One Health

Background: Listeria monocytogenes causes invasive infections with high mortality. However, ecological studies linking human incidence to livestock and weather remain scarce. This retrospective study analyzed the geographical distribution of human listeriosis in Spain using nationwide hospitalization data, livestock censuses, and meteorological records. Methods: Negative binomial regression models, spatial autocorrelation (Moran's Index), and bivariate local indicators of spatial association (LISA) analysis were applied. Results: Between 2016 and 2024, 4,391 hospital admissions were recorded. The national mean incidence was 1.03 per 100,000 inhabitants, peaking in 2019. Bovine density was the primary environmental driver, with an 11% increased risk per 10 heads/km2. Weather-livestock synergies were observed: bovine-associated risk increased exponentially at higher temperatures ([~]21 C) and lower humidity (53%), whereas caprine-associated incidence peaked at cooler temperatures ([~]13 C). Spatial mapping revealed northern clusters for bovine reservoirs and southern segregation for caprine reservoirs, with no associations for ovine or porcine livestock. Conclusions: Zoonotic risk is environmentally conditioned, with weather acting as a biological trigger. This study highlights the critical role of ruminant farming practices and the need for a "One Health" surveillance approach that integrates meteorological and farming data to predict seasonal outbreaks and optimize food chain safety.

Antimicrobial resistance (AMR) is a critical One Health challenge at the interface of agriculture, the environment and human health. In Ireland, cattle production systems generate large volumes of manure and slurry, which are routinely applied to land. However, data on the prevalence and environmental persistence of clinically important resistance phenotypes remain limited. This study investigated the occurrence, characterisation and persistence of extended-spectrum {beta}-lactamase (ESBL) and carbapenemase-producing Enterobacterales (CPE), as well as fluoroquinolone-resistant bacteria on Irish cattle farms. A total of 450 pooled bovine faecal samples were collected from farms across 25 counties, screened using selective culture, antimicrobial susceptibility testing, and MALDI-TOF MS identification. Carbapenemase activity in presumptive CPE isolates was confirmed using phenotypic and biochemical assays, including MALDI-TOF MBT STAR analysis to demonstrate carbapenem hydrolysis. In parallel, a controlled persistence study evaluated the survival of phenotypically resistant ESBL and CPE bacteria in bovine slurry under simulated seasonal conditions. Overall, 29.6% of farms were positive for ESBL and/or CPE, with ESBL only resistance most prevalent (13.7%), followed by combined ESBL and CPE phenotypes (7.5%). Fluoroquinolone resistance was frequently detected and commonly co-occurred with {beta}-lactam resistance, indicating multidrug resistance. Escherichia coli was the dominant carrier of both ESBL and carbapenemase phenotypes. Persistence experiments demonstrated sustained phenotypic resistance in slurry for up to nine months under simulated winter conditions and up to three months during simulated summer conditions, with resistance becoming undetectable following extended verification. These findings demonstrate that clinically important AMR phenotypes are embedded within Irish cattle production systems and can persist in agricultural waste streams, highlighting slurry as a significant environmental reservoir with implications for environmental dissemination and One Health surveillance.

The 2026 Andes virus (ANDV) outbreak aboard the MV Hondius cruise ship resulted in 11 confirmed cases and 3 deaths and raised questions regarding the origin of infection, with much media focus resting on a landfill in Tierra del Fuego. We evaluated competing exposure hypotheses by assembling open data on reservoir host occurrences, rodent serosurveys, and historical ANDV outbreaks along with the index case's self-documented, publicly-posted citizen-science digital record of their movements. Historical outbreaks associated with human-to-human transmission were concentrated within a restricted region spanning southern Chile and adjacent western Argentina, coinciding with the distribution of the principal reservoir host, Oligoryzomys longicaudatus, and areas identified as elevated risk by multiple ecological and genetic models. The index case was documented within this transmission focus shortly before the putative exposure period. Together, our open data approach was able to rapidly locate initial exposure within the established ANDV transmission focus and develop scenarios to prioritise further epidemiological investigation.

