Avian Influenza in a connected worldAvian Influenza in a connected worldFAO assistance for outbreak prevention and FAO assistance for outbreak prevention and controlcontrolEran RAIZMAN,Eran RAIZMAN, Sophie VON DOBSCHUETZ, Guillaume BELOT, Emma GARDNER, Sophie VON DOBSCHUETZ, Guillaume BELOT, Emma GARDNER, Akiko KAMATA, Subhash MORZARIA Akiko KAMATA, Subhash MORZARIA

Head of EMPRESHead of EMPRESFood and Agriculture Organization of the United NationsFood and Agriculture Organization of the United NationsRome, ItalyRome, Italy

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FAO Global Mandate

• Improve nutrition

• Increase agricultural productivity

• Raise the standard of living in rural populations

• Contribute to global economic growth

EMPRES-AHEMPRES-AHFAO’s EMERGENCY PREVENTION

SYSTEM for ANIMAL HEALTH

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ANIMAL HEALTH THREATSANIMAL HEALTH THREATSThree of today’s major challenges to animal and public health:

•Risk of Transboundary Animal Diseases (TADs) outbreaks (e.g. Avian Influenza, FMD & PPR)

•Antimicrobial resistance (AMR)

•Food and feed safety

FAO’s RESPONSE: EMPRES-AHFAO’s RESPONSE: EMPRES-AH• Sustainable capacity building

• Knowledge sharing

• Tools & Strategies

• Coordination & Networking

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SUSTAINABLE CAPACITY BUILDINGSUSTAINABLE CAPACITY BUILDING• Technical training

– Increased surveillance

– Laboratory diagnostics training

– Strengthening laboratory capacity

– Disease management

– Developing tools for disease control and eradication

• Advocacy for political will

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KNOWLEDGE SHARINGKNOWLEDGE SHARING• Enabling research environment

• Up-to-date disease intelligence and technology

• Information sharing on applied research

• Disseminating information:

– PUBLICATIONS: EMPRES 360, EMPRES Watch, FOCUS ON

– WEBSITE: EMPRES-AH

TOOLS & STRATEGIESTOOLS & STRATEGIES– Online Information Systems

• EMPRES-i

– Reporting Systems

• EMA-i (Event Mobile Application)

• Genetic Module

– Risk Assessment

– Lab Mapping Tool

COORDINATION & NETWORKINGCOORDINATION & NETWORKING• Disease control activities at

country and regional level

• Grass roots multisectoral approach to health management

• Networking (FMD, OFFLU)

Outline• 2015: An avian influenza year…

• Focus on H5N1 HPAI in West Africa– Situation– FAO’s assistance

• Focus on Influenza A(H7N9)– Situation– FAO’s assistance

• Future prospects for AI control

Outline• 2015: An avian influenza year…

• Focus on H5N1 HPAI in West Africa– Situation– FAO’s assistance

• Focus on Influenza A(H7N9)– Situation– FAO’s assistance

• Future prospects for AI control

Sub-type Species affected Comments

H5N1(2003)

« Classic bird flu »

The ‘classic bird flu’, a highly pathogenic AI virus that can occasionally infect humans

-Endemic in: Egypt, Indonesia, Viet Nam, Bangladesh, Cambodia, China

-New introduction in West Africa in December 2014-2015 is the year with highest number of human

cases: 143 (WHO)

H5N8(2014)

A newly emerged highly pathogenic AI virus, behaving similar to H5N1, a competitor to H5N1

-Spread from the Far East to Western Europe and Northern America late 2014-No human cases reported so far

H5N6(2014)

Another newly emerged highly pathogenic AI virus in Southeast Asia

-Spread rapidly from China to Lao PDR and Viet Nam-3 human cases reported so far, all in China

H7N9(2013)

A low pathogenic AI virus in China that causes disease and mortalities in humans

-Only in China-Most human cases exposed in live bird markets

H9N2

A widespread low pathogenic AI virus that sporadically infects humans

-Immunosuppressive in poultry-Acts as an internal gene donor for other viruses (H7N9, H5N1, H5N8…)

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2015 – An avian influenza year…• HPAI H5 events increased in numbers and geographical extent• Endemic countries reported more outbreaks • Previously unaffected countries detected HPAI H5 viruses in poultry and

wild birds

Geographical Distribution of H5Nx HPAI viruses26 October 2014 – 26 October 2015

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2015 – An avian influenza year…H5N1: 2015 is the year with the highest number of human cases in history New introduction and significant spread of the virus in:

• Israel – Gaza – West Bank• West Africa

Geographical Distribution of H5Nx HPAI viruses26 October 2014 – 26 October 2015

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2015 – An avian influenza year…• HPAI H5 viruses have genetically diversified and re-assorted (N1, 2, 6, 8)• H5N8: Dominant in Republic of Korea

