Bird Flu in Africa Could Swamp Health Systems: Who

Last Updated: 2005-10-28 15:18:32 -0400 (Reuters Health) By Stephanie Nebehay

GENEVA (Reuters) - The World Health Organization on Friday warned that if bird flu arrived in Africa the risk of human infection could match that in Asia and "push fragile health systems close to the brink of collapse".

Any arrival of the deadly H5N1 virus on the vast continent would be "of great concern" for human as well as animal health because disease detection among both was weak, the WHO said.

Migratory birds are heading south for Africa from Siberia, where outbreaks among poultry have occurred. The birds are believed to play a role in the transmission of H5N1 to domestic flocks.

In Africa, as in parts of Asia where the virus is now endemic, many households keep backyard flocks, which often mingle freely with wild birds or share play areas with children, according to the United Nations health agency.

"With few exceptions, notably in large commercial farms, surveillance for avian disease is non-existent," it said in its first public risk assessment for Africa.

Bird nutrition is poor and high mortality common, increasing the likelihood that H5N1 outbreaks will be missed, it added.

"In Africa, the risk of human infection from an avian H5N1 virus can be expected to be similar to that seen in Asia."

Since the outbreak first surfaced in Asia in late 2003, 62 people have died in Vietnam, Thailand, Cambodia and Indonesia and the virus has spread to Europe's eastern border.

Experts fear it will mutate into a form that could spread easily among people, triggering a pandemic. Millions of people could die.

ONLY SOUTH AFRICA PREPARED

H5N1 has been found among birds in Croatia, Romania, Turkey and Russia, but no human cases have been found so far in Europe.

"The risk (in Africa) is higher than in Europe in terms of detection and response," WHO spokesman Dick Thompson said.

"South Africa is the only country in sub-Saharan Africa to have drawn up a pandemic preparedness plan," he said.

Poultry production systems in Africa would create "multiple opportunities for human exposure", according to the WHO.

"As in Asia, African households, especially in rural areas, traditionally slaughter and consume birds when signs of illness appear in backyard flocks," it said.

Experience in Asia, where birds and humans often live cheek-to-jowl, showed that the late detection of outbreaks among flocks increased the likelihood that the virus becomes endemic.

And in Africa, early detection of the virus among humans -- when treatment with antiviral drugs is most likely to improve chances of survival -- is unlikely, according to WHO.

"Surveillance systems, with rare exceptions, are not sufficiently sensitive to pick up clusters of human cases -- a critical early warning signal that the virus is improving its transmissibility," it added.