Herd-level risk factors associated with the presence of Phage type 21/28 E. coli O157 on Scottish cattle farms

<p>Background: E. coli O157 is a bacterial pathogen that is shed by cattle and can cause severe disease in humans. Phage type (PT) 21/28 is a subtype of E. coli O157 that is found across Scotland and is associated with particularly severe human morbidity.</p> <p>Methods: A cross-sectional survey of Scottish cattle farms was conducted in the period Feb 2002-Feb 2004 to determine the prevalence of E. coli O157 in cattle herds. Data from 88 farms on which E. coli O157 was present were analysed using generalised linear mixed models to identify risk factors for the presence of PT 21/28 specifically.</p> <p>Results: The analysis identified private water supply, and northerly farm location as risk factors for PT 21/28 presence. There was a significant association between the presence of PT 21/28 and an increased number of E. coli O157 positive pat samples from a farm, and PT 21/28 was significantly associated with larger E. coli O157 counts than non-PT 21/28 E. coli O157.</p> <p>Conclusion: PT 21/28 has significant risk factors that distinguish it from other phage types of E. coli O157. This finding has implications for the control of E. coli O157 as a whole and suggests that control could be tailored to target the locally dominant PT.</p&gt

Temporal trends in the discovery of human viruses

On average, more than two new species of human virus are reported every year. We constructed the cumulative species discovery curve for human viruses going back to 1901. We fitted a statistical model to these data; the shape of the curve strongly suggests that the process of virus discovery is far from complete. We generated a 95% credible interval for the pool of as yet undiscovered virus species of 38–562. We extrapolated the curve and generated an estimate of 10–40 new species to be discovered by 2020. Although we cannot predict the level of health threat that these new viruses will present, we conclude that novel virus species must be anticipated in public health planning. More systematic virus discovery programmes, covering both humans and potential animal reservoirs of human viruses, should be considered

How many cows do I need? Sample size calculations for testing co-infection using existing study data

Background There is little empirical research on the co-infection of Fasciola hepatica and Escherichia coli O157 in cattle. E. coli is controlled in the gut by a Type 1 immune response, whereas F. hepatica is known to suppress these immune responses and induce an anti-inflammatory environment in the host. We evaluate the statistical feasibility of re-testing isolates from a planned UK Food Standards Agency study on E. coli prevalence for F. hepatica presence, in order to establish whether there is an association. Methods We simulate synthetic datasets representing the proposed FSA sampling strategy. Sample sizes within farms and F. hepatica infections are simulated using Beta-Binomial distributions. E. coli infections are simulated using a logistic random-intercepts model under an alternative hypothesis that the odds ratio of E. coli presence is double when F. hepatica is present, with farm- and isolate-level prevalence rates constrained to current estimates. Statistical power is calculated by fitting models to each of the simulated datasets assuming a type I error rate of 5%. Owing to the E. coli status being known in advance of the F. hepatica test, we restrict the sampling strategy to only test farms with >0% an

Human viruses:discovery and emergence

There are 219 virus species that are known to be able to infect humans. The first of these to be discovered was yellow fever virus in 1901, and three to four new species are still being found every year. Extrapolation of the discovery curve suggests that there is still a substantial pool of undiscovered human virus species, although an apparent slow-down in the rate of discovery of species from different families may indicate bounds to the potential range of diversity. More than two-thirds of human viruses can also infect non-human hosts, mainly mammals, and sometimes birds. Many specialist human viruses also have mammalian or avian origins. Indeed, a substantial proportion of mammalian viruses may be capable of crossing the species barrier into humans, although only around half of these are capable of being transmitted by humans and around half again of transmitting well enough to cause major outbreaks. A few possible predictors of species jumps can be identified, including the use of phylogenetically conserved cell receptors. It seems almost inevitable that new human viruses will continue to emerge, mainly from other mammals and birds, for the foreseeable future. For this reason, an effective global surveillance system for novel viruses is needed

Pathogenic Potential to Humans of Bovine Escherichia coli O26, Scotland

Escherichia coli O26 and O157 have similar overall prevalences in cattle in Scotland, but in humans, Shiga toxin–producing E. coli O26 infections are fewer and clinically less severe than E. coli O157 infections. To investigate this discrepancy, we genotyped E. coli O26 isolates from cattle and humans in Scotland and continental Europe. The genetic background of some strains from Scotland was closely related to that of strains causing severe infections in Europe. Nonmetric multidimensional scaling found an association between hemolytic uremic syndrome (HUS) and multilocus sequence type 21 strains and confirmed the role of stx<sub>2</sub> in severe human disease. Although the prevalences of E. coli O26 and O157 on cattle farms in Scotland are equivalent, prevalence of more virulent strains is low, reducing human infection risk. However, new data on E. coli O26–associated HUS in humans highlight the need for surveillance of non-O157 enterohemorrhagic E. coli and for understanding stx<sub>2</sub> phage acquisition

Applying phylogenomics to understand the emergence of Shiga Toxin producing Escherichia coli O157:H7 strains causing severe human disease in the United Kingdom

Shiga Toxin producing Escherichia coli (STEC) O157:H7 is a recently emerged zoonotic pathogen with considerable morbidity. Since the serotype emerged in the 1980s, research has focussed on unravelling the evolutionary events from the E. coli O55:H7 ancestor to the contemporaneous globally dispersed strains. In this study the genomes of over 1000 isolates from human clinical cases and cattle, spanning the history of STEC O157:H7 in the United Kingdom were sequenced. Phylogenetic analysis reveals the ancestry, key acquisition events and global context of the strains. Dated phylogenies estimate the time to the most recent common ancestor of the current circulating global clone to 175 years ago, followed by rapid diversification. We show the acquisition of specific virulence determinates occurred relatively recently and coincides with its recent detection in the human population. Using clinical outcome data from 493 cases of STEC O157:H7 we assess the relative risk of severe disease including HUS from each of the defined clades in the population and show the dramatic effect Shiga toxin complement has on virulence. We describe two strain replacement events that have occurred in the cattle population in the UK over the last 30 years; one resulting in a highly virulent strain that has accounted for the majority of clinical cases in the UK over the last decade. This work highlights the need to understand the selection pressures maintaining Shiga-toxin encoding bacteriophages in the ruminant reservoir and the study affirms the requirement for close surveillance of this pathogen in both ruminant and human populations

