**3. Animal health approaches**

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 have been greatly impacted by Avian Influenza.

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 important elements for prevention and control of Avian Influenza.

#### **3.1 Commercial farms**

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

Disease Management of

sectors.

the community.

**3.3 Live bird markets** 

farms.

poultry feed (USAID/Bangladesh 2010).

the sources of infectious diseases like avian influenza.

Avian Influenza H5N1 in Bangladesh - A Focus on Maintaining Healthy Live Birds 263

economic impact on the population of Bangladesh. Many backyard poultry and mini-farm holders (100-1,000 birds) are particularly vulnerable. As of October 2010, the government had

Although there is a policy to provide compensation for all species of poultry culled and the eggs destroyed, the compensation is not equivalent to what the farmers could have received from healthy birds. Even though compensation rates have increased, the compensation provided to these farmers is not enough money to be able to re-establish themselves in the poultry practice. The main objective of a rehabilitation program for the farmer at the community level is to help restock and repopulate their flocks, bringing them back into the poultry practice. These programs raise awareness about Avian Influenza and biosecurity practices, as well as leads to the mobilization of resources between the public and private

To implement the rehabilitation program, the Ministry of Fisheries and Livestock (MoFL) developed and approved rehabilitation policy guidelines. District committees and six selected NGOs implemented the program as per the rehabilitation policy guidelines to assist a total of 14,000 backyard poultry holders and 2,240 mini farmers. The NGOs were involved in the assessment of the situation as the policy affected farmers and their families, the submission of a field assessment report to the district committee, assistance in training, procurement, distribution as well as utilization of inputs (new birds, feed, funds for renovations, medical services) as well as supervision, monitoring, follow-up and reporting of the rehabilitation program. The backyard poultry holders received ten fowl of improved variety at the age of 4-5 months, twenty five kilograms of poultry feed, money for renovations or the replacement of a poultry house, medical services like vaccinations and de-worming for one year, and a two-day long awareness and skills development training. Mini farmers received two hundred one-day-old broiler chicks and fifty kilograms of

This rehabilitation program has helped restore confidence among the affected community and has helped small entrepreneurs re-enter the poultry trade. The rehabilitation policy is a unique approach to public-partnerships to re-engage community members in poultry rearing, while decreasing the threat of Avian Influenza. The policy is also complimentary to the Avian Influenza containment program, restocking and repopulating with healthy poultry. To make the policy a success in terms of sustainability, improved biosecurity and preventative measures are need, as well as increased awareness and social commitment of

Additionally, backyard poultry holders have been working on identifying risk factors for characterizing the dispersion of Avian Influenza in backyard flocks. This work has included identifying risk factors for the susceptibility of backyard poultry flocks to Avian Influenza H5 virus as well as assessing the dispersion of the virus within 10km of affected

Live bird markets are an important consideration in disease management for Avian Influenza because infectious diseases are easily spread from one market to another, exposing many animals and humans to the disease. The live bird markets of Bangladesh are very dirty and unhygienic. Vendors, transporter, slaughterers, processors and even consumers are not aware about spreading of disease and contamination. It might be one of

culled almost 2 million chickens and destroyed almost 26 million eggs.

biosecurity level with many farms lacking a gate, footbath, and delineated farm boundaries. In addition, many farm workers do not know how to maintain biosecurity to protect the poultry and themselves from disease.

Commercial poultry businessmen are concerned about Avian Influenza and facing many challenges. The government decided to destroy infected farms as well as other adjacent farms that were situated within five kilometers of the affected farm. During this time, many quality farms were destroyed and the owners did not receive adequate compensation. The government compensation was 90 taka for each chicken, although one the market price of one chicken is approximately 150 taka. Finally the government revised their decision to only destroy farms situated within one kilometer of an affected farm. For this reason, many small and medium poultry businessmen left the poultry business and they are engaged in different business opportunities, such as garments factory, or no business at all. This means that many former small and medium poultry businessmen are unable to support their families. In addition, many of them obtained a loan from the bank to cover start-up costs and are now unable to pay the loan (USAID/Bangladesh 2010).

Unfortunately, most of the commercial farms are not maintaining minimum biosecurity. The Department of Livestock Services (DLS) provides technical support to the farms, but the support is inadequate. The situation requires a combined effort from multiple stakeholders to improve biosecurity level for commercial farms. Private and public sectors should work together to achieve sustainable health for both human and poultry populations. In this regard, human health workers and animal health workers should work together to combat Avian Influenza or other infectious diseases.

