ai in holland 2003: lessons learned from the response activities in holland?

Dutch Avian Influenza outbreak 2003Dutch Avian Influenza outbreak 2003Lessons to be learnedLessons to be learned

The information used in this presentation is based upon publications The information used in this presentation is based upon publications by the RVV, Central Institute Animal Disease Control by the RVV, Central Institute Animal Disease Control

(CIDC – Lelystad, Holland)(CIDC – Lelystad, Holland)

04/08/2304/08/23 www.N2GF.comwww.N2GF.com 22

Part one:Part one:The Avian Influenza virusThe Avian Influenza virus

What is Avian Influenza?What is Avian Influenza?

Why is it so dangerous?Why is it so dangerous?

Why is protection not possible?Why is protection not possible?


Avian Influenza characteristicsAvian Influenza characteristics

256 possible combinations of AI256 possible combinations of AI

Different viruses simultaneously occurred in AsiaDifferent viruses simultaneously occurred in Asia

Change of character within one (!!) monthChange of character within one (!!) month


8 RNA segments

INFLUENZA VIRUS STRUCTUREINFLUENZA VIRUS STRUCTURE

Haemagglutinin

Neuraminidase

Matrix protein

Nucleoprotein


GENETIC REASSORTMENTGENETIC REASSORTMENT

HH1010NN77

HH77 N N33

New Influenza virus:New Influenza virus:256 POSSIBLE256 POSSIBLE

COMBINATIONS!COMBINATIONS!Cell

H7N7H7N7


VIRUS CHARACTERISTICSVIRUS CHARACTERISTICS

A/chick/2003-H7N7A/chick/2003-H7N7 All genes are of avian originAll genes are of avian origin IVPI = 2,94IVPI = 2,94 Sequence at cleavage site: Sequence at cleavage site:

– P E I P P E I P K R R R RK R R R R . G L F . G L F H7 closely related with A/mallard/2000 H7N3H7 closely related with A/mallard/2000 H7N3 N7 closely related with A/mallard/1999 H10N7 N7 closely related with A/mallard/1999 H10N7 No additional glycosylation sites No additional glycosylation sites

(suggest recent introduction from wild fowl)(suggest recent introduction from wild fowl)


WILD BIRD SURVEILLANCEWILD BIRD SURVEILLANCE

In 1999 subtype In 1999 subtype H10N7H10N7 and 2000 subtype and 2000 subtype H7N3 H7N3 was isolated from mallard was isolated from mallard ((Anas platyrhynchosAnas platyrhynchos) in the ) in the NetherlandsNetherlands


AI OUTBREAK IN THE NETHERLANDSAI OUTBREAK IN THE NETHERLANDS

Precursor of the H7N7 virus of Precursor of the H7N7 virus of Dutch outbreak 2003 is probably a Dutch outbreak 2003 is probably a re -assorted LPAI viruses that re -assorted LPAI viruses that circulated in waterfowlcirculated in waterfowl


ConclusionsConclusionsPart onePart one

The most likely course of an outbreak of AI is The most likely course of an outbreak of AI is contact between livestock and waterfowlcontact between livestock and waterfowl

Infected waterfowl keep flying over livestock area’s Infected waterfowl keep flying over livestock area’s during the bird trackduring the bird track

Avian Influenza is most likely less mortal under Avian Influenza is most likely less mortal under waterfowl in the first period of the incubation timewaterfowl in the first period of the incubation time


Part twoPart two Why was the crises in Holland so intense?Why was the crises in Holland so intense?

Where did the outbreak start?Where did the outbreak start?

Why were the results for the Dutch poultry industry Why were the results for the Dutch poultry industry so catastrophic?so catastrophic?

What was the influents of scientific research prior What was the influents of scientific research prior to the outbreak?to the outbreak?


START OF AI OUTBREAKSTART OF AI OUTBREAK

Friday February, 28 2003:Strong suspicion of AI on 6 layer farms in Gelderse Vallei

Signs: Mortality (> 80%), drop in egg production, decreased food consumption, swollen heads, cyanosis, diarrhea and respiratory problems.


