Zoonotic Influenza Subcommittee
Surveillance, Prevention, and Response Plan

June 15, 2006

Mission: To ensure coordination among the Missouri Departments of Agriculture/Health and Senior Services/Conservation/Natural Resources, other state partners, federal animal health agencies (United States Departments of Agriculture and Interior), and associated industries, to provide an integrated response to cases or outbreaks of high pathogenicity avian influenza (or low pathogenicity avian influenza of zoonotic concern) in poultry, waterfowl, swine or other animals, thereby protecting human life and reducing the social, economic, and mental health impacts on Missouri’s citizens and communities.

Chair: Dr. Howard Pue, State Public Health Veterinarian
Co-Chair: Rose Foster, Poultry Health Program Coordinator

Members: Member Information

Guiding Principles in Zoonotic Influenza Preparedness and Response:

1. Disease outbreaks in poultry populations will result in a different response than disease outbreaks in human populations.
2. Early detection of H5/H7 avian influenza in wild/domestic birds is critical in implementing prevention and control programs.
3. A rapid, coordinated response effort among federal, state, local, and industry partners will be essential following confirmed cases of H5 or H7 influenza in poultry or animals.
4. The assessment of the health and educational needs of poultry workers (pre-event, during, post-event) will be coordinated by the Missouri Department of Health and Senior Services and local public health agencies.
5. With effective risk communication, consumer confidence in the safety of poultry products is more likely to remain high.

Assumptions in Zoonotic Influenza Preparedness and Response:

1. The Missouri poultry industry provides an important contribution to the economy of the state of Missouri and its citizens. In 2004, Missouri ranked 4 th in turkey production in the United States as well as 15 th in egg production, and is estimated to be among the top ten states in meat chicken production. The total dollar value added to Missouri’s economy through goods and services associated with the production of poultry and eggs that year was over $970 million.
2. Migratory waterfowl are important to the citizens and economy of Missouri. Hunters of migratory birds in Missouri spend $34,857,535 annually. These expenditures generate $66,044,839 in annual economic activity.
3. Migratory birds are important to non-hunters. In a recent survey, a lmost 9 out of 10 (88%) Missourians reported they were "very" or "somewhat" interested in observing ducks and geese in the outdoors. Only 10 percent reported "not at all."
4. Avian influenza virus may infect people exposed to infected birds but may not evolve into a form capable of efficient human-to-human transmission.
5. High pathogenicity avian influenza may not be lethal to commercial poultry. Lethality in poultry in Asia may not be an accurate indication of lethality in poultry in the United States. United States poultry are under a higher level of care and may have better resistance.
6. Pandemic influenza will have a substantial direct impact on people, and the poultry industry will be severely disrupted due to lack of labor from ill employees and employees afraid to report to work.

Objectives and Strategies (Key to Acronyms)

