http://www.irinnews.org/irin-fp.aspxUpdated everydayen-gbMon, 27 Apr 2009 09:54:05 GMTTEL AVIV Monday, April 27, 2009 (IRIN) - The Israeli Health Ministry issued a special notice on 26 April on the country’s preparedness for the possibility of a swine flu outbreak. TEL AVIV Monday, April 27, 2009 (IRIN) - The Israeli Health Ministry issued a special notice on 26 April on the country’s preparedness for the possibility of a swine flu outbreak.

Any patient displaying symptoms of a sudden respiratory condition (high fever of 38 degrees Celsius, and two of the following conditions: coughing, runny nose, sore throat, shortness of breath) and who has visited countries where swine flu is rife in the seven days before the appearance of these symptoms, or was in contact with anyone who might have been infected with swine flu, or who has been in contact with laboratory samples containing A/H1N1 (swine flu virus), will be considered a suspect of swine flu infection, the notice said.

Patients suspected of being infected with the A/H1N1 virus will be treated with the same measures that were taken to prevent avian flu infections. These include special protection for the medical staff (the wearing of gowns, gloves and protective masks) and close monitoring and documentation of the staff and patients. Blood samples will be taken to determine the nature of the patients’ infection, it added.

The Health Ministry says it has stocks of Tamiflu, a drug for avian flu treatment and prevention in adults and children, and which doctors say might prove effective against swine flu.

Israel has a supply of Tamiflu to treat nearly 25 percent of the country’s population of over 7.2 million people, according to a source in the Health Ministry who was involved in the anti-avian flu preparedness campaign in 2005 but who preferred anonymity.

One person in quarantine

On 26 April a 25-year-old Israeli was hospitalised and put in quarantine soon after returning from Mexico with symptoms of light flu. Blood samples were taken to determine whether he had indeed contracted swine flu.

Local media, however, say the patient was not put in quarantine immediately but left outside in the hall where he may have come into contact with many other patients and visitors. Results from the samples should be known later on 27 April, according to hospital sources.

Mada, the Israeli equivalent of the Red Cross, has since instructed that blood donated by anyone who visited Mexico in the past week should be rejected.

People are being advised to take basic precautions, including covering nose and mouth with a tissue when they cough or sneeze. They are also advised to wash their hands with soap and water, especially after coughing or sneezing.

td/ar/cbhttp://www.irinnews.org/report.aspx?ReportId=84119DAKAR Friday, April 10, 2009 (IRIN) - The US Food and Drug Administration (FDA) has approved a test that can detect the deadly H5N1 virus in humans through throat or nose swabs in 40 minutes. Current laboratory analyses that detect the avian flu strain can take up to four hours for confirmation.DAKAR Friday, April 10, 2009 (IRIN) - The US Food and Drug Administration (FDA) has approved a test that can detect the deadly H5N1 virus in humans through throat or nose swabs in 40 minutes. Current laboratory analyses that detect the avian flu strain can take up to four hours for confirmation.

Based on past pandemics the world is now closer to another influenza pandemic than at any time since 1968, when the last of the previous century's three pandemics occurred, according to World Health Organization (WHO).

As of 8 April 15 countries have reported 417 human H5N1 infections and 257 deaths since 2003.

Created by Arbor Vita Corporation with backing from the US Navy, the rapid test has not yet been approved for use outside the USA, nor has its price been set.

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http://www.irinnews.org/report.aspx?ReportId=83894BANGKOK Tuesday, March 31, 2009 (IRIN) - Improvements have been significant in controlling the avian flu virus, but governments need to urgently tackle the factors allowing animal diseases to travel across borders to stop new contagions, according to top officials.BANGKOK Tuesday, March 31, 2009 (IRIN) - Improvements have been significant in controlling the avian flu virus, but governments need to urgently tackle the factors allowing animal diseases to travel across borders to stop new contagions, according to top officials.

Representatives from 32 countries have been meeting since 26 March in Bangkok at the biennial Food and Agriculture Organization (FAO) conference for Asia and the Pacific [see: http://www.fao.org/world/regional/rap/conference_29th_APRC_News_room.asp] to consider issues such as food security.

A key discussion was the growing threat of transboundary animal diseases, which have gained prominence because of emerging zoonotic diseases - which can be transmitted from animals to humans - such as avian influenza.

“Over the past 10 years, disease outbreaks have affected millions of poor households dependent on livestock for livelihood and food security; [their] occurrence is now considered an emergency,” Carolyn Benigno, animal health officer with the FAO’s Regional Office for Asia and the Pacific, told the conference.

“The emergency nature of animal disease control stems from the fact that 75 percent of infectious agents known to be emerging in human populations are deemed zoonotic,” said Benigno.

Environmental factors

Benigno’s presentation was based on an FAO report to the conference outlining the long-term threat to human populations and food security from transboundary animal diseases.

Foot-and-mouth disease, classic swine fever and haemorrhagic septicaemia are among the “priority diseases” in Asia, while avian influenza remains a threat, according to the report.

“Enhanced surveillance, detection and response in several countries where outbreaks decreased or were eliminated have led to improvements but 11 countries are continuing to experience active infections,” it says.

The report goes beyond the apparent causes of animal diseases to look at a complex interplay of environmental factors behind their spread.

A major trend identified is the increasing demand for meat in the region, fuelled by growing incomes, changing consumption patterns and demographic changes, the report says.

This demand is boosting production, and the legal and illegal trade of livestock and livestock products across borders, while increasing the risk of spreading disease.

Call for regional and national action

Delegates echoed the FAO report in urging greater regional collaboration in fighting transboundary animal diseases, with some calling for common policies across countries to tackle the issue.

“There is still a lack of effective control of domestic animal movement, as well as cross-border control in many countries in Asia,” said Thailand’s delegate, Yukol Limleamthong.

“Regulation of animal movement control must be strictly enforced and practical. As for animal movement across countries, animal movement control regulations [on] both sides should be harmonised,” he said.

“It has to be realised that [these] particular [diseases] cannot be eliminated by unilateral effort, particularly in the region where it is happening now,” added India’s delegate, SK Bandyopadhyay.

The FAO report also asks countries to commit financial and human resources to combat disease and to develop national outbreak response plans.

The avian influenza outbreak in Southeast Asia in late 2003 and early 2004 pushed many governments in the region to introduce plans to deal with outbreaks.

However, the same principles have yet to be applied to tackle other disease outbreaks, Benigno told IRIN, adding that the strategies used to contain avian influenza could be applied more broadly.

“When there’s an outbreak, the same principle that you apply for avian influenza can be applied for this disease or an unknown disease,” she said.

The conference, which ends on 31 March, also discussed food prices after they spiked in 2007 and 2008, with fears the global financial crisis would impose a credit squeeze on farmers and countries’ agricultural sectors.

Delegates debated the impact of climate change on food security and agricultural production, and the problem of water scarcity.

ey/mwhttp://www.irinnews.org/report.aspx?ReportId=83714CAIRO Thursday, March 12, 2009 (IRIN) - An 18-month-old child contracted the H5N1 bird flu virus on 10 March, bringing the number of human cases in Egypt to 58 since records began in 2006, and prompting the World Health Organization (WHO) to ask for a study to be undertaken of the causes. CAIRO Thursday, March 12, 2009 (IRIN) - An 18-month-old child contracted the H5N1 bird flu virus on 10 March, bringing the number of human cases in Egypt to 58 since records began in 2006, and prompting the World Health Organization (WHO) to ask for a study to be undertaken of the causes.

The child - from Manoufiya Province in northern Egypt - is one of several recent cases of young children to have contracted the deadly virus in a country where over five million families raise poultry for a living.

Egyptian Health Ministry spokesman Abdel Rahman Shahin told IRIN the girl exhibited symptoms of infection on 6 March after reported contact with infected birds. She was taken to hospital on 9 March and given the antiviral vaccine Tamiflu.

"Her case has stabilised but she will remain at the hospital for further check-ups," Shahin said.

The child’s case is the latest in a rapidly growing number of cases of child infection in Egypt, causing concern among WHO officials.

On 4 March, a two-year-old boy from the coastal city of Alexandria (220km from Cairo) contracted the virus. The boy is being treated with Tamiflu.

Another two-year-old boy from Fayum, 85km southwest of Cairo, was infected by the virus on 1 March, Nasr al-Sayyid, the assistant health minister, said.

According to the Egyptian Ministry of Health, five cases of bird flu have been registered in 2009; 23 people have died from the virus since records began in 2006.

The rapid growth rate of bird flu infections in children is worrying, said John Jabbour, senior epidemiologist with WHO, which is asking the Health Ministry to investigate why so many children aged 2-3 are being infected.

Jabbour speculated that the reason for the increased number of cases in this age group was that families were no longer as alert as immediately after the last awareness campaign.

He warned that families with poultry must be on their guard at all times, given UN Food and Agriculture Organization (FAO) warnings that the H5N1 strain was endemic in poultry.

"This is a problem that will not go away in poultry, hence people who deal with birds cannot afford to relax. Those who come in contact with birds must make caution part of their daily routine," he said.

