First Human Bird Flu Reported in Horn of Africa

GENEVA, Switzerland, May 15, 2006 (ENS) - The Ministry of Health in Djibouti has confirmed the country’s first case of human infection with the H5N1 avian influenza virus. The patient is a two year old girl from a small rural village in Arta district. She is the first case of human infection with the bird flu virus reported in the Horn of Africa.

The girl developed symptoms on April 23. She is presently in a stable condition with persistent symptoms.

Three tests conducted on May 10 by the Cairo-based U.S. Naval Medical Research Unit 3 (NAMRU-3) confirmed the child’s infection with the H5N1 virus.

Three of the child’s siblings are under investigation for possible infection and are also receiving care. Samples have been taken and are being sent to NAMRU-3 for testing.

At the request of the Ministry of Health, the World Health Organization (WHO) is arranging urgent support for the country’s investigation and response to the outbreak.

Health authorities in Djibouti began surveillance for human cases following reports of a small number of chicken deaths in early April.

U.S. Navy researcher works in virology at the U.S. Naval Medical Research Unit 3 based in Cairo, Egypt. (Photo courtesy U.S. Navy)

In Djibouti, surveillance for additional human and animal cases is presently under way, but is hindered by the country’s lack of resources and of epidemiological and laboratory capacities.

The search for human cases has been further complicated by a concurrent outbreak of dengue fever, which can mask the occurrence of other febrile illnesses with abrupt onset of symptoms, including H5N1 infection.

The situation in animals is poorly understood. Most of the country’s population is concentrated in the Djibouti district, where many households keep small numbers of poultry. Poultry production in other parts of the country is limited. High mortality in poultry flocks has not been detected to date.

To date, there have been 208 human cases of H5N1 avian flu since the latest outbreak began in December 2003. Of these, 115 people have died.

Most of the human cases, 93, have occurred in Vietnam, which also has the highest number of deaths, 42. But there have been no new human cases in Vietnam this year, and health officials are cautiously optomistic that the epidemic may be coming under control.

Animal health technicians disinfect a farm in Tien Giang province, near Ho Chi Minh City, Vietnam, where carcasses of ducks that died of or were culled because of avian flu have been burned and buried. (Photo courtesy FAO)

Still, overall, the H5N1 virus is still spreading. The total number of nations that have detected H5N1 in either wild or domestic birds now comes to 51. More than half those nations have found their first cases since the beginning of 2006.

The virus emerged in the West African country of Cote d’Ivoire for the first time May 11.

The World Organization for Animal Health (OIE) weekly accounting of animal disease confirmed two outbreaks of highly pathogenic H5N1 avian influenza in Abidjan district, occurring among free-ranging chickens and ducks.

The Cote d’Ivoire Ministry of Animal Production and Fish Resources reported that some control measures are already under way, and further steps are to be taken.

Also on May 11, Sudan reported further outbreaks of disease in birds across a broad stretch of the country, both north and south of Khartoum.

The virus has been confirmed in five other African nations - Burkina Faso, Cameroon, Egypt, Niger and Nigeria.

In late April, a minister from the southern African country of Malawi told a 19 nation bird flu conference that Africa is not ready to fight bird flu.

Still, there have been some successes in the battle against bird flu. It appears that Turkish officials have blocked the spread of H5N1 in that country. Turkish health officials detected no new suspected outbreaks in this weekly reporting period, and 12 previously reported outbreaks in nine provinces have been eradicated.

The OIE and the UN Food and Agriculture Organization have organized an International Scientific Conference on Avian Influenza and Wild Birds for May 30-31 in Rome. Scientists will exchange information the role of wild birds, assess the risk of the introduction of the H5N1 viral strain to areas as yet uninfected, as well as propose mitigation and preventive measures.