1. Objective: Assess historic levels of AI in poultry, wild birds, and other significant domestic/wild animals (if any). Footnote 1
• Strategy 1: Obtain report from MDA regarding historic levels of AI in poultry and other significant domestic animals by May 31, 2006. STATUS
• Strategy 2: Obtain report from MDC regarding historic AI surveillance in wild birds and other wild species by February 16, 2006. STATUS
2. Objective: Design and implement a system to conduct surveillance for AI in wild and domestic birds in Missouri. Formalize the system for processing dead/sick bird reports received by state agencies.
• Strategy 1: Specify procedures and roles of MDC, DHSS, MDA, USDA/APHIS/WS & VS, and local public health agencies in receiving dead/sick bird calls from citizens, etc. and forwarding them to the appropriate agencies by April 27, 2006. STATUS
• Strategy 2: Develop and disseminate a database for use by agencies receiving sick/dead bird calls to track data and investigation results (if conducted) by May 17, 2006. STATUS
• Strategy 3: Describe programs in place to test domestic (farm) birds for AI by May 17, 2006. STATUS
• Strategy 4: Determine criteria, protocols, agency roles, and timeline for testing wild birds for AI by May 31, 2006. STATUS
• Strategy 5: Develop an on-line application (or modify an existing one) for reporting of dead birds by citizens, etc. by June 30, 2006. STATUS
3. Objective: Assess current capability and capacity to test for AI in animals at state laboratories (VMDL, SPHL, MDA) and federal laboratories (USDA, USDI).
• Strategy 1: Obtain reports from the laboratories/agencies noted above regarding AI testing capability and capacity by February 16, 2006. STATUS
• Strategy 2: Ensure the laboratories/agencies noted above communicate with each other regarding testing programs by February 16, 2006. STATUS
4. Objective: Assess future needs of VMDL, SPHL, and MDA to initiate, continue, and/or enhance AI testing in animals.
• Strategy 1: Obtain reports from VMDL, SPHL, and MDA detailing projected budgetary requirements to conduct AI testing in animals by March 30, 2006. STATUS
• Strategy 2: Identify proposed sources of funding for AI testing and initiate actions to obtain funding (legislation, grants, etc.) by June 30, 2006. STATUS
• Strategy 3: Identify expansion/surge capacities and develop enhancement plan if needed, by June 30, 2006. STATUS
5. Objective: Assess the extent to which current national/state/local laws, policies, or other factors act as barriers to the collection of AI-associated data, its dissemination, and/or the implementation of effective response activities.
• Strategy 1: Obtain committee member input regarding barriers by March 30, 2006. STATUS
• Strategy 2: Draft proposed changes to laws and polices to enhance data collection/dissemination and response implementation by June 30, 2006. STATUS
6. Objective: Strengthen partnerships among MDA, DHSS, and other state/local agencies and the poultry/livestock industries.
• Strategy 1: Review the Missouri Poultry Improvement Plan so that all partners have an understanding of it by March 16, 2006. STATUS
• Strategy 2: Attend poultry industry meetings and perform site visits to poultry companies to gain knowledge and establish rapport and trust by April 28, 2006. STATUS
• Strategy 3: Participate with the poultry industry in exercises by June 30, 2006. STATUS
7. Objective: Develop working relationships with adjoining states that have significant poultry and livestock industries.
• Strategy 1: Review pertinent aspects of the Tri-State Poultry Plan and integrate health responses accordingly by April 21, 2006. STATUS
• Strategy 2: Liaison with other states’ avian influenza workgroups by May 30, 2006. STATUS
8. Objective: Animal agencies, public health departments, and other entities represented on this subcommittee have pre-event, event, and post-event plans that help protect the health of the public and mitigate risks to poultry/livestock industries in the event of an AI outbreak.
• Strategy 1: Review plans of agencies on this subcommittee to ensure agencies are prepared for all stages of an AI-associated event (identifying areas of responsibility and eliminating gaps/redundancy) by April 30, 2006. (Note: Initially, each agency will review its own plan. At a later date, subcommittee members will review each other’s plans.) STATUS
• Strategy 3 Develop annual influenza vaccination plans for poultry workers and other essential staff by June 30, 2006. STATUS
• Strategy 4: Identify sources of personnel support and other resources external to agencies of this subcommittee that could be used to meet demands of an AI-associated event. STATUS
9. Objective: Monitor human influenza cases that could be due to AI strains of virus.
• Strategy 1: Review routine reports generated by the DHSS Influenza Sentinel Surveillance Program (on-going). STATUS
• Strategy 2: Perform an investigation in the unlikely event of food- or water-borne transmission of AI virus (on-going). STATUS
10. Objective: Public, media, decision makers, and pertinent agencies informed regarding results of surveillance and monitoring efforts, along with appropriate preventive measures and effective interventions.
• Strategy 1: Provide routine feedback on activities conducted by this subcommittee to the Pandemic Influenza Preparedness Committee. STATUS
• Strategy 2: Release information to the public, media, decision makers, etc. through coordinated messages. STATUS
• Strategy 3: Develop a common message among agencies represented on this committee, including links to each other’s web sites. STATUS
• Strategy 4: Develop a structured outreach program that educates the public regarding the safety of the poultry industry and the food supply, as well as other issues of concern to members of this committee. STATUS
• Strategy 5: Provide local public health agencies a list of their responsibilities under the plan formulated by this subcommittee in conducting surveillance, prevention, and control activities related to human avian influenza cases. STATUS