Sino-European Food Safety
Cooperation Forum
Shanghai, 07-11 June 2010
Animal Health Crisis Management
Avian Influenza Cont...
An unprecedented crisis
A complex epidemiology
Socio economic impacts
A major human risk
Importance of the crisis
Destruction of assets :
Over 300 million poultry have died
Market shocks:
Fears of consumers driv...
Livelihood impacts of disease
and control programmes
• Killing birds: compensation needed
• Restriction of movement and sa...
A(H1N1) A(H2N2) A(H3N2)
1918: “Spanish Flu” 1957: “Asian Flu” 1968: “Hong Kong Flu”
20-40 million deaths 1-4 million death...
Biodiversity issue
Possible losses of valuable
local breeds due to
- Control methods (culling)
- Restructuring of the poul...
RESERVOIRS
DEAD-END
hosts
SPILLOVER
GENE POOL
??
Epidemiology of H5N1
A complex cycle
Resistance of HPAI virus in the
environment & indirect
transmission
Specific role of
duck farming systems in
Asia
Sub-clinical infection in ducks
Identification of risk factors
Weak economies and animal health services
Poultry production systems
Movements
Live bird ma...
ESTIMATED DISTRIBUTION OF POULTRY (SOURCE: FAO)
Production systems
124
680
162
215
337
72
123
121
108
53
49
85
97
66
59
246
281
726
221
134
87
82
177
50
58
190
195
115
84
150
101
Trade
• Local, regional, international trade
– legal
– Illegal
• Captive wild
birds
Crested Hawk-Eagles
confiscated at Brussels
...
Live bird markets: mixing species poorly regulated
Movements of animals
Cultural practices
Wild bird migrations
Northern Pintail ringing recoveries
What is the role of wild birdsWhat is the role of wild birds
Vict...
Lake Quinghai
China
15 April 2005
– Bar headed goose
– Great Cormoran
– Goéland ichthyaète
– Brown headed gull
– Tadorne c...
August 2005
Ducks, Geese
and Swans
100 deaths
Husvel/Bulgan.
Mongolia
Original focu
An alarming spread westwardsAn alarming spread westwards
New areas affectedNew areas affected
Emergence
Due to complex and numerous factors
- Globalisation of exchanges
- Climate changes
- Demography, urbanisation
- ...
Livestock Production
systems
Human behaviour
Virus eco-
epidemiology
Pandemic
threat
Pandemic
threat Goose/GD/96
(China, G...
Virus genetic and antigenic evolution
– Gs/GD/1/96 virus has evolved during the last 10 years
resulting in 10 HA clades in...
ck/Nongkhai/NIAH400802/07ck/TH/NP172/06Guangzhou/1/06JapaneseWhiteEye/HK/1038/06
Anhui/1/05dk/Laos/3295/06ck/Malaysia/935/...
Shift of Dominant HA clade of H5N1 viruses in
Southeast Asia during 1996-2007
                   
 
Year
HA clades
Total
 ...
Thailand          
 
Year
HA clades
  0 1 2 3 4 5
  96-99            
  2000            
  2001            
  2002        ...
Possible
H5N1 Virus
Circulation
Pattern in
Vietnam
HA clades of HPAI H5N1 in the World
2.2
2.2
2.2
2.2
2.2
1
2.
3
2.1
1
2.
3
2.1
2.
2
2.3
2.4
2.5
?
2.
32
.4
2.
5
Some Epidemiologic Differences
Between Africa and Asia
• Poultry and human densities
• Wetland free ranging duck productio...
Official declarations
OIE
and WHO
FAO analysis
HPAI situation
HPAI in humans
2003 to 2009
0
10
20
30
40
50
60
2003 2004 2005 2006 2007 2008 2009 2010*
New ly infected countries
Previously infected
countries
HPAI ...
Outbreaks of HPAI in domestic
poultry and Wild birds,
April 2009-April 2010
• Improvement of the situation compared
with 2006
More transparency, more awareness and preparedness
Less outbreaks
A set ...
China
Confirmed HPAI 2003 2004 2005 2006 2007 2008 2009
Poultry outbreaks 0 50 31 10 4 8 2
Human cases (1) 0 8 13 5 4 7
China
Indonesia
HPAI in humans and
poultry 2004-2009
Indonesia
Outbreaks in
2009
0
2
4
6
8
10
12
14
16
Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb
Month
NumberofHPAIoutbreaks/cases
Bangladesh
Bhu...
