06 February 2007
Human Toll from Avian Influenza Continues in Nigeria, Egypt
United Kingdom confirms first highly pathogenic avian flu cases
Washington – The first human death from avian influenza in Africa has been reported in Nigeria, according to the World Health Organization (WHO), and the highly pathogenic Asian strain of bird flu has been found for the first time in the United Kingdom. The H5N1 virus was found in turkeys found dead on a farm in Suffolk, United Kingdom.
On February 6, the Egyptian Ministry of Health and Population also announced a new human death from H5N1 virus infection. The case was confirmed by the Egyptian Central Public Health Laboratory and by the U.S. Naval Medical Research Unit No.3 (NAMRU-3) in Cairo, Egypt. (See related article.)
"NAMRU-3 collaborates very closely with the Egyptian government and, as a WHO reference laboratory, conducts testing at the request of the Egyptian Ministry of Health to identify or confirm suspected [avian influenza] cases,” said Navy Lieutenant Andrew Stegall, NAMRU-3 administration director, in e-mail correspondence.
The 17-year-old female from Fayyoum governorate developed symptoms January 25 and initially was treated for seasonal influenza. She was hospitalized February 1 with fever and breathing difficulties, and died the next day.
Initial investigations into the source of exposure indicate the presence of sick and dead poultry at her home in the days before she became ill. Of 20 cases confirmed to date in Egypt, 12 have been fatal.
FIRST U.K. OUTBREAK
In the United Kingdom, the Veterinary Laboratories Agency confirmed February 3 that the H5N1 virus is similar to a January outbreak on a farm in Hungary, where thousands of geese were killed.
A February 3 report filed by Debby Reynolds, chief veterinary officer with the U.K. Department for Environment, Food and Rural Affairs (DEFRA), with the World Organisation for Animal Health (OIE) in Paris, showed that 2,500 turkeys had died of the viral infection and 4,500 had been destroyed. The outbreak began January 27.
Poultry are being isolated from wild birds in the area, according to a February 6 DEFRA statement, and all bird gatherings – including shows, markets, fairs and pigeon races – have been banned throughout England, Scotland and Wales until further notice. Investigation continues into the source of the outbreak.
The U.K. Health Protection Agency advised that the current level of risk to people from H5N1 is “extremely low.”
FIRST HUMAN DEATH IN AFRICA
The Nigerian government announced February 3 the presence of the H5N1 avian influenza virus in a 22-year-old female from Lagos who died January 16. The victim’s mother died January 4 with similar symptoms but no tests could be done because no blood samples were taken.
The Nigerian fatality brings the total number of human cases around the world since 2003 to 272, with 166 deaths.
The London-based WHO Collaborating Center for Reference and Research on Influenza confirmed the initial positive test findings of a laboratory in Nigeria. Investigations are under way to identify the source of the Nigerian woman’s infection.
H5N1 virus has been identified in poultry outbreaks in Nigeria and, as in other affected countries, according to WHO, sporadic cases of human infection with avian influenza are not unexpected.
WHO says it is working with the Nigerian government to carry out intensive surveillance; reports of other suspected cases may occur as people with influenza-like symptoms seek medical advice.
In the meantime, WHO and OIE are working with partners to find ways to improve and promote the development and production of pandemic vaccines. (See related story.)
One such activity, WHO announced February 1, is to help make pandemic vaccine viruses, which are required to produce pandemic flu vaccines, available to vaccine producers earlier than in the past.
After analyzing biosafety risks, WHO and OIE agreed that if the pandemic preparedness alert phase reaches level 4 (evidence of increased human-to-human transmission) or above, pandemic flu vaccine viruses that WHO Collaborating Centers have developed can be made available to vaccine manufacturers before all safety tests are complete, including tests in chickens and ferrets.
WHO uses six phases of pandemic alert to inform the world about the seriousness of a threat and the need for progressively more intense preparedness activities. The WHO director-general designates the phases.
Each phase recommends activities to be undertaken by WHO, the international community, governments and industry. The world is now in phase three – a new flu virus subtype is causing disease in people but is not yet spreading efficiently and sustainably among them. Phase six reflects efficient and sustained person-to-person transmission.
The accelerated procedure could reduce the time needed to develop pandemic vaccines by about 14 days.
Member states wishing to receive such vaccine viruses should make advance arrangements with customs authorities, courier companies, national regulatory agencies and other authorities, WHO advises.
For more information on U.S. and international efforts to combat avian influenza, see Bird Flu (Avian Influenza).
(USINFO is produced by the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)
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