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Public Health
Interventions for
Prevention and control
of avian influenza
A Manual for Improving Biosecurity
in the Food Supply Chain:
Focusing on Live Animal Markets
March 2006
World Health Organization (2006)
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The main health risk currently is to people who are in close
contact with infected poultry, such as families with backyard flocks
and poultry workers in wet markets or live animal markets.
Globally, the evidence demonstrates that there is no risk of
infection when birds and eggs are well-cooked, as this kills the
virus. Poultry products are important sources of protein
throughout the world. LEE Jong-wook , M.D., Dr P.H., Director
General, World Health Organisation.
In addition to drugs and vaccine, certain public health
interventions must be included in the AI preparedness plans. We
should help educate people to protect their own health, through
information and communication. We should develop educational
messages that are easily understood by lay people, addressing the
need for improved hygiene, sanitation and food safety. These
messages should be translated into local languages, and
disseminated widely.
Samlee Plianbangchang, M.D., Dr P.H., Regional Director, World
Health Organization, Regional Office for South East Asia.
We wish to acknowledge the collective and individual contributions to the development
of this publication. Special thanks to Dr Roy Sparringa, National Agency for Drug and
Food Control, Indonesia; Ms Napapan Nanthapong, Ministry of Public Health, Thailand;
Jenny Bishop, WHO Regional Office for Western Pacific, Philippines; Mr Sanjay
Chaudhary, Food Safety Expert, India; Dr Peter Karim Ben Embarek, WHO Geneva,
Switzerland; Mr Alexander von Hildebrand, and the members of the Avian Influenza Task
Force in WHO Regional Office for South East Asia, India.
Acknowledgments
1. Introduction 1
2. What is Avian Influenza? 3
3. Direct and indirect factors facilitating the spread of Avian Influenza 5
3.1. Primary production farming systems in rural or urban settings 5
3.2. Unsafe transport 6
3.3. Live animal market (wet market) 8
3.4. Unsafe food preparation 12
4. What is biosecurity? 13
5. Taking action to enhance biosecurity all along the food chain 15
5.1. Secured primary production farming systems 15
5.2. Safe transport 17
5.3. Biosecurity in wet markets 18
5.4. Safety at Customers' and Consumers' end 21
6. Protection of human beings 23
7. Promoting Healthy Food Markets - Strategy and Plans 25
8. Key Public Health Messages 29
9. Sample questionnaire to assess practices in wet markets 31
10. Proposed steps to launch a National Healthy Food Markets Programme 33
11. Web Resources 37
This Manual has been developed to help
strengthen the capacity of Member States in
implementing effective public health
interventions to prevent and control the
spread of Avian Influenza (AI) at source.
The Manual attempts to provide simple, yet
valuable, public health related measures that
will not only improve and enhance biosecurity at
critical stages of the food supply chain
(production, transportation, marketing and
consumption), but also ensure that the potential
transmission of Avian Influenza virus from
animals to humans is considerably reduced.
Biosecurity includes the management of all
biological and environmental health risks
associated with food. In the context of this
Manual, biosecurity consists of a set of
management practices which, when followed,
collectively reduces the potential for the
transmission / spread of disease-causing
organisms - such as the Avian Influenza virus -
onto and between sites, animals and humans.
Effective implementation of these simple
public health measures would mean that
the concept of healthy food markets could
be established in practice and that
potential heavy loss of human lives could
also be avoided.
This Manual is addressed specifically to
people who handle poultry and its
products, whether at its stages of
production; transportation; handling and
processing at live animal markets; or closer
to homes, while preparing the food.
The document therefore, seeks to draw
close the attention al those handling
poultry and its by-products, all
along the food supply chain. That
includes, but is not restricted to,
managers of poultry production units,
transporters, marketplace managers,
municipal authorities, health workers,
food inspectors, veterinarians, vendors,
food handlers and consumers.
1
Introduction
Outbreaks of Avian Influenza in poultry, when
caused by highly pathogenic viruses of the H5
or H7 subtypes, are of great concern for the
agricultural sector and can have considerable
economic consequences. Such outbreaks are
also of concern to human health. WHO,
therefore recommends, for certain Avian
Influenza viruses, a series of protective
measures aimed at preventing human
infections in persons at high risk of exposure.
For several reasons, the highly pathogenic
H5N1 virus the greatest concern at
present. Of all Avian Influenza viruses
known to infect humans, H5N1 has
caused the greatest number of cases of
very severe disease and the largest number
of deaths. Moreover, H5N1 has the
potential to trigger an influenza pandemic.
The virus has also proved to be particularly
difficult to control in poultry populations
and is now considered endemic in parts of
South-East Asia
1
.
2.1 Affected species and
natural hosts
Chickens, ducks, geese, turkeys, guinea
fowl, quail, pigeons and numerous wild
birds may all be affected by influenza
viruses. Depending on the virus or on the
host, some birds will be resistant, others will
get infected and may or may not show
clinical signs.
Ducks are known to be resistant to the
viruses and thus act as a "silent
reservoir" that perpetuates transmission.
In recent months, evidence has mounted
that at least some species of migratory
birds are directly spreading the virus, in
its highly pathogenic form, H5N1, to
parts of Central Asia and Europe. In
addition to this, birds that survive
infection may excrete the virus up to 10
days, orally and in faeces, facilitating
further spread.
2.2 Humans at risk
Though Avian Influenza viruses
normally infect only birds and,
unusually, pigs, some strains of the
virus have also crossed the species
barrier since 1959 to infect humans on
10 occasions
2
. While most Avian
Influenza viruses affecting humans
have caused mild respiratory symptoms
2
What is Avian Influenza?
1
http://www.who.int/csr/disease/avian_influenza/guidelines/firstoutbreak/en/print.html
2
INFOSAN Draft Note 2, November 2005- Highly pathogenic H5N1 avian influenza outbreaks in poultry and
in humans: Food Safety implications. http://www.who.int/foodsafety/fs_management/No_07_AI_Nov05_en.pdf
or conjunctivitis, the Highly Pathogenic
Avian Influenza (HPAI)
3
resulted in
severe disease outbreaks with high
fatality rates in 1997, 2003, and in the
ongoing outbreak, caused by the
strain H5N1, that began in South-
East Asian countries in early 2004.
The disease caused by H5N1
follows an unusually aggressive
clinical course, with primary viral
pneumonia and multi-organ failure
being common. From December 2003
to 1
st
of March 2006, 174 human
cases have been reported, of which 94
were fatal
4
.
The H5N1 virus has the potential to
cause catastrophic human pandemics if
it mutates into a form that transmits
rapidly between humans. Allthough
several mutations in the virus have been
detected during 2005, the significance
of these mutations in terms of virulence
and transmissibility in humans, is not
fully understood yet.
2.3 Characteristics of the
Avian Influenza virus
The H5N1virus can survive in faeces for at
least 35 days at low temperature (4C); at
37C, viruses could survive for six days in
stability tests on faecal samples (in studies
using H5N1 viruses circulating during
2004). Avian Influenza viruses can also
survive on other surfaces, such as those
within the poultry house environment, for
several days. In general, low temperatures
maintain the stability of the viruses.
