Influenza A(H7N9) first emerged in China in March 2013. Over 1200 human infections were reported since then and nearly 40 percent have been fatal. The virus is now considered enzootic in poultry population in Eastern and South-eastern parts of China. Epidemiological investigations have shown that most people infected with H7N9 had contact with live poultry or visited live bird markets (LBMs) before falling ill. A marked and steady increase in human infections has been observed during the last months, compared to previous years. There have also been evidence that, in some places, H7N9 has shifted from low to high pathogenicity in poultry requiring further investigation and close monitoring of the virus evolution.
Dr Vincent Martin, FAO Representative in China and DPR Korea, emphasized that H7N9 control requires a holistic ‘One Health’ approach that brings together all actors and disciplines along the poultry value chains. FAO China would not only work closely with Chinese animal health authorities to provide technical support as required, but also facilitate cross-sectional collaborations on H7N9 control among national and international stakeholders.
Dr Bernhard Schwartländer, WHO Representative in China, welcomed the participants and introduced the key objectives of the meeting.
Dr LEE Chin-Kei, an epidemiologist from WHO China, updated on H7N9 situations from human health perspective. Dr Guo Fusheng, National Technical Advisor on Animal Health from FAO China, briefed the participants on H7N9 surveillance and control actions taken by Chinese animal health sector.
The meeting also invited Dr Les Sims, a renowned international expert in Avian Influenza, to give a presentation on H7N9 evolution and share his perspectives on surveillance and control options. Following the presentations, the participants discussed options for better surveillance and control from farm to markets.
The meeting participants concluded that:
- A ‘One Health’ approach is key to effectively control H7N9 and eliminate human infections. This requires cross-sectoral collaboration at all levels and creating incentives for key actors along the poultry value chain.
- The ‘1110’ approach which aims to improve biosecurity of Live Bird Markets and mitigate the risk of human infections (cleaning once a day, disinfection once a week, market closure once a month and no poultry allowed to stay overnight) does not have the required impact and needs to be revisited. Studies on measuring impact of these interventions need to be conducted to provide evidence and suggest corrective or additional measures to better control H7N9 infection in Live Bird Markets. Alternative control measures adapted to local context need to be considered based on successful experience of avian influenza virus control in other places.
- Compulsory vaccination of poultry entering markets and other measures and incentives for disease control need to be further discussed. Understanding the cultural and socio-economic dimensions of H7N9 is essential to eliminating the disease from human and reducing the level of infection in poultry.