A near real-time surveillance program for PRRS in Iowa, United States

1. University of California, Davis A near real-time surveillance program for PRRS in Iowa, United States Perez AM, Polson D, Mueller K, Cano JP, Brito B, Mondaca E, Whedbee Z, Main R University of California in Davis (Perez, Brito, Whedbee) Iowa State University (Mueller, Main) BoehringerIngelheimVetmedica Inc (Polson, Cano, Mondaca) GEOVET Conference 2013 21-23 August London, UK

2. A near real-time surveillance program for PRRS in Iowa, United States • Relevant Context • Prerequisite Culture • Necessary Collaborations • Required Tools

3. A near real-time surveillance program for PRRS in Iowa, United States • Relevant Context • Prerequisite Culture • Necessary Collaborations • Required Tools

4. Porcine Reproductive and Respiratory Syndrome (PRRS) virus • Enveloped RNA virus - order Nidovirus, family Arteriviridae, genus Arterivirus. • Causes reproductive failure of sows and respiratory problems of piglets and growing pigs • The single most important swine disease in North America • Cost for the US swine industry : $664 million USD/year* • Difficult to control • TRANSMISSION • PERSISTENCE • GENETIC DIVERSITY- heterologous protection • MULTIPLE CLINICAL PRESENTATIONS • Swine industry efforts to control PRRS: ARC&E projects

5. A near real-time surveillance program for PRRS in Iowa, United States PRRS is wicked.

6. A near real-time surveillance program for PRRS in Iowa, United States

7. What makes a problem “wicked”? “The kinds of problems that planners deal with…are inherently different from the problems that scientists and perhaps some classes of engineers deal with. Planning problems are inherently wicked.” Rittel & Webber (1973)

8. A near real-time surveillance program for PRRS in Iowa, United States Context: • Science is good… • …and institutional-scale science has & continues to make very valuable contributions to its business & professional constituencies • …but institutional-scale science has limitations… • Institutional-scale science can tell us: • What HAS happened (retrospective, observational) • What CAN happen, given a specific and defined condition set (experimental)

9. A near real-time surveillance program for PRRS in Iowa, United States Context: • We need to complementinstitutional-scale (cross-sectional/static) science with industrial-scale (operational/dynamic) science… …science that can tell us what DOES happen… …every time it happens… …that helps us understand why it happens… …what we can do about it… …and measure if what we did was valuable.

10. A near real-time surveillance program for PRRS in Iowa, United States Key target questions: • Am I negative or positive? • Am I stable or unstable? • Is this resident or non-resident virus? • How did it get here? • Where did it come from? • Is this a previously existing or a new variant? • Where did it start? • When did it start? • How did it start?

11. A near real-time surveillance program for PRRS in Iowa, United States Key target questions: • Is what I’ve been doing working? • Would something else work better? • Am I at lower/same/higher risk today compared to yesterday? • Am I progressing towards or away from my goals of [_____]? • Why am I progressing towards or away from my goal(s)? • What can I do to fix/improve what I’m doing today?

12. A near real-time surveillance program for PRRS in Iowa, United States If PRRSv really costs us “$664,000,000” per year, maybe it’s well worth it to us all to actively work together using all the tools & weapons we have available today to manage it in a coordinated collaborative effort.

13. A near real-time surveillance program for PRRS in Iowa, United States 2009: 10+1 total projects

14. A near real-time surveillance program for PRRS in Iowa, United States 2013: 25+4 total projects

15. A near real-time surveillance program for PRRS in Iowa, United States • Relevant Context • Prerequisite Culture • Necessary Collaborations • Required Tools

16. Area-Regional Control & Elimination (ARC&E) is… …producers & veterinarians working together with their neighbors and business partners so that together they achieve greater sustained improvement in health and productivity in their neighborhood than any one can achieve on their own. A near real-time surveillance program for PRRS in Iowa, United States

17. The Golden (PRRS) Rule “DoTRANSMITunto your neighbor as you would have your neighbor doTRANSMITunto you.”

18. A near real-time surveillance program for PRRS in Iowa, United States Better Together Be BetterTogether

19. A near real-time surveillance program for PRRS in Iowa, United States • Relevant Context • Prerequisite Culture • Necessary Collaborations • Required Tools

