1. OIE National Trainers Course on HPAI Surveillance of Field Veterinarians and Paraprofessionals in collaboration with FAO Shiro Yoshimura Japan/OIE HPAI Special Trust Fund Programme Coordination Office World Organization for Animal Health (OIE) Jakarta, Indonesia 29-31 Oct. 2007

2. The OIE World Organisation for Animal Health ( Office International des Epizooties ) ( WHO is the equivalent organization for Human Health in UN. ) An intergovernmental organisation –operating expenses are paid by member country contributions Founded in 1924 169 Member Countries (In May 2007) –Delegates are Chief Veterinary officers (CVO) Headquarters in Paris

3. The OIE’s objectives 1. Ensure transparency in global animal health situation 2. Collect, analyse and disseminate veterinary information Epidemiology 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

4. WTO & OIE DEFINITIONS: International standards, guidelines and recommendations prepared by relevant international Organizations for animal health and zoonoses : the standards, guidelines and recommendations developed under the auspices of the International Office of Epizootics ( OIE ) WTO : World Trade Organization SPS : Sanitary phytosanitary ANNEX A Members shall base their sanitary or phytosanitary measures on international standards, guidelines or recommendations, where they exist SPS Agreement Article 3 ( Harmonization )

5. Outbreaks of HPAI in Indonesia Starting dateOutbreak provinceNo. of susceptible 10 Jul. 2006 Irian Jaya 9,000 10 Jul. 2006 Irian Jaya 13,000 10 Jul. 2006 Irian Jaya 13,000 10 Jul. 2006 Irian Jaya 13,000 9 Aug. 2006 Irian Jaya 1,000 28 Aug. 2006 Sulawesi Utara 5,000 200520062007Total Cases205531106 Deaths134527 85

6. h g HPAI among poultry and human No seasonality It seems that HPAI virus circulates throughout the year even without appearance of the disease Gaps between the 2 graphs as a problem Indicating the importance of Public awareness, quality surveillance and quick reliable diagnosis

7. Primary known exposures associated with infected birds Unprotected handling Sharing living areas

8. Why you are so important (1) U EuropeAsia North America Africa Pacific Oceania South America Southeast Asia Country Province Provincial Office Animal Health Office Farm Farm Para-professional Field veterinarian

9. Why you are so important (2) Farm : clinical check Unusual signs Diagnosis Positive Control measure Confirmation of freedom ( Surveillance ) Surveillance farm Biosecurity for a farm, nearby farms and its region No infection Biosafety for yourself and farmers Important ! Good knowledge of the disease Animal health guidance good quality sample & information Reporting ( Passive surveillance ) ( Active surveillance ) to locate & Identify the disease

10. Why you are so important (3) Animal health work So-called Kiken Dangerous 3 K job Kitanai Dirty Kitsui Hard work Contributing to Animal health Safe quality products Economy of farmers & a community Public Health In Japan

11. Importance we can see in WHO Strategic Action Plan “Pandemic Influenza” Strengthen Early Warning system Reduce Human Exposure to H5N1 virus Intensify Rapid Containment operations Build Capacity to cope with pandemic Coordinate Global Scientific Research and Vaccine Development 5 4 3 2 1

12. 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.

13. Clinical sings of HPAI Take sharp watch at production parameters to be monitored : increased mortality, reduced feed and water consumption, a drop in egg production Sudden death without clinical signs, a few deaths may occur over several days, followed by a rapid rise in mortality resulting in the death of the majority of the flock Swelling of the wattles Blue discolored comb of an infected chicken on the left compared to a normal chicken on the right Congestion and blood spots on the skin of hocks and shanks HPAI - Opened swollen wattle

14. Take a watch at HPAI outbreaks in Japan(1) (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 3 cases ( 12,000, 52,500 & 93,000birds ) Jan. 2007 Okayama 1 case( 12,000birds ) Notification from a small holder Importance of “public awareness” Delayed notification ? Migratory birds ?

15. Take a watch at HPAI outbreaks in Japan ( 2007) Do not rely on only apparent sings ! Case 1Case 2Case 3Case4 Broiler/LayerBroiler layerLayer No. of chicken12,00052,50012,00093,000 No. of houses3561(15) Infected house1111 Distribution of dead chicken evenly At the center In the corner at the end In the south No. of dead chicken/day D -4 4 3 420 D -3 21 2 432 D -2 18 12 428 D -1246243 234 D-R5003261323 Clinical Signs Typical cyanosis, Oedema of the head, depression, nervous signs Partly cyanosisLack of energy, depression Slight cyanosis, lack of energy

16. Battle against HPAI Cold war (freedom) Confirm no filtration of HPAI Capacity-building, preparedness Locate enemies of HPAI Wipe out all of them Hot war (outbreak) Careful surveillance Public awareness Kids’ participation in the campaign of anti-drunken driving

17. Learn from FMD in 2001 UK 2030 cases with 6 million animals culled The epidemic due to the following factors  A delay in reporting suspicion of disease in pigs  Airborne infection of sheep on a premises nearby to the index case  Movement of infected sheep  The above events took place at a time of year when the climate favored virus survival and when large numbers of sheep were being marketed and move around the country.  Subsequent wide spread from the firstly confirmed case at the abattoir Biosecurity  Keep yourself clean  Clean and disinfect your vehicle before entering and leaving farms  Advices to farmers Keep poultry separate Keep a farm secure Avoid visiting other farms

18. Vaccination & Surveillance Avian InfluenzaSmall pox Range of Susceptible Animals Wide Birds ( domesticated or wild ) Narrow Only human Efficacy of Vaccine Less effective No prevention of infection Masking clinical signs Shedding virus Highly effective Disease management policy Not easy to eradicate without test & culling Focus on higher coverage, 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 entry and exit policy )

19. 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 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

20. Major Equipments for the Laboratories Centrifuge, Incubator, Supplementary Equipment, Reagents, Etc. Cycler for Real-Time PCR Sequencer (for central ref. lab) Biosafety Cabinet C II Review of Lab Equipment of Respective Laboratories Identification of the Equipment and Materials Distribution/Installment of the Equipment for the Laboratories 10

21. For better achievement Animal health work So-called Kiken Dangerous 3 K job Kitanai Dirty Kitsui Hard work Contributing to Animal health Safe quality products Economy of farmers & a community Public Health 4 words starting with “co” for better job 1.Communication 2.Coordination 3.Collaboration 4.Cooperation Top 2 to show our serious involvement 1.Sweat 2.Idea 3. ・・・・・・・・・ 4.Budget Mobilization Working hard sincerely for a community In Japan

22. Communication, Discussion & common understanding(1) a basis for satisfactory achievement Farm Para-professional Provincial Office Farm Animal Health Office Field veterinarian National headquarters Samples Information proposal Samples Information proposal Results Information Plan & instruction

23. Communication, Discussion & common understanding (2) a basis for satisfactory achievement Sector 1Sector 2Sector 3Sector 4 veterinarian Para-professional Much more careful farm-visit Sample and results to be returned Information exchange Discussion & guidance Not one way ! But both ways ! Good coordination

24. 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 Visit for more information