Foot and mouth disease in the Lao People's Democratic Republic: I. A review of recent outbreaks and lessons from control programmes

Field epidemiology capacity of the national veterinary services of Lao PDR: An online survey

Introduction

Capacity in veterinary epidemiology is critical to detect, respond and control infectious diseases. Laos veterinary service is limited by having only a small number of veterinarians who graduated from overseas. Animal science graduates support the majority of the Laos veterinary services. The veterinary program was established in 2009 at the National University of Laos. We aimed to understand the national veterinary epidemiology capacity and identify gaps and training needs.

Method

A cross-sectional online study was conducted in 2021 targeting central (DLF), provincial (PAFO) and district (DAFO) government animal health officers and veterinary/animal science academics (n = 332). The questionnaire addressed skills, experiences and perceived training needs in outbreak investigation, disease surveillance, data management and analysis, epidemiological surveys, One Health, leadership and communication and biosecurity. A descriptive analysis was performed and associations between demographic factors and epidemiological skills were examined.

Results and discussion

In total, 205 respondents completed the questionnaire (61.8% response rate). Respondents reported low or no skills and experience in data management and analysis, epidemiological surveys and One Health. In contrast, higher but limited skills and experiences were reported in outbreak investigation, disease surveillance and biosecurity. Previous epidemiology training was primarily associated with stronger experiences in veterinary epidemiology competencies, followed by respondents that had completed a veterinary degree, highlighting the value of the currently available epidemiology training and veterinary-trained personnel in Lao PDR. This study could help inform the Laos government in its policy planning for field veterinary epidemiology capacity and future training.

Detection of Foot-and-Mouth Disease Virus in the Absence of Clinical Disease in Cattle and Buffalo in South East Asia

Foot-and-mouth disease virus (FMDV) is widespread throughout much of the world, including parts of South East Asia. Surveillance is often limited in endemic areas, relying predominantly on passive outbreak reporting. As part of the World Organisation for Animal Health (OIE)'s South East Asia and China Foot-and-Mouth Disease Project (SEACFMD), field sampling was performed to help understand evidence of widespread virus exposure observed in previous studies. Serum and dry mucosal swabs were collected to evaluate the presence of FMDV RNA on the nasal, oral, and dorsal nasopharyngeal mucosal surfaces of 262 healthy cattle (n = 84 in Laos; n = 125 in Myanmar) and buffalo (n = 48 in Laos; n = 5 in Myanmar) immediately following slaughter in three slaughterhouses. Swabs and serum were tested by the OIE/FAO World Reference Laboratory for foot-and-mouth disease (WRLFMD) using pan-serotypic real-time reverse transcription-PCR (rRT-PCR) and serum was evaluated using the FMD PrioCHECK non-structural protein (NSP) ELISA. In total, 7.3% of animals had detectable FMDV RNA in one or more of the three sites including 5.3% of nasopharyngeal swabs, 2.3% of oral swabs, and 1.5% of nasal swabs. No FMDV RNA was detected in serum. Overall, 37.8% of animals were positive for NSP antibodies, indicating likely past natural exposure to FMDV. Results were comparable for Laos and Myanmar, and for both cattle and buffalo, and were not significantly different between age groups. Detectable FMDV RNA present on the oral and nasal mucosa of clinically-healthy large ruminants in Laos and Myanmar demonstrates the importance of sampling asymptomatic animals as part of surveillance, and may indicate that subclinical infection plays a role in the epidemiology of FMD in these countries.