Biological invasions by feral swine are among the most important drivers of ecological change worldwide, yet invasion dynamics remain poorly documented in tropical South America. In Brazil, the recent spread of wild boar and wild boar-domestic pig hybrids (javaporcos) overlaps with long-established populations of free-ranging feral pigs (porco-monteiro) in the Pantanal, creating a unique scenario of dual invasive lineages of Sus scrofa. We reconstructed the spatiotemporal invasion process of feral swine (S. scrofa) across the state of Mato Grosso do Sul (MS), Brazil, using historical occurrence records, captive-breeding data, landscape variables, detection frequencies, and occupancy estimates from 2007 to 2017. The invasion expanded from 29 municipalities (36.7% of the state) in 2007 to all 79 municipalities by 2017. During this period, at least 247 breeding facilities were identified across 59 municipalities, including numerous informal and clandestine operations involving wild boar and hybrids (javaporcos). Municipalities with the largest numbers of breeding facilities and reproductive stocks consistently coincided with areas of highest invasion intensity, indicating that propagule pressure from captive populations strongly influenced feral swine expansion. By 2017, invasive populations occupied approximately 3.2 million hectares (8.85% of the state territory), with the greatest occupancy concentrated in agricultural landscapes dominated by soybean, maize, sorghum, and sugarcane production. Detection frequency and occupied area were positively associated with croplands, exposed soil fields, and water-associated habitats, suggesting that agricultural mosaics linked by riparian corridors facilitate invasion and persistence. Conservative population estimates ranged from 11,850 to 47,400 individuals statewide, although carrying-capacity scenarios suggested populations could exceed 500,000 animals under favorable conditions. Detection patterns involving native peccaries (Tayassu pecari and Pecari tajacu) indicated differential coexistence responses to invasive swine, with collared peccaries apparently more sensitive to heavily invaded landscapes. Our findings demonstrate that feral swine expansion in central South America was driven by the interaction of anthropogenic propagule pressure, permissive governance, and highly suitable agricultural environments, highlighting the urgent need for coordinated monitoring, regulation of captive breeding, and large-scale adaptive control programs.

Leptospirosis is a globally important environmentally transmitted disease, with approximately one million cases and 60,000 deaths reported annually. In low-income urban communities, inadequate sanitation, drainage and waste management may increase human exposure to contaminated environments. This study investigated the influence of environmental engineering risk factors on Leptospira exposure in four disadvantaged urban communities (favelas) in Salvador, Brazil. A high-precision georeferenced field survey was developed to identify, map and characterise sanitation, stormwater drainage and solid waste infrastructure. Cross-sectional spatial analyses of baseline data were used to assess associations between environmental risk factors and the residential locations of individuals with anti-Leptospira antibodies. Seropositive individuals tended to reside closer to environmental risk factors and at lower relative elevations. Density analyses indicated that seropositive individuals tended to reside closer to inadequate or partially adequate sewerage components than to sewage-contaminated streams or open sewage points. Inadequate streets showed also showed high density peaks, suggesting that exposure may occur through frequent contact with contaminated runoff and standing water. In contrast, open waste dumping sites and vacant lots showed weaker and more diffuse spatial patterns. The findings highlight the importance of infrastructure quality shaping leptospirosis risk within urban informal settlements. The proposed methodology provides a practical approach for high-resolution characterisation of environmental exposure pathways and may support targeted engineering interventions and epidemiological investigations of leptospirosis and other environmentally transmitted diseases.

