At the invitation of DG SANCO, EFSA participated in the context of the Shanghai Expo 2010 in China to the Sino-European Food Safety Cooperation Forum, to the
Seminar on Research for Healthy life and to the Securing Food Safety for a Healthy Life Day from 4 to 11 June.
Former Chief Veterinary Officer of FAO, Mr. Joseph Domenech delivered a lecture on Animal Health Crisis Management in with respect to Avian Influenza Control in Asia.
The event was organised as part of the Better Training for Safer Food programme, which aims to train staff in
Member States and Third Countries in official controls on food.
The forum provided presentations and lectures by staff of the European Commission, the European Food Safety Authority and Member States.
Lectures were also given by representatives of the Chinese General Administration for Quality Supervision, Inspection and Quarantine (AQSIQ), the Ministry of Health, and the Ministry of Agriculture.
3. 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
4. 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
5. 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
6. 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
10. Identification of risk factors
Weak economies and animal health services
Poultry production systems
Movements
Live bird markets
Cultural practices
Wild birds
14. • 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...
18. 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?
19. Lake Quinghai
China
15 April 2005
– Bar headed goose
– Great Cormoran
– Goéland ichthyaète
– Brown headed gull
– Tadorne casarca
>519 morts
(Marc Artois)
21. Original focu
An alarming spread westwardsAn alarming spread westwards
New areas affectedNew areas affected
22.
23.
24. Emergence
Due to complex and numerous factors
- Globalisation of exchanges
- Climate changes
- Demography, urbanisation
- Intensification of the production
- Evolution of ecosystems…
25. 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
26. 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?
28. 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?
29. 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.
31. 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
32. 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
36. 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
37.
38. Outbreaks of HPAI in domestic
poultry and Wild birds,
April 2009-April 2010
39.
40. • 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
47. 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
53. Tools and strategies
to control HPAI exist
– Surveillance and
Disease intelligence
– Stamping out
– Biosecurity
– Movement control
– Vaccination
54. 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
55. 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
57. 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
58. 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
62. 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
66. 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
68. 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
69. Regional Networks:
- Epidemiology
- Diagnostic and
research laboratories
- Socio economics
- Communication
FAO OIE Regional
Animal Health
Centers
70. 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…
71. 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
72. 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
73. 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
75. 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
76. Need to develop more focus
on disease drivers
and not only
on disease events
79. 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
80. Information and Awareness
Provision of information
through multi-track
Campaigns to ensure
Informed decision making
processes and producers’
participation
81. Remaining gaps
• Virology
• Epidemiology
• Trade routes
• Wildfife
• Socio economics
• Vaccines
… Need for Research
83. - Government and private sector
commitment
- Private-public partnership
- Participatory approaches
- Restructuring of the poultry
sector with mitigation of possible
adverse impacts
Responding to challenges
84. Based on
- Strong Veterinary Services
- Biosecurity, Movement Control
- Communication
- Laws and Regulations
- Public Private Partnership
85. Roots of Disease Emergence
Long term global approaches
One World One Health Strategy
Semi-industrial production sector
Live bird markets: Reservoir of infection
Depending on animal turnover,
Duration of stay in the markets,
Biosecurity measures,
Catchment area
Interspecies transmission establish a very complex ecological system in nature.
Some 2001 H5N1 viruses may have been transmitted from domestic poultry back into wild aquatic birds, resulting in a new set of genotypes for 2002.
Influenza A viruses of all 16 subtypes are perpetuated in aquatic birds throughout the world. After transfer to an alternative avian or mammalian host, influenza viruses undergo rapid evolution. for avian influenza viruses, including the H5, this transfer can occur in backyard poultry flocks or live poultry markets where ducks, geese, phaisants, chickens, etc are raised or housed together.
Antigenic and genetic analysis of the H9N2 influenza viruses isolated from domestic ducks in Southern China (2000-2001) provide convincing evidence that the H9N2 influenza viruses lineages established since the mid-1990s in chicken and quail have been transmitted back to ducks (mention pigs usually consider as mixing vessel), generating double or triple reassortants with influenza viruses already residents in ducks (K.S Li et al, 2003).
Mention HPAI the current conception of LPAI in gene pool that become virulent once in spillover host.
There is also a huge international trade in poultry—both legal and illegal. The legal trade involves literally millions of hatching eggs and poultry being shipped to destinations worldwide. For example, prior to the outbreaks in Egypt, the country was reported to export 180 million day-old-chicks plus 500,000 mature fowl a year. Almost 12 million live chickens were officially imported into the Ukraine in 2004 and more than 16 million into Romania. In Turkey, one factory has the capacity to produce over 100 million hatching eggs per year, many of them exported to Eastern Europe and the Middle East. Recent outbreaks in India, Nigeria and Egypt originated within the poultry industry, and there is strong circumstantial evidence that movements of poultry and poultry products are responsible.
