Martin Appelt: Slaughter Inspection - A Case for Change • Robert von Ostertag; 150 years ago there was an epidemic outbreak of

Trichinella in humans and this forced the government to say that slaughter of food animals can only happen in known regulated places

o “Microbiological revolution” - awareness of parasites and bacteria, pasteurization, refrigeration and the role of live animals and meat

o June 1900: Federal Meat Inspection Act Model for similar systems internationally Defines ante and post mortem inspection Demands veterinarians in meat inspection

• 1907- Meat and Canned Foods Act in Canada o Inspection of meat for export and interprovincial trade

• The method they came up with for meat inspection led to eradication or near-eradication from the food supply of crippling meat-borne diseases that commonly infect humans

o Reliable, safe, viable and high quality meat products o Highly efficient and successful meat inspection

• Current situation: o Resource intensive; direct, hands on role for CFIA. Permanent/daily

presence, manual labour o Training intensive, program advice intensive; multiple different

slaughter inspection models co-exist. Mixture of traditional and more or less modernized programs, based on species

o CFIA makes food safety decisions at manufacturing; in a modern system this should be an operator responsibility

• Vision: One slaughter inspection model that applies to all species, risk based, capable of addressing current major public health hazards and recognized by trade partners

• Improve linkage from farm to factory to grocery cart • Increase responsibility of abattoirs for suitability of animals for slaughter • Adapt inspection practices to reflect improved controls and knowledge about

incoming animal status o e.g. Shift from incision and palpation of lymph nodes to visual

inspection o Inspection effort guided by risk; risk estimate based on fact

• Shift model of carcass inspection from hands-o by the government inspector to inspection by oversight

o Build on what has already been done in poultry o Build on best practices in other countries

• Critical path towards the Vision: o Redesign ante-mortem and post mortem inspection for all species o Make changes step by step, based on solid scientific support o Focus on updated food safety conditions using science and risk based

inspection tools o One size fits all- align slaughter inspection for all species o Modernize traditional inspection programs and close the gap between

traditional and modernized o Start pilot sequentially- poultry, swine and finally beef

• CFIA will deliver food inspection in a more horizontal manner, informed by science and focused on the areas of greatest risk

Ontario Poultry Disease Update Dr. Marina Brash Ontario Association of Poultry Practitioners May 27, 2014

• Determined most common diseases in last year for chicken broiler, broiler breeders, turkey, commercial egg layers through survey of Ontario poultry vets (Sept 2012-2013)

• Survey results included 8 vets + AHL Chicken Broiler Most Common Diseases 1) Early colibacillosis (stable to decreasing) 2) Leg issues (bact/developmental increasing, reovirus decreasing) 3) Cellulitis (primary condemns) 4) Ascites (primary condemns), IBD +/- cocci (increasing) Low incidence: infectious bronchitis (IBV), Inclusion body hepatitis (IBH), Necrotic enteritis, spiking mortality Broiler Breeder Most Common Diseases 1) Bacterial tenosynovitis 2) Early colibacillosis 3) Enteritis/cocci 4) In-lay bacterial peritonitis/septicaemia Low incidence: IBV, vertebral abscess (E. cecorum), ILT, Poxvirus infection, Blackhead/Histomoniasis Turkey Most Common Diseases 1) Early colibacillosis 2) Enteritis (cocci/necrotic/viral) 2) Airsacculitis 3) Leg issues 4) Dilated cardiomyopathy Low incidence:

• Aspergillosis - brooder pneumonia - young turkeys more susceptible than young chickens; can be where shavings got wet, mouldy straw, can cause pneumonia and encephalitis in older turkeys

• Erysipelas, type A influenza, fowl cholera, blackhead, parasitic hepatitis Egg Layers Most Common Diseases

• Calcium Depletion/Osteoporosis, Fatty Liver Hemorrhage, IBV, Bacterial peritonitis/salpingitis

Lower incidence: cannibalism, vent trauma, feather pulling, Marek’s disease, Poxvirus infection, focal duodenal necrosis (FDN), histomoniasis/blackhead Prevention of Further Disease Spread

• Primary objective: to restrict infection to one or very few flocks • Control strategies depend on pathogenicity of the strain • Encourage self-reporting by owners of positive flocks • Industry or OMAF conduct trace-out or trace-back from infected premises

if spread is a concern • Industry or OMAF use GIS to identify flocks within a 10 km radius of

known positive flocks for enhanced surveillance • Prevent movement of birds and contaminated materials from infected

flocks • Permit clinically recovered flocks to proceed to processing for human

consumption • Heat treat, clean and disinfect contaminated barns • Vaccination on case by case basis • High risk situation prevention of movement (e.g. formal detention or

quarantine) and industry consider vaccination of flocks within 3 km of known positives

• Heightened biosecurity must be exercised during salvage of recovered and/or vaccinated flocks and during premises clean up

• End response/stand-down: 5 weeks (35 days) without a new case being discovered

Heightened Biosecurity

• “Keep what is outside- outside and what is inside - inside.” • Limit visitors to your farm • Follow proper barn entry procedures:

o Wash hands prior to entry o Wear barn dedicated outwear and footwear o Wear hair cover and mask o Use separate “outside dirty” and “inside-clean” demarcation at your

barn entry • Do not share equipment with other premises • Clean and disinfect any equipment entering the barn • Avoid visiting other farms

Recognizing strengths and limitations of the veterinary medical literature Dr. Brad Hanna, DVM, PhD Department of Biomedical Sciences Ontario Veterinary College May 27, 2014 The Problem:

1. We often exaggerate our own findings -we exaggerate to the point where we mislead 2. We conduct & publish too many poorly designed trials -most published clinical trials contain multiple, substantial errors! -most peer reviewers not experts in all the areas in which they are reviewing 3. We often think about RCTs in isolation (i.e. do not consider how they relate to the greater ‘body of evidence’) -small trials show more scatter around the true effect -large trials tend to show less variation -one clinical trial can tell you something depending on where the result fits into the body of evidence; it can be informative by chance or misleading by chance even if both trials are high quality -virtually all bodies of medical evidence are affected by publication bias -most editors do not like to publish well done studies that show negative or no effect, we lose these studies when looking at the body of evidence, and this will affect the results of studies - publication bias -"beware of the small treatment effect" -systematic reviews look at the entire body of evidence; they select studies according to their quality, not their conclusions - reasonable and transparent exclusion and inclusion criteria -selective citation allows one to simultaneously claim to respect science as a tool for separating what is true from what is false, while never having to give up on a belief regardless of the scientific evidence concerning it -picking and choosing from the published literature is a way of avoiding the truth Main responses to the problem: denial, anger, and then... 1. Rejection of science 2. Acceptance of the necessity to become a more critical reader -good studies are hidden among a sea of flawed reports which lead us backward or in circles --> recognizing strengths and weaknesses is therefore essential -the good news: identifying the most common errors in RCTs is fairly easy -the body of evidence taken as a whole (e.g. the most recent systematic review) provides the most accurate info available on a medical subject We need to read critically -To determine which interventions work, we compare groups -To avoid bias when we do this, we have developed the randomized controlled trial (RCT):

-minimizes the effects of wishful thinking, expectation bias., personal preference

-done well, can provide accurate knowledge of efficacy -can be done improperly → misleading results

-must base conclusions on best scientific evidence, not any scientific evidence

-difficult, expensive to conduct a study that provides accurate information -necessary, because we cannot simply “decide” to be unbiased

Recognizing strengths and weaknesses -different kinds of evidence -in terms of efficacy, RCT provides most reliable data -systematic reviews examine the entire body of evidence (consisting of all good RCTs related to a specific medical question) How can I assess a paper? -reporting guidelines have been developed by international teams -a list of key requirements for good reporting of an RCT CONSORT - Consolidated Standards of Reporting Trials -published at http://www.consort-statement.org/ -25 items which should be taken into account when conducting and reporting clinical trial -developed for human RCTs, modified versions are available for other species and trial designs Benefits of CONSORT -enhances clarity and completeness of reporting -errors become apparent when a trial is thoroughly described -encourages better trial design -allows useful info to be extracted from some poor reports -document to provide justification for each item on the checklist -look for papers that include limitations - good indicator that they did a good job if they considered these instead of making you guess Common Errors Related to Reporting On: -randomization -blinding -background -interventions -numbers analyzed -statistical methods For Livestock & Food Safety: REFLECT Statement -Reporting Guidelines for Randomized Control Trials for Livestock and Food Safety -evidence-based minimum set of items for trials reporting production., health and food-safety outcomes -22 item checklist -evolving document subject to change periodically as new evidence emerges http://www.reflect-statement.org/

Challenges -Formal training in trial design & reporting -Haphazard or no discussion in BSc, DVM, MD programs -Access to the literature post graduation -Alma mater? Professional associations? -Funding agency requirement

-Currently possible to obtain grants without proper knowledge of how to design, conduct or report a trial -Journal requirement -Editors of major medical journals have pledged to require adherence to guidelines, but most do not -Difficult to do in isolation Dave Kelton: What Does a Test Mean? Understanding the Johnes Conundrum

• Health and disease occur in a continuum, individuals and populations move back and forth along that continuum somewhat regularly

• Host, agent and environment alter the balance between health and disease • Exposure to sufficient cause → pathologic process detectable → clinical

disease occurs → outcome (survival or productivity) o In the case of Johnes: Exposure to the Johne’s bug → Antibody

detectable or fecal shedding → Diarrhea and weight loss → Dead or Gone

• Latent period: Time from exposure to agent until pathologic process is detectable

