FMD was first diagnosed in 1902 in meat animals imported from Hong Kong and over the years has been characterised by epidemics every 8-10 years. 0, A and C serotypes have all been incriminated over the years and pigs, cattle and carabao have all been involved in FMD outbreaks.
FMD is regarded as endemic on Luzon, the main island, with Mindanao, the southern most island, free for over 20 years and the Versayas reporting occasional isolated outbreaks associated with imports of livestock or products from Luzon.
Being an archipelago with over 7000 islands, sea transport between islands and from other parts of SE Asia has often been associated with the spread of FMD.
The Current epidemic commenced in 1995 and was centered in Luzon with 22 of the 29 provinces affected and over 100,000 clinical cases reported (probably underestimation). The epidemiological features of the current outbreak:
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The 1995 and 1996 figures grossly underestimate the true number of cases. This is because of the low level of awareness of FMD, the poor coordination between investigating agencies and inadequate records.
Since the overthrow of the Marcos regime, there has been a devolution of power to the provinces and the local government unit (LGU). This has affected agriculture resulting in up to 5 tiers of government starting with barangay (village) level to national level.
Nationally, animal health activities are co-ordinated by the Bureau of Animal Industries (BAI), a bureau with the Department of Agriculture (DA). The DA also has regional headquarters in each office (Regional DA) that implements agricultural policies at a regional level. Within the DA regions, which are made up of provinces, there is a provincial agricultural office headed by a Provincial Veterinarian. Finally at the municipality level, or city level, there are also veterinary offices.
The difficulty with this multi-layered level is that politically the levels of government may be quite opposed and activities are poorly co-ordinated.
At the height of the 1995 epidemic, the Philippine government requested assistance to help control the spread of FMD. AusAID committed around $6 million to a 3 year project centred in the Bikol peninsula, to use as a pilot area to eradicate FMD. It was hoped to use the lessons learned in the project to assist the full eradication of FMD from the Philippines, which is the long term aim of the Philippine government.
Management of the project was carried out by the United Nations' Food and Agriculture Organisation (FAO) who are interested in regional FMD approaches. The project commenced in December 1996
Two long term consultants were employed. A chief technical adviser based in Manila (Ray Webb) and a field officer based in Bikol. The CTA worked closely with the BAI to make sure national decisions in FMD control were consistent with the project activities.
Prior to the project commencement a national FMD control plan was formed based upon four key components:
The other essential requirement before the project started was to set up national and regional FMD Taskforces with membership by all the stakeholders involved.
The first step was to set up a functioning office within the Regional DA headquarters and equip that office.
The next step was to try and sort out "who did what" in terms of animal health and what lines of communication were used to co-ordinate activities. Because of the politicking of many of the public sector offices at all levels a certain amount of discretion was required to ensure positive outcomes. Getting the regional FMD Taskforce set up and functioning effectively was an early challenge.
FMD investigations can be initiated by any level — LGU, Provincial, Regional or National - but records of investigations were often not circulated hence records of FMD outbreaks varied according to whom you asked. Collating all records from all sources was also an important initial task.
a) Disease Investigation and Monitoring
A major factor limiting field activity was resources (transportation, phones and diagnostic equipment). Also lacking was training in disease investigation techniques and FMD recognition. The project response was to initiate wide scale training to all field staff (professional, lab, traders, advisory, field assistants etc). The level of training depended on the position. For vets — weeklong epidemiology courses were held. While for meat inspectors the focus was on disease recognition and sample taking.
The project also initiated uniform FMD investigation reporting forms and guidelines for collection storage and dispatch of laboratory specimens.
Transport infrastructure in the Bikol was quite unreliable making transportation of perishables difficult at times.
A later project initiative in the surveillance area was to initiate weekly reports of field activity from all field offices. These simple weekly forms just listed what barangays had been visited during the week and noted that no FMD cases had been seen in barangays that week. Negative surveillance data becomes very useful for international accreditation of zones for FMD freedom.
To assist with recording outbreak information the project for a FMD information management system called FMD IMS which has been widely used throughout the country and provides a framework for adding other diseases to provide a wide ranging animal health information system.
Bikol had two island provinces, which had been mostly unaffected during the current epidemic and as well was the gateway to the FMD free areas to the south. Enhanced port surveillance became important and the project financed construction of two quarantine facilities on the south to stop FMD spread south.
Other activities included training for inspectors and commissioning a new government act much like the Stock Diseases Act to provide legal protection for quarantine officers. It became aware that a number of other ports provided further risk and the project added other quarantine offices at several minor ports.
Also while the FMD epidemic in Central Luzon continued at a steady rate, outbreaks in Bikol slowed considerably and it was important to have a functioning checkpoint to stop spread of FMD from areas to the north down in Bikol.
Historically, vaccination programs had been poorly carried out with little strategic planning. Trivalent vaccine was used despite abundant evidence that only O serotype was involved in the FMD outbreaks. Also contract vaccinators had received little or no training and were giving vaccines subcutaneous instead of the recommended IM technique.
Project activities in this area included:
The aim of the targeted vaccination program was to halt ongoing outbreaks by providing a large number of immune individuals. The sero surveillance however indicated the level of herd immunity in the Bikol pig population to be very low due to a combination of faulty vaccine administration, incomplete vaccination courses and dubious vaccine storage.
The single biggest problem was that the highly mobile pig population made giving full vaccination courses difficult. However, despite the low level of herd immunity outbreaks did slow markedly so even a short period of immunity may be sufficient to halt outbreaks.
d) Public Education and Information Dissemination
The result of PEID activities was a high level of community awareness of the disease and how it is spread.
Controlling an infectious disease in the absence of herd identification systems and unregulated marketing is difficult and presents many hurdles requiring unique solutions. However, the basics of disease control and eradication are the same in every country and should not deter one from setting high standards and implementing proven programs and techniques that have been used successfully in other countries.
The philosophy of the project management was that initiatives by the project should enhance the long term capability of the Philippines animal health network.
So databases designed for FMD were constructed with a view to adding other disease to them (eg Rabies, hemorrhage septicaemia). Similarly training in epidemology although using FMD as a model, was designed to increase the capability of staff working in all animal health programs.
It is a tendency for projects to throw resources into project that provide short term benefits, often no long term benefit accrues though because of budgetary restraints. The project took particular care in resource placement to make sure that the recipients had ongoing budgetary support for both running costs and maintenance.