REPUBBLICA ITALIANA Regione Siciliana ASSESSORATO DELLA SALUTE Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico BRUCELLOSIS in Sicily: eradication program Bruxelles, 7-8 settembre 2010 SERVIZIO 9 SANITÁ VETERINARIA Dirigente: Dott. Pietro Schembri
Number and distribution of cattle and buffaloes at 31 of July 2010 ASP Cattle / Buffaloes Herds Animals AG 527 10.999 CL 227 8.716 CT 655 29.305 EN 1.473 55.836 ME 2.169 59.141 PA 2.491 80.103 RG 1.670 78.490 SR 918 36.746 TP 339 5.495 Total 10.469 364.831 Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Cattle and buffaloes herds and animals from 2003 to 2009 450.000 400.000 350.000 406.048 377.101 407.619 387.767 387.789 378.783 371.242 300.000 250.000 200.000 150.000 100.000 50.000 12.648 12.268 12.422 12.061 11.781 11.029 10.873 0 2003 2004 2005 2006 2007 2008 2009 N. Herds N. Animals Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Number and regional distribution of sheep and goats at 31 of July 2010 ASP SHEEP & GOATS Herds Animals AG 1.114 144.641 CL 504 86.489 CT 686 108.686 EN 1.218 139.380 ME 1.791 159.747 PA 2.254 216.443 RG 684 33.159 SR 470 34.946 TP 667 101.454 Total 9.388 1.024.945 Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Sheep & Goats herds and animals from 2003 to 2009 1.200.000 1.060.611 1.103.070 1.000.000 1.027.097 1.054.042 1.045.316 1.043.876 1.049.384 800.000 600.000 400.000 200.000 0 8.824 8.954 9.162 9.360 9.337 9.230 9.140 2003 2004 2005 2006 2007 2008 2009 N. Aziende N. Capi Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Historical Criticism a) Problems in animal identification b) No monitoring Brucellosis in Sicily c) Inadequate monitoring of animal movements (transhumance) d) High regional Prevalence and Incidence ( incompatible with eradication and monitoring of infection ) Year 2008: SANAN (from 2006 to 2008) e) High % of OBF & Vaccinated Herds (> 80% Sheep/Goats >88% Bovine) f) Testing intervals (in infected and OBF herds) g) Infection in localized herds and areas (19% of bovine herds and 36% of sheep and goat herds infected during the three years resulted positive for the three consecutive years) Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Brucellosis in Siciliy CRITICAL POINTS a) Problems in animal identification b) No monitoring c) Inadequate monitoring of animal movements (transhumance) COUNTER-MEASURES Electronic identification Implementation of SANAN (systematic monitoring of activities, periodic evaluation of field operations) Regulation and monitoring of transhumance (Regional guide lines, BDN-National data base, no exemptions, etc) d) Infection in localized herds and areas Problematic Herds and/or Areas Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Brucellosis in Sicily 2009: Contingency plan Basic activity: a) 100% monitoring of bovine and sheep and goat breeding herds; b) Strict respect for testing intervals in herds; c) Electronic identification: - of all heads in infected herds; - of all vaccinated heads; - of all heads in movement (transhumance); d) Implementazione of the Information System SANAN; e) Updating of National Database; Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Exceptional activity: a) Identification and management of problematic herds (among those wich every year had one or more positive heads for three consecutive