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STOP AI training manual

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In 2007, USAID launched a worldwide program to battle outbreaks of Avian Influenza under the name STOP AI: Stamping Out Pandemic & Avian Influenza.

This program was one of the largest Training of trainer programs on Avian Influenza of its kind, with training programs conducted in more than 40 countries.

The training manual contains valuable training materials, presentations, background information and references on various subjects:

Module 1 – Overview of Avian Influenza
Module 2 – National Preparedness & Response Plans for HPAI
Module 3 – OIE Avian Influenza Standards and FAO Emergency Prevention System
Module 4 – Public Health and Occupational Safety
Module 5 – Animal Surveillance
Module 6 – Sample Collection and Transport
Module 7 – GIS and Outbreak Mapping
Module 8 – Biosecurity
Module 9 – Introduction to Outbreak Response
Module 10 – Depopulation, Disposal, and Decontamination
Module 11 – Recovery Options.

This training course was intended for animal and human health experts who have limited experience with avian influenza, but who do have field experience with other animal, zoonotic, or infectious diseases. This course includes modules on avian influenza virology, epidemiology, response, and recovery.

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STOP AI training manual

  1. 1. i STAMPING OUT PANDEMIC & AVIAN INFLUENZA (STOP AI) STOP AI CONSULTANTS COURSE: PRE-DEPLOYMENT TRAINING AND AI ESSENTIALS DRAFT PARTICIPANT MANUAL STOP AI August 2007 This publication was prepared by DAI and funded by the U.S. Agency for International Development under Contract No. EDH-I-00-05-00004-00, TO6.
  2. 2. Contents Introduction......................................................................................... 1 Module 1 – Overview of Avian Influenza........................................... 3 Module 2 – National Preparedness and Response Plans for HPAI.............................................................................. 17 Module 3 – OIE Avian Influenza Standards and FAO Emergency Prevention System................................... 58 Module 4 – Public Health and Occupational Safety ....................... 95 Module 5 – Animal Surveillance..................................................... 150 Module 6 – Sample Collection and Transport.............................. 182 Module 7 – GIS and Outbreak Mapping ........................................ 206 Module 8 – Biosecurity.................................................................... 293 Module 9 – Introduction to Outbreak Response.......................... 313 Module 10 – Depopulation, Disposal, and Decontamination ...... 340 Module 11- Recovery Options........................................................ 419
  3. 3. Introduction USAID’s STOP AI project is piloting a series of courses in fall 2007 to build capacity among animal and human health experts to support HPAI preparedness and response in poultry populations worldwide. The purpose of these training courses is to prepare selected experts to be consultants under the STOP AI project; the courses will focus on orienting participants to working effectively with USAID and host country governments while on deployment, and to promote the delivery of consistent technical messages in accordance with current international standards. Pre-Deployment Training Course Pilot This 3-day course is intended for avian influenza experts, from both animal and human health disciples. It will focus primarily on orienting the participants to USAID and STOP AI and the relevant international standards, without delivering in-depth training on the technical aspects of HPAI outbreak investigation or stamp out procedures. The participants selected for this course will possess sufficient technical knowledge through field experience with HPAI. This course is being piloted from September 25 to 27, in Washington, DC for a US and European audience. Pre-Deployment Training and AI Essentials Course Pilot This week-long course is intended for animal and human health experts who have limited experience with avian influenza, but who do have field experience with other animal, zoonotic, or infectious diseases. This course builds upon the 3-day Pre-Deployment Training course and includes additional modules on avian influenza virology, epidemiology, response, and recovery. This course is being piloted twice – once in Washington, DC from October 1 to 5 for a US and European audience, and in Senegal (in conjunction with the veterinary epidemiology course described below) from November 5to 9 for an African audience. Veterinary Epidemiology for HPAI Course Pilot This week-long course is intended for animal health experts with or without field experience in HPAI. It will be held the week after the Pre-Deployment and AI Essentials course and will go into much greater depth on conducting outbreak investigations and designing surveillance programs for HPAI among avian populations. The course is being piloted in Africa from November 12 to 16. Future Plans Following this pilot series, the courses will be modified according to lessons learned from the pilot courses, then conducted in all 4 USAID regions: Europe and Eurasia (E&E), Asia and the Near East (ANE), Latin America and the Caribbean (LAC), and Africa (AFR). STOP AI will most likely hold future courses in the US and Europe as well. This Manual This manual contains draft presentation and participant materials for the Pre-Deployment and AI Essentials pilot courses. The majority of the material contained here has been adapted from other established courses on HPAI. Please see below for more information about the course contributors. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 1
  4. 4. The course modules on working with USAID and on human health are not included in this document, as the intended purpose is to solicit input on the animal health aspects of the training program. A separate draft participant manual for the Veterinary Epidemiology for HPAI course is still in development and will be produced in early October 2007. Contributors The following modules are from UC Davis’ Avian Flu School: Overview of Avian Influenza, Veterinary Surveillance, Prevention and Biosecurity, Recovery Options. The Avian Flu School has been delivered extensively in Africa and the US. Bird Flu Control has provided content for the Public Health and Occupational Safety, and developed the modules on Outbreak Response, Depopulation and Disposal. The modules on Sample Collection and Transport, and Decontamination were developed by AED, with technical input from DAI, to accompany USAID’s Avian Influenza Commodity Kits. These modules have been delivered repeatedly in Eastern Europe, Africa, and Asia. DAI staff developed the modules on National Preparedness and Response Plans, and GIS and Outbreak Mapping Dr. Jim Pearson, who worked for many years in USDA’s National laboratory in Iowa and worked for the OIE, developed the session on OIE Avian Influenza Standards. The FAO overview presentation was provided by Dr. Juan Lubroth at FAO. Providing Feedback on this Draft Manual We invite feedback on the technical content of these draft materials. In order for your feedback to be incorporated prior to the pilot series, please provide your comments to Ms. Megan Fotheringham by August 31, 2007 (see contact information below). Comments received after that date will be incorporated during the post-pilot revision process in December 2007. Ms. Megan Fotheringham Cognizant Technical Officer – STOP AI Avian Influenza Preparedness and Response Unit USAID (202) 712-0537 mfotheringham@usaid.gov Thank you, Dr. Ross Graham Chief of Party STOP AI 1455 Pennsylvania Ave. NW, Suite 400 Washington, DC 20004 (202) 280-2023 Ross_Graham@dai.com DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 2
  5. 5. MODULE 1: OVERVIEW MODULE PURPOSE To provide an overview the natural history of AI, with particular emphasis on the H5N1 Highly Pathogenic (HPAI) strain. MODULE OBJECTIVES At the conclusion of this module, you will be able to: • Define avian influenza; • Identify avian influenza subtypes and pathogenic forms; • Describe how the avian influenza virus is transmitted among birds and to other species; and • Identify potential health and economic risks associated with an outbreak of H5N1 HPAI. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 3
  6. 6. LESSON 1: AVIAN INFLUENZA VIRUSES Avian Influenza—commonly called “bird flu”—is an infection caused by influenza viruses that occur naturally in birds, and less commonly in pigs and humans. (www.pandemicflu.gov) There are many kinds of flu viruses with various classifications and subtypes. For example, seasonal flu, which infects humans, is different than avian flu. Birds, waterfowl, and shorebirds are the reservoir hosts of influenza A viruses. Influenza viruses are named by the proteins on their surfaces, the hemagglutinin antigen (HA) and neuraminidase antigen (NA) proteins. There are 16 HA types and 9 NA types with a possible 144 combinations. The vast majority of these subtypes infect only birds. H5N1 is the subtype of the virus that is the current concern. Reassortment. Influenza viruses have segmented genomes, meaning that the virus’ blueprints are in pieces that can be exchanged with pieces of the blueprints of other flu viruses. Reassortment results in large changes in the virus. Mutations. Mutations happen every time the virus reproduces itself, changing the virus in very small changes. New viruses form when their genetic material combines, resulting in a new virus DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 4
  7. 7. Avian influenza viruses can adapt to grow in new hosts or change in virulence either by reassortment or mutation. Low Pathogenic vs. High Pathogenic Avian influenza viruses can be further divided into two forms based on what they do to non-exposed, or naïve, chickens: 1. Low pathogenic avian influenza (LPAI) • Causes few to no signs of sickness in infected birds. • Can be any of the 144 subtypes 2. Highly pathogenic avian influenza (HPAI) • Causes mortality rates of up to 100% in poultry flocks. • Has only been H5 or H7 subtypes (These are consistent with OIE definitions that will be discussed later). Some H5 and H7 LPAI strains turn into HPAI strains as the viruses reproduce and therefore, mutate. Avian influenza (AI) viruses are enveloped The virus is inactive when the envelope, or membrane coat, is destroyed. Heating, drying, disinfecting and washing with soap and water will destroy the envelope. Avian influenza viruses need a living host to replicate and stay alive DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 5
  8. 8. Time after host dies 100000000 10000000 1000000 100000 10000 Amount of Virus 1000 100 10 1 Hot, dry Cool, humid The amount of virus in a host declines quickly after a host dies. However, the virus will live longer in a dead host if the environmental conditions are humid and cool. Viruses can’t survive long outside of their hosts. Over time, viruses will die as they are exposed to heat, light, or drying. Avian Influenza viruses will be preserved by wetness and cooling. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 6
  9. 9. Take a moment to check your knowledge: How do flu viruses change? Which virus subtypes can cause HPAI? How can flu viruses be destroyed? DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 7
  10. 10. LESSON 2: HISTORY OF H5N1 History of the Global Spread of H5N1 HPAI: • The precursor of the current H5N1 HPAI subtype was first detected in a goose in 1996. Where was the goose? • First reported outbreak in domestic poultry in 1997 (Hong Kong) • Led to first human infections,18 cases, 6 deaths (Hong Kong) • Resulted in culling 1.5 million chickens in Hong Kong to contain spread • Appeared again in Hong Kong (2001)—led to destruction of 1.2 million birds • Numerous outbreaks in Southeast Asia followed • May—June 2005—disease killed birds in China, Mongolia, and Siberia signaling a dramatic geographic expansion and possible involvement of migratory birds in transmission. • The first outbreaks in the European Union were recorded in January 2006 when cases were confirmed in migrating wild swans in Italy, Greece, Germany, and Austria. • February 2006—H5N1 HPAI was detected in commercial poultry flocks in Nigeria. Since then, the virus has been reported in Burkina Faso, Niger, Cameroon, Sudan, Egypt, and Djibouti on the African continent. Primary Spread H5N1 HPAI can be introduced in a new country or region by: • Migratory birds: H5N1 HPAI shows a seasonal occurrence in high-risk areas, which coincides with migratory activity • Legal and illegal poultry trade (both live birds and/or poultry products) • Legal and illegal wild bird/pet trade Latest developments important to the region:________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 8
