Data Handling in an Outbreak

Transcription

1 Data Handling in an Outbreak Emma Paul MA VetMB LLB (Hons) MRCVS Veterinary Adviser Veterinary Exotic Notifiable Diseases Unit (VENDU) Animal Health and Veterinary Laboratories Agency (AHVLA) London, United Kingdom With special thanks to Kate Sharpe, Ruth Moir and Helen Roberts, AHVLA

2 Data Handling in an Outbreak Collection, storage and analysis and distribution of data Data related to disease situation Data related to implementation of control measures Data related to regaining disease free status Experiences gained

3 Definitions What is meant by an outbreak? Exotic (not in this country) Notifiable (official rules governing the control) What is meant by data? Raw data...field visits, existing IT databases (populations, premises, movements etc), lab results Filtered/processed data...reports, maps, press releases, briefing notes to Ministers...EU, OIE reports, presentations... the same fundamental principles apply to any situation Pressure to control the disease Demands on... Databases sophisticated and simple systems... Staff 1... Time allowed to produce reports!

4 Raw Data... How to get information from here to here?

5 Raw Data... Huge amounts!! Data capture... Forms Databases Different sources...teams...organisations Keep it simple and consistent across different diseases Keep it as much in line with BAU business as usual

6 ...Procedures Suspicion stage AHVLA Government Vet No disease VENDU Head Office Government Vets Why get field vet to phone in each Investigation and every time?

7 ...Procedures Suspicion stage EXD1 Why results sent only to VENDU? CVO VENDU Head Office Government Vet Investigation

8 VENDU...3 vets...2 main roles Provision of Veterinary policy advice for exotic diseases Disease reporting function Oversee all exotic dx vet investigations Challenge and audit Ref lab liaison Interpret results on behalf of CVO 24/7/365...Procedures

9 ...Diseases covered in this way... Bluetongue Anthrax CBPP (& caprine) Aujeszky s Others where we control their Contagious agalactia Brucellosis use in Laboratories Foot and Mouth abortus, melitensis, Babesia (bovis,bigemina, Sheep/Goat Pox suis, ovis caballi) Lumpy Skin Disease Rabies Echinococcus (m& g) Pests des Petits Ruminants Vesicular Stomatitis Ehrlichia ruminatum Rift Valley Fever African Horse Sickness Heartwater Rinderpest Contagious Equine Metritis Hendra Warble Fly Dourine Histoplasma farciminosum Avian Influenza Equine Viral Arteritis New World screwworm Newcastle Disease Encephalomyelitis Nipah African Swine Fever (W, E, V, J... + ) PRRS 2 Classical Swine Fever Equine Infectious Anaemia Theileria (equi,parva,annulata) Swine Vesicular Disease Epizootic Lymphangitis Trypanosomosis (Teschen) Glanders & Farcy Epizootic Haemorrhagic Virus West Nile Virus Disease 40 Bat Lyssavirus plus...

10 Communicating details of the exotic disease investigations... Text alerts NDI1 Every stage

11 Number of Exotic Notifiable Disease Investigations by Year Year

12 Disease can t be ruled out and samples taken... Premises restricted, samples taken and submitted... VENDU have details from over the phone Lab report results directly and only to VENDU VENDU in liaison with CVOs and senior policy May be a case conference Or if worrying initial results then CVO may decide on calling an Amber Teleconference...VENDU, reference lab, epidemiologists, field lead, policy teams, communications team, cabinet office, (other government dept e.g. Health if zoonotic disease) CVO may decide to confirm disease...amber goes to a red teleconference UK Government moves to an agreed battle rhythm after confirmation of disease

13 Who Responds to an Animal Disease Outbreak? Chief Veterinary Officer Animal Welfare (CVO) Exotic Disease Policy Wider Stakeholder (Retail& Food) Livestock Export Policy Communications International Relations Finance Legal Disease Mitigation & Control Rural Procurement H&S Defra Policy HR Science Wildlife Contingency Planning Rapid Analysis & Detection of Animal Related Risk ( RADAR) (Maps) Finance National Experts Group Veterinary Exotic Notifiable Disease Unit (monitoring & reporting) HR Field Ops: Regional Operations Director AHVLA National Emergency Epidemiology Group (NEEG) Local Authorities Reference Labs OGD s Cabinet Office/CCS Health Protection Agency (HPA)/ Dept of Health (DoH) Food Standards Agency (FSA) Dept of Transport (DTR) Environment Agency (EA) Dept Communities Local Gov (DCLG) Association of Chief Police Officers (ACPO) National Animal Health & Welfare Panel (NAHWP) 13

