1. Development of a Successful Surveillance Model for Foot and Mouth Disease in Pakistan
M. Hussain, M. Afzal, E. Khan, J. Arshad, N. Panhwer and A. Ahmad
FAO, Pakistan Office, Islamabad

2. FMD Surveillance – Pre-project Scenario
FMD is a notifiable disease in Pakistan
Primarily reported through a passive surveillance system
Monthly report submitted by veterinary assistant / veterinarian to district livestock officer who collects the information and passes on to the Director Animal Health in each Province.
Each province sends a monthly report to the Animal Husbandry Commissioner (CVO) in the Federal Government
On an average outbreaks of FMD were reported annually
No national SOP existed to handle each FMD outbreak

3. Veterinary Service Infrastructure in Pakistan
Province / Region
Hospitals
Dispen-saries
Centres
Mobile Dispensa-ries
Diagnostic Labs
Punjab
523
1299
1782 98 36
Sindh
119 60
786 23 7
Khyber Pakhtunkhwa
115
511
576 8
Balochistan
116
783 - 12 15
Gilgit-Baltistan 21
167 27
Azad Jammu & Kashmir 59 66
129 5
FATA 31
246
472 4
Islamabad Capital 1
Total
988
3139
3772
141 82

4. Essential Elements of the FMD Surveillance Model
Awareness of farmers and other stakeholders
Capacity building of veterinary field staff
Provision of sample collection and dispatch kit to the field staff
Cover expenditure of sample collection and dispatch to the diagnostic lab
Reported outbreak is responded back with outbreak control activities
Report lab results to the field veterinary staff

6. Awareness Seminars for Farmers
Province / Area
Seminars #
Farmers trained #
Punjab 37
1070
Sindh 15
909
Khyber Pakhtunkhwa 36
2179
Balochistan 10
262
FATA
318
Gilgit – Baltistan 7
195
Azad Jammu & Kashmir 26
845
Islamabad 2 72
Total
143
5850

7. Capacity building of field staff
Province / Region
Workshops (#)
Vets trained (#)
Paravets trained (#)
Sample collection Kits provided (#)
Punjab 36
859
173
704
Sindh 17
452
133
395
Khyber Pakhtunkhwa 8
217 18
116
Balochistan 5
188 27
163
Gilgit-Baltistan 2 38 -  35
Azad Jammu & Kashmir 7
137 74
119
Federally Administered Tribal Areas 3 50 30
Islamabad 53 22
Total 80
1994
447
1615

8. Reported FMD Outbreaks (2012)
Province
Total FMD outbreaks
Outbreak (#) due to serotype
ELISA Negative Outbreaks O A
Asia-I
O+ Asia-I
O+A A+
Asia-1
Punjab
164 72 19 28 14 2 1 27
Sindh
686
394 51 97 21 8 4
111
Khyber Pakhtunkhwa
120 24 6 15 5 - 55
Balochistan 7 3
Gilgit- Baltistan
FATA
AJK 60 22 18
Islamabad 11
Total
1088
533
103
147 50
230

10. Reported FMD Outbreaks (2013)
Province
Total FMD outbreaks
Outbreaks (#) due to serotype
ELISA Negative Outbreaks O A
Asia-I
Mixed
Punjab
177 65 47 21 3 41
Sindh
2364
991
959 80 22
312
Khyber Pakhtunkhwa
171 61 44 2 17
Balochistan 42 15 - 1 23
Gilgit-Baltistan 7 5
FATA 18 11
AJK 89 31 25 28
Islamabad 6
Total
2874
1166
1091
110 48
459

12. Reported FMD Outbreaks (2014)
Province
Total FMD outbreaks
Outbreaks (#) due to serotype
ELISA Negative Outbreaks O A
Asia-I
Mixed
Punjab
417
291 37 19 2 68
Sindh
1168
679 92
115
111
171
Khyber Pakhtunkhwa
407
187 24 38
158
Balochistan
193
107 15 16 55
Gilgit-Baltistan 10 7 3
FATA 29 17 12
AJK
534
310 6 5
207
Islamabad 31 11
Total
2813
1629
188
196
119
681

14. Reported FMD Outbreaks (2015)
Province
Total FMD outbreaks
Outbreaks (#) due to serotype
ELISA Negative Outbreaks O A
Asia-I
Mixed
Punjab
202 74 39 33 - 56
Sindh
651
211
215 21
140 58
Khyber Pakhtunkhwa 7 16 9
Balochistan 37 11 19 1 6
Gilgit-Baltistan
FATA 3
AJK
100 30 31 2
Islamabad 23 12
Total
1055
339
325 77
141
167

16. Reported FMD Outbreaks (Jan-Mar 2016)
Province
Total Outbreaks
Serotype O
SerotypeA
SerotypeAsia-1
Mixed
ELISA Negative
Punjab
218 66 35 62 6 49
Sindh
241 52 50 71 10 58
Khyber Pakhtunkhwa 14 5 2 -
Balochistan 1 3
Gilgit-Baltistan
FATA
AJK 25 11
Islamabad 28 4 19
Total
531
136 94
162 16
123

18. Reported FMD Outbreaks (Apr-Jun 2016)
Province
Total Outbreaks O A
Asia-1
Mixed
ELISA Negative
Punjab 96 8 9 52 2 25
Sindh
184 48 39 51 44
Khyber Pakhtunkhwa 26 1 15 7
Balochistan 22  - -  11
Gilgit-Baltistan 3
FATA
AJK 14 4
Islamabad
Total
356 69 59
134 5 89

20. Conclusions
Surveillance model seems to be well suited for endemic settings
Application of surveillance model significantly improved FMD outbreak reporting in the country
The surveillance model assisted in determining the disease pattern as well as hot spots in the country
A Risk Based Control Strategy (RBCS) was developed. This strategy has been approved by the Government of Pakistan and a national program based on the strategy is under active consideration of the Government

21. Acknowledgements
Excellent support of all livestock departments particularly field veterinarians for the implementation of project activities
FMD-WRL UK for sub-typing and vaccine matching
PIADRC, New York for collaboration in genotyping and vaccine matching
Support of AHC Office and NVL
All stakeholders particularly livestock farmers
USDA for financial assistance

22. Thank you!