HPAI outbreaks
In Bangladesh
Bangladesh
Occurrence of HPAI
since March 2007
0
2
4
6
8
10
12
14
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
2008 2009 10
Numberofoutbre...
0
5
10
15
20
25
30
35
40
45
50
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
2008 2009 10
Nu...
Tools and strategies
to control HPAI exist
– Surveillance and
Disease intelligence
– Stamping out
– Biosecurity
– Movement...
Surveillance
Active and passive surveillance
Randomized versus intelligence
Targeted surveillance (risk based)
Specific ca...
Random versus. Intelligence
• Reduces bias
• Requires careful
planning
• Long time frame
• Clustering
• Key informants
• O...
Targeted surveillance and monitoring
of virus circulation based on risk analysis
Disease intelligence
Particularly to address the emergence or re
emergence of new pathogens with regard to
global changes,...
Disease Intelligence
and Tracking
60% of the 1400 infectious agents of humans
have an animal origin; and 75% of new
infect...
GoogleGoogleTMTM
Control of movements
Enforcement
may be very difficult
Culling
Compensation
Enforcement can be very
difficult
Needs compensation
Management of compensation
funds can be difficul...
Vaccination
An important tool
– Good quality: OIE Standards
- Cost (0.5 to 0.8 USD)
and share of cost
– Post-vaccination m...
FAO-OIE-WB
Report on
Biosecurity:
Issues and options
August 2008
Develop, test
and promote
biosecurity
measures
that are:
Developed in a
participatory manner
Practical and
affordable
Prop...
Biosecurity
Production practices/
socio-cultural aspects
Transport/Marketing Processing
International Cooperation
FAO - OIE GF TADS
Global Framework for the Progressive Control
of Transboundary Animal Diseases
...
Crisis Management
Center Global Early
Warning System
Available Tools at
the Global Level
Needs and Gaps
for Avian and Human Influenza in
Africa
ALive provisional Proposal
GLEWS Global Early Warning System
A majo...
Regional Networks:
- Epidemiology
- Diagnostic and
research laboratories
- Socio economics
- Communication
FAO OIE Regiona...
Intersectoral Cooperation
- Human and animal health systems
To be in strong interraction and collaboration
No fusion. Spec...
Global results
- Less contaminated countries
- More sensibilisation and commitment
- Improved transparency
- More awarenes...
Is eradication possible?
- Eradication of all Influenza A viruses is not an option
given the highly diverse gene pool of v...
Lessons learnt
Need to be ready to
respond to emergencies
Stop the outbreaks before they
spread and become a crisis
Emerge...
Credo
Surveillance
Early Warning
Early detection
Early response
Need to better address
the Socio Economic issues
• Economic analysis inputs to disease
epidemiology to support risk assess...
Need to develop more focus
on disease drivers
and not only
on disease events
Public-Private partnership
At all levels
Surveillance
Prevention
Control
Small holders-villagers
Participatory approaches
Capacity building
Training
Communication
and
Information
Information
and Awareness
• Information and dialogue with
commercial farmers
• Need for information and
compliance of the ...
Information and Awareness
Provision of information
through multi-track
Campaigns to ensure
Informed decision making
proces...
Remaining gaps
• Virology
• Epidemiology
• Trade routes
• Wildfife
• Socio economics
• Vaccines
… Need for Research
Remaining gaps (cont.)
… Need for research
Transmission Animals-Humans
- Government and private sector
commitment
- Private-public partnership
- Participatory approaches
- Restructuring of the ...
Based on
- Strong Veterinary Services
- Biosecurity, Movement Control
- Communication
- Laws and Regulations
- Public Priv...