Due to these survival properties, food
preservation processes such as freezing
and refrigeration will not reduce the
concentration or virulence of these viruses
in contaminated meat. Normal cooking
(temperatures at or above 70C in all parts
of the product) will inactivate the virus.
To date, there is no epidemiological
evidence showing that people get infected
following consumption of contaminated
poultry meat that was properly cooked.
4
3
A Global Strategy for the Progressive Control of Highly Pathogenic Avian Influenza (HPAI),FAO/OIE/WHO,
November 2005; http://www.fao.org/ag/againfo/subjects/documents/ai/HPAIGlobalStrategy31Oct05.pdf
4
Lab confirmed cases reported to WHO.
http://www.who.int/csr/disease/avian_influenza/country/cases_table_2006_03_01/en/index.html
3.1. Primary production
farming systems in rural or
urban settings
Based on farm biosecurity and the system
used to market products, FAO has broadly
defined the following primary production
sectors
5
:
Sector 1: Industrial integrated system with
high level of biosecurity and birds/products
marketed commercially (e.g. farms that are
part of an integrated broiler production
enterprise with clearly defined and
implemented standard operating procedures
for biosecurity).
Sector 2: Commercial poultry production
system with moderate to high biosecurity
and birds/products usually marketed
commercially (e.g. farms with birds kept
indoors continuously; strictly preventing
contact with other poultry or wildlife).
Sector 3: Commercial poultry production
system with low to minimal biosecurity
and birds/products usually enter live
bird markets (e.g. a caged layer farm
with birds in open sheds; a farm
with poultry spending time outside the
shed; a farm producing chickens and
waterfowl).
Sector 4: Village, peri-urban or urban
backyard production with minimal
biosecurity and birds/products consumed
locally. This sector includes low income
households wherein people live with poultry
and other animals; and / or carry out
unhygienic slaughtering within household
premises.
The probability of infection is higher in
production sectors 3 and 4 than in
sectors 1 and 2. However, if the virus
does enter farms in sectors 1 and 2,
infection may have a greater impact due
to the concentration of susceptible poultry
in these farms.
More detailed information on primary
production farming systems in rural
and/or urban settings and the
relationships to Avian Influenza can
be found at the websites of the
Food and Agriculture Organisation
(http://www.fao.org/) and of the World
Organisation for Animal Health
(http://www.oie.int/)
Direct and indirect factors facilitating the
spread of the Avian Influenza virus
5
FAO Recommendations on the Prevention, Control and Eradication of Highly Pathogenic Avian Influenza (HPAI)
in Asia September 2004 http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/27septrecomm.pdf
3
High-risk farming practices
6
Some of the salient high-risk farming
practices prevalent in South-East Asia and
possibly contributing to the spread of Avian
Influenza are:
Farming of multiple species of
animals - e.g. raising ducks and
chickens together wherein ducks are
"silent natural carriers" of the virus and
can infect chickens; raising pigs and
poultry together wherein pigs can act
as a "mixing vessel" for virus to adapt
to a more lethal form for humans.
Free-range poultry raising whereby
poultry move in a contaminated
environment to feed themselves.
Free-ranging poultry in densely
populated, rural or peri-urban
settings
Use of untreated chicken faeces as
fertilizer or livestock feed - The virus
can survive in manure for three
months in cool temperatures6. The
droppings of infected wild birds too
can infect poultry.
Contaminated equipment, cages,
vehicles, clothing and shoes - Poor
hygiene, cleaning and disinfection.
Poor ventilation of poultry sheds - The
virus can spread by air if birds are
kept closely together with poor
ventilation.
Inappropriate disposal of dying and
dead birds.
Lack of adoption of `all - in, all - out'
husbandry systems.
3.2 Unsafe transport
Re-usage of dirty vehicles including
motorcycles and cycles without
removal of faecal matter, cleaning
and disinfection is risky. The H5N1
virus can survive in faeces and other
surfaces for several weeks and hence
cleaning and disinfectng of transport
6
6
Let us stop the killer virus at source! - preventive measures to stop the spread of Bird Flu (Draft), WHO/FAO/OIE
November 2005. As from March 2006, final version available at: www.wpro.who.int/avian
All-in, all-out
This refers to rearing chickens of the
same age. Once birds are sent to the
abattoir or market, workers can clean
and disinfect the premises before the
arrival of a new flock. Thus, the flock is
protected against the entry of new,
possibly diseased, birds.
Tricycle used for transportation of poultry without
removal of faecal matter, cleaning or disinfection
(A. Bhatiasevi, 2006)
vehicles is essential to prevent the
Avian Influenza virus from spreading.
This is crucial when moving to and
from poultry farms and in and around
wet markets.
Re-usage of dirty cages for
transportation of poultry without
cleaning and disinfection This is a
potential hazard as Avian Influenza
viruses can be introduced into the
markets from contaminated crates.
Therefore, material of the cage should
be such that it can be easily cleaned
and disinfected e.g. plastic. Avoid wood
as that cannot be cleaned effectively.
Stacking of cages on top of the other
without waste trays underneath the
cages - This is a potential hazard as
the faecal droppings of any infected
birds can infect the other birds as
well as contaminate the cages and
the vehicle.
Transportation of birds from one farm
to another; or from one collection
centre to another; or from the market
back to the farm / collection centre -
The movement of birds, crates, or
vehicles and personnel from a
contaminated market can spread the
virus back to other farms, collection
centres and markets.
Caging of birds in excess of
capacity or over stacking on a two-
wheeler. This causes the birds to
get distressed and defecate, which
contaminates the feathers with
faeces.
7
Continous re-usage of dirty wooden cages, littered
with faecal matter, feathers and dirty water
(WHO, 2006)
Some poultry broiler suppliers do not hesitate to
stack up to 100 birds at one time on a two-wheeler
(WHO, 2006)
3.3. Live animal market
(wet market)
A live animal market or "wet market" is a
place where members of the public go to
buy small animals and birds that are:
live and slaughtered there
live and taken home to be slaughtered,
or
already slaughtered and sold as meat.
3.3.1 `Wet markets whet viruses'
The live animal markets or wet markets
provide optimal conditions for the zoonotic
transfer and evolution of infectious disease
agents. Traditional Asian wet markets
provide major contact points for people and
live animal mixing, making them important
potential sources of viral amplification and
infection
7
. The traditional local demand for
"warm meat" or freshly slaughtered meat
sustains the wet markets.
8
Examples of wet market scenes in Asia
(WHO, 2006)
Wet markets can provide ideal conditions for
zoonotic transfer and evolution of infectious disease
agents (WHO, 2006)
7
Fielding R, Lam WWT, Ho EYY, Lam TH, Hedley AJ, Leung GM. Avian influenza risk perception, Hong Kong,
University of Hong Kong, Special Administrative Region, China, Emerging Infectious Diseases, Vol. 11, No. 5,
May 2005 677. http://www.cdc.gov/ncidod/EID/vol11no05/04-1225.htm
In the wet markets, the live animals, particularly
poultry are enclosed in small cages in numbers
exceeding the capacity of cages. Although,
direct hand-to-face contact is the most likely
path for infection of humans, the flapping by
distressed chickens inverted during inspection by
shoppers raises fecal-dust aerosols and exposes
sellers, shoppers, and passers-by to any virus
particles on an infected bird. Highly dense
urban populations maximize opportunities for
infection and transmission in any outbreak.