Changing the mindset

Jabbour said social behaviour and attitudes also played a vital role in tackling bird flu. "We are not just fighting bird flu only; we are also trying to change the mentality which says reporting a case of bird flu infection in poultry will destroy income," he said.

Assistant Health Minister Sayyed said poultry keepers were often reluctant to report suspected cases for fear that health officials would cull not only their birds but those of neighbouring families.

Egypt does not run a compensation scheme for farmers who lose poultry in a cull.

According to the latest WHO statistics, some 410 people in 15 countries and regions have contracted the virus and 256 of them have died of the disease.

While H5N1 rarely infects people, experts fear it could mutate into a form that could easily be passed from one person to another, leading to a pandemic which could kill millions.

ma/ar/cbhttp://www.irinnews.org/report.aspx?ReportId=83419DHAKA Tuesday, March 03, 2009 (IRIN) - The Bangladesh authorities, with assistance from the UN Food and Agriculture Organization (FAO), have employed 300 field volunteers since October 2008 to strengthen surveillance of bird flu in rural areas. DHAKA Tuesday, March 03, 2009 (IRIN) - The Bangladesh authorities, with assistance from the UN Food and Agriculture Organization (FAO), have employed 300 field volunteers since October 2008 to strengthen surveillance of bird flu in rural areas.

Some 20 confirmed cases in birds have been recorded since that time, mostly in rural homesteads or backyard farms - a thriving part of Bangladesh's poultry industry, which employs some four million people.

Between March 2007 and the end of February 2009 some 570 farms - both commercial and backyard - had reported bird flu cases. Of these, around 50 involved backyard farms.

Outbreaks of the virus generally occur after the end of the rains in October and run until early June when the rains return.

“The coming three months are crucial. Then the [June] monsoon rains will ease the situation,” said Mohammad Abu Bakr, a livestock worker at Jibika-CLP (Char Livelihood Programme), [see: http://www.clp-bangladesh.org/] an NGO funded by the UK’s Department for International Development (DFID), which is active on the river islands.

The authorities, however, appear not to be too concerned, describing the situation as better than last year.

"Winter is the peak period for outbreaks of the disease [among birds]. No major outbreak is likely to happen in the coming months,” chief veterinary officer of the Department of Livestock Services (DLS) Muhammad Salehuddin Khan told IRIN in Dhaka.

Scientists concerned

Some scientists, however, are particularly concerned about the risk in backyard farms.

“Backyard farms are in the rural areas where people are poor and ignorant. They also have very poor access to the media. They do not know much about bird flu or preventive practices,” said Habibur Rahman of Bangladesh Agricultural University.

Cases of bird flu in backyards often go unreported, posing a risk not just to birds but also humans, say scientists and government experts.

“The increasing outbreaks in backyard farms are disturbing. Human infections occur mainly from backyard farms,” said Rahman.

Four hundred and eight confirmed cases of bird flu patients worldwide have been reported to the World Health Organization (WHO) since 2003. Of these, at least 254 had died as of 18 February 2009. Most had had close contact with sick birds.

as/ds/cbhttp://www.irinnews.org/report.aspx?ReportId=83265DAKAR Thursday, February 26, 2009 (IRIN) - Scientists at the US Centers for Disease Control and Prevention, Harvard Medical School and the Burnham Institute for Medical Research have engineered antibodies that can fight off multiple influenza strains, including the highly contagious H5N1 avian flu virus. DAKAR Thursday, February 26, 2009 (IRIN) - Scientists at the US Centers for Disease Control and Prevention, Harvard Medical School and the Burnham Institute for Medical Research have engineered antibodies that can fight off multiple influenza strains, including the highly contagious H5N1 avian flu virus. 

Researchers wrote that until now efforts to develop an all-purpose flu vaccine have been thwarted by the ever-mutating flu virus head, which tricks the body into producing antibodies that are only temporarily effective.

But the lab-created antibodies were able to attack in mice the virus’s hidden non-mutating “neck”, which prevented the virus from multiplying. Researchers have said it will be years before they learn if the antibodies will work in infected humans.

The H5N1 virus emerged in humans in Hong Kong in 1997; of the 408 cases confirmed since, 62 percent resulted in death, according to the World Health Organization as of 24 February.

More on avian flu at http://irinnews.org/Theme.aspx?theme=BRF.

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http://www.irinnews.org/report.aspx?ReportId=83158KATHMANDU Tuesday, February 24, 2009 (IRIN) - Bird flu has reappeared in Jhapa District, nearly 500km south-east of the capital, Kathmandu, despite government efforts to control the deadly virus. The Himalayan nation confirmed its first case of the H5NI virus on 16 January. KATHMANDU Tuesday, February 24, 2009 (IRIN) - Bird flu has reappeared in Jhapa District, nearly 500km south-east of the capital, Kathmandu, despite government efforts to control the deadly virus.

The Himalayan nation confirmed its first case of the H5NI virus on 16 January.

Barely a week earlier the government reported that the risk had been contained after culling more than 28,000 chickens and other birds in the area [see: http://www.irinnews.org/Report.aspx?ReportId=82964].

But on 20 February, the Central Veterinary Laboratory in Kathmandu and the World Organisation for Animal Health (OIE) Reference Laboratory [see: http://www.oie.int/eng/OIE/en_about.htm?e1d1], Weybridge, in London confirmed the H5NI strain in six chicken samples collected from a poultry farm in Sharamati Village Development Committee (VDC) in the district. The samples had been sent to the labs after 150 chickens died.

“Our rapid response team [RRT] has been working actively to control the virus,” said senior government official Hari Dahal, a spokesman for the Ministry of Agriculture and Cooperatives (MOAC) [see: http://www.moac.gov.np/home/index.php], which is leading control efforts.

According to the agriculture minister, the rapid response teams have culled more than 1,000 chickens, ducks, pigeons and eggs in the areas around Sharamati.

Places including Pathnapada, Biringkhola, Tangandubba and Mechetole, near the Indian border in the south, have been declared emergency areas.

The government hopes to complete the culling process soon given that there are not many poultry farms with more than 9,000 chickens.

Growing concerns

However, even government officials expressed concern that as a landlocked country, Nepal remained at risk given its geographical proximity to China and India, which have a history of bird flu epidemics.

A week ago, a team of experts from the UN Crisis Management Centre-Animal Health (CMC-AH) [see: http://www.fao.org/emergencies/programmes/CMC-AH] warned of significant risks after visiting affected areas in the eastern region in the first week of February.

They stressed the urgent need for more laboratory equipment and upgrades for effective diagnosis. In addition, there was a crucial need for active surveillance.

Officials told IRIN the government was already planning a three-month-long surveillance campaign in the affected areas. It has also banned the transportation of poultry products countrywide.

The MOAC has issued strict instructions to officials to quarantine border areas, with particular attention to the Nepal-India border, which stretches about 1,800km in the south.

Meanwhile, the west of the country has also been put on high alert, according to officials.

"There is no case of bird flu virus but we have been taking extra precautions to avoid any risks,” said Muni Lal Chaudhary, chief of the western region’s Regional Livestock Quarantine Office.

He explained that active testing of poultry had started on farms in Banke, Bardiya and Dang districts and others, more than 500km west of the capital.

At the same time, government teams have been mobilised to alert local communities about the potential dangers.

According to the World Health Organization (WHO), since 2003 there have been 408 confirmed human cases of avian influenza worldwide, of whom 254 died.

WHO remains concerned that the H5N1 virus might mutate or combine with a highly contagious seasonal influenza virus to spark a pandemic that could kill millions of people.

nn/ds/mwhttp://www.irinnews.org/report.aspx?ReportId=83112KATHMANDU Tuesday, February 17, 2009 (IRIN) - The H5NI virus has been brought under control after a month-long outbreak in poultry in Jhapa district, nearly 500km south-east of the capital, according to government officials. KATHMANDU Tuesday, February 17, 2009 (IRIN) - The H5NI virus has been brought under control after a month-long outbreak in poultry in Jhapa district, nearly 500km south-east of the capital, according to government officials.

The first confirmed case of bird flu
[see: http://www.irinnews.org/Report.aspx?ReportId=82577] reported in this Himalayan nation was confirmed on 16 January in Kakarvitta town, Jhapa.

The government responded swiftly by culling more than 23,000 chickens as well as hundreds of pigeons, ducks and parrots, and destroying over 5,000 eggs and hundreds of sacks of feed, according to the Ministry of Health.

The swift response by a joint team of staff from the Ministry of Agriculture and Cooperatives, the Ministry of Health and Population and the UN World Health Organization (WHO) swiftly contained the epidemic, said government officials.

"We have already banned production, consumption, sale and transportation of poultry products in Jhapa," said Manash Kumar Banarjee, coordinator of the World Bank-supported and government-run Avian Influenza Control Project (AICP).

As an added precaution, the government conducted bird flu assessments in major cities, including Kathmandu, Pokhara, Surkhet, Rupendehi, Biratnagar and Sindhuli, where there are large poultry markets, but found no evidence of the virus after examining more than 100 samples, according to the AICP.

"The bird flu outbreak has been contained for now," said Pravakar Pathak, director of the government-run Department of Livestock Services.

