1. Dr Keith Hamilton OIE Headquarters, Paris
The avian influenza global picture and an introduction to OIE Standards
Dr Keith Hamilton
OIE Headquarters, Paris
Presentation in 2 parts – general global situation followed by introduction to OIE standards on avian influenza

2. BEHAVIOUR OF THE CURRENT H5N1 “Asian strain”
Rapid spread through 3 continents
Role of commercial exchanges and migratory waterfowl
Difficult to control in countries unable to rapidly detect and control the virus
The wide spread over 3 continents is unprecedented
61 countries infected since end of 2003
Risks to human health. As yet no sustained human to human transmission
AI is NOT A NEW DISEASE, AI viruses have been around for years
Behaviour of HPAI H5N1 Asian Lineage is unusual when compared to previous outbreaks:
Rapid spread over 3 continents through movements of poultry and poultry products – illegal and legal
More evidence to suggest involvement of wild birds especially in some cases, ongoing debate – will be touched on by Ruth Cromie.
IT IS QUITE CLEAR THAT MEASURES SHOULD NOT BE TAKEN TO CONTROL DISEASE IN WILD BIRDS – such as destroying habitat etc – not effective, not proportionate, may exacerbate problem.
HUMAN HEALTH aspect (CASE FATALITY rate is high) but no sustained H2H. Potential for reassortment

3. AVIAN INFLUENZA H5N1 ASIAN STRAIN
: confined to South East Asia
2005: spread to Central Asia, Russia, Eastern Europe
2006:
First infection African Continent (Nigeria) and Middle East
Spread into Western Europe (occurrence mainly in wild birds)
2007: Entrenched in some countries and re-occurrences in others. Less countries reported disease than in 2006
2008: Some reoccurrences, ongoing outbreaks in some countries

4. HPAI JAN-JUN 2006: ongoing and resolved (including non H5N1)
Maps are based on OFFICIAL REPORTS to OIE from OIE Member Countries and Territories.
INFORMATION from OIE World Animal Health Information Database (WAHID) – collation of reports from members – maps for all lısted dıseaes on the OIE website.
Reporting of course depends on the QUALITY OF SURVEILLANCE which is something that is influenced by the STRENGTH OF NATIONAL VET SERVICES. Is why OIE supports strengthening of vet services. Surveillance in wild birds is of course problematic and there will be a degree of underreporting
FIRST HALF OF 2006
Not all H5N1, outbreak of H5N2 in Ostriches in South Africa.
Red dots indicate active infection AT THE TIME. Blue dots – resolved infection.
OPTIMISIM more blue dots than red therefore can be controlled.

5. HPAI JUN-DEC 2006: ongoing and resolved (including non H5N1)
SECOND HALF OF 2006 more cases resolved

6. AVIAN INFLUENZA IN 2006
In total 47 countries reported infections: Asia (15), Africa (8), Europe (24)
Most countries succeeded in eliminating the disease
However in some countries the disease became entrenched: Indonesia, Nigeria, Egypt, and possibly certain zones of Vietnam, Bangladesh and parts of China
Most countries affected eliminated disease
Some countries entrenched
Risk of disease becoming entrenched in areas with HIGH POULTRY DENSITY and WEAK VETERINARY SERVICES

7. HPAI JAN-DEC 2007: ongoing and resolved (including non H5N1)
Canada HPAI H7N3 other HPAI H5N1

8. HPAI in 2007 Reoccurrences, first occurrences and ongoing outbreaks
29 countries reported HPAI H5N1 in poultry, wild birds or both
6 of these for the first time – Bangladesh, Benin, Ghana, Kuwait and Saudi Arabia
Less countries reporting disease than 2006
Reoccurrence in some countries that had dealt with it. Some outbreaks ongoing.
LESS countries reported outbreaks cf 2006
6 first occurrences

