An unintentional introduction of the foot-and-mouth disease (FMD) virus into the domestic livestock population in a U.S. state.
In the following table, note that the low and high likelihoods do not correspond to the low and high impacts. In addition, low and high impacts are not necessarily correlated with each other between different impact categories.
| Category | Description | Metric | Low | Best | High |
|---|---|---|---|---|---|
| Health and Safety | Fatalities | Number of Fatalities | 0 [1] | ||
| Injuries and Illnesses | Number of Injuries or Illnesses | ||||
| Economic | Direct Economic Loss | U.S. Dollars (2011) | $2.3 Billion | $15.2 Billion | $69.0 Billion |
| Social | Social Displacement [2] | People Displaced from Home 2+ Days | 0 | 1,000 | N/A [3] |
| Psychological | Psychological Distress | Qualitative Bins | See text | ||
| Environmental | Environmental Impact | Qualitative Bins [4] | Moderate [5] | ||
| Likelihood | Frequency of Events | Number of Events per Year [6] | 0.04 | 0.1 | 0.1 |
Foot and mouth disease (FMD) is one of the most devastating diseases affecting cloven-hoof animals such as cattle, swine, sheep and deer. The viral disease is highly contagious, with 7 types and more than 80 sub-types, and vaccination for one type does not confer immunity to the others. Additionally, the FMD virus can survive freezing temperatures but not temperatures above 50 degrees Celsius. [7] Thus far, a pan-viral vaccination that would protect against all types has not been developed. FMD is easily transmitted and spreads rapidly through respiration and through contact with milk, semen, blood, saliva and feces. Pigs are particularly efficient amplifiers of the disease as they shed large amounts of virus into the air, while cattle are highly susceptible to the airborne-transmitted virus, owing to the large lung capacity and high volumes of air these animals respire. The FMD virus remains viable for long periods of time in both animate and inanimate objects and can be spread by contact with:
While there are no significant human health implications of FMD, an outbreak of the disease can have important economic impacts. FMD is found in 60 percent of the world’s countries and is endemic in many countries in South America, Africa, Asia and the Middle East. The international community values products that come from FMD-free countries and typically restricts trade in FMD-susceptible products from endemic countries or those affected by an ongoing outbreak. The Office International des Epizooties (OIE), an intergovernmental organization comprised of 158 member countries, was established in 1924 to guarantee the sanitary safety of world trade by developing rules for international trade in animals and animal products. OIE classifies member countries, or zones within countries, as being FMD-free with or without vaccination; the U.S. currently does not vaccinate for FMD and maintains an FMD-free without vaccination status. When an outbreak of FMD occurs in an FMD-free without vaccination country, OIE standards require that country wait 3 months after the last reported case of FMD when a “stamping out” approach has been used for eradication to apply for reinstatement of FMD-free status. If vaccination is used in the eradication process, the country cannot apply for reinstatement of FMD-free status until 3 months after the last vaccinated animal is slaughtered, or 6 months if the animal(s) are vaccinated and not slaughtered. In all cases, serological surveillance evidence must be submitted to prove the disease has been eradicated.
Given the value placed on FMD-free status, a confirmed case of FMD in the U.S. would result in an immediate restriction of exports. The current control strategy (9 CFR 53.4 Destruction of Animals with FMD) in USDA Animal and Plant Health Inspection Service (APHIS) regulations to regain FMD-free status is to stamp out, or cull all infected and susceptible animals. [8] The APHIS Administrator has discretion to examine other options based on the size and/or extent of an outbreak.
For this scenario, a potential introduction of the disease in California is considered. Although limited to one state, a single case of FMD can be considered a national-level event with repercussions across the country.
Carpenter et al [9] studied epidemic and economic impacts of FMD virus spread and control using epidemic simulation and economic optimization models. The simulated index herd was a single 2,000 cow dairy herd located in California. Although the initial infection was presumed to come from an FMD infected feral swine, similar results would come from any single infected animal introduced to the herd. Disease spread was limited to California, but economic impacts, including international trade effects, were felt throughout the U.S. There were five separate index detection delays examined, ranging from 7 to 22 days, with 100 iterations each. This led to a median economic impact estimated at $2.3-$69.0 billion, depending on the number of days delay until detection of disease. The “Low” and “High” estimates on economic burden are extrapolated from these numbers. Similarly direct costs and indirect costs are calculated from these totals. The indirect costs may be significantly higher given the variability in the potential costs listed above. The best case estimate is based on a detection delay of 14 days. This number is extremely difficult to estimate since the actual time from infection to diagnosis is impossible to ascertain.