  11. 11. Terms and Definitions Outbreak: a sudden rise in the incidence of a disease Animal Epidemic: A local, regional, or global outbreak of disease in animals Human Pandemic: a global disease outbreak in humans Discuss concept of pre-outbreak: ___________________________________________ _______________________________________________________________________ _______________________________________________________________________ Summary of the Animal Pandemic: The continued spread across Asia, the Middle East, Europe, and Africa has resulted in the largest avian influenza animal pandemic ever recorded, leading to the deaths of over 140 million birds, with over 194 confirmed deaths in humans (as of August 2007). Discussion Are any of these facts surprising to you? Which of these facts are most important to the stakeholders or constituencies you work with? Based on these facts, what messages are important to communicate with the groups and constituencies you work with? Currently AI is a panzootic and not a human pandemic. What do you think of AI being an animal health emergency? What do you think of the issue of prevalence of the disease in humans? Or the fact that it has been limited to only 256 cases worldwide over several years. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 9
  12. 12. LESSON 3: HPAI TRANSMISSION Highly pathogenic influenza viruses are transmitted in the same basic ways as other influenza A viruses. Most of that transmission is via direct contact or droplet-borne virus rather than by fine aerosol. Within species (intraspecies) transmission The most common transmission for influenza A viruses is from one member of a species to another member of the same species. Between species (interspecies) transmission Interspecies transmission of the influenza A virus occurs rarely between the majority of species, but has higher rates of interspecies transmission between other species, such as between ducks and turkeys. Generally, larger doses of virus and longer contact periods are required for between-species transmission than for transmission within a species. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 10
  13. 13. Exercise 1-1: Identifying the Transmission Paths Purpose: This exercise allows you to check your knowledge about the virus transmission paths. Instructions: Follow the steps below to complete this exercise within your assigned small group: Step Action 1 Study the previous illustration “Paths of Avian Influenza Transmission.” 2 Identify three sources of infection from poultry to other poultry. 3 Identify three barriers to infection from poultry to other poultry. 4 Identify three sources of infection from wild birds to poultry. 5 Identify three barriers to infection from wild birds to poultry. 6 Identify sources of infection from poultry to humans. 7 Identify three barriers to infection from poultry to humans. 8 Discuss with your group: • What parts of the transmission paths are of most concern to you or your community? • What was the most valuable thing you learned about how the virus is transmitted? • How will you use this transmission information to help with your community’s current H5N1 HPAI response? DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 11
  14. 14. LESSON 4: RISK OF H5N1 HPAI TO HUMANS H5N1 HPAI in Humans • Most avian influenza viruses do not infect humans. • H5N1 HPAI can infect humans and is often fatal. • Infections of people have been after heavy exposure. H5N1 HPAI Effects on Humans • The risk from avian influenza viruses is generally low to most people, because most do not infect humans. • H5N1 HPAI is one of the few avian influenza viruses to have crossed the species barrier to infect humans and is among the most deadly of those that have infected humans. • Most cases of H5N1 HPAI in humans have resulted from direct contact with infected poultry (e.g., domesticated chickens or ducks) or surfaces heavily contaminated with secretion/excretions from infected birds. IMPORTANT POINT So far, the spread of H5N1 HPAI virus person-to-person has been limited and has not continued beyond one person or a small cluster of people. Nonetheless, because all influenza viruses have the ability to change, scientists are concerned that H5N1 virus one day could be able to infect humans and spread easily from one person to another. IMPORTANT POINT The H5N1 HPAI virus has raised concerns that it could cause a human pandemic because: 1.It is especially virulent. 2.It can be transmitted from birds to mammals and, in some limited circumstances, to humans. 3.Most humans have no immunity to H5 viruses. Exposures resulting in human infections: • Home slaughter of poultry (dressing, plucking, and contact with blood) • Touching poultry unexpectedly sick or dead • Being less than one meter from dead poultry • There is no evidence that the disease can be transmitted by infected poultry meat as long as there has been no cross contamination and it is cooked to an internal temperature of 70°C (158 F). • H5N1 HPAI can produce rapidly-developing and severe illness in humans, with viral pneumonia and multi-organ failure as common outcomes. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 12
  15. 15. Symptoms in humans are similar to many other syndromes and may include: • Diarrhea • High fever • Lower respiratory tract symptoms (pneumonia) • Vomiting • Abdominal and chest pain • Conjunctivitis • Bleeding from the nose and gums Check your knowledge The majority of human cases have occurred with humans who have had direct and/or sustained contact with No evidence that the disease can be transmitted by consuming infected poultry meat as long as it is cooked to an internal temperature of Human infection is associated with: 1. 2. 3. An effective method for the of birds is needed to protect the public health. For more information about human H5N1 HPAI infections, see: http://www.cdc.gov/flu/avian/gen-info/avian-flu-humans.htm and http://www.who.int/csr/disease/avian_influenza/en/ DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 13
  16. 16. LESSON 5: IMPACTS OF H5N1 HPAI Economic impacts of the Animal Health Emergency of H5N1 HPAI • Combined losses to Gross National Product of affected Asian nations estimated to be US $10-15 billion (FAO 2005) • Substantial economic impact to small farmers and commercial poultry producers • Biosecurity measures involving isolation of flocks, sanitation and disinfection of clothes, equipment, and vehicles also add to cost of containment Estimated US $100 million to address the H5N1 HPAI outbreak in Southeast Asia alone to date. Costs of biosecurity List likely costs or impacts of an H5N1 HPAI outbreak in your country or community: 1. _____________________________________________________________________ 2. _____________________________________________________________________ 3. _____________________________________________________________________ 4. _____________________________________________________________________ 1. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 14
  17. 17. REFERENCES AND RESOURCES CDC (Centers for Disease Control). Avian influenza infection in humans. http://www.cdc.gov/flu/avian/gen-info/avian-flu-humans.htm (accessed 04/25/2006). CIDRAP (Center for Infectious Disease and Policy). 2006. Avian influenza (bird flu): Agricultural and wildlife considerations. http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/biofacts/avflu.html (accessed 04/25/2006). FAO (Food and Agriculture Organization of the United Nations). 1999. Manual on the preparation of national animal disease emergency preparedness plans. http://www.fao.org/docrep/004/x2096e/X2096E00.htm (accessed 04/2006). 2005. Enemy at the gate: Saving farms and people from bird flu. Rome, Italy. 2005b. Global strategy to fight bird flu in animals faces serious funding gap. http://www.fao.org/newsroom/en/news/2005/107804/index.html (accessed 04/35/2005). 2006. Preparing for highly pathogenic avian influenza: A manual for countries at risk. www.fao.org/docs/eims/upload/200354/HPAI_manual.pdf (accessed 05/30/2006). USAID (United States Agency for International Development). 2006. USAID advances U.S. international engagement on avian flu. http://www.usaid.gov/press/factsheets/2006/fs060516.html (accessed 05/23/2006). U.S. National Incident Management System -- an emergency planning and response management model for effectively coordinating the efforts of multiple agencies. (See: http://www.fema.gov/emergency/nims/index.shtm) WHO (World Health Organization). Cumulative number of confirmed human cases of avian influenzaA/(H5N1) reported to WHO. http://www.who.int/csr/disease/avian_influenza/country/cases_table_2006_05_29/en/index.h tml (accessed 05/31/2006). 2006. Avian influenza (“bird flu”) – fact sheet. http://www.who.int/mediacentre/factsheets/avian_influenza/en/index.html#humans (accessed 04/25/2006). World Organization for Animal Health (OIE) is an international authority and important resource for technical information regarding HPAI or other animal health emergencies. (See: http://www.oie.int/eng/ AVIAN_INFLUENZA/home.htm ) http://www.pandemicflu.gov/rcommunication/ http://www.pandemicflu.gov/ Crisis and Emergency Risk Communication: By Leaders For Leaders (Centers for Disease Control and Prevention) Course Book (PDF) (695KB) Participant’s Manual (includes slides) (PDF) (447KB) Communicating in a Crisis: Risk Communication Guidelines for Public Officials (Substance Abuse and Mental Health Services Administration) DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 15
  18. 18. Effective Media Communication during Public Health Emergencies (World Health Organization) Terrorism and Other Public Health Emergencies: A Reference Guide for the Media (U.S. Department of Health & Human Services) Pandemic Influenza Pre-Event Message Maps (PDF) (220KB) both avian flu and pandemic influenza. WHO Handbook for Journalists: Influenza Pandemic (PDF) (738KB) WHO Outbreak Communications Guidelines (PDF) (452KB) (World Health Organization) DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 16
  19. 19. MODULE 2: NATIONAL PREPAREDNESS AND RESPONSE PLANS FOR HPAI MODULE PURPOSE This module is aimed at providing the tools for guidance on preparing and assessing national HPAI preparedness plans that can be used for Highly Pathogenic Avian Influenza (HPAI) and adapted for other transboundary animal diseases. The module will introduce the concepts of Prevention, Preparedness, Response and Recovery activities as the main components of a national preparedness and response plan together with standard operating procedures for implementing the plans. MODULE OBJECTIVES At the end of this module, you will be able to: • Describe the key features of a National HPAI Preparedness and Response Plan (PRP) and the Standard Operating Procedures (SOP) components; • Evaluate an existing National HPAI PRP, and • Identify gaps in an existing National HPAI PRP. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 17
