Sino-European Food Safety Cooperation Forum

Shanghai, 07-11 June 2010

Animal Health Crisis ManagementAvian Influenza Control

Mr. Joseph Domenech

An unprecedented crisisA complex epidemiologySocio economic impactsA 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

Millio

n t

on

nes

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 dimensionThe 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)

Production systems

124

680

162

215

337

72123

121108

53

49

85

97

66

59

246

281

726

221

134

8782

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

Cultural practices

Wild bird migrations

Northern Pintail ringing recoveries

What is the role of wild birds What 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 focus

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)

Weak 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/NIAH400802/07 ck/TH/NP172/06 Guangzhou/1/06 JapaneseWhiteEye/HK/1038/06 Anhui/1/05 dk/Laos/3295/06 ck/Malaysia/935/06 commonmagpie/HK/645/06 Zhejiang/16/06 JapaneseWhiteEye/HongKong/73720/07 WhiteBackedMunia/HongKong/82820/07 Guangxi/1/05 dk/Guiyang/3009/05 dk/Guiyang/3242/05 gs/Guiyang/3422/05 ck/Guiyang3/055/05 gs/Yunnan/4494/05 gs/Guangxi/3017/05 gs/Guangxi/345/05 gs/Guangxi/3316/05 dk/Hunan/127/05 dk/Hunan/149/05 dk/Hunan/152/05 dk/Hunan/139/05 Egypt/0636NAMRU320/07 Egret/Egypt/1162NAMRU3/06 dk/Egypt/22533/06 Egypt/14724NAMRU320/06 turkey/Turkey1//05 WhooperSwan/Mongolia/244/05 Nigeria/6e20/07 ck/Nigeria/641/06 Turkey/15/06 Iraq/207NAMRU3/06 Azerbaijan/001161/06 ck/Krasnodar/01/06 swan/Iran/754/06 ck/Liaoning/23/05 Barhdgs/Qinghai12/05 Barhdgs/Qinghai1A/05 ck/Kyoto/3/04 crow/Kyoto/53/04 ck/Yamaguchi/7/04 ck/Korea/ES/03 dk/Guangxi/13/04 ck/YN/115/04 ck/YN/374/04 Indonesia/CDC1046/07 Indonesia/CDC103220/07 Indonesia/CDC938/06 Indonesia/CDC887/06 Indonesia/CDC1047/07 Indonesia/283H/06 Indonesia/326N/06 Indonesia/CDC742/06 Indonesia/370E/06 Indonesia/5/05 Indonesia/CDC940/06 Indonesia/546bH/06 Indonesia/596/06 Indonesia/599/06 Indonesia/625/06 dk/Indonesia/MS/04 ck/Indonesia/4/04 ck/Indonesia/11/03 ck/Indonesia/7/03 VN/JP14/05 ck/Cambodia/013LC1b/05 VN/1194/04 VN/1203/04 VN/HN3/0408/05 TH/16/04 TH/676/05 VN/JPHN30321/05 HK/213/03 ck/Henan/16/04 ck/Henan/01/04 ck/Henan/13/04 ck/Henan/12/04 dk/Guangxi/50/01 ck/HK/YU777/02 ck/HK/YU22/02 migdk/Jiangxi1653/05 dk/Guangxi/2775/05 ck/Hunan/41/04 blbird/Hunan1/04 treesparrow/Henan/4/04 dk/Hubei/wg/02 sw/Anhui/ca/04 dk/Guangxi/1378/04 dk/Guangxi/1681/04 dk/Guangxi/1311/04 dk/Guangxi/2396/04 ck/Hunan/2292/06 ck/Shanxi/2/06 ck/Myanmar/06010011B/06 dk/Guiyang/504/06 ck/Guiyang237/06 gs/Guiyang/337/06 gs/Guiyang/1325/06 ck/Guiyang441/06 ck/Guiyang1218/06 ck/Guiyang846/06 ck/HK/8911/01 ck/HK/SF219/01 ck/HK/8791/01

gs/Guangdong/1/960.005

2.3.42.3.32.3.22.3.1

2.22.42.5

2.1.32.1.22.1.1189657

430

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 cladesTotal

　 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 　 　 　 　 　　

YearHA clades

　 0 1 2 3 4 5

　 96-99

　 　 　 　 　 　

