New Bird Flu concerns – Guyana must be on alert

(The following is a COMMENTARY written  by former Health Minister Dr Leslie Ramsammy)

The World Health Organization is monitoring new outbreaks of Avian Influenza (bird flu) among poultry populations in several countries. Since November, the WHO has documented bird flu outbreaks in poultry and wild birds in at least 40 countries in Asia and Europe and some human deaths in China. These outbreaks have led to large scale culling (killing) of poultry in several countries.

The WHO is on “high alert”. The world’s premier public health organization is urging countries to closely monitor these outbreaks and to maintain active surveillance, whether countries are near these outbreaks or not. Guyana must be on alert. Both the Ministries of Health and Agriculture must work together in an active surveillance program. It is not too soon to at least think of a dual sector program.

The latest worrying outbreak is presently ongoing in China. The H7N9 avian virus has killed 87 people in China between January 1 and February 12 this year. On February 11, the first acute case of H7N9 avian flu in Beijing appeared, a certain signal of a spreading epidemic in China. The present outbreak with at least 87 deaths so far is worse than the original H7N9 flu outbreak in March 2013. Since the original outbreak in 2013, there have been 1100 human cases, with a 40% mortality rate, a mortality rate far more frightening than the mortality rate of 2% of the flu virus that killed 75M in 1917 and 1918.

H7N9 virus are carried by wild birds and passed on to poultry and then transmitted to humans. About one-third of poultry screened in live animal markets that serve a population of 17M in Guangzhou tested positive for H7N9 this month. Most of the patients in hospitals appear to have contracted the H7N9 virus from direct handling of the birds. But there is also human-to-human infection.

For the first time, human cases of the deadly H7N9 virus have emerged in Sichuan Province in China, Taiwan, Japan, South Korea, Hong Kong and Macau. There are at least five other flu virus presently circulating in China. Several others are spreading in various Asian and European countries. Two types of bird flu, H3N2 and H5N6, have claimed large numbers of chickens and domestic birds in South Korea and the United States this year, and have spread to domestic cats. It is troubling that so many different kinds of avian virus, all with worrying virulent rates, are spreading in different countries simultaneously.

The WHO “high alert” was issued on January 23, 2017. It does not require any specific action to be taken by countries such as Guyana, but it does require vigilance and an active surveillance system among wild birds and poultry. It may also require surveillance of people coming from countries affected. In the USA, the CDC issued a health advisory for people traveling to China and Guyana ought to do the same. I am aware that several Guyanese are travelling to China within the next several weeks.

If the outbreaks worsen, the WHO will next issue a “public health emergency of international concern” advisory. At that time Guyana and other countries must take specific action. If avian flu virus enters Guyana it is likely to do so through wild birds, most likely, or through human cases entering Guyana through our air or shipping ports.

Hopefully, none of these will reach Guyana. I urge the authorities in Guyana and in CARICOM to be vigilant and do not be caught by surprise. When I was Minister of Health and again when I was Minister of Agriculture, I introduced a “backyard surveillance” system, involving citizens across the country. It is never too soon to start.