# 263
Despite rumors to the contrary, reports of the demise of the bird flu threat have been exaggerated. Over the last week we’ve been treated to a rash of newspaper articles and editorials asking where did the H5N1 virus, and the threat of a pandemic; go?
A brief tour will show it hasn’t gone anywhere.
Cairo, Egypt: The deaths this weekend of two women from the H5N1 virus illustrate that the threat of bird flu is still with us. A third victim is reportedly still hospitalized, and up to 30 members of their extended family are being monitored for signs of infection. There are other reports, vague and unconfirmed, of several other possible victims.
Unfortunately, the news comes slowly out of this part of the world. We occasionally hear reports of suspected victims, and then never a word of a follow up. Or, we learn of a case only after a patient has been hospitalized for weeks. Additionally, translation difficulties from Arabic newspapers can confuse the issues.
Yesterday Aljazerra.net reported that `Seventeen people are still being treated for bird flu.’ http://tinyurl.com/ylonjc , yet there has been no other confirmation, and so for now this report remains highly suspect. My personal suspicion is that this may represent the number of human cases in Egypt this year, and not current cases.
Hopefully, we will get some clarification from the authorities soon.
South Korea: With at least 4 major outbreaks in poultry and ducks this month, the H5N1 virus is proving to be well entrenched in South Korea. Over the weekend, news reports indicated that 4,200 hogs were culled in an attempt to thwart the spread of the H5N1 virus from a contaminated area.
While there has been no word of any tests from Korea indicating swine testing positive for the H5N1 virus, pigs are notoriously good mixing vessels for influenzas, and have long been feared as a likely vector. With the emergence of the H3N1 virus in pigs, along with other human influenzas, a co-infection with the H5N1 virus could result in a new, more easily transmitted virus.
This move to cull swine may be nothing more than an abundance of caution on the part of the Koreans. Just as the culling of dogs, cats, and other non-avian species earlier this month in the affected areas may have been nothing more than precautionary. But once again, we are left with more questions than answers, and can but watch and wait for official pronouncements.
Iran : A curious story this week out of Iran, which has long declared itself to be free of the H5N1 virus.
No case of bird flu detected in IRI
Head of Iran Veterinary Organization Hossein Hassani said Sunday no case of bird flu has been detected in Iran yet.
Hassani told IRNA that the Islamic Republic of Iran is still among those states which are "clean of the bird flu virus (H5N1)."
Asked what was the reason behind annihilation of chickens in some of the chicken farms around the country, the official said that the Veterinary Organization decided to immediately destroy any suspicious case since the avian flu has been pandemic in some of the (neighboring) countries.
Hassani added that annihilation of the suspicious cases does not necessarily mean that a case of bird flu was found in the country. He said there was no reason to feel concerned about the outbreak of the disease in Islamic Republic of Iran.
What is missing from this story is any mention of testing of these birds to determine if, in fact, they have the H5N1 virus. But it is a truism that as long as you don’t test, you can’t have a positive result, and without a positive result, you can declare your country free of the disease. As Mr. Hassani said, annihilation of suspicious cases does not necessarily mean that a case of bird flu was found . . . which should be comforting to all of us.
Vietnam : After several months without reported cases of infection, Bird Flu is back. Not that it every left, of course, it just wasn’t being reported. Bird flu doesn’t spontaneously erupt, it requires a host. When we aren’t hearing of outbreaks, it is still out there, unnoticed in the wild or masked by vaccines, or worse, covered up by officials or villagers.
Three outbreaks between Dec. 11 and Dec. 20 in Ca Mau province killed over 2,500 chickens and ducks, while one in neighboring Bac Lieu province killed dozens of ducks, the ministry's Animal Health Department said in a report on Thursday.
Luckily, Vietnam takes bird flu very seriously, and has made some genuine progress in controlling the problem. The fact that outbreaks continue to appear demonstrate just how difficult this task really is.
Nigeria: According to press reports, bird flu has spread to nearly every corner of this country, with infections recently detected by the National Veterinary Research Institute in samples collected from the southern state of Delta, the western state of Kwara which borders Benin, and the northeastern state of Borno. Outbreaks have been reported in 17 of Nigeria’s 36 states.
Yet surprisingly, no human infections have been reported, despite the human cases in Egypt and Djibouti. Just lucky? Or is it simply that there is little or no testing or surveillance for the H5N1 virus among those who are sick and dying in that country?
Ravaged by AIDS, poverty, disease, and civil war, Nigerian’s are no stranger to premature death. One never likes to assume, in the face of little or no evidence that something is happening. But in this case, it’s a pretty good bet.
Nigeria is just one of more than a dozen African nations where surveillance of this disease is all but non-existent. They all have the potential of developing a serious problem, and having it spread, before anyone was aware of it.
Elsewhere in the world, places like Indonesia, Cambodia, China, and Thailand appear to be relatively quiet. The operative word here is `appear’. We’ve learned through experience that transparency in these issues has not been a high priority in the past. And questions remain regarding North Korea, as well. We get absolutely no word out of that country, but have to assume the 38th parallel is no barrier to migratory birds.
The flu season for the northern hemisphere is just beginning to ramp up. Last year, it was in January that the major onslaught of cases began making the news, and those continued through May.
The coming weeks will be a time of continued watchful waiting.
