Towards a risk-based surveillance for Trichinella spp. in Danish pig production.
Increasing demands for cost-effectiveness in surveillance for human health hazards from animal origins can be met by introducing risk-based principles. This e.g. implies targeting subpopulations with higher risk of infection compared to the whole population. Furthermore, historical data from surveillance can be collated and used to assess future risk of infection. To demonstrate the effectiveness of combining these two approaches, we used a model called "Discounting historical evidence". It depends mainly on the annual risk of introduction (PIntro) and the surveillance system sensitivity (SSe) (ability to detect infection if present). The model implies simulations that reiterate for a number of years. For each year the output is updated with the confidence on absence in infection. Trichinella spiralis infection in pigs is used as an example. In Denmark, more than 20 million pigs are tested annually. Despite more than 70 years of testing no pigs have been found positive for Trichinella. Hence, PIntro is low. SSe can be estimated from the maximum number of infected carcasses expected under the specified design prevalence, and the sensitivity of the test applied. According to our assessment, the current prevalence of Trichinella in Danish pigs is less than one case per million, which we interpret as negligible risk. Based on this, a risk-based surveillance programme for Trichinella is designed that targets all out-door reared pigs as well as all sows and boars (current total 610,000 slaughtered annually). These subpopulations are judged to have higher risk of getting Trichinella. Again, SSe and PIntro are estimated and the model results show that risk-based surveillance can be applied without jeopardizing human health. Finally, we incorporate wildlife surveys and test quality assurance in the programme. The results of the simulation model were included in an application to the European Commission concerning Denmark's status as a region with negligible risk of Trichinella. In July 2007, the European Commission granted status as "negligible risk" to Danish pigs and pork.