China is now in its sixth wave of Asian H7N9 outbreaks with more than 1500 laboratory-confirmed cases reported since 2013. Though the public health risk from the H7N9 virus is currently low, its pandemic potential is concerning. Influenza viruses constantly change, and Asian H7N9 could gain the ability to spread easily and sustainably among people, triggering a global outbreak.
Meanwhile sporadic human infections associated with poultry exposure are expected to continue in China, with the possibility of spread to poultry in neighboring countries and associated human infections. With so many unpredictable factors at play, it is vital that all countries have well-trained laboratory professionals capable of responding quickly and effectively to cases of Asian H7N9 and other influenza viruses.
In November 2017, APHL hosted over 150 experts from around the world at a meeting in Bangkok, Thailand, organized in collaboration with the US Centers for Disease Control (CDC), CDC-Thailand and the Thailand Ministry of Public Health. Its purpose was to evaluate and update training modules for response to novel influenza viruses, notably Asian H7N9. The modules will serve as the basis for live presentations that can be adapted to suit the requirements of individual countries. Modules include PowerPoint presentations accompanied by interactive exercises and scenarios.
In Bangkok, subject matter experts from CDC, the World Health Organization, the Food and Agriculture Organization of the United Nations and the World Organization for Animal Health used a One Health approach to assess epidemiology, laboratory and veterinary curricula developed in 2005 for response to the H5N1 virus. Officials from ministries of health and agriculture in 11 countries advised on application of One Health principles, and the status of emerging influenza viruses and training needs in their respective regions. This work was prefaced with sessions on H7N9 evolution and activity, both globally and in China, and best practices in training development.
The results were impressive. In only four days, attendees revised more than 20 training modules and 10 interactive exercises and completed an H7N9 case study. Country delegations also found time to plan their next steps in Asian H7N9 response.
Review of expert evaluations has been completed and updates to training modules are underway. Once finalized, they will be made available electronically for countries to modify according to their needs. Release is targeted for the spring of 2018.