EuFMD OS20

1. Introduction
Foot and mouth disease (FMD) is endemic in the Anatolian region of Turkey. In recent years, a national control strategy to achieve FMD free status has been
implemented. One crucial component of this control strategy is the improvement of outbreak investigations (OI). EuFMD assistance to the General Directorate of Food
and Control (GDFC) aims to improve the ability of Turkey to control FMD, to promote progress along the Progressive Control Pathway for FMD control (PCP), and
subsequently to reduce the FMD risk in the country. Turkey planned to develop an outbreak investigation system to reach this goal. Since FMD is currently endemic in the
region, comprehensive investigation of all outbreaks under the lead of the Central Epidemiology and Monitoring Unit, as described in the National Contingency Plan,
cannot be conducted.
Materials and Methods
A standard operating procedure (SOP) describing a three stage OI plan has been developed. Here, outbreaks are prioritized in levels 1-3, depending on the
epidemiological situation. As a result, a combination of specific measures, including data collection, source tracing, risk factor identification, study on effectiveness of
control measures and economic evaluations are implemented depending on the identified OI level. The framework also identifies which levels of veterinary services,
epidemiological teams and institutions are involved for each OI level. The details of the three level OI is shown in Figure 1. Further, to increase the detection of outbreaks
and reduce the number of unreported outbreaks, a clinical surveillance scheme was developed and shown in Figure 2.
OUTBREAK INVESTIGATION
The development of the OI and clinical surveillance schemes as part of a series of training were jointly delivered
by the GDFC and the EuFMD to 262 veterinarians from all 78 provinces in Anatolia. As a result of this
improvement on OI, 224 suspicions for FMD outbreak were investigated by the local veterinary service team
between 2019 and 2020 (since this programme has started). 192 of them were confirmed as FMD outbreak
based on clinical and laboratory results. Within this context, 48 out of those outbreaks were investigated as level
II by either the epi team from the Central/Regional Research Institutes (C/RVRI) or by a team from ŞAP Institute
and EMEU. Five outbreaks were further investigated at level III to identify risk factors, evaluate vaccination
performance and vaccine effectiveness. As a result of the level II and III investigations two previously not
reported outbreaks were found and as a result of post outbreak level II clinical surveillance, 12 more outbreaks
were detected in five different locations in Samsun, Erzurum, Kars, Ardahan, and Artvin. Through level III clinical
surveillance, two outbreaks were detected in Erzurum and Van provinces this year. One example for the
detection of outbreaks by level II clinical investigation is shown on the map.
Discussion
The OI and clinical investigation scheme has been endorsed by the GDFC and since 2019, all outbreaks have been investigated accordingly. Since launching the system,
data management and quality have also improved. Improved clinical and OI are crucial measures to further eliminate clinical disease and virus circulation, and progress
along to PCP stage 3. In the future, this SOP could serve as a model for more animal diseases, including FAST (FMD and similar transboundary) diseases and more
countries in the region.
Results
Figure 2. The Clinical Surveillance Scheme.
Figure 1. The Details of the Three-Level Outbreak Investigation.
A NEW APPROACH ON OUTBREAK INVESTIGATIONS
FOR THE CONTROL OF FOOT-AND-MOUTH DISEASE (FMD)
IN THE ANATOLIAN REGION OF TURKEY
A.Naci. Bulut1, F. I. Keskin2, S. Cibelik3, B. Deveci3, F. Rosso4, C. Potzsch4
1 Şap Institute, Ankara, Turkey.
2 Central Veterinary Control Research Institute, Ministry of Agriculture and Forestry (MoFAL), Ankara, Turkey.
3 Animal Health and Quarantine Department, General Directorate of Food and Control (GDFC), Ministry of Agriculture and Forestry (MoFAL), Ankara, Turkey.
4 European Commission for the Control of Foot-and-Mouth Disease, Food and Agricultural Organization, Rome, Italy.