Intelink Avian Influenza Daily DigestAvian Influenza Daily Digest
August 12, 2008 14:00 GMT
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Article Summaries ... Announcement
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Announcement Quid Novi
Vietnam: New outbreak reported in Southern Ben Tre Province Regional Reporting and Surveillance
Saudi Arabia: Lifting of a Temporary Import Ban on Chicken Meat and Eggs from 9 Countries and Imposing of a Ban on 3 Countries
8/12/08 ARGUS--A local source reported that the Ministry of Commerce and Industry has lifted, as of 9 August, a temporary import ban on chicken meat and eggs and their fresh and frozen products from Jordan, Thailand, Romania, Italy, Zimbabwe, the West Bank, Gaza, Malaysia and Myanmar. According to the source, lifting of the ban was based on the reports of the World Organization for Animal Health (OIE), which indicated that these countries are free from Avian Influenza (AI). The source also reported that the Ministry of Commerce and Industry imposed a temporary import ban on the same products from Britain, Oceania and Bangladesh. According to the source, the decision to impose the ban was based on OIE reports confirm reported cases of AI among wild migratory birds and domesticated birds in these 3 countries.
Regional Reporting and Surveillance
Azerbaijan Leaders Need Help Preparing for a Pandemic
8/12/08 NTV --It's a long trip for seven Azerbaijan leaders to Central Nebraska. The country is just north of Baghdad, Iraq and borders Georgia, the country now at war with Russia. The country was struck with the Avian Flu in 2006, and CDHD Emergency Response Coordinator Mike Darbro said "they're on the front line of pandemic influenza again."
Pandemic Preparedness, Regional Reporting and Surveillance
Uganda, Kenya Still Fighting Over Chicken Exports
8/12/08 All Africa, contributed by email --Further bilateral trade negotiations on Uganda's poultry and beef exports have stalled following Kenya's failure to present the full risk assessment report on a study carried out by the Kenyan Veterinary Services on hygiene of Ugandan products. At a bilateral meeting last week in Kampala between the two parties, the Ugandan delegation declined to discuss the matter without a full report.
Regional Reporting and Surveillance
Iraq veterinary company warns against smuggled bird flu vaccines
8/11/08 Iraqi Media Network weekly newspaper Al-Sabah, contributed by email --The General Veterinary Company, which is affiliated with the Ministry of Agriculture, said that the bird flu vaccine, which is of the H9N21 [acronym as published] kind and designated for poultry at the private veterinary offices, has entered the country via smuggling. It warned chicken breeders against dealing with the vaccines imported for incubators which are not subjected to quality control at its specialized laboratories in Baghdad and the governorates. It revealed an agreement with the WHO firms on importing its needs of this vaccine
Regional Reporting and Surveillance
India: Culling affected birds only way out
8/12/08 The Hindu --Chief of Veterinary College Mallikarjunappa has said that culling birds the moment they exhibited symptoms of bird flu was the only way out as it was an incurable disease.
Regional Reporting and Surveillance
North Korea: Bird Flu Differential Method Established in DPRK
8/11/08 KCNA --Researches for a strict and prompt prevention of possible outbreak and spread of bird flu have carried out in the DPRK, which have culminated in some significant successes.
Regional Reporting and Surveillance
Indonesia: N. Sumatra remains alert against bird flu outbreak
8/12/08 Jakarta Post --The North Sumatra Health Office remains on "extraordinary occurrence" (KLB) alert status following the deaths of three people and the hospitalization of 13 others believed to have contracted bird flu.
Regional Reporting and Surveillance
Cambodia, FAO start series of market forums on bird flu
8/12/08 Xinhua --The Cambodian Ministry of Agriculture, Forestry and Fisheries (MAFF), with the help from the UN Food and Agriculture Organization (FAO), will hold a series of market forums on avian influenza to prevent and control the disease, said a press release on Tuesday.
Regional Reporting and Surveillance
Bird flu fatality rate drops in Indonesia
8/12/08 Xinhua --The bird flu fatality rate in Indonesia this year dropped from its level last year, the executive chairman of the National Commission of Bird Flu Control and Alertness (FBPI) said here on Tuesday.
Regional Reporting and Surveillance
DPRK vigilant on bird flu
8/11/08 Xinhua --The Democratic People's Republic of Korea (DPRK) has remained vigilant toward a possible outbreak of bird flu and has made several scientific achievements in preventing the disease, the official KCNA news agency said Monday.
Regional Reporting and Surveillance
Knowledge, attitudes, and practices regarding avian influenza (H5N1), Afghanistan
8/11/08 CDC/EID --From February through April 2007, avian influenza (H5N1) was confirmed in poultry in 4 of 34 Afghan provinces. A survey conducted in 2 affected and 3 unaffected provinces found that greater knowledge about reducing exposure was associated with higher socioeconomic status, residence in affected provinces, and not owning backyard poultry.
