Utilizing a combination of molecular and spatial tools to assess the effect of a public health intervention

Muellner, P., Marshall, J. C., Spencer, S. E. F., Noble, A. D., Shadbolt, T., Collins-Emerson, J. M., Midwinter, A. C., Carter, P. E., Pirie, R., Wilson, D. J., Campbell, D. M., Stevenson, M. A. and N. P. French (2011)
Preventive Veterinary Medicine 102: 242-253.

Until recently New Zealand had one of the highest rates of human campylobacteriosis reported by industrialised countries. Since the introduction of a range of control measures in the poultry production chain a reduction in human cases of around 50% has been observed nationwide. To inform risk managers a combination of spatial, temporal and molecular tools - including minimum spanning trees, risk surfaces, rarefaction analysis and dynamic source attribution modelling - was used in this study to formally evaluate the reduction in disease risk that occurred after the implementation of control measures in the poultry industry. Utilizing data from a sentinel surveillance site in the Manawatu region of New Zealand, our analyses demonstrated a reduction in disease risk attributable to a reduction in the number of poultry-associated campylobacteriosis cases. Before the implementation of interventions poultry-associated cases were more prevalent in urban than rural areas, whereas for ruminant-associated cases the reverse was evident. In addition to the overall reduction in prevalence, this study also showed stronger effect in urban areas where poultry sources were more dominant. Overall a combination of molecular and spatial tools has provided evidence that the interventions aimed at reducing Campylobacter contamination of poultry were successful in reducing poultry-associated disease and this will inform the development of future control strategies.