Lost in Translation: Assessing knowledge sources, exchange - Relu ...

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Lost in Translation: Assessing knowledge sources, exchange - Relu ...

Rural Economy and Land Use ProgrammeCentre for Rural EconomySchool of Agriculture, Food and Rural DevelopmentNewcastle UniversityNewcastle upon Tyne NE1 7RUTelephone: 0191 222 6903Fax: 0191 222 5411Email: relu@ncl.ac.ukwww.relu.ac.ukLost in Translation: Assessing knowledge sources,exchange and effectiveness in animal disease controlA Rural Economy and Land Use project investigating uncertaintyin animal disease management in order to help develop moreintegrated and effective strategies.Policy and Practice NotesNote No. 36March 2012The Rural Economy and Land Use Programme is a UK-wide research programmecarrying out interdisciplinary research on the multiple challenges facing rural areas.It is funded by the Economic and Social Research Council, the Biotechnology andBiological Sciences Research Council and the Natural Environment Research Council,with additional funding from the Scottish Government and the Department forEnvironment, Food and Rural Affairs.


Rural Economy and Land Use ProgrammeLost in Translation: Assessing knowledge sources, exchange and effectiveness in animal disease controlAnimal and zoonotic diseases cause major environmental,social, health and economic problems globally. If uncontainedthey have potentially devastating consequences for communities.Containment strategies vary in scale and scope, from planningand prevention policies through to critical outbreak responses.Quick and timely decisions are often required as new informationbecomes available, at every stage of disease containment, butsuch information is often compromised by uncertainty. An open,holistic, and interdisciplinary approach to relevant knowledgesources is called for.What do we mean by uncertainty?Uncertainty is present whenever knowledge andunderstanding are weak, unsettled or inadequate, butalso arises due to inherent (and often unpredictable)variability in systems and processes.— Uncertainties may range from those associated witha particular procedure or technology, through to therelationships within and between organisations concernedwith containing disease.— Knowledge may be lost in the process of translating it fromresearch into the practical implementation of diseasecontainment. This can lead to further uncertainty.Why is an interdisciplinaryapproach needed?An interdisciplinary approach to understanding theseissues is essential because:— While many of these uncertainties are linked to scientificapproaches, technologies and innovations, they are rarelyquantifiable and benefit from social science approachesto improve understanding.— Typical risk assessment and containment strategiesmay ignore the human dimension and social scienceknowledge, and yet what counts as a disease, its impactand the effectiveness of controls, are often inherentlysocio-technical judgements.— Learning from stakeholders is important, whether they arepolicy practitioners, scientists, farmers or veterinarians.Which diseases were investigated?Animal diseases vary greatly in their biologicalcharacteristics, risk to human health, scale of threat,degrees of urgency, and the challenges they pose forstrategies of containment.The research took a cross-disease approach using threecontrasting diseases:— Foot and Mouth Disease: A highly infectious diseasemainly affecting farm livestock. Causes a fever, followedby blisters and ulceration around the mouth and feet.Severe economic and societal consequences of outbreaks.— Avian Influenza: A viral disease of both wild and domesticbirds. Can cause risks to human health and significanteconomic losses. Potential for transformation into apandemic disease of humans is a great concern for worldhealth policy.— Cryptosporidiosis: Gastrointestinal disease in animalsand humans caused by ingestion of the water-borneparasite Cryptosporidium. Responsible for between3000–6000 human cases of illness per year in the UK.As evidence the researchers used secondary data from socialand natural science databases and combined these withinterviews and focus groups, as well as disease-specificworkshops with stakeholder groups.