OUTBREAKS VS. FARMS AT RISKOUTBREAKS VS. FARMS AT RISK


POSSIBLE ROUTE OF ENTRY OF POSSIBLE ROUTE OF ENTRY OF AI VIRUSAI VIRUS

– Free range laying hens infected by LP H7N7 Free range laying hens infected by LP H7N7 variant of wild fowlvariant of wild fowl

– Circulated in one stable of index case indicated Circulated in one stable of index case indicated by positive serology in absence of signs in this by positive serology in absence of signs in this stable stable

– Mutation and selection of HP-variant in chickensMutation and selection of HP-variant in chickens– Clinical signs of AI in other stable of index caseClinical signs of AI in other stable of index case

So

urc

e :

Ag

rari

sc

h D

ag

bla

d


11 AI outbreaks up to 7 March 2003


LPAI VIRUS THAT LPAI VIRUS THAT CIRCULATED FOR CIRCULATED FOR

SOME TIME? SOME TIME?

Animal Health Service

nation wide serological nation wide serological surveillance surveillance

carried out from 7-17 carried out from 7-17 MarchMarch


March 1 : already stand-still

±20 farms infectedMarch 4 : infected farms culled

+ pre emptive culling within 1 km

± 46 farms infected

CO

NT

RO

L O

F A

I (1)

CO

NT

RO

L O

F A

I (1)


March 25 : culling of buffer regions (Wageningen en Putten)

March 25 : Beneden Leeuwen (March 30)


CONTROL OF AI (2)

March 27March 27 :: setting up of setting up of compartments compartments

April 1 April 1 :: culling of all flocks in culling of all flocks in protection zones GVprotection zones GV

April 3April 3 :: Ospel (Nederweert) (7 Ospel (Nederweert) (7 April) April)

April 4April 4 :: 2e Stand-still (till April 10) 2e Stand-still (till April 10) April 10 April 10 :: Koningsbosch (April 14) Koningsbosch (April 14) May 5May 5 :: Vernhout (Zundert) Vernhout (Zundert)

(May 9) (May 9) May 11 May 11 :: last infected farm culledlast infected farm culled


Sentinel birds (10%) on infected farmsSentinel birds (10%) on infected farms

Testing after 3 weeksTesting after 3 weeks

If all sentinel birds negative: lifting of surveillance zoneIf all sentinel birds negative: lifting of surveillance zone

Last surveillance zone lifted 22 AugustLast surveillance zone lifted 22 August

Export live poultry allowed to EU since Export live poultry allowed to EU since

11 July 2003 from the Netherlands with exclusion of existing 11 July 2003 from the Netherlands with exclusion of existing surveillance zonessurveillance zones

Lifting restrictionsLifting restrictions


Scientific influencesScientific influences

The European scientific world is divided in different groups, with all a The European scientific world is divided in different groups, with all a different view on what the best possible solution is on culling animalsdifferent view on what the best possible solution is on culling animals

Some look at it from an animal welfare point of view, others are Some look at it from an animal welfare point of view, others are concentrating on swift crises management, some on have made prior concentrating on swift crises management, some on have made prior experiences with AI, others reject the view of other scientists, based experiences with AI, others reject the view of other scientists, based upon their own (mostly narrow) scientific visionupon their own (mostly narrow) scientific vision

Fighting AI sometimes looks like an exclusive playground for scientists. Fighting AI sometimes looks like an exclusive playground for scientists. Experts outside this scientific community are left out of the discussion, Experts outside this scientific community are left out of the discussion, including farmers organisations, culling experts, scientists specialised including farmers organisations, culling experts, scientists specialised in the human impact of the crises and scientific newcomers with a in the human impact of the crises and scientific newcomers with a different view from what is discussed between exciting scientific different view from what is discussed between exciting scientific experts in this fieldexperts in this field


Conclusions part two:Conclusions part two:Why was the crises in Holland so intense?Why was the crises in Holland so intense?

Density of poultry in the ‘Gelderse Vallei’ was too high

Culling capacity too small during the first weeks of the crises

Contingency plan for birds diseases was outdated and still under construction; the Dutch stamping out procedures during the crises were therefore based upon outbreak of pigs diseases, prior to the AI outbreak

No real corporation between farmers and the government was established, within the first period of the crises

Too much influence of experts and scientists. They had all a different view (mostly based upon scientific laboratory knowledge) on how to handle the crises. This blocked practical solutions (and the necessary pre investments in culling equipment) and paralysed the crises team that was responsible for practical planning and control


Part threePart threeInfectiousness and spreading characteristicsInfectiousness and spreading characteristics

How was it possible that AI was spread in different How was it possible that AI was spread in different area’s in Holland?area’s in Holland?

What was the serologic character of the What was the serologic character of the spreading in Holland?spreading in Holland?

What was the most possible reason for the human What was the most possible reason for the human mortal case?mortal case?


