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FAO. 2021. Technical guidelines on rapid risk assessment for animal health threats. FAO Animal Production and Health Guidelines No. 24. Rome. https://doi.org/10.4060/cb3187en

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Contents

Acknowledgements

Acronyms and abbreviations

Summary

Introduction

Purpose and objectives of the guidelines

Target audience

The risk analysis process

Rapid risk assessment method

Step 1: Triage

Step 2: Establishment of the rapid risk assessment team

Step 3: Hazard profile

Step 4: Formulation of risk questions and sub-questions

Step 5: Data collection and literature review

Step 6: Expert opinion

Step 7: Performing the rapid risk assessment

Step 8: Rapid risk assessment report

Cross-cutting components of the rapid risk assessment process

Risk communication

Risk communication in emergency situations

Risk communication on enduring risks

References

Annexes

1. Participants in the technical expert meeting on the development of a rapid risk assessment method, FAO Headquarters, July 2018

2. Terminology

3. Examples of triage criteria and their use

4. Example of the contents of a hazard profile

5. Example of the formulation of rapid risk assessment objectives and risk questions and sub-questions

6. Expert knowledge elicitation

7. Report template for a rapid risk assessment of a health threat event

8. Example of a scenario tree

Acknowledgements

These FAO technical guidelines on rapid risk assessment were prepared by Paolo Calistri from the FAO Reference Centre for Veterinary Epidemiology at the Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise (IZSAM Teramo, Italy) and FAO experts: Fairouz Larfaoui, Julio Pinto and Cristina Rojo Gimeno.

The preparation of these guidelines was technically coordinated by Julio Pinto, Animal Health Officer, Lead Technical Officer of Project “Strengthening Global Veterinary Epidemiology Capabilities and Rapid Regional Disease Surveillance Information and Sharing” (FAO project symbol GCP/GLO/892/USA).

Special acknowledgements to Paolo Motta (EuFMD) for his technical contribution, Claudia Pittiglio for her inputs to the first version of the draft and the reviewers of the guidelines, Daniel Beltrán Alcrudo (FAO REU) and Ludovic Plee (FAO EMC-AH).

Special thanks to the experts who attended the Technical Expert Meeting on the Development of a Rapid Risk Assessment Method held at FAO Headquarters in July 2018 for their valuable contribution to the first draft of these guidelines.

Special thanks also to the Defence Threat Reduction Agency (DTRA) for its financial support for the development of the guidelines through project Global Early Warning System for Animal Diseases including Zoonosis (GLEWS) GCP/GLO/581/USA.

Acronyms and abbreviations

ASF African swine fever

ASFV African swine fever virus

EKE expert knowledge elicitation

FAO Food and Agriculture Organization of the United Nations

OIE World Organisation for Animal Health

ProMED Program for Monitoring Emerging Diseases

RRA rapid risk assessment

RVF Rift Valley fever

WHO World Health Organization

Summary

When an imminent threat or emergency arises from an animal health event, it is important to conduct a rapid risk assessment (RRA) that informs animal health decision-makers of the most efficient control measures that they can take to control the disease concerned. These technical guidelines on rapid risk assessment provide a simple and practical tool that assists decision-makers in veterinary departments in conducting qualitative RRAs on the emergence, incursion and/or spread of animal health events caused by infectious diseases. Depending on the information, capacities and human resources available, a small, multidisciplinary team can carry out an RRA in two weeks. The simple and flexible methodology for conducting an RRA when facing a disease event proposed in these guidelines covers the full risk assessment process, from the moment when a disease event is suspected or identified through the routine disease intelligence activities, to the assessment of risks and the preparation of a risk assessment report that communicates the results.

The RRA methodology detailed in this document consists of eight steps that are illustrated with examples. In step 1, the disease event is assessed through a triage process based on specific criteria that indicate whether the event should trigger an RRA. Step 2 involves the establishment of a multidisciplinary RRA team. In step 3, the hazard profile of the threat is updated, or a new profile is prepared. Step 4 consists of formulation of the risk questions to be answered by the RRA, and in step 5, the data required to address these questions are collected. If insufficient data are available, an expert opinion is sought in step 6, and once all the necessary information is available, the RRA team will perform the qualitative RRA as step 7. In step 8, the RRA team prepares a short and concise report on the RRA to communicate the risk levels and potential mitigation measures to the risk managers. The outcome of the RRA will provide evidence on the level of risk, which will guide decision-makers and risk managers in responding through the implementation of timely prevention, control and eradication measures that contribute to sustainable livelihoods, animal health, public health and enhanced food security.

Introduction

High-impact animal diseases including zoonoses pose a threat to animal production, food chains and human and animal well-being through their detrimental effects on food security, food safety, animal health and welfare, human health, livelihoods, national economies and global markets, with poor and vulnerable communities facing the greatest threats. The occurrence of high-impact animal diseases disrupts production, livelihoods and access to trade in international and regional markets for livestock and livestock commodities, posing a constant threat to the livelihoods of livestock farmers.

Risk assessment is crucial in providing early warning of animal disease outbreaks and enabling national authorities to inform farmers and other populations at risk of measures for the prevention and control of threats, and to prepare and develop mitigation strategies that minimize the risk of the introduction and spread of animal health threats. An accurate rapid risk assessment (RRA) is crucial for decision-makers involved in the identification and selection of appropriate management (prevention or control) activities.

In many developing countries, the capacities of veterinary service personnel to conduct risk assessments in a timely and systematic manner are limited or lacking. Historically, the risks associated with animal health threats have been assessed according to immediate needs, on an ad hoc and informal basis without a systematic and standard approach. The RRA approach described in these guidelines can also help to establish baselines and support preparedness for the threats arising from animal health events by providing the data and information required to conduct RRAs rapidly.

In an emergency situation, when a rapid and effective response is needed, the limited time available is insufficient to allow a quantitative risk assessment and collection of all the necessary data. The time required for a risk assessment varies according to the issues to be explored, the methodologies chosen, the difficulties associated with data collection and the human resources available during an emergency response. Emergency situations caused by an animal health event call for a rapid assessment of the risk arising from the event in order to inform fast decision-making. A rapid risk assessment results in a qualitative assessment of the risk and can be produced quickly. The results of an RRA inform national veterinary services and the international community of the emergence or spread of a transboundary animal disease or zoonosis and the issues that require attention at the animal–human–ecosystem interface.

