1. on Epidemiology in particular HPAI in Malaysia
OIE training workshop
on Epidemiology in particular HPAI
in Malaysia
in collaboration with CIRAD and Department of Veterinary Services
Bangkok, Thailand
 11 - 15 June 2007
Shiro Yoshimura
Japan/OIE HPAI Special Trust Fund Programme Coordination Office

2. Subjects What’s OIE ? Epidemiology and Disease Programme
TADs and philosophy
What’s HPAI ?
HPAI outbreaks in this region
Avian Influenza in International Animal Health Code ( you can see what are important in the prevention and control of HPAI. )
Diagnosis
Japan/OIE Special Trust Fund Programme for Highly Pathogenic Influenza Control at Source in Southeast Asia

3. The OIE World Organisation for Animal Health
(Office International des Epizooties)
An intergovernmental organisation
operating expenses are paid by member country contributions
Founded in 1924
167 Member Countries (In May 2006)
Delegates are Chief Veterinary officers (CVO)
Headquarters in Paris

4. The OIE’s objectives
Ensure transparency in global animal health situation
Collect, analyse and disseminate veterinary information Epidemiology
Contribute expertise and encourage coordinated approach to disease outbreaks
Improve veterinary services
Within its WTO mandate, safeguard world trade through animal health standards
Animal welfare and animal production food safety

5. Subjects What’s OIE ? Epidemiology and Disease Programme
TADs and philosophy
What’s HPAI ?
HPAI outbreaks in this region
Avian Influenza in International Animal Health Code ( you can see what are important in the prevention and control of HPAI. )
Diagnosis
Japan/OIE Special Trust Fund Programme for Highly Pathogenic Influenza Control at Source in Southeast Asia

6. Epidemiology (definition in a dictionary )
Study of diseases distribution in populations.
It focuses on groups rather than individuals and often takes a historical perspective.
Descriptive epidemiology surveys a population to see what segments (e.g. age, sex, ethnic group, occupation ) are affected by a disorder, follows changes or variations in its incidence or mortality over time and in different locations, and helps identify syndromes or suggest associations with risk factors.
Analytic epidemiology conducts studies to test the conclusions of descriptive surveys or laboratory observations.
Epidemiologic data on diseases is used to find those at high risk, identify causes and take preventive measures, and plan new health services.

7. Epidemiology and Disease Programme
What diseases infect
When
Where
How many & what animals
( zoonoses or not ? )
How
With what consequence
Basis for prevention & control
Information
Timely
No bias
Population
Good for analysis

8. Subjects What’s OIE ? Epidemiology and Disease Programme
TADs and philosophy
What’s HPAI ?
HPAI outbreaks in this region
Avian Influenza in International Animal Health Code ( you can see what are important in the prevention and control of HPAI. )
Diagnosis
Japan/OIE Special Trust Fund Programme for Highly Pathogenic Influenza Control at Source in Southeast Asia

9. TADs and Philosophy TAD : Trans-boundary animal diseases
They cross boundaries even though they do have no feet. Human factors tend to be responsible for most of outbreaks.
Two-way : Diseases are coming into and going out of your country ( concentrate on your own prevention & control and assistance to and sharing information with neighbors ).
Philosophy
There are proverbs
East-West Economic Corridor
that Be kind and sincere to others, and the kindness and
sincerity come back to you from others, and
that Know yourself and have a good knowledge of an enemy, 　 　　you will never lose any battle.

10. Subjects What’s OIE ? Epidemiology and Disease Programme
TADs and philosophy
What’s HPAI ?
HPAI outbreaks in this region
Avian Influenza in International Animal Health Code ( you can see what are important in the prevention and control of HPAI. )
Diagnosis
Japan/OIE Special Trust Fund Programme for Highly Pathogenic Influenza Control at Source in Southeast Asia

11. Avian Influenza In International Animal Health Code
Definition of the disease : an infection of poultry caused by any influenza A virus of
the H5 or H7 subtypes
any AI virus with an intravenous pathogenicity index (IVPI) greater than 1.2 or at least 75% mortality in 4-to 8-week-old chickens infected intravenously

12. Analysis of the global AI situation
Pandemic potential
There is a correlation between high viral load circulating in animals and the environment and the potential for a dangerous viral re-assortment or mutation.
All countries of the world should have efficient veterinary services in order to prevent entry of the disease, to allow early detection and a rapid response, in collaboration with partners.
Mechanisms set up to control AI situation are equally applicable for the control of other emerging and re-emerging animal diseases.

