Quantitative Risk Assessment for African Horse Sickness in Live Horses Exported from South Africa

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.

Assessing the export trade risk of bluetongue virus serotypes 4 and 8 in France

Bluetongue (BT) causes an economic loss of $3 billion every year in the world. After two serious occurrences of BT (bluetongue virus [BTV] occurrence in 2006 and 2015), France has been controlling for decades, but it has not been eradicated. As the largest live cattle export market in the world, France is also one of the major exporters of breeding animals and genetic materials in the world. The biosafety of its exported cattle and products has always been a concern. The scenario tree quantitative model was used to analyze the risk of BTV release from French exported live cattle and bovine semen. The results showed that with the increase in vaccination coverage rates, the risk decreased. If the vaccine coverage is 0%, the areas with the highest average risk probability of BTV-4 and BTV-8 release from exported live cattle were Haute-Savoie and Puy-de-Dôme, and the risk was 2.96 × 10^-4 and 4.25 × 10^-4 , respectively. When the vaccine coverage was 90%, the risk probability of BTV-4 and BTV-8 release from exported live cattle was 2.96 × 10^-5 and 4.24 × 10^-5 , respectively. The average probability of BTV-8 release from bovine semen was 1.09 × 10^-10 . Sensitivity analysis showed that the probability of false negative polymerase chain reaction (PCR) test and the probability of BT infection in the bull breeding station had an impact on the model. The identification of high-risk areas and the discovery of key control measures provide a reference for decision makers to assess the risk of French exports of live cattle and bovine semen.

The seroprevalence of African horse sickness virus, and risk factors to exposure, in domestic dogs in Tshwane, South Africa

Dogs are the only non-equid species to develop the fatal form of African horse sickness (AHS). Research conducted in 2013 questioned the long-held belief that naturally occurring cases of AHS in dogs were contracted exclusively through the ingestion of contaminated horse meat. Culicoides midges, the vector of AHS virus (AHSV) for horses, have an aversion to dog blood meals and dogs were believed to be dead-end or incidental hosts. More recently, dog mortalities have occurred in the absence of horse meat consumption and vector transmission has been suspected. The current study is a retrospective serological survey of AHSV exposure in dogs from an endemic area. Dog sera collected from dogs (n = 366) living in the city of Tshwane, Gauteng Province, South Africa, were randomly selected from a biobank at a veterinary teaching hospital, corresponding to the years 2014-2019. The study used a laboratory in-house indirect recombinant VP7 antigen-based enzyme-linked immunosorbent assay (iELISA) with a test cut-off calculated from AHSV exposure-free dog sera (n = 32). Study AHSV seroprevalence was 6 % (22/366) with an estimated true prevalence of 4.1 % (95 % confidence interval (CI) = 1.3-8.1 %). Incidence was estimated for dogs with multiple serological results with seroconversion occurring at a rate of 2.3 seroconversions per 10 dog years at risk (95 % CI = 0.6-6.2). A subsection of the study sera was tested with AHSV viral neutralisation test (VN) (n = 42) for serotype determination. Antibodies to AHSV serotype 6 were most prevalent (90 %) in VN seropositive dogs (n = 20) with most dogs seemingly subclinically infected (>95 %). Seroprevalence descriptively varied by year and identified risk factors were annual rainfall > 754 mm (odds ratio (OR) = 5.76; 95 % CI = 2.22 - 14.95; p < 0.001), medium human population densities, 783-1663 people/km² (OR = 7.14; 95 % CI = 1.39 - 36.73; p = 0.019) and 1664-2029 people/km² (OR = 6.74; 95 % CI = 1.40 - 32.56; p = 0.018), and the month of March (OR = 5.12; 95 % CI = 1.41 - 18.61; p = 0.013). All identified risk factors were consistent with midge-borne transmission to dogs. The relatively high seroprevalence and seroconversion rates suggest frequent exposure of dogs to AHSV and indicates the need to investigate the role dogs might play in the overall epidemiology and transmission of AHSV.

