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Highly Pathogenic Avian Influenza

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Title: Highly Pathogenic Avian Influenza


1
Highly Pathogenic Avian Influenza
  • Threats to Biodiversity Conservation in Africa

College of African Wildlife Management Mweka,
Tanzania July 2008
2
Overview
  • Highly Pathogenic Avian Influenza
  • Introduction History
  • Current Threat
  • Potential Impacts on Biodiversity Conservation
  • Preparedness and Response
  • Global Avian Influenza Network for Surveillance
    (GAINS)

3
Influenza A Virus
  • Three types of Influenza A virus
  • Seasonal Influenza
  • Widely circulating amongst humans (cause of the
    flu)
  • Avian Influenza
  • Primarily infects birds, but other mammalian
    species (including humans) susceptible
  • Low Pathogenicity
  • High Pathogenicity (H5N1)
  • Pandemic Influenza
  • Virus with the capacity for efficient, sustained
    human to human transmission

4
Influenza A Virus
  • Typified by two types of surface proteins
  • Hemagglutinin (HA)
  • Neuraminidase (NA)
  • No cross immunity between seasonal and avian
    influenza

5
Highly Pathogenic Avian Influenza
  • HPAI defined based upon high mortality rates in
    domestic poultry
  • H5N1 is the currently circulating HPAI strain

6
H5N1 HPAI
  • First Identified in 1996 in Guangdong, China
  • Initial outbreak in domestic poultry 1997, Hong
    Kong
  • 1.5 million chickens culled
  • 18 people infected 6 died
  • Reemergence in Hong Kong in February 2003

7
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8
Historical Influenza Pandemics
  • 20th century pandemics
  • 1918 (50 million deaths globally)
  • 1957 (1 million)
  • 1968 (750,000)

9
Belshe RB. N Engl J Med 200535321
10
Pandemic InfluenzaImpacts
  • Pandemic influenza poses significant public
    health risk
  • No pre-existing immunity to H5N1 in human
    population
  • Isolates have demonstrated some anti-viral
    resistance
  • Vaccine has been developed, but may not cover
    pandemic strain
  • Difficulty of containment
  • Projected Pandemic Costs
  • 10-180 million deaths worldwide
  • Economic Impact 2-3.1 of global GDP (gt2
    trillion USD) (World Bank)

11
Highly Pathogenic Avian Influenza
  • Bird to Bird Transmission
  • Predominant type of transmission to date
  • Primarily still a disease of birds
  • Viral spread via trade in poultry and poultry
    products
  • Via trade in caged/exotic birds
  • Via human movement
  • Via wild birds
  • The relative importance of wild birds in
    transmission varies by situation
  • Research indicates HUMAN MOVEMENT and TRADE are
    the most common sources of viral transmission

12
Highly Pathogenic Avian Influenza
  • Bird to Human Transmission
  • Rare
  • Usually a result of very close contact with
    infected poultry and infected blood/tissues or
    contaminated surfaces
  • Human to Human Transmission
  • Isolated instances suspected (Thailand, 2004)
  • No sustained human to human transmission to date

13
H5N1 Distribution
  • Poultry
  • H5N1 in domestic poultry in Asia, Africa,
    Pacific, Europe and Near East
  • Considered endemic in parts of Asia and Africa
  • gt240 million bird deaths
  • H5N1 case mortality rate in domestic poultry
    90-100 in 48 hours
  • Humans
  • H5N1 confirmed cases in Asia, Africa, and Near
    East
  • 2003-2008 378 cases 238 deaths
  • Case mortality in humans 60

14
H5N1 Influenza Avian Case Distribution
15
H5N1 Influenza Avian Case Distribution
16
H5N1 InfluenzaHuman Case Distribution
17
H5N1 in Africa
  • February 2006, H5N1 first identified in
    commercial poultry in Africa (Nigeria and Egypt)
  • April 2007, H5N1 identified in Ghana and Togo

Poultry Wild birds Captive Birds Humans
FAO
Countries with H5N1 presence in birds (as of
Sept. 2007)
18
Poultry Density and CIRAD Wild Duck Telemetry
Locations in Africa as of June 30, 2008
CIRAD
19
H5N1 East Africa
  • Currently H5N1
  • Egypt
  • Djibouti
  • Sudan
  • Somalia (?)
  • Currently H5N1 Free
  • Kenya
  • Tanzania
  • Uganda
  • Ethiopia
  • Risks
  • Introduction to HPAI free countries via poultry
    trade, human movement, migratory birds
  • Prevention
  • Active, ongoing monitoring surveillance
  • Trade restrictions with positive countries
  • Bolstered inspection at ports of entry
  • Emergency preparedness and response plans ready
    to be mobilized

20
Kenya Red Cross
Rift Valley Falls Along Europe/Southern Africa
Migratory Route Peak Migration Mid September -
Mid November
21
HPAI Poultry Consumption
  • Loss of Domestic Poultry
  • Poultry illness/loss of productivity
  • Poultry death
  • Poultry culls

Irrational Poultry Consumption Fears
Kenya 30 million chickens, 80 raised
traditionally by small holders 2-3
chickens/rural household
  • Loss of income
  • Inability to pay for school fees, medicine,
    dietary staples
  • Loss of protein nutrition

Tanzania 27 million chickens, 70 raised
traditionally by small holders
22
FAO/C.Squarzoni
23
Impacts on Biodiversity Conservation
  • Threats
  • Health of wild birds
  • May 2005, Qinghai Lake National Nature Reserve
    (China) H5N1 outbreak estimates of 5-10 of
    worlds population of Bar-headed Geese (Anser
    indicus) succumbed to AI virus
  • Communities may turn to bush meat for protein
    requirements
  • Fear may incite wild bird culls or
    wetlands/nesting area destruction

