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Avian Influenza (Highly Pathogenic). Fowl plague, Fowl pest, Peste aviaire, Geflugelpest, Typhus exudatious gallinarium, Brunswick bird plague, Brunswick disease, Fowl disease, Fowl or bird grippe. Overview. Organism Economic Impact Epidemiology Transmission Clinical Signs

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avian influenza highly pathogenic

Avian Influenza (Highly Pathogenic)

Fowl plague, Fowl pest, Peste aviaire, Geflugelpest, Typhus exudatious gallinarium, Brunswick bird plague, Brunswick disease, Fowl disease, Fowl or bird grippe

overview
Overview
  • Organism
  • Economic Impact
  • Epidemiology
  • Transmission
  • Clinical Signs
  • Diagnosis and Treatment
  • Prevention and Control
  • Actions to take

Center for Food Security and Public Health, Iowa State University, 2008

influenza virus
Influenza Virus
  • Family Orthomyxoviridae
    • “myxo” means mucus
  • Three main types
    • Type A
      • Multiple species
    • Type B
      • Humans
    • Type C
      • Humans and swine

Center for Food Security and Public Health, Iowa State University, 2008

influenza a
Influenza A
  • Multiple species
    • Humans, pigs, horses, birds, others
  • Most virulent group
  • Classification by surface antigensinto subtypes
    • Hemagglutinin (H or HA)
    • Neuraminidase (N or NA)

Center for Food Security and Public Health, Iowa State University, 2008

influenza a6
Influenza A

Center for Food Security and Public Health, Iowa State University, 2008

influenza a7
Influenza A

Center for Food Security and Public Health, Iowa State University, 2008

influenza b
Influenza B
  • Mostly humans
  • Common
  • Less severe than A
  • Epidemics occur less often than A
  • Human seasonal vaccine
    • Two strains of type A
    • One strain of type B

Center for Food Security and Public Health, Iowa State University, 2008

influenza c
Influenza C
  • Humans and swine
  • Different pattern of surface proteins
  • Rare
    • Mild to no symptoms
  • By age 15, most have antibodies

Center for Food Security and Public Health, Iowa State University, 2008

avian influenza
Avian Influenza
  • Disease based on genetic features and/or severity of disease in poultry
    • Low pathogenic AI (LPAI)
      • H1 to H16 subtypes
    • Highly pathogenic AI (HPAI)
      • Some H5 or H7 subtypes
      • LPAI H5 or H7 subtypes can mutate into HPAI

Center for Food Security and Public Health, Iowa State University, 2008

history
History
  • 1878: First identified case in Italy
  • 1924-25: First U.S. cases
  • Mildly pathogenic avian influenza first identified mid-twentieth century
  • 1970’s
    • Migratory waterfowl carriers
    • Outbreaks in mink, seals and whales

Center for Food Security and Public Health, Iowa State University, 2008

economic impact
Economic Impact
  • Direct losses:
    • Depopulation and disposal
    • High morbidity and mortality
    • Quarantine and surveillance
    • Indemnities
  • 1978-1996: Seasonal outbreaks in Minnesota cost taxpayers $22 million

Center for Food Security and Public Health, Iowa State University, 2008

economic impact15
Economic Impact
  • 1983: U.S. outbreak (H5N2)
    • $65 million in losses
    • Destruction of 17 million birds
    • 30% increase in egg prices
  • 1999-2000: Italy outbreak (H7N1)
    • $100 million in compensation to farmers
    • 18 million birds destroyed
    • Indirect losses of $500 million

Center for Food Security and Public Health, Iowa State University, 2008

economic impact16
Economic Impact
  • 1997: Hong Kong outbreak (H5N1)
    • $13 million for depopulation and indemnities
    • 1.4 million birds
  • 2001: Hong Kong

outbreak (H5N1)

    • 1.2 million birds
    • $3.8 million
  • 2003: European outbreak (H7N7)
    • 30 million birds destroyed
    • $314 million

Center for Food Security and Public Health, Iowa State University, 2008

geographic distribution
Geographic Distribution
  • Worldwide distribution
  • Reservoir
    • Free flying aquatic birds: Ducks, geese, shorebirds, gulls, terns, auks
  • Outbreaks worldwide now
  • Similarity to Newcastle Disease makes actual distribution difficult to define
  • Altered avian ecosystems have created new niche for AI viruses

Center for Food Security and Public Health, Iowa State University, 2008

epidemiology birds
Epidemiology: Birds
  • Initial source of infection
    • Migrating ducks or other waterfowl
  • Spread by aerosol, shared drinking water, fomites
    • To other migratory waterfowl, domestic poultry and pigs, pet birds
  • Virus found in respiratory secretions and feces

