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Live Poultry Markets in Bangkok Metropolitan, Thailand: a Survey of H5 & H7 Prevalence in Bird and Worker’S Vaccination and Knowledge

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Live Poultry Markets in Bangkok Metropolitan, Thailand: a Survey of H5 & H7 Prevalence in Bird and Worker’S Vaccination and Knowledge Live Poultry Markets in Bangkok Metropolitan, Thailand: A Survey of H5 & H7 Prevalence in Bird and Worker’s vaccination and knowledge Prabda Praphasiri, DrPH, PhD 29 August 2016 Thailand MOPH – U.S. CDC Collaboration A joint activity of the Thailand Ministry of Public Health and the U.S. Centers for Disease Control and Prevention The top 10 disease surveillance of Bangkok and Thailand in 2016. Bangkok Thailand Disease Patient Rate Disease Patient Rate /100,000 (person) /100,000 (person) 1. 1. Diarrhea 20,479 359.64 Diarrhea 483,077 738.35 2. Influenza 15,793 277.35 2. Pyrexia 3. Pyrexia (Fever of Unkown 163,447 249.82 (Fever of Unkown 7,548 132.55 Origin) Origin) 3. Pneumonia 89,892 137.39 4. Pneumonia 4,356 76.50 4. Foodborne disease 52,275 79.90 5. Dengue (Total) 3,580 62.87 5. Conjunctivitis 52,246 79.85 6. Hand-Foot Mouth- 2,490 43.73 6. Influenza Disease 50,372 76.99 7. Chickenpox 7. Sexually transmitted 24,844 37.97 1,815 31.87 infection (Total) 8. Dengue (Total) 18,044 27.58 8. Foodborne disease 1,716 30.14 9. Sexually transmitted 16,650 25.45 9. Conjunctivitis 1,573 27.62 infection (Total) 10. 10. Chickenpox 1,295 22.74 Hand-Foot Mouth- Disease 13,727 20.98 Note: Data from the Bureau of Epidemiology Note: Data from the Bureau of Epidemiology at June 7, 2016. at June 7, 2016. Influenza situation in Bangkok per week Number of patient (person) 2000 Med14-15 2015 2016 1500 1000 500 0 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 9.00 8.00 Bangkok 2015 Bangkok 2016 7.00 6.00 5.00 4.00 3.00 5% 2.00 The proportion of ILI ILI The proportion of 1.00 Week patients on all on all outpatient patients 0.00 1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728293031323334353637383940414243444546474849505152 Data from the Bureau of Epidemiology at June 7, 2016. Why Bangkok is at Risk of AI transmission • Sprawling cross-road area with 10 millions population • High density of the inhabitants and high turnover rates of both human and animal population • First entry point for foreigners and tourists traveling into Thailand, including poultry imported for domestic trading Location of Live Bird Market in Bangkok Types and places of poultry purchased at Live Poultry Market in Bangkok District Types of Poultry Places of Poultry (Provinces or countries) Bang Rak Chickens Nakhon Pathom, Bangkok Samphan thawong Chickens Nakhon Pathom, Nakhon Nayok, Bangkok Rat Burana Chickens Phetchaburi Khlong Toei Chickens, Ducks, Nakhon Pathom, Phetchaburi, Ratchaburi, Geese Chachoengsao, Ang Thong, Chon Buri Pom Prap Sattru Chickens, Ducks, Samut Sakhon Phai Geese Bangkok Noi Pet birdsa Bangkok Min Buri Pet birdsa Bangkok, Samut Prakan, Chachoengsao, Phetchaburi Thawi Watthana Pet birdsa Bangkok, Ang Thong, Samut Sakhon, Chachoengsao, Nakhon Pathom, Kanchanaburi, Netherlands, Belgium, Australia, Philippines Chatuchak Pet birdsa 18 provinces Live Bird Market at JJ market in Bangkok Bangkok, Nakhon Nayok, Chachoengsao, Samut Prakan, Phetchaburi, Phra Nakhon Si Ayutthaya, Saraburi, Nakhon Ratchasima, Chon Buri, Pathum Thani, Chiang Mai, Suphan Buri, Buri Ram, Kalasin, Roi Et, Prachin Buri, Songkhla, Yala, Pattani, Narathiwat, Netherlands Thailand avian influenza situation in human • Cumulative number of human confirm Avian influenza 25 case, 17 death in Thailand since 2004-2006* - Distribute in 18 province of Thailand (18/77; 23%) • No confirm Avian influenza case and death in Thailand since 2007 until now * http://dpc2.ddc.moph.go.th/intranet/Report5/file/epr01.pdf 8 Risk of AI transmission in Bangkok • Cumulative number of human • There was reported confirm AI case in human in Bangkok 2005 • Previous study found AI (H5N1) in live bird market, central part of Thailand • Lack of the data amount of shop in Bangkok • Most well known market such as Chatuchak live bird market receive live bird from other province • Unknown vaccine coverage among live bird vendors in Bangkok 9 The organization responsibility to detect avian influenza by type of bird in Thailand since 2004 Organization responsibility for Bird type Year started surveillance disease Wild bird Department of national park, wildlife 2004* and plants conservation (DNP) Farm bird Department of livestock development 2004** (DLD) Zoo bird Zoological park organization 2004*** Live bird in live bird No surveillance system - market 10 Why surveillance in LBMs is important to detect disease? • LBMs play a crucial role in the maintenance, amplification and dissemination of avian influenza viruses • Considered high risk locations for potential zoonotic transmission of influenza viruses to humans • Control measures in LBMs and along the market chain have been found to be effective