Summary of OFFLU TECHNICAL MEETING University of Georgia, Athens, USA 15 April 2015

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1 Summary of OFFLU TECHNICAL MEETING University of Georgia, Athens, USA 15 April 2015 List of participants: Experts Abdelsatar Arafa (Egypt), Abuzied Ahmed (Egypt), Ahmed Setta (Egypt), Ali Tohamy (Egypt), Amanda Hanna (UK), Andrew Breed (UK), Andrew Bowman (USA), Andrew Clements (USA), Angie Maxted (USA), Ana Silvia Gonzalez Reiche (USA), Ann Cullinane (Ireland), Ayman El-Deeb (Egypt), Celina Buscaglia (Argentina), Charlotte Kristiane Hjulsager (Denmark), Christina Marie Hartby (Denmark), Dahlia Grimes (USA), Dan Domingo (USA), Darrell Kapczynski (USA), David Suarez (USA), David Stallknecht (Netherlands), Dejelia Ramona Gomez (Brasil), Diane Poste (USA), Dilmara Reischak (Brasil), Elkady Ahmed (Egypt), Ernesto Soto-Priante (Egypt), Erica Spackman (USA), Eric Niquex (France), Frank Wong (Australia), Gaelle Simon (France), Hatem Eldesouki (Egypt), Helena Ferreira (Brasil), Hiroshi Kida (Japan), Ioannis Sitraras (Netherlands), Isabella Monne (Italy), Jacqueline Nolting (USA), Jill Banks (USA), Jonathan Runstadler (USA), Kateri Bertran Dols (USA), Lars Erik Larsen (Denmark), Magdy El-Kady (Egypt), Mamoona Chaudhry (Pakistan), Manal Afifi (Egypt), Mar Costa- Hurtado (USA), Marek Slomka (UK), Mario Aramouni (UK), Mary Pantin Jackwood (USA), Mia Kim Torchetti (USA), Michel Bublot (France), Mohamed Galal Aggour (Egypt), Nicolas Gaidet (France), Nichole Hines (USA), Peter Durr (Australia), Rabab Amen (Egypt), Richard Slemons (USA), Ruben Donis (USA), Ruth Bouwstra (Netherlands), Saad Gharaibeh (Jordan), Sam McCullough (Australia), Sasidhar Malladi (USA), Scott Strauss (USA), Shadi Amareen (Jordan), Shahin Nossir (Egypt), Sharon Brookes (UK), Susan Detmer (Canada), Susan Trock (USA), Takahiro Hiono (Japan), Thomas DeLiberto (USA), Thomas Chambers (USA), Timm Harder (Germany), Todd Davis (USA), Todd Weaver (USA), Veronique Jestin (France), Vilmos Palya (Hungary), Waheed Mohamed (Egypt), Walid Hamdy Kilany (Egypt), Xiaoyan Zhou (Australia), Xi Guo (China), Yue Xang (USA). OFFLU Steering Committee (SC) Peter Daniels (Australia), Ian Brown (UK), William B. Karesh (USA) OFFLU Executive Committee (EC) David Swayne (USA), Kristien Van Reeth (Belgium), Keith Hamilton (OIE) and Gwenaelle Dauphin (FAO) OFFLU Secretariat Gounalan Pavade (OIE) Summary of main points: Peter Daniels, Chairman of the OFFLU Steering Committee, welcomed the participants and gave an introduction to OFFLU s vision, objectives and the mode of function of its different committees. The outcomes of a combined steering and executive committee meeting in October 2014 to propose a strategic agenda were reported. 1