  20. 20. CURRENT CONTEXT Highly Pathogenic Avian Influenza (HPAI) H5N1 has spread quickly to many countries over the years since it was detected as the cause of not only poultry deaths but of human deaths in Hong Kong in 1997. In 2003, the virus spread to many countries in Southeast Asia and then moved in a northerly direction to Mongolia and the Russian Federation. In 2004 and 2005, several Eastern and Western European countries and some countries in the Middle East saw the infection in poultry and wild birds. The virus continued to move and finally arrived in Africa in 2006 where it affected about eight countries. The zoonotic nature of this virus has made control and eradication of the virus a priority in many countries. As of August 16, 2007, 321 humans have been infected and out of these, a total of 194 have died. It was realized during the current animal epidemic that many countries were not prepared to adequately control the spread of the virus. Many countries did not have any written plans to combat zoonotic diseases or other emergencies for that matter. Several international organizations encouraged countries to prepare National Preparedness and Response Plans in face of HPAI-H5N1 spread. Many of these plans were prepared hurriedly, copied directly from other plans without adaptation to the local area and lacked standard operating procedures for implementation. Many countries, with international donor support are now in the process of reviewing or rewriting their national plans so they can adequately respond to HPAI outbreaks. This module will serve as a guide to highlight essential components that need to be included in a National Preparedness and Response Plan. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 18
  21. 21. DEFINITION, KEY TERMS, PLAN GOALS AND STANDARD OPERATING PROCEDURES DEFINITION HPAI NATIONAL PREPAREDNESS AND RESPONSE PLAN - A document that details a set of implementable actions and activities to prevent, prepare for, respond to and recover from an incursion of HPAI- H5N1 virus KEY TERMS AND GOALS OF THE PLAN Prevention Prevent the introduction and spread of HPAI-H5N1 virus through implementation of activities such as strict biosecurity, targeted passive and active surveillance and improvement of veterinary services delivery Preparedness Prepare for a rapid and coordinated response by bringing together adequate personnel, equipment and supplies Response Respond to the presence of HPAI-H5N1 virus to minimize the spread of disease and to eradicate the disease with minimal loss of animals and livelihoods through control measures Recovery Recover from the devastating impact of an HPAI outbreak on the poultry sector and on livelihoods through restocking, compensation and review and revision of the plan Standard Operating Procedures (SOP) A set of written instructions, protocols, or worksheets that document routine or repetitive activity followed by an organization or body to facilitate consistency in the quality and integrity of a product or end result DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 19
  22. 22. LESSON 1: COUNTRY STATUS AND ASSESSMENT IMPORTANT POINT It is necessary to include the following country information as an introduction to the plan. The information can be obtained from country policy documents, project documents, government ministries, international organization (UN-FAO, WHO, OIE) websites, assessment visits etc. • Country background information including geography, climate and population. Including a country map showing the different regions, provinces etc. as part of the appendices is important. • Veterinary Services (VS) structure and delivery – number of personnel, level of training, diagnostic laboratory system (number of labs, lab infrastructure, type of tests, state of lab equipment and relevance to lab functions, lab personnel and level of training, training opportunities) Resource: OIE Evaluation of Private Veterinary Services (PVS) tool http://www.oie.int/eng/oie/organisation/en_vet_eval_tool.htm?e1d2 Poultry Sector • Poultry production systems • Species and numbers and associated economic importance • Common poultry diseases in the country and their control – Newcastle disease is usually the most common • Descriptions of marketing systems for poultry, live bird markets and distribution channels • Overview of poultry slaughter plants and processing methods if any Migratory and Wild Birds • Main migratory wild bird resting spots and bird habitats and their proximity to poultry production and urban population centers • Interaction between wild birds and poultry Animal Health Surveillance System • Active or passive surveillance, animal health monitoring, surveys, lab testing, data management and reporting DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 20
  23. 23. Sample poultry sector description for Liberia The Republic of Liberia is situated in West Africa and is bordered by the North Atlantic Ocean, Sierra Leone, Guinea and the Ivory Coast. The poultry population is estimated at 3 million and over 95% are raised in the rural towns and villages under an extensive system. Most of the poultry raised are domestic chickens but in a few parts of the country, ducks and guinea fowl are raised. Poultry are raised mostly by women for both household consumption and income generation. They are mostly unconfined and allowed to scavenge for feed during the day. Housing, if available is limited to portable straw or bamboo baskets or clay pots for night time roosting. The lack of housing and veterinary inputs in this system exposes the poultry to extremes of weather, predators and several poultry diseases. This system also allows scavenging poultry to roam freely in living quarters and kitchens thereby increasing the risk of potentially infected poultry coming into very close contact with humans. Newcastle disease virus has been identified as the most important poultry disease in Liberia. At present, three commercial farms are in operation. These operations import day-old chicks and hatching eggs from the Netherlands, the Ivory Coast, Ghana and Guinea. Frozen chicken meat is imported from Brazil (1843 metric tons in 2005). The commercial farms (mostly layer production) have moderate biosecurity, open-sided housing and market their products directly to supermarkets, hotels and traders. Backyard rural chickens are normally marketed and sold at live bird market stalls and roadside stands in many towns and villages. The real value of Liberia’s poultry sector is unknown due to lack of agricultural statistics and to a long civil conflict which ended three years ago. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 21
  24. 24. LESSON 2: PREVENTION AND PREPAREDNESS IMPORTANT POINT It is important for countries to practice prevention measures and at the same time prepare for a possible incursion by HPAI-H5N1 virus. Prevention and Preparedness activities are listed below and are by no means an exhaustive list of activities. Countries should always take their own situation into consideration and include activities that may have not been covered here.. ORGANIZATIONAL STRUCTURE • Chain of command and national and local coordinating mechanisms - Government agencies responsible for writing and implementing the plan - Coordination between animal health and human health agencies - Roles of non-governmental organizations • Setting up regional and local centers for outbreak management • One type of command structure that can be used for outbreak management at the national, regional and local levels is the Incident Management Model (IMM) IMM OVERVIEW In an outbreak, a successful response will depend on: • Making sure that tasks are assigned - In every response, no matter the size, certain jobs or tasks must be successfully completed • A single supervisor delegating, and being responsible for, the actions of all participants - This prevents confusion • Good communication - From the workers to the supervisors and from the supervisors to the workers • IMM provides a flexible structure to accomplish these goals IMM is based on the Incident Command System (ICS) developed by the U.S. Forest Service and now widely used to respond to disasters such as fires or floods, or to manage a planned event such as a parade. IMM is a model specifically designed for HPAI outbreaks, and can be adapted to a country’s needs and to the local situation, as well as used to control other animal disease outbreaks. The basic management features of the IMM are described below. IMM MANAGEMENT FUNCTIONS • INCIDENT COMMAND - Sets the objectives, strategies, and priorities DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 22
  25. 25. - Has overall responsibility for managing the outbreak • OPERATIONS - Determines how operational objectives of the Outbreak Action Plan will be accomplished - Implements the plan • PLANNING - Develops the Outbreak Action Plan for accomplishing the objectives - Collects and analyzes outbreak data, tracks resources (personnel, supplies, materials), and maintains records of the outbreak and response • LOGISTICS - Provides support, resources, training and other services to meet the operational objectives • FINANCE/ADMINISTRATION - Recruits personnel, tracks them and their time worked, and pays salaries - Pays compensation if agreed upon, and all other invoices DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 23
  26. 26. INCIDENT MANAGEMENT MODEL (IMM) DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 24
  27. 27. Legal and Regulatory Framework • Is there a veterinary legal and regulatory framework for plan implementation? If one exists, it should include disease reporting, welfare concerns regarding mass culling and disposal of infected livestock, compensation policies and human and animal movement restrictions. Note: The need for appropriate legislation must be considered since this requires long-term planning in most administrative systems. Laws, regulations and proclamations are required to give authorized people the power to: proclaim a notifiable disease; enter a poultry enterprise or home to inspect birds or collect specimens; define infected areas and disease control zones; institute quarantine of affected or suspect premises; place movement controls on poultry, poultry products and potentially contaminated materials; destroy and dispose of infected or potentially infected birds and contaminated materials; undertake other disease control operations, such as compulsory vaccination if called for; place controls on the operation of enterprises, such as poultry processing; plants and live bird markets. Prevention Strategies • Biosecurity – farms (sector definition), live bird markets, rapid response teams • Surveillance – passive and active (poultry and wild birds), targeted surveillance, sample types, testing of samples, field and lab testing, sample submission, screening and confirmatory tests, frequency of testing, sampling locations, reporting, GIS, data management Note: Surveillance for avian influenza utilizes both passive and active methods of surveillance. Passive surveillance involves routine monitoring through normal laboratory submissions of dead or live birds, normal health monitoring of flocks by farmers and veterinarians and at the village level, the submission of normal mortality through animal health workers and gathering of information by animal health care workers using a simple checklist or form. Passive surveillance at the village level should include adequate public awareness about avian influenza and HPAI in particular, for it to be successful. Active surveillance for AI is based on specific targeted investigations of at-risk populations for evidence of infection. It is recommended that surveillance include commercial farms, wildlife habitats and wetland areas and poultry located close to these areas, live bird markets, poultry slaughter houses and poultry in border villages. Frequency of surveillance should be at least twice a year and maybe more for high risk countries. Community based participatory surveillance methods should be developed to allow rural residents to participate in any proposed surveillance network • Importation bans- seaports, airports and border posts Note: Countries should place importation bans on live poultry, poultry products wild birds and game birds from HPAI infected countries and maintain the ban until there is sufficient proof of an HPAI-clean status. Commercial poultry producers should make sure that their sources of chicks, hatching eggs or pullets are certified disease-free. Import permits issued by the veterinary services should be required for importation of poultry and poultry products. • Improvement of veterinary service delivery including diagnostic capability- physical structure rehabilitation, training of personnel, diagnostic equipment and supplies • Equipment and supplies inventory - transportation, PPE, disinfectants, sampling supplies, culling, disposal, communications equipment, data collection equipment, data management equipment and supplies, etc. • Personnel evaluation and training- rapid response teams (composition), DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 25
