A dynamic, optimal disease control model for foot-and-mouth-disease: II. Model results and policy implications

A dynamic optimization model was used to search for optimal strategies to control foot-and-mouth disease (FMD) in the three-county region in the Central Valley of California. The model minimized total regional epidemic cost by choosing the levels of depopulation of diagnosed herds, preemptive depopulation, and vaccination. Impacts of limited carcass disposal capacity and vaccination were also examined, and the shadow value, the implicit value of each capacity, was estimated. The model found that to control FMD in the region, (1) preemptive depopulation was not optimal, (2) vaccination, if allowed, was optimal, reducing total cost by 3–7%, (3) increased vaccination capacity reduced total cost up to US$ 119 per dose, (4) increased carcass disposal capacity reduced total cost by US$ 9000–59,400 per head with and without vaccination, respectively, and (5) dairy operations should be given preferential attention in allocating limited control resources.     

A decision-tree to optimise control measures during the early stage of a foot-and-mouth disease epidemic

A decision-tree was developed to support decision making on control measures during the first days after the declaration of an outbreak of foot-and-mouth disease (FMD). The objective of the tree was to minimise direct costs and export losses of FMD epidemics under several scenarios based on livestock and herd density in the outbreak region, the possibility of airborne spread, and the time between first infection and first detection. The starting point of the tree was an epidemiological model based on a deterministic susceptible–infectious–recovered approach. The effect of four control strategies on FMD dynamics was modelled. In addition to the standard control strategy of stamping out and culling of high-risk contact herds, strategies involving ring culling within 1 km of an infected herd, ring-vaccination within 1 km of an infected herd, and ring-vaccination within 3 km of an infected herd were assessed. An economic model converted outbreak and control effects of farming and processing operations into estimates of direct costs and export losses. Ring-vaccination is the economically optimal control strategy for densely populated livestock areas whereas ring culling is the economically optimal control strategy for sparsely populated livestock areas.     

Description of an epidemic simulation model for use in evaluating strategies to control an outbreak of foot-and-mouth disease

OBJECTIVE: To develop a spatial epidemic model to simulate intraherd and interherd transmission of foot-and-mouth disease (FMD) virus. SAMPLE POPULATION: 2,238 herds, representing beef, dairy, swine, goats, and sheep, and 5 sale yards located in Fresno, Kings, and Tulare counties of California. PROCEDURE: Using Monte-Carlo simulations, a spatial stochastic epidemic simulation model was developed to identify new herds that would acquire FMD following random selection of an index herd and to assess progression of an epidemic after implementation of mandatory control strategies. RESULTS: The model included species-specific transition periods for FMD infection, locations of herds, rates of direct and indirect contacts among herds, and probability distributions derived from expert opinions on probabilities of transmission by direct and indirect contact, as well as reduction in contact following implementation of restrictions on movements in designated infected areas and surveillance zones. Models of supplemental control programs included slaughter of all animals within a specified distance of infected herds, slaughter of only high-risk animals identified by use of a model simulation, and vaccination of all animals within a 5- to 50-km radius of infected herds. CONCLUSIONS AND CLINICAL RELEVANCE: The FMD model represents a tool for use in planning biosecurity and emergency-response programs and in comparing potential benefits of various strategies for control and eradication of FMD appropriate for specific populations.     

An extended state-transition model for foot-and-mouth disease epidemics in France

The dynamics of foot-and-mouth disease epidemics in France was examined through simulations based on an extended state-transition model. Contagion modelling depended on specific parameters: the so-called dissemination rates. Estimation of these parameters relied on a specific discrete-event simulation model. We were able to address the problem of the hidden spread of the epidemic, before the first outbreak is diagnosed. Furthermore, we took into account the silent development of the disease in affected herds before the diagnosis. The effect of control measures such as the active search for secondary outbreaks could thus be studied. We used the model to compare the development of FMD epidemics in two very different French regions and for different control strategies implemented by the animal-health authorities. These strategies gave similar results in a low herd density area, whereas in a high herd density area, the slaughter of contact herds greatly improved the stamping-out strategy. Finally, key parameters of the model were detected through a sensitivity analysis.     

Simulation analyses to evaluate alternative control strategies for the 2002 foot-and-mouth disease outbreak in the Republic of Korea

Using the stochastic and spatial simulation model of between-farm spread of disease, InterSpread Plus, we evaluated the effect of alternative strategies for controlling the 2002 epidemic of foot-and-mouth disease (FMD) in the Republic of Korea. InterSpread Plus was parameterised to simulate epidemics of FMD in the population of farms containing susceptible animal species in the Korean counties of Yongin, Icheon, Pyongtaek, Anseong, Eumseong, Asan, Cheonan, and Jincheon. The starting point of our analyses was the simulation of a reference strategy, which approximated the real epidemic. The results of simulations of alternative epidemic-control strategies were compared with this reference strategy. Ring vaccination (when used with either limited or extended pre-emptive depopulation) reduced both the size and variability of the predicted number of infected farms. Reducing the time between disease incursion and commencement of controls had the greatest effect on reducing the predicted number of infected farms.     

