Published on March 11, 2014
Sino-European Food Safety Cooperation Forum Shanghai, 07-11 June 2010 Animal Health Crisis Management Avian Influenza Control Mr. Joseph Domenech
An unprecedented crisis A complex epidemiology Socio economic impacts A major human risk
Importance of the crisis Destruction of assets : Over 300 million poultry have died Market shocks: Fears of consumers drive down demand Import bans Poultry prices: increased or decreased Global trade: winners and losers Substitution effects with alternative proteins Internationally 2004-05, 8% decline in global poultry trade. Shift in export of major players (FAO projections March 2006) 0 2 4 6 8 10 2003 2004 2005 2006r Milliontonnes Europe Asia South America North America
Livelihood impacts of disease and control programmes • Killing birds: compensation needed • Restriction of movement and sales: smallholders recover slowly and lose market share • Loss of income for food, education of children and other household expenses... • Changes to the structure of poultry market chains • Gender issue: poultry often owned and managed by women
A(H1N1) A(H2N2) A(H3N2) 1918: “Spanish Flu” 1957: “Asian Flu” 1968: “Hong Kong Flu” 20-40 million deaths 1-4 million deaths 1-4 million deaths Credit: US National Museum of Health and Medicine Human health dimension The risk of a human pandemic
Biodiversity issue Possible losses of valuable local breeds due to - Control methods (culling) - Restructuring of the poultry production sector More big commercial farms Marginalization of small/village backyard holders - Genetic resistance issue
RESERVOIRS DEAD-END hosts SPILLOVER GENE POOL ?? Epidemiology of H5N1 A complex cycle
Resistance of HPAI virus in the environment & indirect transmission
Specific role of duck farming systems in Asia Sub-clinical infection in ducks
Identification of risk factors Weak economies and animal health services Poultry production systems Movements Live bird markets Cultural practices Wild birds
ESTIMATED DISTRIBUTION OF POULTRY (SOURCE: FAO)
124 680 162 215 337 72 123 121 108 53 49 85 97 66 59 246 281 726 221 134 87 82 177 50 58 190 195 115 84 150 101 Trade
• Local, regional, international trade – legal – Illegal • Captive wild birds Crested Hawk-Eagles confiscated at Brussels International Airport in the hand luggage of a Thai passenger...
Live bird markets: mixing species poorly regulated
Movements of animals
Wild bird migrations Northern Pintail ringing recoveries What is the role of wild birdsWhat is the role of wild birds Victim or the problem ? Sentinel or spreader ? Reservoir of virus?
Lake Quinghai China 15 April 2005 – Bar headed goose – Great Cormoran – Goéland ichthyaète – Brown headed gull – Tadorne casarca >519 morts (Marc Artois)
August 2005 Ducks, Geese and Swans 100 deaths Husvel/Bulgan. Mongolia
Original focu An alarming spread westwardsAn alarming spread westwards New areas affectedNew areas affected
Emergence Due to complex and numerous factors - Globalisation of exchanges - Climate changes - Demography, urbanisation - Intensification of the production - Evolution of ecosystems…
Livestock Production systems Human behaviour Virus eco- epidemiology Pandemic threat Pandemic threat Goose/GD/96 (China, Guandong, 1996) W eak Veterinary Services Wild birds: reservoir or victim? EMERGENCE OF HPAI IN ASIA
Virus genetic and antigenic evolution – Gs/GD/1/96 virus has evolved during the last 10 years resulting in 10 HA clades in this lineage. – Clade 2 virus has become the dominant one since 2005 in Southeast Asia as well as in the world – Only clade 2.2 is found outside of Southeast Asia while 2.2 is not common in this region. – It is also changing antigenically while antigenicity of classic H5N1 viruses were quite stable With few exceptions like in China and Indonesia, with an impact on vaccine efficacy Where is this evolution going and what will its impact be?
