Q&A ON AVIAN INFLUENZA

Avian influenza (HPAI) is evolving and presents a growing threat globally. Te Niwha, the national infectious diseases research platform, hosted a webinar to provide expert information on the virus, surveillance, research activities, and how Aotearoa New Zealand is preparing for an animal or human case.

Key points:

• Avian influenza or HPAI (Highly Pathogenic Avian Influenza) virus is most likely to arrive in Aotearoa via wildlife, particularly wild birds, as has been the case globally.
• Most likely indicator – dead birds or ones with neurological or respiratory issues.
• Entry via wild birds into the country cannot be controlled but surveillance activities and research have stepped up around the virus, including learning from international knowledge and experience.
• Avian influenza virus differs from COVID 19 as:
  • It has been present in parts of the world for decades.
  • Influenza virus vaccine development is well-established as is knowledge about the disease and potential treatments.
  • There has been no sustained transmission from human to human.
• Biosecurity New Zealand (the biosecurity arm of MPI) is the lead agency relating to HPAI.  Biosecurity New Zealand, Health NZ, the Ministry of Health and DOC are working together and increasing surveillance activities and planning. 
• An animal or human case in Aotearoa would prompt urgent collective action by agencies to identify the source, assess risk, and manage and treat cases. 
• Te Niwha is funding genomics-based research to develop new tools to enhance surveillance of wildlife and improve preparedness for potential pandemics.
• The public can play a role by reporting dead or sick birds, or mammals, to Biosecurity NZ’s exotic pest and disease hotline (0800 80 99 66).
• DOC has been granted approval to run a vaccine trial on five native birds to test the safety and efficacy of vaccination for some New Zealand species. The vaccine has been used overseas in commercial poultry, zoos, and endangered populations

Speakers and panellists:

• Distinguished Professor Nigel French (Te Niwha Chief Science Advisor, Massey University)
• Professor Jemma Geoghegan (Te Niwha Avian Influenza Surveillance study co-lead, University of Otago, Ōtākou Whakaihu Waka)
• Dr David Winter (Te Niwha Avian Influenza Surveillance study co-lead, Science Leader Genomics and Bioinformatics, ESR)
• Dr Rachel Stanyer (Veterinarian, DOC)
• Dr Mary van Andel (Chief Veterinary Officer, MPI)
• Dr Emma Sherwood (Public Health Medicine Specialist, National Public Health Service, Health NZ)
• Dr Nick von Randow (Chief Clinical Advisor, Public Health Agency, Ministry of Health)

Question: What are the most likely routes for Highly Pathogenic Avian Influenza (HPAI) into Aotearoa? Is there any way we can stop it?

Professor Jemma Geoghegan (Te Niwha Avian Influenza Surveillance study co-lead, University of Otago, Ōtākou Whakaihu Waka)

Across the world this virus has spread through wildlife, primarily wild birds. Most likely sign of the virus arriving would be lots of dead birds. It is very hard to stop it arriving because we can’t shut our borders to migratory birds. What we can do is adapt our surveillance systems to better detect the virus when it arrives. Early detection is the key to stopping the virus’ wider transmission and impact.

We've known about this virus for over 30 years. In the last few years the virus has evolved and acquired genetic mutations allowing it to expand both its host range and geographical range.

This virus has ‘spilled over’ to mammalian hosts; over 60 species of mammalian hosts have now been detected with the virus. The virus has spread to more than 50 farms across the United States. This is the first evidence of sustained mammal-to-mammal transmission of this virus. However, it is important to stress this virus does continue to look very much like an avian virus rather than a human influenza virus.

Dr Rachel Stanyer (Department of Conservation veterinarian) 

MPI and DOC are analysing what kind of birds arrive at what time of year and what migration routes they use. Then sharing that information with people on the ground in regions around the country so they know signs to look for and can increase their surveillance in a safe way.

 

Question: How does HPAI differ from COVID-19?

Dr Nick von Randow (Chief Clinical Advisor, Public Health Agency, Ministry of Health)

A major difference is that much of the world has been living with this particular strain of the HPAI virus for a few years, and with this broader group of viruses for decades; we know a lot more about it than COVID 19 and New Zealand can benefit from the experience of other countries.

There are reports of a higher case fatality rate than COVID 19, but this needs to be interpreted with the knowledge that we probably don’t know everyone who has been infected so it is likely inflated, and a lot of deaths reported have been in countries with health systems not comparable with New Zealand’s. 

The world knows how to make influenza vaccines well, so it is a different situation from COVID 19 where we started out not knowing what the future in vaccines and treatments was going to be. We have candidate vaccines with laboratory evidence of effectiveness in New Zealand’s national reserve supply, and effective antivirals (treatments).