October 2014: Spread to EuropeDecember 2014: Spread to North America

Geographical Distribution of H5Nx HPAI viruses26 October 2014 – 26 October 2015

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2015 – An avian influenza year…• H5N2: Asian reassortant

Endemic in TaiwanSpread significantly in the USA (48 million birds affected)No human case

Geographical Distribution of H5Nx HPAI viruses26 October 2014 – 26 October 2015

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2015 – An avian influenza year…• H5N6: Virus from China

Spread to Lao PDR and Viet NamHuman cases

Geographical Distribution of H5Nx HPAI viruses26 October 2014 – 26 October 2015

Outline• 2015: An avian influenza year…

• Focus on H5N1 HPAI in West Africa– Situation– FAO’s assistance

• Focus on Influenza A(H7N9)– Situation– FAO’s assistance

• Future prospects for AI control

H5N1 HPAI in West Africa - Situation

Introduction:

Nigeria – Dec 2014

Burkina Faso – Feb 2015

Niger - Mar 2015

Côte d’Ivoire and Ghana – Apr 2015

H5N1 in West Africa – FAO’s assistance

FAO assessment missions 2015:

-Nigeria (January)

-Benin & Togo (March)

-Cameroun (April)

-Burkina Faso (April)

-Ghana (June)

-Côte d’Ivoire (May)

Need for a regional approach to tackle the epizootic, with information sharing and coordination among the West African countries

Abuja meeting (15-16 June) to define a regional strategy and an18-month regional action plan

H5N1 in West Africa – FAO’s assistance

• Emergency laboratory support• Provision of equipment and consumables• Support for shipment of samples for disease confirmation and

virus characterization

• Disease control • Review of countries’ contingency plans• Workshop on secure movement of poultry and poultry products • National & district level training on outbreak management• Planned: Regional workshop on risk management along the

production chain (Senegal, December 2015)

H5N1 in West Africa – FAO’s assistance

• Disease surveillance support•Risk-based surveillance protocol developed by HQ•Protocol to be contextualized for each country during missions

• Technical backstopping missions as requested

•Laboratory backstopping in Burkina Faso : Improve good laboratory practices and troubleshooting capacities•Epidemiology backstopping in Cote d’Ivoire : Developing and implementing a risk-based surveillance program

• Production of communication materials and guidelines

Outline• 2015: An avian influenza year…

• Focus on H5N1 HPAI in West Africa– Situation– FAO’s assistance

• Focus on Influenza A(H7N9)– Situation– FAO’s assistance

• Future prospects for AI control

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Influenza A(H7N9) - Situation

• First human cases reported in March 2013• LPAI virus: no clinical signs in poultry or waterfowl• Infects humans 40% case fatality rate• Strong seasonality pattern• Only detected in China so far

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Influenza A(H7N9) - Situation

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Influenza A(H7N9) – FAO’s assistance

Technical assistance• Disease intelligence: close monitoring of the situation and of the

scientific developments• Publication of bi-weekly updates on the situation

• Dissemination of manuals and guidelinesSurveillance Risk assessmentRisk managementLaboratory protocolsRisk communicationBiosecurity in LBMs

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Influenza A(H7N9) – FAO’s assistance

Surveillance in at-risk countries• Longitudinal risk-based surveillance to early detect H7N9

incursion in at-risk countries• Partnerships with national veterinary services

•Viet Nam, Lao PDR, Myanmar • Focus on LBMs and poultry aggregation points

• No H7N9 virus found outside of China so far

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Influenza A(H7N9) – FAO’s assistance

Laboratory• Training of laboratory technicians• Provision of laboratory reagents and equipment• Transport of samples to international reference centers

Epidemiology• Reviewing contingency plan and SOPs• Simulation exercises• Value-chain studies to identify critical control points• Joint risk-assessment

Outline• 2015: An avian influenza year…

• Focus on H5N1 HPAI in West Africa– Situation– FAO’s assistance

• Focus on Influenza A(H7N9)– Situation– FAO’s assistance

• Future prospects for AI control

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Future prospects for AI control• Endemic situation in domestic poultry is unlikely to change in

the foreseeable future– Increasingly identified as one of many other endemic poultry disease– Multi-dimensional problem– Beyond technical approach (holistic all society approach)– Farming systems and value chains need transformation– Socio-economics, poverty, communication, behaviour, tradition

• Increasingly recognized as a global problem– No one country can tackle the disease– Regional and international public good– A concerted global action of all players needed with significant financial

and political commitment needed

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Risk factors for AI introduction and spreadEven if wild birds may play some role (?) in long distance spread and first introduction, the main factors are:

•Legal and illegal trade movements

•People servicing / visiting different farms (vets, technicians, foodstuff providers etc.)

•Limited biosecurity along the value chain This is where YOU can make a significant difference!

Live bird markets are key control points!

• HPAI spreads mostly through the actions ofPEOPLE

• BIOSECURITY is a priority

• Good farm management practices essential

Thank you!