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| Sunday, 30 October 2005 |
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Avian flu: Threat to humanity Many countries in the world are now taking precautions to face the Avian Pandemic Influenza. Nine Asian neighbours of Sri Lanka have already been battered by H5N1 virus. The danger in this virus is that, a terrorist attack can only kill thousands of people but pandemic influenza can kill millions of people. Pandemic influenza in 1918-1919 killed about 40 million persons worldwide. by Jayantha Sri Nissanka Unfortunately bureaucrats are still arguing that Sri Lanka will not be a victim of the virus. Some of the officers were not even willing to accept that Sri Lanka is threatened with the pandemic when the Sunday Observer contacted them. When asked why Sri Lanka was not threatened, a Wild Life Veterinary Officer said that migratory birds do not come from affected countries. But what guarantee can he give the public that all birds coming to Sri Lanka are free from Influenza? Therefore, without having a proper efficient bureaucratic machinery to implement a contingency plan, we are doomed to fail. The influenza outbreak in the past is disquieting. Pandemic Influenza in humans have resulted in 40 million deaths during the Spanish flu due to H1N1 in 1918-19. About 4 million deaths were reported in 1957-58 Asian flu due to H2N2 and 4 million deaths in 1968 (Hong Kong flu due to H3N2), according to the World Health Organisation reports. No vaccine Still Sri Lanka does not have a single dose of influenza vaccine as officials think that it will not spread in Sri Lanka even after the current outbreak was first detected in December 2003 in the Republic of Korea. Only now a decision has been taken in a hurry to import 50,000 doses. Will the health authorities be able to import this stock due to the heavy demand worldwide for the limited vaccine available?. However, Health Ministry Director Medical Supplies Dr. B. V. S. H. Beranagama has requested the local agent to supply the stock. Oseltamivir (Tamiflu) is the drug used for pandemic influenza. It is not only a very expensive drug but takes many years to produce due to the current limited global production capacity of antivirals. As there will not be enough antiviral drugs for all infected persons, the contingency plans should accommodate many non pharmaceutical control measures so as to minimise crowding, control travel, etc. The World Health Organisation (WHO) statement said "The WHO considers the present risk of a pandemic great, but unpredictable in terms of its timing and severity. All conditions for the start of a pandemic have been met except one: changes in the virus that would make it contagious among humans, thus allowing easy and sustainable human-to-human transmission. The likelihood that this will happen is a matter of opportunity and probability. There is no need to panic but to be better prepared." Soon after the threat of the pandemic, Department of Animal Production and Health Director-General Dr. S. K. R. Amarasekara had stopped issuing licences to import poultry products and birds from affected countries recently. However, a surveillance programme to collect random blood samples of migratory birds in different parks to check whether they are infected is yet to be done. India has launched such a project last week. Instructions have been given to field officers in parks to inform the veterinary surgeon if they found any dead birds. However, the Department has faced a shortage of test kits to conduct laboratory tests. The Department is now struggling to get down such test kits. The Department will keep an eye on poultry farms near bird parks to monitor whether they have been affected. Another major obstacle faced by the Department is that it does not have a list of poultry farms in the country. It has a list of about 40 such large farms, but the Department believes that about 70,000 small farms are operating in different parts of the country. The Health Ministry together with the Agricultural Ministry will submit a Cabinet paper next week to get approval for Rs.100 million for the Anti Avian Flu project. However, farm owners were unlikely to complain to health authorities even if their birds have been infected fearing that authorities will slaughter all birds unless the Ministry compensates them. However, Deputy Director-General of the Public Health Services of the Health Ministry Dr. H. M. Fernando said that such a compensation proposal is under consideration. Though the country is still not threatened with Avian Influenza, there is no guarantee that we are safe. According to the WHO, the current Avian Influenza outbreaks are caused by a highly pathogenic influenza virus that may resort or mutate to adapt themselves to human strains. There are three pre-requisites to start influenza pandemic: emergence of a novel virus, ability of the new virus to replicate and cause disease in humans and ability of the new virus to spread efficiently from human to human. The first two pre-requisites have already been met. The newly emerging Avian Influenza Virus (H5N1) has already caused disease in about 117 cases; more than half of them (60) have already died. If H5N1 virus swapped some genetic materials from human and the avian H5N1, a reassortment process known as "antigenic shift", a novel influenza subtype different from both parent viruses that could replicate in humans and be efficiently and rapidly spread from person-to-person, thus, leading to a highly lethal pandemic influenza. The world will have no immunity to the new subtype; and no existing vaccines can confer protection against the novel influenza virus, the WHO claims. Countries affected Nine Asian countries which were affected by H5N1 do not have strong capacities to eliminate the disease. The virus is now considered entrenched in many parts of Vietnam and Indonesia and in some parts of Cambodia, China, Thailand, and possibly also Laos. During early August 2005, highly pathogenic H5N1 Avian Influenza was documented among poultry in parts of Siberia, Russia, adjacent parts of Kazakhstan and Mongolia, Turkey and Romania. Direct or indirect contact of domestic flocks with wild migratory waterfowl has been implicated as a frequent cause of epidemics. Domestic poultry, including chickens and turkeys, are particularly susceptible to epidemics of rapidly fatal influenza. However, domestic ducks could serve as carriers for the virus. The current WHO strategies are essentially geared towards risk reduction to avoid emergence of a new virus. All countries throughout the world need to work together to avert, delay
and contain the anticipated pandemic. It would be a major coordinated global
effort. |
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