South Eastern Europe Management Meeting Tirana, Albania 5-6 February 2020

1. THRACE RISK BASED SURVEILLANCE PROGRAM
-ACTIVITIES IN 2019-
A.Naci Bulut
Şap Institute, Ankara,Turkey

2. BACKGROUND
• This program has been conducted since 2013
• The program has been created based on «risk based surveillance
model» developed by Angus Cameron :
1. Istanbul workshop (September 2012) :Angus
Cameron model (AusVet)
2. Tripartite Group Meeting held at Chania (February
2013): Agreed the model to be applied in the
region and outlined organization and logistic
3. 40th General Session: approved the srveillance
program

3. Objectives
• Provide ongoing evidence to
improve confidence in freedom
from FMD
• Increase the capacity for early
detection of incursions
• Provide a tool for disease managers
to help them estimate the level of
confidence in freedom and identify
areas for attention through the use
of a model for the analysis of FMD
surveillance data to demonstrate
freedom from FMD
• Contributing factors
• Surveillance sensitivity
• Sample size, design prevalence, test Se,
risk-based sampling
• Multiple surveillance activities
• e.g. serosurveillance + passive reporting +
abattoir
• Accumulation of historical evidence
over time
• Risk of introduction of disease over
time
Effects of vaccination
Lower within-herd design prevalence
Lower sensitivity of clinical surveillance
Probability of freedom

4. Tripartite Meeting, Chania, 2013
The effect of a survey with 95%
sensitivity conducted every two
years when the monthly risk of
introduction of infection is 0.05.
This frequency of surveillance is
inadequate to achieve an ongoing
high probability of freedom.
The same 2 yearly surveys, combined
with two other ongoing surveillance
components, each with a monthly
sensitivity of 0.2 (for instance, passive
reporting and abattoir surveillance).

5. Istanbul meeting, May 2013 5
Set by standards or
agreements
Import risk analysis, with
seasonal variation
Monthly probabilities
calculated according
to the RISK
High or Low level
risk factor with
attributable RATE
Set the value before start
Up to 6 surveillance
components

6. Scale of the project
EMPRESi
Model
Surveillance
Istanbul meeting, May 2013 6

7. Aproaches of the Program for Turkish Thrace
• Turkish Thrace is consisting of 5
provinces, Istanbul (European part),
Çanakkale (European Part), Edirne,
Kırklareli and Tekirdağ
• Istanbul was identified as high risk area
and remained area was low risk area
• In high risk area:
• Clinical and serological surveillance in all
epi-units
• Ongoing surveillance activities as 4
periods_Accumulation of historical
evidence over time
• In low risk area:
• Not identified any specific surveillance by
original model- routine passive surveillance

8. 1. Geographical area of FMD risk-based surveillance
Area description: The, Istanbul province, districts in the Turkish Thrace
• Type of epidemiological unit identified : 109 (2 abattoir) villages/epi-units ,
each defined as a single epidemiological unit
2. Surveillance target (per 3-month surveillance cycle)
Serology (Statistical target: To detect a 25% prevalence among animals of each
and every epidemiological unit=village, with a 95% level of confidence)
Collection and testing of 11 samples from vaccinated bovines and/or sheep-
goats, from every epidemiological unit (village).
109 villages X 11 samples /village/cycle X 4 samplings per year = 4796 samples
per annum
(1.199 samples per cycle).
Clinical surveillance (Statistical target: to detect a 5% prevalence of FMD clinical
signs among susceptible animals of each epidemiological unit with a 95% level
of confidence).
Within each and every one of the 120 epidemiological units (villages), clinical
examination of at least 60 bovines (on the basis that vaccinated cattle, will
develop less evident FMD clinical signs). In villages where the total of bovines
is less than 60 all bovines will be examined.
Components of the RB surveillance program: Cycle Year Months
1st cycle 2018 Jan-Feb-Mar
2nd cycle 2018 Apr-Mai-Jun
3rd cycle 2018 Jul-Aug-Sep
4th cycle 2018 Oct-Nov-Dec

9. ADDITIONAL SURVEİLLANCE COMPONENTS IN REMAINED AREA
Clinical surveillance for FMD and LSD
• Statistical target: to detect a herd prevalence of 10% and prevalence within the herds of 5%
FMD for detecting the clinical signs among susceptible animals of each epidemiological
unit with a 95% level of confidence.
• LSD and FMD in four province; only FMD in Istanbul
• (Number of epi-units to be sampled distributed propotion number of total number of
villages per province by expected prevalance; Çanakkale:33; Istanbul:43; Edirne:53;
Kırklareli:52 and Tekirdağ:55)
Integration of S&GP and PPR surveillance into the surveillance program:
• to detect a herd prevalence of 25% with CL95% and prevalence within the herds of 10%
with CL95%
• _a number of 126 villages are randomly selected and from each village a number of 57
animals are selected for clinical examination
• Clinical surveillance for FMD first has been added in remained area of Thrace by Turkish Veterinary Service
to increase detection of probability
• LSD has been also intedrated later in this clinical surveillance component
• Based on PPR workshop outputs, a clinical surveillance also has been integrated for S&GP/PPR

10. MAP DISTRIBUTION OF EPI-UNITS SURVEILLANCE
CONDUCTED IN THRACE
IN HIGH RISK AREA
IN ALL AREA

11. FMD in High/low risk area
Clinical Surveillance Achievement_2019
Province
N.epi-units
controlled
N.cattle
controlled
onfarm
Istanbul 428 25680
Çanakkale 132 7380
Edirne 208 12720
Kırklareli 212 12480
Tekirdağ 220 13200
Total 1200 70920