2 It was suggested that the main purposes of OFFLU, aligned with the vision and objectives as posted on the OFFLU website, are To be an authoritative source of knowledge on influenza in animals globally To support the effective network of animal influenza (AI) laboratories internationally but to also encompass disciplines beyond the laboratory To promote and ensure the sharing of influenza information and biological materials, maintaining the initial OFFLU vision To provide advice specifically wherever standards and systems are developed for the collection, annotation, curation and dissemination of data relating to influenza strains from animal sources, but not developing or maintaining such databases itself To regularly review guidelines for veterinary vaccines and vaccine antigens and vaccination strategies, and to make similar information available for public health purposes To promote more effective surveillance of influenza infections in animal populations, with well-defined objectives To provide expertise to efforts and activities to improve scientific approaches to influenza risk assessment To identify knowledge gaps and opportunities in the prevention, detection and control of influenza for animal health, food security and for public health preparedness (and update the influenza research agenda accordingly) It follows that if OFFLU is to be considered successful in the years ahead it will be consulted as a leading source of knowledge on influenza infections in animals (including wildlife) have maintained its core functionality as a network of influenza laboratories for all affected animal species have partnered in developing standardized processes (databases) for capturing, storing, quality assuring and analysing molecular and epidemiological data regularly advise on the scientifically based selection of antigens for both routine and emergency vaccines against influenza viruses of animal origin (for use in veterinary and public health) have effectively advocated more comprehensive, targeted, efficient, and effective (smarter) surveillance for influenza infections in animal species (working with OIE, FAO, veterinary authorities and the farming, wildlife companion animal and equine sports sectors) promoted and partnered in multidisciplinary collaborations of effective disease control based on an understanding of socio-economic factors and value chains (with an initial focus on H5N1 HPAI and zoonotic AI) have promoted the science to identify which animal influenza viruses pose a risk to animal health and public health (and actively maintained the register of animal influenza research priorities) The meeting was asked to consider whether there were any other major challenges that OFFLU should be identifying and addressing, that a successful and relevant OFFLU might have been expected to address What is OFFLU? Who s going to do the work? (Is the current structure of oversight [SC] and implementation [EC] committees, with specific formally constituted technical activities (TAs), sufficient for now?) What are the resources already available? Can every OFFLU member just contribute to the coordinated management of influenza in animals internationally as part of their day job? Are members already doing that by being in a TA, or in other ways? 2

3 What advocacy or changes of approach are needed? These considerations and questions were left open for consideration against the reports of current TAs and the presentations of proposed new TAs to be presented during the course of the meeting, to be followed up during discussions at the end. The meeting then continued with the first session wherein the leaders of the current OFFLU technical activities presented the key achievements since An overview of OFFLU Vaccine Composition Meeting (VCM) contribution for (Frank Wong, Australia): OFFLU contributes to the WHO VCM to provide six monthly data from the animal sector which is important to select potential vaccine candidate viruses for human vaccines, should H5 or H9 AI viruses in animals emerge to become pandemic threats. Two OFFLU representatives regularly attend WHO VCM. In the year 2012 OFFLU contributed 170 H5N1 sequences and 56 H9N2 sequences; 140 H5N1 sequences and 60 H9N2 sequences in 2013; 48 H5N1 sequences and 12 H9N2 sequences in year 2014; and 46 H5N1 sequences dominated by H5Nx clades and 9 H9N2 sequences in the Feb 2015 meeting. Recent significant OFFLU network contribution include clade viruses from Canada (H5N2), China (H5N6), Italy (H5N8), Japan (H5N8), Lao PDR (H5N6), Russia (H5N8), and USA wild birds and poultry (H5N1, H5N2 and H5N8). Additionally, to generate valuable antigenic data, panels of ferret sera from CDC, Atlanta and St Jude s Children s Hospital were distributed and tested against a panel of avian influenza viruses in three OFFLU laboratories (Australia, Italy and UK) using the standard WHO protocol HI test. The H5 HI data contributed were 41 (in 2012), 21 (in 2013) and 23 (in 2014). Evaluation of HI data from viruses from the recent WHO VCM showed considerable diversity among H5Nx viruses. OFFLU contributed to tracking on-going divergence of A(H7N9) in China poultry or live bird markets environments. Given the success of the contribution, the OFFLU and WHO extended their agreement until 2018 and remain committed to further close collaboration on influenza risks at the humananimal interface. Vaccination technical meeting outputs, Beijing (David Swayne, USA): OFFLU organized a three day technical meeting from 4 to 6 December 2013 in Beijing, China, to revise vaccination strategies based on lessons learned from past ten years from China, Egypt, Vietnam, Indonesia and Mexico accounting for field experience, and experimental data from laboratory and field studies. The meeting reviewed the successes and failures linked to developing and implementing effective HPAI surveillance and vaccination, their impact on control programs and proposed improvements to vaccination strategies. Government representatives from affected countries and Delegates from OIE, FAO, WHO as well as the International Egg Commission (IEC), the International Federation for Animal Health (IFAH) and OFFLU experts participated in this meeting. The members of the OFFLU Technical Activity on vaccination acted as the scientific and organizing committee for this meeting. 3