20. Primary Collaborators: ISU, UC-Davis, FAZD-DHS, CFSPH, Progressus Ltd, BIVI Veterinarians Across U.S. Submitting Cases to their VDL Service Providers Submitters indicate the inclusion of a submission (case) in a specific regional disease monitoring effort (project) on the diagnostic laboratory submission form Case Submission All Dx Results Case Submission All Dx Results Case Submission All Dx Results VDL LIMS (e.g. UMN) VDL LIMS (e.g. SDSU) VDL LIMS (e.g. ISU) Pathogen Specific Dx Data Only (Pushed) Pathogen Specific Dx Data Only Pathogen Specific Dx Data Only Secure Animal Health Diagnostic Database (SAHDD) Based on: HIMS® Platform (Web-Based, Password Protected, Viewable, Sortable) (Pushed) (Pushed) Rhapsody AgConnect® Interpreted Diagnostic Data Pathogen Specific Dx Data Only View only (Pushed) Permissioned Animal Health Officials (Pushed) Interpreted Diagnostic Data Rules-based decisions used to update Initially = System Administrator Goal =Automation (Pushed) Interpreted Diagnostic Data (Pushed) Antigenic Cartography Analysis System Sequence Data PADRAP Data Disease BioPortal® Real-time disease analysis and mapping (Web-based & Password Protected) PADRAP® (Web-based & Password Protected) Cartographs Dynamic Risk Data View Data/Reports View only Input Surveys PermissionedBioPortal® Users Permissioned PADRAPUsers

21. A near real-time surveillance program for PRRS in Iowa, United States • Relevant Context • Prerequisite Culture • Necessary Collaborations • Required Tools

22. A near real-time surveillance program for PRRS in Iowa, United States Design Specifications: • Operations (transactions) user funded • Sampling, logistics, testing, data-management, analytics • Cost-efficient to implement & inexpensive to operate • Convenient & easy to do perpetually • Standardized materials, tools, methods & processes , definitions & metrics, analytics & interpretation

23. A near real-time surveillance program for PRRS in Iowa, United States Design Specifications: • Automated everywhere possible • Interfaced / integrated with all best-in-class tools and methods • Near-real-time results & interpretation • Pre-defined “best-practice” contingencies

24. A near real-time surveillance program for PRRS in Iowa, United States Design Specifications: • Supports well-informed decision-making • Intra-Enterprise • in-process / execution-level • Management oversight / process-level • Inter-Enterprise • Within Areas & Regions • Among Areas & Regions • Policymakers • Supports rigorous research & effective learning • Effective training/education & support structure • Broad & deep support by served constituents and leaders

25. The BioPortal • Collect • Compile • Organize • Analyze • Share • Use data • Web-based health management system • To support “local” decision-making for PRRS management and contingent action execution by veterinary practitioners and farmers • To support “regional” monitoring of progress towards area- and network-based PRRS management Objectives

26. How did it start? January 2010 CADMS/UC-Davis & BoehringerIngelheim collaboration agreement Phases: 1.- Adaptation and implementation Adapt Disease BioPortal platform to manage PRRS cases and become adopted as a standard tool for PRRS ARC&E project use and epidemiological analysis in the U.S. swine industry 2.- Improvement and expansion Increase capabilities of Disease BioPortal to be employed as a surveillance and epidemiological analysis tool for swine diseases

27. Collaborators • Center for Animal Disease Modeling and Surveillance -University of California-Davis (CADMS) • BoehringerIngelheimVetmedica • Iowa State University Veterinary Diagnostic Laboratory (ISU-VDL) • Production Animal Disease Risk Assessment Program (PADRAP) • SE IA PRRS ARC Project Coordinator

28. BioPortal Tools- PRRS site http://fmdbioportal.ucdavis.edu/

29. Space-time genetic visualizer

30. Is it a new isolate to the herd or system? Where did it most likely come from? New isolate to the system (3%)

31. Changes in prevalence and incidence

32. Current work in progress • The system is being piloted by participating farms in a South-East Iowa PRRS Area Control Project • 45 producers-large and small • 410 sites enrolled ~1,000,000 pigs • Local and regional consulting veterinarians • Development and improvement of the PRRS BioPortal tailored to PRRS and the swine industry • Platform for data transfer ISU-VDL –to- BioPortal • Definitions and standards for data management

33. What’s next? • Interpretation algorithms development & automation • Case result • Site status • Site classification • Development phases • Bioportal enhancements (e.g., producer/veterinarian operational health management tools) • Interfaces with other systems (e.g., VDL LIMS, PADRAP) • Broad adoption • Systems • Practices • ARC&E projects • VDL’s • Research leverage

34. Primary Collaborators: ISU, UC-Davis, FAZD-DHS, CFSPH, Progressus Ltd, BIVI Veterinarians Across U.S. Submitting Cases to their VDL Service Providers Submitters indicate the inclusion of a submission (case) in a specific regional disease monitoring effort (project) on the diagnostic laboratory submission form Case Submission All Dx Results Case Submission All Dx Results Case Submission All Dx Results VDL LIMS (e.g. UMN) VDL LIMS (e.g. SDSU) VDL LIMS (e.g. ISU) Pathogen Specific Dx Data Only (Pushed) Pathogen Specific Dx Data Only Pathogen Specific Dx Data Only Secure Animal Health Diagnostic Database (SAHDD) Based on: HIMS® Platform (Web-Based, Password Protected, Viewable, Sortable) (Pushed) (Pushed) Rhapsody AgConnect® Interpreted Diagnostic Data Pathogen Specific Dx Data Only View only (Pushed) Permissioned Animal Health Officials (Pushed) Interpreted Diagnostic Data Rules-based decisions used to update Initially = System Administrator Goal =Automation (Pushed) Interpreted Diagnostic Data (Pushed) Antigenic Cartography Analysis System Sequence Data PADRAP Data Disease BioPortal® Real-time disease analysis and mapping (Web-based & Password Protected) PADRAP® (Web-based & Password Protected) Cartographs Dynamic Risk Data View Data/Reports View only Input Surveys PermissionedBioPortal® Users Permissioned PADRAPUsers

