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1 BC CWD Program Report 2019-20 Prepared by: Cait Nelson and Helen Schwantje GIS maps by: Shari Willmott INTRODUCTION Chronic wasting disease (CWD) is an infectious and degenerative disease of the central nervous system that affects species of the deer family (cervids). CWD belongs to a family of diseases called transmissible spongiform encephalopathies (TSEs) which are caused by abnormal proteins called “prions” and include diseases such as bovine spongiform encephalopathy (i.e. “mad cow disease”), scrapie in sheep and goats, and Creutzfeldt-Jakob disease in humans. These diseases are generally species specific and there is no direct evidence that CWD is transmissible to humans. Although many details about the disease remain unknown, much has been learned through research and experience over the last 3 decades. See research highlights for 2019-20 in Appendix 3. CWD is fatal in all cases and there is no vaccine or treatment. Most cervids that test positive appear healthy and are often hunter harvested animals. Since the disease has a long incubation period, symptoms can take over a year to develop after infection. In later stages of the disease, signs can include weight loss, behavioral changes, drooling and poor coordination. As of May 2020, CWD has been confirmed in captive and/or free-ranging cervids in 26 US states, 3 Canadian provinces, South Korea and Europe. CWD has not been detected in British Columbia (B.C.). Wildlife managers worldwide consider CWD a high priority because of its impact on cervid populations and hunting. No effective disease control exists. Experts have developed guidelines for comprehensive regional and national strategies for CWD surveillance and management, such as the Association of Fish and Wildlife Agencies Technical Report on Best Management Practices for CWD, which recommends that CWD-free jurisdictions focus on preventing the entry of the disease. Collaboration amoung jurisdictions is resulting in better communication and more consistency with legislative and regulatory tools to support CWD surveillance, response and prevention. B.C. is a member of the North American CWD Task Force (CWDTF), formed in 2020 to foster cross-jurisdictional strategies and coordination of efforts. The diagnosis of CWD positive deer and moose near Libby, Montana increases B.C.’s risk for CWD significantly. Montana Fish, Wildlife and Parks (FWP) reported a disease prevalence of 13% in whitetailed deer within the city of Libby from 2019 surveillance, suggesting CWD presence for at least several years. Montana, similar to other jurisdictions, has many challenges with this disease in different ecosystems, so they are revising their CWD management and regulatory measures and continue to collaborate with B.C. and other CWDTF members. The B.C. CWD Program developed and follows the framework outlined in the Surveillance and Response Plan for Chronic Wasting Disease in British Columbia (2019) which is based on 3 principles; Prevention, Surveillance and Preparedness. The Provincial CWD Advisory Committee and Regional Working Groups in Kootenay and Peace Regions membership (both include staff, other ministries, First Nations, stakeholders and local businesses) continue their involvement and support and provide input on CWD Program activities and planning. Annual meetings with the Regional CWD Working Groups and the Provincial CWD Advisory Committee were held in January 2020 and May 2020, respectively. Action items from these meetings are summarized in Appendix 1.

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Page 1: BC CWD Program Report 2019-20 · ecosystems, so they are revising their CWD management and regulatory measures and continue to collaborate with B.C. and other CWDTF members. The B.C

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BC CWD Program Report 2019-20 Prepared by: Cait Nelson and Helen Schwantje GIS maps by: Shari Willmott