4 It was decided that the conclusions from the recommendations of the Verona 2007 meeting were still valid today and required only minor updates. The meeting drew 50 recommendations under 7 categories namely on the complementary role of vaccination in control and prevention of HPAI, on implementation of vaccination, on vaccines, on surveillance, monitoring and evaluation, on research needs, on veterinary services and on public private partnerships and communications. The full recommendations are available at Global animal influenza research agenda 2014 (David Swayne, USA): OFFLU and STAR-IDAZ (Strategic Alliances for the Coordination of Research on the Major Infectious Diseases of Animals and Zoonoses) joined forces to develop a strategic agenda for animal influenza research. Sixty key experts from the fields of animal and human influenza were invited to a consultation in April 2014, at the OIE Headquarters in Paris. These experts came from a broad range of institutions, interests and research areas, including animal health and public health; animal production and trade (poultry, eggs and pork); the pharmaceutical sector; equine sports; policy; and research-funding bodies. The consultation took a global perspective and, by engaging carefully selected representatives, it aligned the priorities of the key stakeholders with interests in funding research, conducting research, and benefiting from the outputs of research. The experts were assigned to working groups and used the feedback from a survey sent out before the consultation to develop a consensus vision and establish a consolidated list of priority topics. 4

5 The experts agreed that their collective vision was global coordinated research to minimise animal and human health risks and maximise social, economic and environmental outcomes and identified six priority areas for research namely surveillance and risk assessment; diagnostic development; prevention and control interventions; vaccine development and delivery mechanisms; host pathogen interaction; and socio-economics and policy. Since the meeting the outputs of the research agenda consultation have been used to develop and inform other funding and research strategies. OFFLU experts and donors were urged to use the research agenda to further promote its use. It was suggested that the agenda should be updated annually IDAZ_Executive_Summary_final.pdf OFFLU ring trial 2014 (Nichole Hines, USA): OFFLU carried out a third annual proficiency test (PT) among veterinary laboratories in The goal was to test the ability in international reference laboratories (and some national and regional laboratories) to detect and characterize AI viruses from both the Eurasian and American hemispheres with the aim of improving accurate global detection and characterization of influenza in birds. Twenty laboratories from as many countries participated, including 9 OIE/FAO Reference Centres and 11 national/regional laboratories. The OFFLU proficiency test technical activity developed a test panel representative of H5 and H7 AI viruses from both the Eurasian and American hemispheres and isolated from a variety of poultry species and wildlife. Each laboratory received the panel for evaluation using molecular assays. Results were reported to the technical activity for data compilation and statistical analysis, which showed that most OIE/FAO Reference Centres successfully detected and subtyped AI viruses from their respective hemispheres. All these Reference Centres 5

6 performed pathotyping, with some inconsistencies in their results. Problems were encountered with detection of viruses from opposite hemispheres e.g. some laboratories in the Northern hemisphere had problems with viruses from the southern hemisphere, vice versa. Most national/regional laboratories reported satisfying real time PCR results. Five of eleven national/regional laboratories also performed pathotyping, which is a notable increase over Some of the other points that were discussed in the presentation include: - Panel selection: Including current strains versus maintaining strains for comparison to previous ring trial performance. How best to balance new strains versus strains currently in panel for direct comparison year to year. - Panel production: Earlier it was decided to have rotating responsibilities for production. NVSL volunteered to continue organizing ring trials. In 2015, NVSL is unlikely to organize due to HPAI H5N1/N2/N8 outbreaks in USA. - Cost of shipping: NVSL faced difficulty to recover shipping costs and this caused delays in the 2014 ring trial. A mechanism has to be ascertained for covering the costs of shipping through participating labs/offlu/oie/fao in advance. - The information gained through the OFFLU ring trial results should be used to improve detection capabilities and global harmonization. Some labs use the results for accreditation while others do not appear to use the information to improve detection capabilities from year to year. OFFLU should find ways to harmonize its international ring trial with other national/regional ring trials in order to prevent duplication of ring trials. - It is possible to include additional national/regional labs from HPAI affected countries in the exercise and OFFLU should contact the labs in this regard. Participation in PT in support of continuous improvement in testing ability is a requirement of laboratories with accredited quality assurance systems and this OFFLU activity provides an essential international service. Importantly, it gives a mechanism for the designated reference centres to ensure that they can accurately detect and identify the spectrum of AI viruses circulating internationally. Update on Swine influenza virus (SIV) group activities (Kristien Van Reeth, Belgium): Influenza surveillance in swine is important to better understand animal health and public health threats. Currently, SIV surveillance is patchy and underfunded. There are challenges to developing sustainable SIV surveillance. There are concurrent circulations of H1N1, H3N2, and H1N2 with multiple lineages. Distinct SIV lineages exist in North America, Europe, and Asia with regional differences. SIV experts from all parts of the world contributed to this technical activity by participating in annual technical meetings and teleconferences. Key achievements of the group include sharing global SIV surveillance data, harmonize diagnostic assays for SIV, define and update research priorities for SIV, developing global antigenic cartography, harmonize standardized nomenclature system for clusters and lineage designation of SIVs and producing advocacy slides and poster. The group also published a paper titled, Review of influenza A virus in swine worldwide: A call for increased surveillance and research in Zoonoses and Public Health journal. 6

