Global prioritization of endemic zoonotic diseases for conducting surveillance in domestic animals to protect public health.

Zoonotic diseases (zoonoses) originating from domestic animals pose a significant risk to people's health and livelihoods, in addition to jeopardizing animal health and production. Effective surveillance of endemic zoonoses at the animal level is crucial to assessing the disease burden and risk, and providing early warning to prevent epidemics in animals and spillover to humans. Here we aimed to prioritize and characterize zoonoses for which surveillance in domestic animals is important to prevent human infections at a global scale. A multi-criteria qualitative approach was used, where disease-specific information was obtained across literature of the leading international health organizations. Thirty-two zoonoses were prioritized, all of which have multi-regional spread, cause unexceptional human infections and have domestic animal hosts as important sources or sentinels of zoonotic infections. Most diseases involve multiple animal hosts and/or modes of zoonotic transmission, where a lack of specific clinical signs in animals further complicates surveillance. We discuss the challenges of animal health surveillance in endemic and resource-limited settings, as well as potential avenues for improvement such as the multi-disease, multi-sectoral and digital surveillance approaches. Our study will support global capacity-building efforts to strengthen the surveillance and control of endemic zoonoses at their animal sources. This article is part of the theme issue 'Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs'.

Studies on intra-ocular vaccination of adult cattle with reduced dose Brucella abortus strain-19 vaccine.

Brucella abortus vaccines play a central role in bovine brucellosis control with tremendous success worldwide for decades. The study was aimed to evaluate the efficacy of reduced dose (5.0 × 10 9 cfu) of S19 vaccine in adult cattle and its shedding in the milk of vaccinated cattle using molecular techniques. The OIE recommended tests (RBPT, SAT, and iELISA) for brucellosis screening in cattle were used. Seronegative cattle (n = 90) of different age groups (young, old heifers & milking cows, n = 30 each) were selected for the vaccine trials. Antibody titers were recorded at 7th, 21st, 30th, 60th, 90th and 120th days post-vaccination (DPV) to monitor the immune responses following vaccination and at 150th, 180th, 210th and 240th DPB following booster-dose to an intraocular group. The humoral immune responses observed by RBPT and ELISA, proved that antibody titers persisted in s/c group compared to the i/o group in all categories. The IFN-γ stimulation (CMI) due to reduced dose vaccination was noticed early as 30th in all groups and declined after 90th DPV, with higher IFN-γ stimulation among the s/c group. The Bcsp31 and IS711 targeted PCR detected the presence of Brucella DNA in milk samples (n = 120) from the vaccinated cows (n = 30) and confirmed by qPCR (TaqMan assay) at 30th, 60th, 90th and 120th DPV. A Significant number, 70% (7/10) was detected in s/c by qPCR. BCSP31 sequence was deposited at NCBI GenBank (accession no. MK881173-6). PCR and qPCR techniques could provide a reliable diagnosis of brucellosis from milk. The intraocular route remains the safer route for vaccinating adult cattle than subcutaneous.

Brucellosis in dairy herds: Farm characteristics and practices in relation to likely adoption of three potential private-public partnership (PPP) vaccination control strategies in West and Central Africa.

Brucellosis is regarded as one of the highest burden zoonotic diseases to persist in many regions globally. While sustained vaccination against B. abortus in an endemic setting can markedly reduce the prevalence of large ruminant and human brucellosis and benefit local livelihoods, the implementation of effective and sustainable control programmes has often failed in the worst affected areas. In a cross-sectional study of 728 peri-urban dairy farmers in nine areas of six West and Central African countries, levels of commercialization and farm characteristics were examined alongside B. abortus seroprevalence estimates to hypothesize the most appropriate model for brucellosis vaccination delivery in each country. Demographic and economic data were collated and used to describe the farming systems currently in place. Furthermore, these data were utilized in a likelihood assessment to generate a quantitative score to hypothesize which of three private-public partnership (PPP) vaccine delivery models, that is 1) transformative, 2) transactional or 3) collaborative, would be most appropriate in each setting. The study sites had substantial differences in their levels of dairy commercialization and the farming practices employed; the heterogeneity across the study sites was evident in the conclusions of which models would be appropriate for vaccination delivery. While Lomé (Togo) had a strong indication for a transformative PPP model, Burkina Faso had strong indication for the collaborative PPP model. Of the remaining study sites, the scores were less dominant for any one model with Cameroon and Ivory Coast sites only just scoring highest on the transformative model and Senegal and Mali sites only just scoring highest on the collaborative model. Interestingly, none of the countries included in the study scored highest on the transactional model which currently is the most commonplace delivery model in the majority of sub-Saharan African countries.

Brucellosis risk factors and milk hygiene handling practices in pastoral communities in Isiolo county, Kenya.

