Djibouti reports first human case of deadly bird flu in east Africa

[DB]

Re: Djibouti reports first human case of deadly bird flu in east Africa

Does anyone else see the problem with these conflicting statements.

"Another WHO official said the affected family lives in an impoverished rural village near Djibouti's border with Somalia and kept chickens."

"They are investigating possible contact between humans and infected birds and looking into the possibility of other human cases."

"Chicken is considered a luxury by most of the population. About 90 % of the poultry eaten in the country is imported frozen."

First off, the infected family lives in an impoverished rural village.

In essence they are poor.

But "chicken is considered a luxury by most of the population and 90% of the poultry eaten in the country is imported frozen."

So if they are poor and chicken is a luxury are we to believe that they "kept chickens"?

Furthermore they are "looking into the possibility of other human cases" and there has been an outbreak of fever that has been going around since April.

Like I said, something is amiss.

[DB]

Re: Djibouti reports first human case of deadly bird flu in east Africa

http://www.news24.com/News24/Africa/...931921,00.html
3 more H5N1 cases in Djibouti

Djibouti - Health authorities in Djibouti have probed more suspected human cases of the deadly H5N1 strain of bird flu.
A day after confirming a two-year-old girl in the tiny Red Sea state was infected with the disease, scientists said three more possible human cases were being investigated.
The World Health Organisation's Maria Cheng said: "Three others are under investigation."
She said samples from the three patients, believed to be from the same family as the child, had been sent to the United States-run laboratory in Egypt that first confirmed the presence of H5N1 in Djibouti on April 27.
Another WHO official said the affected family lives in an impoverished rural village near Djibouti's border with Somalia and kept chickens.
Toddler is alive and being treated
Djibouti's health and agricultural authorities, along with WHO officials, were analysing poultry in the area on Friday.
The WHO representative in Djibouti, Jihane Tawilah, said: "They are investigating possible contact between humans and infected birds and looking into the possibility of other human cases."
He said the infected toddler was alive and being treated in a hospital in the capital.
Djibouti's minister of health, Abdallah Abdillahi Miguil, said an emergency task force had been set up to alert the country's 300 000 population to the disease.
Djibouti is the first East African country to report the appearance of the H5N1 virus in either birds or humans.
It is the second in Africa to report a human case of bird flu, after Egypt, where five people have died of the disease so far.
Most Djiboutians keep cattle
It is the eighth African country to find the strain in birds - after Nigeria, Egypt, Niger, Cameroon, Burkina Faso, Ivory Coast and Sudan.
Djibouti health officials said they were surprised that the region's first cases appeared in the country, as most of the population are nomadic pastoralists who keep cattle, sheep and goats.
Chicken is considered a luxury by most of the population. About 90 % of the poultry eaten in the country is imported frozen. Cheng said the WHO has sent supplies of the anti-influenza treatment, Tamiflu, and protective equipment to Djibouti, and was ready to deploy experts to the Red Sea state if requested.

[DB]

Re: Djibouti reports first human case of deadly bird flu in east Africa

Two things occur to me after reading this. The first is where are the chickens coming from in the first place and why haven't we read of infections in that country? This should raise the hair on the back of your neck. Evidently there is a pocket of virus that has thus far escaped observation.
Second, if there are rumors of illness that have been circulating since April, then either the victims have gotten well, or they were too poor to seek medical attention and simply died and were quietly buried. But in either case, we are not seeing an exponential explosion in illnesses. At least I don't think we are.

Agreed.

An exponential explosion in cases has not been reported.

What does raise the hair on the back of my neck is that Djibouti is a previously French controlled area and with the way the French handled the outbreak of Chikungunya in La Reunion I am a bit concerned that we are being told about something only after it has gotten out of control.

I could be wrong, and it wouldn't be the first time, but the information coming from Djibouti is not reasurring.

I guess we will have to wait another day or even week and see how it all plays out.

