PANDEMIC RISKPANDEMIC RISK

3 pre-requisites for a Pandemic3 pre-requisites for a Pandemic1.1. The emergence of a new virus strain with no The emergence of a new virus strain with no

circulating immunity within the human circulating immunity within the human populationpopulation

2.2. The ability of this strain to infect humansThe ability of this strain to infect humans

3.3. The potential for the new virus to be easily The potential for the new virus to be easily transmitted from person to persontransmitted from person to person

At present, two of the prerequisites for a At present, two of the prerequisites for a pandemic have already been met – a new pandemic have already been met – a new virus capable of infecting humans is virus capable of infecting humans is circulating. circulating.

Pandemic Pandemic riskrisk

Threat of Global Pandemic-Threat of Global Pandemic- Virus may change to highly infectious form for human and Virus may change to highly infectious form for human and

spread from spread from person to personperson to person i.e. i.e. increased transmissibility among human acquired by:-increased transmissibility among human acquired by:-

(a) Reassortment: exchange of genetic material - (a) Reassortment: exchange of genetic material - human + avianhuman + avian or pig or pig

(b) Adaptive mutation- gradual-binding to human cell (b) Adaptive mutation- gradual-binding to human cell increasesincreases

IF PANDEMIC OCCURS – on the basis of 1957 pandemic:IF PANDEMIC OCCURS – on the basis of 1957 pandemic:

- Estimated 2M to 7.4M deaths - with attack rate 25-35% of - Estimated 2M to 7.4M deaths - with attack rate 25-35% of total total population population-Virus with mild disease-Virus with mild disease

-Best circumstances-Best circumstances

SIGNALS FOR PANDEMICSIGNALS FOR PANDEMIC

Cluster of patients with Symptoms of influenza - closely related Cluster of patients with Symptoms of influenza - closely related in time and space suggest human to human transmission in time and space suggest human to human transmission started.started.

Detection of cases in health workers caring for H5N1 would Detection of cases in health workers caring for H5N1 would suggest human to human transmissionsuggest human to human transmission

InvestigateInvestigate -– to confirm diagnosis -– to confirm diagnosis

-- identify source-- identify source

-- determine whether human to human -- determine whether human to human transmission is occurring transmission is occurring

Study virus – specialized WHO Reference LaboratoriesStudy virus – specialized WHO Reference Laboratories

Genetic spotting and other properties.Genetic spotting and other properties.

WHO Pandemic phasesWHO Pandemic phases

WHO pandemic plan: strategic WHO pandemic plan: strategic elementselements

1.1. Reduce human exposure Reduce human exposure to H5N1to H5N1

2.2. Strengthen early Strengthen early warning systemwarning system

3.3. Intensify rapid Intensify rapid containment measurescontainment measures

4.4. Build capacity to cope Build capacity to cope with pandemicwith pandemic

5.5. Coordinate a broad Coordinate a broad multi-sectoral responsemulti-sectoral response

PANDEMIC WILL LEAD TO

•Increased number of people seeking health services

•High rate of absenteeism

•Interruption of essential services— law services, transportation, communication

•Social and economic disruptions

•Losses in trade and commerce

•Curtailment in Intercountry assistance-protection of domestic populations

A Global Strategy for the A Global Strategy for the Progressive Control of Highly Progressive Control of Highly Pathogenic Avian InfluenzaPathogenic Avian Influenza

A Global Strategy for the A Global Strategy for the Progressive Control of Highly Progressive Control of Highly Pathogenic Avian InfluenzaPathogenic Avian Influenza

Infection Control MeasuresInfection Control Measures

1.1. SurveillanceSurveillance2.2. EducationEducation3.3. Influenza TestingInfluenza Testing4.4. Antiviral ChemoprophylaxisAntiviral Chemoprophylaxis5.5. Respiratory HygieneRespiratory Hygiene6.6. Standard precautionsStandard precautions7.7. Droplet PrecautionsDroplet Precautions8.8. Restrictions for ill visitors and ill health Restrictions for ill visitors and ill health

care personalscare personals

WILD LIFE

HEALTHVETERINARY

EARLY WARNING & RESPONSE SYSTEM

vaccinationvaccinationInactivated influenza Inactivated influenza

vaccinevaccineLive attenuated Live attenuated

vaccine(LAIV)vaccine(LAIV)

H5N1 VaccineH5N1 Vaccine

WHO is creating a global stockpile WHO is creating a global stockpile of H5N1 vaccine which could within of H5N1 vaccine which could within 2 years, potentially contain at least 2 years, potentially contain at least 50 million doses – enough for 25 50 million doses – enough for 25 million people to receive two doses, million people to receive two doses, which is likely to be needed to which is likely to be needed to achieve protective levels of achieve protective levels of antibodies.antibodies.

BIOSECURITYBIOSECURITY

Biosecurity includes the management of all biological and environmental health risks associated with food.

Two main elements:

BIO-CONTAINMENT

BIO-EXCLUSION

Major components :

Isolation

Traffic Control

Sanitation

HIGH

biosecurity

LOW

HIGH

A. Birds are always kept in a close building

B. Birds have access to a fenced park

C. Birds are let free in the farm yard

D. Birds are let free in and outside the farmyard

E. Birds go to rice fields and

come back

The key biosecurity The key biosecurity measuresmeasures

✦✦ Keep the wild Keep the wild birds awaybirds away

✦✦ Avoid multi-age Avoid multi-age poultry farmspoultry farms

✦✦ Obtain feed from Obtain feed from a clean, dependable a clean, dependable sourcefarm.sourcefarm.

✦✦ Clean and Clean and disinfect the disinfect the premises and premises and equipment on farmsequipment on farms

Exclude poultry from Exclude poultry from the homethe home

✦✦ Effective Effective management of management of hazardous wasteshazardous wastes

Use only clean and Use only clean and disinfected disinfected transport vehicles transport vehicles for movement of for movement of poultry and eggs.poultry and eggs.

SECURED PRIMARY FARMINGSECURED PRIMARY FARMING PRACTICESPRACTICES

Safe transportSafe transport

Avoid collecting Avoid collecting and transporting and transporting birds from different birds from different farms or collection farms or collection centres in the centres in the same vehiclesame vehicle Give preference to Give preference to non-wooden non-wooden /bamboo cages/bamboo cages

Biosecurity in wet marketsBiosecurity in wet markets

Biosecurity at customer & Biosecurity at customer & consumer endconsumer end

Avoid buying live Avoid buying live poultry/ birdspoultry/ birds

Keep CleanKeep Clean Separate raw and Separate raw and

cooked food itemscooked food items

Cook thoroughlyCook thoroughly Do not prepare Do not prepare

and consume and consume speciality raw speciality raw dishesdishes

Keep food at safe Keep food at safe temperatures .temperatures .

• The Avian influenza crisis is currently one of the most important public health issues of our time with tremendous implications for peoples’ livelihoods and socio-economic impacts.

• These require effective inter-sectoral collaboration between the Ministries of Agriculture and Health of countries in order to solve the problems associated with these outbreaks.

CONCLUSIONCONCLUSION

THANK THANK YOUYOU