The study was conducted from June to August 2014 in Isiolo Central division of Isiolo Sub-County and Sericho division of Garbatulla Sub-County and comprised two components: (i) a cross-sectional study on the milk-handling hygiene practices, where milk traders' households were the study units and (ii) a case-control study on the risk factors for Brucella spp. infection in humans. Results of the cross-sectional study showed that 26.74% of the respondents never washed their hands before milking, 60.47% never washed the udder before milking and 54.65% never withhold consumption of milk from animals under treatment with antibiotics. The case-control study included household units with previous cases of brucellosis (53.33%) and those without (46.67%) over the previous 5 years and identified drinking of raw milk as the main risk factor for infection (OR = 26.44; 95% CI: 8.04-86.99). Pastoralists' unhygienic handling of milk from production to market is suboptimal and this is due to poor knowledge on hygienic practices, poor knowledge on the risks associated with poor milk hygiene and lack of sufficient and potable water for cleaning of milk containers. Many pastoralists still consume milk raw and this is a major public health risk for milk-borne diseases.

"Everything in this world has been given to us from cows", a qualitative study on farmers' perceptions of keeping dairy cattle in Senegal and implications for disease control and healthcare delivery.

The dairy industry in Senegal is growing and evolving against a backdrop of rapid urbanisation and increasing consumer demand for dairy products. Consideration of appropriate cattle healthcare delivery and disease control in these evolving farming systems is of paramount importance given the risks posed by zoonotic pathogens and the economic consequences of disease for livestock keepers. Planning and implementation of disease control and healthcare delivery generally follows a top down approach. Often this does not take into account the views and perceptions of the farmers it impacts and who must behave in the expected way for successful outcomes to materialise. In this study, we asked 76 farmers to discuss their experience and opinions of farming milk producing cattle in 11 focus group discussions conducted in two peri-urban areas of Senegal. The objectives were to investigate farmers' perceptions of the current conditions in farming, to understand how these might impact the future direction of this particular system and how this might affect the feasibility and appropriate methods of cattle healthcare delivery and disease control. The data collected were subjected to thematic analysis and four themes were identified; 1. Revered cattle, 2. The changing face of livestock keeping, 3. Powerlessness, 4. Optimism for the future. Farmers in our study had a deep affinity with their cattle, they respected the traditions surrounding cattle keeping at the same time as striving for advances within the system and their animal's productivity. Within strong social groupings and hierarchical structures they recognised the inherent challenges they face but were hopeful and optimistic about growth and opportunity in the future of milk production. A holistic approach to embedding healthcare delivery and disease control within the broader context in which farmers operate may prove successful. This could involve consideration of funding channels for farmers, access to appropriate inputs and utilising the strong community spirit and social norms of farmers to initiate and facilitate change.

Control of Brucella melitensis in endemic settings: A simulation study in the Nile Delta, Egypt.

Small ruminant brucellosis remains endemic in many low- and middle-income countries (LMICs), where it poses a major economic and public health burden. Lack of resources to support long-term vaccination, inherent characteristics of small ruminant production systems such as mixing of different flocks for grazing and limitations of the vaccines currently available, which can induce abortion in pregnant animals, have all hindered the effectiveness of control programmes. In the current study, the likely effect of different control scenarios on the seroprevalence of brucellosis among the small ruminant population in a hypothetical area of an endemic region was simulated using compartmental models. The model accounts for variability in transmission rates between villages and also simulates control scenarios that target villages with high seroprevalence. Our results show that vaccination of young replacement animals only can effectively reduce the prevalence of small ruminant brucellosis in endemic settings if a high vaccination coverage is achieved. On the other hand, test-and-slaughter alone is not a promising strategy for control of small ruminant brucellosis under husbandry practices typical of endemic low-resource settings. Furthermore, results show the potential success of some strategies requiring a relatively low overall vaccination coverage such as the vaccination of 50% of young replacements and 25% of adult animals each year. Control strategies selectively targeting high initial seroprevalence villages (p > 10%) did not decrease the overall seroprevalence to acceptable levels in most of the examined scenarios. Scenario analysis showed that the efficacy of the simulated control strategies can be improved mostly by decreasing the proportion of between-village trade and also by improving the performance of the used serological tests and increasing vaccine efficacy.

Brucellosis in dairy herds: A public health concern in the milk supply chains of West and Central Africa.