Regional Reporting and Surveillance Science and Technology
Oseltamivir-Resistant Influenza A Viruses Transmit Efficiently Among Guinea Pigs by Direct Contact but not by Aerosol
8/12/08 Journal of Virology [abstract]-- Abstract Influenza viruses resistant to the neuraminidase inhibitor oseltamivir arise under drug selection pressure both in vitro and in vivo. Several mutations in the active site of the viral neuraminidase (NA) are known to confer relative resistance to oseltamivir, and influenza viruses with certain oseltamivir-resistance mutations have been shown to transmit efficiently among co-caged ferrets. However, it is not known whether NA mutations alter the mode of transmission of drug-resistant influenza virus. Here we demonstrate that recombinant human influenza A/H3N2 viruses with and without oseltamivir-resistance mutations (NA-E119V and NA-E119V+I222V) have similar in ovo growth kinetics and infectivity in guinea pigs. These viruses also transmit efficiently by the contact route among co-caged guinea pigs, as in the ferret model. However, in an aerosol transmission model, in which guinea pigs are caged separately, the oseltamivir-resistant viruses transmit poorly or not at all; in cont rast, the oseltamivir-sensitive virus transmits efficiently, even in the absence of direct contact. The present results suggest that oseltamivir-resistance mutations reduce aerosol transmission of influenza virus, which could have implications for public health measures taken in the event of an influenza pandemic.
AI Research
Inverness Medical gets USDA approval for flu test
8/11/08 AP --Inverness Medical Innovations Inc. said Monday the U.S. Department of Agriculture issued the medical diagnostics company a license to make and sell its avian flu test kit for veterinary use.
Science and Technology
Full Text of Articles follow ...
AI Research
Oseltamivir-Resistant Influenza A Viruses Transmit Efficiently Among Guinea Pigs by Direct Contact but not by Aerosol
8/12/08 Journal of Virology [abstract]--
Nicole M. Bouvier, Anice C. Lowen, and Peter Palese*
Division of Infectious Diseases, Department of Medicine, and Department of Microbiology, Mount Sinai School of Medicine, New York, New York
Abstract
Influenza viruses resistant to the neuraminidase inhibitor oseltamivir arise under drug selection pressure both in vitro and in vivo. Several mutations in the active site of the viral neuraminidase (NA) are known to confer relative resistance to oseltamivir, and influenza viruses with certain oseltamivir-resistance mutations have been shown to transmit efficiently among co-caged ferrets. However, it is not known whether NA mutations alter the mode of transmission of drug-resistant influenza virus. Here we demonstrate that recombinant human influenza A/H3N2 viruses with and without oseltamivir-resistance mutations (NA-E119V and NA-E119V+I222V) have similar in ovo growth kinetics and infectivity in guinea pigs. These viruses also transmit efficiently by the contact route among co-caged guinea pigs, as in the ferret model. However, in an aerosol transmission model, in which guinea pigs are caged separately, the oseltamivir-resistant viruses transmit poorly or not at all; in cont rast, the oseltamivir-sensitive virus transmits efficiently, even in the absence of direct contact. The present results suggest that oseltamivir-resistance mutations reduce aerosol transmission of influenza virus, which could have implications for public health measures taken in the event of an influenza pandemic.
Regional Reporting and Surveillance
Saudi Arabia: Lifting of a Temporary Import Ban on Chicken Meat and Eggs from 9 Countries and Imposing of a Ban on 3 Countries
8/12/08 ARGUS--A local source reported that the Ministry of Commerce and Industry has lifted, as of 9 August, a temporary import ban on chicken meat and eggs and their fresh and frozen products from Jordan, Thailand, Romania, Italy, Zimbabwe, the West Bank, Gaza, Malaysia and Myanmar. According to the source, lifting of the ban was based on the reports of the World Organization for Animal Health (OIE), which indicated that these countries are free from Avian Influenza (AI). The source also reported that the Ministry of Commerce and Industry imposed a temporary import ban on the same products from Britain, Oceania and Bangladesh. According to the source, the decision to impose the ban was based on OIE reports confirm reported cases of AI among wild migratory birds and domesticated birds in these 3 countries.
Article URL(s)
http://www.okaz.com.sa/okaz/osf/20080810/Con20080810215765.htm
Pandemic Preparedness > Regional Reporting and Surveillance
Azerbaijan Leaders Need Help Preparing for a Pandemic
8/12/08 NTV --It's a long trip for seven Azerbaijan leaders to Central Nebraska. The country is just north of Baghdad, Iraq and borders Georgia, the country now at war with Russia. The country was struck with the Avian Flu in 2006, and CDHD Emergency Response Coordinator Mike Darbro said "they're on the front line of pandemic influenza again."
The seven leaders will meet with state-wide health officials Tuesday afternoon to discuss pandemic preparedness. Darbro believes they came to Nebraska because it's one of the top ten states in the country for preparedness. Local communities have also been conducting their own emergency preparedness tests recently. Darbro said the Azerbaijan leaders are looking to the local panel for answers, and says they don't have all the answers, but they hope to help.
The country needs all the advice to prepare they can get, and they need it fast.
"It's endemic which means it's in all the wild birds and it's going to stay there. It's there
waiting to happen again, it's there waiting to mutate," Darbro said.
And as soon as it mutates, it's easily transferable from human to human, creating a pandemic. Azerbaijan may be thousands of miles away, but a pandemic would affect Central Nebraskans and the rest of the world. That's why health officials here are more than willing to help.
