Quantitative risk assessment of foot-and-mouth disease introduction into Spain via importation of live animals

Spain has been a foot-and-mouth disease (FMD)-free country since 1986. However, the FMD epidemics that recently affected several European Union (EU) member countries demonstrated that the continent is still at high risk for FMD virus (FMDV) introduction, and that the potential consequences of those epidemics are socially and financially devastating. This paper presents a quantitative assessment of the risk of FMDV introduction into Spain. Results suggest that provinces in north-eastern Spain are at higher risk for FMDV introduction, that an FMD epidemic in Spain is more likely to occur via the import of pigs than through the import of cattle, sheep, or goats, and that a sixfold increase in the proportion of premises that quarantine pigs prior to their introduction into the operation will reduce the probability of FMDV introduction via import of live pigs into Spain by 50%. Allocation of resources towards surveillance activities in regions and types of operations at high risk for FMDV introduction and into the development of policies to promote quarantine and other biosecurity activities in susceptible operations will decrease the probability of FMD introduction into the country and will strengthen the chances of success of the Spanish FMD prevention program.     

Potential impact of an introduction of foot-and-mouth disease into the California State Fair

OBJECTIVE: To estimate the potential spread of foot-and-mouth disease (FMD) if infected livestock had been exhibited at the 2005 California State Fair. DESIGN: Epidemic model. ANIMALS: Dairy cattle, dairy goats, and pygmy goats exhibited between August 24 and August 28 by 195 exhibitors. PROCEDURES: 2 stochastic models were used to simulate epidemics of FMD that might originate from 1, 3, 5, 7, or 10 index cases at the state fair. Data obtained from state fair exhibitors were used to determine the spatial distribution and types of herds to which livestock visiting the state fair returned. RESULTS: Mean estimated numbers of latently infected animals on day 5 were 12.3 and 75.9, respectively, when it was assumed that there were 1 and 10 index cases. Regardless of the number of index cases, mean estimated numbers of subclinically infected and clinically infected animals were low throughout the 5-day study period. Mean estimated duration of the resulting epidemic ranged from 111 to 155 days, mean number of infected premises ranged from 33 to 244, and mean probability that at least 1 animal that became infected with FMD would subsequently leave the state ranged from 28% to 96% as the number of index cases increased from 1 to 10, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that following introduction of FMD at the California State Fair, infection would likely go undetected until after animals left the fair and that the subsequent outbreak would spread rapidly.     

Eliciting the relative importance of risk factors concerning contagious animal diseases using conjoint analysis: a preliminary survey report

Conjoint analysis is a technique well known in marketing research to elicit consumer preferences and opinions. This paper describes the results of an experiment which explores the potential application of conjoint analysis in the field of veterinary epidemiology and economics. In this experiment, the method of conjoint analysis was used to elicit the opinion of experts about the relative importance of risk factors concerning contagious animal diseases. Diseases studied were: African Swine Fever (ASF), Classical Swine Fever (CSF), Foot-and-Mouth Disease (FMD), Swine Vesicular Disease (SVD), Newcastle Disease (NCD) and Avian Influenza (AI). Risk factors included were import of livestock, import of animal products, feeding of swill, tourists, returning livestock trucks and air. The conjoint analysis technique was used to draw up a questionnaire which was handed out during the 7th ISVEE held at Nairobi, Kenya, from 15 to 19 August 1994. According to the experts approached, the factors ‘import of livestock’ and ‘import of animal products’ were the major sources of risk for all diseases. For ASF, CSF and FMD, the risk factor ‘swill feeding’ ranked third. For FMD and the two poultry diseases NCD and AI, only the risk factor ‘air’ was important. Overall conclusion was that conjoint analysis could be a useful method for eliciting the opinion of experts about risk factors concerning contagious animal diseases. In further research, special attention should be given to the selection of experts and the presentation of the conjoint questions.     

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.     

A survey to investigate movements off sheep and cattle farms in New Zealand, with reference to the potential transmission of foot-and-mouth disease