Several international and national institutions and agencies routinely perform RRAs, but few technical guidelines and protocols on how to conduct RRAs are currently available at the national level. In addition, RRA procedures are often tailored to the scope and structure of the organization concerned. Through its animal health programmes, the Food and Agriculture Organization of the United Nations (FAO) has vast experience of performing risk assessment in collaboration with the World Organisation for Animal Health (OIE) and the World Health Organization (WHO). FAO programmes support members in addressing priority diseases and severe outbreaks of, for example, African swine fever, foot-and-mouth disease, Rift Valley fever, Ebola virus disease and highly pathogenic avian influenza. These risk assessment guidelines build on FAO’s experience of conducting risk assessments to alert member nations and provide them with early warning information.

The increased need for RRAs calls for the development of methods, standard procedures and a consistent, structured, harmonized and timely approach that allows RRAs to be conducted rapidly with the available data.

In collaboration with its partners, FAO has developed a harmonized approach and methodology that support early warning, risk-based surveillance and decision-making for effective and timely response to animal disease outbreaks and selection of the most appropriate disease control and mitigation strategies.

Development of this flexible approach to RRA was made possible through support from a group of experts convened to advise and guide FAO on preparing the guidelines at a technical expert meeting held at FAO Headquarters in July 2018. Experts from WHO, European Union organizations (the European Centre for Disease Prevention and Control and the European Food Safety Authority), universities (North Carolina State University in the United States of America and Wageningen University in the Netherlands), national institutions (the Canadian Food Inspection Agency, the Department for the Environment, Food and Rural Affairs in the United Kingdom of Great Britain and Northern Ireland, the Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise in Italy and the Eastern Africa Regional Epidemiology Network) and FAO. See Annex 1 for a full list of participants.

Purpose and objectives of the guidelines

The purpose of these guidelines is to provide a simple methodological step-by-step approach to the development and conduct of an RRA by animal health authorities at the national and regional levels.

The overall objective is to provide a tool for qualitative RRA of the emergence, introduction or spread of priority transboundary animal and zoonotic disease events. Other more complex quantitative approaches that support disease management are available elsewhere, but these are not feasible or practical for an initial RRA conducted in an emergency situation or under an imminent threat.

The guidelines are for use in RRAs of the emergence, incursion or spread of disease in domestic animals and wildlife, including at the interface between animal and human populations. While the steps in the methodology can be followed to assess the medium- and long-term risks that already exist in a country or zone, other guidelines and resources for such a purpose are available elsewhere, such as the Progressive Control Pathway for Foot-and-Mouth Disease. If these guidelines are followed for purposes other than assessment of the emergence, incursion or spread of disease, such as for the eradication of a disease or the monitoring of endemic diseases, the timeframe for conducting the tailored risk assessment will need to be modified.

The outcome of the RRA will provide evidence for decision-making regarding the design of timely prevention, control and eradication measures that contribute to sustainable livelihoods, public health and enhanced food security.

TARGET AUDIENCE

The primary aim of these guidelines is to support development of the capacity of animal health personnel in veterinary services and other professionals in the wildlife, environmental and public health sectors so that they can conduct RRAs during the outbreak and/or the spread of animal health threats.

The intended users of these guidelines are assessors of risks associated with animal health; providers of animal health services in the private and non-governmental sectors; and educational institutions, to provide support for training activities, curriculum development and the design of programmes for the transfer of knowledge on RRA within and among countries.

THE RISK ANALYSIS PROCESS

Risk analysis is an iterative process that comprises four distinct interrelated components: hazard identification, risk assessment, risk management and risk communication.

The risk assessment component of risk analysis is the main focus of these RRA guidelines (Figure 1). Risk assessment is the systematic process of assessing or evaluating the magnitude of the risk of an unwanted outcome resulting from a hazard. In risk analysis, risk is defined as being composed of two contributing components: i) the likelihood (probability) of the hazard causing the unwanted outcome; and ii) a measure of the impact (consequences) of the unwanted outcome (FAO, 2011).

Risk assessments can be quantitative or qualitative. In quantitative risk assessments, likelihood, impact and uncertainty are expressed as numeric values. Such assessments usually involve the development of mathematical models, which can be deterministic when both the inputs and the outputs are expressed as single numbers or point values, or probabilistic when variables are described as probability distributions (OIE, 2004). In qualitative risk assessments, likelihood, impact and uncertainty are expressed using descriptive categories and scales. The likelihood of the unwanted outcome and the magnitude of the consequences are expressed in qualitative terms such as high, moderate, low or negligible (OIE, 2010). Qualitative risk assessments usually require less time to complete than quantitative ones, and are therefore particularly useful in emergency situations. A qualitative risk assessment methodology is presented in these guidelines. A semi-quantitative risk assessment approach can also be followed by assigning numbers (scores) to qualitative estimates in the form of probability ranges, weights or scores, and combining them by addition, multiplication or other mathematical operations to define the final risk estimate (OIE, 2010).

The terminology used in these guidelines is explained in Annex 2.

Rapid risk assessment method

The time required to conduct a risk assessment can range from days to weeks, months to one year depending on the methodologies chosen and the challenges faced in gathering data and information. In emergency situations, it is important that risks are assessed quickly in order to inform the identification and selection of appropriate management measures (prevention or control), because there is often insufficient time available for a full risk assessment exercise. Ideally, an RRA will take less than two weeks to complete.

RRA will support and inform the decision-making process, including:

• the risks that have been identified and their relevance to the scope of the assessment;

• the methods used;

• the applicability and limitations of the assessment.

The following steps in the RRA process are depicted in Figure 2.

Step 1: Triage. A mechanism that uses an algorithm based on specific criteria to indicate whether or not a health event requires an RRA. The criteria considered during triage include potential impacts on animal production and human health, and the risk of emergence of a new pathogen that affects an animal species or of a pathogen jumping to a different animal species. This step can take one day.

Step 2: Establishment of an RRA team. Constitution of a multidisciplinary team to conduct the RRA. The team should be established the day after the triage algorithm has triggered an RRA.

Step 3: Hazard profile. A concise description of the health event, its context, the current state of knowledge of the problem, and potential risk management options. Preparation or updating of the hazard profile of the hazards involved in the health event can take up to two days.

Step 4: Formulation of risk questions and sub-questions. Definition of the specific questions to be answered during the RRA. This step can take between one and three days.

Step 5: Data collection and literature review. Collection and review of relevant information from various sources. This step can take up to two days.

Step 6: Expert opinion (if required). The process of obtaining opinions and judgements from a group of experts.

Step 7: Performing the RRA. The process of assessing the risks in accordance with the risk questions. This step can take up to three days.

