At the invitation of DG SANCO, EFSA participated in the context of the Shanghai Expo 2010 in China to the Sino-European Food Safety Cooperation Forum, to the Seminar on Research for Healthy life and to the Securing Food Safety for a Healthy Life Day from 4 to 11 June. Former Chief Veterinary Officer of FAO, Mr. Joseph Domenech delivered a lecture on Animal Health Crisis Management in with respect to Avian Influenza Control in Asia. The event was organised as part of the Better Training for Safer Food programme, which aims to train staff in Member States and Third Countries in official controls on food. The forum provided presentations and lectures by staff of the European Commission, the European Food Safety Authority and Member States. Lectures were also given by representatives of the Chinese General Administration for Quality Supervision, Inspection and Quarantine (AQSIQ), the Ministry of Health, and the Ministry of Agriculture.

1. Sino-European Food Safety
Cooperation Forum
Shanghai, 07-11 June 2010
Animal Health Crisis Management
Avian Influenza Control
Mr. Joseph Domenech

2. An unprecedented crisis
A complex epidemiology
Socio economic impacts
A major human risk

3. Importance of the crisis
Destruction of assets :
Over 300 million poultry have died
Market shocks:
Fears of consumers drive down demand
Import bans
Poultry prices: increased or decreased
Global trade: winners and losers
Substitution effects with
alternative proteins
Internationally 2004-05,
8% decline in global
poultry trade.
Shift in export of major players
(FAO projections March 2006)
0
2
4
6
8
10
2003 2004 2005 2006r
Milliontonnes
Europe
Asia
South America
North America

4. Livelihood impacts of disease
and control programmes
• Killing birds: compensation needed
• Restriction of movement and sales: smallholders
recover slowly and lose market share
• Loss of income for food, education of children and
other household expenses...
• Changes to the structure of poultry market chains
• Gender issue: poultry often owned and managed
by women

5. A(H1N1) A(H2N2) A(H3N2)
1918: “Spanish Flu” 1957: “Asian Flu” 1968: “Hong Kong Flu”
20-40 million deaths 1-4 million deaths 1-4 million deaths
Credit: US National Museum of Health and Medicine
Human health dimension
The risk of a human pandemic

6. Biodiversity issue
Possible losses of valuable
local breeds due to
- Control methods (culling)
- Restructuring of the poultry production sector
More big commercial farms
Marginalization of small/village backyard holders
- Genetic resistance issue

7. RESERVOIRS
DEAD-END
hosts
SPILLOVER
GENE POOL
??
Epidemiology of H5N1
A complex cycle

8. Resistance of HPAI virus in the
environment & indirect
transmission

9. Specific role of
duck farming systems in
Asia
Sub-clinical infection in ducks

10. Identification of risk factors
Weak economies and animal health services
Poultry production systems
Movements
Live bird markets
Cultural practices
Wild birds

11. ESTIMATED DISTRIBUTION OF POULTRY (SOURCE: FAO)

12. Production systems

13. 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
Trade

14. • Local, regional, international trade
– legal
– Illegal
• Captive wild
birds
Crested Hawk-Eagles
confiscated at Brussels
International Airport in the
hand luggage of a Thai
passenger...

15. Live bird markets: mixing species poorly regulated

16. Movements of animals

17. Cultural practices

18. Wild bird migrations
Northern Pintail ringing recoveries
What is the role of wild birdsWhat is the role of wild birds
Victim or the problem ?
Sentinel or spreader ?
Reservoir of virus?

19. Lake Quinghai
China
15 April 2005
– Bar headed goose
– Great Cormoran
– Goéland ichthyaète
– Brown headed gull
– Tadorne casarca
>519 morts
(Marc Artois)

20. August 2005
Ducks, Geese
and Swans
100 deaths
Husvel/Bulgan.
Mongolia

21. Original focu
An alarming spread westwardsAn alarming spread westwards
New areas affectedNew areas affected

24. Emergence
Due to complex and numerous factors
- Globalisation of exchanges
- Climate changes
- Demography, urbanisation
- Intensification of the production
- Evolution of ecosystems…

25. Livestock Production
systems
Human behaviour
Virus eco-
epidemiology
Pandemic
threat
Pandemic
threat Goose/GD/96
(China, Guandong, 1996)
W
eak Veterinary Services
Wild birds: reservoir
or victim?
EMERGENCE OF HPAI IN ASIA

26. Virus genetic and antigenic evolution
– Gs/GD/1/96 virus has evolved during the last 10 years
resulting in 10 HA clades in this lineage.
– Clade 2 virus has become the dominant one since 2005 in
Southeast Asia as well as in the world
– Only clade 2.2 is found outside of Southeast Asia while 2.2 is
not common in this region.
– It is also changing antigenically while antigenicity of classic
H5N1 viruses were quite stable
With few exceptions like in China and Indonesia, with an
impact on vaccine efficacy
Where is this evolution going
and what will its impact be?