A Qualitative Risk Assessment for Bluetongue Disease and African Horse Sickness: The Risk of Entry and Exposure at a UK Zoo

Bluetongue virus (BTV) and African horse sickness virus (AHSV) cause economically important diseases that are currently exotic to the United Kingdom (UK), but have significant potential for introduction and onward transmission. Given the susceptibility of animals kept in zoo collections to vector-borne diseases, a qualitative risk assessment for the introduction of BTV and AHSV to ZSL London Zoo was performed. Risk pathways for each virus were identified and assessed using published literature, animal import data and outputs from epidemiological models. Direct imports of infected animals, as well as wind-borne infected Culicoides, were considered as routes of incursion. The proximity of ongoing disease events in mainland Europe and proven capability of transmission to the UK places ZSL London Zoo at higher risk of BTV release and exposure (estimated as low to medium) than AHSV (estimated as very low to low). The recent long-range expansion of AHSV into Thailand from southern Africa highlights the need for vector competence studies of Palearctic Culicoides for AHSV to assess the risk of transmission in this region.

An entry risk assessment of African horse sickness virus into the controlled area of South Africa through the legal movement of equids

South Africa is endemic for African horse sickness (AHS), an important health and trade-sensitive disease of equids. The country is zoned with movement control measures facilitating an AHS-free controlled area in the south-west. Our objective was to quantitatively establish the risk of entry of AHS virus into the AHS controlled area through the legal movement of horses. Outcomes were subcategorised to evaluate movement pathway, temporal, and spatial differences in risk. A 'no-control' scenario allowed for evaluation of the impact of control measures. Using 2019 movement and AHS case data, and country-wide census data, a stochastic model was developed establishing local municipality level entry risk of AHSV at monthly intervals. These were aggregated to annual probability of entry. Sensitivity analysis evaluated model variables on their impact on the conditional means of the probability of entry. The median monthly probability of entry of AHSV into the controlled area of South Africa ranged from 0.75% (June) to 5.73% (February), with the annual median probability of entry estimated at 20.21% (95% CI: 15.89%-28.89%). The annual risk of AHSV entry compared well with the annual probability of introduction of AHS into the controlled area, which is ~10% based on the last 20 years of outbreak data. Direct non-quarantine movements made up most movements and accounted for most of the risk of entry. Spatial analysis showed that, even though reported case totals were zero throughout 2019 in the Western Cape, horses originating from this province still pose a risk that should not be ignored. Control measures decrease risk by a factor of 2.8 on an annual basis. Not only do the outcomes of this study inform domestic control, they can also be used for scientifically justified trade decision making, since in-country movement control forms a key component of export protocols.

Post-outbreak African horse sickness surveillance: A scenario tree evaluation in South Africa's controlled area

An African horse sickness (AHS) outbreak occurred in March and April 2016 in the controlled area of South Africa. This extended an existing trade suspension of live equids from South Africa to the European Union. In the post-outbreak period ongoing passive and active surveillance, the latter in the form of monthly sentinel surveillance and a stand-alone freedom from disease survey in March 2017, took place. We describe a stochastic scenario tree analysis of these surveillance components for 24 months, starting July 2016, in three distinct geographic areas of the controlled area. Given that AHS was not detected, the probability of being free from AHS was between 98.3% and 99.8% assuming that, if it were present, it would have a prevalence of at least one infected animal in 1% of herds. This high level of freedom probability had been attained in all three areas within the first 9 months of the 2-year period. The primary driver of surveillance outcomes was the passive surveillance component. Active surveillance components contributed minimally (<0.2%) to the final probability of freedom. Sensitivity analysis showed that the probability of infected horses showing clinical signs was an important parameter influencing the system surveillance sensitivity. The monthly probability of disease introduction needed to be increased to 20% and greater to decrease the overall probability of freedom to below 90%. Current global standards require a 2-year post-incursion period of AHS freedom before re-evaluation of free zone status. Our findings show that the length of this period could be decreased if adequately sensitive surveillance is performed. In order to comply with international standards, active surveillance will remain a component of AHS surveillance in South Africa. Passive surveillance, however, can provide substantial evidence supporting AHS freedom status declarations, and further investment in this surveillance activity would be beneficial.

