Highly Pathogenic Avian Influenza Worldwide situation Larnaca, Cyprus, July 2009
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1 Highly Pathogenic Avian Influenza Worldwide situation Larnaca, Cyprus, July 2009 Dr Ghazi Yehia OIE Regional Representative for the Middle East
2 HPAI Subtype H5N1: sequence of events : confined to South East Asia 2005: spread to Central Asia, Russia, Eastern Europe Beginning 2006: first infection African Continent (Nigeria) and Middle East 2006: Spread into Western Europe (mainly wild birds) 2007, 2008 and 2009: Endemic countries, new infections and re-occurrences
3 Behaviour of the current Subtype H5N1 Spread through 3 continents widespread unprecedented 62 countries/territories reported the occurrence of highly pathogenic avian influenza (HPAI) virus subtype H5N1 Role of commercial exchanges and migratory waterfowl Difficult to control in countries unable to rapidly detect and control the virus Stability of the strain: no human to human transmission
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8 The situation today Reoccurrence in 2009 (resolved): Germany (wild bird only) Lao Hong-Kong (SARPRC) New Outbreaks in 2009 Nepal (first occurrence) Bangladesh China (PR) Egypt India Indonesia Vietnam Mongolia Russia
9 The situation today
10 Observed human cases ( ) Country China Egypt Indonesia Vietnam 2008 cases deaths cases deaths Total cases deaths Total number of cases includes number of deaths. WHO reports only laboratory-confirmed cases. All dates refer to onset of illness.
11 Major Migration Flyways
12 Greater White-fronted geese migration Winter area Breeding area Moult migration Migration Connection?
13 Garganey (Anas querquedula) migration (ringing)
14 Ruff Philomachus pugnax migration
15 White Stork (Ciconia ciconia) migration
16 The situation in the Middle East Since march 2008, except Egypt, no outbreak have been reported in the Middle East Egypt declared to the OIE the 07 July 2008 that HPAI H5N1 is considered as endemic in the country
17 The situation in Egypt Since 17/02/06, Egypt notified 1423 outbreaks to OIE There was seasonality in the outbreak occurrence: a relapse phase of HPAI disease in winter and a decline phase in summer when outbreaks are observed mainly in backyard flocks.
18 The situation in Egypt About 1 million birds have been already destroyed In 2008, about 100 millions birds have been vaccinated (routine and ring vaccination) 81 human cases with 27 deaths
19 The situation in Egypt High concern for the ME Birds vital space (ducks ) and Migratory routes
20 The situation in Egypt High concern for the ME Trade of birds within the region
21 Some Important Lessons learned Early detection and rapid response have prevented establishment of disease in the majority of the infected countries Delayed detection and response have led to entrenched disease (Indonesia, Nigeria, Egypt) Strong governance and efficient national chain of command are essential Compensation is crucial to encourage transparency and biosecurity measures
22 Some Important Lessons learned (Cont) Vaccination can limit spread, but if used alone and with no permanent monitoring it does not eliminate H5N1 Authoritarian policies to change poultry production systems are often inefficient and can be dangerous Specific strategies to control the virus can be efficient (e.g. Vietnam and Thailand) The role of public and private veterinary networks is crucial Inter-sectoral collaboration is essential
23 Conclusions There is a trend of decline of HPAI H5N1, since 2007 in both the number of affected countries and the number of notified outbreaks, that was reinforced in 2009 Nevertheless H5N1 is still a threat of high concern for all Middle Eastern countries considering that the virus has become endemic in some countries, such Egypt Efforts should be continued and strengthened by countries that permanently notify new outbreaks in 2009 so to eradicate the disease in birds and protect Human health
24 Acknowledgements Dr Karim Ben Jebara and the OIE Scientific Information Department
25 Thank you for your attention OIE for the Middle East Kfarshima (Beirut) - Lebanon
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