Annex

Guidance on responding to the continued spread of highly pathogenic avian influenza

Introduction and mandate

1.Disease can have significant impacts on wildlife populations and is of special concern for species of conservation importance that have small populations and/or are highly localised at some stages of their life cycle. Many wildlife diseases are zoonotic, that is, they can infect not only wild and domestic animals, but also have the capacity to infect humans.

2.Highly pathogenic avian influenza H5N1 of Asian lineage (HPAI H5N1) is a viral zoonotic disease that emerged in poultry in southeast Asia between 1997 and 2003. It has since attracted widespread media attention and the attention of decision-makers within governments and international agencies. Between 2003 and 2008, the virus spread in an unprecedented fashion across Asia, the Middle East, Africa and Europe. The disease has had major impacts on rural livelihoods linked to the keeping of domestic birds (mainly chickens, ducks, turkeys, ostrich and quail) and nature conservation, including mortality of waterbirds at many Ramsar sites and negative public attitude toward waterbirds and their habitats as a result of lack of understanding of the role of wild birds in the epidemiology of the disease. There have also been major concerns as to the potential for viral change that might precipitate a human influenza pandemic, given the ongoing exposure of humans to the circulating avian virus through close contact with infected domestic birds and their products.

3.The total number of wild birds known to have been affected has been small in contrast to the number of domestic birds affected. Perhaps a greater threat than direct mortality has been the development of public fear about waterbirds resulting in misguided attempts to control the disease by disturbing or destroying wild birds and their habitats, inappropriate closure of some wetland sites and other outcomes detrimental to nature conservation. Such responses have often been encouraged by misleading and exaggerated messages in the media.

4.Addressing issues raised by the spread of HPAI H5N1 offers an important opportunity to promote effective structures and policies that can also provide models for the control of other emergent diseases. This is an important objective since wildlife disease is increasingly being recognized as a central issue for conservation managers. This is in addition to the disease’s very significant impact on domestic animals and human health.

5.The UN Food and Agriculture Organization (FAO) and the World Organization for Animal Health (OIE) are leading efforts to control avian influenza within the agricultural sector (poultry industry), whilst preparedness for a potential influenza pandemic, and control and prevention of human zoonotic disease, are the responsibilities of the World Health Organization (WHO).

6.Ramsar’s 9^th meeting of the Conference of the Contracting Parties (COP9) in 2005 recognized that, as well as the direct impacts of HPAI H5N1 on susceptible birds, public attitudes (and therefore support for wetland conservation, particularly of Ramsar sites and other wetlands of importance for waterbirds) could be negatively affected by concerns about the possible role of waterbirds in the spread of HPAI H5N1. Parties at COP9 were also greatly concerned that in many countries there was a significant lack of information and, in some countries, public misunderstanding, about important issues related to the spread of HPAI, the risks it may pose, and how to anticipate and respond to outbreaks of HPAI. Accordingly COP9 agreed Resolution IX.23 on Highly pathogenic avian influenza and its consequences for wetland and waterbird conservation and wise use. This Resolution inter alia called on the Convention’s Scientific and Technical Review Panel (STRP) to develop practical advice that could assist countries in responding to this serious and rapidly developing situation.

7.In particular, Ramsar COP9 requested the STRP, with the Scientific Task Force on Avian Influenza and Wild Birds, to provide relevant input on practical measures to reduce the risk of disease transmission between wild, captive and domestic birds to those agencies developing contingency and wetland management plans related to HPAI H5N1; to share this information, including practical advice that will assist countries to respond to this serious and rapidly developing situation; and to report to COP10.

8.In response, the STRP has developed guidance for consideration by the Convention’s Standing Committee and Contracting Parties at COP10. The advice comes in four main sections:Section 1. A ‘guide to avian influenza guidance’;Section 2. Guidelines for reducing avian influenza risks at Ramsar sites and other wetlands;Section 3. Recommended ornithological information to be collected during surveillance programmes or field assessment; andSection 4. Guidelines for Ornithological Expert Panels.

9.The policy positions and technical guidance of the main international conventions and environment agreements concerned with the conservation of wild birds, such as the Convention on Biological Diversity (CBD), Convention on Migratory Species (CMS), and the Ramsar Convention, have been set out in Resolutions agreed and adopted at their respective Conferences of Contracting Parties (see Section 1.3). In addition, the Scientific Task Force on Avian Influenza and Wild Birds (Appendix 2) established by CMS and now co-convened with FAO, is coordinating international scientific advice, including advice on the conservation impact of avian influenza. The Task Force website provides access to a wide range of resources on avian influenza, wildlife, and the environment and is accessible at http://www.aiweb.info.

10.Regrettably, since November 2005, there has been further spread of this virus westwards through Eurasia and into Africa². As a consequence, further experience since Ramsar COP9 in 2005 has been gained with respect to the establishment of surveillance systems for the virus and responding to cases of infection. Important lessons include:²Kilpatrick, M., Chmura, A.A., Gibbons, D.W., Fleischer, R.C., Marra, P.P. & Daszak, P. 2006. Predicting the global spread of H5N1 avian influenza. Proceedings of the National Academy of Sciences 103(15): 19368–19373. http://www.pnas.org/cgi/reprint/103/51/19368; andSabirovic, M., Wilesmith, J., Hall, S., Coulson, N., Landeg, F. 2006. Situation Analysis–Outbreaks of HPAI H5N1 virus in Europe during 2005/2006–An overview and commentary. DEFRA, International Animal Health Division, United Kingdom. 40 pp. http://www.defra.gov.uk/animalh/diseases/monitoring/pdf/hpai-europe300606.pdfThat there is a need for risk assessment and response processes at various scales, including the preparation and implementation of cross-sectoral national contingency plans involving all relevant parts of government. Such planning is central to preparing and responding to HPAI outbreaks, and should be undertaken, wherever possible, before disease occurs.That the development and implementation of surveillance and early warning systems valuably inform responses. These schemes should be developed on the basis of best practice international guidance, be informed by risk assessments, be undertaken to the highest standards – including validation and quality assurance of data – and be implemented using strategic approaches at regional or wider scales.That accurate identification of wild birds, either captured as part of surveillance programmes or reported from infection outbreaks, is critical to understanding the epidemiology of the disease and thus the processes of risk assessment.That whilst there is now a wide range of guidance on issues concerning HPAI H5N1, this exists mostly in just a few international languages, and there is an important need to ensure that key elements are made more widely available to stakeholders and translated into other languages.That there has been a welcome increase in the amount of surveillance, including the development of national and regional early warning systems. The development of the Global Avian Influenza Network for Surveillance (GAINS: http://www.gains.org) has been a very positive development, which has facilitated the sharing of relevant data and information at international scales. Yet the quality of much ornithological information from AI surveillance programmes is often poor, especially with regard to the precise identification of bird species. As recommended by the Scientific Task Force on Avian Influenza and Wild Birds, the involvement of ornithologists in these programmes would help resolve these issues.That, as well as traditional marking methods, i.e., ringing/banding, new methodologies such as satellite telemetry have the potential to provide information on the movements of wild birds, especially at flyway scales, and thus can better inform risk assessments.That there remains a need for further analysis of ornithological datasets and research on a range of issues related to the role of waterbirds in the epidemiology of the disease, as well as a better understanding of the details of the formal and informal trade in poultry.

1) – Guidance related to preparing for and responding to outbreaks of highly pathogenic avian influenza, especially at wetlands

1.1 – Introduction

11.Ramsar COP9 requested the Scientific and Technical Review Panel (STRP), with the Scientific Task Force on Avian Influenza and Wild Birds, to provide relevant input on practical measures to reduce the risk of disease transmission between wild, captive and domestic birds to those agencies developing contingency and wetland management plans related to HPAI H5N1; to share this information, including practical advice that will assist countries in responding to this serious and rapidly developing situation; and to report to COP10.

12.Since COP9, a large body of guidance on responding to the challenges of the spread of HPAI H5N1 has been produced, including much material made available through FAO and OIE websites (see Section 1.3). This includes guidance related to surveillance, enhanced biosecurity, contingency planning and preparation, and responses to outbreaks of HPAI infection.

13.Presented here is a ‘guide to guidance’, a guide to the significant body of information that has been published (mostly since 2005) and which is of potential utility to Ramsar Contracting Parties and others governments and organizations.

14.The guide consists of a guidance framework (Section 1.2), which provides a conceptual map of the available guidance, and a directory of guidance materials (Section 1.3), which organizes the guidance under a number of separate issues and provides source information and hyperlinks.

1.2 – A guidance framework

15.Responding to avian influenza – to the perceived threat as well as to outbreaks of disease – involves a wide range of activities from writing contingency plans to sampling wild birds to dealing with the media. Additional complexity is added by the varying scale on which these activities must be completed – for example, contingency plans are required at the international, national, subnational and site levels.

16.These activities are summarised in Table 1, which provides a ‘road-map’ not only to the activities required at different levels of risk but also to the guidance that exists for these activities.

17.The levels of risk are defined as follows:Low risk - no known infection in geographical regionMedium risk - spreading infection in wild birds or poultry in regionHigh risk - infection in neighbouring countries/regionsImmediate risk - infection in a country/region affecting either wild birds or poultryPost infection - period following an incursion of HPAI

18.The required activities and available guidance are also categorised under seven separate themes:Expert advice and integration within government;Risk assessment;Contingency planning;Surveillance and early warning (wild birds);Epidemiological investigations (response and reporting);Communication, education and public awareness, including media handling; andGuidance for other stakeholders, including relevant statutory bodies.

19.For each theme (for example, contingency planning) and at each level of risk (above), Table 1 provides an introduction to the main activities that should be considered and the principle sources of guidance that are available. Note, however, that this table does not provide a definitive summary of legal obligations under the auspices of other relevant international organizations.

20.A further – cross-cutting – theme of capacity development is of very great importance and underpins the ability to respond in all themes and at all risk stages. Relevant guidance on capacity development is separately highlighted in Table 1.

Table 1. A conceptual map of response activities and the corresponding guidance available. Numbers relate to specific guidance listed in Section 1.3.

