Your SlideShare is downloading. ×
0
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
AI in Holland 2003: Lessons Learned from the response activities in Holland?
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

AI in Holland 2003: Lessons Learned from the response activities in Holland?

290

Published on

Lessons learned from the large scale outbreak of Avian Influenza in Holland 2003, based on the publications of Central Institute Animal Disease Control (CIDC – Lelystad, Holland). …

Lessons learned from the large scale outbreak of Avian Influenza in Holland 2003, based on the publications of Central Institute Animal Disease Control (CIDC – Lelystad, Holland).

Published in: Technology, Health & Medicine
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
290
On Slideshare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
9
Comments
0
Likes
1
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide
  • 07/04/13
  • 07/04/13 This is a cartoon of the structure of the influenza virus. As you can see, it consists of genetic material (point to RNA strands) , wrapped in a protein coat (point to protein coat) . Influenza’s genetic material is RNA as opposed to DNA and it comes in 8 separate segments (CLICK). The protein coat is also special in that it’s decorated with spiky and knob-shaped proteins called hemagglutinin (CLICK) and neuraminidase (CLICK). These two proteins help influenza to attach, invade, and get out of host cells. The RNA segments are the blueprints that encode for the protein coat. Changes in the RNA blueprints will alter the composition of the protein coat including the appearance of the spikes and knobs.
  • 07/04/13
  • 07/04/13 Situation at the start of the outbreak: We knew that two different viruses circulated in wild waterfowl.
  • 07/04/13
  • 07/04/13
  • 07/04/13
  • Transcript

    • 1. Dutch Avian Influenza outbreak 2003 Lessons to be learnedThe information used in this presentation is based upon publications by the RVV, Central Institute Animal Disease Control (CIDC – Lelystad, Holland)
    • 2. Part one: The Avian Influenza virus What is Avian Influenza? Why is it so dangerous? Why is protection not possible?04/07/13 www.N2GF.com 2
    • 3. Avian Influenza characteristics 256 possible combinations of AI Different viruses simultaneously occurred in Asia Change of character within one (!!) month04/07/13 www.N2GF.com 3
    • 4. INFLUENZA VIRUS STRUCTURE Nucleoprotein Matrix protein Haemagglutinin 8 RNA segments Neuraminidase04/07/13 www.N2GF.com 4
    • 5. GENETIC REASSORTMENTH10N7 H7N7H7 N3 New Influenza virus: Cell 256 POSSIBLE COMBINATIONS!04/07/13 www.N2GF.com 5
    • 6. VIRUS CHARACTERISTICS  A/chick/2003-H7N7  All genes are of avian origin  IVPI = 2,94  Sequence at cleavage site: – P E I P K R R R R.G L F  H7 closely related with A/mallard/2000 H7N3  N7 closely related with A/mallard/1999 H10N7  No additional glycosylation sites (suggest recent introduction from wild fowl)04/07/13 www.N2GF.com 6
    • 7. WILD BIRD SURVEILLANCE  In 1999 subtype H10N7 and 2000 subtype H7N3 was isolated from mallard (Anas platyrhynchos) in the Netherlands04/07/13 www.N2GF.com 7
    • 8. AI OUTBREAK IN THE NETHERLANDS  Precursor of the H7N7 virus of Dutch outbreak 2003 is probably a re -assorted LPAI viruses that circulated in waterfowl04/07/13 www.N2GF.com 8
    • 9. Conclusions Part one The most likely course of an outbreak of AI is contact between livestock and waterfowl Infected waterfowl keep flying over livestock area ’s during the bird track Avian Influenza is most likely less mortal under waterfowl in the first period of the incubation time04/07/13 www.N2GF.com 9
    • 10. Part two Why was the crises in Holland so intense? Where did the outbreak start? Why were the results for the Dutch poultry industry so catastrophic? What was the influents of scientific research prior to the outbreak?04/07/13 www.N2GF.com 10
    • 11. START OF AI OUTBREAK Friday February, 28 2003: Strong suspicion of AI on 6 layer farms in Gelderse Vallei Signs: Mortality (> 80%), drop in egg production, decreased food consumption, swollen heads, cyanosis, diarrhea and respiratory problems.04/07/13 www.N2GF.com 11
    • 12. OUTBREAKS VS. FARMS AT RISK04/07/13 www.N2GF.com 12