A Tool for Prioritizing Livestock Disease Threats to Scotland

There are a number of disease threats to the livestock of Scotland that are not presently believed to be circulating in the UK. Here, we present the development of a tool for prioritizing resources for livestock disease threats to Scotland by combining a semi-quantitative model of the chance of introduction of different diseases with a semi-quantitative model of disease impact. Eighteen key diseases were identified and then input into a model framework to produce a semi-quantitative estimate of disease priorities. We estimate this through a model of the potential impacts of the infectious diseases in Scotland that is interpreted alongside a pre-existing generic risk assessment model of the risks of incursion of the diseases. The impact estimates are based on key metrics which influence the practical impact of disease. Metrics included are the rate of spread, the disease mitigation factors, impacts on animal welfare and production, the human health risks and the impacts on wider society. These quantities were adjusted for the size of the Scottish livestock population and were weighted using published scores. Of the 18 livestock diseases included, the model identifies highly pathogenic avian influenza, foot and mouth disease in cattle and bluetongue virus in sheep as having the greatest priority in terms of the combination of chance of introduction and disease impact. Disregarding the weighting for livestock populations and comparing equally between industry sectors, the results demonstrate that Newcastle disease and highly pathogenic avian influenza generally have the greatest potential impact. This model provides valuable information for the veterinary and livestock industries in prioritizing resources in the face of many disease threats. The system can easily be adjusted as disease situations evolve.

Assessing the potential of plains zebra to maintain African horse sickness in the Western Cape Province, South Africa

African horse sickness (AHS) is a disease of equids that results in a non-tariff barrier to the trade of live equids from affected countries. AHS is endemic in South Africa except for a controlled area in the Western Cape Province (WCP) where sporadic outbreaks have occurred in the past 2 decades. There is potential that the presence of zebra populations, thought to be the natural reservoir hosts for AHS, in the WCP could maintain AHS virus circulation in the area and act as a year-round source of infection for horses. However, it remains unclear whether the epidemiology or the ecological conditions present in the WCP would enable persistent circulation of AHS in the local zebra populations. Here we developed a hybrid deterministic-stochastic vector-host compartmental model of AHS transmission in plains zebra (Equus quagga), where host populations are age- and sex-structured and for which population and AHS transmission dynamics are modulated by rainfall and temperature conditions. Using this model, we showed that populations of plains zebra present in the WCP are not sufficiently large for AHS introduction events to become endemic and that coastal populations of zebra need to be >2500 individuals for AHS to persist >2 years, even if zebras are infectious for more than 50 days. AHS cannot become endemic in the coastal population of the WCP unless the zebra population involves at least 50,000 individuals. Finally, inland populations of plains zebra in the WCP may represent a risk for AHS to persist but would require populations of at least 500 zebras or show unrealistic duration of infectiousness for AHS introduction events to become endemic. Our results provide evidence that the risk of AHS persistence from a single introduction event in a given plains zebra population in the WCP is extremely low and it is unlikely to represent a long-term source of infection for local horses.

Establishing post-outbreak freedom from African horse sickness virus in South Africa's surveillance zone

An African horse sickness (AHS) outbreak occurred in South Africa's AHS controlled area in autumn 2016. A freedom from disease survey was performed to establish the likelihood of ongoing circulation of the associated virus during the same period the following year. A single-stage surveillance strategy was employed with a population-level design prevalence of 1% to establish a survey population sensitivity of 95% (probability that one or more positive horses would be detected if AHS was present at a prevalence greater than or equal to the design prevalence). In March 2017, a total of 262 randomly selected horses from 51 herds were sampled from the 2016 outbreak containment zone. Three within-herd and herd-level design prevalence scenarios were used in evaluating the post-survey probability of freedom. Depending on the underlying design prevalence scenarios, effectively ranging between 0.8% and 6.4%, and the use of informed or uninformed priors, the probability of freedom derived from this surveillance ranged between 73.1% and 99.9% (uninformed prior) and between 96.6% and 100% (informed prior). Based on the results, the authors conclude that it is unlikely that the 2016 AHS virus was still circulating in the autumn of 2017 in the 2016 outbreak containment zone. The ability to perform freedom from disease surveys, and also to include risk-based methods, in the AHS controlled area of South Africa is influenced by the changing underlying population at risk and the high level of vaccination coverage in the horse population. Ongoing census post-outbreak must be undertaken to maintain a valid sampling frame for future surveillance activity. The seasonality of AHS, the restricted AHS vaccination period and the inability to easily differentiate infected from vaccinated animals by laboratory testing impact the ability to perform a freedom from disease survey for AHS in the 12 months following an outbreak in the controlled area.