Potential impact of species and livestock density on the epidemic size and effectiveness of control measures for foot-and-mouth disease in Japan

The characteristics of a livestock area, including farm density and animal species, influence the spread of foot-and-mouth disease (FMD). In this study, the impact of livestock area on FMD epidemics was examined using an FMD transmission model. For this simulation, three major livestock areas were selected: the 2010 FMD epidemic area in Japan as the baseline area (BS), a cattle and pig mixed production area (CP) and a cattle production area (C). Simulation results demonstrated that under the 24-hr culling policy, only 12% of epidemics among 1,000 simulations were abated within 100 days in the CP area, whereas 90% of the epidemics ceased in the BS area. In the C area, all epidemics were successfully contained within 100 days. Evaluation of additional control measures in the CP area showed that the 0.5-km pre-emptive culling, even when only targeting pig farms, raised the potential for successful containment to 94%. A 10-km vaccination on day 7 or 14 after initial detection was also effective in halting the epidemics (80%), but accompanied a large number of culled or vaccinated farms. The combined strategy of 10-km vaccination and 0.5-km pre-emptive culling targeting pig farms succeeded in containing all epidemics within 100 days. The present study suggests the importance of preparedness for the 24-hr culling policy and additional control measures when an FMD outbreak occurs in a densely populated area. Considering the characteristics of the livestock area is important in planning FMD control strategies.     

Evaluation of the benefit of emergency vaccination in a foot-and-mouth disease free country with low livestock density

Foot-and-mouth disease (FMD) is highly contagious and one of the most economically devastating diseases of cloven-hoofed animals. Scientific-based preparedness about how to best control the disease in a previously FMD-free country is therefore essential for veterinary services. The present study used a spatial, stochastic epidemic simulation model to compare the effectiveness of emergency vaccination with conventional (non-vaccination) control measures in Switzerland, a low-livestock density country. Model results revealed that emergency vaccination with a radius of 3 km or 10 km around infected premises (IP) did not significantly reduce either the cumulative herd incidence or epidemic duration if started in a small epidemic situation where the number of IPs is still low. However, in a situation where the epidemic has become extensive, both the cumulative herd incidence and epidemic duration are reduced significantly if vaccination were implemented with a radius of 10 km around IPs. The effect of different levels of conventional strategy measures was also explored for the non-vaccination strategy. It was found that a lower compliance level of farmers for movement restrictions and delayed culling of IPs significantly increased both the cumulative IP incidence and epidemic duration. Contingency management should therefore focus mainly on improving conventional strategies, by increasing disease awareness and communication with stakeholders and preparedness of culling teams in countries with a livestock structure similar to Switzerland; however, emergency vaccination should be considered if there are reasons to believe that the epidemic may become extensive, such as when disease detection has been delayed and many IPs are discovered at the beginning of the epidemic.     

Results of epidemic simulation modeling to evaluate strategies to control an outbreak of foot-and-mouth disease

OBJECTIVE: To assess estimated effectiveness of control and eradication procedures for foot-and-mouth disease (FMD) in a region of California. SAMPLE POPULATION: 2,238 herds and 5 sale yards in Fresno, Kings, andTulare counties of California. PROCEDURE: A spatial stochastic model was used to simulate hypothetical epidemics of FMD for specified control scenarios that included a baseline eradication strategy mandated by USDA and supplemental control strategies of slaughter or vaccination of all animals within a specified distance of infected herds, slaughter of only high-risk animals identified by use of a model simulation, and expansion of infected and surveillance zones. RESULTS: Median number of herds affected varied from 1 to 385 (17% of all herds), depending on type of index herd and delay in diagnosis of FMD. Percentage of herds infected decreased from that of the baseline eradication strategy by expanding the designated infected area from 10 to 20 km (48%), vaccinating within a 50-km radius of an infected herd (41%), slaughtering the 10 highest-risk herds for each infected herd (39%), and slaughtering all animals within 5 km of an infected herd (24%). CONCLUSIONS AND CLINICAL RELEVANCE: Results for the model provided a means of assessing the relative merits of potential strategies for control and eradication of FMD should it enter the US livestock population. For the study region, preemptive slaughter of highest-risk herds and vaccination of all animals within a specified distance of an infected herd consistently decreased size and duration of an epidemic, compared with the baseline eradication strategy.     

