1. Bovine tuberculosis (TB) in Italy: epidemiology and eradication Stefano Marangon

2. TB control in Italy Since 1964 bovine tuberculosis (TB) has been submitted to a national eradication programme in breeding herds (L. 615/64), which became compulsory in 1977 (DM 30/6/77) Current TB eradication programme based on EU (Council Directive 64/432/EEC, Annexes A, I and B) and Italian legislation (DM 592/95 and DLgs 196/99)

3. TB legislation DLgs 196/99 The provisions of Directive 64/432/ECC have been transposed in the Italian legislation These provisions define the rules for the intra- Community trade of live bovines and for TB eradication programmes

4. TB legislation DM 592/95 Measures to be enforced in affected holdings TB positive bovines shall be slaughtered movements of live animals are prohibited epidemiological investigation shall be carried out cleansing and disinfection must be guaranteed ………………………………………………………………. Rules for the compensation of bovines slaughtered in the affected premises

5. TB eradication programme: key points Single intradermal cervical tuberculin test (SICTT) Certification of officially-tuberculosis-free (OTF) herds Certification of OTF provinces/regions Movement control (identification and traceability system, pattern of cattle movement, possible application of risk modulating measures,……..) Risk-based surveillance programme

6. TB control: critical points Execution, reading and interpretation of the skin test Management of inconclusive skin tests Control of beef fattening herds Sanitary control of animals introduced from other OTF MS (??)

7. Risk-based surveillance: key points Close cooperation between National, Local Veterinary Services, Epidemiological Centre and Farmers Testing frequency in OTF (skin test every two, three or four years), modulated in different epi situations Tracing-back of TB lesions detected at the abattoir Data collection and information flow Epidemiological investigation

8. Carried out using a standard procedure (format) Tracing-back to identify the origin Tracing forward to identify newly infected herds Identification of TB risk factors in the Country

9. Risk-based surveillance Ireland: major factors associated with TB were introduction of cattle in the herd and presence of badgers Epidemiological studies carried out in other geographical areas indicated the possible involvement of wild species such as badgers, wild boars, deer Identification of TB risk factors, in order to modulate disease control measures

10. Most frequent origin of TB outbreaks in non-OTF areas in Italy Possible introduction of infected animals (illegal movement) Mixed herds (reproduction + fattening/dealers) Common pastures (cross-contamination)

11. Most frequent origin of TB outbreaks in OTF areas in Italy Latency (one case latency period of 10 years) Persistence of M. bovis in the environment (selective culling vs stamping out, disinfection?) Possible introduction of infected animals from OTF and non-OTF areas (Member States?) Promiscuity with goats (possible reservoir of infection?)

12. Rare causes of persistence, introduction or recurrence of TB Promiscuous transports or non disinfected means of transportation Contacts with non OTF cattle at market places and exhibitions Contacts between domestic animals and wildlife (e.g. wild boars) Contaminated whey (cheese factory) Farm workers

13. Programme coverage Prevalence Incidence Slaughterhouse submission rate Reactors with visible lesions (if many – failure to detect infection early by test) Testing history of infected herds (important in herds detected at slaughter: late detection) Human cases (may indicate undetected infection in animals) Performance indicators

14. a)No. of herds/animals b)No. of herds/animals tested c)No. of herds/animals positive d)No. of new herds positive Prevalence (c/b) Incidence (d/b) Coverage (b/a) Commission Decision 2008/940/EC

15. 6 million bovines

16. TB overview in Italy – OTF provinces

17. Tested herds and TB outbreaks in Italy (1995 - 2009)

18. TB outbreaks: prevalence and incidence (1995 - 2009) During the last three years the time to clear infected herds is decreasing

19. TB prevalence and incidence in non-OTF regions (1995 - 2009) Herd prevalence is slightly decreasing, whilst herd incidence is more or less the same