Policy and Practice NotesNote No. 36 March 2012What are the different arenas ofaction in disease management?Prevention(Reducing the occurrence of animal disease)Anticipation(Predicting and preparing for disease outbreaks)Alleviation(Responding to disease occurrence)e.g. Constraining disease transmission within livestockpopulations or changing livestock management practicese.g. Experimental modelling of disease scenarios and thedesign and testing of contingency planning arrangementse.g. Procedures adopted to control and eradicate diseaseand manage the long-term repercussions of outbreaksHow does policy influencedisease management?The strategic level(Structures and processes that shape containment)The tactical level(Procedures and tools for decision making)The operational level(Practical contexts of disease containment)e.g. The use of legislation to mandate stakeholders to act ondisease risks, such as continuous sampling in the UK under the1999 Cryptosporidium Regulationse.g. Elaboration of criteria for intervening in disease outbreaks,such as the creation of surveillance protection zonese.g. The process of vaccinating birds or livestock or theimplementation of biosecurity measures at livestock marketsThe cycle of disease containment applied to Avian Influenza (Fish et al 2011)PreventionAnticipationAlleviationOperationallevelImplementationof measuresImportsmeasurese.g. veterinarychecks includinglaboratory testingUptake of farmlevel biosecuritye.g.covered/netted outdoorenclosuresEpidemiologicalmodellinge.g. spatiallyexplicit stochasticsimulation modelsContingencyplanningexercisese.g. ExerciseHawthornePassivesurveillancee.g. FarmervigilanceActivesurveillancee.g. Stratifiedsurvey, bloodsamples to detectantibodies to H5and H7 serotypesof low-path. AI;randomised flockswithin the poultryindustryData assimilatione.g. Rapid Analysisand Detection ofAnimal-relatedRisks SystemEstablishmentof protectionand surveillancezonese.g. Restrictionsimposed at least3km around anoutbreak pointCullinge.g. Firebreakculling of poultryVaccinationDuty of careto animalse.g. Livestockdisposal measuresWorkerprotection advicee.g. Advice onpersonal protectiveequipment; issuingof antiviral therapyTrauma andoutreache.g. Farm CrisisNetworkTactical levelShaping plansand approcachesApproaches toimport controle.g Designationof borderinspection postsand proceduresDomesticbiosecuritycampaignse.g. Give diseasethe boot campaignApproaches tocontingencyplanning andpreparednesse.g. Exotic animaldisease frameworkresponse planOptions forsampling andtesting(at different spatialscales andfrequencies)e.g. Nationalsurvey for Avianinfluenza virusesof subtypes H5and H7 indomestic poultrySlaughter andvaccinationprotocolse.g. Vaccinedelivery plansStrategic levelPolitical,economic,legal basis forinterventionImports policye.g. negotiation ofimport rules forthe UKAnimal healthpolicye.g. UK VeterinarysurveillancestrategyTransnationalinitiativese.g. FAO GlobalFramework for theControl ofTransboundaryAnimal DiseasesLegislativeprovisions(at different spatialscales) e.g. EU AIDirective 2005/94;Avian Influenza &Newcastle Disease(England andWales) Order 2003