Center for Food Security and Public Health, Iowa State University, 2008

epidemiology pigs
Epidemiology: Pigs
  • Susceptible to infection with all subtypes of avian influenza A
    • Called a “mixing vessel”
  • Receptors for both avian and human influenza virus
  • In US H1N1 stable for almost 30 years
  • Now H1N1, H3N2, H1N2

Center for Food Security and Public Health, Iowa State University, 2008

animal transmission
Animal Transmission
  • Initial source of infection
    • Other poultry, migratory waterfowl, domestic pigs, pet birds
  • Spread by aerosol, shared drinking water, fomites
  • Virus in respiratory secretions and feces
  • Virus present in eggs but eggs unlikely to survive and hatch

Center for Food Security and Public Health, Iowa State University, 2008

human transmission
Human Transmission
  • Previously considered non-pathogenic for humans
  • 1997, Hong Kong
    • 18 humans infected, 6 died
    • H5N1 virus linked to outbreak in live bird market and area farms
  • 2003, the Netherlands
    • 83 confirmed cases in humans, 1 death
    • H7N7 strain
  • Swine are proposed “mixing vessel”

Center for Food Security and Public Health, Iowa State University, 2008

interspecies transmission of influenza a viruses
Interspecies Transmission of Influenza A Viruses

Center for Food Security and Public Health, Iowa State University, 2008

avian influenza26
Avian Influenza
  • Incubation period: 3-14 days
  • Birds found dead
  • Drop in egg production
  • Neurological signs
  • Depression, anorexia, ruffled feathers
  • Combs swollen, cyanotic
  • Conjunctivitis and respiratory signs

Center for Food Security and Public Health, Iowa State University, 2008

post mortem lesions
Post Mortem Lesions
  • Lesions may be absent with sudden death
  • Severe congestion of the musculature
  • Dehydration
  • Subcutaneous edema of head and neck area

Center for Food Security and Public Health, Iowa State University, 2008

post mortem lesions28
Post Mortem Lesions
  • Nasal and oralcavity discharge
  • Petechiae onserosal surfaces
  • Kidneys severely congested
  • Severe congestion of the conjunctivae

Center for Food Security and Public Health, Iowa State University, 2008

avian influenza in cats
Avian Influenza in Cats
  • H5N1 avian influenza in Asia infected cats fed infected dead chickens
  • H5N1 experimentally
    • Respiratory
    • Systemic disease
    • Transmits cat to cat

Center for Food Security and Public Health, Iowa State University, 2008

sampling
Sampling
  • Before collecting or sending any samples, the proper authorities should be contacted
  • Samples should only be sent under secure conditions and to authorized laboratories to prevent the spread of the disease
  • HP AI samples may be zoonotic

Center for Food Security and Public Health, Iowa State University, 2008

diagnosis
Diagnosis
  • Clinically indistinguishablefrom virulent Newcastle Disease (END)
  • Suspect with:
    • Sudden death
    • Drop in egg production
    • Facial edema, cyanotic combs and wattles
    • Petechial hemorrhages
  • Virology and serology necessary for definitive diagnoses

Center for Food Security and Public Health, Iowa State University, 2008

differential diagnosis
Differential Diagnosis
  • Virulent Newcastle disease
  • Avian pneumovirus
  • Infectious laryngotracheitis
  • Infectious bronchitis
  • Chlamydia
  • Mycoplasma
  • Acute bacterial diseases
    • Fowl cholera, E. coli infection

Center for Food Security and Public Health, Iowa State University, 2008

diagnosis33
Diagnosis
  • Laboratory Tests
    • HP AI is usually diagnosed by virus isolation
  • Presence of virus confirmed by
    • AGID
    • ELISA
    • RT-PCR
  • Serology may be helpful

Center for Food Security and Public Health, Iowa State University, 2008

treatment
Treatment
  • No specific treatment
  • Supportive care and antibiotics for secondary infections
  • Antivirals (amantadine) effective in reducing mortality
    • Not approved in food animals
    • Results in resistant viruses

Center for Food Security and Public Health, Iowa State University, 2008

clinical signs in humans
Clinical Signs in Humans
  • 1997: Hong Kong (H5N1)
    • Fever, respiratory, vomiting, diarrhea, pain
    • Fatal cases: severe bilateral pneumonia, liver dysfunction, renal failure, septic shock
  • 1979: MP AI in harbor seals (H7N7)
    • Conjunctivitis