HPAI viruses have been isolated from live
bird markets with, and without, evidence of
clinical disease
8
. Infection can spread from
these markets to humans and to farms via
the movement of contaminated people,
poultry, cages and transport equipment.
Egg marketing practices can also lead to
the spread of AI viruses. Contaminated egg
trays that are recycled without disinfection
can also spread the virus.
3.3.2 High- risk practices in the
wet market
9
9
8
FAO Recommendations on the Prevention, Control and Eradication of Highly Pathogenic Avian Influenza (HPAI)
in Asia September 2004 http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/27septrecomm.pdf
9
FAO/OIE/WHO Consultation on avian influenza and human health: Risk reduction measures in producing, marketing and
living with animals in Asia, Kuala Lumpur, Malaysia, July 2005 See at: http://www.wpro.who.int/health_topics/food_safety/
Caging birds beyond capacity increases the mortality
rate and the risks transmission of Avian Influenza
(WHO, 2006)
Slaughtering chickens in a wet market
(WHO, 2006)
Poor hygiene, cleaning and disinfection
of facility, equipment and personnel
attire.
Preference of `warm meat' i.e. fresh
meat processed immediately after
slaughtering - The regional preference
for warm meat has led to persistence
of wet markets
10
.
Mixed slaughtering and selling zones.
Animals including poultry are
frequently slaughtered at the selling /
display premises, often in open,
unprotected areas, which may release
contaminated faeces or blood.
Keeping multiple species together
and in confined spaces.
Stacking of cages on top of one
another, without waste trays.
Holding of poultry overnight and
return of unsold birds to farms.
Lack of pre-marketing health checks
of poultry birds.
10
10
A place where members of the public go to buy small animals and birds that are: (a) live and slaughtered there
(b) live and taken home to be slaughtered, or (c) already slaughtered and sold as meat.)
Slaughtering, processing, selling and defecating live
poultry broilers - all in the same area (WHO, 2006)
Some bird species may be infected but do not show
symptoms.Allowing different species to mix is risky
(A. Bhatiasevi, 2006)
Cages used without waste trays lead to faecal matter
contaminating the birds below as well as the floor
(WHO, 2006)
Risky operations while defeathering
Lack of food safety awareness of
market stall owners.
Lack of personal protective equipment
for stall owners.
Poor disposal of carcasses and other
hazardous wastes (liquid and solid).
11
Stall owners and food handlers in a wet market lacking awareness about food safety and basic hygiene
(WHO, 2006)
De-feathering without previous scalding not only
hampers the operation per se, but also allows
potential virus contamination from feathers to meat
(A. Bhatiasevi, 2006)
Unsafe disposal of feathers, carcasses and other
potentially hazardous wastes (WHO, 2006)
3.4. Unsafe food preparation
Consumers are the most vital link at the end
of the food chain. All Avian Influenza
preventive and control measures followed by
the supply chain may be undone, on account
of improper handling of food, by the
consumer. Most common errors, having the
potential for increasing the risks of
transmission of Avian Influenza, are as under:
Slaughtering at home Due to
preference for `warm' or `fresh' meat or
on account of religious beliefs or social
customs, many consumers, across
regions, prefer slaughtering at home.
This practice poses potential risks for
transmission of the Avian Influenza virus
as well as other disease-causing
pathogens, as the slaughtering may not
be as professionally carried out as by
slaughtering experts in the wet markets.
Lack of hygiene Poor consumer
knowledge of personal and kitchen
hygiene and sanitation may lead to the
contamination of work surfaces,
equipment and utensils This may
indirectly help transmit the virus to not
only the food handler but also to other
people at home, particularly children
and the immunocompromised or
aged people.
Raw and cooked food together
Potential risk of Avian Influenza
transmission also stems from
possibilities of cross-contamination of
cooked food from raw meat if the
consumer is not careful in segregating
them well. Besides, use of same
knives, utensils and chopping boards
for cooked and raw food without
thorough cleaning and sanitation
offers an indirect transmission route
for the Avian Influenza virus as well as
food pathogens.
Poorly cooked Though there is no
concrete evidence of the transmission
of the Avian Influenza virus to humans
through the food consumption mode,
the possibility of the same cannot be
ignored as the AI virus is killed only
after thorough cooking wherein the
core temperature is above 70 C.
Poor waste management, scavengers
Improper disposal of hazardous waste
like meat trimmings, skin, feathers,
blood, bones etc. outside the homes and
in the open areas offers potential risks
not only to the ill-informed consumer but
also the people in the neighbourhood. In
addition, such a practice attracts
domestic pets, street cats and other
scavengers and may result in the virus to
go across species and also mutate in
animals like pigs, which act as mixing
vessels for the Avian Influenza virus.
12
Cat scavenging on a dead chicken in a wet market
(WHO, 2006)
The Avian Influenza virus is best transmitted
via direct contact with sick and/or dead
birds. Most human cases of AI have been
related to such close contacts.
Biosecurity includes the management of
all biological and environmental health
risks associated with food. In the
context of this Manual, biosecurity
consists of a set of management
practices which, when followed,
collectively reduces the potential for the
transmission / spread of disease-
causing organisms - such as the Avian
Influenza virus -onto and between sites,
animals and humans.
Biosecurity comprises two main elements
11
- bio-containment and bio-exclusion. Bio
containment refers to prevention of spread
of the virus from infected premises and
bio-exclusion refers to measures to
exclude infectious agents from uninfected
ones.
Biosecurity has three major components
12
:
Isolation: refers to the confinement of
live animals within a controlled
environment.
Traffic Control: includes both the
human traffic as well as the vehicular
traffic within the controlled environment.
Sanitation: addresses the cleanliness
and disinfection of materials, people
and equipment entering the controlled
environment.
In simple words, biosecurity is the normal
way to avoid unnecessary contact between
animals and microbes, infected animals
and healthy ones
13
. Biosecurity also
applies to public health measures that will
reduce the contact between animals and
humans.
4
What is biosecurity?
11
FAO Recommendations on the Prevention, Control and Eradication of Highly Pathogenic Avian
Influenza (HPAI) in Asia September 2004.
http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/27septrecomm.pdf
12
Poultry fact sheet no. 26, Cooperative Extension, University of California, March 1997.
http://animalscience.ucdavis.edu/avian/pfs26.htm
13
Prevention and control of avian flu in small scale poultry, A guide for veterinary paraprofessionals
in Cambodia, FAO, 2005.
http://www.fao.org/ag/againfo/subjects/documents/ai/AI-paravets-guide.pdf
14
Example: Biosecurity levels for rural/ urban husbandry practices
11
.
5.1. Secured primary
production farming systems
14
While there is a need to reinforce biosecurity
measures in sectors 1 and 2 farms, priority
must be given to sectors 3 and 4 farms and
associated communities where humans live
in close proximity to the animals being
raised by them or other community
members
15
. The key biosecurity measures
recommended include the following:
Keep the wild birds away It is
important to keep wild birds and
ducks, natural reservoirs of the virus,
off farms. Many species can be
infected but will not show any signs of
disease. They can excrete the virus for
30 days and contaminate feed, and
shared water sources e.g. ponds.
