Erzurum Training Course No. 7

Transcription

1 Erzurum Training Course No. 7 Report of a clinical and epidemiological investigation into an FMD outbreak in Dadaşköy village, Erzurum province, Turkey, 1st June 2010

2 Contents Introduction... 4 Executive Summary... 4 Summary of recommendations for future control actions... 5 Background... 6 Village / agricultural structure... 6 Tending of animals... 9 Feed, water and manure management... 9 Seasonal husbandry... 9 Movement of cattle Veterinary Services Traceability of animals Clinical history FMD control measures Quarantine Treatment Biosecurity Investigations to identify source of infection Sequential report on interviews with farmers visited Farm 1 (Not identified on map) Farm 2 (Not identified on map): Farm 3 (A on the map): Farm 4 (C on the map): Farm 5 (E on the map) Timeline Possible sources of infection... 17

3 Pre-existing infection / continuation of earlier outbreak Introduction by infected animal Introduction by personnel Infection by fomite transmission Windborne spread Hypotheses on source of infection Consideration of forward spread Spread by animals Yayla (summer pasture) Movements of people and vehicles Clinical team - Sampling and testing Samples taken Clinical findings in examined animals Clinical and laboratory Results ANNEX Layout of barns where animals were examined ANNEX Clinical pictures of examined animals ANNEX Pictures of laboratory tests and results ANNEX

4 Introduction The trainers and delegates of ETC-7 real time training course visited Erzurum province between 31 st May and 4 th June The objective of the course was to give delegates real time training in Foot and Mouth disease (FMD) recognition, diagnostic sampling, laboratory testing and epidemiological enquiry. This is facilitated by the FMD situation in the region as it is reasonably certain that real outbreaks will occur that can be used as a model. The outbreak that was investigated was notified to veterinary authorities on 31/5/10 by Dr Naci Bulut of the Turkey FMD institute, acting on information he had received regarding the village of Dadaşköy. Cattle on several farms within the village were reported as being affected with FMD. The following information has been drawn from information from previous EU FMD reports, interviews with the villagers, village leader, clinical investigations, laboratory testing, and information from the official database (Turkvet) and from local veterinary unit staff. Executive Summary A reported outbreak of FMD in Dadaşköy village was investigated by a clinical and epidemiological team. 5 farmers were interviewed and all reported that their animals had recently shown clinical signs suggestive of FMD. Animals owned by 3 of those farmers were examined and it was found that 9 of a total of 11 animals showed clinical signs of FMD. FMD virus or antibody was confirmed in 9 of the sampled animals, following laboratory examination of samples taken at the visit. A range of laboratory sampling methods were employed. FMD type O was the serotype detected. From the lesions seen in the animals examined and from the interviews with the farmers, we consider that virus would have been introduced between 7 19 th May (assuming an incubation period of 2-14 days). However, farmer interviews also indicated that some animals had already recovered and were now out with the rest of the grazing herd so it is likely that we did not find the oldest lesioned animal at this visit. It is possible that disease was circulating at a low level before the above dates and management practices that increased contact between the cattle increased the rate of spread and made the outbreak more obvious. These management practices could have been the gathering for vaccination or the turning out to grazing and corralling of the herd each night.

5 Infection may have been introduced by a number of routes but it considered that the movement of infected and infectious animals was the most likely route. It is likely that the infection will have been carried off the village due to the biosecurity conditions and especially the impending movement to summer grazings. The search for clinical infected animals and the willingness of the villagers to point them out created the impression that the infection was very widespread. A random serological survey in the village and/or making available data from previous random survey for NSP antibodies could have completed the understanding of the epidemiology. Recommendations have been made below which may assist in control of FMD in the village and the surrounding area. These have been made with the national situation in mind and are not intended to replicate those employed in other countries where different conditions exist. The course has been highly valuable to all participants and it is recommended that the course is repeated for more delegates. Summary of recommendations for future control actions During the visit to this village, the Muhtar (Head of the village) was very co-operative and had good knowledge of the disease and its consequences. He was willing to accept advice and keen to make improvements for his village. We invited him to join us on the final day of our course and we presented the results of our investigations and our recommendations for control. He accepted that action was necessary in the village and he agreed to improve his village s local procedures and share the recommendations with other traders and farmers. Recommendations following our investigation and analyses: Vaccination Every calf should be vaccinated when it reaches 2 months old even if this is between the national campaigns. In young and naive animals, the first vaccination should be followed by a booster vaccination after one month and then every 6 months during the national campaigns. Movement controls During an outbreak, ensure movement control on all animals, animal-products and people that can act as a vector of the virus. Ensure 100% coverage of vaccination and only accept movement and trade of vaccinated animals.

