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1. Barriers and opportunities for improving dog bite prevention and dog management practices in northern Indigenous communities

Author

Laurence Daigle, André Ravel, Francis Lévesque, Kabimbetas Noah Mokoush, Yves Rondenay, Audrey Simon, and Cécile Aenishaenslin

Subjects
dog bites, prevention, epidemiology, Indigenous, northern communities, public health, Veterinary medicine, SF600-1100
Abstract

Globally, people living in northern Indigenous communities are at higher risk of dog bites than the rest of the population living in North America, with annual incidence ranging from 0.61 to 59.6/10,000 inhabitants. Considering that rabies is endemic in wild canid populations in certain regions of the Arctic, the prevention of dog bites and the management of dog populations are of crucial importance for public health in these contexts. Most northern communities lack access to veterinary services, mainly due to their remote geographical location and to limited financial resources. Currently, northern Indigenous communities are using different approaches and strategies to prevent dog bites and manage dog populations, but the effectiveness of these approaches sometimes lacks evidence, and their low acceptability may affect their implementation. This study aims to describe (1) the current access and uses of veterinary services, and (2) the perceived barriers and opportunities related to dog population management practices currently implemented, or that could be implemented, in a Naskapi community and an Innu community located in northern Quebec (Canada). Quantitative data were collected through a survey to inhabitants on veterinary services (n = 122). Qualitative data were collected using individual interviews to inhabitants and health professionals to describe how dog population management measures were perceived, and to identify barriers and opportunities related to their implementation (n = 37). Descriptive and inferential analysis (quantitative data) and thematic analysis (qualitative data) were performed. Results show that the two main measures implemented at the time of the study – dog culling and short-duration veterinary clinics – were not perceived as fully acceptable and sustainable. Reinforcing access to veterinary services and other dog-related services, such as shelters and training programs on dogs, was identified as a need to improve dog bites prevention and dog population management in remote Indigenous communities. The implementation of animal health measures should be decided by concerned Indigenous communities to follow decolonial practices. It includes ensuring informed consent of dog owners, improving communication before, during and after interventions, separating veterinary services from rehoming and, most importantly giving back to Indigenous communities the complete leadership over animal health in their communities.

Published
2023
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2. Knowledge, attitudes, and practices regarding dogs and dog bites in Indigenous northern communities: A mixed methods study

Author

Laurence Daigle, André Ravel, Yves Rondenay, Audrey Simon, Kabimbetas Noah Mokoush, and Cécile Aenishaenslin

Subjects
dog bite, epidemiology (EPI), Indigenous, northern community, public health, rabies, Veterinary medicine, SF600-1100
Abstract

IntroductionThe singular relationship developed over the years between northern Indigenous peoples and dogs has been profoundly changed through historical trauma, settlements and increased use of snowmobiles. Issues related to dogs have become increasingly complex and worrisome with the endemic presence of the rabies virus among Arctic fox populations, and given the fact that northern Indigenous peoples may have a higher risk of dog bites than the general population. This study aimed to investigate factors related to the risk of dog bites in Naskapi and Innu communities located in northern Quebec (Canada) by (1) describing the knowledge, attitudes and practices (KAP) regarding dogs and dog bites in these communities, and (2) analyzing experiences of inhabitants and health professionals with regard to dog bites and their management.MethodsA mixed methods study design that combined an observational cross-sectional survey and individual interviews was used. The survey collected data on KAP regarding dogs and dog bites among 122 respondents. Individual interviews (n = 37) were then conducted with victims of dog bites, owners of dogs that have bitten a person before, and health professionals. Descriptive and inferential analysis (quantitative data) and thematic analysis (qualitative data) were performed.Results and discussionResults highlighted that 21% of respondents have had a dog bite in their lifetime. Most respondents were not aware of the risk of contracting rabies following a dog bite, although rabies risk perception was associated with risk perception of dogs (linear regression: coefficient = 0.69, 95% CI = 0.36–1.02). The odds of being more knowledgeable on rabies were higher (logistic regression: OR = 2.92, 95% CI = 1.07–7.98) among young adults. Dogs were perceived as both threats and protectors by community members. When the fear of dogs was present, it affected the quality of life of some inhabitants. There was confusion about responsibilities in the management of biting dogs, although protocols to follow after a bite were clear for health care professionals. This study revealed a lack of awareness and knowledge about dog bites and rabies risks in both communities. Results provide important knowledge for the development of interventions adapted to northern Indigenous communities.

Published
2023
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3. Epidemiology of human exposure to rabies in Nunavik: incidence, the role of dog bites and their context, and victim profiles

Author

Sarah Mediouni, Mario Brisson, and André Ravel

Subjects
Animal, Dog, Injury, Bite, Children, Nunavik, Public aspects of medicine, RA1-1270
Abstract

Abstract Background In Nunavik, Arctic rabies is still endemic due to a spillover from wildlife to dogs. The prevention of human exposure and the management of potential exposure is a significant public health concern in this region. Methods This study retrospectively describes cases of potential exposure to rabies in humans as reported to the Nunavik Public Health Board through their registry of reported cases. We used multi-correspondence analysis as well as univariable and multivariable regression models to test for differences between children and adults in reported cases, and to examine the contexts of exposure to dogs and dog attacks. Results From 2008 to 2017, 320 cases of potential exposure to rabies were reported, 92% of which were linked to dogs. The annual incidence rate was 2.5 per 1000 people. The incidence increased significantly during the study period, although the reasons for this are unclear. Fifteen cases of exposure were with rabid animals, mostly dogs (9 of 15). No human cases of rabies occurred thanks to adequate medical case management. Two specific profiles for potential exposure to rabies were identified based on age and gender. The first was children (

Published
2020
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4. Occurrence and Risk Factors of Dog Bites in Northern Indigenous Communities: A Scoping Review

Author

Laurence Daigle, Léa Delesalle, André Ravel, Barrie Ford, and Cécile Aenishaenslin

Subjects
scoping review, dog bites, epidemiology, Indigenous, northern communities, Veterinary medicine, SF600-1100
Abstract

The relationship between northern Indigenous people and dogs has evolved over the past years alongside events such as colonization, settlement, proliferation of snowmobiling and other socio-cultural and environmental changes. These changes have had negative impacts on this relationship, and with the endemic presence of arctic fox rabies, dog bites have become an important public health burden. The objective of this study was to synthesize the state of knowledge regarding the occurrence of dog bites and associated risk factors in the specific context of northern Indigenous communities. A scoping review was conducted in seven bibliographic databases, from June 2018 to May 2020. From this search, 257 original studies were identified and eight papers were included for final analysis. Annual occurrence of dog bites in northern Indigenous communities ranged from 0.61 to 59.6/10,000 inhabitants. Dog bites affected 27–62.9% of the population in those regions during their lifetime. Very few studies compared the occurrence of dog bites between people living in northern communities with other populations or settings, but available evidence suggests that Indigenous people living in northern communities are at higher risk of dog bites than the rest of the population. Several individual and environmental risk factors were identified in the selected studies, although the strength of evidence varied significantly. Age (children) and gender (male) were well documented individual risk factors. Other factors, such as organizational barriers to dog management and lack of access to veterinary services, were identified and discussed by several authors. The results of this study support concerns about the higher risk of bites in northern Indigenous communities, and underscore the urgent need for more research into the contextual and environmental factors that impact the mitigation of these risks.

