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The national animal disease emergency plan
Preparation of a plan
Emergency disease diagnosis
Emergency vaccination
Training for emergencies
Bibliography
The appearance of a potentially disastrous animal disease in a country or region, or even suspicion of the existence of such a disease, constitutes a disease emergency. This applies to any animal disease that presents a sudden and major threat to food production or public health and for which the country's existing resources are inadequate. The epidemiological characteristics of the disease may indicate that it is new to the country or that an enzootic organism has increased in virulence. Communicable disease control implies cooperation between neighbouring countries. When communication is not possible, this may in itself create an emergency situation. Emergency assistance may also be required in such situations as flooding and other natural disasters or contamination by toxic or radioactive materials.
The mounting of a major emergency disease control campaign is a complex logistical operation that requires the very rapid and effective mobilization of resources and the moulding together of a large group of professional and technical persons of very diverse disciplines and affiliations into a cohesive force. For these reasons, a great deal of forethought and planning is necessary to develop a national animal disease emergency plan, which past experience shows is best done through the task force approach. The highest level of government support should be sought in order to ensure the continuity and longevity of such an approach.
Each country has different animal health situations and conditions and different grades of epidemiological risks. Therefore, preliminary work should identify those diseases which a given country would consider as severely damaging to its animal population. An organizational structure to enact statutes and provide directives necessary to accomplish the objectives should be developed. Locally available financial resources to support this approach should be determined.
The plan should first identify the
government departments and agencies that may provide assistance should an animal disease
emergency occur and clearly define the roles that they may be expected to play. The
Ministry of Agriculture (or its equivalent) should always be the leading agency and the
CVO should have overall responsibility for the execution of any emergency disease control
campaign. Several other agencies should be requested to provide specialized support as
required. These may include: the Cabinet Office (for high-level political coordination);
Ministry of Finance (financial coordination); Ministry of Defence (logistical support,
transport, communications, field operations support, etc.); Ministry of Home Affairs
(quarantine and movement controls); Ministry of Health (zoonoses control); Ministry of
Public Works (provision of equipment for burial of carcasses, etc.); Ministry of
Communications; Ministry of Transport; wildlife conservation authorities; state emergency
services; and universities.
When preparing a national animal disease emergency plan, the following elements should be recommended for action to both the national government concerned and the CVO:
• Establishment of a national committee for animal disease emergency programmes composed of high-level officers from such ministries as agriculture, health, home affairs, defence, education, communications, justice, finance and transport.
• Review of existing laws, regulations and policies to provide legal structures guaranteeing the effective functioning of the national animal disease emergency control programme under all circumstances.
• Establishment of a mechanism responsible for developing the national animal disease emergency task force. This task force should be under the immediate responsibility of a senior veterinary officer, who should appoint the most suitable and competent members available. A list of these members, with full addresses, telephone numbers (including after-business hours), telex and telefax numbers, should be kept in a readily accessible place.
• Advise the government the necessity to provide and support an effective animal health field and laboratory service and, in the event that this does not exist, to work toward the establishment of such a service. This service should be in a position to provide at all times the necessary staff for implementing the decisions of the emergency animal disease task force.
• Identify national and international sources for obtaining, at short notice, funds and procedures necessary to permit immediate emergency animal disease task force action. If administratively possible, mechanisms to fund immediately at least the critical measures to be taken without delay are available to the Minister of Agriculture. It is essential to ensure from the outset the full-time availability of highly competent staff for the task force, as well as availability of reasonable compensation for destroyed property.
• Provision of addresses with business and after-hours telephone contacts of the CVO, the deputy veterinary officer and appropriate senior public servants, as well as a list of the senior national veterinary staff and their office and home addresses and telephone numbers and emergency contacts.
• Keep a list of resources or sources of supply for materials required for an emergency programme, as well as a list of existing facilities related to emergency programmes, such as abattoirs, meat processing plants, milk processing plants, etc. These lists should include full addresses, business and after-hours telephone numbers, telex and telefax numbers.
• Develop effective communications with individual farmers, breed associations and livestock industries, including transportation and marketing systems, enlisting their support and active participation in the emergency programme.
• Establish agreements with relevant agencies and government services to ensure prompt mobilization of all essential personnel, including the armed forces and the police, in the event of an animal disease emergency.
• Keep a list (with full addresses, telephone, including after-business hours, telex and telefax numbers) of agencies and institutions having special facilities or resources and of personnel with specialized qualifications, with a view to enlisting their support to fulfil the objectives of the emergency programme.
