Thursday, January 25, 2018

Peering Down Iraq's Bird Flu Rabbit Hole


Eight days ago, in Conflicting Bird Flu Reports From Iraq, we looked at what appeared (IMHO) to be dubious reports of human `bird flu' infection (and deaths) in and around Mosul. I discussed these reports with Sharon Sanders at FluTrackers, and we both agreed these reports are `iffy' at best.
Sharon started a thread to track these reports (see Iraq - Media report: Human seasonal or avian flu death in Mosul? January 16, 2018) with the disclaimer that these are more likely to be seasonal flu than bird flu.   
Since then, despite denials by the Iraqi MOH, the reports of new `bird flu' cases (and deaths) continue to be published by local, and even international sources. 
Many media sources in the Middle East tend to blur the lines between `bird flu', `swine flu', and `seasonal flu' . So I while I think it is prudent to take notice of them - I tend not to take them too literally. 
Although I remain skeptical, today the Russian government got into the act. This (translated) statement from Russia's Federal Service for Veterinary and Phytosanitary Surveillance (Rosselkhoznadzor) website.
About human cases of influenza birds in the Republic of Iraq

25.01.2018 Mr.

According to the medical service of the province of Salah-ed-Din (north of the Republic of Iraq) of January 21, 2018, the death of a patient infected with the avian influenza virus was recorded in Balad. In the other two cases, the cause of death is established. In total, in the past few days, five deaths of people allegedly from avian influenza and one in Baghdad (January 18 of this year) have been recorded in Salah-ed-Din province.

The authorities also report two deaths in humans, presumably from bird flu in the provinces of Nineveh and Diyala (in the north and northeast of the country).

Although in official reports of fatal cases in humans, the serotype of the influenza virus was not named, earlier the Republic of Iraq notified the World Organization for Animal Health (OIE) that the cause of the bird flu epidemic in the country's poultry farms is the strain AH5N8.

According to OIE, in early January, more than 7,200 poultry were killed by poultry in the Diyala province of poultry farms. On January 18, 2018, the provincial authorities considered the destruction of 70,000 chickens infected with the avian influenza virus on farms.

The Ministry of Health of Iraq has announced the initiation of vaccination against seasonal influenza in provinces in which deaths are likely to be associated with an avian virus.

Rospotrebnadzor draws the attention of citizens and asks to take this information into account when planning trips.
         (Continue . . . )

Although this is posted on an `official' Russian site, I would note it contains no official confirmation, only anecdotal reports. Essentially rehashing many of the unconfirmed media reports over the past week.
If true, this would be a big story.  But that is a pretty  big `if'.
To date, H5N8 has not been linked to human illness (much less death), and while other subtypes might be circulating in Iraq, 5 deaths due to HPAI H5 in just over a week  - after more than a decade without reporting a case - would be extraordinary.

While it is tempting to simply ignore these stories, it is worth noting that 3 months ago the head of Rospotrebnadzor - Anna Popova, Chief State Sanitary Physician of the Russian Federation - reportedly made a public statement regarding potential human infection with HPAI H5N8 in Russia (see A Curious (And Unverified) H5N8 Report From Russia).
As far as I know, there's been no further information released on those claims.
Despite today's Rospotrebnadzor report, seasonal flu seems a much more likely cause of these Iraqi deaths than bird flu - but we'll continue to keep an eye on the situation - just in case more credible information becomes available.

For more on Iraq's recent battles against avian flu in poultry, you may wish to revisit:
OIE Notification: H5N8 In Iraq
FAO EMPRES: Risk Assessment For Spread Of H5N1 In The Middle East
Voice Of Iraq: H5N1 Reported in Sulaimaniya Poultry


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