Presentation at 3rd GRF One Health Summit 2015 Session Case Studies of Integrative Health Risk Management

1. Yannick GARDIN & Marcelo PANIAGO
Ceva Santé Animale
Libourne - France
3rd GRF One Health Summit 2015
Davos, Switzerland – Oct 04-06, 2015

2. How to look at Avian Influenza ?
…until 2004
Avian Influenza was an Avian disease

3. How to look at Avian Influenza ?
From 2004 onwards…

4. How to look at Avian Influenza ?
From 2004 onwards…
Human Doctors & Scientists
Veterinary Scientists
…relayed and amplified by the Media
Avian Influenza became a Human drama…

5. How to look at Avian Influenza ?
The expected source of a pandemia
From drama to dogmas…

6. The dogmas
« the question was not if, but when ? »
All H5 and H7 AIVs (LP & HP) are dangerous
LPAIV  HPAIV (H5 & H7)
More fatalities  higher risk of human to human transmission
Human to human transmission  Pandemia
Close contact between bird and humans  fatalities

7. The dogmas
But some countries decided to vaccinate…
Any poultry positive for H5 or H7, LP or HP, must be destroyed
All imports from an AI+ country should be banned
Only bio-security is efficacious
Old style farming and live bird markets must disappear
« And when it came to controlling the disease,
dogmas were still there »
Vaccination is not an option !

8. Vaccination against Avian Influenza
HPAIV
Challenge
INFECTION
DISEASE
SHEDDING
SPREADING

9. Vaccination against Avian Influenza
HPAIV
Challenge
INFECTION
DISEASE
SHEDDING
SPREADING
With vaccination
Increased resistance
Protection
against
clinical
losses
Reduction of
oral & cloacal
shedding
Reducing / prevention of spreading

10. Vaccination against Avian Influenza
Some countries decided to vaccinate…
and ten years after, they are still vaccinating.

11. Why is vaccination not an option?
Vaccine must be constantly updated to keep its efficacy
Vaccine take is impaired in MDA+ birds
Vaccination must be at farm = poor coverage
Immunity is short lasting and boosting is necessary
DIVA cannot be applied to vaccinated populations
Vaccination doesn’t lead to eradication (Mexico, China, etc.)
With classical inactivated vaccines

12. Why is vaccination not an option?
Vaccine must be constantly updated to keep its efficacy
Vaccine take is impaired in MDA+ birds
Vaccination must be at farm = poor coverage
Immunity is short lasting and boosting is necessary
DIVA cannot be applied to vaccinated populations
Vaccination doesn’t lead to eradication (Mexico, China, etc.)
With rHVT-H5 vaccine
Why
not ?
Cross-clade protection
Breaks through MDA
Hatchery vaccination
1 injection – life long protection
DIVA can be applied

13. Performances of rHVT-H5 vaccine
MDA Status
% protection / challenge H5N1 (cl. 2.2) HPAIV
Controls rHVT-H5 Vaccinated
Challenge at 14 days
MDA - 0 % 100 %
MDA + 20 % 100 %
Challenge at 21 days
MDA + 0 % 100 %
(J. De Vriese et al. AI Symposium, Athens GA, USA, April 5-7, 2009)
Onset of Immunity

14. Performances of rHVT-H5 vaccine
Broad spectrum of protection (H5)
Vaccine
regimen
% protection / challenge
with Egyptian H5N1 HPAIV
2007 (cl. 2.2.1)
No vaccine
Inactivated H5N2
rHVT-H5
(J Rauw et al. Vaccine, 29: 2590-2600, 2011)

15. Performances of rHVT-H5 vaccine
Broad spectrum of protection (H5)
Vaccine
regimen
% protection / challenge
with Egyptian H5N1 HPAIV
2007 (cl. 2.2.1)
No vaccine 0%
Inactivated H5N2 100%
rHVT-H5 100%
(J Rauw et al. Vaccine, 29: 2590-2600, 2011)

16. Performances of rHVT-H5 vaccine
Broad spectrum of protection (H5)
Vaccine
regimen
% protection / challenge
with Egyptian H5N1 HPAIV
2007 (cl. 2.2.1) 2008 (cl. 2.2.1.1)
No vaccine 0%
Inactivated H5N2 100%
rHVT-H5 100%
(J Rauw et al. Vaccine, 29: 2590-2600, 2011)

17. Performances of rHVT-H5 vaccine
Broad spectrum of protection (H5)
Vaccine
regimen
% protection / challenge
with Egyptian H5N1 HPAIV
2007 (cl. 2.2.1) 2008 (cl. 2.2.1.1)
No vaccine 0% 0%
Inactivated H5N2 100% 0%
rHVT-H5 100% 100%
(J Rauw et al. Vaccine, 29: 2590-2600, 2011)