Risks

However, the potential for new outbreaks is great, according to avian influenza specialists.

A team of experts from the UN Crisis Management Centre-Animal Health (CMC-AH) visited the country recently. CMC-AH [ see: www.fao.org/emergencies/programmes/CMC-AH] was established in October2006 by the UN Food and Agriculture Organization (FAO) with the World Organisation for Animal Health (OIE) to enhance FAO's ability to help countries prevent and cope with disease outbreaks.

The CMC-AH team stated after their assessment that while the government's response was efficient and thorough, there were still major risks of outbreaks.

"The response has been robust and with impressive speed but there is still a need for … heightened awareness," said David Hadrill, mission leader of CMC-AH.

Government officials have also said the country remained at risk given that its neighbours, particularly China and India, have a history of bird flu outbreaks. Nepal's huge poultry industry also relies largely on imports from West Bengal and Bihar in India.

Ongoing concerns

Government officials expressed concern over the critical shortage of trained veterinarians, the lack of adequate laboratories for testing and supplies of disinfectants for spraying contaminated areas. There is also a lack of communication equipment to increase public awareness about prevention measures, they said.

The CMC-AH team agreed there was an urgent need for more lab equipment, facility upgrades and consumables to safely and effectively perform diagnostic assessments. It has recommended the Nepalese government consider scenario planning and a financial fund to deal with multiple outbreaks should they occur.

It added that the surveillance was very crucial in the coming months and more resources should be allocated to training. The government is already planning a three-month-long surveillance campaign in the affected areas of east Nepal.

"Fortunately, the bird flu occurred in only one place [Jhapa]. We would be unable to control the outbreak if it had taken place in more than three places [simultaneously]," a government official, who requested anonymity, told IRIN.

nn/bj/mwhttp://www.irinnews.org/report.aspx?ReportId=82964DUBAI Sunday, February 15, 2009 (IRIN) - Egypt has begun implementing its first programme to monitor the movement of migrant birds in the country in a bid to discover if they are able to transmit the highly pathogenic H5N1 bird flu subtype or not, media reports said. DUBAI Sunday, February 15, 2009 (IRIN) - Egypt has begun implementing its first programme to monitor the movement of migrant birds in the country in a bid to discover if they are able to transmit the highly pathogenic H5N1 bird flu subtype or not, media reports said.

The 10-day initiative uses remote sensing techniques and satellite tracking of migrant birds. The government programme - which has been carried out before in China, Nigeria and India - is being undertaken in cooperation with the US Geological Survey, the UN Food and Agriculture Organisation and the US Medical Research Unit.

Meanwhile, Egypt's health ministry said last week that a boy had contracted the deadly H5N1 strain of avian flu. He was the second such case in Egypt within a week, bringing the total number of human infections in the country to 56 since 2006.

dvh/ar/edhttp://www.irinnews.org/report.aspx?ReportId=82933JAKARTA Thursday, February 12, 2009 (IRIN) - Indonesia is making progress in its fight against avian influenza but the danger posed by the H5N1 virus to humans remains high, specialists said. JAKARTA Thursday, February 12, 2009 (IRIN) - Indonesia is making progress in its fight against avian influenza but the danger posed by the H5N1 virus to humans remains high, specialists said.

Last month, the Indonesian Health Ministry announced that two more people had died of the disease, bringing the death toll to 115, the highest in the world. [http://www.who.int/csr/disease/avian_influenza/country/en/] Investigations indicated that both victims visited wet markets before contracting the disease.

On 8 February, a 20-year-old man on the resort island of Bali was hospitalised for suspected bird flu after dozens of chickens in his village tested positive for the virus. Tests were being carried out to determine whether he had contracted bird flu.

However, Bayu Krisnamurthi, executive director of Indonesia's National Committee for Bird Flu Control and Pandemic Preparedness, said there was no evidence the virus had mutated into a form that could make it easier for humans to be infected.

"Bird flu has now become like other infectious diseases spread by animals. The virus is around us, but there's no clinical evidence that it is any more dangerous than before," Krisnamurthi told IRIN.

Progress

James McGrane, team leader of the UN Food and Agriculture Organization's Influenza Control Programme in Indonesia, said the government had made substantial progress in bringing avian influenza under control, but more needed to be done.

"The disease appears to have been contained, with data appearing to indicate that both overall incidence and geographic spread are decreasing, although the disease remains entrenched in some areas," McGrane told IRIN.

"These advances have been made despite the unprecedented challenges presented to avian influenza control given Indonesia's massive and diverse poultry population," he said.

But McGrane said Indonesia needed to work harder to tackle the disease, particularly on Java, where most of the deaths have occurred.

Twelve of Indonesia's 33 provinces have recorded human cases of bird flu while only two provinces have had no avian flu in poultry, the national bird flu committee said.

Chairul Anwar Nidom, a virologist with the Tropical Disease Centre at Airlangga University in Surabaya, said a common policy on bird flu was lacking among government agencies, making controlling the disease more difficult.

"By and large the government has done a good job and people are aware of the danger of bird flu," Nidom said.

But Nidom criticised the government's policy of vaccinating poultry rather than culling, believing that it masks the virus, and ultimately contributes to its mutation.

"There's still no common agreement on this issue among government agencies. The agriculture and farming sector sees the need for vaccinations to save the economy. We are at a crossroads, having to choose between saving poultry and protecting human beings," said Nidom.

Nidom, who first revealed the outbreak of bird flu in Indonesia, said the threat of a pandemic remained high given the unpredictable nature of the H5N1 virus.

"Frankly, we still don't know exactly the virus's pattern of infection and its predispositions. As long as it remains so, it will remain a threat to humans," he said.

Krisnamurthi said despite the progress, there was no room for complacency and the government continued its campaign to warn the public about the danger of bird flu.

Last month, the Indonesian National Committee for Bird Flu Control and Pandemic Preparedness, supported by the UN Children's Fund (UNICEF), launched workshops on pandemic preparedness in 10 cities across the country, he said.

Since last year Indonesia has adopted a policy of only publicly reporting human infections from time to time rather than as they occur.

In addition, the country has been locked in a dispute with the World Health Organization over sharing virus samples for the past two years. Health Minister Siti Fadilah Supari has insisted Indonesia will not share virus samples unless it receives assurances it will be given any vaccine made from the viruses.

atp/bj/mwhttp://www.irinnews.org/report.aspx?ReportId=82896HANOI Wednesday, February 11, 2009 (IRIN) - Vietnam's second human avian influenza case this year has been confirmed by health authorities, who are scrambling to contain the disease that has now spread to poultry in seven central and southern provinces. HANOI Wednesday, February 11, 2009 (IRIN) - Vietnam's second human avian influenza case this year has been confirmed by health authorities, who are scrambling to contain the disease that has now spread to poultry in seven central and southern provinces.

Ly Tai Mui, from northern Quang Ninh Province, is seriously ill with pneumonia, having tested positive for human avian flu. The 23-year-old was hospitalised with fever and breathing difficulties in January after eating a sick chicken.

Nguyen Huy Nga, head of the Preventative Health and Environment Agency, told IRIN the woman had shown "no improvement despite continuous positive treatment".

Nga said no other family members had shown signs of the virus even though they had also eaten infected poultry.

Vaccination efforts have become lax because Vietnam had, until recently, considered itself bird flu-free. Farmers have also delayed reporting outbreaks. In one case a crowd tried to prevent authorities from culling birds that were being transported to the capital and lacked proper health certificates.

"Hundreds of people were trying to grab the chickens," said Nguyen Huy Dang, a senior official with Hanoi's Animal Health Department. "They jumped into the pit where we were burning the [live] birds, even after we told them they had been sprayed with chemicals."

Animal health officials and market workers were unable to stop the crowds, which eventually made off with nearly all 1,500 birds. Police arrested nine people for trying to stop the cull.

"We never expected anything like that to happen," said Dang. "It's never happened before so we didn't have the personnel to prevent it."

Complacency

Vietnam has made impressive gains against avian influenza since the virus first appeared in the county in December 2003 [see: http://www.who.int/csr/disease/avian_influenza/country/en/].

After several dozen people died, the government decided in 2005 to vaccinate all 220 million domestic fowl, according to the UN Food and Agricultural Organization.

Today, however, vaccination efforts are not as rigorous as when the programme was first introduced. Compliance was initially very high as farmers were terrified their flocks would become sick and be culled. But the success of the programme has also bred complacency.

Tran Cong Xuan, head of the Vietnam Poultry Association, said vaccination programmes this year had been patchy. "In some areas officials have not carried out vaccinations properly, and some localities report fake vaccination results as they want to report achievements."

Animal health officials in the southern province of Hau Giang said the recent outbreak of bird flu there was due to several farmers failing to register their ducks so the birds were never vaccinated.

"When we learned there were ducks dying, we came, but there were only 212 ducks left [out of about 400]," said Nguyen Hien Trung, head of the provincial animal health department. The rest of the ducks had died, said Trung. "The owners of the farm said they just threw the dead ducks into the river."

