Foot and Mouth Disease Middle East situation Summary of Answers to the Questionnaire Beirut, Lebanon, 7 9 April 2009

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1 Foot and Mouth Disease Middle East situation Summary of Answers to the Questionnaire Beirut, Lebanon, 7 9 April 2009 Dr Pierre Primot OIE for the Middle East

2 Purpose of the Questionnaire The purpose of this questionnaire was to provide specific information on each regional country to prioritize relevant actions for FMD surveillance, control and eradication in the Middle East In June 2009, an international OIE/FAO conference on FMD will be held in Paraguay to define a global strategy to tackle the disease worldwide This strategy will be adapted specifically to each region or sub-region according to their specificities

3 Questionnaire Answers The questionnaire was sent in September 2008 The initial date for the 5th FMD Round Table was December 2008 Since the postponing of the meeting regular reminders have been sent to Regional Members 16 countries answered to the questionnaire (76 % of Regional Members): Bahrain, Cyprus, Egypt, Iraq, Jordan, Kuwait, Lebanon, Oman, Palestinian Autonomous Territories, Qatar, Sudan, Syria, Turkey, UAE and Yemen

4 Questionnaire - Items 1.FMD outbreaks Strains identification 2.Sampling and Lab analyses 3.Sero-surveillance 4.Vaccination 5.Emergency response 6.Awareness Programs 7.Comments

1. FMD Situation in the ME FMD is endemic and widely spread among various animal species in the Middle East Increase of animal movement makes disease control more difficult

5 1. FMD Situation in the ME FMD is endemic and widely spread among various animal species in the Middle East Increase of animal movement makes disease control more difficult Different strains and variants of FMD viruses are presents: principally O and A strains Periodic devastating epidemics with new serotypes spread rapidly across national and regional borders

6 1. FMD Situation in the ME In 2005, A-Irn-05 emerged in Iran Since then this strain spreads to Saudi Arabia, Turkey (including Thrace), Jordan, Afghanistan, Pakistan and recently Iraq, Kuwait, Bahrain, Lebanon and Libya Matching with A Iraq 22 A Iran 05

7 1. FMD Situation in the ME Since August 2007, a new sublineage appears in Turkey (A Iran 05-ARD-07) Poor antigenic match to A22 Iraq vaccine Vaccine matching with A Turkey 2006

8 A Iran 05 Avril 05

9 A Iran 05 Avril 05 Dec.. 05

10 A Iran 05 Avril 05 Dec. 05 Feb 06

11 A Iran 05 Avril 05 Dec. 05 Feb 06 Dec 06

12 A Iran 05 Avril 05 Dec. 05 Feb 06 Dec

13 A Iran 05 Avril 05 Dec. 05 Feb 06 Dec

14 A Iran 05 Avril 05 Dec. 05 Feb 06 Dec Dec 08

15 A Iran 05 Avril 05 Dec. 05 Feb 06 Dec Dec 08 Jan 09

16 A Iran 05 Avril 05 Dec. 05 Feb 06 Dec Dec 08 Jan 09 Feb 09

17 1. FMD Situation in the ME In 2006, FMDV type A was introduced into Egypt from East Africa New cases in 2009 This suggests the establishment of this East African strain in the Mediterranean region A Egypt 06

18 1. FMD Situation in the ME In new O lineage: O PanAsia 2 Probably originated from India (2001) Dispersal to Afghanistan, Pakistan, Iran, Jordan, Turkey, Israel, PAT, Lebanon (probably), UAE, KSA and Egypt Vaccine matching with O Manisa O PanAsia 2

19 O PanAsia

20 O PanAsia

21 O PanAsia May 06

22 O PanAsia May 06 Jan 07

23 O PanAsia May 06 Jan 07 May 07

24 O PanAsia May 06 Jan 07 May 07 July 07

25 O PanAsia May 06 Jan 07 May 07 July 07 Jan 08

26 1. FMD Situation in the ME Wildlife In the Far East (Egypt, Israel, PAT and Lebanon) cases are often reported in the same period (winter) Wildlife (wild boars, gazelle) could be involved in the epidemiology of the disease and in the spread of the virus

1. FMD Situation in the ME Wildlife Israel reported to OIE FMD in gazelle in 2007 During the months of January to March 2007, a small-scale FMD surveillance was conducted in wild boar along Israel's

27 1. FMD Situation in the ME Wildlife Israel reported to OIE FMD in gazelle in 2007 During the months of January to March 2007, a small-scale FMD surveillance was conducted in wild boar along Israel's northern and northeastern borders (Total: sampled 21, positive 18 (85.7 percent) Between , a total of 740 boar sera were sampled, of which 108 (14.6 percent) were found positive Promed: Foot & mouth disease, wild boar - Israel (N.&N.E.)