14 Co-ordinating and control structures for disease response Strategic Ministers & Senior Officials Tactical National Disease Control Centre (NDCC) Including the Joint Coordination Centre (JCC) Operational Local Disease Control Centre & Forward Operations Base (LDCC) the field staff Affected Premises

15 National Disease Control Centre (London) Operations AHVLA Chief Executive CVO(UK) NDCC Policy Defra Director for Animal Health and Welfare: Disease Control Animal Welfare Rural Communities Policy Unit AHVLA Executive Team Director of Operations Outbreak Veterinary Director Exotic Diseases, Livestock & Movement Controls Sustainable & Competitive Farming Corporate Support Functions Finance Human Resources Operational Communications IT, GIS & Mapping Outbreak Coordination Vet & Tech Operations National Emergency Epidemiology Group (NEEG) Outbreak Co-ordination Centre Disease Reporting Team National Expert Group / Tactical Advisory Group Animal Health: Global Trade & Aquaculture Zoonoses & Surveillance Evidence: Economists & Social Science Sponsorship & Ecosystems Food Policy, Competitiveness & Growth Waste Strategy & Regulation Operations Manual Team Operational Partners Communications Legal (TSOL) Veterinary & Science Experts Stakeholders Finance Knowledge & Information Management, Data, Contingency Planning & Security Procurement Human Resources LDCC Local Operations Reference Laboratories Core Groups AHWBE Regional Policy Liaison Function

16 LDCC

17 Battle rhythm Central spine of three birdtable meetings per day, but flexible NDCC & LDCC have a battle rhythm/day Briefings, strategic stocktakes, COBR meetings all planned in advance at set times Other meetings fit around timings

18 Bird Tables

19 Defra Media Briefing Field Media briefing NDCC BT LDCC BT National Security Council - THRC LDCC/NDCC Teleconference Daily Comms meeting NDCC BT LDCC BT Daily Management meeting Daily Strategic Stocktake Good & Bad points pm Sit rep Battle Rhythm NDCC BT LDCC BT Industry Core Group National Security Council - THRC Animal Disease Policy Group National Experts Group

20 Raw Data...Forms Forms generic, simple (?!) EXD40 28 pages, 11 to be completed before confirmation Handwritten on farm needs to be scanned in or typed up

21 Raw Data...Forms Sample Submission EXD36 EXD37

22 Raw Data...Forms Clinical Cleansing Restriction and notice Inspection Valuation disinfection EXD1 Licence Form EXD44 Notices

23

24 Disease Confirmed... Zones restrictions communicate clearly Plan ahead extent of work required Known timescales find disease but also plan exit strategy Farming Industry like to know the not before dates Tracings out of zone, premises Surveillance work Heavy reliance on existing livestock databases

25 15 source systems/databases across the Delivery Network But, integration on this scale is difficult... different technology platforms, data formats & definitions, refresh rates etc. Rapid Analysis and Detection of Animal-related Risks Launched in National Equine Databas e (NED) Cattle Tracing System (CTS) Animal Movement s Licensing System (AMLS) Scottish Animal Movement s System (SAMS) VLA FarmFil e System MHS Abattoi r Syste m GB Poultr y Regist er Agricultur al Survey x3 (England, Scotland, Wales) AH Sam Syste m AH Vetnet System AH Disease Control Systems (FMD, CSF, AI) Custome r & Land Databas e (CLAD)

26 Why RADAR? In 2001, it took 10 days to produce this map of livestock premises: 4 days to write the code & extract the data from CTS 350k premises (& get extract from Vetnet 550k premises & Agricultural Survey 250k premises) 3 days to manually combine and deduplicate information 3 days to geo-reference the data using address cleansing software & manual look ups as necessary Resulting dataset was so large & technical capability so restricted, it was broken down into tiles limited analytical ability Still no movement information available, only estimates of livestock numbers

27 Taken 7 years to connect to the required data and write the correct algorithms CTS transformation algorithm 20million movement records every year. Each reported independently as a birth, death, on or off. RADAR matches on and off movements, imputes missing movements & creates a life history for each animal. From this it generates population counts, and derives additional information about each animal cattle breeds are converted in to breed purpose dairy, beef etc. Brown Swiss dairy Dexter dual breed Friesian dairy Hereford beef etc

