Sally Furniss
Well-known member
Africa beware, bird flu menace is not over yet
http://www.nationmedia.com/eastafrican/current/Opinion/opinion05030714.htm
By Richard Odindo
East African countries have to prime their public health systems for the real possibility of another epidemic, stressing household kitchens and taking human life much in the same way the Rift Valley Fever has done in Kenya over the past one month or so, and recently in Tanzania.
Since 2003, health experts worldwide have monitored a new and extremely severe influenza virus, the highly pathogenic H5N1 strain ? better known as the bird flu. It has spread rapidly, infecting millions of poultry units in almost 50 countries, in which nearly two-thirds of the world?s population live.
In Africa, a total of 14 avian influenza outbreaks occurred in eight countries between February and December 2006. Africa recorded its first outbreak of the disease in Nigeria in February, 2006, in domestic poultry. Since then, seven other African countries ? Egypt, Niger, Cameroon, Burkina Faso, Sudan, C?te d?Ivoire and Djibouti ? have reported infection and disease outbreaks.
Given the interaction that goes on between populations in these countries and their neighbours, it is critical for authorities in Kenya, Uganda and Tanzania to begin sensitising their nationals, especially domestic and commercial poultry keepers, on what to do to fend off the virus, or manage it should it enter their borders.
Over the past three years, the virus has caused the largest and most severe outbreaks of highly pathogenic disease ever recorded in poultry, leading to over 200 million poultry deaths, including culling in domestic birds in a number of countries. There is a need to minimise infection opportunities because every infection presents a chance of genetic mutation that might give rise to a pandemic virus. Thus, preventing the human pandemic requires control of the disease in animals and sensible precautionary measures to prevent cases of human infection.
THE HIGHLY pathogenic avian influenza virus has developed into a concern for human health for two main reasons. First, since December 1997, this virus has caused severe disease in people, with more than 200 human cases, about 60 per cent of whom ended up dying.
The second and far greater concern, for human health is the risk that the virus ? if given enough opportunity ? will develop the characteristics needed to start an influenza pandemic.
It is three years since WHO began recording human cases of infection with avian influenza A (H5N1).
A description of 205 laboratory-confirmed cases occurring up to end of April 2006 found that 90 per cent of cases were in people aged below 40, that the overall case-fatality rate was 56 per cent, that the median interval from illness onset to hospitalisations was four days, and that the median duration from illness onset to death was nine days. In a recent WHO study it was found that the overall case-fatality rate in avian influenza is 60 per cent. This rate is highest (76 per cent) among those aged 10?19 years; and lowest (40 per cent) among those over 50. Overall, the case-fatality rate was higher among women (65 per cent) than men (55 per cent). This updated analysis found that mortality among those aged 20?39 was higher in females than in males.
Direct contact with infected poultry, or surfaces and objects contaminated by their faeces, is considered the main route of human infection. To date, most human cases have occurred in rural or peri-urban areas where many households keep small poultry flocks, which often roam freely, sometimes entering households or sharing outdoor areas where children play.
THE PRACTICE of home slaughtering, including plucking and other handling of birds, presents the greatest risk of the disease being transmitted to humans in areas with outbreaks in poultry.
As a general recommendation, sick poultry should not be slaughtered for food, and other poultry already dead from any disease should not be eaten.
This recommendation is as important for bird flu as it is for all other diseases.
Most human cases associated with the virus since 2003, have been linked to close contact with infected domestic birds, with especially high risks thought to occur during home slaughter, plucking, butchering and preparation for cooking.
Consumption of inadequately cooked poultry and poultry products (including eggs and blood) is an additional risk.
The spread of avian influenza in Africa is a key concern because all countries on the continent are at risk as they lie below major flyways for the migratory birds.
There is also a high risk of illegal trading in wild birds and poultry products.
Because of the rapid spread of the avian influenza, East African countries have to strengthen their epidemic preparedness and response capacities in order to reduce opportunities of human exposure.
