Report on The Participatory Epidemiological Investigation of FMD in Erzurum Province
Support of the training of veterinary officers in the participatory epidemiological investigation of FMD in Erzurum Province
1200000
1000000
800000
Vaccinations 600000 Population 400000 200000
0 Year 2003 Year 2004 Year 2005
PART TWO
Consultant’s End of Assignment Report
Berhanu Admassu Addis Ababa November 2005
1
Content Page
1. Introduction...... 3 2. Objectives: ...... 3 3. Study structure and Methodology...... 4 4. Results...... 6 4.1. General disease ranking ...... 6 4.2. Recent FMD outbreaks history...... 8 4.3. Incidence and mortality...... 11 4.4. Age groups affected ...... 12 4.5. Sources of FMD outbreaks ...... 13 4.6. Spatial and seasonal Factors ...... 16 4.7. Livestock movement to and from market ...... 17 4.8. Vaccination history...... 20 5. Summary and Conclusion...... 24 6. Annexes...... 27
2 1. Introduction
The province of Erzurum in eastern Anatolia exhibits one of the highest incidences of FMD in Turkey. Previous EUFMD-FAO work with the General Directorate of Protection and Control (GDPC), Turkey, has illustrated the difficulties of FMD control in this region and identified a number of uncertainties in the epidemiology of the disease which if resolved might improve the targeting of control measures. The principle of a longitudinal study to identify the spread of infection in space and time was discussed with GDPC in November 2004 (in Ankara) and in April 2005 (in Rome). The EUFMD Commission conducted a mission to Erzurum in June 2005 which concluded that a rapid epidemiological survey of FMD could proceed in summer 2005. The purpose of the activities is to gain information on the incidence and distribution of FMD in the province, and on the patterns of disease incidence and spread. In doing so, the FAO consultant conducted a mission to Erzurum Province in July 2005 and trained veterinarians in participatory methods and techniques of disease investigation to undertake PE studies to identify key features of FMD epidemiology in Erzurum province. After the training a province wide epidemiological appraisal of current FMD situation and recent FMD history and community experience was conducted. This report is therefore reviews the findings of the participatory epidemiological studies into the epidemiology of foot-and-mouth disease in Erzurum Province conducted in August-September 2005.
Description of the study area Erzurum is the largest province in Eastern Anatolia and is located on a high plateau. The majority of the province is elevated. Depression plains are located between the mountains and plateaus. The province has a long and harsh winters, and short and mild summers. It is snow covered from November to April. The province of Erzurum has a population of about one million people. The largest city Erzurum has a population of about 400,000. For administrative purposes the province is divided into 18 districts which are subdivided into villages. Each district has its Director of Agriculture while each village has its Headman (Muhtar) with important authority in administration at village level.
Erzurum has the highest ratio of meadows and pastures in Turkey, ideal for stockbreeding. The livestock population of the province is Cattle are the most common livestock in Erzurum. There are about 500,000 cattle in the province. The structure of Agriculture is based on communal grazing by all livestock in individual villages. All the animals owned by different farmers share grazing land. The province of Erzurum is a province with one of the highest incidences of FMD in Turkey. 2. Objectives: to gain information on the incidence and distribution of FMD in Erzurum Province and on patterns of disease incidence and spread through province wide epidemiological
3 investigation. In addition, the study sought to collect information on the recent history of FMD circulation and community experience, through the process of participatory disease investigation methods in randomly selected villages from each district.
3. Study structure and Methodology
In this investigation villages are chosen as a basic unit of interest. This will make an easy, faster and cheaper collection of reliable information about the epidemiology of FMD at village level. The study technique is based on selection of villages from each district by simple random selection. Each selected village is visited by a survey team, and a group interview conducted. Once the participatory epidemiological investigation team reaches the selected village, the selection of informants within the village was not at random. The choice of respondents will be on the basis of whom in the village can provide complete and reliable information about the study unit. The interview was carried out with 6-10 livestock owners selected from each village. The interview was based on their indigenous knowledge, perception and the views of interviewee were ascertained. In addition at each village the interviewers were identified informants who were thought by the local community to possess particular knowledge of practices and these key informants includes the village headman (Muhtar). The Muhtar is the democratically elected leader/representative of the village.
For the reason of increasing the precision and variability of the information collected from villagers and to increase the sensitivity of the investigation methods a 99% Cl was used to determine the sample size of the study. Therefore a sample of 98 villages was chosen by simple random sampling from all the villages in 18 districts (N=1050). The sampling frame used was based on up-to-date village lists obtained from the Veterinary Control and Research Institute (VCRI).
Study Methods Participatory methods were used to collect all the required data and information. These methods were semi-structured interviews (SSI), used throughout the investigations; specifically these interviews were used to collect general background information on local perceptions of the most important cattle diseases. Interviews were also used extensively in connection with other participatory epidemiology methods such as matrix scoring, proportional piling, seasonal calendars and participatory mapping.
Study team composition and schedule The survey team contained six veterinarians, who had previously been trained in participatory approach and methods and had experience of using the methods in the field. These investigators were selected from the provincial veterinary service and from the veterinary control and research institute. The investigators were received a ten days PE training. After the training they were practiced in three villages of Erzurum district for 3 days as pre-test and made discussions on the responses in order to develop experience and skill for the main practical fieldwork.
4 The PE disease investigation was started on 8 th , August 2005 and completed on 20 th September 2005. A total of 670 community informants participated in the PE disease investigation.
Map 1. Study area and randomly selected villages
Data
5 4. Results
4.1. General disease ranking
Informal semi-structured interviews were used to collect general background information on local perceptions of the most important cattle diseases. These interviews were based on probing open questions designed to cross check information. The respondents were requested to list the major diseases of cattle and then, to describe the clinical, epidemiological and gross pathological picture for each disease comprehensively. The diseases mentioned were then listed and the respondents were requested to rank them in order of frequency of occurrence and economical importance.