#### **3.2 Backyard farms**

In rural areas, 80 to 90 percent of households raise backyard poultry. Poultry meat is a major source of nutrition, and it is an income source for the majority of impoverished women. Generally, the practices used to rear backyard poultry are unhygienic. Many households keep the birds inside the home or bedroom. Chickens and ducks are kept together in one shed, constructed from bamboo or muddy soil. This makes it difficult to clean the shed properly. Many communities are still unaware of Avian Influenza and how the disease can be spread between poultry or from poultry to humans. Large portions of the population lack knowledge regarding biosecurity, poultry, and human health (USAID/Bangladesh 2010).

In addition, backyard poultry farming methods and scavenging (free-ranging) poultry may put commercial poultry at risk, especially given the lack of biosecurity at commercial farms. The backyard and commercial farmers should be aware of this addition risk. Backyard poultry, which have a greater likelihood of coming into contact with wild, infected foul, should not enter into the commercial farm premises. If backyard poultry enter a commercial farm property, the disease can enter the commercial poultry population and the virus can spread from chicken to chicken.

The national assessment of backyard poultry rearing practices in Bangladesh aimed to describe poultry raising practices over time, specifically as it relates to human-poultry interaction and hygiene practices. It has sought to describe the contribution of poultry production to income and nutrition and describe the epidemiology of poultry illness in terms of incidence, seasonality, clinical signs, outcomes, and pathogens responsible for poultry illness.

Since March 22, 2007, there have been a series of outbreaks of Avian Influenza in Bangladesh, which have resulted in the deaths of a large number of poultry. This has had both a social and economic impact on the population of Bangladesh. Many backyard poultry and mini-farm holders (100-1,000 birds) are particularly vulnerable. As of October 2010, the government had culled almost 2 million chickens and destroyed almost 26 million eggs.

Although there is a policy to provide compensation for all species of poultry culled and the eggs destroyed, the compensation is not equivalent to what the farmers could have received from healthy birds. Even though compensation rates have increased, the compensation provided to these farmers is not enough money to be able to re-establish themselves in the poultry practice. The main objective of a rehabilitation program for the farmer at the community level is to help restock and repopulate their flocks, bringing them back into the poultry practice. These programs raise awareness about Avian Influenza and biosecurity practices, as well as leads to the mobilization of resources between the public and private sectors.

To implement the rehabilitation program, the Ministry of Fisheries and Livestock (MoFL) developed and approved rehabilitation policy guidelines. District committees and six selected NGOs implemented the program as per the rehabilitation policy guidelines to assist a total of 14,000 backyard poultry holders and 2,240 mini farmers. The NGOs were involved in the assessment of the situation as the policy affected farmers and their families, the submission of a field assessment report to the district committee, assistance in training, procurement, distribution as well as utilization of inputs (new birds, feed, funds for renovations, medical services) as well as supervision, monitoring, follow-up and reporting of the rehabilitation program. The backyard poultry holders received ten fowl of improved variety at the age of 4-5 months, twenty five kilograms of poultry feed, money for renovations or the replacement of a poultry house, medical services like vaccinations and de-worming for one year, and a two-day long awareness and skills development training. Mini farmers received two hundred one-day-old broiler chicks and fifty kilograms of poultry feed (USAID/Bangladesh 2010).

This rehabilitation program has helped restore confidence among the affected community and has helped small entrepreneurs re-enter the poultry trade. The rehabilitation policy is a unique approach to public-partnerships to re-engage community members in poultry rearing, while decreasing the threat of Avian Influenza. The policy is also complimentary to the Avian Influenza containment program, restocking and repopulating with healthy poultry. To make the policy a success in terms of sustainability, improved biosecurity and preventative measures are need, as well as increased awareness and social commitment of the community.

Additionally, backyard poultry holders have been working on identifying risk factors for characterizing the dispersion of Avian Influenza in backyard flocks. This work has included identifying risk factors for the susceptibility of backyard poultry flocks to Avian Influenza H5 virus as well as assessing the dispersion of the virus within 10km of affected farms.