for reducing the spread of H5N1 viruses 11 Objectives • To determine knowledge about avian influenza among bird To determine vaccine coverage among bird vendors in Bangkok, November 2013 • To identify H7N9 and other avian influenza viruses in live poultry, environmental samples and live poultry serum in live poultry markets in Bangkok (2013-2016) 12 Study area • 50 districts were listed by Bangkok metropolitan during July 2013 • 9 of 50 districts have live bird market and survey number of shop by BMA veterinary officer during July 2013 13 Cross-sectional survey Sampling method 50 districts Preliminary survey by BMA 9 districts Selected all 9 live bird markets Selected all 76 live bird shops Bird & environment (convenience sampling) 1 vendor (purposive sampling using shop management criteria) 20 bird (if number of bird < 2 environment 20, collected all) fresh feces oropharyngeal swab water serum Data collection • Human : purposive sampling incline to high knowledge of shop management criteria - 1st owner - 2nd worker - 3rd other person in shop • Data collection Questionnaire was developed and reviewed by content experts Train field worker collected sample from live bird shop and interview method Structure interview questionnaire to obtain data » > Demographic data » > General shop information » > Animal-human contact » > Vaccine and illness history in the past 1 year » > Knowledge about avian influenza 15 Poultry sample collection Specimen from bird: convenience sampling • Oropharyngeal swab : 20 avian; 4 samples (pool) • Serum : 20 avian ;20 samples (only food bird) Environmental sample convenience sampling • • Water : 4 samples (from 4 container) • • Feces : 5 area; 1 sample (pool) 16 laboratory – Pathogen detection : Influenza virus A ( H5 and H7) – Laboratory institute : National Institute of Animal Health(NIAH) , Department of Livestock Development – Laboratory detection technique : • Reverse-Transcription PCR (RT-PCR). • hemagglutination(HA) assay • Hemagglutination-inhibition (HI) assay 17 RESULTS 18 No. of shop collected specimen and interviewee in live bird shop, Bangkok, November 2013 76 live bird shops 71 Shops allowed to 4 Shops allowed 1 Shops allowed collected to collected Interviewed Specimen and specimen only only interviewed 19 Distribution of live bird shop were collected data by district, Bangkok, November 2013 Total number of Number of shops Number of District eligible shops provided samples interviewee Pom Prap Sattru Phai 1 1 1 Rat Burana 1 1 1 Bangkok Noi 2 2 2 Bang Rak 2 2 2 Min Buri 11 11 10 Sampan thawong 3 3 3 Thawi Watthana 13 13 12 Klong Toei 18 18 16 Chatuchak 25 24 25 Total 76 75 72 20 Map distribution of live bird shop were collected data by district, Bangkok, November 2013 Shop type and shop staff of live bird shop in Bangkok, November 2013 (n=76) 32% 68% consumption pet Type of shop participant No. (%) of No. (%) of p-value* Consumption bird shop Pet bird shop (n=25) (n=51) Answer questionnaire 23 (92.0) 49 (96.1) 0.339 Giving specimen 25 (100) 50 (98.0) 0.671 22 * Chi-square test Years of operation and number of bird in live bird shop by type of shop in Bangkok, November 2013 (n=72) Type of shop Year of operation, No. (%) of No. (%) of p-value* no. of bird Consumption bird shop Pet bird shop (n=24) (n=49) years 0.001** 0-5 2 (8.7) 17 (34.7) 6-10 4 (17.4) 19 (38.8) > 10 15 (65.2) 11 (22.4) unknown 2 (8.7) 2 (4.1) No. of birds 0.078 < 50 7 (30.4) 26 (53.1) 50-100 11 (45.8) 11 (22.4) > 100 5 (20.8) 12 (24.5) * Chi-square test 23 **68 shops with known years of operation Percentage of Shop have Trading and transport permission license by type of shop in Bangkok, November 2013 (n=72) 100 80 60 consumption % 40 pet 20 0 trading license transport license License 24 Frequency of shop open by type of shop in Bangkok, November 2013 (n=72) Type of shop Frequency of No. (%) of No. (%) of p-value* shop open Consumption bird Pet bird shop shop (n=23) (n=49) Shop open 0.039 everyday 20 (87.0) 31 (63.3) not everyday 3(13.0) 18 (36.7) * Chi-square test 25 Distribution of vendors by age in live bird shop in Bangkok, November 2013 (n=72) 40 20 No.of vendors 0 0-19 20-39 40-59 60-80 years Distribution of vendors by education level in live bird shop in Bangkok, November 2013 (n=72) 30 20 10 0 primary high school diploma Bachelor upper not study No. of vendors No. school bachelor Education level 26 Influenza and vaccine history of shop staff by type of shop in Bangkok, November 2013 (n=154) Type of shop Variable No. (%) of No. (%) p-value* Consumption bird shop Pet bird shop (n=70) (n=84) Flu patient history 1 (1.4) 3 (3.6) 0.382 diagnosed by physician ILI history 1 (1.4) 5 (6.0) 0.153 Vaccine coverage 13 (18.6) 22 (26.2) 0.261 • Vaccine coverage and 95% CI among – Consumption bird vendor = 18.6 (11.05-29.36) – Pet bird vendor = 26.2 (17.92-36.54) • Vaccine coverage among vendors = 22.7 (16.79-29.99) * Chi-square test 27 Knowledge among live bird vendors in live bird shop,Bangkok, November 2013 (n=72) No.
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