6 Ensure good documentation of all animal movements from markets, traders and private sales. This requires full compliance with ear tagging requirements. Quarantine Quarantine purchased animals for at least 3 weeks before introducing them to the herd. Separate any clinically affected animals from healthy animals and provide a designated keeper and good biosecurity. Additional measures The relevant authorities should have enough capacity to enforce the current legislation. Identify stakeholders involved in the industry (including the private veterinarians), keep them informed about the control measures and mandatory legislation and support them in implementing these in their day to day operations and in informing others. Background Village / agricultural structure Dadaşköy village is a suburban settlement located to the North of Erzurum city (pop 400,000). The village is home to some 400 families. It comprises a large number of interconnected unpaved streets with houses, businesses and animal barns interspersed throughout. The village is typical of those in the region if slightly larger than usual. The village is located within one of Erzurum province s 18 administrative districts. The district has its own Director of Agriculture. The village has also appointed a Muhtar or headman who is responsible for the administrative affairs of the village. The cattle of the Muhtar were among those affected by this outbreak. Many of the villagers keep livestock in groups ranging from 2 15 milking cattle to fattening cattle. The milking cattle are kept mainly for domestic / communal dairy production, with larger herds also consigning milk to Erzurum city dairies twice daily. Milk is transported via a pick-up truck mounted tanker which visits individual premises in the village - without any obvious bio-security precautions. It was not possible to ascertain the routes used by the milk tanker outside the village. The typical yield is 5-6 litres per cow per day. The fattening cattle form the larger part of the villagers cattle herd of some 1200 cattle. Around 550 male animals are currently kept communally in a large group to the North West of the village. Further fattening animals (mainly younger animals) are kept in smaller groups in the barns and also in the communal grazing fields to the North East and East of the village.

7 Other than a small number of tethered cattle, there is no containment of individual groups of cattle on the grazing land, which is otherwise entirely communal. Only 2 families keep sheep. These number some 130 adult animals and 70 or so lambs. At the time of the investigation no sheep were evident in the village environs. In general sheep keeping is not seen as being economically viable in this area. Around 5 goats are kept. The fields to the south are mainly used for arable crop production and are not grazed. A limited number of cattle appear to wander freely throughout the village, and consequently the roadways are contaminated with fresh excreta. Because of the system described, the whole village and its associated grazings must be regarded as a single epidemiological unit for FMD control purposes. Figure 1. Overview of location of Dadaşköy in relation to Erzurum

8 Figure 2: Distance between Erzurum market and Dadaşköy was approximately 2.5 km.

9 Figure 3: Location of the various places in the Dadaşköy. A. First farm inspected owned by Seceaddin Gunacay, B location of the infected bull owned by Islam/Hatem Yildizim C. location of several bulls and cow owned by Islam/Hatem Yildizim, D. Place where we had lunch, E. Barn with 3 FMD infected calves owned by Aydin Çelik / Mustafa, F. Corral for collecting cattle used by the whole village, H. Erzurum market Tending of animals The larger grazing groups of cattle are mainly tended by employed shepherds (a local term which includes cowherds), with the milkers and smaller groups tended by owners and their families. The shepherds tend only one farmer s animals. Feed, water and manure management Manure from the non-grazing cattle is deposited in numerous open middens throughout the village and is used both for domestic fuel and fertiliser. Discarded waste food is evident in several areas throughout the village. Water for cattle is obtained from piped troughs and natural pools / watercourses in grazing areas, and by piped supply in other areas / barns. The majority of feed is grazing or forage based, with housed cattle being fed on straw and hay/ haylage. Forage is conserved on some fields during summer when the local stocking density reduces due to transhumance. Seasonal husbandry The spatial distribution and contacts between animals are heavily influenced by the seasons. Snow cover lasts from early November until at least late March. During this time the village cattle are kept in small barns throughout the village without direct contact with other herds within the village. As soon as snow cover leaves, those cattle that are to be grazed are released outside. Any ill cattle, some younger cattle and some milk cattle are not turned out. The older male fattening animals are grazed as a single group after turn-out although they are still contained at night in two large corrals to the North East of the village. In early May the high level snow cover lifts and it is customary for all non-pregnant fattening animals to be taken to Yayla (seasonal highland grazing). The village grounds are some 25km to the south, over three ranges of mountain peaks. The cattle are driven to the Yayla on foot in the course of one day, during which time they must pass through three other villages grazing grounds, albeit with limited contact. The cattle will remain on the highlands throughout the grazing season and return in autumn. This practice allows the village to sustain a cattle herd that is disproportionate to the local feed supply, which has been reduced due to urban expansion.

