BackgroundIn early 2020, during the COVID-19 pandemic, New Zealand implemented graduated, risk-informed national COVID-19 suppression measures aimed at disease elimination. We investigated their impacts on the epidemiology of the first wave of COVID-19 in the country and response performance measures. MethodsWe did a descriptive epidemiological study of all laboratory-confirmed and probable cases of COVID-19 and all patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in New Zealand from Feb 2 to May 13, 2020, after which time community transmission ceased. We extracted data from the national notifiable diseases database and the national SARS-CoV-2 test results repository. Demographic features and disease outcomes, transmission patterns (source of infection, outbreaks, household transmission), time-to-event intervals, and testing coverage were described over five phases of the response, capturing different levels of non-pharmaceutical interventions. Risk factors for severe outcomes (hospitalisation or death) were examined with multivariable logistic regression and time-to-event intervals were analysed by fitting parametric distributions using maximum likelihood estimation. Findings 1503 cases were detected over the study period, including 95 (6•3%) hospital admissions and 22 (1•5%) COVID-19 deaths. The estimated case infection rate per million people per day peaked at 8•5 (95% CI 7•6-9•4) during the 10-day period of rapid response escalation, declining to 3•2 (2•8-3•7) in the start of lockdown and progressively thereafter. 1034 (69%) cases were imported or import related, tending to be younger adults, of European ethnicity, and of higher socioeconomic status. 702 (47%) cases were linked to 34 outbreaks. Severe outcomes were associated with locally acquired infection (crude odds ratio [OR] 2•32 [95% CI 1•40-3•82] compared with imported), older age (adjusted OR ranging from 2•72 [1•40-5•30] for 50-64 year olds to 8•25 [2•59-26•31] for people aged ≥80 years compared with 20-34 year olds), aged residential care residency (adjusted OR 3•86 [1•59-9•35]), and Pacific peoples (adjusted OR 2•76 [1•14-6•68]) and Asian (2•15 [1•10-4•20]) ethnicities relative to European or other. Times from illness onset to notification and isolation progressively decreased and testing increased over the study period, with few disparities and increasing coverage of females, Māori, Pacific peoples, and lower socioeconomic groups.Interpretation New Zealand's response resulted in low relative burden of disease, low levels of population disease disparities, and the initial achievement of COVID-19 elimination.
A population-level food safety response successfully reduced disease incidence.
A population-level food safety response successfully reduced disease incidence.
Salmonellosis remains one of the leading causes of foodborne disease worldwide despite preventive efforts at various stages of the food production chain. The emergence of multi-drug resistant (MDR) non-typhoidal Salmonella enterica represents an additional challenge for public health authorities. Food animals are considered a major reservoir and potential source of foodborne salmonellosis; thus, monitoring of Salmonella strains in livestock may help to detect emergence of new serotypes/MDR phenotypes and to gain a better understanding of Salmonella epidemiology. For this reason, we analyzed trends over a nine-year period in serotypes, and antimicrobial resistance, of Salmonella isolates recovered at the Minnesota Veterinary Diagnostic Laboratory (MVDL) from swine (n = 2,537) and cattle (n = 1,028) samples. Prevalence of predominant serotypes changed over time; in swine, S. Typhimurium and S. Derby decreased and S. Agona and S. 4,5,12:i:- increased throughout the study period. In cattle, S. Dublin, S. Montevideo and S. Cerro increased and S. Muenster became less frequent. Median minimum inhibitory concentration (MIC) values and proportion of antibiotic resistant isolates were higher for those recovered from swine compared with cattle, and were particularly high for certain antibiotic-serotype combinations. The proportion of resistant swine isolates was also higher than observed in the NARMS data, probably due to the different cohort of animals represented in each dataset. Results provide insight into the dynamics of antimicrobial resistant Salmonella in livestock in Minnesota, and can help to monitor emerging trends in antimicrobial resistance.
Many developing countries face significant health burdens associated with a high incidence of endemic zoonoses and difficulties in integrated control measures for both the human and animal populations. The objective of this study was to develop and apply a multicriteria ranking model for zoonoses in Mongolia, a country highly affected by zoonotic disease, to inform optimal resource allocation at the national level. Diseases were evaluated based on their impact on human health, livestock sector health and the wider society through affects on the economic value of livestock, as well as the feasibility of control in both the human and livestock population. Data on disease in Mongolia were collected from various government departments including the Mongolian State Central Laboratory, the Mongolian Department of Veterinary and Animal Breeding, the Mongolian Ministry of Health, Mongolian National Center for Communicable Diseases, the National Center for Zoonotic Disease and expert opinion from a workshop with a number of Mongolian Government officials and researchers. A combined score for both impact of the disease and feasibility of its control was calculated. Five zoonotic diseases were determined to be of high priority from this assessment (i.e. ovine brucellosis, echinococcosis (hydatids), rabies, anthrax and bovine brucellosis). The results supported some of the findings for high-priority diseases (namely brucellosis, rabies and anthrax) from a previous priority setting exercise carried out in Mongolia in 2011, but also identified and ranked additional animal diseases of public health importance. While the process of model development was largely Mongolian specific, the experience of developing and parameterizing this multicriteria ranking model could be replicated by other countries where zoonoses have substantive impacts on both animal and human health.
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