Published
2022
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5. Serological and molecular detection of Toxoplasma gondii in terrestrial and marine wildlife harvested for food in Nunavik, Canada

Author

Nicholas Bachand, André Ravel, Patrick Leighton, Craig Stephen, Momar Ndao, Ellen Avard, and Emily Jenkins

Subjects
Toxoplasma gondii, Zoonosis, Food-borne pathogen, Wildlife, Public health, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Toxoplasma gondii, a zoonotic protozoan parasite, infects mammals and birds worldwide. Infection in humans is often asymptomatic, though illnesses can occur in immunocompromised hosts and the fetuses of susceptible women infected during pregnancy. In Nunavik, Canada, 60% of the Inuit population has measurable antibodies against T. gondii. Handling and consumption of wildlife have been identified as risk factors for exposure. Serological evidence of exposure has been reported for wildlife in Nunavik; however, T. gondii has not been detected in wildlife tissues commonly consumed by Inuit. Methods We used a magnetic capture DNA extraction and real-time PCR protocol to extract and amplify T. gondii DNA from large quantities of tissues (up to 100 g) of 441 individual animals in Nunavik: 166 ptarmigan (Lagopus lagopus), 156 geese (Branta canadensis and Chen caerulescens), 61 ringed seals (Pusa hispida), 31 caribou (Rangifer tarandus) and 27 walruses (Odobenus rosmarus). Results DNA from T. gondii was detected in 9% (95% CI: 3–15%) of geese from four communities in western and southern Nunavik, but DNA was not detected in other wildlife species including 20% (95% CI: 12–31%) of ringed seals and 26% (95% CI: 14–43%) of caribou positive on a commercial modified agglutination test (MAT) using thawed heart muscle juice. In geese, tissue parasite burden was highest in heart, followed by brain, breast muscle, liver and gizzard. Serological results did not correlate well with tissue infection status for any wildlife species. Conclusions To our knowledge, this is the first report on the detection, quantification, and characterization of DNA of T. gondii (clonal lineage II in one goose) from wildlife harvested for food in Nunavik, which supports the hypothesis that migratory geese can carry T. gondii into Nunavik where feline definitive hosts are rare. This study suggests that direct detection methods may be useful for detection of T. gondii in wildlife harvested for human consumption and provides data needed for a quantitative exposure assessment that will determine the risk of T. gondii exposure for Inuit who harvest and consume geese in Nunavik.

Published
2019
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6. Evaluating the Integration of One Health in Surveillance Systems for Antimicrobial Use and Resistance: A Conceptual Framework

Author

Cécile Aenishaenslin, Barbara Häsler, André Ravel, E. Jane Parmley, Sarah Mediouni, Houda Bennani, Katharina D. C. Stärk, and David L. Buckeridge

Subjects
One Health, surveillance, evaluation, framework, methodology, antimicrobial resistance, Veterinary medicine, SF600-1100
Abstract

It is now widely acknowledged that surveillance of antimicrobial resistance (AMR) must adopt a “One Health” (OH) approach to successfully address the significant threats this global public health issue poses to humans, animals, and the environment. While many protocols exist for the evaluation of surveillance, the specific aspect of the integration of a OH approach into surveillance systems for AMR and antimicrobial Use (AMU), suffers from a lack of common and accepted guidelines and metrics for its monitoring and evaluation functions. This article presents a conceptual framework to evaluate the integration of OH in surveillance systems for AMR and AMU, named the Integrated Surveillance System Evaluation framework (ISSE framework). The ISSE framework aims to assist stakeholders and researchers who design an overall evaluation plan to select the relevant evaluation questions and tools. The framework was developed in partnership with the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). It consists of five evaluation components, which consider the capacity of the system to: [1] integrate a OH approach, [2] produce OH information and expertise, [3] generate actionable knowledge, [4] influence decision-making, and [5] positively impact outcomes. For each component, a set of evaluation questions is defined, and links to other available evaluation tools are shown. The ISSE framework helps evaluators to systematically assess the different OH aspects of a surveillance system, to gain comprehensive information on the performance and value of these integrated efforts, and to use the evaluation results to refine and improve the surveillance of AMR and AMU globally.

Published
2021
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7. First 'Global Flipped Classroom in One Health': From MOOCs to research on real world challenges

Author

Rafael Ruiz de Castañeda, Amanda Garrison, Philippe Haeberli, Lisa Crump, Jakob Zinsstag, André Ravel, Antoine Flahault, and Isabelle Bolon

Subjects
Medicine (General), R5-920
Abstract

In 2016 and 2017 the first three MOOCs (Massive Online Open Course) addressing One Health were released, two of them by University of Geneva and University of Basel (Switzerland). With the support of Swiss School of Public Health and using these two highly interdisciplinary MOOCs, the first 'Global Flipped Classroom in One Health' was organized in Geneva and Basel in July 2017. This innovative event gathered 12 Swiss and international MOOC learners to work on specific public/global health challenges at the human-animal-ecosystem interface in interdisciplinary teams supported by experts from academia and international organisations (e.g. World Health Organization) based in Geneva, Basel and internationally. According to the final survey, the level of satisfaction by learners was high and they benefited from the experience in different ways: reinforcement of their knowledge and capacity to perform innovative research in One Health (e.g. using digital epidemiology), visits and meetings with experts in Global Health (e.g. World Health Organization and Institute of Global Health in Geneva, Swiss Tropical and Public Health Institute in Basel) and emerging research collaborations etc. A novel project-based learning and research model arising from MOOCs was successfully created, which offers opportunities for global education and research addressing real world challenges utilising a One Health approach. Keywords: One Health, Global Health, MOOC, E-learning, Flipped-classroom, Project-based learning

Published
2018
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8. Valuing Health Surveillance as an Information System: Interdisciplinary Insights

Author

Nicolas Antoine-Moussiaux, Olivier Vandenberg, Zisis Kozlakidis, Cécile Aenishaenslin, Marisa Peyre, Mathieu Roche, Pascal Bonnet, and André Ravel

Subjects
complexity, decision-making, data, value, network, trend, Public aspects of medicine, RA1-1270
Abstract

The economic evaluation of health surveillance systems and of health information is a methodological challenge, as for information systems in general. Main present threads are considering cost-effectiveness solutions, minimizing costs for a given technically required output, or cost-benefit analysis, balancing costs with economic benefits of duly informed public interventions. The latter option, following a linear command-and-control perspective, implies considering a main causal link between information, decision, action, and health benefits. Yet, valuing information, taking into account its nature and multiple sources, the modalities of its processing cycle, from production to diffusion, decentralized use and gradual building of a shared information capital, constitutes a promising challenge. This work proposes an interdisciplinary insight on the value of health surveillance to get a renewed theoretical framework integrating information and informatics theory and information economics. The reflection is based on a typological approach of value, basically distinguishing between use and non-use values. Through this structured discussion, the main idea is to expand the boundaries of surveillance evaluation, to focus on changes and trends, on the dynamic and networked structure of information systems, on the contribution of diverse data, and on the added value of combining qualitative and quantitative information. Distancing itself from the command-and-control model, this reflection considers the behavioral fundaments of many health risks, as well as the decentralized, progressive and deliberative dimension of decision-making in risk management. The framework also draws on lessons learnt from recent applications within and outside of health sector, as in surveillance of antimicrobial resistance, inter-laboratory networks, the use of big data or web sources, the diffusion of technological products and large-scale financial risks. Finally, the paper poses the bases to think the challenge of a workable approach to economic evaluation of health surveillance through a better understanding of health information value. It aims to avoid over-simplifying the range of health information benefits across society while keeping evaluation within the boundaries of what may be ascribed to the assessed information system.