ck/Nongkhai/NIAH400802/07ck/TH/NP172/06Guangzhou/1/06JapaneseWhiteEye/HK/1038/06 Anhui/1/05dk/Laos/3295/06ck/Malaysia/935/06commonmagpie/HK/645/06Zhejiang/16/06JapaneseWhiteEye/HongKong/73720/07WhiteBackedMunia/HongKong/82820/07 Guangxi/1/05dk/Guiyang/3009/05dk/Guiyang/3242/05gs/Guiyang/3422/05ck/Guiyang3/055/05gs/Yunnan/4494/05 gs/Guangxi/3017/05gs/Guangxi/345/05gs/Guangxi/3316/05dk/Hunan/127/05dk/Hunan/149/05dk/Hunan/152/05dk/Hunan/139/05 Egypt/0636NAMRU320/07Egret/Egypt/1162NAMRU3/06dk/Egypt/22533/06Egypt/14724NAMRU320/06turkey/Turkey1//05WhooperSwan/Mongolia/244/05Nigeria/6e20/07ck/Nigeria/641/06Turkey/15/06Iraq/207NAMRU3/06Azerbaijan/001161/06ck/Krasnodar/01/06swan/Iran/754/06ck/Liaoning/23/05Barhdgs/Qinghai12/05Barhdgs/Qinghai1A/05ck/Kyoto/3/04crow/Kyoto/53/04ck/Yamaguchi/7/04 ck/Korea/ES/03dk/Guangxi/13/04 ck/YN/115/04ck/YN/374/04 Indonesia/CDC1046/07Indonesia/CDC103220/07Indonesia/CDC938/06Indonesia/CDC887/06Indonesia/CDC1047/07 Indonesia/283H/06Indonesia/326N/06Indonesia/CDC742/06Indonesia/370E/06Indonesia/5/05Indonesia/CDC940/06 Indonesia/546bH/06Indonesia/596/06Indonesia/599/06Indonesia/625/06dk/Indonesia/MS/04ck/Indonesia/4/04ck/Indonesia/11/03 ck/Indonesia/7/03VN/JP14/05 ck/Cambodia/013LC1b/05VN/1194/04 VN/1203/04 VN/HN3/0408/05TH/16/04 TH/676/05 VN/JPHN30321/05HK/213/03ck/Henan/16/04ck/Henan/01/04ck/Henan/13/04 ck/Henan/12/04dk/Guangxi/50/01ck/HK/YU777/02 ck/HK/YU22/02migdk/Jiangxi1653/05 dk/Guangxi/2775/05ck/Hunan/41/04blbird/Hunan1/04treesparrow/Henan/4/04dk/Hubei/wg/02sw/Anhui/ca/04 dk/Guangxi/1378/04dk/Guangxi/1681/04dk/Guangxi/1311/04dk/Guangxi/2396/04ck/Hunan/2292/06ck/Shanxi/2/06ck/Myanmar/06010011B/06dk/Guiyang/504/06 ck/Guiyang237/06gs/Guiyang/337/06 gs/Guiyang/1325/06ck/Guiyang441/06ck/Guiyang1218/06ck/Guiyang846/06ck/HK/8911/01 ck/HK/SF219/01ck/HK/8791/01 gs/Guangdong/1/96 0.005 2.3.4 2.3.3 2.3.2 2.3.1 2.2 2.4 2.5 2.1.3 2.1.2 2.1.1 1 8 9 6 5 7 4 3 0 Genetic evolution of Asian-lineage HPAI H5N1 virus (HA gene) Parent virus Gs/GD/1/96 has evolved during 1996- 2008 resulting in 10 different clades.
Shift of Dominant HA clade of H5N1 viruses in Southeast Asia during 1996-2007 Year HA clades Total 0 1 2 3 4 5 6 7 8 9 Out 96-99 29 29 2000 17 3 1 21 2001 18 43 1 1 2 65 2002 17 17 3 7 3 1 7 2 8 65 2003 4 25 33 1 1 5 1 1 7 8 86 2004 4 171 49 16 3 3 14 5 265 2005 3 112 170 1 7 1 9 1 304 2006 5 5 122 5 1 1 139 2007 12 94 22 Total 97 342 471 47 14 26 4 12 9 34 24 1080 ExistMajor clade of the year Dominant HA clade has shifted from 0 to 1 in 2002-03 Dominant HA clade has shifted from 1 to 2 in 2003-05 HA clade 2 is now dominant = why?