• Prepare and regularly review a list of animal diseases that require emergency action should they be introduced into the country. Develop and maintain published information on the behaviour of these diseases and specific control measures.
• Prepare and periodically review action plans for each of the emergency diseases so that the necessary measures can be taken without delay in the event of a national emergency involving one of the diseases listed.
• Prepare procedures to be adopted while awaiting laboratory confirmation of a suspected disease outbreak. These would include initial steps to prevent possible spread of infection, such as quarantine of suspect farm and livestock and preliminary action in the implementation of the national animal disease emergency plan.
• Prepare a manual containing a precise description of the emergency disease control procedures to be followed once the presence of the disease has been confirmed. Different diseases require different strategies for control and eradication, each with its own particular problems. A strategy document should comprehensively describe the disease control problems produced by a particular disease, the several strategies that may be available to combat it and details of the methods selected for particular situations. It should provide all the information required to understand the nature of the disease, its transmission and the principles of its control and eradication. It should also set out the alternative control strategies and the criteria for selection of any particular strategy.
• Prepare disease surveillance procedures to be adopted initially to delineate the geographic distribution of the disease to monitor the effectiveness of the control campaigns and to prove that the country is again free of the disease.
• Prepare mechanisms for the collection, transmission and analysis of epidemiological data.
• Prepare codes of practice for high-risk enterprises, such as production of biologicals, abattoirs, artificial insemination centres, dairy factories and livestock markets.
• Maintain key data on livestock populations and wildlife.
• Keep maps with necessary details and necessary distribution and ownership of stock. Where relevant they should include detail of regular stock movement routes, watering points and holding yards.
The pattern of the national plan
should be used at provincial and regional levels and it should be well-coordinated
vertically and horizontally. All staff involved should have a clear understanding of their
role in the emergency situation (see also Annex 5).
National disease diagnostic facilities
Because of the importance of early, accurate laboratory confirmation of a suspected emergency disease, considerable effort needs to be put into contingency planning for laboratory diagnosis and the upgrading of national laboratory diagnostic capabilities. This should include consideration of the relative emphasis on self-sufficiency for laboratory diagnosis and reliance on international reference laboratories.
Another approach worthy of consideration is the formation of specialist diagnostic teams for emergency diseases. It would be an advantage for specialists to have had firsthand experience or training in the key emergency diseases. Specialists should be available on call from their normal duties to travel to the site of a reported disease to assist local staff in their investigations.
Specialized international reference laboratories
These laboratories act on a worldwide or regional basis and are designated to assist member countries on request and under agreed conditions in identifying and typing isolates of suspected aetiological agents. Many provide a number of other services, including maintenance and distribution, on request, of reference and working reagents, provision of consultant advice and training of professional and technical staff (see Annex 3).
National laboratories should develop lines of communication with the appropriate world or regional reference laboratories for various emergency diseases in advance of a suspected emergency disease occurrence.
They should determine from the reference laboratories:
• whether only isolated organisms will be accepted for definitive identification or whether primary diagnostic specimens (i.e. tissues and blood) will also be accepted;
• what specimens are required and whether preservatives should be added;
• what specimen containers should be used and how they should be labelled;
• what packaging and refrigerants are required;
• what accompanying history is required;
• how the specimens should be addressed and what other information is required on the labels;
• whether a quarantine import permit needs to be obtained before despatch to facilitate customs clearance. Whether couriers are required for biosecurity;
• telephone, telex and telefax numbers and telegraphic address of the reference laboratories.
Roles of national and international laboratories
The limitations of the services
provided by an international reference laboratory should be realized. The reference
laboratory should confirm the diagnosis, type the organism to enable an appropriate
vaccine to be selected and render other assistance within reason. However, once the
disease is diagnosed, the reference laboratory cannot be expected to carry out the many
laboratory tests required to monitor the spread of the disease and the progress of control
campaigns, nor to prove finally that the country is again free of the disease. This is a
national responsibility.
Vaccine supply
In many instances, the rapid establishment of a comprehensive regional or national vaccination campaign is a key component in the control or eradication of an emergency disease outbreak. Usually, adequate supplies of the appropriate vaccine to cope with an emergency will not be available from within the country and will need to be imported. Should this be the case, the countries should, at least for those diseases that constitute the highest threat, have information to assist them in obtaining vaccine and preparing a vaccination campaign plan. The type of data required is:
• scientific information on vaccines and their use;
• names, addresses, telex, telephone and telefax numbers of vaccine manufacturers;
• general information on availability, quality control standards and field performance of vaccines available from potential supplies;
• epidemiological data on susceptible livestock populations in each region, including their vaccination histories.