10 Movement of cattle The population of cattle in the village is moderately to highly transient. Out of the five farmers interviewed four regularly buy and sell cattle, both at local markets and directly from other farms. Village herds in all surrounding districts and provinces contribute to the cattle herd in Dadaşköy. Male animals for fattening tend to be bought in March / April and are kept until June / July in the following year, when they are ready to be butchered. Numerous slaughterhouses are located in the area. Veterinary Services Veterinary services are provided by both the local government vet and also private veterinary surgeons. Twice a year the local government vet visits and vaccinates cattle against FMD, a service provided free of charge under EU state aid programmes. FMD vaccination is compulsory. Sheep are vaccinated once per year. No second / booster vaccines are given to young animals and this is an acknowledged deficit as it leaves them exposed until after the next round of vaccines. Any additional FMD vaccinations required outside of the biannual campaigns (e.g. purchased animals) are given by the private vet at the owner s expense, as is treatment for clinical disease including FMD. Various FMD treatments are described including antibiotics, lesion washes, topical disinfectants etc. Other communicable diseases experienced in the area include anthrax, tuberculosis, paratuberculosis, brucellosis, clostridial myositis (blackleg) and icterus of unspecific cause. Little specific information was obtained from the village visit as this related primarily to FMD. However one cow examined showed signs of submandibular lymphadenopathy (potentially indicative of Mycobacteria infection) and one bull that was inspected appeared to show signs of warble fly (Hypoderma bovis) lesions on its back. In general the farmers interviewed were familiar with the clinical signs of FMD, the most common of which they identified as lameness, excess salivation / mouth lesions and anorexia. The farmers seemed to accept FMD infection as a fact of life, although they certainly realised the negative effect on production of meat and milk, and the disruption caused to livestock management practices. The farmer s beliefs on FMD treatment and prevention were heavily influenced by those of their private vets, who they seemed to consult freely on veterinary matters. Vaccinations under the EU programme were carried out in October 2009 and mid- April 2010 (information from Turkvet). The farmers were highly aware of FMD vaccination and seemed to be welcoming of this. The general perception was that vaccination was effective although some farmers related a negative perception related to cases occurring soon after vaccination. Some farmers who were interviewed tended to rely on vaccinal

11 protection being consistently effective in older cattle that had been vaccinated on multiple occasions. This resulted in older animals often not being presented for vaccination. The flux of animals through the village would appear to reduce the effectiveness of the vaccine campaigns as immunologically unprotected animals are often introduced between times. Traceability of animals Most of the animals inspected bore official eartags, with only smaller numbers of cattle seen to be untagged. (Turkish rules require tags to be inserted before 6 months of age). Registration of cattle / cattle movements appeared to be highly variable and official rules seems to be poorly observed by many farmers. In the main cattle moved in vehicles between provinces are traded with official passports. Intra-province movements are often not recorded and passports are frequently not provided with animals. Further sale of such animals is facilitated by the ability to easily obtain new passports from local veterinarians. Many farmers, who may be registered as cattle farmers, are not recorded as having animals on the Turkvet database, and may use other farmer s registrations. Rules on the submission of movement data to the authorities (for the purpose of database inclusion) appear to be poorly observed, and consequently the database does not appear to form an entirely reliable disease management / investigation tool. Clinical history By all accounts FMD infection has been a commonplace occurrence in the village. The situation may be better or worse in a particular year (e.g. some farmers said that no infection was noted in 2009). Often there are peaks relating to spring turnout and cattle purchase and again in autumn related to return of cattle to the village from seasonal grazing. Farmers who we spoke to felt that that this year had been a bad one so far for FMD as the disease began earlier (before turnout) and more cases were experienced. During the visit it became evident that clinical signs suggestive of FMD had occurred in March of this year, although it appears from the Turkvet system that this was not reported to the authorities. Several farmers and the village leader confirmed this outbreak. It appears that this occurred when cattle were still housed and that the outbreak was limited to certain barns. It is likely that the housing of the cattle would have reduced the opportunity for spread between barns and animals by direct contact.