[Shannon Bennett]

Re: Djibouti reports first human case of deadly bird flu in east Africa

Two things occur to me after reading this. The first is where are the chickens coming from in the first place and why haven't we read of infections in that country? This should raise the hair on the back of your neck. Evidently there is a pocket of virus that has thus far escaped observation.
Second, if there are rumors of illness that have been circulating since April, then either the victims have gotten well, or they were too poor to seek medical attention and simply died and were quietly buried. But in either case, we are not seeing an exponential explosion in illnesses. At least I don't think we are.

http://www.irinnews.org/report.asp?R...untry=DJIBOUTI

DJIBOUTI, 12 May 2006 (IRIN) - Health authorities in Djibouti have reported the first human case of the deadly H5N1 bird flu strain.

In a radio and television address on Thursday, Djibouti’s health minister, Abdallah Abdillahi Miguil, announced that a young girl had been hospitalised with the H5N1 strain of the avian flu virus. Samples from other family members, who had shown flu-like symptoms, had been sent to the laboratory Namru III in Cairo, the Egyptian capital.

The patient comes from a small village, about 30km south of Djiboutiville, the capital. She is receiving treatment at Bouffard, a French military hospital.

Rumours of an outbreak of fever had been circulating in Djiboutiville since the beginning of April, according to an official from Djibouti’s health ministry. It was originally believed to be dengue fever or chikungunya, a mosquito-borne fever that has been reported recently in Mauritius and Reunion. The government, with the help of United States and French troops, and in collaboration with the United Nations World Health Organization (WHO), took several blood samples for testing.

A sample taken from the child, who showed symptoms of fever, tested positive for H5N1 on 27 April. Three chickens were found to be infected with the virus as well.

The confirmation of a human case is alarming, because Djibouti imports chickens from abroad and has no poultry farms. "We are shortly going to ban the import of live poultry. I urge people to cook chicken well before eating it," Miguil said. "We will soon review our mechanisms of disease control. But I ask parents to watch their children and prevent them from playing with birds and from going near dead birds."

People in the capital have panicked since the announcement and stopped eating chicken. Said Ali, the owner of an open-air restaurant, regretted that the announcement was made in the early evening, when the food was already cooked. "If the minister had made his announcement in the morning, we could have made arrangements, but now it’s too late to throw it all away."

"Bird flu will be our only topic of conversation among friends," said Osman Ali, an 18-year-old student.

Confirmation of H5N1 in chickens puts Djibouti in phase III of the global pandemic, according to the WHO definition. Egypt is the only other country in Africa to have reported human infection of the disease.

[DB]

Re: Djibouti reports first human case of deadly bird flu in east Africa

It reminds me of Turkey but it is occuring at the same time as the large family cluster in Indonesia which is also making me uneasy.

Is it me or does this situation appear to be escalating quickly?

[Snowy Owl]

Re: Djibouti reports first human case of deadly bird flu in east Africa

From the above post

Since the virus is present, the Health Minister has taken all dispositions in order to make a proper investigation of the case and its contacts, to reinforce surveillance towards humans and poultry.

The sanitary authorities have decided to give medicine and PPE for the Health Care workers.

The gouvernment has establish Preventive and Control measures but has not given any specifics concerning this.

The gouvernment did not made any statements concerning the eventual culling of poultry as of thursday night.

Via the national radio, the Djibouti government ask the population to take preventive measures, to avoid all contacts with death birds or presenting any sign of illness.

The authorities asked the population to report all suspected cases to the nearest local authority.

Djibouti, small francophone country of about 700, 000 peoples is located at the entrance of the Red Sea and has French and U.S. military bases and contingents of many occidental armies, stationned there in the context of the war on terror.