28 RADAR realising the potential But locations are not just points they can be land parcels, postcodes, parishes, counties, gov offices, AH regions, countries, an outbreak zone or any other type of area you are interested in... Standard GIS packages - useful for visualisation, but limited analytical capability (esp large datasets remember 2001?) e.g. unable to combine land parcels & livestock info on national scale RADAR generates dissolved layers of land parcels with livestock data already combined for easy visualisation & interrogation in GIS The RADAR warehouse is also spatially enabled - allows users to analyse all RADAR data at any location level without using GIS you can even draw your own zone in GIS, upload it into RADAR and query the RADAR data against it immediately But, its not just zones we are interested in!

29 RADAR maps Mapping abattoir locations in relation to zones & IPs

30 RADAR who uses it? COBR, Ministers, Senior Managers & the Press All love maps! RADAR has been commended by the Cabinet Office as the only team in Whitehall which can provide an effective mapping response to COBR within 24hrs of an emergency Left: Taken from Guardian website in April 2006 at Right: Taken from BBC News website on 9 th April 2006 at tland/ stm

31 Epidemiologists... NDCC NEEG In NDCC HQ NEEG Executive Head of NEEG (AH) Head of field Epidemiology (AH) Head of CERA (VLA) FFG Head of VST Epidemiology Field Epidemiologist in NDCC (AH) Team leader: Project Management (CERA) Team leader: Analytical Epidemiology (FFG & VLA) LDCCs Field NEEG In LDCC Field Epidemiologists (AH with VLA VIOs) Project management & admin team (CERA, AH, FFG) Analytical Epi team (FFG & VLA/CERA) incl Modelling team, Duty Epi function and other specialisms as required

32 What NEEG delivers in outbreaks... Hypothesis generation to guide activities Assessment of risks and advice (eg transmission risk from manure) Co-ordinated national investigation Risk factors eg imports, integrated multi-site companies Priorities for epi investigation time periods, risk factors Co-ordinated field investigation Led by Field Epi Makes use of others NEEG in NDCC: overview, joining up with others (OEP) Written Outputs Within NEEG, eg timelines, risk factors, field and expert reports External, eg CVO brief, epidemiology reports, tracing priorities, surveillance strategy, risk assessment and management

33 Real life examples...

34 FMD 2007: The First Weekend FMD confirmed 3 August 07 (Friday) Beef finishing, 64 cattle 3 locations, No movements on, movements off only to slaughter 4.5 km from Pirbright laboratory complex Thame market, 21,000 sheep, 3 August By 6 August 07 (Monday) Virus typed as O1BFS Only present in FMD ref laboratories 51 PZ premises visited 19 reports, all negated except: Second case confirmed

35 September 2007 cluster August 2007 cluster 3 Aug: PZ and SZ established 2 IPs (IP1-IP2) Last case 6 August 24 Aug: PZs lifted 8 Sep: SZ lifted 12 Sept: PZ and SZ established 6 IPs (IP3 IP8) Last case 30 September 17 Oct: PZs lifted 5 Nov: SZ lifted

36 FMD August 2007 Protection Zones Premises Visited Work undertaken Slaughter of Infected Premises / Dangerous Contacts / Slaughter on Suspicion PZ Clinical Inspection of Pigs (Daily) PZ Clinical Inspections of Cattle (2 day cycle) PZ Clinical Inspections and Bleed in Sheep & Goats (2 day cycle for clinical and bled once at 95/5) 82 Samples Taken Species Sheep & Goats Number sampled 1,606

37 FMD August 2007 Surveillance Zone Premises Visited 372 Samples Taken Species Number sampled Work undertaken SZ Clinical Inspections of Cattle (1 final) SZ Clinical Inspection of Pigs (1 final) SZ Clinical Inspection of Camelids (1 final) SZ Sheep & Goat Bleed (1 final at 95/5) Sheep & Goats 4,161

38 FMD 2007: Spread Investigations, IP1 & 2 No evidence of further aerosol spread Met. modelling indicated plumes very unlikely Full surveillance of PZ and SZ as per Directive, plus All live movements out of PZ and SZ traced negative Increased, enforced biosecurity throughout PZ & SZ Premises at risk from water courses and flooded areas traced negative Sewage from Pirbright specified handling protocol Low susceptible population density + few movements Restrictions lifted 8 th September th September...

