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Volume 18, Number 4—April 2012
Online Report
Peer Reviewed Report Available Online Only

Multidisciplinary and Evidence-based Method for Prioritizing Diseases of Food-producing Animals and Zoonoses

Marie-France Humblet1, Sébastien Vandeputte1, Adelin Albert, Christiane Gosset, Nathalie Kirschvink, Eric Haubruge, Fabienne Fecher-Bourgeois, Paul-Pierre Pastoret, and Claude SaegermanComments to Author 
Author affiliations: University of Liege, Liege, Belgium (M.-F. Humblet, S. Vandeputte, A. Albert, C. Gosset, F. Fecher-Bourgeois, C. Saegerman); University of Namur, Namur, Belgium (N. Kirschvink); University of Liege, Gembloux, Belgium (E. Haubruge); Fontin, Belgium (P.-P. Pastoret)

Main Article

Table 2

Fifty-seven criteria used for ranking diseases of food-producing animals and zoonoses classified by category, Europe*

Epidemiology
Score
Ranking Criteria 0 1 2 3 4 5 6 7
1 Illness rate, %   <1 1–10 11–30 31–50 51–70 71–90 >90
2 Case-fatality rate, %   <1 1–10 11–30 31–50 51–70 71–90 >90
3 Agent specificity   1 host species 2 host species 3 host species 4 host species >4 host species    
4 Mode of transmission   No vector-borne transmission (not contagious) Contamination by direct contact Contamination by indirect contact Vector-borne transmission Airborne contamination    
5 Incubation period Not applicable: clinical disease never reported in species considered in the study <1 d 1–7 d 8–14 d 15–30 d 1–6 mo >6–12 mo >12 mo
6 Clinical course Not applicable: clinical disease never reported in species considered in the study <1 d 1–7 d 8–14 d 15–30 d 1–6 mo >6–12 mo >12 mo
7 Environmental persistence None: no persistence in the environment, no vector(s) or wildlife reservoir(s) identified Rare: anecdotal isolation in a potential vector(s) or the environment No data available on presence/survival of pathogenic agent in reservoir(s), vector(s) or the environment Wildlife reservoir(s)/vector(s): pathogen agent persistent in wildlife reservoir(s) and/or vector(s) Environment: agent naturally surviving in the environment (soil, water)      
8 Epizootic potential   Never: only sporadic cases, epizootics never reported Rare: most cases are sporadic; possibility of localized epizootic if conditions are ideal: e.g., abnormal multiplication of reservoir(s) and/or vector(s) Localized: pathogen characterized by localized epizootic potential essentially related to the transmission mode: e.g., food-borne diseases (Inter)national: epizootic characteristics well known after introduction, possibility of wide spatiotemporal expansion      
9 Evolutive characteristics of pathogen   Null: stability of pathogen, stable pathogen–vector(s)/pathogen–reservoir(s) relationships (no impact on pathogenicity) Rare: some mutations/reassortments observed but without any impact on pathogenicity, stable pathogen–vector(s)/pathogen–reservoir(s) relationships Moderate/not determined: pathogen not characterized for evolutive characteristics yet (recently discovered, limited means of study), mutations with limited consequences on its virulence; stable pathogen–vector(s)/pathogen–-reservoir(s) relationships Frequent: genetic variability during replication cycles more or less defined; variability of pathogenicity, species affected, reservoir(s), and vector(s) High: pathogen has a high mutation rate/frequent genetic reassortments and creation of new pathogenic variants at each cycle: variable pathogenicity, host(s), reservoir(s), and vector(s)    
10 Cattle Pathogen never reported as etiologic agent of clinical disease in that species Accidental: few clinical cases reported, only if conditions are favorable (wound, traumatism, favorable environmental conditions) Rare: clinical disease reported in few cases and no need for favorable conditions Occasional: clinical disease occasionally reported and no need for favorable conditions Frequent: clinical disease frequently reported in that species, but not specifically (multispecies pathogen) Specific: clinical disease only reported in that species Reservoir species  
11 Small ruminants Pathogen never reported as etiologic agent of clinical disease in that species Accidental: few clinical cases reported, only if conditions are favorable (wound, traumatism, favorable environmental conditions) Rare: clinical disease reported in few cases and no need for favorable conditions Occasional: clinical disease occasionally reported and no need for favorable conditions Frequent: clinical disease frequently reported in that species, but not specifically (multispecies pathogen) Specific: clinical disease only reported in that species Reservoir species  
