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1. Title, names and addresses of authors

Foot and mouth disease control strategies in North Africa and the Middle East – the current

situation

G. Yehia(1) , P. Primot(1)

(1) OIE Regional Representation for the Middle East PO Box 6220/268 Hazmieh Kfarshima -

Lebanon

2. Keywords

Foot and Mouth Disease – Middle East – North Africa – control – surveillance – sampling -

vaccination – strategy

3. Text

3.1. Introduction

Even if the situation in the Middle East and in North Africa is not strictly the same according

to each epidemiological specificities of both regions, FMD still one of the main constraints

affecting livestock production in this part of the world, remaining a significant drain on the

budgets of the national veterinary services of each country and on the livelihoods of livestock

owners across the region (1).

FMD is mostly endemic in all the Middle East and North Africa region (MENA) and despite

using modern and effective vaccines, periodic devastating epidemics occur, usually

originating from neighbouring regions - West Asia, East and West Africa (Sub Sahara area) -

and spreading rapidly across national and regional borders (1, 2, 3, 4).

The purpose of this paper is to draw up the present situation of the disease in the MENA,

underlining critical gaps in strategies adopted by regional countries for the control of the

disease and proposing actions to be implemented in order to improve this control, taking into

account sub regional areas and particularities of the region.

3.2. Particularities of the region

In almost MENA countries, large ruminant livestock resources are bred, providing livelihood

and employment to a high proportion of the population (1, 7). Geographically, this region is

characterised by extensive land border and much of the region is arid or semi arid, which

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drastically limits the potential availability of natural pasture (5, 6). Therefore transhumance

and animal movement, both for grazing or trade, between neighbouring countries are

important, notably in order to satisfy people needs during Muslim special events (Hajj and

Ramadan) (6, 7). Such fluidity has significant consequences for the spread of animal

diseases, FMD notably (6).

3.3. The current situation of FMD in the MENA

3.3.1. The current situation in the Middle East (3, 4)

FMD is endemic in all the Middle East and periodic devastating epidemics usually occur,

spreading rapidly across national and regional borders in the past few years.

The A Iran 05 topotype, belonging to the Asia topotype, is the predominant serotype A

lineage circulating in the Middle East. It has two different paths of evolution (S and NS

genome regions): the A22 sub-lineage as starting point and A/IRN/105, A-Iran-96, A-Iran-99

as evolutionary intermediates. In Turkey, in 2007, the new sub-lineages A-Iran-05ARD-07 and

A-Iran-05EZM-07 were observed and were predominant in this country. This strain is now

presented in most of the Middle Eastern countries and has reached since the beginning of

2009 Bahrain, Kuwait, Lebanon and Libya (Figure 1). The new epidemic sub-lineage

reported in the above countries and circulating recently in West Eurasia has been named as

A-Iran-05BAR-08

The A Egypt 06 has more than 90% identity with A/KEN/98, A/ETH/92 and A/KEN/05, and all

topotypes are closely related. Its introduction in Egypt from East Africa was probably made

through the trade in live cattle from Ethiopia (via sea-route). The A Egypt 09 identified

recently in Egypt is close related to A/EGY/06 (95.5% identity). This confirms the persistence

of African type A virus in Egypt, spread in 2006 and evolved until 2009.

The O PanAsia II, belonging to the ME-SA topotype, was first recorded in 2003 in India and

is now widely spread in all the Middle East (Figure 2). All viruses are closely related to each

other (with maximum 5% difference) and distinct from the earlier PanAsia lineage. Over the

period 2008-09, it has been reported in Turkey, Saudi Arabia, Kuwait, Iran, Bahrain, and

Pakistan.

