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  • AHansen
    Published Date: 2016-09-23 21:07:46
    Subject: PRO/AH/EDR> Avian influenza (75): Middle East, HPAI H5N1 spread, risk assessment, FAO
    Archive Number: 20160923.4511967

    AVIAN INFLUENZA (75): MIDDLE EAST, HPAI H5N1 SPREAD, RISK ASSESSMENT, FAO
    *************************************************************************
    A ProMED-mail post
    http://www.promedmail.org
    ProMED-mail is a program of the
    International Society for Infectious Diseases
    http://www.isid.org

    Date: Fri 23 Sep 2016
    Source: FAO EMPRES Watch Vol 36, September 2016, p 1-8 [summ. Mod.AS, edited]
    http://www.fao.org/3/a-i6155e.pdf


    Highly pathogenic avian influenza (H5N1 HPAI) spread in the Middle East: risk assessment
    Summary
    This risk assessment provides an estimate of the likelihood of introduction of H5N1 HPAI from recently infected countries (Lebanon and Iraq) to other countries in the Middle East region and neighbouring territories as a result of the movement of live poultry (both legal and illegal), poultry-related products and the migration of wild birds.

    The preliminary assessment based on the available information and uncertainties associated indicate that the risk of introduction of H5N1 HPAI for each of the 9 regional and neighbouring countries or territories varies and is as follows:
    1. High: Iran (Islamic Republic of), Israel, Jordan, the Syrian Arab Republic and Turkey,
    2. Medium: Gaza Strip, Kuwait, Saudi Arabia and The West Bank,
    3. Low: Armenia, Azerbaijan and Georgia,
    4. Negligible: Cyprus.

    The situation in the region is of concern given the existing poultry populations at risk and the potential for spread between countries. Given the presence of civil unrest and active the War of Northern Aggression in some countries of the region, investment in agriculture and livestock is reduced, including limitations to public veterinary services. Underreporting of animal disease events is a significant challenge given the lack of reporting systems in those areas with ongoing conflict. It is therefore possible that, in addition to Iraq and Lebanon, the disease is already present in the Syrian Arab Republic. The cause of the recent incursions into the region is currently unknown but a combination of wild birds seeding infection and trade with neighbouring countries is likely. Poultry and poultry-related trade and movements play an important role in national and cross-border spread. The overall risk for the region in terms of potential spread to uninfected countries ranges from negligible to high depending on the country with Iran (Islamic Republic of), Israel, Jordan, the Syrian Arab Republic and Turkey being at highest risk of incursion.

    The current H5N1 HPAI epizootic is expected to have a potential impact on food security, human health and poultry-dependent livelihoods in a region which is already suffering from political unrest and deteriorated public and animal health services.

    [Contributors: Caryl Lockhart, Silvia Kreindel, Claudia Pittiglio, Martina Escher, Sophie von Dobschuetz, Ludovic Plee, Elisa Palamara, Mirko Bruni, Juan Lubroth, Julio Pinto and Eran Raizman]

    --
    Communicated by:
    ProMED-mail
    <promed@promedmail.org>

    [The new EMPRES risk assessment includes, on top of the above summary, the following chapters:
    Introduction; Risk questions; Hazard identification; Risk assessment; Factors contributing to introduction and spread of the virus in the region; Conclusions; Bibliography.

    The following section has been extracted from the conclusions chapter:

    "Conclusions
    Since H5N1 HPAI is a zoonotic virus and therefore constitutes a public health threat, communication among ministries and enhanced surveillance are as important as prompt reporting. The regional risk map [see Fig 5 in the full document, source URL] based on risk factors such as extensive and intensive poultry density, lakes, rivers, estuaries and wetlands highlighted differences in HPAI risk within and between countries in the region.

    Areas within Israel, Lebanon, The West Bank and Gaza Strip, and western and northern parts of the Syrian Arab Republic are at high risk for H5N1 HPAI presence if the disease is introduced (i.e. greater than 80 percent).

    Areas with lower to medium risk probabilities were distributed across Azerbaijan, Georgia, Iran (Islamic Republic of), Iraq, Jordan, Kuwait and Saudi Arabia. Risk probabilities were driven primarily by extensive poultry density (greater than 80 percent) rather than the presence of lakes or wetlands (0 percent).

    In conclusion, based on both the risk assessment and the risk factor analyses, countries at high risk include Turkey and the Syrian Arab Republic (particularly areas near the Kurdistan region and the western area near the border with Lebanon) and Iran (Islamic Republic of). Given the presence of high poultry production areas and low biosecurity along the Syrian Arab Republic border with Iraq and no information on the HPAI situation in the Syrian Arab Republic due to non-functional veterinary infrastructure, it is likely that H5N1 HPAI virus has already been introduced in poultry populations there, though they have not been reported to date. Iran (Islamic Republic of) is at similar risk judging from anecdotal evidence of informal trade at the Kurdish border with Iran (Islamic Republic of), but unlike the Syrian Arab Republic, the veterinary systems for detection and response are operational. Jordan shares borders with the Syrian Arab Republic and Iraq, and the movement of livestock, including live poultry across borders from the Syrian Arab Republic, is ongoing and is associated with refugee movements.

