Risk assessment procedures frequently require quantitative data on the prevalence of the disease in question. Although most countries are members of the World Organization for Animal Health (OIE), the importance attached to foot-and-mouth disease (FMD) reporting or surveillance for infection varies enormously between infected countries. There is a general consensus that FMD outbreaks in endemic countries are greatly under-reported, to a degree related either to the economic or the political development level of the country. This exploratory study was first undertaken by FAO, but thereafter extended and reviewed by the working group on FMD risk co-ordinated by the European Food Safety Authority (EFSA). The paper attempts to overcome the lack of reporting through using expert opinion to extrapolate incidence indices from countries considered to have 'representative' levels of FMD. These were combined with livestock density distributions to provide maps of prevalence indices, which were found to be highest in China (pigs), India (cattle), the Near East (small ruminants) and the Sahel (small ruminants and cattle). Similar patterns were found when weighted expert rankings of a range of additional ranked disease parameters were also produced, and then combined with susceptible animal densities to produce a weighted multi-species density. Results suggest that the methods can provide useful information at both national and sub-national resolution, even for countries for which quantitative FMD data is currently unavailable: two of the regions identified provide little or no data on a regular basis to the OIE and therefore may be overlooked if the level of officially reported FMD is only used. As the estimated prevalences are based on recent disease history and expert opinion, they are most likely to be inaccurate where FMD incursions are infrequent as a result of the preventive measures and geographical and trade isolation. This study, therefore, highlights the need for specific detailed country risk assessments where livestock trade is under consideration. Validating the approach including ground truthing, will require collaboration between a number of agencies and institutions, in critical countries, particularly those with high disease burdens that share borders or trade livestock with currently FMD-free nations.
A wide range of infectious diseases may change their geographic range, seasonality and incidence due to climate change, but there is limited research exploring health vulnerabilities to climate change. In order to address this gap, pan-European vulnerability indices were developed for 2035 and 2055, based upon the definition vulnerability = impact/adaptive capacity. Future impacts were projected based upon changes in temperature and precipitation patterns, whilst adaptive capacity was developed from the results of a previous pan-European study. The results were plotted via ArcGISTM to EU regional (NUTS2) levels for 2035 and 2055 and ranked according to quintiles. The models demonstrate regional variations with respect to projected climate-related infectious disease challenges that they will face, and with respect to projected vulnerabilities after accounting for regional adaptive capacities. Regions with higher adaptive capacities, such as in Scandinavia and central Europe, will likely be better able to offset any climate change impacts and are thus generally less vulnerable than areas with lower adaptive capacities. The indices developed here provide public health planners with information to guide prioritisation of activities aimed at strengthening regional preparedness for the health impacts of climate change. There are, however, many limitations and uncertainties when modeling health vulnerabilities. To further advance the field, the importance of variables such as coping capacity and governance should be better accounted for, and there is the need to systematically collect and analyse the interlinkages between the numerous and ever-expanding environmental, socioeconomic, demographic and epidemiologic datasets so as to promote the public health capacity to detect, forecast, and prepare for the health threats due to climate change.
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