The most common cattle disease terms mentioned in all 98 villages is presented in Table 1. Many other disease terms were mentioned but were not explored in detail. The discussions have revealed that cattle owners were able to accurately describe and rank cattle diseases based on the frequency of occurrence of the disease. Informants were asked the name by which these diseases are usually called in the village. The local name of these diseases is shown on Table1. Informants from all villages referred to FMD with the local term " Dabak " and the typical signs of FMD were also consistently described as shown on Table 2. The term şap is usually used by veterinary professionals which is the direct translation of the term FMD. The term Dabak means "underfoot" to signify that the sole of the foot is affected.
Dabak (FMD) was invariably mentioned as a major disease concern in each interview. Respondents were asked to rank the five most important diseases among the list provided. Dabak ranked first in 54 villages and 2 nd and 3 rd in 16 villages (Table 1). All livestock keepers were knowledgeable in regard to Dabak and without fail could provide a full and accurate description of the disease.
Table 1: summary of the current cattle diseases according to their importance in Erzurum province
English Local Name equivalent 1st 2nd 3rd 4th 5th Total şap(Dabak) FMD 54 8 8 1 0 71 yanıkara Blackleg 11 22 16 6 1 56 yavru atma Brucellosis 1 17 5 11 7 41 sarılık Icterus 4 16 14 3 1 38 şarbon Anthrax 1 8 6 9 0 24 Others 4 7 9 24 Source: PE investigation result
6 Respondents were also asked to explain about historic disease events. In addition to the list of diseases given in Table 1 and invariably sigir vebasi (rinderpest) was mentioned in their recall. Table 2. Summary of list of historical cattle diseases and their rank
1st 2nd 3rd 4th 5th Total FMD Dabak ( şap) 21 12 6 1 0 40 Rinderpest sigir vebasi 7 0 0 3 0 10 icterus sarılık 4 7 3 3 0 17 Black leg yanıkara 9 13 6 2 0 30 Anthrax şarbon 4 5 12 3 0 24 brucellosis yavru atma 1 2 3 7 2 15 others 1 1 3 4 4 13 Source: PE investigation result
Local perceptions of disease signs
The purpose of this exercise was to recognize whether respondents have personally seen FMD in their lifetimes. All livestock owners involved in the interview exercise in all investigated villages have exposed to FMD and they have seen Dabak (FMD) in their lifetime. Since Dabak (FMD) was the commonly mentioned disease, respondents were again asked to describe the disease as part of the verification process and they described Dabak with the following clinical courses in order of progression. • fever • salivation • loss of appetite • lamness • mouth and foot lesions. • Salivation, fever, mouth and foot lesions are the most frequently noted clinical signs and followed by the development of mouth and foot lesions and lameness. Analysis of the disease signs scores demonstrated good agreement between the informant groups.
Table 3. Matrix of frequencies of clinical signs reported by respondents
Clinical courses Clinical signs and lesions Number of Informants observed salivation 79 Fever (high temperature) 33 Clinical signs observed when in appetence 21 the disease start dullness 6 rough skin 3 lacrimation 1
7 lameness 31 lesion in mouth 19 salivation 9 lesion on foot 8 Clinical signs observed to lesion on muzzle and mouth 5 follow the initial ones lesion in mouth and foot 4 anorexia 5 fever 3 lacrimation 1 rough hair coat 1 lesion on foot 23 lameness 22 lesion in mouth and foot 14 lesion on foot and lameness 7 Clinical signs observed late lesion in mouth 5 in the progression of the lesion in mouth and foot and teat 2 disease lesion in the mouth and tongue 2 fever 2 sudden calve death 1 anorexia 1 salivation and lesion in the mouth 1 Source: PE investigation result
4.2. Recent FMD outbreaks history A retrospective investigation of village FMD outbreaks through targeted focus group and key informants was done in order to find out if there has ever been an outbreak of FMD in the village. If there has been an outbreak, the date of the last outbreak and the estimated number of animals affected was required. If there has never been an outbreak in the memory of any of the villagers, the earliest date since which group is sure that there have been no outbreaks is also required.
Most recent outbreak (2005) Second most recent outbreak (2004) Third most recent outbreak (2003) Year 2002
Year 2001
Year 2000
Year 1998
Figure 1. The percentage of investigated villages reported the last date of FMD outbreak between 1998 and 2005.
8
Informant's observation on the occurrence of FMD in their own herds, neighbouring herds was reported. All the villages surveyed reported having had an outbreak of FMD and occurred very frequently in their herds and also they observed in the neighboring villages. Respondents provided the last date of FMD outbreaks between 1998 and 2005 For all surveyed villages, FMD outbreak is a common episode and the disease was not reported to animal health authorities at every occurrence.
Figure 2. Pattern of FMD outbreaks between 1998-2005
2003-2004-2005
2002-2003-2005
2002- 2003-2004
2001-2002-2003
2000-2001-2002
Outbreak pattern Outbreak 1999-2000-2001
1998-1999-2000
2001
1998
0 5 10 15 20 25 30 35 40 45 50
No.of villages reported
All the 98 villages surveyed reported having had an outbreak of FMD. Among the surveyed villages 64% of them have reported that they have encountered FMD outbreaks in 2005, while 17% of the villages reported that the last date of the outbreak in 2004 and the rest 19% of the villages recalled the date of the outbreak as being about 4-8 years back (see figure 2).
During this investigation the teams have encountered 11 active FMD outbreaks in Ciflik and Merdiven ( A KALE) , Guzelyurt and Toparlak (MERKEZ), ba şpınarlar and kosk ( ENKAYA), sirakonak, (ĐSP ĐR), muratbagi (HORSAN), serdarli bld (TORTUM), bellitas (HINIS) and Tüysüz ( ÇAT) villages.
