ALIRT New Approach to 21st Century Challenges

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ALIRTNew Approach to 21st Century Challenges

• S Peder Cuneo Bob Kattnig
• University of Arizona
• Department of Veterinary Science Microbiology
• Department of Animal Science

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THE OUTBREAK UK Feb 2001

• Feb 20, 2001 FMD confirmed Essex, England 2 cows
  and 308 pigs at slaughter
• Feb 23, 2001 FMD found
• sow unit Heddon-on-the-Wall
• Sourceillegally imported meat
• Swine infected nearby sheep
• Infected sheep spread FMD

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U K the Cost of FMD

• Cattle 599,780
• Sheep 3,191,013
• Pigs 146,714
• Goats 2,262
• Deer/other 1,276
• Total 3,941,045

90 SUICIDES PRODUCERS/CREWS
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Control Programs

• Slaughter of infected and exposed animals on
  infected farm
• ½ mile radius around infected farm all
  susceptible species slaughtered
• 1 ½ mile radius surveillance zone
• Stop all animal movement, close rural areas
• Note 1/2 all animals that killed were not
  infected with FMD

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Role of species in FMD

• Sheep act as maintenance hosts
• Pigs act as amplifiers
• Cattle act as indicators

• Disease is often hard to diagnosis in sheep
• Pigs produce 30-100 X more virus cattle/sheep
• Cattle develop clinical signs faster

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FMD Learning from the U K

• Preparation
• Infected material, animal movement
• Speed of response and local control

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FMD Learning from the U K

• Preparation
• There can be little doubt that the present
  epidemic has taken us all by surprise and found
  us singularly unprepared to deal with it and its
  consequences

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FMD Learning from the U K

• Infected material, animal movement
• We clearly need to be a lot more vigilant than
  we have been We can be a lot more careful about
  tracing animal movements.

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FMD Learning from the U K

• Speed of response and local control
• Preoccupation with forms, formal requisitions,
  formal documentation should take a long second
  place to effective and rapid actions.

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What allowed FMD to spread so quickly?

• Diagnosis was delayed.
• Large numbers of sheep with sub clinical
  infections.
• Large numbers of sheep transported throughout U.
  K.

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The UK Why So Extensive the Devil is in the
Details

• Delay in Recognition
• Failure of Producers
• Index farm 90 of 570 pigs had healing lesions
• Delay in Stop Movement
• 3 days before national ban
• Advanced notice increase in animal movement
• Allowance by government allowed animals in
  transit to continueled to unprecedented increase
  in animal movement
• Sheep
• Silent carriers
• Marketing and movement of sheep
• 20,000 sheep moved through same market as sheep
  from index farm BEFORE stop movement

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UK Outbreak Veterinary Issues

• Dependency on Laboratory Confirmation
• In 1967 Outbreak cull within 24 hours
• 2001 required lab confirmation delay up to 4 days
• Inadequate Veterinary Force
• 2/3 personnel 2001 vs. 1967
• Higher authority unaware/unwilling to use
• Rapid laboratory diagnosis
• Outbreak modeling
• Vaccination
• Organizational Culture
• Decision making by committee
• Fear of personal risk taking
• P Gibbs JVME 30(2) The FMD Epidemic 2001 in UK
  Implications for USA and War on Terror

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Risk Assessment United States Livestock

• Livestock concentration
• Regional
• Highly concentrated parts of United States
• Extensive and Intensive in SW
• Livestock Movement
• Centralized feed supply/distribution
• No immunity FADs
• Possible excessive shedding if infected
• Many FADs common in other areas
• Porous Borders

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Risk Assessment Management

• Focus on Aggregate Statistics
• Inadequate on-farm/ranch biosecurity
• Delay in National Animal ID Program
• Producer reluctance to report problems
• Expanded international trade/travel
• Biosecurity of post harvest food processing

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Risk Assessment Veterinary Medicine

• Identification/reporting/response
• FAD
• Emerging Diseases
• Inadequate FAD awareness
• Veterinary service rural areas

