# 353
For flu watchers, Nigeria, and nearly all of sub-Saharan Africa, is a bit of a paradox. We’ve had plentiful reports of infected poultry from nearly a half dozen African nations for nearly a year, and yet, almost no reported cases of human infection. Egypt, on the other hand, has had 19 confirmed human infections and 11 deaths.
There have been rumors, of course. And speculation. But except for one case in Djibouti, on the eastern coast of Africa, no other human cases have been reported.
The virus appears to be particularly well entrenched in the poultry of Nigeria, as evidenced by this report from Deutsche Presse-Agentur.
Nigeria Records Another Avian Flu Outbreak
More than 3,000 poultry birds were culled in northern Nigeria Wednesday amid fears of another bird flu outbreak, authorities said.
The outbreak occurred in the Girei council area of northern Adamawa State. The state's commissioner for animal production, Salihu Bello, said the birds were killed to prevent a further spread and appealed to poultry farmers in the state to report all cases of suspicious bird diseases in their farms.
Girei is the major centre of poultry in the state. Bello cautioned against eating any birds from the region.
One would think, given the prevalence of the disease in birds there, we’d have seen some human infections.
There are many theories. The most common one is that human infections simply aren’t detected, because there is no surveillance for them. Nigeria is a country plagued by many troubles, including civil strife, AIDS, hunger, and poverty. Healthcare is a luxury that few can afford.
It is argued that it would be very easy for avian flu patients to be dismissed as having atypical pneumonia, and never tested for the H5N1 virus, thereby avoiding detection.
With a population of 131 million, and an average life expectancy of about 47 years, the daily death toll in Nigeria is extensive. Lassa Fever, Malaria, meningococcal meningitis, AIDS, and water borne illnesses, along with a host of other diseases, take a deadly toll. Many die, and are quickly buried, without ever seeing a doctor.
While one never likes to assume facts that are not yet in evidence, it doesn’t take too great of an imagination to suspect some human avian flu cases could be among the hundreds who die each day.
But of course, we don’t know.
Yesterday, an article appeared in THISDAY, an African online news site, which indicates authorities are investigating a possible case of H2H (Human to Human) avian flu transmission in Lagos. There are some disturbing inaccuracies in this report, particularly the citation of the number of cases and deaths reported worldwide to date, and so I approach this report with a bit of caution.
Bird Flu Death Suspected in Lagos
By Steve Dada, 01.24.2007
A mother and daughter, who recently died in mysterious circumstances in Lagos, have been suspected to have died of the deadly bird flu disease, thus, giving rise to speculations of a possible human-to-human infection of the disease in the country.
The two were said to have died within two weeks after they allegedly ate a chicken the mother bought for the family during the Christmas and New Year celebrations at a popular chicken market along Ikorodu Road, Lagos.
While the mother died on the January 4, the daughter also lost her life January 17.
According to information, after the daugher’s death, the father was said to have ordered an autopsy of the girl as well as his dead wife.
The result of the autopsy suspected bird flu disease as the cause of their deaths and it was after this that the father also disclosed that one of the chickens they had bought during the festive season had died mysteriously and they had to quickly slaughter the rest before they could face similar fate.
THISDAY gathered that the family has since been quarantined while further investigations are being carried out by officials of the World Health Organisation (WHO).
WHO spokesman, Mr. Austine Ogbide, in a telephone chat with THISDAY, confirmed that WHO is “aware of the case of a woman and her daughter who allegedly died after consuming a chicken”, but was quick to warn that the “cause of their deaths was yet to be determined”.
He also said the chicken is still being diagnosed and that it may not be proper to conclude that the mother and daughter were killed as a result of the chicken.
He added that WHO is still waiting for the outcome of the investigations after which it would make a definitive statement.
UNICEF record shows that over 300 people world over have been reported to have contacted the disease, and out of the figure, about 68 people have been reported to have died.
If the ongoing investigation confirms that both mother and daughter died as a result of the disease, it would be the first case of human-to-human transmission of the virus in the country.
This article troubles me on several levels. The misstatements on the number of deaths most obviously, but more so, the fact that there appears to be a good deal of supposition involved here. Mentioning Human-to-Human transmission twice in the article, at this early stage, is something we rarely see in the press.
If this article turns out to be valid, then it is troubling. Lagos is one of the largest, and most densely populated cities in the world. Fifteen million people, many of which live in poverty. With a poorly implemented surveillance system, an outbreak there would be difficult to contain.
For now, this is just a single report in a newspaper. Unconfirmed. It bears watching. Given the location, the story is plausible.