24
Biodiversity ConservationOpportunities
  • Accurate information dissemination is essential
  • Targeting local communities, park staff, media
    and human animal health workers
  • Sound, science-based policy decisions
  • Wetlands and protected area preservation
  • Will help limit number of displaced wild birds
    forced into contact with humans and domestic
    poultry

25
Alternative Protein Sources
MEAT Cattle Buffalo Pig Sheep Goat Fish
  • Communities should be prepared to draw on
    alternative protein sources to hedge against
    catastrophic poultry loss
  • Diversified, Site-Appropriate Livestock Portfolio

DAIRY Cattle Sheep Goat
PROTEIN RICH VEGETABLE Peanut Soy
26
Avian InfluenzaPreparedness Response
  • Surveillance
  • Communication Education
  • Diagnostic Capacity Commodity Distribution
  • Research
  • Rapid Response Containment

27
Surveillance
  • Early detection is critical for containment
  • Transparent reporting
  • Donor resources need to be made available for
    active surveillance
  • CDCs Global Disease Detection Center (Kenya)
  • Army Medical Research Unit (Kenya)

International Scientific Task Force on Avian
Influenza
28
Wild Bird Global Avian Influenza Network for
Surveillance (GAINS)
  • Program managed by Wildlife Conservation Society,
    funded by USAID
  • Global surveillance monitoring system
  • Applicable to other diseases, including wildlife
    disease
  • Sharing of near real-time HPAI monitoring in wild
    birds using an accessible online format
  • Tracks genetic changes in the virus
  • Encourages transparent disease reporting
  • Technical support to national laboratories/vet
    services for surveillance and diagnostic
    activities

29
Global Avian Influenza Network for Surveillance
  • Target Audiences
  • Government
  • Local Communities
  • Policy Makers
  • Private Sector
  • Informs decision making to cope with threat of
    HPAI at local through national levels
  • Serves as an early warning system for HPAI
    emergence
  • Potential to limit risks to human health,
    wildlife health, domestic poultry/livelihoods

30
Global Avian Influenza Network for Surveillance
GAINS Global Surveillance Locations
  • Wild Bird Flyways
  • Upcoming work will use sat transmitters to define
    the Nile-Rift Valley flyway

31
  • Data
  • Positive Cases
  • Total Sampled Cases
  • Wild Bird Counts
  • Parameters
  • Dates
  • Location
  • Wild Bird Species
  • H N type
  • Pathogenicity

WISDOM Map Explorer
32
Communication Education
  • Prevention Strategies
  • Recognizing Illness
  • Discouraging Consumption of Sick Poultry
  • Farm/Village Biosecurity
  • Slaughter and Cooking Precautions
  • Behavior Change Communication (i.e. hand washing,
    personal hygiene)

33
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34
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35
Communication Education
  • Preventing Wild Bird Poultry
    Transmission
  • Domestic poultry should not be permitted to
    commingle with wild birds
  • Care taken to avoid shared water sources
  • Fencing or covered sheds
  • Improved husbandry practices (All In-All Out)
  • Biosecurity on farms, in households, at markets,
    and during transport

36
Communication Education
  • Enforcement of the illicit wild bird trade

CDC
37
Diagnostic Capacity Commodity Distribution
  • Personal Protective Equipment
  • Goggles, Aprons, Gloves, Boots
  • Diagnostic Kits/Reagents
  • Capacity Building for National Laboratory
    Diagnosis Epidemiological Surveillance
  • Response Preparation
  • Disinfectants, etc

DAI
Synbiotics
38
Research
  • Wild Birds
  • Can we clarify their role in transmission?
  • Migratory flyways need to be defined
  • Which species may be inapparent carriers? Do some
    species exhibit high mortality rates?
  • Banding, bird counts, telemetry
  • Disease Ecology
  • How persistent is the virus in the environment?

39
FAO
40
FAO
41
Research Development
  • Vaccination
  • Poultry
  • Vaccine available policy on use varies by nation
  • Reduced morbidity and mortality, however viral
    shedding still possible in vaccinated poultry
  • Human
  • April 2007, US FDA approved H5N1 human vaccine
    (Sanofi Pasteur, Inc.)
  • Emergency stockpiles only not commercially
    available
  • Future pandemic influenza strain unknown, so
    vaccine efficacy questionable

42
Response Containment
  • Emergency response plans in place
  • Centrally coordinated effort drawing on diverse
    stakeholders
  • Table and field-tested plans
  • Adequate resources for culling and disposal
  • Compensation plans fair, transparent, and fully
    funded

FAO
43
Additional Resources
  • News Updated Information
  • CIDRAP www.cidrap.umn.edu
  • ProMED Mail www.promedmail.org
  • Centers for Disease Control and Prevention
    www.cdc.gov

44
Additional Resources
  • Multi and Bilateral Efforts
  • United States Agency for International
    Development www.usaid.gov
  • World Health Organization www.who.int
  • UN, Food and Agriculture Organization
    http//www.fao.org/avianflu/en/index.html
  • Including OFFLU and EMPRES
  • World Organization for Animal Health
    http//www.oie.int/eng/info_ev/en_AI_avianinfluenz
    a.htm

45
Additional Resources
  • Monitoring Surveillance
  • Global Avian Influenza Network for Surveillance
    (WCS) www.gains.org
  • Educational Communication Resources
  • InterAction http//www.interaction.org/disaster/av
    ian/index.html
  • Academy for Educational Development
    http//avianflu.aed.org/index.htm
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