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Accredited Veterinarians and USDA(the first line
of defense)

• Currently
• 1992 Dropped state by state test and substituted
  application process
• Graduate from accredited veterinary school
• Complete application
• Candidate certifying ability to perform 16 tasks

• Proposed
• Two tiered system
• Category 1
• Only companion animals
• Category 2
• Equine, food animal and livestock
• Both require renewal every 3 years
• Cat 1 4 training modules
• Cat 2 9 training modules

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Veterinary Schools and FAD Training

• Limited FAD training
• 3-4 hours in 4 years
• Classes are hit and miss as how taught
• 290 California veterinarians
• 33 indicated veterinary education prepared them
  for FAD event
• 50 general preparedness for FAD poor or very
  poor

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Veterinary Schools and FADs

• Changing demographics
• Teaching more specialized
• Tenure system constricts focus
• FAD teaching viewed as unimportant by faculty,
  administration and STUDENTS

• Limited research base for FADs
• Changing Employment
• 1991-2001 predominantly LA 10 to 3
• Critical shortage of non companion animal
  veterinarians

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Critical Issue

• veterinarians since 1992 have not had to
  demonstrate by examination or review of
  coursework that they possess any knowledge of
  FADs
• it is unlikely that many USDA-accredited
  veterinarians have the necessary educational
  background to prevent or recognize an FAD
• JAVM, Vol 222, No 10 May 15, 2003 pg 1354

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Lesions ?

• UK Inadequate Veterinary Force
• USDA since 1994 field veterinarians DECLINE by
  20
• END outbreak in SW we respondedit taxed our
  resources to the maximum Dr. Ron DeHaven APHIS
  VS
• Since 1992 veterinary graduates not prepared to
  deal with FADs
• Risk factors
• Companion animals/exotics vs. production animals

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Call to Action

• We recommend that the Secretary of Agriculture
  develop, and that Congress fund, programs to
  improve higher education in veterinary medicine
  to include focused training on intentional
  attacks, and to provide additional incentives for
  professional tracks in that discipline.
• Gilmore Commission, 2002
• Advisory Panel for Terrorism Involving WMD

• Reform the overall veterinary science curriculum
  placing greater emphasis on large-scale animal
  husbandry, recognition and treatment of animal
  diseases of foreign origin, and diagnostician
  training in these diseases.
• Peter Chalk
• RAND Corporation, 2002

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ALIRT History and Development

• Series of extensive livestock losses brought
  attention to issues
• FMD outbreak and Sept 11 served as Arizonas
  wake up call
• Combined effort
• Arizona Department of Agriculture
• Producers (Az Cattlemen Association/Farm Bureau)
• University of Arizona
• AzVDL
• Department of Animal Science
• Cooperative Extension

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Development of ProgramImportant Issues

• Extensive management range livestock
• Time, Distance and Expense of Obtaining
  Veterinary Help
• Producer who to call
• Response depended on who was contacted/time of
  day
• Delay Causing Difficult Diagnosis
• Delay in identification
• Delay in response

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Issues II

• Poor Communication and Interaction Between
  Responding Agencies and Producers
• Responders not equipped and/or trained
• Samples incorrectly obtained/processed
• Results not returned in timely manner and/or lost
• Producer Issues
• Cost/availability of veterinary care
• Regulatory intrusion
• Confidentiality

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Who will respond?

• Producer?
• Training/equipment/handling/risk?
• State Department of Ag?
• Availability/equipment/authority
• Az VDL
• Location (distance)
• Local veterinarians
• Cost/equipment

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Goals for ALIRT

• Develop trained and equipped first responders
• Diagnostic Samples
• Collection
• Transportation
• Evaluation
• Development and Implementation of ALIRT Committee
• Over watch of response
• Integration of efforts
• Communication to producers/team members
• Update training and support for ALIRT members
• Follow up with producer

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Mechanism for ALIRT Response