The first human case of bird flu in Vietnam in 2009 was of an eight-year-old girl in northern Thanh Hoa province. She eventually recovered but her older sister, who showed symptoms of the virus, died on 2 January. The girl was never tested for H5N1.

According to the World Health Organization (WHO), the avian influenza virus is transmitted to humans by eating uncooked meat or coming into contact with the faeces of an infected bird. Cases of human-to-human transmission are very rare but health authorities fear the virus could mutate into a form that could spread easily between people, developing into a pandemic strain that could move between countries.

mao/bj/mwhttp://www.irinnews.org/report.aspx?ReportId=82866KATHMANDU Tuesday, January 27, 2009 (IRIN) - The authorities in southeastern Nepal are stepping up anti-bird flu measures after the first case of a bird found to have the deadly H5NI virus was discovered earlier this month. There have been no reports of humans affected. KATHMANDU Tuesday, January 27, 2009 (IRIN) - The authorities in southeastern Nepal are stepping up anti-bird flu measures after the first case of a bird found to have the deadly H5NI virus was discovered earlier this month. There have been no reports of humans affected.

To date 26 out of 75 districts in the densely populated Terai region in the south of the country bordering India have been placed on high alert.

The move follows the virus’s detection in the town of Kakarvitta, Jhapa District, bordering on the Indian state of West Bengal, nearly 450km southeast of Kathmandu, on 16 January.

“We are taking all measures to prevent further infections among birds,” said Manas Kumar Banerjee, coordinator of the Health Ministry’s Avian Influenza Control Project (AICP).

An emergency cabinet meeting on 19 January ordered the culling of all birds within 3km of Kakarvitta. As of 26 January, more than 23,000 had been culled. All poultry meat, eggs and production facilities in the area were to be destroyed.

Ban on Indian products

Nepal has been concerned about a possible outbreak since India reported its first case in 2006: Large amounts of poultry were imported from the Indian states of West Bengal and Bihar, but Nepal has now banned the import of all poultry products from its neighbour.

The Word Health Organization (WHO) described a January 2008 outbreak of bird flu in West Bengal as the worst ever in India.

The decision to ban poultry products would remain in tact unless international institutions certified that an epidemic no longer existed in India, according to Dalaram Pradhan, director-general at the government’s Department of Livestock Services (DLS).

The authorities have also warned Nepalese traders against illegally importing birds, promising firm action against violators.

Police and health officials have started checking vehicles suspected of carrying birds or poultry meat from India, and more than 50 families with coughs or respiratory problems have been investigated.

Kathmandu has sought New Delhi's help in controlling the spread of bird flu, as well as stopping the illegal export of birds.

Preparedness

Since 2006 when bird flu was detected in India, the AICP has been supported by the UN and World Bank, and the latter has provided a grant of more than US$18 million for the AICP over four years.

Although there have been bans by the authorities on the import of Indian poultry and eggs, they were very poorly implemented, said a local public health expert.

In the past the UN has warned that Nepal was vulnerable, given the large number of migrating birds.

According to the WHO, since 2003 there have been 399 confirmed human cases of avian influenza worldwide, of whom 251 died.

WHO remains concerned that the H5N1 virus might mutate or combine with a highly contagious seasonal influenza virus to spark a pandemic that could kill millions of people.

nn/ds/cbhttp://www.irinnews.org/report.aspx?ReportId=82577CAIRO Thursday, December 18, 2008 (IRIN) - Egypt suffered its first bird flu fatality in six months when a girl died on 15 December, bringing the death toll from the disease to 23. Health Ministry spokesman Abdel-Rahman Shahin told IRIN in Cairo the death was the first since April 2008. CAIRO Thursday, December 18, 2008 (IRIN) - Egypt suffered its first bird flu fatality in six months when a girl died on 15 December, bringing the death toll from the disease to 23.

(Read more bird flu reports http://www.irinnews.org/Theme.aspx?theme=BRF)

Health Ministry spokesman Abdel-Rahman Shahin told IRIN in Cairo the death was the first since April 2008.

“This indicates the high level of awareness the Health Ministry and media were able to raise among Egyptians handling poultry,” Shahin said, adding: “Virus activity fluctuates every season and tends to be more active in the winter.”

A government committee set up to combat bird flu echoed Shahin’s comments on the success of the public awareness campaign, saying infection rates among domestic poultry had dropped sharply since the second week of January 2008 thanks to increased vaccination efforts.

Samiyah Salem, 16, from al-Zaraaby village in the southern Egyptian governorate of Asyut died after being admitted to Asyut University Hospital on 13 December with a high fever and breathing problems, hospital officials told IRIN. She contracted the disease after exposure to infected household poultry.

To date 51 people have been infected since the first poultry death attributed to the H5N1 virus in February 2006.

“Early diagnosis is the most important factor and determines whether the person will live or die,” Nasr Qilini, a doctor, told IRIN. “Tamiflu vaccination is available at all hospitals and medical units across Egypt.”

Medical experts from the World Health Organization (WHO) fear the H5N1 virus could mutate or combine with the highly contagious seasonal influenza virus, resulting in human-to-human transmission and a pandemic that could kill millions of people.

Of all the Middle East countries Egypt has been the hardest hit by avian flu, suffering its first human death from the disease in March 2006.

ma/at/cbhttp://www.irinnews.org/report.aspx?ReportId=82003DOUALA Monday, December 15, 2008 (IRIN) - Still saddled with high food prices, most Cameroonians are turning to maize as the most affordable staple. But a local NGO says a combination of increasing demand and high production costs - allegedly complicated by embezzlement – could trigger severe food insecurity.DOUALA Monday, December 15, 2008 (IRIN) - Still saddled with high food prices, most Cameroonians are turning to maize as the most affordable staple. But a local NGO says a combination of increasing demand and high production costs - allegedly complicated by embezzlement – could trigger severe food insecurity.

A local NGO is calling on the government to help boost maize production, warning in a recent report: “Cameroon will see its most grave food crisis ever in 2009” unless the country increases production by 120,000 tonnes. The figure is based on Agriculture Ministry estimations of national food needs, a ministry official confirmed.

The Citizens’ Association for the Defence of Collective Interests (ACIDC) said in its report: “If nothing is done to hike the production of maize, the entire country will suffer further increases in the cost of living, with a strong likelihood of more food riots.”

An Agriculture Ministry official is also worried. “We have been calling this to the government’s attention for many months now,” Sikapin Paul, coordinator of the ministry’s maize programme, told IRIN.

In February some 40 people died in Cameroon in riots triggered in part by the high cost of living.
http://www.irinnews.org/Report.aspx?ReportId=76932

The government subsidises maize production but experts say the support falls far short of needs. Overall the government allocates 2.4 percent of the national budget to agriculture.

The most widely cultivated cereal in Cameroon, maize is consumed regularly by about 12 million people or two-thirds of the population.

The price of maize has doubled over the past year, to about 230 CFA francs (47 US cents) per kilogram.

Given that the prices of most foods have gone up, maize remains among the most affordable staples for families. “I prefer to buy 2kg of maize, which is enough to make a meal for four people, rather than 500 CFA francs ($1) worth of potatoes,” homemaker Damen Nicole told IRIN.

Animal feed

Maize also makes up 70 percent of feed for poultry.

The demand for animal feed shot up this year, after poultry production - which had plummeted because of a bird flu scare in 2006 - resumed in March. ACDIC said the demand for maize for poultry feed shot up 40 percent in less than a year.

Some poultry farmers have had to slaughter some of their animals because they can no longer feed them. “The number of chickens at my farm has gone down 30 percent,” Douala-based poultry farmer Djeukeu Patrice told IRIN. “With the same level of revenue I can no longer afford to feed as many as before.”

ACDIC said maize was the main source of income for more than three million small-scale farmers in Cameroon. But, the group said that with the high cost of fertilisers and pesticides and the lack of modern equipment, farmers’ revenues from maize were meagre.

Corruption?

The fraudulent use of agricultural funds was further squeezing resources for maize producers, the local NGO charged in its report.

The group alleged that of 805 million CFA francs ($1.6 million) in subsidies for maize production, 62 percent had been misappropriated by employees of the Agriculture Ministry.

ACDIC said it investigated a list of recipients and learned that some of the groups on the list did not exist, while others received less than stated in government records. “Certain civil servants in the Agriculture Ministry created fictional [cooperatives] to divert these funds,” said Bernard Njonga, the ACIDC president.

The Agriculture Ministry denies the charge. “These are false and offensive allegations,” Sikapin told IRIN.

On 11 December security forces arrested and detained for several hours Njonga and several other activists who had marched in the capital, Yaoundé, to protest against corruption in the Agriculture Ministry.

rk/np/cbhttp://www.irinnews.org/report.aspx?ReportId=81967CAIRO Tuesday, November 18, 2008 (IRIN) - Egypt, the country hit hardest by avian flu in the Middle East, is working on preventative measures to stop a potential human influenza pandemic. The government, the World Health Organization (WHO), the Food and Agriculture Organization (FAO) and the World Organisation for Animal Health (OIE) have put together a plan to boost rapid containment procedures.CAIRO Tuesday, November 18, 2008 (IRIN) - Egypt, the country hit hardest by avian flu in the Middle East, is working on preventative measures to stop a potential human influenza pandemic.

