The Health Burden of Orphan Zoonotic Disease in the United Kingdom, 2005–2009

‘Orphan’ zoonotic diseases attract disproportionately low scientific and public health attention for the impact that they can have. This article pulls together information on their health burden in the UK from routine and enhanced data sources. These diseases are heterogeneous in nature; some have very low case numbers (e.g. hydatid disease), whilst others affect hundreds of patients each year (e.g. toxoplasmosis). The number of deaths attributed to orphan zoonoses is relatively low, and the majority recorded in this article were caused by toxoplasmosis. There is a clear issue of under‐reporting and under‐diagnosis in the data sets presented, and further work should be carried out to obtain more accurate estimates of the prevalence of zoonotic infections. Joint human and veterinary studies are especially important for these diseases.     

A Qualitative Study of State‐Level Zoonotic Disease Surveillance in New England

Zoonotic diseases are infectious diseases transmittable between animals and humans and outbreaks of these diseases in animals can signify that humans are also infected (or vice versa). Thus, communication between animal and human health agencies is critical for surveillance. Understanding how these agencies conduct surveillance and share information is important for the development of successful automated zoonotic monitoring systems. Individual interviews were conducted with 13 professionals who perform animal or human zoonotic disease surveillance in one of the New England states. Questions centred on existing surveillance methods, collaborations between animal and human health agencies, and technological and data needs. The results showed that agencies routinely communicate over suspected zoonotic disease cases, yet there are barriers preventing automated electronic linking of health data of animals and humans. These include technological barriers and barriers due to sensitivity and confidentiality of information. Addressing these will facilitate the development of electronic systems for integrating animal and human zoonotic disease surveillance data.     

Zoonotic Disease Surveillance – Inventory of Systems Integrating Human and Animal Disease Information

Although 65% of recent major disease outbreaks throughout the world have a zoonotic origin, there is still a sharp division among the disciplines into the human and animal health sectors. In the last few decades, a global integrative concept, often referred to as ‘One Health’, has been strongly endorsed. Surveillance and monitoring efforts are major components for effective disease prevention and control. As human health and animal health are inextricably linked, it is assumed that a cross‐sectoral data interpretation of zoonotic disease information will improve their prevention, prediction and control. To provide an overview of existing systems throughout the world which integrate information from humans and animals on zoonotic diseases, a literature review was conducted. Twenty projects were identified and described regarding their concepts and realization. They all vary widely depending on their surveillance purpose, their structure and the source of information they use. What they have in common is that they quite often use data which have already been collected for another purpose. Therefore, the challenges of how to make use of such secondary data are of great interest.     

Prevention and Control of Rabies in an Age of Global Travel: A Review of Travel‐ and Trade‐Associated Rabies Events – United States, 1986–2012

Rabies prevention and control efforts have been successful in reducing or eliminating virus circulation regionally through vaccination of specific reservoir populations. A notable example of this success is the elimination of canine rabies virus variant from the United States and many other countries. However, increased international travel and trade can pose risks for rapid, long‐distance movements of ill or infected persons or animals. Such travel and trade can result in human exposures to rabies virus during travel or transit and could contribute to the re‐introduction of canine rabies variant or transmission of other viral variants among animal host populations. We present a review of travel‐ and trade‐associated rabies events that highlight international public health obligations and collaborative opportunities for rabies prevention and control in an age of global travel. Rabies is a fatal disease that warrants proactive coordination among international public health and travel industry partners (such as travel agents, tour companies and airlines) to protect human lives and to prevent the movement of viral variants among host populations.     

Invasive Pasteurella multocida Infections – Report of Five Cases at a Minnesota Hospital, 2014