years); b) Identification and management of the problematic areas (among those areas: - where the PH are more than 10% of all those present; - where is recorded a significant increase of incidence; - included in 25th percentile with high incidence c) Identification of infection cluster (epidemiological unit based on epidemiological, time and space indicators ) Collateral activity: Brucellosis in Sicily 2009: Contingency plan d) Implementation of grazing anagraph; e) Implementation of records of movement to and from grazing. Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
SHEEP AND GOATS BRUCELLOSIS Results of the eradication programme Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
TRENDS IN HERDS TESTING 9300 9200 9172 9169 N. FLOCKS 9100 9000 8900 8800 8927 8898 9017 8957 8998 8795 9061 8992 8700 8600 2005 2006 2007 2008 2009 YEAR N. herds under the programme N. tested herds
% TRENDS IN HERDS COVERAGE 100 98 96 2005 94 92 2006 2007 2008 2009 90 88 AG CL CT EN ME PA RG SR TP SICILY
% HERDS COVERAGE 100 99,5 99 98,5 98 97,5 97 96,5 2005 2006 2007 2008 2009 % HERDS COVERAGE
TRENDS IN ANIMALS TESTING 1000000 980000 960000 983061 978578 952067 951867 977289 966135 N. ANIMALS 940000 920000 900000 908546 904701 914924 894660 880000 860000 840000 2005 2006 2007 2008 2009 YEAR N. ANIMALS TO BE TESTED N. TESTED ANIMALS
TRENDS IN ANIMAL TESTING 100 98 96 94 92 90 2005 2006 2007 2008 2009 88 86 84 AG CL CT EN ME PA RG SR TP SICILY
% ANIMAL COVERAGE 100 99,5 99 98,5 98 97,5 97 96,5 2005 2006 2007 2008 2009
Sheep and goats brucellosis Territory Coverage 100,50% 100,00% 99,80% 99,68% 99,98% 99,97% 99,50% 99,00% 98,73% 99,17% 99,54% 99,58% 99,33% 99,24% 98,50% 98,00% 97,97% 97,79% 98,86% 97,50% 97,74% 97,00% 96,50% 2003 2004 2005 2006 2007 2008 2009 % tested herds % tested animals Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
% HERDS PREVALENCE (2005-2009) ASP 2005 2006 2007 2008 2009 AG 9,68 12,72 11,60 8,70 5,02 CL 23,65 24,65 20,22 19,61 17,54 CT 33,28 31,11 29,42 24,96 28,50 EN 18,73 14,10 17,81 17,88 24,04 ME 18,46 23,46 17,39 16,54 18,63 PA 6,93 5,33 4,58 2,67 3,58 RG 6,69 5,57 4,06 4,65 3,49 SR 20,43 11,66 8,96 5,24 6,67 TP 26,12 24,65 28,97 20,60 23,20 SICILY 15,37 15,18 14,15 11,96 13,19
% HERDS PREVALENCE (2005-2009) 35 30 25 20 15 10 5 0 AG CL CT EN ME PA RG SR TP SICILY 2005 2006 2007 2008 2009
HERDS PREVALENCE 18% 16% 14% 12% 10% 8% 6% 4% 2% 0% 2005 2006 2007 2008 2009
% HERDS INCIDENCE (2005 2009) ASP 2005 2006 2007 2008 2009 AG 4,48 3,59 4,13 4,22 2,94 CL 3,45 4,65 6,15 10,34 6,83 CT 8,36 6,35 2,9 13,13 21,65 EN 9,13 7,77 14,5 10,19 16,58 ME 9,04 7,19 8,66 9,72 11,37 PA 3,72 2,6 2,95 1,79 2,55 RG 2,34 1,8 0,97 2,24 0,46 SR 6,45 3,37 3,48 3,14 5,19 TP 4,79 4,24 6,01 6,72 9,83 SICILY 5,92 4,72 5,89 6,31 8,11
DISTRIBUTION OF HERDS INCIDENCE 25 20 15 % 10 5 0 AG CL CT EN ME PA RG SR TP SICILY 2005 2006 2007 2008 2009
HERDS INCIDENCE 9% 8% 7% 6% 5% 4% 3% 2% 1% 0% 2005 2006 2007 2008 2009
% ANIMAL PREVALENCE ASP 2005 2006 2007 2008 2009 AG 6,47 3,33 3,78 3,31 2,42 CL 14,03 6,47 5,44 4,09 4,51 CT 13,01 9,01 7,58 4,96 5,35 EN 8,19 3,98 4,68 5,55 4,72 ME 6,21 6,55 7,02 5,95 5,32 PA 3,21 1,71 1,18 0,69 0,93 RG 12,32 4,24 3,69 4,81 3,55 SR 12,18 4,33 2,68 1,67 2,56 TP 11,74 8,46 10,41 7,74 10,76 SICILY 7,90 4,88 4,86 4,07 4,11