The government, the UN World Health Organization (WHO), the Food and Agriculture Organization (FAO) and the World Organisation for Animal Health (OIE) have put together a national contingency plan [http://ocha.unog.ch/drptoolkit/HazardInfo&MonitoringTools/Pandemic/39%20Steps%20Governments%20Should%20Take%20To%20Prepare%20for%20Pandemic.doc] to boost rapid containment procedures, and build capacity to cope with a pandemic.

A potential human influenza pandemic could come about if the H5N1 bird flu virus mutates to allow human to human transmission.

Training exercises - involving the simulated conditions of a pandemic - are being organised in all 26 governorates. So far training teams have been formed and assigned to the governorates of al-Beheria, Menia, Gharbiya, Munufiya, and Sharqiya.

Muhammad Fawzi, director of a committee at the Centre for Future Studies - a government research institution with representatives from the ministries of defence, military production, health and population, interior affairs, environment, and foreign affairs - worked with governors to create the plan, based on WHO and Egyptian government recommendations.

“The two main concerns should a pandemic occur would be to keep the functions and services of the state running while containing the spread of the pandemic in the most efficient manner. We came up with a series of probable outcomes in case of a pandemic and from there began envisioning solutions with necessary procedural, executive responses from the state and the governors,” Fawzi told IRIN in Cairo.

Critical decisions

Key officials have been designated who would make critical decisions such as when to utilise defence forces to maintain security and order in affected areas, or checkpoints at borders between governorates, or when to block certain public services to reduce the spread of the pandemic, Fawzi said.

John Jabbour, a consultant for emerging diseases at WHO, told IRIN Egypt’s preparations appeared to be on the right track: “We have seen very good progress from the Ministry of Health and governorates. Their plan encompasses a macro and micro dimension at the national and sub-national level: from the top executive level of the state down to the single role of every village doctor and the response team assisting him,” he said.

Simulation exercises

Desk simulation exercises conducted by the Health Ministry and WHO medical teams in Gharbiya (northwest of Cairo) and Munufiya (south of Gharbiya and north of Cairo) were deemed successful by WHO in testing the tracking methods and reporting procedures of hospitals and police stations in the two governorates. The Munufiya and Gharbiya pandemic plans were recommended as models for other governorates.

Zuhar Hallaj, an acting WHO representative, however, is concerned about the extent to which desk simulations are adequate forms of preparation.

“The experiences of Munufiya and Gharbiya are successful by WHO’s standards.” said Hallaj. “However, these are desk exercises carried [out] over the course of a day. No field simulation exercises have been carried out and we need to ensure that governorates which have had no cases of infection are as prepared as the ones that did report infection.”

WHO has repeatedly advised the Health Ministry to carry out field simulation exercises. Initially, the government’s Information and Decision Support Centre advised against these for fear of causing panic among residents.

“Field exercises are difficult to carry out because there is bound to be a misunderstanding or rumour through the media that an actual pandemic has hit the area where the field exercise is occurring,” said Fawzi. “This would cause a huge dilemma for security and order in Egypt.”

Vaccine

Both WHO and the Health Ministry predict that a vaccination for the human to human virus would be available, but in limited quantities.

“The maximum global level of vaccine production is 900 million vaccines. This is certainly not enough for the whole world should a global pandemic hit,” warns Hallaj.

The humanitarian implications are serious. Since vaccine manufacturers would probably pass on only small amounts to developing countries, countries like Egypt would have to give vaccination priority to a select few, according to the pandemic preparedness plan.

“Key persons whose prospective illness would be costly to the functioning of main services and government institutions will be given vaccination priority. The rest of the population would be treated with Tamiflu which would be used as chemoprophylaxis” (preventative medication as oppose to treatment of infection), said Hallaj.

Business continuity plans have also been put in place: “Any disruption in key services could cause Egypt trillions of dollars in losses. We have to ensure that people can still draw money from banks and ATM machines during a pandemic; that food and medical supplies are available, water and electricity are running,” Amr Qandil, a WHO representative at the Ministry of Health, said.

ma/ar/cbhttp://www.irinnews.org/report.aspx?ReportId=81520SHARM EL SHEIKH Monday, October 27, 2008 (IRIN) - Some success has been achieved in reducing avian influenza outbreaks in poultry and humans, but the world must still be prepared to tackle an influenza pandemic, experts at an international conference in Egypt have said. SHARM EL SHEIKH Monday, October 27, 2008 (IRIN) - Some success has been achieved in reducing avian influenza outbreaks in poultry and humans, but the world must still be prepared to tackle an influenza pandemic, experts at an international conference in Egypt have said.

“Things are a lot better now than they were when we started this work in 2005 but they are not good enough. We are still not sufficiently prepared to properly bring a pandemic under control quickly,” David Nabarro, senior UN system coordinator for avian and human influenza, told IRIN.

Nabarro said it was especially difficult to get government departments other than Health Ministries to work on a pandemic, and greater international cooperation was needed.

“We have seen very good progress in Egypt, Indonesia, Vietnam, and excellent progress in France, UK and Singapore… We want all countries to be ready but probably we need more time and we need to put some pressure on countries to give this priority attention,” he said.

The experts were attending the sixth International Ministerial Conference on Avian and Pandemic Influenza in Sharm El Sheikh.

Plans untested

Although most countries have put in place plans to deal with a possible outbreak of avian flu, these plans have not been properly tested, according to a 21 October report by the UN System Influenza Coordinator (UNSIC) and the World Bank [see http://www.undg.org/docs/9457/Progress-Report-PRINT.pdf].

Of the 148 countries that have developed a national plan at the top executive level of government, only 53 percent have tested their plans in the past 12 months, and only 25 percent have tested their plans at national and local level, the report said.

“What we want to avoid is for countries to believe that just because they have written a plan, they are prepared. This is not true. Putting the plan [in place] is just the beginning of the job… you have to test your plan to make sure that your assumptions are right,” Nabarro said.

Experts said there was a need to continually revise and update the plans.

Poorest countries at risk

Three years ago people started to get excited about preparedness but the momentum has since slowed, Michael Mosselmans, director of the Pandemic Influenza Contingency (PIC) at the Office for the Coordination of Humanitarian Affairs (OCHA), told IRIN.

Mosselmans said middle income and poor countries lagged behind: “Poor countries like Congo, Sudan, Nepal, Mali and Burundi find it difficult to generate resources to make the right preparations because there are so many real problems they are dealing with, like conflicts, droughts and food security issues. They can’t create the incentives and resources to prepare for something that might happen one day, when they’ve got real problems happening now,” he said.

According to him, donors needed to step in to help.

“Middle income countries have managed to prepare for some aspects of the pandemic particularly around health services, veterinary services and communications but not in other aspects like public transportation, utility services and banking,” he said.

Since late 2003, some 385 human cases of avian flu have been recorded; over 245 people have died in 15 countries in Africa, Asia and Europe. In 2008, 36 cases and 28 deaths were registered, most of them in Indonesia.

The UN/World Bank report indicated that there had been fewer outbreaks of avian influenza in poultry in fewer countries, and fewer reported human cases of H5N1 infection than in the preceding two years.

A severe pandemic might claim the lives of over 70 million people, the World Bank estimates.

dvh/ar/cb http://www.irinnews.org/report.aspx?ReportId=81127CAIRO Thursday, October 23, 2008 (IRIN) - The Centre for Migration and Refugee Studies and the International Organization for Migration (IOM) have launched a report on primary health care among Sudanese refugee and migrant communities in Cairo, focusing on avian and pandemic influenza preparedness. CAIRO Thursday, October 23, 2008 (IRIN) - The Centre for Migration and Refugee Studies and the International Organization for Migration (IOM) have launched a report [http://www.iom.int/jahia/Jahia/pbnAF/cache/offonce?entryId=19603] on primary health care among Sudanese refugee and migrant communities in Cairo, focusing on avian and pandemic influenza preparedness.

About 50 cases of avian influenza (bird flu) have been identified in Egypt since 2003; 22 people have died.

The aim of the research was to design recommendations for pandemic preparedness based on a bottom-top approach that engages migrant communities.

“Most health programmes in Cairo target UNHCR [UN Refugee Agency] recognised refugees. Rejected asylum-seekers, non-registered refugees and economic migrants are a particularly vulnerable group,” said Roberto Pitea, research and project assistant with IOM. They tend to live in crowded urban areas where poultry are reared on rooftops, which puts them at risk.

Sudanese migrant and refugee communities were the focus of the study. “The Sudanese community tends to access health services provided by non-governmental actors, whereas pandemic response will be led by government,” he said.

The Integrated National Plan for Avian and Human Influenza and the National Pandemic Preparedness Plan are Egypt’s answer to a possible pandemic. “Neither of these plans have a migrants’ component,” said Rebecca Dibb, one of the main researchers on the report produced by the Centre for Migration and Refugees Studies (CMRS) at the American University in Cairo.

In Cairo, the research team gathered data from Sudanese migrants about access to health care, water and sanitation, and also tested awareness about avian influenza.