Roots of Disease Emergence
Long term global approaches
One World One Health Strategy
More investment
More Political Commitment
to implement and enforce the
Prevention and Control Measures
Thank you for your attention
Animal Health Crisis Management AI Control Sino EU Forum Shanghai 2010
Animal Health Crisis Management AI Control Sino EU Forum Shanghai 2010
Animal Health Crisis Management AI Control Sino EU Forum Shanghai 2010
Animal Health Crisis Management AI Control Sino EU Forum Shanghai 2010
Animal Health Crisis Management AI Control Sino EU Forum Shanghai 2010
Animal Health Crisis Management AI Control Sino EU Forum Shanghai 2010
Animal Health Crisis Management AI Control Sino EU Forum Shanghai 2010
Animal Health Crisis Management AI Control Sino EU Forum Shanghai 2010
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Animal Health Crisis Management AI Control Sino EU Forum Shanghai 2010

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At the invitation of DG SANCO, EFSA participated in the context of the Shanghai Expo 2010 in China to the Sino-European Food Safety Cooperation Forum, to the
Seminar on Research for Healthy life and to the Securing Food Safety for a Healthy Life Day from 4 to 11 June.

Former Chief Veterinary Officer of FAO, Mr. Joseph Domenech delivered a lecture on Animal Health Crisis Management in with respect to Avian Influenza Control in Asia.

The event was organised as part of the Better Training for Safer Food programme, which aims to train staff in
Member States and Third Countries in official controls on food.

The forum provided presentations and lectures by staff of the European Commission, the European Food Safety Authority and Member States.

Lectures were also given by representatives of the Chinese General Administration for Quality Supervision, Inspection and Quarantine (AQSIQ), the Ministry of Health, and the Ministry of Agriculture.

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  • Semi-industrial production sector
    Live bird markets: Reservoir of infection
    Depending on animal turnover,
    Duration of stay in the markets,
    Biosecurity measures,
    Catchment area
  • Interspecies transmission establish a very complex ecological system in nature.
    Some 2001 H5N1 viruses may have been transmitted from domestic poultry back into wild aquatic birds, resulting in a new set of genotypes for 2002.
    Influenza A viruses of all 16 subtypes are perpetuated in aquatic birds throughout the world. After transfer to an alternative avian or mammalian host, influenza viruses undergo rapid evolution. for avian influenza viruses, including the H5, this transfer can occur in backyard poultry flocks or live poultry markets where ducks, geese, phaisants, chickens, etc are raised or housed together.
    Antigenic and genetic analysis of the H9N2 influenza viruses isolated from domestic ducks in Southern China (2000-2001) provide convincing evidence that the H9N2 influenza viruses lineages established since the mid-1990s in chicken and quail have been transmitted back to ducks (mention pigs usually consider as mixing vessel), generating double or triple reassortants with influenza viruses already residents in ducks (K.S Li et al, 2003).
    Mention HPAI the current conception of LPAI in gene pool that become virulent once in spillover host.
  • There is also a huge international trade in poultry—both legal and illegal. The legal trade involves literally millions of hatching eggs and poultry being shipped to destinations worldwide. For example, prior to the outbreaks in Egypt, the country was reported to export 180 million day-old-chicks plus 500,000 mature fowl a year. Almost 12 million live chickens were officially imported into the Ukraine in 2004 and more than 16 million into Romania. In Turkey, one factory has the capacity to produce over 100 million hatching eggs per year, many of them exported to Eastern Europe and the Middle East.  Recent outbreaks in India, Nigeria and Egypt originated within the poultry industry, and there is strong circumstantial evidence that movements of poultry and poultry products are responsible.
    For obvious reasons, there is little information on the extent of the illegal poultry trade, but recently it was revealed that poultry meat is being illegally imported from Asia into the USA; in October 2005 3,000 chickens were intercepted by Italian customs after being smuggled into the country from China; and in November 2005 the UK authorities revealed that large quantities, possibly hundreds of tonnes, of chicken meat had been illegally imported from China, and fraudulently relabelled before being sold on to food manufacturers across the country. In February 2006, 20 kg of chicken tongues from China were found by customs in Rio de Janeiro, Brazil, and 21 tonnes of (mainly) poultry meat from China were confiscated in southern Spain. These indicate continuing lapses in border controls, despite the widely publicised risks. Illegal poultry movements are reported to be extensive in central Asia. In 2005, Ukraine’s State Department of Veterinary Medicine said there had been substantial illegal re-exportation of meat from Ukraine to Russia via third countries.