12 Swine Pathogen never reported as etiologic agent of clinical disease in that species Accidental: few clinical cases reported, only if conditions are favorable (wound, favorable environmental conditions) Rare: clinical disease reported in few cases and no need for favorable conditions Occasional: clinical disease occasionally reported and no need for favorable conditions Frequent: clinical disease frequently reported in that species, but not specifically (multispecies pathogen) Specific: clinical disease only reported in that species Reservoir species  
13 Equine Pathogen never reported as etiologic agent of clinical disease in that species Accidental: few clinical cases reported, only if conditions are favorable (wound, traumatism, favorable environmental conditions) Rare: clinical disease reported in few cases and no need for favorable conditions Occasional: clinical disease occasionally reported and no need for favorable conditions Frequent: clinical disease frequently reported in that species, but not specifically (multispecies pathogen) Specific: clinical disease only reported in that species Reservoir species  
14 Poultry Pathogen never reported as etiologic agent of clinical disease in that species Accidental: few clinical cases reported, only if conditions are favorable (wound, traumatism, favorable environmental conditions) Rare: clinical disease reported in few cases and no need for favorable conditions Occasional: clinical disease occasionally reported and no need for favorable conditions Frequent: clinical disease frequently reported in that species, but not specifically (multispecies pathogen) Specific: clinical disease only reported in that species Reservoir species  
15 Lagomorphs Pathogen never reported as etiologic agent of clinical disease in that species Accidental: few clinical cases reported, only if conditions are favorable (wound, traumatism, favorable environmental conditions) Rare: clinical disease reported in few cases and no need for favorable conditions Occasional: clinical disease occasionally reported and no need for favorable conditions Frequent: clinical disease frequently reported in that species, but not specifically (multispecies pathogen) Specific: clinical disease only reported in that species Reservoir species  
16 Wildlife Pathogen never reported as etiologic agent of clinical disease in that species Accidental: few clinical cases reported, only if conditions are favorable (wound, traumatism, favorable environmental conditions) Rare: clinical disease reported in few cases and no need for favorable conditions Occasional: clinical disease occasionally reported and no need for favorable conditions Frequent: clinical disease frequently reported in that species, but not specifically (multispecies pathogen) Specific: clinical disease only reported in that species Reservoir species  
17 Presence/absence of vector(s) and/or reservoir(s) in EU Not vector-borne disease and/or no known reservoir Absence of vector(s)/reservoir(s) in EU Localized presence: reservoir(s) and/or vector(s) in a limited area of >1 member states Mediterranean region/northern Europe/central Europe: vector(s) and/or reservoir(s) in 1 of these 3 regions, each one covering several member states, presence linked to bioclimatic preferences Mediterranean region, northern Europe/northern Europe, central Europe: vector(s) and/or reservoir(s) in 1 of both regions according to bioclimatic preferences Generalized repartition: repartition of vector(s) and/or reservoir(s) in the entire EU (few bioclimatic specificities)    
Prevention–control Score
Ranking Criteria 0 1 2 3 4
1 Control of reservoir(s) and/or vector(s) Not applicable: no vector-borne transmission and/or no reservoir(s) known to date Effective: limited reservoir(s), easy to identify; effective control measures and trapping; reservoir(s)/vector(s) with limited demographic and geographic repartition; extensive scientific knowledge of vector(s)/reservoir(s); possibility of integrated control method Limited: limited reservoir(s), easy to identify; effective control measures and trapping but not applicable at a large scale; reservoir(s)/vector(s) with a limited demographic and geographic repartition; extensive scientific knowledge of vector(s)/reservoir(s); no integrated control method Possible but poorly/not effective: reservoirs easy to identify but numerous; control measures and trapping poorly effective (poorly active molecule(s); resistances and/or negative impact on environment); reservoir(s)/vector(s) with a limited demographic and geographic repartition; no scientific knowledge of vector(s)/reservoir(s); no integrated control method Absent/impossible: vector(s)/reservoir(s) not identified; no effective control measure against vector(s) (no active molecule, ineffective trapping); strong demography and/or wide repartition of vector(s) and/or reservoir(s); no scientific knowledge of vector(s)/reservoir(s); no integrated control method
