SEE Management Online Meeting ppt presentations - EUFMD and SEE countries

South Eastern Europe (SEE) Management
Meeting Online
1
1-2 July 2020
South Eastern Europe Management Meeting– 1-2 July

2
South Eastern Europe (SEE) Management Meeting Online
1-2 July 2020
Key objectiveof the SouthEastern Europeregional managementmeeting:
Present progress done in the implementation of EuFMD Phase V workplan for the
South Eastern Europe region and agree on additional areas of interest where
further support is required to improve emergency preparedness and coordination
across the region.
Expected outcomes:
To present the progress done by EuFMD in the implementation of the workplan for
SEE countries and to agree on next steps for different activities to be organized in
the second part of 2020.

Agenda
Day 1: South Eastern European countries
1 July Session Format
9.00 - 9.15 Welcome and introductions Presentation by the EuFMD
team
Section I. RBS/National networks
9.15 -9.45 Risk-based surveillance in Thrace Presentation and discussion
facilitated by O.Nekouei
9.45 – 10.15 Establish national networks to connect veterinary
services, laboratories, research institutions and
universities
Presentation and discussion
facilitated by M.Sabirović
10.15 - 10.45 Coffee Break
Section II. Update on Bovine Ephemeral fever
10.45 -12.00 Update on BEF Presentations by
E.Chevanne and M.Bellachie
12.00 -12.10 Summary and closing of the day Presentation by the EuFMD
team
3
SEE Management Meeting
AGENDA: Day 1

Thrace project: updates & next steps
4
Omid Nekouei, Enrico Mezzacapo
EuFMD. European Commission for the Control of Foot-and-Mouth Disease

● Background
● Recent developments in the Thrace project
○ New database
○ Adaptation of Cameron Model to PPR & SGP
● Proposed next steps to discuss & agree upon
5
1.4.1 Risk based surveillance system
Outline

6
● TRANSBOUNDARY HIGH RISK AREA COORDINATED EPIDEMIO-SURVEILLANCE PROGRAMME
(THRACE) IN BULGARIA, GREECE AND TURKEY
○ Objective: to provide continuous evidence of FMD freedom
and detect possible incursion of FMD and other FASTs at early stage
● Problems:
○ ‘Google Fusion’ service discontinued
○ Although surveillance activities in Thrace have been extended to other important TADs (PPR,
SGP, LSD) since 2016, there has been no model in place to analyze the resultant data
● Cameron model was originally developed in 2013
○ Objective: to analyse cluster-level surveillance data collected from different surveillance
components and calculate the progressive probability of freedom from FMD
● The need for a similar model was also emphasized in Tirana, Albania (5-6 February 2020)
Background

7
● To replace Google Fusion
● To ensure consistency and
accuracy of data entry
● Added functionalities
○ Safe & organized storage of
data
○ Counter-check mechanism
(export error function)
○ User friendly search of old data
● Host: IZSLT (Andrea Vitelli)
● Training meeting was held on
June 23, 2020
https://thrace.izslt.i
t
New Trace database

8
● Turkey
○ Meeting on 17 April 2020 with Naci
○ Turkey does not need an adapted model for PPR or SGP at the moment:
■ the presence of these diseases in Asian part of Turkey
■ ongoing vaccination campaigns in the Thrace region
■ the government preferences
○ Cameron Model will continue to be used for FMD with no significant changes, except
updating:
■ Qurban Festival monthly scores
■ Istanbul province as ‘high risk’ versus the other four provinces as ‘low risk’
Adapting Cameron model to other FASTs

● Meeting April 14, 2020 with Tsviatko
● Meeting May 11, 2020 with Chrysoula
Methodology
● A table for the most reasonable input parameters during the meeting & follow-up communications
● Input parameters were mainly estimated based on available literature and expert opinion
● High uncertainty around some inputs due to the lack of objective evidence, relevant information and data
● Two extreme scenarios were defined (so-called “best & worst” within a reasonable range – a simple sensitivity
analysis)
9
Bulgaria & Greece
South EasternEurope Management Meeting– 1-2 July

1
Table of parameters (example from Bulgaria)

● There are 3 major components under PPR surveillance:
○ Passive farmers reporting (covers all of the population; with low sensitivity)
○ Clinical examinations (sampling is assumed at random; with medium sensitivity)
○ Laboratory testing/serosurveillance (sampling is assumed at random; with high sensitivity)
● There are 2 major components under SGP surveillance:
○ Passive farmers reporting (with low-medium sensitivity)
○ Clinical examinations (sampling assumed at random; with medium-high sensitivity)
1
Surveillance components