Vulnerable

“The findings reveal that Sudanese migrants would be vulnerable in a pandemic, not only because they do not feature in the national pandemic preparedness programme of Egypt, but also because they do not have a sufficient level of awareness of the pandemic, and they are rarely mainstreamed into the work of civil society and international organisations involved in pandemic preparedness work,” said the report, launched on 22 October.

Coordinated efforts are seen as vital to bridging this awareness gap: “National actions must be combined with simultaneous actions in the community, by the media and other relevant sectors. Combined efforts can ensure the Sudanese community is equipped with the awareness required to see behavioral change,” said Yasmine Moataz, another researcher who worked on the report.

Distrust

One challenge is the degree of mistrust between refugee communities and the authorities.

“There is mistrust of information especially from the authorities in Egypt and in the public services. Migrants see that the services provided are discriminatory and that it’s a lower service quality than that provided by NGOs,” said Dibb.

A young Sudanese migrant attending the presentation of the report said: “When refugees here get serious diseases like HIV/AIDS, they get deported. How can I trust the government?”

“Trust should be established between the different parties. If there is networking between the two stakeholders [the government and NGOs], it is going to be better for the migrant and refugee communities,” said Moataz.

The report recommends NGOs advocate migrant-sensitive health policies to increase the level of trust between the Sudanese and health service officials.

Refugees, migrants

According to Africa and Middle East Refugee Assistance (AMERA), an NGO promoting the legal protection of asylum-seekers and refugees, Egypt hosts the fifth largest urban refugee population in the world, mainly concentrated in Cairo and Alexandria.

Official sources say there are 50,000 refugees in Egypt, but NGOs and researchers estimate there are about 500,000, mainly from Sudan, Somalia, Ethiopia and Eritrea. [http://www.irinnews.org/Report.aspx?ReportId=78641]

According to Barbara Harell-Bond, an expert on refugees in Egypt, "estimates for the number of refugees in Egypt vary from 500,000 to 3,000,000; however… it is impossible to give an accurate figure." [http://www.islamonline.net/servlet/Satellite?c=Article_C&cid=1156077765886&pagename=Zone-English-Muslim_Affairs%2FMAELayout]

Some say the Sudanese are the biggest foreign population in Egypt. The World Refugee Survey [http://www.refugees.org/article.aspx?id=2114&subm=179&area=About%20Refugees ] has estimated them at 23,700 in 2008. Many experts say there are far more.

la/at/cbhttp://www.irinnews.org/report.aspx?ReportId=81078BANGKOK Monday, October 13, 2008 (IRIN) - Most Asia-Pacific nations are making progress on avian flu control, but are lagging in plans to tackle the social and economic fallout of a human flu pandemic, a senior UN influenza specialist has warned. BANGKOK Monday, October 13, 2008 (IRIN) - Most Asia-Pacific nations are making progress on avian flu control, but are lagging in plans to tackle the social and economic fallout of a human flu pandemic, a senior UN influenza specialist has warned.

"In general, the situation is that countries are getting much more on top of the bird flu," senior UN System Influenza Coordinator (UNSIC), David Nabarro, told IRIN in Bangkok. "I'm impressed with progress, but I am saying a lot more needs to be done, particularly on multi-sectoral pandemic preparedness."

UNSIC in the Asia-Pacific, collaborating with the Asian Disaster Preparedness Centre and the Kenan Institute Asia, has released its first compilation of simulation exercises conducted by countries to prepare for a human influenza pandemic.

In the book, countries such as Indonesia, Vietnam and China detail and assess their simulations, which range from table-top discussions to full-scale exercises; in one 2006 Australian simulation, 800 participants from domestic government agencies responded to a pandemic originating in a fictional Southeast Asian nation.

The simulations were aimed at testing a range of areas, from cooperation between government agencies to the efficiency of standard procedures and the feasibility of existing pandemic preparedness plans.

Although governments have built experience through simulations, Nabarro writes in the book that many plans worldwide have yet to show how essential services will continue in a pandemic, where there may be high work absenteeism. There is also insufficient preparation for wider social, economic and political consequences.

"The planning for pandemics that has been done by most countries and organisations during the last two years has concentrated on health service planning - making sure that the hospitals are equipped to keep working, making sure that the medical staff have some understanding of what they are expected to do," Nabarro told IRIN.

"Yet … our experience is that a pandemic will do much more than affect the health system, it will affect essential services, it will affect the operation of government and transport and all other aspects of society."

The book, Simulation exercises on influenza pandemic responses in the Asia-Pacific region, will be distributed to governments at the Sixth International Ministerial Conference on Avian and Pandemic Influenza from 24 October this year in Egypt.

It will also be made available to NGOs from next month.

Pandemic fears

Since the re-emergence of the highly pathogenic H5N1 influenza virus in poultry in 2003, 387 cases of human avian flu have been recorded, of whom 245 died, according to September 2008 figures from the World Health Organization.

Health experts fear the H5N1 virus will mutate into a form that can be easily transmitted between humans, leading to a flu pandemic.

Nabarro said the book was aimed at encouraging the testing of pandemic preparedness through simulations - the most effective form of preparation.

While governments have the political will to include pandemic preparedness in their disaster planning, it "sort of comes quite low down the priority list" for busy government officials, who may also need to think beyond a pandemic's immediate health crisis, he said.

"The instinctive impression, for example, in the mind of a senior government figure when pandemic preparedness comes up in discussion is to say, 'Really, that's the ministry of health's job, isn't it?'" he said.

While the book has a few exercise examples that move beyond the health sector to involve countries' finance and tourism sectors, there are "not enough", Nabarro said.

"If a government is preparing for a pandemic, for the continuity during a pandemic, it will only really appreciate some of these broader consequences if it undertakes a simulation," he said.

"If you don't plan for the broader social, economic and political consequences of a pandemic, if you don't do what we call multi-sectoral preparedness planning, then you are missing out on the overall preparation that's necessary."

ey/bj/mw http://www.irinnews.org/report.aspx?ReportId=80878LOME Tuesday, September 30, 2008 (IRIN) - Some 17,000 birds died or have been culled since the outbreak of the H5N1 avian flu virus on 9 September on three poultry farms in Agbata, located 10km east of Lome, according to the country’s livestock director, Komla Batawui.LOME Tuesday, September 30, 2008 (IRIN) - Some 17,000 birds died or have been culled since the outbreak of the H5N1 avian flu virus on 9 September on three poultry farms in Agbata, located 10km east of Lome, according to the country’s livestock director, Komla Batawui.

Zero tolerance

The UN Food and Agricultural Organization adviser to the government, Jacques Conforti, says the risk has been contained. “We focused on free-range poultry, and did not cull poultry in coops in the areas surrounding Agbata. This [the culling] should reduce the risk of the virus spreading to zero.”

Conforti says the disinfection has moved along quickly in the past three weeks, “We do not want to lose any time. We try to disinfect a zone in less than 24 hours before moving to the next at-risk area.” He says officials meet with farmers who point out any sick birds, cull the birds, and pay the farmers for the value of the bird, eggs or bird feed that is destroyed.

Officials have paid close to US$9,000 so far to farmers to compensate them for their losses since the latest outbreak.

Togo’s Minister of Agriculture, Kossi Messan Ewovor, told IRIN this money helps the farmers step forward with their suspicions about sick birds that may carry the deadly H5N1 virus. “This is to assure the poultry farmers they have nothing to lose, and everything to gain in culling sick birds because they help keep their regions and the entire country safe.”

Alphonse Tognizoun, a poultry farmer in Agbata, told IRIN he lost more than 1,000 birds as well as some poultry feed. “I got US$4 per bird and half the value of the food for my birds that was also destroyed, or about 33 US cents per kilo. I didn’t lose eggs, but others who did were paid 6 US cents per egg.”

Following the country’s first outbreak of the virus in August 2007, the World Bank had pushed for farmer payments to encourage quick and accurate reporting, but had also cautioned officials about the difficulty of creating a fair and transparent payment programme to prevent fraudulent poultry claims.

Olga Jonas, the World Bank adviser who coordinates donor avian flu funding, had said payment schemes can be difficult to carry out because it can be hard to prove ownership for small producers in remote areas who live in the bush, far from their chicken coops.

But Togo’s livestock director, Batawui, said there was no room for bird fraud, “If we are not the ones who cull and incinerate the birds ourselves, the farmers must bring us their dead poultry. We register it and give them a receipt with their payment. No cheaters this way.”

Following the last avian flu outbreak, Togolese officials requested international donor assistance; the US$500,000 requested has just now arrived from European Union, African Union, African Development Bank, Economic Community of West African States (ECOWAS) and World Bank. Half of this money will go toward interventions at the farm-level, such as disinfecting farms, culling, and incinerating birds, while the other half is to be spent on training and equipment to help officials respond to and contain the spread.

The World Health Organization estimates the H5N1 virus has killed or led to the destruction of 150 million birds and the deaths of about 200 people worldwide since 2003.

