Spatiotemporal Analysis of Influenza in China, 2005-2018

Influenza is a major cause of morbidity and mortality worldwide, as well as in China. Knowledge of the spatial and temporal characteristics of influenza is important in evaluating and developing disease control programs. This study aims to describe an accurate spatiotemporal pattern of influenza at the prefecture level and explore the risk factors associated with influenza incidence risk in mainland China from 2005 to 2018. The incidence data of influenza were obtained from the Chinese Notifiable Infectious Disease Reporting System (CNIDRS). The Besag York Mollié (BYM) model was extended to include temporal and space-time interaction terms. The parameters for this extended Bayesian spatiotemporal model were estimated through integrated nested Laplace approximations (INLA) using the package R-INLA in R. A total of 702,226 influenza cases were reported in mainland China in CNIDRS from 2005–2018. The yearly reported incidence rate of influenza increased 15.6 times over the study period, from 3.51 in 2005 to 55.09 in 2008 per 100,000 populations. The temporal term in the spatiotemporal model showed that much of the increase occurred during the last 3 years of the study period. The risk factor analysis showed that the decreased number of influenza vaccines for sale, the new update of the influenza surveillance protocol, the increase in the rate of influenza A (H1N1)pdm09 among all processed specimens from influenza-like illness (ILI) patients, and the increase in the latitude and longitude of geographic location were associated with an increase in the influenza incidence risk. After the adjusting for fixed covariate effects and time random effects, the map of the spatial structured term shows that high-risk areas clustered in the central part of China and the lowest-risk areas in the east and west. Large space-time variations in influenza have been found since 2009. In conclusion, an increasing trend of influenza was observed from 2005 to 2018. The insufficient flu vaccine supplements, the newly emerging influenza A (H1N1)pdm09 and expansion of influenza surveillance efforts might be the major causes of the dramatic changes in outbreak and spatio-temporal epidemic patterns. Clusters of prefectures with high relative risks of influenza were identified in the central part of China. Future research with more risk factors at both national and local levels is necessary to explain the changing spatiotemporal patterns of influenza in China.

Cost distribution of bluetongue surveillance and vaccination programmes in Austria and Switzerland (2007-2016)

Bluetongue virus (BTV) is an emerging transboundary disease in Europe, which can cause significant production losses among ruminants. The analysis presented here assessed the costs of BTV surveillance and vaccination programmes in Austria and Switzerland between 2007 and 2016. Costs were compared with respect to time, type of programme, geographical area and who was responsible for payment. The total costs of the BTV vaccination and surveillance programmes in Austria amounted to €23.6 million, whereas total costs in Switzerland were €18.3 million. Our analysis demonstrates that the costs differed between years and geographical areas, both within and between the two countries. Average surveillance costs per animal amounted to approximately €3.20 in Austria compared with €1.30 in Switzerland, whereas the average vaccination costs per animal were €6.20 in Austria and €7.40 in Switzerland. The comparability of the surveillance costs is somewhat limited, however, due to differences in each nation’s surveillance (and sampling) strategy. Given the importance of the export market for cattle production, investments in such programmes are more justified for Austria than for Switzerland. The aim of the retrospective assessment presented here is to assist veterinary authorities in planning and implementing cost-effective and efficient control strategies for emerging livestock diseases.

Bluetongue: control, surveillance and safe movement of animals

The performance of different bluetongue control measures related to both vaccination and protection from bluetongue virus (BTV) vectors was assessed. By means of a mathematical model, it was concluded that when vaccination is applied on 95% of animals even for 3 years, bluetongue cannot be eradicated and is able to re‐emerge. Only after 5 years of vaccination, the infection may be close to the eradication levels. In the absence of vaccination, the disease can persist for several years, reaching an endemic condition with low level of prevalence of infection. Among the mechanisms for bluetongue persistence, the persistence in the wildlife, the transplacental transmission in the host, the duration of viraemia and the possible vertical transmission in vectors were assessed. The criteria of the current surveillance scheme in place in the EU for demonstration of the virus absence need revision, because it was highlighted that under the current surveillance policy bluetongue circulation might occur undetected. For the safe movement of animals, newborn ruminants from vaccinated mothers with neutralising antibodies can be considered protected against infection, although a protective titre threshold cannot be identified. The presence of colostral antibodies interferes with the vaccine immunisation in the newborn for more than 3 months after birth, whereas the minimum time after vaccination of animal to be considered immune can be up to 48 days. The knowledge about vectors ecology, mechanisms of over‐wintering and criteria for the seasonally vector‐free period was updated. Some Culicoides species are active throughout the year and an absolute vector‐free period may not exist at least in some areas in Europe. To date, there is no evidence that the use of insecticides and repellents reduce the transmission of BTV in the field, although this may reduce host/vector contact. By only using pour‐on insecticides, protection of animals is lower than the one provided by vector‐proof establishments.

This publication is linked to the following EFSA Supporting Publications article: http://onlinelibrary.wiley.com/doi/10.2903/sp.efsa.2017.EN-1182/full, http://onlinelibrary.wiley.com/doi/10.2903/sp.efsa.2017.EN-1171/full