Therefore, poultry should be kept in a
protected place
16
: a fenced park,
under the house protected by a
fishing net or better, a secured poultry
pen. They must also have access to
clean water and feed.
Ensure All-in, all-out i.e. ensuring that
all birds from a shed / pen are sent to
the abattoir or market. Workers
should then clean and disinfect the
premises / shed / pen effectively (no
visible feathers or faeces remaining)
before the arrival of a new flock. This
practice would contribute immensely
Taking action to enhance biosecurity all
along the food chain 5
Fenced park Poultry pen Poultry kept under the
House, behind a fishing net
14
Let us stop the killer virus at source! - Preventive measures to stop the spread of Bird Flu (Draft),
WHO/FAO/OIE November 2005. www.wpro.who.int/avian
15
FAO/OIE/WHO Consultation on avian influenza and human health: Risk reduction measures in
producing, marketing and living with animals in Asia, Kuala Lumpur, Malaysia, 2005.
http://www.wpro.who.int/health_topics/food_safety/
16
Prevention and control of avian flu in small scale poultry. A guide for veterinary paraprofessionals in
Cambodia, FAO, 2005. http://www.fao.org/ag/againfo/subjects/documents/ai/AI-paravets-guide.pdf
in the containment of the avian flu.
Unsold birds should not be returned
to the farm, but be slaughtered and
sold as processed meat.
Avoid multi-age poultry farms
17
as
partial sale of birds from commercial
farms presents a greater biosecurity
risk than the sale of the entire batch
of birds as recommended under
all-in, all-out production. This is
primarily because birds remaining in
the farm are exposed to catchers or
other workers, who customarily move
from farm to farm and can readily
spread infection if H5N1 virus is
circulating in the area.
Proper vaccination of domestic
poultry, which ensures that the
vaccine matches the circulating strain
of virus, is considered to be a useful
tool as part of an overall integrated
strategy for the control of H5N1. It
must be implemented in accordance
with existing standards and
procedures for vaccination, including
in backyard flocks in rural and urban
settings. Poultry are usually
vaccinated with a vaccine made from
inactivated viruses which itself does
not pose a food safety risk. Such
procedures would ensure that no
asymptomatic infected bird would
enter the food chain. Therefore,
where there are appropriate
monitoring programmes in place,
vaccinated poultry can enter the food
chain without particular risk to the
consumer.
Prevent movement of poultry from
one farm to another
18
as H5N1
infected birds, if any, on one farm
may transmit the virus to flocks on the
other farm.
Clean and disinfect the premises and
equipment on farms - Install a
disinfectant pool at entrance to each
poultry shed / pen and ensure
vehicles entering the farm are not
contaminated.
Limit the access of visitors to areas
where poultry are housed and
provide clean protective clothes,
including boots, to people visiting the
farm. This is important as clothing
and footwear are important means by
which the virus can spread.
Obtain feed from a clean, dependable
source. Store feed properly so that it is
bird-proof, insect-proof, and rodent-
proof. Obtain water from a clean
source and ensure it is free from
contamination. Drinking water, if
sourced from ponds or from a doubtful
source, should be chlorinated.
Instruct animal health workers to
guard against spreading infection
16
17
Poultry birds of different age are kept by farmers to spread their income and to avoid the financial risks
associated with having all birds entering the market on the same date
18
Costs and Benefits of regulatory Control in Wet Markets in Hong Kong , WHO (WPRO), Draft 02, 2004
accidentally from during their visits to
other farms.
Exclude poultry from the home; also
prohibit farm workers from rearing
their own poultry at home.
Effective management of hazardous
wastes - Proper disposal of carcasses
and other hazardous waste (liquid
and solid) needs to be enforced.
All dead birds and other contaminated
objects (for instance: faeces, blood,
feathers) must be destroyed properly
19
as soon as possible throughout the day:
Burying - Dig a hole (far from the
poultry sheds) put some quicklime
at the bottom and on the borders
of the hole; put all the birds and
objects in the hole; cover with
quicklime; cover with earth.
Incineration, if suitable incineration
facility is available.
More detailed information on biosecurity
measures for primary production farming
systems in rural and/or urban settings
to be found at http://www.fao.org/and
http://www.oie.int/
5.2. Safe transport
Avoid transportation of people and live
animals together, especially poultry,
ensuring a separate enclosure for each.
This will reduce the risks of potential AI
transmission directly as well as indirectly
through faecal depositions.
Use only clean and disinfected transport
vehicles for movement of poultry and
eggs. Do not reuse dirty vehicles, littered
with faecal matter, without proper
cleaning and disinfection, as the H5N1
virus can survive in organic faecal
matter for several days. During vehicle
cleaning and disinfection, the main
areas to concentrate are wheels, wheel
arches, chassis and underbody, if
possible; the trailer / area where poultry
are transported; cages; sheeting or
other covers on the vehicle
Do not cage birds in excess of the
cage capacity. The H5N1 virus can
spread by air if birds are kept closely
together as well as from faecal matter,
which may contaminate the bird's
feathers, on account of less space.
Preferably, cage capacity should not
be less than 300 cm
2
per kg, with a
height of not less than 30 cm
20
.
Use waste trays - If birds with cages
are stacked on top of each other, use
waste trays underneath the cages for
collecting poultry droppings, which
can then be safely disposed along
with other hazardous waste by
burying. The trays used should be of
the same size as the cages.
17
19
Prevention and control of avian flu in small scale poultry, A guide for veterinary paraprofessionals in
Cambodia, FAO, 2005. http://www.fao.org/ag/againfo/subjects/documents/ai/AI-paravets-guide.pdf
20
Costs and Benefits of regulatory Control in Wet Markets in Hong Kong, WHO (WPRO), Draft 02, 2004
Avoid collecting and transporting
birds from different farms or
collection centres in the same
vehicle and avoid transportation of
birds from one farm / collection
centre to another or from the
market back to the farm /
collection center, as H5N1 infected
birds from a farm or a market may
transmit the virus to other healthy
flocks.
Do not transport poultry with other
birds and animals, as this
increases the likelihood that Avian
Influenza viruses will enter other
animal / bird populations, risking
infection and reassortment with the
other influenza viruses, leading
to emergence of new strains of
influenza viruses.
Give preference to non-wooden /
bamboo cages: Use cages made of
materials like plastic or non-toxic
metal that can be easily cleaned and
disinfected.
5.3 Biosecurity in wet
markets
Segregation of species - When
introducing poultry to the market,
maintain the separation of species by
keeping separate species in different
cages.
Ensure all-in, all-out i.e. bringing
in and taking out a flock at one
time. This would imply selling all
birds on site. Avoid returning
unsold birds to the farm, as they
may be infected and may carry
back the virus. Prior arrangements
must be made for birds that are
unsold.
Slaughtering zones - Strictly ensure
a separate area for poultry
slaughtering, processing away
from the selling area. This will
improve biosecurity and reduce
the likelihood that products or
consumers in other areas get
contaminated.
Processing equipment and work
surfaces - Use non-toxic, impervious
and easily cleanable work surfaces
(e.g. chopping boards, work tables).
Avoid use of wooden surfaces,
wooden knives as they cannot be
cleaned.
