Topic
Paper A
Yale Model United Nations XXXIV
WHO
Zoonoses – Particularly Avian Influenza
Sara Sussman
YMUN XXXIV WHO Topic Paper A |2
Letter from the Undersecretary General, ECOSOC Committees
Dear Delegates,
Welcome to the Economic and Social Council Committees at YMUN XXXIV. My name
is David Porter, and I am the USG for ECOSOC. I am a sophomore in Saybrook College here at
Yale and am majoring in history. I grew up in Southern California, and looking forward to
returning to the superior coast after graduation (Yale is great, but the East Coast is nothing
compared to the West). I’ve been doing MUN for 6 years now, since I was a freshman in high
school, and it has certainly broadened my horizons and given me better understanding of the rest
of the world. In addition to MUN, at Yale I am actively involved in the Yale Political Union and
its Liberal Party and in not getting nearly enough sleep.
Each of the ECOSOC committee’s at this year’s YMUN is dealing with issues that are
both pressing internationally and relevant, possibly immediately so, to your lives in America. In
the UN Environmental Program, land degradation is causing famine and economic hardship
around the world, while carbon emissions are possibly the single biggest environmental issue
facing us, in that they are central to the issue of climate change. In the World Health
Organization, ensuring the availability of AIDS drugs is both crucial to human dignity and
essential to economic and social stability in much of sub-Saharan Africa, while Zoonoses are the
looming threat that many recognize but few have dealt with. In OPEC, “Oil, Energy, and
Sustainable Development” bears on both energy security and on the ability of OPEC nations to
prepare to move beyond an oil economy, while “strategies for increasing OPEC market share”
will force you to examine the relationship between oil and international relations. Finally the
Asia and the Pacific committee will both consider how Asia can continue to develop at its
current rate given the pressures that development places on the climate and the relationship
between gender and poverty.
This conference will have the most value for you if you put in effort beforehand to make
it a worthwhile experience. Read the topic papers your chairs have provided you, but don’t limit
yourselves to them. Without having done significant research into the multitude of factors that
affect everything you will be discussing in an ECOSOC committee and making an effort to
understand the relationship between your topics and the nation you represent, you will not find
this conference as rewarding. Good luck, work hard, and feel free to contact either myself or
your chair with any questions you may have about the conference.
David Porter,
Under-Secretary General, ECOSOC Committees
YMUN XXXIV
David.porter@yale.edu
YMUN XXXIV WHO Topic Paper A |3
Letter from the Chair, World Health Organization
Dear Delegates,
Welcome to YMUN’s World Health Organization Committee! The vice-chairs and I have
been working very hard to provide you with interesting, thought-provoking topics for your
weekend Yale. I hope you all enjoy these topics as much as we do and I look forward to meeting
you all in January.
My name is Sara Sussman and I’m a junior here at Yale. My major is History of Science
and Medicine but I am also a pre-med student. I grew up on Long Island, NY and I have been
doing Model UN for 8 years. Besides Model UN, I am a member of Community Health
Educators, where I teach health education to New Haven middle schoolers.
If you have any questions about the topics or the committee feel free to email me at
sara.sussman@yale.edu or check the YMUN website (www.yale.edu/yira/ymun) for updates
before the conference. Once again I look forward to meeting you in January. Until then, good
luck with your research and get ready for a great WHO committee!
Best,
Sara Sussman
YMUN XXXIV WHO Topic Paper A |4
Topic: Zoonoses – Particularly Avian Influenza
History
Zoonoses are defined as being any
disease or infection that can be transmitted
from vertebrate animals to man under
natural conditions. These diseases or
infections can be transmitted by bacteria,
virus, parasites or other unconventional
agents.1 Common zoonoses include
salmonella, transmitted by eating infected
foods, and rabies, which is transmitted
through an animal bite.
There are over 200 zoonoses that
have been identified but one zoonosis has
been getting a large amount of press
coverage lately: avian influenza, or bird flu.
While influenza viruses are usually highly
species-specific, meaning that they only
infect one species and are not usually
contagious to other species, there have been
some cases of humans being infected with
the avian influenza virus, and it has become
a fear that avian influenza will start a new
influenza epidemic in humans.
There are over 100 different strains
of avian influenza. Some of these strains
cause mild respiratory symptoms, reduced
egg production, and ruffled feathers. The
other, less common but more worrisome,
strains cause severe symptoms, rapid
contagion and a mortality rate that is close to
100% within the first two days of infection.
This form of the virus, which was
discovered in Italy in 1878, invades the
internal organs and causes massive
hemorrhaging.2 Many birds can carry some
World Health Organization. “Zoonoses and
Veterinary Public Health.” World Health
Organization, http://www.who.int/zoonoses/en/.
2 World Health Organization. “Avian Influenza (“bird
flu”) Fact Sheet.” World Health Organization,
1
strains of the virus in their intestines with no
signs of infection but still shed the virus in
their saliva, nasal secretions, and feces.
