APHCA special session on avian influenza
(APHCA 2005/07)

APHCA 29th Session

Global Strategy for the Control of Avian Influenza in Asia

... Tackling the Disease at Source...

Bali, Indonesia - September 2005

COORDINATION WITH OIE AND WHO

• Emergency Expert Consultation on the Control of Avian Influenza

• Rome, 3-4 February 2004

• Regional Meetings on Avian Influenza in Animals in Asia
• Bangkok, Thailand, 26-28 February 2004

• Ho Chi Minh City, 23-25 February 2005

• Coordination Meeting between WHO, OIE and FAO

• Venice, September 2004

• OIE/FAO, WHO International Scientific Conference on AI

• Paris, 7-8 April 2005

COORDINATION WITH OIE AND WHO

• Establishment of the OIE/FAO Avian Influenza Network ("OFFLU")

• Secretariat at IZS, Padua, ITALY

• Consultative Workshop:
• Review on Draft Global Strategy for the Control of HPAI

• Bangkok on 17-18 May 2005

• FAO/WHO/OIE Regional Meeting on Human/Veterinary Inferface

• Kuala Lumpur, 4-6 July 2005

Emerging pattern

Imminent Pandemic?

• Wall Street Journal - 2 August 2005

• "Experts Say World Isn't Ready To Defend itself Against Flu" by David Brown

• The FAO and OIE focus is on diminishing the risk of a pandemic by tackling the disease at source

• Poultry; Asia

• GF-TADs - The Global Framework for the Progressive Control of Transboundary Animal Diseases

Type of Farming system

Conclusions of 2004/2005 Activities

• Asia versus Europe/N America

• Country and Regional specific epidemiological analysis

• HPAI Country situation assessments

• Definition of country specific strategies for HPAI control

  - Concept Notes

Results of 2004/2005 Activities

• Socio Economic impact assessments

• Compensation studies

• Market chain studies

• Policies/Poultry Sector Restructuring

• Wildlife field studies

• Vaccine pilot studies

• With OIE and WHO... human/animal interface

A Global Strategy for the
Progressive Control of Highly
Pathogenic Avian Influenza

Why a global strategy?

• HPAI is highly infectious and labile disease

  - The emergence of the current H5N1 Z genotype can be attributed to this phenomenon

• HPAI results from low pathogenic avian influenza (LPAI), which is present in wild birds in many parts of the world. All countries in the world are at risk of being infected unexpectedly

Why a global strategy?

• HPAI has emerged and spread rapidly as consequence of globalized markets

• HPAI is zoonotic and transboundary in nature

  - Protecting human health is an international responsibility
  - WHO: " 7 million people could die of the pandemic"

Avian Influenza: A human disease

WHO - 22 September 2005

Why a global strategy?

• HPAI threatens regional and international trade

  - $1.2 billion in Thailand (4th largest poultry exporting country in the world)
  - $200 million in Vietnam
  - $170 million in Indonesia
  - Total estimated to be $10-15 billion in Asia

• HPAI control beyond the scope and resources of a single country or region

• Endemicity

• H5N1 avian influenza viruses are now established in several countries of Asia, persisting in farmed and wild waterfowl, particularly ducks, and in the multiple avian species found in live bird markets

• The role of ducks as a reservoir of infection, causing persistence and spread of avian influenza is well recognised.

A Global Strategy for the Progressive Control of Highly Pathogenic Avian Influenza

• Asia as a priority

• National

• Regional

• International Levels

• Networking

• Information exchange and concerted action

The global strategy in perspective

• All countries in the world are at risk of being infected

• HPAI has emerged and spreads rapidly as consequence of globalised markets

• HPAI is zoonotic and transboundary in nature

  - Protecting human health is an international responsibility
  - WHO: " 7 million people could die of the pandemic"

The global strategy in perspective

• Livelihoods of poor farmers threatened

  - 80% population live in rural areas
  - Large numbers depend on poultry (136-210 million)
  - At risk countries have dense populations.
  - Rapid spread in India or Bangladesh of HPAI could devastating and present an even increased risk to the rest of the world

What are the major constraints?