Step 8: Reporting on the RRA and its results. Preparation, presentation and dissemination of a report on the results of the RRA. This step can take up to two days.

In addition, the following cross-cutting activities must be performed before and/or during the RRA process.

Disease intelligence. The systematic collection, analysis and communication of data and information for detecting, verifying, assessing and investigating events and levels of risks in order to provide early warning or inform the design and implementation of a response. Disease intelligence activities are conducted at all the steps in the RRA process.

Identification of risk pathways. Presentation of a graphical representation of the logical pathways by which a hazard might be introduced into a new area or might spread.

Uncertainty assessment. The process of identifying and characterizing areas of uncertainty related to input data and variables collected during the risk assessment process, and those that affect the structure of the risk assessment.

RRA is an iterative process. For example, when new data or information become available, the outputs of the steps in the RRA can be reviewed and revised. Periodic reviews of the RRA are also needed when the epidemiological situation changes or new mitigation measures that affect the level of risk are applied.

The following subsections detail the step-by-step approach and the cross-cutting activities.

STEP 1: TRIAGE

A standardized approach should be used to determine the need for an RRA. Such standardization can be achieved through the use of a triage algorithm based on specific criteria, as shown in Table 1. A score is assigned to each yes/no answer, with Yes scoring 1 and No 0. In cases of doubt about the answer or when information is lacking, an additional score for “unknown” can be assigned. A threshold value for triggering a risk assessment has to be set, and the sum of all the scores obtained will be compared with that threshold. Triage can be conducted by the team responsible for the risk assessment and/or for disease intelligence activities.

Based on the information available, the triage process focuses on:

1. the credibility of the data sources used, with possible verification in the field before treating the signal as a health event;

2. the severity of the disease and its consequences;

3. the relevance of the health event to animal and human health, farmers’ livelihoods, the economy and food security.

The results of the triage determine the subsequent steps of the risk assessment process, which can be as follows:

a. No need for further action: the threshold value has not been reached.

b. Need to gather more detailed or additional information: too many of the answers related to the triage criteria are “unknown”.

c. Need for an RRA: the threshold score has been reached and the urgency of the case is considered to require an RRA.

Examples of use of the triage algorithm are provided in Annex 3.

The threshold value beyond which the triage score triggers an RRA varies depending on the capacity of the veterinary services to perform an RRA. For instance, if the veterinary services have the mandate and several staff members have the capacity and are available to perform an RRA, a lower threshold value will be set than when the veterinary services have few officers with the capacity and availability to conduct a RRA.

STEP 2: ESTA BLISHMENT OF THE RAPID RISK ASSESSMENT TEAM

When the score obtained from the triage algorithm reaches the threshold value that triggers an RRA, a team needs to be established to conduct the RRA. Depending on the organizational structure and division of functions in the animal health authority dealing with the disease event, the team can be established by the epidemiology unit of the animal health department responsible for gathering and managing disease intelligence, or the emergency operations centre. This step should take no more than one day.

The RRA assessment team should be multidisciplinary and, depending on circumstances and the capacities available, can include experts in risk assessment or analysis, disease epidemiology or ecology, animal health, value chains, entomology (if the disease is vector-borne or transmitted by vectors), animal health economics, public health, wildlife, and ecology and the environment. Each member of the team can assume more than one role; for instance, an expert in risk assessment may also be an expert in public health. The team should appoint a leader to lead the RRA process, coordinate with experts and consolidate feedback.

The team will also need a spokesperson tasked with managing communications with internal stakeholders and reporting to external institutions or other bodies when needed.

STEP 3: HAZARD PROFILE

Once the team has been established, its first step is to compile and/or update a hazard profile of the threat that is causing the health event. A hazard profile is a description of a health event and its context, the current state of knowledge of the problem and potential risk management options. It includes a comprehensive description of the pathogen (for example, virus, bacteria, parasite, protozoa, fungus, biological toxin, prion), information on the health event, and a description of each hazard (including the transmission and distribution of the pathogen), control measures and the impact of the disease. Compilation of a hazard profile must not be confused with a systematic literature review. The hazard profile applies to the specific context in which the risk assessment will be conducted; draws on data that are related only to the health event concerned; and provides basic information for conducting the RRA. It is therefore useful to prepare general hazard profiles of known pathogens that can be adapted and updated when a health event occurs, thereby speeding up step 3 in the RRA process by facilitating the formulation of risk questions.

The RRA team will gather the information required from available data sources or from expert opinion when limited data are available, such as when the disease involves a new emergent pathogen. It is recommended that the RRA team take a maximum of two days to finalize the hazard profile.

A detailed list of the aspects to be taken into consideration in formulating a hazard profile is provided in Annex 4.

STEP 4: FORMULATION OF RISK QUESTIONS AND SUB-QUESTIONS

The RRA team should formulate the risk questions during the development of the RRA objectives. Depending on the structure and functions of the national animal health department, risk managers in the department may provide the objectives of the RRA, in which case the RRA team will need to prepare risk questions that address those objectives.

The number of risk questions will depend on the objectives of the risk assessment. Each risk question includes a statement on what is to be evaluated and is clearly linked to the objectives of the assessment. Risk questions must therefore be unambiguous and detailed enough to cover all relevant risk factors and each question should be split into a number of detailed and specific sub-questions. It is recommended that risk questions start with “what is the probability of…” or “what are the consequences (or impact) of…” or similar wording. The sub-questions must be very precise and should cover the four main dimensions of risk: i) what – the hazard and event concerned and the effects of the hazard; ii) where – the population and location affected; iii) when – the timeframe of emergence; and iv) how – the possible pathways that the hazard may follow.

As mentioned earlier in this section, risk managers can guide the development of specific risk questions by clearly stating the objectives of the RRA. For example, when one of the objectives of the assessment is to evaluate the possibility of the incursion or spread of a certain infection or pathogen from an infected region into a particular non-infected region, all the relevant characteristics of the infection or pathogen, and the extent of the geographic area under evaluation, must be considered, and the species, subspecies, subtypes and strains of the pathogen must be clearly defined, if necessary. The hosts and/or vector species, spatial area and timeframe covered by the assessment must be defined, including potential pathways of transmission. In general, the more detailed the risk question, the easier it is to identify the data and information required. Examples of ambiguous and correctly worded risk questions and sub-questions are shown in Table 2.

