title: Assessing the time taken for a surveillance system to detect a re-emergence of bovine spongiform encephalopathy in cattle.
abstract: During the bovine spongiform encephalopathy (BSE) epidemic in July 2001 the European Commission established a surveillance scheme for the comprehensive sampling of all BSE clinical suspects, healthy slaughter (HS) animals >30months, and all emergency slaughter and fallen stock animals tested when >24months. With the exponential decline in classical BSE cases, this comprehensive surveillance system has been successively modified to become risk-based, targeting those exit streams and ages where cases from the original epidemic are most likely to be detected. Such reductions in testing are not without losses in the information subsequently collected, which could affect the sensitivity of the surveillance system to relatively small changes in the underlying prevalence of BSE across the European Union (EU). Here we report on a cohort-based approach to estimate the time taken for EU surveillance to observe a theoretical re-emergence of BSE in cattle. A number of surveillance schemes were compared. The baseline scheme considered detection being triggered by at least one case in the 'age window' 48-72 months in the fallen stock or emergency slaughter exit streams. Alternative schemes changed the start and end of this age window as well as considering testing for HS cattle. Under the baseline scheme, an estimated 15 years would lapse ([2.5th, 97.5th] percentiles=[10,24]) prior to detection, during which time 2867 infected animals ([2.5th, 97.5th]=[1722,6967]) would enter the slaughter population. These animals would be predominantly young animals (majority <24months) showing no clinical signs. This baseline scheme reduced the time to detection by 2 years, compared to a scheme where only clinical suspects were tested assuming BSE symptoms are recognised to the same degree by veterinary surgeons. Additional testing of younger animals did not improve detection as young infected animals were unlikely to test positive, but testing of older animals reduced the time to detection. Testing of HS animals >72months reduced the time to detection by one year compared to the baseline model, but would incur a high financial cost, e.g. testing HS animals >72months of age for 14 years would entail approximately 50.4 million additional tests. A limitation of the results is that there is no guarantee that current detection methods, optimised for detection of classical BSE, would identify a novel prion disease in cattle and it is currently difficult to envisage plausible routes by which a re-emergence of classical BSE could occur in Europe.
authors.affiliation: Animal and Plant Health Agency (APHA), Weybridge, UK. Electronic address: robin.simons@ahvla.gsi.gov.uk.
authors.forename: Robin R L
authors.initials: RRL
authors.lastname: Simons
authors.affiliation: Animal and Plant Health Agency (APHA), Weybridge, UK.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Arnold
authors.affiliation: Animal and Plant Health Agency (APHA), Weybridge, UK.
authors.forename: Amie
authors.initials: A
authors.lastname: Adkin
mesh_terms: D000003:Abattoirs; D000818:Animals; D002417:Cattle; D021821:Communicable Diseases, Emerging / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control / Q000662:veterinary; D004196:Disease Outbreaks / Q000517:prevention & control / Q000662:veterinary; D016643:Encephalopathy, Bovine Spongiform / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D005060:Europe / Q000453:epidemiology; D008954:Models, Biological; D018570:Risk Assessment / Q000379:methods*; D018571:Sentinel Surveillance / Q000662:veterinary*
keywords: BSE; Bovine spongiform encephalopathy; Monitoring; Risk-based surveillance; TSE; Targeted monitoring