Background. Direct livestock exposure is a risk factor for zoonotic influenza, including H5N1 highly pathogenic avian influenza (HPAI) A virus. But whether living in regions of high poultry and swine production intensity (PPI, SPI) increases risk of exposure to zoonotic influenza viruses independent of occupational livestock contact remains unclear. Objectives. To determine whether livestock workers and community members with no occupational livestock exposure in North Carolina, where poultry and swine production are increasingly co-located, are at higher risk of exposure to zoonotic influenza. Methods. Saliva samples from industrial livestock operation worker (ILO-W), ILO neighbor (ILO-N) and metropolitan area (Metro) households were analyzed for mucosal influenza A (H5N1, H1N1, and H3N2) hemagglutinin (HA) IgA and IgG antibodies to determine associations of PPI, SPI, exposure group, and detection of a swine-specific fecal contamination marker (Pig-2-Bac DNA) with influenza A antibody levels. Results. Residing in the highest PPI and SPI tertile was associated with significantly higher mucosal H5 and H1 HA IgA levels, including among residents without occupational livestock exposure. Households with occupational poultry or swine contact had significantly higher H5 IgA and IgG and H1 IgA levels compared to Metro households. In regression models accounting for clustering at the participant level, log10 anti-H5 HA mucosal IgA increased 0.16 (95% CI: 0.06, 0.27, p<0.005) and 0.10 (95% CI: 0.03, 0.17, p<0.005), per log10 increase in PPI and SPI, respectively, and 0.16 (95% CI: 0.03, 0.19, p<0.02) when Pig-2-Bac DNA was detected on household surfaces. Conclusions. Mucosal H5 HA IgA and IgG and H1 HA IgA were consistently elevated across different metrics of livestock exposure intensity, including residential exposure, occupational contact within a household, and a molecular marker of household swine fecal contamination in a state with intensive poultry and swine production.

Antimicrobial resistance (AMR) is one of the greatest challenges within the One Health continuum. Exploring transmission routes between health domains and determining their driving forces are key priorities for future research. This effort can be effectively supported by landscape epidemiology, a field of science that integrates methods from landscape ecology and epidemiology to unravel the complex interdependencies behind disease transmission. This exploratory study aimed to demonstrate that landscape diversity and the degree of hemeroby (anthropogenic impact) correlate with the composition of bacterial communities and their AMR profiles. To test this hypothesis, submandibular lymph nodes from Cervidae and Suidae were collected to detect Staphylococcus and Mammaliicoccus bacteria and characterise their AMR features using selective culture and the VITEK 2 Compact automated system. As a result, the bacterial community in the more natural landscape was more diverse, characterised by the dominance of Mammaliicoccus sciuri and pan-susceptible isolates of Staphylococcus hyicus, and it displayed a low-level, heterogeneous AMR profile. Within the more hemerobic landscape, the bacterial community was characterised by the dominance of Staphylococcus epidermidis, a human-adapted species, and the AMR profile showed signs of higher antimicrobial pressure from both public health and veterinary origins. Although this study was based on only two study sites and was therefore not suitable for drawing definite conclusions, the findings suggest that human impact manifests itself in both bacterial and AMR profiles. A high prevalence of mammaliicocci and a heterogeneous AMR profile appeared to be indicators of naturalness. Conversely, the dominance of a human-adapted bacterial species and the accumulation of AMR features characteristic of medical environments likely indicate higher degrees of hemeroby.

Household environments in low-resource settings can become contaminated with fecal matter from multiple sources, including humans and domestic animals. Identifying the source of fecal contamination is critical for designing targeted interventions to reduce exposure to enteric pathogens, particularly for young children who bear the majority of the enteric disease burden. Using data from 140 households with children enrolled in the ECoMiD cohort study in northwestern coastal Ecuador, we (1) characterized source-specific fecal contamination in samples from household floors and maternal and child hands, and (2) identified animal-related and Water, Sanitation and Hygiene (WASH) conditions associated with the presence and concentrations of these markers. We used five qPCR-based microbial source tracking (MST) markers to detect fecal contamination from avian (GFD), canine (DG37), swine (Pig2Bac), ruminant (Rum2Bac), and human (HF183) sources. Prevalence ratios (PR) and mean differences comparing the presence/absence and concentration, respectively, of MST markers between households with and without each animal-related or WASH condition were estimated using generalized linear models with Poisson and Gaussian distributions. Animal MST markers tracked strongly with several animal-related conditions, whereas associations between the human MST marker and household demographic and WASH conditions were more limited. Animal ownership (PR 1.53; 95% CI: 1.04-2.26) was associated with higher prevalence of animal MST markers on floors. Households reporting animal feces indoors had higher prevalence of animal MST markers on floors (PR 1.84; 95% CI: 1.17-2.89), and higher concentrations of animal MST markers on child hands (mean difference 0.27 gene copies (gc)/m2; 95% CI: 0.12-0.41) and maternal hands (mean difference 0.10 gc/m2; CI: 0.02-0.18). Animal feces left unremoved outside the home were associated with higher prevalence of animal MST markers on maternal hands (PR 2.31; 95% CI: 1.11-4.81). Mothers reporting direct contact with animals had higher concentrations of animal MST markers on their children hands (mean difference 0.12 gc/m2; 95% CI: 0.02-0.21). Higher FECEZ scores, an overall metric for animal exposure, were associated with higher prevalence of animal MST markers on maternal hands (PR 2.94; 95% CI: 1.17-7.40). For human fecal contamination, the presence of E. coli on child hands was associated with higher prevalence of human MST markers on floors (PR 1.30; 95% CI: 1.00-1.68). Our findings reinforce household floors and maternal and child hands as key reservoirs of fecal contamination and point to future potential targets worth exploring for interventions in similar high-burden settings.