2 Vaccination Not applicable: clinical disease never reported in species considered in the study Commercialized: commercial vaccine available on a global scale Local/monospecies: vaccine available at a regional/national scale and/or for a targeted species (not systematically available for a global control plan) Experimental: experimental vaccine, not commercialized; severe adverse reaction when applied; limited protector effect Absence: no vaccine available for use in species considered in the study, no experimental vaccine
3 Treatment Not applicable: clinical disease never reported in species considered in the study Available/effective: effective treatment available; recommended in cases of infection; economical and rational from a zootechnical point of view Available but not recommended: masks clinical course of disease; contrary to the control plan; not justified economically or from a zootechnical point of view Available but poorly/not effective: treatment with a limited effectiveness; severe adverse reactions; experimental or empirical treatment Absence: no effective treatment available, no experimental treatment available
4 Availability and quality of diagnostic tools   High: field test(s) available and easy to use, and highly discriminating sensitivity and specificity Moderate: tests only used in local/regional laboratories Low: tests only used in specialized laboratories/national reference laboratory Absence: no diagnostic tools available
5 Knowledge of pathogen   Very high: extensive scientific knowledge of pathogen, extensive scientific literature available on its biology: transmission mode, knowledge of vector(s), infectivity High: detailed scientific knowledge of pathogen but conflicting scientific results; some elements of pathogen biology are still not elucidated Moderate: limited scientific knowledge of pathogen because it is still being characterized; pathogen recently discovered/isolated but belonging to a well known and studied family of pathogens; pathogen characterized by multiple variants not characterized Low: no scientific knowledge of pathogen (multiplication, infectivity, incubation period, transmission mode); pathogen recently discovered or emerging
6 Effectiveness of control measures other than treatment, vaccination, and vector(s)/ reservoir(s) control   High: effectiveness of implemented control measures (quarantine, slaughter, and restriction area); effective epidemiologic investigation (origin of the infection rapidly identified and quick implementation of control measures) Moderate: effectiveness of implemented control measures (quarantine, slaughter, and restriction area); epidemiologic investigation poorly conclusive (incomplete traceability of animals and by-products) Low: limitation of control measures implemented (quarantine, slaughter, and restriction area), limiting dissemination of pathogen; epidemiologic investigation inconclusive Null: ineffectiveness of implemented control measures (quarantine, slaughter, and restriction area) and/or control measures not indicated because of characteristics of pathogen; epidemiologic investigation inconclusive
7 Effectiveness of prevention other than vaccination and control of vector(s)/ reservoir(s)   High: sanitary certificate; effective traceability of animals and by-products; effective disinfection measures; no contact between domestic and wild animals; effective biosecurity measures Moderate: no sanitary certificate; effective traceability of animals and by-products; effective disinfection measures; limited or incomplete possibilities to restrict contacts between domestic and wild animals; effective biosecurity measures Low: no sanitary certificate; incomplete traceability of animals and by-products; ineffective disinfection measures; incomplete restriction of contacts between domestic and wild animals; ineffective biosecurity measures Null: no sanitary certificate; no traceability of animals and by-products; ineffective disinfection measures; no restriction of contact between domestic and wild animals; ineffective biosecurity measures
