And if bird flu hits Africa?

WHO warns of risk, emphasizes the need to strengthen the continent?s laboratory services

By | January 20, 2006

As avian influenza continues to spread from poultry to humans in Asia and Europe, the World Health Organization (WHO) has warned that Africa is at great risk of a pandemic, and urgently needs to strengthen its laboratory facilities to identify avian influenza in humans and animals. International experts, including the UN?s avian flu coordinator David Nabarro, have expressed concern in recent days that migratory birds or travellers may carry the virus to Africa from Turkey or other affected areas. Given these risks, UN Food and Agriculture Organization?s (FAO) deputy director-general David Harcharik said this week that African nations deserve special attention when it comes to improving preparedness for a pandemic. ?In Turkey, the virus has already reached the crossroads of Asia, Europe and Africa, and there is a real risk of further spread,? he said at a meeting in Beijing. Juan Lubroth, head of FAO?s Emergency Prevention System (EMPRES) livestock component said scientists don?t yet have a proper handle on the risk from wild birds. "We don't really have a good clear picture of which of the 250-odd species of migratory birds might be a reservoir for this particular virus,? Lubroth told The Scientist. ?It's only recently that we've seen such species carrying such highly pathogenic viruses.? The FAO is starting some research on this throughout African countries, with the aim of clarifying the picture, he said. In the meantime, there is very little that African governments can do about wildlife, he said. Instead, ?what is appropriate would be for governments and other organizations to improve hygiene and the way poultry are raised... to avoid them coming into contact with wildlife." At a meeting in Brazzaville, Congo, last week, WHO?s regional director Africa, Luis Gomes Sambo, told government representatives and top-level scientists it was also vital for African countries to ensure they have access to laboratory facilities for animal and human virus isolation. During the Brazzaville conference, he convened a panel of scientists from across the continent with the aim of strengthening a regional network for influenza, ensuring better communication between countries, and improving collaboration between public health and veterinary labs. Representatives from 43 of the 46 WHO Africa region member states attended the meeting, said Idrissa Sow, WHO?s acting regional advisor for communicable disease emergency response, based in Harare, Zimbabwe. ?There was a very good response,? she told The Scientist. ?We are still weak, but we are doing our best in the region to bring the labs to a level to cope.? African governments are developing emergency response plans and putting in place early warning systems for avian flu, among other measures, she said. Most African countries do not have laboratories listed as National Influenza Centers (NIC) within WHO?s global influenza surveillance network. Fewer than 10 labs across the whole WHO Africa region serve as reference labs for the rest of the African countries, Sow explained. Nevertheless, the way countries have responded to recent rumors of H5N1 outbreaks and reports of worrying bird deaths have been promising, she said. ?I think they have been handled extremely well.? For example, after a recent bird die-off in Malawi, samples were sent to the NIC in South Africa, ?and very quickly we knew it wasn?t H5N1.? Lubroth said the FAO has also been monitoring "quite a number of rumors" about bird deaths in Africa in recent weeks. So far, however, ?we do not have any evidence that H5N1 is in Africa," he told The Scientist. If the virus does gain a foothold on the continent, the outcome could be dire. ?Africa's limited public health services would be stretched even further,? said Maria Cheng, a spokeswoman for WHO in Geneva, told The Scientist. But exactly how it would pan out is one more unknown, says Lubroth. "I would say that in the African context we do have inferior veterinary services that are not as well established as elsewhere, but also we don't have the density of animal or human populations as in Asia. It's kind of hard to predict what the outcome would be.? Stephen Pincock Links within this article S. Pincock, ?African governments back science,? The Scientist, October 10, 2005 L Ramirez, ?UN experts warn bird flu could devastate Africa,? Voice of America, January 19, 2005. UPI, ?Bird flu could reach EU, Africa by spring,? Jan 18, 2006. Press release, ?Regional director for WHO African region urged to member states in the region to urgently ensure that their national plans include laboratory components for both human and animal aspects,? WHO, January 13, 2006. FAO Emergency Prevention System WHO Global Influenza Surveillance Network ProMed-Mail, ?Avian influenza-Africa: Zimbabwe, suspected,? December 3, 2005. ProMed-Mail, ?Avian influenza-Africa: Malawi, suspected,? December 16, 2005.

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