Practical high pathogenicity avian influenza first-response training exercises

The response to an avian influenza outbreak, especially highly pathogenic avian influenza (HPAI), should focus on four basic principles: 1) protect humans first, 2) protect animals 3) contain the virus, and 4) ensure that the outbreak remains a single event, by preparing response teams to work together effectively through advance training. The Stamping Out Pandemic and Avian Influenza (STOP AI) project is a U.S. Agency for International Development-funded global activity. STOP AI has designed and conducted practical, experiential training exercises that engage participants in simulated experiences that enhance their confidence and ability to apply these principles during a real HPAI outbreak. This article describes three specific exercises: 1) wearing and removing personal protective equipment (PPE) in a controlled environment, 2) site zoning, and 3) a planning and resource mapping exercise staged in Poultopia--a fictional region in a developing country. The PPE activity emphasizes the physical challenges of working in full PPE and the importance of proper equipment removal. In the zoning exercise, response teams focus on the areas and the tasks required by setting up a clean area, transit corridor, infected/culling area, and nontransit areas at a farm, village, or other location. In Poultopia, participants must determine where surveillance should occur, decide where roadblocks should be placed during an outbreak, choose which birds to cull first and determine how to dispose of them safely, ascertain the types of personnel and equipment needed, and assess timing issues. The Poultopia scenarios are adapted to the conditions of the region where the training takes place, thus adding to their realism and utility. The practical techniques described here have been taught successfully through STOP AI in more than 30 countries in Europe, Asia, and Africa.