Virus Watch Online

The outbreak of H5N1 avian influenza in poultry, confirmed at a commercial farm in Kaduna State on 8 February, has now spread to commercial farms in several other contiguous states. No human cases have been detected to date.

Nigerian officials have confirmed outbreaks at commercial farms in the states of Kano, Plateau, Katsina, and Bauchi, and in the Abuja area. Outbreaks have also been detected at more farms in Kaduna. Outbreaks in additional states are currently under investigation.

To date, four patients with respiratory symptoms and a history of exposure to diseased poultry have been investigated for possible infection. This number includes a woman who died of an acute respiratory illness on 16 February. The three remaining patients are all in good condition.

Arrangements are being made to send samples from all four patients for testing at a WHO collaborating laboratory in the United Kingdom.

The initial outbreak in Kaduna state is now known to have begun on 10 January, raising the possibility that earlier human exposures and cases may have occurred in that area and elsewhere. At hospitals in Kaduna, Kano, and Katsina near affected farms, staff from the WHO-led teams have now examined hundreds of patient records, searching for possible cases that may have occurred earlier. No such cases have been identified to date.

The scale of the outbreak in birds is not yet fully understood. Most investigations have followed poultry deaths on large commercial farms, where outbreaks are highly visible. Little is known about the presence of the virus in small backyard flocks, where the greatest risk of human exposures and infections resides.

Nigeria has an estimated poultry population of around 140 million birds, largely concentrated in the south-western part of the country. As is the case in several affected parts of South-east Asia, around 60% of Nigeria’s poultry production takes place in small backyard flocks. Large-scale commercial farming of poultry occurs mainly in the northern states, where outbreaks have been confirmed.

Rapid spread of the virus within Nigeria has raised concern over possible spread to neighbouring countries. Borders are porous and restrictions on the movement of people and poultry are difficult to enforce. WHO staff at offices in these countries are monitoring the situation closely in collaboration with government officials. Rumours of possible human cases in neighbouring countries are also being closely monitored.

Source: World Health Organization

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The occurrence of the disease in India, reported on 18 February, is part of a recent pattern of rapid geographical spread of the virus in wild and domestic birds. India is one of 13 countries that have reported their first cases of H5N1 infection in birds since the beginning of February. (The 13 countries, listed in order of reporting, are Iraq, Nigeria, Azerbaijan, Bulgaria, Greece, Italy, Slovenia, Iran, Austria, Germany, Egypt, India and France.)

On 20 February, Malaysia reported a fresh outbreak in poultry after having been considered free of the disease for more than a year.

The situation in these recently affected countries varies greatly. Most European countries with good veterinary surveillance have detected the virus in a small number of wild birds only, with no evidence to date of spread to domestic birds.

In Azerbaijan, detection of the virus has coincided with die-offs of domestic birds. In Egypt, outbreaks in domestic poultry have now been confirmed in 10 governorates; deaths have also been reported in exotic zoo birds. In Iraq, presence of the virus in birds was found only after the country confirmed its first human case.

In Nigeria, as in India, the first cases were detected in large commercial farms, where the disease is highly visible and outbreaks are difficult to miss.

Apart from Iraq, none of the countries newly affected during February has reported human cases. Iraq has reported two human cases, both of which were fatal; samples from several other patients are currently undergoing tests.

For human health, experience elsewhere over the past two years has shown that the greatest risk of cases arises when the virus becomes established in small backyard flocks, which allow continuing opportunities for close human contact, exposures, and infections to occur.

All available evidence indicates that the virus does not spread easily from poultry to humans. To date, very few cases have been detected in poultry workers, cullers, or veterinarians. Almost all cases have been linked to close contact to diseased household flocks, often during slaughtering, defeathering, butchering, and preparation of poultry for consumption.

No cases have been linked to the consumption of properly cooked poultry meat or eggs, even in households where disease was known to be present in flocks.

Source: World Health Organization

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From the World Health Organization: "The confirmation of highly pathogenic H5N1 avian influenza in domestic birds in northern Nigeria marks the further geographical spread of this virus. Although all evidence to date indicates that the virus does not spread easily from birds to humans, careful monitoring of the situation is warranted."

