The role of pre-emptive culling in the control of foot-and-mouth disease

The 2001 foot-and-mouth disease epidemic was controlled by culling of infectious premises and pre-emptive culling intended to limit the spread of disease. Of the control strategies adopted, routine culling of farms that were contiguous to infected premises caused the most controversy. Here we perform a retrospective analysis of the culling of contiguous premises as performed in 2001 and a simulation study of the effects of this policy on reducing the number of farms affected by disease. Our simulation results support previous studies and show that a national policy of contiguous premises (CPs) culling leads to fewer farms losing livestock. The optimal national policy for controlling the 2001 epidemic is found to be the targeting of all contiguous premises, whereas for localized outbreaks in high animal density regions, more extensive fixed radius ring culling is optimal. Analysis of the 2001 data suggests that the lowest-risk CPs were generally prioritized for culling, however, even in this case, the policy is predicted to be effective. A sensitivity analysis and the development of a spatially heterogeneous policy show that the optimal culling level depends upon the basic reproductive ratio of the infection and the width of the dispersal kernel. These analyses highlight an important and probably quite general result: optimal control is highly dependent upon the distance over which the pathogen can be transmitted, the transmission rate of infection and local demography where the disease is introduced.     

Adaptive Management and the Value of Information: Learning Via Intervention in Epidemiology

Optimal intervention for disease outbreaks is often impeded by severe scientific uncertainty. Adaptive management (AM), long-used in natural resource management, is a structured decision-making approach to solving dynamic problems that accounts for the value of resolving uncertainty via real-time evaluation of alternative models. We propose an AM approach to design and evaluate intervention strategies in epidemiology, using real-time surveillance to resolve model uncertainty as management proceeds, with foot-and-mouth disease (FMD) culling and measles vaccination as case studies. We use simulations of alternative intervention strategies under competing models to quantify the effect of model uncertainty on decision making, in terms of the value of information, and quantify the benefit of adaptive versus static intervention strategies. Culling decisions during the 2001 UK FMD outbreak were contentious due to uncertainty about the spatial scale of transmission. The expected benefit of resolving this uncertainty prior to a new outbreak on a UK-like landscape would be £45–£60 million relative to the strategy that minimizes livestock losses averaged over alternate transmission models. AM during the outbreak would be expected to recover up to £20.1 million of this expected benefit. AM would also recommend a more conservative initial approach (culling of infected premises and dangerous contact farms) than would a fixed strategy (which would additionally require culling of contiguous premises). For optimal targeting of measles vaccination, based on an outbreak in Malawi in 2010, AM allows better distribution of resources across the affected region; its utility depends on uncertainty about both the at-risk population and logistical capacity. When daily vaccination rates are highly constrained, the optimal initial strategy is to conduct a small, quick campaign; a reduction in expected burden of approximately 10,000 cases could result if campaign targets can be updated on the basis of the true susceptible population. Formal incorporation of a policy to update future management actions in response to information gained in the course of an outbreak can change the optimal initial response and result in significant cost savings. AM provides a framework for using multiple models to facilitate public-health decision making and an objective basis for updating management actions in response to improved scientific understanding.     

An analysis of the possible effects of the 2001 foot and mouth disease epidemic on grass pollen concentrations in the Midlands, UK

The 2001 grass pollen season in the United Kingdom was notably severe. An epidemic of foot and mouth disease (FMD) occurred in the UK during February and spread through the country during the summer. The media claimed that the control measures of culling infected animals and the restricted movement of stock, led to reduced grazing allowing pastures to flower more than in previous years. This study aimed to examine whether the severity was due only to weather factors or if the control measures also contributed. Three pollen sites from the FMD-affected Midlands region were investigated and compared with two sites from regions unaffected for differences in pollen catches, culling levels and weather. The June pollen catch in the Midlands was particularly high but this pattern also features in areas such as Cambridge in the East that were minimally affected by the epidemic. In most of the catchment areas affected by FMD the quantity of animals culled was less than 10% of the total livestock. In areas where culling was concentrated we can assume that there would have been some localized affect on the pollen levels. The results show that the main influencing variable on the 2001 grass pollen counts in the Midlands was the weather and that culling due to the foot and mouth epidemic did not exert an important influence at the regional level.     

