intercontinental spread and strategies to control highly ... · david e. swayne exotic &...
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David E. Swayne
Exotic & Emerging Avian Viral Diseases Research Unit
Southeast Poultry Research Laboratory
U.S. National Poultry Research Center
ARS, USDA, Athens, Georgia, USA
Intercontinental Spread and
Strategies to Control Highly
Pathogenic Avian Influenza
Outbreaks
Avian Influenza
• Orthomyxovirus with protein projections on the surface:– 16 hemagglutinin subtypes (i.e. H1-H16)– 9 neuraminidase subtypes (i.e. N1, N2,
N3….N9)– Thus named: H5N1, H9N2, H5N2, etc.
• Vary in disease production (chickens): – Low pathogenicity (LP): local - mild
respiratory disease and egg drop – (H1-16)– High pathogenicity (HP): systemic - deadly
disease (some H5 & H7)
• Can infect a variety of poultry and wild birds species, depending on virus strain
1. Global Control for HPAI
Historical “Stamping-out” Program:
• Enhanced biosecurity → prevent HPAI
introduction onto naïve farms or from leaving
affected farms; movement control essential
• Diagnostics and surveillance → quickly find HPAI
• Elimination of infected poultry (culling) → stamp-
out HPAI action plan
• Education → your individual responsibility and
high compliance rate• Decreasing host susceptibility (vaccines/vaccination) → temporary
solution (5 of 40 outbreaks) (Preventative or Management of Diseases)
Eradication is historical strategy for HPAI
1.1 AIV Ecology/Epidemiology: Dogma
LPAIV
(H1-16)
LPAIV
(H1-13)
Exposure
HPAIV
(H5/H7)HA
Mutation
• Outdoor rearing
• Outdoor access
• Wild bird access
to buildings
•Environmental
exposure Adaptation
e.g.: H9N2 Middle East, Asia, N. Africa
H5N2 Mexico & Central America
e.g.: H7N8 USA 2016
H5N2 USA (1983-84)
H7N3 Mexico (2012-)
20. 2002: Chile, H7N3
21. 2003: Netherlands, H7N7
22. 2004: USA, H5N2
23. 2004: Canada, H7N3
24. 2004: S. Africa, H5N2 (ostriches)
25. 2006: S. Africa, H5N2 (ostriches)
§26. 2005: N. Korea, H7N7
27. 2007: Canada, H7N3
28. 2008: England, H7N7
29. 2009: Spain, H7N7
30. 2011-3: S. Africa, H5N2 (Ostriches)
31. 2012: Chinese Taipei, H5N2
§32. 2012-present: Mexico, H7N3
33. 2012: Australia, H7N7
34. 2013: Italy, H7N7
35. 2013: Australia, H7N2
36. 2015: England, H7N7
37. 2015: Germany, H7N7
38. 2015: France, H5Nx
39. 2016: USA, H7N8
40. 2016: Italy, H7N7
§Vaccine used in the control strategy
1. 1959: Scotland, H5N1
2. 1961: S. Africa, H5N3
3. 1963: England, H7N3
4. 1966: Canada, H5N9
5. 1975: Australia, H7N7
6. 1979: Germany, H7N7
7. 1979: England, H7N7
8. 1983-84: USA, H5N2
9. 1983: Ireland, H5N8
10. 1985: Australia, H7N7
11. 1991: England, H5N1
12. 1992: Australia, H7N3
13. 1994: Australia, H7N3
§14. 1994-95: Mexico, H5N2
§15. 1995 & 2004: Pakistan, H7N3
16. 1997: Australia, H7N4
17. 1997: Italy, H5N2
§18. 1996-present: Eurasia/Afr./N.