While HPAI is a fairly different situation from COVID 19, we are vigilant and monitoring the situation and doing all we can to prepare for more serious scenarios.

 

Question: What surveillance activities are underway in Aotearoa for avian influenza? What scientific developments can enhance surveillance?

Dr Mary van Andel (Chief Veterinary Officer, MPI)

We gather information on what’s happening overseas. We gather data in New Zealand. We are part of networks monitoring the spread of disease globally. With our colleagues overseas, we are monitoring how the disease is behaving as it spreads and what effective responses look like in different contexts. 

Early detection is key to responding effectively and managing impacts of cases in New Zealand. Our surveillance is being tailored towards that. 

There is routine testing of domestic poultry in commercial settings. To enhance surveillance, we’re working with veterinarians and poultry industry organisations to ensure people are aware of clinical signs in poultry and wild birds.  

We do surveillance of migratory wild birds and shore birds, including for avian influenza. 

Community surveillance is important. We ask everybody to keep an eye out for sick or dead birds and report them to the exotic pest and disease hotline (0800 80 99 66) so they can be investigated, and samples tested for exotic animal disease, including HPAI.

We are following spillover events and are in close contact with colleagues at the USDA (the United States Department of Agriculture) about their experiences with spillover into dairy herds. 

New Zealand is a partner in the Antarctic Treaty Area, and we are exchanging information with other treaty signatories. The Southern spread of the disease is somewhere all eyes are at the moment.  

Professor Jemma Geoghegan (Te Niwha Avian Influenza Surveillance study co-lead, University of Otago, Ōtākou Whakaihu Waka)

I'm co-leading a Te Niwha research project with the aim of improving New Zealand’s preparedness. There are two major questions we want to answer. How might this virus get to New Zealand and how can we improve our surveillance, given changes in its host range, to better detect the virus when it does arrive?

There are knowledge gaps about how wild birds in particular transmit viruses and how they interact between the migratory and non-migratory birds. We’ve been working with the Department of Conservation and community groups to sample as many different wild bird species as possible, particularly across the Subantarctic Islands, to try and understand how viruses are transmitted and model how avian influenza virus might spread across New Zealand.

Dr David Winter (Te Niwha Avian Influenza Surveillance study co-lead, Science Leader Genomics and Bioinformatics, ESR)

HPAI is a bird virus but can be acquired through the environment. The Te Niwha research project, that I co-lead with Jemma Geoghegan, is developing new tools for the surveillance toolkit to detect this virus in the community, in wildlife and, potentially, in human cases. 

We are using emerging technologies to detect viruses directly from the environment. For example, a sample of water from an estuary or duck pond will have DNA or RNA information about the creatures and microbes in that area. We are using these eDNA (environmental DNA) samples to ultimately develop a test that can be distributed into the community and detect a particular organism of interest, or a particular variant, or even right down to the level of an individual mutation without the need for complex and expensive laboratory equipment.

 

Question: What would be the response to an incursion of avian influenza into Aotearoa?

Dr Mary van Andel (Chief Veterinary Officer, MPI)

As with any infectious disease control programme, we look to find infection early, contain its spread, and implement relevant and useful control actions. Best responses protect native species, mitigate effects on primary sectors, and investigate spillover and protect human health.

Response and actions to a case of HPAI would be guided by the infected species and the location. We would react differently to an incursion first detected in wild birds, for example, to one detected in commercial poultry.

The poultry industry is learning from colleagues abroad as we all continue to learn and evolve in line with the knowledge of countries who have been dealing with this strain of the disease. We are liaising with cattle industry representatives in the United States about how spillover might be handled in New Zealand if that situation arose.

 

Question: How would the health system respond to a human case of HPAI in Aotearoa?

Dr Emma Sherwood (Public Health Medicine Specialist, National Public Health Service, Health NZ.)

Planning is well underway across agencies with a human or animal case recognised as of the highest priority. Health would stand up an incident management team and a clinical threats advisory group to provide expert guidance. The National Public Health Service would lead the operational response, focusing on rapid detection and case and contact management to prevent further spread, working closely with colleagues at the Ministry of Health, ESR, MPI and DOC. Public health management of a human case could include treatment with antivirals, isolation, and public health services would undertake contact tracing, risk assessment, and management of contacts. This might involve active follow up (checking in with contacts daily), passive follow-up (providing information) and consideration of giving antivirals to close contacts of human or animal cases. Alongside our routine surveillance for HPAI, this would stand up enhanced surveillance, testing people who were exposed to the case, or the same environment - gathering as much information as we can to inform our outbreak investigation and determine the source of infection and inform our risk assessment and contact tracing. Finally, we would continue to provide and publicise guidance regarding infection prevention control and hygiene and sanitation measures for exposed groups (such as personnel protective equipment).

