Policies for Pandemic Influenza: Animal/Public Health

1
Policies for Pandemic InfluenzaAnimal/Public
Health

• Barrett D. Slenning MS, DVM, MPVM
• Animal Biosecurity Risk Management Group
  Population
  Health Pathobiology Dept
  College of Vet Med,
  NC State Univ, Raleigh, NC
• Agriculture Disaster Research Institute
  
  Research Triangle Inst., Research Triangle Park,
  NC

2
Pandemic Influenza Policies Topics

• Introductory comments
• Summary of Kelley/Weiner presentations
• Additional comments from a veterinarians
  perspective

3
Animal and Public Health?

• 75 of CDC AB/Emerging Diseases are Zoonotic
  (dangerous to people)
• The food US consumers eat in one day, on average,
  comes from 30 /- countries
• The typical city has less than 3 days food
  supply
• In US, there are 750K MDs and 75K DVMs
• Of which 80 are companion animal oriented

4
Animal and Public Health?

• Definite Zoonotics
• SARS
• BSE (Mad Cow)
• Psittacosis
• Rift Valley Fever
• Hi-Path Avian Influenza
• Monkeypox
• Hanta virus
• West Nile virus
• Q Fever
• Anthrax
• Plague
• Tularemia

• Viral Hemorrhagic Fevers
• Viral Encephalitis Diseases
• Brucellosis
• Food/H2O Safety Threats
• Retroviruses
• Likely Zoonotics
• Ebola/Marburg
• Human Health Impact in Question
• Swine Vesicular Disease

5
Value of Poultry to North Carolina
6
Pandemic Influenza Policies Topics

• Introductory comments
• Summary of Kelley/Weiner presentations
• Additional comments from a veterinarians
  perspective

7
Pandemic Influenza Take Homes
via Kelley/Weiner

• Both Claiming to know periodicity of influenza
  pandemics is fantasy
• Doesnt guide us, or help us
• Argument from ignorance poor policy basis
• Both Linear extrapolation of 40-90 yr ago is
  dubious
• Should we base plans on a single worst-case
  event?
• Implicit assumptions of similarity in
  understanding, health care, medical tools and
  practices are false
• Both Simple sound bites poor risk communication
  
• Does knowing how 1918 happened have relevance
  to the next pandemic?

8
Pandemic Influenza Take Homes
via Kelley/Weiner

• Kelley Response planning too dependent on
  medical intervention during last phase of
  pandemic
• Too dependent on silver bullets of untested
  anti-virals and vaccinology
• Weiner Genomics too imprecise to understand
  differing genetic changes
• How quick, how bad, how severe?
• We dont understand all that we know, and we
  dont know all we need to understand
• Kelley Economics of just a poultry event are
  bad enough, and worthy of extra effort
• 2nd order effects (social/ psychol/ etc) will be
  massive
• Not socially neutral

9
Pandemic Influenza Policies Topics

• Introductory comments
• Summary of Kelley/Weiner presentations
• Additional comments from a veterinarians
  perspective

10
Additional comments

• Refreshing to hear people worried about BIRDS in
  todays AVIAN pandemic, as opposed to PEOPLE in
  potential future outbreaks
• DHHS has captured the entire agenda, to the
  detriment of us all
• I agree with some things youve heard
• I am not as sanguine about some comments
• Most, however, I just do not know about

11
Hi Path AI Clinical Disease

• High morbidity, high mortality
• (Most get ill, most die)

