Wild boar tuberculosis in Iberian Atlantic Spain: a different picture from Mediterranean habitats

BACKGROUND Infections with Mycobacterium bovis and closely related members of the Mycobacterium tuberculosis complex (MTC) are shared between livestock, wildlife and sporadically human beings. Wildlife reservoirs exist worldwide and can interfere with bovine tuberculosis (TB) eradication efforts. The Eurasian wild boar (Sus scrofa) is a MTC maintenance host in Mediterranean Iberia (Spain and Portugal). However, few systematic studies in wild boar have been carried out in Atlantic regions. We describe the prevalence, distribution, pathology and epidemiology of MTC and other mycobacteria from wild boar in Atlantic Spain. A total of 2,067 wild boar were sampled between 2008 and 2012. RESULTS The results provide insight into the current status of wild boar as MTC and Mycobacterium avium complex (MAC) hosts in temperate regions of continental Europe. The main findings were a low TB prevalence (2.6%), a low proportion of MTC infected wild boar displaying generalized TB lesions (16.7%), and a higher proportion of MAC infections (4.5%). Molecular typing revealed epidemiological links between wild boar and domestic - cattle, sheep and goat - and other wildlife - Eurasian badger (Meles meles) and red fox (Vulpes vulpes) - hosts. CONCLUSIONS This study shows that the likelihood of MTC excretion by wild boar in Atlantic habitats is much lower than in Mediterranean areas. However, wild boar provide a good indicator of MTC circulation and, given the current re-emergence of animal TB, similar large-scale surveys would be advisable in other Atlantic regions of continental Europe

"Louping ill" in goat in northern Spain: more than a forgotten disease

Resumen del trabajo presentado al Joint Meeting of 30th Meeting of the European Society of Veterinary Pathology-Annual Meeting of the European College of Veterinary Pathology and 24th Annual Meeting of the Spanish Society of Veterinary Pathology, celebrado en León (España) del 5 al 8 de septiembre de 2012.-- et al.[Introduction]: Louping ill (LI) is a zoonotic disease caused by a neurotropic singlestrand RNA virus that has been classified into the Flavivirus genus. We report the case of a “Bermeya” goat herd of 70 animals from Asturias, suspected of being infected with a tick-borne encephalitis virus. [Materials and Methods]: Eighteen goats died showing neurological clinical signs. Necropsy was performed in two adult goats. Samples of brain were taken for further histopathological and molecular genetic (RT-PCR and sequencing) studies. In order to confirm the importance of the infection, a serological survey (ELISA) was performed in 178 goats belonging to seven herds geographically close to the affected one. [Results]: The cerebellum showed necrosis of Purkinje cells and neurons. A mild meningeal infiltration with widespread lymphocytic perivascular cuffs, phenomena of neurophagia and gliosis was observed mainly in the hypothalamus region and midbrain, being more severe in the medulla oblongata and cervical spinal cord. Molecular genetic studies identified the virus as a LI strain not described so far. Histopathological lesions together with molecular studies allowed a complete diagnosis: tick-borne encephalitis caused by a new strain of LI virus. The serological survey confirmed the infection in 5.06% of the animals studied. [Discussion & Conclusions]: These findings underline the necessity to implement a specific surveillance plan in Northern Spain focused on ticks, wildlife species and livestock.Peer Reviewe

Spatial relationships between Eurasian badgers (Meles meles) and cattle infected with Mycobacterium bovis in Northern Spain

Recent studies suggest that badgers may be a potential reservoir of Mycobacterium bovis infection for cattle in Northern Spain. The objective of this study was to investigate potential epidemiological links between cattle and badgers. Culture and molecular typing data were available for cattle culled during the national tuberculosis (TB) eradication campaigns between 2008 and 2012, as well as from 171 necropsied badgers and 60 live animals trapped and examined over the same time period.Mycobacterium tuberculosis complex strains were isolated from pooled tissues of 14 (8.2%) necropsied badgers, of which 11 were identified as M. bovis: six different spoligotypes of M. bovis were subsequently identified. In two geographical locations where these isolates were shared between cattle and badgers, infected cattle herds and badgers lived in close contact. Although it remains unclear if badgers are a maintenance or spill-over host of M. bovis in this setting, it would appear prudent to have precautionary measures in place to reduce contact between cattle and badgers.Ana Balseiro is a recipient of a Contrato de Investigación para Doctores award from the Instituto Nacional de Investigación Agraria y Agroalimentaria (INIA). Nelson Marreros holds a Fellowship for Prospective Researcher from the Swiss National Science Foundation. This project was supported by INIA RTA2011-00010-00-00, MCINN Grant AGL2011-30041 and FEDER and FP7 EU Grant TB-STEP (212414).Peer Reviewe

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)