39 Detected 16 September by PZ serosurveillance 15/ 16 sheep sero+ve; 10 with old lesions No clinical signs but 17/ 22 cattle had 4-5 week old lesions All seropositive, virus negative. First evidence that clinical disease could be missed in cattle

40 FMD LDCC Protection Zone Surveillance Work Work undertaken Slaughter of Infected Premises / Dangerous Contacts / Slaughter on Suspicion PZ Clinical Inspection of Pigs (Daily) PZ Clinical Inspections of Cattle (2 days cycle) PZ Clinical Inspection & Bleed in Sheep & Goats (Weekly at 100%) Premises Visited 88 Species Samples taken Cattle 10, 778 Sheep 10, 455 Goats 323

41 Foot power... Stock Checks and Foot Patrols Completed 1km² Tiled Foot Patrolled Premises Stock Checks - to Verify No Stock FMD September Stock Checks and Foot Patrols

42 Fomite Spread? High risk vehicle movements from Pirbright

43 September cluster - Surveillance activities Surveillance Zone Council Directive (2003/85/EC) Additional Intensive Patrol Area (IPA) Enhanced Surveillance Areas (ESAs) Additional Assurance Areas (AAAs)

44 September cluster IPA and ESAs

45 FMD - September 2007 Enhance Surveillance Area (ESA) 9 September to 18 October ESA Area 1 3 Holdings with Cattle Number Sampled ESA1 57 1,777 ESA ESA3a 68 1,957 ESA3b 88 1,660 Work undertaken Cattle Sampling (at 100%) ESA4 Number of premises Cattle Sampled Sheep Sampled Goats Sampled Total Sampled ESA 1-4 Sampled

46 FMD - September 2007 Intensive Patrol Area (IPA) 30 Sept IP8, beef suckler herd 30 Sep detected during intensive PZ surveillance PCR used to detect pre-clinical stage (e.o.d sampling) Number of holdings with Cattle Total Number of cattle sampled 8 1,900 Work undertaken Daily Clinical Inspection / Examination of Cattle. Cattle Sampling (every two days at 100%)

47 September cluster - Additional Assurance Areas 47

48 FMD - September 2007 Additional Assurance (AA) Surveillance Area 16 October 2 November Work undertaken Cattle Sampling (at 100%) AA Area 1 4 Holdings with Cattle Number of Sample Taken AA AA AA3 60 2,021 AA Total 2,621

