Integrated assessment and management of pig health risks – lesson’s learnt


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Presentation by Kate Blaszak of the Smallholder Pigs System Project at the Managing Risks in Emerging Pork Markets: An International South – South Symposium, held in Hanoi, Vietnam, April 23 2012.

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  • Some key questions raised:Now PRRS is in moolaht – are these as susceptible as moopan (exotic pigs)?What is the clinical and production significance of the high Erysipelas exposure?How is HEV endemically maintained (water, faeces, dependent on stocking rate, housing type)Why is Phongkhao so low for JEV infection?Others….?
  • Some key questions raised:Now PRRS is in moolaht – are these as susceptible as moopan (exotic pigs)?What is the clinical and production significance of the high Erysipelas exposure?How is HEV endemically maintained (water, faeces, dependent on stocking rate, housing type)Why is Phongkhao so low for JEV infection?Others….?
  • eg. reduce CSF and PRRS in village to reduce spread of disease while trading…..reduce HEV exposure, S. suis infection or carrier in village reduces risk to SH workers, T/C to consumers…etc
  • Integrated assessment and management of pig health risks – lesson’s learnt

    1. 1. Integrated assessment and management of pig health risks – lesson’s learnt Kate Blaszak, Coordinator and Veterinarian SPSP.
    2. 2. Acknowledgement Presentation on behalf on two projects funded by ACIAR and ILRI for Lao PDR.Acknowledgement and thanks to LP and SKT provincial staff, CIAT, Laos partners from NAHC, DHP, NCLE, NAFRI and Australian partners from AAHL, MORU. Add ACIAR logo
    3. 3. Outline• Integrated Project - One health, One system• Integrated Health Risk Assessment - Concept Planning, Methodology and Training• Integrated Heath Risk Management – Results, Interpretation and Interventions• Discussion and Lessons• Other possible methods
    4. 4. One health, One systemOriginal SPSP project integrated with EcoHealth – EcoZEIDSPSP Aim: to reduce risks and increase productivity associated with smallholder pig systems in Laos – Many of the pig related zoonoses are clinically silent in pigs – they are not a direct risk to pig health but potentially to human health (JEV, HEV, T/C, Trichinella+) – Project is Onehealth, also One system – interested in pig health and production risks in villages & market chains. – Key clinical pig diseases of interest and impact suspected CSF, PRRS, FMD, Erysipelas also Salmonella, endemic parasitism, possible multi-factorial lung, piglet diseases in addition to the infection status related to the above zoonoses.
    5. 5. Integrated Assessment of Pig Health Risks• Planning concepts – One health, risk based questioning• Methodology and Training – integrated training of human and animal health staff – integrated epidemiology – PPP approach from 2005 human census so human centric sampling for human and pig disease exposure – integrated system for village data collection – participatory village mapping for health risks (SPSP) – integrated laboratory training and testing for exposure – integrated analysis of crude seroprevalence and health risks * health risk assessment for actors further along the market chain yet to be done
    6. 6. PPP: Villages 8 SPSP Villagesare randomly - Also PPP bysampled but village HHweighted by numberhumanpopulation2 ECOZEIDProvinces – each30 Villages x15 Humans15 Pigs
    7. 7. Survet for integrated questionnaire development,data entry and web storage – concept designed by Peter Durr of
    8. 8. Staff training and village data collectionInsert some pictures
    9. 9. Integrated assessment for results ofover 700 pig and 1000 human samples– integrated and contextual results EcoZEID and SPSP– crude seroprevalence (village and provincial)– looking for associated zoonotic, pig health risks– village mapping (perceived and possible geospatial disease risks)– challenges-interpretation and validation of some tests in field situation (eg. HEV pigs), retest to confirm some hotspots (T/C) and specificity (JEV)
    10. 10. Human and Pig Hepatitis E Sero-prevalence Results Human Prev 61.4% Pig Prev 64.0%
    11. 11. Human and Pig Trichinella Sero-prevalence ResultsHuman Prev 47.3% Pig Prev 13.2%
    12. 12. Some zoonotic risk resultsDisease exposure to humans Apparent risk factors from Odd’s Ratio Comments and Interventions- Managementand pigs (overall data for increased sero + (and 95%CI)crudeseroprevalence)HEV <50m from pigs 2.12(1.72,3.00) But clinical human HEV? Sero+ appears independent ofHumans:61.4% TBC Lower education level 1.74(1.27, 2.39) owning pigs! Unusual. Using non-bottled or non- Clear link and need for water and sanitation mgt – explore boiled water 4.01(1.87,8.56) constraints, educational campaign. Also would benefit T/C Not using toilets 1.77(1.34,2.35) reduction in contamination. Explore possible increased susceptability if pregnant.Pigs(64%) Pigs E+ also likely HEV 2.56 (1.87,3.10) sero+ Explore the Erysipelas/HEV possible link or not? Penned pigs in wet or dry 2.70(1.72,4.23) Explore significance of penning and HEV? seasonTrichinella Hmong more at risk 1.77 (1.00, 3.12) Consistent with prior ACIAR project. As was higherHuman(47.3%) Lao Loum more at risk 1.53(1.14, 2.06) education level. What practices or point of the pork chain convey the greatest risk, why are some villages hot spotsPigs (13.2%) Pigs in Sanam (why?) 2.12(1.18, 3.82) (ethnicity, other practices?) – how best to target intervention? Data did not show reduced risk from cooking pork! Why? Contamination post cooking? Fermented sausage. More rats in sanam- abherrant?Taenia (4.7%) and Not using toilets 2.65(1.37,5.12) Clear link with lack of toilet use. Some village ‘hot spots’-Cysticercosissolium (2.9%) why? MGT need for hygiene and sanitation behaviour changeJEV also….. JEV human confirmatory testing – but apparently relativelyHuman IgM (4.4%) low seroprevalence of new infections. GOOD mosquito usePigs IgG (75.2%) already found. Pregnancy a known risk factor as is lowerPigs IgM (8.5%) age for clinical infection.