Mortality under animals and bio securityMortality under animals and bio security

The first signs of AI occur first after the infectiousness was on its top The first signs of AI occur first after the infectiousness was on its top three days before mortality under the livestock is visiblethree days before mortality under the livestock is visible

Serologic research starts after the first visible signs of AI and takes Serologic research starts after the first visible signs of AI and takes days before the AI conformation; announcing that there is a case of AI days before the AI conformation; announcing that there is a case of AI and taking precautionary measures is balanced with the financial and taking precautionary measures is balanced with the financial impact for the entire industry and beyond thatimpact for the entire industry and beyond that

In case of the first outbreak, the first line of defence is entirely In case of the first outbreak, the first line of defence is entirely depending on the standard of bio security on the infected farm and the depending on the standard of bio security on the infected farm and the farms and the chain members, in contact with that farmfarms and the chain members, in contact with that farm


5 15 80

583

1934

799

0

500

1000

1500

2000

nu

mb

er

23 24 25 26 27 28

day in Feb.

EXAMPLE MORTALITY(flock of 3800)

Flock infectiousness


NUMBER INFECTED FARMS: 241NUMBER INFECTED FARMS: 241

0

2

4

6

8

10

12

14

28/2 7/3

14/3

21/3

28/3 4/4

11/4

18/4

25/4 2/5

date (2003)

Num

ber

of i

nfe

cted

farm

s


0

2

4

6

8

10

12

14

16

10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35Week

Num

ber x

100

0

negative positive

Total: number 133548

SEROLOGY IN INFECTED ZONES


0

200

400

600

800

1000

1200

1400

10 12 14 16 18 20 22 24 26 28 30 32 34

Week

Num

ber o

f sam

ples

negative positive

Total number: 6073

AVIAN INFLUENZA: RT-PCR


0

20

40

60

80

100

120

140

10 12 14 16 18 20 22 24 26 28 30 32 34

week

Num

ber of

sam

ples

negative positive

Total number: 702l aantal 702 : 702

AVIAN INFLUENZA - VIRUS ISOLATION


RESULTS SEROLOGAL AI-MONITORING IN RESULTS SEROLOGAL AI-MONITORING IN THE INFECTED REGIONSTHE INFECTED REGIONS

Positive HPositive H77Number of Number of

farmsfarmsVirus Virus

isolationisolationStatus of Status of

farmfarm

55241241++InfectedInfected

10611061

1414--

00Pre-emptivePre-emptive

1414

¶ Prevalence within farm varies form 9 –100 %


0

5

10

15

20

2516

-feb 20 24 28

2 6

10 14 18 22 26 30

3 7

11 15 19 23 27

1 M

ay

5 9

13

num

ber o

f cas

es

Num

ber o

f inf

ecte

d fa

rms

Conjunctivitis

Influenza A conj.

H7 conjunctivitis

Farms region 2 (5-day avg)

Farms region 1 (5-day avg)

20

10

Start case finding

Start antivirals

Fatal case

HUMAN CASES

M. Koopmans et al RIVM


Conclusions part three:Conclusions part three: Infectiousness and spreading characteristicsInfectiousness and spreading characteristics

AI is highly infective prior to the first mortal cases under the flockAI is highly infective prior to the first mortal cases under the flock

AI travels light, by dust, people, traffic, ignorance and lack of knowledgeAI travels light, by dust, people, traffic, ignorance and lack of knowledge

Bio security is of utter importance for the entire poultry industry. Farmers Bio security is of utter importance for the entire poultry industry. Farmers therefore must be included within the discussions about AItherefore must be included within the discussions about AI

Minor mistakes in the contingency plan definitively lead to major consequencesMinor mistakes in the contingency plan definitively lead to major consequences

The human infection risk is high, especially during serological research on not-infected farms

One veterinarian died after such an inspection due to a minor mistake in the Dutch contingency plan (the only mortal case during the crises in Holland)


Part four:Part four:Speed of spreading, monitoring and culling tacticsSpeed of spreading, monitoring and culling tactics

How high was the R How high was the R hh reproduction ratio during the reproduction ratio during the

crises?crises?

What is the best option: culling inside out (chasing What is the best option: culling inside out (chasing the virus) or outside in (creating a buffer zone)?the virus) or outside in (creating a buffer zone)?

Was there an Low Path AI strain H7N7 present Was there an Low Path AI strain H7N7 present before High Path AI infection?before High Path AI infection?


