Presentation by Kate Blaszak of the Smallholder Pigs System Project at the Managing Risks in Emerging Pork Markets: An International South – South Symposium, held in Hanoi, Vietnam, April 23 2012.

1. Integrated assessment and management
of pig health risks – lesson’s learnt
Kate Blaszak, Coordinator and Veterinarian SPSP.

2. Acknowledgement
Presentation on behalf on two projects funded by
ACIAR and ILRI for Lao PDR.
Acknowledgement and thanks to LP and SKT provincial staff,
CIAT, Laos partners from NAHC, DHP, NCLE, NAFRI and
Australian partners from AAHL, MORU.
Add ACIAR logo

3. Outline
• Integrated Project - One health, One system
• Integrated Health Risk Assessment
- Concept Planning, Methodology and Training
• Integrated Heath Risk Management
– Results, Interpretation and Interventions
• Discussion and Lessons
• Other possible methods

4. One health, One system
Original SPSP project integrated with EcoHealth – EcoZEID
SPSP Aim: to reduce risks and increase productivity associated with
smallholder pig systems in Laos
– Many of the pig related zoonoses are clinically silent in pigs – they
are not a direct risk to pig health but potentially to human health
(JEV, HEV, T/C, Trichinella+)
– Project is Onehealth, also One system – interested in pig health
and production risks in villages & market chains.
– Key clinical pig diseases of interest and impact suspected
CSF, PRRS, FMD, Erysipelas also Salmonella, endemic parasitism,
possible multi-factorial lung, piglet diseases in addition to the
infection status related to the above zoonoses.

5. Integrated Assessment of Pig Health
Risks
• Planning concepts – One health, risk based questioning
• Methodology and Training
– integrated training of human and animal health staff
– integrated epidemiology – PPP approach from 2005 human
census so human centric sampling for human and pig disease
exposure
– integrated system for village data collection
– participatory village mapping for health risks (SPSP)
– integrated laboratory training and testing for exposure
– integrated analysis of crude seroprevalence and health risks
* health risk assessment for actors further along the market chain
yet to be done

6. PPP: Villages 8 SPSP Villages
are randomly - Also PPP by
sampled but village HH
weighted by number
human
population
2 ECOZEID
Provinces – each
30 Villages x
15 Humans
15 Pigs

7. Survet for integrated questionnaire development,
data entry and web storage – www.quest.survet.net
concept designed by Peter Durr of

8. Staff training and village data
collection
Insert some pictures

9. Integrated assessment for results of
over 700 pig and 1000 human samples
– integrated and contextual results EcoZEID and SPSP
– crude seroprevalence (village and provincial)
– looking for associated zoonotic, pig health risks
– village mapping (perceived and possible geospatial
disease risks)
– challenges-interpretation and validation of some
tests in field situation (eg. HEV pigs), retest to
confirm some hotspots (T/C) and specificity (JEV)

10. Human and Pig Hepatitis E Sero-prevalence Results
Human Prev 61.4% Pig Prev 64.0%

11. Human and Pig Trichinella Sero-prevalence Results
Human Prev 47.3% Pig Prev 13.2%

12. Some zoonotic risk results
Disease exposure to humans Apparent risk factors from Odd’s Ratio Comments and Interventions- Management
and pigs (overall data for increased sero + (and 95%CI)
crudeseroprevalence)
HEV <50m from pigs 2.12(1.72,3.00) But clinical human HEV? Sero+ appears independent of
Humans:61.4% TBC Lower education level 1.74(1.27, 2.39) owning pigs! Unusual.
Using non-bottled or non- Clear link and need for water and sanitation mgt – explore
boiled water 4.01(1.87,8.56) constraints, educational campaign. Also would benefit T/C
Not using toilets 1.77(1.34,2.35) reduction in contamination.
Explore possible increased susceptability if pregnant.
Pigs(64%) Pigs E+ also likely HEV 2.56 (1.87,3.10)
sero+ Explore the Erysipelas/HEV possible link or not?
Penned pigs in wet or dry 2.70(1.72,4.23) Explore significance of penning and HEV?
season
Trichinella Hmong more at risk 1.77 (1.00, 3.12) Consistent with prior ACIAR project. As was higher
Human(47.3%) Lao Loum more at risk 1.53(1.14, 2.06) education level. What practices or point of the pork chain
convey the greatest risk, why are some villages hot spots
Pigs (13.2%) Pigs in Sanam (why?) 2.12(1.18, 3.82) (ethnicity, other practices?) – how best to target
intervention?
Data did not show reduced risk from cooking pork!
Why? Contamination post cooking? Fermented sausage.
More rats in sanam- abherrant?
Taenia (4.7%) and Not using toilets 2.65(1.37,5.12) Clear link with lack of toilet use. Some village ‘hot spots’-
Cysticercosissolium (2.9%) why?
MGT need for hygiene and sanitation behaviour change
JEV also….. JEV human confirmatory testing – but apparently relatively
Human IgM (4.4%) low seroprevalence of new infections. GOOD mosquito use
Pigs IgG (75.2%) already found. Pregnancy a known risk factor as is lower
Pigs IgM (8.5%) age for clinical infection.

