Search Results (94)

Small ruminant production in Kosovo is predominantly extensive, and biosecurity practices remain poorly characterized. The emergence of Peste des Petits Ruminants (PPR) in Europe (beginning in 2024) and the first confirmed case in Kosovo (July 2025) highlight the urgent need for baseline biosecurity data to inform disease control. A cross-sectional pilot study was conducted on 63 small ruminant farms (53 meat-producing, 10 dairy-producing) across seven municipalities in Kosovo between September 2025 and February 2026. Biosecurity practices were assessed using the Biocheck.UGent™ questionnaire during direct on-farm visits. External (Ext) biosecurity scores (preventing pathogen introduction) were higher (p < 0.0001) than internal (Int) scores (limiting spread within farms). For external biosecurity, the highest scores were observed for purchase and reproduction (Ext A), intermediate scores existed for feed and water (Ext C) and visitors and farm workers (Ext D), and the lowest scores were found for transport and carcass removal (Ext B) and infrastructure (Ext E). For internal biosecurity, the highest scores were observed for lamb/kid management (Int H) and dairy management (Int I), followed by the management of adult animals (Int J); work organization (Int K) and reproduction management (Int G) formed an intermediate-low cluster, whereas disease management (Int F) scored the lowest. Benchmarking against the Biocheck.UGent™ worldwide database (predominantly intensive systems, thus not directly comparable) indicated that internal biosecurity and overall biosecurity levels were lower than the benchmark, while external biosecurity was comparable for some components. Given the convenience sample (36.4% response rate), findings are exploratory and are not directly generalizable. Larger herd size was positively correlated with external (ρ = 0.54, p < 0.0001), internal (ρ = 0.35, p = 0.005), and overall (ρ = 0.57, p < 0.0001) biosecurity scores. This first empirical biosecurity assessment of small ruminant farms in Kosovo reveals critical gaps in transport hygiene, disease management, and reproductive management pathways that enable PPR spread and perpetuate endemic zoonoses. The positive association between herd size and biosecurity may indicate structural barriers and/or knowledge gaps for small farms. Current biosecurity tools, designed for intensive systems, require adaptation for extensive production systems. These findings provide a baseline for targeted interventions, policy development, and validation of context-appropriate biosecurity instruments in Kosovo and similar extensive systems globally. Full article

Peste des petits ruminants (PPR) is a highly contagious transboundary disease that affects small ruminants and impacts livestock production and trade. This study investigated the seroprevalence and associated risk factors of PPR in sheep, goats, camels, and wild ruminants in Bahrain. A total of 1240 sheep, 1224 goats, 100 camels, and 38 wild ruminants were tested using competitive ELISA. The individual seroprevalence rates were 26% in sheep and 25.5% in goats, with flock/herd-level prevalences of 22.7% and 29.6%, respectively. No antibodies were detected in camels or wild ruminants. The highest seroprevalence was observed in the Northern governorate. The identified risk factors included geographic location, age (<12 months for goats), sex (male for goats), and health status (weak animals). At the flock/herd level, large flock size and semi-intensive farming increased the likelihood of seropositivity. In addition, a 2023–2024 surveillance campaign tested 1044 young, locally born lambs and kids across all governorates. All animals were found to be negative for PPR according to a competitive enzyme-linked immunosorbent assay (cELISA) and a reverse transcription polymerase chain reaction (RT-PCR) test, confirming the absence of antibodies and active virus circulation in the population. These findings support the classification of Bahrain at Progressive Control Pathway for PPR (PCP-PPR) Level 3 status and emphasize the importance of continued surveillance and regional cooperation to mitigate the spread of diseases. Full article

Peste des petits ruminants (PPR) is an infectious disease with high morbidity and mortality rates, and four distinct lineages have been discovered in different regions globally. In this study, a quadruplex RT-qPCR method capable of differentiating all four lineages of PPRV was established. By screening specific conserved regions across all viral genomes, we designed primers, as well as four TaqMan probes capable of distinguishing all lineages. The established method underwent validation of its relevant characteristics. The sensitivity of the detection method was determined by testing plasmid serial dilutions ranging from 10⁸ to 10⁰ copies/μL; results showed that the method could detect as few as 10 copies per microliter of PPRV. No cross-reactivity was observed among the four probes or with other common pathogens of goats and sheep. The coefficient of variation (CV) values for inter-assay and intra-assay repeatability of each probe were both below 2% (intra-assay: 0.11% to 0.98%; inter-assay: 0.18% to 1.95%), demonstrating excellent repeatability. Testing of 62 clinical samples also confirmed that the method could effectively detect and differentiate clinical samples of different PPR lineages. This method, for the first time, enabled the differentiation of all PPRV lineages in a single reaction, improving the detection efficiency of the PPR virus and providing robust technical support for the global PPR eradication program. Full article

