Evaluating vaccination strategies to control foot-and-mouth disease: a country comparison study.

Vaccination is increasingly being recognised as a potential tool to supplement 'stamping out' for controlling foot-and-mouth disease (FMD) outbreaks in non-endemic countries. Infectious disease simulation models provide the opportunity to determine how vaccination might be used in the face of an FMD outbreak. Previously, consistent relative benefits of specific vaccination strategies across different FMD simulation modelling platforms have been demonstrated, using a UK FMD outbreak scenario. We extended this work to assess the relative effectiveness of selected vaccination strategies in five countries: Australia, New Zealand, the USA, the UK and Canada. A comparable, but not identical, FMD outbreak scenario was developed for each country with initial seeding of Pan Asia type O FMD virus into an area with a relatively high density of livestock farms. A series of vaccination strategies (in addition to stamping out (SO)) were selected to evaluate key areas of interest from a disease response perspective, including timing of vaccination, species considerations (e.g. vaccination of only those farms with cattle), risk area vaccination and resources available for vaccination. The study found that vaccination used with SO was effective in reducing epidemic size and duration in a severe outbreak situation. Early vaccination and unconstrained resources for vaccination consistently outperformed other strategies. Vaccination of only those farms with cattle produced comparable results, with some countries demonstrating that this could be as effective as all species vaccination. Restriction of vaccination to higher risk areas was less effective than other strategies. This study demonstrates consistency in the relative effectiveness of selected vaccination strategies under different outbreak start up conditions conditional on the assumption that each of the simulation models provide a realistic estimation of FMD virus spread. Preferred outbreak management approaches must however balance the principles identified in this study, working to clearly defined outbreak management objectives, while having a good understanding of logistic requirements and the socio-economic implications of different control measures.

Foot and mouth disease model verification and 'relative validation' through a formal model comparison.

Researchers from Australia, New Zealand, Canada and the United States collaborated to validate their foot and mouth disease models--AusSpread, InterSpread Plus and the North American Animal Disease Spread Model--in an effort to build confidence in their use as decision-support tools. The final stage of this project involved using the three models to simulate a number of disease outbreak scenarios, with data from the Republic of Ireland. The scenarios included an uncontrolled epidemic, and epidemics managed by combinations of stamping out and vaccination. The predicted numbers of infected premises, the duration of each epidemic, and the size of predicted outbreak areas were compared. Relative within-model between-scenario changes resulting from different control strategies or resource constraints in different scenarios were quantified and compared. Although there were differences between the models in absolute outcomes, between-scenario comparisons within each model were similar. In all three models, early use of ring vaccination resulted in the largest drop in number of infected premises compared with the standard stamping-out regimen. This consistency implies that the assumptions made by each of the three modelling teams were appropriate, which in turn serves to increase end-user confidence in predictions made by these models.