Avian Influenza in Viet Nam: Lessons Learnt FAO Technical Meeting on HPAI 27-29 th June 2007, Rome...
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Transcript of Avian Influenza in Viet Nam: Lessons Learnt FAO Technical Meeting on HPAI 27-29 th June 2007, Rome...
Avian Influenza in Viet Nam: Lessons Learnt
FAO Technical Meeting on HPAI
27-29th June 2007,
Rome
Dr. Hoang Van Nam
Department of Animal Health
Ministry of Agriculture and Rural Development
VIETNAM
Outlines
• Situation Analysis; • Summary of Lessons Learned:
– Strong Commitment and Leadership from the Government
– Early Detection and Response– Vaccination– Information, Education and Communications – Pandemic Preparedness– Donor support
• Recommendations
Situation Analysis: The Course of the EpidemicTemporal Pattern of 2003/4 (1st), 2004/5 (2nd), late 2005 (3rd) and 2006/7 (4th) AI
Epidemics
Mar
Feb
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
0
50
100
150
200
250
300
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep Oct
Nov
Dec Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep Oct
Nov
Dec Jan
Feb
Mar
No
. o
utb
reak
s
Tet holiday Feb 9-11, 2004
Tet holiday Feb 11-13, 2005
Tet holiday Jan 29-31,
2006
2004 2005 2006
Vaccination Campaign
- 45 mil. poultry culled;
- 27 human cases (16 fatal)
- 2 mil. poultry culled;
- 64 human cases (21 fatal)
- 4 mil. poultry culled;
- 2 human cases
2007
Tet holiday Feb 16-22, 2007
- 99,040 poultry culled;- No human cases
Epi Curve: Viet Nam, A/H5N1, 26-Dec-06 to 25-Jun-07
0
5
10
15
20
25
30
26-D
ec-0
6
02-Ja
n-07
09-Ja
n-07
16-Ja
n-07
23-Ja
n-07
30-Ja
n-07
06-F
eb-0
7
13-F
eb-0
7
20-F
eb-0
7
27-F
eb-0
7
06-M
ar-0
7
13-M
ar-0
7
20-M
ar-0
7
27-M
ar-0
7
03-A
pr-0
7
10-A
pr-0
7
17-A
pr-0
7
24-A
pr-0
7
01-M
ay-0
7
08-M
ay-0
7
15-M
ay-0
7
22-M
ay-0
7
29-M
ay-0
7
05-Ju
n-07
12-Ju
n-07
19-Ju
n-07
Epi Week (week beginning..)
Nu
mb
ers
of
ou
tbre
ak
s
north
central
south
n=70 in 18 Prov
n=80 in 8 Prov
Situation Analysis: Affected Communes - 1st wave (2003-2004)
Situation Analysis: Affected Communes - 2nd wave (2004-2005)
Provinces
Communes
No of outbreaks
1
2 - 3
4 - 7
8 - 14
15 - 21
22 - 37
Provinces
Communes
No of outbreaks
1
2 - 3
4 - 7
8 - 14
15 - 21
22 - 37
Situation Analysis: Affected Communes – 3nd wave (late 2005)
Situation Analysis: Affected Communes – 4th wave (Dec 2006 – Mar 2007)
Situation Analysis: Current situation
• 2 new human cases after over a year and a half.
• A series of outbreaks in late 2006-early 2007 indicated that there is persistent circulation of virus both in the south and the north.
• Since the beginning of May, another wave of epidemic started.
• Outbreaks have been identified always in unvaccinated flocks, particularly in ducks.