Published
2019
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9. Non food-related risk factors of campylobacteriosis in Canada: a matched case-control study

Author

André Ravel, Katarina Pintar, Andrea Nesbitt, and Frank Pollari

Subjects
Campylobacteriosis, Case-control, Matching, Waterborne transmission, Environmental transmission, Swimming, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Campylobacteriosis is a prominent bacterial gastrointestinal infection worldwide with several transmission pathways. Its non-foodborne routes have been less documented and quantified. The study aimed to quantitatively explore the role of potential risk factors not directly associated with food for sporadic cases of C. jejuni infection in Canada. Methods This retrospective matched case-control study was built on an enhanced campylobacteriosis surveillance system and on a survey of healthy people and their behaviour with regards to potential risk factors for gastrointestinal infections that occurred in the same area in Canada. Eighty-five cases were individually matched by age and season to 170 controls. Results Through conditional logistic regression, risk factors were found only among water-related factors (drinking untreated water, using tap filter, drinking water from well and swimming in natural water), whereas drinking bottled water was protective. Among the 32 non-water related factors explored, 12 were surprisingly ‘protective’ factors without relevant explanation for that effect (for example gardening, attending a barbecue, eating food from a fast-food restaurant), suggesting that human infection by Campylobacter may be more frequently acquired at home than outside the home. Conclusions This study confirms and quantifies the importance of the waterborne transmission of campylobacteriosis. People are encouraged to drink only treated water and to avoid the ingestion of natural water as much as possible while swimming or playing in water. Globally, general hygiene and proper food handling and cooking practices at home should continue to be encouraged.

Published
2016
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10. Lyme Disease: Knowledge and Practices of Family Practitioners in Southern Quebec

Author

Cécile Ferrouillet, François Milord, Louise Lambert, Anne Vibien, and André Ravel

Subjects
Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

BACKGROUND: Public health authorities in Quebec have responded to the progressive emergence of Lyme disease (LD) with surveillance activities and education for family physicians (FPs) who are key actors in both vigilance and case management.

Published
2015
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11. Criteria for the prioritization of public health interventions for climate-sensitive vector-borne diseases in Quebec.

Author

Valerie Hongoh, Pierre Gosselin, Pascal Michel, André Ravel, Jean-Philippe Waaub, Céline Campagna, and Karim Samoura

Subjects
Medicine, Science
Abstract

Prioritizing resources for optimal responses to an ever growing list of existing and emerging infectious diseases represents an important challenge to public health. In the context of climate change, there is increasing anticipated variability in the occurrence of infectious diseases, notably climate-sensitive vector-borne diseases. An essential step in prioritizing efforts is to identify what considerations and concerns to take into account to guide decisions and thus set disease priorities. This study was designed to perform a comprehensive review of criteria for vector-borne disease prioritization, assess their applicability in a context of climate change with a diverse cross-section of stakeholders in order to produce a baseline list of considerations to use in this decision-making context. Differences in stakeholder choices were examined with regards to prioritization of these criteria for research, surveillance and disease prevention and control objectives. A preliminary list of criteria was identified following a review of the literature. Discussions with stakeholders were held to consolidate and validate this list of criteria and examine their effects on disease prioritization. After this validation phase, a total of 21 criteria were retained. A pilot vector-borne disease prioritization exercise was conducted using PROMETHEE to examine the effects of the retained criteria on prioritization in different intervention domains. Overall, concerns expressed by stakeholders for prioritization were well aligned with categories of criteria identified in previous prioritization studies. Weighting by category was consistent between stakeholders overall, though some significant differences were found between public health and non-public health stakeholders. From this exercise, a general model for climate-sensitive vector-borne disease prioritization has been developed that can be used as a starting point for further public health prioritization exercises relating to research, surveillance, and prevention and control interventions in a context of climate change. Multi-stakeholder engagement in prioritization can help broaden the range of criteria taken into account, offer opportunities for early identification of potential challenges and may facilitate acceptability of any resulting decisions.

Published
2017
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12. Source attribution of human campylobacteriosis at the point of exposure by combining comparative exposure assessment and subtype comparison based on comparative genomic fingerprinting.

Author

André Ravel, Matt Hurst, Nicoleta Petrica, Julie David, Steven K Mutschall, Katarina Pintar, Eduardo N Taboada, and Frank Pollari

Subjects
Medicine, Science
Abstract

Human campylobacteriosis is a common zoonosis with a significant burden in many countries. Its prevention is difficult because humans can be exposed to Campylobacter through various exposures: foodborne, waterborne or by contact with animals. This study aimed at attributing campylobacteriosis to sources at the point of exposure. It combined comparative exposure assessment and microbial subtype comparison with subtypes defined by comparative genomic fingerprinting (CGF). It used isolates from clinical cases and from eight potential exposure sources (chicken, cattle and pig manure, retail chicken, beef, pork and turkey meat, and surface water) collected within a single sentinel site of an integrated surveillance system for enteric pathogens in Canada. Overall, 1518 non-human isolates and 250 isolates from domestically-acquired human cases were subtyped and their subtype profiles analyzed for source attribution using two attribution models modified to include exposure. Exposure values were obtained from a concurrent comparative exposure assessment study undertaken in the same area. Based on CGF profiles, attribution was possible for 198 (79%) human cases. Both models provide comparable figures: chicken meat was the most important source (65-69% of attributable cases) whereas exposure to cattle (manure) ranked second (14-19% of attributable cases), the other sources being minor (including beef meat). In comparison with other attributions conducted at the point of production, the study highlights the fact that Campylobacter transmission from cattle to humans is rarely meat borne, calling for a closer look at local transmission from cattle to prevent campylobacteriosis, in addition to increasing safety along the chicken supply chain.

Published
2017
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13. Assessing Interventions to Manage West Nile Virus Using Multi-Criteria Decision Analysis with Risk Scenarios.

Author

Valerie Hongoh, Céline Campagna, Mirna Panic, Onil Samuel, Pierre Gosselin, Jean-Philippe Waaub, André Ravel, Karim Samoura, and Pascal Michel

Subjects
Medicine, Science
Abstract

The recent emergence of West Nile virus (WNV) in North America highlights vulnerability to climate sensitive diseases and stresses the importance of preventive efforts to reduce their public health impact. Effective prevention involves reducing environmental risk of exposure and increasing adoption of preventive behaviours, both of which depend on knowledge and acceptance of such measures. When making operational decisions about disease prevention and control, public health must take into account a wide range of operational, environmental, social and economic considerations in addition to intervention effectiveness. The current study aimed to identify, assess and rank possible risk reduction measures taking into account a broad set of criteria and perspectives applicable to the management of WNV in Quebec under increasing transmission risk scenarios, some of which may be related to ongoing warming in higher-latitude regions. A participatory approach was used to collect information on categories of concern to relevant stakeholders with respect to WNV prevention and control. Multi-criteria decision analysis was applied to examine stakeholder perspectives and their effect on strategy rankings under increasing transmission risk scenarios. Twenty-three preventive interventions were retained for evaluation using eighteen criteria identified by stakeholders. Combined evaluations revealed that, at an individual-level, inspecting window screen integrity, wearing light colored, long clothing, eliminating peridomestic larval sites and reducing outdoor activities at peak times were top interventions under six WNV transmission scenarios. At a regional-level, the use of larvicides was a preferred strategy in five out of six scenarios, while use of adulticides and dissemination of sterile male mosquitoes were found to be among the least favoured interventions in almost all scenarios. Our findings suggest that continued public health efforts aimed at reinforcing individual-level preventive behaviours combined with the application of larvicides to manage the risk of WNV infection are the interventions most acceptable and effective at reaching current management objectives now and under future theoretical transmission risk.

Published
2016
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14. Antimicrobial Resistance among Salmonella and Shigella Isolates in Five Canadian Provinces (1997 to 2000)

Author

Leah J Martin, James Flint, André Ravel, Lucie Dutil, Kathryn Doré, Marie Louie, Frances Jamieson, and Sam Ratnam

Subjects
Infectious and parasitic diseases, RC109-216, Microbiology, QR1-502
Abstract

OBJECTIVE: To describe rates of antimicrobial resistance (AMR) among Salmonella and Shigella isolates reported in five Canadian provinces, focusing on clinically important antimicrobials.