• Inexperience

  - Magnitude and logistics

• Inadequate depth in veterinary services

  - Insufficient expertise in epidemiology, diagnosis, emergency response
  - Inadequate disease information systems

• Endemic nature of the disease

  • Poor understanding of the source
  • Lack of information on infection and transmission dynamics

  • Difficult to detect sub-clinical infection (farmed ducks, waterfowl)

• Poor production biosecurity
• Lack of data on disease impacts
• Need for long term regional coordination

• INADEQUATE RESOURCES

FRAMEWORK FOR IMPLEMENTATION

OBJECTIVES

Country level

• Develop strategies for each affected country

  - Stakeholders
  - Vaccination and Logistics
  - Surveillance Techniques

• Prevent introduction of HPAI in non-infected at risk countries

  - Awareness and reporting
  - Early Detection

• Improve epidemiological information

  - Source
  - Disease infection and transmission dynamics

  • On the farming systems

  • At the Market place

• Prepare contingency and emergency preparedness plans
• Develop economic and policy frameworks for reform

OBJECTIVES

Country level

• Improve long-term capacity

  - Diagnosis
  - Epidemiology
  - Disease surveillance
  - Disease reporting
  - Disease information systems
  - Emergency preparedness plans
  - Economic and policy analysis

Regional Level

• Institutionalized and inter-sectoral coordination

• Programme management

• Regional capacity building in diagnosis, surveillance and epidemiology, policy and socio-economic impact assessment

• Public awareness

• Research and development

Regional Level

• Standardization

  - diagnosis
  - surveillance and monitoring protocols
  - disease reporting
  - emergency preparedness planning

• Disease information sharing

• Regulatory frameworks for the management of animal movement

• Adherence to OIE guidelines to facilitate regional trade

International Level

• Strengthen partnership among international organizations (FAO, OIE and WHO)

• Analytical support and coordination of the subregional networks

• Develop the Global Early Warning System (GLEWS) that incorporates other factors than disease presence

• Provision of backstopping to support subregional networks - FAO HQ, OIE/FAO epidemiology collaborating centres, Reference Laboratories and OFFLU

International Level

• Coordinating research needs and evaluation in improved tools for HPAI control

• Provide a global vision for HPAI control (e.g. EMPRES’ GREP, EU FMD, CSF Americas)

• Mobilize and allocate resources for HPAI control and prevention through active donor liaison and advocacy

Policy & Regulatory issues

• Implementation of biosecurity measures

• Animal movement (national, transboundary)

• Reporting the disease

• Sharing information

• Slaughtering and safe disposal of carcasses

• Compensation issues

• Restructuring and readjustment of the poultry industry

• Compartmentalization and zoning

• Control of certain risky traditional practices

Capacity building

• Development of a strong, sustainable human resource base

• Veterinary Services (and Public Health Services)

• Skills in disease management

• Diagnosis and active surveillance

• Vaccine delivery

• Epidemiology and disease monitoring

• Village-based animal health worker training

• Socio Economic analysis

• Policy development and risk analysis

OUTPUTS

• HPAI spread in humans and poultry will be contained

• HPAI incidence in poultry will be progressively reduced

• Progressive HPAI eradication in compartments and zones

• Prevention of establishment of HPAI in non-infected countries (improved capacity for TADs and emerging diseases)

• Emergency preparedness plans for all countries in Asia

IMPACTS

• Global pandemic of HPAI averted

• Livelihoods of over 500 million poor smallholder farmers in Asia safeguarded

• Improved market opportunities for poultry producers at all economic levels

MAJOR PARTNERS

• Participating countries

  - Infected and non-infected countries in Asia

• Regional Organizations (ASEAN, ASEAN+3, and SAARC)

• International Organizations (FAO, OIE and WHO)

• Private Sector

• Donors

• National Agriculture Research and Extension Systems

• NGOs

Global Framework for the Progressive
Control of Transboundary Animal
Diseases

GF-TADs

GOAL of GF-TADs = Vision Development Objective

• To improve the protein food security, alleviate poverty, and improve the incomes of developing countries

• Safeguard the world livestock industry (of developed as well as developing countries) from repeated shocks of infectious disease epidemics

• Promoting safe and globalised trade in livestock and animal products

Regional Support Units

Concepts and key epidemiological aspects of GF-TADs

• Disease and Infection at the SOURCE

• Upstream investigation

• Epidemiology ~ Laboratory Networks

• Knowledge on animal production, land usage, marketing schemes, movement patterns... an integrated approach.

• GLobal Early Warning System FAO-OIE-WHO

Indicator diseases

• NENA - FMD, rinderpest, HPAI, PPR, sheeppox

• Tropical Africa FMD, rinderpest, CBPP, PPR, ASF, RVF, Newcastle disease

• SADC FMD, CBPP, ASF, and Newcastle disease

• Eastern Asia - FMD, HPAI and CSF

• South Asia FMD, HP Avian Influenza, rinderpest, PPR, and Newcastle disease

• Central Asia - HPAI, FMD, rinderpest, and PPR

• South America - FMD, HPAI, BSE, NWSW, and CSF

• Central America & Caribbean - FMD-free region; CSF

• South-Eastern Europe - FMD and CSF

• Others of concern - brucellosis, rabies...