7 Update from Equine expert surveillance panel (ESP) (Ann Cullinane, Ireland): The equine surveillance panel meets annually at OIE. The panel reviews influenza activity and virus strains each year and gives recommendations on vaccine composition. The recommendations are published in the OIE bulletin and on the OFFLU website to guide industry in preparation of commercial vaccines. Equine influenza surveillance is patchy worldwide and efforts are being made to improve global coverage, through OIE laboratory twinning projects and by developing links with stakeholder bodies such as the FEI (International Equine Federation). There is a need to ensure that vaccine manufacturers follow the recommendations of the ESP industry compliance has been less than ideal. The ESP has been engaging with vaccine industry to encourage better compliance with the recommendation. The panel contributed to the OIE Ad hoc on international movement of horses for framing health measures that should be applied to temporary importation of competition and racing horses and to update the research priorities for the Equine influenza in the OFFLU research agenda. Influenza activities at the human-animal interface (Ruben Donis, USA): Influenza activities that were accomplished at the human-animal interface include: WHO VCM collaboration through regular teleconferences, sharing of epidemiological and sequence data, antigenic analyses for panel of viruses and antisera Teleconferences as and when needed to share surveillance data, diagnostic protocols and experimental data in case of new and emerging influenza situations Monthly teleconferences for sharing of H7N9 animal health and public health surveillance system and measures applied in China and surrounding countries and update on risk assessment documents Joint missions comprising of animal and public health experts for assessment and preparedness to influenza affected countries 7

8 Implementation of one health strategic agendas including information and sample sharing policies In the second session of the meeting the main elements of the OFFLU work plan for the next three years were proposed and feedback from the participants requested. Laboratory diagnostic technical activities (Ian Brown, UK): There is a need to improve technologies to develop more effective and universal influenza vaccines and diagnostics. In line with the identified purpose for OFFLU to be an effective laboratory network, four work plans were proposed under this technical activity. Maintain and extend ring trials for frontline diagnostics for avian influenza and initiate similar international proficiency testing for swine and equine influenza groups Compile and share information and data on improved serological tools for the identification of infection with influenza virus subtypes across species which are sensitive, specific and cost efficient Develop a validated cell culture system for isolation and propagation of influenza A viruses Promote full genome sequencing for identification and reporting of influenza viruses particularly as detected as a result of outbreak investigation but also from structured surveillance activities. Collect metadata for meaningful analyses and information on methodology and packages for analyses WHO-VCM and new OFFLU-VCM for AI vaccine update (David Swayne, USA): The ongoing biannual contribution to the WHO VCM will be continued to share and analyse genetic and antigenic data from Reference labs and national labs. The focus will be H5 and H7 HPAI virus and H9N2 LPAI virus. Additionally ferret antisera production and use for antigenic analysis will also be shared. A new technical activity for updating AI vaccines was proposed Poultry Avian influenza vaccine composition (PAIVC) task. The goal of this task is to make recommendations on poultry AIV vaccine seed strains, initially focusing on the H5 lineage, but expanding over time to other subtypes such as H7N3 and H9N2. A group consisting of core OFFLU experts and WHO CC experts will update the inventory and phylogeny of circulating poultry viruses and conduct a review of the vaccines used in the field for efficacy and effectiveness. Based on the data, the group will provide recommendations and assistance to countries on selection of seed viruses for AI poultry vaccines. One Health including risk assessment and nomenclature (Ruben Donis, USA): Influenza activities that will be continued at the human-animal interface include: WHO VCM collaboration and coordination for increasing the sequence data submission and antigenic data Teleconferences as and when needed to share surveillance data, diagnostic protocols and experimental data in case of new and emerging influenza situations Monthly teleconference for sharing of H7N9 animal health and public health surveillance system and measures applied in China and surrounding countries and update on risk assessment documents Implementation of one health strategic agendas including information and sample sharing policies 8

