Summary of the real time training courses on foot-and-mouth disease organized by the EuFMD; presentation of the PeP-C: practical epidemiology for progressive control; lab training. PPT presented at the 84th Executive Committee of the Eufmd, by Eoin Ryan and Vesna Milicevic (both eufmd)

1. Training Programme:
Summary and Outlook
Eoin Ryan and Vesna Milicevic
EuFMD
84ExCom-Pirbright 4-5 October 2012

2. Summary
Training activity Supporting Target
Real-time field training: one Kenya course (NTC10) FMD outbreak FMD free
in September, NTC11 planned for November investigation countries
and local
New approach piloted: more problem solving, small disease control
group learning, use of smart-phone technology actions
PEPc: practical epi training – 2 of 4 weeks FMD Endemic
completed in Istanbul management countries
Modelling (discussed earlier) – Vienna workshop Contingency FMD free
planning countries
Lab training (discussed earlier) – Cairo, Paris, Accra FMD diagnosis Endemic
countries
Surveillance/vaccination strategy training FMD control Endemic
(discussed earlier) – Cyprus, Morocco actions countries
84ExCom-Pirbright 4-5 October 2012

3. Real time field FMD training
• 168 European vets trained 2009-2012
• 48 trained since last General Sesson (May 2011-Sept 2012)
• Plan: 24 more trained by next General Session (3 courses)
New approach piloted this September (NTC10):
• More problem solving exercises
• “Advance team” hunting outbreaks days before the course
 Two separate field investigations, facilitating small group learning, increased
trainee responsibility, contrast of disease outcomes on different farms
 Learning objectives: outbreak investigation, sample collection, lesion ageing,
use of probangs, field epi work, construct timelines, use of penside tests
• Use of smart phone technology (Epi Collect app) for local
investigation and risk factor identification during “transect” walk
 Learning objectives: rapid assessment of risk factors, mitigation measures,
prioritisation of surveillance actions for local disease control centre

4. Issues arising
• Gap identified: lack of epidemiology training for FMD
- At NTC10, only 2/14 trainees (both Australian) had any basic grasp of risk
factor analysis
- FMD outbreaks impose epi demands at local level, not just national level
• Penside tests: new lateral flow device for NSPs used – could identify
animals which have been infected but recovered
- Worked well, although not yet verified
- Australian DAFF advocating inclusion in contingency plan; useful for
EuFMD MS to be familiar with novel diagnostic devices
• Crossover between EuFMD program areas:
- NTC10 identified large SAT2 outbreaks in areas which had recently been
vaccinated
- Evaluation of Svanova penside tests (SAT2- LFD failed to detected
sample…)
- Vaccine matching capacity in Embakasi to clarify vaccine/field match
84ExCom-Pirbright 4-5 October 2012

5. PEPc: Practical Epidemiology for the
Progressive Control Pathway
4 week practical epidemiology course for endemic countries to teach the skills needed for PCP
progress
Turkey, Iran, Egypt, Armenia, Georgia, Azerbaijan
• Week 1: Outbreak investigation (10-14 September)
Including information on prevalence, incidence, diagnostic tests, risk factors
• Week 2: Value chain, socio-economic impact assessment (1-5 Oct)
Including information about risk, costs and benefits of FMD control, measuring FMD impact
• Week 3: Surveys: SP, NSP, questionnaires and monitoring vaccination campaign (12-16 Nov)
Including sample size, survey design, data entry, analysis of data
• Week 4: Control Strategy development (10-14 December)
Putting it all together
Course content: based around the PCP, very practical with lecture time minimised and students
learning whilst working on problems using case-studies. Prior epidemiology training is not
required.
84ExCom-Pirbright 4-5 October 2012

6. Gaps identified
• Epi training for free countries: Denmark workshop & NTCs
identified a need/request for more epidemiology training relevant
to risk-based surveillance & response
• PEPc: addresses national epi needs in endemic countries
• PCP training also needed for regional experts
• Real-time field training: addressed by current program
• Decision support tools/modelling to support contingency planning:
addressed by Vienna and follow-up workshops
• Laboratory training: addressed under WELNET, RESOLAB, EARLN
84ExCom-Pirbright 4-5 October 2012

7. Real time training: trainee perspective

8. Clinical symptoms: cows with salivation

9. Epithelium from tongue

10. Vesicles on teats

11. Lesions aging: 4-5 days lesions

12. SAMPLING
• Probang cups
• Clotted blood
• Epithelium

13. Pan.penside: weak +
SAT 2: neg
NSP Ab: weak +

14. Timeline - large scale farm
84ExCom-Pirbright 4-5 October
2012

15. Transect Walks
September 19th 2012
84ExCom-Pirbright 4-5 October
2012

16. Map - detail
84ExCom-Pirbright 4-5 October
2012