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3.3.2. The current situation in North Africa(2)

In the North Africa region, FMD occurrence is more sporadic and cyclic, usually originating

from exogenous sources. This sub region is threatened by FMD strains circulating in Sub

Sahara and West Africa. Morocco, Algeria and Tunisia experienced their last outbreaks in

1999, with the occurrence of the O Maghreb, belonging to the topotype O WA. Serotype A

was also introduced in 2006 in Mauritania and serotype SAT 2 in Libya in 2003. The

occurrence of A Iran 05 recently in Libya is a critical event, threatening all of the west part of

the North Africa region.

3.4. Current strategies adopted to control the disease

All information reported in this paragraph were compiled from specific country

questionnaires set up in order to well prepare last FMD Round Tables, organized

respectively by the OIE – FAO Regional Animal Health from Tunis and Beirut, in North Africa

and in the Middle East (2, 4).

3.4.1. Laboratory and Sampling

All countries have a national official laboratory which performs FMD analyses, essentially

serological analyses using ELISA tests. Some laboratories in the region are able to work also

with live virus: Iran, Jordan, Syria, Turkey, Egypt and Morocco.

The OIE - FAO World Reference Laboratory (Pirbright) is the main reference laboratory

where sample from the region are sent. Sampling is rarely conducted by Middle Eastern

countries in order to perform virus isolation and strain characterisation (Figure 3).

3.4.2. Serosurveillance

Serosurveillance programmes are generally conducted on a non regular basis in most of

countries of the region, based on punctual serosurveys in order to assess FMD

seroprevalence in the concerned country.

Nevertheless, regular continuous serosurveillance programmes are implemented in some

countries, such as North African countries, Turkey and Iran, both with the support of

international agencies or institutions.

3.4.3. Vaccination

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FMD vaccination is conducted in most of MENA countries, either compulsory or on a

voluntary basis and generally free of charge. In North Africa, Morocco is an exception, having

stopped the vaccination in 2007. Different vaccines and suppliers are used in the MENA

region, principally from Europe, India and Russia. But some countries are also vaccine

producers (Egypt, Jordan, Iran, Turkey and Morocco, which produced vaccines from

imported concentrated antigen).

Vaccination strategies and vaccines strains used in this region are very heterogeneous

(Table 1, 2 and 3) and not usually matching the current circulating strains.

The vaccination is principally implemented on the cattle population, but in some countries

also on sheep and goats (Table 2).

The vaccination coverage is not satisfactory in most of the countries either vaccination is

implemented on a compulsory basis or on a voluntary one (Figures 4 and 5).

The control of vaccination efficacy is rarely implemented, only in North African countries and

in Egypt.

3.4.4. Emergency response

FMD is a mandatory notifiable disease in all countries, but only few ones have a National

Emergency Fund available for FMD emergency response. In the North Africa region zoning

could be implemented to restrict animal movement in case of emergency.

None country has an emergency antigen bank and an emergency stock of vaccine is

available only in very few countries. But, punctual agreement could be signed for vaccine

supplying in emergency situations.

3.4.5. Awareness programmes

All countries have awareness programmes on FMD, mainly focused on farmers by

implementing meetings, sometimes on a regular frequency, and training in some countries.

Awareness programmes mostly depends on current FMD country situation, activating

principally when the disease occur or may occur. Media awareness programmes are used

also in some countries.

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3.5. What could be done to control the disease? - Summary of the frame developed for

the Middle East – 5th FMD Round Table Beirut

During the 5th FMD Round Table held in Beirut Lebanon in April 2009, participants

discussed and adopted the outlines for a relevant programme in support of the OIE/ FAO

strategy for the global control of FMD (4).

The main objective of this programme is to increase and harmonise the level of FMD

surveillance and control in the Middle East region, including:

• Assessing current country strategies to manage the disease;

• Harmonisation between countries surveillance strategies, vaccine programs, vaccine

monitoring, animals and animal products movement control;

• Training technical staff to conduct appropriate prevention and control measures

against the disease;

• Implementing appropriate measures and methodologies in collaboration with

Reference Laboratories, to identify FMD strains circulating in the region and potential

introduction of others.