St. Francis Medical Center Safety Coordinator Richard Simpson said, "We're going to tell them communication is very important."
Simpson said so is taking care of city health employees first.
"It isn't going to help us at all if all our people are sick," he said, referring to doctors and nurses. That also includes firefighters, police officers, and even utilities workers.
For everybody else, he said to stay home. But if people do rush to St. Francis for help, they'd be kept in the lobby and the emergency room, quarantined. Simpson said it's what he hopes would work here, and hopes works for Azerbaijan, so the Avian Flu never spreads across the world.
"In today's transportation, you can be in Azerbaijan one day and back in Grand Island by
tomorrow evening. That's what's scary about it."
Reporter's Notes: Stacia Kalinoski
A pandemic isn't the Azerbaijan peoples' only concern. Their country borders Georgia, which has been fighting with Russia. One of their interpreters said there's a very good chance they could get involved.
Regional Reporting and Surveillance
Uganda, Kenya Still Fighting Over Chicken Exports
8/12/08 All Africa, contributed by email --Further bilateral trade negotiations on Uganda's poultry and beef exports have stalled following Kenya's failure to present the full risk assessment report on a study carried out by the Kenyan Veterinary Services on hygiene of Ugandan products.
At a bilateral meeting last week in Kampala between the two parties, the Ugandan delegation declined to discuss the matter without a full report.
"We need a detailed report to be in position to advise and respond to what is required of us. We only saw highlights, which were availed to the minister in April and we cannot comment much on these highlights," Dr Nicolas Kawuta, the commissioner of Livestock and Entomology at the Ministry of Agriculture, Animal Industry, and Fisheries, and also the leader of Ugandan delegation, said.
The Risk Assessment report is based on a study done by the Kenyan Veterinary Services on Ugachick and Biyinzika farms in Uganda in November 2007 to establish if Ugandan poultry operations guaranteed acceptable levels of hygiene and fit for human consumption.
The study was commissioned after Kenya banned the importation of Ugandan poultry products following the outbreak of Bird Flu in south east Asia in 2006.
Even after the ban was lifted about two years ago, Ugandan traders have not been able to export to Kenya but Kenyan traders continue to export to Uganda more than 20,000 day-old chicks every week.
The Uganda delegation was eager to receive the report in order to establish requirements to facilitate exports to Kenya.
Dr Kawuta said the delay to release the report by the Kenyan team is contrary to International Animal Health Organisation (OIE) guidelines which gives four months within which evaluations have to be released.
Mr Japheth Getugi, the Kenyan High Commissioner to Uganda who led a ten-man team, promised that a full report would be given to the relevant Ugandan authorities as soon as possible.
The report will be forwarded to the ministry of Foreign Affairs who will in turn send to the Ministry of Agriculture.
However, Mr Aga Ssekalala the Proprietor of Ugachick Poultry Breeders, said: "We need a time frame as to when the report will be available; we have already wasted a lot of time and money on this matter. We need to know the way forward."
Mr Getugi said there has never been a ban on Uganda's poultry and poultry products to Kenya.
"There is no ban on importation of day-old chicks from Uganda and urged Ugachick and other exporters to resume exports to Kenya. But should only be done through your appointed agents in Kenya," Mr Getugi said.
The experience for most Ugandan exporters though has been to the contrary. During a recent agricultural show in western Kenya, Ugachick was restricted to only 200 day-old chicks for the exhibition despite processing documents for 20,000.
They were also delayed at the Busia border post for more than four hours. According to Ugachick Marketing Manager Immaculate Ngulumi, their application for transit via Jomo Kenyatta International Airport takes two weeks.
"We have now opted to transit through Rwanda via road where it takes us only six hours. Rwanda lifted a ban on Uganda's poultry exports early this year," Ms Ngulumi said.
Uganda requested to be granted long standing transit rights for day-old chick through Kenya like she does for Kenya exporters to Uganda particularly with import permits for Farmers' Choice.
"This delay in the issuance of transit permits shall be addressed and issues of long standing transit rights will be studies for improvements where necessary," Mr Getugi said.
Kenya however also had a bone to pick with Uganda over the ban on importation of semen, meat and meat products by Uganda.
Eleven years ago, Uganda banned the importation of beef and beef products after the outbreak of Mad Cow disease in Europe.
Now, Kenya wants Uganda to lift the ban.
Dr. Kawuta said the ban applied to all countries and not just to Kenya. "The ban on meat products followed the BSE scare and the situation is still being studied to ensure safety and traceability," Mr Kawuta said adding that the situation is currently on review.
The two countries agreed to initiate a Joint Technical Committee to generate information to inform the review for lifting of the ban.