AIM: To quantify the numbers and extent of movements off sheep and cattle farms in New Zealand, in order to construct more realistic simulation models to investigate how infectious diseases such as foot-and-mouth disease (FMD) might spread. METHODS: Farmers from 500 randomly selected farms, comprising 100 from each of the following sectors, viz beef, dairy, grazing/dairy heifer rearing, sheep, and mixed sheep and beef, were asked to fill in diaries in which they recorded the movements of all animals, products, people, vehicles and equipment coming on to or leaving their farms during two separate 3-week periods, representing relatively 'busy' and 'quiet' times of the year with respect to livestock movements. Where possible, the destination of each movement was identified and geo-coded, to allow the distance travelled to be calculated. Each movement was then classified according to the risk of transfer of FMD virus (FMDV), should the disease have been present on the study farm at the time of the movement. The data were then analysed to establish movement frequencies and distributions of distances travelled, by the different pastoral livestock sectors. RESULTS: Two hundred and seventeen farmers returned one or more diaries. One hundred and ninety-three farmers completed a Busy-period diary, recording a total of 12,052 movements off their farms, a crude average of 62.4 per 3-week period, or 2.97 per day. Of these, 4.0% involved the transport of livestock, equating to 0.12 livestock consignments per day. In contrast, 186 Quiet-period diaries were returned, recording a total of 10,885 movements off, representing a crude average of 58.5 during the 3-week period, or 2.78 per day. Of these, 2.1% involved livestock, equating to 0.06 livestock consignments per day. The mean and median distances travelled during the Busy periods were 30.9 km and 13.1 km, respectively (range 0-1,167 km). In comparison, the mean and median distances travelled during Quiet periods were 41.3 and 14 km, respectively (range 0.4-1,203 km). CONCLUSIONS: People, vehicles, livestock and other items can travel off pastoral livestock farms in New Zealand to other farms either directly or via saleyards over extensive distances. This has implications for the potential spread of infectious diseases such as FMD. Movement parameters intended for use in the InterSpread Plus inter-farm simulation model of FMD were established, which will facilitate the prediction of likely spread and efficacy of controls in the unlikely event of a real-life outbreak.     

A survey to investigate movements off sheep and cattle farms in New Zealand,with reference to the potential transmission of foot-and-mouth disease

AIM: To quantify the numbers and extent of movements off sheep and cattle farms in New Zealand, in order to construct more realistic simulation models to investigate how infectious diseases such as foot-and-mouth disease (FMD) might spread.

METHODS: Farmers from 500 randomly selected farms, comprising 100 from each of the following sectors, viz beef, dairy, grazing/dairy heifer rearing, sheep, and mixed sheep and beef, were asked to fill in diaries in which they recorded the movements of all animals, products, people, vehicles and equipment coming on to or leaving their farms during two separate 3-week periods, representing relatively ‘busy’ and ‘quiet’ times of the year with respect to livestock movements. Where possible, the destination of each movement was identified and geo-coded, to allow the distance travelled to be calculated. Each movement was then classified according to the risk of transfer of FMD virus (FMDV), should the disease have been present on the study farm at the time of the movement. The data were then analysed to establish movement frequencies and distributions of distances travelled, by the different pastoral livestock sectors.

RESULTS: Two hundred and seventeen farmers returned one or more diaries. One hundred and ninety-three farmers completed a Busy-period diary, recording a total of 12,052 movements off their farms, a crude average of 62.4 per 3-week period, or 2.97 per day. Of these, 4.0% involved the transport of livestock, equating to 0.12 livestock consignments per day. In contrast, 186 Quiet-period diaries were returned, recording a total of 10,885 movements off, representing a crude average of 58.5 during the 3-week period, or 2.78 per day. Of these, 2.1% involved livestock, equating to 0.06 livestock consignments per day. The mean and median distances travelled during the Busy periods were 30.9 km and 13.1 km, respectively (range 0–1,167 km). In comparison, the mean and median distances travelled during Quiet periods were 41.3 and 14 km, respectively (range 0.4–1,203 km).

CONCLUSIONS: People, vehicles, livestock and other items can travel off pastoral livestock farms in New Zealand to other farms either directly or via saleyards over extensive distances. This has implications for the potential spread of infectious diseases such as FMD. Movement parameters intended for use in the InterSpread Plus inter-farm simulation model of FMD were established, which will facilitate the prediction of likely spread and efficacy of controls in the unlikely event of a real-life outbreak.     