9 Map 2. Geographical distribution of FMD outbreaks between 1998-2005.
The above map provides the current history of FMD outbreak and community experience for the last eight years in the province. In this FMD outbreaks distribution, some districts such as such as Paslinar, Oltu, Cat, Ilica, Ispir show a better situation in occurrence of outbreaks in 2005. For instance in Paslinar, there was only one village reported an outbreak in 2005. Additional information indicated that this district is an agricultural area and communal grazing is not practiced. Farmers keep animals in their own grazing fields.
In Oltu district, the disease is more of a concern for small-scale farmers with high producing animals. Respondents of the villages often indicated that they are and would be prepared to pay the full cost of vaccine, which is a signal of the importance they place on the disease. It was also mentioned that vaccination coverage is improving from time to time in this district. Farmers are aware of the importance of direct cattle to cattle transmission of FMD and often expressed concerns over the difficulty of avoiding contact with animals in markets such as Erzurum, Oltu and Narman.
10 In ILica only the Elmali village has reported outbreak in 2005. Informants confirmed that cattle were not vaccinated regularly. The source of the outbreak was reported to be an introduction of recently purchased infected heifer. It should be mentioned that the cattle populations of north western districts are epidemiologically separate from the south and eastern districts, because of a vast area with low cattle density.
The north eastern districts of the province have reported several outbreaks. The source of the infection was from Gole market in Ardahan province. The central districts are also illustrating that more villages were infected in 2005. The main source of the infection was purchase of infected animals from Erzurum market.
Reporting outbreaks
11%
24% Reported
Not reported
not remembered
65% Figure 3. Reporting status of FMD outbreaks as recalled by respondents During the discussion informants reported that 65% of the outbreaks occured in 2004 and 2005 were not reported. The reporting of suspected outbreaks of disease is very low. According to the information, out of the reported 24 outbreaks only 18 were investigated by veterinary professionals. Informants have pointed out that incase of an outbreak community members and traders are reluctant to report and /or they do not want somebody to report it. Farmers consider that if an outbreak is reported to higher officials or veterinarians they fear that restriction of animal movements might placed on them. During an outbreak, the provincial, district and village animal health police force commission will immediately ban the entrance and exit of animals and animal products to and from the concerned area. Animal markets are also closed. Due to these fear many outbreaks are not reported.
4.3. Incidence and mortality Proportional piling was used to determine the incidence and mortality of FMD in surveyed villages. The mean incidence and mortality with 95% confidence limits were calculated for each district from the data collected from each village. Therefore the mean
11 incidence and mortality rate of FMD estimated by informants in each district is shown on Table 4. The overall mean incidence rate of FMD for Erzurum province is 30.9% (2.5 - 93.3) while the overall mortality rate of cattle due to FMD is 0.3% (0-5.9).
Table 4 . Mean incidence and mortality rate of FMD per district
Incidence rate Mortality rate Districts % % HINIS 52.2 0.7 TEKMAN 37.5 0.0 HORASAN 40.9 0.3 ÇAT 0.8 0.0 MERKEZ 20.7 0.3 ĐSP ĐR 1.5 0.0 NARMAN 45.6 0.5 ENKAYA 50.2 0.1 KARAÇOBAN 25.7 0.0 KARAYAZI 31.1 0.7 PAS ĐNLER 34.0 0.0 A KALE 34.9 0.7 ILICA 7.9 0.5 PAZARYOLU 37.7 0.0 TORTUM 48.9 1.3 OLTU 6.9 0.0 OLUR 49.1 0.6 30.9 0.3 30.9(2.5-93.3) 0.3(0-5.9)
4.4. Age groups affected
All age groups are affected by FMD. The most severe form of the disease is seen mostly in juvenile cattle (0-2 years of age). Respondents explained that out of 100 animals affected by FMD 88% of them would be juvenile cattle. The reason given to this observation is that cattle owners usually do not want their pregnant cows to be vaccinated in fear of a possible abortion due to the vaccine. This apprehension was developed due to the notice written on the label of the vaccine some years back which says "do not apply the vaccine in late pregnancy". Calving is regularly taking place during the end of the winter season (at the end of February and early March). These young born caves are disregarded during the spring vaccination campaign due to their age; mainly less than 4 months of age. Afterwards they are the first to be affected easily by the disease during the spring and summer outbreak episode. Informants believe that most of these outbreaks are associated with the recent purchase of some of these unvaccinated young cattle from animal market or village livestock dealer.
12
12%
young
adult
88%
Figure 3. Proportion of cattle age groups affected by FMD outbreak
In relation to species involvement respondents mainly associated FMD with cattle. There are some reports from the northern districts that wild pig populations shows some evidence of FMD clinical signs similar to cattle. Framers believe that these wild pigs can sometimes transmit the disease to cattle in the grazing areas in particular when ever there is shortage of feed in the mountainous areas.
Framers also observed mild clinical signs of FMD on small ruminants, in particular sheep affected by FMD. The southern districts such as Karayazi, Hinis, Tekman, Cat and Horsan small ruminant populations are large and they often graze in close association with cattle. For instance the source of May 2005 outbreak in Akkeren and Hacihalil villages in Horsan district was associated with migratory sheep flock came from Igdir. Nomadic sheep are found in Eastern and South-Eastern provinces of the country where flocks of up to 2000 sheep belonging to nomadic tribesmen move with the seasonal growth of herbage from the lowland winter ranges to highland summer grazing areas of Erzurum and back.
4.5. Sources of FMD outbreaks
Interviews with farmers indicated that sources of outbreaks are associated with herds in the same village including own herd and neighboring village herds.
Out of the 98 villages interviewed 41 % of them affirmed that the source of the infection was their own herd while 59 % of the respondents blamed the neighboring village's herd.
