Evolution of HP Avian Influenza Surveillance and Response Capability of Pakistan Dr R. H. Usmani AHC National Coordinator “Program for the Prevention and Control of Avian Influenza in Pakistan”

Infrastructure of Animal Health Services Federal: MILDD MINFAL MOH Livestock & Fisheries PARC (R & D) NRLPD NVL AQD L& DDB FDB NAPHIS NPCPAI Provincial: DG/Director Livestock and Dairy Development Dpt. -- Poultry Production Department -- District Vet Officers (4 provinces + AJK, NA, ICT)

POULTRY SECTOR o Contribution in Nation GDP:1.12% o Contribution in Agri GDP:4.8% o Annual Turn over : US $ 2.38 billion o Population: PS(8.5m); Layer(35m);Broiler(738m); Backyard 45 m; others (0.8m) o Commercial Farms:25,990 o Feed Mills and Production: 122 with 3.62 MMT/annum o Farms: 25,897 o Hatcheries285 o Poultry Processing Plants:3 o Drugs & vaccines production: US $ 240 million o Egg production: 9.0 billion per annum o Poultry Meat production: 1.5 million ton per annum

Production and Marketing Systems o Four types of production systems: breeders, broilers, layers & rural poultry. Duck, peacock, quail & other wild birds rearing. o About 80% of rural families keep 5-10 birds of indigenous breeds, contributing 40% of eggs and 25% of poultry meat. Fresh slaughtering preferred: 2 processing plants with many LBMs. o Ten major and 80 small lakes and water reservoirs where migratory and/or wild birds visit.

HISTORY OF AVIAN INFLUENZA IN PAKISTAN  First outbreak of HPAI H7N3 in ’95: confined to 100 km area. Culling, strategic vaccination (local) helped to control in 3 months. {$ 15 m}  In 1998 outbreak of H9N2 in broilers, spread to layers and now endemic.  In 2000 localized outbreak of H7N3 in small layer area, controlled by vaccination.($ 5-7 m)  In Nov outbreak of H7N3 in Karachi in layers & BB; {$ 120m}  Feb-July, 2006, 26 H5N1 outbreaks recorded. Culling, and strategic vaccination carried out ($ 450m)  Feb-Nov, 2007, 50 outbreaks in back yard/commercial/wild poultry; Three human deaths due to H5N1.  Feb-July, 2008, 12 outbreaks in commercial poultry; Surveillance and preparedness on going.  Since July 2008 no HPAI isolation

HPAI Control Policy in Poultry Prevention: Introduction of environmentally controlled commercial farming and increased biosecurity as well as surveillance. Containment: Infection is urgently diagnosed and contained by zoning and selected culling with compensation Vaccination: Strategic vaccination adopted preferring autologous vaccines.

AI- National Contingency Plan (MINFAL-2004)  Establishment of AI Task Force (Fed + Prov).  Capacity building plans outlined for Central Reference Lab (NRLPD), Vaccines Testing Lab (NVL)and Provincial Influenza Monitoring Labs(# 10).  Awareness and training plans for the introduction of Improved biosecurity measures & controlled culling and dumping outlined.  Mechanism for Strategic vaccination, Compensation & Monitoring devised for containing the virus.  Legislation for establishing AI-free farming zones, live-bird markets, declaration of outbreak and accessibility of officials to farms for disease monitoring narrated.  A detailed work plan (SOPs) to operate in case of AI outbreak outlined.

Surveillance & Monitoring of Avian Influenza Preparation for the Control of Out-Breaks Phase-I ( ) Achievements: 1- Preparation of National Contingency Plan. 2- Establishment of Six Provincial AI Surveillance and Rapid Response Units 3- Up-gradation of National Reference Lab for AI and train lab staff 4- Improve awareness of all stake holders regarding Bird Flu. 5-Preparation of National Program/Project for Prevention and Control of AI in Pakistan

National Program for Prevention & Control of Avian Influenza (NIPCPAI) PMU-NRLPD (2007 to date) Objectives  Establishment of Nation-wide avian influenza surveillance and reporting mechanism  Preparedness plans for fighting outbreaks  Capacity building for AI diagnostics & surveillance, vaccine production/evaluation, and R & D  Impart field and lab staff training and develop Awareness Schemes regarding food safety and biosecurity  Develop compensation policy and farming policy through legislation.  Interact with international agencies for further regional or international coordination for AI control

Current National AI Surveillance Set up AI-Surveillance Set up: - AVIAN INFLUENZA DESK, AHC, Ministry of Food Agriculture and Livestock (MINFAL). - National Program for Prevention and Control of AI, PMU at Nat. Reference Lab for Poultry Diseases, NARC, Islamabad Collaborating Units: Provincial Coordinating Offices, DG (6) Provincial AI Surveillance Labs (10) Regional Surveillance Units (40) NVL for vaccine quality testing (1) NRLAI for diagnostics (1)