● Sheep & goats are treated as “small ruminants”
● Monthly variation in the annual probability of introduction of PPR & SGP in the region due to ‘Qurban
Festival’
● It is believed that the sensitivity of passive farmers reporting and clinical examination is higher for
SGP than for other similar diseases (e.g., PPR)
● Data are analysed on a monthly basis per village/holding (as for FMD)
● In Bulgaria; it was agreed to start the analyses from January 2019 (due to outbreaks of PPR in 2018)
● In Greece; from 2016
● Animals selected within a village/holding for clinical and laboratory examinations are
representative of the small ruminants in that village/holding
1
Key assumptions

Preliminary results (Bulgaria)
● The results indicate that the
sensitivity of the model outputs
(probability of freedom) to changes in
controversial input parameters was
not substantial
○ Highly robust
● This mainly appears to be due to the
full coverage of the passive
reporting system
1

1
PPR best PPR worst
(PPR Bulgaria)

1
SGP
worst
SGP
best
(SGP Bulgaria)

● Using the new database by the representatives since July 
● Review of the final models by Cameron et al.
● To link the models and reports with the new Thrace database
○ To produce automatic results/reports when new data are uploaded in the
database every cycle
1
Next steps

Thank you very much!
1

18
Pillar I - Sub-component: 1.4.2.2
Questionnaire and Interviews
Analysis
Dr Mirzet Sabirovic
European Commission for the Control of Foot-and-Mouth Disease

1.4.2.2. National networks
Questionnaire & Interviews
Key aspects covered:
 National Animal Health Policy - Disease priorities (FMD and FAST diseases)
 National Animal Policy Areas – National legislation and programmes (i.e. surveillance,
disease control, laboratory) priorities
 National stakeholder engagement – availability of science and stakeholders’ networks
Focus: Western Balkans member countries - Establishing national networks to connect
veterinary services, laboratories, research institutions and universities

91.7
8.3
61.5
38.5
0
10
20
30
40
50
60
70
80
90
100
Responded Not responded Interviewed Not responded
Questionnaire Interviews
Western Balkan countries: Questionnaire & Interviews Responses (in %)

Foot-and-
mouth
Disease
(FMD)
Lumpy Skin
Disease
(LSD)
Peste des
Petits
Ruminants
(PPP)
Sheep and
Goat Pox
(S&G Pox)
Bovine
Ephemeral
Fever (BEF)
Rift Valley
Fever (RVF)
Member countries responses (%) 92.31 76.92 61.54 53.85 15.38 7.69
0
10
20
30
40
50
60
70
80
90
100
Western Balkan countries: Priority diseases

Surveillance
programmes
Disease control
programmes
Laboratory
genotyping &
laboratory
testing
National
legislation
Member countries responses (%) 100.00 72.73 45.45 27.27
0.00
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
90.00
100.00
Western Balkan countries: Priority policy aeria

Already established Need to establish No response
No of MC 5 6 2
0
1
2
3
4
5
6
7
Western Balkan countries: External stakeholders networks

Research
laboratorie
s (National,
Regional)
Livestock
Industry
National
scientific
institutes
University(
s)
Smallholde
r farmers
Livestock
industry
value
chains
Other
sector
expertise
(e.g.
environme
nt, public
health)
Member countries responses (%) 90.91 63.64 54.55 54.55 36.36 18.18 9.09
0
10
20
30
40
50
60
70
80
90
100
Western Balkan countries: Potential for stakeholders networks

Priority Theme Priority Evidence needs areas
1. Putting
surveillance into
practice
Wildlife and farm biosecurity
Vectors and their role at farm environment
Involvement and roles of private veterinarians and farmers
Western Balkan countries: Priority themes and identified
corresponding evidence needs areas - analyses

2. Putting disease
control into
practice
Application of risk assessment principles along a country
continuum (i.e. from pre-border through to disease
freedom and exports)
Wildlife and vectors controls
Climate Change and Environment – influence and impact
Vaccination approaches and comparison
Vaccine banks – existence, timely support, guarantees
Zoning and compartmentalisation
Smallholders and Value chains – stakeholders and
practices

3. Putting laboratory
capabilities into
practice
Assessing the relationship between disease events to
support epidemiological investigation and disease control
Serum/samples banks – existence and use
Laboratory tests and standardisation of case definition
Development of laboratory contingency plans

4. Modernising national
legislation and
practices
Legislation review and update - A single disease
contingency plan vs Generic animal disease
contingency plan and adoption of ‘One Health’
approach
Formulation a policy basis for public-private
partnerships in animal disease prevention and control

Western Balkan countries: Questionnaire and Interviews Analysis -
conclusion
 Ensure the Management Meeting agreement on identified priority policy evidence needs areas
for targeted research to progress with the preparation of a call for proposals,
 Pilot the establishment and sustainability of such stakeholders’ national (and regional) networks
through the EuFMD research grants