Knowledge, attitudes and practices of smallholder farmers on foot and mouth disease control in two Cambodian provinces

Food-and-mouth disease (FMD) is endemic in Cambodia. The control programme for FMD has relied on vaccination, with poor vaccination uptake by smallholder farmers becoming an increasing concern. A study to improve the understanding of farmer knowledge, attitudes and practices of FMD control and vaccination was conducted in two Cambodian provinces (Kampong Cham and Pursat). The aim was to identify opportunities to improve the livestock disease control programmes provided by both the government and private sectors. The survey comprised 300 smallholder farmers using a one-on-one interview technique and was completed between January to February 2014. Results identified that over two-thirds of the respondent farmers had not vaccinated their cattle over 2 years (2011-2013). Of those who did, most cattle were vaccinated either once a year or once every 3 years. A booster had never been administered. It was concluded that the FMD vaccine had only been administered through an unreliable and limited government vaccination programme, and private FMD vaccination services were not accessed in the study areas. FMD outbreaks occurred every year during the study period, with a morbidity rate of over 30%. Isolation of first infected cattle from the household herd was not practiced, with treatment identified as the first preference intervention. Farmers often assisted other farmers to restrain and treat infected cattle both before (57%) and after (43%) their own cattle were infected. This indicated that most farmers did not practice basic biosecurity measures and chose to report FMD outbreaks to the village animal health workers (VAHW), friends, neighbours and relatives in preference to government officials. It was concluded that poor knowledge of disease transmission and biosecurity, with low FMD vaccination coverage and a focus on treatment, contribute to regular FMD outbreaks in these communities. Improvement of FMD control requires the cooperation of villagers, VAHWs and village leaders in disease reporting, with either improved funding of government vaccination services or establishing a private FMD vaccination service. Training programmes for farmers on disease transmission, and the importance of biosecurity and vaccination, including information on the cost-benefits of treatment versus full fee bi-annual FMD vaccination, are required.

Foot-and-mouth disease seroprevalence and reporting behaviours in nine northern provinces in Lao PDR: The current situation and challenges for control

Foot-and-mouth disease (FMD), caused by the FMD virus (FMDV), is one of the most important of global livestock diseases, impacting even-toed ungulates and distributed mostly in less developed countries that are home to 75% of the human population. A progressive control pathway for FMD (PCP-FMD) was developed to assist countries to better manage FMD risks and progress towards control and eradication. This requires evidence of current FMD seroprevalence to enable the informed risk assessment and the disease control planning required to progress along the initial stages of the PCP-FMD. Despite Laos being an active member of the South East Asia and China FMD campaign, these data have been challenging to obtain. To address this gap, a cross-sectional seroprevalence study in nine northern Lao provinces was conducted in early 2019. The study sampled 602 large ruminants and 19 goats from 30 villages. Overall, the large ruminant seroprevalence was 43.7% (95% CI 39.7-47.8), and 90% of sampled villages had at least one seropositive animal. Large ruminants suspected of having had clinical FMD in their lifetime were found to have an increased risk of being seropositive (odds ratio 1.96, 95% CI 1.06-3.65, p = .03). An examination of current reporting behaviours of farmers, village veterinary workers and district and provincial officials found that individuals were using their discretion as to whether disease events required reporting along the chain of command. This, plus the lack of a computerized reporting system, contributed to a loss of historical data, potentially compromising progression on the PCP-FMD. Laos requires ongoing support from donor agencies to improve the current animal disease surveillance system and implement effective FMD control strategies that can enable progress on the PCP-FMD.

High seroprevalence of Foot and Mouth Disease in Laos: Call for nationwide vaccination campaigns and disease surveillance

