Economic evaluation of whole genome sequencing for pathogen identification and surveillance - results of case studies in Europe and the Americas 2016 to 2019.

BackgroundWhole genome sequencing (WGS) is increasingly used for pathogen identification and surveillance.AimWe evaluated costs and benefits of routine WGS through case studies at eight reference laboratories in Europe and the Americas which conduct pathogen surveillance for avian influenza (two laboratories), human influenza (one laboratory) and food-borne pathogens (five laboratories).MethodsThe evaluation focused on the institutional perspective, i.e. the 'investment case' for implementing WGS compared with conventional methods, based on costs and benefits during a defined reference period, mostly covering at least part of 2017. A break-even analysis estimated the number of cases of illness (for the example of Salmonella surveillance) that would need to be avoided through WGS in order to 'break even' on costs.ResultsOn a per-sample basis, WGS was between 1.2 and 4.3 times more expensive than routine conventional methods. However, WGS brought major benefits for pathogen identification and surveillance, substantially changing laboratory workflows, analytical processes and outbreaks detection and control. Between 0.2% and 1.1% (on average 0.7%) of reported salmonellosis cases would need to be prevented to break even with respect to the additional costs of WGS.ConclusionsEven at cost levels documented here, WGS provides a level of additional information that more than balances the additional costs if used effectively. The substantial cost differences for WGS between reference laboratories were due to economies of scale, degree of automation, sequencing technology used and institutional discounts for equipment and consumables, as well as the extent to which sequencers are used at full capacity.

Does stress run through the leash? An examination of stress transmission between owners and dogs during a walk.

Humans and dogs have co-evolved for over 10,000 years. Recent research suggests that, through the domestication process, dogs have become proficient at responding to human commands, attention and emotional states. However, the extent to which a companion dog responds to human emotions, such as stress, remains to be understood. This study examines whether a companion dog's stress, as measured by cortisol levels and heart rate, increases during a familiar outdoor walk in response to its owner's experience of stress. Sixty-eight owner/dog dyads participated in this study. The dyads were randomly assigned to an Experimental or Control group. Owners in the Experimental group were informed the walk would be digitally recorded for subsequent evaluation of their handling skills, whereas those in the Control group were informed the walk would be digitally recorded for archival purposes (no evaluation). This manipulation was implemented to induce a mild stress response in the owners. Salivary cortisol samples were collected from the owner and their dog before and after the walk. The dyad was also fitted with monitoring devices to record heart rate throughout the walk. Finally, personality information regarding the owner and their dog was collected. We found that cortisol production within the dyad showed a marginal inverse correlation. We also found that owners' Openness to Experience and dogs' Fearfulness influenced the heart rate of the other during the first minute of a walk. These results support that although stress may be detected within a dyad, this does not result in an associated significant change in cortisol or heart rate.