**2. An overview of AI in Bangladesh**

Highly Pathogenic Avian Influenza (HPAI) is an emerging zoonotic infectious disease, which is caused by the H5N1 subtype of the type A strain of the influenza virus (World Health Organization [WHO], 2006a). The virus is found in, and transmitted through, the feces, saliva, and eye and nasal discharge of infected birds (Centers for Disease Control [CDC], 2008). It is transmitted to healthy birds through contact with infected birds or

<sup>1</sup> The authors would like to acknowledge the contributions and assistance provided by Nicole I. Wanty, M.A.A. and Mohammed Zakaria that helped in the completion of this chapter.

<sup>2</sup> It is important to note that this chapter does not consider an exhaustive list of all possible aspects of disease management for H5N1. For example, this chapter does not explore the clinical management of H5N1 in Bangladesh. As this chapter will demonstrate, the need for clinical management of AI can be decreased, if not completely eliminated, by managing H5N1 in the live birds.

Disease Management of

Avian Influenza H5N1 in Bangladesh - A Focus on Maintaining Healthy Live Birds 261

techniques, providing supplies necessary for improving hygiene-related practices, training relevant individuals on communicating with media personnel and other stakeholders, providing adequate compensation following culling operations, and developing programs

Raising public awareness and increasing communication to the public about Avian Influenza disease management and outbreaks is crucial. Efforts in this vein should focus on improving communication services and methods for information dissemination. This includes developing materials for communication such as websites, printed materials, and audio/video materials. Additionally, it is important to continue developing new communication technologies, such as a web-based SMS gateway, and creating new

Some of the coordination and planning efforts that have been put in place for Avian

the creation, implementation, and revision of the National Avian Influenza and Human

 improving bio-security measures of live bird markets through cleaning, spraying, training personnel, improving sanitation, and constructing separate slaughter places

 obtaining funding from international stakeholders for disease management coordination, prevention, and containment, including strengthening disease management capacity and rehabilitation programs for farmers with infected flocks obtaining the cooperation and collaboration of relevant organizations and NGOs

developing communication materials and methods for the distribution of information

These efforts have primarily focused on the importance of maintaining the health and safety of live birds. Thus far, the efforts from the Bangladesh government and development partners have been effective in enabling the country to prevent the Avian Influenza H5N1 from reaching an epidemic proportion in poultry populations and preventing human

In order to prevent the spread of HPAI (High Pathogenic Avian Influenza) between birds and to human, biosecurity measures need to be maintained at commercial and backyard poultry farms and at live bird markets. In Bangladesh, poultry production occurs in commercial and backyard farms, and distribution occurs at live bird markets, all of which

This is the appropriate time to save the poultry industry. The general population is familiar with Avian Influenza, but they are not properly aware of what they should do to protect human and poultry health from infectious diseases. Biosecurity may be one of the most

Commercial poultry farms, both layer and broiler, are situated in risky locations and operated under unhygienic conditions. Commercial farms are not maintaining minimum

for preparedness, protection, reporting, response, and policy compliance

for monitoring, evaluating, and implementing technical support for projects.

Influenza disease management include but are not limited to the following:

developing and distributing Commercial Farm Bio-security Guidelines

strategies to disseminate information to target audiences.

performing bio-security audits at commercial farms

creating and training response teams

**3. Animal health approaches** 

**3.1 Commercial farms** 

have been greatly impacted by Avian Influenza.

important elements for prevention and control of Avian Influenza.

infection.

Pandemic Influenza Preparedness and Response Plan

contaminated droppings. Humans contract HPAI through direct contact with infected birds. Symptoms of human infection include conjunctivitis, sore throat, sore muscles, and severe respiratory diseases such as pneumonia. The mortality rate for humans is high, capable of reaching 100 percent mortality in as few as two days (CDC, 2007).

Some of the factors that contribute to spread of HPAI from birds to humans include slaughtering poultry and preparing the meat in the home, direct contact with sick or infected birds, and the consumption of infected poultry. Poultry farmers sell infected birds in an attempt to mitigate their losses from culling (Otte et al.) and backyard farmers may choose to eat a sick bird, rather than waste limited resources. Human infection may also occur through direct contact with the feces of contaminated birds. For example, when children ingest soil contaminated with the feces of infected birds (WHO, 2006a) or poultry droppings and waste are used as fertilizers. Disposal of infected carcasses in bodies of water that are used by domestic purposes, including drinking, laundry, swimming, and bathing places people at risk as well. Infected carcasses are also fed to other animals, such as pigs, which may also increase the risk of human infection (Otte et al.).

While human-to-human transmission of HPAI infection is rare, scientists believe that under the right conditions, the H5N1 virus may mutate into a form transmissible from person-to person. The World Health Organization believes the H5N1 virus has already met all of the prerequisites for a pandemic, except the ability to spread from human-to-human. Therefore, the WHO has labeled the H5N1 virus as the most likely virus to start the next pandemic and many people believe that it is only a matter of time until an HPAI pandemic occurs (WHO, 2006a). In light of these forecasts and the unique ability of the influenza virus to spread, it is estimated that human-to-human contagious virus could affect all continents within three months (WHO, 2006a).