Regional Reporting and Surveillance
Iraq veterinary company warns against smuggled bird flu vaccines
8/11/08 Iraqi Media Network weekly newspaper Al-Sabah, contributed by email --The General Veterinary Company, which is affiliated with the Ministry of Agriculture, said that the bird flu vaccine, which is of the H9N21 [acronym as published] kind and designated for poultry at the private veterinary offices, has entered the country via smuggling. It warned chicken breeders against dealing with the vaccines imported for incubators which are not subjected to quality control at its specialized laboratories in Baghdad and the governorates. It revealed an agreement with the WHO firms on importing its needs of this vaccine
In an exclusive statement to Al-Sabah, Dr Sabah Jasim Muzan, the company's director general, said that the poultry vaccines should enter into the country only after they are subjected to quality control and strictly at the company's specialized laboratories, which should decide whether they can be used or cannot be used by the owners of incubators. He noted that the vaccine, which is of the H9N2 [acronym as published] kind and which owners of the private veterinary offices claim that it is designated for bird flu, entered the country via smuggling and was not subjected to any laboratory test to approve or disapprove its use.
He revealed that in cooperation with the Animal Health Organization, the company seeks to import a vaccine for the egg-laying chicken. Dr Muzan noted that a delegation comprising veterinarians from the Higher Committee for Bird Flu, which is headed by the health minister, had left for Rome to discuss the bird flu virus and the use of the PCR [acronym as published] technique on early diagnosis of the disease. He said that an agreement was reached with the specialized laboratory there on a special mechanism for supplying Iraq with the vaccines for this disease based on a special request from the Ministry of Agriculture explaining the country's needs of the required material in order to end the previous state of hesitation on supplying the country with its needs of veterinary medicines, vaccines, enzymes, and requirements.
Four months ago, the General Veterinary Company formed a specialized scientific committee to supervise and monitor the work of the private veterinary offices following the deaths that took place in the fields of chicken farming in the governorates of Al-Najaf, Karbala, and Babil due to their reliance on these offices in supplying them with all their requirements that are not subjected to any veterinary supervision.
FAO says H5N1 situation in birds has improved
8/11/08 CIDRAP --The global H5N1 avian influenza situation in birds improved in the first half of this year, but an H5N1 strain not previously seen in Africa recently cropped up in Nigeria, according to the United Nations Food and Agriculture Organization (FAO).
"Considering the number of outbreaks reported worldwide, the global HPAI [highly pathogenic avian influenza] situation can be said to have improved markedly in the first half of 2008," the FAO said in the latest issue of its avian flu bulletin, AIDEnews.
However, four countries where H5N1 is endemic?Egypt, China, Indonesia, and Vietnam?continued to report outbreaks during the 6-month period, and the virus re-emerged in Pakistan and in Hong Kong's live bird markets, the agency noted.
In June, 11 H5N1 outbreaks were reported in five countries (China, Egypt, Indonesia, Pakistan, and Vietnam), compared with 65 outbreaks in June 2006 and 55 in June 2007, the FAO said. Europe reported no outbreaks, unlike in June of previous years, and no cases were reported in wild birds.
However, Indonesia has not submitted reports on H5N1 events since May, because the new database for the country's Participatory Disease Surveillance system is being modified, according to the report.
"Although there has been an improvement in disease awareness, outbreaks/cases of HPAI are still underestimated and underreported in many countries because of limitations in country disease surveillance systems, which may affect considerably the shape of the distribution of outbreaks by region," the FAO said.
Novel strain in Nigeria
In a statement today about Nigeria, the FAO said recent avian flu outbreaks in the states of Katsina and Kano involved a strain that has never been reported in Africa before but is similar to strains identified in Italy, Afghanistan, and Iran in 2007. The agency did not identify the strain by clade or subclade.
Scott Newman, international wildlife coordinator for the FAO's Animal Health Service, said the discovery is a concern because it is not known how the virus was brought into Africa.
"It seems to be unlikely that wild birds have carried the strain to Africa, since the last migration of wild birds from Europe and Central Asia to Africa occurred in September 2007 and this year's southerly migration into Africa has not really started yet," Newman said.
He said the new strain could have been introduced through international trade or illegal and unreported movement of poultry, adding, "This increases the risk of avian influenza spread to other countries in western Africa."
A team of FAO animal health experts and veterinary epidemiologists is working with the Nigerian government on disease surveillance, outbreak investigations, and the establishment of veterinary drug stockpiles, the agency said.
Increased pathogenicity in Vietnam
In other developments, the pathogenicity of H5N1 strains circulating in Vietnam seems to be rising, according to another article in the FAO's AIDEnews.
Investigators from the US Department of Agriculture and colleagues from Vietnam's National Centre for Veterinary Diagnosis said the increase in pathogenicity is manifested by more severe respiratory tract infections in ducks and an increase in cloacal virus levels, according to the article.
The higher pathogenicity has been seen in H5N1 viruses circulating in the Red River Basin (clades 2.3.2 and 2.3.4) and the Mekong delta (clade 1), the report says.
Jan Slingenbergh of the FAO's Animal Health Service said that despite the increased pathogenicity, avian flu in Vietnam is generally "fairly well in check," according to the report. Slingenbergh participated in an avian flu conference in mid June in Hanoi.
He reported that avian flu in southern Vietnam is well in check, but that efforts in northern Vietnam need "strengthening with measures other than vaccination, and the cost of vaccination cannot continue to be entirely supported by public funds only," the article states.
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Regional Reporting and Surveillance
India: Culling affected birds only way out
8/12/08 The Hindu --Chief of Veterinary College Mallikarjunappa has said that culling birds the moment they exhibited symptoms of bird flu was the only way out as it was an incurable disease.
