Sixth international ministerial conference on ai(sharm el sheikh)


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an International conference on Avian and Pandemic Influenza Virus

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Sixth international ministerial conference on ai(sharm el sheikh)

  1. 1. Welcome you all in the sixth International Ministerial Conference on Avian and Pandemic Influenza in Egypt October 2008
  2. 2. Egypt Experience In Combating Avian Influenza
  3. 3. Current situation of AI in Egypt
  4. 4. n .o p s i e a e o f oi v c s s t 0 100 200 300 400 500 600 700 800 900 1000 f bur e r ay mr h ac 212 a rl pi 26 1st Wave my a 621 jn ue 193 2006 jl uy 2006 a gt us s pe b r e t me ot br co e 10 1 4 8 2 nv me oe br 10 d c me e e br 28 j nay a ur 2nd Wave f bur e r ay mr h ac 61 60 20 a rl pi 60 my a jn ue jl uy Month 2007 a gt us s pe b r e t me ot br co e 2007 nv me oe br 1013 9 5 1 2 1 d c me e e br j nay a ur Feb. 2006 till September 2008 3rd Wave 68 f bur e r ay 40 19 mr h ac a rl pi my a 2008 jn ue Epidemic curve (passive and active surveillance) 14 5 6 2 jl uy a gt us Spe b r e t me 14 2
  5. 5. AI situation in farms (sectors 2&3) and backyard (sector 4): 2006 to 2008 . backyard farm 1000 845 800 600 247 400 226 94 200 27 35 0 2008 2007 2006
  6. 6. 80% 20%
  7. 7. Human cases of Avian Influenza • Total Positive Cases 50 22 Deaths 28 Recovered • Distribution by Gender : 16 Males 34 Females • Breading Type: 2 Cases Farm workers 48Cases Backyard Owners
  8. 8. Confirmed H5N1 Human Cases 2006-2008 10 9 (2 8 ) R e c o v e re d M 8 (2 2 ) D e a ths F 7 M 6 M F F 5 M F M F 4 M F F F F 3 F F F M M F M M 2 F F F F F F M F F F F 1 F F M M F F F F F F F F F F M 0 . . . . ly ly ay ay . . ne ne . . il il il b. b. . . ch ch ch ct ct 7 8 ov ec ov ec ug ug 6 ep ep pr pr pr .0 .0 Ju Ju .0 Fe Fe O O M M Ju Ju ar ar ar N D N D A A S S A A A n n b M M M Ja Ja Fe
  9. 9. Total Admitted, Suspected Human cases for H5N1, Egypt, till October 2008 Suspected Confirmed Year cases cases 2006 1991 18 2007 1829 25 2008 1680 7 Total 5500 50
  10. 10. National Strategies for control of HPAI
  11. 11. 1. Complete Transparency • Egypt has been recognized globally for its transparency policy. • All information regarding the outbreak in birds and infection in humans were openly communicated to the public. • Immediate notification to WHO, OIE, FAO and other international organizations.
  12. 12. 2. Political Commitment Avian Influenza Steering Committee (AISC) Avian Influenza Avian Influenza National Committee Technical (AINC) Committee (AINC) Avian Influenza Local Committee (AINC)
  13. 13. 3. Inter-sectoral collaboration • Joint action by different central government ministries. • Full engagement of the concerned Governors. • Participation of private producers in control measures. • Consistent efforts to change consumer’s behavior to consume frozen poultry meat rather than to purchase and slaughtering live birds.
  14. 14. 4. Following international recommendations • The government began HPAI control strategy and implemented stamping out policy (over 30 million were culled). • Mass vaccination of commercials & backyard flocks (more than 196 million household birds free of charge and more than 750 million farm birds have been vaccinated). • International regulations regarding avian influenza epidemic were applied and followed through a joint partnership with WHO, FAO, OIE, and other international agencies.
  15. 15. 5. Restructuring the poultry industry • Ensure safe poultry production. • Poultry farms census • Strengthen active surveillance in poultry farms and backyards. • Raise Public Awareness, control movement of birds, and strengthen quarantine measures. • Apply strict Biosecurity regulations. • Strengthen veterinary services & national lab infra structure. • Increase capacity of poultry slaughter houses and cold chain. • Establishment of AI free compartment.
  16. 16. Risk factors associated with AI in Egypt • Migratory birds flyways. • Some random & condensed poultry farms, Lack of biosecurity. • Extensive backyard & rooftops rearing of birds • Live bird Markets & shops • No geographical borders between the Egyptian governorates that affect movement control . • Capacity of slaughter houses cover about 50% of our production.
  17. 17. 6. Dealing with Human Cases • Egypt developed its own case definition for early detection; an algorithm for dealing with suspected cases, and it established good medical case management that led to decrease in the case fatality rate. • Dissemination of the case definition, algorithm, and case management protocols. • Identification of referral hospitals fully prepared and equipped to handle suspected human cases. • Stockpiling of the antiviral therapy (2.4 Million doses) and doses necessary medical and PPE.
  18. 18. Cont. Case management protocols • Suspected cases are referred to the nearest chest or fever hospital, and the antiviral therapy begins upon admission, with testing for AI. • The suspected cases are transferred to a previously identified referral hospital upon confirmation of the infection (either through a positive test or severe signs). • Patients are discharged after tests are negative.
