Chicken Farmer

Once there is one case of chicken being infected by avian influenza, government become quite reactive. More seriously, all the chicken, either imported or local fed, are gathered and slaughter, render them the financial loss. Therefore, we thought that if chicken farmers can take initiative to detect their own chickens regularly, will it prevent a large scale outbreak and in turn reduce their loss? We have contacted an association and a chicken farmer respectively and both of them are local. (conflict of interest?)

1. The new territories chicken breeders association (10/7)
We interviewed a representative from the association. Before the interview, we guessed they may be interested a little bit as they suffer the loss of money during central slaughtering. However, out of our expectation, they were almost acceptable to the arrangements from government because they thought that avian influenza detection should be conducted by neutral position, ie government, which is none of chicken farmer/associations’ business.

2. Fork Eat, a local chicken farm (29/7)
We also interviewed two local chicken farmers Mr. Joe Lit and Mr. Charles Lam. They are the founder of the local chicken farm and restaurant “Fork Eat”. Similar to the attitudes of chicken breeders association, they agreed that the role they play in avian flu detection is very passive. The decision, whether slaughter or not, absolutely depends on government. Moreover, they indicated that chicken farms in Hong Kong are undergone regular inspection frequently (approximately 2-3 times per month), which is more than enough in their opinions, so they can’t find any incentive to detect by themselves. (Self check?)

Previously we have proposed government (eg department of health) and chicken farmers will be the major customers in our second direction, avian influenza subtyping, after collecting the chicken farmers’ opinions, we laid the proposal of targeting chicken farmer aside, but confirmed to mainly focus on the market of hospitals/ government/ clinics.

Government

At the beginning, we hoped to have face-to-face interview, along with laboratory visit, unfortunately, due to the government’s policies and instructions, they refused our visit requirement, in alternative, we interviewed them, Department of Health, Centre for Health Protection and Agriculture, Fisheries and Conservation Department (AFAD) through email.

1. Department of health
We interviewed (consulted) Dr. Au Ka-wing, Director of Health. He admitted early treatment for patients infected with avian influenza viruses may reduce the mortality rate and higher speed of laboratory confirmation may help fasten the initiation of medical treatment, although the time lag between onset of illness and initiation of medical treatment for avian influenza infection is affected by many factors, which is also consistent with what Prof Chan said. Nonetheless, targeted treatment for avian influenza may already be initiated for suspected cases before any laboratory confirmation.
The influenza viruses test for human specimens mainly provided by the Public Health Laboratory Services Branch under the Centre for Health Protection of the Department of Health. Thus, we further contacted the Centre for Health Protection for more details.

2. Centre for Health Protection
There are several duties of Public Health Laboratory Services Branch under the Centre for Health Protection. Offering laboratory diagnostic services for disease surveillance and control is one of the examples. They provide not merely diagnostic services to confirm whether the samples are positive on influenza, but also laboratory support on outbreak investigation, in other words, subtyping the suspected samples. During peak season or outbreak, rapid kit with subtyping function may help alleviate the pressure of outbreak investigation.

3. Agriculture, Fisheries and Conservation Department (AFAD)
Unlike Centre for Health Protection, Agriculture, Fisheries and Conservation Department (AFAD) is responsible to avian specimen inspection. They described some methods of detection and their procedures, for instance, haemagglutination inhibition test and direct RNA detection by PCR. In Hong Kong, there is only one veterinary laboratory (Tai Lung Veterinary Laboratory) in Hong Kong, while the detections approximately take at least 4 hours, while the size of sanitary testing and inspecting team is not big enough, 46 people in total. It is not difficult to imagine that the workloads of veterinary laboratory will be very large when handling a large amount of avian specimens during flu peak season.

During the interview with Prof. Chan, we know that point-of-care test for human influenza is quite common nowadays in spite of their high cost, there is nearly no rapid kit focusing on avian influenza subtyping, indicating that it may be a new direction of our product.

Citizen

We interviewed xxx publics by questionnaires………………….

During interview with different stakeholders, we also found they are not separated, but integrated: some cross-linkings do exist among different fields, for example, Prof Chan mentioned that early detection may help alleviate/ reduce the damages brought by rare type of influenza. However, in the process of communicating with general public, we found that some of them thought that there is no actual need. When we kept asking the reasons behind, almost all of them think influenza is not a big problem, reflecting the importance of promotion and education, which is highly related to our design: only people with high awareness, our design can function in maximum.
1 USD =22,732.09VND
Integration and design
We integrated the idea of xxx from xxxx into our project….

Standard Protocol

Concluded from opinions from different stakeholders, we constructed our standard protocol……………

Prototype

We integrated the idea of xxx from xxxx into our product…………………………..

No big difference between paper-based/ solution-based actually, but for solution-based, the pellet may be not condensed at the bottom of test tube paper-based may be better in this way (only need to shake the paper at the bottom before use alternative: try to condense the cell-free solution at the bottom

use smaller tube rather than 15ml tube → easier to make the pellet at the bottom

freeze-dry
during shipping, ensure low-temp environment prevent them from melting and the cell-free sol not dispersed around

• How to be “intergrated”:

Example: Prior to our meeting with Dr. Chan……, we believed as a team that the simplest way to collect ….. would be…... However….. made it clear to us that this is not possible……. Initially we believed the …… but said this would not be possible….

Inspiration

Here are a few examples of excellent Integrated Human Practices work:

• 2016 INSA Lyon
• 2016 UofC Calgary
• 2015 Bielefeld
• 2015 Edinburgh