    http://www.birdlife.org/action/science/species/avian_flu/flu_faq.html (BIRD LIFE INTERNATIONAL)
    A similar concern arises when we look at the multi-billion dollar legal and illegal trade in wild animals. Not only does this practice put wildlife populations at risk, it also creates unique opportunities for novel pathogens (viruses, bacteria, and fungi carried by these animals) to exploit new hosts unprepared for their arrival. Robert A. Cook is chief veterinarian and vice president and William B. Karesh is director of the Field Veterinary Program at the Wildlife Conservation Society, Bronx Zoo, New York.) – web article
    The widespread illegal trade in cage birds is known to have transported flu-infected birds over large distances. Customs in Taiwan recently intercepted two consignments of infected birds smuggled from mainland China. An outbreak of H5N1 at a bird quarantine station in the UK may also be attributable to smuggled birds ‘laundered’ into a legally imported consignment. The most likely source of infection in captive birds is at live animal ‘wet’ markets, where domestic and wild-caught birds are kept in close proximity, posing a high-risk of bird flu cross-contamination
    http://www.birdlife.org/action/science/species/avian_flu/flu_faq.html (BIRD LIFE INTERNATIONAL)
  • Semi-industrial production sector
    Live bird markets: Reservoir of infection
    Depending on animal turnover,
    Duration of stay in the markets,
    Biosecurity measures,
    Catchment area
  • Dead Whooper Swan at Achmag Lake, Mongolia, with lives whopper swans on lake in background
  • Agro-ecosystems
    Waterfowl production: silent infection and transmission to terrestrial poultry (spillover hosts)
    mixing species
    biosecurity and wild birds contacts
    Trade and live bird markets
    Mixing species
    live bird markets
    Human health risk
    Cultural practices
    fighting cocks
    eating practices
    disease infection and spread
    .
  • A CGIAR challenge Programm selection
    World Bnak driven because of interest in food safety
    Investing $50 million from the CGIAR system into GCP
    Gradual exit from the cgiar
  • A CGIAR challenge Programm selection
    World Bnak driven because of interest in food safety
    Investing $50 million from the CGIAR system into GCP
    Gradual exit from the cgiar
  • This paper moves forward from the discussion presented in the FAO/OIE/World Bank position paper on The importance of biosecurity in reducing HPAI risk on farms and in markets, prepared for the Inter-Ministerial Conference on Avian and Pandemic Influenza, held in New Delhi in December 2007. It draws on what we already know about biosecurity, particularly for countries endemically infected with HPAI or at high risk of introduction, identifies problems, proposes solutions and outlines a future course of action.
    Among others, it looks at the basic principles of biosecurity within the overall framework of disease control, discusses species- and sector-specific issues, stresses the importance of situating biosecurity in appropriate economic and cultural settings, and makes the case for the role of communication.
  • These cross cutting principles apply to all biosecurity measures for all stakeholders. The paper FAO-OIE-WB « Biosecurity for highly pathogenic avian influenza: Issues and options » proposes measures for the following stakeholders:
    LARGE-SCALE COMMERCIAL PRODUCERS (SECTORS 1 AND 2)
    SMALL-SCALE COMMERCIAL PRODUCERS (SECTOR 3)
    HATCHERIES
    KEEPERS OF SCAVENGING POULTRY (SECTOR 4)
    DOMESTIC DUCK KEEPERS
    LIVE BIRD MARKETS
    INTERMEDIARIES AND SERVICE PROVIDERS
    POULTRY FANCIERS, AND KEEPERS OF FIGHTING COCKS, EXOTIC BIRDS AND BIRDS OF PREY
    HUNTERS
  • Ana I know you have combined two points and I have again separated them. I have done this for a specific reason, if we do not highlight surveillance then people tend to ignore it. It is a largely a prevention measure even in a endemic disease situation as it allows rapid response if sensitive. In the countries you are presenting to this will be crucial
    Note we have a lot of money being spent on surveillance (according to the RTE 40% of the total budget). This has no monitoring or evaluation process and is often done loosely. I suspect it means taking samples and building laboratories. For TCEO this is OK because labs cost money and involve procurement which is not messy unlike consultants! For AGAH it is good because many of our vets are lab orientated. The bizarre situation is that in the development of the logframe surveillance did not originally receive its own output! So yes I do think we need to separate and highlight this component