Processing - Ensure proper
scalding of poultry before de-
feathering. Use hot, potable water
for scalding and change the
scalding water frequently.
Customer orientation - Do not
allow or permit the customers
to touch and inspect live poultry
before purchase; discourage
selling live poultry to customers.
Cold Chain facilities - Though the
virus survives low temperatures,
adherence to the cold chain is vital
from the food safety perspective.
Ensure chillers and chilled display
cabinets are used with back-up
power supply.
18
Hygiene, sanitation and waste
management
21
:
Compulsory rest days The live
animal markets in many areas might
be working seven days a week.
Having compulsory rest days
periodically would facilitate emptying,
cleaning and disinfecting the entire
market regularly. This would improve
hygiene and prevent build up of
pathogens and H5N1 virus load
Hygienic cages Cages holding
poultry should not be placed
below cages with other birds, to
prevent cross-contamination with
faeces. If unavoidable, place waste
trays under the cages. Ensure
adequate ventilation and lower
stacking crates so as to help
reduce infection.
Cleaning facilities Set up a
separate area to clean and
disinfect cages. Cages should be
made of material easy to clean and
disinfect. Hand washing basins with
soap and potable water should be
provided where humans and birds
come into contact.
Clean and disinfect premises and
equipment Following slaughtering
operations, clean and disinfect
premises (floors, walls, work tables,
slabs, racks etc.) and equipment
(knives, hooks, killing cones, de-
featherer, scalder, chopping board
etc.) frequently.
19
Separate selling area observed in some wet markets
(WHO, 2006)
Use of plastic cages: easy to clean and wash
(WHO, 2006)
21
Let us stop the killer virus at source! - Preventive measures to stop the spread of Bird Flu (Draft),
WHO/FAO/OIE November 2005. As from March 2006, final version available at: www.wpro.who.int/avian
Drainage system Ensure drains
are covered, sloped well and
facilitate flow of effluent in a
direction opposite to the process
flow (e.g. blood and scalding
water from slaughtering area
should not flow towards the
forward process flow areas like
selling area).
Personal protective gear Ensure
workers in slaughtering and
selling operations wear clean,
light coloured protected clothing,
including clean aprons and
rubber boots everyday and avoid
using the same clothes and boots
back home.
Personal hygiene Ensure the
workers handle live poultry and
engage in slaughter only after a
thorough handwash with soap
and potable water. Hands should
be washed frequently with
soap and potable water and
particularly after change of
processes. Following slaughter
and processing, the workers
should preferably take a bath at
the market personnel facilities or
change into clean clothes and
shoes after washing hands, arms
and feet thoroughly with soap and
potable water and drying with
clean towel / cloth.
Effective management of hazardous
waste Proper disposal of carcasses,
blood and other hazardous waste (liquid
and solid) disposal needs to be enforced.
All dead birds and other contaminated
objects (for instance: blood, feathers)
must be destroyed properly
22
as soon
as possible during the day through
proper burying or incineration, as
mentioned earlier.
Disease detection
Monitoring Poultry in the market
should be continuosly assessed for
sickness. Collaborate to conduct
regular surveillance, sampling and
analysis along with market
associations, local health authorities
and veterinary authorities.
Notification Report diseased or
dead birds immediately to health and
veterinary authorities. Appropriate
action should then be taken by the
authorities.
Traceability Support efforts to
ensure that the source of sick birds is
traceable back along the production
and marketing chain.
Food safety training and awareness
Train the market community
associations, market stall owners,
workers and local health authorities
20
22
Prevention and control of avian flu in small scale poultry, A guide for veterinary paraprofessionals in
Cambodia, FAO, 2005. http://www.fao.org/ag/againfo/subjects/documents/ai/AI-paravets-guide.pdf
in basic food safety aspects and
measures to be taken for mitigating
infection risks from Avian Influenza.
5.4 Consumption - Safety at
Customers' and Consumers'
end
Avoid buying live poultry/ birds and then
slaughtering at home and/or in food
service establishments. Slaughtering,
de-feathering and degutting poultry
birds can be risky if infected.
Where available, buy processed,
chilled and hygienically packed
raw poultry meat from an
established and reputed market
place and preferably from an
accredited Hazard Analysis Critical
Control Point (HACCP) food safety
systems certified company.
Keep Clean When preparing food,
follow good hygiene practice. Clean
and sanitize work surface, equipment
and utensils and wash hands
frequently.
Separate raw and cooked food items
Separate raw from cooked meat
and other cooked food items. Use
separate equipment and utensils such
as knives and chopping boards for
raw foods.
Cook thoroughly - To ensure the
safety of cooked meat, its juices must
run clear and no parts of the meat
should be red or pink. Ensure
thorough boiling / roasting / frying
(core temperature of food should be
more than 70 C) as this kills the virus
and other pathogens too.
Eggs from infected birds can harbour
the virus both outside and within the
shell and should therefore be
cooked well (with no "runny" yolks)
before consumption. Raw eggs
should not be used in foods that will
not be further heat-treated as, for
example by cooking or baking.
Do not prepare and consume
speciality raw dishes made from birds
or poultry raw meat and blood.
Keep food at safe temperatures
From the food safety perspective, eat
cooked food immediately and do not
leave cooked food at room
temperature beyond 2 hours. Keep
cooked food steaming hot (more
than 60C) prior to serving.
21
6.1 How are people infected?
Direct contact with an infected bird, poultry, or
spaces and surfaces and objects
contaminated by their faeces, is presently
considered the main route of human
infection. As infected birds shed large
quantities of virus in their faeces, opportunities
for exposure to infected droppings or to
environments contaminated by the virus are
abundant under such conditions. Exposure is
considered most likely during slaughtering,
defeathering, butchering, and preparation of
poultry for cooking.
What precautions should be taken by
people involved in the food chain?
Vaccination for public health purposes:
Health authorities may consider
vaccination against seasonal influenza for
persons at risk of occupational exposure to
the H5N1 virus. Vaccination against
seasonal influenza is a public health
measure aimed at reducing opportunities
for the virus to re-assort during co-infection
of a human with both avian and currently
circulating human influenza viruses. At
least some pandemic viruses are known to
have emerged following a re-assortment
event. Vaccination against seasonal
influenza will not protect people against
infection with the H5N1 virus; no vaccine
against H5N1 is presently available.
Persons who are in close contact with live
animals including birds and poultry should
wash their hands frequently with soap,
particularly after change of a process.
Persons undertaking slaughtering and
those in selling operations should wear
clean, light coloured protected clothing,
including clean aprons and rubber
boots everyday and avoid wearing the
same clothes and boots while returning
home.
Following slaughter and processing, the
concerned persons should preferably take
a bath at the market personnel facilities or
change into clean clothes and shoes after
washing hands, arms and feet thoroughly
with soap and potable water and drying
with clean towel / cloth.
Food handlers /consumers should avoid
buying live animals (poultry) and then
slaughtering them at home / food service
establishments.
Food handlers / consumers involved in
food processing / preparation should wash
their hands thoroughly with soap and warm
water. They should clean and disinfect
equipment and surfaces in contact with the
meat products.