• Incubation period: Time from exposure to agent until clinical disease occurs • Dynamic populations; for example in a dairy herd there is a milking herd, a

replacement herd and there is transmission of agents between different herds through feed and water source, animals products being consumed in the human population

• Tests can be used for surveillance, screening, diagnosis or tracing • Issues: Definition of disease, definition of a test, interpretation of tests • Defining disease relies on understanding where do we make the diagnosis,

and what is the case definition • Gold Standard: The means by which one can determine whether a disease or

condition is truly present or not o Used to evaluate “tests” o Should be biologically unrelated to the test o May have to settle for a lower standard or not standard

• Want to move our diagnostic pressure for Johne’s to identify the infection at a week or month of life (since infection in utero or neonatally is most common)

• Tests available for Johne’s: o Post mortem gross/microscopic examination of gut and lymph nodes o Biopsy of lymph nodes o Fecal culture o Enhanced fecal culture o PCR o Serum ELISA

o Milk ELISA • Sensitivity: Proportion of diseased animals that test positive • Specificity: Proportion of non-diseased animals that test negative • Test interpretation is about probability

o Positive predictive value: The probability of disease if the animal tests positive

o Negative predictive value: The probability of no disease if the animal tests negative

o All of these change with specificity, sensitivity and prevalence of disease:

Probability of disease if test positive Probability of disease if test negative Probability of no disease if test negative

• Screening Test: o Populations o “Healthy” o Early detection of a pathological process or impaired productivity o Sub-clinical disease

• Diagnostic Test: o Individuals o “Sick” o Confirm, classify, treat or give prognosis for diseased individuals o Clinical disease

• Negative results from very sensitive tests can be used to rule out disease • Positive results from very specific tests can be used to rule in disease • There are few perfect tests • Predictive value of test results vary with prevalence, specificity and sensitivity • Published test evaluations need to be reviewed carefully to understand the

test application and the “Gold Standard” that was used Trafficking in Wildlife Lonny Coote May 28, 2014

• Environment Canada - Wildlife enforcement • Legislation - Canada Wildlife Act (CWA), Migratory Birds Convention Act

(MBCA), Species at Risk Act (SARA), Wild Animal & Plant Protection & Regulation of International & Interprovincial Trade Act (WAPPRIITA), Environmental Enforcement Act (EEA), Environmental Violations Administrative Monetary Penalties Act (EVAMPA)

• Priority 1 - Canadian species at high risk for Conservation and/or high risk of non-compliance

• Animal health versus conservation (especially CITES Appendix I species) • IATA containers for for animals refused by CFIA (exports regulated under

WAPTR) • Their legislation does not allow them to euthanize animals that they seize -

trying to put together amendments so that they (Environment Canada - Wildlife enforcement) are able to do this

• CITES community does not want to send the animal into trade, but also do not want to introduce disease

• Animal trophies (prescribed tanning facilities by CFIA) • Bushmeat (DNA testing in general) • Sturgeon caviar (fraudulent CITES permits) • Sharing of intelligence (e.g. import notifications) • Sharing of evidence (e.g. removal notice) • Scientific names of imported species • Joint Force Operations • Birds - historic issue for health reasons

Health Canada’s Approach to Low Risk Veterinary Health Products for Pets Femma Van As, BSc., DVM Veterinary Drugs Directorate-Health Canada May 28, 2014

• Health Canada responsible for: o protecting human & animal health o safety of Canada’s food supply

• Veterinary Drugs Directorate: o allows for evaluation and monitoring of safety, quality & effectiveness, sets standards and promotes prudent use of veterinary drugs administered to food-producing and companion animals

• Veterinary Drug Regulation/Approval - Current Process o Sponsor (party who markets the drug) provides extensive info: Manufacturing and quality controls Animal safety data Efficacy data Human safety data (Food producing animals) Review time (approx 300 days) $26,000-$55,000 (new drug) http://www.hc-sc.gc.ca/dhp-mps/vet/legislation/guide-ld/vdd-guide-ands-padn-eng.php

• Low-risk Veterinary Health Products - Issues o Industry faced challenges in meeting current regulatory

requirements (not adapted to these products) o Increased demand (e.g. vitamins, minerals, homeopathics, probiotics

and botanical products among others) o Veterinary Natural Health Products not included in the Natural Health

Products Regulations o Many products marketed or imported for sale in Canada without

regulatory scrutiny or appropriate market authorization o Quality, safety and efficacy unknown to Health Canada o Regulatory compliance action in Canada/ at the border

Interim Notification Pilot Program (INPP): New Option

• Voluntary option of simplified registration for Low-Risk Veterinary Health Products for companion animals

• Health Canada sets standards - low risk only • Products will have a Notification Number on label • Health Canada would not prioritize the enforcement of the regulatory

requirements for such products Design

• Products intended for use in cats, dogs & horses only • Only pre-cleared ingredients • Only oral/topical/otic (ear) route of administration

• Only general health claims o Permitted claims:

Refer to the maintenance of normal physiology, not to its modification

“Helps maintain”, “supports”, “enhances”, “has a role in”, “contributes to”

Not associated with a specific disease, condition or injury Structure of physiological function “Maintains joint and bone health” vs “Treats osteoarthritis”

• Health Canada sets eligibility standards (Safety, Efficacy, Quality) • Program administered by Third Party

o verifies eligibility o issues NNs o on fee-for-service basis

Development

• Standards developed in consultation with industry and science experts o Recommendation of the Expert Advisory Committee (2010) o INPP consultation - strong stakeholder support (2011)

• Support by Senior Management o Flexible approach to product regulation o Reduction of administrative burden for Industry o Part of HPFB’s regulatory modernisation roadmap (Jan 2013: strong

support during technical discussions) • Administrative process in collaboration with third party administrator

o Customized Database, e-forms • List of Admissible Substances

o Researched over 5400 ingredients (vitamins, minerals, homeopathic, herbal, excipients, etc.)

• Harmonization o Information from other directorates, agencies (e.g. NHPD, CFIA, Food)

and international resources (e.g. US GRAS, EU directives) Implementation

• INPP launched March 2012 • Regulatory Excellence Award “Advancement in Instrument Design” -

March 2012 • ADM Excellence Award “Innovation and Creativity” - 2013

Outcomes

• 474 Notified Products since March 2012 • 5414 ingredients permitted with qualifications;

o approx 3800 homeopathic o approx 1600 herbal, TCM, NMIs

• Use of custom made software o Database and e-forms - Product Notification, New Substance

Application and Adverse Event reporting (interconnected) • Tested and fine-tuned registration model

o Potential to be expanded to food producing animals in the new regulatory framework

Benefits

1. Increased general safety • Low risk ingredients only • Knowledge of manufacturing site (traceability/recalls) • Proper labelling/manufacturing standards • Adverse event reporting

2. Increased access to Low-risk products for animals

• Easier/faster process - reduced requirements/less costly o $750 vs $26,000 (up to $55,000) per product

• Low priority for regulatory compliance enforcement by Health Canada 3. Reduced burden and cost for client

• Simple registration process • Reduced requirement for evidence data

4. Reduced time to market for new products

• From 300 days to 1-4 weeks 5. No increase in government resources

• Administration by third party Lessons Learned

1. Great testing tool • Assessment of effectiveness of approach • Gain knowledge on volume and type of products • Improvements in efficiencies, user-friendliness • Can be refined for future use and expansion

2. All expertise equally important

• Team of science, policy, communication and industry operation experts 3. Third party administration: great option

• Frequent contact with third party builds confidence when administration is processed by third party

4. Other jurisdictions have shown great interest and the INPP may serve as a model for other countries (Australia, USA) INPP “In a nutshell”

• Reduced administration and financial burden on Industry without compromising health and safety of Canadians and animals

• Info: www.lrvhp.ca Jan Sargeant: What Diseases Should We Study? Ben

Marilyn Taylor: Communications in the CFIA Ben

Jim Crawford: The View from Here The next big step in the regulation of meat exports in Canada will be going

paperless. Jim Crawford gave a brief explanation of the Electronic Service Delivery Platform and outlined the need for such a system within the CFIA. Other countries, including China, Australia, and New Zealand already have an electronic platform, although our closest neighbour and major trading partner, the US, still has quite a fragmented system. An electronic system would provide more rapid information to both importing and exporting countries, allow for time tracking, and make communication easier between various parties involved in animal transport. Another of the CFIA’s major plans includes training for CFIA inspectors in Rideau, QU. The program aims to initiate training for inspectors right from the start of their appointment. Thus far, feedback on the course has been positive, so despite the challenges involved in implementation, ‘The View from Here’ is decidedly bright.

