CHAPTER 10 ACTION PLAN

The action plan is a set of instructions covering most aspects of the controls to be implemented and actions to be taken during an FMD emergency, from when the disease is first suspected up to its final eradication.

Since veterinary structures differ from country to country, this chapter provides only a guideline of the actions to be carried out during each phase of an FMD outbreak. Every country should develop its own action plan in which the person or persons responsible for each action are clearly identified. Lines of communication between livestock owners and field and national veterinary services must be identified and made known to all parties. These communication lines underpin the command chain to be activated in the event of suspected FMD. The success of implementation of the action plan depends on each link in the command chain functioning as specified in the plan.

In addition, it is expected that countries will prepare detailed operating procedures, which are generic and apply to FMD as well as to other epidemic diseases. Additional manuals may be required to cover the zoosanitary code of practice in high-risk enterprises such as meat processing plants and livestock markets.^[2]

Investigation phase

The investigation phase commences once a report suspecting FMD has been received by the veterinary services. It should be a well-understood legal obligation of any citizen who suspects the presence of FMD (or any other serious animal disease) to report to a member of the veterinary or animal health services, either directly or via any links in the previously identified chain of communication, e.g. the village assembly person, agricultural extension officer, or district or subprefectural authority. In essence, a suspicious index case or animals with suspect vesicular lesions are most likely to be reported to the local veterinary authorities by an animal health or agricultural extension officer, an abattoir or meat hygiene officer, farmers and livestock owners, community leaders or, in countries where they exist, private veterinary practitioners and ancillary veterinary staff (such as community-based animal health workers employed by government or non-governmental organizations [NGOs]).

Once a report of possible FMD has been received, the following actions must take place:

• immediate investigation of the report, including collecting specimens to confirm the diagnosis with the minimum delay;

• prevention of spread of the disease during the investigation phase;

• reporting to the appropriate national authorities;

• evaluation of the evidence by personnel with sufficient knowledge of FMD to make an informed decision as to whether to proceed to the alert phase or wind down operations.

On receiving information possibly indicating FMD, the local (field) veterinary authority should carry out an investigation by visiting the location of the index case(s) to gather information about the clinical and epidemiological features of the case, and collect specimens that may aid diagnosis. The specimens should be transmitted on ice or in 50 percent glycerosaline (if refrigeration is not available) to the nearest laboratory as soon as possible. The remaining animals should be examined. If there are sufficient grounds to suspect FMD, such immediate quarantine and movement restrictions as are within the power of the local authority should be imposed. In the absence of legal powers, every effort must be made to obtain community cooperation in preventing the movement of susceptible species livestock and their products, pending further investigation.

Depending on the size of the country and veterinary hierarchy, the line of communication from farm level to national veterinary authority may contain few or many links but, given the possibility of FMD, the report should reach the CVO or Director of Veterinary Services (DVS) as soon as possible. While investigating false alarms at the highest level may result in some inconvenience and expenditure, the consequences of missing an index case because a person with imperfect knowledge of the disease was not sufficiently convinced may result in a catastrophe. In countries previously not infected, it is most unlikely that the index case will be the first to have occurred.

If the investigation reveals that the circumstances are not suggestive of FMD, or an alternative diagnosis can be made, a false alarm may be declared and operations may wind down. The declaration of a false alarm should always be accompanied by an expression of public gratitude to those who reported the index case, to encourage people to report suspicions of FMD without fear of being proved wrong. To control major diseases of livestock, it is most important to develop a culture of reporting any and all suspected cases.

Alert phase

If clinical and epidemiological results are highly indicative of FMD, the main actions required are:

• prevention of spread from the identified focus of infection;

• confirmation of the diagnosis;

• identification of other possible foci;

• reporting and dissemination of information.

The CVO or DVS should therefore:

• ensure that all necessary measures are in place to enforce control at local level (i.e. quarantine of infected premises and prohibition of movement of animals, animal products, people, vehicles and fomites);

• activate the National Emergency Preparedness Plan for FMD;

• make the necessary arrangements to ensure that funds are available to cover field and laboratory investigation;

• ensure that equipment, materials and transport (vehicles and fuel) are available;

• appoint and dispatch the FMD expert team, which should include an epidemiologist, a laboratory diagnostician and a control officer, with such technical support as they may require;

• alert the police, army, customs, wildlife authority and relevant government departments (if necessary by convening a meeting of the Interministerial Committee in countries where this is a prerequisite for cooperation);

• define zones of control and observation;

• alert the chief veterinary officer in all provinces or regions in the country (given the potential of FMD to spread rapidly over long distances);

• communicate the details of the outbreak of disease to the international authorities (OIE, FAO, the World Reference Laboratory for FMD and regional laboratories for FMD) as soon as possible.

CVOs in all neighbouring countries should be warned to be on the alert because of the potential for rapid transboundary spread before diagnosis has been confirmed, especially in continental countries with porous borders.

If national and local livestock farmers' associations exist, alerting them to the situation as soon as possible will assist in ensuring their support and cooperation should FMD be confirmed, and will also have a beneficial effect on enforcement of local disease control measures.

Operational phase

The operational phase is initiated when the occurrence of FMD has been confirmed and an FMD emergency is declared in the country. Immediate actions required of the CVO are to:

• brief the appropriate minister and obtain political support for control activities;

• activate the CCEAD;

• prepare and send international disease reports to OIE, FAO and neighbouring countries;

• start a public awareness and education campaign;

• set up national and local disease control centres;

• institute national surveillance for FMD;

• establish zones and movement controls;

• obtain supplies of vaccine, disinfectants and other essential materials;

• institute stamping out and/or vaccination programmes.

Stand-down phase

If FMD is not confirmed, the CVO should inform all parties involved that the projected emergency situation has ceased to exist.

When FMD has been confirmed, the stand-down phase commences when intensive disease surveillance indicates that the control and eradication programme has been successful and there have been no reports of clinical FMD for at least two to three months. The emphasis should then be on:

• instituting rehabilitation programmes for affected farmers and farming communities;

• obtaining verifiable scientific evidence, including the results of clinical and serological surveillance, that the disease has indeed been eradicated from an area or the whole country;

• preparing and presenting a case for freedom to OIE;

• re-establishing trade and normal farming activities;

• instituting programmes to prevent the reintroduction of FMD to free zones or the whole country;

• reviewing the control and eradication programme with all stakeholders; and

• revising the FMD contingency plan in the light of the above.