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From virus to biomass: 7 steps that will make the change in disease control
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From virus to biomass: 7 steps that will make the change in disease control

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I would like to share my vision the possibilities to prevent the return of H7N9. All measures taken in the past to stop major outbreaks have totally failed in every sense of the word. It is time for ...

I would like to share my vision the possibilities to prevent the return of H7N9. All measures taken in the past to stop major outbreaks have totally failed in every sense of the word. It is time for radical change in dealing with outbreaks. This is my step-by-step approach to battle outbreaks.

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    From virus to biomass: 7 steps that will make the change in disease control From virus to biomass: 7 steps that will make the change in disease control Document Transcript

    •  From  virus  to  biomass    -­‐  7  steps  that  will  make  the  change  in  disease  control  -­‐  Harm  Kiezebrink   Page  1   5/30/13  GENEVA—The  H7N9  virus  appears  to  have  been  brought  under  control  in  China  largely  due  to  restrictions  at  bird  markets.  This  outbreak  and  the  countermeasures  taken  created  some  $6.5  billion  in  losses  to  the  economy,  UN  experts  said  on  Tuesday.    This  new  bird  flu  strain  is  known  to  have  infected  130  people  in  mainland  China  since  the  start  of  the  outbreak  in  March,  causing  36  to  die.  “No  new  cases  have  been  reported  since  early  May”,  said  Health  Minister  Li  Bin  during  a  meeting  of  the  World  Health  Organization.  During  the  month  of  April  one  case  was  reported  in  Taiwan,  making  a  total  of  131  cases.    The  problem  with  this  strain,  unlike  H1N1  which  kills  off  flocks,  is  that  it  is  virtually  impossible  for  farmers  to  detect.  Juan  Lubroth,  chief  veterinary  officer  at  the  UN’s  Food  and  Agriculture  Organization  (FAO)  during  a  presentation  at  the  World  Health  Assembly  in  Geneva  said:    “H7N9  is  nearly  impossible  for  farmers  to  detect,  unlike  H1N1  which  kills  off  flocks.  The  economic  impacts  of  H7N9  have  been  astounding,  over  $6.5  billion  has  been  lost  in  the  agriculture  sector  because  of  prices,  consumer  confidence  and  trade.  So  poultry  industry  losses  in  China  have  been  high.”  Mr.  Lubroth  did  mention  later  on  that  the  statistics  came  from  estimates  made  by  China’s  agriculture  ministry.  China’s  Health  Minister  Bin  Li  said:  local  Chinese  authorities  had  shut  down  live  poultry  markets  “temporarily  or  permanently  as  needed”  to  control  the  source  of  outbreaks  in  10  provinces.  It  standardized  methods  of  transporting  poultry  to  reduce  spread  amongst  birds.  So  far,  China’s  government  has  spent  600  million  RMB  or  $97  million  to  support  the  development  of  the  poultry  industry,  Li  said.  Keiji  Fukuda,  WHO  assistant  director-­‐general  for  health  security  explained  that  the  danger  of  large  scale  outbreaks  is  far  from  over:  “The  immediate  outbreak  has  been  controlled,  but  it  is  also  unlikely  that  the  virus  has  simply  disappeared.  We  believe  we  need  to  go  through  another  autumn/winter/spring  season  before  we  really  know”.      
    •  From  virus  to  biomass    -­‐  7  steps  that  will  make  the  change  in  disease  control  -­‐  Harm  Kiezebrink   Page  2   5/30/13  Fukuda  also  said  that  there  was  no  evidence  of  sustained  spread  among  people:    “Most  cases  probably  resulted  from  infected  poultry  or  perhaps  contamination  related  to  live  poultry  markets,  there  have  been  no  (human)  cases  since  May  8;  that  is  a  good  indication  and  means  measures  have  been  implemented  and  taken  seriously.”    Bernard  Vallat,  head  of  the  World  Organization  for  Animal  Health  (OIE),  told  reporters:  “Now  when  the  virus  is  found  at  a  poultry  market,  all  birds  are  killed.  That  is  important,  too.”    Liang  Wannian  of  China’s  health  ministry  said:  “Out  of  60,000  samples  taken  from  birds,  53  were  found  to  carry  the  virus”.      These  are  the  official  statements  on  the  latest  H7N9  developments  in  China.  The  recap:  for  now  we  have  it  under  control;  it  is  far  from  over;  the  economic  costs  have  been  enormous;  next  season  we  will  see  if  and  in  what  strain  it  will  return.  There  is  a  window  of  time  to  prepare  for  what  might  come  this  autumn,  when  a  new  flu  season  starts.      
