Using a participatory qualitative risk assessment to estimate the risk of introduction and spread of transboundary animal diseases in scarce-data environments: A Spatial Qualitative Risk Analysis applied to foot-and-mouth disease in Tunisia 2014-2019

Risk Assessment Tools from the One Health Perspective: A Narrative Review

Background

61% of the infections around the world that have emerged to date are zoonotic. Evidence warns that the threat posed by zoonoses is on the rise, and the risk of a new pandemic is higher now than ever. Early identification of risk, populations at risk, and risk of transmission are essential steps towards a prevention, preparation and response to outbreaks. This review aims to look at the tools available for identifying and estimating risks and threats from one health perspective and finally propose a list of indicators which could assess the risk of transmission of disease at the humans, animals and the environment intersection.

Methods

The databases like PubMed, google scholar, Embase and Scopus were used to extract the relevant articles. A search was carried out using a keyword. A total of 1311 articles were listed initially after the search and reviewed. Out of 1311, only 26 tools which assessed the risk of diseases mainly infectious or were relevant to risk of transmission of any infectious diseases were included in the review.

Results

The tools included in this review involve risk assessment at the environmental, animal and human dimensions. The tools are used to evaluate the contamination of the environment due to chemicals or toxins or the risk of transmission of infection due to environmental factors like air contamination, to identify the animal diseases like bovine respiratory disease and foot and mouth disease and to estimate the human health risk at the community or individual levels.

Conclusion

Risk assessment tools are an essential part of the prevention of pandemics. These tools are helpful in assessing the risk of transmission of infections either from human to human, between human and animals, between animals and animals and so on. Thus this review gives us an insight into the existing risk assessment tools and the need for a One Health risk assessment tools to prevent outbreaks in future. It also provides a list of factors that can be included in a one health risk assessment tool.

Description of the Cattle and Small Ruminants Trade Network in Senegal and Implication for the Surveillance of Animal Diseases

Livestock mobility, particularly that of small and large ruminants, is one of the main pillars of production and trade in West Africa: livestock is moved around in search of better grazing or sold in markets for domestic consumption and for festival-related activities. These movements cover several thousand kilometers and have the capability of connecting the whole West African region, thus facilitating the diffusion of many animal and zoonotic diseases. Several factors shape mobility patterns even in normal years and surveillance systems need to account for such changes. In this paper, we present an approach based on temporal network theory to identify possible sentinel locations, i.e., locations where pathogens circulation can be detected in the early phase of the epidemic (before the peak), using two indicators: vulnerability (i.e., the probability of being reached by the disease) and time of infection (i.e., the time of first arrival of the disease). Using these indicators in our structural analysis of the changing network enabled us to identify a set of nodes that could be used in an early warning system. As a case study, we simulated the introduction of transboundary animal diseases in Senegal and used data taken from 2020 Sanitary certificates (laissez-passer sanitaire (LPS)) issued by the Senegalese Veterinary Services to reconstruct the national mobility network. Our analysis showed that a static approach can significantly overestimate the speed and the extent of disease propagation, whereas temporal analysis revealed that the reachability and vulnerability of the different administrative departments (used as nodes of the mobility network) change over the course of the year. For this reason, several sets of sentinel nodes were identified in different periods of the year, underlining the role of temporality in shaping patterns of disease diffusion.

Approaches for disease prioritization and decision-making in animal health, 2000-2021: a structured scoping review

This scoping review identifies and describes the methods used to prioritize diseases for resource allocation across disease control, surveillance, and research and the methods used generally in decision-making on animal health policy. Three electronic databases (Medline/PubMed, Embase, and CAB Abstracts) were searched for articles from 2000 to 2021. Searches identified 6, 395 articles after de-duplication, with an additional 64 articles added manually. A total of 6, 460 articles were imported to online document review management software (sysrev.com) for screening. Based on inclusion and exclusion criteria, 532 articles passed the first screening, and after a second round of screening, 336 articles were recommended for full review. A total of 40 articles were removed after data extraction. Another 11 articles were added, having been obtained from cross-citations of already identified articles, providing a total of 307 articles to be considered in the scoping review. The results show that the main methods used for disease prioritization were based on economic analysis, multi-criteria evaluation, risk assessment, simple ranking, spatial risk mapping, and simulation modeling. Disease prioritization was performed to aid in decision-making related to various categories: (1) disease control, prevention, or eradication strategies, (2) general organizational strategy, (3) identification of high-risk areas or populations, (4) assessment of risk of disease introduction or occurrence, (5) disease surveillance, and (6) research priority setting. Of the articles included in data extraction, 50.5% had a national focus, 12.3% were local, 11.9% were regional, 6.5% were sub-national, and 3.9% were global. In 15.2% of the articles, the geographic focus was not specified. The scoping review revealed the lack of comprehensive, integrated, and mutually compatible approaches to disease prioritization and decision support tools for animal health. We recommend that future studies should focus on creating comprehensive and harmonized frameworks describing methods for disease prioritization and decision-making tools in animal health.