Foot and mouth disease (FMD) virus remains enzootic in Lao People's Democratic Republic (Lao PDR) due to insufficient control measures, including low vaccination coverage. We assessed virus epidemiology and evaluated knowledge, attitude and practice of Lao farmers and animal health stakeholders towards FMD to support politics in devising evidence-based control measures. Sera were collected from 972 domestic ruminants in three provinces of Lao PDR: Vientiane Capital, Vientiane and Xiengkhouang provinces. Seroprevalence of antibodies directed against non-structural proteins of FMD virus was assessed using a commercial ELISA. Positive sera were further characterized by detecting antibodies directed against the structural proteins of FMD serotypes O, A and Asia 1. Information about farm management, biosecurity practices, livestock trade, and past FMD outbreaks was obtained. Overall 35% (340/972) of the ruminants had antibodies against FMD virus with a similar seroprevalence in each province. Seroprevalence depended significantly on the ruminant species (p < .001): 61% of buffaloes, but only 41% of cattle and 15% of goats were seropositive. While antibodies against FMD serotype Asia 1 were absent, 87% (297/340) of the seropositive animals had antibodies against FMD serotype O and 32% (110/340) against FMD serotype A. Many seropositive animals (31%) had antibodies against both serotypes O and A. The majority of the farmers could name the symptoms of FMD and the susceptible animal species. Although many had likely observed FMD outbreaks in their herd and were aware of FMD vaccines, only few vaccinated their animals. This study confirms that FMD remains enzootic in at least three provinces of Lao PDR where vaccination coverage is low. It also shows the relevance of nationwide active and passive disease surveillance, as well as of vaccination campaigns using bivalent FMD vaccines and targeting all susceptible animal species.

Serological Evidence of Foot-and-Mouth Disease Infection in Goats in Lao PDR

Foot and Mouth Disease (FMD) causes significant economic loss in Lao PDR (Laos) and perpetuates the cycle of smallholder poverty mainly through large ruminant productivity losses, increased costs of production and potential limitations to market access for trade in livestock and their products. Goats are emerging as an important livestock species in Laos, and there is an increasing trend in the number of households with goats, often farmed alongside cattle and buffalo. Although an FMD susceptible species, very little is known about the role of goats in the epidemiology of the disease in Laos. A cross-sectional seroprevalence study was conducted by detecting antibodies to the non-structural proteins (NSP), an indication of a previous infection, and serotype-specific structural proteins (SP) that could be due to vaccination or infection. The study commenced in late 2017 and sera were collected from 591 goats in 26 villages of northern, central and southern Laos. For a subset of sera samples, paired oral swab samples were also collected by a simple random sampling method to detect the prevalence of FMD virus infection at the time of collection. The NSP seroprevalence in the provinces of Borkeo and Xayabouli in the north was 42 and 8%, respectively and in Khammoune in the center, it was 20%. In the other five provinces, Luang Namtha and Luang Prabang (northern Laos), Xieng Khouang and Savannaket (central Laos), and Champasak (southern Laos), the seroprevalence was close to zero. The multivariable analysis indicated that age (p < 0.001) was positively associated with animal-level seropositivity and males were less likely to be seropositive than females (OR: 0.29; 95%CI: 0.10–0.83; p = 0.017). Continued sero-surveillance for FMD in goats is recommended to improve our understanding of their role in the epidemiology of FMD in the region and to extend support to FMD control decisions, particularly regarding vaccination.

A history of FMD research and control programmes in Southeast Asia: lessons from the past informing the future

Foot and mouth disease (FMD) is a major animal health problem within Southeast Asia (SEA). Although Indonesia and more recently the Philippines have achieved freedom from FMD, the disease remains endemic on continental SEA. Control of FMD within SEA would increase access to markets in more developed economies and reduce lost productivity in smallholder and emerging commercial farmer settings. However, despite many years of vaccination by individual countries, numerous factors have prevented the successful control of FMD within the region, including unregulated ‘informal’ transboundary movement of livestock and their products, difficulties implementing vaccination programmes, emergence of new virus topotypes and lineages, low-level technical capacity and biosecurity at national levels, limited farmer knowledge on FMD disease recognition, failure of timely outbreak reporting and response, and limitations in national and international FMD control programmes. This paper examines the published research of FMD in the SEA region, reviewing the history, virology, epidemiology and control programmes and identifies future opportunities for FMD research aimed at the eventual eradication of FMD from the region.