[Snowy Owl]

Re: Djibouti reports first human case of deadly bird flu in east Africa

I just looked over Djibouti news online,

http://www.djibnet.com/news/story.php?id=9395

Radio TV <table border="0" cellpadding="2" cellspacing="0" width="100%"> <tbody><tr valign="top"> <td></td> <td class="djboxbody">RTD Djibouti</td> </tr> <tr valign="top"> <td></td> <td class="djboxbody">RTD Djibouti (afar)</td> </tr> <tr valign="top"> <td></td> <td class="djboxbody">BBC Somali</td></tr></tbody> </table>
<table id="actualit? afrique" summary="actualit?" cellpadding="0" cellspacing="10" width="100%"> <tbody><tr><td class="gtitre_article" valign="bottom">Un premier cas humain de grippe aviaire H5N1 d?tect?</td></tr> <tr> <td class="info_article">DJIBOUTI - 11 mai 2006 - AFP</td> </tr> <tr> <td class="garticle" valign="top">Un premier cas humain de grippe aviaire H5N1 a ?t? recens? ? Djibouti, second pays africain, apr?s l'Egypte, o? le virus hautement pathog?ne a contamin? des ?tres humains, a annonc? jeudi le ministre djiboutien de la Sant?, Abdallah Abdillahi Miguil.
Djibouti est le premier pays d'Afrique de l'Est o? le H5N1 est d?tect? et le huiti?me pays du continent touch? par l'?pizootie. En Egypte, cinq personnes sont d?c?d?es apr?s avoir contract? la maladie.
Un pr?l?vement effectu? le 27 avril chez une personne pr?sentant des sympt?mes de la grippe a r?v?l? un test positif au virus hautement pathog?ne H5N1, a d?clar? le ministre de la Sant?, dans un communiqu? lu ? la radio officielle djiboutienne.
Les tests ont ?t? effectu?s en Egypte, en collaboration avec l'Organisation mondiale de la sant? (OMS), dans un laboratoire du Caire. M. Miguil n'a pas pr?cis? l'identit? du malade, ni son ?tat de sant?, ni l'?tablissement o? il est soign?. Des tests se sont ?galement av?r?s positifs sur trois poules, selon le communiqu? de M. Miguil.
Face ? l'apparition du virus, le minist?re de la Sant? "a pris toutes les dispositions n?cessaires afin de mener une enqu?te plus approfondie du cas et de ses contacts, de renforcer la surveillance chez les humains et les volailles", a affirm? le ministre.
Les autorit?s sanitaires ont ?galement d?cid? "la mise ? disposition de m?dicaments et d??quipements de protection personnels pour le personnel de sant?", selon la m?me source.



Le gouvernement a par ailleurs instaur? "des mesures de contr?le et de pr?vention", selon le ministre de la Sant?, qui n'a pas fourni de pr?cision sur la nature de ces mesures.

Le gouvernement n'avait pas fait ?tat jeudi en fin de journ?e de d?cision sur d'?ventuelles campagnes d'abattages de volailles.
Par le biais de la radio nationale, le gouvernement de Djibouti a ?galement appel? la population ? prendre des mesures de pr?caution, en ?vitant le contact direct avec des oiseaux morts ou pr?sentant des signes apparents de maladie.
Les autorit?s ont en outre demand? aux habitants de "signaler tout cas suspect aux autorit?s locales les plus proches".
Djibouti, petit pays francophone d'environ 700.000 habitants situ? ? l'entr?e de la mer Rouge, abrite des bases militaires fran?aise et am?ricaine, ainsi que des contingents de plusieurs arm?es occidentales stationn?s dans le cadre des op?rations de lutte antiterroriste d?clench?e par les Etats-Unis apr?s les attentats du 11 septembre 2001.
Depuis 2003, la grippe aviaire a tu? 113 personnes dans le monde.
Les experts redoutent une mutation du H5N1 ? la faveur d'une combinaison avec le virus de la grippe humaine. Une telle m?tamorphose pourrait donner naissance ? un virus transmissible de l'homme ? l'homme, au risque de provoquer une pand?mie aussi redoutable que la grippe espagnole qui a tu? des dizaines de millions de gens en 1918.
</td></tr></tbody> </table> http://www.jeuneafrique.com/jeune_af...26djibotcetdn0

[Bruce]

Re: Djibouti reports first human case of deadly bird flu in east Africa

I can see WHO coming to their help shortly so they can start a governmental bird flu monitoring and advisory comity that will help them in reporting more detailed news and advisories to the citizens. <o></o>

[DB]

Re: Djibouti reports first human case of deadly bird flu in east Africa

"Rumours of an outbreak of fever had been circulating in Djiboutiville since the beginning of April"

Ummm,

How big of an outbreak are we talking about here?