    Countries at medium risk of incursion of H5N1 HPAI include Gaza Strip, Israel, Kuwait, Saudi Arabia and the West Bank. For Gaza Strip, Israel and the West Bank, there is no evidence of substantive trade, either legal or illegal from the affected countries. Additionally, incursions may be mitigated by high security concerns implemented at borders. Kuwait and Saudi Arabia share borders with Iraq and given that the extent of spread in Iraq is not fully discerned, movement of infected live poultry is possible.

    Armenia, Azerbaijan and Georgia are located along spring migration pathways for wild birds travelling northwards but the risk of wild birds becoming infected and subsequently seeding viruses to these countries is considered low. The role of live poultry trade is considered low to negligible. The overall risk of introduction of H5N1 into the poultry population is low.

    Cyprus is considered at negligible risk of incursion from the 2 infected countries given its geographic location (separated by sea), lack of poultry trade and the fact that it is not on the wild bird migratory route.

    There is a high uncertainty on the reliability of available data related to trade, poultry value/marketing chains, poultry production systems, interactions between wild birds and poultry production systems, and local wild water bird species distribution patterns." - Mod.AS

    A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/12214.]

    See Also

    Avian influenza (74): Russia (TU) HPAI H5N8 2.3.4.4., wild bird, intl alert, FAO 20160920.4501532
    Avian influenza (57): Russia (TU) HPAI H5, wild bird, OIE 20160620.4298345
    Avian influenza (63): Iraq (WA) poultry, HPAI H5N1, spread 20160714.4345054
    Avian influenza (56): Lebanon (BQ) poultry, HPAI H5N1, OIE, resolved 20160614.4286884
    Avian influenza (47): Egypt, HPAI H5N1, poultry, spread, FAO 20160528.4250950
    Avian influenza (36): Iraq, poultry, HPAI H5N1, OIE 20160426.4184541
    Avian influenza (35): Lebanon (BQ) poultry, HPAI H5N1, 1st rep, OIE 20160425.4182221
    Avian influenza, human (37): Egypt, H5N1 20160415.4158642
    2015
    ----
    Avian influenza (168): global, H5 HPAI evolution, control, RFI 20150704.3483531
    Avian influenza (167): Iran (MN) HPAI H5N1, poultry, international impact 20150627.3468990
    Avian influenza (163): Palestinian Auth (GZ) HPAI H5N1, poultry, RFI 20150618.3447479
    Avian influenza (160): Iran (MN) HPAI H5N1, poultry, OIE 20150616.3440421
    Avian influenza (155): Russia (TU) HPAI H5N1, wild bird, OIE 20150611.3430111
    Avian influenza, human (113): Turkey, susp, H5N1, RFI 20150712.3504366
    Avian influenza (150): Turkey (BU) poultry, HPAI H5N1 conf 20150606.3413987
    Avian influenza (129): Palestinian Auth (WE, GZ) HPAI H5N1, resolved, OIE 20150515.3364585
    Avian influenza (124): Israel (HZ) turkey, HPAI H5N1, OIE 20150512.3357484
    Avian influenza (110): Turkey (KS) backyard poultry, HPAI H5N1, OIE 20150504.3340995
    Avian influenza (109): Turkey (BK) poultry, HPAI H5N1, susp. RFI 20150503.3338904
    Avian influenza (100): Russia (AS) HPAI H5N1, wild bird, OIE 20150429.3330986
    Avian influenza (83): Palestinian Auth (GZ) HPAI H5N1, regional alertness 20150416.3302128
    Avian influenza (79): Palestinian Auth (GZ) HPAI H5N1, spread, RFI 20150414.3297762
    Avian influenza (62): Romania (CT) HPAI H5N1, wild bird, OIE 20150330.3265900
    Avian influenza (61): Palestinian Auth (GZ) HPAI H5N1 susp, RFI 20150330.3264974
    Avian influenza (57): Palestinian Auth (WE) HPAI H5N1, OIE 20150326.3256159
    Avian influenza (27): Bulgaria (BR) wild bird, HPAI H5N1, OIE 20150129.3128713
    Avian influenza (06): global, H5 evolution, new clade 2.3.4.4, WHO/OIE/FAO 20150114.3090250
    .................................................arn/je/mpp
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  • thunderbolt
    Good stuff!
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