28 1. FMD Situation in the ME - Conclusions FMD endemic in the Middle East New epidemic strains can be devastating despite using modern and effective vaccines Barrier to internal movement and export Loss of confidence in vaccination when epidemics occur High risk to introduce new strains from neighboring regions

29 2. Laboratory - Sampling All countries have a national official laboratory which performs FMD analyses, essentially serological analyses using ELISA tests But other techniques are used such as PCR (Iran, Jordan, Syria, Turkey), cell culture isolation (Turkey), VNT (Iran, Turkey and Egypt) or CF (Iran) The OIE - FAO World Reference Laboratory (Pirbright) is the main reference laboratory where sample are sent Cyprus uses the Instituto Zooprofilattico Sperimentale Brescia and the PAT the Kimron Institute (Israel)

30 2. Laboratory and Sampling Few samples are sent to the WRL Number Number of of samples samples sent sent to to WRL WRL for for virus virus isolation isolation Specific FMD Project Bahrain Bahrain Cyprus Cyprus Egypt Egypt Iran Iran Iraq Iraq Jordan Jordan Kuwait Kuwait Lebanon Lebanon Oman Oman PAT PAT Qatar Qatar Sudan Sudan Syria Syria Turkey Turkey UAE UAE Yemen Yemen

31 3. Serosurveillance Some countries have regular continuous serosurveillance programmes with different objectives: To asses FMD prevalence: Turkey - in Thrace Region (European part of Turkey) since 2000 and periodic animal market and slaughterhouses serosurvey in the other regions. In 2008 a systematic serosurveillance has been realised. Study has been still gone on Iran: In the framework of an EUFMD project, in only 2 provinces To evaluate immune status and post vaccination response: Egypt To detect virus introduction: Cyprus - Serosurveillance based on a random sampling and herds proximity to the dividing line between the areas that are under the effective control of the Republic of Cyprus and those are not

32 3. Serosurveillance In other countries, serosurveillance programmes are occasionals serosurveys To assess FMD seroprevalence In Jordan, to detect any circulating FMD virus evidence antibodies after the last outbreaks (2006) 2 year survey Syria and Lebanon have conducted in 2008 serosurvey campaign with the assistance of FAO. Results are still pending actually Bahrain carried out in 2004 a serosurvey programme, using ELISA tests, to monitor the vaccine level of immunity

33 3. Serosurveillance Iraq carried out its first target serosurveillance in 2007 in a limited part of the country. In 2008 a second campaign was carried out in the all country Sudan carried out in 2005 a serosurvey in Khartoum state only, and in 2008 in the northern states, to assess FMD seroprevalence Qatar has just started a surveillance programme

34 4. Vaccination FMD vaccination is: prohibited in Cyprus compulsory in Bahrain, Egypt, Iran, Jordan, Kuwait, Lebanon (cattle), Syria and Turkey implemented on voluntary basis in Oman, PAT, Qatar, Sudan, UAE and Yemen. Qatar will soon enforce compulsory vaccination Vaccination monitoring only in Egypt and Turkey Different vaccines and suppliers are used in the Middle East: Egypt, Jordan, Iran and Turkey are vaccine producers Other supplier sources are Europe, India, Russia and Botswana (only for Sudan)

35 4. Vaccination - Cattle FMD Vaccine Type Quadrivalent vaccine (O, A, SAT1 and SAT2) Tetravalent vaccines (O, A, Asia 1 and SAT 2) Trivalent vaccines (O India 53/73, A Iran 96, Asia 1) Trivalent (O, A 22, Asia 1) Recommendations of the WRL Bivalent vaccines (A and O Manisa). Country Sudan (06) Kuwait Qatar Syria Bahrain Iran Iraq Lebanon Oman PAT Turkey Egypt Jordan Turkey Yemen Annual Frequency Once 3 times Once or twice Twice Twice 3 times Once Twice Once Twice Twice Twice or 3 Times 3 times Twice Twice