INTRODUCTION Chronic wasting disease (CWD) is an infectious and degenerative disease of the central nervous system that affects species of the deer family (cervids). CWD belongs to a family of diseases called transmissible spongiform encephalopathies (TSEs) which are caused by abnormal proteins called “prions” and include diseases such as bovine spongiform encephalopathy (i.e. “mad cow disease”), scrapie in sheep and goats, and Creutzfeldt-Jakob disease in humans. These diseases are generally species specific and there is no direct evidence that CWD is transmissible to humans. Although many details about the disease remain unknown, much has been learned through research and experience over the last 3 decades. See research highlights for 2019-20 in Appendix 3. CWD is fatal in all cases and there is no vaccine or treatment. Most cervids that test positive appear healthy and are often hunter harvested animals. Since the disease has a long incubation period, symptoms can take over a year to develop after infection. In later stages of the disease, signs can include weight loss, behavioral changes, drooling and poor coordination. As of May 2020, CWD has been confirmed in captive and/or free-ranging cervids in 26 US states, 3 Canadian provinces, South Korea and Europe. CWD has not been detected in British Columbia (B.C.). Wildlife managers worldwide consider CWD a high priority because of its impact on cervid populations and hunting. No effective disease control exists. Experts have developed guidelines for comprehensive regional and national strategies for CWD surveillance and management, such as the Association of Fish and Wildlife Agencies Technical Report on Best Management Practices for CWD, which recommends that CWD-free jurisdictions focus on preventing the entry of the disease. Collaboration amoung jurisdictions is resulting in better communication and more consistency with legislative and regulatory tools to support CWD surveillance, response and prevention. B.C. is a member of the North American CWD Task Force (CWDTF), formed in 2020 to foster cross-jurisdictional strategies and coordination of efforts. The diagnosis of CWD positive deer and moose near Libby, Montana increases B.C.’s risk for CWD significantly. Montana Fish, Wildlife and Parks (FWP) reported a disease prevalence of 13% in whitetailed deer within the city of Libby from 2019 surveillance, suggesting CWD presence for at least several years. Montana, similar to other jurisdictions, has many challenges with this disease in different ecosystems, so they are revising their CWD management and regulatory measures and continue to collaborate with B.C. and other CWDTF members.

The B.C. CWD Program developed and follows the framework outlined in the Surveillance and Response Plan for Chronic Wasting Disease in British Columbia (2019) which is based on 3 principles; Prevention, Surveillance and Preparedness. The Provincial CWD Advisory Committee and Regional Working Groups in Kootenay and Peace Regions membership (both include staff, other ministries, First Nations, stakeholders and local businesses) continue their involvement and support and provide input on CWD Program activities and planning. Annual meetings with the Regional CWD Working Groups and the Provincial CWD Advisory Committee were held in January 2020 and May 2020, respectively. Action items from these meetings are summarized in Appendix 1.

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PREVENTION The B.C. CWD Program, with expert advice from partners, has assessed the risk of CWD entering B.C. The most likely risk is human importation of a CWD infected cervid carcass or tissues from a CWD positive location. Degradation of carcasses or tissues infected with CWD can contaminate the environment, with prions directly binding to soil particles. The prions can persist for years, possibly decades, and are resistant to any practical method of destruction. The contaminated environment has the potential to infect healthy cervids through consumption of soil or vegetation. Confirmation that CWD is now present in free-ranging cervid populations in northwest Montana, only 60 kms from the B.C. border and within the natural range of cervid movements, presents a new risk of disease entry through live infected cervids moving into B.C. CWD surveillance in Alberta where mule deer are the primary host, confirms the disease is moving westward towards the B.C. border from southcentral Alberta. Mitigation of this risk has been partially accomplished with Wildlife Act regulations including; prohibition on the importation of live cervids, prohibition on the importation of high-risk parts of harvested cervids, and prohibition on the use of attractants and scents made from cervid materials such as urine. However, awareness and compliance with the regulation requires education and outreach to all hunters. B.C. residents continue to participate in out of province hunts, returning with intact carcasses or high-risk materials. Communication with these hunters for proper disposal of high-risk materials has indicated a lack of awareness of the disease and precautionary measures. It has also confirmed a lack of effective methods and infrastructure for disposing of these high-risk biological materials.

Figure 1: CWD graphic for highway signs. SURVEILLANCE Surveillance is a critical component of disease detection. Since 2002, the B.C. CWD Program has conducted surveillance and outreach activities in target areas of the province, with no positive cases. B.C.’s surveillance objectives are to confirm CWD status (in free-ranging cervid populations) and if introduced, to detect the disease as soon as possible at the lowest possible prevalence. Target surveillance areas are based on risk factors and continue to focus on regions adjacent to jurisdictions with positive cases (Alberta and Montana) and areas with clinically suspect cases. Prior to 2019 B.C. was considered low risk for the presence of CWD. With cases now in northwest Montana, continued westward spread across Alberta and an increase of high-risk material (i.e. intact cervid carcasses) entering the Province, surveillance effort has increased in the highest risk areas. A positive CWD diagnosis can only be made from specific tissues collected from the head of a cervid (samples tested vary with the cervid species, see below). The B.C. CWD Program will accept heads from any cervid species collected from anywhere in the province. Priority is given to cervids exhibiting symptoms and road killed cervids as the most likely to be positive, followed by any cervid harvested or collected in a high-risk area. Heads are generally collected and sampled by Wildlife Health staff or