Understanding the vertebrate hosts exploited by Culicoides biting midges is fundamental to assessing the transmission risk of livestock arboviruses. Blood meal analysis provides direct evidence of host-vector interactions under natural conditions; however, molecular data on Culicoides host feeding are lacking in Ireland. This study aimed to identify the vertebrate blood meal hosts of Culicoides species of veterinary importance and establish host-vector associations relevant to arbovirus transmission. A total of 115 morphologically blood-fed Culicoides females collected from 13 sites across Ireland were analysed using a sequential molecular workflow. Species-specific real-time PCR assays were used to screen for vertebrate hosts, with positive detections confirmed by mitochondrial DNA sequencing. Blood-fed Culicoides were subsequently identified to species level using DNA barcoding, enabling direct linkage between vector species and their vertebrate hosts. Vertebrate DNA was detected in 50 specimens, with cattle and horses accounting for the majority of identified blood meals. Culicoides obsoletus accounted for most cattle (n = 12) and horse (n = 11) blood meals. Culicoides scoticus fed on cattle (n = 6), horses (n = 4) and sheep (n = 1), while C. dewulfi and C. chiopterus fed predominantly on cattle, with occasional horse blood meals. Four cattle blood meals were identified from C. punctatus. No cervid-derived blood meals were detected. This study provides the first molecular characterisation of Culicoides blood meal hosts in Ireland, confirming host-vector associations between major vector species and livestock hosts of veterinary importance. Although the number of successfully characterised blood meals was modest, reflecting the inherent difficulty of recovering recently blood-fed Culicoides from field collections, the findings establish an important baseline for Ireland. The sequential molecular workflow provides a practical framework for future blood meal investigations and will support improved understanding of host-vector interactions relevant to arbovirus surveillance and risk assessment.

The emergence of Highly Pathogenic Avian Influenza (HPAI 2.3.4.4b) in dairy herds in 2024 across 19 states in the United States of America has raised concerns regarding the potential national and global zoonotic impact. All recent modeling efforts implemented homogenous cattle-to-cattle (both intra and inter-herd) transmission models which did not capture the real-world heterogeneity in mixing of animals, individual variations in susceptibility and infectiousness and clinical incidences across pens and lactation groups. The aim of this study was to develop a heterogenous transmission model to estimate the epidemiological parameters for intra-herd HPAI transmission on Californian dairies. We developed a validated stochastic agent-based model to estimate the epidemiological parameters for intra-herd HPAI transmission on California dairies. The hierarchical agent-based model also parameterized stochastic cattle movements within-herd to simulate real dairy management practices. A cow-level SEIR transmission approach was assumed during the outbreak. A novel Bayesian Optimizer with Gaussian Process (BO-GP) was fitted to the agent-based model for validation which converged within 25-40 iterations (out of 100 per farm) with minimal loss over two distinct error metrics, namely, Poisson loss function and temporal distance metric. Our optimized simulations estimated an average R0 was around 10.7-10.8 across all farms within the first 15 days of observed outbreak on four dairy farms with a mean effective transmission rate of 4.5% per contact between susceptible and infectious cows within each pen. Our model demonstrated that the movement of cows between pens ensured localized clusters of outbreaks within the sub-herds (pen population) that prolonged the overall outbreak within farms. We estimated the total duration of infection between 14.5 and 28 days, which is higher than the estimates from the homogenous models. With an integrated hierarchical agent-based model combined with Bayesian approximation, we produced actionable insights on the epidemiology of intra-farm spread of HPAI within cow herds, thereby guiding both future model development and applied disease control strategy.

