Objective To determine the odds ratio and population attributable fraction associated with food and environmental risk factors for acute toxoplasmosis in pregnancy. Design Case-control study. Setting Six large European cities. Participants Pregnant women with acute infection (cases) detected by seroconversion or positive for anti-Toxoplasma gondii IgM were compared with pregnant women seronegative for toxoplasma (controls). Main outcome measures Odds ratios for acute infection adjusted for confounding variables; the population attributable fraction for risk factors. Results Risk factors most strongly predictive of acute infection in pregnant women were eating undercooked lamb, beef, or game, contact with soil, and travel outside Europe and the United States and Canada. Contact with cats was not a risk factor. Between 30% and 63% of infections in different centres were attributed to consumption of undercooked or cured meat products and 6% to 17% to soil contact. Conclusions Inadequately cooked or cured meat is the main risk factor for infection with toxoplasma in all centres. Preventive strategies should aim to reduce prevalence of infection in meat, improve labelling of meat according to farming and processing methods, and improve the quality and consistency of health information given to pregnant women. IntroductionIn Europe, congenital toxoplasmosis affects between 1 and 10 in 10 000 newborn babies, 1 of whom 1% to 2% develop learning difficulties or die and 4% to 27% develop retinochoroidal lesions leading to permanent unilateral impairment of vision.2-6 Effective prevention of congenital toxoplasmosis depends on avoidance of infection during pregnancy. Infection is acquired by ingestion of viable tissue cysts in meat or oocysts excreted by cats that contaminate the environment. Uncertainty about how most women acquire infection results in advice to avoid numerous risk factors, making compliance difficult.8 9 Development of more focused strategies requires up to date and regionally relevant information on the principal sources of infection during pregnancy.The prevalence of previous toxoplasma infection in pregnant women ranges from 10% in the United Kingdom 10 and Norway 11 to around 55% in France 12 and Greece 13; in many countries it has declined sharply over the past three decades.14-16 Regional variation has been attributed to climate, 11 cultural differences in the amount and type of raw meat consumed, 7 17 and the increased consumption of meat from animals farmed indoors and frozen meat. 7 18 The decline in prevalence of infection, however, does not necessarily reflect a fall in the incidence of toxoplasmosis acquired during pregnancy. Instead, the decline in prevalence in pregnant women probably reflects a decline in incidence during childhood. 15More women are susceptible to infection now, and the frequency of exposure to risk factors for infection may have increased. Recent changes include a shift from consumption of beef to pork and poultry and increased consumption of organic meat and "val...

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A total of 1235 tracheal aspirates taken from 724 thoroughbreds in race training, aged from two to 10 years, were examined cytologically and bacteriologically. An inflammation scoring system on a scale of 0 to 9 was devised to allow the severity of lower airway disease to be assessed from the cytological results. The inflammation scores were closely related to the isolation of bacteria (P<0.001), and the most common bacterial isolates were Streptococcus zooepidemicus, Streptococcus pneumoniae and Pasteurella/Actinobacillus-like species. Lower airway disease was less common in older horses (P = 0.031), and the groups at highest risk were the two- and four-year-olds. Lower airway inflammation was more common in the four-year-olds at National Hunt yards than in the four-year-olds at flat racing yards (P = 0.040, odds ratio = 3.80).

Bovine Tuberculosis (bTB) in cattle is a global health problem and eradication of the disease requires accurate estimates of diagnostic test performance to optimize their efficiency. The objective of this study was, through statistical meta-analyses, to obtain estimates of sensitivity (Se) and specificity (Sp), for 14 different ante-mortem and post-mortem diagnostic tests for bTB in cattle. Using data from a systematic review of the scientific literature (published 1934-2009) diagnostic Se and Sp were estimated using Bayesian logistic regression models adjusting for confounding factors. Random effect terms were used to account for unexplained heterogeneity. Parameters in the models were implemented using Markov Chain Monte Carlo (MCMC), and posterior distributions for the diagnostic parameters with adjustment for covariates (confounding factors) were obtained using the inverse logit function. Estimates for Se and/or Sp of the tuberculin skin tests and the IFN-γ blood test were compared with estimates published 2010-2015. Median Se for the single intradermal comparative cervical tuberculin skin (SICCT) test (standard interpretation) was 0.50 and Bayesian credible intervals (CrI) were wide (95% CrI 0.26, 0.78). Median Sp for the SICCT test was 1.00 (95% CrI 0.99, 1.00). Estimates for the IFN-γ blood test Bovine Purified Protein Derivative (PPD)-Avian PPD and Early Secreted Antigen target 6 and Culture Filtrate Protein 10 (ESAT-6/CFP10) ESAT6/CFP10 were 0.67 (95% CrI 0.49, 0.82) and 0.78 (95% CrI 0.60, 0.90) respectively for Se, and 0.98 (95% CrI 0.96, 0.99) and 0.99 (95% CrI 0.99, 1.00) for Sp. The study provides an overview of the accuracy of a range of contemporary diagnostic tests for bTB in cattle. Better understanding of diagnostic test performance is essential for the design of effective control strategies and their evaluation.

