Geographical clustering of cases of bovine spongiform encephalopathy (BSE) born in Switzerland after the feed ban

Case-control study of cases of bovine spongiform encephalopathy born after July 31, 1996 (BARB cases) in Great Britain

This paper reports the results of a case-control study of the bovine spongiform encephalopathy (BSE) cases born in Great Britain after the statutory reinforcement of the ban (BARB) on the feeding of mammalian-derived meat and bone meal on 31 July 1996. A total of 499 suspect clinical cases of BSE, born after 31 July 1996, and reported negative by July 31, 1996 and were compared with the set of 164 confirmed Great BARB cases in Great Britain detected by both passive and active surveillance. Animal-level risk factors (age and type of feed offered) and herd-level risk factors (herd size and type, number of prereinforced feed ban BSE cases born on the holding, the presence of other domestic species and waste management) were obtained for the analysis. BARB cases were 2.56 times (95 per cent CI 1.29 to 5.07) more likely to be exposed to homemix or a combination of homemix and proprietary feeds were 0.59 times (95 per cent CI 0.50 to 0.69) as less likely to be exposed to the unit increases in the number of prereinforced feed ban BSE cases diagnosed on the natal holding. A supplementary spatial analysis of these cases revealed three areas of excess BARB density: Northwest and Southwest of Wales and Northeast of Scotland.

Spatial correlation between the prevalence of transmissible spongiform diseases and British soil geochemistry

Transmissible spongiform encephalopathies (TSEs) are a group of fatal neurological conditions affecting a number of mammals, including sheep and goats (scrapie), cows (BSE), and humans (Creutzfeldt-Jakob disease). The diseases are widely believed to be caused by the misfolding of the normal prion protein to a pathological isoform, which is thought to act as an infectious agent. Outbreaks of the disease are commonly attributed to contaminated feed and genetic susceptibility. However, the implication of copper and manganese in the pathology of the disease, and its apparent geographical clustering, have prompted suggestions of a link with trace elements in the environment. Nevertheless, studies of soils at regional scales have failed to provide evidence of an environmental risk factor. This study uses geostatistical techniques to investigate the correlations between the distribution of TSE prevalence and soil geochemical variables across the UK according to different spatial scales. A similar spatial pattern in scrapie and BSE occurrence is identified, which may be linked with increasing pH and total organic carbon, and decreasing iodine concentration. However, the pattern also resembles that of the density of dairy farming. Nevertheless, despite the low spatial resolution of the TSE data available for this study, the fact that significant correlations are detected indicates there is a possibility of a link between soil geochemistry, scrapie, and BSE. It is suggested that further investigations of the prevalence of TSE and environmental exposure to trace metals should take into account the factors affecting their bioavailability.

Exploratory spatial analysis of Aujeszky's disease during four phases of the eradication programme in Catalonia, Spain (2003-2007)

An exploratory spatial analysis of Aujeszkys disease virus infection from 2003 to 2007 was conducted in Catalonia (north eastern Spain), the largest pig-producing region in the country. The analysis was divided into four periods in relation to the different eradication phases of the programme established in the region. Different purely spatial analyses, based on the Bernoulli model, were run with SaTScan v6.1 in each period. Clusters of positive sow farms (farrow to weaning and farrow to finish) and/or fattening farms were identified in the four study periods in the western part of the region, in the three first periods in the central part and in the last three periods in the north eastern part of the region. The prevalence ratio values of these clusters increased throughout the study period due to the fact that the risk of disease decreased faster outside the clusters than inside the clusters. In order to study the evolution of the disease, we explored for areas where more negative sow farms became infected and areas where more sow farms eliminated the infection. These analyses demonstrated areas with significantly higher proportions of sow farms that became negative, which indicates that the eradication of the disease had a spatial component. Clusters of negative sow farms that were infected again (reinfections) were also detected in the four study periods. The relative risk values of these clusters were much higher compared to the other cluster analyses. There was a geographical association between the clusters of positive sow farms, positive fattening farms and re-infected sow farms. This association could be attributable to the local spread of Aujeszkys disease virus. Pig farm density could be a factor influencing the local spread of infection and was therefore evaluated for clusters of re-infected sow farms and clusters of sow farms that eliminated the infection. The mean density of pig farms was 0.40 farms/km(2) (median of 0.28 and standard deviation of 0.33) in clusters of sow farms that became negative and 1.51 (median of 0.70 and standard deviation of 1.61) in clusters where more sow farms became positive (p-value<0.05).