Major Themes

Risk level	Expert advice & integration within government	Risk assessment	Contingency planning-	Surveillance & early-warning (wild birds)	Epidemiological investigations (response & reporting)	Communication (CEPA) & media issues	Other stakeholders inc. relevant statutory bodies
Low riskNo known infection in geographical region	Identify relevant multi-disciplinary expertise [21].Establish an Ornithological Expert Panel (OEP – see Section 4) processes & arrangements [12].Identify OEP links with neighbouring countries.Develop information tools to assist decision making [06, 17, 18].	As part of the development of a contingency plan, establish arrangements for developing risk assessments.Undertake risk assessment in discussion with Ornithological Expert Panel (OEP – Section 4 [01, 02, 14, 20, 41].Develop information tools to assist decision making [06, 17, 18].	Develop contingency plan for appropriate area, including wetland sites [42, 14, 15, 16, 20], captive collections [44, 45, 54]) in consultation with stakeholders and experts [08, 09, 10, 41].Collaboration with neighbouring countries.Ensure contingency plans are in line with relevant international and national obligations, inter alia, for nature conservation and animal health [21].	Develop national strategy [25, 39, 319, 369], including:-Determining lists of potentially higher risk species [01, 03, 06, 18] and areas [06]-Consultation- International co-ordination.Determine and address capacity development needs.Implement strategy with appropriate methodology [65, 61, 66, 67, 64, 69, 68].Ensure provision of data to GAINS [64] and/or other reporting hub(s) [62, 63].	Identify relevant multi-disciplinary expertise [21].Establish arrangements with multi-disciplinary epidemiological teams.Establish protocols [55, 38, 41, 43].	Establish media strategy in context of the national contingency plan [08, 09, 75-80].Develop media tool kit [78, 79, 80] – including frequently asked questions, maps, positive stories, images, etc.Publish relevant explanatory materials/statement on appropriate web-sites.Identify organizational spokespeople and appropriately train them [75-80].	Develop and maintain contact networks with appropriate stakeholders and establish communication procedures.Establish dialogue regarding best practice biosecurity [26].Disseminate best practice health & safety guidance to relevant stakeholders [59, 55, 56, 57, 73 58].
Medium riskSpreading infection in wild birds or poultry in region****	Undertake risk assessment in discussion with OEP.	Update risk assessment in discussion with OEP and neighbouring countries/regions.	Implement appropriate processes of contingency plans.	OEP to consider need for enhanced surveillance.		Update media tool kit and explanatory materials [78, 79, 80].Consider briefing appropriate media on relevant issues.	Review and update contact network.Brief appropriate stakeholders via a contact network.Advise on relevant and necessary responses [26].
High risk Infection in neighbouring countries/ regions	Convene OEP.Update risk assessment.Exchange risk assessment with neighbouring countries/regions.	Update risk assessment in discussion with OEP and neighbouring countries/regions.	Implement appropriate processes of contingency plans.	OEP to consider need for enhanced surveillance.	Ensure preparedness of epidemiological investigation teams and wider contingency planning issues in the event of an outbreak.	Update media tool kit and explanatory materials [78, 79, 80].Brief appropriate media on the issues.Implement media strategy.	Review and update contact network.Brief appropriate stakeholders via a contact network.Advise on relevant and necessary responses [26].
Immediate riskActive infection in a country affecting either wild birds or poultry	Convene OEP.Use expert advice to guide epidemiological investigations.Use expert advice to guide local responses at the infected premise(s).Use expert advice to determine surveillance needs.	Update risk assessment in discussion with OEP and neighbouring countries/regions.Undertake formal reporting to OIE as appropriate.	Implement appropriate processes of contingency plans.	OEP to consider need for enhanced surveillance especially around infected premises and including potential bridge species.	Undertake epidemiological investigations around infected premise(s) involving relevant expertise.Communicate epidemiological findings with linked countries/regions.Publish results including negative results.	Update media tool kit and explanatory materials [78, 79, 80].Undertake regular briefings of appropriate media on relevant issues.Implement media strategy.	Review and update contact network.Undertake regular briefings of appropriate stakeholders via contact network.Advise on relevant and necessary responses [26].
Post infection (Period following an incursion of HPAI)	Review and update OEP procedures in light of lessons learnt [e.g. 27].	Review and update risk assessment procedures in light of lessons learnt.	Review and update contingency plans in light of lessons learnt.	Review list of potentially higher risk species and areas.Review and update surveillance strategy in light of lessons learnt.	Review and update epidemiological investigation strategy in light of lessons learnt.	Review and update media strategy in light of lessons learnt.	Review and update communication arrangements in light of lessons learnt.

Cross-cutting Issues

(Relevant at all risk levels)	Risk assessment	Contingency planning	Expert advice & integration within government	Surveillance & early-warning (wild birds)	Epidemiological investigations (response & reporting)	Communication (CEPA) & media issues	Other stakeholders inc. relevant statutory bodies
Capacity development	Develop information tools to assist decision making.	Ensure capacity development in addressed is contingency planning.	Develop information tools to assist decision making.	Determine capacity dev needs and address shortcomings.	Ensure adequate capacity to undertake investigations.	Training of spokespeople.

1.3 – A directory of good practice guidance concerning highly pathogenic avian influenza H5N1

21.This directory aims to provide an introduction to the increasingly large number of technical and other guidances that have been produced in recent years related to issues arising from the spread of HPAI H5N1.

22.The directory provides hyperlinks to publications that are accessible via the Internet, and it has also attempted to categorise such guidance with respect to its intended audience and its technical level (i.e., accessibility to various groups within society) and to indicate the language(s) available. The current listing is dominated by publications in the English language. It is hoped that future versions of this listing will contain a better representation of publications in other languages. Contracting Parties and others are encouraged to submit further examples of good practice guidance to Ramsar’s STRP so that this listing can be continually updated.Important note: The Ramsar Convention does not necessarily endorse any of the content of the external web links listed here. These are given solely in the context of their possible utility to Contracting Parties and others.

23. Levels of accessibility are roughly assessed as follows:Public Content accessible to untrained publicGeneral Content accessible to informed public, other stakeholder groups and interested parties, as well as trained professionalsTechnical Language and content aimed largely at professionals or technical specialists in the subject area concerned

Structure and content

24.Guidance documents are organized under the following topics and subtopics:Contingency planning and risk assessmentBackgroundGeneralNature reserves and wild birdsPrevention and controlBackgroundGeneralNature reserves and wild birdsCaptive collectionsPoultry holdingsVaccinationHealth & SafetySurveillance and early warning systemsGeneralMethodologyPast initiativesHealth & SafetyCommunication, education and public awareness (CEPA)General

Table 2. Directory of guidance materials related to avian influenza.

	AUDIENCE	LEVEL
CONTINGENCY PLANNING AND RISK ASSESSMENT
BACKGROUND
European Food Safety Authority (EFSA)01Opinion of EFSA panel on animal health and welfare and their scientific report on migratory birds and their possible role in the spread of highly pathogenic avian influenzaEnglish: http://www.efsa.europa.eu/en/science/ahaw/ahaw_opinions/1484.html02Opinion adopted by the AHAW Panel related to Animal health and welfare risks associated with the import of wild birds other than poultry into the European UnionEnglish: http://www.efsa.europa.eu/en/science/ahaw/ahaw_opinions/ahaw_op_ej410_captive_birds.html	Policy makers & scientistsPolicy makers & scientists	TechnicalTechnical
USGS National Wildlife Health Center(NWHC)03List of Species Affected by H5N1 (Avian Influenza)English: http://www.nwhc.usgs.gov/disease_information/avian_influenza/affected_species_chart.jsp	Policy makers & scientists	General
Centers for Disease Control and Prevention (CDC)04Wildlife Trade and Global Disease EmergenceEnglish: http://www.cdc.gov/ncidod/EID/vol11no07/05-0194.htm	Policy makers & scientists	General
Department for Environment, Food and Rural Affairs ()05Outbreaks of H5N1 HPAI virus in during 2005/2006: an overview and commentaryEnglish: http://www.defra.gov.uk/animalh/diseases/monitoring/pdf/hpai-europe300606.pdf	Policy makers & scientists	General
British Trust for Ornithology06Avian Influenza Incursion Analysis (through wild birds)English: http://www.bto.org/research/reports/Avian_flu.pdf	Policy makers & scientists	Technical
European Commission07National websites of EU Member States dealing with H5N1Various EU languages: http://ec.europa.eu/food/animal/diseases/controlmeasures/avian/nat_websites_en.htm	Policy makers & poultry sector	General
GENERAL
Food and Agriculture Organization (FAO)08Manual on the preparation of national animal disease emergency preparedness plansEnglish: http://www.fao.org/DOCREP/004/X2096E/X2096E00.HTM09National contingency and avian/human pandemic influenza preparedness plansVarious languages: http://www.fao.org/avianflu/en/strategydocs.html10Preparing for highly pathogenic avian influenza: a manual for countries at riskEnglish: http://www.fao.org/docs/eims/upload/200354/HPAI_manual.pdf	Policy makers & veterinary professionalsPolicy makersPolicy makers & poultry sector	TechnicalGeneralGeneral
World Organization for Animal Health (OIE)11Terrestrial Animal Health CodeEnglish:http://www.oie.int/eng/Normes/mcode/en_sommaire.htmhttp://www.oie.int/eng/normes/mcode/en_titre_1.3.htm (Section 1.3: Risk Analysis)http://www.oie.int/eng/normes/mcode/en_chapitre_2.7.12.htm (Section 2.7.12: Avian Influenza)	Policy makers, poultry sector & veterinary professionals	General
Ramsar Convention on Wetlands12Ornithological Expert PanelsEnglish: Section 4 of this Annex (Annex to Ramsar Resolution X.10)French: Section 4 of this Annex (Annex to Ramsar Resolution X.10)Spanish: Section 4 of this Annex (Annex to Ramsar Resolution X.10)	Policy makers	General
NATURE RESERVES AND WILD BIRDS
Ramsar Convention on Wetlands13Handbook 11: Inventory, assessment and monitoringEnglish: http://ramsar.org/lib/lib_handbooks2006_e11.pdfFrench: http://ramsar.org/lib/lib_handbooks2006_f11.pdf (Manuel 11: Inventaire, évaluation et suiv)Spanish: http://ramsar.org/lib/lib_handbooks2006_s11.pdf (Manual 11: Inventario, evaluación y monitoreo)14Wetland Risk Assessment FrameworkEnglish: http://www.ramsar.org/key_guide_risk_e.htmFrench: http://www.ramsar.org/key_guide_risk_f.htm (Cadre d’évaluation des risques pour les zones humides)Spanish: http://www.ramsar.org/key_guide_risk_s.htm (Marco para evaluar el riesgo en humedales)15The Ramsar ‘Toolkit’English: http://www.ramsar.org/lib/lib_handbooks2006_e.htmFrench: http://www.ramsar.org/lib/lib_handbooks2006_f.htm (La “boîte à outils” de la Convention de Ramsar)Spanish: http://www.ramsar.org/lib/lib_handbooks2006_s.htm (“Juego de herramientas” de la Convención de Ramsar)16Handbook 16: Managing wetlandsEnglish: http://ramsar.org/lib/lib_handbooks2006_e16.pdfFrench: http://ramsar.org/lib/lib_handbooks2006_f16.pdf (Gestion des zones humides)Spanish: http://ramsar.org/lib/lib_handbooks2006_s16.pdf (Manejo de humedales)	Site managersPolicy makers & site managersPolicy makers & site managersSite managers	GeneralGeneralGeneralGeneral
European Commission17Urgent preliminary assessment of ornithological data relevant to the spread of Avian Influenza in English: http://ec.europa.eu/environment/nature/conservation/wildbirds/birdflue/docs/rep_spread_avian_influenza_report.pdf18Ornithological data relevant to the spread of Avian Influenza in (phase II): further identification and first field assessment of Higher Risk SpeciesEnglish: **http://ec.europa.eu/environment/nature/conservation/wildbirds/birdflue/docs/spread_avian_influenza.pdf19Methodology for rapid assessment of ornithological sitesEnglish: http://ec.europa.eu/environment/nature/nature_conservation/focus_wild_birds/avian_influenza/pdf/3	Policy makers & scientistsPolicy makers & scientistsPolicy makers & site managers	TechnicalTechnicalGeneral
Health Protection Agency / Department for Environment, Food and Rural Affairs (United Kingdom)20Risk assessment: avian influenza in public parks/parkland & open waters due to wild bird posureEnglish:Assessment-July2006.pdf http://www.hpa.org.uk/infections/topics_az/influenza/avian/documents/AIParksandOpenWatersRisk Assessment-July2006.pdf	Public, captive collection managers & site managers	General
PREVENTION AND CONTROL
BACKGROUND
Ramsar Convention on Wetlands21Resolution IX.23. Highly pathogenic avian influenza and its consequences for wetland and waterbird conservation and wise use (8-15 Nov 2005, Kampala, Uganda)English:   http://www.ramsar.org/res/key_res_ix_23_e.htmFrench:     http://www.ramsar.org/res/key_res_ix_23_f.htm (Résolution IX.23. L’influenza aviaire hautement pathogène et ses conséquences pour la conservation et l’utilisation rationnelle des zones humides et des oiseaux d’eau)Spanish:   http://www.ramsar.org/res/key_res_ix_23_s.htm (Resolución IX.23. La gripe aviar hiperpatogénica y sus consecuencias para la conservación y el uso racional de los humedales y las aves acuáticas)	Policy makers & Ramsar administrative authorities	General
Food and Agriculture Organization (FAO)22Enhancing control of highly pathogenic avian influenza in developing countries through compensation: issues and good practiceEnglish: http://www.fao.org/docs/eims/upload//217132/gui_hpai_compensation.pdf23Highly Pathogenic Avian Influenza in AfricaEnglish: http://www.fao.org/docs/eims/upload//217651/hpai_strategy_africa_en.pdfhttp://www.rlc.fao.org/es/prioridades/transfron/aviar/default.htm24Epidemiology of H5N1 Avian Influenza in Asia and implications for regional controlEnglish: http://www.fao.org/ag/againfo/subjects/documents/ai/HPAI-Masseyreport.pdf25FAO Regional Office for Latin America and the Caribbean Spanish: http://www.rlc.fao.org/es/prioridades/transfron/aviar/default.htm	Policy makers & poultry sectorPolicy makersPolicy makers & poultry sectorPolicy makers & poultry sector	GeneralGeneralTechnicalGeneral
SCOFCAH/ORNIS26Summary Record of the Joint Standing Committee on the Food Chain and Animal Health (SCOFCAH) and of the Ornis Committee/SWG held in on 1 Dec 2006English: http://ec.europa.eu/food/animal/diseases/controlmeasures/avian/docs/scofcah_ornis_com_01122006_en.pdf	Policy makers	General
Avian Diseases (journal)27Lessons learned from Asian H5N1 outbreak control(Sims, L.D. 2007. Lessons learned from Asian H5N1 outbreak control. Avian Diseases 50: 174-181)English: http://www.ncbi.nlm.nih.gov/sites/entrez?term=17494550&cmd=search&db=pubmed	Policy makers & scientists	Technical
GENERAL
Emerging Infectious Diseases (journal)28[Tackling a] multifocal avian influenza (H5N1) outbreakEnglish: http://www.cdc.gov/eid/content/13/10/1601.htm	Policy makers	General
Eurosurveillance Weekly (journal)29Preventing introduction and spread of avian influenza among bird flocks in Europe: recommendations by European Animal Health PanelEnglish: http://www.eurosurveillance.org/ew/2005/050929.asp	Policy makers	General
Food and Agriculture Organization (FAO)30Recommendations on the Prevention, Control and Eradication of Highly Pathogenic Avian Influenza (HPAI) in AsiaEnglish: http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/27septrecomm.pdf31Emergency assistance for early detection and prevention of avian influenza in the Eastern Europe and regionsEnglish: http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/cd/documents/RAF3004d.pdf32Emergency assistance for early detection and prevention of avian influenza in Western AfricaEnglish: http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/cd/documents/RAF3016.pdf33Emergency assistance for early detection and prevention of avian influenza in the Middle East regionEnglish: http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/cd/documents/RAF3005.pdf34Emergency assistance for early detection and prevention of avian influenza in eastern and southern AfricaEnglish: http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/cd/documents/RAF3017.pdf35List of FAO avian influenza manuals and training materialsSpanish: http://www.fao.org/avianflu/es/manuals_es.html	Policy makers & poultry sectorPolicy makers & poultry sectorPolicy makers & poultry sectorPolicy makers & poultry sectorPolicy makers & poultry sectorPolicy makers, poultry sector & scientists	GeneralGeneralGeneralGeneralGeneralGeneral
Wetlands International36How to stop further outbreaksEnglish: http://www.wetlands.org/articlemenu.aspx?id=31c525ed-c4d5-491e-83d9-120dbf3979c1	Public, policy makers & scientists	General
BirdLife International37Guidance for public authoritiesEnglish: http://www.birdlife.org/action/science/species/avian_flu/pdfs/Guidance_Public_Authorities.pdf	Public & policy makers	General
Department for Environment, Food and Rural Affairs ()38Summary epidemiological report on a H5N1 HPAI case in turkeys in England, January 2007 (includes modus operandi of the Ornithological Expert Panel (OEP))English: http://www.defra.gov.uk/animalh/diseases/notifiable/disease/ai/pdf/epid_findings050407.pdf	Policy makers, poultry sector & scientists	General
European Commission39Council Directive 2005/94/EC of 20 December 2005 on Community measures for the control of avian influenza and repealing Directive 92/40/EECAll EU languages: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:32005L0094:EN:NOT40Commission Decision of 26 April 2004 approving contingency plans for the control of avian influenza and disease (Text with EEA relevance) (notified under document number C(2004) 1517)All EU languages: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:32004D0402:EN:NOT	Policy makers & poultry sectorPolicy makers & poultry sector	TechnicalTechnical
World Organization for Animal Health (OIE)41Terrestrial Animal Health CodeEnglish: http://www.oie.int/eng/Normes/mcode/en_sommaire.htmhttp://www.oie.int/eng/normes/mcode/en_chapitre_1.1.2.htm (Section 1.1.2: Notification of Diseases and Epidemiological Information to OIE)http://www.oie.int/eng/normes/mcode/en_chapitre_2.7.12.htm (Section 2.7.12: Avian Influenza)	Policy makers, poultry sector & veterinary professionals	General

