PANDEMIC RISK

3 pre-requisites for a Pandemic 1. The emergence of a new virus strain with no circulating immunity within the human population 2. The ability of this strain to infect humans 3. The potential for the new virus to be easily transmitted from person to person At present, two of the prerequisites for a pandemic have already been met – a new virus capable of infecting humans is circulating. At present, two of the prerequisites for a pandemic have already been met – a new virus capable of infecting humans is circulating.

Pandemic risk

Threat of Global Pandemic- Virus may change to highly infectious form for human and spread from person to person i.e. Virus may change to highly infectious form for human and spread from person to person i.e. increased transmissibility among human acquired by:- increased transmissibility among human acquired by:- (a) Reassortment: exchange of genetic material - human + avian or pig (b) Adaptive mutation- gradual-binding to human cell increases IF PANDEMIC OCCURS – on the basis of 1957 pandemic: IF PANDEMIC OCCURS – on the basis of 1957 pandemic: - Estimated 2M to 7.4M deaths - with attack rate 25-35% of total population -Virus with mild disease -Best circumstances

SIGNALS FOR PANDEMIC  Cluster of patients with Symptoms of influenza - closely related in time and space suggest human to human transmission started.  Detection of cases in health workers caring for H5N1 would suggest human to human transmission  Investigate -– to confirm diagnosis -- identify source -- identify source -- determine whether human to human transmission is occurring -- determine whether human to human transmission is occurring  Study virus – specialized WHO Reference Laboratories Genetic spotting and other properties. Genetic spotting and other properties.

WHO Pandemic phases

WHO pandemic plan: strategic elements 1. Reduce human exposure to H5N1 2. Strengthen early warning system 3. Intensify rapid containment measures 4. Build capacity to cope with pandemic 5. Coordinate a broad multi-sectoral response

PANDEMIC WILL LEAD TO Increased number of people seeking health services High rate of absenteeism Interruption of essential services— law services, transportation, communication Social and economic disruptions Losses in trade and commerce Curtailment in Intercountry assistance-protection of domestic populations

A Global Strategy for the Progressive Control of Highly Pathogenic Avian Influenza

Infection Control Measures 1. Surveillance 2. Education 3. Influenza Testing 4. Antiviral Chemoprophylaxis 5. Respiratory Hygiene 6. Standard precautions 7. Droplet Precautions 8. Restrictions for ill visitors and ill health care personals

WILD LIFE HEALTH VETERINARY EARLY WARNING & RESPONSE SYSTEM

vaccination  Inactivated influenza vaccine  Live attenuated vaccine(LAIV)

H5N1 Vaccine  WHO is creating a global stockpile of H5N1 vaccine which could within 2 years, potentially contain at least 50 million doses – enough for 25 million people to receive two doses, which is likely to be needed to achieve protective levels of antibodies.

BIOSECURITY BIOSECURITY

Biosecurity includes the management of all biological and environmental health risks associated with food. Two main elements:  BIO-CONTAINMENT  BIO-EXCLUSION

Major components : Isolation Traffic Control Sanitation

HIGH biosecurity LOW HIGH A.Birds are always kept in a close building B.Birds have access to a fenced park C.Birds are let free in the farm yard D.Birds are let free in and outside the farmyard E.Birds go to rice fields and come back

The key biosecurity measures  ✦ Keep the wild birds away  ✦ Avoid multi-age poultry farms  ✦ Obtain feed from a clean, dependable sourcefarm.  ✦ Clean and disinfect the premises and equipment on farms Exclude poultry from the home ✦ Effective management of hazardous wastes Use only clean and disinfected transport vehicles for movement of poultry and eggs. Use only clean and disinfected transport vehicles for movement of poultry and eggs.

SECURED PRIMARY FARMING PRACTICES

Safe transport Safe transport  Avoid collecting and transporting birds from different farms or collection centres in the same vehicle  Give preference to non-wooden /bamboo cages

Biosecurity in wet markets

Biosecurity at customer & consumer end  Avoid buying live poultry/ birds  Keep Clean  Separate raw and cooked food items  Cook thoroughly  Do not prepare and consume speciality raw dishes  Keep food at safe temperatures.

The Avian influenza crisis is currently one of the most important public health issues of our time with tremendous implications for peoples’ livelihoods and socio-economic impacts. These require effective inter-sectoral collaboration between the Ministries of Agriculture and Health of countries in order to solve the problems associated with these outbreaks. CONCLUSION

THANK YOU