Sellers' Revisited: A Big Data Reassessment of Historical Outbreaks of Bluetongue and African Horse Sickness due to the Long-Distance Wind Dispersion of Culicoides Midges

The possibility that outbreaks of bluetongue (BT) and African horse sickness (AHS) might occur via long-distance wind dispersion (LDWD) of their insect vector (Culicoides spp.) was proposed by R. F. Sellers in a series of papers published between 1977 and 1991. These investigated the role of LDWD by means of visual examination of the wind direction of synoptic weather charts. Based on the hypothesis that simple wind direction analysis, which does not allow for wind speed, might have led to spurious conclusions, we reanalyzed six of the outbreak scenarios described in Sellers' papers. For this reanalysis, we used a custom-built Big Data application ("TAPPAS") which couples a user-friendly web-interface with an established atmospheric dispersal model ("HYSPLIT"), thus enabling more sophisticated modeling than was possible when Sellers undertook his analyzes. For the two AHS outbreaks, there was strong support from our reanalysis of the role of LDWD for that in Spain (1966), and to a lesser degree, for the outbreak in Cyprus (1960). However, for the BT outbreaks, the reassessments were more complex, and for one of these (western Turkey, 1977) we could discount LDWD as the means of direct introduction of the virus. By contrast, while the outbreak in Cyprus (1977) showed LDWD was a possible means of introduction, there is an apparent inconsistency in that the outbreaks were localized while the dispersion events covered much of the island. For Portugal (1956), LDWD from Morocco on the dates suggested by Sellers is very unlikely to have been the pathway for introduction, and for the detection of serotype 2 in Florida (1982), LDWD from Cuba would require an assumption of a lengthy survival time of the midges in the air column. Except for western Turkey, the BT reanalyses show the limitation of LDWD modeling when used by itself, and indicates the need to integrate susceptible host population distribution (and other covariate) data into the modeling process. A further refinement, which will become increasingly important to assess LDWD, will be the use of virus and vector genome sequence data collected from potential source and the incursion sites.

African Horse Sickness Virus: History, Transmission, and Current Status

African horse sickness virus (AHSV) is a lethal arbovirus of equids that is transmitted between hosts primarily by biting midges of the genus Culicoides (Diptera: Ceratopogonidae). AHSV affects draft, thoroughbred, and companion horses and donkeys in Africa, Asia, and Europe. In this review, we examine the impact of AHSV critically and discuss entomological studies that have been conducted to improve understanding of its epidemiology and control. The transmission of AHSV remains a major research focus and we critically review studies that have implicated both Culicoides and other blood-feeding arthropods in this process. We explore AHSV both as an epidemic pathogen and within its endemic range as a barrier to development, an area of interest that has been underrepresented in studies of the virus to date. By discussing AHSV transmission in the African republics of South Africa and Senegal, we provide a more balanced view of the virus as a threat to equids in a diverse range of settings, thus leading to a discussion of key areas in which our knowledge of transmission could be improved. The use of entomological data to detect, predict and control AHSV is also examined, including reference to existing studies carried out during unprecedented outbreaks of bluetongue virus in Europe, an arbovirus of wild and domestic ruminants also transmitted by Culicoides.

African horse sickness: The potential for an outbreak in disease-free regions and current disease control and elimination techniques

African horse sickness (AHS) is an arboviral disease of equids transmitted by Culicoides biting midges. The virus is endemic in parts of sub-Saharan Africa and official AHS disease-free status can be obtained from the World Organization for Animal Health on fulfilment of a number of criteria. AHS is associated with case fatality rates of up to 95%, making an outbreak among naïve horses both a welfare and economic disaster. The worldwide distributions of similar vector-borne diseases (particularly bluetongue disease of ruminants) are changing rapidly, probably due to a combination of globalisation and climate change. There is extensive evidence that the requisite conditions for an AHS epizootic currently exist in disease-free countries. In particular, although the stringent regulations enforced upon competition horses make them extremely unlikely to redistribute the virus, there are great concerns over the effects of illegal equid movement. An outbreak of AHS in a disease free region would have catastrophic effects on equine welfare and industry, particularly for international events such as the Olympic Games. While many regions have contingency plans in place to manage an outbreak of AHS, further research is urgently required if the equine industry is to avoid or effectively contain an AHS epizootic in disease-free regions. This review describes the key aspects of AHS as a global issue and discusses the evidence supporting concerns that an epizootic may occur in AHS free countries, the planned government responses, and the roles and responsibilities of equine veterinarians.