NATIONAL AI SURVEILLANCE PROGRAM {National Reference Lab for Poultry Diseases, NARC} CENTRAL LAB/ NRLPD ISLAMABAD PROVINCIAL LABS (10) SINDH (8) PUNJAB & ISD (15+1) BALOCHISTAN (7) NWFP & FATA (7+1) NORTHERN AREAS (2) AJK (1)

Northern Areas AJK NWFP FATA Punjab Balochistan Sindh Islamabad Federal Project PMU Regional Surveillance and RR Units

AI- Serosurveillance Protocol A. Suspected Outbreaks Field samples for virus isolation or via PCR detection; typing and serology; Referred by PRIs to NRLPD. B. Non-Vaccinated Healthy Flocks After every 3 months, 10 blood and cloacal samples/farm; Sampling of Wild, Migratory and zoo birds. C. Vaccinated Flocks Serology and virus isolation: 1- Every 12 wk serology of 10 birds/farm. 2- Every 12 wk virus isolation from 10 cloacal swabs/farm. D. AI Vaccine Evaluation All local and imported being valuated by NVL.

AI- Serosurveillance Protocol…..Cont. E. Wild Resident birds Wild birds from LBM, bird catchers, and farmers. Cloacal Swabs, blood and fecal material tested. F. Migratory birds Blood and cloacal samples, and fecal material from migratory bird habitat. C. Zoo birds Serology and virus isolation from blood and fecal material, respectively from zoos. D. Backyard Poultry Swabs and sera collection from back yard poultry.

Samples Received for AI Testing since 2006( surveillance plan) Number of Samples Received for AI Testing (swabs, blood, tissues) 193,000103,00090,000 Number of tissue Samples Forwarded to OIE/FAO Reference laboratories for AI Number of Positive Results Confirmed by OIE/FAO Reference laboratories for AI (USA, Italy, UK) 1064

LEVEL OF LABS & THEIR FUNCTIONS A. National Reference Laboratory Virus Isolation, typing & sequencing; Virus detection thru PCR. Differential Diagnosis/confirmation. Serological based assays; HI, ELISA Biological and molecular characterization of new isolates/IVPI. Production of diagnostic reagents; Lab staff training. B. Provincial Laboratories Serological evaluation. Vaccine immune response evaluation. AI Screening by Rapid test (LFD) Necropsy and clinical diagnosis. C.Regional/District Laboratories Necropsy and clinical diagnosis; Serological evaluation. AI screening by Rapid Test (LFD).

Outbreak Reporting & Handling SOPs ● Notification of Suspected AI by the Regional Surveillance Officer Standstill orders and limitation of movement orders/quarantining by district administration. Collection of sample, its submission to Nat Ref Lab (NRLPD). The confirmed case reported to AHC & MOH at federal level & thereafter to provincial authorities for initiating culling & disinfecting. Slaughter of infected and/or suspected poultry and disposal of farm material and carcasses and disinfection by RRU. Reporting to OIE by AHC office. Payment of compensation Re-population after 8-week interval

Number of Veterinarians that Received Training for AI Control since 2006 Training Topic Epidemiology and outbreak investigation (TOT) (Total=43) Disease Surveillance and Monitoring (TOT) (Total=55) Laboratory TOT training by OIE/FAO Reference laboratories for AI, and other poultry diseases 684 (Total=18) Bio-security and Personal protection (TOT) (Total=60) AI disease prevention and control (TOT) (Total=34)

Participation in Regional/ International Programs for AI Control 1- Pak-Wet-land network (International NGO) 2- HPAI-Strengthening of surveillance in cross-border areas of Pakistan & Afghanistan (US funded; implemented by FAO) 3- AI Control in Asia (JTF-OIE Project) 4- AI.COMM Project (USAID/ AI-BCC)

Future Strategy for AI Control Assumptions: I- Various Avian influenza viruses (AIV) are prevalent in Pakistan. II- AIVs can be introduced from other countries as TAD. III- SwineFlu and BirdFlu mutants remain a zoonotic threat Strategy to Encounter the Brewing Storm 1- Strengthening of the existing AI-Surveillance Network both in animal and human: surveillance, reporting, diagnosis, rapid response. 2- The NPCPAI needs both technical and financial backing for emergency preparedness for stock piling of protective gears, rapid response supplies, diagnostic tools, and enhancing awareness efforts. 3- For Food Security & Safety, the control strategy would include strategic vaccination and biosecurity. 4- Road to better human health and livelihood pass thru the maize of Animal Kingdom,

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