    • 13. POSSIBLE ROUTE OF ENTRY OF AI VIRUS Source : Agrarisch Dagblad – Free range laying hens infected by LP H7N7 variant of wild fowl – Circulated in one stable of index case indicated by positive serology in absence of signs in this stable – Mutation and selection of HP-variant in chickens – Clinical signs of AI in other stable of index case04/07/13 www.N2GF.com 13
    • 14. 11 AI outbreaks up to 7 March 200304/07/13 www.N2GF.com 14
    • 15. LPAI VIRUS THAT CIRCULATED FOR SOME TIME? nation wide serological surveillance carried out from 7-17 March Animal Health Service04/07/13 www.N2GF.com 15
    • 16. CONTROL OF AI (1) March 1 : already stand-still ±20 farms infected March 4 : infected farms culled + pre emptive culling within 1 km 04/07/13 www.N2GF.com ± 46 farms infected 16
    • 17. March 25 : culling of buffer regions (Wageningen en Putten) March 25 : Beneden Leeuwen (March 30)04/07/13 www.N2GF.com 17
    • 18. CONTROL OF AI (2)  March 27 : setting up of compartments  April 1 : culling of all flocks in protection zones GV  April 3 : Ospel (Nederweert) (7 April)  April 4 : 2e Stand-still (till April 10)  April 10 : Koningsbosch (April 14)  May 5 : Vernhout (Zundert) (May 9)  May 11 : last infected farm culled04/07/13 www.N2GF.com 18
    • 19. Lifting restrictions Sentinel birds (10%) on infected farms Testing after 3 weeks If all sentinel birds negative: lifting of surveillance zone Last surveillance zone lifted 22 August Export live poultry allowed to EU since 11 July 2003 from the Netherlands with exclusion of existing surveillance zones04/07/13 www.N2GF.com 19
    • 20. Scientific influences The European scientific world is divided in different groups, with all a different view on what the best possible solution is on culling animals Some look at it from an animal welfare point of view, others are concentrating on swift crises management, some on have made prior experiences with AI, others reject the view of other scientists, based upon their own (mostly narrow) scientific vision Fighting AI sometimes looks like an exclusive playground for scientists. Experts outside this scientific community are left out of the discussion, including farmers organisations, culling experts, scientists specialised in the human impact of the crises and scientific newcomers with a different view from what is discussed between exciting scientific experts in this field04/07/13 www.N2GF.com 20
    • 21. Conclusions part two: Why was the crises in Holland so intense? Density of poultry in the ‘Gelderse Vallei’ was too high Culling capacity too small during the first weeks of the crises Contingency plan for birds diseases was outdated and still under construction; the Dutch stamping out procedures during the crises were therefore based upon outbreak of pigs diseases, prior to the AI outbreak No real corporation between farmers and the government was established, within the first period of the crises Too much influence of experts and scientists. They had all a different view (mostly based upon scientific laboratory knowledge) on how to handle the crises. This blocked practical solutions (and the necessary pre investments in culling equipment) and paralysed the crises team that was responsible for practical planning and control04/07/13 www.N2GF.com 21
    • 22. Part three Infectiousness and spreading characteristics How was it possible that AI was spread in different area’s in Holland? What was the serologic character of the spreading in Holland? What was the most possible reason for the human mortal case?04/07/13 www.N2GF.com 22
    • 23. Mortality under animals and bio security The first signs of AI occur first after the infectiousness was on its top three days before mortality under the livestock is visible Serologic research starts after the first visible signs of AI and takes days before the AI conformation; announcing that there is a case of AI and taking precautionary measures is balanced with the financial impact for the entire industry and beyond that In case of the first outbreak, the first line of defence is entirely depending on the standard of bio security on the infected farm and the farms and the chain members, in contact with that farm04/07/13 www.N2GF.com 23
    • 24. EXAMPLE MORTALITY (flock of 3800) 2000 1934 1500 Flock number infectiousness 1000 799 583 500 5 15 80 0 23 24 25 26 27 28 day in Feb.04/07/13 www.N2GF.com 24
    • 25. NUMBER INFECTED FARMS: 241 14 12 Number of infec ted farms 10 8 6 4 2 0 7/3 4/4 2/5 28/2 14/3 21/3 28/3 11/4 18/4 25/4 date (2003)04/07/13 www.N2GF.com 25