Published
2006
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15. Adaptation and Evaluation of a Multi-Criteria Decision Analysis Model for Lyme Disease Prevention.

Author

Cécile Aenishaenslin, Lise Gern, Pascal Michel, André Ravel, Valérie Hongoh, Jean-Philippe Waaub, François Milord, and Denise Bélanger

Subjects
Medicine, Science
Abstract

Designing preventive programs relevant to vector-borne diseases such as Lyme disease (LD) can be complex given the need to include multiple issues and perspectives into prioritizing public health actions. A multi-criteria decision aid (MCDA) model was previously used to rank interventions for LD prevention in Quebec, Canada, where the disease is emerging. The aim of the current study was to adapt and evaluate the decision model constructed in Quebec under a different epidemiological context, in Switzerland, where LD has been endemic for the last thirty years. The model adaptation was undertaken with a group of Swiss stakeholders using a participatory approach. The PROMETHEE method was used for multi-criteria analysis. Key elements and results of the MCDA model are described and contrasted with the Quebec model. All criteria and most interventions of the MCDA model developed for LD prevention in Quebec were directly transferable to the Swiss context. Four new decision criteria were added, and the list of proposed interventions was modified. Based on the overall group ranking, interventions targeting human populations were prioritized in the Swiss model, with the top ranked action being the implementation of a large communication campaign. The addition of criteria did not significantly alter the intervention rankings, but increased the capacity of the model to discriminate between highest and lowest ranked interventions. The current study suggests that beyond the specificity of the MCDA models developed for Quebec and Switzerland, their general structure captures the fundamental and common issues that characterize the complexity of vector-borne disease prevention. These results should encourage public health organizations to adapt, use and share MCDA models as an effective and functional approach to enable the integration of multiple perspectives and considerations in the prevention and control of complex public health issues such as Lyme disease or other vector-borne and zoonotic diseases.

Published
2015
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16. Description and Determinants of At-Risk Interactions for Human Health Between Children and Dogs in an Inuit Village

Author

Géraldine-G. Gouin, Cécile Aenishaenslin, André Ravel, Audrey Simon, and Francis Lévesque

Subjects
medicine.medical_specialty, Sociology and Political Science, Veterinary (miscellaneous), Public health, food and beverages, Context (language use), Mental health, Education, Human health, Anthropology, Environmental health, medicine, Animal Science and Zoology, Psychology
Abstract

While dogs can have a positive impact on physical and mental health, they also represent a public health risk in terms of bites and zoonotic diseases. In the specific context of Inuit villages, the...

Published
2021
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18. Antimicrobial Resistance of Campylobacter in Broiler Chicken Along the Food Chain in Canada

Author

Blaise Ouattara, Daniel Leclair, Danielle Daignault, Anne E. Deckert, Ousmane Dramé, E. Jane Parmley, and André Ravel

Subjects
Veterinary medicine, Canada, Meat, 040301 veterinary sciences, Tetracycline, medicine.drug_class, chicken, baseline study, Food Contamination, Microbial Sensitivity Tests, Biology, Quinolones, medicine.disease_cause, Applied Microbiology and Biotechnology, Microbiology, Food Supply, 0403 veterinary science, 03 medical and health sciences, Food chain, Antibiotic resistance, Drug Resistance, Bacterial, medicine, Animals, antimicrobial resistance, 0303 health sciences, Baseline study, Lincosamides, 030306 microbiology, Campylobacter, Broiler, 04 agricultural and veterinary sciences, Original Articles, Antimicrobial, Anti-Bacterial Agents, Food Microbiology, Animal Science and Zoology, Chickens, Abattoirs, Food Science, medicine.drug
Abstract

Antimicrobial resistance (AMR) is a major public health threat worldwide. The main objective of this study was to compare AMR in Campylobacter from broiler chickens raised on Canadian farms and their products in different geographical regions of Canada. To do this, antimicrobial susceptibility results from isolates of Campylobacter recovered from a national microbiological baseline study conducted in federally registered establishments and in the retail marketplace were analyzed. Among 1460 isolates tested, 774 (53%) were resistant to at least one antimicrobial, with a predominance of three profiles: tetracycline (39%), quinolone–tetracycline (6.6%), and quinolones only (3.5%). The results showed no significant difference in the frequency of resistant profiles (p ≥ 0.05) among the isolates originating from different points in the food processing chain at slaughterhouses and in retail establishments. This suggests that AMR observed in Campylobacter isolates from raw chicken at retail originated further upstream in the system. A difference in the frequency of certain resistance profiles was observed between the regions of Canada. For instance, in British Columbia, there was more resistance to quinolones, while in Ontario and Quebec, Campylobacter isolates were more resistant to tetracyclines, macrolides, ketolides, and lincosamides. Comparison of AMR data from this study with those from the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) did not show any significant difference and provides evidence that CIPARS produces nationally representative resistance results.

Published
2020

19. Evidence needed for antimicrobial resistance surveillance systems

Author

Cécile Aenishaenslin, David L. Buckeridge, Jane Parmley, Katharina D.C. Stärk, André Ravel, and Barbara Häsler

Subjects
Canada, Interprofessional Relations, 030231 tropical medicine, Advisory Committees, MEDLINE, Guidelines as Topic, Drug resistance, computer.software_genre, Global Health, World Health Organization, 03 medical and health sciences, Antimicrobial Stewardship, 0302 clinical medicine, Antibiotic resistance, Drug Resistance, Bacterial, Global health, Added value, Animals, Humans, Public Health Surveillance, Program Development, Data collection, Public Health, Environmental and Occupational Health, Anti-Bacterial Agents, One Health, Interinstitutional Relations, Risk analysis (engineering), Policy & Practice, Food Microbiology, Business, computer, Data integration
Abstract

