Can 13-year-old manual save PHL from bird flu?

In Photo: Chickens crowd a cage in Jaen, Nueva Ecija, northern Philippines, on August 18. As the Department of Agriculture said a strain of avian influenza has spread to this province, government experts, like veterinarian Joy Lagayan, bank on a 13-year old manual to address bird flu.

IT was a day Joy Lagayan dreaded as she rummaged through shelves looking for something “valuable”. It was something that Lagayan, a veterinarian working for the government, never thought she would pull out from rows and rows of books. She dreaded that day a glossy-white covered book would be put to use after more than a decade.

Because Lagayan knew, as she took a deep sigh, the book spelled death. “It’s our bible,” Lagayan said, while taking by the head the Avian Influenza Protection Program (AIPP) Manual of Procedures.

Dreaded

LAGAYAN, a staff of the Bureau of Animal Industry’s Animal Health and Welfare Division for five years, explained taking out the AIPP manual is bringing her stress.

“It’s stressful; very, very stressful,” Lagayan told the BusinessMirror, when she learned that the Avian Influenza (AI) virus has landed in the Philippines.

“It’s good we have this. It made things a little bit easier for us,” said Lagayan, a doctor of veterinary medicine for 13 years now, tapping the cover page of the AIPP.

The government, led by then- President Gloria-Macapagal Arroyo, started crafting the AIPP in 2004, when the feared AI, commonly known as “bird flu”, resurfaced in Asia. The goal was to protect the country’s borders from the virus that killed millions of birds in Southeast Asia back then.

Border protection

BY virtue of Executive Order (EO) 280, Series of 2004, Arroyo outlined the powers, functions and responsibilities of government agencies in preventing and addressing the bird-flu virus.

“Due to an outbreak of the bird- flu virus, which has affected many countries in Asia, including the deaths of at least twelve people in Vietnam and Thailand, bold, preemptive, active and immediate measures must be taken by the Philippines in order to avert or minimize its grave effects,” Arroyo said in EO 280, signed on February 5, 2004.

“In the event the epidemic can no longer be prevented and, in order to confine, minimize, restrict or regulate the further spread of the contagion, such measures and actions relative to fowl, poultry, other birds or animals and people, infected or suspected to be infected with the virus, need to be implemented,” Arroyo added.

Through EO 280, the secretaries of Health and Agriculture were designated as crisis manager and comanager, respectively, should the bird-flu virus reach the Philippines.

Both Health and Agriculture secretaries were given full power and authority necessary to restrict the entry of bird-flu virus in the country.

The Department of Health (DOH) is particularly tasked to control any possible transmission and cases of bird flu in humans. The Department of Agriculture (DA) was tasked to protect the monitor and protect the Philippine poultry industry from the virus.

The crisis managers are also given the power to “call” upon all government agencies for assistance and support in carrying their respective duties. These government agencies include the departments of Interior and Local Government, Foreign Affairs, Transportation and Communication, Education, Labor and Employment and National Defense. The Office of the Press Secretary was also called to support the crisis managers.

Secure regions

BY 2005 the government intensified its efforts to keep the country’s borders free from AI.

The government, through the DOH, released the “Preparedness and Response Plan for Avian and Pandemic Influenza”, (PRPAPI) paving the way for the codification and institutionalization of measures the state shall undertake in preventing, controlling and addressing the dreaded virus.

In gist, the document outlines four possible stages the Philippines could encounter with bird flu: 1) an AI-free nation; 2) AI outbreak in poultry; 3) AI transmission from poultry to huimans; and 4) AI transmission among humans.

“The pandemic clock is ticking. It cannot be predicted when the pandemic will occur, but it is always best to be prepared all the time,” then-Health Secretary Francisco T. Duque III said in the preface of the document. “After all, it wasn’t raining when Noah built the ark.”

In the same year the DA and DOH issued Joint Administrative Order 01, which authorized the adoption of the AIPP and the establishment of the National Avian Influenza Task Force.

The order emphasized that the AIPP manual is the official AI prevention and preparedness plan of the country.

Shake the disease

TO date, the AIPP only outlines procedures to undertake for Stage 1 and Stage 2 of a bird-flu scenario as outlined by PRPAPI.

There are generally three types of avian influenza: A, B and C, according to the Food and Agriculture Organization of the UN (FAO). Avian-influenza viruses are divided into: highly pathogenic and low pathogenic (LPAI) strains based on its ability to cause disease in poultry.

An LPAI “is a natural infection of waterfowl that may cause minimal to no signs of disease in domestic poultry and wild birds and is not a serious threat,” the FAO said. “Highly pathogenic avian influenza is rarely found in waterfowl, but causes severe disease in domestic poultry with a high death rate.”

The AI viruses are further classified according to their strains, or subtypes based on two proteins: haemglutinin (H) and neuraminidase (N). There are currently 16 recognized H types and nine N types, according to the FAO. The combination of these strains dictate the extent of effect of the virus: Is it dreadful to humans or just mere sickness among chickens?

For the Philippines, the biggest concern now is whether the confirmed AI subtype, A H5 virus in two barangays in San Luis, Pampanga, could be transmitted to humans. Only H5N1 and H5N6 are known to date to be transmissible to humans.

Recent government laboratory tests ruled out that the AI virus the Philippines has contains the strain of H5N.

As for H5N6? The country is still awaiting further information from the Australian Animal Health Laboratory, where samples from the Philippines were brought to.

“We always boast to the international community that we are AI free, for years, in the region,” Lagayan said. “And they always doubted us. They do not believe we were AI free. But now, it’s real. It’s here,” she added. To be continued

Image credits: Nonie Reyes

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