A questionnaire study of associations between potential risk factors and salmonella status in Swedish dairy herds.

In this study associations between potential risk factors and salmonella status in Swedish dairy herds were investigated. A case-control study design was used, including existing as well as new cases. Herds were assigned a salmonella status on the basis of antibody analysis of bulk milk samples. Information on potential risk factors was collected from registry data and from farmers via a questionnaire. Univariable and multivariable logistic regression analyses were used to investigate associations between salmonella status and potential risk factors. In addition, multivariate analysis with Additive Bayesian Network (ABN) modelling was performed to improve understanding of the complex relationship between all the variables. Because of the difficulty in identifying associations between potential risk factors and infections with low prevalence and a large regional variation, exposure of potential risk factors in the high-prevalence region (Öland) were compared to exposure in other regions in Sweden. In total 483 of 996 (48%) farmers responded to the questionnaire, 69 herds had test-positive bulk milk samples. The strongest association with salmonella status was 'presence of salmonella test-positive herds <5 km' (OR 4.3, 95% CI 2.0-9.4). Associations with salmonella status were also seen between 'feeding calves residue milk only' (OR 2.4, 95% CI 1.2-4.6), 'certified organic herds' (OR 2.5, 95% CI 1.2-4.9) and 'frequently seeing signs of rodents' (OR 0.4, 95% CI 0.13-0.97). The ABN model showed associations between Öland and four of the variables: salmonella status, presence of test-positive herds <5km, shared pastures and providing protective clothing for visitors. The latter is probably a reflection of increased disease awareness in Öland. The ABN model showed associations between herd size and housing as well as several management procedures. This provides an explanation why herd size frequently has been identified as a risk factor for salmonella by other studies. The study confirms the importance of local transmission routes for salmonella, but does not identify specific components in this local spread. Therefore, it supports the use of a broad biosecurity approach in the prevention of salmonella. In Öland, some potential risk factors are more common than in other parts of Sweden. Theoretically these could contribute to the spread of salmonella, but this was not confirmed in the present study. The study also highlights the difficulty in identifying associations between potential risk factors and infections with low prevalence and large regional variation.