18. Performances of rHVT-H5 vaccine
« Cross-clade » efficacy
(Gardin et al. 9th ISAI, Athens, GA, USA, 2015)
HVT AIV Strain S.type Clade Vaccinated Not vaccinated Reference
SPF CK No No A/CK/Viet Nam/1203/2004 H5N1 1 4 woa 85% 0% Perez D. 2012
COM BR Yes No A/Duck/Hungary/11804/2006 H5N1 2.2 2 woa 90% 0% De Vriese J. et al. 2009
COM BR Yes Yes (H5N2) A/Duck/Hungary/11804/2006 H5N1 2.2 2 woa 100% 20% De Vriese J. et al. 2009
COM BR Yes Yes (H5N2) A/Duck/Hungary/11804/2006 H5N1 2.2 3 woa 90% 0% De Vriese J. et al. 2009
SPF CK No No A/CK/Egypt/1709-1 VIR08/2007 H5N1 2.2.1 3 woa 100% 0% Rauw F. et al. 2011
SPF CK No No A/CK/Egypt/1709-6/2008 H5N1 2.2.1 3 woa 100% 0% Rauw F. et al. 2011
COM BR Yes No A/CK/Egypt/1709-6/2008 H5N1 2.2.1 4 woa 90% 0% Rauw F. et al. 2012
COM BR Yes Yes (H5N1) A/CK/Egypt/1709-6/2008 H5N1 2.2.1 4 woa 100% 0% Rauw F. et al. 2012
COM BR Yes Yes (H5N1) A/CK/Egypt/1709-1 VIR08/2007 H5N1 2.2.1 4 woa 90% 0% Rauw F. et al. 2012
COM BR Yes Yes (H5N1) A/CK/Egypt/1709-6/2008 H5N1 2.2.1 4 woa 70% 0% Rauw F. et al. 2012
COM BR Yes Yes (H5N1) A/CK/West Java Subang/29/2007 H5N1 2.1.3 4 woa 80% 0% Soejoedono R. D. et al. 2012
COM BR Yes Yes (H5N1) A/CK/Puwakarta-Cilingga/142/2010 H5N1 2.1.3 4 woa 95% 0% Soejoedono R. D. et al. 2012
SPF CK No No A/Whooper Swan/Mongolia/3/2005 H5N1 2.2 6 woa 100% 0% Kapczynski D.R. et al. 2015
SPF CK No No A/CK/West Java Subang/29/2007 H5N1 2.1.3 4 woa 80% 0% Kapczynski D.R. et al. 2015
SPF CK No No A/CK/Queretaro/14588/1995 H5N2 - 4 woa 95% 0% Kapczynski D.R. et al. 2015
SPF CK No No A/CK/Egypt/1709-6/2008 H5N1 2.2.1 4 woa 100% 0% Rauw F. et al. 2012
SPF CK No No A/CK/Egypt/1709-6/2008 H5N1 2.2.1 8 woa 100% 0% Rauw F. et al. 2012
COM BR Yes Yes (H5N1) A/CK/Egypt/1709-6/2008 H5N1 2.2.1 4 woa 93% 0% Kilany W. H. et al. 2012
COM BR Yes Yes (H5N1) A/CK/Egypt-63/2010 "variant" H5N1 2.2.1.1 5 woa 80% 0% Kilany W. H. et al. 2012
SPF CK No No A/CK/Germany/2014 H5N8 2.3.4.4 4 woa 100% 0% Steensels M. et al. 2015
SPF CK No No A/CK/Bangladesh/11RS1 984-33/2011 H5N1 2.3.2.1 4 woa 100% 0% Bonfante F. et al. 2013
COM LY Yes Yes (H5N1) A/CK/Egypt/128s/2012 H5N1 2.2.1 19 woa 73% 0% Kilany W. H. et al. 2014
COM LY Yes Yes (H5N1) A/CK/Egypt/128s/2012 H5N1 2.2.1 19 woa 60% 0% Kilany W. H. et al. 2014
SPF TK No No A/WS/Mongolia/2005 H5N1 2.2 4 woa 96% 0% Kapczynski et al. 2012
Challenge
at:
HPAIV used for challengeType of
bird
with MDA against: % Protection

19. Performances of rHVT-H5 vaccine
+H5N2 1994 Mexico
Protection ≥ 80%
Significant
reduction of
shedding
Cross clade
efficacy
of
rHVT-H5
Vietnam 2004
Mongolia 2005
Egypt 2008
Indonesia 2007
Bangladesh 2011
Hungary 2006
Egypt 2010
Indonesia 2010
Egypt 2008
Egypt 2011
Germany 2014

20. 3rd GRF One Health Summit 2015
Davos, Switzerland – Oct 04-06, 2015

21. Conclusions
As of today, the attitude is “wait and see”. If there is
a break, we must:
- Detect it very fast
- And stamp out everything.
But doing so:
- we accept the initial explosion
- we take the risk of slow detection, spreading
over to other units, getting the situation uncontrolled

22. Conclusions
If we vaccinate, this contamination may also happen
but:
- the probability is lower
- the amount of virus released into the
environment will be much lower
- the risk of spreading to other units will be less
- and risk of contact to humans will be reduced

23. Conclusions
So in brief, there are two options:
- do not vaccinate, let the nature do what it
wants, wait and see, and take high risks.
- vaccinate, implement systematic lab
monitoring, detect and stamp out when something
happen. The risk of break will be lower as well as the
consequences and risks for animals and humans as
well.

24. Food for thoughts
Any proposal to change the status
quo or to overcome old dogmas may
be initially seen as "unwise”, but in
the face of Avian Influenza’s current
situation, it is absolutely needed to
discuss with open minds some
alternatives to fight this disease.

25. 3rd GRF One Health Summit 2015
Davos, Switzerland – Oct 04-06, 2015
marcelo.paniago@ceva.com