OIE National Trainers Course on HPAI Surveillance

of Field Veterinarians and Paraprofessionals

in collaboration with FAO

Shiro YoshimuraJapan/OIE HPAI Special Trust Fund Programme

Coordination OfficeWorld Organization for Animal Health (OIE)

Jakarta, Indonesia29-31 Oct. 2007

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

The OIE’s objectives1. 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

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 OrganizationSPS : 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 )

Outbreaks of HPAI in IndonesiaIndonesia0

20

40

60

80

10

01

20

14

0

Dec-2

003

Feb-

2004

Apr-2

004

Jun-

2004

Aug-2

004

Oct-2

004

Dec-2

004

Feb-

2005

Apr-2

005

Jun-

2005

Aug-2

005

Oct-2

005

Dec-2

005

Feb-

2006

Apr-2

006

Jun-

2006

Aug-2

006

Oct-2

006

Dec-2

006

Feb-

2007

Apr-2

007

No

. o

f O

utb

rea

ks

Starting date Outbreak province No. 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

2005 2006 2007 Total

Cases 20 55 31 106

Deaths 13 45 27 85

h0

200

400

600

800

1000

1200

1400

1600

1800

Dec-03

Feb-04

Apr-04

Jun-04

Aug-04

Oct-

04

Dec-04

Feb-05

Apr-05

Jun-05

Aug-05

Oct-

05

Dec-05

Feb-06

Apr-06

Jun-06

Aug-06

Oct-

06

Dec-06

Feb-07

Apr-07

Cambodia Indonesia Lao Malaysia Myanmar Thailand Vietnam

g

Monthly Cases of Avian Influenza in Human South East Asia

0

2

4

6

8

10

12

14

16

18

20

No

. o

f C

ases

Cambodia Indonesia Laos Thailand Viet Nam

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

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

Why you are so important (1)

UEurope Asia

North America

Africa

Pacific

Oceania

South America

Southeast Asia

CountryProvince Province

Province Province Province Province

Provincial Office

Animal Health Office

Farm Farm

Para-professional Field veterinarian

Why you are so important (2) Farm : clinical check Unusual signs

Diagnosis

　　　　　　　　　　　　　　　　　　　　　　　　　　　 Positive

Control measure

Confirmation of freedom ( Surveillance )

Surveillancefarm farm

Biosecurity for a farm, nearby farms and its region

No infection

No infection

Biosafety for yourself and farmers

Important !Good knowledge of the disease

Animal health guidanceAnimal health guidance

good quality sample& informationReporting

( Passive surveillance ) ( Active surveillance )to locate & Identify the disease

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

Importance we can seein 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 Development5

4

3

2

1

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.

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

Take a watch at HPAI outbreaks in Japan(1)

(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 holderImportance of “public awareness”

Delayed notification ?

Migratory birds ?

Take a watch at HPAI outbreaks in Japan( 2007)

Do not rely on only apparent sings !Case 1 Case 2 Case 3 Case4

Broiler/Layer Broiler Broiler layer LayerNo. of chicken 12,000 52,500 12,000 93,000

No. of houses 3 5 6 1(15)

Infected house 1 1 1 1

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 4 20

D -3 21 2 4 32

D -2 18 12 4 28

D -1 246 243 2 34D-R 500 326 13 23

Clinical Signs

Typical cyanosis, Oedema of the head, depression, nervous

signs

Partly cyanosis Lack of energy, depression

Slight cyanosis, lack

of energy

Battle against HPAICold war(freedom)

Confirm no filtration of HPAICapacity-building, preparedness

Locate enemies of HPAIWipe out all of them

Hot war(outbreak)

Careful surveillance

Public awarenessKids’ participationin the campaign

of anti-drunken driving

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

Vaccination & SurveillanceAvian Influenza Small pox

Range of Susceptible

Animals

Wide

Birds( domesticated or wild )

Narrow

Only human

Efficacy of Vaccine

Less effectiveNo prevention of infection

Masking clinical signsShedding 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 )

Japan/OIE Special Trust Fund Programme for AI Control

Government of Japan OIE Paris (HQ)

National Level

Regional Level

OIE Tokyo

Capacity buildingCapacity building: SoftwareSoftware 　　 ;; Support to •Control Strategy Development, •Capacity building of diagnosis and surveillance, etc.,

•Training for veterinarians and para-professionals on strategic surveillance

HardwareHardware 　 ;; 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

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

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. Communication2. Coordination3. Collaboration4. Cooperation

Top 2 to show our serious involvement

1. Sweat 2. Idea3. ・・・・・・・・・ 4. Budget Mobilization

Working hard sincerely for a community

In Japan

Communication, Discussion& common understanding(1)

a basis for satisfactory achievement

Farm Farm

Farm

Para-professional

Provincial Office

Farm

Farm Farm

Animal Health Office

Field veterinarian

National headquarters

•Samples•Information•proposal

•Samples

•Information

•proposal

•Results

•Information

•Plan & instruction

Communication, Discussion& common understanding (2)

a basis for satisfactory achievement

Sector 1 Sector 2 Sector 3 Sector 4

veterinarian veterinarian

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

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 : oie@oie.inthttp://www.oie.int

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