Nudging in Animal Disease Control and Surveillance: A Qualitative Approach to Identify Strategies Used to Improve Compliance With Animal Health Policies.

Professionals from seven European countries were interviewed to identify strategies used in the surveillance and control of animal infections to influence behaviors such as program enrollment, adoption of biosecurity measures, and engagement in surveillance. To find strategies that were well-designed from a theoretical perspective, three frameworks from nudge theory were applied to the strategies: the Nuffield ladder to determine the strength of the interventions, EAST to identify attributes of the strategies, and MINDSPACE to identify the psychological mechanisms involved. We found that almost two thirds (91/120) of the strategies were designed in a manner likely to trigger multiple psychological mechanisms, which is in line with the existing recommendations for successful effect, i.e., achieving a desired behavior. This was despite that the design of the strategies was based on professionals' empirical understanding of the requirements to achieve anticipated outcomes rather than the systematic use of methods from the behavioral sciences and psychology. The most commonly used strategy was provision of information, and the least used mechanism was making a desired behavior easy to perform. The findings in this study, with all the examples of strategies used, can serve as inspiration for others. The theoretical frameworks may also be beneficial to apply as a complement in future design of new strategies. This study did not include evaluation of how efficient different strategies have been, which would be an interesting area for future studies.

A questionnaire study of associations between potential risk factors and salmonella status in Swedish dairy herds.

In this study associations between potential risk factors and salmonella status in Swedish dairy herds were investigated. A case-control study design was used, including existing as well as new cases. Herds were assigned a salmonella status on the basis of antibody analysis of bulk milk samples. Information on potential risk factors was collected from registry data and from farmers via a questionnaire. Univariable and multivariable logistic regression analyses were used to investigate associations between salmonella status and potential risk factors. In addition, multivariate analysis with Additive Bayesian Network (ABN) modelling was performed to improve understanding of the complex relationship between all the variables. Because of the difficulty in identifying associations between potential risk factors and infections with low prevalence and a large regional variation, exposure of potential risk factors in the high-prevalence region (Öland) were compared to exposure in other regions in Sweden. In total 483 of 996 (48%) farmers responded to the questionnaire, 69 herds had test-positive bulk milk samples. The strongest association with salmonella status was 'presence of salmonella test-positive herds <5 km' (OR 4.3, 95% CI 2.0-9.4). Associations with salmonella status were also seen between 'feeding calves residue milk only' (OR 2.4, 95% CI 1.2-4.6), 'certified organic herds' (OR 2.5, 95% CI 1.2-4.9) and 'frequently seeing signs of rodents' (OR 0.4, 95% CI 0.13-0.97). The ABN model showed associations between Öland and four of the variables: salmonella status, presence of test-positive herds <5km, shared pastures and providing protective clothing for visitors. The latter is probably a reflection of increased disease awareness in Öland. The ABN model showed associations between herd size and housing as well as several management procedures. This provides an explanation why herd size frequently has been identified as a risk factor for salmonella by other studies. The study confirms the importance of local transmission routes for salmonella, but does not identify specific components in this local spread. Therefore, it supports the use of a broad biosecurity approach in the prevention of salmonella. In Öland, some potential risk factors are more common than in other parts of Sweden. Theoretically these could contribute to the spread of salmonella, but this was not confirmed in the present study. The study also highlights the difficulty in identifying associations between potential risk factors and infections with low prevalence and large regional variation.

Comparison of whole genome sequencing typing results and epidemiological contact information from outbreaks of Salmonella Dublin in Swedish cattle herds.

BACKGROUND: Whole genome sequencing (WGS) is becoming a routine tool for infectious disease outbreak investigations. The Swedish situation provides an excellent opportunity to test the usefulness of WGS for investigation of outbreaks with Salmonella Dublin (S. Dublin) as epidemiological investigations are always performed when Salmonella is detected in livestock production, and index isolates from all detected herds are stored and therefore available for analysis. This study was performed to evaluate WGS as a tool in forward and backward tracings from herds infected with S. Dublin. MATERIAL AND METHODS: In this study, 28 isolates from 26 cattle herds were analysed and the WGS results were compared with results from the epidemiological investigations, for example, information on contacts between herds. The isolates originated from herds in three different outbreaks separated geographically and to some extent also in time, and from the only region in Sweden where S. Dublin is endemic (Öland). RESULTS: The WGS results of isolates from the three non-endemic regions were reliably separated from each other and from the endemic isolates. Within the outbreaks, herds with known epidemiological contacts generally showed smaller differences between isolates as compared to when there were no known epidemiological contacts. CONCLUSION: The results indicate that WGS can provide valuable supplemental information in S. Dublin outbreak investigations. The resolution of the WGS was sufficient to distinguish isolates from the different outbreaks and provided additional information to the investigations within an outbreak.

Low prevalence of Salmonella in Swedish dairy herds highlight differences between serotypes.