One Health surveillance for antimicrobial resistance has been promoted by the scientific community and by international organizations for more than a decade. In this article, we highlight issues that need to be addressed to improve the understanding of the effectiveness of One Health surveillance for antimicrobial resistance. We also outline the evidence needed to support countries planning to increase the level of integration of their surveillance system. Based on experience in Canada and other countries, we argue that more effort is needed to understand and measure the added value of One Health for antimicrobial resistance surveillance and to identify the most effective integration strategies. To date, guidelines for the development of One Health surveillance have focused mainly on the types of data that should be integrated. However, it may be necessary to apply the concept of One Health to surveillance tasks beyond data integration to realize the full value of the approach. Integration can be enhanced across different surveillance activities (data collection, analysis, interpretation and dissemination), taking account of the different skills and perspectives of experts and stakeholders involved. More research is needed to investigate the mechanisms through which a One Health approach to surveillance can increase the performance of antimicrobial resistance surveillance and, ultimately, improve health outcomes.Cela fait plus de dix ans que la communauté scientifique et les organisations internationales préconisent l'application de l'approche «Un monde, une santé» à la surveillance de la résistance aux antimicrobiens. Cet article souligne les éléments à considérer pour mieux comprendre l'efficacité d'une surveillance fondée sur cette approche. Nous y évoquons également les données requises pour éclairer les pays dans la définition de leurs plans nationaux afin d'améliorer le niveau d'intégration de leur système de surveillance. À partir de l’expérience du Canada et d'autres pays, nous estimons que des efforts doivent encore être faits pour comprendre et mesurer la véritable valeur ajoutée de l'approche «Un monde, une santé» dans le cadre de la surveillance de la résistance aux antimicrobiens et afin d'identifier les stratégies d'intégration les plus efficaces. À ce jour, les lignes directrices pour l'établissement d'une surveillance fondée sur cette approche se sont principalement axées sur les types de données qui devraient être intégrées. Néanmoins, pour exploiter toute la valeur de cette approche, il pourrait être utile d'appliquer le concept «Un monde, une santé» aux activités de surveillance au-delà de la simple intégration des données. Une meilleure intégration peut être obtenue au niveau des différentes activités de surveillance (collecte, analyse, interprétation et diffusion des données) en tenant compte des différentes compétences et des différents points de vue des experts et des parties prenantes. De nouvelles recherches sont nécessaires pour comprendre les mécanismes par lesquels l'approche «Un monde, une santé» appliquée à la surveillance peut améliorer les performances de la surveillance de la résistance aux antimicrobiens et, en fin de compte, améliorer les résultats de santé.La comunidad científica y las organizaciones internacionales han promovido durante más de una década la vigilancia sanitaria de la resistencia a los antimicrobianos. En este artículo, destacamos las cuestiones que deben abordarse para mejorar la comprensión de la eficacia de la vigilancia de la resistencia a los antimicrobianos de One Health. También esbozamos las pruebas necesarias para apoyar a los países que planean aumentar el nivel de integración de su sistema de vigilancia. Basándonos en la experiencia de Canadá y de otros países, sostenemos que se necesitan más esfuerzos para comprender y medir el valor agregado de One Health para la vigilancia de la resistencia a los antimicrobianos y para identificar las estrategias de integración más eficaces. Hasta la fecha, las directrices para el desarrollo de vigilancia de One Health se han centrado principalmente en los tipos de datos que deben integrarse. Sin embargo, puede ser necesario aplicar el concepto de One Health a tareas de vigilancia que van más allá de la integración de datos para aprovechar todo el valor del enfoque. La integración puede mejorarse en las diferentes actividades de vigilancia (recopilación, análisis, interpretación y difusión de datos), teniendo en cuenta las diferentes competencias y perspectivas de los expertos y las partes interesadas. Se necesita más investigación para estudiar los mecanismos mediante los cuales un enfoque de vigilancia de One Health puede aumentar el rendimiento de la vigilancia de la resistencia a los antimicrobianos y, en última instancia, mejorar los resultados sanitarios.تم الترويج لمراقبة One Health لمكافحة مضادات الميكروبات بواسطة المجتمع العلمي ومنظمات دولية منذ ما يزيد عن عقد من الزمان. نسلط في هذا المقال الضوء على القضايا التي بحاجة للتناول لتحسين فهم فعالية مراقبة One Health لمكافحة مضادات الميكروبات. كما نوضح الأدلة اللازمة لدعم الدول التي تخطط لزيادة مستوى التكامل في نظام المراقبة الخاص بها. وبناءً على التجربة الكندية وتجارب بلدان أخرى، فإننا نزعم أننا بحاجة إلى بذل المزيد من الجهد لفهم وقياس القيمة المضافة لنظام One Health لمراقبة مكافحة مضادات الميكروبات، ولتحديد أكثر استراتيجيات التكامل من حيث الفعالية. وحتى الآن، ركزت إرشادات تطوير نظام One Health للمراقبة بشكل أساسي على أنواع البيانات التي ينبغي إحداث التكامل فيما بينها. ومع ذلك، قد يكون من الضروري تطبيق مفهوم One Health على مهام المراقبة التي تتجاوز تكامل البيانات، وذلك لإدراك القيمة الكاملة لهذا النهج. يمكن تعزيز التكامل عبر أنشطة المراقبة المختلفة (جمع البيانات وتحليلها وتفسيرها ونشرها)، مع الأخذ في الاعتبار المهارات المختلفة ووجهات نظر الخبراء وأصحاب المصلحة المعنيين. هناك حاجة إلى مزيد من الأبحاث للتحقيق في الآليات التي يمكن من خلالها لنهج One Health للمراقبة أن يزيد من أداء مراقبة مكافحة مضادات الميكروبات، مما يؤدي في النهاية إلى تحسين النتائج الصحية.十多年来，科学界和国际组织一直致力于对抗菌素耐药性进行“唯一健康”监测。在本文中，我们强调了需要解决的问题，旨在提高“唯一健康”监测对抗菌素耐药性有效性的认识。我们还对所需的证据进行了概述，以支持那些计划提高其监测系统整合水平的国家。根据加拿大及他国经验，我们认为需要付出更多努力来理解和衡量“唯一健康”监测对抗菌素耐药性的附加价值，并确定最有效的整合策略。迄今为止，制定“唯一健康”监测的指南主要侧重于应整合的数据类型。然而，可能有必要将“唯一健康”概念应用于数据整合之外的监测任务，以实现该方法的全部价值。可以通过不同的监测活动（数据收集、分析、解释和传播）加强整合，同时考虑到所涉专家和利益相关者的不同技能和观点。需进一步研究以调查提高抗菌素耐药性监测表现的“唯一健康”方法，并最终改善健康结果。.Система надзора за резистентностью к антимикробным препаратам One Health находит поддержку научного сообщества и международных организаций уже в течение более десяти лет. В этой статье освещаются проблемы, которые следует решить для улучшения понимания эффективности надзора за резистентностью к антимикробным препаратам One Health. Авторы также описывают характер подтверждений, необходимых для поддержки стран, планирующих повысить уровень интеграции своих надзорных систем. На основании опыта Канады и других стран оспаривается утверждение о том, что нужно больше усилий для понимания и измерения ценности системы надзора за резистентностью к антимикробным препаратам One Health и для выявления наиболее эффективных стратегий интеграции. На сегодня рекомендации по разработке системы надзора One Health в основном сосредотачивались на типах данных, которые следует интегрировать. Однако, чтобы оценить всю ценность подхода, может понадобиться применение концепции One Health к надзорным задачам, не ограничивающимся интеграцией данных. Интеграция может быть усилена между разного рода надзорной деятельностью (сбор данных, анализ, интерпретация и распространение) с учетом различия в навыках и точках зрения специалистов и партнеров, участвующих в работе системы. Требуются дополнительные исследования для изучения механизмов, посредством которых подход One Health к вопросам надзора может улучшить качество работы систем надзора за антимикробной резистентностью и, в конце концов, улучшить результаты работы системы здравоохранения.

Published
2019

20. Urban Household Meat Consumption Patterns in Gabon, Central Africa, with a Focus on Bushmeat

Author

André Ravel, Julie Arsenault, and Nicholas Bachand

Subjects
Consumption (economics), Focus (computing), Geography, Economy, Central africa, Management, Monitoring, Policy and Law, Socioeconomics, Bushmeat, Nature and Landscape Conservation
Abstract

In Central Africa, bushmeat is commonly consumed, although its importance relative to other meats is incompletely understood. The urban demand for bushmeat is thought to be fueling the unsustainabl...