12. SERA SAMPLE COLLECTED IN HIGH RISK AREA
Species sampled No of sera collected %
LR(cattle&W.Buffallo) 2921 60,90
Sheep 1659 34,60
Goat 216 4.50
Total 4796 100.00
4796 sera (11 sera per unit) were collected from cattle, sheep, goat and water buffalo (different
number of sera from different species) in 109 epi units (107 villages; 2 abattoirs) located in
Istanbul in 4 periods of 2019.
• All, 4796, sera were tested by NSP ELISA.
• 8 sera out of 4796 were initially detected as positive; 5, 1,2 and 0 were for 1st, 2nd, 3rd and 4th period respectively
• All 8 sera were re-tested again by NSP ELISAand titred by LPBE.
• Detected as negative by re-tested by NSP ELISA and determined low antibody titres by LPBE sugessted induced by
vaccination
• Although there has been detected negative all initial positive sera by re-test, a follow-up investigation also has been
conducted in each time in order to ensure detection of the any probability
• Sera samples, in total of 1523, were collected in initial positive farms and units and also conducted epidemiological
investigation.
• there has been not detected any risk probability of FMD virus circulation in all 8 villages
conducted follow up investigation

13. Istanbul 132 7620
LSDclınıcalSURVEY
Çanakkale
132 7380
Edirne 208 12720
Kırklareli 212 12480
Tekirdağ
220 13200
Total 904 53700
Clinical surveillance
N.epi-units
controlled
N.cattle
controlled
onfarm
LSD;
Achievement_2019 Design summary:
LSD clinical surveillance
(Statistical target: to detect a herd
prevalence of 10% and prevalence within
the herds of 5% FMD for detecting the
clinical signs among susceptible animals
of each epidemiological unit with a 95%
level of confidence).
(Number of epi-units to be sampled
distributed propotion number of total
number of villages per province by
expected prevalance;
Çanakkale:33;
Istanbul:43;
Edirne:53;
Kırklareli:52 and
Tekirdağ:55)
In total 236 epi units, clinical surveillance
is conducted in every cycle. 4 cycles are
realized a year.

14. S&GP and PPR;
Clinical Surveillance Achievement_2019
Province
Clinical surveillance
N.epi-units
controlled
N.sheep/goats
controlledon
farm
TOTALanimals
controlledon
farm
Istanbul 65 4275 4275
Çanakkale 13 741 741
Edirne 153 8493 8493
Kırklareli 116 6840 6840
Tekirdağ 152 8811 8811
Total 490 29844 29844
Design of S&GP/PPR Clinical
surveillance
to detect a herd prevalence of
25% with CL95% and prevalence
within the herds of 10% with
CL95%
_a number of 126 villages are
randomly selected and from
each village a number of 57
animals are selected for clinical
examination

15. CONFIDENCE RATIO
1. Notification: During the cycle, it has not been notified FMD in Thrace region.
2. Suspect case: It has not been reported any suspect case by clinical examination for FMD and other exotic diseases.
3. Although several initial positives have been detected by NSP ELISA for serology samples, these samples were determined negative
by confirmatory tests and it has been ensured that there has been not detected any risk for circulated virus in the region by follow-up
investigation. These initial positives were assessed false positive which was inherently acceptable within the specificity range of the
NSP tests.

16. Follow-up activities for 2020
• A new protocol describing surveillance activities to be conducted in
2020 has been prepared and delivered to the veterinary service in
Turkish Thrace in 5th January 2020.
• Procurement for material for sampling and test kit for NSP ELISA for
2020 will be proceed next month.
• Recommended that a reminder workshop by visiting each province in
the Turkish Thrace region
• Refresh vet knowledge on risk base surveillance program
• A general lecture on diseases control

17. Vaccination policy in Thrace region
• A routine campaign preventive vaccination implemented in the region is as
following:
• For large ruminants (cattle and water buffalo): Twice a year all population as
campaign, early Spring and Autumn; small ruminants (sheep and goat): once a
year in Spring.
• In addition to campaign vaccination, booster vaccination for primo-vaccinator of
LR is also implemented.
• Monitoring of vaccination
• Cumulative 99.2% and 91.3% for routine campaign and booster respectively
vaccination coverage was achieved in all five provinces in Thrace region.
Spring _2019 Autumn_2019
Provinces Routine campaign Vaccination % Booster vaccination% Routine campaign Vaccination% Booster vaccination%
Çannakkale 99.7 95,5 98,8 91,3
Edirne 97.5 95,9 98,4 89,5
Istanbul 100 96,0 99,6 95,8
Kırklareli 99,9 92,3 97,5 96,0
Tekirdağ 97.8 89,9 96,9 74,3
Total 99.95 93,92 98,24 89,38

18. SP SURVEILLANCE IN THRACE
Çanakkale Edirne Istanbul Kırklareli Tekirdağ
Serotype O 96.8 98.2 97.5 96.4 93.5
Serotype A 99.2 97.9 98.3 96.4 97.5
Serotype Asia1 99.8 98.6 97.8 99.2 97.2
0
10
20
30
40
50
60
70
80
90
100
Protectionratio
Province
Protection rate by Province&Serotype
Serotype O Serotype A Serotype Asia1
• To monitor protection level, post vaccination structural protein (SP) of FMDV
serosurveillance was conducted after spring vaccination campaign to estimate
protection level due to serotype O/PanAsiaII, A/Asia/GenotypeVII and
Asia1/Sindh08 in population existed in all five provinces.
• For this propose, at least %80 protection level with %95 CI was targeted and in
this sera collection frame, in total 3010 sera were collected from cattle in five
provinces.
Provinces N. SERA SAMPLE
COLLECTED
Çannakkale 346
Edirne 584
Istanbul 670
Kırklareli 660
Tekirdağ 750
Total 3010