Risks of Emerging Infectious Diseases in ASEAN · infectious diseases do not go away, actually...

Risks of Emerging Infectious Diseases in ASEANPrasit Palittapongarnpim, M.D.

Department of Microbiology, Faculty of Science, MahidolUniversity

Despite the socio-economic progress of ASEAN and increased importance of NCD, infectious diseases do not go away, actually ASEAN (+China) becomes a hot spot of EID and reemerging diseases. • Nipah encephalitis- Sungai Nipah village Malaysia 1998• SARS- Guangdong China 2002• H5N1 influenza-first human cases in Hong Kong 1997 and

major outbreaks in 2004• Pandemic influenza H1N1 2009 • H7N9 influenza- China 2013• H10N8 influenza-China Dec 2013• Chikungunya- Tanzania 1962, 2005/6 outbreak on La

Réunion Island in the Indian Ocean followed by outbreaks in SE Asia 2005-2008.,

• Streptococcus suis- Denmark 1968 and an outbreak in Sichuan China 2005

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There are also threat of EID from other parts of the world.• Ebola (1976) major outbreaks in Africa 2014• Enterohemorrhagic E. coli (104:H4) 2011• MERS (2012) outbreak in Korea 2015• West Nile encephalitis

• Dengue virus infections• Hand-foot-mouth diseases• Melioidosis• Plague-Surat India 1994• Cholera• Leptospirosis• Salmonellosis• MDR and XDR-TB and other resistant bacteria

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As well as threat from re-emerging endemic diseases.

Are there any things else?

• Many patients with fever are of unknown etiology.▫ No attempts for microbiological diagnosis

▫ Limited facility

▫ Totally unknown even with aggressive attempts.

• Possible causes▫ Unknown rickettsial pathogens

▫ Unknown viruses, particular zoonotic ones.▫ New variants of known pathogens.

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Risk Factors for New EID

• More human population

• Shifting human population profiles. (More aging and immunocompromised population, relatively less children populations, more urbanization)

• Much more domestic animal populations▫ Chicken, pigs, cow

▫ Exotic pets

• More international and domestic travels

• Climate changes and changing environments

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Principles in dealing with the urgent situations such infectious diseases outbreak

• Capacity of personnel

• Availability of essential equipment▫ Preparedness plan

▫ Drilling

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Mitigating Biosecurity Threats in Southeast Asia by APEIR (Asia Partnership on Emerging Infectious Diseases Research)

MBDS (Mekong Basin Disease Surveillance Network)

FETN (Field Epidemiology Training Network)

and CORDS (Connecting Organizations for Regional Disease Surveillance)

Proposal originally prepared by Boonlay Phommasak &

Prasit Palittapongarnpim

Funded by

ASEAN-Canada’s GPP and IDRC

Updated Research Part for ASEAN East-West Corridor

Overview

• 30 month joint project between APEIR, MBDS, and ASEAN+3 FETN▫ Funded by IDRC and GPP

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Asia Partnership on Emerging Infectious Diseases Research

specific objectives

• Develop a greater understanding of the risks of an infectious agents at high-traffic border crossings in Southeast Asia.

• Strengthen laboratory and field surveillance, diagnostics, prevention and response capacities towards infectious pathogens cross-border outbreak potential.

• Synergize efforts among partner GPP projects in laboratory capacity strengthening and risk assessment.

• Build effective and efficient mechanisms for research to directly inform and shape regional policies and practices in surveillance, outbreak investigation and response.