Center for Food Security and Public Health, Iowa State University, 2008

clinical signs in humans37
Clinical Signs in Humans
  • 2003: Netherlands (H7N7)
    • Conjunctivitis
    • Mild influenza or respiratory symptoms
    • Fatal case: Acute respiratory distress syndrome

Center for Food Security and Public Health, Iowa State University, 2008

avian influenza in humans38
Avian Influenza in Humans
  • Risk is low
  • Strains vary in abilityto infect humans
  • Close contact with infected birds
    • High occupational exposure,cultural practices may increase risk
  • April 2008: 31 cases, 24 deaths

Center for Food Security and Public Health, Iowa State University, 2008

h5n1 ai in poultry birds since 2003
H5N1 AI in Poultry, Birds since 2003

Center for Food Security and Public Health, Iowa State University, 2008

recommended actions
Recommended Actions
  • Notification of Authorities
    • Federal:Area Veterinarian in Charge (AVIC)
      • www.aphis.usda.gov/vs/area_offices.htm
    • State veterinarian
      • www.aphis.usda.gov/vs/sregs/official.htm
  • Quarantine

Center for Food Security and Public Health, Iowa State University, 2008

recommended actions42
Recommended Actions
  • Confirmatory diagnosis
  • Depopulation may occur
    • Infected premises
    • Contact-exposed premises
    • Contiguous premises

Center for Food Security and Public Health, Iowa State University, 2008

control and eradication
Control and Eradication
  • Eliminate insects and mice
  • Depopulate flock and destroy carcasses
  • Remove manure down to bare concrete
  • High pressure spray to clean equipment and surfaces
  • Spray with residual disinfectant

Center for Food Security and Public Health, Iowa State University, 2008

prevention
Prevention
  • Appropriate biosecurity
    • Control human traffic
    • Introduction of new birds into flock
    • Avoid open range rearing in waterfowl prevalent areas
  • Education of the poultry industry
  • Prompt response to MP AI outbreaks

Center for Food Security and Public Health, Iowa State University, 2008

vaccination of poultry
Vaccination of Poultry
  • Emergency situations
    • Preserve breeding stock
  • Vaccines
    • Killed and fowl-pox vectored
    • DIVA – Differentiating Infected from Vaccinated Animals
  • US Vaccine bank with 40 mil doses
    • 20 million for H5
    • 20 million for H7

Center for Food Security and Public Health, Iowa State University, 2008

usda prevention activities
USDA Prevention Activities
  • Import restrictions
    • No live birds or bird products from infected countries
  • Increasing surveillance of wild birds
  • National H5 and H7 control program
  • Training for disease recognition
  • Improving diagnostics for rapid detection

Center for Food Security and Public Health, Iowa State University, 2008

slide47

Protection of Humans from H5N1 Avian Influenza

q

q

AI ResponsePlan

U.S. Border

q

q

Proper food handling and preparation

q

Surveillance

q

Food Safety Inspection Service

Biosecurity

q

Avoid contact with poultry

Center for Food Security and Public Health, Iowa State University, 2008

prevention humans
Prevention: Humans
  • Personal Protective Equipment
    • Gloves, masks
    • If working with poultry or wild birds
  • Vaccine
    • April 17, 2007
      • US FDA approved an avian influenza vaccine for humans
      • Not commercially available
      • Part of National Strategic Stockpile
        • For distribution during public health emergency
  • Antivirals

Center for Food Security and Public Health, Iowa State University, 2008

for more information
For More Information
  • Centers for Disease Control and Prevention (CDC)
    • http://www.cdc.gov/flu/avian/
  • World Health Organization (WHO)
    • http://www.who.int/csr/disease/avian_influenza/en/
  • World Organization for Animal Health (OIE)
    • www.oie.int
  • Center for Food Security and Public Health
    • www.cfsph.iastate.edu

Center for Food Security and Public Health, Iowa State University, 2008

acknowledgments
Acknowledgments

Development of this presentationwas funded by grants from

the Centers for Disease Control and Prevention, the Iowa Homeland Security and Emergency Management Division, and the Iowa Department of Agriculture and Land Stewardshipto the Center for Food Security and Public Health at Iowa State University.

Contributing Authors: Danelle Bickett-Weddle, DVM, MPH, DACVPM; Glenda Dvorak, DVM, MPH, DACVPM; Katie Steneroden, DVM, MPH; Anna Rovid Spickler, DVM, PhD; Radford Davis, DVM, MPH, DACVPM; Bindy Comito Sornsin, BS.

Center for Food Security and Public Health, Iowa State University, 2008

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