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Trends and dynamics of HPAI - epidemiological and animal health risks Technical Meeting on HPAI and Human H5N1 Infection Rome, Italy, June 27-29, 2007 J. Domenech L. Sims J. Slingenbergh J. Lubroth FAO, Rome
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Enhanced control in poultry In Viet Nam
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Successes Improvement of the global situation: alertness and preparedness early detection and reporting early response Eradication from many recently infected countries
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Negative aspects H5N1 HPAI viruses remain entrenched in 3 main countries: Indonesia, Egypt, Nigeria These foci of infection are a threat to other countries and a potential human influenza pandemic risk Some recently infected countries (e.g. Bangladesh) share many features of other countries that have not eliminated infection
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HPAI detection by district. HPAI was detected in 223 districts out of a total of 444 Districts since 2003. Source: The Directorate General of Livestock Services Indonesia
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To understand and predict the trends of the disease we know that:
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Tools and strategies to control HPAI exist FAO OIE Recommendations and Global Strategy on the Prevention, Control and Eradication of HPAI –Targeted risk-based active surveillance –Stamping out –Enhanced biosecurity –Movement control –Vaccination –Sustainable changes in practices –Cleaning and disinfection
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These recommended tools and methods work if implemented appropriately
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However, global eradication will not be achieved in the medium term Countries with entrenched infections will need considerable support to achieve required gains
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Methods of control in countries with entrenched infection will differ from newly infected countries Greater focus on risk identification Gradual sustainable risk reduction: e.g. enhanced farm biosecurity, targeted vaccination, improved market hygiene
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Requires: - Good surveillance -Early detection -Early warning and reporting -Early response
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Requires: - Strong Veterinary Services - Enforceable Laws and Regulations - Public-Private Partnerships - Participatory approaches at the village level (where appropriate)
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Needs more long-term investment and More political and industry commitment to go ….
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From this …..
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….. to this
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And from this ….
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…… to this
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Knowledge of factors leading to infection and persistence of infection is improving, based on experiences and specific epidemiological studies (e.g. role of ducks in Asia) Epidemiological studies in some countries hampered by lack of quality data (veterinary capacity) A number of factors were associated with the emergence of this panzootic: Epidemiological risk factors
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Growth of the global poultry sector Development of poultry numbers, 1998 = 100 Source: FAOSTAT 2004 Poultry meat production, million metric tons
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Sub-clinical infection in ducks
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Local, regional, international trade –Legal –Illegal (most important) Captive wild birds - Falcons? Trade in poultry and other birds Crested Hawk-Eagles confiscated at Brussels International Airport in the hand luggage of a Thai passenger...
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124 680 162 215 337 72 123 121 108 53 49 85 97 66 59 246 281 726 221 134 87 82 177 50 58 190 195 115 84 150 101 Poultry trade flows (GIRA, 2004. Courtesy of Cargill) Globalization
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Complex, poorly regulated market chains
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Cultural practices
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Wild birds Much remains unknown regarding H5N1 and wild birds Evidence that wild birds played some role in spread of viruses (e.g. Mongolia in 2005, Europe in 2006,) Significant potential for cross infection between domestic and wild birds Japan and South Korea in 2006-07? Germany and Czech Republic 2007?
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Google TM
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Genetic variations Genetic variations have occurred but until recently were of limited veterinary significance as these did not impact on control Despite genetic changes, still no evidence of enhanced capacity to infect humans Continuing infection provides opportunities for mutation and reassortment Recent emergence of antigenic variants (e.g. Shanxi, Indonesia?) highlights the need for surveillance and, if necessary, modification of vaccines
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Shanxi/2/06 Clade 3.2 WHO 2007
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2.1 2.2 1 2, 2.2 Various incl. 2.2, 2.3, others 2.3 2.2 1’, 3 Geographic distribution of clades and sub-clades of H5N1 viruses other Genetic information helps to identify links between outbreaks
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Conclusions Improvement of the situation compared with 2004 - More awareness and preparedness - Globally fewer reported outbreaks But the viruses are still entrenched in some countries Leading to introduction or recurrent introduction of the viruses to countries or regions And continuing human risk
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Predictions are difficult but now we better understand many risk factors for infection Trade in domestic poultry and other birds (especially illegal trade) Movement of wild Anatidae Infection in neighbouring country
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It is possible to control and, in some places, eradicate H5N1 But there is no room for complacency Need to improve the prevention system in a sustainable way And more commitment And more investment
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Thank you for your attention
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