Rinderpest: a case study of animal health emergency management.

The history of rinderpest and control of the disease in Africa and Asia is reviewed briefly. The present distribution of rinderpest virus in relation to its phylogenetic lineages is presented. Rinderpest-free countries bordering rinderpest-infected countries are considered to be under permanent threat of a transboundary rinderpest incursion and therefore face continuous and serious emergency situations. The nature of these emergencies in relation to the remaining foci of the three lineages is described. It is argued that the Global Rinderpest Eradication Programme (GREP) eradication strategies now need to focus on the use of epidemiological studies to define foci of infection and guide targeted, pulsed vaccination campaigns rather than broad, routine vaccination. The emergency posed by the re-emergence of African lineage 2 virus in East Africa and the challenge of mild rinderpest is explored in some detail as a phenomenon which may be more widespread than has been assumed. Points at which the future of GREP is threatened are illustrated and means of removing some of the dangers are suggested. The lessons which need to be learnt from the experience of the Indian National Project on Rinderpest Eradication and the Pan-African Rinderpest Campaign are discussed, including the value of strengthening surveillance systems in accordance with the Office International des Epizooties Pathway and how to cope with the problem associated with cryptic foci of rinderpest persistence--perhaps the greatest challenge facing GREP. The value of vaccine buffer zones is considered in detail and the authors conclude that unless those zones are of considerable depth and are well maintained, they are unlikely to prevent dissemination of the virus. The role of emergency preparedness planning in preventing the spread of rinderpest is discussed, with the understanding that effective surveillance, as a component of emergency preparedness planning, is safer than vaccination as a means of ensuring that the disease does not re-enter or penetrate a population. The swift initiation of a programme for the eradication of rinderpest from Pakistan is seen as the key issue in dealing with the Asian lineage rinderpest emergency. Development and implementation of strategies with the benefit of experience gained in Africa and India could provide a rapid resolution of the emergency.