Risk factors for emergence of exotic foot-and-mouth disease O/ME-SA/Ind-2001d on smallholder farms in the Greater Mekong Subregion

Foot-and-mouth disease (FMD) is a significant endemic transboundary animal disease in Lao People's Democratic Republic (Lao PDR) and throughout the Greater Mekong Subregion (GMS). The disease has been shown to perpetuate the cycle of smallholder poverty through reduced animal production, plus limitations on market access for trading in livestock and their products. Despite significant national and multilateral efforts to control FMD over the past two decades, endemic FMD viruses (FMDVs) continue to circulate in Lao PDR. Further, the threat from new and emerging FMDVs is increasing as transboundary movements in the region intensify in response to increasing regional demand for meat. Although the economic impacts of FMD on smallholder farmers in Lao PDR are significant, studies investigating household-level risk factors for FMD are lacking. Following an outbreak of a novel FMDV (O/ME-SA/Ind2001d) in Lao PDR in 2015, a questionnaire and serological study were conducted in Naxaythong District to identify household-level risk factors associated with this outbreak, as well as endemic circulating viruses in the outbreak area. Data were analysed using a multivariable generalised estimating equation (GEE) model with a logit link function and associations were calculated as odds ratios (OR) with 95% confidence intervals (CI_95%). After adjusting for other variables, the practice of quarantining new livestock for a minimum of two weeks prior to introduction to a herd was found to be a significant protective factor during the 2015 outbreak (OR 0.225, CI_95% [0.06, 0.88], p-value 0.003). In addition, households owning one or more animals with titres to the non-structural proteins of FMDV, indicating prior infection, had 5.5 times the odds (CI_95% [6.16, 49.11], p-value <0.001) of sharing communal grazing land with neighbouring villages. These findings indicate that implementing basic on-farm biosecurity and improved husbandry measures to minimise FMDV circulation at the household level are important and reinforce the need to enhance the education of smallholder farmers in infectious disease control.

Current situation and future prospects for beef production in Lao People's Democratic Republic - A review

Lao-native beef cattle are primarily Bos indicus, and most ruminant production in Laos is still dominated by small-scale or backyard producers that use traditional practices, resulting in low productivity. The cattle herd size in Laos has grown by an average of 5 percent per year from 1.52 million in 2010/11 to 1.81 million in 2014/15. In 2016, the Laos cattle population was 1.88 million head, with smallholder farmers representing 98% of production despite efforts by the Laos government to develop commercial-scale farms. There were 170 commercial cattle farms in 2016, with 56 percent in the Central region of Laos. Although, overall, ruminant meat production has tended to increase but with consumption at 7.29 kg/capita/yr in 2013, it remains insufficient to meet demand. Crop residues and agro-industrial by-products used in ruminant diets include rice straw, cassava pulp and wet brewers’ grains as roughage, energy and protein sources, respectively. The Belt and Road Initiative proposed by China in 2013 will connect China closely with all countries in Southeast Asia. This initiative will change landlocked Laos to land linked for investors who will benefit from convenient transport at a lower cost, promoting agricultural production in Laos.

Effect of vaccine storage temperatures and dose rate on antibody responses to foot and mouth disease vaccination in Cambodia

A field study investigated the effects of foot and mouth disease vaccine storage temperature for 7 days (frozen, refrigerated or held at ambient temperature) and dose (half or full dose) on the serological response to vaccination. It utilised a complete factorial design replicated on 18 smallholder cattle farms in three villages in Pursat province, Cambodia. Antibody responses from the 108 cattle involved were assessed by serological examination of blood samples collected at primary vaccination (day 0), at booster vaccination (day 30) and finally at 60 days post primary vaccination. Vaccination responses to the inactivated vaccine were assessed by testing for antibodies directed against FMD structural proteins in a liquid-phase blocking ELISA (LPBE test) and differentiated from responses to natural infection by examining antibody titres against non-structural viral proteins (NSPE test). LPBE results indicated that the mean log10 LPBE antibody titres of all experimental cattle increased from below protective levels at day 0 to protective levels at 30 days post primary vaccination, and increased further at 60 days post primary vaccination. Storage at ambient temperature for 1 week had no effect on antibody response to vaccination. However, freezing the vaccine for a week or use of a half dose resulted in significant reduction in titres at day 60 (P = 0.04 and P = 0.02, respectively). The results of this study reinforce the need to store FMD vaccines within the range recommended by the manufacturers and to adhere to the specified dosage instructions.