Timeline (March-December 2020) March April May June July August Sept Oct Nov
1. Consultant to prepare a draft quideline for needs
assessment
2. Consultant to prepare a draft Duestionnaire & Timeline
& Share with team for input/comments
3. EuFMD to inform WB countries - submitt a guideline &
a questionnaire
4. Consultant to follow up Skype/WhatsApp meetings
with Focal Points
5. Consultant to prepare a summary analysis of a
questionnaire results & feedback received from WB
countries via virtual meetings & Preparation for MM
6. EuFMD - Management Meeting
7. EuFMD - Management meting outcomes & meeting
minutes
8. Consultant - prepare a call for proposals
9. EuFMD - Assessment of proposals
10. EuFMD & Consultant - grants commissioning
Western Balkan countries: Questionnaire and Interviews analysis -
timeline

Western Balkan countries: Questionnaire and Interviews analysis -
credits
The EuFMD is very grateful to all South Eastern Europe member
countries for cooperation in providing input through the
questionnaire and interviews

32
Any questions or
comments?

An update on
Bovine Ephemeral Fever
(3-day sickness)
33
Meeting name, place, dates
Michel Bellaichea, Etienne Chevanneb
aKimron Veterinary Institute, Bet Dagan, Israel
bEuFMD. European Commission for the Control of Foot-and-Mouth Disease
1 July,10.45-12.00CEST

34
Outline
● BEF in the European Neighborhood between 2015 and 2019 – a
web-based survey among EuFMD trainees
● Presentation on BEF, its importance and control measures applied
in Israel (expert: Dr Michel Bellaiche)
Expected outcome: Raising awareness about BEF
Meeting name. Place, dates

35
What is Bovine Ephemeral Fever (BEF)? (1/2)
● An acute febrile illness of cattle and water buffaloes
(Bubalus bubalis)
● Also evidence of infection and clinical BEF in yak (Bos
grunniens)
● Antibodies have been detected in a wide range of wild
animals (ungulates, elephants, warthogs, hippopotamus
etc.). Reservoir?
Etiology
● Caused by a rhabdovirus (single-stranded RNA)
● Belongs to the genus Ephemerovirus
● Single serotype worldwide, although 3 geographically
lineages were found

36
What is Bovine Ephemeral Fever (BEF)? (2/2)
● Not an OIE notifiable disease (since 1970)
● No international reference laboratory for BEF
-> BEF is under-rated and under-documented
● Since 2019, BEF is a FAST disease cat.2, along with Rift Valley Fever
● evidence for circulation /disease in one or more neighborhood
countries but not directly bordering European Union Member
Nations;
● vaccination is needed in response;
● ruminants are directly affected with major losses.

37
Bovine Ephemeral Fever (BEF) – symptoms (1/2)
Clinical symptoms: Infection may be clinically unapparent or result in mild
to severe clinical signs:
● Very short incubation period (36-48 hours).
● Rapid onset and rapid recovery, lasting only 1–3 days
● Seldom, prolonged paralysis and ataxia
● Bi-phasic fever (>40.5ºC) – can lead to abortion
● Anorexia
● Salivation
● Drop in milk (loss of about 180 kg of milk)

38
Bovine Ephemeral Fever (BEF) – symptoms (2/2)
Clinical symptoms: Infection may be clinically unapparent or result in mild
to severe clinical signs:
● Ocular and nasal discharge
● Recumbency (sternal or lateral)
● Muscle stiffness or tremors
● Lameness
● Respiratory distress
● Death in severe cases (usually < 1%)
● Fat animals and heavy milkers have more severe symptoms.

39
Bovine Ephemeral Fever (BEF) – Differential Diagnosis
Ephemeral fever produces a clinical syndrome in dairy cattle that is
very similar to RVF.
• Sudden onset of fever of a similar nature to RVF but generally
more severe.
• Same severe dysgalactia, nasal and ocular discharges.
• the muscle weakness and recumbency, which are a feature of
ephemeral fever cases, do not occur with RVF.
• Ephemeral fever does not produce any disease in sheep, goats or
young cattle.
Tick born diseases (sudden fever)
Botulism (recumbency)
Limb damage or hoof infection (ataxia)

40
Bovine Ephemeral Fever (BEF) – Epidemiology (1/3)
● Infection, prevalence and morbidity rates during outbreaks are
often very high.
● Mortality rates are usually low ( but can reach 20%!) especially in
very hot weather.
● Haematophagous (culicoides, mosquitoes) arthropod-borne
disease.
● No transmission by direct contact with infected animals or fomites
(non contagious).

41
● Several wild animals may act as reservoir.
● Evidences of wind-born dispersal through vectors transport.
● Can be spread by animal trade.
● Occurs seasonally (late spring to autumn) over a vast expanse of
the globe encompassing much of Africa, the Middle East, Asia and
Australia.
● The distribution can expand into regions that have historically
been free of the disease.