9. HPAI JAN-1 APRIL 2008: ongoing and resolved (including non H5N1)
Current status.

10. HPAI ACTIVE OUTBREAKS IN 2008
Active outbreaks including Afghanistan, Bangladesh, Benin, Cambodia, China, Egypt, Hong Kong, India, Iran, Indonesia, Laos, Myanmar, Pakistan, Russia, Saudi Arabia, Ukraine, UK, Vietnam, Republic of Korea
Entrenched countries may report through their six monthly reports and will thus not notify every single outbreak
Reminder: significant epidemiological events should be reported (new region, sudden change in pathogenicity etc)
Generally most countries have been able to control outbreaks, there have been reoccurences and in some countries where it has been more difficult to control the disease has become entrenched
March 2008 Vietnam notified presence for the first time in new host species ‘Owston’s palm civets’ in a Cic Phuong national park (was id in civets in 2005 but not notified to OIE).
Disease appears to not be under control in some countries like Indonesia, Egypt, possibly certain parts of Vietnam, Bangladesh and China

11. An introduction to OIE Standards
Presentation in 2 parts – general global situation followed by

12. WORLD ORGANISATION FOR ANIMAL HEALTH OIE
An intergovernmental organisation
172 Members
Founded in 1924
Headquarters in Paris
9 Regional offices and
sub offices
Mandate : “to improve Animal Health
worldwide”
Intergovernmental
1924 predates UN 20+ members. The OIE was set up following an outbreak of Rinderpest in Belgium caused by some Zebu cattle in transit from India to Brazil.
Now (2007)- there are 172 member countries + territories of the OIE
Mali, Botswana, Lebanon, Bulgaria, Brussels, Panama, Argentina, Japan, Thailand
Broad mandate – can be summarised in the objectives

13. OIE STANDARDS (oıe websıte)
Terrestrial Animal Health
Code
Manual of Diagnostic Tests and Vaccines for Terrestrial Animals
Aquatic Animal Health Code
Manual of Diagnostic Tests for Aquatic Animals
OIE publishes standards on prevention of disease spread and on diagnostic testing and vaccine production
Safeguard world trade without unjustified barriers i.e. based on scientific principles
WTO recognises OIE standards, guidelines and recommendations as the international standards for animal health and zoonoses.
Sanitary and Phytosanitary Agreement of the WTO that ‘sanitary measures should be scientifically justifiable’.
CODE
Lays down standards, guidelines and recommendations that should be followed to ensure safe international trade in animals and animal products
One for terrestrial animals and one for aquatic animals
MANUAL
The OIE standards for laboratory testing and vaccination are laid out in the Manual of Diagnostic Tests and Vaccines for Terrestrial Animals. Again, one for terrestrial animals and one for aquatic animals.
Code and Standards adopted each year at gen. session by consensus of IC. Any proposed changes are debated before adoption

14. WHY STANDARDS ARE NECCESSARY
International public good
WTO SPS agreement: Fairer trade and safety of international trade
Harmonisation of national legislation and control measures
Unregulated trade in animals/animal products - rapid global spread of many animal diseases - potentıal significant impact on livelihoods, economies, human health, animal welfare. If follow guidelines - international trade should ıs safer.
Speed and ease of global travel today makes regulations more relevant than ever. Outbreak of TAD in any one country is a risk for the whole international community. Rapid spread and wide occurrence of major TADs including HPAI H5N1 has highlighted the need for a global approach to control – control of widely disseminated disease can only be achieved through HARMONISED global approach.
Everyone should use the same rules so more level playing field. In support of WTO SPS agreement the regulations ARE based on science and should not result in unjustified trade barriers. i.e. in case of AI allow for trade in products that are processed to be safe, findings in wild birds – do not change country status

15. THE OIE STANDARDS FOR AVIAN INFLUENZA
Terrestrial Code Chapter : Avian Influenza
Terrestrial Code Appendix 3.8.9: Guidelines for the surveillance of Avian Influenza
Manual : Chapter
Development of guidelines on the implementation
of vaccination and for compartmentalisation for
AI and Newcastle disease
In the CODE and MANUAL specific sections on AI, this is where to find them.
Terrestrial code – defines NAI and differentiates HPNAI/LPNAI. Defines poultry. Describes the measures for preventing spread of NAI through trade so member states can protect themselves
Appendix on surveillance – specific guidelines on surveillance to detect disease early, declare oneself free, to retain free status and to regain freedom. Provides guidance on surveillance in face of vaccination which is vital if a vaccination programme is adopted.