Although the H5N1 strain of avian influenza is difficult to spread from birds to humans, its arrival in Africa is very troubling. So far, human contagion in other parts of the world has been kept low, thanks in part to aggressive monitoring and rapid and widespread culling of domestic bird populations. Africa's combination of close human/poultry contact and a weak medical and communications infrastructure makes it a likely location for the flu to spread and mutate into a much greater danger to human populations. The continuing AIDS epidemic on the African continent is a perfect example of how its lack of infrastructure and money leave it unable to deal with large scale health threats. In reaching Africa, H5N1 avian fluenza may now have the incubator it needs to launch a pandemic.

More From the World Health Organization:

The confirmation of highly pathogenic H5N1 avian influenza in domestic birds in northern Nigeria marks the further geographical spread of this virus. Although all evidence to date indicates that the virus does not spread easily from birds to humans, careful monitoring of the situation is warranted.

Experience in several other countries has shown how quickly the H5N1 virus can spread and become firmly established in poultry. The ability of this virus to cause rare but severe disease in humans is well documented.

At present, the only confirmed H5N1 outbreak is thought to be confined to a large commercial farm, located in Kaduna State in the northern part of the country, where thousands of chickens were kept in battery cages. Investigations are urgently needed to determine whether the outbreak, which began almost a month ago, has spread from the farm to affect household flocks. Poultry deaths in the adjacent province of Kano have been reported, but the cause has not yet been determined.

The most immediate public health need is to reduce opportunities for human infections to occur. Investigations of human cases in Asia and elsewhere have identified close contact with diseased or dead household poultry as the most important source of human exposure to the virus.

In Nigeria, as in other parts of Africa, most village households maintain free-ranging flocks of poultry as a source of income and food. Close human contact with poultry is extensive.

If the virus has spread to household flocks in Nigeria, public information campaigns will be needed to warn populations to avoid high-risk behaviours, including the slaughtering, defeathering, butchering, and preparation for consumption of diseased poultry.

WHO is ready to respond to requests from Nigeria for support, including assessment teams and the provision of essential supplies and equipment. Infectious disease staff at WHO’s regional office in Harare, Zimbabwe held an emergency meeting today to assess the situation, plan a response, and evaluate the possible risk to other African countries. A team of experts experienced in the investigation of outbreaks has been placed on standby.

No clear information about the source of the Nigerian outbreak is presently available, but the country is known to lie along a flight route for birds migrating from central Asia.

Full sequence information about the virus in the Nigerian outbreak is expected later this week. This information will allow comparison with viruses that have caused human cases elsewhere and thus assist in the assessment of risks to human health. Sequence information may also shed some light on the origins of the outbreak.

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A dozen people feared to have the H5N1 strain of bird flu have been hospitalized in Kurdistan. Meanwhile, Iraqi authorities have begun culling poultry in the region. A team of experts from the World Health Organization is expected to arrive on Wednesday. Two weeks ago, a teenage girl died of the flu in the nearby city of Sulaimaniya after being ill for 15 days.

"We have 12 patients in Sulaimaniya that have lung infections that we suspect may be the bird flu virus," Kurdish Deputy Prime Minister Imad Ahmed told Reuters news agency.

The committee set up to fight the spread of the flu virus reported that they have killed a total of 500,000 birds. In some areas, up to 50% of the bird population was slaughtered.

More information can be found from the BBC website:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/middle_east/4666360.stm

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IT managers are taking the threat of a flu pandemic very seriously. Such a pandemic is expected to knock out 20% of a company's workforce so defenses such as telecommuting and at-work quarantine lock-downs are being considered.

The flu doesn't have to kill the workforce in order to have an impact on a country's economy. It merely has to make them stay home from work. Fortunately for many involved in management and information jobs, that impact can be minimized by providing infected employees with the ability to work from home via telecommuting technology. But there's another advantage as well: it allows healthy employees who are fearful of going to a possibly infected work environment to continue working as well. Key employees could also be protected by telecommuting during the worst phases of the epidemic in the local area. Many IT departments are now strengthening their company's infracture so they can handle a sudden expansion in telecommuting demand.

Ironically, the use of this modern technology may require vital IT personnel to quarantine themselves in the data center so they can ensure the system's uptime. They would have to be locked in with the computers and communications gear along with large caches of food and water for the duration of the outbreak.

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