    • 26. SEROLOGY IN INFECTED ZONES 16 Total: number 14 133548 12 10 Number x 1000 8 6 4 2 0 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 Week negative pos itive04/07/13 www.N2GF.com 26
    • 27. AVIAN INFLUENZA: RT-PCR 1400 Total number: 1200 6073 1000 Number of samples 800 600 400 200 0 10 12 14 16 18 20 22 24 26 28 30 32 34 Week negative positive04/07/13 www.N2GF.com 27
    • 28. AVIAN INFLUENZA - VIRUS ISOLATION 140 120 Total number: 702 l aantal 702 : 702 Number of samples 100 80 60 40 20 0 10 12 14 16 18 20 22 24 26 28 30 32 34 week negative positive04/07/13 www.N2GF.com 28
    • 29. RESULTS SEROLOGAL AI-MONITORING IN THE INFECTED REGIONS Status of Virus Number of Positive H7 farm isolation farms Infected + 241 5 - 14 14 Pre-emptive 1061 0 ¶ Prevalence within farm varies form 9 –100 %04/07/13 www.N2GF.com 29
    • 30. HUMAN CASES 25 20 Conjunctivitis Start case finding Influenza A conj. 20 H7 conjunctivitis Number of infected farms Start antivirals Farms region 2 (5-day avg) number of cases 15 Farms region 1 (5-day avg) 10 10 Fatal case 5 0 2 6 3 7 5 9 20 24 28 10 14 18 22 26 30 11 15 19 23 27 13 1 May 16-feb M. Koopmans et al RIVM04/07/13 www.N2GF.com 30
    • 31. Conclusions part three: Infectiousness and spreading characteristics AI is highly infective prior to the first mortal cases under the flock AI travels light, by dust, people, traffic, ignorance and lack of knowledge Bio security is of utter importance for the entire poultry industry. Farmers therefore must be included within the discussions about AI Minor mistakes in the contingency plan definitively lead to major consequences The human infection risk is high, especially during serological research on not- infected farms One veterinarian died after such an inspection due to a minor mistake in the Dutch contingency plan (the only mortal case during the crises in Holland)04/07/13 www.N2GF.com 31
    • 32. Part four: Speed of spreading, monitoring and culling tactics How high was the R h reproduction ratio during the crises? What is the best option: culling inside out (chasing the virus) or outside in (creating a buffer zone)? Was there an Low Path AI strain H7N7 present before High Path AI infection?04/07/13 www.N2GF.com 32
    • 33. How to stop an epidemic/ pandemic outbreak  If the Rh reproduction ratio between flocks is high, the only option is culling in large numbers to prevent an epidemic or pandemic outbreak  If the Rh ratio is in average more than one, flocks in the entire area within 3 km of an infected farm must be depopulated as soon as possible04/07/13 www.N2GF.com 33
    • 34. The speed of spreading Immediate action within the first 24 hours is vital to stop rapid spreading of the AI Holland was not prepared: R h reproduction ratio at the start of the crises was 8,6 No pre investments in culling capacity was made before the crises, due to high costs and internal political/ scientific discussions, coursing only endless discussions on funding04/07/13 www.N2GF.com 34
    • 35. INFECTION RATE REPRODUCTION RATIO RH BEFORE AND AFTER THE IMPLEMENTATION OF MEASURES Gelderse Vallei LimburgPeriod A B+C A B+C 0.86 5.0 0.91 2.9 Rh (0.28- (2.9-8.6) (0.39-2.13) (no CI) 2.68)95% confidence intervals between bracketsA, before implementation of measures, B and C, after implementation ofmeasures. Periods B and C were combined, because of non-significantdifferences J.A. Stegeman et al. 200304/07/13 www.N2GF.com 35
    • 36. STOP AN EPIDEMIC BY STAMPING OUT R>1 R<104/07/13 www.N2GF.com 36
    • 37. Culling tactics Culling from the centre of the outbreak is essential to catch up with the spreading of the virus and to reduce the R factor Creating buffer zones is essential to protect non-infected farms in the area Both options must be carried out simultaneously Two fully equipped culling crews with sufficient capacity must be available to carry out this tactic of both inside out and outside in culling approach04/07/13 www.N2GF.com 37
    • 38. Monitoring results Samples of Low Path AI were found in samples taken from the period November 2002 till February 2003, prior to the High Path outbreak 1224 farms were inspected 27.010 samples IDEXX ELISA were taken 3 farms were found positive The Low Path AI strain found prior to the outbreak was of type H7N3 This strain was detected in December 2002 The strain was isolated in an other part of country than were the crises started04/07/13 www.N2GF.com 38
