Cross species transmission of ovine Johnes Disease - Phase 1 : National Ovine Johne’s Disease Control and Evaluation Program.

Johne’s disease was investigated in fibre goats on several farms. The disease was caused by sheep [S] strains of Mycobacterium avium subsp. paratuberculosis. The infection appeared to be less severe than the same infection in sheep in that fewer goats than sheep became infected, and fewer goats than sheep developed obvious signs of the infection. However, infected goats shed the organism in their faeces and therefore were able to spread the infection to other goats and sheep. Therefore inclusion of goats in the control program for ovine Johne’s disease is justified. A communication program is recommended to advise producers that ovine Johne’s disease in goats may not be obvious and that testing should be undertaken to ensure disease is not present. The impact of ovine Johne’s disease on the fibre goat industry is projected not to be great due to the small number of herds likely to be infected

Actualisatie Onderbouwing Derogatie 2009

In de nazomer van 2005 heeft de Europese Commissie aan Nederland een derogatie toegekend. Daarmee is een ruimer gebruik van dierlijke mest mogelijk op melkveebedrijven gedurende de periode 2006-2009. Deze toekenning vond plaats op basis van een onderbouwing die, onder meer, stoelde op onderzoek van Schröder et al. (2005) en Aarts et al. (2005). Beide studies deden aannames ten aanzien van, bijvoorbeeld, de mate waarin (1) evenwicht heerst tussen mineralisatie en vastlegging van stikstof (N) in de bodem, (2) proefveldresultaten representatief zijn voor de praktijk, (3) weersomstandigheden representatief zijn voor de lange termijn, (4) relaties tussen bodemoverschot en nitraatconcentraties geldig zijn over een breed traject van overschotniveaus, en (5) jaarlijkse schommelingen van de nitraatconcentratie mogen worden uitgemiddeld in de tijd. Om met ingang van 2010 opnieuw een derogatie te krijgen, zal Nederland in de loop van 2009 een geactualiseerde wetenschappelijke onderbouwing moeten aanleveren. Deze moet behalve ‘Nitraatrichtlijn proof’, ook ‘Kaderrichtlijn Water proof’ zijn. Het ministerie van LNV heeft aan de CDM gevraagd om in kaart te brengen welke aannames een nadere toets behoeven en tijdig aan te geven welke data hiervoor de komende jaren verzameld dienen te worden. De CDM heeft aan de Werkgroep Onderbouwing Gebruiksnormen (WOG) gevraagd om deze inventarisatie uit te voeren

Micro-costing diagnostics in oncology: From single-gene testing to whole genome sequencing

Purpose: Predictive diagnostics play an increasingly important role in personalized medicine for cancer treatment. Whole genome sequencing (WGS) based treatment selection is expected to rapidly increase worldwide. Detailed and comparative cost analyses of diagnostic techniques are an essential element in decision-making. This study aimed to calculate and compare the total cost of currently used diagnostic techniques and of WGS in treatment of non-small cell lung carcinoma (NSCLC), melanoma, colorectal cancer (CRC) and gastrointestinal stromal tumor (GIST) in the Netherlands. Methods: The activity-based costing (ABC) method was conducted to calculate the total cost of included diagnostic techniques based on data provided by Dutch pathology laboratories and the Dutch centralized cancer WGS facility. Costs were allocated to four categories: capital costs, maintenance costs, software costs and operational costs. Outcome measures were total cost per cancer patient per included technique, and the total cost per cancer patient per most commonly applied technique (combination) for each cancer type. Results: The total cost per cancer patient per technique varied from € 58 (Sanger sequencing, 3 amplicons) to € 4738 (paired tumor-normal WGS). The operational costs accounted for the vast majority over 90 % of the total per cancer patient technique costs. The most important operational cost drivers were consumables followed by personnel (for sample preparation and primary data analysis). Conclusion: This study outlined in detail all costing aspects and cost prices of current and new diagnostic modalities used in treatment of NSCLC, melanoma, CRC and GIST in the Netherlands. Detailed cost differences and value comparisons between these diagnostic techniques enable future economic evaluations to support decision-making on implementation of WGS and other diagnostic modalities in routine clinical practice