America, H5Nx (including N1, N2, N3,
N5, N6, N8 reassortants)
19. 1999-2000: Italy, H7N1
1.2. 40 HPAI Disease Events
• H5 Gs/GD largest & longest running since 1920-30
• 1996-2014: 68 countries in poultry, wild birds or humans
• >500m poultry died/culled by mid-2005, >$10B in losses
• Focused in Old World, Northern Hemisphere
1.3 Ecology/Epidemiology: Gs/GD HPAIV
LPAIV
(H1-16)
LPAIV
(H1-13)
Exposure
HPAIV
(H5/H7)HA
Mutation
• Outdoor rearing
• Outdoor access
• Wild bird access
to buildings
•Environmental
exposure Adaptation
Domestic Ducks
H5 Gs/GD
Exposure
Re-adaptation Wild
Waterfowl
A/goose/Guangdong/1/1996 lineage is unique in affecting domestic
poultry (including waterfowl) and wild aquatic birds
– Free-ranging production creates challenges: • Minimal movement controls• Intermixing with wild waterfowl • Short window of availability for vaccination• Difficulty in giving 2 immunizations
– Vaccination has become problematic – lack of consistent disease has reduced farmer support of vaccination
1.4 H5N1 Gs/GD HPAI
• Triad: wild aquatic birds with smallholder and commercial integrated poultry
• Asymptomatic HPAIV-infected domestic ducks have become a major player, and in some locations a reservoir of HPAIV
LPM
H5 GS/GD HPAIV EPIDEMIOLOGY
Naïve
Commercial
Poultry
Infected Poultry
(most HPAIV)
Village
Poultry
Fomites
(clothing, shoes
& equipment -
mechanical)
Periurban
birds
Wild or
Domestic
Waterfowl
1.5 Gs/GD HPAIV
• Three episodes of transboundary H5Nx Gs/GD lineage HPAIV introduction by wild birds– 2005: Spread westward from Quinghai Lake China
to Europe– 2010: Central Asia to Japan and Korea– 2014-15: China to Korea/Japan to Russia, Europe
and North America
• Denial of the major contribution of HPAIV spread in country from agricultural systems – Blame on wild birds for majority of HPAIV spread – Legal and illegal movement/trade of live poultry
main risk factor in spread– Blame all legal trade on meat as high risk even with
OIE code mitigations for risk reduction
1.6. NDV - historical surrogate global poultry
disease, but without severe public health concern
80 countries: NDV; active, suspect or unresolved
July-Dec
2015
Jan-June
2015
(75 poultry or wild birds & poultry, 5 wild birds only)
Summary 1
• Traditional Stamping-out Programs have not eliminated/eradicated H5 Gs/GD HPAIV from the globe, and its “persistence” has changed all control paradigms– Some countries have eliminated/eradicated but a
reservoir in other countries maintains the virus for resurgences, including reintroductions
– Staging for global elimination/eradication: risk reduction and control strategies
– Maintain food security – vaccination stop gap measure
– Upgrading production systems or HPAIV will become as NDV has since 1920’s
• Since 1996 – H5N1 hemagglutinin gradual changes – e.g.
DRIFT (like seen with human seasonal flu)
2.3.4.4
2012-…2016
2.3.2.1
2.2.1
1.1
7.2
2.1.3
2.1 H5 Gs/GD-lineage HPAIV
H5N1 HPAI (22)Bangladesh
Bhutan
Cambodia
Canada
China
Egypt
Germany
Hong Kong
India
Indonesia
Italy
6 genetic clades1.1.2, 2.1.3.2, 2.2.1, 2.3.2.1,
2.3.4.4, 7.2
Epicenter – S. Central &
SE Asia, & NE Africa
2.1. Distribution of H5 Gs/GD Subclades
Japan
N. & S. Korea
Laos
Libya
Nepal
Netherlands
Russia
United Kingdom
USA
Vietnam
Subclade Poultry/Wild Birds Infections Human Cases
1.1.2 Cambodia, Viet Nam Cambodia (7)
2.1.3.2a Indonesia
2.2.1 Egypt, Libya Egypt (4)
2.3.2.1a Bangladesh, India Cambodia
2.3.2.1c China, Indonesia, Lao, Viet Nam Indonesia (1)