If the outbreak of fever is big enough to create rumors than we might have a worse situation than is being reported.

[DB]

Re: Djibouti reports first human case of deadly bird flu in east Africa

http://www.irinnews.org/report.asp?R...untry=DJIBOUTI

DJIBOUTI, 12 May 2006 (IRIN) - Health authorities in Djibouti have reported the first human case of the deadly H5N1 bird flu strain.

In a radio and television address on Thursday, Djibouti?s health minister, Abdallah Abdillahi Miguil, announced that a young girl had been hospitalised with the H5N1 strain of the avian flu virus. Samples from other family members, who had shown flu-like symptoms, had been sent to the laboratory Namru III in Cairo, the Egyptian capital.

The patient comes from a small village, about 30km south of Djiboutiville, the capital. She is receiving treatment at Bouffard, a French military hospital.

Rumours of an outbreak of fever had been circulating in Djiboutiville since the beginning of April, according to an official from Djibouti?s health ministry. It was originally believed to be dengue fever or chikungunya, a mosquito-borne fever that has been reported recently in Mauritius and Reunion. The government, with the help of United States and French troops, and in collaboration with the United Nations World Health Organization (WHO), took several blood samples for testing.

A sample taken from the child, who showed symptoms of fever, tested positive for H5N1 on 27 April. Three chickens were found to be infected with the virus as well.

The confirmation of a human case is alarming, because Djibouti imports chickens from abroad and has no poultry farms. "We are shortly going to ban the import of live poultry. I urge people to cook chicken well before eating it," Miguil said. "We will soon review our mechanisms of disease control. But I ask parents to watch their children and prevent them from playing with birds and from going near dead birds."

People in the capital have panicked since the announcement and stopped eating chicken. Said Ali, the owner of an open-air restaurant, regretted that the announcement was made in the early evening, when the food was already cooked. "If the minister had made his announcement in the morning, we could have made arrangements, but now it?s too late to throw it all away."

"Bird flu will be our only topic of conversation among friends," said Osman Ali, an 18-year-old student.

Confirmation of H5N1 in chickens puts Djibouti in phase III of the global pandemic, according to the WHO definition. Egypt is the only other country in Africa to have reported human infection of the disease.

[DB]

Re: Djibouti reports first human case of deadly bird flu in east Africa

http://www.recombinomics.com/News/05...i_Cluster.html
Commentary

Suspect H5N1 Bird Flu Cluster in Djibouti

Recombinomics Commentary
May 12, 2006

A 2-year-old girl in Djibouti, the first confirmed human bird flu case in sub-Saharan Africa, was in stable condition on Friday while three siblings had tests for possible infection, the World Health Organisation said.

"Three of her siblings are undergoing investigation for possible infection. Their samples have been sent to the same laboratory," Cheng told Reuters in Geneva.

"They have flu-like symptoms," she said.

The family lives in a poor, rural area of the tiny country near the border with Somalia and kept chickens, Cheng said.

The above comments indicate the index case for Djibouti may be part of a familial cluster. The index case is the youngest index case for a familial cluster or for a country. Since 2005, all index cases for a country (Cambodia, Indonesia, China, Turkey, Iraq, Azerbaijan) with the exception of Egypt, have been part of a familial cluster. Egypt is the only country without a H5N1 bird flu familial cluster.

The location of the family near the border of Somalia and its proximity to southwestern Yemen again highlight the fact that many countries in Africa and the Middle East continue to deny H5N1 infections in people of animals.

The denials are supported by media reports of the absence of H5N1 in thousands or tens of thousands of wild birds. However, there reports of negative data are supplied by wildlife or wetlands conservation groups who have yet to disclose any data on the detection of low pathogenic avian influenza (LPAI) in the tested birds. Low pathogenic avian influenza is common in wild waterfowl, and negative H5N1 data in the absence of positive data on LPAI says little about the presence of H5N1, but speaks volumes about the groups collecting the samples and the media report the data, which includes conclusions that wild birds play a minor role in the spread of H5N1.