He was speaking after inaugurating a training programme for veterinarians on the control and eradication of bird flu organised by the zilla panchayat and the Department of Animal Husbandry and Veterinary Services at the Amruth Mahal here on Monday.
Mr. Mallikarjunappa said that bird flu which spread through H5N1 virus could severely affect human beings unless it was controlled.
He said that 14 countries had been affected by bird flu. However, in India the disease had not spread because of the precautionary measures taken up by the department.
Deputy Director of the department N.S. Basavarajappa who spoke on the occasion said that as many as 244 people had died of bird flu in the world. Assistant Conservator of Forest (Wildlife Division) Sudarshan was the chief guest. Rajgopal welcomed the gathering.
President of the District Veterinary Doctors? Association Ramesh proposed a vote of thanks.
Scientists K.J. Sudarshan, D.G. Veerannagowda and Suresh were the resource persons for the programme.
Regional Reporting and Surveillance
North Korea: Bird Flu Differential Method Established in DPRK
8/11/08 KCNA --Researches for a strict and prompt prevention of possible outbreak and spread of bird flu have carried out in the DPRK, which have culminated in some significant successes.
Scientists of the Branch Academy of Cell and Gene Engineering under the State Academy of Sciences have collected and classified analytical data on thousands of viruses belonging to various subtypes which have been confirmed and publicized in the world in recent years.
On this basis, they have laid a scientific and technological foundation for an easy and accurate differentiation of subtypes of HA bird flu viruses from 1 to 15.
On the other hand, they have established a scientific and technological method of quickly differentiating NA subtypes from 1 to 9, which are more difficult to differentiate than HA subtypes because of the scarcity of confirmed data and their excessive variability.
Now they are making confirming experiments on a high standard in contact with relevant units.
Regional Reporting and Surveillance
Indonesia: N. Sumatra remains alert against bird flu outbreak
8/12/08 Jakarta Post --The North Sumatra Health Office remains on "extraordinary occurrence" (KLB) alert status following the deaths of three people and the hospitalization of 13 others believed to have contracted bird flu.
Office head Chandra Syafei Monday said his office had imposed KLB status because it had so far not received autopsy reports to determine the causes of deaths from the Health Ministry, including results on blood samples and bodily fluid from the patients from Air Batu district in Asahan regency.
Chandra said he personally learned that the patients' blood tests were negative for bird flu from the ministry's website, but remained wary due to the lack of an official report from the ministry.
"So far there has yet to be any report specifying whether the three victims in Asahan were positively or negatively infected with the bird flu virus. If the results are positive, we will have to monitor the area longer," Syafei told The Jakarta Post in Medan on Monday.
Chandra said a number of health workers were still in Asahan to monitor the situation.
"We are on full alert to monitor developments of a bird flu outbreak in Asahan. A team from the World Health Organization is still there to investigate the case," said Chandra.
He added that health officials were focusing on the three fatalities and the 13 current patients showing symptoms consistent with bird flu.
Chandra said so far those involved in the investigation could not determine the causes of death of the three victims and the 13 currently hospitalized.
"The three people died following the discovery of dead poultry, but we don't know whether or not it was the cause," Chandra added.
Chandra said authorities had disposed of 276 infected birds in Asahan and would continue to slay birds believed to be infected with virus.
Nearby Labuhan Ratu regency has killed 1,126 birds after seeing hundreds suddenly die in the past week.
Labuhan Batu Vice Regent Sudarwanto said the virus had affected the poultry population in six subdistricts of North Rantau: Padang Bulan, Cendana, Lobusona, Sirandorung, Ujung Bandar and Padang Matinggi.
Sudarwanto said his office had taken several measures to prevent the spread of the disease, such as disposing of birds, conducting public awareness campaigns and using rapid testing. It has also set up posts in bird flu-prone areas.
"We have so far carried out various anticipatory measures to curb the virus spread, and we urge people to remain alert," Sudarwanto said.
Quid Novi
Vietnam: New outbreak reported in Southern Ben Tre Province
8/12/08 Xinhua --Specimens from 570 ducks raised by two households in Vietnam's southern Ben Tre province have been recently tested positive to bird flu virus strain H5N1, according to local newspaper Youth on Tuesday.
The bird flu test has been conducted by Vietnam's 6th Regional Animal Health Center, the newspaper quoted the provincial Veterinary Bureau as reporting. The bureau has disinfected and isolated the affected areas in Ben Tre's Ba Tri district.
The Department of Animal Health under the Vietnamese Ministry of Agriculture and Rural Development has yet to confirm the bird flu outbreak in Ben Tre. Now, only central Quang Ngai province andsouthern Dong Thap and Kien Giang provinces are being hit by the disease, the department said.
Bird flu outbreaks in Vietnam, starting in December 2003, have killed and led to the forced culling of dozens of millions of fowls in the country.
Regional Reporting and Surveillance
Cambodia, FAO start series of market forums on bird flu
8/12/08 Xinhua --The Cambodian Ministry of Agriculture, Forestry and Fisheries (MAFF), with the help from the UN Food and Agriculture Organization (FAO), will hold a series of market forums on avian influenza to prevent and control the disease, said a press release on Tuesday.