8 Surveillance of pathogen   Generalized: surveillance implemented by all EU member states (even worldwide surveillance) Member states at risk: surveillance of pathogen in >1 neighboring member states and in those where epizootics were recently reported Outside EU: pathogen surveyed in non-EU regions Absent: no surveillance of pathogen
Economy/trade Score
Ranking Criteria 0 1 2 3
Individual data (herd/farmer)        
1 Losses of productivity (milk, eggs, growth) Null: no impact on animal productivity Low: losses of productivity <20% Moderate: losses of productivity of 20%–50% Severe: losses of productivity >50%
2 Additional costs: mandatory slaughtering Not required Outbreaks only Outbreaks and restriction areas  
  Additional costs: treatment, disinfection   Low: treatment not required (e.g., slaughtering justified from an economic point of view) or absent (virus), application of basic sanitary measures (disinfection, footbath) Moderate: spontaneous resolution of cases, only the animals with serious clinical signs require treatment, application of basic sanitary measures (disinfection, footbath) High: systematic treatment of animals with clinical signs; application of stricter sanitary measures
3 Additional costs: vaccination   Low: no vaccination advocated or no vaccination available Moderate: vaccination not mandatory but possible in particular cases, e.g., avian sector High: mandatory vaccination
Global (sector/market)        
4 Limitation of importation–exportation Absent: no impact on the importation/exportation of animal and/or by-products Local: restrictions of animal and/or by-products movements limited to surveillance areas implemented when an outbreak is confirmed Regional: animal and/or by-products movements limited in an area greater than the surveillance zone but only in 1 member state International: perturbation/limitation of importations/exportations of animal and by-products between several member states and/or between member states and countries outside the EU
5 Disturbance of supply and demand (decrease in prices) Absent: no impact on supply and demand Low: temporary disturbance of supply and demand in a limited area and low impact on prices Moderate: temporary disturbance of supply and demand and decrease in prices <30% in >1 member states High: major disturbance of supply and demand and decrease in prices >30% affecting several member states
6 Impact on related sectors (tourism, animal feeds) Absent: no impact on related sectors Low: turnover reduction <20% in >1 related sectors Moderate: turnover reduction 20%–50% in >1 related sectors High: turnover reduction >50% in >1 related sectors
7 Impact on cattle industry Absent: no impact on cattle industry Low: increased spends and/or decreased benefits <20% compared with situation before beginning of epizootics Moderate: increased spends and/or decreased benefits between 20% and 50% compared with situation before beginning of epizootics High: increased spends and/or decreased benefits >50% compared with situation before beginning of epizootics
7 Impact on small ruminants industry Absent: no impact on small ruminants industry Low: increased spends and/or decreased benefits <20% compared with situation before beginning of epizootics Moderate: increased spends and/or decreased benefits between 20% and 50% compared with situation before beginning of epizootics High: increased spends and/or decreased benefits >50% compared with situation before beginning of epizootics
7 Impact on swine industry Absent: no impact on swine industry Low: increased spends and/or decreased benefits <20% compared with situation before beginning of epizootics Moderate: increased spends and/or decreased benefits between 20% and 50% compared with situation before beginning of epizootics High: increased spends and/or decreased benefits >50% compared with situation before beginning of epizootics
7 Impact on equine industry Absent: no impact on equine industry Low: increased spends and/or decreased benefits <20% compared with situation before beginning of epizootics Moderate: increased spends and/or decreased benefits between 20% and 50% compared with situation before beginning of epizootics High: increased spends and/or decreased benefits >50% compared with situation before beginning of epizootics
7 Impact on poultry industry Absent: no impact on poultry industry Low: increased spends and/or decreased benefits <20% compared with situation before beginning of epizootics Moderate: increased spends and/or decreased benefits between 20% and 50% compared with situation before beginning of epizootics High: increased spends and/or decreased benefits >50% compared with situation before beginning of epizootics
