Surveillance for avian influenza among humans and animals
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Surveillance for Avian Influenza among Humans and Animals. Presentation Overview. Federal Agencies Animal Influenza Surveillance Poultry Wild Birds Human Influenza Surveillance Routine Enhanced. Federal Agencies. US Department of Health and Human Services (DHHS) CDC

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Presentation Transcript

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Presentation Overview

  • Federal Agencies

  • Animal Influenza Surveillance

    • Poultry

    • Wild Birds

  • Human Influenza Surveillance

    • Routine

    • Enhanced


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Federal Agencies

  • US Department of Health and Human Services (DHHS)

    • CDC

  • US Department of Agriculture (USDA)

  • US Department of the Interior (DOI)


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Influenza

Surveillance Among Humans


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Routine National Surveillance

  • Virologic - laboratory reporting

  • Sentinel Providers Network

  • State and territorial epidemiologists reports

  • Emerging Infections Program

  • New Vaccine Surveillance Network

  • 122 Cities Mortality Reporting System

  • Influenza-associated pediatric mortality


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Human Surveillance

Upon confirmed HPAI in animal species…

  • Conduct active case finding

  • Assess exposures

  • Classify and test potential cases

    • Suggested guideline:

      • CDC case definitions for detection

      • WHO case definitions for reporting


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Enhancing Local Surveillance

  • Enhance surveillance and record review in hospitals

  • Public Service Announcements

  • Telephone hotlines

  • Door-to-door surveys

  • Occupational surveillance


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Poultry Outbreak and Human Surveillance Activities

  • Limit case definition

  • Disseminate case definition

    • Health Alert Network (HAN)

    • Epi-X

  • Create and disseminate outbreak reporting questionnaire

  • Consider database and reporting tools

  • Identify and interview potential cases and contacts


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Surveillance Activities cont.

  • Conduct surveillance for human illness linked to affected premises

  • Ensure timely reporting of cases to CDC

  • Characterize seasonal influenza strains

  • Notify other states that might receive cases or contacts

  • Advise contacts to monitor symptoms for 10 days post-exposure


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Possible Contacts

  • Poultry workers

  • Agriculture responders

  • Farmers

  • Veterinarians

  • People purchasing poultry products

  • Farm visitors

  • Travelers


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Possible Contacts

Also:

  • Healthcare workers

  • Family members and other close contacts

  • Emergency Medical Services staff


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Local Surveillance During Pandemic Alert

Continue routine surveillance activities AND

  • Investigate clusters of influenza-like illness with a) recent travel to area with documented novel or avian flu, or b) severe morbidity and mortality

  • Facilitate viral testing for persons with ILI and epidemiologic risk factors


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Goals of Human Surveillance for Pandemic Influenza

  • Virologic Surveillance

    • Detect initial cases of pandemic strain

    • Track introduction of virus to local areas

    • Monitor changes in virus

  • Disease-based Surveillance

    • Early warning of increased ILI

    • Monitor health effects of pandemic

    • Track trends in disease activity


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Influenza

Surveillance Among Animals


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AI Surveillance

  • Active and passive surveillance currently conducted by various means:

    • NPIP testing of commercial poultry

    • Live bird market system testing

    • Testing prior to export of poultry products

    • State active surveillance programs

    • Diagnostic laboratory evaluation of ill birds

    • Foreign animal disease diagnostician (FAD) investigations of suspect FADs

    • Wild bird surveillance

Protecting American Agriculture


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Avian Influenza Surveillance

  • Markets

  • Laboratories

  • On Farms

  • During Outbreaks

Labs

Markets

Outbreak

On-farm

Protecting American Agriculture


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Notifiable AvianInfluenza (NAI)

“Avian influenza in its notifiable form (NAI) is defined as an infection of poultry caused by any influenza A virus of the H5 or H7 subtypes or by any AI virus with an intravenous pathogenicity index (IVPI) greater than 1.2 (or as an alternative at least 75% mortality) as described… NAI viruses can be divided into highly pathogenic notifiable avian influenza (HPNAI) and low pathogenicity notifiable avian influenza (LPNAI)”

Protecting American Agriculture


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Commercial Flocks

National Poultry Improvement Plan (NIPP)

  • USDA program

  • Monitor poultry production facilities

  • Random testing of flocks

    • Test all ill birds

  • Coordinate with states for response and containment plans


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Wildlife Surveillance

Five components to surveillance

  • Investigation of morbidity and mortality

  • Surveillance in live wild birds

  • Surveillance in hunter-killed birds

  • Sentinel species monitoring

  • Environmental sampling


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Reporting HPAI in Poultry

  • Reporting varies by state

    • Industry

    • Backyard flocks

    • H5 or H7 LPAI

  • Presumptive positive cases reported to USDA or DOI will be immediately reported to:

    • OIE

    • Trade partners

    • Other Federal agencies

    • States

    • Industry


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Response in the Event of an HPAI Outbreak

  • Response actions for domestic flocks:

    • Surveillance

    • Quarantine and humane euthanasia

    • Cleaning and disinfection of premises

    • Possible use of vaccine in poultry

    • Indemnity payments

    • Communication to media and thepublic


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Responding to Influenza among Poultry

  • LPAI outbreak

    • Affected State takes the lead

    • Clean, disinfect, depopulate affected premises

    • USDA provides funding

    • Close attention to H5 and H7 strains

  • HPAI outbreak

    • USDA takes the lead

    • Quarantine, clean, disinfect, and cull the infected and exposed bird population

    • CDC is notified

    • Bird owners compensated


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Summary

  • Avian influenza surveillance among animals and humans involves collaboration among many local, state, and federal agencies

  • Surveillance among humans occurs routinely, and would be enhanced under an increased threat of pandemic influenza

  • Surveillance among animals involves domestic, wild, and imported birds


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References

  • USDA National HPAI Response Plan, Aug 2006, http://www.aphis.usda.gov/newsroom/hot_issues/avian_influenza/contents/printable_version/DraftSummaryNationalHPAIresponseplan08-31-06.pdf

  • An early detection system for highly pathogenic H5N1 avian influenza in wild migratory birds, U.S. Interagency Strategic Plan, March 2006, http://www.doi.gov/issues/birdflu_strategicplan.pdf

  • Morgan, A. Avian influenza: an agricultural perspective. J Infect Diseases. 2006;194(Suppl 2):S139-S146


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References

  • USDA’S Role in the Implementation Plan for the National Strategy for Pandemic Influenza, May 6, 2006.http://www.usda.gov/documents/AI_Fact_Sheet_Implementation_Plan.pdf

  • USDA Avian Flu Brochure http://www.usda.gov/documents/AvianFluBrochure.pdf

  • US Department of the Interior, Issues of Interest: Avian Influenza (Bird Flu). http://www.doi.gov/issues/avianflu.html

  • WHO Case Definitions: http://www.who.int/csr/disease/avian_influenza/guidelines/case_definition2006_08_29/en/print.html


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