Africa is ill equipped to fight a bird flu epidemic
BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7538.380-b (Published 16 February 2006) Cite this as: BMJ 2006;332:380Data supplement
Africa is ill equipped to fight a bird flu epidemic
Peter Moszynski
The emergence of the H5N1 strain of avian influenza in several countries in Europe and Africa last week has led the World Health Organization to issue a warning. It said: "H5N1 is spreading rapidly across the world. All countries must take measures to protect human health against avian flu, and prepare for a pandemic."
H5N1 has now been identified in migratory swans in Italy, Greece, and Slovenia, but it is the arrival of the virus in northern Nigeria that most concerns the authorities. Sub-Saharan countries—beset by poverty, war, and hunger and with extremely weak public health and veterinary facilities—are ill equipped to deal with any crisis involving bird flu. There are also fears that the virus may have already spread undetected to other parts of the continent.
WHO’s director general, Lee Jong-wook, said: "African health systems are already struggling to cope with children and adults suffering from HIV/AIDS, tuberculosis, malaria, respiratory infections, and other infectious conditions. Human cases of H5N1 may be difficult to distinguish from other illnesses.
"We simply do not know what the impact of exposure to avian influenza will be on the many people who may be already immunocompromised and in a fragile state of health."
At a donors’ conference in China last month the UN Food and Agricultural Organization warned that if bird flu became rooted in the African countryside, "the consequences for a continent already devastated by hunger and poverty could be truly catastrophic." Regional health officials now fear a "nightmare scenario" if the Nigerian outbreak is not immediately contained.
Chickens are commonplace in Africa, and most poultry is bought live and slaughtered at home as few people have refrigerators. Another concern is that because many Africans are familiar with Newcastle disease, a poultry infection that has no effect on humans, they are unaware of the risk of transmission from birds to humans of bird flu and use few protective measures. Several suspected cases in humans are currently being investigated.
In Nigeria a major drive to identify outbreaks of bird flu and alert people to its dangers has been combined with a planned campaign on polio. Nigeria had previously experienced a widespread boycott of polio immunisation, leading to a resurgence of the disease.
David Nabarro, head of a new UN influenza task force, said that although no cases had yet been shown of the virus being directly transmitted between people, the arrival of the virus in Nigeria should be "a strong wake-up call." He urged authorities to remain on "high alert for the possibility of sustained human to human virus transmission and of a pandemic starting at any time."
Biosecurity guidelines on bird flu are available from the UK Department for Environment, Food and Rural Affairs at www.defra.gov.uk/animalh/diseases/control/biosecurity.
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