Where did the FMD outbreak occur at first? The response for this question is shown as follows:
13
41% our village
neighbouring 59% village
Number of villages reported our own village herd 40 neighboring village's herd 58
Figure 4. Proportions of villages reported the first outbreak
71% of the investigated villages have also reported that cattle purchased from markets were introduced into their herd during the month or so before the FMD outbreak was first noticed.
Spread of FMD within the province
Where do animals to contact with another herd at most? (Simple ranking in order of importance)
Rank Risk factors Frequencies First Grazing on the plain ●●●●●●●●●●● Second Grazing on the highland pasture ●●●●●●●● Third Watering points ●●●●●● Fourth Homestead area ●●●●●
Respondents clearly showed that one of the most risk factor in their respective villages and districts is the movements of animals within and between villages and districts.
14 Livestock movement is identified as a major factor in the spread of FMD infection and the following reasons were mentioned:
17, 17% Grazing at the plain
36, 36%
During watering
24, 24% Grazing at yayla
23, 23% around homestead
Figure 5. Risk factors identified for the spread of FMD infection during mixing
The interview with informants indicated that FMD outbreaks in cattle are associated with: • uncontrolled communal grazing • contact with neighbouring village pasture • purchase of animals from animal markets without proper veterinary inspection • introducing newly purchased animal into the herd without quarantine • exposure of sick animal out of the barn to the grazing area or forcing to walk on mud, thinking the disease will leave the animal easily • animal dealers, who travel from village to village, • animal trade between villages, purchase of animals from animal markets with out proper examination Depending on proximity to the communal grazing areas, three types of grazing movement pattern are identified. In May the cattle graze the communal grazing in the large plains around the villages.
1. After a long period being kept in door in autumn and winter seasons, cattle (mostly young fattening animals) are turned out to the large plains around the villages. From then on they are moved to higher pastures in the highlands (yayla grazing areas) where they stay from June to the end of September. The land near the villages is then used to grow the fodder crops for winter use. 2. At the end of September and early October, animals are returned from the highlands and stay on the plain grazing fields and make a remarkable density of grazing livestock on the plain, predominantly cattle with relatively few small ruminants and occasional buffalo. 3. In some villages, where there is no movement to the highland pasture, cattle are kept around homestead and on the plain during the spring and summer seasons.
15 Respondents reported that the disease usually occurs in spring and summer seasons when herds congregate around pasture and watering points, creating favorable contribution for the dissemination of virus from infected to susceptible animals.
It is a common practice for herds to share grazing and watering points. Out of 98 villages surveyed only 6 villages have said that they are practicing closed grazing system. The reset 92 villages are sharing contiguous grazing grounds, commonly in a 6-10 grazing groups during spring and summer months in the unenclosed pasture. The number of animals in one grazing group is often around 250-300. The cattle population density and the herding of animals in discrete groups most probably maintain the continual re-introduction of virus, as indicated largely with bought-in subclinically-infected animals. Next to the communal grazing, some degree of contact during watering at streams in yayla and within villages is also identified to contribute for the spread of the virus between different groups of animals in the village and neighboring villages.
Figure 6. Are grazing lands, water sources, drinking troughs shared even temporarily with other herds?
100
80
60 40
20
0 Yes No 4.6. Spatial and seasonal Factors Seasonal variations in the incidence of FMD indicated that most cases 76% of the outbreaks observed in the spring season (April-June). This seasonal pattern was associated with movements of cattle to communal grazing areas. During the autumn and winter season animals are moved and housed in the barn and the incidence decreased. During spring time cattle are moved out of the barn and turned out to the plain grazing areas temporarily until the snow melts on the mountain pasture. The incidence of FMD peaked when cattle are present in the open communal grazing area.
Table 5. The duration of contact between different epidemiological groups is identified as follows.
Grazing at highland pasture area (Yayla) 3(2- 6) months Grazing at the plain area 6(3-6) months Watering at Yayla 3(2-6) months watering at plain 6(3-8) months Table 6. How frequently are animals rotated during the grazing season?
villages never used rotation at all 48
16 villages using rotation twice in a year 15 villages using rotation three times a year times 10 villages frequently rotating with out restriction 27
Table 7. How far pastures are away from different epidemiological groups?
1 km far 65 5 km far 27 10 km far 4 > 10 km far 1
4.7. Livestock movement to and from market an additional risk factor identified was livestock movement to and from markets. Respondents have reported that in Erzurum province and the neighboring provinces large number of animal markets exists without proper veterinary inspection. Introductions of purchased cattle (frequently young animals) from these markets are the first source of the infection. Respondents also believe that close contact with trade cattle within the same village and along the long distances trek without any sanitary control is also serve as source of the infection. Nearly all FMD outbreaks occurred in 2005 in 62 villages were associated with these animal markets as sources of infection. A large proportion of animals produced in Erzurum are sent westwards towards the larger human population densities for fattening and slaughter. The list of these markets associated with the reported outbreaks is shown on Table 8.
Table 8. List of sources of infection of FMD outbreaks in 2005 as perceived by informants
No. of outbreaks Number of reported in villages District 2005 Sources of infection (disease) reported HINIS 4 Erzurum animal market 2 TEKMAN 4 Erzurum animal market 3 TEKMAN Güzeldere village 1 HORASAN 7 Erzurum and Horasan animal market 4 HORASAN Sheep flock came from Igdır 2 ÇAT 1 Erzurum animal market 1 ĐSP ĐR 1 neighboring village 1 OLTU 1 Oltu animal market 1 TORTUM 4 Erzurum animal market 2 TORTUM Tortum animal market 1 TORTUM Oltu animal market 1 TORTUM Ta oluk village 1 TORTUM Dumlu village 1 A KALE 4 Erzurum animal market 1 A KALE A kale animal market 1 PAS ĐNLER 2 Erzurum animal market 2
17 KARAYAZI 9 Erzurum animal market 2 KARAYAZI Neighboring village (Tutak, Agri) 3 KARAYAZI Karayazı animal market 3 KARAÇOBAN 2 Mu Bulanık animal market 2 ENKAYA 6 A kale,Göle and enkaya animal market 3 ENKAYA Oltu animal market 1 NARMAN 4 Narman animal market 3 NARMAN Mahmutçavu village 1 MERKEZ 8 Erzurum animal market 8 OLUR 3 Unknown PAZARYOLU 1 Unknown ILICA 1 Unknown
There is an intensive movement of cattle inside the province from district to district and village to village for breeding, fattening or slaughter for trade.