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trained biologists. Sample tissues are collected, processed and submitted to the Canadian Wildlife Health Cooperative laboratory in Saskatoon, Saskatchewan for immunohistochemistry. Retropharyngeal lymph nodes (RPLNs) and tonsils are collected from deer. RPLNs and obex are collected from moose, elk and caribou. All tissues are fixed in 10% buffered formalin, with a portion retained (frozen) as a back-up sample if re-testing is required. Submission of cervid heads for CWD testing is voluntary in most areas of the province. However, in response to the detection of CWD in Libby, Montana, on the request of the CWD Program, the B.C. Ministry of Agriculture issued a General Order (Animal Health Act) in 2019 (and again in 2020) for mandatory submission of the heads of mule deer and white-tailed deer harvested in management units (MUs) 4-1 through 4-7 in the 2019 hunting season. Once samples are processed and tested, CWD results are posted to the B.C. CWD website: www.gov.bc.ca/chronicwastingdisease In 2019-20, the B.C. CWD Program submitted 1260 samples for testing. See below for an overview of samples numbers by wildlife management region.

Figure 2: Provincial overview (by region) of CWD samples testing in 2019-20.

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Hunters submitted 88% of the 2019 samples. The remaining were sourced from road kills, mortalities and conservation officers. See below samples by source, by species and by sex.

Figure 3: Number of CWD samples by source.

Figure: 4: Number of CWD samples by species.

Figure 5: Number of CWD samples by sex.

8

94

62

903

177

16

4

0 200 400 600 800 1000

CARIBOU

ELK

MOOSE

WHITE-TAILED DEER

MULE DEER

BLACK-TAILED DEER

SPECIES NOT RECORDED

Samples by Species

1109

53

59

13

28

0 200 400 600 800 1000 1200

HUNTER

ROAD KILL

CONSERVATION OFFICER

MORTALITY

SOURCE NOT RECORDED

Samples by Source

393

846

25

0 200 400 600 800 1000

FEMALE

MALE

SEX NOT RECORDED

Samples by Sex

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1069 samples (85% of total) and 144 samples (11% of total) were submitted from the Kootenay and the Peace Regions, respectively. See below for regional overview by MU.

Figure 6: CWD samples from Kootenay Region (2019-20) by wildlife management unit.

Figure 7: CWD samples from Peace Region (2019-20) by wildlife management unit. PREPAREDNESS If CWD is confirmed in a B.C. cervid population, an effective response will require a team effort. The B.C. CWD Program will work collaboratively with government and the Provincial CWD Advisory Committee and Regional Working groups according to the Surveillance and Response Plan. A network approach and an informed public is expected to help support initial response activities to minimize negative impacts to

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cervid populations and potentially eradicate the disease. Response to a positive diagnosis will be managed through an Incident Command System (ICS), led by the Provincial Wildlife Veterinarian and informed by established partnerships. See Appendix 4 for an ICS template. These steps, in general, are outlined in the Surveillance and Response Plan. The initial response phase will gather the required information to assess risk and determine next steps. SUPPORTING ACTIVITIES The B.C. CWD Program and partners must continue to focus on improving the awareness of CWD, the reduction of risks and targeted surveillance where required. Effective and appropriate outreach is a key element. Those resources are developed collaboratively by B.C. CWD Program and disseminated through the B.C. CWD website (www.gov.bc.ca/chronicwastingdisease), the B.C. Hunting and Trapping Regulations Synopsis, partner websites and social media (eg. B.C. Wildlife Federation and others), presentations, workshops, printed material, highway signs and other means. Outreach activities have focused on the hunting public and First Nations communities, but resources are available for anyone. In 2019-20, emergency investments by Government and external partners, especially the Habitat Conservation Trust Foundation and the B.C. Wildlife Federation, provided infrastructure to support enhanced outreach and surveillance activities in the Peace and Kootenay Regions. Regional CWD Program coordinators (contracted through BCCF) were key to local delivery and remain essential to successful program delivery in the Peace and Kootenay Regions. Each coordinator has supplied summary reports with recommendations for improvement of program delivery. A list of recommendations for improved program delivery in 2020-21 is included in Appendix 2.

