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FAO Technical Meeting on HPAI 27-29 th June 2007, Rome Dr. Hoang Van Nam Department of Animal Health Ministry of Agriculture and Rural Development VIETNAM. Avian Influenza in Viet Nam : Lessons Learnt . Outlines. Situation Analysis; Summary of Lessons Learned:

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FAO Technical Meeting on HPAI

27-29th June 2007,

Rome

Dr. Hoang Van Nam

Department of Animal Health

Ministry of Agriculture and Rural Development

VIETNAM

Avian Influenza in Viet Nam: Lessons Learnt


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Outlines

  • Situation Analysis;

  • Summary of Lessons Learned:

    • Strong Commitment and Leadership from the Government

    • Early Detection and Response

    • Vaccination

    • Information, Education and Communications

    • Pandemic Preparedness

    • Donor support

  • Recommendations


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- 45 mil. poultry culled;

- 27 human cases (16 fatal)

- 4 mil. poultry culled;

- 2 human cases

  • 99,040 poultry culled;

  • No human cases

- 2 mil. poultry culled;

- 64 human cases (21 fatal)

Tet holiday Feb 16-22, 2007

2007

Situation Analysis: The Course of the EpidemicTemporal Pattern of 2003/4 (1st), 2004/5 (2nd), late 2005 (3rd) and 2006/7 (4th) AI Epidemics

Mar

Feb

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

Jan

Feb

Mar


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Situation Analysis: Affected Communes - 1st wave (2003-2004)


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Situation Analysis: Affected Communes - 2nd wave (2004-2005)


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Situation Analysis: Affected Communes – 3nd wave (late 2005)


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Situation Analysis: Affected Communes – 4th wave (Dec 2006 – Mar 2007)


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Situation Analysis: Current situation

  • 2 new human cases after over a year and a half.

  • A series of outbreaks in late 2006-early 2007 indicated that there is persistent circulation of virus both in the south and the north.

  • Since the beginning of May, another wave of epidemic started.

  • Outbreaks have been identified always in unvaccinated flocks, particularly in ducks.


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Current situation (Cont’d)…since 1st May 2007 to 6 June


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Situation Analysis: Significant trends

  • Recent marked increase in duck population (subsequent to cessation of the ban on hatching waterfowl)

  • High proportion of these ducks moved from province to province to graze on paddies after rice harvest did not receive H5N1 vaccination  remain highly susceptible to the disease.

  • Within this wave of outbreak, most of outbreaks have been reported in provinces in the Red River Delta

  • Genetic sequencing of recent virus isolates have shown no significant change in the antigenicity  Current vaccine is still effective.


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Summary of Lessons Learned

Strong Commitment and Leadership from the Government

  • Establishment of the National Steering Committee for Avian Influenza Prevention and Control (NSCAIPC);

  • Political systems from Central to grassroots levels were called upon, resulted in:

    • Clear chain of command; and

    • Quick response activities, i.e. funds release, human resources, etc.;

  • Several missions led by Cabinet Members dispatched to the field;

  • Experiences in responding to (SARS) in 2003.


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Early Detection and Response

  • Emergency reporting system using telephones and faxes;

  • Online reporting system (TADinfo) piloted to assist in HPAI information management;

  • AI Reporting Hotline set up;

  • Compensation policy revised;

  • Outbreak containment procedures modified in the light of new knowledge and experiences.


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Vaccination: Scope and progress

  • Now focused on 33 provinces in high risk areas (Red River and Mekong River deltas) with vaccination of all long-lived poultry and all poultry in villages

  • Vaccination of high risk poultry in other provinces

  • Other minor poultry not vaccinated due to insufficient information on response to vaccination

  • In 2005, some 166.3 million doses given to chickens and 78.1 million doses to ducks

  • 2006: 368 million doses given to chickens and ducks (for 2 rounds)

  • Vaccination Plan Phase II 2007-2008 approved; 1st vaccination campaign in 2007 started mid-March, and as of 15 May, 131.7 million birds vaccinated.


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Information, Education and Communications

  • Communication plays the critical role in raising public awareness;

  • Clear, updated information was disseminated to the public regularly through mass media;

  • Daily updates on disease situation and progress of vaccination published on DAH’s website, available both in Vietnamese and English.

  • Various IEC materials were produced and distributed using diverse media to reach diverse audiences. A National and several provincial telephone hotlines, for HPAI were established.


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Pandemic Preparedness

  • One lesson learned was that emergency preparedness plans help coordinate local response.

  • In August 2005 MARD released its Avian Influenza Pandemic Preparedness Plan;

  • Control measures would have been done better if a preparedness was available prior to the first outbreak;

  • Integrated National Operational Program of Avian and Human Influenza (OPI) was produced in May 2006 with the participation of various agencies and donors;

  • Practical SOPs for humane culling, biosecurity, etc. are needed.


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International support

  • FAO was quick to provide limited assistance through regional and national projects;

  • A World Bank Project (Phase I) initiated in 2004;

  • A UN Joint Program Phase I initiated in 2005 with funds from several donors; Phase II to start.

  • A Japan Trust Fund project is providing support through FAO and OIE.

  • A credit facility through World Bank will fund a four-year project commencing in mid-2007.

  • Various bilateral assistances.


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Recommendations

KEY TECHNICAL SUPPORT GAPS

  • Enhance national DAH epidemiology capacity

  • Review legislation and regulations

  • Upgrade laboratory

  • Improve procedures for disease reporting

  • Periodic review of HPAI control strategy

  • Improve vaccination delivery

  • Improve field surveillance


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Recommendations: (Cont’d)

  • Improve response to outbreaks

  • Strengthen research

  • Improve biosecurity of poultry production and marketing

  • Improve international border inspection procedures


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Issues need further study

  • Decision model on controlling of outbreaks

  • Ecology and epidemiology of avian influenza virus

  • Molecular epidemiology

  • Role of migratory birds

  • Humane methods for culling

  • Vaccine efficacy trails;

  • Survey of free-ranging ducks

  • Develop risk-reduction strategies for free-ranging ducks

  • Feasibility of local vaccine production


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