An analysis of the possible effects of the 2001 foot and mouth disease epidemic on grass pollen concentrations in the Midlands, UK

The 2001 grass pollen season in the United Kingdom was notably severe. An epidemic of foot and mouth disease (FMD) occurred in the UK during February and spread through the country during the summer. The media claimed that the control measures of culling infected animals and the restricted movement of stock, led to reduced grazing allowing pastures to flower more than in previous years. This study aimed to examine whether the severity was due only to weather factors or if the control measures also contributed. Three pollen sites from the FMD-affected Midlands region were investigated and compared with two sites from regions unaffected for differences in pollen catches, culling levels and weather. The June pollen catch in the Midlands was particularly high but this pattern also features in areas such as Cambridge in the East that were minimally affected by the epidemic. In most of the catchment areas affected by FMD the quantity of animals culled was less than 10% of the total livestock. In areas where culling was concentrated we can assume that there would have been some localized affect on the pollen levels. The results show that the main influencing variable on the 2001 grass pollen counts in the Midlands was the weather and that culling due to the foot and mouth epidemic did not exert an important influence at the regional level.     

An analysis of the possible effects of the 2001 foot and mouth disease epidemic on grass pollen concentrations in the Midlands,UK

The 2001 grass pollen season in the United Kingdom was notably severe. An epidemic of foot and mouth disease (FMD) occurred in the UK during February and spread through the country during the summer. The media claimed that the control measures of culling infected animals and the restricted movement of stock, led to reduced grazing allowing pastures to flower more than in previous years. This study aimed to examine whether the severity was due only to weather factors or if the control measures also contributed. Three pollen sites from the FMD-affected Midlands region were investigated and compared with two sites from regions unaffected for differences in pollen catches, culling levels and weather. The June pollen catch in the Midlands was particularly high but this pattern also features in areas such as Cambridge in the East that were minimally affected by the epidemic. In most of the catchment areas affected by FMD the quantity of animals culled was less than 10% of the total livestock. In areas where culling was concentrated we can assume that there would have been some localized affect on the pollen levels. The results show that the main influencing variable on the 2001 grass pollen counts in the Midlands was the weather and that culling due to the foot and mouth epidemic did not exert an important influence at the regional level.     

Transmission parameters of the 2001 foot and mouth epidemic in Great Britain

Despite intensive ongoing research, key aspects of the spatial-temporal evolution of the 2001 foot and mouth disease (FMD) epidemic in Great Britain (GB) remain unexplained. Here we develop a Markov Chain Monte Carlo (MCMC) method for estimating epidemiological parameters of the 2001 outbreak for a range of simple transmission models. We make the simplifying assumption that infectious farms were completely observed in 2001, equivalent to assuming that farms that were proactively culled but not diagnosed with FMD were not infectious, even if some were infected. We estimate how transmission parameters varied through time, highlighting the impact of the control measures on the progression of the epidemic. We demonstrate statistically significant evidence for assortative contact patterns between animals of the same species. Predictive risk maps of the transmission potential in different geographic areas of GB are presented for the fitted models.     

Epithelial expression of mRNA and protein for IL-6, IL-10 and TNF-α in endobronchial biopsies in horses with recurrent airway obstruction

Background  

Models of Foot and Mouth Disease (FMD) transmission have assumed a homogeneous landscape across which Euclidean distance is a suitable measure of the spatial dependency of transmission. This paper investigated features of the landscape and their impact on transmission during the period of predominantly local spread which followed the implementation of the national movement ban during the 2001 UK FMD epidemic. In this study 113 farms diagnosed with FMD which had a known source of infection within 3 km (cases) were matched to 188 control farms which were either uninfected or infected at a later timepoint. Cases were matched to controls by Euclidean distance to the source of infection and farm size. Intervening geographical features and connectivity between the source of infection and case and controls were compared.     

