Dataset Information

Psychosocial effects of the 2001 UK foot and mouth disease epidemic in a rural population: qualitative diary based study.

ABSTRACT:

Objectives

To understand the health and social consequences of the 2001 foot and mouth disease epidemic for a rural population.

Design

Longitudinal qualitative analysis.

Setting

North Cumbria, the worst affected area in Britain.

Sample

Purposive sample of 54 respondents divided in six demographically balanced rural occupational and population groups.

Main outcome measures

3071 weekly diaries contributed over 18 months; 72 semistructured interviews (with the 54 diarists and 18 others); 12 group discussions with diarists

Results

The disease epidemic was a human tragedy, not just an animal one. Respondents' reports showed that life after the foot and mouth disease epidemic was accompanied by distress, feelings of bereavement, fear of a new disaster, loss of trust in authority and systems of control, and the undermining of the value of local knowledge. Distress was experienced across diverse groups well beyond the farming community. Many of these effects continued to feature in the diaries throughout the 18 month period.

Conclusions

The use of a rural citizens' panel allowed data capture from a wide spectrum of the rural population and showed that a greater number of workers and residents had traumatic experiences than has previously been reported. Recommendations for future disaster management include joint service reviews of what counts as a disaster, regular NHS and voluntary sector sharing of intelligence, debriefing and peer support for front line workers, increased community involvement in disposal site or disaster management, and wider, more flexible access to regeneration funding and rural health outreach work.

SUBMITTER: Mort M

PROVIDER: S-EPMC1289318 | biostudies-literature | 2005 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Psychosocial effects of the 2001 UK foot and mouth disease epidemic in a rural population: qualitative diary based study.

Mort Maggie M Convery Ian I Baxter Josephine J Bailey Cathy C

BMJ (Clinical research ed.) 20051007 7527

<h4>Objectives</h4>To understand the health and social consequences of the 2001 foot and mouth disease epidemic for a rural population.<h4>Design</h4>Longitudinal qualitative analysis.<h4>Setting</h4>North Cumbria, the worst affected area in Britain.<h4>Sample</h4>Purposive sample of 54 respondents divided in six demographically balanced rural occupational and population groups.<h4>Main outcome measures</h4>3071 weekly diaries contributed over 18 months; 72 semistructured interviews (with the 54 ...[more]

PMID: 16214809

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Project description:BackgroundHand, foot, and mouth disease (HFMD) is a common childhood illness caused by serotypes of the Enterovirus A species in the genus Enterovirus of the Picornaviridae family. The disease has had a substantial burden throughout East and Southeast Asia over the past 15 y. China reported 9 million cases of HFMD between 2008 and 2013, with the two serotypes Enterovirus A71 (EV-A71) and Coxsackievirus A16 (CV-A16) being responsible for the majority of these cases. Three recent phase 3 clinical trials showed that inactivated monovalent EV-A71 vaccines manufactured in China were highly efficacious against HFMD associated with EV-A71, but offered no protection against HFMD caused by CV-A16. To better inform vaccination policy, we used mathematical models to evaluate the effect of prospective vaccination against EV-A71-associated HFMD and the potential risk of serotype replacement by CV-A16. We also extended the model to address the co-circulation, and implications for vaccination, of additional non-EV-A71, non-CV-A16 serotypes of enterovirus.Methods and findingsWeekly reports of HFMD incidence from 31 provinces in Mainland China from 1 January 2009 to 31 December 2013 were used to fit multi-serotype time series susceptible-infected-recovered (TSIR) epidemic models. We obtained good model fit for the two-serotype TSIR with cross-protection, capturing the seasonality and geographic heterogeneity of province-level transmission, with strong correlation between the observed and simulated epidemic series. The national estimate of the basic reproduction number, R0, weighted by provincial population size, was 26.63 for EV-A71 (interquartile range [IQR]: 23.14, 30.40) and 27.13 for CV-A16 (IQR: 23.15, 31.34), with considerable variation between provinces (however, predictions about the overall impact of vaccination were robust to this variation). EV-A71 incidence was projected to decrease monotonically with higher coverage rates of EV-A71 vaccination. Across provinces, CV-A16 incidence in the post-EV-A71-vaccination period remained either comparable to or only slightly increased from levels prior to vaccination. The duration and strength of cross-protection following infection with EV-A71 or CV-A16 was estimated to be 9.95 wk (95% confidence interval [CI]: 3.31, 23.40) in 68% of the population (95% CI: 37%, 96%). Our predictions are limited by the necessarily short and under-sampled time series and the possible circulation of unidentified serotypes, but, nonetheless, sensitivity analyses indicate that our results are robust in predicting that the vaccine should drastically reduce incidence of EV-A71 without a substantial competitive release of CV-A16.ConclusionsThe ability of our models to capture the observed epidemic cycles suggests that herd immunity is driving the epidemic dynamics caused by the multiple serotypes of enterovirus. Our results predict that the EV-A71 and CV-A16 serotypes provide a temporary immunizing effect against each other. Achieving high coverage rates of EV-A71 vaccination would be necessary to eliminate the ongoing transmission of EV-A71, but serotype replacement by CV-A16 following EV-A71 vaccination is likely to be transient and minor compared to the corresponding reduction in the burden of EV-A71-associated HFMD. Therefore, a mass EV-A71 vaccination program of infants and young children should provide significant benefits in terms of a reduction in overall HFMD burden.

Dataset Information

Psychosocial effects of the 2001 UK foot and mouth disease epidemic in a rural population: qualitative diary based study.

Objectives

Design

Setting

Sample

Main outcome measures

Results

Conclusions

Publications

Psychosocial effects of the 2001 UK foot and mouth disease epidemic in a rural population: qualitative diary based study.

Similar Datasets

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