Rural Economy and Land Use ProgrammeLost Managing Translation: E. coli O157 Assessing disease knowledge risk in the British sources, countryside exchange and effectiveness in animal disease controlWhat is are uncertain? the implications for policyand practice?and play/toddler groups, and explaining the consequencesof long term survival of E. coli O157 in the environment.A range of uncertainties may occur at different levels — Organisations such as the NFU can help to inform farmersof disease management. For example, in the case of who may underestimate the risk of disease to visitorsMeasures that combined the highest practicalityAvian Influenza:and children.with the highest effectiveness scored by scientists— Additional measures where further investigation andand farmers were:Strategic Tactical OperationalPriority given to disease * * May vary with reference research to is human/animal required include health removing by different organisations high-shedding— Washing hands with soap and water, particularly afterChanges regulation * Mainly in response E. coli to outbreaks O157 animals rather than from planned the food chain, vaccinating cattletouching farm animals and before eating food.Research & development * Lack of funding and for some carcass-cleaning.diseases— Cattle vaccination.Role of industry * * * Funding and innovation may only happen when legislation forces action— Removing farm animals from the proximity of privateAnimal & land management * * Some production For effective methods implementation, may conflict with mitigation the following measures should and biosecuritywater supplies.Stakeholder communities * * * May cause complexity be considered: in cross-agency working and collaborationDevelopment of new * * * May be too — costly Since and difficult the financial to integrate costs with of existing the disease practices (in excess of £7.2technologiesFor policymakers there are also areas to be addressed:million) are lower than the costs of effective interventionUse — Public of new health and existing authorities, the Food * Standards * * Agency Innovations such as vaccines, detection technologies and mathematicaltechnologies and local government need to put out clear messages modelling to maytherebring newis littleuncertaintiesincentive for organisations or enterprises toInternationalstakeholdersdifferences(open farms, owners * of private * water * suppliesRegulation and intervene, containment making strategies it may more hinder imperative management, for government particularly tofor transboundary take diseases a lead.etc) about the importance of hand washing after contactBehaviours * * * Behaviour of — communities In order to or be individuals effective difficult these to measures predict in contingency need to be planning appliedwith farm animals, ensuring meat products are cookedOutbreak response objectives * * Can vary, leading simultaneously to disproportionate by alleviation the relevant policies government agenciesproperly, providing information to parents of youngRole of individual * * * When key individuals and stakeholders leave an organisation have to there be may fully be involved. institutional memory losschildren, e.g. by articles in magazines, through schoolsWhat are the implications for policyand practice?— Policy makers should continue to take an interdisciplinaryapproach, combining economic and social as well astechnical perspectives.— Policy should aim to improve communicationbetween sectors (e.g. between the policy sector andthe livestock industry and between animal and humanhealth communities) especially regarding informationon uncertainties.— When designing regulation, policymakers should considerhow issues of scale (both within the UK and up toFurther EU/international information levels) can increase complexity.— The processes that drive the prioritisation of diseaseThe research management was carried by different out at the organisations universities needs of Aberdeen, to madeBangor more and transparent Manchester, in the order London to facilitate School of more Hygiene co-ordinated andTropical Medicine, RIVM (the Netherlands) and the AnimalHealth responses and Veterinary to disease Laboratories risks. Agency.Key contact: Dr Norval Strachan, University of Aberdeen,email: n.strachan@abdn.ac.ukProject Website: www.abdn.ac.uk/reluecoliprojectUseful resources:Further informationN.J.C. Strachan, C.J. Hunter, C.D.R. Jones, R.S. Wilson, S. Ethelberg, P. Cross,A.P. Williams, L. MacRitchie, O. Rotariu, D. Chadwick (2011) ‘Comparingpublic The research and technical has been assessments carried of out Escherichia at the universities coli O157 risk.’Philosophical of Lancaster Transactions and Liverpool. of the Royal Society, 366:1999-2009.C. Key D. R. contact: Jones, C. Professor Hunter, A. Louise P. Williams, Heathwaite, N. J. C. Centre Strachan for and Sustainable P. Cross Water‘Escherichia Management, coli Lancaster O157: comparing Environment disease Centre, awareness Lancaster of rural University residents andvisitors email: louise.heathwaite@lancaster.ac.ukin livestock farming areas’ Epidemiology and Infection. In Press.O. Project Rotariu Website: et al. Applying http://www.relulostintranslation.co.uk/risk assessment and spatial epidemiology toelucidate Useful resources: the Fish, of human R., Austin, E. coli Z., O157 Christley, infection. R., Haygarth, Epidemiology P.M., andInfection. Heathwaite, In A.L., Press. Latham, S., Medd, W., Mort, M., Oliver, D.M., Pickup, R.,Relu Wastling, Policy J.M., and Wynne, Practice B. Note (2011) 29, Uncertainties May 2011. The in the role governance of local government of animalin disease: managing interdisciplinary disease risk rural framework areas (http://www.relu.ac.uk/news/for analysis. Philosophicalpolicy%20and%20practice%20notes/Woods%20No.29/PPN%2029.pdf)Transactions of the Royal Society B 366, 2023–2034— A common understanding of existing uncertainties isneeded as a basis for collective and authoritative prioritiesfor managing disease. Currently, the perception andunderstanding of uncertainties vary dramatically betweendifferent stakeholders.— Institutional memory is important in the translation ofknowledge from science to policy. Expertise can be lostover time and mechanisms need to be put in place toaddress this across all scales, stages and levels ofdisease management.— Trust in ‘authorities’ needs to be enhanced in orderto improve uptake of regulations and policy change.P. Cross, Problematic D. Rigby and decisions G. Edwards-Jones. or policy Eliciting implementation expert opinion can on therelative create effectiveness a lack of and enthusiasm practicality for of new environmental legislation interventions or uptake toreduce human exposure to Escherichia coli O157. Epidemiology andInfection. of novel In Press. guidelines.Useful websites:Health Protection Scotlandhttp://www.hps.scot.nhs.uk/giz/e.coli0157.aspx?subjectid=18Health Protection Agency E. coli O157 Independent Investigation ReportJune 2010 www.griffininvestigation.org.uk/International Risk Governance Council http://www.irgc.org/UK Austin, E. coli Z., support Alcock, R.E., group Christley, (HUSH) R., www.ecoli-uk.com/home.phpHaygarth, P.M., Heathwaite, A.L., Latham,Welsh S., Mort, Assembly M., Oliver, Government D.M., Pickup, E. R., coli Wastling, Public Inquiry J.M., Wynne, B., (2012) Policy,http://wales.gov.uk/ecoliinquiry/?lang=enpractice and decision making for zoonotic disease management:Water and Cryptosporidium. Environment International 40, 70–78

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