Geographic and topographic determinants of local FMD transmission applied to the 2001 UK FMD epidemic

Background

Models of Foot and Mouth Disease (FMD) transmission have assumed a homogeneous landscape across which Euclidean distance is a suitable measure of the spatial dependency of transmission. This paper investigated features of the landscape and their impact on transmission during the period of predominantly local spread which followed the implementation of the national movement ban during the 2001 UK FMD epidemic. In this study 113 farms diagnosed with FMD which had a known source of infection within 3 km (cases) were matched to 188 control farms which were either uninfected or infected at a later timepoint. Cases were matched to controls by Euclidean distance to the source of infection and farm size. Intervening geographical features and connectivity between the source of infection and case and controls were compared.

Results

Road distance between holdings, access to holdings, presence of forest, elevation change between holdings and the presence of intervening roads had no impact on the risk of local FMD transmission (p > 0.2). However the presence of linear features in the form of rivers and railways acted as barriers to FMD transmission (odds ratio = 0.507, 95% CIs = 0.297,0.887, p = 0.018).

Conclusion

This paper demonstrated that although FMD spread can generally be modelled using Euclidean distance and numbers of animals on susceptible holdings, the presence of rivers and railways has an additional protective effect reducing the probability of transmission between holdings.

     

Risk maps for the spread of highly pathogenic avian influenza in poultry

Devastating epidemics of highly contagious animal diseases such as avian influenza, classical swine fever, and foot-and-mouth disease underline the need for improved understanding of the factors promoting the spread of these pathogens. Here the authors present a spatial analysis of the between-farm transmission of a highly pathogenic H7N7 avian influenza virus that caused a large epidemic in The Netherlands in 2003. The authors developed a method to estimate key parameters determining the spread of highly transmissible animal diseases between farms based on outbreak data. The method allows for the identification of high-risk areas for propagating spread in an epidemiologically underpinned manner. A central concept is the transmission kernel, which determines the probability of pathogen transmission from infected to uninfected farms as a function of interfarm distance. The authors show how an estimate of the transmission kernel naturally provides estimates of the critical farm density and local reproduction numbers, which allows one to evaluate the effectiveness of control strategies. For avian influenza, the analyses show that there are two poultry-dense areas in The Netherlands where epidemic spread is possible, and in which local control measures are unlikely to be able to halt an unfolding epidemic. In these regions an epidemic can only be brought to an end by the depletion of susceptible farms by infection or massive culling. The analyses provide an estimate of the spatial range over which highly pathogenic avian influenza viruses spread between farms, and emphasize that control measures aimed at controlling such outbreaks need to take into account the local density of farms.     

Contact structures in the poultry industry in Great Britain: Exploring transmission routes for a potential avian influenza virus epidemic

Background  

The commercial poultry industry in United Kingdom (UK) is worth an estimated ￡3.4 billion at retail value, producing over 174 million birds for consumption per year. An epidemic of any poultry disease with high mortality or which is zoonotic, such as avian influenza virus (AIV), would result in the culling of significant numbers of birds, as seen in the Netherlands in 2003 and Italy in 2000. Such an epidemic would cost the UK government millions of pounds in compensation costs, with further economic losses through reduction of international and UK consumption of British poultry. In order to better inform policy advisers and makers on the potential for a large epidemic in GB, we investigate the role that interactions amongst premises within the British commercial poultry industry could play in promoting an AIV epidemic, given an introduction of the virus in a specific part of poultry industry in Great Britain (GB).     