    • 39. Conclusions part four Speed of spreading, monitoring and culling tactics Especially in the first week of the crises, the R h reproduction ratio is extremely high (in Holland, it was factor 8,6; meaning that one farm infected 8.6; each other infected farms infecting other farms, and so on, and so on All efforts must be put in reducing the R h ratio Both culling tactics must take place simultaneously; sufficient equipment must be available before the outbreak Funding for pre investments in culling equipment is necessary; in case the purchasing process starts after the outbreak is confirmed, the responsible government pays all the costs and the purchasing prices are not negotiable, leading to high costs and delivery problems Pre monitoring is necessary to notice possible first signs of LP- and HP-AI; in waterfowl and in livestock04/07/13 www.N2GF.com 39
    • 40. Part five: Imidiate actions What did the Dutch authorities do to stop the crises? Why did the crises team work out of a mobile crises centre? Did it help to prevent a pandemic outbreak?04/07/13 www.N2GF.com 40
    • 41. Immediate actions (1) Stand still on livestock transportation, markets, etcetera Forming crises teams on different levels Implementing zoning and transportation protocols Hiring contracters04/07/13 www.N2GF.com 41
    • 42. Immediate actions (2) Mobile crises centre; ‘Stroe’ During former animal disease crises, the Dutch authorities successfully developed a model for a mobile crises management Centre, based upon the use of a mobile office centre; all participants dealing with crises management used this centre for their operations This centre made an interdisciplinary approach possible to coordinate and control the crises Also major suppliers used this centre for their operations The centre was also used for coordinating information management, accounting, public relations and logistic purposes04/07/13 www.N2GF.com 42
    • 43. Immediate actions (3) Control Measures Stand still  Reduction of number contacts (Pre-emptive) culling  Reduction of infectiousness – Infected farms should be culled within 24 hours  Reduction of number of susceptible birds (farms) – Pre-emptive culling within 48 hours04/07/13 www.N2GF.com 43
    • 44. Immediate actions (4) Measures on February 28TH Stand still  Nation wide for 72 h – Ban of movement of live poultry, hatching eggs, poultry manure, – Export ban on all export of live poultry and eggs – Ban on gathering of poultry and other birds – Obligation to keep poultry inside - ban on free- range housing04/07/13 www.N2GF.com 44
    • 45. Immediate actions (5) Measures on February 28THProtection zone with radius of 3 km – Clinical inspection  Suspected holding: – 5 moribund or diseased birds and 20 blood samples  No disease: – 20 trachea swabs + 20 blood samples Surveillance zone with radius of 10 km – Clinical inspection  of all holdings to be finished before lifting 21 days after last cleaning and disinfection04/07/13 www.N2GF.com 45
    • 46. Culling What culling methods were used? Why did they not only use stable gassing but also the HKI Methods © ? What are the major differences between these culling methods? Why was the HCN method not used during the Dutch crises?04/07/13 www.N2GF.com 46
    • 47. Culling (1) Capacity at start low, later high (50.000 later 1 million birds per day) Methods: – CO2 gas in containers (by HKI) – CO2 gas in shed (by gas suppliers) – CO gas in shed (by gas suppliers) – CO gas in small containers (by experiment) – Electrocution machine (by HKI) – Injection with T61 (small numbers)04/07/13 www.N2GF.com 47
    • 48. Culling (2) Stable gassing versus HKI approachTotal amount of animals culled: 1.200 farms; 31,750,000 animals Stable gassing: – 45% of all farms by stable gassing – 61% of all animals by Co2 stable gassing – 5 % of all animals by Co stable gassing HKI Approach – 55% of all farms by HKI approach – 33% of all animals by HKI approach04/07/13 www.N2GF.com 48
