Ireland’s TB Ireland’s TB Eradication Eradication

PolicyPolicy

Margaret Good SSVIMargaret Good SSVI

TopicsTopics

History ProgrammeHistory Programme Recap (where we’ve been)Recap (where we’ve been)

Current programme (where we Current programme (where we are)are)

Future (where we are going)Future (where we are going)

RecapRecap Programme commenced 1950Programme commenced 1950 Herd and individual animal identification since Herd and individual animal identification since

thenthen Initial good progress before ‘stall’Initial good progress before ‘stall’ Many reviews essentially all expressing Many reviews essentially all expressing

incredulity that the programme that worked incredulity that the programme that worked elsewhere in Europe wasn’t working in Ireland – elsewhere in Europe wasn’t working in Ireland – the recommendations reflected the belief that it the recommendations reflected the belief that it must be that something involving the tuberculin must be that something involving the tuberculin test itself wasn’t being done right!!test itself wasn’t being done right!!

ERAD - establishedERAD - established

LESSONS LEARNEDLESSONS LEARNEDby ERAD & by ERAD & ConclusionsConclusions

All Programme Elements recommended by any ‘experts’ All Programme Elements recommended by any ‘experts’ have been tried and evaluated over the past eighteen have been tried and evaluated over the past eighteen years – and years – and many retained as cost effective control measuresmany retained as cost effective control measures Others have been quietly allowed to lapseOthers have been quietly allowed to lapse Measures determined ineffective will not be re-incorporated unless Measures determined ineffective will not be re-incorporated unless

the situation changes the situation changes

Most current Programme Elements have been optimisedMost current Programme Elements have been optimised

The requirement for a Lab based screening test is The requirement for a Lab based screening test is primarily socio-economic (not now seen as a constraint to primarily socio-economic (not now seen as a constraint to eradication)eradication)

Wildlife resevoir recognised as the primary remaining Wildlife resevoir recognised as the primary remaining constraint to progressconstraint to progress

Constraint to ProgressConstraint to ProgressPrimarily it would appear that the existence of Primarily it would appear that the existence of

an infected wildlife source in which infection an infected wildlife source in which infection with with M. bovisM. bovis is endemic and which share the is endemic and which share the environment with cattle is the main constraint environment with cattle is the main constraint to sustainable progress.to sustainable progress.

Evidenced by EOPEvidenced by EOP

and confirmed byand confirmed by

4-area study4-area study

0

1

2

3

4

5

6

0 1 2 3 4 5 6

Year

APT Offaly

Four Area

Realistic ExpectationsRealistic ExpectationsERAD ‘End of Term Review’ of Percieved ConstraintsERAD ‘End of Term Review’ of Percieved Constraints

1.1. Need for Comprehensive Computer Need for Comprehensive Computer Movement Control System Movement Control System √ √ CMMS √ √ CMMS However little or no apparent effect on disease controlHowever little or no apparent effect on disease control (tracing faster) (tracing faster)

2.2. Need for Lab based Diagnostic Test Need for Lab based Diagnostic Test √ γ- IFN√ γ- IFNNo change in primary use of Field Screening TestNo change in primary use of Field Screening Test

SICTT shown to work very effectively where wildlife removed and R SICTT shown to work very effectively where wildlife removed and R factor reduced below 1factor reduced below 1

3.3. Need for Vaccine to address the Wildlife Need for Vaccine to address the Wildlife Problem -> considerable investmentProblem -> considerable investmentSubstantive Progress being madeSubstantive Progress being made

Irelands StrategyIrelands Strategy• R & D R & D

• Address the Wildlife Constraint Address the Wildlife Constraint

• Improve efficacy of Bovine TB Eradication Improve efficacy of Bovine TB Eradication

• Operate lowest cost interim effective strategy Operate lowest cost interim effective strategy consistent with the goal of Eradicationconsistent with the goal of Eradication

• Use improved tools as they become available Use improved tools as they become available & thereby & thereby

• Accelerate the Eradication ProgrammeAccelerate the Eradication Programme

Badger Vaccination StrategyBadger Vaccination Strategy

• the development of a vaccine for use in badgers is a long term control measure aimed at the protection of badgers in known areas of high risk in which other control measures are also in place

the primary aim of a strategic vaccination programme is to limit the severity of tuberculosis in badgers so exposed so as to reduce the risk of infectivity for other animals, viz. badgers, deer and cattle

Tuberculosis in CattleTuberculosis in Cattle – outbreak investigation – outbreak investigation

ERAD TB ResearchERAD TB Research WildlifeWildlife

Contribution assessmentContribution assessment EOP & 4-Area study EOP & 4-Area study √√√√√√√√√√