42
Walker, P. J., &
Klement, E. (2015).
Epidemiology and
control of bovine
ephemeral
fever. Veterinary
research, 46(1), 124.

43
Context (1/2):
● Increasingly frequent
occurrence of BEF
infections, some of
which associated with
high case-fatality rates
(higher than 20%) were
reported in 2004 in
Israel, in 2012 in Turkey
and in 2013 in Iran
● Poor reports of BEF in
the litterature after 2015
Bovine Ephemeral Fever (BEF)
EuFMD Web-based survey, 2020

44
Context (2/2):
● E-leraning courses
conducted since 2014
● > 10,000 trainees – vet
colleagues - in the
database
● 1,677 contacts in 21
countries of the EU
neighborhood

45
Objectives of the survey:
● Gain better understanding of the BEF situation, surveillance and
control in the countries of West and North Africa, the Middle East
and West Eurasia, between 2015 and 2019
● Explore BEF awareness and training opportunities for veterinarians
in the European Union (EU) neighborhood

46
Methods:
● Web-based survey designed on SurveyMonkey, in December 2019
○ Questionnaire reviewed by the Kimron Veterinary Institute, Israel
○ 35 questions divided into 7 sections: respondent’ sociodemographic,
BEF occurrence, BEF diagnosis, BEF surveillance, BEF vaccines
availability and vaccination, legislation applicable to BEF control
and, knowledge self-assessment and perception of BEF and
interest in training
● Distributed to all trainees from the 21 countries (voluntary participation), in
January 2020
● Data analysis, between February and March 2020
● Report communication to the community in end of March 2020
Note: Answers provided to this survey cannot be considered as official reply
from the respondents’ institution or country

47
Results - Participation
270 responses from all 21 countries
Overall response rate 16.7%
236 «valid» responses

Occurrence of BEF in Israel and the Middle East region:
● BEF was first reported in Israel in 1931.
● Until 1990, it occurred at irregular, long intervals, with the last
outbreak occurring in 1951.
● This pattern has changed in recent years with increasingly frequent
outbreaks in 1990–1991, 1999–2001, 2004, 2008, 2009, 2010, 2014-
2015, 2018.
● BEF outbreaks in the Middle East usually commence during the
spring (May) or autumn (September).
● In Israel, the most severe outbreaks usually occur in the Jordan
Valley where the climate is either Mediterranean or semi-arid.
48South Eastern Europe Management Meeting– 1-2 July
Bovine Ephemeral Fever (BEF) – Occurrence in Israel

Detection of antibodies in Wildlife:
● In Israel, antibodies were detected in Persian fallow deer (Dama d.
mesopotamica) and mountain gazelle (Gazella gazella).

Occurrence of BEF in Israel Fluctuation in occurence and number
of outbreaks -Usually from July to November
11 10
2 0
176
0 0 0
90
45
149
7
1 0
97
46
0 0
66
0
20
40
60
80
100
120
140
160
180
200
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
‫מס‬'‫אירועים‬/
N˚ofoutbreak
‫שנה‬/Year
‫הימים‬ ‫שלושת‬ ‫קדחת‬ ‫אירועי‬ ‫מספר‬
Number of Bovine ephemeral fever outbreaks
2000-2020
0

Results – Reported occurrence
Affected species

Sesonnal trends

Sporadic
Otb

Free

Unkn. status
Unkn. status
Unkn. status

Principles of BEF diagnosis in cattle (epidemio-clinic)
Example in Israel
● Milk drop – one of the indicators
● Clinical symptoms
● Diagnosis in adjacent farms
Bovine Ephemeral Fever (BEF) - diagnosis

Principles of BEF diagnosis in cattle (laboratory)
● In the past VNT – not always 2 serum samples were sent in interval.
● qPCR  Sequencing (whole blood).
● From dead animals: spleen, lymph nodes, lung.
● Virus isolation in cell culture.
Bovine Ephemeral Fever (BEF) – diagnosis

Results – Mapping lab capacities
Lab diagnostic assays:
Virus
isolation
Antigen
detection assays
Antibody
detection assays
Unknown
SEEN 11 16 11 2
Afghanistan 0 1* 1* 0
Georgia 0 1 1 0
Iran (Islamic Republic of) 2 2 1 0
Iraq 0 4* 3* 0
Turkey 9* 8* 5* 2
ME 6 6 6 2
Egypt 3 2 3* 1*
Israel 3* 3* 2* 0
Jordan 0 1 1 0
Palestine (State of) 0 0 0 1
NA 3 7 9 3
Algeria 0 0 1 2
Morocco 2* 3* 4* 0
Tunisia 1 4 4 1
WA 0 1 1 0
Mali 0 1 1 0
Grand Total 34 41 36 7
Table 1: Laboratory diagnostic assays available for BEF in the European neighborhood, number of responses
from Official veterinarian and Laboratory Veterinarian groups by country. *when Laboratory Veterinarians
answered.