2.3.4.4 China (H5N1/N6/N8), Japan & Korea (Rep.)
(H5N8); Lao (H5N6), Viet Nam (H5N6/N1),
Canada Chinese Taipei, USA
China (H5N6) (1)
Unknown Korea (Dem. Peoples Republic) Indonesia (1)
H5N1 HPAI hemagglutinin clades1.1.2 2.1.3.2 2.2.1 2.3.2.1 2.3.4.4 7.2
Reassortment
of Genes
Other
Avian Influenza
Viruses from
Wild Birds and
Live Poultry
Markets
H5N1 (2.3.4.4)
H5N2 (2.3.4.4)
H5N3 (2.3.4.4)
H5N5 (2.3.4)
H5N6 (2.3.4.4)
H5N8 (2.3.4.4)
Drift
Shift
2.1. One Predictable Issue About Avian
Influenza Viruses – They Change
Outcome: Gene reassortment
(e.g. Shift) with H5N2, H5N3,
H5N5, H5N6, H5N8 emerging in
Asia and North America
Recent:• H5N8 HPAI outbreaks in poultry and wild birds – S. Korea & Japan,
winter 2014
• Spring 2014 virus moved to Siberia and west Alaska
• Fall 2014: H5N8 appeared Europe (IcA1), North America (IcA2)
• Fall 2014: Reassortant H5N2 and H5N1 in North America
2.2 Intercontinental Spread 2.3.4.4 Gs/GD lineage HPAIV
Lee et al., J Virol 89:6521–6524, 2015
Winter 2014
Fall 2014 – Winter 2015
Western Russia, Europe,
Japan
North America,
Japan
Chinese Taipei
Japan & Korea
• 311 detections (4 captive wild bird; 21 backyard; 211
commercial flocks, 75 wild birds)
• 21 states affected (AR , CA, IA, ID, IN, KS, KY, MI, MN, MO,
MT, NE, ND, NM, NV, OR, SD, UT, WA, WI, WY)
• ~ 48.6 million commercial birds: Turkeys ~7.5 million (n=153),
Chickens ~41.1 million (n=47)
12/8/2015 to 6/17/2015 – H5 HPAIV in wild bird, backyard
poultry and commercial poultry
Pacific Flyway
Midwest: Central/
MS flyways
USFW
Lesser Snow
Goose (Chen
caerulescens)
Northern Shoveler
(Anas clypeata)
Ring-necked Duck
(Aythya collaris)
Cinnamon Teal
(Anas cyanoptera)
H5Nx North America
Infectivity assess: via BID50
ver09May2015
H5N2
Index
casesH5N1
H5N8
<2log10 mallards
3log10 D. ducks
4.3log10 chickens
5.0log10 turkeys
<2log10 mallards
3log10 D. ducks
5.7log10 chickens
5.0log10 turkeys
3.3log10 EID50 chickens
5.1 log10 EID50 chickens
3 genes (HA, M, PB2)
ver09May2015
269 viruses, 3 genes
(HA, M, PB2)
Pacific Flyway
Central & MS FlywaysH5Nx North America
• Initial spread by wild waterfowl
• Later, farm-to-farm human activity
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H5 HPAI H7 HPAI Me
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Asian-African-European- N. America H5Nx
• 35 epizootics used stamping-out alone, but 5 epizootics
added vaccination as a additional control component
• Vaccination - immediate positive impact on HPAI
prevention & management (disease & mortality)
• But stamping-out alone was associated with shorter
eradication times than stamping-out + vaccination
programs (Pavade et al. OIE Sci Tech Rev 30:661-671, 2011)
• HPAI vaccination can be associated with complacency
Traditional stamping-out (35)
Vaccination included (5)
2.3. HPAI Control Metrics
Timeline HPAI:
14 countries vaccinated poultry against HPAI (2002-2010)
• Preventive (<0.2%): Mongolia, Kazakhstan, France, The Netherlands
• Emergency (<0.8%): Cote d’Ivoire, Sudan, PDR Korea, Israel, Russia, Pakistan
• National/routine (>99%): China (including HK), Egypt, Indonesia and Vietnam,
plus added Bangladesh and Mexico
103715
85081
0.816 862643
0.006 35 2.8 0.068 2.2 108 425 6.3 1626
0
20000
40000
60000
80000
100000
120000
Doses of Vaccine (millions): 2002-2010 (Total >113b)
(90.99%)
(2.32%)(4.65%) (1.43%)
Swayne et al., OIE Sci Tech Rev 30(3):839-870, 2011
2.4. HPAI Vaccination Program
What Can Vaccines Do?