Figure 8: CWD coordinator Brian Paterson at Sportsmen Show (March 2020). Figure 9: BC CWD freezer / drop off location for head collection program (donated by BCWF). CONCLUSION CWD has not been detected in B.C. but the risk of entry continues to increase. This disease has been very costly and difficult, if not impossible, to manage in other jurisdictions. It is critical that B.C. continues its proactive actions to remain CWD free. The disease was not detected in the highest risk areas despite enhanced surveillance activities in 2019-20. Actions taken, including the General Order (Animal Health Act), increased focused outreach, and involvement of First Nations and stakeholders, resulted in a significant increase in samples collected in the highest risk area along the BC-Montana border from 2018-19 (N=99) to 2019-20 (N=1069). 2019-20

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surveillance results, while improved, do not confirm the absence of CWD. If the disease was present in this area (i.e. mandatory MUs) at a prevalence of 0.52% (white-tailed deer) and 3.4% (mule deer) or greater, with the number of samples tested, at least one case would have been detected (at a 95% confidence). Sustained enhanced surveillance in this area is required to maintain confidence that cervid populations are CWD-free. To accomplish this, the BC Ministry of Agriculture has again issued a General Order for mandatory submission of mule deer and white-tailed deer harvested in management units (MUs) 4-1 through 4-7 in the 2020 hunting season. In this past year, new challenges were identified including; an increased disease distribution and prevalence in Alberta and Montana, an increase in hunters returning to B.C. with intact carcasses or high-risk materials and dumping of high-risk materials in the environment as well as an overall lack of awareness of these risks. The solutions to these issues include newly focussed outreach products for more audiences that include First Nations and improved access to appropriate methods of disposal of high-risk materials, particularly in high risk areas. Support and participation from hunters and communities is excellent, but there is much more that can be done. The B.C. CWD Program will continue to work with experts and partners towards strengthening B.C.’s preventative measures and preparedness to protect B.C. cervid populations from the threat of CWD.

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APPENDIX 1: Action Items from 2020 Working Group and Advisory Committee Meetings

BC CWD Program Action Items

Peace Region Working Group Meeting January 23, 2020

• CWD presentation/workshop for Saulteau and West Moberly First Nations

• CWD content for First Nations outreach/social media/newsletter

• Doig River First Nation will present CWD at a community meeting and request permission to use community freezer for samples

• Doig River First Nation will include CWD material in monthly newsletter

• CWD Program staff to attend BC Cattlemen’s AGM

• Develop Best Management Practices for carcass handling and disposal – for hunters

• Develop disposal plan with Peace River Regional District, MOTI, others

• Invite representative from MOTI and Peace River Regional District to working group

• Supply Saulteau/West Moberly freezer location with supplies and posters

• Investigate new freezer location at Corlane’s

• Update hunting/trapping synopsis on the website to include drop off locations

• Develop road kill collection system with Doig River First Nation

• Produce signs for crews collecting road kills

• Investigate development of road kill app

• Develop road kill collection system with MOTI and contractors

• Develop regional specific budget request for 2020-21

Kootenay Region Working Group Meeting January 29, 2020

• Increase awareness of sample collection program and ensure instructions at freezers are clear

• Develop communications and printed material for target audience with focus on risks and Best Management Practices

• Develop outreach / communications strategy (with schedule / important dates) and prepare press release

• Working Group members to disseminate outreach materials / communications - provided by Cait

• Develop Best Management Practices for carcass handling and disposal – for hunters

• Develop disposal plan with municipalities, MOTI, others

• Discuss risk of human exposure to prions in the environment with Public Health working group

• Working Group to prepare a joint statement for improved regulatory tools for CWD

• Develop road kill collection system with MOTI and contractors

• Develop tracking system/tag with trappers/EKTA

• Develop regional specific budget request for 2020-21

Provincial CWD Advisory Committee Meeting May 26, 2020

• Follow up with BCWF app developers at UBC Kelowna and investigate various

wildlife apps

• Develop communications for BC hunters that hunt in Alberta/Saskatchewan

• Develop business case and outreach to MOTI executive and district offices – to

improve access to road kills

• MOTI to provide contacts for annual Roadbuilders meeting, regional MOTI and

maintenance contractors

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Continued...

