New approaches to aquatic and terrestrial animal surveillance: The potential for people and technology to transform epidemiology.

Epidemiology provides insights about causes of diseases and how to control them, and is powered by surveillance information. Animal health surveillance systems typically have been designed to meet high-level government informational needs, and any incentives for those who generate data (such as animal owners and animal health workers) to report surveillance information are sometimes outweighed by the negative consequences of reporting; underreporting is a serious constraint. This problem can persist even when modern advances in information and communications technology (ICT) are incorporated into the structure and operation of surveillance systems, although some problems typical of paper-based systems (including timeliness of reporting and response, accuracy of data entry, and level of detail recorded) are reduced. On occasions, however, additional problems including sustainability arise. We describe two examples of a philosophical approach and ICT platform for the development of powerful and sustainable health information systems that are people-centred and do not exhibit these typical problems. iSIKHNAS is Indonesia's integrated animal health information system, and PIISAC is a sustainable secure research platform based on full production data from participating commercial Chilean aquaculture companies. Epidemiologists working with these systems are faced with interesting new challenges, including the need to develop skills in extracting appropriate surveillance outcomes from large volumes of continually-streaming data.

An assessment of the association between soil pH and ovine Johne's disease using Australian abattoir surveillance data.

There has long been discussion in the literature about the role of soil on ovine Johnes disease (OJD). This is especially true of soil pH, however there is very little research to support an association between pH and OJD prevalence. The primary objective of this study was to examine the hypothesis that there is an association between soil pH and OJD. Several additional hypotheses were also assessed. Sheep properties that were surveyed by the Australian National Sheep Health Monitoring Project where classified as OJD reactor positive or otherwise. A variety of explanatory variables such as soil (especially soil pH), environmental and management factors were examined. Spatial regression models were assessed using information theory to examine support for various hypotheses and to examine associations; especially that soil pH is associated with OJD. A total of 1213 properties from 10,578 were classified as OJD positive (11.5%, 95% CI: 10.9-12.1). Within the limitations of the study, only modest support was found for an association between soil pH and the presence or absence of OJD. Instead, OJD prevalence was affected by several factors concurrently, a so called multi-factorial model (hypothesis). In this supported multifactorial hypothesis soil pH was marginally associated with OJD (p=0.04) and had a relatively weak effect (OR 0.91, 95% CI 0.82 to 1.00). OJD was strongly associated with a number of biosecurity and environmental factors such as the time since infection arrived in a region, absence of biosecurity programs (such as regional biosecurity programs or state based programs) and, to a lesser extent, solar irradiation. Soil pH may play a relatively small role in explaining OJD prevalence when evaluated as part of a multifactorial model. Biosecurity and other environmental factors appear to be more strongly associated with the presence of OJD in Australia.

An evaluation of Foot-and-Mouth Disease outbreak reporting in mainland South-East Asia from 2000 to 2010.

Foot and Mouth Disease (FMD) is considered to be endemic throughout mainland South-East Asia (SEA). The South-East Asia and China FMD (SEACFMD) campaign is a regional control programme which has been ongoing since 1997. The programme encourages countries to submit reports of outbreaks regularly. This paper evolved from a collaboration with SEACFMD to evaluate 10 years worth of reporting. All publicly available outbreak reports (5237) were extracted from the ASEAN Region Animal Health Information System (ARAHIS) for the period from 2000 to mid 2010. These reports included date, outbreak location (at the province and district level) and serotype (if known) plus information on the outbreak size and affected species. Not all records had complete information on the population at-risk or the number of animals affected. This data was transferred into a spatially enabled database (along with data from other sources) and analysed using R and SaTScan. Outbreak serotype was unknown in 2264 (43%) of reports and some countries had very few laboratory confirmed cases (range <1-86%). Outbreak reports were standardised by number of villages in each province. Outbreak intensity varied however there did not appear to be a consistent pattern, nor was there any seasonal trend in outbreaks. Spatial and spatio-temporal cluster detection methods were applied. These identified significant clusters of disease reports. FMD is endemic across the region but is not uniformly present. ARAHIS reports can be regarded as indicators of disease reporting: there may be reports in which laboratory confirmation has not occurred, and in some cases clinical signs are inconsistent with FMD. This raises questions about the specificity of the data. Advances in decentralised testing techniques offer hope for improved verification of FMD as the cause of disease outbreaks. Advances in molecular typing may provide a substantial leap forward in understanding the circulation of FMD in South East Asia.

An evaluation of the sensitivity of acute flaccid paralysis surveillance for poliovirus infection in Australia.

BACKGROUND: World Health Organization (WHO) targets for acute flaccid paralysis (AFP) surveillance, including the notification of a minimum rate of AFP among children, are used to assess the adequacy of AFP surveillance for the detection of poliovirus infection. Sensitive surveillance for poliovirus infection in both developed and developing countries is essential to support global disease eradication efforts. We applied recently developed methods for the quantitative evaluation of disease surveillance systems to evaluate the sensitivity of AFP surveillance for poliovirus infection in Australia. METHODS: A scenario tree model which accounted for administrative region, age, population immunity, the likelihood of AFP, and the probability of notification and stool sampling was used to assess the sensitivity of AFP surveillance for wild poliovirus infection among children aged less than 15 years in Australia. The analysis was based on historical surveillance data collected between 2000 and 2005. We used a surveillance time period of one month, and evaluated the ability of the surveillance system to detect poliovirus infection at a prevalence of 1 case per 100 000 persons and 1 case per million persons. RESULTS: There was considerable variation in the sensitivity of AFP surveillance for poliovirus infection among Australian States and Territories. The estimated median sensitivity of AFP surveillance in Australia among children aged less than 15 years was 8.2% per month at a prevalence of 1 case per 100,000 population, and 0.9% per month at a prevalence of 1 case per million population. The probability that Australia is free from poliovirus infection given negative surveillance findings following 5 years of continuous surveillance was 96.9% at a prevalence of 1 case per 100,000 persons and 56.5% at a prevalence of 1 case per million persons. CONCLUSION: Given the ongoing risk of poliovirus importation prior to global eradication, long term surveillance is required to provide a high degree of confidence in freedom from poliovirus infection in Australia, particularly if a low prevalence of infection is assumed. Adherence to the WHO surveillance targets would considerably improve the sensitivity of surveillance for poliovirus infection in Australia.