Surveillance, Epidemiology, and Tracing

1. Surveillance, Epidemiology, and Tracing Overview Adapted from the FAD PReP/NAHEMS Guidelines: Surveillance, Epidemiology, and Tracing (2011).

2. This Presentation FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview Introduction to when and why Definitions for technical terms Organizational structure Overview of Surveillance Plan

3. Surveillance, Epidemiology, and Tracing Activities FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview

4. Introduction FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • Foreign animal disease (FAD) • Terrestrial or aquatic disease or pest not known to exist in the U.S. • High pathogenicity avian influenza • Foot-and-mouth-disease • Preventative measures for introduction • Import restrictions • Exclusion activities at borders/ports of entry • Public education programs

5. Introduction (cont’d) FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • FAD investigation • Initiated if an FAD is suspected • Foreign Animal Disease Diagnostician • VS Memo 580.4 • Once an FAD is confirmed • Surveillance, epidemiology, and tracing response components are activated • Provide real-time understanding • Enable decisions on interventions

6. Purpose FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • Surveillance, epidemiology, and tracing techniques are used to: • Detect cases • Understand disease characteristics • Identify risk factors • Provide information for decision-making • Design and implement control measures • Evaluate the effectiveness of the control measures implemented

7. Definitions FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • Surveillance • An intensive form of data recording that encompasses gathering, documenting, and analyzing data • Epidemiology • The study of the distribution of disease in populations and of factors that determine its occurrence • Tracing • Information gathering on recent movements of animals, personnel, vehicles, and fomites to identify potential spread of disease

8. Zone/Area Designations FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview

9. Incident Command System FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • Incident Command System (ICS) • Flexible and scalable • Number and names of deployed groups will vary • Planning and Operations Sections • Incident Action Plan

10. Surveillance and Epidemiology FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview

11. Role of Surveillance FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • During an FAD outbreak, surveillance plays a key role in: • Identifying the infectious agent • Determining the scope of the outbreak • Assessing the effectiveness of eradication and control efforts • Demonstrating a return to disease free status

12. Surveillance Plan Elements FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview Disease description Surveillance objectives Stakeholders and responsible parties Population description Case definitions Data sources Sampling methods Diagnostic tests

13. Case Definitions FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • Suspect case • Animal showing clinical signs compatible with FAD • Presumptive positive case • Animal with clinical signs consistent with FAD and positive test results • Confirmed positive case • Agent has been isolated and identified using approved tests

14. Data Sources • Livestock producers • Veterinarians • Livestock organizations • Disease reporting or notification systems • Control programs • Sentinel units • Post mortem diagnostic specimen collection • Wildlife data FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview

15. Sampling Methods FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • Considerations for accurate and practical sampling methods: • Sample type • Sample size • Random sampling vs. targeted sampling • Sampling duration and frequency • Sample areas/locations • Availability of diagnostic tests • Pooled testing

16. Types of Specimens • Blood or serum • Skin or vesicular lesions • Epithelial tissue or vesicular fluid • Feces, rectal swabs, cloacal swabs, or genital tract swabs • Nasal, oral, or oropharyngeal swabs • Nasal discharge, saliva, tears • Semen samples • Tissues • Tonsil, spleen, kidney, liver, lymph node, lung, brain, etc. • Milk • Environmental samples FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview

17. Core Functions FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • Surveillance • Ongoing data collection, analysis, interpretation, and dissemination • Used to determine specific actions for FAD mitigation • Field investigation • Used to collect additional information about cases identified via surveillance • Disease source, history of disease, etc.

18. Core Functions (cont’d) FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • Analytic studies • Utilizes information gleaned from surveillance activities and field investigations • Disease rates and risk factors • Evaluation • Effectiveness • Efficacy • Impact of activities

19. Disease Occurrence FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • Endemic • Present in a population or geographical area at times • Outbreak • Occurrence of more cases of disease than expected in a given area, or a specific group, over a particular time period • Pandemic • An outbreak/epidemic that has spread over several countries

20. Risk Factors FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • A characteristic that is associated with an increase in the occurrence of a particular disease • May include: • Age • Species • Location • Contact

21. Epidemiological Principles FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • Prevent contact between the FAD agent and susceptible animals • Quarantine, movement controls, biosecurity procedures • Stop production of FAD agent by infected or exposed animals • Slaughter or mass depopulation • Increase the disease resistance of susceptible animals to the FAD agent • Emergency vaccination

22. Phases of Investigation FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • Generally, disease outbreaks are investigated in three phases: • Descriptive phase • Analytic phase • Intervention phase

23. Tracing Disease Spread FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview

24. Tracing FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • Trace-back • Animals, animal products, fomites, people, vehicles, equipment, and possible vectors that have been moved onto an Infected Premises • Establish the origin of the agent/hazard

25. Tracing (cont’d) FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • Trace-forward • Animals, animal products, fomites, people, vehicles, equipment, and possible vectors that have left the Infected Premises

26. Additional Operational Procedures FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • A variety of strategies are required to contain, control and/or eradicate an FAD • Biosecurity • Health and safety • Personal protective equipment • Cleaning and disinfection • Quarantine and movement control

27. For More Information FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview • FAD PReP/NAHEMS Guidelines & SOP: Surveillance, Epidemiology, and Tracing (2011) • http://www.aphis.usda.gov/animal_health/emergency_management/ • Surveillance, Epidemiology, and Tracing web-based training module • http://naherc.sws.iastate.edu/

28. Guidelines Content FAD PReP/NAHEMS Guidelines: Surveillance, Epi, and Tracing - Overview Authors (CFSPH) • Kerry Leedom Larson, DVM, MPH, PhD, DACVPM • Glenda Dvorak, DVM, MPH, DACVPM • Janice Mogan, DVM • Courtney Blake, BA Reviewers (USDA APHIS VS) • Dr. R. Alex Thompson • Dr. Lowell Andersen • Dr. Steve Goff • Dr. Fred Bourgeois

29. Acknowledgments Development of this presentation was by the Center for Food Security and Public Health at Iowa State University through funding from the USDA APHIS Veterinary Services • PPT Authors: Patricia Futoma, Veterinary Student; Kerry Leedom Larson, DVM, MPH, PhD, DACVPM • Reviewer: Janice Mogan, DVM