12 FMD control measures Vaccination against FMD is carried out by the state veterinarian twice yearly. This is during the spring and autumn national campaigns.. All bovine animals are eligible for vaccination although the transient nature of the population, the multiplicity of cattle barns and the seasonal translocation of animals may have an effect on vaccination protective effect through reducing coverage. The effectiveness of the cool chain for vaccine transport is reported to be good but this could not be practically verified by the investigators. It is acknowledged that the commonplace absence of a booster vaccination until the next round in six months time may reduce the protective effect, especially in younger animals. Farmers appear not to take vaccination or indeed FMD risk status into account when making purchasing decisions. This means that animals entering herds may either introduce infection or be unprotected until the next round of vaccination and consequently be vulnerable to infection in the meantime. Quarantine It appears that the extent of quarantine / FMD based restrictions on farming activities is limited. In the current outbreak the farmers still propose to take their animals to seasonal grazing within the next week, when it is very likely that some will remain infectious. Individual animals affected with FMD are often confined to barns until better, thus allowing nursing care. These barns also often contain other healthy animals which may or may not be protected by vaccination. Several affected farmers report that recovering or ill animals are simply out grazing with the rest of the village herd. Several clinical cases were found (both tied and loose) in the fields at the visit, representing a major source of infection for other cattle. In one case a lesioned animal was found in recumbency on the roadway through the village, and was being cared for in-situ. Treatment No effective treatment for the viral induced lesions is possible. Nevertheless treatment is reportedly commonly prescribed by the private veterinarian. This includes antibiosis, topical treatments etc. In some cases bacterial infection supervenes and specific treatment is required. Biosecurity In the majority of cases there appears to be little attempt at preventing spread from one infectious animal to others. The use of personal protective equipment,

13 disinfection of PPE, effective isolation of ill animals, building disinfection and facilities e.g. foot dips was not observed. The system of husbandry in the village means that infectious animals and their keepers can freely contaminate roads etc with infectious excretions. Vehicles and people appear to move throughout potentially infected areas at will. The communal grazing system means that practically all grazing stock are exposed to infection as a result of cases occurring in any group. No effective precautions seem possible given the system used although it may be concluded that removing and effectively isolating infected animal may have some effect in reducing overall viral load on the pasture. In the male fattening group it is possible that the practice of communally corralling all animals together at night might lead to more rapid spread within the group, if infectious cases are present alongside unvaccinated animals. The village is located near to a major livestock market (Erzurum animal market). Most likely by buying in infectious animals, one of the traders indicated that he sold and bought cattle almost every week from Erzurum market. Investigations to identify source of infection Previous reports from Turkey in 2010 from the European Animal disease Notification System (ADNS) showed no notifications in 2010 (figure 4). The last official notification in Erzurum was in In the Turkvet database 6 previous notifications were found. In total 4 were type O one type A and one not typed. Figure 4: Report notifications from the European Animal Disease Notification System. N.B. this is an incomplete picture of outbreaks.

