Source: United Nations Office for the Coordination of Humanitarian Affairs - Integrated Regional Information Networks (IRIN)

Date: 02 May 2006
Congo: Interview with Dr Jean Vivien Mombouli on threat of avian flu
[This report does not necessarily reflect the views of the United Nations]

Brazzaville, 2 May 2006 (IRIN) - Threatened by the spread of the avian flu virus, the Republic of Congo sent samples of its dead birds to South African laboratories for testing. The tests registered negative. However, Dr Jean Viven Mombouli, the technical adviser to the Ministry of Health and Population Ministry, who is also the director of research in the Public Health National Laboratory, told IRIN on Sunday that samples were of poor quality and, as such, the country could not be declared safe from contamination of the virus. Below are excerpts of that interview:

QUESTION: Does the negative reading on the tests for the virus mean that the threat of the flu to the country is over?

ANSWER: On the contrary, the threat persists. Even though the [test] results are negative for the moment, that does not mean that Congo is not affected or will not be affected in the near future. We have an obligation to improve our sampling techniques so that our colleagues abroad can obtain better [test] results. Normally, a sample must arrive fresh at the laboratory for examination. The problems of transport and delivery of these samples shows the urgency with which we need to equip our national laboratory with the capacity to identify viruses rapidly and know what we are up against.

We should, at least, be able to know if we have the H5N1 or a subtype of H5N1; even if we still end up sending it abroad for further analysis. Therefore, the national laboratory needs to participate more actively in training technicians from the various ministries in sample taking.

Q: Does the national laboratory have a strategy to monitor and contain viruses, particularly the avian flu virus?

A: The national laboratory in itself cannot contain a virus. It does not have the mandate. There are several branches of government that are involved in the monitoring of the avian flu virus. There is an inter-ministerial committee that is working on this "crisis". It is composed of the health, agriculture, forestry, environment and trade ministries. On the administrative level, the Ministry for the Territorial Administration and Decentralisation is also concerned.

The inter-ministerial committee is under the authority of the prime minister. However, as a technical structure at the level of the national laboratory, we do not have the technical means to observe and detect the virus. These technical means are done on two levels: there is the rapid testing, and the second is the identification of the virus. These are highly trusted strategies that require that cultures of samples be made so as to allow the virus to develop and then be identified. These strategies are applicable in high security laboratories. Unfortunately, I have to say that Congo has not yet reached this level of technical development. The most important task undertaken by our laboratory is observation.

The observation of avian flu is an international job today. Because it is transmitted by air, if someone is affected that person can contaminate others just by breathing or coughing. For the moment, the H5N1 virus has not yet been able to jump from one human to another. We are observing the evolution of the virus so we can identify the moment it makes this leap. It is at that time that the virus will have taken on the characteristics of a pandemic.

There are two ways for the virus to become a pandemic: mutation and mixing.

In fact, a person infected with the normal flu virus and the H5N1 at the same time, can give the H5N1 the characteristics to become transmissible among humans. That would be the starting point of a pandemic. Animals can also serve [as hosts] for the "mixing" of the virus. We fear that pigs can easily transmit viruses to man; pigs could serve as an incubator [for the virus]. All I am saying here is that the task of monitoring is a very important.

Q: Will the degree of attention given to the avian flu not divert attention away from monitoring other viruses such as Ebola that has killed dozens in Congo?

A: Yes, the temptation is there; there is a tendency to neglect Ebola, which, on the demographic scale, affects the greater number of Congolese. However, the danger of these two viruses means that the same monitoring strategies need to be implemented. We are in the process of monitoring the animal population for Ebola. Avian flu today, on the other hand, represents a concern for the economy and health of humans.

Q: You spoke of an inter-ministerial committee. Does it have the financial and material means to accomplish the job it has been given, notably to observe daily the avian flu virus?

A: Personally, I am not part of this committee yet; but the government has put at the disposal of this committee a large amount of money to fight the influenza virus. At the technical level, buildings need to be reinforced in terms of biosecurity so that the technicians can work in a safe environment; not only for themselves, but also for the whole community because laboratories are always built in towns.

Q: Do other central Africa countries have the means to monitor this outbreak?

A: Unfortunately no! Central Africa does not have an international observation system for the flu virus. There are several flu viruses, but today worldwide attention is on the highly pathological H5N1 virus, which is a type A virus. Central Africa needs an integrated surveillance system for the flu virus.

Q: What is your message to Congolese farmers whose livelihoods are threatened?

A: Of course, they must be brave and calm. The avian and other flu are viruses that have existed with humans for millions of years. They are mutants. It is a permanent problem. We have to encourage the public bodies to support the national laboratory and other scientific institutions in our country so that this virus can be researched. Apart from the avian flu, we also have here the HIV virus, which has special characteristics. It is a virus that is heterogeneous in the Congo Basin. We have almost all the sources [of the viruses] in Congo. It is, therefore, a serious concern. There is also the Ebola virus and other viruses are emerging. There is talk of a monkey pox virus, which gives rise to diseases similar to smallpox that the World Health Organisation eradicated with difficulty in the 1980s. However, influenza highlights the weakness of the national laboratory, of the national surveillance system of the disease, and the regional and national scientific technical network.

It is now time to be self-critical and to see where we must begin to strengthen the technical capacities of the national laboratory in terms of human resources and at the technical level.