    13. 13. Pig CSF Sero-prevalence Results Pig CSF Prev 10.3%
    14. 14. Pig PRRS Sero-prevalence Results Pig PRRS Prev 8.2%
    15. 15. Pig Erysipelas Sero-prevalence Results Pig Erysipelas Prev 47.5%
    16. 16. Some pig health and production risk results…. also FMD, othersDisease exposure to pigs Apparent risk factors Odd’s Ratio Comments and Management - Interventions(overall from data for increased (and *95%CI)crudeseroprevalence) sero +Erysipelas (47.5%) Wet season pigs in 5.05 (1.74, 14.69)* Significance ? Enclosures with dirt/mud floors enclosures > pens increase exposure to Erysipelas a soil borne Dry season pigs in 5.21 (1.81, 16.06)* organism? Clinical significance of Erysipelas in enclosures > = pens moolaht?Syndromic and further incidence monitoring could be useful. MGT: Consider balance of pen/enclosure use – NB. Higher risk of HEV with penned pigs.CSF (10.3%) Vaccination at 6 monthly 10.76(3.65, 31.73)* Note- recently introduced pigs were not clearly Vaccination 12 7.40 (3.18, 16.68)* associated with increased CSF sero+ levels (in this monthly case/survey)ie. not vaccinated or not exposed No access to sanam** 2.89(0.89,9.4)* prior to introduction. MGT: biosecurity education and CSF vaccination already conducted, being assessedPRRS (8.2%) Sanam not protective This project clearly shows exposure in moolaht& nor risk. cross pigs and subsequent HP PRRS outbreak in Mai district confirms clinical impact in at least 2 Needs more analysis? villages. MGT: TBC,biosecurity and movement restrictions? education, possible vaccination
    17. 17. (SPSP) B.Houayloun – suspected risks ?Pig pensmostlyconcentrat Few piged in pensvillage on nearperiphery villageor near entrancestreamfacilitatespig Village entrance – few pens may reducedisease biosecurity risk?transferbut mayreducehumaninfections. pig pens near river and vegie gardens so may increase HEV risk
    18. 18. Integrated management of pig health and zoonotic risks• Interventions by *DAFOs and DHOs, supported by PAFOs and PHOs, VVWs, VHWs and NAHC, DHP ……PMC etc• One Health opportunities – disease investigation, vaccine storage and delivery, education, monitoring• Zoonotic risk reduction interventions – Sanitation, consumption and vector prevention – education and behaviour change, reducing humane and pig reservoirs of disease where relevant (human taenia carriers, piga with trichinella infection, pen location and HEV?)• Integrated pig nutrition, health, production solutions for a one system approach• Pig health and production – interventions and monitoring – initial focus on grower pigs* – CSF vaccination intervention – PV seroconversion, pig mortality, dynamics and growth monitoring – Disease outbreak investigation, pathology and response, prevention – Housing and management training, design, implementation – Forage and nutrition interventions – Economic GMA
    19. 19. Reduce pig disease risk, transfer and impact
    20. 20. Integrated pig management 5 ‘principlesof successful livestock management’Ref: Varney – ACIAR 2008, 5 freedoms – FAWC, 1996. Fresh Water ad lib and Management Suitable shelter, suitable diet – for and handling space, bedding – health, production in a stress free comfortable resting and growth manner area. Freedom from Appropriate pain, injury breeding and disease - strategies (and prevention, ability to rapid conduct diagnosis and normal treatment behaviours) we need…………
    21. 21. The challenge – working with farmers to design housing as needed with available resources in villages* and project The need Available in village Possible project contribution Adequate space (and Mostly – focus on size, room for Technical – design with location) all needs farmers. Consider if location important? Shelter and shade Yes – focus on shade Checking, importance. Heat stress reduces growth. Flooring Yes – avoid bamboo slats, Technical- part solid/slatted, design to facilitate easy mgt part raised? Cleaning? Substrate, farrowing Yes -Rice hulls, or straw, even Facilitate discussion on and piglet creep areas banana leaves for farrowing benefits, options, feasibility. sows. Small creep area. Technical design input. Water and feed Yes simple – gravity system Discuss challenges. Provide systems – all access consider cost share. nipples, piping if want. Handling, holding Yes – but not currently Technical – slide in gate/ board….? Think!!!