The Influence of Between-Farm Distance and Farm Size on the Spread of Classical Swine Fever during the 1997–1998 Epidemic in The Netherlands

As the size of livestock farms in The Netherlands is on the increase for economic reasons, an important question is how disease introduction risks and risks of onward transmission scale with farm size (i.e. with the number of animals on the farm). Here we use the epidemic data of the 1997–1998 epidemic of Classical Swine Fever (CSF) Virus in The Netherlands to address this question for CSF risks. This dataset is one of the most powerful ones statistically as in this epidemic a total of 428 pig farms where infected, with the majority of farm sizes ranging between 27 and 1750 pigs, including piglets. We have extended the earlier models for the transmission risk as a function of between-farm distance, by adding two factors. These factors describe the effect of farm size on the susceptibility of a ‘receiving’ farm and on the infectivity of a ‘sending’ farm (or ‘source’ farm), respectively. Using the best-fitting model, we show that the size of a farm has a significant influence on both farm-level susceptibility and infectivity for CSF. Although larger farms are both more susceptible to CSF and, when infected, more infectious to other farms than smaller farms, the increase is less than linear. The higher the farm size, the smaller the effect of increments of farm size on the susceptibility and infectivity of a farm. Because of changes in the Dutch pig farming characteristics, a straightforward extrapolation of the observed farm size dependencies from 1997/1998 to present times would not be justified. However, based on our results one may expect that also for the current pig farming characteristics in The Netherlands, farm susceptibility and infectivity depend non-linearly on farm size, with some saturation effect for relatively large farm sizes.     

Disease contact tracing in random and clustered networks

The efficacy of contact tracing, be it between individuals (e.g. sexually transmitted diseases or severe acute respiratory syndrome) or between groups of individuals (e.g. foot-and-mouth disease; FMD), is difficult to evaluate without precise knowledge of the underlying contact structure; i.e. who is connected to whom? Motivated by the 2001 FMD epidemic in the UK, we determine, using stochastic simulations and deterministic 'moment closure' models of disease transmission on networks of premises (nodes), network and disease properties that are important for contact tracing efficiency. For random networks with a high average number of connections per node, little clustering of connections and short latency periods, contact tracing is typically ineffective. In this case, isolation of infected nodes is the dominant factor in determining disease epidemic size and duration. If the latency period is longer and the average number of connections per node small, or if the network is spatially clustered, then the contact tracing performs better and an overall reduction in the proportion of nodes that are removed during an epidemic is observed.     

The Effect of the Post 2001 Reforms on FMD Risks of the International Live Animal Trade

The 2001 UK foot and mouth disease (FMD) epidemic marked a change in global FMD management, focusing less on trade isolation than on biosecurity within countries where FMD is endemic. Post 2001 policy calls for the isolation of disease-free zones in FMD-endemic countries, while increasing the opportunities for trade. The impact of the change on disease risk has yet to be tested. In this paper, we estimate an empirical model of disease risk that tests for the impact of trade volumes before and after 2001, controlling for biosecurity measures. In the pre 2001 regime, we find that poor biosecurity was associated with the probability of reporting an outbreak. In the post 2001 regime, the risks changed, with trade being a much greater source of risk. We discuss the trade-off between trade restrictions and biosecurity measures in the management of FMD disease risks.     

The 2007–2010 Q fever epidemic in The Netherlands: characteristics of notified acute Q fever patients and the association with dairy goat farming

We describe the Q fever epidemic in the Netherlands with emphasis on the epidemiological characteristics of acute Q fever patients and the association with veterinary factors. Data from 3264 notifications for acute Q fever in the period from 2007 through 2009 were analysed. The patients most affected were men, smokers and persons aged 40–60 years. Pneumonia was the most common clinical presentation (62% in 2007 and 2008). Only 3.2% of the patients were working in the agriculture sector and 0.5% in the meat-processing industry including abattoirs. Dairy goat farms with Coxiella burnetii-induced abortion waves were mainly located in the same area where human cases occurred. Airborne transmission of contaminated dust particles from commercial dairy goat farms in densely populated areas has probably caused this epidemic. In 2010, there was a sharp decline in the number of notified cases following the implementation of control measures on dairy goat and sheep farms such as vaccination, hygiene measures and culling of pregnant animals on infected farms. In combination with a rise in the human population with antibodies against C. burnetii, these have most likely ended the outbreak. Development of chronic Q fever in infected patients remains an important problem for years to come.     