Once the risk questions and sub-questions have been correctly formulated, the available data, evidence and possible sources of information for each question and sub-question must be listed. It is also useful to identify and list the possible approaches to data analysis and the related methods to be used during the risk assessment. In addition, it is during step 4 that the RRA team must decide whether to follow a qualitative or quantitative risk assessment approach (these technical guidelines focus on qualitative risk assessment) and how to address and communicate uncertainties and gaps in existing data and knowledge. The results of this preliminary evaluation will assist in the identification of the data, timeframe, human resources, skills and expertise required for the risk assessment. For example, the RRA team may decide that an expert with a different skillset from those that are already available is required. It is useful to include the limitations of the selected risk assessment approach in the list of uncertainties.

A template for reporting all of the information required for step 4 in a systematic and standardized way, with an example, is presented in Annex 5.

The risk questions and sub-questions formulated must be closely related to the outcomes of the analysis of risk pathways, which is a cross-cutting component of RRA with interconnections to the formulation of risk questions (see Figure 2).

STEP 5: DATA COLLECTION AND LITERATURE REVIEW

During step 5, after identifying the risk questions and data needs, the RRA team rapidly collects the data and evidence needed for the assessment. Data collection and analysis for supporting risk assessment are costly and resource-intensive and uncertainties related to the data often represent one of the main constraints to the timely production of robust RRAs. The data requirements must be clearly defined in detail in order to guide data research and retrieval activities effectively. The literature review and retrieval of data from national and international databases should cover only the information that is essential for performing the RRA in accordance with the nodes of the identified risk pathways (see the section on Risk pathways on page 15) and the formulated questions and sub-questions.

To facilitate the search for data, eligibility criteria should be defined that take into consideration the animal population(s) of interest, the variable of concern, possible geographical and time restrictions and any other specific conditions related to the variable of interest. These criteria will be used to calculate an uncertainty estimate for each step in the risk pathway.

Eligibility criteria include the design and conditions under which the data have been obtained, the time periods when the data were collected or of the most recent experimental reports, whether the data are consistent throughout several studies and, when available, any measure of uncertainty affecting the values.

When data for some crucial input variables are not available, estimates of likely values can be requested from experts through expert opinion exercises and proxy data can be used when primary data are unavailable.

STEP 6: EXPERT OPINION

If there are gaps in the required information and data, expert opinion is essential for providing the necessary inputs and validating the inputs and data for use in risk assessments. Opinions can be obtained via an online questionnaire, from an expert panel or through focus group discussions and interviews using qualitative techniques. When sufficient time is available, expert knowledge elicitation can be carried out using the systematic methodologies described in Annex 6.

STEP 7: PERFORMING THE RAPID RISK ASSESSMENT

Once the risk question(s) are prepared and information for assessing the risks is available, the RRA team performs the RRA. This step can take up to three days. The types of output produced may vary considerably depending on the specific purposes of the RRA. For example, when the main objectives of the assessment are to estimate the probability of a pathogen introduction into pathogen-free countries or zones (entry assessment), or the probability of infection of specific animal or human populations (exposure assessment), the analysis can provide only levels of probability, while assessments that consider the effects of the infection or spread (consequence assessment), both components of the risks – the probability and the consequence – must be taken into account, assessed and jointly evaluated.

Probability estimation – entry and exposure assessment

For each sub-question, the level of probability of the unwanted outcome occurring has to be estimated from a set of probability categories. In entry and exposure assessments, the probability levels reported in Table 3 can be used. Table 3 should be considered only as a general reference to be adapted to each case taking into consideration the implicit and explicit assumptions behind each decision.

Most RRAs can be performed using a qualitative approach, which is easier for decision-makers to understand, particularly because outputs are expressed in terms of risk levels.

Consequence assessment

When the magnitude of the consequences of the occurrence of a certain health event are to be considered, it should be assessed separately from the probability estimation. A health event may have a high probability of occurring, but only minor consequences (such as an endemic disease under a control programme) and vice-versa.

As in probability estimation and uncertainty assessment, consequence levels for use in the assessment must be predefined as in Table 4.

Risk estimation

A simple way to combine probability and consequence levels is to use a simple risk matrix with pre-fixed risk levels (Table 5).

Risk matrices can be very useful for combining results into a single risk estimate, but this methodology must be used carefully. Estimation of the final level of risk should include consideration of the type of health event concerned. For events of particular social or public concern, even in the case of minor or moderate consequences and low probability of occurrence, the final risk can be unacceptable for risk managers and require urgent control or prevention actions.

In addition, the selection on how to derive the final risk values from the probability and consequence levels implies judgement regarding the shape of the distribution in the final risk estimate. For example, in Table 5 the risk levels are symmetric, giving the same weight and importance to the various levels. In other words, the choice of a certain type of risk matrix may imply some judgements regarding the acceptable level of risk, which is ultimately the task of risk managers.

The use of risk matrices presents advantages and disadvantages. Advantages include providing a simple visual way to represent risk as a combination of probability and consequences, enabling many stakeholders to participate in the customization of category definitions, and not requiring special expertise in quantitative risk assessment methods or data analysis. However, there are also limitations such as poor resolution resulting from the ability of risk matrices to compare only a small proportion of hazards, and likelihood of error resulting from the assignment of high qualitative ratings to risks that are quantitatively small, suboptimal resource allocation and a cumbersome procedure for the categorization of uncertain consequences (Cox, 2008).

It is essential that the description of risk combines both the probability and the consequences of the risk concerned. Visually displaying both components can be very useful for comparison of risk estimates related to various health events. Figure 3 illustrates a probability–consequence diagram for health events A, B, C and D. In order to allow comparisons among various health events, the probability and consequence levels must be defined in the same way for all the health events being assessed.

STEP 8: RAPID RISK ASSESSMENT REPORT

Once the risks have been assessed, an RRA report has to be prepared. This step can take a few days. As a general recommendation, a draft of the RRA report should be tailored to the audience to which it is directed. When the main target audience is risk managers, the report must be simple, short and succinct, avoiding technical terminology and focusing on the possible implications of the results of the assessment.

In general, an RRA report can include:

Body of the report:

• date and version of the report;

• disease, country and region;

• objective of the RRA;

• version of the assessment;

• risk questions;

• summary description of the event, with its index number if it is linked to a management information system and situation analysis, and description of the hazard profile;

• clear summary with a concise description of the main conclusions from each risk question;

• overall risk assessment statement and uncertainty level;

• summary of the data or evidence supporting the assessment;

• recommendations including science-based actions to be taken to mitigate the risk, based on the socio-economic and epidemiological context.

Annexes:

• the risk questions and sub-questions that have been addressed;

• background to the event;

• scenario tree depicting risk pathways;

• in-depth description of RRA outcomes, with a clear interpretation of possible implications for the selection of appropriate control and prevention measures;

• method(s) used for the assessment;

• list of all possible sources of uncertainty related to the input data and information and the methodology used for the assessment;

• the sources and references of the data used;

• names and designations of risk assessment team members.