  • Animal Health Crisis Management AI Control Sino EU Forum Shanghai 2010

    1. 1. Sino-European Food Safety Cooperation Forum Shanghai, 07-11 June 2010 Animal Health Crisis Management Avian Influenza Control Mr. Joseph Domenech
    2. 2. An unprecedented crisis A complex epidemiology Socio economic impacts A major human risk
    3. 3. Importance of the crisis Destruction of assets : Over 300 million poultry have died Market shocks: Fears of consumers drive down demand Import bans Poultry prices: increased or decreased Global trade: winners and losers Substitution effects with alternative proteins Internationally 2004-05, 8% decline in global poultry trade. Shift in export of major players (FAO projections March 2006) 0 2 4 6 8 10 2003 2004 2005 2006r Milliontonnes Europe Asia South America North America
    4. 4. Livelihood impacts of disease and control programmes • Killing birds: compensation needed • Restriction of movement and sales: smallholders recover slowly and lose market share • Loss of income for food, education of children and other household expenses... • Changes to the structure of poultry market chains • Gender issue: poultry often owned and managed by women
    5. 5. A(H1N1) A(H2N2) A(H3N2) 1918: “Spanish Flu” 1957: “Asian Flu” 1968: “Hong Kong Flu” 20-40 million deaths 1-4 million deaths 1-4 million deaths Credit: US National Museum of Health and Medicine Human health dimension The risk of a human pandemic
    6. 6. Biodiversity issue Possible losses of valuable local breeds due to - Control methods (culling) - Restructuring of the poultry production sector More big commercial farms Marginalization of small/village backyard holders - Genetic resistance issue
    7. 7. RESERVOIRS DEAD-END hosts SPILLOVER GENE POOL ?? Epidemiology of H5N1 A complex cycle
    8. 8. Resistance of HPAI virus in the environment & indirect transmission
    9. 9. Specific role of duck farming systems in Asia Sub-clinical infection in ducks
    10. 10. Identification of risk factors Weak economies and animal health services Poultry production systems Movements Live bird markets Cultural practices Wild birds
    11. 11. ESTIMATED DISTRIBUTION OF POULTRY (SOURCE: FAO)
    12. 12. Production systems
    13. 13. 124 680 162 215 337 72 123 121 108 53 49 85 97 66 59 246 281 726 221 134 87 82 177 50 58 190 195 115 84 150 101 Trade
    14. 14. • Local, regional, international trade – legal – Illegal • Captive wild birds Crested Hawk-Eagles confiscated at Brussels International Airport in the hand luggage of a Thai passenger...
    15. 15. Live bird markets: mixing species poorly regulated
    16. 16. Movements of animals
    17. 17. Cultural practices
    18. 18. Wild bird migrations Northern Pintail ringing recoveries What is the role of wild birdsWhat is the role of wild birds Victim or the problem ? Sentinel or spreader ? Reservoir of virus?
    19. 19. Lake Quinghai China 15 April 2005 – Bar headed goose – Great Cormoran – Goéland ichthyaète – Brown headed gull – Tadorne casarca >519 morts (Marc Artois)
    20. 20. August 2005 Ducks, Geese and Swans 100 deaths Husvel/Bulgan. Mongolia
    21. 21. Original focu An alarming spread westwardsAn alarming spread westwards New areas affectedNew areas affected
    22. 22. Emergence Due to complex and numerous factors - Globalisation of exchanges - Climate changes - Demography, urbanisation - Intensification of the production - Evolution of ecosystems…
    23. 23. Livestock Production systems Human behaviour Virus eco- epidemiology Pandemic threat Pandemic threat Goose/GD/96 (China, Guandong, 1996) W eak Veterinary Services Wild birds: reservoir or victim? EMERGENCE OF HPAI IN ASIA
    24. 24. Virus genetic and antigenic evolution – Gs/GD/1/96 virus has evolved during the last 10 years resulting in 10 HA clades in this lineage. – Clade 2 virus has become the dominant one since 2005 in Southeast Asia as well as in the world – Only clade 2.2 is found outside of Southeast Asia while 2.2 is not common in this region. – It is also changing antigenically while antigenicity of classic H5N1 viruses were quite stable With few exceptions like in China and Indonesia, with an impact on vaccine efficacy Where is this evolution going and what will its impact be?