  28. 28. Note: Rapid response teams should include veterinary health officers, public health officers and an outbreak response officer as the core team and can additionally have lab assistants, paravets, police officers and in some cases even border agents in a supporting role. Everyone in the team should receive training on HPAI disease recognition and control. • Review of response plans – frequency and method • Simulations – field or tabletop for testing and refining the plan, SOPs, coordinating mechanisms Note: Simulation exercises are used to test and refine emergency plans in advance of any disease emergency. They are also a valuable means of building teams for emergency disease responses and for training individual staff. Simulation exercises may be carried out as a paper table top exercise or through mock activities - or a combination of both. At the completion of each simulation exercise there should be an analysis of the results. This review should identify areas where plans need to be modified and further training is needed. • Compensation strategy – preparation or update of existing strategy Resource: Enhancing Control of Highly Pathogenic Avian Influenza in Developing Countries through Compensation http://www.fao.org/avianflu/en/compensation.html DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 26
  29. 29. LESSON 3: RESPONSE AND RECOVERY The following items should be included in a national plan to address readiness of response and recovery. • Case definition of suspect cases - Sudden death and very high flock mortality - Decreased egg production and poor shell quality - Respiratory signs (gasping, sneezing, coughing) - Oculonasal discharge - Edema and cyanosis of face, wattles and comb - Hemorrhages on shanks, footpads, skin of breast and thighs - Diarrhea, incoordination and nervous signs • Diagnostic capability – field tests, confirmatory tests, international testing and notification - Field and Laboratory Diagnosis • A rapid antigen detection immunoassay, often referred to as antigen capture ELISA, is made by several companies is now available for field testing of cloacal, tracheal, oropharyngeal and brain swabs for HPAI. Many of these tests have variable sensitivities and should only be used as a screening tool. Combined with unmistakable clinical signs, the tests can be used to make a presumptive diagnosis of HPAI enough to initiate control actions. Final laboratory confirmation should be done at an OIE reference laboratory using real time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR) for rapid detection of the virus genome and virus isolation for identification of the virus. - Test Descriptions for HPAI • Rapid Antigen Detection Tests – These are tests used for the rapid detection of influenza Type A viral antigen from specimens such as tracheal, cloacal, oropharyngeal and brain swabs. The test does yield false positives when other proteins interfere. A positive test usually indicates the presence of influenza virus in the respective tissues or samples and should be followed by virus isolation for confirmation. • Virus Isolation (VI) at an approved laboratory – This test utilizes 9-10 day-old embryonated chicken eggs in which centrifuged or filtered samples of tracheal and cloacal swabs or from organs are inoculated into the allantoic cavity. Embryo death within 48 hrs indicates the presence of live virus. Allantoic fluid harvested from the embryo (contains virus) is mixed with chicken red blood cells to test for hemagglutinating activity (HA or Hemagglutination) as an additional confirmation. A panel of antisera is then prepared to identify subtypes of avian influenza as well as tell AI virus from Newcastle disease virus.. • Real Time, Reverse Transcriptase Polymerase Chain Reaction (rRT – PCR) - A rapid molecular test that can be used for diagnosis of type A influenza. The test detects the presence of viral ribonucleic acid (RNA) with the use of matrix DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 27
  30. 30. (MA) gene specific primers and a fluorogenic probe. The assay can also help subtype positive Type A influenza viruses into H5/H7 and non-H5/H7 types using specific hemagglutination (HA) gene primers and probes. The test has higher sensitivity for detecting virus in tracheal than in cloacal samples but has overall high sensitivity and specificity when compared to virus isolation. • Deployment of rapid response teams – How will they be deployed? • Quarantine and movement control- quarantine declaration (legal authority), signage, entry and exit points, disease zoning definitions • Epidemiology- risk analysis, GIS, data management – How will this information be collected and maintained? • Outbreak surveillance – protection zone, surveillance zones in infected areas, live bird markets • Biosecurity protocols- infected and non-infected farms in outbreak area, rapid response teams, live bird markets • Culling methods – cervical dislocation, carbon dioxide, lethal injection for certain species • Disposal methods – burial, burning or incineration and composting • Decontamination - cleaning and disinfection, disinfectants • Vaccination – Will vaccination be used, how will it be used, who provides the vaccine? • Lifting of quarantine • Restocking – Is there a plan for restocking? • Payment of compensation – Will it be paid, who provides the money? • National HPAI PRP review incorporating lessons learned DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 28
  31. 31. LESSON 4: STANDARD OPERATING PROCEDURES Standard operating procedures are crucial to making National Preparedness and Response plans implementable. Detailed descriptions of the activities below are required to make the plans work. Additional SOPs can be added to the list depending on country requirements but must include the core list set out below. Biosecurity • Commercial establishments- farm sanitation, flock management, location, housing, feed delivery, vaccinations, traffic control • Backyard flocks – semi-intensive and extensive systems – housing, sanitation, species, carcass disposal • Households- village flocks, health and hygiene, • Live bird markets- cleaning and disinfection, market shut down, species, • Rapid response teams- seasonal flu vaccinations, Tamiflu prophylaxis, traffic flow, PPE Surveillance • Surveillance and epidemiology network • Surveillance types – active and passive for poultry and wild birds • Surveillance locations • Outbreak surveillance – infected farms, protected zone and surveillance zone • Sampling size determination • Sample collection (tracheal and cloacal swabs, blood), handling and preservation • Sample submission to national and international laboratories Quarantine and Movement Control • Disease zoning definitions (infected premise, protection zone, surveillance zone) • Quarantine control points • Enforcement of movement control One of the most difficult activities to implement during an outbreak, movement control is a priority area where duties may be shared by the veterinary services and the police authorities. Culling • Cervical dislocation (manual and mechanical) • Carbon dioxide gas • Lethal injection (ratites) DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 29
  32. 32. Disposal methods • Burial • Burning or incineration • Composting Decontamination • Disinfection of farms, litter and equipment • Disinfection of laboratory equipment and environment • Types and action of decontaminants Compensation • Compensation rates determination • Payment methods • Funding sources DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 30
  33. 33. LESSON 5: HUMAN HEALTH COMPONENT AN INTEGRATED NATIONAL PREPAREDNESS AND RESPONSE PLAN -- For many countries, having an integrated PRP has its advantages. Resources can be better utilized and animal and public health personnel can improve cooperation. Communication messages for both animal and public can be better integrated with a plan that addresses both animal and public health. Elements of the Human Health Component • Public health infrastructure – what are the mechanisms of human health service delivery • Human resources in public health sector • Public health surveillance systems • Laboratory facilities • Emergency epidemiologic response plans DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 31
  34. 34. LESSON 6: COMMUNICATIONS AND PUBLIC AWARENESS COMPONENT Elements of the Communications and Public Awareness Component • Public awareness of HPAI • National plan and mechanism for HPAI communication • Technical capacity for HPAI communications • State of mass media in the country • National and local communication activities • How do most people in the country get information - print, radio, TV? Communications is an important component of both preparedness and response activities and is usually the primary task of the Ministries of Information and Broadcasting in many countries. A communications working group should be an integral part of a National AI Taskforce. The component also serves as the link between the epidemiologic phases of bird to bird, bird to human and the possible human to human pandemic phase. A citizenry that is well educated about HPAI prior to an outbreak will react better than a citizenry without information. Sharp drops in chicken and egg consumption and sales have been observed during HPAI outbreaks in many countries where public awareness was low. Communications should be directed towards the following issues: • The need to safeguard human health, in particular for extension staff, animal health workers, poultry producers, clinical staff and their families, by improving public awareness and information of the risk of contracting human disease from birds suffering from HPAI. • Communications efforts should also be aimed at the rural populations that raise most of the poultry in many countries. Stopping animal to animal spread will decrease chances of animal to human spread. • To improve opportunities of early warning of an incursion of HPAI by improving public knowledge of the disease (important for disease identification) and how to report suspected cases. This is of prime importance in the village setting. Conventional and traditional methods of communication should be utilized to emphasize reporting of dead birds. Target groups should be the rural community. Hunters and fishermen should be included in the communication strategy. They can be valuable for reporting wild bird deaths in forested areas and in shoreline nesting sites (for waterfowl). Commercial farmers should also be well educated about HPAI and its clinical signs and how best to protect their workers. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 32
  35. 35. LESSON 7: FINANCIAL PLAN - FUNDING COMPONENT Elements of the Financial Plan Should include budgets for the following: • Equipment (laboratory, culling, disposal, PPE) • Training programs • Surveillance activities • Rehabilitation and construction of physical structures • Indemnity, if planned The financial plan should also specify the funding source(s) for implementation of the HPAI PRP. LESSON 8: IMPORTANT APPENDICES 1. Contact lists (national hotlines) 2.HPAI disease facts 3.HPAI lab test descriptions 4. Sample types, sample collection and sample submission 5. International shipment of samples to OIE/FAO reference labs 6. Equipment list for surveillance, culling, disposal, decontamination 7. Types and action of disinfectants 8. Quarantine signage 9. Notice of depopulation (letter) 10. Forms – lab submission forms (national and international),disease investigation forms, depopulation and compensation forms 11. Vaccination guide 12. List of important websites and links 13. FAO production sector description 14. Poultry population by region/district/county and species 15. National veterinary service organogram 16. Country map DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 33