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MBDS (Disease Surveillance)

Strengthen Bio Threat

Surveillance

Risk Management workshop

Develop Biosafety Training

manual

Capacity building

Surveillance equipment & PPE

Surveillance app development

Policy synthesis workshop

Biosafety and Biosecurity web

page

Collaboration with APEIR

Ext Consultant

M & E

APEIR (Research)

Lead research

Data collection

Capacity building: lab,

researchers, MBDS, border

health personnel

Early disease detection

Risk management

workshop (with MBDS)

Collaboration

Ext consultant

M & E

Policy synthesis workshop

OTHERS(Lab, Technical)

ASEAN

WHO EDPLN

Bio Diaspora

IFBA

CORDS

Research activity and collaboration

Activity APEIR MBDS ASEAN+3

FETN

CORDS Bio Diaspora

WHO EDPLN

Research

Surveillance

Training

Technical consultation

Others

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Outline

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• Background

• APEIR-MBDS-ASEAN+3 FETN-Joint Project▫ Background

▫ Objectives

▫ Project activities

• Moving forward

Background of APEIR

• 2006: Initiated as Asia Partnership For Avian Influenza Research (APAIR)

• 2009: Expanded scope to cover all emerging infectious diseases (EIDs) research

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Background

• Regional research network composed of researchers, practitioners, and senior government officials

• Generates 3M collaborative research and actions on EIDs based on Eco Health/One Health concepts▫ Multi-disciplinary

▫ Multi-sector▫ Multi country

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APEIR Network

• Missions▫ Research

▫ Knowledge translation

▫ Policy advocacy ▫ Capacity building

APEIR Member Countries

Background: Vision

• To be the leading EIDs research network in Asia by 2015

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Background

• ASEAN Community (AC) in 2015 will lead to more travel between ASEAN countries

• Need to have the knowledge, capacity and policy to mitigate the risks from potentially dangerous infectious diseases that can cross borders.

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General objective

• To strengthen regional capacity for understanding, preventing, preparing for, and responding to disease agents with bioterrorism and/or pandemic potential in Southeast Asia

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Research Objectives

• Assessing the risk of infectious diseases transmission across borders.

• Increasing capacity for disease detection

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Studied organisms

• Influenza▫ Air-borne transmission: endemic, continuously

emerging and potential pandemic.

• Melioidosis▫ Soil transmission: direct impact from increase

road traffic and frequently fatal.

• Salmonellosis▫ Food-borne transmission: spreading of drug

resistance genes.

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Study locations

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A

B

C

APEIR-MBDS Joint Project Action Plan (September 2014-September 2016)

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Activities2014 2015 2016

Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3

Inception workshop X

Budget analysis X

Ethical/government clearance X X

Budget analysis X

Evaluation of all facilities X

Test running all facilities X

Training X

Sample collection - processing X X X X X

Data sharing and result analysis X X X

Interim technical

report/financial report X X X X

Progress report X X X X

Meeting for reviewing research,

summarizing data and

synthesize policy

X X

Project activities

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Activity Place and date

First preliminary meeting

HSRI Thailand: 19 March 2014

Second preliminary meeting + site visit

Savannakhet and Lao-Vietnam border: 24-26 April 2014

First International Conference on MBDS Collaboration

Mukdahan Grand Hotel, Thailand: 2-3 June 2014

East-West Corridor Inception Workshop

Savannakhet Health Department, Lao PDR: 11-12 September 2014

Laboratory Trial Mukdahan-Amnatcharoen, Thailand: 8-20 December 2014

• As a collateral consequences of an unexpected situation in HSRI, the project budget is suspended since the last quarter of 2014.

• It is expected to resume by the last quarter of 2015.

• This workshop is done as a preparation for resuming the research activities.

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Purpose of Today Workshop

• Face-to-Face Discussion on each subproject▫ Objectives ▫ Sampling methods▫ SOP▫ Requirement: authorization, budget, etc.▫ Limitation▫ Opportunity for training and capacity building▫ Action plan and timelines Next step and contact

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To build laboratory capacity to handle dangerous pathogens, sharing knowledge on some potential pathogens as well as provide laboratory practicing experiences

THANK YOU VERY MUCH

For

YOUR ATTENTION

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Risks of Emerging Infectious Diseases in ASEAN · infectious diseases do not go away, actually...

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