Friday, September 25, 2015

FAO: Addressing Avian Influenza A(H7N9) Risk Communications


Photo Credit    ©FAO/ Cortney Price



While our eyes are firmly fixed on the expected return of HPAI H5 later this fall, in China a different bird flu threat is expected to mark its 4th return.  It is called H7N9, and unlike the Highly Pathogenic H5 viruses like H5N1, H5N6 and H5N8 (which also circulate in China), this virus doesn’t make poultry visibly ill. 


In birds, it is a low pathogenic strain (LPAI), but in humans, it is highly pathogenic.


So much so that more than 30% of those who are hospitalized with the virus do not survive.  It is not quite as deadly as H5N1 - but it has been far more prevalent in China - infecting well over 600 people over the past 3 winters. 


Given the limits of testing and surveillance, and the likelihood that there are many mild cases that go undetected, the full extent of these yearly epidemics is difficult to gauge.  It is likely that 600 cases represents only the tip of the iceberg.


The fact that the virus is LPAI in birds means that often the first (and only) clue that local birds have become infected comes when people in the region begin falling ill. `Healthy looking’ birds do not raise alarm bells, and so the virus is able to spread stealthily, and without interference. 


Much like the disconnect we’ve seen in Saudi Arabia over the risk of camels and MERS, convincing people that healthy birds can give them, or their families, a deadly infection is a tough sell.


The FAO today has released a document  on Avian H7N9 Risk Communications that addresses the many challenges of getting the message out regarding H7N9, and outlines four Risk Communication objectives:

  • 1. increase concern over the risks posed by H7N9;
  • 2. facilitate public support for government efforts to prevent H7N9 incursion/spread;
  • 3. reduce unnecessary product avoidance; and
  • 4. promote longer-term improvements to poultry market chains to reduce the risks posed by H7N9 and other pathogens, both in terms of public health and poultry-related livelihoods.


Over the years we’ve been lucky to benefit from the clear-eyed, coherent risk communications advice and tutelage of Dr. Peter Sandman & Dr. Jody Lanard. The Peter Sandman Risk Communications website is an invaluable repository of risk management advice, that quite frankly, should be second home for anyone involved in public relations or risk communications.

I’ve quite happily featured their writings many times over the year, including:

Sandman & Lanard On Ebola & Failures Of Imagination

NPR: Jody Lanard On Addressing Ebola Fears

Sandman & Lanard: Ebola Risk Communications

It doesn’t take but a cursory reading of this FAO document to recognize many of the `Best Practices’ espoused over the years by Sandman and Lanard.  And in fact, they are credited in the References section.  Things like :

• Inform early, often and transparently as the situation develops

—— Warn that messages designed early in an unfolding event may change as knowledge evolves.
—— Be open about your level of uncertainty.
—— Share your wish that you could be more certain.
—— When you modify your recommendations, highlight the fact that you are making a change and explain why the
change needs to be made.

—— Avoid both overly optimistic and overly alarming speculation.
—— Share the worst-case and most-likely scenarios that you are considering.
—— Show empathy (rather than contempt) for the excessive fears or undue complacency of your audience.

• Do not over-reassure
—— Avoid the temptation to say “The situation is under control.”
—— Instead of saying “the government is taking all possible/necessary measures,” convey the honest extent of your activities and explain them in detail.

• Say what you can realistically achieve
—— Build real expectations; tell people what they can expect.
—— Don’t make unrealistic promises; avoid the temptation to tell your audience what you think they want to hear.

• Share uncertainty and be open to suggestions

—— Convey your own level of uncertainty to your target audiences by sharing the factual and emotional context
of your situation.
—— Employ honesty and empathy.
—— Engage with your audience and listen to viewpoints.


This is just a taste, of course.  You’ll want to download the entire PDF file and read it in its entirety.   Even if you aren’t dealing with H7N9 in China, the techniques and advice offered here would prove invaluable to anyone who is tasked with communicating with the public during an emergency or crisis.


Addressing avian influenza A(H7N9) - Guidelines for risk communication messaging


Addressing avian influenza A(H7N9) - Guidelines for risk communication messaging

Photo Credits ©FAO/ Cortney Price

Sep 2015

Responding to the occurrence of influenza A (H7N9) virus requires a wide array of disciplines. Unlike H5N1 highly pathogenic avian influenza (HPAI), H7N9 is a low pathogenic virus that does not cause any disease signs in infected birds. Consequently there is no signal from poultry of the zoonotic risk at the animal-human interface. This makes it difficult to persuade animal workers of the potential danger from healthy-appearing poultry. Therefore, capacities in risk communication are crucial for animal and public health specialists, epidemiologists, virologists, veterinarians and many others working to reduce the risk this emerging virus poses.

Addressing avian influenza A(H7N9) - Guidelines for risk communication messaging


Cortney Price said...

Dear Michael,

Many thanks for helping to get the word out about the risk communication guidelines!

With regard to your blog entry, would it be possible to update the photo credit you cite? In addition to being contracted as a consultant to produce the document as main author (who benefitted tremendously from the invaluable contributions and mentorship of Jody Lanard and Peter Sandman), I am also the photographer of all the photos (which come from my recent risk communication missions to South East Asia and West Africa.

Much appreciated,

Cortney Price
Risk Communication Advisor

Michael Coston said...


My pleasure, I'll update it immediately.