Published
2015
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21. Public Health Significance of Zoonotic Bacterial Pathogens from Bushmeat Sold in Urban Markets of Gabon, Central Africa

Author

Julie Arsenault, André Ravel, Richard Onanga, Jean-Paul Gonzalez, and Nicholas Bachand

Subjects
Veterinary medicine, Salmonella, Meat, Food Handling, Wildlife, Animals, Wild, Food Contamination, Biology, Lophocebus albigena, medicine.disease_cause, Zoonoses, biology.animal, Campylobacter Infections, medicine, Animals, Humans, Gabon, Bushmeat, Ecology, Evolution, Behavior and Systematics, Disease Reservoirs, Dysentery, Bacillary, Salmonella Infections, Animal, Atherurus africanus, Ecology, business.industry, Campylobacter, Hygiene, biology.organism_classification, Food safety, Cross-Sectional Studies, Food Microbiology, Public Health, business, Porcupine
Abstract

Wild animal meat represents an important source of protein for many people in central Africa. Also known as bushmeat, this meat commodity is derived from wild animals hunted under uncontrolled conditions, transported to distant markets under rudimentary or no hygienic methods, and often eviscerated >24 hr after death. Considering the plausible role of wildlife as a reservoir for bacterial zoonotic pathogens, bushmeat may be an important public health risk in Central Africa. This cross-sectional survey served to evaluate the presence of Campylobacter, Salmonella, and Shigella in the muscle tissue of 128 wild animal carcasses from several hunted wildlife species (guenons [Cercopithecus spp.], collared mangabeys [Cercocebus torquatus], gray-cheeked mangabeys [Lophocebus albigena], African crested porcupines [Atherurus africanus], duikers [Cephalophus spp.], and red river hogs [Potamocherus porcus]) sold in two markets of Port-Gentil, Gabon, in July and August 2010. Salmonella was detected from one carcass; no Campylobacter or Shigella was detected. If Campylobacter and Shigella were present, the maximum expected prevalence was estimated at 6% and 1%, respectively. In light of such very low apparent muscle contamination levels, bushmeat likely does not represent a health risk per se with respect to Campylobacter, Salmonella, or Shigella. However, because carcass evisceration and skinning can take place within households prior to consumption, consumers should follow strict hygiene and food safety practices to avoid potential health hazards associated with the handling, preparation, or consumption of bushmeat.

Published
2012
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22. Fecal Contamination of Recreational Freshwaters: the Effect of Time-Independent Agroenvironmental Factors

Author

André Ravel, Patricia Turgeon, Pascal Michel, Marie Archambault, and Patrick Levallois

Subjects
Hydrology, geography, geography.geographical_feature_category, business.industry, Health, Toxicology and Mutagenesis, Public Health, Environmental and Occupational Health, Drainage basin, Regression analysis, Contamination, Urban area, Pollution, Fecal coliform, Agriculture, Environmental science, Water quality, Water resource management, business, Recreation, Water Science and Technology
Abstract

Fecal contamination of recreational waters is a complex public health and environmental issue involving multiple possible sources and contributing factors. Agricultural and animal production activities represent one such source of contamination from which various microorganisms transmissible to humans can be found. This study used regression models to ascertain and describe various time-independent agroenvironmental determinants associated with fecal contamination of recreational lake waters. From a logistic regression model analysis, two determinants were statistically associated with the level of fecal coliforms, namely: the presence of ruminant production in the area of influence (OR=2.78) and urban area (OR=3.69). Moreover, our data suggest that sources of fecal contamination located within the area of the lake water catchment and from within a distance of two kilometers of the beach have the most influence on the water quality.

Published
2011
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23. Description and Burden of Travel‐Related Cases Caused by Enteropathogens Reported in a Canadian Community

Author

André Ravel, Barbara Marshall, Andrea Nesbitt, Frank Pollari, and Nancy Sittler

Subjects
Adult, Male, Canada, Health Knowledge, Attitudes, Practice, medicine.medical_specialty, Adolescent, Developing country, Campylobacteriosis, Disease, Gram-Positive Bacteria, Risk Assessment, Disease Outbreaks, Cost of Illness, Patient Education as Topic, stomatognathic system, Gram-Negative Bacteria, Prevalence, medicine, Humans, Travel medicine, Child, Developing Countries, Aged, Retrospective Studies, Travel, business.industry, Infant, Hepatitis A, Retrospective cohort study, Bacterial Infections, General Medicine, Middle Aged, medicine.disease, Primary Prevention, Child, Preschool, Population Surveillance, Female, Residence, Seasons, business, Risk assessment, Demography
Abstract

Background Risk of infections by enteropathogens among individuals traveling outside their country of residence is considered important. Such travel‐related cases (TRC) have been poorly estimated and described in Canada. Methods Data from an enhanced, passive surveillance system of diseases caused by enteropathogens within a Canadian community from June 2005 to May 2009 were used to describe TRC in terms of disease (pathogen, symptoms, hospitalization, duration, and timing of sickness relative to return); demographics (age and gender); and travel (destination, length, and accommodation); and to compare them with non‐TRC. Results Among 1,773 reported cases, 446 (25%) were classified as TRC with 9% of them being new immigrants. The main TRC diseases were campylobacteriosis, salmonellosis, and giardiasis. Disease onset occurred before return in 42% of TRC. Main destinations were Latin America/Caribbean and Asia. No differences by month and year were observed for onset, departure, and return dates. In addition to new immigrants, three subgroups of TRC based on travel destination, length of travel, type of accommodation, and age were identified and some diseases were more frequently observed in these subgroups. Generally, TRC did not differ from domestic cases in terms of age, gender, symptoms, hospitalization, and disease duration. Campylobacter coli and Salmonella enteritidis were significantly more frequent among TRC. Conclusions TRC of diseases caused by enteropathogens that are reportable in Canada represent a significant proportion of the burden of the total diseases. Subgroups of TRC exist and are associated with certain diseases. These results help inform the assessment of the actual risk related to travel for each subgroup of travelers and quantify the attribution of traveling abroad to the overall burden of these gastrointestinal diseases.

Published
2011
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24. Sensitivity analysis of agroenvironmental indicators of the hygienic pressure from livestock production on population health

Author

Michel Bigras-Poulin, Stephanie Brazeau, André Ravel, Pascal Michel, and P. Berthiaume

Subjects
education.field_of_study, business.industry, Population, Environmental engineering, Soil Science, Manure, Toxicology, Control and Systems Engineering, Groundwater pollution, Grazing, Environmental science, Livestock, Water quality, Water pollution, business, Surface runoff, education, Agronomy and Crop Science, Food Science
Abstract

Two Agroenvironmental hygienic pressure indicators (AHPIs) were developed to evaluate the effects of livestock production on water contamination and the risk for human health by expressing a complex public health risk via simple quantifiable figures. The first of the two AHPIs is addressing the aspect of surface water contamination while the second one is dealing with groundwater contamination. Each of the two AHPIs is built from a multiplicative model based on 25 parameters related to the transmission of bacteria through excretion by animals, survival in manure, and by run-off or infiltration water produced by rainfall. A global sensitivity approach was used to identify the most significant parameters in regard to the AHPIs output results. This analysis found that bacterial survival on the soil after manure spreading or grazing of animals (Ks), the proportion of bacteria able to reach surface water with run-off from manure on the soil (Brun-off), bacteria concentration in faeces Bconc, within-herd proportion of animals shedding the pathogenic bacteria targeted (Bprev) and the area used for pasture (A) – on bovine farms – are the most influential parameters with respect to the estimation of the AHPIs. With the exception of the latter element, these factors are all directly related to bacterial characteristics and parameters for which obtaining high quality data is most challenging. The identification of these most influential parameters will guide further research to enhance both the precision application of the AHPIs, and their use in managing public health risks.