Epidemiology of foot and mouth disease in Karnataka state, India: a retrospective study

A retrospective study on the epidemiology of foot and- mouth disease (FMD) in Karnataka, India between the years 1977 and 2012-13 based on the data collected through passive and active surveillance was undertaken. A total of 11,159 outbreaks with 0.271 million cases of FMD were recorded from 30 different revenue districts of Karnataka. There was a significant difference between the years for the annual incidence of FMD (P = <0.001, F = 19.10) and also between the months (P = <0.001, F = 4.22). Cattle and buffaloes were the predominant species affected being involved in all of the outbreaks reported. A significant correlation was observed between livestock density and the number of outbreaks reported (r = 0.70, p < 0.02), and number of cases (r = 0.76, p < 0.01) for all the agro-climatic zones. The Central dry zone (n = 2257, 19.89 %) reported the highest number of outbreaks followed by the Northern dry zone (n = 1881, 16.58 %) and the Southern transition zone (n = 1761, 15.52 %), and attack rates were concentrated in the North/Northeastern/Central dry and transition zones. A large majority of the outbreaks were caused by serotype O (64.04 %), followed by Asia 1 (19.87 %) and A (12.27 %). Serotype C was not reported since 1993 in the state. In recent years, serotype O has dominated (82.59 %), with the rest of the outbreaks being almost equally caused by A (9.01 %) and Asia 1 (8.40 %). The study highlights the significance of the O serotype and cattle as the main indicator species in the epidemiology of FMD in Karnataka, India. The findings from this study can be used as baseline epidemiological data for further research to identify endemic and epidemic areas for the development of a sustainable programme for the progressive control of FMD in the state of Karnataka as well as other endemic settings.

A retrospective study on the epidemiology of anthrax, foot and mouth disease, haemorrhagic septicaemia, peste des petits ruminants and rabies in Bangladesh, 2010-2012

Anthrax, foot and mouth disease (FMD), haemorrhagic septicaemia (HS), peste des petits ruminants (PPR) and rabies are considered to be endemic in Bangladesh. This retrospective study was conducted to understand the geographic and seasonal distribution of these major infectious diseases in livestock based on data collected through passive surveillance from 1 January 2010 to 31 December 2012. Data analysis for this period revealed 5,937 cases of anthrax, 300,333 of FMD, 13,436 of HS, 247,783 of PPR and 14,085 cases of dog bite/rabies. While diseases were reported in almost every district of the country, the highest frequency of occurrence corresponded to the susceptible livestock population in the respective districts. There was no significant difference in the disease occurrences between districts bordering India/Myanmar and non-border districts (p>0.05). Significantly higher (p<0.01) numbers of anthrax (84.5%), FMD (88.3%), HS (84.9%) and dog bite/rabies (64.3%) cases were reported in cattle than any other species. PPR cases were reported mostly (94.8%) in goats with only isolated cases (5.2%) in sheep. The diseases occur throughout the year with peak numbers reported during June through September and lowest during December through April, with significant differences (p<0.01) between the months. The annual usages of vaccines for anthrax, FMD, HS and PPR were only 7.31%, 0.61%, 0.84% and 11.59% of the susceptible livestock population, respectively. Prophylactic vaccination against rabies was 21.16% of cases. There were significant differences (p<0.01) in the administration of anthrax, FMD and HS vaccines between border and non-border districts, but not PPR or rabies vaccines. We recommend that surveillance and reporting of these diseases need to be improved throughout the country. Furthermore, all suspected clinical cases should be confirmed by laboratory examination. The findings of this study can be used in the formulation of more effective disease management and control strategies, including appropriate vaccination policies in Bangladesh.