16. OIE TERRESTRIAL CODE AI CHAPTER
Chapter updates for AI since 2004
Differentiate between NHPAI and NLPAI
Appropriate measures for each
Define ‘occurrence in poultry’
Incubation period for trade purposes ’21 days’
Specific risk based trade recommendations for commodities (egg products, meat products etc)
Allows for vaccination
Specific science based guidelines on what territories can reasonably do to prevent introduction/spread of NAI
Chapter UPDATE ın 2004 AND SINCE THEN
MAIN POINTS
LNPAI and HPNAI are defined
LPNAI differentiated from HPNAI - outbreak of LPNAI not have the same consequences for trade as an outbreak of HPNAI. Encouraged reporting of LPNAI
Disease occurence on virus isolation or RNA ID (in past sero positive, RNA and virus)
FINDINGS IN BIRDS BIRDS OTHER THAN POULTRY – OIE recomends such fındıngs of LPAI or HPAI SHOULD NOT CHANGE TRADING STATUS of country – unlike with FMD.
safety of certain commodities for trade– science based i.e. egg products, poultry semen etc i.e. material that would not contain virus or that has been treated sufficiently to kill virus
-accounts for vaccination i.e. allows trade if sufficient monitoring to provide evidence of disease freedom based on approved surveıllance

17. NOTIFIABLE AVIAN INFLUENZA (NAI)
‘an infection of poultry caused by any influenza A virus of H5 or H7 subtypes or by any AI virus categorized as HPAI’
HPAI= Any AI virus with IVPI > 1.2 (6wk old chickens) or at least 75% mortality (4-8 wk old chickens) or H5 or H7 subtype with multiple basic amino acids at cleavage site
Code defines NAI, HPNAI and LPNAI
To date all HPAI viruses have been of subtype H5 or H7 and LPAI of subtypes H5 and H7 have potential to mutate to HPAI. THEREFORE LPAI H5/H7 IN POULTRY notifiable.
HPNAI –IVPI (6 wk old chickens greater than 1.2 or mortality over 75% or H5 OR H7 with multiple basic AAs at HAO cleavage site- where enzymes act).
New chapter will say REGARDLESS OF PATHOGENICITY IN CHICKENS IF SUBTYPE H5 OR H7 AND HAO CLEAVAGE SITE AA SEQUENCE IS SIMILAR TO ANY OF THOSE OBSERVED IN VIRULENT VIRUSES.. WILL BE CONSIDERED HPNAI.
Occurrence of infection is defined as isolation of virus or RNA specific to NAI.
POSITIVE SEROLOGY to H5/H7 alone is not occurrence of infection it may indicate prior exposure. All cases of pos serology should be followed up by virological investigation.
All occurrences of H5/H7 and HPAIs in poultry should be reported to OIE, only occurrence of HPAI in wild birds need to be reported.
OIE RECOMENDS AGAINST TRADE RESTRICTIONS WHEN HPAI FOUND IN ANY OTHER BIRDS THAN POULTRY.
For purposes of code- incubation period is 21 days.

18. POULTRY Birds reared or kept in captivity
for the production of meat or eggs for consumption
for the production of other commercial products
for restocking supplies of game
for breeding these categories of birds
including backyard poultry, fighting cocks
Does not include hunting falcons, racing pigeons, birds kept for show, display or as pets or wild birds
OIE recommends against trade restrictions if Notifiable Avian Influenza in non poultry species but countries should report occurrence in non poultry to OIE
DEFINITION IS SPECIFICALLY FOR AI CHAPTER OF CODE. It separates birds that pose a higher risk to disease spread through trade from those that don’t.
Other captive birds or wild birds are not poultry. FALCONS ARE NOT INCLUDED IN THE DEFINITION OF POULTRY. Therefore an outbreak of NAI in falcons should not affect trade status of a country.
OBLIGATION TO REPORT HPAI in all birds and LPNAI in poultry only.
Should be no trade implications if NAI is found in wild birds or falcons.

