1. OIE training workshop on Epidemiology in particular HPAI OIE training workshop on Epidemiology in particular HPAI and TADS in the Philippines in collaboration with CIRAD and Bureau of Animal Industry Shiro Yoshimura Japan/OIE HPAI Special Trust Fund Programme Coordination Office Manila, Philippines 29 January – 2 Februry 2007

2. Subjects What’s OIE ? Epidemiology and Disease Programme 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. ) Japan/OIE Special Trust Fund Programme for Highly Pathogenic Influenza Control at Source in Southeast Asia

3. What’s OIE ?

4. 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 –Delegates are Chief Veterinary officers (CVO) Headquarters in Paris

5. The OIE’s objectives 1. Ensure transparency in global animal health situation 2. Collect, analyse and disseminate veterinary information 3. Contribute expertise and encourage coordinated approach to disease outbreaks 4. Improve veterinary services 5. Within its WTO mandate, safeguard world trade through animal health standards 6. Animal welfare and animal production food safety

6. Epidemiology and Disease Programme

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

8. TADs and Philosophy

9. TAD : Trans-boundary animal diseases 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. They cross boundaries even though they do have no feet. Human factors tend to be responsible for most of outbreaks. Diseases are coming into and going out of your country. Diseases are coming into and going out of your country. Philosophy Philosophy There are proverbs There are proverbs that Be kind and sincere to others, and the kindness and sincerity come back to you from others, and 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. that Know yourself and have a good knowledge of an enemy, you will never lose any battle.

10. What’s HPAI ?

11. 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.

12. 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)

13. Vaccination Avian Influenza Smallpox Avian Influenza Small pox Range of Susceptibl e AnimalsWide Poultry ( domesticated or wild ) Narrow Narrow Only human Efficacy of Vaccine Not necessarily high High Disease manageme nt policy Not easy to eradicate Focus on early detection & control Eradicated Vaccination : supplementary measure to be supplemented with the identification system, the surveillance etc. under the appropriate strategy ( prevention or control, and in which phase to start )

14. 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 if necessary – –Good governance, legislation, policies and resources, in line with OIE international standards on quality of VS

15. HPAI outbreaks in this region

16. UPDATE ON AVIAN INFLUENZA IN ANIMALS (TYPE H5) as at 31 October 2006 Location Virus type Most recent report remarks CambodiaH5N1 04 / 09 / 2006 China (People's Rep. of) H5N1 04 / 10 / 2006 Hong Kong H5N1 17 / 01 / 2007 IndonesiaH5N1 25 / 09 / 2006 LaosH5N1 04 / 08 / 2006 Malaysia (peninsular) H5N1 18 / 06 / 2006 MongoliaH5N1 28 / 07 / 2006 MyanmarH5N1 04 / 09 / 2006 ThailandH5N1 15 / 01 / 2007 VietnamH5N1 17 / 01 / 2007 Quick reliable diagnosis, transparent report !

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

18. Jan-Mar 2005Apr-June 2005 Jul-Sep 2005 Oct-Dec 2005

19. Lessons to be learnt from Japanese case of HPAI (2004 to 2007) Feb. 2004 Kyoto 2 cases( 225,000&15,000birds ) Feb. 2004 Oita 1 case( 14birds ) Jan. 2004 Yamaguchi 1 case( 35,000birds ) Jan. 2007 Miyazaki 1 case( 12,000birds )

20. Avian Influenza Avian Influenza in International Animal Health Code ( you can see what are important in the prevention and control of HPAI. )

21. 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

22. Avian Influenza In International Animal Health Code(2) Criteria for the NAI (notifiable Avian Influenza )status of a country, a zone or a compartment zonecompartmentzonecompartment the outcome of a risk assessment identifying all potential factors for NAI occurrence and their historic perspective; the outcome of a risk assessment identifying all potential factors for NAI occurrence and their historic perspective;risk assessmentrisk assessment 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; 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. 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 3.8.9.3.8.9.

23. 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. 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.zonecompartmentzonecompartment 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 3.8.9. has been carried out during that three-month period. 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 3.8.9. has been carried out during that three-month period.

24. Importance for the prevention and control of HPAI indicated by OIE Code Improvement of strategies, laws / regulations Diagnostic capacity building Surveillance Provision of necessary materials Training & review for immediate response Coordination & cooperation ＊ With Other ministries, local governments ＊ With Other ministries, local governments ＊ With farmers & consumers ( public awareness ) ＊ With farmers & consumers ( public awareness )

25. Diagnosis What are important ? Accurate Accurate Less time consuming Less time consuming

26. 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, 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.) 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.)

27. 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) With the entry of newly developed tests including antigen detection(Directigen), and direct RNA detection (RT-PCR)

28. Importance for the prevention and control of HPAI indicated by OIE Code Diagnostic capacity building Surveillance Improvement of strategies, laws / regulations Provision of necessary materials Training & review for immediate response Coordination & cooperation ＊ With Other ministries, local governments ＊ With Other ministries, local governments ＊ With farmers & consumers ( public awareness ) ＊ With farmers & consumers ( public awareness )

29. Japan/OIE Special Trust Fund Programme for Highly Pathogenic Influenza Control at Source in Southeast Asia

30. 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, analyse 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$

31. Japan/OIE Special Trust Fund Programme for AI Control Government of JapanOIE Paris (HQ) National Level Regional Level OIE Tokyo Capacity building Capacity building : Software; 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; Hardware; Provision of laboratory diagnostic equipment and materials for capacity building OIE Project Coordinator in Bangkok Development of National Strategies and Training Development of Epidemiology Information Systems (computer software) Development of Regional Strategies including contingency plans, information sharing for early warning Regional Meetings with CVOs and other national officers for initiation and evaluation of activities

32. Thank you for your attention World Organisation for Animal Health 12 rue de Prony 75017 Paris, France Tel: 33 (0)1 44 15 18 88 Fax: 33 (0)1 42 67 09 87 Courriel : oie@oie.intoie@oie.int http://www.oie.int Contact for more information