Published
2010
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25. Agroenvironmental indicators to evaluate the hygienic pressure of livestock production on population health: Assessment of feasibility and usefulness

Author

P. Berthiaume, André Ravel, Stephanie Brazeau, Pascal Michel, and Michel Bigras-Poulin

Subjects
education.field_of_study, business.industry, media_common.quotation_subject, Population, Environmental resource management, Soil Science, Population health, Work (electrical), Control and Systems Engineering, Agriculture, Environmental science, Quality (business), Livestock, Water quality, Indicator value, education, business, Agronomy and Crop Science, Food Science, media_common
Abstract

Two Agroenvironmental Hygienic Pressure Indicators (AHPIs) have been proposed as model-based indicators for the public health risk of surface and ground water contamination by enteropathogens from agroenvironmental sources. Each of these indicators summarises twenty five parameters. The scientific goal of this work was to assess in an ex-ante way the usefulness of these indicators. One of the major reasons why many models and indicators fail to be used is the lack of the necessary data. Hence, the first step of the study assessed the availability of the data necessary for computing the AHPIs for the province of Quebec. Another reason for lack of usage is if the indicators do not meet the needs of the targeted audience. Consequently, this article also demonstrates key aspects of the AHPIs that make them a tool that is likely to be useful for the end-user. The evaluation of the availability and quality of available data for use in the AHPI led to minor modifications to the AHPI original parameters and equations. These modifications are presented. Once modified, adequate data were acquired to compute the indicator for Escherichia coli for surface and groundwater for all livestock farms in the province of Quebec, Canada. Data related to the microbial aspect of the AHPIs such as pathogen presence in livestock, its survival time in storage or on the soil, and its movement with water were the most difficult to obtain. For example, E. coli was used as a general indicator of faecal contamination in the absence of province-wide data on intra-herd contamination by specific human enteropathogens. Maps were generated and interpreted for their biophysical meaning to illustrate how the indicator values could be interpreted by various stakeholders involved in the public health management of water contamination from animal agriculture production and how this could be useful.

Published
2010
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26. Exploring Historical Canadian Foodborne Outbreak Data Sets for Human Illness Attribution

Author

C. Tinga, Barbara Marshall, Ewen C. D. Todd, G. Campbell, André Ravel, M. Cassidy, Judy Greig, and Frank Pollari

Subjects
Canada, business.industry, Foodborne outbreak, food and beverages, Outbreak, Campylobacteriosis, Food Contamination, medicine.disease, Food safety, Microbiology, Disease Outbreaks, Biotechnology, Foodborne Diseases, Geography, Multiple correspondence analysis, Environmental health, medicine, Humans, Botulism, business, Attribution, Sentinel Surveillance, Food Science, Food contaminant
Abstract

Human illness attribution has been recently recognized as an important tool to better inform food safety decisions. Analysis of outbreak data sets has been used for that purpose. This study was conducted to explore the usefulness of three comprehensive Canadian foodborne outbreak data sets covering 30 years for estimating food attribution in cases of gastrointestinal illness, providing Canadian food attribution estimates from a historical perspective. Information concerning the microbiological etiology and food vehicles recorded for each outbreak was standardized between the data sets. The agent-food vehicle combinations were described and analyzed for changes over time by using multiple correspondence analysis. Overall, 6,908 foodborne outbreaks were available for three decades (1976 through 2005), but the agent and the food vehicle were identified in only 2,107 of these outbreaks. Differences between the data sets were found in the distribution of the cause, the vehicle, and the location or size of the outbreaks. Multiple correspondence analysis revealed an association between Clostridium botulinum and wild meat and between C. botulinum and seafood. This analysis also highlighted changes in food attribution over time and generated the most up-to-date food attribution values for salmonellosis (29% of cases associated with produce, 15% with poultry, and 15% with meat other than poultry, pork, and beef), campylobacteriosis (56% of cases associated with poultry and 22% with dairy products other than fluid milk), and Escherichia coli infection (37% of cases associated with beef, 23% with cooked multi-ingredient dishes, and 11% with meat other than beef, poultry, and pork). Because of the inherent limitations of this approach, only the main findings should be considered for policy making. The use of other human illness attribution approaches may provide further clarification.

Published
2009
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27. Quantitative Effect of Refrigerated Storage Time on the Enumeration of Campylobacter, Listeria, and Salmonella on Artificially Inoculated Raw Chicken Meat

Author

André Ravel, Joseph Odumeru, Angela Cook, Katarina Pintar, Susan Lee, and Frank Pollari

Subjects
Salmonella typhimurium, Salmonella, Meat, Time Factors, Food Handling, Colony Count, Microbial, Food Contamination, Biology, medicine.disease_cause, Microbiology, Campylobacter jejuni, Listeria monocytogenes, Food Preservation, medicine, Enumeration, Animals, Humans, Food microbiology, Food science, Campylobacter, Temperature, Food preservation, biology.organism_classification, Consumer Product Safety, Food Microbiology, Listeria, Chickens, Food Science
Abstract

Active monitoring of pathogens on retail foods has been recommended and implemented in a number of developed countries. Because only a portion of retail food is contaminated with pathogens, a cost-effective and informative surveillance program at the retail level often involves a two-stage approach of initial presence-absence analysis and subsequent pathogen enumeration in any positive samples. Most-probable-number (MPN) methods are more resource intensive and therefore used only for samples considered positive by presence-absence methods. Interpretation of the results assumes that the initial bacterial count remains relatively stable between the initiation of the presence-absence analysis and the enumeration analysis. The objective of this study was to quantify the influence of 4 degrees C storage for 5 and 8 days on pathogen counts on raw chicken. The three pathogens examined were Salmonella Typhimurium, Campylobacter jejuni, and Listeria monocytogenes. No significant differences were found between treatments for Salmonella and Campylobacter. However, significant differences were observed for Listeria; counts at day 0 were lower than counts after 5 or 8 days of refrigerated storage (the maximum mean difference was less than 0.6 log units). These findings suggest that a two-stage approach could overestimate the number of Listeria cells on chicken at the time of purchase. By using an MPN analysis on the presumptive positive samples after 5 days of refrigerated storage, this difference will be reduced. These findings support the decision to reduce surveillance costs by performing a two-stage analysis for Salmonella and Campylobacter on retail chicken. This study provides direction for future sampling or surveillance programs that include enumeration of Listeria on retail food.

Published
2007
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28. Development of agroenvironmental indicators to evaluate the hygienic pressure of livestock production on human health

Author

Pascal Michel, André Ravel, Michel Bigras-Poulin, and Denise Bélanger

Subjects
Rural Population, medicine.medical_specialty, Urban Population, Environmental pollution, Risk Assessment, Environmental Illness, Hydrology (agriculture), Environmental protection, Zoonoses, Sustainable agriculture, medicine, Production (economics), Animals, Humans, Environmental planning, Protozoan Infections, business.industry, Public health, Public Health, Environmental and Occupational Health, Agriculture, Bacterial Infections, Geography, Conceptual framework, Animals, Domestic, Livestock, Public Health, business, Water Microbiology, Biomarkers, Environmental Monitoring
Abstract

Infections by enteropathogenic microorganisms linked to agroenvironmental contamination represent a significant threat to urban and rural communities. To better characterize and manage this risk, it is necessary, not only to accurately describe enteric illnesses occurring over time or across regions, but also to correctly assess exposure attributable to this environmental pollution. New agroenvironmental hygienic pressure indicators (AHPIs) were developed to synthesise relevant data expressing this exposure. They were derived from a conceptual framework for developing sustainable agriculture indicators and specifically adapted for describing the microbial risk of water contamination by livestock operations. The proposed indicators include two components, and five attributes whose values are calculated at the livestock operation level from a set of available data related to the fields of microbiology, animal production, agronomy, hydrology, and meteorology. They are then aggregated at a higher geographical level to better express exposure of human populations to potential of water contamination by zoonotic enteropathogens. The indicators are calculated separately by zoonotic enteropathogens, and by water source (surface or groundwater). They take into account the various animal species within each livestock operation. When validated, the proposed indicators will allow decision-makers and public health officials to better manage crucial issues in the area of water safety and agriculture.

Published
2004

29. Development of agroenvironmental indicators to evaluate the hygienic pressure of livestock production on human health.