Inform and Communicate

www.fao.org
www.oie.int

Update on HPAI situation in Asia

FAO Regional Office for Asia and the Pacific

Country Situation

Outbreaks reported in Vietnam, Thailand and Indonesia. Vietnam

• First wave: December 2003 to March 30, 2004

  • 43.9 M chickens, water fowls destroyed, died, 14.76 M quails destroyed in 57 provinces

• Second outbreak from April to November 2004

  • 84000 birds destroyed in 17 provinces

• The third wave from December 2004 to date

  • 470,000 chicken, more than 825,000 ducks, and 551,000 quails were destroyed in 36 provinces

  • Vaccination commenced September 2005, expected cost USD 35M

Country Situation

Thailand

• Second Nationwide Active surveillance Campaign conducted in July 2005

• Supanburi, Kamphang Pet, Saraburi

Indonesia

• Reported in 21 out of 30 Indonesian provinces

• New cases in four provinces (Jambi, South Sulawesi, East Kalimantan, North Sumatra)

• Reported human deaths in July, September

Country Situation

Cambodia

• No reports of HPAI outbreaks

• Three main markets in Phnom Penh still under surveillance (Chbar Ampeov, O’Russey, Central Market)

• Human cases reported in April 2005

Lao PDR

• No reports of HPAI outbreaks

Country Situation

Philippines

• July 2005 - H5 virus infection was suspected in ducks in a province north of Manila. No mortalities, ducks were apparently healthy.

• Chickens were negative to HI test.

• Poultry and ducks were culled.

• Tissue samples were sent to AAHL and found negative for virus isolation.

Country Situation

Outbreaks reported in DPRK, Russia, China, Mongolia, Japan (low path. strain) and Kazakhstan.

Human Cases
(as of 22 Sept 2005)

• Vietnam - 90 (63 fatality Dec 04 - Jun 05)

• Thailand - 17

• Cambodia - 4

• Indonesia - 4

Up close and official for an update

Update: sub-regional networks on
disease surveillance and diagnosis
in Asia

Wantanee Kalpravidh
Mohinder Oberoi
Fusheng Guo
Regional Coordinators
AI Surveillance and Diagnostic Laboratory Networks in Asia

Areas for Regional Collaboration

• Laboratory diagnosis

• Surveillance and Epidemiology analysis

• Control of AI

• Preparedness for non-affected countries

• Establishment of linkage with public health: preparedness for pandemic human influenza

• Socio-economic assessment

• Rehabilitation and Restructuring of poultry production system

• Research

FAO Regional TCPs

Sub-regional TCPs for Networking

Additional Recommendations from the East and South Asia Launching Meetings

Scheme of collaboration for Sub-regional Networking in Asia

• Experts:

• Training and Workshop

• Facilitate regional networking

• Facilitate regional collaboration

Experts

• Experts:

- Epidemiology Consortium:

• CIRAD, RVC, Massey University

• Free University, Belgium, etc.

- Laboratory Consultancy:

• Australian Animal Health Laboratory

- To provide following services:

• Organize training/workshop to improve the knowledge

• Harmonize the methodology

• Publications and Reports:

- Studies: Epidemiology of AI: Country and Regional Status

Training and Workshops

• Epidemiology:

  - FAO training courses on

  • Basic epidemiology and data analysis: June and September 2005

  • Advanced epidemiology and data analysis: June and September 2005

    - for countries in SE Asia, E Asia and S Asia

  • Advanced Epidemiological Techniques for Regional Hubs in Asia: July 2005

• Laboratory:

- 2 JICA/FAO/DVS training courses in Malaysia: December 2004 and July 2005
- FAO regional workshop on laboratory networking: to be organized before the end of 2005

• Preparedness for non-affected countries in Asia: to be organized in October 18-21

- Mostly participated by:

• 8 countries in South Asia and

• 4 countries in Southeast Asia

Facilitation of Regional and International Networking

• Information sharing

• Sharing of regional experts

• Sharing samples with International Reference Laboratories

• Collaboration with other TCPs and/or certain Research Agencies:

  - Production, Ecology and Spread of AI
  - Socio-economic Impact Analysis of AI Control Measures

• Collaboration with OIE and other UN organizations such as WHO, UNDP mainly for the purpose of preparedness for pandemic human influenza

Facilitation of regional collaboration

• Participation the Meetings of Regional Organizations:

  - ASEAN
  - SAARC
  - ASEAN +3 (to be planned)

• Sponsoring certain countries to participate in such regional meetings

• Communication, coordination and collaboration with the Regional Organizations

Partnerships

• Country: affected and non-affected countries

• Regional Organization: ASEAN, ASEAN+3, SAARC

• International Donors and Organizations:

  - Japan, Australia, France, Germany, Canada, USA, Netherlands, etc.
  - FAO, OIE and WHO
  - ADB, World Bank
  - Etc.

