Nigerian death highlights West African bird flu risks

By Alistair Thomson

DAKAR (Reuters) - The death of a young Nigerian woman from bird flu has focused attention on the risk of such human infections in West Africa, where social habits and weak health and veterinary services make the region vulnerable, experts say.

The death, confirmed by the World Health Organization over the weekend, comes a year after Nigeria first found the highly pathogenic H5N1 variety of bird flu in poultry.

"Until a human case appeared, I think there was an impression the linkage with human beings was very remote, so this has come close to home and people are now realizing the seriousness," said Simeon Ehui, the World Bank economist in Nigeria who is coordinating the bank's bird flu response there.

"To the credit of Nigeria, because of the workshops and training of the government, there was a quick detection of that human case, because that person could just have died and the illness could have remained (hidden)," Ehui said.

"Maybe other people have died -- nobody knows," he said.

Since highly pathogenic H5N1 bird flu was first detected in Africa, experts have warned that weak human and animal health services there could allow the disease to go undetected -- giving it more chance to mutate into a form that could pass between humans and trigger a pandemic killing millions.

"It doesn't alter the risk, the genetic change of the virus can happen anywhere. I don't think Lagos is any more likely (than elsewhere, but) the longer the virus is in the environment and is present, the greater the risk," said Francois Le Gall, head of the World Bank's Africa bird flu response unit.

So far Nigeria has got off lightly compared to hard-hit Asian countries, or Egypt in North Africa, which reported its 12th bird flu death on Monday.

For many experts, the surprise is not the first death from bird flu in Nigeria, but how long it has been avoided.

"Given the reliance on poultry and close contact between people and domestic poultry in the country, many people could have been exposed to the virus," the European Center for Disease Prevention and Control (ECDC) said in a briefing paper.

This mimics the situation seen in some countries in South East Asia that have reported cases concurrently in poultry and humans. Thus it has almost been surprising that individual human cases have not occurred previously in Nigeria," it said.

Joseph Domenech, chief veterinarian for the U.N. Food and Agriculture Organization (FAO) in Rome, saw cause for hope.

"It's something we were expecting to happen any time.

"Generally speaking, the surveillance in Africa is not as good as it could be ... (but) if there are more outbreaks being declared, it's also because programs are working: there is better transparency, communications and reporting," he said.

Foreign donors meeting in Mali in December pledged nearly $500 million in extra funds to fight bird flu, mostly for Africa. But money alone is not enough.

The World Bank's Ehui said public perceptions toward bird flu were crucial to identifying and eradicating infections fast.

"In the neighboring countries they think of it (human infection) as a distant possibility. In my own country, the Ivory Coast, they have even made a song and dance out of it," he said, referring to a dance that took Ivory Coast's nightclubs by storm last year, imitating a chicken in its death throes.


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