NATURE RESERVES AND WILD BIRDS
Ramsar Convention on Wetlands42Guidelines for reducing avian influenza risks at Ramsar sites and other wetlands of importance to waterbirdsEnglish: Section 2 of this Annex (Annex to Ramsar Resolution X.10)French: Section 2 of this Annex (Annex to Ramsar Resolution X.10)Spanish: Section 2 of this Annex (Annex to Ramsar Resolution X.10)43Recommended ornithological information to be collected during surveillance programmes or field assessment of wild bird mortality events, especially at wetlandsEnglish: Section 3 of this Annex (Annex to Ramsar Resolution X.10)French: Section 3 of this Annex (Annex to Ramsar Resolution X.10)Spanish: Section 3 of this Annex (Annex to Ramsar Resolution X.10)	Site managersScientists, veterinary professionals, and site managers	GeneralGeneral
CAPTIVE COLLECTIONS (See also: VACCINATION)
European Commission44Commission Decision of 28 August 2007 concerning measures to prevent the spread of highly pathogenic avian influenza to other captive birds kept in zoos and approved bodies, institutes or centres in the Member StatesAll EU languages: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:32007D0598:EN:NOT	Policy makers & captive collection managers	Technical
British and Irish Association of Zoos and Aquariums (BIAZA)45Advice from the British and Irish Association of Zoos and Aquariums on avian influenzaEnglish: http://www.biaza.org.uk/public/pages/care/avian.asp	Captive collection managers	General
POULTRY HOLDINGS (See also: VACCINATION)
Emerging Infectious Diseases (journal)46Control of avian influenza in poultryEnglish: http://www.cdc.gov/ncidod/EID/vol12no09/06-0430.htm	Policy makers & poultry sector	General
Food and Agriculture Organization (FAO)47Prevention and Control of Avian Flu in Small-scale Poultry: A guide for veterinary paraprofessionalsEnglish: http://www.fao.org/ag/againfo/subjects/documents/ai/AIManual_VN2005(en).pdfFrench: http://www.fao.org/ag/againfo/subjects/documents/ai/AI-Manual-french.pdfIndonesian: http://www.fao.org/ag/againfo/subjects/documents/ai/AI_GuideIndonesia.pdfKyrgystan: http://www.fao.org/ag/againfo/subjects/documents/ai/Avian_Flu_kr.pdfLao: http://www.fao.org/ag/againfo/subjects/documents/ai/AIGuideParavets_lao_.pdfRussian: http://www.fao.org/ag/againfo/subjects/documents/ai/AI-Manual-russian.pdfSpanish: http://www.fao.org/ag/againfo/subjects/documents/ai/AI-Manual-spanish.pdfVietnamese: http://www.fao.org/ag/againfo/subjects/documents/ai/AIManual_VN2005(vn).pdf48Prevention and Control of Avian Flu in Small-scale Poultry: A guide for veterinary paraprofessionals in English: http://www.fao.org/ag/againfo/subjects/documents/ai/AIManual_VN2005(en).pdf49Prevention and Control of Avian Flu in Small-scale Poultry: A guide for veterinary paraprofessionals in CambodiaEnglish: http://www.fao.org/ag/againfo/subjects/documents/ai/AI-paravets-guide.pdf	Poultry sector & veterinary professionalsPoultry sector & veterinary professionalsPoultry sector & veterinary professionals	GeneralGeneralGeneral
VACCINATION
PloS Medicine (journal)50A comparative analysis of influenza vaccination programsEnglish: http://medicine.plosjournals.org/perlserv?request=get-document&doi=10.1371/journal.pmed.0030387	Policy makers, poultry sector & veterinary professionals	Technical
European Commission51Vaccination of poultry against highly pathogenic avian influenza H5N1 (Diva strategy)English: http://ec.europa.eu/food/animal/diseases/controlmeasures/avian/discussion_paper.pdf	Policy makers, poultry sector & veterinary professionals	Technical
European Food Safety Authority (EFSA)52Opinion of the Scientific Panel on Animal Health and Welfare (AHAW) related with the vaccination against avian influenza of H5 and H7 subtypes in domestic poultry and captive birdsEnglish: http://www.efsa.europa.eu/EFSA/efsa_locale-1178620753812_1178621165004.htm53Opinion of the Scientific Panel on AHAW on a request from the Commission related with the vaccination against AI of H5 and H7 subtypes as a preventive measure carried out in Member States in birds kept in zoos under Community approved programmesEnglish: http://www.efsa.europa.eu/EFSA/efsa_locale-1178620753812_1178620772568.htm	Policy makers, poultry sector & veterinary professionalsPolicy makers, captive collection managers & veterinary professionals	GeneralGeneral
British and Irish Association of Zoos and Aquariums (BIAZA)54Guidelines on vaccinating birds against avian influenzaEnglish: QA Vaccination.pdf http://www.biaza.org.uk/resources/library/images/BIAZA QA Vaccination.pdf	Captive collection managers and veterinary professionals	Technical
HEALTH & SAFETY
Centers for Disease Control and Prevention55Interim guidance for protection of persons involved in U.S. avian influenza outbreak disease control and eradication activitiesEnglish: http://www.cdc.gov/flu/avian/professional/protect-guid.htmSpanish: http://www.cdc.gov/flu/avian/es/protectionguid_es.htm (Guía provisional para la protección de personas que participen en actividades de control y erradicación de brotes de gripe aviar (o gripe del pollo) en EE.UU.)56Interim recommendations for persons with possible exposure to avian influenza during outbreaks among poultry in the English: http://www.cdc.gov/flu/avian/professional/possible-exposure.htm	Poultry sectorPublic & poultry sector	GeneralGeneral
US Department of Labor Occupational Safety & Health Administration (OSHA)57OSHA Guidance Update on Protecting Employees from Avian Flu (Avian Influenza) VirusesEnglish: http://www.osha.gov/Publications/3323-10N-2006-English-07-17-2007.htmlSpanish: http://www.scribd.com/doc/357117/avian-flu-guidance-spanish?ga_related_doc=1 (Orientación actualizada de OSHA acera de Cómo proteger a los empleados contra los virus de la gripe aviar (influenza aviar))	Poultry sector	General
World Health Organization (WHO)58Protection of individuals with high poultry contact in areas affected by avian influenza H5N1: Consolidation of pre-existing guidanceEnglish: http://www.who.int/csr/disease/avian_influenza/guidelines/high_contact_protection/en/index.html	Animal handlers & poultry sector	General
Food and Agriculture Organization (FAO)59Avian Influenza and Human Health: Risk reduction measures in producing, marketing and living with animals in AsiaEnglish: http://www.fao.org/ag/againfo/subjects/documents/ai/concmalaysia.pdf	Policy makers & poultry sector	General
SURVEILLANCE AND EARLY WARNING SYSTEMS
GENERAL
Food and Agriculture Organization (FAO)60Guiding Principles for Highly Pathogenic Avian Influenza Surveillance and Diagnostic Networks in AsiaEnglish: http://www.fao.org/docs/eims/upload//210749/Gui_principlesHPAI_july04_en.pdf	Policy makers & poultry sector	Technical
European Commission61Guidelines for AI surveillance in wild birds and poultry (in 2007/268/EC: Commission Decision of 13 April 2007 on the implementation of surveillance programmes for avian influenza in poultry and wild birds to be carried out in the Member States)EU languages: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:32007D0268:EN:NOT62EU Animal Disease Notification System (ADNS)English: http://ec.europa.eu/food/animal/diseases/adns/index_en.htm	Policy makers, scientists and veterinary professionalsScientists	TechnicalTechnical
World Organization for Animal Health (OIE)63OIE World Animal Health Situation - Information System and DatabaseEnglish: http://www.oie.int/eng/info/en_info.htm?e1d5	Policy makers, scientists & poultry sector	General
Global Avian Influenza Network for Surveillance (GAINS)64Website for the Wild Bird Global Avian Influenza Network for Surveillance (GAINS)English: http://www.gains.org/	Scientists & veterinary professionals	General
METHODOLOGY
Food and Agriculture Organization (FAO)65Wild bird HPAI surveillance: sample collection from healthy, sick and dead birds (AGA Manual No. 4)English: http://www.fao.org/docs/eims/upload/218650/manual_wildbird_en.pdfFrench: http://www.fao.org/docrep/010/a0960f/a0960f00.htmSpanish: http://www.fao.org/docrep/010/a0960s/a0960s00.htmChinese: http://www.fao.org/docrep/010/a0960c/a0960c00.htmRussian: http://www.fao.org/docrep/010/a0960r/a0960r00.htm66Wild birds and avian influenza: an introduction to applied field research and disease sampling techniques (AGA Manual No. 5)English: http://www.fao.org/ag/againfo/resources/en/manuals/manual5.pdf	Scientists & veterinary professionalsScientists & veterinary professionals	TechnicalTechnical
Wetlands International67Emergency assistance for early detection and prevention of avian influenza: Terms of reference for participants in field sampling missionsEnglish: Wetlands International internal guidance – available on request	Scientists & veterinary professionals	General
Wildfowl & Wetlands Trust (WWT)68WWT Wildfowl Catch ManualEnglish: WWT internal guidance – available on request.	Scientists & veterinary professionals	General
World Organization for Animal Health (OIE)69Terrestrial Animal Health CodeEnglish: http://www.oie.int/eng/Normes/mcode/en_sommaire.htmhttp://www.oie.int/eng/normes/mcode/en_chapitre_3.8.1.htm (Section 3.8.1: Guidelines for animal health surveillance)http://www.oie.int/eng/normes/mcode/en_chapitre_3.8.9.htm (Section 3.8.9: Guidelines for surveillance of avian influenza)	Poultry sector & veterinary professionals	General
PAST INITIATIVES
Wetlands International/CIRAD/FAO70Wild birds and Avian Influenza in Africa: summary of surveillance and monitoring programmesEnglish: http://wildbirds-ai.cirad.fr/index.php	Scientists & veterinary professionals	General
European Commission71Results of EU avian influenza surveillance in poultry and wild birdsEnglish: http://ec.europa.eu/food/animal/diseases/controlmeasures/avian/eu_resp_surveillance_en.htm	Policy makers & scientists	Technical
HEALTH & SAFETY
British Trust for Ornithology (BTO)72Disease from birds, with particular reference to avian influenzaEnglish: http://www.bto.org/ringing/diseases-from-birds.doc	Bird banders/ringers	General
Health & Safety Executive (United Kingdom)73Working with highly pathogenic avian influenza virusEnglish: http://www.hse.gov.uk/biosafety/diseases/avianflu.htm	Scientists	General
US Fish & Wildlife Service74List of guidelines for hunters and bird handlersEnglish: http://www.fws.gov/migratorybirds/issues/AvianFlu/WBAvianFlu.htm	Animal handlers & hunters	General
COMMUNICATION, EDUCATION AND PUBLIC AWARENESS (CEPA)
GENERAL
World Conservation (IUCN)75IUCN Species Survival Commission Media GuideEnglish: http://www.iucn.org/themes/ssc/for_members/media_guide.htm	Those responsible for briefing the media, public, policy makers	General
Science and Development Network76Dealing with the mediaEnglish: http://www.scidev.net/ms/sci_comm/index.cfm?pageid=191	Those responsible for briefing the media, public, policy makers	General
GREEN Communications77Green Guide to effective public relationsEnglish: http://www.greenblog.co.uk/files/guide-to-effective-pr.pdf	Those responsible for briefing the media, public, policy makers	General
Civicus78Civicus Toolkit on handling the mediaEnglish: the Media.pdf http://www.civicus.org/new/media/Handling the Media.pdf	Those responsible for briefing the media, public, policy makers	General
Scientific Task Force on Avian Influenza & Wild Birds79Avian influenza and wild birds information brochures (Avian Influenza & Wild Birds: What is their actual role in the spread of the virus?)English: http://www.aiweb.info/documents/AI_brochure_English.pdfFrench: http://www.aiweb.info/documents/AI_brochure_French.pdfSpanish: http://www.aiweb.info/documents/AI_brochure_Spanish.pdfRussian: http://www.aiweb.info/documents/AI_brochure_Russian.pdfArabic: http://www.aiweb.info/documents/AI_brochure_Arabic.pdfChinese: http://www.aiweb.info/documents/AI_brochure_Chinese.pdf	Those responsible for briefing the media, public, policy makers	General
Ramsar Convention on Wetlands80Handbook 4: Wetland CEPAEnglish: http://www.ramsar.org/lib/lib_handbooks2006_e04.pdfFrench: http://www.ramsar.org/lib/lib_handbooks2006_f04.pdf (Manuel 4: CESP-Zones humide)Spanish: http://www.ramsar.org/lib/lib_handbooks2006_s04.pdf (Manual 4: CECoP sobre los humedale)	Site managers & those responsible for briefing the media, public, policy makers	General