    22. 22. Lessons and other options for integrated assessment• One health, One systems – training, time, silver bullets?• Build in time, expertise for complex statistical analysis• Review existing records, systems (NCLE) more, gap analysis and capacity building for sustainable disease surveillance• Syndromic assessment and monitoring approaches – Within recall time frames maybe quite reliable – Action research• Qualitative and Quantitative risk assessment by matrix – exposure risks (likelihood) and disease consequence (impact)• Options yet to think of………
    23. 23. Lessons and other options – integrated management of health risks• Interventions by risk score and achievability (matrix?)• Consult well with interested farmers, convey the benefits, incentives & listen!• Integrate management of pig health risks along the market chain*• How to best work with, incorporate the sanaam, a traditional ‘biosecure’ measure?• Plan and communicate well internally, consult for good educational approaches• Consulting, integrating with other projects or NGOs for effective solutions• Greater consultation and integration with village policy and management• Integrate with existing systems, HH/ PH vaccination and education interventions?• Endorsement by local Governors• Build links for scaling out – Learning Alliance• Only the start……..initial zoonotic interventions pending• Much more to learn!
    24. 24. Thanks to the teams and partners who contributeto these projects. Any questions?
    25. 25. (extra) Summary crude seroprevalence ILRI provincial survey, ACIAR SPSP survey
    26. 26. (extra summary SPS seroprevalence results) Village Name Village code PRRS IgG CSF IgG HEV Ig total TrichIgG Erysipelas IgG JEV (Ig JEV (IgM) FMD 3 ABC FMD O FMD A FMD Asia 1 total)B. Pakxang 801021 6.67 0.00 63.30 33.33 43.33 80.00 10.00 0.00 0.00 0.00 0.00B. Nongnong 801050 0.00 *55.56 77.78 66.67 77.80 77.78 22.22 0.00 0.00 0.00 0.00B.Houaykeng 801039 10.00 0.00 80.00 10.00 40.00 60.00 10.00 0.00 0.00 0.00 0.00B. Houayloun 801049 4.55 0.00 77.27 22.73 68.18 59.09 0.00 4.55 0.00 0.00 0.00District Ave 5.63 7.04 70.42 30.99 54.93 70.42 8.45 1.41 0.00 0.00 0.00total +/total samplesB. Ompalou 202025 6.67 0.00 60.00 26.67 46.70 80.00 0.00 6.67 6.67 0.00 0.00B. Omkaneng 202019 9.10 9.10 90.90 0.00 72.70 81.80 0.00 0.00 27.30 0.00 0.00B. Sophoun 202003 12.00 4.00 88.46 12.00 76.00 84.62 0.00 0.00 40.00 0.00 0.00B. Poungkhao 202128 0.00 0.00 100.00 16.70 50.00 16.67 0.00 0.00 0.00 0.00 0.00District Ave 8.33 3.33 83.33 15 63.33 76.67 0.00 1.67 25.00 0.00 0.00Comments: sample taken Oct 2011, newly found in * known Zoonotic Risk for first time tested, Phong Khao IgM: new Many High Omkaneng as expected, as expected,end of rainy season moolaht vaccinated relevance? consumption clinical low - why? infections inconclusive and Sophoun (on Khounsy & Khounsy&Conla relevance? Nongnong results: retest? main Conlan 2008 n 2008 high, why? road).PhongKhao Many FMD 2010, pig inconclusive turnover? resultsAverage for whole sample 6.87% 5.34% 76.34% 23.66% 58.78% 73.28% 4.58% 1.52% 11.36% 0.00% 0.00%Comparative LP Province 11.48% 7.54% 82.95% 13.77% 67.21% 76.39% 12.46% 1.31% 5.25% 0.98% 0.33%Note: ACIAR samples are moolaht only.LP included moopan