• Countries in the region have made good progress in managing the epidemic. With support of the international community, they have significantly improved their capacity for early disease detection and rapid response.

  ... But still not sufficient

  ... It is necessary to continue with the 3Cs and support to where it is needed.

Challenges to be met

• Countries’ capacities may be strengthened but such capacities may not be maintained

  - Staff
  - Budget

• Information system: not existing, or existing but not working

• Sharing virus samples:

  - Approval
  - Logistics

• Preparedness for emergency response in non-affected should be considered as important as control of AI in affected countries

Thank you

Dr. Christianne J.M. Bruschke,
Dr. A. Schudel
OIE Scientific and Technical Department,
Paris, France

Eradicating Animal Influenza Viruses at their Source

The FAO-ACPHA/OIE regional avian influenza
economic assessment workshop
26-29 September 2005 Bali

Outline of the Presentation

• Why eradication at the source?

• OIE International Standards

• Zoning and compartmentalisation

• OFFLU

Control of High Pathogenic AI at the animal source

• Virus reservoir provides risk for pandemic

• Elimination of the virus at the source of eminent importance

• Animal health issues must have highest priority in combating the AI crisis

A Realistic Goal

• Stepwise and phased disease control program for each country

• Short, medium and long term frame

• Progressively shift the majority of infected countries to "freedom from infection in defined compartments"

• Ensure that free countries remain free

Critical issues for Avian Influenza control

• Early warning, detection and response

• Standards for

  - disease/infection detection
  - disease/infection prevention
  - animal movements and trade
  - animal and virus destruction
  - production and use of vaccination

• Collaboration of OIE, FAO and WHO

The OIE early warning system

Outbreaks of Avian influenza in Asia (type H5)
(as of 1 September 2005)

OIE International Standards for Avian Influenza

• Terrestrial Animal Health Code - mammals, birds and bees

  - Chapter 2.7.12
  - Appendix 3.8.9

• Manual of Diagnostic Tests and Vaccines for Terrestrial Animals

• Available at www.oie.int

Why standards necessary

• international public good

• safety of international trade

  - fewer disease outbreaks

• harmonisation of national legislation and control measures

  - fewer unjustified restrictions

• fairer trade

  - benefits to developing countries

Terrestrial Animal Health Code

• To avoid introduction of pathogens without using unjustified sanitary barriers

• Gives trading recommendations to the Chief Veterinary Officers of the OIE Member Countries

• Provides guidelines for disease surveillance

Update chapter 2.7.12 on Avian Influenza

• Update Chapter, taking most recent scientific findings into consideration (2004)

• Development of specific risk-based recommendations for most important commodities being traded

• Differentiate restrictions between HPAI and LPAI to encourage transparent reporting

Recent events:

• Expert ad hoc group on pathogenesis and transmission (November 2004)

• Expert ad hoc group on epidemiology and surveillance (November 2004)

• Terrestrial Animal Health Standards Commission (January 2005)

Avian Influenza (Ch. 2.7.12)

• Definition

  - Poultry
  - HPAI free
  - NAI free, free establishment

• Commodity trading recommendations

• Compartmentalization

• Surveillance (with and without vaccination)

  - Clinical
  - Virological
  - Serological

Notifiable avian influenza (NAI): is defined as an 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

...

NAI viruses can be divided into highly pathogenic notifiable avian influenza (HPNAI) and low pathogenic notifiable avian influenza (LPNAI)

HPNAI viruses have an IVPI in 6-week-old chickens greater than 1.2 or, cause 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 HPNAI isolates.

LPNAI are all influenza A viruses of H5 and H7 subtype that are not HPNAI viruses.

Poultry is defined as ‘all birds reared or kept in captivity 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’.