35. A near real-time surveillance program for PRRS in Iowa, United States

36. A near real-time surveillance program for PRRS in Iowa, United States

37. A near real-time surveillance program for PRRS in Iowa, United States

38. Primary Collaborators: ISU, UC-Davis, FAZD-DHS, CFSPH, Progressus Ltd, BIVI Veterinarians Across U.S. Submitting Cases to their VDL Service Providers Submitters indicate the inclusion of a submission (case) in a specific regional disease monitoring effort (project) on the diagnostic laboratory submission form Case Submission All Dx Results Case Submission All Dx Results Case Submission All Dx Results VDL LIMS (e.g. UMN) VDL LIMS (e.g. SDSU) VDL LIMS (e.g. ISU) Pathogen Specific Dx Data Only (Pushed) Pathogen Specific Dx Data Only Pathogen Specific Dx Data Only Secure Animal Health Diagnostic Database (SAHDD) Based on: HIMS® Platform (Web-Based, Password Protected, Viewable, Sortable) (Pushed) (Pushed) Rhapsody AgConnect® Interpreted Diagnostic Data Pathogen Specific Dx Data Only View only (Pushed) Permissioned Animal Health Officials (Pushed) Interpreted Diagnostic Data Rules-based decisions used to update Initially = System Administrator Goal =Automation (Pushed) Interpreted Diagnostic Data (Pushed) Antigenic Cartography Analysis System Sequence Data PADRAP Data Disease BioPortal® Real-time disease analysis and mapping (Web-based & Password Protected) PADRAP® (Web-based & Password Protected) Cartographs Dynamic Risk Data View Data/Reports View only Input Surveys PermissionedBioPortal® Users Permissioned PADRAPUsers

39. A near real-time surveillance program for PRRS in Iowa, United States

40. A near real-time surveillance program for PRRS in Iowa, United States

41. A near real-time surveillance program for PRRS in Iowa, United States

42. Primary Collaborators: ISU, UC-Davis, FAZD-DHS, CFSPH, Progressus Ltd, BIVI Veterinarians Across U.S. Submitting Cases to their VDL Service Providers Submitters indicate the inclusion of a submission (case) in a specific regional disease monitoring effort (project) on the diagnostic laboratory submission form Case Submission All Dx Results Case Submission All Dx Results Case Submission All Dx Results VDL LIMS (e.g. UMN) VDL LIMS (e.g. SDSU) VDL LIMS (e.g. ISU) Pathogen Specific Dx Data Only (Pushed) Pathogen Specific Dx Data Only Pathogen Specific Dx Data Only Secure Animal Health Diagnostic Database (SAHDD) Based on: HIMS® Platform (Web-Based, Password Protected, Viewable, Sortable) (Pushed) (Pushed) Rhapsody AgConnect® Interpreted Diagnostic Data Pathogen Specific Dx Data Only View only (Pushed) Permissioned Animal Health Officials (Pushed) Interpreted Diagnostic Data Rules-based decisions used to update Initially = System Administrator Goal =Automation (Pushed) Interpreted Diagnostic Data (Pushed) Antigenic Cartography Analysis System Sequence Data PADRAP Data Disease BioPortal® Real-time disease analysis and mapping (Web-based & Password Protected) PADRAP® (Web-based & Password Protected) Cartographs Dynamic Risk Data View Data/Reports View only Input Surveys PermissionedBioPortal® Users Permissioned PADRAPUsers

43. A near real-time surveillance program for PRRS in Iowa, United States Reference ATP System

44. A near real-time surveillance program for PRRS in Iowa, United States WT ATP MLV

45. A near real-time surveillance program for PRRS in Iowa, United States

46. A near real-time surveillance program for PRRS in Iowa, United States

47. A near real-time surveillance program for PRRS in Iowa, United States

48. Conclusions • The approach here represents a multi-institutional effort with direct impact in the control of, arguably, the most important disease of swine in the United States. The project may be easily scaled-up to include larger areas as well as other diseases. • Data collection and organization is the most significant challenge. It can be overcome by automating processes and strategizing resources • This tool will demonstrate its value when applied in control interventions, reducing incidence/prevalence

49. Acknowledgments • Swine practitioners and producers • ISU Veterinary Diagnostic Laboratory • BIVI Health Management Center • PADRAP • SE IA PRRS ARC Project Coordinator

50. A near real-time surveillance program for PRRS in Iowa, United States Thank you.