Pacific Region Avian Influenza Training Workshop August 1-5, 2006 Honolulu, Hawaii

Program Goals Create an Avian Influenza education program that blends animal first-responder training, animal health training, and Global Positioning Systems (GPS) training. –Keep animal first-responders safe –Keep island poultry safe Build networks that will facilitate collaboration, co-learning, and the transmission of accurate information.

Workshop Participants A total of 18 participants came from islands across the US-Affiliated Pacific Islands: American Samoa (2), Chuuk (2), Kosrae (2), Majuro (1), Palau (1), Pohnpei (3), Rota (1), Saipan (2), Tinian (2), and Yap (2). 15 of the participants worked within a Land Grant college as either extension personnel or junior researchers; 3 of the participants worked within health services.

Workshop Overview Day 1: Health and safety Day 2: Discussion of Pacific Region surveillance and response plans Day 3: Global Positioning Systems and Geographic Information Systems training Day 4: Field exercises Day 5: Community safety and education strategies

Day 1: Health and Safety Presentation topics include: –Emergency events –Basic principles and preparedness training for a biological outbreak or disaster –Hand hygiene to prevent the spread of disease –Personal protective equipment

Emergency Events by Captain Carter Davis Carter Davis, Captain Honolulu Fire Department CBRNE General Awareness Lecturer/Certified HAZMAT Instructor

Basic Principles and Preparedness Training for a Biological Outbreak or Disaster by Dr. John Casken John Casken, RN, MPH, PhD Director, Office of International Affairs School of Nursing and Dental Hygiene

Hand Hygiene to Prevent the Spread of Disease by Ms. Lynn Nakamura-Tengan Lynn Nakamura-Tengan, MS Extension Educator Human Nutrition, Food and Animal Sciences University of Hawaii

Personal Protective Equipment by Capt. Carter Davis and Dr. Ed Kalinowski Lecture on Personal Protective Equipment and a demonstration on how to don (put on) and doff (take off) equipment Ed Kalinowski, BSN, MEd., DrPH Kapiolani Community College Emergency Medical Services

Day 2: Group Discussion of Pacific Regional Surveillance and Response Plans Regional plans for surveillance and response Discussion topics: –Status report and work in progress toward regional goals –Migratory birds of the Pacific Flyways –Threats to domestic poultry –Legal and illegal poultry trade

US Fish & Wildlife Services Avian Influenza Surveillance Plans by Dr. Jeff Burgett Jeff Burgett, PhD US Fish and Wildlife Service Pacific Islands Office

Overview of Avian Influenza and Wildlife Disease Investigations by Dr. Thierry Work Thierry Work, MS, DVM, MPVM Wildlife Disease Specialist, USGS National Wildlife Health Center

Resources Available at the John A. Burns School of Medicine by Dr. Duane Gubler Duane Gubler, ScD, Director, Asia-Pacific Institute of Tropical Medicine and Infectious Diseases, Professor& Chair, Department of Tropical Medicine and Medical Microbiology, John A Burns School of Medicine

Resources Available at the Secretariat of the Pacific Community by Dr. Konrad Englberger

Lessons Learned from the Recent Avian Influenza Outbreaks by Dr. Steven Ostroff Steven Ostroff, MD

Hawaii Pandemic Influenza Plan by Dr. Arlene Buchholz Arlene Buchholz, DVM, MPH Veterinary Medical Officer Hawaii Department of Health

Guam Pandemic Influenza Plan by Dr. Thomas Poole Thomas Poole, BS, MPH, DVM, DACVPM Guam Territorial Veterinarian

Day 3: Global Positioning Systems (GPS) and Geographic Information Systems (GIS) Training Introduction to GPS and GIS technologies –Applications for GPS and GIS technologies within emergency management –Applications for GPS and GIS technologies within avian influenza surveillance plans and incident reporting databases

Global Positioning Systems (GPS) by Mr. Eugene Dashiell Eugene P. Dashiell, MA, AICP Environmental Planning Services

GPS Field Exercises Participants have an opportunity for one-on-one instruction while practicing with GPS units.

Compatible Geographic Information Systems (GIS) Program During the week of August 1-5, 2006, the Pacific EMPRINTS project hosted a Geographic Information Systems workshop focusing on emergency situations involving an avian influenza outbreak. 15 participants from the US-Affiliated Pacific Islands attended the GIS workshop. The participants from both workshops learned about the each other’s role in the event of an avian influenza emergency.

Avian Influenza Participants Meet the Geographic Information Systems (GIS) Participants Understanding how the GPS data will be used is critical for understanding the applications for the technology in emergency management and Avian Influenza surveillance and reporting.

