Avian Influenza in a connected world FAO assistance for outbreak prevention and control Eran RAIZMAN, Sophie VON DOBSCHUETZ, Guillaume BELOT, Emma GARDNER, Akiko KAMATA, Subhash MORZARIA Head of EMPRES Food and Agriculture Organization of the United Nations Rome, Italy

2 FAO Global Mandate Improve nutrition Increase agricultural productivity Raise the standard of living in rural populations Contribute to global economic growth

EMPRES-AH FAO’s EMERGENCY PREVENTION SYSTEM for ANIMAL HEALTH

4 ANIMAL HEALTH THREATS Three of today’s major challenges to animal and public health: Risk of Transboundary Animal Diseases (TADs) outbreaks (e.g. Avian Influenza, FMD & PPR) Antimicrobial resistance (AMR) Food and feed safety

FAO’s RESPONSE: EMPRES-AH Sustainable capacity building Knowledge sharing Tools & Strategies Coordination & Networking

7 SUSTAINABLE CAPACITY BUILDING Technical training – Increased surveillance – Laboratory diagnostics training – Strengthening laboratory capacity – Disease management – Developing tools for disease control and eradication Advocacy for political will

8 KNOWLEDGE SHARING Enabling research environment Up-to-date disease intelligence and technology Information sharing on applied research Disseminating information: – PUBLICATIONS : EMPRES 360, EMPRES Watch, FOCUS ON EMPRES 360EMPRES WatchFOCUS ON – WEBSITE : EMPRES-AH EMPRES-AH

TOOLS & STRATEGIES – Online Information Systems EMPRES-i – Reporting Systems EMA-i (Event Mobile Application) Genetic Module – Risk Assessment – Lab Mapping Tool

COORDINATION & NETWORKING Disease control activities at country and regional level Grass roots multisectoral approach to health management Networking (FMD, OFFLU)

Outline 2015: An avian influenza year… Focus on H5N1 HPAI in West Africa – Situation – FAO’s assistance Focus on Influenza A(H7N9) – Situation – FAO’s assistance Future prospects for AI control

Outline 2015: An avian influenza year… Focus on H5N1 HPAI in West Africa – Situation – FAO’s assistance Focus on Influenza A(H7N9) – Situation – FAO’s assistance Future prospects for AI control

Sub-typeSpecies affectedComments H5N1 (2003) « Classic bird flu » The ‘classic bird flu’, a highly pathogenic AI virus that can occasionally infect humans -Endemic in: Egypt, Indonesia, Viet Nam, Bangladesh, Cambodia, China -New introduction in West Africa in December is the year with highest number of human cases: 143 (WHO) H5N8 (2014) A newly emerged highly pathogenic AI virus, behaving similar to H5N1, a competitor to H5N1 -Spread from the Far East to Western Europe and Northern America late No human cases reported so far H5N6 (2014) Another newly emerged highly pathogenic AI virus in Southeast Asia -Spread rapidly from China to Lao PDR and Viet Nam -3 human cases reported so far, all in China H7N9 (2013) A low pathogenic AI virus in China that causes disease and mortalities in humans -Only in China -Most human cases exposed in live bird markets H9N2 A widespread low pathogenic AI virus that sporadically infects humans -Immunosuppressive in poultry -Acts as an internal gene donor for other viruses (H7N9, H5N1, H5N8…)

– An avian influenza year… HPAI H5 events increased in numbers and geographical extent Endemic countries reported more outbreaks Previously unaffected countries detected HPAI H5 viruses in poultry and wild birds Geographical Distribution of H5Nx HPAI viruses 26 October 2014 – 26 October 2015

– An avian influenza year… H5N1: 2015 is the year with the highest number of human cases in history New introduction and significant spread of the virus in: Israel – Gaza – West Bank West Africa Geographical Distribution of H5Nx HPAI viruses 26 October 2014 – 26 October 2015

– An avian influenza year… HPAI H5 viruses have genetically diversified and re-assorted (N1, 2, 6, 8) H5N8: Dominant in Republic of Korea October 2014: Spread to Europe December 2014: Spread to North America Geographical Distribution of H5Nx HPAI viruses 26 October 2014 – 26 October 2015

– An avian influenza year… H5N2: Asian reassortant Endemic in Taiwan Spread significantly in the USA (48 million birds affected) No human case Geographical Distribution of H5Nx HPAI viruses 26 October 2014 – 26 October 2015