14 Figure 5: Location of the previous outbreaks in Erzurum province in 2010 in relation to Dadaşköy (A). B = Erduran ), C = Kümbet , D = Akşar , E = Şehitler , F = Tekeli , G = Kilimli Sequential report on interviews with farmers visited Farm 1 (Not identified on map) Owned by the father of the Muhtar, Yusuf Yildirin, 49 fattening cattle aged between 2-3 years old and no sheep and goats. All cattle are out at grazing so none were available for examination... He bought 47 of them one month ago from surrounding provinces and the last one week ago from Ardan province. The cattle were vaccinated approximately 24 th of May 2010 and symptoms (lameness, no appetite and salivation) were seen 4 days ago in all animals. He called the vet and he prescribed antibiotics for secondary infections and they are now all grazing again, no animals were examined. He thought he was the first one to see clinical signs in this outbreak. He also told us of outbreaks in March. He sold his cattle in March to the butcher.

15 In his opinion 50% of the cattle in the village is or has been affected with FMD at the moment. This was however, not verified by other farmers interviewed. Farm 2 (Not identified on map): Another farmer was interviewed. He owned 60 fattening cattle of which 20 were young animals. Three animals were showing clinical symptoms, they were all one to one and a half year old. The last 6 animals were introduced into the herd in January 2010 from Kildan (Ezurum). He sold 2 animals 2 months ago. No animals were available to be examined. Farm 3 (A on the map): The team spoke to the wife of owner, Seceaddin Gunacay. They keep 3 milking cattle, 4 yearlings and three young calves. They also had one breeding bull with warble flies lesions in the skin. One yearling was sick with clinical signs of FMD. The cattle were reported to be vaccinated. Some of the yearlings first showed signs of disease about a week ago (approximately 24 th May 2010). They called the private vet who examined and treated. The ill yearlings were moved inside the barn where the young calves and the bull are also present. The cows remain at grazing. She said they have FMD problems every year, it started this year earlier. They sell the milk twice daily to the city dairy. The milk is collected with a small van with two milk tanks. She was not aware of the route taken after the farm or whether other villages were visited en-route. They have sold only one cow in the previous year, some time ago. The cattle are tended by her and her husband. Farm 4 (C on the map): The official owner in the Turkvet system is Hatem Yildrin, but the real owner is the village leader Islam Yildrin. In total, Islam owns 2000 cattle and trades widely. One Simmental bull tethered (site B on the map) in communal grazing field had clear recent lesions of FMD. Two more bulls and one cow (site C on the map) were inspected. The bulls had FMD lesions but not the cow. Hatem said that the last vaccination was carried out the first week of April. He bought animals from Altonteg Royk, Umundam Kóyá, Siverek, Aksouray, Sivas Sarkisk, Ardahan. Farm 5 (E on the map) Owned by two brothers Aydin Çelik and Mustafa Çelik. They own 8 cows and 7 calves.. Four calves (3 in pen looked approximately 4 months, 1 out grazing) showed clinical signs of FMD 10 day ago (approximately 22 May 2010). One of the calves had unruptured vesicles which could be opened on inspection. Mustafa said the calves would be moved to summer pasture next Saturday.

16 Timeline March clinical signs of FMD in village animals (still inside because the area was still covered with snow.) Not reported to the authorities. First week April - Vaccination in the village by official vets. Second half April - The cattle went outside to common grazing th May (most likely th May) - infection of cattle on farm 5 based on information that the first clinical signs were observed 10 days ago and assuming an incubation period of 2-14 days nd May (most likely nd May) - infection of cattle of farm 5, based on clinical findings that the oldest lesion 7 days old and assuming an incubation period of 2-14 days nd May (most likely nd May) - infection of cattle of farm 3 based on information that first clinical signs observed in farm 3 one week ago and assuming an incubation period of 2-14 days. 24 th May (approx) - re-vaccination by private veterinarian of cattle on farm 1 26 th May (approx) - First clinical symptoms reportedly seen on farm 1 - so most likely time of infection th May assuming an incubation period of 2-14 days.