Introduction: Antimicrobial resistance poses a major global health threat, yet evidence on its economic impact in low- and middle-income countries remains limited. This study estimated the economic burden of infections caused by ESBL-producing Escherichia coli (E. coli), a key resistant pathogen, in Laos. Methods: A prospective cost-of-illness study was conducted among patients with laboratory-confirmed infections in Setthathirath hospital in Vientiane, Laos, collecting cost data through repeated interviews and medical records. Descriptive analyses and econometric modeling approaches, including inverse probability weighting (IPW) and instrumental variable (IV) analyses, were used to estimate out-of-pocket expenditures, public expenditures, total cost of illness, and length of stay, accounting for potential confounding. Results: ESBL-producing E. coli was consistently associated with higher economic burden across all analyses. The unadjusted per-patient cost was US$ 689.0 for ESBL-producing E. coli, compared with US$ 489.4 for non-ESBL-producing E. coli and US$ 537.6 for non-E. coli. The association remained statistically significant for out-of-pocket cost after IPW-adjustment (US$156.2; 95% CI, 14.3 to 298.1; P = 0.03), while other outcomes were not statistically significant. Instrumental variable analyses showed consistent directional effects but with wide confidence intervals and no statistically significant differences. Conclusions: Findings suggest that ESBL-producing E. coli may be associated with increased economic burden in Laos; however, this association was not consistently statistically robust across analytical approaches. These findings suggest a potential economic impact of ESBL infection, although uncertainty remains regarding the magnitude of the effect. Strengthening antimicrobial stewardship, infection prevention and control, and improved diagnostic capacity remain essential to mitigate the potential AMR burden.

We live in an era where advances in microbial detection, DNA sequencing technology, and the availability of big data have allowed inroads to the field of predictive microbiology. The tools presently in use, as well as those on the horizon, provide an opportunity to examine emerging infectious diseases in ways previously not possible. We analysed publicly available data to investigate where and why Salmonella is detected on raw beef products. In addition to analysing beef-related serovars across space and time, we utilised a machine-learning approach (Species Distribution Modelling) to identify areas and predictors of environmental suitability for the most frequent Salmonella serovars found in beef. Our results demonstrate that some serovars, such as Dublin, Montevideo, and Muenchen, exhibit strong regional prevalence while others, notably Anatum, are found broadly throughout the country. The Species Distribution Models show concurrence with these regional trends. Predictors that contributed 10% or more to multiple serovar models included ecoregions (7/15 serovars), avian flyways (8/15), the number of local cattle operations (3/15), and other environmental variables. Our work demonstrates that certain Salmonella serovars commonly associated with beef show regional trends that can be predicted.

Summary Background: Wastewater and environmental surveillance (WES) enables community-level monitoring of infectious diseases. Most progress has focused on sewer-based surveillance, yet nearly half of the global population relies on non-sewered sanitation. In non-sewered settings, urban drainage channels have been used for poliovirus environmental surveillance, but their potential for a multi-pathogen WES with spatially defined catchments, and comparability to sewer-based surveillance, remains under-explored. Methods: Ten drainage channel sampling points with delineated micro-catchments (0.95-3.83 km2 with 12,885-44,146 people) were selected within Kampala. A total of 255 drainage channel and 54 wastewater treatment plant (WWTP) influent samples were collected during two campaigns in March and September-October 2025. A multi-target panel was quantified by digital PCR, including enteric viruses (Norovirus GI and GII, Rotavirus), respiratory viruses (SARS-CoV-2, Influenza A and B viruses, Respiratory Syncytial Virus (RSV)), non-O1/O139 Vibrio cholerae (V. cholerae), and Pepper Mild Mottle Virus (PMMoV) as a fecal indicator. Findings: Enteric viruses, non-O1/O139 V. cholerae, and PMMoV were consistently detected across all drainage channels and WWTP influents. Concentrations were generally lower in drainage than WWTP influents, except for non-O1/O139 V. cholerae. When normalized by PMMoV, concentrations across most drainage channels were comparable to WWTP influents, although comparability varied by target and location. Both concentrations and PMMoV-normalized concentrations varied across sampling locations. Trends between campaigns varied by pathogen target and were not explained by any single micro-catchment characteristic. Influenza A virus was the most frequently detected respiratory virus (8-23% in drainage channels; 3-10% in WWTP influents), while SARS-CoV-2, Influenza B, and RSV were rarely detected. Interpretation: PMMoV-normalized concentrations across most micro-catchments were comparable to WWTP influents, with spatial heterogeneity implying neighborhood-level differences in disease prevalence. Catchment-delineated drainage surveillance has potential to offer spatially resolved public health information in non-sewered settings comparable to sewer-based wastewater monitoring. Funding: Eawag Discretionary Funding

