Multiple Agency Partnerships Is the Key to Emerging Infectious Diseases
Zoonotic diseases are an emerging threat that can have a major impact on the human and animal health, as well as the local economy. Avian influenza, or bird flu, is a disease that can infect domestic birds, causing a large number of deaths due to infection or the culling of the flocks. Farmers can lose their flocks during an outbreak. In addition, the disease may threaten those in close contact with the affected birds. In 2017, after ten years of being free from the disease, Malaysia reported its first highly pathogenic avian influenza (H5N1) outbreak in the state of Kelantan. Fortunately, control of the situation was swift due to the early detection of the avian influenza case and rapid response by the veterinary authority of Malaysia. Malaysia has not reported any human avian flu cases, unlike neighboring countries Indonesia and Thailand.
The National Avian Influenza Simulation Exercise 2018 was a joint collaboration between the Ministry of Health, Malaysia One Health University Network (MyOHUN), the Department of Veterinary Services and the Department of Wildlife and National Parks. This three-day exercise began on August 14, 2018. Participation in this exercise was very diverse, with health practitioners, officers, and academics from ministries, agencies, hospitals, laboratories, health clinics, and universities. The exercises aim was to analyze the ability to coordinate an appropriate outbreak response to the disease threat. A considerable effort was dedicated to the logistical coordination by the agencies in this exercise, spread out across seven locations across the State of Negeri Sembilan. Locations included Tuanku Jaafar Hospital in Seremban, Port Dickson Hospital, Sikamat Health Clinic, Seremban District Health Office, Tuanku Ampuan Durah Secondary School, Port Dickson District Health Office and a Poultry Farm in Port Dickson. The scenarios for the case were developed and refined jointly by the Ministry of Health and the Department of Veterinary Services, making the simulation exercise as close as possible to potential real-life event. The simulation exercise not only exposed participants to the appropriate procedures needed to respond to a disease threat and prevent its spread, but also the necessary procedures that must be taken in preventing it from spreading further. Participants learned about biosafety measures on how to don and doff the personal protective equipment properly. Large white suits, blue gloves, and goggles were worn during the collection of dead domestic birds at the locations. Detailed explanations and instructions were given to ensure safe handling of the specimens.
In addition, this exercise was a networking and collaborating opportunity. According to Dr. Rohani Jahis, the coordinator of the exercise, “We brought in ministries and agencies to collaborate with us to make this exercise a success. We have also incorporated staff and officers from the veterinary department, district health offices, hospitals, health clinics and laboratories to make this exercise a reality.”
The exercise is also a time when gaps and mistakes can be identified in the authorities’ response. The debriefing session on August 16, 2018 gave the evaluators an opportunity to present their observations and feedback. The session was moderated by Prof. Dr. Latiffah Hassan, Coordinator of MyOHUN, and paneled by senior officers from the Ministry of Health, the Department of Veterinary Services, the Negeri Sembilan State Health Department and Department of Wildlife and National Parks. The participants responded with great enthusiasm as they increased their understanding of the interconnectedness of human, animals and the environment. The evaluators also highlighted certain aspects that the authorities must improve on to increase the capabilities and preparedness of human and animal related health agencies in preparing and responding to emerging disease threats in Malaysia.