For obvious reasons, there is little information on the extent of the illegal poultry trade, but recently it was revealed that poultry meat is being illegally imported from Asia into the USA; in October 2005 3,000 chickens were intercepted by Italian customs after being smuggled into the country from China; and in November 2005 the UK authorities revealed that large quantities, possibly hundreds of tonnes, of chicken meat had been illegally imported from China, and fraudulently relabelled before being sold on to food manufacturers across the country. In February 2006, 20 kg of chicken tongues from China were found by customs in Rio de Janeiro, Brazil, and 21 tonnes of (mainly) poultry meat from China were confiscated in southern Spain. These indicate continuing lapses in border controls, despite the widely publicised risks. Illegal poultry movements are reported to be extensive in central Asia. In 2005, Ukraine’s State Department of Veterinary Medicine said there had been substantial illegal re-exportation of meat from Ukraine to Russia via third countries.
http://www.birdlife.org/action/science/species/avian_flu/flu_faq.html (BIRD LIFE INTERNATIONAL)
A similar concern arises when we look at the multi-billion dollar legal and illegal trade in wild animals. Not only does this practice put wildlife populations at risk, it also creates unique opportunities for novel pathogens (viruses, bacteria, and fungi carried by these animals) to exploit new hosts unprepared for their arrival. Robert A. Cook is chief veterinarian and vice president and William B. Karesh is director of the Field Veterinary Program at the Wildlife Conservation Society, Bronx Zoo, New York.) – web article
The widespread illegal trade in cage birds is known to have transported flu-infected birds over large distances. Customs in Taiwan recently intercepted two consignments of infected birds smuggled from mainland China. An outbreak of H5N1 at a bird quarantine station in the UK may also be attributable to smuggled birds ‘laundered’ into a legally imported consignment. The most likely source of infection in captive birds is at live animal ‘wet’ markets, where domestic and wild-caught birds are kept in close proximity, posing a high-risk of bird flu cross-contamination
http://www.birdlife.org/action/science/species/avian_flu/flu_faq.html (BIRD LIFE INTERNATIONAL)
Semi-industrial production sector
Live bird markets: Reservoir of infection
Depending on animal turnover,
Duration of stay in the markets,
Biosecurity measures,
Catchment area
Dead Whooper Swan at Achmag Lake, Mongolia, with lives whopper swans on lake in background
Agro-ecosystems
Waterfowl production: silent infection and transmission to terrestrial poultry (spillover hosts)
mixing species
biosecurity and wild birds contacts
Trade and live bird markets
Mixing species
live bird markets
Human health risk
Cultural practices
fighting cocks
eating practices
disease infection and spread
.
A CGIAR challenge Programm selection
World Bnak driven because of interest in food safety
Investing $50 million from the CGIAR system into GCP
Gradual exit from the cgiar
A CGIAR challenge Programm selection
World Bnak driven because of interest in food safety
Investing $50 million from the CGIAR system into GCP
Gradual exit from the cgiar
This paper moves forward from the discussion presented in the FAO/OIE/World Bank position paper on The importance of biosecurity in reducing HPAI risk on farms and in markets, prepared for the Inter-Ministerial Conference on Avian and Pandemic Influenza, held in New Delhi in December 2007. It draws on what we already know about biosecurity, particularly for countries endemically infected with HPAI or at high risk of introduction, identifies problems, proposes solutions and outlines a future course of action.
Among others, it looks at the basic principles of biosecurity within the overall framework of disease control, discusses species- and sector-specific issues, stresses the importance of situating biosecurity in appropriate economic and cultural settings, and makes the case for the role of communication.
These cross cutting principles apply to all biosecurity measures for all stakeholders. The paper FAO-OIE-WB « Biosecurity for highly pathogenic avian influenza: Issues and options » proposes measures for the following stakeholders:
LARGE-SCALE COMMERCIAL PRODUCERS (SECTORS 1 AND 2)
SMALL-SCALE COMMERCIAL PRODUCERS (SECTOR 3)
HATCHERIES
KEEPERS OF SCAVENGING POULTRY (SECTOR 4)
DOMESTIC DUCK KEEPERS
LIVE BIRD MARKETS
INTERMEDIARIES AND SERVICE PROVIDERS
POULTRY FANCIERS, AND KEEPERS OF FIGHTING COCKS, EXOTIC BIRDS AND BIRDS OF PREY
HUNTERS
Ana I know you have combined two points and I have again separated them. I have done this for a specific reason, if we do not highlight surveillance then people tend to ignore it. It is a largely a prevention measure even in a endemic disease situation as it allows rapid response if sensitive. In the countries you are presenting to this will be crucial
Note we have a lot of money being spent on surveillance (according to the RTE 40% of the total budget). This has no monitoring or evaluation process and is often done loosely. I suspect it means taking samples and building laboratories. For TCEO this is OK because labs cost money and involve procurement which is not messy unlike consultants! For AGAH it is good because many of our vets are lab orientated. The bizarre situation is that in the development of the logframe surveillance did not originally receive its own output! So yes I do think we need to separate and highlight this component