International health experts express concern over unprecedented bird flu spread

Updated:2006-02-21 15:49:19
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International health experts express concern over unprecedented bird
flu spread
By ALEXANDER G. HIGGINS
AP
GENEVA (AP) - International health experts Tuesday expressed concern
over the unprecedented spread of bird flu from Asia to Europe and
Africa, but said the spotlight is on Indonesia because of its
continuing high infection rate among people and poultry.

Fourteen countries - from India to Nigeria and Egypt - have reported
their first cases of birds infected with the deadly H5N1 strain of bird
flu since the beginning of February, the World Health Organization
said.

"It's absolutely unprecedented," WHO spokeswoman Maria Cheng told The
Associated Press. "We've never seen so many outbreaks of the same virus
in so many different regions, and our concern obviously is that humans
could potentially come into contact with birds infected with H5N1,
which would mean populations worldwide are potentially at risk."

WHO says it remains difficult for humans to catch H5N1. The agency has
confirmed 170 human cases, including 92 deaths, since 2003 - mostly in
east Asia. But WHO experts fear that the virus could mutate into a form
that is easily transmitted from person to person, and that that could
set off a flu pandemic.

Many of the locations of recent outbreaks were in Europe, where wild
birds have tested positive for the disease. But poultry cases in India,
Egypt and Nigeria are causing international health authorities more
concern because of the close contact chickens and other domestic fowl
can have with humans who keep them around their homes, increasing the
chance of the disease jumping the species barrier.

"At the moment we don't have very good information about how extensive
these outbreaks are," said Cheng. "Certainly cases like India and Egypt
where population density is quite high and people tend to keep birds at
home, that's a concern."

But so far, she noted, there have no human cases reported in those
countries or Nigeria nor in any of the western European countries.

WHO said the 14 countries that have had outbreaks since the beginning
of February - in order of reporting - are Iraq, Nigeria, Azerbaijan,
Bulgaria, Greece, Italy, Slovenia, Iran, Austria, Germany, Egypt,
India, France, and Hungary. A 15th country, Malaysia, on Monday
reported a fresh outbreak in poultry after having been considered free
of the disease for more than a year.

But Indonesia is a concern because of the high infection rates among
birds and people.

"The more chances H5N1 has to infect people, the more chances it has to
evolve into a form that could spark a pandemic," Cheng said. "And the
place we're seeing the most human infections right now is Indonesia."

H5N1 is widespread among domestic poultry in Indonesia, and the country
has record 26 human cases since July, including 19 deaths, Cheng said.

"That's quite a large number," she said.

The most recent Indonesian human death was confirmed Monday.

Juan Lubroth, head of the infectious disease group at the U.N.'s
Rome-based Food and Agriculture Organization, said, he was concerned
about outbreaks in Africa, but "I do not want to lose focus on the
situation that we have in Indonesia. There is a national strategy in
Indonesia. Now we just have to implement it."

Vietnam has the highest number of confirmed human cases of H5N1 since
2003, with 93 people infected and 42 deaths. None of Vietnam's cases
have been this year. Indonesia is in second place overall, followed by
Thailand with 22 cases and 14 deaths; China, 12 and 8; Turkey 12 and 4;
Cambodia 4 and 4; and Iraq 1 and 1.

Lubroth was reached by telephone in Egypt, where he had gone to help
contain the outbreak among poultry there. The country, as well as
Nigeria and its neighbors in West Africa, were also of concern to him,
he said. Nigeria and Egypt are the two most populous countries in
Africa.

WHO continues to watch India, Egypt and Nigeria closely.

Even though they have reported no human cases, the disease might still
have infected people there, said *** Thompson, another WHO spokesman.
Sometimes initial tests come back negative for H5N1, and the tests have
to be redone to make sure the disease is really absent.

"Initially it can take up to two weeks to get samples, to get them
transported and then it can take a longer time to actually discount
these people," Thompson said.

"As long as the virus is circulating, it could jump into humans," he
added.

Maria Zampaglione, spokeswoman for the Paris-based World Organization
for Animal Health, or OIE, said one reason that so many outbreaks were
being reported is because of increased global awareness.

"The fact that you have so many cases detected in recent days shows the
very high level of monitoring that the countries are putting in place,"
she said. "It is certainly not the first time that these wild birds are
crossing countries. Now it is so crucial and they are monitored so well
that every single case is investigated."


Associated Press writer Sam Cage contributed to this report.





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02/21/06 15:47 EST

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