Regional EpiNet Workshop
Members of the national EpiNet teams, animal
health specialists and laboratory experts from all over the Pacific
participated in a workshop on the topic of “PPHSN Preparedness for Influenza
and other Potential Threats like Dengue and SARS” held in Noumea, New
Caledonia, 7–11 June 2004.
The workshop was co-organised
by the Secretariat of the Pacific Community (SPC) and the World Health
Organization (WHO) in response to the influenza threat and other potential
epidemics. Representatives came from all Pacific Island countries and
territories (PICTs), except Tokelau, Tuvalu and Wallis and Futuna, who could
not make it.
In December 2003, avian influenza caused an outbreak in the poultry
population of the Republic of Korea, and spread to seven other Asian
countries. In January 2004, the health authorities of Viet Nam and Thailand
reported their first cases of human infection caused by avian influenza of
strain H5N1, with fatalities. Other avian flu outbreaks with influenza A
(H7) strains simultaneously occurred in other parts of the world (USA and
Canada), and the WHO confirmed that influenza A strain H7 in Canada had
caused conjunctivitis in a human.
If the H5N1, a highly pathogenic avian influenza (HPAI) virus, continues to
mutate it could give rise to a novel type of virus with potential for
inter-human transmission and possibly start an influenza pandemic.
This situation has caused
concern to PPHSN partners like WHO and SPC who take pivotal responsibility
in scientifically and technically assisting human populations to attain good
health, as well as collaborating with animal health key players in
maintaining well-being and safety of both humans and animals.
Influenza is not the only
threat that faces the PICTs. Dengue, measles and SARS were also on the
agenda. There is a need to continue strengthening infection control so that
if SARS or another similar disease (re-)emerges, PICT preparedness level is
appropriate, and achievements in this area are not lost.
The participants discussed a number of key issues on influenza: epidemiology
of influenza; influenza outbreaks in animals and poultry in Asia and other
parts of the world; animal influenza control measures; human cases of
influenza A/H5N1 in Asia in 2004 and human public
health implications; description and country experiences
with influenza in the Pacific; human influenza control measures;
options for influenza disease burden assessment; laboratory tests for
influenza including rapid diagnostic tests; influenza surveillance
(guidelines for inter-pandemic influenza surveillance and PPHSN influenza
preparedness guidelines); animal influenza surveillance; linking influenza
surveillance with pandemic preparedness levels; and pandemic guidance (WHO
Pandemic Preparedness Checklist and PPHSN
They also discussed: other
zoonoses; hospital-based active surveillance for acute fever and rash
(measles/rubella) and acute flaccid paralysis; dengue
serotype 3 threat to the region and
successful dengue surveillance and control
experiences in the Pacific); infection control in relation to SARS; SARS
preparedness in some PICTs; infection control protocol for highly pathogenic
avian influenza infection/outbreak; PPHSN Regional Infection
control Network; international health
regulations and their implications for the PPHSN; HIV/STI surveillance; and
In response to these issues, the participants agreed on the following
To establish and maintain strong
collaboration between human and animal health services both in country
and at regional level.
To develop and
strengthen capacity on influenza surveillance in PICTs to facilitate
swift detection of an outbreak, and to undertake responsibility of
preparedness to influenza pandemic threat or occurrence.
To explore and develop
feasible options for the assessment of the burden of influenza in PICTs.
To develop and
strengthen laboratory capacities to facilitate efficient surveillance,
especially influenza virologic surveillance, in PICTs.
To further develop and
improve surveillance systems in the PICTs by optimising use of scarce
resources for the PPHSN expanded list of priority diseases.
To undertake training
in epidemiology to facilitate improvement in the surveillance and
response to communicable disease threats and events in the Pacific
To promote a good
understanding of the new international health regulations (IHR) and
related issues, and integrate IHR into the framework of the PPHSN.
To review and improve
on the infection control measures in PICTs by establishing and
formalising the Pacific regional infection control network under the
umbrella of PPHSN.
To formalise and
operationalise the Regional EpiNet team with clear roles and functions,
including funding implications, for endorsement by the Health Ministers
meeting in Samoa in 2005.
Plan of action
A plan of action was also developed. It has been sent to all members of the
National EpiNet teams for their comments and approval. The final version
will be posted on the PPHSN website.
We would like to express our gratitude to the Asian Development Bank, the
French and New Zealand Governments through PREPARE and the World Health
Organization, for their financial support. We would also like to extend our
thanks to all the participants for their valuable contributions to this