27. ck/Nongkhai/NIAH400802/07ck/TH/NP172/06Guangzhou/1/06JapaneseWhiteEye/HK/1038/06
Anhui/1/05dk/Laos/3295/06ck/Malaysia/935/06commonmagpie/HK/645/06Zhejiang/16/06JapaneseWhiteEye/HongKong/73720/07WhiteBackedMunia/HongKong/82820/07
Guangxi/1/05dk/Guiyang/3009/05dk/Guiyang/3242/05gs/Guiyang/3422/05ck/Guiyang3/055/05gs/Yunnan/4494/05
gs/Guangxi/3017/05gs/Guangxi/345/05gs/Guangxi/3316/05dk/Hunan/127/05dk/Hunan/149/05dk/Hunan/152/05dk/Hunan/139/05 Egypt/0636NAMRU320/07Egret/Egypt/1162NAMRU3/06dk/Egypt/22533/06Egypt/14724NAMRU320/06turkey/Turkey1//05WhooperSwan/Mongolia/244/05Nigeria/6e20/07ck/Nigeria/641/06Turkey/15/06Iraq/207NAMRU3/06Azerbaijan/001161/06ck/Krasnodar/01/06swan/Iran/754/06ck/Liaoning/23/05Barhdgs/Qinghai12/05Barhdgs/Qinghai1A/05ck/Kyoto/3/04crow/Kyoto/53/04ck/Yamaguchi/7/04
ck/Korea/ES/03dk/Guangxi/13/04
ck/YN/115/04ck/YN/374/04 Indonesia/CDC1046/07Indonesia/CDC103220/07Indonesia/CDC938/06Indonesia/CDC887/06Indonesia/CDC1047/07
Indonesia/283H/06Indonesia/326N/06Indonesia/CDC742/06Indonesia/370E/06Indonesia/5/05Indonesia/CDC940/06
Indonesia/546bH/06Indonesia/596/06Indonesia/599/06Indonesia/625/06dk/Indonesia/MS/04ck/Indonesia/4/04ck/Indonesia/11/03
ck/Indonesia/7/03VN/JP14/05
ck/Cambodia/013LC1b/05VN/1194/04
VN/1203/04
VN/HN3/0408/05TH/16/04 TH/676/05
VN/JPHN30321/05HK/213/03ck/Henan/16/04ck/Henan/01/04ck/Henan/13/04
ck/Henan/12/04dk/Guangxi/50/01ck/HK/YU777/02 ck/HK/YU22/02migdk/Jiangxi1653/05
dk/Guangxi/2775/05ck/Hunan/41/04blbird/Hunan1/04treesparrow/Henan/4/04dk/Hubei/wg/02sw/Anhui/ca/04 dk/Guangxi/1378/04dk/Guangxi/1681/04dk/Guangxi/1311/04dk/Guangxi/2396/04ck/Hunan/2292/06ck/Shanxi/2/06ck/Myanmar/06010011B/06dk/Guiyang/504/06
ck/Guiyang237/06gs/Guiyang/337/06
gs/Guiyang/1325/06ck/Guiyang441/06ck/Guiyang1218/06ck/Guiyang846/06ck/HK/8911/01
ck/HK/SF219/01ck/HK/8791/01
gs/Guangdong/1/96
0.005
2.3.4
2.3.3
2.3.2
2.3.1
2.2
2.4
2.5
2.1.3
2.1.2
2.1.1
1
8
9
6
5
7
4
3
0
Genetic evolution
of Asian-lineage
HPAI H5N1 virus
(HA gene)
Parent virus
Gs/GD/1/96 has
evolved during 1996-
2008 resulting in 10
different clades.

28. Shift of Dominant HA clade of H5N1 viruses in
Southeast Asia during 1996-2007
Year
HA clades
Total
0 1 2 3 4 5 6 7 8 9 Out
96-99 29 29
2000 17 3 1 21
2001 18 43 1 1 2 65
2002 17 17 3 7 3 1 7 2 8 65
2003 4 25 33 1 1 5 1 1 7 8 86
2004 4 171 49 16 3 3 14 5 265
2005 3 112 170 1 7 1 9 1 304
2006 5 5 122 5 1 1 139
2007 12 94 22
Total 97 342 471 47 14 26 4 12 9 34 24 1080
ExistMajor clade of the year
Dominant HA clade has shifted from 0 to 1 in 2002-03
Dominant HA clade has shifted from 1 to 2 in 2003-05
HA clade 2 is now dominant = why?

