Nigerian poultry farms are again battling the H5N1 bird flu, which is spreading near northern Nigeria’s largest city of Kano. In this ongoing outbreak, which began in December 2006, more than 80,000 birds have been culled from 33 affected farms in and around Kano.
In January 2007, a 22-year old woman died in Lagos, Nigeria, weeks after plucking and disemboweling a chicken believed to be infected with the H5N1 strain. Her death, which was the first reported Nigerian casualty, was partly attributed to an initial clinical misdiagnosis. It wasn’t until after her death that the World Health Organization (WHO) and US Center for Disease Control (CDC) confirmed that the woman in fact died as a result of the H5N1 virus.
Back in February 2006, the state of Kaduna experienced the first reported cases of the H5N1 virus in Nigeria. During that outbreak, the bird flu was first detected on a farm in Jaji, but later spread to other parts of Nigeria. In all, almost 100 farms were affected with over 300,000 birds dying or being culled to prevent further spread. To assist in controlling the spread of the virus, Nigeria banned movement of poultry nationwide and quarantined affected farms. To ease the economic distress and burden on affected farmers, the Nigerian government also offered to compensate bird owners for their loss.
Since the original outbreak in 2006, the virus has continued to spread to 17 of Nigeria’s 36 states. The recent outbreak and rapid spread of the virus indicate a lack of proper surveillance and detection equipment and an unwillingness of farmers to report signs of infection to authorities. Reluctance to report infected birds may be a result of the failure of the Nigerian government to compensate farmers on their poultry losses as promised. It is also believed that there are not enough local experts available with adequate diagnostic tools.
Current Situation
Nigeria is one of three countries identified by health experts as the weakest in the world in its attempt to combat bird flu infections. Millions of Nigerians keep live poultry in their backyards; and in the absence of refrigerators in most households, birds are transported and sold live, to be killed just before being eaten. Nigeria has a poultry population estimated at 140 million, of which, 60 percent are kept by back-yard farmers. Regional conditions of poor hygiene and unregulated movement of livestock increase the risk of spreading the H5N1 virus.
According to the International Federation of Red Cross and Red Crescent Societies (IFRC), the 2006 H5N1 outbreak in Nigeria posed serious threats to all of Africa due to the ease in which infected birds are transited. Fears of spreading bird flu to neighboring countries through the unrestricted trade of infected birds (or their products) are realistic as Nigeria shares boundaries with Cameroon, Chad, Togo, Benin and Niger.
According to Joseph Domenech, chief veterinary officer at the United Nations Food and Agriculture Organization (FAO), Nigeria needs to improve its control systems to prevent a possible pandemic and further spread of bird flu in animals and humans.
Health Care Addresses the Growing Problem
Doctors who have treated H5N1 avian flu patients are meeting March 19-21, 2007 in Antalya, Turkey, to try to find answers as to how the virus infects humans, and how to improve survival chances for those infected with the disease.
“There is [sic] a huge number of unanswered questions about human infections with highly pathogenic H5N1 viruses,” stated Dr. Tim Uyeki, an influenza expert and meeting attending from the US CDC. Doctors are hopeful that by pooling data during the conference, they may be able to discern patterns within the disease, which go undetected when only a few doctors review the isolated cases at each location.
In addition, because the conference is bringing together physicians who have treated H5N1 cases in the 12 countries with registered infections, expectations are high that it will have a positive impact on research collaborations, including planned clinical trials of intravenous forms of two new antiviral drugs.
Another problem being addressed during the conference is the lack of post-death evaluations. Worldwide records indicate only one dozen autopsies have been performed on H5N1 victims due to cultural and religious reason. Dr. Menno de Jong, a virologist at the Tropical Medicine Hospital in Ho Chi Minh City, Vietnam says pleas for more autopsies are made at every scientific meeting on H5N1, but the pleas are unheeded. Dr. de Jong suggests an alternative to performing autopsies would be to encourage hospitals treating H5N1 cases to complete post-mortem biopsies, which use special biopsy needles to take samples of key organs for study. Researchers hope that this small change could help them in the quest for vaccine development.
Hope on the Horizon
Although the H5N1 virus mainly affects birds, the big concern has always been that it could mutate into a disease that easily passes between people, triggering a global pandemic.
Since 2003, H5N1 has spread to more than 50 countries. According to WHO statistics, approximately 279 people have been infected with the H5N1, with 169 dying as a result. Twelve countries have reported deaths, including: Thailand, Vietnam, Cambodia, Azerbaijan, Iraq, Indonesia, Laos, Egypt, Nigeria, Djibouti, Turkey and China. However, figures are likely higher than reported as residents in impoverished rural areas are unlikely to seek medical attention or are unable to afford such luxuries. In Vietnam, forty-two people have died from bird flu since 2003, the second highest fatality level after Indonesia. However, government regulated practices set forth in Vietnam could prove effective elsewhere.
“Vietnam has been very active in education of people about the risks of H5N1 but perhaps more importantly they started vaccination programmes of chickens and ducks,” Dr. de Jong noted.
Similar success stories have also occurred in Indonesia where aggressive public awareness campaigns have proved effective.
“Twenty to 30 years ago we urged people to raise chickens in their backyards but now the paradigm has changed and we have to change the culture and it is not an easy task,” stated Santoso Soeroso, director of the National Infectious Disease Hospital in Jakarta.
Media reporting on March 19, 2007, heralded the impact of a new mobile testing device that could help in detecting bird flu cases. The device, which is being developed with the assistance and backing of the United Nations, costs approximately $1,000, and is the size of a small portable television. The device is ultimately intended to be used as a field based testing center. The portable testing device is user friendly and requires only basic training.
Researchers hope that the use of the machine could save vital time in identifying the source of avian flu outbreaks and increase the chances of containing the spread of disease. The device can be used for monitoring bird flu, foot-and-mouth disease or Rift Valley fever. The portable system could easily be adapted to send results to a main control center to allow for quick response by emergency personnel.
Currently, bird flu testing is completed in laboratories using primarily the ELISA (Enzyme Linked Immunosorbent Assay) technique or the more modern PCR (Polymerase Chain Reaction) technique, neither of which is as fast or efficient as the proposed mobile testing device.
Future Impact
The H5N1 virus will continue to impact Nigeria for the long term. In order to effectively combat further outbreak of the virus, Nigeria needs to be pro-active in its overall efforts. Utilizing international resources in the health care and agriculture industry is essential to combating the spread of the virus. Nigerian governmental oversight and aggressive dissemination of information to provide public awareness regarding the symptoms and methods of contracting the virus are also important in halting the spread of the disease.