The direct economic impact of an FMD outbreak will come from an immediate reduction in lost international trade as well as disease control and eradication efforts, which include the cost of:
Indirect costs can include:
For the purposes of the SNRA, social displacement was defined as the number of people forced to leave home for a period of two days or longer. Note that there are limitations to this measure of social displacement, as the significant differences between temporary evacuations and permanent displacement due to property destruction are not captured.
Psychological impacts for the SNRA focus on significant distress and prolonged distress, which can encompass a variety of outcomes serious enough to impair daily role functioning and quality of life. An index for significant distress was created that reflected empirical findings that the scope and severity of an event is more important than the type of event. The equation for this index uses the fatalities, injuries, and displacement associated with an event as primary inputs; a factor elicited from subject matter experts weights the index for differing psychological impact based on the type of event, but as a secondary input. [13] The numerical outputs of this index formula were used to assign events to bins of a risk matrix for a semi-quantitative analysis of psychological risk in the SNRA.
The United States Environmental Protection Agency (EPA) convened an ad hoc group of environmental experts representing the fields of environmental science, ecological risk, toxicology, and disaster field operations management to estimate environmental impacts for this event. Estimates are based on the following assumptions:
In the event that an FMD outbreak does occur in the U.S., there are four possible strategies for control and eradication of FMD in domestic livestock in the event of an outbreak. Each is supported by critical activities that include surveillance, biosecurity, decontamination, epidemiological activities, movement control, and communication. These four strategies are recognized by the OIE in Article 8.5.47 of the Terrestrial Animal Health Code (2010): [15]
Many factors will be considered when determining whether a particular response strategy would be appropriate and advantageous. While no factor will independently dictate a response strategy, or a decision to employ emergency vaccination, there are many factors that will influence the decision of whether to vaccinate or not. Factors will include: [16]
Similar to estimating the economic implications, establishing the frequency of an occurrence of FMD is difficult. An outbreak of FMD has not occurred in the U.S. since 1929, so any estimate of frequency or impact can only be based on data from other countries where recent outbreaks have occurred, as well as estimates based on models from current U.S. industry information. The United States has experienced nine known outbreaks of FMD from its first occurrence in 1870 to its final eradication in 1929, indicating a low frequency estimate of approximately 0.04, or 9 events in 235 years in the U.S. [17], [18] The highest frequency of occurrence is an estimation based on the recent outbreaks during the previous decade in the United Kingdom, Japan and South Korea. DHS Office of Health Affairs experts estimate a high frequency of once per decade, or 0.1 in a given year. Since FMD is a highly communicable disease that is resilient and easily obtained, the SNRA project team selected 0.1 in a given year as the best estimate for this event.
While there is no historical data from the U.S. from which to estimate the cost of an FMD outbreak, there have been several outbreaks in other countries in the past decade which emphasize the severity of the impact. Examples of outbreaks include the following:
1. There are no significant human health implications resulting from a foot and mouth disease outbreak.
2. See discussion.
3. A high estimate was not determined.
4. The United States Environmental Protection Agency (EPA) convened an ad hoc group of environmental experts representing the fields of environmental science, ecological risk, toxicology, and disaster field operations management to estimate environmental impacts for this event. The comments and rankings presented in this Risk Summary Sheet have not undergone review by the EPA and only represent the opinions of the group. Estimates pertain to the potential for adverse effects on living organisms associated with pollution of the environment; they are grouped into high, moderate, low, and de minimus (none) categories.
5. Floods were given a best estimate of “Low.” Experts indicated that the impacts could be higher depending on the acreage required for disposal of infected carcasses. Additionally, there is some potential for contamination to spread into wild animal populations.
6. Estimates provided by subject matter experts from the Office of Health Affairs (OHA), DHS.
7. United States General Accounting Office, July 2002; Foot and Mouth Disease: To Protect U.S. Livestock, USDA Must Remain Vigilant and Resolve Outstanding Issues; GAO-02-808; at http://www.gao.gov/new.items/d02808.pdf (accessed 10 March 2013).
8. United States General Accounting Office, July 2002; Foot and Mouth Disease: To Protect U.S. Livestock, USDA Must Remain Vigilant and Resolve Outstanding Issues; GAO-02-808; at http://www.gao.gov/new.items/d02808.pdf (accessed 10 March 2013).
9. Carpenter, T.E. O’Brien, J.M. Hagerman, A.D. McCarl, B.A. Epidemic and economic impacts of delayed detection of foot-and-mouth disease: a case study of an outbreak in California. Journal of Veterinary Diagnostic Investigation, 23, 26-33 (2011); at http://www.ncbi.nlm.nih.gov/pubmed/21217024, http://vdi.sagepub.com/content/23/1/26.long (accessed 10 March 2013).