Éva Nagy: Emerging Viral Diseases An emerging disease is defined by either a new infection by a previously

unknown pathogen, a change in the geographical area or population of a known pathogen, or an evolutionary change in an existing pathogen conferring some sort of different infectious capacity, any of which may have a significant impact on human or animal health. Many emerging diseases are the result of changes in host, environment, or agent factors, as well as increases in diagnostic capacity and transportation of people and animals. Viruses in particular have amazing genetic diversity and are able to replicate rapidly, undergo recombination, and even cross species barriers. They can be spread in a variety of ways, ranging from migratory birds to meat and food products. Some emerging animal viruses of concern include PED in the US and Canada, Influenza viruses such as HPAI and H1N1, West Nile Virus, Schmallenburg virus in Europe, Hendra virus in Australia, Eastern Equine Encephalitis, African swine fever, rabies, and many more. They pose a significant threat to food sources, and their potential to infect humans represents a significant risk to human health worldwide. One of the most concerning human viruses in recent years is SARS, which causes severe acute respiratory syndrome. It originated in China in the Himalayan palm civet and was transferred to humans. A similar virus, MERS-Cov caused significant human disease and deaths in Saudi Arabia, where it is thought to have originated in camels. Ebola virus, which is one of the deadliest viruses known to man, has received extensive media coverage recently due to outbreaks in West Africa. Fruit bats are considered to be the natural host of Ebola, a filovirus, and human infection can result in case fatality of up to 90%. While the rapid evolution of viruses makes it very difficult to predict how their infectious capacity will change and cause disease, it is clear that the study of virology is vital in responding to viral outbreaks in both human and animal populations in order to safeguard global health and food security.

Harold Kloeze: National Passive Surveillance and Intelligence Projects - CAHSN and CEZD

Surveillance systems aim to determine disease prevalence and distribution, as well as detect emerging or exotic diseases through the collection and analysis of

data from animal populations. The purpose of surveillance is to monitor changes in diseases that are known to occur in Canada and to confirm freedom of diseases that are believed to be absent in the Canadian population. Two such surveillance systems, the Canadian Animal Health Surveillance Network (CAHSN) and the Centre for Emerging and Zoonotic Disease (CEZD) have been implemented to benefit not only the CFIA but also other stakeholders in the issue of food animal health. The concept of One Health accounts for the intricate relationship between the health of animals, people, and the environment, and it is this philosophy that guides the initiatives set by CAHSN. Some of the challenges met by CAHSN and the CEZD include fragmented legal responsibilities over animal disease reporting between various levels of government, maintaining consistent funding between changing governments at all levels, and sharing information efficiently with each animal industry. Current technology has allowed for rapid sharing of information between a large number of parties, and enhanced capacity for data analysis makes finding useful trends easier than ever before.

Graham Crawshaw: Adventures at the Zoo Program Director of the Toronto Zoo, Dr. Crawshaw, gave very interesting

overview of the work his team is faced with on a regular basis. The Toronto Zoo is responsible for dealing with confiscated wild animals, transporting animals across international borders, and keeping the animals in their care in good health. They are involved in interventional medicine in many cases, including such exciting events as grizzly bear castrations, suturing the wounds of injured monkeys, a gastroscopy in a cheetah, a hyena’s root canal, etc. Zoo animal health includes many facets, such as medicine, surgery, and husbandry, nutrition, reproduction, and animal welfare. While the vets there are generalists by necessity, sometimes they need to call in specialists (often from OVC) to help on especially challenging surgeries. For example, a Black Rhino was treated for colic recently, and the Zoo had to call in the Toronto Fire Department for help in moving and positioning the massive creature. Certainly, there are dangerous aspects to this job- working with venomous species such as snakes requires handling skills and serious planning. When bringing new animals in, the zoo directors must comply with the required CFIA quarantine times for internationally shipped animals, and there are some high-profile newcomers to the zoo, like the Giant Pandas, which may involve significant media attention. Preventative medicine is an important step in maintaining zoo animal health, and things like hoof-trimming, disease testing and monitoring, as well as wildlife control are all part of the regular responsibilities of the vets at the Toronto Zoo. However, the zoo animals are not the only population of concern to the team; there are several breeding programs in place with the goal of maintaining or replenishing wild populations of species like the black-footed ferret, the Eastern loggerhead strike, and the Puerto Rican crested toad. There are several research projects underway at any given time, and on occasion, the zoo is involved in the capture of wildlife such as bears and moose that are injured or find their way into heavily populated areas. Certainly there is always a lot of work to be done at the zoo, but the team is full of passionate, hardworking individuals who work together to protect the health of animals both in captivity and in the wild. Rob Foster: Pathology Update

Ben John Lumsden: Aquaculture Global Aquaculture

• Fastest growing agricultural industry • Fish is the primary source of animal protein for the majority of world’s population • Number of fish caught and number of fishermen are in decline even though the

demand for fish is high

Inland aquaculture

• Availability of fresh water is a limiting factor for the industry

What is most caught

• Fin fish • Molluscs • Aquatic plants

The type and quality of water available determines the species that predominate. Marine dollar value would be dominated by molluscs and finfish

China out produces the rest of the world

Challenges

• New species of finfish should be omnivorous/herbivorous as opposed to feeding on other fish as fish meal production is in decline

• Example of a fish that doesn’t eat other fish is Tilapia • Salmonids are saturated • Very expensive to start a new species so the government often has to be involved • Industry is mostly industrialized but there are some family farms still around • Severe constraints are environmental/legislative

o Has a lot to do with the government being worried about water quality o Problem if a species of fish is grown in an area where they are not naturally

found. Can be a problem if they are released into the environment by accident

Canadian Aquaculture

• Atlantic salmon predominates • Fourth on the list for salmon production • Other species also produced – shellfish, algae, lobster, etc • Majority of the product goes to the US • There is a heavy investment in non-salmon species but these industries are more

likely to fail due to the extra challenges associated with producing other species such as cod

Ontario Aquaculture

• Rainbow trout is the predominate species • Others : arctic charr, brook trout, salmon, tilapia, yellow perch

Aquaculture Issues

• Environmental impact, disease, predators, release of fish, etc. o Release of fish from the net pen into the ocean happens all the time o This can be a problem when the species in the net pen is not native to the

area. Eg. Atlantic salmon in BC are not from BC but there is a wild population now growing in BC due to accidental release

• Regulatory burden • Antibiotic use and residues

o There are not many anti-microbials available for fish o Anti-microbial resistance is a major problem since rotating through products

isn’t possible with the limited selection • Market price fluctuations • Water supply and salt water pollution • Worldwide shortage of fish meal • New species, management of life cycles, larval stages • Contamination of wild vs fresh carcasses with PCB’s – fish have PCBs in their fat

o Found that farm fish have lower amounts of PCBs o Fish meal is scanned for PCBs to prevent farm fish from ingesting the PCBs

• Omega 3 benefit for cardiovascular disease – needs at least 2 meals a week of fish to have a benefit – most people don’t eat this much fish

Diseases of concern

• Three of major concern to Canada • Disease can be spread from farm fish to wild fish and vice versa • Sea lice problem in BC – spread from farmed salmon to wild salmon that are

swimming by the nets o However there is no real good evidence to prove that the lice is coming from

the farm salmon • Ontario- coldwater disease has the largest impact

o Substantial enough to cause economic hardship but not enough to stimulate interest in commercial vaccines

• 3 new viruses have been identified in the Great lakes in the last few years o IHNV – infectious hematopoietic necrosis virus

Jumps from wild pacific salmon to atlantic salmon and rainbow trout There is a vaccine available – costs a couple dollars a shot but the

fish at the affected stage aren’t worth that much since they are very small

To deal with this problem – grow 20% more fish than needed o Sea lice

Many salmon die from secondary bacterial infections

o VHNV

Aquaculture Operations

• Very heavily dependent on human labour • Bird nets are needed as birds are major predators • Predator nets are meant to prevent predation by marine mammals • Feed is 70% of the cost of a salmon operation. Feeding the fish, cleaning nets,

grading and moving fish consume the labour costs

Zoonoses

• Few of major concern apart from intestinal parasites eg anasakis from eating raw fish

• Human disease is more likely due to consumption of shellfish

Davor Ojkic: Diagnostic Virology and Test Development Laboratory testing

• At the individual/flock/herd level o Diagnosis o Management/prevention o Monitoring of vaccination o Export certification o Detection of emerging threats

• At the province/country/region/continent level o Epidemiology o Public health issues o prevention/eradication

Course of Viral Infection

• deciding what test to use can be difficult • depends on the expected stage of infection

Diagnosis

• history • autopsy • laboratory testing

o antibody detection o virus detection

nucleic acid detection antigen detection

o virus isolation

Antibody detection

• ELISA

o Sensitive and specific o Negative during the first week o Species specific conjugate

• Agar gel immunodiffusion • Agglutination

Nucleic acid detection

• PCR – conventional and real time • Sample processing/extraction • Nucleic acid amplification • Detection of amplification

Virus detection with antigen detection

• ELISA • Immunohistochemistry

Virus isolation

• Advanatges o Historically a gold standar o Sensitive o Can isolate multiple viruses

• Disadvantages o Virus must be viable o Slow

Test selection

• Gold standards • Licensed tests • Published procedures • In-house developed tests

Carlton Gyles: VTEC VTEC, or verotoxin-producing E. Coli, are a subset of E.Coli bacteria that

produce Shiga toxin and are widespread in the intestines of cattle. Highly virulent VTEC are called EHEC (entero-hemorrhagic E.Coli). The most common serotype involved in human disease is O157:H7, which was identified in 1982 during Hamburger disease outbreaks. It is shed irregularly in the feces of cattle; typically at low levels-but there are some supershedders-and overall shedding is highest in the summer. Food sources of VTEC include ground beef; fresh produce such as spinach or sprouts, and even dairy products. The capacity to cause disease requires two important characteristics of the bacteria: the ability to colonize the gut, and the ability to produce toxins. O157:H7 has both of these characteristics. In fact, VTEC can adhere to the gut wall by reorganizing the structure of epithelial cells to form pedestals, which eliminate microvilli and allow for intimate adherence of the bacterial cell to enterocytes. The Shiga toxin has several types; Stx 2c is associated with the

highest virulence, although virulence is dependent on both gene content and the level of gene expression. Aside from causing hemorrhagic diarrhea, the toxin enters the bloodstream and causes significant damage to the kidneys, leading to hemolytic-uremic syndrome. Even low numbers of virulent strains such as O157:H7 can cause serious disease, which has lead to an emphasis on this particular strain in research and surveillance. However, there is increasing concern about non-O157 VTEC that can cause disease in humans. Pasteurization and adequate cooking of food will kill all strains. Shedding in cattle can be reduced by post-harvest interventions, but not eliminated. Two cattle vaccines against O157:H7 have been licensed and others are being developed.