Understanding foot-and-mouth disease virus transmission biology: identification of the indicators of infectiousness

The control of foot-and-mouth disease virus (FMDV) outbreaks in non-endemic countries relies on the rapid detection and removal of infected animals. In this paper we use the observed relationship between the onset of clinical signs and direct contact transmission of FMDV to identify predictors for the onset of clinical signs and identify possible approaches to preclinical screening in the field. Threshold levels for various virological and immunological variables were determined using Receiver Operating Characteristic (ROC) curve analysis and then tested using generalized linear mixed models to determine their ability to predict the onset of clinical signs. In addition, concordance statistics between qualitative real time PCR test results and virus isolation results were evaluated. For the majority of animals (71%), the onset of clinical signs occurred 3–4 days post infection. The onset of clinical signs was associated with high levels of virus in the blood, oropharyngeal fluid and nasal fluid. Virus is first detectable in the oropharyngeal fluid, but detection of virus in the blood and nasal fluid may also be good candidates for preclinical indicators. Detection of virus in the air was also significantly associated with transmission. This study is the first to identify statistically significant indicators of infectiousness for FMDV at defined time periods during disease progression in a natural host species. Identifying factors associated with infectiousness will advance our understanding of transmission mechanisms and refine intra-herd and inter-herd disease transmission models

I wish he'd listen: Client-centered interviewing approaches are associated with higher compliance with behavioral modification advice in pet dog owners

In the UK, over 40,000 dogs are given up annually to shelters or euthanized due to problem behaviors. It may be possible to reduce these numbers through behavior counseling and development of a behavior modification plan (BMP) by a canine professional (CP). However, if the client does not or cannot adhere to the BMP the dog's prospects may be compromised. This study explored the experience of the initial behavior consultation and possible reasons for adhering to (or not) the BMP from the client's perspective. An online survey solicited the opinions of canine behavior clients who had sought professional help in the UK for their dog's unwanted behavior within the last 2 years. Principal Component Analysis of Likert scale statements revealed one significant PC (P < 0.001) that explained 57% of the variation in the data and was significantly correlated with BMP compliance (r = 0.567, P < 0.001). Specifically, believing the plan was right for their dog and having CP support throughout to achieve behavior improvement through the implementation of a mutually agreed BMP were important. Qualitative thematic analysis of free text responses regarding motivation for future client BMP compliance echoed these factors. Conversely, a negative consultation experience was created by CPs adopting an authoritarian or ‘telling’ approach with their clients for example, making them feel judged. This was associated with a lack of BMP compliance. Essentially, CPs who involved their clients in BMP development were perceived as creating a positive experience of the initial behavior consultation and as a result were able to promote client BMP adherence and improvement in unwanted behavior improvement. This CP approach, which adopts a nurturing rather than an authoritarian strategy, has been termed Client-Centered Interviewing (CCI). The main thing about CCI is the client is an equal partner in the process. The core conditions are as per Rogers and Egan of empathy, congruence and unconditional positive regard. CCI builds on empathy with the client, avoids inappropriately challenging client beliefs by gently exploring options without being judgemental, clearly explains the likely cause of the behavior and the plan to resolve it, and provides a BMP that is bespoke and flexible. Future research is required to validate the findings, for example through a prospective comparison of Client-Centered Interviewing versus an instructional (authoritarian) approach. Crucially, the impact of Client-Centered Interviewing on canine welfare must also be evaluated

Efficacy of praziquantel has been maintained over four decades (from 1977 to 2018):A systematic review and meta-analysis of factors influence its efficacy

BackgroundThe antihelminthic drug praziquantel has been used as the drug of choice for treating schistosome infection for more than 40 years. Although some epidemiological studies have reported low praziquantel efficacy in cure rate (CR) and/or egg reduction rate (ERR), there is no consistent robust evidence of the development of schistosome resistance to praziquantel (PZQ). There is need to determine factors that lead to variable treatment CR and/or ERR. Therefore, we conducted a systematic review and meta-analysis to review CR and ERR as well as identify their predictors.Methodology/principal findingsIn this systematic review and meta-analysis, a literature review was conducted using Biosis Citation Index, Data Citation Index, MEDLINE, and Web of Science Core Collection all of which were provided through Web of Science. Alongside these, EMBASE, and CAB abstracts were searched to identify relevant articles. Random effect meta-regression models were used to identify the factors that influence CR and/or ERR by considering differences in host characteristics and drug dose. In total, 12,127 potential articles were screened and 146 eligible articles (published from 1979 to 2020) were identified and included for the meta-analysis. We found that there has been no significant reduction in CR or ERR over the study period. The results showed more variability in CR, compared with ERR which was more consistent and remained high. The results showed a positive effect of "PZQ treatment dose" with the current recommended dose of 40 mg/kg body weight achieving 57% to 88% CR depending on schistosome species, age of participants, and number of parasitological samples used for diagnosis, and ERR of 95%.Conclusions/significanceBased on a review of over 40 years of research there is no evidence to support concerns about schistosomes developing resistance to PZQ. These results indicate that PZQ remains effective in treating schistosomiasis