WHO warns on unseen bird-flu cases

SURVEILLANCE: Following the report of China's third confirmed bird-flu death, the health body said that the disease could easily spread via small, undetected outbreaks


Sat, Dec 31, 2005 - Page 5

China's third confirmed bird-flu death highlights the danger of small, undetected H5N1 outbreaks, the WHO said yesterday, as authorities probed how the victim fell ill.

China's health ministry announced on Thursday that a 41-year-old woman from the eastern province of Fujian had died on Dec. 21 after contracting the H5N1 virus about two weeks earlier.

However the woman, a factory worker, lived in an area where no outbreaks had been reported, repeating a pattern seen in China this year.

"We still don't know through which channel this woman was infected. The investigations are continuing," an official with the health ministry's media office said yesterday.

China has confirmed a total of seven human cases of bird flu this year -- all over the past two months -- resulting in three deaths.

Thirty-one outbreaks of the virus among poultry have been reported across large swathes of China this year, but not all the human victims were living in affected areas.

Roy Wadia, the WHO's spokesman in Beijing, said that China's efforts at containing the big, reported outbreaks were impressive.

But he said many people were still in danger from coming into contact with infected poultry via small, undetected outbreaks.

"If it's just a few sporadic birds dying off, people are then exposed and then get sick and die -- it means it's a very difficult thing to stop when it's on a small scale," Wadia said.

"People have to become more aware that the birds that are dying could be infected with H5N1, and reporting has to be done fast. It's a case of awareness and strengthening animal surveillance at the grass-roots level," he said.

Wadia said that China was aware of the challenge and was quickly improving its animal surveillance and health monitoring system.

He said the fact that all seven confirmed cases had been reported recently indicated the government may be succeeding in improving detection methods, and not that the problem was necessarily worsening.

"Our impression is, given the greater awareness in the public health system in general about the bird flu, there are ... more aggressive attempts to identify it at the outset," he said.

With the seventh confirmed human case coming as the year drew to a close, Wadia described this year as a "very significant" year in the fight against bird flu in China.

"Human cases have been identified, surveillance has been strengthened and it's been improving all the time," he said.

But Wadia echoed warnings from other WHO officials and the Chinese government that the bird-flu threat remained high.

"This is not the end of the road. There will be more outbreaks in poultry and possibly more human cases on the Chinese mainland and other countries," he said.

More than 70 people have died from bird flu throughout Asia since late 2003, with nearly 40 of the fatalities occurring this year.

China is seen as a potential flashpoint for a feared global pandemic because it has the world's biggest poultry population combined with often primitive farming conditions where humans and animals live in close proximity.

The virus is currently spread among animals and from animals to humans. The global pandemic would occur if H5N1 becomes easily transferrable between humans. Close contact between people and infected poultry raises that danger.