49 Total number of PZ/SZ blood samples

50 FMD Epidemiology (timeline) PS IP1 IP2 IP4 IP5 IP7 IP6B IP3 IP8B Day of outbreak Day of outbreak Date Day Spread window for PS Source window for IP1A Day 0 IP1A Spread window for IP1A Source window for IP2 Day 0 IP2 Spread window for IP2 Source window for IP4B Day 0 IP4B Spread window for IP4B Source window for IP4B Day 0 IP4B Spread window for IP4B 12/07 Thu 13/07 Fri 14/07 Sat 15/07 Sun 16/07 Mon 17/07 Tue 18/07 Wed 19/07 Thu 20/07 Fri 21/07 Sat 22/07 Sun 23/07 Mon 24/07 Tue 25/07 Wed 26/07 Thu 27/07 Fri 28/07 Sat 29/07 Sun 30/07 Mon 31/07 Tue Source window for IP3B * Day 0 IP3B Spread window for IP3B Source window for IP3C Day 0 IP3C Spread window for IP3C Source window for IP6B Day 0 IP6B Spread window for IP6B Source window for IP7 Day 0 IP7 Spread window for IP7 Source window for IP8B Day 0 IP8B Spread window for IP8B 01/08 Wed 02/08 Thu 03/08 Fri 04/08 Sat 05/08 Sun 06/08 Mon 07/08 Tue 08/08 Wed 09/08 Thu 10/08 Fri 11/08 Sat 12/08 Sun 13/08 Mon 14/08 Tue 15/08 Wed 16/08 Thu 17/08 Fri 18/08 Sat 19/08 Sun 20/08 Mon 21/08 Tue 22/08 Wed Day of outbreak Day of outbreak Date Day Unlikely based on Pirbright evidence 12/07 Thu 13/07 Fri 14/07 Sat 15/07 Sun 16/07 Mon IP1A most likely source window 16/07 to 24/07 17/07 Tue 18/07 Wed 19/07 Thu IP2 most likely source window 17/07 to 29/07 20/07 Fri 21/07 Sat 22/07 Sun 23/07 Mon 24/07 Tue 25/07 Wed 26/07 Thu Pirbright site most likely spread window 25/07 to 05/08 IP1A day 0 27/07 Fri IP1A most likely spread window 25/07 to 05/08 28/07 Sat 29/07 Sun 30/07 Mon IP2 day 0 IP2 most likely spread window 30/07 to 09/08 31/07 Tue 01/08 Wed IP5 most likely source window 30/07 to 11/08 02/08 Thu 03/08 Fri 04/08 Sat 05/08 Sun 06/08 Mon 07/08 Tue 08/08 Wed 09/08 Thu 10/08 Fri KEY - range of uncertainty in age of lesions - most likely source window * Note: On IP3B, 28 out of 29 cattle found to be negative on serology. Therefore, expert opinion confirms that lesions ages must be five days or less. - range of uncertainty in source window - most likely day zero date Note: Expert opinion on IP7 confirms age of lesions at 5 days - range of uncertainty in spread window - most likely spread window PS = Pirbright site 11/08 Sat 12/08 Sun 13/08 Mon IP5 day 0 14/08 Tue 15/08 Wed 16/08 Thu 17/08 Fri 18/08 Sat 19/08 Sun 20/08 Mon 21/08 Tue 22/08 Wed 23/08 Thu 24/08 Fri 25/08 Sat 26/08 Sun IP4B most likely source window 20/08 to 01/09 23/08 Thu 24/08 Fri 25/08 Sat 26/08 Sun 27/08 Mon 27/08 Mon 28/08 Tue 28/08 Tue 29/08 Wed 29/08 30/08 Thu 30/08 31/08 Fri 31/08 01/09 Sat IP5 most likely spread window 12/08 to 21/09 IP3B most likely source window 24/08 to 05/09 Wed Thu Fri 01/09 Sat 02/09 Sun 02/09 Sun 03/09 Mon IP4B day 0 IP3C source window 26/08 to 07/09 03/09 Mon 04/09 Tue 04/09 Tue 05/09 Wed 05/09 * 06/09 Thu 06/09 * 07/09 Fri 07/09 08/09 Sat IP4B most likely spread window 02/09 to 15/09 Wed Thu 08/09 09/09 Sun 09/09 10/09 Mon IP3B Day 0 IP3B most likely spread window Fri Sat 06/09 to 14/09 10/09 11/09 Tue 11/09 12/09 Wed IP3C Day 0 IP3C most likely spread window IP6B source window 03/09 to 15/09 Sun Mon 08/09 to 16/09 IP7 source window 05/09 to 17/09 Tue 12/09 Wed 13/09 Thu 13/09 Thu 14/09 Fri 14/09 Fri 15/09 Sat 15/09 Sat 16/09 Sun 16/09 17/09 Mon 17/09 18/09 Tue 18/09 19/09 Wed IP6B Day 0 IP6B most likely spread window Sun Mon Tue 16/09 to 23/09 19/09 Wed 20/09 Thu 20/09 Thu 21/09 Fri IP 7 Day 0 IP7 most likely spread window 18/09 to 25/09 IP8 source window 12/09 to 24/09 21/09 Fri 22/09 Sat 22/09 Sat 23/09 Sun 23/09 Sun 24/09 Mon 24/09 Mon 25/09 Tue 25/09 Tue 26/09 Wed 26/09 Wed 27/09 Thu 27/09 Thu 28/09 Fri IP 8 Day 0 IP8 most likely spread window 25/09 to 01/10 28/09 Fri 29/09 Sat 29/09 Sat 30/09 Sun 30/09 Sun 01/10 Mon 01/10 Mon Date Day Spread window for PS Source window for IP1 Day 0 IP1 Spread window for IP1 Source window for IP2 Day 0 IP2 Spread window for IP2 Source window for IP4B Day 0 IP4B Spread window for IP4B Source window for IP4B Day 0 IP4B Spread window for IP4B Source window for IP3B Day 0 IP3B Spread window for IP3B Source window for IP3C Day 0 IP3C Spread window for IP3C Source window for IP6B Day 0 IP6B Spread window for IP6B Source window for IP7 Day 0 IP7 Spread window for IP7 Source window for IP8B Day 0 IP8B Spread window for IP8B Date Day IP 1 IP 2 IP 5 IP 4 IP 3 IP8B IP7 IP6B PS