Outbreaks of foot-and-mouth disease in Peninsular Malaysia from 2001 to 2007

This is a retrospective study of the outbreaks of foot-and-mouth disease (FMD) in Peninsular Malaysia between 2001 and May 2007. In total, 270 outbreaks of FMD were recorded. Serotype O virus (89.95 %) and serotype A (7.7 %) had caused the outbreaks. Significant differences on the occurrence of FMD were found between the years (t = 5.73, P = 0.000, df = 11), months (t = 4.7, P = 0.000, df = 11), monsoon season (t = 2.63, P = 0.025, df = 10) and states (t = 4.84, P = 0.001, df = 10). A peak of outbreaks observed in 2003 could be due to increased animal movement and the other peak in 2006 could be due to a compromised FMD control activities due to activities on the eradication of highly pathogenic avian influenza. Cattle (86 % of outbreaks) suffered the most. However, no difference in disease occurrence between species was observed. The populations of cattle (r = 0.672, P = 0.023) and sheep (r = 0.678, P = 0.022) were significantly correlated with occurrence of FMD. Movement of animals (66 % of outbreaks) was the main source for outbreaks. A combination of control measures were implemented during outbreaks. In conclusion, the findings of this study show that FMD is endemic in Peninsular Malaysia, and information gained could be used to improve the existing control strategy.

Perspectives on Australian animal health aid projects in South-East Asia

Future food security poses many challenges and with increasing prosperity and demand for meat, the emerging but largely unregulated trade in livestock and their products from developing countries in South-East Asia and particularly the Mekong region, pose enormous risks of transboundary disease epidemics. However this is a challenge that should be met as substantial improvements in large ruminant production through appropriate knowledge-based interventions can potentially move the largely rural smallholder populations of Lao PDR and Cambodia from subsistence to a productivity focus, offering a new pathway for poverty alleviation. Large development projects have been implemented in the Mekong region to facilitate this process and research is needed to define problems, identify and test solutions, and then suggest the most appropriate delivery mechanisms for promulgating the interventions that are most sustainable. Animal health aid projects are needed to improve livestock productivity, minimize risk to trade and human health and enhance the capacities of countries where there are significant gaps in the provision of veterinary services. Improving large ruminant production, particularly through forages technology and infectious disease risk management including village-level biosecurity, provides a potential driver of foot and mouth disease (FMD) control and eventual eradication in the region. A perspective on issues involved in Australian aid projects addressing regional animal health research and development and a checklist of strategies to consider when designing and managing such projects is provided.

A retrospective study on the epidemiology of foot-and-mouth disease in Bhutan

A retrospective study on the outbreaks of foot-and-mouth disease (FMD) in Bhutan, between the years 1996 and 2008, based on the data collected through passive surveillance, was undertaken. A total of 230 outbreaks of FMD at sub-district level were recorded in 299 villages located in 19 out of the 20 districts in the country. There were no significant differences between the years (P = 0.998) or months (P = 0.989) on the incidence of FMD. The sub-districts in the north (altitude >1,000 m above mean sea level) had significantly (P = 0.008) higher incidences of outbreaks in winter than in summer. The sub-districts that shared border with India had significantly more outbreaks than those that didn't (P = 0.001). Cattle were the most predominant species affected being involved in all of the outbreaks reported. Serotype O, which constituted 70.6% of the outbreaks typed was the most predominant serotype prevalent in Bhutan followed by A (16.7%), Asia 1 (8.8%), and C (3.9%). Cattle density was significantly positively correlated (P = 0.023) with the incidence of disease. Three waves of outbreaks of epidemic proportions were reported in 1997/1998, 2002/2003, and 2007/2008 due to the PanAsia strain of the O serotype. The study highlights the incursion of the PanAsia strain of the O serotype into the country, possibly, through the transboundary movement of animals and the need for active surveillance of FMD, especially at the border areas. The study also highlights the significance of the O serotype and cattle as the main indicator species in the epidemiology of FMD in Bhutan. The findings from this study can be used as baseline epidemiological data for further research to understand the epidemiology of FMD in Bhutan.