Jun 8, 2007 (CIDRAP News) – Health ministers from Asia-Pacific Economic Cooperation (APEC) nations, wrapping up a 2-day meeting in Sydney today, promised to share H5N1 avian influenza samples.
In other developments, English officials yesterday reported another outbreak of the low pathogenic H7N2 avian flu at a small farm not far from the site of a recent outbreak in Wales. Elsewhere, Malaysian officials announced an H5N1 outbreak near Kuala Lumpur, and Vietnam said recent outbreaks of the virus have spread to 16 provinces.
APEC health ministers discuss H5N1
In a statement released at the end of the 2-day APEC health ministers' conference today, the ministers pledged to continue supporting WHO influenza surveillance with the timely sharing of virus samples. APEC's 21 members include many of the countries that have been hardest hit by avian flu, including Indonesia, China, and Vietnam.
Their statement acknowledges the concerns that Indonesia and other developing countries have about equitable access to pandemic vaccines. "We aim to ensure and promote the transparent, fair, and equitable sharing of benefits arising from the generation of information, diagnostics, medicines, vaccines, and other technologies associated with the sharing of virus samples," the ministers said.
The concerns came to a head this year when Indonesia withheld its H5N1 samples for about 5 months. In mid May, Indonesia said it had resumed sending sample to the WHO. At the World Health Assembly in late May, the WHO adopted a resolution calling for an international H5N1 vaccine stockpile, a system for fairly distributing the vaccines, and a group to draw up "terms of reference" for virus sharing.
Tony Abbott, Australia's health minister and chair of the APEC conference, said he was pleased that Indonesia was part of the latest agreement, according to an Associated Press (AP) report. "We need to see exactly what is happening to this virus, because if we're unable to continually track it, we'll be unable to monitor the possibility of rapid mutation to something that could be effectively transmissible human-to-human," he told the AP and other reporters.
Also at the APEC meeting, a senior WHO official warned that the H5N1 virus is mutating rapidly and unpredictably, the Australian Associated Press (AAP) reported today.
Shigeru Omi, WHO regional director for the Western Pacific, told AAP, "The virus is already entrenched, embedded in this part of the world, and it has been very, very unstable and changeable."
Omi said the virus has evolved from two distinct groups into four subgroups, adding, "And I would not be surprised to if we end up with more subclasses in the years to come," he said.
Though the current mutations have not clearly increased the likelihood of human-to-human transmission, they do show that the virus is "risky", Omi told the AAP. "The longer the virus lasts, the more chance such a mutation will occur. It's simple mathematics," he said.
Countries report more poultry outbreaks
The Department of Environment, Food and Rural Affairs (DEFRA) in Britain announced in a statement yesterday that surveillance testing on a small farm in St. Helens in northwestern England, in the wake of a recent low pathogenic H7N2 avian flu outbreak in Wales, showed that poultry there were infected with the same subtype.
DEFRA said the birds at the farm were purchased at a market in Chelford that was linked to the earlier Welsh outbreak. According to a recent British Health Protection Agency (HPA) statement, the Welsh outbreak was linked to four confirmed human cases—two from Wales and two from England, all mild. The two English patients had purchased poultry from a source associated with the Welsh cases, the HPA statement said.
Fred Landeg, DEFRA's chief veterinary officer, said in the statement that surveillance of farms around the area was extensive, and the St. Helens farm is the only place where poultry have shown evidence of H7N2 infection. Animal-health officials placed a 1-km restriction zone around the farm, are tracing bird movements and contacts, and are making plans to cull the birds. Media reports say the farm has a small number of chickens, ducks, and peacocks.
Meanwhile, veterinary officials in Malaysia confirmed an H5N1 avian flu outbreak 3 days ago near Kuala Lumpur, Agence-France Presse (AFP) reported yesterday. Authorities culled 1,359 birds around the affected village, the AFP report said. The outbreak is Malaysia's first since February 2006, according to reports from the World Animal Health Organization (OIE).
Kamarudin Mohammad Isa, a disease control specialist at Malaysia's department of veterinary services, told AFP the affected birds included chickens and quail and that authorities had not yet determined the source of the virus.
There were no confirmed reports of human H5N1 cases, Health Minister Chua Soi Lek told AFP. However, another AFP report today said five Malaysians from the outbreak village have been hospitalized with influenza symptoms. Malaysia has never had a confirmed human H5N1 case.
In Vietnam, the number of provinces reporting recent H5N1 outbreaks in poultry rose to 16, Reuters reported yesterday. The country's animal health department said 240 ducks died in Phu Tho province in northern Vietnam.
Three Vietnamese patients were hospitalized with suspected avian flu, Xinhua, China's state news agency, reported yesterday. They were admitted to the Tropical Disease Hospital in Hanoi, and their test results were expected in 2 or 3 days, the report said.
After a nearly 19-month hiatus in human H5N1 infections, Vietnam recently reported cases in a slaughterhouse worker and a 30-year-old farmer. Both are said to be recovering, and their cases are awaiting WHO confirmation.
Few Indonesians see avian flu as threat
A survey of Indonesians' attitudes about avian flu revealed that 97% were aware of the virus, but only 15% saw it as a direct threat to them or their families, the Jakarta Post reported yesterday.
"Many people still say 'I know the that the disease is dangerous, but it's other people's problem, not mine,'" said Bayu Krisnamurthi, head of the Indonesian National Commission for Avian Influenza and Pandemic Preparedness, the group that released the data.
Indonesians should learn from the Egyptians, who have a lower human death toll because they seek immediate medical care, he told reporters, according to the Post report.
Commission data show that the human death rate in Indonesia from June 2006 to May 2007 rose to 86.4%, from 74.5% the previous year, the Post reported.
About 57% of Indonesia's avian flu patients had contact with dead or infected poultry, 29% lived near poultry farms where sick or dead poultry were reported, and 1% had contact with poultry feces, the commission said. For 13% of patients the source was not known.
Only two of Indonesia's 33 provinces—North Maluku and Gorontalo—remain free of the disease, the report said.
APEC health ministers' statement