3.6. Conclusions

FMD is a main constraint of animal production in the MENA region. To control the disease in

the region, vaccination in large ruminants, sometimes also in small ruminants, is the common

strategy adopted. These vaccination programs are not harmonized between countries with

regularly a poor vaccine matching.

The lack of relevant and harmonized surveillance programmes with well trained staff, the lack

of early warning and rapid response systems in most countries of the region and the poor

level of transparency and collaboration between countries are important factors hampering

the well control of the disease.

The extensive land border in the region and the importance of transhumance and animal

movement between neighbouring countries, notably in order to satisfy people needs during

Muslim special events (Hajj and Ramadan) make the disease control even more difficult.

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Furthermore, some countries are not able to secure funding within their budgets for FMD

surveillance and control programs.

The MENA region is much more complex than other regions, regarding its geographical

location, at the crossing of three continents, and shall be recognized as a high risk area for

the spread of FMD virus to neighbouring regions, especially Europe.

The implementation of a harmonized and coordinated programmes to control the disease

according to each sub regional specificities, shall be a priority, position regularly wished by

Chief Veterinary Officers from this region.

The newly created OIE – FAO Regional Animal Health Centres, in Beirut and Tunis, under

the umbrella of Regional Steering Committees of the GF-TADs shall be the relevant

structures to carry such program in the frame of a global strategy.

4. Acknowledgements (if applicable)

The authors would like to thank staffs from the OIE – FAO Regional Animal Health Centre for

North Africa in Tunis and from the OIE – FAO Regional Animal Health Centre for the Middle

East in Beirut, for their assistance and support.

5. References

1. Aidaros H.A. (2002), Regional status and approaches for control and eradication of FMD

in the Middle East and North Africa - Rev.Sci.Tech.Off.Int.Epi; 21 (3) 451- 458. Available at:

http://www.rr-middleeast.oie.int/download/pdf/1.2%2520Aidaros%5B1%5D.pdf

2. Anonymous. FAO (2007), Report of the 4th FMD Round Table for the control of the

disease in North Africa, Rabat, October 2007. Available at:

http://www.fao.org/AG/AGAInfo/commissions/en/eufmd/event/2007/Rabat_BTOR.pdf

3. Anonymous. OIE-FAO (2007), Report of the 4th FMD Round Table for the control of the

disease in the Middle East, Amman, September 2007. Available at: http://www.rr-

middleeast.oie.int/download/pdf/4th%20round.pdf

4. Anonymous. OIE – FAO (2009), Report of the 5th FMD Round Table for the control of the

disease in the Middle East, Beirut, April 2009. Available at: http://www.rr-

middleeast.oie.int/viewpage.asp?id=492

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5. Bourn D. (2003), Livestock Dynamics in the Arabian Peninsula. A Regional Review of

National Livestock Resources and International Livestock Trade, FAO Report, Roma.

Available at: http://ergodd.zoo.ox.ac.uk/download/index.htm

6. Slingenbergh J. (2003), Clarifying diseases spread in the Eurasian Ruminant Street,

Report of the 35th Session of EUFMD, Rome, App.10. Available at

http://www.fao.org/AG/AGAInfo/commissions/en/documents/sess35/App10.pdf

7. Wint W. (2003) Ruminants, seasons and grazing in the Middle East. William Wint,

Environmental Research Group Oxford, United Kingdom, consultant, mars 2003, Rome.