Current situation (Cont’d)…since 1st May 2007 to 6 June
Province # of commune infected
Nghe An 18
Quang Ninh 4
Can Tho 3
Son La 3
Nam Dinh 26
Dong Thap 3
Bac Giang 4
Hai Phong 2
Ninh Binh 10
Bac Ninh 1
Ha Nam 1
Vinh Phuc 1
Hung Yen 1
Quang Nam 2
Thai Binh 1
Situation Analysis: Significant trends
• Recent marked increase in duck population (subsequent to cessation of the ban on hatching waterfowl)
• High proportion of these ducks moved from province to province to graze on paddies after rice harvest did not receive H5N1 vaccination remain highly susceptible to the disease.
• Within this wave of outbreak, most of outbreaks have been reported in provinces in the Red River Delta
• Genetic sequencing of recent virus isolates have shown no significant change in the antigenicity Current vaccine is still effective.
Strong Commitment and Leadership from the Government• Establishment of the National Steering Committee
for Avian Influenza Prevention and Control (NSCAIPC);
• Political systems from Central to grassroots levels were called upon, resulted in: Clear chain of command; and Quick response activities, i.e. funds release, human
resources, etc.;
• Several missions led by Cabinet Members dispatched to the field;
• Experiences in responding to (SARS) in 2003.
Summary of Lessons Learned
Early Detection and Response
• Emergency reporting system using telephones and faxes;
• Online reporting system (TADinfo) piloted to assist in HPAI information management;
• AI Reporting Hotline set up;• Compensation policy revised;• Outbreak containment procedures modified
in the light of new knowledge and experiences.
Vaccination: Scope and progress
• Now focused on 33 provinces in high risk areas (Red River and Mekong River deltas) with vaccination of all long-lived poultry and all poultry in villages
• Vaccination of high risk poultry in other provinces • Other minor poultry not vaccinated due to insufficient
information on response to vaccination• In 2005, some 166.3 million doses given to chickens and
78.1 million doses to ducks• 2006: 368 million doses given to chickens and ducks (for
2 rounds)• Vaccination Plan Phase II 2007-2008 approved; 1st
vaccination campaign in 2007 started mid-March, and as of 15 May, 131.7 million birds vaccinated.
Information, Education and
Communications
• Communication plays the critical role in raising public awareness;
• Clear, updated information was disseminated to the public regularly through mass media;
• Daily updates on disease situation and progress of vaccination published on DAH’s website, available both in Vietnamese and English.
• Various IEC materials were produced and distributed using diverse media to reach diverse audiences. A National and several provincial telephone hotlines, for HPAI were established.
Pandemic Preparedness
• One lesson learned was that emergency preparedness plans help coordinate local response.
• In August 2005 MARD released its Avian Influenza Pandemic Preparedness Plan;
• Control measures would have been done better if a preparedness was available prior to the first outbreak;
• Integrated National Operational Program of Avian and Human Influenza (OPI) was produced in May 2006 with the participation of various agencies and donors;
• Practical SOPs for humane culling, biosecurity, etc. are needed.
International support
• FAO was quick to provide limited assistance through regional and national projects;
• A World Bank Project (Phase I) initiated in 2004; • A UN Joint Program Phase I initiated in 2005 with
funds from several donors; Phase II to start.• A Japan Trust Fund project is providing support
through FAO and OIE. • A credit facility through World Bank will fund a four-
year project commencing in mid-2007.• Various bilateral assistances.
KEY TECHNICAL SUPPORT GAPS
• Enhance national DAH epidemiology capacity
• Review legislation and regulations • Upgrade laboratory• Improve procedures for disease reporting• Periodic review of HPAI control strategy• Improve vaccination delivery• Improve field surveillance
Recommendations
Recommendations: (Cont’d)
• Improve response to outbreaks• Strengthen research• Improve biosecurity of poultry production
and marketing• Improve international border inspection
procedures
Issues need further study
• Decision model on controlling of outbreaks• Ecology and epidemiology of avian influenza virus• Molecular epidemiology• Role of migratory birds • Humane methods for culling• Vaccine efficacy trails;• Survey of free-ranging ducks• Develop risk-reduction strategies for free-ranging
ducks• Feasibility of local vaccine production