Thailand Year HA clades 0 1 2 3 4 5 96-99 2000 2001 2002 2003 2004 2005 2006 2007 2008 China Year HA clades 0 1 2 3 4 5 96-99 2000 2001 2002 2003 2004 2005 2006 South Vietnam Year HA clades 0 1 2 3 4 5 96-99 2000 2001 2002 2003 2004 2005 2006 2007 2008 North Vietnam Year HA clades 0 1 2 3 4 5 96-99 2000 2001 2002 2003 2004 2005 2006 2007 2008 NORTH VIETNA M SOUTH VIETNA M THA I CHIN A Different pattern between North and South Vietnam North is similar with South China that indicates multiple introduction of virus since 2001 including new clade 7 South has similar pattern with Thailand till 2007.
Possible H5N1 Virus Circulation Pattern in Vietnam
HA clades of HPAI H5N1 in the World 2.2 2.2 2.2 2.2 2.2 1 2. 3 2.1 1 2. 3 2.1 2. 2 2.3 2.4 2.5 ? 2. 32 .4 2. 5
Some Epidemiologic Differences Between Africa and Asia • Poultry and human densities • Wetland free ranging duck production systems absent • Survival of the virus in the environment: temperature... • Less contacts between wild birds and domestic poultry
Official declarations OIE and WHO FAO analysis HPAI situation
HPAI in humans 2003 to 2009
0 10 20 30 40 50 60 2003 2004 2005 2006 2007 2008 2009 2010* New ly infected countries Previously infected countries HPAI in poultry Infected countries 2003 to 2010
Outbreaks of HPAI in domestic poultry and Wild birds, April 2009-April 2010
• Improvement of the situation compared with 2006 More transparency, more awareness and preparedness Less outbreaks A set of tools (culling, biosecurity, vaccination, etc) available and deployed to control the disease • Epidemiology and socio economic impacts are better known • But the virus is still present in around 10 countries • Recurrent introduction or reintroduction of the virus in countries or regions
Confirmed HPAI 2003 2004 2005 2006 2007 2008 2009 Poultry outbreaks 0 50 31 10 4 8 2 Human cases (1) 0 8 13 5 4 7 China
Indonesia HPAI in humans and poultry 2004-2009
Indonesia Outbreaks in 2009
0 2 4 6 8 10 12 14 16 Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Month NumberofHPAIoutbreaks/cases Bangladesh Bhutan India Nepal Reported outbreaks of HPAI in South Asia 2009-10
HPAI outbreaks In Bangladesh
Bangladesh Occurrence of HPAI since March 2007
0 2 4 6 8 10 12 14 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan 2008 2009 10 Numberofoutbreaks HPAI outbreaks in India
0 5 10 15 20 25 30 35 40 45 50 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan 2008 2009 10 Numberofoutbreaks HPAI outbreaks in Egypt
Tools and strategies to control HPAI exist – Surveillance and Disease intelligence – Stamping out – Biosecurity – Movement control – Vaccination
Surveillance Active and passive surveillance Randomized versus intelligence Targeted surveillance (risk based) Specific case of wild birds Special tools such as the SMS Gateway system
Random versus. Intelligence • Reduces bias • Requires careful planning • Long time frame • Clustering • Key informants • Open-ended • Discovery • Identify risk areas • Rapid Community-Based Disease Surveillance
Targeted surveillance and monitoring of virus circulation based on risk analysis
Disease intelligence Particularly to address the emergence or re emergence of new pathogens with regard to global changes, hot spots identification Specific concepts, approaches, methods and tools to be used
Disease Intelligence and Tracking 60% of the 1400 infectious agents of humans have an animal origin; and 75% of new infectious diseases have originated from animal reservoirs Stopping animal diseases ‘at source’ by: • Identifying determinants and drivers of disease emergence and spread • Modelling, mapping and forecasting disease trends and outbreaks • Generating information and data for early warning and response • Tracking genetic evolution of pathogens to improve diagnostics and vaccines
Control of movements Enforcement may be very difficult
Culling Compensation Enforcement can be very difficult Needs compensation Management of compensation funds can be difficult: various systems exist
Vaccination An important tool – Good quality: OIE Standards - Cost (0.5 to 0.8 USD) and share of cost – Post-vaccination monitoring – DIVA approach – Control of virus circulation – Exit strategy
