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Homeland Security


Department of Public Information . News and Media Division . New York

9 February 2007

Over the last two months, there had been new outbreaks of the highly pathogenic H5N1 virus (“avian flu”) in China, Indonesia, Viet Nam, Thailand, Japan, Egypt, Nigeria, Republic of Korea, Hungary, United Kingdom and Turkey, with human infections reported in China, Egypt and Nigeria, David Nabarro, Senior United Nations System Coordinator for Avian and Human Influenza, told correspondents today at Headquarters.

Those outbreaks had not come as a surprise, he said. The upsurge had been expected, since 2003, there had always been a rise in the period from December through April. More outbreaks were to be expected, but it was difficult to predict a geographical distribution. In 2005, massive die-offs of wild birds in northern China and Russia had raised concerns of infections through wild-bird migration. That situation, however, had not occurred during the 2006 season. The current spread of the virus might therefore have more to do with trade than with migration. Information from the last 24 hours, through the website of the United Kingdom Department of Rural Affairs, indicated that the cases in the United Kingdom might have been caused by the “part-processed poultry movement” from Hungary. Once again, poultry movement restriction was important in combating the spread of the virus.

Countries where the virus was enzootic (constantly present among the animal population) such as Indonesia, Egypt and Nigeria, had to cope with the challenge of containing the pandemic as well as to prevent and address damage to the poultry industry and nutritional repercussions, he continued. Indonesia had declared a national emergency, which focused efforts not only by the national Government but also by the provincial governments. The governor of Jakarta had banned “back-yard” poultry, which would have serious social and nutritional repercussions. Indonesia was not studying how to mitigate the effects on people’s livelihoods and the overall market price of poultry.

In Egypt, 55 outbreaks in poultry had been confirmed and 20 cases of human infection had been reported, of which 12 had been fatal, he said. Nineteen of the thirty-six states had reported avian influenza and one human death had been reported. That was a wake-up call that avian flu also posed a threat to humans in sub-Saharan countries such as Niger, Cameroon, Burkina Faso, Côte d’Ivoire and Djibouti, which have also been affected by the virus.

There was a need to maintain the focus on avian influenza, he stressed, because there was still a possibility of a human pandemic developing. One had to consistently work, with high-level political commitment, to control the virus and maintain a strong capacity of veterinary and human health services with robust compensation and rehabilitation measures. Strong involvement of the private sector and civil society was necessary, as were strong communications to the general public. That was what his work was about: bringing together the external partners –- the World Health Organization (WHO), the Food and Agriculture Organization (FAO), the United Nations Children’s Fund (UNICEF), the World Bank and other parts of the United Nations system, the donors and others -- to make sure that would happen. The worst thing would be to say that the situation had not led to a pandemic and was basically a disease in birds, “therefore we can afford to let down our guard”.

In response to a correspondent’s question, Mr. Nabarro said that around 50 per cent of infected people died, but that the death rate was reduced by early diagnosis and intervention. The disease seemed to respond to some anti-viral medicine and nursing was also helpful. According to the website of WHO, there had been a total of 272 confirmed cases of human infection since 2003, with 166 deaths. Human cases of human influenza were therefore, in the big scheme of things, a major global problem. The concern was that a mutation of the virus could enable human-to-human transmission.

Asked what steps he advocated, he answered that FAO was the primary agency to address the issue and that their guidance was clear: restrict and stop the movement of poultry from areas where an outbreak had occurred. Ascertaining whether an outbreak was the result of trade or wild bird migrations was helpful in explaining patterns and implementing the right response.

Commenting on the fact that the Government of Indonesia was no longer sharing virus samples from infected humans with WHO, he said he hoped that whatever concerns Indonesia had that prevented sharing for scientific purposes would be resolved as soon as possible. It was important for the United Nations to study how the virus was evolving. Total transparency in that issue was of the utmost importance.

A secondary, but distinct, issue was that some countries could not get access to biological materials they might need to fight a pandemic, he said. Countries had expressed their wish to have as much access as other countries to anti-viral material. After all, if a human pandemic would start, it would be a global issue. The Government of Indonesia wanted to be able to access vaccines at the moment a pandemic started. WHO, the agency dealing with that issue, would be able to provide more precise information.

Through the World Bank Multi-Donor Finance Facility as well as through a United Nations rapid central financing fund, money was available to help Governments pay for compensation, rehabilitation and other costs, he replied in response to another question. Addressing the dramatic social, economic and nutritional consequences of mass culling was of the greatest concern to all involved. Mass culling must always be accompanied by compensation and rehabilitation.

Asked about the causes for the outbreaks in countries like Japan and the Republic of Korea, he said infection always happened through migration, trade, or a combination of both. The outbreak in the Republic of Korea might have been caused in first instance by migration from China and Mongolia, followed by local transmission from bird movements. The virus had also been found in bird excreta, feathers and water, as well as on the hands of handlers, so that chance infections were also possible.

There had been no confirmation of avian flu in any population in North or South America, he stressed. As for eastern Turkey, where there had been an avian flu outbreak, people were kept under observation. The avian flu and normal influenza periods coincided and it was therefore normal that, in areas where avian flu occurred, people with normal flu symptoms would go to the hospital. There had been improvement in diagnostic tests, which had become more rapid and sensitive. However, access to those tests would be more difficult for countries with a weak infrastructure. Although he could give no projections, one should be prepared for more outbreaks throughout May and June.

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For information media • not an official record

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