Risk Assessment and Response Strategy for Pig Epidemics in China

Strengthening the analysis and risk assessment of the pig epidemic will help to better prevent and mitigate epidemic risks and promote the high-quality development of the pig industry. Based on a systematic understanding of live pig epidemics, a risk assessment index system was constructed, and the spatial and temporal variation characteristics of pig epidemics in China were explored by the entropy method. In recent years, the overall trend in pig epidemics over time first increased and then decreased; in space, the acceleration of the spread of epidemics across the country weakened. China still faces challenges, including many types and a wide range of diseases, large total livestock breeding and weak epidemic prevention and control capacity, and a large risk of introduced foreign animal epidemics. The spatial and temporal variations in the pig epidemic risk were obvious; one high-risk area, two medium-high-risk areas and 10 medium-risk areas have been found in recent years, during which time, the epidemic risk was highest in Beijing, Hainan, Liaoning, Tibet and Zhejiang. However, there were significant differences in the regional distribution of the risk level of pig epidemics in different years. To further build a secure "defense system" for the high-quality development of the pig industry, it is recommended to improve the monitoring and early warning system of pig epidemic risk, perfect the pig epidemic prevention and control system, and strengthen the regional collaboration mechanism of epidemic prevention and control.

A review of qualitative risk assessment in animal health: Suggestions for best practice

Qualitative risk assessment (QRA) can provide decision support in line with the requirement for an objective, unbiased assessment of disease risk according to the Agreement on the Application of Sanitary and Phytosanitary Measures of the World Trade Organization. However, in order for a QRA to be objective and consistently applied it is necessary to standardize the approach as much as possible. This review considers how QRAs have historically been used for the benefit of animal health, what problems have been encountered during their progression, and considers best practice for their future use. Four main elements were identified as having been the subject of some proposed standard methodology: (i) the description of risk levels, (ii) combining probabilities, (iii) accounting for trade volume and time period, and (iv) uncertainty. These elements were addressed in different ways but were highlighted as being fundamental to improving the robustness in estimating the risk and conveying the results to the risk manager with minimal ambiguity. In line with this, several tools have been developed which attempt to use mathematical reasoning to incorporate uncertainty and improve the objectivity of the qualitative framework. This represents an important advance in animal health QRA. Overall, animal health QRAs have established their usefulness by providing a tool for rapid risk estimation which can be used to identify important chains of events and critical control points along risk pathways and inform risk management programmes as to whether or not the risk exceeds a decision-making threshold above which action should be taken. Ensuring a robust objective methodology is used and that the reasons for differences in results, such as assumptions and uncertainty are clearly described to the customer with minimal ambiguity is essential to maintain confidence in the QRA process. However, further work needs to be done to determine if one objective uniform methodology should be developed and considered best practice. To this end, a set of best practice guidelines presenting the optimal way to conduct a QRA and regulated by bodies such as the World Organization for Animal Health or the European Food Safety Authority would be beneficial.