3 7 11 8 2
4 To western 6 provinces 10 1
5
12
9
18 Map. 3. Livestock markets, trade routes and market networking
12 animal markets are identified according to their importance from FMD disease source point of view. These markets are indicated on the map and their list is provided on Table 9 below. Table 9. List of important cattle markets in Erzurum Province shown on Map 3.
No. of market Market name days /week 1 Erzurum animal market 6 2 Narman animal market 1 3 Oltu animal market 1 4 Horasan animal market 1 5 Karayazı animal market 1 6 Pasinler animal market 1 7 Senkaya animal market 1 8 Tortum animal market 1 9 Hinis animal market 1 10 Askale animal market 1 11 Ispir animal market 1 12 Cat animal market 1 None of these animal markets have proper inspection / control services.
Informants were asked whether this disease could be preventable or avoidable. The discussion and scoring of the different preventive methods based on their technical knowledge shows that 90% of the village informants believe that foot-and-mouth disease is preventable and 10% said it can not be prevented. In order to prevent this disease informants suggested some actions as follows. The ranking of these methods indicated that farmers were already knows the major preventive and control methods. Table 10. Livestock owner's technical knowledge on FMD preventive/control measures
vehicles carrying the animal should be closed cabin(wagon)
access to effective veterinary service
Border inspection
avoid buying unvaccinated animal
prevent contact with neighboring herd
Buying animals with inspection
Disinfection of farms, utensiles and other materials
Quarantine newly purchased animal before introduction
Control of grazing area
Control and inspection of animal movement
Suggestive preventive actions preventive Suggestive veterinary inspection service in the animal market
Timely vaccination
0 20 40 60 80 100 19 No.of villages suggesting preventive actions The community already knows the various preventive/control measures of FMD. Several of these are very effective and easy to use for good sustainability. Some of these activities require potentially difficult agreement between neighbouring villages and also some has some legal implications.
4.8. Vaccination history Informants were asked in the interviews about their knowledge, attitudes and constraints in regard to FMD vaccination. They have reported that vaccination was carried out in 83% of the surveyed villages in 2005 and mainly it was a spring vaccination while 17% of the villages have not vaccinated their herd. Since the PE investigation was executed in August and September the report does not include the autumn 2005 vaccination result.
Table 11. The last date of FMD vaccination as recalled by respondents
Last date of vaccination Number of villages The 2005 spring vaccination 80 The 2004 spring vaccination 7 The 2004 autumn vaccination 1 The 2002 spring vaccination 1 No information 9
Figure 7. Three years FMD Vaccination achievements
1200000
1000000
800000
Vaccinations 600000 Population
400000
200000
0 Year 2003 Year 2004 Year 2005
Mass vaccination campaign twice in a year (spring and autumn) is practiced in the province. Frequently, the spring vaccination campaign is carried out between March and April and the autumn vaccination campaign in September and October. However, the vaccination coverage in all districts was analysed and mapped as follows (Map 4-6).
20 Mapping the vaccination coverage is a useful exercise as it provides a very clear overview what has been achieved so far.
Map 4. Vaccination coverage during 2003 spring + autumn vaccination period
Map 5. Vaccination coverage during 2004 (spring + autumn) vaccination period
21
Map 6. Vaccination coverage during 2005 spring vaccination period
As shown on the above Maps and Figure 7, over the last 3years, 1.28 million vaccinations have been completed in a total estimated population of 3.3 million cattle and yet this has failed to control the disease. These conventional mass vaccination campaigns have been unsuccessful in achieving adequate coverage which favours endemic situation for prolonged period. However in some districts the vaccination coverage is improving from time to time and the number of outbreaks reported decreases as the vaccination efficiency increases.
The informants stated that FMD vaccination coverage in their villages were very low, because veterinary services rarely came and if they did, they often came during a time when many cattle were away to grazing areas. They also noted that the teams did not stay long enough for the cattle to be brought from distant areas, and that many of the distant grazing areas had not been visited by the vaccination teams. Informants from the veterinary services confirmed these problems and added that the lack of vaccination crushes made it extremely difficult to vaccinate in many areas. The poor transport situation in the district veterinary offices is also mentioned as a causal factor for reaching late in the village during vaccination programme. In fact most veterinary clinics were and still are without vehicle. Some informants also believe that the vaccine does not protect from having infection. Informants were asked if they observed that vaccinated animals were affected by the disease
22
Vaccinated animals were affected Vaccinated animals were not affected They do not remember
no vaccination
26% of them have observed that vaccinated animals were affected by the disease in their villages. This information might be valuable to the vaccine production institute to recheck the vaccine quality, particularly in relation to innocuity and potency, and constituted serotype. , This shows that there is a need to provide assurance that the vaccines used are of appropriate quality.
23 5. Summary and Conclusion
This PE investigation was an opportunity for veterinarians in Erzurum to practice PE methods. A few lessons learned about these methods were, the use of PE methods enabled about 670 informants to be involved in the investigation over a short time period and recorded the current FMD distribution. The use of PE requires much concentration on the part of the investigators, careful listening and a willingness to cross check information on the spot using open and probing questions. Investigators also need to be constantly aware of their own behaviour and body language, and understand how this affects the interaction with informants. Fr people who are not accustomed to PE, this level of concentration can be tiring but with practice, becomes second nature. These points indicate that future VCRI investigations based on PE methods should include sufficient time for methodology development and fine-tuning of methods in the field.