During October 2014, the Minnesota Department of Health was notified of five Hospital A patients with Pasteurella multocida bacteraemia; three had died. Human soft tissue infection with P. multocida typically results from cat or dog bites or scratches. Invasive infection, defined as a P. multocida isolate from a usually sterile site, is rare. We evaluated P. multocida isolations at Hospital A, compared with other Minnesota hospitals to understand invasive infection trends. A case was defined as clinically confirmed P. multocida in a Minnesota resident during 2012–2014. All hospital laboratories were queried; Fisher's exact test was used for comparison. Medical charts were reviewed for 2014 Hospital A patients with P. multocida infections. The Minnesota clinical laboratories survey response rate was 79% (63/80). At Hospital A, proportion of P. multocida isolates from usually sterile sites increased from 0% (0/2) during 2012 to 11% (1/9) during 2013, and to 86% (5/6) during 2014. The proportion of patients with P. multocida isolated from sterile sites was 35% (6/17) at Hospital A compared with 10% (58/583) statewide during 2012–2014 combined (P < 0.05). Among 2014 Hospital A patients with invasive P. multocida infection, all five were men; median age was 70 (range: 44–78) years. Four were temporally clustered within a 33‐day period; three of those had bacteraemia on admission, making hospital acquisition possible in only one. Among five bacteraemia patients, four had cirrhosis and/or skin ulcerations, and three died. The proportion of invasive P. multocida cases was substantially higher at Hospital A during 2014. No epidemiologic links between patients were found. Three had known pet exposure. Collaborative educational efforts of chronically ill pet owners by physicians and veterinarians can acknowledge the health benefits of pet ownership, while minimizing risk for serious invasive zoonotic infections, including those caused by P. multocida.     

Investigation of nutriactive phytochemical – gamma‐oryzanol in experimental animal models

Gamma‐oryzanol (GO) is an abundant dietary antioxidant that is considered to have beneficial effects in cardiovascular disease, cancer and diabetes. Other potential properties of GO include inhibition of gastric acid secretion and decreased post‐exercise muscle fatigue. GO is a unique mixture of triterpene alcohol and sterol ferulates present in rice bran oil, a byproduct of rice processing. GO has been studied by many researchers over the last three decades. In particular, the utility of GO supplementation has been documented in numerous animal models. A large variety of species was examined, and various experimental methodologies and targets were applied. The aim of this study was to summarize the body of research on GO supplementation in animals and to examine possible mechanisms of GO action. Furthermore, while the safety of GO supplementation in animals has been well documented, studies demonstrating pharmacokinetics, pharmacodynamics and efficiency are less clear. The observed differences in these findings are also discussed.     

Impact of Rabies Vaccination History on Attainment of an Adequate Antibody Titre Among Dogs Tested for International Travel Certification,Israel – 2010–2014

Rabies is endemic in wildlife or domestic carnivore populations globally. Infection of domestic dogs is of particular concern in many areas. In regions where domestic animals are at risk of exposure to rabies virus, dogs should be routinely vaccinated against rabies to protect both pet and human populations. Many countries require demonstration of an adequate level of serum rabies neutralizing antibodies to permit entry of dogs during international travel. We analysed rabies titres of dogs seeking travel certification in Israel to assess demographic and vaccine history factors associated with antibody titres below the acceptable threshold for travel certification. Having received only one previous rabies vaccination and a longer duration since the most recent vaccination was received were primary risk factors for not achieving an adequate rabies virus neutralizing antibody titre for travel certification. These risk factors had stronger effects in younger animals, but were consistent for dogs of all ages. In particular, these findings reiterate the importance of administering at least two rabies vaccinations (the primo vaccination and subsequent booster) to ensure population‐level protection against rabies in dogs globally.     

A Multistate Investigation of Antibiotic‐Resistant Salmonella enterica Serotype I 4,[5],12:i:‐ Infections as Part of an International Outbreak Associated with Frozen Feeder Rodents

While most human Salmonella infections result from exposure to contaminated foods, an estimated 11% of all Salmonella infections are attributed to animal exposures, including both direct animal handling and indirect exposures such as cleaning cages and handling contaminated pet food. This report describes the epidemiologic, environmental and laboratory investigations conducted in the United States as part of the response to an international outbreak of tetracycline‐resistant Salmonella enterica serotype I 4,[5],12:i:‐ infections with over 500 illnesses occurring from 2008 to 2010. This investigation found that illness due to the outbreak strain was significantly associated with exposure to pet reptiles and frozen feeder rodents used as food for pet reptiles. Salmonella isolates indistinguishable from the outbreak strain were isolated from a frozen feeder mice‐fed reptile owned by a case patient, as well as from frozen feeder mice and environmental samples collected from a rodent producing facility (Company A). An international voluntary recall of all Company A produced frozen feeder animals sold between May 2009 and July 2010 occurred. Only 13% of cases in our investigation were aware of the association between Salmonella infection and mice or rats. Consumers, the pet industry, healthcare providers and veterinarians need to be aware of the potential health risk posed by feeder rodents, whether live or frozen. Frozen feeder rodent producers, suppliers and distributors should follow the animal food labelling requirements as described in 21 CFR §501.5, and all packages of frozen feeder rodents should include safe handling instructions. Persons should wash their hands thoroughly with soap and water after handling live or frozen feeder rodents, as well as reptiles or anything in the area where the animals live. Continued opportunities exist for public health officials, the pet industry, veterinarians and consumers to work together to prevent salmonellosis associated with pet food, pets and other animals.     