Other birds or humans in contact with these
excretions could potentially become
infected.3
There are only four strains of the
avian influenza virus that have to date
infected humans, H5N1, H7N3, H7N7, and
H9N2. Most of the cases resulted in mild
symptoms, with the exception of the H5N1
virus.4 This form of the virus is highly
contagious and deadly in birds, and is not
frequently capable of being transmitted to
humans, although there are cases in which it
was found in humans. Humans are likely to
become infected by being in contact with the
infected birds or their excretions. Of the
four viruses that have been found in humans,
H5N1 is the virus reported most frequently
for severe disease and death.5 This is the
virus that is most focused on by health
officials and causes the most concern in
public health communities.
The first documented cases of avian
influenza H5N1 in humans were in 1997 in
Hong Kong and the cases coincided with an
outbreak in poultry farms. It was seen that
the people were infected by direct contact
with the infected birds and was not
contagious between humans.6 Since then
there have been increasing numbers of
infections but still limited transmission
between humans.
http://www.who.int/mediacentre/factsheets/avian_inf
luenza/en/.
3 Centers for Disease Control. “Key Facts about Avian
Influenza” Centers for Disease Control,
http://www.cdc.gov/flu/avian/gen-info/facts.htm.
4
WHO. “Avian Influenza (“bird flu”) Fact Sheet.”
5
CDC. “Key Facts about Avian Influenza.”
6
WHO. “Avian Influenza (“bird flu”) Fact Sheet.”
YMUN XXXIV WHO Topic Paper A |5
In the past, influenza epidemics have
swept across nations in a very short amount
of time. The advent of international travel
has only increased the ability for viruses to
move from country to country as well. In
addition, since avian influenza affects a
particularly migratory animal, the bird, it
would be easier for the virus to be moved
longer distances via the animals.
Current Situation:
Of the avian influenza viruses that
have crossed the species barrier to humans,
H5N1 is the one that is creating the most
concern, having proved fatal to nearly half
of the people infected. The incubation
period of the virus is longer than the typical
human influenza and unlike the regular flu,
which usually proves most dangerous to
infants and elderly people, the majority of
cases of H5N1 were found in people aged
less than 40 years old and mortality was
highest in people from 10-19 years old.7
While there has been evidence of
human-to-human transmission it has been
“limited, inefficient and unsustained”8
However, there is the risk that, given the
opportunity, H5N1 will start the next great
influenza epidemic. In March of 2006, a
research study indicated why the H5N1
influenza does not so easily infect humans
and why it is not readily transmissible from
person-to-person by coughing or sneezing.
“Whereas human influenza viruses attach
themselves to molecules in cells lining the
nose and throat, avian viruses prefer to bind
to molecules located deep in the lungs.” 9
Since influenza viruses are highly mutable
and always changing, the chances of it
transforming into a more contagious viruses
is fairly high since it would just have to
adapt to be able attach to the lining of the
nose and throat. Since this virus does not
usually infect humans, we have little or no
immune protection against them.10 While
many nations and the World Health
Organization are monitoring this disease
closely, effective prevention and
containment strategies for a potential
epidemic must be developed by this
committee.
To date, the country with the most
human cases of H5N1 is Indonesia, with 113
cases, 91 of them fatal. Worldwide, the total
number of reported and laboratory
confirmed cases since 2003 is 335, with 206
of them fatal.11 For a map of all human
H5N1 infections since 2003, please refer to
the World Health Organization’s website at:
http://gamapserver.who.int/mapLibrary/Files
/Maps/Global_H5N1inHumanCUMULATI
VE_FIMS_20071017.png for the most upto-date statistics. The United States
currently has a bird import ban from all
H5N1 affected countries. The current
spread of this virus, since 2003, is the most
severe that we have seen in the history of
this disease and H5N1 has proved to be
particularly tenacious.12
An influenza pandemic is especially
feared because it would have the capability
to rapidly infect multiple countries. Once
the virus is able to be transmitted through
coughing or sneezing, it will become nearly
CDC. “Key Facts about Avian Influenza.”
World Health Organization. “Cumulative Number
of Confirmed Cases of Avian Influenza reported to
WHO.” World Health Organization,
http://www.who.int/csr/disease/avian_influenza/cou
ntry/cases_table_2007_11_12/en/index.html.