A scoping review of foot-and-mouth disease risk, based on spatial and spatio-temporal analysis of outbreaks in endemic settings

Foot-and-mouth disease (FMD) is one of the most important transboundary animal diseases affecting livestock and wildlife species worldwide. Sustained viral circulation, as evidenced by serological surveys and the recurrence of outbreaks, suggests endemic transmission cycles in some parts of Africa, Asia and the Middle East. This is the result of a complex process in which multiple serotypes, multi-host interactions and numerous socio-epidemiological factors converge to facilitate disease introduction, survival and spread. Spatial and spatio-temporal analyses have been increasingly used to explore the burden of the disease by identifying high-risk areas, analysing temporal trends and exploring the factors that contribute to the outbreaks. We systematically retrieved spatial and spatial-temporal studies on FMD outbreaks to summarize variations on their methodological approaches and identify the epidemiological factors associated with the outbreaks in endemic contexts. Fifty-one studies were included in the final review. A high proportion of papers described and visualized the outbreaks (72.5%) and 49.0% used one or more approaches to study their spatial, temporal and spatio-temporal aggregation. The epidemiological aspects commonly linked to FMD risk are broadly categorizable into themes such as (a) animal demographics and interactions, (b) spatial accessibility, (c) trade, (d) socio-economic and (e) environmental factors. The consistency of these themes across studies underlines the different pathways in which the virus is sustained in endemic areas, with the potential to exploit them to design tailored evidence based-control programmes for the local needs. There was limited data linking the socio-economics of communities and modelled FMD outbreaks, leaving a gap in the current knowledge. A thorough analysis of FMD outbreaks requires a systemic view as multiple epidemiological factors contribute to viral circulation and may improve the accuracy of disease mapping. Future studies should explore the links between socio-economic and epidemiological factors as a foundation for translating the identified opportunities into interventions to improve the outcomes of FMD surveillance and control initiatives in endemic contexts.

Coupling spatial statistics with social network analysis to estimate distinct risk areas of disease circulation to improve risk-based surveillance

Most animal disease surveillance systems concentrate efforts in blocking transmission pathways and tracing back infected contacts while not considering the risk of transporting animals into areas with elevated disease risk. Here, we use a suite of spatial statistics and social network analysis to characterize animal movement among areas with an estimated distinct risk of disease circulation to ultimately enhance surveillance activities. Our model utilized equine infectious anemia virus (EIAV) outbreaks, between-farm horse movements, and spatial landscape data from 2015 through 2017. We related EIAV occurrence and the movement of horses between farms with climate variables that foster conditions for local disease propagation. We then constructed a spatially explicit model that allows the effect of the climate variables on EIAV occurrence to vary through space (i.e., non-stationary). Our results identified important areas in which in-going movements were more likely to result in EIAV infections and disease propagation. Municipalities were then classified as having high 56 (11.3%), medium 48 (9.66%), and low 393 (79.1%) spatial risk. The majority of the movements were between low-risk areas, altogether representing 68.68% of all animal movements. Meanwhile, 9.48% were within high-risk areas, and 6.20% were within medium-risk areas. Only 5.37% of the animals entering low-risk areas came from high-risk areas. On the other hand, 4.91% of the animals in the high-risk areas came from low- and medium-risk areas. Our results demonstrate that animal movements and spatial risk mapping could be used to make informed decisions before issuing animal movement permits, thus potentially reducing the chances of reintroducing infection into areas of low risk.

Risk-based serological survey of bluetongue and the first evidence of bluetongue virus serotype 26 circulation in Tunisia

BACKGROUND

Bluetongue (BT), a vector-borne disease of wild and domestic ruminants, is responsible for severe economic losses in flocks. To reduce this impact, a surveillance and control plan was implemented in Tunisia. However, the epidemiological situation of BT remains incompletely understood, especially for the circulating serotypes.

OBJECTIVE

The aim of this survey was to determine the seroprevalence, to identify the circulating serotypes and to identify the associated risk factors for bluetongue virus (BTV) circulation in Tunisia using risk-based sampling (RBS).

METHODS

A total of 3314 blood samples were randomly collected from 67 sectors using risk-based sampling and screened by competitive enzyme-linked immunosorbent assays (c-ELISAs). Out of the 1330 positive samples, 200 samples were analysed by serum neutralization test (SNT) to identify circulating BTV serotypes.

RESULTS

Of 3314 sera, 1330 were c-ELISA-positive (40.1%) for antibodies against the BTV structural protein VP7. The result of SNT showed the presence of BTV-1, BTV-2, BTV-3, BTV-4 and, for the first time in Tunisia, BTV-26. The logistic regression model revealed that older animals had nearly two times the odds of being infected with BTV compared to younger animals. Flocks with a history of BT were almost 1.5 times more likely to be at risk for contracting BTV infection. The flock size, housing indoors and intensive production system were significant protective factors.