John Prescott: The Rapidly Changing World of Veterinary Bacterial Disease Climate change, vector-borne diseases, and antimicrobial resistance have ushered

in a new and frightening landscape in veterinary and human medicine. In the mid-20th century, the advent of antibiotics made medicine virtually unstoppable. Deaths due

to bacterial diseases plummeted, and the perception was that antibiotics were “wonder drugs”. Now, just decades later, human and animal health is threatened by multi-resistant bacterial infections such as MRSA, MSSA, VISA and more. Bacteria

are able to confer resistance to other strains via plasmids, and there are some plasmids that carry genes for resistance to multiple drugs. Some pathogens have

evolved exquisitely to live in a hospital environment, such as those that have acquired the ability to colonize catheters. The problem is attributed to both the

overuse of antibiotics in animal agriculture and to excess prescription and irresponsible use of antibiotics in human healthcare. Each side seems to point to the other as the more significant cause, but it remains extremely difficult to quantify the exact contributions to the problem. Significant data was published showing a direct

correlation between ceftiofur use in the poultry industry and ceftiofur resistant salmonella in humans. At the same time, there is an increasingly large number of

resistant pathogens in human medicine, many of which are not being selected for by agricultural antibiotic use. MRSA, for example, began in human hospitals and spread to veterinary hospitals, but occurs rarely in production animals. Regardless of who is to blame, one seems to disagree that the problem is a very serious one, and that the greatest challenge will be to identify and validate alternative treatments. The concept

of antimicrobial stewardship involves optimizing the use of antibiotics while minimizing resistance, and advocates for the long term management of such a valuable medical tool. Some of the most important examples of stewardship in

human healthcare include dosing according to PK-PD principles, improved susceptibility testing, developing antibiotic use guidelines, and reducing the use of unnecessary prophylactic antibiotics in surgery. Some of the priorities for changing antibiotic use in animal production in Canada include: creating a national system

monitoring the use of antimicrobials in food animals, terminating the use of antibiotics for growth promotion if drugs are used in humans, moving towards

prescription-only use of antibiotics, and monitoring resistance so that corrective actions can be taken. With advances in microbiology such as genome sequencing, the capacity to understand and manipulate the intestinal microbiome is better than ever before. We can expect to be able to target antimicrobials to the pathogen with shorter and shorter turnaround time, leading to improved infection control by patient screening for selected resistance. These changes will not happen overnight, but as

this issue receives more attention in international medicine and politics, small improvements can be made to safeguard our wonder drugs for use in future

generations. Ann West: Veterinary Biologics Ed Creighton: Aquatic Animal Health Program

• Aquatic Animal Health Program (NAAHP) formed in 2005 • Co-delivered by the CFIA and Fisheries and Oceans Canada (DFO) • Designed to help protect Canadian aquatic resources from introduction and

spread of serious infectious diseases as well as support market access for Canadian fish and seafood

• Modelled after Canada’s terrestrial animal health program • Aquatic animal health is not concerned with whether or not it is fit for human

consumption, but rather whether it is going to be a danger to our resident species

• As a member of OIE, Canada has an obligation to base their sanitary measures on standards set out by the OIE

• Health of Animals Act gives CFIA authority and responsibility to react to disease outbreaks and to prevent the introduction of animal diseases into Canada by regulating imports

• Want to convince our trading partners that Canada is a safe place to buy agricultural goods; we do this by developing a strong animal health program

• CFIa is not concerned with all animal diseases, only the most serious ones; so only gets involved with the species that are most susceptible to these serious diseases

• None of the serious aquatic diseases are transmissible to humans • If a serious disease is found, CFIA will work with industry to eliminate or

prevent the spread of disease • Because none of the serious diseases are zoonotic, the inspection of fish for

human consumption is not as rigid or structured as it is with terrestrial animals • CFIA will be implementing a Movement Control program with the idea that

certain diseases that are endemic to areas and we need to restrict the movement of these serious diseases by restricting movement of fish

• Certain species of aquatic animals require an import permit and associated health certification to enter Canada

• Export certificate is issued by the government of the exporting country; entails declaration of disease freedom of premises, state or country of origin

Dave Eagleson: EIS - Enforcement & Investigation Services

• Enforcement and Investigation Services (EIS) is part of the Operations Branch of the CFIA

• Across Canada, there are about 30 investigators in 4 regions: Western, Ontario, Quebec, Atlantic regions

• Roles of EIS: o Provides enforcement and investigative advice, guidance and training o Manages prosecution and administrative monetary penalties (AMPS)

proceedings based on referrals from inspectors o Prepares briefings of evidence for court

o Facilitate contentious issues • AMPS vs. Prosecution:

o AMPS available to violation of Health of Animals Act or Plant Protection

o Prosecution available to all offences or violations • Issuing a warrant is a significant amount of work and legislation; warrants can

be hundreds of pages in length • Maple Lodge Farms: Transport or cause to be transported an animal with

undue exposure to weather o 60 charges for violations between 2008-2010 o 2 convictions after trial and a $40k fine on each o 40 additional guilty pleas o 3 year $1,000,000.00 Probation Order

• Luckhart Transport & Quality Meat Packers: Load, unload or cause to be loaded or unloaded an animal in a way likely to cause suffering

o Trucking company identified as the violator o 3 hogs were found compromised at the time of unloading o 6 AMPS issued

• Everything is a record: notes, reports, memo books, video, scrap paper, photos

• Important to take notes, keep records and report when there is a problem

Les Kumor: Animal Health, Meat Inspection, Trade, Culture, Traditions - the View from China

• Experts Abroad program was created in 2006 as a result of BSE (first case was in May of 2003)

o This was when Canada lost most of the export markets for our beef, so the role of the program was to negotiate access to those markets for our beef

• CFIA postings are unique in that they are the first CFIA positions located in embassies abroad focusing exclusively on CFIA regulatory matters

China • 22 provinces, five autonomous regions and four directly controlled

municipalities • The world’s third largest country by total area (9.6 million square kilometres) • Largest exporter and importer of goods • Became a member of World Trade Organization on November 12 2001 • Agribusiness is one of China’s hottest new industries driven by consumer

demand and population growth • In 2013 Chinese Chuanghui International spent $7.1 billion to buy American

Smithfield, the world’s largest pork producer and processor • Negotiators will take the time to learn your strengths and weaknesses and

you should do the same with your counterpart • Delays can be designed to wear you down until you are ready to concede or

give up • Next 10 to 20 years China will become the world’s biggest importer of

agricultural and food products • Chinese Ministries responsible for animal disease prevention and control:

o Ministry of Agriculture Veterinary Bureau

o General Administration of Quality Supervision, Inspection and Quarantine of the People’s Republic of China

Animal and Plant Quarantine Bureau Import and Export Food Safety Bureau

Bob Friendship: Swine update including what’s happening regarding PED

• Canada is a major pork producer o 7th largest pork producer in the world o 3rd largest pork exporter o Exports 60% of production

• The appreciation of the Canadian dollar resulted in an ongoing, continual erosion of the Canadian hog price relative to the United States

• The explosion of grain prices due to the advance of the ethanol subsidies and artificial usage mandates in Canada and the US is a problem

• Country of Origin Labelling law in the US discriminated against Canadian livestock and resulted in reduced demand, markets and pricing for Canadian hogs

• Animal health problems such as Porcine Reproductive and Respiratory Syndrome (PRRS) and pH1N1 influenza took out what little opportunity for profit existed

• Industry trends: o Fewer farms but larger and more efficient o Networks and interdependence o Multiple sites and lots of pig movement o Heavier market weights o Slow uptake of Improvest (raising intact males) o Niche markets for organic etc.

• Pigs weaned per litter in the North American industry has been increasing over time; same with pigs/sow/year, market weight, growth rate, feed efficiency etc.