Lessons learned about FMD participatory epidemiological investigation
1. The livestock owners were able to accurately define a number of clinical entities including FMD (Dabak), 2. The livestock owners had a remarkable understanding of many of the epidemiological aspects of FMD. They stressed that FMD or Dabak is mainly a disease of young cattle in their herds and they believed that older cattle were largely immune as a result the pervious vaccinations. 3. This investigation suggested that the long-standing persistence of FMD and identified the cattle movement to and from market and trade and introduction to susceptible herd as the primary cause. The statements of livestock owners and the relative ranking of risk factors have clearly indicated that the grazing areas at the depression plains which are located between the mountains and plateaus followed by yayla pasture areas are an area of high FMD transmission. Most of the outbreaks reported in 2005 occurred in the month of May when animals are turned out to these grazing areas. The survival of FMD virus depends on the continued contact between infected animals and naive susceptible cattle. The mixing of newly purchased cattle from markets with unvaccinated (susceptible) young animals in the shared grazing areas provides an excellent setting for the dissemination of the disease. 4. All districts of the province are found to be infected with FMD (Dabak). 5. The reported cases occurred on a more or less regular basis, seasonal and outbreaks are less severe. 6. FMD outbreaks were observed every year or every two years in 90% of the investigated villages 7. The policy for controlling FMD (Dabak) is primarily through mass vaccination and so far the vaccination efficiency is below the required level. 8. The involvement of private veterinarians in the delivery of FMD vaccination is at its start stage in major towns and around commercial farms. Whilst, despite ongoing efforts, remote and marginal villages are not well covered and served. The reason is that private operators at the moment do not find remote and marginal areas attractive and economically viable.
24 9. Often inadequate veterinary surveillance: The ability of field staff at district and provincial level to undertake proper investigation of FMD outbreaks is very low. Again, lack of operational funds limits the ability of staff to travel to reported outbreaks.
Based on these information the conclusion of this participatory epidemiological investigation is that there was sufficient evidence to show that foot-and-mouth disease is still circulating in all districts of Erzurum Province. The pattern of disease outbreaks suggests that FMD is being maintained in an endemic status all over the province. The disease pattern and size of the population can be easily creating favorable condition to an endemic situation.
Further activities suggested
In order to improve FMD reporting, investigation, diagnosis and control of foot-and- mouth disease the following actions are recommended:
1. Improve the detection of outbreaks through fast and accurate disease reporting (all cases including rumours) is required. This requires improving the ability to early detection, rapid diagnosis and swift application of effective control measures. 2. Introduction of Market inspection and surveillance: It becomes very clear from the investigation that most of animal markets are ideal source of FMD. The absences of any checks at the point-of-entry to the market allow both infected and susceptible animals to enter and freely mix within marketplaces. Introducing Market inspection and surveillance should be started at least in to Erzurum animal market. 3. Quarantine and livestock movement control should be applied rigorously but in a way that imposes only the degree of restriction that is necessary to achieve control and that is realistic to gain compliance. Vaccination should be regarded as a secondary disease control process, after livestock movement control. It cannot be expected to be effective if movement control is not rigorously applied.
4. Review and strengthen the current strategic official vaccination practices • to involve private veterinary practitioners to enter into the vaccine market for the supply of vaccine and vaccinate as many animals as possible in order to obtain herd immunity levels of over 80%. The essential roles of government should be to regulate the quality of vaccine and its use in the field. Allowing the private sector to undertake vaccine supply and delivery could significantly reduce public expenditure on much of the FMD vaccination carried out and increase the ability to the public to concentrate on surveillance activities. • introduction of alternative vaccination delivery systems such as the use of para -veterinarians linked with private veterinarians. It can be started as a pilot in some remote and underserved areas and then intensify based on
25 the outcome. As para-veterinarians are members of the local community, they can respond more quickly to any animal health needs. With careful training and with the support of veterinary services, they can assist with the collection of samples for disease surveillance, effectively and rapidly report outbreaks and provide data for veterinary research. They can contribute to animal identification systems, tracing systems and animal movement control systems. They can play an important role in mobilising and informing comunities about animal health issues. In remote, and transhumant communities, they move with herds to highland pasture grazing areas and continue to provide these basic services. They can offer the opportunity to coordinate animal health surveillance and control across extensive grazing areas.
5. Establish a Provincial Disease Control Unit (PDCU) at the Erzurum Veterinary Control and Research Institute. FMD investigation and control should be a function of this unit and make required funds available so that the unit can respond promptly to reports of FMD. This unit should at all time have a car, the operational costs and manpower available to act quickly. The disease reporting system, presently operated needs to be introduced within this unit. The data obtained should be processed by the PDCU. The following activities are proposed: • Establishment of a good reporting system between all levels of partners, i.e. livestock owner, village, district, provincial and PCDU. The PCDU should be responsible of improving disease-reporting formats, mailing systems and the dissemination of information and provision of feedback to the reporter. • Establishment of a disease surveillance system able to detect FMD if it were present • Provide a central capability to undertake FMD diagnostic procedures, establish the ability to swiftly diagnose disease and conduct epidemiological surveys • Develop ability to swiftly react to emergency situations • Discovery of outbreaks and trace back to define the source of the disease. • Training and motivation of all veterinary staff on foot-and-mouth disease surveillance, investigation procedures and in specimen collection which is essential to the success of controlling disease outbreaks in endemic situation. • Improve the awareness of livestock owners to the requirements of FMD control to increase their compliance. • Undertake extension activities to livestock owners so that they understand the need to report FMD outbreaks immediately. 6. Although respondents in this survey ranked Dabak as the most frequent and important disease most of them have not aware of the losses. The disease generally causes only mild to moderate disease in particular in young and low-
26 producing local breeds. The disease is more of a concern for small-scale farmers with higher producing animals. Although the observed mortality rate is very low the impact of the disease on reduced livestock production and other various losses is not well understood. To raise farmers concern for the disease and their willingness to cooperate in control activities, further study on the impact of FMD and the cost-benefit of FMD control should be considered.