    •  From  virus  to  biomass    -­‐  7  steps  that  will  make  the  change  in  disease  control  -­‐  Harm  Kiezebrink   Page  3   5/30/13  Everything  failed  until  today    I  would  like  to  share  my  vision  the  possibilities  to  prevent  the  return  of  H7N9.  All  measures  taken  in  the  past  to  stop  major  outbreaks  have  totally  failed  in  every  sense  of  the  word.    It  is  time  for  radical  change  in  dealing  with  outbreaks.  This  is  my  step-­‐by-­‐step  approach  to  battle  outbreaks.    Step  1:  Community  building:  Who  are  the  victims?    Of  course,  the  animals  that  are  infected  and  those  animals  that  are  eradicated  to  stop  an  outbreak  are  the  obvious  victims.  But  they  are  not  the  only  ones.  Let  me  explain  what  goes  wrong  when  a  farmer  starts  to  realize  that  there  is  something  wrong  with  his  poultry.  He  recognizes  that  an  unusual  amount  of  birds  look  sick,  or  die.  He  probably  knows  that  he  will  get  compensated  in  one  way  or  another,  but  he  also  knows  that  he  will  only  receive  compensation  for  direct  losses,  not  for  economic  costs  such  as  his  inability  to  restock.      There  is  also  a  social  stigma  attached  for  the  farming  family.  The  flocks  of  the  neighboring  farms  are  going  to  be  killed  as  a  result  of  the  outbreak  that  started  or  was  first  discovered  on  his  farm.  In  small  communities,  this  is  a  social  disaster  and  a  shame  for  the  farmer  and  his  family.  This  is  particularly  the  case  if  animal  viruses  
    •  From  virus  to  biomass    -­‐  7  steps  that  will  make  the  change  in  disease  control  -­‐  Harm  Kiezebrink   Page  4   5/30/13  infect  and  kill  humans.  When  this  happens,  the  entire  family  is  stigmatized  within  the  community.  It  is  not  strange  that  in  such  communities  farmers  will  try  to  hide  the  problems  in  the  hope  another  party  will  come  forward  first.      Change  of  focus:      The  focus  should  be  far  more  on  teaching  communities  about  disease  recognition,  prevention  and  the  usefulness  of  distancing  animals  from  humans  to  prevent  A2H  infection.  Farmers  should  be  taught  how  to  kill  animals  without  A2H  contact  and  how  to  dispose  of  infected  carcasses  in  a  safe  manner.  Training  local  veterinary  officers  online  should  be  given  the  highest  priority  because  of  its  reach.  This  can  be  complemented  with  in-­‐class  training  for  regional  veterinary  inspectors,  helping  to  understand  them  how  to  turn  (International)  guidelines  into  practical  and  efficient  SOP’s.    Step  2  How  to  prevent:  not  by  rapid  response    Many  countries  have  formed  special  teams  to  carry  out  rapid  response  activities.  Immediately  after  the  first  signs  of  an  outbreak,  the  teams  are  sent  out  and  start  culling  animals.  It  looks  great,  but  in  all  45  countries  I  have  worked  on  the  review  and  implementation  of  Emergency  Response  procedures,  I  have  yet  to  see  any  positive  results  coming  from  such  strategy:  too  little  -­‐  too  late.      Too  much  focused  on  the  actual  killing  of  animals  and  not  on  issues  such  as  the  prevention  of  viruses  to  spread  amongst  locals  nor  on  efficient  &  effective  traffic  control  and  zoning.  And  the  capacity  is  most  of  the  time  absolute  insufficient  to  deal  with  multiple  outbreaks.  There  aren’t  even  measures  dealing  with  control  of  illegal  animal  transportations  out  of  the  infected  areas,  transmission  of  A2H  infection,  etc.  Taking  away  responsibility  from  the  farmer  and  putting  it  in  the  hands  of  only  a  small  team  of  trained  emergency  responders  is  a  mistake.  In  case  the  outbreak  spirals  out  of  control,  the  capacity  is  insufficient  to  launch  even  medium  scale  outbreak  response  measures.        