Spatial and stochastic simulation to evaluate the impact of events and control measures on the 1997-1998 classical swine fever epidemic in The Netherlands. I. Description of simulation model

The simulation model InterCSF was developed to simulate the Dutch Classical Swine Fever (CSF) epidemic of 1997–98 as closely as possible. InterCSF is a spatial, temporal and stochastic simulation model. The outcomes of the various replications give an estimate of the variation in size and duration of possible CSF-epidemics. InterCSF simulates disease spread from an infected farm to other farms through three contact types (animals, vehicles, persons) and through local spread up to a specified distance. The main disease-control mechanisms that influence the disease spread in InterCSF are diagnosis of the infected farms, depopulation of infected farms, movement-control areas, tracing, and pre-emptive slaughter. InterCSF was developed using InterSpread as the basis. InterSpread was developed for foot-and-mouth disease (FMD). This paper describes the process of modifying InterSpread into InterCSF. This involved changing the assumptions and mechanisms for disease spread from FMD to CSF. In addition, CSF-specific control measures based on the standard European Union (EU) regulations were included, as well as additional control measures that were applied during the Dutch epidemic. To adapt InterCSF as closely as possible to the Dutch 1997/98 epidemic, data from the real epidemic were analysed. Both disease spread and disease-control parameters were thus specifically based on the real epidemic. In general, InterSpread turned out to be a flexible tool that could be adapted to simulate another disease with relative ease. The most difficult were the modifications necessary to mimic the real epidemic as closely as possible. The model was well able to simulate an epidemic with a similar pattern over time for number of detected farms as the real outbreak; but the absolute numbers were (despite many relevant modifications) not exactly the same — but were within an acceptable range. Furthermore, the development of InterCSF provided the researchers with a better insight into the existing knowledge gaps. In part II (see the final paper in this issue), InterCSF was used to compare various control strategies as applied to this epidemic.     

Epidemiological simulation modeling and spatial analysis for foot-and-mouth disease control strategies: a comprehensive review

Foot-and-mouth disease (FMD) is one of the most serious transboundary, contagious viral diseases of cloven-hoofed livestock, because it can spread rapidly with high morbidity rates when introduced into disease-free herds or areas. Epidemiological simulation modeling can be developed to study the hypothetical spread of FMD and to evaluate potential disease control strategies that can be implemented to decrease the impact of an outbreak or to eradicate the virus from an area. Spatial analysis, a study of the distributions of events in space, can be applied to an area to investigate the spread of animal disease. Hypothetical FMD outbreaks can be spatially analyzed to evaluate the effect of the event under different control strategies. The main objective of this paper is to review FMD-related articles on FMD epidemiology, epidemiological simulation modeling and spatial analysis with the focus on disease control. This review will contribute to the development of models used to simulate FMD outbreaks under various control strategies, and to the application of spatial analysis to assess the outcome of FMD spread and its control.     

The 2010 foot-and-mouth disease epidemic in Japan

Foot-and-mouth disease (FMD) occurred recently for the first time in a decade in Japan. The index case was detected on a beef-breeding farm in Miyazaki Prefecture, Southern Japan, on April 20, 2010. After confirmation of this first case, control measures such as stamping out, movement restriction and disinfection were implemented. However, these strategies proved insufficient to prevent the spread of FMD and emergency vaccination was adopted. Up until the last outbreak on July 4, 2010, a total of 292 outbreaks had been confirmed, with about 290,000 animals having been culled. The epidemic occurred in an area with a high density of cattle and pigs, making disease control difficult. Invasion of the disease into a high-density area aided its rapid spread and led to difficulties in locating suitable burial sites. Epidemiological investigations indicated that the disease was introduced into Japan approximately one month before detection. This delay in initial detection is considered to have allowed an increased number of outbreaks in the early stage of the epidemic. Nevertheless, the epidemic was contained within a localized area in Miyazaki Prefecture and was eradicated within three months because of intensive control efforts including emergency vaccination. Although this epidemic devastated the livestock industry in Japan, many lessons can be learnt for the future prevention and control of infectious diseases in animals.     

A comparison of predictions made by three simulation models of foot-and-mouth disease

AIMS: To describe results of a relative validation exercise using the three simulation models of foot-and-mouth disease (FMD) in use by the quadrilateral countries (QUADS; Australia, Canada, New Zealand, and United States of America; USA).

