13 May 2014 - Representatives of the animal and public health ministries in the Lao People's Democratic Republic (Lao PDR), Myanmar and Viet Nam came together in Yangon, Myanmar at the end of April 2014. They met to share surveillance results and review their countries' preparedness and response planning for a potential incursion of the Avian Influenza A(H7N9) virus, one that affects both poultry and humans. The meeting was organized jointly by the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) with the financial support of the United States Agency for International Development (USAID). Soon after the emergence of influenza A(H7N9) in China in early 2013, FAO and WHO have been facilitating surveillance activities in these three countries with USAID support. So far the H7N9 virus has not been found. The aim of the Yangon meeting was to promote information exchange and discussions between animal health and public health experts and between the three countries on the key issues related to the A(H7N9) virus. Lao PDR, Myanmar and Viet Nam are considered at a high risk of incursion of A(H7N9) owing to active human movement and trade in live poultry along their northern borders which are shared with China.
For a highly contagious transboundary animal disease with a zoonotic dimension like A(H7N9), collaboration and timely information-sharing between animal health and public health officials and between countries is particularly important. Because birds infected with A(H7N9) bear no clinical signs, cross-sectoral (animal health/public health) collaboration through joint investigations and regular information exchange as well as targeted surveillance are key for the early detection of an incursion.
Representatives from FAO, WHO, USAID, the Centers for Disease Control and Prevention (CDC) and the World Organisation for Animal Health (OIE) were present at the meeting to facilitate discussions about risk assessments, surveillance results, countries’ approaches to surveillance and risk management as well as lessons learned. On the final day of the meeting, country representatives from both health sectors jointly developed six-month work plans starting in May 2014 in line with their ongoing efforts to improve their countries' surveillance and response capacity. Participants from the three countries identified joint activities including reviewing each country's preparedness and response at the interface of animal health and public health, reviewing their risk assessment for an A(H7N9) virus incursion based on the evolving H7N9 situation in China and maintaining a focus on risk-based surveillance.
Country teams planned to continue surveillance in those areas that are at highest risk of an incursion of A(H7N9) including live bird markets (LBMs) selling imported poultry and farms in provinces that share borders with China. They also gained an understanding of the importance of sharing surveillance data in a timely manner and continuing efforts to enhance country and regional preparedness. The participants found the meeting very useful for learning from experiences in other countries and exchanging information between the animal health and public health sectors.
Country teams also identified the main immediate needs in both health sectors including: i) sustainable mechanisms for cross-sectoral collaboration and information sharing; ii) operating procedures for joint follow-up actions; and iii) support for enhancing trained personnel. FAO and WHO, with support from USAID, will continue to support countries by facilitating training sessions on joint risk assessment, continuing to coordinate laboratory assistance and assisting in running desk-top simulation exercises to test countries’ preparedness plans in case of an incursion of A(H7N9). It was suggested that the Chinese authorities from border provinces will be engaged to improve the knowledge and understanding of cross-border poultry value chains. By working together to combat A(H7N9) while ensuring cross-sectoral collaboration, China, Lao PDR, Myanmar and Viet Nam will enhance their preparedness and response capacity to increase resilience in the event of the virus spreading across borders.