However, 12 months ago, prior to the outbreak of H5N1 in long range waterfowl at Qinghai Lake, there were no reported cases of H5N1 in Russia, Kazakhstan, Mongolia, Europe, the Middle East, or Africa. H5N1 was first reported in each of these areas in the past 12 months, and these reports have firmly linked the H5N1 infections to wild waterfowl. In Europe, where the surveillance is more effective, the initial reports of H5N1 have been from waterfowl infections, and many European countries have yet to report H5N1 in domestic poultry.

In Djibouti, where surveillance is less than ideal, H5N1 was first reported in the index case and domestic poultry. However, there have been persistent reports of large die-offs of waterfowl since the fall, although H5N1 infections have been denied, usually without an explanation for the bird deaths and without evidence of detection of LPAI in wild birds being tested.

Media Link

Map

[HenryN]

Re: Djibouti reports first human case of deadly bird flu in east Africa

Commentary at

http://www.recombinomics.com/News/05...i_Cluster.html

[Sally Furniss]

Re: Djibouti reports first human case of deadly bird flu in east Africa

Siblings of Djibouti bird flu case being tested-WHO
12 May 2006 07:36:28 GMT
Source: Reuters

GENEVA, May 12 (Reuters) - A 2-year-old girl in Djibouti, the first confirmed human case of bird flu in East Africa, is in stable condition while three siblings undergo tests for possible infection, the World Health Organisation (WHO) said on Friday.

Djibouti Health Minister Abdallah Abdillahi Miguil said on Thursday in remarks broadcast on state television the girl had tested positive for the H5N1 virus.

The WHO, a United Nations agency, has accepted as valid the results from the girl's sample tested by a U.S. laboratory based in Egypt, according to WHO spokeswoman Maria Cheng.

"Three of her siblings are undergoing investigation for possible infection. Their samples have been sent to the same laboratory," Cheng told Reuters in Geneva.

The family lives in a poor, rural area of the tiny country near the border with Somalia and kept chickens, she added. The minister said the virus had been detected in three birds.

The WHO had sent supplies of the anti-viral Tamiflu, by Swiss drugmaker Roche <ROG.VX>, as well as personal protective equipment to try to prevent the spread of the deadly virus, Cheng said.

"We will send a support team if and when requested by the health ministry," she added.

The girl's symptoms began on April 23 and tests were conducted by the U.S. Naval Medical Research Unit 3 (NAMRU-3) in Cairo on May 10, Cheng said.

The girl remains under medical care in stable condition, Cheng said, adding: "She still has persistent symptoms, presumably fever and respiratory problems."

The WHO's office in Djibouti was helping authorities to tighten disease surveillance in the region, where outbreaks of dengue fever can complicate diagnosis, according to Cheng.

The WHO has confirmed 13 cases of bird flu in Egypt, including five fatalities, where outbreaks began in March.

In all, the WHO says there have been 208 cases in 10 countries, including Djibouti, since late 2003, and 115 deaths.

Experts fear that bird flu could mutate into a form that passes easily among humans, potentially triggering a pandemic in which millions could die.

http://www.alertnet.org/thenews/newsdesk/L12317721.htm

[AlaskaDenise]

Re: Djibouti reports first human case of deadly bird flu in east Africa

http://www.promedmail.org/pls/promed..._ID:1000,32914

<TABLE summary=""><TBODY><TR><TD noWrap align=right>Archive Number</TD><TD noWrap align=left>20060511.1347</TD></TR><TR><TD noWrap align=right>Published Date</TD><TD noWrap align=left>11-MAY-2006</TD></TR><TR><TD noWrap align=right>Subject</TD><TD noWrap align=left>PRO/AH/EDR> Avian influenza - worldwide (110): Djibouti, susp.</TD></TR></TBODY></TABLE>