12 World Health Organization. “Avian Influenza: Food
Safety Issues.” World Health Organization.
http://www.who.int/foodsafety/micro/avian/en/inde
x1.html
10
Centers for Disease Control. “Current H5N1
Situation.” Centers for Disease Control.
http://www.cdc.gov/flu/avian/outbreaks/current.htm
8 CDC. “Key Facts about Avian Influenza.”
9 World Health Organization. “H5N1 Avian Influenza:
Timeline of Major Events.” World Health
Organization.
http://www.who.int/csr/disease/avian_influenza/time
line_07_11_04.pdf
7
11
YMUN XXXIV WHO Topic Paper A |6
impossible to prevent its transmission. In
addition, in this time of worldwide travel,
containing the infected people to keep the
virus from spreading will be particularly
difficult. Also, as was seen in the 1918
Spanish Influenza epidemic, many people
becoming infected overwhelms the health
services of a nation, making treatment less
available and would also cause economic
and social disruptions.13 It is obvious that a
pandemic must be prevented or dealt with in
a timely matter to prevent a worldwide
emergency.
Not only is it essential that the
nations of this body be prepared for an
outbreak in other nations, they need to be
prepared for an outbreak within their own
nation. A plan of containment and treatment
must be established in order to prevent it
from reaching other countries. Also, the fact
that the virus infects birds gives the nations
another factor to deal with. While the
disease is typically limited to poultry,
evidence has shown the virus in some
species of wild birds. Even if international
travel to and from the infected country is
limited, it is impossible to keep the
migratory birds within a nation’s border.
“Scientists are increasingly convinced that at
least some migratory waterfowl are now
carrying the H5N1 virus in its highly
pathogenic form, sometimes over long
distances, and introducing the virus to
poultry flocks in areas that lie along their
migratory routes.”14 This was discovered
when birds in Turkey, along the migratory
routes of flocks of birds originating from the
Qinghai Lake in China, were found sick
from a virus identical to that of the birds in
China.15 This fact provides a new aspect of
World Health Organization. “Avian Influenza
Frequently Asked Questions.” World Health
Organization.
http://www.who.int/csr/disease/avian_influenza/avia
n_faqs/en/
14 WHO. “Avian Influenza (“bird flu”) Fact Sheet.”
15 Ibid.
13
the problem that must be addressed when
containment plans are formulated.
In addition, the fact that the birds are
often part of the nations food supply
provides another problem to be tackled by
infected nations. The most dangerous
activities for humans that are living in areas
infected with the virus include: “the
slaughtering, defeathering, butchering and
preparation for consumption of infected
birds.” In addition, it was seen that
exposure to feces of the infected birds or
swimming in water where infected bird
carcasses or their feces have been discarded
can cause infection as well.16 There are
measures that can be taken for people to
protect themselves from infection while
slaughtering chicken or preparing meals.17
The information about these protective
measures should be made available to the
public, particularly in infected nations, to
help prevent human infection.
Currently there is no vaccine that can
protect against avian influenza, and
considering that the virus would have to
mutate to be able to easily transmit from
person-to-person, any vaccine that is
developed now would not be able to prevent
against a future form of the virus. There are
some antivirals that have been developed
that can help to limit the symptoms of the
virus and lower its chance of being spread.
One particular antiviral is known as Tamiflu
and can improve the prospect of survival if it
is administered within 48 hours of
infection.18 Clinicians have had a hard time
detecting the effectiveness of this drug,
however, because many of the cases were
discovered after the 48 hour time period.
This emphasizes the need for some sort of
monitoring system to be able to identify
cases before the chance of treating them has
passed.
Ibid.
WHO. “Avian Influenza: Food Safety Issues.”
18
WHO. “Avian Influenza (“bird flu”) Fact Sheet.”
16
17
YMUN XXXIV WHO Topic Paper A |7
Role of the Committee:
This committee needs to develop a
plan to deal with a potential outbreak of
avian influenza. The committee should
focus on what actions will be taken by
specific nations to prevent the spread of the
virus to their citizens or keep the virus from
leaving their country. In addition, the World
Health Organization needs to design a plan
to contain and treat those who were infected.
Many nations, such as the United
States, have already been formulating a
course of action that they would follow in
the case of a worldwide epidemic.
However, more nations need to figure out
how they would handle such a situation. For
the nation who has been infected, the issues
that most need to be dealt with are how to
contain the people who have been infected,
how to treat those infected and prevent them
from infecting those that they are in contact
with, and what to do about the infected
birds. For those nations that want to prevent
their nation from becoming infected, they
must deal with what kind of travel
restrictions will be put in place, how they
will monitor to ensure that no one is
infected, and what they should do about bird
imports into their country.
In addition, a public awareness
campaign should be developed in order to
inform the nation’s people about the risk
that they are at and how to best protect
themselves from becoming infected. This
body should devise a way to quickly and
effectively notify the people within an
infected nation of an outbreak to increase
awareness without causing nationwide or
worldwide panic. Also, the committee must
decide if funding should go into research on
an avian influenza vaccine and whether such
a vaccine should be stockpiled in case of an
outbreak. During the initial outbreak a few
years ago, there was much more panic about
the possibility of an international pandemic
and there were many people who were
interested in purchasing Tamiflu for
themselves before the supply ran out. The
World Health Organization should decide
whether more funding should be put into
creating a larger supply of Tamiflu and other
antivirals that treat the disease.