No abstract

Outbreaks of respiratory infection in institutions in Ontario, Canada were studied from April 20 to June 12, 2009, during the early stages of the emergence of influenza A pandemic (H1N1) 2009. Despite widespread presence of influenza in the general population, only 2 of 83 outbreaks evaluated by molecular methods were associated with pandemic (H1N1) 2009.

L ive bird markets (LBMs) have long been identifi ed as major sites for the maintenance, transmission, amplifi cation, and dissemination of infl uenza A(H5) virus (1,2). Studies in the United States, China, Indonesia, and Vietnam have shown that LBMs can pose a public health risk for zoonotic spill-over to humans through environmental contamination (2-8). In Bangladesh, the fi rst evidence of zoonotic transmission of infl uenza A(H5) virus emerged in 2012; LBMs in Dhaka were considered the main source of exposure for all 3 human cases reported (9,10). The relatively low level of infl uenza A(H5) endemicity found in studies conducted in LBMs in Bangladesh since 2012 (e.g., <10% prevalence at live bird sampling level) (11-13) have contributed to a false sense of security regarding contamination risk. Indeed, since 2013, several infl uenza A(H5) outbreaks in poultry (9 outbreaks), wild birds (5 outbreaks), and humans (2 outbreaks) have occurred in Bangladesh (14,15). During March 2007-December 2020, Bangladesh reported 556 outbreaks of infl uenza A(H5) virus in poultry ( 14) and 8 cases in humans (15).Environmental sampling in LBMs for the purposes of avian infl uenza virus surveillance was fi rst introduced in the United States in 1986 (16). A recent study evaluated the effectiveness of environmental sampling for infl uenza A surveillance and described multiple sampling sites in an LBM (17). Earlier studies from Bangladesh primarily focused on collecting samples from market environment sites (such as market fl oor, stall fl oor, slaughter area, waste bin, poultry cage, water, fecal material on or underneath the poultry cage, blood, and poultry offal) to understand the LBM environment status for infl uenza A (11,12,(18)(19)(20)(21)(22)(23)(24)(25).Few studies to date-1 in Indonesia and 3 in Guangdong, China-have performed simultaneous sampling in different LBM work zones, such as the poultry delivery, poultry holding, poultry slaughter, poultry sale, and waste disposal zones (26)(27)(28)(29). These studies indicated that the poultry slaughter and sale zones were the 2 most contaminated LBM work zones for infl uenza A(H5N1) in Indonesia ( 27) and infl uenza A(H7N9), (H5), and (H9) in China (26,28,29). To date, no studies have been performed in Bangladesh on infl uenza A environmental contamination within different LBM work zones. The results from China and Indonesia have provided additional justifi cation to evaluate the infl uenza A surveillance program of

A workforce with the adequate field epidemiology knowledge, skills and abilities is the foundation of a strong and effective animal health system. Field epidemiology training is conducted in several countries to meet the increased global demand for such a workforce. However, core competencies for field veterinary epidemiology have not been identified and agreed upon globally, leading to the development of different training curricula. Having a set of agreed core competencies can harmonize field veterinary epidemiology training. The Food and Agriculture Organization of the United Nations (FAO) initiated a collective, iterative, and participative process to achieve this and organized two expert consultative workshops in 2018 to develop core competencies for field veterinary epidemiology at the frontline and intermediate levels. Based on these expert discussions, 13 competencies were identified for the frontline and intermediate levels. These competencies were organized into three domains: epidemiological surveillance and studies; field investigation, preparedness and response; and One Health, communication, ethics and professionalism. These competencies can be used to facilitate the development of field epidemiology training curricula for veterinarians, adapted to country training needs, or customized for training other close disciplines. The competencies can also be useful for mentors and employers to monitor and evaluate the progress of their mentees, or to guide the selection process during the recruitment of new staff.

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Purpose: To validate the utility and effectiveness of a standardized tool for prioritization of information sources for early detection of diseases. Methods: The tool was developed with input from diverse public health experts garnered through survey. Ten raters used the tool to evaluate ten information sources and reliability among raters was computed. The Proc mixed procedure with random effect statement and SAS Macros were used to compute multiple raters’ Fleiss Kappa agreement and Kendall's Coefficient of Concordance. Results: Ten disparate information sources evaluated obtained the following composite scores: ProMed 91%; WAHID 90%; Eurosurv 87%; MediSys 85%; SciDaily 84%; EurekAl 83%; CSHB 78%; GermTrax 75%; Google 74%; and CBC 70%. A Fleiss Kappa agreement of 50.7% was obtained for ten information sources and 72.5% for a sub-set of five sources rated, which is substantial agreement validating the utility and effectiveness of the tool. Conclusion: This study validated the utility and effectiveness of a standardized criteria tool developed to prioritize information sources. The new tool was used to identify five information sources suited for use by the KIWI system in the CEZD-IIR project to improve surveillance of infectious diseases. The tool can be generalized to situations when prioritization of numerous information sources is necessary.

Analysis of environmental samples obtained from the Live Poultry Markets (LPMs) of Dhaka City, Bangladesh, has revealed that the highest degree of prevalence of highly pathogenic avian influenza A (HPAI, H5N1), besides other subtypes of the LPAI virus, poses the plausible risk of transmission of these viruses between human and poultry species. The present study was conducted using the OIE risk analysis framework to assess the risk level of each pathway successively. The estimated risk parameters were integrated towards to obtain the overall risk level for each specific HPAI transmission pathway using the matrix adapted by Cristobel Zepeda accompanying other expert consultations. The relevant data obtained from published and unpublished sources, together with survey data of field observations, were used to formulate and confirm the risk pathways and their associated risks. The results revealed that the risk of the release of the HPAI virus was medium when exposure was high. Additionally, the consequence would be considered very high with a medium degree of uncertainty for all parameters. Ultimately, the overall risk for transmission was estimated as medium with a medium degree of uncertainty. The findings of this study reveal that there is a significant threat that HPAI virus transmission could occur among poultry and humans and effectively sustain within the environment of the LPMs. Our findings are primarily focused on public health considerations, the hygienic slaughter of poultry and the relevant cleaning and sanitation practices conducted in the LPMs to support evidence‐based decision‐making processes. The findings of the study have the potential to be used to formulate effective risk reduction measures and can be further adapted in low‐resource settings without major infrastructural changes required of the LPMs. All of which would reduce the risk of HPAI virus release and further lessen the degree of exposure and transmission in established LPMs.