Recent zoonotic coronavirus outbreaks have sparked an interest in understanding coronaviruses circulating in animal reservoirs. While bats are recognised as major reservoirs for these viruses, coronaviruses have also been detected in a wide range of terrestrial small mammals, particularly rodents. However, coronavirus diversity in these mammals, specifically in Europe, is still poorly characterised. In this study, we detected and characterised coronaviruses in terrestrial small mammals and bats from Belgium, France, Germany, and Ireland. We screened tissue samples from rodents and shrews and environmental bat guano using pan-coronavirus real-time and conventional PCRs, with positive results confirmed by sanger sequencing. Among 2667 bat and 1152 terrestrial mammal samples, we detected 59 positive samples, 36 from bats and 23 from rodents, from which we recovered 60 coronavirus sequences, spanning both Alphacoronavirus and Betacoronavirus lineages. Through next generation sequencing we identified one Pipistrellus pygmaeus bat guano sample carrying two distinct alphacoronaviruses, representing Nyctacovirus and Pedacovirus subgenera. Among rodents, most coronavirus-positive samples originated from a zoo in Belgium, where several CoV lineages co-circulated. The identified rodent coronaviruses clustered among previously described rodent-associated lineages, some of which also include human and other mammal-derived coronavirus sequences. Consistent with previous studies, we found sarbecoviruses in horseshoe bats (particularly Rhinolophus ferrumequinum and R. hipposideros) and merbecoviruses in Plecotus auritus bats, and these viruses are distantly related to the human coronaviruses of the respective families. Similar to bat coronaviruses, some rodent coronaviruses strains seemed to be association with specific rodent species. In conclusion, our study enhances the understanding of coronaviruses in rodents and bats, revealing potential hotspots for these viruses and their implication for human and animal health. These findings underscore the necessity for continued surveillance of coronaviruses in wildlife reservoirs to mitigate future zoonotic spillover risks.

Zoonotic spillover and early human-to-human transmission of emerging viruses are often missed by clinical surveillance. Wastewater surveillance (WS) offers low-cost complementary pathogen detection, but its value for emerging viruses remains uncertain. We reviewed evidence of viral shedding in human waste and combined shedding data, detection models and simulated transmission dynamics into a quantitative framework to identify for which types of emerging viruses WS could add most value. Simulations showed that WS improved probability or speed of outbreak detection for viruses shedding >1/100 to >10 times as much as SARS-CoV-2, depending on probability of clinical symptoms and diagnosis. Value added was highest for transmission scenarios with temporally concentrated infections resulting in spikes in daily shedders. Characteristics of SARS-CoV-2, Mpox, Influenza A, Lassa, and Zaire Ebola viruses appear more favourable for WS than others e.g. chikungunya virus. We anticipate this framework can support more targeted, evidence-based application of WS to emerging threats.

