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CHAPTER 3 RISK ANALYSIS FOR FMD


Introduction

Risk analysis is something that people do intuitively in their everyday lives and in their professional work. Only recently has it developed into a more formal discipline that is being used increasingly in many fields. In animal health it has perhaps been most widely applied in import control and quarantine. Quarantine risk analyses are used for helping to decide the most appropriate health conditions for imported animals and animal products and for strategies for quarantine operations.

Risk analysis is a tool that can also be used to very good advantage for animal disease emergency preparedness planning. In this context, it is most readily applied to preparedness planning for the occurrence of transboundary animal diseases (or exotic strains of endemic disease agents) and it will be described for this purpose here. However, there is no reason why risk analysis annot be applied to other animal health emergency planning.

Principles of risk analysis

Risk analysis comprises four components: risk identification, risk assessment, risk mitigation or management and risk communication.

Risk identification

In this first component, the risks of untoward events or things that may happen in the future are first identified and then described. In the context of animal health emergencies, this would include identification of all high threat diseases (exotic or otherwise); the factors that may change the level of risk (e.g. new serotypes or biotypes, or changing epidemiological or livestock husbandry patterns); and factors that may impinge on the capacity of the national animal health services to respond effectively to the disease threats.

Risk assessment

The likelihood of these risks occurring is then estimated. The potential consequences of the risks if they occur are also evaluated and used to modify the assessment of the risk. For example, an exotic disease that had a high risk of entry to a country, but only a low risk of establishment or trivial potential socio-economic consequences for the country, would only get a low overall score in a risk assessment. Conversely, a disease assessed as having a low risk of introduction but significant consequences if introduced would be rated more highly.

Risks can be assessed in a quantified, semi-quantified or qualitative way. It is inherently very difficult to quantify (or actually ascribe probability percentages to) risks in many biological systems because of the lack of historical precedents and serious gaps in available biological data. Risks should be quantified as far as is practicable. If this cannot be done, qualitative risk assessments are recommended for exotic diseases. Risks can be described as extreme, high, medium and low, or preferably by a simple scoring system, for example, 1-5 for both the level of risk and for the degree of potential consequences. This will help to establish a priority ranking for identified risks, and provide a solid platform for contingency planning.

Risk mitigation or management

This is the process of identifying, documenting and implementing measures to reduce identified risks and their consequences. The risks posed by FMD can never be completely eliminated. The aim is to adopt procedures that will reduce the level of risk to what is deemed to be an acceptable level.

This manual could be regarded as providing the risk management framework for FMD contingency planning.

Risk communication

This is the process of exchange of information and opinions on risk between risk analysts and stakeholders. Stakeholders in this context include all those who could be affected by the consequences of the risks (i.e. everyone from farmers to politicians). It is important that risk assessment and risk management strategies be fully discussed with stakeholders so that they feel comfortable that no unnecessary risks are being taken and the risk management costs are a worthwhile "insurance policy".

To ensure ownership of decisions, risk analysts and decision-makers should consult with stakeholders throughout the whole process of risk analysis so that the risk management strategies address stakeholder concerns, and decisions are well understood and broadly supported.

Who should carry out the risk analyses?

The risk assessment component is best carried out by the Epidemiological Unit in the National Veterinary Service as part of the national early warning system for transboundary animal diseases (TADs) and other emergency diseases. Risk management and risk communication are tasks for everyone, but should be coordinated by the chief veterinary officer (CVO).

It should be remembered that risks do not remain static. They will change with factors such as evolution and spread of epidemic livestock diseases internationally; emergence of new diseases; changing international trading patterns in the country; and new scientific knowledge and technology. Risk analysis should therefore not be regarded as a one-off activity but be repeated and updated regularly.

Risk assessment for FMD

As described above, risk assessment consists of identifying the risks, assessing the likelihood of their occurrence and modifying/ reducing them where possible by an evaluation of their potential consequences.

The international status and evolution of outbreaks of FMD (and other important TADs) as well as the latest scientific findings should be constantly monitored. This should be a routine function of the Epidemiological Unit of the National Veterinary Service. Apart from the scientific literature, the most valuable source of information is the International Office of Epizootics (OIE), for example through its weekly disease reports, the annual OIE World Animal Health and through the OIE Handistatus database. Disease intelligence is also available from FAO, particularly in the EMPRES Transboundary Animal Diseases Bulletin, which is published quarterly (and is also available on the Internet at www.fao.org/empres). The Program for Monitoring Emerging Diseases (ProMED), an Internet server and mailing service, currently provides a useful forum for rapid dissemination of official and unofficial information on animal, plant and human disease occurrences around the world. Information may also be obtained from designated OIE and FAO experts and reference laboratories and from regional groups established to coordinate FMD control such as the European Commission for the Control of Foot-and-Mouth Disease (EUFMD), the Pan American Foot-and-Mouth Disease Center (Panaftosa) and the Southeast Asian Foot-and Mouth Disease Campaign (SEAFMD).

Having identified and listed the exotic disease threats, the next step is to assess the seriousness of the threat of entry of each disease to the country[1] and the routes and mechanisms by which the disease may enter. Relevant questions to be answered for FMD include the following:

The next step is to evaluate how serious the socio-economic consequences might be if the disease occurs. There are a number of questions to be answered:

By addressing these questions and issues it will be possible to build up a risk profile for FMD, uncover weaknesses and make judgements on the magnitude of the risk presented by the disease in qualitative, if not quantitative, terms. Most important, it will be possible to get an idea of how FMD ranks in relation to other high-priority risk diseases, and what resources need to be devoted to preparedness for FMD in comparison with other diseases. Possible pressure points for entry of the disease can be ascertained, showing where preventive and disease surveillance activities need to be strengthened. Finally, it should indicate whether the veterinary services and contingency planning need to be strengthened to cope with FMD.

It should be recognized that many risk factors will vary over time, which is one of the many critical reasons why this manual needs to be periodically reviewed.

The value of risk assessment for FMD

The type of risk assessment described will help to:


[1] Risk assessment can also be conducted with zones or regions of a country that have different animal health status. The principles are generally the same and require very fine knowledge of one's animal health status, marketing infrastructure, transportation and regulatory capabilities.

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