Spatial analysis of BSE cases in the Netherlands

BACKGROUND

In many of the European countries affected by Bovine Spongiform Encephalopathy (BSE), case clustering patterns have been observed. Most of these patterns have been interpreted in terms of heterogeneities in exposure of cattle to the BSE agent. Here we investigate whether spatial clustering is present in the Dutch BSE case data.

RESULTS

We have found three spatial case clusters in the Dutch BSE epidemic. The clusters are geographically distinct and each cluster appears in a different birth cohort. When testing all birth cohorts together, only one significant cluster was detected. The fact that we found stronger spatial clustering when using a cohort-based analysis, is consistent with the evidence that most BSE infections occur in animals less than 12 or 18 months old.

CONCLUSION

Significant spatial case clustering is present in the Dutch BSE epidemic. The spatial clusters of BSE cases are most likely due to time-dependent heterogeneities in exposure related to feed production.

Investigation of exposure to swine influenza viruses in Ontario (Canada) finisher herds in 2004 and 2005

The epidemiology of influenza in the North American swine population has changed since the emergence of a triple-reassortant H3N2 influenza virus. Although seen previously in North America, the Ontario swine population had likely been free of viruses of the reassortant H3N2 lineage until 2005. The objective of this study was to investigate the frequency and distribution of exposure to H1N1 and H3N2 subtypes in the Ontario finisher pig population prior to and after the H3N2 outbreak that occurred in 2005. This included investigating prevalence and spatial distribution of positive herds, assessing proportion of random variation at different hierarchical levels, and evaluating selected demographic factors and management procedures as potential risk factors. In total, 919 and 978 sera collected in cross-sectional studies from 46 and 49 finisher herds in 2004 and 2005 were tested by a H1N1 subtype-specific and a H3N2 subtype-specific commercial ELISA. For the H1N1 subtype, the point prevalence of positive herds (>3 reactors) was 19.5% and 30.6% in 2004 and 2005, respectively. For the H3N2 subtype the point prevalence of positive herds (>3 reactors) was 6.5% and 40.8% in 2004 and 2005, respectively. Sera from 2004 that were positive on H3N2 ELISA did not cross-react with any of the H3N2 variants used as antigen on a sequential HI test. Only herds positive for H3N2 subtype in 2005 clustered in space (P<0.01). The H1N1 status in 2005 was associated with the H1N1 status in 2004, and with reported distance to the nearest herd. The H3N2 status in 2005 was associated with reported distance to the nearest herd and a type of replacement gilt source. For H3N2, distance seemed to be important even after controlling for type of gilt source. Most variability in seropositivity was between herds with little variability between pens. This study confirms that in 2005, the epidemic H3N2 subtype co-circulated with endemic H1N1 subtype in the Ontario finisher herds. We concluded that in Ontario, the endemic H1N1 subtype was likely maintained through circulation within herds and sites with common flow. Whereas the transmission of epidemic H3N2 subtype was attributed to local spread, which could include different modes of direct, indirect, and airborne transmission. We emphasize the importance of establishing routine monitoring systems that would allow using molecular tools, and maintaining serum banks as a useful resource for retrospective comparisons.

Identification of the characteristics and risk factors of the BSE epidemic in the Netherlands

It is generally accepted that the bovine spongiform encephalopathy (BSE) epidemic is transmitted by feed contamination with meat and bone meal (MBM). Whether in some cases substances other than MBM have caused the spread of this disease cannot be excluded at present. Detailed knowledge about country-specific transmission routes and relevant risk factors is important to perform accurate risk analyses and to control BSE. In the present study all possible information of Dutch BSE cases was collected. The general epidemiological data were first used for a comprehensive descriptive analysis of the Dutch BSE epidemic. A case-control study was performed to identify the risk factors associated with the occurrence of BSE cases in the Netherlands. Sixty-eight of the 76 BSE cases enrolled in the case-control study. With an oral questionnaire information was collected about cow and farm management. The same questionnaire was used in interviews at 128 randomly selected control farms. Detailed analysis of the case anamneses showed that all affected cows could have been exposed to MBM from pig or poultry feed as a result of cross-contamination. In the case-control study, only feed producer appeared to be a relevant risk factor. Differences in log odds between feed producers were related to the moment of separation of production lines and to the origin of the MBM. The results suggest that there were meaningful differences in the level of infectivity in MBM from different origins at the time that cross-contamination was still possible. No other risk factors, either farm or cow related, were significantly associated with the occurrence of BSE.

