Identifier
Created
Classification
Origin
05HANOI502
2005-03-01 10:43:00
UNCLASSIFIED
Embassy Hanoi
Cable title:  

Second FAO/OIE Regional Meeting on Avian Influenza

Tags:  AMED AMGT CASC EAGR TBIO VM AFLU 
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UNCLAS SECTION 01 OF 06 HANOI 000502 

SIPDIS

DEPT FOR EAP/BCLTV (DUNLAP),CA/OCS/ACS/EAP, OES/STC
(GOLDBERG),OES/IHA (SINGER, COMELLA)
DEPT DOD FOR OSD/ISA/AP FOR LEW STERN
DEPT PASS HHS FOR OGHA/STEIGER, BHAT, ELVANDER;
CDC/NCID/COX
USDA FOR FAS/PASS TO APHIS

E.O. 12958: N/A
TAGS: AMED AMGT CASC EAGR TBIO VM AFLU
SUBJECT: Second FAO/OIE Regional Meeting on Avian Influenza
Control in Asia, Ho Chi Minh City, Vietnam: 23-25 February
2005

Summary
-------

UNCLAS SECTION 01 OF 06 HANOI 000502

SIPDIS

DEPT FOR EAP/BCLTV (DUNLAP),CA/OCS/ACS/EAP, OES/STC
(GOLDBERG),OES/IHA (SINGER, COMELLA)
DEPT DOD FOR OSD/ISA/AP FOR LEW STERN
DEPT PASS HHS FOR OGHA/STEIGER, BHAT, ELVANDER;
CDC/NCID/COX
USDA FOR FAS/PASS TO APHIS

E.O. 12958: N/A
TAGS: AMED AMGT CASC EAGR TBIO VM AFLU
SUBJECT: Second FAO/OIE Regional Meeting on Avian Influenza
Control in Asia, Ho Chi Minh City, Vietnam: 23-25 February
2005

Summary
--------------


1. The Second FAO/OIE Regional Meeting on Avian Influenza
Control in Asia was attended by 168 individuals including
Chief Veterinary Officers of 28 countries and a delegation
from Vietnam's Ministry of Agriculture and Rural
Development, headed by Minister Cao Duc Phat. Leaders of
the UN Food and Agriculture Organization, the World
Organization for Animal Health and, the World Health
Organization emphasized that, although Avian Influenza A,
subtype H5N1 (AI),is an animal disease causing great
economic and social impact on affected countries, the
disease could lead to a new global human health crisis in
the form of an influenza pandemic. Conference attendees
agreed that one year after the beginning of the crisis, AI
is endemic in many countries of Asia, circulating among
poultry, ducks and wildlife in the region, and continues to
pose a serious threat to human health and animals.
Nevertheless, progress has been made in the understanding
of the virus, its early detection and response to the
disease and the role of vaccines in disease prevention.
Over the past year experts have determined that
transmission of the virus occurs primarily as a result of
animal production methods and animal marketing behaviors in
the region. Economic analyses on the impact of AI in the
region suggested that these types of outbreaks are harder
on the poor who rely on growing poultry as a means to make
additional income as well as a necessary source of dietary
protein. Conference recommendations to control virus spread
and disease stressed the need to improve international
coordination, national and regional veterinary services,
diagnostic laboratory capacity, disease surveillance and
epidemiology studies, and more transparent data sharing and
called on developed and developing countries to contribute
to these efforts. The conference presentations and the

reports will be posted on the FAO website at
http//:www.fao.org.


Opening Remarks
--------------


2. The Second FAO/OIE Regional Meeting on Avian Influenza
Control in Asia was attended by 168 individuals including
Chief Veterinary Officers of 28 countries and a delegation
from Vietnam's Ministry of Agriculture and Rural
Development (MARD),headed by Minister Cao Duc Phat. The 3-
day conference was jointly organized by the UN Food and
Agriculture Organization (FAO) and the World Organization
for Animal Health (OIE),in collaboration with the World
Health Organization (WHO). The regional leaders of each of
theses organizations and Minister Phat addressed the
conference. All underscored the immediate challenges and
necessity to lessen the impact of the virus in countries
where it is endemic and to prevent its spread into
unaffected countries. While H5N1 infection has caused
considerable economic and social disruption for some
economies, the potential social and economic effects of a
human influenza pandemic would be devastating. Dr. Shigeru
Omi, World Health Organization Regional Director for the
Western Pacific urged all governments to work on a pandemic
preparedness plan now; explaining that the last influenza
epidemic was 40 years ago, that this resilient, versatile
and highly pathogenic virus is firmly entrenched in Asia
(infecting species, such as cats and tigers that were
previously not thought to be susceptible to Influenza A
viruses),and that the public implications of domestic
ducks carrying and excreting large quantities of the virus
without signs of illness were enormous. He stressed that
the longer the virus circulated in animals, the greater the
risk of human cases, and the higher the risk of a pandemic
virus emerging through genetic changes in the virus.