• New diseases are constantly emerging in the swine industry o Late 1970’s: Actinobacillus pleuropneumoniae (APP) o Late 1980’s: PRRS o Late 1990’s: Post weaning multisystemic wasting syndrome o Some old diseases have been changing such as swine influenza o Porcine Epidemic Diarrhea

• 3 different PED viruses as well as delta coronavirus have been identified in the US

• PED is unrelated to Porcine Coronavirus o Causes watery diarrhea in most pigs of all ages o Closely resembles Transmissible Gastroenteritis (TGE) except:

spreads more rapidly in a population and in between adjacent farms, less vomitting

o Mortality: 70-100% of suckling pigs die from dehydration after 3-4 days; other ages have little to no mortality

• Sources of transmission: disseminated in the feces of infected pigs, indirectly spread by fomites and transportation, potential carrier swine, transmission by birds

• Control: o Sanitary and quarantine measures may slow the spread o There is no effective treatment o Try to establish herd immunity

• First case identified in Canada on January 22 in Ontario o Within 3 weeks another 20 herds with nothing in common but the

same starter feed containing spray-dried plasma • PED does cause viremia and there are subclinical infections in older animals • Last case of PED was May 6th in Manitoba, April 30th in Ontario • Lesson learned: it is really difficult to prevent disease spread by trucks • Ontario progress:

o Successful PED elimination in all-in all-out nurseries and all-in/all-out finisher with subsequent fill remaining PED negative following barn clean and disinfect

o Successful delta coronavirus elimination in a sow herd based on herd depopulation

o Successful sow site PED elimination, also based on a herd depopulation

o All other sites working on PED elimination over the next 2-3 months • Industry pulled together with a coordinated effort against PED • Biosecurity has improved as a result of PED • There is optimism that the disease can be eliminated

Penny Greenwood: Principles of Zoning as a Tool

• CFIA is uniquely positioned to be able to apply the concept of zoning across provincial boundaries

• Difficult to establish and maintain disease free status for an entire territory • Benefits to a country in establishing and maintaining a subpopulation with a

distinct health status within in it’s territory o Define subpopulations of distinct health status within its territory for the

purpose of disease control and/or international trade • Subpopulations may be separated by natural or artificial geographical barriers

or by the application of appropriate management practices • Zoning applies to an animal subpopulation defined primarily on a

geographical basis (using natural, artificial or legal boundaries) • When a foreign animal disease is first detected, the goal of the zone is to

rapidly contain and eradicate the disease o If the disease can be eradicated from the population then the size of

the zone could be slowly reduced or targeted until the disease is gone and the zone is no longer necessary

o As you are shrinking the zone you are allowing more and more of the country to continue trade

• Factors to consider regarding zoning: o Movement controls o Surveillance o National disease control response

o Biosecurity o Import from other countries o Geographic spread within Canada o Export

Tracey Chenier: Modern Animal Reproduction Ben Andrea Ellis: Veterinary Medicine on the World Stage Specialist commissions of the OIE:

• Many categorie such as ‘Aquatic’: Has to compile all diseases within one commission, AND write the code (Aquatic animal health code), also world assembly of delegates

• Want to increase their funding and support • Now a strategic plan to look at all the commissions

OIE governance structure: • Regional commissions (each have a president, two VPs, a secretary, and

support staff o Africa o Americas o Asia/Far East/Oceania o Europe o Middle East

• Also regional and subregional representatives OIE has working groups (membership for 3 years):

• Animal welfare • Animal production and food safety • Wildlife

...and Ad hoc groups (set up by director as needed): • eg: developed a group to deal with PED

OIE delegates: • Nominated by government (ususally Chief veterinary officer) • National focal point for the OIE in the country • National and international status • Negotiates international veterinary standards on behalf of their country • Keeps OIE up-to-date on diseases in their country

National focal points: • Aquatic animal disease • Wildlife • Animal disease notification • Veterinary products • Communication • Animal welfare • Food production safety (animal) • Veterinary laboratories

o Role of focal points is to: establish network of experts in the field, do in country consultations, help draft texts of standards, prepare comments for the delegate.

Reference labs (241 in 37 countries: 116 dzs or topics) – support member countries Collaborating centers (43 in 24 countries: 42 topics) – look at broader topics and have specific expertise in areas Standard cycle (annual): May: general session where 178 country delegates propose minor changes and adopt proposals studies during the year at general sessions June-July: review adopted standards and make comments August-September: reviews comments and proposals and development of new chapters October: OIE submits proposals with technical documents to the delegates of member countries for their review Nov-Jan/Feb – MOST IMPORTANT PHASE* modifications made Final report send out in March Reports can be accessed on the OIE website (very comprehensive)

• Publications every 4 months – scientific and technical review • Terrestrial and aquatic health codes published annually

On OIE site:

• Disease alerts • Global disease situations • International standards • Media resources

Evaluators trained by OIE (PVS evaluations) • Also have a PVS guideline of new vet graduate competencies

Canada’s engagement: • Delegates are very active • Participate in general session • OIE council and regional commission • Members of working and ad hoc groups • Reference labs and collaborating centers • Hosts regional focal point workshops

OIE related functions spread across Canada and not clumped into one area Doug Campbell: Wildlife Diseases in Canada Canadian Cooperative Wildlife Health Center (CCWHC) CCWHC is a university based inter-agency partnership:

· Center for coastal health (Vancouver Island) – non-governmental (epidemiology) · BC provincial diagnostic lab · U of Calgary CVM · WCVM · OVC · FMV · AVC

CCWHC functions: · Disease surveillance (active, passive, enhanced passive) · Information and consultations · Education and training (handbooks, presentations, contractual work (eg. risk

assessment for invasive disease for the provincial government)

· Disease response and management: targeted programs of surveillance, research, and management response. Wildlife disease surveillance:

· 3600 specimens examined · 3% increase over 2008/9

Reports diseases to OIE: · Anthrax · Brucella suis · Echinococcus · etc

CWHC works as a focal point for wildlife disease for the OIE Website for CWHC maintained to get information about the organization and wildlife disease

· Also makes a guide for hunters and harvesters in Northern Canada Emerging infectious diseases are those whose incidence has increased within the past 2 decades or threatens to increase in the near future Principal wildlife issues 30 years ago:

· Epidemics like rabies · Toxins · Sporadic die-offs (eg. from Botulism) · Hunter queries (parasites, food safety)

Concerns in 2014: Mammals: Chronic Wasting Disease, tuberculosis, raccoon rabies, canine distemper in new hosts (marten, fisher), morbilliviruses in marine mammals, lyme disease, hantavirus, white nose syndrome. Birds: West Nile virus, pathogenic avian influenza, botulism (types C and E), Newcastle disease virus, salmonellosis, Mycoplasma gallisepticum in house finches, Trichomoniasis in songbirds Fish, amphibians, reptiles: Fungal diseases (chytrids), frog deformities, ranaviruses, viral hemorrhagic septicemia, koi herpes virus, spring viremia of carp, infectious salmon anemia Spillover: movement is localized and does not become established in the new host species Species jumps: becomes established in a new host species How are they transmitted?

· Direct (rabies, CDV, TB) · Indirect (environmental contamination – HPS, lepto, VLM · Through the food chain (trichenella) · Vector borne (WNV, etc.) · Common exposure (blastomycosis, cryptococcosis)

Many strains of rabies in NA · Western- skunk · Here – raccoon strain from US, bat strain · Northern Canada – fox strain

Fox rabies was the greatest risk previously in Ontario · Oral vaccination greatly reduced arctic fox strain (almost eradicated in Ontario) · Most cases are now bat strain

· 4 cases since 1985, 24 since 1924 (all in people, all bat strain) In Quebec the oral vaccine is used for aerial baiting to prevent the raccoon rabies from penetrating into the province; also intense surveillance being used Visceral larval migrans (indirect transmissions)

· Most commonly associated with Baylisascarius procyonis (raccoon roundworm) · Abberrant migration of nematode parasite · Common disease in rodents, and devastating disease in people · Common for it to migrate to neural (brain) tissue · ~12 cases described in medical literature · Many species can be affected by this parasite

Transmission through the food chain (botulism) · Some methods of food preparation (eg. air crying, fermentation) may promote

botulism · Numerous outbreaks of Type E botulism in the arctic have been due to

consumption of fermented foods · Traditional methods of fermentation are less risky than modern versions · Vector Borne disease – West Nile Virus · Cycles between the reservoir host (birds) and mosquitos · Mosquitos act as a bridge vector and infect humans through bites

Lyme disease · Transferred by blacklegged deer ticks (Ixodes scapularis) · Does not require people to thrive; commonly infects rodents and white-tailed deer · Ecologically first recognized around 1980 in New England · First appeared in Ontario at Long Point and developed along the Great Lakes

Transmission from sites of common exposure – blastomycosis · Cause by an infection with Blastomyces dermatitidis · May be restricted to the skin, but it can become systemic and effect many organs · Associated with sandy acidic soils with high organic content and moisture; found

near waterways (Great Lakes) · Known hot spot in the Kenora, ON area · Spores are commonly inhaled, but can also invade through open skin wounds · Wild canids also susceptible

Human movement of pathogens: · Often no proof of movement, just the appearance of the disease in a new location · Recent example is WNS in bats · First recognized in Howe’s Cavern (NY); popular tourist destination

Human encroachment (as well as domestic species) have invaded wildlife habitat and introduced novel diseases to wildlife How to prevent emergence of new diseases?

· Restrictions of movements of animals (including industries like the pet trade) · Limiting human encroachment

Disease management: · Vaccination (terrestrial rabies) · Slaughter and test

Andrew Peregrine: Emerging parasite problems in ruminants and pets Cysticercus ovis in the Canadian sheep industry:

· In 2011 there was a total of 806, 600 sheep in Canada

· Ontario has the largest lamb market, and more than 60% of sheep slaughtered in Ontario (even though it only accounts for 30% of Canadian sheep farms)

· Sheep are routinely transported between provinces · NOT zoonotic (unlike C. bovis), only an aesthetic issue · C. ovis is the intermediate form of the canine tapeworm Taenia ovis · Canids are the definitive host, sheep are the intermediate host · Transmitted through canids consuming infected sheep carcasses, then the dogs

release eggs in their feces and the sheep consume more eggs At an Ontario lamb feedlot there was an outbreak in 2008

· 4000 head capacity; handles 25,000 animals per year · Between February – May 12% of all carcasses totally condemned

Study was conducted to determine the origin of animals being condemned, and what the on-farm risk factors associated with carcass condemnations are.