Ten herd-level cross-sectional studies were conducted in peri-urban dairy production areas of seven West and Central African countries (Burkina Faso, Burundi, Cameroon, Mali, Niger, Senegal and Togo). The objectives were to estimate herd level Brucella spp. seroprevalence and identify risk factors for seropositivity. In each of the ten study areas, herds (between 52 and 142 per area, total = 965) were selected probabilistically and a structured questionnaire was administered to gather information on their structure and management. A bulk milk sample from each herd was tested by indirect ELISA for Brucella spp. For each area, herd seroprevalence estimates were obtained after adjusting for the assumed performance of the diagnostic test. Herd level risk factors for Brucella spp. seropositivity were identified by means of stratified logistic regression, with each peri-urban zone as a stratum. Area-specific models were also explored. Estimated herd seroprevalences were: Lomé (Togo) 62.0% (95% CI:55.0-69.0), Bamako (Mali) 32.5% (95% CI:28.0-37.0), Bujumbura (Burundi) 14.7% (95%CI:9.4-20.8), Bamenda (Cameroon) 12.6% (95% CI:7.6-21.9), Ouagadougou (Burkina Faso) 3.0% (95% CI:1.0-9.1), Ngaoundere (Cameroon) 2.3% (95% CI:1.0-7.0), Thies (Senegal) 1.3% (95% CI:0.1, 5.3), Niamey (Niger) 1.2% (95% CI:0.08-5.3), Dakar (Senegal) 0.2% (95% CI:0.01-1.7) and Niakhar (Senegal) <0.04%. Logistic regression modelling revealed transhumant herds to be at lower risk of infection (adjusted OR: 0.25, 95% CI: 0.13 - 0.5) and in one of the areas (Bamenda), regular purchase of new animals was found to be strongly associated with Brucella spp. seropositivity (adjusted OR = 5.3, 95% CI: 1.4-25.9). Our findings confirm that Brucella spp. circulates among dairy cattle supplying milk to urban consumers in West and Central Africa, posing a serious public health concern. Control programs are urgently needed in areas such as Lomé or Bamako, where more than 30% of the herds show evidence of infection.

Vaccination control programs for multiple livestock host species: an age-stratified, seasonal transmission model for brucellosis control in endemic settings.

BACKGROUND: Brucella melitensis causes production losses in ruminants and febrile disease in humans in Africa, Central Asia, the Middle East and elsewhere. Although traditionally understood to affect primarily sheep and goats, it is also the predominant Brucella species that affects cows in some endemic areas. Despite this, no licensed vaccine is available specifically for use against B. melitensis in cows. The mainstay of most control programs is vaccination of sheep and goats with a live vaccine, Rev-1. The aim of this study was to investigate how critical vaccination of cows might be, in order to control B. melitensis on a mixed sheep-and-cattle farm. METHODS: A dynamic, differential-equation, age-structured, seasonal model with births and deaths, was used to investigate whether vaccination of both sheep and cattle had an impact on time to elimination of brucellosis on an individual mixed species farm, when compared to vaccination of sheep only. The model was a Susceptible-Exposed-Infectious-Recovered-Susceptible (SEIRS) model with an additional compartment for Persistently Infected (PI) individuals. Transmission parameters were fit based on a nation-wide probabilistic seroprevalence survey in Jordan. RESULTS: The model predicted that it would take 3.5 years to eliminate brucellosis (to less than 0.5% of adult sheep seropositive as a result of infection) on a mixed-species B. melitensis-endemic farm with the median field-study seroprevalence, following vaccination of both sheep and cattle, assuming a vaccine effectiveness of 80%. Limiting the vaccination to sheep only, increased the time to 16.8 years. Sensitivity analysis showed that the finding that vaccination of cattle was of significant importance, was robust. Vaccine effectiveness had a strong influence on time to elimination. CONCLUSIONS: In the absence of further data, vaccination of cattle should be considered essential in Brucella-endemic settings where mixed small ruminant and cattle flocks predominate. Further evidence that Brucella melitensis predominates in cattle in Jordan, as opposed to Brucella abortus, is needed in order to validate this model. The results may be applicable to other mixed-species settings with similar livestock management practices. These methods may be applied to other pathogens affecting multiple livestock species or with seasonal transmission.

Knowledge, Attitudes, and Practices Associated with Brucellosis in Livestock Owners in Jordan.

We evaluated livestock owners' knowledge, attitudes, and practices regarding brucellosis in Jordan. A questionnaire was administered and biological samples were examined to verify the serological status of animals. Seroprevalence estimates indicated that 18.1% (95% CI: 11-25.3) of cattle herds and 34.3% (95% CI: 28.4-40.4) of small ruminant flocks were seropositive. The results showed that 100% of the interviewed livestock keepers were aware of brucellosis: 87% indicated a high risk of infection if unpasteurized milk is consumed and 75% indicated a high risk if unpasteurized dairy products are consumed. Awareness of the risk of infection through direct contact with fetal membranes or via physical contact with infected livestock is considerably lower, 19% and 13%, respectively. These knowledge gaps manifest in a high frequency of high-risk practices such as assisting in animal parturition (62%), disposing aborted fetuses without protective gloves (71.2%) or masks (65%), and not boiling milk before preparation of dairy products (60%). When brucellosis is suspected, basic hygiene practices are often disregarded and suspect animals are freely traded. Public health education should be enhanced as the disease is likely to remain endemic in the ruminant reservoir as long as a suitable compensation program is not established and trust on available vaccines is regained.