Available at : http://ergodd.zoo.ox.ac.uk/download/index.htm

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6. Tables

FMD Vaccine Type Country Annual Frequency

Quadrivalent vaccine (O, A, SAT1 and SAT2) Sudan (2006) Once

Tetravalent vaccines (O, A, Asia 1 and SAT 2)

Kuwait 3 times

Qatar Once or twice

UAE Twice a year

Trivalent vaccines (O India 53/73, A Iran 96, Asia 1)

Syria Twice

Trivalent (O, A 22, Asia 1)

Bahrain Twice

Iran 3 times

Iraq Once

Lebanon Twice

Oman Once

PAT Twice

Turkey Twice

Bivalent vaccines (A and O Manisa)

Egypt Twice (fattening herds) or 3 times

(dairy cattle)

Jordan 3 times

Turkey Twice

Yemen Twice

Table 1: FMD vaccine used in the Middle East for cattle protection (type and annual

frequency) (4)

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FMD Vaccine Type – Sheep and Goats Country Annual Frequency

Tetravalent vaccines (O, A, Asia 1 and SAT 2) Qatar Once - twice

UAE Twice

Trivalent vaccines (O India 53/73, A Iran 96, Asia 1)

Syria Once

Trivalent (O, A 22, Asia 1)

Bahrain Twice

Iran Once

Oman Once

Bivalent (A and O Manisa) Turkey Once

Monovalent (O Manisa)

Iraq Once

Jordan Twice – 3 times

PAT Once - Twice

Table 2: FMD vaccine used in the Middle East for sheep and goats protection (type and

annual frequency) (4)

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Country Strategy Type of FMD

vaccine Annual

Frequency Vaccinated population

Morocco Stopped in 2007

Before Mandatory and free

Monovalent O North Africa

Once between Sept

to Dec

90

Tunisia Mandatory and free

Tetravalent O Manisa, O

Maghreb, A22, SAT 2

Once between Sept

to Dec

75

Algeria Mandatory and free Bivalent O

Manisa, A 22 once 70

Libya Depends on FMD situation

Around outbreaks

Tetravalent A, O, C, SAT 2

Table 3: FMD vaccines used in North Africa for cattle protection (2)

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7. Figures

Figure 1: Dispersion of A Iran 05 in the Middle East and North Africa (Copyright: A. Di Nardo

(WRL Pirbright – 5th FMD Regional Round Table for the Middle East – Beirut Lebanon – 7,8

April 2009) (4)

LLaattee

22000055

22000044

22000077

EEaarrllyy

22000066

LLaattee

22000066

LLaattee 22000088

&& 22000099

MMaarr

22000099

LLaattee

22000055--0099

22000033--0099

JJaann

22000099

22000077

SSuummmmeerr

22000077

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Figure 2: Dispersion of O PanAsia II strain in the Middle East (Copyright: A. Di Nardo (WRL

Pirbright – 5th FMD Regional Round Table for the Middle East – Beirut Lebanon – 7,8 April

2009) (4)

JJaann

22000077--0099

SSuummmmeerr

22000077 SSuummmmeerr

22000077 &&

22000088

JJaann

22000088

JJaann

22000077 &&

22000088

SSuummmmeerr

22000077 &&

22000088

LLaattee 22000066

EEaarrllyy--mmiidd 22000077

EEaarrllyy--mmiidd 22000066

&& 22000077,, 22000099

JJaann

22000077

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Figure 3: samples sent by Middle Eastern countries to the OIE – FAO Reference Laboratory

for virus isolation (2006 – 2007 – 2009) (4)

0

10

20

30

40

50

60

70

Bah

rain

Egy

ptIra

nIra

q

Jord

an

Kuw

ait

Leba

non

Om

anPAT

Qat

ar

Sud

an

Syr

ia

Turke

y

UAE

Yem

en

2006

2007

2008

14

0

10

20

30

40

50

60

70

80

90

Bahrain Iran Jordan Kuwait Lebanon Turkey

2006

2007

2008

Figure 4: Vaccination coverage on the cattle population from Middle Eastern countries where

FMD vaccination is compulsory (4)

15

0

10

20

30

40

50

60

70

80

90

Iraq Oman PAT Qatar

2006

2007

2008

Figure 5: Vaccination coverage on the cattle population from Middle Eastern countries where

FMD vaccination is implemented on a voluntary basis (4)