H1N1 (2009) Surveillance

Transcription

1 H1N1 (2009) Surveillance A tale of two worlds? Lessons learnt from FAO s global and regional projects on H1N1 (2009) Filip Claes, OFFLU team ph1n1 reporting mainly in developed world 1

2 ph1n1 versus swine population Differences between developed versus developing world Developed ph1n1 within list of priority diseases Less barriers on reporting ph1n1 testing feasible Research topic Capacity and Surveillance networks in place (No) coordinated surveillance strategy Developing ph1n1 is not a priority disease Fear for trade implications ph1n1 not an access point for sampling Lack of capacity Focus on other diseases CSF FMD Acute PRRS 2

3 Differences between developed versus developing world Developed History of surveillance Disease base-line low Food Safety Agencies Slaugtherhouse sampling Farming setup Large scale Vaccination Profit driven Developing No history Higher disease burden Food Safety Agencies? Little slaughterhouse sampl Farming setup Small to mixed Little vaccination Profit & livelihoods Backyard close to industry Risk zones High pig population High human density Mixed farming systems Possible recombinations High poultry density HPAI circulating Bird migration routes 3

4 Central and South America Carribean Andean and Central Central America: sampling frame Country Disease (sampling) location Number Sample type Target pop Diagnosis Testing PRRS SI / H1N1 CSF other on-farm slaughter house Belize X X 498 X Healthy X No PCR NVSL Costa Rica X X 520 X Sick-healthy X No PCR NVSL Cuba PCV-2, psuedorabies Serum Swab Other X 81 X X previous history PCR Antigen Antibody Method Protocol X X X 193 X X Sick and healthy X PCR NVSL X X 18 P X PCR bacteriolo gic culture X P X Cult. Mycop lasma spp. X 38 Tissue X PCR Dominican Republic X X 99 X Healthy and sick X No PCR NVSL El Salvador X X 458 X X Guatemala X X 501 X X Honduras X X bacteriologic culture 484 Sick and healthy Sick and healthy X X X X X IP IP PCR PCR NVSL NVSL IP PCR NVSL X 289 X X Sick and healthy X IP Cult. Nicaragua Panama X X X 501 X X Sick and healthy X IP PCR NVSL 4

5 Central America: (epi) sampling approach study population size # of farms/units sampled farm size mean; median (range) Costa Rica Cuba El Salvador Guatemala 37,180 67,584 31,027 10, ; 300 (29-25,000) 4224; ( ) 1349; 700 ( ) ~60; 10.5 (1-1800) # samples/farm 20 ~12 (5-20) ~ % population sampled 1.4% ~0.33% 1.5% 4.8% % population sick 0.5% % -- % sampled sick 31.7% % 66.9% El Salvador ELISA (n=22 farms) 5

6 Central America: Results Low level of ph1n1 detected Other influenza viruses may be circulating Other diseases important porcine circovirus type 2 (PCV-2) Mycoplasma spp. PRRS pseudorabies other bacteriological pathogens Serological exposure to influenza in herds, IP Africa risk zones 6

7 SIV surveillance in Africa TCP planned, yet canceled 3 Pig sector reviews under global TCP Kenya CDC: Human sampling MoA: pig sampling Cameroon Institut Pasteur: human and animal sampling Pig Sector Reviews Provide essential baseline information + trends Useful for control of HPEDs Useful to promote the sustainable development of the pig sector Complement value chain studies Who is who list 7

8 East - South East Asia??? South East Asia objectives 1. Surveillance and monitoring systems and networks established 2. Information on swine influenza is available and communicated 3. Sharing of influenza isolates through established diagnosis and surveillance networks and channels 8

9 1. Surveillance systems and networks are established and functioning Harmonization Surveillance Diagnostic protocols Regional guidelines Capacity strengthening: laboratory and epidemiology Training at different levels Dialogue between epi and lab Quality control of surveillance, laboratory QA, PT Gap analysis and needs assessment 2. Information is available and communicated Coordinated field surveillance activities Epidemiology and ecology of ph1n1 and other influenza subtypes in pig population Samples for other diseases Information sharing through existing platforms and meetings Workshops: harmonization and review of activities Regular updates through existing regional platforms 9

10 3. Sharing of isolates through established networks and channels Guidelines for submission of samples to reference laboratory Strengthening roles of ASEAN leading and regional reference laboratories Strengthening linkage with OIE reference laboratories, FAO collaborating centers and OFFLU Serological Results Vietnam IDEXX Influenza A Ab Test 10

11 Virological Results Vietnam Conclusions South East Asia Network established Harmonisation of epi and lab in region Training and Planning done Reluctance/difficulties for sampling Other diseases prioritized (Fear for trade implications) So collection and testing took longer than anticipated,... but arriving! (cf NCVD) 11

12 General conclusions Harmonisation of approaches Capacity needs Equipment, training Epidemiological and laboratory Optimize Surveillance approach Maximize sample output / minimize effort Integration of various disease surveillance PRRS, FMD, CSF,... Need for incentives (e.g. drugs) General conclusions Political engagement Need for OIE clarification on trade implications Overcome reporting reluctance Different strategies for different regions Integrated systems approach Links with PH side (Human-Animal Interface) (One flu) One Health concept 12

13 Acknowledgements ASEAN lab network (NCVD,...) FAO country and regional offices FAORAP (Subhash Morzaria, Kachen Wongsathapornchai) Luis Espinoza (ECTAD/Panama) EMPRES-I team (Julio, Sophie, Daniele) LADIVES,LANASEVE, CENSA, Centro de Estudios en Salud, Universidad del Valle de Guatemala, NVSL, Ames, Iowa and University of Maryland Central de Sanidad Animal from El Salvador IHIMV, CENEDI. FAO HQ: Gwen, Mia, Astrid, Edith, Philippe A. Surveillance guidelines need for revision / adaptation? 13

14 It s not just about influenza! Learn more about the swine sector Demographics, mapping, other information Additional samples can be collected other diseases Capacity building Laboratory epidemiology 14