How to stop an How to stop an epidemic/ pandemic outbreakepidemic/ pandemic outbreak

If the RIf the Rhh reproduction ratio between flocks is reproduction ratio between flocks is high, the only option is culling in large numbers high, the only option is culling in large numbers to prevent an epidemic or pandemic outbreakto prevent an epidemic or pandemic outbreak

If the RIf the Rhh ratio is in average more than one, ratio is in average more than one, flocks in the entire area within 3 km of an flocks in the entire area within 3 km of an infected farm must be depopulated as soon as infected farm must be depopulated as soon as possiblepossible


The speed of spreadingThe speed of spreading

Immediate action within the first 24 hours is vital to Immediate action within the first 24 hours is vital to stop rapid spreading of the AIstop rapid spreading of the AI

Holland was not prepared: R Holland was not prepared: R hh reproduction ratio at reproduction ratio at the start of the crises was 8,6the start of the crises was 8,6

No pre investments in culling capacity was made No pre investments in culling capacity was made before the crises, due to high costs and internal before the crises, due to high costs and internal political/ scientific discussions, coursing only political/ scientific discussions, coursing only endless discussions on funding endless discussions on funding


INFECTION RATE REPRODUCTION RATIO RINFECTION RATE REPRODUCTION RATIO RHH BEFORE BEFORE

AND AFTER THE IMPLEMENTATION OF MEASURESAND AFTER THE IMPLEMENTATION OF MEASURES

0.860.86

(0.28-(0.28-2.68)2.68)

2.92.9

(no CI)(no CI)

0.910.91

(0.39-2.13)(0.39-2.13)

5.05.0

(2.9-8.6)(2.9-8.6)RRhh

B+CB+CAAB+CB+CAAPeriodPeriod

LimburgLimburgGelderse ValleiGelderse Vallei

95% confidence intervals between bracketsA, before implementation of measures, B and C, after implementation of measures. Periods B and C were combined, because of non-significant differences J.A. Stegeman et al. 2003


STOP AN EPIDEMICSTOP AN EPIDEMIC BY STAMPING OUT BY STAMPING OUT

R > 1

R < 1


Culling tacticsCulling tactics

Culling from the centre of the outbreak is essential to catch Culling from the centre of the outbreak is essential to catch up with the spreading of the virus and to reduce the R up with the spreading of the virus and to reduce the R factorfactor

Creating buffer zones is essential to protect non-infected Creating buffer zones is essential to protect non-infected farms in the areafarms in the area

Both options must be carried out simultaneouslyBoth options must be carried out simultaneously

Two fully equipped culling crews with sufficient capacity Two fully equipped culling crews with sufficient capacity must be available to carry out this tactic of both inside out must be available to carry out this tactic of both inside out and outside in culling approachand outside in culling approach


Monitoring Monitoring resultsresults

Samples of Low Path AI were found in samples taken from the period Samples of Low Path AI were found in samples taken from the period November 2002 till February 2003, prior to the High Path outbreakNovember 2002 till February 2003, prior to the High Path outbreak

1224 farms were inspected1224 farms were inspected

27.010 samples IDEXX ELISA were taken27.010 samples IDEXX ELISA were taken

3 farms were found positive3 farms were found positive

The Low Path AI strain found prior to the outbreak was of type H7N3The Low Path AI strain found prior to the outbreak was of type H7N3

This strain was detected in December 2002This strain was detected in December 2002

The strain was isolated in an other part of country than were the crises started The strain was isolated in an other part of country than were the crises started


Conclusions part fourConclusions part four Speed of spreading, monitoring and culling tactics Speed of spreading, monitoring and culling tactics

Especially in the first week of the crises, the R Especially in the first week of the crises, the R hh reproduction ratio is extremely reproduction ratio is extremely high (in Holland, it was factor 8,6; meaning that one farm infected 8.6; each high (in Holland, it was factor 8,6; meaning that one farm infected 8.6; each other infected farms infecting other farms, and so on, and so onother infected farms infecting other farms, and so on, and so on

All efforts must be put in reducing the R All efforts must be put in reducing the R hh ratio ratio

Both culling tactics must take place simultaneously; sufficient equipment must Both culling tactics must take place simultaneously; sufficient equipment must be available before the outbreakbe available before the outbreak

Funding for pre investments in culling equipment is necessary; in case the Funding for pre investments in culling equipment is necessary; in case the purchasing process starts after the outbreak is confirmed, the responsible purchasing process starts after the outbreak is confirmed, the responsible government pays all the costs and the purchasing prices are not negotiable, government pays all the costs and the purchasing prices are not negotiable, leading to high costs and delivery problemsleading to high costs and delivery problems

Pre monitoring is necessary to notice possible first signs of LP- and HP-AI; in Pre monitoring is necessary to notice possible first signs of LP- and HP-AI; in waterfowl and in livestockwaterfowl and in livestock


Part five:Part five:Imidiate actionsImidiate actions

What did the Dutch authorities do to stop the What did the Dutch authorities do to stop the crises?crises?