6
Protection of human beings
24
All concerned persons at risk, both
environmentally and occupationally
23
,
should be vaccinated with the current
WHO recommended influenza vaccine as
soon as possible, to avoid simultaneous
infection by human influenza and Avian
Influenza. This, however, does not
specifically protect against H5N1.
How do you know if you are infected?
24
Be aware of the early clinical symptoms of
H5N1 infection, but also know that many
other common diseases - of far less concern
- will show similar early symptoms.
Most patients infected with the H5N1
virus show initial symptoms of fever
(380 C or higher) followed by
influenza-like respiratory symptoms,
including cough, rhinorrhea, sore
throat, and (less frequently) shortness
of breath. Watery diarrhoea is often
present in the early stages of illness,
and may precede respiratory symptoms
by up to one week. Gastrointestinal
symptoms (abdominal pain, vomiting)
and headache may occur.
Check for these signs (especially
fever) each day during potential
exposure and for 14 days after last
exposure.
Communicate any symptoms to a
designated local physician and
provide background information on
history of exposure.
23
Persons at risk include poultry workers, poultry transport and slaughtering workers, cullers, veterinarians,
food inspectors, local health authority personnel and other professional groups.
24
http://www.who.int/csr/disease/avian_influenza/guidelines/firstoutbreak/en/print.html
Children especially should be made aware of the
risks involved in having close contact, or playing with
birds (WHO, 2006)
7.1 The impending need
A recent OIE, WHO and FAO consultation
on Avian Influenza and human health
25
recognized the major role that wet markets
have played in the emergence of Avian
Influenza. In 1992, live poultry markets in
USA were considered the "missing link in
the epidemiology of influenza". In 1997,
the wet markets were identified as the
source of H5N1 infections in chicken farms
in Hong Kong, wherein 20 % of the chicken
in wet markets were found to be infected. In
2005, it has been reported that 83% of the
human H5N1 cases around the world have
had exposure to infected poultry.
A joint WHO/ FAO/OIE/World Bank
Conference on Avian Influenza and Human
Pandemic Influenza, held at Geneva
(November 2005, stressed the need to
contain the Avian Influenza H5N1 at the
source i.e. at poultry farms and at live
animal markets or "wet markets".
Subsequently, experts have urged the
countries to develop integrated national
plans across all sectors.
While the efforts of many agencies are
rightly and predominantly aimed at
containing the virus at the primary end of
the food chain i.e. at the poultry farms,
WHO, with its experience of developing
"Healthy Marketplaces", needs to take
initiatives at the intermediate i.e. the
marketplaces, particularly the "wet market"
and the tertiary ends of the food chain i.e.
the food service establishments and food
processing industry, as well as the
consumers of poultry products.
Accordingly, this Manual outlines the
strategy and plans of action for evolving
healthy market places with the emphasis on
"wet markets".
7.2 Strategy
a) Obtain broad political commitment
at the local level and stakeholder
participation
26
.
b) Assess the physical and operational
environment of the market settings
prioritize action and develop an
action plan.
25
OIE/FAO/WHO Consultation on Avian Influenza and Human Health: Risk reduction measures in
producing, marketing and living with animals in Asia, July 2005, Malaysia
26 Healthy marketplaces in the Western Pacific - Guiding Future Action - Applying a settings Approach to the
promotion of Health in Marketplaces, WHO (WPRO), 2004. To be purchased at:
http://www.wpro.who.int/publications/pub_9290611707.htm
Promoting Healthy Food Markets -
Strategy and Plans 7
c) Develop communication plans and
materials aimed at the general public
d) Adapt / develop a framework for
monitoring and analysis of costs and
benefits
27
of "Healthy Food Markets"
7.3 Implementing the
strategy
7.3.1 Obtain broad political
commitment and stakeholder
participation
a) Familiarize stakeholders with the
Healthy Food Markets concept and
food safety, and foster political
commitment of national, provincial and
local authorities for supporting Healthy
Food Markets Programme to ensure
support with appropriate resources.
b) Establish a local / district / provincial
Healthy Food Markets committee with
representation of all stakeholders for
regular monitoring of implementation
of action plans.
c) Identify priority health and safety
issues (current biosecurity level) of the
live animal markets and assess their
potential contribution to the current
outbreak of Avian Influenza.
d) Identify the salient markets that
require priority implementation and
facilitate the launch of a pilot
"Healthy Food Market(s)".
7.3.2 Assess the Physical and
Operational Environment of the
market settings, prioritize action and
develop an action plan.
a) Jointly assess the current situation: design,
construction and upkeep of the physical
environment of the marketplace in the
context of hygiene and sanitation.
Chapter 3.3 in this Manual provides hints
to help evaluate the market operations.
b) Jointly identify the gaps concerning
measures, including infrastructure, aimed
at protecting the health of consumers and
the market community. Adapt measures
outlined under Chapter 5.3, 5.4. and
Chapter 6.0 in this Manual.
c) Prioritize the most urgent and feasible
actions and organize them in a time
framed plan, along with budgetary
needs and identification of roles that
each segment of the market
community should fulfill.
7.3.3 Develop Communication plans and
materials aimed at the general public
To raise awareness on the advantages of
"Healthy Food Markets", some key messages
have been included in this Manual. These,
and the more general "5 key food safety
messages"
28
can be adapted to local needs,
for different public segments, with reference
to Avian Influenza. For example:
26
27
Costs and Benefits of regulatory Control in Wet Markets in Hong Kong, WHO (WPRO), Draft 02, 2004
28
Five Keys to Safer Food: "First adapt, then act" WHO, SEARO, 2005.
http://w3.whosea.org/en/Section23/Section1001/Section1110.htm and "Let us stop the killer virus at
source" - Preventive Measures to stop the spread of bird flu (Draft) WHO/FAO/OIE (2005). As from March
2006, final version available at: www.wpro.who.int/avian
Key food safety messages for
consumers, including those for safe
handling and consumption of poultry
and animal products.
Key food safety messages for the
marketing community with specific
reference to measures for "wet markets".
Key food safety messages for food
service establishments with specific
guidance in the context of handling,
slaughtering processing / cooking
and serving of poultry products.
7.3.4 Adapt / develop a framework for
monitoring and analysis of costs and
benefits of "Healthy Food Markets"
a) To assess the viability to replicate this
initiative in other settings, develop /
adapt a framework for monitoring
and analysis of the actual costs
incurred by the wet market
community and other contributors
(local, district, provincial, national
and international stakeholders).
Include all cost elements viz.
infrastructure, market surveillance,
research, training, etc.
b) Identify indicators to measure the
benefits of Healthy Food Markets viz.
enhanced public health; treatment
and control expenditures avoided;
economic losses avoided; preventing
a pandemic; public empowerment;
etc.
c) Carry out an evaluation of the validity
of Healthy Food Markets.
27
8
Key public health messages
Key public health messages for the general public
Avoid slaughtering live poultry and birds at home / food service establishments.
Slaughtering, de-feathering and degutting poultry / birds can be risky if the poultry
/ bird are infected.
Buy processed, chilled and hygienically packed raw poultry meat from an
established and reputed market place.
Keep Clean
When preparing food, practice good hygiene. Clean and sanitize the work surface,
equipment and utensils and wash hands frequently.