Principles of BEF surveillance:
● Mostly passive surveillance.
● Surveillance of haematophagous arthropods including biting
midges and mosquitoes. (PCR) – negative results around
affected herds.
Bovine Ephemeral Fever (BEF) - surveillance

Results – Surveillance activities
BEF passive surveillance activities between 2015-2019:
● 8/21 countries including Israel, Afghanistan, and Iran (Ismalmic Rep. of)
BEF active surveillance
● 7/21 countries including Afghanistan, and Syrian Arab Republic
Culicoides surveillance
● 7/21 countries including Afghanistan, Israel, Syrian Arab Republic and
Algeria

Principles of BEF prevention and control (vaccination)
● Natural BEFV infection has been reported to result in
durable immunity.
● Live-attenuated, inactivated and subunit vaccines are being
used in field. In Israel: two registered vaccines, both of them
inactivated (short term immunity).
Not mandatory vaccine.
● Control of cattle movements (short viremia, low risk).
● Control of arthropods.
● Some countries require that imported live cattle or bovine
semen are tested and shown to be free of antibodies.
Bovine Ephemeral Fever (BEF) – prevention & control

Results – Vaccine availability
and vaccination
BEF vaccination authorized in 16/21 countries
BEF vaccines used between 2015-2019 in 7/21 countries including Georgia,
Iran (Islamic Republic of), Israel and Tunisia
Veterinary Services & private veterinairians able to purchase the vaccine
(11 countries) > livestock owners (8 countries)
Killed vaccines (11 countries) > Live vaccines (8 countries)
In SEEN and NA - Veterinary Services encourage BEF vaccination to
livestock owners

Principles of BEF treatment
● BEF is rare amongst viral diseases in that rationally based
treatment is possible:
○ Rest
○ Provision of feed and water
○ Actions against recumbency
○ NSAIDS
Bovine Ephemeral Fever (BEF) – Treatment

BEF control in the lesgislation
● One of the sole diseases which are notifiable in Israel and
not in the OIE.
● Notifiable disease under the law of “Animal Diseases (1985)”.
Bovine Ephemeral Fever (BEF) - Legislation

Results – Legislation
applicable to BEF control
Notifiable disease in 7/21 countries of the EU neighborhood
No national control plan/contingency plan in place in the EU
neighborhood
In at least one country, import or quarantine requirements were reported
regarding live animals and semen in the context of BEF. Comments may
suggest that more countries applied measures for live animal or semen
import:
● import ban from BEF affected countries;
● for live animals in particular systematic quarantine with clinical checks
and eventually laboratory testing, vaccination against BEF, vector
control at the quarantine stations.

Socio-economic impact of BEF
● Economic impacts:
○ Loss of milk
○ Abortions
○ Treatments
○ Poor cattle condition at sale
● Threats:
○ Trade to naïve countries etc (Americas and most of
Europe).
Bovine Ephemeral Fever (BEF) - Socio-economic impact

Results – Knowledge self-
assessment and interest in
training
Medium economic impact at farm level (2.5/4)
Attention given to BEF was not sufficient
Poor knowledge on BEF epidemiology (1.4/3), diagnosis (1.3/3), and
control (1.3/3),
Low level of awareness on BEF among Official veterinarians (34/100),
private veterinarians (34/100) and livestock owners (24/100)
Awareness material and online training on BEF raised high interest in
all four regions

Conclusions:
● Results should be validated for official use
● A simple, rapid, cost effective approach
● To draw a picture of the level of understanding, knowledge, awareness and
perception of the FAST situation in different regions from an established
trainee community, including public and private veterinarians
● Useful to assist
o Laboratory and epidemiology networks in planning support activities
o Private stakeholders in identifying partnership opportunities,
o Research groups in identifying knowledge gaps and,
o Training providers in addressing specific knowledge gaps.

Take home messages and recommendations for SEE:
• Passive surveillance
• Wildlife as reservoir
• Awareness and training
• Haematophagous arthropod control
• Treatable (symptomatic) viral disease (short)
• Vaccines available
• Laboratory capacities for diagnostic
• Notification?

Thank you !
Add your personal message
91
The full report of the survey can be consulted here.