Why did the crises team work out of a Why did the crises team work out of a mobile crises centre?mobile crises centre?

Did it help to prevent a pandemic outbreak?Did it help to prevent a pandemic outbreak?


Immediate actionsImmediate actions(1)(1)

Stand still on livestock transportation, markets, Stand still on livestock transportation, markets, etceteraetcetera

Forming crises teams on different levelsForming crises teams on different levels

Implementing zoning and transportation protocolsImplementing zoning and transportation protocols

Hiring contractersHiring contracters


Immediate actionsImmediate actions(2) (2)

Mobile crises centre; ‘Stroe’Mobile crises centre; ‘Stroe’ During former animal disease crises, the Dutch authorities successfully During former animal disease crises, the Dutch authorities successfully

developed a model for a mobile crises management Centre, based developed a model for a mobile crises management Centre, based upon the use of a mobile office centre; all participants dealing with upon the use of a mobile office centre; all participants dealing with crises management used this centre for their operationscrises management used this centre for their operations

This centre made an interdisciplinary approach possible to coordinate This centre made an interdisciplinary approach possible to coordinate and control the crisesand control the crises

Also major suppliers used this centre for their operationsAlso major suppliers used this centre for their operations

The centre was also used for coordinating information management, The centre was also used for coordinating information management, accounting, public relations and logistic purposesaccounting, public relations and logistic purposes


Stand stillStand still Reduction of number contactsReduction of number contacts

(Pre-emptive) culling(Pre-emptive) culling Reduction of infectiousnessReduction of infectiousness

– Infected farms should be culled within 24 hoursInfected farms should be culled within 24 hours Reduction of number of susceptible birds (farms)Reduction of number of susceptible birds (farms)

– Pre-emptive culling within 48 hoursPre-emptive culling within 48 hours

Immediate actionsImmediate actions(3) (3)

Control MeasuresControl Measures


Stand stillStand still Nation wide for 72 hNation wide for 72 h

– Ban of movement of live poultry, hatching eggs, Ban of movement of live poultry, hatching eggs, poultry manure,poultry manure,

– Export ban on all export of live poultry and eggsExport ban on all export of live poultry and eggs– Ban on gathering of poultry and other birdsBan on gathering of poultry and other birds– Obligation to keep poultry inside - ban on free-Obligation to keep poultry inside - ban on free-

range housingrange housing


Measures on February 28 Measures on February 28THTH



Measures on February 28 Measures on February 28THTH

Protection zone with radius of 3 kmProtection zone with radius of 3 km– Clinical inspection Clinical inspection

Suspected holding: Suspected holding: – 5 moribund or diseased birds and 20 blood samples5 moribund or diseased birds and 20 blood samples

No disease:No disease:– 20 trachea swabs + 20 blood samples20 trachea swabs + 20 blood samples

Surveillance zone with radius of 10 kmSurveillance zone with radius of 10 km– Clinical inspection Clinical inspection

of all holdings to be finished before lifting 21 days after of all holdings to be finished before lifting 21 days after last cleaning and disinfectionlast cleaning and disinfection


CullingCulling

What culling methods were used?What culling methods were used?

Why did they not only use stable gassing but also Why did they not only use stable gassing but also the HKI Methods the HKI Methods © © ??

What are the major differences between these What are the major differences between these culling methods?culling methods?

Why was the HCN method not used during the Why was the HCN method not used during the Dutch crises?Dutch crises?


CullingCulling(1)(1)

Capacity at start low, later high Capacity at start low, later high (50.000 later 1 million birds per day)(50.000 later 1 million birds per day)

Methods:Methods:– CO2 gas in containers (by HKI)CO2 gas in containers (by HKI)– CO2 gas in shed (by gas suppliers)CO2 gas in shed (by gas suppliers)– CO gas in shed (by gas suppliers)CO gas in shed (by gas suppliers)– CO gas in small containers (by experiment)CO gas in small containers (by experiment)– Electrocution machine (by HKI)Electrocution machine (by HKI)– Injection with T61 (small numbers)Injection with T61 (small numbers)