Bovine Spongiform Encephalopathy and Spatial Analysis of the Feed Industry

In France, despite the ban of meat-and-bone meal (MBM) in cattle feed, bovine spongiform encephalopathy (BSE) was detected in hundreds of cattle born after the ban. To study the role of MBM, animal fat, and dicalcium phosphate on the risk for BSE after the feed ban, we conducted a spatial analysis of the feed industry. We used data from 629 BSE cases as well as data on use of each byproduct and market area of the feed factories. We mapped risk for BSE in 951 areas supplied by the same factories and connection with use of byproducts. A disease map of BSE with covariates was built with the hierarchical Bayesian modeling methods, based on Poisson distribution with spatial smoothing. Only use of MBM was spatially linked to risk for BSE, which highlights cross-contamination as the most probable source of infection after the feed ban.

Spatial analysis of bovine spongiform encephalopathy in Galicia, Spain (2000–2005)

In Spain, the first bovine spongiform encephalopathy (BSE) case was detected in 2000 in a cow born in the Galicia region (Northwestern Spain). From then and until October 2005, 590 cases were detected, 223 of them in Galicia. In 1994, meat and bone meal (MBM) was banned on ruminant feed and, in 1996, an EU decision mandating an overall change in MBM processing was implemented. This decision was gradually applied in the territory and not enforced before July 1998. The objective of this study was to explore clustering of BSE cases and estimate the standard incidence ratio (SIR) of BSE in Galicia. Our study was based on the BSE cases detected during the surveillance period 2000-2005 in the Galicia region. These cases were divided, based on birth date, into two periods: animals born from 1994 to July 1998, and those born after July 1998. We tested the role of cross-contamination on the geographical SIR distribution for both periods. Hierarchical Bayesian models were used to model the overdispersion and lack of independence of the SIR estimates. The geographical distribution of the standard incidence ratio of BSE between both periods was different. In the second period, the SIR was reduced in some areas. The reduction in these areas could be attributable to the changes in the processing of MBM. We did not find any statistical link between the poultry population and the standard incidence ratio, but pig population had a positive effect.

BSE, feed and cattle in Switzerland: Is there a spatial relation?

Cross-contamination of cattle feed with meat and bone meal (MBM) allowed in feed for other species is regarded as the current hypothesis for the infection pathway of Bovine Spongiform Encephalopathy (BSE) cases occurring after the implementation of a ban on feeding MBM to cattle. This study was aimed at establishing a spatial relation between BSE cases in Switzerland and the findings of MBM in cattle feed. A cluster analysis and a cohort study were performed. Two hundred sixteen BSE cases born after December 1990 and detected until August 1st 2005, screening data of 504 feed producers between 1996 and 2001 and population data from the Swiss 2001 cattle census were included. The cluster analysis showed feed producer, positive for MBM contaminations in cattle feed, as possible cluster centres for BSE cases. In the cohort study, farms within a radius of 2 and 10 km around positive feed producers showed significantly higher odds to have a BSE case than the control group. The odds ratio and its 95% confidence interval were 2.23 (1.26-3.93) for the 2 km radius and 1.38 (1-1.9) for the 10 km radius. The results provide evidence for a spatial relation between cross-contamination and BSE occurrence. These findings support the hypothesis of cross-contamination to be an important route for BSE transmission after a feed ban.

Brief review on the epidemiology of transmissible spongiform encephalopathies (TSE)

Transmissible spongiform encephalopathies (TSE) form a group of human and animal diseases that share common features such as (a) distinct pathological lesions in the central nervous system, (b) transmissibility at least in experimental settings, and (c) a long incubation period. Considerable differences exist in the host range of individual TSEs, their routes of transmission, and factors influencing the host susceptibility (such as genotype). The objective of this review was to briefly describe the main epidemiological features of TSEs with emphasis on small ruminant (sheep, goats) TSE, bovine spongiform encephalopathy (BSE) in cattle and chronic wasting disease (CWD) in deer and elk.

