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This article presents a participative and iterative qualitative risk assessment framework that can be used to evaluate the spatial variation of the risk of infectious animal disease introduction and spread on a national scale. The framework was developed through regional training action workshops and field activities. The active involvement of national animal health services enabled the identification, collection and hierarchization of risk factors. Quantitative data were collected in the field, and expert knowledge was integrated to adjust the available data at regional level. Experts categorized and combined the risk factors into ordinal levels of risk per epidemiological unit to ease implementation of risk-based surveillance in the field. The framework was used to perform a qualitative assessment of the risk of introduction and spread of foot-and-mouth disease (FMD) in Tunisia as part of a series of workshops held between 2015 and 2018. The experts in attendance combined risk factors such as epidemiological status, transboundary movements, proximity to the borders and accessibility to assess the risk of FMD outbreaks in Tunisia. Out of the 2,075 Tunisian imadas, 23 were at a very high risk of FMD introduction, mainly at the borders; and 59 were at a very high risk of FMD spread. To validate the model, the results were compared to the FMD outbreaks notified by Tunisia during the 2014 FMD epizootic. Using a spatial Poisson model, a significant alignment between the very high and high-risk categories of spread and the occurrence of FMD outbreaks was shown. The relative risk of FMD occurrence was thus 3.2 higher for imadas in the very high and high spread risk categories than for imadas in the low and negligible spread risk categories. Our results show that the qualitative risk assessment framework can be a useful decision support tool for risk-based disease surveillance and control, in particular in scarce-data environments., (© 2020 Wiley-VCH GmbH.)

Event-based surveillance (EBS) systems monitor a broad range of information sources to detect early signals of disease emergence, including new and unknown diseases. In December 2019, a newly identified coronavirus emerged in Wuhan (China), causing a global coronavirus disease (COVID-19) pandemic. A retrospective study was conducted to evaluate the capacity of three event-based surveillance (EBS) systems (ProMED, HealthMap and PADI-web) to detect early COVID-19 emergence signals. We focused on changes in online news vocabulary over the period before/after the identification of COVID-19, while also assessing its contagiousness and pandemic potential. ProMED was the timeliest EBS, detecting signals one day before the official notification. At this early stage, the specific vocabulary used was related to 'pneumonia symptoms' and 'mystery illness'. Once COVID-19 was identified, the vocabulary changed to virus family and specific COVID-19 acronyms. Our results suggest that the three EBS systems are complementary regarding data sources, and all require timeliness improvements. EBS methods should be adapted to the different stages of disease emergence to enhance early detection of future unknown disease outbreaks., (© 2020 The Authors. Transboundary and Emerging Diseases published by Blackwell Verlag GmbH.)

Rift Valley fever (RVF) is a vector-borne zoonotic disease that has caused widespread outbreaks throughout Africa and the Arabian Peninsula, with serious consequences for livestock-based economies and public health. Although there have never been any reports of RVF in Morocco, Algeria, Tunisia and Libya, it is a priority disease in the Maghreb, due to the threat of introduction of the virus through transboundary livestock movements or infected mosquito vectors. However, the implementation of surveillance activities and early warning contingency plans requires better knowledge of the epidemiological situation. We conducted a multicriteria decision analysis, integrating host distribution with a combination of important ecological factors that drive mosquito abundance, to identify hotspots and suitable time periods for RVF enzootic circulation (i.e. stable transmission at a low to moderate level for an extended period of time) and an RVF epizootic event (i.e. a sudden occurrence of a large number of infected animals over a large geographic area) in the Maghreb. We also modelled vector species distribution using available information on vector presence and habitat preference. We found that the northern regions of the Maghreb were moderately suitable for RVF enzootics, but highly suitable for RVF epizootics. The vector species distribution model identified these regions as the most favourable mosquito habitats. Due to the low density of animal hosts and arid conditions, the desert region showed low RVF suitability, except in oases. However, the presence of competent vectors in putative unsuitable areas underlines the need for further assessments of mosquito habitat preference. This study produced monthly RVF suitability maps useful for animal health managers and veterinary services involved in designing risk-based surveillance programmes. The suitability maps can be further enhanced using existing country-specific sources of information and by incorporating knowledge - as it becomes available - on the epidemiology of the disease and distribution of vectors in the Maghreb., (© 2015 Blackwell Verlag GmbH.)