International vaccine banks
In many cases the holding of vaccine
stockpiles by an individual developing country is prohibitively expensive. This is
particularly so for vaccines for which there are multiple antigenic types and subtypes. A
cheaper alternative could be for several countries with similar requirements to pool
resources and form an international vaccine bank.
Animal health services
All animal health service personnel should be thoroughly familiar with their respective roles in the event of an emergency.
Special training is needed for emergency disease action and the manual prepared for the national emergency disease plan should form the basis of this training.
The level and range of training needed will vary in relation to the expected roles of the various sections of staff. Veterinary staff will need a comprehensive knowledge of the exotic diseases considered to be the greatest threat. In particular, they should have a thorough knowledge of the clinical symptoms, epidemiology, diagnostic procedures and control measures for such diseases, both at field and laboratory level. Auxiliary personnel should be trained in vaccination procedures for the various diseases, assisting in the taking of diagnostic samples, disposal of animals and cleansing and disinfection procedures. If necessary, the assistance of international organizations, collaborating laboratory centres and veterinary schools should be sought.
Veterinary schools
Teachers at veterinary schools should have knowledge of the national emergency plan and the emergency disease situation at national and international levels. The subject should be included in the curriculum at both graduate and postgraduate levels. Close and regular contact should be maintained between the veterinary schools and animal health services for this purpose.
Simulation exercises
Simulation exercises are as important for emergency disease readiness as the preparation of the national plan. They can also play an important part in amending or updating the plan in light of practical experience.
Purpose
• To train individual "action groups" (task forces) and accustom them to working as a team.
• To identify staff competence in working under emergency disease situations and to select leaders for action groups.
• To identify problems in implementing the national plan.
• To test communications between various groups in the task force.
Objectives and types of exercise. It is important at the outset to decide on the objectives of the exercises so that they may be planned accordingly. An experienced leader should be responsible for drawing up the plan and briefing staff on their respective roles. The exercises may be in the form of simple "desk" exercises, more complex "office" exercises or field simulation exercises.
All these activities are complementary in an emergency response. A simultaneous involvement of all staff will be necessary at times in order to test the effectiveness of the system as a whole and also to serve as continuing training of staff.
Desk exercises can be useful for small groups to develop office in support of field operations, e.g. providing the necessary data and mapping, systems for recording and distributing information of animal movements, contacts, etc.
Office exercises at headquarters and at provincial and field levels are necessary to put all desk procedures into action, coordinate the activities and test the communication network within the animal health service and with the outside organizations that will be involved during an emergency.
Increasingly, national emergency plans are utilizing modem computer-based information systems, and basic training programmes have also been developed and designed to meet the needs of particular national plans. Care must be exercised in developing the computer systems, as a break in the linkage between the input data and retrieval system could cause serious problems in an emergency situation.
Field simulation exercises play a most important part, both in testing the national plan under practical conditions and for the training of staff. They should be designed to provide the most realistic possible simulation of an outbreak of disease. It is important to ensure that the hypothetical epidemiology of the outbreak matches the epidemiology of the emergency disease and that the descriptions of people, places and movements on and off the farms are as real as possible.
At the conclusion of the exercise a comprehensive evaluation should be carried out with observations from the exercise leader and all participants. A report should be prepared for senior animal health service staff who will, if necessary, revise the national plan.
An evaluation of the performance of staff involved in the exercise will assist in the selection of staff for the sections or task forces.
Simulation exercises should be carried out periodically and form pan of the continuing training programme for staff. If a threat from a new exotic disease is identified, a special exercise should be carried out.
Emergency operations manual
An outline of the documents that
should be included in a manual as part of the national emergency plan is given in Annex 5.
FAO. 1980. Report of the Expert Consultation on Emergency Disease Control. Rome, FAO.
FAO. 1984. Emergency disease of livestock. Diseases and diagnoses (Vol. I) and Contingency planning for emergency diseases (Vol. II). Rome, FAO.
WHO/ISS. 1988. Veterinary public health in disaster situations. Veterinary Public Health Report, ISS/WHO/CC/88.2. WHO/FAO collaborating centre for research and training in veterinary public health, Istituto Superiore di Sanità, Rome.