The first forum will be held in Kampong Thom province on Aug. 13 and another 13 forums will be organized in major live bird markets this year, with funding from the United States Agency for International Development (USAID) and Germany.
In the joint release issued by MAFF and FAO, Kao Phal, director of MAFF's Department of Animal Health and Production (DAHP) said "The forums will help market managers, poultry vendors, butchers and middlemen understand the importance of practicing bio-security measures in order to protect their source of livelihood from the threat of avian influenza."
Prime Minister Hun Sen has asked MAFF to focus on bird flu control and prevention in poultry in order to reduce the risk of human infection, he added.
Meanwhile, Lotfi Allal, FAO chief technical adviser, said that "most live bird markets have poor hygienic practices posing the greatest potential health threat to traders and consumers alike."
A market study commissioned by FAO found that only 40 percent of market sellers interviewed packed and took their poultry waste to the disposal bins.
"Human activity through trade and markets is one way of spreading avian influenza so it is important that poultry traders understand the risk posed by live bird markets and by common practice such as mixing ducks and chickens," said the advisor.
"Ducks are natural reservoir for avian influenza. They can be infectious without looking sick and can spread the disease to other poultry and humans," the advisor added.
At the forum, speakers from MAFF, the Ministry of Health and FAO will explain how bird flu can be transmitted through the live bird markets and what can poultry traders do to prevent and control its spread, said the press release.
To prevent bird flu transmission in the market, poultry traders will be encouraged to adopt measures including "buy and sell only healthy poultry, always keep ducks and chickens separate on the farm, on transport and in the market, keep transport cages, egg boxes and market stalls clean," said the press release.
The fourth of all Cambodia's seven human death cases so far over bird flu was a chicken seller who reportedly collected some dead chickens from the area surrounding her school and was sellingthem. The 20-year-old woman from Banteay Meas District in Kampot province died on April 19, 2005.
Regional Reporting and Surveillance
Bird flu fatality rate drops in Indonesia
8/12/08 Xinhua --The bird flu fatality rate in Indonesia this year dropped from its level last year, the executive chairman of the National Commission of Bird Flu Control and Alertness (FBPI) said here on Tuesday.
"The fatality rate in 2007 was 88.1 percent, and in the first semester of 2008 it was recorded at 84.2 percent," Antara news agency quoted FBPI Chairman Bayu Krisnamurthi as saying.
"The decrease has not made us relax, but at least it is a positive sign," he said.
In 2006, 43 people were confirmed to have been infected with the virus, and 34 of them died. In 2007, 27 people were infected, and 23 died.
During the first half of this year, FBHI had recorded 19 bird flu cases and 16 of the sufferers died. Around 42 percent of the patients had had direct contact with infected poultry.
According official sources, 112 people have died since 2003 when bird flu virus attacked Indonesia.
Regional Reporting and Surveillance
DPRK vigilant on bird flu
8/11/08 Xinhua --The Democratic People's Republic of Korea (DPRK) has remained vigilant toward a possible outbreak of bird flu and has made several scientific achievements in preventing the disease, the official KCNA news agency said Monday.
DPRK scientists have developed some methods for quickly differentiating the subtypes of bird flu, which may be helpful in keeping bird flu from spreading, the KCNA said.
The DPRK has taken measures to prevent avian flu from spreading since April. So far about 200,000 farm birds have been killed since bird flu broke out in March 2005 in the country.
Regional Reporting and Surveillance
Knowledge, attitudes, and practices regarding avian influenza (H5N1), Afghanistan
8/11/08 CDC/EID --From February through April 2007, avian influenza (H5N1) was confirmed in poultry in 4 of 34 Afghan
provinces. A survey conducted in 2 affected and 3 unaffected provinces found that greater knowledge
about reducing exposure was associated with higher socioeconomic status, residence in affected
provinces, and not owning backyard poultry.
Avian influenza (H5N1) has been reported in southern Asia (1). In Afghanistan, avian
cases were confirmed from February through April 2007 in 4 of 34 provinces (1). No human
cases have been detected, although limited human-to-human transmission has been reported from
Pakistan (2). Backyard poultry (chickens) were affected in 20 of 22 outbreak sites in 4 eastern
provinces. No outbreaks have been reported from commercial facilities. The response in
Afghanistan was to cull all poultry within a 3-km radius, restrict poultry movement and
importation, and conduct intensive influenza-like illness surveillance and information, education,
and communication (IEC) campaigns within affected provinces. IEC campaigns included leaflets
distributed in affected areas and broadcast media coverage on local television and radio. The
campaign was designed to inform the public through messages aimed at reducing exposure to
disease, preventing spread in poultry, and encouraging reporting. Additional IEC messages were
aired nationally and outbreaks were widely reported by local news media. We conducted a
survey of knowledge, attitudes, and practices (KAPs) regarding avian influenza in Afghanistan.
The aim was to assess factors associated with KAPs.
The Study
Five provinces in Afghanistan were selected as a convenience sample (accessibility) that
included both affected and unaffected areas. Two accessible districts in each province were
randomly selected by using a random number generator. Random transects were used to select
10 households per village. To give an approximately equal male:female ratio, either the head of
household, spouse (woman), or the oldest person available at the time was selected. Participants
provided informed consent. Ethical approval was provided by the Institutional Review Board,
Ministry of Public Health, Afghanistan.