An example of a template for an RRA report is provided in Annex 7.

CROSS-CUTTING COMPONENTS OF THE RAPID RISK ASSESSMENT PROCESS Disease intelligence

Disease intelligence activities consist of continuous monitoring, screening, situation analysis and assessment of emerging and re-emerging threats in order to detect changes in frequency, geographical distribution, transmission patterns, host ranges, virulence and other relevant epidemiological aspects of health events. They require a team or group of people dedicated to the continuous gathering, verification, analysis, assessment and sharing of data and information. Disease intelligence information is gathered from various data sources. Data sources include official and unofficial sources that can be monitored through various approaches and methodologies, including traditional event-based surveillance in the field and the use of innovative web-based tools.

Risk pathways

A crucial step in conducting any risk assessment is the identification and analysis of risk pathways through which a hazard may be introduced and/or spread in a population. This step is interconnected to the formulation of risk questions and the collection of data.

A risk pathway includes all the logical sequences by which a certain animal or human population can be exposed to an infection, or a certain hazard can be transmitted within animal or human populations. It depicts the main mechanisms through which a hazard can, for example, be introduced into or spread throughout a new area. The use of scenario trees is an effective way of depicting risk pathways and:

• identifying data requirements;

• describing a logical chain of events in space and time;

• assisting in the identification of potential risk management measures;

• assisting in estimation of the likelihood of occurrence and subsequent consequences.

By convention, in a scenario tree, boxes or nodes are used to describe the sequence of events, while the probability of each event occurring is defined by an arrow linking the respective boxes or nodes (OIE, 2010).

The probability of transiting from one node to the next is the main objective of step 5 of these guidelines, on data collection. When data are not available, an expert can be asked to estimate these probability values, as described in step 6 in these guidelines, on expert opinion. The correct identification of risk pathways is one of the most crucial components of a risk assessment and must be carefully conducted and revised.

The risk assessors must consider the probability of each event occurring when the event in the previous step of the chain has occurred. For qualitative or semi-quantitative assessments, various approaches may be followed to combine probability ranges or categories.

An example of a scenario tree is shown in Annex 8.

Uncertainty assessment

Assessment of the sources of uncertainty regarding the input data and methods used and their possible effects on the outcomes of the risk assessment is a crucial step in providing a reliable estimation of the level of risks and the associated uncertainty. Uncertainty assessment should not be addressed only at the end of the RRA, but should be considered as soon as the risk questions are formulated and be monitored throughout the RRA process.

In risk assessments, uncertainty should be clearly documented, with all the sources of uncertainty (including the assumptions made and the methods used for the RRA) described and assigned a qualitative level of uncertainty. Table 6 shows an example of low, moderate and high levels of uncertainty.

For instance, the risk of H7N9 avian influenza spreading from affected areas of China to other areas of China between January and May 2018 through formal or informal trade of eggs could be considered negligible with low uncertainty because the available data were known facts: there was no large-scale trade in eggs for breeding in China during that period, and breeder and layer poultry were vaccinated against H7 in September 2017 (FAO, 2019).

Assumptions must always be listed, clearly reported, and considered as potential sources of uncertainty and treated as such. Assumptions establish the conditions that limit the range of applicability of the assessment results. Generally, assumptions are made and used for the sake of simplicity or they derive from the statistical methods used. For example, in risk assessment models, one assumption is that the animals in a specific population (or sub-population such as those sharing living premises, a region, a pasture, etc.) are considered perfectly representative of that population and are randomly mixed within it. This implies, for example, that all the animals in the same (sub-)population have the same probability of being infected by a certain pathogen or of coming into contact with an infected animal within the (sub-)population. Although this proposition is not biologically sound, it is assumed in order to simplify the calculations and allow probabilistic sampling principles to be applied in the assessment.

When an expert opinion is used and experts are uncertain about the probability level that matches the question, they could express their uncertainty regarding the estimates by providing a range of qualitative probability levels rather than a single level.

The causes of uncertainty, effects of uncertainty on the overall system, and associated assumptions at all phases of the RRA process should be explicitly stated in the report. A rationale for the range of uncertainty indicated should also be provided, listing all the sources of uncertainty sources identified. If time permits, feedback on results can be sought with a view to reaching agreement among experts in order to narrow down the overall uncertainty range.

Risk communication

During the RRA process, the communication of risk always needs to be considered. Interactive and transparent communication of risk should ideally start from the beginning of the RRA process and continue throughout and after implementation (OIE, 2019b; FAO, 2011).

A risk communication process should take into consideration the target audience, stakeholders, perceptions of risk and communication channels.

An important factor to take into account in risk communication is the perception of risk – how key stakeholders perceive the risk. The message and language used in messages and reports on the RRA should be adapted to the risk perception (FAO and WHO, 2016). Risk perception can be influenced by many different factors, as illustrated in Table 7.

RISK COMMUNICATION IN EMERGENCY SITUATIONS

The underlying principles of successful risk communication such as trust, transparency, early announcement, listening and planning (WHO, 2008) should be applied in an emergency situation. Communication is important in building, maintaining or restoring trust between the public and risk managers. Early announcement of health risks is important in preventing the spread of rumours and misinformation. Transparency is required to maintain the public´s trust throughout an outbreak. Listening is crucial to understanding the public´s risk perceptions, views and concerns and facilitates effective communication. Planning is required to ensure effective communication.

An important distinction to be taken into account is whether the RRA communication is about an emerging risk or an imminent crisis. When an emerging risk occurs, messages are often direct, frequent and urgent. An emerging risk requires a rapid and effective response, and there may not be enough time for full consultations with all target audiences and key stakeholders for informing the development of messages. There may be incomplete information about the extent and impact of the risk or who is affected; this will need to be addressed in the communication. Coordination of communications among principal stakeholders is also important in order to avoid contradictory messages and public confusion.

RISK COMMUNICATION ON ENDURING RISKS

Enduring risks which last for prolonged periods often require sustained communications. In addition, more detailed information about the risks may be available. For example, communication might focus on stakeholders’ roles in good biosecurity practices following an outbreak. In these cases, messages are often developed, refined and distributed over time (for example, when warning farmers not to give food waste to animals, or to respect biosecurity), or at specific periods of high risk, such as during the summer for vector-borne diseases.

