In the most rapid and far-flung extension of the area of infection since the most recent strain of avian flu was first detected nine years ago, health authorities in India, Western Europe and parts of Africa reported new outbreaks of the disease and announced emergency measures over the weekend.
The current strain of avian influenza, A(H5N1), first surfaced in Hong Kong in 1997. It took eight years to spread throughout China and South East Asia, but in the last few months the disease, apparently carried by wild migrating birds, has spread throughout Asia, Europe and now Africa.
The most alarming new focus of infection is in India, where two separate outbreaks were reported, and state and federal authorities took sweeping measures to cull flocks and curb the spread of the disease to human beings. A house-to-house search for people suffering from unexplained fevers began in the Nandurbar district of Maharashtra, the huge western state that includes the country’s principal financial center and largest city, Mumbai (Bombay). At least six people were quarantined Monday in hospitals with flu-like symptoms, bringing the total to eight.
Health minister Anbumani Ramadoss said that there were no human cases of avian flu in India, despite press reports that a young poultry farmer had died of the disease over the weekend in Gujarat state, which is adjacent to Maharashtra. The dead man, Ganesh Sonarkar, 27, was a resident of Nandurbar district. A second outbreak was feared in Uttar Pradesh, India’s most populous state, in the Ganges Valley, where 1,400 chickens died at a farm. Tests had not yet confirmed the cause of those deaths.
Home minister Shivraj Patil said that all chickens within a two-mile radius of the Maharashtra outbreak would be slaughtered, while those between two and six miles away would be inoculated. The disease has already killed 50,000 chickens in the state. Hundreds of thousands of chickens were slaughtered in the region around the town of Navapur, the center of the state’s poultry industry, in an effort to forestall spread of the pandemic, with the carcasses dumped into pits dug by earthmovers.
Federal health secretary P.K. Hota confirmed that the government’s resources for fighting a flu outbreak were extremely limited: only 100,000 courses of the antiviral drug tamiflu are on hand, in a country with a population of over one billion.
Neighboring Nepal, Bangladesh and Pakistan all banned imports of live poultry and poultry products from India. Pakistan was threatened from both sides, as avian flu was detected last week in wild swans in Iran, its western neighbor, as well as in India.
The outbreaks in India arouse the greatest public health concern because the combination of dense populations, overstretched medical systems, and extreme poverty in the rural areas, where many poor families share living quarters with poultry and livestock. This maximizes the possibility of a mutation of the avian flu virus—which up to now is transmitted only rarely from bird to human—into a human virus which could be transmitted directly from person to person.
In Western Europe, Germany confirmed its first cases of the lethal strain of bird flu in wildlife, with dozens of swans already dead on the Baltic island of Ruegen. The German military was mobilized to search for dead birds on the island and to try to prevent passage of the disease to the mainland, with 60 soldiers in biohazard suits landing on the island and air force planes deployed on reconnaissance missions along the coastline.
New cases were reported in new countries in Europe on a daily basis, as the disease spread to Denmark, Poland, Austria, Italy, Slovenia, Croatia, Bosnia, Romania, Greece, Bulgaria, Ukraine and the European portions of Russia. In Western Europe the disease has been found only in wild birds, and many countries were taking measures to try to protect their huge flocks of domesticated poultry.
Ministers from the 25 member nations of the European Union met in Brussels Monday to discuss efforts to fight the spreading epidemic, but there is such a wide variation of capacities and concern that a truly coordinated campaign seems doubtful.
Netherlands, Sweden and Denmark ordered millions of chickens, ducks and turkeys kept indoors to keep them away from migrating wild birds. French authorities set up a three-kilometer security zone around the location near Lyon where the first infected bird in that country, a wild duck, was found. French farmers will vaccinate 900,000 birds, although the vaccine offers only generic protection, and is less effective against the new H5N1 strain.
The deaths of wild birds in three regions of southern Italy, Apulia, Calabria and Sicily, touched off a nationwide buying panic, as shoppers refused to buy chicken and other poultry. The Italian television news channel RAI News 24 described the situation as one of “bird flu psychosis.”
In Britain, where no cases have yet been detected in either poultry or wild birds, the Blair government and the media have sought to spread complacency and avoid damage to agricultural business interests. There has been no order, as yet, even for locking up domestic fowl indoors. Reliance on the English Channel and the North Sea to stop the flight of infected birds is worse than useless, however.
One French expert told the news agency Agence France-Presse that cross-contamination between wild birds and domestic fowl was inevitable throughout the continent. “We have absolutely no control over the introduction of the virus by migratory birds that are about to start returning from Africa to Siberia, Scandinavia and Greenland,” Jean Ahars said. “It is unavoidable.”
The disease has already jumped the Mediterranean and crossed the Sahara Desert, with reports of new outbreaks in both North Africa and West Africa. Egyptian officials acknowledged multiple outbreaks Friday, and urged people to stop breeding poultry at home—a major source of protein in the diet of millions of poor people. The Cairo zoo was closed after 83 birds died there, six of them testing positive for H5N1.
Cases of dead birds were reported in Nigeria and health officials in countries from Niger to South Africa were assembling tiny stockpiles of tamiflu in anticipation of the spreading epidemic.
The transformation of avian flu into a worldwide pandemic among fowl is nearly complete—only the Western Hemisphere remains exempt, and there are multiple bird flyways connecting eastern Siberia and northern North America which could serve as a conduit.