USAID s approach to the control of avian and pandemic influenza

Transcription

1 USAID s approach to the control of avian and pandemic influenza Murray Trostle, Dr. PH Deputy Director Avian and Pandemic Influenza Unit USAID December 19, 2006

2 USAID goals Prevent an influenza pandemic Contain a human outbreak before it can cause a pandemic In the event of a pandemic, identify and support humanitarian response measures to reduce morbidity and mortality

3 USAID approach Surveillance and Diagnosis Strengthen surveillance and laboratory diagnostic capacity Early-warning networks Incentives to encourage public cooperation Response Containment measures including culling & disposal, animal vaccination Leverage private sector resources Preparedness Support pandemic planning and simulations Communications Targeting high risk populations, general public, to promote low-risk behavior Press/media training and media management to minimize inaccuracies Research Stockpiling

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6 H5N1 outbreaks in poultry (30 November 2006) Total = 4,465 Source:

7 Global HPAI temporal spread since Dec 03 Source: EMPRES Watch: Evolution of Highly Pathogenic Avian Influenza type H5N1 in Europe: review of disease ecology, trends and prospects of spread in autumn-winter

8 Initial Human H5N1 Cases Closely Follow Animal Outbreaks In Most Countries Country 1st animal outbreak started* Jan 2006 Feb st human case (onset of symptoms)* Time lag (months) Total animal outbreaks Total human cases* Azerbaijan Feb Cambodia Jan China/HK Mar 1997 May China Djibouti Egypt Indonesia Iraq Thailand Turkey Vietnam Feb 2004 Apr 2006 Feb 2006 Feb 2004 Jan 2006 Dec 2003 Oct 2005 Dec 2003 Nov 2003 Apr 2006 Mar 2006 Jul 2005 Jan 2006 Jan 2004 Jan 2006 Dec , , Data from WHO and OIE Mean = 3.3 months Median = 1 month

9 Reports of Human Cases Do Not Always Correlate with Reports of Animal Cases Monthly H5N1 human cases & deaths Monthly H5N1 outbreaks in animals D J F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A? D J FMAMJ J ASOND J FMAMJ J ASOND J FMAMJ J A

10 Indonesia 216 animal outbreaks, 74 human cases, 57 deaths 300 million chickens in small back-year free-range farms Government decision-making is primarily at the district level The problem has been that animal outbreaks due to HPAI have occurred throughout the country but very few are reported.

11 Participatory disease surveillance/response Animal health officer teams in 75 districts Average of 2 outbreaks per district per week Integrate with human health surveillance teams and community-based activities

12 Participatory disease surveillance/response Created an evidencebased avian influenza surveillance and control program that is providing the first high quality reporting of animal outbreaks and better implementation of recommended control measures A participatory disease response team is trained in how to properly respond to the event within 24 hours

13 Community involvement Community members trained to detect and report events Response includes identification of means of transmission

14 Mapping in the rural Indonesian PDS/R Context

15 Participatory disease surveillance/response There are two elements to the response Immediate containment response based on culling and ring vaccination Engagement of the community to develop appropriate prevention measures Constraints Inadequate vaccine supply Lack of compensation Inadequate technical support to community decision making

16 A Transformational Moment The growing political and public concern about AI has created an unprecedented opportunity a Transformational Moment to directly address the causes that give rise to AI and other emergent diseases.

17 A Transformational Moment We need to take this opportunity to make serious investments in broad surveillance capacity that will enable countries to face future infectious disease threats We also need to take this opportunity to begin to alter the ways in which humans and animals interact in order to reduce the threat from zoonotic diseases in the future.

18 Thank You