• Deliver outreach to COS regarding access to euthanized animals

• Committee to coordinate communications related to General Order (mandatory

submissions) in Kootenay Region

• Seek funding and partners for purchase of incinerators

• Finalize outreach materials and circulate to committee for input

• Propose meeting to discuss CWD management scenarios

• Request collaborators for white-tailed deer movement study between

BC/Alberta/Montana/Idaho

• Develop business case and funding request for in-province CWD testing

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APPENDIX 2: Recommendations from Regional CWD Program Coordinators

Regional CWD Coordinator Recommendations for 2020-21

Peace Region Provided by: Brian Paterson

• Increase participation of road maintenance contractors.

• Hire 2-3 locals to collect roadkill on a stipend or similar basis.

• Develop and obtain signage for coordinator collecting roadkill cervid heads.

• Determine buy-in for provincial roadkill application for smart phones/mobile devices.

• Increase partnerships with First Nations communities.

• Establish sample drop-off locations at local hunting stores.

• Deliver regional CWD training for FLNRORD biologists.

• CWD information included with BCEID e-licensing.

• Include BC Wildlife Health phone number in CWD section of regulations synopsis.

• Region specific informational CWD business cards or handouts at tag/license vendors.

• Increase use of social media for CWD outreach.

• BC CWD Program attendance at Sportsmen shows.

• Game checks with COS and First Nations.

• Consider incentive programs, local draws, prizes.

Kootenay Region Provided by: Jeff Berdusco

• Focus on engaging with stakeholder groups, members of the public and First Nations to increase awareness regarding potential vectors (carcasses, scents, CWD positive meat, etc…).

• Develop and support a strong hazardous material transport protocol for known affected or CWD positive animals/meat.

• Create video(s) to be posted on the web and social media showing proper cervid sample preparation, tagging and submission.

• Construct shelters for freezers or move to covered locations.

• Create a position or add responsibility to MOTI contractors to manage road-kill samples (currently out of scope for MOTI contractors).

• Work towards more awareness and support from different points of contact for road-kill samples (namely the Conservation Officer Service, RCMP and Trappers) for “year-round” sample submission.

• Partner with First Nations to develop and deliver indigenous specific CWD/wildlife health outreach and messaging.

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APPENDIX 3: THE LATEST IN CWD RESEARCH, SCIENCE AND MANAGEMENT Predicting Spread-Risk Potential of Chronic Wasting Disease to Sympatric Ungulate Species Cullingham et al 2020

As CWD continues to expand, additional wild ungulate species including bison, bighorn sheep, mountain goat, and pronghorn antelope may be exposed. To better understand the species barrier, the current literature on taxa naturally or experimentally exposed to CWD was reviewed to identify susceptible and resistant species. Findings suggest the host range for CWD will potentially include pronghorn, mountain goat and bighorn sheep, but bison are likely to be more resistant. These findings highlight the need for monitoring potentially susceptible species as CWD continues to expand. Control and Surveillance Operations to Prevent Chronic Wasting Disease Establishment in Free-Ranging White-Tailed Deer in Québec, Canada Gagnier et al 2020 The first cases of CWD in Québec were detected in 2018 on a red deer (Cervus elaphus) farm. Immediately following detection, intensive culling efforts were conducted in a control area around the infected farm. To prevent the spread of CWD, Quebec applied legal restrictions regarding the movement of specific anatomical parts of cervids harvested near the affected farm. To determine if CWD was present in free-ranging cervids, over 3000 harvested white-tailed deer (Odocoileus virginianus) and 534 culled white-tailed deer were tested. No positive CWD cases were found, suggesting that if the disease is present in free-ranging animals, infection rates are low, and it may still be possible to prevent its establishment in Québec. Cross-validation of the RT-QuIC Assay for the Antemortem Detection of Chronic Wasting Disease in Elk Haley et al 2020 Conventional diagnosis relies on tissues collected post-mortem; however, recent research has focused on newly developed amplification techniques using samples collected antemortem. The present study sought to cross validate the real-time quaking-induced conversion assay (RT-QuIC) evaluation of rectal biopsies collected from an elk herd with endemic CWD. A significantly higher number of positive samples were identified using RT-QuIC, with results seemingly unhindered by low follicle counts. These findings support the continued development and implementation of amplification assays in the diagnosis of prion diseases, targeting not just antemortem sampling strategies, but post-mortem testing approaches as well.

