NORTHERN OUTBREAK INVESTIGATION NORTHERN LAOS OUTBREAK INVESTIGATION

▪ 23-25 Nov 2017(Sam tai, Houaphanh) ▪ 22-25 December 2017 (Xayabuly, Kho and Boten, Xayabuly province) ▪ 10-14 May 2018(Sam nuea, Hiem and Huamueang, Huaphanh province) ▪ 19-27 May 2018 (Xayabuly, Xayabuly province) FMD OUTBREAKS 2017 - 2018

Date Provinces District Number of Sample Serotpye outbreak (+ve) (strain) Jan 2017 Champasak Sukhuma 3 7 (5) O Champasak 5 3 Phonethong 7 4 Jan 2017 Savannakhet Songkhone 2 2

Nov 2017 Houaphane Samtai 1 7 (2) O (Pan Asia)

Dec 2017 Xayabuly Kob 2 2 (2) O (Pan Asia) Xayabuli 8 0 Boten 1 0 April Houaphane Samneua 23 2(1) O 2018 Huameaung 10 Hiem 11 April Xayabuli Xayabuli 2 0 2018 Total 75 18 (9) HOUAPHANH FMD OUTBREAK NOVEMBER 2017

Ban Nakhoun ❑ The cases were found on 10 November 2017 Ban Nasap ❑ Reported FMD suspected cases on 19 November 2017. ❑ Outbreak investigation on 23-25 November 2017 by DLF team collaborating with VLFO and DLFO ❑ 9 epitheliums samples collected XAYABULY FMD OUTBREAK : November 2017

❑ The cases were found on 25 November 2017 ❑ Reported FMD suspected cases on 13 December 2017. ❑ Outbreak investigation on 25 November 2017 PAFO collaborating with DAFO teams ❑ 7 epitheliums samples collected ❑ Outbreak investigation on 22-25 December 2017 by DLF team collaborating with VLFO and DLFO

❑ Free-range movement of large ruminants in the village towards common grazing area. ❑ Absence of quarantine of infected animals ❑ Lack of FMD vaccination programme in Xayabuli, Khop and Boten districts in 2017. ❑ Truck of the animal trader visiting in the village. HOUAPHANH FMD OUTBREAK April 2018

❑ The cases were found on 12 March 2018 ❑ Reported FMD suspected cases on 8 April 2018. ❑ Outbreak investigation on 19-27 May 2018 by DLF team collaborating with VLFO and DLFO ❑ 7 epitheliums samples collected

❑ Free-range movement of large ruminants in the village towards common grazing area. ❑ Absence of quarantine of infected animals ❑ Lack of FMD vaccination programme in Samnuea, Huameaung and Hiem in 2018. XAYABULY FMD OUTBREAK April 2018

❑ Free-range movement of large ruminants in the village towards common grazing area. ❑ Absence of quarantine of infected animals ❑ Lack of FMD vaccination programme in Xayabuli district in 2018. ❑ Trading movement of beef and pork

❑ The cases were found on 30 April 2018 ❑ Reported FMD suspected cases on 5 May 2018. ❑ Outbreak investigation on 10 May 2018 by DLF team collaborating with PAFO and DAFO ❑ 2 epitheliums samples collected Case study of Houaphanh 2017 Objective: • To collect the relevant information to determine the possible distribution and duration of FMD outbreak in . • To investigate the possible risk of recurrence and or spread of the disease. PLANNING OF INVESTIGATION

• Formation of Investigation Team • Logistics /transport • Vet Medicine Kit • Biosecurity Kit • Tissue and Blood sample collection Kit • Stationary • Budget DATA GATHERING

• Meeting with officials and Livestock technical staff at Provincial , District level • Focus group discussion with villagers including farmers, village head and Village Veterinary Workers INVESTIGATION

• Starting date of the outbreak • Status of the animal health • Possible FMD occurrence • Possible FMD spread • Response from farmers and local authorities. EPITHELIUM SAMPLE COLLECTION INFORMATION FLOW START OF THE OUTBREAK

• Outbreak was started on 10th November,2017 at Ban Maungkhanh village and it spreads rapidly for next 2-3 days within the village. • The infected animals were moving freely within herd and in the village particularly towards the routes of grazing land. • FMD lesions had taken on an average range of 5 – 10 days to heal. USE OF TRADITIONAL MEDICINE