Increase resistance to AIV infection
Reduce replication of AIV in respiratory & GI tract
Prevent illness and death in poultry
Reduced environmental contamination
Reduced transmission to birds
Maintained livelihood and food security of rural poor
Result: Vaccines manage disease
Negative: Makes diagnosis and surveillance difficult
What is needed to have effective LPAI or HPAI
vaccination program?1) High potency vaccine
2) Antigenically relevant vaccine seed strains
3) Proper vaccination program
4) Adequate number of vaccinations
5) Monitor vaccinated populations for protective
titers
6) Survey vaccinated populations to find vaccine
resistant AIV (‘DIVA’)
Vaccines/Vaccination
OIE Performance of Veterinary Services (PVS) tool: Higher critical competencies associated with better HPAI control: • Staffing of veterinarians and paraveterinarians• Professional competencies & continuing education of vets• Emergency funding• Veterinary laboratory diagnosis• Epidemiological surveillance• Availability of veterinary medicines and biologicals• Transparency• Disease prevention, control and eradication measures
Outcome:• Higher PVS scores were associated with shorter time to
eradication, fewer outbreaks, lower mortality rate, and
higher culling rate
Risk Factors for Delayed Eradication
Summary 2
• What is limiting elimination/eradication– Low biosecurity/movement control of small
holder/live poultry market system– Lack transparency & lapses in biosecurity of
commercial integrated production system– Lack of effective compensation system– Inadequate national, Provincial/State and/or local
veterinary services– Limited outside resource funding long term: e.g.
donor fatigue– Need for effective restructuring of national
poultry production systems (long-term)– Inadequate/inflexible vaccination programs
Global Improvements in Last 10 Years
• Rapid Diagnosis – RRT-PCR accelerated speed and
accuracy
• Increased usage of indemnification
• Rapid depopulation – CO2 (whole house and plastic
tent methods) and foam
• Safe Disposal – composting or burial
• Re-invigorated veterinary infrastructure
• Partnerships (trust): government/academia/industry
• Improved surveillance methods (poultry & wild birds)
• Emergency response plans and exercising
• Regionalization of poultry trade
Challenges for Future
• Consistent practice of biosecurity: Are we doomed to
repeat the mistakes of the past?
– Economics
– Social structure
– Low education of workers and farmers
• Vaccines for emergency verses routine use – when &
how
• Resurgence of outdoor rearing in developed and
developing countries: Partnership, trust and education
in outdoor rearing systems for risk reduction and early
detection
• Movement controls and LPM system
• Early warning system in wild bird detections
Conclusions
• Biosecurity is critical in control and eradication
• Eradication requires strong veterinary services,
movement controls, and high level of buy-in and
observance by growers
• Eradication HPAI is not achievable in immediate
future in developing world
– Large number of small producers
– Lack of fair and fast compensation system
– Live market systems disfavors movement control
system and biosecure production
• Prevention is critical in non-affected countries
Conclusion
• Enhance biosecurity on farms after audits on each farm to prevent introduction
• Movement controls/restrictions
• Increased surveillance for earlier detection, quarantine and stamping-out
• Quick depopulation of infected premises (24hr)
• Safe disposal of carcasses and litter
• Vaccine bank for high risk areas
Prevention
Merci Beaucoup!