6. Annexes Annex 1. Schedule for the field work implementation of participatory epidemiological investigation of FMD Date of DISTRICT Villages to be investigated investigation Team MERKEZ so ğucak yolgeçti kırmızıta 08.08.05 A MERKEZ derebo ğazı kümbet güzelyurt 09.08.05 B MERKEZ arıbahçe umudum toparlak 10.08.05 B A KALE ortabahçe merdiven 11.08.05 B A KALE kavurmaçukuru 12.08.05 A A KALE çiftlik yeniköy 13.08.05 A ILICA Çavdarlı A.canören 14.08.05 A ILICA Pa ayurdu Elmalı 15.08.05 B ILICA Toprakkale Kapılı 16.05.05 A PAS ĐNLER B.tuy Karavelet 17.08.05 B PAS ĐNLER Pelitli Ügümü Y.dani ment 18.08.05 A TEKMAN Ba dere Toptepe 19.08.05 B TEKMAN Karatepe 20.08.05 B TEKMAN Düzyurt Güzeldere 21.08.05 B ÇAT A ağıçat Çiri li 22.08.05 B ÇAT Sarıkaya Muratçayır 23.08.05 B ÇAT Tüysüz Çayırtepe 24.08.05 A OLTU Çamlıbel Yarba ı 25.08.05 B OLTU Kalebo ğazı Elmadüzü 26.08.05 A OLTU Süleymanlı 27.08.05 A NARMAN Yukarıyayla 28.08.05 A NARMAN Sütpınar Kı laköy 29.08.05 B NARMAN Araköy Gökda ğ 30.08.05 A KARAYAZI Ulucanlar Yalındal 31.08.05 A KARAYAZI Anıtlı 01.09.05 A
27 KARAYAZI Köyce ğiz Duruca E Karabey Göktepe Sukonak 02.09.05 B KARAYAZI A ağı Đncesu Çaltılı 03.09.05 B ENKAYA ho köy sö ğütler yo ğurtçular 04.09.05 B ENKAYA ba pınarlar kö k 05.09.05 B ENKAYA dörtyol 06.09.05 A ĐSP ĐR ba köy çamlıkaya nahiyesi sırakonaklar 07.09.05 B PAZARYOLU göztepe konakyeri 08.09.05 A KARAÇOBAN Karaköprü Molladavut Çatalgül 09.09.05 A HINIS bellita erence ovakozlu 10.09.05 A HINIS halilçavu tipideresi yayla konak 11.09.05 A OLUR çataksu ormana ğzı yukarı karaca 12.09.05 A KÖPRÜKÖY savatlı y.sö ğütlü dereba ı ılıcasu 13.09.05 B HORASAN bahçe horumlar muratba ğı 14.09.05 B HORASAN yüzören kırkgözeler karabıyık 15.09.05 A HORASAN akkeren danı ment hacıhalil 16.09.05 A TORTUM karli ziyaret alapinar Çaylica 17.09.05 B TORTUM serdarli cevizli (u.dere) 18.09.05 B Annex 2. Last date FMD outbreak per district
Number of Number of FMD outbreaks observed in villages
Districts investigated 2005 2004 2003 2002 2001 2000 1998 1 HINIS 6 4 1 1 2 TEKMAN 5 4 1 3 HORASAN 9 7 2 4 ÇAT 6 1 1 1 1 5 MERKEZ 9 8 1 6 ĐSP ĐR 3 1 2 7 NARMAN 5 4 1 8 ENKAYA 6 6 9 KARAÇOBAN 3 2 1 10 KARAYAZI 10 9 1 11 KÖPRÜKÖY 4 - 2 1 1 12 PAS ĐNLER 5 2 2 1 13 A KALE 5 4 1 14 ILICA 6 1 2 1 2 15 PAZARYOLU 2 1 1 16 TORTUM 5 4 1 17 UZUNDERE 1 - 1 18 OLTU 5 1 1 2 1 19 OLUR 3 3 98 62 16 9 3 2 2 2
28 Annex 3. Last date and pattern of FMD outbreak per surveyed village and sources of the outbreak
Time of the Pattern of the outbreak outbreak at least for District Surveyed village occurred Sources of the disease three years HINIS bellita 2004 ovaçevirme village 2002- 2003-2004 erence May-05 erzurum animal market 2003-2004-2005 halilçavu May-05 2002-2003-2004 ovakozlu May-05 erzurum animal market 2003-2004-2005 tipideresi 2002 2004-2003-2002 yayla konak Jun-05 2003-2004-2005 TEKMAN Ba dere May-03 2001-2002-2003 Düzyurt Jun-05 güzeldere 2002-2003-2004 Güzeldere Jun-05 erzurum animal market 2002-2003-2004 Karatepe Aug-05 erzurum animal market 2002-2003-2004 Toptepe May-05 erzurum animal market 2002-2003-2004 HORASAN akkeren May-05 sheep came from Igdır 2003-2004-2005 erzurum and horasan bahçekoy May-05 animal market 2003-2004-2005 danı ment May-05 2003-2004-2005 hacıhalil May-05 sheep came from Igdır 2003-2004-2005 horumlar Aug-04 2002-2003-2004 erzurum and horasan karabıyık Jun-05 animal market 2003-2004-2005 kırkgözeler May-04 2002-2003-2004 erzurum and horasan muratba ğı Jul-05 animal market 2003-2004-2005 erzurum and horasan yüzören Jun-05 animal market 2003-2004-2005 ÇAT A ağıçat May-04 2002-2003-2004 Çayırtepe May-98 1998 Çiri li Jun-04 2002-2003-2004 Muratçayır Jun-03 2001-2002-2003 Sarıkaya Jun-03 2001-2002-2003 Tüysüz May-05 erzurum animal market 2003-2004-2005 MERKEZ arıbahçe Jun-05 erzurum animal market 2003-2004-2005 derebo ğazı May-05 erzurum animal market 2002-2003-2004 güzelyurt Sep-05 erzurum animal market 2003-2004-2005 kırmızıta May-05 erzurum animal market 2003-2004-2005 kümbet Apr-05 erzurum animal market 2003-2004-2005 so ğucak May-05 erzurum animal market 2003-2004-2005 toparlak Jun-05 erzurum animal market 2003-2004-2005