A practical longitudinal model for evaluating growth in Gelbvieh cattle

Genetic evaluation of growth in Gelbvieh beef cattle was examined by multiple-trait (MTM) and random regression (RRM) analysis. The data set comprised 541,108 animals with 1,120,086 records. Approximately 15% of the animals in the data set had at least one record measured outside of the accepted MTM age ranges for weaning weight (Wwt) and yearling weight (Ywt). Fourteen percent of Wwt records and 19% of Ywt records were measured outside the accepted ranges for MTM analysis, and thus were excluded from MTM evaluations. Two RRM evaluations were performed using cubic Legendre polynomials (RRML) and linear splines (RRMS) with three knots at 1, 205, and 365 d of age. Data Set 1 (d1) utilized all available records, whereas Data Set 2 (d2) included only records measured within MTM ranges (1 d, 160 to 250 d, and 320 to 410 d). The RRML models did not reach convergence until diagonalization was imposed. After diagonalization, it was found that all longitudinal models required fewer iterations to converge than the MTM. Correlations between the MTM, RRML-d2, and RRMS-d2 evaluations were >or=0.99 for all three traits, indicating that these models were equivalent when predicting breeding values from data within the MTM age ranges. Correlations between MTM, RRML-d1, and RRMS-d1 were >0.99 for Bwt and >0.95 for Wwt and Ywt. The lower correlations for Wwt and Ywt indicate that the added information does affect breeding value prediction. The RRM has the capability to incorporate records measured at all ages into genetic evaluations at a computing cost similar to the MTM.     

Evaluation of post-farm-gate passive surveillance in swine for the detection of foot and mouth disease in Australia

Pigs are considered high risk for the introduction and spread of foot and mouth disease (FMD) in Australia. One of the most likely pathways of introduction of FMD into Australia would be through the illegal importation of FMD-contaminated meat, which is then fed to feral or domestic pigs. Locations where animals from different origins are commingled, such as livestock markets and abattoirs, pose a risk for disease spread. Early detection of exotic diseases at these locations is crucial in limiting the spread of an outbreak. The aims of this study were to evaluate the likelihood of exotic disease detection with current passive disease surveillance activities for pigs at saleyards and abattoirs in eastern Australia, and make recommendations for improving surveillance. Sensitivity (Se) of the current post-farm-gate passive surveillance for detection of exotic diseases was estimated using the scenario tree modelling methodology (Martin et al., 2007a). Four surveillance system components were identified: (i) domestic saleyard, (ii) export saleyard, (iii) domestic abattoir, and (iv) export abattoir. Pig farms were classified according to herd size (Small vs. Large) and subsequently into two risk categories depending on the probability of swill feeding (Swill feeding vs. Not swill feeding). A scenario tree representing the pathways by which infected animals could be detected was developed and the Se of detection in each surveillance system component was estimated. Industry statistics, information on previous exotic disease outbreaks, and interviews with pig producers were used to estimate herd category proportions and the relative risk of swill feeding. Quantitative estimates for probabilities of detection were sourced from State legislation and policies, stakeholder consultation and observational studies at saleyards and abattoirs. Results of a FMD case study showed a Se of detection at a representative location for each surveillance system component during a 2-week period of 0.19 at domestic saleyards, 0.40 at export saleyards, 0.32 at domestic abattoirs and, 0.53 at export abattoirs. This output assumed the country was infected with herd and unit design prevalences of 1% and 30%, respectively. Improving disease awareness of saleyard and abattoir stockmen, increasing the presence of inspectors at these venues and identifying those herds posing a higher risk for FMD introduction, could improve the capacity of the country for early detection of emerging animal diseases.     

Evaluation of risks of foot-and-mouth disease in Scotland to assist with decision making during the 2007 outbreak in the UK

An outbreak of foot-and-mouth disease (FMD) occurred in Surrey on August 3, 2007. A Great Britain-wide ban on livestock movements was implemented immediately. This coincided with the start of seasonal sheep movements off the hills in Scotland; the majority of these animals are sold via markets. The ban therefore posed severe economic and animal-welfare hardships if it was to last through September and beyond. The Scottish Government commissioned an analysis to assess the risk of re-opening markets given the uncertainty about whether FMD had entered Scotland. Tracing of livestock moved from within the risk zone in England between July 16 and August 3 identified contact chains to 12 Scottish premises; veterinary field inspections found a further three unrecorded movements. No signs of infection were found on these holdings. Under the conservative assumption that a single unknown Scottish holding was infected with FMD, an estimate of the time-dependent probability of Scotland being FMD free given no detection was made. Analyses indicated that if FMD was not detected by early to mid-September then it was highly probable that Scotland was FMD free. Risk maps were produced to visualise the potential spread of FMD across Scotland if it was to spread either locally or via market sales.     

Early dissemination of foot-and-mouth disease virus through sheep marketing in February 2001

The results of epidemiological investigations suggest that livestock on up to 79 premises, spread widely throughout the British Isles, may have been exposed to infection by foot-and-mouth disease (FMD) virus by the movement of infected sheep before the first case of the disease was confirmed at an abattoir in Essex on February 20, 2001. A further 36 premises may have been infected by this route before the national livestock movement ban was imposed on February 23.     