29. Thailand
Year
HA clades
0 1 2 3 4 5
96-99
2000
2001
2002
2003
2004
2005
2006
2007
2008
China
Year
HA clades
0 1 2 3 4 5
96-99
2000
2001
2002
2003
2004
2005
2006
South Vietnam
Year
HA clades
0 1 2 3 4 5
96-99
2000
2001
2002
2003
2004
2005
2006
2007
2008
North Vietnam
Year
HA clades
0 1 2 3 4 5
96-99
2000
2001
2002
2003
2004
2005
2006
2007
2008
NORTH
VIETNA
M
SOUTH
VIETNA
M
THA
I
CHIN
A
Different pattern between North and South Vietnam
North is similar with South China that indicates multiple
introduction of virus since 2001 including new clade 7
South has similar pattern with Thailand till 2007.

30. Possible
H5N1 Virus
Circulation
Pattern in
Vietnam

31. HA clades of HPAI H5N1 in the World
2.2
2.2
2.2
2.2
2.2
1
2.
3
2.1
1
2.
3
2.1
2.
2
2.3
2.4
2.5
?
2.
32
.4
2.
5

32. Some Epidemiologic Differences
Between Africa and Asia
• Poultry and human densities
• Wetland free ranging duck production
systems absent
• Survival of the virus in the environment:
temperature...
• Less contacts between
wild birds and domestic poultry

33. Official declarations
OIE
and WHO
FAO analysis
HPAI situation

34. HPAI in humans
2003 to 2009

36. 0
10
20
30
40
50
60
2003 2004 2005 2006 2007 2008 2009 2010*
New ly infected countries
Previously infected
countries
HPAI in poultry
Infected countries
2003 to 2010

38. Outbreaks of HPAI in domestic
poultry and Wild birds,
April 2009-April 2010

40. • Improvement of the situation compared
with 2006
More transparency, more awareness and preparedness
Less outbreaks
A set of tools (culling, biosecurity, vaccination, etc)
available and deployed to control the disease
• Epidemiology and socio economic impacts
are better known
• But the virus is still present in around 10
countries
• Recurrent introduction or reintroduction of
the virus in countries or regions

43. China

44. Confirmed HPAI 2003 2004 2005 2006 2007 2008 2009
Poultry outbreaks 0 50 31 10 4 8 2
Human cases (1) 0 8 13 5 4 7
China

45. Indonesia
HPAI in humans and
poultry 2004-2009

46. Indonesia
Outbreaks in
2009

47. 0
2
4
6
8
10
12
14
16
Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb
Month
NumberofHPAIoutbreaks/cases
Bangladesh
Bhutan
India
Nepal
Reported outbreaks of HPAI in South Asia 2009-10

48. HPAI outbreaks
In Bangladesh

49. Bangladesh
Occurrence of HPAI
since March 2007

50. 0
2
4
6
8
10
12
14
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
2008 2009 10
Numberofoutbreaks
HPAI outbreaks in India

51. 0
5
10
15
20
25
30
35
40
45
50
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Jan
2008 2009 10
Numberofoutbreaks
HPAI outbreaks
in Egypt

53. Tools and strategies
to control HPAI exist
– Surveillance and
Disease intelligence
– Stamping out
– Biosecurity
– Movement control
– Vaccination

54. Surveillance
Active and passive surveillance
Randomized versus intelligence
Targeted surveillance (risk based)
Specific case of wild birds
Special tools such as the SMS Gateway
system

55. Random versus. Intelligence
• Reduces bias
• Requires careful
planning
• Long time frame
• Clustering
• Key informants
• Open-ended
• Discovery
• Identify risk areas
• Rapid
Community-Based
Disease Surveillance

56. Targeted surveillance and monitoring
of virus circulation based on risk analysis

57. Disease intelligence
Particularly to address the emergence or re
emergence of new pathogens with regard to
global changes, hot spots identification
Specific concepts, approaches, methods and
tools to be used

58. Disease Intelligence
and Tracking
60% of the 1400 infectious agents of humans
have an animal origin; and 75% of new
infectious diseases have originated
from animal reservoirs
Stopping animal diseases ‘at source’ by:
• Identifying determinants and drivers of disease emergence and spread
• Modelling, mapping and forecasting disease trends and outbreaks
• Generating information and data for early warning and response
• Tracking genetic evolution of pathogens to improve diagnostics and vaccines