13. HPAI Disease Profile
Repeated outbreaks since late 2003 and Viruses holding a foothold and circulating, in the Region
Threatening risks to human and animal health
Socio-economic impacts and Spread to new countries and re-emerging (including roles of migratory birds)
Impediment to trade
Bio-security (animal production systems; backyard,
wet-markets, multi-species raising, etc.)
Gaps between legislation and its enforcement (Needs for Capacity Building and Improvement of relevant infrastructures and resources of National Veterinary Services)
Communication with producers and other stakeholders
Strategic vaccination (as a supplementary tool in at-high risk countries)

14. Vaccination Avian Influenza Smallpox
Range of Susceptible
Animals
Wide
Birds
( domesticated or wild )
Narrow
Only human
Efficacy of Vaccine
Less effective
No prevention of infection
Masking clinical signs
Highly effective
Disease management policy
Not easy to eradicate without test & culling
Focus on
early detection & control
Eradicated
Vaccination : supplementary measure ( no replacement for
existing test & culling measure ) to be supplemented
with the identification system, the surveillance with
sentinel birds etc. under the appropriate strategy
( prevention or control ?, and in which phase to start ? )

15. Reducing the threat at source to its minimum
A rapid reduction of the viral load and its circulation in domestic poultry
Early detection and transparent notification
Appropriate national chain of command
Ensure surveillance in domestic poultry and wild birds
Rapid response
rapid confirmation of suspect cases
containment
Humane slaughter
Resort to vaccination as a supplementary measure if necessary
Good governance, legislation, policies and resources, in line with OIE international standards on quality of VS

16. Subjects What’s OIE ? Epidemiology and Disease Programme
TADs and philosophy
What’s HPAI ?
HPAI outbreaks in this region
Avian Influenza in International Animal Health Code ( you can see what are important in the prevention and control of HPAI. )
Diagnosis
Japan/OIE Special Trust Fund Programme for Highly Pathogenic Influenza Control at Source in Southeast Asia

17. Jan-Mar 2005
Apr-June 2005
Not wind-borne disease
Jul-Sep 2005
Oct-Dec 2005

18. Malaysia
Epidemiological unit: village Affected animals Species: birds Susceptible: 67 Cases: 67 Deaths: 67
New outbreak

19. Thailand as low as possible No epidemic
Successful control with conventional methods without vaccination
4 isolated outbreaks
as narrow as possible
Better prevention
As long as possible
No endemic

20. Avian Influenza Situation in Southeast Asia

21. Monthly cases of Avian Influenza in Human
( Southeast Asia )
Vietnam:Mar.
Indonesia:May
Indonesia:May
Vietnam:Feb
Vietnam:Jun.
Vietnam:Jan.
Indonesia:Feb.
LaoPDR:Jan.
Thailand:Feb.
Indonesia:Aug.-Sep.
Indonesia:Nov.
Vietnam,Thailand:Sep.

22. Lessons to be learnt from Japanese case of HPAI (2004 to 2007)
Jan. 2004
Yamaguchi
1 case(35,000birds)
Feb. 2004
Oita
1 case(14birds)
Notification from a small holder
Feb. 2004
Kyoto
2 cases(225,000&15,000birds)
Delayed notification ?
Jan. 2007
Miyazaki
3 cases (12,000, 52,500 & 93,000birds)
Migratory birds ?
Jan. 2007
Okayama
1 case(12,000birds)

23. HPAI outbreaks in Japan, 2007
Case 1
Case 2
Case 3
Case4
Broiler/Layer
Broiler
layer
Layer
No. of chicken
12,000
52,500
93,000
No. of houses 3 5 6
1(15)
Infected house 1
Distribution of dead chicken
evenly
At the center
In the corner at the end
In the south
No. of dead chicken/day
D-R
500
326 13 23
D-1
246
243 2 34
D-2 18 12 4 28
D-3 21 32
D-4 20
Clinical Signs
Typical cyanosis, Oedema of the head, depression, nervous signs
Partly cyanosis
Lack of energy, depression
Slight cyanosis, lack of energy

24. Subjects What’s OIE ? Epidemiology and Disease Programme
TADs and philosophy
What’s HPAI ?
HPAI outbreaks in this region
Avian Influenza in International Animal Health Code ( you can see what are important in the prevention and control of HPAI. )
Diagnosis
Japan/OIE Special Trust Fund Programme for Highly Pathogenic Influenza Control at Source in Southeast Asia

25. Avian Influenza In International Animal Health Code(1)
Definition of the disease : an infection of poultry caused by any influenza A virus of
the H5 or H7 subtypes
any AI virus with an intravenous pathogenicity index (IVPI) greater than 1.2 or at least 75% mortality in 4-to 8-week-old chickens infected intravenously

26. Avian Influenza In International Animal Health Code(2)
Criteria for the NAI (notifiable Avian Influenza )status of a country, a zone or a compartment
the outcome of a risk assessment identifying all potential factors for NAI occurrence and their historic perspective;
NAI is notifiable in the whole country, an on-going NAI awareness programme is in place, and all notified suspect occurrences of NAI are subjected to field and, where applicable, laboratory investigations;
appropriate surveillance is in place to demonstrate the presence of infection in the absence of clinical signs in poultry, and the risk posed by birds other than poultry; this may be achieved through an NAI surveillance programme in accordance with Appendix 3.8.9.