• Discovery of serious livestock health problem
• Excessive death loss
• Unusual appearance Movement, behavior
• Reporting of problem
• Producer, local veterinarian, livestock officer,
  extension agent
• ALIRT Committee Conference call
• Determines extent of response
• Dispatches first responders

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ALIRT Process

• Secure site/provide for personal safety
• Collect important history
• Collect correct samples in correct order

• Process and transport samples
• Laboratory support aware of response and provide
  priority handling

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Paying for ALIRT

• Cost of response is paid by program
• Travel
• Professional services
• Diagnostics
• Training and equipment paid by program
• Funding
• Obtained through Legislature to Az DOA
• Extensive Support by Arizona Cattle Growers/other
  Ag Groups
• Contract with University of Arizona
• Az VDL Animal Sciences
• Develop program/purchase supplies

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Producer Education/Support

• Producer Handbook
• Response Questionnaire
• English/Spanish
• Web page
• http//ag.arizona.edu/ans/alirt/
• Producer Training
• Accessing System, Meeting ALIRT Team
• Limitations of response, testing
• Operation of Incident Command System
• Ranch/farm Biosecurity
• Follow up post response

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Cooperative Extension

• Training with veterinarians
• Modified field response kits
• Additional shipping kits
• Offices
• Data ports for digital images
• Sites for processing and shipping samples
• Computer access for on line training
• Host Producer Training Sessions
• Incident Command System

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Industry Expansion

• Development and presentation
• National Livestock Emergency Response Conference
• International
• Native Americans
• Wildlife
• Law Enforcement
• Annual Meeting
• Early December, Arizona
• NCBA/BQA Program
• New Mexico Agricultural Incident Response Team

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Veterinary Training

• Full day Training at AzVDL
• 6 hours of continuing education
• Field Investigation Kits and Shipping Supplies
• Field kits provided by ALIRT program
• Supplemental Educational Information
• Books, CDs, on line
• Operation of Incident Command System
• On line from FEMA

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Top Biologic AgentsCDC

• Anthrax, B. anthracis
• Plague, Y. pestis
• Smallpox, Variola major
• Botulism, C. botulinum (toxin)
• Tularemia, F. tularensis
• Hemorrhagic Fever
• Filovirus Ebola, Marburg
• Arenavirus Lassa, Junin

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Top Biologic AgentsCDC

• Anthrax, B. anthracis
• Plague, Y. pestis
• Smallpox, Variola major
• Botulism, C. botulinum (toxin)
• Tularemia, F. tularensis
• Hemorrhagic Fever
• Filovirus Ebola, Marburg
• Arenavirus Lassa, Junin

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New Challenges and Response

• Challenges
• Emerging Diseases
• Texas Fever Tick
• Rift Valley Fever
• Heartwater
• Japanese Encephalitis
• Feral Swine
• Boarder Migration
• High Path AI
• Exotic Pets

• Coordination response
• Producer
• Veterinary Diagnostics
• Industry Outreach/Quality Assurance
• Law Enforcement/EMS
• Agricultural Regulatory Agencies

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Partnerships

• The risk presented by FAD, ag bioterror and
  ongoing animal health problems require a team
  approach to protect Arizonas agriculture
• University of Arizona, Az Dept of Ag and
  Producers have teamed together to provide a
  response TEAM to address this risk

ALIRT
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HAPPY TRAILS !!
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References

• Perspectives in Professional Education JAVM Vol
  222, May 15, 2003
• Growing demands raise doubts about APHISs
  emergency response capability JAVM/News April 1,
  2004
• New directions for the National Veterinary
  Accreditation Program JAVM Vol 220, May 15, 2002
• APHIS Fact Sheet The National Response Plan April
  2005
• APHIS Fact Sheet Emergency Response Foot and
  Mouth Disease and Other Foreign Animal Disease
  January 2002
• Hitting Americas Soft Underbelly the Potential
  Threat of Deliberate Biological Attacks Against
  the U. S. Agricultural and Food Industry Peter
  Chalk RAND National Defense Research Institute
  2004