12
Chicken Food-Chain
Major Flows
Minor Flows
Green lines/font feed segment Red lines/font
live animal segment Purple lines/font
processing/marketing segment Black lines/font
immediate consumption segment
Non-food, non-feed Products uses
Feed Producer
Industrial use (rendering, oils, fertilizer)
Feed Brokers
Feed Milling and Distribution
13
Chicken Food-Chain
Major Flows
Minor Flows
Green lines/font feed segment Red lines/font
live animal segment Purple lines/font
processing/marketing segment Black lines/font
immediate consumption segment
Non-food, non-feed Products uses
Feed Producer
Industrial use (rendering, oils, fertilizer)
Feed Brokers
Exports
Spike Male Lines (1o Breeder, Genetics)
Grandparent Lines (1o Breeder, Genetics)
Cull Hen Market (culls incl chicks)
Broiler Breeders (2o Breeder, Prodn hens)
Grower Unit (Commercial Chicks)
Out-of-State Growing
Hatchery Unit (Commercial Chicks)
14
Chicken Food-Chain
Major Flows
Minor Flows
Green lines/font feed segment Red lines/font
live animal segment Purple lines/font
processing/marketing segment Black lines/font
immediate consumption segment
Non-food, non-feed Products uses
Imports
Feed Producer
Industrial use (rendering, oils, fertilizer)
Exports
Feed Brokers
High processed meats/protein (sausages, deli
prods, protein suppls, powdered, pet foods)
Exports
Spike Male Lines (1o Breeder, Genetics)
Grandparent Lines (1o Breeder, Genetics)
Cull Hen Market (culls incl chicks)
Packer Processor (includes value-added processi
ng)
Broiler Breeders (2o Breeder, Prodn hens)
Grower Unit (Commercial Chicks)
Out-of-State Growing
Hatchery Unit (Commercial Chicks)
15
Chicken Food-Chain
Major Flows
Minor Flows
Green lines/font feed segment Red lines/font
live animal segment Purple lines/font
processing/marketing segment Black lines/font
immediate consumption segment
Non-food, non-feed Products uses
Imports
Feed Producer
Industrial use (rendering, oils, fertilizer)
Exports
Feed Brokers
High processed meats/protein (sausages, deli
prods, protein suppls, powdered, pet foods)
Exports
Spike Male Lines (1o Breeder, Genetics)
Grandparent Lines (1o Breeder, Genetics)
Cull Hen Market (culls incl chicks)
Packer Processor (includes value-added processi
ng)
Broiler Breeders (2o Breeder, Prodn hens)
Grower Unit (Commercial Chicks)
Out-of-State Growing
Hatchery Unit (Commercial Chicks)
Consumer
16
Katrina and Agriculture

• 60-70 of US corn and soy go through the port of
  New Orleans
• Harvests started mid-Sept
• Port regained partial function by end of
  September
• Port personnel are an issue
• Limited river barge travel started back by mid
  October
• Unknown how river has changed
• Barge costs much higher via competition with
  clean-up needs

17
Avian Influenza H5N1 (now)

• Avian Influenza (H5N1)
• 1st seen 1997 Hong Kong
• Late 2003 was the new AI in SE Asia (called
  chicken ebola)
• Fall/Winter 05-06 Killed gt80 people in SE Asia,
  South Asia, Eastern Europe, and Africa
• Cost by Apr06 18-35B, most via destroying gt1
  Billion poultry
• But that isnt the scary part yet...

18
Poultry is THE major high quality protein source
for the world

• Demand over 40 years for all animal proteins has
  grown
• Ruminant meat by 100-150
• Pig meat by 250-300
• Milk by 100-200
• Poultry meat by almost 800
• Is a major source of economic wealth as well

From M Pappaioanou. Natl Inst Anim Ag Emerg
Progr Conf. April 06
19
Poultry as Economic Underpinning Prior to 2004
From M Pappaioanou. Natl Inst Anim Ag Emerg
Progr Conf. April 06
20
HPAI H5N1 World Consumption Export Changes

• Movement of H5N1 to Europe in fall 2005 triggered
  a major disruption in world poultry markets
• Local variations occur, but the trend is bad

Source FAO, February 2006
21
US Trade Exposure lt15
of US Production
22
Ultimate HPAI Costs to Industry -
Best Guesstimate

• Economic losses mounting
• Waiting for others to make production adjustment
• Time period before adjustment depends on how deep
  the pockets of companies and governments
• Unusual situation where lower prices may not
  stimulate increased consumption
  Loss Lowered leg qtr prices 142 M
  / mo Lowered breast prices 104 M / mo
• Total 246 M / mo
• Also, overabundance of chicken is reducing U.S.
  pork and beef wholesale prices.

Estimates from Bill Roenigk Natl Chicken
Council (Pers Communic)
23
Response to Theoretical H5N1 in US Poultry
(Among those who eat poultry, 96)
Note Dont know responses not shown.
Harvard School of Public Health Project on the
Public and Biological Security, January 17-25,
2006.
24
Lessons Learned Avian Influenza 2005-6...
maybe.