Author

Michel Bigras-Poulin, André Ravel, Denise Bélanger, and Pascal Michel

Subjects
*POLLUTION, *PUBLIC health, *MICROORGANISMS, *RURAL industries
Abstract

Infections by enteropathogenic microorganisms linked to agroenvironmental contamination represent a significant threat to urban and rural communities. To better characterize and manage this risk, it is necessary, not only to accurately describe enteric illnesses occurring over time or across regions, but also to correctly assess exposure attributable to this environmental pollution. New agroenvironmental hygienic pressure indicators (AHPIs) were developed to synthesise relevant data expressing this exposure. They were derived from a conceptual framework for developing sustainable agriculture indicators and specifically adapted for describing the microbial risk of water contamination by livestock operations. The proposed indicators include two components, and five attributes whose values are calculated at the livestock operation level from a set of available data related to the fields of microbiology, animal production, agronomy, hydrology, and meteorology. They are then aggregated at a higher geographical level to better express exposure of human populations to potential of water contamination by zoonotic enteropathogens. The indicators are calculated separately by zoonotic enteropathogens, and by water source (surface or groundwater). They take into account the various animal species within each livestock operation. When validated, the proposed indicators will allow decision-makers and public health officials to better manage crucial issues in the area of water safety and agriculture. [ABSTRACT FROM AUTHOR]

Published
2004
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30. How to choose geographical units in ecological studies: Proposal and application to campylobacteriosis

Author

André Ravel, Julie Arsenault, Pascal Michel, Pierre Gosselin, and Olaf Berke

Subjects
Operations research, Epidemiology, Health, Toxicology and Mutagenesis, 030231 tropical medicine, Population, Geography, Planning and Development, Ecological study, Distribution (economics), Unit (housing), Set (abstract data type), 03 medical and health sciences, 0302 clinical medicine, Geographical unit, Campylobacteriosis, Campylobacter Infections, Animals, Humans, Relevance (information retrieval), 030212 general & internal medicine, education, education.field_of_study, Ecology, Geography, business.industry, Data Collection, Quebec, Spatial epidemiology, 15. Life on land, Unit of analysis, Infectious Diseases, Modifiable areal unit problem (MAUP), Epidemiologic Methods, business
Abstract

In spatial epidemiology, the choice of an appropriate geographical unit of analysis is a key decision that will influence most aspects of the study. In this study, we proposed and applied a set of measurable criteria applicable for orienting the choice of geographical unit. Nine criteria were selected, covering many aspects such as biological relevance, communicability of results, ease of data access, distribution of exposure variables, cases and population, and shape of unit. These criteria were then applied to compare various geographical units derived from administrative, health services, and natural frameworks that could be used for the study of the spatial distribution of campylobacteriosis in the province of Quebec, Canada. In this study, municipality was the geographical unit that performed the best according to our assessment and given the specific objectives and time period of the study. Future research areas for optimizing the choice of geographical unit are discussed.

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31. Environmental and demographic risk factors for campylobacteriosis: do various geographical scales tell the same story?

Author

Pascal Michel, Pierre Gosselin, André Ravel, Olaf Berke, and Julie Arsenault

Subjects
Climate, Campylobacteriosis, Biology, Population density, Poultry, Unit (housing), lcsh:Infectious and parasitic diseases, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Campylobacter Infections, medicine, Spatial, lcsh:RC109-216, 030212 general & internal medicine, Demography, 2. Zero hunger, 0303 health sciences, 030306 microbiology, Ecology, Incidence (epidemiology), Quebec, Ecological study, Campylobacter, Modifiable areal unit problem, Ruminants, Models, Theoretical, medicine.disease, Unit of analysis, Residual risk, Infectious Diseases, Research Article
Abstract

Background Campylobacter is a common cause of bacterial gastro-enteritis characterized by multiple environmental sources and transmission pathways. Ecological studies can be used to reveal important regional characteristics linked to campylobacteriosis risk, but their results can be influenced by the choice of geographical units of analysis. This study was undertaken to compare the associations between the incidence of campylobacteriosis in Quebec, Canada and various environmental characteristics using seven different sets of geographical units. Methods For each set of geographical unit, a conditional autoregressive model was used to model the incidence of reported cases of campylobacteriosis according to environmental (poultry density, ruminant density, slaughterhouse presence, temperature, and precipitation) and demographic (population density, level of education) characteristics. Models were compared in terms of number of significant predictors, differences in direction and magnitude of predictors, and fit of the models. Results In general, the number of significant predictors was reduced as the aggregation level increased. More aggregated scales tend to show larger but less precise estimates for all variables, with the exception of slaughterhouse presence. Regional characteristics associated with an increased regional risk of campylobacteriosis, for at least some geographical units, were high ruminant density, high poultry density, high population density, and presence of a large poultry slaughterhouse, whereas a reduction in risk was associated with a lower percentage of people with diplomas, a lower level of precipitation, and warmer temperature. Two clusters of elevated residual risk were observed, with different location and size depending on the geographical unit used. Conclusions Overall, our results suggest that the use of municipality or census consolidated subdivision were the most optimal scales for studying environmental determinants of campylobacteriosis at a regional level. This study highlights the need for careful selection and analysis of geographical units when using ecological study designs.

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32. Factors associated with preventive behaviors regarding Lyme disease in Canada and Switzerland: a comparative study

Author

Jean-Philippe Waaub, Pascal Michel, Cécile Aenishaenslin, Denise Bélanger, Lise Gern, André Ravel, and François Milord

Subjects
Adult, Male, medicine.medical_specialty, Risk perception, Canada, Health Knowledge, Attitudes, Practice, Adolescent, Population, Health Behavior, Tick bites, Disease, Logistic regression, Young Adult, Lyme disease, Ticks, Age Distribution, Protective Clothing, Environmental health, Epidemiology, Medicine, Animals, Humans, Borreliosis, Sex Distribution, education, education.field_of_study, Lyme Disease, business.industry, Public health, Prevention, Preventive behaviors, Public Health, Environmental and Occupational Health, Middle Aged, medicine.disease, Cross-Sectional Studies, Female, Biostatistics, business, Switzerland, Research Article
Abstract

Background Lyme disease (LD) is a vector-borne disease that is endemic in many temperate countries, including Switzerland, and is currently emerging in Canada. This study compares the importance of knowledge, exposure and risk perception for the adoption of individual preventive measures, within and between two different populations, one that has been living in a LD endemic region for several decades, the Neuchâtel canton in Switzerland, and another where the disease is currently emerging, the Montérégie region in the province of Québec, Canada. Methods A web-based survey was carried out in both study regions (814 respondents) in 2012. Comparative analysis of the levels of adoption of individual preventive measures was performed and multivariable logistic regression analyses were used to test and compare how knowledge, exposure and risk perception were associated with the adoption of selected measures in both regions and globally. Results In Montérégie, the proportion of reported adoption of five of the most commonly recommended preventive measures varied from 6% for ‘applying acaricides on one’s property’ to 49% for ‘wearing protective clothing’, and in Neuchâtel, proportions ranged from 6% (acaricides) to 77% for ‘checking for ticks (tick check)’. Differences were found within gender, age groups and exposure status in both regions. The perceived efficacy of a given measure was the strongest factor associated with the adoption of three specific preventive behaviors for both regions: tick check, protective clothing and tick repellent. Risk perception and a high level of knowledge about LD were also significantly associated with some of these specific behaviors, but varied by region. Conclusions These results strongly suggest that social and contextual factors such as the epidemiological status of a region are important considerations to take into account when designing effective prevention campaigns for Lyme disease. It furthermore underlines the importance for public health authorities to better understand and monitor these factors in targeted populations in order to be able to implement preventive programs that are well adapted to a population and the epidemiological contexts therein. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1539-2) contains supplementary material, which is available to authorized users.

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