H5N1 Continues To Spread Around The World

by DemFromCT

Iraq is not an easy place to get anything done.

Some Iraqi farmers are letting their birds loose rather than slaughter them and the lack of a proper shipping container has kept the tissue sample of a man suspected of dying of bird flu sitting in Baghdad despite reports it was being tested abroad.

Poor communications, scarce equipment and the dangers of the insurgency are all plaguing efforts to combat bird flu in Iraq.

Meanwhile Nigeria is reporting H5N1 in at least 3 different states. The presence of H5N1 in Africa is so worrisome that the WHO took the unusual step of announcing a statement by its Director General. In part it said:

This latest outbreak confirms that no country is immune to H5N1. Every country is at risk. Every country must prepare. There is a risk that outbreaks of H5N1 infection in birds could spread within Nigeria and into neighbouring countries. Nigeria is one of several African countries located on the Black Sea-Mediterranean flyway used by migratory birds. Human and animal health services must be on high alert, sharing information and quickly reporting any signs of disease in birds or humans that could be due to H5N1 avian influenza.

African health systems are already struggling to cope with children and adults suffering from HIV/AIDS, tuberculosis, malaria, respiratory infections and other infectious conditions. Human cases of H5N1 may be difficult to distinguish from other illnesses. We simply do not know what the impact of exposure to avian influenza will be on the many people who may be already immunocompromised and in a fragile state of health. Health workers must be fully alert and samples must be taken and sent to laboratories. When human cases of H5N1 are identified, coordinated human and animal health investigations will be essential.

If the H5N1 virus changes to allow it to pass easily from person to person, and it goes unchecked, this could trigger an influenza pandemic. H5N1 is spreading rapidly across the world. All countries must take measures to protect human health against avian flu, and prepare for a pandemic.

There is no time to waste. We are ready to help all African countries take measures to reduce the risks of H5N1.

The presence of HIV and H5N1 together has worried virologists for some time. Robert Webster, a well-known senior virologist at St. Jude's had this to say back in November:

QUESTIONER:  Laurie Garrett, Council on Foreign Relations.

Dr. Webster, you're really the godfather of flu research.  Among flu scientists you wear the crown.  So I had the question for you.

And, Steve [Wolinksy], since you are, also -- your other hat is HIV research, I'd ask you the same question -- does the section of the migratory bird flyway that's likely to fill in in the next few weeks, is that which heads to Africa.  And in Africa we have an unprecedented problem.  They have a massive population of people infected with HIV.

Would you please speculate on what you think would happen when an individual who is HIV positive becomes exposed to a bird or in some other way acquires an infection of H5N1?

WEBSTER:  Well, thank you for the crown.  I'm not sure that I wear it comfortably at the moment -- not at all.

My great concern I think I'm sharing with you is that if this virus and when this virus gets into Africa into the HIV-positive people, who are immunosuppressed, what happens in an immunosuppressed person we know with influenza in cancer patients, the virus is shed for an extended period of time, and it gives the virus the chance to accumulate the mutations of adaptation to humans.

And so this -- you put your finger on the great worry that we all have for this virus getting into Africa along with HIV.

African countries have few resouces and even fewer organized health and veterinary systems in place to deal with an extensive bird flu outbeak. Culling is both expensive and time consuming. As in Iraq, knowing what to do doesn't translate into getting done so easily. On top of that Nigeria has been the center of the WHO's polio eradication program, plagued by mistrust, rumor and suspicion from within, although recently deemed back on track.

As H5N1 continues its inexorable spread around the globe, affecting bird populations, it increases its exposure to humans. Each encounter is another chance for the virus to pick up mutations making it easier to spread from human to human. By next year, every country on the planet, including the US, is likely be affected. The economic toll is likely to run in the billions.

This is still not a pandemic. Human to human transmission is still rare, though more cases are being reported each day (China and Indonesia have recently reported new cases). But there's nothing in the news that's reassuring, and each new case in each new country reminds us that we have a ways to go in regard to pandemic preparedness. And the virus continues to mutate with each new infection.

Forget about labeling this as hype. The story's becoming harder to ignore even if you wanted to. And no one in the medical or science community is blowing this off. We need to keep a very close eye on this deadly virus, and keep another eye on government preparation plans.

The opportunity to rebuild some of our decaying public health infrastructure and create more resilient communities is there. Let's see what we do with the opportunity. 

Comments

[DemFromCT]

Maps of the outbreak in Nigeria can be found here

[Mimikatz]

Thanks for keeping us all up to date. The implications for Africa are truly frightening. There are other stories that are much more fun to read, but this one may be the one that ends up affecting our lives the most.

[Sara]

Today the report is of Swans in Sicily that had just flown north over the Med from Algeria -- first part of the spring return to Northern Europe, Poland, The Baltic States area apparently. Sick and dead birds have also now been found in Southern Italy.

Italy is clearly prepared to test and act -- it was about 24 hours delay between finding the first birds and reporting to the EU the results of tests. Virtually all the Swans in Europe -- Ireland to Western Russia winter in the coastal zone of Algeria, and then return to the same nesting areas every year. I would imagine that could mean many of Europe's swans have the possibility of being exposed. Swans mate for life -- and they make social arrangements during the first migration to the wintering areas, with the males returning to the female's home nest area.