunization Practices (ACIP) recommendations to prevent human rabies have changed. During September 2019-November 2021, the ACIP Rabies Work Group considered updates to the 2008 ACIP recommendations by evaluating newly published data, reviewing frequently asked questions, and identifying barriers to adherence to previous ACIP rabies vaccination recommendations. Topics were presented and discussed during six ACIP meetings. The following modifications to PrEP are summarized in this report: 1) redefined risk categories; 2) fewer vaccine doses in the primary vaccination schedule; 3) flexible options for ensuring long-term protection, or immunogenicity; 4) less frequent or no antibody titer checks for some risk groups; 5) a new minimum rabies antibody titer (0.5 international units [IUs]) per mL); and 6) clinical guidance, including for ensuring effective vaccination of certain special populations.

Associations between unpasteurized camel and other milk consumption, livestock ownership, and self-reported febrile and gastrointestinal symptoms among semi-pastoralists and pastoralists in the Somali Region of Ethiopia.

Contact with livestock and consumption of unpasteurised dairy products are associated with an increased risk of zoonotic and foodborne infection, particularly among populations with close animal contact, including pastoralists and semi-pastoralists. However, there are limited data on disease risk factors among pastoralists and other populations where livestock herding, particularly of dromedary camels, is common. This cross-sectional study used a previously validated survey instrument to identify risk factors for self-reported symptoms. Adults (n = 304) were randomly selected from households (n = 171) in the Somali Region of Ethiopia, a region characterised by chronic food insecurity, population displacement, recurrent droughts and large semi-pastoralist and pastoralist populations. Multivariable logistic regression assessed associations between self-reported symptoms and type of milk consumed, controlling for demographics and human-animal interaction. Consumption of days-old unrefrigerated raw camel milk was significantly associated with symptoms in the 30 days prior to the survey (AOR = 5.07; 95% CI 2.41-10.66), after controlling for age, refugee status, sanitation, camel ownership and source of drinking water and accounting for clustering. Consumption of days-old unrefrigerated raw ruminant milk was significantly associated with symptoms (AOR = 4.00, 95% CI 1.27-12.58). Source of drinking water and camel ownership, a proxy for camel contact, were significantly associated with the outcome in each model. There were no significant associations between self-reported symptoms and fresh or soured animal milk consumption. Research is needed to identify pathogens and major routes of transmission. Tailored communication campaigns to encourage safe food preparation should also be considered.

Success in animal skin fashion in African countries or the boom of the wet market.

The world and the way things are done have changed, from selling clothing in brick-and-mortar stores to online shopping through social media platforms. Population growth has significantly contributed to an increased clothing demand, which, in turn, has increased the demand for animal skin. Traditional markets, also known as wet markets, are considered as major zoonotic disease reservoirs due to human and animal contact. Some groups and individuals continue to believe in traditional medicine and clothing that is made from animal skin, and such beliefs are more accessible with the presence of wet markets. Hence, animal poaching and trafficking have increased to meet the high demands, primarily in the Western world. Poverty is a well-known motivation to commit a crime. Conservationists should not only look at the animal regulation site to propose a solution to animal poaching and trafficking but should also consider communal poverty. Thus, this review aimed to highlight the role of wet market and animal skin fashion on animal welfare and human health.

A Patient With Rheumatoid Arthritis Who Developed Pasteurella Multocida Arthritis Without Animal Contact; Case Report

Pasteurella species are immobile, non-sporeless, gram-negative coccobacilli that can be found in the respiratory tract and gastrointestinal tract flora of pets and can cause various infections with cat-dog bites. While it usually causes cellulitis and abscesses, clinical pictures such as septic arthritis, osteomyelitis, pneumonia, endocarditis, sepsis and meningitis can also be seen in immunosuppressed patients. Here, a case of septic arthritis due to Pasteurella multocida, which developed in the left shoulder joint of a 70-year-old female patient with a history of rheumatoid arthritis, diabetes mellitus, and hypertension, without animal contact or trauma, is presented in the light of the literature.

Occurrence, antimicrobial resistance and virulence properties of thermophilic Campylobacter coli originating from two different poultry settings