AVIAN INFLUENZA - WORLDWIDE (110): DJIBOUTI, SUSPECTED***************************************** *************A ProMED-mail post<http://www.promedmail.org>ProMED-mail is a program of theInternational Society for Infectious Diseases<http://www.isid.org>Date: Thu, 11 May 2006From: Joe Dudley <jdudley@eaicorp.com>Source: Reuters alertnet, 11 May 2006 [edited]<http://www.alertnet.org/thenews/newsdesk/L11478047.htm>One person and 3 chickens in Djibouti have tested positive for the deadly H5N1 avian influenza virus, Djibouti's health minister said on Thursday [11 May 2006]."One patient and 3 domestic chickens have been detected with the H5N1 virus," Abdallah Abdillahi Miguil said in remarks broadcast on state television.The patient in the tiny country of 300 000 at the mouth of the Red Sea is the first human case confirmed in the Horn of Africa, along the path of migratory birds who have been detected with the deadly strain.The results were tested in conjunction with the U.N. World Health Organisation at a laboratory in Egypt, the minister said. The condition of the patient, who the minister said was still in the hospital, was not immediately known.--ProMED-mail<promed@promedmail.org>[In line with the proverbial "one picture is worth 1000 words," a brief look at the map <http://www.countryreports.org/maps/Djibouti/dj-area.gif> should be enough to convince the skeptics that the recent statement that "H5N1 [was] not detected in a single wild bird out of thousands of samples collected in Africa this winter," followed by pacifying conclusions, deserve to be assessed with a critical view. With Egypt and Sudan infected, countries in the horn of Africa and in East Africa should be regarded as being at high risk, while avoiding complacency in more northern regions. The detection of 3 infected birds (kudos to the NAMRU lab in Cairo!) is alarming enough. Combined with a human case, it might signal the presence of a widely spread, established epizootic.Sudan reported to the OIE on 8 May as follows: "A new outbreak has been identified at Atbara, in River Nile State, 250 km to the north of Khartoum. New outbreaks have also been reported in Gezira State in 4 poultry farms located 40-50 km to the south of Khartoum town. For the full report, see <http://oie.int/eng/info/hebdo/A_CURRENT.HTM#Sec10>.Official confirmation and further details of the case and virus in Djibouti are anticipated.The FAO and the OIE have cooperatively published the document "Preparing for Highly Pathogenic Avian Influenza: A Manual for Countries at Risk". Its update of 16 Feb 2006 is available at<http://www.fao.org/docs/eims/upload/200354/HPAI_manual.pdf>. - Mod.AS].</PRE>

[HenryN]

Re: Djibouti reports first human case of deadly bird flu in east Africa

<TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD>Baby in Djibouti diagnosed with bird flu





GENEVA, Switzerland (AP) -- The World Health Organization said Thursday that a baby in Djibouti has contracted the H5N1 virus, the country's first human case of bird flu.
"I believe the person is still alive. It's a 2-year-old girl," WHO spokesman Dick Thompson told The Associated Press in Geneva. He said the girl was confirmed as H5N1 positive by the U.S. Naval Medical Research Unit 3 (NAMRU-3) in Cairo, but could not provide any further details.
The Djibouti government confirmed the human case in the capital and said three chickens also had been infected with the virus.
"Djibouti thus becomes the first country in the Horn of Africa to have detected a human case and bird cases of H5N1," the government said on the official Djiboutian Information Agency web site.
It was not clear from the government statement whether the case of the chickens was related to the human case.
It also did not provide any details on the health of the girl, saying only that she was tested after showing flu symptoms on April 27.
The Health Ministry said the infection occurred despite a heightened alert, but that the government would further increase surveillance of the disease. It told citizens to keep away from any birds showing symptoms of sickness.
Djibouti is now the 10th country where a person has been infected with the deadly virus. At least 207 people have contracted the disease globally and 115 have died over the last three years, according to the U.N. health agency. Virtually all the individuals were exposed to the disease in poultry.
As of April 27, there had been no reports of H5N1 in poultry or wild fowl in Djibouti, according to the Paris-based World Organization for Animal Health.
Health experts fear the bird flu virus could mutate into a form easily spread among people, potentially sparking a pandemic.
Copyright 2006 The Associated Press. All rights reserved.This material may not be published, broadcast, rewritten, or redistributed.

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