ANIMAL PREVALENCE 14 12 10 8 6 4 2 0 AG CL CT EN ME PA RG SR TP SICILY 2005 2006 2007 2008 2009
ANIMAL PREVALENCE 9% 8% 7% 6% 5% 4% 3% 2% 1% 0% 2005 2006 2007 2008 2009
Sheep and Goats Brucellosis Prevalence - Incidence 20,00% 18,00% 17,83% 16,00% 15,62% 15,37% 14,00% 15,18% 14,15% 13,19% 12,00% 10,00% 8,00% 6,00% 4,00% 2,00% 8,96% 6,09% 7,36% 5,89% 7,90% 5,92% 4,88% 4,72% 5,89% 4,86% 11,96% 8,11% 6,31% 4,09% 4,11% Herds Prevalence Herds Incidence Animal Prevalence 0,00% 2003 2004 2005 2006 2007 2008 2009 Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
N. OF OBF AND VACCINATED HERDS 10000 9000 8000 7000 6000 5000 4000 3000 2000 1000 0 2005 2006 2007 2008 2009 N. Herds N. OBF & Vacc Herds
% DISTRIBUTION OF O.B.F. AND V. HERDS 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% AG CL CT EN ME PA RG SR TP 2005 2006 2007 2008 2009
Sheep and Goats Brucellosis % Vaccinated and OBF Herds 84,00% 82,00% 80,09% 80,92% 83,16% 80,00% 78,00% 76,53% 76,00% 74,00% 72,00% 70,53% 70,00% 68,00% 66,00% 64,00% 2005 2006 2007 2008 2009 Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Sheep and Goats Brucellosis Problematic Herds 1.000 900 921 800 700 695 600 500 400 300 200 100 0 257 191 181 153 161 111 109 88 70 48 65 47 31 30 19 27 8 20 A G CL CT EN ME PA RG SR TP Totali 30-set-2009 31-dic-2009 Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Sheep and Goats Brucellosis Problematic Herds 2009 30 of September 2009 n. 921 31 of December 2009 n. 695-226 = -24,54% Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
2008 Sheep and Goats Brucellosis Goals and results 2009: Contingency plan (introduced on July 3th 2009 started on september 1th 2009) Obiettivi Risultati P Herds I Herds P Animals % OBF & Vacc. Herds Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria N. Probl. Herds 11,96% 6,31% 4,07% 81% 921 P Herds I Herds P Animals % OBF & Vacc. Herds N. Probl. Herds >? -20% + (5) = 737 13,19% 8,11% 4,11% 83% 695 = -24,54%
Sheep and Goats Brucellosis Main target: Progressive Eradication Goals 2010-2012 2012 OBF & Vacc. Herds Probl. Herds 2010 90% (+1) -75% (+5) 2011 95% (+1) - 15% (+5)? 2012 98% (+1) - 10% (+5) Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Brucellosis in Sicily 2010 Cross analysis of informative system (BDN-SANAN) Veterinary activities a) Herd testing intervals (shortage of official veterinarians?) Herd Management b) Notifications of cattle rustling and/or loss c) Herd calving rate Comparison with epidemiological data related other diseases Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
cattle rustling and/or loss 20.000 18.000 16.000 14.000 12.000 10.000 8.000 Serie1 Serie2 Serie3 Serie4 Serie5 6.000 4.000 2.000 0 AG CL CT EN ME PA RG SR TP TOTALE
cattle rustling and/or loss 9,00% 8,00% 7,00% 6,00% 5,00% 4,00% 3,00% 2,00% 1,00% 0,00% AG CL CT EN ME PA RG SR TP TOTALE 2005 2006 2007 2008 2009
cattle rustling and/or loss 40,00% 35,00% 30,00% 25,00% 20,00% 15,00% 2005 2006 2007 2008 2009 10,00% 5,00% 0,00% AG CL CT EN ME PA RG SR TP
Herd calving rate (2007) ASP % AG 70,26 CL 115,00 CT 49,75 EN 42,07 ME 27,69 PA 66,24 RG 69,47 SR 60,71 TP 80,63 SICILY 53,14
Herd calving rate (2007) % NASCITE REGISTRATE IN BDN AL 31/12/2007 120% 115,0 0 % 100% 80% 60% 70,26% 49,75% 66,24% 69,47% 60,71% 80,63% 53,14% 40% 42,07% 27,69% 20% 0% AGRIGENTO CALTANISSETTA CATANIA ENNA M ESSINA PALERM O RAGUSA SIRACUSA TRAPANI SICILIA