Thermophilic Campylobacter's (Campylobacter coli and Campylobacter jejuni) are usually zoonotic and spread by raw or undercooked meat especially poultry meat, unpasteurized milk, direct animal contact, and contaminated drinking water. In this study, 385 samples from commercial and backyard poultry settings were screened for the presence of Campylobacter spp. which revealed an isolation rate of 3.9% with higher isolation from the chicken caecum (15/113, 13.27%). On antimicrobial susceptibility testing, the highest resistance was observed for tetracycline (11/13, 84.61%) followed by macrolides (8/13, 61.53%), β-lactams (7/13, 53.84%), fluoroquinolones (5/13, 38.45%) and sulphonamide (4/13, 30.76%). Isolates from backyard poultry showed resistance to tetracycline (100%), β-lactam (66.66%), fluoroquinolone (25%), and macrolide (33.33%). Isolates from commercial poultry showed resistance to tetracycline (80%), macrolides (70%), β-lactams (51.66%), fluoroquinolones (42.5%) and sulphonamides (40%). Among the isolates, 92.30% were multi-drug resistant (MDR). Overall, tet(O) gene was observed in 6/11(54.55%) tetracycline resistant isolates. Notably, tet O gene was found in 6/8(75%) isolates from commercial poultry farms and it was absent in backyard poultry isolates. Similarly 23SrRNA and blaOXA-61 genes were detected in 4/8(50%) and 2/8(25%) macrolide and ampicillin resistant isolates, respectively. Among virulence genes, cdtC gene was noticed in all the Campylobacter isolates (100%), cadF in 93.33%, iamA in 80%, flaA in 73.33%, cdtA in 13.33% and, cdtB in 6.66% isolates while dnaJ, ciaB and pldA genes were not detected in any of the isolate. The Campylobacter isolates possessing antimicrobial resistance and virulence genes pose a serious public health threat through food chain.

Ecology of Middle East respiratory syndrome coronavirus, 2012-2020: A machine learning modelling analysis.

The ongoing enzootic circulation of the Middle East respiratory syndrome coronavirus (MERS-CoV) in the Middle East and North Africa is increasingly raising the concern about the possibility of its recombination with other human-adapted coronaviruses, particularly the pandemic SARS-CoV-2. We aim to provide an updated picture about ecological niches of MERS-CoV and associated socio-environmental drivers. Based on 356 confirmed MERS cases with animal contact reported to the WHO and 63 records of animal infections collected from the literature as of 30 May 2020, we assessed ecological niches of MERS-CoV using an ensemble model integrating three machine learning algorithms. With a high predictive accuracy (area under receiver operating characteristic curve=91.66% in test data), the ensemble model estimated that ecologically suitable areas span over the Middle East, South Asia and the whole North Africa, much wider than the range of reported locally infected MERS cases and test-positive animal samples. Ecological suitability for MERS-CoV was significantly associated with high levels of bareland coverage (relative contribution=30.06%), population density (7.28%), average temperature (6.48%) and camel density (6.20%). Future surveillance and intervention programs should target the high-risk populations and regions informed by updated quantitative analyses.

Aetiology of tinea capitis in China: a multicentre prospective study.

Tinea capitis is still common in developing countries, such as China. Its pathogen spectrum varies across regions and changes over time. This study aimed to clarify the current epidemiological characteristics and pathogen spectrum of tinea capitis in China. A multicentre, prospective descriptive study involving 29 tertiary hospitals in China was conducted. From August 2019 to July 2020, 611 patients with tinea capitis were enrolled. Data concerning demography, risk factors and fungal tests were collected. When necessary, the pathogens were further identified by morphology or molecular sequencing in the central laboratory. Among all enrolled patients, 74·1% of the cases were in patients aged 2-8 years. The children with tinea capitis were mainly boys (56·2%) and were more likely than adults to have a history of animal contact (57·4% vs. 35·3%, P = 0·012) and zoophilic dermatophyte infection (73·5% vs. 47%). The adults were mainly female (83%) and were more likely than children to have anthropophilic agent infection (53% vs. 23·9%). The most common pathogen was zoophilic Microsporum canis (354, 65·2%), followed by anthropophilic Trichophyton violaceum (74, 13·6%). In contrast to the eastern, western and northeastern regions, where zoophilic M. canis predominated, anthropophilic T. violaceum predominated in central China (69%, P < 0·001), where the patients had the most tinea at other sites (20%) and dermatophytosis contact (26%) but the least animal contact (39%). Microsporum ferrugineum was the most common anthropophilic agent in the western area, especially in Xinjiang province. Boys aged approximately 5 years were the most commonly affected group. Dermatologists are advised to pay more attention to the different transmission routes and pathogen spectra in different age groups from different regions.

Predictors of possible exposure to rabies in travellers: A case-control study

BackgroundTimely administration of post-exposure prophylaxis (PEP) can prevent rabies. For non-vaccinated persons, PEP consists of multiple vaccinations and rabies immunoglobulin (RIG) on indication. Since RIG is scarce, the need for PEP could be restricted through preventing animal contact and pre-exposure vaccination. We aimed to identify determinants for possible rabies exposure among travellers to provide more targeted pre-travel advice. MethodA case-control study was performed. Cases were defined as persons with a possible rabies exposure (category II or III injury according to WHO classification guidelines) in a rabies endemic country. Controls did not report exposure during travel. Multivariable logistic regression was performed. Results229 cases and 1427 controls were included. Predictors (p < 0.05) of possible rabies exposure were young age, male sex, travelling to Western or Southeastern Asia, visiting a monkey park, pet ownership, previously visited the same country and considering oneself an experienced traveller. Negative predictors were travelling for business, visiting friends and relatives, and fear of animals. ConclusionsPre-travel advice should take the identified predictors into account to provide better targeted information and pre-exposure prophylaxis.