Separate raw and cooked
Separate raw meat from cooked meat and other cooked food. Use separate
equipment and utensils such as knives and chopping boards for raw foods.
Cook thoroughly
For cooked meat and poultry to be safe, their juices must run clear and no parts
of the meat should be red or pink.
Ensure thorough boiling / roasting / frying (core temperature of food should be
more than 70
0
C) as this kills the virus and other pathogens too.
Do not prepare and consume speciality raw dishes made from birds and poultry
raw meat and blood.
Eggs can contain the virus both on the outside (shell) and the inside (whites and
yolk). Eggs from areas with Avian Influenza outbreaks in poultry should not be
consumed raw or partially cooked (runny yolk); uncooked eggs should not be used
in foods that will not be cooked, baked or heat-treated in other ways.
Key public health messages for the public in affected areas
30
Avoid contact with chickens, ducks or other birds unless necessary.
Keep children away from poultry and their waste or feathers.
Do not keep birds as pets.
If you touch poultry or poultry faeces from affected areas, or walk on soil
contaminated with faeces, wash hands with soap and water. Clean shoes outside
the house. Seek medical help if you feel unwell.
30
Key public health messages for professional cullers
(And people handling diseased birds or decontaminating farms)
Wear protective clothing (mask, goggles, gown, rubber boots and gloves). If
unavailable, cover mouth with a cloth and hands and shoes with plastic bags, tied
with string. Wash or dispose clothing.
Dispose of diseased birds properly by burying bird carcasses and faeces at a
depth of at least 1metre. Avoid generating dust. Clean the area well with
detergent.
All persons who have been in close contact with the infected animals should wash
their hands with soap and potable water and disinfect frequently.
Key messages for Local Health Authorities
All persons exposed to infected chickens or to farms or to live animal
markets under suspicion should be under close monitoring by local health
authorities.
It is recommended that persons at specific risk of inhaling possible infected
material (e.g. cullers and farmers involved in mass culling at commercial
farms, workers at centralized live animal markets) receive prophylaxis with
antivirals3.
Such persons should also be vaccinated with influenza vaccine to avoid
simultaneous infection by human influenza and Avian Influenza and to minimize
the possibility of a re-assortment of the virus's genes.
Persons at high risk for severe complications of influenza (e.g.
immunocompromised, over 60 years old, or with known chronic heart or lung
disease) should not be allowed to work in the high risk areas (e.g. culling,
slaughtering).
There should be a serological surveillance of exposed animal workers and
veterinarians.
Questionnaire to assess practices in wet markets - Page 1
Date: ______________________________ Period of time: _______________________________________
Country:____________________________ Location: _______________________________________
Name of Market: ____________________ Address of Market: ____________________________________
Category of market: (tick one box) Urban market Rural market Other - Describe_______
Category of market: (tick one box) Wholesale Retail Mixed wholesale and retail
Live animal section: (tick one box) Permanent/fixed location Not permanent/fixed
location Mixture fixed/not Fixed
1. Origin of animals sold in Wildlife
the marketplace Animals from backyard/free-range farms
(you may tick more than Animals raised in pens or cages
one box) Origins of some animals not known
2. Total number of animals Less than 10 10-100 101-200 More than 200
for sale in the market on
the day of inspection
(tick one box)
3. Kinds of live animals for Chicken Turkey Dog Civet cat ................
sale in the entire market Duck Wild bird Cat Raccoon dog ................
(you may tick more than Goose Pig Monkey Ferret-badger ................
one box) Quail Rabbit Turtle ................ ................
Pigeon Rodent Reptile ................ ................
4. Manner of caging of Several animals share a cage/crate/pen
animals (you may tick Different kinds of animals are caged separately
more than one box) Different kinds of animals are caged together
Cages are stacked one on top of another
Animals are not caged
5. Types of cage material Steel/Wire Bamboo Wooden crate
(you may tick more than Plastic Basket Sack
one box) Other - Please describe ________________________________________
6. Slaughtering of animals Not done in the market
(YOU MAY TICK MORE Done within animal stalls
THAN ONE BOX) Done in a common area
9
Sample questionnaire to assess practices in
wet markets
(Draft WHO, FOS/WPRO, 2005)
32
Questionnaire to assess practices in wet markets - Page 2
7. No. of days animals may 1 day or less 2 days
remain in the stalls 3-7 days More than 7 days
(you may tick more than Other - Please describe ________________________________________
one box)
8. Fate of animals not sold Returned to farm after each day
at the end of a day or Returned to farm after 1 day
longer Killed and consumed by vendor or family
(you may tick more than Other - Please state ___________________________________________
one box)
9. Are animals arriving on Yes
different days, mixed No
together?
10.In relation to sick or Animals are accepted in the market for sale even if sick Yes No
dead animals Animals are accepted in the market for sale even if dead Yes No
(you must answer all) Animals that die while in the market are still sold Yes No
Animals that become sick while in the market are still sold Yes No
11.Are animals sampled On all animals Yes No
locally for testing? On sick animals Yes No
(you must answer all) On animals that die in the market Yes No
Other Yes No If yes please state:..........
12.Do veterinarians inspect
animals in the market?
(tick one box)
13. How frequently is the Not cleaned Daily Weekly Monthly Other - Please state..
marketplace cleaned?
(tick one box)
14.Are all animals Yes No
removed during cleaning?
15.Are animal stall holders Not required to clean
required to clean their Yes Daily Yes Weekly Yes Monthly Yes Other - Please state
stalls and cages or pens?
(tick one box)
16.Is a particular cleaning Yes No If Yes please describe what is required
programme required and .
enforced for animal stalls?
17.On the day of inspection Yes No If No, please describe
does it appear that the .
cleaning programme
is effective
18.Location of live animal Separated structure from other sections Mixed with other sections
section
No Weekly On arrival of animals only
Daily Monthly Other - Please state
Note: Animal refers to all mammals and birds
Name, function and signature of the person who administered this questionnaire:
(Extract from the report of the Expert
Mission to Support Develop a National
Action Plan to Prevent and Control the
Spread of the Avian Influenza Virus in
Wet Markets, Jakarta, Indonesia, January
2006)
29
STEP 1: Familiarize stakeholders with the
Healthy Food Markets concept and ensure
broad political commitment and active
stakeholder participation
It is envisaged to first hold a two / three day
meeting / workshop of all stakeholders to
familiarize them with the Healthy Food
Markets concept and obtain their
commitment and active support in
developing a National Healthy Food Market
Programme (HFMP). The participation of all
key stakeholders is recommended. Actions
to be taken include:
Constitution and empowerment of a
National Multisectoral HFM Task
Force for initiation, coordination and
monitoring of the HFMP and of Core
Groups for regular oversight of
respective HFM Pilot Projects;
Costing of national HFMP and pilot
HFM projects and provision of
funds from the private sector and
donors.
STEP 2: Raising public awareness for
preventing and controlling Avian Influenza
Based on WHO's advice on prevention and
control of Avian Influenza, the HFMP task
force to develop risk based messages in
local / regional languages for different
target segments viz. consumers, live or wet
animal market personnel and authorities
(national, provincial and local). The risk
communication strategy to disseminate
Avian Influenza prevention messages needs
to be worked out by the Task Force, keeping
in view the priorities and availability of funds.
