OIE training workshop on Epidemiology in particular HPAI in Malaysia in collaboration with CIRAD and...

OIE training workshopOIE training workshopon Epidemiology in particular HPAIon Epidemiology in particular HPAI

in Malaysia

in collaboration with CIRAD and Department of Veterinary Services

Shiro Yoshimura

Japan/OIE HPAI Special Trust Fund Programme Coordination Office

Bangkok, Thailand

11 - 15 June 2007

SubjectsSubjectsWhat’s OIE ?What’s OIE ?Epidemiology and Disease ProgrammeEpidemiology and Disease ProgrammeTADs and philosophyTADs and philosophyWhat’s HPAI ?What’s HPAI ?HPAI outbreaks in this regionHPAI outbreaks in this regionAvian Influenza in International Animal HealtAvian Influenza in International Animal Health Code ( you can see what are important in th Code ( you can see what are important in the prevention and control of HPAI. )he prevention and control of HPAI. )Diagnosis Diagnosis Japan/OIE Special Trust Fund Programme for Japan/OIE Special Trust Fund Programme for Highly Pathogenic Influenza Control at SourcHighly Pathogenic Influenza Control at Source in Southeast Asiae in Southeast Asia

The OIEThe OIE

World Organisation for Animal HealthWorld Organisation for Animal Health((OOffice ffice IInternational des nternational des EEpizooties)pizooties)

An intergovernmental organisationAn intergovernmental organisation– operating expenses are paid by member operating expenses are paid by member

country contributionscountry contributions

Founded in 1924 Founded in 1924 167 Member Countries 167 Member Countries ((In May 2006)In May 2006) – Delegates are Chief Veterinary officers (CVO)Delegates are Chief Veterinary officers (CVO)

Headquarters in ParisHeadquarters in Paris

The OIE’s objectivesThe OIE’s objectives1.1. Ensure transparency in global animal health Ensure transparency in global animal health

situationsituation

2.2. Collect, analyse and disseminate veterinary Collect, analyse and disseminate veterinary informationinformation EpidemiologyEpidemiology

3.3. Contribute expertise and encourage coordinated Contribute expertise and encourage coordinated approach to disease outbreaksapproach to disease outbreaks

4.4. Improve veterinary servicesImprove veterinary services

5.5. Within its WTO mandate, safeguard world trade Within its WTO mandate, safeguard world trade through animal health standardsthrough animal health standards

6.6. Animal welfare and animal production food safetyAnimal welfare and animal production food safety


EpidemiologyEpidemiology(definition in a dictionary )(definition in a dictionary )

Study of diseases distribution in populationsStudy of diseases distribution in populations.. It focuses on groups rather than individuals and often It focuses on groups rather than individuals and often takes a historical perspective. takes a historical perspective. Descriptive epidemiology surveys a population to see Descriptive epidemiology surveys a population to see what segments (e.g. age, sex, ethnic group, occupation ) what segments (e.g. age, sex, ethnic group, occupation ) are affected by a disorder, follows changes or variations are affected by a disorder, follows changes or variations in its incidence or mortality over time and in different in its incidence or mortality over time and in different locations, and helps identify syndromes or suggest locations, and helps identify syndromes or suggest associations with risk factors. associations with risk factors. Analytic epidemiology conducts studies to test the Analytic epidemiology conducts studies to test the conclusions of descriptive surveys or laboratory conclusions of descriptive surveys or laboratory observations.observations. Epidemiologic data on diseases is Epidemiologic data on diseases is used to find those at used to find those at high risk, identify causes and take preventive measures, high risk, identify causes and take preventive measures, and plan new health servicesand plan new health services. .

Epidemiology and Epidemiology and Disease ProgrammeDisease Programme

What diseasesWhat diseases infect infectWhenWhenWhere Where How many & what animals How many & what animals

( zoonoses or not ? )( zoonoses or not ? )HowHowWith what consequenceWith what consequence

Basis for prevention & controlBasis for prevention & control

InformationTimelyNo biasPopulation

Good for analysis


TADs and PhilosophyTADs and Philosophy

1.1. TADTAD : Trans-boundary animal diseases : Trans-boundary animal diseases They cross boundaries even though They cross boundaries even though

they do have no feet. Human factors they do have no feet. Human factors tend to be responsible for most of tend to be responsible for most of outbreaks.outbreaks.

2.2. Two-way Two-way : Diseases are coming into and : Diseases are coming into and going out of your country ( concentrate going out of your country ( concentrate on your own prevention & control and on your own prevention & control and assistance to and sharing information assistance to and sharing information with neighbors ).with neighbors ).