METHODS: A hypothetical population of farms was constructed and, following the introduction of an FMD-like disease into a single farm, spread of disease was simulated using each of the three FMD simulation models used by the QUADS countries. A series of 11 scenarios was developed to systematically evaluate the key processes of disease transmission and control used by each of the three models. The predicted number of infected units and the size of predicted outbreak areas for each scenario and each model were compared using the Kruskal-Wallis test. Agreement among the three models in terms of geographical areas predicted to become infected were quantified using Fleiss' Kappa statistic.

RESULTS: Although there were statistically significant differences in model outputs in terms of the numbers of units predicted to become infected, the temporal onset of infection throughout the simulation period, and the spatial distribution of infected units, these differences were generally small and would have resulted in the same (or similar) management decisions being adopted in each case.

CONCLUSIONS: Agreement among the three models in terms of the numbers of premises predicted to become infected, the temporal onset of infection throughout the simulation period, and the spatial distribution of infected premises provides evidence that each of the model developers are consistent in their approach to simulating the spread of disease throughout a population of susceptible individuals. This consistency implies that the assumptions taken by each development team are appropriate, which in turn serves to increase end-user confidence in model predictions.

CLINICAL RELEVANCE: Relative validation is one of a number of steps that can be undertaken to increase end-user confidence in predictions made by infectious disease models.     

How do resources influence control measures during a simulated outbreak of foot and mouth disease in Australia?

An outbreak of foot and mouth disease (FMD) could seriously impact Australia's livestock sector and economy. As an FMD-free country, an outbreak would trigger a major disease control and eradication program that would include the culling of infected and at risk animals (‘stamping out’), movement restrictions and zoo-sanitary measures. Additional control measures may also include pre-emptive culling or vaccination. However, it is unclear what disease strategy would be most effective under Australian conditions and different resource levels. Using a stochastic simulation model that describes FMD transmission between farms in a livestock dense region of Australia, our results suggest that using current estimates of human resource capacity for surveillance, infected premises operations and vaccination, outbreaks were effectively controlled under a stamping out strategy. However, under more constrained resource allocations, ring vaccination was more likely to achieve eradication faster than stamping out or pre-emptive culling strategies.     

A generic spreadsheet model of a disease epidemic with application to the first 100 days of the 2001 outbreak of foot-and-mouth disease in the UK

A generic, stochastic spreadsheet model was developed to calculate the number of cases within the first 100 days of a propagating epidemic and with the ability to incorporate generic control measures. Foot-and-mouth disease (FMD) epidemics were simulated with a range of assumptions about the number of cases incubating the disease on day 1 and the efficiency of control measures. Particularly severe epidemics resulted from scenarios with low efficiency of control measures and high numbers incubating. Control measures that prevented 0.8 of cases from resulting in new cases were able to reduce substantially the cumulative number of cases. The results of various scenarios using the model were compared to the number of cases of FMD in the first 100 days of the 2001 outbreak in the UK, with specific reference to cases in Cumbria and Anglesey. Potential practical and educational applications of the model are discussed.     

Modelling foot-and-mouth disease: a comparison between the UK and Denmark

Whilst the UK 2001 FMD (foot-and-mouth disease) outbreak provides an extremely rich source of spatio-temporal epidemic data, it is not clear how the models and parameters from the UK can be translated to other scenarios. Here we consider how the model framework used to capture the UK epidemic can be applied to a hypothetical FMD outbreak in Denmark. Whilst pigs played a relatively minor role in the UK epidemic (being the infected animal on just 18 farms), they dominate the Danish livestock landscape. In addition, it is not clear whether transmission parameters from the UK will transfer to Denmark where farming practices may be significantly different. We therefore explore a large volume of high-dimensional parameter space, but seek to relate final epidemic size, risk of spread to Danish islands and potential success of control measures, to early indicators of epidemic dynamics. The results of this extensive modelling exercise therefore allow us to provide timely advice on control options based on the observed behaviours of the first few generations.     

Evaluation of the transmission risk of foot-and-mouth disease in Japan

The transmission risk of foot-and-mouth disease (FMD) in Japan was evaluated using a mathematical FMD transmission model. The distance-based transmission rate between farms, which was parameterized using the FMD epidemic data in 2010 in Japan, was used to calculate the local-level reproduction numbers—expected numbers of secondary infections caused by one infected farm—for all cattle and pig farms in the country, which were then visualized as a risk map. The risk map demonstrated the spatial heterogeneity of transmission risk in the country and identified risk areas with higher possibility of disease spread. This result suggests that, particularly in high-risk areas, it is important to prepare for the smooth and efficient implementation of control measures against FMD outbreaks.     

