Development of core competencies for field veterinary epidemiology training programs.

A workforce with the adequate field epidemiology knowledge, skills and abilities is the foundation of a strong and effective animal health system. Field epidemiology training is conducted in several countries to meet the increased global demand for such a workforce. However, core competencies for field veterinary epidemiology have not been identified and agreed upon globally, leading to the development of different training curricula. Having a set of agreed core competencies can harmonize field veterinary epidemiology training. The Food and Agriculture Organization of the United Nations (FAO) initiated a collective, iterative, and participative process to achieve this and organized two expert consultative workshops in 2018 to develop core competencies for field veterinary epidemiology at the frontline and intermediate levels. Based on these expert discussions, 13 competencies were identified for the frontline and intermediate levels. These competencies were organized into three domains: epidemiological surveillance and studies; field investigation, preparedness and response; and One Health, communication, ethics and professionalism. These competencies can be used to facilitate the development of field epidemiology training curricula for veterinarians, adapted to country training needs, or customized for training other close disciplines. The competencies can also be useful for mentors and employers to monitor and evaluate the progress of their mentees, or to guide the selection process during the recruitment of new staff.

Prevalence and risk factors of Avian Influenza Viruses among household ducks in Chattogram, Bangladesh.

Avian influenza viruses (AIV) increase commercial and backyard poultry mortality and morbidity, reduces egg production, and elevates public health risk. Household ducks propagate and transmit HPAI and LPAI viruses between domesticated and wild birds in Southeast Asian countries, including Bangladesh. This study was conducted to identify epidemiological factors associated with AIV infection among household ducks at Chattogram, Bangladesh. We randomly selected and collected blood and oropharyngeal swab samples from 281 households ducks. We evaluated the serum for AIV antibody using cELISA and tested for H5 and H9 subtypes using the HI test. We tested the swabs with real-time reverse transcriptase PCR (rRT-PCR) for M gene, and H5, H9 subtypes. In the duck populations, the household level AIV sero-prevalence was 57.7% (95% CI: 51.6-63.3) and RNA prevalence was 2.4% (95% CI: 1.0-5.0). H5 and H9 subtype sero-prevalence was 31.5% (95% CI: 22.2-42.0) and 23.9% (95% CI: 15.6-33.9). H5 and H9 subtype RNA prevalence were 0% (95% CI: 0.0-1.3) and 2.4% (95% CI: 1.0-5.0). We determined household-level OR (Odds Ratios) for the "combined (mixed materials-mud and concrete or metallic)" category was 2.2 (95% CI: 1.1-4.2) compared with "wooden/bamboo" category (p = 0.02); 2.8 (95% CI: 1.2-6.6) in households with duck plague vaccine coverage compared with no coverage (p = 0.01); and 2.4 (95% CI: 0.6-9.7) in households that threw dead birds in bushes and the roadside compared with households that buried or threw dead birds in garbage pits (p = 0.21). M gene phylogenetic analysis compared M gene sequences to previously reported Bangladeshi H9N2 isolates. The evidence presented here shows AIV circulation in the Chattogram, Bangladesh study areas. AIV reduction can be achieved through farmer education of proper farm management practices.

Risk Areas for Influenza A(H5) Environmental Contamination in Live Bird Markets, Dhaka, Bangladesh.

We evaluated the presence of influenza A(H5) virus environmental contamination in live bird markets (LBMs) in Dhaka, Bangladesh. By using Bernoulli generalized linear models and multinomial logistic regression models, we quantified LBM-level factors associated with market work zone-specific influenza A(H5) virus contamination patterns. Results showed higher environmental contamination in LBMs that have wholesale and retail operations compared with retail-only markets (relative risk 0.69, 95% 0.51-0.93; p = 0.012) and in March compared with January (relative risk 2.07, 95% CI 1.44-2.96; p<0.001). Influenza A(H5) environmental contamination remains a public health problem in most LBMs in Dhaka, which underscores the need to implement enhanced biosecurity interventions in LBMs in Bangladesh.

Qualitative risk assessment of transmission pathways of highly pathogenic avian influenza (HPAI) virus at live poultry markets in Dhaka city, Bangladesh.

Analysis of environmental samples obtained from the Live Poultry Markets (LPMs) of Dhaka City, Bangladesh, has revealed that the highest degree of prevalence of highly pathogenic avian influenza A (HPAI, H5N1), besides other subtypes of the LPAI virus, poses the plausible risk of transmission of these viruses between human and poultry species. The present study was conducted using the OIE risk analysis framework to assess the risk level of each pathway successively. The estimated risk parameters were integrated towards to obtain the overall risk level for each specific HPAI transmission pathway using the matrix adapted by Cristobel Zepeda accompanying other expert consultations. The relevant data obtained from published and unpublished sources, together with survey data of field observations, were used to formulate and confirm the risk pathways and their associated risks. The results revealed that the risk of the release of the HPAI virus was medium when exposure was high. Additionally, the consequence would be considered very high with a medium degree of uncertainty for all parameters. Ultimately, the overall risk for transmission was estimated as medium with a medium degree of uncertainty. The findings of this study reveal that there is a significant threat that HPAI virus transmission could occur among poultry and humans and effectively sustain within the environment of the LPMs. Our findings are primarily focused on public health considerations, the hygienic slaughter of poultry and the relevant cleaning and sanitation practices conducted in the LPMs to support evidence-based decision-making processes. The findings of the study have the potential to be used to formulate effective risk reduction measures and can be further adapted in low-resource settings without major infrastructural changes required of the LPMs. All of which would reduce the risk of HPAI virus release and further lessen the degree of exposure and transmission in established LPMs.