Stable gassing versus HKI approachStable gassing versus HKI approach

Total amount of animals culled: 1.200 farms; 31,750,000 Total amount of animals culled: 1.200 farms; 31,750,000 animalsanimals

Stable gassing: Stable gassing: – 45% of all farms by stable gassing45% of all farms by stable gassing– 61% of all animals by Co2 stable gassing61% of all animals by Co2 stable gassing– 5 % of all animals by Co stable gassing5 % of all animals by Co stable gassing

HKI ApproachHKI Approach– 55% of all farms by HKI approach55% of all farms by HKI approach– 33% of all animals by HKI approach33% of all animals by HKI approach



Notes on stable gassingNotes on stable gassing Stable gassing as a method can be only used in large stablesStable gassing as a method can be only used in large stables Housing, type of animal, age and amount of animals are crucial for Housing, type of animal, age and amount of animals are crucial for

deploying the most effective and efficient culling methoddeploying the most effective and efficient culling method In Holland, only 45% of all farms were suitable for stable gassing, In Holland, only 45% of all farms were suitable for stable gassing,

housing 66% of all animalshousing 66% of all animals Individual culling is by far more complicated than Stable gassingIndividual culling is by far more complicated than Stable gassing Until now, no gas supplier has come up with better ideas to speed up Until now, no gas supplier has come up with better ideas to speed up

this culling method to reduce the actual culling time to 10 to 15 this culling method to reduce the actual culling time to 10 to 15 minutes, accepting a period of 30 minutes to 3 hours as the best minutes, accepting a period of 30 minutes to 3 hours as the best possible optionpossible option

In case of a new large scale outbreak, gas supply will be a limiting In case of a new large scale outbreak, gas supply will be a limiting factor, due to shortage of gas trucks to transport the gas to the farmsfactor, due to shortage of gas trucks to transport the gas to the farms



Notes on culling operationNotes on culling operation In order to cull from the inside out (chasing the virus) and In order to cull from the inside out (chasing the virus) and

culling outside in (buffering zone) two fully equipped culling culling outside in (buffering zone) two fully equipped culling teams are neededteams are needed

Only a view machines are needed within the crises area at Only a view machines are needed within the crises area at the first 24 hours, but a large amount of machines have to the first 24 hours, but a large amount of machines have to be in stock to catch up after thatbe in stock to catch up after that

Trained personnel is essential, especially to safe garden Trained personnel is essential, especially to safe garden animal welfare aspects during a crisesanimal welfare aspects during a crises

No personnel from outside the area should enter an No personnel from outside the area should enter an infected zone without an absolute reason for it. Personnel infected zone without an absolute reason for it. Personnel should be recruited within the zone and before a possible should be recruited within the zone and before a possible crises. Therefore corporation with farmers and the farmers crises. Therefore corporation with farmers and the farmers industry is crucialindustry is crucial



Notes on capacityNotes on capacity Speed of operation is not depending on the Speed of operation is not depending on the

capacity of the equipment used, nor on the culling capacity of the equipment used, nor on the culling methodmethod

Speed of operation is basically a matter of proper Speed of operation is basically a matter of proper organisation and logisticsorganisation and logistics

Culling operations can easily walk out of hand in Culling operations can easily walk out of hand in case the logistics fail case the logistics fail

Registration during the culling operation is the Registration during the culling operation is the source of future planningsource of future planning



Notes on the veterinarianNotes on the veterinarian Veterinarians are used to work with animals, they are not trained to be Veterinarians are used to work with animals, they are not trained to be

head of operations on a culling sighthead of operations on a culling sight Veterinarians are used to keep livestock alive and not to massive Veterinarians are used to keep livestock alive and not to massive

culling culling Speed of operation is much quicker in case the veterinarian is out of Speed of operation is much quicker in case the veterinarian is out of

sight or not availablesight or not available During culling operations, animal welfare is only a matter of concern as During culling operations, animal welfare is only a matter of concern as

long as there is a veterinarian safeguarding itlong as there is a veterinarian safeguarding it One inexperienced or unprepared veterinarian can do more damage to One inexperienced or unprepared veterinarian can do more damage to

the culling operation than all other members of the culling team the culling operation than all other members of the culling team togethertogether

Veterinarians should be trained about handling animal disease crises, Veterinarians should be trained about handling animal disease crises, starting at the university level up to training on the job, to be prepared starting at the university level up to training on the job, to be prepared better for their role as crises manager during an outbreakbetter for their role as crises manager during an outbreak



HCN is not an optionHCN is not an option HCN is not longer allowed in HollandHCN is not longer allowed in Holland HCN is not an AC approved method listed in the HCN is not an AC approved method listed in the

European legislation HCN is only allowed for European legislation HCN is only allowed for scientific purposes to test culling practicesscientific purposes to test culling practices

HCN is on the list of chemical weaponsHCN is on the list of chemical weapons Better methods are available, with less danger for Better methods are available, with less danger for

the people involved in the culling processthe people involved in the culling process Only a limited amount of experts are licensed to Only a limited amount of experts are licensed to

work with HCN work with HCN


Culling and the effect on humansCulling and the effect on humansWhat about respect?What about respect?