STEP 3: Capacity building of Wet Market
Place Stakeholders in Healthy Food Market
concept
The multisectoral HFMP Task Force, in
close association with donor agencies,
should organize a `Training of Trainers'
programme to familiarize stakeholders
including consumer representatives /
consumer associations with Healthy Food
Markets concept.
STEP 4: Conduct local participatory
situation analysis of the existing market
conditions and identify gaps.
In order to plan activities in the identified
Healthy Food Market Place Projects, the
Proposed steps to launch a National
Healthy Food Markets Programme 10
29
For more information contact Hildebranda@searo.who.int at WHO SEARO
respective core group of pilot projects
should conduct a detailed situational
analysis to identify the needs of the partners.
The core group should conduct a survey
among the `wet market' community
members, consumers and live animal
suppliers to identify health and safety
concerns and possible solutions from their
point of view. Complete the list of concerns
and solutions based on the elements form
the tables below. Based on the survey, the
core group is required to identify the gaps in
the physical and operational environment of
the market setting.
STEP 5: Prioritize the actions and develop
work plans with budgets for respective pilot
projects.
Based on the identified gaps, the respective
core groups to prioritize actions based on
risk and develop work plans in association
with the HFMP task force. The key
processes involved in developing the work
plan are depicted as under:
34
List and
prioritize
activities
based on
identified gaps
Identify budget and
resources required
for prioritized
activities
Market Association
pooled funds
Fees for facilities Define
objectives,
measures and
targets for
each
prioritized
activity
Identify sources and
mobilize funds for
budgeted, prioritized
activities
Self-mobilization by
market members
Define
indicators for
monitoring
and evaluation
of each activity
Develop a time
schedule and identify
who does what and
when for each
prioritized activity
Government /
Donors / Loans
STEP 6: Implement the workplans
Keeping in view the priorities, the workplans
should be implemented by the empowered
core groups for the respective pilot project
in a participatory way. Before and during
the implementation process it is essential
that the ownership of the stakeholders is
ensured. The wet market community and
live animal suppliers should be actively
involved throughout all stages of the
planning process, as many changes and
improvements in the market's physical and
operational environment will require their
cooperation as well as resources.
Relocation decisions, if necessitated,
should be taken only with the involvement
of the market community.
STEP 7: Monitor implementation and
conduct periodic evaluation
With a view to make the Healthy Food
Market projects successful and sustainable, it
is imperative that regular monitoring and
periodic evaluation is undertaken. Therefore,
it is important that the HFMP task force and
core group together establish milestones to
be achieved in the short, medium and long
run. Consequently, it is also important that
appropriate and measurable indicators are
identified and incorporated in the workplans.
The marketplace managers need to be
empowered to monitor the implementation
of all controls and to take corrective action
as necessary. Corrective action needs to be
developed for each control in conjunction
with the person undertaking the control.
STEP 8: Draw from lessons learnt
The evaluation process comprising
collation of data and analysis would
reveal the milestones achieved and the
shortfalls. It is important to find out which
activities did not succeed and why so that
the lessons learnt can be incorporated
into the National Healthy Food Market
Programme. This would facilitate timely,
effective and efficient replication of the
project.
35
1. World Health Organisation - WHO
WHO | Influenza pandemic threat: current situation
http://www.who.int/csr/disease/avian_influenza/pandemic/en/index.html
Avian Influenza: guidelines, recommandations, descriptions
http://www.who.int/csr/disease/avian_influenza/guidelinestopics/en/index.html
Avian Influenza ("bird flu") and the significance of its transmission to humans
http://www.who.int/mediacentre/factsheets/avian_influenza/en/index.html
Avian Influenza Frequently Asked Questions FAQs
http://www.who.int/csr/disease/avian_influenza/avian_faqs/en/index.html
WHO guidelines for the use of seasonal influenza vaccine in humans at risk of AI infection
http://www.who.int/csr/disease/avian_influenza/guidelines/seasonal_vaccine/en/
WHO interim recommendations for the protection of persons involved in the mass
slaughter of animals potentially infected with highly pathogenic Avian Influenza viruses
http://www.who.int/csr/disease/avian_influenza/guidelines/en/Avian%20Influenza.pdf
WHO recommendations relating to travellers coming from and going to countries
experiencing outbreaks of highly pathogenic H5N1 Avian Influenza.
http://www.who.int/csr/disease/avian_influenza/travel2005_11_3/en/index.html
Non-pharmaceutical interventions: their role in reducing transmission and spread
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Food Safety Issues
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Tips that can help you avoid Avian Influenza, WHO Regional Office for South East Asia
http://w3.whosea.org/EN/Section10/section1027/Section2208.htm
2. Food and Agriculture Organisation - FAO
FAO: Animal Health Avian Influenza
http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/special_avian.html
FAO Information Ressources
http://www.fao.org/ag/againfo/subjects/en/health/diseasescards/avian_recomm.html
Web Resources 11
AI Disease card
http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/avian.html
FAO/OIE/WHO Consultation on Avian Influenza and human health: risk
reduction measures in producing, marketing, and living with animals in Asia
[Kuala Lumpur Report]
http://www.fao.org/ag/againfo/subjects/documents/ai/concmalaysia.pdf
Prevention and Control of Avian Flu in Small-scale Poultry: A guide for veterinary
paraprofessionals in Vietnam.
http://www.fao.org/ag/againfo/subjects/documents/ai/AIManual_VN2005(en).pdf
Prevention and Control of Avian Flu in Small-scale Poultry: A guide for veterinary
paraprofessionals in Cambodia.
http://www.fao.org/ag/againfo/subjects/documents/ai/AI-paravets-guide.pdf
Avian Influenza - Safety Measures
http://www.fao.org/ag/againfo/subjects/en/health/diseases-cards/avian_safety.html
Economic and social impacts on Avian Influenza outbreaks
http://www.fao.org/ag/againfo/subjects/en/health/diseases-
cards/cd/documents/Economic-and-social-impacts-of-avian-influenza-Geneva.pdf
3. World Organisation for animal Health - OIE
OIE : Avian Influenza
http://www.oie.int/eng/AVIAN_INFLUENZA/home.htm
OIE Guidelines for control of the disease in Asia
http://www.oie.int/eng/AVIAN_INFLUENZA/guidelines.htm
Zoning and compartmentalisation
http://www.oie.int/eng/AVIAN_INFLUENZA/zoning_2005.pdf
AI Disease card
http://www.oie.int/eng/AVIAN_INFLUENZA/Disease%20card.pdf
4. Other
Biosecurity - General Information and guidelines - University of Minnesota
http://www.ansci.umn.edu/poultry/resources/biosecurity.htm#general
"Avian Influenza risk perception" , Fielding R, Lam WWT, Ho EYY, Lam TH, Hedley AJ,
Leung GM., Hong Kong, University of Hong Kong, Special Administrative Region, China
Emerging Infectious Diseases, Vol. 11, No. 5, May 2005
http:// www.cdc.gov/eid
38
PUBLlC HLALTH
lNTLRvLNTlONS Ior
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A HanuaI fer Impreving iesecurity
in the Feed 5uppIy 6hain:
Fecusing en Live AnimaI Harkets