· Canadian Sheep Identification Program (CISP) established in 2005 · All animals tagged at birth · Animals can be traced back to farm of origin in the cases of reportable disease · C. ovis is a non-reportable disease so it could not be easily traced

Solution? 1. Condemned animals at Provincial abattoir sent information to the Canadian Sheep

Federation 2. CSF contacted Provincial Veterinarians 3. Vets contacted producers

C. ovis was found to occur across Canada, including in Ontario What factors are associated with a farm having C. ovis condemnation?

· Predation of deadstock · Lack of deworming in farm dogs · No financial incentive to producers to prevent it

Giardia:

· A lot of misinformation about this parasite · Vaccine for Giardia was discontinued several years ago as it was ineffective · Water-borne infection · Infects many species, including cattle

o 42% of all cattle positive in a 2007 Eastern Ontario study o Rarely associated with disease, so commonly ignored o NOT ignored in dogs!

· In 1999 7.2% of all dogs tested in Canada (1,216 samples) were positive · Most common intestinal parasite of dogs consistently in studies · 78% of positive dogs look healthy with NO diarrhea

Also most common intestinal parasite of people, though many infections have NO clinical signs

· The vast majority of human infections is through HUMAN origin (not dogs) PCR testing has shown that there are several different assemblages/genotypes of Giardia, and only the A and B assemblages are zoonotic

· Dogs get infected with subtypes A, B, and C · Cats get infected with A and F

What genotypes are dogs in Southern Ontario infected with? · In 75 infected samples tested, only 1 was the B subtype and therefore zoonotic

Should all Giardia infections in dogs and cats be treated? · In people subclinical infections are typically not treated · Most infections in dogs are cats are subclinical · If we aren’t testing, what’s the justification for testing healthy animals? · Becoming resistant to metronidazole (fenbendazole next choice)

Ticks and tick-borne diseases in Canada: The common species found in Ontario are:

· American Dog Tick (Dermacentor variabilis) · Blacklegged Deer Tick (Ixodes scapularis)

Only Ixodes carries Borellia burgdorferi, which is the causative agent of Lyme disease

· Larvae host of mice and birds · Nymphs host on mice and birds · Adults host on white-tailed deer, and commonly dogs and people

Habitat is deciduous forests This species has a two-year life cycle, and the highest seasonal activity is:

· September to November · April to May

50-150 million Ixodes come into Ontario on the backs of migrating birds every spring! Ixodes tracked with passive surveillance (voluntary submissions) Endemic areas in Ontario:

· 1000 Islands · Long Point (~60% of ticks test positive for B. burgdorferi) · Turkey Point · Long Point · Rondeau Provincial Park · Point Pelee National Park · Spreading up the Lake Erie waterline by 50km/year · Brought to this area by migrating birds

Passive surveillance in 2012 determined that 17.5% of I. scapularis carry B. burgdorferi in Ontario

· 9% of the ticks submitted from dogs were positive for B. burgorferi · The ticks must be fully engorged and will only transmit after 24-48 hours

Andrew Peregrine: Pet Importation and Disease Leishmania · Clinical signs develop 3 months to 7 years after initial infection

· Sandflys are the vector (Phlebotomus species outside Americas, Lutzomyia species throughout the Americas)

· Leishmania infantum is the typical species found in dogs · Zoonotic risk · Endemic areas are: Mediterranean basin, Middle East, South America · Huge concern for North America – if it infects wild canids here it will likely be

impossible to eliminate! · Not currently a reportable disease · 14 sandfly species in the US – none are proven to be vectors, but likely some are

Prevalence:

· In highly endemic areas (Greece, Naples area of Italy, Marseille area of France) the infection prevalence in dogs can be as high as 70-90%!

· Most dogs remain subclinical for much of their life · Infected animals will become seropositive regardless of clinical signs · Infection typically occurs in young (2-4yrs) and old (>7yrs) dogs · Some breeds appear to be more susceptible (German shepherd, Rottweiler,

boxer, cocker spaniel) Development of Disease:

· Leishmania promastigotes found in the sandfly gut, and they migrate to the mouthparts when the sandfly is feeding to transfer to new host

· Amastigotes invade host macrophages and are found primarily in hemolymphatic organs

· Chronic intracellular infection · Excesive host immune response causes huge increase in circulating

immune complexes (CICs) · CIC deposition in kidneys causes renal failure and death · Common clinical signs are alopecia, weight loss, and exercise intolerance

Therapy

· Treat symptomatic animals with allopurinol and meglumine antimoniate · Relapses (and retreatment) common · Rarely is the parasite completely eliminated

Importation from endemic countries · Currently testing for Leishmania is NOT required (only rabies vaccination

and physical exam) · Dogs should be tested, and positive ones should not be imported · Dogs that are negative on importation should have follow up testing (ELISA,

IFAT) after 4 months, 1 year, and 2 years · Permethrin is an effective repellant for sandflies in endemic areas

Echinococcus multilocularis · Canids are the definitive hosts, and wild rodents the intermediate host · Canids excrete eggs in feces and the eggs are usually ingested by mice · Alveolar Echinococcosis develops in the mice, and canids eat the mice (cycle

repeats) · Humans can ingest the eggs accidentally and cysts often form in the liver · Incubation in humans can be 5-15 years

In North America

· 2 farm cats in North Dakota · 3/131 cats in Saskatchewan · Human: one in Manitoba (1937), one in Minnesota (1979)

o 2009 dog in BC with hepatic alveolar echinococcus o 2012 dog in Manitoba and Ontario o 2013 and 2014 each one dog in Ontario o ALL these animals lived permanently in the provinces they

were diagnosed in! Zoonotic threat?

· Dogs in intermediate stage of infection could have patent intestinal infections o 13 people who were in contact with the first infected Ontario dog

were tested, and all were seronegative. o The dog in BC, and one of the Ontario dogs, were infected with the

European (not North American) strain of E. multilocularis. Newly endemic issue in Ontario and other parts of Canada! Disease Testing and Analysis Grant Maxie, DVM, PhD, Diplomate ACVP Co-Executive Director, Director, Animal Health Laboratory, Laboratory Services Division, University of Guelph June 5, 2014 Services provided by AHL:

• Anatomic pathology - Guelph and Kemptville • Bacteriology • Clinical Pathology • Immunology/Serology • Molecular Biology • Mycoplasmology • Parasitology • Toxicology/Soil & Nutrient • Virology • Surveillance

AHL expertise, capability

• 16 Vets on staff, all with advanced training in various disciplines • adjunct or associate graduate faculty status within OVC • over 1000 tests available in-house • central support for QA, IT, Finance, HR, Marketing & Sales • provide services for OMAF-MRA, CFIA, and other government agencies,

OVC HSC, researchers, external private practitioners, CCWHC, industry AHL Function & Structure -Client Service -Laboratory testing -Quality program Partnerships & Affiliations (CFIA led):

• TSE Laboratory Network • Avian Influenza Laboratory Network • Canadian Animal Health Surveillance Network (CAHSN) • Network of Networks - “One Health”

o animal health, public health, food safety labs CAHSN/CAHLN

• Federal – provincial – university partnership • Canadian Animal Health Surveillance Network (CAHSN)/Canadian Animal

Health Laboratorians Network (CAHLN) o CFIA – NCFAD o Federal/provincial/university laboratories

• Standardization provided through: o standardized SOPs, upgraded quality programs o standardized reagents, proficiency panels o initial set of high priority agents – AIV, ENDV, CSFV, FMDV, BSE

prion o compatible equipment for real-time PCR and ELISA o training of certified analysts o new or upgraded facilities – CL3, FAD (CL2+) o IT links in place for secure electronic messaging

• Safeguard animal health through: o routine surveillance capability o early detection, with confirmation by central reference lab o surge capacity

• rapid response • appropriate recovery

CAHSN Partner Laboratories: -Abbotsford -Edmonton -Saskatoon -Winnipeg -Ames, IA -Guelph -St-Hyacinthe -Plum Island, NY -Fredericton -Truro -Charlottetown -St. John’s -Mexico City, Mexico CFIA Laboratories

• Medicine Hat • Winnipeg • Ottawa • St-Hyacinthe • Charlottetown

-audited by a number of groups -66 000 cases per year, 818 000 procedures, about 1 million tests per year -do a lot of turkey testing at AHL, followed by poultry, bovine New AHL building

-combined federal and provincial funding -officially opened Oct. 7, 2010 -improved disease detection and emergency preparedness:

• much improved biosecurity of postmortem suite, restricted mammalian and wildlife/avian post mortem rooms

• FAD and TSE labs within the new building, rather than in portables • replacement of many pieces of major equipment • improved flexibility and surge capacity • replace incinerator with an alkaline digester • pneumatic tube delivery system (OVC-HSC to AHL Specimen Reception)

Alkaline tissue digester

• replacement for incinerator • destroys pathogens, including prions • installed August 2011 • operational Sept/Oct 2011 • engineering modifications performed, MOE approval • 5000 lb capacity

o 3000 lb sterile water sent to sanitary sewer o 2000 lb sterile solids to landfill

Diagnostics:

• Infection is not equal to disease • Fundamentals of establishing a diagnosis:

o Education and experience of practitioner o Relevant history o Clinical signs o Sample selection o Valid testing o Accurate diagnosis o Interventions → Outcomes

What is “diagnosis”? 1. The determination of the nature of a case of disease; 2. The art of distinguishing one disease from another Diagnostic Approaches

• pattern recognition, seasoned clinician • multiple-branching method of the delegate • exhaustion method of the novice • hypothetico-deductive – most widely used

Prerequisites to useful test results: • selection of appropriate samples • proper shipping and handling • selection of appropriate tests • testing by valid methods • valid interpretation of results

–"don’t ask the question unless you know what you’re going to do with the answer" What is your goal? (or better, what is your client’s goal?)