  19. 19. 7. Training • Rapid Response Team training (1996 trainee). trainee • Ongoing training courses on safe culling and disposal of infected dead birds (11,000 trainee). trainee • Training for hospitals and health directorates staff (1000 trainee). trainee • Infection control training for health care workers. • Training of lab personnel in the field of avian influenza diagnosis and molecular characterization of AIV. • Training on proper sampling, identification and transportation of samples for (4200 trainee). trainee
  20. 20. 8. Surveillance • Regular reporting system established. • Establishing two reference labs. in Cairo one in MOHP and the other in MOALR. • Establishing four peripheral public health labs and 3 satellite Labs of MOALR. • More than 600,000 samples from chickens were tested for AI. • Sequence of Egyptian AI H5N1 viruses isolated from birds. • Capacity building for Labs. staff, field epidemiologists. • Immediate notification and reporting from peripheral to central level. • Hospital based influenza surveillance is ongoing.
  21. 21. 9. Communication • Over 10 million home visits conducted by 13,000 trained female health educators. • Sixteen TV spots were produced and aired. • More than 6700 seminars for raising awareness of public were conducted. • Raising awareness campaigns using mobile vans. vans • More than 2,000,000 posters and leaflets were produced and disseminated.
  22. 22. Key Constraints & Challenges • Surveillance is difficult due to Extensive rearing of backyard and roof top birds in rural and urban areas. • No geographical borders between the Egyptian governorates that affect movement control . • Lack of biosecurity measures in small scale poultry farms. • Egyptian culture regarding the handling of live poultry and the practice of slaughtering the birds at home. • Avian Flue Fatigue among the public, media, health and veterinary sectors.
  23. 23. Pandemic Preparedness Plan
  24. 24. Guiding Measures 1. Social distancing 2. Organizing health care services 3. Regulation of socio-economic life 4. Application of infection control measures 5. Use of anti-viral drugs 6. Use of vaccines
  25. 25. Associated Plans A set of protocols and plans are already prepared for pandemic preparedness: 1. Supplies management plan. 2. Infection Control protocols. 3. Quarantine measures plan. 4. Clinical management protocols. 5. Deaths manipulation plan. 6. Hospital management plan. 7. Primary health care units management plan. 8. Communication and education plan. 9. Roles of all related ministries and their interventions plan.
  26. 26. Command And Control in Egypt Strategic Level Higher Ministerial (Political) Committee Planning & Preparation Level National Pandemic Inter-ministerial Committee (Tactic) Executive Level Governorates (Operational)
  27. 27. Flow of “Pandemic” Alert The Higher Ministerial Committee (Cabinet secretariat) Operational Room Operational Room National “Pandemic” National “Pandemic” (IDSC) (IDSC) Inter-Ministerial Committee Inter-Ministerial Committee Ministry of Health WHO (MOH) Governorate (MOH) (local authority) Local Directorates Hospitals Other Schools / Health care Civil Emergency Community Universities Private Clinics Gatherings Units Society Police
  28. 28. Notification Flow during Pandemic phase The Higher Ministerial Committee (Cabinet secretariat) Operational Room Operational Room National “Pandemic” National “Pandemic” Mass (IDSC) (IDSC) Inter-Ministerial Committee Inter-Ministerial Committee Media Ministry of Governorate WHO Health (MOH) (local authority) (MOH) Ministry of Interior Local Directorates Directorates (MOH) Cities / Centers Sub-local unit / Districts Other Hospitals / Schools / Health care Civil Emergency Community Gatherings Universities Private Clinics Units Society Police
  29. 29. Pandemic” Response Chain of Command (National Level) The Higher Ministerial Committee Ministry of (Cabinet secretariat) defense Ministry of Interior affairs National “Pandemic” National “Pandemic” Operational Room Operational Room Inter-Ministerial Committee Inter-Ministerial Committee Foreign Affairs (IDSC) (IDSC) Ministry of International Ministry of Cooperation Information Ministry of  Ministry of WHO Ministry of Education Health (MOH) Justice Ministry of State for Environment Affairs Ministry of State for Local Ministry of (MOH) Development Transport Ministry of Social Local Directorates Solidarity Ministry of Ministry of Finance Culture Ministry of Electricity and Energy (MOH) Ministry of Agriculture and Land Ministry of Local Districts Reclamation Petroleum Ministry of Manpower and Immigration Ministry of Communication and Ministry of Hospitals / Information Technology Tourism Ministry of trade and Health care Industry Ministry of Water Resources & Units Ministry of Awqaf Irrigation Ministry of Civil Aviation Ministry of Higher Education and NGOs the State for Scientific Research Supreme councils of Youth & Suez canal Sports authority