In 2023, a highly immunogenic live attenuated vaccine based on the Nigeria 75/1 strain was introduced in Kazakhstan to provide protection against PPR. This study presents the results of a three-year animal trial evaluating the vaccine’s efficacy, safety, and immunogenicity. The novelty of this study lies in the long-term (up to 36 months) evaluation of protective immunity in adult animals, as well as in the comparative analysis of immune responses across different age groups and the assessment of viral suppression following challenge infection. Sheep and goats of different age groups were included, including lambs and kids aged 1.5 and 3 months, as well as adult animals aged 2–3 years. The vaccine was well tolerated following a single immunization, and no clinically significant adverse effects were observed in vaccinated animals, apart from only mild transient local reactions. A strong humoral (IgG) response to PPRV antigens was detected in all groups, with the highest antibody titers observed in young animals. Seroconversion was detected in 100% of vaccinated animals by day 21 post-vaccination. Long-term protective immunity (at least 36 months) was demonstrated in adult animals, whereas in young animals early protection was confirmed at 21 days post-vaccination along with subsequent humoral immune dynamics following a single immunization with a 1.0 mL dose of the vaccine (Nigeria 75/1 strain, titer 10^3.0 TCID₅₀/mL). These findings indicate that the vaccine is well tolerated, highly immunogenic, and provides sustained protection in adult animals while inducing early immune responses in young animals. Full article

Peste des Petits Ruminants (PPR) is a highly contagious viral disease of small ruminants and remains a major threat to food security and rural livelihoods across Africa, the Middle East, and Asia. In the Mediterranean, uneven outbreak reporting and intense spatial clustering hinder the identification of regions where environmental and anthropogenic conditions favor disease occurrence. This study applied an interpretable machine-learning ecological niche modeling framework to characterize PPR spatial suitability in North Africa. A merged outbreak dataset (n = 744) was compiled from the Food and Agriculture Organization (FAO) EMPRES-i and the World Animal Health Information System (WAHIS) databases for 2005–2026. Outbreak locations were linked to environmental and anthropogenic predictors, spatially thinned, and paired with randomly sampled pseudo-absences at a 1:1 ratio. After correlation-based screening and Boruta feature selection, four classifiers were compared under five-fold spatial block cross-validation: a generalized linear model (GLM), a support vector machine (SVM), Random Forest (RF), and extreme gradient boosting (XGBoost). All models showed good discriminatory performance. Random Forest (RF) and extreme gradient boosting (XGBoost) yielded the highest area under the receiver operating characteristic curve value (AUC = 0.94). Random Forest achieved the highest specificity, XGBoost achieved the highest sensitivity, and the support vector machine showed the most even sensitivity–specificity tradeoff among the machine-learning classifiers. Sheep density, mean diurnal temperature range, temperature seasonality, and human population density were consistently the dominant drivers. Predicted PPR suitability based on reported outbreaks was concentrated along the North African coastal belt and low across most arid inland regions. These findings suggest that passive surveillance is likely to be most informative in coastal production systems where host density, environmental suitability, and reporting opportunity overlap. At the same time, areas of lower reported-outbreak suitability should not be interpreted as disease-free and may require complementary active surveillance approaches. Full article

Peste des Petits Ruminants (PPR), a highly contagious disease of domestic and wild small ruminants, is characterized by severe morbidity and mortality. PPRV, the causative agent, is a morbillivirus in the family Paramyxoviridae. The virus poses a significant barrier to sustainable agricultural development in the developing world. Currently, no effective therapeutics agent for PPRV infection is available. Ginsenoside Rb3, the major bioactive constituent in the plants of ginseng, was reported to exert a wide range of pharmacologic and immunologic effects. However, it is unclear whether Ginsenoside Rb3 can act as an antiviral against PPRV infection. Here, we show that Ginsenoside Rb3 exhibits significant antiviral activity against PPRV in cell culture models. The mechanism of action of Ginsenoside Rb3 against PPRV is mainly attributed to its ability to inhibit PPRV-mediated autophagy, thus leading to promotion of interferon responses. In summary, our study establishes Ginsenoside Rb3 as a novel antiviral agent effective against PPRV, sheds light on its mode of action, and reveals a novel immunomodulatory strategy that may prove essential for combating both current and future viral outbreaks. Full article

