OS16 - 6.G4.c Development of a Successful Surveillance Model for FMD in Pakistan - M. Hussain

1. M. Hussain, M. Afzal, E. Khan, J. Arshad, N. Panhwer and A. Ahmad FAO, Pakistan Oﬃce, Islamabad Development of a Successful Surveillance Model for Foot and Mouth Disease in Pakistan

2. FMD Surveillance – Pre-project Scenario •  FMD is a noBﬁable disease in Pakistan •  Primarily reported through a passive surveillance system •  Monthly report submiFed by veterinary assistant / veterinarian to district livestock oﬃcer who collects the informaBon and passes on to the Director Animal Health in each Province. •  Each province sends a monthly report to the Animal Husbandry Commissioner (CVO) in the Federal Government •  On an average 30-50 outbreaks of FMD were reported annually •  No naBonal SOP existed to handle each FMD outbreak

3. Veterinary Service Infrastructure in Pakistan Province / Region Hospitals Dispen- saries Centres Mobile Dispensa -ries Diagnos Bc Labs Punjab 523 1299 1782 98 36 Sindh 119 60 786 23 7 Khyber Pakhtunkhwa 115 511 576 8 7 Balochistan 116 783 - 12 15 Gilgit-BalBstan 21 167 27 - 7 Azad Jammu & Kashmir 59 66 129 - 5 FATA 31 246 472 - 4 Islamabad Capital 4 7 - - 1 Total 988 3139 3772 141 82

4. EssenBal Elements of the FMD Surveillance Model •  Awareness of farmers and other stakeholders •  Capacity building of veterinary field staff •  Provision of sample collecBon and dispatch kit to the field staff •  Cover expenditure of sample collecBon and dispatch to the diagnosBc lab •  Reported outbreak is responded back with outbreak control acBviBes •  Report lab results to the field veterinary staff

5. Awareness Seminars for Farmers Province / Area Seminars # Farmers trained # Punjab 37 1070 Sindh 15 909 Khyber Pakhtunkhwa 36 2179 Balochistan 10 262 FATA 10 318 Gilgit – BalBstan 7 195 Azad Jammu & Kashmir 26 845 Islamabad 2 72 Total 143 5850

6. Capacity building of ﬁeld staﬀ Province / Region Workshops (#) Vets trained (#) Paravets trained (#) Sample collecBon Kits provided (#) Punjab 36 859 173 704 Sindh 17 452 133 395 Khyber Pakhtunkhwa 8 217 18 116 Balochistan 5 188 27 163 Gilgit-BalFstan 2 38 - 35 Azad Jammu & Kashmir 7 137 74 119 Federally Administered Tribal Areas 3 50 - 30 Islamabad 2 53 22 53 Total 80 1994 447 1615

7. Reported FMD Outbreaks (2012) Province Total FMD outbreaks Outbreak (#) due to serotype ELISA NegaBve Outbreaks O A Asia-I O+ Asia-I O+A A+ Asia-1 Punjab 164 72 19 28 14 2 1 27 Sindh 686 394 51 97 21 8 4 111 Khyber Pakhtunkhwa 120 24 6 15 15 5 - 55 Balochistan 19 7 3 - - 2 - 7 Gilgit- BalBstan 7 - 1 2 - 1 - 3 FATA 4 3 - - - - - 1 AJK 60 22 18 - - 1 - 19 Islamabad 28 11 5 5 - - - 7 Total 1088 533 103 147 50 19 5 230

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9. Reported FMD Outbreaks (2013) Province Total FMD outbreaks Outbreaks (#) due to serotype ELISA NegaBve Outbreaks O A Asia-I Mixed Punjab 177 65 47 21 3 41 Sindh 2364 991 959 80 22 312 Khyber Pakhtunkhwa 171 61 44 2 17 47 Balochistan 42 15 3 - 1 23 Gilgit-BalBstan 7 2 - - 5 - FATA 18 - 11 - - 7 AJK 89 31 25 5 - 28 Islamabad 6 1 2 2 - 1 Total 2874 1166 1091 110 48 459

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11. Reported FMD Outbreaks (2014) Province Total FMD outbreaks Outbreaks (#) due to serotype ELISA NegaBve Outbreaks O A Asia-I Mixed Punjab 417 291 37 19 2 68 Sindh 1168 679 92 115 111 171 Khyber Pakhtunkhwa 407 187 24 38 0 158 Balochistan 193 107 15 16 0 55 Gilgit-BalBstan 10 7 3 0 0 0 FATA 29 17 0 0 0 12 AJK 534 310 6 5 6 207 Islamabad 55 31 11 3 0 10 Total 2813 1629 188 196 119 681

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13. Province Total FMD outbreaks Outbreaks (#) due to serotype ELISA NegaBve Outbreaks O A Asia-I Mixed Punjab 202 74 39 33 - 56 Sindh 651 211 215 21 140 58 Khyber Pakhtunkhwa 39 7 16 9 - 7 Balochistan 37 11 19 - 1 6 Gilgit- BalBstan - - - - - - FATA 3 - 3 - - - AJK 100 30 31 2 - 37 Islamabad 23 6 2 12 - 3 Total 1055 339 325 77 141 167 Reported FMD Outbreaks (2015)

14. Reported FMD Outbreaks (Jan-Mar 2016) Province Total Outbreaks Serotype O Serotype A Serotype Asia-1 Mixed ELISA NegaBve Punjab 218 66 35 62 6 49 Sindh 241 52 50 71 10 58 Khyber Pakhtunkhwa 14 5 2 5 - 2 Balochistan 5 - 1 3 - 1 Gilgit-BalBstan - - - - - - FATA - - - - - - AJK 25 10 2 2 - 11 Islamabad 28 3 4 19 - 2 Total 531 136 94 162 16 123

15. Reported FMD Outbreaks (Apr-Jun 2016) Province Total Outbreaks O A Asia-1 Mixed ELISA NegaBve Punjab 96 8 9 52 2 25 Sindh 184 48 39 51 2 44 Khyber Pakhtunkhwa 26 2 1 15 1 7 Balochistan 22 9 - 2 - 11 Gilgit-BalBstan 3 2 1 - - FATA - - - - - - AJK 14 - 8 4 - 2 Islamabad 11 - 2 9 - - Total 356 69 59 134 5 89

16. Conclusions •  Surveillance model seems to be well suited for endemic seings •  ApplicaBon of surveillance model signiﬁcantly improved FMD outbreak reporBng in the country •  The surveillance model assisted in determining the disease paFern as well as hot spots in the country •  A Risk Based Control Strategy (RBCS) was developed. This strategy has been approved by the Government of Pakistan and a naBonal program based on the strategy is under acBve consideraBon of the Government

17. Acknowledgements •  Excellent support of all livestock departments parBcularly field veterinarians for the implementaBon of project acBviBes •  FMD-WRL UK for sub-typing and vaccine matching •  PIADRC, New York for collaboraBon in genotyping and vaccine matching •  Support of AHC Office and NVL •  All stakeholders parBcularly livestock farmers •  USDA for financial assistance

18. hFp://www.fao.org/pakistan Thank you!

OS16 - 6.G4.c Development of a Successful Surveillance Model for FMD in Pakistan - M. Hussain

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