  36. 36. TASK: CASE STUDY Sample National Preparedness and Response Plan from Sarreh Samba • You have been sent as experts to help the country of Sarreh Samba to review and revise their “National Action Plan” for HPAI. You have been asked to come up with a set of recommendations to improve the plan which has 5 components and is in a table form. The components are: 1. Planning and Coordination 2. Surveillance, Situation Monitoring, Assessment and Containment 3. Quality Assurance in Avian Influenza Control 4. Case Management (Public Health) 5. Information, Education and Communication • At your table, assign, assign a reporter for each group to compile answers. Each group will be given a component of the plan to review and a checklist. - Based on the portion of the plan that you have and the checklist provided, review your section. What is missing in the plan? - Is your part of the plan relevant to a preparedness and response plan? What would you do to make it more relevant? - Provide a list of 3-4 recommendations to improve the part of the plan you have been assigned - What about the overall structure of the plan? What would you recommend as a class? • You have 30 minutes for the task. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 34
  37. 37. REFERENCE MATERIALS AND IMPORTANT WEBSITES Manual on the Preparation of National Animal Disease Emergency Preparedness Plans - FAO Preparing for Highly Pathogenic Avian Influenza: A Manual for Countries at Risk – FAO/OIE Manual Avian Influenza Response Plan – Pennsylvania Department of Agriculture WHO Checklist and Indicators for Optimizing the Impact of Polio Activities on EPI The Use of Vaccination as an Option for the Control of Avian Influenza, OIE International Committee paper, May 2003 Guidelines for In-House Composting Poultry Mortality as a Rapid Response to Avian Influenza, Virginia Department of Environmental Quality “Countries Making Progress in Response to Avian Influenza - Situation Remains Serious In Egypt, Indonesia and Nigeria” http://www.fao.org/avianflu/en/index.html FAO: Animal Health Documents http://www.fao.org/avianflu/en/animalhealthdocs.html FAO: Strategy and Policy documents http://www.fao.org/avianflu/en/strategydocs.html FAO: Compensation http://www.fao.org/avianflu/en/compensation.html The New Tool For Evaluation of Veterinary Services (PVS) Using OIE International Standards of Quality and Evaluation http://www.oie.int/eng/oie/organisation/en_vet_eval_tool.htm?e1d2 Checklist and Indicators for Optimizing the Impact of Polio Activities on EPI. www.polioeradication.org/content/publications/checklist_optimizeactivities.pdf DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 35
  38. 38. HANDOUT: NATIONAL PREPAREDNESS AND RESPONSE PLAN CHECKLIST The following checklist can be used to assess the contents of a National PRP. YES NO Plan Structure 1. Is the plan divided into clearly defined components? 2. Do the components cover the following sections? • Country Status? • Prevention and Preparedness? • Response and Recovery? • Public Health? • Public Awareness and Communications? • A Financial/Funding Plan Country Status and Assessment 1. Describes the country, geography, climate, population, and government structure? 2. Describes the veterinary and public health service delivery system? 3. Includes information about the poultry production systems? 4. Species, numbers and associated economic importance of poultry? 5. Descriptions of poultry marketing systems, live bird markets and distribution channels? 6. Any poultry slaughter and processing plants? 7. Any information on main migratory and wild bird resting spots? 8. Is there any interaction between wild birds and poultry mentioned in the plan? 9. Is there a description of an ongoing active or passive animal health surveillance? Prevention and Preparedness 1. Any existing National HPAI PRP? 2. Does the existing plan have animal and human health and communication components? 3. Does the plan mention a veterinary and legal framework for plan implementation (As in an Animal Disease Act)? 4. Is there a clear command structure in the plan? 5. Any regional and local coordinating bodies? 6. Biosecurity programs on farms and live bird markets? 7. Is a biosecurity program in the plan for rapid response teams? 8. Is an equipment and supplies inventory included? 9. Formation of rapid response teams? 10. Information about number and level of training of animal health personnel? 11. Any plans to do simulations (field or tabletop)? 12. Any compensation information or strategy in plan? DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 36
  39. 39. YES NO Response and Recovery 1. Is a case definition for HPAI described? 2. Any information about diagnostic capabilities, types of tests international testing and notification? 3. Will rapid response teams be deployed to outbreaks? 4. Any plans included for quarantine and movement control? 5. Any plans for epidemiological work carried out during outbreak? 6. What about outbreak surveillance? 7. Any mention of biosecurity protocols during an outbreak? 8. Culling methods mentioned? 9. Disposal methods mentioned? 10. What about decontamination? 11. Is a vaccination strategy part of the plan? 12. Restocking program? 13. Does this section describe how compensation will be paid? 14. Any plans for a review of the entire plan after outbreak response? Components of Standard Operating Procedures (SOPs) 1. Does the plan have standard operating procedures? 2. If yes, have they been described for the following activities • Biosecurity in commercial establishments • Biosecurity in backyard flocks • Biosecurity in households (village flocks) • Biosecurity in livebird markets • Biosecurity for rapid response teams (PPE, traffic flow) 3. Is there a description of surveillance activities? • Surveillance and epidemiology networks? • Surveillance types (active and passive for poultry and wild birds) • Surveillance locations? • Outbreak surveillance • Sampling size determination? • Sample collection, handling and preservation • Sample submission to international labs 4. Do the SOPs include descriptions of how quarantine and movement controls are going to be carried out? • Have disease zoning definitions been included? • What about quarantine control points? • Enforcement of movement control? 5. Are culling procedures described? • Descriptions of cervical dislocation? • Use of carbon dioxide gas • Lethal injection for ratites such as ostriches and emus 6. Have carcass disposal methods been described including carcass removal? • Burial? • Burning or incineration? • Composting? DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 37
  40. 40. YES NO Components of Standard Operating Procedures (SOPs) (continued) 7. Decontamination procedures described? • Disinfection of farms, litter and equipment? • Disinfection of laboratory equipment and environment? • List of types and action of disinfectants? 8. Compensation – Is there a strategy • Compensation rates and determination? • Payment methods outlined? • Funding sources described? Public Health Component 1. Does the plan have a public health component? 2. Public health infrastructure and health services delivery? 3. Human resources in the public health sector? 4. Any public health surveillance systems? 5. Any lab facilities? 6. Are there emergency epidemiologic response plans? Communications and Public Awareness Component 1. Does the plan have a communications and public awareness component? 2. Does the plan mention public awareness of HPAI? 3. Is there a national plan and mechanism for HPAI communication? 4. Technical capacity for HPAI communications? 5. Does the plan describe the state of mass media in the country? 6. Description of national and local communication activities? 7. How do most people in the country get information? Financial Plan (Is one included?) 1. Any budget included for equipment (culling, disposal • Laboratory, PPEs etc.) 2. Budget for training programs? 3. Budget for surveillance activities 4. Budget for reconstruction and rehabilitation of physical structures 5. (labs, clinics, local response centers)? 6. 5) Indemnity, if planned. Appendices Any appendices included in the plan? If so, are the following included? 1. Contact lists (National hotlines) 2. HPAI disease facts 3. HPAI lab test descriptions 4. Sample types, sample collection and sample submission DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 38
  41. 41. 5. International shipment of samples to OIE/FAO reference labs 6. Equipment list for surveillance, culling, disposal, decontamination 7. Types and action of disinfectants 8. Quarantine signage 9. Notice of depopulation (letter) 10. Forms – lab submission forms (national and international), disease investigation forms, depopulation and compensation forms 11. Vaccination guide 12. List of important websites and links 13. FAO production sector description 14. Poultry population by region/district/county and species 15. National veterinary service organogramme 16. Country map DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 39
  42. 42. HANDOUT: GENERIC ORGANOGRAMME FOR VETERINARY SERVICES Deputy Director Animal Health Assistant Director Animal Health Principal Laboratory Technologist Senior Laboratory Technologist Principal Vet. Officer Regional Veterinary Officers District Veterinary Officers Director Livestock Services Deputy Director Animal Production Assistant Director Animal Production Principal Animal Production Officer Senior Animal Production Officer Animal Production Officers Principal Research Officer Laboratory Technologists Senior Research Officer Senior Livestock Assistants Research Officer Livestock Assistants DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 40
  43. 43. HANDOUT: INCIDENT MANAGEMENT MODEL (IMM) FOR ANIMAL HEALTH RESPONSE TO HPAI OUTBREAKS Overview In an outbreak, a successful response depends on: • Making sure that tasks are assigned - In every response, no matter the size, certain jobs or tasks must be successfully completed. • A single supervisor delegating, and being responsible for, the actions of all participants - This prevents confusion. • Good communication - From the workers to the supervisors and from the supervisors to the workers • IMM provides a flexible structure to accomplish these goals. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 41
  44. 44. WHAT IS THE IMM What is the IMM? Incident Management Model (IMM) is a tool for effectively managing a Highly Pathogenic Avian Influenza (HPAI) outbreak in poultry populations. IMM is based on the Incident Command System (ICS) developed by the U.S. Forest Service and now widely used to respond to disasters such as fires or floods, or to manage a planned event such as a parade. IMM, a model specifically designed for HPAI outbreaks, can be adapted to a country’s needs and to the local situation; it can also be used to control other animal disease outbreaks. Basic Organizational Features The IMM for HPAI outbreaks in poultry uses some basic organizational features of the Incident Command System (ICS): • Modular and Flexible: as the size and complexity of the outbreak increases, the structure expands from the top down as functions are delegated. • Planning Process: Planning is deciding what will be done, how it will be done, who will do it, and what resources will be needed. The lead agency assigned must have a clear understanding of the national policy on managing the outbreak, and given the mandate and authority to implement it. The planning process must include the following steps: - Assess the current HPAI outbreak situation - Establish outbreak management objectives - Select appropriate strategy and actions required to manage the outbreak - Implement the Outbreak Action Plan, and monitor performance - Adapt if necessary (change strategy, add more resources, etc.) • Outbreak Action Plan: an action plan is essential to an effective outbreak response. It provides personnel with directions on how to implement the actions necessary to manage the outbreak. The plan must: - Specify outbreak management objectives, how to achieve these objectives, how long it will take to achieve these objectives, and who will perform these actions - Indicate what resources (personnel, supplies, equipment, etc.) will be needed to accomplish these objectives - Provide a means of communicating the overall objectives to the supervisors - Outline a procedure in the event that someone gets injured or sick during the outbreak operations • Span of Control - The number of people a supervisor can manage effectively during the outbreak response - Effective span of control may be between 3-7 persons; ideally, one supervisor to five people DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 42