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http://www.irinnews.org/report.aspx?ReportId=80678LOME Thursday, September 18, 2008 (IRIN) - Togo’s government has confirmed the H5N1 bird flu virus is responsible for the 10 September outbreak that killed 3,500 birds and led to the culling of an additional 1,500 others on three farms in Agbata, about 10km east of the capital.LOME Thursday, September 18, 2008 (IRIN) - Togo’s government has confirmed the H5N1 bird flu virus is responsible for the 10 September outbreak that killed 3,500 birds and led to the culling of an additional 1,500 others on three farms in Agbata, about 10km east of the capital.

Since its reappearance in 2003, the highly contagious virus has led to the death of millions of poultry, as well as about 200 people who were infected with the virus by sick birds, according to the World Health Organization (WHO).

Mixed reactions

IRIN traveled a dozen kilometres outside Lome to Agbata to meet with poultry farmers on 17 September, one day after the government announced its lab confirmation.

Antoine Megbeto told IRIN he is not worried because officials have killed any remaining birds that might have been infected. Immediately following the outbreak, the country’s livestock director, Komla Batasse Batawui, told IRIN that officials had culled the surviving birds on all three farms with sick birds.

“We are not scared,” said Megbeto, “We received training starting one year ago [after the country’s first H5N1 outbreak] on how to prevent the virus from spreading. Which is why as soon as I discovered the gruesome and sudden poultry deaths on my farm, I quickly alerted authorities.”

But another farmer who gave his name as Alphonse is less at ease, “I am scared for my family’s health. A team of doctors come around every morning to reassure us everything is well. But my family and I are nevertheless scared to eat poultry, even if they tell us that it is safe as long as it is well-cooked.”

The government has promised compensation to farmers who lost birds; the farmers say no one has told them how much they will receive or by when.

Profits plummet with poultry ban

Shortly after the country’s first H5N1 outbreak in June 2007, the government, like many of its West African neighbours, banned poultry imports from countries with confirmed cases of bird flu.

But despite the ban being in place for about one year, there is still an underground market of illegal poultry imports from countries on Togo’s banned list, according to local consumers.

The first bird flu cases in Togo were discovered on a farm that had received a shipment of birds from Ghana, months before Ghana’s government announced a bird flu outbreak and an export ban in May 2007.

Poultry vendor and importer, Fiacre Lodonou, told IRIN his profits have slowly sunk over the past year because of the more stringent rules that have cut off his cheapest supply of poultry.

“We only started business 15 years ago. Now, because of this [H5N1] virus, my sales have plummeted by more than 70 percent. I cannot even afford to order new birds now.”

The businessman says he fears the flu will not kill only birds, but also his business.

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http://www.irinnews.org/report.aspx?ReportId=80470LOME Thursday, September 11, 2008 (IRIN) - Officials have quarantined Agbata village in southern Togo, and plan to cull all poultry within a three kilometre radius, as they await lab confirmation of which avian flu virus killed 3,000 birds there on 09 September. LOME Thursday, September 11, 2008 (IRIN) - Officials have quarantined Agbata village in southern Togo, and plan to cull all poultry within a three kilometre radius, as they await lab confirmation of which avian flu virus killed 3,000 birds there on 09 September.

Authorities have already slaughtered about 1,500 birds that survived this week's bird flu epidemic in three poultry farms in Agbata, 10 km from the capital, Lome.

Togo’s government is awaiting lab confirmation to learn if it was the H5N1 virus, which was first discovered in Togo in June 2007.

The country’s livestock director, Komla Batasse Batawui, told IRIN officials reacted as quickly as possible and are prepared to do more. “We deplore the fact that these farms lost 80 percent of their poultry. Seven rapid flu tests came back positive and we are waiting lab confirmation. Within the next three weeks, we will slaughter birds within three kilometres of this affected village.”

Batawui said farmers will be compensated for their losses, without specifying how much. The Ministry of Agriculture, Livestock and Fish has launched an appeal for international assistance to fight and prevent the spread of bird flu in Togo.

The West African pandemic advisor for the UN Office for the Coordination of Humanitarian Affairs, Liviu Vedrasco, says while compensation schemes are important, it is critical countries put in place good national pandemic response systems.

Though the virus has been mostly contained to poultry, the World Health Organization has estimated about 200 people worldwide have died from poultry-to-human H5N1 infections in the last five years.

Some experts say the unpredictable H5N1 virus, or still undiscovered viruses, may mutate and potentially spread among humans.

“This most recent outbreak [in Togo] keeps governments alert about the need to have a good human pandemic disaster plan in place [in case of person-to-person H5N1 infections] … It is important governments do not become complacent and think nothing needs to be done. This does not take money [per se], but rather it involves one government ministry talking to another,” said Vedrasco.

Several West African countries have reported similar cases of bird flu in poultry, with only Nigeria reporting one human bird flu death, according to the UN.

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http://www.irinnews.org/report.aspx?ReportId=80309HAI NAM Friday, August 29, 2008 (IRIN) - The key message that needs to be heard is that Avian Influenza (AI) is endemic in Vietnam and needs to be controlled, say UN officials involved in the battle to identify and contain avian influenza outbreaks.HAI NAM Friday, August 29, 2008 (IRIN) - The key message that needs to be heard is that Avian Influenza (AI) is endemic in Vietnam and needs to be controlled, say UN officials involved in the battle to identify and contain avian influenza outbreaks.

According to the Vietnam Partnership for Avian and Human Influenza (PAHI) [http://www.avianinfluenza.org.vn], three provinces have reported new outbreaks in recent weeks. Since the start of 2008, 44 districts in 26 of Vietnam's 64 provinces have reported outbreaks, highlighting the challenge the country faces in controlling the disease.
 
Overall since 2003, Vietnam has had 106 cases of human avian flu and 52 deaths.

Yet compared to 2004 and 2005, when 90 cases of human infection occurred with 39 deaths, [http://www.who.int/csr/disease/avian_influenza/country/cases_table_2008_06_19/en/index.html] Vietnam has made huge strides, according to David Payne, the UN Development Programme avian influenza specialist in Hanoi, "with only five infections since March 2008, all of whom died".

Payne gives the Vietnamese government high marks for recognising early on the severity of the AI problem and turning to the UN and the humanitarian community for advice and support.

"The office of the UN resident representative for Vietnam - with the World Health Organization (WHO), the Food and Agriculture Organization (FAO) and the UN Children’s Fund (UNICEF) taking the lead - has worked closely with the Ministry of Agriculture and Rural Development and other relevant ministries," said Payne, adding that UN agencies have taken a united approach to assisting the government.

The key strategy of the government and UN agencies in confronting avian influenza is the Viet Nam Integrated National Operational Programme for Avian and Human Influenza 2006-2010, known as the "Greenbook". [http://www.avianinfluenza.org.vn/index.php?option=com_content&task=category&id=29&Itemid=59]

It is a US$250 million five-year programme funded initially principally by the Japan International Cooperation Agency (JICA) but now including the World Bank and other donors. It includes improving surveillance abilities, culling and market controls and the goal of vaccinating 30 million poultry twice a year. It is also designed to strengthen overall health capacity, train epidemiologists and establish laboratories.

Awareness raising efforts

An aggressive public awareness programme overseen by the UN Children's Fund (UNICEF) is integral to the strategy.

UNICEF has supported the rental of mobile vans equipped with loudspeakers that travelled around key districts in eight high-risk provinces in the north in March/April 2008, informing residents of ways to safeguard against avian influenza transmission. They have also distributed posters and brochures.

According to Tran Minh Thu, UNICEF's avian influenza communications officer in Hanoi, UNICEF is working with the National Centre of Heath and Education on a variety of awareness raising efforts.

"In May 2007, we provided support for a mass radio and TV awareness campaign and also helped to train provincial and district level health staff on safeguards against AI and human avian influenza and in honing their communication skills," said Thu.

The key messages include hand washing, safe and sanitary slaughter of poultry, thorough cooking of meat, and keeping children away from contact with poultry and their faeces.

Ha Nam Province

In Ha Nam Province, just south of Hanoi, the director of its Centre of Health Education, Pham Quang Mae, told IRIN that since 2003 the province had had five outbreaks of avian influenza with mass culling, and five human deaths.

Mae praised UNICEF's efforts but told IRIN: "We think people have become complacent. They still throw dead chickens into the rivers and the canals… "People are aware of the need to wash their hands but many don't… I believe that things will change, but it will take time."

UNICEF is currently evaluating with the government the next steps in raising community awareness, but Do Thi Dung, vice-director for communications for Ha Nam Province's Centre of Health Education said: "I think the campaign should now involve community health workers at the commune level, not just the provincial and district levels."

In one project, funded by the US Agency for International Development (USAID), UNICEF is helping to do just that.

Tran Thi Cham, chairwoman of the Women's Union in Ha Nam Province, told IRIN, "Since 2007, with the help of UNICEF, we've been training the women's union staff down to the commune level on avian influenza, organising and raising awareness. We do it through poems, singing and plays."
 
The Women's Union in Ha Nam Province has 24 "clubs" - groupings of 60 women - and hopes to expand the number to address the avian influenza problem.

Bui Thi Hang, Ha NaKim Bang District Women's Communication head, said: "Women are the ones who are directly involved in raising poultry so the Women's Union is the most effective means in reaching women with the key messages."