• Majority of farmers in Ban Maungkhanh preferred to treat FMD lesions with tradition medicine such as mixture of lime juice, star fruit and tree bark extract (Ptesocarpus Pedatus Pierre). • Some farmers also used commercial vinegar, others had availed services of VVW for dressing of the foot and mouth lesions and infected animals were injected with vitamin supplement. • 2% Methylene Blue powder was distributed by DLF to DAFO field staff for dressing of FMD foot lesions. OUTCOME OF INVESTIGATION

• Some farmers recalled year 2015 was last FMD vaccination in Cattle and Buffaloes at Maungkhanh village. • FMDV might have possibly entered through trader’s vehicle which came to the village before a week of the first case detected on 10th December 2017. • During group discussion 19 farmers ranked this probability as high risk, followed by proximity of road i.e. exposure of FMDV through animal movements ranked as high risk by 17 farmers. • It was confirmed by famers and village authorities that no new animals have been brought before a period (no recall at least 45 days) of onset of outbreak on 1oth of November 2017. • The location of the affected village and its proximity to the road No.6 B, the only route of transportation which connect busy Sam Tai district headquarter at South around 10 kilometers is perceived as continuous risk of FMD exposure. OUTCOME OF INVESTIGATION

• Namsoi Vietnam-Laos International border at the east of the outbreak village which is around 40 Kilometers where animal’s movements are not uncommon for trade and local meat consumption on either side of the border according to DAFO and quarantine staff based at the border. • The Cattle and Buffalo meat is cheaper in Laos compare to Vietnam hence fresh meat and meat products are sold and purchased at Laos side of the border. Pigs and poultries are traded from Vietnam to Laos however numbers, movement patterns, quarantine and biosecurity practices could be studied further with regard to FMD risks and control. CONTROL MEASURES

Farmers: ▪ Separation of sick animals in the backyard shelter ▪ Treat with traditional herb medicine, vinegar, antiseptics ▪ Seek assistance from VVWs for antibiotics/vitamin injection Veterinary Authority: ▪ Providing technical support on FMD recognition and its prevention and control as well to distribute IEC materials and antiseptics ▪ Animal movements control within the village after the onset of diseases ▪ Disease warning to neighboring villages/districts ▪ Ring vaccination. ANIMAL MOVEMENT CONTROL :PAFO ANIMAL MOVEMNT CONTROL :DAFO Emergency FMD vaccine support

1st: 15000 doses from oie srr, Dec 2017 • XBL 7000 doses • HP 8000 doses 2nd : 20000 doses from oie srr, Jun 2018 • Kham district, Xiengkhouang province 6000 doses • Viengkham, Louangphabang province 6000 doses • Hiem district Houaphan province 8000 doses RING VACCINATION

No Province District No. of No. of large No. of large % Village ruminants ruminants vaccination vaccinated population vaccinated coverage 1 Houaphan Samtai 16 9852 6957 70,61 Hiem 22 8564 6507 75.98 2 Xiengkhoang Kham 18 6815 4860 71.31 3 Luangprabang Viengkham 20 6298 4958 78.72 Sub 3 4 76 21677 16265 75.03 total 4 Xayabuli Xayabuli 13 3134 1841 58,74

Khob 9 3052 1307 51,50

Boten 10 12088 3629 30,02

Sub 32 18274 6830 46,75 total Total 4 7 108 39951 23095 60.89 REGIONAL REFERENCE LABORATORY RESULTS DISCUSSION

• Through Outbreak Investigation • Training of the staff in systematic approach of investigation • Improve active and passive surveillance and network • Improve reporting mechanism for the delivery of timely and accurate reporting of the FMD outbreak by addressing the current gaps . • It was noted that on average 3 days were taken to pass the information from one administrative level to another. DISCUSSION

• Biosecurity practices with traders and farmers shall be enhanced through distribution of posters, guideline booklets to farmers, VVW’s and DAFO considering proximity to the road no.6 and FMD risks. • Animal numbers, movement patterns of animal and animal products, through Namsoi border could be studied further to understand the dynamics of the trade, review the current situation with regard to of FMDV incursion /spread and control measures in Houaphanh province. • Scope the possible options in future to initiate the FMD vaccination programme in Northern Laos especially in Houaphanh and province ( to maintain herd immunity) as one of the tool to control FMD. THANK YOU FOR YOUR ATTENTION