Vaccine Development Project Vaccine Development Project √√√√√√ Badger Population and ecology studiesBadger Population and ecology studies√√√√√√

DiagnosticDiagnostic Blood testing – gIFN, ELISA, LPA, otherBlood testing – gIFN, ELISA, LPA, other√√√√ Strain typing Strain typing √√√√ Tuberculin Potency & Comparison TrialsTuberculin Potency & Comparison Trials√√√√√√√√

Epidemiology/Data AnalysisEpidemiology/Data Analysis CVERACVERA√√√√√√√√

OtherOther GeneticsGenetics√√ TB in other species Deer, Alpaca, SheepTB in other species Deer, Alpaca, Sheep√√√√

Routine Programme elementsRoutine Programme elements

Disease Detection –Disease Detection – Annual Test – SICCT all herds & all animals Annual Test – SICCT all herds & all animals Slaughter checks – under DAF controlSlaughter checks – under DAF control TracingTracing

Backward to identify source of infection Backward to identify source of infection && detect ‘Bought-in’ reactors detect ‘Bought-in’ reactors

Onward to identify other risk herds Onward to identify other risk herds Identified risk animals moved from infected Identified risk animals moved from infected herdsherds

Extra Diagnostics Extra Diagnostics = IFN-γ Assay, AnELISA= IFN-γ Assay, AnELISA

‘‘Quarantine’ Quarantine’ Confine & RemoveConfine & Remove

Restriction of herdRestriction of herd Isolation and removal Isolation and removal

of identified risk of identified risk animalsanimals

Removal co-ordinated Removal co-ordinated and arranged by DAFand arranged by DAF

Cleanse & Disinfect, Cleanse & Disinfect, as appropriateas appropriate

‘‘Treatment’ of Treatment’ of ‘infected’‘infected’ herd herdTesting programme – including Testing programme – including

supplementary tests as necessarysupplementary tests as necessaryEpidemiological investigation, as appropriateEpidemiological investigation, as appropriateAdvice to Keeper – Animal Health and Advice to Keeper – Animal Health and

Public HealthPublic HealthCompensation – individual animal ceiling Compensation – individual animal ceiling Seek to establish source(s) of infection & Seek to establish source(s) of infection &

Wildlife Investigation if implicatedWildlife Investigation if implicatedReturn to trade only in compliance with Return to trade only in compliance with

DirectiveDirective

Investigate close contact Investigate close contact risk herdsrisk herds

Targeted risk-based testingTargeted risk-based testing

forfor

Contiguous herd Contiguous herd

Associated herdsAssociated herds

~ 66% of reactors were disclosed in herds in

~ 30% of the agricultural land

WU Task = where badgers are confirmed as possibly a factor the local density will be reduced subject to two important constraints.

There is likely to be a higher cull in the 30% of the country where TB is consistently recurring in the cattle herds, than in the remaining 70% of the country (targeted intervention policy)

A minimum of 70% of the Jan 2004 estimated of the national population of badgers will be retained.

Tuberculosis in CattleTuberculosis in Cattle – Geographic Distribution – Geographic Distribution

In the years 1998 - 2000 ,

Implement system of QC on Implement system of QC on various aspects of programmevarious aspects of programme

ComputerisationComputerisationData CollectionData CollectionTuberculinTuberculinTest systems/proceduresTest systems/proceduresOperativesOperatives Identity & database (Tags/CMMS)Identity & database (Tags/CMMS)

Programme Evaluation Programme Evaluation Programme effectiveness Programme effectiveness Programme delivery/efficiencyProgramme delivery/efficiency

Doing the ‘right’ thingsDoing the ‘right’ things Are our original objectives still valid?Are our original objectives still valid? Is there any new/additional knowledge?Is there any new/additional knowledge? Are there new/additional tools?Are there new/additional tools? Are all the actions/activities still necessary – cost/benefit?Are all the actions/activities still necessary – cost/benefit? Can we achieve objectives in more efficient/effective ways?Can we achieve objectives in more efficient/effective ways? Is what we are doing going to deliver on our goals in the most Is what we are doing going to deliver on our goals in the most

efficient manner?efficient manner? Doing things ‘right’ Doing things ‘right’

Carrying out all determined functions in most efficient way?Carrying out all determined functions in most efficient way?

Value for Money AuditValue for Money Audit

Improved ToolsImproved Tools

Using GIS technology to focus resources Using GIS technology to focus resources according to riskaccording to risk

Using computer technology and linking Using computer technology and linking databases to manage programme databases to manage programme efficiently and gather data for further efficiently and gather data for further studies. studies.