What about farmers, loosing their entire future?What about farmers, loosing their entire future? What about veterinarians that were not trained for What about veterinarians that were not trained for

the job?the job? What about the cullers, executing millions of What about the cullers, executing millions of

animals?animals? What about animal welfare people, guessing What about animal welfare people, guessing

what’s happening?what’s happening? What about the public, with livestock as pets?What about the public, with livestock as pets? What about the press?What about the press?


Financial aspects Financial aspects (1)(1)

The poultry industryThe poultry industry Direct costs: Direct costs: 376 million376 million Euro (partly paid by the EC) Euro (partly paid by the EC) Indirect costs: Indirect costs: 1 milliard1 milliard Euro (not insurable under the Euro (not insurable under the

Dutch circumstances, due to the current policy of the Dutch Dutch circumstances, due to the current policy of the Dutch authorities in charge of contingency planning)authorities in charge of contingency planning)

Damaged image of the poultry industryDamaged image of the poultry industry Cold shake out with significant losses in market chare, Cold shake out with significant losses in market chare,

losses of important parent stocks and grand parent stockslosses of important parent stocks and grand parent stocks Massive losses of jobsMassive losses of jobs Blockade on future investments, necessary to implement Blockade on future investments, necessary to implement

new European legislation on housing, animal welfare, bio new European legislation on housing, animal welfare, bio security and food quality security and food quality


Human aspects of cullingHuman aspects of culling(2)(2)

Farmers, cullers and veterinariansFarmers, cullers and veterinarians

The industry is the biggest looser in the aftermath The industry is the biggest looser in the aftermath of the crises, especially the farmers and its family of the crises, especially the farmers and its family

Special mental care has to be created for farmers, Special mental care has to be created for farmers, veterinarians and culling personnel to help digest veterinarians and culling personnel to help digest their experiencetheir experience

Professional mental coaches should be part of the Professional mental coaches should be part of the crises teams during an outbreak, to avoid crises teams during an outbreak, to avoid mistakes coursed by too high pressure due to the mistakes coursed by too high pressure due to the immense responsibilities immense responsibilities


Animal welfare aspects of cullingAnimal welfare aspects of culling(3)(3)

Animal welfare peopleAnimal welfare people Animal welfare people should be informed about the Animal welfare people should be informed about the

background of the crises, it’s consequences for animal en background of the crises, it’s consequences for animal en human welfare and about the risks of animal diseases in human welfare and about the risks of animal diseases in case of no controlcase of no control

Animal welfare people should have (limited) access to Animal welfare people should have (limited) access to information before, during and after a crises to judge information before, during and after a crises to judge weather all has bin done to avoid unnecessary culling of weather all has bin done to avoid unnecessary culling of animals in conjunction with the human risks and the animals in conjunction with the human risks and the financial consequences for the farming industryfinancial consequences for the farming industry

Animal welfare people should be actively involved in Animal welfare people should be actively involved in examining the possible culling methods and help to examining the possible culling methods and help to improve these methods, rather than criticising the improve these methods, rather than criticising the government, farmers and cullers for executing culling government, farmers and cullers for executing culling proceduresprocedures


Virological aspectsVirological aspects

VaccinationVaccination TransmissionTransmission DiagnosticsDiagnostics


Vaccination aspectsVaccination aspects(1)(1)

Culling and vaccinationCulling and vaccination Stamping out is the only possible optionStamping out is the only possible option

No vaccination of life stock during outbreak, only as temperately No vaccination of life stock during outbreak, only as temperately procedure in non-infected areasprocedure in non-infected areas

Vaccination of life stock protects only 96% of all vaccinated birdsVaccination of life stock protects only 96% of all vaccinated birds

All vaccinated birds have to be culled (Italy, Mexico, Asia did not cull All vaccinated birds have to be culled (Italy, Mexico, Asia did not cull vaccinated birds, resulting in new outbreaks of new types of viruses) vaccinated birds, resulting in new outbreaks of new types of viruses)