UNICEF acknowledges behaviour change is a long-term challenge. This was demonstrated on a visit to Hoang Thi Tien's duck farm in Que Commune, Kim Bang District.

"I sell the birds and slaughter them at home." Tien told IRIN. She says she vaccinates her chicks, which she buys from a safe hatchery, and even cleanses her motorbike after transporting the chickens and washes her boots with detergent. Nonetheless, her protective gloves are well-worn with tears all over. Worst of all, she lives no more than 100 metres from Le Thi Qanh's farm, and their ducks share a common waterway. Only recently Qanh's flock of 130 ducks were culled because of an AI outbreak. 

"I just don't think I will have an avian flu outbreak here, Tien told IRIN. "It happens to others."

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http://www.irinnews.org/report.aspx?ReportId=80070VIENTIANE Thursday, August 14, 2008 (IRIN) - A new Veterinary Law passed on 25 July is good news in the fight against avian influenza (AI - bird flu), given that Laos is surrounded by neighbours that have suffered severe AI outbreaks. VIENTIANE Thursday, August 14, 2008 (IRIN) - A new Veterinary Law passed on 25 July is good news in the fight against avian influenza (AI - bird flu), given that Laos is surrounded by neighbours that have suffered severe AI outbreaks.

“This is a significant milestone in infectious disease preparedness for this country,” Subhash Morzaria, the AI programme team leader of the UN Food and Agriculture Organization (FAO) in Laos, told IRIN. “It is an indication that the government recognises the significance of animal - and public - health and the importance of ensuring bio-food security,” Morzaria said.

The Veterinary Law 2008 establishes a regulatory framework to strengthen veterinary services, contains provisions for greater transparency in reporting AI and other emerging diseases, and sets out disease control measures, including animal and by-product movements, bio-security and hygiene standards.

Because poultry is one of the cheapest sources of protein, Morzaria explained, failure to protect it could worsen food security and poverty. Strong measures to safeguard the health of animals against infectious diseases such as AI are therefore of the utmost importance, he said.

Last year, two people died in Laos from highly pathogenic avian influenza (HPAI), and another outbreak earlier this year resulted in the culling of 5,000 poultry in six northern villages of Luang Nam Thaa Province, according to the authorities.

However, mountainous Laos, with its low population density and scattered poultry farming, has been spared the severity of AI outbreaks in Vietnam and China, according to Kristina Osbjer, operations officer with the FAO AI Programme. Laos thus has some breathing space to develop disease preparedness strategies, she said, but the country lacks basic infrastructure, and its porous borders make it a likely victim of further AI outbreaks.

FAO working with government on capacity building

“Short- and long-term capacity are major issues in Laos,” explained Osbjer. “We are therefore working with the government to provide capacity building at grassroots level so they can identify the disease and respond faster to nip it in the bud before it becomes entrenched.”

The programme includes training veterinary staff, animal health workers and village veterinary workers in surveillance techniques; improved detection; and systematic recording and reporting of suspected AI cases.

FAO is also leading an active surveillance project on domestic fowl with the Department of Livestock and Fisheries, focusing on the most at-risk sites.
To complement the enhanced surveillance and identification capacities, FAO is expanding the laboratory capacity of the National Animal Health Centre to conduct improved serology and virus isolation on an increased number of samples, said Osbjer.

Awareness raising

Reinforcing all this work is the communications programme led by the UN Children’s Fund (UNICEF) which is ensuring that prevention, recognition and containment information reaches all strata of society.

"Getting out the message about the threat posed by AI has been absolutely central to the whole campaign," said UNICEF head of communications in Laos Simon Ingram. "Thanks to some generous funding that we received from the government of Japan in 2006, UNICEF has supported a massive public information campaign delivering key prevention messages to millions of families, using everything from radio and TV spots to touring puppet troupes and networks of village leaders."

While considerable achievements have been made to prepare Laos for future AI outbreaks, Osbjer said the new Veterinary Law alone would not be enough. “We must stress the need for long-term capacity in the animal and public health sector - not just to deal with avian influenza but all infectious diseases. And for that, the government must educate more staff.”

cw/bj/cb http://www.irinnews.org/report.aspx?ReportId=79817KANO Wednesday, August 13, 2008 (IRIN) - A highly pathogenic strain of avian influenza never previously registered in sub-Saharan Africa has been detected in northern Nigeria but local health officials have downplayed the significance. KANO Wednesday, August 13, 2008 (IRIN) - A highly pathogenic strain of avian influenza never previously registered in sub-Saharan Africa has been detected in northern Nigeria but local health officials have downplayed the significance.

“After a 10-month lull, we have recorded avian influenza outbreaks in two northern states and laboratory analysis showed that the virus belongs to the sub-type related to a different kind [of bird flu] that is found in Europe,” Ibrahim Ahmed, chief epidemiologist in Nigeria’s Federal Department of Livestock, told IRIN.

The new strain of avian influenza was found on two farms in Kano state and its northern neighbour Katsina in July. It was confirmed as avian flu by the World Reference Laboratory in Italy, Ahmed said.

“It is likely the new strain might have been introduced to the country by migratory birds.”

Avian flu was first recorded in Nigeria on a farm in Jaji in northern Kaduna state in February 2006. From there it quickly spread to 25 out of the country’s 36 states, with Kano being the worst hit.

The country has experienced periodic resurgences of the virus, but up until July 2008, the strain was always the same as the initial H5N1 found on the farm in Jaji, Ahmed said.

The latest outbreak was first reported on 16 July on a poultry farm in Fagen-Kawo village where more than half of the village’s 4,249 chickens died and the remaining 1,665 were culled, said Surajo Ibrahim Gaya, Kano Communication Desk Officer on Avian Influenza.

“This is an indication that our surveillance and control strategies are working as we have successfully controlled the earlier introduction and our surveillance network is vigilant enough to detect this newly introduced strain as soon as it came into the country”, Ahmed said.

Blood and sputum samples of a 25 year-old poultry worker DanHussaini Jibrin, who had had contact with sick chickens, were analysed at Asokoro Reference Laboratory in Nigeria’s capital Abuja where he was quarantined for two days after complaining of mild fever.

“We were relieved the result of the analyses on the worker’s blood and sputum showed no bird flu infection,” Gaya said.

Nigeria has so far recorded one human casualty of the avian influenza in February 2006 when a young girl died of avian flu she contracted while cleaning chicken houses in the country’s commercial capital Lagos.

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http://www.irinnews.org/report.aspx?ReportId=79805DAKAR Monday, August 04, 2008 (IRIN) - Niger’s Ministry of Livestock is intensifying its bird surveillance along the 1,500-kilometre border with northern Nigeria after a recent resurgence of bird deaths.DAKAR Monday, August 04, 2008 (IRIN) - Niger’s Ministry of Livestock is intensifying its bird surveillance along the 1,500-kilometre border with northern Nigeria after a recent resurgence of bird deaths.

The Ministry of Livestock in Niger has ordered the killing of more than 20,000 birds suspected of carrying the virus since 2006. It has also paid about US$46,000 in compensation to farmers with sick birds to encourage them to hand over infected animals.

Officials in the northern Nigeria states Kebbi, Kano and Katsina reported several thousand poultry deaths on 29 July. Birds have been sent to laboratories in Italy to determine if the H5N1 avian flu virus is responsible.

Two years ago, a bird flu outbreak in Nigeria spread north to Niger. Niger’s Director of Animal Services, Dr. Maiga Zourkaleni, is preparing a team that will visit high-risk border areas Zinder, Maradi, Dosso and Tahoua. “We are working as hard as we can to prevent another cross-border infection,” he said.

Zourkaleni says his team will reinforce a ban on all poultry products coming from Nigeria. The avian flu director says hundreds of inspectors already work in the high-risk zone along the Nigerian border.

“Our team will continue to raise awareness about the virus’ reappearance in nearby Nigeria. We will make sure inspectors are actively blocking any illegal imports, and that they quickly act on any suspected cases.”

Most West African countries, including Niger, have already banned poultry imports from Nigeria, a policy that the UN Food and Agricultural Organization says is counterproductive.

“To put a ban on anything when you do not have the means to control ports of entry pushes people into clandestine trade,” said Juan Lubroth, the director of infectious diseases at the FAO.

“Clandestine commerce makes things worse because you cannot control and monitor the problem. Bans on poultry are not functional. This is a part of the world where there has been cross border trade for centuries… Managing risks makes more biological sense.”

While more than 140 million birds have died worldwide as a result of H5N1 infections, the virus has not caused a human epidemic, as experts have feared since its resurgence five years ago. According to the World Health Organization, about 200 people have died from contracting the H5N1 virus.

Alex Thiermann with the Paris-based World Organization for Animal Health says it is critical to remain vigilant.

“People become complacent when you predict an emergency and it doesn’t come. However, the risk of a pandemic hasn’t disappeared. The virus has been good to humans thus far; even though it is highly mutative, it does not yet easily infect humans. But we don’t know what will happen. My advice is deal with this problem in poultry, then, we won’t have to deal with it in humans.”

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