Potential Risk Factors Associated with Bovine Spongiform Encephalopathy in Cattle from Schleswig-Holstein, Germany

Since the first detection of bovine spongiform encephalopathy (BSE) in homebred cattle in Germany on 26 November 2000, 382 cases have been confirmed until 30 September 2005. Thirty-two of these cases were reported from the Federal State of Schleswig-Holstein (SH). There are hypotheses on the routes of infection for German cattle, but only few efforts have been made to assess potential risk factors by epidemiological studies. The purpose of this study was to identify potential risk factors at the farm level for the occurrence of BSE in cattle in SH. By applying the method of indirect standardization, the prevalence of various structural and management parameters of BSE-affected farms in SH was compared with the prevalence of these parameters in a standard population of cattle farms from SH. The data describing the standard population were obtained by a cross-sectional study performed in SH in 2003. Data of the BSE case population were available from the central German BSE case database. A possible association of the occurrence of BSE with the feeding of milk replacers to calves was observed. There was a clear indication that the occurrence of BSE was associated with the presence of pigs and/or poultry on the farm. This finding suggests that cross-contamination of feed or cross-exposition may have occurred in SH. The results obtained using the indirect standardization analysis were validated by multiple logistic regression. This study indicates that the feedborne path has been the principal route of transmission for the BSE agent in SH.

Human-mediated foot-and-mouth disease epidemic dispersal: disease and vector clusters

Disease clusters were retrospectively explored at national level using a geo-referenced dataset from the 2001 Uruguayan Foot-and-Mouth Disease (FMD) epidemic. Disease location and time (first 11 epidemic weeks) were analysed across 250 counties (of which 160 were infected), without and with control for human mobility related factors (human population and road densities). The null hypothesis of random disease distribution over space and/or time was assessed with: (i) purely temporal; (ii) purely spatial; and (iii) space/time tests. At least within epidemic weeks 2 and 6, a principal disease cluster was observed in 33 contiguous counties (P < 0.01). Two secondary clusters, located at >100 km from each other, were also observed (P < 0.01). The purely spatial test that controlled for human population density identified two non-contiguous clusters (P < 0.01). Space and time analysis also revealed the same 33 counties as members of the principal cluster, of which 31 were also clustered when human population was controlled (P < 0.01). No clusters were reported by the spatial test when road density was assessed. The hypothesis that human mobility related factors autocorrelate with disease was empirically supported by two pieces of information: (i) removal of human population/road densities eliminated >93.9% of the counties included in the principal disease cluster; and (ii) statistically significant correlations (P < 0.05) were observed in the first three epidemic weeks between road density and the number of cases. Clusters where human population density was associated with 47% greater number of cases/sq. km than that of the principal cluster indicated possible roles as disease vectors (vector clusters). Selective control policy in vector clusters is recommended. Periodic (i.e. weekly) cluster and correlation analyses of both disease and other covariates may facilitate disease surveillance and help design space-specific control policy.

Clustering of Mycobacterium avium subsp. paratuberculosis in rabbits and the environment: how hot is a hot spot?

Clustering of pathogens in the environment leads to hot spots of diseases at local, regional, national, and international levels. Scotland contains regional hot spots of Johne's disease (caused by Mycobacterium avium subsp. paratuberculosis) in rabbits, and there is increasing evidence of a link between paratuberculosis infections in rabbits and cattle. The spatial and temporal dynamics of paratuberculosis in rabbits within a hot spot region were studied with the overall aim of determining environmental patterns of infection and thus the risk of interspecies transmission to livestock. The specific aims were to determine if prevalence of paratuberculosis in rabbits varies temporally between seasons and whether the heterogeneous spatial environmental distribution of M. avium subsp. paratuberculosis on a large scale (i.e., regional hot spots) is replicated at finer resolutions within a hot spot. The overall prevalence of M. avium subsp. paratuberculosis in rabbits was 39.7%; the temporal distribution of infection in rabbits followed a cyclical pattern, with a peak in spring of 55.4% and a low in summer of 19.4%. Spatially, M. avium subsp. paratuberculosis-infected rabbits and, thus, the risk of interspecies transmission were highly clustered in the environment. However, this is mostly due to the clustered distribution of rabbits. The patterns of M. avium subsp. paratuberculosis infection in rabbits are discussed in relation to the host's socioecology and risk to livestock.

Exploratory spatial relative risk mapping

The many faces of disease mapping include maps of disease case locations, regional counts of cases, and disease risk. Another approach is that of mapping the relative risk. Previous methods to map the relative risk were based on regression models of relative risk, given information about geographical locations and established risk factors. However, spatial epidemiological investigations are often exploratory with limited knowledge about the putative risk factors. Indeed, often the primary motivation for the analysis is to identify unknown geographically varying risk factors. An exploratory approach to mapping the spatial relative risk is to scale the risk map using the background risk in the unexposed (or less-exposed) population. Exposure to unknown spatial risk factors is defined via specific cluster analysis. Identification of spatial disease clusters separates the population into those inside and those outside high risk areas (the exposed and unexposed populations). This exploratory approach to relative risk mapping gives the investigator an impression about the importance and geographical distribution of the unknown spatial risk factors. Two examples illustrate the exploratory relative risk mapping approach using a spatial point data set on pseudorabies in pig-herds and a regional count data set on small fox tapeworm infections in red foxes.

