29 November 2013 – With the threat of avian influenza A(H7N9) spreading during the autumn and winter months, the Food and Agriculture Organization of the United Nations (FAO) and the United States Agency for International Development (USAID) have joined forces to enhance surveillance and improve preparedness and response capacities in key countries in Asia and beyond. These initiatives were designed to enable at-risk nations to detect incursion of this virus early and reduce the threat posed by H7N9 to human health.
Since H7N9 emerged in China in March 2013, there have been 139 human cases and 45 deaths. The latest human cases reported in Guangdong and Zheijang provinces in November 2013 indicate that the virus is still circulating in China. According to genetic analysis and experimental infection studies, H7N9 can infect mammalian hosts more easily than H5N1 highly pathogenic avian influenza (HPAI) virus. This suggests the H7N9 virus has the potential to become pandemic.
Continuous presence of H7N9 in China and its strong trading links within Asia raises the possibility of the virus being introduced to a number of surrounding countries, most of which are members of either the Association of the Southeast Asian Nations (ASEAN) or the South Asian Association for Regional Cooperation (SAARC). In response, FAO recently launched two projects to step up H7N9 surveillance programmes in these regions and improve capacities to detect, control and respond to the virus in poultry and animal populations should it spread. FAO is supporting all ASEAN and SAARC nations with preparedness guidance, while targeting specific assistance to priority countries sharing borders or trade routes with China: Bangladesh, Bhutan, Lao People’s Democratic Republic, Myanmar, Nepal and Viet Nam. FAO will also provide a coordination role working closely with other international agencies to ensure there is strong collaboration between the public and animal health sectors at country levels to ensure harmonization of policies on addressing this important public health threat.
Bringing together veterinary experts from the region and from international organizations and development partners, FAO launched both projects in September through a participatory workshop held in Bangkok, Thailand.The Bangkok meeting was one of a number of important opportunities provided by FAO to facilitate information sharing among veterinary experts from the region.
As Principal Livestock Health Officer Jambay Dorjee from Bhutan observed, “H7N9 is no longer [only] a country problem. We need a common understanding of this problem at a regional level.” Dorjee observed that FAO had provided ASEAN and SAARC with a much-needed coordination platform as well as the possibility to source funding through donor agencies. “FAO is taking a very important lead role in this,” Dorjee said. “Without money and without coordination you cannot do anything.”
Mohammed Giasuddin, Director (in charge) of Bangladesh’s National Reference Laboratory for Avian Influenza concurred that the Bangkok meeting was crucial for colleagues who would otherwise not necessarily meet or be able to share information on surveillance and control methods. He added that the meeting would allow Bangladesh authorities to “accelerate our activities of monitoring and surveillance to find the presence of the virus in our country” should it cross the border.
As Nguyen Tung, Vice Director of the National Centre for Veterinary Diagnostics in Viet Nam observed: “the virus has already killed a significant number of people. This meeting constitutes a very important forum for countries [...] to discuss activities of surveillance and preparedness planning in order to minimize the risk to humans.”
FAO is also working to help countries prepare for H7N9 in other parts of the world. FAO will soon begin a related project to increase preparedness for and response to H7N9 in Cameroon, Côte d’Ivoire, Democratic Republic of Congo, Egypt, Ethiopia, Ghana, Kenya, Nigeria, Senegal, the United Republic of Tanzania and Zambia. FAO selected the beneficiary countries based on their trade linkages with China, their history of past incursions of H5N1 and their relative poultry density. The project will focus on raising awareness and providing training to improve preparedness in the face of this new virus as well animal disease threats in general. Specifically, FAO will provide immediate resources to help assess the risks of H7N9 incursion, enhance biosecurity, strengthen laboratory and risk communication capacities and update avian influenza contingency plans.
Since H7N9 does not cause illness in poultry, it is much more difficult to detect in birds than H5N1 HPAI, which is predominantly a poultry disease. Moreover, while wild birds serve as a natural reservoir for avian influenza viruses, current scientific evidence does not point to wild birds being affected by H7N9. Therefore, the need for country collaboration and communication in animal and human health sectors is critical not only to detect this new virus in time, but also to improve our understanding of H7N9 epidemiology in order to plan for appropriate interventions to stop virus spread. FAO's role in promoting coordination among veterinary experts in Asia and Africa and offering opportunities for information sharing will help maintain vigilance and increase preparedness for a situation that cannot afford to be ignored.