17 FMD outbreak in Dadaskoy village Vaccination against FMD carried out from March by mid April Animals released on the pasture The earliest date of infection of animals showing a clinical signs of FMD on May 21, 2010 The first reported date of animals showing a clinical signs of FMD mrt Farmer 1 and Farmer 4 commented that a small number of aminals showed clinical symptoms associated with FMD. The latest date of infection of animals showing a clinical signs of FMD on May 21, 2010 Figure 5: graphical representation of the timeline Possible sources of infection Pre-existing infection / continuation of earlier outbreak Clinical signs of FMD in the village during March 2010 were reported to the investigation team.. This occurred when cattle were indoors and it appears only limited numbers were affected. Cattle were let out to graze in late March / early April. This may have allowed infection to spread to the communal grazings which might have gradually spread through the population. The time between March and the visit at the end of May would allow for several incubation / infectious periods, which would require a continual cycle of infection and sequential exposure of immunologically naive cattle. Whether it is possible for the village population of cattle to support this pattern is questionable but evidence from the UK outbreak in 2007 indicated that waves of infection can move through extensively grazed cattle herds. It is possible that infection from within the barns was spread outwards by removal of contaminated dung from the barns, or that the environs of the village was so contaminated by infectious material that animals kept being infected either by direct contact or by fomites or personnel. However the picture of infection found at the visit and via the interviews with the farmers was one of relatively recent infection, which would have been introduced to most of the diseased cattle around the same time. Most of the keepers interviewed

18 said clinical signs first appeared around 1 week ago and lesion ages for the examined cattle tend to (mostly) support this. This might tend to support a further introduction separate from the March outbreak, or it may be the result of a previously housed infected animal being turned out and therefore exposing the communally grazed cattle. Of course it is possible that the cattle examined at the visit were only the most recently infected (those that were still showing signs). Recovered cattle were not identified or examined. We were unable to take serological samples from healthy cattle as these were away at grazing. Ideally we would have wished to do this in an attempt to estimate how disease had spread through the village. Introduction by infected animal Many farmers in the village regularly buy and sell animals through sources that can only be regarded as extremely high risk in FMD terms. Because of the deficiencies in the compliance with cattle movement registration, it is practically impossible to obtain the full history of cattle introductions. However it is highly likely that cattle will have been brought into the village during the source window and given the level of infection in the region, the reported outbreak in Kümbet (approximately 25 km by road) was ongoing at the time FMD virus was introduced, and the status of the local cattle markets, this must be regarded as one of the most likely routes by which infection was introduced to the village, at whatever date we consider to be the start of this outbreak. Introduction by personnel People, especially those coming into contact with livestock, present a significant risk of spreading FMD in an endemically infected area. Of course if the personnel follow rigorous personal bio-security this risk is vastly reduced. During the visit we did not see any evidence that farmers and other villagers, and other visitors to the village, follow any protocol of disinfection or use protective clothing before coming into contact with the cattle areas or cattle themselves. We found that farmers are regularly visiting other villages to buy animals etc and they could introduce infection on footwear etc. We observed many farmers moving in this way, the milk tanker driver etc. One significant piece of information was obtained from the first farmer interviewed. He said that the first clinical signs in his cattle had been seen some four days previously on May 26th (it is not possible to verify this through lesion age etc because his cattle were not examined). However, one week ago, his private vet visited and carried out a vaccination of 47 of his animals, all of which subsequently showed signs of infection. It is not clear how many other cattle he treated in the village, what biosecurity procedures he followed etc. This particular contact may have either introduced infection or he may have spread it from other infectious

19 animals in the village. The oldest lesion found was 6 7 days old which would suggest that infection was already present at the vet s visit. It has to be considered that any of the villagers or other persons who enter the village could have introduced infection via footwear etc. Infection by fomite transmission. It appears that little equipment such as tractors, feed lorries etc enter the village from other areas. Vehicles were observed in the village for domestic and agricultural purposes. Of these the most significant risk might be considered to be the milk tanker. Twice daily this enters and drives around the cattle fields and village streets and accepts milk in churns from the farmers. No biosecurity procedures were seen to be followed. Infection could thus be easily introduced on wheels, by release of virus laden air from the milk on board, by the driver himself. Given the size of tanks observed and the milk yield of the cattle and the cattle population, it seems likely that the tanker does a round of more than one village. This presents a continual significant risk of both source and spread. For example we saw one clinical case being cared for on the road where the tanker passed and infectious material from this animal may well have been moved on via the wheels. Windborne spread The market is quite close to the village and it seems clear that infected cattle will regularly be present at this site. This is a potential route of spread, but is generally considered unlikely compared to transport of animals. We have not assessed meteorogical data and of course we have no information regarding dates when infection might have been present. Further investigations are not necessary. Hypotheses on source of infection From the lesions seen in the animals examined and the farmers interviewed, we consider that virus would have been introduced between 7 19 th May. However, farmer interviews also indicated that some animals had already recovered and were now out with the rest of the grazing herd so it is likely that we did not find the animal with the oldest lesions. It is possible that disease was circulating at a low level before the above dates and management practices that increased contact between the cattle increased the rate of spread and made the outbreak more obvious. This could have been the gathering for vaccination of the turning out to grazing and corralling of the herd each night. It is not possible to categorically state how infection was introduced as there are a number of high risk activities that could be responsible. We have therefore attempted to rank the potential sources of infection, in terms of relative likelihood. The