36 4. Vaccination - Cattle FMD FMD Cattle Cattle vaccination vaccination - - Annual Annual Frequency Frequency Iran Iran Jordan Jordan Kuwait Kuwait Egypt Egypt Bahrain Bahrain Lebanon Lebanon PAT PAT Syria Syria Turkey Turkey UAE UAE Yemen Yemen Qatar Qatar Iraq Iraq Oman Oman Sudan (06) Sudan (06) 0

37 4. Vaccination Small Ruminants FMD Vaccine Type Sheep and Goats Tetravalent vaccines (O, A, Asia 1 and SAT 2) Trivalent vaccines (O India 53/73, A Iran 96, Asia 1) Trivalent (O, A 22, Asia 1) Bivalent (A and O Manisa) Monovalent (O Manisa) Country Qatar Syria Bahrain Iran Oman Turkey Iraq Jordan PAT Annual Frequency Once twice Once Twice Once Once Once Once Twice 3 times Once - Twice

38 4. Vaccination The vaccination number is very variable country by country In countries where the vaccination is implemented on a compulsory basis, the immune population ratios are fluctuating between 30 to 85 % in cattle, 40 to 90 % in sheep and goats Vaccination Vaccination Ratio Ratio - - Cattle Cattle - - Compulsory Compulsory Vaccination Vaccination Bahrain Iran Jordan Kuwait Lebanon Turkey Bahrain Iran Jordan Kuwait Lebanon Turkey

39 4. Vaccination In those where the vaccination is implemented on a voluntary basis, the ratios are very low or no information is provide except for the PAT where 78 % of the cattle population and 63 % of the sheep and goat population were vaccinated in Vaccination Vaccination ratio ratio - - Cattle Cattle - - Voluntary Voluntary Vaccination Vaccination Oman PAT Qatar Oman PAT Qatar

40 5. Emergency response FMD is a mandatory notifiable disease in all country Only Cyprus, Iran, Iraq, Kuwait, Qatar and Syria have a National Emergency Fund available for disease control. Such fund is available for FMD emergency response Iran, Jordan, Syria, Bahrain and Kuwait have an Emergency Stock of Vaccine available No Emergency Antigen Bank available in none country (Egypt and Lebanon have a project to implement it)

41 5. Emergency response Only Jordan has an official agreement signed between a local private company and the OIE-FAO WRL for vaccine or antigen supply in emergency situation. The same type of agreement is on going in Sudan with the National Laboratory Occasional agreement to supply countries in emergency situation could be established: Iraq received recently in March 2009 vaccines from EU in order to control the disease. Cyprus can received vaccines in emergency situation by the EU vaccine bank.

42 6. Awareness programmes All countries have awareness programmes on FMD, mainly focused on farmers Depending on country situation, regular meeting are organised with farmers and farmers associations, or on a regular basis (Kuwait and Bahrain) Iran has developed specific and regular training programmes for farmers TV and radio awareness programmes are implemented in Turkey, Bahrain, Kuwait and Cyprus

43 7. Country's expectations All countries support the OIE-FAO project to implement a regional strategy for FMD control and surveillance in the Middle East They underline the need to: Identify the circulating strains in the region Harmonize national control strategies which are used in regional countries; Support FMD laboratory diagnostic in Middle Eastern countries Development of rapid and reliable field tests Establish an Ag bank for FMD virus for exotic strains

44 7. Country's expectations Harmonize FMD vaccination (virus strain Ag used in vaccine) in the region, according to circulating FMD strains Develop FMD vaccine production in the region Prepare and implement a specific regional contingency plan to control any exotic FMD virus strain Provide training courses the improvement of preparedness, early warning surveillance systems and emergency management Strengthen public awareness Take into account that FMD is not an important issue for most of small breeders in the region

45 Thank you for your attention OIE for the Middle East Kfarshima (Beirut) - Lebanon Tel: / rr.mideast@oie.int

46 Questions - Discussions

Dr Ghazi Yehia OIE Regional Representative for the Middle East

Foot and mouth disease control strategies in North Africa and the Middle East The current situation Asuncion, Paraguay, 24-26 June 2009 Dr Ghazi Yehia OIE Regional Representative for the Middle East Acknowledgements