Summary of conclusions of the day
comments/questions/ clarifications
EUFMD Team

South Eastern Europe (SEE) Management
Meeting Online
94
Day Two

9
Day 2: South Eastern European countries
2 July Session Format
Section III. Simulation exercises and in-country support
9.00 – 9.30 Simulation exercises Presentation and discussions facilitated by
G.Filipović
9.30-10.00 Simulation exercises Presentation and discussions facilitated by
E.Karalliu,M.De La Puente Arevalo and
M.Hovari
10.00 -10.15 In-country assistance Presentation and discussion in plenary session
by G.Filipović, E.Karalliu and K.Krstevski
10:15 - 10:45 Coffee Break
Section IV. Laboratory preparedness
10.45 -11.05 Laboratory preparedness Presentation and discussion in plenary session
by K.Krstevski
11:05 -11:30 Proficiency testing scheme/
Diagnostic bank of reagents
Presentation and discussion in plenary session
by K.Krstevski
Section V. Barriers to emergency vaccination
11:30 -12:00 Barriers to the use of emergency
vaccination
Facilitated discussion by
B. Sanz- Bernardo and M. Grant
12.00 -12.10 Summary and closing of the day Presentation by the EuFMD team
ghhjjSEE Management Meeting
AGENDA: Day 2

Outcome summary of the CSF
simulation exercise in Montenegro
(using crisis simulation software)
96
Goran Filipović
2 July, 9.00 - 9.30 CEST

97
• Organized in Podgorica, MONTENEGRO
• Pilot project
• Conducted partially online
 Aim: test national contingency plan for CSF
 Objectives:
 Implementation of the measures in suspected and
confirmed case of CSF
 Institutional communication and informing in
emergency
1.4.3.2 Simulation exercises
CSF simulation exercise in Montenegro
Outline
(using Conducttr TeamXp software designed for
simulation of emergency)

98
• Concept note finalized and sent to planning
team one month prior the exercise
• Two online (zoom) briefings:
 First 18/05 to familiarize participants with
purpose&logistics of the exercise
 Second 28/05 to explain the tool (software)
• Conducted: 2nd June 2020
• Evaluation in process
Outline of activities

99
Participants, observers&logistic
• 14 players
 Administration for Food Safety, Veterinary and Phytosanitary Affairs
 Official Veterinarians (AFSVPA)
 Diagnostic Veterinary Laboratory
 Private Veterinarians
• 1 facilitator
• 3 evaluators
 2 evaluators followed exercise online
 1 evaluator in the room
• 2 observers
• 2 persons controlled the software
• 2 persons for video-link logistics

Conduction
 3 sessions (2h30’)
 5 teams (players groups):
• National competent authority team
• Official vets team
• Laboratory team
• Private vets team
• Expert group team
 5 individual roles assigned to the players
(private vet, official vet, epidemiologist, communication person)
 4 individual actors (role players) simulated trough the
software (farmer, media, social networks)

Injects
• More than 50 injects were placed to players,
simultaneously to different teams/roles, relevant for the
scope of their work
• All documents and forms used were adaptation of
authentic documents
• Facilitation was partially implemented trough the software,
asking players to respond the questions
• Players reactions were noted in the software

Outcome
 There were no issues with the software during exercise
conduction
 All players were connected and followed or responded
to the injects trough the software
 All players were engaged during conduction/discussion
 Gaps and strengths in the CP have been detected
 Feedback results: Excellent !

Further projects
Agreed:
• FMD Simex 22-25 September in Albania
• Multinational simex (Bosnia&Herzegovina, Croatia and Serbia),
November/December 2020?
Expressed interest:
• National simex in Serbia?
• National simex in Turkey?
• . . .

Thanks
DISCUSSION

Foot – and – Mouth Disease (FMD)
Simulation Exercise in Albania
22 – 25 September 2020
10
Esa Karalliu
Pillar I Technical Support Specialist
2 July, 9.30 - 10.00 CEST

● The last outbreak of FMD in Albania occurred in 1996.
● Currently Albania has a FMD contingency plan in place although not fully aligned
with the current legislation
● Since 2001, Albania is part of the OIE Members recognized as free from FMD
without vaccination. The free status needs to be reconfirmed each year following the
required procedures.
● This simulation exercise will serve as a good tool in testing the current contingency
plan and identify gaps which will be addressed in the future.
10
FMD simulation exercise in Albania
A bit of background...

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AIMOF EXERCISE
Support the development of the emergency response preparedness of the country for
FMD.
OBJECTIVE:
Test the ability of staff of the National Competent Authority to perform tasks in case of
suspicion of FMD outbreak.
Aim and objectives

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Tabletop(TTX)exercise:
● Measures to be implemented in case of suspicion and confirmation of the FMD
outbreak
● Coordination of DDLLM with International Organizations
Drill(DR)exercise:
● Assess the ability of field staff to carry out:
 biosecurity procedures
 clinical examination and lesion ageing
 taking and packing the samples
 epidemiological survey
Structure and specific objectives

- Refresh and update knowledge about FMD
- Test and improve the FMD national contingency plan
- Improve participants’ knowledge of protocols and operational manuals
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Expected outcomes

Thank you for your attention!