  45. 45. • Unity of Command - Each individual working in the outbreak response is accountable to only one designated supervisor - Supervisors must be able to control the actions of their personnel • Chain of Command - The line of authority within the ranks of the organization - Lower levels within the organization are connected to higher levels - Lower levels are accountable to their higher-level supervisors • Unified Command - Representatives from different ministries, agencies, regional or local offices work together under one command - Under unified command, there is always: • One Incident Commander (IC) • One outbreak command post from where the response is managed • A single Outbreak Action Plan Management Functions Incident Command • Sets the objectives, strategies, and priorities • Has overall responsibility for managing the outbreak Operations • Determines how operational objectives of the Outbreak Action Plan will be accomplished • Implements the plan Planning • Develops the Outbreak Action Plan for accomplishing the objectives • Collects and analyzes outbreak data, tracks resources (personnel, supplies, materials), and maintains records of the outbreak and response Logistics • Provides support, resources, training, and other services to meet the operational objectives Finance/Administration • Recruits personnel, tracks them and their time worked, and pays salaries • Pays agreed-upon compensation, and all other invoices DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 43
  46. 46. Organizational Staff The Incident Commander (IC) is responsible for overall management of the HPAI outbreak response. The IC position is always staffed, even if the other positions are not filled. The IC may assign other personnel as needed to assist in managing the outbreak. IMM personnel are categorized as either Command Staff or General Staff. Command Staff The Incident Commander (IC) is: • In charge of overall outbreak response at the outbreak site • Normally assigned by the lead Ministry (if Vet Services Dept, the IC typically is the Regional Veterinary Officer) • May be assisted by District Veterinary Officers, veterinary technicians, para-veterinarians, trained farmer assistants, and others as necessary • Command Staff • The Incident Commander may have Command Staff (i.e. Information Officer, Liaison Officer, etc.) to carry out duties not identified under General Staff responsibilities. Command Staff report directly to the Incident Commander. Information Officer Activities: • Assists the Incident Commander in providing groups such as the national AI Task Force, the ministries, governors, local officials, the media, donors, NGOs and other relevant groups with general information on the outbreak response • Works closely with the Situation Reports Unit to get the latest outbreak information The Information Officer and the Incident Commander are the only persons authorized to provide official information. All information for public release needs to be cleared by the IC. Liaison Officer Activities: • Assists the Incident Commander in coordinating with the national AI Task Force and donors to ensure that outbreak response activities are complementary and do not duplicate other ongoing efforts • Represents the Incident Commander at donor coordination meetings if the IC is not available The Liaison Officer reports directly to the Incident Commander. General Staff General Staff are assigned functional responsibilities for Operations, Planning, Logistics, and Finance/Administration. The staffing levels for General Staff are, from the top down: • Section (led by Chiefs) • Group (led by Supervisors) • Unit (led by Leaders) DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 44
  47. 47. Operations Section • Epidemiology Group - Surveillance Unit - Diagnostics Unit - Outbreak Mapping Unit • Biosecurity Group - Commercial Backyard Farm Unit - Live Bird Markets Unit - Quarantine Support Unit • Depopulation Group - Culling Unit - Disposal Unit - Decontamination Unit Surveillance Unit Veterinary Officer • Public/Occupational Health Group - Public Health Unit - Occupational Health Unit MOA MOH Commercial Backyard A Veterinary Officer typically leads this section. Incident Commander PLANNING Section LOGISTICS Section OPERATIONS Section Biosecurity Group Epidemiology Group Depopulation Group Diagnostics Unit Outbreak Mapping Unit Farm Live Bird Markets Quarantine Support Unit FINANCE/ADMINISTRATION Section Liaison Officer Public/ Occupational Health Group Public Health Unit Information Officer Rapid Response Team Human Health Officer Site Manager Team 1 Site Manager Culling Unit Disposal Unit Decontami-nation Unit Occupational Health Unit DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 45
  48. 48. • Epidemiology Group - Surveillance Unit - Diagnostics Unit - Outbreak Mapping Unit A Veterinary Epidemiologist typically leads this group. The group provides daily updates to the Situation Reports Unit on activities within its group. - Surveillance Unit Activities: Surveillance Unit • Conducts active surveillance in the infected premises and the protection zone (or FAO “infected zone”), usually 3 km around the index case • Conducts active and passive surveillance within the surveillance and control zone (or FAO “threatened zone”), usually 3-7 km outside the quarantine zone • Performs field/screening diagnostic tests on clinical samples • Collects and sends clinical samples to the Diagnostics Unit for forwarding to the national laboratory - Diagnostics Unit Activities: • Packages and ships samples to a national diagnostic or reference laboratory for confirmation • Compiles test results from Surveillance Unit activities and the national laboratory, and reports results to the Epidemiology Supervisor - Outbreak Mapping Unit Activities: • Maintains maps showing the outbreak areas • Records the locations of the outbreak areas • Helps determine the outbreak zoning areas in coordination with the Quarantine Group • Provides outbreak maps to the outbreak personnel • may use GIS technology if available Incident Commander PLANNING Section LOGISTICS Section OPERATIONS Section Biosecurity Group Epidemiology Group Depopulation Group Diagnostics Unit Outbreak Mapping Unit FINANCE/ADMINISTRATION Section Liaison Officer Public/ Occupational Health Group Information Officer Rapid Response Team MOA MOH ZONES DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 46
  49. 49. • Biosecurity Group - Commercial Backyard Farm Unit - Live Bird Markets Unit - Quarantine Support Unit Incident Commander PLANNING Section LOGISTICS Section OPERATIONS Section Biosecurity Group Epidemiology Group Depopulation Group Farm Commercial Backyard Live Bird Markets Quarantine Support Unit The group provides daily updates to the Situation Reports Unit on activities within its group. A Veterinary or Livestock Officer typically leads this group. - Commercial Backyard Farm Unit Activities: FINANCE/ADMINISTRATION • Evaluates, and if necessary, trains commercial farmers on biosecurity in the outbreak areas - Continuously monitors and reinforces biosecurity principles • Trains backyard flock owners in the outbreak area on biosecurity measures - Continuously monitors and reinforces backyard biosecurity measures - Live Bird Markets Unit (LBM) Activities: • The LBM Biosecurity Unit advises local authorities on LBM management to stop the spread of disease: - When possible, recommends temporary closure and disinfection of live bird markets in the outbreak areas - If live bird markets are allowed to stay open, trains LBM managers and workers on appropriate biosecurity measures and sanitation procedures • Coordinates with the government inspection service to ensure only healthy chickens are sold - Quarantine Support Unit Activities: • Establishes quarantine zone boundaries, provides quarantine information (e.g. entry/exit points, signs) and training to appropriate authorities for enforcement • Coordinates with the Outbreak Mapping Unit to provide map information to identify quarantine zone boundaries and control points for the appropriate authorities • Provides or arranges for technical personnel (i.e. inspections, biosecurity compliance) to assist authorities at control points Once the IC declares that the outbreak has been controlled, this unit informs local authorities that the quarantine is over, and ensures that quarantine restrictions in all areas are lifted. Section Liaison Officer Public/ Occupational Health Group Information Officer Rapid Response Team MOA MOH DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 47
  50. 50. • Depopulation Group - Culling Unit - Disposal Unit - Decontamination Unit MOA MOH The group provides daily updates to the Situation Reports Unit on ongoing depopulation activities. A Veterinary or Livestock Officer typically leads this group. Depending on the size of the outbreak, the Depopulation Group may have multiple teams in different outbreak locations. A site Team Leader (from within the Depopulation Group) is assigned to supervise depopulation activities in each location. - Culling Unit Activities: Culling Unit • Identifies the most appropriate, safe and humane method of euthanizing infected birds • Trains personnel on euthanasia techniques, biosecurity, biosafety, and occupational-safety measures • Supervises the euthanasia of all infected and potentially-infected poultry • If necessary, coordinates the removal of the euthanized poultry and its transportation to the disposal site - Disposal Unit Activities: • Identifies the best method (burial, burning, etc.) and location for disposal of culled birds • Trains personnel on disposal techniques, biosecurity, biosafety, and occupational safety measures • Supervises personnel disposing infected poultry and poultry products to ensure proper and safe disposal • Ensures appropriate measures are in place to protect the environment during and after disposal - Decontamination Unit Activities: • Identifies appropriate disinfectants for procurement • Trains, supervises, and monitors personnel on disinfectant preparation and cleaning and disinfection procedures Incident Commander PLANNING Section LOGISTICS Section OPERATIONS Section Biosecurity Group Epidemiology Group Depopulation Group FINANCE/ADMINISTRATION Section Liaison Officer Public/ Occupational Health Group Information Officer Rapid Response Team Team 1 Site Manager Disposal Unit Decontami-nation Unit DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 48
  51. 51. • Stresses the importance of proper cleaning prior to disinfection • Supervises cleaning and disinfection of infected premises and surrounding areas • Ensures appropriate measures are in place to protect the environment during decontamination • Public/Occupational Health Group - Public Health Unit - Occupational Health Unit The group provides daily updates on its activities to the Situation Reports Unit. A Health Officer typically leads this group. - Public Health Unit Activities: Incident Commander MOA MOH PLANNING Section • Informs MOH on ongoing outbreak response activities • Coordinates with MOH on its clinical investigation in human populations potentially exposed to HPAI - Occupational Health Unit Activities: • Recommends actions to minimize occupational-health hazards in the outbreak response areas • Ensures that all occupational-health policies and procedures are in place and are being followed - Ensures all outbreak personnel are properly trained (e.g. PPEs) - Conducts respiratory fit tests on all outbreak personnel • Monitors the health of outbreak personnel and their families during and after the outbreak response, and refers sick individuals to the hospital LOGISTICS Section OPERATIONS Section Biosecurity Group Epidemiology Group Depopulation Group FINANCE/ADMINISTRATION Section Liaison Officer Public/ Occupational Health Group Public Health Unit Information Officer Rapid Response Team Occupational Health Unit DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 49