2) – Guidelines for reducing avian influenza risks at Ramsar sites and other wetlands of importance to waterbirds

2.1 – Summary

25.These guidelines have been produced in response to a request from Ramsar Contracting Parties at COP9 for guidance on practical measures to reduce risks of highly pathogenic avian influenza (HPAI) for managers of wetland areas. They are intended to reduce the potential risk of outbreaks of the disease at wetlands of national and international importance for waterbirds by proposing a range of measures that can be taken before any outbreaks have occurred.

26.Most of these measures should be systematically planned on the basis of a risk assessment for the site, within the context of site management plans and outbreak response plans (see guidance in Section 1).

27.The guidelines draw to a large extent on existing material, and links to sources are provided throughout.

28.Section 2.3 on risk assessment follows the Ramsar Convention’s Wetland Risk Assessment Framework (Ramsar Convention Secretariat 2007a). The application of this framework to assess the risks of HPAI occurrence at a site (i.e., a specific animal health problem) may have some shortcomings, but the general approach of problem identification, impact prediction, estimation of the extent of impacts, and overall assessment of the risk of adverse impacts, leading to risk management and reduction measures, monitoring and communication with all stakeholders, is recommended as good practice.

29.Section 2.4 on risk reduction (or management) measures describes how managers of an individual wetland or a system of wetlands and other protected areas establish systematic measures to reduce the overall risks of HPAI transmission, based on common principles. As the situation at each site will be different, specific risk reduction measures should be undertaken at each site so that local efforts can be focused on controlling the most significant risk factors. This section lists a range of measures that can be incorporated in site management plans to ensure a systematic and pre-emptive approach towards managing HPAI risks at sites.

30.Section 2.5 covers surveillance programmes, focusing on their application at sites. These are essential for better understanding the disease, monitoring its development, and contributing to early warning systems. They should incorporate the results of risk assessments that have identified those species likely to be at higher risk of carrying the HPAI H5N1 virus, as well as the best strategic design (including optimal selection of sampling sites) and methods of sampling these species. This requires action at many scales, including more effort at national and site levels to monitor the health of wild birds.

31.Section 2.6 deals with outbreak response planning – reducing the risks of significant impacts in the case of an HPAI outbreak, primarily through ensuring that procedures are in place for a rapid response. It lists specific questions for site managers to consider when preparing an outbreak response plan and a format for ornithological information to support response needs.

32.Although these guidelines are aimed at reducing the risks and impact of HPAI, they also provide a framework for managing other emerging or re-emerging diseases at wetlands, particularly infectious processes.

2.2 – Introduction

33.The guidelines are intended to reduce the potential for outbreaks of HPAI H5N1 of Asian lineage at wetlands of importance for waterbirds through a range of measures that can be taken by site managers before any outbreaks have occurred. Most of these measures should be systematically planned on the basis of a risk assessment for the site, within the context of site management plans and outbreak response plans. A holistic and participatory approach to the risk assessment and plans is advocated here in order to improve their effectiveness.

34.The purpose of these guidelines is to provide the managers of wetlands with a series of relatively simple procedures and actions that will effectively reduce the risks of avian influenza virus transmission among domestic birds, wild birds, and people.

35.The guidelines have been kept concise and relatively simple in order to facilitate their use in the widely varied circumstances of wetland areas worldwide. More detailed information can be obtained through the guidance directory in Section 1.3. Contact details of international organizations concerned with avian influenza and wild birds can be obtained from the Scientific Task Force on Avian Influenza and Wild Birds’ AIWEb website (http://www.aiweb.info).

36.The outbreak and spread of the HPAI H5N1 in recent years has led to widespread concern about the potential impacts on human health (especially the risk of a global influenza pandemic), the poultry industry, and the conservation of wild birds. These guidelines focus on the last aspect and are based on the available literature on HPAI H5N1 and the recommendations of international conservation conventions, FAO, OIE, and WHO, as well as selected national sources. The Scientific Task Force on Avian Influenza and Wild Birds in particular has coordinated international scientific advice on the conservation impact of avian influenza.

37.While there are numerous sources of information and advice on the HPAI H5N1, few of these relate to the management of natural areas for wild birds. Recent work for the European Union (Wetlands International & EURING 2006; Veen et al. 2007) identified species that might pose a higher potential risk of spreading HPAI H5N1 along their migration routes to the EU. Analyses of migration routes of these so-called ‘higher risk’ species (on the basis of ringing recoveries) identified wetland sites where such species concentrate. While this approach has not yet been applied to other regions, it is of particular relevance to these guidelines.

38.When planning control measures at individual wetland sites, it is essential that managers should obtain information on the respective national policies, legislative and administrative arrangements, and action plans and contingency plans through the related authorities for human health, animal health, and the environment in their countries.

39.Throughout these guidelines the term ‘poultry’ is defined, following OIE, as ‘domestic birds bred for meat, eggs, feathers, etc., including chickens, turkeys, ducks, geese, quail, etc.’.

Avian influenza and wild birds

40.Wild birds, especially waterfowl and waders/shorebirds, are the natural reservoir of low pathogenic avian influenza (LPAI) viruses. These hosts and their viruses have become well-adapted to each other over time and infection does not usually cause overt disease in wild birds, although recent studies indicate that some behavioural changes may occur in response to infection (van Gils et al. 2007). These low pathogenic viruses replicate mainly in the intestinal tract of aquatic birds and are usually transmitted in the faeces. Thus, transmission in aquatic birds is by the faecal-oral route, i.e., wetland habitats provide the natural source of infection for other individuals.

41.The HPAI H5N1 virus infecting poultry, other domestic animals, wildlife, and humans almost certainly originated from the mutation of a LPAI virus on poultry farms and/or markets in east Asia. The virus has spread rapidly within and between farms, taking advantage of local practices in the feeding, housing, slaughtering, and trade of domestic ducks, chickens and geese. Poor hygiene, overstocking, and mixing of different domestic animals greatly increases the risk of spreading the infection. As a result the virus is now considered to be endemic in poultry of east and southeast Asia (Scientific Task Force on Avian Influenza and Wild Birds 2006).