Qualitative analysis of the risk of introducing Gyrodactylus salaris into the United Kingdom

Gyrodactylus salaris is a freshwater, monogenean ectoparasite of Baltic strains of Atlantic salmon Salmo salar on which it generally causes no clinical disease. Infection of other strains of Atlantic salmon in Norway has resulted in high levels of juvenile salmon mortality and highly significant reductions in the population. The parasite is a major exotic disease threat to wild Atlantic salmon in the UK. This paper qualitatively assesses the risk of introduction and establishment of G. salaris into the UK. The current UK fish health regime prevents the importation of live salmonids from freshwater in territories that have not substantiated freedom from G. salaris. The importation of other species, e.g. eels Anguilla anguilla and non-salmonid fish, represents a low risk because the likelihood of infection is very low and the parasite can only survive on these hosts for less than 50 d. Importation of salmon carcasses presents a negligible risk because harvested fish originate from seawater sites and the parasite cannot survive full strength salinity. The importation of rainbow trout Oncorhynchus mykiss carcasses from G. salaris infected freshwater sites might introduce the parasite, but establishment is only likely if carcasses are processed on a salmonid farm in the UK. A number of mechanical transmission routes were considered (e.g. angling equipment, canoes, ballast water) and the most important was judged to be the movement of live fish transporters from farms on mainland Europe direct to UK fish farms. In the future, territories may have to substantiate freedom from G. salaris and economic drivers for live salmonid imports may strengthen. Under these circumstances, legal or illegal live salmonid imports would become the most significant risk of introduction.     

Parallels,differences and lessons: a comparison of the management of foot-and-mouth disease and COVID-19 using UK 2001/2020 as points of reference

Foot-and-mouth disease (FMD) is an extremely infectious viral infection of cloven-hoofed animals which is highly challenging to control and can give rise to national animal health crises, especially if there is a lack of pre-existing immunity due to the emergence of new strains or following incursions into disease-free regions. The 2001 FMD epidemic in the UK was on a scale that initially overwhelmed the national veterinary services and was eventually controlled by livestock lockdown and slaughter on an unprecedented scale. In 2020, the rapid emergence of COVID-19 has led to a human pandemic unparalleled in living memory. The enormous logistics of multi-agency control efforts for COVID-19 are reminiscent of the 2001 FMD epidemic in the UK, as are the use of movement restrictions, not normally a feature of human disease control. The UK experience is internationally relevant as few countries have experienced national epidemic crises for both diseases. In this review, we reflect on the experiences and lessons learnt from UK and international responses to FMD and COVID-19 with respect to their management, including the challenge of preclinical viral transmission, threat awareness, early detection, different interpretations of scientific information, lockdown, biosecurity behaviour change, shortage of testing capacity and the choices for eradication versus living with infection. A major lesson is that the similarity of issues and critical resources needed to manage large-scale outbreaks demonstrates that there is benefit to a ‘One Health’ approach to preparedness, with potential for greater cooperation in planning and the consideration of shared critical resources.     

Mathematical models of Neospora caninum infection in dairy cattle: transmission and options for control