3.3. PhilosophyPhilosophy There are proverbsThere are proverbs

East-West Economic Corridor

• that Be kind and sincere to others, and the kindness andthat Be kind and sincere to others, and the kindness and sincerity come back to you from others, andsincerity come back to you from others, and

• that Know yourself and have a good knowledge of an enemy, that Know yourself and have a good knowledge of an enemy, 　　　　　　 you will never lose any battle.you will never lose any battle.


Avian InfluenzaAvian InfluenzaIn International Animal Health CodeIn International Animal Health Code

Definition of the disease : an Definition of the disease : an infectioninfection of poultry c of poultry caused by any influenza A virus of aused by any influenza A virus of

– the the H5H5 or or H7H7 subtypes subtypes

– any AI virusany AI virus with an intravenous pathogenicity with an intravenous pathogenicity index (IVPI) greater than 1.2 or at least 75% moindex (IVPI) greater than 1.2 or at least 75% mortality in 4-to 8-week-old chickens infected intrrtality in 4-to 8-week-old chickens infected intravenouslyavenously

Analysis of the global AI situationAnalysis of the global AI situation

Pandemic potentialPandemic potential

There is a correlation between There is a correlation between high viral load circulating in high viral load circulating in animals and the environmentanimals and the environment and and the potential for a the potential for a dangerous viral re-assortment or mutationdangerous viral re-assortment or mutation..

All countries of the world should have efficient veterinary All countries of the world should have efficient veterinary services in order to services in order to prevent entry of the diseaseprevent entry of the disease, to allow , to allow early detectionearly detection and a and a rapid responserapid response, in collaboration with , in collaboration with partners.partners.

Mechanisms set up to control AI situation are equally Mechanisms set up to control AI situation are equally applicable for the control of other emerging and re-applicable for the control of other emerging and re-emerging animal diseases.emerging animal diseases.

HPAI Disease ProfileHPAI Disease Profile

Repeated outbreaks since late 2003 and Viruses holding Repeated outbreaks since late 2003 and Viruses holding a foothold and circulating, in the Regiona foothold and circulating, in the RegionThreatening risks to human and animal healthThreatening risks to human and animal healthSocio-economic impacts and Spread to new countries Socio-economic impacts and Spread to new countries and re-emerging (including roles of migratory birds)and re-emerging (including roles of migratory birds)Impediment to tradeImpediment to tradeBio-security (animal production systems; backyard, Bio-security (animal production systems; backyard,

wet-markets, multi-species raising, etc.)wet-markets, multi-species raising, etc.)Gaps between legislation and its enforcement (Needs for Gaps between legislation and its enforcement (Needs for Capacity Building and Improvement of relevant Capacity Building and Improvement of relevant infrastructures and resources of National Veterinary infrastructures and resources of National Veterinary Services)Services)Communication with producers and other stakeholdersCommunication with producers and other stakeholdersStrategic vaccination (as a supplementary tool in at-high Strategic vaccination (as a supplementary tool in at-high risk countries)risk countries)

Vaccination Vaccination Avian Influenza SmallpoxAvian Influenza Smallpox

Avian InfluenzaAvian Influenza Small poxSmall pox

Range of Range of SusceptibleSusceptible

AnimalsAnimals

WideWide

BirdsBirds( domesticated or wild )( domesticated or wild )

NarrowNarrow

Only human Only human

Efficacy of Efficacy of VaccineVaccine

Less effectiveLess effectiveNo prevention of infectionNo prevention of infection

Masking clinical signsMasking clinical signs Highly effective Highly effective

Disease Disease management management

policypolicy

Not easy to eradicate Not easy to eradicate without test & cullingwithout test & culling

Focus onFocus on early detection & controlearly detection & control

EradicatedEradicated

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 in which phase to start ? )

Reducing the threat at source Reducing the threat at source to its minimumto 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 as a supplementary measure if necessary

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


Jan-Mar 2005 Apr-June 2005

Jul-Sep 2005 Oct-Dec 2005

Not wind-borne disease

Malaysia

0

1

2

3

4

5

6

7

8D

ec-

03

Fe

b-0

4

Ap

r-0

4

Jun

-04

Au

g-0

4

Oct

-04

De

c-0

4

Fe

b-0

5

Ap

r-0

5

Jun

-05

Au

g-0

5

Oct

-05

De

c-0

5

Fe

b-0

6

Ap

r-0

6

Jun

-06

Au

g-0

6

Oct

-06

De

c-0

6

Fe

b-0

7

Ap

r-0

7

No

. of

Ou

tbre

aks

Malaysia

New outbreak

Epidemiological unit: villageAffected animalsSpecies: birdsSusceptible: 67Cases: 67Deaths: 67