    • 49. Culling (3) Notes on stable gassing Stable gassing as a method can be only used in large stables Housing, type of animal, age and amount of animals are crucial for deploying the most effective and efficient culling method In Holland, only 45% of all farms were suitable for stable gassing, housing 66% of all animals Individual culling is by far more complicated than Stable gassing Until now, no gas supplier has come up with better ideas to speed up this culling method to reduce the actual culling time to 10 to 15 minutes, accepting a period of 30 minutes to 3 hours as the best possible option In case of a new large scale outbreak, gas supply will be a limiting factor, due to shortage of gas trucks to transport the gas to the farms04/07/13 www.N2GF.com 49
    • 50. Culling (4) Notes on culling operation In order to cull from the inside out (chasing the virus) and culling outside in (buffering zone) two fully equipped culling teams are needed Only a view machines are needed within the crises area at the first 24 hours, but a large amount of machines have to be in stock to catch up after that Trained personnel is essential, especially to safe garden animal welfare aspects during a crises No personnel from outside the area should enter an infected zone without an absolute reason for it. Personnel should be recruited within the zone and before a possible crises. Therefore corporation with farmers and the farmers industry is crucial04/07/13 www.N2GF.com 50
    • 51. Culling (5) Notes on capacity Speed of operation is not depending on the capacity of the equipment used, nor on the culling method Speed of operation is basically a matter of proper organisation and logistics Culling operations can easily walk out of hand in case the logistics fail Registration during the culling operation is the source of future planning04/07/13 www.N2GF.com 51
    • 52. Culling (6) Notes on the veterinarian Veterinarians are used to work with animals, they are not trained to be head of operations on a culling sight Veterinarians are used to keep livestock alive and not to massive culling Speed of operation is much quicker in case the veterinarian is out of sight or not available During culling operations, animal welfare is only a matter of concern as long as there is a veterinarian safeguarding it One inexperienced or unprepared veterinarian can do more damage to the culling operation than all other members of the culling team together Veterinarians should be trained about handling animal disease crises, starting at the university level up to training on the job, to be prepared better for their role as crises manager during an outbreak04/07/13 www.N2GF.com 52
    • 53. Culling (7) HCN is not an option HCN is not longer allowed in Holland HCN is not an AC approved method listed in the European legislation HCN is only allowed for scientific purposes to test culling practices HCN is on the list of chemical weapons Better methods are available, with less danger for the people involved in the culling process Only a limited amount of experts are licensed to work with HCN04/07/13 www.N2GF.com 53
    • 54. Culling and the effect on humans What about respect? What about farmers, loosing their entire future? What about veterinarians that were not trained for the job? What about the cullers, executing millions of animals? What about animal welfare people, guessing what’s happening? What about the public, with livestock as pets? What about the press?04/07/13 www.N2GF.com 54
    • 55. Financial aspects (1) The poultry industry Direct costs: 376 million Euro (partly paid by the EC) Indirect costs: 1 milliard Euro (not insurable under the Dutch circumstances, due to the current policy of the Dutch authorities in charge of contingency planning) Damaged image of the poultry industry Cold shake out with significant losses in market chare, losses of important parent stocks and grand parent stocks Massive losses of jobs Blockade on future investments, necessary to implement new European legislation on housing, animal welfare, bio security and food quality04/07/13 www.N2GF.com 55
    • 56. Human aspects of culling (2) Farmers, cullers and veterinarians The industry is the biggest looser in the aftermath of the crises, especially the farmers and its family Special mental care has to be created for farmers, veterinarians and culling personnel to help digest their experience Professional mental coaches should be part of the crises teams during an outbreak, to avoid mistakes coursed by too high pressure due to the immense responsibilities04/07/13 www.N2GF.com 56
