Retrospection into Avian Influenza Outbreak in Vietnam during T.D. Nguyen, DVM, PhD National Institute of Veterinary Research Hanoi, Vietnam
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1 Retrospection into Avian Influenza Outbreak in Vietnam during T.D. Nguyen, DVM, PhD National Institute of Veterinary Research Hanoi, Vietnam
2 Poultry production in Vietnam (millions) Number (2004): Chicken = 192 millions Ducks = 69 millions Total = 261 millions 0 Chicken meat production: t to t / year = 17% of total meat products (Pork:75%) Consumption: 60 eggs / person / year 4 kg chiken meat / person / year (FAO)
3 Density of poultry in Vietnam Source : LEAD FAO Year :2002 Map prepared by LEAD - FAO
4 installation
5 installation
6 installation
7 installation
8 Backyard poultry
9 installation
10
11 Trading
12 Highly Pathogenic Avian Influenza in Vietnam
13 Outbreak and Spread of HPAI Ha Tay 27/12/03 Long An, Tien Giang 23/12/03
14 Outbreak and Spread of HPAI 4 weeks post outbreak 6 weeks post outbreak
15 Particularities of HPAI (H5N1) in Vietnam ! Super virulent in chickens " sudden death " not typical lesions at the end! Not only chicken but also ducks affected! Mortality: chicken > ducks! Fatal cases in humans " 15 death out of 23 confirmed cases!patchy but simultaeous cases! Cases in industrial chickens > scanvenging ones
16
17
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20 CONTROL MEASURES
21 Diagnosis
22 Diagnosis
23 Diagnosis Pasteurellosis Influenza by HA and HI, RT-PCR. N1 identification by CDC Number of samples increased rapidly. By epidemiological definition.
24 Quarantine
25 Bird disposal
26 Bird disposal
27 Government reactions 23 Dec: Declaration, DAH responsible 28 Jan: Steering Committee, MARD 4th Feb: Banning bird movement and consumption. Gov. members to provinces 6 FebDirective 35 of Polibureau. Outbreak decreasing 26 Feb: last new case reported. Effective but not in time
28 Number of communes New cases) that declared the new cases of HPAI February 2004 Banning bird movement and consumption
29 Control measures Administrative Detection, Quarantine, Stamping out, Disinfection, Compensation, Awareness, No vaccination Technical Detection, Quarantine, Stamping out, Disinfection, Compensation, Awareness, No vaccination
30 Positive factors Determination of the Gov. (4th Feb.) Decision on banning, Population organized, Awareness (TV, Newspaper, Radio ), Ojective reasons: virus virulence, human cases,
31 Could it be better? Natl. Steerring Committee 1 month after. Human case, Diagnosis, Institutional, Tet (Lunar New Year :1st Feb) Scientist discussions Delay = Disease spreading No preparedness: Diagnosis, Compensation policy, Institutional, Human Unanimity is primordial in fightings
32 Consequences! 57 out of 64 provinces affected! 40 million birds have either died or been destroyed (Aprox. 20% of total population)! Estimated economic loss " Total US$ 120 million Direct loss = 40 million Indirect loss = 40 million Cost of containment = 40 million
33 Influenza (H5N1) infection in Humans in Vietnam! Exposure history to ill or dead chickens! No disease among cullers! No human to human transmission proved! Total of 23 deaths in 33 confirmed cases 15/22 in Vietnam, 8/11 in Thailand! Prevalence in humans: under investigation 10% of poultry workers sero-positive in Hong Kong % of poultry workers sero-positive in Netherland 2003
34 Lessions learnt Early and accurate detection. Transparency and gov. determination timely. Unanimity on an updated understanding, Compensation (unanimous) policy. To alert but not to frighten Systematical surveillance (zoned at-risk-group) Awareness (Vet & Medical Corps first) Interest affected differently.
35 Lessons contd. Measures adapted to the actual situation. Evidence proved again that human Infl. comes from birds. AI virus can readily infect humans and other mamalians directly.
36 More questions arisen An inmunity driven H5N1 AI virus? AI virus readily infect humans. What determine the species barrier? Were pigs infected by H5N1? LPAI can induce avian pandemic after becoming HPAI virus. Human pandemic needs absolutely in-mamal s reassoted virus? Bird to human way of transmission?
37 Thank you
38 Fairy tale of tomorow: Long long ago, the ducks and the chickens were still free, they were friends and shared the same sweat
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