Strategies for the Global Eradication of Peste des Petits Ruminants: An Argument for the Use of Guerrilla Rather Than Trench Warfare

Abstract

Many historical disease eradication campaigns have been characterized by large-scale mobilization and long-term campaigns of mass vaccination. As the duration of a program increases, the total cost also increases, but the effectiveness and sustainability decrease, sometimes resulting in premature loss of stakeholder support, field team fatigue, and failure or major set-backs. In contrast to this trench warfare approach, this paper proposes an eradication strategy modeled on guerrilla tactics: use exceptionally good, locally relevant and timely intelligence; strike rapidly and effectively in small areas; achieve your goals; and keep moving. For peste des petits ruminants eradication, this means a shift away from long-term mass vaccination, focusing instead on addressing some of the challenges that have plagued previous eradication programs: ineffective surveillance and movement management. Recent developments in surveillance have shown that it is now feasible to capture information about almost all cases of disease, all movements and all control activities, from the entire population in real time. Developing powerful, effective and sustainable surveillance systems is an essential prerequisite for rapid, affordable PPR eradication. PPR can be rapidly eliminated from small populations by achieving very high levels of vaccination coverage for only a short period. The key challenge is then to prevent the re-introduction of disease as immunity wanes, and to respond rapidly and effectively in the case of further local outbreaks. A comprehensive understanding of movement patterns and their drivers will allow rapid progressive eradication to be implemented. The population can be divided into manageably small units, targeted sequentially for high-coverage short-duration vaccination, then moving to the next unit based on the distribution of disease and the direction of animal flow. This approach optimizes the use of available resources, and minimizes the challenge and disruption of managing retrograde movement from infected to uninfected areas. High levels of community engagement are required to achieve the quality of surveillance, movement management and rapid response necessary for success. Traditionally, long-term vaccination has been used to first eliminate the virus from a population, and then to protect it against re-introduction of the disease. Under the guerrilla strategy, continuous real-time information, not long-term vaccination, is the main tool for disease eradication.

Epidemiology and Cost of Peste des Petits Ruminants (PPR) Eradication in Small Ruminants in the United Arab Emirates—Disease Spread and Control Strategies Simulations

“…Cameron (2019) [ 19 ] found that a more sustainable option for PPR eradication could be adopting guerrilla tactics, where the primary weapon is information and understanding PPR. This tactic can be divided into four main phases—the foundation, planning, implementation and demonstration of global freedom.…”

Transboundary Animal Diseases, an Overview of 17 Diseases with Potential for Global Spread and Serious Consequences

“…For example, the benefit of the Pan-African Rinderpest Campaign, which had both regional and international support, was estimated to be up to 35,433,000 European currency units (ECU or XEU, later replaced by the Euro; approximately $43,000,000) [554]. In contrast to a disease with such obviously devastating impacts, it can be challenging to demonstrate the overall importance of eradicating diseases with low mortality or that primarily affect animals of lower individual value or that are relied on mainly by individuals in poverty-stricken regions [519,612]. Approaches that include participatory epidemiology and studies focusing on the impact on small stakeholders could help address these issues [3,271,652,653].…”

“…Factors that favored the eradication of Rinderpest such as one serotype, availability of a safe vaccine that confers long immunity, simple diagnostics, short infectious period, close contact required for transmission, no known significant wildlife reservoir or carrier state, and short virus survival in the environment, also apply for PPR [490,501]. Constraints to eradication include widespread distribution, high population turnover in small ruminants, low value of individual animals, and clinical disease that varies by species and breed [519]. Understanding farmer's KAP (knowledge, attitude and practice) towards infectious diseases and consideration of gender issues are important to efforts for limiting impact and spread of disease [520,521].…”

Peste des Petits Ruminants Risk Factors and Space-Time Clusters in Bangladesh

“…We identified 14 hotspots and high–high cluster districts: Joypurhat, Nawabganj, Naogaon, Rajshahi, Nator, Bogra (Rajshahi division), Faridpur, Madaripur (Dhaka division), Moulvibazar, Sylhet (Sylhet division), Noakhali, Chittagong, Feni and Bandarban (Chittagong division). In our resource-limited setting, the first step in control might be vaccinating high-risk animals in these hotspots and high–high clusters before winter and monsoon seasons ( 16 , 36 ).…”

“…Sub-district and district veterinary hospitals supply a limited amount of PPR vaccine, mostly only purchased by conscientious farmers; however, there are sporadic vaccination programs to create awareness among farmers. Knowledge on disease hotspots and risk factors will enable policy-makers to plan efficient control measures in Bangladesh ( 16 ), however such knowledge is lacking. In this study we aimed to identify PPR time-space clusters, determine risk factors and develop predictive PPR risk maps.…”