– An avian influenza year… H5N6: Virus from China Spread to Lao PDR and Viet Nam Human cases Geographical Distribution of H5Nx HPAI viruses 26 October 2014 – 26 October 2015

Outline 2015: An avian influenza year… Focus on H5N1 HPAI in West Africa – Situation – FAO’s assistance Focus on Influenza A(H7N9) – Situation – FAO’s assistance Future prospects for AI control

H5N1 HPAI in West Africa - Situation Introduction: Nigeria – Dec 2014 Burkina Faso – Feb 2015 Niger - Mar 2015 Côte d’Ivoire and Ghana – Apr 2015

H5N1 in West Africa – FAO’s assistance FAO assessment missions 2015: -Nigeria (January) -Benin & Togo (March) -Cameroun (April) -Burkina Faso (April) -Ghana (June) -Côte d’Ivoire (May)  Need for a regional approach to tackle the epizootic, with information sharing and coordination among the West African countries  Abuja meeting (15-16 June) to define a regional strategy and an 18-month regional action plan

H5N1 in West Africa – FAO’s assistance Emergency laboratory support Provision of equipment and consumables Support for shipment of samples for disease confirmation and virus characterization Disease control Review of countries’ contingency plans Workshop on secure movement of poultry and poultry products National & district level training on outbreak management Planned: Regional workshop on risk management along the production chain (Senegal, December 2015)

H5N1 in West Africa – FAO’s assistance Disease surveillance support Risk-based surveillance protocol developed by HQ Protocol to be contextualized for each country during missions Technical backstopping missions as requested Laboratory backstopping in Burkina Faso : Improve good laboratory practices and troubleshooting capacities Epidemiology backstopping in Cote d’Ivoire : Developing and implementing a risk-based surveillance program Production of communication materials and guidelines

Outline 2015: An avian influenza year… Focus on H5N1 HPAI in West Africa – Situation – FAO’s assistance Focus on Influenza A(H7N9) – Situation – FAO’s assistance Future prospects for AI control

25 Influenza A(H7N9) - Situation First human cases reported in March 2013 LPAI virus: no clinical signs in poultry or waterfowl Infects humans  40% case fatality rate Strong seasonality pattern Only detected in China so far

26 Influenza A(H7N9) - Situation

27 Influenza A(H7N9) – FAO’s assistance Technical assistance Disease intelligence: close monitoring of the situation and of the scientific developments Publication of bi-weekly updates on the situation Dissemination of manuals and guidelines Surveillance Risk assessment Risk management Laboratory protocols Risk communication Biosecurity in LBMs

28 Influenza A(H7N9) – FAO’s assistance Surveillance in at-risk countries Longitudinal risk-based surveillance to early detect H7N9 incursion in at-risk countries Partnerships with national veterinary services Viet Nam, Lao PDR, Myanmar Focus on LBMs and poultry aggregation points No H7N9 virus found outside of China so far

29 Influenza A(H7N9) – FAO’s assistance Laboratory Training of laboratory technicians Provision of laboratory reagents and equipment Transport of samples to international reference centers Epidemiology Reviewing contingency plan and SOPs Simulation exercises Value-chain studies to identify critical control points Joint risk-assessment

Outline 2015: An avian influenza year… Focus on H5N1 HPAI in West Africa – Situation – FAO’s assistance Focus on Influenza A(H7N9) – Situation – FAO’s assistance Future prospects for AI control

31 Future prospects for AI control Endemic situation in domestic poultry is unlikely to change in the foreseeable future – Increasingly identified as one of many other endemic poultry disease – Multi-dimensional problem – Beyond technical approach (holistic all society approach) – Farming systems and value chains need transformation – Socio-economics, poverty, communication, behaviour, tradition Increasingly recognized as a global problem – No one country can tackle the disease – Regional and international public good – A concerted global action of all players needed with significant financial and political commitment needed

32 Risk factors for AI introduction and spread Even if wild birds may play some role (?) in long distance spread and first introduction, the main factors are: Legal and illegal trade movements People servicing / visiting different farms (vets, technicians, foodstuff providers etc.) Limited biosecurity along the value chain  This is where YOU can make a significant difference! Live bird markets are key control points!

HPAI spreads mostly through the actions of PEOPLE BIOSECURITY is a priority Good farm management practices essential

Thank you!