Richard Odindo is a consultant in behaviour change communication.
http://www.nationmedia.com/eastafrican/current/Opinion/opinion05030714.htm
By Richard Odindo
East African countries have to prime their public health systems for the real possibility of another epidemic, stressing household kitchens and taking human life much in the same way the Rift Valley Fever has done in Kenya over the past one month or so, and recently in Tanzania.
Since 2003, health experts worldwide have monitored a new and extremely severe influenza virus, the highly pathogenic H5N1 strain ? better known as the bird flu. It has spread rapidly, infecting millions of poultry units in almost 50 countries, in which nearly two-thirds of the world?s population live.
In Africa, a total of 14 avian influenza outbreaks occurred in eight countries between February and December 2006. Africa recorded its first outbreak of the disease in Nigeria in February, 2006, in domestic poultry. Since then, seven other African countries ? Egypt, Niger, Cameroon, Burkina Faso, Sudan, C?te d?Ivoire and Djibouti ? have reported infection and disease outbreaks.
Given the interaction that goes on between populations in these countries and their neighbours, it is critical for authorities in Kenya, Uganda and Tanzania to begin sensitising their nationals, especially domestic and commercial poultry keepers, on what to do to fend off the virus, or manage it should it enter their borders.
Over the past three years, the virus has caused the largest and most severe outbreaks of highly pathogenic disease ever recorded in poultry, leading to over 200 million poultry deaths, including culling in domestic birds in a number of countries. There is a need to minimise infection opportunities because every infection presents a chance of genetic mutation that might give rise to a pandemic virus. Thus, preventing the human pandemic requires control of the disease in animals and sensible precautionary measures to prevent cases of human infection.
THE HIGHLY pathogenic avian influenza virus has developed into a concern for human health for two main reasons. First, since December 1997, this virus has caused severe disease in people, with more than 200 human cases, about 60 per cent of whom ended up dying.
The second and far greater concern, for human health is the risk that the virus ? if given enough opportunity ? will develop the characteristics needed to start an influenza pandemic.
It is three years since WHO began recording human cases of infection with avian influenza A (H5N1).
A description of 205 laboratory-confirmed cases occurring up to end of April 2006 found that 90 per cent of cases were in people aged below 40, that the overall case-fatality rate was 56 per cent, that the median interval from illness onset to hospitalisations was four days, and that the median duration from illness onset to death was nine days. In a recent WHO study it was found that the overall case-fatality rate in avian influenza is 60 per cent. This rate is highest (76 per cent) among those aged 10?19 years; and lowest (40 per cent) among those over 50. Overall, the case-fatality rate was higher among women (65 per cent) than men (55 per cent). This updated analysis found that mortality among those aged 20?39 was higher in females than in males.
Direct contact with infected poultry, or surfaces and objects contaminated by their faeces, is considered the main route of human infection. To date, most human cases have occurred in rural or peri-urban areas where many households keep small poultry flocks, which often roam freely, sometimes entering households or sharing outdoor areas where children play.
THE PRACTICE of home slaughtering, including plucking and other handling of birds, presents the greatest risk of the disease being transmitted to humans in areas with outbreaks in poultry.
As a general recommendation, sick poultry should not be slaughtered for food, and other poultry already dead from any disease should not be eaten.
This recommendation is as important for bird flu as it is for all other diseases.
Most human cases associated with the virus since 2003, have been linked to close contact with infected domestic birds, with especially high risks thought to occur during home slaughter, plucking, butchering and preparation for cooking.
Consumption of inadequately cooked poultry and poultry products (including eggs and blood) is an additional risk.
The spread of avian influenza in Africa is a key concern because all countries on the continent are at risk as they lie below major flyways for the migratory birds.
There is also a high risk of illegal trading in wild birds and poultry products.
Because of the rapid spread of the avian influenza, East African countries have to strengthen their epidemic preparedness and response capacities in order to reduce opportunities of human exposure.
Richard Odindo is a consultant in behaviour change communication.