Human Brucellosis Trends: Re‐emergence and Prospects for Control Using a One Health Approach in Azerbaijan (1983–2009)

Brucellosis is one of the most common and widely spread zoonotic diseases in the world. Control of the disease in humans is dependent upon limiting the infection in animals through surveillance and vaccination. Given the dramatic economic and political changes that have taken place in the former Soviet Union, which have limited control, evaluating the status of human brucellosis in former Soviet states is crucial. We assessed annual spatial and temporal trends in the epidemiology of human brucellosis in Azerbaijan, 1983–2009, in conjunction with data from a livestock surveillance and control programme (2002–2009). To analyse trends, we used a combination of segmented regression and spatial analysis. From 1983 to 2009, a total of 11 233 cases of human brucellosis were reported. Up to the mid‐1990s, the incidence of human brucellosis showed a pattern of re‐emergence, increasing by 25% annually, on average. Following Soviet governance, the incidence rates peaked, increasing by 1.8% annually, on average, and subsequently decreasing by 5% annually, on average, during the period 2002–2009. Despite recent national declines in human incidence, we identified geographic changes in the case distribution characterized by a geographic expansion and an increasing incidence among districts clustered in the south‐east, compared to a decrease of elsewhere in the country. Males were consistently, disproportionately afflicted (71%) and incidence was highest in the 15 to 19 age group (18.1 cases/100 000). During the period 2002–2009, >10 million small ruminants were vaccinated with Rev1. Our findings highlight the improving prospects for human brucellosis control following livestock vaccination; however, the disease appears to be re‐emerging in south‐eastern Azerbaijan. Sustained one health measures are needed to address changing patterns of brucellosis in Azerbaijan and elsewhere in the former Soviet Union.     

Development of equine post anaesthetic myelopathy: Thirty cases (1979–2010)

Post anaesthetic myelopathy is a rare but devastating complication of equine anaesthesia and there is a need for better understanding of the condition and to raise veterinary awareness. The aim of this study was to collect data on unreported cases and combine those with reported cases to better identify possible risk factors and early clinical signs and outcomes of horses developing post anaesthetic myelopathy (PAM). A survey was conducted to identify cases of equine PAM. Records were also requested via the American College of Veterinary Anaesthesiologists listserve. Additional cases of PAM were located through review of the literature. Eighteen new cases and 12 published cases were identified. Large‐framed breeds between 6–24 months of age were more commonly affected (23/30). The majority of horses were positioned in dorsal recumbency during anaesthesia. Lack of movement and deep pain of the rear limbs, loss of anal tone and lack of panniculus response from the mid to caudal thorax distally were the most common clinical findings. Reported treatments resulted in no improvement of clinical signs and all horses died or were subjected to euthanasia from a few hours to 8 days post operatively. Poliomyelomalacia of the caudal spinal cord is the most common histopathological finding. Although a rare complication it is a catastrophic risk that can be eliminated by performing a standing operation. Hopefully in the future better understanding of this condition will lead to prevention and treatment strategies.     

Government Response to the Discovery of a Rabies Virus Reservoir Species on a Previously Designated Rabies‐Free Island,Taiwan, 1999–2014

Taiwan had been considered rabies free since 1961. In 2013, Taiwan confirmed the detection of rabies virus in wild Taiwan ferret‐badgers. Up to December 2014, there have been 423 rabies‐confirmed ferret‐badgers and three cases of spillover infection into non‐reservoir hosts. Genetic analysis indicates that TFBV is distinct from all other known rabies virus variants. To date, ferret‐badger rabies is known to occur only in China and Taiwan. The temporal dynamics of rabid ferret‐badgers in Taiwan suggests that the epizootic appears to have subsided to enzootic levels as of December 2014. According to the current epidemiologic data, there is only one TFBV strain in Taiwan. TFBV is still sequestered to the mountainous regions. Humans are at risk mainly through exposure to the virus from infected domestic meso‐carnivores, mainly dogs and cats. Dogs and cats should be vaccinated to establish an immunological barrier to stop the spread of the disease from mountainous regions to domestic meso‐carnivores.     