CONCLUSIONS

High seroprevalence of BTV among sheep was highlighted in Tunisia. The neutralization test showed the presence of the following BTV serotypes: BTV-1, BTV-2, BTV-3, BTV-4 and, for the first time in Tunisia, BTV-26. Age, production system and flock size were important variables associated with BTV infection in sheep. This finding is crucial, as it will allow the adjustment of the BT control programme in Tunisia.

One Coin, Two Sides: Eliciting Expert Knowledge From Training Participants in a Capacity-Building Program for Veterinary Professionals

Scientific research may include the elicitation of judgment from non-academic subject-matter experts in order to improve the quality and/or impact of research studies. Elicitation of expert knowledge or judgment is used when data are missing, incomplete, or not representative for the specific setting and processes being studied. Rigorous methods are crucial to ensure robust study results, and yet the quality of the elicitation can be affected by a number of practical constraints, including the understanding that subject-matter experts have of the elicitation process itself. In this paper, we present a case of expert elicitation embedded within an extended training course for veterinary professionals as an example of overcoming these constraints. The coupling of the two activities enabled extended opportunities for training and a relationship of mutual respect to be the foundation for the elicitation process. In addition, the participatory research activities reinforced knowledge synthesis objectives of the educational program. Finally, the synergy between the two concurrent objectives may produce benefits which transcend either independent activity: solutions and ideas built by local professionals, evolving collaborative research and training approaches, and a network of diverse academic and practicing professionals. This approach has the versatility to be adapted to many training and research opportunities.

Self-Reporting of Risk Pathways and Parameter Values for Foot-and-Mouth Disease in Slaughter Cattle from Alternative Production Systems by Kenyan and Ugandan Veterinarians

Countries in which foot-and-mouth disease (FMD) is endemic may face bans on the export of FMD-susceptible livestock and products because of the associated risk for transmission of FMD virus. Risk assessment is an essential tool for demonstrating the fitness of one’s goods for the international marketplace and for improving animal health. However, it is difficult to obtain the necessary data for such risk assessments in many countries where FMD is present. This study bridged the gaps of traditional participatory and expert elicitation approaches by partnering with veterinarians from the National Veterinary Services of Kenya (n = 13) and Uganda (n = 10) enrolled in an extended capacity-building program to systematically collect rich, local knowledge in a format appropriate for formal quantitative analysis. Participants mapped risk pathways and quantified variables that determine the risk of infection among cattle at slaughter originating from each of four beef production systems in each country. Findings highlighted that risk processes differ between management systems, that disease and sale are not always independent events, and that events on the risk pathway are influenced by the actions and motivations of value chain actors. The results provide necessary information for evaluating the risk of FMD among cattle pre-harvest in Kenya and Uganda and provide a framework for similar evaluation in other endemic settings.

Risk based serological survey of Rift Valley fever in Tunisia (2017-2018)

Rift Valley fever (RVF) has been reported in the sub-Saharan region of Africa, Egypt and Arabian Peninsula - Yemen and Saudi Arabia, over the past 20 years and is a threat to both the animal and human populations in Tunisia. Tunisia is considered as a high-risk country for the introduction of RVF due to the informal movements of diseased animals already reported in the neighboring countries. The objective of this study was to assess the status of RVF in small ruminants and camels in Tunisia. A risk-based serological survey was conducted to evaluate the presence of RVF based on spatial qualitative risk analysis (SQRA). Samples were collected from small ruminants (sheep and goats) (n = 1,114), and camels (n = 173) samples, belonging to 18 breeders in 14 governorates between November 2017 and January 2018. Samples were tested using an RVF specific multispecies competitive ELISA. Out of the 1,287 samples tested for the presence of RVF IgG antibodies by ELISA, only one positive sample 0.07% (1/1 287) was detected but not confirmed with the virus neutralization test (VNT) used for confirmation. So far, no RVF outbreaks have been reported in Tunisia and our study confirmed the absence of RVF in livestock up to January 2018. Further investigations are needed to confirm the RVF-free status of Tunisia today.