A standardized, structured questionnaire collected information on demographic and
socioeconomic measures, avian influenza information sources and knowledge of appropriate
preventive measures, poultry and animal handling, food and generic hygiene, and human
influenza knowledge and treatment seeking. Questions related to KAPs were scored by a panel
of experts in related disciplines. The questions were ranked for importance in preventing avian
influenza transmission in poultry or reducing human exposure and awarded 5 points, 3 points, or
1 point for correct answers. For each respondent, the sum of scores for correct answers divided
by the sum of available points generated a percentage score. Blank responses to questions were
counted as such and not included in individual denominators. The questionnaire was backtranslated
and pilot-tested. The survey was conducted in May 2007, by trained Afghan surveyors.
Data were double-entered by using Microsoft Access (Microsoft, Redmond, WA, USA) and
analyzed by using Stata 8 software (Stata Corporation, College Station, TX, USA).
KAP scores provided a weighted measure of KAPs related to prevention of avian
influenza. Percentage scores for each respondent were ranked and classified as above or below
the median. The primary analysis was conducted to compare factors (age, sex, socioeconomic
status, provincial exposure to avian influenza IEC campaigns, and poultry ownership) associated
with knowledge above the median. Socioeconomic quintiles (SEQs) were defined by principle
components analysis using employment, education, and household assets as indicators (3).
Factors independently associated by univariate regression at the 95% confidence level were
included in a stepwise multivariate logistic regression model. To numerically evaluate KAP
levels, a secondary analysis assessed differences between mean percentage scores, stratified by
factors identified by logistic regression analysis.
Data for 304 respondents were included in the analysis. Of the 5 provinces, Kabul and
Nangahar had had influenza outbreaks in poultry in 2007. Enrollment characteristics are shown
in the Table. Median age of respondents (38 years) was high, but it reflected the age of heads of
households and spouses. Poultry ownership was reported by 65.2% of households (>95%
backyard ownership) and differed significantly between SEQs (poorest 53/62 [85.5%] vs. least
poor 20/55 [36.4%]; ?2 30.0, p<0.001).
SEQ was positively associated with KAP score above the median (lowest vs. highest:
adjusted odds ratio [AOR] 14.3, 95% confidence interval [CI] 5.2?39.9), as was provincial
exposure to avian influenza IEC campaigns (AOR 9.5, 95% CI 4.9?18.6). Backyard poultry
ownership (nonowners vs. owners: AOR 0.3, 95% CI 0.2?0.7) and older age group (15?20 years
vs. >40 years: AOR 0.3, 95% CI 0.1?0.8) were both negatively associated.
For secondary analysis, overall mean KAP score was 44.4%. Mean KAP score differed
between SEQ (p<0.001, by analysis of variance) and was higher in provinces previously exposed
to IEC campaigns (50.2% vs. 40.1%; p<0.001, by t test).
Specific, self-reported practices also differed by SEQ. Reporting of sick or dead poultry
to authorities was less frequent among lowest SEQ (8/47 [13%]) than highest SEQ (20/49 [37%];
?2 6.6, p = 0.02) where selling poultry in the event of a local outbreak was more commonly
reported (21/66 [66%] vs. 10/51 [18%]; ?2 27.2, p<0.001). Presence of coops was less frequent in
lowest SEQ (9/49 [18.4%]) than in highest SEQ (21/46 [45.6%]; ?2 8.2, p = 0.004).
Conclusions
Human cases of avian influenza (H5N1) have resulted from contact between humans and
infected backyard poultry (4). Risk to humans is also related to frequency of disease occurrence
in the avian population (5). Recently, human-to-human transmission has been reported in the
neighboring Northwest Frontier Province of Pakistan (2). Knowledge of disease is therefore a
key factor in reducing exposure and enhancing reporting.
Overall knowledge was low, although in provinces exposed to intensive IEC campaigns,
KAP scores of the population were higher. This finding indicated that campaigns had some
success in increasing awareness. The level of concern generated by the campaign, government
response, media reports, and proximity to the outbreak are all likely to contribute to this
association. Despite this encouraging evidence, level of knowledge was far higher among
persons with higher socioeconomic status. This finding contrasts with frequency of poultry
ownership. Exposure risk is therefore likely to be considerably higher among lower
socioeconomic groups.
Our results can be broadly generalized to the population, although we did not have access
to unsafe districts (most of the districts in southern and eastern Afghanistan). This limitation may
introduce selection bias, which would underestimate the effect of socioeconomic status because
those living in inaccessible areas likely have a lower status than persons in accessible areas.
Preintervention and postintervention surveys would provide a more robust measure of
effectiveness. In the immediacy of an outbreak, this was unfeasible and would have been
unethical. Although there are limitations to the study design in concluding intervention
effectiveness, the results provide evidence to support further intensive campaigns as a response
to influenza outbreaks in poultry.
Several reports have examined KAPs and behavior related to avian influenza (H5N1) (6?