In this study, a multienzyme isothermal and lateral flow dipstick combination assay for PPRV detection was established, the designed primers and probes targeting the N gene were screened and optimized, and analytical sensitivity, specificity, and repeatability of developed method were systematically evaluated. The experimental results demonstrated that this method is easy to operate, can complete detection within 30 min at 42 °C, and is capable of detecting all lineages of peste des petits ruminants virus (PPRV) without cross-reactivity with other viruses. The limit of detection could reach 10 copies/μL. Repeatability validation showed that the coefficients of variation (CV) for both intra-assay and inter-assay experiments were below 3.0%. The positive detection rate for clinical samples could reach 100%. The test results are visually interpretable via fluorescence and lateral flow strips. In conclusion, this method exhibits high analytical sensitivity, specificity, and excellent repeatability, enabling rapid diagnosis of peste des petits ruminants (PPR). Full article

Peste des petits ruminants (PPR) is a highly contagious viral disease that affects goats and sheep, causing severe clinical signs, high mortality, and significant economic losses in many developing countries. Pakistan is one of the endemic regions where PPR outbreaks caused by the Asian lineage IV virus have been reported frequently, affecting the livelihoods of millions of smallholder farmers who depend on these animals for food security and income generation. In this review, we provide a comprehensive overview of the current status, challenges and prospects for vaccine development against PPR in Pakistan. We discuss the epidemiology, diagnosis, and control of PPR in Pakistan, as well as the existing vaccines based on the attenuated strains and their limitations, such as low thermostability, short shelf life, and inability to differentiate between infected and vaccinated animals. We also highlight the recent advances in vaccine research and development, such as recombinant and vectored vaccines, thermostable formulations, and novel delivery methods that could overcome these limitations and enhance the immunogenicity and safety of PPR vaccines. We review the current and potential strategies for vaccine deployment, such as mass vaccination, targeted vaccination, ring vaccination, and their implications for the global eradication of PPR by 2030. We conclude by providing some recommendations for future research and development to improve vaccine efficacy, safety, and coverage in Pakistan, as well as to monitor the impact of vaccination on PPR incidence and prevalence. Full article

Background: Peste des petits ruminants (PPR) is an acute or subacute contagious trans-boundary viral disease causing high morbidity and mortality in domestic and wild small ruminants. The national UAE-PPR control and eradication plan follows the PPR Global Control and Eradication Strategy (PPR GCES) and relies on the annual mass vaccination of small ruminants to eradicate the disease from the country by 2030. Despite the immunization effort against PPR, the vaccination coverage reached 65% at maximum, which necessitates conducting a post-vaccination evaluation (PVE) study at the national level. Methods: Using multistage random sampling to assess the PPR vaccine and vaccination effectiveness, protocol (2) of the PPR GCES, using two serosurveys; serosurvey (1) (pre-vaccination) at day 0 before vaccination, to assess the primary PPR serological investigation, and serosurvey (2) at (30–90) days post-PPR vaccination, to evaluate the immune response, were carried out from September to December 2024 across the seven Emirates of the UAE. The nucleoprotein-based competitive enzyme-linked immunosorbent assay (c-ELISA) was used to detect PPR antibodies in a total of 1592 and 1589 sera samples collected, respectively, before and after vaccination from different (n = 163) sheep and goats holdings (epi-unit) distributed in the different Emirates of the UAE. Results: In serosurvey (1). prior to vaccination, out of the total 1592 samples tested (839 goats and 753 sheep), 833 animals (52.32%) were found to be seropositive for PPR antibodies. In contrast, in serosurvey (2), after vaccination, 1490 (93.77%) animals were found to be seropositive out of the total 1589 small ruminants (825 goats and 764 sheep) tested by c-ELISA. A statistically significant increase (41.45%) in the overall seroprevalence from (52.32%) pre-vaccination to (93.77%) post-vaccination was observed. Post-vaccination, 93.87% (n = 153) of the vaccinated epi-units achieved more than 70% seroprevalence compared to 43.56% (n = 71) before vaccination. Prediction analysis showed that all the seven UAE Emirates require 1.2 years maximum to reach 100% immune-protection levels. Conclusions: An efficient PPR vaccine was used to immunize small ruminants in the UAE. Higher (89.47–100%) post-vaccination herd immunity than the threshold recommended by the PPR GCES (>80% immunity) was attained, which can efficiently break the spread of PPRV within the UAE. To enhance the eradication of PPR I the UAE, conducting mass vaccination campaigns targeting over the (95%) immunization coverage of eligible animals for the next three years is recommended to attain the requested sustained (>80%) immunity at the animals holding level. Full article