27. Avian Influenza In International Animal Health Code(3)
NAI free country, zone or compartment
A country, zone or compartment may be considered free from NAI when it has been shown that neither HPNAI nor LPNAI infection has been present in the country, zone or compartment for the past 12 months, based on surveillance in accordance with Appendix 3.8.9.
Regaining of NAI free status by a previously free country, zone or compartment
In the case of HPNAI infections, 3 months after a stamping-out policy (including disinfection of all affected establishments) is applied, providing that surveillance in accordance with Appendix  has been carried out during that three-month period.

28. Importance for the prevention and control of HPAI indicated by OIE Code
< requirements to demonstrate past 12 month freedom, or 3 month freedom after a stamping-out >
Improvement of strategies, laws / regulations
Measures to enable stamping-out
Diagnostic capacity building
Surveillance
Provision of necessary materials
Training & review for immediate response
Coordination & cooperation
＊　With Other ministries, local governments
　　　 ＊　With farmers & consumers ( public awareness )

29. Subjects What’s OIE ? Epidemiology and Disease Programme
TADs and philosophy
What’s HPAI ?
HPAI outbreaks in this region
Avian Influenza in International Animal Health Code ( you can see what are important in the prevention and control of HPAI. )
Diagnosis
Japan/OIE Special Trust Fund Programme for Highly Pathogenic Influenza Control at Source in Southeast Asia

30. Diagnosis
What are important ?
Accurate
Less time consuming

31. Diagnosis of Avian Influenza (1) Assessment of pathogenicity
A HPAI virus is defined as one of the two following methods in terms of pathogenicity in chickens.
Any influenza virus that is lethal for six (75%), seven or eight of eight 4-to 8 week old susceptible chickens within 10 days following intravenous inoculation with 0.2ml of a 1/10dilution of a bacteria-free, infective allantoic fluid.
Any virus that has an intravenous pathogenicity index (IVPI) greater than 1.2 as a result of
i) intravenous injection of fresh infective allantoic fluid to ten 6-week-old SPF or SNA chickens,
ii) clinical assessment at 24-hour intervals and scoring clinical signs of each chicken ( 1: sick, 2: severely sick, 3: dead, IVPI is the mean score per bird per observation over the 10-day period.)

32. Diagnosis of Avian Influenza (2) Serological tests
Agar gel immunodiffusion test
Haemagglutination and haemagglutination inhibition tests
ELISA test
With the entry of newly developed tests including antigen detection (Directigen), and direct RNA detection (RT-PCR)

33. Subjects What’s OIE ? Epidemiology and Disease Programme
TADs and philosophy
What’s HPAI ?
HPAI outbreaks in this region
Avian Influenza in International Animal Health Code ( you can see what are important in the prevention and control of HPAI. )
Diagnosis
Japan/OIE Special Trust Fund Programme for Highly Pathogenic Influenza Control at Source in Southeast Asia

34. Activities of the Programme (OIE component)
To encourage the improvement of regional and national HPAI control strategies including the development of contingency plans
To collect, analyze and disseminate Technical information to further strengthen regional early warning systems
To strengthen diagnostic capacity of regional collaborating laboratories and national reference/diagnostic laboratories for HPAI including the holding of training courses on advanced HPAI diagnosis and installment of high performance diagnostic equipment and materials
To hold training courses for field veterinarians and para-professionals on HPAI strategic surveillance
Budget: About 8 million US$

35. Japan/OIE Special Trust Fund Programme for AI Control
Government of Japan
OIE Paris (HQ)
Regional Meetings with CVOs and other national officers for initiation and evaluation of activities
OIE Tokyo
OIE Project Coordinator in Bangkok
Regional Level
Development of Regional Strategies including contingency plans, information sharing for early warning
Capacity building:
Software; Support to Control Strategy Development, Capacity building of diagnosis and surveillance, etc., Training for veterinarians and para-professionals on strategic surveillance (meetings, hands-on workshops, etc.)
Hardware; Provision of laboratory diagnostic equipment and materials for capacity building
Development of Epidemiology Information Systems (computer software)
National Level
Development of National Strategies and Training

36. Thank you for your attention
World Organisation for Animal Health
12 rue de Prony
75017 Paris, France
Tel: 33 (0)
Fax: 33 (0)
Courriel :
Contact for more information