59. GoogleGoogleTMTM

60. Control of movements
Enforcement
may be very difficult

61. Culling
Compensation
Enforcement can be very
difficult
Needs compensation
Management of compensation
funds can be difficult: various
systems exist

62. Vaccination
An important tool
– Good quality: OIE Standards
- Cost (0.5 to 0.8 USD)
and share of cost
– Post-vaccination monitoring
– DIVA approach
– Control of virus circulation
– Exit strategy

63. FAO-OIE-WB
Report on
Biosecurity:
Issues and options
August 2008

64. Develop, test
and promote
biosecurity
measures
that are:
Developed in a
participatory manner
Practical and
affordable
Proportionate to risk
Tailored to situation
and production system
Biosecurity

65. Biosecurity
Production practices/
socio-cultural aspects
Transport/Marketing Processing

66. International Cooperation
FAO - OIE GF TADS
Global Framework for the Progressive Control
of Transboundary Animal Diseases
International Cooperation
FAO - OIE GF TADS
Global Framework for the Progressive Control
of Transboundary Animal Diseases

67. Crisis Management
Center Global Early
Warning System
Available Tools at
the Global Level

68. Needs and Gaps
for Avian and Human Influenza in
Africa
ALive provisional Proposal
GLEWS Global Early Warning System
A major component of GF TADs Initiative

69. Regional Networks:
- Epidemiology
- Diagnostic and
research laboratories
- Socio economics
- Communication
FAO OIE Regional
Animal Health
Centers

70. Intersectoral Cooperation
- Human and animal health systems
To be in strong interraction and collaboration
No fusion. Specific mandates, partners and
stakeholders, methods and tools
- Other sectors:
wildlife, environment, trade, turism, police,
medias, land management…

71. Global results
- Less contaminated countries
- More sensibilisation and commitment
- Improved transparency
- More awareness and preparedness
- Strenghthened Veterinary Services
- Better knowledge of the disease
epidemiology and of root causes of emergence
and spread

72. Is eradication possible?
- Eradication of all Influenza A viruses is not an option
given the highly diverse gene pool of viruses circulating
in the wild waterbird reservoir, in livestock and humans
- In most situations H5N1 HPAI freedom remains a viable
objective
- More difficult is the control of H5N1 HPAI in environments where
both traditional domestic waterfowl production, including rice-
duck agriculture, and commercial chicken plants coincide in the
farming landscape
- Endemic situations require a cautious balancing of all tools and
methods available to contain H5N1 virus spread and persistence

73. Lessons learnt
Need to be ready to
respond to emergencies
Stop the outbreaks before they
spread and become a crisis
Emergency short term improved capabilities

74. Credo
Surveillance
Early Warning
Early detection
Early response

75. Need to better address
the Socio Economic issues
• Economic analysis inputs to disease
epidemiology to support risk assessments
• Socio economic impacts of HPAI
• Costs and cost-effectiveness of prevention
and control measures
• Long Term Restructuring and Socio
economic impacts on small holders,
• Mitigation options
• Impacts on biodiversity

76. Need to develop more focus
on disease drivers
and not only
on disease events

77. Public-Private partnership
At all levels
Surveillance
Prevention
Control
Small holders-villagers
Participatory approaches

78. Capacity building
Training
Communication
and
Information

79. Information
and Awareness
• Information and dialogue with
commercial farmers
• Need for information and
compliance of the population
– information on vaccination
– information on logistics
• Cooperation of farmers and
village heads is crucial for an
effective implementation of
control programmes

80. Information and Awareness
Provision of information
through multi-track
Campaigns to ensure
Informed decision making
processes and producers’
participation

81. Remaining gaps
• Virology
• Epidemiology
• Trade routes
• Wildfife
• Socio economics
• Vaccines
… Need for Research

82. Remaining gaps (cont.)
… Need for research
Transmission Animals-Humans

83. - Government and private sector
commitment
- Private-public partnership
- Participatory approaches
- Restructuring of the poultry
sector with mitigation of possible
adverse impacts
Responding to challenges

84. Based on
- Strong Veterinary Services
- Biosecurity, Movement Control
- Communication
- Laws and Regulations
- Public Private Partnership

85. Roots of Disease Emergence
Long term global approaches
One World One Health Strategy

86. More investment
More Political Commitment
to implement and enforce the
Prevention and Control Measures

87. Thank you for your attention