Introduction/Background: Rift Valley fever virus (RVFV) and peste des petits ruminants virus (PPRV) are significant pathogens affecting small ruminants, causing substantial economic losses in the affected regions. The development of effective vaccines against both viruses is crucial for disease control. Recombinant viruses expressing heterologous antigens have shown promise as multivalent vaccine candidates. Unlike conventional PPRV vaccines, our recombinant RVFV-vectored vaccines offer a novel dual-protection strategy against RVF and PPR, combining safety, immunogenicity, and a DIVA strategy. Methods: Recombinant RVFVs (ZH548 strain) were generated to express either the hemagglutinin (H) or fusion (F) proteins from the PPRV strain Nigeria 75/1. The stability of these recombinant viruses was assessed through consecutive passages in cell culture. Immunogenicity studies were carried out in both mice and sheep to assess the induction of cellular and humoral immune responses capable of providing protection against RVFV and PPRV. These studies included intracellular cytokine staining (ICS), IFN-γ ELISAs, standard ELISAs for antibody detection, and virus neutralization assays. Results: The recombinant RVFVs expressing PPRV H or F proteins demonstrated stability in cell culture, maintaining high viral titers and consistent transgene expression over four passages. Immunization of mice resulted in the production of serum antibodies capable of neutralizing both RVFV and PPRV in vitro as well as cell-mediated immune responses specific to PPRV and RVFV antigens. In mice vaccinated with a high dose (10⁵ pfu), RVFV neutralizing titers reached ≥1:160 and PPRV neutralizing titers ranged from 1:40 to 1:80 by day 30 post-immunization. In sheep, neutralizing antibody titers against RVFV exceeded 1:160 as early as 2 days post-inoculation, while PPRV-specific neutralization titers reached up to 1:80 by day 21 in responsive individuals. In mice, administration of rZH548ΔNSs:F_PPRV elicited a detectable CD8+ IFNγ+ T-cell response against PPRV, with levels ranging from 1.29% to 1.56% for the low and high doses, respectively. In sheep, rZH548ΔNSs:F_PPRV also induced a robust IFNγ production against PPRV at 14 and 21 days post-infection (dpi). Conclusions: The successful generation and characterization of recombinant RVFVs expressing PPRV antigens demonstrate the potential of using rationally attenuated RVFV as a vector for multivalent vaccine development. Notably, the strategy proved more effective for the recombinant virus expressing the F protein, as it consistently induced more robust cellular and humoral immune responses. These results suggest that this approach could be a viable strategy for simultaneous immunization against Rift Valley fever and other prevalent ruminant diseases, such as peste des petits ruminants. Even though challenge studies were not performed in target species, the strong immune response observed supports including them in future studies. Full article

Brucellosis, a zoonotic infection caused by the intracellular pathogen Brucella, leads to chronic multi-organ damage. Currently, rapid, accurate, and sensitive diagnostic technologies are crucial for the prevention and control of brucellosis. This study describes the development of a chemiluminescent immunoassay (Bru-CLIA) for sheep and bovine brucellosis antibody detection, utilizing Brucella abortus strain A19 lipopolysaccharide-coated magnetic particles (LPS-MPs) as the serum antigen and acridinium ester-labeled recombinant streptococcal protein G (AE-SPG) for signal generation. After optimizing the assay’s parameters, the Bru-CLIA demonstrated a sensitivity of approximately 1 IU/mL and 2 IU/mL for detecting sheep and bovine brucellosis, respectively. No cross-reactivity was observed with sera from animals immunized with Escherichia coli O157:H7, Mycobacterium tuberculosis, Vibrio cholerae, Legionella, Salmonella, Foot and Mouth Disease virus types O and A, Bovine viral diarrhea virus, Sheep contagious pleuropneumonia, Goat pox virus, or Peste des Petits Ruminants virus, indicating strong specificity. The testing of 81 sheep serum samples and 96 bovine serum samples revealed that Bru-CLIA showed 87.65% and 93.75% concordance with the ID-VET commercial kits for sheep and bovine brucellosis detection, respectively. These results demonstrate that Bru-CLIA offers high specificity, sensitivity, repeatability, and reliability, making it a viable rapid diagnostic tool for the epidemiological surveillance of brucellosis. Full article