  Impact on lagomorph industry Absent: no impact on poultry industry Low: increased spends and/or decreased benefits <20% compared with situation before beginning of epizootics Moderate: increased spends and/or decreased benefits between 20% and 50% compared with situation before beginning of epizootics High: increased spends and/or decreased benefits >50% compared with situation before beginning of epizootics
7 Impact on wildlife industry Absent: no impact on wildlife industry Low: increased spends and/or decreased benefits <20% compared with situation before beginning of epizootics Moderate: increased spends and/or decreased benefits between 20% and 50% compared with situation before beginning of epizootics High: increased spends and/or decreased benefits >50% compared with situation before beginning of epizootics
Cost of disease in humans        
8 Zoonotic impact (cost of illness) Absent: nonzoonotic or common† disease Low: medical consultation facultative, hospitalization not required, treatment for most severe clinical cases with conventional drugs, maximum incapacity 7 d Moderate: medical consultation necessary, hospitalization of most severe clinical cases, systematic and adapted treatment with conventional drugs, incapacity 8–4 d High: medical consultation necessary, systematic hospitalization but of variable duration, required and adapted treatment with second line drugs, incapacity >14 d, quarantine may be required
9 Zoonotic impact (costs of prevention per person) Absent: nonzoonotic or common disease Low: vaccination not advocated, simple and low-cost preventive measures (handwashing, mask carrying, insect repellents) Moderate: vaccination of populations at risk (YOPI), simple and low-cost preventive measures (handwashing, mask carrying, insect repellents) High: generalized vaccination recommended, restricting and expensive preventive measures (thermograph, quarantine, home containment)
Public health Score
Ranking Criteria 0 1 2 3 4 5 6 7
1 Zoonotic/ common agent† Not zoonotic or common Accidental: human clinical disease only when favorable conditions are set (YOPI, high infection pressure, practices at risk, unusual transmission route) Rare: human clinical disease reported in a minority of cases, without necessity of favorable conditions Frequent: clinical disease often reported in man (multi-species pathogen) without need for favorable conditions Systematic: clinical disease systematically reported in humans      
2 Classification of zoonoses Not zoonotic or common 1: transmission from wild animals to humans 1+: transmission from wild animals to humans with further human-to-human transmission(s) 2: transmission from wild animals to domestic animals to humans 2+: transmission from wild animals to domestic animals to humans, and further human-to-human transmission(s)      
3 Disease knowledge in humans Not zoonotic or common Very high: deep scientific knowledge of pathogen, extensive scientific literature available on its biology: transmission mode, knowledge on vector(s), infectivity High: detailed scientific knowledge of pathogen but conflicting scientific results; some elements of pathogen biology are still not elucidated Moderate: limited scientific knowledge of pathogen because it is still being characterized; pathogen recently discovered/isolated but belonging to a well-known and studied family of pathogens; pathogen has multiple variants not characterized Low: no scientific knowledge of pathogen (multiplication, infectivity, incubation period, transmission mode); pathogen agent recently discovered or emerging      
4 Illness rate, % Not zoonotic or common <1 1–10 11–30 31–50 51–70 71–90 >90
5 Case-fatality rate, % Not zoonotic or common <1 1–10 11–30 31–50 51–70 71–90 >90
6 Mode of contamination Not zoonotic or common No vector-borne transmission (not contagious) Contamination by direct contact Contamination by indirect contact Vector-borne transmission Airborne contamination    
7 Aftereffects or negative impact on the patients' quality of life Not zoonotic or common Null: no after effects Moderate: % disability <30% but no loss of autonomy Severe: after effects not enabling a professional activity but no loss of autonomy Very severe: unable to perform professional activities, loss of autonomy, and personal assistance necessary      