19. GUIDELINES FOR SURVEILLANCE (APP. 3.8.9)
Early detection is essential for effective control
For self declaration of NAI or HPNAI free (from ‘poultry’) status in country, zone or compartment
To maintain free status or following an outbreak
Can be applied to a country, zone or compartment
Even with vaccination
Chapter provides guidance on putting together a surveillance programme that aims to detect an outbreak of NAI early so that control can be implemented when disease situation is more amenable to control. Also to provide early warning for other countries
Guidance on providing evidence of freedom in poultry for self declaration of freedom from country, zone or compartment.
Scientifically impossible to demonstrate the absence of disease in absolute terms, no survey is 100% sensitive or specific. Would need to test every bird every day.
Sufficient confidence can be achieved through a combination of approaches and should be adapted to situation
Guidelines define how to go about building evidence base for freedom following an outbreak or maintaining freedom.
A REQUIREMENT THAT NAI ıs NOTIFIABLE- AWARENESS OF SIGNS IMP

20. Checklist published by OIE practical implementation of compartmentalisation to quickly implement
It isn’t part of the code and it provides practical guidance on what a compartment is and how to establish one quickly.

21. OIE MANUAL OF DIAGNOSTIC TESTS AND VACCINES FOR TERRESTRIAL ANIMALS
A companion volume of the Code
To facilitate international trade in animals and animal products by describing internationally agreed upon laboratory methods for diagnosis and requirements for the production and control of vaccines.
The OIE standards for laboratory testing and vaccination are laid out in the Manual of Diagnostic Tests and Vaccines for Terrestrial Animals. UPDATED THIS YEAR
For most listed diseases including avian influenza (AI), clinical diagnosis alone is not sufficient to confirm infection in livestock. Clinical detection of Notifiable Avian Influenza (NAI) may be problematic especially for Low Pathogenic Avian Influenza viruses (LPAI) or for HPAI in areas also affected by other virulent poultry diseases such as Newcastle disease (the two diseases can be difficult to distinguish from one another). Reliable laboratory diagnostics are therefore essential for disease control and safe trade.
Assurances about the quality and validity of laboratory results can be provided when laboratories comply with OIE standards. These standards also ensure international harmonisation of laboratory diagnostic techniques. OIE reference laboratories uphold these standards and function as centres of expertise.
Early detection is essential for effective control. Problems with clinical dx of many diseases i.e. LPAI or HPAI in areas with concurrent disease (i.e. ND) therefore rely on laboratory diagnosis. Suspicion of listed diseases NEEDS laboratory CONFIRMATION.
Need confidence in lab results-
Confirmation of disease, or declaring freedom following laboratory surveillance or from individual animals tested (pre/post import) for international trade.
Harmonised approach to testing and control for confidence in global trade and for global response to TADs.

22. Standards for….. DIAGNOSTIC MANUAL Diagnostics:
Identification of the Agent
Assessment of pathogenicity
Serological tests
Developing techniques
Vaccines:
Guidance on vaccine production to ensure reliable, pure, safe, potent and effective vaccine
The diagnostic manual provides guidance on the following..
First ID that it is influenza A virus then what subtype
Then assessment of pathogenicity – in vivo tests (live chickens –IVPI/or 75% mortality), molecular- mutliple basic aas at cleavage sit
Developing techniques are not officially recognised so are research tools. All recognised tests start somewhere as research tools.

23. OIE Standards.. The international standard (WTO)
Prevent spread of disease through trade
Facilitate safe trade
Provide guidance on effective, internationally validated diagnostic tests
Guidance on production of reliable, pure, safe, potent and effective vaccine

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Organisation Mondiale de la Santé Animale
World Organisation for Animal Health
Organización Mundial de Sanidad Animal
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