42.Close contact between wild birds and poultry can lead to cross-infection, from poultry to wild birds and from wild birds to poultry. This has caused mortality in many species of wild birds including swans, geese, ducks, cormorants, grebes, gulls, herons, egrets, storks, and raptors, with most reports coming from Europe and Asia.

43.It is clear that legal and illegal trade in domestic poultry has been a crucial factor in the spread of infection both locally and over long, even cross-continental distances, although its relative significance seems to have varied at different times and in different places (Gauthier-Clerc et al. 2007; Kilpatrick et al. 2006). However, analysis of genetic sequences and other largely indirect evidence suggest that wild migratory birds are also likely to have contributed to further spread (see Chen et al. 2006; Kilpatrick et al. 2006; Hesterberg et al. 2007). The relative importance of different modes of viral spread, however, is unclear in the present state of knowledge.

44.Further background information is provided in Appendix 1.

2.3 – Risk assessment

Introduction

45.The rapid emergence of HPAI H5N1, its high level of pathogenicity for poultry and some wild bird species, and its transmission to humans in close contact with poultry have together resulted in a major global response.

46.However, many aspects which may be important in the spread of this subtype of avian influenza virus are poorly understood, including its epidemiology in wild birds and other wildlife, its persistence in the environment, the exact migratory routes used by many bird species, the trade routes (both legal and illegal) used for poultry and poultry products, and the extent of its spread by both the legal and illegal trade in wild birds. At the site level, often little quantitative information is available on the assemblage of bird species present in any particular month of the year, their use of neighbouring areas, and the dynamics of local wetland ecosystems as well as of local poultry enterprises.

47.UNEP (2006) recommends that all countries should undertake risk assessments which should be transparent, structured, and science-based and make use of all available knowledge. In the face of all this uncertainty, the development of accurate risk assessments for both countries and individual wetland sites is problematic. This reflects the need to give priority to applied research, monitoring, and surveillance so that risk assessments and related management actions can be more targeted and accurate. UNEP (2006) provides recommendations on data, information and research needs, emphasizing the importance of enhanced field surveillance efforts.

48.However, it is important to make efforts using the best available information to reduce risks at Ramsar sites and other wetlands, starting with a site risk assessment.

49.The Ramsar Convention’s Wetland Risk Assessment Framework (Ramsar Convention Secretariat 2007a) provides a mechanism for predicting and assessing change in the ecological character of wetlands, and it promotes the usefulness of early warning systems. This framework is outlined in Figure 1 and explained further in Ramsar’s Handbook on Inventory, Assessment and Monitoring (Ramsar Convention Secretariat 2007a). The application of this framework to assess the risks of HPAI occurrence at a site may have some shortcomings, as Ramsar’s Wetland Risk Assessment Framework was not designed with a specific animal health problem in mind. However, the general approach of problem identification, impact prediction, estimation of the extent of impacts, and overall assessment of the risk of adverse impacts, leading to risk management and reduction measures, monitoring and communication with all stakeholders, can still be recommended as good practice.Figure 1. - Model for wetland risk assessment (Ramsar Convention Secretariat 2007a)

Step 1 – Problem identification

50.This step involves recognizing the nature of HPAI H5N1 pathogenicity, means of transmission, etc. While much about the virus and epidemiology of the disease remains unknown, some key points are summarized below (see Appendix 1 for more details):

i)HPAI H5N1 has infected a wide range of birds and some domestic and wild mammal species.

ii)The virus has shown high virulence in most poultry, and infected birds have usually died quickly; there is some evidence that some experimentally infected waterbirds can survive while shedding virus (e.g., ducks, geese, swans and gulls: Chen et al. 2006; Hulse-Post et al. 2005; Brown et al. 2006; Brown et al. 2008);

iii)Cross-infection can occur between domestic / captive birds and wild birds (in both directions), although actual transmission mechanisms are largely undocumented.

iv)Some species are thought to be at a higher risk of infection than others due to their behavioural and ecological characteristics (Wetlands International & EURING 2006; Veen et al. 2007).

v)Although information is still lacking, there is likely to be great variability in the survival of virus in the environment, especially in faecal and other organic material, with temperature, pH, salinity and UV radiation all affecting viral viability.

51.It is therefore important to gather information on ecological aspects of, and human activities within, a site to ensure that the problems can be subsequently both quantified and qualified.

Step 2 – Identification of the adverse effects

Timing of possible outbreaks

52.The potential adverse effects will depend largely on which bird species are present at the site at different times of the year (residents, breeding visitors, non-breeding visitors, passage migrants, and nomadic or irruptive species). The seasonal timing of an outbreak will significantly affect the risks to bird populations owing to the varying presence of different species. Similarly, there may be other relatively predictable times of increased risk due to people and poultry activities, for example, during times of poultry movements, times when people or vehicular access to the site is greater, or times when there is application of fertiliser which may contain potentially infected poultry manure.

Bird distribution on site

53.Bird species occupy different parts of the site according to habitat preferences and daily behavioural patterns (feeding, roosting, bathing/drinking). Most bird species are more sedentary during the breeding and moulting season, remaining within breeding territories or on moult sites.

54.Some species will be present in dense flocks, some in loose dispersed flocks, and others as small groups or individuals. Most species will mix with other species at a site during the course of their stay.

55.Some bird and mammal species will remain far from human habitation, while others are attracted as it offers benefits such as food sources, shelter, nesting and safety from predators. These species, such as sparrows, starlings, crows, pigeons, rats and mice have the potential to carry disease between industrial or domestic poultry and wild birds, and thus they are known as "bridge species" (see Highly Pathogenic Avian Influenza Infection Route Elucidation Team 2004; Veen et al. 2007).

Presence of species of high conservation importance

56.The presence of globally threatened species (more than 1% of a biogeographic waterbird population or more than 20,000 waterbirds) is among the criteria which determine the international importance of a wetland for waterbirds. Important Bird Area criteria include the presence of restricted range and endemic species. Consideration of species of high conservation importance should be a priority during risk assessments, with the aim of reducing the level of risks to such species.

57.It should be noted that HPAI H5N1 has also infected several mammal species, with scavengers and predators of dead birds likely to be most at risk (see Appendix 1).

Step 3 – Identification of the likely extent of the problem

58.Prediction of the extent of HPAI outbreaks at a site is difficult, in view of the scarcity of information about outbreaks in wild birds. Points for site managers to consider are:If the outbreak occurs in poultry, the biosecurity of the facility, early diagnosis of the disease, and speed of response in controlling the outbreak and preventing its further spread are all of critical importance.If poultry and their wastes are kept in biosecure facilities away from the wetlands, the risks of cross-infection to wild birds should be much reduced.The virus can survive in water and spread through wetlands. Waste from poultry facilities should not be allowed to enter wetlands, and for the same reason water supplies for poultry facilities should come from clean sources.Outbreaks in wild birds appear to have been largely self-limiting – e.g., Jungle Crows Corvus macrorhynchos in Japan in 2004 (see Highly Pathogenic Avian Influenza Infection Route Elucidation Team 2004; Sabirovic 2006) – but recorded mortality has been high in some situations, e.g., at Qinghai Lake, China, in May 2005.Some species appear to be more vulnerable to infection, such as swans, ducks and grebes.Wild birds often move outside the wetland’s boundaries to other areas in the surrounding landscape. For instance, ducks, geese, swans and cranes may feed on agricultural fields and use the wetland for roosting. Fish-eating birds like cormorants may commute between wetlands, rivers, fishponds. and coastal areas. In such cases, wider assessments of the risk of cross-infection and spread are thus needed.

Step 4 – Identification of the risk

59.This involves integrating the results from the assessment of likely effects (Step 2) with those from the assessment of the likely extent of the problem (Step 3). A range of techniques exist for estimating risks, often depending on the type and quality of likely effects and their extent. Mapping of the assessments with GIS can be used to link the effects to impacts (e.g., poultry facilities on or near the site, other human activities, distribution of key species at the site across different seasons, seasonal changes in water levels leading to concentrations of wild bird species or wild and domestic birds, important roost sites (either temporary or permanent), wetland margins and crop patterns in adjacent landscapes).

60.This may indicate that the risks caused by an outbreak are higher during the peak migration and non-breeding period for some sites – or the opposite for other sites which have, for example, breeding waterbird populations in summer and are frozen during the winter.

61.Also, the risks posed by infection at sites containing high concentrations of birds (e.g., dense flocks of swans, geese, ducks and cranes) may be relatively high if there are significant infection routes (perhaps bridge species, presence of captive birds, poultry, or feeding stations).

2.4 – Risk reduction measures

Principles

62.Wetland site managers can implement a series of measures that should effectively reduce the risks of HPAI transmission between domestic birds, wild birds, and people at their sites. As the situation at each site will be different, risk reduction measures should be undertaken at the scale of individual sites so that local efforts can be focused on controlling the most significant risk factors.

63.However, managers of individual sites and wetland systems can also put in place systematic measures which should reduce the overall risks of HPAI transmission across all sites. The general principles of these measures are to:

i)physically separate wild birds and domestic/captive birds (including poultry), their food and water sources, and their waste where this is feasible;

ii)improve biosecurity arrangements for domestic/captive birds;

iii)control environmental transmission routes for the virus on the site and, where appropriate, when leaving the site, e.g., via wild, captive or domestic birds and fomites (inanimate contaminated objects such as footwear or vehicle wheels);

iv)improve surveillance and reporting of the health of domestic/captive birds and wild birds;

v)improve the knowledge base on the use of the site by wild birds and potential bridge species; and

vi)be fully prepared with a response plan in the event of an outbreak (see Section 2.6).

64.There is wide international consensus that attempting to control HPAI through responses such as culling or disturbing wild birds, or destroying wetland habitats, is not feasible and should not be attempted, not least since it may exacerbate the problem by causing further dispersion of infected birds. Resolution IX.23 of the Ramsar Convention on Wetlands states that the "destruction or substantive modification of wetland habitats with the objective of reducing contact between domesticated and wild birds does not amount to wise use as urged by Article 3.1 of the Convention, and also may exacerbate the problem by causing further dispersion of infected birds". These conclusions were also highlighted by the Convention on Migratory Species (CMS) Resolution 8.27 and the African-Eurasian Waterbird Agreement (AEWA) Resolution 3.18.

Management planning

65.Wetlands, particularly Ramsar sites, are most effectively managed through site management plans (Ramsar Convention Secretariat 2007b; Chatterjee et al. 2008). Wetland management plans provide a systematic approach to the maintenance of conservation values, sustainable use of natural resources, and other land uses including research, education, and economic activities. Management plans provide a basis for controlling land uses and other activities within the relevant wetland areas when supported by legislation and regulations, and when there is a strong relationship between the management authorities and local stakeholders (e.g., through participatory management approaches and environmental education programmes). Management plans still provide a systematic means of implementing policies and initiatives if these enabling conditions are less than ideal.

66.Local measures related to reducing HPAI risks will usually be related to site managementobjectives concerning the following subjects:

A.conservation of waterbird populations;

B.conservation of threatened or endemic bird species;

C.captive breeding/reintroduction of wild bird species on site;

D.agricultural practices within, adjacent to, and upstream of the site;

E.sustainable use of natural resources (including hunting);

F.human access to different parts of the site;

G.communication, education and public awareness programmes; and

H.stakeholder participation and inter-agency communications.

A. Conservation of waterbird populations

67.One of the main concerns for reserve management will be to maintain the value of the site for waterbird populations, although the details will vary by site, e.g., breeding, staging, and/or over-wintering birds. Reserve management needs to have reliable information on the distribution of these birds across the site and surrounding areas in different seasons, supported by an ongoing monitoring programme.