20 considered opinion of the investigation team is therefore is most likely animal movement: Consideration of forward spread Spread by animals None of the farmers that we spoke to said that they had sold cattle to other farmers within the previous six weeks. In the main the village cattle become fat and are sold direct into abattoirs. Ideally one would use the Turkvet database to examine the movement history of all farmers in the village and this would allow any animal being sold to another farm to be identified and traced. The reliability of this information is not sufficient for these purposes. Further enquiries would include more detailed interviews with all farmers in the village. Yayla (summer pasture) It is clear that the village intends to move the relevant animals to Yayla in less than one week (already delayed for one week due to FMD) This may well include animals which are infectious for FMD. This movement must be regarded as posing a major risk of onward spread of FMD to other villages. Ideally this should be further delayed until the outbreak is over. Movements of people and vehicles It is clear that vehicles and people entering the village are and have been at risk of spreading FMD onward and it is highly likely virus had been moved elsewhere by this route (whether or not this resulted in infection of animals). The sheer number and difficulty in the tracing of these movements means that is it difficult to target any further investigations based on this risk. Ideally the movements of the milk tanker would be investigated further and the villages he visits before and after Dadaşköy would be targeted for FMD surveillance and vaccination.

21 Clinical team - Sampling and testing Samples taken The samples taken depended on the availability of sample material in individual cases. The main samples taken are as follows; Epithelium Where loose epithelium was available, this was removed with forceps and placed into virus buffer which was ph adjusted and was part of the LFD collection kit. Blood Blood collected into plain tubes was taken from ten animals. Probang oropharyngeal probang samples were taken from two animals. Salivary samples - kit for oral saliva collection were used in four animals Clinical findings in examined animals The clinical team visited two barns and all other cattle were examined on the pasture in the village. In total 11 animals were examined. All examined animals, except two showed lesions indicative of FMD. Four animals showed excess salivation and three animals were lame. Rectal temperatures were between 38.4 C and 41.8 C. Dominant lesions found in animals were ruptured vesicles on the dental pad, gums and on the tongue. Some animals had swollen coronary bands, erosions and putrefaction in the interdigital area of hoofs. All lesions were aged as between 2 and 7 days. In animals which had lameness dominant lesions disorders were inter digital destruction of tissue and lesions on the coronary band. Respiratory symptoms were found in two calves and 6 showed high rectal temperatures. Biosecurity and environmental conditions inside the stables are not appropriate. Based on information given by the head of the village (Muhtar) all animals had been vaccinated in spring campaign (in April). The inspection also found that animals inspected on the farm and also on the pasture were properly identified in accordance with Turkish legislation (those inspected). From 9 affected animals samples were taken: epithelium, blood, saliva and 2 probang samples. Based on information given us, all animals had been vaccinated in spring campaign (April 2010). General impression about the affected animals is also that the size of the animals was smaller than expected for their age which could be connected with

22 the disease. Bio security and also hygiene regime on the farms were also not appropriate for effective disease control. Clinical and laboratory Results ANNEX 1 Sample results are provided as an annex. Farm numbers correspond with this report. It should be noted that not all farms who gave information were subject to examination. Layout of barns where animals were examined ANNEX 2 Clinical pictures of examined animals ANNEX 3 Pictures of laboratory tests and results ANNEX 4