Background. Naegleria fowleri, the causative agent of primary amoebic meningoencephalitis (PAM), is a thermophilic free-living amoeba historically endemic to warm freshwater environments, particularly in the southern United States. While human infections remain exceedingly rare, they are almost uniformly fatal. Global climate change is hypothesized to expand the geographic range of thermotolerant pathogens, potentially introducing them into previously unaffected regions. Objective. This study aims to quantify the current and future habitat suitability for N. fowleri within the contiguous United States (US) and, critically, to project these models onto Europe, a continent traditionally considered low-risk, to identify regions of potential emergence under climate change scenarios. Methods. We employed a modeling approach using the machine learning algorithm Maxent, implemented via the `flexsdm` R package. We utilized 204 occurrence records from the contiguous US. We evaluated three environmental datasets (ENVIREM, Global Cloud Dynamics, Worldclim v.2), selecting Worldclim v.2 for its superior predictive performance. Future projections were generated for the 2041-2060 period under the Shared Socioeconomic Pathway (SSP) 2-4.5 (intermediate scenario). Variable importance was assessed using Shapley additive explanations (SHAP) to decouple the contribution of each Bioclimatic predictor and identify the key drivers of range expansion. Results. The Worldclim v.2 dataset provided the most robust model. The model accurately identified the southeastern US as the core current habitat, consistent with historical PAM case distribution. Crucially, when projected onto Europe, the model reveals extensive regions of currently low suitability that transition to moderate or high suitability by 2050, particularly across the Mediterranean basin, parts of Central Europe, and the Atlantic coastal fringes. SHAP analysis identified temperature-related variables, specifically Annual Mean Temperature, Mean Temperature of the Coldest Quarter, and Mean Diurnal Range, as the most influential predictors, followed closely by precipitation variables (Precipitation of Driest Quarter/Month and Precipitation Seasonality). Under the SSP2-4.5 scenario, the model projects a distinct northward and eastward expansion of suitable habitat, with Ukraine emerging as a region of particular concern, especially in light of recent anthropogenic hydrological changes to the Dnipro River basin. Conclusion. Our findings support the hypothesis that global warming will facilitate the geographic spread of N. fowleri, carrying this pathogen into uncharted European waters. The projections for Europe, and for Ukraine, in particular, suggest a non-negligible risk of future autochthonous PAM cases. These results warrant the proactive inclusion of this pathogen in public health surveillance programs and climate change adaptation strategies across the continent.

BackgroundIdentifying risk factors for Leishmania infection in dogs is essential for understanding disease epidemiology and informing control and targeted prevention. This systematic review and meta-analysis examined these risk factors across endemic and non-endemic regions of Europe. MethodsInclusion criteria included studies that quantified the association between Leishmania infection (both asymptomatic infection and canine leishmaniosis) and risk factors among European dogs. Non-peer reviewed grey literature and studies that focus only on prevention were excluded. The search included all records indexed in PubMed up to 17th March 2026. Risk of bias was assessed using the ROBINS-E tool. Random-effects multilevel models were used for meta-analysis, and sensitivity analyses were conducted to assess robustness. ResultsOf the 46 studies included, 94% were cross-sectional and 76% assessed seroprevalence. Studies were primarily conducted in Southern Europe (Spain 35%, Portugal 17%, Italy 17%, and Greece 11%). There was considerable evidence of an association between increasing age and infection (OR = 1.15 [95% CI: 1.10, 1.21] per year). Five additional factors showed some evidence of association: male sex (OR = 1.17 [1.01, 1.36]), higher body weight (OR = 1.06 [1.02, 1.09] per kg), outdoor housing (OR = 1.84 [1.26, 2.69]), outdoor sleeping (OR = 2.50 [1.52, 4.09]), and neuter status showing higher odds in neutered dogs (OR = 2.22 [1.37, 3.61]). Other potential risk factors, with weak or no clear evidence, included fur length, coat color, breed, utilization (e.g. pet or hunting), urbanicity, care setting, clinical signs, cohabitation, co-infection, sand fly density, land cover, home features, owner perception and knowledge of the disease, travel history and origin of dog, and area-level socioeconomic deprivation. Over 75% of analytical units were assessed as having a high risk of bias, with the remaining assessed as moderate risk. Inadequate handling of confounders was the primary source of bias risk. ConclusionsThe results highlight key risk factors to consider in future research and for improving prevention and disease control, with most identified factors likely acting as proxies of exposure to sand fly bites. Future studies should ensure adequate control for confounding, while causal inference would be strengthened by conducting longitudinal cohort studies.