3. Both Dr. T. Fujita, OIE Representative, Asia and the
Pacific Region, and Dr. Samuel Jutzi, Director Animal
Production and Health Division, FAO, Rome, emphasized the
need for international collaboration and partnerships to
strengthen veterinary services in the region for more
effective early detection and response systems, biosecurity
and, ultimately, disease control. Both organizations are
working together to strategically control trans-boundary
animal diseases, globally and regionally under the FAO/OIE
Global Framework for the Progressive Control of
Transboundary Animal Diseases.


4. Minister Cao Duc Phat noted that Vietnam had
experienced an unprecedented number of human deaths due to
H5N1 infection. He described the measures Vietnam and MARD
have taken since late 2003 when the H5N1 outbreaks were
first acknowledged including the culling or death of 43.8
million poultry or 16.8% of the total poultry population in
2003/2004 and more than 1.5 million more as a result of the
2004/2005 outbreaks. Other activities include full and
timely disclosure of outbreak situations, improving control
of poultry movement and transportation and slaughtering
practices, improving biosecurity, mobilizing government
authorities at all levels and public organizations to
participate in disease prevention and control, and
monitoring disease in duck populations and restricting
breeding and others. However, Vietnam still faces many
challenges including the persistence of backyard and small-
scale production facilities, limited veterinary skills in
the country as a whole, and limited laboratory and
diagnostic capabilities. He acknowledged assistance from
international donors and multinational organizations and
pledged Vietnam's willingness to share experiences and
participate in activities of the international community to
prevent and control AI.

Epidemiology of Avian Influenza A, Subtype H5N1
-------------- --


5. Dr. Roger Morris, Massey University EpiCenter, New
Zealand, outlined the current epidemiology of Avian
Influenza H5N1 in Asia. H5N1 viruses were first isolated
in geese and domestic ducks in 1996 and have been
circulating extensively in the region since then. There are
no records of the virus in wild birds until 2002. The
spread throughout the region since the first identification
of H5N1 in diseased geese in 1996 may be due to a number of
factors such as cross infection at live poultry markets,
movement of infected birds, inadvertent transport of the
virus on equipment and infection of migratory birds by
domestic ducks and geese. Migratory birds are not thought
to be the main source of viral transmission. Dr. Morris
notes that the epidemic is best understood as a "reservoir-
spillover-aberrant host relationship" -- that is, domestic
ducks, geese and quails are the reservoir, which infected
wild waterfowl and then domestic poultry, spilling over to
a number of mammalian species, including man as an aberrant
host becoming diseased but not involved in transmission
(yet). Dr. Ian Brown OIE/FAO Reference Laboratory for AI,
VLA-Weybridge UK, provided further evidence noting that
since first recognized, the H5N1 virus has mutated numerous
times; these changes are reflected in changes in the
pathology of the disease in the host and spreading to other
unlikely hosts.


6. Recent analyses from Thailand showed significant
correlation between free grazing duck distribution and the
distribution of outbreaks of AI in domestic poultry.
Analyses of Vietnam's poultry outbreaks appear to show
similar patterns, clustering primarily in the Red River
Valley, near Hanoi in the north of Vietnam and in the
Mekong River Delta region in the south of Vietnam where the
density of both poultry, water fowl and humans are high.
Dr. Nguyen Tien Dung, Chief, Virology Department, National
Institute for Veterinary Research (NIVR),identified
through sero-surveillance studies risk factors contributing
to both the first (2003/2004) and second (2005/2005) AI
outbreaks in Vietnam. Risk factors include: high chicken
and duck density, bird movement (marketing, offal disposal,
and disposal of infected birds),poultry management
practices (backyard flocks, raising/housing of multiple
bird species in a single location, and little or no
biosecurity),surveillance (incomplete) and detection
(delayed and/or disease misdiagnosis),and inadequate
compensation and public awareness.


7. In humans, both Drs. Oshitani and Horby from WHO
confirmed that currently there is no efficient human-to-
human transmission of H5N1 AI. However, human cases
correlate geographically with outbreaks in poultry.
Recommendations to reduce the risk of human infections were
to identify the at-risk populations through better
surveillance and well-conducted epidemiologic studies,
eliminate the source of human infection and establish
appropriate interventions at the animal and human interface
through greater public awareness, use of personal
protective equipment for health care workers and farmers,
the use of antivirals, and the development and use of
influenza vaccines. At the time of the conference, 44 AI
cases and 32 deaths from AI had been confirmed in humans in
Vietnam. [Note: On February 20, 2005, Vietnam announced the
33rd confirmed human death. End note]. Dr. Horby contended
that the number of known cases was most likely an
underestimate of the infected population. [Note: On
February 19, 2005, Nature published a report, based on a
study from Japan, alleging that the sensitivity of the
diagnostic tests used by Vietnam's laboratories was too low
to identify all cases. Scientists from Vietnam noted that
the laboratories would begin using the more sensitive
diagnostic test and training the technicians better. This
information was not reported at the conference. End Note]