Population-level retrospective study of neurologically expressed disorders in ruminants before the onset of bovine spongiform encephalopathy (BSE) in Belgium, a BSE risk III country

A retrospective epidemiological study (n = 7,875) of neurologically expressed disorders (NED) in ruminants before the onset of the bovine spongiform encephalopathy epidemic (years studied, 1980 to 1997) was carried out in Belgium. The archives of all veterinary laboratories and rabies and transmissible spongiform encephalopathy (TSE) epidemiosurveillance networks were consulted. For all species, a significantly higher number of NED with virological causes (rabies) was reported south of the Sambre-Meuse Valley. During the period 1992 to 1997, for which the data were complete, (i) the predicted annual incidence of NED varied significantly as a function of species and area (higher numbers in areas where rabies was present) but was always above 100 cases per million, and (ii) the mean incidence of suspected TSE cases and, among them, those investigated by histopathological examination varied significantly as a function of species and area. The positive predictive value of a presumptive clinical diagnosis of NED ranged from 0.13 (game) to 0.63 (sheep). Knowledge of the positive predictive value permits the definition of a reference point before certain actions (e.g., awareness and training campaigns) are undertaken. It also shows the usefulness of a systematic necropsy or complementary laboratory tests to establish an etiological diagnosis. TSE analysis of a small, targeted historical sampling (n = 48) permitted the confirmation of one case and uncovered another case of scrapie. The results of the present study help to develop and maintain the quality of the worldwide clinical epidemiological networks for TSE, especially in countries that in the past imported live animals, animal products, and feedstuffs from countries with TSE cases.

Spatial heterogeneity of the risk of BSE in France following the ban of meat and bone meal in cattle feed

In France, meat-and-bone meal (MBM) has been prohibited for cattle feeding since 1990, but bovine spongiform encephalopathy (BSE) cases, called 'NAIF', appeared in animals born after this feed ban. Furthermore, in 1996 a new measure was taken: removal of cadavers and specified risk materials (SRM) from the processing of MBM dedicated to animal feed. Nevertheless, BSE cases (called 'super-NAIF') appeared in cattle born after this measure was in force. We analysed the spatial distribution of 445 'NAIF' and 58 'super-NAIF' cases detected in France from July 1, 2001 to July 31, 2003. The detection of BSE was based both on the mandatory reporting system (MRS) and the systematic test screening of cattle at the abattoir and at the fallen-animal plant with rapid tests. The background population was based on the adult-cow census. The disease mapping of the BSE risk was based on the standardised incidence ratio (stochastic Poisson process). A spatial component, which takes into account the spatial dependence between the geographical units by a notion of adjacency was used to eliminate the over-dispersion in the risk assessment. The geographical units were defined by hexagons with a side of 23km (France had 1264 hexagons). The parameters were estimated by a Metropolis Gibbs sampling algorithm using the Markov-chain Monte Carlo methods. The BSE cases were not randomly distributed. Furthermore, the areas at risk for the 'super-NAIF' matched part of the areas at risk for the 'NAIF' cases-which suggests that it might be a common source of contamination.

Prevalence of BSE in cattle found dead, euthanased or emergency slaughtered on farms in western France in 2000, 2001 and 2002

The overall trend and the trend within birth cohorts of the prevalence of bovine spongiform encephalopathy (BSE) in cattle found dead, euthanased or emergency slaughtered on farms in the Bretagne, Basse Normandie and Pays de la Loire regions of France, during the periods from August 7 to December 22 in 2000, 2001 and 2002, were analysed by non-conditional logistic regression, adjusted for the region and for the type of animals. The overall prevalence of BSE during these three periods decreased from 2.71 per 1000 in 2000 to 1.41 per 1000 in 2001 and 0.42 per 1000 in 2002. The prevalence within birth cohorts started to decrease for the cohort born between July 1, 1995 and June 30, 1996 (cohort 95/96) and the trend was reinforced for cohort 96/97, suggesting that the exposure of animals to the BSE agent had started to decrease for animals born after July 1995, that is, one year before the ban on specified risk materials in meat and bone meal was implemented in France. However, considering that most of the animals would have been infected at between six and 18 months of age, the decrease may have been due, at least partly, to this control measure.