Day 4: Avian Influenza Field Exercises Participants were given the opportunity for hands-on response training. Three Avian Influenza situations were developed representing the most probable AI encounters. –Response to a single bird death (with site containment) –Response to a multiple bird death –Dead bird sampling and shipping

Response to a Single Bird Death With proper Personal Protective Equipment, Jabukja Aikne (Majuro, Marshall Islands) carefully double- bags the chicken carcass. Later, he will disinfect the area with a 10% bleach solution and label the carcass. While Jabukja is collecting the carcass, his partner, Felix Sengeau (Palau, FSM), in the “Cold Zone,” is collecting important information about the site, including GPS data. This information is collected on a Sample Submittal form.

Response to a Multiple Bird Death Responding to a multiple bird death in a confined space, the participants don complete Personal Protective Equipment (PPE). Responders carefully take throat and cloacae samples from each bird and relay incident information to “Cold Zone” partner. Outer surfaces of sample vials are cleaned, and then passed to “Cold Zone” partner for collection. Later, the carcasses will be collected for disposal and surfaces will be sanitized.

Dead Bird Sampling and Shipping Wearing proper Personal Protective Equipment, participants collect throat and cloacae samples, properly label the sample vial and fill out a sample submittal form. Then, participants place the sample in a nitrogen-charged shipping container.

Skill/Task Evaluations Participants were evaluated on their ability to perform 12 specific skills or tasks during the training exercises: Personal Protective Equipment Skills/Tasks Task 1: Demonstrated ability to select appropriate Personal Protective Equipment for task Task 2: Demonstrated ability to don correctly Personal Protective Equipment Task 3: Demonstrated ability to doff properly Personal Protective Equipment without contaminating self, or environment unnecessarily Task 4:Demonstrated proper hygiene while in Personal Protective Equipment, (ie. did not touch face or hair with gloves during exercise) Dead Bird Sample Collection Skills/Tasks Task 1: Demonstrated ability to collect trachea and cloacae samples Task 2: Demonstrated knowledge and ability to properly prepare trachea and cloacae samples for shipping Task 3: Demonstrated ability to properly sanitize work area after collecting samples Dead Bird Response Skills/Tasks Task 1: Single bird death: Demonstrated ability to assess the situation and respond accordingly Task 2: Multiple bird death: Demonstrated ability to assess the situation and respond accordingly Task 3: Demonstrated knowledge of multiple ways to dispose of bird carcasses in a sanitary manner Global Positioning System (GPS) and Reporting Skills/Tasks Task 1: Demonstrate ability to obtain accurate GPS coordinates during training exercise Task 2: Demonstrate ability to fill out mortality investigation (or sample submittal) form

Day 5: Community Safety and Education Strategies Presentation topics include: –Backyard biosecurity –Community education and extension materials Build an Avian Influenza response kit / Personal Protective Equipment kit Program graduation

Backyard Biosecurity by Dr. Thomas Poole

Community Educational Materials by Dr. Thomas Poole

Build an Avian Influenza response kit / Personal Protection Equipment kit Each kit contains: –10 tyvek suits –10 N95 respirators –25 nitrile gloves –20 booties –goggles –2 spray bottles –30 hand sanitizing wipes –Global Positioning System unit –pens, markers, tape, scissors –air-tight storage container Kino Ruben (Chuuk, FSM) packs his Avian Influenza Response kit.

Program Graduation All 18 Avian Influenza Training Program participants completed the course and each mastered the 12 items on the Skills Assessment form, as verified by the program instructors.

Thank you to our Instructors and Advisers Arlene Buchholz, DVM, MPH, Veterinary Medical Officer, Hawaii Department of Health Jeff Burgett, PhD, US Fish and Wildlife Service, Pacific Islands Office John Casken, RN, MPH, PhD, Director, Office of International Affairs, School of Nursing and Dental Hygiene Eugene P. Dashiell, MA, AICP, Environmental Planning Services Carter Davis, Captain, Honolulu Fire Department, CBRNE General Awareness Lecturer/Certified HAZMAT Instructor Jim Foppoli, DMV, State Veterinarian, Hawaii Department of Agriculture Duane Gubler, ScD, Director, Asia-Pacific Institute of Tropical Medicine and Infectious Diseases, Professor& Chair, Department of Tropical Medicine and Medical Microbiology, John A Burns School of Medicine Darcy Hu, PhD, Ecologist, National Park Service, Pacific West Regional Office Ed Kalinowski, BSN, MEd, DrPH, Kapiolani Community College, Emergency Medical Services Lynn Nakamura-Tengan, MS, Extension Educator, Human Nutrition, Food and Animal Sciences Stephen Ostroff, MD, formerly of the Department of the Interior, Health and Human Services Thomas Poole, BS, MPH, DVM, DACVPM, Guam Territorial Veterinarian Thierry Work, MS, DVM, MPVM, Wildlife Disease Specialist, USGS, National Wildlife Health Center