Peste des petits ruminants (PPR) is an extremely contagious viral disease that significantly affects the health of small ruminants and the economies of livestock, particularly in areas adjacent to endemic regions. This study focused on assessing the vulnerability of different domestic and wild animal species in Kazakhstan, which includes local sheep and goats, African Cameroon goats, saigas, calves, and ground squirrels, to infection by the PPR virus (PPRV). Experimental infections used a virulent strain of PPRV (Nigeria 76/1), with animals being monitored over a period of 21–28 days to evaluate clinical signs, pathological lesions, and viral dissemination. The manifestation of disease differed across species, breed, and age. In Cameroon, goats and saigas displayed severe illness with a mortality rate of 100% and elevated virus levels in key organs, whereas local sheep and goats presented age-related subacute, abortive, and latent manifestations. Calves exhibited mild, subclinical infections, while ground squirrels showed no susceptibility. Viral shedding was observed in the secretions of infected animals, with transmission occurring through airborne and alimentary pathways. No virus carriage was detected in the animals that had recovered. The investigation emphasizes the notable variations in PPRV pathogenesis and transmission risk among different species, highlighting the necessity for focused surveillance and control strategies to avert incursions in PPR-free areas like Kazakhstan. Full article

The Peste des Petits Ruminants (PPR) live attenuated vaccines, the PPR virus (PPRV) Nigeria 75/1 strain (lineage II) and PPRV India Sungry 96 strain (lineage IV), currently used for control and eradication programme are very efficient vaccines as they provide the host, sheep and goats, a lifelong immunity after a single minimum recommended dose of 10^2.5 TCID₅₀/mL. Unfortunately, both live attenuated vaccines are thermolabile and their use requires maintaining the cold chain from the manufactory premises to the field as most PPR-infected regions are facing of hot climate, with poor infrastructure, and the maintenance of an effective cold chain remains a challenge. To address this challenge, efforts have focused on developing thermotolerant (ThT) PPR vaccines using different stabilisers and improving the freeze-drying process. This study aimed to define the criteria for the evaluation of the stability of ThT PPR vaccines. A total of 37 batches of freeze-dried PPR vaccines using the PPRV Nigeria 75/1 strain, including eight (8) and twenty-nine (29) vaccines labelled as ThT and conventional formulations, respectively, were tested to evaluate the stability at temperatures of 40 °C to simulate the field conditions in some hot climate regions. All the vaccine batches included in this study initially showed acceptable levels of residual moisture, below 3%, and titres above the minimum WOAH standard requirement of 10^2.5 TCID₅₀/mL. Following the incubation at 40 °C, 56.7% and 46% of the 37 vaccine batches tested retained titres above 10^2.5 TCID₅₀/mL on day 3 and day 5, respectively. These vaccines use stabilisers such as skimmed milk, lactalbumin–sucrose, trehalose and one unnamed product (which may be protected for patent). The mean of titre loss among the PPR vaccines maintaining titres above 10^2.5 TCID₅₀/mL was 0.78 log10 at day 3 and 0.99 log10 at day 5, suggesting a significant early degradation during the first 3 days. Based on these data, it is proposed that thermotolerant PPR vaccines should maintain a minimum titre of 10^2.5 TCID₅₀/mL for vaccine dose on day 5 post-incubation at 40 °C with a titre loss below 1 log10 per mL. Preliminary immunogenicity test results showed that the PPR ThT vaccine meeting this criterion could be used in the field without maintaining a cold chain for up to 3 weeks, offering a practical solution for vaccination in remote areas. Full article