References

CAC. 2007. Principles and guidelines for the conduct of microbiological risk management (MRM). CAC/GL 63-2007. Codex Alimentarius Commission (CAC). (also available at http://www.fao.org/input/download/standards/10741/CXG_063e.pdf).

CAC. 2014. Principles and guidelines for the conduct of microbiological risk assessment. CAC/GL30-1999. (also available at http://www.fao.org/fao-who-codexalimentarius/sh-proxy/en/?lnk=1&url=https%253A%252F%252Fworkspace.fao.org%252Fsites%252Fcodex%252FStandards%252FCXG%2B30-1999%252FCXG_030e_2014.pdf).

Cox, L.A.T. 2008. What’s wrong with risk matrices? Risk Analysis, 23(2): 497–512.

ECDC. 2011. Operational guidance on rapid risk assessment methodology. Stockholm, European Centre for Disease Prevention and Control (ECDC). (also available at https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/1108_TED_Risk_Assessment_Methodology_Guidance.pdf).

EFSA. 2014. Guidance on Expert Knowledge Elicitation in Food and Feed Safety Risk Assessment. Parma, Italy, European Food Safety Authority (EFSA). EFSA Journal, 12(6): e3734. doi:10.2903/j.efsa.2014.3734. (also available at https://efsa.onlinelibrary.wiley.com/doi/epdf/10.2903/j.efsa.2014.3734).

EFSA. 2017. When food is cooking up a storm – proven recipes for risk communications. (also available at https://www.efsa.europa.eu/sites/default/files/corporate_publications/files/riskcommguidelines170524.pdf).

EFSA Scientific Committee, Benford, D., Halldorsson, T., Jeger, M.J., Knutsen, H.K., More, S., Naegeli, H., Noteborn, H., Ockleford, C., Ricci, A., Rychen, G., Schlatter, J.R., Silano, V., Solecki, R., Turck, D., Younes, M., Craig, P., Hart, A., Von Goetz, N., Koutsoumanis, K., Mortensen, A., Ossendorp, B., Martino, L., Merten, C., Mosbach-Schulz, O. & Hardy, A. 2018. Guidance on Uncertainty Analysis in Scientific Assessments. EFSA Journal, 16(1): e5123. (also available at https://doi.org/10.2903/j.efsa.2018.5123).

FAO. 2011. A value chain approach to animal diseases risk management – Technical foundations and practical framework for field application. Animal Production and Health Guidelines No. 4. Rome. (also available at http://www.fao.org/3/a-i2198e.pdf).

FAO. 2012. Good Emergency Management Practices: The Essentials – a guide to preparing for animal health emergencies. Animal Production and Health Manual No. 11. Rome. (also available at http://www.fao.org/publications/card/en/c/68b14f27-5234-51f3-b46e-8ecea0029d9b).

FAO. 2019. Chinese-origin H7N9 avian influenza spread in poultry and human exposure Qualitative risk assessment update. FAO Animal Health Risk Analysis Assessment No. 8 (February 2019). Rome. (also available at http://www.fao.org/3/CA3206EN/ca3206en.pdf).

FAO & WHO. 2016. Risk communication applied to food safety. Handbook. Food Safety and Quality Series No. 2. Rome and Geneva. (also available at http://www.fao.org/3/a-i5863e.pdf).

OIE. 2004. Handbook on Import Risk Analysis for Animals and Animal Products. Volume 2. Quantitative risk assessment. 119 pp. Paris. (also available at https://www.oie.int/doc/ged/D11250.PDF).

OIE. 2010. Handbook on Import Risk Analysis for Animals and Animal Products. Volume 1. Introduction and qualitative risk analysis, 2nd edition. 85 pp. Paris.

OIE. 2019a. Manual of Diagnostic Tests and Vaccines for Terrestrial Animals 2019. Paris. (also available at http://www.oie.int/standard-setting/terrestrial-manual/access-online/).

OIE. 2019b. Terrestrial Animal Health Code. Volume I. General provisions. Paris. (also available at http://www.oie.int/standard-setting/terrestrial-code/access-online/).

WHO. 2008. World Health Organization Outbreak Communication Planning Guide. 19 pp. Geneva. (also available at https://www.who.int/ihr/elibrary/WHOOutbreakCommsPlanngGuide.pdf?ua=1).

WHO. 2012. Rapid Risk Assessment of Acute Public Health Events. 39 pp. Geneva. (also available at http://whqlibdoc.who.int/hq/2012/WHO_HSE_GAR_ARO_2012.1_eng.pdf?ua=1).

Annex 1

Participants in the technical expert meeting on the development of a rapid risk assessment method, (FAO Headquarters, July 2018)

Annex 2

Terminology

REFERENCES

CAC. 2007. Principles and guidelines for the conduct of microbiological risk management (MRM). CAC/GL 63-2007. Codex Alimentarius Commission (CAC). (also available at http://www.fao.org/input/download/standards/10741/CXG_063e.pdf).

ECDC. 2011. Operational guidance on rapid risk assessment methodology. Stockholm, European Centre for Disease Prevention and Control (ECDC). (also available at https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/1108_TED_Risk_Assessment_Methodology_Guidance.pdf).

EFSA Scientific Committee, Benford, D., Halldorsson, T., Jeger, M.J., Knutsen, H.K., More, S., Naegeli, H., Noteborn, H., Ockleford, C., Ricci, A., Rychen, G., Schlatter, J.R., Silano, V., Solecki, R., Turck, D., Younes, M., Craig, P., Hart, A., Von Goetz, N., Koutsoumanis, K., Mortensen, A., Ossendorp, B., Martino, L., Merten, C., Mosbach-Schulz, O. & Hardy, A. 2018. Guidance on Uncertainty Analysis in Scientific Assessments. EFSA Journal, 16(1): e5123. (also available at https://doi.org/10.2903/j.efsa.2018.5123).

FAO. 2011. A value chain approach to animal diseases risk management – Technical foundations and practical framework for field application. Animal Production and Health Guidelines No. 4. Rome. (also available at http://www.fao.org/3/a-i2198e.pdf).

FAO & WHO. 2016. Risk communication applied to food safety. Handbook. Food Safety and Quality Series No. 2. Rome and Geneva. (also available at http://www.fao.org/3/a-i5863e.pdf).

OIE. 2010. Handbook on Import Risk Analysis for Animals and Animal Products. Volume 1. Introduction and qualitative risk analysis, 2nd edition. 85 pp. Paris.

OIE. 2019a. Manual of Diagnostic Tests and Vaccines for Terrestrial Animals 2019. Paris. (also available at http://www.oie.int/standard-setting/terrestrial-manual/access-online/).