  52. 52. Planning Section • Outbreak Information Management Group - Surveillance Support Unit - Central Disease Reporting Unit - Situation Reports Unit • Recovery Group - Compensation Unit - Recovery Unit MOA MOH Information Officer Surveillance Support Unit The Planning Chief is typically a government administrator or planner. • Outbreak Information Management Group - Surveillance Support Unit - Central Disease Reporting Unit - Situation Reports Unit A Veterinary Officer typically leads this group. - Surveillance Support Unit Activities: Compensation Unit MOA MOH Information Officer Surveillance Support Unit • Plans future surveillance based on ongoing outbreak operations • Provides the Supplies Group logistical requirements (supplies, PPEs, test kits, etc.) for ongoing and future surveillance activities • Assists with surveillance after outbreak has been controlled - Central Disease Reporting Unit Activities: • Functions as the central point for all data and information collected from the outbreak • Maintains all outbreak databases, including lab results, infected premises, culling, and surveillance locations - In a GIS database if possible - Produces comprehensive maps on all outbreak activities from above databases - Situation Reports Unit Activities: • Writes regular (typically, daily) updates/reports on ongoing outbreak situation for Incident Commander Incident Commander PLANNING Section LOGISTICS Section OPERATIONS Section Recovery Group Outbreak Info Management Group Central Disease Reporting Unit Recovery Unit FINANCE/ADMINISTRATION Section Liaison Officer Situation Reports Unit Incident Commander PLANNING Section LOGISTICS Section OPERATIONS Section Recovery Group Outbreak Info Management Group Central Disease Reporting Unit FINANCE/ADMINISTRATION Section Liaison Officer Situation Reports Unit DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 50
  53. 53. • Provides situational information to the Information Officer (through the IC) to respond to external requests for information from ministries, national, regional and local governments, offices, NGOs, media, donors, etc. • Recovery Group - Compensation Unit - Recovery Unit A Veterinary or Livestock Officer typically leads this group. - Compensation Unit Activities: • Adapts a national compensation MOA MOH Compensation Unit plan (if it exists) to local conditions - Provides information on pricing, payment methods, and documentation of compensation • If compensation plan is implemented, coordinates with the Depopulation Group and Cashier Unit for compensation payments - Recovery Unit Activities: • Develops follow-on surveillance plans to monitor for disease re-occurrence in areas where outbreak has been controlled • Plans for reinforcing biosecurity measures • Recommends alternative livelihood recovery options such as restocking of poultry, or paying compensation to affected farmers - Submits a recovery plan and budget for consideration of the national government Incident Commander PLANNING Section LOGISTICS Section OPERATIONS Section Recovery Group Outbreak Info Management Group Recovery Unit FINANCE/ADMINISTRATION Section Liaison Officer Information Officer DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 51
  54. 54. Logistics Section • Facilities Group - Base Camp Unit - Sanitary Services Unit • Supply Group - Supply Inventory Unit - Equipment Unit - Provisions Unit • Support Group - Operations Support Unit - Transport Unit - Communications Unit - Demobilization Unit MOA MOH OPERATIONS Section The Logistics Chief is usually a government administrator. • Facilities Group - Base Camp Unit - Sanitary Services Unit An administrative officer typically leads this group. - Base Camp Unit Activities: Incident Commander PLANNING Section LOGISTICS Section Supply Group Support Group Facilities Group Base Camp Unit Sanitary Services Unit • Manages all base camp activities • Determines locations and manages the supply stockpiles, rest and refreshment areas, washing and sanitary services areas • Provides shelter for outbreak personnel as needed • Secures the base camp, especially supply stockpiles - Sanitary Services Unit • Provides adequate facilities (wash and sanitation areas, water, soap, etc.) for outbreak personnel • If needed, assists with the disposal of used PPEs and contaminated supplies • If needed, assists with cleaning and disinfection of contaminated equipment for re-use FINANCE/ADMINISTRATION Section Supply Inventory Unit Equipment Unit Provisions Unit Liaison Officer Operations Support Unit Transport Unit Communica-tions Unit Demobilization Unit Information Officer DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 52
  55. 55. • Supply Group - Supply Inventory Unit - Equipment Unit - Provisions Unit An administrative officer typically leads this group. - Supply Inventory Unit MOA MOH Activities: • Manages and issues all outbreak supplies, including: - PPEs - Surveillance supplies - Disinfectants - Cleaning supplies - Maps - Fuel for outbreak equipment - Provisions (food and water) • Monitors outflow of commodities during outbreak operations to plan for future needs • Orders outbreak supplies as needed - Equipment Unit Activities: • Manages outbreak equipment, such as backpack sprayers, digging tools, tractors, bulldozers, etc. • Issues equipment and ensures return, and requests additional equipment as needed • Provides training to outbreak personnel in use of equipment if required • Develops and enforces cleaning and disinfection procedures for outbreak equipment • Maintains inventory and location of outbreak equipment - Provisions Unit • Provides supplies to outbreak personnel • Provides food and water to outbreak personnel working in remote locations (e.g. depopulation activities) • Issues clean clothes, rubber boots or other supplies to outbreak personnel if needed Incident Commander PLANNING Section LOGISTICS Section OPERATIONS Section Supply Group Support Group Facilities Group FINANCE/ADMINISTRATION Section Supply Inventory Unit Equipment Unit Provisions Unit Liaison Officer Information Officer DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 53
  56. 56. • Support Group - Operations Support Unit - Transport Unit - Communications Unit - Demobilization Unit An administrative officer typically leads this group. - Operations Support Unit Activities: Incident Commander MOA MOH PLANNING Section LOGISTICS Section OPERATIONS Section • Functions as central point for requests for supplies, equipment, personnel, or services from groups within the Operations Section • Fills requests and delivers to operational site Supply Group - Individuals or operational teams can also get supplies from the Supply Group if needed • Schedules delivery of sanitary services • Coordinates with Personnel Unit to provide personnel to assist in field operations, and coordinates with Transport Unit as needed - Transport Unit Activities: • Provides transportation of personnel, commodities, supplies, equipment, and waste • Manages transportation assets (government or leased vehicles) • Manages fuel supply • Ensures that all transportation assets are cleaned and disinfected - Communications Unit Activities • Manages the communications and electronic equipment used in outbreak response, such as radios, cell phones, computers, laptops, GPS units, software, etc. • Prepares a communications plan for the most effective use of equipment • Ensures continuous communication links between the incident command post and the national coordination level - Demobilization Unit Activities: • Prepares the demobilization plan • Dismantles the operations set-up and base camp • Cleans, disinfects and stores equipment for future use • Inventories and returns unused AI commodities to appropriate storage facility Support Group Facilities Group FINANCE/ADMINISTRATION Section Liaison Officer Operations Support Unit Transport Unit Communica-tions Unit Demobilization Unit Information Officer DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 54
  57. 57. Finance/Administration Section • Personnel Group - Personnel Unit - Training Unit - Time Keeping Unit • Finance Group - Procurement Unit - Accounts Payable Unit - Cashier Unit The Finance/Administration Chief sets the maximum cash payment allowed per transaction. A Personnel or Finance Officer typically leads this section. • Personnel Group - Personnel Unit - Training Unit - Time Keeping Unit An administrative officer typically leads this group. - Personnel Unit Activities: MOA MOH • Recruits and manages personnel for outbreak response • Tracks and accounts for all personnel while operation is ongoing (check-in and check-out) • Coordinates with Training Unit to ensure all personnel are properly trained • Identifies to the Public/Occupational Health Group the outbreak personnel needing training in public and occupational health safety, and health monitoring - Training Unit Activities: • Provides required training to outbreak personnel as defined in the national preparedness plan - PPEs - Biosecurity - Biosafety - Safety Incident Commander PLANNING Section LOGISTICS Section OPERATIONS Section FINANCE/ADMINISTRATION Section Finance Group Personnel Group Liaison Officer Personnel Unit Training Unit Time Keeping Unit Procurement Unit Accounts Payable Unit Information Officer Cashier Unit MOA MOH Incident Commander PLANNING Section LOGISTICS Section OPERATIONS Section FINANCE/ADMINISTRATION Section Finance Group Personnel Group Liaison Officer Personnel Unit Training Unit Time Keeping Unit Information Officer DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 55
  58. 58. - Occupational health • Provides specific job-required trainings (e.g. culling, cleaning and disinfection, disposal) - Time Keeping Unit Activities: • Documents time worked by outbreak personnel • Approves timesheets for payment by Cashier Unit Finance Group - Procurement Unit - Accounts Payable Unit - Cashier Unit A government official from the Ministry of Agriculture, or a Comptroller (someone who controls payments) typically leads this group. - Procurement Unit Activities: • Purchases goods and supplies for use in outbreak response (through the MoAg Procurement Office if appropriate) • Procures services of personnel needed for outbreak response (through the MoAg Procurement Office if appropriate) • Drafts and reviews contracts or provides specifications for goods and services associated with the outbreak response - Accounts Payable Unit Activities: • Receives and maintains a log of invoices associated with the outbreak response • Coordinates with Comptroller approval of invoices for payment • Coordinates with the Compensation Unit to approve payment for culled birds - Cashier Unit Activities: • Maintains cash control - Ensures payments do not exceed amount of funds received - Ensures maximum cash payment limits are not exceeded • Disburses funds • Pays personnel and approved invoices related to the outbreak response, including compensation payments Incident Commander PLANNING Section LOGISTICS Section OPERATIONS Section FINANCE/ADMINISTRATION Section Finance Group Personnel Group Liaison Officer Procurement Unit Accounts Payable Unit Information Officer Cashier Unit MOA MOH DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 56
  59. 59. HANDOUT: FAO POULTRY SECTORS DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 57
  60. 60. MODULE 3: OIE AI STANDARDS AND FAO AI PROGRAMS MODULE PURPOSE Overview of the World Organization for Animal Health (OIE) avian influenza standards for surveillance, diagnosis, disease reporting and status; and of the Food and Agriculture Organization’s (FAO) AI-related programs. MODULE OBJECTIVES At the conclusion of this module, you will be able to: • Explain OIE avian influenza disease guidelines on reporting; • Describe what is required to declare freedom from disease in a zone or compartment; • Identify the distinctions and complementarities between the OIE and FAO, and • Describe the FAO programs that address HPAI control. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 58