51 Tracings (Sept. cluster) Be careful about the phrasing of situation report questions!

52 Other data used for freedom evidence... Abattoir surveillance 360 abattoirs Additional checks Total numbers animals slaughtered in GB (30 July 28 October) Sheep Goats Cattle Pigs Deer TOTAL 3,741,760 1, ,984 1,968,128 19,378 6,261,109

53 ...Clinical Inspections at welfare visits...pre-movement licensing inspections of pigs 952 Certificates 1,892,195 animals

54 FMD freedom - Additional sampling within 150 km of Pirbright 95% confidence of detecting 1% prevalence of sheep flocks and beef cattle herds = 307 herds km = km = km = km = 154

55 It can also analyse Individual Animal life histories... RADAR again...analysis of movement data enabled UK to negotiate reduction in nation-wide intra-community trade ban Direct Moves useful for diseases which spread fast e.g. FMD Far m A Far m B Indirect moves via a transient location Far m A Market Far m B Indirect movements via several residences useful for slower spread e.g. TB FMD areas in yellow were lifted out of restriction as RADAR proved no movements out of the risk area had occurred Far m A Far m B Market Far m C Far m D Far m E

56 FMD 07 ~ a small outbreak Only 8 infected premises animals slaughtered (mainly cattle and pigs) Intensive surveillance well beyond minimum requirements of EU Directive 1200 visits 60,036 surveillance samples tested 800 goats, 21,000 sheep, 26,500 cattle 125 to 400 staff ~ 50 vets, Animal Health officers Nationwide monitoring through report cases (>220), >6million animals at abattoirs, 766 welfare visits, 1600 licensing inspections Plus 307 premises in 20 to 150KM zones around outbreak

57 05/08/07 07/08/07 09/08/07 11/08/07 13/08/07 15/08/07 17/08/07 21/08/07 23/08/07 25/08/07 27/08/07 29/08/07 31/08/ /09/ /09/07 15/09/07 17/09/07 19/09/07 21/09/07 25/09/07 27/09/07 02/10/07 04/10/07 08/10/07 10/10/07 12/10/07 17/10/07 19/10/07 23/10/07 25/10/07 29/10/07 31/10/07 S I P Staffing at the LDCC - August to November 2007 LDCC Resources - August and September Outbreaks Final SZ surveillance Veterinary Technical Administration Management External Resource Total First cluster Second cluster Dates

58 About halfway through FMD... September 22 nd...bluetongue-8 detected in a cow = potential for mass confusion! BTV-8 FMD

59 Zone boundaries kept changing for BTV as well as for FMD...

60 Plus different trade/export areas

61 Defra website interactive map

62 Legal Declarations... FMD Zone restrictions declarations x 2 August - amended 6 x Sept amended 9 x TCZ x 10

63 Defra website licensing matrices

64 13 th November... Highly pathogenic H5N1 confirmed in turkeys!! Defra website crucial in advising farmers...and staff Highlighted certain weaknesses systems geared up for one outbreak but 3 simultaneously put it under extra pressure

65 Data Handling - Conclusions FMD 07 assumption that one will find early disease in cattle may not be correct First time that pre-clinically viraemic animals were detected using PCR in an outbreak Be prepared! Directive may lay out surveillance requirements but... Judged by the reporting aim for one version of the truth! Try to keep everything BAU Clear communication lines teams not people Different meetings to discuss different angles but don t be crippled by the battle rhythm The same process for different diseases Training, exercises

66 Data Handling - Conclusions UK future... Still improving our databases...sam, MOSS, CPH viewer

67 CPH Viewer Application There are a number of tasks that the user may now want to do, in this instance we investigate whether stock is kept on a contiguous CPH Can build up the spread of land being used by an individual farm business Data from Animal Health Customer Database now being used in tandem with RPA land CPH 01/001/0001 parcel data. - We now understand that cattle are kept on the neighbouring CPH. Using land parcel data, captured as a result of a subsidy claim CPH 01/001/0002

68 Data Handling - Conclusions UK future... Still improving our databases...sam, MOSS, CPH viewer NDCC/LDCC...new managing outbreaks project Reduced staffing, more outsourcing, reduced budgets Virtual teams...no longer able to rely on teams all in one place NDCC lite/ldcc lite concept

69 Thank you