ZKEA

Biological Warfare : Biological Terrorism : Emerging Diseases

Archived News
Week ending April 20th, 2007

Indonesia sent a chill through the World Health Organization recently when it refused to supply any more samples of the avian flu virus that has killed scores of its people. The move, which seemed aimed at gaining access to vaccines at an affordable price, threatens the global effort to track the virus and develop vaccines. But Indonesia has raised a valid point that needs to be addressed: if a pandemic should strike, poor countries would be left without protection.

The W.H.O. relies on a global network of laboratories to provide virus samples so experts can determine which are most likely to spread. These strains are then used to develop the seed stocks that are given - at no cost - to manufacturers to use in making vaccines.

In a typical flu season, the key strains emerge from Asia, while the vaccines are sold primarily in the West. This has not caused a ruckus because most developing countries consider influenza one of their lesser health threats. But with rising fears of an avian flu pandemic, the dynamic has changed.

Indonesia decided to act after a foreign company announced work on a vaccine that would be based on its samples. Indonesia stopped cooperating with the W.H.O. and started negotiations to send future samples to another vaccine maker in return for technology that would allow Indonesia to make its own vaccine.

That may be good for Indonesia but could be harmful to global health ..

Indonesian officials fear an outbreak of disease could take hold amid severe flooding in the capital Jakarta, which has already left 29 people dead. "We fear that diarrhoea and dysentery may break out, as well as illnesses spread by rats," one official said.

More than a third of a million people are thought to have fled their homes amid Jakarta's worst floods in years, caused by days of torrential rains.

While floods were said to have receded in some places, more rain is forecast.

The floods have affected much of the city of at least nine million people - with estimates of the flooded area ranging between nearly 40% and 75%.

Apart from those swept away or drowned, a number of people were killed by electrocution, police spokesman Ketut Yoga Ana said.

Officials said the unsanitary conditions could cause an outbreak of disease, with fresh water and electricity services down in many areas. "We know it's hard for the residents [to use and drink clean water] under the circumstances...

The "deadly" H5N1 avian flu is back on the front pages of newspapers and TV news shows. The British environment minister has pledged quick action to "eradicate" the disease from the U.K., and over 150,000 turkeys on one farm have been culled. "This is," someone said on the BBC's "Breakfast" show Monday, "a disease of birds, not humans." And so it is.

The H5N1 virus has still not made the critical interspecies leap which would make it easy for an infected person to give the disease to another person. That may happen, or it may not; and nobody can predict the outcome or its timing with any degree of confidence. Meanwhile, as of the World Health Organization's compilation on Feb. 3, there had been a total of 271 laboratory-confirmed cases of the virus in humans, and of that number a staggering 165, or 61%, died, making it one of the most lethal pathogens in history, even if not one of the most infectious.

Still, just 18 months ago many experts were predicting a global pandemic in a matter of months, perhaps one that would kill millions. There is historical precedent: The 1918-1919 "Spanish Flu" swept around the world in a matter of weeks, and before the disease burned out, more than 50 million people had died. Today H5N1 is reminiscent only of the Asian "Swine flu," which threatened the U.S. in 1976 but never turned into a serious threat to human life (although the media hype surrounding it helped undermine Gerald Ford's presidency). In 2004, worried people rapidly bought up much of the world's supply of Tamiflu and Relenza, the only two drugs that seemed to have a chance of beating H5N1. Now most of us have forgotten the names of these drugs...

Most of the scattered bird flu outbreaks so far this year probably can be traced to illegal or improper trade in poultry, scientists believe. This probably includes recent outbreaks in Nigeria and Egypt as well as the large outbreak on a turkey farm in England.

Last winter, wild migrating birds were deemed the primary culprit in the bird flu infestations that hopscotched across Europe and Africa. Dead swans and ducks were found in many countries, including Austria, France and Italy.

"Many of us at the outset underestimated the role of trade," said Samuel Jutzi, director of Animal Production and Health at the United Nations Food and Agriculture Organization in Rome. "The virus is behaving rather differently than last year ┠it's rather enigmatic."

No outbreaks have been attributed to wild birds so far this season and not a single infected wild bird has been detected in Europe or Africa, despite a heightened surveillance system devised in the wake of the crisis last year.

In most parts of the world, there have been far fewer outbreaks compared with a similar period in 2006. In Europe, there has been only one outbreak in Hungary in January and another this month on a turkey farm in Suffolk, England.

Investigators from the Food and Agriculture Organization and the British government suspect that trade may have set off those outbreaks.

The poultry farm that was the site of the outbreak in Suffolk was owned by a company, Bernard Matthews, that also raises birds in Hungary, said a spokeswoman for the British Department for Environment, Food and Rural Affairs, which is investigating the outbreak.

An outbreak of bird flu on a farm run by Europe's biggest turkey manufacturer Bernard Matthews is the highly pathogenic H5N1 version of the virus which can kill humans, the European Commission said on Saturday.

Government veterinary experts were called to the farm near Lowestoft in eastern England late on Thursday. Preliminary tests showed the birds were killed by the H5 strain of avian flu.

The British government is enforcing EU-agreed controls to contain the outbreak, which means setting up a protection zone with a radius of 3 km (2 miles) and a surveillance zone of 10 km around the infected farm, the Commission said.

It was the second confirmed case of H5N1 in the 27-country European Union this year, following one in Hungary.

Television footage showed hundreds of dead turkeys being tipped into a truck for disposal after the Department for the Environment, Food and Rural Affairs moved to contain the outbreak which has killed 2,500 birds on the farm.

"All poultry farmers are in shock as we had no inkling that is had suddenly turned up in England," National Farmers' Union Poultry Board chairman Charles Bourns told Reuters.

The farm has 160,000 turkeys, but only one of the 22 sheds that house the birds has so far been affected by the outbreak.

Strict movement controls are in place, poultry must be kept indoors, gatherings of poultry and other birds are ..

More than a year after a virulent strain of tuberculosis killed 52 of 53 infected patients in a rural South African hospital, experts here and abroad say the disease has most likely spread to neighboring countries, and some say urgent action is essential to halt its advance.

In Tugela Ferry, 52 patients died of TB, setting off global alarms. Several expressed concern at what they called South Africaâ™s sluggish response to a health emergency that, left unchecked, could prove hugely expensive to contain and could threaten millions across sub-Saharan Africa.

The director of the governmentâ™s tuberculosis programs called those concerns unfounded and said officials were doing everything reasonable to combat the outbreak.

The form of TB, known as XDR for extensively drug-resistant, cannot be effectively treated with most first- and second-line tuberculosis drugs, and some doctors consider it incurable.

Since it was first detected last year in KwaZulu-Natal Province, bordering the Indian Ocean, additional cases have been found at 39 hospitals in South Africa's other eight provinces. In interviews on Friday, several epidemiologists and TB experts said the disease had probably moved into Lesotho, Swaziland and Mozambique â - countries that share borders and migrant work forces with South Africa.

But no one can say with certainty, because none of those countries have the laboratories and clinical experts necessary to diagnose and track the disease. Ominously, none have the money and skills that would be needed to contain it should it begin to spread...