Parameterization of the duration of infection stages of serotype O foot-and-mouth disease virus: an analytical review and meta-analysis with application to simulation models

Foot-and-mouth disease (FMD) is considered one of the most important infectious diseases of livestock because of the devastating economic consequences that it inflicts in affected regions. The value of critical parameters, such as the duration of the latency or the duration of the infectious periods, which affect the transmission rate of the FMD virus (FMDV), are believed to be influenced by characteristics of the host and the virus. Disease control and surveillance strategies, as well as FMD simulation models, will benefit from improved parameter estimation. The objective of this study was to quantify the distributions of variables associated with the duration of the latency, subclinical, incubation, and infectiousness periods of FMDV transmission. A double independent, systematic review of 19 retrieved publications reporting results from experimental trials, using 295 animals in four reference laboratories, was performed to extract individual values related to FMDV transmission. Probability density functions were fitted to data and a set of regression models were used to identify factors associated with the assessed parameters. Latent, subclinical, incubation, and infectious periods ranged from 3.1 to 4.8, 2 to 2.3, 5.5 to 6.6, and 3.3 to 5.7 days, respectively. Durations were significantly (p < 0.05) associated independently with route of exposure, type of donor, animal species, strains, characteristics of sampling, and clinical signs. These results will contribute to the improvement of disease control and surveillance strategies and stochastic models used to simulate FMD spread and, ultimately, development of cost-effective plans to prevent and control the potential spread of the disease in FMD-free regions of the world.     

A review of foot-and-mouth disease with special consideration for the clinical and epidemiological factors relevant to predictive modelling of the disease

Modelling the epidemiology of foot-and-mouth disease (FMD) has been undertaken since the early 1970s. We review here clinical factors and modelling procedures that have been used in the past, differentiating between those that have proved to be more relevant in controlling FMD epidemics, and those that have showed less significance. During the 2001 UK FMD epidemic, many previously developed FMD models were available for consideration and use. Accurate epidemiological models can become useful tools for determining relevant control policies for different scenarios and, conversely, inaccurate models may become an abuse for disease control. Inaccuracy presents two opposing difficulties. Firstly, too much control (in terms of animal slaughter for 2001) would negatively impact the farming community for many subsequent years, whilst too little control would permit an epidemic to persist. Accuracy however, presents the optimal permutation of control measures that could be implemented for a given set of conditions, and is a prerequisite to boosting public confidence in the use of epidemiological models for future epidemics.     

Effectiveness of movement-prevention regulations to reduce the spread of foot-and-mouth disease in The Netherlands

After the foot-and-mouth disease (FMD) outbreak in 2001 the Dutch government implemented movement-prevention regulations to reduce the number of contacts between farms and consequently the risk of spread of highly contagious animal infections in the future. We studied the efficacy of these regulations by comparing registered cattle-movement data from 2000 to those from 2002. We also used the spatial and stochastic simulation model InterFMD to evaluate the consequences of the observed alterations in cattle-contact structure on the spread and control of a FMD epidemic.

There was a significant decrease in the number of cattle movements “for live use”, no difference in the number of group movements “for live use” and a distinct change in the overall contact structure. The most important structure changes were a decrease in the number of group movements from dairy farms to cattle-collection centres (−44%), and an increase in the number of group movements from dairy farms to beef farms (111%).

Our simulations demonstrated that the implemented regulations result in a concentration of the FMD-affected area and therefore in a reduction in size of the epidemics. Based on the intended Dutch strategy to control future FMD outbreaks, the decrease in extreme epidemics (95th percentiles) went from 31 infected farms in an epidemic-length of 65 days to 8 infected farms in an epidemic-length of 53 days in sparsely populated areas. In densely populated areas this decrease went from 135 infected farms to 103, while the duration reduced from 88 days to 81.     

Simulated economic consequences of foot-and-mouth disease epidemics and their public control in France

The efficient management of foot-and-mouth disease (FMD) epidemics in France was examined through a simulation model which combines epidemiological and economic modules. From the reactions of the importing countries in terms of the products subject to import bans and the regionalization commitments, the economic module assesses the financial consequences of FMD outbreaks borne not only by the breeding sector but also by the other economic sectors on regional and national levels. Among the control options for FMD, the strategy of stamping out infected herds and dangerous in-contact herds most often contributes to reducing the economic consequences of FMD epidemics. Implementing a campaign of emergency vaccination is socially optimal if the additional export losses associated with the delay of slaughtering the vaccinated animals are offset by the gains of reducing the duration of the FMD epidemic. The importance of reducing as much as possible the total duration of the import bans is stressed by the estimated cost of an extra week of import bans. The optimal control strategy was unaffected by the introduction of stochastic parameters.