Responding to Highly Pathogenic Avian Influenza (HPAI) requires coordination of government agencies responsible for human, domestic animal, and wildlife health. What are the roles of different agencies in Aotearoa in terms of preparedness and response, and how do they work together?  

Dr Mary van Andel (Chief Veterinary Officer, MPI)

If HPAI is detected in New Zealand or its territories, Biosecurity New Zealand, the biosecurity arm of MPI, is the lead agency and would coordinate any response in partnership with DOC, the Ministry of Health and Health NZ. 

Surveillance, preparedness and response planning are all part of our joint preparation. A range of other groups would be involved in a response to HPAI, including industry groups, veterinary professionals, regional councils, organisations that support birds and wildlife, Fish and Game, Forest and Bird, and healthcare providers. At MPI, we are working with these groups to ensure they are informed about the possibility HPAI could arrive in New Zealand and how to keep safe.

Our overall focus needs to be on response options that represent the best approach for New Zealand to the particular strain of HPAI. We need to focus on protecting unique native species, mitigating the impacts on primary sectors, especially our poultry sector, maintain vigilance and be there to investigate possible spillover events, and of course take measures to protect human health.

Dr Emma Sherwood (Public Health Medicine Specialist, National Public Health Service, Health NZ.)

Health NZ and its National Public Health Service would be responsible for the operational response to any human or animal cases of HPAI, so managing any human contacts of animal cases. We are also the lead for developing health and safety and Infection Prevention and Control guidance for public and occupational groups. We have been working closely with other agencies particularly with MPI and DOC.

Dr Nick von Randow (Chief Clinical Advisor, Public Health Agency, Ministry of Health)

The Ministry of Health has a strategic response, oversight, and monitoring role. We have the role of convening across the health sector. We are responsible for the New Zealand Pandemic Plan and oversee the national reserve supply of vaccines and antivirals. 

Dr David Winter (Te Niwha Avian Influenza Surveillance study co-lead, Science Leader Genomics and Bioinformatics, ESR)

ESR would be contributing as needed as part of a united approach to dealing with HPAI. We have depth in our referencing laboratories, epidemiologists and public health physicians, and the sequencing team.  We have had discussions already with the MPI Animal Health Lab about how we could support sequencing if they became part of the response from MPI. 

 

Question: How can the public help? What should the public do if they see potentially infected wildlife? 

Dr Rachel Stanyer (Veterinarian, DOC) 

Look out for any unusual signs in wildlife, a number of dead birds or those with respiratory or neurological issues.  Keep your distance, don’t touch birds, ring the Biosecurity hotline (0800 80 99 66) right away to report it and keep dogs away to make sure scavenging can’t occur. 

Marine mammals have been quite heavily affected in other countries especially South America so report any signs of illness in these animals.

 

Question: How are New Zealand’s endangered and taonga bird species being protected from the possibility of HPAI?

Dr Rachel Stanyer (Veterinarian, DOC) 

DOC is running a vaccine trial of a number of endangered species and working closely with MPI and Biosecurity NZ on an overall goal of continuing important conservation work while reducing the impacts of HPAI and providing for animal health and welfare, and the safety of staff and volunteers. 

We're working on district plans, with 49 regional districts each unique and with their own set of risk profiles and challenges in relation to HPAI.  These will help guide those in districts on sites and species of concern, what actions they should and shouldn't continue, and how to continue essential conservation work safely.

We've working on captive facility guidelines and communications and engagement with a wide range of stakeholders.

The purpose of our vaccination trial is to check the safety and the efficacy of a vaccine registered for use in New Zealand. It reduces the clinical signs of disease, mortality rates, and environmental shedding of the virus. We’re using it on a select group of native bird species in a trial. We have ethics approval to do this. In the trial we have to be able to recapture birds and see if they've had an adverse reaction and take bloods for antibody levels, plus give two vaccinations.

We’re not the first to do a vaccination trial in native or captive birds. There have been many vaccination studies in zoo birds overseas, with more than 30,000 birds in total vaccinated and few adverse reactions noted. Overseas studies found different species produce different levels of antibodies so we need to understand how New Zealand birds respond.

For a few species, using vaccination might be an effective tool during outbreaks to protect a core breeding population to prevent species extinction. It is not possible to vaccinate all our endangered birds, but we can focus on those species in captivity where the full two doses of vaccine can be given.