14 February 2006
Feb 7th-14:
Avian Flu outbreaks reported in Nigeria, Azerbeijan, Greece, Italy,
Bulgaria, Slovenia, Austria, Germany
and Iran. Is this how quickly human flu will spread when the next pandemic
hits?
Over the course of
one week from Feb 7-14 laboratory-proven H5N1 infection of animals was reported
for the first time from five nations (Nigeria, Azerbaijan, Greece, Italy, and
Bulgaria). Initial results for H5N1,
pending official confirmation in a second reference laboratory, were also reported
from Slovenia, Austria, Germany, and Iran.
Fortunately, so far no human infections with H5N1 have been confirmed in
any of these countries, although some persons are being tested for this H5N1
avian flu virus.
Nigeria is the first
nation in Africa to have reported H5N1 outbreaks. Chickens were reported to be
infected with this virus and a die-off of chickens in northern Nigeria began in
mid-January, approximately one month previously. In a WHO update 13 February,
posted on their website, it was stated that “Occurrence of the bird flu has so
far been confirmed in poultry in the three northern states of Kaduna, Kano and
Plateau. Unconfirmed cases, also in poultry, have however been reported in
Yobe, Nassarawa and Jigwa states as well as in the Federal Capital
Territory---all in the north of the country”. The WHO has sent a team of
experts to Nigeria to work as partners with the Nigerian team already in
place.
Most of the other
H5N1 outbreaks reported in the past week do not involve poultry at this time.
Instead, birds and particularly swans have been found to be infected with the
H5N1 avian flu virus. Predictably, there will likely be more nations, from
Europe to the Middle East, Asia to Africa that will report additional H5N1
avian outbreaks in the weeks ahead.
Key lessons learned
from the past 25 months of outbreaks of H5N1 must routinely be applied to these
and future outbreaks. Such lessons include educating young persons and adults
to avoid close contact with ill or dead poultry, and testing and rapidly
treating patients with such exposure to poultry for H5N1 virus infection.
One can reasonably
anticipate that when the next human pandemic of influenza occurs, whether
directly related to the H5N1 virus or not, that the nation-by-nation spread of
the pandemic human flu virus will at some point be as rapid as the avian
outbreaks of H5N1 have been in the past week.
If we are not much better prepared for the next human pandemic of
influenza than we are today, then eventually the survivors will have investigations
and commissions that will try to examine why we did not use the time we have
now to prepare better for the pandemic.
Daniel R. Lucey, MD,
MPH
Director, Centre for
Biologic Counterterrorism and Emerging Diseases
ER One Institutes,
Washington Hospital Center
Co-Director, Master
of Science Program in Biohazardous Threat Agents and
Emerging Infectious
Diseases
Georgetown University
School of Medicine, Washington, DC
Website:
www.BePast.org; cell #: 202-299-4398