#### **3.3 Live bird markets**

262 Health Management – Different Approaches and Solutions

biosecurity level with many farms lacking a gate, footbath, and delineated farm boundaries. In addition, many farm workers do not know how to maintain biosecurity to protect the

Commercial poultry businessmen are concerned about Avian Influenza and facing many challenges. The government decided to destroy infected farms as well as other adjacent farms that were situated within five kilometers of the affected farm. During this time, many quality farms were destroyed and the owners did not receive adequate compensation. The government compensation was 90 taka for each chicken, although one the market price of one chicken is approximately 150 taka. Finally the government revised their decision to only destroy farms situated within one kilometer of an affected farm. For this reason, many small and medium poultry businessmen left the poultry business and they are engaged in different business opportunities, such as garments factory, or no business at all. This means that many former small and medium poultry businessmen are unable to support their families. In addition, many of them obtained a loan from the bank to cover start-up costs

Unfortunately, most of the commercial farms are not maintaining minimum biosecurity. The Department of Livestock Services (DLS) provides technical support to the farms, but the support is inadequate. The situation requires a combined effort from multiple stakeholders to improve biosecurity level for commercial farms. Private and public sectors should work together to achieve sustainable health for both human and poultry populations. In this regard, human health workers and animal health workers should work together to combat

In rural areas, 80 to 90 percent of households raise backyard poultry. Poultry meat is a major source of nutrition, and it is an income source for the majority of impoverished women. Generally, the practices used to rear backyard poultry are unhygienic. Many households keep the birds inside the home or bedroom. Chickens and ducks are kept together in one shed, constructed from bamboo or muddy soil. This makes it difficult to clean the shed properly. Many communities are still unaware of Avian Influenza and how the disease can be spread between poultry or from poultry to humans. Large portions of the population lack knowledge

In addition, backyard poultry farming methods and scavenging (free-ranging) poultry may put commercial poultry at risk, especially given the lack of biosecurity at commercial farms. The backyard and commercial farmers should be aware of this addition risk. Backyard poultry, which have a greater likelihood of coming into contact with wild, infected foul, should not enter into the commercial farm premises. If backyard poultry enter a commercial farm property, the disease can enter the commercial poultry population and the virus can

The national assessment of backyard poultry rearing practices in Bangladesh aimed to describe poultry raising practices over time, specifically as it relates to human-poultry interaction and hygiene practices. It has sought to describe the contribution of poultry production to income and nutrition and describe the epidemiology of poultry illness in terms of incidence, seasonality, clinical signs, outcomes, and pathogens responsible for

Since March 22, 2007, there have been a series of outbreaks of Avian Influenza in Bangladesh, which have resulted in the deaths of a large number of poultry. This has had both a social and

regarding biosecurity, poultry, and human health (USAID/Bangladesh 2010).

poultry and themselves from disease.

and are now unable to pay the loan (USAID/Bangladesh 2010).

Avian Influenza or other infectious diseases.

**3.2 Backyard farms** 

spread from chicken to chicken.

poultry illness.

Live bird markets are an important consideration in disease management for Avian Influenza because infectious diseases are easily spread from one market to another, exposing many animals and humans to the disease. The live bird markets of Bangladesh are very dirty and unhygienic. Vendors, transporter, slaughterers, processors and even consumers are not aware about spreading of disease and contamination. It might be one of the sources of infectious diseases like avian influenza.

Disease Management of

**3.4 Waterfowl** 

complete(USAID/Bangladesh 2010).

**4. Human health approaches** 

communications.

Avian Influenza H5N1 in Bangladesh - A Focus on Maintaining Healthy Live Birds 265

is easier to work in a private live bird market than in a public market. In a private market, there are fewer hoops to jump through than in the public sector because it only requires dealing with the owner for making decisions regarding cost-sharing. However, the public sector is needed for developing the necessary infrastructure to sustain effective biosecurity at the live bird markets. Additionally, collecting cost-share money from stakeholders can be difficult because they rely on donors to pay all funds. For the sustainability of the program, it is necessary to have a plan regarding who will pay for live bird market cleaners and disinfection operations. It is also important that enough time be given for training cleaners after the renovations of live bird markets are

Thus far, the affected domestic poultry seems to be limited to chickens. However, there has been an investigation by the Department of Forestry to determine whether H5N1 is infecting wild waterfowl in Bangladesh. This work has focused on investigating if contact between wild and domestic waterfowl is associated with H5N1 in wild migratory birds as well as determining whether infection with influenza A impairs flight or migration using satellite. This study plans to examine 600 wild waterfowl and shorebirds to be tested by Rapid Test, PCR, and ELISA. Thus far, 34 birds of 11 species have been sampled, and there have not

Prevention efforts examining wild migratory birds is vital to preventing the spread of infection among domestic poultry populations. Migratory birds may transport the disease