Shedding and extensive and prolonged environmental contamination of goat farms of Q fever patients by Coxiella burnetii.

BackgroundA majority (>70%) of Q fever patients in South Korea do not have a history of animal contact. Therefore, unconscious environmental exposure is suspected. The aim of this study was to investigate exposure of Q fever patients to environmental contamination and animal shedding.MethodsTwo goat farmers were enrolled. One was diagnosed with Q fever 3 years ago (Farm 1). Among 20 goats on Farm 1, five were tested randomly and found to be Q fever PCR‐positive. Three of the five were Q fever ELISA‐positive. Two of five environmental samples taken in 2015 were PCR‐positive. In 2018, 17 of 18 environmental samples were PCR‐positive. On Farm 2, 54 of the 77 goats were PCR‐positive, and 63 were ELISA‐positive. Twelve of 14 environmental samples were PCR‐positive. Repeat administration of oxytetracycline to goats led to a gradual reduction in PCR‐positive tests over a 5‐month period. However, PCR‐positivity of the farm environment persisted for 5 months.ConclusionThe environment on farms owned by Q fever patients was contaminated extensively and persistently, even after antibiotic treatment of goats and environmental decontamination. Undetected environmental contamination can be a major source of sporadic Q fever infection in South Korea.

A statistical modelling approach for source attribution meta-analysis of sporadic infection with foodborne pathogens.

Numerous source attribution studies for foodborne pathogens based on epidemiological and microbiological methods are available. These studies provide empirical data for modelling frameworks that synthetize the quantitative evidence at our disposal and reduce reliance on expert elicitations. Here, we develop a statistical model within a Bayesian estimation framework to integrate attribution estimates from expert elicitations with estimates from microbial subtyping and case‐control studies for sporadic infections with four major bacterial zoonotic pathogens in the Netherlands (Campylobacter, Salmonella, Shiga toxin‐producing E. coli [STEC] O157 and Listeria). For each pathogen, we pooled the published fractions of human cases attributable to each animal reservoir from the microbial subtyping studies, accounting for the uncertainty arising from the different typing methods, attribution models, and year(s) of data collection. We then combined the population attributable fractions (PAFs) from the case‐control studies according to five transmission pathways (domestic food, environment, direct animal contact, human–human transmission and travel) and 11 groups within the foodborne pathway (beef/lamb, pork, poultry meat, eggs, dairy, fish/shellfish, fruit/vegetables, beverages, grains, composite foods and food handlers/vermin). The attribution estimates were biologically plausible, allowing the human cases to be attributed in several ways according to reservoirs, transmission pathways and food groups. All pathogens were predominantly foodborne, with Campylobacter being mostly attributable to the chicken reservoir, Salmonella to pigs (albeit closely followed by layers), and Listeria and STEC O157 to cattle. Food‐wise, the attributions reflected those at the reservoir level in terms of ranking. We provided a modelling solution to reach consensus attribution estimates reflecting the empirical evidence in the literature that is particularly useful for policy‐making and is extensible to other pathogens and domains.

Human Brucellosis in Greece, 2005-2020: A Persistent Public Health Problem.

Brucellosis remains an important zoonosis in various parts of the world. In Greece, brucellosis is endemic in sheep and goats. Since 1998, animal control measures include vaccination of sheep and goats older than 3 months of age in the mainland (vaccination zone) and slaughtering of infected livestock on the islands (eradication zone). We retrieved data from the mandatory notification system for 2005-2020 to describe the epidemiology in humans and assess current public health measures. Overall, 1786 notifications and an additional 111 cases related to an outbreak in 2008 (eradication zone) were recorded. The mean annual notification rate was 0.9/100,000 population (standard deviation [SD]: 0.35). A substantial mean annual decline in notification rate was reported in 2019 and 2020. A statistically significant decreasing trend of brucellosis notification rate was observed over the whole 16-year period (p < 0.001). The mean annual notification rate was significantly higher in the vaccination zone (1.2/100,000) (SD: 036) compared with the eradication zone (0.2/100,000) (SD: 0.14) (p < 0.001). Seventy percent of cases was male (n = 1175) and the highest mean notification rate was recorded in the 45-64 age group (1.3/100,000). The majority of cases (71%) reported animal contact and almost half of the cases (49%) were stockbreeders by occupation. Consumption of unpasteurized dairy products, mainly of their own production, was reported by 57% of cases; for 115 (6.5%) cases, animal exposure or consumption of unpasteurized dairy products were not recorded. Despite animal control measures, brucellosis remains endemic in Greece with cases in the vaccination zone, as well as the eradication zone. We recommend re-evaluation and strengthening of animal control programs and training of people working in stock breeding regarding disease transmission in co-operation with local farmers' associations.