Sheep and Goats Brucellosis Problematic Herds 2009 30 of September 2009 n. 921 31 of December 2009 n. 695-226 = -24,54% Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Bovine Brucellosis Problematic Herds 2009 30 of september 2009 n. 436 31 of december 2009 n. 207-229 = -52,52% Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
TB Outbreaks 2009 Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Anthrax: problem areas Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
LEUKOSIS: Outbreaks 2009 Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Brucellosis in Sicily Specific measures Primary: a) Improvement of monitoring: BEV Sicily (monthly) & three-monthly reports (activity indices) Involvement of General Directions b) Regional controls: On the effectiveness of field activities (health status, implementation of the information system); On auditing activities run by the provincial veterinary authorities on field activities Secondary: a) Technical training (valutazione collegiale, condivisione, etc..); b) Involvements of farmers c) Evaluetion of problematic herds (with or within health problems) Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Brucellosis in Sicily Evaluetion of problematic herds - with health problems - with no-health problems Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Brucellosis in Sicily Years 2011-2012 Remodeling of the contingency plan based on: a) New criticism arising from cross analysis of Information systems; b) New regional epidemiological situation; Diversification of operations according to local health level attained: Areas close to eradication (AG-RG-PA) Stamping Out Areas with non-compliant evolution (CT-EN-ME) Vaccination (?) Areas with intermediate evolution (CL-SR-TP) case by case assessment Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
BOVINE BRUCELLOSIS Results of the eradication programme Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
TRENDS IN HERDS TESTING 11400 11200 11232 11209 11131 11128 N. HERDS 11000 10800 10600 10926 10877 10610 10602 10567 10588 10400 10200 2005 2006 2007 2008 2009 YEAR N. HERDS UNDER THE PROGRAMME N. TESTED HERDS
% HERDS COVERAGE 100,00 99,90 99,80 99,70 99,60 99,50 99,40 99,30 2005 2006 2007 2008 2009
% TRENDS IN HERDS COVERAGE 100 90 80 70 60 50 40 2005 2006 2007 2008 2009 30 20 10 0 AG CL CT EN ME PA RG SR TP SICILY
TRENDS IN ANIMALS TESTING 320000 310000 312526 311010 300000 293598 293257 290000 280000 270000 276583 276538 270208 267703 278649 274657 260000 250000 240000 2005 2006 2007 2008 2009 N. ANIMALS TO BE TESTED N. TESTED ANIMALS
% ANIMAL COVERAGE 100,00 99,50 99,00 98,50 98,00 97,50 2005 2006 2007 2008 2009
% TRENDS IN ANIMAL TESTING 100 90 80 70 60 50 40 30 2005 2006 2007 2008 2009 20 10 0 AG CL CT EN ME PA RG SR TP SICILY
Bovine Brucellosis Territory Coverage 100,50% 100,00% 99,50% 99,68% 99,67% 99,85% 99,80% 99,88% 99,80% 99,98% 99,97% 99,87% 99,55% 99,59% 99,51% 99,00% 99,07% 98,50% 98,57% 98,00% 97,50% 2003 2004 2005 2006 2007 2008 2009 % tested herds % tested animals Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
% HERDS PREVALENCE (2005 2009) ASP 2005 2006 2007 2008 2009 AG 1,58 1,72 2,69 0,87 0,70 CL 4,29 9,89 7,09 5,06 3,88 CT 16,15 12,76 21,58 12,01 9,62 EN 23,06 12,03 16,14 9,17 9,75 ME 11,30 16,11 14,77 10,66 13,10 PA 5,67 4,04 4,53 2,28 2,73 RG 1,86 1,33 1,66 1,73 1,53 SR 7,19 7,62 8,49 8,90 10,40 TP 7,49 4,41 6,14 4,49 3,43 SICILY 9,47 8,06 9,28 6,12 6,72