10. Hagerman, USDA Office of Economic Research Services, unpublished.
11. Farm animals removed for euthanization as part of control efforts are not included in the SNRA’s measure of social displacement.
12. START is a Department of Homeland Security University Center of Excellence that focuses on social and behavioral aspects of terrorism, natural disasters, and technological accidents, and the social, behavioral, cultural and economic factors influencing responses to and recovery from catastrophes.
13. A Significant Distress Index is calculated from these inputs using a formula proposed by subject matter experts consulted for the SNRA project: NSD = CEF × (5 Fat + Inj + ½ D), where NSD represents the number of persons significantly distressed, CEF is the expert assessed Event Familiarity Factor, Fat is the number of fatalities, Inj is the number of injuries and/or illnesses, and D is the number of persons displaced (Social Displacement). In words, this formula suggests that there are 5 significantly distressed persons for each life lost; 1 for each person injured; and 1 for each 2 people displaced.
This formula was constructed to reflect the empirical finding that the most severe stressor of a disaster is losing a loved one, followed by injury, followed by displacement. Uncertainty was captured by applying the index formula to the low, best, and high estimates of these three human impact metrics.
The Event Familiarity Factor is intended to capture the extent to which the event entails an ongoing threat with uncertainty regarding long term effects, is unfamiliar, or that people dread, exacerbating psychological impacts. This factor, ranging from 1.0 for familiar events to 1.3 for unfamiliar events, was provided by subject matter experts for each national-level event included in the SNRA: Animal Disease Outbreak was given a CEF of 1.0.
The numerical estimates calculated from this formula are reported in Appendix G. The semi-quantitative risk matrix is discussed in the Findings (Psychological Distress Risk).
14. The 2011 SNRA referred to impacts as ‘consequences’ because of prior usage in quantitative risk assessment (Kaplan and Garrick [1981, March], On the quantitative definition of risk: Risk Analysis 1(1) 11-32). Except where it will cause confusion, ‘impact’ is used synonymously in this document because of pre-existing connotations of the word ‘consequence’ within FEMA.
15. Foreign Animal Disease Preparedness & Response Plan (FAD PReP)/Foot-and-Mouth Disease Response Plan (The Red Book) USDA Animal and Plant Inspection Service (USDA-APHIS). Chapter 5, General FMD Response, November 2010 draft, at http://www.aphis.usda.gov/animal_health/acah/downloads/documents/FMD_Response_Plan_November_2010_FINAL.pdf; Chapter 4, FMD Response Goals and Strategy, updated (June 2012) draft citing 2011 OIE Terrestrial Animal Health Code, at http://www.aphis.usda.gov/animal_health/emergency_management/downloads/fmd_responseplan.pdf.
16. Ready Reference Guide to Foot and Mouth Disease (FMD) Response and Emergency Vaccination Strategies, USDA APHIS Veterinary Services, 7/27/2011; incorporated as section 4.4.1 (General Factors that Influence the Response Strategy) of Foreign Animal Disease Preparedness & Response Plan (FAD PReP)/Foot-and-Mouth Disease Response Plan (The Red Book) USDA Animal and Plant Inspection Service (USDA-APHIS), June 2010; at http://www.aphis.usda.gov/animal_health/emergency_management/downloads/fmd_responseplan.pdf.
17. Foot and Mouth Disease Factsheet. American College of Veterinary Pathologists, July 2012; at http://www.acvp.org/media/factsheet/FootMouth.cfm (accessed 10 March 2013).
18. Foot and Mouth Disease: A threat to U.S. agriculture. Congressional Research Service, RS-20890, April 16, 2001; at http://www.nationalaglawcenter.org/assets/crs/RS20890.pdf (accessed 10 March 2013).
19. Carpenter, T.E. O’Brien, J.M. Hagerman, A.D. McCarl, B.A. Epidemic and economic impacts of delayed detection of foot-and-mouth disease: a case study of an outbreak in California. Journal of Veterinary Diagnostic Investigation, 23, 26-33 (2011); at http://www.ncbi.nlm.nih.gov/pubmed/21217024, http://vdi.sagepub.com/content/23/1/26.long (accessed 10 March 2013).
20. ‘South Korea reports another FMD case’. Xinhua [China Radio International], April 20, 2011. At http://english.cri.cn/6966/2011/04/20/2821s633266.htm (accessed 10 March 2013).
21. APHIS Evaluation of the Foot and Mouth Disease Status of Japan. Veterinary Services, Animal and Plant Health Inspection Service, USDA, April 1, 2011. At http://www.r-calfusa.com/Animal_Health/110401APHISJapanFMDEvaluation.pdf (accessed 10 March 2013).