Multicountry simulation exercise,
Bosnia&Herzegovina, Croatia and
Serbia, November/December 2020
Maria De La Puente Arevalo, Mark Hovari
2 July, 9.30 - 10.00 CEST

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Multicountry simulation exercise
DURATION: Two days
DATES: End of November/Beginning of December 2020
• 17 - 19 November
• 24 - 26 November
• 08 - 10 December
Any preference?

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AIM: The aim of the exercise is to assess procedures in case of a TADs (FMD and/or
ASF) outbreak occurring simultaneously in Bosnia and Herzegovina, Croatia and Serbia
POSSIBLE OBJECTIVES:
• Assess the cross border communication in case of TADs outbreaks;
• Compare SOPs applied in the different countries to identify good practices;
• Assess capacity to define and establish zones in case of TADs;
• Assess capacity to plan stamping out of large scale commercial farms in case of
outbreak of TADs requiring stamping out of a holding;
• Assess measures in case of TADs confirmed in a slaughterhouse;
• Assess hazard specific measures with respect to epidemiological investigation and
tracing of ASF
• Assess hazard specific measures with respect to measures in wild boar in case of
ASF
Any preference?

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TYPE OF EXERCISE: Tabletop, face-to-face in one of the three
countries, using Conducttr Team Xp.
Plan B: Online tabletop, using zoom and Conducttr Team Xp.
• The exercise could have a part where multi-hazard management
capacities are tested and a disease specific part (ASF/FMD)
Any suggestions?

Presentation and discussions on the
in-country assistance support
provided to Albania through the
development of technical
documents
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Goran Filipović
Esa Karalliu
Kiril Krstevski
2 July, 10.00 – 10.15 CEST

Objective: Discussions on adaptation of the documents
developed for Albania to other countries in the region and
identifying needs to provide additional specific support for
improving their emergency preparedness system;
Expected outcomes: Agree with the countries to provide
support on developing technical documents in areas of
concern, as per their specific needs.
1.4.3.3 In-country assistance

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Documents developed for Albania:
● SOP for FMD clinical examination
1. CHECKLISTOF ACTIVITIES TO BE
UNDERTAKEN
2. EQUIPMENTNEEDED
3. WORKINSTRUCTIONTO CLINICALY
EXEMINETHEANIMALS
4. CLINICALINVESTIGATIONFORMFORFMD
● SOP for FMD epidemiological
enquiry
UNDERTAKEN
2. EQUIPMENTNEEDED
3. WORKINSTRUCTIONFORTHE
EPIDEMIOLOGICALENQUIRY
4. PAPERFORMFORFMDEPIDEMIOLOGICAL
ENQUIRY

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Documents developed for Albania:
● SOP for FMD clinical examination
UNDERTAKEN
2. EQUIPMENTNEEDED
3. WORKINSTRUCTIONTO CLINICALY
EXEMINETHEANIMALS
4. CLINICALINVESTIGATIONFORMFORFMD
● SOP for FMD epidemiological
enquiry
UNDERTAKEN
2. EQUIPMENTNEEDED
3. WORKINSTRUCTIONFORTHE
EPIDEMIOLOGICALENQUIRY
4. PAPERFORMFORFMDEPIDEMIOLOGICAL
ENQUIRY

Advantages of this approach:
● Easier work in case of FAST disease emergency
● Standardization in undertaken actions
● Better national and international networking
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Thanks
DISCUSSION

Laboratory preparedness /
PTS
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Kiril KRSTEVSKI
2 July, 10.45 - 11.05 CEST

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Proposal for Workshop: How to develop, test and improve your laboratory contingency
plan
Background: Majority of the Laboratories (11/13) in SEE do not have written contingency
plans for dealing with FMD and similar TADs outbreaks and have not carried out simulation
exercises to test their readiness. There is a lack of knowledge and experience in writing
adequate laboratory contingency plans for FAST diseases.
Learning objective: To improve the knowledge on Lab contingency planning among the
Laboratory managers and contribute to development of good quality LCPs.
Target audience: Institute or Laboratory leaders responsible for organization, management
and supervision of the laboratory work
Laboratories that will develop own CP would get technical support and guidance for
organization Lab SimEx in 2021 (closer work with volunteering laboratories)
Laboratory preparedness suport
1.4.3 Training activities

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Support in reagentsfor PTS (all 1.4 beneficiary countries)
(butalsoto ensurecontinious capacity for rapid and accurateFMD diagnosis)
- Questionnaire on specific needs circulated after the MM in Tirana (March)
- First deliveries have been organized in May, last ones should be completed soon
○ COVID-19 situation have negatively affected the process and caused delivery
delays (reduced staff at IZLSER, reduced flight options, longer times for customs-
clearance upon arrival)
1.6 Proficiency Testing Service
PTS – update
PT panels and participationat the EURLannualmeeting
- SEE countries that are not EU or EU-candidate countries
CoordinationwithEU-RL(ANSES) and PT follow–upover thelast six months:
- Basic training in PCR for two countries (1+1) was initially scheduled for April (postponed)
- EU-RL is checking and will soon recommend serotype-specific PCR protocols (available
protocols should increase the use PCR for typing)
- Proposal for advanced molecular training on FMDV sequencing (VP1) –for countries with
good experience in PCR and sequencing other pathogens.