Integrating human health as part of Avian Influenza disease management requires coordination between stakeholders at all levels and involves multiple components. Although the clinical aspects of human health management of Avian Influenza are beyond the scope of this chapter, it is important to note that is an imperative part of disease management. We will address the following 6 components related to human health in this section: planning, surveillance, laboratory work, research, capacity building, and

Planning for both preparedness and response to an outbreak in Bangladesh has involved developing and implementing the National Avian Influenza and Pandemic Influenza Preparedness Plans and Pandemic Contingency Plan by a national multi-sectoral planning team. The goal of the plan is a comprehensive and coordinated response to address H5N1 in domestic poultry and minimize transmission to humans. The plan addresses multiple sectors and works to strengthen capacity among many other aspects of H5N1 prevention. Surveillance efforts on Avian Influenza have focused on high-risk group surveillance, hospital-based surveillance, population-based surveillance, drug trials, and the previously discussed surveillance at live bird markets. For example, the Avian Influenza Contact Follow-Up Monitoring Committee regularly follows up in affected districts with people exposed to poultry. People involved in culling infected poultry or in close contact (less than 1 meter) with infected poultry were given a single dose of anti-viral tablets for 7 days and followed up for 14 days. People with household contacts (more than 1 meter) and health care worker contact (unprotected) or other contact were followed up for 14 days without

been any reported outbreaks in waterfowl (USAID/Bangladesh 2010).

along migration paths and infect poultry along those routes.

Once a virus develops in one market, it can easily be transported to other markets and farms by way of contaminated equipment, birds, people, and vehicles. In addition to animal infections, many human infections around the world have been traced to live bird markets, including the single human case of Avian Influenza, which was identified in Bangladesh on May 22, 2008. Consequently, there is great need for biosecurity in the live bird markets.

Live bird market surveillance for Avian Influenza in Bangladesh has involved identifying Avian Influenza subtypes and strains that are circulating in domestic waterfowl in live bird markets in Bangladesh, exploring every day practices of poultry rearing, particularly human interactions with poultry, exploring poultry raisers' perceptions and practices regarding sick poultry, and exploring human and poultry interactions in the local poultry markets.

Currently, the biosecurity in live bird markets is low. Slaughterers and poultry processors do not use protective gear such as masks and gloves. Birds are processed and slaughtered in the same place, rather than using the more hygienic process of completing these two processes in separate locations. After processing the birds, the waste (offal, blood, and feathers) are not properly stored and disposed of. Vendors throw the waste from their stalls elsewhere on the market premises. Cleaning crews are not aware of the need to use proper protective gear or the need for spraying and disinfection methods. Additionally, consumers come to the markets without wearing masks or gloves, and are, therefore, exposed to the hazards that result from the unhygienic practices (USAID/Bangladesh 2010).

The United States Agency for International Development's (USAID) Stamping Out Pandemic and Avian Influenza (STOP AI) helps countries prepare for, respond to, and recover from HPAI outbreaks. The project delivers technical assistance and training, and promotes collaboration between animal and human health professionals. STOP AI aims to mobilize public and private sector partners as well as NGOs to implement systematic and sustained behavioral changes that will result in measureable improvements in biosecurity. Stop AI has put forth a framework in which the public animal health system, private sector poultry industry, public health system, civil society, as well as donors and NGOS work together to provide and implement a systematic, commercially-viable Avian Influenza surveillance, biosecurity, and outbreak response program/plan. This framework includes developing public-private partnerships and providing on-demand national level assistance. In developing this framework, STOP AI conducted a baseline market survey in Bangladesh, held stakeholder workshops to share survey data and an action plan, and adopted training materials for ground-level stakeholders such as farmers, veterinarians, and cleaners. Recommendations include renovating, upgrading, cleaning, and disinfecting live bird markets. In order to carry out these activities, capacity building is required to train stakeholders and acquire supplies such as sprayers, pressure washers, detergents, masks, and gloves (USAID/Bangladesh 2010).

Implementing effective biosecurity is not without challenges and requires the combined efforts of stakeholders in both the public and private sectors. One challenge is that differing political views can delay development work. People in the private sector engaged in biosecurity endeavors tend to do so for personal interests, and may not be motivated or willing to make concessions not within their personal interest. Similarly, the poultry industry-related stakeholders want and need to see direct benefits in order to become engaged in practicing biosecurity. The industry stakeholders also need training on how to apply the biosecurity measures.