Implementing a probabilistic definition of freedom from infection to facilitate trade of livestock: putting theory into praxis for the example of bovine herpes virus-1

International trade of livestock and livestock products poses a significant potential threat for spread of diseases, and importing countries therefore often require that imported animals and products are free from certain pathogens. However, absolute freedom from infection cannot be documented, since all test protocols are imperfect and can lead to false-negative results. It is possible instead to estimate the "probability of freedom from infection" and its opposite, the probability of infection despite having a negative test result. These probabilities can be estimated based on a pre-defined target prevalence, known surveillance efforts in the target population and known test characteristics of any pre-export test. Here, calculations are demonstrated using the example of bovine herpes virus-1 (BoHV-1). In a population that recently became free of BoHV-1 without using vaccination, the probability of being infected of an animal randomly selected for trade is 800 per 1 million and this probability is reduced to 64 (95% probability interval PI 6-161) per 1 million when this animal is tested negatively prior to export with a gB-ELISA. In a population that recently became free of BoHV-1 using vaccination, the probability of being infected of an animal randomly selected for trade is 200 per 1 million, and this probability can be reduced to 63 (95% PI 42-87) when this animal is tested negatively prior to export with a gE-ELISA. Similar estimations can be made on a herd level when assumptions are made about the herd size and the intensity of the surveillance efforts. Subsequently, the overall probability for an importing country of importing at least 1 infected animal can be assessed by taking into account the trade volume. Definition of the acceptable level of risk, including the probability of false-negative results to occur, is part of risk management. Internationally harmonized target prevalence levels for the declaration of freedom from infection from selected pathogens provide a significant contribution to the facilitation of international trade of livestock and livestock products by allowing exporting countries to design tailor-made output-based surveillance programs, while providing equivalent guarantees regarding the probability of freedom from infection of the population. Combining this with an approach to assess the overall probability of introducing at least 1 infected animal into an importing country during a defined time interval will help importing countries to achieve their desired level of acceptable risk and will help to assess the equivalence of animal health and food safety standards between trading partners.     

Descriptive epidemiology of the 2001 foot-and-mouth disease epidemic in Great Britain: the first five months.

In February 2001, foot-and-mouth disease (FMD) was confirmed in Great Britain. A major epidemic developed, which peaked around 50 cases a day in late March, declining to under 10 a day by May. By mid-July, 1849 cases had been detected. The main control measures employed were livestock movement restrictions and the rapid slaughter of infected and exposed livestock. The first detected case was in south-east England; infection was traced to a farm in north-east England to which all other cases were linked. The epidemic was large as a result of a combination of events, including a delay in the diagnosis of the index case, the movement of infected sheep to market before FMD was first diagnosed, and the time of year. Virus was introduced at a time when there were many sheep movements around the country and weather conditions supported survival of the virus. The consequence was multiple, effectively primary, introductions of FMD virus into major sheep-keeping areas. Subsequent local spread from these introductions accounted for the majority of cases. The largest local epidemics were in areas with dense sheep populations and livestock dealers who were active during the key period. Most affected farms kept both sheep and cattle. At the time of writing the epidemic was still ongoing; however, this paper provides a basis for scientific discussion of the first five months.     

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.     

Spatial distribution of foot-and-mouth disease in Pakistan estimated using imperfect data

We estimated the spatial distribution of foot-and-mouth disease (FMD) in Pakistan; we used a probability co-kriging model and the number of FMD outbreaks reported between 1996 and 2000 by Pakistan to the Office International des Epizooties. We used a k-Bessel model and small-ruminant and human densities as surrogate covariates for the population at risk and for livestock markets and movements, respectively. Compared to no or only one covariate, the co-kriging model with both densities provided the best fit to independently obtained data on the spatial distribution of virus isolations (P = 0.57). The estimated probability of an FMD outbreak per 25 km² cell ranged from 0.017 to 0.812, with the maximum relative probability of 47.8 (0.812/0.017). Areas with the highest relative probability of having an FMD outbreak were located in the Punjab region; this is a major animal-production area located along a traditional international animal-trade route.     