13. Pig CSF Sero-prevalence Results
Pig CSF Prev 10.3%

14. Pig PRRS Sero-prevalence Results
Pig PRRS Prev 8.2%

15. Pig Erysipelas Sero-prevalence Results
Pig Erysipelas Prev 47.5%

16. Some pig health and production risk results….
also FMD, others
Disease exposure to pigs Apparent risk factors Odd’s Ratio Comments and Management - Interventions
(overall from data for increased (and *95%CI)
crudeseroprevalence) sero +
Erysipelas (47.5%) Wet season pigs in 5.05 (1.74, 14.69)* Significance ? Enclosures with dirt/mud floors
enclosures > pens increase exposure to Erysipelas a soil borne
Dry season pigs in 5.21 (1.81, 16.06)* organism? Clinical significance of Erysipelas in
enclosures > = pens moolaht?Syndromic and further incidence
monitoring could be useful.
MGT: Consider balance of pen/enclosure use – NB.
Higher risk of HEV with penned pigs.
CSF (10.3%) Vaccination at 6 monthly 10.76(3.65, 31.73)* Note- recently introduced pigs were not
clearly Vaccination 12 7.40 (3.18, 16.68)* associated with increased CSF sero+ levels (in this
monthly case/survey)ie. not vaccinated or not exposed
No access to sanam** 2.89(0.89,9.4)* prior to introduction.
MGT: biosecurity education and CSF vaccination
already conducted, being assessed
PRRS (8.2%) Sanam not protective This project clearly shows exposure in moolaht&
nor risk. cross pigs and subsequent HP PRRS outbreak in
Mai district confirms clinical impact in at least 2
Needs more analysis? villages.
MGT: TBC,biosecurity and movement restrictions?
education, possible vaccination

17. (SPSP) B.Houayloun – suspected risks ?
Pig pens
mostly
concentrat Few pig
ed in pens
village on near
periphery village
or near entrance
stream
facilitates
pig Village entrance – few pens may reduce
disease biosecurity risk?
transfer
but may
reduce
human
infections.
pig pens near river and vegie gardens so
may increase HEV risk

18. Integrated management of pig health
and zoonotic risks
• Interventions by *DAFOs and DHOs, supported by PAFOs and PHOs, VVWs, VHWs and NAHC, DHP ……PMC etc
• One Health opportunities – disease investigation, vaccine storage and delivery, education, monitoring
• Zoonotic risk reduction interventions – Sanitation, consumption and vector prevention – education and
behaviour change, reducing humane and pig reservoirs of disease where relevant (human taenia carriers, piga
with trichinella infection, pen location and HEV?)
• Integrated pig nutrition, health, production solutions for a one system approach
• Pig health and production – interventions and monitoring – initial focus on grower pigs*
– CSF vaccination intervention
– PV seroconversion, pig mortality, dynamics and growth monitoring
– Disease outbreak investigation, pathology and response, prevention
– Housing and management training, design, implementation
– Forage and nutrition interventions
– Economic GMA

19. Reduce pig disease risk, transfer and
impact

20. Integrated pig management 5 ‘principles
of successful livestock management’
Ref: Varney – ACIAR 2008, 5 freedoms – FAWC, 1996.
Fresh Water ad lib and Management Suitable shelter,
suitable diet – for and handling space, bedding –
health, production in a stress free comfortable resting
and growth manner area.
Freedom from Appropriate
pain, injury breeding
and disease - strategies (and
prevention, ability to
rapid conduct
diagnosis and normal
treatment behaviours)
we need…………

21. The challenge – working with farmers to design
housing as needed with available resources in
villages* and project
The need Available in village Possible project contribution
Adequate space (and Mostly – focus on size, room for Technical – design with
location) all needs farmers. Consider if location
important?
Shelter and shade Yes – focus on shade Checking, importance. Heat
stress reduces growth.
Flooring Yes – avoid bamboo slats, Technical- part solid/slatted,
design to facilitate easy mgt part raised? Cleaning?
Substrate, farrowing Yes -Rice hulls, or straw, even Facilitate discussion on
and piglet creep areas banana leaves for farrowing benefits, options, feasibility.
sows. Small creep area. Technical design input.
Water and feed Yes simple – gravity system Discuss challenges. Provide
systems – all access consider cost share. nipples, piping if want.
Handling, holding Yes – but not currently Technical – slide in gate/
board….? Think!!!

