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January 25, 2005

It Just Keeps Coming: Bird flu fears hit tsunami-wrecked region

Topics: Health Issues

It's begining to sound like a tired old song and I'm weary from sing'n it. But the bird flu is in the news again, and it looks like there is now concern about it moving into the tsunami-devastated region of Aceh. In todays Asia Times Online we find that:

(...)  It stems from the destruction of the infrastructure used to monitor the spread of avian influenza being destroyed by the tsunami in Indonesia's northern Aceh province, the worst-hit area, where over 150,000 people died. What is more, Aceh is within the path of   migratory birds identified last year as being possible carriers of the avian-flu virus.  -End item

In my post on Jan 22 I entitled "Vietnam reports two more bird flu deaths: CDC says an influenza pandemic possible with high rates of illness and death" I wrote about an article in MedicineNet.com where we learned:

(...)  The recent outbreak of bird flu-related human deaths in Vietnam may be a harbinger of a global pandemic that could kill far more people than the recent tsunami, according to the World Health Organization (WHO).    -End item

Now just two days later we have this article in AT- online:

- Asia Times Online
BANGKOK - As South and Southeast Asia struggle to deal with the mounting death toll after the devastating Indian Ocean tsunami, another killer - bird flu - has eared its ugly head in some parts of the region.

(...)  The lethal avian flu has left nine dead in Vietnam since the beginning of the year. The latest victim of the H5N1 virus, who succumbed on January 15, was a 17-year-old boy from Vietnam's southern Bac Lieu province. That raised to 29 the number of people who have died in that Southeast Asian country since the region was hit by the deadly H5N1 strain of the virus at the end of 2003.

(...)  Thailand, where 12 people perished from the virus in the past year, also confirmed the presence of bird flu in two provinces this month - but the virus was only confined to poultry. In the eastern province of Rayong, the country's Livestock Department has identified the virus in 20 fighting cocks. A further 50 chickens were detected with the disease in the central province of Phitsanulok.

(...)  "Of the 15 avian influenza virus subtypes, H5N1 is of particular concern for several reasons," the World Health Organization stated over the weekend. "H5N1 mutates rapidly and has a documented propensity to acquire genes from viruses infecting other animals."

(...)  The United Nations' Geneva-based health agency also warned that "laboratory studies have demonstrated that isolates from this virus have a high pathogenicity and can cause severe disease in humans".

(...)  "There has been a drift in the virus in January 2005 when compared to what it was in January 2004," Juan Lubroth, senior officer at the FAO's animal-health division, told Inter Press Service, referring to the changes that take place in the virus over a period of time. "This is the case throughout the region," he said.
Read more...

Again, as in the above mentioned previous article and quoting from the CDC's own assessment of the situation we hear:

"If these H5N1 viruses gain the ability for efficient and sustained transmission between humans, there is little preexisting natural immunity to H5N1 in the human population, and an influenza pandemic could result, with high rates of illness and death."

This stuff is about as serious as a heart attack, but it spreads, and it spreads, and it spreads. That's the makings of the pandemic WHO is worried about.

Update: Human to Human transmission has already occurred!
"...
the virus has already recombined and is capable of transmitting human to human fatal infections under the appropriate conditions, such as close contact during the care of infected patients."
- Recombinomics Sept 04

Commentary
Probable Human Transmission in Thailand

Recombinomics
September 28, 2004

The "documentation of human-to-human transmission in this situation is better than it has been in previous cases."

The above is the key statement in the report below.  It is unlikely that this is the first H5N1 human to human transmission.  It is just the one with the strongest epidemiological data because the mother was in Bangkok, when the daughter became ill in northern Thailand.  The key epidemiological fact in this case and the cluster in southern Vietnam in late July / early August was the fact that the relative/care-giver developed symptoms 1-2 weeks after the initial case.

The publicly available sequences of chicken isolates from southern Vietnam associated withe the Vietnamese cluster were virtually identical to the isolates from the beginning of this year.

In Vietnam and Thailand in particular, the isolates have polymorphisms not found in other H5N1 isolates.  However, these polymorphisms are found in other mammalian isolates such as H1N2.  Thus the virus has already recombined and is capable of transmitting human to human fatal infections under the appropriate conditions, such as close contact during the care of infected patients.

Media link

Posted by Hyscience at January 25, 2005 8:23 PM



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