29 umudum 2003 2001-2002-2003 yolgeçti Jun-05 erzurum animal market 2003-2004-2005 ĐSP ĐR ba köy Jun-02 2000-2001-2002 çamlıkaya nahiyesi Jun-02 2000-2001-2002 sırakonaklar Aug-05 neighbouring village 2003-2004-2005 NARMAN Araköy May-05 neighbouring village 2003-2004-2005 May-Jun- Gökda ğ 2003 2001-2002-2003 Kı laköy Apr-05 narman market 2003-2004-2005 Sütpınar Jun-05 narman market 2000-2001-2002 Yukarıyayla Jun-05 narman market 2003-2004-2005 a kale,sgöle, nkaya ENKAYA ba pınarlar May-05 hayvan pazarları 2003-2004-2005 dörtyol Jun-05 Oltu animal market 2003-2004-2005 ho köy Jun-05 2003-2004-2005 kö k Aug-05 2003-2004-2005 a kale,göle and enkaya sö ğütler Jun-05 animal market 2003-2004-2005 a kale,göle and enkaya yo ğurtçular Jul-05 animal market 2003-2004-2005 mu bulanık animal KARAÇOBAN Çatalgül 2005 market 2003-2004-2005 mu bulanık animal Karaköprü 2005 market 2003-2004-2005 Molladavut 2004 2002-2003-2004 ağrı ve horasan animal KARAYAZI Anıtlı Jun-05 market 2003-2004-2005 A ağı Đncesu Jun-05 karayazı animal market 2003-2004-2005 Çaltılı Jun-05 karayazı animal market 2002-2003-2004 Duruca E May-05 neighbouring village 2003-2004-2005 Göktepe Jun-05 neighbouring village 2003-2004-2005 Köyce ğiz Jun-05 erzurum animal market 2003-2004-2005 Karabey May-05 Villages from Tutak, Agri 2003-2004-2005 Sukonak May-05 2003-2004-2005 Ulucanlar 2005 erzurum animal market 2003-2004-2005 Yalındal 2004 2002-2003-2004 KÖPRÜKÖY savatlı Aug-04 2002-2003-2004 y.sö ğütlü Aug-03 2001-2002-2003 dereba ı 2001 1999-2000-2001 ılıcasu 2004 2002-2003-2004 PAS ĐNLER B.tuy 2005 erzurum animal market 2003-2004-2005 Karavelet 2004 2002-2003-2004 Pelitli Jun-03 2001-2002-2003 Ügümü Apr-05 animal markets 2003-2004-2005
30 Y.dani ment Jun-04 2002-2003-2004 A KALE çiftlik Aug-05 2003-2004-2005 kavurmaçukuru Jul-05 erzurum animal market 2001-2002-2003 ortabahçe Apr-05 a kale animal market 2003-2004-2005 yeniköy 2004 2002-2003-2004 merdiven May-05 2003-2004-2005 ILICA A.canören 2001-2002-2003 Çavdarlı 2000 1998-1999-2000 Elmalı Jun-05 2003-2004-2005 Kapılı 2000 2000-2001-2002 Pa ayurdu 2004 2002-2003-2004 Toprakkale 2004 2002-2003-2004 PAZARYOLU göztepe May-01 2001 konakyeri 2005 2003-2004-2005 TORTUM Alapinar 2004 2002-2003-2004 Çaylica 2005 fromTa oluk village 2003-2004-2005 dumlu village and Karli 2005 erzurum animal market 2003-2004-2005 erzurum,tortum and oltu Serdarli bld Jul-05 animal markets 2002-2003-2005 Ziyaretli Jul-05 2002-2003-2005 UZUNDERE cevizli Sep-04 2002-2003-2004 OLTU Çamlıbel Sep-04 2002-2003-2004 Elmadüzü Aug-03 2001-2002-2003 Kalebo ğazı May-03 2001-2002-2003 Süleymanlı Jun-05 Oltu animal market 2002-2003-2005 Yarba ı Sep-98 1998 OLUR çataksu Jun-05 2002-2003-2005 ormana ğzı Jun-05 2002-2003-2005 yukarı karaca Jun-05 2002-2003-2005
31 Annex 4. Vaccination achievements figures (2003-2005)
FMD vaccination FMD vaccination FMD vaccination coverage in 2003 coverage in 2004 coverage in 2005 (only Districts (spring + autumn) (spring + autumn) spring ) MERKEZ 90781 79417 50859 A KALE 28729 33435 28943 ÇAT 14790 6412 13844 HINIS 13491 20910 14868 HORASAN 35322 54337 25961 ILICA 27760 34290 26907 ĐSP ĐR 23640 24810 15850 KARAÇOBAN 11465 10890 5528 KARAYAZI 19058 11379 12325 KÖPRÜKÖY 10659 15179 9312 NARMAN 27249 29052 19951 OLTU 21832 33871 27710 OLUR 16540 16619 13460 PAS ĐNLER 19311 27765 30185 PAZARYOLU 7080 5270 5478 ENKAYA 21075 23718 23654 TEKMAN 20650 10100 17390 TORTUM 33264 30620 20260 UZUNDERE 3598 2108 1812
32