FAO-OIE-WB Report on Biosecurity: Issues and options August 2008
Develop, test and promote biosecurity measures that are: Developed in a participatory manner Practical and affordable Proportionate to risk Tailored to situation and production system Biosecurity
Biosecurity Production practices/ socio-cultural aspects Transport/Marketing Processing
International Cooperation FAO - OIE GF TADS Global Framework for the Progressive Control of Transboundary Animal Diseases International Cooperation FAO - OIE GF TADS Global Framework for the Progressive Control of Transboundary Animal Diseases
Crisis Management Center Global Early Warning System Available Tools at the Global Level
Needs and Gaps for Avian and Human Influenza in Africa ALive provisional Proposal GLEWS Global Early Warning System A major component of GF TADs Initiative
Regional Networks: - Epidemiology - Diagnostic and research laboratories - Socio economics - Communication FAO OIE Regional Animal Health Centers
Intersectoral Cooperation - Human and animal health systems To be in strong interraction and collaboration No fusion. Specific mandates, partners and stakeholders, methods and tools - Other sectors: wildlife, environment, trade, turism, police, medias, land management…
Global results - Less contaminated countries - More sensibilisation and commitment - Improved transparency - More awareness and preparedness - Strenghthened Veterinary Services - Better knowledge of the disease epidemiology and of root causes of emergence and spread
Is eradication possible? - Eradication of all Influenza A viruses is not an option given the highly diverse gene pool of viruses circulating in the wild waterbird reservoir, in livestock and humans - In most situations H5N1 HPAI freedom remains a viable objective - More difficult is the control of H5N1 HPAI in environments where both traditional domestic waterfowl production, including rice- duck agriculture, and commercial chicken plants coincide in the farming landscape - Endemic situations require a cautious balancing of all tools and methods available to contain H5N1 virus spread and persistence
Lessons learnt Need to be ready to respond to emergencies Stop the outbreaks before they spread and become a crisis Emergency short term improved capabilities
Credo Surveillance Early Warning Early detection Early response
Need to better address the Socio Economic issues • Economic analysis inputs to disease epidemiology to support risk assessments • Socio economic impacts of HPAI • Costs and cost-effectiveness of prevention and control measures • Long Term Restructuring and Socio economic impacts on small holders, • Mitigation options • Impacts on biodiversity
Need to develop more focus on disease drivers and not only on disease events
Public-Private partnership At all levels Surveillance Prevention Control Small holders-villagers Participatory approaches
Capacity building Training Communication and Information
Information and Awareness • Information and dialogue with commercial farmers • Need for information and compliance of the population – information on vaccination – information on logistics • Cooperation of farmers and village heads is crucial for an effective implementation of control programmes
Information and Awareness Provision of information through multi-track Campaigns to ensure Informed decision making processes and producers’ participation
Remaining gaps • Virology • Epidemiology • Trade routes • Wildfife • Socio economics • Vaccines … Need for Research
Remaining gaps (cont.) … Need for research Transmission Animals-Humans
- Government and private sector commitment - Private-public partnership - Participatory approaches - Restructuring of the poultry sector with mitigation of possible adverse impacts Responding to challenges
Based on - Strong Veterinary Services - Biosecurity, Movement Control - Communication - Laws and Regulations - Public Private Partnership
Roots of Disease Emergence Long term global approaches One World One Health Strategy
More investment More Political Commitment to implement and enforce the Prevention and Control Measures
Thank you for your attention
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