22. Lessons and other options for
integrated assessment
• One health, One systems – training, time, silver bullets?
• Build in time, expertise for complex statistical analysis
• Review existing records, systems (NCLE) more, gap analysis
and capacity building for sustainable disease surveillance
• Syndromic assessment and monitoring approaches
– Within recall time frames maybe quite reliable
– Action research
• Qualitative and Quantitative risk assessment by matrix –
exposure risks (likelihood) and disease consequence (impact)
• Options yet to think of………

23. Lessons and other options – integrated
management of health risks
• Interventions by risk score and achievability (matrix?)
• Consult well with interested farmers, convey the benefits, incentives & listen!
• Integrate management of pig health risks along the market chain*
• How to best work with, incorporate the sanaam, a traditional ‘biosecure’ measure?
• Plan and communicate well internally, consult for good educational approaches
• Consulting, integrating with other projects or NGOs for effective solutions
• Greater consultation and integration with village policy and management
• Integrate with existing systems, HH/ PH vaccination and education interventions?
• Endorsement by local Governors
• Build links for scaling out – Learning Alliance
• Only the start……..initial zoonotic interventions pending
• Much more to learn!

24. Thanks to the teams and partners who contribute
to these projects. Any questions?

25. (extra) Summary crude seroprevalence ILRI
provincial survey, ACIAR SPSP survey

26. (extra summary SPS seroprevalence results)
Village Name Village code PRRS IgG CSF IgG HEV Ig total TrichIgG Erysipelas IgG JEV (Ig JEV (IgM) FMD 3 ABC FMD O FMD A FMD Asia 1
total)
B. Pakxang 801021 6.67 0.00 63.30 33.33 43.33 80.00 10.00 0.00 0.00 0.00 0.00
B. Nongnong 801050 0.00 *55.56 77.78 66.67 77.80 77.78 22.22 0.00 0.00 0.00 0.00
B.Houaykeng 801039 10.00 0.00 80.00 10.00 40.00 60.00 10.00 0.00 0.00 0.00 0.00
B. Houayloun 801049 4.55 0.00 77.27 22.73 68.18 59.09 0.00 4.55 0.00 0.00 0.00
District Ave 5.63 7.04 70.42 30.99 54.93 70.42 8.45 1.41 0.00 0.00 0.00
total +/total samples
B. Ompalou 202025 6.67 0.00 60.00 26.67 46.70 80.00 0.00 6.67 6.67 0.00 0.00
B. Omkaneng 202019 9.10 9.10 90.90 0.00 72.70 81.80 0.00 0.00 27.30 0.00 0.00
B. Sophoun 202003 12.00 4.00 88.46 12.00 76.00 84.62 0.00 0.00 40.00 0.00 0.00
B. Poungkhao 202128 0.00 0.00 100.00 16.70 50.00 16.67 0.00 0.00 0.00 0.00 0.00
District Ave 8.33 3.33 83.33 15 63.33 76.67 0.00 1.67 25.00 0.00 0.00
Comments: sample taken Oct 2011, newly found in * known Zoonotic Risk for first time tested, Phong Khao IgM: new Many High Omkaneng as expected, as expected,
end of rainy season moolaht vaccinated relevance? consumption clinical low - why? infections inconclusive and Sophoun (on Khounsy & Khounsy&Conla
relevance? Nongnong results: retest? main Conlan 2008 n 2008
high, why? road).PhongKhao
Many FMD 2010, pig
inconclusive turnover?
results
Average for whole sample 6.87% 5.34% 76.34% 23.66% 58.78% 73.28% 4.58% 1.52% 11.36% 0.00% 0.00%
Comparative LP Province 11.48% 7.54% 82.95% 13.77% 67.21% 76.39% 12.46% 1.31% 5.25% 0.98% 0.33%
Note: ACIAR samples are moolaht only.LP included moopan