The transmission and control of Neospora caninum infection in dairy cattle was examined using deterministic and stochastic models. Parameter estimates were derived from recent studies conducted in the UK and from the published literature. Three routes of transmission were considered: maternal vertical transmission with a high probability (0.95), horizontal transmission from infected cattle within the herd, and horizontal transmission from an independent external source. Putative infection via pooled colostrum was used as an example of within-herd horizontal transmission, and the recent finding that the dog is a definitive host of N. caninum supported the inclusion of an external independent source of infection. The predicted amount of horizontal transmission required to maintain infection at levels commonly observed in field studies in the UK and elsewhere, was consistent with that observed in studies of post-natal seroconversion (0.85-9.0 per 100 cow-years). A stochastic version of the model was used to simulate the spread of infection in herds of 100 cattle, with a mean infection prevalence similar to that observed in UK studies (around 20%). The distributions of infected and uninfected cattle corresponded closely to Normal distributions, with S.D.s of 6.3 and 7.0, respectively. Control measures were considered by altering birth, death and horizontal transmission parameters. A policy of annual culling of infected cattle very rapidly reduced the prevalence of infection, and was shown to be the most effective method of control in the short term. Not breeding replacements from infected cattle was also effective in the short term, particularly in herds with a higher turnover of cattle. However, the long-term effectiveness of these measures depended on the amount and source of horizontal infection. If the level of within-herd transmission was above a critical threshold, then a combination of reducing within-herd, and blocking external sources of transmission was required to permanently eliminate infection.     

Animal disease and human trauma: the psychosocial implications of the 2001 UK foot and mouth disease disaster

The 2001 UK foot and mouth disease (FMD) crisis is commonly understood to have been a nonhuman animal problem, an economic industrial crisis that was resolved after eradication. By using a different lens, a longitudinal ethnographic study of the health and social consequences of the epidemic, the research reported here indicates that 2001 was a human tragedy as well as an animal one. In a diary-based study, it can be seen that life after the FMD crisis was accompanied by distress, feelings of bereavement, fear of a new disaster, loss of trust in authority and systems of control, and the undermining of the value of local knowledge. Diverse groups experienced distress well beyond the farming community. Such distress remained largely invisible to the range of “official” inquiries into the disaster. That an FMD epidemic of the scale of 2001 could happen again in a developed country is a deeply worrying prospect, but it is to be hoped that contingency plans are evolving along with enhanced understanding of the human, animal, and financial cost.     

Epidemiological consequences of an incursion of highly pathogenic H5N1 avian influenza into the British poultry flock

Highly pathogenic avian influenza and in particular the H5N1 strain has resulted in the culling of millions of birds and continues to pose a threat to poultry industries worldwide. The recent outbreak of H5N1 in the UK highlights the need for detailed assessment of the consequences of an incursion and of the efficacy of control strategies. Here, we present results from a model of H5N1 propagation within the British poultry industry. We find that although the majority of randomly seeded incursions do not spread beyond the initial infected premises, there is significant potential for widespread infection. The efficacy of the European Union strategy for disease control is evaluated and our simulations emphasize the pivotal role of duck farms in spreading H5N1.     

Prediction and Control of Brucellosis Transmission of Dairy Cattle in Zhejiang Province,China

Brucellosis is a bacterial disease caused by brucella; mainly spread by direct contact transmission through the brucella carriers, or indirect contact transmission by the environment containing large quantities of bacteria discharged by the infected individuals. At the beginning of 21st century, the epidemic among dairy cows in Zhejiang province, began to come back and has become a localized prevalent epidemic. Combining the pathology of brucellosis, the reported positive data characteristics, and the feeding method in Zhejiang province, this paper establishes an dynamic model to excavate the internal transmission dynamics, fit the real disease situation, predict brucellosis tendency and assess control measures in dairy cows. By careful analysis, we give some quantitative results as follows. (1) The external input of dairy cows from northern areas may lead to high fluctuation of the number of the infectious cows in Zhejiang province that can reach several hundreds. In this case, the disease cannot be controlled and the infection situation cannot easily be predicted. Thus, this paper encourages cows farms to insist on self-supplying production of the dairy cows. (2) The effect of transmission rate of brucella in environment to dairy cattle on brucellosis spreading is greater than transmission rate of the infectious dairy cattle to susceptible cattle. The prevalence of the epidemic is mainly aroused by environment transmission. (3) Under certain circumstances, the epidemic will become a periodic phenomenon. (4) For Zhejiang province, besides measures that have already been adopted, sterilization times of the infected regions is suggested as twice a week, and should be combined with management of the birth rate of dairy cows to control brucellosis spread.