    25. 25. ck/Nongkhai/NIAH400802/07ck/TH/NP172/06Guangzhou/1/06JapaneseWhiteEye/HK/1038/06 Anhui/1/05dk/Laos/3295/06ck/Malaysia/935/06commonmagpie/HK/645/06Zhejiang/16/06JapaneseWhiteEye/HongKong/73720/07WhiteBackedMunia/HongKong/82820/07 Guangxi/1/05dk/Guiyang/3009/05dk/Guiyang/3242/05gs/Guiyang/3422/05ck/Guiyang3/055/05gs/Yunnan/4494/05 gs/Guangxi/3017/05gs/Guangxi/345/05gs/Guangxi/3316/05dk/Hunan/127/05dk/Hunan/149/05dk/Hunan/152/05dk/Hunan/139/05 Egypt/0636NAMRU320/07Egret/Egypt/1162NAMRU3/06dk/Egypt/22533/06Egypt/14724NAMRU320/06turkey/Turkey1//05WhooperSwan/Mongolia/244/05Nigeria/6e20/07ck/Nigeria/641/06Turkey/15/06Iraq/207NAMRU3/06Azerbaijan/001161/06ck/Krasnodar/01/06swan/Iran/754/06ck/Liaoning/23/05Barhdgs/Qinghai12/05Barhdgs/Qinghai1A/05ck/Kyoto/3/04crow/Kyoto/53/04ck/Yamaguchi/7/04 ck/Korea/ES/03dk/Guangxi/13/04 ck/YN/115/04ck/YN/374/04 Indonesia/CDC1046/07Indonesia/CDC103220/07Indonesia/CDC938/06Indonesia/CDC887/06Indonesia/CDC1047/07 Indonesia/283H/06Indonesia/326N/06Indonesia/CDC742/06Indonesia/370E/06Indonesia/5/05Indonesia/CDC940/06 Indonesia/546bH/06Indonesia/596/06Indonesia/599/06Indonesia/625/06dk/Indonesia/MS/04ck/Indonesia/4/04ck/Indonesia/11/03 ck/Indonesia/7/03VN/JP14/05 ck/Cambodia/013LC1b/05VN/1194/04 VN/1203/04 VN/HN3/0408/05TH/16/04 TH/676/05 VN/JPHN30321/05HK/213/03ck/Henan/16/04ck/Henan/01/04ck/Henan/13/04 ck/Henan/12/04dk/Guangxi/50/01ck/HK/YU777/02 ck/HK/YU22/02migdk/Jiangxi1653/05 dk/Guangxi/2775/05ck/Hunan/41/04blbird/Hunan1/04treesparrow/Henan/4/04dk/Hubei/wg/02sw/Anhui/ca/04 dk/Guangxi/1378/04dk/Guangxi/1681/04dk/Guangxi/1311/04dk/Guangxi/2396/04ck/Hunan/2292/06ck/Shanxi/2/06ck/Myanmar/06010011B/06dk/Guiyang/504/06 ck/Guiyang237/06gs/Guiyang/337/06 gs/Guiyang/1325/06ck/Guiyang441/06ck/Guiyang1218/06ck/Guiyang846/06ck/HK/8911/01 ck/HK/SF219/01ck/HK/8791/01 gs/Guangdong/1/96 0.005 2.3.4 2.3.3 2.3.2 2.3.1 2.2 2.4 2.5 2.1.3 2.1.2 2.1.1 1 8 9 6 5 7 4 3 0 Genetic evolution of Asian-lineage HPAI H5N1 virus (HA gene) Parent virus Gs/GD/1/96 has evolved during 1996- 2008 resulting in 10 different clades.
    26. 26. Shift of Dominant HA clade of H5N1 viruses in Southeast Asia during 1996-2007                       Year HA clades Total   0 1 2 3 4 5 6 7 8 9 Out   96-99 29                     29   2000 17     3   1           21   2001 18     43   1       1 2 65   2002 17 17 3   7 3 1   7 2 8 65   2003 4 25 33 1 1 5   1 1 7 8 86   2004 4 171 49     16 3 3   14 5 265   2005 3 112 170   1     7 1 9 1 304   2006 5 5 122   5     1   1   139   2007   12 94                 22   Total 97 342 471 47 14 26 4 12 9 34 24 1080 ExistMajor clade of the year Dominant HA clade has shifted from 0 to 1 in 2002-03 Dominant HA clade has shifted from 1 to 2 in 2003-05 HA clade 2 is now dominant = why?
