Challenges and limitations of the avian influenza vaccination strategy in Egypt
27 January 2010 ľ The first confirmed cases of highly pathogenic avian influenza (H5N1 HPAI) in Egypt were reported to international authorities in early February 2006. By the end of the year, a total of 1,641 outbreaks took place in Egyptian territories, most of them in commercial poultry farms. In view of this emergency situation, and in consideration of the potential implications to human health and food security, the Government of Egypt decided to use mass vaccination against H5N1 HPAI based on the positive experiences initially had in the People’s Republic of China and later in Viet Nam. During the large-scale implementation of this control measure from 2006 to 2009, reduced attention was given to other essential activities and disease mitigation procedures such as outbreak investigations, biosecurity and surveillance. As time passed by it was clear that the impacts of vaccination in reducing outbreaks were very limited.
The Food and Agriculture Organization of the United Nations (FAO) and the General Organization of Veterinary Services (GOVS) were both interested in determining the factors that more significantly contributed to the lack of positive impact that the vaccination programme had on hampering disease transmission dynamics. A collaborative assessment study indicates that the shortcoming of the Egyptian vaccination strategy may be due in part to structural and institutional weaknesses such as (1) lack of detailed vaccination programs and protocols, (2) limited government controls and collaborations with the private sector, (3) inadequate training of field technicians performing immunization duties, (4) absence of a monitoring system to track coverage and antibodies, and (5) lack of sufficient support in terms of communication and funding. Now, as Egypt deals with an endemic disease situation, it is evident that vaccination against avian influenza should be considered as one of the many tools within a broad portfolio of control measures.
A valuable lesson learned from the disease situation in Egypt is that the rigorous implementation of disease mitigation programmes should encompass –when and where possible– the following actions: farm registration, national livestock inventories, movement controls, culling with compensation, sampling and surveillance, enhanced in-farm biosecurity, routine cleaning and disinfections of markets, outbreak investigations and follow-ups, and vaccinations. These actions should be balanced and reassessed against an evolving disease environment, without over-attention or under-emphasis on a single disease control measure, and with more than appropriate institutional support –be it national, regional or international.
The study, and publication of findings, was carried out by Marisa Peyre, a researcher for the French Agricultural Centre for International Development (CIRAD) in conjunction with collaborators from international technical bodies. Financial support for the project was generously provided by the United States Agency for International Development (USAID) and implement by the Emergency Centre for Transboundary Animal Diseases (ECTAD) of the FAO and GOVS within the framework of a project titled ‘Strengthening Avian Influenza Detection and Response’ (SAIDR).
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