    •  From  virus  to  biomass    -­‐  7  steps  that  will  make  the  change  in  disease  control  -­‐  Harm  Kiezebrink   Page  5   5/30/13  Change  of  focus    The  farmer  suffers  the  most  when  his  animals  are  infected.  He  bears  the  responsibility  to  protect  his  business  through  the  implementation  of  biosecurity  measures.  The  situation  is  comparable  to  the  risk  of  fire.  The  farmer  needs  to  have  fire  extinguishers  at  hand  as  a  first  response  tool  in  order  to  prevent  his  farm  from  burning  to  the  ground.  Likewise,  the  farmer  has  the  primary  responsibility  to  respond  to  a  disease  by  informing  the  authorities  followed  by  killing  animals  on  the  farm.  By  making  use  of  techniques  which  prevent  A2H  contact  he  can  do  so  safely  and  efficiently.  The  Anoxia  Method  is  the  best  method  for  this.      Step  3:  Emergency  response:  How  to  prevent  large-­‐scale  outbreaks      An  outbreak  of  animal  diseases  is  a  crisis,  not  yet  a  disaster.  When  it  happens,  it  is  the  responsibility  of  the  government  apparatus  such  as  the  Veterinary  authorities  to  manage  and  coordinate  all  activities.  Veterinary  authorities  should  not  be  involved  in  carrying  out  control  measures  as  it  results  in  a  conflict  of  interest.      Unfortunately,  this  is  what  is  happening  during  every  major  outbreak.    In  China,  during  a  crisis  situation,  the  only  group  that  has  had  some  kind  of  training  in  disease  control  is  Veterinary  managers.  These  are  the  only  people,  because  of  their  understanding  of  the  English  language,  who  have  understood  the  foreign  Experts  that  gave  these  training  courses.  In  an  attempt  to  spread  this  knowledge  further  downstream,  a  half-­‐day  Train-­‐The-­‐Trainer  course  has  been  added  to  the  curriculum.  I  have  provided  these  courses  the  world  over  and  in  hindsight  I  have  doubts  if  these  courses  have  helped  the  150.000  veterinary  officers  and  their  1.500.000  veterinary  assistants.  When  the  first  signs  of  a  larger  outbreak  occur,  local  farmers  and  local  officials  are  recruited  to  go  and  kill  animals.  The  responders  are  not  the  ones  that  have  received  proper  training.        
    •  From  virus  to  biomass    -­‐  7  steps  that  will  make  the  change  in  disease  control  -­‐  Harm  Kiezebrink   Page  6   5/30/13  Change  of  focus:    It  is  not  the  task  of  veterinary  officers  to  do  the  field  work:  they  are  in  charge  and  responsible  for  the  management,  the  safety  of  the  responders,  the  control  over  the  traffic;  the  registration  &  administration;  the  finance;  the  legal  issues;  the  specific  veterinary  tasks  like  epidemiology  &  surveillance;  Occupational  health  &  Safety,  providing  tools  &  equipment,  etc.  Local  farmers  and  local  officials  should  be  excluded  from  carrying  out  the  response  activities  in  case  of  very  large  outbreaks.  The  best  solution  is  to  train  local  fire  brigades  as  the  first  responders  to  outbreak  situations.  The  Anoxia  Method  should  be  their  method  of  Choice.  Firefighters  are  likely  to  have  a  better  understanding,  after  training  of  course,    of  the  human  health  risks  involved  and  how  to  protect  against  the  risks  of  infection;  fire  brigades  already  have  most  of  the  materials  to  use  the  Anoxia  method;  firefighters  are  trained  to  work  under  stress,  still  being  able  to  carry  out  orders.        Step  4:  Prevent  any  A2H  contact,  whatever  it  takes    Preventing  an  outbreak  by  closing  down  markets  is  costly,  but  it  is  the  price  of  panic  amongst  the  population  and  amongst  government  officials.  A  large-­‐scale  infection  amongst  relief  workers  is  the  spark  to  the  gunpowder  barrel.        The  risk  of  creating  a  human  pandemic  caused  by  choosing  the  wrong  procedures  to  stop  an  outbreak  is  very  serious,  given  the  fact  that  still  so  much  is  still  unknown  about  the  source  of  infection  and  they  way  humans  got  infected  during  the  early  stages  of  an  outbreak.  Therefore,  all  existing  methods  of  culling  and  slaughter  of  animals  should  be  banned,  because  they  are  all  based  on  (partial)  A2H  contact.  All  methods  are  based  on  mobilizing  existing  methods  of  slaughter  e.g.  hypoxia  methods,  using  gas;  electricity  based  methods;  mechanical  methods.  All  existing  methods  have  been  made  applicable  for  specific  use  only,  based  on  the  type  of  housing;  type  of  animal  species;  number  of  animals  etc.  Not  one  method,  except  for  the  anoxia  method,  can  be  applied  as  a  general  method  of  choice.          