    27. 27. Thailand             Year HA clades   0 1 2 3 4 5   96-99               2000               2001               2002               2003               2004               2005               2006               2007               2008             China             Year HA clades   0 1 2 3 4 5   96-99               2000               2001               2002               2003               2004               2005               2006                                             South Vietnam         Year HA clades 0 1 2 3 4 5 96-99             2000             2001             2002             2003             2004             2005             2006             2007             2008             North Vietnam         Year HA clades 0 1 2 3 4 5 96-99             2000             2001             2002             2003             2004             2005             2006             2007             2008             NORTH VIETNA M SOUTH VIETNA M THA I CHIN A Different pattern between North and South Vietnam North is similar with South China that indicates multiple introduction of virus since 2001 including new clade 7 South has similar pattern with Thailand till 2007.
    28. 28. Possible H5N1 Virus Circulation Pattern in Vietnam
    29. 29. HA clades of HPAI H5N1 in the World 2.2 2.2 2.2 2.2 2.2 1 2. 3 2.1 1 2. 3 2.1 2. 2 2.3 2.4 2.5 ? 2. 32 .4 2. 5
    30. 30. Some Epidemiologic Differences Between Africa and Asia • Poultry and human densities • Wetland free ranging duck production systems absent • Survival of the virus in the environment: temperature... • Less contacts between wild birds and domestic poultry
    31. 31. Official declarations OIE and WHO FAO analysis HPAI situation
    32. 32. HPAI in humans 2003 to 2009
    33. 33. 0 10 20 30 40 50 60 2003 2004 2005 2006 2007 2008 2009 2010* New ly infected countries Previously infected countries HPAI in poultry Infected countries 2003 to 2010
    34. 34. Outbreaks of HPAI in domestic poultry and Wild birds, April 2009-April 2010
    35. 35. • Improvement of the situation compared with 2006 More transparency, more awareness and preparedness Less outbreaks A set of tools (culling, biosecurity, vaccination, etc) available and deployed to control the disease • Epidemiology and socio economic impacts are better known • But the virus is still present in around 10 countries • Recurrent introduction or reintroduction of the virus in countries or regions
    36. 36. China
    37. 37. Confirmed HPAI 2003 2004 2005 2006 2007 2008 2009 Poultry outbreaks 0 50 31 10 4 8 2 Human cases (1) 0 8 13 5 4 7 China
    38. 38. Indonesia HPAI in humans and poultry 2004-2009
    39. 39. Indonesia Outbreaks in 2009
    40. 40. 0 2 4 6 8 10 12 14 16 Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Month NumberofHPAIoutbreaks/cases Bangladesh Bhutan India Nepal Reported outbreaks of HPAI in South Asia 2009-10
    41. 41. HPAI outbreaks In Bangladesh
    42. 42. Bangladesh Occurrence of HPAI since March 2007
    43. 43. 0 2 4 6 8 10 12 14 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan 2008 2009 10 Numberofoutbreaks HPAI outbreaks in India
    44. 44. 0 5 10 15 20 25 30 35 40 45 50 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan 2008 2009 10 Numberofoutbreaks HPAI outbreaks in Egypt
    45. 45. Tools and strategies to control HPAI exist – Surveillance and Disease intelligence – Stamping out – Biosecurity – Movement control – Vaccination
    46. 46. Surveillance Active and passive surveillance Randomized versus intelligence Targeted surveillance (risk based) Specific case of wild birds Special tools such as the SMS Gateway system
    47. 47. Random versus. Intelligence • Reduces bias • Requires careful planning • Long time frame • Clustering • Key informants • Open-ended • Discovery • Identify risk areas • Rapid Community-Based Disease Surveillance
    48. 48. Targeted surveillance and monitoring of virus circulation based on risk analysis
    49. 49. Disease intelligence Particularly to address the emergence or re emergence of new pathogens with regard to global changes, hot spots identification Specific concepts, approaches, methods and tools to be used
    50. 50. Disease Intelligence and Tracking 60% of the 1400 infectious agents of humans have an animal origin; and 75% of new infectious diseases have originated from animal reservoirs Stopping animal diseases ‘at source’ by: • Identifying determinants and drivers of disease emergence and spread • Modelling, mapping and forecasting disease trends and outbreaks • Generating information and data for early warning and response • Tracking genetic evolution of pathogens to improve diagnostics and vaccines
    51. 51. GoogleGoogleTMTM
    52. 52. Control of movements Enforcement may be very difficult