68.In many cases the parts of the sites used by these birds will be distant from human activities due to factors such as habitat distribution, protection, regimes and disturbance. Situations can occur, however, when wild birds will inevitably come into close proximity with people and their activities:

i)small or linear sites surrounded by dense human populations (e.g., coastlines and rivers near cities, lakes near urban centres);

ii)small sites located in intensive agricultural landscapes or densely populated rural areas;

iii)sites where feeding of wild birds occurs, either by site managers or the public;

iv)sites where domestic/captive birds are present on the wetlands or around their margins, or on water courses that drain into them;

v)sites where wild birds feed on agricultural land inside or around a protected area; or

vi)large sites that include human settlements and are used for natural resource exploitation (fishing, hunting, collection of other wetland products, grazing, etc.).

69.In general, best practice measures should be put in place to minimize contact between wild bird populations and domestic/captive birds (including poultry) and their waste. Some of these measures are outlined in Section 2.4.

70.In situations of heightened risk, further measures should be taken to minimize contact between wild bird populations and domestic/captive birds (including poultry), as well as people, although this may be difficult to achieve in some situations. Some practical steps that can be taken are:

i)to zone land uses to separate human activities;

ii)to restrict human and vehicular access to those parts of the site where contact with wild bird populations is minimal, in the case of virus circulation at the site or in its surroundings, in order to reduce risk of onward spread of infection and minimise human health risks. This can be done through management zones, controls on vehicle access, fencing, etc. (see Section 1.3 for examples);

iii)to further constrain movements of free-flying or feral birds;

iv)to prohibit use of live decoy birds for hunting/trapping, releases of birds for hunting activities, and "merit releases" of captive birds (the traditional custom of releasing caged birds at certain times of the year as part of religious practices, especially in Asian countries);

v)to prohibit public feeding and hunting of wild birds in the case of HPAI outbreaks;

vi)to consider alternatives to the feeding of wild birds by reserve managers in order to avoid over-concentration of wild birds and related disease transmission risks; and

vii)to promote public education to raise awareness of HPAI, the risks it poses, and some simple precautions and response actions.

71.Regulations may be required to ensure enforcement of the above measures.

B. Conservation of threatened or endemic bird species

72.For threatened or endemic species, generally the same measures as for other waterbird populations should be undertaken, although any restrictions on access and activities would be for those parts of the site used by the threatened species. Effective conservation measures will require detailed information on the distribution of these species at the site (including those areas used for feeding, bathing, roosting, and nesting, and seasonal changes in these), supported by monitoring programmes.

C. Captive breeding/re-introduction of wild bird species on site

73.According to D. Armstrong, "Disease is increasingly recognized as a significant risk factor in conservation programs involving animal movements such as reintroduction or translocation. Disease risk poses threats not only to the species on which programs are focused but also to other species that share the habitat. The concern over disease processes and their impact extends across diverse areas of interest including the fields of conservation biology, wild and zoo conservation management and veterinary medicine as well as to agricultural medicine and human medical fields. However disease risk has proven to be complex and difficult to assess and quantify in the context of a conservation program. The growing recognition that disease issues can profoundly affect the viability of populations and consequently the success or failure of conservation programs has led to diverse efforts by individuals and groups to develop some rational means to:

i)assess the risks that disease poses to these programs;

ii)develop well reasoned understandings of the factors and issues involved; and

iii)make reasonable decisions based on these assessments." (Armstrong et al. 2003).

74.Some wetland protected areas maintain collections of captive wild birds, for public education and display, research, captive breeding and release programmes to bolster wild populations of rare and endangered species. In general, such collections of captive birds should not be allowed to mix with wild birds – they should be kept in aviaries and not allowed to roam freely around the site. Preventing wild birds such as sparrows, starlings, pigeons, crows and gulls from entering enclosures is difficult unless they are completely enclosed with roof-netting and sheltered feeders are provided. See Section 1 for examples of guidelines.

75.In addition, in order to reduce virus transmission, water and waste from captive bird collections should not be allowed to enter natural wetlands. This will be difficult to achieve in some sites with established collections without the construction of water management structures or water treatment facilities.

76.Birds to be released from the captive breeding facility as part of reintroduction programmes should undergo thorough pre-release health screening as recommended by IUCN’s Reintroduction Specialist Group (IUCN 1998).

77.There are many existing guidelines on good health care and biosecurity for poultry and captive birds, e.g., reducing risks from personnel movements, bird movements, and contaminated food and water – see Section 1 for examples, including FAO guidelines on avian influenza and keeping small-scale poultry (in different languages).

78.Captive bird populations should be kept under surveillance for HPAI and other infectious diseases, sick birds should be quickly quarantined, and causes of death should be investigated in a timely manner.

79.It is worth emphasizing that under unusual circumstances such as crowding, HPAI H5N1 could be devastating. The crowding of birds can be regarded as a pervasive threat, with HPAI H5N1 as just one example among many infectious diseases that could lead to significant mortality.

80.In view of the significant risks posed by a potential outbreak of HPAI H5N1, collections of high conservation value species should develop and test contingency plans (using similar principles to those within these guidelines). These should include having good biosecurity arrangements in place, and managers should consider dispersion to separate cage facilities or sites to reduce risks. Where appropriate, consideration should be given to vaccination of captive birds with the aim of reducing mortality and potential viral shedding.

81.Wildlife rehabilitation facilities should also be reviewed for biosecurity and preferably kept separate from captive bird collections to reduce risks of introducing disease.

D. Agricultural practices within, adjacent to, and upstream of, the site

82.There are a number of agricultural practices which have the potential to increase the risks of HPAI infection on site, among which are:

i)intensive poultry farming (chickens, turkeys, quail, ducks and geese);

ii)domestic poultry rearing (generally small scale for subsistence) and rearing exotic birds (pigeons, pheasants, ornamental waterbirds, etc.);

iii)draining of waste water and poultry wastes into drains that are connected to wetlands;

iv)spreading organic manure from poultry farms as fertilizer on farmland; and

v)using fish food that includes poultry manure as an ingredient for aquaculture.

83.In general, intensive poultry rearing is not a suitable activity for a wetland that is important for waterbirds, and this should be reflected in the management plan for the site and the management regime for the wetland. This may become a cause of conflict where intensive farms already exist, and often wetlands are considered suitable environments for free-range duck farming. In such cases, the options include:

i)improving the biosecurity of the farm as far as possible so that there is no connection with wild birds or the wetland system;

ii)relocating the farm to another place with no connection to the wetland system; or

iii)closing the farm down and compensating the owners.

84.Which approach is appropriate will need to be determined locally.

85.Small-scale poultry rearing is harder to control (see Section 1.3), but in general birds should be kept indoors or in an enclosure and off the wetland system. If the risk is considered to be high, the activity could be banned in certain management zones within a wetland protected area.

86.Manure from intensive poultry farms is commonly used as a fertilizer on agricultural land. It is recommended that this practice should be banned completely within wetlands in order to reduce disease risks. The option of controlled usage in specified areas (e.g., away from wetlands) can be considered, but attention should be paid to spillage along access routes, drainage off fields into the wetlands, and use of fertilized fields by wild birds. In these situations, a pre-treatment for poultry manure through heat or sun-drying that inactivates viruses is recommended.

87.Any fish food used on-site for aquaculture should not include poultry manure or other poultry byproducts as an ingredient. Alternative foods are available.

E. Sustainable use of natural resources (including hunting)

88.Public access to parts of the wetland site can provide the benefit of improved reporting of unusual occurrences of sick or dead birds, especially if public education is conducted.

89.In the event of a reported HPAI outbreak at or near a site, it is recommended that management authorities contact hunting representatives and immediately stop hunting and trapping of wild birds at the site until further notice. Continued shooting may cause infected birds to disperse as a result of disturbance. Additionally, hunters are at increased risk of infection from handling killed birds and therefore should be warned (see health and safety section below).

90.The use of live decoy birds should be prohibited at high risk sites. European Union Member States, Decision 2005/734/EC elaborates on conditions where the use of live decoys may be allowed, including individual numbered bands on decoy birds and biosecurity measures for their upkeep (European Commission 2005). This guidance may be useful outside the EU as well.

F. Health and safety aspects

91.The main risks involved through the use of natural resources relate to bringing people into close contact with wild waterbird populations, placing people theoretically at risk of HPAI infection from wild birds. Where an assessment of the risk suggests that virus is not circulating in poultry or wild birds in the geographical area concerned, then no specific control measures are considered necessary. It is worth noting that previous live wild bird surveillance suggests that prevalence is low even where there have been active outbreaks of HPAI H5N1 in poultry.

92.General advice should be provided to the public not to handle sick wild birds or those found dead and to report any unusual incidents to a specified authority immediately. An emphasis should be placed on good hygiene practices such as washing hands after handling any birds, and not eating, drinking or smoking until hands have been washed. More detailed guidance is available from a number of sources listed in Section 1.3.

93.Hunters (including waterbird trappers) and bird ringers/banders are at a slightly higher risk because they handle freshly killed or live wild birds. Guidelines for hunters and bird ringers/banders are available on a number of websites (Section 1.3). Guidance generally encourages good hygiene practices such as washing hands after handling killed birds; de-feathering in well-ventilated areas; not eating, drinking or smoking until hands have been washed; and ensuring that shot birds are cooked properly.

G. Human access to different parts of the site

94.As noted above, public access to parts of the site can provide the benefit of improved reporting of unusual occurrences of sick or dead birds, especially if public education is conducted.

95.At times of low risk, i.e., when there have not been reports of HPAI in the region, there is no reason to impose additional controls on human access. At times of increased risk, e.g., when HPAI has been reported in the region, restrictions should then be considered. Management zoning for wetland protected areas should seek to create zones where important feeding and roosting concentrations of migratory waterbirds, breeding colonies, and rare and endangered species are not disturbed by human presence. Regular human disturbance effectively reduces the extent of suitable habitat and increases the stress on individual birds through reduced feeding opportunities and increased energy expenditure and may lead to increased disease susceptibility. Certain activities such as hunting, jet-skis, and speedboats create more disturbance than, for example, walking or cycling.

96.For health and safety advice for the general public, researchers, hunters, ringers/banders and others, see above or Section 1.3.

H. Communication, education and public awareness programmes

97.Public education is an important proactive measure that site managers can take in order to ensure that local stakeholders are informed with sound, balanced factual information about HPAI, the risks it poses, and the measures that they can take to protect themselves. It should also indicate how they can contribute towards reducing HPAI risks at the site and provide clear information about the communication lines in case of an outbreak.

98.It is suggested that the main target groups for HPAI awareness programmes should be members of any existing site management committee (such as local government agencies, community leaders, hunting and trapping associations, NGOs), local residents and users of the wetlands, and schools. Local public health and veterinary services should always be involved.

99.Communication needs to be tailored for the local situation and kept simple (see Alders & Bagnol 2007 and other guidance sources in Section 1).

100.Simple information leaflets or posters in local languages are among the most effective ways of reaching a wide range of people around the site.

101.Reporting of dead or sick birds by the public and others should be encouraged as part of surveillance programmes (see Section 2.5), with procedures for simple reporting systems communicated widely.

I. Stakeholder participation and inter-agency communications

102.Wetland site managers need to appreciate the wide range of agencies that may be involved in an HPAI outbreak response, from human and animal health professionals to local government, law enforcement professionals, and environmental authorities. Indeed, one of the major challenges posed by HPAI is the need for efficient inter-agency coordination among these stakeholders. The formation of national committees including all relevant organizations has been found valuable by several Contracting Parties and is recommended good practice (see also Sections 1 and 4). This needs to include coordination at a local level as well.

103.These coordination mechanisms should be agreed and set out in an outbreak response plan (see Section 2.6). The outbreak response plan should be shared with all key stakeholders so that it can be followed correctly. All contingency and communications plans need to be formulated, and relationships developed, in ‘peacetime’, i.e., prior to increased risk of disease. The running of scenario-based exercises will help to ensure that plans are fit for purpose.

104.Site management plans provide a practical framework for establishing measures to minimize HPAI risks on a site specific basis. These should be discussed and agreed with stakeholders so that they can be implemented efficiently, with local cooperation and support. It is recommended that public education measures be undertaken first, so that the stakeholders understand the risks involved and how they can contribute towards the collective security of the site.