9). Similar to the finding in the Lao People?s Democratic Republic (6), our study suggests that
conventional education and behavior change messages have a limited effect in populations with
highest exposure. Efforts to ensure that IEC messages are suitable for lower socioeconomic
groups should be adopted, specifically by improving the knowledge of community leaders,
designing messages in a suitable format for the poor and illiterate, and ensuring that the most
accessible channels are used. Messages should carefully balance the risk for human disease
against potential nutritional and economic consequences of high population concern (e.g., food
scares).
Successfully promoting behavior change is a lengthy process and requires frequent
reinforcement. The acuteness of avian influenza (H5N1) outbreaks requires a concerted effort to
enhance knowledge and change behavior among those most at risk in low-income countries.
Page 5 of 6
Acknowledgments
We thank the participants and surveyors in this study for their cooperation; Katy Todd for advice on data
analysis; Annick Lenglet and Richard Reithinger for comments on the manuscript; Sayara Media Communication
for field management; and the Ministry of Public Health, Afghanistan, for support.
This study was supported by the Animal Population Health Institute and the US Naval Medical Research
Unit 3, Cairo, Egypt, with funding from the Centers for Disease Control and Prevention, Atlanta, Georgia, USA, and
the United Nations Children?s Fund, Kabul, Afghanistan.
Mr Leslie is an infectious disease epidemiologist working as a technical advisor to the Afghan Public
Health Institute in Kabul and a doctoral student at the London School of Hygiene and Tropical Medicine doing
research on malaria in Afghanistan and Pakistan. His research interests include infectious disease epidemiology
(primarily vector-borne and zoonotic disease), outbreak investigation, and socioeconomic factors related to disease.
References
1. World Organisation for Animal Health. Update on avian influenza in animals (type H5) [cited 2008
Apr 15]. Available from http://www.oie.int/downld/AVIAN%20INFLUENZA/A_AI-Asia.htm
2. World Health Organization. Avian influenza ? situation in Pakistan ? update 2. April 3, 2008 [cited
2008 Apr 15]. Available from http://www.who.int/csr/don/2008_04_03/en/index.html
3. Filmer D, Pritchett LH. Estimating wealth effects without expenditure data ? or tears: an application to
educational enrollments in states of India. Demography. 2001;38:115?32. PubMed
4. Dinh PN, Long HT, Tien NT, Hien NT, Mai le TQ, Phong le H, et al. Risk factors for human infection
with avian influenza A H5N1, Vietnam, 2004. Emerg Infect Dis. 2006;12:1841?7. PubMed
5. Mills CE, Robins J, Bergstrom CT, Lipstich M. Pandemic influenza: risk of multiple introductions and
the need to prepare for them. PLoS Med. 2006;3:e135. PubMed DOI:
10.1371/journal.pmed.0030135
6. Barennes H, Martinez-Aussel B, Vongphrachanh P, Strobel M. Avian influenza risk perceptions, Laos.
Emerg Infect Dis. 2007;13:1126?8. PubMed
7. Olsen SJ, Laosiritaworn Y, Pattanasin S, Prapasiri P, Dowell SF. Poultry-handling practices during
avian influenza outbreak, Thailand. Emerg Infect Dis. 2005;11:1601?3. PubMed
8. Abbate R, Di Giuseppe G, Marinelli P, Angelillo IF. Knowledge, attitudes, and practice of avian
influenza, poultry workers, Italy. Emerg Infect Dis. 2006;12:1762?5. PubMed
Page 6 of 6
9. Al-Shehri A-S, Abdel-Fatteh M, Hifnawy T. Knowledge and concern among avian influenza among
secondary school students in Taif, Saudi Arabia. East Mediterr Health J. 2006;12(suppl 2):S178?
88. PubMed
Address for correspondence: Toby Leslie, Research Department, Afghan Public Health Institute, Ministry of Public
Health, Great Massoud Square, Kabul, Afghanistan; email: toby.leslie@lshtm.ac.uk
Table. Enrollment data for avian influenza knowledge, attitudes,
and practices survey, Afghanistan, May 2007
Characteristic Value
No. respondents 304
% Male 46.8
Median age, y (interquartile range) 38 (27?50)
Age range, y, no. (%)*
15?20 30 (10.0)
21?30 85 (28.2)
31?40 64 (21.3)
>40 122 (40.5)
No. (%) in each province
Herat? 32 (10.5)
Kabul? 64 (21.0)
Kandahar 79 (26.0)
Nangahar? 64 (21.0)
Samangan 65 (21.0)
No. (%) with no formal education
Male 36 (26.1)
Female 117 (75.0)
*Age data missing for 3 respondents.
?Only 1 district reported results because of security concerns.
?Provinces exposed to avian influenza and intensive information,
education, and communication campaigns (Kabul, March 2007, and
Nangahar, February 2007).
Science and Technology
Inverness Medical gets USDA approval for flu test
8/11/08 AP --Inverness Medical Innovations Inc. said Monday the U.S. Department of Agriculture issued the medical diagnostics company a license to make and sell its avian flu test kit for veterinary use.
The kit called BinaxNOW, gives test results within 15 minutes, compared with traditional methods which can take days. The company already has a kit for human use approved by the Food and Drug Administration.
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