9 Epidemiology including social aspects (Gwenaelle Dauphin, FAO): The epidemiology group will work on two broad topics Risk assessment and Surveillance. Risk assessment tasks include identifying risk factors to AI and making such information available to countries and the scientific community, providing advice to countries/institutions for performing national or regional risk assessment, encourage the sharing of risk assessment results, risk maps and make them available to countries and support evaluation and validation of risk assessment tools of possible interest and explore their application. Surveillance tasks include review and appraise global animal influenza surveillance and control activities, produce or review recommendations for animal influenza surveillance, encourage countries to share influenza surveillance results and provide/suggest mechanisms or a platform for sharing and propose approaches on applied molecular influenza surveillance. The socio-economic group will work towards understanding the social and economic impact of influenza viruses in animals and their impact on humans, development of social and economic assessments to demonstrate the social and economic profitability of (i) changes of practices along the producer/consumer value chain, (ii) of the research programme as proposed and the social costeffectiveness of new technologies developed. Wildlife technical activity (Billy Karesh, USA): A new technical activity on wildlife was formed with a mix of wildlife experts, ecologists, people who work with influenzas in wildlife, as well as a bit of lab expertise. This group will work towards, To provide a platform for discussion, coordination, and data sharing between key wildlife experts involved in influenza surveillance and research Regular review of the OFFLU Research Priorities on Avian Influenza: Wild Birds To review existing findings from 10 years of extensive wild bird surveillance and highlight the main outputs To explore and answer specific technical questions including evidence about wild birds acting as a bridging species between poultry and wild bird reservoir, benefits of wild bird surveillance, relevance of influenza infections in other wildlife species To decide whether there is a need to develop/coordinated a low-cost targeted wild bird surveillance strategy at a global level accounting for existing surveillance programmes To provide OFFLU with technical expertise on influenzas in wild animals OFFLU website and communications (Gounalan Pavade, OFFLU): The participants were updated on the overall contents of the OFFLU website. Specific information about the news item and documents posted under publications, upcoming influenza meetings, guidance and resource materials on animal influenzas, training tools from various sources, humananimal interface and archives of past OFFLU technical meetings was informed to the experts. The participants were encouraged to share interesting and new influenza materials to the OFFLU Secretariat for posting on the website. 9

10 Strategic/future discussions (Peter Daniels and David Swayne): An open session was moderated at the end of the session to get feedback from the participants on the strategic agenda for OFFLU as identified in the reiteration of its purposes and the related criteria against which its success could be assessed, and the new technical activities proposed as a consequence. Members were in broad agreement with the proposals presented. It was noted that the holding of the OFFLU technical meeting back-to-back with the international AI symposium worked well with the significant participation of experts to the OFFLU meeting. Having a technical meeting in conjunction with the international avian influenza symposium provided a good visibility to the OFFLU network. Feedback from the experts revealed that OFFLU is serving as a useful and valuable platform for the interaction amongst influenza experts working on avian, swine, equine and public health. The organizers of the International Avian Influenza Symposium were thanked for their generous inclusion of the OFFLU meeting, and particularly the provision of the venue, within the overall arrangements for the AI Symposium. At the end of the discussion, the meeting was closed by a vote of thanks to all the participants. 10

11 APPENDIX: AGENDA OF THE MEEETING OFFLU TECHNICAL MEETING 15 April 2015 Masters Hall at the Continuing Education Center, University of Georgia, Athens, Georgia Wednesday 15 April Welcome and introduction David Swayne, USA (Chair of OFFLU Executive committee) OFFLU Strategic directions Peter Daniels, Australia (Chair of OFFLU Steering committee) Session 1: OFFLU key achievements and opportunities (since London 2012 meeting) Chair: Peter Daniels An overview of OFFLU VCM contribution for Frank Wong, Australia Vaccination technical meeting (Beijing) outputs David Swayne, USA Global animal influenza research agenda 2014 David Swayne, USA OFFLU ring trial 2014 Nichole Hines, USA Swine influenza group technical activity update Kristien van Reeth, Belgium Equine influenza group update Ann Cullinane, Ireland Influenza activities at the human-animal interface Ruben Donis, USA Break Session 2: Proposed work plan for next three years Chair: David Swayne Laboratory diagnostic technical activities Ian Brown, UK WHO-VCM and new OFFLU-VCM for AI vaccine update David Swayne, USA One Health including risk assessment and nomenclature Ruben Donis, USA Epidemiology including social aspects Gwenaelle Dauphin, FAO OFFLU wildlife technical activity Billy Karesh, USA Information access including website and OFFLU communications to influenza experts - Gounalan Pavade, OFFLU Secretariat Strategic/future directions open discussion Peter Daniels and David Swayne Closing 11