2.5 – Wild bird surveillance

105.Comprehensive surveillance programmes are essential for better understanding the disease, monitoring its development, and contributing to early warning systems. They should incorporate the results of risk assessments that have identified those species likely to be at higher risk of carrying HPAI H5N1, as well as the best strategic design (including optimal timing of surveillance and selection of sampling sites) and methods of sampling these species. This requires action at many levels, including more effort at national and site levels to monitor the health of wild birds. Interest groups, such as hunters and birdwatchers, can play a vital role in the monitoring and reporting of dead birds or unusual mortality, provided their members are trained to minimise risks of self-infection and spread of the disease. In addition to bird trappers supplying samples for active live bird surveillance, hunters can also be useful for supplying samples from birds killed as part of normal hunting activities.

106.Significant efforts have already been made to try to understand the role of wild birds as vectors of HPAI H5N1, as well as the actual and potential impact of the virus on wild populations of conservation concern. Many countries have initiated or reinforced surveillance programmes aimed at determining the presence and extent of the virus in wild bird populations.

107.In 2005, a Global Avian Influenza Network for Wild Bird Surveillance (GAINS) was established in order to build capacity for field operations for collection of samples from wild birds, improve the understanding of virus strains and transmission of influenza viruses in wild birds, and disseminate information to all levels of governments, international organizations, the private sector, and the general public.

108.Surveillance should:

i)be undertaken with clearly set objectives;

ii)be conducted with standardised protocols in line with national and international programme requirements, including appropriate consideration for health and safety and legal and ethical aspects and in cooperation with relevant local and national authorities;

iii)strive always to identify birds to species level and report these data (see guidance in Section 3), where possible including broader contextual epidemiological data (e.g., age, sex, and proportion of population affected);

iv)consider monitoring methods that are both active (sampling live or shot/killed birds, or active targeted dead bird surveillance) and passive (wider sampling of birds found dead);

v)establish sampling methods that follow recognized standard protocols (e.g., major FAO guidance documents listed in Section 1.3);

vi)involve, as appropriate, public reporting of target species’ mortality and morbidity. Contact numbers and procedures for reporting dead and sick birds should be widely publicised;

vii)ensure high quality data with appropriate validation procedures;

viii)ensure that results are reported in a timely fashion to ensure their maximum utility, including use of initiatives such as GAINS; and

ix)be coordinated at a subnational, national and international level.

2.6 – Outbreak response planning

109.The final and crucial step concerns reducing the risks of significant impacts in the case of an HPAI outbreak, primarily through ensuring that procedures are in place for a rapid response. Outbreaks of HPAI H5N1 among wild birds typically occur unexpectedly, confronting site managers with an emergency situation that demands immediate action. Managers, together with local and national authorities, will have to take decisions about restricting human use of the site, monitoring bird mortality, and possibly sampling to assess presence and extent of infection.

110.It is important to note that national veterinary authorities are responsible for responses to HPAI H5N1 cases in wild birds. The Chief Veterinary Officers of the 170 member countries of OIE have obligations to report to OIE all cases of HPAI in wild birds and any control measures undertaken. Communication to the public also falls both within their competence, as well as that of respective public health authorities, and this must be handled with care. Site managers should always ensure full cooperation with relevant authorities and should inform themselves of national and other policies before outbreaks occur.

111.Specific questions for site managers to consider when preparing an outbreak response plan include:What are the existing national and/or subnational regulations, plans or guidelines for HPAI outbreaks?Who are the responsible human health, animal health, and environmental protection authorities? Contingency plans should provide contact details (such as mobile phone numbers) so that rapid contact can be made with key individuals.What equipment needs to be kept on site to respond to an HPAI outbreak? Personal protective equipment, cleansing and disinfection equipment, and storage facilities for samples are amongst items to be considered.If dead or sick birds are found, what procedures should be followed in order to confirm the cause of death?Who needs to be informed at a local level? Contact details should be gathered in advance.At what stage should control measures be put in place?How will the public be informed and when? Is there a standard message that can be prepared in advance and used in the event of an outbreak?How will the media be dealt with? Is there a standard message that can be prepared in advance and used in the event of an outbreak?What controls on access to the site are required? How will these be implemented? Are cleansing and disinfection facilities available for decontaminating vehicles, etc.?How can the local spread of the disease be quickly contained?What measures are needed to protect reserve staff and their families, or others, living on site?Who are the local ornithological and related experts who can assist rapid response measures in the case of an outbreak? Contact details should be gathered in advance.Where can the necessary information on bird distribution, movements and other related information, such as existing HPAI surveillance data, be accessed?

112.As for formation of stakeholder groups and communication strategies, full outbreak response plans need to be formulated in ‘peacetime’, i.e., before risk of HPAI outbreaks. Moreover, these plans need to be tested by scenario-based exercises. Such exercises involving all stakeholders will improve preparedness by both fine-tuning plans and providing staff training.

113.Any outbreak of HPAI H5N1 in a wetland site in domestic/captive or wild birds will also lead to a series of questions, which necessitate quick answers. Such questions include:How many birds are affected and which species are involved? What proportion of the population does this constitute?Are there ‘higher risk’ species⁴ present and in what numbers?⁴To date, only identified within Europe (Wetlands International & EURING 2006; Veen et al. 2007).Are there concentrations of roosting/nesting birds that use the site?Is there a special risk for transmission of the virus to and from poultry in the neighbourhood and, if so, which species can be expected to be involved?Are there endangered species present which might need special attention and/or protection?Are there any neighbouring sites to which the virus might spread because the sites are commonly used by the same birds?What is the position of the site in the flyways of migratory waterbirds and can any prediction be made with respect to spread of the disease at a larger geographical scale?What is the timing of migration for higher risk species occurring at the site?

114.In order to find answers to these questions, it is necessary to locate quickly and analyse ornithological data that might be managed by different organizations and/or individual ornithologists.

115.A draft Rapid Assessment Format for ornithological data in case of an outbreak of HPAI H5N1 is given by Wetlands International & EURING (2006). Its purpose is to give guidance to site owners and site managers to help them prepare for an outbreak of HPAI H5N1 in their wetland area. Since wetland sites vary greatly with respect to size, habitat characteristics, avifauna, human use, and other aspects, the format provided is of a very general nature. Its main purpose is to guide and stimulate site managers to seriously consider possible future events, to prepare for an outbreak of HPAI H5N1, and to develop a strategy in anticipation of the possible spread of the disease to their site.

116.The draft Rapid Assessment Format was tested at four sites in Europe and west Africa. The format lists the following site-related information and attributes which are considered to be fundamental in preparing for an HPAI H5N1 outbreak:

1)General information on the site (location, size, ownership);

2)Short description of the general and ecological characteristics of the site (accessibility, habitat characteristics, human use);

3)Occurrence of vulnerable bird species (status, numbers and seasonal presence of higher risk species, species with a high "contact risk with poultry", and endangered species);

4)Places with high concentrations of vulnerable bird species within the site;

5)Local movements of vulnerable bird species to neighbouring sites;

6)Position of site in the flyway and consequences of bird movements for further spread of HPAI H5N1 virus;

7)Human use of the site and any disturbance effects;

8)Existence of poultry farms within a radius of 10 km of the site (although it should be noted that many species of birds have far greater daily ranges than this);

9)Measures to be considered in case of an outbreak; and

10)Data sources.

2.7 – References

AIWEb. 2008. Useful links. Available from http://www.aiweb.info/document.aspx?DocID=14.Alders, R.G. & Bagnol, B. 2007. Effective communication: the key to efficient HPAI prevention and control. World’s Poultry Science Journal 63: 139-147.Armstrong, D., Jakob-Hoff, R. & Seal, U.S. (eds.). 2003. Animal movements and disease risk. Fifth ed. CBSG, Apple Valley, Minnesota, USA.Brown, J.D., Stallknecht, D.E., Beck, J.R., Suarez, D.L. & Swayne, D.E. 2006. Susceptibility of North American ducks and gulls to H5N1 Highly Pathogenic Avian Influenza viruses. Emerging Infectious Diseases 12(11): 1663-1670.Brown, J.D., Stallknecht, D.E. & Swayne, D.E. 2008. Experimental infection of swans and geese with Highly Pathogenic Avian Influenza virus (H5N1) of Asian lineage. Emerging Infectious Diseases 14(1): 136-142.Chen, H., Smith, G.J.D., Li, K.S., Wang, J., Fan, X.H., Rayner, J.M., Vijaykrishna, D., Zhang, J.X., Zhang, L.J., Guo, C.T., Cheung, C.L., Xu, K.M., Duan, L., Huang, K., Qin, K., Leung, Y.H.C., Wu, W.L., Lu, H.R., Chen, Y., Xia, N.S., Naipospos, T.S.P., Yuen, K.Y., Hassan, S.S., Bahri, S., Nguyen, T.D., Webster, R.G., Peiris, J.S.M. & Guan, Y. 2006. Establishment of multiple sublineages of H5N1 influenza virus in Asia: implications for pandemic control. Proceedings of the National Academy of Science 103: 2845-2850.Chatterjee, A., Phillips, B., Stroud, D.A., Alberts, F., Hails, S., Minaeva, T., Pittock, J., Prietto, C. & Tunde, O. (2008). Wetland Management Planning. A guide for site managers. WWT, Wetlands International, IUCN & Ramsar Convention. 76 pp.European Commission 2005. Decision 2005/734/EC. Available from 00790080.pdf http://europa.eu.int/eur-lex/lex/LexUriServ/site/en/oj/2005/l_279/l_27920051022en 00790080.pdfGauthier-Clerc, M, Lebarbenchon, C. & Thomas, F. 2007. Recent expansion of highly pathogenic avian influenza H5N1: a critical review. Ibis 149: 202-214. doi: 10.1111/j.1474-919x.2007.00699.xHesterberg, U., Harris, K., Cook A. & Brown, I. 2007. Annual Report. Surveillance for avian influenza in wild birds carried out by Member States. February- December 2006. Community Reference Laboratory for avian influenza and Newcastle disease. 53 pp. Available from http://ec.europa.eu/food/animal/diseases/controlmeasures/avian/annrepres_surv_wb_02-12-2006_en.pdf.Highly Pathogenic Avian Influenza Infection Route Elucidation Team. 2004. Routes of Infection of Highly Pathogenic Avian Influenza in Japan. Highly Pathogenic Avian Influenza Infection Route Elucidation Team, Food Safety and Consumer Bureau, Ministry of Agriculture, Forestry & Fisheries, Tokyo, Japan.Hulse-Post, D.J, Sturm-Ramirez, K.M., Humberd, J., Seiler, P., Govorkova, E.A., Krauss, S., Scholtissek, C., Puthavathana, P., Buranathai, C., Nguyen, T.D., Long, H.T., Naipospos, T.S.P., Chen, H., Ellis, T.M., Guan, Y., Peiris, J.S.M. & Webster, R.G. 2005. Role of domestic ducks in the propagation and biological evolution of highly pathogenic H5N1 influenza viruses in Asia. Proceedings of the National Academy of Sciences 102: 10682-10687. Available from http://www.pnas.org/cgi/content/full/102/30/10682.IUCN. 1998. Guidelines for reintroductions. Prepared by IUCN/SSC Reintroduction Specialist Group. IUCN, Gland, Switzerland and Cambridge, UK. 10pp.Kilpatrick, M., Chmura, A.A., Gibbons, D.W., Fleischer, R.C., Marra, P.P. & Daszak, P. 2006. Predicting the global spread of H5N1 avian influenza. Proceedings of the National Academy of Sciences 103(15): 19368–19373. Available from http://www.pnas.org/cgi/reprint/103/51/19368.Ramsar Convention Secretariat 2007a. Inventory, assessment, and monitoring: An Integrated Framework for wetland inventory, assessment, and monitoring.Ramsar handbook for the wise use of wetlands, 3rd edition, Vol. 11. Ramsar Convention Secretariat, Gland, Switzerland. 49 pp. Available from http://www.ramsar.org/lib/lib_handbooks2006_e11.pdf.Ramsar Convention Secretariat 2007b. Managing wetlands: Frameworks for managing Wetlands of International Importance and other wetland sites. Ramsar handbook for the wise use of wetlands, 3rd edition, Vol. 16. Ramsar Convention Secretariat, Gland, Switzerland. 93 pp. Available from http://www.ramsar.org/lib/lib_handbooks2006_e16.pdf.Sabirovic, M., Wilesmith, J., Hall, S., Coulson, N., Landeg, F. 2006. Situation Analysis – Outbreaks of HPAI H5N1 virus in Europe during 2005/2006 – An overview and commentary. DEFRA, International Animal Health Division, United Kingdom. 40 pp. Available from http://www.defra.gov.uk/animalh/diseases/monitoring/pdf/hpai-europe300606.pdf.Scientific Task Force on Avian Influenza and Wild Birds. 2006. Avian Influenza and Wild Birds: What is their actual role in the spread of the virus? CMS Secretariat, Bonn, Germany. Available from http://www.cms.int/avianflu/cms_ai_brochure_oct06.pdf.UNEP 2006. Conclusions and Recommendations of the Scientific Seminar on Avian Influenza, the Environment and Migratory Birds (10-11 April 2006). UNEP DEWA, CMS & AEWA, Nairobi. 9 pp. Available from http://www.aiweb.info/documents/conclusions_nairobi_ai_seminar.pdf.van Gils, J.A., Munster, V.J., Radersma, R., Liefhebber, D., Fouchier, R.A., & Klaasen, M. 2007. Hampered Foraging and Migratory Performance in Swans Infected with Low-Pathogenic Avian Influenza A Virus. PLoS ONE 2(1): e184. doi:10.1371/journal.pone.0000184.Veen, J., Brouwer, J., Atkinson, P., Bilgin, C., Blew, J., Eksioĝlu, S., Hoffmann, M., Nardelli, R., Spina, F., Tendi, C. & Delany, S. 2007. Ornithological data relevant to the spread of Avian Influenza in Europe (phase II): further identification and first field assessment of Higher Risk Species. Wetlands International, Wageningen, The Netherlands. Available from http://ec.europa.eu/environment/nature/conservation/wildbirds/birdflue/docs/spread_avian_influenza.pdf.Wetlands International & EURING. 2006. Urgent preliminary assessment of ornithological data relevant to the spread of Avian Influenza in Europe. Report commissioned by European Union (EU) Directorate General for the Environment. 230 pp. Available from http://ec.europa.eu/environment/nature/conservation/wildbirds/birdflue/docs/rep_spread_avian_influenza_report.pdf. (17 MB file).

