Vientiane.- Preparations for the possible spread of avian influenza (H7N9) into Lao PDR received high level attention this week at a joint National Preparedness and Contingency Planning workshop in Luang Prabang. This workshop was attended by Dr Sinlavong Khudphaithun, Minister of Government House, Head of National Emerging Infection Disease Coordination Office; Dr Eksavang Vongvichit, Minister for Health; Dr Phouangparisack Pravongviengkham, vice Minister of Agriculture and Forestry; Mr Daniel Clune, Ambassador of the United States of America to Lao PDR; Dr Juliet Fleischl, WHO Representative and Dr Stephen Rudgard, FAO Representative to Lao PDR among others; international partners from both the human and animal health sectors.

The continuing reports of human cases of avian influenza (H7N9) in China have raised concerns for the Government of Lao PDR and its relevant Ministries especially the Ministry of Health and Ministry of Agriculture and Forestry.

“Human and animal health need to collaborate closely to effectively deal with serious zoonotic threats such as avian influenza H7N9; we have the experience of Severe Acute Respiratory Syndrome (SARS) and avian influenza H5N1 emerge and re-emerge” commented Dr Eksavang Vongvichit, Minister of the Ministry of Health.

“The source of infection for human H7N9 cases in China is poultry. Due to increased demand for poultry in Lao PDR, a significant trade exists. We need to understand the movement to facilitate early detection of virus in poultry. Accomplishing this aids targeting of active surveillance by our Ministry of Health colleagues, hence our ministry encourages multi-sectorial collaboration” adds Dr Phouangparisack Pravongviengkham, Vice Minister of Ministry of Agriculture and Forestry. 

 “WHO and FAO jointly supported the measures taken by the Lao Government in response to the threat of H7N9, and the development of a Joint National Preparedness and Contingency Plan with relevant avian influenza emergency response and a multi-sectoral framework will facilitate the coordination among the line ministries and international partners” commented Dr Juliet Fleischl, WHO Representative to Lao PDR.

The good news is, political and public awareness of emerging infectious diseases like H5N1 and H7N9 is growing. These threats is an international shared risk and concern, not exclusive to China or countries where human cases of H7N9 have been reported, so international participation is needed to strengthen the International Health Regulation (IHR 2005) core capacity to monitor cross border transmission.

This makes the coordination from the National and Provincial levels, down to the District and Village levels vital; and the contingency plan can be used as operational guidelines during the emergency situation including standard operating procedures (SOPs) and intervention measures relevant to emergency response to H7N9 based on possible scenarios of its incursion into Lao PDR.

In the area of preparedness, hospitals and health centres are encouraged to strengthen infection prevention and control measures, to report and monitor patients with severe acute respiratory infections and to set aside isolation wards, medical equipment and supplies to treat suspected cases of H7N9 when needed.

Avian influenza symptoms include acute respiratory infection, fever, cough and shortness of breath.  People with such symptoms should seek immediate medical attention as their condition may deteriorate quickly and severely. 

Precautionary measures that the public can take to protect themselves include frequent hand washing with soap and water; avoiding contact with or eating sick or dead animals, and making sure that all poultry products are cooked well before consumption.

As H5N1 is believed to be still circulating in the Southeast Asia region, it is important to report cases of sick and dead animals to the local authorities, the cooperation of human health, veterinary health and environmental health is needed for successful public health interventions.  The economic impacts on both public and animal health sectors can be substantial if avian influenza or other infectious diseases is not detected and contained.

 “The key challenge is the difficulty in detecting H7N9 infections in poultry as the virus causes no symptoms in poultry. So, well-designed animal surveillance and active public awareness are crucial preventive measures” said Dr Stephen Rudgard, FAO Representative to Lao PDR.

The commitment of the Government, line ministries and in particular that of the international partners such as the US Agency for International Development (USAID) and US Centre for Disease Control, FAO and WHO is key to ensure that Lao PDR is well prepared and ready to deal with the H7N9 epidemic when it arises.