  61. 61. STOP AI WORLD ORGANIZATION FOR ANIMAL HEALTH (OIE) AVIAN INFLUENZA STANDARDS Prepared by Dr. James E. Pearson, Animal Health Consultant STOP AI WORLD ORGANIZATION FOR ANIMAL HEALTH (OIE) AVIAN INFLUENZA STANDARDS • Overview of the OIE • Guidelines for Avian Influenza Disease Reporting and Status • Avian Influenza Diagnostic Standards • Determination of Avian Influenza Disease Status • Guidelines on Surveillance for Avian Influenza DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 59
  62. 62. STOP AI OVERVIEW OF THE WORLD ORGANIZATION FOR ANIMAL HEALTH (OIE) 12 rue de Prony 75017 Paris, France http://www.oie.int STOP AI WORLD ORGANIZATION FOR ANIMAL HEALTH (OIE) • Formed in 1924 (not a UN organization) • 169 member countries • The OIE country delegate is usually the Chief Veterinary Officer • Headquarters is in Paris, France • Director General is Dr. B. Vallat • Central Bureau has a staff of about 65 people • Five regional offices of about two people each • Most of the OIE outputs are developed by experts, who volunteer their time. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 60
  63. 63. STOP AI THE OIE’S OBJECTIVES • To ensure transparency in the global animal disease and zoonosis situation (reason for its formation in 1924) • Within its WTO mandate, to safeguard world trade by publishing health standards for international trade in animals and animal products (standard-setting role) • To collect, analyze, and disseminate scientific veterinary information • To provide expertise and encourage international solidarity in the control of animal diseases STOP AI OIE OBJECTIVES (CONT.) • To improve the legal framework and resources of national veterinary services • To provide a better guarantee of the safety of animal-originated food • To promote animal welfare, through a science-based approach DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 61
  64. 64. STOP AI OIE INFORMATION SYSTEM ª Promote transparency in and knowledge of global animal disease situation STOP AI OIE’S INTERNATIONAL STANDARDS • Enhance safety of international trade of animals and animal products • Encourage harmonization of national legislations and control measures • Narrow the gap between rich and poor countries • Surveillance and control of animal diseases and zoonoses • Promote fairer trade (fewer unjustified restrictions on trade) DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 62
  65. 65. STOP AI SPECIALIST COMMISSIONS • Are made up of volunteers from member countries who are experts • Role is to use current scientific information to: – Develop and revise OIE’s International Standards – Study problems of epidemiology and the prevention and control of animal diseases – Address scientific and technical issues raised by member countries STOP AI SPECIALIST COMMISSIONS (cont.) Terrestrial Animal Health Standards Commission Code Commission Scientific Commission for Animal Diseases Scientific Commission Biological Standards Commission Laboratories Commission Aquatic Animal Health Standards Commission Aquatic Animals Commission DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 63
  66. 66. STOP AI Terrestrial Animal Health Standards Commission Code Commission Responsible for annually updating the Terrestrial Animal Health Code, ensuring it reflects current scientific information STOP AI Biological Standards Commission Laboratories Commission Oversees production of the Manual of Diagnostic Tests and Vaccines for Terrestrial Animals Establishes or approves methods for: • diagnosing diseases of mammals, birds and bees • testing biological products, such as vaccines, that are used for control purposes DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 64
  67. 67. STOP AI OIE AI REFERENCE LABORATORIES • Laboratories have expertise and capability to completely characterize AI isolates. They are located in: – Insel Riems, Germany – Hew Haw, U.K. – Geelong, Australia – Padova, Italy – Ames, Iowa, U.S. STOP AI THE OIE INTERNATIONAL COMMITTEE • The highest authority of the OIE • Comprised of all the OIE delegates, usually the Chief Veterinary Officer • Meets at least once a year • Elects the members of the Specialist Commissions All official acts of the OIE must be approved by the International Committee; most of the decisions are by consensus. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 65
  68. 68. STOP AI AVIAN INFLUENZA DISEASE GUIDELINES Terrestrial Animal Health Code Chapter 1.1.1 STOP AI AVIAN INFLUENZA DISEASE GUIDELINES • Notifiable Avain Influenza (NAI): infection of poultry caused by any influenza A virus of the H5 or H7 subtypes or by any AI virus with an intravenous pathogenicity index (IVPI) greater than 1.2, or as an alternative, at least 75% mortality in inoculated chickens DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 66
  69. 69. STOP AI AVIAN INFLUENZA DISEASE GUIDELINES (CONT.) • Highly Pathogenic Notifiable Avian Influenza (HPNAI): has an IVPI in 6-week-old chickens greater than 1.2 or, as an alternative, causes at least 75% mortality in 4-to 8-week-old chickens infected intravenously. H5 and H7 viruses which do not have an IVPI of greater than 1.2 or cause less than 75% mortality in an intravenous lethality test should be sequenced to determine whether multiple basic amino acids are present at the cleavage site of the hemagglutinin molecule; if the amino acid motif is similar to that observed for other HPNAI isolates, the isolate being tested should be considered as HPNAI. STOP AI AVIAN INFLUENZA DISEASE GUIDELINES (CONT.) • Low Pathogenicity Notifiable Avian Influenza (LPNAI): all influenza A viruses of H5 and H7 subtype that are not HPNAI viruses. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 67
  70. 70. STOP AI AVIAN INFLUENZA DISEASE GUIDELINES (CONT.) • Avian Influenza that is not notifiable: – Isolations of H1-4, H6, H8-16 “non-pathogenic” avian influenza strains. STOP AI AVIAN INFLUENZA DISEASE GUIDELINES (CONT.) • Zone or region: means a clearly defined part of a country containing an animal subpopulation with a distinct health status with respect to a specific disease for which required surveillance, control and biosecurity measures have been applied for the purpose of international trade DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 68
  71. 71. STOP AI AVIAN INFLUENZA DISEASE GUIDELINES (CONT.) • Compartment: means one or more establishments under a common biosecurity management system containing an animal subpopulation with a distinct health status with respect to a specific disease or diseases for which required surveillance, control and biosecurity measures have been applied for the purpose of international trade STOP AI AVIAN INFLUENZA DISEASE GUIDELINES: ZONING AND COMPARTMENTALIZATION • Zoningapplies to an animal subpopulation, defined primarily on a geographical basis (using natural, artificial or legal boundaries) • Compartmentalization applies to an animal subpopulation, defined primarily by management and husbandry practices related to biosecurity In practice, spatial considerations, biosafety, biosecurity, and good management play important roles in the application of both concepts. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 69
  72. 72. STOP AI Avian Influenza Disease Guidelines (cont.) • Poultry: all domesticated birds used for the production of meat or eggs for consumption, for the production of other commercial products, for restocking supplies of game, or for breeding these categories of birds STOP AI OIE AVIAN INFLUENZA DIAGNOSTIC STANDARDS Manual of Diagnostic Tests and Vaccines for Terrestrial Animals Chapter 2.7.12 DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 70
  73. 73. STOP AI CLASSICAL AVIAN INFLUENZA DIAGNOSTIC METHODS, OIE • Isolation in embryonating chicken eggs, virus identification by hemagglutination and neuraminidase inhibition, and characterization by chicken inoculation • This method requires a biosafety level 3 laboratory STOP AI ALTERNATIVE AVIAN INFLUENZA DIAGNOSTIC METHODS • Biosafety level 2 methods: – Avian influenza antigen capture ELISA test – Perform PCR on tissue or swab samples using primers to screen for AI viruses and if positive, test with primers to evaluate if virus is H5 or H7 – Submit to an OIE Reference Laboratory for characterization – Serology: Immunodiffusion, ELISA DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 71
  74. 74. STOP AI AVIAN INFLUENZA DISEASE STATUS Terrestrial Animal Health Code Chapter 2.7.12 STOP AI AI DISEASE STATUS, OIE CODE • NAI status of a country, a zone or a compartment is determined on the basis of the following: – outcome of a risk assessment – NAI is notifiable in the whole country – appropriate surveillance is in place DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 72
  75. 75. STOP AI NAI FREEDOM, OIE CODE • A country, zone or compartment may be considered free from NAI when it has been shown that neither HPNAI nor LPNAI infection has been present in the country, zone, or compartment in the past 12 months, based on surveillance in accordance with Appendix 3.8.9 of the OIE Code STOP AI NAI FREEDOM, OIE CODE (CONT.) • Imports will come from a country, zone, or compartment NAI free and veterinary administrators shall meet the other requirements contained in the OIE Code DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 73
  76. 76. STOP AI NAI FREEDOM, FOLLOWING AN OUTBREAK, OIE CODE • In the case of HPNAI infections, freedom can be declared three months after a stamping-out policy (including disinfection of all affected establishments) is applied, providing that surveillance in accordance with Appendix 3.8.9 has been carried out during that three-month period. STOP AI GUIDELINES ON SURVEILLANCE FOR AVIAN INFLUENZA Terrestrial Animal Health Code Appendix 3.8.9 (MORE DETAILS LATER IN THE COURSE) DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 74
  77. 77. STOP AI OIE NAI SURVEILLANCE • Early warning system throughout the production, marketing and processing chain for reporting suspect NAI cases • System for detecting and investigating outbreaks of disease or NAI infection • Procedures in place for the rapid collection and transport of samples to the laboratory, and for the performance of appropriate tests STOP AI OIE NAI SURVEILLANCE (CONT.) • A system in place for recording, managing and analyzing diagnostic and surveillance data • Implement, when relevant, regular and frequent clinical inspection, and serological and virological testing of high-risk groups of animals • Both design of the survey and the basis for the sampling process need to be aimed at the population within the country, zone, or compartment DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 75
  78. 78. STOP AI OIE NAI SURVEILLANCE (CONT.) • Surveillance should cover all the susceptible poultry species within the country, zone, or compartment. Active and passive surveillance for NAI should be ongoing. Active surveillance should occur at least every six months. Surveillance should be composed of random and targeted approaches using virological, serological and clinical methods. STOP AI OIE NAI SURVEILLANCE (CONT.) • Virological surveillance should be conducted: – to monitor at-risk populations – to confirm clinically-suspect cases – to follow up positive serological results – to test ‘‘normal’’ daily mortality DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 76
  79. 79. STOP AI OIE NAI SEROLOGICAL SURVEILLANCE • Serological surveillance aims at the detection of antibodies against NAIV. Positive NAIV (H5 or H7) antibody test results can have four possible causes: – natural infection with NAIV – vaccination against NAI – maternal antibodies derived from a vaccinated or infected parent flock are usually found in the yolk and can persist in progeny for up to 4 weeks – positive results due to the lack of specificity of the test STOP AI OIE NAI VIROLOGICAL SURVEILLANCE FOLLOWING THE DETECTION OF AI ANTIBODY • Virological testing should be initiated in all antibody-positive flocks. The samples should be evaluated for the presence of AI virus, by virus isolation and identification, and/or detection of influenza A-specific proteins or nucleic acids. DRAFT TRAINING MANUAL STOP AI CONSULTANTS COURSE 77

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