Evaluation of Pet‐Related Management Factors and the Risk of Salmonella spp. Carriage in Pet Dogs from Volunteer Households in Ontario (2005–2006)

The purpose of this study was to determine pet‐related management factors that may be associated with the presence of Salmonella spp. in feces of pet dogs from volunteer households. From October 2005 until May 2006, 138 dogs from 84 households in Ontario were recruited to participate in a cross‐sectional study. Five consecutive daily fecal samples were collected from each dog and enrichment culture for Salmonella spp. was performed. A higher than expected number of the dogs (23.2%; 32/138) had at least one fecal sample positive for Salmonella, and 25% (21/84) of the households had at least one dog shedding Salmonella. Twelve serotypes of Salmonella enterica subsp. enterica were identified, with the predominant serotypes being Typhimurium (33.3%; 13/39), Kentucky (15.4%; 6/39), Brandenburg (15.4%; 6/39) and Heidelberg (12.8%; 5/39). Univariable logistic regression models were created with a random effect for household to account for clustering. Statistically significant risk factors for a dog testing positive included having contact with livestock, receiving a probiotic in the previous 30 days, feeding a commercial or homemade raw food diet, feeding raw meat and eggs, feeding a homemade cooked diet, and having more than one dog in the household. In two‐variable models that controlled for feeding raw food, the non‐dietary variables were no longer statistically significant. These results highlight the potential public health risk of including raw animal products in canine diets.     

Annual survival and site fidelity of free‐ranging white‐tailed deer (Odocoileus virginianus): comparative demography before (1983–1992) and after (1993–2005) spatial confinement

Survival and movement are important demographic variables influencing the dynamics of large herbivores with implications for management and evolution of life‐history strategies. Management practices such as spatial confinement and harvest regulation attempt to control survival and movement for the sustainability of harvested deer populations, but a paucity of long‐term data exists on these management practices. We examined annual survival and site fidelity of free‐ranging white‐tailed deer (Odocoileus virginianus) over 10 years (1983–1992) to compare demographic parameters after spatial confinement (1993–2005). We used capture records (n = 174; 104 females, 70 males), marked deer recaptures (n = 42), and dead recoveries (n = 68) to estimate sex‐specific, age‐specific and time‐specific parameters. We found that annual female survival was 50% from 1983–1987 during a period of intense harvest, but increased to 93.7% after intense harvesting was eliminated. Prior to spatial confinement, annual survival of marked male deer averaged 36.7%–42.5%. After spatial confinement, annual survival increased on average for males (58%–99%) and females (77%–98%). Females showed high levels of site fidelity (>99%) prior to spatial confinement, whereas males showed much less site fidelity (≤4.5% for the 2 top‐ranking models). During spatial confinement, the semi‐impermeable fence effectively increased site fidelity of males (≥56%). These results stem from long‐term study (23 years) of a large herbivore experiencing changes to life‐history, resulting from changes in management that were applied to the population and aimed at altering population demographics, for sustainability of a harvestable population of deer.     

Investigation of the Concurrent Emergence of Salmonella enteritidis in Humans and Poultry in British Columbia,Canada, 2008–2010

An increase in the rate of human infections with Salmonella enteritidis (SE) occurred between 2007 and 2010 in British Columbia (BC). During the same time period, an increase in SE from poultry‐sourced isolates and increased clinical severity in poultry were also observed in BC. This article describes a multi‐sectoral collaboration during a 3‐year investigation, and the actions taken by public health and animal health professionals. Human cases were interviewed, clusters were investigated, and a case–control study was conducted. Environmental investigations were conducted in food service establishments (FSE). Suspect foods were tested. Laboratory data from poultry‐sourced isolates were analysed. Five hundred and eighty‐four human cases of SE with the same pulsed‐field gel electrophoresis pattern were identified between May 2008 and August 2010. Seventy‐three percentage of cases reported consumption of eggs. The odds of egg consumption were 2.4 times higher for cases than controls. Implicated FSE were found to use ungraded eggs, which had been distributed illegally. Investigation suggested that there were multiple suppliers of these eggs. Collaboration between public health and animal health professionals led to data sharing, improved understanding of SE, engagement with the poultry industry and public communication. Multi‐disciplinary, multi‐sectoral and multi‐pronged investigations are recommended to identify the likely source of illness in large, protracted foodborne outbreaks caused by commonly consumed foods.