20. PUGLIA4,6074,4694,38883243 3.6198.191.890.55 SARDEGNA9,1365,6435,62916110 0.0099.750.,80.20 SICILIA10,84410,58510,5513912641 0.2699.683..12.50 TOSCANA2,104680 000 0.00100.000.00 UMBRIA4,0311,988 440 0.0100.000.20 VALLE D'AOSTA1,1991,124 1870 0.00100.001.600.62 Total110,78574,86173,95466640718 2.7098.790.900.55 Statistics in non-OTF regions (IT-2009): herds REGION total herds total eligible herds herds controlled positive herds new positive herds herds stamped out % positive herds stamped out Indicators coverage (%) Prevalence (%) Incidence (%) 1234567 8 = (7/5)x 100 9 = (4/3)x 100 10=(5/4)x 100 11=(6/4)x10 0 ABRUZZO4,5743,2452,809650 0.0086.560.210..18 BASILICATA3,1433,0483,00922123 13.6498.720.730.40 CALABRIA7,8276,794 49253 6.12100.000.720.37 CAMPANIA12,2979,7059,49642301 2.3897.850.440.32 LAZIO12,5877,6197,52823176 26.0998.810.310.23 LIGURIA1,7501,2271,225000 0.0099.840.00 LOMBARDIA13,6474,079 210 0.00100.000.050.02 MARCHE4,7691,9871,986000 0.0099.950.00 MOLISE3,1522,574 220 0.00100.000.08 PIEMONTE15,11810,094 851 12.50100.000.080.05

21. Statistics in non-OTF regions (IT-2009): animals REGIONTotal animalsAnimals to be examined Examined animals Examined animals individually Positive animals SlaughterIndicators Positive animals from slaughter or culling Slaughtered animals coverageP 123456789 =(4/3)x10010 =(6/4)x100 ABRUZZO37,181331843006230,0625312 90.59 %0.18 % BASILICATA89,419865918638986,3881279417899.77 %0.15 % CALABRIA117,064106976 106,976197196200100.00 %0.18 % CAMPANIA462,221429981411618369,6439589571,02595.73 %0.23 % LAZIO306,749273879273872273,872236223316100.00 %0.09 % LIGURIA15,813140951409214,09200099.98 %0.00 % LOMBARDIA1,370,946541453 541,453100100.00 %0.00 % MARCHE56,762473634726250,26200099.79 %0.00 % MOLISE49,08644606 44,80616 100.00 %0.04 % PIEMONTE794,086526060514779514,77935826036297.86 %0.07 % PUGLIA180,167179053176756177,261315 33998.72 %0.18 % SARDEGNA26540511686411631312468029 99.53 %0.02 % SICILIA380,255370,289368,489 4,3614,0254,64499.51 %1.18 % TOSCANA32,62817,114 22,387000100.00 %0.00 % UMBRIA65,67149,598 666100.00 %0.01 % VALLE D'AOSTA42,14030,221 42 100.00 %0.14 % Totale4,265,5932,867,3272,8296002,804,9696,6996,1757,16998.68 %0.24 %

22. Statistics in OTF regions/provinces (IT-2009) REGION Total cattleOTF herdsInfected herdsSingle Skin test pre - movement test N° animals with TB suspected lesions N° positive animals (isolation) herdsanimals herds% % skin test frequency tested animals ABRUZZO: Pescara83614,100836100.0000.00two years7633000 EMILIA ROMAGNA: whole Region 7,275470,3807,27199.9540.05two years263,60726,81852 FRIULI VENEZIA GIULIA: whole Region 2,48191,2972,48099.9610.04none02,86522 LOMBARDIA: Bergamo, Como, Lecco, Sondrio 4092199,2624,092100.0010.02 two years97,9656,13511 MARCHE: Ascoli Piceno70011,146700100.0000.00 two years5,87128200 PIEMONTE: Novara, Verbania e Vercelli 60411,2831,052174.1700.00 two years11,2831,25400 SARDEGNA: Oristano1,52364,6871,523100.0000.00 two years0000 TOSCANA: whole Region77626,283776100.0000.00 three years26,28365760 TRENTINO-ALTO ADIGE (BZ)8,538144,2958,538100.0000.00none20,2440140 TRENTINO-ALTO ADIGE (TN)1,50844,4401,50499.7340.27yearly38,5882,12300 VENETO: whole Region7,787325,4947,787100.0000.00three years0000 Total36,1201,402,66736,559101.22100.03 471,47440,134285

23. TB statistics (IT-2009) (OTF + non-OTF regions)

24. Cases reported at the abattoir (IT-2009) Region Animals slaughtered Notification form (10/33) * Herds notified (10/33) Herds notified and M bovis positive Abruzzo21,692441 Basilicata15,231111 Calabria46,779342927 Campania180,7308460 Emilia-Romagna412,063222 Lazio63,610322919 Liguria14,150000 Lombardia666,021771 Marche34,084000 Molise11,796111 Piemonte474,84710 1 Puglia54,1634234 Sardegna39,476542 Sicilia115,480312914 Toscana52,283111 Umbria27,605443 Valle d Aosta8,015440 Veneto697,292444

25. Conclusions TB eradication programmes should be: properly managed (updated register of farms and animals, information system,………) based on reliable testing procedures regularly monitored modulated according to the epidemiological situation