Legislated Salmonella control in Sweden has been in place since the 1960s. The purpose of this study was to investigate presence of Salmonella antibodies in dairy cattle herds and to provide a basis for decisions on how surveillance and control can be improved. Bulk milk samples from all Swedish dairy herds (n=4 683) were analysed with two different ELISAs; one detecting antibodies against Salmonella Dublin (Dublin ELISA), and one detecting antibodies against several of the serotypes causing bovine salmonellosis including S. Dublin (Bovine ELISA). Information about herds, i.e. geographical location, local animal density, number of test positive herds within 5km, animal trade and herd size, was based on register data. The results confirm a very low prevalence of Salmonella in Swedish dairy herds throughout the country with the exception of an island in the southeast. The test positive herds split into two groups; 41 herds (1%) positive in the Dublin ELISA, and 101 herds (2%) positive in the Bovine ELISA but negative in the Dublin ELISA. Geographical location of positive herds, and comparison of the results of the screening with serotypes previously isolated from some of the herds, indicated that the first group represents herds presently or previously infected with S. Dublin while the second group represents herds presently or previously infected with other serotypes. Differences in serological status between herds in different regions, of different size, with different animal purchase patterns et cetera, were tested using logistic regression. Presence of positive herds within 5km was significantly associated to testing positive. For herds testing positive in the Dublin ELISA, significant associations were also seen with herd size. Purchase of animals during the last year was not significantly associated with the outcome in the final models. We conclude that for future surveillance, the Bovine ELISA can be used to help in identifying infected herds, and the Dublin ELISA can be used to distinguish herds with S. Dublin infections. The geographical clustering of test positive herds could facilitate future surveillance and disease control interventions. The results highlight differences between S. Dublin and other serotypes, e.g. concerning prevalence and degree of geographical clustering. Further studies on risk factors and potential local spread of Salmonella is warranted, particularly in the regions with clustering of S. Dublin infected herds.

Factors affecting costs for on-farm control of salmonella in Swedish dairy herds.

BACKGROUND: The Swedish control program for salmonella includes restrictions and on-farm control measures when salmonella is detected in a herd. Required control measures are subsidised by the government. This provides an opportunity to study costs for on-farm salmonella control. The aim of this study was to describe the costs for on-farm salmonella control in Swedish cattle herds and to investigate the effects of herd factors on these costs in dairy herds. RESULTS: During the 15 years studied there had been a total of 124 restriction periods in 118 cattle herds; 89 dairy herds, 28 specialised fattening herds and three suckler herds. The average costs per herd for on-farm salmonella control was 4.60 million SEK with a median of 1.06 million SEK corresponding to approximately 490 000 and 110 000 EUR. The range was 0.01 to 41 million SEK corresponding to 1080 EUR to 4.44 million EUR per farm. The costs cover measures required in herd-specific control plans, generally measures improving herd hygiene. A mixed linear model was used to investigate associations between herd factors and costs for on-farm salmonella control in dairy herds. Herd size and length of the restriction period were both significantly associated with costs for on-farm control of salmonella with larger herds and longer periods of restrictions leading to higher costs. Serotype detected and administrative changes in the Swedish Board of Agriculture aiming at reducing costs were not associated with costs for on-farm salmonella control. CONCLUSIONS: On-farm control of salmonella in Swedish cattle herds incurred high costs but the costs also varied largely between herds. Larger herds and longer restriction periods increased the costs for on-farm control of salmonella in Swedish dairy herds. This causes concern for future costs for the Swedish salmonella control program as herd sizes are increasing.

Evaluation of the specificity of three enzyme-linked immunosorbent assays for detection of antibodies against Salmonella in bovine bulk milk.

BACKGROUND: The Swedish Salmonella control program has been running for decades and has resulted in a low prevalence of Salmonella in Swedish food producing animals. Routine bacteriology is used to detect Salmonella, however, bacteriology is time consuming, costly and has a low sensitivity. Different enzyme-linked immunosorbent assays (ELISAs) have been developed for detection of antibodies against Salmonella Dublin and S. Typhimurium in bovine bulk milk, individual milk samples as well as in sera. Screening bulk milk for antibodies against Salmonella spp. could improve the cost-effectiveness of the surveillance in Swedish dairy cattle, but as characteristics of tests may vary in different populations, tests should always be evaluated in the specific population where they will be used. Hence, the aim of this study was to evaluate the specificities of three bovine ELISAs when used to analyse bulk milk samples from Swedish dairy cattle. A second aim was to compare the performance of the two Dublin ELISAs tested. METHODS: Bulk milk samples for analysis were randomly selected from samples collected within the Swedish bulk milk sampling scheme and analyzed with the three ELISAs; a Danish in-house Dublin ELISA, PrioCHECK(®) Salmonella Ab bovine Dublin ELISA and PrioCHECK(®) Salmonella Ab bovine ELISA (hereafter named mixed ELISA). The specificities of the ELISAs were calculated assuming a disease-free status in Sweden i.e. that all test positive samples were assumed to be false positive results. This assumption can be used when a disease is known to be infrequent. RESULTS: The calculated specificities of the two Dublin ELISAs and the mixed ELISA, when using the producer's recommended cut-off value of the corrected optic-density percent (ODC%) were 99.4% (95% Confidence Interval (CI): 98.8% -99.8%), 99.4% (95% CI: 98.8% -99.8%) and 97.9% (95% CI: 96.8% -98.7%), respectively. The correlation between the ODC% values of the two Dublin ELISAs was 0.83. CONCLUSIONS: We conclude that the evaluated ELISAs have sufficiently high specificities to be used as supplement to bacteriological examinations in the Swedish Salmonella control program in cattle as well as a primary screening test in routine surveillance for S. Dublin.