Paratuberculosis, a chronic disease affecting ruminant livestock, is caused by Mycobacterium avium subsp. paratuberculosis (MAP). It has direct and indirect economic costs, impacts animal welfare and arouses public health concerns. In a survey of 48 countries we found paratuberculosis to be very common in livestock. In about half the countries more than 20% of herds and flocks were infected with MAP. Most countries had large ruminant populations (millions), several types of farmed ruminants, multiple husbandry systems and tens of thousands of individual farms, creating challenges for disease control. In addition, numerous species of free-living wildlife were infected. Paratuberculosis was notifiable in most countries, but formal control programs were present in only 22 countries. Generally, these were the more highly developed countries with advanced veterinary services. Of the countries without a formal control program for paratuberculosis, 76% were in South and Central America, Asia and Africa while 20% were in Europe. Control programs were justified most commonly on animal health grounds, but protecting market access and public health were other factors. Prevalence reduction was the major objective in most countries, but Norway and Sweden aimed to eradicate the disease, so surveillance and response were their major objectives. Government funding was involved in about two thirds of countries, but operations tended to be funded by farmers and their organizations and not by government alone. The majority of countries (60%) had voluntary control programs. Generally, programs were supported by incentives for joining, financial compensation and/or penalties for non-participation. Performance indicators, structure, leadership, practices and tools used in control programs are also presented. Securing funding for long-term control activities was a widespread problem. Control programs were reported to be successful in 16 (73%) of the 22 countries. Recommendations are made for future control programs, including a primary goal of establishing an international code for paratuberculosis, leading to universal acknowledgment of the principles and methods of control in relation to endemic and transboundary disease. An holistic approach across all ruminant livestock industries and long-term commitment is required for control of paratuberculosis. Electronic supplementary material The online version of this article (10.1186/s12917-019-1943-4) contains supplementary material, which is available to authorized users.

SummaryIn the last decades, many regional and country-wide control programmes for Johne's disease (JD) were developed due to associated economic losses, or because of a possible association with Crohn's disease. These control programmes were often not successful, partly because management protocols were not followed, including the introduction of infected replacement cattle, because tests to identify infected animals were unreliable, and uptake by farmers was not high enough because of a perceived low return on investment. In the absence of a cure or effective commercial vaccines, control of JD is currently primarily based on herd management strategies to avoid infection of cattle and restrict within-farm and farm-to-farm transmission. Although JD control programmes have been implemented in most developed countries, lessons learned from JD prevention and control programmes are underreported. Also, JD control programmes are typically evaluated in a limited number of herds and the duration of the study is less than 5 year, making it difficult to adequately assess the efficacy of control programmes. In this manuscript, we identify the most important gaps in knowledge hampering JD prevention and control programmes, including vaccination and diagnostics. Secondly, we discuss directions that research should take to address those knowledge gaps. K E Y W O R D Scontrol, Johne's disease, Mycobacterium avium subspecies paratuberculosis, prevention

The objective of this paper is to study shedding patterns of cows infected with Mycobacterium avium subsp. paratuberculosis (MAP). While multiple single farm studies of MAP dynamics were reported, there is not large scale meta-analysis of both natural and experimental infections. Large difference in shedding patterns between experimentally and naturally infected cows were observed. Experimental infections are thus probably driven by different pathological mechanisms. For further evaluations of shedding patterns only natural infections were used. Within such infections, the transition to high shedding was studied as a proxy to the development of a clinical disease. The majority of studied cows never developed high shedding levels. Those that do, typically never reduced their shedding level to low or no shedding. Cows that eventually became high shedders showed a pattern of continuous shedding. In contrast, cows with an intermittent shedding pattern had a low probability to ever become high shedders. In addition, cows that start shedding at a younger age (less than three years of age) have a lower hazard of becoming high shedders compared to cows starting to shed at an older age. These data suggest the presence of three categories of immune control. Cows that are intermittent shedders have the infection process under control (no progressive infection). Cows that start shedding persistently at a young age partially control the infection, but eventually will be high shedders (slow progressive infection), while cows that start shedding persistently at an older age cannot effectively control the infection and become high shedders rapidly.

Epidemiological models have been developed to test hypotheses on Mycobacterium avium ssp. paratuberculosis (Map) transmission in a herd, and to compare different paratuberculosis control strategies and alternatives for certification-and-surveillance schemes. The models are simplified representations of existing biological processes tailored to the questions they are intended to answer. Such models depend on available knowledge about the underlying processes, notably in relation to pathogen transmission. All decisions relating to integration of specific aspects of the herd structure and transmission mechanisms as well as modeling objective will influence model behavior and simulation results. This paper examines assumptions on pathogen transmission and risk mitigation represented in 8 epidemiological models of within-herd Map transmission in dairy cattle. We describe available models' structure and examine them in the context of current knowledge about host infection and pathogen transmission pathways. We investigate how population structure and herd management are modeled with regard to their influence on contact structure and pathogen transmission. We show that assumptions about routes of transmission and their contribution within a herd vary greatly among models. Gaps of knowledge that are pivotal to defining transmission equations and parameters, such as variation of susceptibility with age and variability of pattern of shedding, are identified. Quantitative estimates of this incomplete information should be targeted by future research. Existing models could be improved by considering indirect transmission via the environment taking account of Map survival and contact structure between animals in a herd, and by including calf-to-calf transmission, which has recently been proven as being important.

-A bulk milk quality assurance programme for Mycobacterium avium subsp. paratuberculosis (Map) in dairy herds was simulated with a stochastic simulation model (JohneSSim). The aim of this study was to evaluate the epidemiological and economic effects of preventive management measures and various test schemes in a simulated population of closed Dutch dairy herds over a 20-year period. Herds were certified as 'low-Map bulk milk' if, with a certain probability, the concentration of Map in bulk milk did not exceed a maximum acceptable concentration of 10 3 Map organisms per litre (based on pasteurisation studies). The programme started with an initial assessment; test-negative herds entered a surveillance procedure and test-positive herds a control procedure. The simulations showed that herd examinations by ELISA for the initial assessment, surveillance and control procedures effectively ensure the quality of 'lowMap bulk milk': > 75% of simulated herds were certified and > 96% of certified herds produced bulk milk with < 10 3 Map/L if the initial herd-level prevalence was 30%. Preventive management measures only had a minor effect on bulk milk quality of certified herds. Culling based on biennial faecal culture was more effective than culling based on annual ELISA. Average total discounted costs for 20-year participation in a programme consisting of initial assessment by ELISA, surveillance by biennial ELISA and control by biennial faecal culture were e16 × 10 3 per herd.In conclusion, this study shows that a bulk milk quality assurance programme for closed Dutch dairy herds is feasible and provides information on the cost-effectiveness of different programmes. The concepts of this study equally apply to other countries because mechanisms of paratuberculosis infection, disease, and testing are comparable in other dairy cattle populations. dairy cattle / milk / paratuberculosis / stochastic simulation model / quality assurance programme