Introduction: Veterinary Professionals are at risk of contracting zoonoses, including potential emerging infections. Personal Protective Equipment (PPE) could reduce infection transmission risk, but use of it in the profession is low. Understanding Veterinary Professionals experiences with PPE could help identify facilitators and barriers, therefore informing a future strategy to improve usage. Methods: Two focus group discussion with veterinary nurses and two with veterinarians took place at a tertiary small animal teaching hospital. With an interpretivist epistemology, transcriptions were inductively coded and analysed using thematic analysis. Results: Veterinary Professionals frequently reported underusing PPE, despite significant zoonotic risk. Friction in interdisciplinary relationships negatively impacted veterinary professionals experiences with PPE: differing views on risk, policy and PPE, contrasting perceptions of each other, and challenges with communication impacted PPE decision-making. Barriers included an absence of initial recognition of risk, a staff culture of prioritising patient health over risk to self, friction in response to others PPE use or lack thereof, an overly complex policy, and a lack of cultural and institutional reaction to occupationally contracted zoonoses. Facilitators included effective inter and intradisciplinary communication and previous personal experience with serious zoonoses. Conclusion: Veterinary Professionals experiences with PPE, are shaped by social and professional factors, such as interdisciplinary friction, perceptions of self and others, of risk and policy. Recommendations are for the findings to be used locally to embed PPE use into everyday practice. At a national level, the United Kingdom Health Security Agency (UKHSA) should use the findings to evaluate current policies regarding PPE and zoonoses in veterinary practice and produce a simplified national guidance, in collaboration with veterinary professionals with lived experience. Further research into General Practice Veterinary Professionals experiences and the interdisciplinary social dynamics is recommended.

Koalas within Australia are facing multiple threats from habitat loss, climate change and pervasive chlamydial disease. A safe and effective vaccine to protect koalas against chlamydia would be a welcome veterinary intervention to prevent this devastating disease which causes blindness, renal and reproductive pathology, infertility and mortality. However, over a decade of vaccine development and research trials has produced conflicting results, which vary from no observable indication of protective efficacy to a 64% reduction in chlamydia associated mortality. Given this discrepancy we conducted an independent analysis of data underpinning the highly cited publication demonstrating vaccine efficacy that was the basis for a permit for limited use in koalas. In doing so, we identified a substantial error in the way the data was encoded for analysis, which resulted in survival from birth to time of vaccination incorrectly being attributed to vaccination. After correction for this error, we show using the exact methods of the original authors that there was no significant difference in the survival or disease rate between vaccinated and unvaccinated koalas. Furthermore, we identified a substantial source of bias whereby animals with disease at their first health assessment were not excluded from the study and as those animals were generally not vaccinated, they were almost six times more likely to be included in the control group. Reanalysis including only koalas that were healthy on initial assessment and for which follow-up health assessments were performed, showed that vaccinated individuals were equally likely to contract disease or to die with disease; 18 of 143 vaccinated koalas (12.6%) developed disease and 3 (2.1%) died, compared to 63 of 439 control animals (14.4%) that developed disease and 11 (2.5%) that died. This study highlights the importance of randomised, observer blinded, placebo-controlled studies in veterinary settings to uphold scientific rigor and prevent stratification bias.

Antimicrobial resistance is a growing threat to health systems, but stewardship programs must compete for funding with many urgent health priorities in low- and middle-income countries. Evidence that quantifies not only effectiveness but also economic value is therefore essential for policy and budget decisions. We evaluated targeted antimicrobial stewardship programs in four tertiary hospitals in Nepal and Laos using interrupted time-series analyses of antibiotic use, combined with micro-costing to estimate benefit-cost ratios. Stewardship was associated with immediate reductions in antibiotic use across the three Nepal hospitals, whereas effects in Laos were more heterogeneous. Economic returns were positive across sites, with the largest returns observed in the private hospital in Nepal. Here, we show that pragmatic, ward-focused stewardship can reduce antibiotic use and generate measurable economic value in resource-constrained hospital settings, supporting its prioritization as a scalable investment for antimicrobial resistance control.