OIE. 2019b. Terrestrial Animal Health Code. Volume I. General provisions. Paris. (also available at http://www.oie.int/standard-setting/terrestrial-code/access-online/).

WHO. 2012. Rapid Risk Assessment of Acute Public Health Events. 39 pp. Geneva. (also available at http://whqlibdoc.who.int/hq/2012/WHO_HSE_GAR_ARO_2012.1_eng.pdf?ua=1).

Annex 3

Examples of triage criteria and their use

Annex 4

Example of the contents of a hazard profile

The following aspects should be compiled in a hazard profile.

CLASSIFICATION OF THE CAUSATIVE AGENT

• virus, bacteria, parasite, protozoa, fungus, biological toxin, prion;

• taxonomic name;

• number of strains;

• different levels of pathogenicity of strains and related importance for immunogenicity/vaccination.

PERSISTENCE

• chemical and physical tolerance (pH, temperature, disinfectants, resistance to ultraviolet light);

• presence in meat, germinal products, dairy products, skins and hides, mechanic and biological vectors.

PATHOGENESIS

• dynamics of infection and replication in vertebrate hosts: organs with pathogen replication, organs where the pathogen can persist and timing, length of viraemia, shedding routes and timing;

• characteristics of immune response in vertebrate hosts: timing and length of antibody response (for each antibody class) to natural infection and vaccination, length of maternal immunity, importance for serological diagnosis;

• dynamic of infection and replication in invertebrate hosts (for vector-borne diseases): vector competence, extrinsic incubation period, presence of transovarial/transstadial transmission.

EPIDEMIOLOGY

• definitive hosts;

• intermediate hosts;

• reservoirs;

• zoonotic potential;

• vectors implicated (biological, mechanical);

• transmission: direct or indirect, transovarial, transplacental, sexual transmission, direct contact, aerosol, etc.;

• sources of disease agent and their relevance for agent transmission/spread: carcasses, fresh or frozen meat, skins and hides, germinal products, environment or water;

• geographical distribution: enzootic, epizootic, sporadic or seasonal;

• transmission parameters such as basic reproduction number (R0), infectious period.

DIAGNOSIS

• clinical signs and pathognomonic signs;

• differential diagnosis;

• laboratory tests available and their performance (sensitivity and specificity), OIE gold standard tests and those recommended for international animal trade.

PREVENTION AND CONTROL

• prevention measures for international trade (OIE);

• availability of vaccination or antimicrobial treatment;

• control strategies applied: culling of all contact animals, culling of only affected animals, recommended size of control zones, (emergency) vaccination, movement restrictions, screening, other control strategies;

• feasibility of vector control measures.

IMPACT

• number of outbreaks and number of species/animals affected in main epidemics (reported by year, country or other relevant epidemiological features) according to available official and unofficial data;

• morbidity per species;

• case fatality rate per species;

• production losses;

• tourism losses;

• losses due to reduction of consumer confidence;

• animal welfare;

• trade restrictions, by commodity;

• environmental impact, impact on biodiversity;

• public health impacts;

• economic impact considering the costs of prevention, control, eradication, trade restrictions, production losses, mortality, human disease.

Annex 5

Example of the formulation of rapid risk assessment objectives and risk questions and sub-questions

OCCURRENCE OF RIFT VALLEY FEVER (RVF) HUMAN CASES IN THE NIGER IN 2016

The RRA had the following objectives:

a. to assess the risk of RVF spreading into neighbouring countries;

b. to assess the potential consequences for public and animal health in the Niger.

The following table provides examples of possible questions and related sub-questions.

Annex 6

Expert knowledge elicitation

Expert knowledge elicitation (EKE) is a standardized method of obtaining knowledge from experts who can be asked for specific information (data, facts, etc.) or judgements (probabilities, estimates, etc.), the latter being more challenging as experts are frequently asked to use their expertise to estimate uncertain quantities. The estimations made by the experts are personal and subjective and express the expert’s own beliefs. Elicitation methods aim to reduce this subjectivity through consensus or mathematical aggregation of experts’ estimates.

Three EKE methodologies are presented in the following paragraphs. The time required to implement these methodologies ranges from ten days to several months.

The Sheffield protocol. This method allows experts to interact with each other during face-to-face meetings or elicitation workshops during which they discuss and exchange opinions about the questions concerned under the supervision of the elicitor. EKE through this method can be completed in two to three days following at least two weeks of preparation. Discussion among the experts is required in order to seek consensus on the estimates (behavioural aggregation). This method does not need mathematical manipulation and aggregation of estimates. Results can be quite robust as they derive from an in-depth discussion among experts. Possible shortcomings include issues related to the management of groups where minority opinions, although valid, may be overwhelmed by the most popular judgements or dominant personalities.

Cooke’s method. This method requires between ten days and two weeks for completion and is highly dependent on the availability of the experts, especially when a web survey is used rather than individual interviews. Much attention needs to be devoted to the formulation of questions in the questionnaire to avoid misunderstandings in the interpretation of respondent experts, and mathematical procedures for the aggregation of answers must be carefully chosen and applied to avoid unwanted distortions. This method does not allow the experts to discuss their judgements and interaction is limited to the initial training and briefing session. Instead of behavioural aggregation, a form of mathematical aggregation is applied. Weighted aggregation of experts’ estimations is carried out. For this purpose, seed questions are used to “calibrate” the experts, identify those who are most capable of giving judgements with high precision, and define the weight to be applied to the opinion of each expert.

The Delphi method. This method shares features with both of the others and is the most time-consuming of the three. Repeated rounds of elicitation are managed by an elicitor over a period of up to several weeks. Judgements from each round are returned to the experts in the subsequent round anonymously. EKE through this method can be carried out through a web-survey approach alone. When all rounds are completed, final estimates are obtained via simple, equal-weighted, mathematical aggregation.

Selection of the method for performing an EKE should take into consideration:

• the deadlines and time available for performing a formal EKE;

• the availability of human and financial resources for physical meetings and/or elicitation workshops;

• the languages spoken by the experts and difficulties in finding a common language;

• the disciplines of the experts and possible difficulties in reaching a common understanding regarding the risk questions and related terminology;

• the possible existence of differences in opinion due to institutional relations or scientific positions.

Further details on how to aggregate the judgements provided by experts during an EKE are provided in the following paragraphs.

PROBABILITY EXPRESSED USING CATEGORICAL LEVELS

If experts are requested to express their probability judgements using categorical levels, the following method can be used to aggregate their estimates:

1. I f it is possible to gather experts (even by telephone) for a collegial discussion, agreement should be reached through discussion of discrepancies among the judgements (starting with the most extreme values) and the rationale for them.