Thailand

0

50

100

150

200

250

300

350

400D

ec-0

3

Jan-

04

Feb

-04

Mar

-04

Apr

-04

May

-04

Jun-

04

Jul-0

4

Aug

-04

Sep

-04

Oct

-04

Nov

-04

Dec

-04

Jan-

05

Feb

-05

Mar

-05

Apr

-05

May

-05

Jun-

05

Jul-0

5

Aug

-05

Sep

-05

Oct

-05

Nov

-05

Dec

-05

Jan-

06

Feb

-06

Mar

-06

Apr

-06

May

-06

Jun-

06

Jul-0

6

Aug

-06

Sep

-06

Oct

-06

Nov

-06

Dec

-06

Jan-

07

Feb

-07

Mar

-07

Apr

-07

May

-07

No

. o

f O

utb

rea

ks

Thailand

Successful control with conventional methods without vaccination

as low as possible No epidemic

as narrow as possibleAs long as possible

No endemic

Better prevention

4 isolated outbreaks

Avian Influenza Situation in Southeast Asia

0

200

400

600

800

1000

1200

1400

1600

1800

De

c-0

3

Fe

b-0

4

Ap

r-0

4

Jun

-04

Au

g-0

4

Oct

-04

De

c-0

4

Fe

b-0

5

Ap

r-0

5

Jun

-05

Au

g-0

5

Oct

-05

De

c-0

5

Fe

b-0

6

Ap

r-0

6

Jun

-06

Au

g-0

6

Oct

-06

De

c-0

6

Fe

b-0

7

Ap

r-0

7

No

. o

f O

utb

rea

ks

Cambodia Indonesia Lao Malaysia Myanmar Thailand Vietnam

Avian Influenza Situation in Southeast Asia

Monthly Cases of Avian Influenza in Human South East Asia

0

2

4

6

8

10

12

14

16

18

20

Jan-

04

Feb

-04

Mar

-04

Apr

-04

May

-04

Jun-

04

Jul-0

4

Aug

-04

Sep

-04

Oct

-04

Nov

-04

Dec

-04

Jan-

05

Feb

-05

Mar

-05

Apr

-05

May

-05

Jun-

05

Jul-0

5

Aug

-05

Sep

-05

Oct

-05

Nov

-05

Dec

-05

Jan-

06

Feb

-06

Mar

-06

Apr

-06

May

-06

Jun-

06

Jul-0

6

Aug

-06

Sep

-06

Oct

-06

Nov

-06

Dec

-06

Jan-

07

Feb

-07

Mar

-07

Apr

-07

May

-07

Jun-

07

No

. o

f C

ases

Cambodia Indonesia Laos Thailand Viet Nam

Vietnam:Feb

Vietnam:Jan.

Vietnam:Mar.

Vietnam:Jun.

Indonesia:Feb.

Indonesia:May

Indonesia:May

Indonesia:Aug.-Sep.

LaoPDR:Jan.

Monthly cases of Avian Influenza in Human ( Southeast Asia )

Thailand:Feb.

Vietnam,Thailand:Sep.Indonesia:Nov.

Lessons to be learnt from Lessons to be learnt from

Japanese case of HPAIJapanese case of HPAI (2004 to 2007)(2004 to 2007)

Feb. 2004Kyoto

2 cases(225,000&15,000birds)

Feb. 2004Oita

1 case(14birds)

Jan. 2004Yamaguchi

1 case(35,000birds)

Jan. 2007Miyazaki

3 cases (12,000, 52,500 & 93,000birds)

Jan. 2007Okayama

1 case(12,000birds)

Notification from a small holder

Delayed notification ?

Migratory birds ?

HPAI outbreaks in Japan, 2007HPAI outbreaks in Japan, 2007Case 1Case 1 Case 2Case 2 Case 3Case 3 Case4Case4

Broiler/LayerBroiler/Layer BroilerBroiler BroilerBroiler layerlayer LayerLayer

No. of chicken No. of chicken 12,00012,000 52,50052,500 12,00012,000 93,00093,000

No. of houses No. of houses 33 55 66 1(15)1(15)

Infected house Infected house 11 11 11 11

Distribution of Distribution of dead chicken dead chicken

evenlyevenly At the At the centercenter

In the In the corner at corner at the endthe end

In the southIn the south

No. of dead No. of dead chicken/daychicken/day

D-D-RR 500500 326326 1313 2323

D-1D-1 246246 243243 22 3434

D-2D-2 1818 1212 44 2828

D-3D-3 2121 22 44 3232

D-4D-4 44 33 44 2020

Clinical SignsClinical Signs

Typical cyanosTypical cyanosis, Oedema of tis, Oedema of the head, deprehe head, depression, nervous ssion, nervous

signssigns

Partly cyanosisPartly cyanosis Lack of energy, Lack of energy, depressiondepression