NAI status (Ch. 2.7.12)

• The NAI status of a country, zone or compartment

  - HPAI free
  - HPAI infected
  - NAI free zone or compartment

• Guidelines for trade of poultry and poultry products

Guidelines for Surveillance (app. 3.8.9)

• Defines principles and provides a guide for Disease Surveillance

• To seek recognition for a declared free NAI status

  - Maintenance or following outbreak
  - With or without vaccination
  - Application can be made for a country, zone or compartment

Surveillance Strategies

• Random surveillance

  - Statistically based surveys
  - Serological testing followed by virological methods for confirmation

• Targeted surveillance

  - Aimed at high risk groups
  - Serological and virological methods concurrently

Surveillance Strategies

• Detection of clinical signs of NAI at the flock level

  - Important for HPNAI

• Strategies

  - Clinical followed by serological surveillance or
  - Serological followed by clinical surveillance

Surveillance: Vaccinated flocks

• Strategy dependent on the type of vaccine used

  - Inactivated whole AIV
  - DIVA: Hemagglutinin expression-based vaccines

• Sentinel birds

  - Unvaccinated, permanently identifiable

OIE Manual of Diagnostic Tests and Vaccines for Terrestrial Animals

• The Manual is a companion volume of the Code.

• The purpose is to facilitate international trade in animals and animal products by describing internationally agreed upon laboratory methods for diagnosis and requirements for the production and control of vaccines.

Diagnostic Techniques

• Identification of the Agent

• Assessment of pathogenicity

• Serology

• Developing techniques

• new interpretation and definition of notifiable AI

Vaccines

• Existing standard

  - based on traditional inactivated vaccine
  - use of subtypes homologous to the outbreak, but normally low pathogenicity subtypes

• new DIVA strategies can reduce mass culling

• recombinant vaccines have a place

Animal Welfare

• Animal welfare is included in the strategic plan of OIE

• Animal welfare concerns

  - Guidelines on killing for disease control
  - Guidelines on slaughter, including religious
  - Guidelines on land transport

Zoning and Compartmentalisation (Ch 1.3.5)

• To establish and maintain a subpopulation with a different health status within the national borders

• Zoning: separation by natural or artificial geographical barriers

• Compartmentalisation: separation via a biosecurity management system

Zoning and Compartmentalisation Benefits

• Allows a stepwise approach to disease control in a country

• May encourage the efficient use of resources

• May allow safe trade in certain commodities due to functional separation

Principles for definition of a zone or compartment

• Establishment by the veterinary administration

• The animals belonging to the subpopulation should be clearly recognisable

• The measures necessary to preserve distinct health status must be defined and appropriate to the disease

Sequence of steps in definition of zone or compartment

• Exporting country

  - defines the zone or compartment
  - Identifies animals and has a valid traceability in place
  - Defines the standard operating procedures (eg biosecurity manual)
  - Provides the information to the importing country

Sequence of steps in definition of zone or compartment

• Importing country determines whether it accepts the zone or compartment

  - Evaluates the Vet Services of the exporting country
  - Makes risk assessment
  - Takes own health status into account
  - Takes OIE standards into account

Sequence of steps in definition of zone or compartment

• Importing country

  - Rejects
  - Requests further information
  - Recognises

• Formal agreement between both parties

Factors for the evaluation of the zone or compartment

• Definition

• Epidemiologic separation from potential sources of infection (physical or biosecurity)

• Standard operating procedures in place

• Permanent supervision and assessment by Veterinary Services

• Surveillance for the agent/disease

• Diagnostic capabilities

• Notification and emergency response

OIE/FAO Network for Avian
Influenza (2005)

OFFLU

OIE/FAO Network for Avian influenza OFFLU

• To offer veterinary expertise to Member Countries to assist in the control of AI

• To develop research on avian influenza (AI)

• To collaborate with the WHO Influenza Network on issues relating to the animal-human interface

Structure OFFLU

• Steering Committee

• Secretariat:

  - Dr I. Capua, OIE reference laboratory Padova

• Scientific Committee:

  - experts with international repute with proven lab expertise and/or field experience

• Team of Scientific Collaborators

  - Scientists having first hand experience, national and regional expertise in lab work, epidemiology or field control

Scientific Collaborators

• Invited to participate from as wide a field as possible

• Terms of Reference

  - Liaise with Sc.C. to advise in management, control and eradication of AI
  - Promote the collection of strains for identification
  - Assist in training for lab diagnosis and field surveillance
  - Promote linkages between diagnostic labs in poor countries with industrialized countries

OFFLU: main priorities

• Exchange of virus isolates and sequence data among reference and diagnostic labs

• Exchange of Scientific information

• Communication with member countries and international organisations

• Provide advice and expertise to infected countries

• Monitor vaccine trials

GF-TADs

• Depends commitment of collaborators

• Financial resources

• Ambitious program

World Organisation for Animal Health
created in 1924 in Paris