AVIAN INFLUENZA IN VIETNAM

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AVIAN INFLUENZA IN VIETNAMCum ga

• Le Thi Kim Thoa MD. MPH
• Senior lecturer of Hygiene and Epidemiology
• Ha Noi Medical University
• 1 Ton That tung Ha noi
• Viet Nam
• Telephone [phone]
• Fax [phone]
• E-mail lethikimthoa_hmu_at_yahoo.com
• lethikimthoa_at_hmu.edu.vn

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AVIAN INFLUENZA IN VIETNAM

• Purpose To provide the lessons on avian flu in
  Viet Nam
• Contents
• Introduction
• Short terms strategy
• Long-terms strategy
• Lessons learnt
• How to keep sustainable

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Introduction

• Avian influenza A (AIA) is an infectious disease,
  caused by H5N1 virus that can survive for long
  periods in bird faeces for at least 35 days at
  temperature (40C
• The disease occurs worldwide "bird flu"
• H5N1 virus transmitted from farm to farm by the
  movement of live poultry (faeces), people (when
  contaminated shoes, clothing, vehicles,
  equipment, feed, and cages)
• Restriction on the movement of live poultry, both
  within and between countries.

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AIA H5N1 outbreaks

• Began in Asia in mid-2003 reported by nine Asian
  countries (Viet Nam listed 2)
• Now spread to Europe
• Become endemics in several countries including
  Viet Nam among most chicken population Cum ga
• In late July 2005, focus in Asia to affect
  poultry and wild birds in Russia
• Greatest present concern for human health (number
  of cases and deaths)

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Cum ga OUTBREAKS in Viet Nam

• Cum ga outbreaks among poultry population
  before humans
• Three cum ga outbreaks among humans paralleled
  with three cum ga outbreaks in poultry
  population
• Cum ga outbreaks among humans started the
  beginning 2004

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Cum ga OUTBREAKS among poultry population

• Cum ga outbreaks among poultry started 2003
• Appear at the South first and then the North
• Very fast speed
• Spread out quickly
• All (61 provinces) reported outbreaks in poultry
  44,5 millions poultry killed among 300 millions
  poultry population

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Cum ga OUTBREAKS among humans in Viet Nam

• Very severe disease, high mortality among
  infected patients
• Children first and then adults
• Rural and then urban
• The first case on December , 2003
• Total 93 cases and 42 deaths
• CFR 45.2

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Exposures detected

• Directly contacted
• Slaughtered ill poultry
• Resided in poultry outbreak regions
• Eaten swans blood curd
• Contacted patients with H5N1
• Care patients

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Clinical featuresamong cum ga patients

• Initial syndromes
• Fever
• Myalgia
• Headaches
• Cough
• Coryza
• Diarrhea
• Respiratory syndromes
• Chest paint
• Crepitation

• Pleura effusion
• Pneumothorax
• Respiratory failure
• Others
• Hepatomegaly
• Delirium
• Cerebral hemorrhage
• Multiple organ failure

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Short term strategyEmergency actions

• Communication
• Build up a network for cum ga prevention
• Provided relevant documents
• Supervision at different levels
• Destroy poultry and domestic birds
• Meetings and training
• Vaccinated for poultry
• Supports from organizations and other countries

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Communication

• Contents
• cum ga information
• Relevant documents
• Control measures
• Relevant documents
• Policies
• Roles and tastes of all sectors and organizations
  at different levels

• Mass media
• Television
• Newspapers
• Radio
• Meetings
• Training
• Internet

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Body networking

• Multi sectors participated
• Health sector to be as a main coodinator
• Central level
• Provincial level
• District level
• Commune level
• Village level
• Group level

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Relevant documents

• Instructions
• Government at different level
• Health sector
• Agriculture sector
• Guidelines
• Ministry of health
• Ministry of argricultrure
• Reports

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Supervisions

• Destroy poultry and their production including
  eggs at the outbreak areas, in a radius of 3 km
• Do not allow poultry transport, buy and sell
  poultry and process poultry during outbreaks
• Vaccination for poultry
• Disinfestations for breeding facilities
• Isolated uninfected poultry

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Destroy poultry

• Destroy completely in outbreak areas around
• Forced destroy
• Voluntary destroy
• Destroyed numbers of poultry
• From 10 Jan 2005 to 30 Jan 2006
• Total poultry destroyed 3 962 528
• - chickens 1 334 499
• - ducks, swans and grooses 2 128 134
• Destroy measures
• Dig bury holes all suspected poultry
• Burn infected and dead poultry

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Supports

• International organizations
• USDP
• WHO
• UNICEF
• 5 Countries 6.8 million USD
• Australia
• Holland
• Finland
• Switzerland
• Luxembourg

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Effects

• Community participation in all activities from
  the central levels to individual level.
• A lot of documents provided
• Stop outbreaks among poultry in all provinces
• No new human case in December 2005.
• Vaccination has been process for all provinces

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Impacted

• To make the fear of eating poultry and their
  products
• Severe losses economics
• Loss a large and good foods
• Markets in disorder (most prizes of food up)
• Poultry farmers loss their incomes after dry
  storm, become the poor.
• A big amount of valuable birds were killed

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Long terms prevention

• Objective No epidemic occur in both poultry and
  humans
• Strengthen the supervision system at different
  level
• Review and develop the policies realistic
• To encourage all communities participating in
  prevention
• Education of prevention measures
• Continue to support from international
  organizations and countries
• Sharing experiences

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Lessons learnt

• Identify the first case in both poultry and
  humans as soon as possible
• Information on cum ga correctly in time
• Participation
• Produce the timely decisions
• Develop policies in terms of compensations and
  loan fund supports
• How to sustain the effects

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• cum ga outbreaks
• In Viet Nam
• outbreaks among poultry in 61 provinces (all)
• outbreaks among humans in 32 provinces (gt50)