Revisiting Hunter Perceptions toward Chronic Wasting Disease: Changes in Behavior over Time Holland et al 2020 Hunters play a vital role in the management of wildlife diseases such as Chronic Wasting Disease, but their harvest rates may change based on their perception of disease risk. The objective was to estimate how hunter harvest may change over time based on perception of disease and proximity to disease location. We found that hunters harvested fewer deer in the 4 years following disease discovery but that in the next 4-year period harvest rates increased to be similar to those from before the discovery of the disease. This indicates that changes in behavior due to disease presence may diminish over time. An empirical analysis of hunter response to chronic wasting disease in Alberta

Pattison-Williams et al 2020

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An integral partner in CWD management is the hunting community. This article empirically explored the response of Alberta mule deer hunters to CWD by modeling license application trends in areas where CWD has been positively detected in wild cervids. Results indicated that hunters are continuing to apply to hunt mule deer in areas with CWD and this relationship is not statistically impacted by the increasing prevalence of CWD. This outcome may be because CWD prevalence in Alberta is relatively low (but increasing), which is consistent with the literature indicating that few hunters avoid CWD zones until prevalence increases dramatically. Results also suggest that hunter-based strategies remain effective options for management. Chronic Wasting Disease Modelling: An Overview Winter and Escobar 2020 To update the research community regarding the status quo of CWD epidemiologic models, a meta-analysis on CWD research was conducted and explored the analytical methods used historically to understand CWD. CWD modeling was initiated in the early 2000s and has increased since then. Studies focused primarily on regression and compartment model–based models, population-level approaches, and host species of game management concern. Similarly, CWD research focused on single populations, species, and locations, neglecting modeling using community ecology and biogeographic approaches. Chronic wasting disease detection relied on classic diagnostic methods with limited sensitivity for most stages of infection. Past modeling efforts generated a solid baseline for understanding CWD in wildlife and increased our knowledge on infectious prion ecology. Future analytical efforts should consider more sensitive diagnostic methods to quantify uncertainty and broader scale studies to elucidate CWD transmission beyond population-level approaches. Considering that infectious prions may not follow biologic rules of well-known wildlife pathogens (i.e., viruses, bacteria, fungi), assumptions used when modeling other infectious disease may not apply for CWD. Chronic wasting disease is a new challenge in wildlife epidemiology. Inactivation of chronic wasting disease prions using sodium hypochlorite (bleach) Williams et al 2019 Hunters, meat processors and others in contact with tissues from potentially CWD-infected cervids need a practical method to decontaminate knives, saws and other equipment. Prions are notoriously difficult to inactivate, and most effective methods require chemicals or sterilization processes that are either dangerous, caustic, expensive or not readily available. Although corrosive, sodium hypochlorite (bleach) is widely available and affordable and has been shown to inactivate prion agents including those that cause scrapie, bovine spongiform encephalopathy and Creutzfeldt-Jakob disease. In the current study, bleach was confirmed as an effective disinfectant for CWD prions at minimum times and bleach concentrations. A five-minute treatment with a 40% dilution of household bleach was effective at inactivating CWD seeding activity from stainless-steel wires and CWD-infected brain homogenates. However, bleach was not able to inactivate CWD seeding activity from solid tissues in our studies. Chronic wasting disease and implications for cervid populations Ketz et al 2019

Geographic detection and distribution of CWD notably increased after 2002, although the disease has been present in North America since at least the 1960s. CWD is characterized by a prolonged course of individual infection, lengthy epizootics that last for decades, and delayed population effects until after prevalence has reached a sufficient level. The available literature on CWD was reviewed and synthesized to assess the current state of the science on disease dynamics and population impacts. The early phase of a CWD epizootic is characterized by slowly increasing prevalence and geographic spread, but these eventually accelerate and lead to declines in survival and recruitment that drive population reductions. The threshold for these population impacts depends on species-specific demography, genetics,

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transmission and numerous factors influencing cervid infection and mortality. As prevalence and spread continue to accelerate, management actions to mitigate CWD impacts will be challenging, costly and will likely require changes in how we manage cervid populations.

Chronic Wasting Disease in Cervids: Implications for Prion Transmission to Humans and Other Animal Species Osterholm et al 2019 CWD has been confirmed in at least 26 U.S. states, three Canadian provinces, South Korea, Finland, Norway, and Sweden, with a notable increase in the past 5 years. The continued geographic spread of this disease increases the frequency of exposure to CWD prions among cervids, humans, and other animal species. Since CWD is now an established wildlife disease in North America, proactive steps, where possible, should be taken to limit transmission of CWD among animals and reduce the potential for human exposure.

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APPENDIX 4: Incidence Command System (Template)