Development and Validation of a Standardized Tool for Prioritization of Information Sources.

PURPOSE: To validate the utility and effectiveness of a standardized tool for prioritization of information sources for early detection of diseases. METHODS: The tool was developed with input from diverse public health experts garnered through survey. Ten raters used the tool to evaluate ten information sources and reliability among raters was computed. The Proc mixed procedure with random effect statement and SAS Macros were used to compute multiple raters' Fleiss Kappa agreement and Kendall's Coefficient of Concordance. RESULTS: Ten disparate information sources evaluated obtained the following composite scores: ProMed 91%; WAHID 90%; Eurosurv 87%; MediSys 85%; SciDaily 84%; EurekAl 83%; CSHB 78%; GermTrax 75%; Google 74%; and CBC 70%. A Fleiss Kappa agreement of 50.7% was obtained for ten information sources and 72.5% for a sub-set of five sources rated, which is substantial agreement validating the utility and effectiveness of the tool. CONCLUSION: This study validated the utility and effectiveness of a standardized criteria tool developed to prioritize information sources. The new tool was used to identify five information sources suited for use by the KIWI system in the CEZD-IIR project to improve surveillance of infectious diseases. The tool can be generalized to situations when prioritization of numerous information sources is necessary.

Respiratory infection in institutions during early stages of pandemic (H1N1) 2009, Canada.

Outbreaks of respiratory infection in institutions in Ontario, Canada were studied from April 20 to June 12, 2009, during the early stages of the emergence of influenza A pandemic (H1N1) 2009. Despite widespread presence of influenza in the general population, only 2 of 83 outbreaks evaluated by molecular methods were associated with pandemic (H1N1) 2009.

Prevalence and patterns of antimicrobial resistance of fecal Escherichia coil among pigs on 47 farrow-to-finish farms with different in-feed medication policies in Ontario and British Columbia.

The main objectives of this study were to determine the prevalence and patterns of antimicrobial resistance in pigs on farms that medicated swine ration and those that did not. A total of 940 isolates of Escherichia coli from 188 pooled fecal samples obtained from weaner and finisher pigs on 47 farrow-to-finish swine farms (34 farms used in-feed medication and 13 did not) were tested for susceptibility to 21 antimicrobials using a breakpoint concentration method. The prevalence of resistance varied widely (0.0% to 81.3%) among the antimicrobials tested. Ninety percent of all the isolates tested were resistant to one or more antimicrobials. The most common multi-drug resistance patterns were to 2 to 6 antimicrobials. Resistance was significantly more frequent (P < 0.01) on farms that used in-feed medication compared to those that did not, and significantly more frequent (P < 0.01) in weaner pigs compared to finisher pigs. These findings indicate that resistance to a broad range of antimicrobials was prevalent among fecal E. coli isolates of pigs on study farms, and that this constitutes a potential reservoir for resistance genes that could spread to pathogens. The findings also provide further evidence that use of medication in swine rations provides selective pressure for antimicrobial resistance in E. coli in pigs.

Associations of antimicrobial uses with antimicrobial resistance of fecal Escherichia coli from pigs on 47 farrow-to-finish farms in Ontario and British Columbia.

This study assessed the associations between antimicrobial use and other management practices in pigs and antimicrobial resistance in generic Escherichia coli recovered from feces of weaner and finisher pigs on 39 purposefully selected farrow-to-finish farms in Ontario and 8 in British Columbia. Antimicrobials (n = 13), most frequently penicillins and tetracycline, wer dministered to different age groups of pigs on study farms through various routes of administration. Logistic regression was used to model risk factors to antimicrobial resistance in fecal E. coli of pigs for the following antimicrobials: ampicillin, apramycin, carbadox, cephalothin, chloramphenicol, kanamycin, neomycin, nitrofurantoin, spectinomycin, streptomycin, sulfamethoxazole tetracycline, and cotrimoxazole (trimethoprim and sulfamethoxazole). Use of antimicrobials in weaner pigs compared with use in finisher pigs was associated with resistance in most models. There was phenotypic evidence of different mechanisms of resistance selection, including direct selection [use of carbadox was associated with carbadox resistance (OR = 6.48)]; cross-resistance [use of spectinomycin was associated with streptomycin resistance (OR = 2.29)]; and possible co-selection [ceftiofu use was associated with tetracycline resistance (OR = 6.12)]. These results provide further evidence that use of antimicrobials in pigs selects for resistance among fecal E. coli within and between classes of antimicrobials.