8 Control plan (vaccination, determination of populations at risk, surveillance of the disease, definition of areas at risk) Not zoonotic or common Worldwide (EU and other countries): international and coordinated control plan (member states and third-world countries) Generalized (EU): coordinated control plan implemented in all member states Targeted: coordinated control plan implemented in >1 member state(s) at risk Extracommunautary: absence of a control plan in EU but implemented in third-world countries Absent: no control plan elaborated and implemented    
9 Epidemic potential Not zoonotic or common Never: only sporadic cases, epidemics never reported Rare: most cases are sporadic but when favorable conditions are set, possibility of localized epidemics, e.g., abnormal multiplication of reservoir(s) and/or vector(s) Localized: pathogen characterized by localized epidemic; potential pathogenicity essentially related to transmission mode (e.g., food-borne diseases) (Inter)national: epidemic characteristics well known after introduction, possible a wide spatiotemporal expansion      
10 Vaccination Not zoonotic or common Commercialized: commercial vaccine available on a global scale Local/monospecies: vaccine available at a regional/national scale (not systematically available for a global control plan) Experimental: experimental vaccine, not commercially available; severe adverse reaction when applied; limited protector effect Absence: no commercially available or experimental vaccine      
11 Treatment Not zoonotic or common Existing/effective: effective treatment commercially available Available but not recommended: major side effects Available but poorly effective: treatment with limited effectiveness, partial resistance of pathogen or experimental treatment Absent: no commercially available or experimental treatment      
12 Availability and quality of diagnostic tools Not zoonotic or common High: field test(s) available and easy to use with highly discriminating sensitivity and specificity Moderate: tests only used in local/regional laboratory Low: tests only used in specialized laboratories/national reference laboratory Absence: no diagnostic tools available      
Society Score
Ranking Criteria 0 1 2 3 4
1 Lower human consumption of animals No: no impact on consumption Low: impact on consumption and a decrease <20% compared with previous consumption Moderate: impact on consumption and a decrease of 20%–50% compared with previous consumption High: impact on consumption and a decrease >50% compared with previous consumption  
2 Perception of problem by the consumer (problem poorly known or unknown, problem poorly controllable or uncontrollable, affects a sensitive public) Not zoonotic or common Null: clear perception by the consumer; problem well known, controllable, and no impact on the family; short-term effect; does not affect a sensitive public (children, pregnant women) Low: clear perception by the consumer; problem well known, controllable, and no impact on the family; long-term effect; does not affect a sensitive public (children, pregnant women) Moderate: clear perception by the consumer; problem poorly known, controllable, with an impact on the family; long-term effect; affects a sensitive public (children, pregnant women) High: bad perception by the consumer; problem poorly known, difficult to control, with an impact on the family; long-term effect; affects a sensitive public (children, pregnant women)
3 Potential impact of media Null: no impact of media on consuming habits Low: short-term and minor impact on consuming habits Moderate: long-term but minor impact on consuming habits High: major and long-lasting impact on consuming habits (rejection of a particular by-product)  
4 Impact on animal welfare and biodiversity Null: no impact on animal welfare and biodiversity: no slaughtering, no specific control measures applied to wildlife, no quarantine or containment of animals Low: no slaughtering but limited control measures and limited containment of species at risk (domestic and wild animals) Moderate: selective slaughtering of animals showing clinical signs in outbreaks, control and containment of species at risk (domestic and wild animals) High: systematic slaughtering of domestic and wild animals (outbreaks and surveillance zones), mandatory quarantine, containment of domestic animals at risk  

*EU, European Union; YOPI, young, old, pregnant, immunosuppressed.
†Common, pathogen able to cause a clinical disease in humans and animals but without a zoonotic characteristic (common source of contamination).

Main Article

1These authors contributed equally to this article.

Page created: February 17, 2012
Page updated: February 17, 2012
Page reviewed: February 17, 2012
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