title: U.K. Foot and Mouth Disease: A Systemic Risk Assessment of Existing Controls.
abstract: This article details a systemic analysis of the controls in place and possible interventions available to further reduce the risk of a foot and mouth disease (FMD) outbreak in the United Kingdom. Using a research-based network analysis tool, we identify vulnerabilities within the multibarrier control system and their corresponding critical control points (CCPs). CCPs represent opportunities for active intervention that produce the greatest improvement to United Kingdom's resilience to future FMD outbreaks. Using an adapted 'features, events, and processes' (FEPs) methodology and network analysis, our results suggest that movements of animals and goods associated with legal activities significantly influence the system's behavior due to their higher frequency and ability to combine and create scenarios of exposure similar in origin to the U.K. FMD outbreaks of 1967/8 and 2001. The systemic risk assessment highlights areas outside of disease control that are relevant to disease spread. Further, it proves to be a powerful tool for demonstrating the need for implementing disease controls that have not previously been part of the system.
authors.affiliation: Cranfield University, Institute for Environment, Health, Risks and Futures, Cranfield, Bedfordshire, MK43 0AL, UK.
authors.forename: João
authors.initials: J
authors.lastname: Delgado
authors.affiliation: Cranfield University, Institute for Environment, Health, Risks and Futures, Cranfield, Bedfordshire, MK43 0AL, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Pollard
authors.affiliation: Cranfield University, Institute for Environment, Health, Risks and Futures, Cranfield, Bedfordshire, MK43 0AL, UK.
authors.forename: Kerry
authors.initials: K
authors.lastname: Pearn
authors.affiliation: Animal and Plant Health Agency, Department of Epidemiological Sciences, Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB, UK.
authors.forename: Emma L
authors.initials: EL
authors.lastname: Snary
authors.affiliation: Department for Environment, Food and Rural Affairs, Area 1D, Nobel House, 17 Smith Square, London, SW1P 3JR, UK.
authors.forename: Edgar
authors.initials: E
authors.lastname: Black
authors.affiliation: Cranfield University, Institute for Environment, Health, Risks and Futures, Cranfield, Bedfordshire, MK43 0AL, UK.
authors.forename: George
authors.initials: G
authors.lastname: Prpich
authors.affiliation: Cranfield University, Institute for Environment, Health, Risks and Futures, Cranfield, Bedfordshire, MK43 0AL, UK.
authors.forename: Phil
authors.initials: P
authors.lastname: Longhurst
mesh_terms: D000818:Animals; D002417:Cattle; D002418:Cattle Diseases / Q000453:epidemiology* / Q000635:transmission*; D004196:Disease Outbreaks / Q000662:veterinary*; D005536:Foot-and-Mouth Disease / Q000453:epidemiology* / Q000635:transmission*; D008962:Models, Theoretical; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D014186:Transportation; D006113:United Kingdom / Q000453:epidemiology
keywords: Disease; FMD; foot; mouth; network; risk; systemic