Another difficulty lies in the cost-sharing of funds; direct spending of cost-share funds without a sub-contract is difficult to manage within municipality regulations. As such, it is easier to work in a private live bird market than in a public market. In a private market, there are fewer hoops to jump through than in the public sector because it only requires dealing with the owner for making decisions regarding cost-sharing. However, the public sector is needed for developing the necessary infrastructure to sustain effective biosecurity at the live bird markets. Additionally, collecting cost-share money from stakeholders can be difficult because they rely on donors to pay all funds. For the sustainability of the program, it is necessary to have a plan regarding who will pay for live bird market cleaners and disinfection operations. It is also important that enough time be given for training cleaners after the renovations of live bird markets are complete(USAID/Bangladesh 2010).

### **3.4 Waterfowl**

264 Health Management – Different Approaches and Solutions

Once a virus develops in one market, it can easily be transported to other markets and farms by way of contaminated equipment, birds, people, and vehicles. In addition to animal infections, many human infections around the world have been traced to live bird markets, including the single human case of Avian Influenza, which was identified in Bangladesh on May 22, 2008. Consequently, there is great need for biosecurity in the live bird markets. Live bird market surveillance for Avian Influenza in Bangladesh has involved identifying Avian Influenza subtypes and strains that are circulating in domestic waterfowl in live bird markets in Bangladesh, exploring every day practices of poultry rearing, particularly human interactions with poultry, exploring poultry raisers' perceptions and practices regarding sick

poultry, and exploring human and poultry interactions in the local poultry markets.

hazards that result from the unhygienic practices (USAID/Bangladesh 2010).

and gloves (USAID/Bangladesh 2010).

apply the biosecurity measures.

Currently, the biosecurity in live bird markets is low. Slaughterers and poultry processors do not use protective gear such as masks and gloves. Birds are processed and slaughtered in the same place, rather than using the more hygienic process of completing these two processes in separate locations. After processing the birds, the waste (offal, blood, and feathers) are not properly stored and disposed of. Vendors throw the waste from their stalls elsewhere on the market premises. Cleaning crews are not aware of the need to use proper protective gear or the need for spraying and disinfection methods. Additionally, consumers come to the markets without wearing masks or gloves, and are, therefore, exposed to the

The United States Agency for International Development's (USAID) Stamping Out Pandemic and Avian Influenza (STOP AI) helps countries prepare for, respond to, and recover from HPAI outbreaks. The project delivers technical assistance and training, and promotes collaboration between animal and human health professionals. STOP AI aims to mobilize public and private sector partners as well as NGOs to implement systematic and sustained behavioral changes that will result in measureable improvements in biosecurity. Stop AI has put forth a framework in which the public animal health system, private sector poultry industry, public health system, civil society, as well as donors and NGOS work together to provide and implement a systematic, commercially-viable Avian Influenza surveillance, biosecurity, and outbreak response program/plan. This framework includes developing public-private partnerships and providing on-demand national level assistance. In developing this framework, STOP AI conducted a baseline market survey in Bangladesh, held stakeholder workshops to share survey data and an action plan, and adopted training materials for ground-level stakeholders such as farmers, veterinarians, and cleaners. Recommendations include renovating, upgrading, cleaning, and disinfecting live bird markets. In order to carry out these activities, capacity building is required to train stakeholders and acquire supplies such as sprayers, pressure washers, detergents, masks,

Implementing effective biosecurity is not without challenges and requires the combined efforts of stakeholders in both the public and private sectors. One challenge is that differing political views can delay development work. People in the private sector engaged in biosecurity endeavors tend to do so for personal interests, and may not be motivated or willing to make concessions not within their personal interest. Similarly, the poultry industry-related stakeholders want and need to see direct benefits in order to become engaged in practicing biosecurity. The industry stakeholders also need training on how to

Another difficulty lies in the cost-sharing of funds; direct spending of cost-share funds without a sub-contract is difficult to manage within municipality regulations. As such, it Thus far, the affected domestic poultry seems to be limited to chickens. However, there has been an investigation by the Department of Forestry to determine whether H5N1 is infecting wild waterfowl in Bangladesh. This work has focused on investigating if contact between wild and domestic waterfowl is associated with H5N1 in wild migratory birds as well as determining whether infection with influenza A impairs flight or migration using satellite. This study plans to examine 600 wild waterfowl and shorebirds to be tested by Rapid Test, PCR, and ELISA. Thus far, 34 birds of 11 species have been sampled, and there have not been any reported outbreaks in waterfowl (USAID/Bangladesh 2010).

Prevention efforts examining wild migratory birds is vital to preventing the spread of infection among domestic poultry populations. Migratory birds may transport the disease along migration paths and infect poultry along those routes.