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LAB RT-qPCR
(100 tests)
Ag-ELISA
(50 tests)
NSP ELISA
(460 tests)
SPC-O
(max.90 tests)
SPC-A
(max.90 tests)
SPC-Asia1
(max.90 tests)
Delivery status
1 YES NO YES YES YES YES delivered
2 YES YES YES YES YES YES delivered
3 YES YES YES YES YES YES
will be
dispatched
soon
4 YES NO YES NO NO NO
5 NO YES NO YES YES YES
6 YES YES YES YES YES YES
7 YES NO NO NO NO NO
8 YES YES YES NO NO NO delivered
11 YES NO YES NO NO NO delivered
• Expected delivery of PT samples: July
• Annual EU-RL Workshop (ANSES): September
Support in reagents (through the diagnostic bank- 1.4.4)
1.6 Proficiency Testing Service

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Kiril KRSTEVSKI
2 July, 11.05 - 11.30 CEST
Diagnostic bank of reagents

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2019 2020 2021 2022
REVISE AND PLAN THE RESTOCK ANNUALY
INITIAL
PROCUREMENT
AgELISA
SPCE (O,A,Asia)
NSP ELISA
PCR tests
RESTOCK
RESTOCK
shelf life 3
shelf life 2
shelf life 1
NO RISK -
- PT participation
- exclude suspect
NO RISK -
- PT participation
- exclude suspect
NO RISK -
- PT participation
- exclude suspect
RESTOCK
1.4.4 Diagnostic bank of reagets for FAST diseases
Where we are at the moment?

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Kits for FMDV detection Tests (kits)
Ag-ELISA (serotyping) 750
RT-qPCR (+ RNA extraction) 1 000
Kits for antibody detection
(serology)
Tests (kits)
NSP ELISA 460
SPC ELISA (Serotype O) 270
SPC ELISA (Serotype A) 270
SPC ELISA (Serotype Asia-1) 270
Current Quantities (July 2020)
Procurement Total
250 1 000
1 000 2 000
Procurement Total
5 060 5 520
720 990
720 990
720 990
Restock proposal (Year 2)
Diagnostic bank – FMD kits: update and plans

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We need to prioritizethediseases and methods(foroptimal use of theavailablefunds)
- EuFMD Category 1 diseases have been confirmed as priority animal diseases for the
region (questionnaire Mirzet Sabirovic)
- PPR
- LSD, SPGP(Capripoxviruses )
- Realtime PCR methods for virus detection
- First line diagnostic technique, valid protocols exist
- Lower costs to include them, especially if adapted to the same PCR components
used for FMD PCR kit assembly
Proposal for extension to other diseases

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Any questions or
comments?

Barriers to the use of emergency
vaccination
Component 1.3.1
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Beatriz Sanz Bernardo
Malin Grant
2 July, 11.30 - 12.00 CEST

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Experience from South East European countries
FMD outbreaks
Bulgaria…………2011
Turkey …………..present
LSD outbreaks SGPX outbreaks PPRV outbreaks
Albania ………… 2016 - 2017
Bulgaria ………...2016
Greece ………….2015 - 2017
Montenegro …2016
Serbia ………….. 2016
Turkey ………… 2013 - present
Bulgaria ………... 2013
Greece …………. 2006 - 2007
………… 2013 - 2018
Turkey ………….. present
Bulgaria ………… 2018
Turkey …………... present
Aim: existing barriers on the use of LSD (and other FAST diseases)
emergency vaccination
Source: OIE WAHIS Interface

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1. From Contingency planning to deployment of emergency
vaccination
Lessonsfromdetection of FASToutbreaks
● Did you have a contingencyplan when a FAST disease occurred in your country?
● Was emergency vaccination part of the plan?
● Difficulties to organize emergency vaccination: selection of vaccine, geographical area and
duration of the campaign.
○ What stoppedyoufrom start emergency vaccination?
● For diseases controlled by stamping out, were you ready for emergency vaccination if
thediseasewouldhave spreadfurther?
○ When do you startimplementing vaccination?
FAST
FMD outbreaks LSD outbreaks SGPX outbreaks PPRV outbreaks

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2. Practicalities on emergency vaccination
Lessonsfromdetection of FASToutbreaks
1. Movement restrictions (animals and products).
2. Vaccination to cull vs vaccination to live.
3. DIVA capacity.
4. Other comments.
FAST
FMD outbreaks LSD outbreaks SGPX outbreaks PPRV outbreaks

Thank you !
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