3) – Recommended ornithological information to be collected during surveillance programmes or field assessment of wild bird mortality events, especially at wetlands

3.1 – Recommended information to be collected

117.All birds from which samples are taken should be identified to species. Where clearly distinguishable subspecies or discrete populations exist, as for some geese, this information should also be collected and reported⁵. Age⁶ and sex should be recorded wherever possible.⁵Wetlands International’s publication Waterbird Population Estimates [Wetlands International 2006. Waterbird Population Estimates - Fourth Edition. Wetlands International, Wageningen, The Netherlands. 239 pp.] should be used as a source of information on the taxonomy and populations of waterbirds.⁶Waterbirds are aged mainly by the size and shape of their wing feathers (mainly on greater covert and tertial shape-http://www.bto.org/ringing/ringinfo/resources/topography.pdf) and their tail feathers (juveniles having notched tail feathers).

118.Close collaboration with ornithologists in the capture and sampling of live birds not only facilitates identification of birds but also gives the opportunity to collect additional information on the sampled live birds (such as weight, age, sex and condition), which are important to developing a better understanding of viral ecology and epidemiology. Standard protocols exist for the collection of such data through national ringing schemes (details of which are available for Europe, for example, via EURING (http://www.EURING.org)). Recording individual ring numbers in the reporting spreadsheet provides a means of accessing these data for future analysis.

119.To provide an audit of identification, it is highly desirable that a clear digital photograph is taken of each sampled bird (especially those found dead and/or not identified by ornithologists) and stored at least until confirmation of laboratory tests. In order to facilitate identification of bird species (which can sometime vary in quite minor plumage details, especially at certain times of the year), photographs should be taken according to the guidance given in Section 3.2 below. In the event of positive results, further examination of such photos can provide additional information on the age and sex of the bird, in addition to proving the identity of the species beyond doubt and thus allowing the case to be correctly put into context. To facilitate this, each individual bird should be given a code that is used on the cloacal and oro-pharyngeal swabs taken, and this code should be on a piece of card that is visible in each photograph taken.

120.Especially related to sampling in the vicinity of outbreaks, it is desirable to collect a range of contextual information so as to better understand the viral epidemiology of H5N1 HPAI in wild bird populations. Such information should include:

i)date of sampling, clear locational and descriptive data about the catching site, ideally GPS coordinates, including habitat description (e.g., lake, river, village pond, fish farm, etc.) and distance to human settlement, agricultural land, and poultry farms; it may also be useful to include details about the season and relate this information to the natural behaviour/cycle of the affected birds, e.g., moulting, pre-migration, during migration, etc.;

ii)record of the numbers of each species of other live birds in the sampling area that were not sampled;

iii)if available, records of bird movements (arrivals/departures) that occurred at the sampling site prior to the sampling;

iv)assessment of the numbers of each species of live bird in the sampling area that were not sampled but that were showing signs of ill health; and

v)given that birds of some species (such as Mallards Anas platyrhynchos) can occur either as wild birds that are able to move between sites or occur in a feral state, habituated to foods provided by humans, distinguishing between these categories would be useful. Sometimes the presence of unusual plumage patterns, indicating domestication, is useful in this respect.

3.2 – Guidance on taking photographs of dead birds for identification purposes

121.The following simple guidance will assist non-specialists in taking photographs, especially of dead birds, that will allow subsequent identification to species. Different bird species are identified by differing characteristics, so it is difficult to provide universal guidance applicable in all situations. However, the following is a minimum standard that should be followed.

122.All wild birds collected for analysis for HPAI should have digital photographs taken as soon as possible after collection. The bird should fully fill the photograph and wherever possible include a ruler or other scale measure.

123.Each photograph should be taken at the highest resolution possible and if the camera has a ‘date stamp’ feature then this should be enabled so that the image is saved with a time reference – this may help verify the sequence of images taken at a site on a day. Images should be downloaded to a computer as soon as possible and information about location and date added to the file properties.

124.Photographs should be taken of:the whole bird, dorsal side, with one wing stretched out and tail spread and visible;the head in profile clearly showing the beak;close-up photos of the tips of wing feathers, as these can often determine whether the bird is an adult or a juvenile (bird in its first year); andideally photographs of both dorsal and ventral views of the bird, as photos of the upper and under surfaces of the wing and spread tail will facilitate aging and sexing of birds (e.g., Northern Pintail Anas acuta);

125.Any ventral photographs should show the legs and feet (since leg colour is often an important species diagnostic). If any rings (metal or plastic) are present on the legs, these should be photographed in situ as well as recording ring details. Any conspicuous markings/patterns should also be photographed.

126.At certain times of the year, such as late summer (July - August in the northern hemisphere) many waterbirds, especially ducks and geese, undergo moult and can be especially difficult to identify by non-specialists. At such times clear photographs are especially important to aid identification of (duck) carcasses. The patch of colour on the open wing (called the "speculum") is often especially useful. The identification of young gulls at any time of the year is also difficult and typically they will also need to be photographed and identified by specialists.

127.Photographs should be retained, linked to an individual specimen, at least until laboratory tests are returned as negative for avian influenza. A unique code or reference number that is the same as the code or reference number of any samples taken from the birds should be visible in each photograph so as to link samples and photographs.

128.Photographs can be used immediately if identification of the species of bird is in any doubt, and for subsequent checking of the identification if necessary.

4) – Ornithological expert panels

129.Several Contracting Parties have found it valuable to establish advisory panels involving best available ornithological expertise as a means of responding to the call in Resolution IX.23 to integrate ornithological expertise within government disease response processes. Such panels can provide specialist advice to veterinarians, epidemiologists, and others in response to outbreaks. The following guidance is based on these experiences.

130.Whether a separate panel is established or alternatively that ornithological expertise is integrated into other governmental processes instead will depend on the nature of existing organizational structures. This should be determined nationally. However, ideally any Ornithological Expert Panel (OEP) should be part of the epidemiological team that has the responsibility to investigate HPAI outbreaks, as such integration greatly assists in the identification of achievable scientific objectives.

131.Tables 1 and 2 above list further sources of information and guidance as to how expert specialist advice can be integrated within government responses.

4.1 – Composition

132.Ornithological Expert Panels should comprise best available ornithological expertise drawn from both governmental and non-governmental sectors, including ornithological experts from research institutes or universities as appropriate. Staff from national bird ringing centres and national or other relevant waterbird monitoring schemes, where these exist, should be involved in order to facilitate rapid analysis of data and information drawn from relevant databases and other information sources

4.2 – Establishment

133.OEPs or other advisory bodies should be established in advance of disease outbreaks as part of forward national contingency planning. There is value to all involved in explicitly establishing the formal relationship between the OEP (or similar) within other government disease response processes and structures.

4.3 – Scale and federal states

134.The scale at which advice is sought will depend on how government is structured. If animal disease responses are coordinated within federal states at subnational scales, then typically specialist ornithological advice should be available to decision-makers at that scale.

4.4 – Mode of working

135.In order to facilitate the rapid convening of advisory expertise, contingency planning should include means of bringing together relevant experts at short notice in order to provide advice to decision-makers immediately after confirmation of infection outbreaks. Where possible, the experts should be made aware and kept up to date on the epidemiological features of any outbreak involving domestic poultry and the progress of the epidemiological investigations. It should be anticipated that experts will be scattered and may not be able to assemble physically, thus necessitating the use of teleconferencing or other similar arrangements, which should be planned for.

4.5 – Emergency ornithological field assessments

136.In order to assist epidemiological investigation, and to help better to reduce risk of the spread of disease, contingency planning should address the need for emergency field assessments to establish the nature of, and collect information on, populations of wild birds near an outbreak site. These field assessments are usually driven by outbreak specific objectives, but they can include local wild bird movements and the degree of access to domestic poultry. Ornithological advice on additional and specific surveillance is frequently sought following these assessments. One possible format for such evaluations is provided by Wetlands International (2006).

137.Field assessments should be complemented by desk-based rapid ornithological data assessments that seek to interrogate available data sources and thus to inform risk assessments. Even if available data on birds near outbreaks may be limited, they will always assist decision-making to systematically collate relevant information.

4.6 – International networking

138.It is very valuable to be able to share risk assessments and ornithological data and evaluations between neighbouring countries or within wider geographic regions. To this end, national OEPs should collaborate together at regional scales to develop collective international assessments and understanding.

4.7 – Lessons learnt

139.Following the activation of the OEP in the event of an outbreak, it is essential afterwards to then undertake a formal ‘lessons learnt’ review to identify any problems or areas of operation where there may be scope for improvement of activity. The outcome of such a review should then be implemented by modifying contingency arrangements (and/or formal Terms of Reference).

4.8 – References

Wetlands International 2006. Urgent preliminary assessment of ornithological data relevant to the spread of Avian Influenza in Europe. Wetlands International report to DG-Environment, European Commission. 230 pp. Available from http://ec.europa.eu/environment/nature/conservation/wildbirds/birdflue/docs/rep_spread_avian_influenza_report.pdf.

Appendices

Appendix 1

Scientific summary of highly pathogenic avian influenza H5N1: wildlife and conservation considerations

Appendix 2

Scientific Task Force on Avian Influenza and Wild Birds

Appendix 3

Terminology⁷