　 2000 　 　 　 　 　 　　 2001 　 　 　 　 　 　　 2002 　 　 　 　 　 　　 2003 　 　 　 　 　 　　 2004 　 　 　 　 　 　　 2005 　 　 　 　 　 　　 2006 　 　 　 　 　 　　 2007 　 　 　 　 　 　　 2008 　 　 　 　 　 　

China 　 　 　 　 　　

YearHA clades

　 0 1 2 3 4 5

　 96-99

　 　 　 　 　 　

　 2000 　 　 　 　 　 　　 2001 　 　 　 　 　 　　 2002 　 　 　 　 　 　　 2003 　 　 　 　 　 　　 2004 　 　 　 　 　 　　 2005 　 　 　 　 　 　　 2006 　 　 　 　 　 　　 　 　 　 　 　 　 　　 　 　 　 　 　 　 　

South Vietnam 　 　 　 　

YearHA clades

0 1 2 3 4 596-99

　 　 　 　 　 　

2000 　 　 　 　 　 　2001 　 　 　 　 　 　2002 　 　 　 　 　 　2003 　 　 　 　 　 　2004 　 　 　 　 　 　2005 　 　 　 　 　 　2006 　 　 　 　 　 　2007 　 　 　 　 　 　2008 　 　 　 　 　 　

North Vietnam 　 　 　 　

YearHA clades

0 1 2 3 4 596-99

　 　 　 　 　 　

2000 　 　 　 　 　 　2001 　 　 　 　 　 　2002 　 　 　 　 　 　2003 　 　 　 　 　 　2004 　 　 　 　 　 　2005 　 　 　 　 　 　2006 　 　 　 　 　 　2007 　 　 　 　 　 　2008 　 　 　 　 　 　

NORTHVIETNAM

SOUTHVIETNAM

THAI

CHINA

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

2.22.

2

2.2

2.2

1 2.3

2.1

1 2.3

2.1

2.2

2.32.42.5

?

2.32.42.5

Some Epidemiologic DifferencesBetween 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 infectedcountries

HPAI in poultryInfected 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

0

50

100

150

200

250

Tet periodFeb 9-11, 2004

Tet periodFeb 11-13, 2005

2nd wave: 2004/52 mil. Poultry culled

Tet periodFeb 16-21, 2007

3rd wave: late 20054 mil. Poultry culled

4th wave: 2006/ 200799,040 Poultry culled

5th wave: mid 2007169,188 Poultry culled

Duck hatching ban lifted28 Feb 07

Harvest period

2004 2005 2006 2007 2008

Sporadic outbreaks

1st wave: 2003/445 mil. Poultry culled

No

. o

utb

reak

s

Data source: DAH and WHO

2003: 3 human cases (3 fatal)2004: 29 human cases (20 fatal)2005: 61 human cases (19 fatal)2006: No human case reported2007: 8 human cases (5 fatal)2008: 6 human cases (5 fatal)2009: 5 human cases (5 fatal)2010: 5 human cases (2 fatal)

Temporal Pattern of HPAI outbreaks in VietnamJan 2004 – Mar 2010

2009 2010

Tet periodJan 26-31, 2009 Tet period

Feb 15-18, 2010

Tet periodFeb 6-11, 2008

China

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

IndonesiaHPAI in humans and poultry 2004-2009

Indonesia Outbreaks in 2009

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Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb

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HP

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utb

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ks

/ca

se

s Bangladesh

Bhutan

India

Nepal

Reported outbreaks of HPAI in South Asia 2009-10

HPAI outbreaks In Bangladesh

BangladeshOccurrence of HPAI since March 2007

0

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4

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14

Jul

Aug

Sep Oct

Nov

Dec Ja

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Apr

May Ju

n

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2008 2009 10

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s

HPAI outbreaks in India

0

5

10

15

20

25

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35

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45

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Jul

Aug

Sep Oct

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Dec Ja

n

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Sep Oct

Nov

Dec Ja

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2008 2009 10

Nu

mb

er o

f o

utb

reak

s

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 surveillanceRandomized versus intelligence Targeted surveillance (risk based)Specific case of wild birdsSpecial 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 Tracking60% of the 1400 infectious agents of humans have an animal origin; and 75% of new infectious diseases have originatedfrom 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

GoogleGoogleTMTM

Control of movements

Enforcement may be very difficult

Culling Compensation

Enforcement can be very difficult Needs compensationManagement 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 situationand 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 AfricaALive provisional Proposal

GLEWS Global Early Warning SystemA 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 informationthrough multi-track Campaigns to ensureInformed decision makingprocesses 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