Use of epidemiologic risk modeling to evaluate control of foot-and-mouth disease in southern Thailand

OBJECTIVE: To assess the impacts of the introduction of foot-and-mouth disease (FMD) and various FMD control programs in southern Thailand. ANIMALS: A native population of 562,910 cattle and 33,088 buffalo as well as 89,294 animals legally transported into southern Thailand. PROCEDURES: A quantitative risk assessment was used to ascertain the probability of FMD introduction, and an intrinsic dynamic model was used to assess impacts. Value for the transmission rate (beta) was estimated. Five scenarios created to assess the impacts of nonstructural protein (NSP) testing, mass vaccination, and culling were examined. Impacts were assessed through an examination of the estimated annual cumulative incidence (ACI) of FMD. The ACIs of various scenarios were compared by use of the Tukey Studentized range technique. RESULTS: beta was estimated at 0.115. Approximately 35,000 cases of FMD would be expected from the baseline situation. A 30% reduction of ACI was detected with the introduction of NSP antibody testing. Prophylactic vaccination resulted in an 85% reduction of ACI. Concurrent use of NSP antibody testing and vaccination reduced the ACI by 96%, and the addition of an eradication policy resulted in a slightly greater decrease in the ACI (98%). CONCLUSIONS AND CLINICAL RELEVANCE: The study used epidemiologic models to investigate FMD control interventions. Results suggested that vaccination has more impact than the use of NSP testing. Use of the NSP test reduced ACI during peak seasons, whereas vaccination diminished the underlying incidence. The best mitigation plan was an integrated and strategic use of multiple control techniques.     

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.     

Foot and mouth disease in Tanzania: an overview of its national status

The presence of foot-and-mouth disease (FMD) in Tanzania is a major obstacle to the development of the national livestock industry because of its adverse effects on livestock production and on trade of animals and animal products into lucrative export markets. FMD is endemic in Tanzania, the affected area is extensive and lack of funding makes eradication unrealistic. Uncontrolled livestock movements, the presence of large populations of wildlife in regular contacts with livestock, and the general lack of enthusiasm for FMD control among the key stakeholders, are some of the factors favouring the persistence of FMD in Tanzania. This review examines the epidemiology, dynamics and socio-economic significance of FMD in the national herd. Various control options available in Tanzanian context are also explored.     

Experiences with the conversion of legal regulations in practice

An intensive preparation is necessary to make legal regulations work in practice. Examples are given how the registration procedure of a livestock enterprise is performed. Firstly, the owner has to declare the type of keeping system and the animal species. Secondly, he has to apply for a registration number which is related to the farm site and which is listed in the geographical information system (GIS). The particular procedures of licensing livestock operations and their facilities this according to the animal transport regulation (Viehverkehrsordnung) and the animal disease act (Binnenmarkt-Tierseuchenverordnung) are explained. The precise registration and licensing of facilities and operations is important for common market trade and the issuing of health certificates. Health certificates have to show name and address of facilities and operations and can give the registration number or license number. The control actions of the veterinary service are described when the arrival of an animal transport is announced and how to prevent the spread of infectious diseases in case of danger. Special regulations for the import of animals such as quarantine and laboratory tests are explained.     

Village level risk factors for foot-and-mouth disease in Northern Thailand

A study was undertaken in northern Thailand to identify factors which put some villages at higher risk of foot-and-mouth disease (FMD) outbreaks than others. The number of FMD outbreaks experienced in the previous 5 years and data on 145 putative risk factors were obtained by interview from 60 villages during 1991–1992. Univariable analyses identified 27 factors for further investigation using logistic regression. When villages were classified into three FMD frequency groups of zero to one, two to three or four or more outbreaks in the last 5 years, the important factors explaining the differences in risk were the total number of cattle and buffaloes purchased in the previous year, the number of neighbouring villages which shared a common water source and whether agriculture was the most important source of cash income for the village. These factors were also the most important variables in explaining the difference in risk when comparing villages with zero or one outbreak with those having four or more. We concluded that the greatest impact on reducing spread of FMD among villages would be obtained through the development of strategies to reduce the likelihood of introduction through livestock purchases and for villagers to take greater care when livestock are grazed with those from neighbouring villages and when sharing common water supplies.     

Estimating the risk of importation of foot-and-mouth disease into Europe

The opinions of a number of recognised world experts on foot-and-mouth disease (FMD) were sought in order to answer key questions relating to the importation of the disease into European countries from countries outside Europe. In addition, their opinions were sought on where in Europe a primary outbreak of FMD was most likely to occur and the number of outbreaks likely to occur within European countries in the next five years. The Balkans group of countries was considered to be the most likely group within Europe to have a primary outbreak of FMD and also most likely to have the highest number of primary outbreaks. Turkey was considered to be the country outside Europe which was most likely to be the source of an outbreak within Europe as a whole, and the illegal importation of livestock was considered to be the most likely route of introduction of FMD into Europe. Results specific to the Islands group of countries, which included the UK and Ireland, suggested that this group was likely to have a mean of one primary outbreak of FMD in the five years from September 2000, and that the importation of foodstuffs by people entering those countries from Turkey was the most likely source of an outbreak.