% HERDS PREVALENCE 10% 9% 8% 7% 6% 5% 4% 3% 2% 1% 0% 2005 2006 2007 2008 2009 HERDS PREVALENCE
% HERDS PREVALENCE 25 20 15 10 2005 2006 2007 2008 2009 5 0 AG CL CT EN ME PA RG SR TP SICILY
% HERDS INCIDENCE ASP 2005 2006 2007 2008 2009 AG 1,26 0,31 1,58 0,17 0,53 CL 3,57 6,08 5,91 4,64 3,45 CT 6,81 4,08 5,5 7,45 7,99 EN 13,29 7,22 12,07 8,13 8,09 ME 9,04 8,29 12,54 8,65 10,83 PA 4,45 2,86 3,4 1,52 2,41 RG 1,02 0,93 1,3 1,25 1,34 SR 4,08 4,31 5,32 6,13 7,14 TP 1,5 1,47 3,8 2,88 3,43 SICILY 5,93 4,35 6,38 4,68 5,51
HERD INCIDENCE 7% 6% 5% 4% 3% 2% 1% 0% 2005 2006 2007 2008 2009
DISTRIBUTION OF HERD INCIDENCE 15 10 5 0 AG CL CT EN ME PA RG SR TP SICILY 2005 2006 2007 2008 2009
% ANIMAL PREVALENCE ASP 2005 2006 2007 2008 2009 AG 0,21 0,07 1,55 0,06 0,07 CL 1,36 0,86 0,59 0,43 0,21 CT 2,80 3,25 3,62 2,42 1,54 EN 4,14 2,43 3,96 2,00 2,58 ME 1,62 2,00 2,78 2,23 2,45 PA 1,16 0,85 0,75 0,53 0,58 RG 0,33 0,22 0,35 0,19 0,23 SR 1,62 1,48 1,68 2,62 2,13 TP 1,07 0,71 2,17 1,47 1,05 SICILY 1,83 1,48 1,96 1,37 1,31
ANIMAL PREVALENCE 3% 2% 2% 1% 1% 0% 2005 2006 2007 2008 2009
% ANIMAL PREVALENCE 5 4 3 2 1 0 AG CL CT EN M E PA RG SR TP SICILY 2005 2006 2007 2008 2009
Bovine Brucellosis Prevalence - Incidence 10,00% 9,00% 9,25% 9,37% 9,28% 8,00% 7,00% 6,00% 5,00% 4,00% 3,00% 2,00% 1,00% 0,00% 8,06% 7,17% 6,72% 6,12% 6,38% 5,18% 5,93% 5,51% 4,54% 4,68% 4,35% 1,66% 1,83% 1,96% 1,31% 1,47% 1,48% 1,37% 2003 2004 2005 2006 2007 2008 2009 Herds Prevalence Herds Incidence Animals Prevalence Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
N. OF OFFICIALLY FREE HERDS 12000 10000 8000 6000 4000 2000 0 2005 2006 2007 2008 2009 N. HERDS O. F. HERDS
PERCENTAGE DISTRIBUTION OF O. F. HERDS 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% AG CL CT EN ME PA RG SR TP SICILY 2005 2006 2007 2008 2009
Bovine Brucellosis % OBF Herds 92,00% 90,71% 90,00% 88,00% 86,79% 87,52% 86,00% 84,32% 84,00% 81,98% 82,00% 80,00% 78,00% 76,00% 2005 2006 2007 2008 2009 Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Bovine Brucellosis Problematic Herds 500 450 436 400 350 300 250 200 192 207 150 100 50 0 102 65 56 55 39 21 27 34 19 1 0 2 2 7 13 1 7 AG CL CT EN ME PA RG SR TP Totali 30-set-09 31-dic-09 Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Bovine Brucellosis Problematic Herds 2009 30 of september 2009 n. 436 31 of december 2009 n. 207-229 = -52,52% Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
Bovine Brucellosis Goals and results Situazione di partenza (2008) P Herds Piano Straordinario (2009) (emanato il 3 luglio 2009 avviato il 1 settembre 2009) Obiettivi Risultati I Herds P Animals % OBF & Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria Vacc. Herds N. Probl. Herds 6,12% 4,68% 1,37% 88% 436 P Herds I Herds P Animals % OBF & Vacc. Herds N. Probl. Herds >? -20% + (5) = 349 6,72% 5,51% 1,31% 91% 207 = -52,52%
Bovine Brucellosis Main target: Progressive Eradication Goals 2010-2012 2012 OBF & Vacc. Herds Probl. Herds 2010 94% (+1) -75% (+5) 2011 97% (+1) - 15% (+5)? 2012 99% (+1) - 10% (+5) Dipartimento Attività Sanitarie ed Osservatorio Epidemiologico Servizio 9 Sanità Veterinaria
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