• individual disease event, outbreak investigation • surveillance

o proving freedom from disease support exports

o documenting prevalence of disease benchmark for disease eradication monitor progress of eradication

What do you want to prove?

• ‘not known to have the disease’ o we may not have looked intensively, properly, etc. o importer may use as a trade barrier

• ‘known not to have the disease’ o we have proof that we are free of disease X o exporter has a trade advantage

Process of assay validation -Want the assay to predict accurately the negative or positive infection status of an animal or herd.

1. feasibility - select method - ab, ag? 2. develop and standardize - analytical Sn and Sp, repeatability (analytical validation) 3. characterize performance - accuracy, precision, cut-off, diagnostic Sn & Sp (DSn & DSp +- CI) (field validation) 4. monitor performance for validity - estimate prevalence, calculate PPV and NPV 5. maintain/extend validation criteria

Selecting cut-off points -based on reference population

• visual inspection of frequency distribution - cross-over • receiver operating characteristic (ROC) analysis • mean of all negative values + 2 or 3 SD • select for preferred DSn or DSp

Beyond Koch’s postulates? 1. The microbe must be present in every case of the disease. 2. The microbe must be isolated from the diseased “host” and grown in a pure culture. 3. The disease must be reproduced when a pure culture is introduced to a non-diseased susceptible “host”. 4. The microbe must be coverable from an experimentally infected host.

Proving causation A causal mechanism, or "sufficient cause" for a given disease, although appearing to be individual, typically requires the joint action of component causes Which test for an infectious agent? When? An array is tests is available: • the agent itself - agent/antigen detection • the body’s reaction to the agent - antibody detection AHL User’s Guide and Fee Schedule offers guidance on test selection •each test (or other observation) is only one spoke in the diagnostic wheel •with high DSn, or a lowered cut-off for surveillance, expect false-positives –then rely on confirmatory testing with high DSp Animal Health Strategic Investment (AHSI) "This includes activities aimed at providing Ontario with improved methods to address an animal health crisis: •new tests for emerging diseases, •baseline surveillance for the early detection of emerging hazards, •development and testing of emergency and business continuity plans for the Animal Health Laboratory." •OMAFRA, $7.5 million over 5 years, 2008-2013 •5 calls for proposals, spring/summer/fall 2009, winter/fall 2010 –53 projects funded, $4.8 M –involved 1 post-doc, 7 PhD students, 1 DVSc student, 8 MSc students, 14 summer or part-time students –primary focus of projects: •surveillance, 31 •new test development, 21 •emergency preparedness,1 •Method development –equipment and method development estimated at $1.2M –~100 tests developed or modified •Enhanced surveillance - fund $250K of additional testing •Emergency preparedness –participated in FBCC poultry disease outbreak simulation in June 2010 to test surge capacity in the Avian Virology – Immunology Lab –participated in OPIC/OSHAB swine disease simulation, Sept, 2011, to test AHL necropsy lab emergency preparedness –small ruminant (sheep/goat) disease simulation, fall 2012

o AHSI funding ended April 30, 2013 o wrap-up forum, November 8, 2012, Holiday Inn, Guelph o presentations, posters o publication o AHSI magazine is posted at: http://www.uoguelph.ca/omafra_partnership/en/partnershipprograms/resources/AHSIMagazine_June06_WEB2.pdf

Bringing new equipment/facilities on-line • ELISA robot • Luminex – multiplex ELISA and PCR • MALDI-TOF – bacterial speciation • nucleic acid extraction robots • GS Jr – gene sequencing • pneumatic tube delivery system • alkaline tissue digester • FAD lab, room 2811 • TSE lab, room 1822 MALDI-TOF MS = matrix-assisted laser-desorption- ionization – time-of-flight mass spectrometer a. Compares a mass fingerprint profile to a database of the mass spectra of bacterial species b. 96 analyses in 20 minutes, $0.10/colony c. Saves a day in bacterial speciation GS Junior •virus identification by massively parallel sequencing •100,000 reads x 500 bp, 10 hrs •unbiased detection of nucleic acids •sequence whole virus genomes •detect new viruses, in complex mixtures OSHAB PRRSV sequence project •Ontario Pork Industry Council – Swine Health Advisory Board •primary focus on mitigating impacts of, and eventually eradicating, PRRSV •participating clinics and producers sign waivers to share information on matches •AHL does sequence analysis and generates homology (sequence distance) tables and phylogenetic trees to demonstrate similarities of viruses in outbreaks, and maintains a central database •>600 sequences in the database 2013-18 Disease Surveillance Plan - DSP Vision : Provide value to stakeholders through an effective and sustainable animal health network Objectives: 1. Develop an overall plan for the Ontario Animal Health Network (OAHN), and engage stakeholders. 2. Enhance Ontario animal disease surveillance. 3. Integrate Ontario animal disease surveillance with national surveillance (CAHSN).

4. Develop enhanced laboratory tools for early disease detection and surge capacity. Enhancing Ontario Surveillance

• Develop a surveillance expert network, based largely on the RAIZO system in Quebec

• Purpose: share animal health expertise and information • Set up for each commodity:

o bovine o swine o poultry o equine o bees o fish o small ruminants o wildlife/zoo o companion animal/public health

• Each expert network will include: o animal health network coordinator o species specialists - 1 each from OMAF, AHL, and OVC o up to 3 private veterinarians selected based on input from the

species-specific veterinary association Evolution of testing •from basic culturing through to gene sequencing •central labs

–multiplexing, internal controls, validation, QC •alternative samples - oral fluids •pen-side tests Can we succeed with less-than-perfect tests? 1. Yes, look at the success of brucellosis and tuberculosis eradication programs in Canada. 2. Remember that no test is perfect or free-standing - only ‘one spoke in the wheel’. 3. Incorporate testing as an integral part of a management protocol. Good news •increased awareness among laboratorians of the need for, and the complexity of, test validation •increased awareness among clinicians of critical assessment of test results •increased inter-laboratory collaboration

–OIE, AAVLD/NAHLN, CAHSN/CAHLN, Vet-LRN Goat Scrapie and Other Prion Diseases in Canada Gordon Mitchell, DVM, PhD National and OIE Reference Laboratory for Scrapie and CWD, Ottawa Laboratory

Fallowfield, Ottawa, Canada June 6, 2014

• 1938 - goat scrapie reported in Canada • Chronic Wasting Disease (CWD) - US, Canada (1996) & South Korea • Bovine Spongiform Encephalopathy (BSE) can cross species barriers

o First Canadian case in 2003 Prions

• protein only hypothesis • normal prion protein (PrPc) expressed in many cells • abnormally folded prion protein (PrPSc) converts PrPc to PrPSc which

accumulates causing neurodegenerative disease • no immune or inflammatory response

Prion Primer

• Prolonging Incubation Period o Clinical signs develop late --> shedding

• Environmental Persistence o Binding to soil, minerals o Resistance to digestion, acid, base, heat, cold o Infectivity after years (16 years) o Absence of immune or inflammatory response o Lesions confined to the CNS o Progressive, fatal neurological disease

Prion Primer

• Susceptibility to infection depends on: o age of infection o route o dose o prion strain o breed o PrPc Genetics (PRNP)

-most definite way to transmit disease is putting it directly in the brain Scrapie

• 1st described: 1732 • 1st reported in Canada: 1938 • Reportable since: 1945 • Surveillance and Eradication program since 2005

o Active - detect pre-clinical cases and trace • U.S goal to be scrapie free by 2017

Clinical Signs - Classical Scrapie (Considerable variability)

• Tremors, Incoordination, Wasting • Behavioural (apprehension, aggression) • Teeth grinding, licking • Pruritis → Wool loss • Nibbling reflect • Clinical course 1-6 months

• Incubation period 2-5 years • Rare signs before 18 months • 3-5% annual herd mortality up to 20%

Clinical Signs - Atypical Scrapie

• Vague or absent signs • Ataxia, emaciation possible • Pruritis not a feature • Older animals: 5->10 years • No PrPSc in lymphoid tissues • Genetic resistance to Classical scrapie (ARR)

Chronic Wasting Disease (CWD)

• 14 States, 2 Canadian provinces, Korea • 1996 first identified in Canadian elk • Eradication initiated in 2000, changes pending • Only TSE with wildlife reservoir • Natural transmission in 4 cervid species: White-Tailed Deer, Mule Deer, Elk,

Moose • Experimental transmission in others: Fallow deer, Red deer, Reindeer

Clinical signs - CWD

• Isolation, somnolence • Hyper-excitability • Ataxia, Paralysis • Uneven haircoat • Teeth grinding, drooling • Difficult swallowing • Emaciation, wasting • PU/PD, Pneumonia • Clinical course acute or weeks to months • Onset ~3-4 years • Can be ~16-18 months