Slight Slight cyanosis, lack cyanosis, lack

of energyof energy


Avian InfluenzaAvian InfluenzaIn International Animal Health Code(1)In International Animal Health Code(1)

Definition of the disease : an Definition of the disease : an infectioninfection of poultry c of poultry caused by any influenza A virus of aused by any influenza A virus of

– the the H5H5 or or H7H7 subtypes subtypes

– any AI virusany AI virus with an with an intravenous pathogenicity intravenous pathogenicity index (IVPI) greater than 1.2index (IVPI) greater than 1.2 or or at least 75% moat least 75% mortality in 4-to 8-week-old chickens infected intrrtality in 4-to 8-week-old chickens infected intravenouslyavenously


CriteriaCriteria for the NAI (notifiable Avian Influenza )status of a for the NAI (notifiable Avian Influenza )status of a coucountryntry, a , a zonezone or a or a compartmentcompartment

the outcome of a the outcome of a risk assessmentrisk assessment identifying all potenti identifying all potential factors for NAI occurrence and their historic perspecal factors for NAI occurrence and their historic perspective;tive;

NAI is NAI is notifiablenotifiable in the whole country, an on-going NAI in the whole country, an on-going NAI awareness programmeawareness programme is in place, and all notified susp is in place, and all notified suspect occurrences of NAI are subjected to ect occurrences of NAI are subjected to field andfield and, wher, where applicable, e applicable, laboratory investigationslaboratory investigations;;

appropriate appropriate surveillancesurveillance is in place to demonstrate the is in place to demonstrate the presence of infection in the absence of clinical signs in presence of infection in the absence of clinical signs in poultry, and the risk posed by birds other than poultry; poultry, and the risk posed by birds other than poultry; this may be achieved through an NAI surveillance progthis may be achieved through an NAI surveillance programme in accordance with Appendix ramme in accordance with Appendix 3.8.9.3.8.9.

http://www.oie.int/eng/normes/mcode/en_chapitre_1.1.1.htm#terme_zone_region

http://www.oie.int/eng/normes/mcode/en_chapitre_1.1.1.htm#terme_compartiment

http://www.oie.int/eng/normes/mcode/en_chapitre_1.1.1.htm#terme_appreciation_du_risque

http://www.oie.int/eng/normes/mcode/en_chapitre_3.8.9.htm#chapitre_3.8.9.


NAI free country, zone or compartmentNAI free country, zone or compartment

A A countrycountry, , zonezone or or compartmentcompartment may be considered free from may be considered free from NAI when it has been shown that NAI when it has been shown that neither HPNAI nor LPNAI neither HPNAI nor LPNAI infectioninfection has been has been presentpresent in the country, zone or in the country, zone or compartment compartment for the past 12 monthsfor the past 12 months, based on surveillance , based on surveillance in accordance with Appendix 3.8.9.in accordance with Appendix 3.8.9.

Regaining of NAI free statusRegaining of NAI free status by a previously free by a previously free country, zone or compartmentcountry, zone or compartment

In the case of HPNAI infections, In the case of HPNAI infections, 3 months after a 3 months after a stamping-stamping-

outout policy policy (including disinfection of all affected (including disinfection of all affected establishments) is applied, providing that establishments) is applied, providing that surveillancesurveillance in in accordance with Appendix 3.8.9. has been carried out during accordance with Appendix 3.8.9. has been carried out during that three-month periodthat three-month period..

http://www.oie.int/eng/normes/mcode/en_chapitre_1.1.1.htm#terme_zone_region

http://www.oie.int/eng/normes/mcode/en_chapitre_1.1.1.htm#terme_compartiment

Importance for the prevention Importance for the prevention and control of HPAI indicated and control of HPAI indicated

by OIE Codeby OIE Code < requirements to demonstrate past 12 month < requirements to demonstrate past 12 month

freedom, or 3 month freedom after a stamping-out >freedom, or 3 month freedom after a stamping-out >

Improvement of strategies, laws / regulations Improvement of strategies, laws / regulations Measures to enable stamping-outMeasures to enable stamping-outDiagnostic capacity buildingDiagnostic capacity buildingSurveillanceSurveillanceProvision of necessary materialsProvision of necessary materialsTraining & review for immediate responseTraining & review for immediate responseCoordination & cooperationCoordination & cooperation

＊　＊　 With Other ministries, local governments With Other ministries, local governments 　　　＊　　　　＊　 With farmers & consumers ( public awareness )With farmers & consumers ( public awareness )


DiagnosisDiagnosis

What are important ?What are important ?AccurateAccurateLess time consumingLess time consuming

Diagnosis of Avian InfluenzaDiagnosis of Avian Influenza(1) (1) Assessment of pathogenicityAssessment of pathogenicity

A HPAI virus is defined as one of the two following metA HPAI virus is defined as one of the two following methods in terms of pathogenicity in chickens.hods in terms of pathogenicity in chickens.