Disease surveillance programmes ought to be evaluated regularly to ensure they provide valuable information in an efficient manner. Evaluation of human and animal health surveillance programmes around the world is currently not standardized and therefore inconsistent. The aim of this systematic review was to review surveillance system attributes and the methods used for their assessment, together with the strengths and weaknesses of existing frameworks for evaluating surveillance in animal health, public health and allied disciplines. Information from 99 articles describing the evaluation of 101 surveillance systems was examined. A wide range of approaches for assessing 23 different system attributes was identified although most evaluations addressed only one or two attributes and comprehensive evaluations were uncommon. Surveillance objectives were often not stated in the articles reviewed and so the reasons for choosing certain attributes for assessment were not always apparent. This has the potential to introduce misleading results in surveillance evaluation. Due to the wide range of system attributes that may be assessed, methods should be explored which collapse these down into a small number of grouped characteristics by focusing on the relationships between attributes and their links to the objectives of the surveillance system and the evaluation. A generic and comprehensive evaluation framework could then be developed consisting of a limited number of common attributes together with several sets of secondary attributes which could be selected depending on the disease or range of diseases under surveillance and the purpose of the surveillance. Economic evaluation should be an integral part of the surveillance evaluation process. This would provide a significant benefit to decision-makers who often need to make choices based on limited or diminishing resources.

A 12-month abattoir study was undertaken from January 2003. We collected 7492 intestinal samples from cattle, sheep and pigs at slaughter. Rectal samples were taken from cattle and sheep and caecal samples from pigs. They were examined for verocytotoxigenic E. coli (VTEC) O157, Salmonella, thermophilic Campylobacter and Yersinia enterocolitica. Data were collected on the animal from which the sample came and this information was analysed to look at potential risk factors for carriage of these organisms. Logistic regression models were run where an adequate number of positive results were available. This revealed that VTEC O157 carriage in cattle was associated with the summer period and that age was a protective factor. Salmonella carriage in pigs was associated with lairage times >12 h, the North East and not feeding when there was no bedding available. In cattle, carriage was associated with the summer period, the Eastern region of GB and dairy animals. In sheep a spring seasonal effect was seen, which coincided with the lambing period. The carriage of thermophilic Campylobacter in cattle was associated with single-species abattoirs, with age a protective factor. In sheep, winter was a risk period with lairage management influential. For pigs, lairage times of <12 h were found to be associated with carriage. A seasonal trend for carriage of Y. enterocolitica in all species was demonstrated with the period December-May a risk. For cattle, age was also a risk factor; for sheep feeding in the lairage and for pigs being held overnight were risk factors.

The objective of this study was to develop and parametrize a mathematical model of the sensitivity of pooled sampling of faeces to detect Salmonella infection in pigs. A mathematical model was developed to represent the effect of pooling on the probability of Salmonella isolation. Parameters for the model were estimated using data obtained by collecting 50 faecal samples from each of two pig farms. Each sample was tested for Salmonella at individual sample weights of 0.1, 0.5, 1, 10 and 25 g and pools of 5, 10 and 20 samples were created from the individual samples. The highest test sensitivity for individual samples was found at 10 g (90% sensitivity), with the 25 g test sensitivity equal to 83%. For samples of less than 10 g, sensitivity was found to reduce with sample weight. Incubation for 48 h was found to produce a more sensitive test than incubation for 24 h. Model results found increasing sensitivity with more samples in the pool, with the pools of 5, 10 and 20 being more sensitive than individual sampling, and the pools of 20 being the most sensitive of those considered.

Animal health surveillance programmes may change in response to altering requirements or perceived weaknesses but are seldom subjected to any formal evaluation to ensure that they provide valuable information in an efficient manner. The literature on the evaluation of animal health surveillance systems is sparse, and those that are published may be unstructured and therefore incomplete. To address this gap, we have developed SERVAL, a SuRveillance EVALuation framework, which is novel and aims to be generic and therefore suitable for the evaluation of any animal health surveillance system. The inclusion of socio-economic criteria ensures that economic evaluation is an integral part of this framework. SERVAL was developed with input from a technical workshop of international experts followed by a consultation process involving providers and users of surveillance and evaluation data. It has been applied to a range of case studies encompassing different surveillance and evaluation objectives. Here, we describe the development, structure and application of the SERVAL framework. We discuss users' experiences in applying SERVAL to evaluate animal health surveillance systems in Great Britain.