• Avian Influenzas (H5N1) spread means animal
  health public health are the same
• But public health will always be the priority
• Public health response can be deleterious to
  animal agriculture
• Prevention response is best responsibility of
  industry

25
Threats in Spread of H5N1 Confusing,
to say the least

• Joint statement by the OIE and the FAO- 13 April
  2006 Rome ...transmission and spread of
  highly pathogenic avian H5N1 influenza virus is
  essentially only by domestic and wild birds...
• www,promedmail.org- 2 May 2006 ...A top bird
  flu expert on Tuesday predicted that the H5N1
  virus will not reach the United States this year
  via migratory birds, but warned it will
  eventually arrive -- possibly through infected
  birds smuggled into the country...
• Science Magazine- 27 April 2006 ...The question
  is what role wild birds now play as the virus
  hops across continents. There's growing suspicion
  that international smuggling of contaminated live
  poultry or poultry products, such as fertilizer,
  may be playing a bigger role...

26
Planned Mismanagement?

• Making enough vaccine
• Vaccinating people against H5N1 before a
  pandemic starts is not yet a practical
  possibility, because not enough vaccine is
  available. This is partly because all the vaccine
  factories are being used to make vaccine for
  ordinary flu.
• There is, however, massive global capacity for
  making flu vaccine for chickens, and in April the
  WHO held a meeting to explore the possibility of
  using these facilities to make human vaccine. It
  concluded that the manufacturing processes and
  standards are not that different, and it should
  be possible to divert some plants.

27
Take Homes on Policy...

• Focusing on what ifs rather than what is can
  be disastrous
• Over reliance on medical technology what should
  be the last step in several to protect the public
• Ignoring where an agent is now means we have no
  idea where it will be tomorrow
• Risk based, science based decisions are the only
  ones that are defensible
• Not, in reality, what we are doing now.
• All the same, there are cautionary tales of
  importance.
• H3N8 in horses since mid-60s. Jumped to dogs
  around 35-40 years later. Weve followed the
  Asian H5N1 for only 10 years...
• Diseases dont need to be fatal to kill...

28
UK Farmer who committed suicide when his animals
were buried too close to water table, and his
household water turned red. UK April 2001 C.
Brown, U GA CVM
29
Policies for Pandemic InfluenzaAnimal/Public
Health

• Barrett D. Slenning MS, DVM, MPVM
• Animal Biosecurity Risk Management Group
  Population
  Health Pathobiology Dept
  College of Vet Med,
  NC State Univ, Raleigh, NC
• Agriculture Disaster Research Institute
  
  Research Triangle Inst., Research Triangle Park,
  NC

30
(No Transcript)
31
Understanding Pandemic Influenza

• Pandemics occur when novel strain emerges that
  is
• readily transmitted between individuals
• genetically unique (popn lacks preexisting
  immunity)
• increased virulence
• Facilitated by modern population densities and
  movement of people, animals, and products
• In spring 03, SARS traveled to 5 countries w/in
  24 hr after emerging in rural China
  

32
Turkey Food-Chain
Major Flows Minor
Flows
Green lines/font feed segment Red lines/font
live animal segment Purple lines/font
processing/marketing segment Black lines/font
immediate consumption segment
Non-food, non-feed Products uses
Imports
Feed Producer
Industrial use (rendering, oils, fertilizer)
Exports
Feed Brokers
High processed meats/protein (sausages, deli
prods, protein suppls, powdered, pet foods)
Exports
Grandparent Lines (1o Breeder, Male)
Grandparent' Lines (1o Breeder, Female)
Cull Hen Market (culls incl poults)
Packer Processor (includes value-added processi
ng)
Production Breeders (2o Breeder, Prodn hens)
Grower Unit (Commercial Poults)
Darkout Site (2o Breeder, Hens)
Out-of-State Growing
Hatchery Unit (Commercial Poults)
Consumer
33
Egg Food-Chain
Major Flows Minor
Flows
Green lines/font feed segment Red lines/font
live animal segment Purple lines/font
processing/marketing segment Black lines/font
immediate consumption segment
Non-food, non-feed Products uses
Imports
Feed Producer
Industrial use (rendering, oils, fertilizer)
Exports
Feed Brokers
High processed meats/protein (See Poultry Meat
Chain)
Processed Eggs (Bakery, commercial)
Grandparent Lines (Genetics, male/female)
Cull Hen Market (culls incl chicks)
Off-Line Egg Production (Middlemen)
Multiplier Lines (Comml Layer Hens)
Consumer
Out-of-State Egg Handlers/Brooders
Layer Unit (Commercial eggs)
Layer Growout Site (Comml Layer Hens)
In-Line Egg Production (Direct Sale)
34
(No Transcript)
35
From Saif, Ohio State University, Current
information on influenza virus infection. Feb
2006
36
(No Transcript)
37
(No Transcript)
38
(No Transcript)