①① Any influenza virus that is Any influenza virus that is lethal for six (75%),lethal for six (75%), seve seven or eight of eight 4-to 8 week old susceptible chicn or eight of eight 4-to 8 week old susceptible chickens within 10 days following intravenous inoculatikens within 10 days following intravenous inoculation with 0.2ml of a 1/10dilution of a bacteria-free, infon with 0.2ml of a 1/10dilution of a bacteria-free, infective allantoic fluid.ective allantoic fluid.

②② Any virus that has an intravenous pathogenicity inAny virus that has an intravenous pathogenicity index (IVPI) dex (IVPI) greater than 1.2greater than 1.2 as a result of as a result of

i) intravenous injection of fresh infective allantoic i) intravenous injection of fresh infective allantoic fluid to ten 6-week-old SPF or SNA chickens, fluid to ten 6-week-old SPF or SNA chickens,

ii) clinical assessment at 24-hour intervals and scoii) clinical assessment at 24-hour intervals and scoring clinical signs of each chicken ( 1: sick, 2: severing clinical signs of each chicken ( 1: sick, 2: severely sick, 3: dead, IVPI is the mean score per bird prely sick, 3: dead, IVPI is the mean score per bird per observation over the 10-day period.) er observation over the 10-day period.)

Diagnosis of Avian InfluenzaDiagnosis of Avian Influenza(2) (2) Serological testsSerological tests

Agar gel immunodiffusion testAgar gel immunodiffusion testHaemagglutination and haemagglutination Haemagglutination and haemagglutination inhibition testsinhibition testsELISA testELISA test

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

SubjectsSubjectsWhat’s OIE ?What’s OIE ?Epidemiology and Disease ProgrammeEpidemiology and Disease ProgrammeTADs and philosophyTADs and philosophyWhat’s HPAI ?What’s HPAI ?HPAI outbreaks in this regionHPAI outbreaks in this regionAvian Influenza in International Animal HealtAvian Influenza in International Animal Health Code ( you can see what are important in th Code ( you can see what are important in the prevention and control of HPAI. )he prevention and control of HPAI. )DiagnosisDiagnosis Japan/OIE Special Trust Fund Programme for Japan/OIE Special Trust Fund Programme for Highly Pathogenic Influenza Control at SourcHighly Pathogenic Influenza Control at Source in Southeast Asiae in Southeast Asia

Activities of the Programme (OIE component)Activities of the Programme (OIE component)

To encourage the improvement of To encourage the improvement of regional and national regional and national HPAI control strategiesHPAI control strategies including the development of co including the development of contingency plansntingency plans

To collect, analyze and disseminate To collect, analyze and disseminate Technical informatiTechnical informationon to further strengthen regional early warning systems to further strengthen regional early warning systems

To strengthen To strengthen diagnostic capacitydiagnostic capacity of regional collaboratin of regional collaborating laboratories and national reference/diagnostic laboratorg laboratories and national reference/diagnostic laboratories for HPAI including the holding of ies for HPAI including the holding of training coursestraining courses on on advanced HPAI diagnosisadvanced HPAI diagnosis and and installment of high perforinstallment of high performance diagnostic equipment and materialsmance diagnostic equipment and materials

To hold To hold training courses for field veterinarianstraining courses for field veterinarians and and para-para-professionalsprofessionals on HPAI strategic surveillance on HPAI strategic surveillance

BudgetBudget: About 8 million US$: About 8 million US$

Japan/OIE Special Trust Fund ProgrammJapan/OIE Special Trust Fund Programme for AI Controle for AI Control

Government of Japan OIE Paris (HQ)

National Level

Regional Level

OIE Tokyo

Capacity buildingCapacity 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

Thank you for your attention

World Organisation for Animal HealthWorld Organisation for Animal Health

12 rue de Prony75017 Paris, FranceTel: 33 (0)1 44 15 18 88 Fax: 33 (0)1 42 67 09 87Courriel : [email protected]://www.oie.int

Contact for more information

mailto:[email protected]

http://www.oie.int/

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OIE training workshop on Epidemiology in particular HPAI in Malaysia in collaboration with CIRAD and...

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