CWD Necropsy Findings

• Depleted fat stores • Muscle wasting • Frothy rumen contents • Aspiration pneumonia • No gross brain lesions

Final Diagnosis of Scrapie and CWD

• Clinical signs and necropsy findings are nonspecific • Rule-outs include:

o Ectoparasites (lice, mites) o Malnutrition o Hypomagnesaemia o Pregnancy toxemia o Sarcocystosis

o Rabies o Listeriosis o Maedi-visna o Pseudorabies

• Diagnostic testing required for confirmation Why Control prion diseases? Cons:

• Costs - Surveillance, Diagnosis, Control, Compensation • Destruction of healthy animals • Government control • No risk to human health (Scrapie, CWD)

Pros:

• Trade/market access barrier to export • Partners (EU/US) engaged in eradication • Animal welfare • Environmental accumulation - future problems • Impossible to rule out human health implications

o Strain mutation, host range, increased exposure, in vitro studies National Scrapie Eradication Program

• Import controls • Education • Animal ID/traceability • Surveillance • Mandatory Disease Control Actions on Infected Premises • Voluntary Scrapie Flock Certification Program

National CWD Control Program

• Eradication no longer an option • Various control options being explored

National and OIE Reference Laboratory for Scrapie and CWD:

• 2 Veterinary Pathologists, 2 Scientists, 6 Technicians, 1 Summer Student • Diagnostic Testing

o Rapid Testing: ELISA (Scrapie, CWD, BSE) o Confirmatory Tests: Immunohistochemistry & Western

Immunoblotting (Scrapie, CWD) o Additional Tests: Rodent bioassay, Ovine PrP genotyping, Strain

discrimination, SRM detection in meat • Research

o Improved or novel detection methods o Transmission and pathogenesis studies o Environmental persistence o Strain characterization

Diagnostic Testing: Scrapie, CWD, BSE

• Sample collection - Obex

Goat Scrapie • Goats of the world (millions)

o Asia, Africa - 800 o Europe - 13 o USA - 3 o Canada - 0.3

• 1939 - 1st experimental transmission and 1st natural case in France 1942 • Goats, naturally infected with classical and atypical scrapie and BSE

Goat Scrapie Clinical Signs

• Significant variability in clinical sign but assess for: o postural and gait abnormalities (tremors, ataxia) o signs of pruritus (scratch test, hair loss) o visual impairment (menace)

Goats - PRNP Genetics

• 25 amino acid substitutions • Some potentially protective

Canadian Goat Scrapie

• 1973: Quebec → 7 yr old goat on a farm with sheep scrapie cases • 2007: Ontario → mature goat from farm with sheep scrapie cases • 2013: Ontario → mature goat with suspicious clinical signs from a large dairy

goat operation - no known ties to sheep scrapie cases • 2013: Herd in Northern Ontario

o 482 Dairy goats - Saanen and British Saanen o Indoor housing, 2 large barns o No history of sheep housed on site o Unclear genetic susceptibility linkage in goats o Depopulate all animals >12 months of age = 315 o Obex, LN, blood, rectum o 15 clinical suspects transported to OLF o ELISA Results: 315 animals tested; 60 positive, 255 negative o IHC Results: 60 animals confirmed o RAMALT of Positive Goats: 55 tested; 8 negative, 47 positive

Goats for further study

• 15 goats transported to OLF prior to depopulation • 9 euthanized over last 6 months:

o 4 positive - clinical signs of scrapie 3 in mid to late gestation

o 5 negative - various medical reasons Future Plans:

• Survey remaining RAMALT from negative animals • Sequencing of PRNP for polymorphisms • Evaluation of ultrasensitive tests on blood

• Characterize PrP deposition in adult and fetal/placental tissues collected at necropsy

• Strain characterization studies Tribunal Cases and the Health of Animals Act Andrea Horton, Counsel Monique Brand, Counsel Agriculture and Food Inspection Legal Services Unit June 6, 2014 Intro:

• Agriculture and Food Inspection Legal Services Unit = Department of Justice legal services unit that provides assistance to AAFC and CFIA

• Act on behalf of Minister of Justice as official legal advisor to CFIA and Department of Agriculture on all matter of law connected with its operations

• Operates with full bilingual capability • Lawyers cover both common law and civil law regimes

• Provide the following services to CFIA:

o General advice - all Operations issues, including recalls, and questions from Programs

o Contracts & MOUs o Information sharing o Labour and employment law o Access to information & privacy o Represent CFIA before AMPS Review Tribunal o Advice to EIS o Area management team member o Support Justice litigation counsel and Crown agents o Conduct litigation, subject to workload limitations and conflicts of

interest o Support in development of regulations and legislative initiatives

• Legal assistance may be required in circumstances such as:

o where an interpretation of law or legal principles is required o where legal issues are raised in correspondence or other

communication o where concerns exist regarding how legislation should be

understood or applied o where policies that may have legal implications (most do) are under

development o where an Agency employee is contacted by a lawyer about Agency

activities o where there is the possibility that litigation will be commenced

against the Agency

• In May 2014, new process for requesting legal advice introduced in Ontario through email

• Each new request for legal assistance should contain the following

documents/information: o A. Requestor o B. Facts / Current Situation / Issues o C. Program Involvement o D. Time-frame and Justification o E. CFIA Priority o F. Counsel Previously Consulted o G. Attachments

• Who can request legal advice?

o First, seek support and engage management and programs within the line function

o Requests related to program development or issues management should be made by an Inspection Manager or Area Program Specialist with approval from the RD or Program Manager

• Overview of the Review Tribunal process:

o Notice of Violation o Request for Review of the Notice by the recipient (called the

Applicant before the Tribunal) o Preparation for Hearing o Hearing o Testimony before the Tribunal o Veterinarian will be qualified as an expert witness, where they will

be able to give their opinion o Important to be consistent with any other CFIA veterinarians

testifying o Cross examination by Applicant (or his/her counsel) o Redirect o Decision o Judicial Review Application

Notices under the Health of Animals Act (HAA)

• HAA - section 18 o Removal of Imports

• HAA - section 48 o Disposal of affected or contaminated animals and things

• Challenge to Notices - judicial review application (with or without a motion for an injunction)

• Discuss: best practices in situations such as the ones discussed Testifying

• What to do if you receive a subpoena or summons:

o contact your supervisor and legal services o testimony or document production o Crown immunity o date requirements

• TIPS: o You’re under oath. Honesty is the best policy. o Be sure that you understand the question before you answer. o Don’t guess. If you don’t know, it’s perfectly acceptable to say that

you don’t know. o Take your time. Give the question as much thought as it requires

before answering. o Answer the question that is asked and then stop. o Give an audible answer. Don’t nod or shake your head yes or no. o Talk loudly enough so that everybody can hear you. o Don’t look to your lawyer for help when you’re on the stand.

You’re on your own. o Beware of questions involving distances or time. If you give an

estimate, be sure that everyone understands that you are estimating.

o Don’t fence or argue with the lawyer on the other side. o Avoid joking and wise cracks. A hearing is a serious matter. o Be courteous. Don’t lose your temper no matter how hard you

are pressed. Lose your temper and you may lose your case. o Look the chairperson in the eye and tell your story. They

are naturally sympathetic to a witness and want to hear what he/she has to say.

Jan Sargeant: what diseases should we study?

- as health professionals there are a large number of diseases of potential concern- and limited time and resources to address them… therefore we must prioritize- But how (and why?)

- why prioritize? control and prevention, preparedness and response o need to consider costs, mortality, impact on economics (trade etc.),

prevalence - STEPS

o identify the measurable criteria to assess zoonotic diseases § high-risk groups (humans and animals for all) § control measures § socio-economic burden § disease trend § severity § duration § case-fatailty § incidence § transmission potential § scientific information

o conjoint analysis- public, health practitioners and animal practitioners did online survey. Survey takers are given a choice task made of a series of combinations (choose one from three choices, each choice has 3 criteria) this helps you understand the importance of the different criteria

o get relative weighting for each level (none, low, med high) of every criteria

Criteria to prioritize:

- economics - fatalities/mortalities (human and animal) - prevalence (animals/ humans) - contagious - mode of transmission/mobility - possible treatment - prevention methods (availability of vaccine) - geographical distribution - mutation potential - known or emerging disease - morbidity - incubation period - age segregation of people affected - etiology - pathogenicity

Rob Foster- Pathology Update

Diseases of note for 2014: - bluetongue virus- Europe - Contagious equine metritis - Schmallenburg virus - Middle easy respiratory syndrome coronavirus (MERS-CoV)- camels - H9N7 LPAI China - Henipavirus in rats in China (Mojiang Virus) - Ebola Virus disease jump to West Africa - Pneumonic plague hits Madagascar - PED, Deltacoronavirus in USA then Canada

The daily grind for health workers- is this a reportable disease? Is this a notifiable disease (immediate or annual)? Is this likely to affect human health? Into which category does this fit? Organ response to injury- inflammation, regeneration and scar formation. Cell response to injury- permanent cells (post mitotic)- can not regenerate. Stable cells types can regenerate if need be, labile cells (epithelial cells, bone marrow, round cells-lymphocytes) regenerate constantly

Where to start- - facts- write them down

- patient details (species, breed, age) - what parts affected- body, organs, tissues? - What are lesions like? - Differential Diagnosis