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The Effectiveness of a Foot and Mouth Disease Outbreak Control Programme in Thailand 2008?2015: Case Studies and Lessons Learned.

ABSTRACT: Three Foot and Mouth Disease (FMD) outbreaks in northern Thailand that occurred during the implementation of the national FMD strategic plan in 2008?2015 are described to illustrate the lessons learned and to improve the prevention and control of future outbreaks. In 2008, during a FMD outbreak on a dairy farm, milk delivery was banned for 30 days. This was a part of movement management, a key strategy for FMD control in dairy farms in the area. In 2009, more than half the animals on a pig farm were affected by FMD. Animal quarantine and restricted animal movement played a key role in preventing the spread of FMD. In 2010, FMD infection was reported in a captive elephant. The suspected source of virus was a FMD-infected cow on the same premises. The infected elephant was moved to an elephant hospital that was located in a different province before the diagnosis was confirmed. FMD education was given to elephant veterinarians to promote FMD prevention and control strategies in this unique species. These three cases illustrate how differences in outbreak circumstances and species require the implementation of a variety of different FMD control and prevention measures. Control measures and responses should be customized in different outbreak situations.

SUBMITTER: Yano T

PROVIDER: S-EPMC6313864 | biostudies-other | 2018 Dec

REPOSITORIES: biostudies-other

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The Effectiveness of a Foot and Mouth Disease Outbreak Control Programme in Thailand 2008⁻2015: Case Studies and Lessons Learned.

Yano Terdsak T Premashthira Sith S Dejyong Tosapol T Tangtrongsup Sahatchai S Salman Mo D MD

Veterinary sciences 20181206 4

Three Foot and Mouth Disease (FMD) outbreaks in northern Thailand that occurred during the implementation of the national FMD strategic plan in 2008⁻2015 are described to illustrate the lessons learned and to improve the prevention and control of future outbreaks. In 2008, during a FMD outbreak on a dairy farm, milk delivery was banned for 30 days. This was a part of movement management, a key strategy for FMD control in dairy farms in the area. In 2009, more than half the animals on a pig farm ...[more]

PMID: 30563300

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Project description:BackgroundType 2 diabetes mellitus is preventable through lifestyle intervention. Diabetes prevention programmes (DPPs) aim to deliver prevention-based behaviour change interventions to reduce incidence. Such programmes vary from usual primary care in terms of where, how, and by whom they are delivered. Implementation is therefore likely to face new commissioning, incentive and delivery challenges. We report on the implementation of a national DPP in NHS England, and identify lessons learned in addressing the implementation challenges.MethodsIn 2017/18, we conducted 20 semi-structured telephone interviews covering 16 sampled case sites with the designated lead(s) responsible for local implementation of the programme. Interviews explored the process of implementation, including organisation of the programme, expectations and attitudes to the programme, funding, target populations and referral and clinical pathways. We drew on constant comparative methods to analyse the data and generate over-arching themes. We complemented our qualitative data with a survey focused on variation in the financial incentives used across sites to ensure usual primary care services recruited patients to new providers.ResultsWe identified five over-arching areas of learning for implementing this large-scale programme: 1) managing new providers; 2) promoting awareness of services; 3) recruiting patients; 4) incentive payments; and 5) mechanisms for sharing learning. In general, tensions appeared to be caused by a lack of clear roles/responsibilities between hierarchical actors, and lack of communication. Both local sites and the national NHS coordination team gained experience through learning by doing. Initial tensions with roles and expectations have been worked out during implementation.ConclusionsImplementing a national disease prevention programme is a major task, and one that will be increasingly faced by health systems globally as they aim to adjust to demand pressures. We provide practical learning opportunities for the wider uptake and sustainability of prevention programmes. Future implementers might wish to define clear responsibilities for each actor prior to implementation, ensure early engagement with new providers, offer mechanisms/forums for sharing learning, generate evidence and provide advice on incentive payments, and prioritise public and professional awareness of the programme.

Project description:Hand, foot, and mouth disease is a common childhood illness caused by enteroviruses. Increasingly, the disease has a substantial burden throughout east and southeast Asia. To better inform vaccine and other interventions, we characterised the epidemiology of hand, foot, and mouth disease in China on the basis of enhanced surveillance.We extracted epidemiological, clinical, and laboratory data from cases of hand, foot, and mouth disease reported to the Chinese Center for Disease Control and Prevention between Jan 1, 2008, and Dec 31, 2012. We then compiled climatic, geographical, and demographic information. All analyses were stratified by age, disease severity, laboratory confirmation status, and enterovirus serotype.The surveillance registry included 7,200,092 probable cases of hand, foot, and mouth disease (annual incidence, 1·2 per 1000 person-years from 2010-12), of which 267,942 (3·7%) were laboratory confirmed and 2457 (0·03%) were fatal. Incidence and mortality were highest in children aged 12-23 months (38·2 cases per 1000 person-years and 1·5 deaths per 100,000 person-years in 2012). Median duration from onset to diagnosis was 1·5 days (IQR 0·5-2·5) and median duration from onset to death was 3·5 days (2·5-4·5). The absolute number of patients with cardiopulmonary or neurological complications was 82,486 (case-severity rate 1·1%), and 2457 of 82486 patients with severe disease died (fatality rate 3·0%); 1617 of 1737 laboratory confirmed deaths (93%) were associated with enterovirus 71. Every year in June, hand, foot, and mouth disease peaked in north China, whereas southern China had semiannual outbreaks in May and September-October. Geographical differences in seasonal patterns were weakly associated with climate and demographic factors (variance explained 8-23% and 3-19%, respectively).This is the largest population-based study up to now of the epidemiology of hand, foot, and mouth disease. Future mitigation policies should take into account the heterogeneities of disease burden identified. Additional epidemiological and serological studies are warranted to elucidate the dynamics and immunity patterns of local hand, foot, and mouth disease and to optimise interventions.China-US Collaborative Program on Emerging and Re-emerging Infectious Diseases, WHO, The Li Ka Shing Oxford Global Health Programme and Wellcome Trust, Harvard Center for Communicable Disease Dynamics, and Health and Medical Research Fund, Government of Hong Kong Special Administrative Region.

Dataset Information

The Effectiveness of a Foot and Mouth Disease Outbreak Control Programme in Thailand 2008?2015: Case Studies and Lessons Learned.

Publications

The Effectiveness of a Foot and Mouth Disease Outbreak Control Programme in Thailand 2008⁻2015: Case Studies and Lessons Learned.

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