Intervention and Control Strategies
--------------


8. Prevention and control of H5N1 AI infection requires a
multi-tiered, multi-faceted strategic approach, which is
culturally, socially, and economically sensitive, and
reasonably priced and low-tech enough to be applied
effectively over a wide range of farm situations. Experts
stressed key strategies to be implemented including
improving veterinary services, laboratory diagnostic
capacity, surveillance and detection, animal husbandry
management including application of enhanced biosecurity
methods, strategic use of vaccines, possible restructuring
of the poultry industry and greater emphasis on public
awareness and farmer training on AI management and control.
Depending upon the country situation and outbreak status,
implementation of all or some of these activities may be
necessary.

Vaccines
--------------


9. A number of presentations addressed the pros and cons
of vaccine use as a tool to help control H5N1 AI. Clearly,
depending upon the phase of an outbreak or infection, a
mixed control approach is generally recommended. Depending
upon the country, vaccination intervention may be
considered. In general, vaccination against H5N1 AI,
protects birds against developing the clinical signs of the
disease and death, helps to reduce viral shedding if the
bird is infected, prevents bird to bird, and, hopefully,
bird to human contact transmission. As a food safety
issue, vaccination prevents H5N1 AI in poultry meat.
However, the widespread use of vaccinations is
controversial from a number of perspectives including the
overall cost particularly to small backyard farmers,
limited effectiveness in ducks, the inability to
discriminate between infected birds or vaccinated birds (a
concern of importing countries) and the development of a
sense of complacency among farmers and the public that the
problem will go away without making the necessary
infrastructure and biosecurity changes.

Food Safety
--------------


10. Of concern to both poultry producers and consumers is
the issue of food safety. Dr. David Swayne, Southeast
Poultry Research Laboratory, USDA/ARS, presented a number
of studies examining the ability to infect meat by giving
birds AI infected feed and viral load in the body of H5N1
AI infected birds. He approached food safety from the
perspective of worker safety issues and consumer
protection. Workers or individuals who slaughter poultry
or fowl (chicken, ducks, geese, quail) infected with Avian
Influenza H5N1 maybe at risk from exposure through
inhalation or mucosal membrane contact with virus particles
which may be in the bird's respiratory and digestive
tracts, in the blood, meat or bones, or as contaminants on
feathers. This possibility necessitates the use of
appropriate personal protective equipment when slaughtering
poultry and fowl.


11. Consumers not involved in slaughtering should be made
aware that the blood, meat or bones of H5N1 infected
poultry and fowl may contain the virus. Cooking to 70
degrees C will kill H5N1 virus. Additionally, H5N1 AI
virus may contaminate eggs, particularly if laid shortly
before death. Pasteurization and cooking thoroughly will
inactivate the virus. In summary, infected birds, (sick,
dying or potentially infected) should not be processed for
consumption. Proper vaccination can prevent H5N1 virus
from invading poultry meat.


Economic Impact
--------------


12. Evaluation of the economic impact of the H5N1 AI
outbreak is complex. All economies of Southeast Asia with
H5N1 AI outbreaks experienced GDP reductions, not only from
loss of poultry stocks and human illnesses, but also from
the costs necessary to respond to the outbreaks. Experts
noted that the impact of the outbreaks varies along the
market chain, e.g., industrial production system versus
backyard scavenging system. Socioeconomic surveys of
countries in Southeast Asia document that the resulting
effects of H5N1 AI outbreaks take the heaviest toll on the
poorest families. Loss of birds, restriction of bird
movements and sale, lowered prices, loss of substantial
proportion of annual income coupled by the lack of
compensation, all impact the livelihood of subsistence
farmers. Additionally, concomitant increases in the price
of other sources of protein, put those at the bottom of the
economic ladder at greater risk of nutritional
deficiencies. Medium- to large-scale producers also
experience financial loss primarily due to lack of adequate
compensation, and in Vietnam, the need to obtain loans to
finance culling, disposal, restocking, and perhaps, changes
in animal husbandry practices. However, these producers
may be able to shift production to other types of
commodities, such as pigs or rice.

Conference Conclusions
--------------


13. Conference delegates concluded that to reduce the risk
of a global human pandemic of H5N1 AI, a concerted effort
to control the spread, and if possible, eliminate the virus
from the region is necessary. Such goals will require
concerted efforts and collaboration on the part of
international organizations, governments and others.
Representatives of FAO and OIE project that more than 100
million USD is needed in direct financial support as well
as in-kind assistance to make the improvements recommended
by the body. They noted that less than 18 million USD was
donated in the past year towards mitigating this problem.
While these donations have contributed to improvements in
the veterinary systems of countries in the region, it falls
short of the true need. Final conference recommendations
will be posted on the FAO website at http//: www.fao.org.
MARINE