    • 57. Animal welfare aspects of culling (3) Animal welfare people Animal welfare people should be informed about the background of the crises, it’s consequences for animal en human welfare and about the risks of animal diseases in case of no control Animal welfare people should have (limited) access to information before, during and after a crises to judge weather all has bin done to avoid unnecessary culling of animals in conjunction with the human risks and the financial consequences for the farming industry Animal welfare people should be actively involved in examining the possible culling methods and help to improve these methods, rather than criticising the government, farmers and cullers for executing culling procedures04/07/13 www.N2GF.com 57
    • 58. Virological aspects Vaccination Transmission Diagnostics04/07/13 www.N2GF.com 58
    • 59. Vaccination aspects (1) Culling and vaccination Stamping out is the only possible option No vaccination of life stock during outbreak, only as temperately procedure in non-infected areas Vaccination of life stock protects only 96% of all vaccinated birds All vaccinated birds have to be culled (Italy, Mexico, Asia did not cull vaccinated birds, resulting in new outbreaks of new types of viruses) Protection of people: pre-amative vaccination of all people (!!) against human flue is the best possible protection of those who are in immediate contact with life stock during the crises04/07/13 www.N2GF.com 59
    • 60. Transmission of AI (1) Infection of H7N7 in pigs in Holland  48 farms with mixed herds that were located within the protection zones and had infected poultry were tested for antibodies.  13 farms: prevalence ranging from 2,2 to 42%.  No increase in prevalence after re-testing.  No evidence of efficient transmission among pigs  H7 haemagglutination inhibition test low specificity.04/07/13 www.N2GF.com 60
    • 61. Transmission of AI (2) Transmission in Asia Especially in open housing system in Vietnam and Indonesia (humans, pigs, poultry and ducks living under the same roof), bio security is likely to faille Transmission to other types of birds, elephants and dogs are recently registered Especially young children are in danger The first case of human to human transmission is currently under investigation Until now, no change of a transmitted AI virus into a new human virus is registered04/07/13 www.N2GF.com 61
    • 62. Diagnostic aspects (1) Diagnosis in field difficult lack of characteristic clinical signs. – First signs were reduction of food and water intake Early warning system – Respiratory problems – Drop egg production – Increased mortality Serological monitoring with emphasis at farms at risk (a.o. free range farms)04/07/13 www.N2GF.com 62
    • 63. Public Health aspect Reassortment could result in human pandemic To prevent development of new dangerous strain the chance of simultaneous infection with HPAI strain H7N7 and human influenza should be minimal Measures taken: Protective clothing, masks and eye protection Vaccination against human influenza Prophylactic treatment with anti viral drug Tamiflu Medical checks of people active at culling Several cases of conjunctivitis in people working at culling 88 people were directly infected, 8,000 people were indirectly infected; one veterinarian died of pneumonia caused by H7N704/07/13 www.N2GF.com 63
    • 64. Summery (1)  Influenza viruses are to stay in the wild bird population  Keep poultry separated from wild fowl  High biosecurity  Practical contingency plan  Human- and economic risk management04/07/13 www.N2GF.com 64
    • 65. Summery (2)  Compartmentalisation – targeted surveillance within compartment  Surveillance of live bird markets  Targeted vaccination programme04/07/13 www.N2GF.com 65
    • 66. Summery (3)  Corporation between farmers, animal health services and officials  Active involvement of farmers in case of an outbreak  Sufficient culling capacity to cull the maximum amount of animals within an area of 3 kilometres within 24 hours after the first positive AI test results  Yearly test of the contingency plan with all participants04/07/13 www.N2GF.com 66
    • 67. Conclusions HPAI can appear suddenly without detected LPAI infection High mortality Rapid spread between farms Transport Persons Dust Fast culling infected farms essential Public health consequences04/07/13 www.N2GF.com 67

    ×