2. I f it is not possible to gather experts or agreement is not reached, the uncertainty in the judgement has to be reflected in terms of a range of levels with the minimum and maximum levels estimated by the experts delineating the lower and upper bounds of the range. For instance in a case where three experts provide levels of 2, 2 and 3, the aggregated judgement would be “between 2 and 3” (i.e., ranging from “unlikely” to “likely”). The range reflects the heterogeneity of judgements among experts.

3. As an alternative, an empirical distribution could be set based on the relative frequency with which the experts select each level as an estimate. In the example above, a frequency of 66.66 percent (two out of three experts) would be assigned for level 2 and 33.33 percent (one out of three experts) for level 3, reflecting the uncertainty in the judgements or estimates among the experts.

PROBABILITY EXPRESSED USING RANGES

When individual judgements are expressed as ranges of levels, two options are available:

1. U se face-to-face, telephone or virtual discussions to seek agreement among the experts regarding the range.

2. I f this cannot be achieved, determine the aggregated range by computing the minimum of the lower bounds and the maximum of the upper bounds of all the ranges indicated by the experts. For instance, if three experts provide the following estimated probability levels:

• from 1 to 2 (“extremely unlikely” to “unlikely”);

• from 1 to 3 (“extremely unlikely” to “likely”);

• from 2 to 3 (“unlikely” to “likely”);

the aggregated probability estimate would be: from 1 (“extremely unlikely”) to 3 (“likely”) or from < 1 percent to 66 percent. In this case, the range will reflect the uncertainty in each judgement and the variability in judgement among the experts, with all the values in the range considered equally probable.

3. As a third option, an empirical distribution could be set by calculating the relative frequency of each of the levels included in the ranges provided by the experts. In the example above, in which a total of seven overall probability levels are expressed by the three experts (two by the first expert, three by the second and two by the third), a step function with frequency of 0.29 = 2 out of 7; 0.43 = 3 out of 7; 0.29 = 2 out of 7 for levels 1, 2 and 3 respectively, would reflect the uncertainty in the judgements/estimates, with differential probability reflecting the differences in the confidence assigned to the various levels.

Annex 7

Report template for a rapid risk assessment of a health threat event

Confidentiality notice: This document is confidential and contains information and intellectual property of (name of institution). Neither this document nor any of the information contained herein may be disclosed or distributed.

Date of start of the RRA: dd/mm/yyyy

Index number of disease event (if in the information management system):

Disease, country and region:

Objective of the assessment:

Version of the assessment:

Last update made by:

Summary of the event and hazard profile

•

•

•

•

•

Risk questions

Overall risk assessment statement and uncertainty

Summary data or evidence supporting the assessment

Recommendations/actions

•

•

•

•

•

Risk assessment (please note that the risk assessment questions need to be adapted to the specific objective of the risk assessment)

Annex 1: Event background to and background information on the specific health threat

Annex 2: Scenario tree of risk pathways
(an illustration of the risk questions and the timeline)

Annex 3: Risk matrix used

Experts consulted

Risk assessment team members

References and data sources
Disclaimer

Annex 8

Example of a scenario tree

The following is an example of a scenario tree depicting risk pathways of the introduction of African swine fever virus (ASFV) into country Y, which is not infected by African swine fever (ASF), through contaminated pork meat and other pork products from ASF infected country X and the subsequent infection of local domestic pigs or wild boar in country Y.

FAO ANIMAL PRODUCTION AND HEALTH GUIDELINES

1. Collection of entomological baseline data for tsetse area-wide integrated pest management programmes, 2009 (En)

2. Preparation of national strategies and action plans for animal genetic resources, 2009 (En, Fr, Es, Ru, Zh)

3. Breeding strategies for sustainable management of animal genetic resources, 2010 (En, Fr, Es, Ru, Ar, Zh)

4. A value chain approach to animal diseases risk management – Technical foundations and practical framework for field application, 2011 (En, Zh, Fr**)

5. Guidelines for the preparation of livestock sector reviews, 2011 (En)

6. Developing the institutional framework for the management of animal genetic resources, 2011 (En, Fr, Es, Ru)

7. Surveying and monitoring of animal genetic resources, 2011 (En, Fr, Es)

8. Guide to good dairy farming practice, 2011 (En, Fr, Es, Ru, Ar, Zh, Pte)

9. Molecular genetic characterization of animal genetic resources, 2011 (En, Zh**)

10. Designing and implementing livestock value chain studies – A practical aid for Highly Pathogenic and Emerging Disease (HPED) control, 2012 (En)

11. Phenotypic characterization of animal genetic resources, 2012 (En, Fre, Zhe)

12. Cryoconservation of animal genetic resources, 2012 (En)

13. Handbook on regulatory frameworks for the control and eradication of HPAI and other transboundary animal diseases – A guide to reviewing and developing the necessary policy, institutional and legal frameworks, 2013 (En)

14. In vivo conservation of animal genetic resources, 2013 (En, Zh**)

15. The feed analysis laboratory: establishment and quality control – Setting up a feed analysis laboratory, and implementing a quality assurance system compliant with ISO/IEC 17025:2005, 2013 (En)

16. Decision tools for family poultry development, 2014 (En)

17. Biosecurity guide for live poultry markets, 2015 (En, Fre, Zhe, Vi)

18. Economic analysis of animal diseases, 2016 (En, Zh)

19. Development of integrated multipurpose animal recording systems, 2016 (En, Zh)

20. Farmer field schools for small-scale livestock producers – A guide for decision makers on improving livelihoods, 2018 (En, Fre)

21. Developing sustainable value chains for small-scale livestock producers, 2019 (En, Zh**)

22. Estimation des bilans fourragers dans la région du Sahel d’Afrique de l’Ouest et Centrale, 2020 (Fr)

23. Carcass management guidelines – Effective disposal of animal carcasses and contaminated materials on small to medium-sized farms, 2020 (En)

24. Technical guidelines on rapid risk assessment for animal health threatss, 2021 (En)

Availability: February 2021

Ar – Arabic

En – English

Es – Spanish

Fr – French

Pt – Portuguese

Ru – Russian

Vi – Vietnamese

Zh – Chinese

Multil – Multilingual

* Out of print

** In preparation

e E-publication

The FAO Animal Production and Health Guidelines are available through authorized FAO Sales Agents or directly from Sales and Marketing Group, FAO, Viale delle Terme di Caracalla, 00153 Rome, Italy.