Protection of people: pre-amative vaccination of all people (!!) against Protection of people: pre-amative vaccination of all people (!!) against human flue is the best possible protection of those who are in human flue is the best possible protection of those who are in immediate contact with life stock during the crisesimmediate contact with life stock during the crises


Transmission of AI Transmission of AI (1)(1)

Infection of H7N7 in pigs in HollandInfection of H7N7 in pigs in Holland

48 farms with mixed herds that were located within 48 farms with mixed herds that were located within the protection zones and had infected poultry were the protection zones and had infected poultry were tested for antibodies.tested for antibodies.

13 farms: prevalence ranging from 2,2 to 42%.13 farms: prevalence ranging from 2,2 to 42%.

No increase in prevalence after re-testing.No increase in prevalence after re-testing.

No evidence of efficient transmission among pigsNo evidence of efficient transmission among pigs

H7 haemagglutination inhibition test low specificity.H7 haemagglutination inhibition test low specificity.


Transmission of AI Transmission of AI (2)(2)

Transmission in AsiaTransmission in Asia

Especially in open housing system in Vietnam and Especially in open housing system in Vietnam and Indonesia (humans, pigs, poultry and ducks living Indonesia (humans, pigs, poultry and ducks living under the same roof), bio security is likely to failleunder the same roof), bio security is likely to faille

Transmission to other types of birds, elephants Transmission to other types of birds, elephants and dogs are recently registeredand dogs are recently registered

Especially young children are in dangerEspecially young children are in danger The first case of human to human transmission is The first case of human to human transmission is

currently under investigationcurrently under investigation Until now, no change of a transmitted AI virus into Until now, no change of a transmitted AI virus into

a new human virus is registereda new human virus is registered


Diagnostic aspectsDiagnostic aspects(1)(1)

Diagnosis in field difficult lack of characteristic Diagnosis in field difficult lack of characteristic clinical signs.clinical signs.– First signs were reduction of food and water First signs were reduction of food and water

intakeintake Early warning systemEarly warning system

– Respiratory problemsRespiratory problems– Drop egg production Drop egg production – Increased mortalityIncreased mortality

Serological monitoring with emphasis at farms at Serological monitoring with emphasis at farms at risk (a.o. free range farms)risk (a.o. free range farms)


Public Health aspectPublic Health aspectReassortment could result Reassortment could result

in human pandemicin human pandemic To prevent development of new dangerous strain the chance of simultaneous

infection with HPAI strain H7N7 and human influenza should be minimal Measures taken:

Protective clothing, masks and eye protection

Vaccination against human influenza

Prophylactic treatment with anti viral drug Tamiflu

Medical checks of people active at culling

Several cases of conjunctivitis in people working at culling

88 people were directly infected, 8,000 people were indirectly infected; one veterinarian died of pneumonia caused by H7N7


Influenza viruses are to stay in the wild bird populationInfluenza viruses are to stay in the wild bird population

Keep poultry separated from wild fowlKeep poultry separated from wild fowl

High biosecurityHigh biosecurity

Practical contingency planPractical contingency plan

Human- and economic risk management Human- and economic risk management

SummerySummery(1)(1)


CompartmentalisationCompartmentalisation– targeted surveillance within compartmenttargeted surveillance within compartment

Surveillance of live bird marketsSurveillance of live bird markets

Targeted vaccination programmeTargeted vaccination programme



Corporation between farmers, animal health services and officialsCorporation between farmers, animal health services and officials

Active involvement of farmers in case of an outbreakActive involvement of farmers in case of an outbreak

Sufficient culling capacity to cull the maximum amount of animals Sufficient culling capacity to cull the maximum amount of animals within an area of 3 kilometres within 24 hours after the first within an area of 3 kilometres within 24 hours after the first positive AI test resultspositive AI test results

Yearly test of the contingency plan with all participantsYearly test of the contingency plan with all participants



ConclusionsConclusions

HPAI can appear suddenly without detected LPAI infectionHPAI can appear suddenly without detected LPAI infection

High mortality High mortality

Rapid spread between farmsRapid spread between farms

TransportTransport

PersonsPersons

DustDust

Fast culling infected farms essentialFast culling infected farms essential

Public health consequencesPublic health consequences

ai in holland 2003: lessons learned from the response activities in holland?

Technology

infected farm

bio security

avian influenza

ai outbreak

day avg

conclusions part

adifferent view

outbreak