    •  From  virus  to  biomass    -­‐  7  steps  that  will  make  the  change  in  disease  control  -­‐  Harm  Kiezebrink   Page  7   5/30/13  Change  of  focus    To  prevent  A2H  contact,  the  Anoxia  method  should  be  used  as  the  standard  method  of  euthanizing  animals  in  the  field;  carried  out  by  trained  fire  brigades;  excluding  A2H  contact.  This  is  a  key  issue  to  prevent  panic.      Step  5  Depopulation  of  animals:  Euthanasia  instead  of  mass  slaughter  or  killing        When  the  time  has  come  to  take  the  decision  to  cull  large  numbers  of  animals,  no  country  in  the  world  is  ready  for  the  logistics  involved.    Discussing  options  has  proven  to  have  a  negative  effect  on  the  consumption  of  animal  products,  besides  that,  governments  need  to  pretend  to  have  control  to  prevent  panic  in  the  market:  “It  will  not  happen,  we  are  prepared”.        The  moment  an  outbreak  occurs  it  becomes  clear  no  safe  procedures  and  proper  materials  or  personnel  are  in  place  to  deal  with  a  real  large-­‐scale  outbreak.  It  happens  all  over  the  world  and  it  is  very  hard  to  predict  when  and  where  the  next  outbreak  will  take  place.  The  outcome  is,  unfortunately,  invariably  the  same:  animals  are  being  treated  as  if  they  are  the  primary  source  of  all  evil  turning  responders  into  torturers.  Animals  are  buried  alive,  burned  alive  or  thrown  into  the  river  (alive)  with  their  ears  clipped  off  to  prevent  the  carcasses  to  be  traced  back  to  their  owners.      Change  of  focus    All  animals  are  equal  and  no  animal  is  more  equal  than  others.  All  animals  deserve  respect,  even  if  they  are  sick,  infected  or  crippled.  Euthanizing  them  without  any  form  of  stress  or  pain  is  the  best  possible  option,  and  therefore  the  Anoxia  method  should  be  used  to  euthanize  animals.        
    •  From  virus  to  biomass    -­‐  7  steps  that  will  make  the  change  in  disease  control  -­‐  Harm  Kiezebrink   Page  8   5/30/13  Step  6  Disposal:  Use  fermentation  as  the  first  option                        Viruses  need  living  animals  to  replicate  and  the  replication  stops  at  the  moment  the  animal  is  dead.  For  that  reason,  animals  should  be  killed  as  soon  as  possible.  However  contaminated  carcasses  still  need  to  be  disposed  of  properly.  The  virus  does  not  replicate  any  more  but  is  still  present  or  in  case  of  a  bacterial  disease  the  carcass  is  still  very  much  contagious.  After  killing  the  animals,  the  next  question  is:  what  to  do  with  the  carcasses  and  infected  manure?      Standard  procedure  is  to  load  carcasses  on  open  trucks  and  trailers  and  transport  them,  through  populated  areas,  to  a  burial  or  incineration  location.  The  manure  is  usually  buried  at  the  farm.  The  risks  of  spreading  viruses  or  bacterial  infections  through  transportation,  pollution  of  ground  water  and  poor  disposal  management  are  high,  besides  that,  animals  cannot  be  buried  near  rivers  or  in  mountainous  rocky  areas.  The  place  used  for  burial  of  animals  cannot  be  reused  for  decades  and  there  is  always  the  risk  of  scavengers  digging  up  the  carcasses.  Thus  burial  is  not  the  most  ideal  method  of  disposal  of  carcasses.  Incineration  and  burning  carcasses  is  not  an  option  either:  contaminated  dust,  straw  and  feathers  are  blown  into  the  sky,  transporting  the  organic  infected  materials  over  large  distances.    Change  of  focus      If  possible,  carcasses  should  be  handled  at  the  farm,  using  fermentation.  The  carcasses  and  manure  are  piled  together  and  wood  chips  are  added.  The  pile  is  covered  under  large  plastic  sheets  to  start  the  fermentation  process.  The  temperature  will  kill  all  viruses  and  the  materials  coming  out  after  the  fermentation  process  is  finished  are  safe  for  reuse  as  fertilizer.      
    •  From  virus  to  biomass    -­‐  7  steps  that  will  make  the  change  in  disease  control  -­‐  Harm  Kiezebrink   Page  9   5/30/13      Step  7  Carcass  disposal:  turn  animal  corpses  into  biomass  energy    What  to  do  with  large  numbers  of  infected  animals  if  fermentation  is  not  an  option?  Fermentation  requires  specific  farming  conditions,  and  in  case  these  are  not  met,  carcasses  have  to  be  transported  away  from  the  farm.  This  can  be  done  safely  using  container  zip-­‐bags  and  transport  to  a  cold  storage  facility  for  temporary  storage  purposes.  The  cold  storage  capacity  can  easily  be  increased  by  building  temporary  cold  storages  in  empty  warehouses.      Within  one  day  a  warehouse  can  be  turned  into  a  cold  storage  so  the  capacity  is  therefore  practically  unlimited.  Later,  the  frozen  carcasses  can  be  transported  safely  to  a  location  where  it  is  used  as  biomass.    Change  of  focus    Turning  infected  carcasses  into  biomass  is  adding  a  profit  to  the  process  instead  of  a  calculated  loss  of  a  valuable  resource.  But  for  all,  it  is  the  safest  and  most  practical  way  of  handling  infected  carcasses                About the authorHarm Kiezebrink (1958) is an international consultant on animal diseasecontrol and emergency management. He has hands-on experience in variousmass culling operations and developed new technologies for optimumperformance. He is a regular advisor for national governments andinternational organizations.