12 May 2006
H5N1 in the
Horn of Africa: First human infection in Djibouti and new poultry infections in
Sudan confirmed.
The WHO
reported May 12 the first confirmed patient with H5N1 infection in the Horn of
Africa. A 2 year old girl from a rural village in the district of Arta became
ill April 23, was tested for H5N1 virus on May 10 at the NAMRU-3 reference lab
in Cairo, apparently after the deaths of some chickens resulted in increased
surveillance for this virus. At least three chickens in Djibouti have
also tested positive for H5N1. Fortunately, the child is alive and still
under medical care. Djibouti is working with the WHO to expand their response
to this H5N1 outbreak.
Djibouti is
now the 8th African nation to report avian infections with the H5N1
virus. These 8 nations are: Nigeria, Egypt, Niger, Cameroon, Burkina Faso, Cote
d’Ivoire, Sudan, and Djibouti.
Sudan
confirmed on May 8, 2006 the presence of H5N1 avian influenza virus in poultry
in its first follow-up report to the OIE (world Animal Health Organization in
Paris). The initial report April 19 was of an H5 virus (Neuraminidase
undetermined) in the states of Khartoum and Gezira. The May 8 report to
OIE reported two new outbreaks, in Atabara in River Nile state, 250 km
north of Khartoum and in Gezira state, ~ 45 km south of Khartoum. The
H5N1 virus was confirmed at the OIE/FAO avian influenza lab in Padova, Italy by
virus isolation and RT-PCR sequencing to prove the characteristic amino acid
sequence in the cleavage site of the H5 protein seen with highly
pathogenic avian influenza (HPAI).
The Horn of
Africa includes Sudan, Djibouti, Eritrea, Ethiopia, and Kenya. Earlier in
2006 the WHO called attention to the ongoing health crisis in the Horn of
Africa. This crisis is related to multiple factors including drought,
malnutrition, economic and political instability, and increased infectious
diseases, including HIV/AIDS and other communicable diseases (see: www.who.int/hac/crises/international/hoafrica/en/index.html
The addition
of H5N1 avian influenza to the ongoing health crises in the Horn of Africa will
worsen matters considerably if it is not controlled as soon as possible.
Increased surveillance for H5N1 in both avian and human populations is
needed to determine the extent of spread of this virus. International
assistance should be provided when requested by member nations of this region,
such as that being provided by the WHO at the recent invitation of Djibouti.
Director,
Center for Biologic Counterterrorism and Emerging Infectious Diseases
EROne Institutes, Washington Hospital Center
Co-Director,
Master of Science graduate school program
Biohazardous Threat Agents and Emerging Infectious Diseases
Georgetown University Medical Center
Washington, DC
e-mail: Daniel.R.Lucey@Medstar.net
website:www.BePast.org