Africa 'cannot meet WHO bird flu priorities'

[Treyfish]

Africa 'cannot meet WHO bird flu priorities'

Chickens at a farm in Salemata, Senegal


2 November 2007
Source: The Lancet Infectious Diseases

Africa has little ability to achieve any of the priorities identified by the WHO to fight avian influenza, warn Folorunso O. Fasina, Shahn P. Bisschop and Robert G. Webster in The Lancet Infectious Diseases.
The African strain of H5N1 has acquired "troubling" properties such as respiratory rather than faecal transmission in poultry and a mutation associated with increased spread of disease in mammals, including humans.
Moreover, the probability of human infection on the continent is increased by inefficient diagnosis, denial of outbreaks, inter-ethnic crises, politicisation of the issue, and poor reporting, surveillance and communication of risks.
Control remains problematic because of ineffective border controls and overtaxed health-care systems, as well as inadequate biosecurity.
The crowding of poultry farms and burgeoning live poultry markets promote the rapid spread of disease, as do high-risk conditions and practices, such as the slaughter of sick birds in homes.
Only 40 Africans are known to have been infected. But because of Africa's limited capacity to cope with a pandemic, this still represents a grave danger, warn the authors.
They call for each African nation to realistically assess its status, conduct regular active surveillance and be more forthcoming with data.
Link to full article in The Lancet Infectious Diseases*:tiphat: http://www.scidev.net/opinions/index.cfm?fuseaction=readopinions&itemid=683&langauge=1

 

[Theresa42]

Re: Africa 'cannot meet WHO bird flu priorities'

Only 40 Africans are known to have been infected.

Just to clarify, I'm (almost) certain that number includes Egyptians.

 

[Theresa42]

Re: Africa 'cannot meet WHO bird flu priorities'

The African strain of H5N1 has acquired "troubling" properties such as respiratory rather than faecal transmission in poultry....

I didn't know this.

 

[Theresa42]

Re: Africa 'cannot meet WHO bird flu priorities'

An excerpt from The Lancet article. Hat-tip, Inky!

by Folorunso O Fasina, Shahn P Bisschop, and Robert G Webster

There is little information about highly pathogenic avian influenza (HPAI) H5N1 virus in Africa, where health infrastructure is inadequate and human-animal contact is common.1,2 The global status of HPAI H5N1 in human beings was recently reported,3 but region and continent-specific information remains deficient. Here we describe how urbanisation and altered farming have increased the risk of HPAI H5N1 in Africa.

Sub-Saharan Africa has undergone rapid urbanisation. About 40% of the population is now urban (table).4 An estimated 60% of urban residents inhabit slums,5 and urban/peri-urban agriculture has proliferated.

[snip]

Urban and peri-urban poultry production is increasing rapidly6 because of the unavailability of both land and economic options.7 The crowded proximity of peri-urban poultry farms, inadequate biosecurity, and burgeoning live poultry markets promote the rapid spread of disease.

The control of avian influenza H5N1 in Africa remains problematic. Human and animal disease surveillance is weak, cross-border movement is not effectively managed, and health-care systems are overtaxed by AIDS, tuberculosis, and malaria. When avian influenza H5N1 hit the African continent in early 2006,1,2 it was not contained for several reasons, including delayed official decisions, inexperience, lack of prompt intervention planning, poor preparedness, corruption, and hesitation by farmers to report outbreaks. Similar factors have been associated with the continued spread in Asia.8 The true situation in most African countries is unknown. Each affected country, apart from Egypt, took approximately 4 weeks to officially confirm the initial outbreak, and reporting of outbreaks is still delayed in most countries.9 Most cases of HPAI H5N1 infection occurred in urban and peri-urban poultry populations.9 Free-range (rural) poultry have been less affected; these birds mix freely with domestic and wild fowl and often cohabit with human beings, but their low population density appears to offset their risk of infection.

Farming conditions in Africa are similar to those in affected Asian countries, and therefore the epidemiology of H5N1 influenza is expected to be similar. To date, 40 Africans are known to have been infected, with a 40% fatality rate. Most infected individuals (80%) were women, which may reflect the female role in food preparation.

Seasonal human influenza is grossly under-reported in Africa, and therefore less-than-severe HPA1 H5N1 influenza is also unlikely to be detected. However, even the small number of reported cases portends grave danger for Africa, with its limited capacity to cope with a pandemic and its high-risk conditions and practices (including home slaughter of sick birds).10 Our assessment of the perceptions of farmers and the public showed evident knowledge gaps and the gross downplaying of avian influenza (Fasina et al, unpublished data). The general public is sometimes clearly misinformed by the government as to the true nature of avian influenza outbreaks.11 These findings have serious public-health implications, because farmers prepare poultry and poultry products sold to the public, usually without inspection.

 

[Treyfish]

Re: Africa 'cannot meet WHO bird flu priorities'

Thanks, T42!:tiphat:

 

[Farmer]

Re: Africa 'cannot meet WHO bird flu priorities'

Originally Posted by treyfish
The African strain of H5N1 has acquired "troubling" properties such as respiratory rather than faecal transmission in poultry....


I didn't know this.

I found 2 'credible' references to respiratory transmission: 1) a 2004 FAO document that makes reference to "suggested" respiratory transmission to exotic birds in Cambodia. However, I found that this was apparently later reduced to "respiratory transmission" in subsequent reports by other entities; and 2) a report on highlights from the spring 2006 FAO and OIE International Scientific Conference on Avian Influenza and Wild Birds by Ward Hagemeijer.

1) "H5N1 was also isolated in two outbreaks involving non-poultry avian species. A large variety of captive birds as well as free-flying crows were affected in the outbreak at Tamao Zoo, Kandal province. The disease appeared first in raptors such as grey headed fish eagle, serpent eagles, hawk eagles, spotted wood owls, brown fish owl, spot bellied eagle owl and buffy fish owls in the first two to three days. The raptors were fed chicken meat or carcases obtained from the Kandal Market in central Phnom Penh. Consideration must be given to the oral point of entry or respiratory if the contaminated carcass was soiled with affected bird faeces. The live poultry market located approximately 30-40 m away from where the serpent eagle?s enclosure is another possibility. Herons, egrets and cranes were subsequently affected suggesting respiratory transmission or mediated through free or wild birds such as crows which frequent the aviary areas. Psittacines were affected in a further outbreak, although only 2 recent introductions died in an aviary group of 30. A total of 86 birds died and 261 birds remained clinically unaffected. Clinical signs, primarily lethargy and inappetence, were also evident in zoo cats (tiger, leopard, etc. all have recovered)."

http://www.fao.org/docs/eims/upload/159535/AVIbull016.pdf
__________________________________________
2) "Differences Between LPAI and HPAI Viruses
There are indications that HP H5N1 behaviors differ from those of LP H5N1:

Most notably, direct transmission of HP H5N1 from wild birds to humans has been documented (Azerbaijan);


There is high lethality among water birds infected with HP H5N1, although this varies significantly among types;


Transmission of virus genes from poultry to wild birds and respiratory transmission and transmission to felids have also been documented;

HPAI H5N1 virus has also shown increased thermal stability[9]; and


Finally, the persistence of HP H5N1 in water appears to be shorter than for other AI viruses; persistence is longer in brackish than in fresh water.[10]"
http://www.medscape.com/viewarticle/542626

Does anyone have anything else? This certainly does not refer to the African situation...