Since 2007, AI has become a major public health concern throughout Bangladesh, because it affects poultry at commercial farms, live bird markets, and backyard poultry farms throughout the country, which puts many people at risk of exposure to the disease. Avian Influenza affects the health of both poultry and humans, which necessitates a multi-sector approach to manage the health, social, and economic factors of the disease. Stakeholders from all levels of government as well as the private sector need to work together in the areas of animal health, human health, public awareness, public communication, and capacity building.

Animal health issues require the involvement of veterinarians, commercial poultry farmers and stakeholders, and backyard poultry farmers. These individuals are necessary for disease management because they can directly help minimize threat of H5N1 in humans by controlling infections in poultry, strengthening disease prevention and preparedness capability, strengthening surveillance measures and capacity, strengthening disease surveillance and diagnostic capacity, and improving bio-security in poultry production and trade.

In terms of human health, the involvement of the Department of Health is crucial for coordinating and improving the overall response capacity for disease outbreaks. The Departments of Health workers are necessary to implement and support monitoring for disease and progress evaluation of disease management. In addition, it is important to involve private sector physicians and health professionals to monitor disease outbreaks in the human population.

Multi-sector activities should focus on building capacity and infrastructure to support disease management. This includes training individuals associated with poultry production and poultry marketing about Avian Influenza-related issues and relevant prevention techniques, providing supplies necessary for improving hygiene-related practices, training relevant individuals on communicating with media personnel and other stakeholders, providing adequate compensation following culling operations, and developing programs for monitoring, evaluating, and implementing technical support for projects.

Raising public awareness and increasing communication to the public about Avian Influenza disease management and outbreaks is crucial. Efforts in this vein should focus on improving communication services and methods for information dissemination. This includes developing materials for communication such as websites, printed materials, and audio/video materials. Additionally, it is important to continue developing new communication technologies, such as a web-based SMS gateway, and creating new strategies to disseminate information to target audiences.

Some of the coordination and planning efforts that have been put in place for Avian Influenza disease management include but are not limited to the following:


260 Health Management – Different Approaches and Solutions

contaminated droppings. Humans contract HPAI through direct contact with infected birds. Symptoms of human infection include conjunctivitis, sore throat, sore muscles, and severe respiratory diseases such as pneumonia. The mortality rate for humans is high, capable of

Some of the factors that contribute to spread of HPAI from birds to humans include slaughtering poultry and preparing the meat in the home, direct contact with sick or infected birds, and the consumption of infected poultry. Poultry farmers sell infected birds in an attempt to mitigate their losses from culling (Otte et al.) and backyard farmers may choose to eat a sick bird, rather than waste limited resources. Human infection may also occur through direct contact with the feces of contaminated birds. For example, when children ingest soil contaminated with the feces of infected birds (WHO, 2006a) or poultry droppings and waste are used as fertilizers. Disposal of infected carcasses in bodies of water that are used by domestic purposes, including drinking, laundry, swimming, and bathing places people at risk as well. Infected carcasses are also fed to other animals, such as pigs,

While human-to-human transmission of HPAI infection is rare, scientists believe that under the right conditions, the H5N1 virus may mutate into a form transmissible from person-to person. The World Health Organization believes the H5N1 virus has already met all of the prerequisites for a pandemic, except the ability to spread from human-to-human. Therefore, the WHO has labeled the H5N1 virus as the most likely virus to start the next pandemic and many people believe that it is only a matter of time until an HPAI pandemic occurs (WHO, 2006a). In light of these forecasts and the unique ability of the influenza virus to spread, it is estimated that human-to-human contagious virus could affect all continents within three

Since 2007, AI has become a major public health concern throughout Bangladesh, because it affects poultry at commercial farms, live bird markets, and backyard poultry farms throughout the country, which puts many people at risk of exposure to the disease. Avian Influenza affects the health of both poultry and humans, which necessitates a multi-sector approach to manage the health, social, and economic factors of the disease. Stakeholders from all levels of government as well as the private sector need to work together in the areas of animal health, human health, public awareness, public communication, and capacity

Animal health issues require the involvement of veterinarians, commercial poultry farmers and stakeholders, and backyard poultry farmers. These individuals are necessary for disease management because they can directly help minimize threat of H5N1 in humans by controlling infections in poultry, strengthening disease prevention and preparedness capability, strengthening surveillance measures and capacity, strengthening disease surveillance and

In terms of human health, the involvement of the Department of Health is crucial for coordinating and improving the overall response capacity for disease outbreaks. The Departments of Health workers are necessary to implement and support monitoring for disease and progress evaluation of disease management. In addition, it is important to involve private sector physicians and health professionals to monitor disease outbreaks in

Multi-sector activities should focus on building capacity and infrastructure to support disease management. This includes training individuals associated with poultry production and poultry marketing about Avian Influenza-related issues and relevant prevention

diagnostic capacity, and improving bio-security in poultry production and trade.

reaching 100 percent mortality in as few as two days (CDC, 2007).

which may also increase the risk of human infection (Otte et al.).

months (WHO, 2006a).

the human population.

building.


These efforts have primarily focused on the importance of maintaining the health and safety of live birds. Thus far, the efforts from the Bangladesh government and development partners have been effective in enabling the country to prevent the Avian Influenza H5N1 from reaching an epidemic proportion in poultry populations and preventing human infection.