    53. 53. Culling Compensation Enforcement can be very difficult Needs compensation Management of compensation funds can be difficult: various systems exist
    54. 54. Vaccination An important tool – Good quality: OIE Standards - Cost (0.5 to 0.8 USD) and share of cost – Post-vaccination monitoring – DIVA approach – Control of virus circulation – Exit strategy
    55. 55. FAO-OIE-WB Report on Biosecurity: Issues and options August 2008
    56. 56. Develop, test and promote biosecurity measures that are: Developed in a participatory manner Practical and affordable Proportionate to risk Tailored to situation and production system Biosecurity
    57. 57. Biosecurity Production practices/ socio-cultural aspects Transport/Marketing Processing
    58. 58. International Cooperation FAO - OIE GF TADS Global Framework for the Progressive Control of Transboundary Animal Diseases International Cooperation FAO - OIE GF TADS Global Framework for the Progressive Control of Transboundary Animal Diseases
    59. 59. Crisis Management Center Global Early Warning System Available Tools at the Global Level
    60. 60. Needs and Gaps for Avian and Human Influenza in Africa ALive provisional Proposal GLEWS Global Early Warning System A major component of GF TADs Initiative
    61. 61. Regional Networks: - Epidemiology - Diagnostic and research laboratories - Socio economics - Communication FAO OIE Regional Animal Health Centers
    62. 62. Intersectoral Cooperation - Human and animal health systems To be in strong interraction and collaboration No fusion. Specific mandates, partners and stakeholders, methods and tools - Other sectors: wildlife, environment, trade, turism, police, medias, land management…
    63. 63. Global results - Less contaminated countries - More sensibilisation and commitment - Improved transparency - More awareness and preparedness - Strenghthened Veterinary Services - Better knowledge of the disease epidemiology and of root causes of emergence and spread
    64. 64. Is eradication possible? - Eradication of all Influenza A viruses is not an option given the highly diverse gene pool of viruses circulating in the wild waterbird reservoir, in livestock and humans - In most situations H5N1 HPAI freedom remains a viable objective - More difficult is the control of H5N1 HPAI in environments where both traditional domestic waterfowl production, including rice- duck agriculture, and commercial chicken plants coincide in the farming landscape - Endemic situations require a cautious balancing of all tools and methods available to contain H5N1 virus spread and persistence
    65. 65. Lessons learnt Need to be ready to respond to emergencies Stop the outbreaks before they spread and become a crisis Emergency short term improved capabilities
    66. 66. Credo Surveillance Early Warning Early detection Early response
    67. 67. Need to better address the Socio Economic issues • Economic analysis inputs to disease epidemiology to support risk assessments • Socio economic impacts of HPAI • Costs and cost-effectiveness of prevention and control measures • Long Term Restructuring and Socio economic impacts on small holders, • Mitigation options • Impacts on biodiversity
    68. 68. Need to develop more focus on disease drivers and not only on disease events
    69. 69. Public-Private partnership At all levels Surveillance Prevention Control Small holders-villagers Participatory approaches
    70. 70. Capacity building Training Communication and Information
    71. 71. Information and Awareness • Information and dialogue with commercial farmers • Need for information and compliance of the population – information on vaccination – information on logistics • Cooperation of farmers and village heads is crucial for an effective implementation of control programmes
    72. 72. Information and Awareness Provision of information through multi-track Campaigns to ensure Informed decision making processes and producers’ participation
    73. 73. Remaining gaps • Virology • Epidemiology • Trade routes • Wildfife • Socio economics • Vaccines … Need for Research
    74. 74. Remaining gaps (cont.) … Need for research Transmission Animals-Humans
    75. 75. - Government and private sector commitment - Private-public partnership - Participatory approaches - Restructuring of the poultry sector with mitigation of possible adverse impacts Responding to challenges
    76. 76. Based on - Strong Veterinary Services - Biosecurity, Movement Control - Communication - Laws and Regulations - Public Private Partnership
    77. 77. Roots of Disease Emergence Long term global approaches One World One Health Strategy
    78. 78. More investment More Political Commitment to implement and enforce the Prevention and Control Measures
    79. 79. Thank you for your attention
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