The Sultanate of Oman boasts remarkable biodiversity, exemplified by such species as the Arabian leopard (Panthera pardus nimr) and the Arabian oryx (Oryx leucoryx), national symbols that highlight the extensive conservation efforts required to protect the country’s natural heritage. During decades, Omani authorities have taken significant measures to safeguard wildlife and preserve the natural environment. A sanctuary dedicated to the reintroduction of the Arabian Oryx, after extinction in nature in 1972, was established in 1980 in the Al Wusta Governorate under the patronage of the Royal Diwan and currently administrated by the recently established Environment Authority. During the almost 40 years since the reintroduction and the creation of the sanctuary, the oryx population has grown slowly but constantly. In 2021, the sanctuary hosted 738 oryx, allowing the start of the reintroduction of the species into the natural environment. Small groups of animals were released into the wild in selected areas. No animal health adverse events were recorded, and mortality was generally due to injuries received as a consequence of fighting, in particular during mating season. Standard veterinary care, including control of internal and external parasites, was regularly provided. In some occasions, immunization against certain diseases, such as clostridial infections, pasteurellosis, or mycoplasmosis, was also applied. In 2023, an FMD outbreak in cattle reported in Dhofar, about 500 km from the Al Wusta sanctuary, motivated specific prophylactic actions to prevent the risk of diffusion to oryx. From December 2023 to January 2024, an immunization program was undertaken using an FMD vaccine against serotypes A, O, and SAT 1, mostly in male oryx, while pregnant oryx were avoided for abortion risk due to handling. The following year, in January 2025, a severe outbreak occurred in oryx herds held in the sanctuary. The rapid onset and the spread of clinical symptoms among animals (100% morbidity in the second day after the first appearance of signs in some individuals) were suggestive of a highly contagious disease. The animals suffered from severe depression and inappetence, rapidly followed by abundant salivation, erosions of the oral mucosa and tongue, and diarrhea, with a short course characterized by prostration and death of the animal in the most severe cases. Therapeutical attempts (administration of antibiotics and rehydration) were mostly ineffective. Laboratory investigations (ELISA and PCR) ruled out contagious bovine pleuropneumonia (CBPP), Johne’s disease and Peste des petits ruminants (PPR). Both serology and antigen detection showed positiveness to foot-and-mouth disease (FMD). Out of a total population of 669 present in the sanctuary at the beginning of the outbreak, 226 (33.78%) oryx died. Despite the vaccinal status, the 38.49% of dead animals resulted being vaccinated against FMD. Taking into account the incalculable value of the species, the outbreak represented a very dangerous event that risked wiping out the decades of conservation efforts. Therefore, all the available means, such as accrued biosecurity and adequate prophylaxis, should be implemented to prevent the recurrence of such health risks. The delicate equilibrium of wild fauna in Oman requires study and support for an effective protection, in line with the national plan “Vision 2040”, targeting the inclusion of the Sultanate within the 20 best virtuous countries for wildlife protection. Full article

Peste des petits ruminants is a highly contagious transboundary viral disease that poses a serious threat to small ruminant populations worldwide. In 2024, seven outbreaks of PPR were recorded in sheep flocks from Timiș County, marking the second confirmed incursions of peste des petits ruminants virus (PPRV) in Romania. This study aimed to document the clinical presentation, pathological findings, and diagnostic confirmation with these field outbreaks. Comprehensive field investigations were carried out between July and September 2024, including clinical examinations, post mortem analysis, serological screening, and molecular detection using reverse transcription polymerase chain reaction (RT-PCR). A total of 13,203 sheep were evaluated, with an overall mortality rate of 12.77%. Characteristic clinical signs included mucopurulent nasal discharge, oral erosions, respiratory distress, and diarrhea. Gross lesions observed during necropsy included hemorrhagic bronchopneumonia, bile-stained liver, catarrhal enteritis, and mucosal hemorrhages. Serological testing revealed flock-level seroprevalence rates ranging from 46.7% to 80.0%, with higher rates observed in older animals. RT-PCR confirmed PPRV infection in all affected flocks. Our findings provide strong evidence of virulent PPRV circulation in an area where the virus had not been reported before. The results highlight an urgent need to strengthen surveillance systems, enhance diagnostic capacity, and foster cross-border collaboration. These field-based insights can contribute to both national and international efforts aimed at controlling and ultimately eradicating the disease. Full article